Friday, March 23, 2018

H5N8: South Africa Issued Orders To Avoid Contact With Shore Birds



As I reported 3 days ago (see South Africa: Media Reports Of Another Penguin Colony Hit By H5N8), HPAI H5N8 continues to be reported in wild birds in South Africa; most recently impacting shore birds. 
While no human infections have been reported with this avian subtype, laboratory experiments suggest it has some zoonotic potential (see Virology: The Zoonotic Potential Of Multiple Subgroups of Clade H5N8 Virus).
The CDC's Influenza Risk Assessment Tool (IRAT) ranks H5N8 in the middle of the pack among the 14 novel viruses with pandemic potential they currently track, ranking its threat in the low-moderate range (less than 5).

Although apparently enacted more to protect seabird colonies from cross-contamination that to protect people from the virus, South Africa's (DEA) Department of Environmental Affairs issued the following statement today regarding avoiding contact with seabirds.

Environmental Affairs on Avian Influenza outbreak affecting several seabird species

23 Mar 2018

Avian Influenza outbreak on seabirds

The Department of Environmental Affairs (DEA), together with all relevant management authorities, is managing seabird colonies and stringent biosecurity measures are being implemented at the various seabird rehabilitation centres, captive institutions and known breeding localities to address the spread of the H5N8 strain of the Avian Influenza that is affecting several seabird species, such as, Swift terns, African Penguins and Cape Gannets, across the country’s coastline.
The Swift terns seems to be most affected than many other species.

In an effort to manage the spread of avian influenza, a decision was taken to halt all the research activities involving the handling of seabirds. This highly pathogenic H5N8 avian influenza is the same strain reported in the poultry industry in 2017. This strain of bird flu has not been found to affect people, as was confirmed through testing of people in contact with infected chickens in South Africa in 2017.
However, bird flu viruses can in rare cases cause infections in humans. Thus, strict biosecurity measures should be enforced and precautions should be taken when handling affected seabirds.
Wild birds are carriers of the disease and are able to carry the disease through flyways. In seabirds, the disease is spread through direct contact between healthy and infected birds. Most seabird species live in colonies, and may contract the disease from each other, or through indirect contact with contaminated equipment or other materials. The current outbreak adds further pressure to already declining seabird populations. Processes are in place to ensure extended surveillance of infected seabirds.

The Department will exercise even stricter precautions and stringent biosecurity measures during the preparation of the voyage to Marion Island (April 2018).

Members of the public are urged to exercise caution when approaching seabirds, especially found along the beach as well as when visiting seabird colonies. Sick seabirds should be reported to the nearest local veterinarian, conservation authority or to a permitted seabird rehabilitation centres.

For media enquiries contact:

Zolile Nqayi
Cell: 082 898 6483

Billions of birds migrate from Europe and Asia each winter to roost in South Africa's summer season, including a number of seabird species.

With fall now arriving in South Africa, they will soon be making the return trip (primarily) via the East Africa-West Asian Flyway - with stop-over sites in the Middle East and the Mediterranean - and some will likely be carrying the H5N8 virus.
Since HPAI H5N8 only arrived in South Africa 10 months ago, exactly how this newly established pool of HPAI avian flu will affect the spread of the virus by migratory birds is anyone's guess.
But given the events of the past few years, we should be prepared for surprises.

Netherlands Reports A Reassorted H1N2 Flu Virus


Influenza reassortment - also known as Antigenic Shift - is something we've discussed often in the blog, albeit mostly in birds, swine, and other mammals.  This reshuffling of influenza genes is the primary force behind the creation of novel or pandemic flu (see NIAID Video: How Influenza Pandemics Occur).
While less commonly reported in humans, as any virologist will tell you; shift happens. 
A couple of months ago, in Double-Whammied By Influenza, we looked at the relatively common occurrence of human dual infection with two types of flu - the prerequisite for reassortment.

The biggest concern is of seeing a humanized (H1N1 or H3N2) influenza virus reassort with a novel flu, like H7N9 or H5N1, potentially producing a highly virulent and easily transmitted hybrid.  
While we've seen co-infections (see Lancet: Coinfection With H7N9 & H3N2), a viable novel-seasonal reassortment has not emerged.
While rare, the same can not be said for reassortments between seasonal flu subtypes.
In 1988-1989 in China (see Human influenza A (H1N2) viruses isolated from China), and again between 2000 and 2003 in the Northern Hemisphere, we saw the brief appearance of a human H1N2 virus - a reassortment between seasonal H1N1 and H3N2.
While a minor player in most regions, H1N2 was the predominant Influenza A(H1) virus reported during the UK's 2001–02 influenza season (cite).
These were human-origin H1N2 viruses, not to be confused with the swine-origin variant H1N2 viruses that have circulated in pigs for decades and that we've seen occasionally jump to humans over the past decade.

From a 2014 EID Journal article -  A Historical Perspective of Influenza A(H1N2) Virus - we learn that this reassorted virus vanished in early 2003, as suddenly as it arrived:
By early 2003, A(H1N2) viruses were no longer being isolated from human samples. In 2006, an A(H1N2) virus that was a triple reassortant-like virus and, with the exception of the matrix gene, genetically similar to A(H1N2)pdm09 viruses, was isolated from swine in China (41).
In late 2009, a novel A(H1N2) virus was isolated from a human in India (5). This H1N2 virus was a reassortant of A(H1N1)pdm09 and A(H3N2) viruses co-circulating in the population. Although this virus had a similar genetic makeup to previously observed A(H1N2) viruses, the source of the HA component differed and was derived from the A(H1N1)pdm09 virus (5).

While ultimately unable to compete against the more biologically `fit' wild H1N1 and H3N2 viruses, both of these incidents suggest H1N2 wasn't that far off the mark.  It obviously transmitted well enough in China and the UK to become - at least for a time - widespread. 
As noted above, rare `one-offs' of H1N2  have been detected in recent years, but we've seen no signs of ongoing transmission.
In late 2016, in EID Journal: Characterization of a Novel Human Influenza A(H1N2) Virus Variant, Brazil, we looked at a triple reassortant H1N2 variant with genetic contributions from swine H1N2 (hemagglutinin), H3N2 (neuraminidase), and pandemic H1N1 (remaining genes) in a teenage pig farm worker. 
All of which brings us to a report today from the Netherlands of a single detection of a reassorted H1N2 virus in a hospitalized patient, who has since recovered. 
This report from NIVEL (Dutch Institute For Health Services Research).

New variant flu virus found

In the Netherlands, it has been found a particularly influenza virus in a general medical practice; a new strain of influenza A (H1N2). The patient was seriously ill and has been restored. The doctor took a nose and throat of sample for influenza surveillance NIVEL Care Records - sentinel. There are no other patients were found with the virus.
The new flu virus consists of parts of two currently circulating influenza viruses. Probably someone infected with both viruses and is hereby created a new combination. This is called a reassortant virus. It's not very common that a reassortant virus, but happens often. Researchers do not expect this virus makes people more ill or can spread faster than the regular flu viruses now. The flu shot this season probably provides protection against this variant.

General complaints

The patient visited in early March 2018 a doctor who participates in the sentinel stations of NIVEL Care Registrations first line . These GPs report weekly on people with flu-like symptoms and taking nose and throat samples off at some of these patients. These samples are sent to the RIVM laboratory for research on viruses that can cause flu-like symptoms. In the laboratory and confirmed by further research at the Erasmus Medical Center found the patient to wear a new strain of influenza virus with them. The patient had general flu-like symptoms such as fever, cough, shortness of breath, sore throat and diarrhea. The patient has fully recovered and is no longer contagious.
Further research

in order to identify possible spread family members are investigated if they develop flu-like symptoms. Within that general practice in the Netherlands and elsewhere are no other infections this flu virus found. According to protocol also informed the health authorities, laboratories and international organizations on this finding.

Peilstations NIVEL care registrations

NIVEL care registrations first line makes use of data which are collected routinely in the care sector at different primary disciplines. Including at nearly 500 general practices with over 1.8 million registered patients. Over forty of these practices - the sentinel stations - also report weekly on the occurrence of a number of diseases, events and transactions that are missing from routine records and are not easy to include, such as influenza. These sentinel existence since 1970.

More information
12th newsletter influenza season 2017-2018
RIVM new flu virus
Frequently asked questions about the new flu virus

While likely a one-off, H1N2 has shown enough tenacity in the past that we'll be keeping out eye out for more reports in the months ahead.

Thursday, March 22, 2018

Russia Reporting A Late Season Surge In H1N1


Two months ago, in Russia As An Outlier in This Year's Flu Epidemic, we looked at what had been (up to epi week 2) a lackluster flu season in Russia. In late January the rate of ILI & ARI morbidity was nearly 30% below the baseline for that time of year.
By mid-February (epi week 6_, in Russia : A Late Season Flu Surge & 3 NAI Resistant H1N1 Viruses, we saw the ILI & ARI rate finally exceed the baseline (by 6.6%) for the first time this winter. 
By last week (week 10) - after appearing to peak the previous week - the rate fell below the baseline once again.  Now last week's report appears to have been in error or complete, as week 11 has once again jumped to the highest level of activity (94.6 per 10 000 of population) for the season (30.3% over baseline). 
While a far cry from the severe season of 2016, this is the highest level of flu activity to be reported this late in March by the Russian Institute of Influenza in the past 7 years. 
Two months ago, the dominant strain in Russia was A(H3N2), while today H1N1 has now pulled into the lead. 

Given the atypical flu seasons we've been seeing the past 12 months around the globe (summer H3N2 outbreaks in Hong Kong & China, followed by Influenza B this winter, and back-to-back H3N2 seasons in the Northern Hemisphere), the unusually mild, and late arriving flu season in Russia this winter is worth noting. 

Some excerpts from this week's Russian Influenza Epidemiological Report (Week 11) follow:

Influenza and ARI morbidity data. Increase of influenza and other ARI activity was registered during week 11.2018 in Russia. The ILI & ARI incidence rate (94.6 per 10 000 of population) was above by 30.3% the nationalwide baseline.

Etiology of ILI & ARI morbidity. The overall percent of respiratory samples positive for influenza was estimated as 26.5%. Proportion of influenza A(H1N1)pdm09, A(H3N2), type A and type B viruses was estimated as 38.4%, 24.8%, 2.6% and 34.1%, respectively.

Antigenic characterization.
222 influenza viruses were characterized antigenically in Moscow and Saint-Petersburg NICs, including 65 influenza A(H1N1)pdm09 viruses, 44 influenza A(H3N2) strains and 113 influenza type B strains.
All influenza A(H1N1)pdm09 strains were related to influenza A/Michigan/45/2015, influenza A(H3N2) strains to A/Hong Kong/4801/2014 viruses. 97 influenza type B strains belonged to Yamagata lineage and were like B/Phuket/3073/2013 reference virus, 6 influenza type B strains belonged to Victoria lineage and were antigenically related to B/Brisbain/60/2008 strain.

Genetic characterization. Full-genome NGS of 58 influenza positive samples and viruses from 6 cities was conducted. 16 influenza A(H1N1)pdm09 viruses belonged to phylogenetic group 6B.1 with amino acid substitutions in HA S84N, S162N and I216T.
According to phylogenetic analisis of HA 18 of 22 tested influenza A(H3N2) viruses belonged to clade 3C.2a carring aa substitutions L3I, N144S, F159Y, K160T, N225D and Q311H in HA1. Four influenza A(H3N2) viruses belonged to genetic subgroup 3C.2a1 and carried aa substitutions K92R, N121K, T135K and H311Q.
2 influenza B viruses of Victoria-lineage belonged to genetic subgroup 1A (B/Brisbane/60/2008-like). All 18 influenza B viruses of Yamagata-lineage belonged to clade 3 (B/Phuket/3073/2013-like) and had substitution L172Q and M251V in HA1.

Susceptibility to antivirals.Most viruses were susceptible to NA inhibitors excluding three influenza A(H1N1)pdm09 strains isolated in Moscow which had H275Y amino acid substitution in NA responsible for highly reduced susceptibility to oseltamivir and zanamivir.
14 influenza strains tested in MUNANA-assay for antiviral resistance to NA inhibitors in RII NIC, including 3 A(H1N1)pdm09 strains isolated in St.Petersburg, 4 A(H3N2), two B Victoria strains and 5 B Yamagata viruses were susceptible to oseltamivir and zanamivir. All influenza A strains tested were resistant to rimantadine.

Percent of positive ARI cases of non-influenza etiology (PIV, adeno- and RSV) was estimated as 18.3% of investigated patients by IFA and 8.3% by PCR. Last weeks RSV dominated among ARI agents.

In sentinel surveillance system clinical samples from 144 SARI and ILI/ARI patients were investigated by rRT-PCR. 35 (44.3%) influenza cases were detected among SARI patients, including 8 influenza A(H1N1)pdm09 cases, 16 influenza A(H3N2) cases and 11 influenza B cases. Among ILI/ARI patients 20 (30.8%) influenza cases were detected, including 4 influenza A(H1N1)pdm09, 8 influenza A(H3N2) and 8 influenza B cases.

This late season surge in influenza activity - particularly in countries bordering Russia - has also been noted in the latest Joint ECDC - WHO/Europe weekly influenza Update.

Week 10/2018 (5-11 March 2018)

    • Influenza viruses continue to circulate widely in the Region, apart from some eastern European countries that have only recently reported increased activity.
    • Similar to the previous week, 50% of the individuals sampled from primary healthcare settings tested positive for influenza virus, despite the peak rate for the Region occurring in week 05/2018.
    • Both influenza virus types A and B were co-circulating with a higher proportion of type B viruses and with B/Yamagata continuing to be the dominant lineage.
    • Similar proportions of influenza type A and B viruses were reported in patients admitted to ICU, while the majority of severe cases reported this season have been due to influenza type B and occur in persons above the age of 15 years.

Although the Northern Hemisphere's flu season is clearly winding down, what happens over the next few weeks could still have some influence over what happens in the upcoming Southern Hemisphere flu season.

Eur. Resp.J.: Influenza & Pneumonia Infections Increase Risk Of Heart Attack and Stroke


For the past several years we've watched as a growing body of evidence has linked influenza and other respiratory infections to heart attacks and other cardiovascular incidents - particularly in the week following onset of infection.
While in January of this year, in NEJM: Acute Myocardial Infarction After Laboratory-Confirmed Influenza Infection, we looked at a report that found a `significant association' between recent (lab confirmed) influenza infection and Myocardial Infarction. 
In fact, they reported the odds of having a heart attack in the 7 days following influenza diagnosis went up 6-fold among the subjects in that study.
We've another study - published this week in the European Respiratory Journal - that also finds `substantially increased MI rates in the week after S.pneumoniae and influenza' while the risks of stroke was elevated for as much as 28 days.

First a link and the Abstract, followed by excerpts from a press release by the European Lung Foundation.
Laboratory-confirmed respiratory infections as triggers for acute myocardial infarction and stroke: a self-controlled case series analysis of national linked datasets from Scotland 
Charlotte Warren-Gash, Ruth Blackburn, Heather Whitaker, Jim McMenamin, Andrew C. Hayward 

European Respiratory Journal 2018; DOI: 10.1183/13993003.01794-2017


While acute respiratory infections can trigger cardiovascular events, the differential effect of specific organisms is unknown. This is important to guide vaccine policy.

Using national infection surveillance data linked to the Scottish Morbidity Record, we identified adults with a first myocardial infarction (MI) or stroke from 01/01/2004 to 31/12/2014 and a record of laboratory-confirmed respiratory infection during this period. Using self-controlled case series analysis, we generated age- and season-adjusted incidence ratios (IR) for MI (n=1,227) or stroke (n=762) after infections compared to baseline time.

We found substantially increased MI rates in the week after S.pneumoniae and influenza: adjusted IRs for days 1–3 were 5.98, 95% CI 2.47–14.4, and 9.80, 95% CI 2.7–40.5, respectively.
Rates of stroke after infection were similarly high and remained elevated to 28 days: day 1–3 adjusted IRs 12.3, 95% CI 5.48–27.7, and 7.82, 95% CI 1.07–56.9, for S.pneumoniae and influenza. Although other respiratory viruses were associated with raised point estimates for both outcomes, only the day 4–7 estimate for stroke reached statistical significance.

We showed a marked cardiovascular triggering effect of S.pneumoniae and influenza, which highlights the need for adequate pneumococcal and influenza vaccine uptake. Further research is needed into vascular effects of non-influenza respiratory viruses.


Laboratory-confirmed respiratory infections are linked to strokes and heart attacks in a Scottish population

 From the European Lung Foundation:

Flu and pneumonia infections increase risk of having a heart attack and stroke

European Lung Foundation

People who have had flu or pneumonia may be six times more likely to suffer from a heart attack or stroke in the days after infection, according to new research published in the European Respiratory Journal [1].
The research, funded by the Academy of Medical Sciences, is the largest study to look at the risk of heart attacks and strokes due to specific respiratory infections. It found that several different organisms that cause respiratory infections also increase heart attack and stroke risk, including S. pneumoniae bacteria and influenza.
The researchers say that the findings suggest that getting vaccinated against these two infections could also have a role in preventing heart attack and stroke, along with preventing infection in the first place.
In general, respiratory infections are thought to increase the risk of heart attack and stroke by causing inflammation, which can lead to the development of blood clots. The influenza virus and S.pneumoniae, the most common pneumonia causing bacteria, can also have harmful effects on the heart muscle.
The new research found that having flu or pneumonia increases the risk of having a heart attack for up to a week after infection, and the risk of having a stroke is increased for one month.
        (Continue . . . . )

As any paramedic, ER nurse, or doctor can tell you, heart attacks are more common during the winter than in the summer.

In fact, a 1998 study looked at the rate of heart attacks in the United States, and found that Acute Myocardial Infarctions (AMIs) run as much 53% higher during the winter months than than during the summer.
While cold weather combined with strenuous physical activity (like clearing snow from sidewalks) have often been blamed for this spike, even in balmy Southern California, studies have shown a 33% increase in heart attacks over the winter holidays.
Increasingly, the evidence points to a previously under appreciated side effect of our annual winter respiratory illness epidemic as being behind this increase in excess winter mortality.

All reasons why I am a proponent of getting the flu vaccine every year, and why I elected to take the Pneumovax 23 vaccine when it was offered by my doctor. 
While recommended for everyone over 65, the CDC has a long list of qualifying conditions (which includes smoking, diabetes, and a litany of immunocompromising conditions , etc.) for those under the age of 65.  
To see if you fall into any of these groups and should consider getting the vaccine, either visit the CDC's Pneumococcal Vaccination webpage or talk with your doctor. 

ECDC RRA On Measles In EU & Harvard Study On Mumps Vaccine

Credit ECDC


Measles, which was once almost a youth’s `rite of passage’, was declared `eliminated' (defined as `absence of continuous disease transmission for 12 months or more in a specific geographic area') in the United States in 2000, more than 35 years after the introduction of the first measles vaccine in 1963.
During the 1950s the US saw roughly 4 million infections which hospitalized nearly 50,000, and contributed to the deaths of several hundred every year.
Nevertheless, cases still occur, and in 2017 the CDC recorded 118 cases from 15 states and the District of Columbia who contracted the disease. They cite:
  • The majority of people who got measles were unvaccinated.
  • Measles is still common in many parts of the world including some countries in Europe, Asia, the Pacific, and Africa.
  • Travelers with measles continue to bring the disease into the U.S.
  • Measles can spread when it reaches a community in the U.S. where groups of people are unvaccinated.
As noted, measles is less controlled outside of the United States, and Europe continues to report large surges of cases every few years, involving not hundreds - but thousands - of cases.

Since 1999 EU countries have reported nearly 200,000 cases.

 With measles on the rise again early in 2018, the ECDC has published a new RRA (Rapid Risk Assessment).  First we've the ECDC news report, followed by a link to the full 13 page PDF report, after which I'll return with a postscript on new research on the Mumps vaccine.

ECDC Rapid Risk Assessment highlights young adults and healthcare workers as groups that are susceptible to measles, 21 March 2018

21 Mar 2018

ECDC assesses the risk of measles transmission in the EU/EEA in latest rapid risk assessment.

The latest ECDC rapid risk assessment on the risk of measles transmission in the EU/EEA highlights that vaccination coverage and occurrence of cases vary within countries and population groups. It points to the need for systems to identify and vaccinate young adults, who are increasingly affected and therefore increase measles circulation, but who may not be aware of their vaccination status. Finally, ECDC signals the frequency of cases amongst healthcare workers as a matter of concern and suggests that Member States may consider specific interventions to ensure this group is vaccinated.

    Measles cases occur unequally within countries

Data showing the distribution of measles cases within countries (Figure 1) highlights the importance of vaccination coverage of at least 95% of the general population throughout a whole country with two doses of measles-containing vaccine. This is recommended and necessary to ensure that measles circulation is interrupted, and that introduction of measles cases does not result in secondary cases. The availability of data at subnational level allows identification of geographical areas where measles cases are occurring and where targeted actions may be needed to identify unvaccinated individuals, increase coverage rates and carry out response activities.
    Measles increasingly affects young adults who may not be aware of their vaccination status

Some countries have seen an increasing proportion of cases among adults, prompting the need to consider actions to identify people or pockets of susceptible individuals who are incompletely vaccinated or not vaccinated at all. In light of current outbreaks in several EU countries, individuals who have not been vaccinated with two doses of measles-containing vaccine are at risk of contracting and further spreading measles, especially to infants who are too young to be vaccinated and are more vulnerable to complications from the disease.

Healthcare providers should consider recommending vaccination for all eligible individuals who are not immunised, or not fully immunised, in line with national recommendations. Any encounter with the healthcare system should be used as an opportunity for a catch-up vaccination against measles as well as other vaccine-preventable diseases.

    Frequency of measles cases amongst healthcare workers a matter of concern

The frequent occurrence of measles among healthcare workers in several EU/EEA countries is a matter of concern and Member States may consider specific interventions to address this, such as ensuring that all healthcare workers are immune to measles, with proof/documentation of immunity or immunization as a condition of enrolment into training and employment.

ECDC Rapid Risk Assessment highlights young adults and healthcare workers as groups that are susceptible to measles, 21 March 2018

21 Mar 2018

Given the current extent of measles circulation in the EU/EEA, the trend in recent years, and the fact that vaccination coverage for the first and second dose is suboptimal, there is a high risk of continued measles transmission with mutual exportation and importation between EU/EEA Member States and third countries.

Risk of measles transmission in the EU/EEA - EN - [PDF-1.44 MB]

Along with measles, another highly transmissible `childhood' disease - mumps - has been making a comeback in the United States in recent years, and not just in children.  Until 2005 - the mumps vaccine had been credited with reducing the incidence of mumps by about 99%. 

A study, published yesterday in Science Translational Medicine, suggests waning effectiveness of the mumps component in the MMWR vaccine may be behind the dramatic resurgence in mumps cases over the past dozen years. 
They report: `Synthesizing data from six studies of mumps vaccine effectiveness, we estimated that vaccine-derived immune protection against mumps wanes on average 27 years (95% confidence interval, 16 to 51 years) after vaccination.
First a link to the study, and then some excerpts from a Harvard Crimson report on the study.

Vaccine waning and mumps re-emergence in the United States

Joseph A. Lewnard1,* and  Yonatan H. Grad2,3,*

Science Translational Medicine 21 Mar 2018:
Vol. 10, Issue 433, eaao5945
DOI: 10.1126/scitranslmed.aao5945

Harvard Study Links Mumps Outbreaks to Waning Vaccine Immunity 

The recent spate of mumps outbreaks across the country, including one at Harvard, may be due to the waning effectiveness of the mumps vaccine, according to a new study published by two researchers at the Harvard School of Public Health.
Cases of mumps have been on the rise nationwide, according to the Centers for Disease Control and Prevention. In 2017, more than 5,000 people contracted the disease, up from fewer than 1,000 in 2012. College campuses have been hit particularly hard, which experts have previously attributed to the close contact between students.
Grad said he wanted to discover whether the increase in mumps cases was due to a new strain of mumps resistant to the vaccine—or due to the vaccine’s effectiveness wearing off as patients aged. Currently, federal recommendations call for two vaccinations: one between 12 and 15 months of age, and a second between four and six years.
“In our analysis, we saw that waning was consistent with what we were observing, whereas the appearance of a new strain that escaped the vaccine was not,” he said.
In the research paper, the authors suggest a third vaccination around age 18 as a possible means to reduce cases of mumps. The scientists are not the first to consider this idea: In light of recent research, the CDC recommended a third dose for at-risk populations in a January report.
Still, official recommendations do not call for all people to be routinely vaccinated at 18, which the authors say “should be assessed in clinical trials.”

(Continue . . . )

For more on measles, mumps, and the third element of the childhood disease trifecta - Pertussis - you may wish to revisit these blogs:

AMA Statement Supporting Stricter Requirements For School Vaccinations
CDC Telebriefing: Worst US Measles Outbreak In 20 Years

California: Pertussis Rising (Again)

NYC Health Department Investigating Measles Outbreak

ECDC: Risk Assessment On Measles Outbreak Aboard Cruise Ship

Wednesday, March 21, 2018

Germany: Schleswig-Holstein Ag Minister Confirms H5N6 On Hallig Suederoog


Although Germany reported the new H5N6 virus for the first time in a wild duck during the first week of January (see OIE Report), it hadn't - until today - reported this recent reassortment in poultry. 

The following announcement from the Schleswig-Holstein Government website, and describes an outbreak on the small island of Hallig Suederoog (pop. 2) off the northwest coast of Germany.

Avian Influenza on Hallig Süderoog

datum 03.21.2018
In a poultry farm with 57 chickens, turkeys, ducks and geese the avian influenza virus of subtype H5N6 has been detected.
Approximately one year after the last detection of avian influenza in Schleswig-Holstein has come again to an outbreak of notifiable animal disease. In a small animal husbandry on the holm Süderoog in the district of North Friesland experts from the Friedrich Loeffler Institute had detected the pathogen subtype H5N6. The 57 chickens, turkeys, ducks and geese must now be killed.
Restricted zones established

On the holm a restricted area was established after the outbreak. A complementary observation area includes the island of Pellworm. In these zones, strict security measures such as an obligation to keep poultry apply. In addition, the transport of live birds in the area is prohibited.
Strict security measures

The Environment Ministry urged all poultry farmers to comply with the prescribed safety regulations and for example, to feed their animals where wild birds do not have access. Feed, bedding and other items with which the poultry can come into contact should be kept away from wild birds. If it comes in a stable to increased animal deaths must be called a veterinarian to determine the cause. Dead wild birds such as ducks, geese, gulls and raptors should be reported to the veterinary or town clerk's office.

new subtype

The now proven pathogen subtype H5N6 is very similar to the subtype H5N8, which infected many animals in Europe in winter 2016/2017. H5N6 has so far been detected in Switzerland, the United Kingdom, Ireland, Sweden and Denmark. In January, the pathogen first appeared in a wild duck in Bavaria. It is not known that the virus can be transmitted to humans.

With migratory birds now headed north for the spring, countries along the flyways will need to stay alert for additional outbreaks.