HFMD in Thailand is under control, says deputy minister

Published: 11/07/2012 at 01:36 AM Hand, foot, and mouth disease (HFMD) in Thailand is under control thanks to measures put in place to prevent a virulent strain from spreading to Thailand from Cambodia, Deputy Public Health Minister Surawit Khonsomboon said yesterday.

Extraordinary surveillance measures were being implemented to keep Enterovirus Type 71 (EV-71), a strain of HFMD that has claimed the lives of more than 60 children in Cambodia, from spreading to Thailand, Dr Surawit said.
Parents are being advised to encourage their children to wash their hands often and avoid taking them to crowded places, Dr Surawit said.
If parents suspect an infection they should immediately take their children to a doctor to reduce the risk of complications of the disease which can affect victims' brains, lungs, and hearts, he said.
Authorities have sent a communicable disease control unit to the Chong Jom-Osamach border crossing in tambon Dan of Kap Choeng district of Surin to screen Cambodian parents and their children for HFMD virus strains.
Any Cambodian travellers suspected of carrying the virus would be quarantined, the Surin provincial health office said.

Meanwhile, parents of 16 Cambodian children attending a pre-school child centre in Ban Dan in the same border district of Surin were asked to take their children back to Osamach in Cambodia.
Sirichai Tantiratananon, president of tambon Ban Dan administration organisation, said it was a temporary measure to prevent the children infecting their Thai peers.
Satawas Sinprasitkul, director of Kap Choeng district hospital, said no Cambodian patients with EV-71 has been admitted to his hospital since the virus was found across the border three months ago.
Dr Apichart Rodsom, chief of the provincial health office in Kanchanaburi, said four new HFMD cases in children aged three to five which were reported this week were not the EV-71 strain.

EV-71 is one of two pathogens commonly found in infected Thai patients, but it was a virulent form of the virus that was detected in recent Thai cases, the permanent secretary for public health, Dr Paijit Warachit, said. The other type of HFMD virus commonly found in Thailand is Coxsackie A 16, he said.
http://www.bangkokpost.com/news/loca...eputy-minister

China-Mainland baby, young girl treated for deadly virus #EV71

Mary Ann Benitez

Wednesday, July 11, 2012

Two mainland children - a five-year- old girl from Guangxi and a 39-day-old baby boy from Shenzhen - are being treated at Hong Kong hospitals for a severe form of enterovirus infection, the Centre for Health Protection said last night.

It is the third and fourth such case of the infection this year and comes days after Cambodia announced that Enterovirus71 was....

The clinical diagnosis was meningitis due to EV infection, with her cerebrospinal fluid specimen testing positive for the virus. Her condition is stable.
The girl's older twin brothers, aged seven, also had symptoms and sought medical help. Other family members did not have any symptoms.
The baby boy lives in Shenzhen and had fever on July 4. He was brought to Hong Kong for treatment the next day and admitted to Prince of Wales Hospital in Sha Tin.
He no longer has fever and was stable last night.
His cerebrospinal fluid specimen tested positive for EV while his rectal swab tested positive for the Coxsackie virus. Both viruses cause hand, foot and mouth disease, so called because of characteristic rashes...
The specific strain of EV for both children has not yet been typed, but most likely could be EV71, which experts and the CHP have said "is more likely associated with severe medical complications and even death." ...

http://www.thestandard.com.hk/news_d...=20120711&fc=2

Research Continues Into Mystery Disease in Cambodia

10 de julio de 2012, 15:20 Phnom Penh, July 10 (Prensa Latina) Specialized physicians are continuing their tireless efforts today to identify a rare disease that has killed at least 61 children under three years of age in Cambodia. Virologists at the Pasteur Institute, involved in the investigation, dismissed for now that it has anything to do with Enterovirus 71 (EV71), associated with brucellosis, as a cause of the sudden outbreak of severe fever and respiratory and neurological problems detected in the Kantha Bopha Children's Hospital in this capital... However, they are considering the possibility that since brucellosis is endemic in neighboring Indochinese countries, they may be dealing with a mutation of the virus.  ....Although 15 of the 24 blood samples analyzed by Pasteur Institute showed the presence of EV71, Asgari noted that these results require further research in the coming days... http://www.plenglish.com/index.php?option=com_content&task=view&id=524596&Itemid=1

CNN’s Sanjay Gupta Talks To Mediaite About Mystery Illness Claiming Lives In Cambodia

CNN’s Sanjay video

by Alex Alvarez | 3:04 pm, July 10th, 2012



CNN’s Sanjay Gupta is in Cambodia this week, covering a perplexing illness that, to date, has taken the lives of over 50 young children. Gupta, a neurosurgeon, has been talking with local doctors and officials from the World Health Organization in an effort to determine what, exactly, has caused these children to succumb and perish so quickly. Eleven hour time difference be damned, Gupta graciously made time to speak with us about his report and what he’s been able to learn so far.

According to Dr. Gupta, the illness appears to be some combination of an enterovirus (Type 71, specifically) and a second, “mystery” component still being investigated. He explained that these issues manifest in children who “arrived with mild symptoms, were treated and given medicine — bad medicine, or medicine that was inappropriate or wrong.” The issue of patients being given medicine that is incorrect, old, diluted or counterfeit is a widespread one, he noted, and one that poses a real and fatal threat across third world countries and the United States alike....http://www.mediaite.com/tv/cnns-sanjay-gupta-talks-to-mediaite-about-mystery-illness-claiming-lives-in-cambodia/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+mediaite%2FClHj+%28Mediaite%29

Cambodians fear mystery deaths #EV71 VIDEO

Video http://in.reuters.com/video/2012/07/10/cambodians-fear-mystery-deaths?rpc=401&videoId=236424756&feedType=VideoRSS&feedName=WorldNews&rpc=401&videoChannel=117460

CHOLERA outbreak in CUBA

Date: Tue 10 Jul 2012

http://www.bostonherald.com/news/international/americas/view/20120710cuba_reports_more_cholera_cases/srvc=home&position=recent


The number of cholera cases confirmed in eastern Cuba jumped from 30 to 85 over the weekend [7-8 Jul 2012] but the death toll remained at 3, one government official said, although independent reports put the number of deaths as high as 15. As many as 5 other cases of cholera also were unofficially reported in Havana, and dissidents in Guantanamo near the eastern tip of the island reported cholera-like cases in Caimanera, a village on the edge of the US naval base.

The state-owned TV station in Granma province, where the outbreak has hit hardest, suggested that residents avoid traveling outside the area, and trucks with loudspeakers urged them to boil water and wash their hands often, 2 residents said.

Public health officials in the British-run Cayman Islands, just south of Granma, issued a advisory against travel to Cuba, and US Representative Ileana Ros-Lehtinen, R[epublican]-Florida, warned potential travelers that visiting the island "may put them at risk of becoming ill with cholera." The CDC in Atlanta had not issued any special travel notices on Cuba as of Monday evening [9 Jul 2012]. Its Web page recommends only general vaccinations, like those for hepatitis A and B, typhoid fever, and rabies.

Cuban government epidemiologist Ana Maria Batista Gonzalez told Granma's Telecentro TV station Sat 7 Jul 2012, that 30 cholera cases had been confirmed in the province, then raised the number to 85 when she appeared again on the station the next day, said [SM], a doctor and dissident in the Granma town of Manzanillo.

A Cuban government statement, on 3 Jul 2012 -- the only other official word on the outbreak, said 53 cholera cases had been confirmed and that the outbreak was "under control." There was no explanation for the conflicting numbers, although it's possible that the number 53 referred to cases in the southeastern region, not just Granma.

Batista also noted the number of suspected cases in Granma rose from 332 to 346, and more general cases of diarrhea and vomiting rose from 3422 to 3998, [SM] said. Most of the cases have been recorded in Manzanillo and the provincial capital, Bayamo, as well as nearby municipalities of Niquero, Yara, and Bartolome Maso, Batista said. All are along Cuba's southern coast, about 415 miles [670 km] east of Havana.

Batista said the death toll remained at 3, the same number the government reported on 3 Jul 2012. A Bayamo dissident said he had heard reports of 5 deaths and [SM] put it at about 10. Havana dissident [CM] has reported about 15.

Police continued a heavy security presence at area hospitals and relatives were not allowed to visit patients with cholera, CM said. He was fired from his public health job after he began speaking out against the government and his wife became a human rights activist.

Cholera was declared eradicated in Cuba no later than the early 1900s, but an ongoing outbreak in neighboring Haiti has killed more than 7400 people and scores of Cuban doctors have worked there.

Philippines Spray planes against #EV71

Tight watch against enterovirus

Tuesday, 10 July 2012 20:48

Philippines

AIRPORT quarantine authorities are spraying incoming airplanes, either with connecting flight or direct from Cambodia, with disinfectants in a bid to control or prevent the entry of the deadly virus traced to have killed 61 children in Cambodia this past week....

.....On Tuesday the officials sprayed three Cebu Pacific flights from Saigon, one Philippine Airlines flight, also from Saigon, one Kuwait Airways which made a stopover in Bangkok and a Thai airways from the Thai capital. R. Mercene..

http://businessmirror.com.ph/home/nation/29754-tight-watch-against-enterovirus \


As part of the airport’s precautionary measures, quarantine officers assigned to each incoming flight spray “Coopex” germ disinfectants on aircraft cabins to extinguish the virus.

http://manilastandardtoday.com/www2/2012/07/11/health-airports-alerted-to-enterovirus-71/

Mexico applied a million #bird flu vaccines from China

July 10, 2012
Guadalajara, Mexico. - A batch of one million vaccines from China will be implemented in the coming days the birds were not infected by bird flu at farms in Mexico to try to protect their health, reported the National Union Poultry (A).
A According to the number of farms with confirmed presence of the flu has risen to 29, five more than the last report, so that the epidemic is already affecting some 2.5 million birds...
http://www.noticiassin.com/2012/07/mexico-aplicara-un-millon-de-vacunas-contra-gripe-aviar-provenientes-de-china/

'No need to panic,' Cambodia says on virus

PHNOM PENH, Cambodia – Officials of a Cambodian hospital slammed the World Health Organization (WHO) for creating “unnecessary panic” about a previously unidentified disease that has so far killed over 60 children here.

“There’s no need to panic,” Dr Denis Laurent, Biologist and Deputy Director of the Kantha Bopha Children’s Hospital (KBCH) in Phnom Penh told Rappler. Laurent is the assistant of Dr Beat Richner, the founder and head of KBCH who was the first to sound the alarm about the disease.

The WHO has alerted neighboring countries including the Philippines about an "unknown disease" that had killed 52 children in Cambodia.

The Pasteur Institute in Phnom Penh earlier announced that it discovered Enterovirus Type 71 in about two-thirds of patients. The virus is the “perfect explanation” for the deaths, according to the institute’s virology unit head Philippe Buchy who was cited by Bloomberg.

While the Enterovirus 71 was indeed found in a majority of the fatal cases, there are still questions left unanswered, Richner said in a statement released Sunday..



“Unfortunately, WHO gave a declaration on July 2 to [a news agency] without being clear on the facts being presented on June 29 in the Ministry Of Health by Kantha Bopha to all the [health] officials,” Richener said. “WHO was telling the whole world: new mystery killer disease in Cambodia! This was causing unnecessary panic in Cambodia.”

LONG LINE. Parents and children are hoping to avail of free medical treatment. Photo by Paul John Cana

Richener added that the issue is “not alarming."

“In June, 75,799 sick children were treated in our outpatient stations, 16,517 severely sick children were hospitalized, among them 5,534 severe cases of the hemorrhagic dengue fever. Only 34 cases with this…‘new’ disease were hospitalized. This declaration by WHO…was neither professional nor necessary, but causing panic for nothing.”
...According to Laurent, no new fatalities from the disease have been reported since the latest statement issued by the hospital Sunday... http://www.rappler.com/world/8364-no-need-to-panic,-cambodia-says-on-virus

Thailand-Disease warning for schools due to HFMD

 July 10, 2012 5:47 pm

Thailand-The Public Health Ministry on Tueday instructed schools and nurseries nationwide to close if they find that students in five classes or more have contracted hand, foot and mouth disease.

The move follows reports that at least 64 children in Cambodia died after being infected with enterovirus 71, know to cause the disease, since April this year.

In Thailand, about 10,813 children are believed to have caught the disease during the most recent outbreak but there were no reports of any fatalities.

Disease Control Department director general Dr Pornthep Siriwanarangsan said the strain of hand, foot and mouth disease currently spreading in the country is not a virulent one.

It is recommended that children with fever, blister-like lesions on the tongue, gums and inside of the cheeks, and a pimple-like rash on the hands and feet be taken to a clinic for treatment.

About 20,000 nurseries have been told to suspend classes if they find that two or more children have been infected with the virus. School who find infected students in five classes have been told to close. http://www.nationmultimedia.com/national/Disease-warning-for-schools-30185866.html

MASK

MASKhttp://www.timesofmalta.com/articles...disease.427938

Philippines-Doctors, health care providers told to report Enterovirus 71 cases

July 10, 2012 5:48pm

The Health Department will require doctors and health care providers to report incidents of Enterovirus 71 infections by making it a notifiable disease....

A notifiable disease is a disease that must be reported to public health authorities at the time it is diagnosed because it is potentially dangerous to human or animal health...
The DOH said EV-71 causes diseases of varying intensity, including the often mild hand, foot and mouth disease (HFMD), acute respiratory disease, acute flaccid paralysis (polio-like) and the deadly brainstem encephalitis.
It said HFMD is a self-limiting illness whose symptoms include fever with skin lesions or rashes.

Philippine authorities last weekend went on alert against what was then a mystery disease, amid reports of children in Cambodia dying from it.

Also, the DOH and World Health Organization (WHO) clarified the Cambodian EV-71 infection was of the encephalitis type and not HFMD.

The DOH said affected Cambodian children had fever followed by rapid respiratory deterioration and impaired consciousness.

"Death occurred 24 hours from hospital confinement," the DOH said http://www.gmanetwork.com/news/story/264880/news/nation/doctors-health-care-providers-told-to-report-enterovirus-71-cases

WHO Defends Warning on Cambodia Virus

Updated July 10, 2012, 6:37 a.m. ET

As Cambodian authorities grapple with a disease outbreak that has killed more than 50 children, they're also struggling with another issue: how to best manage interest from the outside world without triggering alarm.

The issue bubbled to the surface earlier this week when Beat Richner, a well-known doctor in Cambodia and founder of the Kantha Bopha Children's Hospitals where the disease was first reported, complained that international health authorities moved too quickly to sound the alarm, risking a panic before they had all the facts.
Writing in a post on his Facebook page, he said the World Health Organization's declaration ...

  The rest is subscription   http://online.wsj.com/article/SB10001424052702303567704577518312828428088.html

'Cambodian infection is encephalitis type, not #HFMD'

 07/10/2012 6:06 PM
MANILA, Philippines - The World Health Organization (WHO) and the Department of Health (DOH) reported today that the disease that struck and killed Cambodian children in the last few months was of the encephalitis type and not the hand foot and mouth disease (HFMD) they earlier reported.
The health agencies maintained, however, that the new strain discovered is linked to the Enterovirus-71 (EV-71), which causes different diseases of varying intensities.
EV-71 may also cause HFMD as well as acute respiratory disease, acute flaccid paralysis (polio-like), and the deadly brainstem encephalitis...
...It also urged parents and day-care personnel to clean and disinfect toys and teaching tools that are easily shared with other children.
http://www.abs-cbnnews.com/nation/07/10/12/cambodian-infection-encephalitis-type-not-hfmd

Undiagnosed illness in Cambodia - update

9 July 2012 -As part of the continuing investigations into the undiagnosed illness, the Ministry of Health of the Kingdom of Cambodia is finalizing the review of all suspected hospitalised cases. This final review added an additional two cases between April to 5 July 2012, making the total number of children affected to be 59. Of these, 52 have died.
The age of the cases range ...

http://www.who.int/csr/don/2012_07_09/en/index.html

Cause of lethal children's disease still contested #EV71 #HFM

Cause of lethal children's disease still contested

Tuesday, 10 July 2012

Xiaoqing Pi

A Cambodian woman (L) pulling a child on a gurney at Kantha Bopha children's hospital in Phnom Penh. Medical experts are scrambling to respond to what the Cambodian health ministry and World Health Organization have labelled an "undiagnosed syndrome" that has claimed the lives of at least 56 boys and girls, mostly toddlers, since April. Photograph: AFP Photo / Khem Sovannara

While virologists may have identified a common infection in the mystery illness that has taken the lives of dozens of Cambodian children since April, the actual cause of the deaths is still a matter of conjecture.

The two sides racing to find the cause of the deaths and a possible cure for the illness that has plagued the Kingdom are at odds over almost everything to do with the case.

Kantha Bopha Children’s Hospitals, which first identified that an unusual syndrome was striking down children, alerted the Ministry of Health in June of their concerns about a possible “new deadly illness”.

Kantha Bopha says it has identified 66 cases of the mystery illness in its hospitals, 64 of the cases were fatal.

However, the Ministry of Health and the World Health Organization, which is assisting the ministry’s investigations, yesterday put the number at 59 cases with 52 deaths across Cambodia – a pared down number from the initial media reports from the WHO of 60 deaths.

A joint press release from the MoH and the WHO said that their investigations were not finalised, but officials believed that the deaths were caused by severe cases of Hand, Foot and Mouth Disease, a common disease in children and infants.

Symptoms of the HFMD include fever, painful sores in the mouth and a rash with blisters on hands, feet and buttocks, said the press release.

The unknown disease, however, presents the symptoms of deadly respiratory destruction and neurological affliction, as both Kantha Bopha and the MoH and WHO have reported.

Kantha Bopha officials yesterday said they remained suspicious of the information published by MoH and WHO.

Dr Denis Laurent, assistant to Kantha Bopha Hospitals founder Dr Beat Richner, said yesterday that 64 children died of the disease in their hospitals alone.

“It’s up to you to choose,” said Dr Laurent of the discrepancy in numbers. “You can believe in the MoH, or you can believe in us.”

Richner remained concerned that the children’s deaths were caused by maltreatment and drug intoxication in private clinics. http://www.phnompenhpost.com/index.php/2012071057324/National-news/lethal-childrens-disease-still-contested.html

Enterovirus 71 cited in puzzling Cambodian infections

Lisa Schnirring Staff Writer
Jul 9, 2012 (CIDRAP New) – Lab analysis in the mysterious recent illnesses and deaths of dozens of Cambodian children pointed to enterovirus 71 (EV-71), a virus that causes hand, foot, and mouth disease (HFMD) and can lead to severe complications in some patients, the World Health Organization (WHO) announced today.

Cambodia's health ministry is finalizing its review of all suspected hospitalized cases, which included two additional cases, raising the total to 59 infections, 52 of them fatal, according to the WHO. However, hospital sources said the number of children with severe infections is somewhat higher.

Dr. Beat Richner, founder and head of Kantha Bopha Children's Hospitals, which has five facilities in Cambodia, said yesterday in a statement that 66 children have been admitted to the hospitals with the same symptoms and clinical findings, and only two patients have survived.

The WHO and local health officials are exploring other factors that might be contributing to the serious and fatal complications in some of the patients. The WHO said lab tests conducted by Cambodia's Pasteur Institute have turned up other pathogens, including dengue virus and Streptococcus suis. Tests have ruled out H5N1 and other influenza viruses, SARS (severe acute respiratory syndrome), and Nipah virus.

The Pasteur Institute tested 24 samples, and EV-71 was found in 15 of them, according to a report today from the Phnom Penh Post.

Richner said the children suffered from encephalitis, with the condition progressing to total destruction of lung alveoli during the last hours of the children's lives. He said in the statement that he and his team wrote a letter to the health ministry on Jun 20 describing the clinical picture of the cases and suggested that the condition might be caused by an enterovirus infection, intoxication from a medication given before hospitalization, or both. He said all 64 of the children who died at Kantha Bopha hospitals had been previously treated at outside private clinics.

The WHO, the Pasteur Institute, and the US Centers for Disease Control and Prevention (CDC), are assisting Cambodia's health ministry with the outbreak investigation.

H.E. Mam BunHeng, the country's health minister..

http://www.cidrap.umn.edu/cidrap/content/other/news/jul0912cambodia-br.html

Jabs hope after Cambodian deaths

Jabs hope after deaths

Tuesday, July 10, 2012

An experimental vaccine for Enterovirus 71 - linked to the mystery disease that has killed 52 children in Cambodia since April - is undergoing clinical trials in the mainland and Taiwan.

The vaccine is likely to be on the market sooner than any drugs, said virology professor Malik Peiris at the University of Hong Kong School of Public Health.
The Cambodian Ministry of Health and the World Health Organization announced yesterday in Phnom Penh that laboratory results of all hospitalized cases from April to last Thursday revealed "a significant portion of the samples tested positive for EV71, which causes hand, foot and mouth disease."

The children range from three months to 11 years old, with a 1.3:1 male to female ratio.
Hong Kong's Centre for Health Protection has told doctors to remain vigilant of "febrile patients returning from Cambodia with respiratory and/or neurological symptoms."
Peiris said the virus does not have to be some "new mutant strain because we know EV71 can cause this type of problem." In 1998, about 200 children died during an outbreak in Taiwan, he said.
Sufferers develop brain stem encephalitis and respiratory distress within hours.
Meanwhile, 15 Hongkongers, among a 32-member tour group to Cambodia last month, have been diagnosed with bacterial dysentery after complaining of fever, diarrhea and vomiting. http://www.thestandard.com.hk/news_detail.asp?we_cat=4&art_id=124187&sid=36977414&con_type=1&d_str=20120710&fc=2

Tonight on AC360: Mystery illness kills children in Cambodia

An illness that quickly turns deadly is claiming the lives of young patients in Cambodia. Doctors at the Kantha Bopha Children's Hospital who regularly treat conditions like Dengue fever, malaria and tuberculosis say they've never seen anything like it.

A World Health Organization representative says many of the children died within 24 hours of being admitted to the hospital. The sickness begins with a mild fever and then rapidly impairs the body. The speed of deterioration and other symptoms are baffling to medical experts.
An enterovirus associated with hand foot and mouth disease has been linked to some of the patients, but that's only one small clue and doctors aren't sure what it means. While parents try to maintain hope, medical experts are working to uncover a pattern and find more pieces to the puzzle.
CNN's Dr. Sanjay Gupta traveled to Cambodia and was granted access to the intensive care unit. Watch his report to learn more at 8 and 10 p.m ET on AC360. http://ac360.blogs.cnn.com/2012/07/09/tonight-on-ac360-mystery-illness-kills-children-in-cambodia/

A report on the 11 yr old Cambodian death from # HFM

..
Vorn Pov


Among the dead was Vorn Pov, whom his father said was 12 years old. In Cambodia, it’s common to add a year when counting ages. Vorn Pov died on June 23, about a week after he first became sick. His father, Khuth Vorn, 53, lives in a wooden thatched roof house next to lush green rice fields in Prey Veng province, southeast of Phnom Penh near the border with Vietnam.


When Vorn Pov first got sick, Khuth Vorn took him to a local clinic, where he stayed for three days. He was transferred to a private clinic in Prey Veng provincial town for four days when his condition worsened, after which he was taken to the Kantha Bopha hospital, Khuth Vorn said. His son arrived at 5 p.m. and was pronounced dead four hours later.


“The doctors said his lungs had burned,” Khuth Vorn said, sitting shirtless at a stone table as half-a-dozen barefooted small children played around him in dirt littered with plastic bags, empty soda bottles and discarded cigarette packages. “My wife was sobbing. We felt helpless.”


Provincial and district officials visited him yesterday to find out more details about his son’s illness, he said.


Iceberg Effect


“If EV-71 is the explanation, what very likely occurred is a massive outbreak of hand, mouth and foot disease, which might not have hit the radar because it’s generally a mild disease and lasts for a few days,” said Peiris.


Peiris explained that in epidemiology there is what is called the iceberg effect: where only a small percentage of the affected present as a serious disease. “What is different could be the host’s ability to combat the disease,” he said.


Hand, foot and mouth disease is a common infectious disease in infants and children, according to the joint release. It is spread from person to person by direct contact with nose or throat discharges, saliva, fluid from blisters, or the feces of the infected, according to the release. http://ki-media.blogspot.com/2012/07...foot.html#more

Cambodian Killer Unmasked?

Scientists have identified a possible culprit in the mysterious syndrome that has killed dozens of children in Cambodia since April, the Cambodian Ministry of Health and the World Health Organization announced on 8 July...
... They found strains of Streptococcus in throat samples from a number of patients but eliminated it as the cause of death after finding the same strains in samples from children with other symptoms.



Neighboring Vietnam has been badly hit by hand, foot, and mouth disease, so "we were expecting an outbreak sooner or later," Buchy says. But samples from victims did not initially test positive for Enterovirus 71. It was only after contacting scientists at the Oxford University Clinical Research Unit in Ho Chi Minh City, Vietnam, that the Pasteur team learned that the primers and probes they had designed for the virus in 2009 were out of date. Sequences of more recent Enterovirus 71 strains from Vietnam revealed that the virus had undergone significant genetic drift, Buchy says.



If Enterovirus 71 is indeed the culprit, one puzzling aspect may be the high number of fatal cases in a country of only 15 million people. Vietnam, which has a population roughly six times as large, confirmed only 20 deaths from hand, foot, and mouth disease between January and April of this year. In China, meanwhile, the health ministry announced last week that 240 people died of hand, foot, and mouth disease between January and May 2012. (The death toll has been higher this year than in years past, a ministry official told China Daily.)

While health officials have no idea how many people might be infected with hand, foot, and mouth disease in Cambodia, Buchy speculates that the population is largely naive to the virus and that "we may have a huge proportion of the child population that is not totally immune." Institut Pasteur scientists are now testing additional samples from the 24 patients and waiting for cell culture results. They will then start sequencing the Cambodian strain, Buchy says. Eventually, he says, they hope to determine "for how long and at which level the virus has been circulating" in Cambodia.http://news.sciencemag.org/scienceinsider/2012/07/cambodian-killer-unmasked.html?rss=1

EV-71 virus can result in brain swelling and death – Cambodian deaths tied to common child

PHNOM PENH: Mean Thida, 4, affected with mystery disease, sleeps beside her mother as she receives treatment via a bottle of serum, not in photo, at their home near a dump site at Sambour village, on the outskirts of Phnom Penh, Cambodia, yesterday. A deadly form of a common childhood illness has been linked to many of the mysterious child deaths in Cambodia that caused alarm after a cause could not immediately be determined, health officials said yesterday.— AP

http://news.kuwaittimes.net/2012/07/09/ev-71-virus-can-result-in-brain-swelling-and-death-cambodian-deaths-tied-to-common-child-illness/

Indonesia heightens monitoring on Cambodian mysterious disease

English.news.cn 2012-07-09 19:16:57

July 9 (Xinhua) -- Indonesian Health Ministry is put under a heightened state of vigilance to monitor the recent development of a mysterious disease that reportedly has killed more than 50 children in Cambodia since April, local media reported on Monday. The Health Ministry's director general for disease control and environmental health, Tjandra Yoga Aditama, said that his ministry had been corresponding with the World Health Organization (WHO) and the Cambodian Health Ministry to gather information about the disease's symptoms, and determine whether or not the disease might spread to other countries. "Currently, the Cambodian Health Ministry and the WHO have yet to collect all the data. Therefore, we can only refer to the disease as an undiagnosed syndrome and a neuro-respiratory syndrome," Tjandra was quoted as saying by the Antara news agency...Even though the disease has claimed dozens of lives, the WHO has yet to issue a travel warning for Cambodia. http://news.xinhuanet.com/english/world/2012-07/09/c_131704362.htm

WHO Update on investigation of unknown disease in Cambodia

Update on investigation of unknown disease in Cambodia

CAMBODIA, 8 July 2012 – The Cambodian Ministry of Health, in partnership with the World Health Organization and other partners, is currently conducting an active investigation of the undiagnosed syndrome that affected children in Cambodia. Based on the latest laboratory results, a significant proportion of the samples tested positive for Enterovirus 71 (EV-71), which causes hand, foot and mouth disease (HFMD). The EV-71 has been known to generally cause severe complications among some patients.http://www.wpro.who.int/en/
http://www.wpro.who.int/CAM_mystery_8July.pdf
Some kids had strep suis and Dengue

Ben Tre: Part pig "run" PRRS

Ben Tre: Part pig "run" PRRS

Sunday, 08/07/2012 14:49 \

blue ear pig Lo spread, many pig farmers in Ben Tre province rushed to sell pork "non", despite heavy losses.


 According to Ben Tre Veterinary Department, the three southern provinces as Binh Duong, Dong Nai and Bac Lieu has announced blue ear pig. This disease tends to spread and the annual peak in July, 8 calendar.
http://nld.com.vn/20120708023653586p0c1002/ben-tre-ban-heo-chay-dich-tai-xanh.htm

SINGAPORE-Local farms take precaution against bird flu

Updated 10:52 PM Jul 08, 2012

SINGAPORE - Farms in Singapore are taking precaution against bird flu, after recent outbreaks in some parts of Asia.

They have increased the disinfection frequency to twice a week - from once every week.

At N & N Agriculture farm in Lim Chu Kang, vehicles have to be thoroughly sanitised before they can enter.

And they have to go through another round before they can enter the egg production area of the farm.

Apart from strict compliance with AVA guidelines, some farm owners have also gone the ...


http://www.todayonline.com/Singapore...ainst-bird-flu

Thailand Public Health Ministry orders 4 mil Tamiflu in case of #bird flu outbreak

Public Health Ministry orders 4 mil Tamiflu in case of bird flu outbreak
 Sunday, 08 July 2012

• BAGKOK, 6 July 2012 -The Ministry of Public Health has reaffirmed that no outbreak of avian flu has been detected in Thailand, but to play it safe the ministry has ordered millions of doses of antiviral drugs of Tamiflu in case of emergency.

According to Department of Disease Control Director-General Dr. Pornthep Sririwanarangsan, the stocking up on Tamiflu is necessary because not only has the avian flu outbreak been reported in China, but also in Mexico.

Dr. Pornthep said even though Thailand has been free of such flu since 2007, the Ministry of Public Health is taking no chances. It has instructed public health volunteers across the country to monitor the poultry situation and notify authorities if the animals’ deaths are suspected to have been caused by H1N1.
He claimed that no dead poultry in Thailand have been found infected by the avian flu so far. He assured the public that since Thailand is an exporter of poultry, it is unlikely for the avian flu to enter the country.
However, 4 million Tamiflu tablets will be obtained to make sure people receive the medication immediately should they develop the H1N1 symptoms. Moreover, the quarantine zones along the Thai border have also been told to be extra cautious about all the birds imported into the country.

http://www.pattayamail.com/news/public-health-ministry-orders-4-mil-tamiflu-in-case-of-bird-flu-outbreak-14415

Doctors identify Cambodia mystery illness

Scientists identify illness that killed 64 children as Enterovirus 71, a strain of hand, foot and mouth disease. Last Modified: 08 Jul 2012 12:07

Video

Scientists in Cambodia have said they have identified the mystery illness that has killed dozens of children in the past three months. The Pasteur Institute in Phnom Penh, the Cambodian capital, announced on Sunday that tests indicate the unknown sickness that has led to the deaths of 64 children and hospitalisation of 66 is the Enterovirus 71. The virus is a strain of hand, foot and mouth disease (HFMD) that is widespread in Asia, but not usually found in Cambodia. HFMD is a human ailment caused by intestinal viruses, and not to be mistaken for foot-and-mouth disease, which only affects animals. Infected children generally suffer from high fever, rashes, respiratory and sometimes neurological problems. In 64 of the 66 cases, the children's health deteriorated much faster than doctors expected. This is one of the reasons why the illness was difficult to identify, as the Enterovirus 71 usually does not lead to such quick deaths. Paediatrician Beat Richner, founder of Kantha Bopha children's hospitals, was the first to raise concerns about the illness. Richner said all the patients who died were treated in private clinics in local areas before being brought to the Kantha Bopha hospitals in the capital and the northwestern province of Siem Reap. "They all got injections or infusions by private centres before coming to us," he said. "Some died four hours after arriving." Faulty prescriptions? Out of the 66 children hospitalised, the two patients that lived were treated only by Kantha Bopha staff, suggesting that botched medical treatment may be a factor. "All these children have encephalitis [inflammation of the brain] and in the later hours of their life they develop a severe pneumonia with a destruction of the alveoli in the lungs. That is the reason they die," Richner said. The alveoli, or air sacs, are pockets in the lungs where the exchange of oxygen and carbon dioxide takes place. There is no known cure for the Enterovirus, but doctors recommend good hygiene especially for young children. The UN health body and Cambodian officials have urged parents to bring their sick children to hospital if they see any signs of any unusual illness. There have been no cases reported outside Cambodia so far. http://www.aljazeera.com/news/asia-pacific/2012/07/201278103438248264.html

Officials make break in baffling disease killing Cambodian children

Hattip TETANO

(CNN) -- Health officials say they have made an important discovery in the mystery surrounding the deaths of more than 60 children in Cambodia.

The Institut Pasteur in Cambodia tested samples taken from 24 patients and found 15 had tested positive for Enterovirus Type 71.

"These results now give a good explanation to this outbreak," Dr. Philippe Buchy, head of the institute's virology unit, said in an e-mail. "We will get more results hopefully by next Tuesday or Wednesday."

In milder cases, EV71 can cause coldlike symptoms, diarrhea and sores on the hands, feet and mouth, according to the journal Genetic Vaccines and Therapy.

But more severe cases can cause fluid to accumulate on the brain, resulting in polio-like paralysis and death.
Deadly disease kills Cambodian children

There is no effective antiviral treatment for severe EV71 infections, and no vaccine is available.

Adults' well-developed immune systems usually can fend off the virus, but children are vulnerable to it, according to the CDC.


http://edition.cnn.com/2012/07/08/wo...ldren-disease/

MEXICO SECRETARY OF HEALTH DENIES H7N3 CAN INFECT HUMANS

Or anything else for that matter..

SECRETARY OF HEALTH, CHERTORISKI SOLOMON: Good afternoon everyone, I greet with respect to fellow media, I thank the Secretary Ferrari's invitation to be together, to comprehensively platicarles all sides of this issue we have As always busy.

I would start by saying that the Ministry of Health we have one of the expert groups for influence in the world, recognized worldwide as reiterated today headed by Dr. Pablo Kuri, three messages that I would very timely.
The first influence is a disease that affects several animal species including as we all know and have experienced the human being, yet each of these viruses is limited to the transmission within the same species. In this particular case the H7N3 virus is only transmitted between birds, I want it very clear that no virus among lizards, whales, horses and of course reiterated among humans, but the virus that we are living today in the country today, focusing on the state of Jalisco has no chance of being transmitted to humans. I say this with all punctuality, with precision throughout history has never been a case of transmission of this virus to humans and I think it is very important as we have been doing throughout the week to reiterate this message there is no risk of infection in humans.   http://translate.google.com/translate?sl=auto&tl=en&js=n&prev=_t&hl=en&ie=UTF-8&layout=2&eotf=1&u=http%3A%2F%2Fwww.sagarpa.gob.mx%2Fsaladeprensa%2Fboletines2%2FPaginas%2Fdefault.aspx 


..Chertorivski Solomon, owner of Health, noted that "there is no risk of human infection" by bird flu and if they even broke the cordon sanitaire and someone were to eat eggs or chicken infected, your health is no risk.
http://www.jornada.unam.mx/ultimas/2012/07/06/153333235-se-duplicara-cuarta-emergente-de-exportacion-de-huevo   
 


Due to the outbreak of bird flu that has affected A7N3 thousands of birds in the municipalities of Tepatitlán Acatic and Jalisco, the State Government through the Ministry of Health reports that this virus is not transmissible to exotic beings human by any means.

Likewise, this office has ruled out the possibility of avian flu infection who consume eggs and poultry.

 Avian influenza is a highly contagious viral disease caused by a virus Type "A" that affects several species of birds of all ages, as wild and domestic turkeys, chickens, ducks, water birds, the latter acting as potential carriers virus.

  Dr. Jose Trevino Leo Cardenas Director of Prevention and Disease Control, reported that this disease is only transmitted between birds that have contact with infected feces, secretions, contaminated food and water or improper handling of dead birds.  

http://translate.google.com/translate?sl=es&tl=en&js=n&prev=_t&hl=en&ie=UTF-8&layout=2&eotf=1&u=http%3A%2F%2Fwww.masnoticias.net%2Fnote.cgi%3Fid%3D418307

56 Cambodian children killed by unknown disease in 3 months

..The Cambodian Ministry of Health and the World Health Organization (WHO) said late Friday that the initial investigation results showed that 56 children had died of the undiagnosed disease in the last three months and an active investigation is still going on.
The death toll was lower than the 61 deaths announced on Wednesday.
"Preliminary findings identified a total of 74 cases who were hospitalized from April to 5 July 2012," said a joint statement of the ministry and the WHO....

http://news.xinhuanet.com/english/health/2012-07/07/c_131700297.htm

PHL officials on alert for Cambodia respiratory disease

July 7, 2012 7:34am

Philippine authorities are now on alert for a mysterious respiratory disease that has so far killed at least 56 children in Cambodia.

The Bureau of Quarantine has intensified its medical inspection of passengers from Southeast Asia especially from Cambodia, radio dzBB reported Saturday....


“The DOH is now monitoring (the disease). Airports will screen inbound travelers as standard operating procedure,” he said.
So far, he said little is known of the disease other than that it “affects children, (and is) very fatal,” with its mode of transmission unknown, and causative organism unknown.

In other posts on his Twitter account, Tayag said symptoms of the disease include fever and respiratory and/or neurological symptoms followed by death within 24 hours.

Another sign of the disease includes an elevated white blood cell count, he added.

So far, he said none of the hospital staff who took care of the children with symptoms had gotten sick.

WHO: 74 cases identified, at least 56 fatal

The World Health Organization said the Cambodian Ministry of Health is actively investigating the syndrome.

It said preliminary findings identified 74 cases who were hospitalized from April to July 5...


http://www.gmanetwork.com/news/story/264501/news/nation/phl-officials-on-alert-for-cambodia-respiratory-disease

Unknown Disease Killing Children Across Cambodia, WHO Says

By Jason Gale - Jul 6, 2012 3:26 AM ET

Victims of a disease that’s killed dozens of children in Cambodia were from more than half the country’s provinces, a World Health Organization official said.
The first 57 patients were from 14 of Cambodia’s 24 provinces, with most coming from the southeastern provinces of Kampong Cham, Kampong Speu and Prey Veng, said Joy Rivaca Caminade, a technical officer with WHO’s Regional Office for the Western Pacific in Manila. The Ministry of Health was first alerted to the cases by Kantha Bopha Children’s Hospital in the capital, Phnom Penh, Caminade said in an e-mail today.

Enlarge imageUnknown Disease Killing Children Across Cambodia, WHO Says



People wait with their children for free medical treatment at Kuntha Bopha Hospital in Phnom Penh. Photograph: Landov



People wait with their children for free medical treatment at Kuntha Bopha Hospital in Phnom Penh. Photograph: Landov




Health officials are searching for the cause of the deaths, which may be the result of a combination of different diseases, according to Caminade. Surveillance in the Southeast Asian nation hasn’t picked up anything of this scale in recent years, she said. So far, there is no evidence of clustering of cases that could indicate that it’s spreading from person to person.
The undiagnosed syndrome has been reported in 67 hospital patients since April, 66 of whom have died, said Aphaluck Bhatiasevi, a WHO spokeswoman, in a telephone interview fromPhnom Penh today. It’s unlikely influenza is the cause, she said.
No Autopsies

“No autopsy was done on any of the cases,” said Nima Asgari, the leader of the WHO’s emerging disease surveillance and response team in Cambodia.
Health officials are reviewing hospital records and treatments provided, as well as surveying relatives of patients, to understand the events that occurred from when the children fell ill to their hospitalization. The information is then being matched with laboratory data, he said.
“As you can imagine, this will take time and we are still at the data analysis part,” Asgari said in an e-mail today.

Children admitted to the hospital with symptoms including high fever, breathing difficulty and neurological problems saw their respiratory function worsen quickly, Caminade said yesterday. A review of 57 cases found 46 of them died within 24 hours of admission, with the rest suffering the same fate within three days, she said. The stricken children were aged three months to seven years.
The United Nations health agency is working with Cambodia’s health ministry and has offered support and access to international experts in areas such as epidemiology, she said. The WHO is on standby to provide support for clinical management and supplies of medicines if requested. http://www.bloomberg.com/news/2012-0...-who-says.html

 

July 5, 2012

The Agriculture, Fisheries & Conservation Department has shut down the Mong Kok Bird Garden for three weeks due to the detection of the H5N1 virus. It was found in a swab sample collected from a birdcage holding an Oriental magpie robin on June 25.

The department has closed the shop involved and sent its birds to the department's animal management centre in Sheung Shui to be put down. It has ordered all pet bird shop operators in the garden to thoroughly clean their stalls.

The Centre for Health Protection has put all stall operators and workers in the garden under medical surveillance. It has opened a hotline, 2125 1122, to provide health advice to the public.
Three hundred swab samples are collected per month from 39 pet bird stalls, including the 18 stalls in the Bird Garden, to test for avian flu viruses. More than 1,700 swab samples have been collected from stalls so far this year. Of the 3,200 samples tested last year, none were positive for avian influenza.

Meanwhile, a dead house crow found in Yau Yat Chuen on June 29 has tested positive for H5N1. Cleaning and disinfection in the area has been stepped up.

 

July 5, 2012

JAKARTA - AFP: Directorate General of Disease Control and Environmental Health (P2PL) Ministry of Health to ensure the death of the girl residents Khanewal district, West Java, KK (8) is due to bird flu (H5N1). Director General Tjandra Yoga Aditama P2PL in Jakarta, Thursday ( 5/7), said the new cases of H5N1 have been confirmed by the Center for Basic Biomedical and Health Technology, Balitbangkes, Ministry of Health.
In chronological order, describing the case of KK Tjandra since June 18, 2012 from a fever. Then, on June 19 KK went on holiday to Singapore and the next day seeing the doctor and was diagnosed with strep throat. On June 24, KK returned to Jakarta in unsanitary conditions, so on June 25 went to Hospital B in Khanewal district with heat complaints over one week, vomiting, cough, no appetite. Of the RS, KK diagnosed febrile and impairment of consciousness and the images thorax there Duplex bronchopneumonia . On June 26 households forcibly asks to go home from the hospital, then went to the hospital's in West Jakarta. But the situation got worse, so ventilator and intointensive care unit (ICU). Two days later, on June 28, families are referred to the RSP with the diagnosis of suspected bird flu, and on June 29 the results of the sample by the Research and Development (BTDK) Positive H5N1. "Worse case condition and eventually died on July 3, 2012 at 22:45 pm," said Tjandra. local health office and home epidemiological investigation of cases, the environment, markets and hospitals where the case was referred to hospital were treated before referral FB (RSP) . "It was found possible risk factors is due to contact with poultry on June 12, is concerned to go to market with his father and brother, bought 5 chickens alive and voted to cut the chicken in poultry slaughterhouses. KK also hold the chicken is cut, "said Tjandra. In that incident, the cumulative number of bird flu in Indonesia since 2005 until today is 190 cases with 158 deaths. (Ant/OL-16)

 

Friday, July 06, 2012

Excerpt:
Twenty-five stall owners and workers and 14 staff members from the department have been put under medical surveillance by the Centre for Health Protection.
Health and agriculture officials said the announcement of the infected tourist spot - the first in five years - was not delayed, even though droppings inside the cage of the magpie robin were collected on June 25.
Tests on the samples usually take weeks to complete, and the results from the department laboratory came out only yesterday morning.
So far this year 22 dead wild birds have been found to be infected, a five- year high.

University of Hong Kong scientists will genetically sequence the virus to see if it has not shifted from the dominant strain, clade 2.3.2.1, said HKU professor of virology and gene sequencing expert Guan Yi.

Hong Kong Closes Bird Market Over Avian Flu Virus

Hong Kong Closes Bird Market Over Avian Flu Virus

Excerpt:
Hong Kong. Hong Kong on Thursday closed a popular tourist spot where hundreds of caged birds are on display after the deadly H5N1 avian flu virus was detected at one of the stalls.

The agriculture, fisheries and conservation department said it was closing the Yuen Po Street bird market in the city’s bustling Mongkok district for 21 days. There are about 70 bird stalls in the market.

The move came after the virus was found in a swab sample collected from a cage holding an oriental magpie robin during a routine avian influenza surveillance operation.

All the stall’s birds would be killed, the department said in a statement.

A spokeswoman told AFP they were still investigating the cause of the virus as the bird itself was not infected.

Indonesia Ministry of Health Update: Bird Flu Case report 190

Indonesia Ministry of Health Update: Bird Flu Case report 190

Laporan Kasus Flu Burung ke 190

July 5, 2012

Ministry of Health, "Directorate General of Disease Control and Environmental Health" announced one new case of H5N1 have been confirmed by the Center for Basic Biomedical and Health Technology, Balitbangkes. Case on behalf of the families (female, 8 years) who Falkirk District, West Java. On June 18, 2012 the case began to experience fever, June 19, the case went on holiday to Singapore and the next day for treatment didokter private practice, was diagnosed with strep throat. On June 24, returned to Jakarta. June 25, the case went to the hospital. Falkirk District B with a complaint over a week heat, vomiting, cough, no appetite and was diagnosed with febrile and impairment of consciousness and no radiographic results Duplex bronchopneumonia. June 26, forced to go home, then went to the hospital. S West Jakarta, the situation gets worse case then mounted ventilator and ICU admission, on June 28, referred to the RSP with the diagnosis of suspected bird flu, on June 29, the results of the sample by the Research and Development (BTDK) Positive H5N1.Kondisi case worsened and finally died world on July 3, 2012 at 22:45 pm.
Epidemiological investigations have been done to the house of the case, the environment, markets and hospitals where the case was referred to hospital were treated before referral FB (RSP). Acquired risk factors, namely the possibility of contact with poultry as before (date June 12) the case goes to market with his father and brother, bought 5 chickens living in which case the vote and cut the chicken in the poultry abattoir (TPU), the case also hold the chicken been deducted. Every day the case to the school through a new market Falkirk existing poultry seller.
With the increase of these cases, the cumulative number of bird flu in Indonesia since 2005 until this news was broadcast on 190 cases with 158 deaths.
Director General of Disease Control and Environmental Health Prof. dr. Tjandra Yoga Aditama as the focal point of the International Health Regulations (IHR) has been informed about the case to the WHO.
This information is published by the Center for Public Communication, Secretariat General of the Ministry of Health. For further information please contact via telephone: (021) 52907416-9, fax: (021) 52921669, Fast Response Response Centre (PTRC): 500-567 and 081 281 562 620 (sms), or e-mail kontak@depkes.go . id

Mexico Ministry of Health insists that bird flu is not transmitted to humans

  Given the low reported in egg consumption, the health secretary in Jalisco, Antonio Muñoz Serrano insists that the bird flu affected farms in Jalisco is not transmitted to humans.  It tells people there is no risk from eating any animal protein, "That the virus survives at low temperatures and with increasing temperature either in the cooking food, or else to be outside the virus becomes dehydrated and dies ... ".  Add that on farms in the Highlands of Jalisco was decreed a quarantine, so that no product from other sites will be in the market.  http://www.notisistema.com/noticias/?p=510340

Indonesian girl who travelled to Singapore dies from avian flu

SINGAPORE - The Health Ministry says it has been informed of a case of avian influenza A (H5N1) in an eight-year-old girl from Indonesia who had travelled to Singapore.

In a statement, the ministry said the girl developed fever in Singapore on June 18 and returned to Indonesia on June 24. She died on July 3 this year.


Singapore's Health Ministry is in close contact with the Indonesian health authorities and the World Health Organisation.
The Indonesian health authorities have reported that the girl had exposure to poultry while in Indonesia, a few days before her travel to Singapore. They are monitoring her close contacts, including family members. All contacts have remained well.

As a precautionary measure, Singapore's Health Ministry has alerted hospitals to the case and commenced contact tracing in Singapore.

The girl stayed at a hotel in Singapore with her mother and other relatives from 19 to 24 June 2012 on a vacation. She was brought to see a general practitioner for high fever on 22 June and was given treatment. Her relative who lives here and the general practitioner who treated the case are both well.http://www.todayonline.com/Singapore/EDC120706-0000142/Indonesian-girl-who-travelled-to-Singapore-dies-from-avian-flu

Mexico hides threat from #H7N3 #BIRDFLU

Mexico has spent a lot of time, telling me that their H7N3 Outbreak is
 1-Under control
 2-It will not effect exports
3-Humans can't catch it
 4-Eat all chicken and products from them without worry



 The Ministry of Health insisted that citizenship should be quiet, because the strain of the H7N3 virus is only transmitted between animals, but not to humans. http://www.oem.com.mx/elsoldemexico/notas/n2605916.htm

State of Puebla called the people to be calm, because this strain is spread only among animals and fails to humans.
http://www.elgolfo.info/elgolfo/nota/121303-ssa-llama-a-la-tranquilidad-en-puebla-por-gripe-aviar/
I beg to differ 

Influenza A virus subtype H7N3
http://en.wikipedia.org/wiki/Influenza_A_virus_subtype_H7N3

 Zoonotic potential of highly pathogenic avian H7N3 influenza viruses from Pakistan
http://ukpmc.ac.uk/abstract/MED/19535120/reload=0;jsessionid=Ct905QPdCi3usLwwUqdd.0

Human Illness from Avian Influenza H7N3, British Columbia
http://wwwnc.cdc.gov/eid/article/10/12/04-0961_article.htm

The appearance of human infections caused by avian influenza A H7 subtype viruses underscores their pandemic potential and the need to develop vaccines to protect humans from viruses of this subtype
http://www.osti.gov/energycitations/product.biblio.jsp?query_id=1&page=0&osti_id=21141027

WHO update-Undiagnosed illness in Cambodia

Undiagnosed illness in Cambodia - update

6 July 2012 -The Ministry of Health of the Kingdom of Cambodia is conducting active investigation into the cause of a recent undiagnosed syndrome that has caused illness and deaths among children in the country.
Preliminary findings of the investigation identified a total of 74 cases who were hospitalised from April to 5 July 2012. Of these, 57 cases (including 56 deaths), presented a common syndrome of fever, respiratory and neurological signs, which is now the focus of the investigation.
The majority of the identified cases to date were under three years old. Most of them were from the southern and central parts of the country and received treatment at Kantha Bopha Children’s hospital, which is a reference paediatric hospital. Despite all efforts, many of the children died within 24 hours of admission.
Available samples have been tested at the Institut Pasteur in Cambodia. Although a causative agent remains to be formally identified, all these samples were found negative for H5N1 and other influenza viruses, SARS, and Nipah.
The Ministry of Health was first alerted to this by Kantha Bopha Children’s hospital in Phnom Penh, where the majority of the cases were hospitalised.
The Ministry of Health notified WHO about this event through the IHR notification mechanism as it met the criteria for notification of any event where the underlying agent or disease or mode of transmission is not formally identified.
WHO and partners are assisting the Ministry of Health with this event which focuses on hospitalised cases, early warning surveillance data, laboratory data and field investigations.
While this event is being actively investigated, the Government is also looking at other diseases occurring in the country, including dengue, hand-foot-mouth and Chikungunya.
Parents have been advised to take their children to hospital if they identify any signs of unusual illness. The Government is also reinforcing awareness of good hygiene practices to the public, which includes frequent washing of hands.   http://www.who.int/csr/don/2012_07_06a/en/index.html

CAMBODIA - A disease whose origin is still unknown, killed 63 children since last April

Hattip Pathfinder

Since April, Cambodia, on 64 infected children, only one girl survived this unknown disease. The Pasteur Institute, in collaboration with the Kantha Bopha Foundation, attempts to locate the origin of this pathology. A mysterious disease, hitherto unknown to researchers, has killed 63 children since April in central and southern Cambodia. 90% of them were under 5 years.

In collaboration with the Kantha Bopha Foundation, researchers at the Pasteur Institute are examining samples from the patients and try to find the origin of pathology.Which symptoms does one recognize this strange disease? Two recurring syndromes characterize it: infection encephalitis - affecting one part of the brain - and a lung infection.
"Usually, we get a lot of children in the hospital for dengue, pneumonia, encephalitis and meningitis, explains Denis Lawrence, a biologist for the Kantha Bopha Foundation. But since April 20, we were surprised by a very serious development of acute pneumonia. Children die very quickly, between 24 and 48 hours after arrival.

"Kantha Bopha FoundationThe Kantha Bopha foundation has existed since 1992 and is led by the Swiss pediatrician Beat Richner. It comprises five hospitals (three in Phnom Penh to Siem Reap and two). These establishments do not care for the children from poor families, free of charge. Its budget is fed mainly by private donations.

Nevertheless, the expert believes that there is no cause for alarm: no new cases have been recorded since the beginning and the risks of epidemics are lower.
In addition, doctors have "done a lot of samples that have helped to eliminate the origins of the most dangerous in terms of contagion," says Philippe Buchy, head of virology division at the Pasteur Institute. "This disease could simply be the most severe form of a common disease in Cambodia and in neighboring countries," said he

.Another avenue is explored: a link between a virus and a drug reaction or chemical. "All children who died had taken drugs prior to their arrival at the hospital. The girl who survived the disease had not received the other hand, says the biologist. There is a real problem of self-medication in Cambodia. more poor buy medicines, often counterfeit, without the original packaging and it is difficult for doctors to know what patients have ingested.

"WHO rushed"
The warning from the WHO [World Health Organization, ed] on this disease has caused some panic in Phnom Penh. People call us to know whether to leave the country. This announcement was made too early, we do not have enough information about the disease, "laments Denis Lawrence.
Researchers at the Pasteur Institute hope to receive conclusive results explaining the cause of the disease within a week and a half.http://www.lexpress.fr/actualite/sci...e_1135343.html

Philippines DOH ready for 'mysterious' respiratory disease

By Sheila Crisostomo July 07, 2012 12:00 AM

MANILA, Philippines - The Philippines has prepared plans for cases like the “mysterious” respiratory disease that had claimed the lives of 61 children in Cambodia, the Department of Health (DOH) said yesterday.
“For cases like this, the DOH has prepared plans, and usually, the National Epidemiology Center is the responsible agency within the department while the Bureau of Quarantine increases its surveillance for such disease crossing the borders,” the DOH said in a statement...

“We are advising the public to understand the risk of travel to Cambodia and to withhold unnecessary travel to this country. People going to the area should practice necessary precautions,” the DOH noted...

..But DOH Undersecretary Dr. Ted Herbosa said there is no need yet to place in quarantine travelers from Cambodia who will manifest any illness upon arrival in the country’s airports.
“There is no cause for alarm. The monitoring is just part of our contingency measures. The WHO had issued the advisory so that people can be forewarned... that there is this thing there,” he said in a telephone interview. – With Rudy Santos http://www.philstar.com/Article.aspx...bCategoryId=63

Cambodia: undiagnosed illness affecting children

06 Jul 2012

ECDC An outbreak of an undiagnosed illness affecting children has been reported by the Ministry of Health of the Kingdom of Cambodia to World Health Organization (WHO). Out of the 62 children, 61 have died. No apparent clustering of cases or signs of transmission have been reported so far. Between April and June, a total of 58 children below age of 7 years have been admitted to a hospital in Phnom Penh. Further 4 children were admitted to a hospital in Siem Reap, with high fever and encephalitic and/or respiratory symptoms. In total, 62 cases were reported, the majority being on children under 3 years of age. Fifty-six of 58 patients hospitalized in Phnom Penh and four of four patients hospitalized in Siem Reap have died. Of these cases, 46 died within 24 hours of admission, and the majority of the rest died between 1-3 days after admission. Sixty-one deaths were reported. The Cambodian Ministry of Health and WHO are conducting an active investigation in order to determine cause and source of the illness. ECDC is closely monitoring the situation. http://ecdc.europa.eu/en/press/news/Lists/News/ECDC_DispForm.aspx?List=32e43ee8-e230-4424-a783-85742124029a&ID=666