Flu Scan for Dec 29, 2014

Flu keeps rising in US
H5N1 cases in Egypt
H7N9 cases in China region
Avian flu in 4 countries

US flu markers rise higher

The nation's flu markers showed another sharp spike last week, with all 10 of the Centers for Disease Control and Prevention (CDC) regions reporting that clinic visits for flu-like illness were above their baselines.

Overall, the percentage of doctor's visits for flu-like illness climbed from 3.7% to 5.5% last week, while the percentage of respiratory samples that were positive for flu increased from 25.9% to 28.1%

Four more pediatric flu deaths were reported, lifting the season's total to 15 from 9 states. Overall deaths from pneumonia and flu reached the epidemic threshold for the first time this season.

Twenty two states—mostly in the Southeast and Midwest—and Puerto Rico reported intense flu activity, up from 13 the week before, and 36 states are now reporting geographically widespread flu, up from 29 and Guam the previous week.

H3N2 is still the dominant strain, and 67.4% of the viruses tested showed a mismatch with the strain included in the vaccine, which is slightly less than the percentage seen the week before.
Dec 29 CDC FluView


Four H5N1 cases, one fatal, reported in Egypt

Egypt has identified four human H5N1 influenza cases over the past few days, according to government and media reports, continuing an increase in the rate of cases that began in November.

Today Agence France-Presse (AFP) said a case was identified in a 42-year-old Cairo man, marking the city's first case this year but the 25th case nationwide. The story also cited a fatal case in the southern province of Aswan but gave no details; it said this was the country's 10th death this year.

A machine-translated report from the Egyptian Ministry of Health, posted Dec 25 on the blog Avian Flu Diary, said the fatal case involved a 5-year-old boy who fell ill after having contact with sick birds and died on Dec 24.

A third case involves a 25-year-old woman in Minya province, according to another machine-translated MOH statement posted by Avian Flu Diary. The fourth case, according to a translated media report posted by the same blog, is in a 30-year-old woman in Monufia province who had contact with sick chickens.

Meanwhile, a Gulf Today story today reported four fatal avian flu cases in neighboring Libya, but it didn't specify which strain. It said three cases were in Tripoli, the capital, and the fourth was in Tobruk, which lies near the Egyptian border.

The country's health minister said the World Health Organization (WHO) would be sending a team to check on the cases within 2 days, according to the story.
Dec 29 AFP story
Avian Flu Diary posts:
Dec 28
Dec 27
Dec 25


Four H7N9 cases reported in China, Hong Kong

Four more H7N9 avian influenza infections have been reported over the past 5 days, three in China's Zhejiang province and one in a Hong Kong resident that had recently traveled to Guangdong province.

Two of the Zhejiang province cases are in men from Yongkang, a 57-year-old who has been isolated and hospitalized and a 75-year-old who died from his infection, according to translated reports from the FluTrackers infectious disease news message board and a report today from Agence-France Presse (AFP).

The other case-patient from the province is a 20-year-old woman from Shaoxing. According to FluTrackers' translation of a city health bureau statement, she had visited a farmers market a week before she got sick and is hospitalized in critical condition.

The patient whose H7N9 infection was detected in Hong Kong is a 68-year-old woman who had visited the Guangdong city of Shenzhen 2 weeks ago, according to a separate AFP story today. She was hospitalized on Dec 25. Hong Kong's Centre for Health Protection (CHP) said today that health officials have located two people who traveled with the woman on Dec 13 and that the group went to a wet market where they bought vegetables but did not have contact with poultry.

She apparently visited two doctors in Hong Kong on Dec 19 and Dec 23, but did not reveal her travel to the mainland, the CHP said. The CHP is monitoring clinic staff and tracing people who were at the clinic during those times. Her infection is the 10th H7N9 illness detected in Hong Kong since the virus emerged. All had a history of travel to China's mainland.

The H7N9 detection in Hong Kong, the first since early 2014, prompted the CHP yesterday to raise its pandemic alert level from serious to alert. The four new cases lift the global H7N9 total to 474 cases, according to a case list kept by FluTrackers.

In a related development, the WHO on Dec 24 supplied more details about 11 H7N9 cases, 5 of them fatal, that China reported to the agency on Dec 16. Symptom onsets ranged from Nov 11 to Dec 1. Ages range from 31 to 81 years, and three of the patients are women.

Cases are from five different provinces: Xinjiang (4), Zhejiang (2), Guangdong (2), Fujian (1), and Jiangsu (1), and one patient is from Shanghai. All but one had a history of exposure to live poultry. Five are listed in severe condition, and one has mild infection that hasn't required hospitalization.
Dec 29 AFP story
FluTrackers H7N9 case list
Dec 29 CHP statement on H7N9 case
Dec 29 AFP story on Hong Kong case
Dec 24 WHO statement


Avian flu pops up in Russia, Taiwan, South Korea, Japan

Various strains of both highly pathogenic avian influenza (HPAI) and low-pathogenicity H5 avian flu have been reported in birds in Russia, Taiwan, South Korea, and Japan in recent days.

Russia reported a Eurasian wigeon infected with H5N8 avian flu, which has not been seen in the Russian Federation before. The infection was discovered in a sample from the bird's trachea during monitoring, according to a Dec 12 notice from the International Organization for Animal Health (OIE).

The bird, which was destroyed, was in Belaya Gora in the Sakha republic, which is in northeastern Russia. Further investigation, including screening for H5N8 and wildlife control, will be conducted, said the OIE notice.

The Taiwan outbreak, reported by OIE Dec 26, involves subclinical low-pathogenicity H5 avian flu in 20 ducks on a breeder farm housing 2,600 birds. None have died or been destroyed. The farm has been quarantined and disinfected, and movement of poultry within the country has been restricted. The outbreak occurred in Jiaoxi Township in Yilan County, which is in northeastern Taiwan.

Meanwhile, a case of avian flu of unspecified type occurred in Seongnam, a satellite city of Seoul, South Korea, according to a short notice today in the Chosun Ilbo newspaper. It says this is the first case of avian flu in the Seoul area this winter.

In Japan, 42,000 chickens have been slaughtered on a farm in Miyazaki after confirmation of H5N8 avian flu there, according to an article in the Japan Times. It is the second outbreak of HPAI this year in Japan; the first occurred earlier this month in nearby Nobeoka and resulted in destruction of 4,000 birds.

Movement of poultry within 10 kilometers of the new outbreak farm has been restricted. According to the article, officials are shocked at the new outbreak, saying, "Unlike the first case (in Nobeoka), the bird flu this time will involve far bigger numbers of chickens and farms. We need to move quickly."
Dec 12 OIE notice regarding Russia
Dec 26 OIE notice regarding Taiwan

Dec 29 Chosun Ilbo notice
Dec 29 Japan Times article


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