Published Date: 2003-03-14 23:50:00
Subject: PRO/AH/EDR> Avian influenza, human - Netherlands (03)
Archive Number: 20030314.0628
AVIAN INFLUENZA, HUMAN - NETHERLANDS (03)
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[1]
Date: Fri 12 Mar 2003
From: ProMED-dmail <promed@promedmail.org>
Source: Newsletter Influenza-Surveillance, National Influenza Centrum
(NIC), 12 Mar 2003 [Dutch trans. & edited by Mod.
AS]<http://www.virology.nl/files/NLNB02-03_03.pdf>
Virology Update: HPAI Epidemic in the Netherlands
-------------------------------------------------
The Highly Pathogenic Avian Influenza (HPAI) epidemic is the first one
since 1926. Following investigations, carried out by the Erasmus Medical
Center Rotterdam and the ID-DLO, Lelystad, the virus was found to be an
entirely-avian H7N7. The H7 hemagglutinin is closely related to a H7N3
influenza virus which had been isolated earlier by the Rotterdam lab from a
migrating wild duck, while the N7 neuraminidase is related to a H11N7
influenza virus from another waterfowl, a Shoveler (_Anas
clypeata_). Ducks might be, via free-roaming and back-yard chickens, the
source of the current infection.
Infection of humans with H7N7 is not excluded; it happened twice in the
past. There is a risk that if avian and a human flu viruses infect the same
person simultaneously, a recombinant, which might be pandemic, may emerge.
This risk is very low. As far as known, human pandemics have never emerged
from avian influenza epizootics. In spite of the published precautionary
directives to people engaged in the HPAI control activities, an H7N7
infection has been recorded in a veterinarian who was engaged, until 4 Mar
2003, in investigating the outbreaks in the Gelders Valley. One and a half
days later he showed symptoms of bilateral conjunctivitis (no respiratory
symptoms), which disappeared spontaneously after several days. In the past,
a total of 2 independent human infections with H7 virus had been recorded,
both manifesting conjunctivitis. However, it should be said that there are
no reports, from any country, of human flu or conjunctivitis during past
outbreaks of fowl plague (HPAI).
******
[2]
Date: Fri 14 Mar 2003
From: ProMED-mail <promed@promedmail.org>
Source: Eurosurveillance Weekly, Vol 7, Issue 11, updated Fri 14 Mar 2003
[edited]
<http://www.eurosurveillance.org/ew/2003/030313.asp>
Now at Least 5 Cases of Human Infection with Avian H7N7 Virus
-------------------------------------------------
At least 5 workers have been infected now with highly pathogenic avian
influenza (HPAI) during outbreak of avian influenza in poultry farms in The
Netherlands. Earlier this month, an outbreak of highly pathogenic avian
influenza (HPAI) in several Dutch poultry farms was reported. Extensive
control measures to prevent spread to unaffected poultry farms have been
implemented (1).
A worker who visited several affected farms subsequently developed acute
conjunctivitis (1). He did not show any other signs of disease. A clinical
sample was investigated by reverse transcription polymerase chain reaction
(RT-PCR), and was shown to be positive for influenza A H7/N7 virus.
Sequencing of PCR products revealed sequences identical to those detected
in HPAI-infected chickens for all 3 PCR fragments investigated (2). In
reaction to these findings, all workers with symptoms of either
conjunctivitis or influenza-like symptoms were invited to provide samples
for microbiological evaluation. Samples were taken from the nose and
conjunctiva. The first results show another 4 individuals positive for A
H7N7. Samples from approximately 30 other workers are currently being
collected and investigated. Additional information is expected over the
weekend.
Coincidentally, this week, data from routine human influenza virus
surveillance in the Netherlands indicate that the peak season for influenza
virus infection has begun (based on currently available preliminary data,
mostly influenza A/H3N2)(3). Co-infection with both human and avian
influenza viruses leads to the very small possibility of a reassortment of
both viruses, from which a variant might emerge that could be dangerous to
human health.
To prevent human HPAI infection, those working with infected poultry in the
Netherlands have been advised to wear masks covering the nose and mouth,
and glasses during clearing of affected farms. In addition, all workers are
to be vaccinated with the human influenza vaccine and workers with
influenza-like symptoms are being exempted from work.(3)
Enhanced surveillance for human HPAI infection has been organised through a
collaboration involving local Municipal Health Services (GGDs), GPs, the
RIVM (National Institute of Public Health and the Environment), and the
National Influenza Centre. In addition, the state secretary for Public
Health, Mrs. Ross, decided yesterday that all individuals who have been
involved in the culling of poultry from infected farms will undergo testing
for both human and avian influenza
References:
(1)Ministry of Health, Welfare and Sport, The Netherlands. Ruimer pluimvee
besmet met vogelpestvirus (press release) 11 Mar 2003.
(<http://www.minvws.nl/document.html?folder=393&page=19347>).
(2) Fouchier R, Koopmans M, Meijer A, Wilbrink B, van Wijngaarden J,
Osterhaus A. Avian Influenza, human - Netherlands. H7N7 Conjunctivitis;
human. ProMED-mail posting, 11 Mar 2003. [see: "Avian influenza, human -
Netherlands 20030311.0594"]
(3) Van Steenbergen J. Avian Influenza, human - Netherlands. Protective
measures and surveillance of symptoms in humans (persons possibly exposed)
ProMED mail posting, 11 Mar 2003.
--
ProMED-mail
<promed@promedmail.org>
See Also
Avian influenza, human - Netherlands 20030311.0594Avian influenza, human - Netherlands (02) 20030313.0615
Avian influenza - Netherlands (02): suspected 20030301.0509
Avian influenza - Netherlands (03) 20030302.0528
Avian influenza - Netherlands (04) 20030304.0540
Avian influenza - Netherlands (05): OIE 20030304.0545
Avian influenza - Netherlands (06) 20030304.0546
Avian influenza - Netherlands (07) 20030305.0549
Avian influenza - Netherlands (08) 20030306.0552
Avian influenza - Netherlands (09) 20030307.0563
Avian influenza - Netherlands (10) 20030310.0583
Avian influenza - Netherlands (11) 20030311.0593
Avian influenza - Netherlands: suspected 20030301.0503
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