07/22-28 | Weekly Bird Flu Thread: "Deception Dominates WHO's Bird Flu Releases"

Link to last week's thread: http://www.timebomb2000.com/vb/showthread.php?t=204090

Here is an important link...
Johns Hopkins on influenza: http://www.iom.edu/Object.File/Master/33/450/Rashid Chotani.pdf

Deception Dominates World Health Organization's Bird Flu Releases​

By Marilyn Bardsley

July 16, 2006

Culture of Deception

If ever there was a need for clear and accurate information about the spreading and rapidly mutating avian influenza, it is now as the threat of a pandemic looms increasingly large. At a time when governments and individuals around the world are making preparations to battle a potentially life-altering disaster, there is no need for a group of bureaucratic elites to decide what information people are capable of handling.

The U.N.'s World Health Organization (WHO) has published its guidelines for the communicating of information about disease outbreaks, but these guidelines have not prevented a deliberate culture of deception from dominating the statements WHO makes to the press.

It has been suggested that WHO does not want people to panic, hence they are not candid when significant events in the evolution of a pandemic are unfolding. What is wrong with this rationale?

On a scale of death, destruction and disaster, Hurricane Katrina would be a minor event compared to an H5N1 influenza pandemic. Would anyone suggest today that state and local governments on the Gulf Coast should have played down the potential for destruction before Katrina hit? So that people wouldn't panic? Then why deceive the world about a pandemic that would kill tens of millions? Why not be truthful so that people and governments have the maximum time available to prepare?

Human-to-Human (H2H) comes out of the closet

WHO cannot guarantee that H5N1 will turn into a pandemic strain and, if it does, when it will happen, any more than people on the Gulf Coast knew for certain where Katrina would hit and what strength it would pack when it did hit. But those uncertainties didn't stop officials and forecasters from warning the region days in advance and cable news broadcasters from almost non-stop coverage as Katrina moved closer. The rationale was that everyone should be as prepared as possible as soon as the danger was recognized.

A pandemic can emerge as quickly as a hurricane and engulf the entire world in a few weeks on the wings — not of migratory birds — of big metal "birds" with airline logos on their sides. One big difference is that one can evacuate from the path of a hurricane, but the pandemic will be global.

Now that most people, at least in western countries, know that the deadly H5N1 strain of avian flu is the most likely candidate for the next pandemic, many are watching the news for any sign that a major evolutionary change in the virus has occurred. The change that people have been trained to look for by countless media reports is that the virus has adapted to humans and can be easily transmitted from person to person like the annual flu.

Earlier this year, WHO did not admit to any human-to-human transmission, despite a number of very suspicious family clusters in Asia, Turkey, Iraq and Azerbaijan. In every single case, WHO used some excuse or another to hide these human-to-human transmissions from the media and the public.

That is, until Indonesia made it impossible to hide — and still the WHO did its very best to deceive the media and the public. It was only on May 30 that Maria Cheng, WHO spokeswoman, finally admitted that there were "probably about half a dozen" cases of human-to-human transmission. These cases went back years and WHO knew then that they were human-to-human cases, but refused then to admit it.

And Dr. Angus Nicoll, chief of flu activities at the European Center for Disease Prevention and Control, acknowledged that "we are probably underestimating the extent of person-to-person transmission."

Indonesia, the Time Bomb

In mid-April 2006, Bernard Vallat, head of the Paris-based World Organization for Animal Health (OIE) told reporters: "Indonesia is a time-bomb for the region." Vallat was referring to Indonesia having Asia's highest number of unchecked infection sites, which he correlated to the number of bird flu cases in birds and humans. Ever mindful of its tourist revenue, the Indonesian agriculture minister rebutted Vallat's comment by announcing that Indonesia was winning its fight against bird flu and expects to be free of the killer virus by 2008.

This Indonesian official's comment was greeted with scorn, but then reports of new cases went comparatively quiet at the end of April and into the first week in May. But the events that put Indonesia squarely into the international spotlight for two months had begun in late April and had gone virtually unnoticed even by the Indonesia media until May 9 when the local media announced that in the Karo area of North Sumatra a man had been hospitalized with suspected bird flu. The Indonesian press also took notice that his mother had died a few days earlier and that others in the family were sick.

Indonesia and other countries had experienced a number of family clusters, which raised the specter of human-to-human transmission, but WHO maintained that in these clusters family members were all infected from exposure the same flu-infected birds, usually in the preparation or eating of them. It was difficult to prove otherwise because WHO withheld critical information about onset dates. Significant gaps between onset dates can account for transmission from one person to another.

But this time it was different: facts emerged that made it impossible for WHO to sweep things under the rug, although they did try.

WHO Saves the World: the Containment Plan

WHO kept talking about a barbeque that occurred on April 29 where all the family members ate chicken and pork, implying that they all ate the same infected meat, but then it became known that the first person to die was already sick on April 27, meaning that she had probably become infected from an unknown source some 2-5 days earlier.

As her condition worsened, many of her relatives came into close contact with her either to nurse or comfort her. Several spent the night in her small room sitting in close proximity while she coughed violently. When she died May 4, her relatives had already been infected and started dying five days later: one on May 9, one on May 10, two on May 12 and one on May 13th. From the onset dates it was likely that she had infected her family members, one of whom was still alive in the hospital.

By that time WHO's laboratory in Hong Kong was confirming that it was an H5N1 infection and WHO was bringing in its team and Tamiflu just like it had done in several countries a few months before. By WHO's calculations they had a maximum 3-week window to contain, or at least slow a pandemic strain after it emerged. They were late in the process since they only had one man on the ground 19 days after the first victim had become sick. The larger team of three didn't assemble in Indonesia until May 18.

But, late or not, the WHO team would go into the village, treat everyone with Tamiflu, test the chickens and kill them if they were infected. Everything would be okay.

But it was a long way from okay.

"Evil Spirits"

The WHO team got a nasty shock in mid-May when they tried to work their usual magic on the villagers in North Sumatra. This small village was a Christian community in the midst of a dominantly-Muslim country, but it had maintained some of the types of beliefs found in other rural communities around the world.

The villagers understood perfectly the tragedy that had befallen their neighbors: "it had been caused by evil spirits." The family had been cursed. No one would go anywhere near their three modest homes. The remaining family members had fled the village to get away from the "evil spirits" and the suspicions of their neighbors.

Declan Butler, reporter for the highly respected Nature publication, summarizes the various reports coming from Indonesian media:

"...villagers concerned that their animals would be killed became hostile to outsiders, resulting in international experts and local teams being subsequently barred from the village for a whole five days. Victims refused to take Tamiflu, fled the government hospital, while families refused protective gear when caring for their sick...the list of unanticipated confusion goes on."

The villagers did not permit the WHO team to go in and test their animals so the source of the infection of the first victim will never be known. It could have been poultry, pigs, cats or any other H5N1-susceptible animal.

As if to underscore the magnitude of the Indonesia problem, a group of protesters beheaded a chicken and drank its blood to show authorities that poultry was not the source of the problem. Later, 100 poultry dealers tore apart live chickens and ate them.

None of the villagers' behavior is necessarily WHO's fault, but it shows that the WHO containment plan won't work in much of the Third World, which represents the areas most likely to produce a pandemic strain.

On that same day, Gina Samaan, a field epidemiologist for the World Health Organization in Kubu Sembilang investigating the recent cluster told reporters that the "avian flu deaths confirmed this week on Sumatra were probably not a result of human-to-human infection and did not suggest that the virus had mutated into a more deadly form." Unfortunately, she was wrong.

The Double Skip

Then on May 22 came the news that another cluster family member, Dowes Ginting, the father of 10-year-old Rafael who died of H5N1 on May 13, died right after they had brought him to the hospital. Dowes started coughing a couple of days after his son's death. He had close contact with his son, caring for him as he was dying.

Dowes was deeply depressed by his son's death, refused treatment for the deadly flu and escaped from the hospital, traveling through at least four villages before he found someone to take care of him. He sought out a local healer — referred to in the press as a "witch doctor " — and hid out in one of the local villages until he was near death, when his wife took him to the hospital.

This event created some very serious credibility problems for WHO. The infection onset dates strongly suggested that son Rafael had been infected by his aunt, the first victim in the family, and that Dowes was infected by his son. Not only did this cluster point to human-to-human transmission, it pointed to human-to-human-to-human transmission. Even worse, you have a man infected with a potential pandemic strain of the virus running around exposing any number of people. So much for the containment plan.

Did the WHO team know about Dowes? If they did know about it, why did they suppress that information and what is one to make of WHO field epidemiologist Gina Samaan's statement?

Damage Control

Something very frightening had happened in that North Sumatran village which was clearly different from other outbreaks. Not only was the variation of the virus a threat, the dangerous, but understandable, behavior of the terrified villagers compounded the threat. For the first time a huge global audience saw how a pandemic could emerge.

Instead of admitting the obvious, WHO went into damage control mode and issued this statement on May 23, the day after Dowes Ginting died:

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

The exposure of the family members, at least from what was described in the Indonesian press, was probably not much different than one would get sitting next to a person for a couple of hours on an airplane or children playing in school. The first victim's family members sat in a room with her for several hours, which is similar to exposure that exists in homes, schools and businesses everywhere.

"....Priority is now being given to the search for additional cases of influenza-like illness in other family members, close contacts, and the general community. To date, the investigation has found no evidence of spread within the general community and no evidence that efficient human-to-human transmission has occurred."

From now on there is no talk of "no confirmed cases of human-to-human transmission" in what WHO tells the media. Now the wording has changed ever so slightly to "no evidence that efficient human-to-human transmission has occurred." Good thing that there wasn't because that is a pandemic, but WHO never explained that to reporters.

"Full genetic sequencing of two viruses isolated from cases in this cluster has been completed by WHO H5 reference laboratories in Hong Kong and the USA. Sequencing of all eight gene segments found no evidence of genetic reassortment with human or pig influenza viruses and no evidence of significant mutations. The viruses showed no mutations associated with resistance to the neuraminidase inhibitors, including oseltamivir (Tamiflu).

"The human viruses from this cluster are genetically similar to viruses isolated from poultry in North Sumatra during a previous outbreak."

The world was left to puzzle out how something so dangerous could occur within the context of this statement. "No significant mutations?" Obviously something significant occurred in this variation of the virus. While the most of the media latched onto this phrase and trumpeted it in the headlines, others wondered if WHO's experts understood enough about the virus to even know what mutations were significant.

More Spin

On May 24 a very nervous global audience, astonished that the Indonesians had let the infected Dowes Ginting leave the hospital, was soothed by WHO spokesman Dick Thompson: "There are 33 people identified as close contacts," he told reporters. "We've asked them to observe home quarantine. That's something they are willing to do to protect themselves and their families." The number quickly rose to 54 people as WHO realized how many people Dowes had exposed in his escape from the hospital in Medan and there was absolutely no assurance that they had identified them all.

At the same time, Maria Cheng, another WHO spokesperson, told the New York Times the villagers were quarantined. She did not mention that the quarantine was voluntary, not enforced, and villagers went about their business as usual. Furthermore she neglected to mention that many refused to have their blood tested and refused the anti-viral Tamiflu. Not exactly an ideal quarantine — not even close to ideal. Upon questioning, she admitted that the villagers "had not been as cooperative as we'd like." Quite an understatement, given the facts.

In the next few days WHO continued to downplay the events in Indonesia, telling the press "that even if human-to-human transmission did occur, it was in a very limited way and the infection has not spread beyond the family cluster. In addition, scientific evidence has shown the virus has not mutated into one that can be easily passed among people."

That statement may have been true, but WHO would have had no way of knowing it when they announced it. They had no effective means of identifying everyone that had been exposed and no effective way of monitoring those that they knew had been exposed.

Keeping WHO honest

At least one expert wasn't impressed by WHO's attempts to play down the significance of the Indonesian cluster. Dr. Henry L. Niman, founder of Pittsburgh-based recombinomix, Inc., has been promoting a theory of viral evolution called recombination, which he calls "elegant evolution." Recombination, as Niman explains it, permits researchers to predict the genetic components of a pandemic influenza virus because changes in the viruses are predictable and permit vaccines to be prepared in advance.

His daily commentary on his web site and his explanations of virus behavior on discussion forums like Flutrackers have made him a popular figure among the growing number of people who closely watch the forward march of the deadly H5N1 virus. Several of his predictions have been unnervingly accurate. Niman also brings into high relief inaccuracies and spin in the WHO press releases.

For example, WHO's desire to pretend, while it could, that human-to-human transmission did not occur in various cluster cases around the world, led various WHO spokespeople to claim during last winter's large Turkish cluster that the H5N1 incubation period was as long as 17 days. Niman punctured the credibility of this statement by referring his audience to a New England Journal of Medicine article indicating that most H5N1 infections had an incubation period of 2-5 days.

Niman always reminds his audience that the H5N1 virus doesn't read WHO press releases.

As long as WHO could keep a lid on the virus genetic information, Niman's theories on a particular cluster could not be proven. Imagine WHO's surprise when Niman was the first to expose WHO's deceptions about the virus mutations in the large Indonesian cluster that had not yet been made public.

Withholding The Evidence

WHO has been able to get away with many of its deceptions regarding the genetic mutations in the H5N1 virus because of its increasingly controversial practice of not making the genetic information public so that the world's scientific community can study it. Hopefully, this practice is coming to an end — one way or another.

Some interesting things happened when various influenza experts met in Jakarta June 21-23. The presentations and the information about the mutations in the large Indonesian cluster discussed in this closed session were leaked. Niman received the genetic sequences from that cluster and divulged what he learned to his entire audience.

It was no surprise to Niman that the mutations were much more extensive than WHO let on to the public. Apparently, the statement that WHO released was accurate, but the wording was very carefully parsed and much information had been left out.

Subsequently, Nature published a revealing article on the full mutations in the Indonesian cluster where human-to-human transmission took place at least twice. Declan Butler commented on it in his blog:

"WHO said on 23 May that there was 'no evidence of genetic reassortment with human or pig influenza viruses and no evidence of significant mutations.'

"The data obtained by Nature suggests that although the WHO statement was not incorrect, plenty more could have been said. Viruses from five of the cases had between one and four mutations each compared with the sequence shared by most of the strains. In the case of the father [Dowes Ginting] who is thought to have caught the virus from his son — a second-generation spread — there were twenty-one mutations across seven of the eight flu genes."

WHO has to abide by the constraints put on them by member states, who own the genetic information gathered within their countries. Countries may not permit the sharing of the influenza genetic data because they want to have an advantage in developing a vaccine faster if a pandemic strain emerges in their country — a vaccine which would find a ready market in the rest of the world. Some media reports have suggested that Indonesia is willing to share its information, but WHO has not yet formally requested it.

In a world where it is increasingly difficult to get a large number of countries to agree on anything and where the levels of ignorance and poverty encourage a perfect breeding ground for the development of a pandemic strain of influenza, it is unreasonable to expect that WHO can always contain the outbreaks in time and that they can persuade corrupt and negligent governments to act responsibly.

What we can and should expect from WHO is the truth — as soon as they know it — not spin or information management that insults human intelligence. If the United Nations' World Health Organization cannot be trusted in the prelude to a pandemic, what good do they serve?

http://www.crimelibrary.com/news/original/0706/1402_who_looking.html



Photos: WHO Seal & Dr Henry Niman

Excellent commentary; the best I have seen so far. So much for trusting WHO when they have to answer to political objectives of member countries!

The world is getting closer and closer to having a very transmissible human-to-human strain- got preps?!

I check Dr. Niman's page for commentary every few hours.

http://www.recombinomics.com/whats_new.html

H5N1 Bird Flu in Aksu Xinjiang​

http://www.recombinomics.com/News/07210601/H5N1_Aksu.html

Recombinomics Commentary
July 21, 2006

China has announced it had killed nearly 400,000 chickens in the far northwest of the country to control a fresh outbreak of bird flu.

The outbreak was discovered on July 14 in Aksu city, Xinjiang region, when 3,045 chickens were found dead, the agriculture ministry said in a brief statement on its website on Friday. .
Since then 356,976 chickens have been killed as part of emergency measures to contain the outbreak,

The above comments suggest that the H5N1 Qingahi strain of bird flu is expanding into new areas. Initial reports of H5N1 infections this spring in China were similar to 2005 (see map) in timing, but somewhat to the south in location. Although H5N1 was detected at Qinghai Lake in May, most of the H5N1 positive bar headed geese were near the southern border of Qinghai Province and the adjacent northern region of Tibet.

These reports were followed by outbreaks to the west in Xingiang province, as happened in 2005. However, these reports were further to the south. The report above extends this trend. Asku city is only about 50 miles from the borders with Kyrgyzstan and Kazakhstan. Moreover, the outbreak is only a few hundred miles from borders with Uzbekistan, Tajikistan, Afghanistan, Pakistan, and India. H5N1 has previously been reported in Afghanistan, Pakistan, and India, but the latest report from China suggests unreported H5N1 is also in Tajikistan, Uzbekistan, and Kazakhstan.

This added spread is also being reported in Russia, where H5N1 has again been detected in the areas near Chany Lake, but also to the east in a massive die-off in Tuva. These data suggest significant levels of H5N1 in a wider area, and suggest additional recombinants will be flying south in a few months as the northern regions begin to cool.

These new sequences are expected to create new problems.

Indonesia faces obstacles in eradicating bird flu​

http://english.peopledaily.com.cn/200607/22/eng20060722_285658.html

The huge territory and people's ignorance had hampered Indonesian health authorities' efforts to eliminate bird flu, Indonesian Vice President Jusuf Kalla said here on Friday.

Since the government launched massive efforts to combat the spread of the virus a few years ago, many chicken and bird traders and owners have been reluctant to kill their belongings which were found infected with the H5N1 virus, due to the lack of knowledge about the danger of virus and the consideration that about ten U.S. cents compensation for a poultry was too little.

The vice president said it was necessary for the country to take stern actions to fight bird flu and asked the people to be submissive to any orders from health authorities for eliminating the outbreak.

Kalla called on the people to immediately slaughter their poultry when they were infected with the avian influenza virus.

"We need stern acts. We ask all the people to stamp poultry ( infected with the virus). All must obey rules," he said.

Indonesia has recorded 42 human deaths from the virus.

Earlier, the World Health Organization top official David Nabarro has said that the huge territory has hampered the bird flu eradication in Indonesia.

Most of poultry in Indonesia is in back yard, which leads the virus to spread easily and difficult to control.

Source: Xinhua

China

New Bird Flu Focus Registered in China​

22 July 2006 | 10:59 | FOCUS News Agency

Beijing. A new bird flu focus was registered among poultry in China, the Chinese Xinhua agency reports.

According to the information the birds infected with the dangerous for humans strain of H5N1 were found in several poultry farms near the town of Asku.

Some 3,000 birds died of the infection. Then the authorities killed more than 350,000 poultry to avoid the dissemination of the virus. According to the Ministry of Agriculture of China the situation there was under control.

http://www.focus-fen.net/index.php?catid=139&newsid=92681&ch=0&datte=2006-07-22

Sun, July 23, 2006 : Last updated 9:00 am (Thai local time)

Avian influenza suspected after two dine on doves​

Two cases of suspected bird flu in humans have been found in Uttaradit, one of the seven provinces declared a "red zone" by the Department of Livestock Development (DLD), a local health official said yesterday.

A 67-year-old man and his 35-year-old son-in-law were recently admitted to Uttaradit Provincial Hospital. They had developed symptoms similar to those caused by the bird-flu virus after eating spotted doves, said Dr Boonrieng Chuchaisaengrat, head of the provincial health office.

The men were transferred from Tha Pla District Hospital on Friday and detained at the provincial hospital, said Boonrieng.

Blood samples were collected from the two patients and sent for testing at the Northern Medical Science Centre in Pitsanulok. The results were expected in a few days, he added.

Panom Meesiriphan, chief of the province's livestock office, insisted that although there had been suspicious deaths of poultry in many districts, there had been no confirmed case of the H5N1 virus.

Despite declaring seven provinces bird-flu "red zones" the DLD's director-general Yukol Limlamthong said Thailand had not been hit by an outbreak of the virus.

"The red zone means the area has a high risk of becoming an infected area, but it does not mean that it is already infected," said Yukol.

Besides Uttaradit, the other six red-zone provinces are Sukhothai, Pichit, Pitsanulok, Suphanburi, Nakhon Pathom and Kanchanaburi.

When the country recorded the first cases of bird flu between January and May 2004, the DLD used the term "red zone" to define the provinces that were hit by the virus.

The DLD's new definition of "red zone" has confused some medical practitioners. A source at the Disease Control Division said that for some doctors "red zone" meant an infected area. "Medical doctors believe the H5N1 virus has already arrived in Thailand, but no one wants to confirm it," said the source, who asked not to be named.

On Friday a leading virologist from Siriraj Hospital, Professor Prasert Thongcharoen, expressed doubt about the accuracy of official reports on bird flu. He said that in his experience when livestock officials said "no" it meant "yes".

http://nationmultimedia.com/2006/07/23/national/national_30009355.php

Lone Bird flu survivor goes home after 7 relatives die​

http://www.thejakartapost.com/detaillgen.asp?fileid=20060723132339&irec=5

MEDAN, North Sumatra (AP): Jones Ginting can't remember much of his battle with bird flu, and it's probably for the best.

For the first two weeks, he slipped in and out ofconsciousness at a hospital. His skin stuck to the sweaty sheets as his fever raged up to 39.5 C (103.1 F). He slept with arms stiff as pipes. When he did come to, he was delirious, angry even, fighting nurses who tried to give him the antiviral drugTamiflu. Always struggling to breathe.

Perhaps in the back of Ginting's mind, he remembered how his family had gathered for a feast in late April. They had laughed while eating chicken curry and grilled pork as their children played. Then, one by one, they started falling sick and dying.

First his sister, then nephews, a niece and two other siblings.

The world turned its attention to the family and the tiny Christian farming village on Indonesia's Sumatra island. Seven of the eight sickened relatives tested positive for the H5N1 bird flu virus, the World Health Organization said. And though specimens were not taken from Ginting's sister before her burial, she is considered part of the world's largest reported cluster of cases.

WHO later said she likely was infected from contact with poultry, then passed the virus on to the other relatives through human-to-human transmission. The spread stopped with the eighth blood-related family member, and no one else became sick. But themere size of the cluster was enough to raise international concern.

Ginting, 24, initially was scared and confused and refused to believe bird flu was to blame. When first admitted to Adam Malik Hospital in early May, the orange farmer went with his gut instinct and ran away. His wife, Amnestia Tarigan, and their twosmall boys climbed into a taxi and raced to a nearby doctor who was a trusted relative. Ginting took some medicine and then drove two hours to a town near his home village where he visited a traditional healer. His condition worsened and he was eventuallybrought back to the hospital in Medan.

"Jones was afraid to stay at the hospital because his brother and other relatives had died there," recalled Amnestia, 23. "He was afraid he would die there. That's why he ran."

After returning, Ginting continued to grapple with death. His head pounded and it "felt like a hammer was hitting my hips again and again." Blood gushed out of his nose, and he had nonstop coughing fits that lasted up to two hours. He was so tired.

"I had no hope at all," Ginting told The Associated Press while sitting on the floor of a relative's house in Medan after being discharged. "I was very sick. I thought maybe I could die at any time. Just die - that's it."

His doctor also didn't think the young man with a shaved head and colorful tattoos would make it.

"Everybody was surprised. The international doctors were all surprised. How can he survive?" asked Dr. H. Luhur Soeroso, a specialist who treated Ginting. "Everyone told me, it's a miracle." (**)

Thailand

Suspected bird-flu cases in Phichit​

http://nationmultimedia.com/2006/07/24/national/national_30009409.php

Three more people with suspected bird-flu have been reported in Phichit, one of the provinces listed by the government as an avian-flu "red zone".

Two of the patients were men aged 59 and 86 and the other was a boy aged seven. All three had reportedly been in contact with dead chickens and were being treated in an isolation ward at Phichit Hospital.

Pending the results of laboratory tests for evidence of the bird-flu virus, doctors said the three patients were not allowed visitors.

Livestock officers in the province were stepping up disinfection of sites where irregular poultry deaths were reported. Hundreds of such deaths have recently been reported in the province.

Meanwhile, deputy chief health officer for Chiang Mai, Surasing Wisarutarat, warned the public not to cook dead chickens, no matter how they died.

"The group we're most concerned about is immigrant workers," he said. "They are most likely to opt for dead chickens and risk contracting bird flu."

Despite numerous reports of irregular poultry deaths in many areas, particularly the North and Central provinces, the Department of Livestock Development insists that no avian flu has been detected so far.

BIRD FLU / HEAVY RAINS INCREASE THREAT​

http://www.birdflubreakingnews.com/...www.bangkokpost.com/News/24Jul2006_news10.php

Virus could reappear among weakened birds

KULTIDA SAMABUDDHI

There is a high possibility that bird flu will re-emerge in poultry flocks in areas where birds have been left weakened by the effects of heavy rainfall and flooding, the Livestock Development Department admitted yesterday.

"It is highly possible the disease will make a comeback because weak and sick fowls can be easily infected by the H5N1 virus," said Nirundorn Aungtragoolsuk, director of the Disease Control Bureau.

Falling temperatures during the wet season would make the birds even more vulnerable.

Dr Nirundorn's comment followed reports of mass deaths of poultry in five tambons in the northern province of Phitsanulok, which led to livestock officials culling more than 1,000 fowls to prevent the spread of the disease.

Tests are being made on chicken carcasses for evidence of avian flu.

Thailand had been free of bird flu for 256 days as of yesterday since the last culling of H5N1-infected poultry last November.

Fears of its re-emergence loomed again recently when a number of fowls were found dead from unknown causes.

However, lab tests found no trace of the bird flu virus in the carcasses.

Dr Nirundorn said the situation was most worrying in Phichit, Phitsanulok and Sukhothai, where chickens had died in large numbers.

Last week, the department declared six provinces _ Phichit, Phitsanulok, Sukhothai, Nakhon Pathom, Suphan Buri and Kanchanaburi _ red zones and began stringent monitoring for bird flu.

"These provinces are prone to a bird flu outbreak because they have been heavily hit by floods and heavy rain. There are also a large number of free-range ducks roaming in the fields there," said Dr Nirundorn. Free-range ducks are recognised as prime causes of bird flu outbreaks.

Two villagers from the flood-hit Uttaradit province were listed as suspected bird-flu cases on Saturday after eating spotted doves.

Doctors took blood samples for tests. Results are expected in a few days.

H5 Bird Flu Confirmed in Pichit Thailand​

Recombinomics Commentary
July 24, 2006

Officials said the H5 virus was detected on a farm in the northern province of Pichit, one of seven "red zone" provinces where surveillance was stepped up this month, and test results were expected in a few days.
If H5N1 is confirmed, it would be Thailand's first confirmed outbreak of the virus in nearly nine months.

An 11-year-old girl was in a Pichit hospital on Monday with flu-like symptoms after chickens died on her family farm, a doctor told Reuters. Test results are due on Tuesday.
"The chickens started to die on July 8 and she helped her mother bury the dead chickens without any protective gear

Three more people with suspected bird-flu have been reported in Phichit, one of the provinces listed by the government as an avian-flu "red zone".

Two of the patients were men aged 59 and 86 and the other was a boy aged seven. All three had reportedly been in contact with dead chickens and were being treated in an isolation ward at Phichit Hospital.
The above comments confirm H5 bird flu in Phichit, Thailand and raise the possibility the strong possibility that the patients hospitalized in the area with bird flu symptoms are infected. Although Thailand has denied H5N1 in birds, dogs, and people in the past, the denials have been controversial. H5N1 cas been isolated from dog, cat, and tigers in Thailand.

The detection of H5 in birds will almost certainly be H5N1 and the relatively large number of people hospitalized in the area is cause for concern.

http://www.recombinomics.com/News/07240601/H5_Pichit.html

Bird flu spiraling out of control in Indonesia​

http://www.birdfludefense.com/019738.html

(NewsTarget) While Indonesia discovered its first bird flu outbreak fairly late in comparison to some other infected countries, it has endured one of the fastest spreads, with 42 human H5N1-caused fatalities reported since the first case was confirmed a year ago.

Until the latest Indonesian death was confirmed yesterday, Vietnam topped Indonesia as the country hardest hit by bird flu with 42 deaths since 2003 -- but Vietnam has not had a single human case this year. The disease continues to rage out of control in Indonesia, and experts say it will only get worse.

“It’s like trying to fix the roof while there’s a storm going on,” said Dick Thompson, a spokesman for the World Health Organization. “Until the animal situation gets under control, there’s going to be this steady drip, drip, drip of human cases, and that’s a problem.”

Although H5N1 is still a relatively rare disease among Indonesia's 245-million-strong population --compared to Vietnam's 84 million people -- experts say the country's decentralized government is exacerbating the problem. Since the fall of the Suharto dictatorship in 1998, most regions of the country have moved to a system of self-government; a condition most prefer to the harsh central control of the previous government in Jakarta.

“Decentralized units get very wary when the center takes on emergency powers,” said Dr. David Nabarro, chief pandemic flu coordinator for the United Nations.

The lack of communication and cooperation between the regions has assisted bird flu's spread. Commonly, the response to a bird flu outbreak in Indonesia consists of limited culling and a vaccination ring around the cull, a practice that has been largely ineffective compared to the repression methods in other infected countries. Thailand quickly stemmed the tide of their outbreak by culling millions of chickens, and Vietnam brought their infections under control with mandatory vaccinations.

Other issues assisting the disease's spread are the sheer prevalence of poultry in Indonesia, a lack of compensation for culled birds -- causing a lack of cooperation from farmers -- and even superstition. Members of one village refused vaccination for the infection because they believed it had been brought on by witchcraft.

Indonesia does have the potential to fight off bird flu, as it did when a polio outbreak hit last year. A lone case of the disease was reported in May of 2005, which quickly grew to 303 cases, but a countrywide immunization campaign reduced the cases to just two so far this year. But so far, the country has shown no signs of such organization against bird flu.

Duck hunter exposed to type of bird flu

http://news.yahoo.com/s/nm/20060724/us_nm/birdflu_hunters_dc



By Maggie Fox, Health and Science Correspondent
Mon Jul 24, 6:27 PM ET



WASHINGTON (Reuters) - A U.S. duck hunter and two state wildlife employees had evidence of an uncommon type of bird flu virus in their blood, researchers reported on Monday in one of the first studies to show that hunters might be at risk.
]

The virus was H11N9, not known to be dangerous to humans and not related to the feared H5N1 virus circulating in wild and domestic birds and among some people, the researchers said.

But their study, published in the journal Emerging Infectious Diseases, shows that people who work with wildlife should take care.

"To our knowledge, this study is the first to show direct transmission of influenza A viruses from wild birds to humans," Dr. James Gill of the University of Iowa and colleagues wrote in their report.

The H5N1 avian influenza virus has not yet caused a human pandemic, but it has killed 132 people out of the 230 infected. It has infected birds in about 50 countries and is spreading faster than any other avian influenza ever has.

Many experts believe it may pose the worst threat of an influenza pandemic in 30 years.

The natural host is ducks, and migrating waterfowl have been shown to spread the disease. Most ducks do not become sick from avian influenza, but some strains can kill chickens in a day.

NO PROTECTIVE GEAR

The researchers studied 39 duck hunters who were hunting in southeastern Iowa at Lake Odessa Wildlife Management Area, and 68 Iowa Department of Natural Resources employees who either hunted or help band wild ducks.

Three of the men had antibodies against H11N9, suggesting they had either been infected in the past or had fought off an infection.

All three "had substantial lifetime exposures to wild waterfowl," the researchers wrote.

None of the other hunters or wildlife workers had evidence of H11N9 virus in their blood, the researchers said.

In addition, the two wildlife employees had antibodies against a mallard duck strain of H2N2 influenza, which caused human epidemics in the 1950s and 1960s.

"Even though the H11-positive study participants had several years of exposure to wild birds infected with avian influenza virus through hunting and duck banding, they did not wear personal protective equipment, such as gloves, masks, or eye protection," the researchers wrote.

They did not ask the three men if they had flu-like symptoms.

"Although the sample size of our study was relatively small, our results suggest that handling wild waterfowl, especially ducks, is a risk factor for direct transmission of avian influenza virus to humans," they wrote.

The U.S. Fish and Wildlife Service and the U.S. Geological Survey are testing wild birds for H5N1 flu, which has not been seen in the Americas yet.

"Many species that breed in Alaska migrate and winter throughout parts of Russia and Asia," the USGS says in a statement on its Internet Web site at http://alaska.usgs.gov/.

"Birds could be exposed to H5N1 in Asia or Russia during winter or on migration and carry the virus to Alaska in spring along migratory corridors."

=



<i>mo_magic expressed concern that there wasn't much news on H5N1; and seeing as I have a bit of time (before looking into the ME) I'll see what I can find for him..</i>

<B><font size=+1 color=red><center>Thailand confirms new bird flu cases</font>

By Amy Kazmin
July 25 2006 03:00
<A href="http://www.ft.com/cms/s/0154603c-1b7a-11db-b164-0000779e2340,_i_rssPage=7f5f6b12-2f66-11da-8b51-00000e2511c8.html">LINK</a></center>
Thailand has confirmed a small outbreak of bird flu in fighting cocks in its northern province of Pichit, the first cases of avian influenza detected in birds in Thailand since last November. Agricultural authorities said that birds had died of a type of bird flu, though they claimed that the sub-type had yet to be confirmed.</b>

However, Bangkok-based bird flu experts said they were in little doubt that the virus was the highly contagious H5N1.

Thailand culled millions of birds in 2004 and has maintained tight surveillance over poultry.

=




<B><font size=+1 color=brown><center>Hunters and wildlife workers test positive for bird flu virus </font>

1.00pm Tuesday July 25, 2006
<A href="http://www.nzherald.co.nz/section/story.cfm?c_id=2&objectid=10392874">LINK</a></center>
WASHINGTON - A US duck hunter and two state wildlife employees had evidence of an uncommon type of bird flu virus in their blood, researchers reported on Monday in one of the first studies to show that hunters might be at risk.

The virus was H11N9, not known to be dangerous to humans and not related to the feared H5N1 virus circulating in wild and domestic birds and among some people, the researchers said. </b>

But their study, published in the journal Emerging Infectious Diseases, shows that people who work with wildlife should take care.

"To our knowledge, this study is the first to show direct transmission of influenza A viruses from wild birds to humans," Dr. James Gill of the University of Iowa and colleagues wrote in their report.

The H5N1 avian influenza virus has not yet caused a human pandemic, but it has killed 132 people out of the 230 infected. It has infected birds in about 50 countries and is spreading faster than any other avian influenza ever has.

Many experts believe it may pose the worst threat of an influenza pandemic in 30 years.

The natural host is ducks, and migrating waterfowl have been shown to spread the disease. Most ducks do not become sick from avian influenza, but some strains can can kill chickens in a day.

The researchers studied 39 duck hunters who were hunting in southeastern Iowa at Lake Odessa Wildlife Management Area, and 68 Iowa Department of Natural Resources employees who either hunted or help band wild ducks.

Three of the men had antibodies against H11N9, suggesting they had either been infected in the past or had fought off an infection.

All three "had substantial lifetime exposures to wild waterfowl", the researchers wrote.

None of the other hunters or wildlife workers had evidence of H11N9 virus in their blood, the researchers said.

In addition, the two wildlife employees had antibodies against a mallard duck strain of H2N2 influenza, which caused human epidemics in the 1950s and 1960s.

"Even though the H11-positive study participants had several years of exposure to wild birds infected with avian influenza virus through hunting and duck banding, they did not wear personal protective equipment, such as gloves, masks, or eye protection," the researchers wrote.

They did not ask the three men if they had flu-like symptoms.

"Although the sample size of our study was relatively small, our results suggest that handling wild waterfowl, especially ducks, is a risk factor for direct transmission of avian influenza virus to humans," they wrote.

The US Fish and Wildlife Service and the US Geological Survey are testing wild birds for H5N1 flu, which has not been seen in the Americas yet.

"Many species that breed in Alaska migrate and winter throughout parts of Russia and Asia," the USGS said.

"Birds could be exposed to H5N1 in Asia or Russia during winter or on migration and carry the virus to Alaska in spring along migratory corridors."

- REUTERS

=




<B><font size=+1 color=green><center>Govt stifling bird-flu mapper, says firm </font>

25 July 2006
By PAUL GORMAN
<A href="http://www.stuff.co.nz/stuff/0,2106,3743291a7144,00.html">LINK</a></center>
Christchurch technology that could save thousands of lives around the world in a bird-flu pandemic is being stifled by government bureaucracy here, its developers say.

Encos Global Systems has developed a computer-based application called Chameleon that enables medical field teams to identify, isolate and contain outbreaks of bird flu almost instantaneously. </b>

Using palm pilot computers, medical field workers enter their diagnosis of a case of bird flu into a centralised database. Within seconds, decision-makers can see the spread of the disease and immediately quarantine infected suburbs or towns.

New Zealand's army and navy have carried out successful trials of the system.

Overseas agencies, including the World Health Organisation (WHO), the United Nations Foundation (UNF), the Food and Agriculture Organisation and the Centre for Disease Control in the United States have been given demonstrations of it and are said by Encos to be excited about the technology.

The UNF has told Encos it supports Chameleon and is now giving demonstrations to WHO regional offices throughout South-east Asia.

"If WHO expresses the need for software applications, we will surely endorse Chameleon," UNF technology partnerships director Mitul Shah told the company in May.

But the privately owned Christchurch company of 30 staff, which specialises in automating processes that rely heavily on paperwork, says it is having a hard time at home cutting through government red tape.

Chief executive Chris Hogg said the company felt frustrated that the Government appeared uninterested in its product. The cost of the system to the Government would be less than $1 for every New Zealander.

"We've been to a number of government departments and have got absolutely zero traction," Hogg said.

"It's probably no different here than anywhere else. It's like nothing's going to happen until it (bird flu) hits."

Encos had approached the Ministry of Health twice and was told there was "no need for anything yet and when we do we'll tender it", Hogg said.

Environmental Science and Research (ESR) was contacted about Chameleon but had not responded, while the Ministry of Civil Defence and Emergency Management had said Encos should wait for any request for proposals that might be made. It was too busy to see a demonstration of the system, but had added the company to its database.

Biosecurity New Zealand said it had also put Encos on file and would be in touch if a request was issued.

An ESR spokeswoman told The Press the organisation had no record of any approach by Encos. Civil Defence and Biosecurity did not return calls.

Health Minister Pete Hodgson referred questions from The Press to the Ministry of Health.

Public health directorate senior adviser Annie Coughlan said the ministry had given "careful consideration" to the Chameleon system but was not interested in it at this stage.

"The Ministry of Health works closely with the World Health Organisation around potential outbreak investigation tools and this is not one of those tools," she said.

The Government was happy with progress on pandemic planning, she said.

National Party health spokesman Tony Ryall said the Government's slow response to a potentially life-saving idea from a New Zealand business showed how fragmented the health system had become.

He said the company was caught in a "labyrinth of bureaucracy".

A navy spokeswoman confirmed that it had been involved in a trial of the system but did not want to comment further, saying the Ministry of Health was the lead agency in pandemic planning.

The army is publicly backing the equipment.

Lieutenant Colonel Oiroa Kaihau , of the army's Health Support Battalion in Palmerston North, said Chameleon was "a fantastic piece of kit".

The army had carried out a trial in Manawatu in February. Four teams had been sent out with information on a hypothetical outbreak of bird flu and had to interpret it and send it to the Chameleon website.

The trial monitored the website to see the way it mapped the spread of the disease and confirmed the accuracy of the readings.

Some personnel had worn protective clothing suitable for nuclear, biological or chemical attack, but that had not inhibited the ability to send the data, Kaihau said. "It was very useful and has a lot of wider applications, not just pandemic planning. But for people who want to map it (the spread of bird flu), it's fantastic," he said.

=





<B><font size=+1 color=blue><center>Regional action plan for avian flu</font>

Tuesday, July 25, 2006
<A href="http://www.fijitimes.com/story.aspx?id=45318">LINK</a></center>
THE Sectretariat of the Pacific Community has been tasked with drafting an action plan in the event a human case of the avian influenza is reported in the region.

This was resolved at the weeklong meeting in Nadi this week which focuses on the implementation of the Pacific Regional Influenza Pandemic Preparedness Plan.</b>

Doctor Ken Cokanasiga, adviser for the Animal Health and Production Group in Suva said the project would give the countries an opportunity to establish a proper framework for addressing zoonotic diseases diseases transmitted from animals to humans and other emerging threats.

"This is because the region is vulnerable to the introduction of pandemic influenza through the movement of people, migratory birds and legal and illegal trade in poultry and poultry products."

Dr Cokanasiga said the approach being taken was in line with international efforts by the World Health Organization, the Office of International Epizooties (OIE) and Food and Agriculture Organisation to address a potential pandemic through collaboration between animal health and human health authorities. Dr Cokanasiga said the development of the PHOVAPS advisory group was a direct response to a regional request made at the 2005 PHOVAPS Meeting in Nadi last year.

=





<B><font size=+1 color=purple><center>Community prepares for possibility of pandemic flu</font>

The Daily Press
Monday, July 24th, 2006 01:17:59 PM
<A href="http://www.ashlandwi.com/dailypress/index.php?sect_rank=5&story_id=210355">LINK</a></center>
In Bayfield County and across the state and nation, public health agencies are working with hospitals, clinics, other agencies and organizations to assess and improve community readiness for pandemic influenza.

On July 26, the Bayfield County Health Department and Red Cliff Tribe will facilitate a pandemic influenza assessment. Participants include representatives from Memorial Medical Center in Ashland, clinics, emergency management, human services long term care and nursing homes, in addition to local and tribal governments. </b>

"The group will complete a standard questionnaire to help determine our level of preparedness in the event of pandemic influenza. Our discussion and results will be used by Wisconsin Division of Public Health to advance state and local readiness. This process helps identify the parts of our response plan that need more input from local decision makers," said Amelia Lindsey, Bayfield County health officer.

Other events planned include pandemic influenza education meetings and a tabletop exercise to further enhance the existing Bayfield County and Red Cliff Tribe pandemic influenza plan.

A functional mass clinic exercise in September will allow public health officials to practice setting up and conducting a mass vaccination/dispensing clinic while working with emergency planning partners.

It is critical for individuals, families and businesses to plan for long-term emergencies such as pandemic influenza that will disrupt routine activity. Visit www.pandemicflu.gov for details on the steps you should take:

• Make your individual, family and business emergency plans

• Consider the special needs of seniors, people with limited mobility or limited access to emergency information, children and pets

• Practice good hand washing hygiene

• Cover coughs and sneezes

• Stay home and away from others when you are sick

• Get adequate sleep and physical activity,

• Eat a balanced diet

• Make sure adult and child immunizations are up to date

Currently, the U.S. federal government is focusing on comprehensive public health efforts that include increasing surveillance monitoring for outbreaks, international cooperation, antiviral and vaccine stockpiles, and building more robust capacity for vaccine production. These advancements will enhance response no matter what pandemic strain emerges or where.

For more information about local emergency planning efforts contact Jan Victorson at 373-6113, Amelia Lindsey at 373-6109, or Dick Reese at 779-3707, ext. 236.

=




<B><font size=+1 color=red><center>Hotels lined up to be flu quarantine stations </font>

25 July 2006
By CHALPAT SONTI
<A href="http://www.stuff.co.nz/stuff/0,2106,3742739a11,00.html">LINK</a><?center>
Hotels will be used to quarantine travellers to New Zealand in the event of a flu pandemic.

A top pandemic response planner has confirmed officials are negotiating with hotels and motels in the seven cities with international airports over their use as quarantine stations. </b>

John Ladd, operations coordinator for the inter-agency Border Working Group, said hotels were the most appropriate places to hold international visitors who had travelled through at-risk areas but did not show outward signs of flu.

The length of quarantine would depend on the severity of the pandemic, said Mark Jacobs, director of public health, but was typically two incubation periods. An incubation period is the time between someone getting infected and becoming sick.

Mr Ladd said if the seasonal flu was a guide, the incubation period was likely to be up to 48 hours. He would not reveal which hotels were being considered.

Planners originally considered the Ohakea Air Force base the most suitable quarantine station, but that was rejected as it "just didn't make sense".

"Ohakea is not a particularly salubrious place. There are a lot of human rights issues to take into account, people have to be able to get hold of their loved ones and so on."

AdvertisementAdvertisementHealth workers would examine passengers at the airport before moving them to the appropriate place.

In busy airports, such as Auckland, care would have to be taken not to let passengers from different aircraft mix.

However, Mr Ladd said he did not expect a flood of travellers to New Zealand in a pandemic. The Sars virus outbreak saw just a handful of people travel to New Zealand on some flights from Asia.

Legislation before Parliament allows for automatic visa extensions for travellers already in New Zealand to restrict the need for face-to-face contact.

Various places have previously been mooted as quarantine stations for the general population, including islands, schools and prison facilities.

Worst-case scenarios show if the bird flu virus H5N1 sparked a pandemic, 1.6 million people would become ill in New Zealand, with 1.3 million sick at its peak. About 33,000 of those were likely to die.

About 100 people have died worldwide of bird flu since 2003.

Europe raps delay of bird-flu report​

http://www.bangkokpost.com/breaking_news/breakingnews.php?id=111207

Goverment reluctance to admit that bird flu has broken out again after eight virus-free months was "dissappointing," European diplomats monitoring the situation said Tuesday.

Agriculture Minister Sudarat Keyuraphan confirmed on Monday a fresh outbreak of the H5N1 virus in the northern province of Pichit.

But local farmers had claimed two weeks ago that fighting cocks and ordinary chickens were dying with all the symptoms of bird flu.

Diplomats said the official and unofficial reports of bird flu-like deaths "don't look good" and that more outbreaks were likely to reported over the coming weeks. Laos recently admitted that bird flu had appeared again after a period of almost two years.

European observers said it was damaging to Thailand's credibility to delay confirming outbreaks of bird flu, which also slowed down the official containment measures such as culling and isolating the affected areas.

Thailand recently sought European Community permission to resume its exports of fresh and quick-frozen poultry, after an eight-month period without any appearance of the H5N1 virus.

The EC had announced earlier this month that its ban on fresh poultry imports from China, Thailand and Malaysia would remain in place until the end of 2007.

Thai Senator Nirun Phitakwatchara accused the ministry of resorting to its "old tricks" of trying to suppress bird-flu news in an effort to protect poultry exports.

"The Agriculture Ministry has once again put export income ahead of people's lives," Nirun told the Bangkok Post.

The authorities were criticized for allegedly covering up the initial outbreaks of bird flu in Thailand in early 2004.

Officials with the Livestock Development Department's Disease Control Bureau said that all fowl near the infected farm in Pichit had been culled over the weekend and a ban placed on all movement fowl in the infected province.

The recurrence of bird flu was suspected a fortnight ago following the deaths of some 30 fighting cocks and free-range chickens.

The Public Health Ministry reported that an 11-year-old boy from Pichit had become Thailand's latest suspected bird-flu case. Blood samples from a total of eight suspected victims were currently being tested, it added. (dpa)

China recommends Margaret Chan to head World Health body


China will recommend Margaret Chan, a Hong Kong-born public health official, as the next head of the World Health Organization (WHO).

The Xinhua News Agency quotes foreign ministry spokesman Liu Jianchao as recommending Ms Chan, now an assistant director general at the WHO, for the role.

"We believe Madam Margaret Chan would help the organization play a more active role in the health sector on the world stage if she were elected WHO director general," he said.

Ms Chan was director of health of Hong Kong from 1994 until 2003, during which time she oversaw efforts dealing with the world's first outbreak of H5N1 bird flu virus and the Severe Acute Respiratory Syndrome (SARS) crisis.

The new head of the WHO will be elected by its 192 member states on November 9, filling the post left vacant following the sudden death of director general Lee Jong-Wook on May 22.

http://www.birdflubreakingnews.com/.../news/stories/asiapacific_stories_1696654.htm

I try to follow the h5N1 situation closely but this "update" contains some info that I have missed (see Bold. If the H5N1 maintains a high pathogenicity and near current mortality of 50%, the following high end estimate of infection of 54% of Americans implies the death of about 27% of Americans or roughly 75 million people.

Lets hope that this bug trades mortality for infectiability when it goes pandemic. It is my understanding that this is the norm - viruses generally lose mortality as it gains infectability, BUT this H5N1 is starting from a very high mortality...

http://www.birdflubreakingnews.com/...deindianabusiness.com/contributors.asp?ID=733


Contingency Planning For The Avian Flu Pandemic

By: Scott R. Gane - Regional Vice President, Initial Security - East Central Region

Category: Crisis Management


By now you have read the world headlines; “More than 100 million birds in affected countries have either died from the Avian flu or were killed in order to try to control the outbreaks” or “First human case of Avian flu results in death” and realized that they were talking about Vietnam, Thailand or some other Asian country.

Those countries are half a world away and while it’s unfortunate for them, it doesn’t affect me.

With that type of thinking you are putting your business at serious risk if you do not, at the very least, update your disaster management and business continuity plans to address this fast moving and mutating virus.

Pandemics have occurred intermittently over centuries. The last three pandemics, in 1918, 1957 and 1968, killed approximately 40 million, 2 million and 1 million people worldwide, respectively. Although the timing cannot be predicted, history and science suggest that we will face one or more pandemics in this century.

What is the Bird Flu?

Avian influenza, otherwise referred to as Influenza A (H5N1), is an infection caused by avian (bird) influenza (flu) viruses. These influenza viruses occur naturally among birds. Wild birds worldwide carry the viruses in their intestines, but usually do not get sick from them. However, avian influenza is very contagious among birds and can make some domesticated birds, including chickens, ducks and turkeys, very sick and can kill them.

Confirmed cases of human infection from several subtypes of avian influenza infection have been reported since 1997. Most cases of avian influenza infection in humans have resulted from contact with infected poultry (i.e., domesticated chickens, ducks, and turkeys) or surfaces contaminated with secretion/excretions from infected birds. The spread of avian influenza viruses from one ill person to another has been reported very rarely, and transmission has not been observed to continue beyond one person.

Facts you should know:

• Although avian influenza A viruses usually do not infect humans, more than 180 confirmed cases of human infection with avian influenza viruses have been reported since 1997. The World Health Organization (WHO) maintains situation updates and cumulative reports of human cases of avian influenza A (H5N1)

• In 2004 the U.S. Government issued a ban on the importation of poultry from countries affected by avian influenza viruses, including the H5N1 strain.

• There is no commercially available vaccine to protect humans against the H5N1 virus that is being detected in Asia and Europe.

• The U.S. government has determined that there is a risk to handling feather products from countries experiencing outbreaks of H5N1 influenza.

• The Center for Disease Control (CDC) does not recommend any travel restrictions to affected countries at this time.

• H5N1 has infected more than 190 humans, killing over half of them.

• A U.S. modeling project on Influenza A (H5N1) conducted at the Los Alamos National Laboratory determined that with no intervention a pandemic flu with low contagiousness could peak after 117 days and infect 33 percent of the U.S. population. A highly contagious virus could peak after 64 days and infect about 54 percent of the population.

The researchers then compared what might happen in scenarios involving the use of different interventions. When the simulated virus was less contagious, the three most effective single measures included distributing several million courses of antiviral treatment to targeted groups seven days after a pandemic alert, school closures and vaccinating 10 million people per week with one dose of a poorly matched vaccine. The results also showed that vaccinating school children first is more effective than random vaccination when the vaccine supply is limited. Regardless of contagiousness, social distancing measures alone had little effect.

But when the virus was highly contagious, all single intervention strategies left nearly half the population infected. In this instance, the only measures that reduced the number of cases to below the annual flu rate involved a combination of at least three different interventions, including a minimum of 182 million courses of antiviral treatment.

Bill P comment: this level of antivirals for slightly over 60% of US population wont be available for many years if it was placed on open order today. When a pandemic hits, the backlog will spike; so having 182 M courses in place pre-pandemic seems to me to be extremely unlikely.

Also note the above doesnt spell out the three different interventions for HPAI H5N1 - the above implies soical distancing and pre-pandemic vaccination. BUT there wont be a vax for years so this increases the liklihood for a very nasty pandemic.


What should you do?

The following will guide you in addressing general and specific activities you can do in preparing for the Avian Flu (or other business continuity issues) in your business:

• PLANNING
o Consider the impact of a pandemic on your business
 Assign a pandemic coordinator/team
 Identify critical business functions that need to be maintained
 Train and prepare ancillary workforce
 “What if?” financial impact – set thresholds
 Company response plan – use triggers and procedures for activating and terminating plan
 Emergency communications plan
 Training and test your plan

o Consider the impact of a pandemic on your employees and customers
 Forecast employee absences (consider external factors as well)
 Employee access (and availability) to healthcare (improve as needed)
 Identify key customers with special needs, incorporate into your plan
 Where possible, modify the frequency of face-to-face contact

• POLICES (New and/or Updated)
o Establish polices to be implemented during a pandemic
 Policy for flexible worksite (where possible)
 Revised IT policy and infrastructure to allow employee’s to work from home
 Policy for preventing spread while at work (cough etiquette, etc.)
 Policy for restricting travel
 Policy for employees who have been exposed, are suspected to be ill or become ill at work

• COMMUNICATION & EDUCATION
o Develop platforms (e.g. hotlines, dedicated Web sites) for communicating pandemic status and actions for employees
 Ensure communications are culturally and linguistically appropriate
 Develop and disseminate materials covering pandemic fundamentals (signs & symptoms of influenza, hand hygiene, contingency plans)
 Develop and disseminate materials for the “at home” care of ill employees (and family members)


** A reminder that the main purpose of the Communication Plan is to limit the fear and anxiety of your employees as well as mitigate rumors and misinformation.**

In the event of pandemic influenza, businesses will play a key role in protecting employee’s health and safety as well as limiting the negative impact to the economy and society. Planning for pandemic influenza is critical. It’s time to sit down with your Disaster Management/Business Continuity Team and add to your existing contingency plans to address the pandemic influenza.

No one can predict when a pandemic might occur. Experts with the National Institutes of Health have conducted modeling that would suggest (with the migration patterns) it could affect the United States in the next ten months.

Bill P: I suppose this means that the first wave will reach the US between now and May 2007. Other sources of info indicate there could be 3 or more waves lasting for 6-8 weeks of peak intensity such that the pandemic lasts for about 18 months or so.


Take the time to update your disaster management and business continuity plans today. Communicate your plans with your employees, suppliers and customers to let them know you are thinking about their safety. This will give you piece of mind and your business an opportunity to survive a modern day pandemic/disaster.

I dont have a iPod so I dont do podcasts but this looks interesting. One of the principals - Tommy Thompson, is a former US SEc of Health and Human Services so this info is likely spot on...

http://www.deloitte.com/dtt/article...gle_Pandemic&gclid=CNaMzsL2rIYCFQRNPgodUj18Gg


The Blizzard Ahead: Preparing Your Business For the Coming Pandemic
Deloitte Insights podcast

Subscribe (RSS) | Subscribe (iTunes) | Listen now

Business has not been a central focus of public discussion regarding a flu pandemic to date. However, a pandemic flu outbreak in any part of the world would interrupt the lives of millions of people in every way possible. Impact on the U.S. economy would be devastating and the likelihood of significant disruptions in daily routine—for families, companies and society as a whole—is a very real possibility.

In this Deloitte Insights podcast, Deloitte & Touche LLP’s Steve Ross and Don Ainslie, and the Deloitte Center for Health Solutions’ Independent Chairman Tommy G. Thompson, discuss critical steps that U.S. government and businesses should take now to prepare for a possible flu pandemic. They believe that business should plan as if a blizzard were coming—a blizzard that could last up to 18 months and that could disrupt travel, employee productivity, the product supply chain and business operations on a global scale.

Related Material:

Impacts & Responses for Eight Industries
Pandemic Flu Roundtable on Preparation, Productivity and Profitability
Business Continuity Services: Pandemic Planning, Preparedness and Response

Bill P: It appears Laos has or expects outbreaks soon. Telling everyone to prevent outbreaks more actively is a weak approach to the problem; these outbreaks cannot be prevented so advising people to prevent them seems misdirected.

Lao govt urges fiercer fight against bird flu

http://news.xinhuanet.com/english/2006-07/25/content_4877158.htm?rss=1


www.chinaview.cn 2006-07-25 18:23:21

HANOI, July 25 (Xinhua) -- The Lao government has recently urged local sectors and people nationwide to prevent potential bird flu outbreaks more actively, according to reports reaching here from Laos' news agency KPL Tuesday.

Under a directive issued by Lao Prime Minister Bouasone Bouphavanh, organizations and individuals in the country, especially state agencies at both central and local levels, should make greater efforts to combat bird flu which may hit some localities in the near future.

Laos' National Committee for Avian Influenza Prevention has recently built up a national strategy on preventing and battling the disease. Funds for the strategy's implementation are being mobilized.

Bird flu has not yet stricken Laos, but it may occur in some areas, the directive quoted a report of the World Health Organization (WHO) as saying.

A total of 231 human cases of bird flu infections, including 133 fatalities, have been confirmed in 10 countries, since 2003, according to a statement of the WHO posted on its website on July 20. Countries with high numbers of fatalities include Vietnam with 42, Indonesia with 42 and Thailand with 14. Enditem

H5N1 Bird Flu Recombinant in Ivory Coast

http://www.recombinomics.com/News/07250601/H5N1_Ivory_Coast_Recombinant.html

Recombinomics Commentary
July 25, 2006

The HA sequence from an H5N1 bird flu sequence from the Ivory Coast , A/chicken/Ivory Coast/1787/2006(H5N1), shares a number of polymorphisms with other Qinghai isolates. However, the haplotype containing these polymorphisms indicate the Ivory Coast isolate is a recombinant and was independently introduced into the area. It has little in common with the three different sets of sequences from Nigeria, or the sequences from Niger. These data indicate migrating birds have brought in multiple versions of the Qinghai strain into western Africa. The Ivory Coast lies within the East Atlantic Flyway, which connects western Africa with western Europe and northeast Canada.

The Qinghai isolates have a discrete number of polymorphism over laid onto the Qinghai genetic background. Discordance among these newly acquired polymorphisms identify recombination. The Ivory Coast isolate has tandem polymorphisms, G195A and C211T as well as C1261T. The polymorphisms are common, but found in non-overlapping haplotypes. G195A and C1261T are in isolates from Mongolia in 2005, Turkey, Iraq, and northern Nigeria. C211T is in Italy, Iran, Kasnodor, Afghanistan, and 2006 isolates from Mongolia and Tyva. Additional discordance is seen because the Ivory Coast isolate has A74G, which is in a Crimean isolate, as well as Kurgan / Nigeria polymorphisms, H433A, G643A, G1708A

The recombinants in the Ivory Coast will increase the genetic diversity in the Qunbghai isolate in western Africa. Efforts to discount the role of migratory birds in the increase and distribution of this diversity are cause for concern.

Suspect H5N1 Bird Flu Patient in Pichit Thailand Dies

http://www.recombinomics.com/News/07250602/H5N1_Pichit_Fatality.html


Recombinomics Commentary
July 25, 2006

A 17-year-old youth from the northern province of Phichit who died from acute lung infection and flu-like symptoms on Monday had probably been infected with the deadly H5N1 bird flu virus, a senior Public Health official revealed yesterday. ''There is a high possibility that this man died from avian influenza,'' the official said, adding that doctors had failed to detect the virus because the tissue samples from the patient had deteriorated.

The official said the youth, from Thap Khlo district, was admitted to the hospital last Tuesday after developing a high fever. His condition deteriorated rapidly.

The teenager had buried about 20 fowls that had died of unknown causes in his village shortly before he fell ill.

The above description strongly suggests that H5N1 human fatalities will soon be confirmed in Thailand. HPAI H5 was reported to the OIE on July 24, 2006, leaving little doubt that H5N1 bird flu was causing fatalities in Thai poultry.

Several patients linked to dead or dying birds are being tested, However, the death of a 17 year with bird flu symptoms which developed after handling dead poultry is a likely bird flu case.

Recent sequences from Laos and Malaysia indicated the Fujian strain of H5N1 in China had moved into southeast Asia. All reported human cases in China in 2005 and 2006 have been the Fujian strain, which is clade 2 and distinct from the earlier clade 1 isolates in Vietnam, Thailand and Cambodia cases in 2004 and 2005.

The large number of reported cases in Thailand suggest there are unreported cases in neighboring Cambodia, Laos, and Vietnam. The reported and unreported human cases are cause for concern.

http://www.birdflubreakingnews.com/...org/apps/news/story.asp?NewsID=19304&Cr=&Cr1=

Americas must prepare for bird flu,

UN agencies and partners urge in new drive

25 July 2006 – Though no cases of avian flu or its H5N1 virus have been reported yet in birds or humans anywhere in the Americas, United Nations health agencies and other partners today launched a new preparedness campaign for the disease, which they say could reach the hemisphere at any time and possibly mutate into a human pandemic.

“We need to be prepared for H5N1 to enter the Western Hemisphere, whether it is through wild birds or commerce or a combination of the two. We should take this interval to get prepared,” said David Nabarro, senior UN system coordinator for avian and human influenza, in a message taped for a two-day meeting of health experts at the Pan American Health Organization (PAHO) headquarters in Washington.

The new Inter-Agency Communication Framework for Avian and Human Influenza in the Americas sets forth a common approach for communicating with the media, government officials, the private sector and the general public, as part of ongoing efforts to prevent and prepare for avian and pandemic flu.

To date, H5N1 has been detected in birds in some 45 countries in Asia, Europe, Africa and the Middle East, spreading to 30 of those countries in just the past six months. The disease has prompted the death or culling of more than 200 million birds and has cost $10 billion in economic losses in Asia alone. In 10 countries, the virus has infected humans, causing 231 cases and 133 deaths as of 20 July.

At the very least, the arrival of H5N1 in birds in Latin America and the Caribbean would represent a serious threat to the poultry industry. In addition, the virus could mutate into a strain that is easily transmissible between humans.

Polling in Latin America and the Caribbean shows low public awareness of the risks of avian flu, as well as widespread scepticism about the likelihood of H5N1 mutating into a human virus that could spark a pandemic. Few people in the region see the problems as requiring priority attention.

Among the goals of the communications campaign, the health experts plan to disseminate information on the spread of avian flu and actions to counter it, to build trust with public health officials and animal health officials, and to work with governments to bolster their own communications strategies.

The Lefties will like this one (not) - it seems some are more equal than others after all.


Roche criticized for marketing Tamiflu to businesses


Jul 25, 2006 (CIDRAP News) – Pharmaceutical maker Roche has drawn sharp criticism for promoting the sale of its antiviral drug oseltamivir (Tamiflu) to businesses while governments stockpiling the drug for defense against a possible flu pandemic wait to receive their own supplies, according to a report in the San Francisco Chronicle.

In releasing a pandemic planning guide for US businesses last week, the Swiss-based company said that "close to 60" companies had ordered Tamiflu in quantities ranging up to hundreds of thousands of treatment courses. The firm said its planning "Toolkit" provides guidance on how to buy and distribute the drug. Though government policies discourage personal stockpiling, the guide suggests that businesses can give Tamiflu to employees for storage at home.

In a story published Jul 23, the Chronicle quoted several medical and policy experts who criticized Roche's action, asserting that government orders for Tamiflu should come first.

"I think it is socially irresponsible," said Dr. Brian Johnston, a Los Angeles emergency physician and trustee of the California Medical Association, according to the story.

James Love, director of the Consumer Project on Technology, said he believes that Roche is giving corporations priority over governments because the corporations pay much more for the drug.

Businesses pay $61 per treatment course, a pack of 10 pills, while wealthy countries pay $19 and poor countries pay slightly less, according to the Chronicle.

The federal government has a stated goal of stockpiling enough antiviral drugs to treat 81 million people, or about 25% of the population, by 2008. But that includes a projected 31 million courses in state stockpiles, with the states paying 75% of the cost.

So far the federal stockpile contains 6.2 million treatment courses, with a total of 21.6 million expected by December, the newspaper reported, quoting federal officials.

Roche officials maintained that the criticism of the marketing program is unjustified, because the company has succeeded in boosting production sufficiently to assure that there will be enough Tamiflu for all customers, the story said.

The firm has made deals with 15 subcontractors to handle various parts of the production process. This will boost production capacity to 400 million treatment courses by the end of this year, the report said. Roche spokesman Terry Hurley in Nutley, N.J., told the newspaper the company currently has orders for "about half of that."

"Corporate orders are being filled within days," Hurley said. "Roche has ensured sufficient supply of Tamfilu to fill government orders, and there is adequate supply of Tamiflu to meet season demand."

Roche officials also defended their marketing effort as merely a way to help businesses protect their workers and to ensure that businesses can survive and help countries weather the pandemic, according to the Chronicle.

Holly Babin, a spokeswoman for the US Department of Health and Human Services, told the newspaper that federal policy does not specifically address whether corporations should buy their own Tamiflu supplies. But she said HHS still recommends against personal stockpiling of the drug.

Thank you

Thanks to all who dug up these articles as it was starting to get too quiet on the H5N1 front. Excellent work.

Bird flu kills Thai youth amid new outbreaks​

http://www.dose.ca/toronto/news/sto...cWkFQsiMDfJefedFe8Hp1BDuc5eVEseFJSTO/dsm5xQ==

Wednesday, July 26, 2006

BANGKOK (Reuters) - A 17-year-old Thai has died of the H5N1 bird flu virus, the country's 15th death since the virus swept across parts of Asia in late 2003, a senior health official said on Wednesday.

The young man died on Monday in the northern province of Pichit, where authorities have confirmed the country's first outbreak of the virus among poultry in eight months.

"The final lab test confirmed that he died of bird flu," Kamnuan Ungchusak, head of the Health Ministry's epidemiology bureau, told Reuters by telephone from the hospital where the youth died.

He is believed to have caught the virus while helping his father bury dead chickens last week. The father remained healthy, Kamnuan said.

"We have quarantined the family and there is no report of a new case yet," he said.

The last death in Thailand occurred in December 2005.

Not including the latest death, bird flu has killed 132 people worldwide since the virus re-emerged in Asia in 2003, the World Health Organization says.

At present, H5N1 remains essentially a disease of birds and is hard for people to catch.

But scientists fear the virus could mutate into a form that spreads easily among humans and trigger a pandemic in which millions could die.

Americas must prepare for bird flu,
UN agencies and partners urge in new drive​

http://www.noticias.info/asp/aspComunicados.asp?nid=204294&src=0

Though no cases of avian flu or its H5N1 virus have been reported yet in birds or humans anywhere in the Americas, United Nations health agencies and other partners today launched a new preparedness campaign for the disease, which they say could reach the hemisphere at any time and possibly mutate into a human pandemic.

“We need to be prepared for H5N1 to enter the Western Hemisphere, whether it is through wild birds or commerce or a combination of the two. We should take this interval to get prepared,” said David Nabarro, senior UN system coordinator for avian and human influenza, in a message taped for a two-day meeting of health experts at the Pan American Health Organization (PAHO) headquarters in Washington.

The new Inter-Agency Communication Framework for Avian and Human Influenza in the Americas sets forth a common approach for communicating with the media, government officials, the private sector and the general public, as part of ongoing efforts to prevent and prepare for avian and pandemic flu.

To date, H5N1 has been detected in birds in some 45 countries in Asia, Europe, Africa and the Middle East, spreading to 30 of those countries in just the past six months. The disease has prompted the death or culling of more than 200 million birds and has cost $10 billion in economic losses in Asia alone. In 10 countries, the virus has infected humans, causing 231 cases and 133 deaths as of 20 July.

At the very least, the arrival of H5N1 in birds in Latin America and the Caribbean would represent a serious threat to the poultry industry. In addition, the virus could mutate into a strain that is easily transmissible between humans.

Polling in Latin America and the Caribbean shows low public awareness of the risks of avian flu, as well as widespread scepticism about the likelihood of H5N1 mutating into a human virus that could spark a pandemic. Few people in the region see the problems as requiring priority attention.

Among the goals of the communications campaign, the health experts plan to disseminate information on the spread of avian flu and actions to counter it, to build trust with public health officials and animal health officials, and to work with governments to bolster their own communications strategies.

WHO to observe Chinese tests on 2003 bird flu case​

http://www.alertnet.org/thenews/newsdesk/HKG91960.htm

HONG KONG, July 26 (Reuters) - China has invited UN experts to observe its tests to verify findings by eight Chinese scientists that a man who died in late 2003 contracted the H5N1 bird flu virus, the World Health Organisation said on Wednesday.

The man's case has spurred questions about whether there might have been other human H5N1 infections in China prior to its first reported human case near the end of 2005.

"We've got two experts who are currently in Beijing. They are observing and discussing the testing of the samples from the November 2003 case," said WHO spokesman Roy Wadia.

"I don't know how long the mission will last, but I don't anticipate it stretching beyond a few days from now."

The Chinese researchers published a letter in the New England Journal of Medicine in June. They said the 24-year-old man, who was admitted to hospital in November 2003 for respiratory distress and pneumonia and later died, had been infected with H5N1.

The report was one of the clearest indications yet that the virus might have been brewing for much longer in the vast country than what had been reported.

The H5N1 virus made its first known jump to humans in Hong Kong in late 1997, and then more or less petered out until it re-emerged in parts of Southeast Asia in late 2003, when it killed three people in Vietnam.

The virus is known to have infected 19 people in China since last year, killing 12 of them, according to the WHO.

In Thailand, an official said on Wednesday that a 17-year-old male had died of H5N1, the country's 15th death from the disease. The youth died on Monday in the northern province of Pichit, where authorities have confirmed the country's first outbreak of the virus among poultry in eight months.

Still largely a scourge in birds, it has killed 133 people around the world since late 2003. But experts fear the virus could trigger a pandemic if becomes easily transmissible among people.

The 24-year-old Chinese man exhibited clinical symptoms of the respiratory disease SARS when he was admitted to hospital but tested negative for that.

His virus samples genetically resembled H5N1 viruses taken from Chinese chickens in various provinces in 2004, the eight experts said.

Govt ponders new bird flu tactics​

http://www.thejakartapost.com/detailnational.asp?fileid=20060726.H07&irec=6

Tb. Arie Rukmantara, The Jakarta Post, Jakarta

Faced with the rising impact of infectious diseases that originate in animals, the health minister proposed Tuesday that the Agriculture Ministry's Animal Health Directorate be merged with her office.

"So many human fatalities in the country are caused by diseases transmitted by animals, such as anthrax, rabies and the recent one, bird flu," Health Minister Siti Fadilah Supari told The Jakarta Post.

"I think it's time for animal health experts to work together with physicians under the same roof."

She said the directorate should be combined with her ministry's subdirectorate of zoonosis (animal diseases communicable to humans).

"The aim is to formulate and execute integrated policies on how to deal with animal illnesses to save not only animals' lives but also people's," she said.

No comprehensive statistics are available on the country's annual mortality rate from zoonoses, but the Environment Ministry's 2005 State of Environment report shows 14 people died of anthrax alone last year.

Siti cited poor management of a rabies outbreak in Halmahera, North Maluku, which is becoming endemic, killing scores of people annually. She says local authorities and residents do not know whether to turn to the Health Ministry or the Agriculture Ministry for help.

"My ministry has a subdirectorate of zoonosis, which oversees zoonotic diseases in humans. But when dealing with the sources, dogs in the case of rabies, it's the Agriculture Ministry's authority," she said, adding that if both offices failed to address an outbreak in a similar manner, attempts to control it could be ineffective.

"That's also the case with bird flu," she concluded.

The public and international organizations have criticized the messy management of bird flu, saying lack of coordination between the Health Ministry, which deals with patients, and the Agriculture Ministry, which deals with sick and dead poultry, hampers efforts to contain the spread of the deadly virus.

Indonesia has recorded 43 bird flu deaths, the world's largest number of human fatalities.

Dr. Santoso Soeroso, director of Sulianti Saroso Infectious Disease Hospital, one of 44 government-sanctioned bird flu hospitals, supported the minister's idea.

"Over the past 20 years, about 87 percent of the emerging infectious diseases have come from animals," he told the Post.

"Therefore, the idea should be thoroughly and seriously discussed for the sake of saving more lives," he added.

He said at present about 150 zoonoses had been recognized by health experts, but many of them were not being dealt with effectively here.

Glaxo has bird flu 'breakthrough'

http://news.bbc.co.uk/2/hi/business/5214776.stm


UK drugs firm GlaxoSmithKline believes it has developed a vaccine for the H5N1 deadly strain of bird flu that may be capable of being mass produced by 2007.
The vaccine has proved effective at two doses of 3.8 micrograms during clinical trials in Belgium, BBC business editor Robert Peston has learned.

It is the size of the dose that is highly significant, Glaxo explained.

Firms want the smallest effective dose so that they can get the maximum number of shots out of a quantity of vaccine.

Glaxo has yet to publish the results of its tests.

The news of the work on a potential vaccine came as Glaxo reported its profits had risen 14% in the three months to June to £1.32bn (US$2.4bn).

Delivery

Glaxo said that governments could order the vaccine for delivery and stockpiling in early 2007.


All being well, we expect to make regulatory filings for the vaccine in the coming months
Glaxo boss Jean-Pierre Garnier


One of Glaxo's main rivals, the French drug company Sanofi Aventis, has also been working on a vaccine.

A study published in the Lancet in May showed that Sanofi's vaccine had some effectiveness in some patients who were treated with two 7.5 microgram doses.

In February, the NHS awarded a contract to another firm - Baxter International - for two million doses of its H5N1 vaccine to inoculate "key" public service workers.

Government talks

Drug companies are looking to develop treatments because of concerns that the H5N1 virus will combine with a human flu virus and mutate into a form which can spread between humans.

Since 2003 there have been 231 cases of bird flu in humans, resulting in 133 deaths.


A pandemic flu strain spreading between humans has yet to emerge. Since no one knows what such a strain would look like, companies cannot yet develop a targeted vaccine.

But a number of firms, including Glaxo, are seeking to develop vaccines based on the existing H5N1 strains in order to give humans some form of protection.

Glaxo says it will now start discussing with governments about whether they want the vaccine and how much they may want to order.

Its vaccine, like others in development, is on a fast track for approval with the relevant licensing authorities in the US and Europe - the US Food and Drug Administration (FDA) and the European Medicines Evaluation Agency (EMEA).

"All being well, we expect to make regulatory filings for the vaccine in the coming months," said Glaxo chief executive Jean-Pierre Garnier.

Prime desire

Glaxo seems highly confident that demand for its vaccine will be huge, the BBC's business editor said.

The UK and US have both indicated a desire to "prime" their respective populations with an initial inoculation.


Mr Garnier said he recently met US President George W Bush to discuss the vaccination programme.

Following that meeting, Glaxo received $272m (£148m) of funding, earmarked in part for the development of new technologies to produce vaccines.

Glaxo said its new vaccine would give limited immunity to bird flu in the event of a pandemic. A second shot would be necessary for complete immunisation, the company said.

If there were a pandemic outbreak in the early autumn, mass manufacture of Glaxo's vaccine could probably be started quickly through collaboration with rival pharmaceutical companies.

Glaxo said it was also talking to the Gates Foundation about how to provide the vaccine to poorer, developing countries.

Shotgun effect

Despite the company's optimism, there were a number of unanswered questions, the BBC's business editor said.

Firstly, there is uncertainty over how many doses can be manufactured quickly, and how easy it would be to make the transition from laboratory testing to mass production.

And secondly, it is not clear how effective the vaccination would be if H5N1 were to mutate significantly.


Glaxo says its vaccine is more akin to shotgun treatment than a "precision-rifle cure", which means that it appears to be effective against small mutations in the virus strain.

However, it has yet to determine the effectiveness of the vaccine against big changes in the H5N1 strain.

Glaxo said the cost of the vaccine is likely to be a little more than for conventional flu vaccines, which retail for about £4 per shot.

According to Glaxo, the side effects or reactions to its bird flu vaccine have been very similar to those generated by a conventional influenza treatment, and have been limited to a fever in a number of patients.

Drug companies including Glaxo have been looking to expand their vaccination programmes as fears rise about an outbreak of a viral pandemic and governments come under increased pressure to protect their populations.

Glaxo bought Canadian vaccine company, ID Biomed, for $2bn last autumn and is now probably the second-largest manufacturer of flu vaccines after Sanofi.

Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/business/5214776.stm

Published: 2006/07/26 08:15:16 GMT

Low-dose Glaxo bird flu vaccine seen ready in 2007

LONDON (Reuters) - A bird flu vaccine for humans that uses only a very low dose of active ingredient has proved effective in clinical tests and could be mass produced in 2007, its maker GlaxoSmithKline Plc said on Wednesday.


Europe's biggest pharmaceuticals group said it was on track to start manufacturing by the end of 2006 and could make hundreds of millions of doses next year, assuming the product is approved by regulators.

It will probably cost around 4 pounds ($7.40) -- the same as a conventional flu shot -- and Glaxo is talking to groups like the Bill & Melinda Gates Foundation and the Global Fund to Fight AIDS, TB and Malaria about funding it in poor countries.

Glaxo believes its H5N1 vaccine will work more efficiently than rival ones in development because of the proprietary adjuvant used in its manufacture. Adjuvants are additives put into vaccines that boost the immune system and make it respond more efficiently.

A key challenge in the race to produce a vaccine for millions of people around the world -- which governments are keen to stockpile -- is how to make the maximum number of shots from the minimum amount of antigen, or active ingredient.

Antigen is produced in chicken eggs in a slow and laborious process.

Glaxo's vaccine contains just 3.8 micrograms of antigen, yet more than 80 percent of healthy adult volunteers who received two doses had a strong immune response.

That level of protection meets or exceeds requirements set by regulatory agencies for approving new flu vaccines, and is twice as good at half the dose as results with an experimental vaccine produced by Sanofi-Aventis.

BREAKTHROUGH

Glaxo Chief Executive Jean-Pierre Garnier said it was a "significant breakthrough."

"All being well, we expect to make regulatory filings for the vaccine in the coming months," he said.

Sanofi in May reported good responses with a vaccine using a conventional adjuvant given at two doses of 30 micrograms. But when the dose was reduced to 7.5 micrograms, only 40 percent of people were protected.

While Glaxo's vaccine offers protection against the deadly H5N1 avian flu virus now circulating, its impact on any mutated strain of virus is not certain.

However, experts say it could "prime" a person's immune system so they will get stronger effects from a later, better-matched vaccine.

Glaxo said it would now also study the ability of its vaccine to offer cross-protection to variants of the H5N1 virus.

Shares in Glaxo, which will report quarterly results at 1100 GMT on Wednesday, rose more than 1 percent following the news.

$2 BILLION SALES?

Deutsche Bank analysts said an H5N1 vaccine could have sales potential of $2 billion a year, which would add 3-5 percent to Glaxo's long-term earnings.

Dresdner Kleinwort said an effective vaccine could be a slight negative for Roche Holding AG, since it might reduce demand for its Tamiflu flu drug.

The H5N1 strain of avian influenza has spread rapidly out of Asia and has killed more than 130 people who have come into close contact with infected birds.

Experts fear it could trigger a pandemic, a global epidemic of flu that could kill millions, if it acquires the ability to pass easily from human to human.

Companies are racing to develop pandemic H5N1 vaccines that could save lives and buy time to develop a vaccine against a pandemic strain. It could take from four to six months from the start of a pandemic before a specific vaccine will be ready.

Other firms working on a bird flu vaccine include Novartis AG and Baxter International Inc.

Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO​

26 July 2006

http://www.who.int/csr/disease/avian_influenza/country/cases_table_2006_07_26/en/print.html

Avian influenza – situation in Thailand ​

26 July 2006

The Ministry of Public Health in Thailand has confirmed a case of human infection with H5N1 avian influenza. The patient, a 17-year-old man from Thap Khlo district of Phichit province in the north, developed symptoms on 15 July, was hospitalized on 20 July and died on 24 July.

On 10 July, the young man had buried the carcasses of dead chickens. This case coincides with a recurrence of a confirmed H5N1 outbreak in animals in the province. Control measures have been implemented to contain the animal outbreak and human surveillance has been strengthened. Field investigations have not found any indications of respiratory illness in close contacts of the young man.

This is the first human case of H5N1 infection reported from Thailand in 2006.

http://www.who.int/csr/don/2006_07_26/en/index.html

Tuva and Mongolia H5N1 Bird Flu Sequences Are Similar

Recombinomics Commentary
July 26, 2006

The full sequence of all eight gene segments from a crested grebe, A/grebe/Tyva/Tyv06-2/06(H5N1), in Tyva (Tuva) has been released. The sample was collected June 24, 2006 and provides the most current view of the evolution of the H5N1 bird flu Qinghai strain. The isolate comes from a recent massive die-off that rivals the Qinghai outbreak at Qinghai Lake in China in 2005.

The current outbreak extends from the Russian province of Tuva, into northern Mongolia. Recently, and H5N1 isolate from a whooper swan in Mongolia, A/whooper swan/Mongolia/2/06(H5N1), was also made available at GenBank. The two sequences are remarkably similar. They have a number of recently acquire polymorphisms that are not found in other Qinghai strain, yet the polymorphisms are in both the Mongolian and Russian isolates. These shared polymorphisms are in all eight gene segments as listed below

The shared polymorphisms indicate the Qinghai strain of H5N1 continues to evolve. Unlike the polymorphisms in western Africa, the similarity between these recent isolates is striking. There are differences and some additional polymorphisms are shared with other isolates such as mute swan isolate from Italy or Astrakhan, but these two isolates have more similarities than the various isolates from Nigeria, Niger, and the Ivory Coast.

However, these are early collections, and additional birds will bring in new H5N1 sequences to Mongolia. Similarly, many of the isolates from Africa, Europe, and the Middle East are now at Chany Lake, generating new combinations of sequences.

These newly acquired sequences can be used to classify the isolates and show that the strain is constantly evolving via evolution as shown by discordant newly acquired polymorphisms.

The widespread detection of the Qinghai strain raises surveillance issues. Wild life conservation groups failed to find H5N1 in Africa and few countries have detected H5N1 in live wild birds, although detection in dead birds has been widespread.

These recent sequences demonstrate an expanded geographical reach and added genetic complexity generated by recombination. The Qinghai stain of H5N1 will soon be mixing with the H5 found to be widespread in Canada in 2005. The first published sequence has acquired swine sequences, indicating the swine can serve as reservoirs and create new H5N1 sequences worldwide,

PB2 A1398G T1460C

PB1 T87C C557T G1362T T2196C

PA T147C G228A T571C T1594C G1825G

HA G59A C796T A1300GG1562T

NP C74T G343A

NA C162T C979T G1361A

MP C559A

NS T41A A849G A851G

http://www.recombinomics.com/News/07260601/H5N1_Tuva_Mongolia.html

Laos

Laotan officials confirm bird flu case ​

27.07.2006 Source: URL: http://english.pravda.ru/world/83585-Bird_flu-0

Lao Foreign Ministry spokesman Yong Chanthalansy confirmed a report on the Web site of the Vientiane Times newspaper that the Lao government's National Infectious Disease Prevention and Control Committee on July 18 had confirmed that the chickens died of bird flu, the AP reports.

The results of laboratory tests to determine whether it was the virulent H5N1 virus were expected in a week or two, he told The Associated Press by phone.

The committee's statement said 2,580 chickens were found dead at the farm in Xaythany district, 25 kilometers (15 miles) south of Vientiane, according to the newspaper. It said the same farm experienced a bird flu outbreak in 2004.

http://english.pravda.ru/news/world/27-07-2006/83585-Bird_flu-0