9/9-15 | Weekly Weekly Bird Flu Thread: WHO, More Human Bird Flu Deaths Indonesia

JPD

Inactive
More Human Bird Flu Deaths Confirmed In Indonesia By WHO

http://www.medicalnewstoday.com/healthnews.php?newsid=51497

Main Category: Bird Flu / Avian Flu News
Article Date: 09 Sep 2006 - 10:00am (PDT)

According to the World Health Organization (WHO) two more humans have died of H5N1 infection, bringing the total number of human deaths to 48. One is a 4-year-old girl from Makassar, South Sulawesi Province. Authorities say the girl developed bird flu like symptoms on June 18th, 2006, was hospitalized on June 23rd and died the following day. The girl had had contact with chickens near her home.

There are two other cases, one fatal and the other not, that date back to June and November, 2005, after a recent revision of case definitions for H5N1 infection. One was an 8-year-old girl from Tangerang, Banten Province, who became ill on June 24th, 2005 and died on July 14th, 2005 - she was part of a family cluster. The other was a 45-year-old man from Magelang, Central Java Province, who became ill on November 25th, 2005, and subsequently recovered.

WHO says after the recent revision of case definitions, its figures for Indonesia now tally with those of the Indonesian Ministry of Health.

63 humans have been infected with H5N1 in Indonesia, of which 48 (76%) have died.
 

JPD

Inactive
Indonesia

VP suggests using force to cull bird flu-infected fowls

http://www.antara.co.id/en/seenws/?id=19717

Makassar, South Sulawesi (ANTARA News) - Vice President Jusuf Kalla said force should be appplied to cull bird-flu infected fowls in order to prevent the spread of the virus effectively.

The VP said local authorities could use the Law on Prevention of Contagious Diseases in forcing people to surrender their fowls to be culled.

Kalla made the remarks when delivering an address at a seminar on the prevention of bird flu at Hasanuddin University (Unhas) here on Saturday.

He said the government was mobilizing military personnel in bird flu prone areas in the country to cull fowls by force if breeders whose birds were infected with the bird flu virus refused to give up their fowls.

Indonesia has declared the outbreak of the disease in the country an extraordinary case since September 15 last year.

The most recent human infection of bird flu took place in West Java`s Garut district, scores of people were suspected of bird flu infection and two of them died.

Until recently, a total of 62 bird flu cases in humans had been confirmed in Indonesia and 47 of the sufferers had died. (*)
 

JPD

Inactive
Oregon and Washington State

Bird owners need to register flocks

http://www.tri-cityherald.com/tch/opinions/story/8170369p-8062861c.html

Published Friday, September 8th, 2006

Keeping a few pet chickens in a backyard coop is a harmless endeavor. Under normal circumstances, the birds would hardly be noteworthy.

But in this era of uncertainty about avian flu, chicks, ducks, turkeys and other poultry have become a lot more interesting to state agriculture officials.

They're asking bird owners to register with the state to help create a database on the location of all hobby flocks statewide.

It's a sensible precaution.

If bird flu were ever to become an issue in the Northwest, this information would allow animal health officials to contact owners quickly and locate flocks that may be in the vicinity of an outbreak. Quick action made possible by a comprehensive bird registry could prevent a more widespread problem.

But many bird owners don't seem to agree. They think their flocks are none of the state's business.

Only about 5 percent of the estimated bird owners in the state have complied since the state's registry began in January.

State agriculture officials say the information would be confidential. They're not interested in information on individual birds, just the locations of the flocks.

Animal identification programs have been in place for years. Some programs are put in place to maintain animal health. Others - like branding - help prevent rustling and allow stray animals to be returned to their rightful owners.

Give the state Department of Agriculture credit for being pro-active on the issue of avian flu.

And, bird owners, please give them the very basic information they are asking for. You'll be protecting everyone - and every bird - in the long run.

For information on the registry program in Oregon, call 503-986-4860 or visit the state Web site at oregon.gov/ODA/ AHID. In Washington, call 360-725-5493 or go to agr.wa.gov on the Web.
 

JPD

Inactive
Alberta Canada

Pandemic plans front and centre at GYRD meeting

http://www.edsonleader.com/story.php?id=253434

Grande Yellowhead Regional Division (GYRD) chief deputy superintendent Judy Grigat said a group of school boards near Edmonton met in February and the message was clear, bird flu or some other pandemic-like strain was still a hot topic.

Ed Moore
Leader staff
Monday September 11, 2006
"At all the meetings they said it's not a matter of if, it's when (a pandemic will hit)," Grigat said.

She told trustees during last Wednesday's GYRD monthly meeting that a pandemic was something that cannot be "cast in stone" as far as planning is concerned.
But the one thing that surprised Grigat was that none of the boards planned school closures if a pandemic did occur.

The chief deputy superintendent said that the board will have to ramp up discussions with the division's principals when it came to a possible pandemic and what steps could be taken to lessen the damage.

Grigat said one way would be to teach youngsters to wash their hands frequently and thoroughly in an effort to kill germs. Another way would be to instill in children the need to cover their mouths when they sneeze, she added.

Another way to lessen the pandemic is to convince teachers and bus drivers to stay off the job if they feel ill, Grigat said.

In a backgrounder paper to the board, Grigat said the World Health Organization (WHO) advised that globally a pandemic was long overdue and the influenza outbreaks in Asia, Africa and Europe has alerted WHO to the potential of this being the start of a world-wide pandemic.

Public Health Canada, Alberta Health and Wellness, Emergency Management Alberta, Aspen Regional Health and Capital Health already have plans in place.
Board chairperson Shirley Mahon asked Grigat if there were sufficient soaps and towels within Grande Yellowhead schools to ensure adequate handwashing.
Grigat replied she assumed there was but was not sure. She said more towels would be used in such a situation so the division would have to make sure there were ample supplies to ensure this.

A committee will be formed within the division that will ensure an influenza response plan is in place.

The committee will consist of director of transportation services Leigh McDonald, communications manager Nicole Merrifield and five principals (one from each zone) to be established under the direction of Grigat to develop an influenza pandemic prevention and response plan.

Mahon wondered if a trustee should be included on the committee, but Lobstick trustee Lynda Akers disagreed.

She suggested a facilities liaison person could sit on the committee. That person would be able to advise Mahon on the ongoing status of the pandemic plan. Superintendent of Schools Dean Lindquist agreed that a facility services person would be a vital member of such a committee.

Grigat said an influenza pandemic response plan would be at least six to eight months in the making.

The board passed the two recommendations necessary to get the process underway.
 

Fuzzychick

Membership Revoked
Alberta Canada

Pandemic plans front and centre at GYRD meeting

http://www.edsonleader.com/story.php?id=253434

Grande Yellowhead Regional Division (GYRD) chief deputy superintendent Judy Grigat said a group of school boards near Edmonton met in February and the message was clear, bird flu or some other pandemic-like strain was still a hot topic.

Ed Moore
Leader staff
Monday September 11, 2006
"At all the meetings they said it's not a matter of if, it's when (a pandemic will hit)," Grigat said.

She told trustees during last Wednesday's GYRD monthly meeting that a pandemic was something that cannot be "cast in stone" as far as planning is concerned.
But the one thing that surprised Grigat was that none of the boards planned school closures if a pandemic did occur.

The chief deputy superintendent said that the board will have to ramp up discussions with the division's principals when it came to a possible pandemic and what steps could be taken to lessen the damage.

Grigat said one way would be to teach youngsters to wash their hands frequently and thoroughly in an effort to kill germs. Another way would be to instill in children the need to cover their mouths when they sneeze, she added.

Another way to lessen the pandemic is to convince teachers and bus drivers to stay off the job if they feel ill, Grigat said.

In a backgrounder paper to the board, Grigat said the World Health Organization (WHO) advised that globally a pandemic was long overdue and the influenza outbreaks in Asia, Africa and Europe has alerted WHO to the potential of this being the start of a world-wide pandemic.

Public Health Canada, Alberta Health and Wellness, Emergency Management Alberta, Aspen Regional Health and Capital Health already have plans in place.
Board chairperson Shirley Mahon asked Grigat if there were sufficient soaps and towels within Grande Yellowhead schools to ensure adequate handwashing.
Grigat replied she assumed there was but was not sure. She said more towels would be used in such a situation so the division would have to make sure there were ample supplies to ensure this.

A committee will be formed within the division that will ensure an influenza response plan is in place.

The committee will consist of director of transportation services Leigh McDonald, communications manager Nicole Merrifield and five principals (one from each zone) to be established under the direction of Grigat to develop an influenza pandemic prevention and response plan.

Mahon wondered if a trustee should be included on the committee, but Lobstick trustee Lynda Akers disagreed.

She suggested a facilities liaison person could sit on the committee. That person would be able to advise Mahon on the ongoing status of the pandemic plan. Superintendent of Schools Dean Lindquist agreed that a facility services person would be a vital member of such a committee.

Grigat said an influenza pandemic response plan would be at least six to eight months in the making.

The board passed the two recommendations necessary to get the process underway.


Ah huge wake up call IMHO, they've said jack about about the "mild" form found here in the U.S. Watch and wait...
 

JPD

Inactive
California

State Formula Determines Who Gets Shots During Bird Flu Pandemic

http://abclocal.go.com/kabc/story?section=local&id=4545637

SAN FRANCISCO, September 9, 2006 - California health officials have settled on a formula for resolving a wrenching question that would arise if a bird flu pandemic strikes the state: who gets doses of scarce vaccine?

The complex process for picking who would receive bird flu shots is contained in the state's Pandemic Emergency Preparedness and Response Plan. State officials completed a new version of the plan last week, and a copy was obtained late Friday by The Associated Press.

The state did not draw up a hierarchy of Californians who would most need inoculation, though it hints at groups most vulnerable. "Very young persons, elderly adults, and persons with underlying disease are at high risk of complications during interpandemic influenza outbreaks," it states.

Instead of setting out a list of likely candidates, the state developed a scoring system that the report says "produces a rank-ordered list of target groups prioritized for influenza vaccination." The formula is designed to be flexible enough to accommodate variables in a pandemic.

The system considers:

* The goals of a vaccination program, such as minimizing illness, social disruption and economic losses.
* Rationing strategies, such as emphasizing people who perform essential emergency-services roles or who are especially vulnerable to disease.
* Precise criteria for determining who qualifies as a member of those critical or vulnerable groups.

The state's formula represents a new attempt to grapple with the subject of a fierce debate over who should be inoculated in a worst-case scenario.

Vaccine factory employees and front-line health workers head the Bush administration's own list, but there is no consensus on who would get vaccinated next. Should it be school-age children who are flu's prime spreaders? The frail elderly who may be at highest risk of death? Police, firefighters, utility workers who would have to keep order and essential services running?

Congress allocated $3.8 billion last year with the goal of being able to distribute vaccine to every American within six months of a pandemic striking. The Bush administration leaves it up to states to determine how to distribute the vaccines.

While several pharmaceutical companies are conducting clinical trials, no vaccine currently exists. It would take time for researchers to develop a highly effective vaccine after they identified a lethal bird flu strain.

"It becomes a high-stakes process to the extent there's a shortage of vaccine, and early on, that's certainly likely to be the case," said Dr. Mark Horton, the state public health officer and chief deputy director in the California Department of Health Services.

The state plan envisions beginning vaccinations when a pandemic reaches the World Health Organization's "Phase 6" - the most severe stage in a pandemic. At that stage, "sustained" human-to-human spread of the disease is occurring.

Currently, the virus has not mutated into a form easily spread among people. But the deadly Asian strain of bird flu has ravaged poultry and killed at least 141 people worldwide.

The state released a draft bird-flu response plan in January. For nearly nine months, it worked on improvements. But the version released this month contained only "relatively minor, technical" changes, Horton said.

However, it is sure to evolve in the coming months and years. For instance, Horton said, it currently has no specific guidance on another potentially grisly issue - what to do with a large number of dead bodies.

California, the nation's most populous state, is uniquely vulnerable the virus arriving via birds or people. In addition to having a citizenry with ties to Asia, where the disease has hit hardest, California has a $2.5 billion poultry industry, and millions of birds migrate along its flyways.

State Fish and Game authorities have spent the past few weeks trying to catch some of those migrating birds, with limited success. They have been focusing especially on pintails, a type of duck with an exceptionally wide range of migration, said agency spokesman Patrick Foy.

Pintails fly all the way to Alaska and Siberia, where their flyways can intersect with those of birds that have traveled through Asia, Foy said.
 

JPD

Inactive
A very interesting read: Gojus Notes and Thoughts-
Safe America Pandemic meeting for Business
that took place in NYC on Sept. 6, 2006.

http://www.fluwikie2.com/pmwiki.php?n=Forum.GojusNotesAndThoughts-SafeAmericaConferenceNYC

07 September 2006
Goju – at 12:11

These are my notes and thoughts from the Safe America Pandemic meeting for Business that took place in NYC on Sept. 6, 2006.

Safe America is a 12 year old company encouraging people to prepare for emergencies. They have partnered with many large corps now for the prep for BF

The conference was Business focused

It was held in NBC-TV’s Studio where they shoot SNL (Saturday Night Live – go figure!)

They are holding similar events in Major and secondary cities

www.safeamerica.org

They gave out a CD with Power point presentations, PSA tv spots, and all slide shows presented at the conference – I have uploaded them to www.mipodcast.com/H5N1

There are many valuable gems there – look for the file named - SafeAmericaPresentation

On to the Meeting…..

First panel CDC Dept of Homeland Security National Center for Disaster preparedness – Columbia University (Megadisasters)

My notes: Talked about Migratory birds and and poultry trade as spreading disease Said most bird problems in Asia. Will ask families of sick people to stay home Navu study – wash hands 5x a day reduced illness by 45% Kept using 1918 figures of 30% sick & 2.5% fatality, 1–2 months to reach US after Efficient H2H in asia Initial response may be travel restrictions

Trying to push the first wave later in time and lower case rate Used comparison of 1918 – Phili vs St Louis – Phili had big parade biggest death rate. St Louis instituted social distancing measures and had lowest death rate Goals:

1 – Plan for impact on Biz
2 – Protect People
3 –Establish policies
4 – Allocate resources
5 – Communicate and educate
6 – Coordinate plans and responses

They hope to not have to distribute critical resources during pandemic 1-telecommunications 2 – Electricity 3 – Water expect 30–50% worker outages

Gut from Columbia said We are facing a Megadisaster Not facing reality Says public is very worried Hospitals need $5 billion now and $1 billion each year to hope to deal with this.

Overall it was good general BF coverage – they were begging for biz to pay attention Say it ultimately comes down to the individual

GOJU ASKED THE FIRST QUESTIONS: 1 – Why do you use CFR of 2.5% when the current rate has been 50% and Indonesia is seeing 80% - It seems to be getting worse 2 – You say the birds are a problem in asia, what about the LPAI found in the birds in PA and Mich this past week?

Answers We don’t know what the CFR will finally be so we are using history as a guide They were stumped at the bird question said wasn’t problem at this point in time – It seems they were talking heads sent by the agencies to give the party line. –

Someone in the audience said they ran simulations and did a study where they had 80–90% worker outages.

Bottom Line – We know more

During break I met a woman who works for the company who will be distributing Tamiflu for Roche to biz – she knew nothing and has not prepped herself

Panel 2 Understanding corporate threat 2 consultant companies and homeland security

talked about Train studies of London underground maintenance and part supply was biggest long term problem How could Biz lower their staffing needs to 50% Big empasis on not planning but DOING – moving to ACTION Said this is NOT 1918 – medical, population, society, politics 73% of Biz who had 10 day disruption had to close 43% never recovered Doing is the key Communication tools very important to develop All comes down to taking action NOW

Break

Panel 3 Plotting Prevention and Treatment Solvay Pharma (making vax) Roache labs NYC Dept of health Affiliated Physicians 3M

I missed most of the vax guy talk – had to talk a call from my biz Roche – they are making 400 million dose by end of year and have enough to deal with problem in 2 years US is stockpiling Tami in 10 locations to be used by emergency personal NYHD – he was funny – he complained about the lack of preparedness and that NYC and other health depts. Are not being given what they need – he wanted toi be booked on SNL – only funny moment of the day (leave it to us New Yorkers to laugh in the face of disaster)

This was a disappointing section – not much to report

Break – I turn and see Dr Nabarro (UN) sitting by himself in the front row. He must have just arrived. So… I sat next to him, introduced myself, told him I have followed his career and thought he was very brave to say 150 million would die only to have to retract it next day. Next we talked… for 10 minutes… alone… uninterrupted.

There is NO news from China
Indonesia is a mess & not cooperating Going to Indo next week to see what happened w/ tami blanket – he didn’t know results yet of that & roadblocks
Key people ARE supplied
He is prepped but wouldn’t talk about it
Africa is a BIG concern

He was impressed with my knowledge He reads the flu forums sometimes He is exhausted and very concerned When I mentioned Qinhai – his eyes lit up and muttered “you know about that?” We exchanged cards and he introduced me to his UN assistant. We exchanged cards – I put the flu forums URL on the back of my cards

NEXT was a teleconferenc call with Dr Houssin – Chief Med officer National flu coordinater – FRANCE They are developing plans Improving regional and local responses Stockpiled: 14 mill antivirals 350 mill masks 160 mill other masks ? 40 mill vax ? they are working with: embassies hospitals airports cross border relations doing social distancing experiments with Sanove vantris (spelling?) involving: mask usage, eworking, how to deal w/ sick workers AT THE WORKPLACE People not taking it seriously – they think Gov will take care of them

QUESTION TIME Goju gets first question:

When WHO raises the pandemic level to 4, 5 & 6 what will Frances response be?

Answer: They will not close borders but will put restriction on them and monitor them They may quarentine arirports for a time

Nabarro Speaks Says he lives and breaths this He was not happy with the French response to my question about the airports He kept saying “when the pandemic comes…” “the Possible pandemic” H5N1 is the nastiest virus ever seen” Talked about cats, gogs infected and limited H2H Showed an interactive map of H5N1 spread Emphasized how fast it is spreading this year He has BIG worries about Nigeria and Egypt – did not elaborate Quiet this summer but expect increases in asia and Africa Going to Indo next week to see whats going on there

He is sad about thailands recurring outbreaks after they effectively beat it last year Probably many more infections and deaths than reported Inefficient H2H in N Sumatra There will be a pandemic – may be H5N1 could be like 1918 or worse Would not estimate how many would die – said he got into trouble for doing that before Once it goes efficient H2H – BOOM it will be too late to prep Right now we have “God given time” to prepare Levels 4, 5 & 6 could happen very fast UN asked WHO to go to level 4 months ago – they refused – he said they were right to refuse Restriction of movement may be necessary

His job is to coordinate 100–200 international bodies to all work together in same direction Talked about how they did it for SARS and how close we were to a pandemic Possible threats – Rule of law, security, continuance of governments UN is following 2 models for pandemic – Heavy and Light Must engage the public Life goes on he said – must maintain functioning Most countries will keep borders open (hence the france comments) Keep transportation moving Talked about you cannot cull poultry if you don’t compensate farmers Said indo gov is scared to take money from World Bank due to certain Corruption.

Break

Panel 4 Red cross Homeland security – Cptn Lynn Slepski Walgreens Deloitte & Touche

Trying to recruit volunteers for Red Cross – very poor response Business continuity presentation – excellent Must – cross train workers Plan for leadership continuity Don’t do tabletop exercises – just do Make a continuity plan – any plan but institute NOW tweek as you go Quality assurance plan Preposition supplies Teach people how to use those supplies – used the example of N-95 mask usage for a bearded worker How do u pay for voluntary or forced quarentine of workers The homeland security officer (in a uniform – I loved this lady)….. She asked who washed their hands before eating lunch – 10 out of 250 – HA She talked about her preps and how UNPREPARRED she really was – She talked like a mom to her kids about behaving in a healthy and responsible way This woman put me to tears – tears were streaming down my face – I couldn’t help it – it was the first time I have heard anyone talk like me BEGGING each and every person in the room to begin prepping.

Break

Panel 5 Campell soup NBC Motorola St barnabas health system JMC Marketing

Motorola is making all wireless devices into emergency communication deveices with something she called – ICOE – In Case Of Emergency – it is a number you dial and they will contact you in case of national emergency They are going to start airing PSA’s on TV all over the country about hand washing and food prep – for 2 weeks per person in English and Spanish

GOJU’s TAKE ON ALL THIS

1 – We know more than almost everyone on the planet.

2 – TPTB are taking this VERY seriously

3 – I asked each member of Safe America if they themselves are prepared – 2 said they have 2 weeks of food… not much else – everyone else said… no. I asked why since I really didn’t understand how THEY knowing everything but haven’t prepped… there was stunning silence – from each and every one of them.

4 – of the 30–40 people I spoke with, 2 were prepped for 3 months, 5 for 2 weeks.

5 – I spoke with a rep from HESS oil. I expressed my feeling that if oil stopped, we are screwed. She agreed and then told me how this was on the front burner in all the oil companies plans. She said the wells, refineries and shipping all were 24/7 with multiple levels of backup both in parts and manpower – they are confident they can ride it out BUT… the problem they are having is further down the line at the regional and local level. They can’t guarentee that the oil will reach the pumps and if it did, that the pumps would work. That was an opinion echoed through the day. They are VERY aware that if they screw up, Power, Food, Water are all done for. I asked if they were making deals with the military to supply them first to run things like Power plants and food transport – she said they do have arrangements for this but she didn’t think that would be necessary due to the planning they have done… including the power industry

6 – many people who spoke and I spoke with were “talking heads” sent by their companies or agencies with a script (I use the word loosely). They were not experts in their fields nor very well informed outside of their directed framework.

7 – I spoke with a rep from UNICEF – they are planning a major campaign to educate KIDS to the BF – I heard this from multiple people there – they believe the way to get to the parents is through the kids. They believe that the pandemic will spread through the schools. They want hand washing and cough techniques to be a BIG part of the education process.

8- My final thought – the world is waking up to actually doing something. The problem IMHO is much larger than we as a planet can deal with… If we have a high CFR, We Are Screwed.

I have contact info for Dr Nabarro. As in my questions at the conference, I will contact him ONLY ONCE… so the message MUST BE ON POINT.

Lets mull over this meeting, all I have seen and decide as a group how to make use of this valuable resource. We have one bullet – lets use it wisely.

Wishing you all good luck. We’re gonna need it.
 

JPD

Inactive
Experts see conditions exist to foster flu pandemic

http://www.timesnews.net/article.php?id=3675301

Published 09/10/2006 By J.H. OSBORNE

Second in a series

KINGSPORT - To become a pandemic influenza threat to humans, the avian (or bird) flu that has been making headlines around the world the last couple of years would have to mutate to a strain easily passed from one person to another.

It hasn't done that - yet - pandemic experts told local health officials last week.

"Human-to-human transmission with efficiency hasn't happened yet," said Dr. David Henderson, a Bethesda Md.-based epidemiologist.

He was among several pandemic experts who spoke Friday at a preparedness summit hosted by the Sullivan County Regional Health Department.

To date, there have been no confirmed cases of avian flu, in birds or people, in the United States, Henderson said.

But two major factors have federal, state and local health officials concerned and making preparedness plans: history tells us the world is about due for an influenza pandemic; and past pandemics had their roots in bird flu.

"That's how we got pandemics in the past," Henderson said. "Everything has happened except the efficient transmission from human to human."

Henderson said there has also been an increase in the incidence of bird-to-human transmission, most notably in countries in Asia.

Earlier this year, health officials reported human-to-human transmission of the bird flu among several members of a family in Indonesia, Henderson said.

That cluster of seven cases comprises the bulk of only nine, or maybe 10 at the highest, cases of human-to-human transmission of the virus on record, Henderson said.

That helps explain the World Health Organization's (WHO) current pandemic alert level of "phase 3," which signifies "little to no" reports of human-to-human transmission.‘MIXING VESSELS'

According to the Tennessee Department of Agriculture:

•Avian influenza viruses mutate rapidly. A mutation can cause an outbreak to shift from causing only mild illness in birds to causing rapid high mortality rates. A viral mutation during the course of an epidemic may also alter which species can be infected by the virus. Avian influenza is currently of concern because more than 100 people have been infected with the H5N1 virus over the past 2 years, resulting in 60 human deaths. However, avian influenza will not become widespread in people unless the virus gains the ability to be transmitted from person to person easily. When human or swine populations are infected by more than one strain of influenza virus at the same time, these non-avian species can serve as a "mixing vessel" for the mutation and spread of a strain that can be transmitted easily between humans.FLU TERMS DEFINED

According to the U.S. Department of Health and Human Services, on the Web site www.pandemicflu.gov:

•Seasonal (or common) flu is a respiratory illness that can be transmitted person to person. Most people have some immunity, and a vaccine is available.

•Avian (or bird) flu is caused by influenza viruses that occur naturally among wild birds. The H5N1 variant is deadly to domestic fowl and can be transmitted from birds to humans. There is no human immunity and no vaccine is available.

•Pandemic flu is virulent human flu that causes a global outbreak, or pandemic, of serious illness. Because there is little natural immunity, the disease can spread easily from person to person. Currently, there is no pandemic flu.

President Bush issued the National Strategy for Pandemic Influenza in late 2005.

Its stated intent is "stopping, slowing or otherwise limiting the spread of a pandemic to the United States; limiting the domestic spread of a pandemic, and mitigating disease, suffering and death; and sustaining infrastructure and mitigating impact to the economy and the functioning of society."

It gives the U.S. Department of Health & Human Services (HHS) the leading role in federal pandemic preparedness.

Earlier this year, Bush released an implementation plan for the strategy, outlining more than 300 actions for Federal departments and agencies and setting expectations for state and local governments.

In April, Gov. Phil Bredesen signed a planning resolution detailing HHS' and Tennessee's shared and independent responsibilities for pandemic planning.

Tennessee received nearly $2 million in federal funding for phase one for pandemic planning activities, and the state is scheduled to receive another $4.4 million.

Tennessee's state pandemic preparedness plan is available online at www2.state.tn.us/health/CEDS/pandemic.htm
 

JPD

Inactive
Study: New Details About Bird Flu

http://www.11alive.com/news/health/health_article.aspx?storyid=84482

Provided By: The Associated Press
Last Modified: 9/10/2006 10:40:36 AM

By RANDOLPH E. SCHMID
AP Science Writer

WASHINGTON (AP) -- When bird flu infects people, the virus is more concentrated in the throat than the nose, the opposite of human flu. This finding may help doctors more quickly diagnose the bird flu in people.

The disease has been linked to the deaths of more than 140 people worldwide, mostly among Asian farm families who live in close contact to birds. There have been no reports of infections of people in the United States.

Health officials have monitored the disease as it moves through poultry and other animals. The fear is it could mutate into a form that spreads easily from person to person, a development that officials say could lead to a global pandemic.

Researchers are studying the disease in an effort to find a way to prevent or block it and to treat victims.

Menno de Jong of the Oxford University Clinical Research Unit at the Hospital for Tropical Diseases in Ho Chi Minh City, Vietnam, reports in Monday’s issue of Nature Medicine that people with bird flu had much higher levels of the virus in their throat than in their nose.

That is important in showing doctors a better way to diagnose the disease, he said. It is also important that physicians can detect the virus in diarrhea and other rectal secretions. This is one more way the disease can spread and shows the need for infection-control measures, de Jong said in an interview via e-mail.

“Our observations suggest that early recognition and early treatment may provide the best benefit. Early recognition and diagnosis will pose a challenge for clinicians,” he said.

De Jong and his co-authors studied 18 people infected with bird flu, which is known as H5N1, and compared them with eight people who had common human flu viruses.

“Our observations suggest that H5N1 virus replicates to very high levels—higher than common human flu—in the respiratory system and that these high levels of virus ignite an overwhelming intense inflammatory response,” he said.

In inflammation, the body’s immune system causes blood vessels to allow chemicals and blood cells to leak into an infected area, designed to attack the infection, but an over-response can cause harm.

“Extensive damage to the lungs and possibly other organs are likely caused by both the direct effects of the virus as well as by the intense inflammatory response to the virus by the infected individual,” de Jong said.
He said the researchers could detect the bird flu virus in the blood of people who died of the disease, but not in the blood of these who survived an infection.

“The virus in the bloodstream most likely is picked up during passage of the blood through the lungs where most virus replication occurs,” he said.

“The presence of virus in the bloodstream may be a direct consequence of high levels of virus in the most important site of infection (lungs) and reflect an overall high ‘bodyburden’ of virus in fatal cases,” he said.

Dr. Wilbur H. Chen of the University of Maryland School of Medicine in Baltimore said that researchers are clamoring for more details on how the bird flu affects humans, and in particular better ways to quickly diagnose the illness.

Chen, who was not part of de Jong’s research team, said it sounds like the researchers found some useful information.

De Jong’s work was funded by the Wellcome Trust.
 

Bill P

Inactive
September 11, 2006

H5N1 replicates more strongly than common flu - study

By Steve Holland and Thomas Ferraro

\HONG KONG (Reuters) - The H5N1 bird flu virus replicates far more aggressively in people than common human flu viruses, a study of patients in Vietnam has found, offering further insight as to why the virus is so deadly.

The study, in the latest issue of Nature Medicine, also found that the virus had got into the blood stream of many of the human victims it killed, which means the virus could have spread to other parts of the body.

Menno de Jong, a key researcher in the study, explained that the unusually high viral loads triggered intense "cytokine" responses -- an immune system overreaction that can be fatal.

Cytokines are proteins in the immune system that fight off intruders such as bacteria and viruses.

"During H5N1 infection, the (cytokine) response seems to be very, very intense. Cytokines want to get rid of this intruder but if you have very high levels of cytokines, it can also damage the body ... it can be directed against your own cells and organs," de Jong told Reuters in an interview.

The study involved 18 people infected with H5N1 and 8 with human flu in 2004 and 2005 in Vietnam.

Scientists found far higher viral loads in the nose and throats of those infected with bird flu than human flu.

Thirteen of those infected with H5N1 died and the virus was found in the blood of at least 9 of them, implying it could have been transported out of the respiratory tract.

The virus was also found in the rectums of most of those with H5N1, suggesting it could have spread through the blood stream into the gastrointestinal tract.

Those with common flu had no virus in their blood or rectum. No one died in that group.

"The fatal outcome of H5N1 infections seems to be associated with high levels of replication of the virus and also the detection of the virus in the blood," said de Jong, of the Oxford University Clinical Research Unit at the Hospital for Tropical Diseases in Ho Chi Minh City in southern Vietnam.

The team was able to draw a connection between those who were most ill and the level of cytokines found in them.

"We found that levels of cytokines were much higher in H5N1 patients than in the human flu cases. Again, the highest levels of cytokines were found in those who died of H5N1," he said.

"The high levels of the virus triggered an overwhelming inflammatory response that contributed to lung dysfunction and eventual death."

De Jong highlighted the need to stop the virus replicating.

"What's important is to stop the replication as soon as possible, so you prevent damage to the lungs and prevent the inflammatory response to the virus," he said.

But he conceded that early diagnosis was a challenge, especially in remote places where health services were not readily available.


http://thestar.com.my/news/story.as...01_NOOTR_RTRJONC_0_-266907-1&sec=Worldupdates
 

JPD

Inactive
Indonesia

Coercion needed in bird flu fight, VP Kalla says

http://www.thejakartapost.com/detailnational.asp?fileid=20060911.H02&irec=1

The Jakarta Post, Jakarta

The government needs to use coercion to ensure the fight against bird flu is "effective and successful", Vice President Jusuf Kalla said Saturday.

He said coercion should be used in cases where poultry owners with infected fowl refused to allow their fowl to be culled by authorities to prevent the spread of the killer virus.

"If coercion is not used in the mass cull of infected poultry the effect of the spread will be extremely dangerous," Kalla was quoted by Antara as saying when addressing a symposium on the prevention of bird flu at Hasanuddin University in Makassar, South Sulawesi.

The government confirmed Thursday that a woman from South Sulawesi had died of H5N1, the human strain of bird flu, in June, while infected birds were found dead in the same province.

Kalla argued that the use of force was permitted under the law on prevention of infectious diseases.

He cited as an example the country's biggest bird flu cluster in Tanah Karo, North Sumatra, where seven people were infected but many locals refused to cull their infected birds.

Authorities had then to deploy police and soldiers to supervise the culling of their infected fowl, Kalla added.

South Sulawesi Governor Amin Syam acknowledged facing a hurdle from local people who refused to cull infected birds.

This was due to a lack of awareness of the danger of bird flu and the low compensation offered to breeders for their culled fowls, Amin was quoted by Antara as saying.

Kalla was of similar view that the lack of knowledge about the danger of the lethal disease made local people reluctant to cull their infected poultry.

"Those who don't want to take such a risk are always a small group, whose only income is from the poultry business," he said.

Indonesia, the world's fourth most populous nation, is grappling with ongoing outbreaks of the H5N1 virus and has the world's highest human toll from the disease.

The virus is not transmitted from person to person, but the chance of a mutation that would allow it to do so is heightened as more humans catch it from infected birds.

The World Health Organization has recorded two more cases of bird flu in the country, one of them fatal, bringing the country's confirmed death toll from the virus to 48.

The cases, which occurred last year, were added to the WHO tally because of a recent change in the testing standards that the body sets for cases of the H5N1 virus. They were already included in Indonesia's Health Ministry tally.

"WHO is adding two cases in Indonesia, dating back ... to 2005," the WHO said in a statement Saturday as quoted by AP. "The retrospectively confirmed cases bring the total in Indonesia to 63. Of these cases, 48 have been fatal."

The retrospectively confirmed fatal case was an eight-year-old girl who died on July 14 2005 on the outskirts of Jakarta. She was part of a cluster of deaths in one family that made up Indonesia's first reported cases of the virus, the WHO statement said.

In the second case, a 45-year-old man from Central Java province fell sick but recovered, the WHO said.
 

JPD

Inactive
Immediate Treatment Needed for Bird Flu Cases, Study Says

http://www.nytimes.com/2006/09/11/world/11flu.html?_r=2&oref=slogin&oref=slogin

By DONALD G. McNEIL Jr.
Published: September 11, 2006

Avian flu kills in much the same way the global flu pandemic of 1918 did, by drowning victims in fluid produced in their own lungs, a new study has found. The study also suggests that immediate treatment with antiviral drugs is crucial, because the virus reproduces so quickly that, if not suppressed within the first 48 hours, it tends to push victims into a rapid decline to death.

“The paradigm ‘hit hard and hit early’ probably is very true for H5N1 influenza,” said Dr. Menno D. de Jong, an Oxford University virologist and the study’s lead author. However, he added, because the body’s own immune response does part of the damage, doctors should consider giving anti-inflammatory drugs along with antivirals like Tamiflu.

Although the results of the relatively small study are precisely what flu experts had predicted from laboratory work, Dr. Anne Moscona, a professor of pediatrics and immunology at the Weill Cornell Medical College, called it a “major advance,” because so little clinical information had previously been gleaned from the 241 known cases of the disease.

Many of those cases have been in rural villages in Asia, where victims pick it up from backyard chickens and are buried before the virus that killed them is even identified. Provincial hospitals have done few autopsies and little genetic analysis.

This study, which appears in the October issue of Nature Medicine, was led by an Oxford research team in Ho Chi Minh City, Vietnam, and compared 18 people with the A(H5N1) avian flu in 2004 and 2005 to 8 people infected with seasonal human flus.

It found that the avian flu patients, and particularly the 13 who died from it, had unusually high levels of the virus in their bodies. Consequently, they also had high levels of the chemicals, known as cytokines and chemokines, that set off the immune system’s inflammatory response.

Those chemicals, some of which are produced in cells lining the narrowest passages in the lungs, draw in white blood cells to attack invaders. But doing so too vigorously can flood the lungs, causing deadly pneumonia.

The effect, known as the “cytokine storm” is the leading theory as to why so many young, previously healthy people died in the 1918-19 pandemic, known as the Spanish flu, which killed tens of millions of people. Seasonal flus tend to kill the very old and very young, who usually die from bacterial infections that develop days after the milder flu virus has irritated their lung tissue.

The avian flu virus was easier to detect in throat swabs than in nasal swabs, Dr. de Jong said, which is the opposite of how seasonal flu is detected, and useful for doctors doing flu tests. And the virus was found in rectal swabs, which is important for hospitals to know because it means diarrhea, common among flu patients, can also spread the disease.

Flu experts were surprised that such high concentrations of the virus were found in nose and throat swabs. Earlier studies had suggested that the avian flu is not easily transmitted between humans because, unlike seasonal flu, it attaches primarily to receptors found deep in the lungs.

Dr. de Jong said there could be several explanations: the throat swabs could have picked up virus coughed up from the lungs. Different receptors are spread up and down the breathing tract. And it is possible — though unproved — that some people may simply be born with receptors more amenable to the virus. That theory has been offered by epidemiologists who note that, even in villages where all the chickens are sick, human outbreaks tend to cluster in families.

The study also showed that some of the flu strains isolated in Vietnam had particular genetic changes that virologists have been watching for, fearing that these changes would make them more lethal.

But those changes appeared in only some patients, and in those who died as well as those who lived, “so I wouldn’t make too much of it,” Dr. Moscona said.

Henry L. Niman, a Pittsburgh biochemist who has been tracking viral changes and raised earlier alarms about E627K, agreed.

“Lethality in the virus may rely on several changes,” he said. “But it’s got several different paths to the same end. That’s what makes it so efficient.”
 

Bill P

Inactive
Controlling immune response may cut bird flu death rate

Study shows how H5N1 ravages the body.

Helen Pearson

http://www.nature.com/news/2006/060904/full/nm1493.html


Avian influenza kills so many of its human victims because it replicates profusely and over-stimulates the immune system: those findings, from the most extensive analysis of those infected, suggest that drugs to calm the immune system might help when standard antiviral treatment is unavailable or given too late.

Since 2003, more than 240 people have been diagnosed with H5N1 infections, and more than 140 of them have died. But there has been little information about how the virus ravages the body because many individuals are treated in rural or ill-equipped hospitals and too few samples have been collected. Autopsy tissue has also been hard to come by because of cultural taboos.

Vietnamese researchers collected and analyzed samples from 18 individuals infected in 2004 and 2005, 13 of whom later died. The researchers, led by Menno de Jong of the Oxford University Clinical Research Unit in Ho Chi Minh City, took blood, nose and throat samples, typically about six days into an infection, and compared them with those from individuals infected with H3N2 or H1N1 human flu strains.

The team found that H5N1 multiplies to levels up to hundreds of times higher than those of the human strains. The virus appears to prefer the lower respiratory tract, rather than the nose and throat favored by regular flu viruses. The team also detected viral RNA in the blood of patients who died, suggesting that it reached particularly high levels in these people, they report in Nature Medicine1.

"It's really going to be a landmark paper in describing what happens when humans are infected with avian influenza," says Peter Openshaw, an Imperial College London expert in immune response to respiratory infections.

The immune systems of those infected with H5N1 show hallmarks of intense activation. The researchers found high levels of several cytokines and chemokines in blood, particularly in patients who died, and a marked drop in infection-fighting white blood cells, or lymphocytes.

This uncontrolled outpouring of molecules, dubbed a 'cytokine storm,' can be triggered by toxins and bacterial infection, and is thought to eventually lead to the failure of lungs or other organs.

Researchers have previously suspected that avian flu can trigger a cytokine storm, which is also thought to have been important in severe acute respiratory syndrome and in the 1918 flu pandemic. But for H5N1, this is "the first time there is real data to support that concept," Openshaw says.

It is possible that the virus triggers this reaction because it replicates so fast, or because it makes proteins that aggressively stimulate the human immune system.

The study may explain why Tamiflu (oseltamivir), a drug that blocks viral replication, has so far saved few lives. The inflammatory response might have spun out of control by the time those infected began treatment, underscoring the need for early diagnosis and treatment.

It also suggests that drugs that quell the immune response might cut the death rate. Some doctors have already tried using steroids, which broadly suppress the immune system, but those drugs have not shown a clear benefit. Medicines that instead act on specific molecules — such as the anti-tumor necrosis factor therapy used for rheumatoid arthritis — might be more effective.

De Jong says researchers need to collect more samples to test, for example, whether genetic makeup makes some people particularly susceptible. "It's too bad we haven't learned more," De Jong says. "If samples had been collected from all those patients, we would be a lot further in understanding this disease."



Article brought to you by: Nature Medicine

References
de Jong M. D., et al. Nature Medicine, advance online publication DOI: 10.1038/nm1477(2006).
 

JPD

Inactive
Sudan

Bird flu case confirmed in Juba

http://www.newvision.co.ug/D/8/13/520450

Monday, 11th September, 2006
E-mail article E-mail article Print article Print article

By Joyce Namutebi

THERE is a confirmed outbreak of bird flu (Avian Influenza) in Juba, Southern Sudan, the Ministry of Health has announced.

The chairperson, National Task Force on Bird Flu, Dr. Sam Okware, said yesterday the outbreak was confirmed on September 6, and is affecting local chicken.

He directed the district health officers and district veterinary officers in Nebbi, Arua, Koboko, Yumbe, Moyo, Adjumani, Pader, Gulu, Kitgum, Lira. Apac, Kaabong, Kotido and Moroto districts to strengthen their task forces on bird flu to enhance surveillance and public education.

“In addition, the people at the country borders should be on high alert for any suspicious birds or poultry products being brought into the country,” Okware said in a press release yesterday.

He asked the public, especially people who have been travelling to Juba or Southern Sudan to be on ‘high alert’.
 

JPD

Inactive
High H5N1 Levels In Patient Throats in Vietnam

http://www.recombinomics.com/News/09110601/H5N1_Vietnam_Throat.html

Recombinomics Commentary
September 11, 2006

The highest viral RNA levels occurred in H5N1-infected individuals who died (Table 2), suggesting that the level of viral replication influences outcome. Viral RNA could also be detected in blood specimens from 9 of 16 H5N1-infected individuals and in the rectal swabs from 5 of 7 of these individuals (Table 2). It remains unclear whether the detection of virus in rectal specimens reflects genuine gastrointestinal infection. However, symptoms of diarrhea frequently occur during influenza H5N1 (refs. 1,2,15) and were present in three of the five individuals with detectable viral RNA in the rectum. No viral RNA was present in the blood of surviving H5N1-infected individuals or in those with human influenza. Individuals with detectable H5N1 RNA in blood also had higher pharyngeal viral loads (median 7.4 log10 copies per ml; range 5.1–7.4) than those without evidence of H5N1 RNA (6.0 log10 copies per ml; range 4.3–7.0; P = 0.021), suggesting that the presence of viral RNA in blood reflects an overall high viral burden.

An E627K substitution in the viral polymerase basic protein 2 (PB2), which is associated with adaptation and virulence of H5N1 viruses in mammals12, was present in five of eight isolates from fatal cases and in three of four isolates from patients who survived

Notably, three of four viruses without this substitution, but none of the viruses containing Lys627, contained an D701N substitution in PB2 that has been associated with adaptation of H7N7 viruses to mammalian cells

The study also showed that some of the flu strains isolated in Vietnam had particular genetic changes that virologists have been watching for, fearing that these changes would make them more lethal.

But those changes appeared in only some patients, and in those who died as well as those who lived, “so I wouldn’t make too much of it,” Dr. Moscona said.

Henry L. Niman, a Pittsburgh biochemist who has been tracking viral changes and raised earlier alarms about E627K, agreed.

“Lethality in the virus may rely on several changes,” he said. “But it’s got several different paths to the same end. That’s what makes it so efficient.”

The above comments from a recent paper in Nature Medicine on H5N1 infected patients in Vietnam as well as comments in a Donald McNeil article in today’s NY Times raise a number questions concerning recent H5N1 infections and human-to-human transmission in familial clusters.

The paper describes high levels of H5N1 in the throat of H5N1 infected patients in Vietnam in 2004 and 2005. These high levels were also associated with H5N1 in the blood and rectum as well as increases in cytokine levels.

Almost all H5N1 isolates from these changes had one of two changes in PB2, E627K or D701N, that were associated with increased H5N1 levels in mammals. E627K has been shown to increase levels 20 fold, while D701N has increased levels 3-4 fold in laboratory mouse experiments.

The levels of H5N1 in the throat of patients was higher than H3N2 in the throat of seasonal flu patients suggesting that in some locations in the upper respiratory tract, the replication of H5N1 is quite efficient. The spillage of virus into other sites, such as the blood or rectum, create an increased number of transmission opportunities to relatives who care for these patients or stay in close contact with the patent, especially if there is frequently coughing.

The presence of two different changes, each associated with increased H5N1 replication in mammals, suggests selection from several independent genetic alterations can generate high levels of H5N1 in patients.

Although patients in Indonesia generally do not have the PB2 changes described above, the patients in the Karo cluster had a set of tandem alterations, K660R and A661T, between the two changes seen in patients in Vietnam. Similarly, the remaining H5N1 patients in Indonesia, who had a novel HA cleavage site, also had a pair of changes, T524I and K526R, just upstream from changes in Pb2 in the patients in Vietnam. Although these changes in H5N1 isolates from Indonesian patients have not been reported to be associated with increased H5N1 levels in mammals, media reports have indicated that the patients in Karo did have increased levels of H5N1 in their upper respiratory tract.

The high levels of H5N1 in patients are cause for concern. H5N1 in Vietnam appears to have used two distinct genetic changes in PB2 to generate very high levels of H5N1 in patients. These two changes are not found in patients in Indonesia, but it is likely that additional changes contribute to the high lethality rate and large and frequent familial clusters.

The use of Tamiflu to reduce viral load may contribute to the recovery of some patients and may also serve to halt production and limit detection of H5N1 in other patients, such as those linked to H5N1 positive patients in the Garut cluster.

Since H5N1 has already generate changes that allow for very high levels of virus in the throats of patients, a similar change that allows for high levels in the noses of patients may significantly increase transmission beyond familial clusters.

Such changes at S227N in HA may have contributed to the size of clusters in Turkey. These patients already had PB2 E627K, but the changes in the receptor binding domain may have altered tissue tropism.

In any event, it is clear that H5N1 can make minor changes in its genome to produce high levels of replicating virus in humans, with severe consequences that are frequently lethal. The high levels in recent patients also serve as a warning to persons caring for these patients without proper safeguards.

Moreover, the associate of the high levels of H5N1 in humans with an extremely high case fatality rate remains a cause for concern. The recent data does not indicate that a more efficiently transmitted H5N1 would necessarily be a less lethal virus, since the lethality is in part linked to an internal polymerase gene that is independent of the surface proteins affecting viral entry and exit from cells.
 

JPD

Inactive
Planes play big role in spreading flu

Cancelling flights might delay future pandemic.

http://www.nature.com/news/2006/060911/full/060911-2.html

Published online: 12 September 2006;

Helen Pearson

Can air travel help influenza to whip around the world? A study after the terrorist attacks of 11 September 2001 has shown that the answer is yes: a steep drop in air travel delayed the spread of winter flu across the United States.

This suggests that grounding flights might slow the spread of a future flu pandemic, and perhaps buy precious time for vaccinations and quarantine.

Several earlier studies have suggested that air travel might play such a role, but these have mostly been based on computer models.

John Brownstein of the Children's Hospital Boston and his colleagues tested the idea using data collected from real life. They studied statistics on influenza death in many US cites collected between 1996 and 2005 by the Centers for Disease Control and Prevention (CDC), along with estimates of the numbers of passengers who travelled by plane within the United States and from there to another country.

When studying their data, they noticed something odd: the flu spread far more slowly during the winter of 2001-2002. They realised that far fewer people travelled by air after 9/11 because of temporary flight restrictions and troubled nerves. "We were in the unique position of observing a natural experiment," says co-author Kenneth Mandl, also at the Children's Hospital (see 'A novel opportunity').

The 27% drop in passenger numbers on international flights delayed the normal peak of flu deaths by nearly two weeks, from February to March. And the fall in domestic air travel meant that the disease took 16 days longer to spread throughout the country. The reduced air travel did not, however, cut the total number of people who eventually died from the flu — 39,132 people died that winter, close to the usual number of 40,000.

November hotspot

The researchers found that the number of people travelling in November is the best predictor for the rate at which the flu spreads in any given year, probably because so many people travel during Thanksgiving holiday, just when influenza gets going for the winter season. The results are reported in PLoS Medicine1.

Air travel helps the virus spread because infected people carry it with them as they hop from one area of the globe to another. In addition, there is some evidence that it spreads more readily among people cooped up together on a plane.

The study supports the idea that cancelling flights at the start of a future flu pandemic might also delay its spread. This is of particular interest at the moment because of fears that the H5N1 influenza virus in bird flocks will start spreading between people and explode into a pandemic.

A week's head start

A delay of just one or two weeks might allow public-health officials time to distribute antiviral drugs or vaccines and isolate those already infected. "It will only make a difference if you were racing to put a control measure in place," says Ira Longini, an expert in modelling the spread of disease at Fred Hutchinson Cancer Research Center in Seattle, Washington.

Having a plan in place to instigate these measures is far more important than having a plan to cancel air travel, notes Longini. He wrote one of two epidemiological studies last year that showed it would be possible to avert a pandemic if such measures were introduced within weeks of the first infection (see 'Drugs could head off a flu pandemic - but only if we respond fast enough').

Because restricting air travel would have huge social and economic repercussions, it is not currently a major part of international plans for a flu pandemic. But it might make good sense, Longini says, to cancel flights from a region if an outbreak was just emerging there and had been recognized in good time.
 

JPD

Inactive
WHO warns against the possible spread of bird flu across the Middle East

http://www.kuna.net.kw/Home/Story.aspx?Language=en&DSNO=904362

HLT-EGYPT-FLU-WARNING
WHO warns against the possible spread of bird flu across the Middle East

CAIRO, Sept 12 (KUNA) -- The World Health Organization cautioned Tuesday against the spread of bird flu, which could decimate up to seven million people worldwide and between 120,00 and 750,000 in the Middle East alone if unchecked.

Participants in the 53rd session of the WHO's Regional Committee for the Eastern Mediterranean area, who met in the Iranian city of Isfahan on Saturday, agreed on the need to "stand up at all cost to the threat of the spread of bird flu" in this part of the world, a statement by the WHO's Cairo office said.

The participants also agreed that Egypt was the most exposed country in the Middle East to the disease with 14 cases of bird flu deaths already reported in that country.

Nine new cases of bird flu had also been reported in various Egyptian provinces, the Egyptian National Bird Flu Committee said. (end) az.
 

JPD

Inactive
Vietnam metro to check passengers for bird flu

http://www.thanhniennews.com/healthy/?catid=8&newsid=19980

International visitors arriving at Ho Chi Minh City airport will have their body temperatures taken as a precaution after bird flu outbreaks were recently reported in some countries.

Remote temperature-measuring machines using infrared and specialized thermometers are being installed at Tan Son Nhat Airport, ready to operate around the clock.

Those having a temperature of over 38 degrees Celsius would be taken to isolation rooms to test for bird flu.

The task will be carried out jointly by the International Quarantine Center and airport authorities.

The Health Ministry has instructed 14 hospitals in major cities to keep continuous watch to tackle probable outbreaks.

The hospitals and preventive health care centers have been told to ensure the operation of disease surveillance systems around the clock and sufficient supply of facilities for treating bird flu patients.

The government recently instructed state agencies and local administrations to intensify the fight against bird flu, and temporarily ban import of live poultry and poultry products from countries hit by the disease.

Bird flu has killed at least 141 people in 10 countries since December 2003.

Vietnam has registered 42 fatalities, second only to Indonesia where 47 have been killed. No new human cases have been reported since mid-November 2005
 

BREWER

Veteran Member
Great Job JPD...

Thanks for your diligence. Many good articles and all pointed in the direction of Pandemic.
 

Bill P

Inactive
Bird flu case confirmed in Juba, Sudan
http://crofsblogs.typepad.com/h5n1/2006/09/bird_flu_case_c.html

Via New Vision Online, a Uganda news source: Bird flu case confirmed in Juba.

There is a confirmed outbreak of bird flu (Avian Influenza) in Juba, Southern Sudan, the Ministry of Health has announced.

The chairperson, National Task Force on Bird Flu, Dr. Sam Okware, said yesterday the outbreak was confirmed on September 6, and is affecting local chicken.

He directed the district health officers and district veterinary officers in Nebbi, Arua, Koboko, Yumbe, Moyo, Adjumani, Pader, Gulu, Kitgum, Lira. Apac, Kaabong, Kotido and Moroto districts to strengthen their task forces on bird flu to enhance surveillance and public education.

“In addition, the people at the country borders should be on high alert for any suspicious birds or poultry products being brought into the country,” Okware said in a press release yesterday.

He asked the public, especially people who have been travelling to Juba or Southern Sudan to be on ‘high alert’.


September 11, 2006 at 03:07 PM | Permalink
 

JPD

Inactive
RI raises its bird flu toll to 49 after adding a child's death

http://www.thejakartapost.com/detaillgen.asp?fileid=20060913115313&irec=1

JAKARTA (AP): Indonesia's tally of people killed by bird flu climbed to 49 after a 5-year-old boy who died in March was added to the list, a Health Ministry official said Wednesday.

The child, who died in Sulianti Saroso hospital in Jakarta, was added after a recent change in the testing standards that the World Health Organization sets for cases of the H5N1 virus, said Runizar Roesin, of the ministry's bird flu information center.

The U.S. Centers for Disease Control and Prevention in Atlanta, Georgia confirmed the results, he said. (**)
 

JPD

Inactive
From Indonesia, The Jakarta Post:

Bird flu: A beginner's guide, to quell panic

http://www.thejakartapost.com/detailfeatures.asp?fileid=20060913.T01&irec=0

Why is flu in birds suddenly such a problem? Headlines, newscasts, and documentaries flood us with news of developments. What does it all mean? Where did it come from and where is it going?

Terminology we have not seen before, like "H5N1", "clusters", "genetic drift and shift", "zoonosis", "pandemic" and others get thrown around as if plainly understood. Getting a grasp of the problem and the risks, and thus putting breaking news into context, requires some understanding of virus biology.

Without it, we are at the mercy of irrational fear and the dire consequences of panic in the face of what is likely to be a relatively minor threat.

Contributor J Kevin Baird offers a "road map" for the uninitiated to navigate through the quagmire of misunderstanding:

How a virus works

The chemical code of life is deoxyribonucleic acid (DNA). All living things possess their own unique code, expressed in the sequence of just four different chemicals.

Some evolutionary biologists view all forms of life as simply representations of a survival strategy by a particular collection of these four chemicals. This view holds, for example, that the being we see as a horse is an instrument constructed around horse DNA that allows the molecule to survive.

No living things express this minimalist concept more plainly than viruses. Viruses represent the simplest form of what can be considered a living thing. They are bundled packages of DNA or its complementary chemical partner, RNA (as with influenza).

The bundles of proteins and other biological molecules surrounding the genetic material provide the virus a means of getting into a particular kind of cell it favors, so HIV favors immune cells and hepatitis virus favors liver cells, etc.

Once inside the target cell, the genetic code of the virus inserts itself into genetic material of the cell and issues instructions to the cell to make thousands of copies of the virus. The hijacked and doomed host cell bursts, releasing new viruses to infect new cells.

Balancing act

This form of parasitism is a tricky business for the virus. If all viruses were completely successful, there would be no life left in which to continue their existence. A virus that asserts itself too powerfully will eventually kill off the beings it depends upon to live.

It must show some restraint or perish. Conversely, the virus must also deal with a host having the equipment to defend itself from such attacks. The host immune system vigorously counterattacks, and a lack of assertiveness by the virus would be its doom.

The virus must strike a working balance between successful copying and coping with a provider bent on its destruction. These forces have shaped the viruses into the agents of many diseases we recognize today.

Living evolution

Viruses, like all living things, evolved into the beings present today. Their strategies have been honed and refined by natural selection, the crucible of Darwinian evolution. Viruses that have been with us a long time have adopted various strategies of balance between the harm they cause and the infection absolutely required for their survival.

These viruses tend to be more benign. Their balancing act is a good one. But Nature experiments continuously. New viruses are constantly thrown out, testing the waters of the living world they inhabit. The newer viruses are clumsier and they tend to cause more severe disease.

Viruses are not thinking, strategizing beings. External forces drive their strategizing, where a good strategy results in more copies being made than with a poor strategy.

Think of coconut trees. On the most isolated sandy atoll in Indonesia we see coconut trees standing. How did they get there? Coconuts float. They drop into the sea and off they go, at the mercy of wind, wave and current to find a suitable sandy beach.

A very, very small fraction of them, perchance, actually do. Coconuts do not consult maps and weather forecasts. If one lands on a beautiful sandy beach in Alaska -- and some do -- it is doomed. Most others become waterlogged and sink without ever seeing a beach.

The coconut tree employs a strategy of dumping hundreds of coconuts into the sea and playing the odds that one of them will land at a hospitable site.

Viruses do much the same. They cast themselves out into the living world in their billions playing the odds some of them will find that tropical sandy beach of viruses -- access to the cell they are capable of commandeering.

The nature of bird flu This is what is going on with bird flu. The influenza virus experiments by creating copies with random errors in its genetic code. A very small fraction of those errors will, by chance, yield a virus better equipped to find its sandy tropical beach.

This is called genetic drift. Still other viruses will find themselves in the same host already infected by a related virus strain, and the two of them combine to create many thousands of hybrids with a relatively dramatically different genetic makeup compared to either of the original strains.

Rarely, one of those hybrids will successfully propagate and infect other hosts. This is called genetic shift.

Bird flu is in a group of closely related viruses known as influenza-A. Different strains inhabit the group, much like the races and myriad ethnic groups of humans. The strain designation for bird flu is H5N1, each letter referring to a convenient identity marker found in the envelope enclosing the genetic code of the virus.

Those marker types (the numbers) are specific biological molecules that vary slightly among strains. These variations provide scientists a convenient means of classifying viruses in the influenza-A group, much like we use characteristics of skin color and facial features to determine a person's group identity.

Exactly where H5N1 strain emerged from and how is unclear. It may have been produced by a genetic shift event with the mixing of influenza strains circulating in different bird species. Clearly, the new strain found traction and has been wildly successful.

Its lethality to chickens has not slowed it down, largely because it can infect other species of birds, notably domesticated ducks, and do relatively little harm. Dead chickens simply represent the collateral damage of successes enjoyed elsewhere.

Bird flu in people H5N1 happens to be able to infect people. But the human host does not entirely agree with the virus -- although able to find receptive target cells and replicate itself, the strain finds it very difficult to bridge into a new human host.

Almost all human infections have been in the wake of direct contact with infected chickens, and the few cases of documented transmission from human to human followed close and prolonged contact with an infected person.

A superior influenza-A virus needs no such thing -- it jumps from human to human with great efficiency. This is probably a product of both the infectious dose -- a relatively low number of virus particles needed to successfully seed an infection -- and the inability of the human immune system to defeat the invasion.

H5N1 as it exists today does not possess the equipment to manage this.

Fatality rate with bird flu

The term "case fatality rate" describes the percentage of people exposed to a disease who succumb to it. Scientists do not know the case fatality rate for H5N1 infection. What they do know, and what the media often present as the case fatality rate, is the fatality rate among confirmed infections.

No one knows how many people have been infected by H5N1. We only know how many people have been diagnosed as infected and what happened to them.

The difference between these numbers -- real versus observed infections -- may be very large. People who experience H5N1 infection and an unremarkable illness will not be diagnosed. The reliable diagnosis of H5N1 requires an extraordinarily high degree of technical expertise and very costly equipment and supplies.

The laboratories capable of doing this do not examine people with mild illness. There are not enough machines and money to do so. Consequently, it is very likely that the true case fatality rate for H5N1 infection is very much lower than the more than 50 percent figures often described.

The writer is an expert in tropical infectious diseases who worked formerly with the U.S. Navy as a microbiologist. He was also a section editor for the American Journal of Tropical Medicine & Hygiene. He can be reached at jkb@vhasia.com.sg
 

JPD

Inactive
Indonesia pushes bird flu education

http://news.bbc.co.uk/2/hi/asia-pacific/5327522.stm

By Lucy Williamson
BBC News, Jakarta

Shaded from the afternoon sun by a thick tree, Punjang sits on the floor, moving beans around a large piece of paper.

His wife watches, bemused, as two of Indonesia's new bird flu trainers explain the rules of the game.

"These are your chickens," says Wiwin, pointing towards a pile of red beans. "And these are chickens that are sick."

Punjang is trying to play along, but he is finding it funny. Wiwin moves some beans across the paper. Punjang shakes with laughter again.

Not that Punjang has much to laugh about.

The elderly chicken scratching sedately around the edge of his veranda is the only remaining sign of his livelihood.

Six month ago, he had hundreds of birds, he says, but within the space of a day or two, they all suddenly died. He did not know much about bird flu then.

The same is true of almost all Indonesia's small-scale farmers. Many keep just a handful of birds to supplement the family income.

There are around 30 million such households, tucked deep into Indonesia's vast territory. It is these so-called "backyard farmers" that have presented the government here with a challenge.

New tactic

Since bird flu first appeared in Indonesia three years ago, it has spread to 29 out of the country's 33 provinces, leading to the deaths of millions of birds, as well as at least 46 humans.

In villages like Punjang's where farming is usually free-range, and where chickens mix freely with those from neighbouring houses, viruses like H5N1 spread quickly.


In relation to tsunamis and earthquakes and malaria, this is still a low-profile event
John Weaver, FAO in Jakarta

But with outbreaks often occurring simultaneously in villages thousands of kilometres away, getting to the affected areas fast enough to contain the disease is a problem.

And in Indonesia's heavily decentralised system, policies made in Jakarta are often held up or in practice even blocked at the local level.

So the government is trying a new tactic.

Backed by international organisations, it is putting in place specialist teams of vets at the provincial and the district level, to provide rapid response and surveillance at a grassroots level.

Elly Sudiana coordinates the programme from the Ministry of Agriculture in Jakarta.

She says the new teams have given the government a direct command line to the village level and that as a result, dealing with and reporting outbreaks has been much faster.

But for the scheme to work, the teams will need to prevent future outbreaks too. And that is where the beans come in.

In rural areas, there is little information about how bird flu spreads. So the teams go door-to-door visiting every farmer, teaching them how to protect their chickens and themselves.

Back in Cijeler village in West Java, Wiwin runs through the basic rules with Punjang: put your chickens in a cage; do not keep them too close to the house; disinfect the area regularly; and burn any droppings.

His lone chicken continues to pluck at the ground in front of his house.

Punjang is saving up the money to replace his lost stock. He says he wishes he had known before to keep them caged.

Funding shortage

There is a desperate need for greater public awareness in Indonesia - especially in rural areas.

The government has launched a campaign on radio and television to try and get its message across. It has also increased the amount of compensation it will pay to farmers who cull sick birds and stream-lined the way that money can be paid.

Vets questioning a farmer about a bird flu outbreak
Officials say more funding is needed to fight bird flu in Indonesia

But fighting bird flu will take much more money than is currently available. Teams like Wiwin's are expensive to run; they are currently operating in just nine of Indonesia's 29 affected provinces.

And government plans to vaccinate bird stocks have been dented by financial constraints too.

The Agriculture Ministry has bought 60 million doses of the vaccine, but there are 300 million chickens in Indonesia, and it is not clear how the shortfall will be made-up.

International donors have pledged around $50m (£26.8m) next year to help Indonesia fight bird flu. The government says it needs more than $350m to carry out its National Plan.

But it has also cut its own contribution, something that international organisations say has made it harder to generate donations.

According to John Weaver, a senior technical advisor with the UN's Food and Agriculture Organisation in Jakarta, part of the problem is that bird flu is competing with other major problems in Indonesia.

"In relation to tsunamis and earthquakes and malaria, this is still a low-profile event," he says. "So politically, the leaders of these provinces give it the priority you'd expect, which is not very high."

Indonesia says it needs the money it has cut from the budget to pay for reconstruction in the wake of this year's earthquake in Yogyakarta.

But while the human cases continue to creep into the headlines, bird flu experts worry that if Indonesia's problem is left to grow, it could become a global one.
 

JPD

Inactive
Ugandan gov't issues bird flu alert

http://english.people.com.cn/200609/13/eng20060913_302158.html

The Ugandan government has issued a bird flu alert after an outbreak was confirmed in the neighboring southern Sudan.

Sam Okware, the chairperson of National Task Force on Bird Flu, told Xinhua by telephone on Tuesday that the outbreak was confirmed on September 6, and is affecting local chicken in Juba of southern Sudan.

Okware said he has directed the district health officers and district veterinary officers in northern Uganda bordering southern Sudan to be on high alert.

Okware asked the public, especially people who have been traveling to Juba or southern Sudan to be on high alert.

Groups of Ugandans have been traveling to Juba to witness the ongoing peace talks between the Ugandan government and rebels of the Lord's Resistance Army.

A ministry of health press release on Monday called on health officials in the northern Uganda to strengthen their task forces on bird flu to enhance surveillance and public education.

"In addition, the people at the country's borders should be on high alert for any suspicious birds or poultry products being brought into the country," the release said.

Early this year, the government equipped its laboratory with a bird flu-testing machine after the east African country was thrown into panic when birds and poultry died of suspected avian flu in several districts.

Bird flu is a highly infectious disease in birds, which may through constant contact passes onto humans.

The deadly H5N1 strain of bird flu virus has killed a number of people in several countries across Asia, Europe and Africa as the wild birds spread the virus along their migration journey.
 

Bill P

Inactive
Yippee - skippee?? NOT!

Study: Live H5N1 virus vaccines effective​



http://www.topix.net/content/newscom/0770424239071573748103618501920791417101

Newscom

September 12, 2006

U.S. scientists say live, weakened versions of differing strains of avian flu viruses have offered protection when tested in mice and ferrets.

Researchers say their findings are encouraging because they demonstrate the ability to create a vaccine based on one particular strain of the H5N1 flu virus that could potentially protect against different emerging H5N1 flu strains.

If an influenza pandemic were imminent or under way, we would need a vaccine that could stimulate immunity quickly, preferably with a single dose, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. "The encouraging findings of this study suggest vaccines based on live, but weakened, versions of the H5N1 avian influenza virus may quickly stimulate protective immunity.

We are further exploring this live, attenuated vaccine strategy as one of several tools that we hope to have available in the event of an influenza pandemic, he added.

Senior investigator Dr. Kanta Subbarao and co-chief investigator Dr. Brian Murphy explain the research in the Sept. 12 issue of PLoS Medicine.
 

JPD

Inactive
School Officials Roll Out Bird Flu Guidelines

http://www.nbc4.tv/health/9843788/detail.html

POSTED: 5:24 pm PDT September 13, 2006

LOS ANGELES -- The bird flu has not arrived in North America.

However, state school officials are rolling out new guidelines to be ready just in case.

Schools are hotbeds for germs and flu transmission.

In the case of a widespread flu pandemic this can become a serious problem. That's why school and health officials are trying to prepare for the worst-case scenario.

Wednesday the state schools chief made a checklist available to all schools to help them better prepare and respond to pandemic flu.

The list includes steps such as:

# Prepare for the possibility of schools functioning with only 30 percent of staff people present

# Account for what students with medical conditions will need in case of emergency

# Develop a communication plan about schedule changes and possible school closures

Schools are encouraging students to stop the spread of infections in low-tech ways like washing their hands, covering their mouths when they sneeze and cough and staying home if they are sick.

Web sites:

CDC Cover Your Cough
CDC Materials
Pandemic Flu Individuals and Families Planning Pandemic Flu Planning Checklist
 

PCViking

Lutefisk Survivor
Sudan

Thursday, Sep 14, 2006

First bird flu case in Sudan

KHARTOUM: South Sudan has found the first case of bird flu in a poultry farm in the capital city of Juba, the Sudan Tribune reported on its website on Tuesday. An official was quoted as saying the deadly virus was confirmed on September 6 and was affecting local chicken. He said he had directed officials to enhance surveillance and public education. ``In addition, the people at the border areas should be on high alert for any birds or poultry products being brought into the country,'' he said. He asked the public, especially those who have been travelling to Juba or South Sudan, to be on ``high alert.'' — Xinhua

http://www.hindu.com/2006/09/14/stories/2006091405581500.htm

:vik:
 

New Freedom

Veteran Member
http://www.kuna.net.kw/Home/Story.aspx?Language=en&DSNO=904362


WHO warns against the possible spread of bird flu across the Middle East
HLT-EGYPT-FLU-WARNING
WHO warns against the possible spread of bird flu across the Middle East

CAIRO, Sept 12 (KUNA) -- The World Health Organization cautioned Tuesday against the spread of bird flu, which could decimate up to seven million people worldwide and between 120,00 and 750,000 in the Middle East alone if unchecked.

Participants in the 53rd session of the WHO's Regional Committee for the Eastern Mediterranean area, who met in the Iranian city of Isfahan on Saturday, agreed on the need to "stand up at all cost to the threat of the spread of bird flu" in this part of the world, a statement by the WHO's Cairo office said.

The participants also agreed that Egypt was the most exposed country in the Middle East to the disease with 14 cases of bird flu deaths already reported in that country.

Nine new cases of bird flu had also been reported in various Egyptian provinces, the Egyptian National Bird Flu Committee said. (end) az.
eh
 

JPD

Inactive
Indonesia

Vaccination, biosecurity holes leave RI at risk of bird flu

http://www.thejakartapost.com/detailheadlines.asp?fileid=20060914.A06&irec=5

Abdul Khalik, The Jakarta Post, Jakarta

Bird flu will continue to move through the country's poultry flocks because of shortfalls in the vaccination and biosecurity measures applied here, new research reveals.

Santoso Soeroso, the director of Sulianti Saroso Hospital, Indonesia's main treatment center for bird flu, said the improper vaccination of chickens and ducks may be helping to spread the virus.

"It has become a silent epidemic. People think they have already vaccinated their poultry, they think they have stopped the virus from spreading. In fact, the virus continues to attack (poultry) because the vaccination is improper," he told participants in an Australia-Indonesia science and technology symposium here Wednesday.

Santoso said that research carried out in Bali showed the province had a vaccine failure rate of 39 percent. It also indicated that around 60 percent of ducks had bird flu.

Improper vaccination, he said, includes the use of substandard vaccines and the inability to evaluate the success of the program due to the absence of an unvaccinated control group.

The low coverage of the national vaccination program is another of its weaknesses, he said.

Bagoes Poermadjaja, the deputy director for animal disease monitoring at the Agriculture Ministry, acknowledged that only 60 percent of the country's 300 million chickens and ducks had been vaccinated against bird flu.

"We lack the funds, human resources and capacity for early detection. We are still not giving adequate compensation for slaughtered birds and are having difficulty vaccinating backyard chickens," he told the symposium.

He said there were also deficiencies in the biosecurity measures applied.

Biosecurity includes cage cleanliness and monitoring the movements of birds and chickens to prevent sick poultry being transferred from one area into another.

He said the study showed that most cases of bird flu in humans had occurred in Lampung, Banten, Jakarta and West Java provinces, where poultry is constantly being transported back and forth.

This implied, Santoso said, that monitoring along the busy route was not effective, with the possibility that sick poultry in one of the areas was being taken into the other areas.

Bagoes, however, blamed weak coordination between the central government and regional administrations.

"Regional autonomy has made it more difficult to coordinate as each region has its own authority and priorities. Many regions don't have an agency that specializes in husbandry affairs, let alone bird flu."

The government confirmed Wednesday a 5-year-old boy who died in March had bird flu, bringing the country's toll to 49.

Santoso said that misdiagnosis or late detection had contributed to the high fatality rate here as the country does not have a rapid test for avian influenza.

Jef Hammond of the Australian Animal Health Laboratory said that scientists from both countries were now working on enhancing surveillance efforts at village level so the virus could be detected as early as possible.
 

JPD

Inactive
Shikibo to Launch Anti-Virus Fabric Against Avian Flu

http://www.japancorp.net/Article.Asp?Art_ID=13275

Tokyo, Sept 14, 2006 (JCN) - Shikibo Ltd. and the National Institute of Animal Health have jointly developed a fabric called 'Flutect' that has been proven to block the spread of bird influenza by 99.9%, even after 50 washings, stopping the spread of the virus within 10 minutes of exposure.

Flutect will be available in 2007 in the form of uniforms for poultry house workers, masks, filters, down jackets, lab-coats and so forth.

By Sarah Hall, JCN Staff Writer
 

JPD

Inactive
UK to put City of London through paces on bird flu

http://today.reuters.co.uk/news/art...887866_RTRIDST_0_BIRDFLU-BRITAIN-EXERCISE.XML

LONDON, Sept 14 (Reuters) - The City of London financial services sector will next month test out how it would cope with a bird flu pandemic in an exercise run by Britain's finance industry regulators.

The Bank of England, the Financial Services Authority and the Treasury will organise the bird flu simulation event, which will run from October 13 to November 24.

More than 60 organisations from the financial services industry have been asked to take part.

These three bodies cooperate on business continuity planning for incidents that could cause major disruptions to the City of London financial services industry, one of the world's biggest financial centres and home to some of the world's biggest banks.

The simulation of a major crisis has become an annual event.

Last November, the Bank of England, the Treasury and the FSA -- known as the Tripartite Authorities -- carried out the world's biggest ever business endurance exercise to test the financial sector's ability to deal effectively with a major operational disruption.

This involved about 80 firms, including banks, brokerages and insurers, as well as the financial authorities and the police.

This time it is bird flu, which will be run as an "evolving scenario."

"The overall objective for the authorities is to improve their own and the sector's preparedness by providing an opportunity to review, test and update plans for managing a pandemic threat," the three authorities said on their website -- UK Financial Sector Continuity.

Major banks in the City of London have been gearing up to cope with a potential bird flu epidemic for months now.

Last year, for example, Citigroup (C.N: Quote, Profile, Research), the world's biggest bank, set up an avian flu task force, combining business continuity, health services and security services.

During next month's exercise banks and financial services firms will receive regular updates on the severity of the pandemic, its effect on them and on the wider economy.

Banks will review if contingency plans they have made can actually cope in the face of rampant bird flu which will mean reduced staffing levels, disruption to transport, power and telecoms.

The authorities will publish a report on the exercise after it is completed.

The Bank of England, the Treasury and the FSA's business continuity systems were put into action last year during the suicide bomb attacks on London's transport system in July.

The three activated a secret Internet chatroom, which was set up in the wake of the September 11 bombings of the World Trade Center in New York. This aims to keep lines of communication open between banks and the authorities during a crisis.

In July this year, the Bank of England also ran a seminar to examine how the $2 trillion a day foreign exchange market would cope with a sustained outage of the global currency payments system due to terror attacks or other disruptions.
 

PCViking

Lutefisk Survivor
UPDATED: 17:17, September 14, 2006
WHO confirms 49 bird flu deaths in Indonesia

The World Health Organization ( WHO) confirmed 49 deaths out of 65 cases of avian influenza in Indonesia, the organization spokesperson in Jakarta said Thursday.

The death figure rose after the international organization revised the definition of confirmation for the case on August 29, spokesperson Sari Setiogi said.

"The revision has made three probable cases include in categorize of confirm," she told Xinhua here.

The three new confirmation were an 8-year-old girl who died in June last year from an outskirts of Jakarta, Tanggerang, a 45-year- old man from Magelang, in Central Java province, who survived, and a 5 and a half-year-old boy from outskirts of Jakarta, Bekasi, who died in March this year, said Setiogi.

Indonesia has been the bird flu hardest-hit country after the number of the cases surpassed the figure in Vietnam.

More than 40 millions people were killed in a bird flu pandemic between 1918 to 1919, according to the World Health Organization.

Source: Xinhua

http://english.peopledaily.com.cn/200609/14/eng20060914_302838.html
 

JPD

Inactive
WHO confirms two Indonesian cases, retrospectively

http://www.alertnet.org/thenews/newsdesk/L14723621.htm

GENEVA, Sept 14 (Reuters) - The World Health Organisation (WHO) on Thursday retrospectively recognised a further two cases of bird flu in Indonesia, including one where human-to-human transmission could not be ruled out between siblings.

The United Nations agency said that fresh results had shown that a 27-year-old from West Sumatra province, who cared for his 15-year-old sister in hospital last May, had also been infected with the H5N1 virus despite initially testing negative.

"The 27-year-old male reported no contact with diseased or dead poultry in the days prior to symptom onset as he spent most of his time at the hospital," the WHO said in a statement.

"The investigation determined that he had exposure to his sister during her hospital stay and that human-to-human transmission could not be ruled out as the source of his infection," it said. Both brother and sister recovered.

The WHO also accepted that a five-year-old boy, who died last March in Jakarta, had died of bird flu after being exposed to diseased poultry. Indonesian health authorities announced the case on Wednesday, citing fresh test results.

The retrospectively confirmed bird flu cases -- which follow three others announced last Friday -- bring the total in Indonesia to 65, including 49 fatalities, according to the WHO.

The national death toll is the world's highest from the disease which affectes mainly animals but which experts fear could mutate into a pandemic strain capable of killing millions of people.

Indonesia has been criticised for not doing enough to combat the disease, which is endemic in birds in most of the country's provinces.
 

JPD

Inactive
Indonesian Bird Flu Case May Have Spread Among People (Update2)

http://www.bloomberg.com/apps/news?pid=20601080&sid=ajSTKABq2AL0&refer=asia

By John Lauerman

Sept. 14 (Bloomberg) -- A 27-year-old Indonesian man with bird flu may have caught it after spending six days caring for a sister hospitalized with the disease, the World Health Organization said.

The case brings the country's infections to 65 people, including 49 deaths, the United Nations health agency said on its Web site. The man, from Solok in West Sumatra, developed mild symptoms in May and recovered in a few days.

An investigation ``determined he had exposure to his sister during her hospital stay, and that human-to-human transmission could not be ruled out as the source of his infection,'' the agency said in a statement today. He reported no contact with dead or diseased poultry before falling ill.

The case represents another instance of possible human-to- human transmission and raises questions about the strain of H5N1 spreading in Indonesia, said Ira Longini, a University of Washington epidemiologist who advises the U.S. government on flu issues. Health officials are concerned that the H5N1 bird flu, which has killed more than half of those infected, may mutate into a form that spreads easily among people.

``It's still an avian strain, but it could be more adapted to human populations,'' Longini said today in a telephone interview. ``These human clusters of cases in Indonesia with apparent human-to-human transmission are great cause for concern.''

Initial Tests

The man's initial tests for H5N1 were negative, the WHO said. Follow-up testing of his blood showed a significant increase in antibodies to the H5N1 virus, which met the agency's criteria to confirm the infection.

Disease trackers investigated another outbreak of bird flu among Sumatran family members in May, in which a woman might have passed the infection along to six relatives. One of those patients, a 10-year-old boy, may have then infected his father.

The H5N1 flu has infected 246 people in 10 countries since late 2003, killing 144 of those patients, the WHO said today. More than 200 million birds worldwide have died from the disease or been killed to prevent its spread.

Health officials in the U.S. and other nations have built stockpiles of antivirals such as Roche Holding AG's Tamiflu and GlaxoSmithKline Plc's Relenza. Roche said today that its U.S. supply chain for Tamiflu is fully operational and able to make treatments for 80 million influenza cases.
 

Bill P

Inactive
Early Flu Season
Flu season hits in Dale County, Alabama

http://www.wtvynews4.com/home/headlines/3913151.html

Updated: 6:33 PM Sep 13, 2006
Erica Proffer


Thirty-five to 40 cases of the flu have been reported in Dale County.

This comes months before the normal flu season, and months before vaccinations arrive.

Normally, the virus comes in the cooler months and doctors say it's mostly found in children.

The normal flu season begins in November, but doctors are saying it has already struck in some areas.

“In fact, the first flu cases came in late August,” said Emergency Medical Doctor, Dr. Carl Barlow. “Since then, we've probably had 35-40 cases of the flu that we've diagnosed with the flu test, and have been positive. A lot of them have been in children."

Doctors say there are some ways to help reduce the spread of the virus.

One way is to sneeze or cough into your elbow instead of your hand, because it makes less contact throughout the day.

Doctors also say one of the main ways to reduce the spread of the flu is by washing your hands, but it's important how you wash them. They suggest using a lot of friction and be sure you clean both sides of the hands, and underneath your fingernails. It's not necessary to rinse in scalding hot water. Then, dry with a paper towel that's already down. Use that paper towel to cut off the water.

Doctors say these few steps will go a long way in helping reduce the spread of the flu.

Since many of the flu cases have been found in children, Ozark School officials have sent their annual health precautions letter a little early, to help combat the spread.

In that letter, officials encourage parents to review with children the basics of good hygiene and health care.

Superintendent, Dr. Dan Payant of Ozark City Schools says, “We want to remind parents to not send their children to school if they're experiencing those types of symptoms: coughing, sore throat, fever. Keep them at home till they get healthy."

Both doctors and school leaders say if you have symptoms of the flu, the most important thing is to stay home.

The flu cases in Ozark are being double checked by state health leaders to make sure it is in fact the influenza virus.

No flu vaccinations are available at this time. Doctors expect them to arrive closer to October.
 

JPD

Inactive
City to spend six weeks answering bird flu alarm

http://business.guardian.co.uk/story/0,,1872823,00.html

Jill Treanor
Friday September 15, 2006
The Guardian

A dead swan was enough to raise fears of bird flu ripping through Britain. The prospect of a sick bird contaminating humans is being taken so seriously that for six weeks this year the City will practise how it would cope with such a disaster.

The length of the exercise will be unprecedented for the City, which is more accustomed to preparing for terrorist attacks or an energy crisis.

Every Friday for six weeks starting on October 13, more than 60 organisations in the City will be asked to react to a new scenario about a pretend bird flu pandemic. The exercise will end on November 24, by which time the authorities hope to know how the City would cope with reduced staffing levels and the knock-on effect this might have on essential services such as transport, power and telecoms.

The event is being run by the tripartite authorities - the Bank of England, Financial Services Authority and the Treasury - which simulate a disaster every year. Last year was billed as the world's biggest ever business endurance exercise as it included more than 80 firms. Whereas it lasted a day, this year's event is scheduled to run for six weeks.

"The overall objective for the authorities is to improve their own and the sector's preparedness by providing an opportunity to review, test and update plans for managing a pandemic threat," the three authorities said.

The FSA has already asked insurance companies about their ability to withstand a deluge of claims on life insurance policies in the event of a bird flu pandemic. Last year the City regulator also asked financial firms to prepare plans to continue operating in the event of their staff being struck by the flu after warnings that 10% of personnel could be off work for three months.

The effectiveness of those plans is likely to be tested by this year's exercise in disaster planning. Though the authorities will not give public updates on the exercise while it is under way, it plans to publish a report once it has finished.
 

Hiding Bear

Inactive
Thanks for your many updates JPD.

As for myself, I was struck with a severe 'stomach' flu earlier this week - as well as many others within the local area. Some children were hospitalized.

It is quite amazing exactly how fast a flu can spread. That is why I am pessimistic the avian flu can be controlled if it becomes Human to human. So far, the HTH spreading hasn't breeched beyond family links, but it may be only one or two mutuations away from being so. Hopefully, we will have some warning by reading TB2K or whatever so at least we could take some additional last minute precautions.
 

JPD

Inactive
'Ticking Time Bomb': Prisons Unprepared For Flu Pandemic,
Says New Research

http://www.sciencedaily.com/releases/2006/09/060915012301.htm

As the fear of an impending avian flu pandemic is compelling hospitals, businesses and cities to develop preparedness plans, one of the most potentially dangerous breeding grounds of disease is woefully ill-prepared for a crisis, according to a new study being presented today by researchers at Saint Louis University.

"There’s a real failure to recognize how important the health status of inmates is to the public health of all of us," says Rachel Schwartz, Ph.D., a researcher at the Institute for Biosecurity at Saint Louis University School of Public Health. "Nearly 85 percent of those in jails and prisons will be released within a year. So even if we as a society don't think protecting them from disease is a priority, prisoners released into the general population pose a real threat to society."

The research is being presented today at the Correctional Medicine Institute’s 2006 Conference in Baltimore.

There are more than two million prisoners in the United States, making up what Schwartz calls "a highly vulnerable population."

"There’s a much higher level of disease among prisoners – people with HIV, drug-resistant tuberculosis, hepatitis C and other diseases," she says.

She adds that 80 percent of inmates come to prison with some sort of illness.

"And once they’re incarcerated, they’re more likely to get other diseases. It makes correctional facilities into ticking time bombs. Many people crowded together, often suffering from diseases that weaken their immune systems, form a potential breeding ground and reservoir for diseases."

Schwartz and fellow researchers studied research and protocols from the Centers for Disease Control, the World Health Organization and other governments to identify what plans were in place for prisons should an infectious disease break out.

Many of the correctional facilities that Schwartz and colleagues studied have acknowledged they don’t have an adequate plan to deal with a pandemic or similar health crisis. Schwartz says there’s reluctance among government leaders to provide prisoners with medical care, such as flu vaccines.

"The thinking is that there won’t be enough for the general public, and that they should get the shots first," she says. "We tend to think of all inmates as being violent offenders, but the average length of incarceration is only 48 hours. Many are not convicted criminals, but rather people merely accused of crimes and awaiting trial.

"We know that illness among prisoners will eventually spread and cause illness in society, so we must address this now."

The solution, says Schwartz, is to spend more energy and money on preparedness. She and fellow researchers developed a plan to educate the judicial and prison systems on ways to prevent the spread of disease, from meticulous hand-washing to appropriate use of quarantine and isolation in prison and jail settings.

The pandemic plans are designed to provide useful information for many kinds of crisis situations, Schwartz says.

"Ideally, they will help authorities prepare and respond to anything from a bird flu breakout to a biological attack. The information is also critical for existing illnesses within prisons, like HIV, not just emerging infections."

Saint Louis University School of Public Health is one of only 37 fully accredited schools of public health in the United States and the nation’s only School of Public Health sponsored by a Jesuit university. It offers masters degrees (MPH, MHA and MS) and doctoral programs (Ph.D.) in six public health disciplines and joint degrees with the Doisy College of Health Sciences, and schools of Business, Law, Medicine and Social Service. It is home to seven nationally recognized research centers and laboratories with funding sources that include the National Institutes of Health, the Centers for Disease Control and Prevention, the Health Resources and Services Administration, the American Cancer Society, the Robert Wood Johnson Foundation and the World Health Organization.

The Saint Louis University Institute for Biosecurity was established in 2000 to provide public health and emergency response professionals with the education needed for preparedness, response, recovery and mitigation of emerging public health threats. Faculty and staff at the Institute conduct research that contributes to the development of national policies to address these threats.
 

JPD

Inactive
S.Korea says 5 more infected with bird flu 2003-04

http://www.alertnet.org/thenews/newsdesk/SEO196446.htm

SEOUL, Sept 15 (Reuters) - Five more South Koreans were infected with the H5N1 bird flu virus about three years ago but none of them developed any serious illnesses, officials said on Friday after recently completed testing on old samples.

South Korea, which did not have comprehensive testing at the time, sent samples of 318 poultry industry workers taken during an outbreak in late 2003 and early 2004 to the U.S. Centers for Disease Control and Prevention in 2005 for further examination.

Of those workers, four South Koreans were infected, the CDC has said. The government said in February the four did not develop major illnesses.

The results prompted South Korean health officials to send samples to the CDC from another 2,109 people and of these, five were also infected, the health agency said on Friday.

"The five did not develop major illnesses and have no strain to transmit bird flu," the Korea Centre for Disease Control and Prevention said in a statement.

About 400,000 poultry at South Korean farms were infected by bird flu between December 2003 and March 2004, but no human cases were reported at that time.

All of the samples sent by South Korea to the United States were from people involved in the culling of about 5 million poultry.

There have been no reported cases of bird flu in South Korea since the 2003-2004 outbreak.

The World Health Organisation said on Thursday two cases in Indonesia had been recognised retroactively, including one where human-to-human transmission could not be ruled out.

The latest number of cases globally stands at 246 since 2003 not including the South Korean cases, with 144 deaths.
 
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