Vietnam Reports Progress On New Bird Flu Vaccine

Photo Credit – FAO

 

# 6603

 

 

For several months now we’ve been watching reports out of Vietnam concerning the newly discovered clade 2.3.2.1 C of the H5N1 virus. This is the most recent variation of clade 2.3.2.1 that has been circulating for several years in South East Asia and China.

 

Just over a year ago (see FAO Warns On Bird Flu) concerns were raised over this clade, as the poultry vaccine currently in use was ineffective against it.

 

H5N1 – like all flu strains – is a constantly moving target, mutating and evolving, looking to evade host defenses. Which means that new clades, and variations within each clade, continue to emerge.

 

You can see the evolution of the virus in the chart below, starting with Clade 0, first detected in 1996.

 

(click to load larger image)

All of which means we are not watching just one H5N1 virus strain, we are watching at least 20 genetically separate clades of the virus, with many minor variants of each clade thrown in the mix.

 

Since first reported in July, this latest clade ( 2.3.2.1 C) has made headlines across Vietnam due to its rapid spread. A few earlier reports include:

 

Vietnam: Ministry Bans Transport Of Waterfowl Over H5N1 Fears

V Said, C Said

Vietnam Reports A Possible Change In The H5N1 Virus

 

Today, some encouraging news out of Vietnam as they announce early tests results on a new poultry vaccine that shows promise against this emerging clade.

This from the the Saigon-Daily.

 

 

Vietnam develops vaccine for toxic bird flu virus

Wednesday, Oct 03, 2012

At a meeting of the Steering Board for Bird Flu Prevention on October 2 in Hanoi, it was announced that Vietnam has now developed a vaccine that can control the new highly toxic strain of bird flu virus.

 

Pham Van Dong, head of the Department of Animal Health, said that health officials tested the newly developed vaccine on a flock of chickens and the test results were positive.

 

In future, they will conduct experimental tests on water-fowl and if test results are once again positive, the new vaccine will be used throughout the country.

 

The new bird flu strain, 2.3.2.1 C, has recently spread to Vietnam and is now present in affected areas in the northern and central provinces of Hoa Binh, Tuyen Quang, Thai Binh, Ha Tinh and Quang Ngai.

 

Of these, Quang Ngai Province has reported the highest number of dead poultry with nearly 24,000 birds having died so far.

 

The Department of Animal Health said that the bird flu pandemic will develop unpredictably because illegal transportation and sale of poultry of unmarked origin is far too rampant.

 

The Mekong Delta provinces were hence quick to implement the campaign ‘Month for disinfection at farms and prevention and control of bird flu’ in October. During the campaign, farm owners will have to tidy their farms and disinfect their surroundings at least once a week as well as disinfect transportation and cages after use.

 

Slaughterhouses and poultry markets will have to be disinfected once a day, when the butchering is over.

 

 

While we continue to see isolated human infections around the world (see A WHO Flu Review), H5N1 remains largely an avian-adapted virus, and for now primarily a threat to poultry.

 

The concern, of course, is that with continual changes to the virus, one of these days it may better adapt to human or mammalian physiology.

»» Read More

Vietnam: Ministry Bans Transport Of Waterfowl Over H5N1 Fears

Photo Credit – FAO

 

# 6564

 

 

Over the past few weeks we’ve seen a growing number of reports out of Vietnam regarding a newly emerging sub-clade of the H5N1 virus (see Vietnam Reports A Possible Change In The H5N1 Virus). 

 

While the origin of this virus is in dispute (see V Said, C Said), what is clear is the concern being expressed by officials over this new threat.

 

This new sub-clade has been dubbed 2.3.2.1 C, and is the third variation of the 2.3.2.1 clade that has been circulating for several years in South East Asia and China. Just over a year ago (see FAO Warns On Bird Flu) concerns were raised over this clade, as the poultry vaccine currently in use was ineffective against it.

 

The myriad of H5N1 viruses we have today have all essentially evolved from clade 0, first identified in 1996. You can see the history of the virus in the chart below. H5N1 – like all flu strains – is a constantly moving target, continually evolving, looking for an evolutionary advantage.

 

Some less successful clades have died out along the way, but many co-circulate around the globe today.

 

(click to load larger image)

 

All of which means we are not watching just one H5N1 virus strain, we are watching at least 20 genetically separate clades of the virus, with many minor variants of each clade thrown in the mix.

 

Which brings us to today’s report from the SGGP (Sài Gòn Giải Phóng), the official newspaper of the Vietnamese government.

Ministry fears spread of virus, bans transport of water fowl

Wednesday, Sep 19, 2012

 

The Ministry of Agriculture and Rural Development has decided to stop transport of live water-fowl from North and Central Vietnam to the South, in an effort to curb spread of the new highly toxic strain of avian flu virus.

 

Pham Van Dong, deputy director of the Department of Animal Health, stated this at a meeting held yesterday in Hanoi by the National Steering Committee for Avian Flu Prevention and Control.

 

The new strain, 2.3.2.1 C, which has been detected, is highly toxic and therefore extremely deadly.

 

The virus strain has recently spread to Vietnam and is now present in affected areas in the northern and central provinces of Hai Phong, Ha Tinh, Ninh Binh, Nam Dinh, Bac Kan, Thanh Hoa and Quang Ngai.

 

Fearing the virus may spread to South Vietnam, the Department of Animal Health was asked to isolate the virus and ban transport of live water-fowl from infected areas.

 

Dong said that slaughterhouses practicing good hygiene should be mentioned to localities from the central province of Thua Thien-Hue to Ho Chi Minh City.

 

Because the new strain is different from the earlier A/H5N1 virus, the ministry has urged for experiments and tests to confirm whether the vaccine used to combat A/H5N1 is also effective against the new strain. If the existing vaccine is ineffective, studies on new vaccines should be conducted soon.

 

The Central Veterinary Diagnosis Center has been asked to study the new strain to help find a specific medication to fight the virus.

 

 

Although the above story describes this new strain (2.3.2.1 C) as `highly toxic and therefore extremely deadly’ this would appear to be referring mainly to its effect on poultry.

 

Vietnam has reported only 4 human infections this year (2 fatal), and none have been reported since last March (see WHO Update Avian influenza – situation in Viet Nam – update).

 

Thus far, we have scant hard data on the threat this new clade poses to humans.

 

While we continue to see isolated human infections around the world, H5N1 remains largely an avian-adapted virus, and for now primarily a threat to poultry.

 

The concern, of course, is that with continual changes to the virus, one of these days it may adapt to human or mammalian physiology.

 

And so the world remains at Pre-pandemic Phase III on the H5N1 virus, and we continue to watch for signs that the virus is moving towards becoming a bigger threat.

»» 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

Vietnam Intensifies Bird Flu Prevention Efforts

H5N1 Outbreaks In Vietnam - Map Credit OIE

# 6488

 

While an emerging H3N2v swine flu and reports of H3N8 `seal flu’ have been making headlines over the past few weeks, in Vietnam the struggle to contain and control outbreaks of H5N1 bird flu in poultry continues.

 

In recent days Vietnam has reported fresh outbreaks of the disease in the cities of Hai Duong and Hai Phong, and the provinces of Quang Binh and Ha Tinh.

 

Today, local media is reporting that Nguyen Van Binh, head of Department of Preventive Health, has ordered new steps to be taken across the country to curb the spread of the virus.

 

The story appears in the Saigon-Daily, and it appears to call for a fresh look, and new approaches to containing the disease.

 

Health departments to ascertain, curb possible spread of H5N1 virus

Friday, Aug 10, 2012

Nguyen Van Binh, head of Department of Preventive Health, said that municipal and provincial departments of health across the country have been ordered to do a thorough study of old cases of outbreaks of diseases, so as to ascertain and curb the possible spread of H5N1 virus.

 

Medical workers, especially those at border gates, have been advised to keep a close watch on patients suspected of having contracted the H5N1 strain, by placing them in quarantine and isolation wards in hospitals.

(Continue . . . )

 

 

Vietnam was one of the earliest countries affected by the H5N1 virus, and for a time, lead the world in human cases and deaths.

 

Through massive educational and regulatory efforts, by 2006 they’d gone from being the worst afflicted country in the world to being viewed as the `poster child’ for successful bird flu containment.

 

But that victory was fleeting.

 

After nearly 18 months  of quiescence, the virus retuned in 2007.  Since then, Vietnam has been engaged in a more-or-less constant battle with sporadic outbreaks of the virus in poultry, along with occasional human infections and fatalities.  

 

 

The latest OIE filing on the H5N1 virus (08/08/12
Follow-up report No. 73) indicates there have been 346 outbreaks reported since 2007.

 

The news out of Vietnam isn’t all bad.

 

Despite hundreds of outbreaks in poultry, they’ve managed to keep reported human cases down to the low and mid single digits since 2007. 

 

A far cry from the 61 cases they reported in 2005.

 

 

Today’s report indicates that there are still great concerns over the the spread of virus in Vietnam, particularly in those provinces bordering China, Laos, and Cambodia.

 

The arrival of a vaccine resistant clade of the H5N1 virus (2.3.2.1) in 2010 (see FAO Warns on Bird Flu), only increases the need for Vietnam to be proactive in identifying and containing the virus.

»» Read More

CDC Issues HFMD Travel Notice For Vietnam

 

Photo Credit University of Iowa

#6349

 

In terms of threat levels, the CDC issues several different types of travel notices, with the lowest threat belonging to the category called `In The News’. 

 

Essentially, this is an acknowledgement there are reports of sporadic cases of a disease in a specific country or region, but that they pose `No increased risk over baseline for travelers observing standard recommendations’.

 

On Friday, the CDC issued an `In The News’ travel notice on the ongoing outbreak of HFMD in Vietnam.

 

HFMD (Hand Foot Mouth Disease) is a relatively common, and usually mild, viral illness seen mainly in children under the age of 10 (although adults are vulnerable as well) and may be caused by several of the non-polio enteroviruses.

 

The 60+ non-polio enteroviruses identified to date are among the most prevalent viral infections in the world, probably only second to the myriad and ubiquitous variants of Rhinovirus (`common cold’) that circulate every year.

 

The most common causes of HFMD are the Coxsackie A16 virus, and the Enterovirus-71 (EV-71), and more rarely the Coxsackie A10 virus. In recent years, we’ve also seen the emergence of the Coxsackie A6 virus as a cause, first in Finland, and this past year, even in the United States (see MMWR: Coxsackievirus A6 Notes From The Field).

 

HFMD in the United States is most often due to the Coxsackie A16 virus, which is generally mild, rarely causes serious illness, and outbreaks of which are not uncommon in childcare facilities.

 

EV-71 HFMD is most commonly found in the Asia, with serious outbreaks recorded over the past dozen years in places like China, Malaysia, Hong Kong and most recently, Vietnam.

 

This version of the HFMD can sometimes be quite serious, with viral meningitis - and less commonly, encephalitis – complicating matters.

 

Two major genotypes of EV-71, EV-71 B and EV-71 C, have been identified as being responsible for a number of severe outbreaks in Australia, Japan, China, Malaysia, and Taiwan since 1997.

 

A couple of years ago, the Virology Journal, published an analysis of an EV-71 HFMD virus that caused a major disease outbreak in Fuyang City, China in 2008 that showed it was due to an emerging recombinant virus (see China: A Recombinant EV-71).

 

A reminder that viruses are always changing, evolving, looking for an evolutionary advantage.

 

Yesterday, the Thanh Nien Daily carried a story indicating that the number of HFMD cases in Vietnam this year is 10 times greater than last year, and that researchers are looking to see if the virus has mutated.

 

 

Cases of HFMD in Vietnam increase more than tenfold year on year

Saturday, May 26, 2012 04:20:00

The number of hand, foot and mouth disease (HFMD) cases in Vietnam is 10.2 times higher over the first five months of 2012 than it was for the same period last year.

 

According to the Ministry of Health’s report on Friday, 46,277 HFMD cases have been recorded across Vietnam since the beginning of this year.

 

Twenty-seven deaths have also been reported, 1.7 times more than last year, it said.

 

(Continue . . . )

 

 

With that in mind, here are some excerpts from the CDC’s Travel Notice, and some resources on HFMD from the CDC Website.

 

 

In the News
Hand, Foot, and Mouth Disease in Vietnam

This information is current as of today, May 27, 2012 at 15:03 EDT

Released: May 25, 2012

What Is the Current Situation?

As of April 29, 2012, the Vietnam Ministry of Health has confirmed nearly 40,000 cases of hand, foot, and mouth disease (HFMD) since the beginning of 2012. Cases have occurred in 63 provinces, and 20 deaths (all in children under 5) have occurred in 10 provinces. Hai Phong in the North has the highest number of cases, followed by Bac Can, Yen Bai, Lao Cai, Hoa Binh, Da Nang, Vinh Phuc, Quang Tri, Dong Thap, and Binh Dinh Provinces in the Center and Southern Regions. The Vietnam Ministry of Health is taking steps to control the outbreak.

 

Large outbreaks of severe HFMD occur frequently in some countries in Asia. Thousands of people may get infected during these outbreaks. Some people, particularly young children, may have severe disease requiring hospitalization or even causing death. To learn more outbreaks occurring around the world, visit the World Health Organization’s website.

<SNIP>

How Can Travelers Protect Themselves?

There is currently no vaccine or medicine to prevent HFMD. However, you can protect yourself from HFMD by practicing healthy personal hygiene.

• Wash your hands often with soap and water, especially before eating and after going to the bathroom or changing a diaper. If soap and water are not available, use an alcohol-based hand cleaner with at least 60% alcohol. Consider packing alcohol-based hand cleaner in your carry-on luggage to ensure you have it when needed.
• Disinfect dirty surfaces and soiled items. If you are able, first wash the items with soap and water; then disinfect them with a solution of chlorine bleach (made by mixing 1 tablespoon of bleach with 4 cups of water) or a cleaning product that contains bleach.
• Avoid close contact such as kissing, hugging, or sharing eating utensils or cups with people who have HFMD.

There is no specific treatment for HFMD. If you do develop mouth sores:

• Take over-the-counter medications to relieve pain and fever. (Caution: Aspirin should not be given to children.)
• Use mouthwashes or sprays that numb mouth pain.
• Drink plenty of liquids to stay hydrated.

Seek medical care:

• If you are sick and unsure if you have HFMD.
• If you cannot swallow liquids to stay hydrated.

 

 

You obviously don’t have to travel to Vietnam, or other parts of Asia, to be exposed to HFMD. 

 

For that reason, everyone should learn about the virus, and how it is spread.  To that end, we’ve a couple of multimedia products related to hand, foot, and mouth disease from the CDC.

 

• CDC Feature: Hand, Foot, & Mouth Disease
  An article that provides the basics about hand, foot, and mouth disease, who is commonly affected, symptoms, how it spreads, and ways to prevent it.
• Podcast: Hand, Foot, and Mouth Disease
  A CDC pediatrician and dad talks about hand, foot, and mouth disease, its symptoms, and tips to prevent your family from getting this disease.

»» Read More

WHO: Vietnam Avian Flu Update

Dak Lak Province -Photo Credit Wikipedia

 

# 6216

 

We’ve confirmation this morning from the World Health Organization on a human infection by the H5N1 virus that I wrote about last Thursday (see Media Report: 4th Vietnamese H5N1 Case Of 2012).

 

After roughly 20 months without detecting a human case,  Vietnam has now detected four H5N1 infections since the first of the year.

 

 

Avian influenza – situation in Viet Nam – update

12 March 2012 - The Ministry of Health, Viet Nam has reported a confirmed case of human infection with highly pathogenic avian influenza A(H5N1) virus in the country.

 

The case is a 31 year-old male from Dak Lak province. He developed symptoms on 29 February 2012 and sought health care on the same day. On 4 March 2012, he was admitted to a hospital and was diagnosed with viral pneumonia. He was transferred to a referral hospital on 5 March 2012, where he is currently being treated.

 

Laboratory tests were confirmed by the Pasteur Institute Ho Chi Minh City, a WHO National influenza Centre.

 

Epidemiological investigation indicate that the man was involved in the slaughter and consumption of sick poultry. Pasteur Institute Ho Chi Minh City and the local health sector are conducting further investigation and providing appropriate response. No close contacts of the case have reported respiratory symptoms.

 

To date, of the 123 confirmed cases reported in Viet Nam, 61 have been fatal.

 

 

Compared to the early outbreak years of 2004 and 2005  - a time during which they saw 90 human cases and 39 deaths - Vietnam has made considerable progress in their fight against the H5N1 bird flu virus.

 

By 2006, they’d gone from being the worst afflicted country in the world to being viewed as the `poster child’ for successful bird flu containment.

 

But that victory was short-lived.

 

After more than a year of near-quiescence,  H5N1 retuned in 2007, and since then Vietnam has been engaged in a more-or-less constant battle with the virus.

 

Mostly involving sporadic outbreaks in poultry, but with occasional human infections and fatalities as well.  

 

For now, the virus remains very difficult for humans to contract - but the concern is that the more opportunities we afford it - the better the chances are that the virus will eventually figure us out.

»» Read More

Media Report: 4th Vietnamese H5N1 Case Of 2012

Photo Credit Wikipedia

 

# 6209

 

The Thanh Nien Daily is reporting on Vietnam’s 4th known H5N1 infection of 2012, that of a 32-year-old male, known as N.D.T, from Dak Lak Province.  This would appear to be the same case that Crof mentioned overnight (here), but with a few more details.

 

Unlike the other cases we’ve seen this year from Vietnam, which have all come from the southern provinces, this one hails from the Central Highlands region.

 

 

 

Vietnam reports 4th bird flu infection 

Last Updated: Wednesday, March 07, 2012 07:10:00

Vietnam’s fourth bird flu (H5N1) patient of the year, and the first in the Central Highlands region, is being treated at the Hospital for Tropical Diseases in Ho Chi Minh City, the hospital’s deputy director Le Manh Hung told Thanh Nien Wednesday.

 

The 32-year-old male patient, known as N.D.T, from Dak Lak Province, was admitted to the hospital on Monday with high fever, fatigue and respiratory problems.

 

He was put on a breathing machine and kept in quarantine.

(Continue . . . )

 

 

While we continue to see a steady trickle of human H5N1 cases coming out of regions where the virus is endemic, most of these cases have been `one-off’ infections, with no sign of onward transmission.

 

For now, it remains difficult for humans to contract this virus, as it is far better adapted to avian physiology.

 

The concern, of course, is that over time, that may change.

»» Read More

WHO: Vietnam Avian Influenza Update

 

 

# 6196

 

 

From the World Health Organization this morning, confirmation of Vietnam’s most recent H5N1 infection, that of a 22 year-old man from Binh Duong province.

 

 

Avian influenza – situation in Viet Nam – update

5 March 2012 - The Ministry of Health has reported a confirmed case of human infection with avian influenza A (H5N1) virus.

 

The case is a 22 year-old male from Thanh Hoa province who lived and worked in Binh Duong province. He developed symptoms on 17 February 2012 and first sought medical care on 21 February 2012. He was admitted to the intensive care unit of the Hospital for Tropical Diseases on 23 February 2012 and received Oseltamivir upon admission. He is currently still in hospital.

 

Confirmatory test results for influenza A (H5N1) were obtained on 25 February 2012 by the Pasteur Institute Ho Chi Minh City, a WHO National influenza Centre.

 

Epidemiological investigation indicates that the man was involved in the slaughter and consumption of ducks. Pasteur Institute in Ho Chi Minh City and the local health sector are conducting the investigation and response. Close contacts of the case with fever have received prophylaxis and are being monitored; all have been confirmed as negative for H5N1 by PCR.

 

To date, of the 122 confirmed cases in Viet Nam, 61 have been fatal.

 

 

 

According to some Vietnamese media reports, this young man is recovering, and may soon be released from the hospital.

»» Read More

Vietnam Gears Up To Fight Bird Flu

 

 

 

# 6166

 

Compared to the `bad old days’ of 2004 and 2005  - a time during which they saw 90 human cases and 39 deaths - Vietnam has made considerable progress in their fight against the H5N1 bird flu virus.

 

By 2006, they’d gone from being the worst afflicted country in the world to being viewed as the `poster child’ for successful bird flu containment.

 

But that victory was fleeting.

 

After more than a year of near-quiescence, the virus retuned in 2007, and since then Vietnam has been engaged in a more-or-less constant battle with sporadic outbreaks of the virus in poultry, along with occasional human infections and fatalities.  

 

During the first six weeks of 2012, Vietnam has recorded dozens of outbreaks of the virus in poultry, and has reported two fatal cases of the disease. 

 

Of particular concern this winter has been the emergence of a new vaccine resistant clade of the virus (2.3.2.1) in the northern part of the country, which spurred an FAO warning last fall (see FAO Warns on Bird Flu).

 

 

All of which serves as prelude to the following story from the Sai Gon Giai Phong  (SGGP) online, outlining the emergency steps being taken by the government to try to prevent a massive outbreak of the virus.

 

The following is just an excerpt, follow the link to read it in its entirety.

 

PM calls for urgent measures to prevent spread of bird flu

Prime Minister Nguyen Tan Dung on February 20 sent an urgent dispatch to all provincial authorities to step up measures and tighten supervision so as to prevent the spread of bird flu (H5N1) virus, which has reoccurred in Vietnam.

 

The dispatch clearly states of the high risk of a fresh bird flu outbreak in Vietnam. Provincial People’s Committees have been ordered to improve food hygiene, especially in slaughterhouses and processing units and constantly monitor bird flu cases so as to contain the infection.

 

Local authorities have been asked to closely cooperate with the Ministry of Health and the Steering Committee for Bird Flu Prevention to conduct timely action and keep the authorities briefed on all developments concerning spread of the virus.

 

The dispatch also states that the health minister monitor all infected cases and step up ways to reduce fatal deaths, provide sufficient disinfectant chemicals and necessary medical equipment to fight the disease.

 

Inspectors from the Ministry of Agriculture and Rural Development have arrived in provinces to supervise and monitor measures to contain the spread of the dreaded bird flu virus.

 

The People’s Committee of the Mekong delta province of Dong Thap has ordered related agencies in its districts to implement appropriate measures, ask staff to work round-the-clock and set up a hotline to receive information of fresh outbreaks in the province.

 

Agricultural authorities’ in Dong Thap Province must monitor closely all breeding farms, households maintaining indoor incubators, open bred water fowl and all markets selling poultry.

 

Meanwhile the Steering Committee for Bird Flu Prevention in the Mekong delta province of Ca Mau has instructed the department of animal health to spray disinfectant in farms most vulnerable to the infection.

 

Authorities in Ca Mau have made it mandatory for breeders owning more than 20 poultry to vaccinate, or else the government will not support them in event of losses.

(Continue . . . )

 

 

As we’ve seen with Indonesia, Egypt, Bangladesh, India, and China . . . once the H5N1 virus becomes well established in a region, it can be extraordinarily difficult to eradicate. 

 

For now, the virus remains very difficult for humans to contract - but the concern is that the more opportunities we afford it - the better the chances are that the virus will eventually figure us out.

 

Of concern, while we hear very little out of neighboring Laos and Cambodia, the assumption must be that the virus is probably making inroads in those nations as well.

»» Read More

Vietnam Gears Up To Produce H5N1 Vaccine

 

Photo Credit PHIL

 

# 6149

The creation of two easily transmissible (between ferrets, anyway) forms of H5N1 in the laboratory – currently the subject of discussion in Geneva – has had one immediate (and I believe, positive) effect.

 

Many scientists and governments, who over the past few years had begun to wonder if the virus was truly capable of jumping to humans, are once again looking at H5N1 as a serious pandemic threat.

 

While it has yet to happen in nature, the genetic changes needed to transform the virus – as described by Fouchier in Malta - were shockingly small  (see New Scientist: Five Easy Mutations).

 

The veil of apathy over the H5N1 virus, which has settled in over the past few years, appears to be lifting.

 

One such example comes today from Vietnam, which is once again seeing a resurgence of the bird flu virus (in poultry).

 

Today the director of the National Institute of Hygiene and Epidemiology announced that they may begin testing a human H5N1 vaccine by the end of the year.

 

This from the Vietnam News Agency.

 

Viet Nam may begin producing H5N1 vaccines for humans next year

Updated February, 16 2012 11:54:00

HA NOI – Viet Nam may begin producing bird flu vaccines for humans next year, according to the National Institute of Hygiene and Epidemiology's director Nguyen Tran Hien.

 

The institute, which started researching development of the vaccine in 2005, is now producing an experimental version of the vaccine and testing its safety and effectiveness.

 

"These tests will facilitate the production and use of the vaccine for humans," Hien said.

 

The institute plans to carry out clinical trials of the vaccine at the end of this year, said Hien, adding that their research results would then be submitted to Ministry of Health.

(Continue . . . )

 

 

Vietnam (pop. 87 million) has recorded fewer than 30 human infections with the H5N1 virus since 2006. And were this rate of infection expected to remain more or less constant, developing and deploying a vaccine would seem a poor allocation of resources.

 

But the concern is that with 20+ clades (major versions) of the virus in circulation around the world – and more likely to develop – one of these days this virus will figure us out, and begin to spread with deadly efficiency through the human population.

 

Given the speed at which influenza spreads, and the expected 6 to 12 month lag time in developing, testing, and deploying a vaccine –  for many countries, having a vaccine already stockpiled is an attractive alternative.

 

It will be interesting to see how many of the countries that invested in (now expired) H5N1 vaccines back in 2006-2007 will now choose to refresh their stockpiles.

»» Read More

Vietnam:`New’ H3N2 Swine Flu Virus Reported

 

UPDATED: 1500hrs

Henry Niman has posted this afternoon that after further review, he believes this report to be a badly translated repost of a story from December on 10 Cases in the United States we already knew about. 

Today’s story is ambiguous enough to make that a plausible explanation.   Unless and until we can get some confirmation of this story I would advise that you view the following report with caution.

 

# 6131

 

 

This morning Editor & Senior Moderator Tetano on FluTrackers has picked up a series of news articles coming out of Vietnam talking about 10 human cases of infection by a `new’ H3N2 swine flu virus.

 

Two of these articles are machine translated from Vietnamese, and are therefore a bit garbled, but the third is an English Language report from the VOV (Voice of Vietnam). 

 

Assuming the major points of today’s report are correct (not always a given), there is not enough information provided to know how this virus compares to the A/H3N2v virus which has been detected in a handful of cases in the United States (see CDC Releases Updated H3N2v Interim Guidance).

 

Keeping the usual caveats in mind regarding early media reports, here is the story from the Voice of Vietnam.

 

 

New strain of swine flu detected

Updated : 5:16 PM, 09/02/2012

(VOV) - The Heath Ministry has quoted sources from the Ho Chi Minh City Pasteur Institute confirming that a new kind of porcine flu virus, A/H3N1, has appeared, apparently a combination of the pig-related A/H1N1 and A/H3N2 flu viruses.

 

The medical sector has monitored 10 patients infected with the A/H3N2 virus with porcine origin, and found that three of them had not had direct contact with any diseased pigs.

 

Therefore, the sector has not ruled out the possibility of a mutation in the A/H3N2 strain which could lead to transmission between humans, instead of strictly from pigs to humans as previously.

 

However, the situation has not reached an alarming level because the virus has not changed much; it has low toxicity and has shown no sign of drug resistance.

 

Flu vaccines are able to cope with small changes in this kind of virus, said Le Hoang San, Vice Director of the HCMC Pasteur Institute.

 

 

Swine are highly susceptible to the influenza virus, and are capable of serving as `mixing vessels’, allowing them to reassort into new hybrid strains.

 

Reassortment happens when two different influenza viruses co-infect the same host, swap genetic material, and produce a hybrid virus. 

 

That is essentially what happened in 2009, when the H1N1 swine flu virus emerged after bouncing around swine herds for a decade or more, picking up genetic changes along the way.

 

And not surprisingly, this recently emergent `humanized’  H1N1 virus has re-entered the swine population and is once again mixing and matching with other circulating swine flu viruses.

 

As a result we now have a Swine H3N2 virus that has reassorted with the 2009 pandemic H1N1 virus, producing a new hybrid that has – in a limited fashion – begun to emerge into the human population.

 

The article above calls the Vietnamese strain a `combination of the pig-related A/H1N1 and A/H3N2 flu viruses’ – which if we take literally – suggests a different reassortment than the one we’ve seen in the United States.

 

 

As stories in the media often gloss over or confuse crucial scientific details we really need to wait for a more definitive report before we can talk about the origin, genetic makeup, and potential of this new virus.

 

For now, this is simply something new to keep an eye on in the ever changing and always surprising world of influenza.

 

Update:  In a conversation with Sharon Sanders of FluTrackers this morning, she pointed out that this article refers to this new reassortant virus as H3N1 (once) and H3N2 (twice).

I took the first mention (H3N1) as a likely misprint, but until we can get some clarification, I don’t think we can say with any confidence exactly which strain this new virus is.

»» Read More

Media Reports Bird Flu Fatality In Vietnam

 

 

# 6116

 

 

Crof over at Crofsblog (link Vietnam: 2012’s second H5N1 death confirmed) has picked up an English language report from TuoiTreNews.vn of a recent H5N1 fatality in Soc Trang Province.

 

Reportedly this involves a 26-year-old female who fell ill after slaughtering and eating `infected meat’.

 

Assuming a confirmation from the World Health Organization, this would make the second human case reported in Mekong Delta region of Vietnam this year (the first occurring in Kiên Giang Province).

»» Read More

FAO Warns On Bird Flu

 

 

Photo Credit – FAO

 

# 5792

 

Although we generally talk about the H5N1 bird flu as if it were a single entity – in reality there have been more than a dozen clades of the virus identified - with numerous variants within each clade.

 

You can see an overview of the evolution of the H5N1 virus over the years in the graphic below.

 

For more on this evolution see Variations On A Bird Flu Theme.

 

H5N1, like all influenza A viruses, is constantly under pressure to change and mutate, looking for a biological advantage. Most of these mutations, thankfully, are evolutionary dead ends and fail to spread and thrive.

 

But in this viral version of king-of-the-hill, nature occasionally produces a more `fit’ and competitive virus, and it begins to dominate and spread.

 

One of these `new’ clades making inroads over the past few years has been 2.3.2.  I wrote of the spread of this emerging clade earlier this year in What Goes Around, Comes Around and EID Journal: H5N1 Branching Out).

 

Somewhat ominously, last Spring we began to see reports of poultry vaccine failures in Vietnam due to the spread of a mutated version this clade (further classified as clade 2.3.2.1).

 

In late May Vietnam announced a cessation of poultry vaccinations until a new formulation could be developed (see Reuters Vietnam halts bird flu vaccination due to new type).

 

Which brings us to a press release, issued today by the United Nation’s Food and Agriculture Organization (FAO), warning of a possible resurgence of the H5N1 virus this fall and winter, in part due to the emergence and spread of this new clade of the virus.

 

Bird Flu rears its head again

29-08-2011

Increased preparedness and surveillance urged against variant strain

29 August 2011, Rome - FAO today urged heightened readiness and surveillance against a possible major resurgence of the H5N1 Highly Pathogenic Avian Influenza amid signs that a mutant strain of the deadly Bird Flu virus is spreading in Asia and beyond, with unpredictable risks to human health.

 

The H5N1 virus has infected 565 people since it first appeared in 2003, killing 331 of them, according to WHO figures. The latest death occurred earlier this month in Cambodia, which has registered eight cases of human infection this year -- all of them fatal.

 

Since 2003 H5N1 has killed or forced the culling of more than 400 million domestic poultry and caused an estimated $20 billion of economic damage across the globe before it was eliminated from most of the 63 countries infected at its peak in 2006.

 

However, the virus remained endemic in six nations, although the number of outbreaks in domestic poultry and wild bird populations shrank steadily from an annual peak of 4000 to just 302 in mid 2008. But outbreaks have risen progressively since, with almost 800 cases recorded in 2010-2011.

Virus spread in both poultry and wild birds

At the same time, 2008 marked the beginning of renewed geographic expansion of the H5N1 virus both in poultry and wild birds.

 

The advance appears to be associated with migratory bird movements, according to FAO Chief Veterinary Officer Juan Lubroth. He said migrations help the virus travel over long distances, so that H5N1 has in the past 24 months shown up in poultry or wild birds in countries that had been virus-free for several years.

 

"Wild birds may introduce the virus, but peoples' actions in poultry production and marketing spread it," Lubroth noted.

 

Recently affected areas are to be found in Israel and the Palestinian Territories, Bulgaria, Romania, Nepal and Mongolia.

 

A further cause for concern, Lubroth said, is the appearance in China and Viet Nam of a variant virus apparently able to sidestep the defences provided by existing vaccines.

 

In Viet Nam, which suspended its springtime poultry vaccination campaign this year, most of the northern and central parts of the country -- where H5N1 is endemic -- have been invaded by the new virus strain, known as H5N1 - 2.3.2.1.

High alert

Viet Nam's veterinary services are on high alert and reportedly considering a novel, targeted vaccination campaign this fall. Virus circulation in Viet Nam poses a direct threat to Cambodia, Thailand and Malaysia as well as endangering the Korean peninsula and Japan further afield. Wild bird migration can also spread the virus to other continents.

 

"The general departure from the progressive decline observed in 2004-2008 could mean that there will be a flareup of H5N1 this fall and winter, with people unexpectedly finding the virus in their backyard," Lubroth said.

 

The countries where H5N1 is still firmly entrenched – Bangladesh, China, Egypt, India, Indonesia and Vietnam – are likely to face the biggest problems but no country can consider itself safe, he said.

 

"Preparedness and surveillance remain essential," Lubroth underlined. "This is no time for complacency. No one can let their guard down with H5N1." 

 

 

For now H5N1 is primarily a threat to poultry.

 

The virus remains poorly adapted to human physiology, and despite ample opportunities in places like Egypt and Indonesia, only causes rare, sporadic infections.

 

The concern, of course, is that over time that may change.  And so the world remains at Pre-pandemic Phase III for the H5N1 virus, and we continue to watch for signs that the virus is adapting to humans.

 

 

But H5N1 is not the only pandemic threat in the wings. 

 

We’ve seen scattered human infections by avian H7, H9, and H11 viruses, along with rare swine flu reassortments in recent years. We could even see an increase in virulence among the human influenzas already in circulation.

 

While we worry most about the H5N1 virus – primarily due to its high mortality rate – nature’s laboratory continues to experiment with a growing variety of viral options.

 

Which is why the question it isn’t `if’ another pandemic will happen. 

 

It’s pretty much just a matter of when.

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Vietnam’s HFMD Outbreak

 

 

# 5768

 

 

Photo Credit University of Iowa

HFMD (Hand Foot Mouth Disease) is a relatively common, and usually mild, viral illness seen mainly in children under the age of 10 (although adults are vulnerable as well) and may be caused by several of the non-polio enteroviruses.

 

The 60+ non-polio enteroviruses identified to date are among the most prevalent viral infections in the world, probably only second to the myriad and ubiquitous variants of Rhinovirus (`common cold’) that circulate every year.

 

The two most common causes of HFMD are the Coxsackie A16 virus, and the Enterovirus-71 (EV-71).

 

The disease caused by the Coxsackie A16 virus is generally the milder of the two, rarely causes serious illness, and outbreaks are not uncommon in childcare facilities. 

 

EV-71 HFMD is most commonly found in the Asia, with serious outbreaks recorded over the past dozen years in places like China, Malaysia, Hong Kong and most recently, Vietnam.

 

This version of the HFMD can sometimes be quite serious, with viral meningitis - and less commonly, encephalitis – complicating matters.

 

This summer Vietnam has seen an explosion of HFMD cases, and has recorded more than 80 deaths. Although the headline in the following story from Than Nien News uses the term `pandemic’, this outbreak would be better described as an `epidemic’.

 

Hand, foot and mouth disease spreads to pandemic levels

Last updated: 8/19/2011

Official re-classifies the outbreak as death toll reaches 81

The Ministry of Health is considering declaring hand, foot and mouth disease (HFMD) a pandemic, as more than 32,000 cases of the illness have killed 81 across the country so far this year.

 

According to the ministry, the disease has hit 52 of 62 cities and provinces, mostly in the southern and central regions. Some 96 percent of the fatalities have been children under the age of five.

(Continue . . . )

 

According to a recent VOA Vietnamese news report, about 1/3rd of the cases reported in Vietnam have been due to the more serious virus; EV-71.

 

For more on HFMD, we turn to the CDC’s webpage, which offers advice on prevention, and treatment, focusing primarily on the mild version more likely to be encountered outside of Asia.

 

 

Hand, Foot, and Mouth Disease

 

Hand, foot, and mouth disease is a contagious viral illness that commonly affects infants and children. While there is no vaccine to prevent the disease, there are simple steps you and your family can take to reduce the risk of getting sick.

 

Hand, foot, and mouth disease (HFMD) is a contagious viral illness that commonly affects infants and children in the U.S. and abroad. In the U.S. and other countries with temperate climates, HFMD occurs most often in summer and early autumn. While there is no vaccine to prevent the disease, there are simple steps you and your family can take to reduce the risk of getting sick.

HFMD

• Usually causes fever, sores in the mouth, and a rash with blisters.
• Is moderately contagious.
• Mostly affects children younger than 10 years of age, but people of any age can be infected.
• Has no specific treatment.
• Infection risk can be reduced by practicing good hygiene, such as washing hands frequently.
• Is not the same as foot-and-mouth disease.

(Continue . . . )

 

The CDC also offers a short (4 minute) audio podcast on HFMD, which may be listened to HERE.

 

 

Two major genotypes of EV-71, EV-71 B and EV-71 C, have been identified as being responsible for a number of severe outbreaks in Australia, Japan, China, Malaysia, and Taiwan since 1997.

 

Last year, the Virology Journal, published an analysis of an EV-71 HFMD virus that caused a major disease outbreak in Fuyang City, China in 2008 that showed it was due to an emerging recombinant virus (see China: A Recombinant EV-71).

 

Viruses are always changing.

 

Normally mild viral diseases like HFMD can sometimes mutate or pick up genetic material from other viruses and become more virulent or more transmissible as a result.

 

While serious cases are uncommon in Europe or the United States at this time, there is no reason to believe we are immune to an importation of a more severe version of HFMD.

 

More than enough reason to pay close attention to what is happening in Asia today.

»» Read More

Vietnam’s Battle With FMD, PRRVS & Bird Flu

 

 

 

 

# 5365

 

 

A disturbing report from the Viet Nam News today on the steady increase in bird flu, foot and mouth disease (FMD), and blue ear syndrome (PRRSV in swine) across the country.

 

Blaming a lack of vaccines, officials say these diseases are becoming pervasive nationwide. Additionally, local authorities have supposedly failed to report outbreaks to the public.

 

FMD and PRRVS, unlike bird flu, are not believed to pose a significant direct threat to human health. The FAO  gives this advice on the control of FMD.

 

Control/Vaccine

To eradicate the disease a stamping out policy can be applied. This involves quarantine, movement restrictions and slaughter and disposal of all affected an in-contact livestock on affected premises followed by cleaning and disinfection.

 

Inactivated vaccines have been successfully used in many parts of the world. Although protected against disease, vaccinated animals are not totally resistant and can still become infected and shed virus. Resistance falls fairly quickly, so animals must be revaccinated at regular intervals (4-6 months) to maintain immunity.

 

While not without risk, Vietnamese officials concerned over rising food prices and growing food insecurity, are reportedly looking for ways for consumers to safely process and consume the meat from FMD infected animals.

 

This from Viet Nam News.

 

 

Ministry warns of increasing disease threat

Updated March, 10 2011 10:21:12

 

 

HA NOI — Foot-and-mouth disease, bird flu and blue-ear syndrome are becoming more pervasive nationwide, says director of the Ministry of Agriculture and Rural Development's Animal Health Department Hoang Van Nam.

 

The country did not have enough vaccines to properly combat poultry and cattle diseases and local authorities intentionally have not reported what was actually happening to the public despite the outbreak of the diseases, Nam said.

 

<SNIP>

 

"It is not necessary to slaughter all the cattle infected with foot-and-mouth disease; we can eat their meat if it is cooked properly," said agriculture minister Cao Duc Phat.

 

"We need to instruct people how to hygienically slaughter cattle infected with foot-and-mouth disease," he said.

(Continue . . . )

 

 

FMD is endemic in many parts of the world (Africa, Asia, South America, some parts of Europe), but has been eradicated in many others. 

 

The last outbreak of FMD in the United States was in 1929 – but vigilance is maintained to prevent its return.

 

(current outbreaks FMD – Source OIE)

»» Read More

A Roundup Of Recent Bird Flu Reports

 

 

# 5322

 

 

This blog doesn’t attempt to list every H5N1 bird flu outbreak that crosses the wires, since those stories are already well covered by terrific bloggers and newshounds at Crofsblog, Arkanoid Legent, Chen Qi, the Flu Wiki, FluTrackers and others.

 

 

H5N1 outbreaks are ongoing among poultry and wild birds in a number of countries right now, including Egypt, Indonesia, Japan, Korea, Bangladesh, Vietnam and Cambodia.     

 

But when activity increases or is somehow unusual in nature, or jumps to regions where it is less common, or involves suspected human cases, I try to provide some coverage.

 

Yesterday, after an absence of new outbreaks for nearly a year, India reported a reoccurrence of H5N1 to the OIE at a state duck & poultry farm in Tripura.

 

 

Map credit- OIE.

 

 

The epidemiological notes on the OIE Report states:

 

Epidemiological investigation is ongoing. Stamping out of all domestic birds is being applied in an approximately 3-km-radius zone around the outbreak followed by compensation of the owners.

 

An intensive surveillance campaign has been launched in a 10-km-radius zone including:

- Closure of poultry markets and prohibition on sale and transportation of poultry products in the infected zone;
- Disinfection of premises after culling and sealing of premises where appropriate.

Restocking will be permitted in accordance with a protocol to be followed in this regard.

 

 

This report appears in the Indian Newspaper, The Hindu:

 

Birdflu in Tripura, culling begins

At least 3000 poultry, including chicken and ducks, were today culled in a State-owned poultry and within its three km radius here following outbreak of birdflu in Tripura.

 

State Animal Resource minister Aghor Debbarma told newsmen over two thousand chicken and ducks have died in the area since February 3 last and blood samples of some of them which were sent to Regional Animal Diseases Diagnostic Centre in Kolkata tested positive for H5N1 virus.

 

(Continue . . . )

 

 

 

Given the past history of outbreaks, and the porous border between India and hard hit Bangladesh, it isn’t particularly surprising to find the virus has returned.

 

Meanwhile, Vietnam has seen the re-emergence of the virus in a number of places this month, including Nam Dihn, Tom Hum, and Lang Son Province.

 

Overnight we learned via a pair of stories posted by Treyfish on FluTrackers that authorities are looking into a suspected H5N1 fatality in Thừa Thiên-Huế province.

 

 

From a machine translation of a story that appears in the VN Express, it is reported that a 15-year-old has died shortly after being transferred to the Hue Central Hospital for fever and respiratory problems.

 

While testing has not yet confirmed the presence of the H5N1 virus, 27 Healthcare workers and 4 patients who had contact with the teenager have been placed in quarantine and are receiving prophylactic antivirals.

 

Additionally, relatives and contacts of the victim are to receive Tamiflu.

 

 

Teenager suspected death from influenza A/H5N1

15-year-old patient in the mountainous district of Nam Dong, Thua Thien - Hue province, was taken to the family at the Medical University Hospital, Hue, then move the Hue Central Hospital and died there.

Through diagnosis, doctors Hospital of Hue Medical University identified patient (hospital day 14 / 2) with signs of influenza A/H5N1 infection with symptoms such as fever, dyspnea, pneumonia, failure acute respiratory. Health status is increasingly critical. The same day of admission, Hue University of Medicine decided to move patients to the Hue Central Hospital. However, only two half hours from when the referral, the patient died.

 

27 doctors, nurses, nurses and technicians of the University Hospital of Hue Medical and four patients share a room, contact with the sick, must be quarantined immediately and tamiflu medication within 10 days to prevent influenza A/H5N1 vaccine. On the same day, the University Hospital of Hue Medical and disinfection carried out the entire hospital.

 

Health Department of Thua Thien - Hue province has also sent its staff to the South East district conducted disinfection patient residence area, and isolation and to relatives of patients with preventive medication tamiflu.

 

 

And lastly, from Sumatra, Indonesia we get this report posted by Dutchy – again on FluTrackers – of a large outbreak of bird flu in poultry and a suspicious fever being reported by children in the region. 

 

Out of an abundance of caution, these children are being monitored by local health authorities. While Tamiflu has been dispensed (a standard precaution in these sorts of cases), no confirmatory test results have been received indicating that these children have the bird flu virus.

 

 

 

 

Fever Attacks 16 Children

Thursday, February 17, 2011

KAYUAGUNG - The bird flu virus attacked the village of Old Srigeni, District Kayuagung, OIC. Hundreds of chickens and ducks died, ironically, this animal carcasses thrown into the River Komering by the citizens.

''We do not know what disease that makes chickens and ducks died,''said Kadesh Srigeni Old Mujahid.

This problem, already reported to the Animal Husbandry Department OIC. Officers had been taking samples chicken and sent to a laboratory (lab) in Flash Lampung. The result is ''a dead chicken of the residents are attacked due to bird flu,''he said.

<SNIP>

The result, as many as 16 children have a fever, hot and diarrhea. ''We have not find out whether they are exposed to the virus or not, that obviously they already we give the drug Tamiflu, bird flu antiviral drugs,''said Hakim.

He said there is one resident who develop shortness of breath. This incident “could not said outbreaks or unusual events, because there is no insulation our citizens and we continue monitor developments in the field by reducing medical personnel,''he said.

 

 

It should be noted that fevers and diarrhea are not uncommon symptoms, and may be due to a wide variety of causes.  Their proximity to a bird flu outbreak raises concerns, but often these cases turn out to be something far more mundane.

 

Despite the obvious concerns over human exposure to bird flu, the H5N1 virus remains primarily adapted to avian physiology. Humans have only rarely contracted the virus, usually after direct exposure to infected birds.

 

The concern, of course, is that over time the virus may adapt better to humans, and spark another pandemic.

 

So we remain at Pre-pandemic Phase III for H5N1 and and monitor reports such as these with considerable interest.

»» Read More

Bird Flu Reports From Vietnam & Indonesia

 

 

# 4981

 

 

Overnight a number of bird flu reports have been posted by newshounds on the major flu forums, and by bloggers in Flublogia.  Once again it is Indonesia which is seeing the most activity, but we’ve fresh reports coming out of Vietnam as well.

 

Since Indonesia has been getting most of the attention these past few weeks, we’ll start with reports from Vietnam posted by Managing Editor of FluTrackers, Sally Furniss.

 

First from the Voice of Vietnam, this translated article on outbreaks in Ha Tinh province.

 

Updated at: 9:29 PM, 13/10/2010
Appearance of avian influenza H5N1 in Ha Tinh GUIs

(VOV) - After 3 days of an outbreak, nine households have poultry and water fowl infected with a total of 3,000 children, including the destruction of 2,745 chickens, ducks and geese.

 

Avian influenza H5N1 appeared in rural China Southern, Cam Thanh, Cam Xuyen district of Ha Tinh when many parts are focused on handling environmental hygiene, especially carcasses following the recent floods.

 

To encircle, control services, Animal Health Branch of Ha Tinh province coordinated with local authorities to promptly provide a ton of lime powder, 130 liters of chemical disinfection, and also founded 4 pin to control the killing operation, trade, movement of poultry, waterfowl in the area.

 

However, the mob, controlling epidemic facing many difficulties because there are no drugs to vaccination.

Original Source

 

Sally as also posted 3 more news reports in this thread on an outbreak in Dak Lak province.

 

Re-appearance of H5N1 avian influenza

thesaigontimes.vn - 13-10-2010 16:48

Earlier, a flock of nearly 500 households in eight villages, Hoa Son commune with the phenomenon of a number of seizures, difficulty breathing, green manure, white, die-off and reported to local animal health. Through testing the samples were determined ducks were H5N1 avian influenza, has conducted all destroyed.

 

Provincial Animal Health Department also directly examine two other ducks breeding establishments in the district with more than 1,500 children have symptoms similar to H5N1-infected ducks, said the movement's destruction and prevent spread.
According to VNA    Original Source

 

 

The always reliable Dutchy has posted a number of reports coming out of Indonesia, including starting this thread on outbreaks occurring in four sub-districts of Bengkulu, Sumatra.

 

Bird Flu Outbreak Threatens to Spread

Thursday, October 14, 2010 12:13:49

Related to this, the Department of Agriculture and Livestock (Distannak) BU should immediately anticipate. If not the plague would spread to other districts in the BU.

 

Addressing the issue, Kadistannak BU Ir Batman Meiry Arsyad says bird flu case in Lais is likely to spread to the City of Arga Makmur and the surrounding district.

 

For that it had to anticipate. Among them spraying disinfectant in affected areas suspect bird flu.

 

<SNIP>

Meanwhile, in Putri Hijau , hundreds of chickens owned by residents in the Village Like Medan also died suddenly. the community is worried by the incident.

 

But so far there has not been to Like Medan related officials who fall to do the checking, Kamto said Wibowo, a resident Like Medan Putri Hijau subdistrict.

Original Source

 

Ida at the Bird Flu Information Corner has another report on this outbreak.

 

Kaur, Bengkulu ::: Bird flu spreads in four sub-districts

Posted by Ida on October 14, 2010

Bengkulu – Livestock Service of Bengkulu stated emergency to four sub-districts (kecamatan) in Kabupaten Kaur, Bengkulu. They are Kecamatan Luas, Kelam Tengah Kaur Selatan, Padang Guci Hulu and Tetap.

 

This is reported by Participatory Disease Surveillance and Response (PDSR).

 

Even though, until now Disease Control Center (LDCC) has not issued extraordinary-event (Kejadian Luar Biasa/KLB) status to Kabupaten Kaur.

 

So far, the disease has not spread to human.
Source: Indonesia local newspaper, Bengkulu Ekspress. http://www.bengkuluekspress.com/ver3...21&artid=22391

 

 

Dutchy also has a report on a small outbreak near Bandung, the capital of West Java Province, and a follow up to yesterday’s report of H5N1 bird deaths in Banyumas, Central Java.

 

Arkanoid Legent has another report from a different source on the Central Java outbreak mentioned above.

 

Indonesia : A number of chickens died of bird flu suspected

Machine translated report from Wawasan Digital :

" SRAGEN : Outbreaks of Avian Influenza virus or better known as bird flu, allegedly rampant in Hamlet Karangasem RT 02/RW V, Kelurahan Karang Tengah, Sragen District Municipality. At least 6 kinds of bangkok chickens, died suddenly. The death of the chickens are only lasted 12 hours, since the first symptoms appear.

 

And finally, from the current Indonesian thread on the Flu Wiki we get (among other reports), another story that states that the bird flu vaccine upon which Indonesia (and other Asian countries) depend so heavily may no longer be effective.

 

This report (one of several overnight) was relayed by dbg to bgw in MT.

 

October 14 2010
Bird Flu Was Followed By The Other Illness [Central Java]

The Vaccine Has Not Been Effective

Purwokerto - The bird flu Illness that attacks the poultry in the Banyumas territory up to now was still being difficult to be controlled. The problem, the cause virus of this illness had the trend be mutated as well as brought the other prospective illness.

 

That was revealed by Chairman Council Ekonomy Livestock Central Java, Gembong Heru Nugroho, responded to the case emergence of bird flu in Banyumas.

 

"Till now the bird flu illness is still continuing to be available. Moreover, this illness emergence was precisely followed by the other illness or happened the complication with the other illness like ND (New Castle Deseases-Red) or the bronchitis infection," said he, yesterday.

 

According to Gembong, bird flu unlike previously again that could be handled with giving of the vaccine and spraying of disinfectant. Now the vaccine is not effective any more.

Original Source

 

The diminishing effectiveness of bird flu vaccines in poultry has been a subject of considerable debate over the past few years, and has been covered extensively in this blog -  including:

 

A Roundup Of Indonesian Reports

Egypt’s Plan To Fight Bird Flu

Indonesia: Changes In The H5N1 Virus

Food Insecurity And The Control Of Bird Flu

 

The upshot is that the  OIE (World Organization For Animal Health) has maintained a long-standing position that vaccination of poultry cannot be considered a long-term solution to combating the avian flu virus.

 

They have repeatedly urged nations to develop an `exit strategy’ away from vaccines, and move towards humane culling for the control of avian influenza.

 

A difficult sell, however, to countries where food insecurity is a daily reality and where poultry serves as both an important part of their diet and provides a bit of income and/or wealth for a largely poor population.

»» Read More