Monkeypox Outbreak Reported In Central African Republic

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Monkeypox is a rare virus, endemic in monkeys and rodents in central Africa, that produces a remarkably `smallpox looking'  illness in humans, albeit with a much lower fatality rate. Human monkeypox was first identified in 1970 in the DRC, and since then has sparked mostly small, sporadic outbreaks in the Congo Basin and Western Africa.

But in 1996-97, a major outbreak occurred in the Democratic Republic of Congo (see Eurosurveillance Report), where more than 500 cases in the Katako-Kombe and Lodja zones were identified.  Mortality rates were lower for this outbreak (1.5%) than earlier ones, but this was the biggest, and longest duration outbreak on record.

The name `monkeypox’  is a bit of a misnomer. It was first detected (in 1958) in laboratory monkeys, but further research has revealed its host to be rodents or possibly squirrels.  Humans can contract it in the wild from an animal bite or direct contact with the infected animal’s blood, body fluids, or lesions.

Consumption of undercooked bushmeat is also suspected as infection risk, but human-to-human transmission is also possible.  This from the CDC’s Factsheet on Monkeypox:

The disease also can be spread from person to person, but it is much less infectious than smallpox. The virus is thought to be transmitted by large respiratory droplets during direct and prolonged face-to-face contact. In addition, monkeypox can be spread by direct contact with body fluids of an infected person or with virus-contaminated objects, such as bedding or clothing.

According to the CDC there are two distinct genetic groups (clades) of monkeypox virus—Central African and West African. West African monkeypox is associated with milder disease, fewer deaths, and limited human-to-human transmission.

Credit CDC

On December 30th the Institut Pasteur in Bangui confirmed two cases of monkeypox virus infection in the Bangassou district of the  Central African Republic.  In a report on their website, they wrote:

A team from Doctors without Borders Belgium located in this area at the border of the Democratic Republic of the Congo, has collected samples from two children of the same family who presented with rashes (maculopapular) after consuming thryonomys meat a rodent locally known as sibissi.

One of the children, aged 9 years died. As the clinical picture was not in favor of a measles infections, highly endemic in Central African Republic, the samples were sent to the Institut Pasteur in Bangui for analysis.

The Laboratory of Arboviruses, Viral Hemorrhagic Fevers and of Emerging Zoonotic viruses led by Dr. Emmanuel Nakouné  received the samples on December 25th and immediately conducted molecular analyzes that proved positive for monkeypox virus.

Today Pathfinder on FluTrackers posted a media report that indicates this outbreak extends beyond those first two cases, although details remain scant.

Virus "Monkeypox": the epidemic confirmed in the Mbomou

Par Journaldebangui.com, source Rjdh - 18/01/2016

It is the Minister of Public Health has certified that the Thursday, January 14, 2016, during a press conference. A virus epidemic "Monkeypox" plaguing the region

This is for several days as information relating to the presence of the disease in Mbomou circulate. Two deaths were deplored and several patients quarantined. This is now a reality and that the Ministry of Health has certified. Ms. Margueritte Maliévo Samba said that after tests and investigations made ​​by his department, the disease is confirmed in the Mbomou.

The government official gave details on disease patterns of contamination, saying "there are two modes of transmission of this disease. The first mode is that of the transmission of live or dead animals, contaminated with man. The second mode is sick or deceased person to another healthy person in close contact with body fluids including blood, urine, vomit, sweat, semen or by handling objects contaminated by secretions " .

The Ministry of Health says have control of the situation, however, calls for vigilance "I call all the Central African population in general and that of the Prefecture of Mbomou especially for calm and strict compliance with preventive measures which were to wash hands regularly, avoid any manipulation with sick or dead animals and secretions of infected person and objects "launched the Health Minister.

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Although generally limited to small outbreaks in Africa, in 2003 the United States saw an outbreak (of the milder, West African clade) that affected 47 confirmed and probable cases in six states—Illinois, Indiana, Kansas, Missouri, Ohio, and Wisconsin, all of whom had contact with infected prairie dogs purchased as pets.

These pets became infected when an animal distributor imported hundreds of small animals from Ghana, which in turn infected prairie dogs that were subsequently sold to the public (see MMWR Update On Monkeypox 2003).

While still considered a geographically limited threat, in 2010 a study that appeared in PNAS warned that the incidence of human monkeypox infection was increasing, and that it posed a potential risk well beyond localized outbreaks in Africa. 

Major increase in human monkeypox incidence 30 years after smallpox vaccination campaigns cease in the Democratic Republic of Congo 

Anne W. Rimoina,b,1,Prime M. Mulembakanic, Sara C. Johnstond,James O. Lloyd Smithb,e,Neville K. Kisaluf, Timothee L. Kinkelac,Seth Blumbergb,e,Henri A. Thomasseng,Brian L. Pikeh,Joseph N. Fairh,Nathan D. Wolfeh,Robert L. Shongoi,Barney S. Grahamj,Pierre Formentyk,Emile Okitolondac,Lisa E. Hensleyd,Hermann Meyerl,Linda L. Wrightm, andJean-Jacques Muyemben

(Excerpt)

Thirty years after mass smallpox vaccination campaigns ceased,human monkeypox incidence has dramatically increased in rural DRC. Improved surveillance and epidemiological analysis is needed to better assess the public health burden and develop strategies for reducing the risk of wider spread of infection.

Although monkeypox outbreaks tend to burn themselves out fairly quickly, and rarely spread very far, those were the same qualities we attributed to Ebola two years ago.  So we'll keep an eye on this outbreak, in the unlikely event it should spread beyond a handful of cases in Mbomou.

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Hong Kong Issues Zika Travel Advice & Letter To Doctors

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Due to the rapid spread of the  Zika Virus in the tropical Americas, and a concurrent rise in microcephalic birth defects in Brazil, the CDC issued a revised travel advisory and a HAN: Recognizing, Managing & Reporting ZIka Virus Infections In Travelers for clinicians late on Friday. 

While a firm connection between the Zika virus and the increase in Microcephalic births in Brazil has yet to be completely established, the risks to women and their unborn babies is considered great enough to demand immediate action.

Today it is Hong Kong's turn.  First with a statement on their CHP website, and then via a letter sent to all local doctors asking them to stay vigilant for possible imported cases.

18 January 2016

DH alerts travellers to risk of Zika virus infection 

The Department of Health (DH) today (January 18) drew the public's attention to the latest situation of the mosquito-borne Zika virus infection and appealed to travellers for vigilance and due consideration of health risks before travel.

According to the latest report by the Pan American Health Organization (PAHO)/World Health Organization (WHO), autochthonous transmission of Zika virus was reported from epidemiological week 17 of 2015 to epidemiological week 2 of 2016 in the following countries and territories in the Americas Region: Brazil, Columbia, Ecuador, El Salvador, French Guiana, Guyana, Guatemala, Haiti, Honduras, Martinique, Mexico, Panama, Puerto Rico, Paraguay, Saint Martin, Suriname and Venezuela.

"We have been monitoring Zika virus transmission overseas and noted reports of microcephaly and other poor pregnancy outcomes in babies whose mothers were infected with Zika while pregnant and studies are being carried out to determine what effects Zika virus can have on foetuses. In view of the latest situation, as a precautionary measure, we advise pregnant women and those planning pregnancy to adopt necessary anti-mosquito precautions. We will issue letters to doctors and hospitals for heightened vigilance," a spokesman for the DH said.

Pregnant women should consider deferring their trip to areas with past or current evidence of ongoing Zika virus transmission. Those who must travel to any of these areas should seek medical advice from their doctor before the trip, strictly follow steps to avoid mosquito bites during the trip, and consult and reveal their travel history to their doctor if symptoms develop after the trip.

Women preparing for pregnancy should also consult their doctor before travelling to these areas, strictly follow anti-mosquito precautions during the trip, and report to their doctor if feeling unwell after the trip.

"Locally, no human cases have been reported to the Centre for Health Protection (CHP) of the DH so far and the CHP's Public Health Laboratory Services Branch (PHLSB) is capable of detecting Zika virus. Although Zika virus infection is not a statutorily notifiable infectious disease under the Prevention and Control of Disease Ordinance (Cap 599) now, we appeal to doctors to stay alert to the possibility of Zika in travellers returning from affected areas who present a clinically compatible picture not attributable to dengue fever or chikungunya fever. Laboratory testing for Zika virus infection is available at the PHLSB. They should contact the PHLSB for further information as necessary," the spokesman said.

Zika is primarily transmitted to humans through bites from Aedes mosquitoes. Aedes aegypti, which is currently not found in Hong Kong, is considered the most important vector for Zika transmission to humans. Other Aedes mosquito species such as Aedes albopictus widely present locally are also considered as potential vectors. There is therefore a risk of secondary spread for imported infections in Hong Kong.

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The letter to doctors (Vigilance against Zika virus infection (  717.93 Kb) repeats much of the above information, and adds:

Medical practitioners should be aware of the possibility of Zika virus infection for travellers returning from affected areas and present with clinically compatible picture. Laboratory testing for Zika virus infection is available at the Public Health Laboratory Services Branch (PHLSB) of CHP. Please contact PHLSB for further information as necessary. 

If you encounter patients with laboratory confirmed Zika virus infection please report to the Central Notification Office (CENO) of CHP via fax (2477 2770), CENO On-line (https://cdis.chp.gov.hk/CDIS_CENO_ONLINE/ceno.html) or phone (2477 2772) for investigation and control measures.

While there is always great reluctance to issue travel advice that will negatively impact  a nation's economy - particularly one as precarious, and as dependent upon tourism as Brazil's -  until the risks are better understood health departments much act out of an abundance of caution.

The concern is two-fold.     

First and foremost over the concerns for mothers and their unborn child, but secondly because viremic travelers who return to areas where suitable mosquito vectors are present, could potentially `seed' the virus to the local mosquito population and start chains of local transmission.


For some recent blogs on that possibility, you may wish to revisit:

Despite What You May Have Heard About The 1st Zika Case In The US . . .

The International Exchange Rate Of Infectious Diseases

PNAS: Asymptomatic Humans Transmit Dengue Virus To Mosquitoes

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CHP: Guangdong Province - 5th H5N6 Case In Past Month

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Up until a month ago, known H5N6 cases were widely scattered and sporadic in China, with only 4 cases reported across three provinces (Sichaun =1, Guangdong = 1, Yunnan=2)  over a span of 19 months.  

Between December 29th and mid-January we saw 4 additional cases emerge from Guangdong province, prompting state media sources to reassure on Friday that there was No Evidence Of H-2-H Transmission Of H5N6.

Today we have a 5th notification, involving a 31 year old woman hospitalized in Futian, Shenzhen, published by neighboring Hong Kong's CHP.   Given Guangdong Province's close proximity to, and trade relations with, Hong Kong - they tend to be more willing to share timely avian flu reports than do other Provinces.


First the Hong Kong Notification, then I'll have a bit more.

 CHP notified of additional human case of avian influenza A(H5N6) in Guangdong

The Centre for Health Protection (CHP) of the Department of Health (DH) was notified of an additional human case of avian influenza A(H5N6) in Guangdong by the National Health and Family Planning Commission today (January 18), and again urged the public to maintain strict personal, food and environmental hygiene both locally and during travel.

The case involves a woman aged 31 in Futian, Shenzhen. She developed fever and cough on January 8 and is currently hospitalised for treatment in critical condition.

From 2014 to date, a total of nine human cases of avian influenza A(H5N6) have been reported by the Mainland health authorities.

"All novel influenza A infections, including H5N6, are statutory notifiable infectious diseases in Hong Kong," a spokesman for the CHP said.

"We will remain vigilant and work closely with the World Health Organization and relevant health authorities to monitor the latest developments," the spokesman said.

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Although it has yet to have as big of impact as avian H7N9, the recently (2014) emerged H5N6 virus - a reassortant of H5N1 and H6N6 - has generated a good deal of concern as it has infected a small, but growing number of humans over the past 20 months.


Last October, in H5N6: The Other HPAI H5 Threat, we looked at the history of this rising avian flu threat, while last summer H5N6 Rising: Infecting Birds, Humans, & Even Cats, we looked at a report which appeared last June’s Nature’s Scientific Reports, that warned:

The extensive migration routes of wild birds may contribute to the geographic spread of H5N6 AIVs and pose a risk to humans and susceptible domesticated animals, and the H5N6 AIVs may spread from southern China to northern China by wild birds. Additional surveillance is required to better understand the threat of zoonotic transmission of AIVs.

While details have been scant, we've seen nothing to suggest any of these five cases are epidemiologically related, or that the virus is circulating in the human population.

Five cases in such a short period of time, however, does suggest the virus is getting better established in poultry populations and the environment.

It has already turned up in wild and migratory birds in Hong Kong (see Hong Kong: Magpie Robin Tests Positive For HPAI H5) several times. Given the lack of wild bird surveillance and reporting out of Mainland China, we don't really have a good feel for how rapidly the virus might be spreading. 

While H7N9 and H5N1 have been the most worrisome avian flu viruses to date, H5N6 is showing signs of becoming a contender, and is definitely a virus to watch.

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Indiana BOAH: Additional H7N8 Outbreaks Were LPAI

Indiana BOAH - Jan 17th

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An update today from Indiana's Board of Animal Health clarifies and revises last night's statement now that laboratory testing has come back on 8 of the 9 newly discovered outbreaks.

Instead of all of those outbreaks being HPAI H7N8, the vast majority (so far) are LPAI.

Highly pathogenic avian influenza is more apt to be recognized based on the appearance and behavior of infected birds, and that is what led to the initial quarantine and  testing.  LPAI infection is more subtle, and isn't always readily apparent without testing.

It turns out that eight of the nine subsequent positive tests returned from other farms in Dubois county are LPAI H7N8, with one still pending.  No additional farms have been announced as infected today.

This statement was emailed a short while ago from the Indiana BOAH.

Indiana Clarifies Avian Flu 

Findings in Nine Flocks

Laboratory Results Confirmed Overnight

FOR IMMEDIATE RELEASE

INDIANAPOLIS (17 Jan. 2016)--Laboratory testing of samples from eight of nine Southern Indiana turkey flocks was completed overnight by the U.S. Department of Agriculture (USDA) National Veterinary Services Laboratory in Ames, Iowa. While all nine were announced as H7 influenza-positive yesterday, the specific strain was yet to be determined. The Indiana State Board of Animal Health (BOAH) has been informed eight are low-pathogenic H7N8. Testing continues on the remaining sample.

Avian influenza does not present a food safety risk; poultry and eggs are safe to eat. The Centers for Disease Control and Prevention (CDC) considers the risk of illness to humans to be very low.

Indiana State Veterinarian Bret D. Marsh, DVM calls this good news, and evidence that Indiana’s aggressive surveillance and response efforts in Dubois County are working.

“The low-path H7N8 virus was identified during testing in the 10-km zone around the initial flu-positive flock,” Dr. Marsh said. “Because flu viruses are constantly mutating, we want to catch any case as early as possible after infection. We know this virus strain can intensify, so finding these cases as low-path strains shows we are keeping pace with the spread of this disease in the area.”

In addition to the HxNx naming scheme for specific strains, AI viruses are further classified by their pathogenicity—the ability of a particular virus strain to produce disease in domestic chickens. Highly pathogenic avian influenza (HPAI) virus strains are extremely infectious, often fatal to domestic poultry, and can spread rapidly from flock to flock. Low pathogenicity avian influenza (LPAI) virus strains occur naturally in wild migratory waterfowl and shorebirds without causing illness. LPAI viruses have the potential to mutate into HPAI.

“This finding does not alter the aggressive control strategy BOAH has set forth,” added Dr. Marsh. “Nor does it change our resolve to eliminate this virus wherever we find it.”

Priority response by the state of Indiana and USDA continues on all the infected farms. Turkeys are being humanely euthanized on infected sites within 24 hours of diagnosis. Depopulation eliminates the source of infection to prevent the disease from spreading. Disposal of the turkeys, primarily via indoor composting, will be followed by thorough cleaning and disinfection of all barns.

Aggressive testing of other poultry farms in the area continues. During the last 24 hours, commercial farms have yielded 100 negative flu tests, beyond the nine new positives. In addition, state and federal teams have visited 503 residences in the area to identify any small flocks for testing. Tests are pending on 17 small flocks. Residential visits will continue in the 10-km area.

 From APHIS, a similar announcement (excerpt below), the a brief discussion.

Update on H7 Avian Influenza Cases in Indiana, Additional Flocks Now Confirmed as Low Pathogenic

Last Modified: Jan 17, 2016

Cases Found Through Surveillance Testing in Initial Control Area

 

WASHINGTON, January 17, 2016 -- The United States Department of Agriculture’s (USDA) Animal and Plant Health Inspection Service (APHIS) has confirmed the pathogenicity of eight of the nine H7N8 avian influenza detections announced on January 16. The turkey flocks have been confirmed as low pathogenic avian influenza, with additional testing ongoing for the ninth flock.

These January 16 detections were identified as part of surveillance testing in the control area surrounding the initial highly pathogenic H7N8 avian influenza (HPAI) case in that state, identified on January 15.

The pathogenicity of a virus refers to its ability to produce disease.  Birds with low pathogenic avian influenza (LPAI) often show no signs of infection or only have minor symptoms.  HPAI viruses spread quickly and cause high mortality in domestic poultry.  H7 LPAI viruses have been known to mutate into HPAI viruses in the past.

“It appears that there was a low pathogenic virus circulating in the poultry population in this area, and that virus likely mutated into a highly pathogenic virus in one flock,” said Dr. John Clifford, USDA Chief Veterinarian. “Through cooperative industry, state and federal efforts, we were able to quickly identify and isolate the highly pathogenic case, and depopulate that flock.  Together, we are also working to stop further spread of the LPAI virus, and will continue aggressive testing on additional premises within the expanded control area to ensure any additional cases of either HPAI or LPAI are identified and controlled quickly.”

(Continue . . .)

HPAI viruses have been generated in the lab by repeated passage of LPAI viruses through chickens (cite FAO) but exactly how and why this occurs naturally is poorly understood (see JVI  Emergence of a Highly Pathogenic Avian Influenza Virus from a Low Pathogenic Progenitor). .

While we haven't seen it happen all that often, the risk is considered great enough that all LPAI H5 and H7 outbreaks must be reported to the OIE, and immediate steps must be taken to contain and eradicate the virus. 

Over the past year we've seen an unusual increase in number of these LP to HP conversions  (see You Say You Want An Evolution?) involving multiple H7 & H5 subtypes.  Now, it appears, we can add Indiana to the list.


It is going to be very interesting to see what the epidemiological investigation turns up on this newest avian influenza virus, and we will hopefully learn more about the European outbreaks in the days ahead as well.

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Egyptian MOH Statement: No Bird Flu Cases Since Last Summer

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By this time last year, Egypt was embroiled in the largest outbreak of H5N1 human infection on record (see EID Dispatch: Increased Number Of Human H5N1 Infection – Egypt, 2014-15), and would soon stop publicly reporting on cases altogether (see Regarding The Silence Of The Egyptian MOH).

Last month in In The Land Of Limited Press Freedom, The Internet Rumor Is King, we looked what happens when local health officials are less than open about disease outbreaks.   

Over the past few weeks we've seen a constant stream of frantic Arabic media headlines announcing `Confirmed Bird Flu Cases', which are followed almost immediately by denials from health officials.  A couple of recent examples include:

«Bird flu» to end the life of Egyptian girl

Al-Qabas  - Jan 16, 2016    

Announced an Egyptian hospital death-old girl two years and a half as a result of being   infected with Pfirs bird flu, as has been the detention of her cousin under treatment. The results of the tests confirmed the child bird flu, after he came to the hospital in a degraded state suffer pneumonia twofold.

Health»: 15 suspected case of the avian influenza in North Sinai
Saturday, January 16, 2016 - 19:52

Undersecretary of the Ministry of Health in northern Sinai, Dr. Tarek Khater, that the total pathological cases and suspected of having the flu emerging at the county level stood at 15 cases, and was placed under them treatment 8 cases in El-Arish General Hospital and 7 in the central Bir al-Abed Hospital

These media reports often confuse seasonal flu with bird flu, and continue to regard seasonal A/H1N1 as a highly dangerous pandemic `swine flu'.  Add in the vagaries of translation software, and you end up with a melange of dubious value.


While there have been numerous statements from officials denying bird flu cases appearing  in the media, the MOH website itself has been largely silent on the issue. At least until yesterday, when they posted the following long, reassuring statement, insisting there have been no bird flu (H5N1) cases reported in Egypt since last summer. 

(translation)

Influenza Conference statement January 16, 2016

In the official spokesman of the Ministry of health and population Dr. Sampath at the press conference held by the Ministry here Saturday by the National Institute for training in Abbasiya letter reassuring for citizens not to worry or fear from seasonal influenza Ah1n1, noting that Egypt has no epidemic outbreaks of the virus, stressing the adoption of all the measures, the Ministry and preventive measures necessary to confront and prevention, called on citizens to proper health methods in disease prevention and, in the case of the onset of symptoms is consult Doctor or go to the nearest hospital.

Dr. said Mohamed Awad tageldin, former Health Minister Professor of respiratory diseases, contagious viral disease influenza, there is a difference between flu and colds since cold symptoms is simple and its nose only flu symptoms, your entire body with high temperatures and infect the upper respiratory tract and lower, and noted that the most serious complications of influenza infection is pneumonia.

He thanked all the viruses and chest hospitals operating in receiving influenza cases and provide treatment and medical care.

He explained that the more serious categories are children less than 5 years and older persons click 65 General and thoracic sensitivity ill, pregnant women and women who are breastfeeding, chronic diseases heart, kidney and diabetes, and those with weak immune systems, such as organ transplantation.

He advised the most susceptible to influenza virus infection to receive vaccinations each year for cases with weak immune and above, and washing hands down, good ventilation, and consult your physician in cases of high temperatures.

Dr. said Underwood, head of the preventive medicine, Ministry of health and population during the press conference, it was suspected the number 1037 if bird flu since June 2015 until now, where all came negative for bird flu, confirmed the absence of any confirmed human cases of infection with the bird flu virus in Egypt since June 2015, and that winter this year completely free of bird flu so far, they have not recorded any cases of injury or death Until now.

Qandil, confirmed once again the absence of so-called alkhnair flu virus now infects humans, as this was the most commonly used title in 2009 when the global influenza pandemic, since 2010 the World Health Organization announced the end of the pandemic, the virus causing the pandemic has same epidemiology of seasonal influenza viruses since then was put into viruses involved in seasonal influenza vaccination.

Underwood said that seasonal influenza virus H1N1-type is prevalent during the current influenza season at global, regional and national level and is from seasonal influenza, which is monitored in Egypt and respond to treatment with the drug tamiflu and is the same type of viruses within the taste of existing seasonal flu.

(Continue . . . )

Given the Egyptian MOH's past obfuscation of bird flu reports, and the media's penchant for prematurely calling any severe respiratory illness a `suspected bird flu', I wouldn't care to wager any money on what is really going on in Egypt.  

I'm not blogging individual media reports because my level of confidence in them is so low.   

But since Egypt has been a perennial hot spot for avian flu, I continue to monitor it - as do other Flublogians (i.e. Crof, FluTrackers, etc.) - and if something credible emerges, you can be certain we'll write about it. 

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APHIS/Indiana BOAH: HPAI H7 Avian Flu Detected At 9 Additional Farms

Indiana BOAH

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The USDA's APHIS and the Indiana Board of Animal Health (BOAH) have announced this evening the results of rapid testing of farms around the turkey farm that yesterday was determined to be infected with a new, HPAI H7N8 virus.

Nine additional farms, all located in Dubois county, have tested postive for H7 avian flu.  Although likely H7N8, the full subtype should be known in a day or so. 

This dashes the hopes, expressed yesterday, that the first farm might be an isolated event, and will undoubtedly lead to even greater testing and surveillance in the region.   First a statement from the Indiana BOAH, then the statement from APHIS.

FOR IMMEDIATE RELEASE
 
More Cases of Highly Pathogenic Avian Influenza Diagnosed in Indiana

INDIANAPOLIS (16 January 2016)—The Indiana State Board of Animal Health (BOAH) announces nine more commercial turkey farms in Dubois County have tested positive for highly pathogenic avian influenza. This brings the total to 10 commercial turkey operations. Further testing is underway to determine the virus type.

All positive flocks are located within the original control area, and were identified by surveillance testing. New 10 km circles have been drawn, to expand the control area slightly beyond Dubois County into Martin, Orange, Crawford and Davies counties.
Avian influenza does not present a food safety risk; poultry and eggs are safe to eat. The Centers for Disease Control and Prevention (CDC) considers the risk of illness to humans to be very low.

Poultry flocks in the surrounding area are being tested daily for the presence of avian influenza. State and federal agencies are working alongside the poultry operations to minimize the impact and eliminate the disease.

Depopulation activities are underway on most of the sites. Depopulation of the index site was completed this morning. All infected flocks are located in Dubois County, Indiana.

REPORTING
 
Backyard poultry owners are encouraged to be aware of the signs of avian influenza and report illness and/or death to the USDA Healthy Birds Hotline: 866-536-7593. Callers will be routed to a state or federal veterinarian in Indiana for a case assessment. Dead birds should be double-bagged and refrigerated for possible testing.

Signs include: sudden death without clinical signs; lack of energy or appetite; decreased egg production; soft-shelled or misshapen eggs; swelling or purple discoloration of head, eyelids, comb, hocks;nasal discharge; coughing; sneezing; incoordination; and diarrhea. A great resource for backyard bird health information is online at: www.healthybirds.aphis.usda.gov

UPDATES and INFORMATION:
 
Situation updates and status reports about ongoing avian influenza activities, along with critical disease-related information, will be posted online at: www.in.gov/boah/2390.htm . Users may subscribe to email updates on a link at that page.

Additional H7 Avian Influenza Cases Found in Indiana

Last Modified: Jan 16, 2016

 

Cases Found Through Surveillance Testing in Initial Control Area

Andrea McNally (202)799-7033andrea.c.mcnally@aphis.usda.gov
Lyndsay Cole (970)494-7410lyndsay.m.cole@aphis.usda.gov

WASHINGTON, January 16, 2016 -- The United States Department of Agriculture’s (USDA) Animal and Plant Health Inspection Service (APHIS) has confirmed the presence of H7 avian influenza in 9 flocks in southwestern Indiana.  These new cases were identified as part of surveillance testing in the control area surrounding the initial highly pathogenic avian influenza (HPAI) case.  Testing is currently ongoing at the National Veterinary Services Laboratories in Ames, Iowa to determine the pathogenicity of these new cases.

No cases of HPAI H7N8 virus infection have been reported in humans at this time, and no human infections associated with avian influenza A viruses of this particular subtype (i.e., H7N8) have ever been reported. As a reminder, the proper handling and cooking of poultry and eggs to an internal temperature of 165 ˚F kills bacteria and viruses, including HPAI.

APHIS continues to work closely with the Indiana State Board of Animal Health on a joint incident response. State officials quarantined the affected premises and depopulation of birds on the affected premises has already begun. Depopulation prevents the spread of the disease. Birds from the flock will not enter the food system.

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CDC Zika Press Conference: Audio & Transcript

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The CDC has posted the transcript of last night's hastily called CDC press conference (at 7pm EST) on yesterday's release of new, interim travel advice for pregnant women seeking to travel to countries where the Zika virus is transmitting.


As to why a late Friday presser instead of waiting until Monday, (asked by journalist Eben Brown), Dr. Lyle Petersen explained:

The reason is we believe this is a fairly serious problem. The infection is or the virus is spreading fairly rapidly throughout the Americas. We know in populations that it does affect, a large percentage of the population may be become infected. And because of this growing risk of or growing evidence that there's a link between Zika virus and microcephaly, which is a very severe and devastating outcome, it was important to warn people as soon as possible.

A press release by the state of Hawaii yesterday (HAWAII DEPARTMENT OF HEALTH RECEIVES CONFIRMATION OF ZIKA INFECTION IN BABY BORN WITH MICROCEPHALY) - born to a mother who lived in Brazil during her 1st trimester last year - only serves to highlight the risks.


Last night the CDC followed up this press conference by releasing: 

CDC Issues Interim Travel Advice On Zika Virus (Level 2 - Enhanced Precautions) 

CDC HAN: Recognizing, Managing & Reporting ZIka Virus Infections In Travelers

 

The audio and transcript of last night's 38 minute press conference outlines some of the preliminary data - gathered primarily in Brazil - that prompted the issuance of these recommendations, and discusses the potential for future spread in the United States. 


The transcript/audio is very informative, and highly recommended. 

 

Transcript for CDC Telebriefing: Zika Virus Travel Alert

Press Briefing Transcript

Friday, January 15, 2016 at 7 pm E.T.

• Zika Virus Travel Alert[audio MP3 - 8 MB]

Please Note:This transcript is not edited and may contain errors. 

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