Showing posts with label quarantine. Show all posts
Showing posts with label quarantine. Show all posts

Queensland: A Hendra Watch & A New Vaccine

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Nipah/Hendra Virus & Fruit Bat Home Range – WHO


# 6706

 

 

Although long known to carry rabies, over the past two decades bats have increasingly been linked to emerging infectious diseases.

 

The SARS-CoV (coronavirus) outbreak of 2002-2003 – which infected roughly 8,000 people and killed nearly 800 – is undoubtedly the best known of these diseases, but is by no means the only one to emerge.

 

Genetic analysis of two recent novel coronavirus infections in the Middle East suggest (but fall short of proving) that bats may be the primary host for this virus as well (see Coronavirus `Closely Related’ To HK Bat Strains).

 

And the natural reservoir for the Ebola viruses (including Marburg) are believed to be fruit bats of the Pteropodidae family.

 

Prior to the SARS outbreak - during the 1990s – two new bat-borne viruses made headlines; Nipah and Hendra, both henipaviruses of the family Paramyxoviridae.

 

Of the two, Nipah has been the deadliest, causing outbreaks primarily in India and Bangladesh. But the virus was first discovered in April of 1999 when an outbreak occurred at a pig farm in Malaysia. 

 

During this initial outbreak, the virus jumped to local swine herds from bats, and infected more than 250 people, killing more than 100. The virus was then exported via live pigs to Singapore, where 11 more people died (see MMWR Update: Outbreak of Nipah Virus -- Malaysia and Singapore, 1999)

 

Over the past decade, Nipah has sparked a hand full of smaller outbreaks across Southern Asia with the greatest activity centered around Northern India and Bangladesh. Fruit bats (Pteropodidae) are considered the natural host of Nipah virus.

 

Perhaps most concerning has been evidence of limited nosocomial, or human-to-human transmission, of the Nipah virus (see Bangladesh: Updating The Nipah Outbreak).

 

The Nipah virus, like it’s close cousin the Hendra virus, is classified as a biosecurity level 4 (BSL-4) agent.

 

While not associated with as many human fatalities, the Hendra virus was first identified after the deaths of 13 horses and a trainer in Hendra, a suburb of Brisbane, Australia in 1994. A stable hand, who also cared for the horses, was hospitalized, but survived.

 

Another outbreak was later identified as having taken place in MacKay, 1000 km to the north of Brisbane, the previous month. Two horses died, and the owner was hospitalized several weeks later with meningitis. He recovered, but developed neurological symptoms and died 14 months later.

 

Over the past 18 years 40 outbreaks of Hendra virus – all involving horses – have been reported in Australia. Four human fatalities have been linked to the virus as well.

 

Subsequent studies have showed a high prevalence of the newly identified Hendra virus in Pteropid fruit bats (flying foxes) in the region.

 

Unlike Nipah, to date no human-to-human transmission of Hendra has been documented.


All of which brings us to the latest outbreak news, and hope for a new vaccine for horses that just became available. First stop, an update from the QLD Department of Agriculture, Fisheries, and Forestry.

 

November 2012


Hendra virus communique no.10-5 November 2012

Hendra virus incident Ingham

Biosecurity Queensland is managing a Hendra virus incident in Ingham after a positive test result was received on Friday 2 November 2012.

 

A mare was first noticed unwell on Wednesday 31 October 2012 by her owner. She was not interested in food, had a slight nasal discharge, rapid, laboured breathing, elevated heart rate, lowered head and was unsteady on her feet.

 

A private veterinarian visited the horse and collected samples for Hendra virus testing. The horse deteriorated and went down and was euthanased on Thursday 1 November 2012.

Movement restrictions

Biosecurity Queensland has quarantined the property and undertaken tracing and risk assessments to determine susceptible animals that may have had exposure to the virus.

 

There are eight horses remaining on the property as well as dogs and cats. Several rounds of testing will be conducted on animals assessed to be at risk of being exposed to Hendra virus before the quarantine can be lifted.

 

Restrictions will apply to moving horses and horse materials on and off the infected property, and the property will be quarantined for at least one month. There are no other movement restrictions for the general Queensland horse population because of Hendra virus.

Hendra virus vaccine

A commercial pharmaceutical company has released a Hendra virus vaccine for use in horses under a Minor Use Permit. Under permit conditions, only accredited veterinarians can administer the vaccine.

 

The vaccine provides another option for the horse industry to reduce the risk of Hendra virus infection; however it is important to remember no vaccine is 100% effective and people in contact with horses need to continue to practice good biosecurity and hygiene measures even if horses are vaccinated.

 

Horse owners should discuss with their veterinarian whether vaccinating their horse is appropriate.

 


From CSIRO (Commonwealth Scientific and Industrial Research Organisation) we get more details on this newly available vaccine, via a 9 minute audio podcast & transcript.

 

Vaccine for killer Hendra virus launched

Australian horse owners and the equine industry have received an important boost in their fight against the deadly Hendra virus with the introduction of Equivac® HeV vaccine. (9:02)

  • 1 November 2012

 

 

A final note, in the QLD notice above, it mentions that dogs and cats are quarantined, as well as horses. This comes about primarily because in 2011, we saw the first evidence of canine infection with the virus (see Australia: Dog Tests Positive For Hendra Virus).

 

The Queensland DAFF maintains a FAQ file on Hendra and dogs, where they write:

 

What animals have been shown to get Hendra virus?

Naturally occurring infection is limited to horses, flying foxes, humans and dogs. In animals, naturally occurring clinical disease is limited to horses.

 

Hendra virus is present in wild flying fox populations but does not appear to cause disease in them.

Laboratory studies have shown that other species including cats, guinea pigs, ferrets and pigs can develop disease when inoculated with Hendra virus in an experimental setting. Other species, including rabbits and dogs, have developed antibodies to Hendra virus in an experimental setting, but did not develop any signs of illness.

 

Although transmission from animals other than horses to humans has not been demonstrated, it is always a concern whenever a virus adapts to or jumps to a new host.

 

It not only gives the pathogen fresh opportunities to mutate and evolve, it provides another potential vector to spread the disease.

 

And when that host is a dog or a cat – animals with whom humans closely interact – it naturally serves to increases those concerns.

»» Read More

New Zealand : Airline Passengers Quarantined

 

 

 

# 6136

 

On an otherwise quiet Sunday afternoon here in the states, news wires are carrying reports of a Boeing 777-200 inbound from Japan that has landed at Auckland’s airport with roughly 60 passengers exhibiting flu-like symptoms.

 

While this sounds like the opening scene to a pandemic disaster movie, in all likelihood this will sorted out to be standard H3N2 influenza which is currently spreading across much of Japan. 

 

The sudden onset of so many cases during this flight has obviously set off alarm bells for local health authorities, however.

 

New Zealand has developed one of the most aggressive airport disease surveillance and interdiction systems in the world. 

 


For now, local media is reporting that all 274 passengers remain on the plane, and health authorities are setting up some sort of quarantine.

 

A couple of reports:

 

First from TVNZ

 

Health scare at Auckland Airport

breaking news

Published: 9:48AM Monday February 13, 2012

A major health response is under way after an Air New Zealand plane landed at Auckland Airport with children with flu-like symptoms on-board.

 

A group of 60 passengers arrived into Auckland off NZ90 from Narita, Tokyo, this morning with the symptoms.

 

Air New Zealand is following public health procedures and has advised the Auckland Regional Public Health Service.

(Continue . . .)

And this report from 3News New Zealand.

 

Flu-like symptoms on Air NZ Tokyo flight

By 3 News online staff

Sixty passengers arriving at Auckland International Airport this morning have reported flu-like symptoms, Air New Zealand has confirmed.

 

Flight NZ90 from Tokyo landed a short time ago and passengers remaining on the plane could be seen on the plane wearing face masks.

(Continue . . . )

 

 

While the odds favor this outbreak turning out to be something fairly mundane, I’ll keep an eye on it and update this blog if I hear more.

»» Read More

Japan: Quarantine At Ports Ineffective Against Pandemic Flu

 

 

# 4229

 

 


Japan, India, and China were among the nations that attempted to identify and interdict those who might be carrying the H1N1 virus when they entered their country.  

 

While their efforts may have slowed the introduction of the virus, they certainly didn’t stop it. 

 

And a study today out of Japan suggests that between asymptomatic or mild infections, and a silent incubation period of several days, there wasn’t much chance of long-term success. 

 

For every person identified, and quarantined, by port authorities  - researchers estimate 14 others infected by the virus entered undetected.

 

First a article from The Yomiuri Shimbun, followed by a link to the study which appears in Eurosurveillance.

 

 

 

Quarantine at ports found ineffective against new flu

The Yomiuri Shimbun

The number of people infected with new flu who passed undetected through airport quarantine between April last year, when the new strain of influenza began spreading, and May was about 14 times higher than the number of infected people stopped at the airports, according to a study carried out by Tokyo University.

 

The research results confirm anew that to prepare for an outbreak of new infectious diseases, such as bird flu, it is essential to take comprehensive countermeasures, such as having medical institutions prepare to treat large numbers of patients and closing schools, in addition to quarantine, from the early stage of proliferation of such a disease.

 

An official of the Health, Labor and Welfare Ministry said, "We'll use the data to work out to what extent quarantine measures [at ports] can prevent new infectious diseases from entering the nation."

 

The research results were to be published Thursday in the online version of Eurosurveillance, a European journal on infectious disease prevention.

 

Most of the infected people who passed through quarantine undetected were experiencing the incubation stage of new flu, in which fever and other noticeable symptoms do not appear.

 

(Continue . . . )

 

 

 

Eurosurveillance, Volume 15, Issue 1, 07 January 2010

Rapid communications

When should we intervene to control the 2009 influenza A(H1N1) pandemic?

H Sato , H Nakada, R Yamaguchi, S Imoto, S Miyano, M Kami

We simulated the early phase of the 2009 influenza A(H1N1) pandemic and assessed the effectiveness of public health interventions in Japan. 

We show that the detection rate of border quarantine was low and the timing of the intervention was the most important factor involved in the control of the pandemic, with the maximum reduction in daily cases obtained after interventions started on day 6 or 11.

Early interventions were not always effective.

 

 

 

Last month we looked at the failure of thermal scanners to detect those with fevers from entering Singapore in Travel-Associated H1N1 Influenza in Singapore  and last summer I wrote about ways passengers were defeating the scanners to get home in Vietnam Discovers Passengers Beating Thermal Scanners.

 

Areas that receive a small number of arrivals might be able to institute a quarantine system (see Can Island Nations Effectively Quarantine Against Pandemic Flu? ), but even then the ability to interdict infected travelers won’t be 100%.

 

The four successful quarantines during the 1918 pandemic were in American Samoa (5 days' quarantine) and Continental Australia, Tasmania, and New Caledonia (all 7 days' quarantine).

 

  • The Spanish Flu did not reach American Samoa until 1920, and had apparently weakened, as no deaths were reported.
  • Australia's quarantine kept the influenza away until January of 1919, a full 3 months after the flu has swept New Zealand with disastrous effects.
  • Tasmania kept the flu at bay until August of 1919, and health officials believed they received an milder version, as their mortality rate was one of the lowest in the world.
  • By strictly enforcing a 7-day quarantine, New Caledonia managed to avoid introduction of the virus until 1921.

Eventually, once the quarantines were lifted, the virus did make it to these isolated regions of the world. 

»» Read More

Experts: Extreme Measures Won’t Stop The Flu

 


# 4041

 

 

Dovetailing into my last blog, we get this report from Maria Cheng, AP Medical writer, who explores the success (or lack thereof) of China’s extraordinary efforts to keep the H1N1 virus out of their country.

 

Along the way we get confirmation that the number of cases, and deaths, reported by China are `minimum numbers’, and not representative of the true picture.

 

This is an excellent report and worth reading in its entirety.

 

Experts: Radical Measures Won't Stop Swine Flu

Quarantines Have Failed To Contain Disease, Health Experts Say

MARIA CHENG, AP Medical Writer

LONDON --

Health experts say extraordinary measures against swine flu -- most notably quarantines imposed by China, where entire planeloads of passengers were isolated if one traveler had symptoms -- have failed to contain the disease.

 

Despite initially declaring success, Beijing now acknowledges its swine flu outbreak is much larger than official numbers show.

 

China's official count of some 63,000 reported illnesses with 53 deaths dwarfs estimates of millions of cases with nearly 4,000 deaths in the United States, a nation with about a third of China's population.

 

Dr. Michael O'Leary, WHO's top representative in China, says there has been a dramatic spike in Chinese swine flu cases recently and those reported by the government are only "minimum numbers."

 

"We have new cases occurring all the time," he told The Associated Press last week. "There's always more deaths than we could possibly know about."

(Continue . . . )

 

The problem of course is, between incubation periods of up to 4 days, and totally asymptomatic carriers, it is impossible to interdict everyone coming into the country who may be infected and shedding virus.

 

Just as India and Japan discovered, the best you can hope to do is slow down the introduction of the virus.  

 

Areas that receive a small number of arrivals might be able to institute a quarantine system (see Can Island Nations Effectively Quarantine Against Pandemic Flu? ), but even then the ability to interdict infected travelers won’t be 100%.

 

The four successful quarantines during the 1918 pandemic were in American Samoa (5 days' quarantine) and Continental Australia, Tasmania, and New Caledonia (all 7 days' quarantine).

 

  • The Spanish Flu did not reach American Samoa until 1920, and had apparently weakened, as no deaths were reported.
  • Australia's quarantine kept the influenza away until January of 1919, a full 3 months after the flu has swept New Zealand with disastrous effects.
  • Tasmania kept the flu at bay until August of 1919, and health officials believed they received an milder version, as their mortality rate was one of the lowest in the world.
  • By strictly enforcing a 7-day quarantine, New Caledonia managed to avoid introduction of the virus until 1921.

 

Eventually, once the quarantines were lifted, the virus did make it to these isolated regions of the world. 

 

Given the current level of international trade and travel, quarantines for air and sea ports that handle a substantial number of passengers really aren’t practical.  

 

At least, not for very long.

»» Read More

Ukraine Extends Quarantine To Another 7 Regions

 


# 3992

 

Although the Internet continues to be filled with wild, unsubstantiated(and frankly, unbelievable) stories of nefarious doings in Ukraine, there is nothing credible that I’ve seen to indicate anything more than a very nasty outbreak of the H1N1 flu.

 

The numbers today indicate more than 1 million infected, and roughly 200 deaths.   A mortality rate not unlike what you would expect from seasonal flu.  

 

The difference with this flu, of course, is the age groups it is affecting.  Instead of infecting and killing the elderly, this H1N1 virus continues to show a preference for younger victims.

 

Three updates today.  The first two from the Kyiv Post.  The last one from RIA Novosti.

 

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(Click map to enlarge)

 

Another seven regions introduce quarantine measures against spread of flu epidemic
Today at 15:04 | Ukrainian News

The authorities of Donetsk region, Zhytomyr region, Kyiv region, Kirovohrad region, Luhansk region, Poltava region, and Chernihiv region have introduced quarantine measures to fight the spread of the flue epidemic adding to 9 regions where the Cabinet of Ministers declared quarantine last week.

 

"Except the nine regions, among the newly added are Donetsk region, Kyiv region, Chernihiv region, and Zhytomyr region. Restricting anti-epidemic quarantine measures have been declared there. We follow the level of the epidemic in Poltava region, Luhansk region, and Kirovohrad. Restricting quarantine measures have been introduced there too," chief sanitary doctor of Ukraine Oleksandr Bilovol announced this at a news briefing.

 

Bilovol said the introduction of the quarantine measures is necessary to cut the rate of people suffering from the flu and acute respiratory viral infections.

 

The Cabinet of Ministers introduced quarantine in nine regions of Ukraine to fight the A(H1N1) flu epidemic on Oct. 30.The authorities of Poltava region have asked the Cabinet of Ministers cancel quarantine in educational institutions.

 

 

 

Seventy A(H1N1) cases confirmed in Ukraine, 17 die
Today at 14:51 | Interfax-Ukraine

Seventy cases of the A(H1N1) flu subtype have been laboratory-confirmed in Ukraine, and 17 of these cases ended up lethally, Ukrainian First Deputy Health Minister Vasyl Lazoryshynets said at a news briefing on Nov. 11.

 
"But this does not mean that the other deaths were not caused by this flu virus, because everything depends on the way laboratory samples are taken and transported," he said.

 

 

Ukraine flu death toll rises to 189 

KIEV, November 11 (RIA Novosti) - Ukraine's death toll from an epidemic of flu and respiratory illness has risen to 189 people, and reported cases have exceeded 1 million, the health ministry said in a press release late on Tuesday.

 

The epidemic was declared in Ukraine in late October, when the first confirmed swine flu cases were also reported. Sixty-seven people have since been confirmed as having the A/H1N1 virus, of whom 14 have died.

 

The western Lvov and Ivano-Frankovsk regions of the ex-Soviet nation, home to 46 million, have been the worst-hit by the epidemic.

»» Read More

Ukraine Update: H1N1 Quarantine

 

 

# 3912

 

This story is updated  at

WHO Dispatching Team To Ukraine

 

 

Yesterday I reported on an outbreak of an `unknown disease’ that had claimed at least 22 lives (see Reports Out Of The Ukraine).   While test results were pending, it appeared that this outbreak was most probably due to the pandemic H1N1 virus.

 

Today, Ukrainian officials have confirmed that it has been identified as the H1N1 pandemic virus, and have announced extraordinary measures including partial quarantines, school closures, and travel restrictions will be utilized to try to slow the spread of the flu.

 

The newshounds at FluTrackers have been all over this story for several days, with now over 150 posts on their Ukraine: at least 30 die of swine flu - most were "young and healthy  and Ukraine - H1N1 - 37 fatalities suspected - 11 confirmed threads.

 

Hogweed brings us this report from KyivPost, the Ukraine’s largest English Language newspaper.   Their server is heavily burdened today, and load times can be delayed.

 

Quarantine ordered

 

Ukrainian government imposes quarantine in nine western regions

Quarantine ordered
Today at 14:06

Ukraine suffered its first death from swine flu, as the government declared a massive quarantine and control effort to head off a possible epidemic, the Interfax news agency reported. The victim was a man living in Ukraine's western Lviv region, said Health Ministry spokesman Roman Pavliv.

 

The government announcement one week after reports surfaced of as many as 30 deaths potentially caused by swine flu, all in Ukraine's western provinces.

 

The Health Minister currently was monitoring 22 persons in the region showing swine flu symptoms, of which one had been confirmed as suffering from full-blown swine flu, according to the report.

 

"Unfortunately, we can state that there is in fact a swine flu epidemic in the country," said Vasyl Kniazhevych, Ukraine's Health Minister, at a Kyiv press conference. "We have a lot of work to do."

 

Ukrainian Prime Minister Yulia Tymoshenko ordered a massive and for Ukraine unprecedented disease-control program to go into effect immediately in an attempt to prevent the spread of the disease.

 

Schools nationwide will close for three weeks, and "all mass gatherings will be forbidden," Tymoshenko said, in comments reported by Channel 5 television.

 

The bans would come at the height of Ukraine's football season and autumn school semester. They would hinder much political campaigning planned by candidates in the January presidential elections.

 

A "full quarantine" will be imposed in nine of Ukraine's western provinces, with police monitoring the entrance and exit of all persons, she said. It will block those lacking justification for travel.

 

Read the remainder of the story here.

 

Other reports include this one from Reuters, posted by Dutchy.

 

Ukraine shuts schools,cancels public events due H1N1

Fri Oct 30, 2009


(Adds schools closed, public events banned)


KIEV, Oct 30 (Reuters) - Ukraine on Friday closed schools, banned all public events and imposed restrictions on people's movements around the country for a three-week period after confirming its first death from H1N1 swine flu.


"All educational institutions without exception ... will be switched on to a three-week holiday period," Prime Minister Yulia Tymoshenko announced. She indicated this period could be extended if it was deemed necessary.

 

"Apart from this, we will take the decision to cancel all mass meetings ... for three weeks," she said at an emergency government session.

 

"We will introduce a special system to stop unnecessary travel by people from one region to another," she added.

(Continue. . . )

 

While I’ll keep a watch on this evolving story, and bring you the highlights, the best place I know of to follow the hour-by-hour developments are on these FluTrackers threads.

»» Read More