Vietnam: Possible human fatal infection with Porcine Reproductive Respiratory Syndrome (PRRS) virus-reporting error

[alert]

Obviously, S. suis infection is a high possibility here as well.

The mention of 4 human infections toward the end of the article makes me suspect that this might be S. suis.

http://promedmail.org/pls/apex/f?p=..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,82927

Archive Number 20100526.1751
Published Date 26-MAY-2010
Subject PRO/AH/EDR> Porcine reprod. & resp. syndrome - Viet Nam (02), human fatality susp.

PORCINE REPRODUCTIVE AND RESPIRATORY SYNDROME - VIET NAM (02), HUMAN
FATALITY SUSPECTED
***************************************************************************************
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: Wed 26 May 2010
Source: VietnamNet Bridge [edited]
<HTTP: pig-disease-feared-to-claim-first-fatality-912419="" 201005="" social="" english.vietnamnet.vn="">


Pig disease feared to claim 1st fatality
----------------------------------------
Porcine reproductive and respiratory syndrome (PRRS), commonly dubbed
blue-ear disease, is suspected as the culprit behind the death of a
man in the central province of Quang Ngai on Monday [24 May 2010].

Nguyen Xuan Men, deputy director of the provincial Department of
Health confirmed with the online newspaper Vnexpress that the young
man was suspected to be the 1st to succumb to the deadly pig disease
that is spreading to pig herds in the north. According to Men, the
young man suffered from diarrhea, high fever, convulsion, and skin
hemorrhage after eating fresh pig blood pudding. He was not
hospitalized in time and lost consciousness.

The man, who was transferred to the Central Hospital of Hue from
Quang Ngai, died on Monday. Health workers immediately disinfected
where he was living and examined people who had been in contact with
the deceased. Health workers said the virus of PRRS has a particular
affinity for macrophages particularly those found in the lung.
Macrophages are part of the body defenses. Those present in the lung
are called alveolar macrophages. They ingest and remove invading
bacteria and viruses but not in the case of the PRRS virus. Instead,
the virus multiplies inside them producing more viruses and kills the
macrophages.

Once it has entered a herd PRRS virus tends to remain present and
active indefinitely. The fatality rate is at 7 percent; thus, it can
do harm if patients are not timely hospitalized.

The National Department of Health reported that no new blue ear
disease outbreaks were reported in recent days. However, the epidemic
remained active in 15 provinces nationwide, mostly in northern
provinces including Hanoi. Since April this year, 4 positive [human?]
cases of porcine reproductive and respiratory syndrome have been
detected.

--
Communicated by:
Charles Ortleb
<RUBICONMEDIA@YAHOO.COM>

[Initially reported by Viet Nam to the OIE as starting in March 2007,
PRRS was declared endemic in February 2008. Some investigators are of
the opinion that it had been circulating in the region since 1999
(for more detailed information, see: Porcine reprod. & resp. syndrome
- Viet Nam 20100414.1206).

Porcine reproductive and respiratory syndrome (PRRS) is characterised
by reproductive failure of sows and respiratory problems of piglets
and growing pigs. The disease is caused by porcine reproductive and
respiratory disease (PRRS) virus, a virus classified as a member of
the order _Nidovirales_, family _Arteriviridae_, genus _Arterivirus_.
The primary target cell of the virus is the alveolar macrophage of
the pig. 2 major antigenic types of the virus exist, the European and
the American type.

The virus is primarily transmitted via infected pigs but also by
faeces, urine, semen and fomites. PRRS virus infection occurs in most
major pig-producing areas throughout the world. The reproductive
failure is characterised by infertility, late fetal mummification,
abortions, stillbirths, and the birth of weak piglets that often die
soon after birth from respiratory disease and secondary infections.
Older pigs may demonstrate mild signs of respiratory disease, usually
complicated by secondary infections.:magnify: No other species are known to be
naturally infected with PRRSV. Virological diagnosis of PRRS virus
infection is difficult. For further information readers are referred
to chapter 2.8.7 in the O.i.E. Manual
(<HTTP: 2.08.07_prrs.pdf="" pdf="" 2008="" mmanual="" normes="" eng="" www.oie.int="">).

There are no previous records of human cases of PPR virus infection
at least to this moderator's knowledge. Indeed none of the viruses
classified in the family _Arteriviridae_ are known to be natural
human pathogens. Therefore this Vietnamese report must regarded with
caution in the absence of confirmatory laboratory diagnosis.
Nonetheless the nature of the exposure (consumption of amounts of
fresh (uncooked?) pig blood is exceptional. Furthermore the outcome
of infection in pigs is in general less dramatic than that described
in the case of this unfortunate man.

Confirmatory diagnosis is awaited. If this report is authenticated it
is a very serious development in view of the global occurrence of the
PRRS in pigs and the genetic lability of the virus. - Mod.CP]</HTTP:></RUBICONMEDIA@YAHOO.COM></HTTP:></HTTP:></HTTP:>

 

[alert]

Re: Vietnam: Possible human fatal infection with PRRS virus

Re: Vietnam: Possible human fatal infection with PRRS virus

Here is the original article. Perhaps the ProMED post should have been labelled as "heavily edited". I am leaning toward S. suis on this one.

http://english.vietnamnet.vn/social/201005/Pig-disease-feared-to-claim-first-fatality-912419/

Pig disease feared to claim first fatality
Last update 11:46, Wednesday, 26/05/2010 (GMT+7)
,
VietNamNet Bridge ? Porcine Reproductive and Respiratory Syndrome (PRRS), commonly dubbed blue-ear disease, is suspected as the culprit behind the death of a man in the central province of Quang Ngai on Monday.

Blue-ear disease spreads in northern, central regions

Blue-ear pig disease confuses the market

Nguyen Xuan Men, deputy director of the provincial Department of Health; confirmed with the online newspaper Vnexpress that the young man was suspected to be the first to succumb to the deadly pig disease that is spreading to pig herds in the north.

According to Men, the young man suffered from diarrhea, high fever, convulsion, and skin hemorrhage after eating fresh pig blood pudding. He was not hospitalized in time and lost consciousness.

The man, who was transferred to the Central Hospital of Hue from Quang Ngai, died on Monday.

Health workers immediately disinfected where he was living and examined people who had been in contact with the deceased. Health workers said the virus of PRRS has a particular affinity for the macrophages particularly those found in the lung.

Macrophages are part of the body defenses. Those present in the lung are called alveolar macrophages. They ingest and remove invading bacteria and viruses but not in the case of the PRRS virus. Instead, the virus multiplies inside them producing more viruses and kills the macrophages.

Once it has entered a herd the virus tends to remain present and active indefinitely. The fatality rate is at 7%, thus, it can do harm if patients are not timely hospitalized.

The National Department of Health reported that no new blue ear disease outbreaks were reported in recent days. However, the epidemic remained active in 15 provinces nationwide, mostly in northern provinces including Hanoi.

Since April this year, four positive cases of Porcine Reproductive and Respiratory Syndrome have been detected.

VietNamNet/SGT

 

[alert]

Re: Vietnam: Possible human fatal infection with PRRS virus

Re: Vietnam: Possible human fatal infection with PRRS virus

Treyfish has been posting updates on a large S. suis outbreak ongoing in Vietnam. The last posts on that are here:

http://www.flutrackers.com/forum/showthread.php?t=146983

Notably, infection of pigs with PRRS virus has apparently been linked to increased susceptibility to infection with S. suis.

 

[Treyfish]

Re: Vietnam: Possible human fatal infection with PRRS virus

Re: Vietnam: Possible human fatal infection with PRRS virus

6:32 AM, 27/05/2010
Quang Ngai: There are no conclusions about the cause of death from suspected swine Streptococcus



Afternoon 26 / 5, Dr. Nguyen Xuan Men - Deputy Director of Quang Ngai Department of Health said the Department had written to directors of Hue Central Hospital confirmed causes of death of Mr Bui Van Nhuan (37 years old ) suspected swine streptococcus bacteria in the ward chief Lo, Quang Ngai city.

In the last few days, some mass media that Mr. Bui Van Nhuan death by suspected swine Streptococcus. This has to affect the psychology of people and communities.

Previous information on, pending the conclusion of the Central Hospital in Hue, Quang Ngai province, the health sector has been assigned to the Center of preventive medicine in promoting active communities on the fields of prevention, such as pigs should not be unknown origin, not given away slaughter and consumption of the pigs died of unknown causes, and recommended people not eat more soup, pig heart or undercooked pork, source unknown Original. /. :tiphat:http://vovnews.vn/Home/Quang-Ngai-C...ghi-nhiem-lien-cau-khuan-lon/20105/144928.vov

 

[Arkanoid Legent]

Pig disease feared to claim first fatality

Pig disease feared to claim first fatality

Porcine Reproductive and Respiratory Syndrome (PRRS), commonly dubbed blue-ear disease, is suspected as the culprit behind the death of a man in the central province of Quang Ngai on Monday.

Nguyen Xuan Men, deputy director of the provincial Department of Health; confirmed with the online newspaper Vnexpress that the young man was suspected to be the first to succumb to the deadly pig disease that is spreading to pig herds in the north.


(read more, link)

 

[alert]

Re: Vietnam: Possible human fatal infection with Porcine Reproductive Respiratory Syndrome (PRRS) virus - S. suis more likely

Re: Vietnam: Possible human fatal infection with Porcine Reproductive Respiratory Syndrome (PRRS) virus - S. suis more likely

There are two pathogens likely involved in this incident. PRRS is caused by a vrius, and affects only pigs. S. suis is a bacterium, and spreads from pigs to humans. Vietnam has reported at least 4 fatal S. suis infections in central Vietnam in the past few days, and this could be the first one in North Vietnam. Human infections with the PRRS virus are previously unheard of. PRRS infections in pigs do increase the likelihood that the pig will carry S. suis, so it isn't entirely incorrect to link the man's death with that virus, but the man's death was likely not caused by himself being infected with the virus. Several other articles have described this in more detail (such as the ones in http://www.flutrackers.com/forum/showthread.php?p=357218#post357218 )

Since the article itself states that the disease has a 7% fatality rate, it is almost certain that the disease that is suspected to have killed this man is S. suis, as it would be impossible to calculate the fatality rate of a virus if this was the first human case.

I believe the article that ProMED is quoting is in error.

 

[Giuseppe]

Re: Vietnam: Possible human fatal infection with Porcine Reproductive Respiratory Syndrome (PRRS) virus

Re: Vietnam: Possible human fatal infection with Porcine Reproductive Respiratory Syndrome (PRRS) virus

Porcine Reproductive and Respiratory Syndrome - Vietnam, Human Infection Debated (from ProMedMail.org, extract, edited)

[Source: ProMedMail.org, full text (LINK). Extract, edited.]

Archive Number 20100528.1778
Published Date 28-MAY-2010
Subjec PRO/AH Porcine reprod. & resp. syndrome - Viet Nam (04): RFI

PORCINE REPRODUCTIVE & RESPIRATORY SYNDROME - VIET NAM (04): HUMAN INFECTION DEBATED
***************************************************************************
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 28 May 2010
From: Trevor Drew <t.w.drew@vla.defra.gsi.gov.uk> [edited]

Re: ProMED-mail Porcine reprod. & resp. syndrome - Viet Nam (02), human fatality suspected 20100526.1751
----------------------------------------------------------------------
I would like to endorse the views expressed by Dr Kelly Lager (ProMED-mail posting no. 20100527.1762), concerning the supposed involvement of PRRSV in human deaths in Viet Nam. As a pig virologist who has spent many years studying this virus, both in Europe and in Asia, I am also concerned about the claims made by a Vietnamese medical official, that PRRSV was causative in this and other cases in that country. There has been no accompanying scientific evidence to support such a claim and, without such evidence, these claims only serve to generate significant disruption and possibly panic within the population of Viet Nam and beyond. Also, quite apart from the potential damage to the larger-scale pig production in the region, pigs are a significant part of the rural economy and a major protein source for the country - constituting more than 70 percent of the total meat production of the region.

Pigs are also part of the societal fabric, often acting as a form of savings and additional income at times of hardship, school fees, etc. So any associated panic could have significant sociological consequences in the longer term. As Kelly Larger says, there are far more reasonable explanations for this small number of deaths.

Anyone who has been studying this virus must be concerned about the increasing diversity exhibited by this virus, particularly in Asia, where the methods of production and numbers of pigs seem to provide optimal conditions for its evolution. And, considering PRRSV is a virus relatively new to pigs, having been known to science only for the last 20 years, it would be rash to totally dismiss the possibility of a jump to another species, including man. But until this and other cases are carefully investigated, I would suggest it is the duty of all scientists and communicators of science to present such information in a responsible way.

I raise the question of whether the inclusion of the caveat within the initial and subsequent ProMED reports was sufficient, or whether the opinion of a PRRSV expert should have been sought and published alongside the original report.

--
Prof Trevor Drew PhD, MSc, CBiol, MSB
Head of Virology Department
Head of Statutory and Exotic Virus Programme
Chair, VLA Academic Board
OIE Reference Expert for CSF, BVD & EVA
Veterinary Laboratories Agency (Weybridge)
New Haw, Addlestone
Surrey KT15 3NB
UK
<t.w.drew@vla.defra.gsi.gov.uk>
<http://www.vla.gov.uk/>

[Editor's comment: We appreciate Prof. Drew's views as an expert on this topic and thank him for this contribution. ProMED sees its primary role as a provider of early warnings of emerging disease outbreaks. Thus we need to balance the requirement for rapid reporting, needed to recognize and combat an outbreak, with the need for cautious interpretation of incomplete information and deliberation among experts. We decided to pass along this news story (which was already widely available on the Internet and in the public domain) with our view that the occurrence of PRRS in humans was unproven and indeed unlikely. Part of our role is to temper media sensationalism with rational context.

As Prof. Drew states however, species jumps can and do occur unexpectedly. Such species jumps are an important source of newly emerging infectious diseases and a major reason for ProMED's emphasis on "one medicine" in our reporting. We also recognize our obligation to provide a forum for informed discussion and to present further evidence, which we eagerly await, as it becomes available. - Ed.LM]

[see also:
Porcine reprod. & resp. syndrome - Viet Nam (03): human fatality
debated 20100527.1762
Porcine reprod. & resp. syndrome - Viet Nam (02), human fatality
suspected 20100526.1751
Porcine reprod. & resp. syndrome - Viet Nam 20100414.1206
Streptococcus suis, human - Viet Nam 20100430.1398
Streptococcus suis, human - Viet Nam 20100503.1432
2007
----
Streptococcus suis, human, porcine & PRRS - Viet Nam 20070726.2403]
...................................arn/mj/lm
(...)
-
-----

 

[alert]

Re: Vietnam: Possible human fatal infection with Porcine Reproductive Respiratory Syndrome (PRRS) virus

Re: Vietnam: Possible human fatal infection with Porcine Reproductive Respiratory Syndrome (PRRS) virus

It would be nice if some Vietnamese official would contact ProMED with more information. I don't really think anyone really suspected PRRS virus in the decased human; I think it was likely a reporting error.

http://www.promedmail.org/pls/otn/f...,F2400_P1001_USE_ARCHIVE:1001,20100527.1762,Y

Archive Number 20100527.1762
Published Date 27-MAY-2010
Subject PRO/AH> Porcine reprod. & resp. syndrome - Viet Nam (03): human infection debated

PORCINE REPRODUCTIVE & RESPIRATORY SYNDROME - VIET NAM (03): HUMAN
INFECTION DEBATED
***********************************************
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: Thu 27 May 2010
From: Kelly Lager <Kelly.Lager@ARS.USDA.GOV> [edited]


I read the 26 May 2010 post about PRRSV being the suspected cause of
a human death. From what I have read for the 26 May 2010 post [see
20100526.1751] and a related 3 May 2010 post [20100503.1432,
published by ProMED-mail's Mekong Basin Disease Surveillance (MBDS)
web-site], it seems very unlikely the cause of death for the
individual was a PRRSV infection.

I realize one of the great benefits of ProMED is quickly getting
information to the public about potential emerging disease issues,
but the 26 May 2010 report seems to have no supporting data for such
an unprecedented claim.

The 3 May 2010 post is a good example of an informative post,
although it is confusing when people are diagnosed with a _Strep
suis_ infection and then are considered to be suffering from "blue
ear," a pig disease believed to be caused by PRRSV, or at least PRRSV
is presumed to play a significant role in the clinical presentation
of blue ear. In the 26 May 2010 report, there is no mention of a
possible _Strep suis_ infection in the affected man (a possibility
based on the 3 May 2010 post), but the etiology of his death is
considered to be blue ear, and thus PRRSV must be the cause. However,
there is no diagnostic evidence presented to support this assumption.

I study pig viruses, and certainly I am sensitive to perceived
zoonotic issues for the swine industry, so please feel free to view
my comment as from someone who carries a bias. However, as just
stated, I see no evidence for what was reported in the 26 May 2010
post. This is important because many people follow ProMED daily, and
this post will cause quite a ripple in the swine industry. I
certainly respect that ProMED is not responsible for economic issues
concerning the swine industry, but I do feel ProMED has an obligation
to pass along lay news reports that contain fact. I do understand
that it is difficult to sometimes sort fact from speculation, so
please do not take my message too negatively.

I enjoy following ProMED and believe the world is a better place
because of ProMED, I just have a concern with the conclusions stated
in the 26 May 2010 post. If there is anything I can do that can be
considered constructive to your program, then please let me know.

--
Kelly M. Lager, DVM, PhD
Veterinary Medical Officer
National Animal Disease Center, USDA-ARS
Ames, Iowa 50010
<Kelly.Lager@ARS.USDA.GOV>

[The published view of a Vietnamese medical official that "a young
man was suspected to be the 1st to succumb to the deadly pig disease
PRRS" was posted by ProMED-mail, since it is our job to be an early
warning system. The commentary in the posting, however, rightly made
the point that the report must be regarded with caution in the
absence of confirmatory laboratory diagnosis.

Having said that, Dr Lager's reservations are consensually shared by
ProMED-mail's veterinary moderators. As one of us, Mod.PC, remarked
in an editorial discussion, "pig blood pudding could have contained
any pathogen such as _Strep suis_, _E. coli_ etc., and there was no
information that PRRS had been isolated from the dead human;" and
"there is just no reason to believe that PRRS has suddenly become a
zoonotic disease. What changed? What is different? Just an evolved
virus? It is pretty speculative."

Suspected correlation between PRRS in pigs and human infections with
_Strep suis_ was widely publicised, since 2005, in China and Viet
Nam. For an exhaustive discussion of the issue, in July 2007, see
posting 20070726.2403. And as stated by Mods.QCN/TD in posting
20100503.1432, referred to by Dr Lager, "an experimental study has
shown that many more pigs are affected with meningitis when they are
infected with both _S. suis_ type 2 and PRRS viruses. Therefore,
there is an assumption that the PRRS virus outbreak may have led to
an increased risk of transmission of _S. suis_ to humans through
exposure to pigs with PRRS virus infection and concomitant _S. suis_
disease." This is certainly so when uncooked pig's blood is consumed,
as in the current, fatal case.

Summing up, it seems most unlikely that the case in question was a
human PRRS infection. Obtaining the laboratory results from Viet Nam
will help to definitely refute the speculation. - Mod.AS]

 

[alert]

Re: Vietnam: Possible human fatal infection with Porcine Reproductive Respiratory Syndrome (PRRS) virus

Re: Vietnam: Possible human fatal infection with Porcine Reproductive Respiratory Syndrome (PRRS) virus

This is the MBDS post referenced in the above ProMED post. I believe the red text is the confusion cited above.

http://www.promedmail.org/pls/otn/f...,F2400_P1001_USE_ARCHIVE:1001,20100503.1432,Y

Archive Number 20100503.1432
Published Date 03-MAY-2010
Subject PRO/MBDS> Streptococcus suis, human - Viet Nam

STREPTOCOCCUS SUIS, HUMAN - VIET NAM
***************************************
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: Thu 29 Apr 2010
Source: Sai Gon Giai Phong (SGGP) Daily [edited]
<http://www.saigon-gpdaily.com.vn/Health/2010/4/81586/>


Four patients have contracted a bacterium called _Streptococcus suis_
(_S. suis_) because they have eaten underdone diseased pigs, said a
health official on [28 Apr 2010].

Dr. Nguyen Van Kinh of the National Institute of Infectious and
Tropical Diseases said 4 people suffering from blue ear pig disease
come from northern provinces where the disease is spreading at an
alarming rate, sending the government scrambling to adopt counter-measures.

Of 4 patients, 2 were taken to the hospital in serious condition and
had to use a breathing machine, said Dr. Kinh, adding that people
usually contract the _Streptococcus suis_ bacterium, a pathogen with
serious economic effects on the pig industry worldwide, only when the
blue ear disease attacks pigs in the region. The hospital is
receiving daily admission of 1-2 people contracting the bacterium. He
warned people not to butcher and eat diseased pigs.

Infected patients have experienced nausea, fever, vomiting and
[hemorrhagic bullae]. Because such symptoms are like normal flu,
patients often buy anti-flu drugs to treat themselves at home. They
are hence taken to medical facilities late, which sometimes costs
them their lives.

--
Communicated by:
PRO/MBDS
<promed-mbds@promedmail.org>

[_Streptococcus suis_ inhabits pigs and other animals such as
ruminants, cats, dogs, deer and horses. _S. suis_ is usually
transmitted nasally or orally, and colonizes the palatine tonsils of
both clinically ill and healthy pigs. Prevalence of asymptomatic
carriage may be as high as 80 percent, and the morbidity ranges from
less than one percent to over 50 percent, although it rarely exceeds 5 percent.

_S. suis_ infections in humans are reported from countries where pig
farming is common. It is likely that exposure to pigs and uncooked or
partially cooked pork products are risk factors for _S. suis_
infection in humans. The incubation period is as short as 2 hours to
as long as a few days. There is no evidence of human to human
transmission of _S. suis_.

It has been observed that the _S. suis_ infections were reported in
regions with blue ear disease (porcine reproductive and respiratory
syndrome, PRRS) outbreaks. PRRS is not an animal to human transmitted
disease. _S. suis_ infection in pigs can cause septicemia,
meningitis, arthritis, and sudden death in young pigs after weaning,
but the infection can also be limited to the respiratory tract, where
it causes bronchopneumonia. PRRS infection can increase the incidence
of _S. suis_ in pigs.

An experimental study has shown that many more pigs are affected with
meningitis when they are infected with both _S. suis_ type 2 and PRRS
viruses. Therefore, there is an assumption that the PRRS virus
outbreak may have led to an increased risk of transmission of _S.
suis_ to humans through exposure to pigs with PRRS virus infection
and concomitant _S. suis_ disease. However, this assumption has not
been confirmed.

The newswire above reports 4 cases who are infected by _S. suis_ who
are under treatment in the National Institute of Infectious Diseases
and mentions porcine reproductive and respiratory syndrome (PRRS) as
a course of these _S. suis_ cases. It reports that all 4 patients are
from provinces where PRRS outbreaks are reported, and all of them ate
partially cooked pork before falling sick. The report says 1-2 people
with the same symptoms have been admitted to the hospital each day.
However, the total number of _S. suis_ cases is not reported.

Further information about the total number of _S. suis_ cases and
epidemiological information would be highly appreciated.

 

[sharon sanders]

Re: Vietnam: Possible human fatal infection with Porcine Reproductive Respiratory Syndrome (PRRS) virus

Re: Vietnam: Possible human fatal infection with Porcine Reproductive Respiratory Syndrome (PRRS) virus

We have been reporting on this event for weeks and we stand by our news analysts:


Vietnam- At least 22 cases of swine streptococcus in humans

http://www.flutrackers.com/forum/showthread.php?t=145651

Patients infected with streptococcus swine increased-4 dead

http://www.flutrackers.com/forum/showthread.php?t=146983

Many suspected cases streptococcus swine in Central Region

http://www.flutrackers.com/forum/showthread.php?t=146980

5th strep suisse death in Vietnam

http://www.flutrackers.com/forum/showthread.php?t=147058



We do not receive the funding or recognition that ProMed does because we are "common citizens". Well, I like it that way.

We are grassroots. Citizens outreach to each other.

 

[alert]

Re: Vietnam: Possible human fatal infection with Porcine Reproductive Respiratory Syndrome (PRRS) virus

Re: Vietnam: Possible human fatal infection with Porcine Reproductive Respiratory Syndrome (PRRS) virus

I believe the red text at the end of this article settles the question. No one suspects PRRS virus in the human; it is the S. suis bacterium that is suspected. Perhaps this article should be sent to ProMED.

http://www.saigon-gpdaily.com.vn/Health/2010/5/82385/

Doctors suspect diseased pigs in man?s death
Doctors suspect a patient in the central province of Quang Ngai died due to consuming diseased pigs, said a health official on May 24.

Dr. Nguyen Xuan Men, deputy director of the Department of Health of the province, confirmed that a 37 year old man in the Quang Ngai City died on May 22. Quang Ngai province is one of the provinces stricken by ?the Porcine Reproductive and Respiratory Syndrome Virus (PRRSV)? also known as ?Blue ear" disease in pigs.

The victim?s family said he ate pig blood curds on May 21. In the afternoon, he experienced fever, acute diarrhea and bleeding under the skin. He was rushed to Quang Ngai General Hospital for emergency treatment and was then transferred to the Central Hospital in Hue, where he died the next day.

The Quang Ngai Department of Health May 24 ordered the Department of Preventive Health to disinfect the patient?s house and the hospital where he was treated, as well as urged the Central Hospital in Hue to announce test results quickly, to confirm if the man in fact died of pig bacterium.

 

[Treyfish]

Re: Vietnam: Possible human fatal infection with Porcine Reproductive Respiratory Syndrome (PRRS) virus

Re: Vietnam: Possible human fatal infection with Porcine Reproductive Respiratory Syndrome (PRRS) virus

:tiphat:An experimental study has shown that many more pigs are affected with
meningitis when they are infected with both _S. suis_ type 2 and PRRS
viruses. Therefore, there is an assumption that the PRRS virus
outbreak may have led to an increased risk of transmission of _S.
suis_ to humans through exposure to pigs with PRRS virus infection
and concomitant _S. suis_ disease. However, this assumption has not
been confirmed.

 

[alert]

Re: Vietnam: Possible human fatal infection with PRRS virus

Re: Vietnam: Possible human fatal infection with PRRS virus

6:32 AM, 27/05/2010
Quang Ngai: There are no conclusions about the cause of death from suspected swine Streptococcus



Afternoon 26 / 5, Dr. Nguyen Xuan Men - Deputy Director of Quang Ngai Department of Health said the Department had written to directors of Hue Central Hospital confirmed causes of death of Mr Bui Van Nhuan (37 years old ) suspected swine streptococcus bacteria in the ward chief Lo, Quang Ngai city.

In the last few days, some mass media that Mr. Bui Van Nhuan death by suspected swine Streptococcus. This has to affect the psychology of people and communities.

Previous information on, pending the conclusion of the Central Hospital in Hue, Quang Ngai province, the health sector has been assigned to the Center of preventive medicine in promoting active communities on the fields of prevention, such as pigs should not be unknown origin, not given away slaughter and consumption of the pigs died of unknown causes, and recommended people not eat more soup, pig heart or undercooked pork, source unknown Original. /. :tiphat:http://vovnews.vn/Home/Quang-Ngai-C...ghi-nhiem-lien-cau-khuan-lon/20105/144928.vov

This post actually calls the man's death "suspected swine Streptococcus", and if I am reading it correctly, it might even say that S. suis is confirmed. I guess we all missed that one.

 

[alert]

Re: Vietnam: Possible human fatal infection with Porcine Reproductive Respiratory Syndrome (PRRS) virus

Re: Vietnam: Possible human fatal infection with Porcine Reproductive Respiratory Syndrome (PRRS) virus

Hat-tip Treyfish. Also see this thread, which contains an article which states that the CFR for S. suis is about 7%, further increasing our confidence that the bacterium is the suspected cause of this fatality.

http://www.flutrackers.com/forum/showthread.php?t=147126

 

[Treyfish]

Re: Vietnam: Possible human fatal infection with Porcine Reproductive Respiratory Syndrome (PRRS) virus-reporting error

Blue ear pig frightening. Alarms patients swine streptococcus surge
05.29.2010, 09:45

(24h) - In the last few days, some mass media reported patients N. death due to streptococcus swine, affecting people and the psychological community.
In just over a month (late April to May), Hue Central Hospital received 28 patients (BN) in the Central provinces like Quang Ngai, TT-Hue, Quang Tri, Quang Binh ... streptococcus infected pigs in which there are many patients with positive blood cultures and some suspected. Up to date have been 28-5 five patients died due to streptococcus swine and 7 patients were treated at the Faculty of Science-Emergency and spread the Hue Central Hospital.

Patients die in Quang Ngai streptococcus swine?

The patient died of swine streptococcus latest in Hue Central Hospital as he Bui Van N. (37 years old, resident P. Lo District, Quang Ngai City.) Patients hospitalized in light condition 21-5 high fever, pneumonia and multiple organs failure after eating pig blood pudding, to dawn, the death 22-5.

N. In addition patients with 4 patients (including TT-Hue has 2 cases) have died of swine streptococcus. Although the conclusions of BV T. Hue, the patient Ư N. death is due to streptococcus swine, but 26-5 pm, Dr. Nguyen Xuan Men, deputy director of Quang Ngai Department of Health said that the past few days, some mass media reported patients N. death due to streptococcus swine, affecting people and the psychological community.

According to BS Passion infect swine streptococcus disease from pigs to humans by contact or eating undercooked pork, pigs eat more soup. The clinical manifestations of this disease is sepsis, bleeding under the skin throughout the body and form for the necrosis, leading to multiple organs failure and death. Previously, on 24-5, Quang Ngai Department of Health has sent an official letter T. BV Hue Ư mention this problem.

receiving the written request certifying causes of death of BN N. and BV is an official letter is a formal reply BN N. streptococcus swine die. " According to BS Biology, although BN N. have negative test results because the grassroots level in the previous Patients already taking antibiotics.

BS confirmed births, N. patients certainly infected swine streptococcus. Besides based on the results of blood cultures, this result may be determined by epidemiological factors (patients eat pork), clinical signs of disease consistent with symptoms of swine streptococcus, in addition patients also suffered multiple organ meats.

Moreover, in many cases the results of blood cultures grew streptococcus swine but not the patient is still infected and some cases being treated in hospital. The medical records of patients N. clearly also have more notes than full haemorrhage, deep black skin, purple lips, the dark eye conjunctivitis, abdominal pain shady forest ...

People should not be subjective

Although doctors have been advised not to eat pig blood pudding, pig hearts before swine streptococcus status is up, but the observation of PV, quite a subjective and people still did not exclude food "blocks export "outside the menu that morning.

According to Dr. Duong Van Sinh, the symptoms of swine streptococcus infections similar to food poisoning such as vomiting, diarrhea loose stools, fatigue, severe shock, multiple organ failure ... However, some cases occur these signs are as food poisoning, so do not come immediately to hospital visits, and a number of cases to hospital too late when it is very difficult to treat.

Mr. Hoang Huu Nam, deputy director of TT-Hue Department of Health said: "Afternoon 27-5, the Department has collaborated with the Center for Preventive Medicine and Department of Health profession monitor the situation the positive and suspected cases streptococcus infection in swine BV T. Ư Hue. Of the 5 patients with TT-Hue countryside was being treated at Hue Central Hospital, after taking a specific list on 28-5, the authorities were coordinating Chloramin B injection in the BN area that students live. Of these 5 patients, 3 patients but when the pigs of Animal Health Department inspection, the pigs remain healthy and far, on TT-Hue province has not yet happened blue ear pig. "

Situation of swine streptococcus infection increased sharply in the Central, TT-Hue Department of Health to step up propaganda activities. For those cases had positive test results, the Department set up teams to carry out sanitation in areas where patients live.

Dr. Duong Van Sinh warns that people should not use processed food from pork of unknown origin, not cooked, when processed to bring gloves, absolutely not eat pig blood pudding. Bacterial transmission from pigs to humans, so when people exposed to pigs should be protected belongings. Immediately after suspected exposure to germs to wash hands thoroughly.

Especially when people 40-41 degrees high fever, diarrhea, with patches of hemorrhagic necrosis of the skin, stiff neck ... just need basic medical examination and treatment. The functional need urgently to strengthen quarantine and strict prohibition of circulation of cattle diseases by province. :tiphat:http://us.24h.com.vn/tin-da-nang/bao-dong-benh-nhan-lien-cau-lon-tang-dot-c498a300213.html

 

[alert]

Re: Vietnam: Possible human fatal infection with Porcine Reproductive Respiratory Syndrome (PRRS) virus-reporting error - S. suis confirmed

Re: Vietnam: Possible human fatal infection with Porcine Reproductive Respiratory Syndrome (PRRS) virus-reporting error - S. suis confirmed

http://tintuc360.net/news.aspx?title=16-5242s-Nguoi-dau-tien-tu-vong-vi-lien-cau-lon.html

The first person to die of swine streptococcus
26/05/2010 14:00 05/26/2010 14:00


TinTuc360 ( Trần An ) TinTuc360 (Chen An)



On 25 / 5, Central Hospital in Hue (Thua Thien-Hue) Nguyen said he (37 years old, residing in Ward Road District, Quang Ngai City) had died on 22 / 5 is due to past infections associated for pigs. This is the first deaths from the disease this year so far.


Mr. Duong Van Sinh, Head of the Emergency Resuscitation Hue Central Hospital said the test results for swabs of patients he has seen swine streptococcus infections.

Before that, he admitted in a state Yuan high fever, diarrhea, pneumonia and multiple organs failure. The reason was because he was determined to eat more pork soup on the morning of 21 / 5, then high fever and diarrhea should be taken to emergency family at the Hospital of Quang Ngai province.

But the situation is not relieved, but also heavier, so the patient was transferred to Hue Central Hospital for treatment. However, to date 22 / 5, the patient died.

According to Duong Van Sinh, during nearly two months back, Hue Central Hospital has received many patients with swine streptococcus infections. Most patients were admitted to hospital too late to treatment difficult.

* T?n bệnh nh?n đ? được thay đổi * Name was changed patients

 

[alert]

Re: Vietnam: Possible human fatal infection with Porcine Reproductive Respiratory Syndrome (PRRS) virus-reporting error

ProMED is beginning to realize the error; as this MBDS post is titled as suspected S. suis, not suspected PRRS.

http://promedmail.org/pls/apex/f?p=..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1040,82966

Archive Number 20100529.1782
Published Date 29-MAY-2010
Subject PRO/MBDS> Streptococcus suis, human - Viet Nam (03): fatality, susp.

STREPTOCOCCUS SUIS, HUMAN - VIET NAM (03): QUANG NGAI, FATALITY, SUSPECTED
**************************************************************************
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 26 May 2010
Source: VietNamNet Bridge [edited]
<http://english.vietnamnet.vn/social/201005/Pig-disease-feared-to-claim-first-fatality-912419/>


Porcine reproductive and respiratory syndrome (PRRS), commonly dubbed
blue ear disease, is suspected as the culprit behind the death of a
man in the central province of Quang Ngai on Monday [22 May 2010].

Nguyen Xuan Men, deputy director of the provincial [Quang Ngai]
Department of Health confirmed with the online newspaper Vnexpress
that the young man was suspected to be the first to succumb to the
deadly pig disease that is spreading to pig herds in the north.

According to Men, the young man suffered from diarrhea, high fever,
convulsion, and skin hemorrhage after eating fresh pig blood pudding.
He was not hospitalized in time and lost consciousness.

The man, who was transferred to the Central Hospital of Hue from
Quang Ngai, died on Monday [24 May 2010].

Health workers immediately disinfected where he was living and
examined people who had been in contact with the deceased.

The [Ministry] of Health reported that no new blue ear disease
outbreaks were reported in recent days. However, the epidemic
remained active in 15 provinces nationwide, mostly in northern
provinces including Hanoi.

Since April [2010], 4 positive cases of porcine reproductive and
respiratory syndrome have been detected.

--
Communicated by:
PRO/MBDS
<promed-mbds@promedmail.org>

******
[2]
Date: Thu 27 May 2010
Source: Thanh Nien Online [In Vietnamese, trans. Mod.QCN, edited]
<http://www.thanhnien.com.vn/news/Pages/201022/20100527004759.aspx>


Dr Duong Van Sinh, Head of Intensive Care Unit of the Hue Central
Hospital, said there were 28 suspected _Streptococcus suis_
infections admitted to the hospital in April and May 2010.

Patients were mainly from the central provinces. There are 4
confirmed and 3 suspected _S. suis_ infected patients being treated
in the hospital.

Regarding the cause of death of the 37-year-old male patient from
Quang Ngai City, the clinical manifestation showed that the patient
was infected with _S. suis_. Professor Bui Duc Phu, Director of the
Hue Central Hospital said the results of blood culture were negative.
However, Professor Phu said that negative results do not mean that
the patient was not infected by _S. suis_, the culture results might
have been affected by strong antibiotic used.

The patient ate pig blood pudding the morning of 21 May 2010, at noon
the same day he suffered from fever, diarrhea, hemorrhagic bullae,
and skin necrosis. The patient was brought to the Quang Ngai
hospital, and then transferred to the Hue Central Hospital. Due to
the severe condition, he died on 24 May 2010.

--
Communicated by:
PRO/MBDS
<promed-mbds@promedmail.org>

[PRRS is caused by an arterivirus and may increase the incidence of
_S. suis_ in pigs. However, PRRS virus has not been reported to be
transmitted from animals to humans.

_S. suis_ inhabits pigs and other animals. It enters the human body
through open wounds or the consumption of uncooked or partially
cooked pork products. The clinical symptoms of _ S. suis_ infection
include headache, fever, vomiting and meningeal signs. Up to 31
percent of patients also have skin findings, including petechiae,
purpura, and ecchymoses, and hemorrhagic bullae and skin necrosis
(additional information in PRO/MBDS posting Streptococcus suis, human
- Viet Nam 20100503.1432)

The newswires above report that after eating fresh pig blood pudding,
a man from Quang Ngai, an area affected by porcine reproductive and
respiratory syndrome, developed symptoms such as diarrhea, high
fever, convulsion, and skin hemorrhage. When he lost consciousness he
was admitted to hospital where he died. The clinical symptoms and
epidemiological information favored the hypothesis that the death was
caused by _S. suis_ infection. However, the culture results were
negative to _S. suis_.

The hospital authority did not mention if they were going to use
laboratory methods such as agglutination or polymerase chain
reaction, which could identify _S. suis_, to determine the etiology
in this case. If _S. suis_ infection were confirmed, this would be
the 1st patient to die of _S. suis_ infection in Viet Nam in 2010.

The report that 4 positive cases and 1 death of porcine reproductive
and respiratory syndrome had been detected might be incorrect as
there have been no reports of clinical symptoms and laboratory
results of these patients to suggest PRRS virus, which has never been
reported in humans.

The newswire above also reports that there were 28 suspected _S.
suis_ infections admitted to the Hue Central hospital in April and
May 2010. In a previous posting, PRO/MBDS reported 22 cases of _S.
suis_ admitted to the Central Hospital of Tropical diseases in Ha Noi
since the beginning of 2010 (see prior PRO/MBDS posting Streptococcus
suis, human - Viet Nam (02): RFI 20100525.1730).

For a map of Viet Nam with provinces, see
<http://en.wikipedia.org/wiki/File:VietnameseProvincesMap.png>. The
interactive HealthMap/ProMED-mail map with direct links to other
outbreaks in Viet Nam and surrounding countries reported on by
ProMED-mail and PRO/MBDS can be accessed at
<http://healthmap.org/r/00J1>. - Mod.QCN]

[Editor's note: The general ProMED-mail list has posted several
reports discussing the possibility that a human case of PRRS virus
infection had occurred as per the newswire accounts. While there have
not been prior reports of PRRS virus infections in humans, the
possibility of a change in the virus with a new species jump is
always out there, and ProMED-mail follows its mission of early
reporting of unusual health events. The absence of official
information on the results of laboratory testing on the suspected
case in the newswires above makes it very difficult to evaluate the
report as to its accuracy. For those readers who are interested in
following the debate, we suggest you read the reports from the
general ProMED-mail list mentioned below. - Dep.Ed.MPP]

[ProMED-mail postings on the suspected case mentioned above are
available at <http://www.promedmail.org>:

 

[alert]

Re: Vietnam: Possible human fatal infection with Porcine Reproductive Respiratory Syndrome (PRRS) virus-reporting error

Certainly my vote for one of the most interesting ProMED posts ever. The ProMED moderators do in this post what many of us on FT have been doing in this thread for the past couple days.

http://promedmail.org/pls/apex/f?p=..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,82972

Archive Number 20100529.1788
Published Date 29-MAY-2010
Subject PRO/AH/EDR> Porcine reprod. & resp. syndrome - Viet Nam (05): human NOT


PORCINE REPRODUCTIVE & RESPIRATORY SYNDROME - VIET NAM (05): HUMAN NOT
**********************************************************************
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: Sat 29 May 2010
From: Quoc Cuong Nguyen
<quoc@promedmail.org>


[On Wed 26 May 2010, ProMED-mail published the posting 'Porcine
reprod. & resp. syndrome - Viet Nam (02), human fatality suspected'.
It was based upon a report titled "Pig disease feared to claim 1st
fatality" which was published in VietnamNet Bridge, an English online
newspaper in Vietnam, at
<http://english.vietnamnet.vn/social/201005/Pig-disease-feared-to-claim-first-fatality-912419/>.

Following the above ProMED-mail posting and 2 subsequent responses,
the text in the original report from which 'VietnamNet Bridge' derived
its information, namely Vnexpress.net, has been scrutinised by
ProMED-mail's MBDS Vietnamese-speaking moderator. His results follow.
- Mod.AS]

Below are 2 articles in Vietnamese in Vnexpress.net.

The 1st article [No 1 in commentary] quoted Nguyen Xuan Man saying
that the death might be due to _Streptococcus suis_.

The 2nd article [No 2 in commentary] said that the fatality rate among
_S.suis_ patients is 7 percent.

I guess The Vietnamnet Bridge mistakenly translated _S. suis_ into
PRRS, then copied exactly one paragraph about PRRS from the pig site
<http://www.thepigsite.com/diseaseinfo/97/porcine-reproductive-respiratory-syndrome-prrs> [See No 3 in the commentary], inserting it into that controversial article. [See commentary
further].

--
Communicated by:
Nguyen Cuong Quoc
PRO/MBDS (Mekong Basin Disease Surveillance) Moderator
Chapel Hill, North Carolina, USA

[The following provides additional information on the sources, 2 in
Vietnamese and 1 in English, as forwarded by Nguyen Cuong Quoc, and
upon which the controversial Vietnamnet Bridge report of 26 May 2010
was based.

1. Vnexpress.net (in Vietnamese), dated 24 May 2010, dealt with a
youth suspected as a fatal case of swine streptococcus bacteria. The
article included the sentence: "On the afternoon of 24 May, Mr Nguyen
Xuan Men, deputy director of Quang Ngai Department of Health,
confirmed this young [man] (at Nghia Chanh Ward, Quang Ngai City) died
of suspected swine streptococcus." See at
<http://vnexpress.net/GL/Doi-song/2010/05/3BA1C323/>.

2. Vnexpress.net (in Vietnamese), dated 26 May 2010, dealt with a
hospitalised 52-year-old female from Duc Thang commune, Tien Lu
District, Hung Yen province, who nearly died of swine Streptococcus.
The article included the passage: "Streptococcus is a disease [it is a
bacterium] transmitted from pigs to humans, causing septicemia,
meningitis or a combination of both. The disease has become epidemic,
scattered throughout the year, but can be fatal if treated late. The
death rate is about 7 percent." See at
<http://vnexpress.net/GL/Doi-song/2010/05/3BA1C3C6/>. (A picture of
the patient is included).

3. The web-site page
<http://www.thepigsite.com/diseaseinfo/97/porcine-reproductive-respiratory-syndrome-prrs>, dealing with PRRS, includes the following passage: "The virus of PRRS has a particular affinity for the macrophages particularly those found in the lung. Macrophages are part of the body defences. Those present in the lung are called alveolar macrophages. They ingest and remove invading bacteria and viruses, but not in the case of the PRRS virus. Instead, the virus multiplies inside them producing more virus and kills the macrophages. Once it has entered a herd it tends to remain present and active indefinitely." This passage was copied into the Vietnamnet Bridge article, with an added suffix "The fatality rate is at 7 percent; thus, it can do harm if patients are not timely hospitalized". (derived from source No
2).

The findings of Nguyen Cuong Quoc and his suggested conclusion clearly
indicate that the article in the Vietnamnet Bridge of 26 May 2010 was
erroneous and misleading: in fact, not even a suspicion of PRRS
infection in a human patient has been raised in Viet Nam. The 2 cases
involved were infected, or suspected to be infected, by _S. suis_. -
Mod.AS]

[see also:
Porcine reprod. & resp. syndrome - Viet Nam (04): RFI 20100528.1778
Porcine reprod. & resp. syndrome - Viet Nam (03): human fatality
debated 20100527.1762
Porcine reprod. & resp. syndrome - Viet Nam (02), human fatality
suspected 20100526.1751]
....................qcn/arn/ejp/jw