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H1N1 Swine Flu Now In
Birds...Turkeys In Chile

From Patricia Doyle, PhD
Hello Jeff - This just gets crazier and crazier. This is definitely a good set-up for A-H1N1 to meet and join H5N1.  
So, it now appears that H1N1 Swine Flu aka Pandemic Flu is being found in Turkeys. We know that H5N1 also is found in turkeys. Let's hope that the two viruses don't meet and recombine into a disaster. H5N1 brings to the table an ability to kill easily, and H1N1 brings to the table an ability to spread rapidly, person-to-person.
Preliminary genetic study of 1st transmission of A(H1N1) 2009 virus from human to birds.
During this week, Chile communicated to WHO the 1st isolation of A(H1N1) swine flu virus in turkeys. The finding was done by the Chilean farming agency SAG.
The 1st case in Chile of human A(H1N1) 2009 infection was confirmed by the Institute of Public Health (national reference laboratory) on 17 May 2009; from then on, we have reached a total of 12 175 laboratory confirmed cases with 116 deaths.
Two days ago, the Institute of Public Health confirmed the virus finding in 2 private turkey plants in Valparaiso (Chile). These turkeys were not for consumption but for production of eggs. As with pigs, there is no risk to people from meat consumption. This situation was detected only because of behavior changes and lower egg production. There is no record of previous infection in workers of these 2 farms (3 countries had previously detected A(H1N1) 2009 virus transmission from humans to pigs).
Yesterday [22 Aug 2009], the Institute of Public Health (ISP) analyzed the genetic and antigenic characteristics of the hemmaglutinin (HA) gene of the viruses of the turkeys in the outbreak. These strains showed 99.5 to 98.9 percent similarity in nucleotides and amino acids to the A/California/4/2009 strain. At the same time, they were 100 percent similar in nucleotides and amino acids to the strains circulating in Chile in human cases. This week, we will analyze the complete genome, and we will send the results to ProMED.
Our point is that for the 1st time, it has been proven that transmission of the new virus from humans to birds has occurred. This is a concern vis a vis the possibility that this may happen in Asia or Africa under conditions of co-infection with H5N1 virus.
-- Julio Garcia Moreno MD, MSc. Head, Biomedical Department Instituto de Salud Publica de Chile <mailto:jgarcia@ispch.cl>jgarcia@ispch.cl
[2] OIE Report On Outbreak In Chile Turkey Farms Date: 21 Aug 2009 Source: OIE WAHID Disease Information 2009; 22(35) [edited] http://www.oie.int/wahis/reports/en_imm_0000008389_20090821_200818.pdf
Influenza A H1N1, Chile
Information received on 21 Aug 2009 from Dr Ternicier Claudio, Jefe Division Proteccion Pecuaria, Servicio Agricola y Ganadero, Ministerio de Agricultura, Santiago, Chile
Summary Report type: Immediate notification Start date 23 Jul 2009 Date of 1st confirmation of the event 20 Aug 2009 Report date 21 Aug 2009 Date submitted to OIE 21 Aug 2009 Reason for notification: Emerging disease
Morbidity 61.4 percent Mortality 0 percent Zoonotic impact: No Causal agent: Influenza A Virus This event pertains to the whole country
New outbreaks Summary of outbreaks - Total outbreaks: 2
Valparaiso (Las Palmas, Quilpue, Valparaiso; Pucalan, Quillota, Nogales)
Species Birds Susceptible 29 782 Cases 24 337 Deaths 0 Destroyed 0 Slaughtered 0
Affected Population: The birds are breeding turkeys which presented a drop from 70 percent to an average of 31 percent and a reduction in the quality of the shell. Neither respiratory signs nor increased mortality were observed. Necroscopy of the affected birds showed salpingitis, peritonitis and an interruption of follicular development. No other lesions were observed. Samples of embryonated eggs collected from the incubation building gave negative results with real time PCR. 20 days after the beginning of the event, a recovery in the laying rate was observed.
Outbreak 2 (Foco 2) Pucalan, Quillota, Nogales, Valparaiso
Date of start of the outbreak 29 Jul 2009 Outbreak status Continuing (or date resolved not provided) Epidemiological unit: Farm
Species Birds Susceptible 29 772 Cases 12 248 Deaths 0 Destroyed 0 Slaughtered 0
Affected Population The birds are breeding turkeys showing an abnormal decrease in laying rate. Neither respiratory signs nor increased mortality were observed.
Summary of outbreaks: Total outbreaks: 2 Outbreak statistics Species: Birds Susceptible 59 554 Cases 36 585 Deaths 0 Destroyed 0 Slaughtered 0
Species Birds Apparent morbidity rate 61.43 percent Apparent mortality rate 0.00 percent Apparent case fatality rate 0.00 percent Proportion susceptible animals lost* 0.00 percent * Removed from the susceptible population through death, destruction and/or slaughter
Epidemiology: Source of the outbreak(s) or origin of infection - Unknown or inconclusive.
Epidemiological comments: The affected farms are turkey breeding premises belonging to the same company, vertically integrated, where appropriate biosecurity measures are applied.
Outbreak no. 1 is composed of 5 breeding premises. The outbreak started in premises no. 1 and through horizontal transmission, it reached 3 other premises.
In the outbreak n. 2 of 5 existing sectors are affected [the meaning of this is unclear. Perhaps: "In outbreak no. 2, 2 of 5 existing sectors are affected" - Mod.LM]
Prior to the appearance of clinical signs, some birds were exposed to people showing respiratory symptoms.
The affected premises were systematically monitored through serological testing with negative results until 28 Jul 2009. Serotyping allowed exclusion of the presence of H5 and H7 viruses and allowed confirmation of the detection of A/H1N1 2009 pandemic influenza virus 2009.
Samples were sent to the Public Health Institute of Chile (ISP), Ministry of Health. The ISP confirmed the presence of A/H1N1 2009 pandemic influenza virus 2009 using real time PCR. The RT-PCR for seasonal H1 and H3 influenza gave a negative result. Samples will be sent to the OIE Reference Laboratory.
Control measures - Measures applied: Quarantine, Screening, Disinfection of infected premises/establishment(s), Vaccination prohibited, No treatment of affected animals.
Measures to be applied - No other measures
Laboratory name and type: Public Health Institute (National laboratory) Species Birds Test real-time PCR Test date 20 Aug 2009 Result Positive
Species Birds Test virus sequencing Test date 21 Aug 2009 Result Positive
Laboratory name and type: Quarantine Station and Lo Aguirre Laboratory (National laboratory) Species Birds Test agar-gel immunodiffusion (AGID) Test date 15 Aug 2009 Result Positive
Species Birds Test antibody detection ELISA Test date 14 Aug 2009 Result Positive
Species Birds Test haemagglutination inhibition test (HIT) Test date 19 Aug 2009 Result Positive
Species Birds Test neuraminidase inhibition assay Test date 19 Aug 2009 Result Positive
Future Reporting The event is continuing. Weekly follow-up reports will be submitted.
-- Communicated by several ProMED readers
The 2 reports taken together advance, to some degree, our knowledge of H1N1 pandemic potential. Dr. Julio Garcia has most kindly provided us with preliminary analysis indicating that the virus that infected the birds is indeed the current novel, pandemic strain of H1N1. ProMED-mail is very appreciative of Dr. Garcia and the Public Health Institute of Chile's quick communication, underscoring a central tenet of ProMED-mail, that rapid sharing of information among the world's emerging disease specialists is one of the most valuable assets in combating the current or any pandemic emerging disease.
The 2nd important pieces of new information are quantitative details on the magnitude of production losses, which then appear to be the main clinical finding, as neither respiratory signs nor mortality were observed. However, post mortem lesions affecting the reproductive tract were observed as well. While the production losses were striking, and the morbidity was greater than 50 percent, the effect on the grandparent stock only lasted for some 20 days or so before they appeared to recover, according to the OIE report. Obviously, the associated economic losses will be significant; further details from knowledgeable individuals in agriculture would be appreciated.
Two clues are revealed as we learn more about this unusual event in Chile. 1st, the current pandemic strain continues to be, as Jim Steele would say, adventurous, by moving from humans into turkeys. Secondly, the H1N1 pandemic virus has not been highly lethal when it comes out of humans and infects farm animals, since neither swine in Canada nor turkeys in Chile have exhibited a high mortality rate comparable to the devastation in farms experiencing H5N1. Overall, this event should serve as a warning to agricultural and public health sectors to prepare well for the fall [2009], as the current pandemic influenza virus is active in its ability to spread across species.
Finally, Dr. Garcia Moreno's comments about co-circulation of this virus with H5N1 are insightful, given that we now have further evidence that this particular H1N1 virus can move into animal populations without too much clinical disturbance in animal populations. Therefore, crossing the species appears to occur in a somewhat unobtrusive and, therefore, potentially unobserved fashion in some parts of the world. This observation should serve to alert animal health officials in Africa and Asia, where H5N1 control and surveillance efforts should be intensified. It also underscores the value of all the hard work in controlling H5N1 done by countries like Nigeria or by long standing global control programs, which were established in 2005. The payoff for these programs happens every time an H1N1-infected human steps onto a poultry farm which could have been harboring H5N1 if not for the effectiveness of the "on the ground" control program efforts developed by dedicated local, state, national and international teams.
Valparaiso and Santiago, in central Chile, can be located on the HealthMap/ProMED-mail interactive map at http://healthmap.org/r/00It. - Mod.PC
Patricia A. Doyle DVM, PhD Bus Admin, Tropical Agricultural Economics Univ of West Indies Please visit my "Emerging Diseases" message board at: http://www.emergingdisease.org/phpbb/index.php Also my new website: http://drpdoyle.tripod.com/ Zhan le Devlesa tai sastimasa Go with God and in Good Health 
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