NEWS SCAN: H5N1 case in Cambodia, H5N1 outbreaks in Bangladesh, H1N1 mutations, measles in Europe

Jan 17, 2012

WHO confirms first H5N1 case of 2012, in Cambodian toddler
The World Health Organization (WHO) yesterday confirmed that a 2-year-old Cambodian boy is sick with H5N1 avian flu, the first confirmed 2012 case in the world. Citing information from Cambodia's health ministry, the WHO said that the boy, from Banteay Meanchey province, which borders Thailand in northwestern Cambodia, had his first symptoms Jan 3 and was hospitalized Jan 9. He has received oseltamivir (Tamiflu) and is on a ventilator, the report said. "There have been reports that the boy was exposed to sick poultry in his village," the WHO said. No human contact has tested positive for the disease. Since 2005, Cambodia has confirmed 19 H5N1 cases, 16 of them fatal. All eight cases in 2011 in the country were fatal. The WHO's global H5N1 case count has now reached 578, including 340 deaths.
Jan 16 WHO report
Jan 16 WHO global H5N1 case count

Bangladesh reports 3 H5N1 outbreaks on poultry farms
Bangladesh has confirmed three recent outbreaks of H5N1 avian flu that killed 3,676 poultry, with an additional 40,173 culled to prevent disease spread, according to a report to the World Organization for Animal Health (OIE). The first outbreak, on a farm in Meherpur district of Khulna division near the border with India, killed 597 birds on a commercial poultry farm, and the remaining 1,803 were culled. It began Dec 24, was resolved Dec 26, and was reported in the local media. The second outbreak, the largest, began Jan 8 and was resolved the same day. It involved 2,418 poultry deaths on a farm in Dhaka district of Dhaka division, northeast of Dhaka city, which is in central Bangladesh. An additional 34,496 birds were destroyed. The third H5N1 outbreak began Jan 10 and was resolved the next day. The disease killed 661 birds on a farm in Manikgonj district in the southwestern part of Dhaka division. Officials culled an additional 3,874 poultry in that outbreak.
Jan 15 OIE report
Meanwhile, Hong Kong officials reported that preliminary tests on the carcass of a little egret in Yuen Long indicated H5 avian flu. Two chicken farms are within 3 kilometers of where the bird was found, but authorities have found no signs of the disease in domestic flocks. Hong Kong had raised its avian flu alert level on Dec 20 after finding H5N1 in a market chicken and two wild birds but then lowered it again last week.
Jan 14 Hong Kong government report

Fatal H1N1 case involved rare combination of mutations
A fatal pandemic H1N1 infection reported by the Minnesota Department of Health (MDH) marked the first reported case in which a mutation conferring oseltamivir resistance and one sometimes linked with severe illness occurred together, according to a report in Influenza and Other Respiratory Viruses. The virus had the hemagglutinin mutation known as H275Y, which confers oseltamivir resistance, and the neuraminidase mutation D222G, which has been found in some severe H1N1 cases. The patient was a 59-year-old with immunosuppression and multiple conditions that confer a high risk of severe illness; he or she died 34 days after falling ill. Further investigations are needed to determine the significance of infections with H1N1 strains featuring both mutations, the report says. The D222G mutation was first reported by Norwegian investigators, who said in March 2010 that they had detected it in 11 of 61 severe H1N1 cases between July and December 2009 but not in any of 205 mild cases analyzed during roughly the same period. A leading US flu expert said at the time that global H1N1 data did not show a clear association between the mutation and severe illness.
Jan 14 Influenza Other Respi Viruses abstract
Mar 4, 2010, CIDRAP News story on D222G
Oct 25, 2010, CIDRAP News item on D222G

European measles cases top 28,000 through November
Yesterday the European Centre for Disease Prevention and Control (ECDC) reported 917 new measles cases through November, bringing the 2011 total for the continent to 28,887, almost identical to 2010 levels but much higher than previous years'. Two more cases of measles encephalitis were reported since the previous ECDC report a month ago, bringing the yearly total to 26. The number of measles-related deaths remained at eight. The first 11 months of 2010 saw 28,868 measles cases in Europe, compared with 7,175 in all of 2009 and 7,817 in 2008. Thirteen of the 29 reporting countries had rates above 1 case per 100,000 population through November, and only three countries—Cyprus, Hungary, and Iceland—were measles free. The highest incidence was among infants younger than 1 year, at 39.1 cases per 100,000 population. The agency expects the rate of cases to increase later this month as Europe enters its peak measles transmission period.
Jan 16 ECDC news release
Jan 16 ECDC report

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