# 4157
With the first day of winter less than a week away in the northern hemisphere, and cooler weather already present in many places, we are beginning to see an upsurge in reports of B2B (bird to bird) H5N1 avian flu around the world.
While hardly earth shattering news (we see this pattern every year), it is an important reminder that there are other flu viruses out there that deserve our attention.
Perhaps lost in the swirl of H1N1 pandemic news:
Vietnam has reported 5 cases of H5N1, all fatal, during 2009.
Indonesia has stopped reporting on cases, although the local press has covered numerous suspected cases over the past 12 months. How many of those were really infected is anybody’s guess.
B2B outbreaks in Indonesia are so common they are rarely mentioned in the the press.
Egypt has reported the most human H5N1 cases this year, with nearly 40 infections. Most have occurred in toddlers during 2009, and for reasons not well established, the mortality rate has dropped to around 10%.
The virus continues to circulate among domesticated birds in that country. Here are a few of the reported outbreaks listed on the SAIDR website for the month of December.
---------------------------------------------------------- Date of result: 10 December 2009
Date of sampling: 9 December 2009
Governorate: Minya
District: Beni Mazar
Village: Nazlet Amro
Type of rearing: Household
Species: Mixed (Chicken, ducks)
Number of birds: 30
Vaccination status: Unvaccinated
Purpose of sampling: PDS
Comment: Source of infection determined to be young grower Peking ducks bought from Beni Mazar live bird market.---------------------------------------------------------- Date of result: 10 December 2009
Date of sampling: 9 December 2009
Governorate: Minya
District: Beni Mazar
Village: Sandafa
Type of rearing: Household
Species: Chicken
Number of birds: 20
Vaccination status: Unvaccinated
Purpose of sampling: PDS
Comment: Source of infection determined to be young grower chickens bought from Sandafa live bird market.---------------------------------------------------------- Date of result: 10 December 2009
Date of sampling: 8 December 2009
Governorate: Sharkiya
District: Zakazig
Village: Kafr Atik
Type of rearing: Household
Species: Mixed (Chicken, ducks)
Number of birds: Not reported
Vaccination status: Unvaccinated
Purpose of sampling: PDS
Comment: Source of infection for the reported case was determied to be dead birds disposed of at garbage collection area. The affected household had poultry flock kept in an open rooftop system close to garbage collection area with possible mechanical spread of infection. *
Source of the index outbreak: Mortalities started at another nearby village (Neshwa) after receiving different poultry species from different sources for a wedding party, the later village had household poultry positive for AI by RFT at the governmental veterinary clinic, the garbage from village Neshwa usually aggregated at Kafr Atik area where the reported outbreak took place.
---------------------------------------------------------- Date of result: 9 December 2009
Date of sampling: 9 December 2009
Governorate: Dakahlia
District: Mit Ghamr
Village: Saharagt el Kobra
Type of rearing: Household
Species: Chickens
Number of birds: 20
Vaccination status: Unvaccinated
Purpose of sampling: PDS
Comments: Source of the samples for confirmed case is dead and sick poultry thrown at the garbage collection area. In accordance with the PDS plan, teams targeted the high-risk areas in the village; among these are the garbage collection areas. The teams found many dead and sick poultry thrown at the garbage collection area.--From interviews with families in the area, it was determined that one family bought ducks from a female street vendor. A day later, the duck developed nervous manifestations and yellowish diarrhea, followed by progressive poultry mortality in the existing poultry flock at the household. The family at the affected household thrown the dead and sick birds at the garbage collection area. The confirmed outbreak was reported in another house close to the garbage collection area, which has a scavenging poultry flock which eats remnants at the garbage site and thus was exposed to the sick and dead birds.
--A cat was found dead at the affected house which had a history of exposure to the infected birds. Samples were taken from the cat today for testing at NLQP.
Vietnam recently reported a human infection/fatality from the H1N1 virus. Here is the WHO situation update, released late last week.
Avian influenza – situation in Viet Nam - update 7
11 December 2009 -- The Ministry of Health has reported a new confirmed case of human infection with the H5N1 avian influenza virus. The case has been confirmed at the National Institute of Hygiene and Epidemiology (NIHE).
The case is a man from Dien Bien Phu city, Dien Bien Province. He developed symptoms on 18 November, was hospitalized at Dien Bien general hospital and died on 28 November 2009.
The source of exposure is currently under investigation. His family keep some chickens and wild geese in their household.
Of the 112 cases confirmed to date in Viet Nam, 57 have been fatal.
And as this report from Xinhua News tells us, B2B outbreaks of the avian flu virus are now starting up again in Vietnam.
Bird flu reappears in N Vietnam
www.chinaview.cn 2009-12-15 13:36:32
HANOI, Dec. 15 (Xinhua) -- Bird flu reappeared in Vietnam's northern province of Thai Nguyen, killing 405 poultry, the Animal Health Department under the Ministry of Agriculture and Rural Development said on its website on Tuesday.
The disease broke out in two communes of Thai Nguyen province from Dec. 9 to 11, according to the department.
To prevent the spread of bird flu, local authorities have taken prevention measures including the destruction of 4,100 ducks, 102 chickens and 17,750 poultry eggs in the affected communes.
Currently, Vietnam has two provinces affected by the H5N1 flu, namely the southern province of Ca Mau and the newly-reported Thai Nguyen province, said the department.
We remain at pre-pandemic level III on the H5N1 virus, and while human infections are rare, the possibility exists that the virus could mutate in such a way as to make it more transmissible among humans.
That hasn’t happened in the dozen years since the H5N1 virus first jumped to humans in Hong Kong. Maybe it never happens. There may be some biological barrier that we don’t understand that will prevent it.
But it is worth noting that the novel H1N1 virus bounced around in pigs for many years before it acquired the changes it needed to adapt to humans.
Nature moves at its own pace.
