Monday, May 29, 2017

Saudi MOH Announces 1 Primary MERS Case In Madina


The holy month of Ramadan began on Friday, May 26th, a time when tens of thousands of religious pilgrims will descend upon Saudi Arabia's Holiest cities (mostly Mecca and Madina) to perform Umrah.

Today we learn of a primary MERS case in the city of Madina, involving a 60 year old Saudi male, with no listed risk exposure.

Each year since MERS emerged we've seen concerns over the international spread of MERS by religious pilgrims returning from the Hajj or from performing Umrah during Ramadan, but so far, neither has sparked an outbreak.

Nevertheless, public health officials around the world will be alert for any signs of infection among returning travelers.

USGS: Preparing The Nation For Severe Space Weather


Although there were few visible effects beyond some spectacular aurora sightings as far south as Arizona, Colorado, and Tennessee - over the weekend the earth took a a glancing blow from a small CME (Coronal Mass Ejection) from the sun.

The resultant G3 geomagnetic storm (see chart above) sparked the auroras, and likely caused some minor electrical and communications disruptions, particularly in the higher latitudes. NOAA describes the effects of a G3 storm as:
G 3     Strong
Power systems: Voltage corrections may be required, false alarms triggered on some protection devices.
Spacecraft operations: Surface charging may occur on satellite components, drag may increase on low-Earth-orbit satellites, and corrections may be needed for orientation problems.

Other systems: Intermittent satellite navigation and low-frequency radio navigation problems may occur, HF radio may be intermittent, and aurora has been seen as low as Illinois and Oregon (typically 50° geomagnetic lat.).

Nothing terrible, but a reminder that far more severe space weather (G4=Severe, G5=Extreme) is not only possible, it is virtually guaranteed.  We know that, because it has happened before. A few of many examples include:
  • In 2012 the earth narrowly missed being hit by a massive solar storm, one that - had it been earth-directed - could have caused extensive damage to our electrical grid and electronic infrastructure (see NASA: The Solar Super Storm Of 2012). 
  • In 1989  an earth-directed storm caused a major power outage in Quebec, and in 2003, power stations in Europe were affected by another solar event (see NASA's The Day the Sun Brought Darkness)
  • A large Solar storm hit in May of 1967, knocking out radar and high frequency radio communications, and briefly had the U.S. military on alert thinking the USSR was jamming the airwaves (see How a 1967 Solar Storm Nearly Led to Nuclear War)
  • And the Granddaddy of them all, the 1859 Carrington Event,  which sparked electrical fires in telegraph offices, sparked auroras as far south as Cuba, and if repeated today would cause massive failures of the grid. 
 These disruptions are caused by sunspots, solar flares, and CMEs.
Solar flares are rated as either C Class (minor), M Class (Moderate), or X Class (extreme), and while the electromagnetic radiation they release can reach earth in only about 8 minutes time, their effects are mostly limited to disrupting communications and potentially damaging satellites.
A CME (Coronal Mass Ejection) is the ejection of a massive amount of plasma (electrons and protons & small quantities of helium, oxygen, and iron) from the the sun that may last for hours. Some of this plasma falls back into the sun, but trillions of tons can escape and if aimed in their direction, impact surrounding planets.

While they pose little direct physical danger to us on the earth’s surface (we are protected by the earths magnetic field and atmosphere), a large CME can wreak havoc with electronics, power generation, and radio communications
As we become more dependent upon sensitive electronic equipment (think power grid, internet, communications, etc.) these storms increasingly threaten both our economy and our society.
In 2013 Lloyds issued a risk assessment for the insurance industry called Solar storm Risk to the north American electric grid which calls another `Carrington’ class event inevitable, and the effects likely catastrophic, but the timing was unknowable.  Some of my other blogs on this threat include: 
The UK’s Space Weather Preparedness Strategy
Solar Storms, CMEs & FEMA
NASA Braces For Solar Disruptions
In 2015, in USGS: Preparing The Nation For Severe Space Weather, we saw the OSTP (Office of Science & Technology Policy) warn of the risks of severe space weather. They released enhanced preparedness plans to deal with a direct hit by a major CME, which was published in a White House blog called Enhancing National Preparedness to Space-Weather Events. 
Last October, in Executive Order: Coordinating Efforts to Prepare the Nation for Space Weather Events, we saw the White House's response to this threatdirecting the government to prepare for severe space weather.
The stakes are very high, as a direct hit by a G5 storm could take out large portions of the electrical grid for days, weeks, or even months.  In January of this year, the AGU's journal Space Weather published a study that attempted to quantify the costs of such an event.
Quantifying the daily economic impact of extreme space weather due to failure in electricity transmission infrastructure
Edward J. Oughton1,*, Andrew Skelton1, Richard B. Horne2, Alan W. P. Thomson3 and Charles T. Gaunt4
Version of Record online: 17 JAN 2017

The accompanying press release from the American Geophysical Union summarizes:
Extreme space weather-induced electricity blackouts could cost U.S. more than $40 billion daily

New study finds more than half the loss occurs outside the blackout zone

18 January 2017
Joint Release

WASHINGTON, DC — The daily U.S. economic cost from solar storm-induced electricity blackouts could be in the tens of billions of dollars, with more than half the loss from indirect costs outside the blackout zone, according to a new study.

Previous studies have focused on direct economic costs within the blackout zone, failing to take into account indirect domestic and international supply chain loss from extreme space weather.

“On average the direct economic cost incurred from disruption to electricity represents only 49 percent of the total potential macroeconomic cost,” says the paper published in Space Weather, a journal of the American Geophysical Union. The paper was co-authored by researchers from the Cambridge Centre for Risk Studies at University of Cambridge Judge Business School; British Antarctic Survey; British Geological Survey and University of Cape Town.

Under the study’s most extreme blackout scenario, affecting 66 percent of the U.S. population, the daily domestic economic loss could total $41.5 billion plus an additional $7 billion loss through the international supply chain.

(Continue . . . )

All of which leads up to a recent report by the USGS on the the potential impacts of a CME, and how they, and the nation, are preparing for it.  I've only included some excerpts, follow the link to read it in its entirety.

Preparing the Nation for Intense Space Weather
Such events can be hazardous to the economy and national security
Release Date: May 1, 2017

While major geomagnetic storms are rare, with only a few recorded per century, there is significant potential for large-scale impacts when they do occur. Extreme space weather can be viewed as hazards for the economy and national security.


When a large sunspot emerges, the likelihood of an abrupt emission of radiation and an intense solar wind becomes greater. When these winds reach the Earth, electrically charged particles enter the Earth’s magnetosphere, ionosphere, and interior, inducing a geomagnetic storm. The storm can interfere with utilities, infrastructure, and technologies essential to modern society, disrupting daily life, the economy, and national security.
Informing Utility Companies

The USGS monitors the Earth’s magnetic field at 14 ground-based observatories positioned across the United States and its territories. Scientists continuously monitor the geomagnetic field throughout the Nation and its territories, providing information on magnetic storm intensity. Some USGS observatories have operated continuously for over 100 years.

“USGS observatories help support infrastructure critical to keeping the electric grid running smoothly in crises,” Olson said.

Utility companies use recently published geoelectric hazard maps to assess the vulnerability of power-grid systems and mitigate the adverse effects of intense magnetic storms, which, Olson says, “have had a history of shutting down the electric grid.”

NERC recently released two reliability standards for utility companies: One requires North American utility companies to develop operating procedures for weathering potentially serious geomagnetic storms, and the other requires utilities to carefully assess their systems to ensure they are prepared for a magnetic storm.

“These standards are supported by historical, global data and real-time information from the USGS on forthcoming hazards so that electric utilities can be as prepared as possible,” Olson said.
         (Continue . . . )

While efforts are being made to harden the grid and our electronics infrastructure against severe space weather, for now at least, they remain extremely vulnerable.  
As a general rule I promote `all threats preparedness' - rather than planning for a specific event - but prolonged power outages are so often a big part of a wide range of disasters that being ready for one makes sense. 
While few of us can prepare for a months-long power outage - that envisions an absolute worst case scenario - which isn't the only (or even most likely) outcome.  As an added bonus, preparing for severe space weather will also help prepare us in the event of an EMP attack - or a cyber attack - on our electrical grid.

A more reasonable goal for most families would be the ability to deal with 10 days to two weeks without power.  A not-unheard of amount of time to restore power after a hurricane, blizzard, or earthquake.
So . . . if a disaster struck your region today, and the power went out, stores closed their doors, and water stopped flowing from your kitchen tap for the next 7 to 14 days  . . .  do you have: 
  • A battery operated NWS Emergency Radio to find out what was going on, and to get vital instructions from emergency officials?
  • A decent first-aid kit, so that you can treat injuries?
  • Enough non-perishable food and water on hand to feed and hydrate your family (including pets) for the duration?
  • A way to provide light (and in cold climates, heat) for your family without electricity?   And a way to cook?  And to do this safely?
  • A small supply of cash to use in case credit/debit machines are not working?
  • An emergency plan, including meeting places, emergency out-of-state contact numbers, a disaster buddy,  and in case you must evacuate, a bug-out bag?
  • Spare supply of essential prescription medicines that you or your family may need? 
If your answer is `no’, you have some work to do.  A good place to get started is by visiting

Sunday, May 28, 2017

Shaanxi Province Reports Large Poultry Die Off - H7N9 Suspected


Up until January of this year, and for the first four years of its existence, H7N9 has been exclusively a low pathogenic virus (in birds).  Unlike its HPAI H5 cousins, which are known to cause high mortality in poultry and some types of wild birds, LPAI H7N9 had produced few if any symptoms in poultry.
It was, however, extremely pathogenic in humans, and its ability to spread silently in poultry and other birds made it very difficult to track, with our first clue of an outbreak often coming only after humans in contact with birds fell ill. 
H5 and H7 LPAI viruses have the ability to mutate into HPAI viruses, and that is precisely what happened in January of this year in southern Guangdong Province, where at least three human infections, and several poultry outbreaks were caused by a newly emerged HPAI version of H7N9.

The big questions at the time were:
  • Just how `biologically fit' was this new HPAI variant?   
  • Would this virus spread via migratory birds beyond Guangdong Province?
  • How does it compare in human infectivity with the LPAI version?
Although there is still much we don't know about HPAI H7N9, slowly the answers to these questions have been emerging.  I say `slowly' because we don't know what we don't know.

After China announced two human infections with HPAI H7N9, and Taiwan announced one (imported) case, last January - we've heard of no additional human HPAI infections.
Either there haven't been any, or China simply isn't differentiating between LPAI and HPAI human infections in their reporting.
We have, however, continued to see reports of heavy poultry losses due to H7N9 - first in neighboring Hunan Province, then further north in April and May -  a pretty good sign that the HPAI version is spreading.
Some of these outbreaks have been confirmed as HPAI H7N9, while we await official word on others (see CHINA: HPAI H7N9 Expands Its Range).
As far as the biological `fitness' of the virus, three weeks ago in Eurosurveillance: Biological Characterisation Of (HPAI) A(H7N9) Viruses In Humans, we learned that  HPAI H7N9 virus retains the ability to infect both birds and humans, and in fact, appears to be potentially slightly more infectious in both than the LPAI version. The authors write:

Our data show that the HPAI H7N9 viruses retained dual receptor binding properties, with slightly increased binding preference for both receptors compared with LPAI H7N9 (AnH1) viruses. . . . .  The persisting preference for both avian- and human-type receptors of HPAI H7N9 viruses may result in their circulation in poultry and possible transmission among humans.

They also found that his HPAI H7N9 virus can quickly mutate into an antiviral resistant virus early during treatment.  This HPAI virus is also antigenically different from the older LPAI H7N9 virus, and so existing vaccines are unlikely to be effective.
On paper, at least, HPAI H7N9 looks very fit. 
It is not alone, of course.  It circulates concurrently across China with two distinct LPAI H7N9 lineages (Pearl River Delta and Yangtze River Delta), encompassing dozens of genotypes and variants, all of which are looking for an evolutionary advantage.  

And new genotypes and variants are formed practically on a daily bases.  Some will be evolutionary failures, while others may prove competitive enough to thrive. The point being, the H7N9 threat is constantly evolving. 

All of which brings us to one of many reports in the Chinese media this weekend of a very large and sudden die off in poultry in northern Shaanxi Province. Reportedly 22,000 birds died over a matter of a few days, and while test results are pending, H7N9 is suspected.

This (translated) report from Hong Kong's Oriental Daily

Shaanxi farm suspected H7 bird flu burst

WASHINGTON roundup both sides re-transmission of bird flu, Yuyang District, Yulin City, Shaanxi has a chicken farm suspected outbreak of H7 avian influenza, caused by a large number of chickens died.
Network file transfer Yulin City Animal Husbandry and Veterinary Bureau issued, referring to the local chicken farm located in the Green Cheung ecological cattle home town of the beam, since there are chickens on Sunday onset; as of last Thursday, a total of forty-five thousand chicken farm , there are more than twenty-two thousand chickens died; another report showed that chickens suspected of being infected H7 virus, authorities have sent samples of animal disease prevention and control center of the provincial tests and is awaiting test results.

Assuming this report - and last week's report from Tianjing - are confirmed as HPAI H7N9 (other HPAI viruses, including H5N6  and H5N8 are also possible), we'll have additional evidence that this HPAI virus is moving steadily north - likely carried by migratory birds.
Already, parts of Eastern Russia are on alert for the possible arrival this summer of H7N9 from China (see here), and other countries, from Vietnam to the south to Mongolia to the north are on watch as well.
While the good news remains that H7N9 (LPAI or HPAI) has yet to achieve the ability to spread easily from human-to-human, the virus continues to evolve, leaving many of the world's best bird flu experts seriously concerned (see NPR: A Pessimistic Guan Yi On H7N9's Evolution).

Saturday, May 27, 2017

CID Journal: Flu Vaccine Reduces Severe Outcomes in Hospitalized Patients


Although far from perfect, most years the seasonal flu vaccine provides a moderate level of protection against currently circulating influenza viruses. Much depends, however, on how close of a match the vaccine is to those viruses, and on the individual immune response of the recipient. 
Flu vaccines have provided reasonably good protection against H1N1 and Influenza B viruses in recent years  - often reaching  VE (Vaccine Effectiveness) Ratings 50%-60%.
The H3N2 vaccine component over the past few years has been problematic (see Eurosurveillance: Interim Estimates Of Flu Vaccine Effectiveness Against A(H3N2) - Canada, January 2017 and Branswell: H3N2 Remains the `Weak Link’ In The Flu Vaccine),  often providing only half that level of protection.

Although the elderly (> 65) are considered to be at greatest risk from influenza infection, they - by virtue of having a less robust immune system and more comorbidities - are also the group most apt to see reduced protection from the seasonal flu vaccine (see PLoS One: Limited Effectiveness Of Flu Vaccines In The Elderly & Flu Shots And The Elderly).
Which is not to say they don't derive benefits, just not as much as we'd like, considering their overall risks from influenza infection.

In 2011,  NFID - the National Foundation for Infectious Diseases - convened a group of experts to address the issues of influenza and the elderly. From that panel a 5-page brief  emerged, called: Understanding the Challenges and Opportunities in Protecting Older Adults from Influenza.

This report pointed out that although the elderly generally see less protection from the flu vaccine, older individuals may still mount a robust immune response. In populations 65 and older, the brief points out that:
  • Hospitalization rates for influenza and pneumonia are lower in community-dwelling adults who received the seasonal influenza vaccine.
  • Immunization is associated with reduced hospitalization of older patients for cardiac, respiratory, and cerebrovascular diseases.
While the goal of vaccinating the younger population is to prevent infection, the authors point out that:
  • . . . the goal in older adults is to prevent severe illness, including exacerbation of underlying conditions, hospitalization, and mortality. 
Since then, we've seen a good deal of research suggesting that even a little protection can mean a lot, particularly for those with elevated risk factors, like the elderly. In 2014, a study from the CDC: Flu Shots Reduce Hospitalizations In The Elderly, appeared to support those goals.

This past week, a new study in the journal Clinical Infectious Diseases suggests that even among those hospitalized with influenza, having been vaccinated is associated with less severe illness, lower mortality, and shorter hospitalization stays.

Influenza vaccination modifies disease severity among community-dwelling adults hospitalized with influenza
Carmen Sofia Arriola, DVM, PhD, Shikha Garg, MD , Evan J Anderson, MD , Patricia A Ryan, MS , Andrea George, MPH , Shelley M Zansky, PhD , Nancy Bennett, MD, MS , Arthur Reingold, MD , Marisa Bargsten, MPH , Lisa Miller, MD, MSPH

Clin Infect Dis cix468.
Published: 19 May 2017


We investigated the effect of influenza vaccination on disease severity in adults hospitalized with laboratory-confirmed influenza during 2013−14, a season in which vaccine viruses were antigenically similar to those circulating.

We analyzed data from the 2013−14 influenza season, and used propensity score matching to account for the probability of vaccination within age strata (18−49, 50−64 and ≥65 years). Death, intensive care unit (ICU) admission, and hospital and ICU lengths of stay (LOS) were outcome measures for severity. Multivariable logistic regression and competing risk models were used to compare disease severity between vaccinated and unvaccinated patients, adjusting for timing of antiviral treatment and time from illness onset to hospitalization.

Influenza vaccination was associated with a reduction in the odds of in-hospital death among patients aged 18−49 years (adjusted odds ratios [aOR] =0.21; 95% confidence interval [CI], 0.05 to 0.97), 50–64 years (aOR=0.48; 95% CI, 0.24 to 0.97), and ≥65 years (aOR=0.39; 95% CI, 0.17 to 0.66). Vaccination also reduced ICU admission among patients aged 18−49 years (aOR=0.63; 95% CI, 0.42 to 0.93) and ≥65 years (aOR=0.63; 95% CI, 0.48 to 0.81), and shortened ICU LOS among those 50−64 years (adjusted relative hazards [aRH]=1.36; 95% CI, 1.06 to 1.74) and ≥65 years (aRH=1.34; 95% CI, 1.06 to 1.73), and hospital LOS among 50−64 years (aRH=1.13; 95% CI, 1.02 to 1.26) and ≥65 years (aRH=1.24; 95% CI, 1.13 to 1.37).

Influenza vaccination during 2013−14 influenza season attenuated adverse outcome among adults that were hospitalized with laboratory-confirmed influenza.
  The CDC published a summary of these results yesterday:

 New CDC Study Shows Flu Vaccine Reduces Severe Outcomes in Hospitalized Patients

 May 25, 2017 – A new study in the journal Clinical Infectious Diseases (CID) showed that flu vaccination reduced deaths, intensive care unit (ICU) admissions, ICU length of stay, and overall duration of hospitalization among hospitalized flu patients. This study is an important first step in better understanding whether flu vaccines can reduce severe flu outcomes even if they fail to protect against infection.

The study looked at hospitalized flu patients during 2013-2014 and compared patients who had been vaccinated to those who had not. The observed benefits were greatest among people 65 years of age and older, which is notable because people in this age group are at increased risk of serious flu complications and have the highest hospitalization rate among all age groups.

The study found that vaccinated adults were 52-79% less likely to die than unvaccinated flu-hospitalized patients. In other words, an unvaccinated hospitalized flu patient was 2 to 5 times more likely to die than someone who had been vaccinated.
(Continue . . . )

While influenza is hardly a trivial illness, for those of us over a certain (ahem) age, influenza increasingly becomes a threat to life. Just 10 days ago, in Int. Med. J.: Triggering Of Acute M.I. By Respiratory Infection, we saw additional evidence that a variety of respiratory infections - including influenza - can trigger heart attacks in the elderly.

While it doesn't protect against all respiratory infections - two years ago, in UNSW: Flu Vaccine Provides Significant Protection Against Heart Attacks, we saw a study that found that if you are over 50 - getting the flu vaccine can cut your risk of a heart attack by up to 45%
Which is one of the big reasons why I elect to get the vaccine every year (see  #NatlPrep: Giving Preparedness A Shot In The Arm).

While no drug or vaccine can claim to be 100% safe or benign, flu vaccines are among the safest drugs available - and given the mounting evidence influenza's toll - the rewards for me far exceed the risks.

Hopefully - after considering the pros and cons - they will for you, too.

A Reminder About Naegleria Season


The Memorial Day Weekend traditionally signals the start of the long awaited summer swimming season - but with that comes risks - including the dangers of rip currents (see How Not To Be Swept Away This Summer), potentially serious salt water skin infections (see Vulnerable To Vibrio), and an extraordinarily rare, but often fatal, brain infection from an amoebic parasite called Naegleria fowleri
Dubbed the `brain eating amoeba' by the press - this infection is called PAM (Primary amebic meningoencephalitis) - and occurs when the amoeba enters the brain through the nasal passages, usually due to the forceful aspiration of contaminated water into the nose.  
Until a few years ago, nearly all of the Naegleria infections reported in the United States were linked to swimming in warm, stagnant freshwater ponds and lakes (see Naegleria: Rare, 99% Fatal & Preventable), making this pretty much a summer time threat.

In 2011, however,  we saw two cases reported in Neti pot users from Louisiana, prompting the Louisiana Health Department to recommend that people `use distilled, sterile or previously boiled water to make up the irrigation solution’ (see Neti Pots & Naegleria Fowleri).

While extraordinarily rare in the United States, every year Pakistan reports a dozen or more infections from this `killer amoeba’, as chlorination of their water supplies is often inadequate, and for many, nasal ablutions are part of their daily ritual. 

Last year we looked at an MMWR: Epidemiological Investigation Into A Case Of Primary Amebic Meningoencephalitis  in California which suggested a poorly chlorinated spring-fed swimming pool was the likely source of infection and death of a 21 year old woman.  
This was also an unusual finding, and furthers the recent pattern of seeing PAM cases arise from atypical settings (Northern states, via neti pots and municipal water supplies, etc.) in the United States.
Up until a recently, infection with Naegleria fowleri was universally fatal, but in 2013 an investigational drug called miltefosine was used successfully for the first time to treat the infection.  Early diagnosis, and administration of this drug, are crucial however.

Even with this new drug, prevention is the key to saving lives, and leading the charge in educating the public is, a USF Philip T. Gompf Memorial Fund project, which was set up by a pair of Florida doctors who tragically lost their 10 year-old son to this parasite in 2009.  

As a thermophilic (heat-loving), free-living amoeba, it is hardly surprising to see that Florida and Texas lead the nation in cases over the past three decades, although infections have occurred as far north as Minnesota. 

Credit Florida DOH
The State of Florida's Primary Amebic Meningoencephalitis (PAM) website recommends:
The only known way to prevent Naegleria fowleri infections is to refrain from water-related activities. However, some common-sense measures that might reduce risk by limiting the chance of contaminated water going up the nose include:
  • Avoiding water-related activities in bodies of warm freshwater, hot springs, and thermally-polluted water such as water around power plants.
  • Avoiding water-related activities in warm freshwater during periods of high water temperature and low water levels.
  • Holding the nose shut or using nose clips when taking part in water-related activities in bodies of warm freshwater such as lakes, rivers, or hot springs. 
  • Avoiding digging or stirring up sediment while taking part in water-related activities in shallow, warm freshwater areas. 
Recreational water users should assume that there is always a low-level of risk associated with entering all warm fresh water in southern tier states. Because the location and number of ameba in the water can vary a lot over time, posting signs is unlikely to be an effective way to prevent infections. In addition, posting signs on only some fresh water bodies might create a misconception that bodies of water that are not posted are Naegleria-free.
Information about the risks associated with Naegleria fowleri infection should be included in public health messages discussing general issues of recreational water safety and risk.
When preparing solutions of tap water for sinus irrigation, the user should use tap water previously boiled for 1 minute (at elevations above 6,500 feet, boil for 3 minutes) and left to cool, use water filtered with an absolute filter pore size of 1 micron or smaller, or use clearly marked distilled or sterile water in the irrigation device. Rinse the irrigation device after each use with water that has been previously boiled, filtered, distilled, or sterilized and leave the device open to air dry completely.
For some of my earlier blogs on Naegleria you may wish to revisit:

A Reminder About Naegleria
Reminder: COCA Call Today On Naegleria Fowleri & Cryptosporidium
MMWR: CDC Imports Investigational Drug For Amoebic Infections

Friday, May 26, 2017

Rosselkhoznadzor: Avian Flu Outbreaks In Udmurt Republic - Russia

Udmurt Republic - Credit Wikipedia


For the past month we've been following two different, but connected, HPAI H5N8 bird flu stories out of Russia.  

While HPAI H5N8 is considered to present a very low human health risk, there are concerns that bird flu contaminated products might help spread the virus to poultry in currently unaffected regions.
A week ago, we learned about the detection of infected poultry products in the Kirov Region and the Udmurt Republic.
While it may or may not be related to the spread of contaminated food products, today the Udmurt Republic is reporting outbreaks of avian flu on two private farms in Malopurginskiy area.

Bird flu has reached the Udmurt Republic

May 25, 2017 in Malopurginskiy area of ​​the Udmurt Republic in two private farms registered avian influenza type A. In the study in the Udmurt veterinary diagnostic center in Izhevsk pathological material from dead birds isolated the genetic material of the virus of influenza A. To confirm the diagnosis and typing of the 05/25/2017 virus material sent to the State Organization "ARRIAH" in Vladimir. 

State Veterinary Service of the Republic of Udmurtia measures are taken in accordance with the Order of the Ministry of Agriculture of 27.03.2006 number 90 "On approval of rules for combating avian influenza." 

We kindly ask the population to adhere to the following rules:
- Avoid contact of poultry with wild and synanthropic birds: to provide watering of birds, preventing them to open bodies of water; provide under confinement birds build fences mesh with awnings; prohibited catch wild waterfowl for the content of individual farms; not to carry out evisceration of game hunting in the territory of households and not to feed the waste pet; isolated storage to provide feed indoors; organize isolated storage equipment for care of poultry, keep it clean; produce timely cleaning yards and paddocks of debris and bird waste products; to carry out feeding birds in the area.
- Ensure the separation of the different species of birds.
- Acquire the young birds and hatching eggs from safe sources, refraining from buying live birds at markets and trade in unauthorized places.
- Do not allow unauthorized persons to domestic poultry.
- Avoid eating and feeding of animals in suspect poultry disease.
- Use feathers in life after the heat treatment (scalding).
- Daily inspect all the birds in the yard.
- Prepare stock disinfectants (chloramine, bleach) and to disinfect poultry houses and equipment after their complete purification.
- Provide disinfection manure and litter by incineration or biothermal method.
- Observe good personal hygiene: care for the bird to carry out in special clothing, wash hands with soap and water after leaving, evisceration with gloves, etc.
- At the first signs of the disease and the anomalous behavior of the birds, and in case of sudden mass death should immediately contact the local veterinary service to identify the causes of the disease and to prevent epizootic.
Remember that mortality in poultry bird flu can reach 100%.

While avian flu reports continue to dwindle in Western Europe, we've now seen reports of HPAI H5 outbreaks in poultry from at least 10 regions of Russia over the past 30 days.
If that weren't concerning enough, Russia is also watching the northward drift of H7N9 in China - recently reported in poultry in Inner Mongolia - as a threat to their southern border (see China MOA: Suspected HPAI H7N9 Outbreak In Tianjin).
And it isn't lost on the rest of the world - but particularly in Europe - that the changes to the H5N8 virus that made it more virulent in birds this past winter, appear to have occurred over last summer in migratory birds in Russia,China, and Mongolia (see EID Journal: Reassorted HPAI H5N8 Clade - Germany 2016).

All of which means that increased bird flu activity across these same regions again this summer is far from a welcome sign.