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A Highly Pathogenic #Avian #H7N9 #Influenza Virus Isolated from A #Human Is Lethal in Some #Ferrets Infected via #Respiratory #Droplets (Cell Host Microbe, abstract)

Title : A Highly Pathogenic #Avian #H7N9 #Influenza Virus Isolated from A #Human Is Lethal in Some #Ferrets Infected via #Respiratory #Drop...

15 Dec 2017

Highly pathogenic #avian #influenza #H5N8, #SouthAfrica [a #poultry #outbreak] (#OIE, Dec. 15 ‘17)


Title: Highly pathogenic #avian #influenza #H5N8, #SouthAfrica [a #poultry #outbreak].

Subject: Avian Influenza, H5N8 subtype, poultry epizootics in South Africa.

Source: OIE, full page: (LINK).

Code: [     ]

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Highly pathogenic avian influenza H5N8, South Africa

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Information received on 15/12/2017 from Dr Bothle Michael Modisane, Chief Director , Department of Agriculture, Forestry and Fisheries, Animal Production and Health, PRETORIA, South Africa

  • Summary
    • Report type    Follow-up report No. 21
    • Date of start of the event    19/06/2017
    • Date of confirmation of the event    22/06/2017
    • Report date    15/12/2017
    • Date submitted to OIE    15/12/2017
    • Reason for notification    New strain of a listed disease in the country
    • Causal agent    Highly pathogenic avian influenza virus
    • Serotype    H5N8
    • Nature of diagnosis    Clinical, Laboratory (advanced)
    • This event pertains to    a defined zone within the country
  • Summary of outbreaks   
    • Total outbreaks: 1
      • Total animals affected: Species    - Susceptible    - Cases    - Deaths    - Killed and disposed of – Slaughtered
        • Birds    - 1260    - 2    - 0    - 0    - 0
      • Outbreak statistics: Species    - Apparent morbidity rate    - Apparent mortality rate    - Apparent case fatality rate    - Proportion susceptible animals lost*
        • Birds    - 0.16%    - 0.00%    - 0.00%    - 0.00%
          • *Removed from the susceptible population through death, destruction and/or slaughter
  • Epidemiology
    • Source of the outbreak(s) or origin of infection   
      • Unknown or inconclusive
  • Epidemiological comments   
    • Coordinates modified to protect confidentiality as required by South African Legislation.

(...)

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Keywords: OIE; Updates; Avian Influenza; H5N8 ; Poultry; South Africa.

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Weekly #US #Influenza #Surveillance #Report - 2017-18 Season, Wk 49 ending Dec. 9 ‘17 (@CDCgov, summary)


Title: Weekly #US #Influenza #Surveillance #Report - 2017-18 Season, Wk 49 ending Dec. 9 ‘17.

Subject:  Human Influenza Viruses, A & B types, current epidemiological situation.

Source: US Centers for Disease Control and Prevention (CDC), FluView, full page: (LINK). Summary, edited.

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Weekly U.S. Influenza Surveillance Report - 2017-2018 Influenza Season Week 49 ending December 9, 2017

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Language: [ English (US)Español ]

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All data are preliminary and may change as more reports are received.


Synopsis

    • During week 49 (December 3-9, 2017), influenza activity increased in the United States.
  • Viral Surveillance:
    • The most frequently identified influenza virus type reported by public health laboratories during week 49 was influenza A.
    • The percentage of respiratory specimens testing positive for influenza in clinical laboratories increased.
  • Novel Influenza A Virus:
    • One human infection with a novel influenza A virus was reported.
  • Pneumonia and Influenza Mortality:
    • The proportion of deaths attributed to pneumonia and influenza (P&I) was below the system-specific epidemic threshold in the National Center for Health Statistics (NCHS) Mortality Surveillance System.
  • Influenza-associated Pediatric Deaths:
    • One influenza-associated pediatric death was reported.
  • Influenza-associated Hospitalizations:
    • A cumulative rate of 4.3 laboratory-confirmed influenza-associated hospitalizations per 100,000 population was reported.
  • Outpatient Illness Surveillance:
    • The proportion of outpatient visits for influenza-like illness (ILI) was 2.7%, which is above the national baseline of 2.2%.
    • Seven of the 10 regions reported ILI at or above region-specific baseline levels.
    • Four states experienced high ILI activity; five states experienced moderate ILI activity; New York City, Puerto Rico, and 16 states experienced low ILI activity; 25 states experienced minimal ILI activity; and the District of Columbia had insufficient data.
  • Geographic Spread of Influenza:
    • The geographic spread of influenza in 12 states was reported as widespread; Puerto Rico and 26 states reported regional activity; 10 states reported local activity; the District of Columbia, the U.S. Virgin Islands and two states reported sporadic activity; and Guam did not report.

(…)

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Keywords: US CDC; USA; Updates; Seasonal Influenza.

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#USA reported one additional case of #human #infection with #influenza #H3N2v virus (@CDCgov, Dec. 15 ‘17)


Title: #USA reported one additional case of #human #infection with #influenza #H3N2v virus.

Subject: Influenza A of Swine Origin, H3N2v subtype, human case.

Source: US Centers for Disease Control and Prevention (CDC), full page: (LINK). Extract, edited.]

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Novel Influenza A Virus

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One human infection with a novel influenza A virus was reported by Iowa during week 49. This person was infected with an influenza A(H3N2) variant [A(H3N2)v] virus and reported direct contact with swine during the week preceding illness onset.

The patient was an adult < 50 years of age, was not hospitalized, and has fully recovered from their illness.

No human-to-human transmission has been identified.

A total of 67 variant virus infections have been reported to CDC during 2017.

Sixty-two of these have been A(H3N2)v viruses (Delaware [1], Iowa [1], Maryland [39], Michigan [2], Nebraska [1], North Dakota [1], Ohio [15], Pennsylvania [1], and Texas [1]), one was an influenza A(H1N1) variant [A(H1N1)v] (Iowa [1]) virus, and four were influenza A(H1N2) variant [A(H1N2)v] viruses (Colorado [1] and Ohio [3]).

Six of these 67 infections resulted in hospitalization; all patients have recovered.

Early identification and investigation of human infections with novel influenza A viruses are critical so that the risk of infection can be more fully understood and appropriate public health measures can be taken.

Additional information on influenza in swine, variant influenza infection in humans, and strategies to interact safely with swine can be found at http://www.cdc.gov/flu/swineflu/index.htm. .

(…)

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Keywords: US CDC; USA; Updates; Swine Influenza; H3N2v; Human.

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#Review of #global #influenza #activity, October 2016– October 2017 (@WHO, Dec. 15 ‘17)


Title: #Review of #global #influenza #activity, October 2016– October 2017.

Subject: Human Influenza Viruses, A & B types, global activity report.

Source: World Health Organization (WHO), Weekly Epidemiological Record (WER), full PDF file: (LINK).

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Keywords: WHO; Worldwide; Updates; Influenza A; Influenza B; H1N1pdm09; H3N2.

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Highly pathogenic #avian #influenza #H5N6, #Netherlands [infected #wildbirds] (#OIE, Dec. 15 ‘17)


Title: Highly pathogenic #avian #influenza #H5N6, #Netherlands [infected #wildbirds].

Subject: Avian Influenza, H5N6 subtype, wild birds epizootics in Netherlands.

Source: OIE, full page: (LINK).

Code: [     ]

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Highly pathogenic influenza A viruses (infection with) (non-poultry including wild birds) H5N6, Netherlands

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Information received on 15/12/2017 from Dr Christianne Bruschke, Chief Veterinary Officer , Ministry of Economic Affairs, Ministry of Economic Affairs, The Hague, Netherlands

  • Summary
    • Report type    Immediate notification
    • Date of start of the event    09/12/2017
    • Date of confirmation of the event    13/12/2017
    • Report date    15/12/2017
    • Date submitted to OIE    15/12/2017
    • Reason for notification    Recurrence of a listed disease
    • Date of previous occurrence    16/05/2017
    • Manifestation of disease    Clinical disease
    • Causal agent    Highly pathogenic influenza A virus
    • Serotype    H5N6
    • Nature of diagnosis    Clinical, Laboratory (advanced)
    • This event pertains to    a defined zone within the country
  • New outbreaks (2)
    • Outbreak 1 (HPAI WB H5N6 2017-01)    - Elburg, GELDERLAND
      • Date of start of the outbreak    09/12/2017
      • Outbreak status    Continuing (or date resolved not provided)
      • Epidemiological unit    Village
      • Affected animals: Species    - Susceptible    - Cases    - Deaths    - Killed and disposed of – Slaughtered
        • Mute Swan:Cygnus olor(Anatidae)  - … – 1    - 1    - 0    - 0
    • Outbreak 2 (HPAI WB H5N6 2017-02)    - Hulshorst, GELDERLAND
      • Date of start of the outbreak    09/12/2017
      • Outbreak status    Continuing (or date resolved not provided)
      • Epidemiological unit    Village
      • Affected animals: Species    - Susceptible    - Cases    - Deaths    - Killed and disposed of – Slaughtered
        • Mute Swan:Cygnus olor(Anatidae) – … – 6    - 6    - 0    - 0
  • Summary of outbreaks   
    • Total outbreaks: 2
      • Total animals affected: Species    - Susceptible    - Cases    - Deaths    - Killed and disposed of – Slaughtered
        • Mute Swan:Cygnus olor(Anatidae)  - … – 7    - 7    - 0    - 0
      • Outbreak statistics: Species    - Apparent morbidity rate    - Apparent mortality rate    - Apparent case fatality rate    - Proportion susceptible animals lost*
        • Mute Swan:Cygnus olor(Anatidae)    - **    - **    - 100.00%    - **
          • *Removed from the susceptible population through death, destruction and/or slaughter
          • **Not calculated because of missing information
  • Epidemiology
    • Source of the outbreak(s) or origin of infection   
      • Unknown or inconclusive
  • Epidemiological comments   
    • H5N6 was confirmed in 7 Cygnus olor found in wetland areas near Elburg and Hulshorst.
    • Subtype H5N6 is a reassortment linked to H5N8, it is not the Asian zoonotic H5N6.
  • Control measures
    • Measures applied   
      • Vaccination permitted (if a vaccine exists)
      • No treatment of affected animals
    • Measures to be applied   
      • No other measures
  • Diagnostic test results
    • Laboratory name and type    - Species    - Test    - Test date    - Result
      • Wageningen Bioveterinary Research, Lelystad (National laboratory)    - Mute Swan    - polymerase chain reaction (PCR)    - 13/12/2017    - Positive
  • Future Reporting
    • The event is continuing. Weekly follow-up reports will be submitted.

(...)

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Keywords: OIE; Updates; Avian Influenza; H5N6 ; Wild Birds; Netherlands.

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Highly pathogenic #avian #influenza #H5N6, #Korea (Rep. of) [a #poultry #outbreak] (#OIE, Dec. 15 ‘17)


Title: Highly pathogenic #avian #influenza #H5N6, #Korea (Rep. of) [a #poultry #outbreak].

Subject: Avian Influenza, H5N6 subtype, poultry epizootics in .

Source: OIE, full page: (LINK).

Code: [     ]

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Highly pathogenic avian influenza H5N6, Korea (Rep. of)

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Information received on 12/12/2017 from Dr Oh Soon-Min, Director General - Chief Veterinary Officer, Animal Health Policy Bureau, Ministry of Agriculture, Food and Rural Affairs (MAFRA), SEJONG-SI, Korea (Rep. of)

  • Summary
    • Report type     Follow-up report No. 1
    • Date of start of the event     17/11/2017
    • Date of confirmation of the event     19/11/2017
    • Report date     12/12/2017
    • Date submitted to OIE     12/12/2017
    • Reason for notification     Recurrence of a listed disease
    • Date of previous occurrence     13/10/2017
    • Manifestation of disease     Clinical disease
    • Causal agent     Highly pathogenic avian influenza virus
    • Serotype     H5N6
    • Nature of diagnosis     Laboratory (advanced)
    • This event pertains to     the whole country
  • Summary of outbreaks    
    • Total outbreaks: 1
      • Total animals affected: Species     - Susceptible     - Cases     - Deaths     - Killed and disposed of  - Slaughtered
        • Birds     - 12000     - 850     - 0     - 12000     - 0
      • Outbreak statistics: Species     - Apparent morbidity rate     - Apparent mortality rate     - Apparent case fatality rate     - Proportion susceptible animals lost*
        • Birds     - 7.08%     - 0.00%     - 0.00%     - 100.00%
          • *Removed from the susceptible population through death, destruction and/or slaughter
  • Epidemiology
    • Source of the outbreak(s) or origin of infection    
      • Unknown or inconclusive
  • Epidemiological comments    
    • Epidemiological investigation is ongoing.

(...)

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Keywords: OIE; Updates; Avian Influenza; H5N6 ; Poultry; S. Korea.

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Highly pathogenic #avian #influenza #H5N2, #Taiwan [two #poultry #outbreaks] (#OIE, Dec. 15 ‘17)


Title: Highly pathogenic #avian #influenza #H5N2, #Taiwan [two #poultry #outbreaks].

Subject: Avian Influenza, H5N2 subtype, poultry epizootics in Taiwan.

Source: OIE, full page: (LINK).

Code: [     ]

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Highly pathogenic avian influenza H5N2, Chinese Taipei

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Information received on 14/12/2017 from Dr Tai-Hwa Shih, Chief Veterinary Officer, Deputy Director General, Bureau of Animal and Plant Health Inspection and Quarantine Council of Agriculture Executive Yuan, Ministry of Agriculture, Taipei, Chinese Taipei

  • Summary
    • Report type     Follow-up report No. 81
    • Date of start of the event     07/01/2015
    • Date of confirmation of the event     11/01/2015
    • Report date     12/12/2017
    • Date submitted to OIE     14/12/2017
    • Reason for notification     Recurrence of a listed disease
    • Date of previous occurrence     23/07/2014
    • Manifestation of disease     Clinical disease
    • Causal agent     Highly pathogenic avian influenza virus
    • Serotype     H5N2
    • Nature of diagnosis     Clinical, Laboratory (advanced)
    • This event pertains to     a defined zone within the country
  • Summary of outbreaks    
    • Total outbreaks: 2
      • Total animals affected: Species     - Susceptible     - Cases     - Deaths     - Killed and disposed of  - Slaughtered
        • Birds     - 7677     - 261     - 261     - 7416     - 0
      • Outbreak statistics: Species     - Apparent morbidity rate     - Apparent mortality rate     - Apparent case fatality rate     - Proportion susceptible animals lost*
        • Birds     - 3.40%     - 3.40%     - 100.00%     - 100.00%
          • *Removed from the susceptible population through death, destruction and/or slaughter
  • Epidemiology
    • Source of the outbreak(s) or origin of infection    
      • Unknown or inconclusive
  • Epidemiological comments    
    • Samples from Yunlin County were sent to the National Laboratory, Animal Health Research Institute (AHRI) for diagnosis.
      • Highly pathogenic avian influenza H5N2 subtype was confirmed by AHRI.
      • The infected farm has been placed under movement restriction.
      • All animals on the infected farm have been culled.
      • Thorough cleaning and disinfection have been conducted after stamping out operation.
      • Surrounding poultry farms within 3 km radius of the infected farm are under intensified surveillance for three months.
    • Suspected signs were observed in poultry carcasses during post-mortem inspection in an abattoir in Kaohsiung City.
      • Samples were sent to the AHRI for diagnosis.
      • H5N2 subtype HPAI was confirmed by the AHRI.
      • The carcasses were destroyed and thorough cleaning and disinfection have been conducted in the abattoir.
      • After tracing back to the farm of origin, any positive results will be included in follow-up reports.

(...)

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Keywords: OIE; Updates; Avian Influenza; H5N2 ; Poultry; Taiwan.

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14 Dec 2017

#Health and #Development at Age 19–24 Months of 19 #Children Who Were Born with #Microcephaly and … Congenital #Zika … — #Brazil, 2017 (@CDCgov, absract)


Title: #Health and #Development at Age 19–24 Months of 19 #Children Who Were Born with #Microcephaly and … Congenital #Zika … — #Brazil, 2017.

Subject: Zika Congenital Infection, follow-up report on development of children born during the outbreak.

Source: US Centers for Disease Control and Prevention (CDC), MMWR Morbidity and Mortality Weekly Report, full page: (LINK). Abstract, edited.

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Health and Development at Age 19–24 Months of 19 Children Who Were Born with Microcephaly and Laboratory Evidence of Congenital Zika Virus Infection During the 2015 Zika Virus Outbreak — Brazil, 2017

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Weekly / December 15, 2017 / 66(49);1347–1351

Format: [ PDF [108K] ]

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Ashley Satterfield-Nash, DrPH1; Kim Kotzky, MPH1; Jacob Allen, MPH2; Jeanne Bertolli, PhD3; Cynthia A. Moore, MD, PhD3; Isabela Ornelas Pereira4; André Pessoa, MD5; Flavio Melo, MD6; Ana Carolina Faria e Silva Santelli, MD7; Coleen A. Boyle, PhD3; Georgina Peacock, MD3


Summary

  • What is already known about this topic?
    • Congenital Zika virus infection has been linked to increased rates of microcephaly and a unique pattern of birth defects among infants.
    • Although children with microcephaly and laboratory evidence of Zika virus infection have been described in early infancy, the subsequent health and development in young children have not been well characterized, constraining planning for the care of these children.
  • What is added by this report?
    • The growth and development of 19 children, aged 19–24 months, with laboratory evidence of Zika virus infection were thoroughly assessed.
    • All children had at least one adverse outcome including feeding challenges, sleeping difficulties, severe motor impairment, vision and hearing abnormalities, and seizures, and these outcomes tended to co-occur.
  • What are the implications for public health practice?
    • Children with microcephaly and laboratory evidence of Zika virus infection face medical and functional challenges that span many areas of development, some of which become more evident as children age.
    • They will continue to require specialized care from clinicians and caregivers.
    • These data allow for anticipation of medical and social services needs of affected children and families, such as early intervention services, and planning for resources to support these families in healthcare and community settings.


Abstract

In November 2015, the Brazilian Ministry of Health (MOH) declared the Zika virus outbreak a public health emergency after an increase in microcephaly cases was reported in the northeast region of the country (1). During 2015–2016, 15 states in Brazil with laboratory-confirmed Zika virus transmission reported an increase in birth prevalence of microcephaly (2.8 cases per 10,000 live births), significantly exceeding prevalence in four states without confirmed transmission (0.6 per 10,000) (2). Although children with microcephaly and laboratory evidence of Zika virus infection have been described in early infancy (3), their subsequent health and development have not been well characterized, constraining planning for the care and support of these children and their families. The Brazilian MOH, the State Health Secretariat of Paraíba, and CDC collaborated on a follow-up investigation of the health and development of children in northeastern Brazil who were reported to national surveillance with microcephaly at birth. Nineteen children with microcephaly at birth and laboratory evidence of Zika virus infection were assessed through clinical evaluations, caregiver interviews, and review of medical records. At follow-up (ages 19–24 months), most of these children had severe motor impairment, seizure disorders, hearing and vision abnormalities, and sleep difficulties. Children with microcephaly and laboratory evidence of Zika virus infection have severe functional limitations and will require specialized care from clinicians and caregivers as they age.

(…)

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Suggested citation for this article: Satterfield-Nash A, Kotzky K, Allen J, et al. Health and Development at Age 19–24 Months of 19 Children Who Were Born with Microcephaly and Laboratory Evidence of Congenital Zika Virus Infection During the 2015 Zika Virus Outbreak — Brazil, 2017. MMWR Morb Mortal Wkly Rep 2017;66:1347–1351. DOI: http://dx.doi.org/10.15585/mmwr.mm6649a2.

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Keywords: US CDC; Updates; Zika Virus; Zika Congenital Syndrome; Microcephaly; Brazil.

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#Influenza [#H1N1pdm09, #H3N2, B] virus characterisation, #Summary #Europe, November 2017 (@ECDC_EU, edited)


Title: #Influenza [#H1N1pdm09, #H3N2, B] virus characterisation, #Summary #Europe, November 2017.

Subject: Human Influenza Viruses, A & B types, genetic and antigenic characterization of circulating strains.

Source: European Centre for Disease Prevention and Control (ECDC), full page: (LINK).

Code: [     ]

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Influenza virus characterisation, Summary Europe, November 2017

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Surveillance report  / 14 Dec 2017 / Publication series: Influenza Virus Characterisation / Time period covered: 2017 – 2018

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This is the first report for the 2017–18 influenza season. As of week 48/2017 nearly 3 000 influenza detections have been reported across the WHO European Region. Co-circulating type A viruses are prevalent over type B, with A(H3N2) less prevalent than A(H1N1)pdm09 viruses and B/Yamagata more prevalent than B/Victoria viruses.


Executive summary

Only two EU/EEA countries have shared influenza positive specimens with the London WHO CC since week 40/2017. Of the 31 specimens received, 23 have collection dates after 31 August 2017 which fall within the time period (1 September 2017 to 31 January 2018) to be considered for the February 2018 WHO Vaccine Consultation Meeting (VCM).

The four A(H1N1)pdm09 viruses characterised antigenically showed good reactivity with antiserum raised against the 2017–18 vaccine virus, A/Michigan/45/2015.

While genetic analysis of three viruses is pending, one virus - and others from the European region with collection dates after 31 August 2017 deposited in GISAID - have all fallen in subclade 6B.1, defined by HA1 amino acid substitutions S162N and I216T, many with additional substitutions of S74R, S164T and I295V.

None of the 13 A(H3N2) viruses recovered to date had sufficient HA titre to allow antigenic characterisation by HI assay in the presence of oseltamivir. While genetic analysis of these viruses is pending others - from the European region with collection dates after 31 August 2017 deposited in GISAID - fall within the 3C.2a genetic clade, with a minority falling in the 3C.2a1 genetic subclade.

The two B/Victoria-lineage viruses tested, both from Norway, have collection dates in June 2017 and both were antigenically distinct from tissue culture-propagated surrogates of B/Brisbane/60/2008. Phylogenetic analyses showed both viruses to carry an HA1 double amino acid deletion, falling within a subcluster of genetic clade 1A viruses with recently circulating viruses from Canada, Trinidad and the USA.

Of the five B/Yamagata viruses characterised antigenically, four reacted well with post-infection ferret antiserum raised against egg-propagated B/Phuket/3073/2013, the recommended vaccine virus for use in quadrivalent vaccines for 2017–18 and for trivalent vaccines in the southern hemisphere 2018 season. The two characterised viruses, like others recently circulating in the European region and reported to GISAID, fall within genetic clade 3.

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Download: |-- Influenza virus characterisation, Summary Europe, November 2017 - EN - [PDF-2.14 MB] –|

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Keywords: ECDC; Updates; European Region; Seasonal Influenza.

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Low pathogenic #avian #influenza #H5N2, #Dominican Republic [Three #poultry #outbreaks] (#OIE, Dec. 14 ‘17)


Title: Low pathogenic #avian #influenza #H5N2, #Dominican Republic.

Subject: Avian Influenza, H5N2 subtype, poultry epizootics in Dominican Republic.

Source: OIE, full page: (LINK).

Code: [     ]

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Low pathogenic avian influenza (poultry) H5N2, Dominican Republic

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Information received on 13/12/2017 from Dra Nimia Lissette Gómez Rodríguez, Directora, Dirección de Sanidad Animal Dirección General de Ganadería (DIGEGA), Ministerio de Agricultura, Santo Domingo, Dominican Republic

  • Summary
    • Report type     Follow-up report No. 1
    • Date of start of the event     30/09/2017
    • Date of confirmation of the event     18/10/2017
    • Report date     13/12/2017
    • Date submitted to OIE     13/12/2017
    • Reason for notification     Recurrence of a listed disease
    • Date of previous occurrence     26/02/2009
    • Manifestation of disease     Clinical disease
    • Causal agent     Low pathogenic avian influenza virus
    • Serotype     H5N2
    • Nature of diagnosis     Clinical, Laboratory (advanced)
    • This event pertains to     a defined zone within the country
  • Summary of outbreaks    
    • Total outbreaks: 3
      • Total animals affected: Species     - Susceptible     - Cases     - Deaths     - Killed and disposed of  - Slaughtered
        • Birds     - 107900     - 15553     - 15553     - 33843     - 0
      • Outbreak statistics: Species     - Apparent morbidity rate     - Apparent mortality rate     - Apparent case fatality rate     - Proportion susceptible animals lost*
        • Birds     - 14.41%     - 14.41%     - 100.00%     - 45.78%
          • *Removed from the susceptible population through death, destruction and/or slaughter
  • Epidemiology
    • Source of the outbreak(s) or origin of infection    
      • Unknown or inconclusive
  • Epidemiological comments    
    • No new outbreaks have been detected around the index outbreak.
    • The index outbreak is closed.
    • Three new outbreaks have been confirmed positive for avian influenza (H5N2); one of them is resolved.
    • The other outbreaks are under official control until all control measures have been implemented.
    • Surveillance is still on-going in the outbreak area (1 km) and in the area around the outbreaks (3-5 km), including screening and traceability.

(...)

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Keywords: OIE; Updates; Avian Influenza; H5N2 ; Poultry; Dominican Republic.

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