Survey suggests avian flu cases may be going unnoticed

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first_imgJan 10, 2006 (CIDRAP News) – A survey conducted in Vietnam in 2004 suggests that human cases of avian influenza may be much more common but less severe than indicated by the numbers of confirmed cases, although the findings are not backed by laboratory testing.In the questionnaire survey of more than 45,000 people in a rural area hit by avian flu in poultry, about 18% reported having had a recent flu-like illness, according to the report in Archives of Internal Medicine.People who had had direct contact with sick or dead poultry had a significantly higher rate of flu-like illness, defined as cough and fever, than those without such contact. The authors—Anna Thorson, MD, PhD, of the Karolinska Institutet in Stockholm and several colleagues—estimate that 650 to 750 cases were attributable to contact with sick or dead poultry.The findings “are consistent with a higher incidence of HPAI [highly pathogenic avian influenza] among humans than has been recognized previously,” the report says. “The results suggest that the symptoms most often are relatively mild and that close contact is needed for transmission to humans.”The World Health Organization has logged 147 confirmed human cases of H5N1 avian flu, including 78 deaths, since late 2003. Disease experts have often speculated that the true number of cases could be significantly higher because of mild or asymptomatic cases going undetected.As the authors acknowledge, however, the new study is only suggestive, because it involved no blood testing to verify H5N1 infection in the survey participants.Capitalizing on a regular demographic survey conducted in a rural area of Ha Tay province of Vietnam, the authors added questions about flu-like illness and contact with poultry. The survey was conducted in the spring of 2004. Participants were asked if they had been sick with a cough and either fever or dyspnea in the previous 6 months and if they’d had any contact with poultry in that time.About 84% of the 45,476 people surveyed lived in households with poultry, and about 26% (11,755) lived in households that reported sick or dead poultry, the article says.Just having poultry in the household was not a significant risk factor for self-reported flu-like illness, but having sick or dead poultry in the household was (odds ratio, 1.14; 95% confidence interval [CI] 1.06 to 1.23). Contact with sick or dead poultry was even more significant, increasing the risk by 73% (odds ratio, 1.73; 95% CI, 1.58 to 1.89).The researchers say the “convincingly higher” risk in people who had direct contact with sick or dead poultry demonstrates that “the flulike illness in our study was not easily transmitted from birds to humans.”The link between illness and contact with sick or dead poultry varied across different age-groups. There was no link at all in children younger than 7, while the association was strongest in adults between the ages of 19 and 45 (odds ratio, 2.36; 95% CI, 2.13 to 2.62).People who had been sick after contact with sick or dead poultry also were more likely to have missed work or school than those who had been sick without such exposure, the report says.The authors state, “In the absence of serological data, we cannot state the cause of disease.” They say the findings could reflect other illnesses that strike both poultry and humans, such as psittacosis, but in the circumstances, avian flu was the most likely cause of the illness linked to contact with sick or dead poultry.The data need to be confirmed by population-based serologic studies and by virologic testing in patients with mild infection, the researchers add.Other disease experts varied in their reactions to the study.Dr. Frederick Hayden, an avian flu specialist at the University of Virginia, said the study was evidence of the need for widespread blood testing in Asia to learn the true incidence of human cases, according to an Associated Press (AP) report today.Dr. Gregory Poland, a flu expert at the Mayo Clinic in Rochester, Minn., took the findings seriously. “I would call this the smoking gun,” he told the AP. “All of us have been concerned and have guessed that the data we have so far has been the tip of the iceberg.”Poland said the findings suggest that the prevalence of mild human cases in rural areas is “pretty high.”But Michael T. Osterholm, PhD, MPH, was skeptical of the authors’ conclusions, given the lack of proof that the survey respondents had avian flu. He is director of the University of Minnesota Center for Infectious Disease Research and Policy, publisher of this site.”I don’t believe the study really adds much to our understanding of the possible relationship between H5N1 infection and mild illness,” he said. “There is no serologic data demonstrating that the people even had H5N1 infection. Several recent efforts in Southeast Asia show that very few asymptomatic or mild infections occur in settings where we know H5N1 transmission has occurred.”In addition, the connection between reported illness history and the presence of sick or dead birds could be a result of “recall bias, a common problem in similar retrospective studies,” he said.Thorson A, Petzold M, Chuc NTK, et al. Is exposure to sick or dead poultry associated with flulike illness? Arch Intern Med 2005 Jan 9;166(1):119-23 [Abstract]last_img

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Eurostat: How Europeans usually travel and spend during spring and summer

first_imgIn the spring of 2018, EU residents made almost 390 million tourist trips, representing 34% of the annual total. During those trips, they collected over 1,8 billion overnight stays and spent 170 billion euros. To estimate the potential loss that the tourism sector will experience due to these constraints, Eurostat has set aside baseline figures from the previous two years for the period March-June and July-August at EU level. Source: Eurostat Belgians preferred to travel abroad, where the vast majority of trips during the spring and peak summer seasons were outside the country of residence (79%). 390 million trips in the spring, 270 million trips during the peak summer season Challenging moments are ahead of the tourism sector, and as with everything, those involved in strategic and market development will recover faster. Spring and summer are the most popular seasons in the European tourism industry. In 2019, the number of overnight stays and non-residents in EU tourist accommodation facilities during the spring and peak of the summer season was almost one third (32%) of the annual total number of overnight stays. The tourism industry is currently the hardest hit by the impact of the Covid-19 epidemic, and is among the first industries to stop and recover the longest. For the purpose of this analysis, the “summer peak” season does not cover June, but focuses on two months (July and August) that overlap with the main holiday season in most Member States. In the summer of 2018, EU residents made over 270 million trips, accounting for 24% of the annual total. Those trips amounted to over 1,9 billion overnight stays and almost 138 billion euros in tourist spending. During the summer, this also applied to Greeks, Romanians, Portuguese and Spaniards, who spent most of their tourist trips within their country of residence (95%, 91%, 90% and 89%). On the other hand, tourism is directly and deeply affected this time, and although it recovers quickly, this time we can only talk about the beginning of recovery when a cure is found. From that moment on, 3-5 years of recovery await us, so that global travel returns to the same numbers as before. Also, a factor that is extremely important is domestic consumption, ie domestic tourists, and not so much dependence on foreign tourists. For example, in Germany and Austria they have the habit, but also the financial power, to generate domestic travel throughout the year, so they will recover much sooner, while in Croatia, primarily due to the worse financial situation, we are extremely dependent on foreign tourists – which is the current situation further negative factor. More than two thirds (70%) of trips were in the country of residence, while 22% were trips to other EU countries and 8% to destinations outside the EU. A similar pattern was observed for year-round travel, including during the peak summer season.center_img At the other end of the scale, residents in Romania and Spain preferred to travel to their country of residence in the spring, making up 94% and 90% of domestic travel, respectively. There will be more weekend travel, and large malls will be avoided. Active holidays in rural and continental areas will be required. Awareness of organic and organic food will increase significantly, as will demand for it. Digitization will play a key role, as will mobile payments. Too much dependence on tourism will unfortunately cost Croatia dearly, but as every crisis offers an opportunity, this is certainly not the time to bow your head, but to roll up your sleeves and define a new tourism paradigm on a healthy and sustainable basis. Are any of our new tourist stories being considered? This, as well as the next few years, regional travel will be in focus The share of spring season member states in annual tourist accommodation is relatively similar, ranging from 24% in Croatia and 27% in Bulgaria to 35% in Cyprus, Luxembourg, Malta and the Netherlands. In the height of the summer season, this share ranged from 23% in Malta to 58% in Croatia. Preferred European destinations outside the EU were: Spain, Italy and to a lesser extent France and Germany, which together accounted for 49% of intra-EU travel during spring 2018 and 45% in summer. Spain and Italy are the main destinations for visitors within the EU The share of overnight stays in these accommodation facilities was particularly high in June for the spring season and amounted to 11% of the annual total, as well as in July (15%) and August (17%). A similar trend was observed for both residents and non-residents of the countries visited. Also, as measures are relaxed throughout Europe, so is the economy, and all countries will encourage and communicate domestic consumption, so that citizens can shop and travel locally. Logically, it is imperative to start the local economy as soon as possible. Optimistic estimates say that 25-30% of last year’s annual turnover is expected this year. Certainly how this extraordinary situation will leave various consequences on the behavior of tourists and how the tourism sector will change. One thing is for sure, more will travel within Europe, and car and train will be the dominant transports, while air traffic will fall significantly. As Eurostat’s analysis focused on “spring and summer tourism”, it should be noted that the most important for us are the seventh, eighth and ninth months, where 63 percent of total turnover is realized. From March to June, Austria dominated the top 5 most favorable destinations within the EU, and in July and August Croatia was among the most popular destinations for tourists from the EU.last_img

The first residents have staked their claim in a new Sunshine Coast community

first_imgHarmony’s first residents – Ben Francis and Caisa Tottszer.THE first residents have moved in to AVID Property Group’s $3 billion Palmview development, Harmony.Ben Francis and his partner Caisa Tottszer, both aged 21, moved in just before Christmas, and are among the first of 12,000 residents expected to move in to the masterplanned community over the next 15 to 20 years.“We were looking to buy a house for around six months and looked at places and developments all over the coast,” Mr Francis said.“We decided to buy a piece of land in Harmony, as we had heard great things about the plans for the development, as well as it being so central to everything on the Sunshine Coast.“I work in Caloundra and my partner works in Noosa, so it is the perfect location for us. We both grew up on the Sunshine Coast and love the lifestyle here.”The couple chose a three-bedroom, single story house by Sunshine Coast builder, NuTrend Quality Homes. Harmony at PalmviewAVID Property Group general manager Queensland Bruce Harper said it was exciting to be welcoming the first residents at Harmony.More from news02:37Purchasers snap up every residence in the $40 million Siarn Palm Beach Northless than 1 hour agoNew apartments released at idyllic retirement community Samford Grove Presented by “Harmony has been almost 10 years in the making and it is rewarding to finally see our first residents settling in and buyers’ dreams becoming a reality,” Mr Harper said.“We are looking forward to hosting a range of events, like long table dinners, that will help residents meet their neighbours and develop lifelong friendships.”Mr Harper said there was a “hive of activity on-site” with lots of homes due for completion. Once complete, Harmony will feature 4800 homes, 100 hectares of open space, including Queensland’s first grand linear park, and a 15,250sq m town centre.Harmony is home to the largest display village on the Sunshine Coast, Harmony Display World.The display precinct showcases 43 architecturally designed homes from 25 local and national builders. THE BASICS HARMONYDeveloper: AVID Property GroupPrice: House and Land Packages from $416,261Location: Palmviewlast_img

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