Influenza Virus Mashup

(Mon, 30 Nov 2009 14:26:00 +0000)

# 4100

On Monday morning we get an update from the ECDC on H1N1 pandemic activity in Europe over the previous 72 hours (Friday/Saturday/Sunday).

With this report we also get an update on the mutations seen in the HA1 gene of the H1N1 virus.

Main developments in past 72 hours

• Influenza activity is high in 27 EU countries and 13 countries report a rising trend
• More  mutations  have  been  reported  by  EU  countries,  with  a  few  in  the  haemagglutinin  gene  at location 222
• A total of 858 fatal cases in Europe and EFTA countries and 7 710 in the rest of the world have been reported up to date.

Mutations in the haemagglutinin HA1 gene D222G

Following initial reports from Norway, WHO has noted that a spontaneous mutation in the haemagglutinin gene D222G has been observed in at least seven countries world-wide (1). These spontaneous mutations have been detected retrospectively following genetic sequencing. They were first detected in April and were seen in Mexico and the USA and so are not a recent phenomenon (1,2).

Finnish and French virologists reported another three cases last week (3).  As in a number of the cases the viruses were reported from two patients with very severe illness who died. WHO and ECDC are currently assessing the public health significance of this mutation (1,2). It is unclear whether the mutation is especially pathogenic or whether it is somehow selected for in very ill patients. 

However there is no evidence that the virus is transmitting, none of the patients are reported to be connected to each other and the mutation is not spreading in Europe. As further sequencing is undertaken reports of its detection in other European countries can be expected.

(Mon, 30 Nov 2009 13:19:00 +0000)

# 4099

While the  H5N1 virus has been off the radar scope for awhile, replaced in our attentions by the H1n1 virus, it is still out there; in the wild, endemic in the domesticated birds of several nations, and occasionally infecting humans.

Over the long holiday weekend we learned of Egypt’s 89th known H5N1 human infection.   Today, three new reports: two from Indonesia and one from Vietnam.

First, out of Vietnam, we get this newspaper report of that country’s first known H5N1 fatality since last spring.   Treyfish on Flutrackers has the story from the Vietnam Express, and the complete translated text here.

In Vietnam The youth died of H5N1

November 30, 2009, 17:27 GMT +7

Patients age 23, in ward Sam Min, the city of Dien Bien, had eaten more duck soup for about a week before has the disease. Especially as the H5N1 ca 5 this year are fatal.

 
Notified by the Department of Preventive Health and Environment (Ministry of Health), patients starting on November 18 patients with sudden high fever, cough, shortness of breath. However, six days after the last patient visit at the medical ward station, then transferred to the Clinic The area of Phu on November 25.

A day later, he continued to be transferred to Hospital Dien Bien province and was diagnosed with severe pneumonia monitor viral, antibiotic treatment, transmission service, antipyretic. Patients to proceed more severe and the patient died on November 28.

As of 29/11, Institute of Hygiene and Epidemiology central results of patients tested positive for H5N1 virus.

 

Officially Vietnam has reported 4 cases of human H5N1, with all four dying.  If officially confirmed, it will probably be a couple of days before news of this case is relayed to the WHO.

We next jump to Indonesia, where getting good information on H5N1 has been almost impossible for the past couple of years.  Government silence on outbreaks in poultry and human infections is pretty much standing policy.

So while we sometimes see local media accounts of H5N1 infections, we almost never get official confirmation. 

Ida at the Bird Flu Information Corner (BFIC) - a  joint venture between Kobe University in Japan and the Institute of Tropical Disease, Airlangga University, Indonesia – remains our best source of information about what is going on in that archipelago nation.

Ida translates local media reports and posts them on the BFIC site.  Today we have two such reports, the first involving a suspected human infection in Padang.

Padang, West Sumatera ::: Duck farmer suspected to contract bird flu

November 30, 2009

Padang, West Sumatera – A resident of Tanjuang Durian, Nagari Baru Kecamatan Bayang Kabupaten Pesisir Selatan, Dasrizal (37), suspected to contract bird flu virus and admitted to M Djamil hospital.

 

Patient is a duck farmer, and raising hundreds of ducks. He is reported to have found almost of all his ducks suddenly died. Subsequent to the finding, he burried the dead ducks. He developed high fever at noon of the same day, and his family gave him antipyretic drug, a kind of paracetamol.

 

Dafrizal’s fever was getting higher in the afternoon and his family brought him to Pasa Baru public health center in the evening. Public health center was then referred Dafrizal to M Zein Painan hospital, where he was diagnosed as bird flu suspect. Patient was transferred to M Djamil hospital to receive better treatment as bird flu suspect patient.

 

Source: Indonesia local newspaper, Padang Today. http://padang-today.com/?today=news&id=11542

This second story involves government supplied poultry – a contribution by local governments to their community – that have suddenly died from bird flu.    Other communities received similar contributions, and so the search is on for other outbreaks.

Lhoksukon, North Aceh ::: Government contributed poultries die of bird flu

November 30, 2009

Lhoksukon – Avian influenza (AI) rapid response team of Livestock Service and Animal Health Service in North Aceh culled number of bird flu infected chickens. Those chickens were contributed by local government for community in Calong, Kecamatan Syamtalira Aron.

 

AI team coordinator, dr Muzakir Anwar on Monday (29/11) said depopulation was done last Wednesday (25/11) after receiving report that 330 of 400 contributed chickens suddenly died. Further check to survived and dead chickens showed positive bird flu infection.

 

Previously, 90 of 400 contributed chickens were reported to have died of bird flu infection in Simpang Empat, Kecamatan Simpang Keuramat. Same incidents occurred in Matang Kuli, Baktiya, dan Muara Batu at the following day.

 

Currently, livestock service is waiting for report from three other sub-district (Kecamatan) which received same contributions; Cot Girek, Langkahan and Saenuddon. So far no report from those three sub-districts, but there is high possibility that same incident may happen.

(Continue . . . )

The great unknown, of course, is whether the H5N1 virus will ever make the adaptations required to make it an easily transmissible human pathogen.   So far, that hasn’t happened.  

And perhaps, there are biological barriers to prevent it from ever happening.  We simply don’t know.

Many scientists are concerned over what happens when the H1N1 swine flu virus meets up with the H5N1 bird flu virus in the same host (human, bird, pig).   Again, scientists don’t know if a reassortment will occur.  

They just know it’s possible.

There are some that would argue that since H5N1 hasn’t learned to jump to humans yet, it probably won’t. 

That’s possible, of course. 

 

But that ignores the reality that the novel H1N1 virus bounced around in pigs for many years before finding the right genetic combination to make it a human adapted virus.

And so we continue to watch warily as influenza evolves on multiple fronts.  The H1N1 pandemic, of course.  But also H5N1 bird flu, and the H7, H9, and H10 avian viruses as well.

We cohabitate with a immense, diverse, and ever evolving world of pathogens. 

We would ignore them at our considerable peril.

(Mon, 30 Nov 2009 06:45:21 -0500)

Swine flu started in pigs (although we don’t exactly when or where), adapted to and passed to humans who returned the favor and passed it back to pig herds. Then we heard that turkeys in Chile had contracted the virus, followed by ferrets and a house cat. We can infect animals cross species with flu in the laboratory, but all of these are cases acquired in the natural world by animals interacting with humans. Once cats were on the menu, the next question was dogs, another population “companion animal” (aka, pet) in the US and Western Europe (and literally a menu item in many parts of Asia). In recent years there have been periodic outbreaks of “dog flu,” an H3N8 subtype that didn’t seem to infect humans but produced “kennel cough” like symptoms in dogs. Now we get reports out of China that the family dog can also be infected with swine flu — by us:

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