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#Analysis of recent #scientific #information on #avian #influenza A(#H7N9) virus - 10 February 2017 (@WHO, edited)

  Title : #Analysis of recent #scientific #information on #avian #influenza A(#H7N9) virus - 10 February 2017. Subject : Avian Influenza, ...

23 Mar 2017

Establishing a #Timeline to Discontinue #Routine #Testing of Asymptomatic #Pregnant Women for #Zika Virus Infection — American #Samoa, 2016–17 (@CDCgov)

 

Title: Establishing a #Timeline to Discontinue #Routine #Testing of Asymptomatic #Pregnant Women for #Zika Virus Infection — American #Samoa, 2016–17.

Subject: Zika Virus & Pregnancy, MMWR report.

Source: US Centers for Disease Control and Prevention (CDC), MMWR Morbidity and Mortality Weekly Report, full page: (LINK). Abstract, edited.

Code: [     ]

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Establishing a Timeline to Discontinue Routine Testing of Asymptomatic Pregnant Women for Zika Virus Infection — American Samoa, 2016–2017

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Weekly / March 24, 2017 / 66(11);299–301

Format: [ PDF [102 KB] ]

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W. Thane Hancock, MD1; Heidi M. Soeters, PhD2; Susan L. Hills, MBBS3; Ruth Link-Gelles, PhD4,5; Mary E. Evans, MD6; W. Randolph Daley, DVM1; Emily Piercefield, MD7; Magele Scott Anesi, MPH8; Mary Aseta Mataia8; Anaise M. Uso, BDS8; Benjamin Sili8; Aifili John Tufa, MPH9; Jacqueline Solaita8; Elizabeth Irvin-Barnwell, PhD10; Dana Meaney-Delman, MD11; Jason Wilken, PhD1; Paul Weidle, PharmD6; Karrie-Ann E. Toews, MPH1; William Walker, DVM3,4; Phillip M. Talboy12; William K. Gallo, MBA13; Nevin Krishna, MS1; Rebecca L. Laws, PhD4,14; Megan R. Reynolds, MPH15; Alaya Koneru, MPH5; Carolyn V. Gould, MD3

1Division of State and Local Readiness, Office of Public Health Preparedness and Response, CDC; 2Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, CDC; 3Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC; 4Epidemic Intelligence Service, CDC; 5Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC; 6Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC; 7Division of Parasitic Diseases and Malaria, Center for Global Health, CDC; 8Department of Health, American Samoa Government; 9Pacific Islands Health Officer’s Association, Honolulu, Hawaii; 10Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry; 11Office of the Director, National Center for Emerging and Zoonotic Infectious Diseases, CDC; 12Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC; 13Office for State Tribal Local and Territorial Support, CDC; 14Division of Environmental and Occupational Disease Control, California Department of Health; 15Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, CDC.

Corresponding author: W. Thane Hancock, vie1@cdc.gov, 671-735-3339.

Suggested citation for this article: Hancock WT, Soeters HM, Hills SL, et al. Establishing a Timeline to Discontinue Routine Testing of Asymptomatic Pregnant Women for Zika Virus Infection — American Samoa, 2016–2017. MMWR Morb Mortal Wkly Rep 2017;66:299–301. DOI: http://dx.doi.org/10.15585/mmwr.mm6611a5.

 

Summary

  • What is already known about this topic?
    • CDC recommends Zika virus testing of asymptomatic pregnant women who live in areas with active Zika virus transmission as part of routine obstetric care during the first and second trimesters.
    • Currently, there are no CDC recommendations to guide the discontinuation of testing for asymptomatic pregnant women following the end of Zika virus transmission in a jurisdiction.
  • What is added by this report?
    • Information on Zika virus transmission from the existing enhanced surveillance in American Samoa and current CDC guidance were used to develop criteria for calculating an end date (October 15, 2016) for active mosquito-borne transmission of Zika virus and to propose a timeline for discontinuation of routine screening of asymptomatic pregnant women in American Samoa (conception after December 10, 2016, with permissive testing for asymptomatic pregnant women who conceive through April 15, 2017).
  • What are the implications for public health practice?
    • The rationale described in this report might be adapted by similar jurisdictions with small populations and a potential for interruption of Zika virus transmission to help guide decisions about when to discontinue routine screening of asymptomatic pregnant women for Zika virus infection following the end of active mosquito-borne transmission.

 

Abstract

The first patients with laboratory-confirmed cases of Zika virus disease in American Samoa had symptom onset in January 2016 (1). In response, the American Samoa Department of Health (ASDoH) implemented mosquito control measures (1), strategies to protect pregnant women (1), syndromic surveillance based on electronic health record (EHR) reports (1), Zika virus testing of persons with one or more signs or symptoms of Zika virus disease (fever, rash, arthralgia, or conjunctivitis) (13), and routine testing of all asymptomatic pregnant women in accordance with CDC guidance (2,3). All collected blood and urine specimens were shipped to the Hawaii Department of Health Laboratory for Zika virus testing and to CDC for confirmatory testing. Early in the response, collection and testing of specimens from pregnant women was prioritized over the collection from symptomatic nonpregnant patients because of limited testing and shipping capacity. The weekly numbers of suspected Zika virus disease cases declined from an average of six per week in January–February 2016 to one per week in May 2016. By August, the EHR-based syndromic surveillance (1) indicated a return to pre-outbreak levels. The last Zika virus disease case detected by real-time, reverse transcription–polymerase chain reaction (rRT-PCR) occurred in a patient who had symptom onset on June 19, 2016. In August 2016, ASDoH requested CDC support in assessing whether local transmission had been reduced or interrupted and in proposing a timeline for discontinuation of routine testing of asymptomatic pregnant women. An end date (October 15, 2016) was determined for active mosquito-borne transmission of Zika virus and a timeline was developed for discontinuation of routine screening of asymptomatic pregnant women in American Samoa (conception after December 10, 2016, with permissive testing for asymptomatic women who conceive through April 15, 2017).

(…)

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Keywords: US CDC; USA; Updates; Zika Virus; Pregnancy; American Samoa.

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#Human #infection with #avian #influenza A(#H7N9) virus – #China (@WHO, Mar. 23 ‘17)

 

Title: #Human #infection with #avian #influenza A(#H7N9) virus – #China.

Subject: Avian Influenza, H7N9 subtype (Asian Lineage), human cases in China.

Source: World Health Organization (WHO), full page: (LINK).

Code: [     ]

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Human infection with avian influenza A(H7N9) virus – China

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Disease outbreak news  / 23 March 2017

On 17 March 2017, the National Health and Family Planning Commission of China (NHFPC) notified WHO of 22 additional laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus in mainland China.

 

Details of the cases

Onset dates ranged from 28 February to 13 March 2017.

Of these 22 cases, only two were female.

The median age is 52.5 years (age range among the cases is 33 to 77 years old).

The cases were reported from:

  1. Chongqing (1),
  2. Fujian (1)
  3. Guangdong (3),
  4. Guangxi (6),
  5. Guizhou (3),
  6. Henan (2),
  7. Hunan (5), and
  8. Jiangxi (1).

Of the six cases reported from Guangxi province, five were from the same city (Hechi).

At the time of notification, there were three deaths, and 17 cases were diagnosed as either pneumonia (6) or severe pneumonia (11).

The clinical presentations of two cases were not available at time of notification.

Nineteen cases were reported to have had exposure to poultry or live poultry market.

Three cases are still under investigation.

No clusters were reported.

To date, a total of 1329 laboratory-confirmed human infections with avian influenza A(H7N9) virus have been reported through IHR notification since early 2013.

 

Public health response

Considering the increase in the number of human cases since December 2016, the Chinese government at national and local levels is taking further measures including:

  • Continuing to strengthen control measures with a focus on hygienic management of live poultry markets and cross-regional transportation.
  • Assessing and analysing the avian influenza A(H7N9) epidemic trend to guide control measures in the provinces.
  • Increasing attention and guidance to Guangxi and Hunan provinces in epidemic control and prevention.
  • Conducting public risk communication and increasing information publicity to provide the public with guidance on self-protection.

 

WHO risk assessment

The number of human infections with avian influenza A(H7N9) in the fifth epidemic wave (i.e. onset since 1 October 2016) is greater than the numbers of human cases reported in earlier waves.

Human infections with the avian influenza A(H7N9) virus remain unusual.

Close observation of the epidemiological situation and further characterization of the most recent human viruses are critical to assess associated risk and to adjust risk management measures in a timely manner.

Most human cases are exposed to avian influenza A(H7N9) virus through contact with infected poultry or contaminated environments, including live poultry markets.

Since the virus continues to be detected in animals and environments, and live poultry vending continues, further human cases can be expected.

Although small clusters of cases of human infection with avian influenza A(H7N9) virus have been reported including those involving patients in the same ward, current epidemiological and virological evidence suggests that this virus has not acquired the ability of sustained transmission among humans. Therefore the likelihood of further community level spread is considered low.

 

WHO advice

WHO advises that travellers to countries with known outbreaks of avian influenza should avoid, if possible, poultry farms, contact with animals in live poultry markets, entering areas where poultry may be slaughtered, or contact with any surfaces that appear to be contaminated with faeces from poultry or other animals. Travellers should also wash their hands often with soap and water, and follow good food safety and good food hygiene practices.

WHO does not advise special screening at points of entry with regard to this event, nor does it currently recommend any travel or trade restrictions. As always, a diagnosis of infection with an avian influenza virus should be considered in individuals who develop severe acute respiratory symptoms while travelling in or soon after returning from an area where avian influenza is a concern.

WHO encourages countries to continue strengthening influenza surveillance, including surveillance for severe acute respiratory infections (SARI) and influenza-like illness (ILI) and to carefully review any unusual patterns, ensure reporting of human infections under the IHR 2005, and continue national health preparedness actions.

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Keywords: WHO; Updates; China; H7N9; Avian Influenza; Human.

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#Zika Virus - #CaseCounts in the #US as of March 22 2017 (@CDCgov, edited)

 

Title: #Zika Virus - #CaseCounts in the #US as of March 22 2017.

Subject: Zika Virus, current epidemiological report, USA.

Source: US Centers for Disease Control and Prevention (CDC), full page: (LINK).

Code: [     ]

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Zika Virus - Case Counts in the US as of March 22 2017

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Language: [ English | Español | Português ]

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Zika virus disease is now a nationally notifiable condition. Cases are reported to CDC by state, territorial, and local health departments using standard case definitions.

This webpage contains provisional data reported to ArboNET for January 1, 2015 – March 22, 2017

 

US States

  • 5,158 Zika virus disease cases reported
    • 4,861 cases in travelers returning from affected areas
    • 222 cases acquired through presumed local mosquito-borne transmission in Florida (N=216) and Texas (N=6)
    • 75 cases acquired through other routes, including sexual transmission (N=45), congenital infection (N=28), laboratory transmission (N=1), and person-to-person through an unknown route (N=1)

US Territories

  • 38,212 Zika virus disease cases reported
    • 147 cases in travelers returning from affected areas
    • 38,065 cases acquired through presumed local mosquito-borne transmission
    • 0 cases acquired through other routes*

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{*} Sexually transmitted cases are not reported for US territories because with local transmission of Zika virus it is not possible to determine whether infection occurred due to mosquito-borne or sexual transmission.

 

Cases in Pregnant Women

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US Maps

 

Laboratory-confirmed symptomatic Zika virus disease cases and presumptive viremic blood donors reported to ArboNET by states and territories — United States, 2015–2017 (as of March 22, 2017)

[States - Symptomatic disease cases**: (N=5,158)(No.  (%)) - Presumptive viremic blood donors†: (N=43)(No.  (%))]

  1. Alabama - 40 (1) - 0 (0)
  2. Arizona - 54 (1) - 1 (2)
  3. Arkansas - 15 (<1) - 0 (0)
  4. California - 434 (9) - 5 (12)
  5. Colorado - 57 (1) - 0 (0)
  6. Connecticut - 58 (1) - 0 (0)
  7. Delaware - 17 (<1) - 0 (0)
  8. District of Columbia - 34 (1) - 0 (0)
  9. Florida‡ - 1,109 (22) - 26 (60)
  10. Georgia - 110 (2) - 0 (0)
  11. Hawaii - 16 (<1) - 0 (0)
  12. Idaho - 5 (<1) - 0 (0)
  13. Illinois - 94 (2) - 0 (0)
  14. Indiana - 53 (1) - 0 (0)
  15. Iowa - 27 (1) - 1 (2)
  16. Kansas - 22 (<1) - 0 (0)
  17. Kentucky - 33 (1) - 0 (0)
  18. Louisiana - 39 (1) - 0 (0)
  19. Maine - 14 (<1) - 0 (0)
  20. Maryland - 134 (3) - 0 (0)
  21. Massachusetts - 125 (3) - 1 (2)
  22. Michigan - 69 (1) - 0 (0)
  23. Minnesota - 64 (1) - 0 (0)
  24. Mississippi - 25 (1) - 0 (0)
  25. Missouri - 36 (1) - 0 (0)
  26. Montana - 9 (<1) - 0 (0)
  27. Nebraska - 13 (<1) - 0 (0)
  28. Nevada - 22 (<1) - 2 (5)
  29. New Hampshire - 12 (<1) - 0 (0)
  30. New Jersey - 182 (4) - 0 (0)
  31. New Mexico - 10 (<1) - 0 (0)
  32. New York - 1,012 (20) - 3 (7)
  33. North Carolina - 100 (2) - 0 (0)
  34. North Dakota - 3 (<1) - 0 (0)
  35. Ohio - 85 (2) - 0 (0)
  36. Oklahoma - 29 (1) - 0 (0)
  37. Oregon - 48 (1) - 0 (0)
  38. Pennsylvania - 178 (4) - 0 (0)
  39. Rhode Island - 54 (1) - 0 (0)
  40. South Carolina - 54 (1) - 0 (0)
  41. South Dakota - 2 (<1) - 0 (0)
  42. Tennessee - 61 (1) - 0 (0)
  43. Texas‡ - 317 (6) - 3 (7)
  44. Utah - 22 (<1) - 0 (0)
  45. Vermont - 11 (<1) - 0 (0)
  46. Virginia - 114 (2) - 0 (0)
  47. Washington - 71 (1) - 0 (0)
  48. West Virginia - 11 (<1) - 1 (2)
  49. Wisconsin - 52 (1) - 0 (0)
  50. Wyoming - 2 (<1) - 0 (0)

[Territories - Symptomatic disease cases**: (N=38,212)(No.  (%)) - Presumptive viremic blood donors†: (N=325)(No.  (%))]

  1. American Samoa - 132 (<1) - 0 (0)
  2. Puerto Rico - 37,083 (97) - 325 (100)
  3. US Virgin Islands - 997 (3) - 0 (0)

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{**} Includes reported confirmed and probable Zika virus disease cases per the CSTE case definitions.

{†} Presumptive viremic blood donors are people who reported no symptoms at the time of donating blood, but whose blood tested positive when screened for the presence of Zika virus RNA by the blood collection agency. Some presumptive viremic blood donors develop symptoms after their donation or may have had symptoms in the past.  These individuals may be reported as both Zika virus disease cases and presumptive viremic blood donors.

{‡} Includes 216 cases in Florida and 6 cases in Texas that were acquired through presumed local mosquito-borne transmission.

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Keywords: USA; US CDC; Updates; Zika Virus.

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#Germany, #Avian #Influenza #H5N8 / #H5N5–Situation #Update–New #Epizootics reported, March 16-22 '17 (FLI, edited)

 

Title: Germany, Avian Influenza H5N8/H5N5 - Situation Update - New Epizootics reported, March 16-22 '17.

Subject: Avian Influenza, H5N8, H5N5 subtypes, poultry and wild birds epizootics in Germany.

Source: Friedrich-Loeffler Institut, Germany, full page: (LINK). Edited.

Code: [    ][    ]

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Friedrich-Loeffler Institut - Germany

Avian Influenza H5N8/H5N5 - Situation Update - New Epizootics reported,  March 16-22 '17

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[Species - Federal State - District - Date reported]

  1. Turkey - Niedersachsen - Cloppenburg - March 22
  2. Duck - Niedersachsen - Ammerland - March 21
  3. Buzzard - Schleswig-Holstein - Segeberg - March 21
  4. Turkey - Niedersachsen - Oldenburg - March 21
  5. Swans - Sachsen - Bautzen - March 21
  6. Cormorants - Sachsen - Sachsische Schweiz-Osterzgebirge - March 21
  7. Buzzard - Schleswig-Holstein - Dithmaschen - March 20
  8. Buzzard - Sachsen-Anhalt - Borde - March 20
  9. Turkey - Niedersachsen - Cloppenburg - March 18
  10. Turkey - Niedersachsen - Cloppenburg - March 17
  11. Turkey - Niedersachsen - Cloppenburg - March 17
  12. Turkey - Niedersachsen - Cloppenburg - March 16


(...)

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[Epizootics Location Map]

epideutz23317
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Active Outbreaks

{    } = 1-2 Outbreaks;

{    } = 3-4 Outbreaks;

{    } = 5-7 Outbreaks;

{    } = 8-16 Outbreaks;


Adiministrative Divisions

{ Bundeslander } = State Borders;

{ Regierungsbezirke } = Region Borders;

{ Kreise } = Districts.

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Keywords: Germany; Updates; H5N8; H5N5; Avian Influenza; Poultry; Wild birds.

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#USA, #Alabama: #Avian #Influenza [#H7N9] #Updates and Helpful #Information [as of March 23 ‘17] (DoA, edited)

 

Title: #USA, #Alabama: #Avian #Influenza [#H7N9] #Updates and Helpful #Information [as of March 23 ‘17].

Subject: Avian Influenza, H7N9 subtype (North American Lineage), poultry epizootics in the US.

Source: US State of Alabama Department of Agriculture, full page: (LINK).

Code: [     ]

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Avian Influenza Updates and Helpful Information

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Here is the current list of confirmed Low-Pathogenic Avian Influenza in Alabama

[County   -   Farm Type   - Date Confirmed Positive for LPAI]

  1. Madison * – Backyard - 03/22/2017
  2. Lauderdale * – Commercial - #USA, #Alabama: #Avian #Influenza [#H7N9] - 03/22/2017
  3. Cullman – ​Commercial - 03/22/2017
  4. Madison – Backyard - 03/21/2017
  5. Pickens – Commercial - 03/21/2017
  6. Jackson – Backyard - 03/16/2017

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{*} = These are the sites mentioned in the March 14th press release.

(…)

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Keywords: USA; Updates; Avian Influenza; H7N9; Poultry; Alabama.

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22 Mar 2017

#USA, #Alabama: #Avian #Influenza [#H7N9] #Updates and #Information (DoA, March 22 ‘17)

 

Title: #USA, #Alabama: #Avian #Influenza [#H7N9] #Updates and #Information.

Subject: Avian Influenza, H7N9 (North American Lineage), poultry epizootics in the US State of Alabama.

Source: US State of Alabama Department of Agriculture, full page: (LINK).

Code: [     ]

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Avian Influenza Updates and Helpful Information

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Here is the current list of confirmed Low-Pathogenic Avian Influenza in Alabama

[County    -   Farm Type   - Date Confirmed Positive for LPAI]

  1. Cullman – ​Commercial - 03/22/2017
  2. Madison – Backyard - 03/21/2017
  3. Pickens – Commercial - 03/21/2017
  4. Jackson – Backyard - 03/16/2017

(…)

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Keywords: USA; Updates; Alabama; H7N9; Avian Influenza; Poultry.

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A #shooting incident [suspected #terror attack] happened on #Westminster Bridge in #London, March 22, 2017 (Reuters)

 

Title: A #shooting incident [suspected #terror attack] happened on #Westminster Bridge in #London, March 22, 2017.

Subject: Terror Attack, shooting incident in London.

Source: Reuters, full page: (LINK). via Instagram.

Code: [  !  ]

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Keywords: UK; England; Terrorism; Society.

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Highly pathogenic #avian #influenza #H5N8, #Slovenia [infected #wildbirds] (#OIE, Mar. 22 ‘17)


Title: Highly pathogenic #avian #influenza #H5N8, #Slovenia [infected #wildbirds].

Subject: Avian Influenza, H5N8 subtype, wild birds epizootics in Slovenia.

Source: OIE, full page: (LINK).

Code: [     ]

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Highly pathogenic influenza A viruses (infection with) (non-poultry including wild birds) H5N8, Slovenia

Information received on 22/03/2017 from Dr Janez Posedi, Director General, Administration of the Republic of Slovenia for Food Safety, Veterinary Sector and Plant Protection (AFSVSPP), Ministry of Agriculture, Forestry and Food, Ljubljana, Slovenia

  • Summary
    • Report type    Follow-up report No. 3
    • Date of start of the event    01/01/2017
    • Date of confirmation of the event    05/01/2017
    • Report date    22/03/2017
    • Date submitted to OIE    22/03/2017
    • Reason for notification    New strain of a listed disease in the country
    • Causal agent    Highly pathogenic avian influenza virus
    • Serotype    H5N8
    • Nature of diagnosis    Laboratory (basic), Laboratory (advanced)
    • This event pertains to    a defined zone within the country
  • Summary of outbreaks   
    • Total outbreaks: 10
      • Total animals affected: Species    - Susceptible    - Cases    - Deaths    - Destroyed    - Slaughtered
        • Mallard:Anas platyrhynchos(Anatidae)  - … – 2    - 2    - 0    - 0
        • Mute Swan:Cygnus olor(Anatidae)  - … – 250    - 250    - 0    - 0
        • Greater White-fronted Goose:Anser albifrons(Anatidae)  - … – 1    - 1    - 0    - 0
      • Outbreak statistics: Species    - Apparent morbidity rate    - Apparent mortality rate    - Apparent case fatality rate    - Proportion susceptible animals lost*
        • Mallard:Anas platyrhynchos(Anatidae)    - **    - **    - 100.00%    - **
        • Mute Swan:Cygnus olor(Anatidae)    - **    - **    - 100.00%    - **
        • Greater White-fronted Goose:Anser albifrons(Anatidae)    - **    - **    - 100.00%    - **
          • *Removed from the susceptible population through death, destruction and/or slaughter
          • **Not calculated because of missing information
  • Epidemiology
    • Source of the outbreak(s) or origin of infection   
      • Unknown or inconclusive

(...)

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Keywords: OIE; Updates; Avian Influenza; H5N8 ; Wild Birds; Slovenia.

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Highly pathogenic #avian #influenza #H5N1, #Vietnam [a #poultry #outbreak] (#OIE, Mar. 22 ‘17)


Title: Highly pathogenic #avian #influenza #H5N1, #Vietnam [a #poultry #outbreak].

Subject: Avian Influenza, H5N1 subtype, poultry epizootics in Vietnam.

Source: OIE, full page: (LINK).

Code: [     ]

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Highly pathogenic avian influenza H5N1, Vietnam

Information received on 22/03/2017 from Dr Dong Pham Van, Director General, Chief Veterinary Officer, Department of Animal Health, Ministry of Agriculture and Rural Development, Hanoï, Vietnam

  • Summary
    • Report type    Follow-up report No. 5
    • Date of start of the event    14/02/2017
    • Date of confirmation of the event    15/02/2017
    • Report date    22/03/2017
    • Date submitted to OIE    22/03/2017
    • Reason for notification    Reoccurrence of a listed disease
    • Date of previous occurrence    10/2016
    • Manifestation of disease    Clinical disease
    • Causal agent    Highly pathogenic avian influenza virus
    • Serotype    H5N1
    • Nature of diagnosis    Clinical, Laboratory (advanced)
    • This event pertains to    the whole country
  • Summary of outbreaks   
    • Total outbreaks: 1
      • Total animals affected: Species    - Susceptible    - Cases    - Deaths    - Destroyed    - Slaughtered
        • Birds    - 794    - 396    - 396    - 398    - 0
      • Outbreak statistics: Species    - Apparent morbidity rate    - Apparent mortality rate    - Apparent case fatality rate    - Proportion susceptible animals lost*
        • Birds    - 49.87%    - 49.87%    - 100.00%    - 100.00%
          • *Removed from the susceptible population through death, destruction and/or slaughter
  • Epidemiology
    • Source of the outbreak(s) or origin of infection   
      • Unknown or inconclusive

(...)

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Keywords: OIE; Updates; Avian Influenza; H5N1 ; Poultry; Vietnam.

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#Avian #Influenza #H7N9 [Asian Lineage] – #Global situation #update, 22 March 2017 (#FAO, edited)

 

Title: #Avian #Influenza #H7N9 [Asian Lineage] – #Global situation #update, 22 March 2017.

Subject: Avian Influenza, H7N9 subtype (Asian Lineage), enzootic in poultry and human cases in China.

Source: Food and Agriculture Organization (FAO), full page: (LINK).

Code: [     ][     ]

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Avian Influenza H7N9 [Asian Lineage] – Global situation update, 22 March 2017

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The next update will be issued on 29 March 2017

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Disclaimer

Information provided herein is current as of the date of issue. Information added or changed since the last H7N9 situation update appears in red. Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in one geographic location but reported in another. For cases with unknown onset date, reporting date was used instead. FAO compiles information drawn from multiple national (Ministries of Agriculture or Livestock, Ministries of Health, Provincial Government websites; Centers for Disease Prevention and Control [CDC]) and international sources (World Health Organization [WHO], World Organisation for Animal Health [OIE]) as well as peer-reviewed scientific articles. FAO makes every effort to ensure, but does not guarantee, accuracy, completeness or authenticity of the information. The designation employed and the presentation of material on the map do not imply the expression of any opinion whatsoever on the part of FAO concerning the legal or constitutional status of any country, territory or sea area, or concerning the delimitation of frontiers.

 

Overview

  • Situation:
    • Influenza A(H7N9) virus with pandemic potential.
  • Country:
    • China; three human cases originated in China and were reported in Malaysia (1) and Canada (2).
  • Number of human cases:
    • 1349 confirmed; 497 deaths (since February 2013)
  • Provinces/municipalities:
    • [China]
      • Beijing,
      • Chongqing,
      • Shanghai and
      • Tianjin municipalities;
      • Anhui,
      • Fujian,
      • Guangdong,
      • Guizhou,
      • Hebei,
      • Henan,
      • Hubei,
      • Hunan,
      • Jiangsu,
      • Jiangxi,
      • Jilin,
      • Liaoning,
      • Qinghai,
      • Shandong,
      • Sichuan,
      • Yunnan and
      • Zhejiang;
      • Hong Kong SAR;
      • Macao SAR,
      • Guangxi,
      • Ningxia Hui and
      • Xinjiang Uyghur Autonomous Regions;
    • [Taiwan],
    • [Malaysia]
      • Sabah;
    • [Canada]
      • British Columbia.
  • Animal/environmental findings:
    • around 2,500 virological samplesfrom the environment, chickens, pigeons, ducks and a tree sparrow tested positive; positives mainly from live bird markets, vendors and some commercial or breeding farms.
  • Highly pathogenic virus findings:
    • Out of the 1292 confirmed human cases, H7N9 virus isolates from three cases (two from Guangdong and one from Taiwan Provinces) were found to be highly pathogenic for chickens.
    • In addition, the H7N9 highly pathogenic avian influenza virus was detected in 16 chicken and 6 environmental samples from Guangdong Province.
  • Note:
    • The United States Department of Agriculture (USDA) National Veterinary Services Laboratories (NVSL) have confirmed a H7N9 highly pathogenic (Tennessee), and a H7N9 low pathogenic avian influenza virus (Tennessee, Alabama, Kentucky).
    • Sequencing of the genome confirmed that they are of North American wild bird lineage origin.
    • These viruses are thus not the same as the ones currently circulating in China. [reference1, reference 2, reference 3, reference 4, reference 5]
  • FAO actions:
    • liaise with China and partners, monitor situation, monitor virus evolution, conduct market chain analysis, risk assessment, surveillance guidance and communication.

 

Map. Human cases and positive findings in birds or the environment

Human cases and positive findings in birds or the environment

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Note:  Human cases are depicted in the geographic location where they were reported; for some cases, exposure may have occurred in a different geographic location. Precise location of 18 human cases in Anhui (1), Beijing (1), Guangdong (1), Hebei (2), Hunan (1), Hubei (2), Jiangsu (1), Jiangxi (5), Sichuan (2) and Zhejiang (2) Provinces are currently not known, these cases are therefore not shown on the map.

 

Situation update

  • Animals
    • 16 March: MoA published the results of the national animal H7N9 surveillance for the month of February [reference]:
      • Out of a total of 444,950 samples (328,211 serum samples and 116,739 virology samples) collected from 19,181 locations in 27 provinces, 756 serum and 97 virology samples tested positive.
      • H7 serologically positive samples were found in eight provinces namely Chongqing, Liaoning, Hubei, Henan, Shandong, Guangdong, Jiangsu, and Hunan; of which 694 positive chicken samples (more than 90%) were from farms or households.
      • H7N9 virologically positive samples were found in the following provinces:
        • Guangdong: 28 chicken and 7 environmental samples from 1 household, 21 markets/live bird trading areas;
        • Jiangsu: 17 chicken, 2 duck and 5 environmental samples from 4 households and 8 markets/live bird trading areas;
        • Hubei: 12 chicken and 5 environmental samples from 1 farm and 11 markets;
        • Fujian: 8 chicken samples from 7 markets; and 1 environmental sample from a market;
        • Henan: 1 chicken sample and 3 environmental samples from 1 live bird slaughter shop and 2 live bird trading area;
        • Zhejiang: 1 chicken sample and 3 environmental samples from 4 markets;
        • Liaoning: 1 chicken and 1 environmental sample from 1 market;
        • Chongqing: 1 chicken and 1 environmental sample from 1 farm.
      • No positives were found in Beijing; Tianjin; Hebei; Shanxi; Inner Mongolia; Jilin; Heilongjiang; Shanghai; Anhui; Fujian; Jiangxi; Shandong; Guangxi; Sichuan; Guizhou; Shaanxi; Qinghai; Ningxia; Xinjiang.
    • 14 March: the 2017 National Animal Disease Surveillance and Epidemiological Surveys Program was released by MoA, covering priority animal diseases [reference]. Annex 1 outlines locations, sample size, tests and responsibilities for influenza surveillance in animals.
      • Guangdong:
        • Zhongshan City announced a regular closure plan from 1 April 2017: LBMs will be suspended for three days twice a month (from 1 to 3 and from 15 to 17) between 1 November and 30 April (high season of avian influenza) and once a month (on the 15th) the rest of the year. [reference].
        • Zuzhou City: temporary closure of all the LBMs in the entire city from 20 March to 9 April [reference].
        • Shantou City: LBMs of the whole city were suspended from 18 to 20 March [reference].
        • According to the provincial CDC monitoring results, during the week 10, of the 847 environmental specimens from 69 LBMs in 21 cities, 32 samples tested positive for H7 subtype. The positive rate declined with 3.6% compared to 8.3% last week [reference].
      • Guangxi:
        • Yizhou City: due to the report of two human cases and a positive sample collected in a LBM, live bird trade of the entire city are suspended from 17 to 26 March (10 days) [reference].
        • Baise City: monthly suspension days of LBMs and live bird shops was set in Napo County on 14 and 15 March [reference].
      • Guizhou:
        • in Qiannan Prefecture, LBMs in Sandu County will be temporarily suspended of from 14 to 29 March [reference].
      • Hunan:
        • in Changsha City, all LBMs will be temporarily closed from 17 March to 6 April (21 days) [reference].
      • Jiangxi:
        • Shangrao County: for prevention purposes, the closure of all LBMs, including live bird trading area and white poultry slaughter & sales area in Xinzhou District is extended until 2 April [reference].
        • Pingxiang City: for prevention purposes, all LBMs are temporarily closed in the city from 13 to 31 March [reference].
  • Humans
    • Since the last update (15 March 2017), 29 new human cases have been reported in:
      • Guangxi (7),
      • Hunan (5),
      • Guangdong (3),
      • Guizhou (3),
      • Henan (3),
      • Jiangsu (3),
      • Hebei (2),
      • Chongqing (1),
      • Fujian (1), and
      • Jiangxi (1).
    • For detailed information on human cases, please refer to WHO's Disease Outbreak News.

 

Figure 1. Number of positive virological samples from birds or the environment, by province and origin as of 22 March 2017. Information provided corresponds to both high and low pathogenic H7N9 viruses.

Number of positive virological samples from birds or the environment, by province* and origin

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Figure 2. Number of officially reported human cases since February 2013 as of 22 March 2017. Information provided corresponds to both high and low pathogenic H7N9 viruses.

Number of officially reported human cases since February 2013

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Figure 3. Incidence of officially reported human cases by month, based on onset date as of 22 March 2017. Information provided corresponds to both high and low pathogenic H7N9 viruses.

Incidence of officially reported human cases by week, based on onset date

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Note: For cases with unknown onset dates from wave 1 (n=7), wave 2 (n=2), wave 3 (n=146), wave 4 (n= 27) and wave 5 (n=434) reporting dates were used instead.

 

Publications

  • In addition to the surveillance findings by MoA and MoH, 1,728 virologically positive samples have also been reported in 12 peer-reviewed articles (1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12). A total of 71,920 samples have been collected in these studies since April 2013, of which 1,728 (2.4%) were positive for H7N9 (1,215 environmental samples, 501 chickens, 1 goose and 1 tree sparrow).
  • An analysis of the number of human infections during the five waves of H7N9 was published:
    • the clinical characteristics and risk factors for human infections do not appear to have changed.
    • The reported human infections during the fifth epidemic, total of 460 as of 24 February 2017, represent a significant increase compared with the first four epidemics, which resulted in 135 (first epidemic), 320 (second), 226 (third), and 119 (fourth epidemic) human infections [reference].

 

FAO’s support to countries

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Keywords: FAO; H7N9; Updates; Avian Influenza; Human; poultry; China.

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