Keeping updates in this thread to reduce threadcount. If it ever appears that the flu has jumped the human barrier or if the flu appears in any other continents (right now Asia and Europe are impacted), I'll start a new thread. The gist of this update is that avian flu has now been confirmed (in birds) in Europe; Turkey, specifically. It is also highly suspected in Romania.
From: ProMED Digest <promed-digest-Owner@promed.isid.harvard.edu >
Date: Oct 9, 2005 4:51 PM
Subject: PRO> ProMED Digest V2005 #446
To:
promed-digest@promedmail.org
ProMED Digest Sunday, October 9 2005 Volume 2005 : Number 446
In this issue:
PRO/AH/EDR> Avian influenza - Europe (12): Romania, ducks, susp.
PRO/AH> Avian influenza, human - East Asia (142): CDC update
PRO/PL> Cabbage leaf spot - Ukraine (Odessa)
PRO/EDR> Dengue/DHF update 2005 (32)
See the end of the digest for information on how to retrieve back issues.
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Date: Sat, 8 Oct 2005 17:24:48 -0400 (EDT)
From: ProMED-mail <promed@promed.isid.harvard.edu>
Subject: PRO/AH/EDR> Avian influenza - Europe (12): Romania, ducks, susp.
AVIAN INFLUENZA - EUROPE (12): ROMANIA, DUCKS, SUSPECTED
********************************************************
A ProMED-mail post
<http://www.promedmail.org>
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International Society for Infectious Diseases
<http://www.isid.org>
Sponsored in part by Elsevier, publisher of Tuberculosis
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Date: Sat, 8 Oct 2005
From: ProMED-mail <promed@promedmail.org>
Source: The Guardian, 8 Oct 2005 [edited]
<
http://www.guardian.co.uk/birdflu/story ... 04,00.html>
Fears that the deadly Asian bird flu may have spread to Europe were heightened
yesterday when the Romanian government confirmed that 3 ducks have died of a
strain of the disease in the east of the country. Scientists in Britain are to
conduct tests on samples to find out whether the domestic ducks were infected
by the dangerous H5N1 strain, which has so far been confined to Asia.
The Romanian government warned that it feared that the ducks were infected
with the strain, and strong security measures were put in place in the village
of Ceamurlia, in eastern Romania, where the birds died [in late September
2005]. Restrictions were placed on the movement of people and animals into and
out of the village near the Black Sea, and there were plans to vaccinate
people. Nearly all the domestic fowl in the village have been slaughtered.
Gabriel Pedoi, a senior Romanian health official, told the Associated
Press: "We are in the phase of suspicion. We are trying to isolate the virus
and we are taking all measures to isolate the disease."
If it is confirmed that the ducks died of the H5N1 strain of bird flu, Europe
will be placed on high alert. The strain has killed 60 people in Asia and
there are fears that the virus could soon develop into a form that passes more
easily to humans. In the worst-case scenario, that could trigger a human flu
pandemic.
European Union officials were last night counselling caution after a scare in
August 2005, when the virus spread to the Asian part of Russia. Sources said
Romania had not yet notified the European commission and they pointed out that
a seagull died of a mild version of bird flu in Finland recently.
But the World Health Organisation said it was taking the development
seriously, though it would only become fully involved in the outbreak if it
were transmitted to humans.
"If it were to spread to other geographical areas then we would be concerned
because H5N1 is quite strong and it can persist," said spokeswoman Maria Cheng.
The [UK] Department for Environment, Food and Rural Affairs (Defra) said the
current assessment of the risk of the strain spreading from Russia to Britain
was low, but that any new, confirmed cases in countries that had not
experienced them before would trigger a further risk assessment. Asked if the
Romania cases could have resulted from migrating birds landing -- the most
obvious way the disease would spread -- a spokesman said: "It is too early to
say, if it is indeed confirmed, how the disease has been transmitted."
The dead birds were first noted in Ceamurlia [in late September 2005],
Romanian officials told AP. Samples were sent to a laboratory in Bucharest,
where scientists found antibodies to bird flu. Unable to find out the exact
strain of the virus, the scientists sent samples to Britain for testing at the
Veterinary Laboratories Agency, based in Weybridge, Surrey. The results are
expected in the next few days.
The findings in Romania follow warnings from the British Veterinary
Association (BVA) that some strain of avian flu is bound to arrive in Britain.
The best-case scenario has always been that infected birds would swiftly die
from the virus before they could get far. Each step towards the UK will raise
concern, however, that this scenario is too optimistic.
Different species of birds are affected differently by the virus, and some
will survive longer than others. The BVA pointed out that highly pathogenic
strains of avian flu have been spread by wild birds.
If avian flu gets into the domestic poultry flock, the risk of it passing to
humans clearly rises sharply. So far, the strain of avian flu that has spread
to humans in Asia has not shown an ability to transfer easily from one human
being to another. When that happens, experts believe we will have to deal with
a pandemic.
[Byline: Nicholas Watt in Brussels, Sarah Boseley & Riazat Butt]
- --
ProMED-mail
<promed@promedmail.org>
[Ceamurlia is situated in the south of Tulcea County, about 50 km to the south
of the county's capital, Tulcea (population: 92 000). See maps at:
<http://www.sgs.ro/images/romania-map.gif> Europe
<
http://www.bsrec.bg/romania/map.jpg> whole country
<http://www.aboutromania.com/Tulcea.gif> Tulcea.
The Danube Delta is characterised by the plentiful population in an expanse of
wetlands and a flyway for migrating birds. Such birds were suspected as
vectors of West Nile virus into the region during the 1990's. See: Costin
Cernescu et al. Continued Transmission of West Nile Virus to Humans in
Southeastern Romania, 1997-1998. JID, Feb 2000,181,pp 710-712. - Mod.AS]
[Elsevier reference:
Avian influenza: perfect storm now gathering? [Editorial] The Lancet 2005;
365:820. <
http://thelancet.url123.com/26swp>]
[see also:
Avian influenza - Europe (10): Romania, ducks, susp. 20051007.2928
Avian influenza - worldwide: preventive measures 20050930.2861
Avian influenza - Europe (04): EU, preventive measures 20050824.2498
Avian influenza - Europe (05): EU, preventive measures 20050825.2511
Avian influenza - Asia (23): migratory birds 20050907.2657
Avian influenza - Asia (25): migratory birds 20050909.2675 ]
....................arn/pg/jw
------------------------------
Date: Sat, 8 Oct 2005 20:37:57 -0400 (EDT)
From: ProMED-mail <promed@promed.isid.harvard.edu >
Subject: PRO/AH> Avian influenza, human - East Asia (142): CDC update
AVIAN INFLUENZA, HUMAN - EAST ASIA (142): CDC UPDATE
****************************************************
A ProMED-mail post
<http://www.promedmail.org>
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<http://www.isid.org >
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Date: Sat 8 Oct 2005
From: ProMED-mail <
promed@promedmail.org>
Source: CDC Outbreak Noticed, 5 Oct 2005 [edited]
<http://www.cdc.gov/travel/other/avian_influenza_se_asia_2005.htm >
Human Infection with Avian I influenza A (H5N1) Virus in Asia;
Released 23 Sep, updated 5 Oct 2005
- -----------------------------------
According to the World Health Organization (WHO), the Ministry of Health in
Indonesia has reported the 4th laboratory-confirmed human case of avian
influenza A (H5N1) in Indonesia. The patient, a 27-year-old woman from
Jakarta, developed symptoms on 17 Sep 2005, was hospitalized on 19 Sep, and
died on 26 Sep. Preliminary investigations have indicated that the patient had
direct contact with diseased and dying chickens in her household shortly
before the onset of illness.
Indonesia has reported outbreaks of avian influenza A (H5N1) among poultry
since June 2004. In July 2005, the 1st laboratory-confirmed human case of H5N1
infection in Indonesia was reported in a 38-year-old man who later died. His 2
young daughters also died of a severe pneumonia illness compatible with H5N1
infection; the 8-year-old daughter tested positive for antibodies to H5N1
virus and is therefore considered a probable H5N1 case by WHO.
The 2nd laboratory-confirmed case, reported on 19 Sep 2005, occurred in a 37-
year-old woman from Jakarta who became ill on 31 Aug and died on 10 Sep 2005.
The source of her infection is still under investigation; however, she was
reported to live in an area where chickens and ducks are present. Laboratory
specimens from poultry in the area are being tested.
The 3rd laboratory-confirmed case, reported by the Ministry of Health on 22
Sep 2005, occurred in an 8-year-old boy who was hospitalized for observation
and treatment.
In response to the most recent deaths, the Ministry of Health of Indonesia, in
collaboration with WHO, has launched an epidemiologic investigation and
heightened surveillance for cases. Close contacts of the most recent cases are
being traced and monitored. In addition, some persons with respiratory
symptoms or possible exposure to H5N1 are being hospitalized for observation
and considered as suspect cases by the Ministry of Health until diagnostic
tests either confirm or rule out infection.
In addition, on 19 Sep 2005, the Ministry of Health of Viet Nam reported a new
laboratory-confirmed human infection with avian influenza A (H5N1) virus to
WHO. This infection occurred in a 35-year-old man from Ben Tre Province in
southern Viet Nam; he became ill on 25 Jul 2005 and died on 31 Jul. Since mid-
December 2004, 64 human cases of H5N1 have been reported in Viet Nam, of which
21 were fatal.
During 2005, outbreaks of H5N1 among poultry have been confirmed in Cambodia,
China, Indonesia, Thailand, Viet Nam, Russia, and Kazakhstan; poultry
outbreaks were also reported in Malaysia and Laos during 2004. Since Jan 2004,
116 human cases of avian influenza A (H5N1) have been reported to date: 91 in
Viet Nam, 17 in Thailand, 4 in Cambodia, and 4 in Indonesia, resulting in 60
deaths. CDC remains in communication with WHO and continues to closely monitor
the H5N1 situation in countries reporting human cases and animal outbreaks.
Most cases of H5N1 infection in humans are thought to have occurred from
direct contact with infected poultry in the affected countries. Therefore,
when possible, care should be taken to avoid contact with live, well-
appearing, sick, or dead poultry and with any surfaces that may have been
contaminated by poultry or their feces or secretions.
Transmission of H5N1 viruses to 2 persons through consumption of uncooked duck
blood may also have occurred in Viet Nam in 2005. Therefore, uncooked poultry
or poultry products, including blood, should not be consumed.
The threat of novel influenza subtypes such as influenza A (H5N1) will be
greatly increased if the virus gains the ability to spread from one human to
another in a sustained fashion. Such transmission has not yet been observed;
however, a few cases of limited person-to-person spread of H5N1 viruses may
have occurred. For example, one instance of probable person-to-person
transmission associated with close contact between an ill child and her mother
is thought to have occurred in Thailand in September 2004. More recently,
several clusters of human H5N1 cases in Viet Nam are being investigated for
possible person-to-person transmission of H5N1 viruses. So far, spread of H5N1
virus from one ill person to another has been reported very rarely, and
transmission has not been observed to continue beyond one person.
H5N1 infections in humans can cause serious disease and death. An inactivated
vaccine to protect humans against influenza A (H5N1) is not yet available, but
one is undergoing human clinical trials in the United States. The H5N1 viruses
currently infecting birds and some humans in Asia are resistant to amantadine
and rimantadine, 2 antiviral medications commonly used to treat influenza. The
H5N1 viruses are susceptible to the antiviral medications oseltamavir and
zanamavir, but the effectiveness of these drugs when used for treatment of
H5N1 virus infection is unknown. For more information about antiviral drugs
for influenza, see
<http://www.cdc.gov/flu/professionals/treatment/>.
CDC has not recommended that the general public avoid travel to any of the
countries affected by H5N1. Persons visiting areas with reports of outbreaks
of H5N1 among poultry or of human H5N1 cases can reduce their risk of
infection by observing the following measures:
Before any international travel to an area affected by H5N1 avian influenza,
visit CDC's Traveler's Health Web page on Southeast Asia to educate yourself
and others who may be traveling with you about any disease risks and CDC
health recommendations for international travel in areas you plan to visit.
<http://www.cdc.gov/travel/seasia.htm>
For a list of affected areas and other information about avian influenza, see
this website:
<
http://www.cdc.gov/flu/avian/index.htm>.
Be sure you are up to date with all your vaccinations, and see your doctor or
health-care provider, ideally 4-6 weeks before travel, to get any additional
vaccination medications or information you may need.
Assemble a travel health kit containing basic 1st aid and medical supplies. Be
sure to include a thermometer and alcohol-based hand gel for hand hygiene. See
the Travelers Health Kit page in Health Information for International Travel
for other suggested items. Identify in-country health-care resources in
advance of your trip. Check your health insurance plan or get additional
insurance that covers medical evacuation in case you become sick. Information
about medical evacuation services is provided on the U.S. Department of State
web page Medical Information for Americans Traveling Abroad, at
<
http://travel.state.gov/travel/tips/hea ... _1185.html>.
During travel to an affected area, avoid all direct contact with poultry,
including touching well-appearing, sick, or dead chickens and ducks. Avoid
places such as poultry farms and bird markets where live poultry are raised or
kept, and avoid handling surfaces contaminated with poultry feces or
secretions. As with other infectious illnesses, one of the most important
preventive practices is careful and frequent handwashing. Cleaning your hands
often with soap and water removes potentially infectious material from your
skin and helps prevent disease transmission. Waterless alcohol-based hand gels
may be used when soap is not available and hands are not visibly soiled.
Influenza viruses are destroyed by heat; therefore, as a precaution, all foods
from poultry, including eggs and poultry blood, should be thoroughly cooked.
If you become sick with symptoms such as a fever, difficulty breathing, or
cough, or with any illness that requires prompt medical attention, a U.S.
consular officer can assist [American citizens] in locating medical services
and informing your family or friends. Inform your health care provider of any
possible exposures to avian influenza. It is advisable that you defer further
travel until you are free of symptoms, unless your travel is health-related.
After your return monitor your health for 10 days. If you become ill with
fever and develop a cough or difficulty breathing, or if you develop any
illness during this 10-day period, consult a health-care provider. Before you
visit a health-care setting, tell the provider the following: 1) your
symptoms, 2) where you traveled, and 3) if you have had direct contact with
poultry. This way, he or she can be aware that you have traveled to an area
reporting avian influenza.
For more information about H5N1 infections in humans, visit the World Health
Organization avian influenza website at
<
http://www.who.int/csr/disease/avian_influenza/en/>
and the CDC Avian Influenza site,
<http://www.cdc.gov/flu/avian/index.htm>.
For more information about CDC's health recommendations for travel to Asia, see
<http://www.cdc.gov/travel/seasia.htm> and
<http://www.cdc.gov/travel/eastasia.htm>.
- --
ProMED-mail
<promed@promedmail.org>
[This advice is specifically directed to US citizens, but it is generally
applicable for travellers to East Asia from all countries. Other nationals
should contact their local health authorities for additional advice. - Mod.CP]
[see also:
Avian influenza, human - East Asia (118): CDC trav... 20050813.2372
Avian influenza, human - East Asia (105): CDC update 20050724.2144
Avian influenza, human - East Asia (93): CDC advice 20050622.1744
Avian influenza, human - East Asia (79): WHO update 20050519.1376
Avian influenza, human - East Asia (59): CDC guide... 20050328.0892
Avian influenza, human - East Asia (34): CDC Updates 20050220.0558
Avian influenza, human - East Asia (09): CDC update 20050116.0144]
.................cp/pg/jw
From: ProMED Digest <promed-digest-Owner@promed.isid.harvard.edu >
Date: Oct 9, 2005 6:58 PM
Subject: PRO> ProMED Digest V2005 #447
To:
promed-digest@promedmail.org
ProMED Digest Sunday, October 9 2005 Volume 2005 : Number 447
In this issue:
PRO/AH/EDR> West Nile virus update 2005 - Western Hemisphere (15)
PRO/AH/EDR> Avian influenza - Asia (39): Turkey, turkeys, H5 conf.
See the end of the digest for information on how to retrieve back issues.
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- Hide quoted text -
Date: Sun, 9 Oct 2005 19:58:27 -0400 (EDT)
From: ProMED-mail <promed@promed.isid.harvard.edu>
Subject: PRO/AH/EDR> Avian influenza - Asia (39): Turkey, turkeys, H5 conf.
AVIAN INFLUENZA - ASIA (39): TURKEY, TURKEYS, H5 CONFIRMED
**********************************************************
A ProMED-mail post
<http://www.promedmail.org >
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International Society for Infectious Diseases
<http://www.isid.org>
Sponsored in part by Elsevier, publisher of Tuberculosis
<http://thelancet.url123.com/a5dpp>
[1]
Date: Sun 9 Oct 2005
From: Nati Elkin <nati@poultrymed.com>
Source: AP via CNN, 9 Oct 2005 [edited]
<http://edition.cnn.com/2005/WORLD/europe/10/08/turkey.bird.flu.ap/index.html?
section=cnn_latest>
Turkey confirms bird flu
- ------------------------
Anatolia, quoting officials, said that on Friday [7 Oct 2005], it was
confirmed that the birds in Turkey died of the H5 type of bird flu.
Turkey's agriculture minister confirmed the country's 1st cases of
bird flu, and officials ordered all winged animals and street dogs in
the village where it was detected destroyed as a precaution against
the disease spreading, the Anatolia news agency said.
Military police have also set up roadblocks at the entrance to the
village near Balikesir in western Turkey and are checking all
vehicles entering and exiting, Anatolia said on Saturday [8 Oct 2005].
[Belikesir is situated in the southwestern, Asian part of Turkey's
northwestern Marmara region (which has also a European part). See map
at
<http://www.plantours.com/regions/marmara.gif>.
For a map of Turkey, showing the location of the Beliksir region, see:
<
http://www.hippodromehotel.com/guide/im ... es_map.gif>].
The birds belonged to a turkey farmer, CNN-Turk reported, saying that
2000 birds died. Anatolia did not cite a number but said that any
animals that did not die of the disease were destroyed.
The outbreak was confirmed by Agriculture Minister Mehdi Eker, who
said that Turkish officials had been communicating with officials in
the European Union and other international organizations about the
outbreak, Anatolia reported. Eker did not specify how many birds died
of the disease.
The outbreak was initially brought to officials' attention on
Wednesday [5 Oct 2005], Anatolia said. On Thursday officials went to
the village and destroyed all the birds on the turkey farm that were
still alive and buried them, then disinfected the area, Anatolia said.
That would suggest the scientists have narrowed it down to an H5 type
virus -- the family of the bird flu virus that experts are watching
- -- but have not narrowed it further to determine whether it is the
exact strain H5N1 that health officials are particularly worried
about.
"Unfortunately we met with bird flu," Anatolia quoted Eker as saying.
"But everything is under control, every kind of precaution has been
taken so that it doesn't spread."
Officials from the Health Ministry and the Agriculture Ministry were
sent to investigate, CNN-Turk reported.
They ordered all winged animals in the village destroyed Saturday [8
Oct 2005], saying that farmers would be compensated for their losses,
Anatolia said.
The farmer whose birds carried the disease said he had not been
checked by doctors yet and was scared to go near his wife and
children, Anatolia reported.
Eker said the flu was likely carried by birds migrating from the Ural
Mountains, which divide Europe and Asia, across Turkey and into
Africa.
Cases of bird flu were also confirmed Saturday [8 Oct 2005] in
Romania, which borders Turkey [see ProMED reference below].
- --
ProMED-mail
<promed@promedmail.org >
******
[2]
Turkey culls poultry to stem spread of bird flu-TV
Date: 9 Oct 2005 10:19:57 GMT
From:
Source: Reuters
<
http://www.alertnet.org/thenews/newsdesk/L09397296.htm>
ANKARA, Oct 9 (Reuters) -
Turkey culled about 1500 chickens and turkeys overnight
to prevent the spread of avian flu after reporting its
first outbreak of the disease on a farm near the Aegean
Sea, NTV private television said on Sunday.
The authorities have also imposed a 3 km (2 miles)
quarantine zone around the affected farm, where nearly
2000 turkeys died of the globally feared disease on
Tuesday and Wednesday, the station said.
Officials were not immediately available to confirm the
reports and it was not clear why the first reports of the
outbreak only surfaced on Saturday evening.
"Last night, some 1500 birds were slaughtered," NTV said.
The authorities have drawn up a national action plan, it
said, but gave no details.
The Anatolian state news agency said veterinary teams had killed 600 turkeys
overnight in one farm alone in the affected area of northwestern Turkey as a
precautionary measure. The birds were buried in lime-drenched pits, it said.
The culling will resume on Sunday evening [9 Oct 2005], the agency said.
[By Gareth Jones]
- --
ProMED-mail
<
promed@promedmail.org>
[The possible spread of H5N1 (final identification yet to be
confirmed) to the coastlines of the Black Sea area (Tulcea, Romania,
Europe in the west, and southern Marmara, Asia in the southwest)
might be a attributed to transmission by migrating birds. These
locations are situated on a main migratory birds flyway; the annual
southwards migration has began in September 2005. As indicated in the
special report "Wild birds and avian influenza" of FAO's Animal
Production and Health Department:" "... it is plausible that HPAI
H5N1 virus could spread from Siberia to the Caspian and Black Sea
areas in the foreseeable future. Some birds are currently nesting in
the newly HPAI affected areas of Novosibirsk and Altai in Russia and
will migrate to the above-mentioned areas for upcoming winter or land
to rest on their way to Africa and Europe. The exact risk will likely
depend on the identification of specific migratory species that carry
H5 viruses without suffering the disease, and knowledge of their
resting areas and wintering grounds combined with the existing
production poultry systems and husbandry.
Bird migration routes run across southwest Asia and some Mediterranean
countries, where bird flu outbreaks could possibly occur". The report includes
a schematic major-flyways map. See:
<http://www.fao.org/ag/againfo/subjects/en/health/diseases-
cards/avian_HPAIrisk.html>.
Final identification of the Romanian and Turkish isolates, and official
confirmation, including epidemiological data, are anticipated. - Mod.AS]
[From the map referenced above, it seems clear to me that, at least up until
now, the virus has not been spread by migrating birds, since the direction of
spread has been east-west, cutting across several north-south flyways and
following the frontier between Russia and Kazakhstan westwards from the
Mongolian border. Could there be a flourishing trade in poultry along the
border? - Mod.JW]
[see also:
Avian influenza - Asia (38): Russia (Urals) 20051006.2918
Avian influenza - Europe (10): Romania, ducks, susp. 20051007.2928
Avian influenza - Europe (11): Turkey, turkeys, susp. 20051008.2937
Avian influenza - Europe (12): Romania, ducks, susp. 20051008.2939
Avian influenza - worldwide: preventive measures 20050930.2861
Avian influenza - Europe (04): EU, preventive measures 20050824.2498
Avian influenza - Europe (05): EU, preventive measures 20050825.2511
Avian influenza - Asia (23): migratory birds 20050907.2657
Avian influenza - Asia (25): migratory birds 20050909.2675]
....................arn/msp/jw
------------------------------
End of ProMED Digest V2005 #447
