Taiwan’s H5 Outbreak Continues: 655 Farms Affected, 2M+ Culled

Credit FAO

 

# 9667

 

Despite Taiwan’s reassurance on the effectiveness of their poultry biosecurity measures, just a little over three weeks after their first farm infection was announced (see Taiwan: HPAI H5N2 Outbreak in Pingtung County), their mixed- subtype HPAI H5 outbreak has now spread to more than 650 farms, and has resulted in the culling of more than 2 million birds.

While the H5N8 virus was believed introduced by migratory birds, the post mortem analysis on how this virus has managed to spread so quickly, and to so many farms, will be of considerable interest.

 

As the following report notes, we are just a couple of week from the spring festival (aka Lunar New Year), an extended holiday that traditionally features both massive travel across Asia and the liberal consumption of poultry.  For more on the public health challenges of this New Year’s celebration, you may wish to revisit last week’s Health Vigilance Urged For China’s Spring Festival.

 

This from Xinhua News.
 

 

 

Over 2 million poultry culled in Taiwan

Feb 03,2015

TAIPEI, Feb. 2 (Xinhua) -- More than 2.14 million chicken, ducks and geese have been culled in Taiwan as one of the most severe avian flu outbreaks in a decade continues to cause huge losses, Taiwan's agriculture authority said on Monday.

Of all tested farms, 655 in 14 cities or counties have been confirmed as infected with H5 strains of the virus.

All cities and counties in the island have been required to complete their epidemic prevention plans for the Spring Festival period by Friday. Lunar New Year, which falls on Feb.19 this year, usually sees a surge in transportation and consumption of poultry and eggs.

As part of epidemic prevention, culls and disinfection of farms were carried out in affected areas, particularly in Changhua, Yunlin, Chiayi, Tainan and Pingtung.

Taiwan Bird Flu: Eating Chicken Is Safe – Raw Raw Raw!

Credit China Times

 

# 9647

 

One of last year’s genuinely `bad ideas’ came from Saudi Arabia, where for a time it became a thing to post pictures of people kissing camels in order to prove that `beauty’  did not spread the MERS coronavirus. 

 

While there is no evidence that anyone died from this practice, it nonetheless undermined their public health’s messaging on MERS prevention, which recommends wearing masks and gloves around camels.

 

Today, in the midst of Taiwan’s worst avian flu outbreak (in poultry) in a decade, with more than 500 farms affected and well over 1.5 million birds culled, we have an ill advised PSA emerge from the Taipai City council meeting where several people apparently ate raw chicken in solidarity with the embattled poultry producers  to prove it’s safety.

Given the general prevalence of Campylobacter, E. coli  and Salmonella in raw poultry, exposure to bird flu may be the least of the dangers of consuming chicken tartare. 

But desperate economic times apparently call for desperate measures.  This from the China Times.

 

Taiwan members of the bird flu outbreak Taipei, raw chicken leg chicken farmers (photo)

16:22 on January 30, 2015 source: China News Network to the engagement (0)

 Beijing, January 30, according to Taiwan's China Times reported bird flu outbreaks spread throughout the island, people can smell chickens, chicken raising business plunge, several Taipei City councilors 29th came out to support farmers, Mr Lin Ruitu followed by eating raw chicken meat, called "to be a human Guinea pig, eat to see if any deviations from the".

It was reported that the Tipei City Council on 29th "save chicken farmers" activities, a number of city councillors to attend solidarity speaker Wu Bizhu said in Taipei, she will tell "Government" in the fight against bird flu at the same time, don't forget the chicken farmers livelihoods.

Reports said Mr llyr was eating raw chicken leg, in places someone exclaim, discourage, but Lin Ruitu insisted, before eating says "to dip soy sauce or eat."

(Continue . . .)

 

Forget the soy sauce, what this dish needs is a nice combination oseltamivir-penicillin-imodium dipping sauce.

Taiwan CDC: Genetic Analysis Of H5N2/H5N8

Credit FAO 

 

 

# 9627

 

Despite the fearsome reputation of H5N1 as a threat to human health, other H5 avian viruses have demonstrated a wide range of pathogenicity in people. Even among H5N1 clades, not all viruses are created equal. We’ve seen considerable variability in that subtype’s ability to infect, and kill around the globe (see Differences In Virulence Between Closely Related H5N1 Strains).

 

In Bangladesh, only 1 (14%) of  7 known H5N1 cases has died, while in Cambodia 37 of 56 (66%) have succumbed. In Egypt, the CFR is running about 35%, while in Indonesia, it is a stratospheric 83%.

 

Although there are likely many factors involved in causing this disparity in CFRs – including quality of, and delays in seeking medical care – it suggests that the H5N1 virus may be more virulent in some regions of the world than in others.

 

The recently emerged H5N6 is known to have killed at least two people (see WHO GAR Update – H5N6 In China), but the (old) H5N2 virus appears to have – at most – produced antibodies in a handful of poultry workers and The Human Risk From H5N2 Is Considered Low.

Over the past year we’ve watched the emergence of a new, robust Highly Pathogenic (in birds) H5N8 virus that has spawned several other reassortant subtypes – including a new H5N2 – which have spread quickly via migratory birds to poultry farms across Korea, China, Taiwan, Japan and have even made it into Europe and the Pacific Northwest.

Despite a good deal of infected-poultry-to-human contact, we’ve not seen any evidence of these new subtypes causing illness in humans.

 

Granted, cullers are using PPEs and some are probably receiving prophylactic antivirals, but many poultry workers have had unprotected exposure prior to detection and culling, and none have (as yet) become sick. Despite this reassuring track record, Taiwan public health authorities are monitoring nearly 3,000 people who have been exposed.

 

Below you’ll find a statement by Taiwan’s CDC on recent genetic analysis of their recently arrived H5N8 and H5N2 subtypes,  that cautiously finds them to pose little threat to human health.

 

Gene sequence alignment of avian flu viruses shows transmission still limited to poultry; Taiwan CDC continues to closely monitor outbreak situation to ensure health and wellbeing of people in Taiwan ( 2015-01-26 )

In the afternoon of January 23, 2015, the Taiwan Centers for Disease Control obtained the genome sequences of the H5N2 and H5N8 viruses from the Council of Agriculture and submitted it to the National Influenza Center for gene sequence alignment.  The results showed that both the H5N2 and H5N8 viruses are of avian origin.  Based on the sequence data, the Taiwanese viruses were identified as closely related to the Japanese, the American, the Canadian, the German and the Republic of Korea H5N8 viruses. 

Unlike the H7N9 virus, the H5N8 virus does not replicate well in mammalian cells and is not as fatal.  Although several H5N8 outbreaks have been reported many countries around the world, no evidence of bird-to-human transmission has been found.

Taiwan CDC once again emphasizes that the H5N2 and H5N8 viruses are currently still limited to transmission among poultry and no bird-to-human transmission has occurred. As for treatment, the US Centers for Disease Control (US CDC) and the World Health Organization (WHO) currently recommend oseltamivir or zanamivir.  Taiwan CDC will continue to closely monitor the development of the outbreaks and the viruses for new mutations in order to facilitate timely implementation of relevant disease control measures and ensure the health and wellbeing of the people in Taiwan.

In response to the ongoing avian influenza outbreaks among poultry, Taiwan CDC is monitoring everyone who has been exposed to the poultry farms where avian influenza outbreaks have occurred, including poultry farm workers and public health workers, for influenza-like symptoms for 10 days as a precaution.  Those who develop influenza-like illness will be further evaluated and tested for influenza. As of January 24, 2015, a total of 2,906 people are being monitored.  Of the people being followed up, 40 people have developed influenza-like symptoms. Specimens have been collected from 28 of them (1 is positive for seasonal influenza, the other 23 are negative and 4 tests results are pending),while the other 12 people are still being monitored for their health status.  76 other people have been removed from surveillance.

Taiwan CDC reminds poultry farm workers to take additional preventive measures to ward off infection.  If fever or influenza-like symptoms develops,please put on a mask and seek immediate medical attention.  Moreover, poultry farm workers must inform the physician of their exposure and job history to facilitate diagnosis and treatment.  The general public is urged to practice good personal hygiene such as washing hands frequently and putting on a mask when coughing and take preventive measures such as avoiding direct contact with poultry and birds or their droppings/dead bodies, and consuming only thoroughly cooked poultry and eggs to prevent infection.  For more information, please visit the Taiwan CDC website at http://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Consultation Hotline, 1922 (or 0800-001922).

 

So far, good news indeed.  The lack of replication in mammalian host cells is particularly encouraging. 

 

The caveat being that flu viruses are constantly changing, and what we can say about their behavior today, cannot be guaranteed tomorrow.

Health Vigilance Urged For China’s Spring Festival

Credit CDC

 

# 9626

 

In China, it is often called Chunyun, Chinese New Year, or simply, The Spring Festival.  In Korea it is called Seollal. While in Vietnam it is celebrated as Tết Nguyên Đán ; the Feast of the First Morning.  Tết for short.

 

By whatever name, the Lunar New Year is undoubtedly the most important holiday in all of Asia

 

Each year it inspires the largest migration of humans on the planet as hundreds of millions flee the big cities and return to their home towns for a few days to attend a reunion dinner with their families - preferably on the eve of the lunar New Year.

 

The entire Spring festival travel season begins about 2 weeks before the Lunar New Year, and runs for about 6 weeks. With the New Year falling on February 19th this year, we are 10 days from the start of an event which could see more than 3 billion passenger journeys – mostly by crowded train –  across Asia over the next 60 days.

 

Ducks, geese, and chickens figure prominently at many of these family dinners, and the live markets do tremendous business during this time of year.  Many cities are therefore reluctant to halt the trade in live birds until after the New Year.

 

As all of this occurs during the height of the regular flu season, and concurrent with China’s winter spike in avian flu cases, public health agencies are understandably alert to the possibility of seeing a post-holiday surge in illnesses, including influenza, measles, malaria, tuberculosis and food poisoning. 

 

In 2010, in The Impact Of Mass Gatherings & Travel On Flu Epidemics , we looked at a study  published in BMC Public Health, that looked at and attempted to quantify the impacts of mass gatherings and holiday travel on the spread of an influenza epidemic.

 

And in 2011, in Viruses With A Ticket To Ride, we looked at research that appeared in BMC Infectious Diseases, that looked at the incidence of ARI (Acute Respiratory Infection) presenting within 5 days of train or tram travel in the UK. They found that recent  bus  or  tram  use  within  five  days  of  symptom  onset  was  associated  with  an  almost  six-fold  increased  risk  of  consulting  for  ARI.

While seemingly a strong finding, this observational study was limited by its small size, the fact that it was only conducted in a single location (Nottingham, UK), and that it was conducted during a normal flu season, not a pandemic.

The good news is, that while mass gatherings may provide greater opportunities for disease outbreaks, history has shown that major epidemic outbreaks have been a rarity (for a notable exception, see The Impact Of Mass Gatherings & Travel On Flu Epidemics).

 

While the risks of seeing a major disease outbreak in any given year are small, public health authorities must anticipate and prepare for the worst.  A few days ago Taiwan’s CDC issued the following advisory for those intending to travel to mainland China.

 

Press Releases

As H7N9 outbreak escalates in China, Taiwan CDC reminds travelers visiting China to heighten vigilance for avian flu

( 2015-01-22 )

As the ongoing H7N9 outbreak in China escalates and the winter break and the Chinese New Year Holiday are fast approaching, the Taiwan Centers for Disease Control (Taiwan CDC) reminds travelers visiting China to heighten their vigilance for avian influenza and practice good personal hygiene and avoid contact with poultry and birds and consume only thoroughly cooked poultry and eggs in order to ward off infection.

In light of a significant increase in the number of H7N9 cases (29), which were confirmed in mostly Fujian Province and Guangdong Province, China, last week, Taiwan CDC has issued a travel notice of Level 2: Alert for avian influenza to Xinjiang Uyghur Autonomous Region, Jiangsu Province, Zhejiang Province, Guangdong Province, Fujian Province, Shanghai City, and Jiangxi Province, and a travel notice of Level 1: Watch for avian influenza to the other provinces and cities in China, excluding Hong Kong and Macau.

<SNIP>

Taiwan CDC once again urges travelers visiting China to practice good personal hygiene such as washing hands frequently and putting on a mask when coughing and take preventive measures such as avoiding direct contact with poultry and birds or their droppings/dead bodies, and consuming only thoroughly cooked poultry and eggs. If influenza-like illness symptoms develop upon arriving in Taiwan, please voluntarily notify the airline crew and the quarantine officer at the quarantine station in the airport. If symptoms such as fever and cough develop after returning to Taiwan, please put on a surgical mask and seek immediate medical attention.  Moreover, please inform the physician of the recent travel and exposure history to facilitate diagnosis and treatment. For more information, please visit the Taiwan CDC website at http://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Consultation Hotline, 1922 (or 0800-001922).

 

And for some health and safety tips from America’s CDC, we have following from the CDC Travelers Health Website.

 

Lunar New Year 

Released: January 13, 2015

The Year of the Goat begins on February 19, 2015, and many travelers will visit Asia to celebrate the Lunar New Year. If you are traveling to Asia, plan ahead for a safe and healthy trip.

Every destination has unique health issues of which travelers need to be aware. To find specific information about the places you are traveling, visit our destination pages. In addition to being up-to-date on routine vaccines, you will find vaccine and medicine recommendations, along with many other tips for safe and healthy travel.

What can travelers do to protect themselves?

Before your trip:

• Schedule an appointment with your healthcare provider at least 4–6 weeks before you depart. Talk to your doctor or nurse about vaccines and medicines recommended for your destination. Travelers who want to reduce their risk of seasonal flu should receive the flu vaccine at least 2 weeks before departure. See the Travel Clinics webpage for help in finding a travel medicine clinic near you.
• Consider travel health and medical evacuation insurance.
• Pack a travel health kit.

During your trip:

• Choose safe transportation: Motor vehicle crashes are the #1 killer of healthy US citizens in foreign countries. Read about ways to prevent transportation injuries by visiting the Road Safety page.
• Reduce your exposure to germs: Wash your hands often, and avoid contact with people who are sick. Read more about reducing your exposure to germs in the “Stay Healthy and Safe” section of the destination page.
• Prevent mosquito bites: Diseases spread by mosquitoes, such as malaria, dengue, chikungunya, and Japanese encephalitis, are common throughout Asia. Read more about ways to prevent bug bites by visiting the Avoid Bug Bites page. You may also need to take prescription medicine to protect against malaria or get a vaccine against Japanese encephalitis. Talk to your doctor or nurse about prevention steps that are right for you and your destination.
• Follow food and water safety guidelines: Eating contaminated food and drinking contaminated water can cause illnesses such as hepatitis A, typhoid fever, and travelers’ diarrhea. Read about how to prevent these diseases by visiting the Safe Food and Water page on the Travelers’ Health website.
• Do not touch birds, pigs, or other animals, and avoid farms and poultry markets: Bird flu strains, such as H7N9 and H5N1, are flu viruses that have been seen in China.

• If you feel sick during your trip:
• Talk to a doctor or nurse if you feel seriously ill, especially if you have a fever.
• For more information about medical care abroad, see Getting Health Care Abroad.
• Avoid contact with other people while you are sick.

After your trip:

• If you are not feeling well after your trip, you may need to see a doctor. If you need help finding a travel medicine specialist, see Find a Clinic. Be sure to tell your doctor about your travel, including where you went and what you did on your trip. Also tell your doctor if you were bitten or scratched by an animal while traveling.
• If your doctor prescribed antimalarial medicine for your trip, keep taking the rest of your pills after you return home. If you stop taking your medicine too soon, you could still get sick.
• Malaria is always a serious disease and may be deadly. If you become ill with a fever either while traveling in a malaria risk area or for up to 1 year after you return home, you should seek immediate medical attention and should tell the doctor about your travel history.
• For more information, see Getting Sick after Travel. 

 

While each year public health agencies gear up for the Hajj, The Lunar New Year, the Super Bowl, and other mass gathering events - and rarely does anything really bad happen - the old adage is true.

 

`When public health works, nothing happens’.

Taiwan CDC: Monitoring 1300+, But No Human H5 Cases Detected

 

# 9613

 

If there is any good news to be had in Taiwan’s massive avian flu outbreak, it is that despite monitoring hundreds of people who have had contact with infected birds, as of January 20th no human infections have been reported.

 

While sharing some of the gene segments with the hard-to-catch but often-deadly H5N1 virus, H5N8 derived viruses (including Taiwan’s new H5N2 & H5N3) have not demonstrated the ability to infect humans. 

 

That could change, of course, as the virus evolves or reassorts with other viruses – but for now it is reassuring news.  

 

Last spring, during Korea’s major outbreak of H5N8 - while no human cases were detected - 11 dogs at 2 poultry facilities developed antibodies to the virus. Hopefully, a few weeks from now, serological tests will be performed on these `contacts’ to see if any of them display raised antibody titers for these new viruses.

 

This from Taiwan’s CDC.

 

 

Although no bird-to-human transmission of avian influenza occurs, Taiwan CDC continues to closely monitor outbreak situation to ensure health and wellbeing of people in Taiwan

( 2015-01-21 )

In response to the occurrence of avian influenza infections in local poultry farms, the Taiwan Centers for Disease Control (Taiwan CDC) will continue to closely monitor the health status of poultry farm workers and disease control personnel. As of January 20, 2015, a total of 1,377 people are being monitored and followed up for influenza-like symptoms. At the time of writing, no bird-to-human transmission of avian influenza has occurred. Poultry workers working at poultry farms where avian influenza infections have occurred are urged to voluntarily notify the local health bureau when respiratory symptoms develop during the health monitoring period for assistance in seeking medical attention.

The ongoing avian influenza outbreak in poultry continues to persist. Although no bird-to-human transmission of H5N2, H5N8, and H5N3 has occurred, Taiwan CDC is monitoring everyone who has been exposed to the poultry farms where avian influenza outbreaks have occurred for influenza-like symptoms for 10 days as a precaution. Those who develop influenza-like illness will be further evaluated and tested for influenza. Of the 1,377 people being monitored and followed up, 32 people have developed influenza-like symptoms. Specimens have been collected from 22 of them (1 is positive for seasonal influenza and the other 21 are negative), while the other 10 people are still being monitored for their health status. 3 other persons have been removed from surveillance.

Taiwan CDC has been maintaining an effective communication channel with the Council of Agriculture to frequently exchange information concerning animal and human influenza outbreaks, including the location of the outbreak, the type of the virus that caused the outbreak, and the contact information of the people involved in the outbreak. As soon as Taiwan CDC was notified of the recent avian influenza outbreaks in local poultry farms by the Bureau of Animal and Plant Health Inspection and Quarantine, Council of Agriculture, Taiwan CDC has been implementing relevant disease control measures correspondingly and according to the standard operation procedures outlined under the “Animal Influenza Preparedness and Response Guidance” in the “Handbook for the Control and Prevention of Novel Influenza A Virus Infections”, including proactively investing the disease outbreaks, conducting relevant health education, compiling lists of contacts, issuing health-monitoring notices, and proactively monitoring and following up on potentially exposed individuals who have developed influenza-like symptoms.

Taiwan CDC reminds poultry workers to take additional preventive measures to prevent infection. If fever or influenza-like symptoms develops, please put on a mask and seek immediate medical attention. Moreover, poultry workers must inform the physician of their job and exposure history to facilitate diagnosis and treatment. For more information, please visit the Taiwan CDC website at http://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Consultation Hotline, 1922 (or 0800-001922).

• Last modified at 2015-01-21
• Data from Division of Planning and Coordination

Taiwan’s HPAI H5 Outbreak Expands – 239 Farms Confirmed

 

# 9597

 

Taiwan’s Council of Agriculture has confirmed that 239 poultry farms have now tested positive for one of the four types of HP H5 avian flu (H5N2, H5N2 new, H5N8, H5N3 new) spreading across their island . Focus Taiwan reports that as of 6pm Sunday Evening among those farms includes `51 farms that were infected with H5N8, 15 with a new variant of H5N3 and 99 with a new variant of H5N2’.

 

In a significant development, the new H5N2 – a reassortant of the recently arrived H5N8 virus and an N2 subtype - has also moved from just infecting waterfowl, to infecting poultry as well.

 

This report from Channel News Asia:

 

Bird flu detected in Taiwan chickens as more poultry culled

TAIPEI: New avian flu strains H5N2 and H5N8 have spread from waterfowl to chickens in Taiwan for the first time.

The highly pathogenic viruses have infected chicken farms in Pingtung and Changhua counties of southern Taiwan, raising fears that the avian flu outbreak could get out of control.

Based on the latest data released by the Council of Agriculture, 239 poultry farms have been infected since the outbreak on Jan 9. The number of poultry dead or culled climbed past 650,000 on Monday (Jan 19). As the outbreak continues to spread among chickens, geese and ducks, that number is fast approaching 1 million.

Geese are the worst affected, with more than 30 per cent of the island's total population infected. But the numbers of infected ducks and chickens so far remain under control.

(Continue . . .)

How these highly pathogenic viruses have managed to spread so extensively in this short amount of time in a country well-versed in dealing with avian flu, and supposedly boasting excellent biosecurity, remains to be explained. 

 

While focus right now is on containment, the post mortem review on all of this is likely to be very messy, 

 

Already there are suggestions in the press that officials have ignored and failed to clean up low path (LPAI) outbreaks over the past 11 years, allowing these LPAI virus to evolve into HP viruses (for a long media diatribe (in Chinese), see IDN-NEWS Legislator Chen Bao-ji dereliction of major combat epidemic curse turn).

 

This is not the first time we’ve heard this accusation, as three years ago the director-general of the Bureau of Animal and Plant Health Inspection and Quarantine (BAPHIQ) resigned after it was revealed he delayed action on an outbreak of what turned out to be HPAI H5N2 (see Asia One story Taiwan agency intentionally delays action on H5N2: Recording).

 

A far less incendiary report comes from RFA.org.

 

Concealed for 11 years and finally see the light of H5N2 invade Taiwan not cleaned

2015-01-19

Taiwan bird flu spread of the epidemic spread, in addition to migratory birds, waterfowl, land birds infected, vaccination unit confirmed Monday near the central Taiwan, Miaoli County, a poultry farm finds three dead, "resident birds" bulbul, also diagnosed with novel H5N3, officials initially judged, migratory birds may have been infected, and the analysis, the recent bird flu geographical distribution, consistent with the migration paths of migratory birds.

Epidemic prevention unit in the past few days in transit point for migratory birds the virus into Taiwan, Council of Agriculture chairman Chen Bao-ji Monday to face the Legislative Yuan KMT and DPP's question "Put all the blame for the outbreak of migratory birds, migratory bird called too heavy" when frankly, after the 2003 invasion of Taiwan is no H5N2 cleaned. (Editor: Hu Hanjiang)

 

While the Channel News Asia story quotes officials as saying less than 1% of the nation’s poultry has been affected, it is still early days, and it may be some time before the full extent of this outbreak is quantified.

 

In an attempt to halt the spread, beginning tomorrow all `farms, markets, slaughter houses and vehicles transporting poultry’ are ordered to be disinfected over a 72-hour period. 

Taiwan Now Reporting Novel H5N3 In Poultry

 

# 9582

 

Taiwan’s multi-subtype outbreak of avian influenza across scores of poultry farms becomes even more complex today with the announcement that novel H5N3 has been detected on two goose farms in Kaohsiung and Pingung, in Southern Taiwan.

 

While I’m sure we’ll get a more detailed analysis in the next few days, this is being reported as a new reassortment between the Korean H5N8 virus and an N3 strain previously reported in Thailand and Mongolia in 2011.

This comes less than a week after the announcement (see OIE Notification On Taiwan’s `New’ HPAI H5N2) of their discovery a new H5N2 reassortant virus, again with the Korean H5N8 virus, and makes the third subtype detected since this outbreak began. 

 

Media reports now put the number of farms with confirmed HPAI at over 100, and that number is likely to grow.   This from the Bangkok Post.

 

3rd bird flu strain identified in Taiwan

Published: 16 Jan 2015  Online news: Asia Writer: Kyodo News

A third highly pathogenic strain of avian influenza that is new to Taiwan was identified Friday as outbreaks of bird flu have spread to more poultry farms on the island, animal health authorities said Friday.

Chang Su-san, director general of the Bureau of Animal and Plant Health Inspection and Quarantine, told a press conference that birds on 101 goose, duck and chicken farms in northern, central and southern parts of the island have been confirmed to be infected with the H5N2, H5N8 or H5N3 subtypes of bird flu virus.

Tsai Hsiang-jung, director general of the Animal Health Research Institute under the Cabinet's Council of Agriculture, said DNA sequencing indicates it is a hybrid of an N3 strain responsible for the outbreaks Thailand in 2012, in Mongolia in 2010,  and Kaohsiung last year, and an H5 strain responsible for outbreaks among poultry in South Korea last year.

(Continue . . .)

 

While the Korean H5N8 subtype has not shown any indications yet of infecting humans, it does show an aptitude for spreading long distances quickly via wild and migratory birds, and an ability to readily reassort with other viruses. 

 

Both traits are concerning, as future reassortants may not prove as benign for human health.

But even if this virus remains strictly an avian virus, it poses an immense potential threat to the poultry industry. In a world where 1 in 8 people are under nourished (see Food Insecurity, Economics, And The Control Of H7N9), anything that threatens the production of affordable protein is a major global security concern.

OIE Notification On Taiwan’s `New’ HPAI H5N2

 

# 9570

 

 

With more than 20 farms confirmed as having avian flu (apparently a hodgepodge of H5N2, H5N8, and a new H5N2), and with more than 40 farms under investigation (see Taiwan’s Avian Flu Outbreak Spreads To More Farms) this OIE notification of 5 outbreaks of HPAI H5N2 among geese and ducks across two counties will likely expand over the next few days.

 

We do get a description, via the Epidemiological notes,  that this `new’ H5N2 virus is apparently a mixture of the Korean H5N8 and a strain of H5N2  previously seen in China.

 

Being a new reassortant of H5N2, we’ll have to watch it carefully to see if it presents any greater threat to poultry, or humans, than have the other HPAI H5N2 subtypes that have been encountered.

 

Epidemiology

Source of the outbreak(s) or origin of infection

• Unknown or inconclusive

Epidemiological comments

Abnormal mortalities in 4 goose farms in Yun-Lin County and an acute egg drop syndrome in a layer duck farm in Ping-Tung County were noticed early January 2015. Local disease control center staff went to these farms to conduct movement restrictions and clinical inspection and then sent dead geese and layer ducks samples to the National Laboratory for diagnosis.

Specific RNA product of avian influenza virus was detected and subtyped as H5N2 by RT-PCR. Highly pathogenic avian influenza strain was confirmed by the National Laboratory based on sequencing analysis of HA0 cleavage site. It is worth noting that H and N genes of these isolates are different from the H5N2 strains previously isolated in Taiwan.

The homology of H5 between the isolates from these infected farms and the South Korea 2014 H5N8 strain is near 99%. The homology of N2 between the isolates from these infected farms and the China 2011 H5N2 strain is 96%. This H5N2 strain is obviously novel to Taiwan.

All the geese and ducks on the infected farm will be culled. The actual number of culled geese and ducks will be available when stamping out will finish and be reported in the next follow-up report. Thorough cleaning and disinfection will be conducted after stamping out operation. Surrounding poultry farms within a 3 km radius of the infected farm are under intensified surveillance for 3 months.

Control measures

Measures applied

• Stamping out
• Quarantine
• Movement control inside the country
• Screening
• Zoning
• Disinfection of infected premises/establishment(s)
• Vaccination prohibited
• No treatment of affected animals

Measures to be applied

• No other measures

Taiwan’s Avian Flu Outbreak Spreads To More Farms

 

# 9566

 

The numbers are changing almost by the hour, and no one knows for sure just how widespread this outbreak really is, but for now Taiwan’s Council of Agriculture has announced that avian flu (H5N8 or H5N2) has been detected on at least 20 farms – and some media reports put the number of farms under suspicion of infection at triple that.

What is apparent is that this is not a localized outbreak, affecting a single county or cluster of farms.

First this update from Taiwan Today, after which I’ll return with a bit more on Taiwan’s bird flu woes.

 

Taiwan ups fight against H5N2, H5N8 bird flu

Publication Date：01/13/2015

Source： Taiwan Today

Taiwan is ramping up efforts to contain a potential outbreak of bird flu following the discovery of H5N2 and H5N8 viruses in 20 southern Taiwan poultry farms, according to the Council of Agriculture Jan. 13.

A new variant of the H5N2 strain was confirmed in Pingtung and Yunlin counties, with the highly pathogenic avian influenza subtype H5N8 detected in Chiayi County, the COA Bureau of Animal and Plant Health Inspection and Quarantine said.

“Lab tests conducted by the Animal Health Research Institute show that the aberrant H5N2 variant resembles a composite of cases reported in South Korea and mainland China’s Jilin province, while the H5N8 virus is closely related to a strain found in the former last year."

(Continue . . . )

 

While there are reportedly 8 poultry workers exhibiting mild flu-like symptoms who are being monitored, we’ve no indication that any of them have anything more exotic than seasonal colds or flu.  

Headlines today from Taiwan’s Central News Agency include CDC calls for calm as bird flu spreads.  To that end Taiwan’s CDC has published a Q&A on these two new avian viruses, which includes the following reassurance:

 

Q: poultry farms H5N8 or highly pathogenic H5N2 avian flu virus will infect humans?

A: States to investigate the evidence so far shows that at present there is no H5N2, H5N8 report of the virus infecting humans, but if it's a lot of exposure as high risk personnel, such as livestock, animal-related workers, and so on, do not rule out possibility of opportunistic infections. As long as people have good health habits and positive attitude towards avian, no need to be overly concerned.

Review and update: 2015-01-13

Q: H5N1 avian influenza virus H5N2, H5N8 avian influenza viruses prevention method the same?

A: The precautionary approach is the same. People usually do not contact with unknown birds, dead birds, and so on, when you wash your poultry and bird droppings, must wear masks, gum gloves, wash hands cleaned with SOAP. Poultry meat and eggs, carefully cooked, there is no risk of contracting bird flu through diet.

This is not Taiwan’s first brush with avian influenza, although with two new and apparently already widespread strains to deal with, this could well be the most challenging.

 

Three years ago the director-general of the Bureau of Animal and Plant Health Inspection and Quarantine (BAPHIQ) resigned after it was revealed he delayed action on an outbreak of what turned out to be HPAI H5N2 (see Asia One story Taiwan agency intentionally delays action on H5N2: Recording).

 

More recently Taiwan dealt with an outbreak of LPAI H5N3 back in 2013.

 

Given the high biosecurity standards for poultry farms in Taiwan, there will doubtless be a lot of questions surrounding how these two new avian viruses (H5N8 and a `new’ H5N2 strain) could have spread so rapidly across the island without alarm bells going off.

But for now, the focus is on containment and eradication. 

OIE Report On Taiwan’s H5N8 Outbreak

Credit OIE 

 

# 9565

 

While we await details on the `new’ strain of H5N2 detected by Taiwan’s Agricultural department, we have the official OIE report on yesterday’s announced H5N8 outbreak – the first appearance of this recently emerged avian virus in that island nation.

 

 

From the epidemiological notes:

Source of the outbreak(s) or origin of infection

• Unknown or inconclusive

Epidemiological comments

Abnormal mortality was noticed and reported to the local disease control center by the owner of the breeding goose farm. Two dead geese were taken from the farm for diagnosis and the farm has been put under movement restrictions since then. Specific RNA product of avian influenza virus was detected and subtyped as H5N8 by RT-PCR. Highly pathogenic avian influenza was confirmed by the National Laboratory based on sequencing analysis of HA0 cleavage site. All the geese on the infected farm will be culled. The actual number of culled geese will be available when stamping out will finish and be reported in the next follow-up report. Thorough cleaning and disinfection will be conducted after stamping out operation. Surrounding poultry farms within a 3 km radius of the infected farm are under intensified surveillance for 3 months.

Taiwan CDC Statement On Detection Of H5N8 & H5N2 Avian Flu

Photo Credit – FAO

 

# 5960

 

The evidence with HPAI H5N8 and H5N2 has been - that, despite being cousins to some pretty nasty H5 viruses (H5N1, H5N6) – neither has shown the ability to infect, or sicken, humans.

 

That said, we have seen some studies suggesting there may have been  a few subclinical H5N2 human infections in Taiwan a few years back, and last spring Korea discovered a number of dogs with antibodies to H5N8.

 

But so far, no symptomatic human cases have been reported with either subtype

 

The concern of course is that influenza viruses are constantly changing, and so their observed behavior in the past is not guaranteed to hold true in the future.

 

Today Taiwan announced the detection of H5N8, along with a supposedly `never-seen-before’ strain of H5N2 (see Taiwan Reports H5N8 On Goose Farm and `New Strain’ Of H5N2), and since they are dealing with new (or relatively new) viral strains, an abundance of caution is warranted.

Taiwan’s CDC  has issued a statement, as has the City of Taipai’s Health Department, urging people to exercise caution around live poultry, and advising anyone working with poultry who develops symptoms of influenza to immediately seek medical care. 

 

These machine translations are a bit kludgy, but they leave no doubt that the local health departments are taking these outbreaks seriously.

 

Press release

Domestic poultry farms although outgoing H5N2, H5N8 avian flu is a new virus, there is no birds-to-human transmission case (2015-01-11)

Southern domestic duck and geese farms concerned outgoing H5N2, H5N8 avian flu outbreaks, although global has not yet spread human cases of infection, disease control programme according to the new Handbook of type a influenza epidemic prevention and control work in the "guidelines on prevention of influenza outbreaks in animals personnel" as standard operating procedure, close monitoring of poultry farms, health epidemic prevention personnel. But due to the discovery of H5N2 H5N8 for domestic first new strain, which occurred in January 2014 and 3 HA cut points and South Korea (birds, ducks and wild ducks) sequences of more than 96% Similarly, CDC Department of the future will also be conducted on relevant contacts seroepidemiological survey, conduct a follow-up investigation of the effects of the new virus.

According to the Council of agriculture issued H5N8 and H5N2 avian influenza viruses detected, in view of the two viruses are similar to January 2014 found virus in South Korea, are the highly pathogenic virus; Japan in April outbreak, China in October, Germany and the Netherlands and the United Kingdom in November also poultry disease is transmitted, in December, Italy, Russia, the United Kingdom and the United States have been found with the virus. The World Health Organization says, did not rule out are among the migratory birds spread the virus from Asia to Europe, and anticipation of future possible poultry outbreaks in more countries.

CDC also calls for, in the event of avian influenza outbreaks in poultry farms of relevant staff, during the self-health management, such as acute respiratory infection symptoms appear, should take the initiative to notify the local health board to assist medical care.

Addition, people also through following measures prevention infection avian influenza: including keep indoor air circulation, and service wash, not mess touch mouth, and nasal and the eyes, and not purchased or feeding sources unknown or smuggling of poultry bird, and poultry meat and the egg class Che late Cook cooked only can edible, and cuisine born fresh poultry livestock meat products and the egg class Hou immediately wash, tool, and chopping block also to Che late cleaning Hou to again using.

Once people developed fever, cough, runny nose, sneezing, muscle pain, flu-like symptoms such as headaches, and extreme tiredness, should wear a mask for medical treatment as soon as possible and take the initiative to inform the contact history, work and travel for the benefit of physicians in medical and communications. The latest outbreak and other related information, see the CDC website (http://www.CDC.gov.TW) or by calling toll-free notification and concern to public hotline 1922 (or 0800-001922) to contact.

 

 

 

Taipei City Government Health Bureau January 11

"unidentified birds against avian influenza, do not buy, do not support, do not touch, poultry products should be cooked,"

Press Release 11 January 2015

 
for the domestic chicken farm in southern Outgoing H5N2, H5N8 bird flu, the Taipei City Government Department of Health Bureau of Disease Control, said there were only two kinds of virus infected birds, according to the survey world, mankind has yet to determine the case, but still called for raising poultry industry and the public

My friends, in order to safeguard their health, personal hygiene should be strengthened, and pay attention to meat, eggs should be cooked; unidentified birds, do not buy, do not support, do not touch, such as preventive measures.

Director Chen Shaoqing Disease Control Department, said health authorities in response to this incident, today (11th) morning went to South Central Wholesale Poultry Market staff for high-risk bird flu prevention advocacy, and ask the staff to wear masks to protect the health ; Health Bureau to take care of the health of poultry workers, have been implemented since October 28 102 years the medical staff for consultation services, and with the work of staff time, every Friday 22:00 to 12:00 there is a healthy demand for work who see the doctor, has a total of 14 people for treatment, such as time outside consultation for medical care card holders can also go to the designated hospitals free registration fee and some burden.

Taipei City Health Bureau said it had jurisdiction Circular medical institutions to strengthen informed physicians, infectious disease prevention and control strain Hospital (JMS Peace School District) and all designated isolation hospital preparedness has completed a total of Taipei City Hospital and 16 strains of infectious diseases designated isolation hospital, has reserves sufficient amount of gowns, masks, publicly funded influenza antiviral agents are in safety stock, ready to respond to the epidemic, to ensure public health.

Taipei City Health Bureau said that poultry products do not have to worry too much about the safety of the general cooking process (each part was heated to 70 ° C or more) can make the bird flu virus to the activity, poultry and eggs should be cooked, It should be noted when handling and cooking raw food preparation cooked separately at any time during the hand-washing and other measures to prevent contamination of food containers, can be effective against avian influenza. 

(Continue . . .)

Taiwan Reports H5N8 On Goose Farm and `New Strain’ Of H5N2

UPDATED: 

Take this for what it’s worth - since it lacks any real detail - but as soon as I posted this blog entry -  this came over the `wire’ from Focus Taiwan:

New H5N2 virus found in Taiwan first of its kind anywhere: expert

2015/01/11 21:33:14

Taipei, Jan. 11 (CNA) A new type of the H5N2 avian influenza virus detected at goose farms in southern Taiwan has never been seen before, the director-general of Taiwan's government-run Animal Health Research Institute said Sunday.

Tsai Hsiang-jung said the H5N2 subtype flu strain is a recombinant virus, and "after reporting the case to the World Organization for Animal Health, it will be the first of its kind in the world."

(Continue . . . )

And so the plot thickens.  . . .

 

 

# 9559

 

Rumors of H5N8 in Taiwan have been rife the past 24 hours, but this morning we have confirmation that a goose farm in Chiayi County tested positive for this recently emerged avian virus.  Additionally, there are reports of several more farms infected with H5N2 and that genetic analysis reveals this is a new, never seen-before-in-Taiwan strain.

 

Like everyone else on the trail of this story, my first stop for more information was to be BAPHIQ, Taiwan’s Bureau of Animal and Plant Health Inspection & Quarantine.  Unfortunately their website is not responding, possibly overloaded by hordes of visitors seeking more details. 

I’ll try to get an update from there later in the day.

 

For now, much of what we know comes from the local and international press, and details are a bit sketchy.  But what we know is that on Friday we saw a report from  Taiwan: HPAI H5N2 Outbreak in Pingtung County, and that other farms were being tested.

 

From Taiwan’s Central News Agency this morning we get the following report describing this `new’ strain, and the detection of H5N8.  How this HPAI H5N2 differs from previous outbreaks (and how it compares to other H5N2 virus outbreaks around the globe) remains to be seen.

 

Taiwan hit by new type of H5N2, H5N8 for first time

2015/01/11 20:22:14

Taipei, Jan. 11 (CNA) Taiwan's agriculture authorities confirmed on Sunday that outbreaks of avian influenza at goose farms in southern Taiwan have been caused by two highly pathogenic viruses -- H5N8 and a new type of H5N2 -- seen for the first time in the country.

The Bureau of Animal and Plant Health Inspection and Quarantine under the Council of Agriculture said the bird flu outbreaks reported at four goose farms in Yunlin County have been confirmed as being caused by a new strain of the H5N2 virus.

The H5N8 infection found in tissue samples from geese raised on a farm in Dalin Township in Chiayi County was identified as an H5N8 subtype similar to the avian flu virus that attacked South Korea in 2014, the bureau noted.

(Continue . . . )

 

The inexorable spread of H5N8 – first detected in South Korea just shy of a year ago (see Korean Poultry Outbreak Due To H5N8) – has led to detections in China, Russia, Germany, the Netherlands, the UK, Japan, the United States and now Taiwan.  

Frankly, we’ve never observed an emergent HPAI virus spread so far, in such a short period of time before.  One can presume that it has arrived in other areas as well, places that do not routinely test for or report on avian viruses.

 

So far, we’ve no evidence that this reassorted H5N8 virus poses a serious human health threat, but its threat to poultry is all too obvious.  Over the past year South Korea has had to cull 15 million birds, and they are still not rid of the virus. 

 

Like its H5N1 and H7N9 counterparts, H5N8 will undoubtedly evolve into new clades and subclades, and possibly even reassort with other viruses into new subtypes.

 

So what we can say about its threat, and behavior today may not hold true tomorrow.  The same can be said for H5N2, which up until now has not been considered a serious human health either.

 

With the H5N8 virus now moving south along the migratory flyways to Taiwan, Southeastern China and Vietnam must now be on heightened alert for its arrival, as well as their neighbors and frankly, all points south.

Taiwan: HPAI H5N2 Outbreak in Pingtung County

 

 

# 9553

 

Taiwan can be added to the growing list of recent HPAI (highly pathogenic avian influenza) outbreaks in poultry, with word this morning that a large egg farm in Pingtung County – in the far south of the island – has begun culling more than 120,000 birds after the  H5N2 virus was confirmed.

First, this brief notice from Hong Kong’s government:

 

Taiwan's Pingtung eggs ban entry

January 9, 2015

Taiwan authorities announced the outbreak of highly pathogenic H5N2 in Pingtung County subtype of avian influenza, CFS announced immediate entrance to the county's ban eggs.

It should be because of bird flu, the center in November 2012, August 2013 and December last year, has announced a ban on Taiwan and Penghu, Hualien and Ilan egg import ban is still in force.

Centre will closely monitor the OIE news about bird flu outbreak in Taiwan, to act according to the local epidemic.

 

Meanwhile Taiwan's Central News Agency (Focus Taiwan) is reporting:

120,000 chickens to be culled after avian flu confirmed

2015/01/09 19:40:05

Taipei, Jan. 9 (CNA) All of the 120,000 chickens on a farm in Pingtung County will be culled after some have been confirmed infected with highly-pathogenic H5N2 avian influenza, the county government said Friday.

(Continue . . . )

 

Reports suggest that this outbreak may have begun sometime in December, and that eggs have been shipped from the farm after the virus emerged.  Once cooked, however, the virus would be deactivated.

HPAI H5N2 is believed to pose very little risk to human health, although those with long memories will recall that we’ve seen a small number of seroprevalence studies that have found elevated H5N2 antibody titers – particularly among poultry workers.

 

J Epidemiol. 2008;18(4):160-6. Epub 2008 Jul 7.

Human H5N2 avian influenza infection in Japan and the factors associated with high H5N2-neutralizing antibody titer.

Ogata T, Yamazaki Y, Okabe N, Nakamura Y, Tashiro M, Nagata N, Itamura S, Yasui Y, Nakashima K, Doi M, Izumi Y, Fujieda T, Yamato S, Kawada Y.

Arch Virol. 2009;154(3):421-7. Epub 2009 Feb 3.

Serological survey of avian H5N2-subtype influenza virus infections in human populations.

Yamazaki Y, Doy M, Okabe N, Yasui Y, Nakashima K, Fujieda T, Yamato S, Kawata Y, Ogata T.

 

While suggestive of (possibly sub-clinical) prior H5N2 infection (note: other factors might be associated antibody positivity), there is precious little evidence to link any significant or serious human illness to the H5N2 virus. After an earlier HPAI H5N2 outbreak in Taiwan back in 2012 we saw assurances from the WHO: Human Risk From H5N2 Is Low. 

Of course, the caveat holds that influenza viruses are constantly changing.  What was true last year, or even last week, may not hold true forever.

But for now, much like the HPAI H5N8 virus, H5N2 is viewed as primarily a threat to birds, and not to humans.

Taiwan Reports 2nd Imported H7N9 Case This Week

 

 

# 8528

 

The Taiwan CDC deactivated their Central Epidemic Command Center on April 15th due to the slackening of H7N9 cases being reported on the Chinese Mainland, and the anticipated lowered risk with warmer temperatures on the way.

 

In the 10 days since then, two H7N9 cases have arrived in Taiwan from China. The first case, I reported on last Tuesday (see Taiwan Announces 3rd Imported Case Of H7N9).

Today, we’ve media reports of a 4th case – that of a Taiwanese businessman who recently returned from a trip to China. A h/t to @Makoto_au_japon for tweeting the original media reports. 

 

Taiwan confirms 4th imported H7N9 case (update)

Central News Agency
2014-04-25 09:24 PM

Taipei, April 25 (CNA) Taiwan's Centers for Disease Control (CDC) confirmed Friday the island's fourth imported case of H7N9 avian flu since April last year.

The patient, a 39-year-old Taiwanese businessman, developed symptoms similar to that of H7N9 when he entered Taiwan on April 19, after traveling to Beijing and Kunshan in eastern China. X-ray test results on April 23 showed that he had pulmonary infiltration. He was then sent to a hospital for intensive care, the CDC said.

The case was confirmed to be H7N9 at 6 p.m. Friday. Initial investigation found that the patient neither had contact with birds nor visited markets where live poultry was sold when he was in China, according to the CDC. People who have had close contact with the patient, including three family members and one colleague, did not develop suspicious symptoms, the CDC said. CDC officials said they are also keeping track of a total of 57 medical personnel who have come in contact with the patient, as well as eight passengers who were on the same flight with him

(Continue … )

 

Thus far, I can find no official statement on the Taiwan CDC site,  but there is a fresh follow up press release on  Tuesday’s case, which also carries some advice for travelers to Mainland China.

.

Taiwan CDC obtains list of 94 contacts of third imported H7N9 case( 2014-04-25 )

The Taiwan Centers for Disease Control (Taiwan CDC) has obtained the list of 94 people who have come into contact with the third imported case of H7N9 influenza who was confirmed on April 22, 2014. The list of contacts includes her husband and daughter, passengers on the same flight, a tour leader, a tour guide, a bus driver, and 32 other members of her tour group who returned to China in the morning of April 24, a hotel security guard who had took the case to the hospital, and health care workers at the clinic and the hospitals where the case sought medical attention. All of the contacts were investigated and followed up. Thus far, 2 of the contacts have developed symptoms, but have been eliminated according to their negative laboratory test results. In addition, a total of 71 close contacts were provided with post-exposure prophylaxis after the clinician’s assessment. All close contacts will be followed up by the public health authority for 10 consecutive days.

Of all the potential casual contacts at the popular tourist attractions, restaurants and hotels the case visited, none have developed upper respiratory tract symptom thus far. The public health authority have conducted thorough health education activities for all contacts, issued them with “Self-Health Management Advice for H7N9 Influenza”, and will be following up with them closely until the period of voluntary contact tracing is lifted. When a contact develops influenza-like illness symptoms such as fever and cough, the public health authority will voluntarily assist the individual in seeking medical attention. As of now, Taiwan CDC has issued a travel notice of Level 2: Alert for avian influenza to Guangdong Province, Jiangsu Province, Hunan Province, Fujian Province, and Anhui Province, and a travel notice of Level 1: Watch for avian influenza to the other provinces and cities in China, excluding Hong Kong and Macau. Travelers visiting China are urged to practice good personal hygiene and avoid contact with poultry and birds. On the other hand, physicians are advised to pay additional attention to patients with pneumonia and inquire about such patient’s travel history.

In addition, Taiwan CDC once again reminds travelers visiting China to take preventive measures such as avoiding direct contact with poultry and birds or their droppings, consuming only thoroughly cooked poultry and eggs and practice good personal hygiene such as washing hands frequently to prevent infection. If symptoms such as fever or influenza-like symptoms develop upon returning to Taiwan, please voluntarily notify the airline crew members and the quarantine officer at the quarantine station in the airport. If the aforementioned symptoms develop after returning to Taiwan, please put on a surgical mask and seek immediate medical attention. Moreover, please inform the physician of the recent exposure and travel history to facilitate diagnosis and treatment. For more information, please visit the Taiwan CDC’s website at http://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Care Hotline, 1922 (or 0800-001922).

 

Taiwan CDC: Epidemiological Follow Up On Imported H7N9 Case

 

 

# 8514

 

Yesterday’s announced imported H7N9 case in Taiwan remains hospitalized and in serious condition, and Taiwan’s CDC is actively involved in monitoring 96 of her contacts – including members of her family, members of her tour group, airline passengers seated near her, and medical staff who were potentially exposed before her diagnosis.

 

Of these, all remain well except one who is complaining of fatigue and fever, and who is undergoing tests.

 

Additionally – based on media reports – `measures to prevent the spread of the disease have been taken to help 48 of them’.  It isn’t clear from that report whether this refers to PEP (post-exposure prophylaxis) antivirals, quarantine, or both.

 

The good news is, while some limited human-to-human transmission of the H7N9 virus has been documented, so far – based on the follow up of hundreds of contacts of known cases – it apparently is a rare event.

 

This from  Taiwan’s CDC .

 

 

 

Disease Control Department keeps track of mainland China imported the H7N9 flu case confirmed cases and their associated contacts (2014-04-23)

Yesterday (4/22) day recognized the Department of Disease Control, Nanjing, Jiangsu Province in mainland China imported 44 year old woman confirmed cases of H7N9 flu, is a serious illness, continued to receive treatment in hospital. Contacts currently available, including cases husband and daughter near the same plane seat passenger, tour leader / guide / driver / medical staff members and a total of 96 people, of which only one group member with fever and malaise, by local medical personnel arrange for medical treatment and specimen collection for examination, another physician evaluate the remaining 95 people who are in close contact with a total of 48 without proper protective prophylactic dosing.

During the tour of patients in Taiwan, visited the attractions, restaurants and hotels, the number of patients who may have contact with the investigation a total of 62 people, all without upper respiratory tract symptoms. Medical personnel have invited all contacts and self health management 10 days to 10 tracks expire, if contact occurs with fever, cough, influenza-like symptoms during the period, please wear a mask their doctor and take the initiative to inform the physician contact history.

The Agency for human disease avian influenza outbreaks travel recommendations, Hunan Province in China, Anhui, Jiangsu, Guangdong, Fujian Province, is the second stage: Alert (Alert), the remaining provinces (excluding Hong Kong and Macao) remains the first stage NOTE: (Watch). The department plans to once again remind people of the affected areas, it is important to implement good hygiene practices such as hand washing, avoiding contact with birds, especially not to pick up dead birds, eating chickens, ducks, geese and eggs to be cooked in order to avoid infection. When you return home if fever or flu-like symptoms, they should inform the airline personnel and airport and port of quarantine officers; such as after returning the above symptoms should wear a mask and seek medical advice and inform the physician contact history and travel history. Latest epidemic diseases and other related information can be found in the Agency website ( http://www.cdc.gov.tw ) the "H7N9 flu Corner" and "International Travel Information" area, or call the toll-free hotline and caring people informed epidemic 1922 ( or 0800-001922) contact.

Taiwan Announces 3rd Imported Case Of H7N9

 

 

# 8512

 

Even though the number of H7N9 cases being reported on the Chinese mainland has decreased markedly over the past month, we continue to see exported cases turning up in places like Hong Kong, Malaysia, and today - for the third time – Taiwan.

 

This report from Focus Taiwan.

 

Taiwan confirms 3rd imported H7N9 case (update)

2014/04/22 23:17:38

Taipei, April 22 (CNA) The Centers for Disease Control confirmed Tuesday the third imported case of H7N9 avian flu since April last year.

The patient, a 44-year-old woman from China's Jiangsu Province, entered Taiwan April 17 as part of a tour group. She is currently in serious condition in a hospital intensive care unit.

The woman had a dry cough and muscle soreness when she arrived in Taiwan and went to a clinic in New Taipei for treatment that day.

On April 18, she developed nausea and fever and sought treatment at a hospital the following day, where an X-ray showed that she had pneumonia and pleural effusion.

On April 20, she was taken to a medical center accompanied by her tour group leader and was given tamiflu. The medical center then notified the CDC of a suspected H7N9 avian flu case.

(continue . . .)

 

Although the number of H7N9 cases has declined, since the first of April FluTrackers has recorded 16 cases on their H7N9 Case Line List,  three of which were exported from the Chinese mainland (2 to Hong Kong, 1 to Taiwan).

 

• #414 - Man, 67 [Yim] from Zongyang, April 8 confirmed case in Tongling a hospital for treatment Anhui province
• #415 - Woman, 82, with underlying medical conditions, lives in Liwan, Guangzhou, withblood-stained sputum since April 7, no fever; confirmed in Hong Kong on April 9; exposure history to poultry under investigation. Hospitalized in HK, stable. Guangdong province
• #416 - Woman, 81, [Hemou] Guangzhou City native, living in Liwan District of Guangzhou City. Confirmed on April 8, currently in critical condition in a Guangzhou hospital. Guangdong province
• #417 - Man, 37, [Liu], Shantou City native, living Jinping District. Confirmed on April 9, currently in critical condition, in a Shantou city hospital. Guangdong province
• #418 - Woman, 71, Heyuan City native, residing in Heyuan City. Confirmed on April 9, currently in critical condition, in a Heyuan City hospital. Guangdong province
• #419 - Man, 79, [Luomou], Guangzhou native, residing in Haizhu District of Guangzhou, w/underlying conditions. Confirmed on April 10, currently in critical condition in a Guangzhou hospital. Guangdong province Death
• #420 - Woman, 85, Hong Kong PRC SAR, developed fever, cough with blood-stained sputum and shortness of breath since April 11, earlier traveled to Dongguan from April 4 to 5, confirmed on Apr 13. Currently hospitalized in critical condition. Guangdong province
• #421 - Man, 52, from Chongqing, unemployed. Seek treatment on April 10 at a clinic, hospitalized on April 13 in Changzhou after exacerbations. Confirmed on April 13. Currently in serious condition. Jiangsu province
• #422 - Man, 30, [Wang], Hengyang Hengyang County, currently in a hospital for treatment [Nanhua University]. Hunan province
• #423 - Man, 60, [Wu] hospitalized in serious condition, exposure to poultry Jiangsu province
• #424 - Man, 70, [Zhang] Tongling City, April 16 confirmed cases of human infection of H7N9 avian influenza, April 14 died. Anhui province Death
• #425 - Man, 34, [Pu]. Confirmed on April 17, currently in a Wuxi hospital in critical condition. Jiangsu province
• #426 - Woman, 35, [Lumou]. Confirmed on April 19, currently in a Wuxi City hospital in critical condition. Jiangsu province
• #427 - Woman, 55, [Wang], Shantou City. Confirmed on April 19, currently in critical condition in a Shantou city hospital. Guangdong province
• #428 - Man, 50, [Tang Moumou], Yongzhou Lanshan, currently in a Yongzhou hospital for treatment. Hunan province
• #429 - Woman, 44, resident in Nanjing, Jiangsu Province, China, Onset on April 17, hospitalized on April 19 in Taipei, confirmed on April 22. Currently in critical condition in a Taipei hospital. Jiangsu province