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January 31, 2020

Nigeria: Lassa Fever

The commissioner for health in Edo state, Dr. Patrick Okundia, on Jan. 24 in Benin said 76 out of 175 suspected cases of Lassa fever tested positive to the epidemic.

Okundia made this known during a Lassa fever committee meeting chaired by the state deputy governor, Philip Shaibu, and a representative of the World Health Organization.

He said: "A total of 76 suspected cases of Lassa fever were confirmed yesterday in the state, and they are currently on admission in the Irrua Specialist Teaching Hospital. We have not recorded any new death but have also reduced our case fatality rate to less than 10%. The number of cases in the ward now is 34, and we have discharged over 28 patients that have been fully treated and cured."

In his remarks, Shaibu called on all hospitals across the 18 local government areas of the state to refer any suspected cases to Irrua Specialist hospital and isolation centers.

He said: "Ministries of environment, agriculture, education, information, and other relevant ministries should also step up in the area of public awareness of the people. The 18 local government councils of the state should call for an emergency meeting, which will include private health practitioners for the purpose of early referral."

On her part, the state coordinator of the World Health Organiation, Faith Ireye, revealed that contact tracing in the state is the best in the country. Ireye called on the people to practice simple handwashing to avert contracting the disease.

 China: Coronavirus

A total of 840 new cases of pneumonia caused by new coronavirus infection were added in Hubei Province (Wuhan, Huangshi, Shiyan, and Xiangyang). The total also includes new cases in Yichang, Jingzhou, Jingmen, Ezhou, Xiaogan City, Huanggang City, Xianning City, Suizhou City, Enshi Prefecture, Xiantao City, Tianmen Qianjiang City, and Shennongjia Forest District.

There were 25 new deaths in the province, including 19 in Wuhan, 2 in Xiaogan, and 1 in Jingmen, Ezhou, Huanggang, and Tianmen.

As of Jan. 28, Hubei Province has cumulatively reported 3,554 cases of pneumonia caused by new coronavirus infection.

At present, 3,349 patients are still being treated in the hospital, of which 671 are critically ill. A total of 22,095 close contacts have been tracked, and 20,366 people are still under medical observation.

 India: Kyasanur Forest Disease

Viscera samples of dead monkeys, collected from Shantigrama in Koppa taluk in Chikkamagaluru district, have tested positive to Kyasanur Forest disease (KFD).

The ticks from 10 different places in Koppa taluk, including Shantigramma, Heruru and Kunduru, were collected and sent to the laboratory. The presence of KFD virus was confirmed in the samples of infected ticks collected from Shantigrama.

District Surveillance Officer Dr. Manjunath said that the ticks collected during December were sent to the Viral Diagnostic Laboratory in Shivamogga. The outbreak of KFD begins from January. Vaccination is being given to people residing in Malnad, where the infected ticks were found. Awareness is being created on the precautionary measures. People who come across dead monkeys should immediately alert the health department, he said.

 Sierra Leone: Marburg Virus Disease

Scientists have detected Marburg virus in fruit bats in Sierra Leone, marking the first time the deadly virus has been found in West Africa. A total of 11 Egyptian rousette fruit bats tested positive for active Marburg virus infection. Research teams caught the bats separately in 3 health districts.

The presence of Marburg virus, a close relative to Ebola virus that also causes hemorrhagic disease in people, was detected in advance of any reported cases of human illness in Sierra Leone. However, the virus's presence in bats means people who live nearby could be at risk for becoming infected. No outbreaks have been reported to date.

The findings, based on PCR, antibody, and virus isolation data, were officially published Jan. 24 in the journal Nature Communications. Preliminary findings were announced in December 2018 to ensure rapid notification to the citizens of Sierra Leone and the international health community.

The paper highlights the value of collaborating with government and key stakeholders across human, animal, and environmental sectors to engage at-risk communities about the discovery, address health concerns, and communicate risk-reduction strategies before recognized spillovers occur.

Marburg virus was detected by projects led by the Centers for Disease Control and Prevention, the USAID-funded PREDICT project led by the One Health Institute at the UC Davis School of Veterinary Medicine; Njala University, Sierra Leone; and the University of Makeni, Sierra Leone.

Uganda: Crimean CONGO Hemorrhagic Fever

Social media have reported a confirmed case of Crimean-Congo hemorrhagic fever [CCHF] in Kagadi, in addition to 4 more suspect cases reported from the same district. An RFI has been sent to the members in order to verify the event and collect more information on cases, occupational exposure and implemented public health response measures.

EpiCore network has confirmed the event. Following a direct information from the National Public Health Institute a CCHF case has been confirmed in a 23-year-old patient in Kagadi District while results from samples taken from 4 suspected cases from the same area are pending; in addition, 9 contacts have been line listed and are under observation. The District Rapid Response Team is currently investigation the outbreak in collaboration with the National Rapid Response Team and WHO representatives.

The RFI has been confirmed, EpiCore network may provide further details about ongoing investigation and lab results, if available.

Zimbabwe: Anthrax

More than 30,000 cattle have been vaccinated against anthrax in Bikita and Gutu districts in Masvingo Province following the outbreak of the disease recently, an official has said. This comes in the wake of reports that more people continued to be diagnosed with anthrax as the districts have recorded more than 70 patients while 50 cattle have also died as of Jan. 24.

In an interview, the Department of Veterinary Services provincial officer, Dr. Ernest Dzimwasha, said his office had managed to attend to 2 dip tanks in Bikita and Gutu where officials vaccinated a considerable number of animals. "Following the outbreak of anthrax last week, we launched a massive vaccination exercise. We managed to vaccinate 14,832 cattle in Bikita and another 18,335 in Gutu from 2 dip tanks," he said. He added that the anthrax situation was expected to normalize after the vaccination but indicated that the department always carried routine vaccination programs. "We hope our vaccination exercise will put a stop to cattle deaths. The department is also carrying out routine vaccination exercises regardless of whether there is an outbreak or not," he said.

However, Bikita District Development Coordinator Mr. Bernard Hadzirambwi said the district was still recording cattle deaths despite the ongoing vaccination exercise. He appealed for more vaccines which would cover more cattle. "As of Jan. 20, the number of people treated of human anthrax had risen to 72 from 34 last week while cattle deaths increased to 50 from 33 cases. While the vaccination exercise is ongoing in Bikita East, the vaccines are not adequate. We, therefore, appeal to the Government to avail more vaccines that can cover the whole district. We expect at least 14,000 more vaccines, to carter for the remaining areas," he said.

Indonesia: Anthrax

The village of Panguragan Kulon in Indonesian port city Cirebon is unique in its own way. Most villagers earn their living by collecting and reselling trash. Huge sacks of waste are visible along the roads of Panguragan Kulon, many of them appearing to contain bottles.

However, when CNA visited the village in mid-January, a different type of waste was found at the backyard of a house: medical waste. Small needles, used hospital infusion bottles, and syringes with dried blood were just a few of the items scattered on the ground. Dozens of white gunny bags containing other medical waste such as medicine and little glass vials were also filling up a backyard about 1600 sq ft.

"I rented this house about 15 months ago. The garbage has always been there," an occupant told CNA. The woman lives there with her husband and her children aged 13 and 23. They rented the house for 3 million rupiah ($220) per year, knowing that the backyard is filled with medical waste. "Let it be ... we need the money," she said.

When it was pointed out that there may be viruses in the waste, she said her family never went to the backyard anyway. "I am not concerned ... We are never sick," she said. Her lack of concern was despite an investigation that concluded several years ago showing that the soil has been contaminated with various viruses, and also traces of anthrax.

Her younger sister, who lives a few miles away, claimed that the waste belongs to a man who worked for the military. In 2017, the man ordered people to dump the medical waste at the backyard of the house. Items that were considered recyclable were sold to someone else.

January 24, 2020

Canada: Equine Herpesvirus

On 6 Jan 2020, the Ontario Ministry of Agriculture, Food and Rural Affairs (OMAFRA) was notified of 2 cases of equine abortion in Simcoe County. Both cases were confirmed to be caused by equine herpesvirus type 1 (EHV-1). Both mares aborted during their 10th month of pregnancy, and both mares arrived from an out-of-province location in December.

A third mare was exposed to the infected mares, but she has remained unaffected.

The farm manager kept the new mares separate from the resident mares and in a small group. This type of management procedure reduced the risk of spreading the virus to the entire herd. Working with the facility's veterinarian, the farm manager isolated the affected mares and has voluntarily placed the premises under quarantine to reduce the risk of viral spread.

United States: Chronic Wasting Disease

The Michigan Department of Agriculture and Rural and Development (MDARD) has confirmed chronic wasting disease (CWD) in 3 white-tailed deer from a Newaygo County deer farm. All 3 deer were 4.5 years old. The samples were submitted for routine testing as part of the state's CWD surveillance program for farmed deer.

To date, CWD has not been detected in free-ranging deer in Newaygo County. As part of MDARD's disease response, an investigation will be conducted to rule out exposure of any other farmed deer.

"Chronic wasting disease is a serious disease affecting both farmed and free-ranging deer," said state veterinarian Nora Wineland, DVM. "MDARD and the Michigan Department of Natural Resources work together, in partnership with the state's deer farmers, to ensure the protection of all of Michigan's deer."

China: Coronavirus

An unexplained pneumonia in China caused the Korean quarantine authorities to strengthen the quarantine, and a fever-sensing camera is installed to monitor the body temperature of Chinese tourists who entered Korea at Incheon Port 1 International Passenger Terminal.

Pneumonia confirmed by the new coronavirus, which is prevalent in Wuhan, China, was confirmed for the first time on Jan. 20. According to health officials, a Chinese woman, who arrived at Incheon International Airport on a plane from Wuhan last weekend, was confirmed with pneumonia. The patient showed signs of pneumonia, including high fever and cough. The health authorities entered the airport at the same time, confirmed the symptoms of high fever, suspected pneumonia, and went into quarantine and testing. The Centers for Disease Control immediately quarantined the woman and entered treatment with a nationally designated quarantine bed.

Meanwhile, Beijing's Daxing District Health and Welfare Committee said 2 fever patients who had been to Wuhan were confirmed as a new pneumonia patient on Jan. 19. They are currently being treated at a designated hospital and said they are stable. Daxing District is where Beijing New Airport opened last year. The Guangdong Provincial Health and Welfare Committee said that a 66-year-old man who had visited a relative's home in Wuhan showed fever and lethargy and was diagnosed with Wuhan pneumonia. Confirmation patients have also emerged in Shenzhen, a neighboring Hong Kong province in southern China, raising concerns that the new pneumonia has already spread throughout China.

Bangladesh: Nipah Virus

Media sources in Bangladesh are reporting a Nipah virus infection in the city of Khulna. The reported case is a 20-year-old female who has been hospitalized since Jan. 11 at the Khulna Medical College Hospital (KMCH).

"A medical board has confirmed her infection by Nipah virus. As her infection is a risk to other patients, she is being treated separately at the hospital's Medicine unit 1," said SM Kamal Hossain, chief of KMCH Medicine Department.

According to the World Health Organization (WHO), in the Bangladesh and India outbreaks, consumption of fruits or fruit products contaminated with urine or saliva from infected fruit bats was the most likely source of infection. Fruit bats of the family Pteropodidae are the natural hosts for Nipah virus. There is no apparent disease in fruit bats.

In more recent outbreaks of the disease, person-to-person transmission has been seen in Bangladesh and India.

The disease in humans can range from asymptomatic infection to fatal encephalitis. Encephalitis and seizures occur in severe cases, progressing to coma within 24 to 48 hours.

The case fatality rate is estimated at 40% to 75%; however, this rate can vary by outbreak depending on local capabilities for surveillance investigations, according to the WHO.

Czech Republic: Avian Influenza

The presence of highly pathogenic avian influenza has been confirmed in the Czech Republic 3 years after the previous event. The outbreak affects a small poultry farm in Stepanov nad Svratkou, in the Vysocina Region. The virus was introduced by wild water birds. It is a highly pathogenic subtype of H5N8 virus, fatal to birds, but transmission to humans has not yet been reported.

The infected stock were 12 hens, 6 of which died within 2 days, and there were 3 ducks. Veterinary inspectors started their investigation and took precautionary measures immediately after the reporting by the breeder about the poultry deaths, and sent dead hens for examination to the State Veterinary Institute in Prague. The latter confirmed the highly pathogenic avian influenza in all 6 animals.

"My colleagues at the Ministry are ready to help affected farmers with compensation that they are legally entitled to. But most important now is to prevent further spread of infection, in particular by preventing contact between wild and domestic birds," said Minister of Agriculture Miroslav Toman.

"The remaining poultry on the farm will be euthanized; a 3-km protection zone and a surveillance zone of 10 km radius will be defined, and extraordinary veterinary measures will be declared there," said Zbynek Semerad, the Central Director of the State Veterinary Administration.

Brazil: Yellow Fever

With the arrival of summer when the occurrence of diseases transmitted by mosquitoes, such as yellow fever, increases, the Brazilian Ministry of Health is alerting the population to get vaccinated against the disease.

January 17, 2020

India: Kyasanur Forest Disease

A 58-year-old woman from Seegemakki village in Tumari Gram Panchayat limits in Sagar taluk died due to Kyasanur Forest Disease (KFD), also known as monkey fever, at a private hospital in Manipal in Udupi district on Jan. 11.

The deceased, who had complained of high fever and aches in joints, was admitted to government sub-divisional hospital in Sagar city for treatment on Jan. 7. Her blood tested positive for KFD.

Rajesh Suragihalli, District Health Officer, told The Hindu that as her health condition had worsened, she was shifted to a private hospital in Manipal for advanced treatment. She failed to respond to the treatment.

A year after a major outbreak of the disease in the region, 2 other confirmed cases of Kyasanur Forest disease (KFD) popularly known as 'monkey fever' have been reported in Shivamogga district of Karnataka in the past one week.

One victim, from Hemmakki village in Theerthahalli was diagnosed on Jan. 2. The other, from Sagar, was diagnosed on Jan. 7. The diagnosis was confirmed after tests conducted at the Virus Diagnostic Laboratory (VDL) in Shivamogga.

Both suffered from fever and dehydration, which are known symptoms of KFD. One was shifted to Kasturba Hospital in Manipal after the fever continued to persist. He is currently receiving treatment and is likely to get discharged soon. The other has been admitted to a government hospital in Sagar.

KFD recurs every year in the months from November to May and is widely reported in the summer months. These are the first cases reported in the KFD season of 2019-20. Last year, the disease took the lives of 14 people, including 12 people from Shivamogga district. 441 people were diagnosed with the disease in total. The outbreak of the disease in 2018 began as early as November in Aralagodu village in Shivamogga.

In 2019, the Karnataka Health Department admitted that there were lapses in managing the outbreak of the disease last year. The protocol was not followed in vaccinating a 10 km radius when the suspected case of KFD was found in Aralagodu. Subsequently, an outbreak of the disease occurred in Brahmana Ilakale, 8.6 km from Aralagodu.

Zimbabwe: Anthrax

Three people are battling for their lives after consuming meat from animals that died of anthrax in Mahusekwa, Marondera district. The 3 cases were picked at Chimbwanda Clinic last week and were confirmed at Mahusekwa Hospital on Jan. 6.

Marondera District Veterinary Officer Dr. Kramer Manyetu said the affected 3 people consumed meat from 2 cattle. "No meat was still available when the affected property was visited. The 2 cattle deaths were reported at Chimbwanda West Dip Tank, which has a census of 800 cattle. The combined census for a 10-kilometre radius is 4,500 cattle covering a total of 3 dip tanks, namely, Chimbwanda West, Chimbwanda communal area and Nyandoro," he said. Dr. Manyetu said they had secured 5,000 doses required to cover the 3 dip tanks.

The Department of Veterinary Services has received 811,000 doses of anthrax vaccine from Botswana's Vaccine Institute to deal with outbreaks during the rainy season.

Another outbreak of anthrax has hit Bikita District in Masvingo with 28 people reportedly diagnosed with the disease at different clinics so far. Masvingo Department of Veterinary Services provincial officer Dr. Ernest Dzimwasha confirmed.

Bikita District Development Coordinator Mr. Bernard Hadzirambwi said most parts of Bikita East constituency were badly affected. "We are battling an anthrax outbreak in Bikita District, which … has killed 24 cattle in Ward 19 and 20 in Bikita East. … We have a total of 28 people diagnosed with the disease and more are expected as we hear that some are ignoring advice against eating beef from dead cattle," he said.

Anthrax is a life-threatening infectious disease caused by bacteria that normally affects animals, especially ruminants. The disease affects all warm-blooded animals, including humans. Signs of anthrax include sudden death of livestock, rapid decomposition of the bloated carcasses and tarry blood coming out of all natural openings. The blood of the carcass is brownish and does not clot. During the rainy season, the country usually experiences more anthrax outbreaks because of the rains that wash away the top soil and expose spores.

Malaysia: Poliomyelitis

Two more children have been confirmed infected with polio virus in Sabah after a 3-month baby boy was recorded having the disease in Tuaran in December last year.

Health director-general Datuk Dr. Noor Hisham Abdullah said the 2 boys, aged 8 and 11 were foreigners. "The 8-year-old boy who is from Sandakan was found not vaccinated against polio. He had fever and 3 days later, he could not walk.

"Another boy in Kinabatangan who was also not vaccinated, was admitted to the hospital after complaining of back pain and was unable to walk. The patient is now able to walk with a walking stick," he said.

He said all patients are still being treated at the hospital and are in stable condition. Dr. Noor Hisham added that tests at the World Health Organization Polio Regional Reference Laboratory (WHO Polio RRL) in Melbourne, Australia found the polio virus which infected all 3 patients have genetic links with the polio case in Philippines. And that detailed investigations conducted to identify the source of infection in the 2 new cases found they were having acute flaccid paralysis (AFP).

To date, 705 residents from the villages of the 2 boys had been screened and there were no AFP cases recorded. The Health Ministry is calling on Sabahans especially parents to pay attention to their children's vaccination requirements by getting 2 dosages of oral polio vaccine during an ongoing campaign. He also reminded the people to obtain early treatment at the clinic and hospital if there were symptoms of polio and take the preventive measures as advised by the Health Ministry.

Argentina: Hantavirus

A pregnant woman from an area in Buenos Aires province was admitted to hospital with a hantavirus infection, so the local health authorities are investigating how she was infected in order to predict if there are possibilities of more cases.

The patient is 28 weeks pregnant and was taken into the health system for a physical illness that later was recognized by the physicians attending her as a hantavirus infection; currently she is hospitalized in the interzonal hospital San Martin in La Plata.

The municipal Secretary of Health, Diego Schiaffino, stated that the woman "never met the serious condition criterion" and indicated that her progress was favorable, so that she will be released in the coming hours.

"We are dedicated to tracking down and evaluating [the situation] in order to see how and where she was infected. We wish to see if she was infected in the area, what is the situation where she lives, if she has traveled elsewhere, if she has worked in the countryside," the local official remarked.

Pakistan: Poliomyelitis

A 3-year-old boy in Thatta's Mirpur Sakhro has been diagnosed with polio in Sindh, bringing the total for 2019 to 25 cases and Pakistan's tally to 135. The Emergency Operation Centre (EOC) for polio in Sindh confirmed the case.

This is not a case from 2020, as the 34-month boy was affected by polio with weakness in the left upper and lower limbs on dec. 26. According to his parents, he had received 7 doses of the oral polio vaccine and 3 routine doses plus the IPV were verified by card. An investigation has been opened into these claims.

EOC Sindh's spokesperson said that the long gap in door-to-door campaigns during 2019 created a large pool of vulnerable children. The National EOC and Sindh EOC have started to fight back to eradicate polio and reverse this trend. The 1st step was the successful December NID, and now areas with recent detections are being targeted in a special response round.

"We will follow this up with 2 NIDs in February and April with another targeted case response in between," the spokesperson said. Efforts from December to April will bridge the immunity gap and lead to a significant decrease in the intensity of virus transmission in the 2nd half of 2020, they said.

 Thailand: Coronavirus

The World Health Organization (WHO) is working with officials in Thailand and China following reports of confirmation of the novel coronavirus in a person in Thailand.

The person was a traveler from Wuhan, China, and was identified by Thai officials on Jan. 8, and hospitalized that day. The person is recovering from the illness according to Thai officials.

The possibility of cases being identified in other countries was not unexpected and reinforces why WHO calls for on-going active monitoring and preparedness in other countries. WHO has issued guidance on how to detect and treat persons ill with the new virus.

The genetic sequencing shared by China enables more countries to rapidly diagnose patients.

WHO reiterates that it is essential that investigations continue in China to identify the source of this outbreak and any animal reservoirs or intermediate hosts.

Japan: Classical Swine Fever

The agriculture ministry said on Wednesday that a classical swine fever [CSF] infection has been confirmed at a pig farm in the prefecture of Okinawa for the first time since the autumn of 1986.

The Okinawa Prefectural Government plans to cull more than 1,800 pigs at the farm in the city of Uruma and at another farm where infection is suspected, in accordance with the law.

In September 2018, the 1st CSF outbreak in Japan in 26 years was identified at a pig farm in the central city of Gifu. Before the latest outbreak in Okinawa, CSF infections were confirmed in a total of 12 prefectures, mainly in the Chubu and Kanto regions, such as Aichi, Mie and Saitama. The virus is believed to have been transmitted through wild boars.

The ministry will carefully look into infection routes, as it is thought that pigs at the farm in Okinawa may have become infected via different routes to prior cases.

Officials in Okinawa's pork industry were shocked by the news and expressed fears over the spread of the disease and harmful rumors.

"After the outbreak in Gifu, we strengthened epidemic prevention measures. It is regretful that we are put in such a serious situation," said Seizo Inamine, 64, chairman of the prefecture's pig farming promotion council. "We are praying that vaccination will be conducted to prevent further spread of the disease."

January 10, 2020

India: Kyasanur Forest Disease

A slew of preventive measures taken by the Department of Health and Family Welfare against Kyasanur Forest disease (KFD), also known as monkey fever, has paid off as no positive cases have been reported in the State since July.

In the KFD season of 2018-19 (from September 2018 to June 2019), 14 people died in Karnataka because of this viral infection. Of them, 12 were from Shivamogga district. Of the 440 positive cases reported during this period, 341 were from Shivamogga district.

Kiran SK, Deputy Director of Viral Diagnostic Laboratory (VDL), Shivamogga, the main arm of the department in tackling KFD, told The Hindu that to prevent the outbreak, field-level vigilance was stepped up from June in 14 affected subdistricts spread over 8 districts.

He said that coordination between the Health and Family Welfare, Animal Husbandry, and Forest Departments was imperative for successful on-field vigilance in tackling the outbreak as it involves identifying dead monkeys in forests, collecting their blood samples and viscera for tests, and disposing of the carcass in a safe manner. In all the affected districts, a Rapid Response Team (RRT) comprising senior officials of these departments were formed for better coordination.

Canada: Vaping-related illness

Alberta's chief medical officer of health confirmed the province's first case of severe vaping-associated lung illness on Jan. 2. Dr. Deena Hinshaw said the case was confirmed a few days ago but would not say where in Alberta it was reported.

Hinshaw said the patient was admitted to hospital for treatment but would not release any further information about the patient for confidentiality reasons, apart from saying they are now recovering at home.

"We're not releasing that information because it is a rare event," Hinshaw said. "In this particular case, the symptoms really were about the lungs."

The Alberta case is the 15th vaping-associated illness reported in Canada, according to the Public Health Agency of Canada.

Of the 14 other cases, 3 occurred in British Columbia, 2 were in New Brunswick, 4 were reported in Ontario, and 5 happened in Quebec. Of those 14 cases, 11 people required admission to hospital.

"We are actively monitoring the situation in Alberta and working with health officials across Canada to share information and better understand this illness," Hinshaw said.

Zimbabwe: Anthrax

 A deadly anthrax outbreak has hit Gokwe North district in the Midlands province, with farmers losing large herds of cattle while several people were reportedly hospitalized after eating infected meat.

Midlands veterinary officer Munyaradzi Chigiji confirmed the development and said his department had since moved in to put the outbreak under control. "We have had great losses of livestock to date, and our tests confirmed that it was anthrax. Farmers have lost huge numbers of cattle due to the outbreak so far. We have also recorded cases of human beings who have been treated of the disease in the affected areas. Although we cannot confirm the number of deaths of the livestock, what we can say is that farmers have lost out," Chigiji said.

"During my visit to the area, I arrived at a homestead which had lost 15 cattle. I also visited another one which had lost 4. We also have several other farmers who have lost their livestock due to anthrax." The hardest hit areas are Nembudziya, Simchembo and Chireya.

Southern Eye spoke to farmers at Nembudziya Growth Point who confirmed that the outbreak was wreaking havoc in the area. "I lost a herd of 11 cattle due to the outbreak. In my village alone, over 80 cattle have perished in the recent past due to the outbreak. Here, our main economic activity has been cotton growing, but lately we had shifted to cattle ranching because the cotton has become less profitable due to falling prices," said Nomore Machivenyika, a farmer in Maserukwe village. "This outbreak has, therefore, come as a big blow for us."

United Kingdom: Avian Influenza

Authorities are investigating a suspected case of a notifiable bird disease on a poultry farm in County Fermanagh. It was discovered 4 days ago when a vet became concerned about increased mortality among the broiler birds.

Tests are being run to see whether it is bird flu or another disease called Newcastle disease. It will be several days before final results are back. Restrictions have been put in place on the farm as a precautionary measure.

The Department of Agriculture Environment and Rural Affairs can order the culling of birds to prevent disease spreading. Farmers have been urged to step up their biosecurity.

The disease risk increases in winter with the arrival of migratory birds which can carry them. In recent years bird flu has been confirmed in wild birds on several occasions.

Last month, the H5 strain of bird flu was detected at a commercial poultry business in Suffolk; 27 000 chickens were culled there.

China: Plague

On Nov. 11, Beijing Center for Disease Control (Beijing CDC) identified 2 cases of Yersinia pestis, induced pneumonic plague, in a husband and wife from the Sunitezuo Qi County of the Xilinguole Prefecture in Inner Mongolia Autonomous Region. Three days later, another case was identified in a patient from Huade County of Ulanchabu City in Inner Mongolia, 130 km from the first 2 cases. China CDC established no epidemiological relationship between the 2 events.

A total of 447 persons with direct contact in Beijing and 46 in Inner Mongolia were quarantined for medical observation. As of Nov. 21, all persons with direct contact were discharged from medical observation.