Category: Pandora Report

The Pandora Report 2.21.14

by Siddha Hover, posted in Pandora Report

Editor’s note: Hello all Pandora Report subscribers! This is unfortunately my last week as author of the Pandora Report. It’s been such a pleasure having the opportunity to write the Pandora Report, and I would like to thank all of you for taking the time to subscribe and read it. I leave you all in the trusty hands of the new Pandora Report team – goodbye, thank you, and remember to stay away from the bats.

Highlights include PEDv, 1918 Spanish Flu, MERS-CoV, and Ebola. Happy Friday!

As deadly pig virus spreads, USDA warns of impact on hog supply

Porcine epidemic diarrhea virus (PEDv)has spread to a further two states, with Montana and Idaho reporting cases for the first time. The virus, which has a fatality rate approaching 100% in piglets, has swept across the country, with 3,528 cases in 25 states. Contaminated feed was recently put forth as a potential source of the virus’ spread. Before you start autoclaving your pork products, remember that the virus poses no threat to humans.

Chicago Tribune – “PEDv causes diarrhea, vomiting and severe dehydration in pigs. Research by the U.S. hog industry determined it is spread orally through infected pig manure, and can be carried by trucks, boots, clothes and water. But feed containing porcine by-products, including but not limited to plasma, recently came into focus as a means of transmission. The Canadian Food Inspection Agency (CFIA) found the virus in samples of U.S.-origin plasma from a third-party manufacturer for Grand Valley Fortifiers, a livestock feed company based in the province of Ontario. The company recalled the feed.”

Study revives bird origin for 1918 flu pandemic

According to a new study published in Nature, the 1918 (H1N1) Spanish flu virus originated not from reassortment in pigs, but from domestic water and shore birds. This most recent study contradicts finding in a persuasive 2009 study which found the virus to have circulated in humans and pigs for up to 15 years prior to the pandemic. Historical epidemiology is critical to better understanding, and therefore predicting, emerging  pandemic threats.

Nature – “The virus that caused the 1918 influenza pandemic probably sprang from North American domestic and wild birds, not from the mixing of human and swine viruses. A study published today in Nature1 reconstructs the origins of influenza A virus and traces its evolution and flow through different animal hosts over two centuries. ‘The methods we’ve been using for years and years, and which are crucial to figuring out the origins of gene sequences and the timing of those events, are all flawed’, says lead author Michael Worobey, an ecologist and evolutionary biologist at the University of Arizona in Tucson. Worobey and his colleagues analysed more than 80,000 gene sequences from flu viruses isolated from humans, birds, horses, pigs and bats using a model they developed to map evolutionary relationships between viruses from different host species. The branched tree that resulted showed that the genes of the deadly 1918 pandemic virus are of avian origin.”

Saudi Arabia’s MERS Death Toll Reaches 60

The sixtieth MERS-CoV fatality in Saudi Arabia was a 22-year old male with previously existing conditions. The young man was also battling cancer. There have been 182 cases of the virus globally, of which 165 have been in Saudi Arabia. All but nineteen of the fatalities have been in Saudi Arabia. No word yet on whether he had previous contact with camels.

Gulf Business – “The virus, which first appeared in 2012, has affected around 182 people globally and has resulted in 79 deaths till date, according to World Health Organisation (WHO). MERS, a deadly but less transmissible virus than SARS, has symptoms such as coughing, fever and pneumonia. Although the worldwide number of MERS infections is fairly small, the high death rate among confirmed cases and the spread of the virus beyond the Middle East is keeping scientists and public health officials on alert. Cases have been reported in Saudi Arabia, Qatar, Kuwait, Jordan, UAE, Oman and Tunisia as well as in several countries in Europe.”

Man steals phone from Ebola patient, gets infected

As this is my last Pandora Report, it is only appropriate Ebola is mentioned at least once. This story is making the rounds again following it’s use in a promotional AARP blog post (bold move, AARP, bold move). Its moral? Don’t steal things from hospitals. Especially things located in a hospital’s active quarantine zone. Especially things located in a hospital’s active quarantine zone during an Ebola outbreak.

The Daily Monitor (Uganda) – “Security and medical officials in Kibaale District have registered a case in which a man allegedly went in an isolation ward at Kagadi Hospital and stole a cellular phone from one of the Ebola patients…Police detectives began tracking him after he apparently began communicating to his friends using the phone. But as police zeroed in on him, he developed symptoms similar to those of Ebola and sought medication at the hospital…In his confession made to the police, the suspect, now patient, claimed he had visited the isolation ward to give them comfort although he confessed to knowing none in person.”

(image courtesy of NIAID)

The Pandora Report 2.14.14

by Siddha Hover, posted in Pandora Report

Highlights include H7N9 in Hong Kong, H5N1, a new case of MERS, and a new global initiative to counter infectious diseases. Happy Friday, stay warm, and Happy Valentine’s day!

Hong Kong Reports Fifth H7N9 Bird Flu Case

We wrote earlier this week about the H7N9 case in Malaysia, in which a Chinese tourist brought the virus to Malaysia. Hong Kong has since reported its fifth case of the virus. The patient is a 65 year old male with underlying medical conditions.  Tensions are understandably running high in the area, with Chinese authorities recently arresting a man for spreading false rumors about the virus.

Naharnet – “Preliminary investigations showed the man had traveled to the neighboring Chinese province of Guangdong from January 24 to February 9, and had purchased a slaughtered chicken in the village near his residence on January 29. Seven family members had remained asymptomatic, with five classified as close contacts to be admitted to hospital for observation and testing. Hong Kong late last month slaughtered 20,000 chickens after the deadly H7N9 bird flu virus was found in poultry imported from Guangdong. Fears over avian flu have grown following the deaths of three men from the H7N9 strain in the city. All had recently returned from mainland China.”

Canadian who died from H5N1 flu might have caught it in illegal bird market
It is thought the Canadian who contracted H5N1 became infected after passing through an illegal live poultry market in Beijing. Such markets have been banned in the city since 2005 – local demand for fresh poultry, however, has caused a thriving illicit industry to spring up.

CBC – “The source of the woman’s infection has been a mystery; she spent her entire trip in Beijing, where H5N1 reportedly hasn’t been discovered for some time, and her travelling companion said she did not have contact with live birds while there. But scientists from Beijing’s Centre for Disease Prevention and Control are hypothesizing that illegal live bird markets may have been the source of the woman’s infection.”

Camel-owner in Abu Dhabi in intensive care after contracting MERS virus
A camel-owner in the UAE has presented with MERS, giving further credence to the theory of camels as potential hosts. The 67-year old man had previously existing medical conditions, becoming symptomatic on January 20th.  There have been 182 laboratory-confirmed cases of the virus to date, with 79 deaths.

The National – “A camel owner in the emirate has become the latest person to be infected with the Mers coronavirus. The Emirati, 66, is in intensive care after complaining of respiratory problems and was found to have contracted the virus, it was confirmed on Thursday…He owns camels in the UAE and had recently travelled to Oman where he was in contact with other beasts, the World Health Organisation says.”

U.S. launches new global initiative to prevent infectious disease threats
Working with WHO, the Food and Agriculture Organization, and the World Organization for Animal Health, the US launched a new global initiative to help countering emerging infectious diseases. Speaking about the threat of emergent infectious diseases, Health and Human Services Secretary Kathleen , “A threat anywhere is indeed a threat everywhere”.

Washington Post – “Faced with what they describe as a perfect storm of converging threats from infectious-disease epidemics, U.S. officials launched a global effort Thursday with more than two dozen countries and international organizations to prevent deadly outbreaks from spreading. The goal is to prevent, detect and respond to infectious-disease threats where they start. That’s more effective and less costly than treating sick people after diseases spread. The new initiative is intended to bolster security at infectious-disease laboratories, streng-then immunization programs and set up emergency-response centers that can react to outbreaks within two hours.”

The Pandora Report 2.6.14

by Siddha Hover, posted in News, Pandora Report

Highlights include H10N8, H7N9’s second wave, MERS-CoV update, and a Burholderia antrimicrobial. Happy Friday!

New China bird flu a reminder of mutant virus risk

We covered this story when it first came out, but the emergence of a novel strain of highly pathogenic avian influenza (HPAI) is noteworthy enough to mention twice.  It’s H10N8 everyone and it’s in humans. There have been just two cases since the virus jumped from birds to humans in December of 2013, including one fatality. There are a couple things about H10N8 which is troubling scientists. The first is that it’s jumped host, and in the process, opened up a completely naive population (us) to infection. The second is that it’s thought to be reassorted – a mix of a couple other strains of avian flu. Reassortment scares everyone – if it can mutate once to be able to infect humans, it can mutate twice to become readily transmissible person-t0-person. Still, we’re novel hosts, which means the virus isn’t yet well-adapted to us. It’s also worth mentioning here that H7N9 also made the jump from poultry to person, and it remains poorly suited to human hosts.

Reuters – “The death of a woman in China from a strain of bird flu previously unknown in humans is a reminder of the ever-present potential pandemic threat from mutating animal viruses, scientists said on Wednesday. The new strain, called H10N8, has so far infected only two people – a fatal case in a 73-year-old and another in a woman who is critically ill in hospital. But the fact it has jumped from birds to humans is an important warning, they said. ‘We should always be worried when viruses cross the species barrier from birds or animals to humans, as it is very unlikely that we will have prior immunity to protect us’, said Jeremy Farrar, director of Wellcome Trust and an expert on flu.”

China reports 11 new H7N9 human cases

Chinese health authorities have reported a further 11 laboratory-confirmed cases of H7N9, bringing the number of second wave infections up to 181, and the total number of cases up to 317. The majority of the cases are coming from just two Chinese provinces, Guandong and Zhejiang. While the influx of cases in Hong Kong are all thought to originate from poultry imports, there has been no evidence to indicate the virus has been transmitted internationally. Also, aside from one cluster, there has been no evidence of sustained person-to-person transmission.

Xinhua – “Eleven Chinese people were confirmed to be infected with the H7N9 bird flu on Wednesday in four regions, with 8 in critical condition, according to local health authorities. The southern province of Guangdong reported 4 new cases, including a 5-year-old girl and a 42-year-old man in Zhaoqing City, a 49-year-old man in Foshan City and a 56-year-old man in Shenzhen City, said the provincial health and family planning commission. The girl and the man from Foshan are in stable condition while the other two remain in critical condition, according to the commission. The eastern province of Zhejiang, the region hit hardest by the H7N9 virus, confirmed four new human cases on Wednesday, bringing the total number of affected cases to 69 in the province so far this year, said the provincial health and family planning commission.”

Middle East respiratory syndrome coronavirus (MERS-CoV) – update

With H7N9 picking up and H10N8 emerging, MERS-CoV has been flying under the comparative radar. Speaking anecdotally, the number of cases seems to be declining, with just one new case in the last two weeks. Globally, there have been 181 cases to date. While camels remain the likely culprit, no vector or reservoir has been confirmed.

WHO – “The case is a 60-year-old man from Riyadh who became ill on 19 January and who had underlying medical conditions. He was hospitalized on 24 January and died on 28 January. Respiratory specimens were collected and sent to the central laboratory in Riyadh and confirmed positive for MERS-CoV on 28 January. Details of his possible contact with animals are unknown, and he has no history of contact with a laboratory-confirmed case. WHO has also been informed by the United Arab Emirates of the death on 16 January of a previously reported case of a 33 year-old male healthcare worker from Dubai (see Disease Outbreak News update from 3 January 2014).”

U.S. Eyes $90 Million Contract for Bioterror Treatments

The Department of Health and Human Services (HHS) awarded a $19.8 million dollar contract to a company working on  antimicrobials against the agents Burkholderia mallei, the causative agent of glanders,  and B. pseudomallei, the causative agent of melioidosis, respectively.  B. mallei, it should be noted, may have been used during WWI by the Germans, in an ill-fated attempt to use infected horses to spread the disease across the Russian front lines. While B. mallei does cause serious disease in horses and donkeys, cases of human infection are rare.

NTI – “The contract award marked a new investment in ‘broad-spectrum antimicrobials’ by the federal agency’s Biomedical Advanced Research and Development Authority. Such treatments are designed to be of use in responding to a potential biological strike, as well as for handling other health threats. ‘Antibiotic resistance adversely impacts our nation’s ability to respond effectively to a bioterrorism attack and to everyday public health threats,’ BARDA Director Robin Robinson said in a statement. ‘By partnering with industry to develop novel antimicrobial drugs against biothreats that also treat drug-resistant bacteria, we can address health security and public health needs efficiently.’

(image: James Jin/Flickr)

The Pandora Report 1.31.14

by Siddha Hover, posted in Pandora Report

Highlights include abrin poisoning, norovirus on another couple cruises, a B. anthracis bacteriophage, and H7N9 fears in Hong Kong. Happy Friday!

Bank worker, 36, ‘spiked her Magistrate mother’s Diet Coke with deadly poison’
A woman in the UK is standing trial for attempting to poison her mother with abrin, by spiking her Diet Coke soda with the toxin. As we mentioned last week after a man tried to sell abrin hidden in candles, abrin is 75 times more toxic than it’s bean-derived cousin, ricin. No word yet on the source of the toxin in the case. The woman was arrested following a counterterrorism effort in the UK – she will not, however, be charged with acts of terrorism or violations of the BWC. She maintains her innocence.

London Evening Standard – “Abrin strikes at the liver, stomach and kidneys and is potentially fatal. It costs between £600 and £900. Kuntal Patel, 36, is accused of spiking a Diet Coke with abrin…Patel was arrested after a hunt for toxic chemicals at her home following information passed to the Met from the US. She has said the substance was intended for a suicide bid which she later abandoned.”

Cruise ship back in Houston after nearly 200 fall ill
We’d like to say upfront that we have a degree of admiration for anyone still willing to go on cruise ships. While we understand that hundreds of ships plow through various bodies of water without issue everyday, when things go wrong on a cruise ship, they have the unique capacity to go spectacularly wrong. In 2013 alone, there were nine outbreak of gastrointestinal illnesses on US-based cruise ships  – 7 caused by norovirus and one caused by E. coli (the cause of the ninth case rather ominously remains “unknown”). Compared to, for instance, last February’s incident involving a week of no power or working toilets, this week’s two incidents – one norovirus outbreak on a ship sickening 170, and another sickening 700, seem relatively tame.

Houston Chronicle – “The Caribbean Princess left the Port of Houston on Jan. 25 bound for the Western Caribbean with more than 4,200 people on board. The vessel was scheduled to return on Saturday. According to CDC spokesman Llelwyn Grant, 162 of the 3,102 passengers and 11 of the 1,148 crew members had reported illness by late Thursday afternoon. Ship employees implemented some of the agency’s recommendations for preventing further infections, he said…Caribbean Princess passengers will remain on the ship until they are cleared by U.S. Customs authorities, which will take several hours, according to Princess Cruises spokeswoman Julie Benson. Besides overnight accommodations in Houston, the cruise line said passengers would be offered a 20 percent credit toward a future cruise.”

Newly-discovered virus has voracious appetite for anthrax
The Tsamsa virus, a surprisingly large, newly-discovered bacteriophage (bacteria-eating virus), seems to have a preferential appetite for Bacillus anthracis. This appetite can hopefully be one day harnessed  The virus was discovered in a zebra carcass in Namibia by an international team of scientists, led by researchers from Universities Berkeley and KwaZulu-Natal  from universities around the world. And people say academia isn’t glamorous.

UC Davis PR– “The virus was isolated from samples collected from carcasses of zebras that died of anthrax in Etosha National Park, Namibia. The anthrax bacterium, Bacillus anthracis, forms spores that survive in soil for long periods. Zebras are infected when they pick up the spores while grazing; the bacteria multiply and when the animal dies, they form spores that return to the soil as the carcass decomposes.”

Hong Kong reports third H7N9 death
China has culled 22, 604 birds following a batch of poultry testing positive for H7N9. Adding to fears over the virus’ spread, yesterday another patient died following an H7N9 infection, the third in the last month. Hong Kong has also shut it’s live poultry market for three weeks to allow for thorough disinfection. The most recent death, which comes just one day before the Chinese new year, has definitely not helped assuage fears. Still no sign of sustained person-to-person transmission

Economic Times – “The 75-year-old man had previously travelled to the neighbouring Chinese city of Shenzhen and died Wednesday morning, a Department of Health spokesman confirmed to AFP without elaborating. Fears over avian flu have grown following the deaths of two men from the H7N9 strain of the virus in Hong Kong since December. A 65-year-old man with H7N9 died on January 14 and an 80-year old man died on Boxing Day last year. Both had recently returned from mainland China.”

(image courtesy of Matt Wade/Wikicommons)

The Pandora Report 1.23.14

by Siddha Hover, posted in News, Pandora Report

Highlights include dengue in Texas, H7N9 spiking ahead of the Chinese New Year, renaming the 1918 influenza, and a man selling abrin on the black market. Happy Friday (stay warm)!

Rare Disease Linked to Dengue Virus Caused Texas Woman’s Death
A Texan woman thought to have been infected and died with West Nile Virus has been discovered to have actually succumbed to   dengue. The woman’s case was recently published by the CDC, which warned of the need for effective surveillance. Dengue thankfully remains relatively rare in the US – the woman represented just the third case in nearly a decade.

LiveScience – “The woman died after her dengue infection brought on another condition called hemophagocytic lymphohistiocytosis (HLH), in which white blood cells build up in the skin, spleen and liver, and destroy other blood cells. HLH is most frequently associated with Epstein Barr virus infection, but also has been linked to dengue, according to the researchers, from the Centers for Disease Control and Prevention.”

H7N9: Bird flu cases surge ahead of Chinese New Year
As the Chinese New Year approaches, the number of H7N9 cases has steadily increased, with  73 cases in the last three weeks alone. This is making people very nervous  – Chinese New Year often means millions of people travelling in very close quarters, over long periods of times. However, health officials are careful to point out that influenza case numbers, across strains, increase in the colder months. As long as the virus remains poorly transmitted person-to-person, things are fine.

BBC – “Proffesor John McCauley, the director of a WHO collaborating centre on influenza in London, said: ‘I’ve been worried all the time about H7N9; it’s highly virulent and the case fatality is about one in three, so it poses a threat.’ The range of the virus had also spread, he added, with cases in Guangdong province, further south and east than previously. He said the winter might not be the whole explanation, particularly in southern provinces closer to the equator. ‘It may be seasonal, or an alternative is more poultry exposure in the build-up to Chinese New Year, and more poultry going through the markets. They might need to reconsider closure of the markets’.”

1918 Flu Pandemic That Killed 50 Million Originated in China, Historians Say
The 1918 Spanish influenza, like so many strains of the virus, has apparently suffered for decades under an egregious misnomer. According to a new hypothesis, proposed by historian Mark Humphries, the grandfather of modern H1N1 strains may have originated in China. Humphries published his research in the journal War in History, in it arguing that the importation of almost 100,000 Chinese laborers to support the British and French lines may have introduced the virus to Europe. For those of you wondering, the pandemic strain was dubbed the Spanish flu apparently because Spain was one of the only countries to report on its heavy case numbers during the otherwise heavily censored WWI.

National Geographic – “In the new report, Humphries finds archival evidence that a respiratory illness that struck northern China in November 1917 was identified a year later by Chinese health officials as identical to the Spanish flu. He also found medical records indicating that more than 3,000 of the 25,000 Chinese Labor Corps workers who were transported across Canada en route to Europe starting in 1917 ended up in medical quarantine, many with flu-like symptoms…Writing in the January issue of the journal War in History, Humphries acknowledges that his hypothesis awaits confirmation by viral samples from flu victims. Such evidence would tie the disease’s origin to one location.”

Feds: Fla. man sold deadly toxin to NJ agent
A 19 year old in Florida has been apprehended after selling to toxin abrin to an undercover FBI agent. The deal was agreed upon online, with the FBI agent posing as a buyer on an intermediary cyber black market. The suspect was arrested after directing the FBI agent to two candles filled with the toxin, left in a fast food bag at a rest stop in Florida. A McDonalds bag, for those of you wondering about the culinary preferences of illicit toxin sellers. On a less flippant note, abrin is tremendously potent – while it presents similarly to ricin, it is 75 times more toxic.

The Grand Island Independent – “Prosecutors said Korff negotiated over the Internet with the undercover agent in New Jersey.’He allegedly peddled the poison on a virtual black market of illegal and dangerous good, hidden in the shadow of a secretive computer network favored by cybercriminals,’ said New Jersey U.S. Attorney Paul J. Fishman. Korff received $1,500 over the Internet from the agent and left the toxin hidden in two candles at a rest stop near Fort Myers, Fla., authorities said. Korff was arrested after the candles were found to contain abrin.”

(image:Calvin Teo)

The Pandora Report 1.17.14

by Siddha Hover, posted in Pandora Report

Just a quick note that the Biodefense Policy Seminars are back on! Our February speaker is Charles Duelfer, former Special Advisor to the Director of Central Intelligence for Iraq WMD and former Deputy Executive Chairman of the UN Special Commission on Iraq (UNSCOM). Free and open to the public – click here for more information!

Highlights include Salmonella,  H5N1 in Canada, H7N9 picking up in China, and Chikungunya in St. Martin. Happy Friday!

Why Salmonella bacteria is a near perfect killer
Much like an action film protagonist, Salmonella biofilms are notoriously difficult to kill. According to new research from the Journal of Applied and Environmental Microbiology, once Salmonella bacteria are able to form biofilms on a given surface, three different common disinfectants all are rendered ineffective. Salmonella’s ongoing hardiness explains in part the difficulty in effectively containing outbreaks.

ANI – “Mary Corcoran, a researcher on the study, said that they found that it was not possible to kill the Salmonella cells using any of the three disinfectants if the biofilm was allowed to grow for seven days before the disinfectant was applied, asserting that even soaking the biofilms in disinfectant for an hour and a half failed to kill them.”

H5N1 strain from Alberta nurse resembles Chinese strain
The strain of H5N1 which killed a nurse in Canada closely resembles a Chinese strain of the virus. The nurse, in her early 20s, had recently returned from a three-week visit to Beijing. However, as she had no reported contact with poultry, and Beijing has not reported any recent outbreaks of H5N1, the source of infection and method of transmission remain unclear.

CBC – “Virologist Kevin Fonseca of Alberta Health Services and his colleagues said the patient experienced symptoms of malaise, chest pain, and fever during the return flight on Dec. 27 and went to the local emergency department on Dec. 28…After a chest X-ray and CT scan suggested a diagnosis of pneumonia, the woman was prescribed an antibiotic and discharged home. The patient came back to the same emergency department on Jan. 1 with worsening inflammation of the membrane surrounding the lung, chest pain, shortness of breath, a mild headache that felt worse when she moved her head, nausea, vomiting and other symptoms, Fonseca’s team said in their posting on ProMed, an internet-based disease alert system. On Jan. 2, the patient reported visual changes and a continuing headache. As oxygen needs increased, doctors admitted her to the ICU for intubation and ventilation. In the early morning of Jan. 3, she had sudden tachycardia or fast heart rate and severe hypertension, followed by hypotension. Doctors took steps to keep her heart beating. At this point, the patient’s pupils were dilated and there was no response to pain. Further tests and a neurologic exam indicated brain death.”

New cases put H7N9 pace near last year’s peak
The number of H7N9 cases in China are picking up again, with nearly 35 cases reported in the last week. This is just three under peak numbers during the height of the infection at the virus’ initial emergence. Health officials monitoring the situation remain split on the implications of the increased numbers – however, the prevailing opinion seems to be that as long as the virus remains poorly transmitted between people, we don’t panic.

CIDRAP – “The steady stream of new cases could mean that Chinese health officials are better at detecting cases, but he added that it doesn’t look like they missed many cases last year in the early months of the outbreak. ‘There must be a similar widespread circulation in poultry,’ said Osterholm, who is the director of the Center for Infectious Disease Research and Policy, publisher of CIDRAP News, Recent H7N9 developments raise questions about what’s being done to minimize the risks to humans and should be setting off bells, whistles, and sirens warning about the threat, he said. ‘Each one [case] is another throw at the genetic roulette table’.”

Chikungunya virus spreads in Caribbean just weeks after breaking out in tiny St. Martin
In the two weeks since Chikungunya made it to the Caribbean, it has quickly spread to over 200 people. The virus can cause febrility, joint pain, and intense myalgia. Trouble in paradise (it had to be said)?

FOX – “The virus then spread to neighboring Dutch St. Maarten, and the U.S. Centers for Disease Control says new cases have also been confirmed in the French Caribbean islands of Martinique, Guadeloupe and St. Barthelemy. The British Virgin Islands reported three cases Monday. CDC epidemiologist Erin Staples said Tuesday that ‘further spread to other Caribbean islands and to the surrounding mainland areas is possible in the coming months and years’.”

The Pandora Report 1.10.14

by Siddha Hover, posted in News, Pandora Report

Highlights include PEDv thriving in the polar vortex, H5N1 in Canada, archaeological epidemiology,  H7N9 in China, and MERS in Oman. Happy Friday!

Cold, wet weather may help spread deadly pig virus: USDA
Porcine Epidemic Diarrhea virus (PEDv) has officially spread to 22 states, helped in part by the colder weather, and affecting over 2,000 hogs. The virus, which causes diarrhea, vomiting, dehydration, and death in piglets, reaches as far west as California. The cooler weather enables the hardy virus freezes on clothes and on the bottom of shoes, enabling spread.

Baltimore Sun – “‘The virus likes cold, wet and cloudy days,’ said Rodney Baker, a swine veterinarian at Iowa State University at Ames, Iowa, the top pork producing state in the United States.Earlier this week several hog producing states experienced double digit sub zero temperatures, and forecasters now are calling for warmer temperatures as highs climb toward 30 degrees Fahrenheit by the weekend. Baker told Reuters the virus can remain viable after a single, maybe even a couple of freeze-thaw cycles. Cold weather and cloudy conditions protect the virus, but heat and sunlight will deactivate it, Baker said. The spread of the disease has heightened scrutiny of the U.S. trucking industry as livestock transport trailers are seen as a means of transmission.”

H5N1 bird flu death confirmed in Alberta, 1st in North America
The first H5N1 fatality in North America occurred in Canada last week. A Canadian woman returning from China became symptomatic on December 27th, was hospitalized January 1st, and died January 3rd. The woman had not visited any live farms, not had she come in contact with poultry – the method of transmission remains unclear. Remember, while H5N1 has a fatality rate of 60%,  there is currently no indication the virus is readily transmissible person-to-person. It’s just not well adapted to our immune system – for now at least, it prefers the birds.

CBC – “Dr. Gregory Taylor, deputy chief public health officer, said the avian form of influenza has been found in birds, mainly poultry, in Asia, Europe, Africa and the Middle East….The officials added that the woman was otherwise healthy and it’s not yet clear how the person contracted H5N1. Speaking to Evan Solomon, host of CBC News Network’s Power & Politics, Taylor said the patient was relatively young. ‘This was a relatively young — well, a young person compared to me, with no underlying health conditions,’ he said. Taylor is 58 [reports have listed the girl as 20 years old]. Officials emphasized that this is not a disease transmitted between humans.”

Scientists unlock evolution of cholera, identify strain responsible for early pandemics
The next time you’re in Philadelphia, instead of visiting the well-trod landmarks, consider visiting the Mütter museum, home to the 200-year old intestinal samples. Those samples, taken during a cholera epidemic at the turn of the 18th century, has helped scientists characterize the classical biotype of cholera, thought to be responsible for seven outbreaks during the 19th century. Scientists had thus far been unable to study the classical biotype, due to its preference for the intestines – unlike bones which can linger for millennia, the transience of intestines makes collecting DNA samples over time challenging.

Medical Express – “Researchers carefully sampled a preserved intestine from a male victim of the 1849 pandemic and extracted information from tiny DNA fragments to reconstruct the Vibrio cholera genome. The results, currently published in The New England Journal of Medicine, could lead to a better understanding of cholera and its modern-day strain known as El Tor, which replaced the classical strain in the 1960s for unknown reasons and is responsible for recent epidemics, including the devastating post-earthquake outbreak in Haiti. ‘Understanding the evolution of an infectious disease has tremendous potential for understanding its epidemiology, how it changes over time, and what events play a role in its jump into humans,’ explains Poinar, associate professor and director of the McMaster Ancient DNA Centre and an investigator with the Michael G. DeGroote Institute of Infectious Disease Research, also at McMaster University.”

WHO: China Reports Eight New Cases of H7N9
China reported eight new cases of H7N9 in the last five days, including three cases in which exposure to live poultry could not be confirmed. Again, a slight increase in case numbers was expected with the cooler weather, and as of yet, there remains no confirmed, ongoing transmission person-to-person.  For a full breakdown of the seven cases (the eighth case was announced by health authorities in Hong Kong), see the GAR above.

WHO – “The National Health and Family Planning Commission of China has notified WHO of seven additional laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus. On 4 January 2014, WHO was notified of an 86-year-old man from Shanghai City became ill on 26 December and was admitted to hospital on 30 December. He is currently in critical condition. He has a history of exposure to live poultry. On 5 January 2014, WHO was notified of 34 year old woman from Shaoxing City, Zhejiang Province became ill on 29 December and was admitted to hospital on 2 January. She is currently in critical condition.”

New Case of MERS in Oman
A 59-year-old man has died of MERS in Oman, bringing the total number of cases globally up to 178. The patient became symptomatic on December 24th, was hospitalized on December 28th, and died on December 30th. The patient had extensive exposure to camels, including participation in camel racing events.  It looks more and more like camels, everyone.

WHO – “Globally, from September 2012 to date, WHO has been informed of a total of 178 laboratory-confirmed cases of infection with MERS-CoV, including 75 deaths. Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns.”

(Image depicting jar of intestine, credit: McMaster University)

The Pandora Report 1.3.13

by Siddha Hover, posted in Pandora Report

The first Pandora Report of the new year, and it’s (unsurprisingly) flu heavy. Highlights include H1N1 attacking the young, new MERS-CoV cases, H7N9 in Taiwan, H5N1 in China, and the gain-of-function debate (so more H5N1). Happy Friday!

Notice to Clinicians: Early Reports of pH1N1-Associated Illnesses for the 2013-14 Influenza Season
The CDC has a health alert out, detailing the tendency of this season’s predominant flu strain (which, as we’ve said before, looks like its going to be H1N1) to disproportionately affect the young. This is possibly because the elder amongst us are more resilient, due to cross-reactive immunity – they’ve been around longer, which means there’s a greater chance they have been exposed to similar viruses. The upshot is if you’re young and healthy, get a flu shot.

CDC – “From November through December 2013, CDC has received a number of reports of severe respiratory illness among young and middle-aged adults, many of whom were infected with influenza A (H1N1) pdm09 (pH1N1) virus. Multiple pH1N1-associated hospitalizations, including many requiring intensive care unit (ICU) admission, and some fatalities have been reported. The pH1N1 virus that emerged in 2009 caused more illness in children and young adults, compared to older adults, although severe illness was seen in all age groups. While it is not possible to predict which influenza viruses will predominate during the entire 2013-14 influenza season, pH1N1 has been the predominant circulating virus so far. For the 2013-14 season, if pH1N1 virus continues to circulate widely, illness that disproportionately affects young and middle-aged adults may occur.”

Six new cases of MERS virus hit Saudi Arabia, UAE
The WHO has reported six new cases of MERS-CoV. Of the six, five are Saudi nationals, with one case in the United Arab Emirates. Three of the cases, including one involving a wife tending to an ill husband, are reportedly asymptomatic. Ages of the new patients range from 59 to 73 years old, with the latter succumbing to the virus. The new cases bring the global total to 176, with 74 deaths. There is still no substantive information on the virus’ source, transmission, or vector. Sadly, “it might be camels” remains our most conclusive evidence to date – which is not to impugn the work of the scientists involved, which has been fastidious, but rather to bemoan the complexity of the virus itself.

Reuters – “MERS emerged in the Middle East in 2012 and is from the same family as the SARS virus. It can cause coughing, fever and pneumonia. Although the worldwide number of MERS infections is fairly small, the more than 40 percent death rate among confirmed cases and the spread of the virus beyond the Middle East is keeping scientists and public health officials on alert. Cases have been reported in Saudi Arabia, Qatar, Kuwait, Jordan, United Arab Emirates, Oman and Tunisia as well as in several countries in Europe, and scientists are increasingly focused on a link between the human infections and camels as a possible ‘animal reservoir’ of the virus.”

Hundreds monitored in Taiwan after H7N9 strain of bird flu after infected tourist discovered
A tourist infected with H7N9 spent over a week travelling through Taiwan from mainland China before being hospitalized. Health authorities in Taiwan are scrambling to reach all people he potentially came in contact with during his tour. Three medical personal who had dealings with the infected patient have subsequently developed symptoms of upper respiratory infections themselves. However, it should be emphasized that there remains no conclusive evidence of sustained person-to-person transmission of the virus.

Channel Asia – ”  As many as 500 people may have had contact with him, all of whom are being asked to report to doctors should they develop possible symptoms, the statement added. The 149 people who may have had close contact include two family members accompanying him on the tour, the tour guide, bus driver, medical personnel and patients sharing the same hospital ward, it said.”

China confirms H5N1 bird flu outbreak in Guizhou
Following the death of approximately 8,500 birds on a farm in Southwest China,  health authorities have confirmed an outbreak of H5N1 amongst poultry in the area. The area has subsequently been sealed off, with a further 23,000 birds culled for safety. As of yet, no human cases have been reported in the area.

Xinhua – “The southwest China province of Guizhou has reported an outbreak of H5N1 in poultry, the Ministry of Agriculture (MOA) announced Thursday. Some chickens at a farm in a village of Libo County in the prefecture of Qiannan in Guizhou showed symptoms of suspected avian flu and 8,500 chickens died on Dec. 27, 2013. The National Avian Influenza Reference Laboratory confirmed the epidemic was H5N1 bird flu after testing samples collected at the farm, according to the MOA.”

European Researchers Urge H5N1 Caution
The debate over gain-of-function (GOF) research continues to rage in the scientific community – in the most recent move, fifty scientists have drafted an open letter to the head of the European Commission, urging him to hold a press conference to discuss the merits of GOF research. For those of you not interested in macropolitics within the scientific community, gain-of-function research involves experiments in which viruses are carefully but deliberately mutated to increase pathogenicity in some way – in this case, by increasing transmissiblility between mammals. The research which launched the current maelstrom was Ron Fouchier’s  mutation of H5N1 to make it more transmissible between ferrets (and therefore, also, humans). We’ll leave the polemic arguments to those who are better informed, but in the meantime, the  letter is available here.

Science – “Fouchier’s struggles, which included the Dutch government using export regulations to bar him from publishing his results, compelled the European Society for Virology (ESV) to write its own letter to the EC in October. That letter expressed concern that the Dutch government’s tactics were inappropriate and threatened to set a precedent that could stymie the dissemination of research findings elsewhere. On the scientific side of the debate, some have argued that gain-of-function research, especially those studies that engineer deadly strains of the bird flu virus, can potentially result in inadvertent escapes from the lab and widespread infection. Proponents of the work argue that studying how mutations confer the ability to infect new individuals via novel routes can yield key insights into how the pathogens spread.”

(image of H1N1 via CDC/ Doug Jordan, M.A.)

The Pandora Report 12.27.13

by Siddha Hover, posted in Pandora Report

Highlights include H1N1 in Texas, 59 people with TB, a H7N9 fatality, H5N2 in ostriches, and vaccines coming to a mountain train near you. Happy Friday, and as our last Pandora Report from 2013, Happy New Year!

H1N1 Causes Early Spikes in Flu Cases
The flu season is in full swing, a couple weeks earlier than expected, with five deaths in Texas already. Luckily, the vaccine for this year’s flu contains the H1N1 strain currently predominant. Everyone please get vaccinated!

KUT – “‘[H1N1] is actually in the vaccines this year. So we’re finding that people who have been vaccinated, even if they come down with the illness, have a less severe course of it,’ Hydari said. He added that vaccine shortages that complicated flu season in the past is not an issue this year. Hydari also said that flu vaccines take about two weeks to take affect, and because the flu season typically peaks in January it’s not too late to get a shot this year.”

Dozens Test Positive For Tuberculosis After Exposure at Hospital Neonatal Unit
Fifty-nine people have tested positive for TB following exposure at a hospital in Nevada. A mother and her newborn twins are thought to have brought the bacteria to the hospital over the summer. All three died in the hospital, and were not discovered to have TB until after an autopsy was performed on the mother. Following hospital staff falling ill, and 977 people potentially exposed and subsequently tested, just two had active infections – the 59  mentioned above are latent cases. TB is still very real, and very scary – as this case illustrates, as few as three people can potentially infect dozens.

ABC – “‘Unfortunately, this situation is a hospital epidemiologist’s worst nightmare as neonates are highly susceptible to contracting TB and their infections can progress quite rapidly,’ he said. A mother and her newborn twins died of tuberculosis at Summerlin Hospital over the summer, prompting an investigation by the Southern Nevada Health District. Hospital staff didn’t realize the infected woman had tuberculosis until after she and one of the twins died and they performed an autopsy, according to KTNV, ABC’s Las Vegas affiliate. The other twin was in the NICU being treated without being under quarantine. The second twin also tested positive for tuberculosis and died in August, health department spokeswoman Stephanie Bethel told ABCNews.com.”

 Hong Kong confirms first death from H7N9 bird flu
An eighty-year old male has died from H7N9 in Hong Kong. Still, no confirmed, sustained person-to-person transmission yet.

Reuters – “The man, the second person in Hong Kong to be diagnosed with the virus strain, lived in the southern Chinese city of Shenzhen and had eaten poultry there, media reported. The H7N9 strain was first reported in humans in February in mainland China, and has infected at least 139 people in China, Taiwan and Hong Kong, killing more than 40. Experts say there is no evidence of any easy or sustained human-to-human transmission of H7N9, and so far all people who came into contact with the man had tested negative for the strain, authorities said.”

Low Pathogenic Bird Flu in Western Cape Ostriches
Small outbreaks of H5N2 have been reported in South African ostriches. The low pathogenic influenza strain has been reported in seven farms and roughly 2,000 birds. Authorities remain uncertain as to the source of the outbreaks.

Poultry Site – “The World Organisation for Animal Health (OIE) received follow-up report no. 4 on 23 December. The report states that the affected population comprises commercial ostriches. A total of 10,171 birds were involved, out of which 2,230 tested positive for the virus. None died or been destroyed. According to the OIE’s Animal Health Information Department, H5 and H7 avian influenza in its low pathogenic form in poultry is a notifiable disease as per Chapter 10.4. on avian influenza of the Terrestrial Animal Health Code (2013).”

Keeping Vaccines Fresh
Apparently silicon packets can keep more than your new shoes fresh – scientists at the University of Portland have managed to preserve virus pathogenicity over time by coating the little zombies in a layer of silica. Some viruses subsequently cleansed of the silica coating retained infectivity. While this apparently means viruses may actually be able to survive inside volcanoes (we definitely feel there’s a movie in this somewhere), it also is good news for developing vaccines for use in places lacking widespread refrigeration.

New York Times – “Most vaccines are made of weakened virus or viral bits, and many need refrigeration. Keeping them cold is a major challenge when it comes to protecting children living in villages without electricity.’It’s hard to put a fridge on the back of a donkey,’ said Kenneth M. Stedman, a biologist at Portland State and the lead author of the study. By recreating the chemical-laden hot-spring environment, Dr. Stedman’s team coated four types of virus with silica, stored them, then washed off the silica and tried to infect cells. One heavily studied virus, phage T4, which infects the cells of E. coli bacteria, retained 90 percent of its infectivity for almost a month. The virus used in smallpox vaccines also did well, but it is naturally able to be stored dry.”

(Image: Afrikanischer/Strauss/Wikicommons)

The Pandora Report 12.20.13

by Siddha Hover, posted in News, Pandora Report

Highlights include more pneumonic plague in Madagascar, H1N1  in Texas, Chikungunya in the Caribbean, H7N9 in Hong Kong, and MERS in Saudi Arabia. Happy Friday, and a very happy holiday season to everyone.

Pneumonic Plague Cases Up in Madagascar
The latest numbers in the plague outbreak in Madagascar suggest as many as  17 of 43 cases may be pneumonic plague – the highly virulent, highly infectious, transmissible person-to-person form of the traditional bacteria. As we’ve mentioned before, the case fatality rate for pneumonic plague is 100% unless antibiotics are prescribed in the first 24 hours following infection. However, as the disease’s incubation period can be up to three days, and as it often presents initially with flu-like symptoms, timely detection can be very challenging. We’ll keep you posted.

Madagascar-Tribune (originally in French) – ” 43 suspected cases of pneumonic plague and bubonic plague were detected Mandritsara since 20 November until 5 December 2013. 17 suspected cases of pneumonic plague were detected Analanjirofo. 15 cases of bubonic plague have been recorded in the district of Ikongo. In the district of Tsiroanomandidy, 3 cases of bubonic plague have been suspected.”

Montgomery County, Texas: Mystery Illness Likely H1N1 Virus
A regional hospital in Texas has reported eight cases of an as yet diagnosed illness – of the eight, four patients have subsequently died. One of the remaining four patients has subsequently been diagnosed with H1N1. The CDC is working with local health authorities to determine the pathogen in play.

Houston Chronicle – “Recent mystery deaths in Montgomery County could be attributed to the H1N1 virus. Conroe Regional Hospital this month reported eight cases of a mystery illness to the county’s public health department. Two of the patients tested negative for all flu viruses. Nichols-Contella said the 2013 influenza vaccine protects against the H1N1 virus. None of the patients who died had received a flu shot, the release said.”

Chikungunya Outbreak Grows In Caribbean
Chikungunya has struck the sunny Caribbean, with two cases reported to the WHO last week. Since the initial outbreak, a further 10 cases have emerged. Chikungunya is an Alphavirus, and is spread through arthropods, primarily mosquitoes. The outbreak on St. Martin signifies the first time the virus has appeared in the Western hemisphere. There was no international travel in the case histories of the patients involved. Fortunately, very few people understand better than epidemiologists the tendency of infectious diseases to spread with vigor, so surveillance systems are already in place.

NPR – “Except for a small number of imported cases each year, chikungunya has stayed out of the Americas until now. But U.S. health officials have been on the lookout for its arrival. The chikunguyna virus was discovered in 1955 by two scientists in Tanzania. ‘Microbes know no boundaries, and the appearance of chikungunya virus in the Western Hemisphere represents another threat to health security,’ CDC director Dr. Tom Frieden wrote in statement Wednesday. ‘CDC experts have predicted and prepared for its arrival for several years, and there are surveillance systems in place to help us track it.’ With about 9 million Americans traveling to the Caribbean each year, the CDC anticipates chikungunya will be a more frequent visitor to the U.S. in the next few years. One of the mosquitoes that carries the virus — the Asian tiger mosquito — is already a familiar pest in many parts of the U.S. during the summer.”

Two more H7N9 bird flu cases linked to Shenzhen’s Longgang district
Two individuals who lived or worked near the wet markets which tested positive for H7N9 last week have subsequently contracted the virus themselves. The two have been hospitalized and are in critical condition.  Again, the reemergence of the virus is consistent with expected seasonal patterns.

South China Morning Post – “Three patients who have contracted the H7N9 strain of bird flu had visited the Longgang district of Shenzhen, including the latest case announced yesterday, mainland health authorities said. A 38-year-old Shenzhen man was in critical condition after being diagnosed with the deadly strain of the flu, Shenzhen’s centre for disease control and prevention said. The patient is a migrant worker who lives and works in Nanwan Street, in Longgang district, near one of the infected markets where authorities found the H7N9 virus on December 11. A second patient, a 39-year-old man from Dongguan, commuted to the district. The pair follow Tri Mawarti, a domestic helper who was the first person in Hong Kong diagnosed with the virus. She is believed to have handled a live chicken at a flat in Nanwan Street before falling ill.”

WHO: Middle East respiratory syndrome coronavirus (MERS-CoV) – update
A further two cases of MERS-CoV have been confirmed in Saudi Arabia. The two patients are both female, aged 51 and 26 respectively. The former has no know exposure to the virus, whereas the latter had previously been exposed to an infected patient. Globally, there have been 165 cases to date, with 71 deaths.

WHO – “The first case is a 51 year-old female from Saudi Arabia, living in Jawf province with onset of symptoms on 20 November 2013. She has underlying chronic disease and was transferred to Riyadh for treatment in an intensive care unit. She had no reported contact with animals. The epidemiological investigation is ongoing. The second case is a 26 year-old female who is a non-Saudi healthcare worker in Riyadh. She is asymptomatic. She had reported contact with a 37 year-old male laboratory confirmed case that was reported to WHO on 21 November 2013.”

(image: Clavius66/Wikimedia)