News Scan for Feb 03, 2017

H7N9 cases in Sichuan
H5N5 in swans in Poland
Predicting Ebola severity

New H7N9 cases confirmed in Sichuan province

Today China reported two more cases of H7N9 avian flu in Sichuan province, according to FluTrackers, an infectious disease tracking message board. The patients are in critical condition. According to translated news reports, no close family contacts have tested positive for the highly pathogenic strain.

In other H7N9 news, Hong Kong's Centre for Health Protection (CHP) today posted an overview of 57 cases reported from the Chinese mainland from Jan 16 to Jan 29. Nine of the cases proved fatal. Thirty-two of the patients had reported exposure to poultry or live-bird markets, while investigations to determine exposure are still under way for 21 patients.

The clear majority of cases involved men (45), and symptom onset occurred from Jan 4 to Jan 29. Jiangsu province reported the most cases (13), followed by Guangdong (10), Zhejiang (8), Hunan (7), Jiangxi (7), Anhui (6), Fujian (4), and 1 case each in Hubei and Sichuan.

"Since November 2016, the Mainland health authorities have already recorded 298 human H7N9 cases thus far. We would also like to remind the public that human H7N9 cases continue to occur in neighbouring Guangdong, and the positive percentage for H7 virus of environmental samples is substantial. We again urge the public to pay special attention to health risks of the places of visit," a spokesman for the CHP said.

H7N9 was first detected in humans in 2013.
Feb 3 FluTrackers post
Feb 3 CHP update


Poland reports first H5N5 outbreak; more countries note H5N8

Poland has become the latest country in Europe to report highly pathogenic H5N5 avian flu for the first time, with the virus implicated in an outbreak in Lower Silesian province in the southwest that killed 20 mute swans, officials said today in a report to the World Organization for Animal Health (OIE).

The event began on Jan 27 and has been declared as resolved. Seven countries in Europe have now reported recent H5N5 outbreaks. In addition to Poland, the others are Germany, Greece, Italy, Montenegro, the Netherlands, and Slovenia.

In other avian flu developments, Macedonia reported a highly pathogenic H5 detection in wild birds, while five other European countries reported more H5N8 outbreaks, according to OIE reports.

Macedonia's H5 outbreak began on Jan 13 and involved two mallards found dead at a nature park in Negotino municipality in the central part of the country. Testing was done as part of active surveillance.

Denmark reported four more H5N8 outbreaks in wild birds that began from Jan 7 to Jan 23, affecting different parts of the country. The virus killed three white-tailed eagles and one Eurasian widgeon. Finland reported one more wild-bird outbreak, involving a white-tailed eagle found dead on Jan 22 on the island city of Vardo in the far southwest of the country.

Elsewhere, Greece reported three more H5N8 outbreaks in wild birds, two in Peloponnese region in the south and one in Western Macedonia region in the northwest. The events involved three birds—a mute swan, a graylag goose, and a magpie—found dead on Jan 26. Ireland reported two more outbreaks involving whooper swans found dead in Roscommon and Leitrim counties on Jan 18 and Jan 19, respectively. And Poland reported one more outbreak in backyard poultry, an event that started on Jan 30 in Podkarpackie province in the southeast, killing 44 of 125 susceptible birds.
Feb 3 OIE report on H5N5 in Poland
Feb 3 OIE report on H5 in Macedonia
Feb 3 OIE report on H5N8 in Denmark
Feb 3 OIE report on H5N8 in Finland
Feb 2 OIE report on H5N8 in Greece
Feb 3 OIE report on H5N8 in Ireland
Feb 3 OIE report on H5N8 in Poland


New scale predicts Ebola severity, outcomes

Researchers who treated patients in Sierra Leone during the 2013-2015 Ebola outbreak published a study yesterday in PLoS Neglected Tropical Diseases that aims to accurately help providers gauge which Ebola patients need the most attention in the critical first days after diagnosis.

The research was based on observations and clinical characteristics collected on 158 Ebola patients. The prognosis potential for each characteristic was measured against collected outcome data, and after statistically weighing disease scores, the authors were able to accurately predict death at triage 91% of the time and death after triage 97% of the time.

Co-infection with malaria was associated with a 2.5-fold increase in the odds of death. Disorientation, hiccups, diarrhea, conjunctivitis, shortness of breath, and muscle aches were also strong predictors of death.

Age was also a predictor of mortality. "The patient group aged between 5 and 24 years had the lowest mortality rate of 42.5%, which was significantly lower than other age groups," the authors write. "The over-45's and under-5's were particularly vulnerable, being 11.6 and 5.4 fold more likely to die, respectively."

The authors said this information can help care providers assess which patients need the most help fastest during an Ebola outbreak.
Feb 2 PLoS Negl Trop Dis study

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