World NewsDisclaimer: The opinions, interpretations, conclusions, and recommendations contained herein are those of the respective author(s) and do not reflect the official views or policies of CEEZAD.
An Exciting Nobel Prize in Medicine and Physiology
October 12, 2015
The 2015 Nobel Prize awards in Medicine and Physiology are exciting for many reasons. The three recipients-two microbiologists and a pharmacologist-all working with natural compounds, developed therapies to fight various parasites, making remarkable contributions to human and animal health. This linking of human, animal and environmental medicine, known as "One Health" has become an essential focus in effective medical research and practice.
The pharmacologist, Youyou Tu, aged 84, at the China Academy of Traditional Chinese Medicine in Beijing, won half of the $960,000 prize, becoming the first science Nobel winner from China who had worked solely in China for her entire career. Professor Tu's work led to the drug Artemisinin which has significantly reduced death rates from malaria. The other half of the prize is shared between Dr. William Campbell, aged 85, Research Fellow Emeritus at Drew University in New Jersey, and Professor Satoshi Ōmura, aged 80, of Tokyo University, whose combined work led to the drug Avermectin active against a broad range of nematodes and arthropod parasites.
The ages of the three recipients-all in their eighties-indicate that the Nobel Committee of the Karolinska Institutet in Stockholm is increasingly willing to wait until the practical effects of medical discovery are clear. As Nobel Prizes are awarded only to living persons, there is an intriguing reality that many of those who are deserving of Nobel Prizes will not receive them before death intervenes. Professor Tu investigated the anti-malarial properties of some 2,000 herbal preparations and credited the 4th century Chinese physician and herbalist Ge Hong for his work elucidating that an extract made from the sweet wormwood shrub Aterisia annua could be used to treat malaria. This early work led Professor Tu to use modern laboratory techniques to guide her team to the discovery of the anti-malaria drug Artemisinin.
Professor Ōmura identified a compound in a bacterium living in a soil sample which was toxic to roundworms, while Dr. Campbell and his colleagues isolated the active ingredient from the bacterium and developed the parasite fighting drug Avermectin. This drug was subsequently chemically modified to the chemical compound Ivermectin which is widely used to treat parasites in numerous domestic and farm animals, as well as human diseases such as River Blindness and Lymphatic Filariasis with its disabling symptoms of Elephantiasis. Dr. Campbell's discovery was made in 1975 while working at the U.S. pharmaceutical company Merck. As the Nobel Committee noted: "We live in a biologically complex world which is populated not only by humans and other large animals, but also by a plethora of other organisms, some of which are harmful or deadly to us. . . ". After decades of limited progress in developing durable therapies for parasitic diseases, the discoveries of this year's Laureates radically changed the situation (See: www.nobelprize.org/nobelprizes/medicine/laureates/2015/press.html).
These awards indicate that products derived from the natural world-soil bacteria and herbs-can be developed into medicines that save millions of human and animal lives. The Nobel Committee stressed that the first half of its award was not to traditional Chinese medicine itself, but rather to the original scientific research that led to such an important discovery, significantly reducing deaths from malaria, especially among children Furthermore, it should be noted that the second half of the Nobel went to two individual scientists rather than a pharmaceutical company, indicating that the continued focus of the Committee is on the scientific work and its impact, rather than the marketing of the resulting product. The donation of millions of drug treatments to animals and people in greatest need is an important indication of how those in need might eventually receive a life-saving drug, while a pharmaceutical company still makes a significant profit from the marketing of that drug.
Ivermectin-a highly effective chemically modified compound of Avermectin-is used to treat a variety of parasitic diseases in companion and food animals and in humans. What is striking is that as Professor Ōmura was collecting soil samples from a golf course in Japan, and Dr. Campbell in the United States was investigating the properties of those samples neither could have imagined how significant their work would be many decades later throughout the world.
Underlying these awards and the on-going research is the reality that efficacious medicine in the twenty-first century is carried out by teams of scientists, doctors and nurses grounded in a One Health-based awareness that the environment, human medicine and animal medicine are a seamlessly interconnected web.
Avian Influenza Update: The Lull before the Storm?
September 22, 2015
A state-by-state analysis of Highly Pathogenic Avian Influenza (HPAI) H5 virus outbreaks indicates that the outbreak in the U.S. is over. However, the damage that has been done is considerable. For example, in Iowa alone more than 30 million hens and 1.5 million turkeys have been killed, resulting in a loss of half of the state's poultry flock over a period of six months, as well as an estimated economic loss to the state of $1.2 billion (For further information, see: www.cidrap.umn.edu/news-perspective/2015/08/report-finds-12-billion-iowa-avian-flu-damage).
The situation remains disturbing. Already, more than 48 million birds have been killed throughout the country between December 2014 and June 2015, with an economic loss of some $3.3 billion. Furthermore, as Marilyn McKenna has pointed out, "while the flu was originally brought to the US by wild birds migrating down from Canada, most of the spread within the US was due to people and vehicles inadvertently carrying the virus from farm to farm." Extensive biosecurity measures were being taken on a state-by-state and farm-by-farm basis to try to prevent spread of these HPAI viruses. However, it is not over yet; and Dr. John Clifford, Deputy Administrator of APHIS has pointed out: "It's very likely that wild birds will carry the virus with them when they begin migrating south in the fall." See phenomena.nationalgeographic.com/2015/07/15/bird-flu-2/
The HPAI virus strains detected in the U.S. have primarily been H5N2, but there have also been cases of H5N8 and H5N1. Although the risk of bird-to-human transmission of these viruses is limited, unprotected contact with any infected poultry, either sick or dead, should be avoided. The possibility of any virus reassorting or mutating is always present. Therefore, the Centers for Disease Control and Prevention (CDC) has issued new guidance for clinicians and public health professionals on appropriate safety measures. (See www.cdc.gov/flu/avianflu/h5/index.htm)
No vaccines have been used to date, in part because of the limited efficacy of existing vaccines, as well as the potential permanent trade restrictions that would be placed on U.S. poultry if vaccines were to be used. However, the U.S. Department of Agriculture's Animal and Plant Health Inspection Service (APHIS) is assessing the environmental impact of vaccine use and has also requested proposals for vaccine doses to equip the National Veterinary Stockpile.
Publicity about avian influenza has often centered on the danger of an HPAI virus moving from birds to humans. It is true that during the past 13 years there have been 844 confirmed human cases of HPAI H5N1 reported to the World Health Organization (WHO), with 449 deaths (See www.who.int/influenza/human_animal_interface/H5N1_cumulative_table_archives/en/). However, another grave danger is that HPAI, especially with the many H5 strains, can become endemic in a nation's wild birds, as has already happened in many parts of the world. The Food and Agriculture Organization (FAO) has pointed out that: "During a public health emergency, there is need to ensure an appropriate balance between regulatory measures for controlling the biological risk and efforts to ensure stakeholder engagement. Failure to engage stakeholders may hinder efforts to control the disease" (www.fao.org/docrep/018/i3609e/i3609e.pdf).
This outbreak of HPAI caused by several H5 strains is an indication of the need to integrate human, animal and environmental policies in a coherent One Health perspective. Attempts to focus on necessary emergency measures are now essential.
What do we know about the bird flu infecting US farms?
April 28, 2015
Bird flu has been infecting poultry farms in the West and Midwest. With large scale chicken farms affected and increasing numbers of birds being destroyed to contain the spread, GENeS has reached out to experts to find out what we know about current strains of the virus.
Read More at GENeS
Are Camels the Key to Stopping MERS-CoV?
March 5, 2015
This concise and insightful four-minute video sets out the present situation in February 2015 with Middle East Respiratory Syndrome-Corona Virus (MERS-CoV) which has sickened more than a thousand people since 2012, killing some 30% of those who became ill. Dromedary camels have been identified as the primary source of the virus, although there has been some human illness and death not directly linked to camels. Laboratory work has focused on repurposing existing drugs for MERS-CoV and in the search for an effective vaccine. Using a One Health approach, CEEZAD personnel collaborated with NIH personnel to help study the epidemiology of MERS-CoV in Jordan as documented in the video where both CEEZAD and NIH personnel are shown sampling dromedary camels.
Can We Stop Ebola?
Can we stop the spread of the Ebola virus within the next year or will this virus become a global scourge for decades to come? At the present moment, no one knows the answer to that question. The virus appears to have been contained in both Senegal and Nigeria through impressive action, especially by national governments, nongovernmental organizations and many brave doctors and nurses. However, the situation in Liberia, Sierra Leone and Guinea continues to be very serious indeed, despite the impressive efforts of Medecins Sans Frontieres (Doctors Without Frontiers) and a rapidly expanding international effort to tackle the virus.
With approximately 5,000 reported deaths in West Africa thus far, Ebola appears to be of minimal consequence besides the millions dying throughout the world from malaria, tuberculosis, HIV/Aids and other diseases. However, with more than 10,000 cases expected each week for the next few months and a fatality rate of 50% to 70% the present situation is far more serious than simply the reality that a few thousand people in West Africa have died in agony from a disease whose rapid emergence was unexpected by everyone except a few public health specialists.
Now a surfeit of information and policy proposals have emerged. Many academic journals, including Nature, Science, The Lancet and The New England Journal of Medicine, have made their coverage of Ebola free of charge, available to anyone with a computer and an internet connection. Certain facts have emerged, at times disputed, but largely agreed.
First, the international community has been slow to act in part because the spread of Ebola had been confined to Africa for the past several decades. Second, the absence of a tested and trusted vaccine available on an industrial scale has meant that difficult decisions have to be made now about whether to treat a few individual patients with untested vaccines and the serum of those who have survived Ebola. Third, the spread of the virus into urban areas in West Africa with weak public health surveillance and treatment has placed great stress on a few key individuals who have not been given the resources to tackle what has already become an endemic with sporadic international spread.
There is much confusion about whether or not Ebola spreads easily. On the one hand, those who are not showing symptoms of the disease do not appear to transmit it. Even if a person has a temperature and fatigue that characterize the initial phase of Ebola, more than a handshake appears to be necessary to transmit the disease from such a person with early symptoms to another person. Furthermore, there is no evidence of aerosol transmission from one individual to another, although experimental animals could be infected by aerosol exposure under laboratory conditions. The greater the viral load of the person infected with Ebola and the weaker the immune system of the person being exposed to the virus, the more likely transmission is to occur. The disease can be transmitted by blood, saliva, sweat, tears, vomit, stools and other bodily fluids easily encountered by health care workers. However, the relative risks of transmission from different sources are not clear. Surprisingly, of the 375 health workers that according to the World Health Organization (WHO) have been infected by the virus as of 23 September, the 164 who have survived are often not clear on how they contracted Ebola. For a balanced reflection on how transmission occurs and how to prevent it, see the article by Jon Cohen, "When Ebola protection fails," Science, 3 October 2014, Vol. 346, no. 6205, pp. 17-18, doi: 10.1126/ science. 346.6205.17.
The general belief is that if you keep a two-meter distance from another person and protect your mucosal membranes by a face mask (preferably a N95 mask) you are unlikely to acquire the virus. However, if someone with a high viral load of the virus sneezes at you droplets of the virus and your mucosal membranes and eyes are not properly protected, infection is possible; however, this would not be a regular transmission route. Because corpses have very high viral levels, burial teams and family members are at a particularly high risk of acquiring Ebola, especially with the African funeral rites which encourage close contact with the corpse—a practice that is now being tackled by extensive education programs.
David L. Heymann, Professor of Infectious Diseases and Epidemiology at the London School of Tropical Medicine and Hygiene, as well as Head of the Centre on Global Health Security at Chatham House, London UK, has set out in detail the necessity of "innovative and intensified patient isolation, contact tracing and community empowerment." In tackling an earlier outbreak of Ebola in what was then Zaire, now the Democratic Republic of Congo, a three-pronged strategy was implemented successfully: "First, patients were identified and isolated, and protective clothing was provided to health workers. Second, contacts of all patients with Ebola were monitored, and their temperature taken twice a day for three weeks. Those with fever were isolated until diagnoses could be confirmed and those with Ebola were hospitalized. Third, individuals were educated to protect themselves and their families" ("Ebola: learn from the past", Nature 514, pp. 299-300, 16 October 2014. doi: 10.1038/514299a). Unfortunately, this type of comprehensive health care was far easier to achieve in the rural area where Ebola first occurred when a person became infected (possibly from the blood of a game animal butchered for food) than in the tightly packed slums of Monrovia, Liberia.
Important work in confronting Ebola has been launched by the Institut Pasteur, a not-for-profit foundation with its headquarters in Paris which has created 32 Institute Pasteur Centres in 25 nations. From September 10th to 13th many "Pasteurians" met in Paris with the objective of paving the way "for research on Global Health and One Health and to stimulate, catalyse, and support collaborations between the network's diverse group of institutes." (See Audrey Ceschia, "The Institut Pasteur network: a crucial partner against Ebola", The Lancet, Vol. 384, Issue 9950, pp. 1239-1240, 4 October 2014, doi: 10.1016/S0140-6736(14)61694-9). The focus there, as recommended by Professor Heymann, was on "diagnostic support, epidemiological surveillance, case management [and] capacity building to support and train local staff. . ." Clearly, a One Health perspective will be essential to ameliorate a very dangerous virus that has emerged from complex human and animal interaction in both rural and urban environments.
It might be possible to stop the spread of Ebola within the next 12 months, but it is going to take a great deal of imaginative policy formulation and implementation, from many international organizations, national governments, non-governmental organizations and local communities-and much human courage, as well as an extensive financial commitment.
Virus Kills Millions of American Pigs, Pushing Up Pork Prices
A virus that has wiped out as many as seven million pigs in the United States during the past year is pushing the price of pork to record highs and contributing to rising overall meat costs.
Porcine epidemic diarrhea virus, or PEDv, largely escaped public attention until recently, but the National Pork Producers Council (NPPC) estimates it has already killed 10 percent of the country's pigs. Other estimates, including those of the U.S. Department of Agriculture, are lower, with losses projected in the 5 to 7 percent range.
The virus is highly unlikely to pose a direct threat to humans, according to health experts. But across the United States, individual farmers have had to deal with thousands of sick and dying baby pigs, an impact that Howard Hill, president of the NPPC, has described as "heartbreaking."
Read More at National Geographic
CEEZAD One Health Bulletin #4: The Spread of Middle East Respiratory Syndrome Coronavirus (MERS-CoV)
Since the emergence of the first known case of MERS-CoV in a human in Jordan in April 2012, as noted in the CEEZAD One Health Bulletin #2 below, this RNA virus has puzzled virologists, epidemiologists and public health officials. What is the source of the virus? How does the virus spread? Does this virus have pandemic potential? The answer to each of these three questions is still much debated, but understanding of the virus is increasing on a daily basis because of extensive international surveillance, monitoring, laboratory investigation and public health care. However, MERS-CoV has now been found in humans in 14 countries-9 in the Middle East, as well as Greece, Malaysia, the Netherlands, Philippines and the USA, as visitors to the Middle East have contacted the virus and returned to their home countries. With more than 600 confirmed laboratory cases of MERS-CoV, and a death rate of approximately 30%, it should be noted that 514 of these cases and 160 deaths have been in Saudi Arabia.
What is the source of the virus?
Present evidence indicates that the source of the virus for humans is camels, but it is not yet clear how camels have themselves contacted the virus, as well as what has caused the appearance of the virus at this time.
How does the virus spread?
This virus can spread from camels to people, but it is not sustained from human to human. However, it does appear that a number of health personnel in Saudi Arabia are acquiring the virus from patients, often with underlying health conditions who have contacted MERS-CoV. The considerable effectiveness in mitigating and controlling the virus outside of Saudi Arabia suggests that weak infection control within Saudi Arabia is a possible contributory factor to the spread of the virus. A One Health perspective is essential in the search to understand the interaction between human, animal and environmental factors for the emergence and continued transmission of this virus to humans.
Does this virus have pandemic potential?
On May 14, 2014, for the fifth time in less than two years, the International Health Regulations (IHR) Emergency Committee Concerning MERS-CoV met. They concluded that "based on current information . . . the seriousness of the situation had increased in terms of public health impact, but that there is no evidence of sustained human-to-human transmission. As a result of their deliberations, the Committee concluded that the conditions for a Public Health Emergency of International Concern (PHEIC) have not yet been met" (See WHO website on MERS-CoV).
This assessment looks to be balanced and accurate; however, as the Muslim pilgrimage season to Mecca in Saudi Arabia approaches, one moderator for ProMed Digest, Vol 23, Issue 34 has reported on May 14th a personal view that: "This moderator is concerned about what may happen in the coming months with the increase in pilgrims to Saudi Arabia if the increased transmission of the MERS-CoV continues in the Arabian Peninsula. . . . As the pilgrimage peak seasons are coming up, there will be an increase in travel to and from Saudi Arabia, with individuals returning to their home countries, many of which are resource poor and may not have the ability to identify early importations or implement infection control measures. In addition, not all of these individuals reside in major cities in their home countries, so they will be returning to areas with even lesser infrastructures available to address possible cases. Concerns are that the potential for both community and nosocomial spread in these areas is significant. And remembering the evolution of the SARS outbreak, there was a significant increase in transmission associated with the appearance of 'super shedders.'"
This ProMed Digest report continues: "While full details are not presently available, it appears as though there may have been a "super shedder" in the UAE last month (April 2014). In addition, there is already evidence to demonstrate that the requested "self-exclusion" of high risk individuals has not been successful, as a number of the recent importations were in individuals who should have self-excluded. Also, while the genomic studies on the virus have not shown major changes from earlier viruses identified, is there certainty that this rules out the possibility of the virus having made changes that impact on its transmissibility? Until there is sound scientific data on the routes of transmission (especially studying the events of April and May 2014) that confirm there is minimal risk of increased spread outside of the Arabian peninsula, this moderator remains concerned about the upcoming major human migration to and from the Arabian Peninsula. Please note that the above mentioned concerns re: the PHEIC decision today (14 May 2014) are those of this moderator and do not reflect a consensus of the ProMED editors and moderators. - Mod.MPP."
The concerns of this moderator appear to be well-founded. MERS-CoV poses a significant international health risk, both to humans, camels and other animals. It is not a pandemic at this time, but the danger of a pandemic is increasing.
Facing up to H7N9 influenza A
March 5, 2014
The lab at Kansas State University College of Veterinary Medicine is developing a vaccine and anti-viral drug to confront the H7N9 influenza A strain. This work by Dr. Juergen Richt, Director of CEEZAD, and his lab staff has been highlighted in a short video of less than two minutes that has been widely shown in quite a few states, and is now available internationally through this CEEZAD website.
Watch the video here: TVeyes
The international experience with H7N9 in both people and animals will be reported regularly on this CEEZAD website.
CEEZAD News: Open Paper of the Day
February 25, 2014
The wide-ranging website from publishing house Mary Ann Liebert covering science, technology and medicine has chosen to make an earlier paper from Professor Juergen A. Richt and Dr. Robert E. Kahn their "Open Paper of the Day," available free of charge for approximately one month at the link: online.liebertpub.com/doi/pdfplus/10.1089/vbz.2013.999.ceezad. This study, "The Novel H7N9 Influenza A Virus: Its Present Impact and Indeterminate Future," written in April 2013 was originally published in Vector-Borne and Zoonotic Diseases, Vol 13, No 6, 2013, and remains disturbingly accurate almost a year later.
CEEZAD One Health Bulletin #3: The Continuing Danger of the H7N9 Influenza A Virus
February 24, 2014
According to Flutrackers, some 361 persons in China have now been infected with the H7N9 influenza A virus, with 112 deaths; and an indeterminate number of others are still in the hospital with serious infections. Approximately 225 persons have already been infected in the continuing second wave of this virus which began in January 2014. Therefore, it is timely that the wide-ranging website from publishing house Mary Ann Liebert covering science, technology and medicine has chosen to make an earlier paper from Professor Juergen A. Richt and Dr. Robert E. Kahn their "Open Paper of the Day," available free of charge for approximately one month at the link: online.liebertpub.com/doi/pdfplus/10.1089/vbz.2013.999.ceezad
The concluding sentences of their paper, "The Novel H7N9 Influenza A Virus: Its Present Impact and Indeterminate Future," written in April 2013 and published in Vector-Borne and Zoonotic Diseases, Vol 13, No 6, 2013, remain disturbingly accurate almost a year later: "In the case of H7N9, reassortment of several influenza viruses appears to be the basis of this new strain; and several adaptive mutations have already occurred, leading to a partial adaptation to the human environment. This is a very disturbing reality, as this new avian virus seeks not only to survive in avian species but is looking for new opportunities in mammalian and human populations. The outcome of this cross-species interaction with this new H7N9 virus is at present indeterminate. What is determinate-what is conclusively settled-is that an increased commitment to the objectives and implementation of the 'One Health' approach to medicine in general is now more urgent than ever."
As this H7N9 Influenza A virus generally does not cause signs of disease in poultry, but kills some 20-25% of infected humans, surveillance and eradication is proving very difficult, because there is often no indication to humans that specific poultry should not be handled. However, it is important to note that the virus does not pass readily from human to human, even though it does appear to have some ability to cross the species barrier from chickens and ducks to humans.
From February 14th to February 28th, the major city of Guangzhou in southern China has closed its live poultry market-one of the largest in China-in which more than 60,000 birds per day were sold last year. In January, Shanghai in eastern China stopped all live poultry sales for three months. Other disease control measures have included the mass slaughter of chickens and other poultry on both the Chinese mainland and in Hong Kong. However, it is not yet clear whether these disease control measures and advice to the public to cook poultry thoroughly and to practice excellent hygiene (especially careful washing of hands) will be sufficient to stop the further spread of the H7N9 influenza A virus. The President of the Guangdong Poultry Industry Association, Chen Yingfeng, has estimated that throughout China live poultry suppliers are presently losing more than 1 billion yuan ($150 million) per month, following earlier losses of 70 billion yuan ($11 billion) during the last bird flu outbreak in China in April 2012.
Avian Influenza in Cambodia
February 20, 2014
In the third human case of avian influenza this year in Cambodia, the illness of a four-year-old boy was detected by a mobile surveillance team during contact tracing of the second confirmed case. Happily, the boy was immediately admitted to hospital; Tamiflu was administered one day after the detection; and the boy is now in good condition. However, of the 50 confirmed cases of avian influenza in Cambodia since 2005, only 16 persons have survived.
A Joint Press Release from the Kingdom of Cambodia and the World Health Organization (WHO) has noted that the boy had "played [with] and carried [a] dead chicken six days before developing symptoms." Beginning in mid-January some 350 chicken, ducks and geese had died in the village; however, samples taken to the National Veterinary Research Institute (NVRI) by Animal Health Officers had tested negative for H5N1 avian influenza.
The Cambodian Minister of Health, Dr. Mam Dunheng pointed out that: "Avian influenza remains a serious threat to the health of all Cambodians and more so for children who seem to be most vulnerable and are at high risk. . . . Children often care for domestic poultry by feeding them, cleaning pens and gathering eggs . . . [and] they often treat them as pets and . . . like to play where poultry are found. I urge parents and guardians to keep children away from sick or dead poultry and prevent them fro playing with chickens and ducks. Parents and guardians must also make sure children thoroughly wash their hands with soap and water before eating and after any contact with poultry. Hands may carry the virus that cannot be seen by the naked eye. Soap washes away the virus on hands. If children have fast or difficult breathing, their parents should seek medical attention at the nearest health facility and attending physicians must be made aware of any exposure to sick or dead poultry."
In view of the recent outbreaks of avian influenza, a nationwide public health campaign was launched by radio at the end of January. Stress has been placed on keeping poultry away from areas where people live, not eating any sick poultry or poultry found dead, as well as cooking well any poultry that is eaten.
For further information, see: Press Release
African swine fever detected in Poland
February 18, 2014
A dead wild boar was found in Poland about 900 metres from the Belarusian border, just as about a month ago an infected dead boar was found in Lithuania, near the Belarusian border. Russia has already banned all pork imports from the European Union (EU); however, the EU Health Commissioner Tonio Borg pointed out that neither of these outbreaks nor one other case of African swine fever occurred on EU territory. At a meeting of EU Agricultural Ministers held in Brussels on February 17th, Borg stressed that "the fact that the three cases which have been found have been on the border with Belarus indicates that this [disease]was imported from the East, so we feel it even more unjust that there should be this ban against the EU when the disease came from outside the EU-indeed from the very country which is imposing this ban."
Although African Swine Fever does not cross the species barrier and is not dangerous to humans, the disease is consistently lethal for both wild boars and farmyard domestic pigs. Not only is the disease a threat to swine health, but the livelihood of many farmers and pork producers and distributors is threatened. Poland's agricultural minister Stanislaw Kalemba estimated that "approximately 5,000 to 6,000 tonnes of our pork products are not crossing the eastern border each day." An attempt is being made at arbitration, but an official complaint to the World Trade Organization (WTO) may be necessary.
For further information, see: thenews.pl
CEEZAD One Health Bulletin #2: The Puzzle of Middle East Respiratory Syndrome Coronavirus (MERS-CoV)
February 13, 2014
The first known case of MERS-CoV in a human occurred in Jordan in April 2012, although the new virus was not confirmed by laboratory analysis until some months later, as further cases occurred in Saudi Arabia. To date, there have been 182 laboratory-confirmed cases of human infections with 78 deaths; and it is clear that this virus is now a significant threat to both people and animals throughout the Middle East, especially in Saudi Arabia, where 144 people have been infected and 59 have died. Infection occurs especially among men older than 45 who already have underlying chronic disease. Furthermore, there have been small healthcare-associated clusters, which indicate that human-to-human transmission can occur with unprotected exposure. Whether the virus can attain self-sustained transmission is not yet known, nor is the original source.
Research published in The Lancet on 14 December 2013 concluded: "Transmission within Saudi Arabia is consistent with either movement of an animal reservoir, animal products, or movement of infected people. Further definition of the exposures responsible for the sporadic introductions of MERS-CoV into human populations is urgently needed." (See Matthew Cotton, Simon J. Watson, Paul Kellam et al. Lancet 2013. doi:10.1016/S0140-6736(13)61887-5 ). That same Lancet article reflected that because there had been "a substantial period since these viruses shared a common ancestor . . . there might be an intermediary host as the source of human infections" possibly "camels, bats, goats, sheep, dogs, cats, rodents, and others."
In his blog called " Virology Down Under " in the entry for 30 January 2014, Dr. Ian Mackay has summarized research on MERS-CoV antibodies that so far have been found by various investigators in dromedary camels from Saudi Arabia, Oman, the Canary Islands, Jordan, Qatar and United Arab Emirates. In the entry for 2 February 2014, entitled "One Health Initiative is alive and well among Australian influenza specialists," Dr. Mackay reflects that "we still have a lot of data holes to plug in the story of H7N9 and MERS-CoV--both virological and clinical gaps." He has also raised the issue of "whether our own hospital systems enhance the spread of viruses, as they may have done during SARS. Did the West see more of it because of its highly structured intensive care units concentrating cases and funneling infection at healthcare workers, or was it just that less developed nations didn't detect its entry?" Of course, both possibilities could have occurred.
Dutch, Qatari and British scientists have discovered an outbreak of the virus "that involved both camels and humans, but they don't answer the key question of whether camels infected humans or the other way around" (See CIDRAP News and Perspectives, 16 December 2013 ). The complexity of the underlying One Health issues is noted in The Lancet Infectious Diseases February 2014 by Neil Ferguson and Maria Van Kerkhove: "An understanding of the role of animals in the transmission of MERS-CoV is urgently needed to inform control efforts. This virus can spread from person to person, sometimes causing substantial outbreaks, but whether the virus is capable of self-sustained (i.e., epidemic) human-to-human transmission is unknown. If self-sustained transmission in people is not yet underway, intensive control and risk-reduction measures targeting affected animal species and their handlers might eliminate the virus from the human population. Conversely, if zoonotic exposure causes only a small fraction of human infections, then even intensive veterinary control efforts would have little effect on cases in people."
In summary, more than a year after MERS-CoV was first identified neither its source, route of transmission or pandemic potential have been definitively clarified. What is clear is that One Health-oriented unified human, animal and environmental research is now essential.
CEEZAD One Health Bulletin #1: Avian Influenza Increases in China
January 31, 2014
The World Health Organization reports that: "Some avian influenza ("Bird Flu") viruses can infect humans and cause disease. These include H5N1, H7N3, H7N7, H7N9 and H9N2. Some of these infections have been very severe and some have resulted in deaths, but many infections have been mild or even subclinical in humans." However, during January 2014 alone there were 110 people infected with the H7N9 virus, of whom 20 have died, while others are still in intensive care. Furthermore, a newly discovered Influenza virus H10N8 has emerged, killing one person and placing another in critical condition, apparently after both persons had been exposed to domestic fowl in a local "wet market." Nevertheless, despite the renewed emergence of various influenza viruses in China, none of these avian influenza viruses have passed in a sustained manner from person to person.
It is true that a family cluster of H7N9 avian influenza cases has just been reported in Zhejiang where both parents and their daughter contracted the disease, after working as vegetable dealers in a wet market. However, the cause of illness may well be the exposure of all three persons to live poultry rather than human-to-human transmission.
WHO advice about how to protect yourself from avian influenza rightly remains unchanged:
- "Avoid contact with sick or dead poultry; and keep children away from poultry.
- Avoid touching any surfaces that may have been contaminated with poultry feces or blood.
- Do not eat raw or undercooked poultry. Cook poultry to internal temperature of 70 C (until meat is not pink in the centre), and do not touch cooked meat with raw meat.
- Clean cooking implements that have been in contact with raw meat before re-using.
- Wash hands regularly, especially after handling poultry, while cooking and before eating.
- Cover your mouth and nose when you cough or sneeze."
"WHO does not recommend any specific measures be applied to travellers at this time. Poultry, poultry products (eggs), and pork can be safely consumed provided they are properly cooked and properly handled during food preparation." However, all travellers to China are being advised to stay away from live poultry, especially in agricultural markets. The danger of a further increase in avian influenza viruses passing from poultry to humans is especially high at this time of year as the Chinese New Year commences, with millions of people and their poultry (dead or alive) moving around the country.For further information, see the website of ProMED and the WHO International Travel Health Updates
First North American Death from H5N1 Avian Influenza (Bird Flu)
January 10, 2014
The death caused by H5N1 Avian Influenza on January 3, 2014 of an Alberta, Canada resident who had recently returned by air from Beijing to Vancouver has been widely reported. Alberta's Chief Medical Officer of Health rightly suggested that this was "a rare and isolated case." Furthermore, Dr. Michael Osterholm, Director of the University of Minnesota's Center for Infectious Disease Research and Policy (CIDRAP) pointed out that "this doesn't fundamentally change the risk picture for H5N1 around the world."
Two cases of H5N1 were reported in China during 2013, both fatal. The World Health Organization (WHO) reports that 384 of the 648 known human cases of H5N1 have been fatal. However, this particular avian influenza virus does not readily pass between humans, although the virus is widely prevalent, perhaps even endemic, in chickens and wild birds in parts of Asia. Anyone visiting China should avoid contact with chickens, ducks, turkeys and wild birds, especially at live animal markets, where numerous animal species and their viruses intermingle.For further information see CIDRAP news
Indiana reports four fair-linked H3N2v cases
July 2, 2013
Indiana health officials yesterday reported four variant H3N2 (H3N2v) influenza infections in people who attended the same county fair, which could herald a wave of similar infections that occurred last summer. All four of the people visited the Grant County Agricultural Fair from Jun 16 to Jun 22 before they got sick, and at least two had contact with swine, according to a statement from the Indiana State Department of Health (ISDH). Grant County is in central Indiana, and the fairgrounds are located in Marion. The Indiana State Board of Animal Health said 13 pigs at the fair tested positive for H3N2 and that pigs infected with swine influenza viruses sometimes don't show any signs of illness. Flu viruses aren't transmitted by eating pork or pork products. H3N2v was first detected in people in July 2011, and only 12 cases were detected from five states that year. But the number of cases skyrocketed over the summer of 2012, with hundreds of infections in 12 states, according to the Centers for Disease Control and Prevention (CDC). The H3N2 strain was first detected in swine in 2010. Read More
Potential Hot Spot for Avian Flu Transmission Identified in Western Alaska
July 2, 2013
ANCHORAGE, Alaska - Low-pathogenic avian influenza viruses with Eurasian genes have been found among birds in the Yukon-Kuskokwim Delta of western Alaska, supporting the theory that the area is a potential point of entry for foreign animal diseases such as the more highly pathogenic H5N1 strain, according to a new study by U.S. Geological Survey scientists. The Yukon-Kuskokwim Delta is an important breeding ground for many bird species and is located where multiple migratory flyways converge, providing opportunities for avian pathogens to spread. Among these pathogens are H5N1 avian influenza, which occurs in both low-pathogenic and the more dangerous highly pathogenic forms. After the outbreak of the highly pathogenic H5N1 strain of avian influenza in wild birds of China in 2005, the USGS and the U.S. Fish and Wildlife Service, in cooperation with the Yukon-Kuskokwim Health Corporation, the Kawerak Tribal Corporation and other partners, conducted four years of testing wild migratory birds in western Alaska for the highly pathogenic H5N1 strain. Read More
H7N9 bird flu kills about 1/3 hospitalized patients - study
June 24, 2013
PARIS - The H7N9 bird flu that hit China this year killed over a third of hospitalized patients, said researchers Monday who labelled the virus "less serious" but probably more widespread than previously thought. They warned watchdogs not to take comfort from a lull in new infections, as the virus may reappear in the autumn. In what they described as the most complete picture of the virus' severity, researchers in Beijing and Hong Kong found that H7N9 proved fatal in 36 percent of patients admitted to hospital in mainland China. This was a lower fatality rate than H5N1-type bird flu which emerged in 2003 and killed about 60 percent of hospitalised patients. Read More
How Nature Builds A Pandemic Flu Virus
June 7, 2013
Here's a sobering thought: Wild birds - including city pigeons and ubiquitous Canada geese - carry 170 different types of bird flu. You know, all those viruses with the Hs and Ns in their names, like H1N1 and H5N1. Only a dozen of these viruses have infected humans so far, but many of those have been deadly, and three of them have caused global flu pandemics. Does every bird flu that leaps into people have the potential to turn into the next "big one" that spreads rapidly around the world? That's the "critical but currently answerable question," writes Dr. Anthony Fauci, who directs the National Institute of Allergy and Infectious Diseases. Read More
Association between adverse clinical outcome in human disease caused by novel influenza A H7N9 virus and sustained viral shedding and emergence of antiviral resistance
May 29, 2013
Background:On March 30, a novel influenza A subtype H7N9 virus (A/H7N9) was detected in patients with severe respiratory disease in eastern China. Virological factors associated with a poor clinical outcome for this virus remain unclear. We quantified the viral load and analysed antiviral resistance mutations in specimens from patients with A/H7N9.
Methods:We studied 14 patients with A/H7N9 disease admitted to the Shanghai Public Health Clinical Centre (SPHCC), China, between April 4, and April 20, 2013, who were given antiviral treatment (oseltamivir or peramivir) for less than 2 days before admission. We investigated the viral load in throat, stool, serum, and urine specimens obtained sequentially from these patients. We also sequenced viral RNA from these specimens to study the mutations associated with resistance to neuraminidase inhibitors and their association with disease outcome.
Findings:All patients developed pneumonia, seven of them required mechanical ventilation, and three of them further deteriorated to become dependent on extracorporeal membrane oxygenation (ECMO), two of whom died. Antiviral treatment was associated with a reduction of viral load in throat swab specimens in 11 surviving patients. Three patients with persistently high viral load in the throat in spite of antiviral therapy became ECMO dependent. An Arg292Lys mutation in the virus neuraminidase (NA) gene known to confer resistance to both zanamivir and oseltamivir was identified in two of these patients, both also received corticosteroid treatment. In one of them, wild-type sequence Arg292 was noted 2 days after start of antiviral treatment, and the resistant mutant Lys292 dominated 9 days after start of treatment.
Interpretation:Reduction of viral load following antiviral treatment correlated with improved outcome. Emergence of NA Arg292Lys mutation in two patients who also received corticosteroid treatment led to treatment failure and a poor clinical outcome. The emergence of antiviral resistance in A/H7N9 viruses, especially in patients receiving corticosteroid therapy, is concerning, needs to be closely monitored, and considered in pandemic preparedness planning.
Funding:National Megaprojects of China for Infectious Diseases, Shanghai Municipal Health and Family Planning Commission, the National Key Basic Research Program of China, Ministry of Science and Technology, and National Natural Science Foundation of China. Read More
North Korea Culls Birds in Effort to Contain Flu
May 24, 2013
North Korea has culled hundreds of thousands of birds in an effort to contain a deadly strain of bird flu found in a Pyongyang farm, the state media said, throwing the spotlight back on the country's vulnerable food supply. The state news agency said this week that its scientists found ducks in the Tudan Duck Farm in the North Korean capital infected with the H5N1 virus from migratory birds. About 164,000 ducks were killed since the first case was observed last month, according to the state report filed at the World Organisation for Animal Health. Read More
Weekly Overview: New Pig Viral Disease Confirmed in US
May 21, 2013
ANALYSIS - Porcine epidemic diarrhoea virus (PEDV) has been found for the first time in four states in the US, while Foot and Mouth disease (FMD) has been reported in Kazakhstan (in cattle). In advances in disease control, there is a new vaccine against African Swine Fever in Kenya and a promising diagnostic tool for FMD from USDA ARS. There has been official confirmation of porcine epidemic diarrhoea virus (PEDV) in the US for the first time. This is not a new virus, according to USDA, nor is it a regulatory/reportable disease. Since PEDV is widespread in many countries, it is not a trade-restricting disease but rather a production-related disease. Read More
New reports yield clues about H7N9 detection, links to poultry
May 20, 2013
May 16, 2013 (CIDRAP News) - Though the steady stream of new H7N9 cases has tapered, the pace of publications on the new virus is still brisk, with new reports today on Taiwan's case, a link between markets and human cases, and risk assessment and planning for possible scenarios in Europe. All three reports were published in today's issue of Eurosurveillance.
Lessons from Taiwan's H7N9 case:
In the report on Taiwan's only case, officials from the Taiwan Centers for Disease Control wrote that they learned several useful lessons from the case involving a man in his 50s who got sick in the middle of April after traveling for work to China's Jiangsu province, where the virus had already sickened people and been detected in live-market poultry. Within days of the announcement of the first cases in China, Taiwanese officials made H7N9 a notifiable disease and prepared for suspected cases to be detected through its influenza surveillance system, as well as the surveillance system for community-acquired pneumonia of unknown cause. The enhanced surveillance activities helped flag the man's illness. His was the only H7N9 infection confirmed in Taiwan among 358 suspected cases and 41 severe pneumonia illnesses from Apr 3 through May 10. Read More
Scientific Committee on Emerging and Zoonotic Diseases meets on risk assessment and local response to human infection of avian influenza A(H7N9) virus
May 1, 2013
Hong Kong (HKSAR) - The Scientific Committee on Emerging and Zoonotic Diseases (SCEZD) of the Centre for Health Protection (CHP) of the Department of Health today (April 30) convened a meeting to assess the risk and local response in view of the recent human cases of avian influenza A(H7N9) in the Mainland. The SCEZD reached a consensus view that the emergence of human infections with the novel avian influenza virus reported in the Mainland since March 31 is of concern as further human sporadic infections and expansion of geographic spread in the Mainland and other countries/areas is anticipated. Read More
Does H7N9 Chinese Flu Pose a Threat for Pigs?
Apr 30, 2013
A recent outbreak of avian influenza virus in China has made headlines in the mainstream media during the last several weeks. As of April 28, 24 people have died and 122 have been reported as being infected. Influenza viruses are classified in subtypes based on the two main proteins that coat the virus: hemagglutinin (H) and neuraminidase (N). The avian influenza virus causing the current outbreak has been characterized as subtype H7N9. Avian influenza viruses typically affect poultry and wild birds. Birds infected with avian flu can sometimes develop severe disease, but at other times they remain asymptomatic, but can still transmit the virus. Some strains of the virus have the ability to infect humans while others don't. The current H7N9 virus is difficult to control because it does not cause disease in birds, although it can prove fatal to humans. Read More
CDC activates emergency center over H7N9
Apr 10, 2013
The US Centers for Disease Control and Prevention (CDC) activated its Emergency Operations Center (EOC) in Atlanta yesterday to support the response to the H7N9 influenza outbreak in China, CDC officials said in an e-mailed statement today. The EOC was activated at level 2, the second of three levels. Level 1, the highest, signals an agency-wide response. "This is a limited activation that allows for the use of additional resources and staff to meet the technical needs of a public health response," the agency said. Activation was prompted because the novel H7N9 avian influenza virus has never been seen before in animals or humans and because reports from China have linked it to severe human disease, the agency said. Read More
Biodiversity Does Not Reduce Transmission of Disease from Animals to Humans, Researchers Find
Mar 25, 2013
More than three quarters of new, emerging or re-emerging human diseases are caused by pathogens from animals, according to the World Health Organization. But a widely accepted theory of risk reduction for these pathogens -- one of the most important ideas in disease ecology -- is likely wrong, according to a new study co-authored by Stanford Woods Institute for the Environment Senior Fellow James Holland Jones and former Woods-affiliated ecologist Dan Salkeld. The dilution effect theorizes that disease risk for humans decreases as the variety of species in an area increases. For example, it postulates that a tick has a higher chance of infecting a human with Lyme disease if the tick has previously had few animal host options beyond white-footed mice, which are carriers of Lyme disease-causing bacteria. If many other animal hosts had been available to the tick, the tick's likelihood of being infected and spreading that infection to a human host would go down, according to the theory. Read More
Researchers Explain How Prion Diseases May Spread
Mar 13, 2013
Medical researchers at the University of Alberta have made a discovery that may explain how prion diseases, like chronic wasting disease and mad cow disease, adapt in order to spread between various types of animals. The research team, led by neurologist Valerie Sim, discovered that a miniscule change in the prions' makeup appears to give the disease the ability to adapt - to mimic and recreate new strains with which it comes into contact. The team has been studying this area for two years. Read More
Schmallenberg found in UK goats and alpacas
Mar 1, 2013
The Schmallenberg virus has been found in goats and alpacas in Britain for the first time. The Animal Health and Veterinary Laboratories Agency (AHVLA) reported two cases of the virus in goats in East Sussex and one case of Schmallenberg antibodies in an alpaca in Northamptonshire. An AHVLA spokesman said: "We were aware the Schmallenberg virus can affect goats and alpacas, but these are the first confirmed cases we have had in the UK so far. They are both serological results [from blood and plasma] which show that the antibodies to Schmallenberg are in the blood stream which does not mean that the disease has manifested itself. Although this development is not entirely unexpected, with any new presentation of the disease, it's a concern." The AHVLA has asked farmers with goats and alpacas to look out for the symptoms of Schmallenberg virus and report any suspicious cases to vets. Read More
Cambodia sees spike in bird flu deaths
Mar 1, 2013
Hong Kong (CNN) -- In the last two months, eight people in Cambodia have died from bird flu, a rare but deadly disease causing concern among health authorities. Six of the victims have been children. The H5N1 virus, known to be highly contagious to poultry, typically resembles the flu when contracted by humans. But it kills more than half the people it infects, according to Centers for Disease Control and Prevention. Of the nine confirmed H5N1 cases in Cambodia this year, only an 8-month old infant has survived. The infant had received medical attention early, said Dr. Ly Sovann, the Ministry of Health's deputy director for communicable diseases control in Cambodia. The eight bird flu deaths in the last six weeks -- considering that Cambodia has had 19 reported deaths from the disease in the last 10 years -- has sparked increased surveillance efforts. Health officials are warning people to wash their hands often, to keep children away from poultry and to avoid eating sick poultry. Read More
Farm virus 'can infect wild animals'
Feb 20, 2013
A livestock virus sweeping through British sheep flocks and cattle herds has infected wild deer, say scientists. The disease, which is spread by insects, causes birth defects in lambs and can reduce milk yields in cattle. Outbreaks have been reported in farm animals in Belgium, France, Germany, Italy, Luxembourg, The Netherlands, Spain and the UK. European scientists say wild deer can catch the virus, and are calling for the impact on wildlife to be monitored. Read More
Catching the Next H5N1 Before it Hits
Feb 14, 2013
When the bird flu, or H5N1, began sweeping across three continents in 2004, it caused a worldwide panic, killing more than 50 percent of its 600 human victims and 100 million birds. It also added to growing fears about the unpredictability of such epidemics, which were taking an increasingly more significant economic and human toll. Although H5N1 seemed to come out of nowhere, the early 2000s was not the first time the world had encountered the virus. Five years earlier, H5N1 left plenty of so-called "viral chatter"-small outbreaks that precede large outbreaks-killing six of the 18 people who were infected in Hong Kong, China. If scientists had recognized these infections before they turned to outbreaks and then a global pandemic, the story of H5N1 would have been much different. Read More
FAO urges stronger measures on global health threats
Feb 5, 2013
29 January 2013, Rome - The world risks a repeat of the disastrous 2006 bird flu outbreaks unless surveillance and control of this and other dangerous animal diseases is strengthened globally, FAO warns. "The continuing international economic downturn means less money is available for prevention of H5N1 bird flu and other threats of animal origin. This is not only true for international organizations but also countries themselves," says FAO Chief Veterinary Officer Juan Lubroth. "Even though everyone knows that prevention is better than cure, I am worried because in the current climate governments are unable to keep up their guard." Continued strict vigilance is required, however, given that large reservoirs of the H5N1 virus still exist in some countries in Asia and the Middle East, in which the disease has become endemic. Without adequate controls, it could easily spread globally as it did at its peak in 2006, when 63 countries were affected. Read More
Serological evidence of ebolavirus infection in bats, China
Jan 17, 2013
Background: The genus Ebolavirus of the family Filoviridae currently consists of five species. All species, with the exception of Reston ebolavirus, have been found in Africa and caused severe human diseases. Bats have been implicated as reservoirs for ebolavirus. Reston ebolavirus, discovered in the Philippines, is the only ebolavirus species identified in Asia to date. Whether this virus is prevalent in China is unknown. Findings: In this study, we developed an enzyme linked immunosorbent assay (ELISA) for ebolavirus using the recombinant nucleocapsid protein and performed sero-surveillance for the virus among Chinese bat populations. Our results revealed the presence of antibodies to ebolavirus in 32 of 843 bat sera samples and 10 of 16 were further confirmed by western blot analysis. Conclusion: To our knowledge, this is the first report of any filovirus infection in China. Read More
Calls for virus vaccine fast, as still births and deformities increase
Jan 17, 2013
As sheep farmers in the region experience higher than normal losses, still births and deformities, the NFU says every effort must be made to ensure a vaccine is available later this year to help combat the spread of the deadly Schmallenberg virus. The disease has spread across England and Wales to the Scottish border region, and has now been confirmed on more than 1,000 UK farms. Although it is still being recognised by Defra and the European Commission as 'low impact' on a national scale, the cost for individual businesses can run into thousands of pounds. It comes at the same time as lamb prices have hit their lowest level for three years and livestock producers are facing rising production costs due to the extreme weather in 2012. Read More
Avian Influenza Found in New York Live Bird Market; Japan and Taiwan Halt Poultry Exports from New York
Jan 14, 2013
USDA's National Veterinary Services Laboratories has confirmed H5N1 (presumably low pathogenic) from a live bird market in New York. According to USDA's agreement with Taiwan, FSIS has been notified to amend the FSIS Export Library to state that the export of poultry meat and meat products from the State of New York to Taiwan is prohibited effective immediately. Read More
Scientists engineer the Schmallenberg virus genome to understand how to reduce disease caused by the virus
Jan 11, 2013
Researchers from the MRC Centre for Virus Research at the University of Glasgow in Scotland have developed methods to synthesize and change the genome of Schmallenberg virus (SBV). SBV is a recently discovered pathogen of livestock such as cattle, sheep and goats. The researchers have laid bare important ways by which this virus causes disease. The full report about the study publishes on January 10 in the Open Access journal, PLOS Pathogens. SBV is of great concern because it causes stillbirths, abortions and fetal defects in pregnant cows and ewes. It has spread rapidly throughout Europe since its discovery in Germany less than eighteen months ago (in October 2011). Read More
Threat of African Swine Fever Spread in Eastern Europe: Urgent Need for International Collaboration
Jan 2, 2013
One of the main recommendations of an FAO regional meeting on African Swine Fever (ASF) was that the disease should be considered as a top priority animal health problem by all affected countries and a threat for the whole Europe. According to FAO, a regional consultation in the Hungarian capital, Budapest, in early December 2012, resulted in a number of recommendations. The group discussed the progressive spread of African Swine Fever (ASF) in the Russian Federation, in Georgia, Armenia and in some other south Caucasian countries, and the threat of further spreading to Europe and Asia. It was assessed that the effects include the socioeconomic impact of the disease affecting the pig production sector, particularly poor rural families, the financial losses due to high mortality and trade restrictions, the high cost of controlling outbreaks, and the negative impact on the development of the pig sector. Read More
Pigs in Southern China Infected With Avian Flu
Dec 21, 2012
Researchers report for the first time the seroprevalence of three strains of avian influenza viruses in pigs in southern China, but not the H5N1 avian influenza virus. Their research, published online ahead of print in the Journal of Clinical Microbiology, has implications for efforts to protect the public health from pandemics. Influenza A virus is responsible both for pandemics that have killed millions worldwide, and for the much less severe annual outbreaks of influenza. Because pigs can be infected with both human and avian influenza viruses, they are thought to serve as "mixing vessels" for genetic reassortment that could lead to pandemics, and pigs have been infected experimentally by all avian H1-H13 subtypes. But natural transmission of avian influenza to pigs has been documented only rarely. Read More
BSE infected cattle have prions in saliva
Dec 14, 2012
ROGUE proteins responsible for mad cow disease have been discovered in the saliva of cows infected as part of an experiment. The finding might pave the way for a simple test for BSE before the symptoms are apparent. The result from a team led by Yuichi Murayama at the National Institute of Animal Health in Tsukuba, Japan, also suggests, not for the first time, that saliva may be one way some prion diseases can spread. This group of diseases includes scrapie, chronic wasting disease and variant Creutzfeldt-Jakob Disease (vCJD), the human form of mad cow disease. However, all available evidence suggests this method of transmission is highly unlikely. So far, the team stress there is no epidemiological evidence that saliva, milk, blood or spinal fluid from BSE-infected animals is infectious. Read More
Draft criteria for US funding of H5N1 research spark debate
Dec 5, 2012
Researchers are giving mixed reviews to a draft U.S. government plan to subject some grant requests for studies involving the H5N1 avian influenza virus to special reviews-and perhaps even require the work to be kept secret. Elements of the plan have been "very controversial within [the] U.S. government" committee that developed it, Amy Patterson, associate director for science policy at the National Institutes of Health (NIH) in Bethesda, Maryland, told a meeting of the National Science Advisory Board for Biosecurity (NSABB) earlier this week. Patterson unveiled the proposal-formally known as A Proposed Framework for Guiding HHS [the Department of Health and Human Services] Funding Decisions about Highly Pathogenic Avian Influenza H5N1 Gain-of-Function Research-at the 27 November meeting of NSABB, which advises the U.S. government on overseeing "dual use" biological research that could be used for good and evil. Read More
Transmission of Ebola virus from pigs to non-human primates
Nov 19, 2012
Ebola viruses (EBOV) cause often fatal hemorrhagic fever in several species of simian primates including human. While fruit bats are considered natural reservoir, involvement of other species in EBOV transmission is unclear. In 2009, Reston-EBOV was the first EBOV detected in swine with indicated transmission to humans. In-contact transmission of Zaire-EBOV (ZEBOV) between pigs was demonstrated experimentally. Here we show ZEBOV transmission from pigs to cynomolgus macaques without direct contact. Interestingly, transmission between macaques in similar housing conditions was never observed. Piglets inoculated oro-nasally with ZEBOV were transferred to the room housing macaques in an open inaccessible cage system. All macaques became infected. Infectious virus was detected in oro-nasal swabs of piglets, and in blood, swabs, and tissues of macaques. This is the first report of experimental interspecies virus transmission, with the macaques also used as a human surrogate. Our finding may influence prevention and control measures during EBOV outbreaks. Read More
Rift Valley Fever Kills 17 of 34 Cases in Mauritania Outbreak
Nov 8, 2012
An outbreak of Rift Valley Fever (RVF) in Mauritania has now infected 34 humans and caused 17 deaths in the region, according to an update from the WHO. Although cases began appearing in mid-September, officials declared an official outbreak on Oct. 4. RVF is an insect-borne and zoonotic virus that primarily infects animals, but can also infect humans. It was named for the place it was first identified in 1931, Kenya's Rift Valley. While non-human animals are typically infected through Aedes mosquitoes, humans are more often infected through contact with contaminated animal blood or organs, which may occur during animal births, slaughter, or the practice of veterinary medicine. Read More
Study: Fair-related swine and human H3N2 viruses closely match
Oct 26, 2012
Researchers report that swine and human influenza A/H3N2 viruses associated with an Ohio county fair held in July make a nearly perfect genetic match, suggesting that there is almost no biological barrier to prevent such viruses from passing between humans and pigs. The authors sequenced the genomes of H3N2 viruses isolated from pigs that were exhibited at the fair and from several people who were infected with strains of variant H3N2 (H3N2v, the term for the human version) after participating in or visiting the fair. They found that the genomes were more than 99% the same, according to their report in Emerging Microbes and Infections. The human cases were among 306 H3N2v cases reported by the Centers for Disease Control and Prevention (CDC) since Jul 12 of this year. The vast majority of these occurred in young people who were involved in agricultural fairs. The cases have mostly been fairly mild, and no sustained human-to-human transmission has been seen. But they have prompted health officials to warn people at risk for flu complications to stay out of swine barns at fairs, and fair visitors and participants have been urged to take special precautions if they have exposure to pigs. Andrew S. Bowman, DVM, of The Ohio State University (OSU), first author of the new study, said it is the first study in a peer-reviewed journal to compare the genomes of H3N2 viruses recovered from people and pigs in connection with county fair-related cases. The research team also included scientists from Minnesota and Iowa. The H3N2 viruses in the fair-related cases, both swine and human, carry the M or matrix gene from the 2009 H1N1 pandemic virus. In the current study, the authors call the swine-origin strain H3N2pM. Read More
Avian influenza A H5N1 virus: a continuous threat to humans
Oct 1, 2012
A 59-year-old woman, who had no known underlying disease, first presented at the accident and emergency department on 12 November 2010, with 1 week of fever associated with haemoptysis, dyspnea, sore throat and rhinorrhea. She travelled to Shanghai, Nanjing and Hangzhou for 10 days and returned to Hong Kong on 1 November 2010. She visited a wet market while she was in Shanghai, but she denied any direct contacts with birds or poultry. Upon admission, her body temperature was 38.7 C, with a respiratory rate of 24 breaths per minute and oxygen saturation of 96% while breathing ambient air. Chest radiograph revealed left middle zone consolidation. The clinical diagnosis was acute community-acquired pneumonia, for which she was treated as an outpatient with 1 g of oral amoxicillin-clavulanate twice daily. Read Full Review at nature.com
Schmallenberg virus: First Welsh case in Ceredigion
Sept 26, 2012
A virus affecting cattle, sheep and goats has been detected for the first time in Wales, the Welsh government has confirmed. Schmallenberg virus (SBV) antibodies have been discovered in three cows and one calf on premises in Ceredigion. SBV produces fever, diarrhoea and loss of milk production in adult cattle, though animals recover. It is thought to pose no risk to humans. The disease was first seen last year in northern Europe. It is named after the German town, about 50 miles (80km) east of Cologne, where it was identified. Read More
Notes from the Field: Highly Pathogenic Avian Influenza A (H7N3) Virus Infection in Two Poultry Workers- Jalisco, Mexico, July 2012
Sept 14, 2012
During June-August 2012, Mexico's National Service for Health, Safety, and Food Quality reported outbreaks of highly pathogenic avian influenza (HPAI) A (H7N3) virus in poultry on farms throughout the state of Jalisco (1,2). This report describes two cases of conjunctivitis without fever or respiratory symptoms caused by HPAI A (H7N3) virus infection in humans associated with exposure to infected poultry. Patient 1. On July 7, a poultry worker aged 32 years complaining of pruritus in her left eye was examined at a clinic in Jalisco. Physical findings included redness, swelling, and tearing. Conjunctivitis was diagnosed; the patient was treated symptomatically and recovered fully. Because the patient had collected eggs in a farm where HPAI A (H7N3) virus was detected, the Institute for Epidemiological Diagnosis and Reference, Mexico, tested ocular swabs from both of her eyes for influenza A (H7) by real-time reverse transcription-polymerase chain reaction (rRT-PCR), and embryonated chicken eggs were inoculated for viral isolation. The swab material was positive for influenza A (H7) virus by rRT-PCR and virus was isolated from each eye. These findings were reported to the World Health Organization on July 19, and full genome sequences (CY125725-32) were uploaded to GenBank. The virus was closely related by nucleotide sequence to previously reported HPAI A (H7N3) viruses collected during poultry outbreaks in Jalisco with sequences available in GenBank (JX397993, JX317626). . Read More
Threatwatch: Swine flu evolves under the radar
Sept 12, 2012
Two weeks ago, a woman died after catching flu from a pig at an agricultural fair in Ohio. Now a new study has found that pigs in Korea are harbouring a similar strain of flu that is more lethal and contagious -at least in animals- than the experimental bird flu that caused intense controversy last year. Robert Webster and colleagues at St. Jude Children's Research Hospital in Memphis, Tennessee, put an H1N2 flu virus, from the lungs of a pig slaughtered in South Korea in 2009, into the noses and windpipes of three ferrets. All the animals died, which is worrying, as ferrets catch and develop flu in a similar way to humans. What's more, the virus was transmitted via airborne droplets to three ferrets in nearby cages, killing two of them. In passing between the ferrets, the H1N2 acquired two mutations that made it more contagious and more virulent in the animals. The mutated version also grew faster than the original pig virus in cells cultured from the human nose and lung, and in fresh samples of human alveoli. In an intact lung, this alveolar growth could cause lethal pneumonia. Read More
Vietnam hit by new 'highly toxic' bird flu: reports
Sept 10, 2012 Posted by Claudinne
Times Live A new highly-toxic strain of the potentially deadly bird flu virus has appeared in Vietnam and is spreading fast, according to state media reports. The strain appeared to be a mutation of the H5N1 virus which swept through the country's poultry flocks last year, forcing mass culls of birds in affected areas, according to agriculture officials.
UN warns over swine fever outbreak in Ukraine
Aug 29, 2012
Medical Express The United Nations food agency on Tuesday warned that an outbreak of African swine fever in Ukraine could pose a risk for animal health in the region as a whole despite swift moves to limit its spread.
Swine flu present in many 'healthy' farm-show pigs, UF researchers report
Aug 16, 2012
GAINESVILLE, Fla. - Despite their healthy appearance, several pigs on show at a 2009 U.S. state fair competition were infected with swine flu, according to a new study by University of Florida infectious disease experts. Up to 20 percent of show pigs at the 2009 Minnesota state fair were infected, and an infected animal was also found at the 2009 South Dakota fair, the researchers report in the September issue of the Centers for Disease Control and Prevention's Emerging Infectious Diseases journal. The findings come in the wake of recent CDC warnings to fairgoers and reports of new swine flu strains, called H3N2 variants, in people who had direct or indirect contact with pigs at agricultural fairs."The new H3N2 variant viruses that are circulating now in pigs and apparently affecting people at pig shows are offsprings of the 2009 pandemic virus that spread throughout the world," said lead investigator Dr. Gregory Gray, chairman of the UF College of Public Health and Health Professions department of environmental and global health, and a member of UF's Emerging Pathogens Institute. "It mixed with the viruses that were already present in pigs and out has come a new progeny virus." Read More
"No surprise" that deadly Schmallenberg Virus has over-wintered
Aug 16, 2012
UK News News that the sheep and cattle disease Schmallenberg Virus has over-wintered in this country and will almost certainly bring fresh outbreaks next spring is disappointing - but not a surprise to the industry. Scientific experts gathered from across the animal health and welfare industry at a conference organised by the NFU last week to discuss animal health and the Schmallenberg Virus. NFU animal health adviser, Catherine McLaughlin, said more needed to be done to identify where the disease was circulating, to help farmers plan and avoid livestock contact with midges that bite and infect the animal with the virus. "Scientists from the Royal Veterinary College and the Institute of Animal Health have confirmed that the Schmallenberg Virus has over-wintered," she said. "This is concerning for our members who will be planning autumn breeding, a critical time. Animals infected with the virus during these early months of pregnancy are most at risk of producing deformed offspring and of having abortions. "But early reports do show us that livestock that had the disease this year and last will have developed immunity and this will help build a natural resistance here in the UK. "What we need is more efficient and effective diagnostics on the ground, identifying where the Schmallenberg Virus is, and therefore likely to cause potential problems. This will be the best tool to help farmers in the fight against this disease this year. "We also need to have the vaccine, which we understand has been developed, to be licensed and approved as soon as possible." NFU vice-president Adam Quinney, who chaired the animal health conference, said: "The report from the IAH and the Royal Veterinary College on Schmallenberg has confirmed what we always suspected. The midge has over-wintered and will cause problems for livestock farmers next spring. But from the advice we have received today we are hoping there will be a low incidence rate on-farm. "That said, there will be some tough decisions that need to be made, not least about tupping and managing the all-important breeding season for autumn." According to the latest figures, the total number of affected farms in the UK was 276. There have been three outbreaks confirmed in Cornwall, nine in Devon, seven in Dorset and three in Somerset. Carl Padgett, president of the British Veterinary Association, said: "Work on a vaccine is progressing well, but it is unlikely to be available for some months."
Mexico destroys 8 million chickens amid bird flu outbreak
Aug 8, 2012 Posted by Claudinne
Eight million chickens have so far been slaughtered in Mexico and 66 million more were vaccinated in a bid to contain a bird flu outbreak in the west of the country, authorities said. The agriculture ministry said in a statement that during the vaccination process in the Los Altos region of Jalisco state, diseased chickens were identified, leading to the destruction of the flu-carrying fowl. Food safety officials say the outbreak, which was first detected on June 20, is confined to Los Altos, which is an egg-producing area. Inspections in other parts of the country have not turned up any signs of the disease. A national animal health emergency was declared at the beginning of July, and the prices of both eggs and chickens have skyrocketed. Mexican authorities hope to vaccinate 80 million fowl in the first phase of its program, and then analyze the results before proceeding to phase two. The virus responsible for the outbreak, H7N3, has occasionally caused human disease in various parts of the world, according to the United Nations, but has not shown itself to be easily transmittable between humans. Some bird flu strains, such as H5N1, have caused serious infections in people. The World Health Organization has documented 607 human cases of bird flu since 2003, 358 of which were fatal, according to July data. Authorities in Guatemala have stepped up safety checks on its border with Mexico to keep bird flu from spreading into the country.
The Evolution of Bird Flu, and the Race to Keep Up
Aug 6, 2012 Posted by Claudinne
On May 20, a 10-year-old girl in rural Cambodia got a fever. Five days later, she was admitted to a hospital, and after two days of intensive care she was dead. The girl was the most recent documented victim of the influenza virus H5N1, a strain that has caused 606 known human cases and 357 deaths since it re-emerged in 2003 after a six-year absence. H5N1 can race through bird populations, and the World Health Organization suspects the girl was infected while preparing chicken for a meal. While humans are not ideal hosts for H5N1, bird flu viruses do sometimes manage to adapt for easy transmission from human to human, and the results can be devastating. In 1918, one such transformation led to the Spanish flu pandemic, a global outbreak that claimed an estimated 50 million people. To better understand the possibility of H5N1 making a similar transformation, two teams of scientists recently manipulated the virus until it could spread through the air from one ferret to another. If a flu virus can infect a ferret, then it could theoretically infect other mammals, including humans. Last fall, the scientific community became embroiled in a debate about whether the details of this research should be published; security experts, among others, feared that the information could be used to develop a biological weapon. After months of arguments, a federal advisory board recommended in March that the results be published in full. In May, Nature published the first of the two controversial papers; now the second team has published the results of their experiments in the journal Science. link to full text article in New York Times
Novel H3N8 strain found in dead seals may pose human threat
Aug 3, 2012 Posted by Claudinne
A research team that analyzed the strain of H3N8 influenza linked to a baby seal die-off in New England last year found that it originated in birds and has adapted to mammals, signaling a possible threat to humans and animals alike.
The study, which appeared today in mBio, the online journal of the American Society for Microbiology (ASM), also revealed mutations that are known to make flu viruses more transmissible and able to cause severe disease.
In December 2011, scientists with the National Oceanic and Atmospheric Administration (NOAA) announced that an investigation of 162 seal deaths that fall revealed the H3N8 virus in samples from all five animals studied, the first time the strain had been linked to large-scale mortality in marine mammals. Study authors include researchers from NOAA, Columbia University, and several other institutions. [CIDRAP news for full article]
For more information on the Emergence of Fatal Avian Influenza in New England Harbor Seals please visit asm.org.
Schmallenberg vaccine 'desperately needed'
A vaccine to protect sheep from the Schmallenberg virus is "desperately needed to prevent a catastrophe" in the UK flock, sheep industry leaders have warned.
The National Sheep Association and Sheep Veterinary Society joined forces to warn that tupping, the most infective period for the virus in ewes and their unborn lambs, was getting close, but although a vaccine had been developed, it was moving too slowly through the Veterinary Medicines Directorate's approvals process. [Farmers Weekly for full story]
Highly Pathogenic Avian Influenza Confirmed in Mexico
Jul 1, 2012 Posted by Claudinne
Southwest Farm Press--Mexican veterinary authorities are confirming this week there has been an outbreak of avian influenza near Guadalajara that has caused the death of nearly a quarter million chickens since early June and so far has forced a quarantine zone around three poultry processing facilities in the Mexican state of Jalisco.
In a follow-up report submitted to the World Organization for Animal Health (OIE), Mexican animal health officials said intravenous pathogenicity tests revealed a highly pathogenic H7N3 subtype that is the cause of the current outbreak. Mexican veterinary authorities are intensifying avian influenza control efforts in the region, which houses several large commercial farms. Southwest Farm Press for full story
Fouchier Study Reveals Changes Enabling Airborne Spread of H5N1
Jun 21, 2012 Posted by Claudinne
A study showing that it takes as few as five mutations to turn the H5N1 avian influenza virus into an airborne spreader in mammals—and that launched a historic debate on scientific accountability and transparency—was released today in Science, spilling the full experimental details that many experts had sought to suppress out of concern that publishing them could lead to the unleashing of a dangerous virus.
In the lengthy report, Ron Fouchier, PhD, of Erasmus Medical Center in the Netherlands and colleagues describe how they used a combination of genetic engineering and serial infection of ferrets to create a mutant H5N1 virus that can spread among ferrets without direct contact.
They say their findings show that H5N1 viruses have the potential to evolve in mammals to gain airborne transmissibility, without having to mix with other flu viruses in intermediate hosts such as pigs, and thus pose a risk of launching a pandemic. CIDRAP news for full story
Hong Kong Human case of H5N1 Confirmed
June 13, 2012 Posted by Claudinne
CNTV--Hong Kong health authority says a two-year-old boy has been confirmed as having H5N1 Influenza, or bird flu. The boy was admitted to a Hong Kong hospital on Monday with convulsions after arriving from Guangzhou and is now in a stable condition. He had been in contact with a live duck between May the 17th and 19th at a farmer’s market in Guangzhou. Related Video
Rethinking science on pandemic-potential viruses
May 31, 2012 Posted by Claudinne
The issue was whether the new mutants could ward off a major pandemic of bird flu or start one, explained Stephanie Holmer, a graduate student in Duke’s Department of Cell Biology.
Egypt's Real Crisis: The Dual Epidemics Quietly Ravaging Public Health
Posted May 16, 2012 by Chris Miller
Lost in the recent political jockeying and protest violence leading up to Egypt's May 23 presidential elections is the unfolding public health disaster there. Avian flu and foot and mouth disease are running rampant, killing people and livestock as well as inflating the price of food. It's a serious health and economic issue, but it has potentially much larger implications for Egypt. This little-discussed crisis is beginning to resemble those that occur in failed states.
Weapons of Mass Disease: UW Gets $8.1 Million to Study Ebola, Yellow Fever, and More for Biodefense
Posted May 14, 2012 by Chris Miller
"There have been as many plagues as wars in history; yet always plagues and wars take people equally by surprise." Albert Camus wrote that in his classic The Plague back in 1947, and the words are as true now as they were then. That's one reason why a UW lab is collaborating with a local biotech company to study some of the world's most lethal pathogens: to help prevent mass casualties in the unlikely event of germ warfare.
Report details changes that may boost H5N1 spread in mammals
Posted May 4, 2012 by Chris Miller
The first of two controversial H5N1 avian influenza studies to see print suggests that just four mutations in one of the virus's surface proteins may be enough to equip it to spread among mammals, but the findings are freighted with qualifiers. After months of debate and discussion, Nature yesterday published the report by Yoshihiro Kawaoka, DVM, PhD, and colleagues describing a lab-derived hybrid virus, with elements of H5N1 and pandemic H1N1, that spread among ferrets via respiratory droplets. Kawaoka works at the University of Wisconsin. The authors say their findings answer the "fundamental question" of whether flu viruses wearing the H5 hemagglutinin (HA) surface protein found in H5N1 can spread in mammals.
Roberts, Brownback Say "Mad Cow" Safeguards Work
Posted April 25, 2012 by Chris Miller
The discovery of a dairy cow in California with a form of so-called “Mad Cow” Disease has federal and state officials scrambling to assure the public that the incident poses no threat to the nation’s food supply, or to human health. Kansas Public Radio’s Bryan Thompson reports.
Israel Update: Health Officials Plan 20,000 Turkey Cull--Third case discovered at Moshav Zavdeil
Posted April 1, 2012 by Claudinne Roe
Times of Israel--The Agriculture Ministry plans to slaughter 20,000 turkeys from the same coop after avian flu was discovered there.
The coop, on Moshav Zavdiel, near Lachish in the lower Judean plain, is the third farming community discovered in Israel in recent weeks with an avian flu outbreak.
Officials hope they can stem the spread of the disease by killing the birds.
A number of cats were found dead before the last cull, with signs pointing to them having eaten the carcasses of infected turkeys near Shalva, in the south, according to a report by the World Organization for Animal Health.
In 2006, southern Israel’s poultry industry was brought nearly to the brink of collapse, growers said, after a number of culls following the discovery of bird flu.
The H5N1 virus, as this strain of avian flu is officially known, can be deadly if transferred to humans. It has lead to the deaths of millions of birds in Europe and Asia as health officials attempt to contain the virus.
Israel: Stray Cats Confirmed with H5N1
Posted March 24, 2012 by Claudinne Roe
Three stray cats found by the Veterinary Service and Health Ministry inspectors at Shalva and Holit in southwest Israel were confirmed as having died from eating poultry infected with avian flu.
The carcasses were sent for examination, and the diagnosis was confirmed. As a result, the health authorities on Thursday said it expects to catch 30 more stray cats in the area near Eilat.
The public was asked to avoid contract with stay cats in the area and to report to the local veterinary services any sick-looking cats just in case, even though the disease is not known to affect humans.
HPAI outbreaks in Hadaromposted March 14, 2012 by Ashley Layton
Article date: March 12, 2012
ISRAEL - The Israeli veterinary authorities have reported two new outbreaks of highly pathogenic avian influenza in Hadarom. Link to article
The World Organisation for Animal Health received an immediate notification on Friday, 9 March. The outbreaks were initially observed on 7 March and confirmed on 8 March. 12-week-old and 8-week-old turkeys constitute the affected population.
Finland is now on ASF alertposted March 7, 2012 by Ashley Layton
March 6, 2012
ANALYSIS - The country's food safety authority has put out an alert over African swine fever (ASF), which has been reported from the first time in the region of Russia that borders Finland, writes senior editor, Jackie Linden. The disease represents a growing threat to the European pig industry.
Bat flu could pose risk to humans; Evidence of virus proving not all animal flu had been discoveredposted March 2, 2012 by Ashley Layton
Feb 29, 2012
For the first time, scientists have found evidence of flu in bats, reporting a never-before-seen virus whose risk to humans is unclear.The surprising discovery of genetic fragments of a flu virus is the first well-documented report of it in the winged mammals. So far, scientists haven't been able to grow it, and it's not clear if — or how well — it spreads.Flu bugs are common in humans, birds and pigs and have even been seen in dogs, horses, seals and whales, among others. About five years ago, Russian virologists claimed finding flu in bats, but they never offered evidence. Read More...