06/12-16 | New Weekly Bird Flu Thread

Cholesterol-lowering Drugs May be Useful in an Influenza Pandemic

06/13/06 -- Recent concerns about the possibility of a serious influenza pandemic have spurred many countries to start stockpiling vaccines and antiviral agents. However, an article in the July 15 issue of Clinical Infectious Diseases, now available online, proposes that cholesterol-lowering drugs known as statins could be helpful, and would be more readily available in the event of a global influenza pandemic.

Statins lower "bad" cholesterol levels in the blood by blocking the liver's production of cholesterol. Statins may further protect the heart by regulating the immune system and reducing inflammation. Recent studies suggest that these effects also help patients with serious infectious diseases such as pneumonia and bacterial infection of the blood.

Because influenza is associated with inflammation and an increased risk of cardiovascular diseases, the anti-inflammatory and immunomodulatory effects of statins might also help people with influenza, suggests David Fedson, MD, a retired former director of medical affairs for a major vaccine maker. If an influenza pandemic did occur, statins would have the added benefit of being immediately available, unlike influenza vaccines, which have to be manufactured after the virus strain is identified.

"It is important to recognize that the statins/influenza idea is only that--an idea," Dr. Fedson said. "It needs to be confirmed by rigorous scientific studies." Statins wouldn't replace vaccines, he added, because "unlike vaccines, they probably wouldn't prevent [influenza virus] infection itself." However, if research demonstrates that statins are beneficial, "their value would most likely be in preventing serious complications and death. In order to do this, they would probably have to be continued throughout the duration of the illness."

Besides being readily available, statins would be relatively inexpensive, particularly the generic varieties. "As generics, they are already being produced in several developing countries and should be available and affordable in almost all countries," Dr. Fedson said. "Keep in mind that very large amounts of statins are produced for tens of millions of cardiovascular disease patients to take year round. For influenza, they probably would be taken for only five to 10 days, and this would not have a major impact on ordinary production and sales levels by the manufacturers."

Further research on statins as treatment and prophylaxis for pandemic influenza, including laboratory studies and clinical trials, is crucial, Dr. Fedson said, concluding in his article that statins "could become the only currently available agents to alter the course of what otherwise might become an unprecedented global health crisis."

Source: Infectious Diseases Society of America

http://www.bio.com/newsfeatures/newsfeatures_research.jhtml?cid=19600003

http://www.breitbart.com/news/2006/06/14/060614110034.2edesmai.html

China investigates suspected bird flu case as Hong Kong goes on alert
Jun 14 9:17 AM US/Eastern

China is investigating a suspected human bird flu case in the south of the country that has triggered alarm bells across the border in the regional economic hub of Hong Kong.

A 31-year-old man, identified only by his surname Jiang, was suspected to have contracted the deadly H5N1 virus in the boomtown of Shenzhen in Guangdong province and was in critical condition in hospital, Xinhua news agency said.

The truck driver, who developed a fever, back pains and a cough on June 3, was admitted to hospital on Friday. Preliminary tests carried out by local health officials showed he had H5N1, it said.

Jiang has since been transferred to another hospital in Shenzhen for "advanced treatment", Xinhua said, adding that provincial authorities had reported the case to the health ministry for verification.

A health ministry spokesman confirmed to AFP that tests were being carried out on the man. He said an official announcement on whether he had contracted bird flu would only be made after the tests were completed.

If confirmed, the man would become China's 19th reported human case of bird flu. Twelve of those cases have been fatal.

China has reported 35 cases of bird flu outbreaks among poultry since October last year, although many of the human cases have been in areas where no outbreaks have been officially recorded.

Xinhua reported that Jiang may have contracted the virus after his wife had bought a chicken from a wet market two weeks earlier and served it for dinner to him and four other family members.

The other relatives had not shown any signs of illness, the agency said, adding that they were under observation.

While the mainland carried out investigations, the Chinese autonomous territory of Hong Kong was preparing to slap an immediate ban on poultry imports from the mainland if the case was confirmed as H5N1.

"We are very concerned about this bird flu case in Shenzhen (as the patient) didn't make any contacts with poultry and birds," Hong Kong Health Secretary York Chow said.

"(This) makes us think there is a possibility that there might be poultry which might not have clear flu symptoms but can spread virus to humans. That's what we are most worried about."
Chow said the health department was sending a team of experts to Shenzhen Wednesday to gather more information and find out how the man had contracted the virus.

"Most importantly, we want to know whether he has come into contact with trucks and people coming in and out of Hong Kong," he said.

Authorities have stepped up inspections of chickens imported from the mainland and Chow said an immediate ban on imports from China would be imposed for three weeks if the man was confirmed to have the H5N1 virus.

The latest case threatened to be a repeat of events in March, when Hong Kong temporarily banned bird imports from Guangdong following the death there of a 32-year-old man from bird flu.

Hong Kong was the scene of the world's first reported major bird flu outbreak among humans in 1997, when six people died and more than two million poultry were culled.

But it has remained free of bird flu since early 2003 with stringent border control and a reduction in the number of poultry imports from China.

More than 120 people worldwide have died from bird flu since it re-emerged as a threat in 2003, with most of the victims in Asia.

Humans are believed to contract the virus mainly from direct contact with infected animals. Scientists fear a global pandemic if the virus mutates and becomes easily transmissible between humans.

http://www.breitbart.com/news/na/060613130528.zy7z8g0p.html

Hong Kong reports suspected human bird flu case in south China
Jun 13 9:05 AM US/Eastern

A 31-year-old man is suspected to have contracted bird flu in southern China.

The man is in critical condition in hospital after visiting a wet market in Shenzhen city where live chickens were on sale, the Centre for Health Protection (CHP) said in a statement Tuesday.

It said health department officials from China's Guangdong province had notified Hong Kong of the case. Thousands of people cross the border daily from Guangdong into the southern Chinese territory of Hong Kong.

"He developed fever and pneumonia on June 3. He is now under treatment in a local hospital. His condition is critical," said the statement.

"The CHP is maintaining close liaison with the Ministry of Health and the Health Department of Guangdong Province to obtain more informaion on the case."

The man would become China's 19th reported human case if he is confirmed as having the deadly H5N1 strain.

Twelve of those cases have been fatal. More than 120 people worldwide have died from bird flu since it re-emerged as a threat in 2003, with most of the victims in Asia.

Hong Kong however has remained bird-flu free since early 2003, prompting local authorities Tuesday to step up inspection of chickens imported from the mainland.

"Even though Hong Kong has been free from human avian influenza cases since early 2003, members of the public should be vigilant given the large volume of population flow between Guangdong and Hong Kong," the statement said.

The new case was not reported by China's official media on Tuesday.

Grim realities of bird flu hits politicians ​

Thursday June 15, 2006
By Mike Houlahan


Politicians were confronted with the unpleasant realities of a bird flu pandemic yesterday, with local government representatives asking for special powers to allow them to bury the dead.

Hastings District Council mayor Lawrence Yule, speaking on behalf of Local Government New Zealand, told the Government administration select committee that local authorities would need many laws relaxed in the event of a bird flu pandemic.

Among them would be regulations governing the establishment and maintenance of cemeteries, registration of funeral directors, certification of mortuaries and provision for the handling and transportation of dead bodies - all of which are administered by local authorities.

Mr Yule told the committee, which is hearing submissions on the Law Reform Epidemic Preparedness Bill, it could take local authorities up to a year to acquire land under the Public Works Act for a cemetery.

Similarly, the Health Act and burial regulations meant funeral directors and mortuaries needed certification - a process that would need fast-tracking if a worst-case-scenario disease outbreak stuck New Zealand.

It has been predicted that if a bird flu pandemic struck the country it could infect about 1.6 million people and kill 33,000 in eight weeks.

Mr Yule said councils also wanted to see rules governing quorums, public access to meetings, and public consultation relaxed.

The northern branch of the Employers and Manufacturers Association also made a submission yesterday. It called for labour laws to be relaxed so businesses were not obliged to suspend workers if they were barred from going to work.

http://www.nzherald.co.nz/section/story.cfm?c_id=1&ObjectID=10386638

http://www.birdflubreakingnews.com/...ay/National/20060613091037/Article/index_html


JAKARTA: INDONESIA has nearly half of the worldwide human deaths attributed to the bird flu this year, making it one of the highest-risk countries in the world.

The warning comes from the World Bank in a report released yesterday. It said that up to June this year, the number of WHO-confirmed cases of bird flu in Indonesia had jumped to 49, with 37 deaths, giving the country a mortality rate of 75 per cent.

This is well above the worldwide average of 57 per cent.

Out of a poultry stock of 1.3 billion, more than 10.5 million reportedly died of the deadly H5N1 virus, which causes bird flu.

Culling, on the other hand, has been on a relatively minor scale, with fewer than 100,000 affected birds culled.

The World Bank warned that if adequate steps were not taken to prevent and control the outbreak of the virus, it would threaten Indonesia’s economy.

"Moreover, perceived inaction by the Government, as compared to other affected countries, is seriously threatening Indonesia’s image among investors and tourists," it said.

The greatest risk to humans is if the virus changes to a form which is more easily transmitted from human to human. At present, people have been mostly infected by coming into contact with sick poultry.

The World Bank warned that the probability of the virus mutating to human-to-human transmission in Indonesia was significant.

"While tests indicate that there has been no significant change to the virus, the probability of moving from the current phase of primarily poultry-centred outbreaks with isolated human infections, to a more efficient human-to-human transmission is considered to be significant in Indonesia," said the report.

In the event human-to-human transmission becomes a reality, it said Indonesia would be the hardest hit among affected Asian countries.

"Like SARS, an avian influenza pandemic would have large demand effects, hampering services like tourism, hotels, restaurants and other activities that entail face-to-face meetings.

"Such a scenario could result in a projected 2.8 per cent decrease in GDP, a 3.1 per cent decrease in industrial output and a two per cent increase in inflation," said the report.

To prevent and control outbreaks, Indonesia needs to develop an adequate surveillance system of poultry stocks to monitor the circulation of the virus.

However, surveillance coverage is limited and generally unreliable in detecting outbreaks.

"Control measures are seriously underfinanced and fraught with implementation problems," it added.

Indonesia confirms 38th bird flu death​

JAKARTA (XFN-ASIA) - The government today confirmed its 38th death from bird flu after tests by a WHO-accredited laboratory found that a seven-year-old girl who died this month was infected.

"It came back positive," said I Nyoman Kandun, director of the health ministry's communicable disease control center.

"We have checked everybody who had contact with her and they are negative,"he said.

The girl, who was earlier identified as Yohana, came from the Pamulang area southwest of the capital and died June 1 after treatment in a Jakarta hospital.
tn/sb/sm/zr

http://orange.advfn.com/news_Indonesia-confirms-38th-bird-flu-death_15795838.html

Macao on high alert over bird flu concern​

http://english.people.com.cn/200606/15/eng20060615_274401.html

he Macao authorities are on high alert over the bird flu concern, according to an official statement issued here Thursday.

The statement issued by the Health Bureau (HB) said the bureau will maintain all its preventive measures against avian flu.

The statement cautioned the public to "keep a distance" from poultry wastes and urged those stay in close contact with live poultry to wear gloves and gauze masks.

The HB also opened an around-clock telephone hotline for residents to check information.

Meanwhile, the region's Civic and Municipal Affairs Bureau (CMAB) has pledged to strengthen preventive measures against the disease.

The bureau announced Wednesday that it will halt the import of live poultry from the mainland city of Shenzhen, where a suspected human bird flu case occurred recently.

The CMAB said it will also tighten the control at local poultry wholesale and retail markets to prohibit imported live poultry from staying overnight.

Source: Xinhua

Bird flu situation more serious this year​

http://www.shanghaidaily.com/art/2006/06/15/283259/Bird_flu_situation_more_serious_this_year.htm

Winny Wang
2006-06-15
MORE species of migrant birds have died in China this year from the bird flu, national chief veterinary officer Jia Youling said today, Xinhua news agency reported.

The Ministry of Agriculture said 1,168 migrant birds were found dead from the H5N1 bird flu strain in Qinghai Province and Tibet Autonomous Region, including egrets, widgeons, snipes and crows, which are the newest species to die from the epidemic disease.

Jia, also the director of the Animal Husbandry and Veterinary Bureau under the Ministry of Agriculture, said the ministry will strengthen inspections along the migrant birds' main flight routes in China, from East Africa to West Asia.

The ministry will also send inspectors and experts to monitor the epidemic situation. These groups will be in charge of handing the deceased birds and sterilizing the contaminated areas.

So far, thirty-one expert groups have gone into rural areas to immunize poultry in contaminated areas.

Jia said the Ministry of Agriculture will cooperate with the Ministry of Forestry to analyze some of the migrant birds to offer insight into the diseases origin and to improve the control of the deadly strain, especially in autumn, the peak season when migrant birds fly through China.

Reporter Hospitalized in Bandung With H5N1 Bird Flu Symptoms​

http://www.recombinomics.com/News/06150601/H5N1_Reporter_Bandung.html

Recombinomics Commentary
June 15, 2006

the Spreading Reporter of the Time newspaper the Setiabudi Echo was treated in the Handsome Sadikin Hospital (RSHS), Bandung because of being suspected of being attacked by bird flu .Spreading that was assigned in Tasikmalaya, West Java was brought to RSHS, on Wednesday (14/6) around struck 23.00 WIB with the high and breathless fever complaint. The temperature of the Spreading body also achieved 39 Celcius levels. After doing the inspection, the doctor referred Spreading was treated in isolation space. Spreading felt the high fever was accompanied breathless since Saturday set and at that point he only underwent treated the road. However because the illness it was felt never will recover Spreading immediately was brought to RSHS. two weeks set, Spreading could cover the funeral of bird flu casualties and the extermination of the positive poultry was infected by bird flu.

The above translation indicates that a reported covering an earlier H5N1 bird flu case in Bandung has now developed symptoms and has been hospitalized with a high fever and breathing difficulties. Symptoms began on Saturday and hospitalization was on Wednesday.

There have been clusters of bird flu cases in Bandung as well as much of the region in western Java. In addition, nurses in the hospital in Bandung also developed symptoms. Initial tests on the health care workers were negative, but more reliable antibody tests could not be run until later in the month.

Although most reports mention some link with birds, the H5N1 isolated from patients have a novel cleavage site that does not match the bird isolates, raising questions about the origin of the infections as well as ease of transmission.

In the past, the clusters have generally involved family members with close contact to the index case or other family members. Confirmation of H5N1 in the reporter would indicate that H5N1 transmission was becoming more efficient, since poultry contacts would likely have been minimal.

Three Fatal Suspect H5N1 Bird Flu Cases in Lampung Sumatra​

http://www.recombinomics.com/News/06140602/H5N1_Lampung_Fatal.html

Recombinomics Commentary
June 14, 2006

In three successive days, from Friday (9/6) up to Sunday (11/6), three children from one family died. Expected, because in the surrounding environment the death of the poultry especially the chicken, had happened they died because of AI.

"But we were still continuing to prove the cause of the death of three children. Because of this death his characteristics cluster or mengelompok with the story of the death of the poultry around it," said Ayla Kayrus, the Section Head the Prevention and Observation of the Lampung Illness of the Health Service that was contacted per the telephone, on Tuesday (13/6).

Ayla said, Yudha (4) died on Friday (9/6) struck 09.00 now his twins Yudhi (4) died on Saturday (10/6) struck 16.00. Both of them died in their house in the Sweet Pandanus Village, the Village of the Pawpaw Gutter, the Wonosobo Subdistrict, the Tanggamus Regency. Now the older brother, Misyani (5) died in RS Abdul Moeloek (RSAM) Banda Lampung, on Sunday (11/6) struck 17.20.

"Because the twin died in the house, the team survailance from the Community Health Centre and the Health Service of Tanggamus could not take the example of blood both of them. Now, the example of Masyani blood could be taken," said Ayla.

The above translations describes the death of three suspected H5N1 bird flu cases. Two of the siblings died at home, so no samples were collected, The third sibling died shortly after admittance and a serum sample is being tested.

Birds are reported to have died in the area, and last year there was a three member familial cluster that was H5N1 confirmed (although confirmation of the third case was via sero-conversion and was not reported until 4 months after initial reports). The cluster had a characteristic time gap between disease onset dates, indicating human to human transmission. The three family members survived.

The latest cluster is more typical of clusters in Indonesia, which have a very high case fatality rate. Surveillance in Indonesia is poor and failure to collect samples in index cases is common.

China confirms new human case of bird flu ​

2006-06-15 20:43:21

BEIJING, June 15 (Xinhua) -- A 31-year-old man in south China's Guangdong Province has been confirmed to have contracted bird flu, bringing the country's total human infections of the disease to 19, reported the Chinese Ministry of Health on Thursday.

The patient, surnamed Jiang, is a migrant worker in Shenzhen City. He showed symptoms of fever and pneumonia on June 3 and has been hospitalized. He is now in critical condition, said the ministry in a report.

Epidemiological research found Jiang had been to a local market several times before developing the symptoms, where live poultry were sold.

Jiang's samples tested H5N1 positive by the Shenzhen center for disease control and prevention (CDC) and the provincial and national CDCs.

He has been confirmed to be infected with bird flu in accordance with the standards of the World Health Organization (WHO) and the Chinese government, said the ministry.

Jiang was reported by the local health authorities as a suspected case of bird flu on Tuesday.

All 98 people who had close contact with Jiang tested clear of the disease, the local health bureau said on Thursday.

Health department of the neighboring Hong Kong on Tuesday warned the public to be vigilant against bird flu, while Macao health authorities announced on Wednesday it will halt the import of live poultry from Shenzhen.

The ministry has reported the new case to the WHO, Hong Kong, Macao and Taiwan, as well as several countries.

This is the 19th human case of bird flu reported in China. Among the previous 18 cases, 12 have died.

Globally, 225 human infections, including 128 deaths, have been recorded by the WHO, according to its official website.

Health experts fear the bird flu virus would mutate into a form that can easily pass between people, causing a global pandemic. Enditem

http://news.xinhuanet.com/english/2006-06/15/content_4703586.htm

Neurological Complications in H5N1 Patient in Medan Sumatra​

http://www.recombinomics.com/News/06150602/H5N1_Sumatra_Neuro.html

Recombinomics Commentary
June 15, 2006

After being stated recovered from bird flu, JG must reside in the hospital and might not come home. He the diagnosis suffered the infection in and around the brain. If being forced to come home, JG could be suddenly unconscious.

"There were the infection and the clump of pus in and around his brain," said the Co-ordinator Tim the Handling of Adam's Hospital Bird Flu the Medan Owner, Adlin Adnan in Medan, on Thursday morning (15/6). This infection was known after being done pemindaian against JG. "The temperature of his body also was not yet stable," said Adlin.

This hospital, said Adlin, will coordinate with the Hospital of Sulianti Saroso Jakarta to memperlajari the patient's relations recovered bird flu and the brain infection. According to Adlin, the case that was suffered by JG was classified as rare and first happened in Sumatra.

The above translation indicates that the sole survivor of the H5N1 bird flu cluster near Medan, north Sumatra, has neurological involvement. Neurological involvement of H5N1 has been associated with PB2 E627K. This polymorphism is found in all human isolates that are H1, H2, or H3. PB2 in H5N1 has been associated with neurological problems in mammals. Mice infected with H5N1 have neurological involvement and E627K has been found in brain isolates. Similarly, tigers in Thailand infected with H5N1 have neurological symptoms and E627K. E627K has also been found in H5N1 from cats and dogs. Experimental ferrets infected with H5N1 with E627K have hind leg paralysis.

PB2 E627K is also associated with increased activity at lower temperatures (33 C), which would increase levels in the nose and throat of humans. Declan Butler reported that cases in northern Sumatra had increased levels of H5N1 in their nose and throat, suggesting the H5N1 from these patients had E627K. This change was found in H5N1 (A/Indonesia/6/2005) from the second confirmed case in Indonesia (see phylogenetic tree), suggesting E627K is also in the north Sumatra cases. Isolates from these cases also have an H5N1 wild type cleavage site, RERRRKKR, which was also present in the above examples of neurological involvement.

Neurological involvement of H5N1 is cause for concern. The effectiveness of neuraminidase inhibitors such as Tamiflu is unclear. In addition, the isolates from Sumatra are amantadine resistant, further limiting treatment options. This complication creates additional concerns linked to an H5N1 pandemic, which could significantly impact treatment centers and anti-viral stockpiles.

http://www.thejakartapost.com/detailnational.asp?fileid=20060615.H01&irec=0


Public skeptical about govt's bird flu drive

Tb. Arie Rukmantara, The Jakarta Post, Jakarta

Disbelieving promises of compensation, many people from North Sumatra to Jakarta to South Sulawesi are refusing to support the government's bird flu containment program.

Residents of Tanah Karo in North Sumatra -- where the world's biggest bird flu cluster has killed seven members of one family -- gathered Wednesday in front of the governor's office in Medan to protest a ministerial decree that orders a poultry cull in the regency.

"We reject the decree because we don't believe our fowl have caught bird flu," a demonstrator told Antara.

Issued on June 2 by Coordinating Minister for the People's Welfare Aburizal Bakrie, the decree enforces strict flu monitoring in Tanah Karo and selective poultry culling. All poultry will be killed in a one-kilometer radius around every spot where bird flu cases are found.

In Jakarta, where the H5N1 virus has killed 11 people, doubts linger about whether the government is serious about arresting the spread of the flu.

"I believe the government will only start treating the problem seriously if the number of human flu fatalities grows (significantly). When the flu kills one or two people (in a month) they don't do anything and consider it normal," said 48-year-old Sri, an employee at a private company in Central Jakarta.

Thousands of chickens are dying daily in Gowa regency, South Sulawesi, with random testing suggesting most are succumbing to bird flu. While villagers incinerate the bodies of the dead birds, they leave the living birds untouched, allowing the disease to spread further.

"I don't want to kill the rest of my chickens because the government has not promised me any compensation," one resident said.

The Agricultural Ministry has allocated Rp 30 billion (about US$3.3 million) to compensate villagers for the fowl that are culled. This works out at a compensation payment of Rp 10,000 per chicken, significantly lower than the birds' market price of Rp 15,000 - Rp 30,000.

The ministry's Avian Influenza Control Unit coordinator, Darminto, said public distrust of the program had been fueled by the government's slow progress in combating the flu and people's lack of knowledge about the deadly disease.

"People in Karo, for instance -- they are not aware that only sick chickens and others in a one-kilometer radius would be culled," Darminto said.

The unit and the international Food and Agriculture Organization are carrying out disease mapping in Karo to determine how many of the some 2 million poultry in the regency should be destroyed.

The mapping began Monday and was expected to be completed in two weeks.

Darminto said the mapping was necessary to help the Karo people control the virus' spread.

Recently, the team found an infected chicken in a traditional market, he said.

"We know that the chickens in the market were brought in from several regions across Sumatra, including Deli Serdang regency," he said.

Bird flu killed thousands of poultry in Deli Serdang last year.

Indonesia's bird flu death toll stands at 37 -- the world's second highest tally, after Vietnam with 42.

http://scienceblogs.com/effectmeasure/2006/06/indonesian_local_news_on_bird.php#more



Indonesia Local News On Bird Flu

Two articles in local Indonesian news sources are of interest. They illustrate the difficulty of trying to figure out what is happening using local news reports. Both relate to the hospitalization of a reporter for the Indonesian magazine Tempo who had covered the culling of poultry and the funeral of a bird flu victim. I have had both articles translated by a native speaker, since previous translations were via machine (see, for example, here). The machine translations are much more difficult to read but the essential elements of the reports are discernible. Since we have more idiomatic translations, we present them here as a service and an illustration for readers who don't follow this closely what these reports are like.

Liputan6.com, Bandung:

Tempo reporter Rambat Eko Setiabudi has been admitted to Hasan Sadikin hospital with suspicion he might have bird flu. Rambat, who was on duty in Tasikmalaya, West Java was brought into the hospital on Wednesday (14/6) around 11PM, complaining of high fever and difficulties breathing. His temperature was 39 degrees Celsius. After examination, the doctor admitted Rambat to the isolation ward.

Rambat's high fever and breathing difficulties began Saturday afternoon and visited the doctor. The symptoms persisted and he was brought into the hospital.

Two weeks ago, Rambat covered a funeral of a bird flu victim and another on the culling of poultry.

To check his condition, blood was drawn to be sent to the Center in Jakarta. The result will be in within 5 or 6 days.

TEMPO Interaktif, Jakarta:

A Tempo reporter, R (age 28), based in Tasikmalaya, West Java, was placed in an isolation room after being admitted to Hasan Sadikin hospital, Wednesday (14/6) around midnight. He had been sent to a local hospital by a physician in Tasikmalaya.


R gave a history of having fever (up to 39 degrees C) since Sunday 11/6. He became worried Wednesday when his fever did not come down and he had difficulties breathing. Some days earlier he covered the culling of poultry and went to a funeral of a bird flu victim.

The specialist from the local hospital sent the patient to Hasan Sadikin hospital, "because the Tasikmalaya hospital does not have isolation room," accordingly to Undang Sudrajat, his uncle.


The head of the Isolation Ward at the Hasan Sadikin hospital, Adang Rasmita, said R is still weak, but improving. His temperature dropped to 37 - 37.5 C. and he no longer has difficulties breathing. However, the hospital is still monitoring his heart, pulse and oxygen level. "It is important that we monitor the oxygen level, because ina bird flu patient, this can drop suddenly", Adang said.

Dengue fever is another possibility for his illness, accoring to Adang. The patient will be kept in the isolation room until next week.

Official says bird flu spreading among migratory birds​

http://english.people.com.cn/200606/15/eng20060615_274411.html

China's chief veterinary officer on Thursday warned that bird flu is on the rise among migratory birds in China this year.

Jia Youling said in a statement to Xinhua that great progress has been made in China's fight against avian influenza this year, but the virus was killing a rising number of wild birds.

Jia, director of the Animal Husbandry and Veterinary Bureau under the Ministry of Agriculture, said bird flu among migratory birds in China last year was only found near Qinghai Lake in the southwestern Qinghai province.

However, this year the scope had been enlarged to Jinzhou and Panjin cities in the northeastern Liaoning province, and to Yushu, Golog and Haibei prefectures in Qinghai, and Nagqu in Tibet Autonomous Region.

According to the Ministry of Agriculture, 1,168 migratory birds had been found dead in Qinghai and Tibet by June 1. The disease was striking more species of wild birds than last year.

Experts said these areas were all on bird migration routes between east Africa and west Asia.

Countries and regions on this route had reported outbreaks of avian influenza since July 2005, including Mongolia, Kazakhstan, Turkey, China, India and others, said experts.

Jia said the Ministry of Agriculture would target future supervision on the migration paths in China, especially on areas with a record of infection, and border and lake areas.

A nationwide immunization drive had also been launched in China's vast rural areas to contain the virus.

The ministry said 31 groups of inspectors had been dispatched to 248 villages in 62 counties around the country to study the effectiveness of previous immunization efforts. They found the measures had proved effective in rural areas.

The Ministry of Agriculture would study migration patterns of the wide birds to prepare for the epidemic controls in autumn, another peak migration season.

Source: Xinhua

June 16, 2006

Another Death in Indonesia Deepens Fears of Bird Flu's Spread​

By DONALD G. McNEIL Jr.

The death of a 38th person from avian flu in Indonesia was confirmed yesterday by the World Health Organization and the situation in that country continued to worsen.

Indonesia is now in second place, after Vietnam, which has had 42 deaths, but none this year, while Indonesia's caseload is climbing rapidly and striking many family clusters.

The World Bank said Monday that Indonesia's response to the flu was disorganized and underfinanced. On Tuesday, the World Animal Health Organization said Indonesia was no longer even counting most poultry outbreaks. In the last year, it has officially reported the deaths of only 800 chickens, while there have been news reports of the deaths of thousands of birds from 29 of the country's 33 provinces.

Indonesia, the world's fourth-most-populous nation, has 242 million inhabitants and an estimated 1.3 billion chickens spread across 18,000 islands.

On Monday The Jakarta Post quoted several local health experts as saying that the government was not disclosing how widespread the disease was or how many times human-to-human transmission might have occurred. And last week Indonesia's health minister, Siti Fadilah Supari, said she was "running out of ideas for how to make the public aware" of the threat and get them to kill sick chickens instead of eating them.

Yesterday the Indonesian Health Ministry said the death of a 7-year-old girl in Banten Province on June 1 was the country's 38th from avian flu. The girl's 10-year-old brother died May 29, but he was buried before specimens were taken, so he was not included in the count. Chickens in the family's household had died earlier.

According to news agency reports quoting health officials, the 7-year-old had tested negative for avian flu in nose and throat swabs taken when she was alive, but then tested positive when lung tissue was taken after her death.

Nose and throat swabs — the routine way of diagnosing regular flu — may give false negatives because the bird flu virus attaches to cells deep in the lungs, not to the upper respiratory tract. In January, according to the World Health Organization, the same error caused the first human cases in Turkey's outbreak to be misdiagnosed.

Dr. Henry L. Niman, a biochemist who has questioned many of the health organization's official counts, argued that flu cases were underestimated because of that error and because blood tests could also produce false negatives if the blood was drawn before detectable antibodies had built up. Victims can die before that happens, and the outbreak in Indonesia has a very high death rate: of the 50 known cases, 38 have died.

An Indonesian newspaper, The Tempo, reported yesterday that one of its reporters who covered the extermination of infected poultry and the funeral of a flu victim near Jakarta had been hospitalized with flu symptoms; the newspaper did not report any test results.

Dick Thompson, a World Health Organization spokesman, said he knew nothing about the reporter who fell ill, but he said the agency was drafting safety guidelines for journalists. "Some of them are getting pretty close to cases," he said.

There have been several reports of Indonesian nurses' falling sick after tending avian flu victims, which could indicate that the virus was spreading more easily between humans. On June 6, the World Health Organization reported that tests on four such nurses had convincingly ruled out A(H5N1), the avian flu, and indicated that one had a seasonal flu, A(H1N1), instead.

Dr. Niman said convincing evidence could be obtained only from blood tests.

Mr. Thompson, who recently returned from Indonesia, said that he did not know how the nurses had been tested, but that he thought that Indonesian health authorities "are really on top of the human cases, investigating them aggressively," even though animal cases were spiraling out of control.

http://www.nytimes.com/2006/06/16/world/asia/16flu.html?_r=1&oref=slogin

Hong Kong:

June 15, 2006




Hospitals boost scrutiny on avian flu


The Hospital Authority has started a three-week enhanced surveillance programme, following notification from the Guangdong Health Department of a suspected human case of avian flu in Shenzhen.



Under the programme, public hospitals should report to the authority's e-Flu system all patients fulfilling the case definition of having pneumonia of unidentified etiology and who had travelled in the seven days before the onset of symptoms, to affected areas or countries with confirmed human cases of avian influenza.



The authority today received 10 pneumonia cases of unidentified etiology, involving five men and five women who had visited Guangdong and Hubei.



Public hospitals are providing rapid tests for these patients, and the cases have been reported to the Centre for Health Protection.

Hong Kong:

http://news.gov.hk/en/category/healthandcommunity/060615/html/060616en05001.htm



June 15, 2006


*
Government on full alert against bird flu
*

The ministry of health in Beijing has informed the Centre for Health Protection that a critically ill man in Shenzhen is suffering from avian influenza. In response, the Government is imposing a three-week ban on live-poultry imports from the Mainland.

The 31-year-old man is in critical condition in a Shenzhen hospital.



Secretary for Health, Welfare & Food Dr York Chow said Hong Kong would suspend the import of live poultry and birds from the Mainland for three weeks from tomorrow. The supply of Mainland chilled and frozen poultry meat will not be affected.



Relevant bureaux and departments have also stepped up preventive and control measures against avian flu.



"The import suspension is a preventive measure. So far, no problem has been spotted in Mainland poultry or poultry products for supply to Hong Kong," Dr Chow said.



"But at present, we still cannot clearly grasp the detailed information to confirm the source of infection of the patient in question. The relevant authorities' preliminary assessment is that the patient had paid a number of visits to a wet market which also sells live chickens before his onset. Therefore, we consider that it is necessary to suspend live chicken imports for the sake of safety and also to give time to the relevant authorities to conduct a full investigation."



The Government will resume the import of live poultry if no more human cases are found and no bird flu outbreaks have occurred in the chicken farms in Guangdong and Shenzhen.



The Health, Welfare & Food Bureau reviewed the preventive and surveillance measures this morning.



Strengthened surveillance measures
*The Centre for Health Protection has informed all doctors in Hong Kong of the latest situation and reminded them to report suspected bird flu infections. The Centre has also contacted public and private hospitals to enhance surveillance of suspected infections.



*The Hospital Authority has activated an enhanced surveillance programme.



*The Food & Environmental Hygiene Department has increased the number of imported live poultry sampled for rapid H5 virus tests by 50%. At the retail level, the department will strengthen inspection and enforcement action.



*The Department of Health will maintain temperature screening for in-bound travellers at all immigration control points.



*The Customs & Exercise Department has stepped up its surveillance work at all border control points to combat illegal import of poultry.



*The Agriculture, Fisheries & Conservation Department will step up inspection on local poultry farms and has issued advisory letters to remind farmers to remain vigilant in their farm bio-security measures. The department has also issued advisory letters to fishermen to remind them not to bring any live poultry, live birds or bird carcasses into Hong Kong.



Enhanced public education

*The Government will increase broadcasts of announcements in the public interest regarding preventive measures against bird flu.


*The Department of Health will continue to disseminate health advice and useful information.



*Health information leaflets will be distributed to travellers and health messages will be broadcast at immigration control points.



*The Hong Kong Travel Industry Council has been informed of the situation and has provided health advice to travel agencies accordingly.

Youth dies of bird flu, local tests show​

http://www.thejakartapost.com/detaillgen.asp?fileid=20060616164154&irec=0

AKARTA (AP): A 14-year-old Indonesian boy died of bird flu, the Health Ministry said Friday, the latest in a series of cases in the sprawling nation that are concerning international experts.The boy, who died on Wednesday in a hospital in the capital, Jakarta, had come into contact with dead chickens, said Health Ministry official Nyoman Kandun.

He said local tests had confirmed that the youth was infected with the H5N1 strain of the bird flu virus, but that specimens had also been sent to an international laboratory for confirmation, as is standard practice in dealing with bird flucases.

If confirmed, Indonesia's human death toll from bird flu has hit at least 39.

Indonesia's bird flu case load has risen sharply this year, and it now trails only Vietnam, where 42 people have died.The H5N1 virus is considered endemic in poultry in most provinces across the archipelago.

Bird flu has killed at least 128 people worldwide since it started ravaging Asian poultry farms in late 2003.

So far, most human cases have been linked to contact with infected birds, but experts fear the virus could mutate into a form more easily transmissible among humans, potentially sparkinga pandemic that could kill millions worldwide.

The World Bank this week said Indonesia's efforts to stop H5N1's spread are underfunded, and urged the cash-strapped government to be more aggressive in culling fowl in infected areas - something it has been unwilling to do so far.

Health officials have expressed concern over the possible transmission of among humans after several members of the same family contracted the illness on Sumatra island. (**)

Bird flu patient has neurological tests​

http://www.thejakartapost.com/detaillgen.asp?fileid=20060616140557&irec=2

JAKARTA (Bloomberg): Jones Ginting, the only survivor of seven members of an Indonesian family infected with bird flu, is being investigated for rare neurological symptoms associated with the illness.

Magnetic resonance imaging (MRI) scans of Ginting's brain are being checked for signs of infection, said Nur Rasyid Lubis, deputy director of the Adam Malik Hospital. He said the scanswere taken late Thursday at the hospital in Medan, the capital of North Sumatra province.

"It's not yet clear whether he's suffering from a brain infection," Lubis said in a telephone interview.

If confirmed, Ginting would be one of few human cases of avian influenza in which disease of the central nervous system has been observed. Doctors are studying the H5N1 avian flu strain to improve treatments and prevent illness. Human H5N1 cases provide opportunity for the virus to mutate into a pandemic form that may kill millions of people.

Avian flu has infected at least 226 people in 10 countries, killing 129 since late 2003, the World Health Organization said Thursday. In most cases, severe respiratory disease is the main symptom.

"It's unusual for bird flu patients to undergo an MRI scan," said Sari Setiogi, a spokeswoman for the WHO in Jakarta, the Indonesian capital. Ginting's neurological symptoms may have been caused by an unrelated illness, she said.

Diseases involving the central nervous system, including encephalitis, transverse myelitis and Guillain-Barre syndrome, have been associated with influenza in humans, according to Harrison's Principles of Internal Medicine, 13th edition. Thecause of the disease isn't established, the medical book said.

Neurological symptoms may occur during H5N1 illness, "but probably not very frequently," said Menno de Jong, head of the virology department at the Oxford University Clinical Research Unit in Ho Chi Minh City, Vietnam, in an e-mail Friday. (**)

New China case suggests H5N1 now more infectious-HK​

http://www.alertnet.org/thenews/newsdesk/SP207334.htm

HONG KONG, June 16 (Reuters) - China's latest human bird flu infection is worrying as it indicates that the H5N1 virus may have mutated and become as infectious in warm months as it is in cooler ones, Hong Kong's health minister said on Friday.

The H5N1 virus thrives in lower temperatures and is more infectious in the cooler months between October and March in the northern hemisphere.

But China's confirmation on Thursday that a 31-year-old truck driver in the southern city of Shenzhen had been infected by the disease has brought uneasiness.

"Is this because the virus has changed, so that it can be highly infectious all year round? Or, if it is happening in summer, winter would be even worse?" Health Secretary York Chow told reporters. "We will have to monitor further.

"We have a suspicion, but we have not confirmed it yet, that the virus might have become more virulent and more widespread than we have expected. If that is the case, the risk for humans to be infected in future is higher."

The truck driver was admitted to hospital and is critically ill. He visited a wet market where live poultry was sold and ate a chicken before he fell ill, but he is not known to have had any other close contact with poultry.

He is the 19th person in China to be infected, 12 of whom have died. But, like most of the other cases, it is a mystery how he came to be infected because there was no known outbreak of the disease in poultry in the area where he lived.

The official Xinhua news agency said on Friday that the government has not found the disease in Shenzhen poultry farms.

Experts in Hong Kong, including Chow, have highlighted the possibility that the human infections in China may have been due to contact with infected poultry which were not taken ill by the disease, which are described as "asymptomatic".

A recent study of faecal samples taken from healthy poultry in markets found that one percent were infected with the virus.

Lo Wing-lok, an infectious disease expert in Hong Kong, said China must explain how the truck driver came to be infected when it claimed there were no H5N1 outbreaks in birds in the area.

"They ought to come up with a reasonable explanation how this man came to be infected. Blanket denials don't help at all. When they deny we have to think twice about accepting," Lo said.

He recalled an incident in late January when a chicken that was smuggled into Hong Kong from Shenzhen was found with H5N1.

"It took only one tiny bird to show that the virus is there (in Shenzhen)," Lo said, adding that China should disclose how it conducts disease surveillance in poultry.

"I don't know if there is insufficient surveillance or if the data is too frightening to be disclosed," he said.

False Negatives Raise H5N1 Surveillance Concerns In Indonesia​

http://www.recombinomics.com/News/06160601/H5N1_Indonesia_Surveillance_Concerns.html

Recombinomics Commentary
June 16, 2006

According to news agency reports quoting health officials, the 7-year-old had tested negative for avian flu in nose and throat swabs taken when she was alive, but then tested positive when lung tissue was taken after her death.

Nose and throat swabs - the routine way of diagnosing regular flu - may give false negatives because the bird flu virus attaches to cells deep in the lungs, not to the upper respiratory tract. In January, according to the World Health Organization, the same error caused the first human cases in Turkey's outbreak to be misdiagnosed.

There have been several reports of Indonesian nurses' falling sick after tending avian flu victims, which could indicate that the virus was spreading more easily between humans. On June 6, the World Health Organization reported that tests on four such nurses had convincingly ruled out A(H5N1), the avian flu, and indicated that one had a seasonal flu, A(H1N1), instead.

Dr. Niman said convincing evidence could be obtained only from blood tests.

Mr. Thompson, who recently returned from Indonesia, said that he did not know how the nurses had been tested, but that he thought that Indonesian health authorities "are really on top of the human cases, investigating them aggressively," even though animal cases were spiraling out of control.

The above comments in today's Donald McNeil article in the New York Times has more curious comments by WHO and health officials. Testing in Jakarta is generally quite reliable, so it was surprising that WHO failed to confirm an 18 year old brother who had tested positive in Jakarta and his sister had tested positive in both Jakarta and Hong Kong. It was highly unlikely that a sibling of an H5N1 bird flu confirmed patient would falsely test positive in Jakarta. The Hong Kong lab ran additional tests and confirmed the Bandung cluster.

The repeated false negatives by Hong Kong in the latest cluster from Bandung raises serious questions about the "definitive" negative results on the nurses in Bandung. As noted on the media reports, the false negatives were generated by nose and throat swabs. This type of testing has previously been called Goldilocks testing because it is too late to detect H5N1 in the nose and throat, but too early to detect H5N1 antibodies in the blood, but just right to generate false negatives.

The testing of the nurses was clearly in the Goldilocks category because the antibody levels peak 3-4 weeks after symptoms, and at least two of the four nurses were tested about a week after symptoms. Since the time for collecting samples is fast approaching, it is surprising that the WHO spokesperson did not know of plans to due further testing to truly rule up H5N1 infections in the nurses.

Moreover, the H5N1 isolated from patients in Western Java, including Tangerang, Jakarta, and Bandung, have a novel cleavage site that does not match reported bird isolates but do match and isolate from a cat. Therefore, the source of the H5N1 in these cases remains unclear.

As the number of human cases and poultry outbreaks continue to increase, the surveillance failures become more clear. New sequences at Genbank from birds in Indonesia identify one isolate with a cleavage site that matches the Qinghai strain. This isolate is cause for concern because all Qinghai isolates reported to date have PB2 E627K, which is associated with a poor outcome and was detected in the second reported Indonesian case. Thee has also been speculation that the higher levels of H5N1 in the nose and throat of members of the Sumatra cluster was due to E627K.

Thus, release of the human sequences, as well as more data on H5N1 in animals in Indonesia is urgently needed.

Bird flu information drive a failure: Govt​

http://www.thejakartapost.com/detailnational.asp?fileid=20060616.H02&irec=2

Tb. Arie Rukmantara, The Jakarta Post, Jakarta

The government has admitted its bird flu information campaign has failed to improve public awareness about the deadly disease.

Director general of communicable diseases control I Nyoman Kandun said Thursday a lack of public awareness about the seriousness of the disease had played a part in causing the nation's high rate of human deaths from bird flu.

WHO spokeswoman Sari Setiogi confirmed Thursday that a seven-year-old girl who died in Jakarta had become the nation's 38th bird flu fatality after positive testing by a World Health Organization-affiliated laboratory in Hong Kong.

The girl's brother also died after showing bird flu symptoms but was buried before tests were taken, the Health Ministry said.

On Thursday, ministry officials said a Tempo newspaper correspondent based in Tasikmalaya, West Java, was suspected to be suffering from the H5N1 virus after showing flu symptoms, including an high fever and severe breathing problems.

The journalist is being treated at the Hasan Sadikin Hospital in Bandung. Doctors suspect he caught the virus when he covered a mass cull of flu-infected poultry in Tasikmalaya earlier this month. The virus has also killed a 15-year-old boy in the town.

Kandun said villagers' fierce objections to the government's plan of a mass poultry cull in Tanah Karo, North Sumatra, proved the government's public awareness campaign had failed. The flu has claimed seven lives in the area, in the largest known human bird flu cluster ever detected.

"Such a public reaction shows up the flaws in our (government) strategy," he said.

On Wednesday, a group of people from Tanah Karo protested a government plan to cull poultry in the area by killing a chicken and eating it raw. They insisted there was no bird flu in Tanah Karo, a large poultry center in the country.

Public health experts have also said the slow progress in combating bird flu in the country was due partly to the lack of coordination between the health and agriculture ministries.

World Health Organization experts have also expressed concerns that regional administrations are not acting quickly enough to implement the government's national bird flu strategy, faulting them for failing to initiate flu surveillance in at-risk areas.

Kandun said the government would opt to intensify its information campaign rather than enforce the 1984 Plague Law, which punishes people who refuse to cooperate with the government in tackling the spread of infectious diseases.

The comment came, after chief welfare minister Aburizal Bakrie said the government would enforce the law and the 1967 Infectious Disease Control Law to arrest the spread of H5N1 in the country.

Another Death in Indonesia Deepens Fears of Bird Flu's Spread​

http://www.nytimes.com/2006/06/16/w...NJuZnXrBZEw+cl+wDVC/tw&oref=slogin&oref=login

By DONALD G. McNEIL Jr.
Published: June 16, 2006

The death of a 38th person from avian flu in Indonesia was confirmed yesterday by the World Health Organization and the situation in that country continued to worsen.

Indonesia is now in second place, after Vietnam, which has had 42 deaths, but none this year, while Indonesia's caseload is climbing rapidly and striking many family clusters.

The World Bank said Monday that Indonesia's response to the flu was disorganized and underfinanced. On Tuesday, the World Animal Health Organization said Indonesia was no longer even counting most poultry outbreaks. In the last year, it has officially reported the deaths of only 800 chickens, while there have been news reports of the deaths of thousands of birds from 29 of the country's 33 provinces.

Indonesia, the world's fourth-most-populous nation, has 242 million inhabitants and an estimated 1.3 billion chickens spread across 18,000 islands.

On Monday The Jakarta Post quoted several local health experts as saying that the government was not disclosing how widespread the disease was or how many times human-to-human transmission might have occurred. And last week Indonesia's health minister, Siti Fadilah Supari, said she was "running out of ideas for how to make the public aware" of the threat and get them to kill sick chickens instead of eating them.

Yesterday the Indonesian Health Ministry said the death of a 7-year-old girl in Banten Province on June 1 was the country's 38th from avian flu. The girl's 10-year-old brother died May 29, but he was buried before specimens were taken, so he was not included in the count. Chickens in the family's household had died earlier.

According to news agency reports quoting health officials, the 7-year-old had tested negative for avian flu in nose and throat swabs taken when she was alive, but then tested positive when lung tissue was taken after her death.

Nose and throat swabs — the routine way of diagnosing regular flu — may give false negatives because the bird flu virus attaches to cells deep in the lungs, not to the upper respiratory tract. In January, according to the World Health Organization, the same error caused the first human cases in Turkey's outbreak to be misdiagnosed.

Dr. Henry L. Niman, a biochemist who has questioned many of the health organization's official counts, argued that flu cases were underestimated because of that error and because blood tests could also produce false negatives if the blood was drawn before detectable antibodies had built up. Victims can die before that happens, and the outbreak in Indonesia has a very high death rate: of the 50 known cases, 38 have died.

An Indonesian newspaper, The Tempo, reported yesterday that one of its reporters who covered the extermination of infected poultry and the funeral of a flu victim near Jakarta had been hospitalized with flu symptoms; the newspaper did not report any test results.

Dick Thompson, a World Health Organization spokesman, said he knew nothing about the reporter who fell ill, but he said the agency was drafting safety guidelines for journalists. "Some of them are getting pretty close to cases," he said.

There have been several reports of Indonesian nurses' falling sick after tending avian flu victims, which could indicate that the virus was spreading more easily between humans. On June 6, the World Health Organization reported that tests on four such nurses had convincingly ruled out A(H5N1), the avian flu, and indicated that one had a seasonal flu, A(H1N1), instead.

Dr. Niman said convincing evidence could be obtained only from blood tests.

Mr. Thompson, who recently returned from Indonesia, said that he did not know how the nurses had been tested, but that he thought that Indonesian health authorities "are really on top of the human cases, investigating them aggressively," even though animal cases were spiraling out of control.

Bird flu may recur in Maharashtra: Experts​

http://timesofindia.indiatimes.com/articleshow/1652369.cms

MUMBAI: Experts have warned of another outbreak of bird flu in Maharashtra after the monsoon due to the unscientific disposal of chicken culled in the first episode of the dreaded virus outbreak in February.

Maharashtra witnessed an outbreak of the bird flu in the Nandurbar and Jalgaon regions, giving a body blow to the once booming poultry industry.

If experts of the technical committee set up by the Maharashtra government are to be believed, unscientific disposal of composting poultry litter will lead to spread of the dreaded avian influenza (H5N1) virus in the same region after the rains.

The Maharashtra Pollution Control Board (MPCB) claims that the animal husbandry department ignored its guidelines.

But the department maintains that it followed World Health Organisation norms in composting of culled chickens.

"Despite giving it proper guidelines on how to coordinate with firms specialising in composting, the department ignored them and followed its own method," said MPCB member secretary DB Boralkar.

"Following a meeting with state and central government officials March 1, we had told the animal husbandry department to coordinate with Excel industries for aerobic composting," Boralkar said.

"Neither did they comply nor take the suggestions of Excel. This was despite basic enquiries on the cost factors and methods involved."

Bird flu may have become more virulent ​

Hong Kong, China

16 June 2006 12:42

Bird flu may have become more virulent, increasing the risk to humans, Hong Kong's health chief warned on Friday following the latest infection in a neighbouring Chinese city.

China on Thursday confirmed its 19th human case of bird flu, a 31-year-old man from the southern economic boom town of Shenzhen, bordering Hong Kong, who is critically ill in hospital.

Health Secretary York Chow said he was particularly worried about the latest H5N1 infection as it had occurred in a city-dweller with no history of close or prolonged contact with poultry.

The fact that the infection occurred in the summer, rather than the winter like most other outbreaks, was a further cause for concern, Chow said.

"We have a suspicion, but we have not confirmed it yet, that the virus might have become more virulent and more widespread than we have expected. If that is the case, the risk for humans to be infected in future is higher," he warned.

Humans are believed to contract the virus mainly from direct contact with infected animals. Scientists fear a global pandemic if the virus mutates and becomes easily transmissible between humans.

Chow said the authorities would continue to monitor the situation for similar cases, warning there might be more outbreaks among poultry and human infections in the coming winter.

The patient, a truck driver who remained critical in hospital, came down with fever and pneumonia-like symptoms on June 3. Test results released on Thursday confirmed the potentially deadly H5N1 strain of bird flu.

Investigation found he visited a local market, where live poultry was sold, several times before he became ill. None of the people who were in close contact with him had shown any symptoms, the authorities said.

He was the 19th human to have contracted the strain in China. Twelve of those cases have been fatal.

Hong Kong has been particularly concerned about the case in Shenzhen as thousands of people cross the border daily from Shenzhen and Guangdong province.

The Hong Kong government said it was maintaining temperature screening at immigration for all arrivals, with customs stepping up surveillance to combat smuggling of poultry into the territory.

Hong Kong was the scene of the world's first reported major bird-flu outbreak among humans in 1997, when six people died and more than two million poultry were culled.

But the southern Chinese territory has remained free of bird flu since early 2003 with stringent border control and reduction of the number of poultry imports from China.

More than 120 people worldwide have died from bird flu since it re-emerged as a threat in 2003, with most of the victims in Asia. -- AFP

http://www.mg.co.za/articlepage.asp...ng_news__international_news/&articleid=274685

Bird Flu Virus Risk May No Longer Be Seasonal​

http://health.dailynewscentral.com/content/view/2305/

A recent bird flu case involving a man in southern China may indicate that the H5N1 virus has mutated so that the infection risk is as high in summer as in winter, Hong Kong's health chief said Friday.

China confirmed on Thursday that the 31-year-old man in the mainland city of Shenzhen, just across the border from Hong Kong, was critically ill with H5N1.

"We are concerned whether the virus has mutated so that the infection rate has become equally high all year around," said York Chow, secretary for Health, Welfare and Food.

Equally Active in Summer?

The spread of the bird flu virus is believed to be most active in winter, when many birds migrate.

The virus "is now found in summer. Is it because the summer and winter seasons make no difference to it? Or is it that it is active in summer, but gets even stronger in winter? We still have to monitor the situation, and we can't say for sure now," Chow said.

The official Xinhua News Agency said Thursday that the Shenzhen man, hospitalized in critical condition, had visited a local market where live poultry was sold several times before developing a fever and pneumonia on June 3.

No bird flu outbreak has been reported in Shenzhen. Health experts say close contact with infected birds puts people at high risk for infection, but the World Health Organization has said that eating well-cooked chicken does not pose a bird flu risk.

Further Mutation Feared

The man is China's 19th reported human case of bird flu, Xinhua said. Twelve people have died.

Hong Kong said it would halt imports from the mainland for three weeks starting Friday.

Bird flu has killed at least 128 people worldwide since it started ravaging Asian poultry farms in late 2003.

Scientists fear the H5N1 virus will mutate into a highly contagious form, possibly sparking a global pandemic. So far, most human cases have been linked to infected birds.

Gearing up for an emergency: Testing disaster kits ​

CHARLES PASSY
June 16, 2006 6:46 AM
The Wall Street Journal

The big one is coming.

At least that's what some disaster-kit retailers are saying - whether the big one is a hurricane, earthquake, tornado or bird-flu pandemic. After Hurricane Katrina struck the Gulf Coast last year, preparedness has become a growing industry, with stores selling a range of emergency kits. They're generally designed to get people through the first three days after a catastrophe, stocked with flashlights, ponchos, food bars and even portable toilets.

As this year's hurricane season begins, we bought five one- or two-person kits online. Then we showed them to a group of South Floridians who have survived electricity outages and major property damage through three hurricanes in the past two years. We also sought advice from Red Cross preparedness expert Keith Robertory, who named five essentials for any kit: food, water, first-aid supplies, a radio and a source of light. Anything beyond that, he said, depends on location, climate and individual needs for medication and comfort.

The Preparedness Center's $199 kit had 31 items, from a knitted cap to a 13-function knife to freeze-dried food. One surprise: The food required boiling water to prepare, and the kit had nothing to heat up the water - or any water at all. (There's a five-gallon container to fill on your own.) Finally, the panelists found the elaborate restroom kit, including a ''urinal bag,'' a bit much. ''This is ridiculous,'' said one.

The rest of the kits had all five essentials, including sealed packs of water. (The Red Cross recommends keeping a gallon of water a day per person.) Frontier Survival's $92 Deluxe 2-Person 72-Hour Honey Bucket Kit held 29 items, including a gas and water shut-off tool, leather gloves and two ponchos. The bucket can double as a toilet, but the panelists doubted that was necessary, saying they had found plenty of post-storm bathroom alternatives. (We'll leave it at that.) Still, the combination radio-flashlight-siren won points, and two shortbread-like high-calorie food bars and a small supply of six boxes of water were included.

The remaining kits came with backpacks to hold the supplies. The 26-item Hurricane Go Bag Kit, for $90 from Camping Survival, had a small first-aid box and unappetizing ready-to-eat food rations. Even in a disaster, we might have trouble with the ''restructured beefsteak,'' to say nothing of the high, thirst-inducing salt content. We did like the hand-powered flashlight.

Emergency Essentials' $100 Trekker 2-Person 72-Hour Emergency Kit held 49 items. The two food bars and 12 water boxes were complemented with smart extras such as sun-block wipes, toilet paper and multipurpose pliers that one panelist thought would have been useful in hurricanes past. ''It sure beats rummaging through your tool box,'' he said. The kit also had a check-off list of everything else you might need, like prescription medication and extra clothing. The kit comes with two backpacks, and it's our Best Value.

For Best Overall, the judges went with Nitro-Pak Preparedness Center's Executive 72-Hour Survival Kit, with 77 items. A basic kit costs $136, but we ordered the $150 upgraded version, with a wind-up solar radio - a worthy choice, as some panelists said they had quickly run out of batteries after a storm. The basics were mostly well covered, with two high-calorie food bars, 24 water pouches (4.2 ounces each) and a good first-aid kit. The backpack was rugged and held plenty of extras: blankets, a light/heat candle, masks, gloves, ponchos, waterproof matches, a whistle, nylon cord and even playing cards to pass the time.

Is a prepackaged kit really necessary? It's not too difficult to buy the essentials and throw them into a bag. But the panel conceded that if this is what it takes to be prepared, the expense is worth it.

---

STORE/PRICE/PHONE: Nitro-Pak Preparedness Center Executive 72-Hour Survival Kit $149.99 800-866-4876 nitro-pak.com

QUALITY: Best Overall. The most complete and best-designed of the bunch. The big selection of items includes a 60-piece first-aid kit, rugged backpack and even a deck of playing cards.

SHIPPING COST/TIME: Expedited delivery cost $71.38, in three business days. Our order arrived on time.

RETURN POLICY: ''Total satisfaction guarantee,'' site says, within four months. You pay return shipping, unless company is at fault. Return authorization required.

PHONE/WEB EXPERIENCE: Phone order went smoothly. Site says processing now takes two to five days, ''due to recent bird-flu demands.''

COMMENT: Like the other retailers, company stocks a wide variety of disaster kits and items. We went with the solar radio upgrade; standard kit is $135.99.

STORE/PRICE/PHONE: Emergency Essentials Trekker 2-Person 72-Hour Emergency Kit $99.99 800-999-1863 beprepared.com

QUALITY: Best Value. A lot for the money, including a tube tent, sleeping bags, ponchos, waterproof matches, 100-hour candle, hand warmers and bug repellent.

SHIPPING COST/TIME: We paid $42.98 for expedited shipping in three business days, plus a $9 handling charge. Arrived on time.

RETURN POLICY: Company has a 30-day ''unconditional satisfaction guarantee.'' You pay return shipping, unless company is at fault.

PHONE/WEB EXPERIENCE: Helpful. When we had a question about shipping, phone rep called us back right away with an answer.

COMMENT: Company sells a ''Trekker'' kit for one person, at $69.99.

STORE/PRICE/PHONE: Camping Survival Hurricane Go Bag Kit $89.95 800-537-1339 campingsurvival.com

QUALITY: Comes with a handy backpack, but first-aid kit is inconsequential and MREs aren't very appetizing.

SHIPPING COST/TIME: Rush shipping, within three days, cost $59 and was on time.

RETURN POLICY: Notify within seven days of receipt, in new condition. Subject to 5 percent restocking fee. You pay return shipping if company not at fault.

PHONE/WEB EXPERIENCE: Site is a little basic, but placing order by phone was hassle-free.

COMMENT: A spokesman says this is designed as a ''basic kit,'' and that the food is ''just as good'' as some supermarket brands.

STORE/PRICE/PHONE: Frontier Survival Deluxe 2-Person 72-Hour Honey Bucket Kit $91.99 208-745-8145 frontiersurvival.com

QUALITY: Some items - notably, the radio/flashlight/siren - met with approval. Supplies come in a bucket; testers preferred the backpacks in some of the other kits.

SHIPPING COST/TIME: We paid $51.80 for on-time expedited shipping in three business days.

RETURN POLICY: Within eight days. Items must be in new condition. You pay return shipping.

PHONE/WEB EXPERIENCE: Another no-frills site, but phone rep was able to handle our order relatively efficiently.

COMMENT: Kit didn't have toilet paper, but a spokeswoman says it is normally included. ''Maybe we just missed putting it in,'' she says.

STORE/PRICE/PHONE: The Preparedness Center Personal Essentials Portable Emergency Preparedness Kit $199 707-472-0280 preparedness.com

QUALITY: The most expensive, and the most disappointing. No water. No backpack or bucket to store items. Panel found the ''urinal bags'' a bit much.

SHIPPING COST/TIME: We paid $56.79 for expedited shipping in three business days. Order was on time.

RETURN POLICY: Must contact within three days. Items must be like new, food items not returnable. You pay return shipping, unless company is at fault.

PHONE/WEB EXPERIENCE: Detailed site includes an ''earthquake info'' section. Easy online ordering.

COMMENT: Company says it sells other ''more mobile'' kits and that bathroom supplies are popular. It will also be switching to ready-to-eat meals from freeze-dried food.

AP-WS-06-16-06 0941EDT

http://www.newspress.com/Top/Article/article.jsp?Section=BUSINESS&ID=564753380392894478

H5 Bird Flu Confirmed in Sick Gosling on PEI Canada​

http://www.recombinomics.com/News/06160602/H5_PEI_Gosling.html

Recombinomics Commentary
June 16, 2006

A case of H5 avian flu has been confirmed in a gosling by the Atlantic Veterinary College.

Dr. Lamont Sweet, P.E.I.'s chief health officer, said in a news release there is no evidence the virus can be transmitted by eating poultry products, but anyone in contact with poultry needs to take special care.

The sick gosling was from a flock of 20 geese and ducks kept in the backyard of a private home in O'Leary.

The above comments on a confirmed H5 infection in a sick gosling are cause for concern. Distinguishing high pathogenic avian influenza (HPAI) from low path (LPAI) is a relatively simple task. The HA cleavage site of HPAI has multiple basic amino acids, and the H5N1 of concern in Canada would be the Qinghai strain, migrating via the east Atlantic flyway. Virtually all Qinghai isolates have an HA cleavage site of GERRRKKR. This strain was initially identified at Qinghai Lake in May of 2005 and has since spread to southern Siberia, followed by migration to Europe, the Middle East, and Africa. The East Atlantic Flyway links northern Siberia, western Europe, western Africa, and northeast Canada. H5N1 in northeast Canada could then migrate to the south.

Recent sequences from Niger indicate the H5N1 there is distinct from the H5N1 in Nigeria, indicating the infections arrived via migratory birds. Other African countries in the eastern Atlantic flyway include Cameroon, and the Ivory Coast, where H5n1 has been detected. H5N1 has also been detected throughout western Europe (see phylogenetic tree), so migration into Canada this season is expected. Moreover, sequences from H5N1 in Astrakhan suggest H5N1 may have already been introduced into northern Canada last season.

Canada conducted tests on samples collected across southern Canada in August.. H5 was detected, including Prince Edward Island. The LPAI H5 was widespread, but the infected wild birds were healthy. Waterfowl can harbor H5N1 without evidence of illness.

The finding of a sick gosling is a concern, and may signal the appearance of HPAI H5N1. The announcement indicated H5 was confirmed, suggesting that the infection has already been somewhat categorized. Since the announcement did not say that the H5 was LPAI, it is more likely that it indeed is HPAI.

The sequence of the HA cleavage site would be definitive. GERRRKKR would indicate the Qinghai strain of H5N1 bird flu has been confirmed in North America.

H5 Positive Geese in Canada Had Fatal Qinghai Symptoms​

http://www.recombinomics.com/News/06160603/H5_Fatal_Symptoms_Canada.html

Recombinomics Commentary
June 16, 2006

The owner of the birds, who raised them for personal consumption, told authorities he noticed four of his geese were walking oddly on Sunday. The next day he discovered four had died.

He disposed of three but took one for testing to the Atlantic Veterinary College in Charlottetown. The laboratory there confirmed the presence of an H5 virus.

The goose was part of a small, free-range flock of chickens, geese and ducks. Four of 11 geese in the flock were discovered dead on Monday. None of the other birds fell ill at the time but all have since been destroyed as a precautionary measure.

The above comments increase the likelihood that the geese died of H5N1 bird flu. Geese usually are resistant to low pathogenic avian influenza (LPAI). H5N1 can attack the brain, especially the Qinghai strain since in has PB2 E627K, which is linked to neurotropism. Therefore, geese walking oddly is an indication of H5N1 bird flu infection. Since one of the geese was positive for H5, it is likely that the H5 is H5N1 and all of the dead birds were infected.

The Qinghai strain of H5N1 has never been reported in the Americas. However, prior to the identification of the Qinghai strain in China in May of 2005, none of the countries to the west of China had reported the Asian stain of H5N1. The isolates in Russia, Kazakhtsan, Mongolia, India, Europe, the Middle East, and Africa have reported H5N1 for the first time in the past 12 months.

H5N1 in North America would be a surprise. North American sequences have previously been identified in Qinghai strains in Astrakhan.

Thanks JPD. Those stories on the Prince Edawrd Isand case seem rather definative.

It appears that the Prince Edwward Isand strain did come in on a migrating bird. Therefore I assume the strain could travel on another migrating bird to the US.

Link to tomorrows (6/17) Bird Flu thread: http://www.timebomb2000.com/vb/showthread.php?t=201083