10/13/07-10/19/07|Weekly Bird Flu Thread:Indonesia Confirms 88th Fatality

Link to Last Weeks Thread:

HEALTH - 10/6/07-10/12/07|Weekly Bird Flu Thread:H5N1 mutates, more infectious to humans

http://www.timebomb2000.com/vb/showthread.php?t=260043

Johns Hopkins on influenza:

http://www.iom.edu/Object.File/Master/33/450/Rashid Chotani.pdf

National Avian Influenza Surveillance Information:

http://wildlifedisease.nbii.gov/ai/

CDC

http://www.cdc.gov/flu/avian/index.htm

WHO

http://www.who.int/csr/disease/avian_influenza/en/index.html

CIDRAP

http://www.cidrap.umn.edu/

Official U.S. Government Web site

http://www.pandemicflu.gov/

FAO

http://www.fao.org/ag/againfo/subjects/en/health/diseases-cards/special_avian.html

Public Health Agency of Canada

http://www.phac-aspc.gc.ca/influenza/avian_qa_e.html

European Union

http://ec.europa.eu/dgs/health_consumer/dyna/influenza/country_en.htm

The World Bank

http://web.worldbank.org/WBSITE/EXT...68427~piPK:64168435~theSitePK:1793593,00.html

Indonesia Confirms Death of Boy From Bird Flu, 88th Fatality ​

http://www.bloomberg.com/apps/news?pid=20601087&sid=aI5YCCy4u7qs&refer=home

By Claire Leow

Oct. 13 (Bloomberg) -- Indonesia, with more fatalities from a deadly strain of avian influenza than any other country, confirmed a 12-year-old boy died this morning from the virus, making it the country's 88th fatality.

The boy, known by his initial ``I,'' died at Persahabatan Hospital in east Jakarta, Noordin, a duty officer at the Health Ministry, said in a telephone interview.

The boy's family lives in Tangerang, outside Jakarta, and a team from the ministry is meeting with the family and investigating the circumstances, he added.

The H5N1 virus is known to have infected 330 people in a dozen countries since 2003, the World Health Organization said on Oct. 8. Three of every five cases have been fatal. Millions may die if H5N1 develops the characteristics of seasonal flu and begins spreading easily between people, touching off a global outbreak, according to the Geneva-based agency.

Bird flu, pig disease return to Mekong Delta as weather cools​

http://vietnamnews.vnagency.com.vn/showarticle.php?num=02HEA131007

(13-10-2007)

HCM CITY — Bird flu is recurring in the Mekong River Delta as the weather turns from hot to cold in the last months of the year, according to the region’s animal health officials.

The Animal Health Department on Thursday said of the 300 ducks on a farm in Tra Cu District, Tra Vinh Province, five dead ducks had been tested positive for the deadly H5N1 virus.

The flock had come from different places, and had not yet been vaccinated.

Local veterinary workers culled infected water fowl immediately after the blood test results, and quarantined the affected area to prevent the spread of the virus.

The National Steering Committee for Avian Flu Control and Prevention is urging provinces and cities nationwide to promote vaccinations for poultry to stem the spread of the virus.

Bird flu broke out in Viet Nam in May, ravaging provinces across the country. In September, Tra Vinh Province was the last locality in the Mekong region to be declared free of the virus.

Pig disease

Local animal health workers in Ca Mau City in the Mekong Delta Province of Ca Mau on Thursday destroyed nine pigs infected by pig disease to prevent its outbreak in the city and surrounding areas.

Over the last three weeks, local animal health workers in Ca Mau City culled 56 sick animals and collected blood samples for testing.

Medically called Porcine Reproductive and Respiratory Syndrome (PRRS), this blue ear disease first struck the central provinces of Quang Nam, Quang Ngai and Da Nang City in late June.

The disease then broke out in the Mekong Delta Province of Long An in late July. Local veterinarians have destroyed 32 out of 40 infected pigs on a farm in Can Giuoc District.

In the last two days, local veterinarians in Khanh Hoa Province’s districts of Dien Khanh, Cam Lam, and Ninh Hoa and Nha Trang City culled 270 pigs infected by the disease.

As of October 11, Khanh Hoa, Ca Mau and Lang Son Provinces were reportedly still trying to control the disease—VNS

Concern for bird flu increases among researchers​

http://media.www.dailyvidette.com/m...Flu.Increases.Among.Researchers-3031086.shtml

Andrew Cross
Issue date: 10/15/07 Section: News


H5N1, avian influenza, bird flu. Call it what you want, it is back in the news again.

H5N1 is the subtype of the Influenza A virus that causes illness in humans and some other species of animals.

The virus has killed tens of millions of birds worldwide and is slowly spreading to humans.

Some researchers claim to have found proof of human to human transfer, and experts believe the latest mutation could pose deadly for millions of humans.

The bird flu has killed hundreds of people since 2003, but that number is predicted to rise dramatically in years to come.

Three conditions must be met in order for a virus to be considered a pandemic.

A new influenza subtype, for which there is little or no immunity, must emerge. This subtype must be able to cause illness to humans, and the virus must spread easily among humans.

Louis Brown is the director of the Nevada State Health Laboratory and an associate professor of pathology and laboratory medicine at the University of Nevada School of Medicine.

"H5N1 has not established efficient and sustained human-to-human transmission," Brown said.

Brown explained that unless this particular strain of virus changes or mutates, it is unlikely to be considered a pandemic. He went on to say that a mutation of the virus could encourage communicability.

A recent study by the University of Wisconsin-Madison determined that the bird flu has mutated and now has the ability to develop in the upper respiratory system of humans.

Researchers discovered small but significant changes in the virus that may allow it to infect more cell types and spread more easily.

Warmer temperatures found in the lungs facilitate the development of the virus.

According to Brown, the latest mutation could result in "efficient human-to-human transmission due to droplets spread from coughing and sneezing."

Robert G. Webster is the director of the World Health Organization Collaborating Center on the Ecology of Influenza and Viruses in Lower Animals and Birds and a world renowned expert on the avian flu.

The bird flu originally struck individuals in close contact with chickens and other birds.

"Previously most avian viruses were transmitted through the feces," Webster said.

"In the chicken the virus can be transmitted from bird to bird in respiratory secretions. Influenza viruses in chicken houses and in live poultry markets can be transmitted through the air," Webster continued.

Some experts believe that as an increased number of humans and animals are exposed to the virus, it will continue to mutate and could possibly become a pandemic.

Korea to implement special bird flu preventative measures beginning in November​

http://www.kois.go.kr/News/News/NewsView.asp?serial_no=20071015010

Korea plans to tighten oversight and enforce countermeasures to prevent the outbreak of bird flu during the winter months, the Ministry of Agriculture and Forestry said Monday (Oct. 15).

The plan, which goes into effect on November 1 and will be enforced through February, focuses attention on getting poultry farmers to exercise greater caution in protecting their feed and birds. The four-month period coincides with the arrival of migratory birds that have been cited for causing the avian disease.

"Of the seven cases of bird flu outbreaks reported last year, four involved contamination caused by the farmer entering coops wearing regular boots and shoes," said Kim Chang-seob, the ministry's chief veterinary officer.

He said authorities have told all poultry farmers to prepare special "decontamination" footwear that should only be worn inside coops, and to properly cover feed they give to their chicken and ducks so that migratory or wild birds that may have the bird flu virus cannot contaminate the food source.

To enforce these rules, Kim said farms that do not follow the new safety procedures and consequently report a bird flu outbreak will not be entitled to full compensation for birds culled.

He, also said farms that report the suspicious deaths of animals quickly will be given a reward of 1 million won ($1,090).

The official, in addition, said 14 regions that have been hit repeatedly by the bird flu will come under special scrutiny this year, with inspectors paying daily visits. These include a bird sanctuary for migratory birds, and poultry farms.

If a bird flu case is reported, the government quarantines an area up to 3 kilometers around the suspected site and destroys all birds that could have contracted the disease. Movement of chickens and ducks from the region and the surrounding area will be forbidden for at least 30 days.

The country has been hit by a bird flu epidemic twice in the winters of 2003 and 2006. In the last outbreak Seoul spent 58.2 billion won ($63.4 million) to compensate farmers for culled animals.

Nine million ducks and 70 million chickens are farmed domestically in Korea.

No Korean has yet contracted bird flu, but 202 people from 12 countries have perished from the disease.

Turkey adopts action plan against bird flu​

http://www.todayszaman.com/tz-web/detaylar.do?load=detay&link=124735

Turkey, not completely immune to any relapse of bird flu outbreaks because it lies on the flight path of migratory birds, has spurred into action to take measures against possible bird flu cases and three ministries -- health, environment and agriculture -- have drafted an emergency action plan to fight against the threat posed by migratory birds.

Three ministries have drafted an emergency action plan to fight against the threat of bird flu posed by migratory birds.

Officials from the Ministry of Health have announced that they have launched joint researches and studies with the Ministry of Environment and the Ministry of Agriculture to avert any possible bird flu cases. Ministry officials, afraid of encountering the bird flu -- a contagious disease spread by animals and caused by viruses that normally infect birds and less commonly pigs, but cross the species barrier to infect humans on rare occasions -- that claimed the lives of hundreds of people all around the world last year, have taken action to introduce protective measures against the disease with a credit of some $22 million contracted from the World Bank and a donation of 6 million euros granted by the European Union. The virus, identified as H5N1, was first discovered at a farm near Manyas, just south of the Marmara Sea, and the country was cleared of the threat of the disease after imposing quarantine and killing more than 10,000 birds at the site where it was originally found. The three ministries aim to conduct national operations against bird flu in Samsun, which is frequented by migratory birds, and determine an action plan to be adopted for the fight against H5N1.

Exercises will be held in a town near the Kızılırmak Kuş Cenneti (Bird Paradise) from Oct. 16 to 19 and conducted by around 65 experts from the Protection and Control Directorate-General. Approximately 50 veterinarians from provinces where chicken raising is common will take part in the exercise and will attend a seminar on bird flu; an imaginary scenario will be developed to show the participants what will be done in the event of an outbreak. Related ministries and provincial directorates will establish a National Center for Disease Crisis in the town to discuss the problems encountered throughout the exercise. The exercise, that aims at dismissing the bird flu threat within the shortest possible time, will also be observed by the United Nations, an EU delegation, the World Bank and the Food and Agriculture Organization.

Summit set to tackle possible flu epidemic​

http://www.themorningsun.com/stories/101607/loc_flu.shtml

By Rosemary Horvath
Sun Staff Writer

Pandemic influenza authority Dr. Arnold S. Monto will be the keynote speaker at a summit in Alma on Oct. 23 designed to prepare the general public and professionals in the public service, business and health areas.

The deadline to register is Friday.

Sponsored by the Mid-Michigan District Health Department, the summit is the second in a series of educational sessions to increase understanding of the threats and implications of an influenza pandemic.

"The most resilient communities are the ones that plan and work together," Health Officer Kim Singh said.

The health department district includes Gratiot, Montcalm and Clinton counties.

A pandemic influenza coordinating committee was an outgrowth of a summit held in 2006 to discuss avian flu, more commonly known as the "bird flu."

"The thought was that the bird flu would be the cause of our next pandemic," Singh said. "There is still that potential but a pandemic may be from a different strain altogether."

Monto is professor of epidemiology at the University of Michigan School of Public Health. He travels through continents sharing knowledge and research on prevention and treatment of influenza, respiratory infections and infectious disease.

His base has been Ann Arbor since 1965, when he joined the Tecumseh Study, a large-scale, long-range epidemiological experiment to measure and understand the chronic and acute disease dynamics of the Michigan community.

His lab is currently involved in a large study called Flu-Vacs that is comparing the effectiveness of a traditional killed-virus flu shot to the attenuated-virus nasal spray.

More than 2,000 healthy adults in Mt. Pleasant, Ann Arbor and Livonia were given a shot, a nasal spray, or a placebo and then monitored to see whether they become infected and how their antibody levels respond.

A pandemic influenza "is not a question of if, but when" is the theme of the summit.

There have been three pandemics in the last century Singh said.

"Look at history and the timing of them," she said. "There is a cycle for pandemics. Pandemics are expected to continue. Viruses can mutate and change. What we currently have vaccines for would not address the new viruses."

Singh said the committee’s goal is to be prepared.

"It’s human nature to be complacent," she said. "This is an opportunity to expand our knowledge. The first summit gave basic information. This one has a world renown physician that specializes in influenza and respiratory illnesses."

The program includes a panel discussion featuring officials from the Michigan Department of Education, Michigan State Police, Michigan Department of Community Health and Michigan Department of Transportation.

Breakout sessions in the afternoon will focus on emergency management, school, household and business preparation.

Already signed up to attend are 80 members of the business community, chambers of commerce, community organizations, first responders, government and religious leaders and health professionals.

The summit lasts from 8:30 a.m. to 3 p.m. at Masonic Pathways on Wright Avenue. There is no charge to attend. Lunch will be served.

this is interesting, and I would like to attend, but Alma is a ways away for me for sure.

Flu biology: receptors, I​

http://scienceblogs.com/effectmeasure/2007/10/flu_biology_receptors_i.php

Category: Bird flu • biology
Posted on: October 16, 2007 5:22 AM, by revere

The need for better information about the science of avian influenza is urgent. But science is a slow process, or at least slow relative to an urgent time scale, even in times of rapid advances in technology. Even so, while we are waiting for the other shoe to drop, we continue to learn and unlearn about the influenza virus. One major gap has been understanding where humans have cells with receptors for bird flu viruses. A new paper published online last week in The FASEB Journal is finally providing some information. As usual, it is both informative and confusing. To understand what it is and is not saying we'll need to do a little review of the biology. We'll do this in two parts. The second post, tomorrow, will provide details of the FASEB paper (FASEB is the Federation of American Societies for Experimental Biology).

First a review:

Host cells (in this case, human cells) don't usually sit around naked. They've got clothes on. We explained this in excruciating detail in a series of posts earlier (see here, here, here and here). Here's a short recap. The raw cell surface (its bare skin, so to speak, the cell membrane lipid bilayer) is clothed with a "lawn" of hairy protein threads sticking from and through it. The proteins are decorated with complex sugars (collectively called glycans) and the combination is called a glycoprotein. The sugars can be of different kinds and can be attached in different ways. Thus cells that would otherwise look pretty much the same when naked (a bag made of cell membrane) can look very different when clothed. This is an interesting biological tactic, so let's pause for a minute to consider it (just for fun).

All cells have the same genetic endowment, encoded in their DNA. What makes one cell different from another is its ability to turn some of the genes that make proteins on or off in various combinations. The genes make proteins by translating the code sequence into an amino acid sequence. A protein is just a bunch of amino acids strung together. Since there are a lot of genes there are a lot of possible combinations, too, most of which are non functional or never used. But what's left is more than enough to produce lots of different kinds of cells, even though they are all starting with the same inventory of genes. They employ the same genes but in different ways.

It turns out that's only a fraction of the information space available to cells. People don't (usually) sit around naked either. We wear clothes. Our choice of clothes is usually not genetically determined but responds to things that occur in and around us. I'll just leave it at that. And just like people after they are born, cells can put on all sorts of clothes. The change in appearance from wearing a different set of clothes is called post-translational modification. It occurs without any change in the genetic sequence or its expression by translation into proteins. Adding complex sugars to proteins produces the most abundant source of post-translational modifications we know of, enormously increasing the "information space" available to a cell. What does this have to do with pandemic influenza?

The different sugars that decorate the proteins on the cell surface and the specific way they decorate that surface are the ways that things outside the cell tell one kind of cell from another. This ability is biologically important. It is the way other cells or hormones, for example, are able to interact with a particular cell. But pathogens, like viruses, bacteria and fungi have co-evolved to exploit those same recognition markers for their own purposes, just like a burglar uses a window you use to look out or provide fresh air to get in. In particular, the influenza virus looks for cells with a specific sugar attached in a specific way, and when it encounters it as it is randomly floating around, it sticks to it, initiating further processes which result in the virus being taken into the cell. The glycoprotein the virus sticks to is called the receptor (as is the part of the virus that sticks to it).

The sugar the flu virus sticks to is one of a family of sugars with 9 carbons called a sialic acid. Sialic acid is bigger than glucose or simple sugar but smaller than the 12 carbon table sugar. The latter, however, is really two smaller 6 carbon sugars stuck together while sialic acid is a single sugar. While sialic acids are sometimes found on their own in nature, they are usually found attached to other sugars which in turn are attached to proteins to make glycoproteins (that is, they are articles of cell clothing). You can look in the earlier posts whose links are above for an explanation of the terminology, but the short version is this. Flu viruses from birds like sialic acids that are attached via something called an α2,3Gal linkage, while those more adapted to humans stick to sialic acids attached through an α2,6Gal linkage. Think of it as one liking cells with blue shirts and another liking cells in red shirts (no political implication intended). The assumption together with some supporting evidence has been that birds have cells with α2,3Gal and humans with α2,6Gal, which explains why bird viruses infect birds and usually not humans and vice versa. Pigs, it turns out, have both kinds of cells in their tracheas (windpipes), which gave rise to the "pig as mixing vessel" story of pandemic flu emergence. The pigs get co-infected and the bird and human viruses mix, producing hybrid new combinations with human liking receptors but bird infection characteristics. Presto. Pandemic. Except it doesn't seem to be that simple.

The underlying assumptions are two: that humans don't have α2,3Gal receptors in their respiratory tract or anywhere else accessible to an avian flu virus; and that without the matching receptor there won't be an infection. Neither of these seems to be true. Taking the second one first, we know that α2,3Gal liking virus can infect cells with α2,6Gal receptors, although they probably do this less easily. But maybe not, in some cases. The other assumption is also in question because we don't really have good information about what sialic acid linkages appear on human cells and which ones.

Influenza B virus offers pandemic clues​

http://www.upi.com/NewsTrack/Science/2007/10/16/influenza_b_virus_offers_pandemic_clues/5031/

Published: 16, 2007 at 10:46 AM
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HOUSTON, Oct. 16 (UPI) -- U.S. scientists say the structure of a protein on the influenza B virus offers clues about mutations that might result in a flu pandemic.

Researchers at the Baylor College of Medicine and Rice University compared the protein, called hemagglutinin, with a similar protein found on the surface of the influenza A virus.

Assistant Professor Qinghua Wang , Associate Professor Jianpeng Ma, and colleagues said the comparison might be key to understanding the changes that must occur before avian flu -- a form of the influenza A virus -- mutates to a form that can easily infect humans, said Ma, who holds a joint appointment at Rice.

Ma and Wang have identified a particular residue or portion of the protein that might play a role in how different types of hemagglutinin bind to human cells.

The complex study is presented in the early online edition of the Proceedings of the National Academy of Sciences.

Millions at risk as flu pandemic conditions ripen in China, health official warns​

http://www.interfax.cn/displayarticle.asp?aid=28684&slug=FLU-PANDEMIC-OUTBREAK

hanghai. October 16. INTERFAX-CHINA - A Chinese health official with the China Center for Disease prevention and Control (China CDC) warned yesterday that China is increasingly at risk of influenza pandemics that could see almost 200 million people infected in China, according to domestic media.

Models based on previous pandemic influenza outbreaks in China, and taking into account current conditions across the populous nation, forecast 177 million to 197 million Chinese people infected, with predictions ranging between 460,000 and 6.95 million deaths if China is hit by a flu pandemic now, Feng Zijian, director of the emergency treatment office of the China CDC told the 2007 Conference on Flu Vaccination and Training for Community Health Center Doctors, held in Guangzhou, the Guangzhou Daily reported.

Experts at the conference emphasized that the risk of pandemic-level influenza outbreaks has been increasing since 2003. "Around the globe we are seeing a greater number of bird flu outbreaks, each one enhancing the risk of bird flu, an influenza A strain virus, being transmitted to humans," Zhong Nanshan a member of the Chinese Academy of Engineering, who is well known for his work in SARS treatment, said.

Zhong said that Luohu type flu virus, which is prevalent in Guangdong, is a variant of the influenza A/Solomon Islands virus. The Luohu strain is not a 100 percent match with vaccines for the strains recommend by the WHO, but the present vaccines are still effective in preventing influenza. Zhong explained that strains of influenza in China have never precisely matched WHO-recommended vaccines, though the efficacy of those vaccines in treating flu in China has never been compromised.

Zhong said that flu vaccination can reduce mortality rates due to flu by more than half, and appealed to people in all high risk groups, such as the elderly, young and ill, to be vaccinated as soon as possible in preparation for the onset of the flu season.

Kids' hygiene crucial to curb flu pandemic​

http://www.onmedica.net/content.asp?c=40730&t=1

16 Oct 2007
OnMedica Staff

Washing handsEfforts to contain a bird flu pandemic or another eruption of Severe Acute Respiratory Syndrome should focus on making sure that children wash their hands regularly, concludes an analysis of published research.

Around one in ten to one in seven people go down with flu every year, and in the event of a pandemic one in every two people is likely to be infected.

While vaccines and antiviral drugs have their place, these may not be widely available, and other more universal measures may need to be applied, say the authors of the Cochrane Review.

The findings are based on 51 studies out of an initial trawl of more than 2,000, and although of variable quality, the key message to emerge was that simple hygiene is very effective.

One of the most effective methods of containing the spread of respiratory disease is to curb the spread of infection from young children to other household members, the evidence suggests.

This is important, because young children are less capable of maintaining good hygiene themselves

Two studies reported that repeated hand washing among children cut new cases of colds by as much as 20%.

Another study suggested that the addition of an alcohol rub to hand washing cut school absenteeism by 43%.

Other research on the prevention of SARS suggests that thorough cleaning of household facilities and regular hand-washing several times a day also worked extremely well.

Isolation techniques, good hygiene and simple surgical masks, rather than the more expensive variety, also seem to be effective, the evidence shows. It was unclear whether adding antiseptics to hand-washing had much impact.

And too little research had been carried out on the value of screening at international ports of entry or closing off certain areas to draw any valid conclusions, say the authors.

HEALTH-ASIA: Four Years On Questions Hover on Bird Flu ​

http://www.ipsnews.net/news.asp?idnews=39672

CHIANG RAI, Thailand, Oct 16 (IPS) - Four years after the first outbreak of avian flu, experts say many key questions hover around the disease: what kind of contact between fowl and humans leads to its transmission to people, and how effective can poultry vaccination really be.

The H5N1 strain of avian flu, which has led to the culling of millions of birds and poultry with compensation payments to farmers running into millions of dollars, is now adjudged to be endemic in places like Indonesia and Vietnam.

In truth, "there are still huge gaps in our knowledge of the virus", explained Richard Brown, public health specialist from the World Health Organisation (WHO) in Bangkok.

"The outbreak has gone on for a long time (since 2003), but there are no breaking developments in the research of the virus," he said at a discussion on the cross-border challenges of avian flu at a workshop for journalists in the Mekong region here recently.

As of Oct. 12, 2007, 331 human cases of avian flu in 12 countries in East Asia, Europe and Africa have been reported to the WHO. Of these, 203 have resulted in deaths. Indonesia has been the worst-hit with 87 deaths out of 109 cases, or a mortality rate of 80 percent.

Unresolved questions include at exactly what stage do humans get infected with avian flu -- on handling the sick birds, or from eating birds that were sick and died?

There is not enough knowledge about individual human cases of avian flu which have occurred at different times of the year and in different places, Brown explained. Not even the incubation period among humans -- which WHO officials put at between two to 10 days -- is certain.

Media reports focus on what might happen if the virus mutates to become freely transmittable to and among humans, and many predict huge numbers of deaths if this happens.

In terms of death statistics so far, human avian influenza is not a huge public health issue. As Brown put it, there are 40 million people living with HIV around the world. More people die of traffic accidents in Vietnam than of avian flu.

But a mix of fear, disaster and the unknown makes avian flu a topic of concern. Other factors add to this -- that avian flu marks the arrival of a new emerging infection has a large impact on the poultry industry, a high mortality rate, and the potential to cross national boundaries.

"There was a perception of a dangerous virus moving with ease through the region, and predictions of gloom and doom rapidly made the outbreak news," Brown said. "The prediction of a pandemic created a fertile ground for speculation and rumours."

In the case of Severe Acute Respiratory Syndrome (SARS) in 2002-03, after the initial panic there was soon a lot of information to identify risk factors linked to it. But this has not happened with avian flu, added Brown, who was also involved in addressing SARS in China.

Brown emphasised the importance of the availability of reliable information, likening the spread of rumours to a pandemic. "The truth becomes distorted and, like a virus, becomes mutated," he said.

There also remain different views on key aspects of the avian flu issue, such as the role of wild birds and the impact of vaccination of poultry against avian flu.

While Brown said that wild birds are unlikely to have a big role in spreading avian flu, Parntep Ratanakorn of Mahidol University said at the same seminar that he thought otherwise.

Different countries have also chosen different responses to avian flu. The fact that Thailand’s neighbours, China and Vietnam, vaccinate their poultry has put this country’s ban on vaccination under closer scrutiny.

Thailand has avoided vacciantion, largely because it is among the largest exporters of poultry products -- and vaccinated products cannot be exported. Over 90 percent of Thai poultry exports go to the European Union. The country earns some one billion dollars a year from exporting more than 300,000 tonnes of cooked and semi-cooked chicken meat.

The stagnation in research can be traced to countries’ unwillingness to share information, especially when they see themselves as losing face if an outbreak occurs.

In previous outbreaks in Thailand, some blamed neighbouring Laos for being the source of avian flu. At one point, this led to a postponement of a senior officials’ meeting to discuss bird flu.

The vaccination question is not a black-and-white issue, explained Christine Ahlers, animal production officer from the Emergency Centre for Transboundary Animal Diseases of the U.N. Food and Agricultural Organisation (FAO).

Parntep added that the decision to use vaccination entails not just the actual use of vaccines on birds, but monitoring its use well, deciding and controlling in which outbreak areas to use them.

If a country can do all these things, apart from undertaking bio-safety measures in poultry farms, then it can be a viable option, he explained.

"Vaccination is not the final solution to controlling avian flu," Ahlers said. "By vaccinating you prevent them from getting sick, but not from carrying the virus." This is why vaccinated poultry meat is unexportable, because the virus can still be spread through such meat.

Vaccination is a "useful tool to control avian flu in areas where it is endemic," but it alone cannot eradicate the virus, she explained. She believes that if outbreaks of avian flu are sporadic, eradication is still the best option.

Roche Drops As Tamiflu Sales Wither​

http://www.forbes.com/home_asia/mar...miflu-markets-equity-cx_po_1016markets08.html

LONDON -

Fears of bird flu have apparently diminished, taking a bite out of Roche Holding's sales, but the Swiss pharmaceuticals maker's weak revenue outlook and subsequent stock-market tumble on Tuesday seem to have created a buying opportunity for long-term investors.

Revenue for the first nine months of the year rose 12%, to 33.9 billion Swiss francs ($28.6 billion), marking a decline from the corresponding period last year, in which sales rose 19%. Analysts had expected sales for the first nine months of 2007 to run 33.97 billion Swiss francs ($28.69 billion) to 34.63 billion Swiss francs ($29.24 billion).

On Tuesday afternoon in Zurich, Roche stock was down 2.7%, or 5.80 Swiss francs ($4.90), at 210.90 Swiss francs ($178.10).

A decline in demand for Tamiflu, widely seen as the best defense against bird flu, is part of the problem. Last year the World Health Organization called Tamiflu's little golden capsules its "primary recommended antiviral of choice" in managing patients infected with the H5N1 bird flu virus. It prompted a number of governments to quickly stockpile the drug, and that boosted Roche's shares.

Roche (other-otc: RHHBY - news - people ) said that Tamiflu sales had peaked, with revenue having dropped 2% over the first nine months and 60% in the third quarter, year-on-year -- but it added that it had expected the drop off.

The Basel-based drug-maker also confirmed its 2007 guidance, saying it expected sales to grow at double-digit rates in local currencies. Its pharmaceuticals division, which brings in the lion's share of profits, grew 13%, to 27.12 billion Swiss francs ($22.90 billion), more than twice the global market growth rate.

Rival Pfizer (nyse: PFE - news - people ) has by contrast seen its sales growth eroded by the onslaught of cheaper generic drugs, along with the loss of U.S. patent protection on some of its hottest drugs.

Given the reaction to Tuesday's figures from Roche, now might well be a good a time as any to invest in the Swiss firm. Helvea analyst Andrew Fellows has a "buy" rating on the stock, and a price target of 305 Swiss francs ($257.51). He called the big decline in Tamiflu sales a "red herring," which was distracting investors from what actually looked like a promising future for the drug maker.

"The company is going to deliver good top-line growth in pharmaceuticals over the next five years," he said. "They have a very strong franchise of oncology, half a dozen key drugs in that area, and outside that they have probably the strongest pipeline of late stage drugs in the sector."

Roche said on Tuesday that it had received a "positive market response" to its European launch of the cancer drug Avastin, which was developed by its American subsidiary Genentech (nyse: RNA - news - people ), and that the early uptake for Mircea, which was recently launched in the EU as an anaemia treatment, was "encouraging."

At first glance, Roche's sales growth appears to have waned. Having seen sales grow 16% in the first quarter, the rate declined to 14% in the second quarter and 12% in the third. But Fellows said the figures were still "very strong," and that the huge growth rate in the first quarter, boosted by a strong increase in key drugs, had been at an "unsustainable level anyway."

The big challenge for Roche now was to successfully deliver the late-stage compounds it had in the pipeline, which included two in diabetes and one in degenerative disease dyslepidemia. "They need to deliver good results in those products," said Fellows.

6 bird flu "areas of concern" identified in Negros Occidental​

http://www.pia.gov.ph/default.asp?m=12&fi=p071017.htm&no=13

Bacolod City (17 October) -- Six areas in Negros Occidental were identified as prone to Avian Influenza.

These are the cities of Cadiz, Escalante, Sagay, Himamaylan, Bago and the town of San Enrique.

Remelyn Recoter, Department of Agriculture in Region 6, technical director for operations, said these places are "areas of concern" for bird flu because migratory birds were often seen here.

Recoter said Western Visayas ranks third in poultry production in the country. It contributes 40 percent of the total national production.

Recoter noted the reported 87th death recently due to bird flu in Indonesia, where 80.55 percent are fatalities out of reported cases, and is followed by Thailand, with 68 percent mortality, China and Vietnam.

Prescilla Duque, OCD, executive officer said that in Southeast Asia, the Philippines, Singapore and Brunei are the only countries that still free of Bird Flu. Dr. Melvin Ibanez, SP member and chair of the SP committee on health stressed the need for vigilance on the reporting of any illegal activities, sudden deaths or increase in poultry mortality because of limitations in surveillance system.

http://www.thejakartapost.com/detailcity.asp?fileid=20071017.C06&irec=1

Multa Fidrus, The Jakarta Post, Tangerang

Tangerang regency in Banten province has recorded five deaths from bird flu after the latest victim, a 12-year-old boy, died from the virus on Oct. 13.

The regency health agency's head of communicable disease prevention, Yuliah Iskandar, told The Jakarta Post on Tuesday the boy, a resident of Ceger village in Sepatan district, had suffered high fever from Sept. 30 but was only admitted to Tangerang General Hospital on Oct. 8.

The boy, identified only as Ir, was then transferred to Persahabatan Hospital on Oct. 9 under suspicions he had contracted bird flu.

Ir had shown symptoms of fever, leucopenia (a decrease in the number of white blood cells), thrombositopenia (a decrease in the number of platelets in the blood) and pneumonia (an infection of the lung that causes respiration problems).

The Health Ministry's research and development center confirmed a day later the boy had been infected by the H5N1 virus.

"He was brought here last Tuesday and placed directly in the special care unit for bird flu patients. He died on Saturday," said an on-duty nurse at the hospital.

Yuliah said the agency had taken blood samples from the victim's family members and his neighbors to be tested at a Health Ministry laboratory, with the results to be announced within three days.

Yuliah said the victim and his family had not had direct contact with live poultry and birds near the house in the village, but there was a poultry-breeding business some 500 meters away from the victim's house.

"We have assigned a team to investigate the source of the H5N1 virus in the neighborhood but there are no indications bird flu has spread in the neighborhood," she said.

Following the deaths of Iwan Siswara, an official at the Supreme Audit Agency (BPK), and his two young daughters from bird flu early in July 2005, the central government declared Tangerang a bird flu red zone.

In August, a Tangerang maid died from bird flu two days after being treated for a high fever and acute pneumonia at Tangerang's Sari Asih Hospital.

Her employers, Wahyu Proyato and Winda Amalia, residents of Perumnas II complex in Tangerang regency, said they had no idea how their maid contracted the virus because there were no chickens at their home or in the neighborhood.

Banten province has recorded 19 human cases of bird flu, 15 of which have been fatal.

Banten Governor Ratu Atut Chosiah issued a bylaw on poultry restrictions on Jan. 19, which included a ban on keeping backyard fowl.

Unfortunately, the ordinance has yet to take effect due to prolonged protests from the Banten Council.

Report Finds Major Gaps Exist in U.S. Pediatric Pandemic Preparations​

http://www.prnewswire.com/cgi-bin/s...07/0004683994&EDATE=WED+Oct+17+2007,+10:00+AM

WASHINGTON, Oct. 17 /PRNewswire-USNewswire/ -- The American Academy of
Pediatrics (AAP) and Trust for America's Health (TFAH) issued a new report
today, Pandemic Influenza: Warning, Children At-Risk, which finds that
children and teens between the ages of 0-19 account for nearly 46 percent
of all H5N1 "bird" flu deaths. The report also identifies gaps in U.S.
preparedness for treating and caring for children during a possible
pandemic flu outbreak.

Four key areas of concern raised in the report include:
child-appropriate doses of vaccine and medications; management and
treatment of children who become ill; including children in strategies to
slow the spread of influenza in communities; and caring for and supervising
the health of children if schools and childcare facilities are closed for
extended periods of time.

"Children are not simply small adults, especially when it comes to
medical concerns. The fact that H5N1 has been disproportionately impacting
children and adolescents should give us pause," said Jeff Levi, PhD,
Executive Director of TFAH. "As the U.S. prepares for the threat of a
possible pandemic flu, we must make caring for our kids a priority, not an
afterthought."

Some key gaps identified in the report include:

-- There are currently only 100,000 courses of antivirals for children
in the Strategic National Stockpile. There are currently 73.6 million
children in the U.S. A severe pandemic outbreak could result in 25 percent
of the U.S. population becoming ill. Children are known to often be
disproportionately impacted by contagious respiratory illnesses.

-- Neither of the two antiviral drugs that have been shown effective
against H5N1 are licensed for children younger than 1 year of age.

-- A vaccine that is well-matched for a pandemic would not be available
for at least 6 months after a major outbreak begins, and tests would have
to be conducted to determine safety levels for children and adults once it
is available.

-- The U.S. Centers for Disease Control and Prevention (CDC) recommends
that the public consider using of N95 respirator masks in certain
circumstances during a pandemic outbreak, however, N95 respirator masks are
not currently produced in children's sizes.

-- Approximately 30 million children rely on the National School Lunch
Program for meals each day and many rely school nurses for health care, and
there are no plans in place to provide these services if schools are
closed.

"Children tend to be major vectors. They are inherently more at-risk
for contagious respiratory diseases because they have limited pre-existing
immunity, often spend lots of time in groups, and tend to share germs
easily," said AAP Committee on Infectious Disease (COID) Member John S.
Bradley, MD, FAAP, of Children's Hospital San Diego. "Right now, we are
behind the curve in finding ways to limit the spread of a pandemic in
children even though they are among those most at-risk."

Experts predict a severe pandemic flu outbreak could result in up to
1.9 million deaths in the U.S., approximately 9.9 million Americans needing
to be hospitalized, and an economic recession with losses over $680 billion
to the U.S. Gross Domestic Product.

"What will happen when children miss school? How long can parents stay
home to care for their children? These are the million dollar questions
parents and policy-makers should think about now while we have time to
prepare," said Henry H. Bernstein, DO, FAAP, AAP COID Member and Chief,
General Pediatrics, Children's Hospital at Dartmouth.

The AAP and TFAH recommend specific actions to ensure the health and
welfare of the nation's children are protected in the event of a flu
pandemic:

-- Pediatricians and pediatric medical and surgical subspecialists
should be included in pandemic planning at all levels of government.

-- The U.S. Department of Health and Human Services (HHS) should
conduct additional studies on vaccine efficacy in young children, support
the development of additional flu vaccine products, and conduct more
studies of antiviral agents for infants.

-- HHS should immediately convene an independent task force to study
and make specific recommendations about the use of surgical masks, N95
respirators, and other personal protective equipment by children.

-- HHS should conduct further studies on the feasibility of prolonged
school and childcare center closures, including a more precise assessment
of the long-term interruption of the school meals program and how to
mitigate the impact on students who rely on them.

-- The Federal government should ensure that the Strategic National
Stockpile includes sufficient pediatric doses of antiviral medications to
ensure treatment of 25 percent of the nation's children and adolescents, or
about 18.4 million individuals.

-- All schools should educate students in infection control. Children
should receive grade-appropriate health education about communicable
diseases and methods to interrupt disease spread (cover cough, wash hands,
etc).

-- Educators and school administrators should be encouraged to get an
annual influenza vaccination and should remind families that public health
experts recommend annual flu vaccines for 1) all children with high risk
conditions who are 6 months of age and older, 2) all healthy children ages
6 months through 59 months, 3) all household contacts and out-of-home
caregivers of children with high risk conditions and of children younger
than 5 years if age, and 4) all health care professionals. CDC and state
and local health departments should encourage and support seasonal flu
vaccination clinics in school settings to maximize flu vaccine coverage
rates.

The full report is available on the TFAH website,
http://www.healthyamericans.org, or on the AAP website at http://www.aap.org.

The American Academy of Pediatrics is an organization of 60,000 primary
care pediatricians, pediatric medical subspecialists and pediatric surgical
specialists dedicated to the health, safety and well being of infants,
children, adolescents and young adults.

Trust for America's Health is a non-profit, non-partisan organization
dedicated to saving lives by protecting the health of every community and
working to make disease prevention a national priority.

Bird flu kills ducks in southern Vietnam​

http://www.thanhniennews.com/healthy/?catid=8&newsid=32428

Bird flu returned to southern Vietnam this week after an absence of two months, and officials warned farmers of more outbreaks as the weather cools.

Tests performed at a laboratory for the Mekong delta region confirmed the H5N1 virus in the samples taken from ducks at the farm in Tra Cu district in Tra Vinh province, Tien Phong (Vanguard) newspaper said.

At least five ducks were dead among 300 at the farm, officials said.

A Tra Vinh Animal Health Department official said by telephone that authorities were contacting the farm owner to get more details.

He said the last bird flu outbreak was found among ducks in the same district in late August.

Agriculture Minister Cao Duc Phat on Tuesday urged animal health authorities to step up vaccinating poultry because bird flu would soon return among unvaccinated birds, especially as the weather cooled in autumn and winter in northern provinces.

Bird flu has infected seven people in Vietnam so far this year, four of whom have died, bringing the death toll since late 2003 to 46.

Globally, the H5N1 virus has killed 202 people out of 330 known cases, according to the World Health Organization.

Hundreds of millions of birds have died or been slaughtered.

But Vietnam's poultry stock has been increasing, with 226 million birds reported at the end of August, up 5.3 percent from a year ago, of which the waterfowl stock expanded 8.7 percent to 68 million, government figures showed.

Africa: U.S. Announces Boost for FAO's Bird Flu Programme​

http://allafrica.com/stories/200710171010.html

17 October 2007
Posted to the web 17 October 2007

Rome

The United States will support FAO's avian influenza control and prevention programme with an additional US$38 million, FAO announced today. The United States is one of the biggest donors to the agency's programme.

With the new funding, US support to the FAO avian influenza programme has reached a total of about $63 million.

FAO is currently assisting more than 100 countries in their efforts to prevent and control avian influenza.

The United States Agency for International Development (USAID) said in a letter to FAO that the contribution will be earmarked for core Highly Pathogenic Avian Influenza containment and control activities, including in-country surveillance and early warning, efforts to reduce disease transmission, and communication to increase public awareness and preparedness.

Confidence

"Avian influenza will probably stay with us for several years to come. The support from the United States will enable FAO to continue and strengthen avian influenza prevention and control campaigns in affected countries," said FAO's Chief Veterinary Officer Joseph Domenech.

"Our latest contribution reaffirms the confidence we place in FAO to contain and control Highly Pathogenic Avian Influenza at its animal source. Lending support to countries through FAO remains a key element in managing the global risk," said Ambassador Gaddi Vasquez of the US Mission to FAO.

"This new contribution from USAID is a welcome expression of trust in FAO's global leadership in the fight against avian influenza," said Anne M. Bauer, Director of FAO's Emergency Operations and Rehabilitation Division.

The new money will go into ongoing and new surveillance and response, planning, training, logistics, technical, laboratory, and communication projects and activities in western, eastern and southern Africa, Southeast Asia, the Indian sub-continent, Central Asia, central/eastern Europe, Indonesia and Egypt.

Involving local communities

Cross-border surveillance and the more active involvement of local communities and village animal health workers in control and response activities will be some of the priority areas to be supported with US funding. Fresh money is also being directed at FAO's current work on the socio-economic impact of HPAI, biosecurity and wild bird surveillance.

USAID specified that as part of its support to FAO's efforts to control HPAI globally, it was particularly interested in backing the UN agency's aim to establish an avian influenza communications capacity.

New US funds will also go to the Crisis Management Centre - Animal Health, an emergency response unit run by FAO, which in collaboration with the World Organisation for Animal Health (OIE) supports governments' response to avian influenza and other transboundary animal diseases through the rapid provision of technical and operational expertise.

The main donors to FAO's avian influenza programme, amounting to around $180 million, are: the United States ($63 million); Australia ($14 million); Japan ($13 million); the United Kingdom ($10 million) and Sweden ($10 million); followed by UN Development Programme administered funds; Canada; Germany; the Asian Development Bank; France; Norway; Switzerland; Belgium; the European Commission and Spain. The avian influenza programme is also supported by financial resources from FAO's Technical Cooperation Programme.

Preparations under way for bird flu season​

http://www.examiner.com/a-995829~Preparations_under_way_for_bird_flu_season.html

BALTIMORE (Map, News) - Masked hospital staff quickly checked in and evaluated coughing volunteers during an avian flu simulation at the University of Maryland Medical Center on Wednesday.

Although the “bird flu” occasionally jumps from animal to human, emergency responders are trying to prepare for the worst-case scenario — a pandemic flu outbreak quickly spreading from human to human.

“The genetic makeup of avian influenza has the capability to change and may [be] transmitted,” Medical Director for Infection Control Harold Standiford said. “We just want to be prepared.”

“I’m in respiratory distress,” volunteer and nursing student Laura Alberico said from a small mobile hospital bed awaiting pseudo-treatment. “I went to Singapore, but I wouldn’t have been able to leave with this cough.”
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But her “symptoms didn’t appear until after she boarded the plane.”

Assumed patients were received at the first tent and assigned treatment according to their breathing and cognitive abilities.

“With the avian flu, we typically look for respiratory issues and determine the necessary treatment,” said Marianna McNeil, emergency medical nurse.

The staff is trained to evaluate patients through a series of questions and observation.

“Currently, there is no cure for the avian flu,” Kellogg said. “We are strategizing with other local hospitals and the Strategic National Stockpile in the event that supplies become necessary.”

In the event an outbreak of the avian flu hits Baltimore City, the Medical Center would experience high volumes of cases varying in symptoms.

“We would be inundated with people displaying a variety of respiratory issues,” Emergency Medical Nurse Bluma Bier said.

The Medical Center works with other hospitals and two mental health facilities to prepare staff for a wide variety of avian-infected patients and their psychological status in the event an outbreak occurs.