Summary Mortality in ducks and geese caused by highly pathogenic avian influenza A (H5N1) infection had not been previously identified in Bangladesh. In June–July 2011, we investigated mortality in ducks, geese and chickens with suspected H5N1 infection in a north-eastern district of the country to identify the aetiologic agent and extent of the outbreak and identify possible associated human infections. We surveyed households and farms with affected poultry flocks in six villages in Netrokona district and collected cloacal and oropharyngeal swabs from sick birds and tissue samples from dead poultry. We conducted a survey in three of these villages to identify suspected human influenza-like illness cases and collected nasopharyngeal and throat swabs. We tested all swabs by real-time RT-PCR, sequenced cultured viruses, and examined tissue samples by histopathology and immunohistochemistry to detect and characterize influenza virus infection. In the six villages, among the 240 surveyed households and 11 small-scale farms, 61% (1789/2930) of chickens, 47% (4816/10 184) of ducks and 73% (358/493) of geese died within 14 days preceding the investigation. Of 70 sick poultry swabbed, 80% (56/70) had detectable RNA for influenza A/H5, including 89% (49/55) of ducks, 40% (2/5) of geese and 50% (5/10) of chickens. We isolated virus from six of 25 samples; sequence analysis of the hemagglutinin and neuraminidase gene of these six isolates indicated clade 2.3.2.1a of H5N1 virus. Histopathological changes and immunohistochemistry staining of avian influenza viral antigens were recognized in the brain, pancreas and intestines of ducks and chickens. We identified ten human cases showing signs compatible with influenza-like illness; four were positive for influenza A/H3; however, none were positive for influenza A/H5. The recently introduced H5N1 clade 2.3.2.1a virus caused unusually high mortality in ducks and geese. Heightened surveillance in poultry is warranted to guide appropriate diagnostic testing and detect novel influenza strains.

BackgroundIn Bangladesh, nomadic duck flocks are groups of domestic ducks reared for egg production that are moved to access feeding sites beyond their owners’ village boundaries and are housed overnight in portable enclosures in scavenging areas. The objectives of this study were to measure the prevalence of influenza A virus RNA and H5‐specific antibodies in nomadic ducks and to characterize nomadic duck raising practices in northeastern Bangladesh.MethodsWe tested duck egg yolk specimens by competitive ELISA to detect antibodies against avian influenza A (H5) and environmental fecal samples by real‐time reverse‐transcription polymerase chain reaction (rRT‐PCR) to detect influenza A virus RNA and H5 subtype.ResultsThe median age of the ducks was 24 months (range: 8‐36 months) and the median flock size was 300 ducks (range: 105‐1100). Of 1860 egg yolk samples, 556 (30%, 95% confidence interval (CI): 28‐32) were positive for antibodies against H5 and 58 flocks (94%) had at least one egg with H5‐specific antibodies. Of 496 fecal samples, 121 (24%, 95% CI: 22‐29) had detectable influenza A RNA. Thirty‐three flocks (53%) had at least one fecal sample positive for influenza A RNA.ConclusionsNomadic ducks in Bangladesh are commonly infected with avian influenza A (H5) virus and may serve as a bridging host for transmission of avian influenza A (H5) virus or other avian influenza A viruses subtypes between wild waterfowl, backyard poultry, and humans in Bangladesh.

In a group of 22 healthy pigs aged between 4 and 6 months, 2 pigs became ill with high fever, complete anorexia, cough and abnormal swaying movements on 22 June 2015. One of them died on June 24 and the second died on July 3. Shortly after, the remaining pigs also fell ill and died from the same illness by 10 August 2015. We investigated the aetiology, epidemiological and clinical features of the outbreak. We recorded the clinical signs and symptoms for each pig with the date of onset of illness. Veterinarians conducted post‐mortem examinations on the 12 dead pigs, they collected tissue samples from the dead pigs and placed them in a tube containing 1 mL of nucleic acid extraction buffer (lysis buffer). We tested all the tissue samples by real‐time reverse transcription polymerase chain reaction (rRT‐PCR) to detect classical swine fever virus (CSFV) because the animals’ symptoms matched those of this disease. We also conducted a phylogentic analysis of the nucleotide sequence of the E2 gene segment of CSFV detected in a lung tissue sample. The attack rate (22/22) and the case fatality were 100%. The predominant symptoms of the disease included high fever, cough, diarrhoea and swaying movements of the hind legs prior to death. Of the 12 pigs tissue samples tested, all had evidence of the presence of CSFV RNA by rRT‐PCR. The phylogenetic analysis indicated that the virus belongs to genotype 2.2, which is closely related to CSFV genotype 2.2 reported in India. Our investigation suggests that CSF is circulating in pigs, posing a risk for communities in Bangladesh that rely on pigs for economic income and dietary protein. Future research could focus on estimating the disease and economic burden of CSFV in pig rearing areas to determine if interventions might be warranted or cost‐effective.

BackgroundNational media reported a febrile illness among dormitory residents of a boys' religious school. We investigated the outbreak to identify cause.MethodsIndividuals with fever (>100°F) and cough or sore throat between 1 and 13 August 2011 were influenza‐like‐illness (ILI) case‐patients. We collected histories and specimens from hospitalized case‐patients and visited campus to explore environmental context.ResultsAll 28 case‐patients were dormitory residents including 27 hospitalizations. Accommodation space per resident was <0.8 square metres. Nasal and oropharyngeal swabs from 22 case‐patients were positive for influenza B virus using real‐time reverse transcription polymerase chain reaction (rRT‐PCR).ConclusionsOvercrowding likely facilitated transmission leading to this dormitory outbreak.

Background Antimicrobial-resistant bacteria are a growing public health threat. In 2017 the U.S. Food and Drug Administration implemented Veterinary Feed Directive (VFD) rules changes to limit medically important antimicrobial use in food-producing animals, combating antimicrobial-resistant bacteria. The effect of the VFD rule changes on the occurrence of bacteria resistant to medically-important antimicrobials in retail meats is yet to be investigated in the U.S. This study investigates whether the VFD rule changes affected the occurrence of tetracycline-resistant and erythromycin-resistant bacteria (Salmonella, Escherichia, and Campylobacter) in retail meats in the U.S. Methods Multivariable mixed effect logistic regression models were used to analyze 2002–2019 retail meats surveillance data from the National Antimicrobial Resistance Monitoring System (NARMS) in the U.S. Variables included VFD rule changes, meat type, quarter of year, and raising claims. A potential association between these variables and the occurrence of tetracycline-resistant and erythromycin-resistant bacteria (Salmonella, Escherichia, and Campylobacter) in retail meats was estimated. Results Analysis included data regarding tetracycline-resistant Salmonella (n = 8,501), Escherichia (n = 20, 283), Campylobacter (n = 9,682), and erythromycin-resistant Campylobacter (n = 10,446) in retail meats. The odds of detecting tetracycline-resistant Escherichia (OR = 0.60), Campylobacter (OR = 0.89), and erythromycin-resistant Campylobacter (OR = 0.43) in chicken breast significantly decreased after the VFD rule changes, compared to the pre-VFD rule change period. The odds of detecting tetracycline-resistant Salmonella (0.66), Escherichia (OR = 0.56), and Campylobacter (OR = 0.33) in ground turkey also significantly decreased. However, the odds of detecting tetracycline-resistant Salmonella (OR = 1.49) in chicken breast and erythromycin-resistant Campylobacter (OR = 4.63) in ground turkey significantly increased. There was no significant change in the odds of detecting tetracycline-resistant Salmonella and Escherichia in ground beef or pork chops. Conclusions The implementation of VFD rule changes had a beneficial effect by reducing the occurrence of tetracycline-resistant and erythromycin-resistant bacteria in chicken and ground turkey. Ongoing surveillance of antimicrobial resistance and antimicrobial use could complement the implementation of stewardship such as VFD rule in food-producing animals in the U.S.

Group A rotavirus (RVA) associated diarrhoea in piglets represents one of the major causes of morbidity and mortality in pig farms worldwide. A diarrhoea outbreak occurred among nomadic piglets in north‐western district of Bangladesh in February 2014. Outbreak investigation was performed to identify the cause, epidemiologic and clinical features of the outbreak. Rectal swabs and clinical information were collected from diarrhoeic piglets (n = 36). Rectal swabs were tested for RVA RNA by real‐time reverse transcription polymerase chain reaction (rRT‐PCR) using NSP3‐specific primers. The G (VP7) and P (VP4) genes were typed by conventional RT‐PCR and sanger sequencing and full genome sequences were determined using next‐generation sequencing. We found the attack rate was 61% (50/82) among piglets in the nomadic pig herd, and the case fatality rate was 20% (10/50) among piglets with diarrhoea. All study piglets cases had watery diarrhoea, lack of appetite or reluctance to move. A novel RVA strain with a new P[49] genotype combined with G4 was identified among all piglets with diarrhoea. The genome constellation of the novel RVA strains was determined to be G4‐P[49]‐I1‐R1‐C1‐M1‐A8‐N1‐T7‐E1‐H1. Genetic analysis shows that the novel G4P[49] strain is similar to Indian and Chinese porcine or porcine‐like G4 human strains and is genetically distant from Bangladeshi human G4 strains. Identification of this novel RVA strain warrants further exploration for disease severity and zoonotic potential.

Asthma is a substantial health problem among children and adults worldwide, many countries having increasing prevalence of bronchial asthma. Within our knowledge no epidemiological studies have addressed the burden of bronchial asthma among secondary school students in Bangladesh. This study aimed to determine the prevalence of bronchial asthma and its associated factors among secondary school students. A cross sectional study was conducted from January 2010 to June 2010. Two hundred and fifty secondary school students from class VI to class X were randomly selected from a purposively selected secondary school at Mirpur in Dhaka city. International Studies of Asthma and Allergies in Childhood (ISAAC) core asthma questionnaire was self administered for diagnosis of asthma. Out of 250 students male was 128(51%) and female was 122(49%), mean age of the respondents was 12.9±1.2 years. Minimum education level of respondents' parents were primary, half of the respondents' father's education level was graduate and above (52.8%) and half of the respondents' mother's education level was high school (58.4%). The prevalence of bronchial asthma was 11.6% (95%CI: 7.64% to 15.56%). The proportion of bronchial asthma was higher in male than female (15.6% vs 7.4%, p<0.05). Bronchial asthma was found significantly higher among the students who had attacks of pneumonia during their childhood (under class VI) compared to children who did not (23.8% vs 9.1%, p<0.05). About 11% students were exposed to passive smoking. Passive smoking significantly associated with bronchial asthma (p<0.038). Risk indicators associated with bronchial asthma included history of pneumonia (OR=3.109, 95%CI: 1.32 to 7.29), maternal asthma (OR=2.73, 95% CI: 1.05 to 7.11) and male sex (OR=2.32, 95%CI: 1.01 to 5.33).This study showed that the prevalence of bronchial asthma was high among secondary school students than common people. Passive smoking, history of pneumonia, maternal asthma and male sex were found to be significant risk indicators for bronchial asthma. So that greater efforts are needed to prevent childhood pneumonia and passive smoking to reduce the chances of subsequent development of bronchial asthma. DOI: http://dx.doi.org/10.3329/bmj.v41i1.18778 Bangladesh Medical Journal 2012 Vol. 41 No. 1; 28-31

Background: Tuberculosis (TB) has been an important public health concern in Bangladesh. The most common cause of human TB is Mycobacterium tuberculosis, while bovine TB is caused by Mycobacterium bovis.