01/23 | Avian Flu alert in France

PARIS (Reuters)
France is investigating a possible case of bird flu in a French woman who has returned from Turkey, the French health ministry said yesterday. “A first test has come out as negative. Other tests are under way,” a ministry spokesman said.
The woman, 32, was hospitalised in Montpellier following a two-week stay in the Tarsus region, which, the ministry said, is not known to have be been affected by the disease. The woman had been travelling on her own. Tarsus lies in Turkey’s East Mediterranean part.
Turkey has reported at least four deaths from the H5N1 strain of bird flu this month, bringing the strain to the gates of Europe and the Middle East. The epicentre of Turkey’s outbreak is in the east, near to Syria, Iraq, Iran and Armenia.
The woman, who had seen dead birds while travelling the country, showed symptoms of flu combined with breathing difficulties and was hospitalised on Saturday, the ministry said in a statement.
The H5N1 bird flu virus has killed at least 80 people since late 2003. Victims contract the virus through close contact with sick birds, but there are fears it could mutate into a form that can pass easily from person to person, sparking a pandemic. The French government tightened its protection measures against a possible outbreak of the virus. It has raised the number of departments where poultry must be kept inside to 58 — almost two thirds of the country — from 26.
Meanwhile, Turkish authorities took hope yesterday that the deadly H5N1 strain of bird flu can be brought under control if caught in time, after the discharge of two toddlers from an Ankara hospital and with a third child steadily overcoming the virus in this eastern city.
The Canal brothers, Muharrem, five, and Iskender, two, left Ankara’s Numune Hospital on Saturday night to return to their home in Beypazari, 70 kilometers west of the capital, cured of the virus that has killed four people in Turkey since the current outbreak began in December.
Their joyful mother praised the medical authorities, thanking them for "acting very quickly," a news agency reported.
The parents played a part as well, immediately taking the children to a hospital two weeks ago as soon as they saw them playing with a discarded pair of gloves an uncle had worn to handle a brace of ducks dead of flu. They became the seventh and eighth patients cured of bird flu among the 21 cases confirmed in Turkey so far – including the four who died at the Van hospital in Istanbul, where they were brought in too late to be saved.

http://www.bahraintribune.com/ArticleDetail.asp?ArticleId=93979&CategoryId=3

[January 21, 2006]

Bird flu mutates​

(New Scientist Via Thomson Dialog NewsEdge)THE bird flu virus spreading through Turkey could be accumulating mutations that are helping it adapt to humans. But fears of an imminent pandemic may be premature, as the virus is showing none of the mutations' feared effects.

Samples of the H5N1 virus that killed Turkish teenagers Fatma and Mehmet Ali Kocyigit early this month have now been sequenced at the National Institute for Medical Research in London. Some of Mehmet's virus had a mutation in a surface protein called haemagglutinin, which makes it better at binding to cells in the human respiratory tract as well as to cells in birds.

While this is worrying, it is not clear whether that mutation alone is enough to make the virus any better at spreading among humans than before. "We'll know it means something if we see it in a cluster of human cases," says Michael Perdue of the World Health Organization. A cluster could mean the mutation is being selected for by being transmitted from human to human.

Mehmet's virus also carried a mutation in the polymerase gene that has been shown to make it more lethal to mice. But if anything the cases in Turkey have been milder than those elsewhere.

What now seems undeniable is that wild birds spread H5N1 from central Asia to Turkey. The virus taken from the teenagers is most closely related to a distinctive strain that was found in wild geese and ducks at Qinghai Lake in China in the spring of 2005 and has since crossed Russia and circled the Black Sea.

http://www.tmcnet.com/usubmit/2006/01/21/1303872.htm

=




<B><font size=+1 color=red><center>Algeria steps up measures against bird flu</font>

22 Jan 2006 19:06:52 GMT
Source: Reuters
<A href="http://www.alertnet.org/thenews/newsdesk/AHM265972.htm">www.alertnet.org</a></center>
ALGIERS, Jan 22 (Reuters) - Algeria will spend eight billion dinars ($111 million) to protect itself from any outbreak of bird flu in the North African country, state radio said on Sunday.

Health Minister Amar Tou was quoted as saying the money would be used to import more than seven million doses of anti-viral drugs. He stressed that no case of the disease had been so far reported in the country.</b>

Tou also said the government had ordered seven million masks for health staff in case of any epidemic.

The authorities have said they plan increased health checks at airports and ports to ensure passengers and goods from places hit by the virus do not bring it into the country of 33 million.

Turkey has reported at least four deaths from the H5N1 strain of bird flu this month, bringing the strain to the gates of Europe and the Middle East.

The H5N1 bird flu virus has killed at least 80 people since late 2003. Victims contract the virus through close contact with sick birds, but there are fears it could mutate into a form that can pass easily from person to person, sparking a pandemic.

Huge numbers of birds migrate to Africa every year in search of warmer climates. Birds from Russia fly via eastern Europe and congregate in areas like the Rift Valley in East Africa.

=




<B><font size=+1 color=brown><center>Timeline for Kocyigit Ozcan Family Clusters in Dogubeyazit</font>

<A href="http://www.recombinomics.com/News/01220601/H5N1_Kocyigit_Ozcan_Timeline.html">Recombinomics Commentary</a>
January 22, 2006</center>
Below is a summary of the Kocyigit/Oscan cluster. All members from Dogubeyazit and are likely involved in human-to-human H5N1 transmission, as well as cluster-to-cluster H5N1 transmission. Disease onset dates are from media reports or extrapolation from hospital admission dates.</b>

Sagdic Village

Kocyigit family
Zeki Kocyigit (father)
Marifet Kocyigit (mother) related to Ozcan1
Mehemet Ali Kocyigit (14M) deceased January 1, H5N1+
Fatma Kocyigit (15F) deceased January 5, H5N1+
Hulya Kocyigit (11F) deceased January 6, H5N1 +
Ali Hasan Kocyigit admitted Van January 1, released

Ozcan1 family cousins to Kocyigit
Samil Ozcan (father)
Refika Ozcan (33F - mother) admitted to Van January 6, released
Aysegul Ozcan (9F) admitted to Van January 4 H5N1 +
Yusuf Ozcan (3M) admitted to Van January 4 H5N1 +
Hakan Ozcan (15) admitted to Van January 5, released
Hatice Ozcan (15F) admitted to Van January 4, released, attended Fatma burial
Mehemet Ozcan (13M) admitted to Van January 5, released
Ahmet Ozcan (11M) admitted to Van January 6, released
Mustafa Ozcan (6M) admitted to Van January 6, released
Rumeysa Ozcan (1) admitted to Van January 6, released
Rukiye Ozcan admitted to Van January 6, released

Ozcan2 family cousins to Ozcan1
Mehemet Emin Ozcan (father)
Fatma Ozcan (14F) deceased January 15 H5N1+
Mehemet Ozcan (5M) admitted to Van January 15 H5N1+

Sulucam village

Ozcan3 family
Yavuz Ozcan (3M) admitted to Van January 14
Volkan Ozcan (2M) admitted to Van January 14

unknown village

Ozcan4 family
Six Ozcans related to Fatma Ozcan admitted to Igdir State Hospital January 20

Timeline

January 20 Six Ozcans related to Fatma Ozcan transferred to Igdir State Hospital

January 16 WHO update on Mahamet Ozcan (5M) and Fatma Ozcan (14F). Report gives disease onset dates and hospitalization. Fails to mention prior disease in Ozcan cousins and Kocyigit cousins. Fatma Ozcam (14F) buried. Hatice Ozcan (15F) at burial

January 15 Fatma Ozcan (14F) dies

January 14 Yavaz Ozcan (3M) and Volkan Ozcan (2M) hospitalized in Van

January 13 Yavaz Ozcan (3M) and Volkan Ozcan (2M) develop symptoms

January 11 Mahamet and Fatma Ozcan hospitalized in Van

January 9 WHO update on Ozcan (9F) and Ozcan (3M) indicates they are siblings. No disease onset dates or relationships to other patients given.

January 7 WHO update confirms Muhamet Ali Kocyigit (14M) and Fatma Kocyigit (15F) are H5N1 positive, Hulya Kocyigit (12F) has died, and Kocyigit (6M) hospitalized. Mentions 30 patients being tested, including many from Dogubeyitz. No disease onset dates from Kocyigit siblings and no mention of relationship to Ozcans in the hospital.

January 6 Rifica Ozkan (33F), Hakan Ozcan (15M), Rukiye Ozcan hospitalized in Van

January 5 WHO Turkey report indicates Mehamet Kocygit (14M) was hospitalized and died on January 1 and Fata Kocyigit (15F) died January 5 after hospitalized January 1 in Van. Rumeysa Ozcan (1F), Mustafa Ozcan (6F), Ahmat Ozcan (11M), Mehemet Ozcan (13M) hospitalized in Van. Rifica Ozkan (33F), Hakan Ozcan (15M), Rukiye Ozcan develop symptoms

January 4 Mehemet (5M) and Fatma Ozcan (14F) develop symptoms. Hatice Ozcan (15F), Aysegul Ozcan (9F), Yusuf Ozcan (3M) admitted to Van. Aysegul (9F) and Yusuf (5M) placed in ICU. Rumeysa Ozcan (1F), Mustafa Ozcan (6F), Ahmat Ozcan (11M), Mehemet Ozcan (13M) develop symptoms

January 1 Ducks began dying in Ozcan2 flock. Mahamet (5M) and Fatma (14F) slaughter duck. Mehemet Ali (14M), Fatma (15F), Hulya (12F), Ali Hasan Kocyigit (6M) transferred to Van from Dogubeyitz hospital. 3 oldest siblings unconscious. Hatice Ozcan develops symptoms

December 30 Mehemet Ali (14M), Fatma (15F), Hulya (12F), Hasan Ali Kocyigit admitted to Dogubeyitz hospital

December 29 Asyegul Ozcan (9F) and Yusuf Ozcan (3M) develop symptoms

December 26 Fatma (15F), Hulya (12F), Ali Hasan Kocyigit (6M) develop symptoms

December 24 Kocyigits have Ozcan family over for dinner

December 18 Mehemet Ali Kocyigit (14M) visits doctor with mild symptoms

December 16 Mehemet Ali Kocyigit (14M) develops symptoms

=




<B><font size=+1 color=green><center>Six More Ozcan Family Members With H5N1 Bird Flu Symptoms</font>

<A href="http://www.recombinomics.com/News/01210603/H5N1_Turkey_Ozcan_6.html">Recombinomics Commentary</a>
January 21, 2006</center>
Six members of the Ozcan family living in the Dogubayazit district of the far eastern Turkish province of Agri on the Iranian border were transferred on Friday to Igdir State Hospital with suspected bird flu.

Six members of the Ozcan family, related to Fatma Ozcan who died of bird flu last Sunday, applied to hospital complaining of sickness. </b>

Father Mehmet Ozcan said that they had paid a condolence visit to Fatma's family. Two days ago he and his children ate chicken which his wife had killed and put into the deep freezer a month ago.

The above comments raise more questions concerning extended human-to-human transmission chains within the Ozman/Kocyigit family. There have already been 4 H5N1 confirmed fatalities and 3 more H5N1 positive family members in the hospital, but 9 additional family members have been hospitalized and released and it remains unclear if the six new patients are among those released or are additional family members.

Answers to these questions are not in the WHO updates on H5N1 positive patients in Turkey because although the 7 H5N1 family members are described, WHO failed to give any relationship information for those hospitalized patients who were or were not lab confirmed.

It is unclear if the admission of these family members to Igdir State Hospital indicates they live in a separate village, or merely reflects that fact that the other hospitals in Dogubeyitz or Van are already full.

The WHO updates also failed to give disease onset dates. Dates in various media reports strongly supported extensive human-to-human transmission through several transmission chains over an extended time period.

=



<B><font size=+1 color=blue><center>Mideast on edge as bird flu kills in Turkey; no cases confirmed</font>

STEVEN R. HURST, Associated Press Writer
January 22, 2006 1:40 PM
<A href="http://www.newspress.com/Top/Article/article.jsp?Section=WORLD&ID=564668855436576613">www.newspress.com</a></center>
CAIRO, Egypt (AP) - Bird flu has killed in Turkey on the northern fringe of the Middle East, and residents in the Arab lands to the south fear migrating birds have already spread the virus to their countries.</b>

No cases have been confirmed despite scares in Lebanon and Iraq, but many Arabs have stopped eating chicken, health officials are stockpiling medicine, poultry flocks have been culled and citizens have been warned to be alert for dead birds and people with symptoms of the disease.

Fears the virus is already among them deepened when Turkey's agriculture minister on Friday accused unnamed countries among its neighbors of concealing outbreaks. Turkey has confirmed the deadly H5N1 strain in 21 people, including four children who died.

A team of U.S. government flu experts on Sunday visited a hospital in Van, the eastern Turkish city where the children died. The team was hoping to assess what help the United States could provide and planned trips to bordering Azerbaijan, Georgia and Armenia.

Other countries bordering Turkey are Iran, Iraq, Syria, Bulgaria and Greece.

In Cairo, Imthithal Sayed, a 17-year-old student, said her mother ''banned poultry from our house two months ago. She won't cook chicken or let us order it from takeout restaurants. I'm convinced it's dangerous. We don't want to get sick and die.''

The H5N1 strain has killed at least 80 people worldwide, according to the World Health Organization.

Fears that the virus had moved south erupted in northern Iraq on Tuesday when a 15-year-old girl in a Kurdish area near the border with Turkey and Iran died after contracting a severe lung infection. Her hometown of Raniya is just north of a reservoir that is a stopover for migratory birds from Turkey.

WHO officials subsequently said tests showed bird flu did not kill the girl, but confusion surrounding the case points to the possible chaos that could accompany a genuine outbreak in the region. Iraqi officials said tissue samples from the dead girl were sent to Amman, Jordan, for testing. The Jordanians said they had never received the samples.

On Thursday, the WHO announced in Geneva that the tests were negative, but Iraqi authorities said that was not conclusive. Then on Saturday, a WHO official in Cairo said the tests had actually been done by Iraq's Agriculture Ministry and that they were in fact negative.

Iraqis in the north of the country remained concerned nevertheless.

''We have not eaten chicken in our house for two months. And now the news from Turkey has had a big psychological impact,'' said Ashti Ibrahim, a 43-year-old homemaker in Kirkuk.

Merwan Jalal, a 51-year-old Kirkuk engineer, said his wife still prepared chicken dinners but ''it just doesn't taste the same because we're obsessed with the disease.''

In Lebanon, a sick 6-year-old boy was moved to Beirut for observation but health officials released him from the hospital Saturday after tests showed he did not have bird flu.

While none of the countries in the Middle East have yet reported a confirmed case of the disease either in birds or humans, all say they have programs in place to combat the disease should it appear. Poultry imports throughout the region are virtually frozen. In Egypt, cat owners can't even find imported food for their pets. Stocks have been impounded at Mediterranean ports until the scare is over.

Some Syrians aren't buying eggs despite government assurances there is no bird flu in the country.

''Maybe its true, but I prefer not to take chance or endanger my children,'' said Sahar Ahmed, a 45-year-old Damascus homemaker.

The Syrian government has put notices in the state-run media warning about the disease and some flocks have been culled after birds died from unexplained causes.

Jordan said it imported 60,000 doses of Tamiflu, Kuwait said it had 5 million Tamiflu capsules on hand, and Egypt said a local pharmaceutical firm was gearing up to make a similar anti-viral medication.

But in a part of the world renowned for fatalism, 30-year-old Mariam Mohammed said there wasn't much point in worrying.

''It's in God's hands. Our house is full of chicken.''

<table width="100%" border="1" cellspacing="0" cellpadding="3" bordercolor="#000000" height="43"><tr><td bgcolor="D08153"><font face="Verdana, Arial, Helvetica, sans-serif" size="4"><b><font size="4" color="#FFFFFF">Turkey culls over 1 million fowl in fight against bird flu</font></b></font></td></tr><tr><td bgcolor="#f5f5dc" height="2"><div align="left"><font face="Verdana, Arial, Helvetica, sans-serif" size="4"><b><font size="2">Fair use policy applies
http://english.people.com.cn/200601/20/eng20060120_236843.html</B>

Turkey culls over 1 million fowl in fight against bird flu



Turkey has culled 1.107 million fowl so far to combat bird flu spread in the country, Turkish National Coordination Center for Bird Flu announced on Thursday.

According to the center, bird flu was detected in 13 provinces and 24 localities in Turkey while suspected bird flu cases were reported in 28 provinces and 73 localities.

The provinces where bird flu was detected are as follows: Igdir, Erzurum, Agri, Sanliurfa, Erzincan, Bitlis, Yozgat, Ankara, Bursa, Istanbul, Van, Aydin and Kars.

So far, there are 21 people confirmed of infecting bird flu in Turkey, among whom four children have died since.

The virulent H5N1 strain of bird flu has killed about 80 people in Asia since its latest outbreak in late 2003.

Experts fear that the disease, which currently jumps from birds to humans, might mutate into a form that can easily transmit among humans, which would lead to a global pandemic, killing millions.

</font></font></div></td></tr></table>

Jan. 30, 2006 issue - The appearance of bird flu in Europe, and particularly the outbreak in Turkey, has created several scientific mysteries. Why, for instance, did the disease infect birds almost simultaneously in 13 provinces scattered around the country? Why were more people infected (21 so far) than in any other outbreak since the disease first began infecting humans in 2003? And why have so few of the Turkish victims died—four, perhaps five—compared with previous outbreaks, in which half the human cases proved fatal? As the Turkish outbreak enters its fourth week, most of the people who contracted the disease are now on the mend. One person appears to have caught the virus without getting sick at all.

Doctors and health officials, worried about the threat of a human pandemic, aren't even sure if these developments constitute good news or bad. Europe, though, is turning out to be a better place to study H5N1, the virus that causes bird flu, than Asia ever was. In nine years in Asia, the virus has infected only 144 people, killing 75, usually one or two at a time. As a result, scientists haven't had much chance to observe the way the disease behaves in humans. The outbreak in Turkey has given them an unprecedented opportunity to get to know their foe.

The most evocative mystery concerns the relative mildness of the virus in Turkey compared to Asia. Turks who have contracted the disease have fared relatively well. As of last week, several had already been released from the hospital, some of them only mildly ill. And all of those who died did not, unlike the survivors, get early doses of Tamiflu, the antiviral drug, which has to be administered within 24 hours to be effective. This doesn't sound like the killer disease we've been hearing about. "This could be as bad as H5N1 gets," says Angus Nicoll, an ECDC scientist working in Ankara. "It could be that the virus is in the throes of changing and becoming less pathogenic."

Scientists are quick to point out, however, that it's way too soon to write off H5N1 as a dud. Other explanations for why the Turkish death rate is lower have not been discounted. It could be, for instance, that people in Turkey are simply more resistant to the virus than Asians. Or perhaps Turkish authorities were able to detect cases more quickly. Scientists are waiting with particular interest to learn the lab results on a brother and sister in an Ankara hospital; the girl is only mildly ill, and the boy isn't sick at all. He was taken there as a precaution and then tested positive for the virus. If the virus has turned less deadly, it may actually be more worrisome. Its mildness could enable it to spread more easily in people who have no symptoms, while the virus evolves the ability to pass to other humans. The answers to these questions will bear on how to combat H5N1 in future outbreaks.

The Turkish outbreak has also afforded scientists an opportunity to bring the latest in virus-hunting technology and techniques to bear. As the virus has made its way around the globe, it has been constantly mutating. To track the changes, scientists are using the latest genetic sequencing techniques, which give them a rapid turnaround—with some results in a few days. So far the news is inconclusive. The Medical Research Council lab in Britain has discovered a worrisome mutation in one of its Turkish samples, previously seen in an outbreak in Hong Kong, which made the virus better at infecting humans than chickens. So far, however, they've been able to rule out any recombination with human influenza. Gene-sequencing information can confirm where the victim caught the disease—and so far that seems in every case to be from birds directly. "It's not clear yet that the situation we're observing in Turkey, the number of infections, the virulence, is any different than what we've been seeing in Vietnam," says MRC's Alan Hay. For now, scientists are putting their hopes and fears on hold, and just trying to unravel the virus's genetic secrets.

http://msnbc.msn.com/id/10965122/site/newsweek/

Woman In France Negative For Bird Flu

A woman in France who doctors suspected had been infected with bird flu has tested negative for the virus.A Health Ministry official confirmed tests carried out on the woman showed no signs of the deadly H5N1 strain.The 32-year-old woman had recently returned from Turkey and is being treated in a hospital in Montpellier.

Turkey has confirmed 21 human H5N1 infections, including four deaths.

Outbreaks in poultry have been reported across the country, including areas just miles away from Armenia, Iran, Iraq, Syria and Georgia.

The virus - that jumps from birds to humans - has killed at least 79 people in east Asia and Turkey since 2003.

Experts fear the virus could mutate into a form spread easily among humans, triggering a pandemic capable of killing millions.

The latest alert in France follows confirmation by the World Health Organisation that avian flu killed two children in Indonesia last week.

http://uk.news.yahoo.com/22012006/140/woman-france-negative-bird-flu.html

There was a discussion re some question as to whether the black plague was really carried and spread via rats/fleas and was instead a virus like the Spanish flue. The result being that Europeans may have some immunity. So maybe Turkey will be a laboratory for the scientists and they can get a handle on this before we get the pandemic. But whatta I know?

Taz

Even though the initial tests have come back negative, they still keep this woman in isolation and receiving antiviral treatment.

Do they not trust the negative result???

There was that Turkish girl who initially tested nagative, yet died of H5N1...
__________________________________________________________



MONTPELLIER, France: A young woman who recently returned from Turkey has been hospitalised in southern France amid fears she could be suffering from bird flu, the health ministry said yesterday.

"A 32 year-old woman returning from a stay in the Tarsus region of Turkey, where she was travelling alone, is being treated at Montpellier hospital for flu-like symptoms accompanied by breathing difficulties," a statement said.

The case was being treated as potential bird flu because of the "symptoms and because the woman saw dead birds while travelling in a country affected by the epidemic," the statement said.

However the ministry said an initial diagnostic test on the woman had proved negative.

"Samples taken from inside her nose and throat will undergo analysis at a Marseille laboratory for traces of the H5N1 strain of the virus. Results should be known by the end of the day," the statement said.

The woman has been placed in an isolation ward and is receiving "antiviral treatment," the ministry said. The potentially deadly H5N1 bird flu virus has killed around 80 people since re-emerging in 2003, four in Turkey and the others in East Asia.

http://www.thepeninsulaqatar.com/Di...=January2006&file=World_News2006012321845.xml

WASHINGTON - the H5N1 avian influenza virus can survive for more than a month in bird droppings in cold weather and for nearly a week even in hot summer temperatures, the World Health Organization said on Friday.

When people become infected with bird flu, they get a high fever and pneumonia very quickly, according to an updated factsheet from the WHO.

The new factsheet incorporates the most recent findings on the avian flu virus, which WHO says is causing by far the worst outbreak among both birds and people ever recorded.

It has been found from South Korea, across Southeast Asia, into Turkey, Ukraine and Romania. It has infected 149 people and killed 80, according to the WHO figures, which do not include the most recent deaths and infections in Turkey.

Bird droppings may be a significant source of its spread to both people and birds, the WHO said.

"For example, the highly pathogenic H5N1 virus can survive in bird feces for at least 35 days at low temperature (4 degrees C or 39 degrees F)," the WHO site reads.

"At a much higher temperature (37 degrees C or 98.6 degrees F), H5N1 viruses have been shown to survive, in fecal samples, for six days."

Poultry, especially those kept in small backyard flocks, are the main source of the virus.

"These birds usually roam freely as they scavenge for food and often mingle with wild birds or share water sources with them. Such situations create abundant opportunities for human exposure to the virus, especially when birds enter households or are brought into households during adverse weather, or when they share areas where children play or sleep," WHO says.

H5N1 has different qualities from seasonal flu, the WHO said.


LONG INCUBATION PERIOD

"The incubation period for H5N1 avian influenza may be longer than that for normal seasonal influenza, which is around 2 to 3 days. Current data for H5N1 infection indicate an incubation period ranging from 2 to 8 days and possibly as long as 17 days," it said.

"Initial symptoms include a high fever, usually with a temperature higher than 38 degrees C (100.4 degrees F), and influenza-like symptoms. Diarrhea, vomiting, abdominal pain, chest pain, and bleeding from the nose and gums have also been reported as early symptoms in some patients."

And with H5N1 infection, all patients have developed pneumonia, and usually very early on the illness, the WHO said.

"On present evidence, difficulty in breathing develops around five days following the first symptoms. Respiratory distress, a hoarse voice, and a crackling sound when inhaling are commonly seen."

There is bloody sputum, it said.

"Another common feature is multi-organ dysfunction, notably involving the kidney and heart," WHO said.

The WHO recommends using Tamiflu, Roche AG's flu drug known generically as oseltamivir, as soon as possible to treat bird flu.

WHO stresses that H5N1 remains mostly a disease of birds, with tens of millions infected in two years.

"For unknown reasons, most cases have occurred in rural and periurban households where small flocks of poultry are kept. Again for unknown reasons, very few cases have been detected in presumed high-risk groups, such as commercial poultry workers, workers at live poultry markets, cullers, veterinarians, and health staff caring for patients without adequate protective equipment," it adds.

"Also lacking is an explanation for the puzzling concentration of cases in previously healthy children and young adults."


Story by Maggie Fox, Health and Science Correspondent

http://www.planetark.com/dailynewsstory.cfm/newsid/34606/story.htm

Significant Dot...

Posted 1/22/2006 9:51 PM

Mutations that could make it easier for the bird flu virus to infect humans have been found in a sample taken from a patient in Turkey, a report in the journal Nature said Friday.

The World Health Organization is monitoring the situation, but a spokeswoman said it is too early to know whether the virus is changing in ways that would signal the start of a human flu pandemic.

"It's one isolate from a single virus from Turkey," WHO's Maria Cheng said in Geneva. One mutation found "suggests the virus might be more inclined to bind to human cells rather than animal cells," Cheng said, but there's no evidence that it's becoming more infectious.

"If we started to see a lot more samples from Turkey with this mutation and saw the virus changing, we'd be more concerned," she said.

The Nature report cites a second mutation that also "signals adaptation to humans."

Flu viruses mutate all the time, Cheng said. "For us to assign public health significance to a genetic change we need to match it to what is happening epidemiologically — how the virus is behaving — and clinically — if it's more or less virulent," Cheng said.

The avian flu first was detected in poultry flocks in Turkey in October. Then, on Jan. 5, the Turkish Ministry of Health reported that two teenagers, a brother and sister, had died from the disease, the first human cases outside East Asia.

Unlike in other countries, where cases were scattered geographically and the fatality rate was more than 50%, in Turkey, families have been affected, and there are more reports of people with mild symptoms. In addition to Turkey's 21 cases and four deaths, WHO has reported 145 cases and 78 deaths in Cambodia, China, Indonesia, Thailand and Vietnam.

"When this outbreak (in Turkey) was first reported, there was a lot of concern it was behaving differently," Cheng said.

That doesn't appear to be the case so far, Cheng said. "The team there told us that after two weeks of investigating, they haven't found substantial differences in the pattern we've seen in Southeast Asia."

She said the rapid increase of cases in a rural community in eastern Turkey is probably because of the practice of bringing poultry inside homes to protect them during cold weather, which would increase human exposure to infected chickens.

The mutations, which were detected by scientists at a lab in London, may "signify the virus is trying different things to see if it can more easily infect humans," Cheng said. "So far, we haven't seen that the virus has the ability to do this. But it's important that we continue monitoring."

The H5N1 strain first infected humans in 1997 in Hong Kong. It re-emerged in 2003, and efforts to stamp it out have failed. Health officials have seen no evidence yet that the virus can spread easily in humans.

"We would be concerned if we were seeing successive generations of spread of the virus" in Turkey, Cheng said. "We haven't so far. All these people had a very clear history of contact with diseased birds."

http://www.usatoday.com/news/health/2006-01-22-bird-flu-mutations_x.htm

ATHENS - Greek health officials are examining 54 illegal immigrants picked up in eastern Greece near the Turkish coast for signs of the bird flu virus, the merchant marine ministry said on Saturday.

"First indications showed there are no signs of bird flu. The immigrants seemed to be just tired. The process is still ongoing," a ministry spokeswoman said. She said health officials are also conducting autopsies on three dead illegal immigrants found within the group.

A police official said the immigrants were found in two rubber boats 10 miles north-east of the island of Samos near the Turkish coast. They were transferred to the port of Lavrio east of Athens, where they were placed under quarantine. Bird flu virus has killed four Turkish children. There are fears the virus could mutate into a form that can pass easily from person to person, setting off a pandemic.

Tens of thousands of migrants attempt to cross illegally into European Union member Greece every year either through the Greek-Turkish land border that stretches along the Evros river or by boarding a boat along the western Turkish coast.

http://www.planetark.com/dailynewsstory.cfm/newsid/34605/story.htm

=



<B><center><font size=+1 color=blue><center>Two more Turks beat bird flu</font>

22/01/2006 20:54 - (SA)
Hande Culpan
<A href="http://www.news24.com/News24/World/Bird_flu/0,,2-10-1959_1867413,00.html">www.news24.com</a></center>
Van - Turkish authorities took hope on Sunday that the deadly H5N1 strain of bird flu could be brought under control, after two toddlers were discharged from an Ankara hospital.

A third child was steadily improving from the lethal virus. </b>

The Canak brothers, Muharrem, 5, and Iskender, 2, left Ankara's Numune Hospital on Saturday night to return to their home in Beypazari.

Four people have died of the virus in Turkey since the current outbreak began in December.

They Canak brothers owe their recovery partly to their parents, who immediately took the children to a hospital two weeks ago as soon as they saw them playing with a discarded pair of gloves an uncle had worn to handle a brace of ducks dead of avian influenza.

They became the seventh and eighth patients cured of bird flu among the 21 cases confirmed in Turkey so far.

Authorities have drawn hope from the statistics, saying they compare favourably with the mortality rate from bird flu in eastern Asia, where it has claimed about 80 lives - or 58% of all confirmed cases - since 2003.

"In my opinion, the virus is probably mutating in a manner favourable to humans," said Van hospital's chief physician, Huseyin Avni Sahin.

All four who died here from the disease - the first victims outside China and Southeast Asia - were treated at Sahin's hospital, where four more children are currently undergoing treatment, including five-year-old Muhammed Ozcan.

The boy, whose 16-year-old sister Fatma was the last person to die of H5N1 in Turkey on January 15, spent several days hovering between life and death and is now steadily improving, despite having been brought late to the hospital.

The Van hospital has been at the centre of the war against bird flu in Turkey since the first cases arrived here late in December from the remote town of Dogubeyazit, near Turkey's border with Iran.

"We gained a lot of experience" since then, Sahin explained.

"We react much faster now and put the patients under medication much faster than we used to.

"If the virus does not mutate into a form transmissible between humans, I am convinced that we will overcome the crisis," he said.

=




<B><font size=+1 color=purple><center>Avian flu claims two Indonesian children </font>

Posted on : Mon, 23 Jan 2006 00:06:00 GMT
Author : Ravi Chopra
News Category : Health
<A href="http://www.earthtimes.org/articles/show/5088.html">www.earthtimes.org</a></center>
Bird flu claimed two children of the same family in Indonesia, taking the disease's toll in the country to 14, Indonesia's Healthy Ministry spokesperson Hariadi Wibisono confirmed on Saturday.</b>

“These two cases have been confirmed positive from (the World Health Organization laboratories in) Hong Kong,” said Wibisono, who heads the department for control of animal-borne illnesses in the Health Ministry. Further detailing the latest deaths, he said that the victims were a 4-year-old boy and his 13-year-old sister from the town of Indramayu in West Java province. The two's father is also believed to have been infected and has been hospitalized. The results of his blood tests are awaited.

Wibisono added that so far, five of those who were infected by the dreaded H5N1 virus have survived. No human-to-human transmission of the virus have been noted yet but medical experts the world over are concerned that the H5N1 might mutate into a strain that can pass from one human to another, triggering off a global pandemic.


The children, who died in the Hasan Sadikin hospital, lived close to poultry farms and were believed to have come in contact with chickens that had succumbed to bird flu. Indramayu is located around 175 km east of Jakarta.

Excluding the two children, around 80 people have given in to bird flu in Asia since the virus first reared its head in 2003. This has led to the slaughter of a number of poultry in many countries including Vietnam, China and Indonesia. Several countries have also announced mass slaughter of poultry and ducks to contain the disease and many been stockpiling anti-viral drugs.

WHO says not overplaying threat of flu pandemic​

http://www.alertnet.org/thenews/newsdesk/L23269551.htm

23 Jan 2006 11:53:34 GMT

Source: Reuters

By Stephanie Nebehay

GENEVA, Jan 23 (Reuters) - The World Health Organisation (WHO) denied on Monday it was exaggerating the risk of a human influenza pandemic and called for improved surveillance of birds to ensure early detection of the deadly avian flu virus.

The example of Turkey, where children fell ill almost simultaneously with the first confirmed outbreaks in birds, showed the urgent need for all countries to develop early warning systems, said Lee Jong-Wook, WHO director-general.

The H5N1 virus has killed at least 80 people in six countries since late 2003. Victims contract the virus through close contact with sick birds, but there are fears it could mutate into a form that can pass easily from person to person, sparking a pandemic.

"Concern has been expressed that we are overplaying this threat. We are not," Lee said in an opening speech to the WHO's executive board, holding a week-long meeting in Geneva. "We can only reduce the devastating human and economic impact of a pandemic if all we all take the threat seriously now and prepare thoroughly. This is a global problem," he said.

The United Nations agency has predicted between two and 7.4 million people could die if a pandemic sweeps the world.

Turkey has reported 21 cases of bird flu, including the deaths of four children, but the WHO says that human cases appear to be winding down there following mass poultry culling and public education campaigns.

WHO experts will help nearby countries deemed "at risk" to assess the situation. These include Syria, Iran, Iraq, as well as Ukraine, Georgia and Azerbaijan.

LESSONS FROM TURKEY

Unlike in East Asia -- where outbreaks had been detected in poultry well ahead of human cases -- the "unique feature" in Turkey had been "almost no prior warning of infection in poultry", said Lee, a South Korean doctor.

"The Turkey experience demonstrates the dangers poised by avian influenza in birds and the vital importance of surveillance and effective early warning systems," he added.

"A pandemic could arise with little or no warning from the animal side."

The outbreak in Turkey had also shown how fast national authorities, backed by international experts, can move in a health crisis, Lee said. Within a day, samples had been taken from suspect cases and shipped to WHO laboratories in Britain.

"Results were available within 24 hours; 100,000 treatment courses of oseltamavir (Tamiflu) were available were available one day after the first cases were confirmed," he added.

Lee also backed a proposal by several Western countries to bring forward compliance by member states with new International Health Regulations, specifically regarding bird flu. The rules, agreed last May, cover all health emergencies of international concern. They are mandatory from mid-June 2007, but some states have proposed immediate voluntary compliance on bird flu to share information and clinical samples rapidly.