New/Old significant Avian Outbreaks in U.S./Canada

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Virginia - Human Avian H7N2

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In the United States in 2002, Virginia experienced an outbreak of avian influenza A (H7N2) in which 4.7 million turkeys and chickens were destroyed. One
culler developed upper respiratory signs and was subsequently tested
and found to have antibodies to avian influenza A (H7N2). Nasal
swabs and other specimens suitable for viral isolation were not
collected, and therefore virus isolation could not be performed.

Note:

In 2003, there was an outbreak in the Netherlands with H7N7 avian
influenza A, causing symptoms of upper respiratory disease and
conjunctivitis. This outbreak of avian influenza A H7 occurred mostly
among poultry workers. H7 viruses are not as dangerous as the H5N1
viruses that are currently causing serious problems in Asia at this
time. The H7 avian influenza A viruses are not nearly as dangerous as
some of the other strains that are not H7. The H7 viruses seem to cause
less serious disease symptoms, and it has primarily caused illness
among poultry workers.

It should be noted that the use of personal protective equipment is
mandatory for all persons involved in poultry culling activities, which
should minimize infection in poultry workers. Human infection with the
H7 avian influenza viruses is rare, however persons who have had close
contact with infected birds may become infected and exhibit symptoms,
most commonly conjunctivitis and/or upper respiratory symptoms. The
risk of infection to poultry workers is low, especially when persons
wear appropriate personal protective equipment and follow standard
depopulation procedures when in contact with infected birds.

The reported symptoms of avian influenza in humans have ranged from
typical influenza-like symptoms (cough, sore throat, fever and muscle
aches) to eye infections, pneumonia, acute respiratory distress, viral
pneumonia and other severe and life-threatening complications.

Diagnosis is made by using certain tests, such as reverse
transcription-polymerase chain reaction (PCR) and cell culture of
material obtained from nasal swabs. An antiviral medication,
oseltamivir, TamifluTM, Roche Laboratories, is used as a treatment for
influenza A and B, and as prophylaxis within 48 hours of exposure, to
help treat a person exposed to or infected with this virus. Studies to
date suggest that these prescription medications approved for human
influenza strains would be effective in preventing avian influenza
infections in humans. However, sometimes flu strains can become
resistant to these drugs and so they may not always be effective.

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	Virginia - Human Avian H7N2 http://www.exoticpetvet.net/avian/influenza.html In the United States in 2002, Virginia experienced an outbreak of avian influenza A (H7N2) in which 4.7 million turkeys and chickens were destroyed. One culler developed upper respiratory signs and was subsequently tested and found to have antibodies to avian influenza A (H7N2). Nasal swabs and other specimens suitable for viral isolation were not collected, and therefore virus isolation could not be performed. Note: In 2003, there was an outbreak in the Netherlands with H7N7 avian influenza A, causing symptoms of upper respiratory disease and conjunctivitis. This outbreak of avian influenza A H7 occurred mostly among poultry workers. H7 viruses are not as dangerous as the H5N1 viruses that are currently causing serious problems in Asia at this time. The H7 avian influenza A viruses are not nearly as dangerous as some of the other strains that are not H7. The H7 viruses seem to cause less serious disease symptoms, and it has primarily caused illness among poultry workers. It should be noted that the use of personal protective equipment is mandatory for all persons involved in poultry culling activities, which should minimize infection in poultry workers. Human infection with the H7 avian influenza viruses is rare, however persons who have had close contact with infected birds may become infected and exhibit symptoms, most commonly conjunctivitis and/or upper respiratory symptoms. The risk of infection to poultry workers is low, especially when persons wear appropriate personal protective equipment and follow standard depopulation procedures when in contact with infected birds. The reported symptoms of avian influenza in humans have ranged from typical influenza-like symptoms (cough, sore throat, fever and muscle aches) to eye infections, pneumonia, acute respiratory distress, viral pneumonia and other severe and life-threatening complications. Diagnosis is made by using certain tests, such as reverse transcription-polymerase chain reaction (PCR) and cell culture of material obtained from nasal swabs. An antiviral medication, oseltamivir, TamifluTM, Roche Laboratories, is used as a treatment for influenza A and B, and as prophylaxis within 48 hours of exposure, to help treat a person exposed to or infected with this virus. Studies to date suggest that these prescription medications approved for human influenza strains would be effective in preventing avian influenza infections in humans. However, sometimes flu strains can become resistant to these drugs and so they may not always be effective.

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	Duck Hunters in Iowa H11N9 - Avian antibodies from CDC http://www.cdc.gov/ncidod/eid/vol12no08/06-0492.htm Hunters and Wildlife Professionals James S. Gill,* Comments to Author Richard Webby,� Mary J.R. Gilchrist,* and Gregory C. Gray� *University of Iowa Hygienic Laboratory, Iowa City, Iowa, USA; �St Jude Children's Research Hospital, Memphis, Tennessee, USA; and �University of Iowa College of Public Health, Iowa City, Iowa, USA Suggested citation for this article We report serologic evidence of avian influenza infection in 1 duck hunter and 2 wildlife professionals with extensive histories of wild waterfowl and game bird exposure. Two laboratory methods showed evidence of past infection with influenza A/H11N9, a less common virus strain in wild ducks, in these 3 persons. Wild ducks, geese, and shorebirds are the natural reservoir for influenza A virus (1); all 16 hemagglutinin (H) and 9 neuraminidase (N) subtypes are found in these wild birds (1,2). Recently, the rapid spread of influenza A/H5N1 virus to new geographic regions, possibly by migrating waterfowl, has caused concern among public health officials who fear an influenza pandemic. Until now, serologic studies of the transmission of subtype H5N1 and other highly pathogenic strains of avian influenza have focused on humans who have contact with infected domestic poultry (3,4). In this cross-sectional seroprevalence study, we provide evidence of past influenza A/H11 infection in persons who were routinely, heavily exposed to wild ducks and geese through recreational activities (duck hunting) or through their employment (bird banding). To our knowledge, this study is the first to show direct transmission of influenza A viruses from wild birds to humans. The Study In mid-October 2004, we enrolled 39 duck hunters who were hunting in southeastern Iowa at Lake Odessa Wildlife Management Area, the state's only limited-access public waterfowl hunting area managed by the Iowa Department of Natural Resources (DNR). In February 2005 we enrolled 68 Iowa DNR employees, many of whom had duck hunted or had been involved annually in capturing and banding wild ducks and geese as part of their duties of employment. Ten (15%) of the 68 DNR workers reported no contact with ducks. The duck-hunting group consisted of men >16 years of age, and the DNR group consisted of 65 men and 3 women enrollees. The average age of the duck hunters and DNR workers was 34 and 47 years, respectively. The average number of years of waterfowl or bird exposure of the duck hunters and DNR workers was 19.8 and 21.5, respectively. In the 3 years before the study, influenza vaccine had been administered to 37% of the duck hunters and 35% of the DNR workers. Microneutralization assay, adapted per Rowe et al. (5), was performed on all serum samples with influenza A subtypes H1 through H12 from avian sources. Virus at 100 TCID50 (50% tissue culture infective dose)/50 μL was incubated at 37�C for 2 h with heat-inactivated serum in 96-well plates. One hundred microliters of trypsinized London MDCK cells at 2 � 105 cells/mL, grown to 70%�95% confluency, was added to each well. After 24 h at 37�C, the cells were acetone-fixed, and horseradish peroxidase�based ELISA was performed with mouse-specific anti-influenza A antibody. Optical density was read at 450 nm. All tested virus isolates were titrated with and without trypsin in the University of Iowa's Emerging Pathogens Laboratory; no significant difference in titers was observed. Backtiter controls were performed with each microneutralization assay. Hemagglutination inhibition (HI) assay with horse erythrocytes, adapted per Meijer et al. (6), was performed on all hunter serum samples by using avian influenza A subtype H11. Heat-inactivated serum treated with receptor-destroying enzyme was first heme-adsorbed with packed horse erythrocytes. Serum was then incubated with virus at 8 hemagglutinin U/50 μL with 1% horse erythrocytes in 0.5% bovine serum albumin in phosphate-buffered saline for 1 h at room temperature in V-bottom plates. The plates were then examined. One 39-year-old duck hunter had a titer of 40, and 2 male DNR workers, ages 52 and 53, had titers of 10 against influenza A/H11N9/duck/Memphis/546/76 by microneutralization assay (Table). These 3 study participants had substantial lifetime exposures to wild waterfowl. The duck hunter and the 2 DNR workers had 31, 27, and 30 years of duck-hunting experience, respectively. The duck hunter spent 25�60 days in the marsh each year hunting ducks. He harvested 100 ducks annually and handled another 300 ducks with his hunting partners during the duck-hunting season from mid-September to early December. One of the positive DNR workers (age 52) had several years of live wild duck�banding exposure as part of his annual duties of employment, in addition to 27 years of duck-hunting exposure. Each year this wildlife professional had contact with >100 live ducks during the banding season in late August and early September. Serum samples from all other study participants were negative against subtype H11N9 according to results of microneutralization assay and horse erythrocyte HI assays. The duck hunter's serum was not reactive to any other avian influenza hemagglutinin subtypes tested (H1�H10 and H12). The sera of the 2 H11-positive DNR workers had titers of 10 for influenza A/H2N2/mallard/NY/6750/78 according to microneutralization assay results and were negative for H1, H3�H10, and H12. Results of the H11 microneutralization assay were verified by horse erythrocyte HI assay that used subtype H11N9 virus. The titers by horse HI assay of the microneutralization assay�positive duck hunter and the 2 DNR workers were 10 or 20 (Table). These 3 study participants had not been vaccinated against influenza within 3 years before the study. References 1. Stallknecht DE, Shane SM. Host range of avian influenza virus in free-living birds. Vet Res Commun. 1988;12:125�41. 2. Fouchier RA, Munster V, Wallensten A, Bestebroer TM, Herfst S, Smith D, et al. Characterization of a novel influenza A virus hemagglutinin subtype (H16) obtained from black-headed gulls. J Virol. 2005;79:2814�22. 3. Bridges CB, Lim W, Hu-Primmer J, Sims L, Fukuda K, Mak KH, et al. Risk of influenza A (H5N1) infection among poultry workers, Hong Kong, 1997�1998. J Infect Dis. 2002;185:1005�10. 4. Koopmans M, Wilbrink B, Conyn M, Natrop G, van der Nat H, Vennema H, et al. Transmission of H7N7 avian influenza A virus to human beings during a large outbreak in commercial poultry farms in the Netherlands. Lancet. 2004;363:587�93. 5. Rowe T, Abernathy RA, Hu-Primmer J, Thompson WW, Lu X, Lim W, et al. Detection of antibody to avian influenza A (H5N1) virus in human serum by using a combination of serologic assays. J Clin Microbiol. 1999;37:937�43. 6. Meijer A, Bosman A, van de Kamp EE, Wilbrink B, van Beest Holle Mdu R, Koopmans M. Measurement of antibodies to avian influenza virus A (H7N7) in humans by hemagglutination inhibition test. J Virol Methods. 2006;132:113�20. 7. Hinshaw VS, Wood JM, Webster RG, Deibel R, Turner B. Circulation of influenza viruses and paramyxoviruses in waterfowl originating from two different areas in North America. Bull World Health Organ. 1985;63:711�9. 8. Stallknecht DE, Shane SM, Zwank PJ, Senne DA, Kearney MT. Avian influenza viruses from migratory and resident ducks of coastal Louisiana. Avian Dis. 1990;34:398�405. 9. Ramirez A, Capuano AW, Wellman DA, Lesher KA, Setterquist SF, Gray GC. Preventing zoonotic influenza infection. Emerg Infect Dis. 2006;12:997�1000. 10. Fouchier RA, Schneeberger PM, Rozendaal FW, Broekmen JM, Kemink SA, Munster V, et al. Avian influenza A virus (H7N7) associated with human conjunctivitis and a fatal case of acute respiratory distress syndrome. Proc Natl Acad Sci U S A. 2004;101:1356�61. 11. Kurtz J, Manvell RJ, Banks J. Avian influenza virus isolated from a woman with conjunctivitis. Lancet. 1996;348:901�2. 12. Beare AS, Webster RG. Replication of avian influenza viruses in humans. Arch Virol. 1991:119:37�42. 13. Krauss S, Walker D, Pryor SP, Niles L, Chenghong L, Hinshaw VS, et al. Influenza A viruses of migrating wild aquatic birds in North America. Vector-Borne Zoonotic Dis. 2004;4:177�89. 14. Hanson BA, Stallknecht DE, Swayne DE, Lewis LA, Senne DA. Avian influenza viruses in Minnesota ducks during 1998�2000. Avian Dis. 2003; 47:867�71. 15. Slemons RD, Hansen WR, Converse KA, Senne DA. Type A influenza virus surveillance in free-flying, nonmigratory ducks residing on the eastern shore of Maryland. Avian Dis. 2003;47:1107�10. Comment : Later on in the final conclusion the early conclusion is refuted. To the best of my recollection when I first found this article no such text was included to refute the first statement.

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	Avian in New York - 2003 H7N2 in New York � 2003 In November 2003, a patient with serious underlying medical conditions was admitted to a hospital in New York with respiratory symptoms. One of the initial laboratory tests identified an influenza A virus that was thought to be H1N1. The patient recovered and went home after a few weeks. Subsequent confirmatory tests conducted in March showed that the patient had been infected with an H7N2 avian influenza A virus.

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	http://www.cdc.gov/ncidod/EID/vol10no12/04-0961.htm FRAZER VALLEY - BRITISH COLUMBIA - CANADA http://www.exoticpetvet.net/avian/influenza.html Two poultry workers in the Fraser Valley region of British Columbia were confirmed by testing. Clinical signs were unilateral (one sided) conjunctivitis and upper respiratory symptoms in one patient, and unilateral conjunctivitis and headache in the second. There is currently no evidence of person-to-person transmission of avian influenza in this outbreak. The strain here was not given. Likely to have been the same H7N7 avian influenza A, in the human outbreak in the Netherlands. Human Illness from Avian Influenza H7N3, British Columbia Avian influenza that infects poultry in close proximity to humans is a concern because of its pandemic potential. In 2004, an outbreak of highly pathogenic avian influenza H7N3 occurred in poultry in British Columbia, Canada. Surveillance identified two persons with confirmed avian influenza infection. Symptoms included conjunctivitis and mild influenzalike illness. Influenza is the most diversified in birds, particularly in wild waterfowl (1). Concern exists that outbreaks of avian influenza in domestic poultry could, through a process of genetic reassortment, mutation, or both, introduce new influenza subtypes into the human population. In the context of widespread susceptibility, such an event could be the precursor of a pandemic (2,3). An outbreak of avian influenza emerged on a farm in the Fraser Valley of British Columbia on February 6, 2004. Slightly increased deaths (8�16 deaths/day) were noted among 9,200 chickens in one barn. Avian influenza infection was confirmed on February 16, 2004, and later genotypic and phenotypic intravenous pathogenicity index (IVPI) testing characterized the virus as low pathogenicity avian influenza (LPAI) H7N3. On the same farm, an adjacent barn that contained 9,030 chickens had a dramatic increased in deaths from February 17 through 19 (2,000 deaths in 2 days). Genotypic and IVPI testing confirmed highly pathogenic avian influenza (HPAI) H7N3 in this second flock. The Canadian Food Inspection Agency ordered the culling of both flocks and initiated active avian influenza surveillance on all farms within 5 km, but the virus spread nonetheless. On April 5, the Canadian Food Inspection Agency ordered depopulation of all poultry in the Fraser Valley south of the Fraser River (19 million birds). In total, the Canadian Food Inspection Agency identified avian influenza in 42 of the ≈600 commercial poultry farms in the region and in 11 backyard flocks, which represented ≈1.3 million birds (4). The last infected farm was identified on May 21, 2004. To mitigate the risk for human infection and the potential for genetic reassortment, federal workers involved in the depopulation were required to wear personal protective equipment, including N95/North 7700 masks, gloves, goggles, and biosafety suits and footwear. They were also required to take prophylactic oseltamivir at a dose of 75 mg per day for the duration of exposure plus 7 days and to receive the commercially available human influenza vaccine for the 2003-04 season, if they had not already done so (5). All protective measures were provided free of charge and were recommended also for exposed farm workers and their families. Following reports of human illness, these measures were more rigorously promoted and reinforced through worker screening, information letters prepared by the British Columbia Centre for Disease Control, and media bulletins. We report the results of enhanced surveillance for human illness in association with this poultry outbreak of HPAI H7N3 in British Columbia. The Study After the first report to public health authorities of poultry outbreaks on February 18, 2004, enhanced surveillance for conjunctivitis and influenzalike illnesses was implemented for federal workers, farm workers and their household contacts, and any other potentially exposed persons. Illness was reported to the British Columbia Centre for Disease Control by using a standard questionnaire and report form. Respiratory specimens were tested at the British Columbia Centre for Disease Control by reverse transcription�polymerase chain reaction for influenza and by cell culture for all respiratory pathogens; influenza isolates were sequenced to determine the subtype (e.g., H7). Suspected human cases were defined as illness in persons presenting after February 6, 2004, with two or more new or worsening conjunctivitis or influenzalike symptoms, with onset from 1 day after first exposure (defined as direct contact or shared air space) to 7 days after last exposure to a potential source of avian influenza virus in the Fraser Valley. Confirmed cases had laboratory-confirmed influenza A (H7) virus in conjunctival, nasal, nasopharyngeal, or throat specimens by reverse transcription�polymerase chain reaction (6) or cell culture. Influenza hemagglutinin and neuraminidase subtyping was performed at the National Microbiology Laboratory. Serum samples were tested for antibody to influenza A (H7) by hemagglutination inhibition and microneutralization assays (7) at the National Microbiology Laboratory. Microneutralization assays were repeated at the U.S. Centers for Disease Control and Prevention on serum samples from two persons with confirmed infections and from eight persons with suspected cases. Approximately 2,000 poultry farm workers are in the Fraser Valley. Approximately 650 federal workers assisted with outbreak management and control; not all had poultry exposure. From February 18 to June 1, 2004, a total of 77 symptomatic persons were reported to the British Columbia Centre for Disease Control. Fifty-seven had suspected (n = 55) or confirmed (n = 2) avian influenza infections. Among the 20 reports that did not meet the suspected or confirmed case definitions, 9 had insufficient information to determine case status, 3 did not meet the symptom requirements, 3 did not have a relevant exposure history, 1 had onset before February 6, 3 had onset >7 days after exposure, and 1 had onset <1>48 hours after onset or refused treatment. All recovered fully. Respiratory specimens (nasal, nasopharyngeal, throat, and conjunctival) were collected from 47 patients with suspected cases (86%) an average of 5 days after onset (range 0�27 days). Cell culture identified pathogens in two persons: adenovirus type 3 in one (conjunctival and nasal specimens) and HSV-1 in another (throat specimen). All other results were negative for respiratory viruses, including influenza. No antibody to influenza A H7 could be detected in paired acute- and convalescent-phase serum samples (n = 17), drawn an average of 9 days (range 0�33 days) and 31 days (range 18�88 days) after onset, respectively, or in convalescent-phase serum samples (n = drawn an average of 28 days (range 8�56) after onset from patients with suspected cases. Influenza A H7N3 infection was confirmed in two men (40 and 45 years of age) exposed on different farms March 13 and March 22�23. Both had direct conjunctival contact with infected poultry. One was not wearing eye protection, and the other was wearing glasses that were bypassed by a feather. Neither was taking oseltamivir prophylaxis. Neither was vaccinated against human influenza virus. Symptoms developed 1�3 days after exposure (March 16 and 24). Conjunctivitis and coryza developed in the first patient, and conjunctivitis and headache developed in the second. Both received oseltamivir treatment, and symptoms resolved fully. Active daily surveillance by the local health unit identified no secondary cases. Influenza A H7N3 virus was isolated from a nasal specimen from one man (A/Canada/444/04) and a conjunctival specimen from the other (A/Canada/504/04); both samples were collected within 1 day of onset. No antibody to influenza A H7 could be detected by hemagglutination inhibition or microneutralization assays in serum samples collected 34 days and 8 and 22 days after onset, respectively. Virus isolated from birds on the same source farm as the human isolate A/Canada/444/04 was confirmed as HPAI H7N3 by genotyping and IVPI. Virus from birds on the same source farm as A/Canada/504/04 showed insertion sequence match with HPAI H7N3, but IVPI was not performed (C. Kranendonk, National Centre for Foreign Animal Disease, pers. comm.). Both human isolates contained an insertion sequence similar to that seen only in the HPAI avian virus. These insertion sequences vary from the poultry virus by one and two amino acid differences, respectively. Based on the consensus sequence for HPAI H7 viruses, only A/Canada/504/04 is likely highly pathogenic in chickens (. Phenotypic pathogenicity testing on the human isolates is ongoing. Conclusions We report the first known human avian influenza H7N3 infections. Although enhanced surveillance identified 57 persons meeting a suspected case definition, avian influenza infection was confirmed in only 2. The two patients had conjunctivitis and mild, influenzalike illnesses, similar to symptoms reported from the Netherlands in association with another H7 subtype (H7N7) (9). Neither confirmed case in British Columbia mounted a hemagglutination inhibition or serum neutralizing antibody response. This finding has been observed elsewhere in association with avian influenza infection (10,11). A possible explanation includes highly localized infection without induction of systemic antibody. Mechanical trauma, irritation due to dust or airborne particulate matter, or an allergic cause of symptoms associated with viral contamination, rather than infection, is less likely given the delay to symptom onset, consistent with the incubation period for influenza. Among suspected cases, respiratory rather than conjunctival symptoms predominated. Other pathogens were also detected among suspected case reports, a finding consistent with the relatively nonspecific case definition applied. From February 6 to May 21, 2004, routine influenza surveillance activities in the Fraser Valley also identified human influenza A from nine persons and two long-term care facility outbreaks. Although no coinfections were identified, this human influenza activity increased concerns about potential mixture of avian influenza with human influenza strains. Avian influenza H7 has caused human illness previously, most notably 89 confirmed human infections, including one death in the Netherlands in 2003 (9). Based on the precedent set by the Netherlands in protecting exposed persons, British Columbia recommended comprehensive precautions for workers early in the outbreak. These precautions may have prevented further human infections. The strain circulating in British Columbia may have been more limited in its ability to cause human illness. The genomic sequence of the avian viruses from the source farms of the two human isolates was consistent with HPAI, whereas one of the human isolates was consistent with LPAI. The presence of an insertion sequence in the human LPAI isolate likely signifies that the virus in poultry mutated from HPAI to LPAI, and both were circulating among the birds on that source farm, the latter undetected. A less likely explanation is that mutation from HPAI to LPAI occurred in the human host. To date, illness in humans from H7 subtypes differs markedly in severity from that of avian influenza H5N1 (12). Their lower virulence should not be inferred to indicate lower pandemic potential since subclinical or mild infections may have greater opportunity through surreptitious spread to reassort and through mutation to become more virulent. A compilation and detailed overview of the protective measures used in all avian influenza outbreaks would help to estimate the actual risk to persons and populations. Recommendations for precautions that are both necessary and reasonable during future poultry outbreaks could then be refined. Ms. Tweed is an epidemiologist at the British Columbia Centre for Disease Control. Her main research interests are vaccine-preventable, respiratory, and emerging infectious diseases. References 1. Suarez DL, Spackman E, Senne DA. Update on molecular epidemiology of H1, H5, and H7 influenza virus infections in poultry in North America. Avian Dis. 2003;47:888�97. 2. Trampuz A, Prabhu RM, Smith TF, Baddour LM. Avian influenza: a new pandemic threat? Mayo Clin Proc. 2004;79:523�30. 3. Zambon MC. The pathogenesis of influenza in humans. Rev Med Virol. 2001;11:227�41. 4. Lees W, Chown L, Inch C. A short summary of the 2004 outbreak of high pathogenicity avian influenza (H7N3) in British Columbia, Canada. Ottawa, Ontario: Canadian Food Inspection Agency, Animal Products, Animal Health and Production Division; 2004. 5. National Advisory Committee on Immunization. Update: statement on influenza vaccination for the 2003-04 Season. Canadian Communicable Disease Report. 2004;30:1�5. 6. Spackman E, Senne DA, Myers TJ, Bulaga LL, Garber LP, Perdue ML, et al. Development of a real-time reverse transcriptase PCR assay for type A influenza virus and the avian H5 and H7 hemagglutinin subtypes. J Clin Microbiol. 2002;40:3256�60. 7. Rowe T, Abernathy RA, Hu-Primmer J, Thompson WW, Lu X, Lim W, et al. Detection of antibody to avian influenza A (H5N1) virus in human serum by using a combination of serologic assays. J Clin.Microbiol. 1999;37:937�43. 8. Hirst M, Astell CR, Griffith M, Coughlin SM, Moksa M, Zeng T, et al. Novel avian influenza H7N3 strain outbreak, British Columbia. Emerg Infect Dis. 2004;10:2192�5. 9. Koopmans M, Wilbrink B, Conyn M, Natrop G, van der Nat H, Vennema H, et al. Transmission of H7N7 avian influenza A virus to human beings during a large outbreak in commercial poultry farms in the Netherlands. Lancet. 2004;363:587�93. 10. Alexander DJ, Brown IH. Recent zoonoses caused by influenza A viruses. Rev Sci Tech. 2000;19:197�225. 11. Kurtz J, Manvell RJ, Banks J. Avian influenza virus isolated from a woman with conjunctivitis. Lancet. 1996;348:901�2. 12. Tran TH, Nguyen TL, Nguyen TD, Luong TS, Pham PM, Nguyen VC, et al. Avian influenza A (H5N1) in 10 patients in Vietnam. N Engl J Med. 2004;350:1179�88. Suggested citation for this article: Tweed SA, Skowronski DM, David ST, Larder A, Petric M, Lees M, et al. Human illness from avian influenza H7N3, British Columbia. Emerg Infect Dis [serial on the Internet]. 2004 Dec [date cited]. Available from http://www.cdc.gov/ncidod/EID/vol10no12/04-0961.htm

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	RECENT OUT BREAK DATA OF AVIAN IN WEST VIRGINIA 25, 000 Turkeys Slaughtered at W.Va. Farm 25, 000 Turkeys Slaughtered at W.Va. Farm THE ASSOCIATED PRESS Published: April 3, 2007 Filed at 1:26 a.m. ET CHARLESTON, W.Va. (AP) -- A strain of avian flu different from the one that has infected humans in Africa and Asia was detected at a turkey farm, requiring the slaughter of 25,000 birds, state agriculture officials said Monday. ''People should not be worried,'' said Buddy Davidson, a spokesman for the state Agriculture Department. ''This should not affect the average person at all.'' The turkeys are being destroyed to prevent the virus, which can kill birds, from mutating and spreading. Authorities are telling poultry farms in five counties not to remove any bird bedding or manure until testing can be done. The flu was detected during routine screening. Routine tests have been done since a 2002 outbreak in Virginia. as posted by New York Times ================================================= Avain flu found at farm Strain poses no risk to humans By Tara Tuckwiller Staff writer About 25,000 turkeys were being destroyed Monday at a Pendleton County farm after avian flu was found there � a low-pathogenic strain humans can�t catch, government officials said. The virus, H5N2, typically causes no symptoms or only minor sickness in birds. The turkeys at the farm showed no symptoms. Routine blood tests, now required for every flock before it is moved, revealed the virus, state agriculture department spokesman Buddy Davidson said. The U.S. Department of Agriculture�s national lab confirmed the test results Saturday, and the USDA released a public statement Sunday night, Davidson said. H5N2 was last detected in West Virginia in 2002. That time, about 14,000 chickens on a Hardy County farm were destroyed. The recent infection was found on a southern Pendleton County farm that produces for the Virginia Poultry Growers Cooperative. Officials are not releasing the exact location of the farm or the name of the farmer, �both for the farmer�s privacy and for biosecurity,� Davidson said. If people or vehicles visited the farm, they could carry the virus away and spread it. �We�re being extra careful even with our own personnel, to minimize any traffic between that farm and anywhere else.� No infection has been found at neighboring farms. The USDA statement said �all poultry operations within a six mile radius of the affected farm will be closely monitored.� The turkeys were all expected to euthanized by Monday night, Davidson said. By the end of the day today, they will be moved to another location on the farm for composting, he said. Then the poultry house can be decontaminated. �There would be no reason [the farmer] couldn�t go back into business in the not-too-distant future,� Davidson said. The USDA will pay the farmer for his losses. While low-pathogenic avian flus like the one found in Pendleton County pose no human health risk, �USDA�s policy is to eradicate all H5 and H7 subtypes because of their potential to mutate into highly pathogenic avian influenza, which has a high mortality rate among birds,� the USDA statement said. A highly pathogenic avian flu, H5N1, has spread through Asia, Europe and Africa, killing 170 people since 2003, according to the World Health Organization. International animal health standards now require countries to report all H5 and H7 detections, but the USDA said this �should not significantly impact U.S. exports of poultry and poultry products.� Poultry is West Virginia�s biggest agriculture industry, with $223 million in cash receipts in 2005. On Monday, state Agriculture Commissioner Gus Douglass ordered a halt to any movement of poultry manure in Pendleton, Mineral, Hardy, Hampshire and Grant counties for at least 30 days. Farmers must not clean out their poultry houses or apply any manure to land, as part of the state�s avian flu response protocol. It is unknown how the turkeys got the virus. �I�m sure that is going to be looked at in the near future,� Davidson said. �At this point, we�re concentrating on operations. We may never know where it came from.� ================================================ Can H5N2 become HiPath or spread to humans? OLD RESEARCH) The deadly H5N1 virus has killed at least 76 people worldwide since 2003. (AP) Up to 77 people in Japan may have been infected with a mild form of bird flu, in what could be the world's first case of human infection of the H5N2 virus, health officials said Tuesday. The possible past sufferers, mostly chicken farm workers, came from two prefectures, Saitama and Ibaraki, outside of Tokyo, a Health Ministry official said on condition of anonymity, citing internal policy. Those who may have been infected showed evidence of antibodies to the H5N2 virus, which is weaker than the deadly H5N1 form, the official said. No virus had been found among them. No human infection of the milder strain had been reported, and the latest results showed a possibility of bird-to-human transmission of the H5N2 virus for the first time, the ministry official said. The absence of flu-like symptoms among them, however, means the there is little chance of developing a full-blown disease from it, she said. None of them showed signs of the disease and there was no danger that they would or infect others, she said, but added that the ministry planned to follow up on their health conditions. In related developments: # Preliminary tests Tuesday showed another person in Turkey has tested positive for a deadly strain of bird flu, raising the number in the country to 15, a Health Ministry official said. The number of people hospitalized with symptoms also climbed to about 70, officials said. # On Tuesday, workers in Turkey continued killing birds across the country as Turks observed the beginning of the Eid al-Adha, the most important holiday of the Islamic year. Turkey has also stepped up an awareness campaign to combat the bird flu outbreak, with imams warning about the danger through loudspeakers. # Bulgaria launched a bird flu prevention campaign Tuesday, which includes general information on bird flu and advice on avoiding contact with birds, following strict hygiene and eating only well-cooked poultry products and eggs. "The instructions will be publicized through regional health care inspectors, general practitioners, mayors and media," the Health Ministry said in a statement. # Russian President Vladimir Putin called on Prime Minister Mikhail Fradkov on Tuesday to develop a plan to prevent bird flu in Russia. "We must do everything possible in order not to allow this problem to emerge here," Putin told a meeting of top government officials. The country's chief epidemiologist also announced heightened inspections on its southern border and of people arriving from Turkey. In Japan, seventy people have tested positive for antibodies to the H5N2 in Ibaraki, about 65 miles north of Tokyo, and seven others in Saitama, just outside the capital, have tested positive for the same antibodies, the ministry official said. Saitama health official Tatemitsu Yoshida said the central government notified prefectural officials that the results do not pose any serious problems, but poultry farm workers should take appropriate measures such as wearing masks and washing their hands frequently. The much more deadly H5N1 virus has killed at least 76 people worldwide since 2003, according to the World Health Organization's Web page. Japan so far has suffered one case of human infection of the more deadly virus, but no deaths. There have been several outbreaks of bird flu among poultry flocks in the two prefectures, mostly in Ibaraki since last year. A total of 353 chicken farm employees at affected farms as well as quarantine officials have undergone various tests since the outbreak started in June, the ministry official said. Japan has culled hundreds of thousands of birds to stop the disease's spread since it was detected in the country in 2004 for the first time in decades. Ibaraki alone had culled 2.5 million birds since the outbreak began, prefectural health official Masahiko Shimada said. Most of the human infections in the world have been linked to direct contact with sick poultry, but scientists fear that the virus could mutate into a form that spreads easily between humans, sparking a global flu pandemic that could kill millions. There is no known cure or vaccination for H5N1 in humans. This is old news - but there is a pattern of H5N2 going hi path and also transferring to people. To say an infection in birds of H5N2 is not a potential problem for humans is not true. It is a potential problem. http://www.rferl.org/featuresarticle/2005/07/bc3517d5-1793-4cf6-9359-183ac707bf7c.html And our medical observations show that there have been no human cases," Onishchenko said. In related news, more than 19,000 chickens on a farm in Taiwan were slaughtered Jan 15, 2004 because of an infection with H5N2 influenza, a less pathogenic strain than H5N1, according to an online report in the Taipei Times. Birds at 21 other farms within 1 kilometer of the affected farm were inspected and found to be healthy, the report said. The last outbreak of highly pathogenic avian influenza (HP AI) affecting the layer industry in the US was in 1983-84 when H5N2 was found in Pennsylvania and Virginia. There was a small H5N2 HP AI outbreak in Texas in 2004 in broilers. The AI strain in Texas was not clinically highly pathogenic in the birds; however, it was genetically similar to other highly pathogenic strains and was classified as HP AI. H5N2 has not been associated with any human illnesses. Comment : H5N2 is not a classic low path Avian in chickens. It has a history of on numerous occasions going high path. And this classically occured in Pennsylvania Virginia..much too close to WV to be ignored. http://depts.washington.edu/einet/newsbrief77.html?article=1303#1303 Japan (Saitama and Ibaraki): World�s first confirmed human cases of H5N2 infection The world's first confirmed human cases of less pathogenic avian influenza virus infection are too "risky to ignore," even though none of those affected have had health problems, Japanese officials warned. The H5N2 strain [serotype of avian influenza virus], a milder form than the H5N1 serotype, needs global attention, because it could mutate, they said 11 Jan 2006. "In the past, there was a case where a mild strain [i.e. a LPAI (low pathogenic avian influenza) virus] eventually transformed to a lethal one for chickens [i.e. a HPAI (highly pathogenic avian influenza) virus]," warned a researcher at the National Institute of Infectious Diseases. The Japanese government said that 77 farm workers had been infected with H5N2, after tests on 350 workers and their families at affected chicken farms. The workers are the world's first to test positive for the mild strain. Chickens at some 40 farms in Ibaraki Prefecture have been infected with H5N2 since June 2005. The human infections probably took place before the infections were detected in chickens in the areas. The people were probably exposed to the virus while dealing with chickens and their excrement without taking proper preventive measures. The Health Ministry said it asked the Agriculture, Forestry and Fisheries Ministry and local governments to adopt preventive measures such as advising workers at chicken farms to put on masks at work even if no abnormalities have been found in chickens. According to WHO, an H5N2 epidemic in birds in 1983-1984 in the USA originally caused little death, but within 6 months reached a mortality rate of 90 percent. Japan, which has stockpiled Tamiflu in case of an avian influenza pandemic, designates all H5 [serotype] strains as avian influenza, requiring the killing of the infected chicken. "If a patient with conventional human influenza is infected by mild bird flu, it could create a new type of human influenza strain for which no vaccine or medicine are prepared," the institute's scientist said. "Because it is winter, and it is the season for influenza, the authorities should keep their eyes on even the milder avian influenza viruses," he said. Japan's Health and Welfare Ministry instructed poultry workers to take preventive measures, such as wearing masks and washing their hands frequently. "Workers who were infected with human influenza should avoid working in poultry farms," the Ministry said. But no one has been found to fall ill from the mild strain. Japan is the only country to treat H5N2 as an infectious disease, the researcher said. "I hope these cases provide a warning whistle to countries worldwide," he said. "Scientists only found in 1997 that avian influenza is infectious for human beings, and now we know that a milder [form] of the avian virus, which is hard to detect because it doesn't [produce] any physical symptoms, can infect human beings," he said. �Interim Report on a Serological Survey for [Human] Antibodies to the Highly Pathogenic Avian Influenza Virus in Ibaraki and Saitama Prefectures� (10 Jan 2006) is available at the Ministry of Health, Labour and Welfare website: http://www.mhlw.go.jp/houdou/2006/01/h0110-4.html (in Japanese). (Promed 1/8/06, 1/10/06, 1/11/06, 1/12/06)