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TURKEY</ST1:p IN THE STRUGGLE
Against avian influenza<O:p</O:p
Asst. Prof. Dr. Turan Buzgan<O:p</O:p
The Ministry of Health Primary Health Care General Directorate
. . . . . . <O:p</O:p
? On 30 December 2005, the experts carried out investigations in Erzurum upon the the notification that there were some suspected winged animal deaths in Erzurum Province Horasan District. The health personnel and the public living there were trained for the subject. The suspected ones were administered protective medicine.
? On 31 December 2005, 4 people from the same family between the ages of 4 and 15 were referred to Van Y?z?nc? Yıl University and hospitalized due to high fever, respiration insufficiency, leucopenia and severe pneumonia picture.
In relation with these patients it was reported that:
? 21 December 2005: this family?s chickens died because of some reason, 2 chickens were slaughtered by the children, the chickens were contacted closely and these chickens were eaten by the whole family,
? 23-24 December 2005: The first symptoms of the disease appeared,
? 27 December 2005: One of the family members consulted to hospital with the complaint of upper respiratory system deficiency.
? 28 December 2005: A second family member consulted to hospital with the complaint of upper respiratory system deficiency.
? 29 December 2005: A third family member consulted to hospital with the complaint of upper respiratory system deficiency.
? 31 December 2005: Four of the family members consulted to hospital, there was the notification of avian influenza in the region and there was the history of contact with the diseased animals and these patients were referred to Van Y?z?nc? Yıl University.
? 31 December 2005: Smear samples were obtained from the patients and these samples were sent to Refik Saydam Hygiene General Directorate. On the same day, the antiviral medicine for this Oseltamivir (Tamiflu ?) was sent to Van Province by the Ministry.
? 1 January 2006: There were no avian influenza virus in the samples in the smear samples of the patients (Rapid test, ELISA, RT-PCR). On the same day Mehmet Ali KO?YİĞİT died because of the disease. 2 more people were also hospitalized because of the same reason.
? On 1 and 2 January 2006: The clinical situations of the patients got worse and they did not respond to treatments, and samples from the lower respiratory system of the patients and a sample from the lungs of the dead patient were taken.
? 3 ? 4 January 2006: It was found that there was the avian influenza virus in the second samples sent to Refik Saydam Hygiene General Directorate (H5N1). The results were also sent to Istanbul University ?apa Medical Faculty Virology Department and the results were confirmed. We sent the samples to the reference laboratory of WHO in London for additional confirmation. We notified the case to WHO on the same day and announced the results to the public via press conference.
? 4 January 2006 : We sent another group consisting of experts from the Primary Health Care Services General Directorate, Ankara Training and Investigation Hospital Infectious Diseases Clinic and Hacettepe University Medical Faculty. The group concerned carried out investigations in Van, Doğubeyazıt, Iğdır, Aralık and Erzurum. The health personnel was trained, some emergent precautions were taken relevant tasks were organized. Additionally, they ensured that some enlightening and educating programmes were carried out.
? 4 January 2006: We formed a Crisis Coordination Center with regard to avian influenza within the Ministry. We accelerated notification activities via press.
? 5 January 2006: We sent case notification forms to relevant place. The patient named Fatma Yiğit also died.
? 5 January 2006: A group of experts from WHO, European Commission and CDC came into our country and we handled the first negotiations.
? 5 January 2006: We reviewed together with the Ministry of Agriculture and Rural Affairs the precautions taken and to be taken.
? 6 January 2006: The analyses carried out in London confirmed the result obtained here. H5N1 virus was also detected in a patient that consulted from Van Province. The third patient named H?lya Ko?yiğit died.
? 6 January 2006: We sent teams consisting of doctors and nurses and ambulances to the region.
? 6-7 January 2006: The Avian Influenza Scientific Board of the ministry of Health negotiated with WHO, European Commission and European CDC experts.
? 7 January 2006: Meetings were carried out at the level of ministers between the Ministry of Health and The Ministry of Agriculture and Rural Affairs.
? 7 January 2006: 100 thousand more boxes of Tamiflu were added to the current stock.
? 8 January 2006: The Minister of Health Prof. Dr. Recep Akdağ went to Van Province together with WHO, European Commission and European CDC experts, the Avian Influenza Scientific Board of the Ministry of Health and Ministry staff. Because of the bad weather conditions in Van Province, the plane landed in Erzurum and they drove to Van. The group visited the hospital and carried out some investigations. Some additional practitioners were reinforced in the region.
? 8 January 2006: The authorities from WHO stated that Turkey treated the matter early, behaved transparently, notified early and maintained any kind of cooperation.
? 8 January 2006: Governors from the 9 provinces, Provincial Health Directors, Provincial Agriculture Directors and other relevant people met and discussed the situation.
? 8 January 2006: 5 more new cases were detected ( 2 from Ankara, Beypazarı, 1 from Sincan, 2 from Ağrı, Doğubeyazıt). Thus the number of cases with positive results in terms of avian influenza became 9.
? 9 January 2006: There were five more case notifications (1 from Van, 2 from Kastamonu, 1 from ?orum and 1from Samsun) and thus the number of cases became 14.
? 9 January 2006: The Minister of Health Prof. Dr. Recep Akdağ left Van and went to Doğubeyazıt and Ağrı and carried out some investigations together with the committee. The committee returned Ankara late at night on the same day.
? 9 January 2006: 5 ventilators were delivered to Van Provincial Health Directorate by the Ministry of Health and it was ensured that these devices be installed in the hospital.
? WHO stated that the testing quality of the reference laboratory (RSHCD) in Turkey was high, there was contact histories with the dead or diseased winged animals of the cases and there were no proof of transmission among human beings.
? 10 January 2006: There was one more case in Kangal, Sivas. Thus the number of laboratory confirmed cases became 15 with this case hospitalized in Cumhuriyet University Medical Faculty. 5 more ventilators were sent to Van Y?z?nc? Yıl University Medical Faculty.
? 11 January 2006: 2 more cases were detected (one of them hospitalized in Diyarbakır Dicle University Medical Faculty, the other in Şanlıurfa Children Hospital).
? 11 January 2006: The H5N1 virus detected in the laboratory analysis of the patient H?lya Ko?yiğit was found positive, thus the number of confirmed cases became 18.
? 11 January 2006: The Minister of Health Recep Akdağ and the European Region Director of WHO Marc Danzon arranged a press conference. M. Danzon stated that Turkey treated the matter just on time and appropriately and there were no danger and there were not any limitations in visiting Turkey.
? 11 January 2006: The Scientific Consultation Committee under the directorship of the Under secretary of the Ministry of Health. On 14 January 2006, a bigger meeting in terms of participation was planned.
? 12 January 2006: A meeting in which Under secretaries from the Ministry of Internal Affairs, Health, Environment and Forest, Agriculture and Rural Affairs participated was carried out on the subject of the avian influenza and the precautions to be taken.
? 12 January 2006: 6 thousand 500 ?N-95? type preventive masks taken by the Borders and Coasts Health General Directorate were delivered to 81 provinces.
? 13 January 2006: 109 new samples were investigated in RSHCGD and no positive results were detected.
? 14 January 2006: The studies were evaluated in a meeting under the directorate of esteemed Abd?llatif Şener. It was decided that the studies were going to be carried out within the scope of National Avian Influenza Coordination Center under the co-presidency of Health and Agriculture under secretaries.
? 14 January 2006: The foreign experts from WHO, America and Europe CDC, FAO and OIE, the Avian Influenza Scientific Consultation Committee member and representatives from the Ministry of Agriculture met under the directorship of the Under secretary of the Ministry of Health.
? Case definitions, preventive measures, surveillance and treatment protocols with regard to the avian influenza were reviewed.
? 14 January 2006: It was decided that an enlightment and education meeting to be arranged with the participation of governors, health directors, agriculture and internal affairs directors of 81 provinces and 2 physicians from every province on 20 ? 21 January 2006.
http://www.saglik.gov.tr/eng/
FROM--------
TURKEY</ST1:p IN THE STRUGGLE
Against avian influenza<O:p</O:p
Asst. Prof. Dr. Turan Buzgan<O:p</O:p
The Ministry of Health Primary Health Care General Directorate
. . . . . . <O:p</O:p
? On 30 December 2005, the experts carried out investigations in Erzurum upon the the notification that there were some suspected winged animal deaths in Erzurum Province Horasan District. The health personnel and the public living there were trained for the subject. The suspected ones were administered protective medicine.
? On 31 December 2005, 4 people from the same family between the ages of 4 and 15 were referred to Van Y?z?nc? Yıl University and hospitalized due to high fever, respiration insufficiency, leucopenia and severe pneumonia picture.
In relation with these patients it was reported that:
? 21 December 2005: this family?s chickens died because of some reason, 2 chickens were slaughtered by the children, the chickens were contacted closely and these chickens were eaten by the whole family,
? 23-24 December 2005: The first symptoms of the disease appeared,
? 27 December 2005: One of the family members consulted to hospital with the complaint of upper respiratory system deficiency.
? 28 December 2005: A second family member consulted to hospital with the complaint of upper respiratory system deficiency.
? 29 December 2005: A third family member consulted to hospital with the complaint of upper respiratory system deficiency.
? 31 December 2005: Four of the family members consulted to hospital, there was the notification of avian influenza in the region and there was the history of contact with the diseased animals and these patients were referred to Van Y?z?nc? Yıl University.
? 31 December 2005: Smear samples were obtained from the patients and these samples were sent to Refik Saydam Hygiene General Directorate. On the same day, the antiviral medicine for this Oseltamivir (Tamiflu ?) was sent to Van Province by the Ministry.
? 1 January 2006: There were no avian influenza virus in the samples in the smear samples of the patients (Rapid test, ELISA, RT-PCR). On the same day Mehmet Ali KO?YİĞİT died because of the disease. 2 more people were also hospitalized because of the same reason.
? On 1 and 2 January 2006: The clinical situations of the patients got worse and they did not respond to treatments, and samples from the lower respiratory system of the patients and a sample from the lungs of the dead patient were taken.
? 3 ? 4 January 2006: It was found that there was the avian influenza virus in the second samples sent to Refik Saydam Hygiene General Directorate (H5N1). The results were also sent to Istanbul University ?apa Medical Faculty Virology Department and the results were confirmed. We sent the samples to the reference laboratory of WHO in London for additional confirmation. We notified the case to WHO on the same day and announced the results to the public via press conference.
? 4 January 2006 : We sent another group consisting of experts from the Primary Health Care Services General Directorate, Ankara Training and Investigation Hospital Infectious Diseases Clinic and Hacettepe University Medical Faculty. The group concerned carried out investigations in Van, Doğubeyazıt, Iğdır, Aralık and Erzurum. The health personnel was trained, some emergent precautions were taken relevant tasks were organized. Additionally, they ensured that some enlightening and educating programmes were carried out.
? 4 January 2006: We formed a Crisis Coordination Center with regard to avian influenza within the Ministry. We accelerated notification activities via press.
? 5 January 2006: We sent case notification forms to relevant place. The patient named Fatma Yiğit also died.
? 5 January 2006: A group of experts from WHO, European Commission and CDC came into our country and we handled the first negotiations.
? 5 January 2006: We reviewed together with the Ministry of Agriculture and Rural Affairs the precautions taken and to be taken.
? 6 January 2006: The analyses carried out in London confirmed the result obtained here. H5N1 virus was also detected in a patient that consulted from Van Province. The third patient named H?lya Ko?yiğit died.
? 6 January 2006: We sent teams consisting of doctors and nurses and ambulances to the region.
? 6-7 January 2006: The Avian Influenza Scientific Board of the ministry of Health negotiated with WHO, European Commission and European CDC experts.
? 7 January 2006: Meetings were carried out at the level of ministers between the Ministry of Health and The Ministry of Agriculture and Rural Affairs.
? 7 January 2006: 100 thousand more boxes of Tamiflu were added to the current stock.
? 8 January 2006: The Minister of Health Prof. Dr. Recep Akdağ went to Van Province together with WHO, European Commission and European CDC experts, the Avian Influenza Scientific Board of the Ministry of Health and Ministry staff. Because of the bad weather conditions in Van Province, the plane landed in Erzurum and they drove to Van. The group visited the hospital and carried out some investigations. Some additional practitioners were reinforced in the region.
? 8 January 2006: The authorities from WHO stated that Turkey treated the matter early, behaved transparently, notified early and maintained any kind of cooperation.
? 8 January 2006: Governors from the 9 provinces, Provincial Health Directors, Provincial Agriculture Directors and other relevant people met and discussed the situation.
? 8 January 2006: 5 more new cases were detected ( 2 from Ankara, Beypazarı, 1 from Sincan, 2 from Ağrı, Doğubeyazıt). Thus the number of cases with positive results in terms of avian influenza became 9.
? 9 January 2006: There were five more case notifications (1 from Van, 2 from Kastamonu, 1 from ?orum and 1from Samsun) and thus the number of cases became 14.
? 9 January 2006: The Minister of Health Prof. Dr. Recep Akdağ left Van and went to Doğubeyazıt and Ağrı and carried out some investigations together with the committee. The committee returned Ankara late at night on the same day.
? 9 January 2006: 5 ventilators were delivered to Van Provincial Health Directorate by the Ministry of Health and it was ensured that these devices be installed in the hospital.
? WHO stated that the testing quality of the reference laboratory (RSHCD) in Turkey was high, there was contact histories with the dead or diseased winged animals of the cases and there were no proof of transmission among human beings.
? 10 January 2006: There was one more case in Kangal, Sivas. Thus the number of laboratory confirmed cases became 15 with this case hospitalized in Cumhuriyet University Medical Faculty. 5 more ventilators were sent to Van Y?z?nc? Yıl University Medical Faculty.
? 11 January 2006: 2 more cases were detected (one of them hospitalized in Diyarbakır Dicle University Medical Faculty, the other in Şanlıurfa Children Hospital).
? 11 January 2006: The H5N1 virus detected in the laboratory analysis of the patient H?lya Ko?yiğit was found positive, thus the number of confirmed cases became 18.
? 11 January 2006: The Minister of Health Recep Akdağ and the European Region Director of WHO Marc Danzon arranged a press conference. M. Danzon stated that Turkey treated the matter just on time and appropriately and there were no danger and there were not any limitations in visiting Turkey.
? 11 January 2006: The Scientific Consultation Committee under the directorship of the Under secretary of the Ministry of Health. On 14 January 2006, a bigger meeting in terms of participation was planned.
? 12 January 2006: A meeting in which Under secretaries from the Ministry of Internal Affairs, Health, Environment and Forest, Agriculture and Rural Affairs participated was carried out on the subject of the avian influenza and the precautions to be taken.
? 12 January 2006: 6 thousand 500 ?N-95? type preventive masks taken by the Borders and Coasts Health General Directorate were delivered to 81 provinces.
? 13 January 2006: 109 new samples were investigated in RSHCGD and no positive results were detected.
? 14 January 2006: The studies were evaluated in a meeting under the directorate of esteemed Abd?llatif Şener. It was decided that the studies were going to be carried out within the scope of National Avian Influenza Coordination Center under the co-presidency of Health and Agriculture under secretaries.
? 14 January 2006: The foreign experts from WHO, America and Europe CDC, FAO and OIE, the Avian Influenza Scientific Consultation Committee member and representatives from the Ministry of Agriculture met under the directorship of the Under secretary of the Ministry of Health.
? Case definitions, preventive measures, surveillance and treatment protocols with regard to the avian influenza were reviewed.
? 14 January 2006: It was decided that an enlightment and education meeting to be arranged with the participation of governors, health directors, agriculture and internal affairs directors of 81 provinces and 2 physicians from every province on 20 ? 21 January 2006.