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June 27, 2007

Tamiflu resistance again

There's been a bit of a buzz about a paper by Australian researcher Jennifer McKimm-Breschkin at the Toronto flu meetings last week. McKimm-Breschkin told the gathering of 1500 flu obsessed scientists just what they didn't want to hear: that she and her colleagues had evidence from the laboratory that clade 2 H5N1 avian influenza virus isolated from birds in Indonesia were becoming resistant to the only oral antiviral effective against the virus, oseltamivir (Tamiflu). In comparison to clade 1 (southeast asian) virus from a few years back, the sensitivity was 20 to 30 times less.

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Posted by dymaxion at 10:17 PM | Comments (0) | TrackBack

Mild bird flu: no news is bad news

For a long time I (and many others) were of the opinion that the reported deaths from H5N1 and the extraordinaraily high Case Fatality Ratio (CFR; proportion of all infections that end fatally) was an over estimate due to underascertainment of infections that were mild, inapparent or just undiagnosed because they weren't severe enough to come to the attention of the medical care system. The reason for thinking this was that this is the pattern for most other infectious diseasesk, even serious ones like TB and cholera. Most of the infections are asymptomatic or at least undiagnosed. It is estimated that half of all seasonal flu infections are also asymptomatic. So this was expected to be true of H5N1 as well. But for some time there has been no or little evidence of the hypothesized "missing" cases. Every time we look hard for them we don't find them. The latest search was reported in the form of an abstract and oral presentation at the big flu meeting in Toronto. I'd like to say they have now been found. But I can't:

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Posted by dymaxion at 10:16 PM | Comments (0) | TrackBack

Indonesian Girl Hospitalized for Bird Flu

Indonesian health officials say a three-year-old girl is being treated
for bird flu.
Officials say the girl's condition has improved since she was admitted
to a hospital in Pekanbaru, on Sumatra island.
Health authorities say the girl tested positive for the H5N1 virus
after coming in contact with dead chickens.

Posted by dymaxion at 09:56 PM | Comments (0) | TrackBack

Egyptian boy tests positive for bird flu

A four-year-old Egyptian boy has tested positive for the H5N1 bird flu
virus, becoming the 37th human case in the Arab country, the official
Middle East News Agency reported on Saturday.
It quoted a health ministry statement identifying the boy as Emad
Mohamed el-Daramalli from the Upper Egypt province of Qena.

Posted by dymaxion at 09:55 PM | Comments (0) | TrackBack

Bird flu spreads in Bangladesh, more chickens culled

DHAKA, June 24 (Reuters) - Health workers in Bangladesh have culled
78,000 chickens over the past six days after bird flu spread to
another district in the north of the country, an official said on
The H5N1 strain of bird flu was first detected near the capital Dhaka,
in central Bangladesh, in March and has since spread to

Posted by dymaxion at 09:55 PM | Comments (0) | TrackBack

Potentially lethal H5N1 bird flu resurfaces in Europe

A bird flu scare in central Europe was spreading Wednesday as Czech
authorities said the H5N1 virus potentially lethal to humans had been
found in a flock of chickens after discoveries among wild birds in
The presence of H5N1 bird flu was confirmed on a poultry farm near the
village of Norin, just four kilometers (2.5 miles) from a farm where

Posted by dymaxion at 09:55 PM | Comments (0) | TrackBack

Bird flu confirmed in Togo

Independent tests carried out in Italy have confirmed the presence
for the first time of the deadly H5N1 strain of bird flu in poultry
from the west African nation of Togo, officials said Wednesday.
"The results of the tests from the world reference laboratory in Padua
have come in: it is clearly H5N1," said Agriculture Minister Yves

Posted by dymaxion at 09:54 PM | Comments (0) | TrackBack

June 21, 2007

Trying to solve the pandemic vaccine problem: too little, too late

One of the big issues over sharing of viral isolates from Indonesia was the contention, probably well justified, that the poor nations would be last in lie for any vaccine that might be available in the event of a pandemic. While a well matched vaccine has to await the emergence of a pandemic strain, there are good reasons to think vaccines made from pre-pandemic strains would provide some cross-protection, and such vaccines are already in production, although in small quantities.

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Posted by dymaxion at 09:53 PM | Comments (0) | TrackBack

Indonesia man becomes 80th bird flu victim

Via Reuters: Indonesia man becomes 80th bird flu victim-official. Excerpt:

A Indonesian man who slaughtered sick chickens and then ate them has died of bird flu, health officials said on Thursday, taking the country's human death toll to 80.

Bayu Krisnamurthi, the head of the country's commission on bird flu control, confirmed the latest death during a news conference.

Suharda Ningrum, of the health ministry's bird flu centre, said the man from Riau Province in Sumatra died on Tuesday.

He was admitted to the Arifin Achmad Hospital in Pekanbaru in Riau on Monday, hospital spokesman Nuzelly Husnedi said.

The spokesman said the man lived on a palm oil plantation in a remote area and had been in contact with sick fowl.

"He kept some chickens in his house. At least three died all of a sudden and he slaughtered the rest," said Husnedi, adding that the family then ate them and the man fell sick the next day.

"He suffered from high fever and had difficulty breathing."

Azizman Saad, head of the hospital's bird flu control section said the remaining family members were being monitored.

"His family has been examined and we are waiting for the results. So far, none have developed bird flu symptoms."

Posted by dymaxion at 09:51 PM | Comments (0) | TrackBack

Vietnam: "This is not going to go away"

Via Yahoo News, an AFP story: Vietnam bird flu death a call for action, say experts. Excerpt:

"This is not going to go away," said WHO's Vietnam communications officer Dida Connor, speaking before news of the human death. "There is a sense of complacency which is potentially catastrophic if it was to increase."

The human fatality, which brought the country's bird flu death toll to 43, followed several avian influenza cases across Southeast Asia last week.

On Thursday, Indonesia said a 29-year-old man had died of bird flu, bringing the death toll in the country worst hit by the virus to 80.

In Malaysia five people were quarantined with suspected bird flu, while Myanmar reported a fresh poultry outbreak.

Vietnam's unusual summertime outbreak, concentrated in the densely populated northern Red River delta region, follows the ending in March of a two-year ban on duck hatching that has triggered a surge in production.

Nationwide vaccination campaigns -- widely hailed as a model that other countries have sought to emulate -- have become increasingly spotty, Vietnamese and international animal health officials have warned.

"We've had bird flu for four years," said the UN Food and Agriculture Organisation's Vietnam bird flu specialist Jeffrey Gilbert. "Everyone's tired of it... but it's going on, and we are increasingly challenged to get these messages across to people that the risk hasn't gone away."

"People get very bored very quickly," he added.

"We can get the farmer to come in once or twice, but the third time he may see that it's not much of a priority anymore. He may not bother, or he may bring in 50 ducks and not bother to notify the authorities that there's another 150 (needing vaccination) still in the field."

The Vietnamese government's response to the young man's death is the subject of a story in Thanh Nien Daily.

Posted by dymaxion at 09:46 PM | Comments (0) | TrackBack

Saudis to shut down all live poultry outlets in Riyadh

Via TradeArabia.com: Clamp on live poultry outlets. Excerpt:

Municipal authorities in Riyadh have decided to shut down all the 385 stores that slaughter live poultry from July 26, a top municipality official said.

Soliman Al-Buthi, general manager of the Directorate General of the Environmental Health Department in the Riyadh Municipality, said the move was part of the precautionary measure to check the spread of bird flu and other diseases.

He said that live poultry shops would be given an ultimatum to close their businesses before the specified date or face forced closure.

“All live poultry outlets will be shut down starting from this July 28,” Al Buthi was quoted as saying in the Arab News.

The measures are part of necessary precautions being taken through a joint decision made by the Riyadh Municipality, the Ministry of Agriculture and the Ministry of Health to stop the spread of bird flu in the capital.

“The Ministry of Agriculture receives reports on bird flu, while our role is to determine the location of the report in the city. The Ministry of Health’s role is to later take the samples,” Al Buthi added.

Live poultry stores are used by those who wish to purchase fresh chicken that is slaughtered in front of them in the Islamic way.

The stores give customers the opportunity of choosing the size and shape of chickens before slaughtering.

Posted by dymaxion at 09:45 PM | Comments (0) | TrackBack

Ghana hit by third B2B outbreak

Via Myjoyonline.com: Bird flu hits Aflao.

About 1100 birds have been destroyed following the discovery of another case of the Bird flu disease at the border town of Aflao near Lome.

Officials of the Veterinary Service Department detected the virus after a poultry farmer in a community at Aflao took his sick birds to the Veterinary laboratory here in Accra to be tested. The birds reportedly started dying since last Wednesday but did not show any signs of the disease.

The Volta Regional Director of the Veterinary Services, Dr Ben Aniwa told Joy News measures have been put in place in Aflao to prevent the disease from spreading to other parts of the region.

He assured: “We have started the control measures. We have destroyed about 1100 birds and all other birds around the area. Our people are on high alert to make sure that the disease is put under control at the shortest possible time.”

The Volta region becomes the third region to be hit by the disease after it was discovered in Tema of the Greater Accra region and Sunyani in the Brong Ahafo region.

Posted by dymaxion at 09:41 PM | Comments (0) | TrackBack

US leads bird flu preparation efforts - report - Reuters AlertNet

US leads bird flu preparation efforts - report
Reuters AlertNet, UK - 4 hours ago
The H5N1 avian flu virus currently circulating among birds in Asia, parts of Europe and Africa is the No. 1 suspect. It is responsible for the death or ...
Bird flu found in Siberian ducks Science Daily (press release)
all 6 news articles

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

Czechs report first poultry H5N1 outbreak - CIDRAP

Dog Flu Diet and Diseases
Czechs report first poultry H5N1 outbreak
CIDRAP, MN - 3 hours ago
Jun 21, 2007 (CIDRAP News) – Agriculture officials in the Czech Republic today confirmed the country's first H5N1 avian influenza outbreak in poultry, ...
H5N1 bird flu virus confirmed in Czech Republic People's Daily Online
H5N1 bird flu virus confirmed in Czech Xinhua
H5N1 bird flu confirmed at Czech France24
Reuters India
all 46 news articles

Posted by dymaxion at 09:35 PM | Comments (0) | TrackBack

Indonesian bird flu Tamiflu resistant - Globe and Mail

Indonesian bird flu Tamiflu resistant
Globe and Mail, Canada - 12 minutes ago
TORONTO — An Australian researcher says H5N1 avian flu viruses from Indonesia are markedly less susceptible to the antiviral drug Tamiflu than a previous ...

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

Nearly 13% of Vietnam's waterfowls carry H5N1

Roughly 13 percent of waterfowls in Vietnam have bird flu virus strain
H5N1, local newspaper Labor reported Wednesday.
HANOI, June 13 (Xinhua) -- Tests show that nearly 21.7 percent of
waterfowls in capital Hanoi, 21.2 percent in northern Bac Ninh
province, and over 7.6 percent in northern Bac Giang province carry

Posted by dymaxion at 09:30 PM | Comments (0) | TrackBack

Myanmar reports new bird flu outbreak in private farm north of Yangon

YANGON, Myanmar (AP) -- Myanmar has detected the H5N1 bird flu virus
among chickens on a private farm, an official said Wednesday, marking
country's first outbreak of the deadly virus since April.
Than Hla, an official at the Livestock Breeding and Veterinary
Department, said the virus was detected in a small farm in Bago, 80

Posted by dymaxion at 09:30 PM | Comments (0) | TrackBack

Bangladesh authorities cull 7,000 chickens as bird flu spreads

NEW DELHI, June 18 (KUNA) -- Bangladesh authorities have culled 7,000
chickens as bird flu has spread to another district in the country.
The infected chickens were culled after bird flu was detected on two
farms in Jaipurhat district of Bangladesh, news agencies reported
Monday from capital Dhaka.
With this exercise, about 172,000 chickens have now been culled and

Posted by dymaxion at 09:29 PM | Comments (0) | TrackBack

Bird flu discovery closes Hong Kong market

Hong Kong has "temporarily" closed the city's popular bird market
after finding the H5N1 virus, or bird flu, in a starling in a shop
there, the government said.
Officials detected the virus in a fecal swab sample taken from a
Daurian starling in the bird market on June 4, the Agriculture,
Fisheries & Conservation Department said in a statement released late

Posted by dymaxion at 09:29 PM | Comments (0) | TrackBack

Dangerous Bird-Flu Virus kills Bohemian turkeys.

Dangerous Bird-Flu Virus kills Bohemian turkeys. Turkeys at the farm in Zalsi, east Bohemia, have been killed by the most pathogenic H5N1 bird flu virus that is dangerous to man, tests ... infected with H5N1 virus. Here is the link to Ceskenoviny CZ News:  http://www.ceskenoviny.cz/news/index

Posted by dymaxion at 09:28 PM | Comments (0) | TrackBack

Second Human Fatality in Vietnam

Second Human Fatality in Vietnam Via VietNamNet Bridge, 21/06/2007 A female patient from Nam Dinh has died as a result of the Bird-Flu H5N1 virus, at the National Institute for Transmitted ... protection, 1918, Turkeys, H5N1, Pandemic, vaccine, Poultry Factory Farms, Human Bird Flu, asymptomatic

Posted by dymaxion at 09:28 PM | Comments (0) | TrackBack

June 04, 2007

Vietnam: One confirmed human case, two suspected including a death

More bad news from Thanh Nien Daily: Vietnam reports another human bird flu case. Excerpt:

Vietnam confirmed a new human bird flu case Friday as the latest outbreak swept through 14 provinces within the last month.

A worker at a slaughterhouse in Hanoi had tested positive for the H5N1 virus strain, Nguyen Duc Hien, head of the National Institute for Tropical Diseases, said.

He was admitted to the institute May 26, just 12 days after starting to work at the abattoir. Hien said the man was recovering and his condition stable.

Director of Hanoi’s Bach Mai Hospital, Tran Thuy Hanh, said in the past two days two patients had been admitted with typical bird flu symptoms, one of whom had died Friday.

The hospital had taken samples from them for tests, she added.

So Vietnam has one more confirmed human case and two suspected cases including a death. Still more reasons for other countries to send their epidemiologists to Vietnam—not just to help, but to learn from their colleagues in the front lines.

Posted by dymaxion at 11:04 PM | Comments (0) | TrackBack

Bird flu spreads to 15th locality in Vietnam

HANOI, June 4 (Xinhua) -- Bird flu has hit Vietnam's northern Thai
Binh province, raising the total number of affected localities
nationwide to 15, according to a local veterinary agency on Monday.
The disease, on May 31, killed 10 ducklings and infected 80 others
in a total flock of 120 chickens and 650 ducklings raised by a

Posted by dymaxion at 10:53 PM | Comments (0) | TrackBack

A New Line of Defense Against Bird Flu -- Enserink 2007 (529): 3 -- ScienceNOW - on article in PLoS Medicine

A New Line of Defense Against Bird Flu -- Enserink 2007 (529): 3 -- ScienceNOW - on article in PLoS Medicine
Physicians may someday get an extra tool to deal with a global outbreak of bird flu in humans. In laboratory experiments, antibodies from patients who successfully battled avian influenza protected mice from the virus, researchers say in a paper published in this month's issue of Public Library of Science (PloS) Medicine. Although less practical than antiviral drugs, antibodies could provide crucial help, says Albert Osterhaus, a virologist at Erasmus Medical Center in Rotterdam, the Netherlands. Industrially produced antibodies are already used against a variety of diseases, including rabies and hepatitis A and B. But they may be useful in influenza as well. During the 1918 influenza pandemic, some doctors experimentally treated patients by transfusing them with blood products from recovered patients; a review study published last year suggested that such treatments may have cut mortality in half. For the new study, researchers at the Hospital for Tropical Diseases in Ho Chi Minh City, Vietnam, took blood samples from four patients as they recovered from infection with H5N1--the virus that causes avian influenza--in 2004 and 2005. Scientists at the Institute for Research in Biomedicine (IRB) in Bellinzona, Switzerland, then isolated the so-called memory B cells, which produce antibodies; using a special trick that employs the Epstein-Barr virus, they "immortalized" these cells to make them crank out antibodies indefinitely. Finally, researchers at the U.S. National Institute of Allergy and Infectious Diseases in Bethesda, Maryland, tested four of these antibodies in a mouse strain highly susceptible to H5N1 infection.

Posted by dymaxion at 10:53 PM | Comments (0) | TrackBack

Indonesian teenager dies of bird flu

Indonesian teenager dies of bird flu
An Indonesian girl from Central Java has died of bird flu, a health ministry official said on Friday.
Posted by ojcius to H5N1 AvianFlu INDONESIA on Sat Jun 02 2007 at 03:30 UTC | info

Posted by dymaxion at 10:51 PM | Comments (0) | TrackBack

China shares bird flu sample, first time in year-WHO

China shares bird flu sample, first time in year-WHO
China has shared human bird flu samples for the first time in more than a year, giving a boost to international efforts to track the deadly H5N1 virus and develop vaccines, the World Health Organisation said on Friday.
Posted by ojcius to H5N1 AvianFlu China on Sat Jun 02 2007 at 03:32 UTC | info

Posted by dymaxion at 10:51 PM | Comments (0) | TrackBack

FDA issues guidance on flu vaccine development - CIDRAP

FDA issues guidance on flu vaccine development
CIDRAP, MN - 5 hours ago
In April the FDA approved the nation's first human vaccine aimed at the pandemic threat posed by the H5N1 avian influenza virus. In a clinical trial, ...

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

China reports soldier died of bird flu: WHO - China Post

China reports soldier died of bird flu: WHO
China Post, Taiwan - 11 minutes ago
The soldier, surnamed Cheng, was diagnosed with the H5N1 virus on May 18 and had been receiving treatment at a military hospital. ...

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

Will First-Responders Show Up for Work During a Pandemic? Lessons From a Smallpox Vaccination Survey of Paramedics.

Disaster Manag Response. 2007 April - June; 5(2): 45-48
Mackler N, Wilkerson W, Cinti S

BACKGROUND: The presence of H5N1 influenza in Southeast Asia has reawakened fears of a worldwide influenza pandemic of the sort that occurred in 1918. It is estimated that up to 1.9 million people in the United States could die if such an outbreak occurs. It is unlikely that a vaccine for a pandemic strain will be available quickly enough to protect first-responders. Similar concerns existed in 2002 when the United States attempted to vaccinate first-responders against smallpox, a potential biologic weapon. METHOD: We conducted a survey of one group of first-responders, paramedics, to determine if fear of infection would compromise their ability to care for persons potentially infected with smallpox. RESULTS: Three hundred paramedics were given the survey, and 95 (32%) responded. More than 80% of paramedics polled would not remain on duty if there were no vaccine and no protective gear. Even if protective gear was available but the vaccine was unavailable, only 39% of respondents would remain on duty. Finally, although 91% of paramedics would remain on duty if they were fully protected, this number falls to 38% if the respondent believed that his or her immediate family was not protected. The results of this survey are relevant to current concerns about an influenza pandemic. Every effort must be made to protect first-responders from pandemic influenza and educate them about it.

Posted by dymaxion at 10:41 PM | Comments (0) | TrackBack

Vaccines in development against avian influenza.

Minerva Med. 2007 Apr; 98(2): 145-53
Cox MM

Avian influenza has become a high priority item for all public health authorities. An influenza pandemic is believed to be imminent. The only questions are what will be the causative agent and when will it happen. Recently, most attention has been directed to human cases of avian influenza caused by an H5N1 avian influenza virus. An effective vaccine will be needed to substantially reduce the impact of an influenza pandemic. Despite the fact that the current influenza vaccine manufacturing technology is not adequate to support vaccine production in the event of a pandemic influenza outbreak, most of the ongoing clinical development is occurring with vaccines made in embryonated chicken eggs. It is clear that innovative production technology is required. This review provides an update on the status of avian vaccine development. In addition available manufacturing technologies are presented, some of which could be more suitable to adequately respond to an emergency situation where billions of doses of vaccines would be required within a very short period of time. The review is concluded with some proposed areas of focus for pandemic vaccine preparedness.

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

The origin and virulence of the 1918 "Spanish" influenza virus.

Proc Am Philos Soc. 2006 Mar; 150(1): 86-112
Taubenberger JK

The "Spanish" influenza pandemic of 1918-19 caused acute illness in 25-30 percent of the world's population and resulted in the death of up to an estimated 40 million people. Using fixed and frozen lung tissue of 1918 influenza victims, the complete genomic sequence of the 1918 influenza virus has been deduced. Sequence and phylogenetic analysis of the completed 1918 influenza virus genes shows them to be the most avian-like among the mammalian-adapted viruses. This finding supports the hypotheses that (1) the pandemic virus contains genes derived from avian-like influenza virus strains and that (2) the 1918 virus is the common ancestor of human and classical swine H1N1 influenza viruses. The relationship of the 1918 virus with avian influenza viruses is further supported by recent work in which the 1918 hemagglutinin (HA) protein crystal structure was resolved. Neither the 1918 hemagglutinin (HA) nor the neuraminidase (NA) genes possess mutations known to increase tissue tropicity that account for the virulence of other influenza virus strains like A/WSN/33 or the highly pathogenic avian influenza H5 or H7 viruses. Using reverse genetics approaches, influenza virus constructs containing the 1918 HA and NA on a modern human influenza virus background were lethal in mice. The complete 1918 virus was even more virulent in mice. The genotypic basis of this virulence has not yet been elucidated. The complete sequence of the non-structural (NS) gene segment of the 1918 virus was deduced and also tested for the hypothesis that enhanced virulence in 1918 could have been due to type I interferon inhibition by the NS1 protein. Results from these experiments suggest that in human cells the 1918 NS1 is a very effective interferon antagonist, but the 1918 NS1 gene does not have the amino acid change that correlates with virulence in the H5N1 virus strains identified in 1997 in Hong Kong. Sequence analysis of the 1918 pandemic influenza virus is allowing us to test hypotheses as to the origin and virulence of this strain. This information should help elucidate how pandemic influenza virus strains emerge and what genetic features contribute to virulence in humans.

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