Avian Influenza - Netherlands

[Reasonable Rascal]

AVIAN INFLUENZA - NETHERLANDS
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A ProMED-mail post

Date: Sat, 01 Mar 2003
From: ProMED-mail<promed@promedmail.org>
Source: AP Online, 01 Mar 2003 [edited]
<http://www.austin360.com/aas/news/ap/ap_story.html/Intl/AP.V6977.AP-Netherlands-Bir.html>


Dutch Ban Poultry Exports; Suspect Flu
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AMSTERDAM:The Dutch government banned all exports of poultry and related farm products Saturday after a suspected outbreak of bird flu on 6 Dutch farms.

The Agriculture Ministry ordered farmers to keep chickens and other birds inside and prohibited the transport or sale of eggs, poultry or animal feed.

The infections are believed to be in the villages Scherpenzeel, Renswoude and Barneveld in the eastern province of Gelderland, near the German border.

Avian influenza generally infects only birds, but there have been isolated cases when humans contracted the disease. The most recent was in Hong Kong last month when a boy and his father became sick after having been in direct contact with sick birds.

To prevent infections from spreading in the Netherlands, roads were closed for a radius of 6 miles around all suspect farms, according to an Agriculture Ministry statement.

The Netherlands, which suffered several severe outbreaks of swine fever in recent years, is a main exporter of chickens and eggs in Europe. The association for poultry and eggs farmers said a long-term ban would cost the industry tens of thousands of dollars a week.

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ProMED-mail
<promed@promedmail.org>

[In case the current outbreak is found to be caused by the Highly Pathogenic Avian Influenza (HPAI) virus, this news might become very alarming. Details on the identification of the involved virus are expected soon. Low Pathogenic Avian Influenza (LPAI) virus has been evolving in Northern Italy for some time (see ref).

ProMED-Mail is grateful to Marja Wijdeveld for providing us with preliminary information on this item. - Mod.AS]

[Reasonable Rascal]

AVIAN INFLUENZA - NETHERLANDS (02)
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A ProMED-mail post


Date: 1 Mar 2003
From: ProMED-mail <promed@promedmail.org>
Source: Press release - Ministry of Agriculture, Nature Management and Fisheries, 1 Mar 2003 [translated from Dutch, edited by Mod.AS]
<http://www.minlnv.nl/infomart/dossiers/vogelpest/>

Suspected Avian Influenza in the Netherlands
---------------------------------------------
A suspected outbreak of Avian Influenza was reported by the Animal Health Service to the National Veterinary Inspection Service (RVV) on Fri, 28 Feb 2003, involving 6 layer farms in the Gelder Valley. This area is characterized by a very dense poultry population. In all 6 affected farms a high mortality (exceeding 80 percent) among the chickens was observed.

Highly Pathogenic Avian Influenza (HPAI) is a list A disease which should be dealt with according to EU regulation 92/40/EEC. The definite diagnosis, currently under performance in the national veterinary research institute in Lelystad, might take up to 14 days. At this stage, HPAI is strongly suspected. In view of this strong suspicion, the following steps have been imposed:

a. Stand still: From 1 Mar 2003, 1.30 pm, all movements of live poultry, hatching eggs, table eggs, used bedding, and poultry litter are forbidden in the Gelder valley. From 12.00 pm, same date, such movements are forbidden in the whole country -- outside the Gelder valley -- as well, excluding table-eggs. Poultry should be kept indoors within the Gelder valley; this relates to game and pet birds as well.

b. Export ban: The export of live poultry and hatching eggs is prohibited, with immediate implementation.

At this stage, there is no reason to suspect any public health risk. To be on the safe side, advice from the Food and Commodities Authority (VWA) has been sought.

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ProMED-mail
<promed@promedmail.org>

[Obviously, the Dutch authorities have timely taken the prescribed severe measures to contain this outbreak and prevent its spread. This might be a complex burden, in view of the location and the regional structure of this intensive industry. Discovering the disease on 6 farms simultaneously might indicate earlier contacts with other farms, which should be excluded and certainly are presently investigated by the authorities.

According to Netherlands' reports to the OIE, HPAI has never been recorded there in the past. - Mod.AS]

[Reasonable Rascal]

AVIAN INFLUENZA - NETHERLANDS (03)
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A ProMED-mail post


Date: Sun, 2 Mar 2003
From: ProMED-mail <promed@promedmail.org>
Source: Reuters AlertNet, 2 Mar 2003 [edited]
<http://www.alertnet.org/thenews/newsdesk/L02562748>


Dutch to cull chickens on avian flu outbreak
---------------------------------------------
The Netherlands will cull chicken flocks at poultry farms in the centre of the country after preliminary tests confirmed an outbreak of bird flu, the Dutch agriculture ministry said on Sunday. "Preliminary Dutch tests showed it was bird flu, we are still awaiting European-validated results, but they will show the same," a spokeswoman at the agriculture ministry said. So far 13 farms are known to be affected.

Flocks on farms within a one-kilometre radius of those farms will also be culled starting on Monday or Tuesday, she added. On Saturday the ministry announced it was investigating "serious suspicions" 6 poultry farms were infected with bird flu and imposed precautionary measures in a 10-km zone surrounding the farms. The only way to eradicate the disease quickly in commercial poultry is by destroying infected flocks and imposing a strict quarantine. The Dutch poultry organisation, NOP (Nederlandse Organisatie van Pluimveehouders), feared the measures did not go far enough. "I am pleased that these measures will be taken, but I think that the one-kilometre zone is not enough," Jan Wolleswinkel, head of the NOP, told Reuters. The NOP independent organisation representing the interests of about 15 000 poultry farms in the Netherlands. Wolleswinkel said that according to some estimates, about one-third of the Dutch poultry livestock was located in the Gelderland province, which spans from the centre to the east of the country, where the disease was detected. The flu, an avian H7 virus or "classical strain" of the disease, is harmless to humans, a spokeswoman for the Dutch food and non-food authority (VWA), told Reuters.

"In Europe there have been several cases of avian flu, and they have never had any human consequences. Several cases have been described where avian flu type H5 and H9 lead to serious influenza in humans resulting fatalities," she said quoting from an advisory report the VWA issued on Sunday. In Hong Kong, a highly contagious strain of bird flu has jumped to humans and killed one man late last month, whereas the Exotic Newcastle strain -- also harmless to humans -- infected its eighth farm in California last month. A European committee for the food chain and animal health, in which all European Union member states are represented, was slated to review the situation on Wednesday.

[Byline: Wendel Broere]

--
ProMED-mail
<promed@promedmail.org>

[Reasonable Rascal]

AVIAN INFLUENZA - NETHERLANDS (05): OIE
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A ProMED-mail post

Date: 3 Mar 2003
From: ProMED-mail <promed@promedmail.org>
Source: Office International des Epizooties(OIE), Disease Information [edited]
<http://www.oie.int/Messages/030303NLD.htm>


HIGHLY PATHOGENIC AVIAN INFLUENZA IN THE NETHERLANDS

(Disease never reported before to the OIE)

Information received on 3 Mar 2003 from Dr Frederik H. Pluimers, Chief Veterinary Officer, Ministry of Agriculture, Nature Management and Fisheries, The Hague.

Report date: 2 Mar 2003.

An outbreak of Avian Influenza (AI) has been identified in the Netherlands. At this moment there are 16 poultry farms suspected of Avian Influenza.

The Reference Laboratory, the Central Institute for Animal Disease Control (CIDC), Lelystad, the Netherlands confirmed the diagnosis of Highly Pathogenic Avian Influenza with the PCR test on 2 Mar 2003.

The virus is an H7 subtype for which nucleotide sequencing has demonstrated the presence of multiple basic amino acids at the cleavage site of the haemogglutinin. The IVPI results are not yet available.

Control measures undertaken on the 1 Mar 2003:

- A complete nationwide ban on markets, exhibitions, and all other events where live poultry is brought together (01.30 hours a.m.).

- Standstill: prohibition on all transport of live poultry, hatching eggs, consumption eggs, the litter and the manure in a circle of more than 10 km around the suspected farms (01.30 hours a.m.).

- Standstill nationwide: the standstill was extended nationwide for a minimum period of at 72 hours (noon 12.00 hours). Consumption eggs are excluded from this ban.

- Export ban: a complete ban was established on the export of live poultry and hatching eggs from the Netherlands (noon 12.00 hours).

- Tracing: the National Inspection Service for Livestock and Meat started tracing of the products, the feed and the animal contacts.

- A regional Crisis Centre has been set up.

Animal Health Information Department
Office international des epizooties (OIE)
<information.dept@oie.int>

Further details will be published in the next issue of Weekly Disease Information, available on line as from Friday 7 Mar 2003 afternoon (GMT).

--
ProMED-mail

[Reasonable Rascal]

AVIAN INFLUENZA - NETHERLANDS (06)
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A ProMED-mail post

[1]
Date: Tue, 04 Mar 2003
From: ProMED-mail <promed@promedmail.org>
Source: Reuters HealthNews, 04 Mar 2003 [edited]
<http://reuters.com/newsArticle.jhtml?type=healthNews&storyID=2325278>


Experts: Bird Flu Hits Dutch Poultry, No Human Risk
--------------------------------------------------
A highly contagious and fast-spreading bird influenza virus has brought the poultry industry in the Netherlands, the largest exporter of poultry in Europe, to a standstill, but the government has said
the virus poses no danger to humans.

To prevent the spread of the disease, authorities Monday began isolating and destroying poultry in one of 17 farms suspected of harboring the virus in the Eastern province of Gelderland, near the German border.

A spokeswoman for the Ministry of Agriculture said that authorities were set to work throughout Monday night to destroy the poultry at 4 more farms.

Called the Klassieke Vogelpest in Holland, the bird flu is a highly contagious viral infection that spreads very quickly through the air and via infected manure carried on shoes or tires from farm to farm. The virus is an H7 subtype of avian influenza, according to the Ministry of Agriculture.

Both the Ministries of Health and Agriculture have said there is no indication that the virus could spread to humans. A ministry Web site press release said it is 100 percent safe to eat eggs.

"The avian influenza is 100 percent not dangerous to humans," Monique Matze, a spokeswoman for the Ministry of Agriculture, said in an interview with Reuters Health. When asked if the elderly and persons
with compromised or weakened immune systems might be at greater risk, she responded, "no, there is absolutely no danger."

Matze said that the virus could spread to other birds, including turkeys, Guinea fowl, and pigeons, presenting further complications for authorities. Part of the reason that infections spread so fast is
the high density of the animals in Holland.

There has been criticism of the government for responding too slowly to the disease. Some farmers have been quoted in the media saying they fear that the disease might now reach the German boarder.

"We have lots of regulations in place and a whole system of alerts for disease that might be contagious," said Matze. "But you have to sort out what sort of virus it is...you must have the correct diagnosis."

Just a few weeks ago in Hong Kong, 2 members of the same family died and a third became seriously ill with an avian flu virus. Health authorities believe they contracted the disease via contact with infected poultry on a relative's farm. Doctors confirmed that one patient had contracted the virus H5N1 after visiting relatives who keep chickens in China's southern Fujian province. His 9-year-old son was also infected but recovered.

These were the first cases of bird flu passing to humans since an outbreak in the territory killed 6 people in 1997, triggering worldwide alarm.

"Given the conditions in the Netherlands I don't think there is any risk of infection to humans," said Albert Osterhaus, a leading Dutch virologist, in an interview with Reuters Health on Tue, 4 Mar 2003.

Osterhaus, an advisor to Health Ministry, said that the Netherlands is experiencing an outbreak of the H7N7 strain of the bird virus. The concern is that if a human does become infected with the bird virus
and a human flu virus at the same time, the viruses could "exchange genetic material and create a new virus which could be fatal, which then could lead to a pandemic," Osterhaus said.

[Byline: Andrew Conaway]

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[2]
Date: Tue, 04 Mar 2003
From: ProMED-mail <promed@promedmail.org>
Source: EU press release IP/03/305, 03 Mar 2003 [edited]


Commission adopts control measures to contain avian influenza outbreak in the Netherlands
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Brussels: Following a suspected outbreak of avian influenza in the Netherlands on 28 Feb 2003, the Commission adopted a Decision today to reinforce the control measures already put in place by the Dutch
authorities. Avian influenza is a highly contagious poultry disease that can cause severe economic damage to the poultry industry.

Suspicion of an outbreak of avian influenza in the province of Gelderland arose on the evening of 28 Feb 2003. The Dutch authorities, in cooperation with the Commission services, immediately put in place measures foreseen in Directive 92/40/EC. These measures include a nationwide standstill for the transport of live poultry and hatching eggs and a prohibition on dispatching any live poultry or hatching eggs from the whole territory of the Netherlands.

The Commission Decision adopted today reinforces these measures by defining them at the EU level. The Commission Decision specifies that no live poultry and hatching eggs may be dispatched from the
Netherlands to other Member States or third countries. They may also not be transported within the Netherlands. The Decision is addressed to the Member States, and all Member States must amend the measures they apply to trade so that they are in compliance with this decision. In view of the specificity of poultry production, the Dutch veterinary authority may authorise movements of day-old chicks and
poultry for immediate slaughter within the Netherlands as of 4 Mar 2003.

The measures contained in the Commission Decision are applicable until 6 Mar 2003. However, the situation will be reviewed at the meeting of the Standing Committee on the Food Chain and Animal Health
scheduled for 5 Mar 2003. This meeting includes representatives of the Member States and the Commission. The urgent measures adopted by the Commission could then be updated to take into account the development of the situation.

The Commission will continue to work closely with the Dutch authorities to ensure proper co-ordination within the EU.

--
ProMED-mail
<promed@promedmail.org>

[All 15 haemagglutinin (H) and 9 neuraminidase (N) subtypes of Influenza A viruses have been isolated from birds. 6 (H) subtypes (H1, H2, H3, H5, H7 and H9) and 3 (N) subtypes (N1, N2 and N7) have been isolated in the past, also from humans. In 1986, an influenza A virus (A/England/268/96), subsequently identified by the International Reference Laboratory for Avian Influenza CVL, Weybridge to be of subtype H7N7, was isolated from a 43-year-old housewife. She was referred to a hospital in Oxford, UK, with a 1-day history of right conjuctivitis. The possible source of infection was a piece of straw which had entered her eye while she was cleaning out her duck house. (Kurtz et al, Lancet, Vol 348, Sep 1996, 901-902). Influenza A viruses of H7N7 subtype have been commonly isolated in surveillance studies of waterfowl in Europe and other parts of the world. They have also been identified in the past in horses and seals; see review by D.J. Alexander and I.H. Brown in Rev. sci. tech. OIE, 2000,19 (1), 197 - 225.

The significance of the current highly pathogenic avian influenza (HPAI) outbreak in the EU context may be illustrated by the past reported incidence of the disease in the 15 member-countries, as presented in OIE's data base "Handistatus II" (last year of occurrence in parentheses): Austria (1946); Belgium (-); Denmark (0000); Finland (0000); France (1948); Germany (0000); Greece (0000); Ireland (1983); Italy ((04/2000); Luxembourg (1956); Netherlands (0000); Portugal (0000); Spain (0000); Sweden (0000); UK (01/1992). HPAI has been recorded in the past only in 4 out of the other 30 European countries, namely Albania (1973); Armenia (1985); Romania (1942); and Switzerland (1930). - Mod.AS]

[Reasonable Rascal]

AVIAN INFLUENZA - NETHERLANDS (04)
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A ProMED-mail post

Date: Mon 3 Mar 2003
From: "Ron A.M. Fouchier" <r.fouchier@erasmusmc.nl>
Source: Department of Virology, Erasmus Medical Centre, Rotterdam, The
Netherlands, Mon 3 Mar 2003 [edited]


Characterisation of the Virus Causing the Current HPAI Outbreak in the
Netherlands
----------------------------------------------------------------------
On Sat 1 Mar 2003 five 70-week old layer chickens at a farm in Scherpenzeel that were suffering from respiratory problems, diarrhoea, yawning and swollen heads and combs were culled and sent to us by the national inspection service for livestock and meat (RVV) for investigation. Upon autopsy, gross lesions of the animals included marked subcutaneous oedema of head, comb and wattles, diffuse pulmonary oedema, and multifocal haemorrhage in various tissues, consistent with highly pathogenic avian influenza (HPAI). Cloacal swabs and tracheal swabs were collected for influenza virus antigen detection as well as RNA isolation for molecular diagnostics. Swabs obtained from 4 out of 5 animals showed a weak positive reaction for influenza A virus in the Directigen A/B test (Becton Dickinson), a viral antigen detection system. All cloacal and tracheal swabs were negative upon RT-PCR testing for Newcastle disease virus and other avian paramyxoviruses. RT-PCR specific for the matrix gene of influenza A virus showed that all
five animals were positive, confirming the Directigen antigen detection results.

Parts of the hemagglutinin (HA) and neuraminidase (NA) genes were amplified by RT-PCR and sequenced providing clear evidence for the viral subtype: H7N7. The HA gene displayed high homology to the HA of A/Mallard/Netherlands/12/00 (H7N3) and the NA gene displayed high homology to the NA gene of A/Shoveler/Netherlands/18/99 (H11N7), two viruses isolated within our ongoing avian influenza virus surveillance studies. Since no viruses in the public sequence databases displayed higher homology to the H7N7 virus than the viruses isolated from Dutch wild ducks (_Anas platyrhynchos_ and _Anas clypeata_) and because the virus subtype is distinct from those involved in recent HPAI outbreaks elsewhere in the
world, we suspect that this H7N7 virus was introduced from a wild bird reservoir (ducks, geese).

The HA protein of the H7N7 virus contains a protease cleavage site consisting of multiple basic amino acids, PEIPKRRRR*GLF in agreement with this virus being classified as an HPAI. This cleavage site is distinct from those seen in other recent H7 HPAI outbreaks. Since the cleavage site of HA of A/Mallard/Netherlands/12/00 (PEIPKGR*GLF) does not contain multiple basic amino acid residues, it is possible that a low pathogenic duck virus was transmitted to poultry, in which it has mutated to an HPAI, as was the case with HPAI (H7N1) in Italy in 1999-2000.

Further characterisation of the virus genome and histology and immunohistochemistry of the organs of affected animals is currently in progress.

Ron A.M Fouchier, Thijs Kuiken, Frits H. Pluimers and Albert D.M.E. Osterhaus. Dept. Virology, Erasmus Medical Centre, Rotterdam, The Netherlands. (F.H. Pluimers is Chief Veterinary Officer in The Netherlands)

--
Ron A.M. Fouchier, PhD
Dept. Virology
Erasmus MC
Dr. Molewaterplein 50
3015 GE Rotterdam
The Netherlands
<r.fouchier@erasmusmc.nl>

[The authors or this report are to be congratulated in respect of the remarkable speed with which this critical analysis has been carried out. The haemagglutinin (HA) protein of influenza virus is a trimer of disulphide-linked HA1 and HA2 molecules that mediates the attachment and entry of the virus into a host cell. The haemagglutinin protein is synthesized as an HA0 precursor molecule which is cleaved to HA1 and HA2. Virions with uncleaved haemagglutinin are non-infectious. Haemagglutinin cleavability is dependent on both the primary structure at the cleavage site and the presence of appropriate proteases in the cell membrane. Consequently the properties of the haemagglutinin protein play a major role in determining the relative virulence of influenza viruses. In the case of avian influenza viruses, epithelial cells of the respiratory and intestinal tracts can mediate cleavage of the viral haemagglutinin protein and support viral multiplication. On the other hand, only the haemagglutinin protein of virulent viruses is susceptible to cleavage in more vulnerable tissues leading to systemic disease and death. This phenomenon accounts for both the difference in virulence of virus strains and the inherent differences in susceptibility of different avian species. In general, wild ducks appear to be resistant to strains of avian influenza viruses which are highly virulent in domestic fowl. The data presented above by Drs. Fouchier, Kuiken, Pluimers and Osterhaus establish with reasonable certainty that the H7N7 avian influenza virus responsible for the current outbreak in the Netherlands arose by mutation of a wild duck virus subsequent to transmission to domestic poultry. - Mod.CP]

[Reasonable Rascal]

AVIAN INFLUENZA - NETHERLANDS (08)
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A ProMED-mail post

Date: Wed, 05 Mar 2003
From: ProMED-mail <promed@promedmail.org>
Source: A letter from the Minister of Agriculture to the Speaker of the Dutch Parliament, 05 Mar 2003 [translated from Dutch, edited] <http://www.minlnv.nl/infomart/parlemnt/2003/par03060.htm>


Avian Influenza - Current Situation
---------------------------------------
At this moment there are 18 poultry farms where symptoms of Avian Influenza (AI) have been recorded. During the last 24 hours, one farm has been added to the list; the "10 km infected zone" in the Barneveld area has been applicably extended.

Samples are taken from all farms involved; the AI virus has been already definitely identified, by a validated test method, in 2 of them. The results of the official EU-prescribed tests are not yet available. The initial results of samples from a suspected farm in Laren are negative; consequently, I have cancelled the destruction of poultry within a 1-km zone around the said farm. The birds on the suspected farm itself have been destroyed.

During the first 72 hours following the notification of the disease to the Services under my political responsibility, central as well as regional crisis-management activities have been put into action. It has been confirmed that the national mass-destruction capacity is limited. I have therefore requested assistance abroad. This has enabled increasing the number of destroyed animals from several tens of thousands to 150 000 per day as of 5 Mar 2003. From 6 Mar 2003, the capacity will be more than 250 000 animals/day. The applied methods are required to minimize the risk of spread, and to comply with bio-security, effectiveness and speed of the killing, environmental, and labor considerations.

As of this morning, the entire stock in 7 affected plants has been stampedout; it is expected that during the day, the number will reach 14. This activity is carried out 24 hours a day. Subsequent to the destruction of the poultry in affected plants, all animals within a 1-km radius around them will be destroyed as well, excluding -- as mentioned earlier -- in the farms around the plant in Laren.

Based upon the Italian experience and advice from prominent veterinarians, I have decided that destruction of all animals within a 3-km zone is out of order. This is based upon the concentration of potential spread of infection within a radius of 1 km around the plants.

Vaccination as an alternative control method cannot be applied, since the Italian experience has demonstrated that vaccination might be beneficial only if there is an absolute certainty of the absence of the virus. In addition, the Netherlands still has no test for the detection of the virus. On top of that, vaccination of poultry is exceptionally laborious and time-consuming, therefore logistically not simple to apply.

Regarding public-health considerations: as said in my letter of 3 Mar 2003, the risks for public health are negligible, based upon information from the Food and Non-Food Authority (VWA) and from the
Coordinating Board for Infectious Disease (BAO) in the Ministry of Public Health, Sport and Welfare (VWS). BAO's determination, in turn, is based upon the opinion of the Outbreak Management Team Influenza (OMT) chaired by the Director Public Health in the National Institute for Public Health and Environment (RIVM). The Secretary of State of the VWS has adopted, on 5 Mar 2003, BAO's statement dated 4 Mar 2003. However, scientists represented in the OMT have remarked that the possibility of the current virus mutating when in contact with human influenza virus cannot be completely excluded. In such a case, the avian virus might change into a variant which might endanger humans. In view of the available data of the current avian virus in the poultry farms, they consider the possibility of such a development
very remote.

The opinions of VWA and OMT/BAO have taken these exceptional possibilities into account. Therefore, the OMT includes in its opinion a recommendation to take protective measures for people who come in extended and close contact with infected poultry. This relates mainly to the personnel engaged with the destruction activities; such measures have already been applied.

Within the limits of my legal capacity and as far as control measures are not affected, I shall exclude avians of rare breeds from destruction.

--
ProMED-mail
<promed@promedmail.org>

[There is a lot to learn from this ministerial letter about crisis management aspects of the current HPAI epizootic in the Netherlands. Details on the measures applied to protect personnel from the virus are of special interest. - Mod.AS]

[Reasonable Rascal]

AVIAN INFLUENZA - NETHERLANDS (09)
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A ProMED-mail post

Date: Fri, 7 Mar 2003
From: ProMED-mail <promed@promedmail.org>
Source: De Volkskrant (Amsterdam), 07 Mar 2003 [translated from Dutch, edited].
<http://www.volkskrant.nl/denhaag/1046932125599.html>


Veerman fears new outbreaks
---------------------------
Minister Veerman of Agriculture is seriously considering the appearance of new Fowl Plague [Vogelpest - - the Dutch term for Highly Pathogenic Avian Influenza, HPAI] outbreaks. Blood tests in chickens should clarify the possible risks of the appearance of the animal disease in the entire country. "I am afraid that the end of the crisis is not yet in sight", he told the parliament Thursday.

The minister fears that, in addition to the HPAI virus present in the Gelders Valley, a second less infectious variant is circulating. A less pathogenic virus might develop into a dangerous one, causing the disease to turn up in other places.

While this scenario is not yet supported by hard facts, the Minister based his suspicions upon the Italian experience. The virus has struck there time and again since the late 90's, leading to the accumulated destruction of almost 20 million chickens.

In the Gelders Valley, the virus has been identified in 8 farms. 17 additional farms are "suspected". Veerman has already decided to eliminate the poultry on about 60 farms, including the infected and suspected ones. All the chickens (about half a million) will be destroyed by the end of this week. Destruction capacity is sufficient to reach this goal.

Veerman rejected the demand of VVD and LPF (political parties) to destroy additional poultry farms. He regards the proposed measures as sufficient. He also defended his decision to carry out the stamping-out activities "from insideout" (first the infected farms, then the surrounding ones).

Following a request from the parliament, Veerman will ask the European Commission to review its AI vaccination policy. At present, the Commission allows vaccination only as an extreme measure.
Scientists in the ministry have indicated that vaccination will result in technical as well as financial difficulties, both interfering with tests and compromising export of eggs.

The Cabinet Council will discuss extra financial support for the affected poultry owners. In addition to compensation for the killed animals, covered by both the cabinet and "Brussels", the parliament wants compensation for losses due to discontinued exports. Minister of Social Affairs De Geus is investigating whether the affected farmers may be eligible for aid payments.

--
ProMED-mail
<promed@promedmail.org>

[From this news item it seems that the total number of HPAI outbreaks in the Netherlands has reached 25. An official update might be expected in today's (Friday) weekly information bulletin of the OIE.

Readers may refer to the following relevant EU publications:

1. Chronology of outbreak in the Netherlands starting 28 Feb 2003
<http://europa.eu.int/comm/food/fs/ah_pcad/ah_pcad_77_en.pdf>

2. Fact sheet Avian Influenza
<http://europa.eu.int/comm/food/fs/ah_pcad/ah_pcad_76_en.pdf> - Mod.AS]

[Flipper]

however, scientists represented in the OMT have remarked that the possibility of the current virus mutating when in contact with human influenza virus cannot be completely excluded. In such a case, the avian virus might change into a variant which might endanger humans. In view of the available data of the current avian virus in the poultry farms, they consider the possibility of such a development
very remote.


2 days ago one of the workers who are destroying the chickens has been infected with the virus... He is not terminally ill but there is a warning now for those workers to get an influenza shot to prevent more cases.

They also found more infected farms in one of the provinces near the Belgium border...

Flipper

[Reasonable Rascal]

AVIAN INFLUENZA - NETHERLANDS (11)
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A ProMED-mail post

Date: Tue, 11 Mar 2003
From: ProMED-mail <promed@promedmail.org>
Source: IrelandOnLine, 11 Mar 2003 [edited]
<http://breakingnews.iol.ie/news/story.asp?j=64397790&p=64398496>


Dutch poultry flu spreads
-------------------------
The Dutch government has extended restrictions on the transport of poultry to a second province, indicating that an outbreak of bird flu has spread.

The agriculture ministry imposed a new ban in the southwestern Dutch province of Zeeland yesterday and said it had "serious indications" that a poultry farm there was contaminated with the highly contagious avian influenza -- which is not dangerous to humans.

The Netherlands has slaughtered hundreds of thousands of chickens since health authorities first discovered an infected farm 10 days ago in the central province of Gelderland.

The European Union has banned all exports of Dutch poultry until 13 Mar 2003.

--
ProMED-mail
<promed@promedmail.org>

[The Dutch Zeeland province is on the border with Belgium. As reported today by the Dutch daily "de Volkskrant", the Belgian National Food Authority (VAA) has applied to the police to prevent any entry of Dutch poultry into Belgium. The Belgian authorities have taken initial safety measures upon the first reports of the Dutch HPAI outbreak last week. These steps included the closing down of all poultry markets; more than 20 farms that had imported live birds or hatching eggs from the Netherlands prior to the notification of the outbreak have been put under surveillance. - Mod.AS]

See also:

AVIAN INFLUENZA, HUMAN - NETHERLANDS

http://medtech.syrene.net/forum/showthread.php?s=&threadid=1200

Avian Influenza - Belgium: Suspected

http://medtech.syrene.net/forum/showthread.php?s=&threadid=1201

RR

[Reasonable Rascal]

AVIAN INFLUENZA - NETHERLANDS (10)
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A ProMED-mail post

[1]
Date: Sun, 09 Mar 2003
From: ProMED-mail <promed@promedmail.org>
Source: Press release, Netherlands Ministry of Agriculture 8 Mar 2003 [translated from Dutch & edited by Mod.AS]
<http://www.minlnv.nl/infomart/persinfo/>


Monitoring of poultry for fowl plague
--------------------------------------
Minister Veerman of Agriculture, Nature Management and Fisheries, has decided to start a countrywide surveillance programme, monitoring the presence of the Highly Pathogenic Avian Influenza
(Klassieke Vogelpest; HPAI) virus. Behind this decision is the possibility that, besides the highly pathogenic virus variant, a less pathogenic variant might also be circulating in the Netherlands.

Randomly selected samples will be collected in all provinces andsectors. In addition, it has been decided to test all meat-producing duck, turkey, and chicken farms which provide access to the outdoors [for the poultry]. The total number of such farms, within and outside the Gelders Valley, is about 1300. This mass survey will be completed next week and will be regularly repeated for the foreseeable future.

So far, 14 farms have been found infected and 22 seriously suspected in the Gelders Valley. The HPAI variant is very infectious, recognizable by swelling of the head and neck and the discoloration of the comb and legs. Incubation is about 10 days. The disease then proceeds swiftly, leading to death in most cases.

The low-pathogenic variant [LPAI] is much less recognizable, demonstrating lower infectivity and mortality. The main symptom is decreased egg laying.

******
[2]
Date: Sun, 9 Mar 2003
From: ProMED-mail <promed@promedmail.org>
Source: De Volkskrant, Amsterdam, 8 Mar 2003 [translated from
Dutch & edited by Mod.AS]
<http://www.volkskrant.nl/binnenland/1047019695763.html>


Compensation for fowl-plague affected farms
----------------------------------------------
The cabinet has allocated at least 5 million Euros for farms affected by the fowl plague [Highly Pathogenic Avian Influenza]. Minister Veerman will increase the fund when industry, local governments and municipalities contribute their share. The number of infected and suspected farms in the Gelders Valley has in the meantime become 36.

Following the same policy which was adopted during the FMD crisis, the emergency fund will support, besides the affected poultry farm, other affected activities such as recreation and catering enterprises. The new fund is meant only to compensate lost income, while the costs involved in the destruction of hundreds of thousands of birds are to be covered by the government and the European Union.

The number of infected farms is currently 11; another 25 are suspected. All 36 farms are situated within the Gelders Valley, where the first outbreak was discovered on Friday, 9 days ago. The ministry's spokesperson is not worried about the new cases. "Fowl plague can have an incubation time of 2 weeks. New foci outside the current infected zone would be a cause for worry."

The minister has extended the ban on transportation, adding horses, cattle, sheep and pigs to the list of animals that are not allowed to enter or exit the poultry-farms area.

The destruction of about 500 000 chickens on the infected, suspected, and neighbouring farms is proceeding without problems. The "Belgian" method (using carbon monoxide or dioxide) and other
methods, such as electrocution, provide sufficient destruction capacity.

State-secretary Ross (Public Health) urges all destruction personnel to get a flu vaccination. Fowl plague is not dangerous, but a person with flu may undergo the risk of enabling the fowl virus to mix with the human flu virus, producing a new and possibly dangerous type. There is no point in vaccinating poultry owners or their families: the vaccine works only after 10 days, when the birds have already been eliminated.

[Byline: Marc Peeperkorn]

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ProMED-mail
<promed@promedmail.org>

[On Sunday, 9 Mar 2003, 3 additional suspected farms have been reported, bringing the total number of HPAI infected/seriously suspected poultry plants in the Netherlands to 39. From the official press release, one may conclude that the presence of LPAI variant is based upon observed decreased egg production in layer flocks. The Dutch mass-testing programme is impressive, and is essential for decision making -- including the possible use of vaccines. It has been previously reported that veterinary students from the Faculty of Agriculture in Utrecht have been recruited to assist in the control and monitoring activities.

This serious outbreak might lead one to question the role that current farming practices, such as outdoor rearing of poultry -- whether due to animal welfare or other (organic farming) considerations -- might have played in exposing susceptible domestic animals to infection. - Mod.AS]

[Reasonable Rascal]

AVIAN INFLUENZA, HUMAN - NETHERLANDS (06)
******************************************
A ProMED-mail post

Date: Tue, 18 Mar 2003
From: ProMED-mail <promed@promedmail.org>
Source: Agrarisch Dagblad, 18 Mar 2003 [translated from Dutch by Mod. AS,
edited]

Fowl plague infects 31 people
-----------------------------
THE HAGUE: The number of people infected by the avian influenza virus has risen to 31. This has been reported to the parliament on Mon, 17 Mar 2003, in a letter from the Ministry of Public Health.

Last Friday, it was announced that the number of people, infected by the virus, was 19. Almost all of them were involved in poultry depopulation activities on infected premises. One case of human-to-human transmission has been reported. According to the Ministry, the [eye] lesions are unharmful and easy to heal.

--
ProMED-mail
<promed@promedmail.org>

[The Dutch Ministry of Agriculture announced yesterday (17 Mar 2003) that the total number of poultry plants affected by highly pathogenic avian influenza (HPAI) has risen to 87, of which 52 are regarded "definitely infected" and 35 "seriously suspected". Following the recording of a new outbreak in Putten, the Gelders Valley area of animal transport restrictions has been extended. - Mod.AS].

[Reasonable Rascal]

AVIAN INFLUENZA, HUMAN - NETHERLANDS (07)
*****************************************
A ProMED-mail post

Date: Wed 19 Mar 2003
From: Adam Meijer <Adam.Meijer@rivm.nl>


The antiviral susceptibility of the highly pathogenic avian influenza (HPAI) H7N7 influenza A virus causing conjunctivitis in humans
----------------------------
Following the identification of an increasing number of human cases of influenza A/H7N7 associated conjunctivitis last week, we determined the susceptibility of the virus isolated from the clinical sample of the first reported case in anticipation of the possible use of antivirals for the prophylaxis and treatment of HPAI H7N7 (1). This stock virus was typed as H7 using the hemagglutination inhibition assay with an anti-H7 antiserum. The susceptibility of the virus for the neuraminidase inhibitors oseltamivir (Tamiflu) and zanamivir (Relenza) was tested using a miniaturized format of the fetuin based biochemical assay (2). [Oseltamivir and zanamivir are a well-tolerated influenza virus neuraminidase inhibitors, active against both A and B influenza viruses. Oseltamivir is administered orally, and zanamivir via an inhaler. - Mod.CP].

The 50 per cent inhibitory concentration (IC50) of oseltamivir for the H7N7 virus was 1.29 nM (95 per cent confidence interval [CI] 1.19-1.40 nM) and of zanamivir 3.94 nM (CI 3.61-4.29). A known sensitive control virus (A/Chicken/Pennsylvania/21525/83 H5N2) had an IC50 of 0.33 nM (CI 0.30-0.36) for oseltamivir, similar to previous observations. IC50 values for sensitive H1N1 and H3N2 clinical isolates were between 0.2 and 6.8 nM for oseltamivir and between 0.3 and 13.1 nM for zanamivir, dependent on
isolate and assay (3).

This shows that the currently circulating HPAI H7N7 virus in the Netherlands is susceptible to oseltamivir as well as zanamivir. Since orally dosed oseltamivir becomes available systemically (highly likely including the conjunctivae via the tear-fluid) whereas zanamivir taken via an inhalator is only locally active in the respiratory tract, Tamiflu was the drug of choice for the prophylaxis and treatment of infection of
persons with the H7N7 virus (4).

These measures, effective as of 16 Mar 2003, call for prophylactic oseltamivir treatment of all persons involved directly in the screening and culling of infected flocks, and therapeutic application in all persons within these groups with conjunctivitis and/or influenza-like illness. [The rationale is presumably to reduce the probability of co-infection of individuals by the avian virus and any fortuitously circulating human
influenza virus, which might allow the generation by sub-unit reassortment of a human influenza A virus with a novel combination of haemagglutinin (H) and neuraminidase (N) antigens. - Mod.CP].

References:
(1) Fouchier R, Koopmans M, Meijer A, Wilbrink B, van Wijngaarden J, Osterhaus A. Avian Influenza, human - Netherlands. H7N7 Conjunctivitis; human. ProMED-mail posting, 11 Mar 2003. [see: "Avian influenza, human - Netherlands 20030311.0594"] .
(2) Aymard-Henry, et al. Bull World Health Org 1973; 48: 199-202.
(3) Wetherall, et al. J Clin Microbiol 2003; 742-50.
(4) Ministry of Health, Welfare and Sport, The Netherlands. Extra maatregelen tegen risico's vogelpestvirus (press release) 15 Mar 2003. (<http://www.minvws.nl/document.html?folder=393&page=19369>) [see: "Avian influenza, human - Netherlands (04) 20030315.0643"].

Contributed by Adam Meijer, Berry Wilbrink, Jan van Wijngaarden, Ron Fouchier, Ab Osterhaus, Marion Koopmans, National Institute of Public Health and the Environment, Bilthoven, The Netherlands. (Jan van Wijngaarden is inspector of infectious diseases of the Ministry of Health, Welfare and Sport; Ron Fouchier and Ab Osterhaus are from the National Influenza Centre for the WHO in the Netherlands at Erasmus MC, Rotterdam, The Netherlands).

--
Adam Meijer, PhD
Diagnostic Laboratory for Infectious Diseases and Perinatal Screening
National Institute of Public Health and the Environment
PO Box 1, 3720 BA Bilthoven
The Netherlands
<adam.meijer@rivm.nl>

[ProMED-mail welcomes the opportunity to assist in disseminating this essential information rapidly to interested parties. ProMED-mail has no commercial association with the biopharmaceutical companies marketing these neuraminidase inhibitors. - Mod.CP]

[Reasonable Rascal]

AVIAN INFLUENZA - NETHERLANDS (15)
**********************************
A ProMED-mail post

Date: Mon, 24 Mar 2003
From: ProMED-mail <promed@promedmail.org>
Source: Reuters, 24 Mar 2003 [edited]


Dutch bird flu cases keep rising, no end in sight
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The number of bird flu cases in the Netherlands continued to grow on Monday and authorities remained unsure when the outbreak would stop spreading.

All confirmed cases so far have been confined to the central Gelderland province, calming fears that the highly-contagious disease would spread like wildfire through the European Union's biggest poultry exporter and the world's largest egg exporter.

But several more cases are being reported each day, with confirmed ones growing to 97 farms on Monday and the number of farms suspected of infection at 37, agriculture ministry spokesman Benno Bruggink told Reuters. "We don't know really (when the number of cases will stop growing). Our epidemiologists are working on it, trying to find the logic of where it's expanding," he added.

Poultry exports have been banned and agricultural transport severely restricted in the country, which is also the world's fourth biggest poultry exporter. The outbreak has cost the poultry sector in the Netherlands, which has around 100 million birds, more than 40 million euros since the disease was discovered 3 weeks ago, based on estimates by authorities of around 2 million euros per day.

Tests are continuing on farms throughout the country and the aim is eventually to probe all farms. Bruggink said antibodies for a lower-grade variant of the bird disease had been found on 3 turkey farms outside the main contaminated area, in the southwest of the country, but no quarantine was imposed as the actual disease had not been found. The less virulent variant of bird flu is not harmful in itself, but authorities fear it mutates into the deadly version.

--
ProMED-mail
<promed@promedmail.org>

[The Dutch ministry of Agriculture, Nature Management & Fisheries reports on Tue, 24 Mar 2003 that 7 outbreaks have been added since yesterday, the total number of poultry farms affected by fowl plague (highly pathogenic avian influenza, HPAI) reaching 141, of which 97 are "definitely infected" while 44 are, at present, regarded "highly suspected".

In another press release, the Ministry announced an alleviation of the animal transport restrictions, allowing broilers for immediate slaughter to be imported from German farms directly to Dutch slaughterhouses. The Ministry explains that the decision is considered not to compromise biosecurity. It has been taken in view of the animal welfare problems, created on German farms due to the Dutch import ban. This measure comes into effect Tue, 24 Mar 2003, at 18.00 pm. - Mod.AS]

[Reasonable Rascal]

AVIAN INFLUENZA, HUMAN - NETHERLANDS (08)
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A ProMED-mail post

Date: Thu 27 Mar 2003
Source: Eurosurveillance Weekly, Thu 27 Mar 2003, Volume 7 / Issue 13 [edited]
<http://www.eurosurveillance.org/ew/2003/030327.asp>

Human Infection Associated with Outbreak of Fowl Plague (Avian Influenza) in The Netherlands: Update as of Thu 27 Mar 2003
---------------------------------------------------
At the beginning of March 2003 an outbreak of highly pathogenic avian influenza (A/H7N7) in several Dutch poultry farms was reported (1). On Tue 11 Mar 2003, several workers who had been exposed to A/H7N7 infected poultry developed conjunctivitis. Some of them tested positive for influenza A/H7N7 (2). One week later, 2 close contacts of a worker with H7N7 infection developed similar eye symptoms. They had also been infected with the avian influenza virus, although they had no exposure to infected poultry themselves, which strongly suggests human-to-human transmission of the virus (3).

The latest enhanced surveillance (up to Wed 26 Mar 2003), established by the Centre for Infectious Disease Epidemiology (RIVM) in collaboration with a multi-organisation partnership, has identified 247 persons with acute health problems among the population exposed to infected poultry. Of these, 194 had conjunctivitis, 17 had influenza-like illness (ILI) only, and 36 reported other symptoms such as diarrhoea, and nausea. Of the 194 persons with conjunctivitis, 35 also reported ILI.

Of the 247 patients, 65 (26.3 percent) have tested positive for influenza A/H7N7, 5 were influenza A/H3 positive, 137 were influenza virus negative, and in 40 results are pending. Of 194 patients with conjunctivitis, 169 test results were available, 61 had conjunctival swabs positive for H7N7 (36 percent), and 4 had throat swabs positive for H3 (2 percent). 4 patients with positive H7N7 results had unknown or other (no conjunctivitis or ILI) symptoms. No additional contacts, besides the 2 already mentioned, have been reported A/H7N7 positive.

No double infections with influenza A/H7N7 virus and A/H1 or A/H3 influenza viruses have been found. Co-infection with both human and avian influenza virus could potentially lead to a reassortment of both viruses and result in a new pandemic.

Since Thu 13 Mar 2003 there has been a fall in the number of reported conjunctivitis patients (the total number, as well as the number and proportion of H7 infections). This decline may be due to control measures, e.g., wearing protective glasses, mouth masks, and improved personal hygiene that were implemented around that time. The drop in the number of H7 infections after 20 Mar 2003 coincides with the implementation of oseltamivir prophylaxis, which became obligatory for all workers on 14 Mar 2003, although it is too early to suggest a causal relationship. The enhanced surveillance continues.

References:

(1) Ministry of Health, Welfare and Sport, The Netherlands. Ruimer pluimvee besmet met vogelpestvirus (press release) 11 Mar 2003. (http://www.minvws.nl/document.html?folder=393&page=19347).

(2) Fouchier R, Koopmans M, Meijer A, Wilbrink B, van Wijngaarden J, Osterhaus A. Avian Influenza, human - Netherlands. H7N7 Conjunctivitis; human. ProMED mail posting, 11 Mar 2003 [see: Avian influenza, human - Netherlands 20030311.0594].

(3) Meijer A, Du Ry van Beest Holle M, Fouchier R, Natrop G, Wilbrink B, Bosman A, et al. Outbreak of fowl plague (avian influenza) leads to secondary human cases, March 2003, the Netherlands. Eurosurveillance Weekly 2003; 7: 030320. (http://www.eurosurveillance.org/ew/2003/030320.asp).

(By A. Meijer 1, M. Du Ry van Beest Holle 2, 3, R. Fouchier 4, G. Natrop 5, B. Wilbrink 1, A. Bosman 2, 3, A. Osterhaus 4, J. van Steenbergen 6, M. Conyn-van Spaendonck 2, M. Koopmans 1

1 National Institute of Public Health and the Environment (RIVM), Diagnostic Laboratory for Infectious Diseases and Perinatal Screening
2 RIVM, Centre for Infectious Disease Epidemiology
3 European Programme for Intervention Epidemiology Training (EPIET), mirna.dury@rivm.nl
4 Erasmus Medical Centre Rotterdam, Department of Virology
5 Municipal Health Service
6 Office of the National Coordination Structure for Infectious Disease Control)

--
ProMED-mail
<promed@promedmail.org>

[Flipper]

From the local news:

This week the first human victim was confirmed. A vet who was working in one of the infected areas has died by an pulmonary infection with the avian influenza. He didnt use (or didnt know...)the anti viral medications that people who get into close contact with infected livestock are required to take...

There is a lot of concern right now in the affected areas but no extra measures ar being taken except opening a special information number.
In belgium the government is taking more steps like giving everybody in a certain range around infected farms the anti viral medicines.

On a side note:
Possibly there will be a shortage of human influenza vaccin because these are being used in the infected areas for destruction workers etc.


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