08/05-11 | Weekly Bird Flu Thread: Second Confrmed H5N1 Fatality In Thailand, 2 weeks

Link to last week's thread: http://www.timebomb2000.com/vb/showthread.php?t=206012

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

Second Confirmed H5N1 Bird Flu Fatality In Thailand​

Recombinomics Commentary
August 3, 2006

more than 6,000 cases have been diagnosed this year, of which 300 were fatal, he said.

"Influenza, too, is worrying … there has been a significant rise in the mortality rate from the disease over the years," Thawat said.

A 27-year-old Thai man has died of bird flu, the country's second death this year and its 16th victim since the H5N1 virus swept across parts of Asia in late 2003, a senior health official said on Saturday.

The man died on Thursday in the province of Uthai Thani, 220 km north of Bangkok, after having contact with sick chickens, Prat Boonyawongvirot, permanent secretary in the Ministry of Public Health, told Reuters.

"It is confirmed that this man has died of H5N1," Prat said.

The above comments on the death of a 9 year old girl in Lon Buri and 27 year old in Uthai Thani are cause for concern. Although the 9 year old had bird flu symptoms, she tested negative for H5N1. However, the comments above described an alarmingly high case fatality rate of 5% for cases diagnosed as seasonal flu. The high case fatality rate suggests H5N1 fatalities may be going undetected in Thailand.

In 2004 H5N1 was causing fatal cases in both Thailand and Vietnam. Although Thailand reported on 12 fatalities, a retrospective study indicated many patients with laboratory confirmed H5N1 were not included in the totals reported by Thailand or WHO.

In early 2005 fatal H5N1 cases reported in Vietnam. However, most of the fatal cases in Vietnam were in southern Vietnam, where almost all patients died. In contrast, the cases in the north were milder and the size of the clusters were larger, including a family of five in Haiphong. Although all five family members tested positive for H5N1, they all recovered after a brief hospital stay. Neighbors of the family were also hospitalized, but reports from Vietnam ceased. Although 1000 serum samples were collected in northern and central Vietnam, the results from those tests were never disclosed.

The Manila meeting in May of 2005 described H5N1 in 2005 and noted that the H5N1 in northern Vietnam were similar to isolates from Thailand. Although H5N1 was reported in birds in early 2005, there were no reported cases in humans in Thailand in early 2005. The failure to report any human cases in Thailand raised the possibility that the cases were mild and not detected.

The above comments indicate that H5N1 fatalities are again being reported in Thailand. There have now been two confirmed H5N1 positive fatalities. However, the 5% case fatality rate in seasonal flu patients again raises concerns about under reporting of H5N1 cases.

More information on the sero-types of the fatal seasonal flu cases would be useful as would sequence information. The 5% case fatality rate is at a pandemic level and is cause for concern.

http://www.recombinomics.com/News/08050601/H5N1_Thailand_Fatalities_2.html

Thailand confirms 16th bird flu death​

by Anusak KonglangSat Aug 5, 7:28 AM ET

Thailand has reported its 16th bird flu death after test results confirmed that a 27-year-old man had died from the H5N1 virus.

"The victim was a 27-year-old man from the central province of Uthai Thani," said Thawat Sunthrajarn, director general of the Public Health Ministry's disease control department, on Saturday. Thawat said the man died on Thursday.

It was Thailand's second bird flu fatality this year, following the death of a 17-year-old boy in late July. The boy died after coming into contact with a bird that had the disease.

The public health ministry said the 27-year-old farmer got sick on July 24 after burying a dead chicken with bare hands. He had 16 chickens at his farm, but the ministry did not say whether all his chickens were dead.

The man then developed a severe headache and fever, the ministry said in a statement. He was from Uthai Thani's Sawang Arom district, 220 kilometers (136 miles) north of Bangkok.

Following his death, health workers gave his wife anti-virus drugs and put her under a 14-day bird flu surveillance.

Earlier in the day, Thai Prime Minister Thaksin Shinawatra discussed bird flu during his weekly radio show and urged the public to report to health authorities any information on the deadly virus.

"If you see dead chickens or know someone gets sick (due to suspected bird flu), you must immediately give all such information to doctors so that authorities can contain the outbreak," Thaksin said in a radio address.

Thailand is among the countries hardest hit by the deadly H5N1 virus, recording 24 human cases, 16 of them fatal, since the outbreak in 2004.

To help control the virus, 900,000 volunteers have been recruited across the country to spray disinfectant around poultry farms every three months and check for signs of illness among residents.

Thailand was criticized for being slow to respond to the outbreak of bird flu in January 2004, but now is considered one of the countries best prepared to battle the disease.

The kingdom aims to be completely free of the virus in three years.

Bird flu has badly hurt Thailand's poultry industry, once the world's biggest, after countries around the world slapped bans on raw Thai chicken in the wake of the bird flu outbreak in 2004.

Thailand, now the world's fourth-largest exporter of poultry, only exports cooked chickens.

Health experts fear the H5N1 strain of bird flu could mutate into a form that is transmitted more easily between humans, which would mark the first stage of a global flu pandemic that could kill millions.

Thailand has stockpiled 1.5 million capsules of the anti-viral drug oseltamvir, a generic version of the drug Tamiflu, which the kingdom began producing this year.

Tamiflu, believed to be the most effective defense against bird flu, is designed to block reproduction of the influenza virus after infection.

If taken early enough, the drug can avert the worst effects of flu and shorten the duration of sickness.

http://news.yahoo.com/s/afp/2006080...cYCnwfuOrgF;_ylu=X3oDMTA3MXN1bHE0BHNlYwN0bWE-

Bird-flu film being shot at Chandler, Gilbert sites​

Edythe Jensen
The Arizona Republic
Aug. 4, 2006 12:00 AM

CHANDLER - Don't panic if you see armed National Guard troops wearing surgical masks along south Dobson Road on Sunday.

They're just actors trying to block entry into the fictitious town of Fleetwood for a British Broadcasting Corp. documentary about bird flu, which will film in Chandler and Gilbert.

The filming of Pandemic will close Dobson Road south of Queen Creek Road on Sunday from 7 a.m. to 5 p.m. On Monday, crews will take the drama to Mercy Gilbert Hospital, which opened in June at Val Vista Drive and the Santan Freeway in Gilbert.

Producer Marilyn Anderson said the made-for-television show, filmed by Randy Murray Products of Phoenix, will air on the Discovery Channel next year.

She said the company tried to keep news of the filming quiet because the set is closed and there's no provision for spectators and no need for extras. They're also taking care not to identify Chandler or Gilbert in the film "because we don't want to scare anybody," Anderson said.

There will be no closures or disruptions at the hospital, spokeswoman Julie Graham said. She said about 12 hours of filming Monday will be in an unopened section of the new hospital's emergency room. Some filming will take place in the facility's isolation rooms, but the crew will have to vacate those rooms if patients need them, Graham said.

It is likely that some hospital patients will get a glimpse of the film's actors in the hallways, she said.

Dan Cook, Chandler's assistant public-works director, said the film company was required to pay for police traffic services related to the road closure, but was not charged additional fees.

Graham said the firm will pay Mercy Gilbert $1,500 for use of its rooms; the money will go into a foundation for construction of the facility's second wing.

Chandler and Gilbert residents won't be seeing big explosions and fancy sets like the ones going on along Loop 202 in Mesa in connection with another movie production that started last month and continues this weekend.

The Red Mountain Freeway between Higley and Power roads in Mesa will be closed again - from 10:30 p.m. Friday to 5 a.m. Monday - for the filming of chase scenes in The Kingdom. The movie stars Jamie Foxx, Jennifer Garner, Jason Bateman and Chris Cooper, and centers on a team of four FBI agents investigating a crime scene in a Middle Eastern country.

http://www.azcentral.com/news/articles/0804evpandemic0804.html#

Bad news from an expert..

I trust this has not been posted, yet. I've added the bold print. Fair use applies...
http://www.bangornews.com/news/templates/?a=138275

Bird flu scenario dire, expert tells MDI audience
Friday, August 04, 2006 - Bangor Daily News

BAR HARBOR - It's beginning to look like when, not if, planning should begin for a bird flu epidemic, a Pulitzer Prize-winning journalist told a full house Wednesday at Mount Desert Island Biological Laboratory.

That kind of epidemic could throw the planet into chaos, said Laurie Garrett, a health and science journalist who is a senior fellow at the Council for Global Relations.

"The likely death toll would dwarf all but thermonuclear threats," she said.

The recently emerged flu strain that's more officially known as H5N1 came from densely populated Guangdong, China, in 1996 or 1997. It's a type of flu that has never circulated among human beings, Garrett said.

Humans' utter lack of immunity to the strain is one reason the lethality rate is 55 percent. That number dwarfs the rate from the last devastating flu pandemic in 1918, which had 2 percent lethality and still killed more than 55 million people.

The two strains, which both developed from wild birds, share something else: They are most fatal to the young and vigorous.

"It is more dangerous to be young and healthy, because you have a stronger immune system," she told the crowd.

Once attacked by the flu virus, the immune system fights back. Because of the many and vicious symptoms of the disease, the immune system might fight back a little too hard, according to Garrett.

"The lungs become collateral damage," she said.

In addition to the high lethality rate of the virus, there are more reasons to be alarmed, Garrett said.

It's a difficult, slow process to develop flu vaccines. If the H5N1 virus mutates so that it easily can be transmitted from person to person, time will be a scarce resource as people gear up to protect themselves against it.

The speed of jet travel means that the virus could move much faster than the vaccine can be developed. Even if a vaccine can be developed in time, she said, the U.S. doesn't have a good track record in distribution - unlike Europe, which gets a lot of vaccines to its citizens.

Containment of an outbreak would not be possible, she said, and culling domesticated birds in an effort to avoid the spread of the disease has not been effective.

Garrett, who has won the Pulitzer, Polk and Peabody prizes for reporting, reminded her audience that Europeans "have another institution we don't have," she said, "national health care."

Another problem is that, in general, the U.S. is poorly prepared for an epidemic.

A flu plan for New York City estimated that there might be 280,000 hospitalizations and 12,000 to 114,000 deaths. These numbers do not reflect the virus's 55 percent lethality rate, Garrett said.

"But there's only 28,000 hospital beds," Garrett said. "Where do those patients go?"

Worldwide panic caused by a pandemic also would mean that the global delivery system would grind to a halt, she said, which wouldn't be good for the American consumer.

"We have globalized our consumer system, we have globalized our food system," she said. "We would find ourselves isolated from our chain of production."

The panic would affect Americans in other ways, she said, as citizens from poor nations likely would attempt to enter wealthy states illegally in search of drugs or vaccines.

Garrett saw some of this panic firsthand, as she was in China during the SARS outbreak. She described being stopped an average of 12 times a day to be checked for fever. She spoke of dangerous rumors that flew around the country by text messages that were believed more readily than the official news dispersed by the government.

"Though they never actually declared martial law, it was martial law," Garrett said.

In terms of what ordinary Americans can do to prepare - or attempt to prevent - a devastating global pandemic of bird flu, Garrett said people should focus close to home.

"Think global and act local," she said. "What is the nature of your community? Who would be in charge? And who do you know in your neighborhood who would need your help?"

TB2K'ers. My comments: These questions must be answered individually as the .gov has repeatedly said 'you are on your own'. Believe it.

PB2 E627K in Indonesian H5N1 Bird Flu Patients ​

http://www.recombinomics.com/News/08050602/H5N1_Indonesia_E627K.html

Recombinomics Commentary
August 4, 2006

The Indonesian government authorized the release of H5N1 sequences from Indonesia. Yesterday, the sequences generated by the CDC in Atlanta and Hong Kong University in Hong Kong were released to the public at the Los Alamos National Labs flu database.

As expected, most of the human isolates from patients on Java have a novel HA cleavage site, RESRRRKKR. However, these isolates also have a number of additional changes that readily distinguish the isolates from all public avian H5N1 sequences. Although the human sequences are clearly related to Indonesian avian sequences, they do not match, raising concerns over the source of the human infections. The only non-human sequence that does match is A/feline/Indonesia/CDC1/2006.

The sequences released included all eight gene segments. Analysis of the PB2 sequences indicates several patients who died in 2006 have the E627K polymorphisms. These patients were in West Java or in the Jakarta area and died between 2/10/06 and 4/26/06.

The presence of PB2 E627K in patients in Indonesia is cause for concern. The polymorphisms is found in all reported human isolates and increases polymerase activity at lower temperatures. The change is associated with increased virulence in mice. All Indonesian isolates listed below are from fatal cases.

DQ529292 A/chicken/Nigeria/641/2006 2006 H5N1
DQ533586 A/Cygnus olor/Italy/742/2006 2006 H5N1
DQ852607 A/grebe/Tyva/Tyv06-2/06 2006 H5N1
ISDN138771 A/Indonesia/321H/2006 2006 H5N1
ISDN183285 A/Indonesia/CDC370/2006 2006 H5N1
ISDN183288 A/Indonesia/CDC370E/2006 2006 H5N1
ISDN183289 A/Indonesia/CDC370P/2006 2006 H5N1
ISDN183293 A/Indonesia/CDC370T/2006 2006 H5N1
ISDN183296 A/Indonesia/CDC390/2006 2006 H5N1
ISDN183320 A/Indonesia/CDC582/2006 2006 H5N1
ISDN133103 A/Turkey/12/2006 2006 H5N1
ISDN133377 A/Turkey/15/06 2006 H5N1
ISDN133363 A/Turkey/651242/06 2006 H5N1
ISDN133371 A/Turkey/65596/06 2006 H5N1
AB264769 A/whooper swan/Mongolia/2/06 2006 H5N1
AB239300 A/bar-headed goose/Mongolia/1/05 2005 H5N1
DQ237956 A/bar-headed goose/Qinghai/0510/05 2005 H5N1
DQ095761 A/Bar-headed Goose/Qinghai/12/05 2005 H5N1
DQ095757 A/Bar-headed Goose/Qinghai/5/05 2005 H5N1
DQ095752 A/Bar-headed Goose/Qinghai/59/05 2005 H5N1
DQ095755 A/Bar-headed Goose/Qinghai/60/05 2005 H5N1
DQ095758 A/Bar-headed Goose/Qinghai/61/05 2005 H5N1
DQ095760 A/Bar-headed Goose/Qinghai/62/05 2005 H5N1
DQ095762 A/Bar-headed Goose/Qinghai/65/05 2005 H5N1
DQ095763 A/Bar-headed Goose/Qinghai/67/05 2005 H5N1
DQ095753 A/Bar-headed Goose/Qinghai/68/05 2005 H5N1
DQ095759 A/Bar-headed Goose/Qinghai/75/05 2005 H5N1
DQ100542 A/black-headed goose/Qinghai/1/2005 2005 H5N1
DQ100543 A/black-headed goose/Qinghai/2/2005 2005 H5N1
DQ100544 A/black-headed gull/Qinghai/1/2005 2005 H5N1
DQ095756 A/Brown-headed Gull/Qinghai/3/05 2005 H5N1
DQ650670 A/chicken/Crimea/08/2005 2005 H5N1
DQ449639 A/chicken/Kurgan/05/2005 2005 H5N1
DQ323675 A/chicken/Kurgan/3/2005 2005 H5N1
DQ389161 A/Cygnus olor/Astrakhan/Ast05-2-1/2005 2005 H5N1
DQ434890 A/Cygnus olor/Astrakhan/Ast05-2-10/2005 2005 H5N1
DQ343506 A/Cygnus olor/Astrakhan/Ast05-2-2/2005 2005 H5N1
DQ358750 A/Cygnus olor/Astrakhan/Ast05-2-3/2005 2005 H5N1
DQ365011 A/Cygnus olor/Astrakhan/Ast05-2-5/2005 2005 H5N1
DQ365001 A/Cygnus olor/Astrakhan/Ast05-2-6/2005 2005 H5N1
DQ363921 A/Cygnus olor/Astrakhan/Ast05-2-7/2005 2005 H5N1
DQ386305 A/Cygnus olor/Astrakhan/Ast05-2-8/2005 2005 H5N1
DQ399543 A/Cygnus olor/Astrakhan/Ast05-2-9/2005 2005 H5N1
DQ232608 A/duck/Novosibirsk/56/2005 2005 H5N1
DQ320856 A/Environment/Qinghai/31/2005 2005 H5N1
DQ100545 A/great black-headed gull/Qinghai/1/2005 2005 H5N1
DQ095754 A/Great Black-headed Gull/Qinghai/2/05 2005 H5N1
DQ232607 A/grebe/Novosibirsk/29/2005 2005 H5N1
DQ840532 A/swan/Astrakhan/Russia/Nov-2/2005 2005 H5N1
ISDN129518 A/turkey/Turkey/1/05 2005 H5N1
DQ138181 A /Viet Nam/DT-036/2005 2005 H5N1
DQ492899 A/Vietnam/CL105/2005 2005 H5N1
DQ492902 A/Vietnam/CL2009/2005 2005 H5N1
AB239307 A/whooper swan/Mongolia/3/05 2005 H5N1
AB239314 A/whooper swan/Mongolia/4/05 2005 H5N1
AB239321 A/whooper swan/Mongolia/6/05 2005 H5N1
DQ236079 A/cat/Thailand/KU-02/04 2004 H5N1
DQ530170 A/dog/Thailand-Suphanburi/KU-08/04 2004 H5N1
ISDN40383 A/Thailand/16/2004 2004 H5N1
AY907672 A/tiger/Chonburi/Thailand/CU-T3/04 2004 H5N1
AY907671 A/tiger/Chonburi/Thailand/CU-T7/04 2004 H5N1
DQ017251 A/tiger/Thailand/CU-T4/04 2004 H5N1
DQ017252 A/tiger/Thailand/CU-T5/04 2004 H5N1
DQ017253 A/tiger/Thailand/CU-T6/04 2004 H5N1
DQ017254 A/tiger/Thailand/CU-T8/04 2004 H5N1
AY651718 A/Viet Nam/1194/2004 2004 H5N1
ISDN40379 A/Viet Nam/1203/2004 2004 H5N1
AY651719 A/Viet Nam/1203/2004 2004 H5N1
AY818126 A/Viet Nam/1203/2004 2004 H5N1
AY651721 A/Viet Nam/3062/2004 2004 H5N1
DQ492894 A/Vietnam/CL01/2004 2004 H5N1
DQ492896 A/Vietnam/CL26/2004 2004 H5N1
DQ492897 A/Vietnam/CL36/2004 2004 H5N1
AY221588 A/Pheasant/Hong Kong/FY155/01-MB 2001 H5N1
AF508640 A/Ostrich/South Africa/9508103/95 1995 H9N2

Second Confirmed H5N1 Bird Flu Fatality In Thailand ​

http://www.recombinomics.com/News/08050601/H5N1_Thailand_Fatalities_2.html

Second Confirmed H5N1 Bird Flu Fatality In Thailand

Recombinomics Commentary
August 3, 2006

more than 6,000 cases have been diagnosed this year, of which 300 were fatal, he said.

"Influenza, too, is worrying … there has been a significant rise in the mortality rate from the disease over the years," Thawat said.

A 27-year-old Thai man has died of bird flu, the country's second death this year and its 16th victim since the H5N1 virus swept across parts of Asia in late 2003, a senior health official said on Saturday.

The man died on Thursday in the province of Uthai Thani, 220 km north of Bangkok, after having contact with sick chickens, Prat Boonyawongvirot, permanent secretary in the Ministry of Public Health, told Reuters.

"It is confirmed that this man has died of H5N1," Prat said.

The above comments on the death of a 9 year old girl in Lon Buri and 27 year old in Uthai Thani are cause for concern. Although the 9 year old had bird flu symptoms, she tested negative for H5N1. However, the comments above described an alarmingly high case fatality rate of 5% for cases diagnosed as seasonal flu. The high case fatality rate suggests H5N1 fatalities may be going undetected in Thailand.

In 2004 H5N1 was causing fatal cases in both Thailand and Vietnam. Although Thailand reported on 12 fatalities, a retrospective study indicated many patients with laboratory confirmed H5N1 were not included in the totals reported by Thailand or WHO.

In early 2005 fatal H5N1 cases reported in Vietnam. However, most of the fatal cases in Vietnam were in southern Vietnam, where almost all patients died. In contrast, the cases in the north were milder and the size of the clusters were larger, including a family of five in Haiphong. Although all five family members tested positive for H5N1, they all recovered after a brief hospital stay. Neighbors of the family were also hospitalized, but reports from Vietnam ceased. Although 1000 serum samples were collected in northern and central Vietnam, the results from those tests were never disclosed.

The Manila meeting in May of 2005 described H5N1 in 2005 and noted that the H5N1 in northern Vietnam were similar to isolates from Thailand. Although H5N1 was reported in birds in early 2005, there were no reported cases in humans in Thailand in early 2005. The failure to report any human cases in Thailand raised the possibility that the cases were mild and not detected.

The above comments indicate that H5N1 fatalities are again being reported in Thailand. There have now been two confirmed H5N1 positive fatalities. However, the 5% case fatality rate in seasonal flu patients again raises concerns about under reporting of H5N1 cases.

More information on the sero-types of the fatal seasonal flu cases would be useful as would sequence information. The 5% case fatality rate is at a pandemic level and is cause for concern.

Conflicting data over 2nd fatality​

http://nationmultimedia.com/2006/08/06/headlines/headlines_30010472.php

Confirmed death in area chickens tested negative

The Public Health Ministry yesterday confirmed the second human death from the bird-flu virus this year. The announcement has revealed a discrepancy in information coming from the ministry and the Department of Livestock Development (DLD).

Pinij Charusombat, the Public Health Minister, yesterday announced that a 27-year-old man from Uthai Thani's Sawang Arom district who died Thursday was killed by the H5N1 virus. The announcement was based on the results of laboratory tests conducted by the Medical Science Department and Siriraj Hospital.

It was the second instance of a human confirmed case in an area where the DLD's laboratory tests showed chickens had tested negative for the virus.

"We are doubtful. We don't understand how people can be infected with the virus when our lab tests showed chickens there were not infected with H5N1," said Nirundorn Aungtrakulsook, director of the DLD's Animal Epidemic Control and Veterinary Division.

The DLD was still insisting that Nong Bua Lamphu's Na Klang sub-district and Phichit's Bang Mun Nak district were the only two areas in the country where the virus had been detected in chickens.

The department also said that chickens in Phichit's Thab Khlo district - where the first human case this year was confirmed - were negative to the virus.

The DLD's director general, Yukol Limlamthong, insisted that the whole province of Uthai Thani was clear of the virus.

Nirundorn said there were no reports about mysterious deaths of chickens in Uthai Thani's Sawang Arom district. He claimed that livestock officials in the province had been informed about the death of three chickens in a house there last month and they collected the bodies for tests, which proved negative.

He said livestock officials visited the same house again on Thursday after learning about the culling of seven more chickens. These were also tested and again, he insisted, the results were negative.

He encouraged the Public Health Ministry to investigate how the two human victims could have been exposed to the virus.

Dr Thawat Sunthrajarn, director general of the Public Health Ministry's Disease Control Department, denied making a comment on the information from the DLD. He only said jokingly, "it [the virus] might come from nowhere."

Thawat said medical doctors never rely on the information of the DLD during a surveillance programme for any endemic disease.

"Bird flu is like dengue fever in that they are both endemic diseases and the virus can exist anywhere and can be active when the conditions are right. For us, any place that reports mass chicken deaths with unclear reasons, we assume it is a bird-flu area. We don't wait for the lab tests of the DLD," he said in a telephone interview yesterday.

Dr Pratch Boonyawongviroj, permanent secretary of the Public Health Ministry, said the latest victim became sick on July 24 after burying his dead chickens on July 17. He went to see a doctor on July 27 and was tested with a bird-flu rapid-test kit. The result was negative.

On July 30 the man went to the Sawang Arom hospital with symptoms that appeared the same as those caused by bird flu. But a laboratory test again confirmed that he was negative for the virus.

The next day, doctors decided to give him oseltamivir, an anti-viral drug that can be used to treat bird flu, and transferred him to Uthai Thani provincial hospital, where he died on Thursday. Yesterday he was confirmed as the country's 16th victim of bird flu since the first outbreak in 2004.

Meanwhile Agriculture Minister Sudarat Keyuraphan yesterday announced 29 provinces as high-risk bird-flu areas. The 29 provinces are: Bangkok, Sing Buri, Angthong, Ayutthaya, Nonthaburi, Suphan Buri, Chai Nat, Pathum Thani, Lop Buri, Chachoengsao, Nakhon Nayok, Nakhon Phanom, Kalasin, Khon Kaen, Phichit, Kamphaeng Phet, Nakhon Sawan, Chaiyaphum, Nakhon Phatom, Phitsanulok, Udon Thani, Kanchanaburi, Samut Prakan, Nakhon Ratchasima, Prachin Buri, Phetchabun, Uttaradit, Sukhothai and Uthai Thani

Indonesia tests 7 for bird flu from same village
Cases in area where cluster from same family killed by virus in May​

Reuters

Updated: 8:15 a.m. ET Aug 2, 2006

MEDAN, Indonesia - Seven Indonesians from the same village in North Sumatra have been hospitalized and are being tested for bird flu, an official said on Wednesday, raising fears of new cluster cases in the country.

The group comes from Karo district in North Sumatra province where bird flu killed as many as seven people in an extended family in May, triggering fears the H5N1 bird flu virus had mutated into a form that could spread easily between people.

“Whether it is a new cluster or not, that must be scientifically proved,” said Runizar Ruesin, head of the bird flu information center at Indonesia’s health ministry.

He said the seven were admitted to the local Kaban Jahe hospital, with three referred to the state-run Adam Malik hospital.

The latter three are children — two siblings aged 10 and six and their 18-month-old neighbor.

“I am still waiting for the result of the tests.”

Another official said chickens in the area where they lived had died and tested positive for bird flu. Sick poultry is the usual mode of transmission of the disease, endemic in birds in about two-thirds of the country’s provinces.


URL: http://www.msnbc.msn.com/id/14148626/

Death sparks Thai bird flu alert​

BANGKOK, Thailand (Reuters) -- A 27-year-old Thai man has died of bird flu, the country's second death this year, officials said on Saturday, as they put eight more provinces, including the Bangkok area, on a bird flu watchlist.

The man died on Thursday after the H5N1 virus killed chickens on his backyard farm in the province of Uthai Thani, 220 km (135 miles) north of Bangkok, the third province to suffer an outbreak since the virus re-emerged in July after an eight-month lull.

"He buried them without any protection and that's why he caught bird flu," Thawat Suntrajarn, chief of the Department of Disease Control, said of Thailand's 16th victim since the disease swept through parts of Asia in late 2003.

The World Health Organization, which says bird flu killed at least 134 people worldwide before the latest Thai death, urged previously hard-hit countries to be vigilant.

"Even in a country as well prepared as Thailand, it can come back and you can never rest easy," said Chadin Tephaval, a spokesman for the WHO in Thailand.

In Uthai Thani, 116 chickens and fighting cocks were culled to prevent the virus spreading from the dead man's farm.

His wife was not sick, but was being monitored after she cooked and ate some of the dead birds, Thawat said.

Since the death of a Thai teenager in late July, Thailand has rushed to plug gaps in its bird flu defenses.

The area around the sprawling Thai capital was among eight provinces declared bird flu risk zones on Saturday, increasing the total to 29 of Thailand's 76 provinces.

"The ministry will step up proactive measures and campaigns to fight the virus," Agriculture Minister Sudarat Keyuraphan said in announcing the expanded watchlist.

She said local officials would go on a door-to-door campaign to educate villagers on how to handle sick or dead poultry.

A new call center would take reports of suspicious poultry deaths and answer questions about the disease.
Warnings ignored

The fact that people were still handling dead chickens with their bare hands showed the government's safety message was not getting through, officials say.

"We have been using billboards, radio spots and television to tell people to protect themselves from the disease, but some are still complacent or ignore the warnings," Thawat said on Friday.

The government has threatened fines of up to 4,000 baht (about $100) or two months in jail for failing to report sick or dead birds.

The crackdown came after villagers in the province of Pichit, where the teenager died last month, were found to be hiding sick birds for fear their remaining flocks would be culled.

The outbreaks in Thailand and neighboring Laos, where bird flu was found on a farm near the capital Vientiane last month, renewed fears the disease is flaring up again in Asia.

In Vietnam, where there have been no confirmed cases among poultry or humans this year, authorities are taking no chances.

Animal health workers slaughtered 53 wild storks at a theme park in Ho Chi Minh City on Saturday after random tests showed H5, part of the H5N1 virus, in two birds.

In Indonesia, tests confirmed six suspected human cases were not bird flu, an official said.

News of the suspected cases in Northern Sumatra province had raised concern of possible "cluster" outbreaks where several members of one family have the virus and of possible mutations making human-to-human transmission easier.

Indonesia's health ministry said on Thursday that preliminary tests showed the illnesses were not bird flu after all, and on Saturday Runizar Ruesin, head of the health ministry bird flu center, told Reuters that further tests on the six confirmed "all of them negative" for the disease.

Indonesia and Vietnam have each had 42 deaths, the highest number of confirmed human deaths of any countries in the world.


Find this article at:

http://edition.cnn.com/2006/HEALTH/conditions/08/05/thai.birdflu.reut/index.html

Cambodia steps up bird-flu precautions along Thai border​

Aug 6, 2006, 16:29 GMT

Phnom Penh - Cambodia destroyed thousands of smuggled eggs and mounted a campaign to warn people against buying illegally imported poultry products, in the wake of new reported bird-flu cases in neighbouring Thailand and Laos, authorities said Sunday.

Meach Son, the Agriculture Ministry chief in the northwestern province of Banteay Meanchey, said his department had destroyed 5,000 chicken eggs Friday to try to prevent outbreaks of avian influenza along its borders.

Thailand and Laos both reported new cases of the deadly H5N1 strain of the virus in recent weeks.

'We have also made a proclamation to all the people not to eat eggs and chicken brought illegally from Thailand and have warned people engaged in this trade that we will close them down,' Son said by telephone.

The Cambodian crackdown on cross-border poultry trade and new efforts to educate people about the virus followed Thailand's confirmation of the second human death this year. Laos reported it had detected the virus on a farm last month.

Cambodia has recorded six confirmed human cases of bird flu, all of them fatal. Most of those occurred near its border with Vietnam.

However Thailand, traditionally an important supplier of poultry to Cambodia, has also been hard hit by the disease and Son said authorities on the country's Thai border were taking no chances.

http://news.monstersandcritics.com/...eps_up_bird-flu_precautions_along_Thai_border

Similiar to story above, WHO releases sequencing information.

JPD - I welcome your comments about what this sequencing information means.

WHO to Make Genetic Codes Public
From Bird-Flu Viruses in Indonesia

By NICHOLAS ZAMISKA
August 6, 2006 12:14 p.m.

The World Health Organization said it will make sequences of the bird flu virus from Indonesia public after the country's health minister agreed late last week to their release amid a chorus of calls from scientists for greater transparency.

Indonesian health officials have been sending the sequences, or genetic codes, of the H5N1 viruses that infected people to a WHO-affiliated laboratory in Hong Kong, which would confirm the cases and analyze the viruses. But from there, the genetic blueprint of the virus would be held in a password-protected database administered by the WHO and accessible only by a limited number of WHO labs around the world.

Scientists have been calling on the WHO and its network of laboratories to release the sequences so that more people can study them and try to determine how the virus is evolving, if at all, how to stop it from killing humans and how to ward off any mutation to a form that would be easily passed from person to person, sparking a pandemic. The sequences will now be released to a publicly accessible database.

"We've informed the labs that they have Indonesia's permission to upload the sequences to the public databases," Dick Thompson, a spokesman for the WHO in Geneva, said Sunday. "We've requested that they do that."

The Centers for Disease Control and Prevention in Atlanta, which has some Indonesian viruses, has informed the WHO that they have made the sequences public after receiving the WHO's request, Mr. Thompson added. The WHO is still waiting to hear back from the Hong Kong lab.

The Indonesian sequences are of special interest because earlier this year, international health experts identified an unusually large cluster of human cases in which the virus may have passed among a small chain of people, a potential precursor to a pandemic. The virus has killed at least 42 people in Indonesia since last year -- nearly a third of the 134 people who have died world-wide since it re-emerged in Asia in late 2003.

The WHO has so far declined to release the sequences, saying it was bound to keep information it received from countries confidential, in part because certain countries, such as Indonesia, hadn't agreed to a wider release.

On Thursday, Indonesian Health Minister Siti Fadilah Supari announced at a news conference that her government would allow the sequences to be shared, according to a report in the Jakarta Post. "I've learned that scientists across the world have complained that they could not access the data and made statements as if we had hidden it," she said at a news conference, according to the report. "For the sake of basic human interests, the Indonesian government declares that genomic data on bird flu viruses can be accessed by anyone."

Nyoman Kandun, director general of disease control and environmental health at the Indonesian Ministry of Health in Jakarta, confirmed that the health minister had decided to release the data.

When asked what prompted the decision, he said in a telephone interview on Sunday evening, "Because there were requests from many people who said that we were hiding all the information--that is why the minister of health decided to release all the information to put in the genome bank."

He added that the WHO, as well as foreign scientists, had been pressing the Indonesian government to release the sequences.

Click to expand...

http://online.wsj.com/article/SB115487975075128081.html?mod=home_whats_news_us

Lab result complicates bird flu case​

Victim's chickens were not infected

KULTIDA SAMABUDDHI

The Livestock Development Department has urged the Public Health Ministry to conduct thorough checks of the latest bird flu fatality in Uthai Thani after fowl samples collected from the victim's village tested negative for the H5N1 bird flu virus.

Seven chicken carcasses and cloacal swabs of live fowls collected from the house of a 27-year-old man, who died from bird flu last Thursday, all tested negative for the contagious virus, said director of the LDD's disease control bureau Nirundorn Aungtragoolsuk.

The laboratory result, which was released yesterday _ a day after the Public Health Ministry confirmed the country's 16th bird flu victim _ indicated that the latest death was more complicated than previous cases, which were found in bird flu outbreak areas, said Dr Nirundorn.

The man, whose name was withheld, developed flu-like symptoms and a high fever shortly after burying a dead chicken in his backyard with his bare hands on July 17. His condition deteriorated until he died around 10 days later. He was the second human case reported this year.

"Since the H5N1 bird flu virus was not detected at the victim's house and in the nearby vicinity, public health officials should find out how and where the man contracted the virus," he said.

Dr Nirundorn said veterinarians would check the test result by using an egg inoculation method, which was more accurate than the real-time PCR (polymerase chain reaction).

Kamnuan Ungchusak, director of the epidemiology bureau under the Public Health Ministry, said further inquiries into the Uthai Thani death were unnecessary as it was apparent that the man caught the virus while burying a dead chicken with his bare hands. "I'm not surprised that the LDD's test could not find the H5N1 virus in poultry samples from the house because the test was conducted long after the man was infected by the virus, and most of the chickens were already dead," said Dr Kamnuan.

He insisted it was the LDD's duty to track down the source of the disease in Uthai Thani and explain why a villager in a non-outbreak zone contracted the virus.

Bang Mun Nak district in the northern province of Phichit and Nakhon Phanom's Muang district in the Northeast are the only two areas confirmed by the LDD as having bird flu since July 24, the most recent outbreak.

Caretaker Public Health Minister Phinij Jarusombat yesterday inspected the bird flu control scheme in Uthai Thani, where another six bird flu suspected cases, including the wife of the latest bird flu victim and his neighbours, were reported.

Disease Control Department chief Thawat Sundrachan, who accompanied Mr Phinij, told doctors to give oseltamivir, the anti-viral drug for treating bird flu patients, to suspected bird flu cases even in districts outside LDD risk-zones.

Caretaker Agriculture and Cooperatives Minister Sudarat Keyuraphan said 200 fowls on a poultry farm in Uthai Thani's Muang district had died en masse yesterday, prompting livestock officials to cull almost 20,000 chickens on the farm as a precautionary measure.

http://www.bangkokpost.com/News/07Aug2006_news10.php

Thailand

Two Uthai Thani men put under close medical
watch for bird flu virus​

The Public Health Ministry has put two men in Uthai Thani under observation for avian influenza.

Caretaker Public Health Minister Pinit Charusombat (พินิจ จารุสมบัติ) said the two men, aged 73 and 19, had touched dead chickens without wearing gloves before falling ill. They are being treated at Uthai Thani hospital, Mr. Pinit said, adding the 19-year-old is in serious condition.

Mr. Pinit said the ministry is waiting for results of laboratory tests, which should come out today, to decide of the two men have bird flu virus.

Indonesia

Local tests indicate boy has bird flu, health official says​

http://www.thejakartapost.com/detaillgen.asp?fileid=20060807130052&irec=0

JAKARTA (AP): A 16-year-old Indonesia boy has tested positive for bird flu, health officials said Monday, citing local laboratory results that would take the total number of human infections in the country to 55.

Additional tests were needed to confirm the results, but preliminary findings showed that the boy contracted the potentially fatal illness from sick chickens in Bekasi, east of the capital, Jakarta.

He was receiving treatment at Sulianto Saroso Hospital for Infectious Disease, said I Nyoman Kandun, a leading Health Ministry official.

Hospital director Dr. Santoso Suroso said the patient's "condition is deteriorating and he is supported by a respirator."

Indonesia has recorded 42 human deaths from the H5N1 strain of the virus since July 2005 and is tied with Vietnam as the world's hardest-hit country.

The boy had been receiving treatment at a local hospital, but was moved to a national hospital on Saturday, said Ningrum, an official with the ministry's bird flu center.

Blood samples would be sent to a World health Organization-recognized laboratory in Atlanta, Georgia in the United States for secondary testing.

The bird flu situation in the vast archipelago grabbed world attention in May when seven members of a single family died of the virus -- the largest recorded cluster to date. The WHO concluded that limited human-to-human transmission likely occurred, but the virus did not spread beyond the blood familymembers.

Authorities fear the virus could mutate to become more easily passable between people and cause a worldwide pandemic.

Vietnam

Bird flu found in storks​

http://vietnamnews.vnagency.com.vn/showarticle.php?num=01HEA070806

HCM CITY — HCM City’s Animal Health Department has culled 53 storks in the Suoi Tien Tourism Zone after receiveing two positive results from tests for the H5N1 bird flu virus in the stork population.

The initial test was conducted by the HCM City Laboratory, but there has been no confirmation from the regional laboratory.

Animal Health Department deputy director Nguyen Kim Chau said these were the first positive results since last year. No other birds in the zone were infected, said tourism zone director Huynh Dong Tuan. The affected birds have been isolated at a safe distance from visitors, he added. — VNS

Cats infected with bird flu in Iraq: report​

http://www.thanhniennews.com/healthy/?catid=8&newsid=18564

Cats that died during an outbreak of bird flu in Iraq last February were infected with the H5N1 virus, US naval medical researchers reported.

Any cat that becomes ill or dies when suspected bird flu is circulating should be tested for the virus, the Navy team reported in the August issue of the journal Emerging Infectious Diseases.

The team at the Naval Medical Research Unit No 3 or NAMRU-3, based in Cairo, have been studying bird flu viruses taken from animals and people in the region.

The H5N1 Avian influenza virus spread out of eastern Asia and into Europe and the Middle East late in 2005. It has been found in 48 countries since it re-emerged in 2003, mostly in birds.

It can infect other animals as well as humans, and has so far killed at least 134 people in 9 countries. Experts are afraid it may evolve just enough to pass easily from person to person, sparking a pandemic that could kill millions.

Samuel Yingst, Magdi Saad and Stephen Felt of NAMRU-3 had been hearing stories from veterinarians in Turkey and Iraq who said cats had died where bird flu outbreaks were being reported in January.

But they could not get any samples from the cats.

"After H5N1 influenza was diagnosed in a person in Sarcapcarn, Kurdish northern Iraq, the government of Iraq requested a World Health Organization investigation, which was supported in part by Naval Medical Research Unit No 3 veterinarians," they wrote in their report.

People told the WHO team about cats that had died in a house near the city of Erbil where 51 chickens died. The researchers got the bodies of two of the cats and a sick goose from next door.

The animals had flu virus throughout their bodies, Yingst and colleagues reported. The virus found in the cats and goose strongly resembled the virus from a person who died in Iraq, suggesting it had not become adapted to cats.

The researchers said their findings support the idea that cats can be infected with H5N1 and may play a role in transmitting it, and that the virus could possibly mutate in the bodies of cats.

Flu viruses change in two ways - by steady mutation, which H5N1 has been seen to do, and by reassortment, which means swapping genes with other flu viruses. In 1957 and 1968 pandemic influenza broke out after the H3N2 viruses reassorted with other viruses.

Cats are mammals and biologically closer to humans than birds are, so in theory a virus that can easily infect a cat could infect a person more easily than a purely avian virus, which H5N1 remains.

"The route of infection in these cats cannot be determined definitively. How cats behave when eating birds makes both oral and respiratory infection possible," the researchers added.

A cat died of bird flu in Germany in March and Austrian experts said a cat there was infected with H5N1 a week later but did not get sick.

The Iraqi cats were infected with a distinct strain of the H5N1 virus known as Clade II, which was first found in migrating birds in Qinghai Lake in western China in 2005, the NAMRU team said. "To our knowledge, this is the first report of a Qinghai-like virus detected in domestic cats," the report reads.

JPD - I welcome your comments about what this sequencing information means.

Click to expand...

Hiding Bear here is an explanation from Dr. Niman:

Unique Human H5N1 Bird Flu Sequences in Indonesia ​

http://www.recombinomics.com/News/08070601/H5N1_Indonesia_Unique.html

Recombinomics Commentary
August 7, 2006

The human H5N1 Indonesian sequences sequestered at the WHO private database at Los Alamos were released to the public on Friday. Prior to this release, only two sequences, the HA and NA of A/Indonesia/5/05 were public. Thus was the first human isolate in Indonesia and was placed in the WHO data base by the CDC on August 1, 2005 and released on March 25, 2006. The release on Friday dramatically increased the number of public sequences to 504 (8 gene sequences from 63 human isolates).

Phylogenetic trees of HA sequences in the private database were discussed at the recent meeting in Jakarta. Most of the human sequences had the novel HA cleavage site RESRRRKKR. However, these sequences, primarily from the Jakarta / West Java area, also had several additional changes in HA and they formed a separate branch on the tree. Moreover, there were no avian sequences on this branch.

This lack of matching avian sequences raised concerns about the origin of the human H5N1. As indicated above, the first human sequence was isolated in July, 2005. The public avian sequences were from a wide geographical range in Indonesia, but most were collected prior to the first human case. None of these 2003-2005 isolates had the novel cleavage site. More recent collections were sent to Australia for analysis and those avian sequences were not included in the released data.

Analysis of the newly released data indicates that the human isolates with the novel cleavage site have a large number of unique polymorphism not found in any public Indonesian avian sequence, although the unique polymorphisms are clearly on an Indonesian genetic background. These unique polymorphisms are only all eight gene segments adding additional evidence suggesting the majority of the human cases are not linked to avian H5N1 in Indonesia.

The acquired polymorphisms are not random. As noted earlier for the first human sequences, they can frequently be found in other polymorphism on other H5N1 genetic backgrounds. This same type of acquisitions have been noted in Qinghai isolates found in the Middle East, Europe, and Africa. Although the isolates have a Qinghai genetic background, they are punctuated with a variety of shared polymorphisms whose distribution is far from random. These polymorphism are acquired via recombination.

These acquisitions also can be used to trace origins. The human sequences in Indonesia have a number of mammalian polymorphisms that are frequently found in isolates from humans, swine, dogs, and horses. In addition, a cat isolate, A/feline/Indonesia/CDC1/2006, matches the majority of the human isolates in all eight gene segments. A couple of the M polymorphisms are lusted below with isolates that share the polymorphism.

The presence of these polymorphism in mammalian isolates and the absence in Indonesian avian isolates, raises serious concerns about the origin of the H5N1 infections in Indonesia.

A discussion of these is also found at Indonesian Human H5N1 Sequences Released on FuTrackers.

JPD

Man suspected of catching bird flu admitted to hospital in Bangkok​

http://news.xinhuanet.com/english/2006-08/07/content_4931221.htm

BANGKOK, Aug. 7 (Xinhua) -- A man was admitted into a hospital in downtown Bangkok on Monday on suspicion of deadly bird flu virus, the Bangkok Metropolitan government officials told Xinhua.

The man who lives in Sathorn District, a main commercial zone of Bangkok, was isolated by the hospital after suffering a few days of flu symptoms, the official said.

It was very likely that the patient has been infected with the deadly H5N1 bird flu virus. It will take at least three days for the lab test result to come out, according to the hospital.

Thailand is fighting a new outbreak of the deadly H5N1 strain of bird flu virus which was confirmed in several provinces across the country.

The latest outbreak killed a 27-year-old man of the northern province of Uthai Thani last week, the country's 16th victim, following another fatality a week earlier in Phichit, prompting officials to conduct a large-scale culling of infected chickens.

Several hundred persons have also been placed under quarantine in the Thai government attempt to contain the outbreak. Enditem

Readers gird for bird flu​

http://www.orlandosentinel.com/news...7,0,7929914.column?coll=orl-opinion-headlines

Nearly 1,300 across U.S. share tips on preparations
Published August 7, 2006

When I asked readers of this column for their views on bird flu and the threat of a human influenza pandemic, I had a feeling quite a few would respond. Indeed, the sheer volume of e-mails, calls and letters has been overwhelming -- nearly 1,300 to date.

Equally impressive, most of those sharing their thoughts have conducted rather extensive research, particularly in terms of how to prepare for a pandemic. I appreciate those efforts; I, too, take the issue very seriously.

Mary Cornell of Orlando advised that accurate information and self-help are crucial, and suggested that the medical community train auxiliary personnel -- at least one person for every block -- to take care of people in the event of a pandemic.

Ellen Rice of Olympia, Wash., offered a simple, sensible plan: Stay informed (she checks her favorite site, www.fluwikie .com, every day); prepare (she picks up a few extra canned goods and other supplies each time she visits a grocery store); and educate others.

Weighing in from Smithville, N.J., Bob Friedenberg worried that Tamiflu isn't likely to work in the event of a pandemic. He urged that the federal government work "24/7 to develop a new vaccine."

Chuck Mundy of Longwood indicated that the prospect of preparing for a crisis that could last several months was overwhelming. "I overcame my inertia by breaking it down into weeks -- 12 of them for me. I prepared a 'menu' of everything I would need for a family of four for one week. Then I proceeded to buy one week at a time," he stated. Mundy also raised the concern that not everyone has the resources to secure supplies as he has. One of his personal solutions to that challenge is to contribute some of his supplies to a local food bank.

Chris Kamen of Santa Barbara, Calif., also sounded the importance of prepping: "A small amount of preparation now could save your family. By the time you hear that a pandemic has begun, it could be too late to do anything."

But Mark Sevelis of Germantown, Wisc., raised a skeptical eye and asked, "Is there really any reason to wait for the sky to fall? If these events are going to happen, they are going to happen. I try to live and enjoy each day as if it is my last. I do not worry about things that may or may not happen." Sevelis even tried to cast the issue in positive terms by urging people to "try to think of phenomena like the avian flu and bubonic plague as a population control for the human race."

Linda Angel of Priest River, Idaho, also summed up the bird-flu issue as "all hype," Moreover, she called it a tactic by the government to keep people stirred up and divert attention from the poor job it's doing.

Orlandoan Diane Simek mentioned that this is no "hype situation," even though no one in her circle of friends and family is concerned about it. She believes that the problem is real and worries that people have not prepared. Simek also expressed hope that the government would take care of the situation.

Debra Schrader of Rock Tavern, N.Y., is not waiting around for the government to act. In fact, she said, "I don't believe the government is doing all [it] can to inform the public. What I believe they're doing is covering their butts." Schrader stressed the importance of heeding warnings. Half of her family is willingly preparing, and she personally has shouldered the burden of stocking up for the other half.

Finally, the most complete description of preparations arrived from the Pacific Northwest. The writer asked that her name not be used because of the extensive and costly arrangements -- about $3,500 worth -- that she and her family have made and their desire to keep those details private.

Thus far, they have bought a six-month supply of food; three 55-gallon water barrels; seeds for the vegetable garden; bicycles to use when there's no gas for the car; a wood-burning stove; a stockpile of batteries; solar chargers; a crank/solar radio; protective masks; antibiotics; over-the-counter medicines; salt and soda; disposable urinals, bedpans and a bedside portable toilet; latex disposable gloves; and a six-month supply of cat food and litter. They also have stored cash, books, games and videos (for when there is electricity). And they are considering the acquisition of guns. The goal, she said, is to "think of everything we would need to live apart for six months."

Thailand

Man quarantined for H5N1​

http://www.bangkokpost.com/News/08Aug2006_news11.php

Hospital in Bangkok awaits detailed lab test

SUPOJ WANCHAROEN

A male patient was quarantined in Bangkok yesterday after preliminary tests at a hospital showed he had the bird flu virus in his blood, deputy city clerk Pitinan Natrujiroj said yesterday. He said the hospital was waiting for detailed laboratory test results to confirm whether the man had caught bird flu.

The patient is a 37-year-old man from Sathon district. He was admitted to Phetchavej Hospital in Wattana district on Aug 2 and had reportedly touched a pigeon. Detailed lab tests are expected to be released in a week, said Mr Pitinan.

A female patient who had been quarantined earlier in Taling Chan district was found to only have influenza, he said.

Renewed outbreaks of bird flu in poultry and suspected human cases in several provinces have hit the country's poultry markets that are usually bustling on the eve of Chinese All Souls Day today.

Orn-araya and Jintana Thongprathuang, sisters who sell processed fresh chicken at Klong Toey market, said their income yesterday plunged about 70% from the same day a year ago as they sold fewer chickens while market prices for processed fresh chickens had slumped over 20%.

Last year, they sold almost 300 chickens on the eve of All Souls Day alone as opposed to just over 100 yesterday. Prices for whole chickens have to about 80 baht.

Ms Orn-araya said she was confident that poultry at Klong Toey market was free from the avian flu virus due to stringent preventive measures.

The chickens are from farms in Nakhon Pathom and Chachoengsao and only delivery trucks with permits to transport poultry from the Livestock Department are allowed to enter the market.

Ms Jintana added that workers also cleaned the market with chlorine and other disinfectants supplied by the Livestock Department twice a week.

Bangkok Governor Apirak Kosayodhin inspected the city's major poultry abattoirs in Soi Mangkorn and Leng Buai Iah Market in the Yaowarat area.

After the visit, Mr Apirak said sanitary procedures practised by all abattoirs in the area met city standards.

However, the governor said abattoirs should be relocated to non-residential areas to help prevent the virus being passed on to humans.

Another measure was to have fresh markets sell only cooked chickens.

Mr Apirak said the city had continuously implemented bird flu prevention measures since last year, particularly in districts with a high poultry density such as Klong Sam Wa, Nong Chok, Min Buri, Saphan Sung, Lat Krabang, and those on the Thon Buri side as well as where bird flu outbreaks were reported two years ago.

The city had also set up three checkpoints to stop unlicensed trucks carrying in poultry from provinces such as Suphan Buri, Chachoengsao and Nakhon Pathom, to Bangkok, he said.

Meanwhile, caretaker Public Health Minister Phinij Jarusombat yesterday said the recent H5N1 human fatality, a 17-year-old who from Phichit, died as a result of bird flu alone.

Previously, he was thought to have contracted haemorrhagic fever in combination with bird flu.

Mr Phinij insisted no new strains of H5N1 had developed and that the oseltamivir drug still worked effectively in humans against the virus.

WHO confirms Thai avian flu death,
Indonesia reports fatality​

http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/aug0706thailand.html

Aug 7, 2006 (CIDRAP News) - A World Health Organization (WHO) reference laboratory confirmed today that a 27-year-old man who died on Aug 3 in central Thailand's Uthai Thani province had H5N1 avian influenza.

The WHO said investigators found that the man had contact with household chickens, which started dying about 1 week before the patient began having influenza symptoms.

The man had symptoms beginning Jul 24 and was hospitalized Jul 30. The Bangkok Post reported today that the man developed flulike symptoms shortly after burying dead chickens in his backyard with his bare hands.

The WHO announcement brings Thailand's official avian flu toll to 24 cases, with 16 deaths. The man's death marks Thailand's second avian flu death in 2 weeks.

The Post also reported six suspected cases in Uthai Thani province where the man died, which is about 137 miles north of Bangkok: the man's wife and five of his neighbors. Thai agriculture minister Sudarat Keyuraphan told the Post that 200 fowl died on a poultry farm in the province yesterday, which prompted an order to cull nearly 20,000 chickens on the farm. She told The Nation, a Thai newspaper, that the culling would be postponed until laboratory tests confirmed an outbreak in the province's poultry.

The WHO notes that avian influenza outbreaks have been officially recorded in the northern provinces of Phichit and Nakhon Phanom. Thailand's only confirmed human avian flu case so far this year was in a 17-year-old boy who died of the disease Jul 24 in Phichit province. Thai news outlets, however, have reported poultry outbreaks in several northern and central provinces, and on Jul 31 all of Thailand's provinces were put on avian flu alert.

As of today, the Thai Health Ministry has reported that 122 patients from 16 provinces are under surveillance for possible avian flu.

Thailand launched a week-long campaign today to check every house in 29 provinces to help slow a resurgence of bird flu in the country, Reuters reported today. Volunteers will inspect backyard farms for sick or dead birds and will educate residents about the H5N1 virus. Until last week, the country had reported no avian flu since 2005.

In Indonesia, The Associated Press reported today that a 16-year-old boy died after testing positive for H5N1 virus. The boy was admitted to the hospital 2 days ago. Reuters reported earlier today that the boy lived on the outskirts of Jakarta and was being treated at a human bird flu facility at a local hospital.

An Indonesian health ministry official told Reuters that the boy had been in contact with sick chickens. He said samples from the boy had been sent to the US Centers for Disease Control and Prevention in Atlanta.

If the results confirm the findings of the local test, the Indonesia will surpass Vietnam as the country with the most avian flu deaths. Confirmation will mean the boy becomes Indonesia's 55th human case and its 42nd death, according to a WHO tally. In July, Indonesia recorded its 42nd death, which ties it with Vietnam. All of Indonesia's deaths have occurred in 2005 and 2006.

Indonesia Records 43rd Bird Flu Death​

http://abcnews.go.com/Health/wireStory?id=2283073

Indonesia Records 43rd Death From Bird Flu, More Than Any Other Country in the World

By ALI KOTARUMALOS

JAKARTA, Indonesia Aug 7, 2006 (AP)— A 16-year-old Indonesian boy died from bird flu on Monday, officials said citing local test results. If confirmed, the death would bring the country's tally to 43, the highest in the world.

Normally reliable tests performed at a local laboratory showed that the boy who died late Monday had the H5N1 virus, said Dr. Santoso Suroso, the director of the capital's infectious diseases hospital.

The boy, whose name was not released, was admitted to hospital on Saturday.

He was reported to have had contact with sick chickens at his home, just east of Jakarta, health officials said.

If confirmed by a World Health Organization-accredited laboratory, the death will be Indonesia's 43rd from the H5N1 virus since July 2005, a third of which have occurred this year.

Neighboring Vietnam is the second worst hit at 42, but it has not recorded any new deaths this year.

The H5N1 virus has killed at least 135 people worldwide since it began ravaging Asian poultry stocks in late 2003, according to WHO. That figure does not include Monday's death in Indonesia.

So far, most human cases have been traced to contact with infected birds, but experts fear the virus which remains hard for people to catch will mutate into a form that spreads easily among people, potentially sparking a pandemic.

Experts say Indonesians will continue to die until the nation stops the rampant spread of infection among its hundreds of millions of backyard poultry.

"I just think that we're not getting it that this is fundamentally an animal issue," Dr. Anthony Fauci, the U.S. National Institutes of Health's infectious disease chief told The Associated Press by phone.

"You've got to worry about the humans, but if you don't clean up the animals, it doesn't matter what you do," Fauci said.

Vietnam largely controlled the spread of the virus by launching a nationwide mass vaccination campaign in poultry last year. Thailand, which has reported 16 deaths, relies on strong village-based surveillance and mass slaughtering when outbreaks are discovered.

Bird flu in Indonesia grabbed the world's attention in May when seven members of a single family died of the virus the largest recorded cluster to date. The WHO concluded that limited human-to-human transmission likely occurred, but the virus did not spread beyond the blood family members.

Associated Press medical writer Margie Mason contributed to this report.

Fourth case of bird flu outbreak in Bucharest​

http://www.makfax.com.mk/look/agenc...ion=2&NrArticle=23624&NrIssue=31&NrSection=20

Bucharest, 13:03

Bird flu continues to spread in Romania, where the fourth outbreak has been detected in southern Bucharest, as well as additional ten in the Prahova locality, central Romania.

"200 people living in Bucharest's fourth district have been quarantined last night, which sets the number of isolated residents of the capital to 400", Marius Dobresku, the spokesman of the city authorities, said.

"Nearly 250 birds have been culled since dead birds were found in several courtyards in the region", he added.

Romanian authorities decided to end the quarantine and allow people to move freely in all localities were bird-flu outbreaks were recorded, after the 15-patients suspected of bird-flu tested negative, said an official with the Health Ministry.

However, “Ending the quarantine does not mean disinfection and culling of birds in the affected areas will stop,” Rodica Costinea of the Health Ministry, said.

Thailand

100 hospitals to build rooms for bird flu-suspected patients​

http://www.thaisnews.com/news_detail.php?newsid=182740

The Cabinet has approved a budget of 20 million baht for 100 hospitals across to Thailand so they can build rooms for bird flu patients.

The Deputy Minister of Public Health, Mr. Anutin Charnvirakul, said each hospital will be granted with 200,000 baht so bird flu-suspected patients can be supervised in special rooms. The Public Health Ministry and the Agriculture and Cooperatives Ministry will work together on this project. As for the anti-bird flu vaccine, the government has not permitted for it to be used on humans. However, suspected patients will be treated with normal anti-influenza vaccine. Meanwhile, Mr. Anutin insisted that the government reveals all bird flu-related information to the general public.

He also said that the reshuffle of public health officials has not been proposed at the Cabinet meeting today as the ministry is waiting for the selection of the new election commission members to be completed first.

Bird flu's spread in Indonesia worrying, experts says​

http://www.thejakartapost.com/detaillgen.asp?fileid=20060808141455&irec=2

JAKARTA (AP): The speed at which Indonesia has become the country with the most human bird flu deaths has experts worried, but they say the pace will continue until the problem is tackled at the source.

"When you have trouble controlling infection among the chicken flocks, you are naturally going to see continuing infections among humans," Dr. Anthony Fauci, the U.S. National Institutes of Health's infectious disease chief told The AssociatedPress by phone in a recent interview.

He said the more it spreads, the greater chance it has of eventually evolving into a strain that could cause a human pandemic.

"It's obviously a toll in human suffering, but it also continues to give this virus the capability of circulating," he said. "And the more it circulates, the more you have an opportunity."

Fauci, who visited Southeast Asia last year, said Indonesia has not shown the same aggressive approach as Vietnam and Thailand in tackling the problem in poultry.

The country's 43 reported deaths in just over a year comes as the H5N1 virus spreads virtually unchecked among the billions of poultry in backyard farms throughout the vast archipelago.

Indonesia became the nation hardest hit by bird flu after local tests concluded a 16-year-old boy from Jakarta's outskirts succumbed to the H5N1 virus late Monday. The tests were conducted by a typically reliable local laboratory, but have not beenconfirmed by a World Health Organization-affiliated lab.

The country has racked up nearly a third of the world's fatalities in just one year, with the latest case surpassing Vietnam's reported 42 deaths, which occurred over a period of about 2 1/2 years.

Experts say the number of human deaths are a symptom of a much larger problem - the rampant spread of infection among the country's poultry.

Bird flu spreads to Indonesia's Papua​

http://www.antara.co.id/en/seenws/?id=17857

Jakarta (ANTARA News) - Bird flu has spread to Indonesia's easternmost province of Papua, with laboratory tests confirming the deadly H5N1 strain in poultry there, an animal husbandry official said Tuesday.

The confirmation comes as Indonesia reported overnight that a teenager was the 43rd bird flu fatality here. If confirmed by the World Health Organisation, Indonesia would become the country with the most human deaths from the disease.

In Papua, samples were taken from about 30 chickens in the Mimika area
after chickens from a local farm began to die in the second week of July, said Alexander Radjasa Pintadewa, the head of the Papua animal husbandry office.

"We have received the results of testings from the Bogor Veterinary
Research Center, which said that three of the some 30 samples... were
positively infected by the H5N1 virus strain," he told AFP.

Pintadewa said these were the first known cases of bird flu infection found in the province. The virus has already been detected in 27 other provinces out of 33 in the Indonesian archipelago.

Isolated Papua, which is located on one of the world's largest islands and shares a border with Papua New Guinea, lies some 3,000 kilometres (1,800 miles) from the capital Jakarta where the latest bird flu fatality occurred Monday.

The district animal husbandry office has since conducted limited culls,
slaughtering hundreds of chickens, spraying disinfectant and banning the
transport of poultry out of Mimika, Pintadewa said.

Indonesia, the world's fourth most populous nation, has been accused of
acting too slowly to curb the spread of H5N1 and criticised for failing to conduct mass slaughters of sick birds, as recommended by the United Nations.

The government, arguing it is faced with financial constraints, has so far opted to vaccinate poultry instead. (*)

China confirms human bird flu case from 2003​

http://thestar.com.my/news/story.as...01_NOOTR_RTRJONC_0_-262765-3&sec=Worldupdates

By Ben Blanchard

BEIJING (Reuters) - China confirmed on Tuesday that the country's first human case of the H5N1 bird flu virus in 2003 was two years earlier than originally reported, prompting the UN's health agency to call for greater transparency.

The case had spurred questions about whether there might have been other human H5N1 infections in China prior to what had been its first reported human case, near the end of 2005.

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

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

China's Health Ministry confirmed the case on Tuesday by "parallel laboratory tests" carried out in cooperation with the UN's World Health Organisation, Xinhua said.

"It speaks about the need for really close collaboration and transparent communication between various players within the government structure," said Roy Wadia, the WHO's spokesman in Beijing.

"The Ministry of Health says it was not aware of the man's H5N1-positive tests until the letter came out in the journal in June," he added.

"As we've said all along, it has been conceivable that there have been sporadic cases out here and in other countries that have not been picked up. It's good that this case came to light, but the question is how many cases might there be out there?"

Wadia said the health ministry had told them military scientists first tested the man and found he was infected with the H5N1 virus but did not tell the health department until much later.

China's health ministry said there was no cause for alarm.

"Although this human infection confirmed in the mainland was two years earlier than previous figures, it has no indication that China had an outbreak of bird flu in 2003," spokesman Mao Qun'an was quoted by the official Xinhua news agency as saying.

"People need not panic," he said. "The surveillance capability of bird flu in the country is significantly strengthened nowadays in comparison with two years ago."

BREWING

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

Lo Wing-lok, an infectious disease expert in Hong Kong, said this incident was a lesson and reminder for China to be honest, transparent and more forthcoming with information.

Experts in Hong Kong have long insisted that the virus has always been present in mainland China, but Chinese authorities have denied that.

Even after several members of a Hong Kong family contracted the virus in Fujian province in southern China in February 2003, the incident was swept under the carpet.

"If it had been more forthcoming, so much more could have been done for the rest of the world. But now, the virus has spread to three continents," Lo said.

"It's a lesson to be learnt."

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

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

(Additional reporting by Tan Ee Lyn in Hong Kong)

Thailand declares Bangkok, one third of country
disaster zone to fight bird flu​

http://www.forextv.com/FT/AFX/ShowStory.jsp?seq=142227

08/08/06 10:32 am (GMT)
BANGKOK (XFN-ASIA) - Thailand has declared more than one third of the country, including Bangkok, a disaster zone as a precaution to help local officials battle bird flu, officials said.

The cabinet also approved the creation of "death squads" tasked with immediately killing any infected chickens, as well as all poultry within a one-kilometer radius of any future outbreaks.

"The cabinet today approved a declaration naming 29 provinces as disaster areas so that the government can carry out aggressive, offensive measures to clean up the bird flu outbreak," government spokesman Surapong Suebwonglee told reporters.

Most of the provinces are in central and northeastern Thailand.

Surapong said the declaration will make it easier for government to provide compensation to farmers whose birds must be killed.

Agriculture Minister Sudarat Keyuraphan said the government will test chickens within five kilometers of an outbreak to check the spread of the deadly H5N1 virus.

Four new mobile labs will be deployed across northern and central Thailand to test for the disease.

The government also issued strict safety measures for another 30 provinces, requiring vehicles and equipment to be disinfected before travelling between farms.

Thailand has slaughtered 300,000 birds since two bird flu outbreaks were detected last month. Two people have died of the disease in the last two weeks, after nearly eight months with no sign of the virus.

The government has approved 65 mln baht to compensate farmers whose birds were killed.

Thailand has suffered 24 human cases of bird flu, including 16 fatalities, since the disease was first detected in the country in early 2004.

3 suspected bird flu patients admitted to hospital in Thailand​

http://english.people.com.cn/200608/08/eng20060808_291046.html

Three persons were admitted to hospital in Bangkok, capital of Thailand, on Tuesday on suspicion of contracting bird flu virus, an official of the Bangkok Metropolitan Administration told Xinhua.

Laboratory blood tests will take at least three days to confirm whether the patients were infected with the deadly bird flu, the official said.

On Monday, a man who lives in downtown Bangkok was put in quarantine at a hospital in Bangkok after suffering a few days of flu-like symptoms.

Meanwhile, Thailand's caretaker Prime Minister Thaksin Shinawatra has declared at a meeting Tuesday to allocate a 20 million baht (about 500,000 U.S. dollars) fund to fight bird flu, which re-emerged in the kingdom late July when a 17-year-old boy died from the deadly H5N1 avian influenza virus, the first fatality of the disease this year and the 16th death since the epidemic first broke out in early 2004.

The second victim was a 27-year-old man who died on August 3. Both of the two fatalities occurred in lower northern Thailand.

Source: Xinhua

Another H5N1 Bird Flu Fatality in Bekasi Indonesia ​

http://www.recombinomics.com/News/08070602/H5N1_Bekasi_Another.html

Recombinomics Commentary
August 7, 2006

A 16-year-old Indonesian boy died from bird flu on Monday, officials said citing local test results. If confirmed, the death would bring the country's tally to 43, the highest in the world.

Normally reliable tests performed at a local laboratory showed that the boy who died late Monday had the H5N1 virus, said Dr. Santoso Suroso, the director of the capital's infectious diseases hospital.

A 16-year-old Indonesian boy was tested positive for bird flu and was in a deteriorating condition, health officials said Monday.

The boy, whose name was not released, was admitted to hospital on Saturday.

He was reported to have had contact with sick chickens at his home, just east of Jakarta, health officials said.

The above report describes yet another H5N1 bird flu fatality in Bekasi, Indonesia. Bekasi has been the site of a disproportionate number of human fatalities in Indonesia. Released human H5N1 sequences show that the sequences in Bekasi are easily distinguished from reported avian sequences. Moreover, the more recent human sequences from Java, including those from Bekasi have evolved even further from the avian H5N1.

The failure to match the avian sequences is cause for concern. Although media and WHO reports cite contact with infected birds, the true source of the infections remain unclear, Avian sequences from 2003-2005 isolates are quite distinct from the majority of human sequences. The largest differences are with the most recent isolates from the Jakarta area.

91 recent avian samples have been sent to Australia for H5N1 isolation and sequencing. If the recent avian sequences do not match the human sequences, then it is likely that the source of the human H5N1 infections is not domestic poultry.

H5N1 Bird Flu Case in Downtown Bangkok ​

http://www.recombinomics.com/News/08070603/H5N1_Bangkok_Downtown.html

Recombinomics Commentary
August 7, 2006

A man was admitted into a hospital in downtown Bangkok on Monday on suspicion of deadly bird flu virus, the Bangkok Metropolitan government officials told Xinhua.

The man who lives in Sathorn District, a main commercial zone of Bangkok, was isolated by the hospital after suffering a few days of flu symptoms, the official said.

It was very likely that the patient has been infected with the deadly H5N1 bird flu virus.

The above comments support recent media reports that the patient has tested positive for H5N1 in initial tests. Reports also indicate that he has touched a pigeon. This is the fourth patient to have tested positive. Two have been confirmed in local testing and have died. A third person was not confirmed. The sudden increase in lab confirmed H5N1 in three separate provinces of Thailand is cause for concern.

In addition, a number of suspect cases are teasing positive for seasonal flu. Many if not most of the seasonal flu patients are H1 positive. However, a number are influenza A positive, H5 negative, but have not been sero-typed.

The number of influenza positive fatalities has increased and the number cited for this year is equal to a 5% case fatality rate, which is extraordinarily high for seasonal flu. I recent fatality of a 19 year old in a district that has had both human and bird H5N1 was said to have died from complications of pneumonia. This year there have already been 300 flu deaths.

These numbers raise concerns that H5N1 fatalities are being misdiagnosed as seasonal flu. Requests were made for further testing of the second H5N1 fatality because the live chickens were H5N1 negative. The tight linkage expectations are cause for concern.

In Indonesia, the number of fatal cases has now reached 43, the highest in the world. However, the H5N1 in human cases in Indonesia does not match the avian sequences in Indonesia. Instead, these patients have mammalian polymorphisms, including those found in H1N1. In addition, there are polymorphisms commonly found in H5N1 from Vietnam.

The sequence data raises concerns over an evolving H5N1 that is acquiring mammalian polymorphisms and becoming better adopted to humans. Reassortment experiments failed to find H3N2/H5N1combinations that produce more growth or transmission. However, H5N1 has been evolving via recombination. The acquisitions of new polymorphisms has produce an ever increasing variety of H5N1 strains capable of producing fatal infections in humans.

The Fujian strain, which causes fatal human infections in China has been detected in Laos and Malaysia. Qinghai sequences, which are readily transported and transmitted by migratory waterfowl, have also been found in Indonesia cases.

More information of sequences of H5N1 in poultry and people in Thailand, as well as sequences of the H1 seasonal flu would be useful.

Indonesia Reports Total of 44 Bird Flu Deaths ​

By VOA News
08 August 2006

Indonesian health officials say two teenagers have died of bird flu over the past two days, bringing the country's total number of victims to 44, the highest in the world.

Local laboratory tests this week showed both 16-year-olds, a boy and a girl, had bird flu when they died. It is not clear whether their deaths were linked.

If the World Health Organization (WHO) confirms the latest two deaths, Indonesia will surpass Vietnam with the highest human death toll from the virus.

Meanwhile, China's government has confirmed that a man died of bird flu in 2003, two years before the country reported its first human case of the illness. China's health ministry announced that news Tuesday after it was first reported in June by Chinese researchers describing the case in a U.S. medical journal.

http://www.voanews.com/english/2006-08-08-voa29.cfm

Another H5N1 Bird Flu Fatality in Tangerang Indonesia​

http://www.recombinomics.com/News/08080601/H5N1_Tangerang_Another.html

Recombinomics Commentary
August 8, 2006

INDONESIA said today that two teenagers had been confirmed as its 43rd and 44th bird flu deaths, making the country the world's hardest hit by human fatalities from the deadly virus.

"Samples from both of them have been confirmed as positive by both a health ministry laboratory and by the US NAMRU (Naval Medical Research Unit) laboratory," Runizar Ruzin, from the health ministry's bird flu centre, said.

A 16-year-old boy died last night and a 16-year-old girl died today, Rizin said.

The above comments chronicle the steady rise in the number of H5N1 bird flu fatalities in the Jakarta area. The 43rd death was in the Bekasi area, which has had reported cases since last year. The 44th cases is in the same area as the first reported case, in July, 2005.

The steady increase is cause for concern because the source of these infections has not been determined. H5N1 from the cases in the Jakarta area have a novel cleavage site and do not match the public avian sequences from Indonesia. The cleavage site has not been reported for any isolate, and the HA has additional unique sequences. Moreover, the recent release of the sequence data from these cases show that all eight gene segments have unique polymorphisms and phylogenetic trees of each gene indicate the human sequences form a separate branch that does not include avian isolates.

Since the reported avian isolates are from 2003-2005, it is possible that the lack of a match is related to the date of collection. However, two of the CDC avian isolates were from the fall of 2005 and those sequences did not match. Moreover, several recent human isolates have PB2 E627K and these isolates are evolving away from the 2005 human isolates. The more recent 2006 isolates are less related to the existing avian sequences. Many of the new polymorphism are frequently detected in mammalian isolates, raising the possibility of a a mammalian reservoir. Moreover, the recent isolates from the Karo cluster have acquired Qinghai sequences and an avian isolate from Bali has a Qinghai cleavage site.

Thus, the human H5N1 in Indonesia represents at least two distinct strains and the isolates from Java do not match the avian sequences.

Information on the recent avian samples sent to Australia for sequencing would be useful as would a more robust surveillance of H5N1 in migratory birds and mammals including swine, cats, and dogs. Moreover, testing of human cases with bird flu symptoms in the absence of contact with dead or dying birds would be useful.

Int'l experts monitoring Thailand​

http://www.bangkokpost.com/News/09Aug2006_news10.php

APIRADEE TREERUTKUARKUL

International bird flu experts are keeping a close watch on Thailand, besides China and Indonesia, as a country where a human flu pandemic might break out. Prasert Thongcharoen, a leading virologist at Siriraj Hospital, yesterday said the rising rate of infection by the H5N1 bird flu and human influenza viruses in Thailand had raised concerns among medical experts over the possibility of virus mutations that could lead to an influenza pandemic.

Their concerns mounted after bird flu claimed two lives in Thailand within two weeks, on July 24 and Aug 3.

''The longer the H5N1 strain of bird flu and other types of influenza co-exist in the environment, the greater the possibility that the virus will mutate,'' he said.

Dr Prasert pointed out that illegal vaccine use in poultry by farmers posed a major hurdle to efforts to eradicate the deadly bird flu virus.

Vaccination could increase immunity in vaccinated fowls but could not kill the H5N1 virus; therefore, the virus could continue spreading without detection by vets since the vaccinated fowls would not show any symptoms of bird flu, he said.

Epidemiologists and experts in related fields attending an emergency meeting on bird flu control yesterday urged the Livestock Development Department to step up suppression of illegal use of bird flu vaccines by farmers in order to control the spread of the virus more effectively.

Caretaker Public Health Minister Phinij Jarusombat, who chaired the meeting, said illegal use of vaccines in poultry would cause difficulties in virus detection and complicate the screening process for suspected cases.

The situation had become complicated because some farmers had smuggled in vaccines for the H5N2 strain from China for their poultry. This raised concern that there could be cross-breeding of the H5N1 and H5N2 strains, Mr Phinij said.

Meanwhile, the cabinet has approved a 20-million-baht budget to install negative pressure rooms, or isolation wards essential for separating patients having flu-like symptoms, at a total of 100 community and provincial hospitals nationwide.

Supakit Sirilak, provincial public health chief in Uthai Thani, believes the negative pressure rooms will provide more safety for hospital staff and patients. The air which flows in a one-way direction will be sterilised and reduce the possibility of virus circulation in the air.

The rooms, costing around 200,000 baht each, will be equipped with a disinfectant ventilation system.

Most pressure rooms at hospitals around the country now are just normal pressurised rooms which allow the virus to circulate in the air, raising the chance people will contract the virus, he said.

Installation of the negative pressure rooms at the 100 community and provincial hospitals is expected to be completed in the next few months.

Government spokesman Surapong Suebwonglee said the cabinet also approved another 10 million baht to support the work of public health volunteers, who have been assigned to visit all communities to detect traces of bird flu.

In this fourth bird flu outbreak in Thailand, there have been two human fatalities. One was a 17-year-old male in Phichit province and the other a 27-year-old man in Uthai Thani. Both had had direct contact with dead chickens.

Meanwhile, the Public Health Ministry reported yesterday that the 19-year-old male patient in Uthai Thani who had been hospitalised since Saturday with bird flu-like symptoms was discharged yesterday after laboratory tests from showed he did not have bird flu.

In Bangkok, the city administration revealed that since August 1 nine people have been quarantined as suspected bird flu cases. However, all nine tested negative for bird flu.

Indonesia

East Java regency on bird flu alert​

JEMBER, East Java (Antara): The Jember regency administration declared his region on high alert for bird flu after dead chickens were found infected by the HN51 virus in three districts.

The head of the Jember Livestock and Fishery Agency, Daddy Kusdriana, on Wednesday lead the slaughter of hundreds of chickens from three districts -- where the dead chickens werefound.

Daddy said laboratory tests confirmed the chickens had bird flu. He, however, did not mention the real number of chickens that had died because of the virus.

Experts have expressed disappointment with the government's efforts to curb H5N1 in poultry, saying its unwillingness to set aside funds to support mass poultry culls has hampered its bird flu campaign.

Health Ministry officials said Tuesday that local tests had confirmed two teenagers died of the virus, bringing the country's death toll to 45.(**)

Indonesia

Bird flu spreads to six districts in Bantul​

Slamet Susanto, The Jakarta Post, Bantul

Bird flu has spread to six of the 17 districts in Bantul regency, according to preliminary tests, says the Bantul Livestock, Marine Resources and Fishery Office.

"The virus started attacking poultry populations well before July 13," said the head of the office, Sumartilah, referring to the day locals first started reporting sick or dead birds.

The six districts are Srandakan, Sanden, Pleret, Bantul, Sedayu and Jetis, Sumartilah said.

The country's bird flu death toll climbed to 44 Tuesday, making it the nation with the highest number of deaths from the virus.

Sumartilah said the majority of the infected chickens were free-range layers.

The tests were done soon after residents reported the sudden deaths of their chickens.

"The dead chickens had dark blue or purple combs, mucus around their beaks, diarrhea and white droppings," Sumartilah said.

She said the rapid spread of the virus might be connected to the wet weather in Bantul, the hardest-hit area in the May 27 earthquake.

The infected birds roamed about freely as their coops were destroyed in the quake, she said.

In order to help curb the spread of the deadly virus, the livestock office has been spraying disinfectant around the affected areas. "The disinfectant is to stop the virus from infecting humans," Sumartilah said.

The test results were reported to the Bantul Health Office, which says it will monitor any developments closely.

Up to 2,000 chickens had died in the six district as of early July. "In the evening our chickens still looked healthy, but in the morning they were all dead," said Darno, a resident of Trirenggo village in Bantul district.

Syamsudin, a resident of Segoroyoso hamlet, said the virus had been spreading fast over the last month. "But reports of dead chickens have steadily increased over the last two weeks."

Syamsudin and the other residents are worried the virus could spread to humans. Two months after the disaster many of them continue to live in semipermanent structures with poor sanitation.

Syamsudin said all dead chickens needed to be immediately buried. "How can we live without fear when we are still living among the ruins of our homes."

Human death toll rising in Indonesia​

By MARGIE MASON, AP Medical Writer
Published Monday, August 7, 2006

JAKARTA, Indonesia (AP) - The fast-mounting human death toll from bird flu in Indonesia - now believed the country worst-hit by the disease - concerns experts who fear the virus will keep infecting people until it is controlled in poultry.

Local tests concluded two teenagers living in Jakarta's outskirts succumbed to the H5N1 virus this week. Specimens have been sent to the U.S. Centers for Disease Control and Prevention for confirmation, and if positive, the country's death toll would rise to 44, making Indonesia the world's hardest-hit nation.

The country has racked up nearly a third of the world's fatalities in just one year, with the latest cases surpassing Vietnam's reported 42 deaths, which occurred over about 2 1/2 years.

But experts say the number of human deaths is a symptom of a much larger problem - the rampant spread of infection among the country's billions of poultry raised in backyard farms.

"When you have trouble controlling infection among the chicken flocks, you are naturally going to see continuing infections among humans," Dr. Anthony Fauci, infectious disease chief at the U.S. National Institutes of Health, told The Associated Press.

He said the more it spreads, the greater chance it has of eventually evolving into a strain that could cause a human pandemic.

"It's obviously a toll in human suffering, but it also continues to give this virus the capability of circulating," he said. "And the more it circulates, the more you have an opportunity."

Fauci, who visited Southeast Asia last year, said Indonesia has not shown the same aggressive approach as Vietnam and Thailand in tackling the problem in poultry.

Vietnam has not reported any human cases in nearly nine months and no poultry outbreaks this year, after launching a nationwide vaccination campaign in poultry last year.

Thailand - which has reported 16 deaths and is now experiencing a flare-up - relied on strong village-based surveillance and mass slaughtering when outbreaks were discovered.

But in Indonesia, many local governments have refused to carry out mass poultry slaughters and vaccinations have been sporadic. One of the main issues is a lack of centralized control in a young democracy where public awareness about the disease is lacking.

"I knew about bird flu from the TV and radio, but when my son got sick I had no clue it was bird flu," said the mother of one of the teens who died this week, 16-year-old Megi Supatra. She said he was initially diagnosed with typhoid and told to go home.

The U.N. Food and Agriculture Organization is working with the government at the village level to develop local outbreak detection teams to snuff out poultry outbreaks before they can spread.

But progress is slow with limited resources in a country of 220 million people spread across 17,000 islands.

"It's a disgrace. We have the biggest problem in the world with avian influenza in Indonesia and yet the world is still not investing in getting a systematic control program in place," said Peter Roeder, an FAO expert in Rome who has worked closely with Indonesia. "What's Vietnam going to feel like if they get virus reintroduced from Indonesia?"

So far, about $50 million has been committed to the World Health Organization and FAO for work in animal and human health in Indonesia over the next 18 months, the World Bank says.

Roeder said that amount is needed over three years just to deal with the problem in poultry

The H5N1 virus has killed at least 135 people since it began ravaging Asian poultry stocks in late 2003. So far, most human cases have been traced to contact with infected birds, but experts fear the virus will eventually mutate into a form that spreads easily among people, potentially sparking a pandemic.

In May, seven of eight Indonesian family members died after becoming infected with H5N1 - the largest cluster ever reported. WHO said limited human-to-human transmission occurred. However, the virus did not spread beyond the blood relatives.

Amid international criticism, Indonesia's health minister recently said the country would make genetic information collected from virus specimens available for the scientific community to study.

But experts say the answer still lies with poultry.

"If you really want to control the spread of H5N1, it is important to root it out at the source and to actually make sure that you get the problem controlled in chickens," said Albert Osterhaus, a virologist at the Erasmus Medical Center in Rotterdam, The Netherlands. "It will be very hard because apparently the virus is endemic and all over the place there."

----

http://www.islandpacket.com/24hour/healthscience/story/3345709p-12319463c.html

China confirms 2003 bird flu death​

15:36 09 August 2006

China has announced its first confirmed human death from bird flu actually occurred in late 2003 – several months earlier than the previously reported first death from the current outbreak.

The announcement on Tuesday comes as south-east Asian nations are caught in the grip of the latest outbreak of the virus. Also on Tuesday, Indonesia reported two more human bird flu deaths, raising the toll there to 44 and making it the world's hardest hit nation.

The country reported its first bird flu deaths in July last year and has seen a steady rise in victims since then. Experts blame the escalation on Indonesia’s failure to carry out the widespread culls seen in other countries struck by the H5N1 strain.

And Thai officials have declared more than one-third of their country, including Bangkok, a disaster zone as a precautionary measure to help officials there battle bird flu. On 5 August the nation reported its 16th bird flu fatality.

Its cabinet also approved the creation of chicken "death squads" tasked with the immediately culling of any infected birds as well as all poultry within a 1-kilometre radius of any outbreaks.

Bogus email
The Chinese health ministry confirmed its first human case through laboratory tests that were carried out with the World Health Organization (WHO) and researchers from the Chinese Academy of Military Medicine, the ministry said on its website.

It identified the victim as a 24-year-old private in the People's Liberation Army, surnamed Shi. China had previously said its first human bird flu case was in November 2005.

Officials admitted their mistake after eight Chinese scientists published a letter in the New England Journal of Medicine in June 2006, claiming Shi became ill from bird flu on 25 November 2003 and later died. The journal even received a bogus email claiming to come from an author of the letter and asking for its withdrawal (see Bogus request to withdraw Chinese bird flu paper).

Stronger surveillance
Although nearly three years have passed since Shi died in Beijing, the government said there was no reason to worry about its ability to react quickly. "People shouldn't panic," said Mao Qun'an, a spokesman for the health ministry, according to the state-run Xinhua news agency. "The country's bird flu surveillance capability is much stronger now than it was two years ago."

Prior to China's announcement, the first human death from bird flu in recent years was believed to have been in Vietnam in January 2004. Since then, over 220 people have caught the virus, resulting in about 130 fatalities.

Roy Wadia, a Beijing-based spokesman for the WHO, said he did not want to speculate on any cover-up in this case, but that it highlighted weaknesses in the way officials report threats to public health: "This actually pinpoints a challenge facing the communication mechanism within the Chinese government structure."

China was widely criticised for initially covering up the deadly Severe Acute Respiratory Syndrome (SARS) outbreak in late 2002, enabling the virus to spread more easily and kill hundreds globally.

http://www.newscientist.com/article/dn9705-china-confirms-2003-bird-flu-death.html