CIDRAP : WHO cites 7th coronavirus case, gives surveillance guidance

From Robert Roos at CIDRAP, please click the link for more information on patient details : 

A third case in a family cluster of novel coronavirus infections has been confirmed, raising the global case count to seven, and the fourth illness in the family is now listed as a probable case, the World Health Organization (WHO) has announced.

In a statement dated yesterday, the WHO also indicated that only one death has been attributed to the novel virus so far, contradicting a Nov 23 announcement that reported two deaths among the first six cases.

The WHO also offered new surveillance recommendations for the novel virus. The agency called for testing of patients in any cluster of severe, unexplained respiratory infections, regardless of location or travel history, and testing of healthcare workers who suffer unexplained pneumonia after caring for patients with severe respiratory infections.

And in a related development, the Saudi Medical Journal reported that the person who had the third known novel coronavirus case is a 45-year-old gym teacher who visited a farm 3 days before he got sick and who survived his severe illness despite having preexisting health problems and only one kidney.

Update on cases

In reporting on cases 3 through 6 on Nov 23, the WHO said two of the confirmed patients belonged to the same family and household in Saudi Arabia and that two more members of the same family were sick, but their cases had not been confirmed. The latest statement said three of the confirmed case-patients and the person with the probable case all belong to the same family.

The statement did not specify whether the family members are thought to have passed the virus to one another or caught it from another source. "The source of the virus is unknown, as is the mode of transmission," the statement says.

The cases occurred in the Jeddha and Riyadh areas of Saudi Arabia, which are bout 850 kilometers apart, and in Doha, Qatar, the WHO noted.

The new announcement notes only one death from the novel coronavirus so far, a change from last week's statement noting two deaths among the first six cases. The WHO did not respond to a query about this point this afternoon."

Malaysia : Woman, 27, dies of H1N1

Via The Star :

" A 27-year-old woman here has become the country's first A(H1N1) influenza-related fatality this year when she succumbed to the virus at the Tuanku Ja'afar Hospital.

The woman, who worked in Singapore, had fallen ill while still in the republic and died just before Hari Raya.

It is learnt that the victim had earlier been asked by her family to return home after she did not recover from fever for several days.

State health director Datuk Dr Zailan Adnan said a post-mortem revealed that she was infected by the virus.

“We have reasons to believe that she may have been infected in the republic. She returned for treatment here but died several days later,” she said.

Those infected will show symptoms such as flu, fever, lethargy, runny nose, cough, sore throat, lack of appetite, vomiting and in some cases, diarrhoea.

Dr Zailan said that despite the woman's death, the people need not panic.

“We have tested her family members and none of them has been infected. The situation is very much under control and it is my hope that no one will spread rumours,” she said.

It is understood that the victim had immediately sought treatment at Tuanku Ja'afar Hospital upon her return from Johor Baru and was prescribed with medication."

Reports from 3 states suggest more variant H3N2 cases

From CIDRAP :

" Reports from three states today suggested an increase in swine-origin H3N2 influenza activity, with one human case confirmed in Hawaii and suspected human cases cited in connection with county fairs in Ohio and Indiana.

The Hawaii Department of Health (DOH) announced yesterday that a case of variant H3N2 (H2N2v) was confirmed in a Maui resident who had possible exposure to pigs.

In Ohio, state officials said preliminary test results pointed to possible H3N2v in 10 people who had contact with swine at the Butler County Fair, north of Cincinnati. Officials were awaiting further test results from the Centers for Disease Control and Prevention (CDC).

And in Indiana—where four cases of H3N2v were reported last week—both people and pigs were being tested in the wake of sickness among pigs in the swine barn at the Monroe County Fair in Bloomington, according to state officials and media reports." 

West Nile virus kills 4 in U.S.

Via Xinhua :

" The U.S. Centers for Disease Control and Prevention (CDC) said Wednesday that 241 cases of West Nile virus disease, including four deaths, have been reported in 42 states so far this year.

This is the highest number of cases reported through the end of July since 2004. Almost 80 percent of the cases have been reported from three states - Texas, Mississippi and Oklahoma.

"It is not clear why we are seeing more activity than in recent years," said Marc Fischer, epidemiologist with CDC's Arboviral Diseases Branch. "Regardless of the reasons for the increase, people should be aware of the West Nile virus activity in their area and take action to protect themselves and their family."

Cambodia starts education campaign, enhanced surveillance for hand, foot and mouth disease

From WHO :

" In response to the outbreak of a severe form of Hand, Foot and Mouth Disease (HFMD), the Ministry of Health (MOH) has instructed all public health facilities to report mild and severe cases of HFMD among children.

Mild cases present with fever and blisters on the hands, feet and/or mouth. Such cases may be managed at home or at health centers or health posts. Most of these cases recover within 7-10 days. However, some children develop a severe disease characterized by fever with neurologic symptoms (such as vomiting, somnolence, convulsions or spasms) or respiratory symptoms (fast breathing or difficulty in breathing). These children have to be referred to hospitals for treatment.

"Children with any of the following signs: very high fever, vomiting, convulsions, spasms or difficulty breathing must be immediately brought to a hospital for diagnosis and treatment," Minister of Health H. E. Mam Bunheng advised parents.

Frequent washing of hands with soap and water, especially after touching any blisters or sores, before preparing food and eating, before feeding young infants, after using toilets and after cleaning children is encouraged.

The Ministry of Health, in collaboration with UNICEF and WHO, is developing information and educational materials to inform the general public about the disease.

The investigation into the recently reported illnesses and deaths in Cambodia concluded that a severe form of hand, foot and mouth disease caused by enterovirus 71 (EV-71) was the cause in majority of the cases reported to the Ministry of Health.

Based on the investigation, a total of 78 cases were identified. These included the initial 62 cases reported by the Kantha Bopha hospital, and cases reported from other hospitals. Of these, the investigation focused on 61 cases that fitted the criteria used (the case definition).

The latest follow-up on these 61 cases indicate that 56 died and three recovered.

During the past week, 533 HFMD cases have been reported to the MOH from 17 of the 24 provinces and there have been nine confirmed cases of severe EV71 infection. Of the nine cases, three died, one recovered, five are still sick."

Malaysia : Miri, Sibu on cholera watch list

Via NST :

" THIRTY-TWO new cases were detected on Saturday bringing the total number of people infected with cholera in Bintulu to 232.

However, Assistant Minister for Public Health Dr Jerip Susil said the outbreak was "under control and contained".

He also declared the popular Ramadan bazaar there as "clean" as all the stall owners and their workers had been tested and found to be free of the cholera bacteria.

Health authorities are keeping a surveillance on the larger nearby towns of Miri and Sibu for fear the infection could spread there.

"We are keeping a close watch. So far from the reports that we got, the outbreak is well contained and there were no reports of cases elsewhere in the state," he said yesterday.

The number of people still in Bintulu hospital on Saturday was 41 while another eight were kept in isolation at the National Service training camp in Similajau, a few kilometres outside Bintulu town which had been temporarily turned into a special quarantine centre.

The camp is currently empty as the NS programme is on a break.

On the Ramadan bazaar, he said when the outbreak was reported this month, one of their priorities was to ensure the bazaar was not affected.

"We made all the stall owners and their workers undergo mandatory screening for the cholera bacteria.

"Tests on the samples and swabs taken showed all were negative. None were carrying the cholera bacteria."
He said the stall owners and their workers had to wear special tags to show their customers that they were "clean".

The tags are similar to the ones worn by frontline service staff at the height of the bird flu infection, declaring they had no flu or fever."

New Zealand : Influenza rates in Canterbury soar

Via Stuff :

 " Influenza rates in Canterbury have soared in the past week and are now above the national average. A handful of swine flu cases have also been reported. The national average stands at about 20 cases per 100,000 people.

 Last week, the Canterbury average jumped to 50 cases per 100,000. Canterbury District Health Board planning and funding general manager Carolyn Gullery said the number of people suffering from influenza had increased in the past week. ''We had been tracking below the national average, but now we've gone above it, which is not a good sign for us,'' she said.

 ''It's definitely causing concern and we'll be monitoring it closely over the coming weeks.'' The board would continue to encourage people to have flu vaccinations, she said, but immunisation rates were below last year's levels. ''There's been less take-up with the under-18 age group,'' she said. ''Last year was really good, but this year hasn't been a repeat of that."

Concern grows over swine flu outbreak in Bolivia

Article via Channel News Asia :

 " An epidemic of swine flu has infected almost 900 people and claimed 11 lives in Bolivia, health officials said Tuesday. Although most of the cases occurred in the last few weeks, the outbreak does not rise to the level of a national epidemic, officials said.

 "At the national level, the situation is under control. The most affected area is in the west," Johnny Rada, director of the ministry of health's epidemiology service, told AFP. According to official tallies, 873 cases have been reported across the country, of which 606 are in the western department of La Paz and 60 in the department just south of it, Oruro.

 There have also been 167 cases reported in the large eastern department of Santa Cruz, and 36 in central Cochabamba department. A health alert has been issued for La Paz and Oruro, which, according to Rada, will permit health workers to intensify preventative measures.

 Deputy Health Minister Martin Maturano also urged Bolivians to take precautions, such as eating well and frequently washing their hands. Bolivian authorities have not said whether the strain of the virus originated as swine or avian flu -- in other words whether it first spread to humans from pigs or birds."

Unknown disease kills 60 Cambodian kids in 3 months

Article via The Star :

 " The World Health Organization (WHO) said on Wednesday that an unidentified disease has killed 60 Cambodian children within the last three months and the agency is working with Cambodian health ministry to investigate the cause.

 According to the WHO, the symptoms of the disease include high fever and neurological involvement or respiratory difficulty.

 So far, 61 cases of the disease were reported, all under seven years old. Only one patient has survived the disease.

 "WHO is working with the Ministry of Health to conduct an investigation. At this point in time, little information is available, as the investigation is still ongoing," said Dr Pieter van Maaren, representative of WHO-Cambodia, in an e-mail to China's Xinhua news agency.

 Cambodian Minister of Health Mam Bunheng told Xinhua on Wednesday that his officials and WHO officials have been working closely to identify the disease and way of disease spread."

Malaysia : Sixty-six others with H1N1-like symptoms quarantined at training camp

Article via The Star :

" Four National Service trainees remained warded at the Kuala Nerang Hospital for Influenza A (H1N1) illness.

Sixty-six others were quarantined at the Dusun Minda NS Training Camp in Kuala Nerang after they, too, displayed H1N1-like symptoms, said Kedah Health Department director Dr Ismail Abu Taat. 

He said the four warded at the hospital were females while those quarantined at the camp comprised 45 boys and 21 girls.

“All of them are in stable condition. The camp has taken extra precautionary measures to prevent the illness from spreading,” he said yesterday.

Last week, 90 trainees at the camp came down with the illness after they complained of flu and cough.

The camp has not been closed, although trainees and instructors have been advised to keep the premises clean and wear face masks."

Malaysia : 96 NS trainees quarantined for H1N1 infection

Article via The Star, in the state of Kedah, up north in Malaysia :

" KUALA NERANG: Some 96 of 300 National Service (NS) trainees at Kem Dusun Resort near here have been quarantined for H1N1 infection since Wednesday night. NS Training Department director-general Datuk Abdul Hadi Awang Kechil said 18 trainees were being treated and quarantined at Kuala Nerang Hospital while 78 more were quarantined in a special block in the camp.

"The Health Department is monitoring the cases and preventive measures have been taken to stop the virus from spreading," he said when contacted Thursday. The camp management has also complied with procedures set by the Health Department and several health staff have been stationed in the camp.

"At the moment, all the trainees and staff are not allowed to leave camp until further notice." Abdul Hadi advised parents not to visit the trainees, adding that contact was only allowed when necessary.

"If they need to meet with the trainees, parents can come but they must wear masks. They need not worry as preventive measures are taken in camp."

All the trainees involved are from Group 2, 2012."

Australia : Record number contract melioidosis in NT

Article via 9 News, excerpt :

" A record 97 people have contracted a potentially fatal bacterial disease in the Northern Territory this wet season, health authorities say.

Acting director of the Centre for Disease Control in the Territory, Steven Skov said there had been 97 cases of melioidosis locally this wet season, resulting in nine deaths.

Dr Skov said the figure was a record number of cases, although not a record number of deaths, which has dropped in recent years due to better treatments and awareness of the disease.

The soil-borne disease is thought to lie dormant in the ground for most of the year, but comes to the surface when there is heavy rain during the wet season.

Those at risk of catching melioidosis include gardeners who come into close contact with soil and people with compromised immune systems.

During the past three years there has been a spike in the number of cases, which researchers had put down to strong wet seasons."

Israel : After years of calm, measles cases spike in northern Israel

Via Haaretz :

" Israel's Health Ministry reports increase of cases after four year period of relative calm; spike partly attributed to families refusing to be vaccinated.

There has been a significant increase in cases of the measles in northern Israel, according to recent research carried out by Israel's Health Ministry.

The study by the ministry's epidemiology department found 96 cases of measles by the end of May 2012, compared to only four cases of the disease in the same period in 2011, 14 in 2010, and two in 2009.

Some 63 of the cases this year – 65 percent - were reported in the north, while 20 percent were in Tel Aviv – some 20 percent - eight cases in the center of the country, four in Haifa, one in Jerusalem, and one in southern Israel.

The reported increase comes after four years of calm. In contrast to the previous country-wide outbreak, the current spike is concentrated in northern Israeli towns where vaccination rates stand at less than 90 percent, among refugees communities in Tel Aviv, and especially among babies who not yet one-year-old - the minimum vaccination age in Israel.

In light of the outbreak, the Health Ministry is now completing immunization programs among populations that refused to be vaccinated in the past, most of which are from small towns in the north. Family members of those suffering from measles are also eligible for preventative vaccination.

A large part of those who refuse to be vaccinated do so on ideological grounds, also citing possible side effects and exposure to toxins."

Australia : Two horses, dog in Queensland test positive to Hendra virus

Via The Australian :

" TWO horses and a dog have have tested positive to the Hendra virus on Queensland properties quarantined with the deadly disease.   

Authorities last week announced two horses had died of Hendra on properties near Rockhampton and at Ingham.

A dog on the Ingham property and two horses on the Rockhampton property tested positive in results returned on Monday night, Agriculture Minister John McVeigh says.

There has only been one other reported case of Hendra infecting a dog.

The dog had returned a weak positive test, Mr McVeigh said.

"Hendra officers have taken steps to isolate the animals and the properties will remain quarantined," he told parliament on Tuesday.

Chief veterinary officer Rick Symons will hold a media conference in Brisbane at 11am (AEST).

Since the start of 2011 there have been 13 Hendra outbreaks in Queensland, resulting in the deaths or euthanasia of 16 horses and one dog."

Philippines : Dengue cases in Zambo City reach 1,053; 14 dead

Article via PIA :

" The City Health Office revealed that dengue cases in the city is now at 1,053 with 14 fatalities.

City Health Officer Dr. Rodelin Agbulos again called on the public to continue intensified clean up drives to put a halt to the increasing number of dengue cases.

“Efforts have to be doubled or tripled in order to bring down the number of cases being registered in the hospitals and clinics. We appeal to the public to continue the campaign to search and destroy breeding places of dengue and help reduce the number of dengue incidents,” Agbulos stressed.

Agbulos said outbreak level remains in Zamboanga with the recent figure. He said the outbreak declaration cannot be lifted as of the moment. He also added that they have deployed teams in the different barangays in the city everyday to continue with the anti-dengue campaign. Medical teams, to include doctors in the different sub-districts of the city, are also advised to intensify their monitoring activities in their area."

Bangladesh : Poultry vaccination plan triggers shock

Via BD News 24 :

" The government's move to vaccinate poultry against frequently changing avian influenza virus has 'surprised' experts because globally it is recommended not to use it for public health's sake.

Experts say the available vaccines in the world have been able to reduce poultry fatalities for some time, but the vaccinated birds' capabilities to transmit the disease 'silently' after being infected caused 'massive' human mortalities.

Indonesia, Egypt and Vietnam had been vaccinating poultries but stopped after an influx of human fatalities last year followed when the virus also changed its strain.

Fisheries and Livestock Minister Abdul Latif Biswas on Sunday told journalists that considering poultry farmers' 'long-standing demand' the government planned to 'experimentally' introduce the vaccine.

He said a committee had been formed to finalise the decision to that end.

The Food and Agriculture Organisation (FAO) and the World Health Organisation (WHO) experts say they are 'surprised' by the move.

Mat Yamage, Chief Technical Adviser to the FAO Avian Influenza Control Programme, told bdnews24.com that earlier they 'warned' the government against using vaccines.

He said the situation where the vaccine once used was 'serious' and that 'there is no record of successfully controlling H5N1 with vaccines'.

"We would strongly say it should be discussed with technical experts."

Globally, it is recommended that poultry farms maintain bio-security to prevent the virus and government have measures for early reporting, rapid action, culling and surveillance to control avian influenza outbreaks."

Nepal : Dengue detected in duo in Chitwan

Article via The Himalayan Times :

" Dengue fever, which is communicated from mosquito bite, has been detected on two patients in Chitwan district.

One dengue patient was found at Bharatpur Hospital and another at Chitwan Medical College. The dengue patient found at Bharatpur Hospital is undergoing treatment, said senior doctor Bijay Paudel.

Dr. Arun Sedhain said the dengue patient was found at the Chitwan Medical College on the third week of April.

He said the patient is under the care of the Hospital.

It is said that number of patients suffering from fever is increasing at the Chitwan Hospital with sudden rise of temperature and mosquito bites."

Singapore : Dengue outbreak in Ang Mo Kio Avenues 5 and 10

Article via Straits Times :

" Two areas in Ang Mo Kio have been hit with a spate of dengue fever.

Since April 12, 53 people living in Ang Mo Kio Avenues 5 and 10 have caught the viral disease. The cases are from 19 housing blocks in the area.

A National Environment Agency (NEA) spokesman said the outbreak was the largest so far this year.
A dengue cluster is formed when there are two or more dengue cases in an area within two weeks."

India : Encephalitis kills 15 kids in Bihar

Article via Two Circles :

" Suspected encephalitis has killed 15 children in Bihar's Muzaffarpur and Gaya districts in the last week, officials said Saturday. The mosquito-borne disease, which claimed nearly 150 lives last year, has returned with a vengeance.

Eleven children have died in Muzaffarpur and four in Gaya. Over two dozen children have been admitted to hospitals in both places. According to officials, 24 children have been admitted for treatment in hospitals in Muzaffarpur, about 70 km from here.

Muzaffarpur civil surgeon Gayan Bhusan said the children died after contracting high fever followed by convulsions."

India : Dengue claims two more in Tirunelveli

Via Times of India :

 " TIRUNELVELI: Two more persons, including a six-year-old child, fell victim to dengue in Tirunelveli on Saturday as the illness threatens to assume epidemic proportions. According to health officials, the number of persons who have died due to dengue in Kadayanallur and adjoining rural areas in the southern district has risen to 10 with these two deaths since April.

The two deceased were identified as Sharmila (6) daughter of Kumaresan of Udayampuli near Mukkoodal, about 40 kilometres from Kadayanallur, the epicentre of the outbreak and Hassan Mohideen (58) of Vadakarai near Alangulam. The two were admitted in the government hospital at Tirunelveli since May 10. "We did our best to save them.

 But they were brought to the government hospital after the illness turned severe. They had taken treatment in private hospitals before coming to the GH. If they had come earlier, they would have been saved,'' said deputy director (health) Meeran Mohideen. Now as many as 110 persons belonging to all age groups from various villages in Kadayanallur region are undergoing treatment at the government hospital for dengue. A battery of health officials have plunged into action soon after the outbreak was reported last month.

Besides state health officials, experts from the Vector Control Research Centre, Pondicherry have landed in Tirunelveli to study the unusual outbreak of the disease in summer, as dengue is usually reported only during winter. The dengue outbreak was reported from Kadayanallur region way back in 2009 when a number of deaths were reported. This year, in April, three persons died sparking fear of dengue though officials were on a denial mode initially. Later they admitted that the cause of death was dengue and sprang into action."

Leptospirosis in Peru

Via CDC, excerpt :

" What Is the Current Situation? 

Flooding has caused an outbreak of leptospirosis in Peru, especially in the Loreto region. This is the worst flooding seen in this area for over 20 years. Peru has reported more than 300 cases and 3 deaths associated with leptospirosis thus far in 2012. Health authorities have alerted people to take precautions against the infection.

What Is Leptospirosis? 

Leptospirosis is a disease that is spread by animal urine. People become infected with the disease when they come in contact with body fluids of infected animals or in contact with water, soil, or food contaminated with infected urine. Leptospirosis is a hazard for many people who work outdoors or with animals. The disease has also been associated with swimming, wading, kayaking, and rafting in contaminated lakes and rivers. Symptoms include high fever, headache, chills, muscle aches, vomiting, jaundice (yellow eyes and skin), red eyes, abdominal pain, diarrhea, and rash. Some people do not experience symptoms. This disease can cause kidney or liver failure and/or meningitis (swelling of the tissue covering the brain). Without treatment, recovery can take several months. Leptospirosis occurs throughout the world, especially in regions with flooding. Leptospirosis occurs more often in tropical areas. Urban areas lacking sanitation may also have a higher risk of leptospirosis."

Dengue fever kills 14 Cambodian children in 1st four months

Via Xinhua :

 " Cambodia reported 2,277 dengue fever cases, killing 14 children in the first four months of 2012, Dr. Char Meng Chuor, director of the National Center for Parasitology, Entomology and Malaria Control, said Sunday.

During the four months this year, the infection cases of the disease had increased by 369 percent if compared to the same period last year, he said.

 "It's a concern for us," he said, appealing to people to sleep in mosquito nets and keep clean environment around their houses. "To prevent the disease, it's required to kill larvae by using Abate and by filling in puddles around houses, which are sources of mosquitoes," he said.

 About 270 tones of Abate (a chemical substance used to kill larvae in water pots) will be distributed free of charge to households this year, he added."

South Africa : HPAI Outbreak Discovered in Western Cape Province

Via Xinhua :

" The South African veterinary authorities have discovered another outbreak of highly pathogenic avian influenza at a commercial ostrich farm located in Western Cape Province.

The World Organisation for Animal Health (OIE) received Follow-up Report No. 11 yesterday, 9 May. A total of 310 ostriches were found susceptible, out of which 98 cases were identified.

No deaths were reported, and no birds were destroyed. Initially, no clinical signs or mortalities were seen. Stamping out of ostriches on positive farm is taking place. The presence of the H5N2 sub-type of the HPAI virus has been confirmed. The source of the outbreak remains inconclusive."

Indonesia : Riau boy: 157th bird flu fatality Indonesia : Riau boy - 157th bird flu fatality

Via The Jakarta Post :

" A two-year old boy, identified only as MAF, died from bird flu last Friday in a state hospital in Riau, the Health Ministry has confirmed.

A ministry team has investigated the boy’s neighborhood and found that he may have had contact with quails’ eggs because his parents sold them, the ministry’s directorate general for disease control and environmental health said in a press statement released on Tuesday night.

The boy, a resident of Siak in Pekanbaru, was brought to a private clinic on April 20 after developing a fever on April 17, the statement said.

He was then rushed to a private hospital on the night of April 20 because his condition had not improved, it said.

On April 21, he was treated in another hospital identified only as EB, where doctors reported the case to the Riau Health Agency’s post command. He was referred to a state hospital, identified only as AA.

“[The boy’s] condition deteriorated and he died on April 27 at 11:45 p.m. at Hospital AA,” the statement said.
The total number of bird flu cases since 2005 now stands at 189, with 157 fatalities after the latest case.

Director general Dr. Tjandra Yoga Aditama has reported the latest case to the World Health Organization, the statement said."

Indonesia : Bali Boy Dies From Bird Flu

Via The Jakarta Post :

" An eight-year-old boy died from bird flu in a Bali hospital on Tuesday night. The boy, Ni Putu Purnami, was in critical condition when he was transferred from Bangli Hospital to Sanglah Hospital on Tuesday afternoon and he was immediately isolated.

“Clinically, and supported by the VCR (Visual Convention Reaction) laboratory result, the victim was positively infected with the H5N1 virus,” said Sanglah Hospital spokesman Ida Bagus Ken Wirasandi on Wednesday.

Putu died at 10:15 p.m. after four hours at the hospital. Ken said Putu’s family told him the victim was in contact with dead poultry two months ago.

The Bali Health Agency head Ketut Suarjaya said that seven people on Bali have died since the virus first reached the island in 2007. “In 2011, 46 patients were suspected to have of avian flu [in Bali],” Suarjaya said."

Hong Kong : Two linked imported cases of dengue fever investigated

Press release from Hong Kong's Centre for Health Protection :

" The Centre for Health Protection (CHP) of the Department of Health is investigating two imported and related cases of dengue fever and has urged people to guard against the disease. The first patient is a 24-year-old woman who developed headache, myalgia and rash since April 9.

The second patient is a 25-year-old man who developed similar symptoms as well as fever, arthralgia and retro-orbital pain on the same day. They sought medical consultation at a private hospital and a general out-patient clinic respectively but no hospitalisation was required.

The pair is now in stable condition. The woman's blood sample tested positive for the dengue virus while that of the man tested positive for dengue IgM. The CHP's investigation revealed that the two patients had travelled together to Bali, Indonesia, from April 4 to 8, where both were bitten by mosquitoes.

The CHP will continue to follow up on the cases. There have been 18 confirmed cases of dengue fever in 2012, and they were all imported. Last year 30 cases of imported dengue fever were reported to the CHP, with no local cases."

Vietnam reports 4th bird flu infection

Article via Thanh Nien News :

" Vietnam’s fourth bird flu (H5N1) patient of the year, and the first in the Central Highlands region, is being treated at the Hospital for Tropical Diseases in Ho Chi Minh City, the hospital’s deputy director Le Manh Hung told Thanh Nien Wednesday.

The 32-year-old male patient, known as N.D.T, from Dak Lak Province, was admitted to the hospital on Monday with high fever, fatigue and respiratory problems. He was put on a breathing machine and kept in quarantine. His family said they had previously slaughtered and eatend a sick home-raised chicken more than 10 days ago.

T. then developed a cough and high fever. The chicken's flock also died, the family said. T. was treated with medicine at home for the first three days after falling sick. After being admitted to Dak Lak Hospital, his condition did not improve.

 He was then transferred to the Hospital for Tropical Diseases where tests showed he was positive with the H5N1 virus Vietnam has so far this year reported four bird flu infections, two of which are fatal, after 20 months’ absence."

Bhutan Reports Another HPAI Outbreak

Via The Poultry Site :

 " The Bhutanese veterinary authorities have reported another outbreak of highly pathogenic avian influenza at two villages in Mongar.

The World Organisation for Animal Health (OIE) received Follow-up Report No. 6 on Friday, 20 April. The outbreak has affected backyard free-ranging chicken in two villages, Yangbari and Patong. Out of 265 susceptible chickens, 70 cases were reported.

The 70 chickens were reported dead. One carcass tested positive to real-time PCR on 5 April. However, subsequently 16 samples from the affected and nearby villages tested negative to H5N1.

 Clinical and laboratory surveillance within a 3-km-radius showed no new cases. Therefore, at this stage, this could be a suspected H5N1 outbreak. The source of the outbreak remains inconclusive."

3 test positive for avian flu in Taiwan

Via Channel News Asia :

" Three poultry farm workers have been tested positive for the H5N2 avian influenza strain but none have displayed flu symptoms, Taiwan's disease control authorities said.

They were among 141 people working at five poultry farms where the avian flu was discovered.

Tens of thousands of chickens in the farms have been culled since the outbreak of H5N2 in the past few months.

Medical experts believe the test results may well be a cross-reactivity since all the three persons had flu jabs last year, Xinhua news agency reported.

Cases of humans who tested positive for H5N2 while showing no health disorders were previously reported in South Africa and Japan between 1993 to 1995.

Taiwan authorities confirmed the outbreak of H5N2 following sporadic reports in farms in central Taiwan.

The flu has so far affected chicken farms in Changhua, Tainan and Nantou."

India : Punjab records first swine flu death

Via Times of India :

" The deadly swine flu is back in Punjab, with the state reporting the season's first fatality due to the disease, sending the state health department -- that grappled with more than 300 such cases over the last two years -- into a tizzy.

Vijay Kumar, 35, resident of Nangal -- a town located on the banks of the country's biggest dam Bhakra Nangal -died in Ludhiana on Friday evening. Kumar, who died at Dayanand Medical College and Hospital (DMCH) was one of the two patients from the state, who had tested H1N1 positive earlier this month.

"The patient's blood sample showed high level of infection which usually happens in this flu, if not reported on time. By the time he was here, he had septicemia -- a bacteria that occurs with infections, resulting in a cardiac arrest," Dr Rajesh Mahajan, professor of medicine at DMCH, told TOI.

Lack of isolation wards, bed facilities and ventilators at district hospitals in Punjab have been a cause of concern. Between 2009 and 2010, there were 252 people in Punjab who tested positive for the flu, leaving 73 of them dead due to delay in treatment. A woefully small number of central government laboratories with facilities to test throat swabs for swine flu has already hampered the early treatment of patients."