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EpiSouth Weekly Epi Bulletin N146 - 30 December 2009 05 january 2010 (Extracts, edited)

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  • EpiSouth Weekly Epi Bulletin N146 - 30 December 2009 05 january 2010 (Extracts, edited)

    EpiSouth Weekly Epi Bulletin N146 - 30 December 2009 05 january 2010 (Extracts, edited)


    [Source: EpiSouth, full PDF document (LINK). Extract, edited. Maps available also at: (LINK).]

    EpiSouth Weekly Epi Bulletin N146 - 30 December 2009 05 january 2010

    The objective of the bulletin is to report new heath events occurring outside and inside EpiSouth area that have potential implications on EpiSouth population. It does not aim to provide an exhaustive review of international alerts. Since 2006, The French public health Institute (InVS) is issuing an online epidemic intelligence bulletin (Bulletin hebdomadaire International - BHI). In order to limit duplication and to make this already verified information available to a larger audience, information relating to health events of interest for EpiSouth population are translated and integrated in the relevant e-web sections. Despite all verifications, WP6 team would not be responsible for potential errors. The recipient is responsible for the cautious use of this information. Neither the European Commission nor any person acting on behalf of the Commission is liable for the use that may be made of the information contained in this report. Data maps and commentary used in this document do not imply any opinion of EpiSouth countries or its partners on the legal status of the countries and territories shown or concerning their borders.


    INDEX e-WEB n146
    • A(H5N1) Human influenza Egypt
    • A(H5N1) Avian influenza Rep. of Korea
    • A(H5N1) Human and avian influenza WORLD : Summary 2010
    • INSIDE Events: West Nile - Romania
    • OUTSIDE events: none


    Location: Egypt - Event: A(H5N1) Human

    On 05 January 2011, the Egyptian Ministry of Health reported 4 new A(H5N1) human infections.
    • The 116th case is:
      • A 56 year-old woman from Sharkia governorate (cf. map1).
      • She developed symptoms on 22 December 2010
      • She was hospitalised on 23 December and is in stable condition.
      • No information is available regarding poultry exposure.
    • The 117th case is:
      • A 25 year-old woman from Qena governorate (cf. map1).
      • She developed symptoms on 19 December 2010
      • She was hospitalised on 27 Dec and died on 29th December.
      • Exposure to poultry was documented.
    • The 118th case is:
      • A 27 year-old male from Ismailia governorate (cf. map1).
      • She developed symptoms on 23 December 2010
      • She was hospitalised on 28 December and is under treatment.
      • Investigations into poultry exposure are ongoing
    • The 119th case is:
      • A 40 y-old male from Daqahliya governorate (cf. map1).
      • She developed symptoms on 25 December 2010
      • She was hospitalised on 30 Dec. and died on 2nd January 2011.
      • Exposure to poultry was documented.


    Comments
    • In Egypt, the last human case was reported on 23rd December 2010 in Luxor Governorate (cf. eWEB n145).
    • Since the 1st case of bird flu in Egypt, the case count is 119 cases including 40 deaths.
    • The available information does not indicate a change in the epidemiology of the virus in Egypt.


    Location: Rep. Korea - Event: A(H5N1) Epizootic
    • On 29th December 2010, the Korean Ministry of Health reported to OIE 2 outbreaks of an A(H5N1) avian influenza virus in 2 farms (poultry and ducks infected), in the Chungcheongman-do and Jeolla provinces (cf. map 2).
    • In the Rep. of Korea, the last A(H5N1) epizootic was reported on 12th December 2010 in wild birds in the same province (cf. eWEB n143).


    REPORT OF NEW HEALTH EVENTS OCCURRING INSIDE THE EPISOUTH AREA (occurring in one or several EpiSouth countries)

    Area: Romania - Event: West Nile
    • On 30th December, National Sanitary Veterinary and Food Safety Authority (NSVFSA) of Romania reported to the OIE a West Nile equine outbreak (6 horses) in Braila and Constanta regions (cf. map 3).
    • These outbreaks are located nearby mosquito breeding area.
    • Last November 2010, Bulgaria reported a West Nile equine outbreak in the North-East part of the country (the Varna oblast) near to the Romanian border (cf. eWEB n138)


    Comments
    • This summer, Romania reported fatal cases of WN infections (cf. eWEB n128).
    • In Romania, active surveillance of human and animal cases of WN infections cases was implemented in the South of the country in 1997. Between 1997and 2009, 4 human cases were confirmed in the district of Brail and in Bucharest (cf. e-WEB n32 ) and in Dolj district (cf. eWEB n76).


    REPORT OF NEW HEALTH EVENTS OCCURRING OUTSIDE THE EPISOUTH AREA (not occurring in one or several EpiSouth countries)

    Area: WORLD - Event: A(H5N1) Epizootic
    • Avian Influenza A(H5N1) (cf. map 4 & 5)
      • Circulation of Avian Influenza virus A(H5N1) is on going on the three continents affected since the epidemic starts in 2003: Asia , Europe and Africa.
      • In 2010 18 countries notified avian influenza A(H5N1) outbreaks ( cf. Map 5), versus 12 countries in 2009. (cf. eWEB n94).
      • In Asia: outbreaks have been documented in poultry farms in Bangladesh, Bhutan, Cambodia, Rep. of Korea, India, Japan, Laos, Myanmar, Nepal and Vietnam. Outbreaks have been documented in wild birds in China (including Hong-Kong) and in Mongolia.
      • In Europe and the Middle-East: avian influenza A(H5N1) outbreaks were described in Romania and Israel among poultry and in wild bird in Bulgaria and Russia.
      • In Africa, Egypt is still enzootic for avian influenza A(H5N1) virus.


    Comments
    • Since 2008, Indonesia and Egypt are considered as enzootic without any obligation to report new avian flu outbreaks to OIE.
    • In most affected countries, avian flu outbreaks were reported among poultry.
    • In the absence of adequate surveillance of wild birds, the persistence of avian influenza A(H5N1) among wild birds cannot be excluded and could lead to possible reintroduction of the virus.


    Area: WORLD - Event: Human A(H5N1) avian influenza (cf. map 4 and 5)
    • From the beginning of the outbreak in November 2003, 516 confirmed A(H5N1) human cases have been reported to WHO in 15 countries, of which 306 have been fatal (case fatality rate (CFR) 59%).
    • From 1st January to 31st December 2010, 48 A(H5N1) avian influenza cases including 24 deaths (CFR 50 %) were reported by 5 countries (Cambodia, China, Egypt, Indonesia and Vietnam)
    • In 2009, these 5 same countries reported 73 human cases including 32 deaths, (CFR 44%). (cf. eWEB n94).
    • Since 2003, the annual number of reported cases decreases (cf. figure 1).
    • In 2010 the global CFR was 49%, but largely varies according to countries. Among countries with more than 1 reported death, Indonesia had the highest CFR: 78% (7 deaths of 9 reported human cases), while in Egypt was 43%.
    • The difference in observed CFRs between countries may be due to disparities in access to health care, treatment and diagnostic, but also to the performance of monitoring and reporting systems (cf. article Eurosurveillance).


    Comments
    • Over the period 2003-2010, the number of cases, initially more important in Asia has gradually declined.
    • In Asia, in 2003-2005, the largest number of cases was reported in Vietnam and Thailand.
    • In 2006, there was a geographical extension to Europe and Africa (Azerbaijan, Turkey, Iraq and Djibouti).
    • From 2006, Indonesia reported the largest number of cases.
    • Since 2009, over 50% of human cases worldwide are reported in Egypt (cf. Figure 2).
    • In 2010, no cluster (with more than 1 confirmed case) was reported to WHO.
    • To date, there is no change in the transmission of the virus.

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