Pandemic Update: 17th February 2009
Global Highlights since February 3, 2009
仅仅不吃鸡鸭鸟类,不知行不行?
T
wo new human cases were reported in both 
Egypt and Vietnam. Poultry outbreaks continue in both nations.
Indonesia detected an additional suspected human infection, and reported new cases among birds.
China found the virus among poultry for the first time since December. Despite the discovery, the nation remains unable to link its recent rash of human infections to outbreaks among birds.
Hong Kong has detected H5N1 in at least 12 wild birds found dead in various areas over the past several weeks. Bangladesh continues to find the virus among its poultry flocks.
Outbreaks of low pathogenic influenza struck birds in both Canada and France. The flu strains involved are different than H5N1, and are not considered a serious threat to human health.
Please log into the International SOS Pandemic Preparedness Website first in order to view links to specific pages.
See the International SOS Travel Advisory (in 'Risk and Travel Advisory', requires members' login number), especially if you are traveling to affected countries.
For further details, see the latest news below, or on the International SOS Pandemic Preparedness website. A catalogue of editorials from each weekly "Pandemic Update" can also be found in the "Pandemic Information Service" section of the website.
Editorial: Face masks - can they prevent illness? How long can they last?
Although the effectiveness of face masks and respirators in reducing the transmission of influenza in the general community is not known1, masks may afford some protection.
A report published this month in Emerging Infectious Diseases suggests that, "Although [..] community use of face masks is unlikely to be an effective control policy for seasonal respiratory diseases, adherent mask users had a significant reduction in the risk for clinical infection."
The study compared two types of masks to see how effective each one was for preventing an influenza-like infection in a household setting. People on the study either used surgical masks, non-fit-tested P2 (N95) masks or no mask. The N95 masks, which are ideally fit-tested before use, were not fit-tested in this study since the researchers wanted to simulate a scenario in the general community. In such a scenario, fit testing may not be feasible.
Adults who wore masks were up to four times less likely to become infected than someone who wore no mask. No difference could be found between the preventative effects of P2 (N95) masks versus surgical masks, as the data was insufficient.
An important issue raised was compliance with wearing a mask. More than half of the participants did not wear masks when they should have. In the event of a pandemic, low compliance may present a challenge for public health workers and pandemic planners.
Another study published this month by the American Journal of Infection Control evaluated performance of N95 masks after prolonged storage. Twenty-one models of National Institute for Occupational Safety and Health (NIOSH)-certified N95 masks were selected for the study. Each was stored under various conditions in the original packaging for up to six years in research laboratories, and up to 10 years in warehouse facilities.
The results varied, and the degree of filtration loss was model specific. The authors conclude that, "[..] most N95 filtering face piece respirators stored for up to 10 years at warehouse conditions will likely have expected levels of filtration performance and that the degree of filtration efficiency degradation is likely model specific."
These studies further support current guidance, which advises, "Employers should consider stockpiling facemasks and respirators".2
1US Department of Health and Human Services Guidance "Summary of Interim Public Health Guidance for the Use of Facemasks and Respirators in Non-Occupational Community Settings during an Influenza Pandemic" http://www.pandemicflu.gov/vaccine/maskguidance.html accessed 16 February 2009
2 US Department of Labor, Occupational Safety and Health Administration "Proposed Guidance on Workplace Stockpiling of Respirators and Facemasks for Pandemic Influenza"
http://www.osha.gov/dsg/guidance/stockpiling-facemasks-respirators.html accessed 16 February 2009
Latest News
Africa | Asia | Europe | North America
Not all affected countries are listed here, only those with significant recent developments. For more detailed information please see the individual Country pages of the International SOS Pandemic Preparedness website.
Africa
Egypt: Two additional human cases have occurred in Egypt, bringing the 2009 case count there up to four. All have been children under two years old, none of whom have died of their infections. The most recent cases were a 2-year-old boy from Suez governorate and an 18-month-old boy from the central governorate of Minia. Both had contact with sick or dead birds before falling ill in early February. H5N1 influenza is consistently present among Egyptian poultry.
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Asia
Bangladesh: More than 660 birds died from H5N1 at a poultry farm in Narayanganj, Dakah. They were from a flock of 1500, all of which were destroyed.
China: No new human cases have been reported since the last PIS email update. However, authorities have detected H5N1 virus among birds in one area. Dead birds collected in the northwestern Xinjiang Uygur Autonomous Region tested positive for H5N1 avian flu. Around 500 birds died in Hetian (also called Hotan), in the south of the region. A human fatality occurred in Xinjiang Uygur in January. However, the 31-year-old woman died in the regional capital, Urumqi - which is far from poultry outbreak.
This is the first time China has found infected birds since December. So far this year, eight people have contracted avian flu in China. Authorities have not detected poultry outbreaks near most of these cases.
Hong Kong: At least 12 wild birds found dead in various areas of Hong Kong have tested positive for H5N1 avian flu. The animals were collected in late January and February 2009. Almost all were found on the west coast of Lantau, and authorities speculate they may have washed ashore from mainland China. One of the infected birds was a grey heron found in the Mai Po Nature Reserve. Authorities closed the park for three weeks as a precaution. Preliminary tests on a bird found dead on the north-eastern island of Tung Ping Chau are positive for H5 flu.
Indonesia: Another suspected human case has been reported. A 20-year-old man from Jagapati village, Badung on the Indonesian island of Bali is under medical care after showing symptoms of influenza. The man fell ill a few days after birds tested positive to H5N1 in the area.
Hundreds of chickens have died in four districts in Central Java, Indonesia. The four districts reporting the outbreaks include Bambanglipuro, Jetis, Piyungan and Bantul.
Vietnam: Poultry outbreaks have spread into seven provinces in the country so far this year. Two new human cases have been reported in the past two weeks.
A 23-year-old woman from the Dam Ha district, in the northern province of Quang Ninh, was hospitalized in late January. She had contact with sick and dead birds. Flu outbreaks had recently been reported among poultry in her province.
A man in his 30s was infected in the northern province of Ninh Binh, even though no poultry had been reported infected there. He fell ill on February 5, and was hospitalized. He is known to have slaughtered backyard ducks for consumption. No outbreaks of avian flu have been reported among poultry in this province.
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Europe
France: A duck farm in the Vendee region detected a low pathogenic H5N3 influenza among the birds. Around 50 birds of the flock of 5,000 died, and the rest were culled. The influenza strain found in France is not considered a significant threat to human health.
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North America
Canada: In late January, a single turkey farm in the Fraser Valley of British Columbia detected H5N2 influenza among its birds. The strain was a low pathogenic type, and did not kill most of the birds. The entire flock of around 60,000 birds was culled preventatively and a 3 km quarantine zone was established around the affected farm.
In mid-February, authorities found poultry on a second farm sick with an H5 type of influenza. The exact subtype has not yet been determined.
Neither outbreak involved highly pathogenic H5N1 virus, which has killed millions of birds and infected hundreds of people since 2003.