E. Coli Meat Recall / Michigan

E Coli as a biological weapon; http://www.globalsecurity.org/wmd/intro/bio-ecoli.htm


E. COLI VTEC NON-O157 - USA: O45, SMOKED MEAT, ALERT, RECALL
***********************************************
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ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Wed 5 Jan 2011
Source: Wausau (MI) Daily Herald [edited]


Three new cases of _E. coli_-related illness have been traced from
Michigan back to a Wausau butcher shop in which an outbreak 1st was
reported just before Christmas 2010.

The illnesses bring to 7 the number of people sickened by _E.
coli_-infected smoked meat products produced at Zillman Meat Market
in late 2010, the Marathon County Health Department said Tuesday [4
Jan 2011]. The department also expanded its advisory on smoked meats
produced at Zillman's to between 30 Sep and 23 Dec 2010, rather than
beginning on 13 Nov 2010, because the department still has not pinned
down the source of the bacteria.

While the 3 cases announced are new, they are related to the prior 4
illnesses and involve some of the same people, said Judy Burrows, the
Health Department's chronic disease prevention director. "The folks
we know from Wausau who were sick had shared some of their smoked
meat products with others from Michigan," Burrows said.

The Health Department advises that any ready-to-eat smoked meat
produced at Zillman's within the advisory range be thrown away, or
that customers contact Zillman's about returns. The advisory relates
only to the smoked meat, and none of Zillman's other meat products
were included in the advisory.

Since the initial advisory on 22 Dec 2010, Zillman's has thoroughly
cleaned all of its equipment, Burrows said. "There are no additional
steps Zillman needs to take because these new cases happened prior to
all of the cleaning, so they're good to go," she said.

Burrows said the Health Department still is trying to pin down
whether the _E. coli_ contamination came from a person or somehow
ended up on Zillman's equipment. She also said very few people came
forward with tales of sickness from the smoked meat after 3 news
releases were issued in December 2010, hampering the investigation on
how and when the contamination 1st occurred. Less information means
the Health Department must cast a wider net with its advisory, Burrows said.

Burrows said the Michigan cases were discovered after the Wisconsin
Department of Health Services contacted other state health
departments in search of illnesses caused by this particular
bacterial strain, _E. coli_ O45, because it is a newer, slightly
different form of bacteria studied for only about 10 years.

Tim Monson, a microbiologist with the Wisconsin State Lab of Hygiene,
said Tuesday [4 Jan 2011] that E. coli O45 is an "emerging pathogen"
that can transfer its toxins to other bacteria, but it also tends to
be less toxic than other strains of _E. coli_.

--
Communicated by:
ProMED-mail


[This outbreak once again underscores the relevance of non-O157
strains of verotoxin-producing _E. coli_. Other _E. coli_ serogroups
that have been associated with VTEC (verotoxin-producing _E. coli_)
disease include motile ones such as O26:H11 and O104:H21 and
non-motile ones such as O111:NM (or H-). Such non-O157 isolates can
be obtained from sheep and cattle and, although they cause as many as
30 percent of outbreaks of VTEC (1), appear to be somewhat less (or
at least more variably) virulent in a variety of in vivo and in vitro
assays (2-4).

In analyzing the genetic and phenotypic profiles of non-O157 groups,
it has been found that they belong to their own lineages and have
unique profiles of virulence traits different from O157 (5). The
serogroups appearing to be most prominent are O26, O111, O128, and
O103 (6), the former serotype being the implicated strain in this outbreak.

If a laboratory is using sorbitol-MacConkey (sMAC) plates to identify
VTEC by virtue of O157's inability to ferment sorbitol, the non-O157
strains will be missed. In a 3-year pediatric study from the
University of Washington, USA (7), 1851 stool samples were processed
for sorbitol fermentation as well as toxin production by EIA (enzyme
immunoassay), and 28 strains of O157 were found along with O103 (4
strains), O118 (2 strains), O111 (2 strains), and 3 other strains.

Clinically, the O157 infections had a higher frequency of bloody
stools, fecal leukocytes, and abdominal pain with shorter symptom
duration. Five (18 percent) of O157 infections developed HUS; none of
the non-O157 strains did. Since toxin assay did not identify all O157
strains found on sMAC plates, the investigators did not advocate
performing toxin assay alone. Non-O157 can produce hemolytic-uremic
syndrome, as demonstrated by a cluster of O121 cases associated with
a lake in Connecticut, USA (8).

Since toxin assays are not uniformly performed in many areas, and
most cases do not produce HUS, it is likely that cases due to
non-O157 strains are being missed. How frequent this phenomenon will
become over time is unclear.

Because of the higher risk of morbidity and mortality in VTEC
infections treated with antimicrobials (9), antimicrobials should not
be used for known acute cases.

References
----------
1. Hussain HS, Omaye ST: Introduction to the food safety concerns of
verotoxin-producing _Escherichia coli_. Exp Biol Med 2003; 228(4):
331-2; available at .

2. Blanco J, Blanco M, Blanco JE, et al: Verotoxin-producing
_Escherichia coli_ in Spain: prevalence, serotypes, and virulence
genes of O157:H7 and non-O157 VTEC in ruminants, raw beef products,
and humans. Exp Biol Med 2003; 228: 345-51; available at
.

3. Law D, Kelly J: Use of heme and hemoglobin by _Escherichia coli_
O157 and other Shiga-toxin-producing _E. coli_ serogroups. Infect
Immun 1995; 63(20): 700-2; available at
.

4. Tzipori S, Wachsmuth KI, Smithers J, Jackson C: Studies in
gnotobiotic piglets on non-O157:H7 _Escherichia coli_ serotypes
isolated from patients with hemorrhagic colitis. Gastroenterology
1988; 94(3): 590-7; abstract available at
.

5. Schmidt H, Geitz C, Tarr PI, et al: Non-O157:H7 pathogenic
Shiga-toxin producing _Escherichia coli_: phenotypic and genetic
profiling of virulence traits and evidence for clonality. J Infect
Dis 1999; 179(1): 115-23; available at
.

6. Bettelheim KA: Role of non-O157 VTEC. Symp Ser Soc Appl Microbiol
2000; (29): 38S-50S; abstract available at
.

7. Klein EJ, Stapp JR, Calusen CR, et al: Shiga toxin-producing
_Escherichia coli_ in children with diarrhea: a prospective
point-of-care study. J Pediatr 2002; 141(2): 172-7; available at
.

8. McCarthy TA, Barrett NL, Hadler JL, et al: Hemolytic-uremic
syndrome and _Escherichia coli_ O121 at a lake in Connecticut, 1999.
Pediatrics 2001; 108(4): E59; available at
.

9. Iijima K, Kamioka I, Nozu K: Management of diarrhea-associated
hemolytic uremic syndrome in children. Clin Exp Nephrol 2008; 12(1):
16-9; abstract available at
. - Mod.LL]

[see also:
2010
----
E. coli VTEC non-O157 - USA (07): O26, ground beef, alert, recall 20100831.3097
E. coli VTEC non-O157 - USA (06): O145, lettuce 20100528.1777
E. coli VTEC non-O157 - USA (05): O145, lettuce 20100525.1738
E. coli VTEC non-O157 - USA (04): O145, lettuce 20100517.1618
E. coli VTEC non-O157 - USA (03): O145, lettuce, recall 20100507.1483
E. coli VTEC non-O157 - USA (02): (OH, MI, NY) O145 20100505.1460
E. coli VTEC non-O157 - USA: (MI, OH) 20100427.1358
2008
----
E. coli VTEC non-O157, restaurant - USA (04): (OK), O111 20081201.3779
E. coli VTEC non-O157, restaurant - USA: (OK), O111 20080902.2748
E. coli VTEC non-O157, past. ice cream, 2007 - Belgium: Antwerp 20080218.0655
2007
----
E. coli VTEC non-O157, beef sausage - Denmark 20070602.1784
E. coli VTEC non-O157, 2000-2005 - USA (CT) 20070118.0240
2006
----
E. coli VTEC non-O157, lettuce - USA (UT)(02): background 20060905.2523
E. coli VTEC non-O157, lettuce - USA (UT) 20060904.2521
E. coli VTEC non-O157 - Norway (03) 20060416.1133
E. coli VTEC non-O157 - Norway 20060329.0947
E. coli VTEC non-O157, minced beef - Norway 20060304.0680
2005
----
E. coli O145, fatal - Slovenia 20050916.2739
2003
----
E. coli, VTEC non-O157 - UK (Scotland): correction 20030828.2166
E. coli, VTEC non-O157 - UK (Scotland) 20030825.2144
2001
----
E. coli O26 - South Korea 20010509.0896
1999
----
E. coli O111, diarrhea - USA (Texas) 19990707.1134
1997
----
E. coli, non-0157 - Belgium 19970610.1215]
...................................................ll/msp/mpp

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Camels Dying / Pakistan

Article; http://tribune.com.pk/story/99212/camels-dying-from-virus-in-cholistan/


ProMed Report

UNDIAGNOSED LETHAL DISEASE, DROMEDARY CAMELS - PAKISTAN: DIFFERENTIAL DIAGNOSIS
***********************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Thu 6 Jan 2011
From: William Taylor [edited]

Since the publication linking PPR with sudden camel death in Sudan
(ref.), this condition warrants consideration and would be easily
verified. There is certainly plenty of PPR in Pakistan.

Ref.
Abdelmelik I. Khalafalla, Intisar K. Saeed, Yahia H. Ali, Magdi B.
Abdurrahman, Olivier Kwiatek, Genevieve Libeau, Ali Abu Obeida and
Zakia Abbas (2010). An outbreak of peste des petits ruminants (PPR)
in camels in the Sudan. Acta Tropica, Vol 116 (2), 161-165.

--
William Taylor


[Dr Taylor's authoritative comment is highly appreciated.

The recent paper referred to includes the following information on
the camel disease in Sudan, eventually diagnosed as PPR:

Mortality rates were up to 50 percent. The main features of the
disease were bloody diarrhea of affected camels, sudden death of
apparently healthy animals and abortion of she-camels. In general,
the clinical feature of PPR in camels, as described in this
communication, was not different from that reported in sheep and goats.

The severity of PPR in camels seemed to be much higher in adult
animals since more than 50 percent of deaths were reported in adult
animals (mostly recently-delivered and pregnant females) in
comparison to calves and young camels. The main post-mortem findings
included lung congestion and consolidation mostly in apical lobes,
paleness and fragility of liver. Lymph nodes were enlarged and
inflamed, and small intestine and stomach showed inflammation and
hemorrhage. In one case, the lips were swollen, and hemorrhagic
ulcers were seen on the tongue.

In line with a comment from a subscriber, we remind readers that the
camels in Pakistan (and in Sudan) are dromedary (single-humped)
camels. - Mod.AS]

[see also:
Undiagnosed lethal disease, camels - Pakistan: Cholistan, RFI 20110105.0051
2010
----
Undiagnosed disease, camels - Pakistan: Thar, RFI 20101117.4170]
...........................................arn/msp/mpp

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and its associated service providers shall not be held
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or archived material.
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The most important disease you probably never heard of

Welcome to Johne’s (“yo-knees”), the most important disease that you probably never heard of. It is a serious, debilitating and sometimes fatal illness of cattle, goats, and sheep (among other animals), which the livestock and dairy industry is desperate to keep out of the public consciousness, despite the fact that it costs industrial agriculture many millions of dollars every year.

The reason for such industry reticence is that Johne’s Disease in livestock is very similar – and possibly even identical – to Crohn’s Disease in people, which currently afflicts an estimated 500,000 sufferers in North America alone, causing severe ulcerations of the gastro-intestinal tract, immense pain, and loss of appetite and weight, often requiring surgical removal of the damaged bowel. And the big, dirty secret of today’s industrial dairy and meat producers is that animals suffering from flagrant Johne’s Disease currently provide milk and meat directly to the American consumer.

In short, we eat lots of very, very sick cows, animals so ill that if you knew you were eating them, you wouldn’t.

Full article;

http://chronicle.com/blogs/brainstorm/the-most-important-disease-you-probably-never-heard-of/30509

Johnes Information Center; http://www.johnes.org/zoonotic/index.html

Another good reason to quit eating meat and dairy...if you care about your health and the health of your children and their childrens children....and so on.

S. Korea Devistated by Animal Disease

Recall that in 2008, thousands of S. Korean's protested imports of USA meat ; http://www.huffingtonpost.com/2008/05/31/tens-of-thousands-of-sout_n_104478.html

and now, only two years later, they are suffering huge outbreaks of Foot and Mouth, a cattle disease, and avian flu;
http://madcowhorses.blogspot.com/2010/12/s-korea-devistated-by-animal-disease.html
with thousands upon thousands of their own animals being culled, they will be BEGGING for USA meat soon.

Yellow Fever Outbreak / Uganda

Viral zoonotic hemorrhagic diseases on the NIAID priority list are yellow fever, Crimean-Congo hemorrhagic fever, Chikungunya virus, Hendra virus and Nipah virus hemorrhagic fever. Other hemorrhagic zoonoses on the NIAID list are Ebola hemorrhagic fever, Marburg hemorrhagic fever, Hanta-virus hemorrhagic fever, Rift Valley fever, Lassa fever, Lymphocytic chorio-meningitis virus, hemorrhagic fever, Junin virus or Argentine hemorrhagic fever, Machupo virus or Bolivian hemorrhagic fever, and Guanarito virus.

Read more: http://www.livestrong.com/article/172469-list-of-emerging-viral-zoonotic-diseases/#ixzz19RI4Tkfl http://www.livestrong.com/article/172469-list-of-emerging-viral-zoonotic-diseases/

UNDIAGNOSED DISEASE - UGANDA (09): YELLOW FEVER VACCINATION
***********************************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Tue 28 Dec 2010
Source: The New Vision (Uganda) [edited]



Yellow fever: ring vaccination not enough
-----------------------------------------
At least 2.5 million people will be vaccinated in northern Uganda
against the yellow fever [outbreak] that had by the weekend [25-26
Dec 2010] killed 45 people and infected 178 others.

The disease [yellow fever], whose fatality rate ranges between 15
percent and 50 percent, is taken so seriously that just one confirmed
case is considered an outbreak by the World Health Organisation.
While the health ministry has instituted measures to contain the
disease, a mass rather than ring-vaccination would be a more
effective control mechanism. Diseases know no borders. With increased
travel within the region the disease could have been transmitted far
beyond the surrounding districts. Therefore, a mass vaccination
[campaign], as was done in the Gambia in the 1970s, is the best
approach in the long run. Yellow fever vaccination could also be
added to the expanded programme for immunisation that currently
covers the 6 killer diseases (tetanus, diphtheria, whooping cough,
polio, tuberculosis, and measles).

Global statistics show that yellow fever cases are on the increase
with 90 percent of the 200 000 cases registered annually being in
Africa. Uganda is therefore, likely to experience a resurgence of
yellow fever, just like polio a few years ago.

Since most Ugandan health units are not equipped to test for yellow
fever, the medical workers should be highly suspicious and
investigate all cases with yellow fever symptoms like high fever,
chills, headache, muscle aches, vomiting, and backache. Anybody who
presents [with] these symptoms should immediately take a medical check-up.

Uganda should be more vigilant since all factors responsible for the
resurgence of yellow fever are prevalent here -- reduced immunisation
against the disease; deforestation bringing people in closer contact
with monkeys; and population movements making it easier to transport
the disease far and wide.

Therefore, unless stringent measures like mass immunisation are taken
in collaboration with neighbouring countries, Uganda is likely to
register more yellow fever outbreaks in other places with its attendant costs.

--
Communicated by:
Thomas James Allen


[The following commentary is predicated on the assumption that the
outbreak of undiagnosed disease affecting several villages in
northern Uganda has been unequivocally identified as an outbreak of
yellow fever virus infection. This remains to be confirmed
unequivocally by laboratory testing.

Yellow fever is an acute viral haemorrhagic disease transmitted by
infected mosquitoes. Several different species of the _Aedes_ and
_Haemagogus_ mosquitoes transmit the virus. The mosquitoes either
breed around houses (domestic), in the jungle (wild), or in both
habitats (semi-domestic).

The following information is taken from the WHO fact sheet at
:
There are 3 types of transmission cycles.
- Sylvatic (or jungle) yellow fever: in tropical rainforests, yellow
fever occurs in monkeys that are infected by wild mosquitoes. The
infected monkeys then pass the virus to other mosquitoes that feed on
them. The infected mosquitoes bite humans entering the forest,
resulting in occasional cases of yellow fever. The majority of
infections occur in young men working in the forest (such as for logging).
- Intermediate yellow fever: in humid or semi-humid parts of Africa,
small-scale epidemics occur. Semi-domestic mosquitoes (that breed in
the wild and around households) infect both monkeys and humans.
Increased contact between people and infected mosquitoes leads to
transmission. Many separate villages in an area can suffer cases
simultaneously. This is the most common type of outbreak in Africa.
An outbreak can become a more severe epidemic if the infection is
carried into an area populated with both domestic mosquitoes and
unvaccinated people.
- Urban yellow fever: large epidemics occur when infected people
introduce the virus into densely populated areas with a high number
of non-immune people and _Aedes_ mosquitoes. Infected mosquitoes
transmit the virus from person to person.

There is no specific treatment for yellow fever, only supportive care
to treat dehydration and fever. Associated bacterial infections can
be treated with antibiotics. Supportive care may improve outcomes for
seriously ill patients, but it is rarely available in poorer areas.
Vaccination is the single most important measure for preventing
yellow fever. In high risk areas where vaccination coverage is low,
prompt recognition and control of outbreaks through immunization is
critical to prevent epidemics.

To prevent outbreaks throughout affected regions, vaccination
coverage must reach at least 60 percent to 80 percent of a population
at risk. Preventive vaccination can be offered through routine infant
immunization and one-time mass campaigns to increase vaccination
coverage in countries at risk. WHO strongly recommends routine yellow
fever vaccination for children in areas at risk for the disease.

The yellow fever vaccine is safe and affordable, providing effective
immunity against yellow fever within one week for 95 percent of those
vaccinated. A single dose provides protection for 30-35 years or
more, and probably for life.

The HealthMap/ProMED-mail interactive map of Uganda can be accessed
at . - Mod.CP]

[see also:
Undiagnosed disease - Uganda (08): yellow fever susp. 20101224.4531
Undiagnosed disease - Uganda (07): plague suspected 20101208.4382
Undiagnosed disease - Uganda (06) 20101206.4365
Undiagnosed disease - Uganda (05) 20101205.4354
Undiagnosed disease - Uganda (04) 20101203.4340
Undiagnosed disease - Uganda (03) 20101202.4334
Undiagnosed disease - Uganda (02): (TG) 20101130.4302
Undiagnosed disease - Uganda: Acholi, RFI 20101129.4297]
...................................cp/mj/mpp

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S. Korean Ag Tanks Due to Foot & Mouth Disease

FMD is of concern as a biological weapon for the following reasons:

The disease causes a high rate of morbidity in multiple species.
The disease is highly communicable and spreads rapidly once introduced into nonimmune herds. It is defined by the OIE as a category A disease: "Communicable diseases which have potential for serious and rapid spread, irrespective of national borders, which are of serious socioeconomic or public health consequence and which are of major importance in the international trade of livestock and products" (see References: OIE: OIE classification of diseases).
State public health officials and state veterinarians agreed in a 2001 survey that the risk of a bioterrorism attack with an agent affecting animals was greater than the risk of an attack with an agent affecting people. Both groups shared similar risk assessments of FMD as a bioterrorism agent (see References: Tharratt 2002).
FMD can lead to dramatic economic losses (see References: Paarlberg 2002):
Up to $14 billion (9.5%) of US farm income would be lost in the event of an outbreak similar to the 2001 epidemic in the UK, according to recent economic models.
The most affected sectors would be the cattle, milk, sheep, and swine markets.
This model predicted that most loss would not be from decreases in production but rather from lost export markets and decreases in consumer demand. Without adverse consumer reaction, the losses would be closer to $6.8 billion.

Full article; http://www.cidrap.umn.edu/cidrap/content/biosecurity/ag-biosec/anim-disease/foot-mouth.html#_FMD_as_a


FOOT & MOUTH DISEASE - SOUTH KOREA (23): SPREAD, VACCINATION
***********************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


In this update:
[1] Update as of 25 Dec 2010
[2] The Japanese experience

******
[1] Update as of 25 Dec 2010
Date: 27 Dec 2010 [S. Korean time]
Source: Joongang Daily [edited]

The Grand National Party is pushing for integration of inspections
and a single government body to oversee the deadly foot-and-mouth
disease (FMD) after 2 additional outbreaks of FMD at pig and cattle
farms were confirmed by health authorities yesterday [26 Dec 2010].

"Currently, quarantine operations are divided among 3 government
offices -- the National Veterinary Research and Quarantine Service,
the National Plant Quarantine Service and the National Fisheries
Products Quality Inspection Service -- but they need to be
integrated," said Chung Woon-chun, a former agriculture minister who
now heads the GNP's special committee for counteracting FMD.

"The GNP will come up with measures to effectively contain the
disease," he said. "And it will also encourage the public's
consumption of beef and pork because an outbreak of FMD doesn't
affect food safety."

The Ministry for Food, Agriculture, Forestry and Fisheries said
yesterday [26 Dec 2010] a pig farm with 2100 pigs in Yeoju County,
Gyeonggi tested positive for the disease. All animals on the farm and
within a 500-meter (0.31-mile) radius were slaughtered to prevent the
disease from spreading.

Of 140 cows raised at a cattle farm in the same county, 2 tested
positive as of yesterday [26 Dec 2010] afternoon and are also slated
to be culled, according to the ministry.

In addition to the Yeoju farm, the ministry received a report of a
suspected FMD case at a farm with 5000 pigs in Icheon, Gyeonggi,
raising concerns among health officials and area residents.

Despite the government's efforts to eliminate the disease by
vaccinating cloven-hoofed animals beginning Saturday [25 Dec 2010],
health officials are facing another obstacle: disinfectants have been
freezing in the recent cold spell and can't be sprayed to help
prevent the spread of FMD.

The Korean government had refrained from using the vaccine because
doing so would make it more difficult for Korea to regain its
FMD-free status, which is necessary for exports.

Since the outbreak of the disease on 29 Nov 2010 in North Gyeongsang,
it has spread to Gyeonggi, Gangwon and Incheon. There have been 51
infections reported, and more than 325 000 livestock have been
ordered to be culled. The Agriculture Ministry estimated losses
related to the disease at around 400 billion (USD 347 million).

The worsening situation is forcing local governments to cancel or
suspend their long-prepared celebrations for the 1st sunrise of 2011,
an annual event held by many communities in Korea.

North Gyeongsang, which has lost the most livestock from FMD, decided
to cancel all such events.

Some events that have been canceled include the Yeongdeok Sunrise
Festival, organized by the Yeongdeok County Office, and a bell
ringing ceremony to mark the new year, organized by the North
Gyeongsang Provincial Government. Cheongwon County in North
Chungcheong decided to cancel its year-end concert and will offer
refunds on purchased concert tickets, officials there said.

President Lee Myung-bak yesterday [26 Dec 2010] ordered winter
gloves, earmuffs and other winter-protection clothes to be given to
farmers and government officials combating the disease after he was
briefed by his Presidential Chief of Staff Yim Tae-hee about current
FMD countermeasures.

[Byline: Kim Mi-ju]

--
Communicated by:
Sabine Zentis
Gut Laach
52385 Nideggen

[The description of the current situation in S. Korea, including
cancellations of public events or gatherings, is reminiscent of the
2001 FMD epizootic in the UK when, on top of such events, most of the
open parks and nature reserves were closed to the public for extended
periods, the countryside badly hit; the rural sector suffered
enormous economical losses in the agri-business, including
agri-tourism and catering, and the general elections had to be
postponed. The UK outbreak started on 19 Feb 2001 and resolved after
more than 6 months.

Britain's "Foot and Mouth Disease 2001: Lessons to be Learned
Inquiry", said in the introduction to the report: "By the end of
September [2001], over 2000 premises had been declared infected,
millions of animals destroyed and many rural lives and livelihoods
affected in a manner unknown for a generation". The crisis was
estimated to have cost Britain BP 8 billion (USD 16 billion) in costs
to the agricultural and support industries, and to the outdoor industry.

The Korean epizootic is even more reminiscent of the recent epizootic
in Japan. Lessons which may have been derived from the Japanese
event, which was caused by the same virus strain currently
circulating in S. Korea, could be helpful for the decision-makers in
S. Korea. Two documents in Japanese, addressing some of the issues,
have already become available (for URLs, see in commentary of posting
20101225.4546). A paper in English, which includes some useful data
and analysis of the Japanese epizootic, is reviewed in item 2 below.

We have received from a subscriber the map (in Japanese): "Main route
of spread of FMD, as of 24 Dec 2010, AM 11.00", for which we are
grateful. The map shows the timeline and traces the suggested routes
of FMDV dissemination throughout 4 administrative districts of S.
Korea, beginning with the apparent index case. The map, published by
Chosun online (Japanese edition), does not include references. See at
.

Legend:
orange line: confirmed route
white line: suspected route
1 spread to Gyeonggi-do
2 to Gangwon-do
3 to Incheon city
4 possibility of national spread

Dates included stand for days of confirmation, such as 11-29, which
means 29 Nov 2010. - Mod.AS]

******
[2] The Japanese experience
Date: December 2010 (Article 1st published online: 15 Aug 2010)
Source: Transboundary and Emerging Diseases 57 (6) (2010) 396-403
[modified, edited]



An epidemic of FMD occurred in Miyazaki, Japan, beginning in late
March 2010. Here, we document the descriptive epidemiological
features and investigate the between-farm transmission dynamics. As
of 10 Jul 2010, a total of 292 infected premises have been confirmed
with a cumulative incidence for cattle and pig herds of 8.5 and 36.4
percent, respectively for the whole of Miyazaki prefecture.

Pig herds were more likely to be infected than cattle herds (odds
ratio = 4.3 [95 percent confidence interval (CI): 3.2, 5.7]).
Modelling analysis suggested that the relative susceptibility of a
cattle herd is 4.2 times greater than a typical pig herd (95 percent
CI:3.9, 4.5), while the relative infectiousness of a pig herd is
estimated to be 8.0 times higher than a cattle herd (95 percent CI: 5.0, 13.6).

The epidemic peak occurred around mid-May 2010, after which the
incidence started to decline, and the effective reproduction numbers
from late May 2010 were mostly less than unity, although a
vaccination programme in late May 2010 could have masked symptoms in
infected animals. The infected premises were geographically confined
to limited areas in Miyazaki, but sporadic long-distance
transmissions were seen within the prefecture. Given that multiple
outbreaks in Far East Asian countries have occurred since early 2010,
continued monitoring and surveillance is deemed essential.

[Byline: H. Nishiura and R. Omori]

--
Communicated by:
ProMED-mail

[The data from Japan underlining the long-known but sometimes
forgotten picture of pigs being strikingly effective FMD virus
emitters, while cattle are very susceptible (to aerosol infection),
are indeed relevant to the S. Korean situation and predictive of the
extensive spread of the disease as, unfortunately, became realized
there. - Mod.AS]

[see also:
Foot & mouth disease - S. Korea (22): OIE follow-up, vaccination 20101225.4546
Foot & mouth disease - S. Korea (21): (KW, GB) susp. 20101222.4502
Foot & mouth disease - S. Korea (20): (KG), update 20101220.4489
Foot & mouth disease - S. Korea (19): (KB, KG), update 20101217.4460
Foot & mouth disease - S. Korea (18): (KB, KG), OIE follow-up 20101215.4446
Foot & mouth disease - S. Korea (17): (KG) spread 20101215.4442
Foot & mouth disease - S. Korea (16): (KB), update 20101213.4429
Foot & mouth disease - S. Korea (15): (KB), spread 20101211.4414
Foot & mouth disease - S. Korea (14): (KB) OIE follow-up 20101209.4393
Foot & mouth disease - S. Korea (13): (KB) spread 20101206.4369
Foot & mouth disease - S. Korea (12): (KB), update 20101204.4348
Foot & mouth disease - S. Korea (11): (GN) update 20101201.4321
Foot & mouth disease - S Korea (10): (KB), porcine, bovine, st O 20101130.4312
Foot & mouth disease - S Korea (09): (KB) OIE 20101130.4301
Foot & mouth disease - S Korea (08): (KB) recurs, RFI 20101129.4296
Foot & mouth disease - S. Korea (07): resolved 20100623.2096
Foot & mouth disease - S Korea: update, serotype O, genotyping 20100501.1416
Foot & mouth disease, bovine - S Korea (09): conf, serotype O, OIE
20100410.1168
Foot & mouth disease, bovine - South Korea (08): susp. RFI 20100408.1140
Foot & mouth disease, bovine - South Korea (07): resolved 20100323.0919
Foot & mouth disease, bovine - South Korea (02): serotype A 20100111.0130
Foot & mouth disease, bovine - South Korea: (KG), OIE 20100108.0089]
............................................arn/msp/mpp

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Swine Flu (H1N1) Death / Egypt

INFLUENZA (21): EGYPT (NORTH SINAI) H1N1 FATAL
**********************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Thu 16 Dec 2010
Source: Al-Masry Al-Youm [edited]



A 40-year-old woman from North Sinai Governorate died Wednesday night
[15 Dec 2010] from the H1N1 virus [influenza A/(H1N1) 2009 virus],
commonly known as swine flu, at Ismailia General Hospital, medical
sources confirmed. She was reportedly transferred to the hospital
following a severe lung infection.

The hospital sent her blood samples to the Ministry of Health, which
confirmed the H1N1 infection. She died only hours after being moved to
the quarantine ward.

There is another confirmed case of H1N1 in the hospital, a 35-year-old
woman who is currently receiving treatment, the same source added.

[Byline: Hani Abdel Rahman]

--
Communicated by:
HealthMap Alerts via
ProMED-mail

[This death of the woman in the North Sinai governorate of Egypt as a
result of influenza A/(H1N1) 2009 virus infection and another
confirmed case, which follow reports of cases in Israel and Yemen,
confirm that the winter influenza epidemic is now underway in the
Middle East as well as in parts of Europe. In contrast, cases of avian
A/(H5N1) influenza virus infection in Egypt have occurred sporadically
throughout the year and are believed to have been contracted from
diseased domestic poultry with no spread from person to person. The
most recent human avian influenza case occurred in Gharbia governorate
and was recorded on 2 Dec 2010.

A map of the governorates of Egypt showing the location of North Sinai
in the northeast (at 18) can be accessed at:
. The
HealthMap/ProMED-mail interactive map of Egypt is available at
. - Mod.CP]

[see also:
Influenza (20): WHO, Europe, UK 20101217.4463
Influenza (19): Europe, Israel, Yemen 20101216.4454
Influenza (18): WHO update, UK 20101212.4418
Influenza (17): Canada (MB), 1st nation 20101203.4341
Influenza (16): Zimbabwe (MV) 20101126.4274
Influenza (15): WHO update 20101124.4243
Influenza (14): swine origin (tr) H3N2 viruses 20101112.4117
Influenza (13): WHO update 20101111.4092
Influenza (06): WHO update 116 20100912.3295]
......................................................cp/msp/jw
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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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************************************************************
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