Saudi MOH Reports 4 More MERS Cases

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After reporting only one additional case yesterday, the Saudi MOH is back today with 4 more MERS cases, 3 in hard-hit Riyadh and one in Najran.  Few details other than location, age and gender are provided. Additionally, 1 death and 1 recovery are reported.

 

Since the 3rd of August, Saudi Arabia has reported 39 MERS cases, with 3 dozen of those from Riyadh alone.  Cases in the capital city have been attributed to a large familial cluster, a large number of nosocomial cases, a couple with recent camel exposure, and the rest are either unknown or unspecified.

The Saudi MOH has also published their weekly MERS report, that unfortunately – beyond acknowledging 21 new  cases over the past 7 days – provides very little regarding the epidemiology of this recent surge in cases.

 

MOH: ‘21 MERS-CoV Cases Reported Last Week’

16 August 2015

In its weekly press release, the Ministry of Health (MOH) announced that 20 confirmed cases of the Middle East Respiratory Syndrome-Coronavirus (MERS-CoV) have been reported in Riyadh and another case in Abha last week, from August 9th to 15th, 2015, corresponding to Shawwal 24th to 30th, 1436H (the 33rd International Week).

“During the same period, 844 samples were tested for Coronavirus at the MOH laboratories across the Kingdom, including 5 cases at the MOH hospitals and 16 other cases at the other health sectors. While the total number of visits by public health teams to persons in contact with positive cases was 21,” indicated the Ministry, adding that the number of persons who were in contact with positive cases at homes was 119, and the number of visits by the Ministry of Agriculture (MOA) was one.

Besides, the Ministry announced that 588 cases out of the total of 1,092 confirmed cases have been cured, at a rate of 54.8%. There are 25 other cases still receiving treatment, and four cases have been isolated at home.

Within the same vein, the Command and Control Center (CCC) keeps on its efforts around the clock by carrying out epidemiological surveillance tasks, making sure that all governmental and private health facilities abide by infection control measures, as well as coordinating with the relevant governmental sectors, international health organizations, including the World Health Organization (WHO), and think-tanks to follow up all developments regarding Coronavirus. Over and above, the Ministry keeps on its efforts and full coordination with the Ministry of Agriculture (MOA), to launch anti-Coronavirus awareness campaigns at the gathering places of camels to urge camels’ owners and shepherds to be careful and take protective measures when dealing with camels. Finally, the MOH highlighted that it will remain committed to the preset preparations and cooperative efforts with other parties, including the Saudi community and healthcare staff, who represent the cornerstone in this regard.

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Avian Path: Susceptibility of Wild Passerine Birds To HPAI H5N1

Credit Wikipedia

 

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Avian influenza has long been known to circulate in wild aquatic birds of the orders Anseriformes (ducks, geese, and swans, etc.) and Charadriiformes (shorebirds, gulls, and auks, etc.) - and importantly - these species can often carry these viruses will little or no ill effect. 

 

All influenza A viruses - including human and swine strains – are believed to have originated from these natural avian hosts.

Less well adapted to the viruses, and therefore far more susceptible to illness, are the Galliformes; an order of heavy-bodied ground-feeding birds that includes turkey, chicken, quail and pheasant. Commercially raised gallinaceous birds are easily infected by both low and high path viruses, and can rapidly succumb to HPAI infection.

 

Although it is no secret that Passerine birds  (aka `perching’ and `songbirds’) have been infected with HPAI H5N1 in the past (see EID journal Characterization of Avian Influenza Viruses A (H5N1) from Wild Birds, Hong Kong, 2004–2008), until recently little research has been conducted on how highly pathogenic avian influenza affects this largest of all classification of birds.    

 

Because of the low expectations of finding HPAI H5 in non-aquatic birds, passerine birds are rarely routinely tested in North America (see Surveillance Plan for the Early Detection of H5N1 Highly Pathogenic Avian Influenza Virus in Migratory Birds: 2009).

Nevertheless, there has been a growing concern that passerine species could be a significant vector for HPAI viruses, and might contribute to local transmission of these viruses to poultry flocks.

 

We’ve seen the deaths of passerine birds like Oriental Magpie Robins in Hong Kong, and Crows in India, infected with HPAI H5 viruses, and a little more than a month ago, in Minnesota DNR: HPAI H5 Discovered In Second Wild Bird, we saw the first detection of North American HPAI H5 in a passerine species (Chickadee). 

 

The Survey of H5N1 Flu Virus in Wild Birds in 14 Provinces of China from 2004 to 2007, published in 2009, found 26 positive samples distributed across 9 species from among 7320 passerine samples tested, providing a very low incidence of 0.36%.  However, among tree sparrows tested, the prevalence was three times higher at 1.09%.

 

The 2012  PLoS One Study A Survey of Avian Influenza in Tree Sparrows in China in 2011, found serological evidence of prior H5 subtype HPAI infection in 94 of 800 (11.75%) of sparrows tested, showing that HPAI H5 infection need not always prove fatal in that species. 

 

In 2013, in Pathogenesis in Eurasian tree sparrows inoculated with H5N1 highly pathogenic avian influenza virus and experimental virus transmission from tree sparrows to chickens  by Yamamoto Y, Nakamura K, Yamada M, Mase M., the authors found that inoculated birds lived up to 11 days and shed copious amounts of the virus during that time, and suggested that Eurasian tree sparrows could be potential vectors to housed poultry.

 

All of which serves as prelude to a study, published on Friday, that looks at the susceptibility of three passerine bird species (reed buntings, brown-eared bulbuls and pale thrushes) to HPAI H5N1, and finds that 2 out of 3 (buntings & bulbuls) sickened and died, while pale thrushes seroconverted exhibited no clinical signs of infection. 

 

Avian Pathol. 2015 Aug;44(4):243-247.

Susceptibility of wild passerines to subtype H5N1 highly pathogenic avian influenza viruses.

Fujimoto Y¹, Usui T, Ito H, Ono E, Ito T.

 

Abstract

Highly pathogenic avian influenza (HPAI) viruses of the H5N1 subtype have spread throughout many areas of Asia, Europe and Africa, and numerous cases of HPAI outbreaks in domestic and wild birds have been reported. Although recent studies suggest that the dissemination of H5N1 viruses is closely linked to the migration of wild birds, information on the potential for viral infection in species other than poultry and waterfowl is relatively limited.

To investigate the susceptibility of terrestrial wild birds to infection with H5N1 HPAI viruses, common reed buntings (Emberiza schoeniclus), pale thrushes (Turdus pallidus) and brown-eared bulbuls (Hypsipetes amaurotis) were infected with A/mountain hawk-eagle/Kumamoto/1/07(H5N1) and A/whooper swan/Aomori/1/08(H5N1). The results showed that common reed buntings and brown-eared bulbuls were severely affected by both virus strains (100% mortality).

While pale thrushes did not exhibit any clinical signs, seroconversion was confirmed. In common reed buntings, intraspecies-transmission of A/whooper swan/Aomori/1/08 to contact birds was also confirmed. The findings show that three passerine species; common reed buntings, brown-eared bulbuls and pale thrushes are susceptible to infection by H5N1 HPAI viruses, which emphasizes that continued surveillance of species other than waterfowl is crucial for effective monitoring of H5N1 HPAI virus outbreaks.

 

With 5,000 passerine species and dozens of HPAI viruses in circulation around the globe, research into their interactions has only just begun.  The evidence to date, while limited, suggests that passerine birds may play a bigger role in the spread of avian flu than previously suspected.

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Japan: Volcanic Alert Raised For Sakurajima – Webcams

 

Credit Japan’s Meteorological Agency

 

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Japan’s Meteorological Agency has issued an Alert Level 4 (Prepare to Evacuate) for residents living near the Sakurajima Volcano located in the Kagoshima Prefecture on the southwest tip of Kyushu Island.  According to the agency, the number of earthquakes in Sakurajima begun to rise and instrumentation shows deformation suggesting a large eruption may be immanent.

The volcano has been under a heightened alert (level 3 – do not approach) since July.

 

Sakurajima was responsible for Japan’s largest volcanic eruption of the 20th century, when it produced a large Peléan eruption in 1914.  Erik Klemetti posted an excellent overview of the Sakurajima volcano this morning on his Wired Blog (see Sakurajima in Japan Might Be Headed Towards a Large Eruption).

 
Being located only 10 kilometers from a major population center (Kagoshima City  pop. 680,000), this volcano has an unusually high number of webcams trained on it, and its surroundings, 24/7.  While a truly massive eruption is not currently expected, the impacts could be substantial .

You’ll find a large assortment of webcams available at http://www.mbc.co.jp/web-cam/

 

There are 108 active volcanoes in Japan, and on average, they see about 15 volcanic events (including eruptions) every year, so Japan heavily promotes seismic and volcanic awareness and holds drills often. 

(Credit Japan Meteorological Agency (JMA))

(Credit JMA Volcano Warning pamphlet)

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Saudi MOH Reports 1 Additional MERS Case

 

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Over the past 13 days Saudi Arabia has reported no fewer than 35 MERS cases (see list below), with all but a couple coming from the capital city of Riyadh.  Most have been linked to either a familial or nosocomial outbreak, although for some cases no source of infection has been determined.

Today the MOH announces another case, that of a 63 year-old female, whose exposure risks are under review.

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Novel H5N1 Reassortment Detected In Migratory Birds - China

 

#10,417

 

Seven months ago, in H5N1 Detected In Swan Die Off In Henan Province, I wrote about the discovery of nearly 100 dead birds (swans & ducks) at the Sanmenxia reservoir in Henan province, which authorities attributed to the H5N1 virus. Sanmenxia reservoir is a major overwintering habitat for a variety of waterfowl migrating between China, Mongolia, and Siberia.

 

We take special note of these large die offs because in the past they have occasionally denoted a change in the virus, as was the case in Qinghai Lake both in 2005 and 2009.

• What emerged at Qinghai Lake in 2005 was clade 2.2 (aka QH05) of the H5N1 virus.  And over the next 18 months, this new clade vastly expanded its geographic range across Asia, and into Europe and Africa (see H5N1 Influenza Continues To Circulate and Change 2006 by Webster et. al.).
• Four years later researchers found evidence of another clade (2.3.2) (see 2011 EID Journal New Avian Influenza Virus (H5N1) in Wild Birds, Qinghai, China), at another bird die off in the same region. In short order the 2.3.2 clade began to show up in migratory birds, and poultry, from Japan to India, supplanting the old 2.2 clade in many regions.

Earlier this summer, in Deja Flu: Another Qinghai Lake H5N1 Die Off, we saw another reported mass die off of waterfowl,  purported to be due to H5N1, but we’ve not seen any analysis come out of that incident yet.

Earlier this week, however,  Scientific Reports published an open access study on the genetics of the H5N1 virus that caused last January’s die off in Henan Province, and once again we find ourselves looking at a novel reassortment. 

 

First the abstract (the entire study is available online) then I’ll return with a bit more.

 

Highly Pathogenic Avian Influenza A(H5N1) Virus Struck Migratory Birds in China in 2015

Yuhai Bi,^a,1,2,6 Zhenjie Zhang,³ Wenjun Liu,^1,6 Yanbo Yin,⁵ Jianmin Hong,⁷ Xiangdong Li,⁸ Haiming Wang,⁹ Gary Wong,¹ Jianjun Chen,^6,10 Yunfeng Li,¹¹ Wendong Ru,¹¹ Ruyi Gao,¹¹ Di Liu,^1,6 Yingxia Liu,² Boping Zhou,² George F. Gao,^1,2,6,12 Weifeng Shi,^b,3 and Fumin Lei^c,4,6

 

Abstract

Approximately 100 migratory birds, including whooper swans and pochards, were found dead in the Sanmenxia Reservoir Area of China during January 2015. The causative agent behind this outbreak was identified as H5N1 highly pathogenic avian influenza virus (HPAIV). Genetic and phylogenetic analyses revealed that this Sanmenxia H5N1 virus was a novel reassortant, possessing a Clade 2.3.2.1c HA gene and a H9N2-derived PB2 gene.

Sanmenxia Clade 2.3.2.1c-like H5N1 viruses possess the closest genetic identity to A/Alberta/01/2014 (H5N1), which recently caused a fatal respiratory infection in Canada with signs of meningoencephalitis, a highly unusual symptom with influenza infections in humans. Furthermore, this virus was shown to be highly pathogenic to both birds and mammals, and demonstrate tropism for the nervous system.

Due to the geographical location of Sanmenxia, these novel H5N1 viruses also have the potential to be imported to other regions through the migration of wild birds, similar to the H5N1 outbreak amongst migratory birds in Qinghai Lake during 2005. Therefore, further investigation and monitoring is required to prevent this novel reassortant virus from becoming a new threat to public health.

(Continue . . . )

 

As we’ve discussed before, since HPAI H5N1 emerged as a single clade (0) in China in 1996, it has has evolved into more than 20 clades and subclades – and many more variants - and more are to be expected. This constant evolution is something we’ve looked at often, including Moving Viral Targets & EID Journal: The Expanding Variants Of H5N1). 

 
  Not all of these clades are currently circulating

 

While some of these evolutionary variations come about slowly due to antigenic drift, more abrupt changes can come about through antigenic `shift’ – or reassortment.  Which is the process that produced the novel virus described in today’s report.

The H5N1 viruses that are circulating in China can be genetically quite distinct from the viruses circulating in Egypt, or Vietnam, or Indonesia. Some regions may have multiple clades in circulation, and some clades may pose more of a risk to humans than others (see Differences In Virulence Between Closely Related H5N1 Strains).

 

Since clades are based on the HA gene of the flu virus, we can see several different subtypes (H5N1, H5N8, H5N2) fall into the same clade.

 

The novel reassortment in today’s is a mix of a H5N1 clade 2.3.2.1c virus and an H9N2-derived PB2 gene.

 

Clade 2.3.2.1c  describes an H5 HA gene segment which has been showing up in Vietnam, China,  India, Bulgaria, and Indonesia for several years, and was recently detected in Nigerian poultry (see EID Journal: H5N1 In Nigerian Poultry – 2015. 

 

Of note, this is the same H5 clade isolated from a Nurse who returned to Alberta, Canada from a trip to China (see Alberta Canada Reports Fatal (Imported) H5N1 Infection) in late 2013, and similar to one that killed a captive tiger in Jiangsu Province - also in 2013 - with both cases exhibiting unusual neurological symptomology.

To close, a few excerpts from the discussion section of the report.

 

The novel isolates were found to be highly pathogenic to chickens and mice, and virus isolated from mouse brains after challenge. It should be noted that meningoencephalitis was also observed in the fatal human case with Alberta2014, an unusual outcome for infections with H5N1 HPAIV in humans²⁰. Neurological symptoms were also noted in the non-surviving tiger infected with Tiger2013, with the heart, liver, spleen, lung, kidney, aquae pericardii, and cerebrospinal fluid all positive for H5N1 virus as detected by real-time RT-PCR²¹. This suggests that the novel Sanmenxia Clade 2.3.2.1c-like H5N1 viruses possesses tropism for the nervous system in several mammal species, and could pose a significant threat to humans if these viruses develop the ability to bind human-type receptors more effectively.

(SNIP)

It is believed that overlapping migratory flyways help circulate H5 HPAIVs amongst different bird species, and allow the spread of the virus across continents⁸. Recently sequential outbreaks of the H5N8 virus in domestic poultry in China, Korea, and Japan during 2010–2015^34,35, Europe in 2014–2015³⁶, and North America in 2014–2015^4,37,38 were considered to have occurred due to waterfowl migration^36,37,39. Therefore, the migration of wild birds plays an important role in the transmission and spread of H5 HPAIVs, posing a severe risk to animal and human health. Further investigation is required to monitor the evolution and transmission of these novel Sanmenxia Clade 2.3.2.1c-like H5N1 isolates, in order to prevent their spread to other countries and avoiding a repeat of what had happened in the past with circulating Qinghai-like Clades 2.2 and 2.3.2 H5N1, and Clade 2.3.4.4 H5N8 viruses^{7,9,15,16,19,36,37,40,41}.

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UCAS Clearing 2015 @JM Kuching Office

UCAS Clearing 2015

Date: 15 August 2015 (Saturday)

Time: 9.00am - 5.00pm

Venue: JM Kuching Office

Come & visit us!

For any inquiry, please contact us at:

Tel: 082-237 379 | 012-896 6738

Email: daniel@jmecc.com | jmsarawak@jmecc.com

Address: 191C, 1st Floor, Sublot 4, Lot 3166, 2 1/2 Mile, Rock Road,

93250 Kuching, Sarawak. 

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OIE Notification Of LPAI H5N2 In Mexico

Sinaloa, MX

 

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Eight days ago, Media Reports: H5N2 Poultry Outbreak – Sinaloa, Mexico, we looked at multiple media reports of an outbreak of H5N2 on a farm in Sinaloa.  Mexico’s Agricultural Ministry (SAGARPA)  and National Health Service, Food Safety and Food Quality (SENASICA ) websites have been strangely quiet on the issue, however. 

Today, the OIE published an official notification, which confirms this is an LPAI H5N2 virus – not the highly pathogenic H5N2 strain  that has recently plagued North American poultry farms. 

While in recent years it has been mostly been HPAI H7N3 viruses that have cropped up in Mexico (see OIE: Mexico Reports HPAI H7N3 In Two States), Mexico has a long history of LPAI (low pathogenic) H5N2 outbreaks going back more than 20 years (1994).

LPAI avian viruses are considered less dangerous than HPAI viruses, but those of the H5 and H7 subtype have been known to convert to a higher pathogenicity, hence the need to control both types of viruses.  It is not immediately clear why, more than three weeks after the event began, today’s  report indicates that culling has not been completed.

 

Source of the outbreak(s) or origin of infection

• Unknown or inconclusive

Epidemiological comments

Following the epidemiological surveillance activities carried out by the Veterinary Services of Mexico, avian influenza subtype H5N2 has been identified ; the intravenous pathogenicity test revealed that it corresponds to a low pathogenic avian influenza virus. The virus was isolated in a commercial farm of laying hens in the State of Sinaloa. The corresponding epidemiological investigation was initiated, including sampling in 4 industrial poultry farms and in 33 backyard poultry farms located in the 10-km zone around the outbreak, with a total of 720 samples of blood serum and tracheal and cloacal swabs, without detecting evidence of virus circulation. The production unit has been quarantined and a sanitary barrier has been set up. A humanely slaughter of birds programme will be launched even though it is a virus of low pathogenicity. Note by the OIE Animal Health Information Department: H5 and H7 avian influenza in its low pathogenic form in poultry is a notifiable disease as per Chapter 10.4. on avian influenza of the Terrestrial Animal Health Code (2015).

Control measures

Measures applied

• Movement control inside the country
• Screening
• Quarantine
• Zoning
• Vaccination prohibited
• No treatment of affected animals

Measures to be applied

• Disinfection / Disinfestation
• Stamping out

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