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fredag 28 juli 2023

Globaali lintuinfluenssatilanne OIE-WAHIS lähteessä WOAH

 https://www.woah.org/app/uploads/2023/07/hpai-situation-report-20230721.pdf

 HIGH PATHOG ENICITY AVIAN INFLUENZA (HPAI) – SITUATION REPORT 21/07/2023
1 Situation report period covered: 23 June to 13 July 2023
This report provides an update of the high pathogenicity avian influenza (HPAI) situation, according to the information submitted through the World Animal Health Information System of the World Organisation for Animal Health (WAHIS) between 23 June and 13 July 2023.


Seasonal trend
Using data reported to the World Organisation for Animal Health (WOAH) between 2005 and 2019 by 76 affected countries and territories for 18,620 outbreaks in poultry, we carried out a Seasonal and Trend decomposition using Loess (STL) analysis to determine the seasonal pattern of the disease (detailed methodology presented in Awada et al., 20181). Based on the data reported to WOAH, spread is lowest in September, begins to rise in October, and peaks in February. Figure 1 shows the global seasonal pattern of HPAI in poultry and the red rectangle indicates where we currently are in the cycle based on the period covered in “recent updates” below.

 HIGH PATHOGENICITY AVIAN INFLUENZA (HPAI) – SITUATION REPORT 21/07/2023
2

  • On-going events for which there were new reported outbreaks, by world region (reported through follow-up reports):

Europe
Subtype H5N1
United Kingdom, 

  • Africa, Americas, Asia, and Oceania

No new outbreaks reported in the on-going events, or no on-going events.


  • New outbreaks and associated subtypes

During the period covered by this report, a total of five new outbreaks in poultry were reported by five countries (Denmark, Germany, Poland, Sweden and United Kingdom). Details are presented in Figures 2 and 3.

HIGH PATHOG ENICITY AVIAN INFLUENZA (HPAI) – SITUATION REPORT 21/07/2023
3

 Events which started before the 3-week period but were reported during the 3-week period (reported through immediate notifications)


Africa
H5N1
The occurrence of H5N1 clade 2.3.4.4b - Lineage: Reassortment Eurasian and North American in the area of Maritime in Togo started on 21 June 2023 (new strain in the area)
H7
The occurrence of H7 in South Africa (Mpumalanga) started on 29 May 2023 (new strain in the country)


Asia
H5N6
The recurrence of H5N6 in Philippines (Nueva Ecija) started on 4 January 2023
Americas, Europe, and Oceania
No events reported

HPAI in non-poultry ( Siis ei  siipikarjan puolella vaan luonnon linnuissa)

  • New events by world region (reported through immediate notifications)

Africa,  Americas, Asia, Europe and Oceania
No new events reported.

  • On-going events for which there were new reported outbreaks, by world region (reported through follow-up reports):
Americas
H5N1 in non-poultry birds
Brazil

Europe
H5 in non-poultry birds
Belgium, Norway

Europe
H5N1 in non-poultry birds
Belgium, Finland, Germany, Hungary, Ireland, Italy, Latvia, Lithuania, Poland, Russia, Spain, Sweden, United Kingdom
  • Africa, Asia, and Oceania

No new outbreaks reported in the on-going events, or no on-going events.


  • New outbreaks (Tarkkaa tätä !)

During the period covered by this report, a total of 100 outbreaks in non-poultry birds were reported by 15 countries
(Belgium, Brazil, Finland, Germany, Hungary, Ireland, Italy, Latvia, Lithuania, Norway, Poland, Russia, Spain, Sweden,
United Kingdom). Details are presented in Figures 4 and 5.

 

 HIGH PATHOG ENICITY AVIAN INFLUENZA (HPAI) – SITUATION REPORT 21/07/20

 (sivulla 4 on KARTTA: MAP! page 4)

HIGH PATHOG ENICITY AVIAN INFLUENZA (HPAI) – SITUATION REPORT 21/07/2023
(4)
Figure 4. Distribution of HPAI new outbreaks in non-poultry animals, and corresponding subtypes.
Figure 5. Number of new outbreaks by geographical region

  • Events which started before the 3-week period but were reported during the 3-week period (reported through immediate notifications or through emails)
Europe
H5N1 in non-poultry birds
A recurrence started in Sweden (Enköping, Karlshamn, Mörbylånga, Uppsala, Uppsala, Växjö) on 12 February 2023
 H5N1 in mammals (Puolan kissat!)
National authorities of Poland informed WOAH of unusual mortalities in felids associated with H5N1 in different areas of the country. As of 12 July, 28 dead cats and 1 dead caracal tested positive for H5N1. Molecular analyses suggest infection from similar or common sources (under investigation). These analyses also showed mutations of the virus that increase its adaptation to mammals (see report).

Africa, Americas, Asia, and Oceania

No events reported

 HIGH PATHOG ENICITY AVIAN INFLUENZA (HPAI) – SITUATION REPORT 21/07/2023
(page5)

Epidemiological background

High pathogenicity avian influenza (HPAI) is caused by influenza A viruses in the family Orthomyxoviridae. Since its identification in China (People’s Rep. of) in 1996, there have been multiple waves of intercontinental transmission of the H5Nx Gs/GD lineage virus. 
HPAI has resulted in the death and mass slaughter of more than 316 million poultry
worldwide between 2005 and 2021, with peaks in 2021, 2020 and 2016. During each of the years 2006, 2016, 2017 and 2021, more than 50 countries and territories in the world were affected with HPAI. In addition, up to now, humans have occasionally been infected with subtypes H5N1 (around 870 cases reported, of which half died), H7N9 (around 1,500 cases reported, of which about 600 died), H5N6 (around 80 cases reported, of which about 30 died), H9N2 (around 80 cases reported, of which 2 died) and sporadic cases have been reported with subtypes H3N8, H7N4, H7N7 and H10N3  

Key messages

The current HPAI epidemic season continues with 5 outbreaks being reported in poultry and 100 in non-poultry birds over the 3 weeks covered by the report, mainly in Europe, and also in the Americas (Brazil). About 17,000 poultry birds died or were culled worldwide during the 3 weeks period. Based on the previous HPAI seasonal patterns, the number of outbreaks in animals is expected to have passed the peak and decline. This is what we are seeing for poultry worldwide, with very low figures for the 3 weeks covered by the report, while some new outbreaks continue to be detected in non-poultry birds, sometimes causing high mortality, such as the large mortality event among wild birds of the Laridae family reported in Russia (Udmurt), with 916 dead birds detected in a single outbreak (see event).


WOAH recommends that countries maintain their surveillance efforts, biosecurity measures at farm level, and continue timely reporting of avian influenza outbreaks in both poultry and non-poultry species.
WOAH also stresses the importance of reporting outbreaks of avian influenza in unusual hosts, as the virus has been increasingly detected in mammals in recent months, a situation that should be monitored.
Deaths in felids associated with HPAI H5N1 in Poland are of high interest to the intersectoral international community.

On 16 July 2023, the World Health Organization (WHO) commented that human A(H5N1) infections following contact with an infected cat had not been documented and that the risk of human infections following exposure to infected cats at the national level in Poland was assessed as low for the general population, and low to moderate for cat owners and those occupationally exposed to A(H5N1)-infected cats (such as veterinarians) without the use of appropriate personal protective equipment (PPE). Find out more in WOAH's recently published Q&A on avian influenza cases in cats.
High quality of information is key to support early detection and rapid response to potential threats to both animal and public health.


Recent news
- OFFLU’s annual report: tackling animal influenza through data sharing
- WOAH’s Animal Health Forum reshapes avian influenza prevention and control strategies
- WOAH Statement on avian influenza and mammals
- OFFLU statement: Infections with Avian Influenza A(H5N1) virus in cats in Poland
WOAH resources
- Avian influenza portal
- Self-declared disease status
- World Animal Health Information System (WAHIS)
- Q & A: Avian influenza in cats
- Animal Health Forum on avian influenza : policy to action: The case of avian influenza – reflections for change
- Strategic challenges in the global control of high pathogenicity avian influenza
- Resolution adopted in WOAH General Session 2023: Strategic challenges in the global control of HPAI
- Preliminary FAO/WHO/WOAH Joint Rapid Risk Assessment - Human infection with influenza A(H5N1), Cambodia (2023)
- One health Joint plan of action (2022 – 2026)


HIGH PATHOGENICITY AVIAN INFLUENZA (HPAI) – SITUATION REPORT 21/07/2023
(6)
- The first meeting of the Standing Group of Experts on HPAI for Europe, May 2023
- Technical meeting on HPAI vaccination, GF-TAD Americas, March 2023

Awareness tools
- Avian influenza: understanding new dynamics to better combat the disease
- Avian influenza: why strong public policies are vital
- Video: Avian influenza threatens wild birds across the globe
Press inquiries: media at woah.org

OFFLU resources
- OFFLU annual report 2022
- OFFLU Statement on high pathogenicity avian influenza caused by viruses of the H5N1 subtype
- OFFLU avian influenza matching (AIM) pilot study
- OFFLU avian influenza VCM report for WHO vaccine composition meetings (February 2023)


Other relevant resources
- WHO, Human infection with avian influenza A(H5) viruses
- Epidemiological Alert Outbreaks of avian influenza and human infection caused by influenza A(H5) public health
implications in the Region of the Americas
- WHO, Influenza at the human-animal interface, Summary and risk assessment, from 4 March to 24 April 2023


Muistiin  virusblogiin 28.7. 2023. Suomen valtiollinen taso on  tehnyt ensimmäisen  informaatiokokouksen medialle  tästä asiasta eilen.

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Ruokavirastomme Lintuinfluenssaa koskevat linkit

 

Ajankohtaista lintuinfluenssasta 

(Mainittu nimeltä: Larus  ridibundus, Skrattmås,  Haettemåge,Black-headed Gull, Lachmöwe, Fransaterna , fäärin kielellä)
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Lokkilinnut Laridae merkityksestä lintuinfluenssavirus reservoaarina?

Lokkilinnuissa (LARUS sp. LARIDAE)  on LPAIV  muuttunut  neljän viime vuoden aikana HPAIV  lintuflunssamuotoon muotoon ja H5Nx lintuviruksia  on niissä esiintynyt ja ne toimivat ilmeisesti  luonnollisena säiliönä  lintuinfluenssaviruksille. https://www.biorxiv.org/content/10.1101/2023.02.17.528990v1.full.pdf 

 

Discussion

During the 2020-2021 and 2021-2022 outbreaks of high pathogenicity avian influenza in the UK, there has been an increased detection of HPAIV H5N1 in seabirds of the Orders Suliformes (Suulalinnut, sulor,Sulidae)  and Laridae (Lokkilinnut, måsar, trutar)) . 3,6,16,34 This investigation of naturally acquired infection revealed that gross pathology was limited to pancreatic necrosis in the herring gull (Larus argentus,Harmaalokki, Gråtrut, Soelvmåge, Silbermöwe ) and proventricular ulceration in the great skua (.Stercorarius skua, Isokihu, Storlabben, Storkjove Grosse Raubmöve)) The pancreatic changes were less characteristic compared to that in Galliformes  ( Domestic fowls, Kanalinnut, Hönsfåglar,Hoensefugle)  and Anseriformes ( Sorsalinnut, Andfåglar, Andefugle, Gooselike fowls),  and required immunohistochemical confirmation. Microscopic evaluation confirmed a multi-systemic HPAIV infection including neuro-, cardio, and pneumo-tropism, which may have been contributary to the mortalities seen. In addition, acute reproductive damage in female great skuas’ (Stercorarius skua,) was noted. Overall, seabirds (merilinnut,  sjöfåglar, havfugle) are highly susceptible t odeveloping pathologies in multiple organ systems following HPAIV infection.

Historically, gull species ( LARUS species, lokkilajit, måsar och trutar, måger och tore måger, gulls)  from the Order Laridae have been associated with infection with LPAIV including H11, H13 and H16 subtypes. These infections have been predominantly associated with replication in epithelial cells of intestine that has been hypothesised to facilitate faecal-oral transmission in black headed gulls (Larus ridibundus, Naurulokki,  Skrattmås, Häettemåge, Lachmöwe) .   For HPAIV, natural infection has been reported in great skuas (Stercorarius skua) , European herring gulls (Larus argentatus,), black-headed gulls (Larus ridibundus) , and great black-backed gulls (Larus marinus, Merilokki, Havstruten, Svartbag, Mantelmöwe)

 The most common and severe pathology in all birds examined was pancreatic necrosis associated with viral infection (except for in the black-headed gull (L.ridibundus) where the pancreas was unavailable), followed by splenic necrosis and pneumonia (except in the long tailed skua, Stercorarius longicaudus, Tunturikihu,Fjällabb,  ). Such lesions are like those reported from experimentally challenged common gulls (Larus canus, Kalalokki, Fiskmås,  Stormmåge, Sturmmöwe) (with H5N1, plus naturally infected black headed gulls (L.ridibundus)  and herring gulls (L. argentatus) , together with a recent report of naturally infected sandwich terns (Thalasseus sandvicensis);(  Riuttatiira, Kentsk tärna, Sterna sandvicensis?) .  Although RT-PCR was not conducted on  tissues from the current investigation, the abundance of virus antigens in the heart, brain, kidney, spleen, lung, pancreas, and liver strongly suggests the utility of these organs for diagnostic evaluation. It has been proposed that the enterotropic adaptation of HPAIV in wild waterbirds ( villit vesilinnut) has facilitated long term persistence and dissemination in these species with virus  being maintained in stable equilibrium without undue pathological impact on the  host. 10,11

 In this report, we noted higher level of immunolabelling in the trachea, proventriculus, gizzard and duodenum in the great skua, and additionally antigens detected in the respiratory and enteric epithelium, which were generally absent in the previous GB epizootic in great skua in 2021.

 Similar respiratory and enterotropism was observed in the long tailed skua, herring gull and black-headed gull in this study. The nasal turbinates were only examined in the herring gull which showed viral associated rhinitis and epitheliotropism. Previously, infection of the intestine had only been observed rarely with H5N1 clade 2.2 viruses in common gulls 23 and a laughing
gull  (Leucopheus atricilla,Larus atricilla,   Naurulokki  P.Amerikassa, Lattermåge) infected with an ‘Eurasian-lineage’ of H5N1.

 Avian influenza viruses preferentially bind the α-2,3 sialic acid residues. 13

 Based on lectin histochemistry on other gull species including  American herring gulls (Larus smithsonianus), laughing gulls (Leucophaeus atricilla, Laridae ) and (Larus delawarensis), the respiratory epithelium express both α-2,3 and α-2,6 sialic acids, whereas the intestinal tracts express predominantly α-2,3 and rarely α-2,6 sialic acids.
The pathway of incursion in free-ranging seabirds is not understood but has been proposed to be either independent incursion or onward introductions from species movements between colonies and the movement of seabirds between mainland and islands particularly during the breeding season.   Herring gull and great skua can opportunistically predate or scavenge on other birds  and this was observe in the outbreak in gannet colonies. Further, contact transmission between common
gulls (Larus canus) and European herring gulls  have been documented previously with experimental infection with HPAIV H5N1 clade 2.2 and H5N8 clade 2.3.4.4b. 23,46

More recent HPAIV H5N1 outbreaks (June and August 2022) in wild bird (villilinnut) rescue centres / hospitals in England (East Sussex and Cornwall) have been confirmed in herring gulls. After epidemiological assessment, the most likely source of infection appeared to be the introduction within the premises of infected / diseased herring  gulls which had then transmitted the disease to the resident gulls of the same species within and among enclosures (APHA, unpublished data). It is not uncommon for skuas (KIHUT, labbar)  or gulls (LOKIT, måsar och trutar, måger)  to congregate in high densities during the breeding season for nesting, feeding and bathing facilitate close contact. These behaviors could facilitate dissemination of HPAIV especially if virus replication is prominent in respiratory and intestinal tracts.   Infections through such contact can lead to birds from other colonies becoming exposed and infected, which then themselves spread virus to new localities and susceptible avian species. Further, these seabirds  (MERILINNUT, sjöfåglar, havfugle )are often in areas with high seal (hylkeet, sälar) populations plus other scavenging mammals (imettäväiset, nisäkäseläimet)  that can predate on sick or dead birds, and result in exposures of other host population types to infectious materials either directly or indirectly through the environment. 
The distribution and ecology of seabird populations also challenge the current understanding of HPAIV transmission at a global level. Both long tailed skua and
great skua are transitory migrant birds - long tailed skuas are a passage migrant in
the UK and breed in Arctic region,  whereas great skuas migrate to the
northernmost isles of the UK in summer for breeding and return to the coasts of Spain and Africa, and as far as Brazilian and Argentinian coasts for wintering
Black-headed gulls are found across the UK, 28 and herring gulls are found throughout the year around the UK coastline and inland around rubbish tips, fields,large reservoirs, and lakes, especially during the winter months. 

 Recent ring recovery data revealed that great skua, European herring gulls and black-headed
gulls migrate between Europe to Iceland and other North Atlantic islands, and to North America.  The pelagic and migratory nature of gulls have led to suggestion of intercontinental dissemination and shaping of influenza A virus evolution.  Apart from the increased mortality in seabirds during 2022 which has resulted in an immediate impact upon populations, there is generally a significant deficit in knowledge on the impact of infectious diseases on population structures across these species. However, a trend towards a reduction in breeding abundance in the UK for herring gulls, black-headed gulls and great skuas has been noted.

 The pathogenic mechanism of HPAIV on reproductive organs of wild bird is poorlydocumented. Previous reports have demonstrated epithelial labelling of virus antigen in the oviduct of common buzzards ( Buteo buteo,  Accipitridae , Päiväpetolinnut,  Hiirihaukka, Ormvråk, Musvåge) and peregrine falcons ( Falco peregrinus, Falconidae,  Muuttohaukka, Pilgrimsfalk, Vandrefalk), infected with HPAIV.  In domestic poultry, both HPAIV and LPAIV infection can lead to short to long term reduction in egg production or embryonic death because of viral-induced pathology on the ovaries, oviduct, or conceptus. There has been an increased detection of reproductive pathologies in laying poultry (siipikarja, fjäderfä), both Galliformes  (Kanalinnut, hönsfåglar)and Anseriformes ( sorsalinnut, andfåglar , andefugle) during the 2022 epizootic season in the UK which can be attributed to virus infection in situ (Lean F, unpublished). However, the impact on the poultry sector, where an abundance of eggs is produced daily, cannot be compared to seasonal reproductive cycle in seabirds (merilinnut, sjöfåglar, havfugle)  and as such the longer-term impact on population densities for these species will require monitoring to assess population recovery. In conclusion we demonstrate the susceptibility and pathology of a subset of Laridae (lokkilinnut, måsar och trutar, måger)
 and Suliformes  (Suulalinnut, Sulor, Suler, Basstölpel)) following a naturally acquired infection with HPAIV H5N1 clade  2.3.4.4b. 

We associate rapid mortality with the observed multisystemic dissemination of viral antigen and resultant tissue damage. Reproductive pathology is also noted amongst the female great skua(Stercorarius skua, isokihu, Storlabben, Storkjove) but the longer-term impact on population fecundity warrants further investigation

Mainittuja lintulajeja:

CHARADRIIFORMES , Kahlaajalinnut, Vadarfåglar  el.vadarna

STERCORARIIDAE, Kihut, Labbar, Kjöver

LARIDAE  Lokit, Måsar och trutar, Möger

STERNIDAE, Tiirat, Tärnor , Terner

GALLIFORMES  kesyt  (siipikarja), fjäderfä, Hönsfåglar,  ja  villit kanalinnut, Vilda hönsfåglar 

ANSERIFORMES, Sorsalinnut, Andgålar, Andefugle 

ACCIPITRIFORMES   Päiväpetolinnut

ACCIPITRIDAE, Kotkat, Haukat, Örnar, Hökar,  Vråkar

FALCONIDAE, Jalohaukat , Falkfåglar 

Koetan tässä katsoa lintulajeille  nimiä latinaksi, suomeksi, ruotsiksi, tanskaksi ja jopa saksaksi, jos mahdollsita.  Paikkailen tätä luetteloa vielä.  28.7. 2023

 


 

 



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HPAI H5N1 Clade 2.3.4.4b kehittyminen

 https://wwwnc.cdc.gov/eid/article/29/7/22-1893-f1

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Tänään klo 12-13 ruotsin aikaa Suomen virallinen taho antoi informaatiotta lintuinfluenssasta ja lehdistö sai esittää kysymyksensä.

 HS. fi  esittää informaation  iltapäivän  artikkelissa:

 https://www.hs.fi/kaupunki/art-2000009746364.html


Lintuinfluenssa on levinnyt turkistarhojen eläimiin, jotka ovat todennäköisesti saaneet tartunnat luonnonvaraisilta linnuilta. Tähän mennessä kolmelle turkistarhalle on määrätty eläinten lopetuksia. Kuva: A Oyvind Zahl Arntzen / LEHTIKUVA , Kimmo Mäntylä / Lehtikuva

| Päivitetty

Suomessa on kesän aikana kuollut tuhansia lintuja H5N1-tyypin korkeapatogeeniseen lintuinfluenssaan.

Virukseen ovat nyt poikkeukselliset kuolleet etenkin naurulokit. Lintuinfluenssa ei ole aiemmin aiheuttanut naurulokkien joukkokuolemia.

Virus on levinnyt Suomessa turkistarhoille. Tähän mennessä sitä on todettu yhteensä 20 turkistarhan eläimissä. Ruokaviraston mukaan kolmelle tarhalle on lähetetty lopetuspäätöksiä eläimistä. Lopetusten on tarkoitus käynnistyä tällä viikolla.

Ruokaviraston osastonjohtajan Terhi Laaksosen mukaan on mahdollista, että virus on tarttunut myös turkiseläinten välillä, mutta sen varmistamiseksi tarvitaan lisää tutkimusta.

HS kokosi neljä kysymystä ja vastausta tämän hetkisestä lintuinfluenssatilanteesta.

1. Miksi on huolestuttavaa, jos virus tarttuu turkiseläinten välillä?

Terveyden ja hyvinvoinninlaitoksen (THL) yksikön päällikön Anna Katzin mukaan lintuinfluenssa voi muuntua helpommin nisäkkäästä toiseen leviäväksi, jos se pääsee kiertämään turkiseläin­tarhoissa.

”Tähän on todella paljon vielä matkaa. Mitään sellaista ei tällä hetkellä ole suoraan näköpiirissä, että virus muuttuisi esimerkiksi suoraan ihmisestä toiseen herkemmin tarttuvaksi juuri nyt”, hän sanoo.

Asiasta ovat huolissaan myös Maailman terveysjärjestö (WHO) ja Euroopan tartuntatautivirasto.

Katzin mukaan ei voida tietää, voiko virus muuttua ihmisten väliseksi pandemiaksi.

”Tällaista ennustetta ei voida tehdä. Tähän ei ole kellään vastausta”, hän sanoo.

Suomessa ei ole toistaiseksi todettu lintuinfluenssaa ihmisillä. Lintuinfluenssa tarttuu heikosti ihmiseen suoraan linnuista.Tartunta edellyttäisi ihmisen läheistä kontaktia sairaaseen tai kuolleeseen eläimeen tai niiden ulosteisiin.

Kuten muutkin influenssavirukset, lintuinfluenssa muuntuu helposti. Kun sitä esiintyy paljon linnuissa, on suurempi mahdollisuus, että se siirtyy muihin eläinlajeihin.

Viruksessa on jo havaittu muutoksia, jotka lisäävät sen kykyä lisääntyä nisäkässoluissa. Muutokset havaittiin tartunnan saaneista nisäkkäistä otetuista näytteistä. Havaintoja on tehty myös Suomessa.

Kyseiset muutokset eivät kuitenkaan vielä tarkoita lisääntynyttä kykyä tarttua linnuista nisäkkäisiin.

2. Missä lintuinfluenssaa on?

Turkiseläimiin lintuinfluenssa on tarttunut neljän kunnan alueella Etelä- ja Keski-Pohjanmaalla: Kaustisella, Kauhavalla, Halsuassa ja Evijärvellä.

Lintujen joukkokuolemia on ollut useiden maakuntien alueilla. Ruokavirasto perusti 20. heinäkuuta korkeapatogeenisen lintuinfluenssan esiintymisalueiden ympärille tartuntavyöhykkeen. Sillä pyritään estämään taudin leviäminen siipikarjaan ja vankeudessa pidettäviin lintuihin.

Tällä hetkellä se kattaa Varsinais-Suomen, Satakunnan, Etelä-Pohjanmaan, Pohjanmaan ja Keski-Pohjanmaan, Uudenmaan, Kanta-Hämeen, Pirkanmaan ja Päijät-Hämeen.

Tartuntavyöhykkeellä on kiellettyä pitää siipikarjaa tai vankeudessa pidettäviä lintuja ulkona. Lisäksi viranomaiset suosittelevat siipikarjan ja vankeudessa pidettävien lintujen pitämistä sisällä koko Suomessa.

Lintuinfluenssa ei ole toistaiseksi päässyt pahasti leviämään siipikarjaan Suomessa. Ainoat tapaukset ovat vuodelta 2021, jolloin Janakkalassa kuoli tarhattuja fasaaneja.

3. Mitä varotoimia tavallisen ihmisen täytyy noudattaa?

Tärkeintä on välttää koskemista kuolleisiin ja sairaisiin lintuihin tai muihin villieläimiin sekä niiden eritteillä tahriintuneisiin pintoihin. Lintujen ulosteisiin ei saa koskea paljain käsin.

Lintuinfluenssan ei ole todettu tarttuvan elintarvikkeiden välityksellä. Kananmunia ja siipikarjaa voi syödä normaalisti. Normaali ruuanvalmistuksessa käytetty lämpötila on riittävä tuhoamaan mahdolliset lihassa esiintyvät virukset.

Liha on kypsää, kun sen sisälämpötila on vähintään 75 astetta, ja liha ja lihasneste eivät ole punertavia.

Suomessa voi syödä raakaa kananmunaa ja niitä sisältäviä tuotteita. Suomessa kaikki myytävät raa'at kananmunat ovat kotimaisia. Ulkomailla kananmunat pitää kypsentää salmonellariskin vuoksi.

Pikkulintuja voi edelleen ruokkia. Ruokintalautojen olisi hyvä olla niin sanottua hygieniamallia, joihin ruokailevat linnut eivät voi ulostaa. Pikkulasten ei kannata antaa syöttää lintuja kädestä, koska linnut voivat tartuttaa salmonellaa.

Marjojen, hedelmien tai muiden kasvisten käyttöä ei tarvitse rajoittaa lintuinfluenssan takia. Vihannekset ja hedelmät kannattaa pestä kuten normaalistikin. Näkyvästi likaisten marjojen syömistä on syytä välttää.

Jos puutarhakalusteissa, kuistilla, laiturilla tai muulla oleskelupaikalla on lintujen kakkaa, ne voi pestä pois vedellä ja tavanomaisella pesuaineella. Sen jälkeen pitää pestä hyvin kädet.

Luonnonvesissä uimista pitää välttää, jos vesistön alueella on ollut runsaasti lintujen kuolemia. Muuten uiminen on turvallista.

Luonnonvaraisten lintujen joukkokuolemista pitää ilmoittaa kunnan valvontaeläinlääkärille.

4. Voiko lintuinfluenssa tarttua lemmikkiin?

Maailmalta tiedetään tapauksia, joissa lintuinfluenssa on tarttunut kissoihin. Periaatteessa myös koira voi saada tartunnan, jo se syö sairastuneen linnun.

Koirat ja kissat kannattaa pitää pois alueilta, joissa luonnonvaraisia lintuja on kuollut suuria määriä. Lemmikit kannattaa pitää erossa luonnonvaraisista linnuista varmuuden vuoksi.

Valitettavasti selaimesi ei tue HTML5-videoita.(Kts.suoraan HS:fi linkistä, infotilaisuus on kuunneltavissa)

Viranomaiset järjestivät infotilaisuuden Suomen lintuinfluenssatilanteesta Teamsin välityksellä. Infossa olivat mukana Ruokaviraston, Terveyden ja hyvinvoinnin laitoksen (THL), sosiaali- ja terveysministeriön sekä maa- ja metsätalousministeriön asiantuntijat. Voit katsoa tilaisuuden yllä olevasta soittimesta.

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torsdag 27 juli 2023

WHO : DENGUE Amerikkojen alueella. Aedes aegypti moskiittolajit välittävät tätä ARBO-virustautia

 https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON475

  Amerikan alueen  dengue-infektioista. 

Tämän vuoden 2023 alussa on ollut merkittävän laajalti dengue-purkauksia WHO:n  Amerikkojen alueella. lähemmä 3 miljoonaa epäiltyä  ja varmistettua tapausta tähän mennessä, mikä on jo ylittänyt koko  viime vuoden   tapausten yhteismäärän 2,8 miljoonaa.
Tämän  alkuvuoden denguetapauksista ( 2 997 097) on 45% laboratoriovarmistettuja ja 0.13% vaikean asteiseksi luokiteltuja.  Brasiliassa, Perussa ja Boliviassa  on ollut eniten  denguatapauksia. Kuolemantapauksia on WHO alueelta  raportoitu 1302 , mortaliteetti on 0.04%.
WHO työskentelee   näiden ARBO-virusperäisten tautien  ehkäisemiseksi ja kontrolloimiseksi aktiivisti  jäsenmaidensa kanssa terveydenhuoltoa ja  epidemiologista seurantaa vahvistaen.
WHO on määritellyt dengue-riskin suureksi  alueellisella tasolla  johtuen,  Aedes -lajien  erityisesti  Aedes aegyptii  moskiittojen  levinnäisyydestä,  jatkuvasta vaikean taudin ja kuoleman riskistä ja  historiallisten  tartunta-alueiden   edelleen  laajentumisista seutuihin, joisa mahdollisesti  koko väestö riskiryhmineen ja  terveydenhoitohenkilöstöineen  saataa olla   tietämäton   uhkaavista vaaranmerkeistä.

Dengue – the Region of the Americas

19 July 2023

Situation at a glance

Since the beginning of 2023, dengue outbreaks of significant magnitude have been recorded in the WHO Region of the Americas, with close to three million suspected and confirmed cases of dengue reported so far this year, surpassing the 2.8 million cases of dengue registered for the entire year of 2022. Of the total number of dengue cases reported until 1 July 2023 (2 997 097 cases), 45% were laboratory confirmed, and 0.13% were classified as severe dengue. The highest number of dengue cases to date in 2023 are in Brazil, Peru, and Bolivia. Additionally, 1302 deaths were reported in the Region with a Case Fatality Rate (CFR) of 0.04%, in the same period.

WHO ei  suosittele kuitenkaan  matkustusrajoituksia  Amerikkoihin  denguen nykyiselle purkausalueille  perustuen  asiasta  saatavilla olevaan informaatioon. 

As part of the implementation of the Integrated Management Strategy for the Prevention and Control of Arboviral Diseases (IMS-Arbovirus), WHO is actively working with the Member States to strengthen healthcare and surveillance capacity.

WHO has assessed the risk of dengue as high at the regional level due to the wide spread distribution of the Aedes spp. mosquitoes (especially Aedes aegypti), the continued risk of severe disease and death, and the expansion out of historical areas of transmission, where all the population, including risk groups and healthcare workers, may not be aware of warning signs.

WHO does not recommend any travel and/or trade restrictions for countries in the Americas experiencing the current dengue epidemics based on the currently available information.

 TILANTEEN tarkempaa kuvausta: kts. linkki

#Description of the situation

Dengue is the arbovirus that causes the highest number of cases in the Region of the Americas, with epidemics occurring cyclically every 3 to 5 years. During the first half of 2023, dengue outbreaks of significant magnitude were recorded in South America.  Between epidemiological week (EW) 1 and EW 26 of 2023 (week ending on 01 July), a total of 2 997 097 cases of dengue were reported in the Region of the Americas, including 1302 deaths with a CFR of 0.04%, with a cumulative incidence rate of 305 cases per 100 000 population. Of the total number of dengue cases until EW 26 of 2023, 1 348 234 (45%) were laboratory confirmed, and 3907 (0.13%) were classified as severe dengue.1 The highest number of dengue cases was observed in Brazil, with 2 376 522 cases, followed by Peru with 188 326 cases, and Bolivia with 133 779 cases.

The highest cumulative incidence rates were observed in the following subregions: the Southern Cone2 with 862 cases per 100 000 inhabitants, the Andean Subregion3 with 268 cases per 100 000 inhabitants, and the Central American Isthmus and Mexico4 with 59 cases per 100 000 inhabitants.

The highest number of severe dengue cases was observed in the following countries: Brazil with 1249 cases, Peru with 701 cases, Colombia with 683 cases, Bolivia with 591 cases and Mexico with 141 cases.

All four dengue virus serotypes (DENV1, DENV2, DENV3, and DENV4) are present in the Region of the Americas. In 2023, up to EW 26 (ending on 1 July), simultaneous circulation of all four serotypes has been detected in Brazil, Colombia, Costa Rica, Guatemala, Honduras, Mexico, and Venezuela; while in Argentina, Panama, Peru, and Puerto Rico, DENV1, DENV2 and DENV3 serotypes circulate, and in Nicaragua the serotypes DENV1, DENV3 and DENV4.

In 2022, 2 811 433 dengue cases were reported in the Region of the Americas, the third highest year on record, only surpassed by 2016 and 2019. In 2019, the highest number of historical dengue cases was registered, with more than 3.1 million cases for the Region of the Americas, including 28 203 severe cases and 1823 deaths.

Between 12 June to 1 July 2023, some countries in the Southern Cone and the Andean subregion have been showing a decrease in the number of cases due to multiple factors, including, the implementation of control measures, and the change in temperature and climate, mainly in the Southern Cone. There is also a delay in the notification of data from some countries in Central America and the Caribbean. These have resulted in a decline in cases and the downward trend observed in the epidemiological curve below.

Figure 1. Number of dengue cases in 2022, 2023 (up to EW 26) and average of the last 5 years in the Region of the Americas ... (Kts WHO linkki )

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MERS (+), yksittäinen infektio todettu Yhdistyneessä Arabiemiraatissa (Al Ain kaupungissa , Abu Dhabi-valtiossa) 23.6. 2023 ,

 Abu-Dhabilainen  28 vuotias mies  sai  oireita  niin paljon että joutui sairaalaan 8.6.  Hänen tilansa teho-osastolla pahen. Mers- tetti nenänäyttestä otettiin 21.6 ja se oli negatiivinen. i ja  katsottiin MERS-CoV PCR testi  suoritettiin 23.6 ja se oli positiivinen. Mitään  kontaktia  dromedaareihin, vuohiin tai lampaisiin ei anamneeissa ollut.  Kontakteja  voitiin löytää 108 siihen mennessä ja heidän koronavirustilannettaan  seurattiin 14 vrk eikä sekundääritapauksia havaittu. 
Vuodesta 2013 laskien UAE:ssa tämä tapaus on ensimmäinen   94 varmistetun tapauksen jälkeen, Niissä on ollut 12 kuolemaa.  Koko maailmasta  on raportoitu WHO:lle vuoden 2012 jälkeen 2605 tapausta ja 936 niistä johti kuolemaan. 
WHO mo0nitoroi edelleen epidemiologista tilannetta ja suoritaa riskiarvioita, jotka perustuvat viimeisimpään  saatavilla olevaan informaatioon. 
WHOpainottaa kaikille jäsenmailleen  akuuttien respiratoristen  infektioiden  vahvan seurannan  tärkeyttä. MERS-COV kuuluu näihin  seurattaviin . Tulee myös   huolellisesti   antaa kuvasu epätavallisista   sairastumisen  malleista.

Middle East Respiratory Syndrome - United Arab Emirates
24 July 2023
Situation at glance: On 10 July 2023, the United Arab Emirates (UAE), notified WHO of a case of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in a 28-year-old male from Al Ain city in Abu Dhabi. The case had no history of direct or indirect contact with dromedaries, goats, or sheep. The patient was admitted to the hospital on 8 June. A nasopharyngeal swab was collected on 21 June and tested positive for MERS-CoV by polymerase chain reaction (PCR) on 23 June 2023. All 108 identified contacts were monitored for 14 days from the last date of exposure to the MERS-CoV patient. No secondary cases have been detected to date.

Since July 2013, when the UAE reported the first case of MERS-CoV, 94 confirmed cases (including this new case) and 12 deaths have been reported. Globally, the total number of confirmed MERS-CoV cases reported to WHO since 2012 is 2605, including 936 associated deaths.

WHO continues to monitor the epidemiological situation and conducts risk assessments based on the latest available information. WHO expects that additional cases of MERS-CoV infection will be reported from the Middle East and/or other countries where MERS-CoV is circulating in dromedaries.

WHO re-emphasizes the importance of strong surveillance by all Member States for acute respiratory infections, including MERS-CoV, and to carefully review any unusual patterns.

Tässa on  yksityiskohtainen kuvaus  otsikon MERS-CoV infektiosta: 

"Description of the case: On 10 July 2023, the International Health Regulations National Focal Point (IHR NFP) of the United Arab Emirates (UAE) notified WHO of a confirmed case of MERS-CoV in Abu Dhabi. The patient is a 28-year-old male, non- Emirati national living in Al Ain city, a non-healthcare worker.  The case visited a private medical center multiple times between 3 and 7 June 2023, complaining of vomiting, right flank pain, and dysuria (pain when passing urine). On 8 June, the case presented to a government hospital with vomiting, and gastrointestinal symptoms including diarrhea, and was given an initial diagnosis of acute pancreatitis, acute kidney injury, and sepsis.On 13 June, he was in critical condition and referred to an intensive care unit (ICU) at a specialized government tertiary hospital where he was put on mechanical ventilation. He deteriorated and a nasopharyngeal swab was collected on 21 June and tested positive for MERS-CoV by PCR on 23 June 2023.The case has no known co-morbidities, no history of contact with MERS-CoV human cases, and no recent travel outside the UAE. The patient has no known history of direct contact with animals including dromedary camels, nor consumption of their raw products.All 108 contacts that were identified have been monitored for 14 days from the last date of exposure to the MERS-CoV patient, no secondary case was identified. The case has no family members or household contacts identified in the UAE.

 Prior to this notification, the last MERS-CoV infection reported from the UAE was in November 2021. The first laboratory-confirmed case of MERS-CoV in UAE was in July 2013. Since then, the UAE has reported 94 cases of MERS-CoV (including this current case) and 12 associated deaths (Case Fatality Ratio (CFR): 13%).

Epidemiology of the disease:

Middle East respiratory syndrome (MERS) is a viral respiratory infection that is caused by a coronavirus called Middle East respiratory syndrome coronavirus (MERS-CoV). Humans are infected with MERS-CoV from direct or indirect contact with dromedary camels who are the natural host and zoonotic source of the MERS-CoV infection.

MERS-CoV infections range from asymptomatic or mild respiratory symptoms to severe acute respiratory disease and death. A typical presentation of a person with MERS-CoV disease is fever, cough and shortness of breath. Pneumonia is a common finding, but not always present. Gastrointestinal symptoms, including diarrhoea, have also been reported. The virus appears to cause more severe disease in older people, persons with weakened immune systems and those with chronic diseases such as renal disease, cancer, chronic lung disease, and diabetes. Severe illness can cause respiratory failure that requires mechanical ventilation and support in an intensive care unit resulting in high mortality.

No vaccine or specific treatment is currently available, although several MERS-CoV-specific vaccines and treatments are in development. Treatment is supportive and based on the patient’s clinical condition.

Public health response

  • A total of 108 contacts from health care facilities were identified and screened for MERS-CoV (56 from the first government hospital and 52 from the second government hospital) all of which were health care workers (HCWs), screening for exposed HCWs was repeated by respiratory samples, all results were negative.
  • All 108 identified contacts were monitored for 14 days from the last date of exposure to the MERS-CoV patient, and no secondary cases have been detected to date.
  • Abu Dhabi Public Health Centre (ADPHC) has updated the case definition for MERS-CoV, strengthened surveillance activities to identify possible cases, conducted several workshops and issued circulars for MERS-CoV.
WHO risk assessment. Middle East Respiratory Syndrome (MERS) is a viral respiratory infection of humans and dromedary camels which is caused by a coronavirus called the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). Infection with MERS-CoV can cause severe disease in humans resulting in high mortality. Approximately 35% of patients with MERS-CoV have died, but this may be an overestimate of the true mortality rate, as mild cases of MERS-CoV may be missed by existing surveillance systems. Until more is known about the disease, the case fatality rates are counted only amongst the laboratory-confirmed cases reported to WHO.

Humans are infected with MERS-CoV from direct or indirect contact with dromedaries, a host and zoonotic source of MERS-CoV infection. MERS-CoV has demonstrated the ability to be transmitted between humans. So far, the observed non-sustained human-to-human transmission has occurred among close contacts and in healthcare settings. Outside of the healthcare setting, there has been limited human-to-human transmission.

Cases of MERS-CoV infection are rare in the UAE. Since July 2013, a total of 94 MERS-CoV cases, including this current case, resulting in 12 deaths (CFR 13%) have been reported to WHO from the UAE.

Globally, the total number of laboratory-confirmed MERS-CoV cases reported to WHO since 2012 is 2605, including 936 associated deaths as of July 2023. The majority of the reported cases have occurred in countries in the Arabian Peninsula. Outside of this region, there has been one large outbreak in the Republic of Korea, in May 2015, during which 186 laboratory-confirmed cases (185 in the Republic of Korea and one in China) and 38 deaths were reported. The global number reflects the total number of laboratory-confirmed cases and deaths reported to WHO under IHR (2005) to date.

The notification of this case does not change the overall risk assessment. WHO expects that additional cases of MERS-CoV infection will be reported from the Middle East and/or other countries where MERS-CoV is circulating in dromedaries, and that cases will continue to be exported to other countries by individuals who were exposed to the virus through contact with dromedaries or their products (for example, consumption of camel’s raw milk), or in a healthcare setting.

WHO continues to monitor the epidemiological situation and conducts risk assessments based on the latest available information. 

WHO advice

 https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON478

... More:

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måndag 24 juli 2023

WHO tuorein raportti 152.( 20.7. 2023 ) . Vielä on uusia Covid-19 tapauksia ja kuolemantapauksiakin, vaikka yleiskuva on että lientyvä suunta jatkuu.

Overview

Globally, over 836 000 new COVID-19 cases and over 4500 deaths were reported in the last 28 days (19 June to 16 July 2023). While five WHO regions have reported decreases in the number of both cases and deaths, the Western Pacific Region has reported a decline in cases but an increase in deaths. As of 16 July 2023, over 768 million confirmed cases and over 6.9 million deaths have been reported globally. Currently, reported cases do not accurately represent infection rates due to the reduction in testing and reporting globally. During this 28-day period, 56% (131 of 234) of countries and territories reported at least one case – a proportion that has been declining since mid-2022.

In this edition, we include:

  • The COVID-19 epidemiological update at the global and the regional levels
  • An update on hospitalizations and ICU admissions
  • An update on the SARS-CoV-2 variants of interest (VOI) and variants under monitoring (VUM)

9
SARS-CoV-2 variants of interest and variants under monitoring
Geographic spread and prevalence
Globally, from 19 June to 16 July 2023 (28 days), 8712 SARS-CoV-2 sequences were shared through GISAID.
WHO is currently tracking several SARS-CoV-2 variants, including:
• Two variants of interest (VOIs); XBB.1.5 and XBB.1.16.
• Seven variants under monitoring (VUMs) and their descent lineages; BA.2.75, CH.1.1, XBB, XBB.1.9.1,
XBB.1.9.2, XBB.2.3 and EG.5.
EG.5 was added as a VUM on 19 July 2023. EG.5 is a descendent lineage of XBB.1.9.2 with an additional mutation, F456L, in the spike protein. EG.5 has shown rising sequence prevalence globally since epidemiological week 21 (22 to 28 May 2023). Currently, there is no evidence of rising cases and deaths or a change in disease severity associated with EG.5.
Globally, 118 countries have reported the detection of XBB.1.5 since its emergence. Notably, its prevalence has been declining steadily.

 In epidemiological week 26 (26 June to 2 July 2023),

 XBB.1.5 accounted for 15.8% of sequences, compared
to 23.5% in week 22 (29 May to 4 June 2023).
XBB.1.16 has been reported from 98 countries. In week 26, 

XBB.1.16 accounted for 20.7% of sequences, similar to the prevalence of 20.2% observed in week 22. Its prevalence has surpassed that of XBB.1.5 in week 24 (12 to 18 June 2023). 

An analysis of available data indicates that countries with a low prior prevalence of XBB.1.5 have experienced increases in the prevalence of XBB.1.16, while countries that had a high prevalence of XBB.1.5 have reported low circulation of XBB.1.16.


Table 3 shows the number of countries reporting the VOIs and VUMs and their prevalence from week 22 to week 26. During the period of the last five weeks, the VOI and the VUMs that have shown increasing trends are highlighted in orange, those that have remained stable are highlighted in blue, while those with decreasing trends are highlighted in green.
Among the VUMs, XBB.1.9.2 has shown an increasing trend in recent weeks, whilst other VUMs have shown declining or stable trends during the same reporting period.
Table 3. Weekly prevalence (%) of SARS-CoV-2 VOIs and VUMs, week 22 to week 26 of 2023 

Lin.           Cntr.  Sequences§       2023-22   2023-23   2023-24   2023-25   2023-26
XBB.1.5*  118        255 791          23.5       22.0          18.8         19.6         15.8
XBB.1.16* 98           35 817          20.2       20.5          21.9         22.7         20.7
BA.2.75*  124        122 038             3.2         2.9            3.4           2.9           1.9
CH.1.1*      95          42 538             0.9         0.8            0.7           0.7           0.7
XBB*       130          64 829             5.9         5.8            7.0           6.3           5.1
XBB.1.9.1* 99         47 080           17.7       18.2          16.2         15.0         13.7
XBB.1.9.2* 85         25 357           12.0       13.3          14.0         13.9         17.4
XBB.2.3*    66           7 373            4.2          3.9            4.0           5.2           4.4
Unassigned 92       149 884            1.8           1.7            2.2          2.1            9.5
Other+       209    6 754 797            9.6        10.1           11.1         10.7           9.9.

§ Number of countries and sequences are since the emergence of the variants
* Includes descendant lineages, except those individually specified elsewhere in the table. For example, XBB* does not include XBB.1.5, XBB.1.9.1,
XBB.1.9.2, XBB.1.16, and XBB.2.3 The prevalence of EG.5 and its descendent lineages will be included in subsequent WEU editions.
+ Others are other circulating lineages excluding the VOI, VUMs, BA.1*, BA.2*, BA.3*, BA.4*, BA.5*

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söndag 23 juli 2023

Turkistarhojen zoonoosiriskeistä tutkimustyö Suomessa

 Ruokaviraston tutkimuksia 2/2023 | Turkistarhojen zoonoosit – riskiprofiiliJulkaisija Ruokavirasto, riskinarvioinnin yksikkö
Tekijät Heidi Rossow, Leena Seppä-Lassila, Suvi Joutsen, Terhi Järvelä, Pirkko
Tuominen
Julkaisun nimi Turkistarhojen zoonoosit – riskiprofiili
Julkaisusarjan nimi
ja numero
Ruokaviraston tutkimuksia 2/2023
Julkaisuaika 3/2023
ISBN PDF 978-952-358-048-0

 https://www.ruokavirasto.fi/globalassets/yhteisot/riskinarviointi/projektit/ruokaviraston_tutkimuksia_2_2023_turkistarhojen_zoonoosit--riskiprofiili.pdf

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Globaalisti vallitseva kladi HPAI H5N1 viruksesta on 2.3.4.4b. On 35 genotyyppiä ( esim. G07, G10) . Antigeeniklusteri mainitaan.

 https://pubmed.ncbi.nlm.nih.gov/37347504/

 https://wwwnc.cdc.gov/eid/article/29/7/22-1149_article

Abstract

Highly pathogenic avian influenza (HPAI) subtype H5N1 clade 2.3.4.4b virus has spread globally, causing unprecedented large-scale avian influenza outbreaks since 2020. 

In 2021, we isolated 17 highly pathogenic avian influenza H5N1 viruses from wild birds in China.

 To determine virus origin, we genetically analyzed 1,529 clade 2.3.4.4b H5N1 viruses reported globally since October 2020 and found that they formed 35 genotypes. The 17 viruses belonged to genotypes G07, which originated from eastern Asia, and G10, which originated from Russia. The viruses were moderately pathogenic in mice but were highly lethal in ducks. The viruses were in the same antigenic cluster as the current vaccine strain (H5-Re14) used in China. In chickens, the H5/H7 trivalent vaccine provided complete protection against clade 2.3.4.4b H5N1 virus challenge. Our data indicate that vaccination is an effective strategy for preventing and controlling the globally prevalent clade 2.3.4.4b H5N1 virus.

Keywords: China; H5N1; antigenic property; clade 2.3.4.4b; influenza; influenza virus; phylogeny; protective efficacy; virulence; viruses; wild birds.

 

 

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Miten influenssaviruskladeja merkitään? Löytyi arikkeli asiasta vuosilta 2001-2014 . Kladit ovat kronologisessa järjestyksessä . H5N1 timeline.


Review
. 2014 Jul;3(2):117-27.
doi: 10.7774/cevr.2014.3.2.117. Epub 2014 Jun 20.
Evolutionary dynamics of highly pathogenic avian influenza A/H5N1 HA clades and vaccine implementation in Vietnam
Thanh Hoa Le  1 , Nga Thi Bich Nguyen  1
Affiliations
Free PMC article
Abstract

Based on hemagglutinin (HA) and neuraminidase (NA), influenza A virus is divided into 18 different HA (H1 to H18) and 11 NA types (N1 to N11), opening the possibility for reassortment between the HA and NA genes to generate new HxNy subtypes (where x could be any HA and y is any NA, possibly).

 In recent four years, since 2010, highly pathogenic avian influenza (HPAI) viruses of H5N1 subtype (HPAI A/H5N1) have become highly enzootic and dynamically evolved to form multiple H5 HA clades, particularly in China, Vietnam, Indonesia, Egypt, Cambodia, and Bangladesh.

 So far, after more than 10 years emerged in Vietnam (since late 2003), HPAI A/H5N1 is still posing a potential risk of causing outbreaks in poultry, with high frequency of annual endemics. 

Intragenic variation (referred to as antigenic drift) in HA (e.g., H5) has given rise to form numerous clades, typically marking the major timelines of the evolutionary status and vaccine application in each period. 

The dominance of genetically and antigenically diversified clade 2.3.2.1 (of subgroups a, b, c), clade 1.1 (1.1.1/1.1.2) and re-emergence of clade 7.1/7.2 at present, has urged Vietnam to the need for dynamically applied antigenicity-matching vaccines, i.e., the plan of importing Re-6 vaccine for use in 2014, in parallel use of Re-1/Re-5 since 2006.

 In this review, we summarize evolutionary features of HPAI A/H5N1 viruses and clade formation during recent 10 years (2004-2014). Dynamic of vaccine implementation in Vienam is also remarked.

Keywords: Clades; Genotypes; HPAI A/H5N1; Orthomyxoviridae; Reassortment; Subtypes; Vaccines; Vietnam.

See this image and copyright information in PMC
Fig. 1
Emergence timelines of hemagglutinin-based clades of A/H5N1 in Vietnam (only those clades that emerged and identified in Vietnam are presented). Data used for making timelines of H5N1 occurence were collected from the following published sources: Nguyen et al. [41,42], Creanga et al. [43], World Health Organization/World Organisation for Animal Health/Food and Agriculture Organization (WHO/OIE/FAO) H5N1 Evolution Working Group [44], Inui [45]; A/B/C marks for clades were taken from the above listed publications; question mark (?) indicates upcoming confirmation of clades in 2014.
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H5N1-kannoilla tehtyjä rokotuksia tutkittu niiden IgG vasteesta

 https://journals.asm.org/doi/10.1128/mBio.00449-21

 DOI: https://doi.org/10.1128/mbio.00449

Vaccines
Research Article
6 July 2021
Broadly Reactive IgG Responses to Heterologous H5 Prime-Boost Influenza Vaccination Are Shaped by Antigenic Relatedness to Priming Strains

Authors: Jiong Wang, Dongmei Li, et al. 

Abstract

Prime-boost vaccinations of humans with different H5 strains have generated broadly protective antibody levels. However, the effect of an individual's H5 exposure history on antibody responses to subsequent H5 vaccination is poorly understood. To investigate this, we analyzed the IgG responses to H5 influenza A/Indonesia/5/2005 (Ind05) virus vaccination in three cohorts: (i) a doubly primed group that had received two H5 virus vaccinations, namely, against influenza A/Vietnam/203/2004 (Vie04) virus 5 years prior and A/Hong Kong/156/1997 (HK97) 11 years prior to the Ind05 vaccination; (ii) a singly primed group that had received a vaccination against Vie04 virus 5 years prior to the Ind05 vaccination; and (iii) an H5-naive group that received two doses of the Ind05 vaccine 28 days apart. Hemagglutinin (HA)-reactive IgG levels were estimated by a multiplex assay against an HA panel that included 21 H5 strains and 9 other strains representing the H1, H3, H7, and H9 subtypes. Relative HA antibody landscapes were generated to quantitatively analyze the magnitude and breadth of antibody binding after vaccination. We found that short-interval priming and boosting with the Ind05 vaccine in the naive group generated a low anti-H5 response. Both primed groups generated robust antibody responses reactive to a broad range of H5 strains after receiving a booster injection of Ind05 vaccine; IgG antibody levels persisted longer in subjects who had been doubly primed years ago. Notably, the IgG responses were strongest against the first priming H5 strain, which reflects influenza virus immune imprinting. Finally, the broad anti-H5 IgG response was stronger against strains having a small antigenic distance from the initial priming strain. IMPORTANCE The antigenic shift and draft of hemagglutinin (HA) in influenza viruses is accepted as one of the major reasons for immune evasion. The analysis of B cell immune responses to influenza infection and vaccination is complicated by the impact of exposure history and antibody cross-reactions between antigenically similar influenza strains. To assist in such analyses, the influenza "antibody landscape" method has been used to analyze and visualize the relationship of antibody-mediated immunity to antigenic distances between influenza strains. In this study, we describe a "relative antibody landscape" method that calculates the antigenic distance between the vaccine influenza strain and other H5 strains and uses this relative antigenic distance to plot the anti-H5 IgG levels postvaccination. This new method quantitatively estimates and visualizes the correlation between the humoral response to a particular influenza strain and the antigenic distance from other strains. Our findings demonstrate the effect of a subject's H5 exposure history on H5 vaccine responses quantified by the relative antibody landscape method.

Keywords: H5 monovalent influenza vaccine (MIV); HA imprinting; hemagglutinin (HA) antigenic distance; influenza virus antibody landscape; original antigenic sin (OAS).

INTRODUCTION
A number of highly pathogenic avian influenza (HPAI) A viruses, such as the H5, H7, and H9 strains, pose a significant threat to cause human pandemics as a result of their fast mutation rate and high pathogenicity (1, 2). To date, there is no evidence of sustained human-to-human transmission of these strains, despite repeated documentation that humans can contract these viruses from infected poultry (3). The first known human H5N1 infection was reported in 1997 during a poultry H5 outbreak in Hong Kong (4). From 2003 to January 2015, a total of 694 laboratory-confirmed human H5 cases were reported across 16 countries, and 58% of those people died as a result (5). Vaccination against future pandemic strains is the most viable path toward mitigating potential outbreaks. However, current H5 nonadjuvanted monovalent influenza vaccine (MIV) formulations are poorly immunogenic (6–10) and generally require a prime and boost strategy in order to achieve protective levels of immunity (11, 12). Interestingly, boosting with nonadjuvanted MIV, even in subjects who had been primed several years prior, led to robust and broad antibody responses to variant H5 MIVs (11). Such prime and boost strategies also appear to be needed for recent RNA vaccines (13) to other non-influenza virus vaccines, and understanding the immunobiology of this phenomenon remains highly relevant.
It has been generally accepted that immunological protection against influenza virus infection is due predominately to antibodies directed against the viral surface hemagglutinin (HA) protein, which is thus the major target of most influenza vaccines (14). A specific language has evolved to describe the potential confounding effects of such exposure on the development of subsequent immunity to influenza. HA imprinting is the initial exposure to an influenza virus strain, first described for childhood H1 influenza, which emerging evidence suggests may protect from subsequent H5 infection (2). However, when a person is sequentially exposed to two related virus strains, they tend to elicit an immune response dominated by antibodies against the first strain to which they were exposed (15, 16). This is true even following a secondary infection or vaccination. This phenomenon has been variously referred to as “original antigenic sin” (OAS), HA seniority, or a negative antigenic interaction (17–19). Thus, the immune response to a new influenza viral infection or vaccination is at least partially shaped by preexisting influenza immunity. Because there is still antigenic overlap between even mostly dissimilar influenza strains, it is critical to understand the antibody responses against antigenically similar virus stains for vaccine development, especially within the context of OAS.
The HA protein is composed of two domains, the highly plastic globular HA1 head domain and the conserved HA2 stalk domain. The hypervariable head domain is believed to be immunodominant, and virus infection or/and vaccination elicits strain-specific neutralizing antibodies primarily targeting this domain, resulting in limited cross-reactivity to divergent virus strains that vary significantly in their HA1 head domain sequences (20). In contrast, antibodies targeting the conserved HA2 stalk domain have been shown to broadly cross-react with multiple influenza viral strains (21). The viruses themselves can be categorized based on the phylogenetic distances of HA sequences. Ten clades of H5 HA (clades 0 to 9) have been identified within the H5N1 virus subtype (22). H5N1 viruses from clades 0, 1, 2, and 7 have the capacity to infect humans (23). These scatter into three distinct antigenic clusters, as determined by antigenic cartography generated by analyzing neutralizing serum antibody levels elicited in mice vaccinated against single influenza virus strains (1). An effective H5 influenza vaccine would ideally induce broad cross-reactivity against all three H5 clades. However, as discussed above, HA imprinting or OAS may impede the generation of broadly cross-reactive H5N1 antibodies if the prime and boost H5N1 vaccine strains reside in different antigenic clusters.
To address this issue, we reanalyzed serum samples from a previous H5 human vaccine study (DMID 08-0059) (24) using our mPlex-Flu multiplex assay (25) to measure the anti-HA IgG antibodies against all 10 clades (subclades) of H5 influenza virus. During this study (Fig. 1), longitudinal samples were collected prior to and after vaccination with an inactivated influenza A/Indonesia/5/2005 (Ind05) MIV from (i) subjects who had received two prime H5 MIV vaccinations (A/Hong Kong/156/1997 [HK97] in 1997 to 1998 and A/Vietnam/1203/2004 [Vie04] in 2005 to 2006 [the doubly primed long-interval boost {DL-boost} group]), (ii) subjects who had received only one prime Vie04 vaccination in 2005 to 2006 (long-interval boost [L-boost] group), and (iii) subjects in an H5 influenza virus-naive group, who were also given the Ind05 booster 28 days after the prime event (short-interval boost [S-boost] group). The mPlex-Flu assay (25) enables us to simultaneously evaluate the magnitude and breadth of the IgG repertoire directed against HAs from 21 H5 influenza virus strains and 9 other influenza A virus (IAV) strains (H1, H3, H7, H9). We also introduce a novel multiple-dimensional data analysis method named relative antibody landscapes, which enables quantitative analysis of antibody responses to antigenically similar influenza virus strains related to vaccine strains. The relative antibody landscapes method enables analysis of antibody-mediated immunity to a spectrum of HAs after H5 vaccine priming and boosting. This report demonstrates that as the relative antigenic distance between the original priming strain and the new H5 boosting vaccine strain becomes smaller (i.e., the strains are more antigenically similar), the greater the increase in the anti-HA IgG response to the original H5 MIV strain. Thus, in a vaccine response, the original HA imprinting influences vaccine responses occurring significantly later. We discuss the relevance of these findings to the development of influenza vaccines designed to induce broad antibody-mediated protection.
 


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