Avian Flu Scan for Dec 23, 2014

News brief

China reports world's 2nd H5N6 case

China today reported the world's second known human case of H5N6 avian flu, in a 58-year-old man in Guangzhou, Guangdong province, Hong Kong's Centre for Health Protection (CHP) said.

The first case, in early May, was in Sichuan province and proved fatal.

The current H5N6 patient is hospitalized in critical condition in Guangzhou, the CHP said in a press release. His close contacts have shown no sign of illness.

The man tested positive for H5N6 in routine testing by provincial health officials for influenza and severe pneumonia, Xinhua, China's state news agency, reported today. Further testing by the Chinese Center for Disease Control and Prevention confirmed the result yesterday.

"All boundary control points have implemented disease prevention and control measures" a spokesman said in the CHP release. "Thermal imaging systems are in place for body temperature checks of inbound travellers. Suspected cases will be immediately referred to public hospitals for follow-up investigation."
Dec 23 CHP news release
Dec 23 Xinhua story
May 6 CIDRAP News scan on first H5N6 case

Egypt reports its 21st H5N1 infection

Egypt's Ministry of Health today reported the nation's 21st case this year of H5N1 avian flu, in a 42-year-old from Sohag governorate in central Egypt, according to a translated statement posted on the infectious disease blog Avian Flu Diary.

The man first had symptoms on Dec 19 and was hospitalized the next day with fever and a cough, the statement said. He has received oseltamivir (Tamiflu) and is in stable condition. He tested positive for H5N1 yesterday.

He owns a farm where dead birds had been identified before he fell ill, the health ministry said. Of Egypt's 21 cases this year, 9 have been fatal, the ministry reported. Four of the patients—including the latest—are still receiving treatment.
Dec 23 Avian Flu Diary post

Two reports note phylogeny of H10N7 in European seal die-off

Genetic analysis of H10N7 avian flu viruses isolated from dead seals in Denmark and Germany shows they are closely related to H10N7 strains from the republic of Georgia and from Egypt, as well as those recently identified in other parts of northwestern Europe, according to separate reports yesterday in Emerging Infectious Diseases.

In Denmark, researchers isolated H10N7 from two of four dead seals they examined after a die-off of at least 152 harbor seals on the island of Anholt. They found both the hemagglutinin (HA) and neuraminidase (NA) segments showed high-level nucleotide sequence identity to avian flu viruses from birds in Scandinavia and Georgia.

The HA of the Danish viruses was 98.7% identical and the NA 97.0% identical to viruses isolated from seals in Sweden in April.

In the German report, samples from 11 of 17 dead seals tested positive for influenza A, and H10N7 was identified on further testing. The German team found the HA and NA genes were most closely related to H10N7 viruses recently found in migratory ducks in Georgia, Egypt, and the Netherlands.

The report said that, in the coastal waters of Schleswig-Holstein, Germany, alone, 1,400 of about 12,000 harbor seals have died of influenza-like illness. Officials last week estimated the death toll among seals in Sweden and Denmark to be about 3,000.
Dec 22 Emerg Infect Dis Danish report
Dec 22 Emerg Infect Dis German report
Dec 16 CIDRAP News scan on death toll in seals

News Scan for Dec 23, 2014

News brief

New, possibly tick-borne virus cited in death of Kansas resident

A Kansas resident who died this past summer was infected with a new virus that may have been carried by ticks, the Kansas Department of Health and Environment (KDHE) reported in a press release yesterday.

The patient died after having symptoms like those of other tick-borne diseases, including fever and fatigue, the KDHE said. The virus's host is unknown, but it is believed to be spread through bites from ticks or insects.

The virus has been named Bourbon, after the southeastern Kansas county in which the patient lived, the KDHE reported. For confidentiality reasons, officials are releasing no information about the victim, said Kansas State Epidemiologist Charles Hunt, MPH.

Because of the patient's symptoms and changes in blood counts, it was initially believed that he or she had a tick-borne illness such as ehrlichiosis or Heartland virus disease, the agency said. But the patient tested negative for known tick-borne diseases, and after further investigation the pathogen was found to be a new virus.

"It is not known if Bourbon virus was the cause of death or how much it contributed to the resident's death," the department said.

The statement said there are plans to look for the virus in other Kansas residents with similar illnesses who have tested negative for Heartland virus within the past year, the statement said. The heartland virus was discovered in Missouri in 2012.

Hunt told CIDRAP News that the Centers for Disease Control and Prevention (CDC) is taking the lead in developing the testing plan. He said he didn't know how many patients would be involved in the study.

The CDC has developed a blood test for the virus, the KDHE said. There are also plans to test ticks and insects in an effort to learn how people get infected.
Dec 22 KDHE press release

New case of listeriosis tied to caramel apples; source a mystery

An additional case of listeriosis linked with commercially produced, prepackaged caramel apples has been reported, this one in Wisconsin, bringing the total to 29 cases in 10 states (see CDC map below), according to a CDC update yesterday.

All case-patients have needed hospitalization, and five deaths have occurred. Listeria monocytogenes contributed in three of the deaths and may have contributed in a fourth. Nine of the cases were in pregnant women or newborns.

Of the 23 case-patients who have been interviewed to date, 20 (87%) had eaten commercially produced, prepackaged caramel apples in the month before they became ill. No illnesses have been related to plain apples or to caramel candies.

States affected include Arizona (4 cases), California (1), Minnesota (4), Missouri (5), New Mexico (5), North Carolina (1), Texas (4), Utah (1), Washington (1), and Wisconsin (3).

CDC, Food and Drug Administration (FDA), and public health personnel in several states are investigating the outbreak. No specific brand of caramel apples or source of contamination has been identified yet, and no products have been recalled. The CDC is advising consumers to refrain from eating any commercially produced, prepackaged caramel apples until more information is available.
Dec 22 CDC update
Dec 19 CIDRAP News story on outbreak