Avian Flu Scan for Apr 25, 2016

News brief

H5N6 hospitalizes girl in China's Hunan province

For the second time in a week, China reported an H5N6 avian flu case, this time in an 11-year-old girl from Hunan province, according to a provincial government announcement translated and posted by FluTrackers, an infectious disease news message board.

The girl, from Zhuzhou city, got sick on Apr 11 and was apparently hospitalized 2 days later. Testing to determine the cause of her pneumonia revealed the H5N6 virus. She was treated in the intensive care unit, where he condition is improving. The statement didn't say how she was exposed to the virus.

China reported its previous H5N6 infection last week, which involved a 35-year-old man from Hubei province, which shares a border with Hunan. Both are in south central China.

The first human infection involving the novel virus was reported by China in 2014, and the country has now reported 12 such cases, 9 since the end of December. China and a few other Asian countries have reported H5N6 in poultry, but China is the only one to report human cases.

The World Health Organization has said it is closely monitoring H5N6 developments, and that most patients had been exposed to live poultry before they became ill. So far its assessment of the risk hasn't changed.
Apr 25 FluTrackers thread
Apr 21 CIDRAP News scan "Chinese man hospitalized with H5N6 infection"

Lebanon reports first H5N1 outbreak as Ghana, Mexico report events

Lebanon's agriculture ministry recently reported the country's first known highly pathogenic H5N1 avian flu outbreak, which struck a large farm in the eastern region, while officials in Ghana and Mexico reported more highly pathogenic outbreaks in poultry, according to separate reports to the World Organization for Animal Health (OIE).

The Lebanese outbreak was detected after the farm owner reported abnormal bird deaths, which began on Apr 20. Authorities immediately quarantined the farm in the Beqaa Valley, and investigation and further sampling are under way. The outbreak killed 20,000 of 80,000 susceptible birds, with the remaining ones destroyed to curb the spread of the virus, according to the Apr 23 OIE report.

Ghana also reported H5N1 at two commercial farms in the southern part of the country, part of ongoing activity in a handful of African countries, with Nigeria the hardest hit. Ghana reported its most recent outbreak in early February.

Ghana's latest events began on Apr 3 at a layer farm in Eastern region, according to an Apr 22 OIE report. Of 3,940 chickens at the facility, 2,210 deaths were reported, with the remaining ones culled as part of the outbreak response. On Apr 12 the virus struck another layer farm, this time in Western region, killing 102 of 252 birds. The remaining ones were slaughtered.

Elsewhere, animal health officials in Mexico reported six more highly pathogenic H7N3 outbreaks, all but one at commercial poultry farms. Four different states were affected: Puebla and Veracruz, which reported two outbreaks, and two others that reported one outbreak apiece: Oaxaca and Jalisco. All are in southern Mexico. The largest of the events occurred at a layer farm in Jalisco state that housed 161,000 chickens.

The events began from Apr 5 to Apr 20. Of 172,813 susceptible birds at the six locations, the virus killed 1,723, and the remaining poultry are slated for depopulation, and other control measures and investigations are under way.

Mexico confirmed its first H7N3 outbreak last April. So far this year it has reported 29 outbreaks involving the strain.
Apr 23 OIE report on H5N1 in Lebanon
Apr 22 OIE report on H5N1 in Ghana
Apr 22 OIE report on H7N3 in Mexico

News Scan for Apr 25, 2016

News brief

WHO salutes recent malaria successes on World Malaria Day

Global public health initiatives have cut malaria cases 37% and malaria deaths 60% since 2000 and led to other notable progress against the mosquito-borne disease, the World Health Organization (WHO) said today in a new report and press release to commemorate World Malaria Day.

A year ago, the World Health Assembly (WHA) resolved to eliminate malaria from at least 35 countries by 2030, and the WHO said today that 8 countries reported no cases of the disease in 2014: Argentina, Costa Rica, Iraq, Morocco, Oman, Paraguay, Sri Lanka, and United Arab Emirates. Also, the WHO European Region recently reported no locally transmitted cases for the first time, down from 90,000 infections in 1995.

As well, an additional 8 countries tallied fewer than 100 indigenous malaria cases in 2014, with 12 nations reporting between 100 and 1,000 indigenous cases.

The WHA's 2015 goals call for the elimination of local transmission of malaria in at least 10 countries by 2020. The WHO estimates that 21 countries are in a position to achieve this goal, including 6 countries in the African Region, where the burden of the disease is heaviest.

Since 2000, malaria mortality rates have declined by 60% globally, and overall incidence of the disease has dropped 37%, the WHO. In the WHO African Region, malaria mortality rates fell by 66% among all age groups and by 71% among children under 5 years. Sub-Saharan Africa recorded 88% of global malaria cases and 90% of malaria deaths last year.

The WHO also noted the heavy burden that the disease still causes. About 3.2 billion people remain at risk of malaria worldwide, and last year 214 million new cases were reported in 95 countries, including 438,000 deaths.
Apr 25 WHO news release
Apr 25 WHO report
WHO malaria fact sheet

PAHO notes more than 10,000 new chikungunya cases in the Americas

The Pan American Health Organization (PAHO) late last week reported 10,662 new cases of chikungunya in the Americas, bringing the 2016 outbreak total to 54,286 confirmed and suspected cases.

The previous update included 2,508 new cases. The total since 2013 has now reached 1,933,832 cases.

According to the Apr 22 report, Brazil—which has reported an explosion of cases in recent months of Zika, another mosquito-borne disease—accounted for almost all the new cases. It reported 10,111 new chikungunya cases from just 1 week in late February and early March and now has 13,676 cases this year. Even though Brazil is still well behind in reporting cases, it has now passed Colombia as the hardest-hit nation in 2016. Colombia, in fact, adjusted its numbers downward by 200 cases, to 11,843.

Other countries reporting new cases were Guatemala, with 229 new infections and 1,550 total, and El Salvador, which had 127 new cases and 4,389 for the year. Many countries, however, have not reported new numbers for many weeks.

PAHO did report did not report any new chikungunya-related deaths for the year, leaving that number at two. The outbreak was first reported in December 2013 on St. Martin in the Caribbean with the first recorded cases of the disease in the Americas.
Apr 22 PAHO update

Peru reports 25 yellow fever infections; China notes 2 new imported cases

Peru became the first country in the Americas with confirmed cases of yellow fever, with 25 cases, PAHO said late last week, while the WHO noted 2 new cases in China.

The 25 new cases is more than the nation's 2014 and 2015 total combined, PAHO said. Because of the outbreak, the agency on Apr 22 told countries in the region to vigilantly conduct surveillance and diagnose cases so that outbreaks can be prevented, treated, and tracked.

PAHO does not recommend any travel restrictions; rather, it emphasizes the need for vaccination coverage. However, the agency said that global yellow fever vaccine supplies are insufficient in light of growing outbreaks in Africa. Angola, the Democratic Republic of Congo, and Uganda have all reported extensive outbreaks this year.

Kenya has had 2 exported cases, according to PAHO, and China has recently updated its total cases to 11, according to an Apr 22 WHO news release. Both countries traced the origins back to unvaccinated travelers in Angola, which has the largest outbreak. Since December 2015, 1,908 suspected cases have been reported there, with a fatality rate of 13%. To combat the outbreak, officials plan to vaccinate almost 2.15 million people in targeted areas.

In response to the yellow fever cases, China has worked to get its citizens in Angola vaccinated, increased surveillance and communication surrounding yellow fever, and taken other steps, according to the WHO. Because the current climate in China is unfavourable to the mosquito disease vector, the agency said the risk of local transmission is low.
Apr 22 PAHO alert
Apr 22 WHO news release

Tanzania cholera outbreak tops 24,000 cases

An outbreak of cholera in Tanzania has grown to 24,108 cholera cases and 378 deaths, the WHO said on Apr 22.

Although the frequency and intensity of the cases have fluctuated since the outbreak started last year, countries neighboring Tanzania have also experienced outbreaks, the WHO said. Zanzibar, for instance, has reported 3,057 cases, including 51 deaths. WHO cites unclean water and unsanitary latrines as two factors of the disease's spread, adding that because Tanzania has international seaports and airports, cholera could spread well past its borders.

To contain the outbreak, health officials have focused on communicating healthy habits, establishing water safety, monitoring for the disease, and treating patients, the WHO said. A national cholera task force made up of members such as the country's ministry of health, the WHO, and the US Centers for Disease Control and Prevention is overseeing the response.
Apr 22 WHO news release