Seroprevalence Study: Avian Flu In Chinese Pigs

 

Since pigs can be infected by more than one flu virus at the same time, the potential exists for two viruses to swap genetic material (reassort), resulting in a new hybrid strain.

 

# 6796

 

Although we tend to think of H5N1 whenever someone mentions `avian flu’, in truth there are many different avian influenza viruses.  If you go back far enough, all influenza A strains – even those thought of today as primarily adapted to humans, equines, or swine – appear to have an avian origin.

 

Influenza A viruses have 8 gene segments (PB2, PB1, PA, HA, NP, NA, M1, M2, NS1, NS2) and are broadly categorized by their HA (hemagglutinin) and NA (neuraminidase) genes.

 

With the recent discovery of H17N10 (see A New Flu Comes Up To Bat), scientists have now identified 17 different serotypes of Hemagglutinin (HA) and 10 serotypes of Neuraminidase (NA), which make many different combinations of HA and NA proteins possible.

Thus far, only about 100 of these combinations have been isolated in nature.

 

But the flu universe is far more diverse than that might lead to you believe, as influenza’s 8 gene segments are largely interchangeable parts. If you were to take two different influenza A viruses (say H3N2 and H5N1) and reshuffle them using reverse genetics, you can come up with 254 possible reassortments.

 

And within each of these HA/NA combinations you can have multiple clades (genetically distinct families), and within each clade, many minor variants – all of which makes for tremendous variety in these viruses.

 

Many of the the H1, H2, and H3 viruses have adapted to human physiology, but we occasionally see infection by other `novel’ strains. Most worrisome, due to its high fatality rate, is H5N1.  But we occasionally see (usually mild) infections by other avian strains.

 

MMWR: Mild H7N3 Infections In Two Poultry Workers - Jalisco, Mexico)

EID Journal: Human Infection With H10N7 Avian Influenza

PLoS One: Seroprevalence Of H9N2 In Poultry Workers – Pune, India

 

Last year scores of dead seals were discovered along the shoreline of New England, predominantly from the North Shore of Massachusetts to the southern coast of Maine.  Investigations showed (see mBio: A Mammalian Adapted H3N8 In Seals) their deaths to be due to a variant of the H3N8 avian flu strain, versions of which are known to also infect horses and dogs.

 

With the propensity of these avian strains to evolve and adapt, scientists are understandably very interested in any avian flu virus that appears to be moving towards `humanization’.

 

While it is possible for a flu virus to jump directly from birds to humans, often it requires an intermediate host to aid in its development. The graphic below illustrates that swine – which are generally susceptible to human and avian flu viruses - are considered excellent mixing vessels’ for influenza viruses.

 

 

The H1N1 `swine flu’ virus of 2009 kicked around in pigs for up to a decade before it adapted well enough to human physiology to spark a human pandemic. Over the past few years we’ve watched attempts by three other swine `variant’ viruses (H1N1v, H1N2v, H3N2v) to jump to mankind. 

 

Which makes the active surveillance of swine a potentially important tool for the early detection of emerging influenza viruses.

 

Unfortunately, while there are some surveillance systems in place, only a tiny fraction of the world’s swine population is actively monitored  (see Helen Branswell’s SciAm Article from late 2010 called Flu Factories).

 

All of which serves as prelude to a new study, recently published in the Journal of Clinical Microbiology, that found low levels of H3, H4, and H6 subtypes of avian influenza in Chinese pigs. Somewhat reassuringly, evidence of infection with the H5N1 virus was not found.

 

These H3, H4, and H6 avian viruses were not seen in a similar study done in 2001, suggesting their arrival into the swine population may be a recent development.

 

 

Seroepidemiological Evidence of Avian Influenza A Virus Transmission to Pigs in Southern China

Shuo Su, Wenbao Qi, Jidang Chen, Wanjun Zhu, Zhen Huang, Jiexiong Xie, and Guihong Zhang

J. Clin. Microbiol. published ahead of print 21 November 2012 doi:10.1128/JCM.02625-12

ABSTRACT

Recently, three novel avian-origin swine influenza viruses (SIVs) were first isolated from pigs in Guangdong Province, southern China, yet little is known about the seroprevalence of avian influenza among pigs in southern China. Here, we report for the first time the seroprevalence of avian H3, H4, and H6 influenza viruses in swine populations and the lack of seroepidemiological evidence of avian H5 influenza transmission to pigs in China.

 

A copy of the study can be downloaded here.

 

The American Society for Microbiology has published a press release with more information, excerpts of which you’ll find below:

 

 

 

Pigs in southern China infected with avian flu

WASHINGTON, DC – December 19, 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.

 

In the study, from 2010-2012, Guihong Zhang and colleagues of the College of Veterinary Medicine, South China Agricultural University, Guangzhou, People’s Republic of China, tested 1080 21-25 week old pigs for H3, H4, H5, and H6 subtypes of avian influenza virus, and H1 and H3 subtypes of swine influenza virus. Thirty-five percent of the serum samples were positive for H1N1, and 19.7 percent were positive for H3N2 swine flu virus, and 0.93 percent, 1.6 percent, and 1.8 percent were positive, respectively, for the H3, H4, and H6 subtypes of avian influenza A virus. However, no serum samples collected in 2001 were positive for any of these viruses, indicating that transmission into swine was recent.

 

Given the recent transmission of avian influenzas into swine, “We recommend strongly that the pork industry worldwide should monitor the prevalence of influenza in pigs, considering their important role in transmitting this virus to humans,” says Zhang.

 

Previously, novel reassortant H2N3 influenza viruses were isolated from US pigs, which “were infectious and highly transmissible in swine and ferrets without prior adaptation,” according to a 2009 paper in the Journal of Molecular and Genetic Medicine by Wenjun Ma et al. Those viruses resembled, but were not identical to the H2N2 human pandemic virus of 1957.

 

 

The ability of influenza viruses to evolve, mutate, or reassort in swine hosts has been a frequent topic of discussion in this blog.  For more on this, you may wish to revisit:

 

H3N2v: When Pigs Flu

You Say You Want An Evolution?

The (Swine) Influenza Reassortment Puzzle

»» Read More

China Reports H5N1 Outbreak In Poultry

Credit Wikipedia

 

# 6562

 

 

Via Xinhua news this morning, confirmation of a large cull of poultry in China’s Guangdong Province, after the discovery of the H5N1 `bird flu’ virus on Sept 11th.

 

 

Bird flu hits S China city

English.news.cn   2012-09-18 19:19:19

BEIJING, Sept. 18 (Xinhua) -- The H5N1 avian flu virus has been detected in the city of Zhanjiang in south China's Guangdong province, experts confirmed on Tuesday.

 

The virus has infected 14,050 ducks and killed 6,300 of them since Sept. 11, when symptoms were first reported, a Ministry of Agriculture official said.

 

After the epidemic was confirmed, local authorities cordoned off an infected area in the city and killed all poultry in the area before starting to decontaminate it, the official said.

 

China is particularly prone to bird flu epidemics, as it has the world's largest poultry population and many rural farmers live in close proximity to their poultry.

 

 

 

Zhanjiang is a prefecture-level city, with a population of more than 6 million, and is a prominent seaport and a major trade center.  

 

While this story states that China is particularly prone to bird flu epidemics, relatively few are mentioned in the state controlled media.

»» Read More

V Said, C Said

Photo Credit – FAO

 

# 6546

 

 

Last week, reports of a new strain of the H5N1 virus (see Vietnam Reports A Possible Change In The H5N1 Virus) – which supposedly originated in China -  began to appear in the Vietnamese media.

 

Dubbed clade 2.3.2.1 C, this virus had recently been reported in seven provinces and cities, namely Haiphong, Ha Tinh, Ninh Binh, Nam Dinh, Bac Kan, Thanh Hoa and Quang Ngai.

 

Media reports strongly suggested that poultry smuggling out of China had recently introduced the virus to Vietnam.

 

Although China rarely admits to having a `bird flu problem’, the evidence often suggests the opposite.  Just a few examples include:

 

• We’ve seen the recurring phenomenon of H5N1 infected poultry carcasses - apparently dumped into the upper Pearl River by farmers - washing up on the beaches of Hong Kong (see The Winter Of Our Disbelief).
• Earlier this summer, authorities in Taiwan seized, and destroyed 38 birds being smuggled into their country from China that were infected with the H5N1 virus (see Taiwan Seizes H5N1 Infected Birds).
• And migratory birds that arrive in Japan, Hong Kong, and South Korea – many originating in China - have been found to be carrying the H5N1 virus (see Global H5N1 Blind Spots).

 

Today, Xinhua News – the official press agency of the People's Republic of China – has a long story about this newly detected clade of the H5N1 virus, but unlike earlier reports out of Vietnam, makes no mention of it originating in China.

 

In fact, they point the finger at Vietnam.

 

New bird flu strain develops unexpectedly in Vietnam

2012-09-10 19:37:08

HANOI, Sept. 10 (Xinhua) -- A new bird flu strain is developing unexpectedly in Vietnam and causing great concern to the government and public.

 

According to the National Animal Health Diagnosis Center, the new strain of bird flu virus, which is suspected to have higher risk of causing human death than previously known ones, appeared in July and widely spread in August in Vietnam's seven central and northern provinces.

 

Hoang Van Nam, head of Ministry of Agriculture and Rural Development (MARD)'s Animal Health Department, said that this virus, thought to belong to H5N1 - Clade 2.3.2.1, is different from the two strains of A and B that appeared in Vietnam in 2011, due to its higher pathogenic risk.

 

According to the department, as of Sept.6, the new virus strain has attacked seven central and northern cities and provinces, including Hai Phong, Thanh Hoa, Ha Tinh, Ninh Binh, Nam Dinh, Bac Can and Quang Ngai, and over 180,000 infected poultry have been culled so far this year.

 

Apart from the newly-found strain of the virus, the bird flu has developed unexpectedly in the country so far this year. Normally, avian influenza appears shortly before or after the traditional lunar Tet holidays (which often falls in late January and early February). However, it has appeared since July this year and fast spread without warning. In the Central Highlands Dak Lak province, about 30 influenza epidemic spots were found in only one day.

(Continue . . . )

 

 

In the global scheme of things, it may not make a lot of difference on which side of a country’s border this new clade of H5N1 originated.  Viruses rarely respect artificial man-made barriers like borders, anyway.

 

But this story illustrates just how vulnerable news stories can be to government manipulation and `spin’. 

 

A reminder that, while we are often dependent upon government operated news agencies, we shouldn’t put too much faith in the details. 

 

Caveat Lector should always be our guide.

»» Read More

Taiwan Seizes H5N1 Infected Birds

 

Photo Credit USDA

 

# 3437

 

Despite only rarely being acknowledged as a problem by their government, there is compelling evidence to suggest that the H5N1 virus is firmly entrenched in many parts of China.

 

There are, of course, the 43 human cases that have been officially reported over the past decade, and from time to time the Chinese media mentions a culling operation taking place at an infected farm. 

 

There are unofficial reports and rumors, often carried by the dissident press, but more tangibly, we’ve seen a steady trickle of H5N1 infected birds – most coming from the mainland – detected each year in Hong Kong.

 

Perhaps even more ominously, we’ve seen the recurring phenomenon of infected poultry carcasses - apparently dumped into the upper Pearl River by farmers - washing up on the beaches of Hong Kong (see The Winter Of Our Disbelief).

 

Today, we’ve a story that bolsters concerns that the H5N1 virus remains active in China, and illustrates just how easily dangerous pathogens can move from one region to the next. 

 

Authorities in Taiwan have seized, and destroyed, 38 birds being smuggled into their country from China that were infected with the H5N1 virus.

 

Taiwan finds H5N1 virus in birds smuggled from China

Posted: 17 July 2012

TAIPEI: Dozens of pet birds smuggled from southern China into Taiwan tested positive for the deadly H5N1 avian flu virus and were destroyed, Taiwanese authorities said Tuesday.

(Continue . . . )

 

The story indicates the smuggler was detained at Taoyuan international airport in Taiwan after arriving from Macau with his winged contraband. Nine people exposed to these birds were observed for 10 days, and luckily none showed signs of infection.

 

This is not the first time that H5N1 infected birds have been smuggled into Taiwan.  From Taiwan’s Bureau of Animal and Plant Health Inspection and Quarantine (BAPHIQ) we get this account of an incident from 2005.

 

H5N1 Avian Influenza Virus Detected in Smuggled Birds from China

In midnight of October 14, 2005, Taiwan Coast Guard Administration confiscated 1,037 birds from a freighter of which the ship staff smuggled the birds from China into Taichung. All the birds were humanely sacrificed on next day and immediately sent to the Animal Health Research Institute for routine diagnosis to find out if they were infected with avian influenza and other concerned diseases. The test results confirmed that those smuggled birds were infected with highly pathogenic avian influenza (HPAI) H5N1 virus.

 

 

Porous borders, security guards that will look the other way for the right price, and a lucrative market make bird smuggling a popular gambit in many parts of the world, and it can involve anything from expensive exotics to everyday poultry.

 

Some earlier blogs on bird smuggling involving the H5N1 virus include:

 

Update On West Bank Bird Flu Outbreak

S. Korea: Police To Step Up Fight Against Poultry Smugglers

West Bengal: Thousands Of Chickens Smuggled Out

Vietnam Finds Bird Flu In Smuggled Chinese Chickens

Vietnam Detects `New Strain' Of H5N1

Hong Kong Investigating Source Of Bird Flu Virus

 

 

To be fair, China isn’t the only source of H5N1 infected birds, and H5N1 isn’t the only dangerous pathogen being smuggled across borders around the world.

 

The trade in exotic pets, and `bush meat’, provides an easy avenue for the cross-border introduction of zoonotic diseases around the globe.

 

As an example, we saw a rare outbreak of Monkeypox in the United States in 2003, when an animal distributor imported hundreds of small animals from Ghana, which in turn infected prairie dogs that were subsequently sold to the public (see MMWR Update On Monkeypox 2003)

(Photo Credit CDC PHIL)

 

This outbreak infected at least 71 people across 6 states. No vaccine is available for Monkeypox, but the smallpox vaccination is said to reduce the risk of infection.

 

Last year  British papers were filled with reports of `bushmeat’ being sold in the UK. A couple of links to articles include:

 

Meat from chimpanzees 'is on sale in Britain' in lucrative black market

Chimp meat discovered on menu in Midlands restaurants

 

The slaughtering of these intelligent (and often endangered) primates for food (but mostly profit) is horrific its own right, but it also has the very real potential of introducing zoonotic pathogens to humans.

 

 

In 2005, the CDC’s EID Journal carried a perspective article on the dangers of bushmeat hunting by Nathan D. Wolfe, Peter Daszak, A. Marm Kilpatrick, and Donald S. Burke.

 

It describes how it may take multiple introductions of a zoonotic pathogen to man – over a period of years or decades – before it adapts well enough to human physiology to support human-to-human transmission.

 

 

Bushmeat Hunting, Deforestation, and Prediction of Zoonotic Disease

 

Beyond H5N1, SARS and monkeypox, a few other viruses of concern include Hendra, Nipah, Ebola, other avian influenzas, hemorrhagic fevers, many variations of SIV (Simian immunodeficiency virus), and of course . . .  Virus X.

 

The one we don’t know about.  Yet.

 

On the frontlines attempting to interdict the next emerging pathogen is the above mentioned Dr. Nathan Wolfe, whom I’ve written about several times before, including:

 

Nathan Wolfe And The Doomsday Strain

Nathan Wolfe: Virus Hunter

 

You can watch a fascinating TED Talk by Dr. Wolfe HERE on preventing the `next pandemic’.

(Click Image to view video)

 

While it may take multiple introductions over many years before a zoonotic disease can get a foothold in a new region, the public health risks posed by these smuggling operations are all too real.

A sobering thought, considering the number of illicit items that manage to get across international borders undetected.

»» Read More

China: H5N1 Reported In Poultry

 

 

Map Credit – FAO

 

# 6415

 

 

The OIE received notification today from China’s Ministry of Agriculture of an outbreak of highly pathogenic H5N1 among poultry in their northwestern Xinjiang Uygur autonomous region.  

 

While doubts exist that all outbreaks of bird flu in China are officially reported, based on the last follow-up report to the OIE (06/06/12 Follow-up report No. 5), this would be the sixth state-recognized outbreak of 2012.

 

OIE H5N1 Reports China (People's Rep. of) 2012

• 31/03/12 Follow-up report No. 1 50193
• 18/04/12 Follow-up report No. 2 50313 
• 24/04/12 Follow-up report No. 3 50346
• 17/05/12 Follow-up report No. 4 50483 
• 06/06/12 Follow-up report No. 5 50600

 

 

First the story as reported by Xinhua News, then a link to the OIE report.

 

 

China confirms H5N1 bird flu outbreak in Xinjiang

English.news.cn   2012-07-02 21:37:30

BEIJING, July 2 (Xinhua) -- China's northwestern Xinjiang Uygur autonomous region has reported an outbreak of H5N1 in poultry, the Ministry of Agriculture (MOA) announced Monday.

 

The disease has killed 1,600 chickens raised by the Xinjiang Production and Construction Corps (XPCC), a unique economic and semi-military government organization of about 2.5 million people.

 

A total of 5,500 XPCC-farmed chickens showed symptoms of suspected avian flu on June 20, according to the MOA.

 

The National Avian Influenza Reference Laboratory Monday confirmed the epidemic was H5N1 bird flu after testing samples collected at the farm, the MOA said.

 

Local authorities have sealed off and sterilized the infected area, where a total of 156,439 chickens have been culled and safely disposed of to prevent the disease from spreading, according to the MOA.

 

Bird flu, or avian influenza, is a contagious disease of animal origin caused by viruses that normally infect only birds and, less commonly, pigs. It can be fatal to humans.

The OIE report appears in the FAO’s EMPRES-i database.

»» Read More

China Reporting H5N1 In Poultry

 

Map Credit Wikipedia

# 6290

 

 

Via the China Daily we’ve a report (that has also been echoed in Chinese Language news reports overnight) that a large outbreak of H5N1 has been detected in Northwestern China.

 

The big news here isn’t so much that Chinese poultry have been discovered to be infected by the H5N1 virus (something that many observers suspect happens more often than we are told), but that in this case, it is being publically acknowledged.

 

Here is the report from China Daily.

 

H5N1 bird flu reported in NW China

Updated: 2012-04-18 20:30

(Xinhua)

BEIJING - China's Northwestern Ningxia Hui autonomous region has reported an outbreak of the highly epidemic H5N1 bird flu virus in poultry, the Ministry of Agriculture (MOA) announced Wednesday.

 

More than 23,000 chickens at several farms in a village of Touying town in the city of Guyuan in Ningxia showed symptoms of suspected avian flu Friday and the National Avian Influenza Reference Laboratory confirmed the epidemic was a H5N1 bird flu case after testing samples collected at those sites, according to the MOA.

 

The body said in a statement that a total of 95,000 chickens have been culled after the H5N1 bird flu case was confirmed.

 

"The epidemic is under control now," it said, as a team was dispatched to the quarantined area to guide epidemic prevention.

»» Read More

Global H5N1 Blind Spots

 

 

 

Hong Kong Wild Bird H5N1 Detections 1/1/12 – 4/4/12 – Source Govt. of Hong Kong

 

# 6270

Today the Government of Hong Kong has announced positive lab results from another wild bird discovered to have died from the H5N1 virus. This makes the 19th such case thus far in 2012 (see map for locations).

 

First the latest press release, and then I’ll return with more.

Bird carcass H5N1 positive

April 10, 2012

The carcass of an Oriental magpie robin found near 19 Station Lane in Hung Hom on April 4 was confirmed to be H5N1-positive, the Agriculture, Fisheries & Conservation Department said today.
The Oriental magpie robin is a common resident bird in Hong Kong.

 

The department will continue to conduct inspections of poultry farms to ensure that proper precautions against avian influenza have been implemented.

In the past the Hong Kong government has attributed poultry outbreaks in the region to introduction of the virus from wild and migratory birds (see Wild Birds Eyed As Likely Source Of Hong Kong Bird Flu Outbreak).

 

Each year Hong Kong generally sees a couple of dozen dead birds test positive for the H5N1, so today’s report is neither unusual nor particularly alarming.

 

Hong Kong is, admittedly, one of the few places in the world where public health authorities take notice of (and test) something as seemingly inconsequential as a single dead bird.

 

Hong Kong’s surveillance, reporting, and ability to respond to an outbreak of disease is as good as it gets.  Which is why I am more comforted by these reports than alarmed.

 

As good as Hong Kong’s surveillance is, it serves as a reminder that neighboring China - with a land area 8,700 times larger than the SAR of Hong Kong - rarely reports the discovery of H5N1 in either wild birds or in poultry.

 

Hong Kong in relation to China - Credit Wikipedia

 

We do hear unofficial, usually anecdotal reports of large poultry outbreaks or wild bird die off from the dissident press. But official confirmation rarely comes.

 

Given that most of the migratory birds that arrive in Hong Kong either originated from, or recently passed through mainland China, it is a reasonable assumption that the virus can be found among the bird population there as well.

 

But if anyone is actually testing for the virus in China, the results are not generally made available for public consumption.

 

And this is illustrative of one of the great concerns surrounding the H5N1 virus. Many of the countries where the virus is most active are either unable, or unwilling, to provide surveillance or reporting.

 

While we get good reporting out of Hong Kong, Korea, Japan, and Vietnam (among others) we can do little more than guess at how the virus is behaving in places like China, Myanmar, Cambodia, Iran, Laos, and parts of Africa.

 

Today’s H5N1 surveillance system is analogous to the the state of hurricane forecasting 50 years ago, before we had weather satellites providing us with 24 hour global coverage.

Meteorologists were dependent on scattered ship’s reports, and reports from islands, to try to piece together what was going on far out to sea. And back then, it wasn’t unusual for  hurricanes to get `lost’, only to turn up a day or two later threatening a populated coastline with very little warning.

 

Compared to 2006-2007, the amount of bird flu activity around the world appears to have declined, and that has led many to believe that the pandemic threat has somehow lessened.

 

But given the number of `blind spots’ we have around the world, we are dealing with huge gaps in our knowledge of what is actually going on.

 

And when you are dealing with a constantly mutating, highly pathogenic virus that is endemic in countries with inadequate surveillance and reporting, one must remember that no news isn’t always good news.

»» Read More

Study: Dual Receptor Binding H5N1 Viruses In China

 

(Very Simplified Illustration of RBDs)

# 6238

 

 

Human adapted influenza viruses have an RBD - Receptor Binding Domain (the area of its genetic sequence that allows it to attach to, and infect, host cells) that – like a key slipping into a padlock -`fit’ the receptor cells commonly found in the human upper respiratory tract; the alpha 2,6 receptor cell.  

 

Avian adapted flu viruses, like the H5N1 virus, bind preferentially to the alpha 2,3 receptor cells found in the gastrointestinal tract of birds. 

 

While there are some alpha 2,3 cells deep in the lungs of humans, for an influenza to be successful in a human host, it needs to a able to bind to the a 2,6 receptor cell.

 

A design flaw that - at least for the time being – is believed to have kept the H5N1 virus from taking off in the human population (note: there are likely other genetic barriers as well).

 

All of which serves as prelude to a study out of China where researchers have found at least two strains of the H5N1 virus that demonstrated the ability to bind to both a2,3 and a2,6 receptor cells.

Before anyone starts to head down to the bunker, these viruses were collected between 2003 and 2009, and despite their ability to bind to human-type receptors (at least at high viral loads), they have not managed to spark a pandemic.

The following excerpts come the abstract that appears in Biomedical and Environmental Sciences, Volume 25, Issue 1(h/t Tetano on FluTrackers for this link). 

Follow the link to read it in its entirety.

 

Identification of Dual Receptor-binding Specific Strains of Human H5N1 Viruses in China

Jian Fang ZHOU, Shu Mei ZOU, Zi LI, Min WANG, Jie DONG, Jun Feng GUO, He Jiang WEI, Le Ying WEN, Hong XU, Yue Long SHU

Abstract (excerpts):

 

 

<SNIP>

Results Dual binding preference to 2, 3 and 2, 6-glycans were found in two strains: A/Guangdong/1/06 (A/GD/1/06) and A/Guangxi/1/08 (A/GX/1/08). Though minor effect of short-2, 6-binding was detected in A/GX/1/08 at a low virus titer, both showed high affinity to the oligosaccharide at a high load. Notably both are of the long-2, 6-recognition, with the same topology as that of human H1N1 and H3N2 viruses.

Conclusion The findings suggest that human H5N1 virus in China likely acquired the potential human-adaptation ability. Further research and surveillance on receptor-binding specificity of H5N1 viruses are required.

 

 

 

While a significant step towards adaptation to human hosts, obviously something more is needed to make the H5N1 virus a pandemic threat.

 

Lest anyone be too comforted, this study does show that the H5N1 virus is capable of evolving towards a more `humanized’ pathogen.

 

Which is why the world remains at pre-pandemic Phase III on the H5N1 virus, and we continue to watch for signs of better adaptation to humans.

 

 

»» Read More

China: Hebei Outbreak Identified As Adenovirus 55

 

 

Adenovirus- Credit CDC

 

 

# 6171

 

 

Yesterday the Internet was abuzz with rumors of `SARS’, or at least something that looked like SARS, sending scores of people to hospitals in Hebei, China (see China Denies Internet Rumor Of SARS Outbreak).

 

While SARS seemed unlikely (we haven’t seen an outbreak in 9 years), news reports out of Hebei over the past week have suggested some kind of respiratory outbreak was in progress.

 

Today, Taiwan’s CDC is reporting that China has notified them that the outbreak is due to the Adenovirus type 55, not to SARS.

 

A hat tip to Shiloh on FluTrackers for picking up this story and adding it to their thread.

 

China confirms suspected adenovirus infection outbreak: CDC

2012/02/24 19:54:00

Taipei, Feb. 24 (CNA) An outbreak of disease that is causing a stir in the Chinese online community is not SARS but adenovirus infection, the Centers for Disease Control (CDC) confirmed Friday after checking with the Chinese health authorities.

 

China told the CDC that the suspected outbreak in Hebei Province was in fact adenovirus type 55 infection, CDC Deputy Director-General Chou Chih-hau said.

 

China, however, did not reveal the scale of the epidemic to Taiwan.

(Continue . . . )

 

 

Adenoviruses are one of the most common causes of respiratory illness in the world, and to date, more than 50 different types have been isolated.

 

The CDC’s Adenovirus Information page describes the virus this way:

 

Adenoviruses most commonly cause respiratory illness. The symptoms can range from the common cold to pneumonia, croup, and bronchitis. Depending on the type, adenoviruses can cause other illnesses such as gastroenteritis, conjunctivitis, cystitis, and less commonly, neurological disease.

 

Infants and people with weakened immune systems are at high risk for severe complications of adenovirus infection. Also, adenoviruses commonly cause acute respiratory illness in military recruits.

 

Some people infected with adenoviruses can have ongoing infections in their tonsils, adenoids, and intestines that do not cause symptoms. They can shed the virus for months or years.

 

We have seen rare outbreaks of emerging strains of adenovirus that have caused more serious illness, including one serotype (Ad14) that has been associated with a number of deaths during the past decade (see 2007 MMWR Acute Respiratory Disease Associated with Adenovirus Serotype 14 --- Four States, 2006—2007).

 

Like all viruses, adenoviruses are capable of evolving and mutating, and new strains are likely to crop up from time to time, with varying degrees of severity.

 

While not influenza (or worse, SARS), we’ll keep an eye on this outbreak, and see how it progresses.

»» Read More

FluTrackers: Assessment Of H5N1 In China

 

 

# 6097

 

 

The newshounds on the major flu forums do an incredible job searching for, translating, and analyzing media reports of infectious diseases from all over the world. I’ve said it before, but much of what I do in this blog is only possible due to their efforts.

 

In terms of organization, quality, and volume of information, it would be hard to find a more impressive repository of emerging disease news than one can find at FluTrackers.com.

 

With two recent high profile human infections from the H5N1 virus in China (and others being reported in Indonesia, Cambodia, Egypt, and Vietnam), along with the ongoing controversy over the merits and dangers of H5N1 research, media attention has once more turned towards bird flu.

 

Sharon Sanders, Editor of FluTrackers, has distilled the combined efforts of the FluTrackers team into a handy overview of the H5N1 risks in China based on information they have been able to accumulate.

 

Anyone wanting a crash course on the H5N1 situation in China need only follow the embedded links to get a grasp of the situation. As this overview emphasizes, state control of local media makes making definitive statements difficult.

 

 

 

FluTrackers.com Risk Assessment of H5N1 type influenza in China

The FluTrackers Team
January 24, 2012

We feel that we can not say with 100% certainly what the exact situation is but this is our opinion based on the facts as we ascertain them as of this date and time.

Humans are at continuous risk of exposure to H5N1 poultry.

1) China has an endemic H5N1 problem in poultry. We know this for several reasons:

a) There have been warnings over the years to clean eggs shells due to surface contamination including H5N1:

China - Experts Call for More Stringent Standards for Cleaning Eggs - Avian Flu Mentioned As Risk May 2011

China - Nutrition Society warns on poultry egg shells, meat, and storage due to avian influenza H5N1 contamination January 2012

2) There are numerous H5N1 drills to train emergency personnel how to react to human and poultry outbreaks. A sample of recent drills includes:

China - Human Bird Flu H5N1 Drill held in Qinzhou, Guangxi province – January 2012

China - CDC Holds Suspected Human H5N1 Emergency Drill in Binzhou City, Shandong province December 2011

China - Emergency Poultry Bird Flu Drill Held in Rizhao City, Shandong province December 2011

China - Major H5N1 Poultry Farm Drill Held in Jangmen, Guangdong province November 2011

 

3) There are recent H5N1 poultry outbreaks in countries that border China: Tibet, Vietnam (Human), Vietnam (poultry), Hong Kong (wild bird), Hong Kong (poultry), Bhutan, & Nepal

4) The Russian health minister warned citizens on January 4, 2012 to be vigilant about H5N1 when traveling in China here.

5) Other hints and tips in the Chinese press regarding H5N1 status:

China - "Raw" poultry not allowed on trains in Shenzhen due to bird flu fears January 15, 2012

Ministry of Health: human infection of highly pathogenic avian influenza surveillance will be strengthened for the sporadic cases January 2012

China - Shanghai public health requires all medical institutions to monitor carefully for unexplained pneumonia November 2011

6) No country, where H5N1 has become endemic in the environment, has been able to successfully eliminate this disease. Indonesia, Vietnam, and Egypt, each experiencing current poultry and human H5N1 cases, are the most outstanding examples of this unfortunate phenomena. Therefore, despite the fact that China is not reporting any current H5N1 outbreaks in poultry we believe they occur and this is a constant threat to human health.

We see no evidence of sustained and efficient H5N1 infection between humans in China. However, we feel this risk is unknown since China is not forthcoming, generally, about its disease status.

 

On June 14, 2011 the Ministry of Health announced a creation of a “black list” for media that do not report government sanctioned information. We feel this represents a risk to human health, in general, in China.

The risk of human contamination from H5N1 positive wild birds is unknown in China.Hong Kong reports sporadic cases of H5N1 in wild birds but there are no corresponding human infections that result from contact with such wild birds.

The risk of human contamination from animals (other than poultry), or the environment, in general, is not known.

 

Many studies have demonstrated that animals can harbour the H5N1 virus, including domestic cats and dogs. In an H5N1 endemic environment, it should be assumed that there are many possible vectors for infection.

It is unclear how the most recent human cases of H5N1 were infected here and here. The government of China denied any human-to-human transmission in the Shenzhen case. The government also denied H5N1 poultry as the source. There were some press announcements that contact with a wild bird may have been the cause of the human case in Shenzhen. If this is true, then, logically, there must be many human cases of H5N1 in China amongst people who frequent parks and other outdoor venues. We feel this scenario, while possible, is not likely.

In conclusion, we feel there is a risk to the human population in China from H5N1 type influenza. A culture of hand washing, avoidance of wild birds and poultry, sanitary contact with domestic pets, and social distancing in public is advisable.

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China Reports 2nd Bird Flu Fatality In A Month

 

 

# 6093

 

 

On the heels of recent human H5N1 infections reported in Indonesia, Egypt, Vietnam, and Cambodia -  China has announced their second bird flu fatality in less than a month.

 

This time it reportedly involves a 39-year-old man living in Guizhou, a province in southern China.

 

The AP and AFP are reporting this patient, who was described as being in critical condition several hours ago, as having died on Sunday (AP link)

 

Here is the official notification from the Hong Kong Centre For Health Protection.

 

Notification of a human case of H5N1 in Guizhou

The Centre for Health Protection (CHP) of the Department of Health received notification from the Ministry of Health (MoH) today (January 22) concerning a confirmed human case of influenza A (H5N1) in Guizhou.

A CHP spokesman said the patient was a 39-year-old man living in Guizhou. He developed symptoms on January 6 and was admitted to a hospital on the same day. He is now in critical condition. The man did not report obvious exposure history to poultry before the onset of symptoms.

 

Laboratory tests on the patient's specimen by the Chinese Centre for Disease Control and Prevention yielded a positive result for H5N1.

 

The CHP is maintaining close liaison with the MoH to obtain more information on the case. We will heighten our vigilance and continue to maintain stringent port health measures in connection with this development, the spokesman said.

 

The spokesman reminded members of the public to remain vigilant against avian influenza infection and to observe the following measures:

• Avoid direct contact with poultry and birds or their droppings; if contacts have been made, they should wash hands thoroughly with soap and water;
  
• Poultry and eggs should be thoroughly cooked before eating;
  
• Wash hands frequently;
  
• Cover nose and mouth while sneezing or coughing, hold the spit with tissue and put it into covered dustbins;
  
• Avoid crowded places and contact with sick people with fever;
  
• Wear a mask when you have respiratory symptoms or need to take care of patients with fever;
  
• When you have fever and influenza-like illnesses during a trip or when coming back to Hong Kong, you should consult doctors promptly and reveal your travel history.

 

For further information on avian influenza, please visit the CHP website: www.chp.gov.hk.

Ends/Sunday, January 22, 2012
Issued at HKT 15:44
NNNN

 

Despite the standard cautions about exposure to poultry listed above, the AFP report indicates - that like the case in Guangdong province in late December - this victim claimed no known contact with poultry over the past 30 days.

 

The report goes on to say that 71 contacts of this victim are being monitored, but none have developed any signs of illness.

 

This recent spate of cases comes amid the traditional Lunar New Years celebration, a 6-week period which sees hundreds of millions of Asians returning to home and family to celebrate each year.

 

The Lunar New Year occurs on January 23rd this year, and as they do every year, public health officials will be on the lookout for any signs of unusual disease outbreaks in the wake of this mass migration.

 

The recent spike in human H5N1 infections is something we see each winter, but fortunately we’ve yet to see any signs of sustained human-to-human transmission of this virus.

 

Nevertheless, as these cases continue to trickle in scientists keep watch for any signs that might indicate the virus is adapting better to humans.

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ECDC: Rapid Risk Assessment On China’s H5N1 Fatality

 

 

# 6054

 

 

The other day I spotted a headline that proclaimed the Return of Bird Flu: Chinese Man Dies - as if the H5N1 virus had somehow gone away, only to recently return.

 

Of course, those of us who follow these things know the H5N1 virus has never gone away.

 

During  2011 we saw 60 human infections reported (with 33 fatalities) from around the world - of which the mainstream press rarely took  notice.

 

While this recent case is first one reported from China in 18 months, few veteran flu watchers - I suspect - would care to put money on that being an accurate accounting of Chinese cases. 

 

Or for that matter, wager on the 60 reported cases last year representing the full burden of the disease in humans around the globe.

 

Surveillance and reporting simply isn’t that good.

 

Despite no overt signs of involving human-to-human transmission, the recent case involving a bus driver in Shenzhen, China has – in comparison to the others – garnered a good deal of media attention over the past couple of weeks.

 

Today, the ECDC has released a Rapid Risk Assessment on the H5N1 case in China, where they find that the risk to Europe from the H5N1 virus remains low, and unchanged. 

 

 
 

 

Rapid risk assessment: Human fatality from highly pathogenic avian influenza A(H5N1) virus infection in Guangdong province, China

Scientific Publication - Jan 2012

ABSTRACT

Following reports of a human fatality due to highly pathogenic avian influenza A(H5N1) virus infection in China’s Guangdong province, the European Commission requested an update to the assessment of risk of human-to-human transmission occurring.

ECDC does not consider that there is any change to the previous assessments that the risk for EU/EEA countries is very low.

 

A few excerpts provide their rationale.

 

 

 

ECDC threat assessment for the EU

 
This case of HPAI A(H5N1) virus infection reported in China does not indicate a change in the risk for human-to-human transmission for the following reasons:

•  It is a single isolated case, not part of a cluster.
•  It occurred in a country where avian influenza is entrenched.
•  No contact with sick patients has been reported.
•  The identified clade suggests transmission from birds.

Conclusions 

This new human case is not unexpected. In countries where avian influenza A(H5N1) viruses are entrenched in wild bird populations and are occasionally transmitted to domestic poultry, sporadic infections and even small clusters will probably continue to occur among humans who have contact with infected poultry or wild birds.

Human-to-human transmission cannot be completely ruled out even in this case but there is no evidence of human-to-human transmission here or elsewhere. 

The recent report of a single human case of a wild-type influenza A(H5N1) virus infection in Shenzhen city, Guandong province, China, does not change the current assessment of the risk to human health in the EU or globally. The risk is considered to be very low in EU/EEA countries. However, vigilance for avian influenza A(H5N1) in domestic poultry and wild birds and other animal influenza in Europe and elsewhere remains important.

»» Read More

WHO Updates: Bird Flu In China, Egypt

 

 

# 6053

 

The World Health Organization this morning has posted updates on China’s recent H5N1 fatality (see Shenzhen Bird Flu Suspect Dies) and the details on a new Egyptian fatality as well.

 

First, the Chinese case.

 

Avian influenza - situation in China - update 6

5 January 2012 - The Ministry of Health of China has notified WHO of a human case of avian influenza A (H5N1) virus infection.‪

 

The case is a 39-year-old male from Shenzhen, Guangdong Province. He developed symptoms on 21 December 2011 and was admitted to hospital on 25 December 2011. He was in critical condition and died on 31 December 2011. The case was laboratory diagnosed by Guangdong CDC on 30 December 2011 and confirmed by China CDC on 31 December 2011. Investigation into the source of infection is ongoing. Close contacts of the case are being monitored and to date all remain well.

 

Of the 41 cases confirmed to date in China, 27 have been fatal.

 

 

Next from Egypt, another case from late last year.

 

 

Avian influenza - situation in Egypt - update 60

 

5 January 2012 - The Ministry of Health and Population of Egypt has notified WHO of a case of human infection with avian influenza A (H5N1) virus.‪

 

The case is a 42 year-old male from Menofia Governorate. He developed symptoms on 16 December 2011 and was admitted to hospital on 21 December 2011, where he received oseltamivir treatment. He was in critical condition and died on 22 December 2011.

 

The case was confirmed by the Central Public Health Laboratories, a National Influenza Centre of the WHO Global Influenza Surveillance Network, on 24 December 2011.

 

Investigations into the source of infection indicated that the case had exposure to sick and dead backyard poultry.

 

Of the 157 cases confirmed to date in Egypt, 55 have been fatal.

 

 

Bird flu remains primarily a threat to poultry - as the virus remains poorly adapted to human physiology. Despite ample opportunities to cause illness in humans, the virus only causes rare, sporadic infections.

 

The concern, of course, is that over time that may change.  That the virus will mutate into a form that is easily acquired and passed on by humans.

 

And so we watch developments in places where the virus is endemic with particular interest.

»» Read More

China Seeks To Reassure On Bird Flu

 

Guilty as charged?     Photo Credit – FAO

 

# 6047

 

The news wires this morning are filled with reports on the investigation into the death of a Shenzhen bus driver late last week from the H5N1 virus (see Shenzhen Bird Flu Suspect Dies).

 

The substance of most of these reports appear to be based on the details released in a Xinhua News Service report overnight.

Xinhua is the official news service (some would say press agency) of the Chinese government.

 

The gist of the report (linked below) is that health officials have reportedly identified the H5N1 strain, and have determined through genetic analysis that while pathogenic in humans, it is `not transmissible’.

 

First the Xinhua report (emphasis mine), then I’ll return with a little more.

 

Authorities identify virus leading to Guangdong bird flu death

Source: Xinhua  |   2012-1-2  HEALTH authorities in south Guangdong province have identified the type of the virus that led to the death of a bus driver, but the cause of the bird flu remains unclear, a local disease control center confirmed today.

 

The receptor of the virus, a highly pathogenic H5N1, is poultry, according to a statement released by the Shenzhen Disease Control Center.

 

Though it is highly pathogenic to human beings, the virus can not spread among people, the center said in the statement, adding that there is no need for Shenzhen citizens to panic.

 

Genetic analysis also indicated that the virus was spread directly from poultry to human, according to the statement.

 

A 39-year-old man surnamed Chen in Bao'an district of Shenzhen was hospitalized for fever on December. 21 and tested positive for the H5N1 avian influenza virus. Chen died of multiple organ failure Saturday afternoon.

 

Health authorities are trying to figure out where Chen acquired the virus.

 

The Guangdong Department of Agriculture announced Saturday that no epidemic of bird flu among poultry had been reported in the province.

 

This reassuring missive – complete with the standard admonishment `not to panic’ – is unfortunately both contradictory, and lacking in detail. 

 

We are told in two places that the route of infection is unclear, and in another that genetic analysis shows it was from direct contact with infected poultry.

 

But at the same time we are assured by the Agriculture Department that no outbreaks of H5N1 have been reported in poultry anywhere in the Province.

 

The `receptor’ of the virus – by that I assume they mean the RBD (Receptor Binding Domain) – is stated as being `poultry’. 

 

I’m assuming they mean avian in nature (an affinity for alpha 2,3 receptor cells).

 

A virus’s ability to bind to specific cells is controlled by its RBD or Receptor Binding Domain; an area of its genetic code that allows it to attach to, and infect, specific types of host cells.

 

(A Very Simplified Illustration of RBDs)

Like a key into a padlock, the RBD must `fit’ in order to open the cell to infection.

 

Humans, unlike birds, have mostly alpha 2,6 receptor cells in their upper respiratory tract, making it difficult for avian viruses to attach. Humans do have some a2,3 receptor cells deep in the lungs and in their gastrointestinal tract.

 

The declaration that the `virus can not spread among people’ would therefore seem a bit strong, as we’ve seen limited transmission of avian-adapted viruses among humans in the past.

 

That this virus is not yet well adapted to human physiology - and therefore unlikely to be spread from one human to another - is probably a more reasonable assessment.

 

The lack of additional cases thus far in the province is obviously a good sign, and if that trend continues, would lend credence to the government’s claim that this is not an easily transmissible strain.  

 

But a lack of scientific detail - along with an overly reassuring tone and China’s chequered history on the reporting of previous disease outbreaks - makes it difficult to come away from this report completely assuaged.

»» Read More

Route Of Shenzhen Bird Flu Infection Unclear

 

    # 6046

 

 

 

The means by which a 39-year-old bus driver from the city of Shenzhen in Guangdong Province, China came to contract a fatal H5N1 infection remain unclear according to a report in today’s China Daily.

 

The victim, named Chen, was reported yesterday to have died after spending nearly a week in a coma at a local hospital (see Shenzhen Bird Flu Suspect Dies).

 

Early reports indicate he neither had contact with poultry, or had traveled outside of the city, in the past 30 days. First an excerpt from the Xinhua news report, then I’ll return with more.

 

Cause of bird flu death in S China still unclear

Updated: 2012-01-01 21:06

(Xinhua)

GUANGZHOU - Health authorities in south Guangdong province have yet to find the cause of the highly pathogenic H5N1 virus, commonly known as bird flu, that led to the death of a bus driver, a local disease control official said Sunday.

 

The 39-year-old man surnamed Chen in Bao'an district of Shenzhen was hospitalized for fever on December 21 and tested positive for the H5N1 avian influenza virus. He died of multiple organ failure Saturday afternoon, the Guangdong Health Department said in a statement.

 

The department also said that during the previous month prior to his fever, he had no direct contact with poultry and hadn't traveled out of the city.

 

Chen's wife said he had a habit of doing morning exercises every day near a wetland park and an artificial lake not far from his home, but "no proof has been found that his infection is connected with the migratory birds there," He Jianfeng, director of the Epidemics Studies Institute of the Guangdong Disease Control Center, said Sunday.

 

"We also don't know whether he had eaten poultry before he fell ill," He said.

(Continue . . .)

 

 

Determining the likely route of infection in a specific bird flu patient has always been tricky, and often the `official’ determination is based on circumstantial evidence.  

 

Direct contact with sick or dead birds has been the most common mode cited over the years, even in some cases where the aforementioned birds were not identified or confirmed to be infected with the virus.

 

And often, that was probably a reasonable enough assumption.  Occam's razor being – the simplest explanation is most likely the correct one.

 

Without specific regard to today’s case, it is worth noting that we’ve also seen serological evidence of subclinical, or asymptomatic infection with the H5N1 virus in China and in Thailand, and even among some people who were unlikely to have acquired it directly from poultry.

 

Last December, in Study: Subclinical H5 & H9 Infections In Humans, we saw a report out of China on the detection of antibodies to both H9 and H5 avian influenza viruses among a small number of villagers in and around Beijing, China.

 

The study was titled:

 

Infection With Multiple Avian Influenza Viruses in a Man Without Poultry-Handling Practices Suggesting an Increased Probability of Emergent Pandemic Influenza Virus in General Population

Peng Yang, Weixian Shi, Shujuan Cui, Yi Zhang, Xiujun Liu, and Quanyi Wang

 

 

In September of last year we saw a study that reported the results of this kind of serological testing conducted in a rural village in Thailand in 2008 (see Bangladesh To Share H9N2 Bird Flu Virus). 

 

Out of 800 villagers tested, the authors found 4.7% were seropositive for the Hong Kong H9N2 avian strain, 5.6% had antibodies to A/Thailand/676/2005 H5N1 bird flu, and 3.5% were shown to be seropositive to A/Thailand/384/2006 H5N1.

 

The implications of these studies are that human infection with these avian viruses – while still rare – is probably more common that current surveillance and reporting suggests.

 

And that opens the possibility, at least, that asymptomatic H5N1 infections could (in rare cases) provide a silent route of transmission of the virus.

 

Again, the evidence here is both scant, and primarily circumstantial. And there is no evidence to suggest sustained or efficient transmission.

 

For now, the H5N1 virus appears poorly adapted to human physiology. And while the concern is that, over time, that could change, it is also possible that this virus will never adapt fully to humans.

 

But with the recent laboratory successes in turning the H5N1 virus into a more easily transmissible pathogen (see The H5N1 Research Debate Goes On), there are renewed concerns in the scientific community that this avian virus may one day evolve enough to pose a serious pandemic threat to mankind.

»» Read More

Shenzhen Bird Flu Suspect Dies

 

# 6045

 

Numerous media outlets are reporting that the H5N1 suspect from Guangdong Province – adjacent to Hong Kong – has died from his illness.

 

Most of these media reports appear to be based on a trio of statements issued by the Health department in Guangdong province (links to Google translations below)

 

Note: while readable, these machine translations are nonetheless a bit convoluted.

 

Shenzhen confirmed case of human infection of highly pathogenic avian influenza 2011-12-31 16:51:06

Shenzhen diagnoses an example person to infect the high pathogenic bird flu 2011-12-31 16:51: 06

Shenzhen found a case of human infection of highly pathogenic avian influenza suspected cases 2011-12-30 22:35:08

The highlights are that the patient named Chen, a 39 year-old male bus driver in Shenzhen, developed a fever on December 21st, and was taken to a hospital on December 25th and diagnosed with severe pneumonia.

 

The patient subsequently tested positive for the H5N1 virus, and it was announced he died of massive organ failure on December 31st.

 

Based on the title and text of the latest press release local authorities are apparently considering this to be a confirmed case of H5N1.

 

Authorities state that the man had no contact with poultry, or history of travel outside the city, over the past 30 days. The Health Department is actively monitoring 120 recent contacts of the victim, but none reportedly have shown signs of illness.

 

With this latest case of H5N1 in China, along with reports of avian flu in poultry in the region, public health officials and epidemiologists across Asia will no doubt be watching carefully for any signs of disease outbreaks.

 

For January will see the biggest travel holiday on earth; The Lunar New Year.

 

In Vietnam, it is called  Tết Nguyên Đán or Feast of the First Morning.  Tết for short.

 

In Korea it is called Seollal.

 

In China, it is often called Chunyun, Chinese New Year, or simply, The Spring Festival.

 

By whatever name, the lunar new year is no doubt the most  important holiday in all of Asia.  And more than 2.5 billion passenger journeys – mostly by crowded train –will be made in China alone over this six week period.

 

In many Asian cultures it is a long held tradition that people return home to attend a reunion dinner with their families on the eve of the lunar New Year. They stay a few days, then return to the cities from whence they came.

 

Duck and chicken are, as you might imagine, popular dishes during these gatherings.  And the live markets do tremendous business this time of year.

 

All of which provides opportunities for avian, swine, or human flu viruses to hitch rides to remote areas of the world where they may not have arrived yet, and for viruses to be carried from rural areas back to the cities.

 

This year, the lunar New Year will fall on January 23rd.

 

Due to the potential for disease transmission (including mosquito borne illnesses, food poisoning, flu, etc.) during this very busy holiday period, the CDC posts some travel advice each year to those planning a trip to Asia.

 

Good Luck. Good Health. Good Cheer. Happy Lunar New Year!

The year of the Dragon begins January 23, 2012, and many travelers will visit Asia to celebrate the Lunar New Year. If you are traveling to Asia, the Centers for Disease Control and Prevention (CDC) would like to share information and tips that will help you stay healthy and safe during your trip.

 

Every destination, even in different areas of the same country, has unique health issues that travelers need to be aware of. To find specific information about the areas you plan to visit, see the East Asia, South Asia, and Southeast Asia regional pages on the CDC Travelers’ Health website, or click on the country or countries you will be visiting on the destinations page.

(Continue . . .)

»» Read More