Building the Future of Biodefense

Recommendation: The primary impact of highly pathogenic avian influenza (HPAI) outbreaks in commercial flocks is the increased cost of eggs or poultry products when outbreaks become more widespread. Organizations sensitive to egg and poultry prices should have a contingency plan for price volatility. PHC recommends that continuity plans be reviewed and updated in preparation for high-consequence infectious disease threats.

Situation: According to media sources, avian influenza was detected at a 2nd poultry farm in Japan's northern prefecture of Hokkaido on 11/2, affecting almost 236,000 egg-laying chickens. The number of chickens to be culled represents about 4% of all egg-laying hens in Hokkaido. Additionally, media sources reported avian influenza at a poultry farm in Tainai City in Niigata Prefecture on 11/3. Rapid tests on 10 chickens found 9 positive for A-type avian influenza. Approximately 630,000 egg-laying chickens housed at the facility will be culled. If confirmed as highly pathogenic, this would mark the 1st case in a Niigata farm this season and the 3rd confirmed case nationwide. [Confidence: Very High]

Recommendation: The hepatitis A vaccine is over 95% effective in preventing disease in people who have received two shots. A single shot of the hepatitis A vaccine can prevent hepatitis A if given within 14 days after exposure. Organizations traveling to or working in the northern Sagaing Region of Myanmar should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. The US State Department lists Myanmar under a Level 4: Do Not Travel advisory.

Situation: According to media sources, an outbreak of hepatitis A is spreading rapidly in the northern Sagaing Region of Myanmar, affecting both civilians and resistance fighters in liberated areas. Since mid-Oct, cases of jaundice and liver disease have surged, with some villages reporting that about 2 out of every 5 people have been infected. Medicine shortages caused by junta blockades, along with poor sanitation and limited access to clean water, are driving the spread of the virus. [Confidence: Very High]

Recommendation: Chikungunya circulated at low levels in Bangladesh after a major outbreak in 2017, but the disease has started to resurge in recent years. Organizations in Dhaka, Bangladesh, should reduce mosquito habitats by eliminating standing water and applying insecticides to outdoor storage containers, as well as encouraging employees to prevent mosquito bites. Organizations should support pregnant employees who opt not to travel to the affected area. Employees should consult a doctor about vaccination against chikungunya before traveling to Bangladesh. Vaccine eligibility and availability may vary by country.

Situation: Bangladesh reported 147 new chikungunya cases since the last PHC's alert on 9/11, totaling 879 cases in Dhaka so far this year. Cases peaked at the end of May before declining, though a slight uptick in cases was reported over the past 2 weeks of data. Widespread circulation was documented in Dhaka North and South City Corporations, as well as Chattogram. Health officials noted that cases are likely underreported, given the lack of a routine national chikungunya surveillance system and clinical overlap of the disease with dengue, which is circulating widely. See PHC alerts on 9/11, 8/5, and 6/27. [Confidence: Very High]

Recommendation: The hepatitis A vaccine is over 95% effective in preventing disease in people who have received two shots. A single shot of the hepatitis A vaccine can prevent hepatitis A if given within 14 days after exposure. Organizations in Saskatchewan, Canada, should provide flexible work schedules to support employees making vaccine appointments for themselves or family members.

Situation: Saskatchewan health officials confirmed a hepatitis A case in a food service worker at McDonald's located at 1803 50th Avenue in Lloydminster. Anyone who ate or drank at the restaurant on 10/6, 10/9-13, and 10/16-19 may have been exposed to hepatitis A. Individuals should monitor for symptoms for 50 days following their exposure date, and, if they have not already received 2 doses of the vaccine, get vaccinated within 14 days after exposure. [Confidence: Very High]