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Micronesia, Palau: 300 chickens die of undiagnosed illness, 3 humans with mild flu symptoms, humans have seasonal influenza A, tests still pending on chickens

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  • Micronesia, Palau: 300 chickens die of undiagnosed illness, 3 humans with mild flu symptoms, humans have seasonal influenza A, tests still pending on chickens

    Perhaps a low-path avian flu (with false negatives in chickens due to the expired tests)? Perhaps H1N1pdm09 spreading H2B?

    Published Date: 2014-04-02 10:38:32
    Subject: PRO/AH/EDR> Undiagnosed illness - Palau: human, animal, RFI
    Archive Number: 20140402.2374768

    UNDIAGNOSED ILLNESS - PALAU: HUMAN, ANIMAL, REQUEST FOR INFORMATION
    ************************************************** *****************
    A ProMED-mail post
    http://www.promedmail.org
    ProMED-mail is a program of the
    International Society for Infectious Diseases
    http://www.isid.org

    [1]
    Date: Wed 2 Apr 2014
    Source: Palau Wave Radio [edited]
    http://palauwaveradio.com/?p=2854


    The Bureau of Public Health and the Bureau of Agriculture are informing the public that investigation is ongoing at the PMA poultry farm in Ngerikiil, Airai, where approximately 300 chickens have died since reports were received yesterday morning [1 Apr 2014].

    At the moment, there are no confirmed cases of avian influenza (bird flu) or any other disease transferred between the birds and people [see item 2].

    However, the PMA poultry farm has been quarantined, and the public is urged to remain clear of this area and its surroundings while investigation continues.

    As a precautionary measure, the public is urged to continue practicing healthy habits such as proper hand washing and coughing/sneezing etiquettes in order to prevent the flu. In addition, seasonal flu vaccines will be available free of charge starting Wed 2 Apr 2014 at the Belau National Hospital foyer for those who have not received it yet.

    Furthermore, while investigations are ongoing, the public is urged to refrain from further consumption of PMA poultry farm products including chickens and eggs and the use of chicken manure fertilizers from PMA farm.

    The public is also asked to call 911 to report any clusters of sick or dead birds and are urged not handle the birds.

    Further updates will be disseminated through the media as soon as they are available. For more information on how to prevent the flu, contact the Communicable Disease Unit Hotline at 775-2822.

    Contact: Gaafar Uherbelau, Community Advocacy Program, Tel: 488-2002, Fax: 488-0543, <gaafar.uherbelau@palauhealth.org>.

    [Byline: Sha Merirei Ongelungel]

    --
    Communicated by:
    ProMED-mail
    <promed@promedmail.org>

    ******
    [2]
    Date: Mon 31 Mar 2014
    From: David Duffy <dduffy@hawaii.edu> [edited]


    [The following report has been received through the listserv of the Pacific Public Health Surveillance Network <pacnet@lyris.spc.int>, distributing the following preliminary report by Dawn Fitgibbons, MPH, Public Health Epidemiologist, Palau Ministry of Health].

    Palau poultry deaths, human illness investigation. Preliminary report, 31 Mar 2014
    ----------------------
    Situation Overview
    On Mon 31 Mar 2014 at approximately 1:30 pm in Palau, the MOH received a call from PMA Chicken Farm stating that approximately 200 chickens died over the weekend and that there were 2 workers exhibiting flu-like symptoms. The Koror State Veterinarians had already been called to the scene and quarantined the area. The dead chickens remained on site until responders could arrive to make a decision about disposal. A response team was gathered, and a subgroup of these responders investigated the site. Below are details of the site investigation.

    A. Worker investigation
    -----------------------
    Three workers reported illness in the past 3 weeks. The CAT Team Medical Officer, Air Force Captain Jim Lam, examined these 3 workers.

    1. 27-year-old male Filipino worker residing on the farm with no recent travel history. Patient stated that he began feeling ill on 26 Mar 2014 with a headache, fever, runny nose, and productive cough. He began feeling better on 31 Mar 2014. Presently, the patient displayed no symptoms and reported feeling recovered.

    2. 44-year-old male Filipino worker residing on the farm with no recent travel history. Patient stated that he began feeling ill on 29 Mar 2014 PM with a headache, fever, runny nose, dry dough, weakness, and poor appetite. The patient had a current fever of 102.8 F [39 C] and was still feeling ill but reported getting better. He was given Tylenol and one dose of Tamiflu.

    3. 26-year-old female Filipino worker residing on the farm with no recent travel history. Patient stated that she had a fever and headache with a runny nose 2 weeks ago that lasted 2 days. This was followed by a cough that lasted about one week. The patient currently was feeling well. She also reported that her husband did not become ill.

    B. Chicken Illness
    ------------------
    Late on Thu 28 Mar 2014, a group of chickens became ill and began to die. Illness continued throughout the weekend. Currently, approximately 300 chickens have died. There are about 7000 chickens on the farm in total.

    The staff reported that the chickens had diarrhea and nasal discharge. The chickens progressively became weaker, and their beaks became pale and frail. Additionally, discoloration of feathers and skin also occurred. The feathers became lighter, whereas the skin turned purplish. From time of onset to death is approximately 2 days.

    It should also be noted that the majority of the chickens were younger (about one-month-old) chickens, though older chickens were also affected (about 6 months). The chickens are housed according to age, so most chickens which died were from one coop.

    Also of interest: The chicken feed changed from 27 Feb 2014 to 21 Mar 2014. Usually, the farm orders all food from California. However, due to an error in ordering, locally accessible food was obtained during this period for all ages of chickens. The local food was a combination of feed from the Philippines, locally available pig feed, and cut up banana tree trunk. No other changes to chicken care occurred according to the workers.

    Actions Taken
    1. Approximately 12 chickens of varying ages tested for avian flu via rapid test kit using anal swabs; all tests were negative.
    2. Blood samples were obtained from 3 chickens to be sent out for testing.
    3. Patients were quarantined, and only authorized individuals wearing PPE are allowed on the farm.
    4. Feed samples of current stocks were taken.
    5. Specimen collection kits were received from Guam Public Health Labs this evening [Mon 31 Mar 2014].

    Next Steps
    1. Human nasal swabs are to be taken from all patients and sent out along with chicken blood samples.
    2. The local distributor of feed will be contacted and investigated.
    3. Samples of all feed will be tested.
    4. The chicken distributor in Hawaii will be contacted and questioned about any additional cases.
    5. A recall of all eggs will be distributed locally.

    Submitted by Haley Menard Cash, PhD, MPH
    Epidemiologist
    Palau Ministry of Health

    Remark added by Dawn Fitgibbons, MPH, Public Health Epidemiologist, Palau Ministry of Health: Additional poultry samples will be taken today [1 Apr 2014] and sent to Hawaii State Laboratories along with samples from the affected workers.

    --
    David Duffy
    Pacific Cooperative Studies Unit
    Botany
    University of Hawaii
    3190 Maile Way
    Honolulu Hawaii 96822 USA
    <dduffy@hawaii.edu>

    ******
    [3]
    Date: Wed 2 Apr 2014
    From: David Duffy <dduffy@hawaii.edu> [edited]


    Palau Chicken Death/Human Illness Investigation Follow-up Report, 1 Apr 2014 [From the same source as item 2, in the Palau Ministry of Health].
    -----------------------------------
    Ongoing actions
    1. PMA farms remains under quarantine.
    2. ILIs [influenza like illnesses] are being monitored at Belau National Hospital.

    Further actions taken
    1. A formal press release regarding the situation was drafted and released to the public.
    2. All poultry products originating from PMA farms were recalled.
    3. Additional influenza vaccines have been requested.
    4. Agreement was reached that all samples (human and chicken) will be sent to Hawaii State Laboratories for analysis; USDA permits have been acquired.

    Tests performed
    1. The 2 male workers most recently ill were given rapid influenza A/B tests (QuickVue Influenza Test, Quidel Corporation, exp. 29 Nov 15). The male most recently ill tested positive, the recovered male was negative.
    2. Nine additional chickens tested for avian influenza via rapid test were all negative (Note that these kits expired in 2008.).

    Samples taken to be shipped to Hawaii
    1. Human blood samples from all 5 workers for serum
    2. Human nasopharyngeal swabs from 2 males most recently ill
    3. Tracheal and cloacal swabs of 3 chickens
    4. Lung and trachea biopsies of the same 3 chickens
    5. Whole blood on an additional 3 chickens (these were taken 3/31/14)

    Laboratory stocks
    1. Approximately 500 doses of influenza vaccine
    2. Approximately 400 doses of Tamiflu (expired in 2011 but told by CDC that they are still usable for an additional 5 years)

    Additional information:
    Avian influenza rapid tests were found to have expired in 2008.

    Other potential sources of illness:
    It was discovered that the chickens one month and older are given water from a local river. The chicks (under one month old) are given filtered water. These chicks do not appear to be ill like the older chickens. Therefore, samples of the water were collected and are being cultured overnight.

    --
    David Duffy
    Pacific Cooperative Studies Unit
    Botany
    University of Hawaii
    3190 Maile Way
    Honolulu Hawaii 96822 USA
    <dduffy@hawaii.edu>

    [The initially suggested possible correlation between the 3 humans with upper-respiratory signs and the disease described in the chickens on the egg farm is yet to be thoroughly investigated. It deserves to be indicated that one of the patients underwent the illness a fortnight before the others, which were synchronised with the chicken event.

    On top of avian influenza, Newcastle disease deserves to be excluded. Additional information on the disease in the chickens will be appreciated, particularly PM findings and possible fluctuations in the egg laying curve (e.g. sharp drop). Results of the tests are anticipated with interest.

    The Republic of Palau is an island country located in the western Pacific Ocean, geographically part of the larger island group of Micronesia. The country's population of around 21 000 is spread across 250 islands forming the western chain of the Caroline Islands. The most populous island is Koror. The islands share maritime boundaries with Indonesia, the Philippines, and the Federated States of Micronesia. - Mod.AS

  • #2
    Re: Palua: 300 chickens die of undiagnosed illness, 3 humans with mild flu symptoms, rapid tests on chickens for avian flu negative so far, one human postiive for influenza

    [Source: Pacific News Center, full page: (LINK). Extract.]


    Bird Flu Scare in Palau Has Officials Concerned

    Written by Janela Buhain Carrera, Friday, 04 April 2014 14:14 / Guam News - Guam News


    Guam - Government officials in Palau are in the midst of testing three individuals for possible bird flu virus after hundreds of chickens reportedly died in the span of a few days at a chicken farm. The three employees reported having flu-like symptoms after handling the dead birds. Samples are now being collected from dozens of employees at a chicken farm in Palau after more than 170 birds suddenly died in the span of a few days. The chickens exhibited flu-like symptoms, local officials in Palau reported to Island Times, before they plopped dead to the ground.

    ()


    -
    ------

    Comment


    • #3
      Re: Micronesia, Palau: 300 chickens die of undiagnosed illness, 3 humans with mild flu symptoms, rapid tests on chickens for avian flu negative so far, one human postiive for influenza

      Source: http://www.islandsbusiness.com/news/...e-unconfirmed/

      Chickens die at Palau farm; cause unconfirmed
      From OCEANIA TV NEWS/PACNEWS
      Mon 07 Apr 2014


      KOROR, Palau Chickens from the Palau Mission Academy Poultry Farm died in a matter of days causing concerns in this island nation.

      On March 31, 2014, a team of experts from the Ministry of Health, Quarantine Office, Bureau of Agriculture, and the Koror State Animal Shelter were dispatched to the farm in Airai to investigate what caused 171 chickens to die.

      Initial reports indicated that the avian influenza also known as the bird flu caused the deaths.

      For the safety of the workers on the farm and the public, the farm was quarantined for several hours until the workers were cleared of any type of disease related to the dead birds.

      Two workers who displayed symptoms including headaches and runny noses were tested extensively and later cleared of H5N1 including H1N1.

      The majority of tests conducted by authorities were negative, but some tests were inconclusive.

      Authorities are now looking into sending some samples from the dead birds to Hawaii for further testing...

      Comment


      • #4
        Re: Micronesia, Palau: 300 chickens die of undiagnosed illness, 3 humans with mild flu symptoms, rapid tests on chickens for avian flu negative so far, one human postiive for influenza

        Originally posted by Shiloh View Post
        Source: http://www.islandsbusiness.com/news/...e-unconfirmed/
        Two workers who displayed symptoms including headaches and runny noses were tested extensively and later cleared of H5N1 including H1N1.
        ...
        This phrase is very important and very unclear. H1N1 and H5N1 are both subtypes of infleunza A, but neither is a subtype of the other. We have a previous report above that there has been at least one rapid positive influenza A/B human test. So are these the other two humans? Or do the influenza A negatives suggest the human had influenza B? Influenza B doesn't kill birds.

        Or is this a bizarre way of saying the human(s) had H1N1, not H5N1? H1N1 would be an unlikely, but not impossible, culprit in the chicken deaths.

        Either way, it is important to subtype any influenza A positives that are obtained, whether from humans or birds.

        Comment


        • #5
          Re: Micronesia, Palau: 300 chickens die of undiagnosed illness, 3 humans with mild flu symptoms, rapid tests on chickens for avian flu negative so far, one human postiive for influenza

          Published Date: 2014-04-11 15:24:26
          Subject: PRO/AH/EDR> Undiagnosed illness - Palau (02): resolved
          Archive Number: 20140411.2397617

          UNDIAGNOSED ILLNESS - PALAU (02): RESOLVED
          ******************************************
          A ProMED-mail post
          http://www.promedmail.org
          ProMED-mail is a program of the
          International Society for Infectious Diseases
          http://www.isid.org

          Date: Fri 11 Apr 2014
          From: David Duffy <dduffy@hawaii.edu> [summ., edited]


          [The following report has been received through the listserv of the Pacific Public Health Surveillance Network <pacnet@lyris.spc.int>, distributing the following update of the event by Dawn Fitzgibbons, MPH, public health epidemiologist, Palau Ministry of Health.]

          Palau chicken death / human illness investigation follow-up report, 11 Apr 2014
          ----------------------------------------------------------------------
          Health status of humans and chickens:
          - all farm workers are now healthy, although a seasonal influenza outbreak continues in Palau
          - chickens are now healthy and no more deaths have been reported

          Samples being tested:
          - human samples are influenza A positive; workers contracted seasonal flu
          - chicken samples received at USDA lab in Iowa; still being processed; preliminary results do not suggest avian influenza

          Further actions taken:
          - quarantine of PMA Farms lifted
          - PMA products no longer under recall; advisory to thoroughly cook all poultry and eggs
          - residents of Airai with untreated water advised to boil their water before drinking or food prep

          --
          David Duffy
          Pacific Cooperative Studies Unit
          Botany
          University of Hawaii
          3190 Maile Way
          Honolulu, Hawaii 96822
          USA
          <dduffy@hawaii.edu>

          [The event reported in posting 20140402.2374768, which seemed synchronic in humans and chickens, presented a need to exclude a zoonotic etiology, with special reference to avian influenza, which has been definitely excluded. Commendably, appropriate precautionary measures have been applied, in a timely and transparent manner.

          It is conceivable to assume that the abrupt feed change, as described, and not an infectious disease, was behind the observed health problem in the chickens.

          As David Duffy rightly concludes, "All's well that ends well." - Mod.AS

          Comment

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