Korea: Confirmation Of 5th Positive MERS Case

Coronavirus – Credit CDC PHIL

 

# 10,097

 

One of the two health care workers mentioned earlier today (see MERS: South Korea Isolates Two HCWs – Tests Are Pending) – a physician - has apparently tested positive for the virus, bringing to five the number of cases now confirmed in South Korea.

 

It appears the test results for the second HCW have come back negative.

This from the Korean Herald.

First Homers doctors who treat patients with confirmed infection of five

[Herald] Middle East Respiratory Syndrome (MERS · Homers) infected patients has increased to five. Department of Health and Human Services Centers for Disease Control and Prevention is the Middle East Respiratory Syndrome (Homers) 1 infected patients were announced 27 days been further confirmed. Additional patients Homers the first domestic infection treatment seed doctor E, the first domestic infection of medical staff Homers case is. This domestic Homers patients both increased to five. The classified as suspected cases with Mr. E nurse one out genetic testing results voice turned out to be not infected Homers received a decision.

Although machine translations of Korean text are somewhat syntax-challenged, below you’ll find the official press release.

 

Middle respiratory syndrome ( Merck's ) 5 second patient identification

- First Homers patient care physicians , genetic test results tested positive -

□ Centers for Disease Control and Prevention ( Director : Yang byeongguk ) is 5.26 at 61 Homers total of close contacts people 4 people get the samples received so far two people were confirmed a genetic test results , a double one person said to have been confirmed positive Homers gene .

* 5.26 at 15 during the press briefing after the two is added to the total cases received four test cases in progress

○ The first patient is a patient Homers 5.17 at C treatment in the clinic as a doctor who , 5.26 days under quarantine treatment by the National Inpatient hospital beds .

※ 5.26 days received genetic test results for samples

* A clinic : The first patient 5.12, 5.14 ~ 15 days to visit hospitals
* C clinic : patients first 5.17 days visiting hospitals
* D hospital : Patients First 5.17 ~ 20 days to visit hospitals
* E Hospital : Patient third 5.16 - 20 days Visit institution
□ On the other hand , close contact with the test results confirmed the voice ( Tester 2) whether the symptoms are observed, and is expected to continue the isolation ,
○ Current tests are in progress 2 test results had 5.27 am said that it is possible Checking .

MERS: South Korea Isolates Two HCWs – Tests Are Pending

 

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Although Korea’s current case count stands at 4 (1 imported index case, 3 secondary cases), media reports – backed up by a Korean CDC statement – indicate that at least two others (both HCWs) have been moved into isolation and are being tested for the virus.   

It also appears that the Korean CDC is lowering the threshold of `suspicion’ when it comes to contacts of known cases, moving the fever criteria down from 38 degrees (100.4 F), to 37.5 degrees (99.5).

First, a highly critical report in the Korean Herald which discusses delays in quarantining and testing confirmed case #4, and mentions the two new suspected cases, followed by excerpts from the Korean CDC statement.

 

Health Ministry under fire for MERS

Updated : 2015-05-26 21:36

As Seoul on Monday confirmed its fourth MERS case ― the daughter of the third confirmed patient, who asked to be quarantined but was rejected by the authorities ― the Health Ministry is under fire for the poor handling of the potential patients.

Fear of the Middle East Respiratory Syndrome in korea further spread on Tuesday as two medical staff members who had been in contact with the patients showed symptoms of fever. The two have were transported to a hospital to test for infection, the Korea Centers for Disease Control and Prevention said.

The fourth confirmed patient, in her 40s, spent about five hours with her 76-year-old father, who was sharing the hospital room with the first two confirmed of MERS patients earlier this month.

(Continue . . . )

 

Machine translation of Korean leaves a bit to be desired, and so the results are often mind-numbingly-syntax-challenged.  Still, we can get the gist from the following release (bolded & reformatted for readability).

 

Middle East Respiratory Syndrome (Homers) corresponding status and measures

-Diagnosis patients 4 persons during treatment. It is possible to close contacts of the patients added one, community radio is a possibility low –

-Measures for strengthening non-proliferation in the Mer-

You can select a non-insulated House ever-self-

-Suspected patients of fever over 38 degrees downward adjustment based on the judge: → 37.5 degrees-

□ Disease control headquarters (General Manager: Yang Byung Kook) 5.20 days since until the present Middle East respiratory syndrome (MER) has identified four people as patients, that patients and measures between the brief description elapsed.

○ The first diagnosis the patient is in the Middle East has been infected with the afore-mentioned (4.18-5.3) 5.4, 5.11, fever symptoms occur after patients enter, depending on the diagnostic report 5.19, medical institutions tested, 5.20, MER, after diagnosis as a nationally designated inpatient care on a respirator and undergoing treatment.

* Visit a medical institution: A Senator (5.12, 14, 15), B hospital (5.15-17), C (May 17), D Hospital (May 17-20),

National research hospital treatment Hospital (5.20)

-This patient A ‧ ‧ B C medical care did not say the Middle East at the time of travel powers, D hospital: Bahrain travel power only after diagnosis, know designated inpatient care at the bedside through the mouth's raw epidemiological investigation Saudi Arabia and the UAE, said the fact that travel well

○ Since up until now has been confirmed in three additional expansion pendulum, these are among the hospitalized patient B above in the same room and had to stay in the same room (Mrs.), guardian of the inmate and his guardian (daughter), and is currently hospitalized in stable condition, all State-designated bottle is being treated on a

Close contacts of the patient, on the other hand, pray for us now + 61 2 additional hit daily fever party (first patient care medical staff) have been found to be transferred to the designated inpatient care beds at present, these are the genetic tests will confirm whether the infected in the MERS

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Korean Media Reports 4th MERS Case (Updated)

 

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My thanks to Crof for posting a Yonhap news report (South Korea confirms fourth MERS case) which describes the third transmission of the MERS coronavirus virus (all from the index imported case) in South Korea.  This time, the victim is the daughter of the index patient’s hospital roommate (case #3), who visited the room for several hours before the index case was diagnosed and placed in isolation.

 

As it is 4am in Seoul Korea at this writing, it isn’t terribly surprising that the Korean CDC website hasn’t been updated yet. 

(UPDATED 0650 EST)  The Korean CDC has posted the following (translated) statement:

Date : 2015-05-26 Modified : 2015-05-26 Department : Public Health Crisis Response and 

Middle respiratory syndrome (Merck's) fourth patient identification

3rd Homers patient's daughter (caregiver), tested positive genetic test result - □ Centers for Disease Control (General Manager: Ms. byeongguk) has donated 24 May 25 Middle East during breathing hungun fourth nationally confirmed cases occur in isolation wards He said it is admitted to. The fourth patient was diagnosed 3rd Middle East Respiratory Syndrome (Homers) the patient's daughter (caregiver) while trying to self-observation are classified as isolated target, 5.25 days 11:30 heat through the health centers visited research (38.2) the genetic tests were carried out after the transfer is confirmed by a state-designated isolation wards, it is confirmed positive test results revealed that it has determined to be the fourth confirmed cases. ○ infection of the patient and his father (third Homers patients) B together in the hospital for about four hours and the first confirmed cases has been estimated to be infected with the Father and the while staying in the same room at the same time. ○ patients into inpatient treatment in the current state-designated isolation wards, 5.25 days 24 hour heating according to current medical , no specific details other headache isolated under observation without treatment steady state yeoseo. □ Meanwhile, the Centers for Disease Control is because it was one of the patients is 5.20 days (the first diagnosed patient days) are classified as closely contacts from family and living off alone, this Due to the additional diagnosis and isolation contactor person said did not occur.

 

Since Crof posted the first account an hour ago,  Yonhap news has updated and fleshed out the story a bit more:

 

S. Korea confirms 4th MERS case

2015/05/26 02:18

SEOUL, May 26 (Yonhap) -- South Korea confirmed a fourth case of the Middle East Respiratory Syndrome (MERS) on Tuesday, saying a daughter of the third patient was found to have been infected with the viral virus.

The new patient is believed to have contracted the virus from the first patient, just as her father did. She stayed for four hours at a hospital room her 76-year-old father shared with the first patient, according to the Korea Centers for Disease Control and Prevention (CDC).

After her father was diagnosed with the disease, she was placed in isolation at her home. As her fever rose to over 38 degrees Celsius earlier Tuesday, she was sent to a state-designated hospital and then tested positive for the virus, officials said.

She is currently in a stable condition, they said.

The first patient, a 68-year-old man, was diagnosed with the disease after he had travelled to the Middle East in mid-April and returned home on May 4. All three other confirmed cases were transmitted from him, including his wife, according to CDC.

(Continue . . . .)

 

While we await an official statement, most of the major media organizations in South Korea are reporting this latest development, including the AP, the Chosen Ilbo, and Democra Asia. Recent twitter traffic includes:

 

Outbreaks Of H5N8 & FMD Continue To Plague South Korea

 

Credit Japan’s MAFF

 

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With the Lunar New Year (Seollal in Korea) looming, authorities in South Korea are scrambling to try to contain recent outbreaks of avian (H5N8) influenza in poultry and FMD (Foot & Mouth Disease) in pigs.  

 

In recent days H5N8 was even found in the droppings of birds in the nation’s capital, Seoul. The first detection of HPAI in that city in a decade (see Korea Times Bird flu virus spreads to Seoul).

 

First this report from Korea JoongAng Daily, after which I’ll have a bit more.

 

Foot-and-mouth disease, avian flu strain authorities

Officials struggle to control viruses ahead of the Lunar New Year

Feb 11,2015

Quarantine authorities are scrambling to prevent the further spread of foot-and-mouth disease (FMD) and avian influenza (AI) a week before the Lunar New Year, one of the country’s biggest holidays that prompts mass travel.

Those efforts, however, have appeared to have little effect, with both viruses continuing to advance.

Hongseong County, South Chungcheong, the country’s largest pig-breeding region, has confirmed two outbreaks of FMD since Friday, the first in four years. After animals at one farm tested positive on Friday, FMD was confirmed at another site on Monday just 20 meters (65 feet) away.

There are currently 305 pig farms breeding a total of 494,000 pigs in Hongseong County. The last time the county saw an outbreak of the disease was in February 2011, when more than 50,000 pigs from 127 farms were culled, with damage adding up to 10.76 billion won ($9.82 million).

(Continue . . . )

 

FMD is a highly contagious viral disease that primarily afflicts cloven-hoofed animals (including cattle, sheep, goats, pigs, deer, etc.). Caused by a picornavirus, it has no relation to HFMD, which is a childhood disease in humans caused by a number of non-polio enteroviruses.

 

During the 2010-2011 FMD outbreak in South Korea, roughly 3.5 million animals were destroyed (151,425 cattle, 3,318,299 pigs, 8,071 goats, and 2,728 deer) and buried at more than four thousand locations around the country (EID Journal Control of Foot-and-Mouth  Disease during 2010–2011 Epidemic, South Korea).

 

Additionally, over the past year South Korea has culled roughly 15 million birds in their attempts to contain the recently (January 2014) emerged H5N8 virus.

 

While both diseases were thought under control, last summer we saw South Korea: Fresh Reports Of FMD & H5N8, scattered reports of both livestock diseases throughout the fall , and just last month authorities announced a  36 Hour Farm Lockdown To Halt AI & FMD.

 

FMD is endemic in many parts of the world (Africa, Asia, South America, some parts of Europe), but has been eradicated in many others.  The last outbreak of FMD in the United States was in 1929 – but vigilance is maintained to prevent its return.

 

MAFRA: H5N8 Antibodies Detected In South Korean Dogs (Again)

Spread of H5N8 in Korea – Credit Japan’s MAFF 

 

*** UPDATED ***

 

Although it certainly wasn’t clear from the kludgy machine translation of MAFRA’s statement, or the Xinhua News report cited in this blog, this English language report from the Korea Herald  suggests that this latest case may have been detected using rt-PCR (or other viral test method), not through serum antibodies.  

Hopefully we’ll get something a bit more authoritative to clarify matters. Until then, Caveat Lector. 

Avian influenza detected in dog

Published : 2015-02-02 21:47

Avian influenza was found in a dog on a farm in South Gyeongsang Province amid growing concerns that the disease could spread to other animals, officials said Monday.

The dog ― one of three at a duck farm in Goseong-gun, South Gyeongsang Province ― had antigens for the highly pathogenic H5N8 strain of bird flu, the Ministry of Agriculture, Food and Rural Affairs said. The farm was affected by the disease on Jan. 23.

This is the first time bird flu has been found in a dog in Korea through the detection of antigens, but antibodies for the virus were found in a dozen dogs at virus-affected farms in March last year. The detection of antibodies suggests an immune response to the virus, the ministry said.

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Different viruses have an affinity for binding to, and infecting, different types of cells.  That is why most viruses are fairly selective as to what organ systems they attack, or even what species they can infect.  This explains why a virus might affect a dog, or a cat, or a bird, yet not affect humans. 

 

This species selectivity is known as its `host range'.

 

Most viruses generally have a fairly narrow host range (there are exceptions, of course.  Like rabies).  All of which means that avian influenza viruses tend to infect birds, and swine influenza viruses usually infect pigs, and that we pay special attention when ever we see one of these viruses `break the rules’.

 

The HPAI H5N8 virus, which came to prominence just over a year ago in South Korean poultry and wild birds, has spread remarkably well, now plaguing poultry operations on 3 continents. Although highly destructive in birds, this virus’s one saving grace has been its apparent inability to sicken humans.

 

I say `apparent inability’ because there has been precious little published on human seroprevalence studies among cullers, poultry workers, and others since the virus emerged last year. 

 

You may recall that during Korea’s H5N1 outbreaks early in the last decade they found 9 cullers (who received prophylactic Tamiflu ®)  that  went on to develope antibodies to the virus, even though none were symptomatic (see Avian Influenza A (H5N1) Virus Antibodies in Poultry Cullers, South Korea, 2003–2004).

 

We do know that dogs are susceptible to mild or subclinical infection with H5N8, something we saw reported twice last spring (see Korea Detects H5N8 Antibodies In Farm Dog & Korea Finds More Dogs With H5N8 Antibodies), and that is being reported once again today

 

First the slightly syntax-challenged translation of South Korea’s MAFRA  announcement, followed by a more easily read Xinhua report, after which I’ll return with a bit more.

 

 

Quarantine Division, AI in the dog (H5N8) virus detected confirmation

Added
2015-02-02 10:05:00

 

Agriculture, Forestry, Livestock Quarantine Division (Head of State otolith) said that the H5N8 virus is released from the two nasal passages are raised in the AI occurred last January 23, Gyeongnam Goseong material broiler duck farms.

Factory farms that slaughter for broiler ducks January 23 AI virus has been identified in the previous inspection, and thus farm AI virus was detected in one of my test result breeding dogs are three sampling time were all three had clinical symptoms, the other two antigens, antibodies

No contact is not being propagated as determined by between two dogs that are breeding farm inspection results generated AI * 2014 23 55 two farms in the confirmation H5 antibodies ** 2015 August 24, two tests both farms antibody not detected Agriculture, Forestry, Livestock Quarantine Division was urged to give careful not therefore believe that it is the AI virus has been confirmed in poultry contamination from infected dogs in the dog is not used to our chickens and ducks from the farm to feed.

 

S. Korea confirms dog infected with avian flu

Source: Xinhua | February 2, 2015, Monday | Online Edition

SOUTH Korea's agriculture ministry on Monday confirmed a dog at a duck farm has been infected with avian influenza.

The bird flu virus was found in a dog among three dogs at a duck farm in southeastern South Korea where the highly pathogenic H5N8 strain of virus was confirmed on Jan. 23, the Ministry of Agriculture, Food and Rural Affairs said at a briefing.

There have been no antigens nor antibodies found in two other dogs, reflecting no dog-to-dog transmission of the virus, the ministry said.

The three dogs, which the ministry estimated may have had infected ducks, were culled.

Since the first case of a dog being infected with the poultry virus in March 2014, there have been 55 dogs found with antibodies to the bird flu virus. The antibody means the immune system of the dogs eliminated the virus.

More than 1.8 million ducks and chicken have been culled since the latest outbreak of the bird flu was reported in September 2014.

 

 

H5N8 infection is believed to have been contracted through the consumption of infected birds, something we’ve seen before with both dogs and cats (see A Dog & Cat Flu Review).  New with this report is the announcement that at least 55 dogs in South Korea have now shown evidence of H5N8 antibodies, a four-fold increase over the number revealed last spring.

 

While it’s still a major leap from sparking antibodies in dogs to posing a human health threat, the ability for an avian flu virus to affect any mammalian species is considered a bit of a red flag.

 

This isn’t the first time we’ve seen a novel influenza virus jump to dogs from another species.

• In 2004, the H3N8 equine influenza – a strain that has been around nearly a half century – suddenly jumped, and adapted to dogs, creating a new dog-specific (canine) lineage of H3N8.  Since then, H3N8 has continued to spread  among dogs, although it has never been known to infect humans.
• And again from Korea, in 2008 the CDC’s EID Journal carried a report on a newly emerging canine flu jumping from an avian source (see Transmission of Avian Influenza Virus (H3N2) to Dogs). In 2011, we saw the plot thicken yet again, when it was announced that this canine H3N2 had jumped to cats (see Korea: Interspecies Transmission of Canine H3N2). 
• And during the 2009 H1N1 pandemic, we saw cases of reverse zoonosis, where dogs (and cats) contracted the `humanized’ H1N1 virus from their human contacts (see US: Dog Tests Positive For H1N1)

 

This ability to be infected by more than one type of influenza virus also opens the door to the possibility that dogs could serve as a `mixing vessel’ for influenza viruses, through a process called Reassortment. 

 

Reassortment, or `Shift’ occurs when a single host is simultaneously infected with two different influenza viruses.   When that happens, it is possible for viruses to swap parts of their genetic sequence, and create a new, hybrid virus.

 

While most of the time, this leads to an evolutionary failure, every once in awhile this process produces a viable, even highly competitive, new flu strain. 

 

Although pigs and birds are vastly better `mixing vessels’ for influenza than dogs or cats will ever be, companion animals are of particular concern because of how closely humans interact with them.  

 

Of course, if there is some – as yet unidentified - `species barrier’ that prevents H5 viruses from adapting well enough to humans to pose a serious threat, then all of this concern may be moot.  

 

Some scientists believe that may be a possibility (see Are Influenza Pandemic Viruses Members Of An Exclusive Club?), but few are willing to gamble on our being that lucky. 

 

On Friday, because of the recent arrival of HPAI H5 (H5N8, H5N2 & a `new’ H5N1) into North American birds, the CDC prudently issued two pieces of interim guidance (see links below), that have this to say about the risks posed by HPAI H5 viruses:

 

The appearance of newly detected avian influenza A H5 viruses in North America may increase the likelihood of human infection with these viruses in the United States. Because these newly identified avian influenza A H5 viruses are related to avian influenza A viruses associated with severe disease in humans (e.g., highly pathogenic Asian-lineage avian influenza A (H5N1) virus), they should be regarded as having the potential to cause severe disease in humans until shown otherwise.

An acknowledgment that not only do viruses change over time, so can our understanding of their abilities and threats. 

 

For more, see:

CDC Interim Guidance For Testing For Novel Flu

CDC Interim Guidance On Antiviral Chemoprophylaxis For Persons With Exposure To Avian Flu

South Korea: 36 Hour Farm Lockdown To Halt AI & FMD

AI Disinfection  – Credit MAFRA 

 

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For agricultural interests nothing invokes fear like the emergence of a highly pathogenic strain of avian influenza, or an outbreak of FMD (Foot & Mouth Disease). Both can threaten large segments of a region’s food production, and both are difficult to eradicate or control.

Over the past year South Korea has culled roughly 15 million birds in their attempts to contain the H5N8 virus, and between 2010 and 2011, an outbreak of FMD forced the destruction of nearly 3.5 million animals.

 

While both diseases were thought under control, last summer we saw South Korea: Fresh Reports Of FMD & H5N8, and in the past several months additional outbreaks have been reported. Yesterday, in South Korea Reports New HPAI H5 & FMD Outbreaks, we looked at a new spate of reports of avian flu (and FMD) in South Korea .

 

Although migratory birds have been blamed for much of the the spread of HPAI H5 in Korea, it is also likely that the agricultural industry has exacerbated the spread through the movement of infected birds, supplies, or contaminated vehicles.   FMD can easily be spread in the same way.

 

So today Korean authorities  announced a 36-hour lockdown of all poultry, livestock, farm personnel, and their vehicles across the nation – to begin on Saturday - to allow time for a massive disinfection campaign. 

 

This is the third such lockdown ordered in the past year.

 

Two reports, first from Yonhap News, then from AFP.

 

 

Gov't bans movement of poultry, farmers to prevent spread of AI

2015/01/15 12:02

SEJONG, Jan. 15 (Yonhap) -- The government on Thursday ordered a halt in the movement of all birds, poultry farmers and vehicles to prevent the further spread of bird flu.

The Ministry of Agriculture, Food and Rural Affairs said the ban will go into effect as of 6 a.m. Saturday and stay in place until 6 p.m. Sunday. A total of 106,000 people will be affected along with 31,000 facilities.

Failure to follow the order could result in a maximum fine of 10 million won (US$9,220) or a prison term of less than one year.

The ministry said the order has been issued in consultation with poultry farmers and agricultural cooperatives and that the farmers were given time to stock up on feed.

"Because poultry farmers actively asked for the measure, we expect they will actively adhere to it," said Lee Chun-il, head of the ministry's livestock policy division.

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S. Korea orders lockdown to fight animal disease

South Korea on Thursday announced a 36-hour lockdown over the weekend on poultry and livestock farms across the country to curb the spread of two highly contagious animal diseases -- foot and mouth and bird flu.

The agriculture ministry said the movement of animals, people and vehicles at thousands of farms would be banned from 6:00 am (2100 GMT) on Saturday for disinfection.

A series of outbreaks of foot-and-mouth in recent months have resulted in the slaughter of around 25,000 pigs, and concern has grown as cases have spread to farms close to the capital Seoul.

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South Korea Reports New HPAI H5 & FMD Outbreaks

A year of H5N8 In Korea – Credit Japan’s MAFF 

 

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This week marks the 1 year anniversary of the first detection of the newly emerged HPAI H5N8 virus on the Korean peninsula (see Media Reporting Korean Poultry Outbreak Due To H5N8), and despite the culling of more than 15 million birds and Korean farms having some of the best poultry biosecurity procedures in the world, the virus continues to resurface.

Reintroduction via wild and migratory birds has been largely blamed, but it is also possible that in some cases the virus is being spread inadvertently by the poultry trade  (see Bird Flu Spread: The Flyway Or The Highway?).

 

Although other HPAI viruses are known to have spread via wild and migratory birds, the H5N8 virus appears to be unusually adept at this mode dispersal, having now shown up in Japan, Russia, China, Western Europe, and even the United States. 

In addition to recurring avian influenza outbreaks, South Korea is also battling outbreaks of FMD (Food & Mouth Disease) once again  – which according to the article below – has resulted in the detection of more than 50 cases since the beginning of December spread across 13 Korean cities and counties.  

 

FMD is a highly contagious viral disease that primarily afflicts cloven-hoofed animals (including cattle, sheep, goats, pigs, deer, etc.). Caused by a picornavirus, it has no relation to HFMD, which is a childhood disease in humans caused by a number of non-polio enteroviruses.

 

During the 2010-2011 FMD outbreak in South Korea, roughly 3.5 million animals were destroyed (151,425 cattle, 3,318,299 pigs, 8,071 goats, and 2,728 deer) and buried at more than four thousand locations around the country (EID Journal Control of Foot-and-Mouth  Disease during 2010–2011 Epidemic, South Korea).

 

The AI cases announced today are described as HPAI H5, and a final determination of the subtype will be announced over the next few days.  Given the recent events in Taiwan, and the propensity of H5 viruses to reassort, there is always the chance that these outbreaks will end up being something other than H5N8.

 

 

Korea confirms additional AI case

Updated : 2015-01-14 19:58

An additional case of avian influenza has been confirmed in Busan, South Korea’s largest sea port, quarantine officials said Wednesday.

According to Busan municipal authorities and quarantine officials, chickens and geese that were found dead at a poultry farm on Tuesday all tested positive for the H5 strain of bird flu.

It said further tests are needed to determine whether they died from the highly pathogenic H5N8 strain of the animal disease.

The confirmation marks the first time that Busan has reported a bird flu case since 2008.

Quarantine officials said 580 birds at the farm that raised geese, chickens and pigeons were all culled to prevent further spreading of the disease. It said four checkpoints have been set up around the poultry farm to disinfect cars and control the movement of people and animals.

In addition to the Busan case, quarantine officials said tests showed birds at a duck farm in Anseong, near Seoul, have tested positive for the H5 strain.

(Continue . . .)

Meanwhile, Back In Korea . . . .

Korean H5N8 Outbreaks: 2014 – Source Japan’s MAFF

 

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Given its geographic spread to Europe, Japan, and even North America, it is hard to believe that this time last year HPAI H5N8 wasn’t on anyone’s radar, and was still several weeks away from its debut in South Korea. 

 

Over the winter and spring, this emergent virus spread quickly across the Korean peninsula, leading to  the deaths and/or culling of roughly 15 million birds.

 

While there have been some recent scattered reports out of South Korea, so far the bulk of the H5N8 story this fall  has been centered around its arrival in Europe and Japan.  Today, however, there are reports of the virus being detected in a market very near the nation’s capital Seoul.

Avian flu found near Seoul

Yonhap News
By Kim Se-jeong

The Ministry of Agriculture, Food and Rural Affairs (MAFRA) said Sunday that it had discovered the bird flu virus in a chicken sold at a traditional market in Seongnam, Gyeonggi Province during a random inspection.

This is the first case of avian influenza confirmed in Gyeonggi Province this winter.

According to the ministry, the H5N8 strain was confirmed Saturday in the chicken sold at Moran Market in Seongnam, where about one million people live. The discovery was made five days after a sample was sent for examination. About 3,200 chickens on sale at the market were culled, and 11 chicken vendors shut down, it said.

The ministry is investigating whether there are any other suspected cases of avian influenza in the Seoul area. The ministry said the infected chicken had been supplied from a farm in Incheon.

(Continue . . . )

 

My thanks to to Sharon Sanders of FluTrackers has located the following (syntax challenged translation of the)  MAFRA report (link below):

AI detected in the course of regular surveillance in Seongnam Moran Market

date 2014-12-28 15: 30: 00

Agriculture, Forestry, Animal Husbandry and Food are always forecasting * December 28 AI course of the match Seongnam material Moran Market detected highly pathogenic AI virus in the poultry sales facilities December 22 of Veterinary Defense Agriculture, Forestry, Livestock Quarantine support for regular surveillance by sampling at the Headquarters were inspected at the headquarters, December 26 ** H5N8 AI virus has been detected, December 27 announced that the final diagnosis by highly pathogenic. 

(Continue . . .)

South Korea Reports New H5N8 Outbreak

Credit FAO

 

 

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Last January South Korea reported the emergence of a new highly pathogenic strain of avian influenza called H5N8, which proceeded to march across that nation infecting scores of farms, and resulted in the culling of more than 10 million birds (see South Korea: 30 Days Into Their H5N8 Outbreak).

 

Although previously seen in other parts of the world in a low pathogenic form (see CIDRAP 2008 Low-pathogenic avian flu hits Idaho game farm), only one detection of H5N8 in an HPAI form had previously been recorded in China back in 2009-10 (see Characterization of three H5N5 and one H5N8 highly pathogenic avian influenza viruses in China).

 

In mid-April, the same strain showed up in Japan, presumably carried there by migratory birds.  Although no human infections have been recorded with H5N8, in March it was disclosed that Korea Found Dogs With H5N8 Antibodies.

Through a combination of massive culling, disinfection of farms and equipment, and the restriction on the movement of poultry, equipment, and personnel, by late spring this outbreak was believed brought under control - and while Korea did report a new farm infection over the summer - several weeks ago they declared the outbreak to be finally over.

 

That victory was short lived, as over the past couple of days local media has been reporting on an outbreak on a duck farm in the southwestern city of Yeongam (see Korean Herald S. Korea confirms new case of avian influenza), and overnight the FAO posted an official report.

 

All of the ducks on the affected farm have been destroyed, adjacent farms are under scrutiny, and the countdown clock is reset once again to determine if the virus has been contained.

 

With this new strain found both in wild and migratory birds, and in domesticated poultry, preventing future outbreaks will be difficult.  Like the more recently emerged H5N6 virus now cropping up in China and Vietnam (see FAO Warns On H5N6), this virus is a cousin of the H5N1 virus which has plagued poultry farmers in Asia and the Middle East – and sparked pandemic concerns globally – for well over a decade.

 

After 10 years of mainly watching the H5N1 virus, over the past two years we’ve seen the emergence of a number of worrisome avian reassortant viruses, including H7N9, H10N8, H5N6 and H5N8. 

 

Beyond the threat to agricultural interests and food security and the local economy, these viruses are all evolving and playing `mix and match’ with their genes,  and appear to be producing new clades and subtypes at an increasing rate (see Eurosurveillance: Genetic Tuning Of Avian H7N9 During Interspecies Transmission).  

 

While none of these viruses has shown the ability to spread easily among humans and spark a pandemic -  the more players on the roster - the greater the odds are that one of them will eventually hit a home run.

EID Journal: Two Dispatches On SFTS

Photo Credit Wikipedia

Tick Species Associated with SFTS in China

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SFTS or Severe Fever with Thrombocytopenia Syndrome - a tickborne Phlebovirus  - was first discovered in China in 2009, but has also been found in Japan and Korea. It is genetically similar to the recently discovered Heartland Virus (see MMWR: Heartland Virus Disease — United States, 2012–2013) that has been detected in roughly a dozen people here in the United States.

 

Phleboviruses are part of the very large family Bunyaviridae.

 

To date over three hundred Bunyaviruses have been identified around the world, with rodents often cited as carriers. While not all Bunyaviruses are dangerous to humans (some only infect plants), the Bunyavirus family include such nasties as Crimean-Congo hemorrhagic fever (CCHF), Hantaviruses, and Rift Valley Fever.

 

Most are spread via arthropod vectors (ticks, mosquitoes & sand flies), with the notable exception of Hantaviruses (see Hantaviruses Revisited), which are primarily spread via virus-laden feces and urine of rodents.

 

In 2011, we got our first good look at the disease when the NEJM published a study Fever with Thrombocytopenia Associated with a Novel Bunyavirus in China.  STFS has previously been associated with a 12% mortality rate in China. Since then we’ve seen reports both from Japan and South Korea (see Korean CDC On SFTS Cases) of fatal cases as well.

 

Like with CCHF, under the right conditions, human-to-human transmission of SFTS (via blood, mucus or other bodily fluids) has been documented. (see Person-to-person transmission of severe fever with thrombocytopenia Syndrome virus)

 

As a relatively newly discovered pathogen, we are just beginning to learn about its prevalence, both in ticks and in humans in SFTS endemic areas.  

 

Today, we’ve excerpts from two dispatches published in the CDC’s EID Journal that help in that regard.

 

The first, looks at the various species and the rate of SFTS infection among ticks collected South Korean. They found SFTSV in 5.7% of H. longicornis ticks tested, which represented 81.2% of the ticks sampled.  Other species tested were also found to carry the virus, but it isn’t yet known whether they can transmit it to humans. 

 

Severe Fever with Thrombocytopenia Syndrome Virus in Ticks Collected from Humans, South Korea, 2013

Seok-Min Yun¹, Wook-Gyo Lee¹, Jungsang Ryou, Sung-Chan Yang, Sun-Whan Park, Jong Yeol Roh, Ye-Ji Lee, Chan Park, and Myung Guk Han

Author affiliations: Korea Centers for Disease Control and Prevention, Cheongwon-gun, South Korea

Abstract

We investigated the infection rate for severe fever with thrombocytopenia syndrome virus (SFTSV) among ticks collected from humans during May–October 2013 in South Korea. Haemaphysalis longicornis ticks have been considered the SFTSV vector. However, we detected the virus in H. longicornis, Amblyomma testudinarium, and Ixodes nipponensis ticks, indicating additional potential SFTSV vectors.

 

The second study, this time out of China, is a seroprevalence study of healthy individuals, looking for evidence of prior infection with SFTS, without a history of severe illness. 

 

Antibodies against Severe Fever with Thrombocytopenia Syndrome Virus in Healthy Persons, China, 2013

Lei Zhang¹, Jimin Sun¹, Jie Yan, Huakun Lv, Chengliang Chai, Yi Sun, Bin Shao, Jianmin Jiang, Zhiping Chen, and Yanjun Zhang

Abstract

In June 2013, a subclinical infection with severe fever with thrombocytopenia syndrome virus (SFTSV) was detected in Zhejiang Province, China, prompting seroprevalence studies in 6 districts within the province. Of 986 healthy persons tested, 71 had IgG antibodies against SFTSV. This finding suggests that most natural infections with SFTSV are mild or subclinical.

Conclusions

SFTSV can cause severe disease and high rates of death among infected hospitalized patients. The virus also has the limited ability to be transmited from person to person through contact with contaminated blood, but secondary cases are generally less severe and have so far not resulted in fatalities (7–9). Nonetheless, there is great public health concern regarding SFTSV.

Our seroprevalence study was prompted by the identification of a subclinical, secondary infection that was most likely caused by person-to-person transmission of the virus from an infected family member with a fatal case of SFTS. We found an overall SFTSV seroprevalence of 7.2% among 986 healthy persons who reported no symptoms associated with SFTS. Because the seropositive participants in our study did not have contact with persons with diagnosed cases of SFTS, their infections most likely occurred through natural exposure. From this, we conclude that SFTSV infections are widespread in rural areas of Zhejiang Province, and only a small percentage of the infections result in clinical disease.

 

Like a lot of viruses, infection with SFTS appears to carry with it a wide range of illness – ranging from subclinical to mild to occasionally life-threatening.  Very few viruses are universally fatal (rabies comes close, though).

 

This is a pattern we see with everything from influenza to West Nile Virus to MERS. It is also a fact of life that surveillance is far more likely to pick up severe cases than mild ones, and that can sometimes skew our perception of just how deadly an emerging pathogen really is.

 

You don’t have to travel to Asia to be exposed to a potentially serious  tickborne disease.  The CDC maintains a long  (and growing) list of of tickborne pathogens available locally, including:

 

Babesiosis , Ehrlichiosis, Lyme disease, Rickettsia parkeri Rickettsiosis, Rocky Mountain Spotted Fever (RMSF), STARI (Southern Tick-Associated Rash Illness), Tickborne relapsing fever (TBRF), Tularemia, and 364D Rickettsiosis.

 

Whether a new and emerging threat, or simply our ability to finally recognize a long-time nemesis, it makes sense to take precautions against ticks and other vector-borne diseases.

 

For help in that regard, the following CDC website offers advice on:

 

Preventing Tick Bites

 

And for more on tickborne pathogens, you may wish to revisit:

 

EID Journal: Seroprevalence Of B. Miyamotoi In N.E. United States

The Tick Borne Identity

CDC: Estimate Of Yearly Lyme Disease Diagnoses In The United States

Korea: Fears Of H5N8 Resurgence

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Six months ago a new strain of Highly Pathogenic Avian Influenza (HPAI) called H5N8 appeared in South Korea, and proceeded to spread rapidly across that nation’s poultry industry.  While not showing any signs of infecting humans, this emerging strain has proved deadly to birds, and has even infected dogs (see Korea Finds More Dogs With H5N8 Antibodies).

 

Through a combination of massive culling, disinfection of farms and equipment, and the restriction on the movement of poultry, equipment, and personnel, by late spring this outbreak was believed brought under control.

 

South Korea was within days of declaring the outbreak officially over, when over the past week, three new outbreaks have been reported.   A development all the more surprising because summer, traditionally, has been the least likely time to see HPAI outbreaks in Korea.

 

This from The Korea Times.

 

New bird flu case in Daegu fuels concerns for nationwide spread

By Kim Se-jeong

A new case of avian influenza has been found in Daegu, triggering fears that the disease may be spreading across the country, officials said Wednesday.

According to Daegu Metropolitan Government (DMG), the H5N8 virus was found in three chickens that recently died at a poultry farm in Okcheon.

"The presence of the highly pathogenic virus has been confirmed," said an official from DMG. Since late last month, 100 chickens and 94 geese have died on the farm.

This case follows two separate cases reported in Hoengseong, Gangwon Province last Saturday and in Muan, South Jeolla Province earlier this week.

(Continue . . . )

 

 

The past sixteen months have been marked by the emergence of several new avian flu strains, including H7N9, H5N8, H6N1, H10N8, and H5N6.  While we tend to think of these viruses each as a single entity, in truth, each comes in a variety of clades, with numerous variants within each clade, and all continue to evolve, mutate, and reassort over time. 

 

In EID Journal: H7N9 As A Work In Progress, we learned that the H7N9 avian virus continues to reassort with local H9N2 viruses, making the H7N9 viruses that circulated in wave 2 genetically distinct from those that were seen during the 1st wave.

While in EID Journal: Describing 3 Distinct H5N8 Reassortants In Korea, we saw hints of the genetic diversity already present very early in the Korean outbreaks.

 

And just last week, in EID Journal: Mutations Of A(H10N8) Virus in Chicken Eggs and MDCK Cells we saw hints that this new virus ``might be undergoing rapid adaptation to mammals and developing antiviral drug resistance’.

 

 

Thus far, none of these viruses has demonstrated any overt signs of efficient adaptation to humans. The remain primarily adapted  to avian physiology.

 

Yet all of them continue to circulate, adapt, and evolve. 

 

So what we can say about them – and the risks they pose to public health – today, may well change tomorrow.  So we watch these outbreaks with interest – not only because of the social and economic impact these poultry outbreaks may have – but also to look for any signs that `something’ has changed.

Korea Finds More Dogs With H5N8 Antibodies

 

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Ten days ago in Korea Detects H5N8 Antibodies In Farm Dog we learned of a single dog at a farm in Chungcheongnam-do province that had tested positive for antibodies to the H5N8 avian flu virus, which emerged in that country’s poultry flocks last January (see South Korea: 30 Days Into Their H5N8 Outbreak).

.

Antibodies to a virus generally rise a couple of weeks after exposure, and are considered a solid indicator of past infection (either symptomatic or sub-clinical).

 

While not terribly common, we’ve seen dogs (and other non-avian species) infected with novel avian influenzas in the past.  In late 2012, in China: Avian-Origin Canine H3N2 Prevalence In Farmed Dogs, we looked at a study that found a newly emergent avian origin H3N2 virus prevalent in pet and farmed dog populations in southern China.

 

Although we’d seen reports of a handful of similar infections with the avian H5N1 virus during the last decade (see Study: Dogs And H5N1), canines were not generally believed very susceptible to `humanized’  flu strains.  That is, until we began seeing dogs infected with the 2009 pandemic H1N1 virus (see Companion Animals And Novel H1N1).

 

The concern is that  viruses are given new opportunities to evolve, adapt and mutate when they jump species, which led the author of a 2008 EID study - Transmission of Avian Influenza Virus (H3N2) to Dogs - to write:

 

Transmission of avian influenza A virus to a new mammalian species is of great concern, because it potentially allows the virus to adapt to a new mammalian host, cross new species barriers, and acquire pandemic potential.

 

All of which serves as prelude to a new status report from Korea’s Ministry of Food, Agriculture and Rural Affairs  that now raises to 11 the number of  dogs, from two farms, that have tested positive for the H5N8 virus. First a somewhat cryptic (machine translated) snippet from that report (h/t Sharon Sanders @FluTrackers for the link), then some excerpts from a Yonhap News report.

 

( One pig inspection situation ) the current test results were all negative pigs , dogs , today (3:24 days) 2 farms (Cheonan one , give one ) in addition to antibodies (H5 type) have been identified.

So far, research results, this time in addition to detection of antibodies to the last two farms ( one 3:11 ) antibodies such as those listed in the case of dogs , as - Dogs are AI antibody was confirmed to be without symptoms, which detects antibodies to the virus has been exposed to the disease state is determined not to be caused by infection

 

S. Korea reports additional infection of bird flu in dogs

2014/03/24 02:46

SEJONG, March 24 (Yonhap) -- South Korea reported additional cases of avian influenza (AI) in dogs Monday, further confirming the spread of the bird flu to different species.

The cases also marked the first time in the world in which infected dogs survived, according to officials from the Ministry of Agriculture, Food and Rural Affairs.

The ministry said antibodies to AI have been detected in 11 dogs at two separate farms in Cheonan, 80 kilometers south of Seoul, and Buyeo, located 195 kilometers south of the capital.

The detection of antibodies against bird flu confirms that the canines have at least once been infected with the virus that mostly affects poultry. The first case of a dog being infected with the virus was reported March 11 at a different farm in Cheonan.

(Continue . . . )

 

In addition to incrementing the number of birds culled since January over the H5N8 virus to more than 11 million, this article also makes mention of the first known H5N1 infection in dogs ( in Thailand in 2004) which was described in this 2006 Dispatch to the CDC’s EID Journal.

Dispatch

Volume 12, Number 11–November 2006

Fatal Avian Influenza A H5N1 in a Dog

Thaweesak Songserm,* Alongkorn Amonsin,† Rungroj Jam-on,* Namdee Sae-Heng,* Nuananong Pariyothorn,† Sunchai Payungporn,† Apiradee Theamboonlers,† Salin Chutinimitkul,† Roongroje

Abstract
Avian influenza H5N1 virus is known to cross the species barrier and infect humans and felines.

We report a fatal H5N1 infection in a dog following ingestion of an H5N1-infected duck during an outbreak in Thailand in 2004. With new reports of H5N1 virus continuing across Asia, Europe, and Africa, this finding highlights the need for monitoring of domestic animals during outbreaks.

(Continue . . . )

 

The list of zoonotic diseases (those shared between humans and animals) is long and continually expanding, and includes: SARS, Babesiosis, Borrelia (Lyme), Nipah, Hendra, Malaria, Hantavirus, Ebola, Bartonella, Leptospirosis, Q-Fever, bird flu and many, many others.

 

So understandably, anytime we see a virus – particularly a flu virus – jump species, it gets our attention.

 

And when they infect companion animals, such as dogs and cats, it becomes of even greater concern, because of how closely we humans interact with them.  For now, the H5N8 virus is only known to be pathogenic in avian species, and we’ve seen no evidence that it can infect humans.  And admittedly, that may never happen.

 

But as we learned earlier this month in EID Journal: Describing 3 Distinct H5N8 Reassortants In Korea, this emergent virus is a work in progress, and we can expect to see new variants and/or clades of the virus emerge over time.

 

New variants can behave differently, and so enhanced surveillance and vigilance is required, else we get blindsided by a virus coming out of left field. 

 

The ability of novel influenza viruses to evolve, mutate, or reassort in a variety of hosts has been a frequent topic of discussion in this blog.  For more on this, you may wish to revisit:

 

H3N2v: When Pigs Flu

mBio: Characterizing A Novel Influenza C Virus In Bovines & Swine

PLoS Pathogens: New World Bats Harbor Diverse Flu Strains

mBio: A Mammalian Adapted H3N8 In Seals

The (Swine) Influenza Reassortment Puzzle

Korea Detects H5N8 Antibodies In Farm Dog

 

 

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In addition to announcing that the number of domestic birds culled in South Korea’s 2 month-old H5N8 outbreak has now exceeded 10 million (see Reuters South Korea culls over six percent of poultry to curb bird flu), Korea’s Ministry of Agriculture announced today that a dog from a bird flu affected farm in Chungcheongnam-do province has tested positive for antibodies to the H5N8 virus.

 

This marks the first time that evidence of an H5N8 infection has been found in a non-avian species, although the dog was reportedly asymptomatic. 

 

Antibodies are generally detectable a couple of weeks after exposure, and are considered an indicator of past infection. First a report from Arirang News, then I’ll have more on the expanding host range of influenza viruses.

 

Dog infected with Avian Influenza

Updated: 2014-03-14 PM 4:30:10 (KST)

Authorities have confirmed that a dog at a farm in Korea's Chungcheongnam-do province has been infected with the H5N8 strain of avian influenza.

Korea's agriculture ministry said Friday that the dog had tested positive for having antibodies against the H5 strain, meaning its immune system is battling the virus.

It's the first time in Korea that a mammal has come down with the AI virus.

Authorities say the dog became infected after eating an infected chicken at the farm.

Prior to this case, it was believed that the AI virus could only be transmitted among the same species.

It's raising concerns that humans could be susceptible to the H5N8 strain, but health authorities say that's very unlikely, although the farm's workers are being tested.

(Continue . . . )

 

Despite the tendency of officials to make reassuring blanket statements whenever a new disease threat appears, one of the oft mentioned caveats in this blog is that viruses constantly evolve, as does our understanding of them.  What might be reasonably stated as `true’  last week could easily require revision and amendment tomorrow.

 

And one of those areas of knowledge that seems to constantly evolve centers around the host range of various influenza viruses.

 

So the detection of H5N8 antibodies in canines, while potentially significant, isn’t completely unexpected. Over the past decade we’ve seen plenty of evidence of influenza’s cross-species promiscuity.

• Five years ago, few scientists would have put money on bats being a host species for influenza, yet in 2012 CDC researchers discovered a new flu strain in Guatemalan bats (see A New Flu Comes Up To Bat) and last year we saw in  PLoS Pathogens: New World Bats Harbor Diverse Flu Strains.
• One of the surprises with the H5N1 avian flu virus was how readily it infected dogs and cats (see Study: Dogs And H5N1 and Israel: Cats Infected With H5N1 for background), when previously neither species had been consider particularly susceptible to influenza.
• The (formerly) pandemic H1N1 2009 flu virus was documented in  turkeys, skunks, ferrets, cats, elephant seals and dogs.
• While in That Touch Of Mink Flu I wrote about 11 farms in Holstebro, Denmark that were reported to be infected with a variant of the human H3N2 virus.
• In 2012 we also saw mBio: A Mammalian Adapted H3N8 In Seals
• And just last week, we learned of a previously unknown subtype of Influenza C (see mBio: Characterizing A Novel Influenza C Virus In Bovines & Swine) prevalent in cows. 

 

Today’s announcement simply means that scientists now have a little better understanding of this emerging H5N8 virus.  We’ve moved beyond saying it can `only infect birds’, but the role or importance of mammals in the ecology of this virus is far from established.   

 

What can be said, two months into this outbreak, is that in its present incarnation, the H5N8 virus is primarily a threat to avian species, as it doesn’t appear to readily sicken or infect mammals.

 

But as we learned yesterday (see EID Journal: Describing 3 Distinct H5N8 Reassortants In Korea) there are at least three genetically distinct versions of the virus in play on the Korean peninsula, and these will inevitably change, evolve, or reassort over time.

 

And as we know all too well . . . as viruses evolve, so can the threat they pose.   

South Korea: 30 Days Into Their H5N8 Outbreak

H5N8 Spread in Korea - Credit Japan’s MAFF

 

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It’s been exactly  a month since we first learned South Korea’s H5N8 outbreak - affecting both wild birds and poultry – but thus far, not humans.

 

Although previously seen in a low pathogenic form (see CIDRAP 2008 Low-pathogenic avian flu hits Idaho game farm), at least one detection of H5N8 in an HPAI form was recorded in China in 2009-10 (see Characterization of three H5N5 and one H5N8 highly pathogenic avian influenza viruses in China).

 

Despite intensive containment measures, disinfection and culling of farms, and the halting of poultry product transport, the virus has continued to spread across much of the South Korean Peninsula over the past 30 days.   Today,  a couple of reports indicating that the battle being waged is far from over.

 

From the Korean JoongAng Daily.

 

Bird flu still spreading so culling continues

Vigilance is wearying farmers, quarantine officials are exhausted

Feb 18,2014

Avian influenza continues to spread despite efforts to control it, including the culling of more than four million ducks and chickens.

Bird flu now threatens the Seoul metropolitan area, with another confirmation of the H5N8 strain at a duck farm in Anseong, Gyeonggi, yesterday, the third outbreak in the province.

Some 7,000 ducks at the farm and more than 100,000 chickens and ducks at six other farms within a three-kilometer (1.8-mile) radius were culled yesterday to prevent the spread of the disease.

(Continue . . . )

 

And this report from KBS World.

 

Highly Pathogenic AI Case Confirmed in North Jeolla Province

Write : 2014-02-17 18:59:37 Update : 2014-02-17 19:44:09

North Jeolla Province has confirmed ducks at a farm in Gimje tested positive for a highly pathogenic strain of bird flu.

Quarantine authorities have decided to cull seven-thousand ducks and another 14-thousand ducks at another farm located within a three-kilometer radius.

The latest infection is stirring up fears of a renewed spread of the bird flu after signs of the epidemic letting up in North Jeolla Province.

 

In 2011 we saw the massive spread of another avian flu – H5N1 - across much of South Korea, resulting in the culling of more than 5.5 million birds on nearly 250 farms (see South Korea: Two New Bird Flu Outbreaks Reported).  At the time migratory birds were blamed for the introduction of that virus into the poultry industry.

 

Although Korean officials have been quick to blame Migratory birds for bringing the virus to their country, and spreading it between farms, not everyone is in agreement (see  Korea: H5N8 Spreads, Debate Over Source Intensifies).

 

Despite a degree of uncertainty regarding its mode of dispersal, given the flight paths of migratory birds that are currently overwintering on the Korean peninsula (see map below), Japan and other countries are on heightened alert for any signs of H5N8’s arrival on their shores.

 

Credit U.S. Fish and Wildlife Service

 

How H5N8 will eventually interact with other flu viruses, and various hosts, is something we will have to wait to see. 

 

But the unexpected appearance of this avian virus last month is further proof (as if we needed it) that Nature’s laboratory is open 24/7, is constantly coming up with new viral and bacterial threats, and that we need to improve not only our surveillance, but our biosecurity measures, if we hope to keep them at bay.