More EEE

EASTERN EQUINE ENCEPHALITIS - USA (18): (NEW JERSEY) EQUINE


***********************************************************

A ProMED-mail post



ProMED-mail is a program of the

International Society for Infectious Diseases





Date: Thu 27 Oct 2011

Source: Harnesslink.com [edited]







A 3-year-old horse from Gloucester County was euthanized on 20 Oct

2011 after contracting eastern equine encephalitis (EEE), a serious,

mosquito-borne illness in horses.



"With an increase in the state's mosquito population due to rain

storms in the last couple of months, horse owners must be vigilant in

protecting their animals from diseases spread by mosquitoes," said New

Jersey secretary of agriculture Douglas H Fisher. "Horse owners should

contact their veterinarians to have their animals vaccinated against

these illnesses."



This deadly disease is easily prevented by vaccination. Effective

equine vaccines for EEE and another mosquito-borne disease, West Nile

virus (WNV), are available commercially. Horse owners should contact

their veterinarians if their horses are not already up-to-date on

their vaccinations against both EEE and West Nile virus.



The Gloucester County stallion's vaccination status against EEE is

unknown with no report of vaccination in 2011.



EEE causes inflammation of the brain tissue and has a significantly

higher risk of death in horses than West Nile virus infection. West

Nile virus is a viral disease that affects horses' neurological

systems. The disease is transmitted by mosquito bite. The virus cycles

between birds and mosquitoes with horses and humans being incidental

hosts. EEE infections in horses are not a significant risk factor for

human infection because horses (like humans) are considered to be

"dead-end" hosts for the virus.



Earlier this month [October 2011], the 1st case of West Nile virus in

a horse was reported in Monmouth County. The 11-year-old mare was

treated for the disease.



The New Jersey Department of Environmental Protection reports that the

exceedingly high levels of precipitation experienced statewide due to

Hurricane Irene and subsequent rainstorms resulted in much higher than

normal mosquito populations. They said the immense amount of

floodwater throughout the state created habitat for those species of

mosquitoes which utilize semi-permanent, standing water for larval

development.



In 2010, New Jersey had 1 case of EEE and 2 cases of equine WNV. All 3

animals were euthanized. [It is also likely all 3 animals were

deficient in their vaccination status. - Mod.TG]



For more information about EEE and West Nile virus in horses, visit

the New Jersey Department of Agriculture website at

.



EEE and West Nile virus, like other viral diseases affecting horses'

neurological systems, must be reported to the state veterinarian at

609-292-3965 within 48 hours of diagnosis.



--

Communicated by:

ProMED-mail





[The east coast has had a lot of water which is perfect for the

breeding of mosquitoes. Mosquitoes are the carrier of this viral

disease. Vaccinations are cheap and easy compared to the agony of

enduring the loss of your pet. Especially with such things as

Hurricane Irene this year (2011) it is difficult to imagine why owners

have not already vaccinated.



Clearly it is still warm and the mosquito threat is still prevalent.

Owners are encouraged to vaccinate their horses. - Mod.TG]



[New Jersey can be located on the HealthMap/ProMED-mail interactive

map at . Gloucester and Monmouth counties

can be seen on the map at

. -

Sr.Tech.Ed.MJ]



[see also:

Eastern equine encephalitis - USA (17): (WI) equine 20111009.3030

Eastern equine encephalitis - USA (16): (MA) human 20111008.3025

Eastern equine encephalitis - USA (15): (VT) emu 20110927.2923

Eastern equine encephalitis - USA (14): (WI) equine 20110925.2914

Eastern equine encephalitis - USA (13): (WI) equine 20110918.2838

Eastern equine encephalitis - USA (12): (MI) equine 20110915.2813

Eastern equine encephalitis - USA (11): (NY) equine 20110904.2703

Eastern equine encephalitis - USA (10): (MA) human 20110904.2701

Eastern equine encephalitis - USA (09): (NY) equine 20110830.2664

Eastern equine encephalitis - USA (08): (WI) equine 20110825.2586

Eastern equine encephalitis - USA (07): canine, human, equine

20110824.2583

Eastern equine encephalitis - USA (06): (NY) human, fatal

20110818.2504

Eastern equine encephalitis - USA (05): (NY) human, fatal

20110817.2489

Eastern equine encephalitis - USA (04): (NY) human 20110814.2462

Eastern equine encephalitis - USA (03): (WI) equine, alpaca

20110811.2434

Eastern equine encephalitis - USA (02): (WA) corr. 20110807.2395

Eastern equine encephalitis - USA (02): (NY) 20110807.2387

Eastern equine encephalitis - USA: (FL) 20110729.2272]

.................................................sb/tg/mj/dk

*##########################################################*

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using information posted or archived by ProMED-mail. ISID

and its associated service providers shall not be held

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or archived material.

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ANAPLASMOSIS-LIKE ILLNESS - SWEDEN: NEW TICK-BORNE PATHOGEN

***********************************************************

A ProMED-mail post



ProMED-mail is a program of the

International Society for Infectious Diseases





Date: Tue 25 Oct 11 2011

Source: The Local [edited]







Swedish researchers have discovered a new tick-borne illness that can

cause blood clots in the legs and lungs, with 3 cases having been

reported in Sweden.



A total of 8 cases of the disease have been reported so far, with

patients in Germany, Switzerland, and the Czech Republic also having

been infected. All of those affected by the disease suffer from a

weakened immune system, the Dagens Nyheter (DN) newspaper reported.



The illness, which researchers call "neo disease" after the bacterium

that causes it, _Candidatus Neoehrlichia mikurensis_, also brings

about flu-like symptoms with long-lasting high fevers, coughing, and

aches. The disease can be treated with antibiotics.



The 1st case was discovered in the summer of 2009 after a 77-year-old

man from Gothenburg came down with a high fever and lost

consciousness. During his treatment, doctors discovered blood clots in

his leg and lungs. The man's fever returned several times and doctors

eventually found traces of an unknown bacterium in his blood. The

disease, which is transmitted by ticks, had never before been reported

in Sweden and it was unclear what caused the disease in humans. The 2

additional Swedes who have become ill due to the bacteria are in their

60s and 70s.



It remains unclear why the disease causes blood clots, but researchers

have a number of theories in mind. "When the body can't deal with an

infection in the blood, it traps the infection in a blood clot,"

Christine Wenneras, a professor at Sahlgrenska University Hospital in

Gothenburg, told the newspaper.



According to researchers, 10 percent of ticks in southern Sweden carry

the bacteria.



--

Communicated by:

ProMED-mail





[A HealthMap/ProMED-mail interactive map of Sweden can be seen at

. - Sr.Tech.Ed.MJ]



[Anaplasmataceae is a family of Gram negative, obligate intracellular

alphaproteobacteria that consists of 6 genetically distinct genera: 1)

_Ehrlichia_, _Anaplasma_, and _Neorickettsia_; 2) _Wolbachia_ and

_Aegyptianella_, which only infect nematodes, arthropods, or birds;

and 3) the newly proposed genus _Candidatus Neoehrlichia_

(). _Candidatus_ is the term

used for an interim taxonomic status of noncultivable prokaryotic

organisms. _Neoehrlichia_ refers to a new _Ehrlichia_; _mikurensis_

refers to Mikura Island in southern Japan, where the organism was

discovered ().



_Candidatus Neoehrlichia mikurensis _ recently was discovered in ticks

and wild rodents in East Asia (Japan, China, Russia) and Europe

(Sweden, Italy, Netherlands, Germany)

(). A closely related

but distinct species, _Candidatus N. lotoris_, was found in raccoons

in North America ().

Experimental infection with _Candidatus Neoehrlichia mikurensis_ in

rats did not elicit antibodies against _Anaplasma phagocytophilum_ and

_Ehrlichia muris_ antigens

(), which further

support the position that _Candidatus Neoehrlichia_ is a separate

genus.



_Candidatus N. mikurensis_ has been identified by PCR amplification of

its 16S rRNA gene in at least 4 humans in Europe with febrile

illnesses that was associated with thrombotic or hemorrhagic events.

Several of the infected patients have been immunocompromised

(,

, and

). - Mod.ML]



[see also:

2010

----

Anaplasmosis, human granulocytic - China (03): susp. 20101002.3573

Anaplasmosis, bovine - USA: (KS, NE, IA) 20100918.3376

Anaplasmosis, human granulocytic - China (02): background

20100912.3292

Anaplasmosis, human granulocytic - China: (HE) susp, RFI

20100910.3274

Anaplasmosis, ehrlichiosis - USA: (WI, MN) Alert 20100515.1593

2009

----

Anaplasmosis - USA: (WI, MN) 20090909.3186

2008

----

Anaplasmosis, nosocomial transmission - China: (AH) 20081120.3661

Anaplasmosis, human granulocytic - USA: (MN), ex transfusion 2007

20081024.3362

Anaplasmosis, human granulocytic - Canada: 1st rep., (AB)

20080731.2352

2007

----

Ehrlichiosis, fatal - USA (MO) 20070607.1849

2003

----

Ehrlichiosis, human granulocytic - USA (MA) 20030903.2211

Ehrlichiosis, human monocytic - USA (NC) 20030625.1571

1999

----

Ehrlichiosis, human - Mexico 19990713.1173

1998

----

Ehrlichiosis, human granulocytic - USA (Connecticut) 19980713.1318

Ehrlichiosis, human granulocytic - Sweden 19980418.0719

1995

----

Human granulocytic ehrlichiosis (5) 19950802.0625

Human granulocytic ehrlichiosis - Europe? 19950723.0581]

.................................................sb/ml/mj/dk

*##########################################################*

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ProMED-mail makes every effort to verify the reports that

are posted, but the accuracy and completeness of the

information, and of any statements or opinions based

thereon, are not guaranteed. The reader assumes all risks in

using information posted or archived by ProMED-mail. ISID

and its associated service providers shall not be held

responsible for errors or omissions or held liable for any

damages incurred as a result of use or reliance upon posted

or archived material.

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************************************************************

ANNOUNCEMENTS (13): INFECTIOUS DISEASES OF CONCERN TO CAPTIVE AND

**********************************************************************************************************************

A ProMED-mail post



ProMED-mail is a program of the

International Society for Infectious Diseases





Date: 21 Oct 2011

From: Kathry Gamble





We are pleased to announce the 1st edition of "Infectious diseases of

concern to captive and free-ranging animals in North America," as

coordinated by the American Association of Zoo Veterinarians (AAZV):



Napier JE, Gamble KC (editors). Infectious diseases of concern to

captive and free-ranging animals in North America, 1st edition. Yulee,

Florida: Infectious Disease Committee, American Association of Zoo

Veterinarians, 2011. 374 pp.



With our sister organizations, AAZV's Infectious Disease Committee

coordinated active participation with many other organizations to

complete concise fact sheets on a total of 160 diseases and the

reportable diseases for the 50 United States, Canada, and Mexico.

Membership of the following organizations was represented by 107

authors and 196 reviewers:



American Association of Zoo Veterinarians (AAZV)

American Association of Wildlife Veterinarians (AAWV)

Association of Avian Veterinarians (AAV)

Association of Reptile and Amphibian Veterinarians (ARAV)

Canadian Association of Zoo and Wildlife Veterinarians (CAZWV)

Centers for Disease Control (CDC)

International Association of Aquatic Animal Medicine (IAAAM)

Mexican Association of Conservation Medicine (MACM)

National Animal Disease Center (NADC)

National Veterinary Services Laboratory (NVSL)

United States Department of Agriculture - Animal, Plant and Health

Inspection Services (USDA-APHIS)

United States Department of Agriculture - Animal Research Services

(USDA-ARS)

United States Geological Service (USGS)

Wildlife Disease Association (WDA)



...and additional contributions were provided by 31 colleges and

universities as well as private practitioners and institutions.



This project was designed as a starting reference point for

information needed on infectious diseases which affect zoo and wild

animal species housed or free-ranging in North America. It is

complementary to a similar volume (in its 4th edition) developed for

infectious diseases which affected zoo and wild animal species housed

or free-ranging in Europe. Although these documents were

peer-reviewed, often by a topic expert, they are not intended to be

used as an exclusive information source, but rather this manual should

be used like any other textbook.



It is available as free access on the homepage of AAZV

http://www.aazv.org/.



--

Kathry Gamble

BLUETONGUE - EUROPE (02): SPAIN (EXTREMADURA) BOVINE, BTV-1

Bluetongue As a Bioweapon


Bluetongue is considered as a potential bioweapon because of the following factors:



There is a risk of bluetongue to any country with competent vectors.

Historically, BTV has produced devastating ovine epizootics and been difficult to eliminate and control in bovine populations.


Viremic animals cannot be distinguished from nontransmitting animals.


Widespread infection would result in significant economic costs from lost trade of germ plasm and animal products and regulatory costs would increase.


Source: USAHA 


***********************************************************

A ProMED-mail post



ProMED-mail is a program of the

International Society for Infectious Diseases





Date: Sun 16 Oct 2011

Source: Ministry of Environment and Rural and Marine Affairs, Spain,

Veterinary Health Alert Network news release [in Spanish, trans.

submitter SZ, edited]







1st bluetongue outbreak in 2011-2012 season reported in Caceres

province

---------------------------------------------------------------

The National Reference Laboratory in Algete has confirmed renewed

circulation of bluetongue virus [BTV] serotype 1 in an unvaccinated

sentinel cattle holding in Plasencia (Caceres), which is part of the

National BT Disease Surveillance Program.



The Official Veterinary Services of the Junta de Extremadura have

reported detection of 10 animals positive for BTV-1 (see map at

).



The confirmation of this case of bluetongue means a reappearance of

the disease in Spain since the end of the last disease (vector

activity) season.



During 2010, a total of 91 outbreaks were reported, of which 80 were

of BTV-1, 10 of BTV-4, and one focus of BTV-8.



The reappearance of the disease has led to the strengthening of BT

control measures. These measures involve, in the affected area,

increased surveillance and biosecurity measures, vector control, and

the recommendation for vaccination of susceptible species.



Official notification of the new outbreak has been sent to the

European Commission, OIE, and other autonomous communities and sectors

involved.



--

communicated by:

Sabine Zentis

Castleview Pedigree English Longhorns

Gut Laach

52385 Nideggen

Germany







[BTV-1 was detected in the same location/region during the same season

last year (2010); see slide 3 in Spain's presentation to EU's SCOFCAH

(Standing Committee on the Food Chain and Animal Health, UK), "Updates

2009-2010 and Disease Future: Perspective in Spain", available at

.

This may be indicative of the endemic status (or overwintering) of

this virus in Spain, though reintroduction from Northern Africa is not

excluded. BTV-1 and BTV-4 are currently circulating in Morocco (see

commentary in ProMED-mail 20111008.3023). - Mod.AS



A HealthMap/ProMED-mail interactive map of Spain can be seen at

. - Sr.Tech.Ed.MJ]



[see also:

Bluetongue, sheep - Algeria (02): (AN), spread 20111008.3023

2010

---

Bluetongue - Europe (06): Spain (AN) st 8, susp, RFI 20101126.4267

Bluetongue - Europe (04): Spain, serotypes 1, 4 20101016.3751

Bluetongue - Europe (03): Spain (AN), BTV-4, OIE 20101006.3627]

.................................................arn/mj/sh

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using information posted or archived by ProMED-mail. ISID

and its associated service providers shall not be held

responsible for errors or omissions or held liable for any

damages incurred as a result of use or reliance upon posted

or archived material.

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Brucellosis / USA / 7 / Wyoming

BRUCELLOSIS, BOVINE - USA (07): (WYOMING)

The BIG LIE here is that Brucellosis is a DOMESTIC CATTLE disease that spreads onto wildlife because they have no immunity to domestic animal disease. The Cattlemen like to blame the wildlife for the spread as makes a good excuse to cull wild herds of deer, sheep, buffalo, etc.,...which frees up grazingland for their domestic cows and sheep.  


*****************************************

A ProMED-mail post



ProMED-mail is a program of the

International Society for Infectious Diseases





Date: 15 Oct 2011

Source: Wyoming News [edited]







Brucellosis Confirmed In 3 Wyoming Cattle

-----------------------------------------

Livestock officials have confirmed 3 cases of brucellosis in cattle

from the northern part of the state. The 3 confirmed cases are the

first since February.



Brucellosis is a bacterial disease that originates in elk and bison.

It is easily transmittable between livestock and causes livestock to

abort their fetuses. Brucellosis has been an ongoing issue across the

country but Wyoming has maintained a good handle on stopping the

spread of the disease. Until now the state has not seen a case of

brucellosis since February [2011]. Two 13-month old heifers raised on

a ranch in Meeteetse have been confirmed with having brucellosis.

After preliminary testing Wyoming Livestock Board officials announced

that another animal in the herd also tested positive with the

disease.



The herd has since been quarantined. 2 other herds nearby have also

been quarantined and are currently being tested for the disease.

Officials attribute the outbreak in the Meeteetse to the same strain

of brucellosis found in elk that roam various areas of Park County.



[Byline:Garrett Adams]



--

Communicated by:

ProMED-mail





[Brucellar reactors among the bison and elk have long been blamed for

the appearance of new infections in cattle. -Mod.MHJ]



[The interactive HealthMap/ProMED map for Wyoming is available at

- CopyEd.EJP]



[see also:

Brucellosis, bovine - USA: (WY) 20110212.0481

2010

----

Brucellosis, bovine - USA (04): (WY) bison 20101202.4325

Brucellosis, bovine - USA (03): (WY) 20101126.4261

Brucellosis, bovine - USA (02): (MT, WY) 20101107.4041

Brucellosis, bovine - USA: (WY) 20101101.3956

Brucellosis, cervid - USA (02): (WY) corr. 20100212.0501

Brucellosis, cervid - USA: (WY) 20100211.0480

2009

----

Brucellosis, cervids - USA (02): (WY) 20090220.0718

2008

----

Brucellosis, bovine - USA (07): (WY) 20080807.2427

Brucellosis, bovine - USA (06): (WY) ex elk 20080727.2288

Brucellosis, bovine - USA (05): (WY) 20080726.2273

Brucellosis, bovine - USA (04): (WY) 20080626.1966

Brucellosis, bovine - USA (03): (WY) 20080619.1907

2007

----

Brucellosis, cervidae - USA (WY) 20070214.0546

2004

----

Brucellosis, bovine - USA (WY) (02) 20040725.2035

Brucellosis, bison vaccination - USA (WY) 20040327.0847

Brucellosis, bovine - USA (WY) 20040124.0280

Brucellosis, bighorn sheep - USA (WY) 20040118.0194

Brucellosis, elk - USA (WY) 20040110.0114

2003

----

Brucellosis, bovine - USA (WY) 20031216.3073]

.................................................sb/mp/mhj/ejp

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ProMED-mail makes every effort to verify the reports that

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using information posted or archived by ProMED-mail. ISID

and its associated service providers shall not be held

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or archived material.

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Undiagnosed Wildlife Die Off / NH

PRO/AH/EDR​> Undiagnose​d die-off, marine wildlife - USA: (NH), RFI



ProMED-mail promed@promed.isid.harvard.edu to promed-ahead-e.

show details 1:25 PM (7 hours ago)



UNDIAGNOSED DIE-OFF, MARINE WILDLIFE - USA: (NEW HAMPSHIRE), REQUEST

FOR INFORMATION

************************************************************************************

A ProMED-mail post



ProMED-mail is a program of the

International Society for Infectious Diseases





Date: Fri 7 Oct 2011

Source: The Boston Globe [edited]







A dead 8-foot-long bluefin tuna [_Thunnus thynnus_] washed up on a

beach in New Hampshire Wednesday [5 Oct 2011], the latest of a number

of sea creatures whose bodies have mysteriously washed up on the

state's shore.



"All of this together is very concerning," said Ellen Goethel, a

marine biologist and vice chair of the Hampton Conservation

Commission.



Goethel's 31-year-old son found the tuna when he was walking Plaice

Cove Beach in Hampton. Goethel, who went to the beach to observe the

fish, said she had seen 5 dead seabirds and 3 dead seals on the beach

the week before [week of 25 Sep 2011].



"I don't believe that it was caught and lost. It wasn't injured from

fishing," Goethel said.



The New England Aquarium said last week [week of 25 Sep 2011] that a

dozen seal pups had washed up on the state's beaches. The aquarium is

conducting tests on the creatures to determine if disease could be the

cause of death. The tests are not expected back until Thursday [13 Oct

2011], Tony LaCasse, spokesman for the aquarium, said today [7 Oct

2011]. Tests are also being conducted on the dead birds, said Allison

McHale, fishery policy analyst with the National Oceanic and

Atmospheric Administration.



Goethel is worried about the diseases the marine life may carry, such

as hepatitis. She added that many locals walk their dogs on the beach

on a daily basis. "My concern was to get the animals off the beach as

quickly as possible," she said.



[Byline: Amanda Cedrone]



--

Communicated by:

ProMED-mail from HealthMap Alerts





[The broad range of taxa implicated (birds, mammals, fish) indicates

an unspecific cause and potential implications for public health,

domestic animal health, and biological conservation. Although the

attack rate does not seem to be elevated (1 fish, 5 sea birds, 3 adult

seals, and 12 pups), an outbreak investigation would be pertinent.

More information on the results of the investigation would be greatly

appreciated.



For a picture of the bluefin tuna see

- Mod.PMB]



[A HealthMap/ProMED-mail interactive map of New Hampshire can be seen

at . - Sr.Tech.Ed.MJ]



[see also:

Undiagnosed die-off, seal - Canada: (NL) 20110118.0207

Epizootic ulcerative synd., fish - Australia (03): (QL) stingrays

20111003.2974

Epizootic ulcerative synd., fish - Australia (02): (QL) human susp.

20110927.2926

Epizootic ulcerative synd., fish - Australia: (QL) 20110925.2908]

.................................................sb/pmb/mj/mpp

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using information posted or archived by ProMED-mail. ISID

and its associated service providers shall not be held

responsible for errors or omissions or held liable for any

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"Bird Flu" Kills 2 More in Indonesia

ProMED-mail promed@promed.isid.harvard.edu to promed-ahead-e.


show details 7:05 PM (17 minutes ago)



AVIAN INFLUENZA, HUMAN (60): INDONESIA (BALI), FATAL, SUSPECTED

***************************************************************

A ProMED-mail post



ProMED-mail is a program of the

International Society for Infectious Diseases





[1]

Date: Mon 10 Oct 2011

Source: Jakarta Globe [edited]







Bali officials are on alert again after 2 children at Denpasar's

Sanglah General Hospital were diagnosed with the H5N1 strain of avian

influenza. Five- and 10-year-old siblings, resident in Bangli

district, were admitted to the hospital on Friday night [7 Oct 2011]

with symptoms of avian influenza and placed in isolation. The

hospital's medical and nursing director, Anak Agung Ngurah Jaya

Kusuma, said on Sunday [9 Oct 2011] that the children had been in

direct contact with dead poultry around their house and were treated

at a local health clinic before being brought to Sanglah.



Officials are still waiting for results of further tests from Udayana

University and the Health Ministry.



Bali Animal Husbandry Agency head Putu Sumantra said a team had been

deployed to Bangli, but preliminary results showed no trace of H5N1

[presumably in poultry - Mod.CP]. He said that given the preliminary

test, he was not ready to conclude that the birds had died of avian

influenza. "Nevertheless, we remain vigilant. Some of the dead birds

have been sent for further lab tests; the area has been sterilized,

and we have taken samples from family members," he said.



A total of 2 people died of the virus in 2007 and 2008 [in Bali], but

the province has still not enacted a 2005 gubernatorial regulation

banning the import of poultry into the island from other areas.

Denpasar agricultural quarantine chief Saiful Muhtadin said many

attempts have been made to smuggle poultry into Bali, especially

through Padangbai and Gilimanuk harbors.



[Byline: Made Arya Kencana]



--

Communicated by:

Nati Elkin



******

[2]

Date: Mon 10 Oct 2011

Source: Avian Flu Diary [abridged & edited]







Roughly 48 hours ago [8 Oct 2011], FluTrackers posted an Indonesian

MetroTV report on 2 children (a 5-year-old boy and a 10-year-old boy)

hospitalized on Friday [7 Oct 2011] with severe respiratory symptoms

on the resort island of Bali. Given their reported contact with

chickens and the endemic nature of the H5N1 virus in Indonesia, bird

flu was immediately suspected. Over the next 2 days, the news hounds

on FluTrackers and Flu Wiki posted more than 24 translated reports on

these 2 children, and yesterday [9 Oct 2011], we learned that

preliminary testing indicated bird flu, and that both children were on

respirators.



This morning [10 Oct 2011], we have had word that both children have

died and that H5N1 has been confirmed. While a number of news reports

are reporting these deaths, TEMPO Interaktif seems to have the most

details. The TEMPO Interactive reports that the 2 children from

Tembuku Village, Bangli, Bali allegedly died from bird flu early

Monday morning [10 Oct 2011]. The bodies of the brothers are still

stored at the General Hospital Center for Sanglah.



According to other reports, prophylactic Tamiflu is being provided to

family members and close contacts of these boys, and the community has

been told that Tamiflu will be provided to anyone who had contact with

sick or dead chickens.



All of this is highly reminiscent of the events of August 2007, when

an outbreak of H5N1 killed 2 women (and was suspected in the death of

one of the women's 5 year-old daughter) on the island of Bali. Bali,

with a population of just under 4 million, is a popular international

tourist destination, although its reputation has suffered in recent

years due to outbreaks of bird flu, dengue, and rabies.



A number of countries, including the US and Australia, have issued

travel health warnings for Bali and for the rest of Indonesia [with

respect to risk of rabies virus infection - Mod.CP]. Although news

reports of bird flu outbreaks and human cases in Indonesia have

declined over the past couple of years, the virus remains endemic in

that country and continues to mutate and spread.



Reporting and surveillance in Indonesia, as in much of the world,

leaves much to be desired, so while Indonesia reports 146 total deaths

from the H5N1 virus, the actual number is unknown. With these 2 new

deaths, a good deal of attention will be focused on Bali over the next

couple of days to see whether additional cases show up.



[Byline: Michael Coston]



--

Communicated by:

ProMED-mail Correspondent Mary Marshall



[ProMED-mail acknowledges receipt of another report with similar

information from Dr. Andri Jatikusumah, M.Sc., Direktur Eksekutif,

Center for Indonesian Veterinary Analytical Studies (CIVAS), Jl.RSAU.

No 4, Atang Sanjaya, Kemang Bogor.



Reports of human cases of avian influenza A/(H5N1) virus infection

from Indonesia have not always been confirmed by laboratory diagnosis

at a WHO-accredited institution. While the 2nd report announcing the

death of the 2 siblings states that the diagnosis of avian influenza

A/(H5N1) virus infection has been confirmed, the 1st report states

that it is not yet certain that the deaths of the domestic poultry in

the village where the children lived were the result of avian

influenza virus infection. Further information is awaited.



Denpasar in Bali, Indonesia can be located in the HeathMap/ProMED-mail

interactive map at: . - Mod.CP]



[see also:

Avian influenza, human (59): transmission in mammals 20110926.2921

Avian influenza, human (58): H5N1 2.3.2.1 clade, WHO 20110902.2682

Avian influenza, human (57): alert 20110829.2654

Avian influenza, human (56): Cambodia (KC) 20110819.2525

Avian influenza, human (55): data analysis 20110811.2439

Avian influenza, human (54): Egypt, WHO 20110810.2427

Avian influenza, human (53): Cambodia, Egypt 20110803.2338

Avian influenza, human (52): Cambodia (BM) 20110729.2279

Avian influenza, human (45): Indonesia (JK), WHO 20110603.1700]

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