Forum: News Reports for October 4

Summary from Indonesia Outbreak tracking as at 3 October 2006

Summary of News for 3 October 2006

(From WHO as at 3 Oct)
Total human cases worldwide 252, deaths 148 (2006 – 105 with 70 deaths)

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

Indonesia

• Bird flu campaign in West Java to involve school children (link http://tinyurl.com/z2ndn)
• Avian influenza – situation in Indonesia – update 35 (WHO) (link http://tinyurl.com/ljwbs)
• Letter to Jakarta Post paints a worrisome picture (link http://tinyurl.com/gk5v7)
• Translation of news within the thread at 06:30, 11:07, 16:55, 19:19
• Separate thread for outbreak discussion (link Indonesia Outbreak XIII )
• Separate thread for Summary of cases (link Case Summaries )

European Community

• Health experts urge EU to prepare for more bird flu cases (link http://tinyurl.com/nso8s)

United Kingdom

• Norfolk is ready for a flu pandemic (link http://tinyurl.com/oqvcz)
• Treatment to ‘neutralise all flu’ (link http://tinyurl.com/zwdzu and http://tinyurl.com/za4xf)

Panama

• Mystery illness kills 6, national epidemic alert declared (link http://tinyurl.com/jbpea and http://tinyurl.com/ejmg8)

United States of America

• US governors prepare for flu pandemic (link http://tinyurl.com/hb2wh)
• Two US scientists win Nobel for ‘gene silencing’ (link http://tinyurl.com/l337d)
• Emergency Medical Services – A Place at the Table (link http://tinyurl.com/mvl9s)
• Experts to release recommendations for improving pandemic flu science and technology policy (link http://tinyurl.com/heuf3)
• (Austin, Texas) Study recommends strategy for distributing flu vaccine during shortage (link http://tinyurl.com/mqkqh)

General

• WHO: we now have only “God given Time” to prepare (link http://tinyurl.com/nsbkt)
• Bird flu fears: why prepare now for bird flu? (link http://tinyurl.com/zux7o)
• Staving off panic in a pandemic (link http://tinyurl.com/g26nw)
• Use of statins in fighting cytokine storms (link http://tinyurl.com/efukx)

Link to news thread for 3 October (link News Reports for Oct 3 )
(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.

No more News Summary from me

This is the last News Summary I can create for a couple of weeks as I am re-arranging computing power amongst other things ;-)

There is a copy of my template in the Sandbox if anyone wants to give it a go.

I will be checking in intermittently but don’t panic if I don’t post for a couple of weeks. Love you all.

Many, many thanks to you, AnnieB. Best wishes to you!

H5N1 Suspect Cluster in Makassar South Sulawesi Grows

Recombinomics Commentary

October 4, 2006

“The above translation indicates the number of hospitalized suspect H5N1 bird flu victims continues to increase in Makassar in South Sulawesi. In June a confirmed H5N1 case died in Makassar and recently the number of additional hospitalized patiens began to increase dramatically. Some of the earlier cases are recovering, so the recent cases could be seasonal flu, or H5N1 responding to Tamiflu treatment.

The clustering in the same neighborhood, however, remains a cause for concern.”

http://tinyurl.com/nrela

Phillipines

DoH chief asks mayors to ready bird flu containment plan

HEALTH Secretary Francisco Duque III asked town mayors Wednesday to prepare bird flu containment plans to control any local outbreak and safeguard the country — among the few in Asia that have stayed free of the disease.

A bird flu outbreak could have a devastating impact on people and businesses in affected communities and eventually on the national economy, Duque told mayors at a one-day meeting organized by his department and the Asian Development Bank.

“Every local government, every community should be able to draft a local preparedness and action plan,” Duque told the mayors. “Only when action starts in communities can we control and contain a budding epidemic from turning into a deadly national disaster.”

http://tinyurl.com/r245p

Singapore

Singapore tests contingency plan to counter bird flu

Singapore is operationally ready to handle any outbreak of bird flu should it happen, according to Minister of State for National Development Grace Fu.

Ms Fu was present at Exercise Gallus IV, a bird flu preparedness exercise conducted by the Agri-Food and Veterinary Authority (AVA) at one of Singapore’s poultry farms today.

“It has shown that we are operationally ready to handle the situation at every stage… all our personnel, together with the external cullers, they know exactly what to do, so I think we are in a very good position to handle the situation when it arises”, she said.

http://tinyurl.com/syvdm

Indonesia

West Java to up fight against bird flu

West Java province has dropped out of a special commission to educate the public about bird flu and will improve its existing working team instead, an official says.

Provincial health office head Yudi Prayudha said the decision was taken after the province was declared the country’s worst affected by the H5N1 virus.

Health Ministry data shows that out of the country’s 52 deaths from bird flu, 19 came from West Java.

http://tinyurl.com/naqgk

Thank you so much Annie for all your hard work! We will miss you- stay well!

China reports second bird flu outbreak in a week

BEIJING : A new outbreak of bird flu has killed about 1,000 poultry in northern China in the second such case in a week, state media reported on Wednesday.

Some 72,930 domestic poultry have been slaughtered and the outbreak is now under control, Xinhua news agency said. Laboratory tests had confirmed the H5N1 strain of the virus, which can be deadly to humans, it added.

The outbreak, in Henan New Village in Yinchuan, regional capital of the desert-like Ningxia Hui region, follows a similar occurrence in neighbouring Inner Mongolia.

It’s interesting that they were able to slaughter 73K birds before it made the news.

Oremus – at 14:28

Makes me wonder what else is going on that we don’t hear about.

Thanks, Annie B for all your work! See you in a few weeks.

I’m not sure if this has already been posted. Apologies if I’m a day late…

New Drug stops Influenza and Bird Flu Virus

http://tinyurl.com/qx7p5

Stripped down virus to neutralize flu. BBC news http://tinyurl.com/k9y2v

I just saw this report from the University of Wisconsin-Madison

http://tinyurl.com/g855t

New drug blocks influenza, including bird flu virus

….So, we can all relax, eat our preps, etc. or do the science people here have reservations about these 2 new “miracle cures” - one thought I had was this is all too convenient - solutions out of nowhere when things are really getting worrisom?

Sunny. Well, to answer your question, it seems that a wide disparity of human beings and companies have decided that there is money to be made from this issue…in the past month or so there appears to be a lot of ‘snake oil’ going around…

…the truth is that at the moment

1) H5N1 is driving the bus…human beings lost control of the situation in 1997…we cannot even influence the outcome…the Tamiflu blanket is an illusion created to make the World Health Organization and others including Governments with control issues, feel better.

2) there are no effective prophylactics (preventatives)…including vaccines or antivirals.

3) there are no effective treatments even when all cases have been treated within an intensive care environment with every advancement in machinery and pharmaceuticals avaliable.

4) not one study or word has been released as to the quality of life of the survivors of H5N1 in the past several years. You would think that these survivors would be examined and explored in detail.

4) there are no plans in place to prevent a widespread collapse of infrastructure…JWB, a electrical grid expert, has predicted on flu wiki I believe that the grid will collapse within a few weeks.

5) I being involved in the food industry on several levels cannot quite get my head around how they are going to insulate the just in time food delivery infrastructure from collapse.

The bottom line…don’t eat you preps quite yet…the pandemic will probably break open overnight about one day after every expert in the world determines that the danger is passed.

I’m not surprisedthat MSM is all over any medication or vaccine they think would prevent this. We live in a real time of ‘I want a pill to make it go away/to make me feel better’. No one recuperates any more; we’re so pressured to get back to work, to be productive that few people (other than Lily) know how to really relax, or can take the proper amount of time to get better before dragging themselves back to work.

I’ve worked for hospital/health care systems my whole life, and they’re far more strict about calling out sick than most other companies as far as I can tell-one place only allowed 3 callouts a year before the disciplinary process kicked in!

I only had the seasonal flu once-and that was enough-but I was out of work 2 weeks, and in bed for a full week. I was 5 months pregnant and was not about to kill myself or my baby by rushing back to work.(he’s 30 and fine now!)

“one thought I had was this is all too convenient - solutions out of nowhere when things are really getting worrisom?”

Sunny. There is no point having it if you don’t trust it…so trust you intuition…I can tell it is good!!

Sunny – at 18:49. I hope they have found a miracle cure, but I’m not going to relax completely until I see that this cure actually works and is readily available and affordable.

Dengue outbreak in India:

http://tinyurl.com/f8rsh http://tinyurl.com/m9enr

Question: There are multiple reports of rapidly escalating numbers of dengue patients in India. They’re up to 2700+ today. Health care workers sick. The Indian Prime Minister’s grandkids sick. People panicking. Hospitals closing.

1. Isn’t dengue endemic in that area, meaning that most people ought to have immunity? Whatever’s hitting them is obviously something that a significant percentage of the population doesn’t have immunity to.

2. Would past exposure to dengue cause test results to come up positive for dengue? (Are they testing for antibodies or actual virus?)

3. How LIKELY would it be that dengue could be confused on a large scale with h5n1. I know that the symptoms can be similar and there has been both recent and historic misdiagnosis.

Anyway — something to watch closely, I guess.

From the WHO website for Dengue Fever

There are four distinct, but closely related, viruses that cause dengue. Recovery from infection by one provides lifelong immunity against that serotype but confers only partial and transient protection against subsequent infection by the other three. There is good evidence that sequential infection increases the risk of more serious disease resulting in DHF

Characteristics

Dengue fever is a severe, flu-like illness that affects infants, young children and adults, but seldom causes death.

The clinical features of dengue fever vary according to the age of the patient. Infants and young children may have a non-specific febrile illness with rash. Older children and adults may have either a mild febrile syndrome or the classical incapacitating disease with abrupt onset and high fever, severe headache, pain behind the eyes, muscle and joint pains, and rash.

Dengue haemorrhagic fever is a potentially deadly complication that is characterized by high fever, haemorrhagic phenomena—often with enlargement of the liver—and in severe cases, circulatory failure. The illness commonly begins with a sudden rise in temperature accompanied by facial flush and other non-specific constitutional symptoms of dengue fever. The fever usually continues for two to seven days and can be as high as 40–41°C, possibly with febrile convulsions and haemorrhagic phenomena.

In moderate DHF cases, all signs and symptoms abate after the fever subsides. In severe cases, the patient’s condition may suddenly deteriorate after a few days of fever; the temperature drops, followed by signs of circulatory failure, and the patient may rapidly go into a critical state of shock and die within 12–24 hours, or quickly recover following appropriate volume replacement therapy.

Groups call for pandemic flu vaccine master plan

Public health and infectious disease experts today called on the United States to develop a “master plan” for development of pandemic influenza vaccines in order to translate scientific advances more rapidly into improved pandemic preparedness.

The recommendation was one of seven pandemic policy suggestions made by the Trust for America’s Health (TFAH), a nonprofit public health advocacy group, and the Infectious Diseases Society of America (IDSA).

“The United States must expand and accelerate research efforts and ensure we rapidly translate scientific breakthroughs into real-world practice to prepare for a possible pandemic,” Kathleen Maletic Neuzil, MD, coauthor of the report, said in a news release. She is chair of the IDSA’s Pandemic Influenza Task Force and an associate professor of medicine at the University of Washington School of Medicine.

[snip]

“An effective US vaccine research and development strategic program must be much larger in scale than current funding permits, in addition to being multinational in scope,” the report states. It describes current vaccine development efforts as a “patchwork” that may not produce rapid progress.

The groups called for a “Pandemic Vaccine Research and Development Master Plan to systemize and greatly enhance the current U.S. and international vaccine research and development strategies, bringing together the knowledge of government and private industry scientists.”

The master plan should include an inventory of all relevant issues and all activities already under way, the report says. The plan should state which sectors are responsible for completing each activity, list funding needs, and provide benchmarks for measuring progress.

[snip]

 The TFAH-IDSA report also makes the following recommendations:

• The Centers for Disease Control and Prevention should implement a nationwide, real-time system to track flu vaccine efficacy, distribution and redistribution, uptake, and impact.
• The United States should boost surveillance for novel flu viruses by expanding working relationships with other countries, especially in Southeast Asia, through the World Health Organization.
• The nation should embrace policies to increase seasonal flu vaccination in order to reduce the toll of flu and to stabilize vaccine manufacturing capacity. This should include developing “standardized templates for conducting mass vaccinations and countermeasure distribution.”
• The Food and Drug Administration (FDA) should streamline the licensing process for pandemic vaccines, using a different approach than with season flu vaccines.
• The FDA should adopt criteria for accepting foreign clinical trial data for registering flu vaccines in the United States.

http://tinyurl.com/keugf

Texas, USA

Local Health Officials Host Community Meeting On Pandemic Flu]

The Waco-McLennan County Public Health District hosts a community meeting Wednesday on preparations for pandemic flu.

The meeting at the McLennan Community College Conference Center is free and open to the public.

Two sessions are scheduled, one from 8:30 a.m. until noon and the second from 1:30 p.m. until 5 p.m.

http://tinyurl.com/pcmzz

New Jersey, USA

State prepares for flu pandemic

New Jersey is struggling to stockpile enough medicines, and to determine who gets first dibs, against a flu pandemic that health officials warned Tuesday is sure to strike, though they can’t say when.

[snip]

State health officials Tuesday launched an awareness campaign that they hope will motivate people to take some basic steps that may help avert getting sick.

“Get flu ready” is the watchword of the campaign, which urges people to stockpile food and water in case officials order people to stay at home; identify emergency phone numbers; wash hands and stay home if sickened; and keep abreast of alerts in the media.

Jacobs is appearing in 30-second public service announcements airing at video screens located in 176 Acme, Pathmark and ShopRite supermarkets throughout New Jersey. Posters and fliers developed by the state and local health departments, in English and Spanish, will be displayed at places such as municipal buildings, doctors’ offices and schools.

[snip]

As for priorities, Jacobs drew on the experiences of Hurricane Katrina, just 13 months ago. The storm sent New Orleans police officers fleeing from their posts to care for their families, Jacobs said.

This, he suggested, taught him that first responders and providers of medical care need to know their families are also protected, so they will likely get dibs on the available anti-virals.

http://tinyurl.com/mjjfk

Indiana, USA

Indiana counties prepare for pandemic

All 92 Indiana counties have submitted plans to the state for dealing with any kind of flu pandemic.

At the Pandemic Influenza State Summit earlier this year, Gov. Mitch Daniels challenged all Indiana counties to create local plans for responding to a possible influenza pandemic. County officials used templates provided by the Indiana Department of Homeland Security in the development of the plans, which include specific roles and responsibilities for various local agencies that might be involved in such a response.

[snip]

The plans go beyond public health-related issues to also include issues related to other essential government services. Since a pandemic could potentially affect a large percentage of the population, the plans also consider how those services will continue to be provided with a drastically reduced workforce.

http://tinyurl.com/ndv5n

South Dakota, USA

Getting prepared for the worst

PIERRE - If a severe pandemic of H5N1 or another strain of influenza virus were to spread, about 236,000 South Dakotans would likely become infected, and nearly 5,000 of them would die.

That the message Dr. Lon Kightlinger told Pierre-area business leaders at a noon seminar about the bird flu Tuesday.

Kightlinger, the state epidemiologist for the Department of Health, spoke to businessmen and women about the possibility of a flu pandemic and what should be done to curb the spread of illness in the work place.

[snip]

Health officials around the world expect that a pandemic of H5N1 could infect one-third of the population. Kightlinger said that millions will die. Just in the United States, projections estimate 90 million infected and 2 million dead.

http://tinyurl.com/mcwaj

Yeah! South Dakota is using the HHS 2% CFR and not the CDC .2% CFR number.

Virginia, USA

Preparing for the worst

The Loudoun County Health Department will hold a mass-vaccination exercise at Heritage High School in Leesburg on Oct. 21. In order to test the mass-dispensing site plan, this exercise calls for a large number of volunteers to act as “patients.” Go to www.loudoun.gov/health/volunteer.htm for details.

The exercise is part of a campaign to increase awareness of and preparedness for a potential influenza pandemic. Flu kills 30,000 Americans each winter. Pandemic flu occurs about every 30 years and is capable of killing significantly more people.

http://tinyurl.com/sxwmd

Georgia, USA

On the lookout for flu vaccine

Georgia public health officials and private organizations say they haven’t gotten the amount of flu vaccine they had expected to receive by now and that most people in the state won’t be able to get their shots until late this month or early November.

That’s not dangerously late, but it’s getting close to taking-a-chance territory. Flu season runs from October through March, and vaccine usually begins arriving in September.

“We’ve received 10 percent of what we ordered, and I’m extremely upset,” said Atlanta’s Dr. Sandra Fryhofer, a spokeswoman for the American College of Physicians, which represents 110,000 internists. “We had people scheduled for shots. A lot of elderly people who come in for shots and don’t get them don’t come back. We’ll run out this week for sure.”

[snip]

Some delivery problems exist, however, said Dr. Stuart Brown, director of the Georgia Division of Public Health. The state has received about 10 percent of what it ordered, which he said has caused “enormous angst.”

Medical officials recommend that flu shots be offered no later than mid-October, he said, and it looks as if it’ll be the end of the month, or later, before public health agencies have enough supply to meet demand.

[snip]

A small number of seasonal flu cases have been reported around the state, which isn’t as unusual as it is worrisome, Brown said. “Remember, flu season runs through March. But there is value in getting vaccinated earlier.”

http://tinyurl.com/hrhfj

‘Washington, USA

http://www.seattlest.com/archives/2006/10/04/speaking_tour_104_1010.php|Speaking Tour: 10/4 - 10/10]]

Illsley Ball Nordstrom Recital Hall at Benaroya Hall, 7:00–8:30pm. You can always Tivo House, M.D. How could you miss The Threat of Pandemic Influenza: How Can We Stop the Spread? When over 500 million people travel across the globe each year, it’s worth remembering that we are only as healthy as the people with whom we interact. Ann Marie Kimball and Ira Longini discuss worldwide pandemics and examine their health-related realities in order to creep the f*ck out of you. Free, but RSVP is req’d.

http://tinyurl.com/gr866

If you can get to Seattle, this would definitely be worth going to.

Correct link for the Seattle talk.

Speaking Tour: 10/4 - 10/10

CNN headline news “ticker” announced tonight that so far 87 people have died of dengue in India already.-The information posted earlier here from WHO indicates that dengue seldom causes death.? I think since Avian flu is often misdiagnosed as dengue, we should keep on eye on this situation.

‘Massachusetts, USA

Fighting the flu

The government expects a record 100-million doses of flu vaccine this year. But more than 200-million people are considered high risk, plus children being vaccinated for the first time need two shots. So, is there enough?

[snip]

For the first time, the CDC is recommending flu shots for all children six-months to five-years old, especially those with chronic illnesses. Two thirds of those kids don’t get flu shots.

“When a child ends up in the hospital, is in an intensive care unit on a ventilator, maybe even dies, when there was a recommendation that that child should’ve gotten a flu vaccine and didn’t, um, it’s a tragedy,” Dr. Julia McMillian of the American Academy of Pediatrics said.

http://tinyurl.com/ku6gn

Comment

Making sure children get flu shots could save their lives, pandemic or no pandemic.

worrywart – at 21:52

I think since Avian flu is often misdiagnosed as dengue, we should keep on eye on this situation.

Given the high death rate, involvement of health care workers and similar symptoms exhibited by patients with dengue fever and H5N1, I agree with you. You would think they had already tested patients for flu A, but you never know.

H5 Detected in Washington State

Recombinomics Commentary October 4, 2006

Don Kraege, waterfowl section manager for the state Department of Fish and Wildlife, said about 525 samples from wild bird have been taken since testing started in July.

And Roger Woodruff, director of the U.S. Department of Agriculture’s Wildlife Services Office for Washington and Alaska, said his agency has collected 300 samples so far.

Both reported finding some H5 detections.

The above comments indicate H5 has been detected in Washington state and possibly Alaska. These findings are not a surprise. H5N1 has been detected in Michigan, Maryland, Pennsylvania, Illinois, and Montana. In addition, H5 has been detected in New Jersey and California. In several instances, the reports on H5N1 indicated additional samples that were positive for H5 but negative for N1 have been found, suggesting additional H5 serotypes were being detected but not reported.

Last year Canada reported detection of H5N2, H5N3, and H5N9 in addition to H5N1. This year Quebec has reported H5N2 and H5N6. Canada has indicated that this year’s result mirrors last year, suggesting many additional H5 serotypes were being detected this year. The report from southern Canada last suggests H5 has been in the United States in 2005 in addition to 2006.

‘’‘H5 has been found in dead birds on Prince Edward Island as well as Lakeport, California. More detail on the PEI isolate was not forthcoming, but the H5 positive goose was one of four that died suddenly after displaying bird flu symptoms. The H5 in California is undergoing further analysis.

The frequent detection of H5 in Canada and the United States in 2005 and 2006 was unexpected.’‘’

Sequence data on the recent isolates would be useful.”

http://tinyurl.com/op8br

(Current as of Oct 4th, 2006 )

Canadian Cooperative Wildlife Health Centre

“All viruses detected were North American strains with LOW or NO potential to cause disease in domestic chickens. Data are displayed as they are entered into Canada’s National survey database by participating laboratories, and will change over time accordingly. Data taken from “RT-PCR” section of database

“In August 2005, Canada initiated a national inter-agency survey for influenza A viruses in healthy live wild ducks. Some 4405 samples were obtained from ducks in six different regions of the country, and 4268 of these were successfully linked to field data. Of these 4268 samples, 37% were found to contain one or more Influenza A viruses, and H5 viruses were found in 5% (208). All H5 strains detected were North American in origin and not disease-causing (all were “low pathogenicity” strains).

There was wide variation among the six different regions in the proportion of ducks infected and in the prevalence of different virus strains. For example, no H5 virus strains were found in 779 ducks sampled in Alberta, while 161, or 25%, of 640 ducks sampled in British Columbia carried H5 virus strains. Prevalence of infection with influenza viruses varied from 10% in Alberta samples to 49% in samples from Quebec and 55% in samples from British Columbia.

AIV - Overall Results by Species - 2006

Species Sampled Tested 4,899

With Influenza Virus 715

Mallards Tested, 1104 - Postive for Virus - 425 American Black Duck, 171 - Positive for Virus - 87 Canada Goose, 900 - Positive for Virus - 0 Herring Gull, 294 - Postive for Virus - 48

(excerpts from table)

Prince Edward Island, - 103 Tested, # With Influenza virus 33

Ontario, 517 Tested, # With Influenza virus 11

Nova Scotia, 61 Tested, # With Influenza virus 11

http://tinyurl.com/zve5r

http://tinyurl.com/hdc4h

http://tinyurl.com/kgg74

“and H5 viruses were found in 5% (208). “…if I remember right, H5 represented a far higher porportion last year.

‘Fit chickens can carry bird flu’

The Jakarta Post, Bandung

“A healthy chicken could be a carrier of the bird flu virus although it shows no symptoms of the illness, a health official warned Wednesday.

‘’‘Head of the West Java Animal Husbandry Office, Rachmat Setiadi, said the warning was made following the discovery of healthy chickens that tested positive with H5N1 virus from a serology test conducted on 20 chickens around the house of two dead flu victims — 23-year-old IJ and his 20-year-old brother — in Kebonwaru area, Batunggal.

He said earlier, only chickens and ducks are believed to carry the virus.

“The test has shown that four healthy chickens were infected with H5N1. We should be more cautious,” he said Wednesday in Bandung.’‘’

Currently, people are only made aware of the danger of bird flu when chickens die suddenly in their neighborhood, but Rachmat said healthy chickens could also be carriers.

‘’‘Out of Bandung’s 26 cities and regencies, only two — Tasikmalaya city and Ciamis regency — are free of H5N1 virus in poultry.

He said cases where healthy chickens were infected with bird flu had occurred not only in Bandung, but also in other cities and regencies. However, he did not name the cities or regencies.’‘’

He recommended that residents stop keeping chickens in their backyards or near their houses.

Meanwhile, serology tests on 11 dogs kept by the family of the bird flu cluster in Kebonwaru have came back negative, according to head of Bandung City Agriculture Office, Yogi Supardjo.

He said the result showed that dogs could not spread the virus.”

http://tinyurl.com/j49t2

Monotreme — they’ve had issues detecting H5N1 in Indonesia, though, and if the virus has changed … will the tests still work?

Asymptomatic H5N1 Infected Chickens in Indonesia

Recombinomics Commentary October 5, 2006

Head of the West Java Animal Husbandry Office, Rachmat Setiadi, said the warning was made following the discovery of healthy chickens that tested positive with H5N1 virus from a serology test conducted on 20 chickens around the house of two dead flu victims — 23-year-old IJ and his 20-year-old brother — in Kebonwaru area, Batunggal

“The above comments indicate asymptomatic chickens can carry H5N1 bird flu. Although many H5N1 sequences from birds and people in Indonesia have been published, the link between H5N1 in dead poultry, and H5N1 in dead patients has not been established.

All reported sequences from human cases in 2006 on the island of Java have has a novel HA cleavage site. The novel cleavage site has only been detected in one duck on Java in Indramayu, and that sequence was similar to a few human sequences from late 2005 / early 2006 (in upper twig of lower branch of HA tree). The vast majority of human cases are on a separate twig of the lower branch, and these do not match any reported poultry isolates on Java. Matching sequences have been found in two chickens in central Sumatra, isolated in 2005.

The H5N1 asymptomatic chickens on Java are positive for antibodies. It is not clear if H5N1 sequences have been detected in the asymptomatic birds. These infections could represent a separate reservoir. There have also been repots on the recovery of suspect bird flu victims. However, these patients have been H5N1 negative, so it remains unclear if they are infected with H5N1, or if the H5N1 sequence from these recovered is different than the H5N1 fatal cases. Almost all H5N1 human sequences in Indonesia are from fatal cases.

Asymptomatic chickens in Vietnam have also been reported previously.

Clearly more surveillance and sequences from H5N1 infected people, birds, and other mammals are indicate.”

http://tinyurl.com/afp73

Indonesia’s Bird Flu Variant Shows No Major Changes (Update1)

Oct. 5 (Bloomberg) — “The bird flu virus that’s killed one person a week in Indonesia this year hasn’t mutated to become more contagious to people, the country’s agriculture ministry said, citing an analysis of virus samples.

Tests on 49 samples taken from birds on the islands of Sumatra, Java and Bali showed the H5N1 avian influenza virus has undergone no major changes, the ministry said in a statement today. The analysis was undertaken by a World Organization for Animal Health reference laboratory in Geelong, Australia.

Flu viruses make minor genetic changes when they reproduce, though most of the time they don’t become more infectious in the process. Disease trackers are monitoring H5N1 to check whether it has mutated to become easily transmissible between people. Millions could die if the virus sparks a global outbreak.

Further Analysis

Samples of the H5N1 virus taken from birds were collected between September in 2005 and March, Elly Sawitri, an official at the agriculture ministry’s avian flu center, said in a telephone interview today. Animal health authorities will dispatch samples collected in the past six months for analysis, Sawitri said.

Indonesia agreed to deposit avian flu genetic information in public databases, such as GenBank, four months ago to help scientists better track dominant variants of the virus and to speed preparations for vaccines to fight a human outbreak.

The virus may have infected as much as 27 percent of fowl and caged birds in the Southeast Asian nation, Musny Suatmodjo, Indonesia’s director of animal health, said last week.

The health ministry and Singapore’s Temasek Life Sciences Laboratory Ltd. are developing a diagnostic kit to speed the diagnosis of human H5N1 cases. The kit may be available within a year, Tan Kok Keng, Temasek Life’s chief operating officer, told reporters in Jakarta today.

‘We cannot wait any longer, we’re fighting with time, Tan said. The kit will be developed in Indonesia using H5N1 strains collected in the country, and assisted by Temasek Life’s scientists and technology.

`The kit should help make diagnosing cases faster because many patients are receiving proper treatment too late, Health Minister Siti Fadilah Supari said.’

http://www.bloomberg.com/apps/news?pid=20601080&sid=ahDuD4y1bQxU&refer=asia

If the sequences of H5N1 in sick people in Indonesia do not match the sequences in birds, how relevant is it that the bird virus has not changed? Shouldn’t they be sequencing pigs, cats, dogs and people to see if the H5N1 that is more likely to infect mammals has changed? And why is the Indonesian scientist who wants to do that sequencing being held up by red tape?

COMMENT From Klatu – at 00:39

“He recommended that residents stop keeping chickens in their backyards or near their houses.”

Yeah, like that will work.

Hillbilly Bill - at 08:24

There is a sophisticated plan underway, so that each family will keep the chickens that belong to their neighbours or relatives.

“Each person knows who they trust most, so we are pretty confident it will work”, a government official said.

Flu Awareness Week By: Galen McBride, 10/04/2006

The message of International Pandemic Flu Awareness Week is simple:

Be Informed. Get Prepared. Do It Now.

Launched by www.FluWikie.com, an internet-based non-profit resource made up of scientists, health care professionals, and concerned individuals around the world, Pandemic Flu Awareness Week, Oct. 9–15, 2006, is aimed at educating the public to the immediate need for pandemic planning and mitigation.

This campaign seeks to redirect public focus from “bird flu,” a highly contagious disease of poultry, to recognizing the coming danger to human beings of “pandemic flu.”

An influenza pandemic occurs when a new, highly contagious flu strain emerges for which humans have no natural immunity. A pandemic will occur if the H5N1 avian flu virus, currently circulating in more than 50 countries on three continents, mutates to acquire the ability to transmit efficiently from human to human. Flu viruses mutate millions of times a day and this virus has already achieved limited human-to-human (H2H) transmission as acknowledged by the World Health Organization (WHO).

The final step to a global pandemic that would kill millions of people could occur soon. The WHO has recently stated that, due to problems with geography, lack of effective surveillance measures, and in some cases, lack of government cooperation, once a pandemic begins, it probably will not be stoppable. Air travel would bring it to virtually every country in a matter of days.

International leaders are concerned that even a “mild” pandemic, such as those in 1957 and 1968, would have a devastating impact on our highly globalized and interdependent world. Unfortunately, H5N1 appears to be more closely related genetically and behaviorally to the Spanish Flu of 1918–1920, where upwards of 100 million people died. In today’s terms, with our greater populations concentrated in many more major cities, the death toll could reach several times that.

The World Economic Forum has ranked pandemic flu among the top four global risks to national economies. The World Bank estimated a global financial loss of trillions of dollars.

According to the WHO, “Pandemics are remarkable global events. They spread to all parts of the world very quickly and cause illness in more than 25 per cent of the total population.” So far, H5N1, in its prepandemic form, has killed more than 50 per cent of the people who have become infected, despite intensive medical care.

Dr. Martin Meltzer of the Centers for Disease Control (CDC), an expert on the societal impact of diseases, warns that “there is no health care system anywhere in the world that can cope with even a mild pandemic like the one in 1968.” The current H5N1 virus disproportionately targets children and young adults, with a fatality rate this year of 70 to 80 per cent of those aged 10 to 29.

No one can predict when the next pandemic will occur or how many lives it will claim, but it has been estimated that even during a mild pandemic, at least 30 per cent of the workforce would not report for work for extended periods due to sickness or the need to care for family members. A more severe pandemic would cause an even greater absentee rate, with even greater problems.

These grim predictions apply to all industries (including health care and emergency services), all types of businesses and all countries, dramatically increasing the risk of food and fuel shortages, disruptions in electricity and natural gas delivery, affecting the availability of safe drinking water, police and fire protection, and other vital services. In addition, schools, banks, stores, restaurants, sporting venues, churches, government offices, and post offices may be closed for extended periods of time.

During Pandemic Flu Awareness Week, people are encouraged to become more educated to the threat of pandemic flu and to work together and individually to build personal, family and community resilience in advance of a potential disaster. Dr. Michael Osterholm, the Director of the Center for Infectious Disease Reseach and Policy (CIPRAP) and a top advisor to the President, compared the coming pandemic to “50,000 Katrinas happening at one time,” with no assistance being available from neighboring communities or even the federal government. “The worst thing we can do is not prepare and think that it will not happen…It’s not a question of if, but when….”

The US Secretary of Health and Human Services, Michael Leavitt, has repeatedly emphasized in meetings thoughout the country that cities and states “will be on their own. Any community that fails to prepare with the expectation that the government with come to the rescue will be tragically wrong … The cavalry is NOT coming.”

To prepare for a pandemic, individuals and families should gather and store food, water, and prescription and over-the-counter medications and other emergency equipment and supplies. The US Department of Health and Human Services website (www.pandemicflu.gov) recommends that a two-week supply of water, nonperishable foods, and medications be stocked for each household member.

However, many scientific and government experts are urging individuals and families to be prepared for six weeks or longer. In past pandemics, three waves, each lasting six to eight weeks, have occurred. Because the time between waves may not be long enough for the supply and distribution systems to recover, pandemic preparations should be made for as long as possible. Experts such as David Nabarro of the WHO and Dr. Osterholm, have both stated publicly that they have personally prepared their families for more than three months.

Over the next few weeks,The Culpeper Citizen, in conjunction with the Culpeper County government, will run a series of pandemic flu related articles to help county residents become more informed and more prepared for the coming pandemic. <snip> http://tinyurl.com/maosb

News Reports continued here:

News Report October 52006

Annie, we miss you.

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