From Flu Wiki 2

Forum: News Reports for Sept 25

25 September 2006

AnnieBat 02:07

Summary from Indonesia Outbreak tracking as at 24 September 2006

Cases DiscussedJun-06Jul-06Aug-06Sep-06Total
Died, no tests224210
Died, tested positive432211
Other tested positive01304
Suspected symptoms42463587
Tested negative0625536
Totals10148044148

Summary of News for 24 September 2006

(From WHO as at 19 Sep – last update on their site)
Total human cases worldwide 247, deaths 144 (2006 – 100 with 66 deaths)

(If you want the links to open in a new window, hold down the shift key and then click on the link)

Indonesia

China

Vietnam

United Kingdom

United States of America

Link to news thread for 24 September (link News Reports for Sept 24 )
(Usual disclaimer about may not have captured everything. Feel free to add your own where omissions have occurred.)
Please note that I copy the links directly from the thread so if they don’t work you may need to re-visit the Thread.

AnnieBat 02:20

(The following is rather a long post but (I think) has some relevant points to make) Link http://tinyurl.com/hz44c

FluWrap: by Kate Walker UPI Correspondent London (UPI) Sep 20, 2006

One of the major concerns inherent in the possible avian-influenza pandemic is the disease’s extraordinarily high death rate, which is more than half of known cases. But officials are now questioning whether this is indeed the case. <snip> At the moment, experts say, there has not been enough evidence of mild avian-influenza infection to drastically reduce the disease’s mortality rate, nor even to revise it. But, they concur, the possibility merits further study.

Reduced virulence is a possible indicator that avian influenza is preparing itself to become more transmissible — as this column has noted for the past 11 months, reduced virulence can lead to increased transmissibility, as diseases are less able to infect large swaths of people when they kill their host before the infection has been passed on — and it is this fact that health officials wish to monitor more closely, especially as the rainy season in Southeast Asia and the autumnal bird migrations are likely to lead to increased reports of both avian and human infections.

Speaking over the weekend and cited by Canada’s CBCNews, Dr. Michael Osterholm, avian-influenza expert and director of the University of Minnesota’s Center for Infectious Diseases Research and Policy, said: “We need to keep monitoring it. Because, frankly, one of the indications that there may be a changing epidemiology with this is, in fact, if we start seeing larger and larger percentages of individuals who are asymptomatic or only mildly ill that we can clearly confirm as having H5N1 infection.”

<snip>

The World Health Organization and Indonesia are at odds over what constitutes a human case of avian influenza. The disagreement follows an earlier redefining of human avian-influenza infection in humans by the WHO, which saw the number of confirmed Indonesian cases rise.

The Indonesian Health Ministry has so far abstained from adopting the new definition of bird-flu infection. This refusal will not change the global infection statistics, however, as the official figures are those released by the WHO.

Santoso Soeroso, head of the Health Ministry’s avian-influenza verification team, explained that the WHO’s definition has been altered so that it is less restrictive, meaning that cases of bird-flu infection can, in theory, be identified and treated earlier.

According to the new WHO standards, those suffering from acute lower respiratory infections — difficulty breathing, shortness of breath, fever and cough — should be treated as possible cases of avian influenza. The Indonesian Health Ministry currently uses acute higher respiratory infection as a sign of possible bird flu.

<snip> According to a report in the Financial Times over the weekend, the current Thai political crisis that has resulted in the government being deposed in a bloodless military coup may have contributed to the spread of avian influenza in the country.

Thailand had been working hard to combat the spread of avian influenza in the country’s poultry, and until earlier this year it appeared that their efforts had been effective. But an outbreak in poultry along the Mekong River on the Laotian border earlier this summer showed that the virus was still present in a country believed to have defeated it.

Dr. David Nabarro, the United Nations’ senior coordinator for avian influenza, told the Financial Times that he thought the changing political face of Thailand <snip> may have contributed to the disease’s re-emergence.

“You don’t maintain control over this disease unless there is regular top-level direction from a committed senior political figure that wants to be sure that the necessary activities are being undertaken,” Nabarro said.

Commonground – at 06:37

TB Drug Resistance http://tinyurl.com/z92us
Jakarta, (the Analysis) It did not yet end the bird flu virus is crushed, currently the world was haunted with a tuberculosis germ that experienced the change, was mentioned extreme drug resistance (XDR). The case that happened in South Africa killed many time inpatients 25 days. ”Kuman the TB changed so as to be immune to many obat,” the Staff’s words the Teacher shelved Pulmonologi and Medical FKUI Respiration, Dr Tjandra Yoga Aditama in discussions with detikcom on Sunday (24/9). According to Tjandra, this case was the first time found in the second-hand area of the Soviet Union fragment, in the Latvian country. The cause of this germs expansion as resulting from giving of medicine not truly. More serious him again, germs XDR this tuberculosis could not be distinguished from normal germs of the kind TB. Moreover, for the characteristics of his sign equally precisely. Tjandra explained, to know XDR, then must be known first multi drug resistance MDR. according to this lung specialist doctor, tuberculosis was treated with 5 or 6 main medicines that were acknowledged as the first line, for example Rifampisin, IHN, pirazinamid etc.. If not vulnerable with first line medicine, then had second line medicine, for example quinolone, sikloserin, kanamisin et cetera. “Nah, MDR was TB germs that have been immune to first line medicine, especially rifampisin, INH. for MDR this his medical treatment has very much been difficult, very expensive and many of his side-effects. MDR was quite often met everyday in Indonesia,” added Tjandra. Unfortunately, continued Tjandra, evidently germs increasingly ‘pintar’. After immune or could not be killed with medicine rifampisin, INH, they could also be immune with all first line medicine, this germs kind was mentioned super strain, that also has been found in Indonesia. “Yang most again frightening XDR evidently was also immune to 3 or still more second line medicine. This that most mengkhawatirkan,” flat Tjandra. The Health body of the World (WHO) also launched these newest germs at the beginning of last September. WHO also mentioned, XDR as bakteria that was dangerous and was not yet found his medicine.

Mr White42 – at 06:39

Indonesia’s Bird Flu Death Toll Crosses 50 By Kathy Jones Sep 24, 2006, 13:17

24 Sep, (foodconsumer.org) - A nine-year-old Indonesian boy died on bird flu on Friday taking the total death toll to 51, health officials confirmed. Earlier in the week, the Indonesian health ministry had confirmed the country’s 50th fatality from avian influenza.

The 11-year-old boy from East Java province had died in hospital last week. He had contact with dead chickens, the Indonesian officials had revealed. The boy had fallen ill on September 16 and developed symptoms of bird flu after which he was rushed to the hospital.

The 51st victim, who died Friday was said to have had contact with a sick bird. He had suffered from fever, cough, runny nose and pneumonia after he began to get sick on September 13, hospital officials said.

Runizar Ruesin, the head of the centre, told Reuters that local tests proved the boy died of bird flu. “The result came out this morning. It has been confirmed positive,” he said.

Indonesia has thus far registered the highest death toll from the H5N1 virus globally. Last month it overtook Vietnam, which had recorded 42 bird flu deaths. Health experts have criticized Indonesia for failing to take strict measures to curb bird flu. The country did not sanction culling poultry until the situation nearly got out of hand.

more at http://tinyurl.com/jpaq7

lugon – at 07:02

The following was in the Awareness Week thread and I think it belongs here:


Path Forward – at 06:45

Libby in Atlanta – at 21:12 posted

“why workers are leaving WHO” at http://tinyurl.com/h9dwg

The article is actually about health care workers leaving Western Pacific nations to go work in wealthier countries. It is not about workers leaving the World Health Organization.

The most dramatic exodus of health care workers is what some Filipino officials call the “brain hemorrhage” — beyond a mere “brain drain” — of nurses from the Philippines to developed countries.

If we think western countries’ hospitals are going to be short-staffed during a flu pandemic, just try to imagine the situation in developed countries!

lugon – at 07:04

Also:

Path Forward – at 06:45

Whoops — that last line should have been: “…just try to imagine the situation in developING countries!”

Snowhound1 – at 07:50

WHO UPDATE!!!

Avian influenza – situation in Indonesia – update 32

25 September 2006

http://tinyurl.com/lxpx9

The Ministry of Health in Indonesia has confirmed two additional cases of human infection with the H5N1 avian influenza virus. Both cases were fatal.

The first case occurred in an 11-year-old boy from East Java Province. He developed symptoms of fever and cough on 16 September, was hospitalized on 18 September, and died the same day. Poultry in the child’s household began dying in the month prior to symptom onset, and poultry deaths continued thereafter in his neighbourhood.

The second case occurred in a 9-year-old boy from South Jakarta. He developed symptoms of fever and a runny nose on 13 September, was hospitalized on 20 September, and died on 22 September. His history showed recent contact with sick chickens, which he kept as pets.

Of the 67 cases confirmed to date in Indonesia, 51 have been fatal.

Snowhound1 – at 07:51

forgive the exclamation points…still learning my formatting.

worrywart – at 08:33

Comment on the WHO update above …9 year old developed fever and a RUNNY NOSE .. Niman commented on another forum that “Runny nose and H5N1 is not a good combination”. I think this is the first time that there was reference to a runny nose as a symptom in a patient. First I thought that the reporter mentioned it carelessly in the original Indonesian news article, but now that WHO also mentions this, it warrants attention. There is a chance that the virus has changed.

Edna Mode – at 08:39

worrywart – at 08:33

Can you please post a link to the commentary by Niman referencing the implications of runny nose? Thanks.

Monotreme – at 09:32

Russia

Initial human trials of bird flu vaccine in Russia a success

ST. PETERSBURG, September 25 (RIA Novosti) - The first Russian trials of a human vaccine against the H5N1 bird flu virus was a success, a Russian research institute member said Monday.

Marina Yerofeyeva, a lab head at a research center specializing in flu viruses, said three of the six tested versions of the vaccine proved successful, and researchers will now select the most appropriate one.

“There will be two assessment criteria,” Yerofeyeva said. “The first is vaccine safety, i.e. volunteers’ response to a vaccine in question. The other criterion is the number of immune bodies a vaccine produces in volunteers’ blood tests.”

http://tinyurl.com/nts9u

Monotreme – at 09:35

UK

AVIAN ‘FLU LAB

A UK laboratory is playing a vital role in researching avian ‘flu. The Veterinary Laboratories Agency (VLA) works with the European Union Commission and its member states to combat the threat of the virus.

http://tinyurl.com/mku5a


Comment

PR, British-style

Monotreme – at 09:38

FAO

Researchers track birds with GPS to understand spread of avian flu

A team of international scientists led by Rome-based Food and Agriculture Organization of the United Nations (FAO) are tracking wild birds in an attempt to better understand the spread of avian flu.

We are familiar with the images of large poultry farms being cordoned off where large numbers of domesticated chickens are culled to stem the spread of the devastating avian flu. However, little is known of the extent to which wild migratory birds are involved in spreading the virus over great distances. The FAO-led team of scientists is hoping to change that by fixing tiny GPS units to swans in Mongolia to monitor their winter migration patterns.

The FAO and the World Organisation for Animal Health (OIE) held The International Scientific Conference on Avian Influenza and Wild Birds in May 2006 in Rome, and recommended improving our understanding of wild bird behaviour, precise migratory strategies, locations of aggregation and convergence, and interactions between wildlife and domestic species.

[snip]

AVIAN FLU Title Researchers track birds with GPS to understand spread of avian flu A team of international scientists led by Rome-based Food and Agriculture Organization of the United Nations (FAO) are tracking wild birds in an attempt to better understand the spread of avian flu. Migration patterns of the whooper swan could shed light on the spread of avian flu. © D. Burke Migration patterns of the whooper swan could shed light on the spread of avian flu. © D. Burke We are familiar with the images of large poultry farms being cordoned off where large numbers of domesticated chickens are culled to stem the spread of the devastating avian flu. However, little is known of the extent to which wild migratory birds are involved in spreading the virus over great distances. The FAO-led team of scientists is hoping to change that by fixing tiny GPS units to swans in Mongolia to monitor their winter migration patterns.

The FAO and the World Organisation for Animal Health (OIE) held The International Scientific Conference on Avian Influenza and Wild Birds in May 2006 in Rome, and recommended improving our understanding of wild bird behaviour, precise migratory strategies, locations of aggregation and convergence, and interactions between wildlife and domestic species.

“We are working to understand the role wild birds may play in the spread of H5N1,” said Dr Scott Newman, International Wildlife Coordinator for Avian Influenza for FAO, and based in Rome, Italy. “Although poultry and bird trade are probably the primary routes of movement, migratory birds are likely involved in some areas.”

[snip]

The location of the birds is updated twice a week and uploaded to a website using Google Earth software, which can be viewed by the public at http://www.gains.org.

http://tinyurl.com/p75zw

Monotreme – at 09:41

UK

Flu Pandemic Expected in England

A warning has gone into effect in England for an expected flu pandemic in the upcoming months, in which all elementary and secondary schools could be ordered to close.

Authorities claim the pandemic is “inevitable,” warning that 700,000 people could be killed during the months-long pandemic.

http://tinyurl.com/o5h54


Interesting that this story comes from a Turkish news source.

Snowhound1 – at 09:59

This article is about the most recent death in Indonesia of the 9 year old boy. It also has some interesting tidbits of other information which I have copy and pasted below.

 http://tinyurl.com/rcw5b

The country also reported another suspected death, while four patients showing symptoms of the virus were being treated in hospitals….

In the west Javanese town of Bandung, a 23-year-old man died after showing symptoms of the virus before tests could be performed, and his brother was being treated in a hospital, said local health official Fatimah Resmiati. Both fell ill soon after feeding dead chickens to their dogs, she said.

Separately, three members of the same family were being treated as suspected cases in Medan city on Sumatra island, a nurse said. Blood samples had been taken from the patients. Details of their conditions were not released.

Monotreme – at 10:00

Pennsylvania, USA

Be ready to tackle pandemic

Q What should I ask my mom’s nursing home as to how they’ll respond if the pandemic flu hits?

Nursing homes, hospitals, schools, assisted living and retirement communities have all been alerted by the United States Department of Health and Human Services to develop comprehensive preparedness plans to respond to what experts warn is only a matter of time before the next pandemic flu. No one knows how soon or how severe it will. We’ve experienced three in the last century: in 1918–19, 1957–58 and 1968–69.

[snip]

Here are a few questions you should ask your mother’s nursing home administrator. You also could be asking the same kind of questions of your grandchildren’s schools. Anyone living in group settings should be asking, “What’s our response plan, when the pandemic flu strikes?”

Who is in charge of your pandemic flu preparedness plan? (One person should be accountable for overseeing the plan and coordinating with local, state and national agencies.)

Do you have a written plan? Can you explain to me the major points of the plan?

How are you monitoring the detection of pandemic influenza among residents and your staff — who is in charge of it?

What are your backup plans for: supplies, medications and food to care for the residents when suppliers are shut down?

What are your contingency plans if you have massive numbers of staff sick and unable to come to work?

How will you isolate residents who have the pandemic flu?

What are your infection control procedures and who makes sure they are being followed?

http://tinyurl.com/kdoeg


Comment

Very helpful article. The more people who ask these sorts of questions, the more planning will we get done.

Monotreme – at 10:04

UK

Roche Completes Tamiflu Stockpile Delivery To UK Gov

LONDON -(Dow Jones)- The final consignment of the U.K. government’s pandemic stockpile of the antiviral Tamiflu will be delivered this week by Roche to the Department of Health’s facilities.

Fulfilment of the 14.6 million treatment courses of Tamiflu is ahead of schedule as it was brought forward from December to September 2006 and completes an integral part of the Department of Health pandemic influenza plan.

[snip]

Alongside the stockpiling of antiviral drugs, the government is also stockpiling H5N1 vaccine for possible pre-pandemic use, and has invited vaccine manufacturers to tender for 120 million doses. A pandemic vaccine specific to a circulating influenza virus would take around 4–6 months to produce once a pandemic has emerged.

John Melville, Roche U.K. General Manager, said: “Roche has increased the Tamiflu manufacturing capacity 10-fold in the past three years, and by the end of 2006, will have the capacity to produce 400 million courses per year. This has enabled us to deliver the U.K. government stockpile order ahead of the original schedule. The up-scaling of production also means we have an increased capacity to fulfil future requirements including the supply of the drug for the UK’s annual influenza season”. The increased manufacturing capabilities are allowing Roche to meet the Tamiflu pandemic orders for 75 countries by mid-2007.

http://tinyurl.com/k95wl

Klatu – at 10:10

Canine Link to Suspect Fatal H5N1 Cluster in Bandung Indonesia

Recombinomics Commentary

September 25, 2006

Zakaria Divine Guidance, 20, suspect bird flu that was treated in RS Handsome Sadikin (RSHS) Bandung since Sunday afternoon (24/9), till Monday (25/9) still was critical. On the same day, casualties’s older brother, Indra Jayakusuma, 23, died after experiencing the hot sign high and breathless

they the dog breeder that gave ate his kept animal with the chicken died that was bought from the market. The “condition for Divine Guidance very critical, in fact increasingly critical compared to when entering isolation space. His leucocytes descended, now pneumonia on the lungs increasingly spread, so as he suffered breathless difficult and must make use of respiratory aids,

The above translation provides additional detail on the suspect H5N1 bird flu cluster in Bandung. The older brother (23M) has already died, and the condition of the younger brother (20M) is critical. Their status is very similar to an earlier set of siblings who died in Bandung. However, the feeding of dead chickens to dogs is similar to the first cases reported in the Garut cluster. The sequence from H5N1 from one of the fatal cases in the Garut cluster is similar to the H5N1 found in almost all human isolates from Java, but has not been found in poultry on Java.

The failure to match the human sequences with the poultry sequences suggests an alternate reservoir is circulating H5N1.

The only other matching sequence on Java was from cat in Jakarta, raising the possibility of a mammalian pet reservoir. H5N1 has been isolated from cats in several countries, including Thailand, Germany, Egypt, and Austria as well as from dogs in Thailand and Azerbaijan.

In Thailand, the dog, domestic cat, and several wild cat H5N1 isolates have PB2 E627K, which is also in most human isolates from Vietnam and Thailand, but is not found in the Clade 1 H5N1 bird isolates. Moreover, cats and dogs in Thailand have H5N1 antibodies, signaling non-fatal infections.

Antibody levels and H5N1 sequences from dogs and cats in Indonesia would be useful.”

http://tinyurl.com/afp73

Klatu – at 10:28

In Indonesia, eating dog meat is usually associated with people from the Batak culture, who cook a traditional dish named saksang that is like a dog-meat stew.[citation needed] The Minahasa are also well-known for eating dog, which is considered a festive dish and usually reserved for special occasions like weddings and Christmas. However dogs

http://en.wikipedia.org/wiki/Dog_meat

http://tinyurl.com/jkmwq

Minahasa represents a regency of its own with a population of approximately one million inhabitants divided into eight subgroups….

Klatu – at 10:29

from above, ..not consumed by the Muslim population of Indonesia, as dogs are carnivorous and are haraam under Muslim dietary laws.

Dennis in Colorado – at 10:57

Monotreme – at 10:04 … and has invited vaccine manufacturers to tender for 120 million doses.

120 million doses? The population of the UK is only 61 million.

banshee – at 11:00

New plants not the answer to flu pandemic says study

Moving from egg-based production of vaccines to the use of cell-culture technologies in existing manufacturing plants is cheaper and quicker than building new facilities to handle a flu pandemic within the next five years, new research suggests.

A study led by University of Michigan professor of chemical and biomedical engineering Henry Wang and doctoral student Lyle Lash found that training personnel to make cell culture vaccines in existing facilities is the only way to make enough doses to cover the US in a short time without requiring huge capital investments to build new dedicated flu vaccine cell culture facilities…[more]

http://tinyurl.com/m2ym8

evil thinker – at 11:01

Dennis in Colorado - 2 doses per person if the flu is nu. Same as with children and seasonal flu.

Or maybe, less likely, a country is thinking of other countries.

banshee – at 11:07

Monotreme – at 09:41, I was really curious where this Turkish reporter got the “Flu Pandemic Expected in England” story. Really, you would think it would be all over the British press if it was expected that a flu pandemic would occur in the next few months. Well, I believe this BBC story is the genesis of the Turkish report. BBC article is less committed to the idea that a pandemic is going to happen in upcoming months - they just say it is inevitable which is really giving no timeline at all. However, it’s good to see that planning is moving forward in the UK.

School closures aim to curb flu

banshee – at 11:19

Montco health department to offer drive-thru flu shots from The Mercury (Pennsylvania)

…The Montgomery County health department, which this year will hold 17 flu inoculation clinics at scattered sites throughout the county, will experiment with a drive-thru clinic at its final clinic…”We want to try and see if it will work, if it is a viable option for mass inoculations in response to a pandemic,” said Crielly. “We can use this clinic to work out the bugs…” [more]

http://tinyurl.com/m539g

Dennis in Colorado – at 13:08

NEWS (via ProMED): EGYPT http://tinyurl.com/pnu8y

Identification of agent: highly pathogenic avian influenza virus subtype H5N1.

Date of start of the event: 17 Feb 2006.

New outbreaks: Between 29 Aug and 6 Sep 2006, 8 backyard poultry flocks in Cairo (3 flocks), Damietta (2 flocks), Giza (2 flocks) and Sohag were found to be infected. Vaccination with a inactivated vaccine has been carried out on 5 400 000 backyard birds.

Affected population: backyard poultry.

Laboratories where diagnostic tests were performed: Central Laboratory for Veterinary Inspection of poultry production

Results: RT-PCR between 29 Aug - 10 Sep 2006 was positive for H5N1

Source of new outbreaks: unknown or inconclusive.

Klatu – at 13:39

WHO names experts who will advise when pandemic risk appears to be rising

Monday, Sep 25, 2006

(CP) - “The World Health Organization has announced the membership of the panel of experts it will turn to for advice if it believes the threat of a flu pandemic is mounting.

The list of 20 or so international disease experts includes leading avian influenza expert Dr. Robert Webster of St. Jude’s Research Hospital in Memphis, Tenn., Dr. Ab Osterhaus, a veterinary virologist at the Erasmus University in Rotterdam, and Dr. Nancy Cox, director of the influenza division at the U.S. Centers for Disease Control in Atlanta.

Dr. Theresa Tam, director of the Public Health Agency of Canada’s respiratory infections division, is also on the committee, which convened for the first time Monday in Geneva.

The panel’s mandate is to advise the director general of the WHO whenever it appears that there has been a change in the risk of a flu pandemic emerging. This group would review the evidence on patterns of infection and possible human-to-human spread and issue a recommendation on whether it believes it is time to change the pandemic staging level.

The final decision on whether to move up - or down - the pandemic alert ladder rests with the director-general.

The WHO’s pandemic phasing document is a six-step scale from no known pandemic threat (Phase 1) to a full-blown pandemic (Phase 6). The WHO’s current assessment is that the world is in Phase 3 - a novel flu virus that has pandemic potential is causing sporadic human cases but only very limited human-to-human spread.

Evidence of some clustering of cases of human infections of H5N1 avian flu virus in Indonesia and elsewhere this year has led to questions from some quarters about whether the WHO ought to raise the pandemic alert level to Phase 4, characterized as “evidence of increased human-to-human transmission.

This new committee would be the body that would advise on that issue, if asked. But Monday’s meeting was not called for that purpose, WHO officials have said. Instead, this meeting is a chance for the experts to hammer out a procedural framework for future deliberations.” (excerpt)

http://tinyurl.com/j5n53

“On 25 July 2006, the Government of the People’s Republic of China announced the nomination of Dr Margaret CHAN as the candidate for the Director-General of the World Health Organization (WHO).”

Name: Dr MARGARET F C CHAN MD, DSc (Canada), FFPHM (UK), MScPH (Singapore) Nationality: Chinese Age: 59

http://tinyurl.com/kb5jx

http://tinyurl.com/kb5jx

Tom DVM – at 13:51

Klatu. Thanks for the information…all I can say is who cares…they can stick that pandemic alert scale where the sun doesn’t shine at this point…

…as per usual…lots of smoke…no fire.

mj – at 13:56

Missed one or two important things, I think.

http://tinyurl.com/ncxe6

CHRONOLOGY-Bird flu developments Mon Sep 25, 2006 4:08 PM BST (Reuters)

Here is a brief chronology of some of the major bird flu developments in 2006:

Comment: why are they doing this now?

Kathy in FL – at 14:05

But, they may be trying to get the few outspoken members of the health care profession mired in red tape and more “in tune” with the real economic consequences of raising the level.

Or maybe its a case of “you want to run your yap so much, then how about taking a walk in our shoes for a while.” <grin>

TRay75at 14:21

Severe weather radios provided to public schools from CNN.com.

“ … the government planned to announce on Monday that it will supply hazard warning radios to all 97,000 public schools in the United States.”

“The Homeland Security Department now has decided to provide $5 million to make sure these radios are in every public school, NOAA Administrator Conrad Lautenbacher said.”

“Originally conceived as a means to deliver weather warnings, the system now covers all hazards — for example, terrorism, abducted children and derailed trains carrying toxic materials.”

A very good idea, for any emergency situation, but the timing and expenditure of funds at this moment is a bit curious. Usually I anticipate these types of moves toward the end of a fiscal year. Maybe the Katrina lessons and elevated terror situations, as well as other “natural disasters” has gotten someone to do what Washington, Tennessee, North Carolina, Maryland, Florida and Mississippi dis several years ago. Just file it away as an additional item to consider if H5N1 becomes MSM news again.

DennisCat 15:09

I don’t think these are “new to us” but it is a new article.

Two More Human Bird Flu Cases In Indonesia Article Date: 25 Sep 2006 - 11:00am (PDT)

“Two more people have become infected with the H5N1 bird flu virus strain, say officials from the Indonesian Ministry of Health. Both of them died.

An 11-year-old boy from East Java Province developed bird flu like symptoms on September 16, was hospitalized on September 18 and died that day. One month before the boy became ill, chickens were dying in his household. Authorities say chickens continue to die in the area where he lived.

A 9-year-old boy from South Jakarta developed bird flu like symptoms on September 13, was hospitalized on September 20, and died two days later. Authorities say he had had contact with sick chickens.

So far, Indonesia has 67 confirmed cases of bird flu infection, of which 51 have died.”

http://tinyurl.com/l3yff

giraffe – at 15:16

WHO names experts who will advise when pandemic risk appears to be rising

http://tinyurl.com/qbks2

giraffe – at 15:21
 Above story by Helen Branswell..lead paragraph states—CP) - The World Health Organization has announced the membership of the panel of experts it will turn to for advice if it believes the threat of a flu pandemic is mounting. 

The list of 20 or so international disease experts includes leading avian influenza expert Dr. Robert Webster of St. Jude’s Research Hospital in Memphis, Tenn., Dr. Ab Osterhaus, a veterinary virologist at the Erasmus University in Rotterdam, and Dr. Nancy Cox, director of the influenza division at the U.S. Centers for Disease Control in Atlanta.

So sorry, somehow sent post before I had finished it.

giraffe – at 15:25

Well, now I am feeling silly…overlooked that this had already been posted by Klatu…and the first one is much “prettier” too…

FrenchieGirlat 16:07

‘’‘Thailand - Progress in search for ‘bird-flu herbs’ / http://tinyurl.com/lc6pn---

Identifying the right herb as an alternative treatment for the bird-flu virus could take years, as it would not be simple to narrow down the list and complete testing, researchers have said.

Until recently, they were concerned about the cost of using the conventional tissue-culture method on 30,000 substances derived from 150 types of herbs to decide which could be effective.

But a new development has been helping in the fight - Kasetsart University’s “Chemiebase”, an Internet database of herbal extracts which could be used in simulating tests on whether certain herbal substances were worth further trial.

Out of the 40 likely substances taken from a few types of plants, only one turned out to be effective in suppressing the H5N1 strain of bird flu, said Prof Pilaipan Puthavathana of Siriraj Hospital’s Department of Microbiology, who tested the substances for Chak.\\\

The researchers have decided to withhold the name of the herbal substance which in preliminary tests has proven effective in the fight against the bird-flu virus.

AnnieBat 16:09

mj at 13:56 - totally agree - that chronology is full of holes.

Tom DVM – at 16:44

Being from Canada, I am sorry but I have to say something.

SARS had been circulating in Canadian emergency rooms, hospitals and communities for ten days before the World Health Organization got around to announcing that there was a threat in China…a lot of good people were afflicted and died for no good reason…

…I would like to take this opportunity to personally thank the WHO for their attentiveness to science rather than politics.

I guess in this press release they are attempting to make up for the gross incompetence of the past…

…I won’t hold my breath waiting…

…expect the change on the pandemic scale about the time we are all ‘heading for the hills’.

DennisCat 17:30

about the chicken to dog to man link above. (machine translation) Zakaria Divine Guidance, 20, suspect bird flu that was treated in RS Handsome Sadikin (RSHS) Bandung since Sunday afternoon (24/9), till Monday (25/9) still was critical. On the same day, casualties’s older brother, Indra Jayakusuma, 23, died after experiencing the hot sign high and breathless.The older brother was siblings the citizen [*snip*], the Gardener’s District Waru, the Batununggal Subdistrict, of this Bandung City, it was known had contact with the chicken died.

http://tinyurl.com/qs8h8

It seems that the dog owner/breeder is still critical but his older brother has died. But I am having problems with the translation.

Snowhound1 – at 17:40

DennisC-I posted this information in English a little earlier…check out my post at 9:59. :)

spok – at 17:40

FrenchieGirl – at 16:07

“The researchers have decided to withhold the name of the herbal substance”

What a tease!

DennisCat 17:45

Today’s PROMED report.

Published Date 25-SEP-2006 Subject PRO/AH/EDR> Avian influenza (195) - Egypt: OIE

Avian influenza in Egypt: Follow-up report No. 4 End of this report period: 20 Sep 2006. Identification of agent: highly pathogenic avian influenza virus subtype H5N1….

New outbreaks: Between 29 Aug and 6 Sep 2006, 8 backyard poultry flocks in Cairo (3 flocks), Damietta (2 flocks), Giza (2 flocks) and Sohag were found to be infected. Vaccination with a inactivated vaccine has been carried out on 5 400 000 backyard birds. Source of new outbreaks: unknown or inconclusive…. Thus, while the number of infections is small, they cover 4 governorates (administrative divisions) over a wide geographic area. The efforts to control have included an extensive backyard vaccination program in 23 governorates. - Mod.PC]

http://tinyurl.com/hw6dj

DennisCat 17:51

From Michael Osterholm’s presentation : …..”If the pandemic is caused by H5N1, the avian influenza virus strain currently circulating in Asia, it could kill as many as 1.9 million Americans and infect 30 to 60 percent of the population,” he said, adding that H5N1 is the most powerful influenza virus detected in modern history. …

Even the dead will be contagious. “Corpse management, the handling of the dead and how we grieve, will be very important,” he said. “We will see bodies pile up right here in Ventura County. You’ve got to start planning, locally, now.” ….

“The antidote for closed grocery stores is a full pantry of dry and canned goods at home. The treatment for a power shortage is flashlights and radios that crank up or run on batteries.” ,,,,

http://tinyurl.com/equ5c

I agree with with the host who said “you scared the living bejeebies out of me.”

Klatu – at 18:09

USDA Should Revise Avian Flu Plan

SEPTEMBER 25, 2006

National Poultry Justice Alliance npja.org

Plan Protects Big Business, Leaves out Poultry Farmers, Workers, Contract Growers and the Public

WASHINGTON - September 25 - “A broad coalition of stakeholder groups issued a statement today criticizing the U.S. Department of Agriculture’s plan for responding to a U.S. outbreak of bird flu and called for revisions to adequately protect the public and poultry farmers. The coalition charged that the USDA does not acknowledge the risk posed by common poultry industry practices in the emergence and spread of highly-pathogenic avian influenza.

“The USDA is incorrectly focusing its attention on small and free-range poultry farmers,” said Wenonah Hauter, executive director of Food & Water Watch.

The USDA does not address industry practices that increase the risk of spreading avian influenza. “Not only are big poultry producers housing hundreds of thousands of birds, they’re moving birds, feed, and supplies and even poultry waste to be used as fertilizer or to be fed to other animals,” explained Hauter.

Poultry workers and growers would be among the first exposed to an outbreak but USDA does not ensure appropriate protective equipment, specialized sanitation, training, human flu vaccinations and whistleblower protections for workers who detect and report sick birds “ said Mark Lauritsen of the United Food & Commercial Workers.

The plan does not address the potentially huge economic impacts for small processors and the vulnerability of the many workers at large plants if quarantines or depopulation eliminate the supply of poultry.” - excerpt

http://tinyurl.com/gfk8s

Klatu – at 18:11

Par for the course in Canada.

Tom DVM – at 19:06

Klatu.

Regulatory agencies are like Insurance…You are perfectly protected until you actually need to make a claim.

Monotreme – at 21:47

banshee – at 11:07

I’m thinking that was for domestic consumption. The Turkish government instructs the Turkish media to tell the Turkish people that the English are expecting a pandemic this winter. Perhaps psychologically easier than telling the Turkish people that the Turkish government is concerned about a pandemic this winter.

Monotreme – at 21:53

Comment

Re: Expert advisers for phase advance. The only chance of going to phase 4 before the pandemic begins is for the Acting Director-General to convene these experts before Margaret Chan becomes the next Director-General. You can bet she has instructions from Beijing not to go to phase 4 under any circumstances. Karo should have triggered phase 4. Even if phase 4 is called tomorrow, it will take at least a year for most countries to get ready. I’m not at all sure that we have even that long.

Tom DVM – at 21:56

Monotreme. If China is fighting and hiding and spinning to save the Olympics…I’m afraid that horse left the barn a while ago.

Monotreme – at 21:58

USA

Bird flu vaccine supply might be stretched

U.S. researchers say supplies of bird flu vaccine might be expanded through the use of an additive.

The scientists at the Baylor College of Medicine, led by Dr. Robert Atmar, say they achieved an effective immune response to an avian influenza vaccine with doses as low as one-quarter of the norm after adding a chemical mixture known as MF59.

[snip]

“What we found was that when the adjuvant material was included in the vaccine — at all dosage levels — the antibody response was significantly better, and as low as one-quarter the dose worked very well,” Atmar said. “And a single dose of the adjuvanted vaccine was as good as two doses of the vaccine without the adjuvant.”

http://tinyurl.com/q83oz

Monotreme – at 22:04

Tom DVM – at 21:56

It really all depends on the Acting Director-General. If he sees himself as a helpless placeholder, there is no hope of action from the WHO. If, however, he realizes that, whether he wanted it or not, he is in an historical situation, and rises to the occasion, alot may be done. He has the power to go to phase 4, right now. It’s the right thing to do.

If he doesn’t act because he is afraid of what will happen to his career, he will have to look at himself in the mirror for the rest of his life and know that he could have greatly reduced the impact of one of the worst tragedies of all time, and chose not to.

Monotreme – at 22:11

Indiana, USA

If flu pandemic hits, county will rely on state and local plans

TELL CITY - Pandemic influenza: It may be coming, but health officials don’t know when or how severe it will strike.

“We cannot forecast when it will occur,” Karen Gordon told an audience of more than 40 people at the Perry County Pandemic Influenza Public Forum Thursday evening.

[snip]

Perry County Health Department Public Heath Coordinator Heidi Zellers said all counties were requested by State Heath Commissioner Dr. Judith Monroe to hold a pandemic flu forum to inform the public of what could happen, and to discuss the differences between flu and avian flu.

[snip]

Households should also have a three-to-four-day supply of bottled water, nonperishable food and other necessities if stores and other businesses are shut down.

As for how prepared the county is if a pandemic were to break out, Zellers said “we’re still working on it.”

http://tinyurl.com/j8jkd


Comment

Jeez, you all need to talk to the folks in Fort Wayne and Allen County.

Tom DVM – at 22:12

Monotreme. I have been up close and personal with regulators. I don’t mean to paint them all with the same brush but the type I am talking about not only occurs in regulatory agencies but elsewhere…they will never get it…if they got it they wouldn’t do it in the first place…and they would never make the connection that their inaction was the cause of on eof the worst trgedies of all time…unless they were in front of the world court charged with the largest preventable genocide in human history…

…and if they are found to be complicit in the withholding of information that may have prevented a pandemic (like the pig data from China or pig serology demonstrating asymptomatic infections) even at this late date…then the world court is exactly where they should be going…

…otherwise you are going to hear the same old crapp…I signed a confidentiality agreement…I don’t agree with my supervisor but what can I do…I am working within a flawed mandate so it is not my fault…

…trust me…I’ve seen it many times…and remember I was once a regulator…these people only look in mirrors to admire the shimmer of their own reflection and not to reflect in any other ways.

Anon_451 – at 22:17

Monotreme – at 22:11 I live in Southern Indiana, I am so toast it is not funny. What you saw is common in every county in the Southern part of the State. I have tried to talk to the director of Emergency Planning and the Health department. They are convinced that A it will not happen and or B the Feds will bail them out. This is truly the land of OZ.

DennisCat 22:18

Suspect Bird Flu - INDO machine translation-

the Sample of blood of three North Sumatran citizens who were suspected suspect bird flu was sent to the Department’s Laboratory of the Health in Jakarta. The sample of blood that was sent by the side of RSU H. Adam the Medan Owner was from the patient BS (37), Lbt (32) and Rbs (12), the three of them the citizen of the Deli Serdang Regency. I Bagian Medis Deputy Director to RSU. H. Adam the Medan Owner, Dr. M. Nur Rasyid Lubis, SpB justified that when being contacted in Medan, on Monday.

http://tinyurl.com/rehl8

Monotreme – at 22:18

Iowa, USA

Preparation for Pandemic

The Cerro Gordo County Department of Public Health has partnered with local grocery stores to hand out flyers about pandemic flu.

The flyers have tips and a shopping list of what you should do to be prepared if and when it hits. Public Health says it’s a good idea to have 4–6 weeks worth of water and non-perishable food on hand.

http://tinyurl.com/eb9jq


Those nutjobs in Iowa, always doing crazy, radical things like advising people to store 4–6 weeks of food and water to prepare for a pandemic. Not like those solid, conservative citizens of New York City who know that a pandemic is unlikely and that 3 days of food and water is all you need ;-)

I’m being very, very sarcastic, in case anyone is not sure

http://tinyurl.com/eb9jq

Monotreme – at 22:23

Tom DVM – at 22:12

You will probably turn out to be right, but every once in a while people surprise you.

Anon_451 – at 22:17

Have you considered moving north to Fort Wayne? Those folks have totally got their act together.

Monotreme – at 22:28

Mississippi, USA

Health Department Probe Continues

A nationwide search is underway to replace Mississippi’s epidemiologist, Mills McNeil. This comes amid a legislative probe into the state Department of Health after allegations of mismanagement.

McNeil took the hot seat before the Senate Health Committee last month. He defended his decision not to alert the public about all possible cases of West Nile Virus.

“It gives us a chance to look at strategic planning and recruiting people to come to our agency,” said Dr. Brian Amy, State Health Officer.

Amy said Dr. McNeil will now be in charge of a new $25 million lab and remain point person for pandemic flu. He says the decision had nothing to do with the hearings at the Capitol.

http://tinyurl.com/zgh4o


Sorry Mississipians, you are truly screwed. You see Anon_451, it could be worse.

Monotreme – at 22:34

Canada

Jason Kenney Must Resign After Admitting he Mislead House: Owen

Conservative MP Jason Kenney publicly apologized today for repeatedly misleading the House of Commons during Question Period last week. Mr. Kenney claimed that, according to a memo, circulating the names of ATI requesters was a common practice under the former Liberal government. He admitted today that, in fact, the memo said no such thing. The memo spoke of the common practice of circulating minutes from communications meetings on pandemic preparedness strategies, without naming the person who filed the request.

http://tinyurl.com/nwohf


OK, this one is too complicated for me to figure out, but maybe the Canadian Fluwikians understand what’s going on here.

Monotreme – at 22:38

Washington, USA

One on One with Kenny Herrera - Director of safety services at Southwest Washington Medical Center

Most challenging and most rewarding is overseeing a diverse group of departments and having to deal with a diverse group of issues, whether strategically rearranging parking or planning our response to a pandemic and influenza.

http://tinyurl.com/o8se5


OK, so strategically rearranging parking comes before planning a response to a pandemic. But, hey, alot of Directors of Safety services are so focused on strategically rearranging parking that they never even get to planning for a pandemic.

Tom DVM – at 22:42

Monotreme

Nope /:0) remember I was once a regulator on the inside and have been an observer on the outside since Sept 1998…and I have the scars to prove it.

I have so many scars that I think you and I and maybe gs should go to China and help them with their problem.

gs and divert their attention while you and I check some vaccines and labs out…and maybe take a few blood samples…and maybe talk to a few farmers…and maybe pop on over to North Korea.

just kidding gs.

Monotreme – at 22:43

Czech Republic

Government allots more money to universities, for social services

The government found the money in the budget to finance the prevention of a bird flu pandemic and for the modernisation of the timetable of children vaccination.

http://tinyurl.com/zpdh6

Pixie – at 22:49

Thai man dies of bird flu, official says Tue Sep 26, 2006 3:18 AM BST

BANGKOK (Reuters) - A 59-year-old Thai man has died of bird flu, the country’s 17th victim of the H5N1 virus since it swept through much of Asia in late 2003, a senior Health Ministry official said.

The man died on August 10 in a northeastern province near the Lao border after chickens at his house fell sick and died, Kamnuan Ungchusak told Reuters.

He said the final laboratory tests were completed last week.

The man was Thailand’s third victim this year. Its previous death from H5N1 was confirmed on August 5.

According to the World Health Organization (WHO), 146 of the 249 people confirmed as infected with H5N1 bird flu have died since 2003.

Those infected have come from countries ranging from China to Iraq to Djibouti. Indonesia, with 51 deaths, has been the hardest hit.

Initial testing usually takes a day or two to confirm if someone has H5N1. However, more detailed analysis by government laboratories or those affiliated with the WHO can take a week or more.

The H5N1 virus remains mainly a virus of birds, but experts fear it could change into a form easily transmitted from person to person and sweep the world, killing millions within weeks or months. So far, most human cases can be traced to direct or indirect contact with infected birds.

http://today.reuters.co.uk/news/articlenews.aspx?type=globalNews&storyid=2006-09-26T021736Z_01_BKK301031_RTRUKOC_0_US-BIRDFLU-THAILAND.xml&src=rss

AnnieBat 22:51

Tom DVM you need a blood pressure monitor direct connected to your keyboard so that it locks up each time you start venting … and the sad part is you are singing with the choir - we all agree with you.

Not wanting to get political etc etc etc but wanting to lower my blood pressure, compare the ‘actions’ of WHO and other senior officials with those of the 6 HCWs in Libya - and which ones are under threat of a death sentence?????

Anon_451 – at 22:53

Tom DVM – at 22:42 My Chinese is real flaky but my Korean is not to bad, GS and I can divert there attention and I we could get Anon_22 to go along you, Monotreme and her could find the truth. You know a good time could be had by all.

De jure – at 22:57

Anon_451: Somehow Dr. Strangelove comes to mind with you and gs “riding the bomb” into North Korea, while the rest ride the big one into China…

DennisCat 23:02

Pixie – at 22:49

You beat me. This is a major change now that Thailand has a new case. It makes me worry about the “suspects in Thailand” now. I had “ignored” most of their suspected cases, but now I will need to watch more closely. Notice their daily post is now:

Cumulative number of patients under surveillance are 4,976 cases 71 provinces. Today reports are 4 cases; Two cases from Kampaengphet, and 1 each from Kanchanaburi and Suphanburi. Confirmed human case of avian influenza 2006 = 2 cases, with 2 death cases. · The first death case, reported from Phichit province, Tabklo district is 17 years old male. He had onset on July 15, 2006 and died on July 24, 2006. · The second death case, reported from Uthai Thani province, Sawang Arom district is 27 years old male. He had onset on July 24, 2006 and died on August 3, 2006. There are 7 cases under investigate reported, of which waiting for laboratory result.

http://tinyurl.com/e6ru2

Pixie – at 23:07

DennisC - I was speedy on that one because the closing comment interested me greatly. The ReutersUK reporter made a change to the usual “required” blurb we always see tacked on to these reports of fatalities. It now says:

“So far, most human cases can be traced to direct or indirect contact with infected birds.”

That little word, “indirect,” carries great weight. I’d like to see someone explain what “indirect” means it in greater depth. It does open up a new line of inquiry that may lead to them stating the situation as it is more plainly. It’s a beginning.

Interesting too that that case was near the Laos border.

anon mc – at 23:09

COMMENT to Tom DVM at 22:12:

World Court????? You have entirely too much faith. That bureaucracy is not any better than WHO. I suspect their mirrors for admiring themselves may even be bigger than than those belonging to the WHO cronies.

ANON-YYZ – at 23:12

COMMENT

giraffe – at 15:16

The announcement of a meeting of the panel is an indication that the WHO is readying for an escalate to phase 4, should evidence suddenly become overwhelming. It is unlikely that the Acting Director General will veto a recommendation to announce phase 4 by the panel. A complete list of the 20 members will indicate if the outcome is already stacked one way or the other. The ratio of scientists to bureaucrats is the determing factor. If there are only two scientists (Webster and Osterhaus) and the other 18 represent ‘national interests’ then the 2 scientists’ names are just used for lending credibility to the recommendations.

Pixie – at 23:19

Anon-YYZ - Don’t you think it is a case of “we all hang together, or we all hang separately” with the WHO panel? And they’ve obviously decided that “together” is preferable. If they reach accord, agreement of 20 members, blame is very equitably distributed. Which makes me think they must be getting ready to go to 4.

ANON-YYZ – at 23:23

Pixie – at 23:19

I also think they may announce phase 4 before the election of the DG. This removes political hazard from the new DG, and simplifies the election.

Pixie – at 23:32

The WHO panel is the best of the best. Tashiro, everybody - Webster, Osterhaus, Cox (CDC), Tam (Canada), Dmitri Lvov from Russia (yikes!)…. everybody. They will reach solemn agreement. This is like a corporate committee getting together to buy IBM. Nobody gets fired. Nobody takes the blame. It’s a stellar panel. They are not taking any chances here. I find that alarming.

Interesting idea about the DG. Don’t know if it would be before or afer. If it is Chen, then they should do it before, no?

Tom DVM – at 23:37

What can I say…you guys are great…too bad we couldn’t have this team and a little authority…we would be dangerous…and we might actually pull it off!!

ANON - YYZ. I don’t care what they do with their inane and stupid pandemic phase thingy that has been rendered useless by their previous actions…ut you are proabably right at 23:23 because in the end…it’s all about the politics…isn’t it.

anon mc. Then I will haunt them.

ANON-YYZ – at 23:39

The countries with the most to lose i.e. Indonesia and Thailand, no longer have compelling motivation to object announcing phase 4, as bad news have already been widely reported. In fact, it will immediately force donor countries to ante up. I think the Indonesian news summaries here have an impact on TPTB.

26 September 2006

Hurricane Alley RN – at 00:07

If Ms. Chen is voted in as Director General then this panel will be nothing more than a joke. She will have the final word. Her final word will be to tell the panel to keep their mouths shut. When putting someone from a nontransparent country incharge, don’t exprct the situation to become transparent. Why is China pushing so hard for her to get the position ? Just another $65,000 question? Just my .22 (inflation). gina

enza – at 00:24

What would really change if the ‘pandemic phase thingy’ (to quote Tom DVM) were to move to 4? We are so desensitized now; most people will still come home from work, watch their large tvs, eat supper, and go to sleep. Or the WHO may change what phase 4 means.

AnnieBat 01:25

I am just creating the News Summary for today then I will start a new thread, so please save your posting for about 30 minutes.

Cheers and thanks

closed by Monotreme – at 09:09
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