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February 14, 2011

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Update on Influenza A (H5N1) Virus in Japan

February 4

The Oita Prefecture government culled 13,000 chickens at a poultry farm and a meat processing center on February 3rd. Oita is the fifth Japanese prefecture to have confirmed cases caused by the H5N1 virus. The prefecture imposed a ban on the transport of chickens and eggs within a 10-km radius of the farm and conducted on-site inspections at 10 poultry farms within the area. Based on visual examinations, officials did not observe any additional infections, but will wait for the results of blood tests and other exams before deciding if the outbreak has stopped.

Source: Japan Today: http://www.japantoday.com/category/national/view/oita-completes-cull-of-8100-chickens-as-5th-bird-flu-hit-prefecture

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Japan Holds Emergency Meeting on Bird Flu Epidemic

January 30

At an emergency meeting in Tokyo, the Japanese farm ministry urged prefectural officials to make more efforts to control the spread of bird flu. The first outbreak of the H5N1 influenza this season occurred at a Japanese poultry farm in November in the Shimane Prefecture. Since then, further infections have been confirmed at five other farms and a meat processing center, as well as, among wild birds.

There have been five outbreaks of H5N1 influenza this season in the Miyazaki Prefecture in Japan, which has resulted in 96,000 chickens being culled in this prefecture. The highly lethal virus has also been confirmed in chickens at farms in the Aichi and Kagoshima prefectures.

Source: Hindustan Times: http://www.hindustantimes.com/Japan-holds-emergency-meeting-on-bird-flu-epidemic/Article1-656419.aspx

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Northern Hemisphere Countries Show Steady Rise in Flu

January 18

According to the latest World Health Organization (WHO) update, flu activity is increasing in many of the temperate-zone countries of the Northern Hemisphere.

Morocco, Algeria and Tunisia are mostly reporting influenza B. In the Middle East, Iran and Pakistan are mostly reporting 2009 influenza A (H1N1) virus. Flu activity in Mongolia and Northern China has predominantly been H3N2 virus, while South Korea and Japan are reporting that the 2009 H1N1 virus has become the dominant strain. In Western Europe, flu activity has been high, especially in the United Kingdom, France, Portugal, the Netherlands and Denmark, where there have been reports of hospitalizations and deaths from the H1N1 virus and influenza B. The European Centre for Disease Prevention and Control (ECDC) issued a flu surveillance report on January 14, which provided more details on the influenza in the region (See link below).

Further, in the United Kingdom, two patients with the 2009 H1N1 virus have been reported to carry the H275Y substitution, a mutation known to confer resistance to oseltamivir (Tamiflu). Another development is that the Hong Kong's Center for Health Protection has reported that a 3-year-old boy was infected with a "European avian-like H1N1" swine influenza reassortant, which means that this strain has a genetic construct derived from an avian flu virus strain.

Source:
http://www.cidrap.umn.edu/cidrap/content/influenza/swineflu/news/jan1811global.html

ECDC Flu Surveillance:
http://www.ecdc.europa.eu/en/publications/Publications/110114_SUR_Weekly_Influenza_Surveillance_Overview.pdf

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Pandemics in the Age of Twitter: Content Analysis of Tweets during the 2009 H1N1 Influenza Outbreak

January 20

In the context of the high cost of surveys to measure public perceptions in emergencies and the new "infoveillance" methods such as mining, aggregating and analyzing online textual data in real-time, this study evaluated Twitter as a complementary approach for understanding and measuring public attitudes during the 2009 H1N1 pandemic. The study aimed to 1) monitor the use of terms "H1N1" versus "swine flu" over time, 2) conduct a context analysis of "tweets", and 3) validate Twitter as a real-time tracking tool for trends in content, sentiment, and public attention.

The 2009 H1N1 influenza-related tweets were primarily used to disseminate information from reliable sources; thus, 52.6% of tweeted H1N1-related material were from news media. 90.2% of tweets provided references to information that they were providing, allowing others to confirm the trustworthiness of the material. Tweets also provide a source of opinions and experiences. This study demonstrates the potential of using social media to conduct "infodemiology" studies for public health. Tweets can be used for real-time content analysis and knowledge translation research, whose findings could be used by health authorities to respond to public concerns.

Source: Cynthia Chew and Gunther Eysenbach PLoS ONE; 5:11:
http://www.plosone.org/article/info:doi/10.1371/journal.pone.0014118

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United Kingdom's Surge in Flu Could Affect All of Europe

January 7, 2011

An outbreak of the influenza A (H1N1) virus early in the influenza season in the UK could spread to the rest of the European continent. Similar to the 2009 pandemic, this influenza virus primarily affects people under 65 who have previously been healthy with no underlying problems. According to the Great Britain's Royal College of General Practitioners, there were about 99 cases per 100,000 people in the first week of January, a decrease in comparison to December when there were 124 cases per 100,000 people. Swine flu symptoms include fever, muscle aches, a sore throat and diarrhea.

50 people with flu have died, the majority of whom were not vaccinated. Blame is being placed on the British Government for having discontinued its annual flu vaccination campaign. Presently, a vaccine shortage is forcing British authorities to use leftover vaccines from the 2009 swine flu pandemic. European countries such as France and Germany are being encouraged to step up their vaccination programs given that H1N1 appears to be the main virus spreading in Europe.

In the U.S. and Canada, the influenza virus appearing in most cases is H3N2, with H1N1 accounting for only 10 percent of cases.

Source: Associated Press, Maria Chang, January 7, 2011
http://www.washingtonpost.com/wp-dyn/content/article/2011/01/07/AR2011010701809.html?referrer=emailarticle

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World Health Organization Update on Influenza Illness

December 30, 2010

The winter influenza season has begun in the Northern Hemisphere. Parts of the United States and Canada are experiencing increases in influenza-like illness associated primarily with influenza A (H3N2) and type B viruses. In the US, influenza type A viruses account for about 56 percent of virus detections and influenza type B, 44 percent. In contrast, 99 percent of influenza viruses in Canada are type A. The United Kingdom has seen a pronounced increase in both mild and severe cases primarily associated with influenza A (H1N1) virus, which is the 2009 pandemic virus. On the European continent, the Middle East and in northern Asia, rates of influenza-like illness are low, but recent increases have been noted in France, Ireland the Russian Federation, Ukraine, Iran and Mongolia. In the Southern Hemisphere, no significant influenza transmission has been reported.

The majority of the influenza viruses that have been reported throughout the Northern Hemisphere have been antigenically similar to those that constitute the current trivalent influenza vaccine.

Source: World Health Organization (WHO), CSSR Disease Outbreak News
http://www.who.int/csr/disease/influenza/2010_12_30_GIP_surveillance/en/index.html

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Update on Avian Influenza

December 8

In the mail-report of December 8, 2010, ProMed reported cases of H5N1 influenza (Avian influenza) in Indonesia, Nepal, South Korea and Egypt.

In Indonesia, a confirmed human case of H5N1 influenza is being treated in hospital. This case marks the 171st human case of H5N1 virus infection since an outbreak in the country in 2005, and the ninth in 2010.

In Nepal, a commercial poultry farm was identified as being affected with the H5N1 virus but outbreak's etiology so far in unknown. The outbreak began on October 25 and was resolved by October 30.

In South Korea, there is a confirmed case of H5N1 influenza in a wild bird, but at the moment, there are no reports of the virus having spread to the 219 chicken farms and 13 duck farms in the area.

In Egypt, a 30-year-old man who died on December 6 was a suspected case of H5N1 influenza. He was one of five suspected cases of H5N1 influenza undergoing treatment. If confirmed, he will be the 114th human H5N1 influenza case since the first one was recorded in 2006, and is the 24th case in 2010.

Source: ProMED Digest, December 8 2010, vol. 2010, #580.

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Confirmed Case of H5N1 (Avian Flu) Infection in Hong Kong

November 19

On November 17, 2010, the Centre for Health Protection (CHP) confirmed a case of human influenza A (H5N1) infection in a 59-year old woman in Hong Kong. This is the first confirmed case of H5N1 infection since 2003 in Hong Kong. Her symptoms included a runny nose, fever and cough with blood streak sputum. She was placed in intensive care and treated with Tamiflu. Her close contacts had not developed any symptoms at the time of reporting. The source of the infection is not confirmed, but it is possible that it is from either Hong Kong or Mainland China. Before her incubation period, she had traveled to Shanghai, Nanging and Hangzhou in Mainland China; poultry farms and markets are being inspected currently in those locations.

Precautionary measures are in effect in Hong Kong public hospitals, including tests on patients with symptoms of influenza, those have recently returned to Hong Kong from Shanghai, Nanjing and Hangzhou and who have visited markets or had close contact to poultry.

According to the latest update from the World Health Organization, as of October 18, 2010, there were a total of 507 confirmed cases (including 302 deaths) of human infection with the H5N1 virus.

The full articles can be found at:
http://www.chp.gov.hk/files/pdf/cdw_v7_24.pdf
http://www.news.gov.hk/en/categories/health/html/2010/11/20101118_134024.shtml

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