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September 30, 2005
Current Map of Outbreaks of Avian Flu (from Flickr)
map created and supplied by Dr, Niman of Recombinomics.
Sept. 26th stats (according to news reports): 42 cases in 8 Indonesian provinces
Sept. 28th stats (according to news reports): 57 cases in 14 provinces
Legend:
Red Circles = Confirmed Cases, Alive
Red Squares = Confirmed Cases, Dead
Orange Circles = Suspected Cases, Alive
Ornage Squares = Suspected Cases, Dead
Posted by dymaxion at 11:08 AM | Comments (0) | TrackBack
September 29, 2005
Finland to vaccinate entire population against bird flu
In response to a recommendation by the World Health Organization, according to which the avian influenza pandemic threat is real, Finland is preparing to vaccinate its entire population against the disease.
In the second supplementary budget for 2005, released by the Ministry of Finance on Wednesday, it was proposed that a total of EUR 20.8 million be allocated to finance the acquisition of 5.2 million bird flu vaccine doses.
Link.
Posted by dymaxion at 04:05 PM | Comments (0) | TrackBack
Bird flu and statins
In an extremely interesting article in the Clinicians Biosecurity Network Weekly Bulletin (issue of 9/27/05) Borio and Bartlett review a suggestion of David Fedson, an expert on vaccines (and former Director of Medical Affairs at Aventis Pasteur), that statins (tradenames Zocor or Lipitor) might be helpful in preventing serious complications of influenza, perhaps by dampening the cytokine response.
The statins are widely used and available drugs used to lower cholesterol. They also have anti-inflammatory activities, perhaps by preventing activation of the transcription factor NF-kappaB. One mechanism thought to underlie the virulence of the H5N1 virus is production of a "cytokine storm," an unregulated systemic inflammatory response that results in a rapidly developing generalized clotting disorder, hemorrhage, kidney failure and fluid-filled lungs. The phenomenon is similar to or the same as what is called gram-negative sepsis or septic shock, a serious complication of bacterial infections that claims 400,000 to 500,000 lives each year in the US and has 50% to 70% mortality. Treatment for sepsis is a high priority independently of any role for the same or similar mechanism in influenza.
The idea that statins might be helpful for sepsis or influenza is based on more than speculation about mechanism. In 2004 Almog et al. (Circulation, Aug 17 2004;110(7):880-885) reported that patients admitted to the hospital with acute bacterial infections and who were on statins for more than a month for other reasons had a dramatically reduced incidence of severe sepsis (19% versus 2.2%) and reduced admission to the Intensive Care Unit (12.2% vs. 3.7%). An interesting point is that patients on statins might be expected to be at greater risk because they are taking a medication for a pre-existing medical condition.
Another study (.pdf available free on line here) looked back at the experience of over 700 patients that were admitted to a hospital for pneumonia. About 100 of them were also taking statins. Using 30-day mortality as a measure of outcome, the statin group had about two thirds fewer deaths than the non-statin group (odds ratio .36, 95% confidence interval .14 - .92).
Borio and Bartlett also report on an article from The Netherlands by Enserink to appear shortly in Science (hence not available to me other than through their summary). Enserink examined influenza seasons between 1996 to 2003, and using a database of 60,000 primary care patients compared those with at least two statin prescriptions in the previous year to those without. There was a 26% lower risk of pneumonia in the statin group. Because of the imprecision of the measure of statin use, I would expect the statin effect to be even greater than reported here.
Borio and Bartlett conclude:
These studies suggest that statin therapy may ameliorate the course and/or prevent complications of influenza. In these studies, it appears that all of the people were already receiving statins when they got infected. Whether statins would be beneficial after the onset of symptoms is still unknown. However, further investigation is merited. This is particularly important given the likelihood that vaccines and antiviral agents will be in short supply during an influenza pandemic, and statins are widely available and may be produced relatively inexpensively.
This is extremely interesting work. It is too early to say that prophylactic statin use in a pandemic is a reasonable strategy, but it is worth considering.
From Effect Measure:http://effectmeasure.blogspot.com/
Posted by dymaxion at 04:03 PM | Comments (0) | TrackBack
Clean hands the way to stop flu
We're going into the next pandemic with the basic hygienic techniques of 1918, according to a story on BBCNews Online.
kind of story that tells us more about our fellow-citizens than we want to know. During the SARS outbreak, the toilets on my campus had big "wash your hands" signs, but they've long gone. And of course even if you do wash your hands, you then have to turn off the tap (which some slob may have used, if only to fill his water bottle) and then pull the handle on the door (which some other slob has just used).If everyone was to wash their hands the risk of colds, flu and even bird flu would be much less, say UK experts.
Professor John Oxford, of London's Queen Mary's School of Medicine, warns many people are failing to do so and are complacent about personal hygiene.
His team looked at the most effective methods to prevent the transmission of colds and flu, including bird flu.
Rather than relying on products such as antiviral tissues, personal cleanliness should be a priority, they say.
Hand cleaning came out top, followed by disinfecting surfaces.
Automatic taps and doors might help a bit, but it's too late to retrofit our whole sanitary system. Besides, a third slob may then hand you an assignment he's just sneezed on.
It's easy to understand why Howard Hughes tried to avoid infection by walking around in empty Kleenex boxes. But unless paranoia results in demonstrable enhancement of the immune system, we're probably better off just washing our hands.
Posted by dymaxion at 03:48 PM | Comments (0) | TrackBack
Indonesian Bird Flu (H5N1) Update 4MaxedOutMama
Forbes is reporting 63 suspected cases in Indonesia, up from yesterday's 57. Japan is sending a medical team to help at the reference hospital in Jakarta. Is the rapidly growing case count due to better identification because tests are actually being run? Probably. But it still shows the degree of the underlying problem. Also, another zoo in Semerang, Indonesia has been closed to the public because birds there tested positive.
Indonesian health officials are testing the family of two children which died of bird flu-like symptoms. The sister of the two children is now sick with similar symptoms. The two were never seen by doctors or tested. They did have exposure to chickens who died. Is it a coincidence that this was also in Semerang? See the CurEvents.com thread for discussion.
The way these cases break out is this. The first child, a 15 year-old (boy?) became sick on the 15th and died on the 20th of September. The second child, a girl 18 months old, is reported to have died on the 24th of September. Now the 8 year-old girl is sick, and it's a good guess that she was helping to care for the 18 month old girl who was ill. Do you see why people are getting very nervous about possible human to human transmission?
Dr. Niman of Recombinomics comments on the reports in Semerang.
Posted by dymaxion at 03:44 PM | Comments (0) | TrackBack
a. flu b. flubird a.FLU Definitions : Influen...
... ." IMG b. FlubirdAvian Influenza (Bird Flu) and Avian Influenza A (H5N1) Virus What is avian... of avian influenza A (H5N1) among poultry in Asia (see below) is an example of a bird flu outbreak... website.What is an avian influenza A (H5N1) virus? Influenza A (H5N1) virus – also called “H5N1 virus ...
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NEJM - Current Concepts: Avian Influenza A (H5N1) Infection in Humans
... The New England Journal of Medicine just published online a review article on H5N1 titled: Current Concepts: Avian Influenza A (H5N1) Infection in Humans. An unprecedented epizootic avian influenza A (H5N1) virus that is highly pathogenic has crossed the species barrier in Asia to cause many human ...
Posted by dymaxion at 03:37 PM | Comments (0) | TrackBack
China says pandemic planning underway
SHANGHAI, China -- China's Health Ministry on Wednesday launched a contingency plan to prepare the country against a possible influenza pandemic, the official Xinhua News Agency reported. The plan outlines the organization of prevention and enforcement systems, logistics and emergency controls, the report said without giving any details. It said the ministry also urged local authorities to draw up their own plans as a precaution. The H5N1 strain of bird flu has swept through poultryPosted by dymaxion at 03:32 PM | Comments (0) | TrackBack
Suspected Indonesia bird flu cases pass 50 - officials
By Ade Rina and Jerry Norton JAKARTA (Reuters) - Indonesia faces more than 50 suspected cases of deadly bird flu, Indonesian health ministry officials said on Thursday, while lowering their figure on deaths from the disease to five from an earlier estimate of six. Bird flu has killed 65 people in four Asian nations since late 2003 and has been found in birds in Russia and Europe. Experts' greatest fear is that the H5N1 bird flu virus, which has the power to kill one out of every two peoplePosted by dymaxion at 03:31 PM | Comments (0) | TrackBack
September 28, 2005
Avian Flu on NPR: Leavitt and Fauci Interviews on Diane Rehm Show
Diane Rehm interviewed both Michael Leavitt, Secretary of the Department of Health and Human Services and Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases/NIH on her show this morning. Readers can find streams of the show at the following link on WAMU.org. The interviews break no new ground but leave no doubt how seriously the situation is being taken by government officials. Given Rehm's skills as a savvy, intelligent and humane interviewer, this is an excellent place to point friends and colleagues who may not yet have grasped the significance of the looming pandemic.
Posted by dymaxion at 12:38 PM | Comments (0) | TrackBack
At least 57 people suspected of contracting bird flu in Indonesia
JAKARTA (AFP) - At least 57 people were being treated for suspected bird flu in Indonesia, where the disease has already claimed six lives, officials said.
OF the total, 20 patients were under observation at Jakarta's Sulianti Saroso hospital for infectious diseases, a doctor there, Ilham Patu, said.
The latest suspected case, a 23-year-old man from the capital, was admitted late Tuesday.
Blood and muccus samples from the patients were being tested locally with any positive results indicating bird flu being sent to World Health Organization laboratories in Hong Kong for confirmation.
Since Monday the hospital has released five people who were suspected of contracting bird flu but tested negative.
Health ministry spokesman Sumardi said Wednesday that a shipment of some 20,000 doses of Tamiflu, anti-viral medication that can stop flue if given quickly when symptoms develop, will arrive in the country on Friday.
"This medicine will be sold commercially at pharmacies," he said. So far, it has only been available in hospitals.
Six Indonesians have died of bird flu, bringing to 65 the number of people in Southeast Asia known to have died from the H5N1 strain of the virus since 2003. Vietnam has recorded 43 deaths, Thailand 12 and Cambodia four.
The WHO fears H5N1 will mutate, acquiring genes from the human influenza virus that would make it highly infectious and lethal to millions in a global pandemic.
But it has also urged calm, saying investigations in Indonesia had produced no evidence that H5N1 was spreading easily from person to person.
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MedImmune gets NIH pandemic flu vaccine collaboration pact
NEW YORK (MarketWatch) -- MedImmune Inc. said Wednesday it signed an agreement to collaborate with the National Institutes of Health in developing investigational pandemic influenza vaccines. Under the agreement, MedImmune scientists will work with researchers from the
Laboratory of Infectious Diseases to produce and test versions of MedImmune's attenuated, live intranasal flu vaccine for use against different types of potential pandemic influenza strains, including one based on H5N1, a strain of avian influenza.
MedImmune will use its proprietary reverse genetics technology to develop the
pandemic vaccines. The technology will allow MedImmune and NIAID researchers to
alter potentially harmful portions of influenza viruses, such as the
hemagglutinin protein of the H5N1 virus strain, and to rapidly produce
attenuated vaccine strains, thereby accelerating vaccine production. In the
interest of public health, MedImmune has also offered licenses for its reverse
genetics technology to U.S. and international health authorities and other
vaccine manufacturers developing pandemic influenza vaccines.
"As a U.S.-based influenza vaccine manufacturer, MedImmune is committed to
working with public health agencies such as the NIH in preparation for a
pandemic emergency," said James F. Young, Ph.D., president, research and
development. "With the occurrence of several avian or 'bird' influenza cases in
Asia this year, the development of a pandemic vaccine is a proactive step toward
protecting the health of our nation. An intranasal pandemic vaccine may help
facilitate and expedite influenza vaccinations for more Americans in the event
of a pandemic outbreak."
According to the U.S. Centers for Disease Control and Prevention's Advisory
Committee on Immunization Practices, possible advantages of attenuated, live
influenza vaccine include its potential to induce a broad mucosal and systemic
immune response, its ease of administration, and the acce
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Thoughtful or provoking?
First, there are several assumptions that should be questioned, among them that there is evidence the virus has not mutated into a form that is easily transmitted. Given the poor surveillance and lack of seroprevalence studies, itself a scandal, we simply don't know this to be true. Niman at Recombinomics has repeatedly called attention to fallacies in the assumption that lack of evidence of reassortment is sufficient to conclude the necessary step to pandemic ability hasn't occurred. Clearly the biology tells us differently.
Second, the editorial praises Bush's "initiative" announced at the UN for "a new international partnership" to fight bird flu. It is doubtful Bush's do-nothing administration had much to do with it (except to take credit), and even worse, the stated goal of the 16 nation partnership is to ensure adequate sharing of information. The Bangkok Post editorial takes China and Vietnam to task for their failure to share information, but says nothing about the Bush administration's own lack of openness, as revealed in the Nature magazine article of last week (see our earlier post).
Third, The Bangkok Post again raises the hoary specter of avian flu being used as a bioweapon, citing an unpublished and highly censored Canadian military report. It is impossible to comment on leaked intimations of dire threats from sources with questionable motives, but suffice it to say use of avian influenza as a bioweapon makes very little sense, at least one designed against humans. Unless one assumes the object is just to kill as many people as possible (nationality, ethnicity and religion irrelevant), H5N1 would be an abysmal weapon. In the case of nutcase apocalyptic "End of Days" thinking, it is implausible they would have the technical expertise to figure out how to do something even today's best virologists can't do: determine what makes the virus efficiently transmitted. If the object is political, it is hard to see how its use could have any political use. Since an outbreak would appear to be natural (unless a group or country took credit for it, which seems like it wouldn't be such a popular thing to do as it would be killing its own people), no political purpose could be served, any more than a group that took credit for Hurricane Katrina would be likely to profit (or be believed). Talk of avian flu as a bioweapon merely diverts attention from the main focus: responding to the primary public health challgenge of managing a naturally occurring epidemic infectious disease in a highly connected global population.
So the editorial is thoughtful, yes. But some of the thinking is flawed.
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Posted by dymaxion at 12:13 PM | Comments (0) | TrackBack
[2005-09-28] Instituto Butantã produzirá vacina contra gripe aviária
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Are we capable of coping with the deadly bird flu? - Jakarta Post
 Financial Times | Are we capable of coping with the deadly bird flu? Jakarta Post, Indonesia - ... At that time, a small number of chickens in isolated poultry farms in Vietnam were killed by H5N1, an agent of avian influenza. ... Poor response towards bird flu ASEAN considers regional plan to fight bird flu UN Warns of Lack of Bird Flu Funding |
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Four new cases outside Jakarta
The Jakarta Post reports new suspected bird flu cases emerge in regions.
he other cases are in the story. And to think I thought this had been shaping up as a slow news day on the flu front.Four people in Bandung, Semarang and Bandar Lampung have been hospitalized with suspected avian influenza after showing symptoms of the disease.
Chicken vendor Suprat, 58, was admitted to Dr. Kariadi Hospital in Semarang, Central Java, on Tuesday with a high fever, cough and respiratory problems.
The resident of Kendal regency had been treated at Roemani Hospital for a week, before being transferred to the government-designated hospital for bird flu patients.
Roemani Hospital head Sofa Chasani said tests have yet to confirm Suprat has bird flu.
A chicken seller, Suprat supplied 800 kilograms of chicken daily to markets in Semarang and Kendal.
Posted by dymaxion at 12:06 PM | Comments (0) | TrackBack
Philippines have no Tamiflu
Francisco Duque, minister of health in the Philippines, says his country has no antivirals to combat avian flu.
"There is only one drug company producing oseltavimire which is Roche of Switzerland. Developed countries usually have a stock of this medicine. We have a zero stockpile," Duque said.
Posted by dymaxion at 12:03 PM | Comments (0) | TrackBack
China preparing flu plan...maybe
China is developing a plan to combat an avian flu pandemic, according to a story on Canada.com.
The plan outlines the organization of prevention and enforcement systems, logistics and emergency controls, the report said without giving any details. It said the ministry also urged local authorities to draw up their own plans as a precaution.
This does not sound reassuring. I'm nervous enough about our own plans here in Canada, which are publicly accessible but have very little to say about the public's own role in the pandemic. The key words in the Chinese plan seem to be "enforcement" and "controls," with the details kept a surprise until the authorities are good and ready. As for the local plans—as we've seen with Katrina, the locals will be useful scapegoats if everything blows up.
Posted by dymaxion at 12:03 PM | Comments (0) | TrackBack
Dunia Berantakan...
... Dunia Berantakan!!! Dunia yang Berantakan! Itu yang kurasakan beberapa hari ini tentang keadaan dunia di sekelilingku. bagaimana tidak, Virus AI (H5N1) telah menyebar kemana-mana tapi anehnya... mampu menembus barrier antar spesies. Misalnya: Kucing yang memakan ayam yang terjangkiti H5N1 akan ...
Berasal dari sirna mungkin juga menuju sirna! 
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インドネシアの鳥インフルエンザ
... WHO(世界保健機構）の 鳥インフルエンザ更新情報によると （9月16日),インドネシアで、ジャカルタ在住の、37才の女性が H5N1 亜型鳥インフルエンザウイルス感染により、8月31日に 発症し,9月6日に入院し,9月10日に死亡したという。 この患者の感染源を確認するため、インドネシア政府は、 WHO の協力の下、調査を開始した。 患者は、鳥およびアヒルに暴露される機会の多い...が、38才の父親が、H5N1亜型ウイルスに感染していた 事が確認されている。 Herald Tribune 紙によると、インドネシア政府は異常事態を 宣言し、新たな患者の流行の阻止に勤めている. 鶏 ...
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EnergeticNeurons.bloghorn.com
... . A nine-year-old girl that visited the Rangunan Zoo tested positive for H5N1. Two others... providing H5N1 with a "silent spread" of growing efficiency. Recombinomics, Sept. 27, 2005 "H5N1 Jakarta... population if H5N1 should reassort with H3N8 in case of dual infection with the two types of flu ...
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September 27, 2005
Confusing Reports from Indonesia
Readers dismayed with the seeming confusion coming out of Jakarta should be alarmed. In recent days we have heard of confirmed cases and deaths due to the H5N1 virus and later official denials. It appears that there is no trustworthy source of information in the country.
We will continue to reblog conflicting information while trying to seek out the most reliable reports. The worst thing that can happen in a developing pandemic situation is a tacit censorship on the part of interests within the government.
Indonesia has a large tourist industry that is still in the process of recovering from the bombing that took place several years ago. It's possible to imagine that the tourist industry, a major source of foreign currency, is instrumental in suppressing critical information. We can also suspect that confusion will always be a component of any outbreak, no matter the efficiency of the authorities.
Let's hope that the news out of Singapore of a quick (easy to use?) diagnosis kit stands up to scrutiny. Quick and certain diagnosis can make all the difference in an outbreak. Used efficiently, it can greatly decrease confusion on the ground.
Posted by dymaxion at 12:31 PM | Comments (0) | TrackBack
New test for bird flu
Scientists in Singapore said on Tuesday they have developed a test kit which can detect bird flu infections in poultry within four hours -- a tool which could help health officials control the spread of the deadly virus.
In the absence of a vaccine, early identification of the virus is especially important, and current tests used by laboratories take two to three days and sometimes up to a week.
From Reuters.
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Schon sechs Vogelgrippe-Tote in Indonesien
Die Zahl der Todesopfer durch die Vogelgrippe in Indonesien ist auf sechs gestiegen. Zuletzt erlag eine 27-j hrige Frau dem aggressiven Virus H5N1, wie die Gesundheitsbeh rden am Montag mitteilten. Dar ber hinaus best tigten Untersuchungen, dass auch ein in der vergangenen Woche gestorbenes f hriges M dchen mit dem Erreger infiziert war. Unterdessen stieg die Zahl der Patienten mit Verdacht auf Vogelgrippe auf 42. Der Gefl gelpest erlagen seit ihrem Ausbruch Ende 2003 in S dostasien mehrPosted by dymaxion at 12:24 PM | Comments (0) | TrackBack
Indonesia có thêm người chết vì cúm gà
... Indonesia có thêm người chết vì cúm gà Theo thông báo mới nhất, Indonesia có thêm 2 người chết vì cúm gà, nâng tổng số nạn nhân của virus H5N1 lên 6 người. Hiện, 20 người khác có triệu chứng bệnh. Kết quả kiểm tra cho thấy, cả 2 người - một bé gái chết hồi tuần trước và một phụ nữ 27 tuổi … ...
Tin tức Việt Nam hàng ngày - Daily Viet Nam News
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La gripe aviar cobra la vida de otras dos personas en Indonesia
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Most people know we are in danger, but these sites...
The reason for the increased danger is that contrary to what is publically reported by the WHO, human to human transmission of H5N1 Avian flu is quite common. And although the WHO grudgingly admits that H5N1 can be transmitted from a person who has been infected by chickens or other foul to another person, but denies that it can be transmitted beyond the first person infected, this also appears to be false.
Why is this the case? The simplest explaination is simply lack of data. Not every case gets tested and even when tests are done our weak immune response causes a lot of false negatives. Then again there are positive tests that are not counted because a second corroborating test wasn't performed. For example the official data records no cases of H5N1 in Thailand during 2004, yet there were 12 cases with positive tests for H5N1 that didn't make it into the official numbers. That article also lists multiple cases which due to lack of laboratory testing are not included in the numbers and which appear to indicate human to human transmission that is being reported not to exist.
Then there are cases which were not even initially thought to be flu related. This was due to causing meningitis-like symptoms. Four people attending the wake of a fifth person all died within a span of three days aproximately 1 1/2 weeks later even though they had returned home after the wake to separate cities. At the time H5N1 was not known to cause meningitis-like symptoms without apparent respiratory symptoms. Now it is known to do so. Since none of the victims from the wake were tested we cannot know whether or not this was caused by H5N1. However there are basically only two possible culprits. H5N1 would only have to gain the ability to transmit as efficiently from person to person as it transmits from chicken to checken. Meningitis would have to gain the same ability (and is less likely to do so, and would also have to develop a much higher case fatality rate. Note that the 5 fatalities in this cluster was 2 and 1/2 times the entire number of cases of Meningitis in the country that year. It is very unlikely that this was caused by Meningitis, thus making a strong case that H5N1 caused the deaths, and thus indicating that it can transmit from human to human with much greater ease than health officials have been willing to admit.
If these cases were actually H5N1 spreading through concentrated refugee camps then the virus would have had an excellent opportunity to improve its ability to be transmitted from human to human. Before H5N1 couldn't improve its ability to transmit from human to human much because the virus died with its victims, so every human to human transmission was an evolutionary dead end. In a concentrated population even if the ability to transmit from human to human multiple times were weak, it would still occur. Thus the viruses able to transmit only once would die with the first victim, those which could transmit only twice would die with their second vicetim, etc. Those viruses that could pass on to new victims indefinitely would be able to survive and possibly be communicated into the community at large. Furthermore those viruses that could transmit from human to human most easily because they would infect more victims, thus forming a larger portion of each generation than those that could only transmit from human to human with difficulty. If those viruses were somehow able to re-enter the avian population, for example by a scavenger bird eating flesh from a corpse that had died of H5N1, they might then be able to spread even further.
The danger posed by the meningitis form of H5N1 is particularly accute because it is operating completely under the influenza monitoring system's radar. Everyone is looking for flu, not meningitis. Furthermore because people's meningitis has symptoms that are less obvious than the respiratory symptoms that we associate with flu, others nearby are less likely to avoid contact with infected persons, and people who are infected are less likely to make changes in their behavior that would reduce their contact with others, like calling in sick from work. Thus a meningitis form of flu would be likely to spread more easily than a rispiratory form.
Changes like these occur because the genome of any Influenza strain is in a constant state of change. This is due to the process of recombination, which occurs continuously as flu viruses infect animals or people who are already infected by another flu virus, and pick up genes from other strains. Viruses also mutate, and then those mutations are added back into the mix. Again, as H5N1 continues to spread, the number of these recombinations will continue to increase. Also as human flus become more common during the flu season, the chance that this mixing will occur between H5N1 and a human flu increases.
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ICAV holds symposium at Trent
The International Consortium of Anti-Virals (ICAV) held its third symposium at Trent University over the weekend. This event brought together the who’s who in the world of viruses. The current Asian outbreak of the Avian Influenza Virus, H5N1, was of particular interest.Posted by dymaxion at 12:03 PM | Comments (0) | TrackBack
Indonesia Bird Flu Increasing - in Jakarta
It’s frustrating being in such close proximity (30km) with this bird flu (H5N1 virus) outbreak occurring, and knowing that the government has not taken the proper steps to help control it. Is there reason to panic? Should we be considering what could happen? If this were to indeed mutate into human to human contact - how much time feasibly would people have? What about the 99% of the population who cannot afford to leave if an intense outbreak did occur? Why do they always wait until it’s too late, simply to help buffer their own pocketbooks?
These are questions weighing on my mind. These are the frustrations we’re dealing with. These are the times when it’s not easy to remain here.
From the BBC,
Monday 26, September:
Another two people are confirmed to have died from bird flu in Indonesia, bringing the death toll there to six.
Test results show that both a young girl who died last week and a 27-year-old woman who died on Monday had been exposed to the H5N1 virus.
Several other recent fatalities are being investigated, and about 20 people are in hospital with bird flu symptoms.
The deadly disease has already killed dozens of people across Asia, and led to millions of birds being culled.
There is so far no evidence of human-to-human transmission, but health officials fear that if the virus combines with the human influenza virus, it could become highly infectious and lead to a global flu pandemic.
… Last week Health Minister Siti Fadila Supari warned that Indonesia could be facing an epidemic, remarks which were later played down by other officials.
… The WHO has urged countries with infected poultry to use widespread mass culling as the best method of stopping the spread of the disease.
But the government has only carried out limited culling, preferring to vaccinate poultry because of the expense of compensating farmers.
The recent outbreak in Jakarta is causing particular concern because of the close proximity between birds and humans.
Most Indonesian households keep chickens for food or caged birds for pets.
Finding the source of an outbreak is therefore extremely difficult, our correspondent says, and the chances of the virus spreading in a teeming city of more than 15 million people are high.
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CIDRAP >> Indonesia blames two more deaths on avian flu
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S. Korea to issue bird flu alert in mid-October
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September 26, 2005
Meanwhile, back at the avian flu pandemic.
UN health officials are particularly worried about the H5N1 flu strain. So far, there have been 120 reported human
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La Gazzetta del Mezzogiorno - L'influenza aviaria fa altri morti in Indonesia
Una indonesiana di 27 anni è morta oggi in un ospedale di Giakarta dopo essere stata contagiata dal virus H5N1, all' origine dell'influenza aviaria. Test effettuati a Hong Kong hanno intanto accertato che una bimba di 5 anni era deceduta dopo aver contratto la stessa malattia. Una donna ... Copyright: Copyright 2004, Italia OnLine S.r.l.
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False Negative on Sixth H5N1 Fatality in Jakarta Causes Concerns - Recombinomics
| False Negative on Sixth H5N1 Fatality in Jakarta Causes Concerns Recombinomics, PA - The failure of Indonesia to confirm H5N1 in the sixth reported fatal case of bird flu is cause for concern. Thus far Indonesia has ... |
Posted by dymaxion at 06:32 PM | Comments (0) | TrackBack
3 Hungary Officials Get Bird Flu Vaccine - ABC News
 Reuters.uk | 3 Hungary Officials Get Bird Flu Vaccine ABC News - ... and the government's health care commissioner, were the first volunteers to receive the vaccine that Hungarian scientists developed against the H5N1 strain of ... Hungary says could make 50 mln bird flu vaccines 3 Hungary Officials Get Bird Flu Vaccine |
Posted by dymaxion at 06:30 PM | Comments (0) | TrackBack
Bird-flu drug supplies cleaned out
Via the New Zealand Herald: Bird-flu drug supplies cleaned out.
The anti-viral drug Tamiflu is regarded as the best hope against any epidemic. The World Health Organisation has recommended Governments stockpile supplies for essential workers and the New Zealand Government has committed $26 million to buying 850,000 doses of Tamiflu.
At most, this is only enough for about one in five people and more and more New Zealanders are opting to buy their own for about $75.
Manufacturer Roche admits it is unable to keep up with demand.
New supplies arrived in the South Island on Wednesday but stocks nationwide were exhausted by Friday.
Posted by dymaxion at 06:28 PM | Comments (0) | TrackBack
Probable H2H in Thailand
From the New England Journal of Medicine, via Declan Butler at Connotea: Probable Person-to-Person Transmission of Avian Influenza A (H5N1). This is the abstract of the full report. It's enough.
Posted by dymaxion at 06:27 PM | Comments (0) | TrackBack
احتمال بروز بيماري آنفلوآنزاي فوق حاد پرندگان (H5N1)
4 مهر 1384
به دليل احتمال بروز بيماري آنفلوآنزاي فوق حاد پرندگان (H5N1) به طيور/ از سوي سازمان حفاظت محيط زيست؛شكار، صيد و زندهگيري كليه پرندگان در مناطق آبي و تالابي سراسر كشور تا اطلاع ثانوي ممنوع اعلام شد
تهران- خبرگزاري كار ايران
از طريق پرندگان آبزي مهاجر به كشور آنفلوآنزاي فوق حاد پرندگان (H5N1) به كشور منتقل خواهد شد.
به گزارش ايلنا, گزارشهاي واصله از سازمان دامپزشكي كشور حاكي از شيوع بيماري آنفلوآنزاي فوق حاد پرندگان (H5N1) طي هفتههاي اخير در كشورهاي روسيه و قزاقستان است، اين بيماري از طريق پرندگان آبزي مهاجر به كشور قابل انتقال به طيور اهلي است.
همچنين, خطر انتقال بيماري فوقالذكر به افرادي كه به طروق مختلف مانند شكار، صيد، زنده گيري و خريد و فروش با پرندگان آلوده در تماس باشند وجود دارد ؛ لذا به منظور مقابله با بروز احتمالي اين بيماري در كشور و پيشگيري از گسترش احتمالي آن سازمان حفاظت محيط زيست شكار، صيد و زندهگيري كليه پرندگان را در مناطق آبي و تالابي سراسر كشور تا اطلاع ثانوي ممنوع اعلام ميدارد.
بديهي است, با متخلفان طبق قانون برخورد ميشود.
لازم به ذكر است, بيماري آنفلوآنزاي فوق حاد پرندگان تاكنون در كشور گزارش نشده است.
خبرگزاري كار ايران
Posted by dymaxion at 06:26 PM | Comments (0) | TrackBack
FAO: Avian flu endemic in Indonesia
The US Department of State reports that the UN Food and Agriculture Organization has declared Bird Flu Endemic in Indonesia.
Everyone has been soft-pedalling the implications of H5N1 in Indonesia. I presume that's because the implications of an unstable Indonesia don't bear thinking about. Even if the flu doesn't break out into human-to-human form there, the country's going to take a heavy economic hit. Trade and tourism will weaken, riots will break out over poultry culls (or the lack of them), and every social tension in a volatile society will worsen. Outright H2H avian flu will blow the lid off altogether.
So if the US State Department is now aiding FAO in calling H5N1 "endemic" to Indonesia, it looks as if Indonesia's quarter-billion people are being left to dangle in the wind.
Posted by dymaxion at 06:21 PM | Comments (0) | TrackBack
Bird Flu (H5N1) Update - IndonesiaMaxedOutMama
Today Bloomberg conveyed the cheery news that patients under observation for bird flu in Indonesia were dropping:Indonesia's suspected bird flu cases among humans declined to 21 as some patients tested negative for the virus and five people will be released from a Jakarta hospital after showing signs of recovery, a doctor said.Later on they also list five dead in Indonesia. They're wrong on both counts. Another patient died, bringing the total to six, and hospitalized cases are up to 42:
Jessica, a two-year-old girl who died last week, tested negative for the H5N1, a deadly strain of the avian influenza virus, said Sardikin Giriputro, a director at Sulianti Saroso hospital, one of 44 hospitals in the country which have been designated to treat bird flu patients.
Twenty-one patients, including two new ones who were admitted yesterday, remain under observation for avian flu because they were exposed to live chickens or birds shortly before developing bird flu symptoms, Giriputro said.
There are 42 reported human cases of bird flu across Indonesia but only 10 patients have been tested positive of bird flu, Minister of Health Siti Fadillah Supari said here Monday.Not so good. There are real questions about how good testing for H5N1 really is. See this autopsy report, which notes that the virus doesn't seem to be replicating the upper respiratory tract, so swab testing won't work very well. Anyway, 12 of the patients are associated with Ragunan Zoo. It's hard to know exactly what is happening. Plenty of sick people have been turned away from hospitals in Indonesia. It seems as if they are only hospitalizing the very ill.
Six of the ten people infected with bird flu have died recently,the minister said.
Supari said bird flu cases have been reported from at least eight provinces in the country, with Jakarta having the highest case number of 28.
The first case in Indonesia was in July. A father and his two daughters died. Then RD, a woman who worked at the airport, died. Her nephew has now been confirmed as having H5N1. See this Recombinomics commentary:
There is considerable concern over false negatives or misdiagnosis. Rini Ignoble's (Rini Dina's) nephew, Paradise initially was H5N1 positive by PCR, but is now being discharged and is H5N1 negative, He will be the first discharged positive patient. Thus, collections from patients after the H5N1 has been cleared from serum will fail to detect the infection. Similarly, misdiagnosis is common. Karwati was initially diagnosed as having typhus, which was changed to Dengue Fever when she vomited blood and was bleeding from her nose. This presentation sounds similar to the index case in Thailand, who subsequently infected her mother and aunt.It's hard not to see some H2H in this. I don't think anyone really knows what's going on, but Australia (very close to Indonesia) is quite worried and is providing 50,000 courses of Tamiflu to Indonesia:
INDONESIA was struggling to contain an outbreak of bird flu and had been slow in distributing drugs to counter the disease, Foreign Minister Alexander Downer said today.In theory, if you consistently catch severe strains beginning to go H2H that produce high death rates, a milder strain of H2H H5N1 should evolve that is less of a threat to humans. I suppose that is all we can hope for now.
...
The Federal Government has increased the amount of anti-flu medication Tamiflu it is sending to its northern neighbour from 10,000 to 50,000 courses as Indonesia confirmed its sixth death from bird flu.
Asked if he was happy at how quickly the first batch of 10,000 courses of Tamiflu had been distributed, Mr Downer said: "I think it's been a little slowly, a little more slowly than we would have liked.
Posted by dymaxion at 06:14 PM | Comments (0) | TrackBack
Indonesia bird flu toll increases
... Another two people are confirmed to have died from bird flu in Indonesia, bringing the death toll there to six. Test results show that both a young girl who died last week and a 27-year-old woman who died on Monday had been exposed to the H5N1 virus. Several other recent fatalities are being ...
Posted by dymaxion at 06:10 PM | Comments (0) | TrackBack
September 23, 2005
National Tamiflu stockpiles
Randall Parker attempts to create a list of Tamiflu stockpiles around the world. The US, for example, has some 2.3 million doses, and plans to buy up to 20 million doses, eventually covering some 6.7% of the population. France will have the best coverage by the end of 2005, with 14 million doses, enough for over 20% of its population. Read the whole list at Future Pundit</