Avian Flu Scan for Nov 17, 2014

News brief

Egypt reports 2 new H5N1 cases, 1 fatal

A 19-year-old Egyptian woman died today of H5N1 avian flu, an Egyptian health ministry spokesman said, and another person has contracted the disease, according to a Reuters report.

The woman died in a hospital in the southern part of Asyut governorate, which is in the central part of Egypt along the Nile River. She had contact with infected birds, the spokesman said.

Reuters said the second case is in a 30-year-old woman in southern Minya governorate, but a translated statement from Egypt's Ministry of Health on the blog Avian Flu Diary yesterday said the patient is a 3-year-old girl in Minya. Other English-language news outlets reported that age, too.

To add to the confusion, Reuters mentioned a third case in a 3-year-old without specifying the sex of the patient or the governorate. The Reuters story said the child is doing well.

Minya is just north of Asyut and also borders the Nile.

Until further confirmation, CIDRAP News is counting only two new cases, which bring Egypt's total this year to seven—the number that Reuters is also reporting. Egypt confirmed the country's fifth case on Sep 30.

The woman's death brings the number of fatal H5N1 cases in Egypt this year to two.
Nov 17 Reuters story
Nov 16 Avian Flu Diary blog post
Sep 30 CIDRAP News scan on previous case

Two H7N9 cases in China brings reported total to 443

A 54-year-old woman from China's Xinjiang Uygur Autonomous Region and a 45-year-old woman from Jiangsu province were diagnosed with H7N9 avian flu, according to a Nov 15 report from Hong Kong's Centre for Health Protection (CHP). The report said that the 54-year-old woman has died.

There have been 443 human H7N9 cases in mainland China since February 2013, 58 in Jiangsu and 4 in Xinjiang Uygur Autonomous Region, the CHP said. The most recent case was reported on Nov 3 in Jiangsu province.

Hong Kong authorities are conducting thermal imaging at boundary control points and have directed avian flu education at travelers and the travel industry. The CHP is encouraging people to avoid contact with birds and their droppings, wear a mask if they develop respiratory illness, and visit a doctor if they have flu symptoms and a history of travel to affected areas.
Nov 15 CHP press release

News Scan for Nov 17, 2014

News brief

Polio emergency extended as vaccine-derived polio confirmed in 2 nations

The World Health Organization's (WHO's) emergency polio advisory committee met for the third time Nov 2 through Nov 7, advising that global conditions still meet the definition of a public health emergency of international concern (PHEIC), according to a Nov 14 WHO statement.

The committee noted that international spread has continued since its last meeting on Jul 31, with at least three new exportations from Pakistan into neighboring Afghanistan. No other confirmed spread has occurred since March 2014, the panel added.

The risk of new international spread from Pakistan has increased since its last meeting, based on an escalation in case numbers and no improvement in factors that help drive transmission, according to the WHO statement. However, the risk of new spread from nine other countries appears to have decreased, with only two reporting new cases since the end of July: Somalia (one case) and Afghanistan (seven).

The group said it is still concerned that implementation of its temporary recommendations is still incomplete and suggested that Pakistan take further steps, such as restricting international departures of any resident lacking proper polio vaccination documentation. Committee members urged that the PHEIC be extended another 3 months.
Nov 14 WHO statement on polio committee

In another development, the WHO on Nov 14 reported separate unrelated circulating vaccine-derived poliovirus (cVDPV) events in South Sudan and Madagascar.

The South Sudan cases involve two cVDPV type 2 cases isolated from two patients with acute flaccid paralysis (AFP) in people from an internally-displaced persons camp in Unity state, an area where as many as 33% of children are under-immunized against polio. Paralysis onsets were Sep 9 and Sep 12.

In response to the cases, immunization campaigns were held Nov 4, with further efforts scheduled from three states where civil unrest is a problem. The goals of the campaigns are to quickly stop cVDPV2 in the camps while boosting immunity to wild polivovirus type 1.

In Madagascar, cVDPV type 1 (cVDPV1) was isolated from one patient who had AFP onset on Sep 29 and three healthy contacts. Supplemental immunization campaigns are slated for December and January for the country, where as many as 25% of children are thought to be under-immunized against polio. The nation had a cVDPV2 outbreak in 2001, 2002 and 2005, and a VDPV was isolated during a research study in healthy children in 2011.
Nov 14 WHO statement on poliovirus in South Sudan and Madagascar

Minnesota E coli outbreak tied to California celery

An outbreak of Escherichia coli O157:H7 in northern Minnesota has been tied to celery grown in California, according to a Nov 13 report in The Californian.

The Minnesota Department of Health (MDH) confirmed that 57 members of the Fond du Lac Band of Lake Superior Chippewa were sickened by celery served at 5 tribal events from Jul 1-17. Nine people were hospitalized, although no one developed hemolytic uremic syndrome, a dangerous kidney condition associated with E coli infections, the article said.

The tainted celery came from Martignoni Ranch in Gonzales, California. The ranch is located next to a defunct dairy operation. The California Department of Public Health did not find E coli on the ranch or farm, suggesting that the celery could have been contaminated during production, the story said.

The celery was bought from Upper Lakes Food Inc. and prepared by Jim-N-Joe's Northland Katering. Other distributors included Vancouver-based Pro*Act and Mann Packing in Salinas, California.

MDH opened its investigation when five people were treated in 1 day at a hospital in Cloquet, Minnesota. The tainted celery also sickened people in Wisconsin, Alabama, Illinois, Indiana, and Ohio.
Nov 13 Californian article