Adam Meijer, Corien M Swaan, Martin Voerknecht, Edin Jusic, Sharon van den Brink, Lisa A Wijsman, Bettie CG Voordouw, Gé A Donker, Jacqueline Sleven, Wendelien W Dorigo-Zetsma, Sanela Svraka, Michiel van Boven, Manon R Haverkate, Aura Timen, Jaap T van Dissel, Marion PG Koopmans, Theo M Bestebroer and Ron AM Fouchier

A seasonal reassortant A(H1N2) influenza virus harbouring genome segments from seasonal influenza viruses A(H1N1)pdm09 (HA and NS) and A(H3N2) (PB2, PB1, PA, NP, NA and M) was identified in March 2018 in a 19-months-old patient with influenza-like illness (ILI) who presented to a general practitioner participating in the routine sentinel surveillance of ILI in the Netherlands. The patient recovered fully. Further epidemiological and virological investigation did not reveal additional cases.

The agency said baby boomers now have the second-highest hospitalization rate, and the pediatric death rate is especially alarming. News Alerts…

Patients over age 65 who are hospitalized for influenza-like illness were less likely to receive diagnostic tests from providers than were younger patients, a new study showed. Medscape Medical News…

Cornelia Adlhoch, René Snacken, Angeliki Melidou, Silviu Ionescu, Pasi Penttinen and the European Influenza Surveillance Network

We use surveillance data to describe influenza A and B virus circulation over two consecutive seasons with excess all-cause mortality in Europe, especially in people aged 60 years and older. Influenza A(H3N2) virus dominated in 2016/17 and B/Yamagata in 2017/18. The latter season was prolonged with positivity rates above 50% among sentinel detections for at least 12 weeks. With a current west–east geographical spread, high influenza activity might still be expected in eastern Europe.

Baloxavir marboxil is a novel cap-dependent endonuclease inhibitor with potent fast-acting antiviral efficacy for the treatment of influenza types A and B. International Approvals…

The neuraminidase inhibitor helps speed alleviation of fever and flu symptoms in adults and children aged 2 years and older who have uncomplicated influenza. International Approvals…

Ten more children have died of influenza, the CDC said in their weekly flu update; infections are still on the rise. News Alerts…

On 20 March 2018, the National International Health Regulations focal point for the Netherlands notified WHO about a human infected with a new reassortant A(H1N2) of seasonal influenza viruses that was detected in the routine sentinel influenza surveillance for influenza-like illness and other acute respiratory infections in the Netherlands. The patient is a child aged less than two years old, who had onset of symptoms in early March 2018. He was seen by a general practitioner, but did not require hospitalization and has fully recovered.

On 14 February 2018, the National Health and Family Planning Commission (NHFPC) of China notified the World Health Organization (WHO) of one case of human infection with avian influenza A(H7N4) virus. This is the first human case of avian influenza A(H7N4) infection to be reported worldwide.

Alessandro Cassini, Edoardo Colzani, Alessandro Pini, Marie-Josee J Mangen, Dietrich Plass, Scott A McDonald, Guido Maringhini, Alies van Lier, Juanita A Haagsma, Arie H Havelaar, Piotr Kramarz, Mirjam E Kretzschmar and on behalf of the BCoDE consortium

Background and aims The Burden of Communicable Diseases in Europe (BCoDE) study aimed to calculate disability-adjusted life years (DALYs) for 31 selected diseases in the European Union (EU) and European Economic Area (EEA). Methods: DALYs were estimated using an incidence-based and pathogen-based approach. Incidence was estimated through assessment of data availability and quality, and a correction was applied for under-estimation. Calculation of DALYs was performed with the BCoDE software toolkit without applying time discounting and age-weighting. Results: We estimated that one in 14 inhabitants experienced an infectious disease episode for a total burden of 1.38 million DALYs (95% uncertainty interval (UI): 1.25–1.5) between 2009 and 2013; 76% of which was related to the acute phase of the infection and its short-term complications. Influenza had the highest burden (30% of the total burden), followed by tuberculosis, human immunodeficiency virus (HIV) infection/AIDS and invasive pneumococcal disease (IPD). Men had the highest burden measured in DALYs (60% of the total), adults 65 years of age and over had 24% and children less than 5 years of age had 11%. Age group-specific burden showed that infants (less than 1 year of age) and elderly people (80 years of age and over) experienced the highest burden. Conclusions: These results provide baseline estimates for evaluating infectious disease prevention and control strategies. The study promotes an evidence-based approach to describing population health and assessing surveillance data availability and quality, and provides information for the planning and prioritisation of limited resources in infectious disease prevention and control.

Dr Paul Auwaerter discusses the antimicrobial options for postinfluenza MRSA pneumonia, and makes the case for a universal flu vaccine. Medscape Infectious Diseases…

The media reports of influenza-related deaths in children are frightening. How does this year compare with prior years? CHOP Expert Commentary…

Overall hospitalizations for influenza-like illness are at their highest since the CDC began collecting such data, and the season has yet to peak, according to new government information. News Alerts…

Marc Rondy, Esther Kissling, Hanne-Dorthe Emborg, Alin Gherasim, Richard Pebody, Ramona Trebbien, Francisco Pozo, Amparo Larrauri, Jim McMenamin, Marta Valenciano and I-MOVE/I-MOVE+ group

Between September 2017 and February 2018, influenza A(H1N1)pdm09, A(H3N2) and B viruses (mainly B/Yamagata, not included in 2017/18 trivalent vaccines) co-circulated in Europe. Interim results from five European studies indicate that, in all age groups, 2017/18 influenza vaccine effectiveness was 25 to 52% against any influenza, 55 to 68% against influenza A(H1N1)pdm09, −42 to 7% against influenza A(H3N2) and 36 to 54% against influenza B. 2017/18 influenza vaccine should be promoted where influenza still circulates.

As the 2017-18 flu season rages on, experts discuss the best ways to help vulnerable patients. Medscape Emergency Medicine…

Josephine L K Murray, Diogo F P Marques, Ross L Cameron, Alison Potts, Jennifer Bishop, Beatrix von Wissmann, Naoma William, Arlene J Reynolds, Chris Robertson and Jim McMenamin

Scotland observed an unusual influenza A(H3N2)-dominated 2017/18 influenza season with healthcare services under significant pressure. We report the application of the moving epidemic method (MEM) to virology data as a tool to predict the influenza peak activity period and peak week of swab positivity in the current season. This novel MEM application has been successful locally and is believed to be of potential use to other countries for healthcare planning and building wider community resilience.

ProMED Mail

Avian Influenza -- Egypt…

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Avian Influenza H5N6 -- South KoreaDisease: highly pathogenic avian influenzaDate of start of the event: 17 Nov 2017Causal Agent: highly pathogenic avian influenza virusSerotype: H5N6Date of confirmation of the event: 19 Nov 2017Follow-up report no. 6Province: Jeollanam-DoDistrict: Donggang-myeonSub-district: Maegok-riUnit type: farmLocation: Goheung-gunStart date: 1 Jan 2018 [report submitted to the OIE on 3 Jan 2018]Species: birdsSusceptible: 8300Cases: ...Deaths: 0Killed and disposed of: …

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Avian Influenza H5N8 -- Saudi ArabiaA total of 6 new cases of highly contagious bird flu (H5N8) were reported over the past 24 hours in Saudi Arabia. The Ministry of Environment, Water and Agriculture said that the cases had been detected in traditional poultry farms in the city of Riyadh and the governorates of Al-Kharj and Al-Ahsaa.The specialised teams discovered other birds which tested positive in a market in Jeddah and enforced the emergency quarantine plan, reports Al Riyadh. The Saudi authorities culled a total of …

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Avian Influenza H5N8 -- AfghanistanInformation received on [and dated] 6 Jan 2018 from Dr Jahangir Miakhail, Acting Director General, General Directorate of Animal Health and Production, Ministry of Agriculture, Irrigation and Livestock, Kabul, AfghanistanSummaryReport type: immediate notificationDate of start of the event: 28 Dec 2017Date of confirmation of the event: 3 Jan 2018Reason for notification: recurrence a listed diseaseDate of previous occurrence: 30 Apr 2007Manifestation of disease: Clinical …

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Avian Influenza H5N6 -- GermanyInformation received on [and dated] 8 Jan 2018 from Dr. Karin Schwabenbauer, Ministerial Dirigentin and Chief Veterinary Officer, Directorate of Animal Health, Animal Welfare, Bundesministerium für Ernährung und Landwirtschaft (BMEL), Bonn, GermanySummaryReport type: immediate notificationDate of start of the event: 4 Jan 2018Date of confirmation of the event: 4 Jan 2018Reason for notification: new strain of a listed disease in the countryCausal agent: Highly pathogenic …

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Avian Influenza H5N6 -- United KingdomInformation received on [and dated] 10 Jan 2018 from Dr Nigel Gibbens, Chief Veterinary Officer, Department for Environment, Food and Rural Affairs, Department for Environment, Food and Rural Affairs, London, United Kingdom.SummaryReport type: immediate notificationDate of start of the event: 9 Jan 2018Date of confirmation of the event: 9 Jan 2018Reason for notification: New strain of a listed disease in the countryCausal agent: highly pathogenic influenza A virusSerotype: …

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Avian Influenza H5N6 -- South KoreaInformation received [and dated] on 11 Jan 2018 from Dr Oh Soon-Min, Director General - Chief Veterinary Officer, Animal Health Policy Bureau, Ministry of Agriculture, Food and Rural Affairs (MAFRA), SEJONG-SI, Korea (Rep. of)SummaryReport type: Follow-up report No. 9Date of start of the event: 17 Nov 2017Date of confirmation of the event: 19 Nov 2017Date submitted to OIE: 11 Jan 2018Reason for notification: Recurrence of a listed diseaseDate of previous occurrence: 13 Oct …

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Avian Influenza H5N6 -- JapanInformation received on [and dated] 12 Jan 2018 from Dr Kazuo Ito, Director, International Animal Health Affairs Office, Animal Health Division, Food Safety and Consumer Affairs Bureau, Ministry of Agriculture, Forestry and Fisheries, Tokyo, JapanSummaryReport type: Immediate notificationDate of start of the event: 10 Jan 2018Date of confirmation of the event: 12 Jan 2018Report date: 12 Jan 2018Date submitted to OIE: 12 Jan 2018Reason for notification: Recurrence of a listed …

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Avian Influenza H5N8 -- IndiaInformation received on [and dated] 15 Jan 2018 from Mr Devendra Chaudhry, secretary, Animal Husbandry, Dairying and Fisheries, Ministry of Agriculture and Farmers Welfare, New Delhi, IndiaSummaryReport type: immediate notificationDate of start of the event: 26 Dec 2018Date of confirmation of the event: 30 Dec 2018Reason for notification: recurrence of a listed diseaseDate of previous occurrence: 6 Jun 2017Manifestation of disease: clinical diseaseCausal agent: highly …

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Avian Influenza -- AfghanistanInformation received on [and dated] 23 Jan 2018 from Dr Jahangir Miakhail, Acting Director General, General Directorate of Animal Health and Production, Ministry of Agriculture, Irrigation and Livestock, Kabul, AfghanistanSummaryReport type: immediate notificationDate of start of the event: 14 Jan 2018Date of confirmation of the event: 22 Jan 2018Reason for notification: recurrence a listed diseaseDate of previous occurrence: 30 Apr 2017Manifestation of disease: clinical …

ProMED Mail

Avian Influenza H5N6 -- United KingdomThe United Kingdom today reported its 3rd highly pathogenic H5N6 avian flu outbreak in wild birds, this time in Hertfordshire in the southeast, as agriculture officials there upgraded the risk of the virus spreading to other parts of the country.The virus -- a new reassortant between H5N8 that circulated widely last winter [2016-17] and endemic Eurasian viruses -- has turned up in a few European countries this season [2017-18], as well as some in Asia, including in South Korea and …

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Avian Influenza -- RussiaInformation received on 29 Dec 2017 from Dr Evgeny Nepoklonov, deputy head, Federal Service for Veterinary and Phytosanitary Surveillance, Ministry of Agriculture, Moscow, RussiaSummaryReport type: immediate notificationDate of start of the event: 17 Dec 2017Date of confirmation of the event: 19 Dec 2017Reason for notification: new strain of a listed disease in the countryCausal agent: highly pathogenic avian influenzaSerotype: H5N2Nature of diagnosis: clinical, laboratory …

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Avian Influenza -- ChinaInformation received on [and dated] 25 Jan 2018 from Dr Tai-Hwa Shih, Chief Veterinary Officer, Deputy Director General, Bureau of Animal and Plant Health Inspection and Quarantine Council of Agriculture Executive Yuan, Ministry of Agriculture, Taipei, Chinese TaipeiSummaryReport type: Follow-up report No. 86Date of start of the event: 07 Jan 2015Date of confirmation of the event: 11 Jan 2015Report date: 23 Jan 2018Date submitted to OIE: 25 Jan 2018Reason for notification: …

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Avian Influenza H5N6 -- NetherlandsInformation received on [and dated] 24 Jan 2018 from Dr Christianne Bruschke, chief veterinary officer, Ministry of Economic Affairs, The Hague, NetherlandsSummaryReport type: follow-up report no 2Date of start of the event: 9 Dec 2017Date of confirmation of the event: 13 Dec 2017Reason for notification: recurrence of a listed diseaseDate of previous occurrence: 16 May 2017Manifestation of disease: clinical diseaseCausal agent: Highly pathogenic avian influenza …

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Avian Influenza H5N6 -- ChinaInformation received on [and dated] 1 Feb 2018 from Dr Thomas Sit, Chief Veterinary Officer/Assistant Director (Inspection & Quarantine), Agriculture, Fisheries and Conservation Department, Hong Kong Special Administrative Region Government, Hong Kong, Hong Kong (SAR-PRC)SummaryReport type: immediate notificationDate of start of the event: 18 Jan 2018Date of confirmation of the event: 22 Jan 2018Reason for notification: recurrence of a listed diseaseDate of previous occurrence: …

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Avian Influenza H5N6 -- IranInformation received on [and dated] 5 Feb 2018 from Dr Alireza Rafiepoor, Head of Iran Veterinary Organization (IVO), Iran Veterinary Organization (IVO), Ministry of Jihad-e-Agriculture, Tehran, IranSummaryReport type: immediate notificationDate of start of the event: 31 Jan 2018Date of confirmation of the event: 4 Feb 2018Reason for notification: New strain of a listed disease in the countryCausal agent: Highly pathogenic avian influenza [AI] virusSerotype: H5N6Nature of …

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Avian Influenza H5N8, Avian Influenza -- IsraelInformation received on 7 Feb 2018 from Dr Shlomo Garazi, Chief Officer for Import and Export of the Veterinary Services, Veterinary Services and Animal Health, Ministry of Agriculture and Rural Development, BET DAGAN, IsraelSummaryReport type: immediate notificationDate of start of the event: 30 Jan 2018Date of confirmation of the event: 7 Feb 2018Reason for notification: recurrence a listed diseaseDate of previous occurrence: 14 Feb 2017Manifestation of disease: clinical …

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Avian Influenza H5N6 -- IrelandInformation received on [and dated] 9 Feb 2018 from Dr Martin Blake, Chief Veterinary Officer, Department of Agriculture, Food and the Marine, Agriculture House, Dublin, IrelandSummaryReport type: immediate notificationDate of start of the event: 31 Jan 2018Date of confirmation of the event: 8 Feb 2018Reason for notification: new strain of a listed disease in the countryCausal agent: Highly pathogenic avian influenza [AI] virusSerotype: H5N6Nature of diagnosis: laboratory …

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Avian Influenza H5N6 -- ChinaInformation received on [and dated] 10 Feb 2018 from Dr Thomas Sit, Chief Veterinary Officer/Assistant Director (Inspection & Quarantine), Agriculture, Fisheries and Conservation Department, Hong Kong Special Administrative Region Government, Hong Kong, Hong Kong (SAR-PRC)SummaryReport type: immediate notificationDate of start of the event: 7 Feb 2018Date of confirmation of the event: 9 Feb 2018Reason for notification: recurrence of a listed diseaseDate of previous occurrence: 21 …

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Avian Influenza -- GhanaInformation received on 14 Feb 2018 from Dr Kenneth M. K. Gbeddy, Chief Veterinary Officer, Veterinary Services Directorate, Ministry of Food and Agriculture, Accra, GhanaSummaryReport type: Immediate notificationDate of start of the event: 3 Jan 2018Date of confirmation of the event: 10 Jan 2018Report date: 14 Feb 2018Date submitted to OIE: 14 Feb 2018Reason for notification: new strain of a listed disease in the countryCausal agent: Highly pathogenic avian influenza …

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Avian Influenza H5N6 -- SwedenInformation received on [and dated] 20 Feb 2018 from Dr Ingrid Eilertz, Chief Veterinary Officer Director and Head, Swedish Board of Agriculture Department for Animal Welfare and Health, Ministry for Rural Affairs, Jonkoping, SwedenSummaryReport type: immediate notification (final report)Date of start of the event: 28 Jan 2018Date of confirmation of the event: 19 Feb 2018Reason for notification: new strain of a listed disease in the countryCausal agent: Highly pathogenic avian …

ProMED Mail

Avian Influenza -- Worldwide/UnknownIn its latest epidemiologic update on avian influenza [published 25 Jan 2018; see comments below] the World Organization for Animal Health (OIE) said that the highly pathogenic avian flu situation in the 2nd panzootic wave, under way since 2013, is notable. Factors include a substantial number of countries and territories affected by outbreaks in domestic birds, a substantial number of outbreaks, and circulation of diverse subtypes, which has added complexity to control and eradication.In …

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Avian Influenza H5N6 -- VietnamInformation received on [and dated] 24 Feb 2018 from Dr Dong Pham Van, director general, chief veterinary officer, Department of Animal Health, Ministry of Agriculture and Rural Development, Hanoi, Viet NamSummary: Report type: immediate notificationDate of start of the event: 19 Feb 2018Date of confirmation of the event: 22 Feb 2018Reason for notification: recurrence of a listed diseaseDate of previous occurrence: 23 Oct 2017Manifestation of disease: clinical diseaseCausal …

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Avian Influenza H5N6 -- NetherlandsBird flu has been identified on a farm in Oldekerk in Groningen and all 36 000 birds have been destroyed. The flu, a variant of H5 [see comment], was confirmed on [Sun 25 Feb 2018].Two other farms within a 3 km [approx. 1.86 mi] radius of the affected company are now being tested for the deadly virus and farm minister Carola Schouten has imposed a ban on moving birds, eggs and manure within a 1 km [approx. 0.6 mi] radius.Poultry farmers currently have to keep their birds indoors …

ProMED Mail

Avian Influenza H5N8 -- Saudi ArabiaThe Ministry of Environment, Water and Agriculture on Sunday [25 Feb 2018] confirmed the detection of one case of H5N8 avian flu in Al Kharj [governorate, Riyadh region]. The ministry has been actively taking measures to control the spread of the disease.The ministry affirmed that since the outbreak of H5N8 avian flu the number of samples collected reached 9234 in the Kingdom. Only 140 of those samples tested positive, it added.--communicated by:ProMED-MBDS[The HPAI H5N8 event …

ProMED Mail

Avian Influenza H5N6 -- NetherlandsInformation received on [and dated] 27 Feb 2018 from Dr Christianne Bruschke, chief veterinary officer, Ministry of Economic Affairs, The Hague, NetherlandsSummaryReport type: Immediate notificationDate of start of the event: 24 Feb 2018Date of confirmation of the event: 26 Feb 2018Reason for notification: recurrence of a listed diseaseDate of previous occurrence: 8 Dec 2017Manifestation of disease: clinical diseaseCausal agent: highly pathogenic avian influenza …

ProMED Mail

Avian Influenza H5N1 -- IndiaInformation received on [and dated] 1 Mar 2018 from Mr Devendra Chaudhry, secretary, Animal Husbandry, Dairying & Fisheries, Ministry of Agriculture and Farmers Welfare, New Delhi, IndiaSummaryReport type: immediate notificationDate of start of the event: 11 Feb 2018Date of confirmation of the event: 12 Feb 2018Report date: 1 Mar 2018Date submitted to OIE: 1 Mar 2018Reason for notification: recurrence of a listed diseaseDate of previous occurrence: June 2017Manifestation of …

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Avian Influenza -- United StatesInformation received on [and dated] 6 Mar 2018 from Dr John Clifford, official delegate, chief trade advisor, Animal and Plant Health Inspection Service, United States Department of Agriculture, Washington, United States of AmericaSummaryReport type: immediate notificationDate of start of the event: 26 Feb 2018Date of confirmation of the event: 3 Mar 2018Reason for notification: recurrence of a listed diseaseDate of previous occurrence: 2017Manifestation of disease: …

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Avian Influenza H5N8 -- BulgariaBulgaria has reported an outbreak of the highly pathogenic H5N8 bird flu virus on a farm in the northeastern district of Dobrich, the national food safety agency said on [Mon 5 Feb 2018].The virus, found on a farm in the town of General Toshevo, located near the border with Romania, would lead to the death of 140 000 birds, the agency said."A 3-kilometer [2-mile] protection zone and a 10-km [6-mi] observation area around the livestock area were set up," the agency said in a statement, …

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Avian Influenza H5N1 -- IndiaInformation received on [and dated] 7 Mar 2018 from Mr Devendra Chaudhry, Secretary, Animal Husbandry, Dairying & Fisheries, Ministry of Agriculture and Farmers Welfare, New Delhi, IndiaSummaryReport type: immediate notificationDate of start of the event: 11 Feb 2018Date of confirmation of the event: 22 Feb 2018Report date: 7 Mar 2018Date submitted to OIE: 7 Mar 2018Reason for notification: recurrence of a listed diseaseDate of previous occurrence: 6 Jun 2017Manifestation …

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Avian Influenza H5N6 -- United KingdomThe Department for Environment Food and Rural Affairs (DEFRA) and Lincolnshire Trading Standards have issued warnings after confirmed cases of bird flu were discovered near Bourne.DEFRA told Lincolnshire Reporter that H5N6 -- a subtype of the species influenza A virus -- was reported in 2 greylag geese and 2 wild pheasants, which were found dead on farmland near Bourne on [28 Feb 2018].Avian influenza (bird flu) has been identified in wild birds in England in 2018 and all keepers must …

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Avian Influenza -- BulgariaInformation received on [and dated] 8 Mar 2018 from Dr Damyan Iliev, Chief Veterinary Officer & Deputy Executive Director, Bulgarian Food Safety Agency, Ministry of Agriculture and Food, Sofia, BulgariaSummaryReport type: immediate notificationDate of start of the event: 2 Mar 2018Date of confirmation of the event: 2 Mar 2018Reason for notification: 1st occurrence of a listed diseaseManifestation of disease: clinical diseaseCausal agent: Highly pathogenic avian influenza …

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Avian Influenza -- United StatesInformation received on [and dated] 9 Mar 2018 from Dr John Clifford, official delegate, chief trade advisor, Animal and Plant Health Inspection Service, United States Department of Agriculture, Washington, United States of AmericaSummaryReport type: immediate notificationDate of start of the event: 6 Mar 2018Date of confirmation of the event: 8 Mar 2018Reason for notification: recurrence of a listed diseaseDate of previous occurrence: 2017Manifestation of disease: clinical …

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Avian Influenza -- MexicoInformation received on 10 Mar 2018 from MVZ Joaquin Braulio Delgadillo Alvarez, [director general of animal health, National Service of Health and Agrifood Quality (SENASICA), Ministry of Agriculture, Stockbreeding, Rural Development, Fisheries and Food], Mexico.Report type: immediate notificationDate of start of the event: 12 Feb 2018Date of confirmation of the event: 3 Mar 2018Reason for notification: recurrence of a listed diseaseDate of previous occurrence: 31 May …