South Korea: 2nd & 3rd MERS Cases Confirmed

 

#10,071

 

The first imported MERS case reported in South Korea yesterday has expanded today into a local cluster as the patient’s wife, and another patient sharing his hospital room have now both tested positive.  Interestingly, today’s media reports adds Saudi Arabia and the UAE to the first patient’s travel itinerary, in addition to the original reports of Bahrain and Qatar.

 

Another 64 people – mostly family members and contacts of hospital workers who have been exposed – are also quarantined.

 

First this update from Reuters and a statement by the Korean CDC,  after which I’ll return with a bit more:

 

UPDATE 2-South Korea confirms third case of MERS virus; 64 isolated

* Wife of the first patient positive for MERS - officials

* Another who shared hospital room also confirmed

* All three in stable condition - doctors

* Another 64 people isolated (Updates with third case and adds ministry briefing, paragraphs 1-7)

By Meeyoung Cho

SEOUL, May 21 (Reuters) - South Korean health officials confirmed the country's third case of Middle East Respiratory Syndrome (MERS) on Thursday, with the two latest cases found in people who had been in contact with the first patient after he returned from the Middle East.

Authorities have also isolated as a precaution another 64 people who are family members or medical workers treating those three patients, said Yang Byung-guk, director of the health ministry's Korea Centers for Disease Control & Prevention.

Test results came back positive for a 63-year-old woman, the wife of the first proven case, as well as for a 76-year-old man who shared a hospital room with him, the health ministry said.

The first man was diagnosed with the disease on Wednesday after a trip to Bahrain, Saudi Arabia and the United Arab Emirates, where the disease broke out, Yang told a briefing.

(Continue . . . )

 

The South Korean CDC has issued the following somewhat syntax-challenged (translated) statement  along with a document (alas, in the Hanword .hwp format, which I’m unable to open) describing their heightened level of alert.

 

Middle East Respiratory Syndrome ( Homers ) related to response measures strengthened

- Add introduced to prevent the spread and strengthen the quarantine , isolation therapy , contact investigations, and active monitoring of symptoms, such as general measures implemented -

□ The government has 21 days ( Thursday 12) to hold a meeting with Merck's infectious disease specialist crisis management organized at Headquarters , the current infectious disease crisis situation assessment and to discuss the next steps crisis, comprehensive measures are " careful steps , " the But maintaining response was to strengthen actions preemptively .

○ The conference is the first confirmed cases last 5.15 from work 5.17 days to B in a hospital admission while trying , with one of the hospitalized elderly patients ( male , 76 years of age ) egeseodo genetic test results conducted in accordance As a follow up positive judgment is out ,

* 5.20 am from the same fever has been confirmed in epidemiological studies to date courses in the afternoon National hospitalized in isolation wards actions already completed power

○ The Conference Results 5 May 20 at " attention " crisis alert level is upgraded to keep but that close contact with the family and medical power doubts (64 people ) to immediately perform the isolation and ,

○ confirmed cases from contact up to one incubation period of 14 days, the daily monitoring through an additional symptoms to take proactive measures to identify whether the expression was .

□ The government further epidemiological investigation first patient outside Bahrain Middle East respiratory syndrome gukin Saudi Arabia , UAE and some have visited history was confirmed that ,

○ The domestic and international cases reported now in the Middle East respiratory syndrome to infection, all patients were on a straight ‧ , so indirectly associated with the Middle East ,

○ with camels known as a mediator hayeotgeona visit to the Middle East, to stay in contact after returning 14 days fever , cough and breathing difficulties such as respiratory symptoms or more visits to hospitals and medical personnel if you have the facts to inform also , who care for these patients, physicians also actively report was advised .

 

South Korea becomes the 14th nation outside of the Arabian peninsula to see an imported MERS case, yet secondary transmission of the virus outside of the Middle East has been rare.  As we saw in France and the UK back in 2013, and now in South Korea, nosocomial spread of the virus remains a risk.

 

Two weeks ago, in WHO EMRO: Scientific Meeting Reviews MERS Progress & Knowledge Gaps, we looked at some of the glaring deficits in our understanding of how, and why MERS transmits the way it does. From that report:

 

Most importantly, they identified many knowledge gaps that need to be addressed to better understand the transmission dynamics of the virus among animals, between animals and humans, and from human to humans. These knowledge gaps include: the risk factors for transmission between camels and humans, the role of mild or asymptomatic cases in the infection transmission, the seasonal trend of the disease, the specific exposures that put the healthcare workers at highest risk illness, the underlying factors that are contributing into the transmissibility of the virus in healthcare settings, and the behaviors that put certain groups of people at higher risk of illness, etc. 

 

While this year’s outbreak of MERS in the Middle East has been considerably more subdued than last year, we continue to see evidence that the virus is actively circulating in the region.  

With Ramadan now less than a month away – followed in September by the annual Hajj  (see CDC Traveler’s Advice: Umrah, The Hajj and MERS) – millions of religious pilgrims from around the world will visit the Holy Cities and the risks of seeing additional cases exported cannot discounted.

 

And while many countries will probably attempt to implement some sort of enhanced airport screening, as we’ve discussed often in the past (see Why Airport Screening Can’t Stop MERS, Ebola or Avian Flu), those efforts are unlikely to produce much in the way of solid results.

 

Making it important that – whenever possible – outbreaks of emerging viruses are quashed as quickly as possible at the source, before they can board an airplane and spread inexorably around the globe.  

 

A goal toward which, after nearly three years, we don’t seem to be making a lot of progress .

South Korea: Fresh Reports Of FMD & H5N8

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# 8873

 

For large scale agri-business, nothing conjures  feelings of dread like the emergence of a highly pathogenic strain of avian influenza, or an outbreak of FMD (Foot & Mouth Disease), as both threaten large segments of a region’s economy and food production, and neither are easy to eradicate.

 

Last January South Korea was hit by a new strain of avian flu – H5N8 – which spread to scores of farms across the nation and led to the culling of more than 10 million birds.  Although the outbreak appeared to have been stamped out by May, last month (see Korea: Fears Of H5N8 Resurgence) a new outbreak was reported on a poultry farm in Daegu.

 

After a quiet month on the bird flu front, yesterday Korean media reported another outbreak of H5N8, this time in South Jeolla.

 

Avian flu confirmed at South Jeolla duck farm

July 28,2014

Avian influenza (AI) was confirmed yesterday at a duck farm in Korea, local officials said, just days after the government detected another instance of the potentially deadly foot-and-mouth disease.

The South Jeolla Livestock Sanitation Office said yesterday that a highly pathogenic strain of bird flu, H5N8, was discovered Friday at a duck farm in Hampyeong in the southwestern province. Upon official confirmation, approximately 42,000 ducks at the farm were immediately culled, officials said.

(Continue . . . )

 

 

Although there is a decided seasonality to avian flu outbreaks (peaking in winter & spring), theses viruses can continue to circulate year-round.  Areas where the H5N1 virus is particularly well entrenched – like Egypt & Indonesia – frequently report poultry outbreaks even in the heart of summer.

This is the first summer of H5N8, and thus far, the seasonal pattern of the virus appears to be consistent with what we’ve seen with H5N1 and H7N9.   

 

Earlier this year, in EID Journal: Describing 3 Distinct H5N8 Reassortants In Korea – we saw a report on the continual evolution of the H5N8 virus.  Like all flu viruses – H5N8 continues to mutate and adapt – meaning that the virus we see next fall, or next year, may not behave quite like the virus we have before us today. 

 

Adding insult to injury, last week South Korea also reported their first FMD case in three years (see OIE: Foot & Mouth Disease In South Korea), setting off alarm bells, and putting the nation on alert for this hard to eradicate disease.

 

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.

While there were hopes that the discover of FMD last week at a pig farm represented an isolated incident, today another outbreak has been reported on a pig farm 70 kilometers distant from the first report.   This from AFP.

 

S Korea detects second foot-and-mouth case

POSTED: 28 Jul 2014 17:56

South Korea on Monday (July 28) reported its second case of foot-and-mouth disease in less than a week. An official confirmed the case in a pig farm in North Gyeongsang province, but played down the threat.

(Continue . . . )

 

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).

 

While culling was a huge part of the control operation, South Korea also imported a Serotype 0 vaccine and instituted a `vaccinate to live’ policy, as described in the EID dispatch above:

 

According to national policy, culling began in November 2010 for all animals on farms with infected animals. Once vaccination was expanded nationwide in mid-January 2011, a vaccination-to-live policy was implemented; that is, vaccinated animals on farms with infected animals were culled only if the outbreak began within 2 weeks after vaccination but not if the outbreak began >2 weeks after vaccination.

 

As a result, a high percentage of South Korea’s livestock are vaccinated against the currently detected FMD serotype, which ought to help contain its spread.

 

Although the 7 serotypes of FMD are found all over the world, the United States has not seen an outbreak since 1929.

OIE Disease Outbreak Map – Current FMD

 

A 2013 Homeland Security report (see A World Free of one of the Most Virulent Animal Diseases?) on the creation of a new, (single sero-type) non-live virus vaccine for FMD, warns that the costs of an outbreak in this country could exceed $50 billion.

 

While definite progress, with 7 sero-types, and more than 60 known subtypes, the world remains a long way from eliminating this scourge.

OIE: Foot & Mouth Disease In South Korea

 

 

# 8863

 

Foot & Mouth Disease (FMD) is a highly contagious viral disease that primarily afflicts cloven-hoofed animals (including cattle, sheep, goats, pigs, deer, etc.) and poses a serious threat to agricultural interests around the world. It is caused by a picornavirus, and has no relation to HFMD, which is a childhood disease in humans caused by a number of non-polio enteroviruses.

 

There are seven known types and more than 60 subtypes of the FMD virus, and different types are to be found in different parts of the world. 

 

Overnight South Korea has reported their first case of FMD in 3 years, at a pig farm in Uiseong, North Gyeongsang Province (see Korea Herald report S. Korea reports first outbreak of foot-and-mouth disease).   The OIE report (see below) lists the serotype as O (PanAsia Strain), which raised international concern between 1998-2011 when it spread rapidly across Asia, Africa, & parts of Europe (cite). 

 

At this point, only one farm is known to be affected, and the following control measures are being implemented.

 

This return of FMD comes just months after S. Korea began a prolonged battled against the H5N8 avian flu virus in poultry, which resulted in the culling of millions of chickens and ducks. 

 

Both Japan and Korea detected FMD in the spring of 2010, and after the destruction of 290,000 head of livestock, Japan declared their FMD crisis over in August. In South Korea, however, the outbreaks continued into 2011, with 155 outbreaks reported.

2010-2011 FMD – Credit OIE

 

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.

 

OIE Disease Outbreak Map – Current FMD

Although South Korea hasn’t reported FMD in over three years, neighboring North Korea has reportedly been doing battle with the disease for several years (see Xinhua News: Extensive H5N1 Outbreaks In North Korean Poultry).

 

We’ll have to wait to see if this latest outbreak is limited to just one farm, or has already spread.

EID Journal: Describing 3 Distinct H5N8 Reassortants In Korea

Spread of H5N8 - Map Credit Japan’s MAFF

 

# 8373

 

Seven weeks ago a new, highly pathogenic, H5N8 avian flu virus was identified in in South Korea and was subsequently detected on a number of farms and among numerous birds in the wild (see Jan 17th report Media Reporting Korean Poultry Outbreak Due To H5N8).  Up until that time, H5N8 was normally only seen in a low pathogenic form (although one HPAI H5N8 sample had been previously described in China).

 

Despite a massive mobilization of resources against it, that virus continues its march across the Korean Peninsula, and as of three days ago had been detected in all but two provinces of South Korea. 

 

Millions of poultry have been culled, and the outbreak shows no signs of abatement. The good news, so far, is that unlike it’s H5N1 and H5N2 cousins, this H5N8 virus has not shown any inclination to infect humans.

 

Today, Arirang News is reporting an H5N8 positive goose has been found in Gwacheon, about 2 miles from the Seoul Zoo, prompting the closure of that facility.

 

Avian influenza confirmed in goose found dead in Gwacheon

Updated: 2014-03-13 PM 1:02:46 (KST)

Korean officials have confirmed another outbreak of avian influenza in a southern Seoul suburb.

The Animal and Plant Quarantine Agency confirmed Thursday that a dead bean goose found in the city of Gwacheon in Gyeonggi-do Province was infected with the H5N8 stain of the bird flu.

If confirmed to be highly pathogenic, access within 10-kilometers of the area will be restricted, which includes southern parts of the Seoul metro area.

The city has banned the movement of poultry in the area, while officials are stepping up quarantine measures and disinfection procedures are also underway.

Meanwhile, the Seoul Zoo, which is less than two kilometers away from where the dead goose was found, has decided to close its doors for the time being.

 

Against this cluttered tableau we have an ahead-of-print letter published in the CDC’s EID Journal, describing not one – but three distinct novel reassortant influenza A(H5N8) viruses - that have emerged recently in South Korea. 

 

While influenza viruses normally evolve through a process called antigenic drift – a relatively slow process where minor amino acid substitutions accrue during (flawed) reproduction –  sometimes a new `hybrid’ virus will emerge from a process called antigenic shift, or reassortment.

 Reassortment of two Avian Viruses Producing a Hybrid (Reassortant) Virus

Shift occurs when one virus swap out chunks of their genetic code with gene segments from another virus.   While far less common than drift, shift can produce abrupt, dramatic, and sometimes pandemic inducing changes to the virus (see NIAID Video: How Influenza Pandemics Occur).

 

The H5N1 virus came about from a series of these reassortment process, as did the 2009 H1N1 pandemic virus, and the H7N9 virus currently plaguing China.  Luckily, most reassortant viruses are unable to compete with existing `wild’ viruses, and quickly die out. 

 

Only rarely does one appear that is `biologically fit’ enough to thrive, else we’d be hip deep in new viruses all the time.

 

But, history has shown that these reassortants do occur, and sometimes they can be genuine game changers.

 

Some excerpts, therefore, from yesterday’s early release of a genetic analysis of H5N8 viruses sampled from Korea, appearing in the EID Journal.  Much of this is fairly technical, and those who are so inclined will want to follow the link to read it in its entirety, but I’ve excerpted some of the main points.

 

Volume 20, Number 6—June 2014

Letter

Novel Reassortant Influenza A(H5N8) Viruses, South Korea, 2014

Youn-Jeong Lee , Hyun-Mi Kang, Eun-Kyoung Lee, Byung-Min Song, Jipseol Jeong, Yong-Kuk Kwon, Hye-Ryoung Kim, Kyu-Jun Lee, Mi-Seon Hong, Il Jang, Kang-Seuk Choi, Ji-Ye Kim, Hyun-Jeong Lee, Min-Su Kang, Ok-Mi Jeong, Jong-Ho Baek, Yi-Seok Joo, Yong Ho Park, and Hee-Soo Lee

Author affiliations: Author affiliation: Animal and Plant Quarantine Agency, Anyang, Gyeonggi, South Korea

To the Editor: Highly pathogenic avian influenza (HPAI) viruses have caused considerable economic losses to the poultry industry and poses potential threats to animal and human health (www.oie.int/en/ and www.who.int/en/). Since 2003, influenza A(H5N1) viruses with a hemagglutinin (HA) gene derived from A/goose/Guandong/1/96–like viruses have become endemic to 6 countries (Bangladesh, China, Egypt, India, Indonesia, and Vietnam) (1) (www.cdc.gov/).

Furthermore, HPAI viruses with an H5 subtype continue to undergo substantial evolution because of extensive genetic divergence and reassortment between other subtypes of influenza viruses. Especially in China, novel subtypes of H5 HPAI virus, such as influenza A(H5N2), influenza A(H5N5), and influenza A(H5N8) viruses, were reported during 2009–2011 (2,3).

On January 16, 2014, clinical signs of HPAI, such as decreased egg production (60%) and slightly increased mortality rates, were detected in ducks on a breeder duck farm near the Donglim Reservoir in Jeonbuk Province, South Korea. On January 17, a farmer (5 km from the Donglim Reservoir) also reported clinical signs of HPAI in breeder ducks. In addition, 100 carcasses of Baikal teals were found in the Donglim Reservoir.

RNAs extracted from organs (liver, pancreas, and trachea) of dead Baikal teals were positive for H5 subtype virus by reverse transcription PCR (4). We isolated viruses from suspected specimens by inoculation into embryonated specific pathogen–free chicken eggs. The H5N8 subtype was identified by using HA and neuraminidase (NA) inhibition assays.

Three viruses isolated from domestic ducks and wild birds were designated A/breeder duck/Korea/Gochang1/2014 (H5N8) (Gochang1), A/duck/Korea/Buan2/2014 (H5N8) (Buan2), and A/Baikal Teal/Korea/Donglim3/2014 (H5N8) (Donglim3). All 8 RNA genome segments of these viruses were amplified by using segment-specific primers and directly sequenced (5). Sequences of the 8 RNA segments of each virus were submitted to GenBank under accession nos. KJ413831–KJ413854.

<SNIP>

We characterized 3 distinct novel reassortant influenza A(H5N8) HPAI viruses during an influenza outbreak in South Korea. Buan2 and Donglim3 viruses showed high nucleotide identities, which suggested that the outbreak viruses in domestic ducks and Baikal teals might have an identical origin. Although research on the epidemiologic features of this outbreak is currently underway, it seems likely that on the basis of reassortant sequence features of the 8 genome segments, these 2 distinct viruses originated in eastern China. These influenza viruses are a potential threat to the poultry population in South Korea, including gallinaceous birds in live bird markets, or during movement of domestic ducks from one farm to another.

 

Just as H5N1 has evolved into more than 20 clades and sub-clades (and countless variants) over the years, the HPAI H5N8 virus has at least three branches on its family tree, and more are likely to emerge over time.

 

Interestingly, the Buan2 and Donglim3 viruses are closely matched – suggesting a common origin - while the Gochang1 virus is genetically more distinct.

 

The identification of Eastern China as being the likely source of these viruses is consistent with many other studies showing that regions’ capacity for producing reassortant viruses. Last year, in  EID Journal: Predicting Hotspots for Influenza Virus Reassortment, we looked at research that ranked China as one of the globe’s top breeding grounds for new flu strains.

 

For more on the ongoing threat posed by novel reassortant viruses, you may wish to revisit:

 

Eurosurveillance:The Evolving Threat From New, Reassorted H7N9 Viruses

Lancet: Clinical & Epidemiological Characteristics Of A Fatal H10N8 Case

Viral Reassortants: Rocking The Cradle Of Influenza

The Korean `Mystery’ Pneumonia

 

 

 

 

A formerly unknown virus - SARS-CoV (coronavirus) particles (arrows) – PHIL

# 5548

 

 

While it may be of relatively little comfort, there are almost certainly a significant number of – as yet – unidentified respiratory viruses that routinely circulate among humans. 

 

Most of the time there is little about their clinical signs and symptoms to suggest anything unusual about the infection. The patient quickly recovers, and the illness is assumed to be due to one of the `usual suspects’;  a seasonal influenza, RSV, or one of the myriad rhinoviruses that plague mankind.

 

In recent years, however, with advances in microbiology and sequence-independent amplification of viral genomes, the ability of scientists to identify new viruses has improved greatly and so we are adding new names to the `suspect list’.  

 

About a decade ago the human metapneumovirus (HMPV) was identified in Dutch children with bronchiolitis.  Since then, it has been found to be ubiquitous around the world, and responsible for a significant percentage of the world’s respiratory infections . . . yet until 2001, no one knew it existed.

 

In 2003, a coronavirus called SARS-CoV emerged in China, and infected roughly 8,000 people (killing about 800) before it burned itself out. While coronaviruses were first characterized in the 1960s, and were known to cause many relatively mild upper respiratory infections (common colds) every year, a deadly strain had never been identified before.

 

Human Bocavirus-infection (HBoV) wasn’t identified until 2005, when it was detected in 48 (9.1%) of 527 children with gastroenteritis in Spain (cite).  

 

The list grows longer every year. 

 

But only a small number of virus samples are given this sort of scientific scrutiny, and so it is safe to assume there are still unknown viruses out there, waiting to be discovered.

 

Of course,  unknown (or unidentified) doesn’t necessarily mean `new’.

 

Most of the time, these viruses have been around for a long time, and classifying them has very little impact on the public’s health.

 

On very rare occasions, as in the case of SARS, we get a new player; a virus that we’ve never seen before (that we know of).  

 

For the past couple of days there have been media reports out of South Korea that suggest they may be seeing an unusually severe and potentially unknown respiratory virus – and efforts are underway to identify it.

 

Yesterday, Sharon Sanders of FluTrackers  picked on up early reports of a number of pregnant women in a Seoul Hospital with a `mystery’ respiratory virus.  Since then several more articles (some machine translated) have been posted to this ongoing thread.

 

These media reports are confusing, incomplete, at times contradictory, and just a little hyperbolic.

 

Whether there is really anything unusual going on here, is way too soon to tell.   The cause of viral pneumonia often goes unidentified.

 

That said, the following report comes from the Korea Times.

 

05-10-2011 18:36

Woman dies from unidentified viral pneumonia

By Kim Rahn

A woman died from pneumonia caused by an unidentified virus, according to the health authorities.

Fears are rampant as seven others, mostly pregnant women, are hospitalized with the same illness.

 

The Korea Centers for Disease Control and Prevention said Tuesday that a 36-year-old woman, who had been in the intensive care unit at a Seoul general hospital, died in the morning from a cerebral hemorrhage related to her condition. The unidentified woman was one of seven hospitalized for an unknown viral pneumonia.

(Continue . . .)

 

Unusually, the woman who died apparently developed rapidly progressing Idiopathic pulmonary fibrosis – a scaring and stiffening of lung tissue without a known cause that normally takes months or years to manifest.

 

Sifting through the other reports, it appears that these 9 patients:

 

• had no previous contact with each other
• have been transferred from various clinics around the country
• have occurred over an period of a month or more
• and victim’s families and contacts have not developed similar symptoms.

 

Whatever this might be (and it may be something perfectly ordinary, presenting in an unusual way), it doesn’t appear to be terribly contagious.   

 

But this is interesting.  

 

And so we’ll keep an eye on it and see if anything of note follows these reports.  

South Korea: Two New Bird Flu Outbreaks Reported

 

 

# 5311

 

 

In addition to their FMD woes, South Korea (along with Japan) have been dealing this winter with multiple outbreaks of Highly Pathogenic H5N1 – in wild birds and among poultry.

 

Over the past 6 weeks nearly 5.5 million birds have been culled at 249 farms in response to 43 reported bird flu outbreaks (farms in close proximity to outbreaks are also culled).

 

The OIE map below depicts 46 bird flu reports (includes wild birds & poultry) since last fall in South Korea.  A list of OIE Reports, and a summary, are available HERE.

 

 

Yonhap news today has a fresh report on these latest outbreaks, located near Seoul.

 

2011/02/13 13:05 KST

S. Korea confirms 2 more bird flu outbreaks

SEOUL, Feb. 13 (Yonhap) -- South Korea on Sunday confirmed two additional bird flu outbreaks in areas near Seoul despite nationwide efforts to stem the spread of the disease.

(Continue . . . )

South Korea’s experience shows just how difficult it is to contain H5N1 once it establishes a foothold in a region.

 

For now, the impact is primarily an economic one for Korea’s beleaguered agricultural sector. Bird flu remains difficult for humans to contract, and only rarely spreads from human-to-human.

 

That, of course, could change over time.

 

Each new outbreak is another opportunity for the virus to evolve, and to better adapt to new hosts.  And that could someday include humans.

 

So the world watchfully remains at Pre-pandemic Phase III for H5N1 and organizations like the FAO and the OIE, along with the resources of many nations, work to contain its spread.

FMD: North Korea’s OIE Report

 

 

# 5310

 

Late this week North Korea officially notified the OIE of a spate of recent FMD (Food and Mouth Disease) outbreaks in their nation going back to December of 2010.

 

Given the large number of outbreaks in neighboring South Korea over the past few months, and unofficial intelligence reports (see Reports: FMD Suspected In North Korea) beginning nearly a month ago, this notification wasn’t completely unexpected.

 

Foot-and-mouth (FMD) disease is a severe, highly contagious viral disease of cattle and swine. It also affects sheep, goats, deer, and other cloven-hooved ruminants. FMD is not a threat to people and no human health risks are associated with the disease. FMD is caused by a virus. Signs of illness can appear after an incubation period of 1 to 8 days, but often develop within 3 days. There are seven known types and more than 60 subtypes of the FMD virus.

 

 

FMD (not to be confused with HFMD – a usually mild viral illness common to children) is endemic in many parts of the world (Africa, Asia, South America, some parts of Europe), but has been eradicated in many others.

 

The full OIE report is available available here. 

 

It details 48 recent outbreaks involving 500 cattle, nearly 10,000 swine, and 165 goats.  The culling of livestock (if ordered) was not mentioned in this report.

 

According to this initial notification, a locally produced vaccine was employed, but it `was not effective to control the disease’.  The source of these outbreaks was listed as unknown or inconclusive.

 

The following map shows the first 48 outbreaks.

 

 

Under Epidemiological comments, this report indicates that this initial notification is incomplete, that additional outbreaks have been detected, and that further details are expected.

 

This immediate notification report has been prepared and published by the Animal Health Information Department in the meantime and outbreaks are gathered by clusters of outbreaks and by affected district. This is only an approximation of their location.

 

When the exact data on the location of each outbreak will be provided by the National Veterinary Authorities, this report will be amended to reflect more precise locations of the outbreaks and the disease distribution. Not all the outbreaks are processed since approximate geographic locations have not been found.

 

There are additional outbreaks notified in January that are not yet processed and that will be processed as soon as the completed information is received from the country.

 

South Korea meanwhile continues to struggle with their own outbreaks of FMD, with their latest OIE report showing 148 outbreaks since November of 2010.

 

Both Japan and South Korea detected FMD in the spring of 2010, and after the destruction of 290,000 head of livestock, Japan declared their FMD crisis over in August.

 

South Korea, however, continues to find infected livestock and has destroyed millions of head of their combined swine & cattle herds in an effort to contain the virus.

North Korea: FMD Outbreak

 

 

# 5306

 

 

Three weeks after the first intelligence reports emerged suggesting that North Korea was battling outbreaks of FMD (Foot and Mouth Disease) (see Reports: FMD Suspected In North Korea), the NK government has reportedly requested assistance from the UN in combating the disease.

 

Two media reports, then I’ll return with a bit more on FMD. First this from the Korean Herald.

 

U.N. to help with FMD outbreaks in N.K.

2011-02-11 19:13

Seoul remains lukewarm toward assistance amid stalemate in ties

The U.N. has said it will send experts to North Korea next week over a purported foot-and-mouth disease outbreak, in the first international move to help the impoverished state curb the fast-spreading livestock virus.

(Continue . . . )

 

And this from the Daily NK, a NK government opposition newspaper published in South Korea.

 

North Korea Calls for FMD Assistance

By Cheong Sun Jin, Intern

[2011-02-10 17:52 ]  

North Korea has confirmed suspicions that it is battling an outbreak of foot-and-mouth disease, meaning that the disease has now reached every corner of the Korean Peninsula. Pyongyang unexpectedly reported the outbreak to the United Nations’ Food and Agricultural Organization (FAO) yesterday, according to Radio Free Asia (RFA).

(Continue . . .)

 

Given that diseases tend not to respect political borders, even one as tightly controlled as the Korean DMZ, it isn’t altogether surprising that North Korea should be seeing outbreaks at the same time that South Korea is dealing with the worst FMD epidemic in their history.

 

According to a recent AFP report, South Korea’s agriculture ministry has spent (US) $1.7 billion fighting their FMD epidemic, culling and burying more than 3 million head of livestock since November. At the same time, the South has been combating a major outbreak of bird flu.

 

FMD (not to be confused with HFMD – a usually mild viral illness common to children) is a highly contagious viral disease that affects cloven hoof animals, but almost never `infects’ humans.

 

The virus primarily spreads through the movement of infected animals, contaminated vehicles, or feed.

 

Humans are also capable of spreading the disease, as the virus may be carried on clothing and footwear for days, and reportedly can remain viable in human nasal passages for more than 24 hours.

 

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.

 

(current outbreaks FMD – Source OIE)

 

There are 7 known types of FMD, along with numerous sub-types. Immunity to one type does not provide immunity to the others, and the virus continues to mutate, making it even harder to create and maintain vaccine stocks.

 

Both Japan and Korea detected FMD in the spring of 2010, and after the destruction of 290,000 head of livestock, Japan declared their FMD crisis over in August.  

 

In South Korea, however, outbreaks have continued. In an attempt to control FMD, in addition to culling, South Korea has embarked on an extensive vaccination campaign.

 

North Korea, on the other hand, lacks many of the basic resources found in the South. Chronic food shortages make culling of animals a difficult choice, and vaccines against FMD are currently unavailable in the north.

 

South Korea has supplied emergency relief supplies and expertise to the North in the past when FMD was reported.  But in the wake of the attack on Yeonpyeong Island in November and the sinking of South Korea's Cheonan warship last March, relations between the two nations are in serious decline.

 

While there is little enthusiasm for assisting the North in the wake of these recent provocations, allowing a virulent animal disease to spread unchecked just across the DMZ may ultimately prove to be a far less attractive option.

Reports: FMD Suspected In North Korea

 

 

 

# 5239

 

 

While not totally unexpected, the announcement today that FMD (Foot & Mouth Disease) has apparently been detected in North Korean livestock is worrisome news.

 

First, links to several reports (h/t Makoto on FluTrackers for the first one), then some discussion.

 

From the Korea JoongAng Daily:

 

Foot-and-mouth now in North, says military

 

January 18, 2011

North Korea is apparently suffering from its own bout of foot-and-mouth disease, according to a South Korean military official.

 

“According to South Korean and U.S. intelligence, roads have been blocked by the military near Pyongyang to decrease movement of people,” said the official, who asked not to be named. The source said that quarantine measures are proving difficult for North Korea, which lacks preventive medicine such as vaccines and quicklime in which to bury contagious animals.

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From the Korea Times:

 

N. Korea may have FMD outbreak

Kim Young-jin

Foot-and-mouth disease, which has caused South Korea to put down some two million heads of livestock, may have hit North Korea as well, officials here said Tuesday.

 

The officials cited recent visitors to the North who claim the disease broke out late last year in the northern part of the country.

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And from the DailyNK:

 

Intelligence Suggests North Korea Suffering FMD

By Kim So Yeol

[2011-01-18 18:28 ]  

Evidence has emerged that foot-and-mouth disease (FMD) may have broken out in North Korea. Therefore, the question of whether the South Korean government might provide aid to combat any proven outbreak of the disease has arisen.

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We get very little direct news out of North Korea, and frequently must rely on observations from the few international relief workers allowed in and out of their country, and military intelligence analyses.

 

Often these stories are never verified.

 

The food situation in the North has been described as dire for several years, and so the reports above that suggest that infected livestock are being consumed rather than culled – while not verified – at least sound plausible.

 

FMD is described by the USDA thusly:

 

Foot-and-mouth (FMD) disease is a severe, highly contagious viral disease of cattle and swine. It also affects sheep, goats, deer, and other cloven-hooved ruminants. FMD is not a threat to people and no human health risks are associated with the disease. FMD is caused by a virus. Signs of illness can appear after an incubation period of 1 to 8 days, but often develop within 3 days. There are seven known types and more than 60 subtypes of the FMD virus.

 

FMD (not to be confused with HFMD – a usually mild viral illness common to children) 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.

 

Both Japan and South Korea detected FMD in the spring of 2010, and after the destruction of 290,000 head of livestock, Japan declared their FMD crisis over in August.

 

South Korea, however, continues to find infected livestock and has destroyed roughly 15%  (2.1 million animals) of their combined swine & cattle herds in an effort to contain the virus.

 

South Korea has also reportedly destroyed more than 3 million poultry in response to their recent bird flu outbreaks (see S. Korea: Bird Flu Moves North).

 

This is the latest Reuters report on the culling of livestock in South Korea:

 

Major culling in S Korea over foot-and-mouth

Published: 6:09PM Tuesday January 18, 2011 Source: Reuters

 

 

FMD is very difficult to eradicate, as is evident by the ongoing struggles in South Korea to contain their recent outbreak. 

 

North Korea, which lacks many of the resources found in the South, is far less well equipped to deal with an FMD outbreak.

 

Although South Korea has supplied emergency relief supplies and expertise to the North in the past when FMD was reported, in the wake of the attack on Yeonpyeong Island in November and the sinking of South Korea's Cheonan warship last March, relations between the two nations are in serious decline.

 

Aside from the obvious humanitarian issues involved, the destabilizing effects of another agricultural/food crisis in North Korea - combined with the prospect of having FMD becoming entrenched in a neighboring country – should make these latest reports of particular concern to interests in both South Korea and China.

Korea: H5N1 & FMD Outbreaks Continue

 

 

 

# 5227

 

 

Today’s report from Yonhap News indicates that 7 new outbreaks of H5N1 were detected today (Thursday) on poultry farms in central and southeastern South Korea, along with two more reports of FMD in livestock.  

 

This brings the total number of outbreaks of bird flu reported in the past 14 days to 23.

 

On Wednesday Seoul announced the intent to vaccinate all potentially exposed livestock in the country against FMD.  Up until now, vaccination  has been limited due to fears that it would extend the time before the nation could regain FMD free status.

 

To date, roughly 10% of that nation’s 10 million pigs and 3.4 million cattle have been culled due to the disease.

 

For more on the ongoing FMD crisis see South Korea Battles Bird Flu, FMD.

 

Additionally, over the past 2 weeks more than 3 million birds have reportedly been culled due to the growing H5N1 crisis, and the nation’s bird flu alert level has been raised to `Orange’; the second highest level.

 

You’ll find more details on these dual animal disease disasters in this Yonhap News report:

 

2011/01/13 15:17 KST

S. Korea confirms more FMD cases in central, southeastern regions

S. Korea Confirms H5N1 On Two Poultry Farms

 

 

# 5194

 

 

In a story we’ve been following for several days, last night officials announced that two poultry farms located in different parts of South Korea have tested positive for the highly pathogenic H5N1 bird flu virus.

 

Culling is reportedly complete at a duck farm in Cheonan and a poultry farm in Iksan City.  Both farms remain under quarantine, and movements of vehicles and people are restricted.

 

 

In recent weeks there have been more than a half dozen bird flu reports out of South Korea and Japan, involving 3 farms (2 in Korea, 1 in Japan) and a number of wild and/or migratory birds.

 

Both countries have been reported free of the H5N1 virus since 2008.  A few recent reports include:

 

Korea: 2nd Farm Investigated For Bird Flu

South Korea Investigating Cheonan Duck Farm

South Korea Finds 2 H5N1 Infected Owls

Korea: Bird Flu Discovered In Teal Ducks

 

 

Although a number of media sources are now carrying the story of the confirmation, this one (hat tip Shiloh on FluTrackers) comes from Yonhap News.

 

2010/12/31 10:44 KST

S. Korea confirms bird flu outbreak at 2 poultry farms

SEOUL, Dec. 31 (Yonhap) -- South Korea on Friday confirmed its first bird flu outbreak in two years at two poultry farms in the central and southwestern part of the country.

 

The outbreaks at the farms in Cheonan and Iksan, 90 and 230 kilometers south of Seoul, respectively, were first detected on Wednesday after birds started to die off.

 

Both farms have been placed under quarantine with authorities moving to cull and bury their ducks and chickens to prevent further spreading of the disease.

 

(Continue . . . )

 

 

During their last H5N1 outbreak in April-May 2008, South Korea waged a month-long, very expensive battle to contain the virus that resulted in the culling of more than 8 million birds.  

 

Since then, South Korea has conducted year-round monitoring for the bird flu virus (see South Korea To Begin Year-Round Bird Flu Monitoring) in hopes of preventing future outbreaks.

 

In the wake of these latest discoveries, health officials are stepping up inspections, and poultry operations are being urged to increase biosecurity measures.

South Korea Finds 2 H5N1 Infected Owls

 

 

 

# 5132

 

 

After several major bird flu outbreaks over the years, including the wave of H5N1 that swept the country’s poultry farms in 2008 (see here, here, and here), South Korea now mounts an aggressive annual surveillance program starting each fall and running through the spring.

 

The incidence of H5N1 infection among wild birds, and their role in spreading the disease, has been a subject of considerable debate over the years.

 

We’ve seen conflicting studies (and a good deal of rhetoric) that either implicate or exonerate wild or migratory birds as significant vectors of the virus.

 

A few blogs on that contentious debate include:

 

Another Migratory Bird Study

Not One Of The Usual Suspects

FAO: On The Trail Of Avian Influenza

The Migratory Bird Connection

India: The Role Of Migratory Birds In Spreading Bird Flu

 

 

The poultry industry would, naturally, like to lay the problem mainly at the perch of wild and  migratory birds. Naturalists tend to see poor biosecurity in poultry operations - and the illicit poultry trade - as the real culprits.

 

Personally, I’ve never seen any reason why these should be viewed as mutually exclusive options. Both could be major contributors, perhaps with one being a bigger factor than the other depending on where in the world you happen to be.

 

As one might suspect, when you actively look for bird flu . . .  you are more apt to find it.  At least in those regions (primarily Asia) where the virus is endemic.

 

And so it was of little surprise that earlier this week South Korea announced the discovery of a single duck at a wild migratory habitat that tested positive for the H5N1 virus.

 

2010/12/08 00:41 KST

S. Korea confirms bird flu outbreak in southern province

SEOUL, Dec. 8 (Yonhap) -- The South Korean government confirmed on Tuesday a bird flu outbreak in a southwestern region of the country, a main winter habitat of migratory birds.

The agricultural ministry said the state veterinary service confirmed that the bird flu virus was found in one of the blood samples sent from Iksan, North Jeolla Province.

The ministry conducted an emergency disinfection of the area around the Mangyeong River, where the infected wild bird was found, and put an area within a 10-kilometer radius from the site of the outbreak under intensive care.

 

 

While calling a lone infected duck an `outbreak’ might seem to be stretching the definition a bit, H5N1 is a communicable disease in birds, and so where you find one you are apt to find others.

 

Today, Yonhap news is reporting on the discovery of two more infected birds, although the location given is too vague to tell how far removed these cases are from the one reported earlier this week.

 

First the news report,  then a little more.

 

2010/12/10 17:34 KST

S. Korean quarantine officials find dead owls affected by bird flu

SEOUL, Dec. 10 (Yonhap) -- South Korean quarantine officials found two dead eagle owls infected with the virulent strain of bird flu in the central western part of the country on Friday.

 

The farm ministry, however, said that the discovery of the owls did not mean South Korea was affected by the disease since no domestically raised ducks and chickens have become sick from the highly contagious influenza. Exports of poultry will not be affected by the discovery, it stressed.

 

Eurasian Eagle Owl (Bubo bubo)

 

While the List of Species Affected by H5N1 (Avian Influenza) is long (and growing), somewhat surprisingly, owls have only rarely been mentioned.

 

 

 

Most wild birds are thought to become infected through the sharing of virally contaminated water sources.  H5N1 is primarily a gastrointestinal infection in birds, and is generally believed spread through infected feces.

 

Owls,  as opportunistic hunters - have another likely route of infection; the consumption of infected prey.

 

The Eurasian eagle owl is one of the largest owls in the world, and so is quite capable of taking medium sized quarry. Its diet includes mice, rats, rabbit, squirrels and other birds.

 

A scan of the USGS H5N1 database shows that rats, mice, and even rabbits ((a veritable smorgasbord for owls) . . .  along with many species of birds, have all been discovered carrying the H5N1 virus. 

 

So the discovery of two dead owls leads one to suspect there are more infected birds and/or animals in the region.

 

While the detection of a few wild birds with H5N1 in one week in Korea is hardly alarming, it is a reminder that the virus continues to exist, and spread, in the wild. 

 

So surveillance efforts, such as the one ongoing in South Korea and those mounted each year by the USGS, are important measures to help quantify, control, and contain the threat.

South Korean Military In Virtual Lockdown

 

# 3951

 

 

With an unpredictable and oft times hostile neighbor to their north, and a divided peninsula that North and South Korea both claim as their own, the military readiness of South Korea is a constant concern.

 

South Korea maintains the world’s sixth largest number of active troops, the world's second-largest number of reserve troops.  Their defense budget is the 12th largest in the world.

 

Anything that might reduce that readiness is viewed with alarm, and so today the South Korean Military has enacted a number of drastic measures to try to reduce the spread of the H1N1 virus among their ranks.

 

This from the Korea Times.

 

 

Military Takes Drastic Measures Against Flu

By Bae Ji-sook
Staff Reporter

Soldiers have been barred from taking leave and getting overnight passes or receiving visits from outside in order to block the transmission of the fast-spreading influenza A (H1N1) virus.

 

Training schedules for reserve forces, about 300,000 in total, have also been cancelled, the Ministry of National Defense announced Wednesday.

 

Those who are confirmed as patients or are suspected of contracting the flu will have their mandatory military drafting deferred.

 

"To contain transmission, the commanders will be given discretion in troop mobilization," a ministry official said. "Soldiers will be discharged as scheduled and be given emergency leave, but regular holidays and overnight passes will be suspended."

 

A total of 1,455 soldiers were confirmed as patients as of Wednesday. A total of 1,369 have fully recovered, with the rest being treated at military hospitals.

 

The defense ministry will have vaccinated its medical staff by Thursday and complete all inoculations by February.

 

The National Emergency Management Agency suspended the training of 650,000 members of the civil defense corps.

 

The measures came as the central government raised the national alert level to its highest Wednesday.

 

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