02/04 - 05| H5N1: Death toll mounts in Indonesia

PCViking

Lutefisk Survivor
Vol XXVIII NO. 322 Sunday 5 February 2006

Death toll mounts in Indonesia

JAKARTA: Two Indonesians have been confirmed as dying from the bird flu virus by a World Health Organisation-affiliated laboratory, bringing the country's death toll to 16, a health official said yesterday.The test results showed that a 22-year-old chicken vendor who died last month and a 15-year-old teenager who died on Wednesday were Indonesia's latest deaths from the H5N1 virus, health ministry official Hariyadi Wibisono said.

Two more cases had also been confirmed by the Hong Kong-based laboratory, but the patients remained alive, he added. "So the total confirmed bird flu cases in Indonesia are 23, of which 16 have died," Wibisono said.

Both victims, who had already tested positive for the virus in initial tests conducted locally, were reported to have been in contact with poultry.

The patients battling the virus were a five-year-old boy from Lampung province on Sumatra island and a 15-year-old boy from the West Java town of Padalarang, Wibisono said.

Meanwhile, preliminary tests have indicated that a magpie found dead in Hong Kong was infected with bird flu, the government said, in what would be the fifth case detected in two weeks in the city.

Experts were to conduct further tests on the magpie, found in the mainly rural New Territories bordering mainland China, to confirm whether it died of the H5N1 strain of avian influenza, agriculture officials said in a statement.

http://www.gulf-daily-news.com/Story.asp?Article=134593&Sn=WORL&IssueID=28322

:vik:
 

PCViking

Lutefisk Survivor
EU backs pandemic Tamiflu for children
By Beezy Marsh
(Filed: 05/02/2006)

A cough syrup containing the antiviral drug Tamiflu would be available to children during a bird flu pandemic, a European Union regulator has ruled.

If a bird flu virus was circulating in Britain, healthy children aged between one and 12 would be able to get a preventative dose of the Tamiflu cough syrup.


Previously, healthy children could be given Tamiflu only if they developed flu symptoms, but last week, the European Medicines Evaluation Agency (EMEA) altered the licence of the manufacturer, Roche.

The drug is currently available on prescription to people over 65 and to children in certain risk groups over the age of 13, if flu is circulating in the community.

In the event of a bird flu pandemic, the Department of Health would take over distribution of supplies of Tamiflu, deciding whether the drug should be made available for healthy children.

Studies show that when one member of a household is infected with the virus, Tamiflu cuts the risk of children getting it by 55 per cent.

It also reduces the severity and duration of symptoms in children by 36 per cent.

http://portal.telegraph.co.uk/news/...flu05.xml&sSheet=/news/2006/02/05/ixhome.html

:vik:
 

New Freedom

Veteran Member
http://www.medicalnewstoday.com/medicalnews.php?newsid=37129#

Avian Influenza, Situation In Iraq, World Health Organization
04 Feb 2006

Specimens from Iraq's first reported case of human infection with the H5N1 avian influenza virus have now been tested at a WHO collaborating laboratory in the United Kingdom. The case was a 15-year-old girl from the northern part of the country who died of severe respiratory disease on 17 January. Test results have now confirmed her infection.

Specimens from the girl's 39-year-old uncle, who died on 27 January, and a 54-year-old woman under treatment for respiratory illness are being sent to the UK laboratory but have not yet arrived.

A joint WHO/FAO/OIE team of international experts has been despatched to Iraq at the request of the Ministry of Health. The initial small team of epidemiologists and experts on animal disease will conduct a rapid assessment of the situation in the Sulaimaniyah area of northern Iraq. Because of the security situation, the team is not expected to arrive in the area until early next week.

At present, an additional two people, showing symptoms suggestive of H5N1 infection, have been hospitalized for treatment in the Sulaimaniyah area. Health officials, with support from WHO staff, have set up an emergency operations room to respond to the outbreak, investigate rumours, and address public concerns.

Rumours of possible human cases in other parts of the country have been systematically followed up. To date, no such rumours have been substantiated.

The detection of the country's first human case occurred despite the absence of confirmed outbreaks of the disease in poultry. Detection of the case indicates a high level of awareness of the clinical features of this disease and good vigilance on the part of clinicians. It also points to an urgent need to investigate the extent of bird outbreaks in northern Iraq and possibly elsewhere. Team members with veterinary expertise will assess animal health issues and support the government in its efforts to control the spread of the disease in poultry.

Experiences with poultry outbreaks of highly pathogenic H5N1 avian influenza in other countries have shown how quickly this virus can establish itself in poultry populations and spread widely when detection and control measures are delayed. Poultry culling is under way in northern Iraq and large numbers of birds have already been destroyed.

WHO-led teams are currently conducting or completing field assessments in nine countries in the area: Armenia, Azerbaijan, Egypt, Georgia, Iran, Lebanon, Moldova, Syria, and Ukraine.
 

okie medicvet

Inactive
So many sporadic cases showing up around the world..this is traveling..and yet no human to human mutation..but given what we see..it is indeed just a matter of time..and time is running out..

the more cases of birdflu in humans..the greater the chances that it will mutate..the odds are becoming increasingly against us..
 

New Freedom

Veteran Member
http://www.kfmb.com/stories/story.37624.html

Bird Flu Test Receives Federal Approval

Last Updated:
02-04-06 at 11:33AM

A laboratory test that can give a preliminary diagnosis of bird flu in humans received expedited approval Friday from the government.

The new test can provide results on suspected H5 influenza samples within four hours. That process used to take two to three days.

If the test is positive for the H5 strain, further testing would still be needed to confirm and identify the specific subtype of the virus, including the H5N1 strain responsible for the deaths of 86 people since 2003.

The FDA approved the test, developed by the Centers for Disease Control and Prevention.

"Preparing for a possible flu pandemic is a top priority for our nation, and FDA acted quickly to evaluate and expedite CDC's request for approval of this test," acting FDA Commissioner Dr. Andrew von Eschenbach said.

Health officials fear the H5N1 strain will evolve into a virus that can be passed from human to human and lead to an influenza pandemic.

The test "may enable earlier detection of influenza cases caused by this specific virus and allow public health agencies to investigate sources of infection and more quickly respond with control and prevention activities," said CDC Director Dr. Julie Gerberding.

The new test will be distributed to laboratories in all 50 states beginning next week, the CDC said. The agency plans to share the technology with health officials around the world, including the World Health Organization.

Bird flu began cropping up in poultry stocks across Asia in 2003. Since then, it has killed or forced the slaughter of an estimated 140 million birds.

Almost all of the human deaths due to the virus have been linked to contact with infected poultry.

Because of safety concerns associated with the virus, only 140 U.S. laboratories with proper controls in place will receive the tests, said Dr. Steve I. Gutman, director of the FDA's Office of In Vitro Diagnostics Device Evaluation and Safety.

Eighty percent of the population lives within one hour of one of the labs, said Stephan S. Monroe, acting director of the CDC's Division of Viral and Rickettsial Diseases.

The test is not intended for mass screening, officials said. The initial plan is to give it to people with respiratory symptoms who have traveled to areas where the flu is present, Gutman said.

The FDA took just two weeks to approve the test. Von Eschenbach said the speed did not compromise the "quality or integrity of the FDA review process."
 

PCViking

Lutefisk Survivor
okie medicvet said:
So many sporadic cases showing up around the world..this is traveling..and yet no human to human mutation..but given what we see..it is indeed just a matter of time..and time is running out..

the more cases of birdflu in humans..the greater the chances that it will mutate..the odds are becoming increasingly against us..
2/4 Post #14 said:
=
Most H5N1 Cases Now Linked to Human to Human Transmission
"http://www.recombinomics.com/News/02040603/H5N1_H2H_Most.html"
Recombinomics Commentary
February 4, 2006
Almost all cases of H5N1 human infection appear to have resulted from some form of direct or close contact with infected poultry, primarily chickens. In addition, a few persons may have been infected through very close contact with another infected person, but this type of transmission has not led to sustained transmission.

The above comments from the prepared statement for the Senate appropriations committee seriously underplay the involvement of human-to-human transmission of H5N1. The role was even more distorted in the actual testimony, which indicated that strong evidence of human-to-human existed for only two familial clusters. Familial clusters have made up an ever increasing percentage of the official H5N1 cases and virtually all such clusters involve human-to-human transmission among family members.

Although exposure to sick or dying poultry can be frequently linked to the index case in a cluster, this linkage does not necessarily extend to other family members. These members frequently have exposure to both the index case and poultry. To distinguish between a common poultry source and a common family member, the dates of disease onset are used. Since transmission from bird to human is rare, the likelihood of two independent transmission is low. Therefore, if the common source is poultry, the index case and other family members would be expected to develop symptoms over a short time course (1-2 days). If however, the index case transmitted the H5N1 to other family members, the time interval between disease onset in the index case and disease onset in other family members would be long (5-10 days).

The number of family clusters in the various countries reporting H5N1 outbreaks since 2004 has now exceeded thirty. Almost all of these clusters have a time gap of 5-10 days between disease onset of the index case and other family members. This gap indicates that most of the familial clusters involve human-to-human transmission.

The clusters date back to early 2004 in Vietnam and later in Thailand. By early 2005, these clusters account for almost one third of H5N1 cases. In Indonesia, the number of H5N1 patients in familial clusters grew to about two thirds of cases. The initial 15 clusters were described in a recent CDC/WHO publication. At that time, WHO changed wording in their characterization of the H5N1 outbreak. They had indicated that there was little evidence for human-to-human transmission. This changed to little evidence for efficient human-to-human transmission, acknowledging the growing number of familial cases which involved human-to-human transmission.

Recently, the size and number of these clusters grew, and WHO again changed their description from a lack of evidence for efficient human-to-human transmission to a lack of evidence for sustained human-to-human transmission. Although this terminology suggests the increased frequency has been noted by WHO, public comments and media reports still leave the impression that human-to-human transmission of H5N1 is rare or non-existent.

This impression is particularly misleading at the present time because a genetic change has been noted in H5N1 from the index case in Turkey. The change in the receptor binding domain of HA, S227N (also called S223N), increases the affinity of the HA for human receptors. This change coupled with another change, PB2 E627K, increases the efficiency of H5N1 infection in humans, especially in cold weather. These genetic changes have led to very large clusters in Turkey as well as linkage between clusters.

The linked cluster included the index case for Turkey. Index cases from familial clusters have in fact been the index cases for countries since 2005. The index case for Cambodia, Indonesia, China, Turkey, and Iraq all were familial index cases and all clusters included a 5-10 day gap in disease onset dates.

These data leave little doubt that human-to-human transmission of H5N1 is quite common and now represent the majority of human cases. Representations to the contrary are cause for concern.

http://www.recombinomics.com/ has some great commentaries...

:vik:
 

PCViking

Lutefisk Survivor
[February 04, 2006]

Bird flu grips Hong Kong

(The Birmingham Post Via Thomson Dialog NewsEdge)Bird flu has become endemic in Hong Kong after its recent discovery in both local wild birds and chicken, the territory's health secretary said.

"Since different kinds of wild birds and chickens have this virus, we can be quite sure that this virus is endemic in our birds," York Chow said.

Chow used a Chinese term to describe bird flu as having become part of the general environment in Hong Kong.

"It's not just Hong Kong. This virus will exist in neighbouring areas, southern China as well as Hong Kong,"
he added. Chow's comments came after the government announced on Wednesday that both a local chicken brought in from China and a dead crested myna tested positive for the H5N1 bird flu virus.

Previously, bird flu killed six people there in 1997, prompting the government to slaughter the entire poultry population of 1.5 million birds.

But since then, there have been no major outbreaks.

http://www.tmcnet.com/usubmit/2006/02/04/1342642.htm

:vik:
 

PCViking

Lutefisk Survivor
OK, folks...here it is... the official answer for the question "when do they determine if the person died of Bird Flu"? When WHO officially confirms Bird Flu.
_________________________________________________________________

Eleven more suspected Indonesian bird flu cases await WHO confirmation
(AFP)

5 February 2006


JAKARTA -Indonesia, which has already registered 16 bird flu deaths, is awaiting test results from the World Health Organisation (WHO) on 11 more suspected infections, a health official said on Sunday.

“The latest report we have shows that there has been a total of 23 cases of confirmed infection, 16 of them fatal, while we are still awaiting the result of WHO tests on 11 other probable cases, four of them fatal,” said an official at the health ministry’s bird flu information center.

The official, who identified himself as Nurdin, said local tests on the 11 probable cases had tested positive but that only tests conducted by the WHO laboratory in Hong Kong would officially confirm infection cases.

“But from experience, the WHO tests have only confirmed the results of our tests,” Nurdin said.

The latest WHO test results obtained at the weekend showed that a 22-year-old chicken vendor who died last month and a 15-year-old teenager who died on Wednesday were Indonesia’s latest deaths from the H5N1 virus, health ministry official Hariyadi Wibisono has said.

Two more cases had also been confirmed by the Hong Kong-based laboratory, but the patients remained alive bringing the total of confirmed bird flu cases in Indonesia to 23, of which 16 have died,” Wibisono told AFP.

Nurdin could not give details of the two new surviving bird flu cases.

A health official on the weekend said the two were a five-year-old boy from Lampung province on Sumatra island and a 15-year-old boy from the West Java town of Padalarang.

The virus has now killed some 87 people in Asia since 2003.

Indonesia, the world’s fourth most populous nation, was initially accused of covering up the virus, which is transmitted by close contact with infected poultry.

Many Indonesians live with chickens around their homes, even in urban areas, creating ideal conditions for infections to pass from the birds to humans.

A WHO team warned last month that Indonesia needed to focus more on measures aimed at preventing such virus transmission and also on preparations for a possible human pandemic.

Experts fear that H5N1 could mutate into a form easily transmissible by humans, sparking a global pandemic that would have the potential to kill millions.

http://www.khaleejtimes.com/Display...heworld_February119.xml&section=theworld&col=

:vik:
 

PCViking

Lutefisk Survivor
Bulgaria

More Dead Birds

5 February 2006 | 08:33

Is there bird flu in Bulgaria?
After Vidin, Yambol, Bourgas, Pazardzhik more dead birds were discovered in the region of Shabla and Durankulashko Lakes. The samples taken from the dead swans are expected to provide an answer to the question whether the infection has gripped Bulgaria after Romania and Turkey. The state institutions have expressed readiness to act in possible comprehension of the situation. The Minister of Healthcare Radoslav Gaydarski issued an order to the Regional Governors of ten regions on the river valley of the Danube for strict sticking to the recommendations of the veterinarian and health services for the measures against the bird flu. In possible discovering of focus of the illness there are two infection hospitals in Sofia and Varna in full readiness.
The Director of the National Veterinary Medical Service Associate Professor Zheko Baychev assured that there was full readiness to react in possible origin of the infection. 4,000 special prevention costumes and masks have been bought, 700 Tamiflu vaccines and 200 veterinarian specialists are in readiness to react in possible focus of the infection. The Minister of Agriculture and Forestry Nihat Kabil announced that if the sample from the dead bird sent to London proves to be positive the monitoring over the country will be increased.

http://www.focus-fen.net/index.php?focus=hot&hotid=922

:vik:
 

JPD

Inactive
USNORTHCOM prepares for possible pandemic

http://www.northcom.mil/newsroom/news_release/2006/013106a.htm

Jan. 31, 2006

By Sgt. 1st Class Gail Braymen
USNORTHCOM Public Affairs

PETERSON AIR FORCE BASE, Colo. – U.S. Northern Command recently hosted representatives from more than 40 international, federal and state agencies for an exercise designed to provoke discussion and determine what governmental actions, including military support, would be necessary in the event of an influenza pandemic in the United States.

"We're building the knowledge base, trying to get ahead of the curve now as much as we can," said Gene Pino, director of USNORTHCOM's training and exercise directorate. "We're here to explore [and] identify issues, identify challenges and identify concerns from each of our particular perspectives."

Officials consider a pandemic a possibility due to increasing numbers of people around the world contracting a life-threatening flu virus from birds. So far, humans infected with the avian flu virus have been verified in Vietnam, Cambodia, Laos, Korea, Japan, Indonesia, Malaysia, Russia, Kazahkstan, Mongolia, Turkey and, most recently, Iraq. However, no human-to-human cases have yet been confirmed, and there have been no cases of avian flu, in birds or in humans, reported in the United States or Canada. The avian flu does not represent a widespread danger to human populations until the virus mutates into a strain that spreads from person to person.

Well before news headlines started reporting growing numbers of both sick birds and sick people, U.S. and Canadian military officials decided to focus joint exercise efforts on the pandemic influenza scenario.

"Since that time, a tremendous amount of energy has been expended to prepare for the eventuality that this is a very plausible and a very dangerous threat," Pino said.
Exercise attendees analyzed topics such as public health care, maintaining civil order and providing continuity of government and private operations in case of widespread infection and worker absenteeism.

"USNORTHCOM will not be running the show in the event of a pandemic," said Dave Wilkins, the USNORTHCOM exercise facilitator. "We will be taking guidance and requests from other agencies, such as the Department of Homeland Security, via the Secretary of Defense."

One of USNORTHCOM's most critical missions during a possible pandemic is to keep the American public informed. The command will work with the Department of Defense, the Department of Health and Human Services and other agencies at federal, state and local levels and will use a variety of methods, including traditional press releases and USNORTHCOM's public Web site, to disseminate information, said Michael Perini, director of USNORTHCOM public affairs.

"Staying informed is really the best preparation," Perini said. "What we want to do here is to be an integral part of the overall communications process and keep people informed so that they can be prepared."

Exercise participants agreed that the United States will not be able to keep a pandemic influenza from entering the country. Instead, the common goal of all the agencies represented is to contain and mitigate the consequences of the pandemic as much as possible.

"We know it will have an impact," said Army Col. Joe Bassani, chief of the plans division in USNORTHCOM's policy and planning directorate. "We can't stop the pandemic from having an impact. What we are concerned about is what the long-term impact is going to be on the homeland and what USNORTHCOM can do to assist civil authorities in limiting that long-term impact."

The last pandemic influenzas to strike the United States were in the 1960s, 1950s and 1910s. The most severe pandemic, in 1918-1919, caused at least 500,000 deaths in the United States and as many as 40 million deaths worldwide.

But, "unlike previous pandemic influenzas, this will be the first time in the history of humanity that we actually have an opportunity to plan in advance how we would respond to a global pandemic," said Army Lt. Col. (Dr.) Dan Bochicchio, vice chief surgeon of the National Guard Bureau.

About 40 percent of the U.S. work force would be affected in a pandemic, and the virus would probably spread through the population in six- to eight-week "waves," according to Navy Capt. Lynn Slepski of the Department of Homeland Security. With so many people unable to perform their normal jobs, federal and state agencies plan to assist with critical national missions such as maintaining transportation and distribution systems to ensure people have access to food, medicines and other supplies.

Although USNORTHCOM is prepared to take on additional duties if requested by the president or secretary of defense, the command's primary mission will remain its "non-negotiable contract with the American people to defend the homeland," Bassani said.

"We're here to support and defend the nation."

More information on pandemic influenza is available at the U.S. Department of Health and Human Services Web site http://www.pandemicflu.gov/.
 

PCViking

Lutefisk Survivor
Two UN teams in Iraq to check bird flu
Published: 2/5/2006

ARBIL - Two teams from the World Health Organisation are in Iraq to help fight off the spread of bird flu in Kurdistan which has claimed its first victim in the region, officials said.

One eight-member WHO team flew into the region's main city of Arbil and was set to meet later Sunday with Jamal Abdul Hameed, health minister in its autonomous administration.

Another two-member team of WHO veterinarians arrived in Baghdad on Saturday and will head Monday to Arbil to assist their colleagues from the other team.

"At the moment this is an agricultural emergenc
y," said Sam Yingst, a member of the team in Baghdad.

"But we believe that there is a possibility that it may become a human public emergency though it will require a significant change in the nature of the virus."

A massive cull of poultry has been underway in the northern Kurdistan region after an outbreak of the H5N1 strain of the avian influenza virus among birds.

The disease, which struck after hitting neighbouring Turkey last month, has claimed at least one human life in Iraq and a handful of other cases are under investigation.

Iraq confirmed that a 15-year-old girl in Kurdistan had died from the H5N1 virus in January.

Initial reports from a WHO laboratory in Amman said that test results for the virus were negative, but Iraqi authorities later said that the girl was a bird flu victim.

Tests are still under way in Britain on virus samples from the girl's uncle, who also died of a pulmonary infection, and from a woman who hails from the same region and is currently in hospital.

Yingst said the tests on the second individual, which are currently underway in Britain, would be the key.

"We will come to know from the tests of the second person whether or not the virus has shifted or drifted, but at the moment there is no indication of that because, had it occurred, there would have been more cases," he told reporters.

"And if at all it has happened, then this possibility has been elevated by a very significant notch."

Jon C. Bowersox, health attache at the US embassy, said that the health minister had also called on residents of other parts of Iraq not to hunt birds.

"Birds that are migrating down from the north could be infected and some people make their income by hunting birds. It is not simply a matter of chicken," Bowersox said.

Authorities in Iraqi Kurdistan have quarantined 14 people suspected of suffering from bird flu.

Turkey, which has had 21 cases of the flu strain, was previously the only country outside Asia to report fatalities from the virus. Four people have died there.

The first known cases of H5N1 in humans were recorded in Hong Kong in 1997, when six people died.

Since the virus resurfaced in Asia in 2003 there have been 160 confirmed cases, 86 of them fatal.

The WHO said last week it was also sending thousands of doses of the anti-influenza drug Tamiflu to help control the deadly disease.

02/05/2006 15:57 GMT

http://www.turkishpress.com/news.asp?id=106810

:vik:
 

PCViking

Lutefisk Survivor
[February 05, 2006]

4 more die of bird flu

(Sunday Mercury Via Thomson Dialog NewsEdge)FOUR more people have been stricken by the human version of bird flu - and two of them have already died.

A Hong Kong laboratory recognised by the World Health Organisation has confirmed four more human bird flu cases in Indonesia, including two deaths, an Indonesian Health Ministry official said.

Indonesia's total confirmed human bird flu toll now stands at 23 victims.

http://www.tmcnet.com/usubmit/-4-more-die-bird-flu-/2006/02/05/1343498.htm

:vik:
 
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