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May 31, 2006

U.S. poultry experts using Google to beat bird flu

U.S. poultry experts using Google to beat bird flu (info)
Poultry experts are turning to sophisticated computer imaging to help them prepare for the expected arrival of the deadly bird flu virus in the United States later this year.

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Human H5N1 infections: so many cases – why so little knowledge?

Human H5N1 infections: so many cases – why so little knowledge? (info)
This month edition contains an account of clusters of H5N1 infection in humans in Azerbaijan [1]. The account is doubly rare: It describes the first occasion where the source is seemingly wild birds. Reading what happened is reassuring as the people infected had probably killed and defeathered infected swans. I.e. this was not casual exposure to wild birds but rather qualitatively similar to when humans are intimately exposed to sick domestic poultry, which remains the most potent risk factor (one recent analytic study came up with an odds ratio of 29 [2]).
Posted by ojcius and 1 other to avian flu AvianFlu H5N1 on Thu Jun 01 2006 at 02:21 UTC

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Indonesia reports another avian flu death - CIDRAP

Indonesia reports another avian flu death
CIDRAP, MN - 4 hours ago
... reported today that in the remote North Sumatra village that witnessed a large family cluster of avian flu cases, no cases suggestive of H5N1 infection have ...
WHO confirms 6 new H5N1 cases in Indonesia CIDRAP
all 2 related

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FAO: H5N1 could become endemic in Africa

Via Thanh Nien Daily, the FAO warns: Bird flu could become endemic in Africa.

"Africa is the continent where we are really worried to see endemicity becoming established," FAO's chief of animal health services, Joseph Domenech, told Reuters Television in an interview.

"If this is the case, it will be a new plague for African farmers and will be a permanent reservoir for re-infection to other regions through trade and wild birds."

Domenech said the continent was particularly vulnerable to the deadly H5N1 bird flu because of lack of funds and people to monitor and fight the virus. He said other countries should focus efforts on helping Africa to eradicate the disease.

oucauld once observed, "We always find the strength to bear the misfortunes of others." We have borne (and aggravated) the misfortunes of Africa for five hundred years, so we will surely find the strength to ignore avian flu in those unhappy countries.

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Russia: H5N1 continues to affect three West Siberian regions

Via RIA Novosti, a story I've been neglecting: Bird flu continues to affect three West Siberian regions.

Bird flu has been registered in 10 villages in three West Siberian regions, the Russian Agriculture Ministry said Monday.

"The Novosibirsk and Omsk regions and the Altai Territory remain unfavorable in terms of bird flu outbreaks," the ministry said.

The deadly disease, which has claimed dozens of human lives, has been registered in three villages in the Novosibirsk Region, five in the Omsk Region and two in the Altai Territory.

Although no human lives have been claimed to date in Russia, around 1.1 million birds have died of the disease and 300,000 have been culled to control the spread of the virus since the beginning of February.

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Indonesia revives epidemic law

Via People's Daily Online: Indonesia gets tough on bird flu, announcing epidemic law. Note the comment in the next-to-last paragraph.

The Indonesian government Friday reactivated the 1984 epidemic law in its latest effort to fight against bird flu, which so far has killed 36 people.

Under the law, those convicted of blocking government's way to eradicating the disease are punishable by one-year jail term.

Coordinating Minister for People's Welfare Aburizal Bakrie said the government would reactive the law following Indonesia's biggest cluster case in North Sumatra, in which seven family members died of bird flu.

There has been no evidence that the fatalities were resulted from human-to-human virus transmission, he said at a meeting with other related officials at his office here.

The government will establish rapid-response teams in areas considered to be most vulnerable to the disease, he said, adding that President Susilo Bambang Yudhoyono has agreed to disburse a considerable amount of fund to finance the program.

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Nigeria: H5N1 returns to Kano state

Via the People's Daily Online: Nigeria confirms fresh outbreak of bird flu.

The Nigerian Veterinary Research Institute (NVRI) on Thursday confirmed another outbreak of bird flu at a poultry farm in Kakara village in the northern state of Kano.

Timothy Obi, leader of the Avian Influenza task force team of the Food and Agricultural Organization (FAO) , told reporters that the institute said it had diagnosed samples of dead chickens from the farm and found them to be infected with the deadly H5N1 virus.

An official at the Avian Influenza Crisis Management Center who preferred anonymity also confirmed the outbreak.

"The virus was detected on Monday among the over 16,000 chickens on the farm," he said, adding that 11 samples of the dead chickens from the farm were taken to the NVRI for laboratory analysis which later confirmed the virus.

Malam Mohammed Aminu Adamu, chairman of Kano Branch of the Poultry Association of Nigeria (PAN), said that already all birds at Omatiga farm where the outbreak occurred have been culled while the farm had been decontaminated to curtail possible spread.

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Indonesian boy tests positive locally for bird fluReuters: Global Coverage

JAKARTA (Reuters) - A 15-year-old Indonesian boy has tested positive for the H5N1 bird flu, a senior health ministry official said on Wednesday, citing results of a local laboratory.

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WHO map: Indonesia, animal and human H5N1 outbreaksQuiplash!'s Photos

Quiplash! posted a photo:

WHO map: Indonesia, animal and human H5N1 outbreaks

Source of map: the United Nation's World Health Organization, Jakarta, Indonesia

Areas in green are provinces where there have been animal outbreaks of H5N1.

Boxes indicate which towns and cities have had human cases of H5N1 (most of which have been fatal).

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Indonesia ha confirmado nuevos casos de infección humana por virus de la gripe aviar H5N1consumaseguridad.com ::: el diario de la seguridad alimentaria

Según la Organización Mundial de la Salud (OMS), ninguno de los nuevos casos procede de la familia de Karo (Sumatra septentrional) en la que se han registrado varios casos. Uno de ellos es un joven de 18 años de la provincia de Java Oriental, que tiene antecedentes de exposición doméstica a pollos muertos durante la semana anterior a la aparición de los síntomas.

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May 24, 2006

CIDRAP reports first H-to-H to-H Case

Two generations of spread possible in Indonesia H5N1 cases
CIDRAP, MN - 56 minutes ago
May 24, 2006 (CIDRAP News) – For the first time, evidence suggests that the H5N1 avian influenza virus may have passed from one person to another and on to a ...
WHO sees role for older antivirals in some H5N1 cases CIDRAP
all 2 related

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Second Suspect H5N1 Bird Flu Cluster Member Dies in Bandung - Recombinomics

Second Suspect H5N1 Bird Flu Cluster Member Dies in Bandung
Recombinomics, PA - 12 hours ago
Teti died after being treated 19 hours in Space of the Poinciana Tree Isolation RSHS. The Hose five hours after the Teti death, Ade ...

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Qinghai: B2B H5N1 confirmed

Via Reuters, an unsurprising story: New bird flu outbreak found in far-west China.

China said on Wednesday it had confirmed an outbreak of H5N1 bird flu among wild birds in remote far-western Qinghai province and in Tibet.

About 400 wild birds had been found dead "recently", Xinhua news agency said, quoting the Agriculture Ministry.

An outbreak of the H5N1 strain at Qinghai Lake last May killed thousands of birds and that particular strain has since been found in Europe, Africa and the Middle East.

"It is not unusual as it happened last year, but you need to be very careful to make sure people do not get infected," Roy Wadia, spokesman for the World Health Organisation in China, told Reuters by telephone.

The governments of Qinghai and Tibet had disinfected the region where the birds were found, Xinhua said, adding no domestic poultry had been affected.

hannel NewsAsia offers more details in this story, saying the 400 birds were actually found in two separate locations (one in Tibet) on the same flyway.

Posted by dymaxion at 09:57 PM | Comments (0) | TrackBack

Possible Human-to-Human Bird Flu Case With Indonesian FamilyThere goes my pen ...

Possible Human-to-Human Bird Flu Case With Indonesian Family
Wednesday, May 24, 2006
Associated Press

GENEVA  — The U.N. health agency is looking closely at possible limited human-to-human transmission of bird flu between members of an Indonesian family, but said there was no evidence indicating the virus had mutated or that it had spread beyond the relatives.

"We're not surprised that there is possible human-to-human transmission," said Steven Bjorge, a World Health Organization epidemiologist in Jakarta, Indonesia. "The thing we're looking for is whether it's sustained beyond the immediate cluster."

Six of the seven people in the family from northern Sumatra who have caught the deadly disease have died, the most recent on Monday. It is one of the largest human clusters ever reported.

Bjorge, who is the team leader at the village in Kubu Sembelang, said none of the poultry in the area tested positive for the H5N1 bird flu virus, which has led a team of international experts to explore whether the virus spread among the relatives.

He warned, however, that such isolated cases of very limited human-to-human transmission have been documented — including a case in Thailand involving a mother and child — and that it does not mean a pandemic flu strain has emerged.

Bjorge said the virus has not altered its form in any way and is genetically the same as the virus found circulating in the area earlier.

"That, for me, is the most significant piece of evidence," he said. "Despite some weeks now in following up, we cannot find any evidence of any other cases beyond this cluster. If either of those two things changed, then I would be talking very differently."

Bjorge said some samples have been taken from villagers, but cooperation has been limited. If anyone outside the family is found to have even mild flu symptoms, he said they would be quarantined and given the anti-bird flu drug Tamiflu.

Earlier in a statement on its Web site, the WHO in Geneva said it was still investigating the cluster, but experts were looking closely at the possibility of limited human-to-human transmission. Scientists from the WHO and the U.S. Centers for Disease Control and Prevention are investigating.

"All confirmed cases in the cluster can be directly linked to close and prolonged exposure to a patient during a phase of severe illness," the WHO statement said. "Although human-to-human transmission cannot be ruled out, the search for a possible alternative source of exposure is continuing."

Health experts are concerned that if the virus mutates to a form that is easily transmissible between people, it could lead to a pandemic. So far, most human cases have been traced to contact with infected poultry.

Bird flu has killed 123 people worldwide, nearly a quarter of them in Indonesia.

The spread of bird flu from one person to another is very rare, and it has always faded out after that. The start of a flu pandemic would require the virus to be easily spread among people.


*And so it begins ...

Posted by dymaxion at 09:48 PM | Comments (0) | TrackBack

Scientists Study New Technique to Vaccinate Birds Against Avian FluBlogger News Network

By David McAlary
23 May 2006
McAlary report (Real Media) - Download 356k
Listen to McAlary report (Real Media)

Scientists have developed an efficient, cheap way to vaccinate birds against avian influenza and possibly prevent the spread of the deadly H5N1 strain to humans. They have devised a method of combining avian flu vaccine with a vaccine already widely used against another very common bird virus.

With the H5N1 virus spreading among birds globally, American and German biologists working independently of each other have come up with the same approach to reducing the threat to people.

Using genetic engineering, they inserted genes from a bird flu virus into a second avian virus called Newcastle disease, for which a vaccine already exists. The combination virus that resulted from this laboratory experiment, when used in a vaccine, protected chickens against both diseases.

The bird flu viruses the two groups used were not the H5N1 strain that many fear could jump to humans and cause a deadly global pandemic. But the leader of the U.S. research team, microbiologist Peter Palese of the Mount Sinai School of Medicine in New York, says the experiments show in principle that the same approach could work against H5N1 in birds. "Clearly, the principle here is that we make a dual vaccine against both Newcastle disease virus as well as avian influenza and take advantage of the fact that every chicken already is vaccinated against Newcastle diseas," he said.

Newcastle disease vaccinations typically are sprayed into chicken coops or added to the birds' drinking water, quick and inexpensive methods of inoculation. Palese says his study and the one from Germany prove it is possible to design effective multi-disease vaccines that can be administered so cheaply to birds and at the same time cut the threat of avian flu to people. "So it would prevent the spread of avian influenza in chickens and poultry, which would reduce the danger that it would jump into humans," he said.

The German researchers, from the Friedrich Loeffler Institute, believe the combination vaccine approach could work with people as well as poultry. Although they did not specify how, presumably an annual flu virus could be combined with the H5N1 strain to produce a dual human vaccine if H5N1 ever mutates to transmit from person to person.

But infectious diseases physician William Schaffner of the Vanderbilt University School of Medicine in Nashville says the notion is premature. "At the moment, we are just developing pandemic influenza vaccines, so the optimal way to use those vaccines has not yet been established. So thinking about a strategy how they are going to be used, whether introduced into the routine [flu shot] or kept off to the side, is a little in advance of where we are. Nonetheless, you can be sure that those kinds of conversations in advisory committees have already occurred and no decisions have been made about that," he said.

The findings about a combination Newcastle disease and bird flu vaccine appear in the Proceedings of the (U.S.) National Academy of Sciences.

tory originally ran at VOANews.com

This story was originally posted here.

Posted by dymaxion at 09:34 PM | Comments (0) | TrackBack

May 23, 2006

CIDRAP: Case for human spread of avian flu in Indonesia grows

... All seven confirmed cases of H5N1 avian influenza in the family cluster in Indonesia involved "close and prolonged exposure" to another infected person, suggesting person-to-person transmission, the World Health Organization (WHO) said today. However, the WHO statement stopped short of a definite conclusion that the virus spread from person to ...
Pandemic Flu from Europe View Technorati URL search

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BIRD FLU " avian pandemic influenza - review and facts




Pandemic Planning and Preparedness
Testimony of Julie L. Gerberding, MD, MPH

Centers for Disease Control and Prevention
Before the
Subcommittee on Health, Committee on Energy and Commerce
U.S. House of Representatives
May 26, 2005

Mr. Chairman and members of the Subcommittee, I am pleased to be here today to describe planning and preparedness for an influenza pandemic, including the potential threat posed by the H5N1 avian influenza virus currently in Asia. Department of Health and Human Services Secretary Mike Leavitt has made influenza pandemic planning and preparedness one of his top priorities; and each agency within the Department is working together to prepare the United States for a potential threat to the health of our nation.
I will discuss steps the Centers for Disease Control and Prevention (CDC) is taking with many partners both domestically and globally. The strength and flexibility of CDC and other components of the public health system are vital assets as the United States sharpens its readiness for an influenza pandemic. Although we have made significant progress, more work is needed, particularly in the areas of surveillance capacity and response, and the development of potential vaccines. Increased public awareness and understanding about infection control, containment, and other actions also are important in preparation for an influenza pandemic.
Pandemics in Perspective
Seasonal influenza causes an average of 36,000 deaths each year in the United States, mostly among the elderly and nearly 200,000 hospitalizations. In contrast, the actual severity and impact of the next pandemic, whether from H5N1 or another influenza virus, cannot be predicted. However, modeling studies suggest that, in the absence of any control measures, such as vaccination, a “medium-level” pandemic in the United States could result in 89,000 to 207,000 deaths, between 314,000 and 734,000 hospitalizations, 18 to 42 million outpatient visits, and another 20 to 47 million people being sick. Between 15 percent and 35 percent of the United States population could be affected by an influenza pandemic, and the economic impact in our country alone could range between $71.3 and $166.5 billion.
A public health response to a disease of this magnitude involves numerous challenges.

The Current Situation in Asia
For an influenza virus to cause a pandemic, it must meet three major criteria: (1) possess a new surface protein to which there is little or no pre-existing immunity in the human population; (2) be able to cause illness in humans; and (3) have the ability for sustained transmission from person to person. So far, the H5N1 virus has met two of these three criteria, but it has not yet shown the capability for sustained transmission from person to person.
Concerning this third point, it is important to keep in mind the close relationship of viral infections in animal hosts and those in humans. Ongoing dialogue between agricultural and public health officials is extremely important for the careful, consistent surveillance necessary in both animal and human populations. Although the present avian influenza H5N1 strain in Asia does not yet have the capability of sustained person-to-person transmission, chicken-to-human transmission has occurred, and in at least one cluster, limited person-to-person transmission has been identified. As of May 19, 2005 the World Health Organization (WHO) had confirmed 97 cases of H5N1 influenza in humans since January 28, 2004, with a case fatality rate of 55 percent. The World Organization for Animal Health (OIE) confirmed, as of May 13, 2005, that H5N1 had been found in animals from nine Asian countries in 2004 and 2005, with especially large outbreaks among animals in Vietnam and Thailand. Millions of domestic birds have been culled in attempts to stop the spread of the virus among animal populations.
Although human case fatality rates seem to have gone down somewhat since February 2005, CDC, WHO, and other partners are still quite concerned for several reasons. The H5N1 strain now appears to be endemic in poultry and other birds in a number of Asian countries, signaling a potential long-term threat of mutation and reassortment with other viral strains. Recent studies have found that ducks carry the H5N1 strain asymptomatically, making it difficult to monitor the magnitude of transmission from ducks to other species. Confirmation that H5N1 also has been transmitted to mammals is a particular concern, because of the increased potential of the strain to reassort with other strains already common to humans and other mammals. Studies have documented highly pathogenic H5N1 in pigs, tigers, and leopards in Asia. Difficulties in implementing effective in-country surveillance, including enhancing the training of laboratorians, epidemiologists, veterinarians, and other professionals, inhibit the type of comprehensive reporting that is essential to monitor H5N1 and other strains of highly pathogenic avian influenza. Finally, changes in the epidemiology of the infections, such as decreasing mortality rates, could indicate changes that make the viruses better adapted to humans. Additional studies and research are needed to better understand the current situation and how the viruses may be changing.
Responding to a Pandemic
An effective response to an influenza pandemic requires highly collaborative planning, implementation, and flexibility in resolving issues at many levels. The Department of Health and Human Services (DHHS) is leading the coordination of preparedness efforts through its Pandemic Influenza Response and Preparedness Plan, which was released in draft form in August 2004 for public comment and is under revision. In addition, states are either developing pandemic influenza plans or revising existing plans to reflect new information and data. Key elements of these plans include surveillance, infection control, use of antiviral medications, community containment measures, vaccination procedures, communications, and ability to sustain essential services in times of widespread illness. Similar elements inform a plan that CDC is developing, that will provide detailed guidance and materials to states and localities and will complement the DHHS plan. CDC also will take the lead in working with the Advisory Committee on Immunization Practices and the National Vaccine Advisory Committee to prioritize recommended target groups for use of antiviral medications and vaccines during a pandemic when supplies are limited.
Once a pandemic strain starts circulating in the United States, isolation precautions for persons who are ill and quarantine for persons exposed may need to be considered to limit the early spread of pandemic influenza, particularly before a vaccine becomes available. Measures such as these will require a multi-level, multifaceted, staged process, such as evaluating all ill travelers arriving from affected areas. On April 1, 2005 the President amended Executive Order 13295, adding influenza caused by novel or reemergent influenza viruses that are causing, or have the potential to cause, a pandemic to the list of quarantinable diseases. CDC has implemented a series of travel notices to minimize the potential for outbreaks to extend to wider geographic areas. CDC also has expanded the number and capacity of its quarantine stations at major ports of entry into the United States. As with any quarantine, such activities need to be undertaken judiciously to minimize adverse impacts on civil liberties.
Vaccination is the best long-term strategy for influenza prevention and control, both during annual outbreaks and a pandemic; antiviral medications provide an earlier, secondary line of defense. Other measures may help control the spread of influenza in a pandemic situation, such as isolation of ill persons and quarantine of healthy exposed persons. Comprehensive preparedness for annual influenza outbreaks is a vital component of an effective response to pandemic influenza, although pandemic planning will require additional preparation activities.
The United States, working domestically and with global partners, needs to expand the scope of early-warning surveillance activities used to detect the next pandemic. We cannot estimate the amount of time from first detection in another country to peak disease in the United States, but it could be a matter of months or less. Time will be of the essence in making sure we can produce, test, and administer vaccine as quickly as possible. It will take several months for the first dose of pandemic vaccine to be ready and longer to manufacture enough to vaccinate the entire U.S. population. Therefore, vaccine will be in short supply at the start of the pandemic. Under the most favorable conditions, by the time the first dose of vaccine would be given to the first person, many others will have already become ill or died. For this reason, surveillance to monitor ongoing changes in the H5N1 strain of avian influenza currently causing human infections and to monitor for other viruses with pandemic potential is needed to develop prototype vaccine candidates as quickly as possible. Further, because such a pandemic strain can arise anywhere, at any time, expanded global surveillance capacity is needed.
The outbreaks of avian influenza in Asia have highlighted several gaps in disease surveillance globally that the United States must help address to improve our ability to prepare for an influenza pandemic. These challenges include: (1) lack of infrastructure in many countries for in-country surveillance networks; (2) need for increased training of laboratory, epidemiologic, and veterinary staff; and (3) resolution of longstanding obstacles to rapid and open sharing of surveillance information, specimens, and viruses among agriculture and human health authorities in affected countries and the international community. CDC and HHS have made significant progress in the past year toward enhancing surveillance in Southeast Asia. This initiative needs to continue at both national and international levels if we are to expand geographic coverage and develop an adequate capacity to conduct effective surveillance. These efforts, in turn, will increase our ability to detect new variants earlier, make more informed vaccine decisions for yearly epidemics, and build an “early warning system” for new viruses that may cause a pandemic. With the ever-present threat of the emergence of a new pandemic strain, we need to know what is happening in the backyards of Southeast Asia, as well as elsewhere throughout the world. Year-round, world-wide surveillance for infections of humans with new strains of influenza is essential for us to prepare for the next pandemic, as well as for next year’s epidemic. Recently, the Congress passed and the President signed an FY 2005 Emergency Supplemental Appropriations Act for Defense, the Global War on Terror, and Tsunami Relief, which included $25 million in international assistance funds to prevent and control the spread of avian influenza in Southeast Asia. These funds will support human surveillance, laboratory capacity, and enhanced knowledge of state-of-the-art avian influenza laboratory and field techniques in Southeast Asia.
In the past year, CDC has considerably improved domestic surveillance, adding two new major components to our surveillance system. We worked with the Council for State and Territorial Epidemiologists (CSTE) to make confirmed pediatric deaths from influenza nationally notifiable, and we implemented hospital-based surveillance for influenza in children at selected sites. To further improve our understanding of the impact of influenza on severe outcomes, such as hospitalization, we are working with the CSTE to make all laboratory confirmed influenza hospitalizations notifiable. We have issued interim guidelines to states and hospitals to enhance surveillance for potential cases of people infected by avian influenza on several occasions and these enhancements continue. CDC also set up special laboratory training courses for identification of avian influenza using rapid molecular techniques. So far, professionals from 48 states and Washington D.C. have been trained.
However, to be as prepared as possible for a pandemic, we are working to do much more in the domestic surveillance arena. The United States is working to: (1) ensure that states have sufficient epidemiologic and laboratory capacity both to identify novel viruses throughout the year and to sustain surveillance during a pandemic; (2) improve reporting systems so that information needed to make public health decisions is available quickly; (3) enhance systems for identifying and reporting severe cases of influenza; (4) develop population-based surveillance among adults hospitalized with influenza and (5) enhance monitoring of resistance to current antiviral drugs, to guide policy for use of scarce antiviral drugs.
Managing the Vaccine Supply
During an influenza pandemic, the presence of U.S.-based manufacturing facilities will be critically important. The pandemic influenza vaccines produced in other countries will likely not be available to the US market as those governments may prohibit export of the vaccines produced in their countries until their domestic needs are met. However, the vaccine manufacturing system in the United States is fragile. Currently, there are only three influenza vaccine manufacturers producing vaccines for the US market, and only one produces its vaccine entirely in the United States.
During the past several years, CDC and other DHHS agencies have developed several new strategies to address annual influenza outbreaks, including the support of enhanced vaccine production, and have worked to ensure a better match of vaccine distribution to the populations in greatest need. Public demand for influenza vaccine on a yearly basis needs to be both stabilized and increased, so that companies will have a growing market to provide an incentive to increase production. These strategies include $40 million for purchasing influenza vaccine for the pediatric stockpile to protect against annual outbreaks of influenza, and $30 million will be used for contracts to expand the production of bulk single-strain influenza vaccine for use if needed during annual influenza season or possibly in a pandemic situation. In addition, the President is requesting $120 million in fiscal year 2006, an increase of $21 million, to encourage greater production capacity that will enhance the U.S.-based vaccine manufacturing surge capacity to help prepare for a pandemic and further guard against annual shortages.
The Department also appreciates the inclusion of $58 million in the FY 2005 Emergency Supplemental to procure additional influenza countermeasures for the CDC Strategic National Stockpile (SNS) in FY 2005. Currently, the SNS has enough oseltamivir (Tamiflu) capsules to treat approximately 2.26 million adults and oseltamivir (Tamiflu) suspension to treat more than 100,000 children. In addition, SNS contains enough rimantadine (Flumadine) tablets to treat up to 4.25 million people and enough rimantadine suspension to treat up to 750,000. It should be noted, however, that oseltamivir is the only antiviral at this time shown to be effective against the H5N1 avian influenza virus in Asia. In addition, SNS funds have been used to purchase approximately 2 million bulk doses of unfinished, unfilled H5N1 vaccine, although it is not yet formulated into vials nor is the vaccine licensed. Clinical testing to determine dosage and schedule for this vaccine began in April 2005 with funding from the National Institutes of Health.
DHHS also is supporting the development and testing of potential dose-sparing strategies to extend a given quantity of vaccine stock.
Regarding annual influenza vaccination, there is an emerging consensus that it is desirable to expand vaccine coverage beyond the high priority groups for whom routine vaccination is already recommended. Discussions are under way to review the data that would be needed to consider broadening recommendations for influenza vaccination. CDC is developing strategies to increase informed demand for, and access to, influenza vaccine for persons who are currently recommended to be vaccinated each year. For example, according to a 2003 Institute of Medicine report, an estimated 8.2 million additional high-risk uninsured adults 18-64 years old warrant annual vaccination. We recognize that these at-risk persons need better access to vaccine during a pandemic as well as for seasonal influenza.
Additionally, CDC, in conjunction with the Advisory Committee on Immunization Practices, is developing an internal set of possible influenza vaccine supply scenarios that may occur in future influenza seasons and during a pandemic. These scenarios range from worst-case to best-case situations and are an important part of CDC planning efforts. We are preparing recommendations, plans, and communication messages for any of the possible situations.
Although the present avian influenza H5N1 strain in Southeast Asia does not yet have the capability of sustained person-to-person transmission, we are concerned that it could. CDC is closely monitoring the situation in collaboration with the World Health Organization. CDC is using its extensive network of partnerships with other federal agencies, provider groups, non-profit organizations, vaccine and antiviral manufacturers, and state and local health departments to enhance pandemic influenza planning. Our responses to the annual domestic influenza seasons also will inform the nation’s planning and preparedness for pandemic influenza. The same laboratories, health care providers, surveillance systems, and health department plans and personnel guide both responses. These actions, in conjunction with increased public understanding about influenza, will help us all prepare for an influenza pandemic.

Avian Influenza Viruses

What’s Happening Now?

A pandemic is a global disease outbreak. A flu pandemic occurs when a new influenza virus emerges for which people have little or no immunity, and for which there is no vaccine. The disease spreads easily person-to-person, causes serious illness, and can sweep across the country and around the world in very short time.
It is difficult to predict when the next influenza pandemic will occur or how severe it will be. Wherever and whenever a pandemic starts, everyone around the world is at risk. Countries might, through measures such as border closures and travel restrictions, delay arrival of the virus, but cannot stop it.
Health professionals are concerned that the continued spread of a highly pathogenic avian H5N1 virus across eastern Asia and other countries represents a significant threat to human health. The H5N1 virus has raised concerns about a potential human pandemic because:
· It is especially virulent
· It is being spread by migratory birds
· It can be transmitted from birds to mammals and in some limited circumstances to humans, and
· Like other influenza viruses, it continues to evolve.
Since 2003, a growing number of human H5N1 cases have been reported in Azerbaijan, Cambodia, China, Egypt, Indonesia, Iraq, Thailand, Turkey, and Vietnam. More than half of the people infected with the H5N1 virus have died. Most of these cases are all believed to have been caused by exposure to infected poultry. There has been no sustained human-to-human transmission of the disease, but the concern is that H5N1 will evolve into a virus capable of human-to-human transmission.
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Avian Influenza Viruses

Avian (bird) flu is caused by influenza A viruses that occur naturally among birds. There are different subtypes of these viruses because of changes in certain proteins (hemagglutinin [HA] and neuraminidase [NA]) on the surface of the influenza A virus and the way the proteins combine.
Each combination represents a different subtype. All known subtypes of influenza A viruses can be found in birds. The avian flu currently of concern is the H5N1 subtype.
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Avian Influenza in Birds

Wild birds worldwide carry avian influenza viruses in their intestines, but usually do not get sick from them. Avian influenza is very contagious among birds and can make some domesticated birds, including chickens, ducks, and turkeys, very sick and kill them.
Infected birds shed influenza virus in their saliva, nasal secretions, and feces. Domesticated birds may become infected with avian influenza virus through direct contact with infected waterfowl or other infected poultry, or through contact with surfaces (such as dirt or cages) or materials (such as water or feed) that have been contaminated with the virus.
Avian influenza infection in domestic poultry causes two main forms of disease that are distinguished by low and high extremes of virulence. The “low pathogenic” form may go undetected and usually causes only mild symptoms (such as ruffled feathers and a drop in egg production). However, the highly pathogenic form spreads more rapidly through flocks of poultry. This form may cause disease that affects multiple internal organs and has a mortality rate that can reach 90-100%, often within 48 hours. The H5N1 virus is highly pathogenic.
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Human Infection with Avian Influenza Viruses

“Human influenza virus” usually refers to those subtypes that spread widely among humans. There are only three known A subtypes of influenza viruses (H1N1, H1N2, and H3N2) currently circulating among humans. It is likely that some genetic parts of current human influenza A viruses originally came from birds. Influenza A viruses are constantly changing, and other strains might adapt over time to infect and spread among humans.
The risk from avian influenza is generally low to most people, because the viruses do not usually infect humans. H5N1 is one of the few avian influenza viruses to have crossed the species barrier to infect humans, and it is the most deadly of those that have crossed the barrier.
Most cases of H5N1 influenza infection in humans have resulted from contact with infected poultry (e.g., domesticated chicken, ducks, and turkeys) or surfaces contaminated with secretion/excretions from infected birds.
So far, the spread of H5N1 virus from person to person has been limited and has not continued beyond one person. Nonetheless, because all influenza viruses have the ability to change, scientists are concerned that H5N1 virus one day could be able to infect humans and spread easily from one person to another.
In the current outbreaks in Asia, Europe, and Africa, more than half of those infected with the H5N1 virus have died. Most cases have occurred in previously healthy children and young adults. However, it is possible that the only cases currently being reported are those in the most severely ill people, and that the full range of illness caused by the H5N1 virus has not yet been defined.
Symptoms of avian influenza in humans have ranged from typical human influenza-like symptoms (e.g., fever, cough, sore throat, and muscle aches) to eye infections, pneumonia, severe respiratory diseases (such as acute respiratory distress), and other severe and life-threatening complications. The symptoms of avian influenza may depend on which virus caused the infection.
Because these viruses do not commonly infect humans, there is little or no immune protection against them in the human population. If H5N1 virus were to gain the capacity to spread easily from person to person, a pandemic (worldwide outbreak of disease) could begin. No one can predict when a pandemic might occur. However, experts from around the world are watching the H5N1 situation very closely and are preparing for the possibility that the virus may begin to spread more easily and widely from person to person.
For the most current information about avian influenza and cumulative case numbers, see the map on this site’s home page.
For more information about human infection, see http://www.cdc.gov/flu/avian/gen-info/avian-flu-humans.htm
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Vaccination and Treatment for H5N1 Virus in Humans

There currently is no commercially available vaccine to protect humans against H5N1 virus that is being seen in Asia, Europe, and Africa. A pandemic vaccine cannot be produced until a new pandemic influenza virus emerges and is identified.
The U.S. Department of Health and Human Services (HHS), through its National Institute of Allergy and Infectious Diseases (NIAID), is addressing the problem in a number of ways. These include the development of pre-pandemic vaccines based on current lethal strains of H5N1, collaboration with industry to increase the Nation’s vaccine production capacity, and seeking ways to expand or extend the existing supply. We are also doing research in the development of new types of influenza vaccines.
Studies done in laboratories suggest that some of the prescription medicines approved in the United States for human influenza viruses should work in treating avian influenza infection in humans. However, influenza viruses can become resistant to these drugs, so these medications may not always work. Additional studies are needed to demonstrate the effectiveness of these medicines.
The H5N1 virus that has caused human illness and death in Asia is resistant to amantadine and rimantadine, two antiviral medications commonly used for influenza. Two other antiviral medications, oseltamavir and zanamavir, would probably work to treat influenza caused by H5N1 virus, but additional studies still need to be done to demonstrate their effectiveness.

The massive mortality due to the influenza epidemic in October of 1918 in Kansas. This is representative of what happened in every state in the nation.

What would be the Impact of a Pandemic?

A pandemic may come and go in waves, each of which can last for six to eight weeks.
An especially severe influenza pandemic could lead to high levels of illness, death, social disruption, and economic loss. Everyday life would be disrupted because so many people in so many places become seriously ill at the same time. Impacts can range from school and business closings to the interruption of basic services such as public transportation and food delivery.

Pandemics Death
Toll Since 1900

A substantial percentage of the world’s population will require some form of medical care. Health care facilities can be overwhelmed, creating a shortage of hospital staff, beds, ventilators and other supplies. Surge capacity at non-traditional sites such as schools may need to be created to cope with demand.
The need for vaccine is likely to outstrip supply and the supply of antiviral drugs is also likely to be inadequate early in a pandemic. Difficult decisions will need to be made regarding who gets antiviral drugs and vaccines.
Death rates are determined by four factors: the number of people who become infected, the virulence of the virus, the underlying characteristics and vulnerability of affected populations and the availability and effectiveness of preventive measures.
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How are We Preparing?

The United States has been working closely with other countries and the World Health Organization (WHO) to strengthen systems to detect outbreaks of influenza that might cause a pandemic. See Global Activities
The effects of a pandemic can be lessened if preparations are made ahead of time. Planning and preparation information and checklists are being prepared for various sectors of society, including information for individuals and families.
HHS and other federal agencies are providing funding, advice, and other support to your state to assist with pandemic planning and preparation. Information on state/federal planning and cooperation, including links to state pandemic plans, is available on this site. The federal government will provide up-to-date information and guidance to the public through the public media and this web site should an influenza pandemic unfold.
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History of Pandemics
· Timeline of Human Flu Pandemics (National Institute of Allergy and Infectious Diseases)
See a chronology of significant dates in pandemic influenza history.
· Pandemics and Pandemic Threats since 1900
Learn about the three pandemics and several “pandemic threats” that have occurred.
· The Deadly Virus: The Influenza Epidemic of 1918 (National Archives and Records Administration)
View archival documents and photos from the era of the Great Pandemic of 1918.
· The Great Pandemic of 1918: State by State
Read stories and anecdotes of the impact of the Great Pandemic in individual states.
· The American Experience, Influenza 1918 (Public Broadcasting Service)
Read the history of “the worst epidemic the U.S. has ever known”
· Influenza Pandemics of the 20th Century (Centers for Disease Control and Prevention)
Read about the worldwide (pandemic) outbreaks of influenza that occurred in the 20th century: in 1918, 1957, and 1968.
· Swine Influenza A Outbreak, Fort Dix, New Jersey, 1976 (Centers for Disease Control and Prevention)
Find out how the Swine Influenza A Outbreak affected the health of the Fort Dix soldiers in 1976.
· The Swine Flu Episode and the Fog of Epidemics (Centers for Disease Control and Prevention)
Read about the lessons learned from previous epidemics.

(condensed from CDC public websites)

Posted by dymaxion at 10:42 PM | Comments (0) | TrackBack

H5N1 Bird Flu Cluster in Iran Grows to Five - Recombinomics

The above comments indicate the familial cluster of H5N1 bird flu has a least five family members. The two fatal cases have already tested positive for H5N1. ... Growing H5N1 Transmission Chain in Indonesia Raises Concerns Recombinomics ...

Posted by dymaxion at 10:40 PM | Comments (0) | TrackBack

Police and soldiers need not apply

Excellent article from Reuters: Never use police, army, U.S. pandemic expert says.

Dr. D.A. Henderson, who helped wipe out smallpox around the world, has a little piece of advice for governments fighting bird flu -- don't use the military or police to enforce public health.

Henderson, who likes to describe how he was vaccinated thousands of times against smallpox to demonstrate the immunization's safety to wary villagers, says it is much easier to halt epidemics by winning the trust of community leaders and making use of gossipy schoolchildren.

He is critical of parts of the U.S. national pandemic plan that call for the use of quarantine and other imposed types of enforcement should influenza or any other infectious disease bring on a pandemic.

"Never use the police or the military," Henderson told a meeting organized by the University of Pittsburgh Medical Center's Center for Biosecurity, where he works.

"Once we brought military or police in, we found many citizens retired to the woods," Henderson told the meeting on Tuesday.

And when the health teams tried to quarantine families, they found a similar response. "People hid," he said. "They didn't want to be quarantined so they hid cases."

read the whole article.

Posted by dymaxion at 10:36 PM | Comments (0) | TrackBack

Dr. Lee's last warning

Via Reuters: Late WHO chief warns of bird flu "blind spots".

Bird flu threatens human lives in hundreds and possibly thousands of "disease blind spots" around the globe, the late head of the World Health Organisation said in remarks prepared before his death.

The U.N. agency issued the report on Tuesday to the organisation's annual assembly of Director-General Lee Jong-wook, who died on Monday morning from a stroke.

"There are still hundreds, maybe thousands of disease blind spots around the world -- where no one knows what they have to watch for, or what they must report," Lee wrote.

Preparedness for a feared bird flu pandemic, which could kill millions of people, is high on the agenda of the six-day meeting of the WHO's 192 member states.

Health ministers from developing countries, which have so far suffered all the 124 deaths from bird flu, spoke frankly of lacking the funds and technical skills to fight the threat.

editorial comment of the Korea Herald on the death of Dr. Lee.

And here is the obituary published in the UK newspaper The Independent.

I fear we will miss him more than we now imagine.

Posted by dymaxion at 10:35 PM | Comments (0) | TrackBack

Tests On Two Dead Iranians Show H5N1 Bird Flu - Mediafax

Bucharest Daily News
Tests On Two Dead Iranians Show H5N1 Bird Flu
Mediafax, Romania - 15 hours ago
Tests in Iran on the bodies of a brother and sister who died after falling ill with pneumonia-like symptoms showed they had the deadly H5N1 strain of bird flu ...
Gardianul - The turkey hen diversion Bucharest Daily News
PM: Intelligence bird flu report does not link virus to Hungary ... Bucharest Daily News
Hungary Not Responsible For Bird Flu In Romania, Says Health ... Mediafax
Focus News - Mediafax - all 20 related

Posted by dymaxion at 10:30 PM | Comments (0) | TrackBack

Iran denies bird flu claimITN - Headlines

Iran has denied reports two dead pneumonia patients tested positive for the H5N1 bird flu virus.

Posted by dymaxion at 10:27 PM | Comments (0) | TrackBack

Branswell: Indonesian bird flu cluster may be human-to-human-to-human spread: WHO

... The large cluster of human cases of H5N1 avian flu being investigated in Indonesia may represent the first time the virus has been seen to ignite two successive waves of human-to-human spread, the World Health Organization said Tuesday. A spokesperson said the agency has not yet started the process of reviewing whether the global pandemic alert ...
Pandemic Flu from Europe View Technorati URL search

Posted by dymaxion at 10:24 PM | Comments (0) | TrackBack

Recombinomics: Human H5N1 Sequences from North Sumatra Indonesia

... Recombinomics Commentary May 23, 2006 Full genetic sequencing of two viruses isolated from cases in this cluster has been completed by WHO H5 reference laboratories in Hong Kong and the USA. Sequencing of all eight gene segments found no evidence of genetic reassortment with human or pig influenza viruses and no evidence of significant ...
Pandemic Flu from Europe View Technorati URL search

Posted by dymaxion at 10:20 PM | Comments (0) | TrackBack

Seven Indonesian Bird Flu Cases Linked to Patients

... Seven Indonesian Bird Flu Cases Linked to Patients Filed under: General — admin @ 6:37 pm All seven people infected with bird flu in a cluster of Indonesian cases can be linked to other patients, according to disease trackers investigating possible human-to-human transmission of the H5N1 virus. A team of international experts has been unable ...
http://www.williambranham.com/headlines View Technorati URL search

Posted by dymaxion at 10:18 PM | Comments (0) | TrackBack

Tests on two dead Iranians show H5N1 bird fluReuters: World

The two -- a 41-year-old man and 26-year-old woman -- were among five members of the same family who became sick after returning from a trip to the town of Marivan, close to their home in the northwestern city of Kermanshah.

Posted by dymaxion at 05:06 PM | Comments (0) | TrackBack

May 22, 2006

H5N1 Bird Flu Cluster in Iran Grows to Five - Recombinomics

H5N1 Bird Flu Cluster in Iran Grows to Five
Recombinomics, PA - 55 minutes ago
... The above comments indicate the familial cluster of H5N1 bird flu has a least five family members. The two fatal cases have already tested positive for H5N1. ...
H5N1 Bird Flu Cluster in Iran Confirmed Recombinomics
Growing H5N1 Transmission Chain in Indonesia Raises Concerns Recombinomics
Suspect H5N1 Clusters in Surabaya Raise Pandemic Concerns Recombinomics
Recombinomics - Recombinomics - all 6 related

Posted by dymaxion at 11:18 PM | Comments (0) | TrackBack

H5N1 Confirmed in Student Teacher Cluster in Surabaya

H5N1 Confirmed in Student Teacher Cluster in Surabaya (info)
The confirmation of H5N1 bird flu in the student in the teacher/student cluster in Surabaya is cause for concern. The teacher died earlier and the circumstances surrounding here hospitalization and death have not been described. However, the confirmation of her student raises the number of confirmed cases to two, and increases the likelihood at the other three members of the cluster have been infected with H5N1.
Posted by ojcius to avian flu INDONESIA AvianFlu H5N1 on Sun May 21 2006 at 20:40 UTC

Posted by dymaxion at 11:12 PM | Comments (0) | TrackBack

China's ability to detect bird flu outbreak in poultry still too weak: WHO

China's ability to detect bird flu outbreak in poultry still too weak: WHO (info)
http://www.canada.com/topics/news/world/story.html?id=e537723a-3eca-4d08-9a 3b-499b2ecc2280&k=70522
China's ability to detect H5N1 avian flu in poultry flocks across its vast geographic expanse remains a weak link in efforts to contain global spread of the virus and lower the risk it poses to mankind, the World Health Organization's top representative in that country suggests

Posted by dymaxion at 11:11 PM | Comments (0) | TrackBack

Another birdflu case in Indonesia

Thanks to the reader who sent the link to this Radio Australia story: Another birdflu case in Indonesia.

An 18-year-old East Java shuttlecock maker has been diagnosed with bird flu.

Indonesia's Health Ministry says he is undergoing treatment in hospital and a blood sample will go to a Hong Kong laboratory recognised by the World Health Organisation for further testing.

The man has been working with feathers and they will be traced to their source. Most human cases of bird flu from the H5N1 virus are believed to stem from direct or indirect contact with infected poultry.

Posted by dymaxion at 10:35 PM | Comments (0) | TrackBack

Four arrested in Romania for spreading bird flu

Via Yahoo News, an AFP story: Four arrested in Romania for spreading bird flu.

The manager of a major industrial poultry farm in Romania has been arrested on charges of allowing the farm to sell chickens possibly infected with a potentially lethal form of bird flu, prosecutors in the town of Brasov said.

The unnamed manager is the third person from the Drakom Silva poultry operation in Codlea to be arrested in the last few days. The farm's veterinarian, Virgil Udrea, and its owner were both arrested on Wednesday, as was Pati Prod, the owner of another poultry farm in the town.

The two owners have been charged with "spreading disease among animals" and could face up to 15 years in prison if convicted.

Udrea is accused of knowingly allowing the sale of contaminated live birds to private farmers, according to prosecutors.

Posted by dymaxion at 10:31 PM | Comments (0) | TrackBack

H5N1 getting deadlier

Via Bloomberg: Bird flu fatality rate in humans climbs to 64% as virus spreads. And another Indonesian (not in Sumatra) has died.

Bird flu has killed 64 percent of those people known to be infected with the virus this year, according to World Health Organization statistics, with the number of fatalities since Jan. 1 surpassing 2005 levels.

At least 47 of 73 people known to be infected with the H5N1 strain of avian influenza are reported to have died in the first five months of this year, the WHO said on its Web site yesterday. In 2005, 41 of 95 -- or 43 percent -- died.

Health officials are worried the lethal H5N1 virus may mutate into a form that's easily spread among people, touching off a pandemic similar to the one that began in 1918 in which as many as 50 million people died.

In Indonesia, where the rate of fatalities among H5N1 patients is 78 percent, officials are investigating a suspected 33rd death in the country.

A 20-year-old man died in East Java's city of Surabaya today after he had been treated in the Budi Mulia Hospital since May 9, the Antara state news agency said. Samples from the man were sent to Jakarta for testing to confirm H5N1 infection, the report said.

Eleven other people are being tested, including three who are under quarantine in Surabaya with avian flu-like symptoms, Antara reported.

Posted by dymaxion at 10:19 PM | Comments (0) | TrackBack

Branswell: Indonesia tests mathematical models

Via Canoe.ca, a Canadian news source, Helen Branswell looks at the implications of the Tanah Karo outbreak. Our pandemic SWAT teams may be outmatched: Bird flu cases in Indonesia raise questions about pandemic containment plan. Excerpt:

Mathematical models have suggested containing a pandemic could be possible with a swift and sweeping response. Based on those findings, experts at the World Health Organization has been working for months on a strategy to try to effect containment, if and when the need arises.

But the outbreak in Indonesia, where disease investigators have been met with fear and suspicion, illuminates the enormous challenges the pandemic SWAT team would face in trying to snuff out a nascent pandemic strain before it could spread from its place of origin to sweep the globe.

"This cluster in Indonesia is a test case for the pandemic," Maria Cheng, a spokesperson for the WHO, said from Geneva.

"It's basically testing our capacity to respond as quickly as possible, and how quickly we can detect it, and how willing the community is to respond."

As such, the Indonesian outbreak should serve as a stark reminder to all involved of the difficulties inherent in trying to translate the models' findings into reality, said infectious diseases expert Dr. Michael Osterholm.

"Our experiences with the virus during the last six months in Turkey, Iraq and now in Indonesia should give even the most ardent supporters of containment cause to realize why, while such an approach is an ideal, it also is a fantasy."

Posted by dymaxion at 10:14 PM | Comments (0) | TrackBack

Deadly bird flu strain found in Burkina Faso capital (AFP)Yahoo! News: Bird Flu

An expert writes reference numbers on an egg for bird flu tests at a laboratory in Bangkok. Burkina Faso confirmed the presence of the H5N1 strain of bird flu, potentially deadly to humans, at three more sites including in the west African nation's capital.(AFP/File)AFP - Burkina Faso confirmed the presence of the H5N1 strain of bird flu, potentially deadly to humans, at three more sites including in the west African nation's capital.

Posted by dymaxion at 10:10 PM | Comments (0) | TrackBack

Bird flu confirmed near Bucharest: authorities plead for calm (AFP)Yahoo! News: Bird Flu

Sanitary workers put a duck in a plastic container to be culled in Brasov city, 180 kms northeast from Bucharest.  Bird flu has been found in a farmyard near the Romanian capital Bucharest, authorities confirmed, but they did not specify whether it was the potentially lethal H5N1 strain.(AFP/File/Daniel Mihailescu)AFP - Bird flu has been found in a farmyard near the Romanian capital Bucharest, authorities confirmed, but they did not specify whether it was the potentially lethal H5N1 strain.

Posted by dymaxion at 10:10 PM | Comments (0) | TrackBack

Vogelgrippe in Rumänien breitet sich ausHandelsblatt.com

Die Vogelgrippe breitet sich in Rumänien immer weiter aus. Die Zahl der Ortschaften, in denen das auch für den Menschen gefährliche Virus H5N1 bestätigt wurde, hat sich auf 34 erhöht, in weiteren 24 Orten herrscht Verdacht auf Vogelgrippe.

Posted by dymaxion at 10:09 PM | Comments (0) | TrackBack

[21:25] ‘Twee mensen in Iran aan H5N1-virus bezweken'de Volkskrant | Laatste nieuws

Een omgekomen 41-jarige Iraniër en zijn eveneens overleden 26-jarige zuster waren besmet met het vogelgriepvirus H5N1. (21:25, 22-05-06)

Posted by dymaxion at 10:07 PM | Comments (0) | TrackBack

Two generations of spread possible in Indonesia H5N1 cases - CIDRAP

Two generations of spread possible in Indonesia H5N1 cases
CIDRAP, MN - 56 minutes ago
May 24, 2006 (CIDRAP News) – For the first time, evidence suggests that the H5N1 avian influenza virus may have passed from one person to another and on to a ...
WHO sees role for older antivirals in some H5N1 cases CIDRAP
all 2 related

Posted by dymaxion at 06:58 AM | Comments (0) | TrackBack

May 15, 2006

WHO Study Indonesian Bird-Flu Cluster

... "An unusually big cluster of suspected bird-flu cases involving eight members of an extended family in Indonesia is attracting attention from local and international health officials on guard against any sign the virus may have evolved to spread easily among humans. After attending a recent family gathering, the eight people living in the ...
Pandemic Flu from Europe View Technorati URL search

Posted by dymaxion at 10:03 PM | Comments (0) | TrackBack

Indonesia blames 5 deaths in family on avian flu (CIDRAP)

... May 15, 2006 (CIDRAP News) – Indonesian authorities have attributed the deaths of five members of one extended family to H5N1 avian influenza, and three surviving relatives are also suspected of having the virus, according to news services. ...
Bird Cause Flu View Technorati URL search

Posted by dymaxion at 10:00 PM | Comments (0) | TrackBack

Water supplies in a pandemic

A reader who must remain anonymous has sent me an important analysis of how we could lose safe water in a pandemic. I've re-paragraphed it for easier online reading. A PDF is available at the end of the post. While it's based on American practice and regulation, I suspect that similar problems face water systems all over the industrial world.

Water Supplies in a Pandemic

I work for a state agency assisting the water supply industry for my state. As such, I have access to water treatment plant operators and an understanding of water supply systems. My purpose in telling you this is to establish credibility.

I am definitely not authorized to speak publicly for my agency. HOWEVER, as a Civil Engineer (Professional Engineer) in the business, and as a private citizen, I've made an analysis that I'd like to share with you.

Obviously, there are lots of concerns about how people might contract ordinary flu and other diseases. Let me discuss a transmission route that is LIKELY to occur in the event of a pandemic: namely the public water supply systems.

The water supply system
First, let me describe the supply system. The source of public drinking water is typically surface streams and reservoirs. There are communities, most often in rural settings, that get their water primarily from wells and springs. But the great majority of cities and towns in the USA get at least a portion of their water from surface sources.

Water is piped to the water treatment plant where the water is held, temporarily, in large ponds. The water is taken into the treatment plant where large materials are screened out and then the water is put through a series of filters. These include flocculation, and sand filters that remove even small particles down to bacteria sizes.

However, viruses are so small they cannot be filtered out. That's one of the main reasons for chlorination, along with killing any residual bacteria. State law requires there be "log 4" reduction in virus count. That is, 1/10, 1/100, 1/1,000 down to 1/10,000 reduction in virus count. And every treatment plant tests the water to determine that the log 4 reduction is being achieved.

Test results are routinely submitted to drinking water regulatory agencies. Sometimes during normal operation, treatment plants cannot conform and are required to take corrective actions to regain compliance. See concluding comments below.

During normal day-to-day operations the raw water (term used for water before treatment) contains all the stuff that is in rivers and reservoirs. This includes bird and animal fecal droppings, as well as dead and decaying plant and animal matter. Not a pretty sight, but that's the way it is.

Now, in the USA these plants operate quite well and every day provide people with clean, non-contaminated drinking water. Pretty amazing when you consider the volumes of water -- billions of gallons per day. When was the last time you heard about a water-borne disease outbreak??

What happens in a pandemic
Anyway, now let's consider what happens to this system during a pandemic.

Obvously, there is a concern for sufficient numbers of qualified personnel to properly operate all aspects of the system from pumps, valves, and filters to the chlorination equipment. But here's the "pandemic kicker". Ducks and geese having the disease (recall they shed the virus in large amounts even before becoming symptomatic) deposit their droppings in the streams, reservoirs, and in the holding pond right outside the treatment plant. And, of course, when they die their contaminated bodies float and decompose in those surface water sources.

In addition, sewage treatment plants quite commonly discharge to streams and thus some levels of human excrement also end up in surface water supplies. This too, is ongoing day-to-day. Quite simply, sewage treatment plants do not remove all pathogens or chemicals. This is the source of pesticides, herbicides, pharmaceuticals, and other "endocrine disruptors".

We all live downstream
Recall the slogan, "we all live downstream". Well, we really do live downstream. So, flu-contaminated human waste is also in the raw water stream that supplies drinking water treatment plants.

Sewage treatment plant effluent is also used in many areas of the country for "water reuse" such as to water golf courses and other "non-contact" (to humans) uses. On a day-to-day basis these human wastes are removed like the other wastes from the drinking water.

So, during a pandemic, the raw water sources contains both bird and human-generated flu virus.

Speaking to the manager of a large water treatment plant, I find the following. During the summer a typical chlorine stockpile for water treatment is no more than one week. Summer means the greatest water demand during June, July and August. The chlorine is delivered to the drinking water via compressed gas bottles. One bank (say 12 cylinders) is on-line while the other bank of 12 is full and waiting to be put on-line. That's a typical hard plumbing hookup. During the winter, when water demand is lower, the bank may last more than one week.

Not if, but when, there is absenteeism at the chlorine generating plant, the chlorine supply will not be there. MAJOR problem! Without chlorine, the flu virus (along with other infectious agents) could be supplied to the public. Unless the water supply is turned off.

To add to credibility of this scenario, I'd direct you to one water supplier, in Denver, that has made plans to prepare for a pandemic scenario. The article makes good reading up until he talks about chlorine, which is beyond his control. These folks have even taken to stockpiling a 30-day supply of chlorine. After that, they face the decision of supplying contaminated water, or shutting off the supply to the public. See the following, which I think I got from your website. http://www.rockymountainnews.com/drmn/local/article/0,1299,DRMN_15_4626378,00.html

Another pandemic consideration is the length of the flu pandemic. In 12 to 18 months there will be equipment malfunctions in the vast array of equipment throughout the automated system. What breaks and when it breaks could affect the ability to treat the water (water filters through chlorination dispensing) and deliver it (pumps, valves, control systems).

It could be that, after some critical item (or combination of items) breaks, no water will be delivered during a pandemic.

Well, maybe you already knew this stuff. But this supplies some detail of this industry. In my military survival training I learned that water was the most crucial item to life. Recall also that hydration of flu patients is a key item, crucial to their survival. And clean, uncontaminated water could be in seriously short supply to millions of people during a pandemic. Might I suggest individuals seriously consider stockpiling water along with whatever else they do to prepare for a pandemic.

Download water_supply_pandemic.pdf

Posted by dymaxion at 09:38 PM | Comments (0) | TrackBack

Djibouti appeals for help to fight bird fluHarowo.com

Alarab Online

Choukri, first human bird flu case in sub-Saharan Africa

Djibouti, which has confirmed the first human bird flu case in sub-Saharan Africa, has asked the international community for help in halting the spread of the deadly disease.

Laboratory tests last week showed a two-year-old girl tested positive for the deadly H5N1 avian influenza virus.

Three sick siblings have also had tests for possible infections, the World Health Organisation (WHO) said.

Health Minister Abdallah Abdillahi Miguil said more than $4.4 million would be needed to fight the spread of the virus in the Red Sea country of 300,000, to train medical staff, put in surveillance networks and get laboratory equipment and drugs.

"The situation is under control but we are asking for cooperation from partners so that the situation does not worsen," Miguil told a news conference late on Sunday.

He said the girl, from a poor rural area near Somalia, was in stable condition and her family had undergone blood tests.

The WHO says there have been more than 200 cases in 10 countries, including Djibouti, since late 2003, and 115 deaths.

Alarab Online. © 2005 All rights reserved.

Posted by dymaxion at 09:19 PM | Comments (0) | TrackBack

IBM Global Pandemic Initiative

... Dr. Joseph Jasinski, Program Director, IBM Healthcare and Life Sciences Research [ Jasinski] This morning IBM announced a "Global Pandemic Initiative" - a steering committee of global public health experts, academic researchers and philanthropic organizations and a set of projects intended to find new ways to help the world prepare for and ...
HealthNex View Technorati URL search

Posted by dymaxion at 09:17 PM | Comments (0) | TrackBack

First Human Bird Flu Reported in Horn of Africa (Environment News Service)

... First Human Bird Flu Reported in Horn of Africa (Environment News Service) Monday May 15th 2006, 7:13 am GENEVA, Switzerland , May 15, 2006 (ENS) - The Ministry of Health in Djibouti has confirmed the country’s first case of human infection with the H5N1 avian influenza virus. The patient is a two year old girl from a small rural village in ...
Bird Cause Flu View Technorati URL search

Posted by dymaxion at 09:17 PM | Comments (0) | TrackBack

New bird flu outbreak in Romania

... New bird flu outbreak in Romania Romania detected a new outbreak of the deadly H5N1 bird flu virus in poultry on Saturday, just a month after the strain was said to have been eradicated there, authorities said. The discovery of the infected birds in Transylvania prompted authorities to cull hundreds of domestic fowl. The Black Sea state has ...
Bird Flu Info - Latest news on bird flu pandemic, bird flu protection & bird flu symptom View Technorati URL search

Posted by dymaxion at 09:16 PM | Comments (0) | TrackBack

May 10, 2006

Fatal Contact: Bird Flu in America, ABC and the H5N1 Pandemic

Many Americans learned about the Avian Flu for the first time last night. The ABC dramatization, Fatal Contact: Bird Flu in America, of the pandemic flu is based on a plausible scenario as the country reels from an attack of a highly virulent strain of pandemic flu.  Many scientists believe that like the show's scenario, the current H5N1 virus that has mainly struck the bird population across Asia and Europe could be the source of just such a scourge.

Like previous flu viruses that have passed from the bird population to humans, H5N1 presents a number of serious threats.  Because it represents a new strain, humans have no natural immunization to the disease. Once established, flues tend to spread rapidly through the populaton. In previous viruses of this type, the immune systems of young healthy adults tend to overreact fatally to the unrecognized threat, causing something that has been dubbed a cytokine storm.

These deaths, because they occur in the most active group in the population, cause a rippling effect.  Without this important manpower, critical infrastructure, health, supply, service and security systems can break down with dire results.

In the ABC dramatization,   viewers are presented with a scenario in which large numbers of people become sick and die in the first wave of the pandemic while supplies of food, fuel and basic goods and services fail, and order collapse across parts the country. The show portrays price gouging, ordinary people looting and fighting over food and other necessities as well as mob lawlessness in downtown New York as marauding bands attack vital supply chains for high value medicines.

In this depiction, the flu travels from China to the US within hours of the first outbreak of a newly mutated virus that is able to pass readily from human to human.  In several days the US is facing a deadly flu outbreak that quickly spreads beyond hastily set up quarantine lines. As the flu strikes the active population, the system lurches, then grinds to a near halt  Just-in-time supply chains fail, hospitals fill, the general population panics as it treats diseased love ones, and looks to the authorities for anticipated leadership and solutions, faces shortages, widespread confusion and performs the grim task of disposing of the mounting fatalities.

Amplifying on the experience of the deadly Spanish Flu outbreak of 1918-1920, in which a second more deadly wave was followed months later by a third wave, the drama ends with a scene in Africa where an entire village is wiped out by what appears to be a much deadlier mutation of the virus. We are left watching  a flock of wild birds flying across a verdant valley in Angola.

Because it portrays what was described by NIH head Antonio Fauci  a "worst case scenario" the show  has been greeted with controversy from a number of quarters including some of the leading warning voices in the avian flu community. The reserve expressed by some scientists, even those who have worked tirelessly  to raise awareness about the pandemic flu's deadly potential, is that the ABC drama Fatal Contact: Bird Flu in America may have the impact of "sensationalizing" what is a real and serious threat.   They fear the public will treat the drama as just another scare show and will discount it as fiction. Others, especially those who argue that  the Avian Flu has already been "hyped" out of proportion, have argued that the show may lead to panic.

But real panic is more likely to occur should the H5N1 make the changes necessary to transmit easily from human to human.  Especially when the public finds out that drugs like Tamiflu and Rilenza have little or no effect and worse, that there is no vaccine generally available, at least during the first and possibly even the second wave.

So far this morning there have been no reports of supermarkets being overrun by shoppers on hoarding binges. Somehow we doubt there will be any. No doubt, some viewers will treat  Fatal Contact: Bird Flu in America as highly exaggerated entertainment but it does serve to get the word out to many people, perhaps a whole new audience, in one night; perhaps, more than all of the previous news reports

The power of prime time TV to get a message out is enormous. We hope the show will make clear to those responsible for allocating and carrying out preparations for a pandemic, that without diligent, well funded, carefully thought out plans, The H5N1 virus brings with it the real potential for what the show portrayed and maybe even worse.  For an audience being introduced  to this scourge for the first time, the takeaway should be an admonition to make real personal preparations such as storing drinking water, canned and dry foods, sterilizing soaps , cleansers and surgical level face masks, emergency lights and batteries, etc. The public needs to actively urge local authorities to action as well as  participate in community planning events.

Even if we have to face an outbreak worse than the 1918-1920 Spanish Flu episode, most of us will survive.  The greatest problems will be in how we find a way to cope with shortages of necessities and vital supplies, unimaginable personal losses and a potential breakdown of services and even law and order. History tells us that pandemics are inevitable.  Our preparations now could make all the difference.  They won't be wasted.

Posted by dymaxion at 10:47 AM | Comments (0) | TrackBack

May 08, 2006

The Qinghai year

Henry Niman at Recombinomics has a memorable post tonight: One Year of Qinghai H5N1 Bird Flu Migration.

He gives us a useful perspective on how fast and far the virus has spread. Last spring we knew almost nothing. We clutched at machine translations from uncertain Chinese sources, and speculated on rumours of hundreds of human deaths.

In hindsight, it's actually been worse. H5N1 has migrated west with shocking speed. If it hasn't killed hundreds, it's certainly ruined thousands of families and convulsed the economies of countries from Indonesia to Ivory Coast. Worse is to come.

Posted by dymaxion at 09:00 PM | Comments (0) | TrackBack

Roche Urges Care Against Online Counterfeit Tamiflu (Update3) - Bloomberg

Roche Urges Care Against Online Counterfeit Tamiflu (Update3)
Bloomberg - 1 hour ago
... Tamiflu is one of just a few drugs, along with GlaxoSmithKline's Relenza, that has shown signs of fighting the lethal H5N1 bird flu strain. ...
Roche Urges Care Against Online Counterfeit Tamiflu (Update2) Bloomberg
Roche Releases Guidelines for Consumers on How to Avoid ... Yahoo! News (press release)
all 35 related

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UN Bird Flu Crisis Center To Be Opened Within A Month

... A U.N. crisis management center to coordinate international efforts against the spread of bird flu will be opened within a month, a top official with the U.S. Agriculture Department said Monday. The center at the Rome-base Food and Agriculture Organization will dispatch response teams to countries where bird flu is detected in animals and will ...
Pandemic Flu from Europe View Technorati URL search

Posted by dymaxion at 08:50 PM | Comments (0) | TrackBack

Mike Osterholm: "I am not happy"

... A film about a fictional bird flu pandemic that will air on television on Tuesday has experts worried it will panic some people and convince others that legitimate warnings are mere hype. But the same experts are taking advantage of publicity surrounding the made-for-television movie to stress what they see as the need for individuals, ...
Pandemic Flu from Europe View Technorati URL search

Posted by dymaxion at 08:47 PM | Comments (0) | TrackBack

WHO Avian Flu Update: Indonesia

... Avian influenza – situation in Indonesia – update 11 8 May 2006 The Ministry of Health in Indonesia has confirmed the country’s 33rd case of human infection with the H5N1 avian influenza virus. The case, which was fatal, occurred in a 30-year-old man from Greater Jakarta. He developed symptoms on 17 April, was hospitalized on 21 ...
Inolesco: growth of the avian flu View Technorati URL search

Posted by dymaxion at 08:44 PM | Comments (0) | TrackBack

May 01, 2006

Travel restrictions useless against bird flu: study - Reuters.uk

Travel restrictions useless against bird flu: study
Reuters.uk, UK - 34 minutes ago
... Then they modeled several different scenarios for the spread of H5N1 avian influenza into people. Experts stress that any new influenza ...
Update 1: AP: in Pandemic Draft Plan, Borders Open Forbes
Survive bird flu with Kiwi ingenuity Stuff.co.nz
Pandemic panic: Stop worrying Lancaster Newspapers
Savannah Morning News - Angus Reid Global Scan - all 87 related

Posted by dymaxion at 09:19 PM | Comments (0) | TrackBack

US: People expect H5N1 but don't lose sleep

An Angus Reid poll suggests Americans are aware of bird flu, expect to see it in the US in the next year or so, but don't worry about it: Bird Flu Likely, But Little Concern in U.S.

Many adults in the United States believe avian influenza will reach their country, according to a poll by Ipsos-Public Affairs released by the Associated Press. 61 per cent of respondents think it is very or somewhat likely that bird flu will spread to birds in the U.S. within the next 12 months.

Laboratory tests have confirmed the presence of the H5N1 strain of avian influenza in several countries around the world. The World Health Organization (WHO) has warned that the virus could mutate into a form that can be transmitted among people. 66 per cent of respondents are not too concerned or not at all concerned with someone in their immediate family becoming sick from the bird flu.

le story to see the details of the poll.

Posted by dymaxion at 09:16 PM | Comments (0) | TrackBack

Molecular virology: Was the 1918 pandemic caused by a bird flu?Connotea: Bookmarks matching tag AvianFlu

Molecular virology: Was the 1918 pandemic caused by a bird flu? (info)
Mark Gibbs and Adrian Gibbs
Nature 440 (7088), E8 (27 Apr 2006)
Taubenberger et al.1 have sequenced the polymerase genes of the pandemic 'Spanish' influenza A virus of 1918, thereby completing the decoding of the genome of this virus2, 3, 4, 5, 6. The authors conclude from these sequences that the virus jumped from birds to humans shortly before the start of the pandemic and that it was not derived from earlier viruses by gene shuffling, a process called reassortment. However, we believe that their evidence does not convincingly support these conclusions and that some of their results even indicate that, on the contrary, the virus evolved in mammals before the pandemic began and that it was a reassortant. In light of this alternative interpretation, we suggest that the current intense surveillance of influenza viruses should be broadened to include mammalian sources.

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Côte d'Ivoire: Govt Minister, OIE Report First Case of Bird FluAllAfrica News: Health and Medicine

Cote d'Ivoire has reported its first outbreak of the deadly H5N1 strain of bird flu in a poor residential district of the main city Abidjan, the World Organisation for Animal Health (OIE) said on Thursday.

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Dutch allow domestic poultry outdoorsSacBee -- Health & Science News

AMSTERDAM, Netherlands (AP) - The Netherlands' Agriculture Ministry lifted an order keeping all domestic poultry indoors on Monday, as fears over an outbreak of bird flu eased. Among their immediate neighbors, only the Netherlands and Belgium were spared confirmed cases of wild birds infected with the H5N1 strain that is potentially lethal for humans. Germany, Britain, Denmark and France, all reported cases.

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