Summary from Indonesia Outbreak as at 29 October 2006
| Cases Discussed | Jun-06 | Jul-06 | Aug-06 | Sep-06 | Oct-06 | Total |
|---|---|---|---|---|---|---|
| Died, no tests | 2 | 2 | 4 | 3 | 5 | 16 |
| Died, tested positive | 4 | 3 | 2 | 3 | 3 | 15 |
| Other tested positive | 0 | 1 | 3 | 1 | 0 | 5 |
| Suspected symptoms | 4 | 2 | 46 | 38 | 28 | 118 |
| Tested negative | 0 | 6 | 26 | 19 | 7 | 58 |
| Totals | 10 | 14 | 81 | 64 | 43 | 212 |
Please visit these threads for latest information from these regions or to add news
| No | Region Name | No | Region Name | No | Region Name |
|---|---|---|---|---|---|
| 1 | USA | 8 | East Africa | 15 | Arab Peninsula |
| 2 | Canada, Greenland and the Arctic Circle | 9 | Southern Africa and Madagascar | 16 | Central Asia |
| 3 | Central America and Caribbean | 10 | Northwest Europe and British Isles | 17 | Southern Asia |
| 4 | South America and Surrounding Islands | 11 | West and Southwest Europe | 18 | Mainland East Asia and Japan |
| 5 | Northern Africa | 12 | Central and Southeast Europe | 19 | Southeast Asia |
| 6 | West Africa | 13 | Eastern Europe and Baltic Region | 20 | Australasia Melanesia and Micronesia |
| 7 | Central Africa | 14 | Middle East and Caucasus Region | 21 | Pacific Islands and Antarctic |
(Please see the thread Volunteers Needed as Lookouts Worldwide if you want to help)
(From WHO as at 16 Oct - latest update) Total human cases worldwide 256, deaths 151 (2006 – 109 with 73 deaths)
India
Indonesia
Thailand
United States of America
General
Link to news thread for 29 October (link News Reports for October 29 )
(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.
(If you want any of the links to open in a new window, hold down the shift key and then click on the link)
Sorry, I didn’t check the Wiki clock before starting the Summary and starting this thread - has there been a change in daylight saving time or something? I have just got into a habit based on local time of preparing the Summary and getting the new thread going …
here - clocks were turned back 1 hr last night AnnieB
(Missouri USA) Dr. Bao-Ping Zhu - member of CDC Critical Backup Team
By Angie Hutschreider angieh@newstribune.com
With the possibility of an avian flu pandemic, Missouri as well as other states, have been preparing for over a year. Now Missouri has the extra help in preparing for one, just in case, from the State Epidemiologist who is now a member of a Critical Backup team that could be deployed internationally to help combat outbreaks of the flu.
Missouri’s State Epidemiologist, Bao-Ping Zhu, MD, MS, has been chosen as a one out of 150 volunteers to serve on the Centers for Disease Control and Prevention (CDC) Critical Backup Team that can be deployed internationally.
“If an influenza pandemic should flare up somewhere in the world, the CDC’s capacity to fight the epidemic is expected to be quickly exhausted,” Zhu said. “As a member of the Critical Backup Team, I could be asked by the CDC to go to the site to try and “quench the fire” before it goes out of control.”
More at http://tinyurl.com/y8atyv
Vietnam remains on alert after year without bird flu death
HANOI (AFP) - A year ago Vietnam counted its 42nd bird flu fatality and the country was wracked with fears of a further spread of the deadly virus. Today, the Southeast Asian nation is held up as a shining example of how to tackle the disease: its poultry are healthy and there have been no further human cases.
In December 2003, the country of 83 million people and more than 210 million poultry became the first to mourn a human victim of the H5N1 strain of avian influenza. By October 29, 2005, when a 35-year-old Hanoi resident succumbed to bird flu at the Institute of Tropical Medicine in the capital, the statistics were alarming and the future gloomy.
Since then, however, Vietnam has not suffered any human cases and no animal outbreaks were detected between mid-December and August, when some storks tested positive. The virus is still in the environment but it is under control.
“It is clearly a success even if the danger is still here. This past year, the government has been successfully containing the virus,” said World Health Organisation country representative Hans Troedsson.
The government finally realised how serious the problem was in the autumn of 2005. After concealing cases and several times prematurely proclaiming victory over the disease, the communist authorities finally mobilised at the height of the crisis. <snip>
Vietnam’s highest authorities, with the prime minister at the head, made reporting cases a priority, using every tool possible including loudspeakers in villages to raise awareness of the risks posed by the virus.
<snip> “The virus is still there, there is an ongoing risk,” he said. “It is important that the reporting is ongoing.”
More at http://tinyurl.com/y8xyoe
AnnieB – at 23:37
Great table for the lookout posts. Will make finding one much easier in the future. Thanks.
This a.m. on Google NEws, there were two headline bird flu news stories-One through Reutors (Sp?) on GLaxo in talks with British Government about suppling U.K. with “Bird FLU” vaccine.
The other was from the London times, a really great two page article about being on the Bird Flu frount line. So I went to get coffee, and come back to report to the Wiki and now both stories are gone!
The Glaxo story is gone completely, and the London Times has been replaced by a lessor Pandemic Prepardness story.
Anybody is see this? I’m pretty sure I’m not hallucinating this morning.
The London Times was dated Oct. 30-though it seemed to come from its Sunday Suppliment. It was a fantastic article written by a doctor actually treating flu bird flu victims. I’ll continue to try to find it, but I wanted to put the word out-maybe someone with better news tracking skills than I have can help?????
Not news, but a new look at available data. Please see current threat assessment and look for “lugon – at 08:17″. If the data and method are right, the world would be seeing a R-naught between zero and .49, and apparently growing.
Please comment on , not here!
green mom- You have excellant tracking skills!! I’ve had this happen to me several time, and find it odd. I’ll take a look.
GSK advises UK govt. to start bird flu vaccination The Money Times - 59 minutes ago by Bithika Khargarhia - October 30, 2006 - 0 comments. After signing a deal about a countrywide vaccination against an eruption of pandemic bird flu with Singapore, GlaxoSmithKline Plc (GSK), a British healthcare … Glaxo speaks to UK about bird flu vaccine, paper says Reuters GlaxoSmithKline talking to UK govt about bird flu vaccine - repo
Found the Glaxo news, now the other one is gone-
I also found the great article I mentioned before-it is in the Health section, London Times On-line, dated Oct. 30. I’m sorry I don’t know how to do the urls/links-that has now shot up to the top of my flu- to-dolist. I did however, copy the Times article onto my harddrive so I have that.
green mom- found two on the Glaxo
www.earthtimes.org under health news www.pharmalive.com under newsletter overviews
Thanks Cottontop- these stories are hardly breaking news, but I thought the Times one in particular would be a good one to copy and pass around to try to convince others to prep-thats my plan. I’m going to get my son to give me a crash course in links/urls No doubt he’ll enjoy telling his mom what to do……
Green Mom,
The Times story is still there Bird Flu: the front line
green mom- I’m at the bottom of the barrel. I’m computer stupid! A squirrel knows more than I do! Have a great day.
FYI Fox news had a extended television presentation in the DC area at 7 this morning on the pnaflu threat. They likened it to a 1918-style event, and said that it would happen, that we were 2 mutations from a pandemic.
Anon_22, thanks for the link.
Comment: Apololgies for the long article. Wasn’t sure how to condense without the compromising the article.
‘Health hazards galore’ Egypt Reem Leila investigates the recent outbreaks of avian flu as well as salmonella
Scores of victims of avian flu and water contaminated with salmonella have raised serious concerns about disease outbreaks in Egypt. Meanwhile, concerned authorities are scrambling to address health hazards caused by ignorance, negligence and poverty.
Reports of people falling sick and dying from sewage-contaminated water in some Delta villages have been rapidly increasing in recent weeks. According to official reports, a salmonella outbreak has already caused one death and illness in 125 victims throughout 11 villages. These include Balgai, Gemezet Balgai and Serw in the Governorate of Daqahliya, located about 120 kilometres northeast of Cairo.
But villagers are inclined to believe the rumour that the sickness is caused by cholera. Panic worsened after reports that Egypt’s southern neighbour Sudan is suffering from a deadly cholera epidemic. But health officials have strongly denied that the epidemic has migrated to Egypt, insisting that Daqahliya residents are suffering from salmonella due to water contamination. Ministry of Health spokesperson Abdel-Rahman Shaheen told Al-Ahram Weekly that his ministry “has taken all precautions at the southern border to prevent cholera from infecting Egypt.”
After a meeting on Monday, the cabinet issued a report stating that preliminary results indicate that people are afflicted with salmonella, due to contaminated water. During the meeting, Prime Minister Ahmed Nazif stressed the need to overhaul Egypt’s sewage and potable water systems.
Shaheen explained that salmonella is a potentially deadly bacteria for human beings. “Salmonella can cause diarrhea and other flu-like symptoms, and can be deadly if not treated promptly with antibiotics,” he explained. But according to Shaheen, it was not only the contaminated water that made people sick; all those who fell ill had drunk either fresh mango or guava juice, according to samples taken from their stomachs. “The fruits were also infected with salmonella,” revealed Shaheen.
Ten days ago, 19-year-old Sherihan Mamdouh died after she was admitted to hospital with a high fever, vomiting and diarrhea. Others, ranging from ages seven months to 55 years, were admitted to hospitals in Mansoura with similar symptoms over the last few days. So far, 107 people were released from hospital after receiving treatment, while another 18 are still hospitalised.
Nearly 45 samples of the water were taken from villages in Daqahliya to be examined at the ministry’s laboratories. Shaheen confirmed that the samples tested positive for three types of salmonella, in addition to the Streptococcus Faecalis microbe causing severe infection of the digestive system.
Fresh water is not available in many of these villages, therefore residents pump underground water which passes very close to decaying sewage pipes, according to Daqahliya Governor Ahmed Said Sawan. Sawan ordered the cutting off of fresh water supplies in affected areas until the problem is fixed, banned water pumps, and ordered the sterilisation of all water in contaminated areas. He also allocated LE50,000 from the Fresh Water and Sewage Fund to supply the village of Serw with fresh water. This will be done by extending a three kilometre- long pipeline in the coming few days. “Other villages will eventually be provided with fresh water,” asserted Sawan.
Meanwhile, victim number 15 of human bird flu was admitted to hospital last week. Hanan Abul-Magd, 39, from the Nile Delta Governorate of Gharbiya had contracted avian influenza after buying and slaughtering infected ducks at her home. Abul- Magd is reported to be in a stable condition, and her family is being tested for the virus. Six of the 15 who were infected since the outbreak in February have died.
Health officials blamed Abul-Magd’s infection on the poor observance of government regulations aimed at stamping out the virus. According to Shaheen, people are maintaining their old habits and ignoring official warnings. “Earlier this year, the government and international agencies embarked on a nation-wide campaign to persuade people not to keep poultry inside their homes,” stated Shaheen. Since then, the government has overseen the culling of some 30 million birds, and imposed tough restrictions on poultry breeding. “A fine ranging from LE1,000 to LE10,000 was strictly enforced on those who breed fowl on roof-tops,” he added.
Egypt witnessed a concentration of bird-flu infection this year, causing LE600 million in losses since February. John Jabbour, of the Communicable Diseases Surveillance Department at the World Health Organisation’s (WHO) regional office in Cairo, said that “it is a matter of changing behaviour. People are sometimes not honest about breeding birds inside their houses. They know they are in danger, but for other reasons they still keep them.” Jabbour continued that the government has succeeded in removing poultry from the homes of people in Cairo, “but in more rural areas people are not accepting that they have to get rid of backyard birds.” According to Jabbour, the onset of cooler weather could still cause a flare-up of cases in poultry, and has urged increased surveillance accompanied by a fair compensation scheme.
Experts had previously criticised the government for failing to tackle the first outbreak boldly, resulting in six deaths between March and May. “The first time, the government was partially caught by surprise and did not take all the necessary precautions,” stated Mustafa Bastamy, head of the poultry department at the Faculty of Veterinary Medicine, Cairo University. “But they have been working very hard since. The threat has decreased since the government slaughtered many infected poultry during the last outbreak.”
Minister for Health and Population Hatem El-Gebeili declared that hospitals across Egypt had been put on high alert, and that the ministry was “working to ‘recharge’ the media message through all available channels.”
Seventh Egyptian dies of bird flu - agency
found the title on Newsnow but have not yet accessed the registration site.
http://www.newsnow.co.uk/newsfeed/?name=Bird%20Flu
I will post when I find the text.
found something on alertnet Seventh Egyptian dies of bird flu - agency
“An Egyptian woman died of bird flu on Monday, bringing the total number of human deaths in Egypt to seven, the state news agency MENA said.
The victim was a woman from the Nile Delta town of Samanoud who had slaughtered and handled domestic poultry, it said. It was the first human death in Egypt the from the virus since May. “
F.Y.I. The following Google link would not open. In light of the source, I thought the reference was worth passing along.
Free Market News Network, FL - 2 hours ago
“H5N1 bird flu sequences were released this month via the NIAID Influenza sequencing project. The samples were submitted by the Capua lab in Italy.”
I would not be surprized if Dr. N to have some commentary about the samples from the Capua lab.
World experts meet in Cairo to tackle health needs of developing nations
By Deena Douara First Published: October 30, 2006
CAIRO: The Global Forum for Health Research launched its international conference towards “Combating disease and promoting health” in developing countries on Sunday.
Excerpt:
“One person credited for extending help was Dr. David Nabarro, world expert and UN system coordinator on avian flu, who expressed to The Daily Star Egypt his close relationship with the minister since El-Gabaly approached him seeking help with the virus. Nabarro further illuminated influenza concerns currently under discussion such as the great economic repercussions, absenteeism, and resulting security threats.”
Henry L. Niman, Ph.D. wrote to Klatu, Mon, 30 Oct 2006: (re: Capua lab)
“I also received a google alert, but cannot find the article, which appears to be a misquote (or have multiple misquotes.”)
Henry L. Niman, Ph.D.
Last Updated: Monday, October 30, 2006 | 9:49 AM ET
The Canadian Press
“The idea that influenza viruses are always changing in a bid to outsmart the human immune system may not be entirely accurate, suggests a study that may help make flu shots more effective. The work, by U.S. scientists, suggests flu viruses evolve in a pattern of fits and starts, perhaps spurred by a competition between the two circulating types of influenza A that infect people, H3N2 and H1N1.
The finding, if confirmed by other researchers, could offer clues on how best to select the influenza strains that go into the annual flu shot, in particular in the years when H3N2 is undergoing the major changes that precede a bad flu season.
(The study is ‘an awesome use of these data’ from the Influenza Genome Sequencing Project.
-Joshua Plotkin, molecular evolution expert)
“Our hope is, one, we could do a better job of being ready for those big changes, which is important because a lot of people get sick those years,” said David Lipman, the senior author of the paper, which was published in the Oct. 26 issue of the online journal Biology Direct.
It might also help scientists predict whether the avian influenza strain H5N1 is evolving in a way that should set off alarm bells, said Lipman, the director of the U.S. National Center for Biotechnology Information, one of the National Institutes of Health.
The authors suggest the dominant human subtype, H3N2, occasionally goes into brief periods of evolutionary suspension or stasis, lasting months and even a year or so. Spotting an opening, H1N1 surges forward to become the main circulating subtype for a flu season, an occurrence that snaps H3N2 viruses back into action, they say.
“When H1N1 wins, that’s basically a sign that H3N2 is in a stasis period,” said Lipman, who wrote the paper with colleagues from the National Institutes of Health and the Pennsylvania State University.
Study among first to draw on flu genetic census
Their work, which may raise eyebrows among flu scientists, is one of the first to draw on the Influenza Genome Sequencing Project — an ambitious U.S. program aimed at cataloguing the genetic blueprints of as many garden-variety flu viruses as possible from different parts of the world.
The project is a bit like a genetic census of influenza. The growing database gives scientists the chance to study the genetic codes of a large number of flu viruses and look for patterns that may provide insights into everything from how flu evolves to how best to design new flu drugs and vaccines.
Joshua Plotkin, a researcher who specializes in molecular evolution at Harvard, called the work “an awesome use of these data.”
Plotkin is also looking for ways to predict the evolution of influenza viruses. While he didn’t challenge the findings, he suggested this paper doesn’t turn flu dogma on its ear, but rather fine-tunes it.
“It’s been known for a long time that … it sometimes takes two or in rare circumstances even three years” for a sufficiently new strain of H3N2 to emerge and cause a serious epidemic, he said, adding the study conclusions “really fill in the detail of that story.”
Incomplete data set?
But one of the reviewers of the paper remained skeptical Lipman and his co-authors had captured a real pattern, suggesting the collection of 1,000 or so viruses they studied might not have been representative of what was going on around the world.The viruses studied for this paper were from New York state and New Zealand.
(‘I am not convinced that the view of long periods of stasis … described here is not primarily due to the use of a biased [incomplete] data set.’
-Ron Fouchier, a virologist)
“I am not convinced that the view of long periods of stasis … described here is not primarily due to the use of a biased [incomplete] data set,” Ron Fouchier, a virologist from Erasmus University in Rotterdam, wrote in his assessment of the study. (Biology Direct posts the comments of its academic reviewers along with the articles.)
In the paper, titled Long intervals of stasis punctuated by bursts of positive selection in the seasonal evolution of influenza A virus, Lipman and his colleagues charted the evolution of H3N2 and H1N1 viruses between 1995 and 2005.
They saw a pattern in which H3N2 viruses would evolve to the point where they were sufficiently different that they could cause a serious annual epidemic. That’s because the changes made the viruses unrecognizable to the immune systems of many people worldwide.
Signal of bad flu season
Those big influenza years occurred in 1997, with a flu strain named A/Sydney and in 2003 with a strain named A/Fujian.
But because those strains made so many people sick, the H3N2 viruses would have had to acquire significant new changes in successive flu seasons to again infect lots of people. They did not and in the year or two after, the flu seasons were milder.
‘’‘(‘What this … tells us though, is that we need to come up with a better way to analyze the sequence data, to do the [strain] surveillance, to see when it’s going to explode on us.’
-David Lipman, paper’s senior author)’‘’
Eventually, the evolutionary progress of those strains of H3N2 appeared to stall, allowing H1N1 to come to the fore. Being overtaken by the rival strain seemed to push H3N2 back into action.Lipman said a mild H3N2 season followed by an H1N1 season — H1N1 typically causes even milder disease than H3N2 — could be a signal a bad flu season is on the way.
“We don’t know if it’s going to take off next season. Or the season after. What this … tells us though, is that we need to come up with a better way to analyze the sequence data, to do the [strain] surveillance, to see when it’s going to explode on us,” Lipman said.”
“The authors suggest the dominant human subtype, H3N2, occasionally goes into brief periods of evolutionary suspension or stasis, lasting months and even a year or so. Spotting an opening, H1N1 surges forward to become the main circulating subtype for a flu season, an occurrence that snaps H3N2 viruses back into action, they say.”
“When H1N1 wins, that’s basically a sign that H3N2 is in a stasis period,”
This does not appear to make a lot of sense to me.
I think there is one flawed assumption that is commonly made.
H1N1 came along a hundred years ago and as I understand it, all circulating seasonal influenza’s plus the pandemic of 1957 and 1968 were and are offspring of this one dominant subtype.
I am not sure we should extrapolate the norm from this period of time. If hypothetically, a unique H5N1 follows the same pathway of direct mutation without reassortment to produce the next pandemic, would the same rules apply…
…will H5N1 then become the dominant subtype pushing H1N1 out of the picture along with its derivatives…
…the problem for me is that I see nature and pathogen patterns as regularly irregular and 100 years is not long enough to determine an overall pattern.
Another way to look at the statement ‘regularly irregular’ is to say ‘expect the unexpected’.
I think the researchers are pulling predictability from a data set where there isn’t any…but I assume this data has also been restricted from study by independent scientists.
Bird flu: the front line http://www.timesonline.co.uk/article/0,,25149-2425837,00.html
snip~
Farrar, though, believes that such simulations depict an unreal world; how likely is it, he asks, that people will overcome the natural urge to flee a disaster zone and obey quarantine orders: “What do you do then? Do you shoot them? Put them in prisons?”
COMMENT: An interesting take from Dr. Farrar. Sooner or later all the big names fall in place
What Will Americans Do If Bird Flu Strikes www.news-medical.net
click disease/information new, on left
the Huricane Katrina comment I don’t agree with. In a situation like that EVERYBODY is vulnerable!
10/27/2006 2:45:00 PM
WASHINGTON (Dow Jones)--“The U.S. Department of Agriculture will, as of this week, stop issuing press releases on the discoveries of low-pathogenic bird flu, but will continue to compile findings and data from its surveillance program on government Internet sites.
- excerpt
Vol. 10, No. 4 April 2004
These findings conform to the theories of the molecular basisfor the mutation of avian influenza subtype H5 and H7 viruses from low to high virulence in poultry put forward by Garcia et al. (12) and Perdue et al. (13). - excerpt
( Recent USDA guidance appears to run counter to information posted on the CDC website)
H5N1 strain could start wave of bird flu outbreaks
Scientists in Hong Kong and the United States have detected a new strain of H5N1 bird flu virus in China and warned it might have started another wave of outbreaks in poultry in Southeast Asia and move deeper into Eurasia.
The strain, called the “Fujian-like virus” because it was first isolated in China’s southern Fujian province in March 2005, has increasingly been detected since Oct. 2005 in poultry in six provinces in China, displacing other H5N1 strains.
H5N1 strain could start wave of bird flu outbreaks
By Tan Ee Lyn
HONG KONG (Reuters) - Scientists in Hong Kong and the United States have detected a new strain of H5N1 bird flu virus in China and warned it might have started another wave of outbreaks in poultry in Southeast Asia and move deeper into Eurasia.
The strain, called the “Fujian-like virus” because it was first isolated in China’s southern Fujian province in March 2005, has increasingly been detected since October 2005 in poultry in six provinces in China, displacing other H5N1 strains.
The strain might also have become resistant to vaccines, which China began using on a large scale from September 2005 to protect poultry from H5N1, said the scientists.
The researchers are from the University of Hong Kong, including virologists Guan Yi and Malik Peiris, and Rob Webster of St Jude Children’s Research Hospital in the United States.
“The predominance of this Fujian-like virus appears to be responsible for the increased prevalence of H5N1 in poultry since October 2005 and recent human infection cases in China,” they said in an article published in the U.S.-based Proceedings of the National Academy of Sciences (www.pnas.org).
“It has already caused poultry outbreaks in Laos, Malaysia and Thailand, and human disease in Thailand. It is likely that this variant has already initiated a third wave of transmission throughout Southeast Asia and may spread further in Eurasia.”
Comment
uk bird – at 16:35
Bluebonnet – at 16:35
H5N1 strain could start wave of bird flu outbreaks
If Guan Yi and Malik Peiris, and Rob Webster, are publishing/acknowledging this, even though we’ve been forwarned by Niman, that’s very very bad news.
Right, I’m going to bed with a huge glass of BB RWFW - crackey - what’s that acronym again? Looks like I might not have to cook A/Crow/Fujian/Chanterelles/Saint-Emilion/2006–2007 for any of us yet. See you all tomorrow, with a hangover (any prepping item for this? I’m not used to getting sloshed…)
Another thing to keep in mind is that if they are just publishing this information, they have known about this new strain and the potential problems it could cause for at least 6 months or more. (Rough time estimate to collect data, analyze, and publish it)
So they are saying that the dominant strain in China’s markets is Fujian. However, I seem to recall that most of the virulent cluster deaths (at least in Turkey) have been the Qinghai. Does this mean that the Fujian strain is better adapted to birds while the Qinghai is better transmitted to humans? Can someone explain the significance of this “new strain” information in terms of human infection? (NS1, Monotreme ? )
Notice the dates - it has been a year! since Fujian became dominant and now it hits a media. Plus still a lack of full sequences, according to Niman. Really being kept in the loop, aren’t we? Research credits and patent rights and getting a jump on being “the only” vaccine producer are going to kill us all. Its never done like this in the movies!
Much more info on Fujian strain
‘The team has no evidence that the virus is more virulent or more likely to transmit among humans than previous strains, he says. But it has caused one human death in Thailand, and the five Chinese cases for which the team has virus samples. “As far as I know all 20 human cases recognised since November 2005 were caused by this virus,”’
From the New scientist report above.
This is not good. Two Commentaries by Dr. Niman Regarding Egypt:
Commentary
Suspect H5N1 Patients in Egypt Continue to
Recombinomics Commentary
October 30, 2006
A suspected case of human bird flu has been reported in the northern Egyptian governorate of Gharbiyah, raising the number of possible infected humans in the area to five, al-Ghomhuria reported, citing a local hospital.
A 23-year-old woman in the city of Tanta was suspected of having symptoms of avian flu and was transported to a local hospital
The above translation indicates that the number of suspect bird flu cases in the Gharbiyah governorate continue to rise. The only confirmed case (39F) from Samanoud has died today, one month after developing symptoms. The H5N1 HA sequence from this patient has been released, and it has a polymorphisim, M230I, which is adjacent to the receptor binding domain.
Although reports on the latest fatality cite negative tests on relatives, the increasing number of hospitalized patients in the area is cause concern.
Commentary
M230I Alteration Near H5N1 Receptor Binding Doman in Egypt
Recombinomics Commentary
October 22, 2006
On October 11 the WHO update confirmed an H5N1 infection in a patient (39F) in the Gharbiya governorate in the Nile Delta. Today the sequence of the HA gene from that patient was released, A/Egypt/12374-NAMRU3/2006(H5N1). The rapid release of this sequence by the US Naval Medical Research Unit in Cairo is to be commended. It was deposited at GenBank on October 13, 2006 and released shortly thereafter.
This Qinghai sequence has the common HA cleavage site, GERRRKKR, and has many polymorphisms found in isolates from birds and human cases from Egypt and Djibouti reported earlier this year. However, the sequence also has an alteration, M230I, near the receptor binding domain.
Changes in the receptor binding domain are cause for concern because they can alter the ease of transmission. Last year another change in the receptor binding domain, S227N, was predicted based on donor sequences in H9N2 in birds in the Middle East. That change was found in the index case in Turkey, which was linked to a very large cluster. Two of the four human sequences made public contained this change.
Changes in the receptor binding domain in the Qinghai strain are of additional concern because the Qinghai strain has already acquired a mammalian polymorphism, PB2 E627K. This change increases polymerase activity at lower temperatures. It offers strong selective advantage, and therefore is all in human H1, H2, and H3 isolates. The acquisition by H5N1 was first reported in isolates from Qinghai Lake in China. Subsequent isolates in Russia, Mongolia, Afghanistan, Turkey, Azerbaijan, Germany, Sudan, Italy, Croatia Slovenia, Niger, Nigeria, and the Ivory Coast in 2005 and 2006 has shown that this change has become fixed in the Qinghai strain.
Thus, additional changes in or near the receptor binding domain of Qinghai isolates are cause for concern. Results of testing of additional suspect H5N1 patients in Egypt have not been announced. However, H5N1 in Egypt may be further spread by migratory birds.
The change in the cleavage site has been reported in H5N2 birds from Mexico, as well as H5N1 from Vietnam. Recombination between Clade 1 H5N1 in Vietnam and Clade 2 Qinghai H5N1 provides a mechanism for further genetic diversity in the Qinghai strain. The Egypt isolates also have polymorphisms found in human H5N1 isolates in in Indonesia. These acquisitions via recombination demonstrate additional genetic diversity.
The geographic expansion of H5N1 by wild birds in China as well as the Qinghai strain in Europe, the Middle East, and Africa, creates additional opportunities for recombination and added genetic diversity.
This added geographical reach, coupled with increased genetic diversity, are cause for concern.
Emergence and predominance of an H5N1 influenza variant in China G.J.D. Smith, X.H.Fan, J. Wang, K.S. Li, K. Qin, J.X. Zhang, D. Vijaykrishna, C. L. Cheung, K. Huang, J. M. Rayner, J.S.M. Peiris, H. Chen, R. G. Webster, and Y. Guan
State Key Laboratory of Emerging Infectious Diseases, Department of Microbiology, Li Ka Shing Faculty of Medicine, University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong Special Administration Region, China; and Virology Division, Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, TN 38105
Contributed by R. G. Webster, September 20, 2006
The development of highly pathogenic avian H5N1 influenza viruses in poultry in Eurasia accompanied with the increase in human infection in 2006 suggests that the virus has not been effectively contained and that the pandemic threat persists.
[snip]
The predominance of this virus over a large geographical region within a short period directly challenges current disease control measures.
Here’s the journal url.
http://tinyurl.com/y9e2nvSome supporting data are posted, but not the full text (except to subscribers, of course).
When the National Academy of Sciences actually publishes “the pandemic threat persists”, my hair stands on end. I need a mug of hot milk.
Hot milk he**, time for the Single Malt Flu Killer! After dinner tonight for me!
This is a litle bit old, but I have not had the time to post it earlier.
“Unless the Norwegian military atacks Netherland, there will not be vacines for norwegian population in a pandemic”-“ Norway is number 2 on the vacsine lits from Solvay, Nr 1 i Netherland…”
Professor at University of Virginia School of Medicine, David S. Fedson recomneds statins as a way to deal with a pandemic. “ In 6 moths we will se the result of big study on the effect of statins to fight pnaumonia”
Norwegian Nurses Organisation, NSF Journal.24.10.06 (in norwegian)
http://www.sykepleien.no/article.php?articleID=12272
3 articles form David S. Fedson on his teorys about Staitins to fight pandemic. Preparing for pandemic vaccination: an international policy agenda for vaccine development. J Public Health Policy 2005; 26: 4–29.
Vaccine development for an imminent pandemic: Why we should worry, what we must do. Human Vaccines 2006; 2: 38–43.
Pandemic influenza: A potential role for statins in treatment and prophylaxis. Clin Infect Dis 2006; 43: 199–205 http://www.sykepleien.no/article.php?articleID=12273
from the new strain reports- Control Measures Fail to Stop Spread of New H5N1 Virus
….”We don’t know yet whether the people in those metropolitan areas were infected locally by contact with poultry or by contact with other humans,” Webster said, “but we suspect from the studies they are being infected by contact with poultry.”….
Regarding DennisC - at 18:31, I was wondering if PR Newswire is the same as PR News? Wasn’t PR News the website that let you type your own press releases?
Commonground – at 18:41 Yes, it it allows you to post your own news release. In this case, notice it was a press release from St. Jude Children’s Research Hospital. It seems to be the source of the recent articles quoted by news services about the “new strain” in China. The work appears to have been done at St. Jude and U of Hong Kong.
|’’’Rising seas could leave millions homeless in Asia’’’
Millions of people could become homeless in the Asia-Pacific region by 2070 due to rising sea levels, with Bangladesh, India, Vietnam, China and Pacific islands most at risk, says Australia’s top scientific body. A climate change report by the Commonwealth Scientific and Industrial Research Organization (CSIRO) found global warming in the Asia Pacific region could cause sea levels to rise by up to 16 cm (six inches) by 2030 and up to 50 cm (19 inches) by 2070. Rising temperatures will also result in increased rainfall during the summer monsoon season in Asia and could cause more intense tropical storms, inundating low-lying coastal villages.
snip
The report also said rising sea levels and increased rainfall would spread infectious diseases in the region, leaving millions more at risk of dengue fever and malaria. It said local and regional economies would be hard hit by chronic food and water insecurity, warning Sri Lanka’s GDP could fall by 2.4 percent with less than a two degree Celsius warming. snip
Several interesting statements were made in Dennis (18:31) article.
1) “…the increasing number of transmissions from birds to humans in the past year supports this opinion…”, said Robert G. Webster,
2) “Based on their study of vaccinated poultry the Hong Kong/St. Jude team suggested that the vaccination itself might have facilitated emergence of this new variant.”
3) “This emergence and rapid distribution of FL, despite the vaccination program that was started in September 2005, also suggests that the current H5N1 control measures are still inadequate, Webster said.”
4)…”We don’t know yet whether the people in those metropolitan areas were infected locally by contact with poultry or by contact with other humans,” Webster said, “but we suspect from the studies they are being infected by contact with poultry.”
If there was ever a hot article, this would be it.
A new variant that has eluded vaccination programs, may have evolved because of vaccination programs and may have improved infectivity for poultry and humans.
This variant would put in question every blood test that has been taken around the world. Unknown variants would make false negative tests very likely and underestimate actual cases by significant numbers.
The article also stated that 68% of samples tested positive for this new strain meaning the older variants did not disappear but are still present to interact with the new dominant strain in China…
…this article isn’t good from any angle.
Has there been any mention of this yet?
WASHINGTON - Scientists have discovered a new strain of bird flu that appears to sidestep current vaccines. It’s infecting people as well as poultry in Asia, and some researchers fear its evolution may have been steered by the vaccination programs designed to protect poultry from earlier types of the H5N1 flu.
DennisC at 18:31 - I’m sorry but I went to the St. Judes Webpage and I can’t find the article. I went to :New Releases” and “Whats Hot In The News”, I even did a search within the webpage for the article and I can’t find it? I don’t mean to be a bother, I am just very thorough that way…..
This latest strain news has me a bit freaked - their efforts to vaccinate poultry may have made the situation worse?! Isn’t that grand. I understand that they are trying to save zillions of $$$ worth of poultry, keep farmers in business, etc. but to have made teh situation potentially worse for HUMANS?!!!!!
Where’s RWFK when you need it!
oops, I hit post before I placed the hyperlink in…sorry. http://tinyurl.com/yzkd3p Scientists uncover new bird flu strain
My apologies if this is a repeat.
Given this article, what happens when they start vaccinating humans?
TomDVM- Please see my post in Rumors X
I missed an important part of the quote under 4) above
it should have read…
…”Moreover, since November 2005, some of the 22 H5N1 human infections reported from 14 provinces in China were from infected residents of metropolitan areas such as Shangai, Wuhan and Guangzhou, which are remote from poultry farms.
“We don’t know yet whether the people in those metropolitan areas were infected locally by contact with poultry or by contact with other humans,” Webster said, “but we suspect from the studies they are being infected by contact with poultry.”
Okay…it has been a really long day…and I didn’t scroll far enough up. Sincerest apologies….I’ll slink back into the fog.
…genetic sequencing of viruses collected from October 2005 onwards showed the Fujian strain was clearly becoming predominant over other H5N1 strains. Between April and June this year, 103 out of 108 H5N1-positive samples were of the Fujian type.
“That’s pretty conclusive proof that this new variant is predominant,” said Gavin Smith, one of the researchers in the Hong Kong team.
To test how well vaccinated poultry could stand up to various strains of H5N1, the researchers collected 1,113 blood samples from chickens from November 2005 to April 2006.
Only 180 samples, or 16 percent, tested positive for H5N1 antibodies. They were exposed to 3 strains of H5N1 — namely the Yunnan, Guiyang and Fujian-like strains.
The antibodies managed to neutralise the Yunnan and Guiyang strains, but had little or no effect on the Fujian virus.
“The market poultry, many of them don’t have antibodies against H5 virus and those that do are not well protected against the Fujian virus, which is why we think the Fujian-like virus has been able to grow because other (strains) have been suppressed,” Smith told Reuters in an interview.
‘Oct. 30 (Bloomberg) — Scientists have identified more clearly a strain of bird flu that eluded avian vaccine and may be largely responsible for a ``third wave of animal infections in China and other Asian countries over the past year.
The variant, called `Fujian-like virus, has replaced the other H5N1 flu strains that were circulating in Chinese poultry, scientists from Hong Kong and the U.S. said in a study to be published this week in the Proceedings of the National Academy of Sciences. Fujian-like strains have also been found in 22 people infected with H5N1 in China in the past year.’
The findings from China may mean that the vaccine being used there doesn’t give broad enough protection, researchers said. More study is needed to determine why the virus has eluded vaccines in China, where immunizing poultry is compulsory, while appearing to remain effective in Vietnam, said Robert Webster, who helped write the study.
`We need to find out what the difference is, said Webster, a virologist at St. Jude Children’s Research Hospital in Memphis, Tennessee, in a telephone interview. `It’s the same vaccine, and it’s made in China, so we need to find out if the vaccination policy is not being followed or some vaccine is not up to snuff.
Officials from the United Nations’ Food and Animal Organization are checking to see whether vaccines in China protect against the Fujian-like strain, said FAO chief veterinary officer Joseph Domenech.
`If the vaccines are not protecting against new strains of the virus, then those strains have to be included,’‘ he said today in a telephone interview.
Variety of Flu Strains
Poultry vaccines usually contain an oil emulsion, called an adjuvant, that provokes a strong immune response in the animal and gives protection against a wide variety of flu strains.
The virus is ``not as easily affected by the avian vaccine,’‘ said Yi Guan, a microbiologist at the State Key Laboratory of Emerging Infectious Diseases in Hong Kong who led the research, in response to e-mailed questions. `Avian vaccines are not able to prevent infection by this virus as efficiently as they do with other types of H5N1.
Vaccination remains the most effective way to protect poultry against H5N1, Domenech said. The agency is working with governments in Indonesia, China and other countries to improve their ability to monitor for new variants, he said.
`The situation is a lot better today than it was in 2004,’‘ Domenech said.
Strain Emerges
The team of researchers led by Guan took samples from 53,220 poultry in China from July, 2005 through June, 2006. About 2.4 percent were infected with H5N1, more than twice the .9 percent infection rate they found in the same period a year earlier.
A detailed analysis of 390 samples from southern China found that more than two-thirds were of the Fujian-like strain, the study said. The first sample of Fujian-like strain was seen in March 2005, and only one more sample was found from July to September that year.
After that, the prevalence of the strain exploded, the researchers said. Of 108 samples taken from birds from April to June this year, 103 were the Fujian-like strain. The emergence and dominance of the new strain isn’t unusual, said Michael Perdue, project leader for the World Health Organization’s global influenza program.
`We know that strains of flu supplant and replace other subtypes over time, he said today in a telephone interview. `In terms of human risk, there’s nothing to suggest that there’s more or less risk than there was before.
Human Infections
The human infections of Fujian-like strains occurred in areas where outbreaks of the virus hadn’t been seen in birds. That might suggest that the virus is more widespread in China than sampling has shown, or that it has spread from human to human in some cases, the study said.
The strain has spread from birds in China to Laos, Malaysia, and Thailand, the researchers said. More surveillance of poultry is key to understanding how the Fujian-like strain developed and came to the fore, Guan said.
`By doing this we will be able to determine the dynamics of the spread of this virus,’‘ he said.
The research was funded by the U.S. National Institutes of Health in Bethesda, Maryland, and the Li Ka Shing Foundation in China.
To contact the reporter on this story: John Lauerman in Boston at jlauerman@bloomberg.net ;
http://www.bloomberg.com/apps/news?pid=20601101&sid=aUxASXpZsYYI&refer=japan
Scientific American.com
Oct 30/06
FLU IN FLUX: “ Samples taken from poultry in southern China indicate that the H5N1 bird flu virus continues to evolve, keeping alive the threat of a global pandemic.
Despite mass vaccinations of poultry in China, the bird flu virus continues to evolve. Samples collected from poultry markets in southern China over the last year show that a variant of the virus has spread outward from a single province and supplanted strains in the rest of the region, researchers report. The result calls into question the steps taken so far to contain the virus, which public health officials fear could give rise to a deadly worldwide flu pandemic.”
- excerpt
more about egypt CIDRAP News
A 39-year-old woman who was previously listed by the World Health Organization (WHO) as Egypt’s 15th H5N1 avian influenza case-patient died today, the country’s state news agency reported.
She is the seventh Egyptian to die of the illness and the first fatality since May. The woman is from the Nile Delta town of Samanoud, which is about 60 miles northwest of Cairo, Reuters reported today.
According to an Oct 11 WHO statement, the woman became ill on Sep 30 and was hospitalized Oct 4. She had suffered from pneumonia and been treated with oseltamivir. Reuters reported that her contacts have tested negative for the virus.
The WHO report said she had slaughtered and plucked about a dozen ducks after some of the flock got sick and died.
The H5N1 virus first cropped up in Egyptian poultry in February, and a series of human cases followed in April and May. Cases in poultry resurfaced in Egypt Sep 5, when an outbreak was reported on a farm in the southern province of Sohag, about 305 miles south of Cairo. Another outbreak was reported in late September among domestic birds at a home near Aswan, in southern Egypt, near the border with Sudan.
A Reuters report said most commercial ‘poultry flocks in Egypt have been vaccinated against H5N1, but only about 20% of backyard birds have been immunized.
CIDRAP link for the above
Recombinomics Commentary October 27, 2006
“As noted previously, all human sequences from China in 2005 and 2006 were the Fujian strain, as were the wild bird sequences in Hong Kong as well as sequences from Laos and Malaysia. Thus, the current sequences confirm that the Fujian strain has become widespread in China.” - excerpt
to be published Nov 3 (CIDRAP) The NS1 Gene Contributes to the Virulence of H5N1 Avian Influenza Viruses
..A/goose/Guangdong/1/96 (GS/GD/1/96) is a highly pathogenic virus for chickens, whereas A/goose/Guangdong/2/96 (GS/GD/2/96) is unable to replicate in chickens. These two H5N1 viruses differ in sequence by only five amino acids mapping to the PA, NP, M1, and NS1 genes… These results indicate that the NS1 gene is critical for the pathogenicity of avian influenza virus in chickens and that the amino acid residue Ala149 correlates with the ability of these viruses to antagonize interferon induction in CEFs.
October 31 2006 at 02:42AM
‘’‘Hong Kong - Scientists in Hong Kong and the United States have detected a new strain of H5N1 bird flu virus in China and warned it might have started another wave of outbreaks in poultry in Southeast Asia and move deeper into Eurasia.
The strain, called the “Fujian-like virus” because it was first isolated in China’s southern Fujian province in March 2005, has increasingly been detected since October 2005 in poultry in six provinces in China, displacing other H5N1 strains.
The strain might also have become resistant to vaccines, which China began using on a large scale from Sept. 2005 to protect poultry from H5N1, said the scientists.’‘’
The researchers are from the University of Hong Kong, including virologists Guan Yi and Malik Peiris, and Rob Webster of St Jude Children’s Research Hospital in the United States.
“The predominance of this Fujian-like virus appears to be responsible for the increased prevalence of H5N1 in poultry since Oct. 2005 and recent human infection cases in China,” they said in an article published in the US-based Proceedings of the National Academy of Sciences.
“It has already caused poultry outbreaks in Laos, Malaysia and Thailand, and human disease in Thailand. It is likely that this variant has already initiated a third wave of transmission throughout Southeast Asia and may spread further in Eurasia.”
“In the Case of an Outbreak of Pandemic Flu, Large Majority of Americans Willing to Make Major Changes in Their Lives” ….(now look for the caveats)
10/26/06-sorry if this is old news.
http://www.hsph.harvard.edu/press/releases/press10262006.html
note GSK = GlaxoSmithKline Plc (GSK), a British healthcare company
GSK in talks with Blair on bird flu vaccination
GSK is in talks with the Government about a countrywide vaccination against an outbreak of pandemic bird flu. J.P. Garnier, the Chief Executive, is understood to have met Tony Blair and Gordon Brown this month. Among other issues, they discussed the possibility of stockpiling tens of millions of doses of a new vaccine against the H5N1 strain of bird flu developed by the company. Switzerland became the first country to order enough pandemic flu vaccine made by GSK to protect its entire population. GSK’s vaccine has not yet received regulatory clearance but the company expects to file for approval with the European Medicines Agency by the end of the year. The Government is considering its options but is thought to be worried about the cost of vaccinating the UK’s entire population of 60 million. There are also concerns about the effectiveness of the vaccine. It has been shown to offer protection against the H5N1 avian flu virus but its potency against a possible new, mutant strain is unknown. GSK has also discussed the possibility of a mass vaccination programme with the US Government, although no imminent decision is expected.
Could this new strain be part of the reason why we see negative test results for a patient who seems to have ai? (sounds like a dumb question to me, but…?)
Today’s notice of the death in Egypt now makes the “older news” of Oct 17 more understandable:
Egyptian Health Minister Hatem Al Gabali said on Tuesday he feared a fresh spate of human bird flu cases in the coming weeks. “Bird flu is still present and we will witness new cases this winter. We just hope they won’t be fatal,” he told parliament.
“The population still refrains from informing the authorities when poultry is infected, especially in domestic rearings,” he added. Health officials announced last week that the highly pathogenic H5N1 strain of bird flu had been detected in a 39-year-old woman from the northern Delta province of Gharbiya.
Gabali said her condition was stable.
COMMENT With reference the new strains of virus and the vaccine side-steppers - so many countries were saying that, because an exact vaccine could not be acquired, even for poultry, there was the risk that vaccine resistant or side steppers would develop.
Robert Webster et al must be tearing their hair out - “I told you so” is not going to solve the problem, but they did tell us so … Why don’t we just put up a big Wet Paint sign? This all seems to be going the same way … Aagghh - anyone got any leftover BBRWFK?? Share now!
Comment: BBRWFK and other alcoholic coping mechanisms dehydrate the body. Treat after affects tomorrow with hydration (uncaffienated). I am sorely tempted to order the extra large box of Christmas chocolates. . . it may be small joys are all there are to be had.
AnnieB – at 23:39
Robert Webster et al must be tearing their hair out - “I told you so” is not going to solve the problem, but they did tell us so … Why don’t we just put up a big Wet Paint sign? This all seems to be going the same way … Aagghh - anyone got any leftover BBRWFK?? Share now
To be fair, Webster was one of those who admitted avian vaccine was one solution, in the absence of better solutions.
You know what? Nothing was ever going to ‘solve the problem’. Nature has its way of throwing up new strains. Remember that previous pandemic viruses also started from southern China, long before there were poultry vaccines. The question that I still have is this, what is so different about that part of the world, that makes it the origin of pandemic flu viruses? Until someone starts to look at it this way, we won’t get any nearer to figuring out what’s going on, IMHO.
Just getting the News Summary done and then I will start a new thread - a busy day for news today …
Give me another 15 minutes or so …
Actually, I don’t think this Fujian-like strain is that new. Niman did a comment on it on April 5, 2006