News Scan for Feb 04, 2016

H7N9 cases in China
Human-to-human Legionnaires'
Avian flu in 3 African nations

China reports 2 H7N9 cases in Hunan province

China has two new H7N9 avian flu cases, both in men in the same district of Yongzhou city in Hunan province, according to local health officials.

The first patient is a 60-year-old man in Yongzhou, Hong Kong's Centre for Health Protection (CHP) said today. He is from Lingling district and is receiving treatment, according to a statement from Hunan public health officials translated and posted yesterday by FluTrackers, an infectious disease news message board. No word on his condition or potential exposure to poultry.

The second H7N9 patient is a 48-year-old man who died today in a hospital in Yongzhou, according Xinhua, China's state news agency. Local officials said his cause of death was liver and kidney failure, but the man, also from Lingling district, tested positive for the virus. The source of his H7N9 infection is unknown.

Hunan province has reported five H7N9 cases this year, two fatal, the story said. A case list maintained by FluTrackers, however, lists only three 2016 cases in the province. The outbreak total since 2013 has now reached 718 cases, according to FluTrackers.
Feb 4 CHP news release
Feb 3 FluTrackers post on older patient
Feb 4 Xinhua story
FluTrackers H7N9 case list


Portuguese scientists report probable person-to-person Legionnaires'

A Portuguese team reported in the New England Journal of Medicine today on a likely case of human-to-human transmission of Legionella pneumophila, which causes Legionnaires' disease. This finding has not previously been reported.

The case happened in 2014. The researchers detail the case of a 48-year-old man who worked at a cooling tower complex in Vila Franca de Xira, Portugal. Samples from the tower later tested positive for L pneumophila.

The man first had respiratory symptoms on Oct 14, including an intense cough. His 74-year-old mother cared for him till he was admitted to the hospital about 8 hours later. The man's condition deteriorated, and he required extracorporeal membrane oxygenation on Oct 22.

His mother began having symptoms on Oct 27 and was admitted to the same hospital on Nov 3 with septic shock caused by pneumonia. She died on Dec 1, and her son died on Jan 7, 2015. Both later tested positive for an L pneumophila strain that matched an outbreak strain attributed to the son's workplace.

The authors conclude, "Factors that suggest person-to-person transmission are the severity of the respiratory symptoms in Patient 1, the very close contact that occurred during the 8 consecutive hours when Patient 2 took care of Patient 1, and the small area of the nonventilated room where this contact took place. In addition, the timeline of the events was highly coherent."
Feb 4 N Engl J Med letter


Nigeria, Cote d'Ivoire, South Africa confirm H5 outbreaks

Nigeria is battling nine new outbreaks of H5N1 avian flu, Cote d'Ivoire details two H5N1 outbreaks in chickens, and South Africa confirms low-pathogenic H5N2 on three ostrich farms, according to separate reports posted yesterday by the World Organization for Animal Health (OIE).

The Nigerian H5N1 outbreaks, in Kano and Plateau states and the Federal Capital Territory, involved flocks ranging in size from 2 to 200,000 poultry. They began from Jan 27 to Feb 1. Of 210,549 birds on the eight farms and one backyard flock, 1,952 birds were felled by the virus and the rest were euthanized to prevent further disease spread.

Cote d'Ivoire officials reported two H5N1 outbreaks in Abidjan district in the south that occurred in early January. Of the 2,723 broilers and egg-laying chickens on the two farms, 1,172 birds contracted the virus and 1,122 died. Response measures included control of poultry movement and disinfection of the two holdings.

In South Africa, low-pathogenic H5N2 struck three ostrich farms in Western Cape Province in the south, which also had confirmed H7N3 on different ostrich farms (see yesterday's Flu Scan). One of the H5N2 outbreaks happened last September, and the other two in November, according to the OIE report.

The flocks ranged from 355 to 736 birds. Of the 1,806 susceptible ostriches, 575 tested positive for the virus. As was the case with the H7N3 outbreak reported yesterday and per protocol for low-path viruses, no surviving birds were culled.
Feb 2 OIE report on Nigeria
Feb 2 OIE report on Cote d'Ivoire
Feb 2 OIE report on South Africa

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