06/22 | Daily Bird Flu Thread: Earliest Human Case of Bird Flu Disclosed

Link to yesterday's thread: http://www.timebomb2000.com/vb/showthread.php?t=201469

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

http://www.620ktar.com/?nid=36&sid=190360

Earliest Human Case of Bird Flu Disclosed​

June 21st, 2006 @ 5:21pm

By MARILYNN MARCHIONE
AP Medical Writer

(AP) - Beijing scientists said in a medical journal Wednesday that a man in mainland China died of bird flu in November 2003 _ two years before the communist country reported any human infections to the World Health Organization.

At the last minute, however, the scientists asked without explanation to withdraw the journal report. But it was already in print.

The man's death was initially thought to have been caused by SARS, the scientists wrote. That raises the possibility that other cases attributed to SARS may have actually been the deadly H5N1 flu.

"It's hard to believe that this is the only person in all of China who developed H5N1" that year, said Dr. John Treanor, a flu expert at the University of Rochester.

WHO was surprised by the report, which came not from the Chinese government but from eight scientists in a research letter in the New England Journal of Medicine.

"We will formally request the Ministry of Health to clarify this," and why it has taken more than two years to come to light, said Roy Wadia, a WHO spokesman in China.

At least one scientist e-mailed the journal Wednesday morning, asking that the report be withdrawn. With the article already in print, journal editors were waiting to see whether the authors would now retract the paper.

"We can't speculate" what the problem was, said journal spokeswoman Karen Pedersen.

The Beijing case does not necessarily mean the world faces any greater danger of a pandemic; bird flu does not spread easily from person to person, and nearly all human cases have involved close contact with infected poultry.

But the report raises questions about the ability and willingness of scientists in China to study the disease. During the SARS outbreak, some public health experts questioned whether the Chinese were being candid about the extent of the crisis.

Dr. Lindsey Baden, a New England Journal editor, said he does not know what caused the delay in reporting the Beijing bird flu case but suspects it took time for scientists to realize they had a novel H5N1 strain and to do the genetic sequencing needed to analyze it.

"It's to be praised that they are doing this kind of work and sharing it," Baden said.

Efforts to reach the Chinese scientists for comment were unsuccessful. They are from the Beijing Institute of Microbiology and Epidemiology, the 309th Hospital of the People's Liberation Army, the Beijing Genomics Institute and were led by Dr. Wu-Chun Cao at State Key Laboratory of Pathogens and Biosecurity.

Yoshihiro Kawaoka, a virologist from the University of Wisconsin-Madison and the University of Tokyo, said the Chinese may now be taking a look at other SARS cases to see whether they were bird flu.

It was not until 2005 that China reported its first human cases of bird flu. Eight infections and five deaths were recorded that year. So far this year, China has reported at least 10 infections and seven deaths.

The SARS outbreak began in China in November 2002 but was not recognized until the following spring. More than 1,450 cases of severe acute respiratory syndrome were confirmed, the vast majority in Asia. However, some were diagnosed not by lab tests but based on symptoms, which are very similar to those of bird flu.

The New England Journal report raises the possibility that the two dangerous viruses emerged simultaneously.

The patient, a 24-year-old man with pneumonia and respiratory distress, died four days after he was hospitalized in 2003, they reported. The main outbreak of SARS, occurred earlier that year and sporadic cases were still happening. Doctors initially diagnosed that as his cause of death. But tests failed to find the SARS virus.

Further tests of the man's lung tissue yielded fragments of a flu virus, the Chinese scientists reported. Genetic sequencing revealed it to be a mixed virus, with genes similar to two distinct types of bird flu seen in northern and southern China.

"It suggests to me that H5N1 infections were occurring in China probably not recognized or not detected maybe in the background of the SARS epidemic," Treanor said. "I don't know how you could interpret it any other way."

Bird flu crossed the species barrier to infect humans on at least three occasions in recent years: in Hong Kong in 1997 (18 cases with six deaths), in Hong Kong in 2003 (two cases with one death) and in a series of cases that began in December 2003 and was recognized in January 2004, WHO reports. In the last series, 225 cases and 128 deaths have been reported from 10 countries.

The two 2003 Hong Kong cases were strongly suspected to have resulted from a family's travel to mainland China, but this was never proved and there were no known poultry outbreaks of the disease at the time being reported in China.

The newly disclosed case in Beijing means "there may be more jumps from birds to people than we realized," said Baden of the medical journal.

___

On the Net:

World Health Organization:

http://www.who.int/mediacentre/factsheets/avian_influenza/en/

New England Journal: http://www.nejm.org

World Health Organization has concluded human-to-human transmission likely

WHO: Bird flu spread among family members​

By MARGIE MASON, AP Medical WriterWed Jun 21, 4:50 PM ET

The World Health Organization has concluded that human-to-human transmission likely occurred among seven relatives who developed bird flu in Indonesia.

In a report obtained Wednesday by The Associated Press, WHO experts said the cluster's index case was probably infected by sick birds and spread the disease to six family members. One of those cases, a boy, then likely infected his father, it said.

The U.N. agency stressed the virus has not mutated and that no cases were detected beyond the family.

Seven of the eight relatives died last month, but one was buried before samples could be taken to confirm bird flu infection.

"Six confirmed H5N1 cases likely acquired (the) H5N1 virus through human-to-human transmission from the index case ... during close prolonged contact with her during the late stages of her illness," the report said.

The report was distributed at a closed meeting in Jakarta attended by some of the world's top bird flu experts. The three-day session was convened after Indonesia asked for international help. The country has recorded the world's highest number of human bird flu cases this year, and 39 of those infected have died.

"What is happening in Indonesia? That is the No. 1 question," said Bayu Krishnamurthi, Indonesia's national bird flu coordinator. "With all of these limited resources — human, financial, institutional — what should we do?"

The experts were expected to discuss the large family cluster during the session. One of the remaining mysteries is why only blood relatives — not spouses — became infected.

The WHO report theorizes the family shared a "common genetic predisposition to infection with H5N1 virus with severe and fatal outcomes." However, there is no evidence to support that.

Keiji Fukuda, WHO's coordinator for the Global Influenza Program in Geneva, said the Indonesian case appears to resemble other family clusters where limited human-to-human transmission occurred following close contact. He said scientists must find out whether anything is different about the way the virus is behaving.

"The really critical factor is why did that cluster develop?" he said. "What's the reason why people in a cluster got infected?"

Fukuda said that although the cluster in the farming village on Sumatra island grabbed world attention, no country — including Vietnam and Thailand, which have largely controlled the virus — is safe from bird flu.

"This is a virus that you both have to respect a lot and (you) have to be concerned about the overall situation, even in areas in which it looks like control has been achieved," he said on the meeting's sidelines. "The real question is: Can you sustain that control for a virus which is really able to persist this way?"

Bird flu has killed at least 130 people worldwide since it began ravaging Asian poultry stocks in late 2003. Experts fear the virus will mutate into a form that spreads easily among people, potentially sparking a pandemic. So far, it remains hard for people to catch, and most human cases have been traced to contact with infected birds.

Indonesian officials said the country lacks manpower and money to battle the H5N1 virus alone. The government has been saddled with a series of natural disasters, including the 2004 tsunami and an earthquake last month on Java Island.

Indonesia needs $50 million from donors in the next three years to establish a system to help fight bird flu in poultry, according to Peter Roeder of the U.N. Food and Agriculture Organization.

Indonesia has said it needs $900 million over the next three years for its overall battle against the H5N1 virus but has only budgeted $59 million.

___

http://news.yahoo.com/s/ap/indonesi...5KTvyIi;_ylu=X3oDMTBiMW04NW9mBHNlYwMlJVRPUCUl

A Closer Look at Bird Flu's Victims​

THE WALL STREET JOURNAL ONLINE
June 21, 2006

Researchers will never know precisely how all the 130 people who have died of H5N1 avian influenza acquired the disease. But the details of their investigations offer glimpses into the lives of the victims -- who have been largely young, in close contact with poultry, and mostly from Southeast Asia. While the fatality count has slowly ticked higher, the victims' stories -- or what little we know of them -- have sometimes been overshadowed by broader concerns about food safety, bird migratory patterns and feared mutations that could make the virus easily transmissible between people, potentially sparking a global pandemic.

Here is a look at the victims, based on updates on avian flu from the WHO. Click on the highlighted column headers to re-sort by country or age.

Interactive table on link: http://online.wsj.com/public/resources/documents/retro06-avfludeaths-date_desc.html

Today's WSJ Bird Flu Headlines....

Avian Flu News Tracker​

June 21, 2006 12:24 p.m.

Updated regularly with news on avian-flu precautions, research and outbreaks. All times EST.

Wednesday, June 21

12:05 p.m.: The EU pledged between €50 million and €65 million (US$62 million to $80 million) in aid to European poultry farmers hit by bird flu. The money is expected to cover 50% of measures taken that affect production, including the destruction of hatching eggs, the destruction of chicks and the early slaughter of some of the breeding flock. EU nations that have requested bird-flu aid include the Czech Republic, Germany, Greece, Spain, France, Ireland, Italy, Cyprus, Hungary, the Netherlands, Austria, Poland, Portugal and Slovakia.

8:20 a.m.: Southeast Asian health ministers met in Myanmar to kick off a three-day meeting on "rapid response and pandemic preparedness." The world's top bird-flu specialists met separately in the Indonesian capital of Jakarta to try to help officials in the sprawling island nation map out a plan to control the spread of H5N1 there.
[Image]

7:30 a.m.: WSJ.com has posted a complete list of confirmed victims of the H5N1 bird flu, with case by case details, sortable by age, date of death, or country. In an accompanying piece, Matt Phillips reports that the details of the investigations offer glimpses into the lives of the victims -- who have been largely young, in close contact with poultry, and mostly from Southeast Asia. Plus, a Q&A with a Berkeley professor on what influences the disease's spread.

3:00 a.m.: Indonesia called for the world to help it fight bird flu following a surge in human cases this year that have put the country on pace to become the hardest hit by the virus. "What is happening in Indonesia? That is the No. 1 question that we very much would like to have the answer from you," Bayu Krishnamurthi, Indonesia's national bird-flu coordinator, asked a panel of animal and health experts at the opening of a three-day meeting in Jakarta. "With all of these limited resources -- human, financial, institutional -- what should we do?"

http://online.wsj.com/public/articl...fcgN3zajns2WY43LVH7E4_20051019.html?mod=blogs

For quite a while I have been checking the daily flu articles at this site
http://www.curevents.com/vb/forumdisplay.php?f=40
But now it says forbidden and I cannot access it. Does anyone know why or have another way to get into it??? Thanks!!! I am trying to keep close track as my daughter leaves for India in a few weeks for 5 months.

News Release
For Immediate Release
No Additional Evidence of Avian Influenza Found in P.E.I. Backyard Flock
OTTAWA, June 20, 2006 - Testing by Canada’s avian influenza (AI) reference laboratory in Winnipeg has found no additional evidence of AI virus in birds from a small backyard flock in western Prince Edward Island.

Samples from the flock, including an index bird, were sent to the Winnipeg lab for confirmatory testing consistent with Canada’s procedures for preliminary findings of H5/H7 AI virus in poultry. All birds tested negative on serological and virological tests. The fact that the H5 virus was not detected in testing at the Winnipeg lab, along with the absence of clinical signs of disease in the birds depopulated in the flock, indicates that only a very small amount of low pathogenicity virus may have been present in the index bird. A finding of incidental contamination in the index bird would not be unexpected given that it spent time out of doors and other birds on the farm were confirmed to have co-mingled with wild migratory
birds which commonly carry AI viruses.

Canada’s AI response protocols, agreed to by the federal and provincial governments, require that disease control measures be immediately implemented upon preliminary findings of an H5 or H7 virus since these subtypes have the potential to mutate into highly pathogenic forms. The Winnipeg lab will attempt to grow virus from samples from the index bird in order to characterize the virus. This process will take up to two weeks. Ultimately, it may not be possible to gain further information about the virus. This situation is not unusual as was evidenced in the 2005 survey of AI in wild birds.

Given the initial finding of H5, a quarantine on the index premises will be maintained until test results are complete consistent with Canada’s precautionary approach and guidelines of the World Organization for Animal Health (OIE).

Birds from a second premises, that had frequent contacts with the index premises, were also tested as a precautionary measure and all results were negative. A quarantine that had been placed on this second premises has been released.

The Canadian Food Inspection Agency (CFIA) will report new information regarding this situation as it becomes available. The CFIA advises bird owners to routinely practice strict biosecurity to protect their birds from AI and other threats. For additional information on avian influenza, visit the CFIA website at www.inspection.gc.ca

For additional information, contact:
Canadian Food Inspection Agency
Media relations:
(613) 228-6682

PCR Insert Contains Key H5 Sequence from Dead PEI Goose
​

http://www.recombinomics.com/News/06210603/H5_PCR_PEI.html

Recombinomics Commentary
June 21, 2006

Using polymerase chain reaction or PCR testing, the scientists searched for tiny bits of genetic material from flu viruses. They spotted enough to declare that they had found an influenza A virus of the H5 subtype.

`They found a little piece that matched the H5, enough of a little piece to say it's H5. However, they can't tell if the virus is alive or not,'' Bosse says.

But there wasn't sufficient material to tell if it was highly pathogenic or a virus of low pathogenicity, or what the neuraminidase _ the N in a flu virus's name _ subtype was.

The above description of testing on Prince Edward Island raises questions about the insert generated in the PCR test as well as the sequence of the insert. The tiny bits of genetic information described above are primers. The primers bind to the genetic information of the virus, and then the polymerase reaction fills in the gap between the primers using the virus RNA as a template. Thus, the insert contains the sequence of the virus and it can be used to identify the viral sequence between the primers.

This insert was specific for H5, so it almost certainly included the HA cleavage site. The sequence of the HA cleavage site is diagnostic for high pathogenic avian influence (HPAI) or low pathogenic avian influenza (LPAI). Moreover, the GERRRKKR sequence at the cleavage site would indicate that the H5 was from the H5N1 Qinghai strain.

The Canadian Food Inspection Agency has maintained that the H5 in the dead goose was an incidental finding and the goose died of unknown causes. The key test of this hypothesis is the sequence of the HA cleavage site. If it has multiple basic amino acids, it is HPAI like the Qinghai strain of H5N1. If the multi-basic amino acids are missing, then it is LPAI bird flu, as suggested.

The isolation of H5 virus is unlikely because the samples at Winnipeg have degraded and are now PCR negative. In view of the state of the material in Winnipeg, the sequence of the insert created on Prince Edward Island should be released. This sequences would answer to key questions, is the H5 from HPAI and is it from the Qinghai strain of H5N1.

H5 Test Failure in Winnipeg Raises Surveillance Concerns​

http://www.recombinomics.com/News/06210602/H5_Winnipeg_Surveillance_Failure.html

Recombinomics Commentary
June 21, 2006

The Winnipeg lab will attempt to grow virus from samples from the index bird in order to characterize the virus. This process will take up to two weeks. Ultimately, it may not be possible to gain further information about the virus. This situation is not unusual as was evidenced in the 2005 survey of AI in wild birds.

The above comments from the Canada Food Service Program compare the testing of samples collected in August 1005 from healthy young wild birds to the testing of samples from a dead free range goose collected on Prince Edward Island on June 5, 2006.

The results from the August collections are at the Canadian Wildlife Health Center. The data indicated bird flu was frequently detected in the wild birds and almost 20% of the samples were positive for H5. Thus, the testing showed that samples properly collected and stored for several months could still yield positive PCR data as well as isolated virus.

The detection frequency was among the highest in countries that have increase surveillance of wild birds and screening for H5N1. Only one country, Russia, has been able to detect H5N1 in live birds. Collections of healthy birds shot by hunters have tested positive for the Qinghai strain of H5N1. In Europe many countries have detected H5N1 in wild birds, but the positive samples are from birds that have died. Initial positives were in mute swans near the Volga Delta or Danube Delta. The swans are easily noticed and deaths of swans were observed by local residents prior to testing. Hundreds of dead swans have tested positive fro H5N1 and virus has been frequently isolated. Several European countries have also found H5N1 in dead or dying birds on farms, but these tests were in countries that had already found H5N1 in wild birds.

Other countries, however, initially found H5N1 in birds on farms. Most of these countries had poor surveillance programs. Many found no bird flu in wild birds, indicating the collection testing process was flawed because low pathogenic avian influenza is common in wild birds and the low path virus should have been detected if samples were properly collected and tested.

In some countries, like India and Indonesia, a small number of samples are collected, which decreases the likelihood of positives. When the first human cases in Indonesia were identifies in July of 2005, animal samples were collected in neighboring communities. However, the number of samples collected was small, indicating the effort was not serious. The number of human cases has steadily increased and surveillance issues in Indonesia are still of concern.

In India, the failure to find H5N1 in wild birds is also suspect. Many instances of unexplained wild bird deaths have been investigated, but the number of samples tested are minimal. Until this year, India denied H5n1 in poultry or people, yet serum samples collected in 2002 from poultry workers were positive fro H5N1. Moreover, the Qinghai strain of H5N1 was identified in bar headed geese at Qinghai Lake in 2005. These birds winter I Indian so H5n1 in bar-headed geese in India is likely. This year H5N1 infections in bar headed geese in Qinghai province was found again, yet India still maintains that H5N1 is not in wild birds. H5N1 has now been acknowledged in domestic poultry, but media reports indicate the sequences in the domestic poultry match wild bird isolates in Qinghai and Xinjiang provinces in China.

Countries in Africa had also had difficulties in detecting H5N1 in wild birds. Initial detection has almost exclusively been on farms. This limitation is almost certainly linked to a poor surveillance system. Detection on farms is easier because the dead or dying birds are rich sources of H5N1and the deaths usually involve multiple birds.

Thus, the failure of Winnipeg to characterize H5 from a dead goose on a farm on Prince Edward Island is cause for concern. The failure reflects a poor decision to collect samples from a single dead bird followed by delays in shipment to Winnipeg. These delays almost certainly contributed to sample degradation and failure to detect the confirmed H5 in the index goose. The detection failure suggests that culturing will also be unsuccessful. In may instances PCR positive samples fail to generate isolated virus and the frequency of viral isolation from negative samples is low.

The Winnipeg failure raises surveillance issues. The proper collection, packaging, and/or shipment procedures appear to be lacking, generating false negatives which are cause for concern.

It seems what Recombinomics said a week or so ago about human to human transmission was right.

The question is now - will the virus jump to the general population instead of just being contagious from genetically similar persons?

WHO: Bird flu likely spread among family members in cluster

JAKARTA (AP): The World Health Organization concluded that human-to-human transmission likely occurred among seven relatives who died from bird flu on Indonesia's Sumatra Island, while an animal health expert said the disease was more widespread in poultrythan previously thought.

In a report obtained by The Associated Press, WHO experts said the cluster's first case was probably infected by sick birds and spread the disease to six family members living in a remote village. One of those cases, a boy, then likely infected his father, it said.

The U.N. agency stressed the virus had not mutated in any major way and that no cases were detected beyond members of the family, who died last month.

"Six confirmed H5N1 cases likely acquired (the) H5N1 virus through human-to-human transmission from the index case ... during close prolonged contact with her during the late stages of her illness," the report said.

The report was distributed at a closed meeting in Jakarta attended by some of the world's top bird flu experts. The three-day session that wraps up Thursday, was convened after Indonesia asked for international help. The country has recorded theworld's highest number of human bird flu cases this year, and 39 of those infected have died.

More outbreaks also are occurring in poultry than earlier thought, said Jeff Mariner, an animal health expert from Tufts University working with the U.N. Food and Agriculture Organization in Jakarta.

He is coordinating a pilot project that involves local surveillance teams conducting field interviews to track backyard poultry that have rapidly died. The teams then use bird flu test kits to identify outbreaks.

In the 12 pilot districts on Java Island, 78 poultry outbreaks were detected from January to May. Birds discovered in those outbreaks were slaughtered to limit the spread of infection.

"We thought there was dramatic underreporting, but we never imagined that it would be so pervasive," Mariner said on the meeting's sidelines. "These numbers of outbreaks only represent, say, a third of the coverage in the district."

The experts were expected to discuss Sumatra's large family cluster during the session. One of the remaining mysteries is why only blood relatives - not spouses - became infected.

The WHO report theorizes the family shared a "common genetic predisposition to infection with H5N1 virus with severe and fatal outcomes." However, there is no evidence to support that. (**)

Click to expand...

Jakarta Post
http://www.thejakartapost.com/detaillgen.asp?fileid=20060622142454&irec=4

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<B><font size=+1 color=red><center>Chinese coy on bird flu mix-up</font>

AP
23jun06
<A href="http://www.heraldsun.news.com.au/common/story_page/0,5478,19557242%255E24331,00.html">link</a></center>
MILWAUKEE -- A man in China thought to have SARS actually died of bird flu in November 2003 -- two years before the country reported any human bird flu infections to the World Health Organisation.

The man's death in Beijing raises the possibility other cases attributed to SARS may have actually been the deadly H5N1 flu. </b>

"It's hard to believe that this is the only person in all of China who developed H5N1" that year, said Dr John Treanor, a flu expert at the University of Rochester.

The report came not from the Chinese government but from eight scientists in a research letter to the New England Journal of Medicine.

A WHO spokesman said it would formally ask the Chinese health ministry to clarify the letter and why its contents took more than two years to come to light.

One scientist yesterday asked that the report be withdrawn. But with the article in print, the journal was waiting to see if the authors would retract the paper.

During the SARS outbreak, some experts questioned China's honesty about the extent of the crisis.

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<B><center>Thu, Jun. 22, 2006
<font size=+1 color=brown>South Florida banks, U.S. Treasury conduct pandemic-response drill</font>

BY NIALA BOODHOO
nboodhoo@MiamiHerald.com
<A href="http://www.miami.com/mld/miamiherald/business/14877474.htm">link</a></center>
The U.S. Treasury Department today is helping South Florida banks conduct the first-ever test of financial systems should a flu pandemic hit the country.

The Treasury Department and FloridaFirst, a regional financial coalition set up in response to last year's hurricane season, are conducting the drill at the Miami-Dade Emergency Operations Center.</b>

Some experts have warned it is a case of when, not if, the avian flu mutates into a form that can pass among humans and becomes a global pandemic. If that happens, businesses should be prepared for employee absenteeism as high as 50 percent, and many other challenges including quarantines, they say.

FloridaFirst was set up last October with the goal of preparing financial institutions to respond to threats or events caused by terrorism or natural disasters. It was the second such coalition created in the United States.

The Treasury Department is hoping today's exercise in Miami will encourage other regions across the country to conduct similar drills, said spokeswoman Jennifer Zuccarelli. More than 70 people are participating.

''We're hoping that this gets them moving to prepare for a potential catastrophe,'' she said.

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<B><font size=+1 color=green><center>WHO calls for calm amid bird flu probe in Zambia</font>

Jun 22, 2006, 13:32 GMT
<A href="http://news.monstersandcritics.com/health/article_1174834.php/WHO_calls_for_calm_amid_bird_flu_probe_in_Zambia">link</a></center>
Lusaka - The World Health Organization (WHO) on Thursday appealed for calm in Zambia as laboratory tests on possible presence of the avian influenza were carried out on scores of wild birds that died in unknown circumstances in the Southern province.

Provincial health authorities, meanwhile issued an appeal to people who ate the dead birds to immediately report to health centers for medical examinations.</b>

Southern Province chief health officer Gardener Siakantu said there was urgent need for such people to be examined and monitored even before the laboratory tests were concluded.

WHO country representative Stella Anyangwe said it would be premature to speculate that the birds died of the feared H5N1 flu virus.

'Birds die all the time, and mostly of viral infections, so there is need to wait for test results being conducted,' she said.

Ananygwe however, called on health and agriculture authorities for quick action if it was found that the birds died of the virus that can be transmitted to humans.

On Monday, district veterinary officials said they had found and collected over 40 dead wild birds near the port offices of the Zambia Revenue Authority in the tourist capital of Livingstone, some 470 kilometers south of Lusaka.

Tests were ordered on samples of the birds to determine the cause of death.

In the wake of an outbreak of the flu in West Africa, Zambian authorities in March this year, banned the import of all poultry products and the movement of live birds in a bid to cut the risk of a similar outbreak.

The movement of poultry and frozen poultry products within the country was also restricted to the permission of health and veterinary authorities.

This was Zambia first case of mass deaths of birds in unclear circumstances. Reports of the dead birds and suspicion of Avian Flu have triggered panic among poultry farmers and consumer watchdogs, and resort owners in the tourist province.

Another bird flu death occurs in Indonesia

6/22/2006 9:52:00 AM -0400

JAKARTA, June 22 (UPI) -- The World Health Organization says Indonesian officials have confirmed their nation's 51st case of human infection by the H5N1 avian influenza virus.

The case, which was fatal, involved a 13-year-old boy from South Jakarta who developed symptoms June 9, one week after helping his grandfather slaughter diseased chickens at the family home. The boy was hospitalized June 13 and died the next day.

WHO officials said of the 51 cases occurring in Indonesia, 39 have been fatal.

WHO and the Food and Agriculture Organization, both United Nations operations, have joined the Indonesian government in convening an expert consultation in Jakarta this week to assess the nation's avian influenza situation.

http://www.birdflubreakingnews.com/...sTrack/view.php?StoryID=20060622-093405-8305r

WHO seeks meeting with Chinese over report of unreported 2003 bird flu case​

The Canadian Press

Thursday, June 22, 2006


The World Health Organization has requested a meeting with officials of the Chinese Ministry of Health to ask about a startling admission in an academic journal that China had a human case of H5N1 avian flu two years before Beijing began to officially report cases.

The request, from the WHO's representative in China, was submitted Thursday, the day the report was published in the New England Journal of Medicine.

A spokesperson for WHO's Beijing office said the organization had to wait until the journal was published before it could formally ask for answers and a meeting. But WHO staff in Beijing began making informal inquiries a couple of days ago, when tipped to the pending publication by journalists.

"The Chinese government has indeed taken notice of this story,'' Roy Wadia said from Beijing.

"And what we're told is that they're making their internal inquiries and will get back to us as soon as possible. And so we are awaiting a formal answer from them.''

In a move that has taken the international influenza community by surprise, eight Chinese researchers submitted a letter to the journal describing the molecular characteristics of H5N1 viruses taken from the lung tissue of a man who died in November 2003, apparently in Beijing.

That's a full two years before China began reporting H5N1 cases to WHO. And it predates by a month the first confirmed human infections since the worrisome virus - which first attacked humans in 1997 in Hong Kong - re-emerged in Asia in late 2003.

Since its re-emergence, H5N1 has infected at least 228 people in 10 countries, killing at least 130. China, which only began reporting cases in November 2005, has admitted to 19 H5N1 cases with 12 deaths.

If Chinese officials knew of the case in November of 2003 and had alerted the world at the time, countries in the region may have been able to respond more quickly when they started to see avian flu within their borders, Wadia said.

"Lives could have been saved in Vietnam and Thailand,'' he said.

"So there are all sorts of implications here.''

Influenza experts outside China have long believed the country has hidden or missed human cases of H5N1 - but hadn't anticipated seeing proof in the pages of one of the world's most prestigious medical journals.

In the hours before the official release of this week's issue, corresponding author Dr. Wu-Chun Cao contacted the journal and asked to withdraw the letter. But it was too late. The hard copy of the journal was already printed; first-class subscribers had had the journal for days.

Spokesperson Karen Pedersen said Thursday the journal had sent an e-mail to Cao, a researcher with the State Key Laboratory of Pathogens and Biosecurity, asking for an explanation and asking if the authors want to retract the letter. Retraction would remove the material from the scientific literature.

"We have not received a response from the author,'' Pedersen said. "If we were to retract we would need an explanation. And they just have not responded.''

Cao also did not respond to an e-mail from The Canadian Press seeking an interview or additional information.

Wadia said WHO officials will ask about the attempted withdrawal.

"But I think for us really the focus is more on the case as to when it was known, who knew it, how it was done, all the testing protocols, all the technical information and also how it was communicated within the government, and to whom and at what time,'' he said.

"I think it's fair to say . . . that this story raises at the moment far more questions than there are answers. And we certainly hope to get at least some of these answers in the next few days.''

The WHO must follow strict protocol when seeking information from a country, a potentially time-consuming process that requires correspondence to be addressed through the ministry of health in the country.

"The way we work is through the MOH. And we can't at this moment in time at least pick up the phone and call these scientists ourselves,'' he explained.

http://www.canada.com/topics/news/world/story.html?id=b09738e4-49eb-4e5f-a965-d786fc1d45fb&k=29373

Human H5N1 From 2003 in Beijing​

Recombinomics Commentary
June 22, 2006

The genomic sequence of the virus (A/Beijing/01/2003) was determined, and its eight segments were genetically related most closely to corresponding sequences of influenza A (H5N1) viruses that had been isolated from chickens in various regions of China in 2004. The segments of the polymerase basic protein 1 gene (PB) and the nonstructural gene (NS) were most closely related to those from Guangdong Province (in southeastern China), with 99 percent identity. The segments of the polymerase basic protein 2 gene (PB2) and HA gene were closest to those from Jilin Province (in northeastern China), with 99 percent and 97 percent identity, respectively. The segments of the neuraminidase gene (NA), nucleoprotein gene (NP), and M gene were closest to those from Hubei Province (in mideastern China), with 98 percent, 98 percent, and 99 percent identity, respectively, and the polymerase acidic protein gene (PA) segment was closest to that from Japan, with 99 percent identity.

These findings suggest that influenza A/Beijing/01/2003 may be a mixed virus.

The above comments from today's New England Journal of Medicine paper on a 2003 human case in Bejing provide additional information on the diversity of H5N1 that can cause fatal human infections. The relationship to a variety of H5N1 bird flu isolates from poultry in China indicates the 2003 human isolate has undergone significant reassortment and recombination. The sequences summarized above are not yet available, but the HA and NA phylogenetic trees which include the isolate allow the new sequences to be positioned relative to other H5N1 sequences in the public domain.

The HA tree shows the 2003 human sequence, A/BJ01/2003, which is most closely related to 2001 and 2002 H5N1 isolates from China. The current H5N1 isolates from humans are on a higher branch, which has Qinghai sequences (represented by Gs/QH/5/2005) at the bottom, Indonesian sequences (represented by Ck/Indonesia/2A/2003) in the middle, and Fujian sequences from China (represented by Dk/Fj/1734/2005) near the top of the branch. The top of the tree has human sequences from Vietnam and Thailand which represent clade 1.

These new data raise questions on the number of unreported human cases in China. Earlier in 2003 a family from Hong Kong returned from a trip to Fujian province. They were infected with H5N1, listed as A/HK/212/2003 and closer to the top of the tree. Thus, it appears that at least two genetically diverse versions of H5N1 were in humans in China in 2003.

This year all reported sequences from China are the Fujian strain, but the number of unreported cases in the past and present, remain unclear.

http://www.recombinomics.com/News/06220601/H5N1_Beijing_2003.html

Empty promises fill bird-flu war chest​

http://www.thestandard.com.hk/news_detail.asp?pp_cat=11&art_id=21346&sid=8535869&con_type=1

The main obstacles in the world battle against bird flu are empty promises, according to a health expert.

Chester Yung

Friday, June 23, 2006

The main obstacles in the world battle against bird flu are empty promises, according to a health expert.

Sanjay Sinho, the health unit director of the nongovernment organization CARE, said Thursday donor countries at a January World Bank conference on bird flu in Beijing pledged US$1.9 billion (HK$14.82 billion) to combat bird flu around the world but only US$300 million has been received so far.

"Pledging is one thing. The physical provision of money is another," he said. "It is hard enough to contain an outbreak of disease when it is reported immediately and where there are good systems in place."

Many developing countries have little or no human and animal health systems to deal with a possible pandemic such as bird flu, he added.

"Much of the money pledged for combating bird flu needs to go toward issues like compensation for destroyed birds and alternative livelihoods as well as to strengthening health systems."

However, the empty promises have undermined these efforts, especially the surveillance systems at the community level.

"Unfortunately, it is a very common problem and happens in many places," he said. "It will put more pressure on the national level [to combat bird flu]" and the disease could spread faster.

Secretary for Health, Welfare and Food York Chow Yat-ngok earlier warned poor countries could not afford timely bird-flu tests, and that this could delay raising an outbreak alert.

In a commentary entitled "Hard Truths about the Bird Flu," Stanford University Hoover Institution fellow Henry Miller suggested rich countries should plough more resources into developing nations primarily for surveillance as this is "a politically incorrect but rational strategy"

Miller said: "They will not only obtain timely warning of an H5N1 strain that is transmissible from human to human, but will also get to focus the vast majority of their funding on parallel, low- and high-tech approaches, vaccines, drugs and other public health measures that will primarily benefit themselves."

In a report released by brokerage firm CLSA last November, researchers said corrupt or inept mainland officials and other bureaucratic problems may thwart the government's efforts to control the spread of the H5N1 virus in China, described as the "epicenter" of the problem.

The report quoted Caijing, a leading mainland journal, as saying local officials are still wary of reporting bad news to the central government, adding that inadequate compensation for culled poultry stocks reduces farmers' incentive to report outbreaks.

Meanwhile, Sinho feared Indonesia is a likely place where a human bird flu pandemic may originate.

He said the recent human clusters found in North Sumatra, where seven members of a family died from bird flu, showed the virus could have jumped from human to human.

In 2003, H5N1 re-emerged in humans, causing more than 120 deaths worldwide - with a mortality rate of more than 50 percent - although there is no convincing evidence yet of human-to-human transmission.

Scientists fear the virus could mutate into a strain that is easily transmissible among humans, triggering a pandemic.

Curevents:

Try this link: http://www.curevents.com/vb/forumdisplay.php?f=40

Thank you for your thread again PC Viking. I notice that the bird flu is no longer the flavor of the day for the MSM, so I doubt we'll see much from them until the fall. It's hurricanes and real estate now, along with a dab of Korea and Iraq.

U.S. Outlines Plans To Fight International Avian Flu Pandemic

June 22, 2006 4:08 p.m. EST


Matthew Borghese - All Headline News Staff Writer
Washington, D.C. (AHN) - The United States Department of State is outlining American preparations against a global avian flu pandemic.

According to the Department, "The United States is working with countries around the world and key international organizations such as the World Health Organization and the UN Food and Agriculture Organization to assist in preparedness for, surveillance against, and response to the threat of avian influenza and a human pandemic."

Officials report that the U.S. is working with at least 46 countries, as well as leading non-governmental agencies, to develop preparedness plans.

The U.S. is also working on animal-surveillance early-warning networks and diagnostic and laboratory capacity in at least 25 countries.

According to the Department, "in 2004, the United States launched the Influenza Genome Sequencing Project. As of April 10, 2006, genome sequences of 1053 human influenza isolates have been made publicly available."

Furthermore, officials say "the United States has deployed over 55,000 sets of personal protective equipment for use by first responders to outbreaks in 22 countries in Asia and the Near East, Europe and Eurasia, and Africa."

http://www.birdflubreakingnews.com/...//www.allheadlinenews.com/articles/7003997776

Link to tomorrows (6/23) Bird Flu thread: http://www.timebomb2000.com/vb/showthread.php?t=201683