AVIAN VIRUS IN ASIA

Avian / human cases, Asia

In January 2004, a major new outbreak of H5N1 surfaced in Vietnam and Thailand's poultry industry, and within weeks spread to ten countries and regions in Asia, including Indonesia, South Korea, Japan and mainland China. Intensive efforts were undertaken to slaughter chickens, ducks and geese (over forty million chickens alone were slaughtered in high-infection areas), and the outbreak was contained by March, but the total human death toll in Vietnam and Thailand was twenty three people.

In July 2004, fresh outbreaks in poultry were confirmed in Ayutthaya and Pathumthani provinces of Thailand, and Chaohu city in Anhui, China.

In August 2004, avian flu was confirmed in Kampung Pasir, Kelantan, Malaysia. Two chickens were confirmed to be carrying H5N1. As a result Singapore has imposed a ban on the importation of chickens and poultry products. Similarly the EU has imposed a ban on Malaysian poultry products. A cull of all poultry has been ordered by the Malaysian government within a 10km radius of the location of this outbreak. These moves appear to have been successful and since then, Singapore has lifted the ban and Malaysia has requested the OIE declare Malaysian poultry avian influenza free .

An outbreak of avian influenza in January 2005 affected thirty three out of sixty four cities and provinces in Vietnam, leading to the forced killing of nearly 1.2 million poultry. Up to 140 million birds are believed to have died or been killed because of the outbreak.

Vietnam and Thailand have seen several isolated cases where human-to-human transmission of the virus has been suspected. In one case a young girl, who received the disease from a bird, was held by her mother for roughly five days until she died. Shortly afterwards, the mother also died. In March 2005, it was revealed that two nurses who had cared for avian flu patients had tested positive for the disease.

In July 2005, a death in Jakarta was the first confirmed human fatality in Indonesia. The deaths of the man's two children, neither of whom were reported to have had close contact with poultry, further raised concerns of human-to-human transmission (although infection by eating undercooked poultry may be a more likely explanation) [16]. As of July 20, the outbreak had claimed at least fifty eight human lives mostly in Vietnam. What concerns health researchers now is that the virus mortality rate in Vietnam has dropped significantly lately, from more than 65% to about 35% in a year. This might be a sign that the virus is able to infect a larger number of people (i.e., the virus is able to spread more easily) and possibly develop into a global pandemic with millions of deaths despite the lower reported percentage of deaths. For example, the mortality rate of 1918 Spanish flu (H1N1) pandemic was less than 5% . Also, in July 2005, it was confirmed H5N1 had appeared in Russia's Novosibirsk region, probably carried by migratory birds .

On July 28, avian influenza was reported to have killed two more people in Vietnam, raising the death toll to sixty . As of July 2005, most human cases of avian influenza in East Asia have been attributed to consumption of diseased poultry. Person-to-person transmission has not been unequivocally confirmed in the outbreaks in East Asia.

Asia and beyond

Also in early August, an avian outbreak of H5N1 flu was confirmed in Kazakhstan and Mongolia, suggesting further spread of the virus . Later in August, the virus was found in western Russia, marking its appearance in Europe. As a result, Dutch authorities ordered that free-range chickens would have to be kept indoors. EU officials chose not to impose a similar policy on member countries.

Chinese government officials have said more than 1,000 migratory birds have been found dead during 2005.

In late September 2005, the UN health representative responsible for coordinating a response to an outbreak, David Nabarro, stated that a flu pandemic could happen at any time, and kill from five to 150 million people. He further stated that as the virus had spread to migratory birds, an outbreak could start in Africa or the Middle East, rather than southeast Asia as has been widely assumed. At the same time, agricultural ministers of Association of South East Asian Nations announced a three-year plan to counter the spread of the disease.

In early October 2005, Romanian officials quarantined Ceamurlia de Jos, a Danube delta village of about 1,200 people, after three dead ducks there tested positive. However, there have been no immediate reports of sickness in the village. The Agriculture Minister said the virus found in the farm-raised ducks came from migrating birds from Russia. Pending scientific clarification, this is the first time the virus had been detected in Europe. Six villages have been put under quarantine following the deaths of domestic birds and over 6000 birds have been killed.

On 13 October 2005 the EU Health Commissioner Markos Kyprianou confirmed that tests on the dead turkeys found on farms in Kiziksa, Turkey, showed that they had died from the H5N1 strain. Even before the test results were available, some 5,000 birds and poultry have been culled in the area. It is believed that the disease had spread from migratory birds that land at the Manyas bird sanctuary (a few miles from the infected farm) on their way to Africa.

On 14 October 2005, European health officials confirmed what many had long feared -- the arrival of the H5N1 strain on Europe's doorstep. The European Commission said the avian influenza outbreak in Turkey was indeed H5N1, and advised Europe to prepare for a pandemic. It has also been reported in Romania.

On 15 October 2005, the British Veterinary Laboratory in Weybridge confirmed that the virus detected in Ciamurlia, Romania is H5N1.

On 17 October 2005, a avian influenza outbreak occurred in Chios, Greece. The mayor of Chios said a farmer on Oinousses who raised turkeys and chickens noted the previous week that some of his birds had died. Two state veterinarians were sent in to look at nine turkeys. They also took blood samples from some chickens. The mayor said a state lab in Athens confirmed that one of the nine samples proved positive. Authorities have yet to announce what measures they will be taking. The farmer was taken to a hospital for observation.

On 19 October 2005, China announced a fresh outbreak of avian influenza, saying 2,600 birds have died from the disease in Inner Mongolia. The deaths, at a farm near the region's capital of Hohhot, were due to the H5N1 strain, the Xinhua news agency said.

On 21 October/22 October 2005, the British Government announced that a parrot from South America had died in quarantine from H5N1 . Because the parrot died in quarantine, the United Kingdom is still considered free of avian flu. The staff that had been in contact with the parrots were immediately given anti-viral drugs.

On 26 October 2005, Croatia announced H5N1 strain was found in dead swans .

On 31 October 2005, Russia confirmed previously suspected H5N1 avian influenza in ten rural communities across Russia. The confirmed outbreak sites are in the central areas of Tula and Tambov, as well as in the Urals province of Chelyabinsk and in Omsk and Altai, in Siberia.

On 31 October 2005, Canada has discovered a strain of H5 avian flu in wild birds and is now checking whether it is the same H5N1 killer strain which has spread to Europe.

On 11 November 2005, Kuwait has reported positive testing of two birds, one infected with H5N1, and the other with the H5N2 virus, making them the first cases of infection in the Middle East. A flamingo holding the H5N1 virus was found dead by the sea, as the scource reports, it was killed by authorities and did not die from the virus, however, it does not report why it was killed. The second bird, a falcon, was found at the Kuwait airport, holding the H5N2 virus.

On 19 November 2005, Wild birds in Manitoba, Canada have tested positive for a low-pathogenic subtype of the H5N1 avian flu virus.

On Sunday November 20, CTV News reported H5N1 strain was found in a farm in the Fraser Valley area of British Columbia, Canada. The Canadian Food Inspection Agency has ordered a precautionary cull of 65,000 birds.

Pig cases

In February 2004, avian influenza virus was detected in pigs in Vietnam, increasing fears of the emergence of new variant strains. In May 2005, the occurrence of Avian influenza in pigs in Indonesia was reported ("swine flu"). Along with the continuing pattern of virus circulation in poultry, the occurrence in swine raises the level of concern about the possible evolution of the virus into a strain capable of causing a global human influenza pandemic. Health experts say pigs can carry human influenza viruses, which can combine (i.e. exchange homologous genome sub-units by genetic reassortment.) with the avian virus, swap genes and mutate into a form which can pass easily among humans.

Tiger and leopard cases

Variants have been found in leopards and tigers in Thailand, with high lethality.

Human cases