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November 28, 2006

The best summary of H5N1 to date

This week The New England Journal of Medicine (NEJM) published three articles on the evolving story of the influenza A/H5N1 panzootic that has the potential to become a human pandemic. Two are rather meager case series, one from Turkey and one from Indonesia. It is an extraordinary indication of the paucity of information that these papers could get published in one of the world's premier medical journals, a fact duly noted by Canadian Press's Helen Branswell. The two papers have some moderately interesting information, none of it startling for those who follow this issue. But the Commentary by Robert Webster and Elena Govorkova that accompanies the two papers is a model of clarity and a stunning summary of where we are at this moment. Hardly a word of the 1600 word essay is wasted. It would make an admirable blog post. Here are the opening and closing paragraphs:

Read the rest of this post... | Read the comments on this post...

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

Avian flu found in Africa, has killed 40,000 birds on Nigerian farm.

Byline: Shashank Bengali NAIROBI, Kenya _ A deadly strain of bird flu has been discovered on a poultry farm in northern Nigeria, health officials said Wednesday, marking the virus's first known appearance in Africa. A highly pathogenic form of the H5N1 virus has killed 40,000 birds in the rural

Publication: Knight Ridder Washington Bureau (via Knight-Ridder/Tribune News Service)

Posted by dymaxion at 10:33 PM | Comments (0) | TrackBack

Pandemic vaccines: promises and pitfalls.

Med J Aust. 2006 Nov 20; 185(10): S62-S65
Booy R, Brown LE, Grohmann GS, Macintyre CR

Prototype vaccines against influenza A/H5N1 may be poorly immunogenic, and two or more doses may be required to induce levels of neutralising antibody that are deemed to be protective. The actual levels of antibody required to protect against a highly pathogenic virus that potentially can spread beyond the large airways is unknown. The global capacity for vaccine manufacture in eggs or tissue culture is considerable, but the number of doses that can theoretically be produced in a pandemic context will only be sufficient for a small fraction of the world's population, even less if a high antigen content is required. The safety of new pandemic vaccines should be addressed in an internationally coordinated way. Steps are underway through the Therapeutic Goods Administration to evaluate mock-up vaccines now, so that the time to registration of a new product can be minimised. It will be 3-6 months into the pandemic before an effective vaccine becomes available, so other control measures will be important in the early stages of a pandemic. The primary goal of a pandemic influenza vaccine must be to prevent death, and not necessarily to prevent infection.

Posted by dymaxion at 10:29 PM | Comments (0) | TrackBack

Development of a triage protocol for critical care during an influenza pandemic.

CMAJ. 2006 Nov 21; 175(11): 1377-81
Christian MD, Hawryluck L, Wax RS, Cook T, Lazar NM, Herridge MS, Muller MP, Gowans DR, Fortier W, Burkle FM

BACKGROUND: The recent outbreaks of avian influenza (H5N1) have placed a renewed emphasis on preparing for an influenza pandemic in humans. Of particular concern in this planning is the allocation of resources, such as ventilators and antiviral medications, which will likely become scarce during a pandemic. METHODS: We applied a collaborative process using best evidence, expert panels, stakeholder consultations and ethical principles to develop a triage protocol for prioritizing access to critical care resources, including mechanical ventilation, during a pandemic. RESULTS: The triage protocol uses the Sequential Organ Failure Assessment score and has 4 main components: inclusion criteria, exclusion criteria, minimum qualifications for survival and a prioritization tool. INTERPRETATION: This protocol is intended to provide guidance for making triage decisions during the initial days to weeks of an influenza pandemic if the critical care system becomes overwhelmed. Although we designed this protocol for use during an influenza pandemic, the triage protocol would apply to patients both with and without influenza, since all patients must share a single pool of critical care resources.

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

Has H5N1 returned to North Korea?

From Korean News, a website of North Korea's Korean Central News Agency: Anti-epidemic work against bird flu intensified in DPRK. Here's the story:

The government of the Democratic People's Republic of Korea has intensified the anti-epidemic work against bird flu at the turn of the season. This work is under way every year as a nationwide movement under the coordinated guidance of the State Emergency Preventive Committee.

U Song Rim, director of the Central Veterinary and Anti-epizootic Center under the Ministry of Agriculture, told KCNA that the anti-epidemic work against bird flu is brisk as the veterinary and anti-epizootic organizations are playing an increasing role.

He went on to say:

The poultry farms have conducted vaccination against H5N1 virus as part of the work for preventing bird flu.

The above-said institutions are keeping abreast with news of the spread of bird flu worldwide on a regular basis and taking relevant measures.

In the meantime, the veterinary and anti-epizootic organizations in the provinces, cities and counties have set up posts to observe migratory birds in order to closely follow where they stay at present and abnormal symptoms. Measures are being taken to ensure that not only the poultry farms but the rural farms raise their domestic animals strictly indoors during the migration of birds.

The border quarantine offices are conducting strict quarantine work to prevent the spread of bird flu to the country in close touch with the veterinary and anti-epizootic officials.

A research work is also making rapid progress to manufacture medicine to prevent bird flu.

Well, that's very reassuring. But here's the Seoul Times: Bird flu outbreak plagues Korea. And this story quotes the Korean Central News Agency as saying

... authorities culled over 100,000 fowl in Hadang farm in Pyongyang, North Korea's capital city.

So what's going on? The Seoul Times seems to be the only news source with this report, and I can't find anything in the North Korean media (admittedly very sparse) to confirm it. Is this a belated reference to an earlier North Korean outbreak?

The world media lit up today at the news that the South Koreans were culling dogs and cats as well as poultry. But a new poultry outbreak in North Korea seems to me a lot more significant.

Posted by dymaxion at 10:08 PM | Comments (0) | TrackBack

Roche rejects claims of increased Tamiflu resistance in H5N1 ... - Forbes



Swissinfo
Roche rejects claims of increased Tamiflu resistance in H5N1 ...
Forbes, NY - 19 hours ago
ZURICH (AFX) - Roche Holding AG has rejected recent claims of increased resistance to anti-flu treatment Tamiflu in patients infected with the H5N1 'bird flu ...
Roche says no increase noted in bird flu's resistance to Tamiflu ... MarketWatch
Roche says Tamiflu resistance fears unfounded Swissinfo
Update on Tamiflu: no increase in drug resistance observed Canada NewsWire (press release)
all 13 news articles

Posted by dymaxion at 10:04 PM | Comments (0) | TrackBack

Second H5N1 Bird Flu Outbreak In South Korea - Medical News Today



E Canada Now
Second H5N1 Bird Flu Outbreak In South Korea
Medical News Today, UK - 10 hours ago
A second H5N1 bird flu outbreak has occurred at a farm in the Hwangdeung district, just two miles from the farm where an outbreak hit last week, say South ...
South Korea confirms second H5N1 bird flu case Reuters India
Bird flu outbreak caused by `highly pathogenic` type of H5N1 Zee News
H5N1 hits second South Korean poultry farm CIDRAP
Bloomberg - Bloomberg
all 495 news articles

Posted by dymaxion at 10:04 PM | Comments (0) | TrackBack

Flu viruses survive frozen in lakes, study finds - Reuters AlertNet


Flu viruses survive frozen in lakes, study finds
Reuters AlertNet, UK - 3 hours ago
... Migrating birds are blamed, in part, for the spread of H5N1 avian influenza, which has killed or forced the culling of more than 200 million birds globally. ...

Posted by dymaxion at 10:04 PM | Comments (0) | TrackBack

UN expert: Bird flu will cost another US$1.3 billion, despite ... - International Herald Tribune



UN News Centre
UN expert: Bird flu will cost another US$1.3 billion, despite ...
International Herald Tribune, France - 3 hours ago
AP. UNITED NATIONS: Progress has been made in fighting the deadly H5N1 strain of bird flu, but at least US$1.3 billion (€990 million) is still needed as the ...
$1 billion more needed for bird flu-World Bank Reuters AlertNet
Up to $1.5 billion needed to counter bird flu over the next three ... UN News Centre
A worst case scenario Park Hills Daily Journal
SpiritIndia
all 18 news articles

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

South Korea to slaughter 236,000 poultry after outbreak of bird flu

... South Korea to slaughter 236,000 poultry after outbreak of bird flu. South Korean quarantine officials will slaughter 236,000 poultry after an outbreak of the virulent H5N1 form of bird flu at a.. . 10 is the new 15 as kids grow up faster. Zach Plante is close with his parents he plays baseball with them and, on weekends, helps with work in the ...
Journey of a lifetime View Technorati URL search

Posted by dymaxion at 09:59 PM | Comments (0) | TrackBack

Bird flu danger looms greater than before next spring

... humans, but the risk that the virus might mutate into a strain that does so remains a big concern. New branches of the H5N1 virus are spreading in Southeast Asia, and Finland might have to change the vaccine that it has ordered. As many as 111 ...

Posted by dymaxion at 09:59 PM | Comments (0) | TrackBack

Woman dies from Avian flu, raising Indonesia's death toll to 57

... Ministry tests confirmed on Nov. 13 that the woman from the city of Tangerang, on the western outskirts of Jakarta, was H5N1 positive. The World Health Organization has not confirmed the death. It was Indonesia's 57th death from the virus, said ...

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

November 14, 2006

China's first human bird flu patient healthy after one year recovery

Via People's Daily Online: China's first human bird flu patient healthy after one year recovery.

The first person to survive the bird flu in China has been given a clean bill of health following medical checks performed on Saturday at the Hunan Provincial Children's Hospital.

Ten-year-old He Junyao's body functions are all normal, said hospital officials, adding that the disease has not affected the boy's growth.

Doctor Jiang Yaohui said the hospital's timely and proper treatment of He helped save his life.

The doctor said the hospital will provide free medical exams for He until he is 18.

The boy was hospitalized on Oct. 18 last year after suffering fever and a cough for five days. The Ministry of Health identified him as China's first human bird flu patient.

Since last October, China has reported 19 human cases of bird flu in Hunan, Anhui and Guangxi, 14 of them died.

While this is good news, it's also a reminder that every hot-zone country should be monitoring all its H5N1 survivors—and the rest of us should be helping to finance the costs of such follow-up. Like China and Indonesia and Vietnam, we also have a stake in understanding every aspect of avian flu.

Posted by dymaxion at 11:07 PM | Comments (0) | TrackBack

Canada: Parents warned to watch children taking Tamiflu

Via the Globe and Mail, a CP story: Parents warned to watch children taking Tamiflu. Excerpt:

Doctors and parents should watch for signs of bizarre behaviour in children treated with the flu drug Tamiflu, health officials suggested Monday in citing an increasing number of such cases from overseas.

U.S. Food and Drug Administration officials still don't know if the more than 100 new cases, including three deaths from falls, are linked to the drug or to the flu virus — or a combination of both. Most of the reported cases involved children.

Still, FDA staff suggested updating Tamiflu's label to recommend that all patients, especially children, be closely monitored while on the drug. They also acknowledged that stopping treatment with Tamiflu could actually harm influenza patients if the virus is the cause of the delirium, hallucinations and other abnormal behaviour.

The FDA's pediatric advisory committee is to discuss the recommendation Thursday. The FDA isn't required to follow the advice of its outside panels but usually does. An FDA spokeswoman did not immediately return a call seeking comment.

Posted by dymaxion at 10:57 PM | Comments (0) | TrackBack

Chinese promise H5N1 samples, deny claim of new strain - ThePoultrySite.com


Chinese promise H5N1 samples, deny claim of new strain
ThePoultrySite.com, UK - Nov 13, 2006
... avian influenza virus samples, despite reported misuse of some shared previously, and repeated its rejection of a report that a new strain of H5N1 virus has ...

Posted by dymaxion at 10:55 PM | Comments (0) | TrackBack

Bird flu patient in critical condition in Indonesia - People's Daily Online



Playfuls.com
Bird flu patient in critical condition in Indonesia
People's Daily Online, China - 14 hours ago
... Indonesia, which has been affected the hardest in this regard, has become one of the front lines in the fight against the H5N1 virus. ...
Indonesia's health ministry says woman, 35, being treated for bird ... Canada.com
Bird flu kills woman in Jakarta Sydney Morning Herald
Indonesian boy dies of bird flu, woman in hospital being treated ... Canada.com
Daily News & Analysis
all 109 news articles

Posted by dymaxion at 10:54 PM | Comments (0) | TrackBack

CU Invents 'Chip' To Diagnose Bird Flu

Researchers at the University of Colorado have developed an accurate, cost-effective and fairly quick test to diagnose avian flu in humans.The test is a "gene chip" which recognizes the distinctive genetic ...

Posted by dymaxion at 10:48 PM | Comments (0) | TrackBack

November 06, 2006

EGYPT: Seventh bird flu death confirmed

Egypt's health ministry on Wednesday confirmed the death of a woman from the deadly avian influenza virus H5N1, bringing the total death toll from the disease up to

Posted by dymaxion at 11:05 PM | Comments (0) | TrackBack

The WHO's shortlist

Via The Lancet Blog, the shortlist for the Director-General job. Excerpt:

The shortlist of candidates for WHO Director General was formally announced by Bolivian Executive Board President Fernando Antezana Aranibar just after 4:30 pm this afternoon.

But from the volume of chatter in the lobby of WHO in the hour leading up to the announcement—thanks mainly to the prevelance of Blackberries and mobiles transmitting vote counts from inside the closed Board meeting throughout the afternoon—it was clear the final result was a surprise to few.

Margaret Chan, China, was the first to secure her place for the interviews tomorrow, with Shigeru Omi, Japan, and Julio Frenk, Mexico, close behind. The fourth and five places were much more hotly contested, finally going to Kazem Behbehani, Kuwait, and Elena Salgado Mendez, Spain.

Posted by dymaxion at 10:50 PM | Comments (0) | TrackBack

Another Indonesian villager dies of bird flu-like symptoms

Via People's Daily Online: Another Indonesian villager dies of bird flu-like symptoms.

A 17-year old resident of Kalimandi village in Banjarnegara, in Indonesia's Central Java province, died of a disease suspected of bird flu Monday morning.

The results of tests conducted on Juwanto's blood had shown that there was reason to believe he was suffering from bird flu, Hartono, director of the local Margono Soekarjo Hospital said. Juwanto was previously a patient of Immanuel Hospital in Banjarnegara.

"We are now still waiting for the results of a test on samples of Juwanto's blood by the Health Ministry in Jakarta," Antara news agency quoted Hartono as saying.

He said Juwanto was immediately put in an isolation ward after being admitted to Margono Soekarjo Hospital on Sunday evening as he was in a very weak condition.

Juwanto was showing symptoms associated with bird flu such as high fever, breathing problems and coughing when he entered the hospital.

His parents meanwhile said that Juwanto started developing the symptoms on Wednesday after being treated at Immanuel Hospital for a week. "We did not believe that he had contracted bird flu. Initially, we thought he was only suffering from a lung infection," they said.

Mistinem, 32, a resident of Kaliurip village, also in Banjarnegara district, died of bird flu last Oct. 13. She died after being treated for 12 hours at the Margono Soekarjo Hospital. She had been ill since Oct. 8.

This is the only report I've seen about this case, and it may not be H5N1. But I'll try to keep track of it.

Posted by dymaxion at 10:49 PM | Comments (0) | TrackBack

Chinese scientists identify deadly gene in H5N1 - Reuters AlertNet



China Daily
Chinese scientists identify deadly gene in H5N1
Reuters AlertNet, UK - 17 hours ago
HONG KONG, Nov 6 (Reuters) - Chinese scientists have identified a gene in the H5N1 bird flu virus which they say is responsible for its virulence in poultry ...
Scientists collar bird flu's 'killer' gene Register
Chinese scientists identify deadly gene in H5N1 China Daily
Chinese scientists identify deadly gene in H5N1 ABC News
all 16 news articles

Posted by dymaxion at 10:32 PM | Comments (0) | TrackBack

US Government approves firefighting foam in bird flu fight

... The United States government has approved the use of firefighting foam to quickly kill chickens in the event of an outbreak of deadly bird flu H5N1 in commercial poultry. The Idea originally was researched by animal health officials in North Carolina and Delaware. According to officials at the US Agriculture Department, water-based foam can be ...
Bird Flu (Avian influenza) View Technorati URL search

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