link to News Summary for November 23 and News Reports for November 24 [http://www.newfluwiki2.com/showDiary.do?diaryId=223|here]]
link to previous days News Reports
sorry guys forgot a [ in that link… it’ll still work though:-)
Comment: interesting discussion of clusters…
Rapid tests for bird flu are flawed, studies find
Quick results are key to halting spread
By Donald G. McNeil Jr. / The New York Times Published: November 24, 2006
Avian flu is extremely hard to detect with standard tests, but waiting for laboratory confirmation of an outbreak would cause dangerous treatment delays, according to new studies of two flu outbreaks.
The studies, published Thursday in The New England Journal of Medicine, were of family clusters of flu cases in Turkey and Indonesia.
Rapid tests on nose and throat swabs failed every time, and in Turkey, so did all follow-up tests, known as Elisas. The only tests that consistently did work were polymerase chain reaction tests, or PCRs, which can only be done in advanced laboratories and take several hours.
“It’ll be a disaster if we have to use PCRs for everybody,” said Dr. Anne Moscona, a professor of pediatrics and immunology at Weill Cornell Medical College. “It just isn’t available at a whole lot of places.”
If the H5N1 virus mutates into a pandemic strain, rapid tests “will be really key,” she said.
The studies followed clusters in three separate families in Indonesia in 2005 and in what appears to have been one extended family near Dogubayazit, in eastern Turkey, in January.
Case clusters particularly worry public health authorities because they raise the possibility that the flu is mutating to spread faster between people.
In the Indonesian cases, the authors, a mix of experts from Indonesia, the World Health Organization and the Centers for Disease Control and Prevention in Atlanta, concluded that human-to-human transmission had probably taken place in two of the three family clusters.
In one case, a 38-year-old government auditor appeared to have caught the flu from his 8-year-old daughter or her 1-year-old sister. All three died; his wife and two sons did not become ill.
No one in the family had any known contact with poultry, wild birds, animals or sick people, so the source was a mystery.
“But you can’t always tell what a young child has done,” said Dr. Tim Uyeki, a CDC flu specialist and an author of the study. “There’s no magical test, and you don’t always get a perfect explanation.”
The Dogubayazit cluster was a cause célèbre for some Internet flu-watchers following Turkish media reports in January. They argued that widespread human-to-human transmission seemed to be taking place, and that it may have begun at a banquet in late December attended by members of two related families named Ozcan and Kocyigit. The Turkish government and the WHO did not link the cases or families and tentatively blamed all transmission on birds.
[snip]
Ultimately, only 10 came up positive on PCR tests, and only 8 of those were confirmed by a WHO laboratory. All were children; four died and four survived.
The study confirmed early suspicions that the families were linked; 7 of the 8 children were related or lived near each other. The December banquet was not mentioned.
It was impossible to tell whether the other argument made by the Internet flu-watchers was correct: that poor testing and the oseltamivir had disguised the real extent of the outbreak.
Nonetheless, the lead author, Dr. Ahmet Faik Oner, a professor of medicine at Yuzuncu Yil University in Turkey, said in a telephone interview that he believed there had been no human-to-human transmission because all the children had been in close contact with poultry within seven or fewer days before they fell ill and because none of their parents or the hospital staff that treated them had become sick.
Uyeki declined comment on the Turkey outbreak but said both studies lent support to the theory that some people are genetically more susceptible to the flu, or at least to the strain that was circulating last year and in January.
Nonetheless, the lead author, Dr. Ahmet Faik Oner, a professor of medicine at Yuzuncu Yil University in Turkey, said in a telephone interview that he believed there had been no human-to-human transmission because all the children had been in close contact with poultry within seven or fewer days before they fell ill and because none of their parents or the hospital staff that treated them had become sick.
Well, I guess the river does not run through Turkey then…
Mass Death of Home Birds Observed in Garatepe Village of Barda District
Within approximately 5 days, a mass death of home birds has been observed in 50 families of the Internally Displaced Persons (IDP) residing in the Garatepe village of Barda district of Azerbaijan. The IDPs are concerned that the mass death is caused by the “bird flu” virus, Trend Regional Correspondent reports.
Although the IDPs held the vaccination of the birds, as yet there are no results. They have repeatedly appealed to the Barda Veterinary Department, but no measures have been taken. Expressing his concern over the mass death of the birds, the Head of the Garatepe village municipality, Nizami Abbasov, said that he also appealed to the Barda Veterinary Department, but have been given false promises.
In response, the Head of the Barda Veterinary Department, Aydin Mammadov, stressed that they have not received any information regarding the mass death of the birds. Despite that the IDPs continue to living in the territory of Barda, the State has not allocated any finance for their medication. The IDPs should therefore appeal to the Veterinary Department at their own district.
http://tinyurl.com/y56ul9
But it’s heartening to see NY Times devoting a good sized paragraph to comments made by ‘internet flu-watchers’:
The Dogubayazit cluster was a cause célèbre for some Internet flu-watchers following Turkish media reports in January. They argued that widespread human-to-human transmission seemed to be taking place, and that it may have begun at a banquet in late December attended by members of two related families named Ozcan and Kocyigit. The Turkish government and the WHO did not link the cases or families and tentatively blamed all transmission on birds.
Nimbus do you have a link for that NEJM article? I would like to send it to my pediatrician.
History Lover – at 12:11
Here’s the one for Turkey: http://content.nejm.org/cgi/content/full/355/21/2179
And the one for Indonesia: http://content.nejm.org/cgi/content/full/355/21/2186
Finance sector survives bird flu exercise
Fri Nov 24, 2006 5:16 PM GMT65
LONDON (Reuters) - The financial regulator said London’s financial services sector had shown it could cope with a bird flu pandemic, after a six-week simulation that ended on Friday.
The Financial Services Authority said early feedback showed that the sector, which includes some of the world’s biggest banks, would be able to keep core services running in the face of huge disruption caused by a pandemic.
The simulated pandemic broke out in southeast Asia and spread to Europe and around the rest of the world, causing absenteeism and transportation disruptions.
“It was a bit daunting at 10am on a Monday morning dealing with this escalating pandemic. It was a bit like being in that film ‘The Day After Tomorrow’,” said a participant at a major bank who worked on the desk-bound exercise.
“We were satisfied with how it went and it was useful to go through the process,” she said.
[snip]
The three activated a secret Internet chatroom, which was set up after the September 11 bombings of the World Trade Centre in New York, which keeps communication open between banks and the authorities in a crisis.
Korea - Blood tests of 14 show no bird flu infections
November 25, 2006
The nation’s health authority said yesterday that there had been no sign of human infection in the quarantine area in North Jeolla province where bird flu is believed to have broken out.
Following a suspected bird flu infection at a farm in Iksan, the Ministry of Agriculture and Forestry warned of the possibility of human infections, saying the virus could be a highly pathogenic strain. The Korea Center for Disease Control and Prevention said yesterday that it had examined the couple who owns the farm and 12 visitors who had been there since last Sunday, when birds began dying.
None of the people showed signs of bird flu, the center said, although it would be too early for symptoms to show up. More tellingly, though, blood tests of the 14 people showed no signs of the virus.
More tests are under way, the center said, but one official there said it would be very unusual if an initial blood test were found to have been incorrect.
The center said the 14 people and all quarantine officials in the region are taking Tamiflu, an anti-viral medication, as a precaution.
Another bird flu outbreak was confirmed in Pyeongtaek, southern Gyeonggi province, on Wednesday, the center said, but added that the strain of the virus found there appeared to be far less virulent than the one further south.
[snip]
24 Nov 2006 - 8:00am (PST)
After the South Korean Agriculture and Forestry Ministry announced that approximately 6,000 chickens in one farm died as a result of bird flu infection, the Japanese government has suspended imports of South Korean poultry.
Japan’s Chief Cabinet Secretary, Yasuhisa Shiozaki, added that people coming into Japan from South Korea will have to disinfect the soles of their shoes.
Authorities in South Korea say the outbreak is of a ‘low-grade’ strain of bird flu. The affected farm is located south of the capital Seoul. Ministry officials say the strain is definitely not the virulent H5N1 nor the milder H5N2. Officials stressed that humans are not at risk.”
Nimbus – at 11:09 wrote:
“Rapid tests on nose and throat swabs failed every time, and in Turkey, so did all follow-up tests, known as Elisas. The only tests that consistently did work were polymerase chain reaction tests, or PCRs, which can only be done in advanced laboratories and take several hours.”
PCR tests (the gold standard) are not infallible - especially if samples have degraded before testing. A recent Indonesian patient had to have multiple PCR tests over several weeks before a postive confirmation was made, post-mortem. No explanation for this has ever been put forward.
Klatu – at 14:10 and Nimbus – at 11:09
All good reasons why I think we’re deeper into the soup pot than it may look…. :(
Grace RN – at 14:46
Yes, and that is why I like to keep aware of all the “not bird flu but close” and rumors. I just want to make sure not too many things “fly below the radar”. Yes, tose groups will mostly/or all be other things, but I worry that the real start will first look like something else and will not be diagnosed early.
Nov 24/06
TORONTO (CP) - “The Public Health Agency of Canada has signed a deal to purchase 500,000 treatment units of the flu drug Relenza to be added to the federal pandemic influenza stockpile.
The agency confirmed Friday that a deal was signed this week with GlaxoSmithKline for Relenza, an alternative to the better-known flu drug Tamiflu. Alain Desroches, a spokesman for the agency, said the purchase is another step in achieving the goal of having 5.5 million treatment courses of flu drugs in the national antiviral stockpile. The aim is to have about 90 per cent Tamiflu and 10 per cent Relenza, he said.
Desroches said that with this purchase and a pending delivery of 1.4 million treatment courses of Tamiflu, the national stockpile will hit about 5.1 million treatment courses.
“We’re not there yet, but we’re getting there,” Desroches said from Ottawa.
Adding Relenza to the inventory diversifies Canada’s antiviral holdings, providing a hedge in case the strain of flu that causes the next pandemic develops resistance to Tamiflu. Rare cases of Tamiflu resistance have already been reported in some human cases of H5N1 avian flu.
It’s an approach British experts urged that country’s government to take this week. A report from the Royal Society and the Academy of Medical Sciences expressed concern that Britain has not diversified its flu drug stockpile.
“We are concerned that decisions are being made . . . that fail to take account of expert advice,” said Sir John Skehel, chair of the working group that wrote the analysis of Britain’s pandemic preparedness efforts. “For example, the decision to continue to stockpile just one antiviral drug is a major concern.”
“This needs to be reconsidered,” Skehel said. “New evidence that H5N1 can develop resistance to Tamiflu indicates that a combination of antivirals should be stockpiled by the U.K. for the most effective management of a pandemic.” The cost of amassing Canada’s national antiviral stockpile has been shared by the federal, provincial and territorial governments.” - excerpt
New drug to boost defence against bird flu pandemic
A new flu drug that can kill deadly strains of bird flu is promising to transform global preparations for an influenza pandemic.
Peramivir, an antiviral agent, could provide the world with a critical new line of defence against flu viruses with the potential to cause millions of deaths, such as the H5N1 avian strain, research has suggested.
Studies in the United States show that it should be more powerful and easier to give to seriously ill patients than either Tamiflu or Relenza, the two existing drugs for H5N1 flu.
Flu experts said that the advent of a third effective option could save hundreds of thousands of lives if H5N1 acquires the ability to pass easily from person to person — the key trigger for a pandemic. H5N1 has already infected 258 people and killed 153, mainly in South-East Asia, and it has recently mutated in ways that make human infections more probable.
“We need as many good antiviral drugs for flu as we can develop,” said Frederick Hayden, a World Health Organisation medical officer who has studied peramivir. “Having multiple options with different antiviral spectra is very desirable.”
Peramivir has two important advantages over the other therapies. Tamiflu, which is taken orally, and Relenza, which is inhaled, are difficult to administer to unconscious patients. Peramivir does not have this problem because it is injected, and the first human studies have shown that it also reaches the bloodstream in higher concentrations and remains active for longer.
The new drug would also provide a valuable alternative if a pandemic strain were to evolve resistance to Tamiflu, the front-line treatment that has been stockpiled by many countries, including Britain. Some H5N1 viruses have already shown resistance to Tamiflu, and if such a strain became dominant the drug would become useless. This week, a report from the Royal Society urged the Government not to rely on it exclusively.
Laboratory tests show that peramivir is effective against every known variant of H5N1, and its greater potency means that the virus is less likely to acquire resistance.
It is also simple to manufacture from synthetic raw materials that are readily available in bulk. Tamiflu production has been delayed by a shortage of star anise, the plant from which the active ingredient comes.
Peramivir was developed by BioCryst Pharmaceuticals, based in Alabama. It said that facilities already exist that could make a billion doses a year; Roche can make only 400 million doses of Tamiflu a year. BioCryst recently completed successful safety trials on human volunteers, which also proved that both intramuscular (IM) and intravenous (IV) injections deliver high levels of the drug to the bloodstream.
Phase 2 trials of the IM formulation will start testing peramivir’s effectiveness in more than 100 patients with seasonal flu from next week, and a similar study of the IV injection is due to begin in January. If these are successful, larger phase 3 trials would take place during next winter’s flu season, and the drug could be marketed within two to three years.
If a flu pandemic were to start before then, peramivir could be made available as an emergency measure, as it already has a good safety record.
[snip]
http://www.timesonline.co.uk/article/0,,2-2471200,00.html
This sounds almost too good to be true.
wow! ! !
(dammed, now i will have to serve all my guests beans for many years,,,)
wasnt i suposed to leave this fourm for the new one…?
We have our wonder drup ladies and gents. No need to prep anymore. go back to life as you knew it.
sorry. what is a wonder drup? I meant, wonder drug.
sorry again. Bump was me. twice. Somebody get me away from this damn keyboard.
My goodness. If this drug is what it says it is, all the flu forums can be closed down, and a lot of people won’t have to buy much food for a long, long time. Cottontop - just back away from the keyboard, we’ve all had to do that at times~!
;-)
ahhh.. i liked prepping! now i have to go back to studys agian.. well it was a exiting year :D
or not. http://scienceblogs.com/effectmeasure/2006/10/new_antiviral_peramivir.php
maybe the idea of getiing 5 shots in 5 days makes this hole math even worce.. before we had to worry about getting in line during 24h fro tamiflu…
but good news anyway, more tools to hammer that crepy thingy
BeWell-
It’s just one of those nights. I was laughing so hard at myself. Oh well….
Anyway, the tone of the article is what I noticed. Sounds as if they have announced “the miricle”, and this is just the first in several to come. Smells to me.
cheap beans anyone? good quality, not stored longer than a year..
From the Effect Measure article on peramivir (link at urdar-Norway – at 21:52):
‘’So we have a possible new antiviral. It is not a cure. It may help. Neither a vaccine nor the new antiviral will be available in any appreciable quantities for a year or more, and then only enough for a small fraction of the world’s population. Too bad we didn’t start this earlier. Tell your governments.
Life is about timing.’‘
I think that sums it up pretty well. Let’s cross our fingers and hope we get that year and more.
Satellite Observation Used To Track Avian Flu
An international, interdisciplinary team of researchers led by professor Xiangming Xiao of the University of New Hampshire is taking a novel scientific approach in an attempt to understand the ecology of the avian influenza, develop better methods of predicting its spread, and provide an accurate early warning system.
Xiao and colleagues were recently awarded $1.55 million for a four-year project funded by the U.S. National Institutes for Health (NIH) as part of the Ecology of Infectious Diseases (EID) Program jointly sponsored with the U.S. National Science Foundation. The EID program supports research projects that develop quantitative analysis and modeling capacity for better understanding the relationship between man-made environmental change and transmission of infectious agents.
The UNH project will use environmental remote sensing data from Earth observing satellites in combination with research in epidemiology, ornithology, and agriculture to provide a better picture of how the Highly Pathogenic Avian Influenza survives and gets transmitted among poultry and wild birds. The work focuses on China, where outbreaks of the virus have been prominent.
[snip]
The ecology of the avian influenza involves a complex web of factors, including environmental settings, agricultural practices of rice production and harvesting, poultry production involving huge populations of free-grazing ducks, and the migratory behavior of wild bird populations. Depending on how all of these risk factors intermingle over time, the virus can be spread through the environment by infected wild birds or domestic poultry.
Says Xiao, “The strength of our group, and of this proposal, is that over the last few years we’ve been able to pull a lot of information out of satellite observations that can help unravel the complex risk factors involved in avian flu ecology.”
For example, using imagery of varying resolution from different types of satellites, the team can map and track the spatial-temporal dynamics of crop cultivations (when planted, harvested, etc.) and wetlands. Used in conjunction with other geospatial data of environment, bird migration, and poultry production, dynamic maps of “hot spots” and “hot times” for viral transmission can be developed in near-real-time mode and will aid the public, researchers, business, and decision-makers in preparing for a potential pandemic crisis.
More here: http://www.medicalnewstoday.com/medicalnews.php?newsid=57183
Pretty cool stuff :)
we have known for a long time that af1…has beena round all of us. It is everywhere. The time to plan is now.please people take this seriously. THERE is no time to prepare but now. the govt. knows this is going to happen. store food and water for at least 2 months. this will be a PANDEMIC.
I’m with raddar.If the Govt. gets involved in the handleling or distribution of these drugs somehow it will get screwed up.Take it from someone who went thruu katrina.I myself will still prep just to play it safe and to protect my family….Be good and be safe