10/14-10/20/06 | Weekly Bird Flu Thread:Scientists Examine Novel Bird Flu Vaccine

Link to last week's thread:

http://www.timebomb2000.com/vb/showthread.php?p=2066740&posted=1

Johns Hopkins on influenza:

http://www.iom.edu/Object.File/Maste... Chotani.pdf

National Avian Influenza Surveillance Information:

http://wildlifedisease.nbii.gov/ai/

Scientists Examine Merits of Novel Bird Flu Vaccine​

http://www.technewsworld.com/rsstory/53655.html

By Lauran Neergard
AP
10/13/06 8:00 PM PT

New research shows that there may be a way to boost people's protection against bird flu -- by giving shots to people in advance of an outbreak in a method known as "prime-and-boost." University of Rochester scientists reported Friday the first evidence that this approach could work.

A unique study suggests there may be a way to kick-start people's protection against bird flu just in case it triggers a worldwide outbreak years from now.

If a flu pandemic began, it would take several months to tailor a vaccine to the precise strain causing illness and then to make enough vaccine for every American. Worse, people almost certainly will require two doses to protect against a flu strain their bodies have never before encountered.

Scientists have long wondered if giving shots in advance might help -- a vaccine that wouldn't fully protect but would introduce people's immune systems to a brand new type of flu. Then, once a pandemic began, they'd need only one booster shot of vaccine tailored to the exact strain, significantly cutting the time it would take to protect a population.

Prime and Boost

Friday, University of Rochester scientists reported the first evidence that this so-called "prime-and-boost" method could work.

If the findings hold up, they raise the possibility of giving "priming" shots to doctors, nurses and other first-responders who would be on the front lines of a flu pandemic long before much vaccine was ready -- or maybe even offering such shots to whoever wanted them.

"You'd have people who were prepared as much as possible in advance," said Dr. John Treanor, a Rochester vaccine specialist who led the research. "It is something a lot of people are very, very interested in. It does have some major implications for policy."

The researchers tracked down 37 people who had tested an experimental bird flu vaccine back in 1998. At the end of 2005, each got a single booster shot designed to fight a different strain of the H5N1 virus.

H5N1is thought to have made its first jump from poultry into people in Hong Kong in 1997. The Rochester volunteers got their first inoculations with vaccine made from that Hong Kong strain.

However, the deadly Asian bird flu has continued evolving as it hop-scotched across the globe -- and the booster doses were made from a very different strain that emerged in Vietnam in 2004. The booster recipients were compared with people vaccinated for the first time against the Vietnam strain.
Scientific Credibility

The booster method worked better, Treanor and colleague Dr. Nega Ali Goji reported Friday at a meeting of the Infectious Diseases Society of America.

More than twice as many of the booster recipients had a protective immune response compared to people given their first-ever dose of H5N1 vaccine. They even seemed a little more protected than those who got the optimal two doses.

The findings are intriguing, said Dr. Anthony Fauci, infectious disease chief at the National Institutes of Health, which funded the work.

"It really does add some degree of scientific credibility to the issue of priming," Fauci said.

However, he cautioned, much more research is needed before the government would even consider recommending advanced shots for bird flu: "Policy decisions would require considerably more information than we have."

The work reflects what happens every winter with seasonal flu: When small children are first vaccinated against regular flu, they need two doses. After that, one shot a year is enough. Even though the strain that circulates each winter is slightly different, the shot awakens their immune system's memory of influenza just enough.

"Your flu vaccine experience is a constant series of booster doses," Treanor explained.

Australia offers Rp 11b for bird flu​

http://www.thejakartapost.com/detailnational.asp?fileid=20061014.H13&irec=12

JAKARTA: Australia has pledged a further Rp 11 billion to strengthen the capacity of disease investigation centers to diagnose the avian influenza virus in poultry.

The project is part of a Rp 107 billion package that Australia has pledged to combat the virus in Indonesia.

"Australia is working with Indonesia's National Committee for Avian Influenza Control and Pandemic Influenza Preparedness to manage the regional threat of avian influenza," Australian ambassador Bill Farmer said Friday.

The diagnosis will be managed by the Australian Animal Health Laboratory. It will increase the capacity of national, regional and provincial laboratories in Indonesia to investigate suspected avian influenza cases and outbreaks.

Conference told of bird flu risk for health workers​

http://www.abc.net.au/news/newsitems/200610/s1765033.htm

The doctor who diagnosed the first case of SARS in Toronto has urged Australian governments to ensure front-line health workers are protected in the event of a flu pandemic.

Tom Stewart from Toronto University has addressed the Australian and New Zealand Intensive Care Society's conference in Hobart.

Dr Stewart says seven of his colleagues became ill during the SARS outbreak in 2002, and three succumbed to the virus.

He says despite the risks, doctors and nurses rejected pleas from their families to stay at home.

"There was a lot of stress on my colleagues, and a lot of after-effects of that stress," he said.

"That could be better more improved by preparation, training, teaching, a plan on how we're going to deal with a surge of critically ill patients, where we're going to put them, who's in charge."

Hundreds of medical experts are discussing the scenario of an Avian influenza pandemic at the Hobart conference.

They say bird flu has already been detected in 53 countries, and if the virus spreads to Australia the predicted mortality rate is 35 per cent.

Professor Marcus Skinner, from Tasmania's North West Regional Hospital, says existing preparedness plans do not anticipate the rapid erosion of front-line hospital staff in the event of an avian flu outbreak.

"We need to be able to identify early these patients, so that they can go down the path of appropriate isolation and management and that at the same time we can protect our scarce staffing resources, particularly in rural areas," he said.

The conference concludes today.

http://today.reuters.com/news/artic...0_RTRUKOC_0_US-BIRDFLU-USA.xml&src=rss&rpc=22


Low-risk H5N1 bird flu in Ohio wild birds- USDA


WASHINGTON (Reuters) - Northern pintail birds in Ohio have tested positive for a low-pathogenic strain of the H5N1 bird flu virus, the U.S. government said on Saturday, adding to recent cases in Pennsylvania, Maryland and Michigan.

A strain of the H5N1 avian influenza virus was found in "apparently healthy" wild birds sampled October 8 in Ottawa County, located on Lake Erie about 15 miles southeast of Toledo, the departments of Agriculture and Interior said.

"Initial tests confirm that these wild bird samples do not contain the highly pathogenic H5N1 strain that has spread through birds in Asia, Europe and Africa," the USDA said in a statement.

The government said it was conducting additional tests to determine, in part, if the ducks had H5N1 or two separate strains with one virus contributing H5 and the other N1. A second round of tests could take up to 21 days to confirm whether it was the low-pathogenic H5N1 bird flu.

The virus also was found in Pennsylvania in September and in Michigan and Maryland in August.

The Agriculture and Interior departments are working with states to collect between 75,000 and 100,000 wild bird samples in addition to more than 50,000 environmental tests throughout the United States.

A low-pathogenic strain, which produces less disease and mortality in birds than does a high-pathogenic version, poses no threat to humans. It is common for mild and low pathogenic strains of bird flu to appear in the United States and other countries.

The latest H5N1 bird flu strain in Asia, Europe and Africa is known to have killed at least 141 people and forced hundreds of millions of birds to be destroyed.

Indonesia

A boy dies of bird flu, taking human death toll to 53​

http://www.thejakartapost.com/detailgeneral.asp?fileid=20061015133335&irec=2

JAKARTA (AP): An 11-year-old boy has died of the virulent H5N1 strain of bird flu, raising the national death toll from the disease to 53, the director of the hospital where the patient wasbeing treated said Sunday.

The boy, who wasn't named by officials, was admitted to the Sulianti Saroso Hospital for Infectious Diseases in Jakarta on Thursday and died Saturday night, said Director Dr. SantosoSuroso.

1918 pandemic puzzle is missing pieces​

http://www.sunherald.com/mld/sunherald/living/15763785.htm

By KAT BERGERON
kbergeron@sunherald.com

Nearly nine decades after the 1918-1919 influenza pandemic swept across the Mississippi Coast - and every country in the world - researchers and health officials continue to study and revise death tolls.

Even less seems to be known about how many caught the flu and survived.

Statewide, the Mississippi Department of Health, Bureau of Vital Records, listed 6,219 deaths from influenza in 1918 and 3,013 in 1919, but researchers question the accuracy of record-keeping of that era, not just in Mississippi but across the country. Millions also likely died of flu complications, such as pneumonia.

"At the time there were no surveillance systems like today that could track the levels of flu around the U.S.," said Christine Pearson, spokesperson for the Center for Disease Control and Prevention in Atlanta. "At that time, they didn't have the great understanding of influenza or pandemic."

The 1918 pandemic puzzle is missing pieces.

Are the memories of men like Tommie Dukes Sr., who has an oral history in Southern Miss archives, correct? As an adult, the National Negro League player born in 1906 and raised in the Kiln and Lumberton recalled the flu pandemic of his youth: "And every day they was hauling caskets from Bay St. Louis to the Kiln. You'd see them trucks coming there with caskets."

The virulent flu sometimes displayed frightening plaguelike symptoms, including swiftness, bleeding and body blueness.

The public was not kept informed of Coast numbers, either the dead or those who survived.

Explained a Nov. 1, 1918, article in The Daily Herald, the region's largest newspaper and forerunner to this one:

"Official information as to the number of cases of influenza occurring in the Mississippi Coastal District has been withheld heretofore because of the fear that a certain portion of the population might be tempted to become careless if on a certain day the number of cases reported by physicians should happen to be low.

"It is now believed, however, by health authorities that the people in general have by this time become sufficiently convinced as to the need of precaution, and that it is therefore safe to give figures."

But the Herald did not publish the totals, not even the day it gave that report. The editors did chart Gulfport's daily count for October. The highest was Oct. 14 with 50 new cases and the lowest was Oct. 21 with eight. This tidbit provides a rare snapshot at other Coast cities.

That month, there apparently were as many as 6,000 new cases a day in Mississippi. The statistic comes from U.S. Deputy Secretary of Health and Human Services Alex Azar, who on a visit to Mississippi this May included a brief overview of the 1918 pandemic.

"It appeared to come in slowly in the last days of September," Azar told those gathered in Jackson for a statewide pandemic planning session. "Initial reports included 'a few cases...from Montgomery and Leake counties and suspected cases from Meridian.'

"The situation quickly worsened. One week after it appeared, Mississippi officials reported to the U.S. Public Health Service that 'epidemics have been reported from a number of places in the state' and 'the epidemic is spreading rapidly.'

Eight decades later, debate and research continue into the origins of the pandemic that began in the spring of 1918. Fast-moving because it was a strain for which people had not developed immunity, this influenza was particularly deadly to the young, ages 20 to 30, although no one, no age was left untouched.

"When a pandemic strikes, it can cause a loss of life, but it also alters society," Azar said.

Those who remained healthy still found their lives and mobility drastically altered. School classes were canceled and offices closed, some stores shuttered, especially on weekends, and church choirs fell silent. Hard-hit were the state colleges where panicked parents were not allowed to pull out students because of quarantines.

Leslie C. Frank, the Coast district's head health officer, issued an order that "all clerks and other persons waiting on or serving the public in mercantile establishments, meat markets, barber shops, fruit stands, conductions on street cars and places where the public served are urgently requested to wear masks.

"The public generally are also requested to wear said masks while in any of the above mentioned places."

The same newspaper announcement said masks were available at "local Red Cross headquarters." Then came this Oct. 19 report: "Little children were at headquarters asking for masks, but were turned away because none had been made for general distribution."

Despite this hitch, the Red Cross was commended daily for its dedication and volunteers.

The offers of help from those who could give it - fraternal lodges, individuals, Catholic nuns - were often lauded in the newspaper, the primary source of any flu news in this era.

As phone and telegraph operators fell to the flu bug, communication was hampered further; public services were curtailed. Most telling were signs posted on houses in the cities that complied with Frank's dictates. The signs read: "Influenza. Visiting forbidden to and from this house. U.S. Public Health Service."

In Mississippi, not all public gatherings were canceled as the surgeon general had dictated. There were fairs, rallies to raise money for U.S. involvement in World War I and a few religious conferences.

Coast communities did what they were asked to do, and Harrison County postponed its fair. Canceled war bond rallies were blamed for organizers not meeting patriotic donation goals, and, not surprisingly, the rallies were one of the first public events brought back.

Schools took longer to reopen, some more than six weeks, and students were only allowed in the classroom with doctor's notes verifying their families were flu-free.

Many 20th century histories claim the pandemic was first in Europe. More recent research raises questions about whether it actually started in the U.S. and arrived in Europe via American soldiers, then came back again to the U.S. with an autumn vengeance.

Historians believe it was misnamed "Spanish Flu" because more news about the disease came out of Spain, which was not involved in the war and did not have all the wartime censorship. Even the king got it.

The one certainty is that World War I soldiers and sailors helped spread it throughout the world. Then, with defeat of the Germans, Americans spontaneously gathered in their towns to celebrate Armistice Day.

Ironically, Nov. 11, 1918, likely exposed more to the influenza. There was, after all, a good reason for edicts of no public gatherings.

By Armistice Day, the three Coast counties were through the worst of their share of the pandemic.

Stone County, which quarantined itself in October to prevent spread into its pineywoods, felt confident enough on Nov. 1 to lift the quarantine.

"Everything is fine in Stone County, then comes the Armistice and everyone is jumping up and down and celebrating and probably spreading germs," said Charles L. Sullivan, historian and professor emeritus at Mississippi Gulf Coast Community College.

Sullivan said the Perkinston campus didn't reopen until Jan. 27, 1919. As happened in much of the country, first came the bigger cities, then the smaller ones, then the rural areas.

The strain sputtered on through 1919, with some reports in 1920, but not with the ferocity of 1918.

A researcher's

perspective

Several years ago, Deanne Stephens Nuwer of the University of Southern Mississippi-Gulf Coast researched the 1918 pandemic to present a paper to the Southern Association of Medicine and Science.

"My impression is that more Mississippians died and there was more of a social impact than has been previously recognized," said Nuwer, who has a doctorate in Southern history.

"Things shut down here during the flu epidemic in 1918. When you have no church services and soldiers being isolated, that disrupts life. Schools and dormitories shut down and parents went in panic mode.

"I can't imagine the fear. Here we are in little South Mississippi and we are dealing with this in a one-on-one -basis but realizing it is a global story. It's probably akin to the AIDS scare in the 1980s when people were afraid to touch anyone.

"The lesson we should have learned from 1918 is that there needs to be a more cooperative effort at health care. Each state and city was onto itself, even on the Coast, and the resources shared and the knowledge shared could have been so much greater."

- KAT BERGERON

If the findings hold up, they raise the possibility of giving "priming" shots to doctors, nurses and other first-responders who would be on the front lines of a flu pandemic long before much vaccine was ready -- or maybe even offering such shots to whoever wanted them.

Click to expand...

They have already tried this strategy - to force doctors, nurses, and first reponders to take the small pox vaccine. Wisely, the vast majority refused to do so. But it's a good way to introduce new viruses into the population to keep dragging down the immunity of the "herd."

Indonesian woman dies of H5N1 strain of bird flu, lifting death toll to 54​

http://www.cbc.ca/cp/health/061016/x101606.html

04:28:06 EDT Oct 16, 2006
Canadian Press

JAKARTA, Indonesia (AP) - A 67-year-old woman died overnight of bird flu, the second death in as many days, taking Indonesia's human toll from the disease to 54, Health Ministry and hospital officials said Monday.

The woman, who was also diagnosed with encephalitis, or inflammation of the brain, was hospitalized with bird flu symptoms on Oct. 10 after coming into contact with fowl in West Java province, said Runizar Roesin of the National Bird Flu Information Center.

She died late Sunday, he said, a day after an 11-year-old boy succumbed to the disease in a Jakarta hospital.

Health officials were trying determine whether there was any link between bird flu and the woman's brain inflammation, said Hadi Yusuf, her chief doctor at the Hasan Sadikin hospital in Bandung town.

The H5N1 virus has killed at least 148 people worldwide - more than a third of them in Indonesia - since it began ravaging Asian poultry stocks in late 2003, according to the World Health Organization.

Most of those killed have been infected by domestic fowl, but WHO fears the virus could mutate into a form that easily spreads among humans, sparking a pandemic with the potential to kill millions.

Indonesia, the world's fourth most populous country and home to millions of backyard chickens, is considered a hot spot for that to happen.

The government has been criticized for failing to aggressively deal with the virus in poultry stocks, either by mass slaughters or vaccination.

It says it lacks the resources to compensate farmers for slaughtered birds and earlier complained that while it needed US$250 million a year to fight bird flu it had received only US$100 million from its own coffers and the international community.

Bird Flu Kills 150th Person; May Have Infected Victim's Brain​

http://www.bloomberg.com/apps/news?pid=20601203&sid=a3hfCjy66dgA&refer=insurance

By Karima Anjani and Aloysius Unditu

Oct. 16 (Bloomberg) -- Bird flu may have infected an Indonesian woman's brain before it killed her yesterday, marking the 150th fatality caused by the virus worldwide since late 2003.

The 67-year-old woman from Indonesia's West Java province tested positive for the H5N1 strain of avian influenza on Oct. 11, four days after she was hospitalized in the city of Bandung with flu-like symptoms. Her condition deteriorated when she developed encephalitis, or an acute inflammation of the brain, said Hadi Yusuf, one of her doctors at Hasan Sadikin Hospital.

``Our concern is that the condition was caused by a bird flu infection in her brain,'' Yusuf said over the telephone today.

Neurological symptoms occur rarely with human H5N1 cases, according to virologist Menno de Jong, whose team observed 18 patients in Vietnam. Doctors are studying the virus to improve treatments for the disease, which threatens to mutate into a contagious form that could kill millions of people.

The virus is known to have infected 255 people in 10 countries during the past three years, killing 59 percent of them. The latest fatality brings to 72 the number of people known to have died from H5N1 this year alone -- almost as many as the total number of fatalities recorded in the previous three years.

New infections provide more chances for the virus to mutate into a lethal pandemic form, such as the one in 1918 that killed as many as 50 million people. In most H5N1 cases, severe respiratory disease, including pneumonia, is the main symptom.

Diseases involving the central nervous system, including encephalitis, transverse myelitis and Guillain-Barre syndrome, have been associated with influenza in humans, according to Harrison's Principles of Internal Medicine, 13th edition. The cause of the disease isn't established, the medical book said.

75% Fatality Rate

The woman from West Java was the second person to die of avian flu at the weekend in Indonesia, where three of every four reported cases of the virus have been fatal.

An 11-year-old boy from a southern suburb of the capital, Jakarta, had the H5N1 strain when he died on Oct. 14, Joko Suyono, an official at the health ministry's avian flu information center, said late yesterday.

Test results reported by a U.S. navy laboratory confirmed an initial diagnosis made by a local laboratory, he said. The boy may have picked up the H5N1 virus from infected fowl in his neighborhood, Suyono said.

The fatalities take to 54 the number of people reported to have died in Indonesia from H5N1 since July 2005. A least one avian-flu death has been reported every month since September last year as authorities struggle to control the virus in poultry.

Indonesia, the world's fourth-most-populous country, surpassed Vietnam in August as the country with the most H5N1 fatalities.

Indonesia has reported 71 H5N1 cases, giving it a case- fatality rate of 75 percent -- the highest after Cambodia, where all six of that country's known H5N1 patients died, giving it a case-fatality rate of 100 percent.

Fatal H5N1 Encephalitis Case Raises Pandemic Concerns​

http://www.recombinomics.com/News/10160603/H5N1_Encephalitis_Indonesia.html

Recombinomics Commentary
October 16, 2006

The "PCR test first, second, fourth, and the five results of the negative."
Only that third that said false positive or positive border line

The above description of the most recent confirmed H5N1 positive case raises additional questions about testing in Indonesia. The patient developed encephalitis and died. Multiple organs, including her brain were involved, yet most of the testing yielded negative results.

Negative results have also been reported for other severely ill contacts of H5N1 cases, incl;uding the large Garut cluster. These negatives, frequently in samples collected after Tamiflu treatment has started, continue to raise concerns on the true extent of H5N1 infection in Indonesia.

Sequencing data clearly show that the vast majority of cases are not linked to H5N1 positive poultry, yet a poultry link is usually required for H5N1 testing of patients with bird flu symptoms

Now H5N1 is being detected in patients with symptoms of encephalitis. The sole surving member of the Karo cluster also developed a brain infection, but that infection was said to be negative for H5N1.

The current H5N1 positive fatal encephalitis case increases concerns hat H5N1 in human is much greater than the number of WHO confirmed cases.
.

CHRONOLOGY-Bird flu developments​

http://today.reuters.com/news/artic...U.xml&WTmodLoc=HealthNewsHome_C2_healthNews-7

(Reuters) - The World Health Organization (WHO) confirmed three cases of human infection with the H5N1 avian influenza virus in Indonesia. All three cases were fatal.

In the latest case a 67-year-old woman from West Java Province was hospitalized on October 7, and died eight days later.

Of the 72 cases confirmed to date in Indonesia, 55 have been fatal.

Here is a brief chronology of some of the major bird flu developments in 2006:


Jan 18 - International donors pledge $1.9 billion to combat the spread of bird flu at a conference in Beijing.

Feb 8 - The first African cases of the deadly H5N1 strain are detected in poultry in the northern Nigerian states of Kano, Kaduna and Plateau.

Feb 11/12 - Italy says six wild swans found in Sicily and on the southern mainland tested positive for H5N1. In Greece, three swans found south of Thessaloniki test positive for H5N1. These are the first known cases of the strain in the EU. Several countries subsequently report outbreaks in wild birds.

Feb 17 - Egypt finds its first cases of H5N1 in chickens.

Feb 18 - India announces its first cases of H5N1, finding the virus in poultry in a western state.

Feb 22 - The EU approves plans by France and the Netherlands to vaccinate millions of hens, ducks and geese against bird flu.

Feb 25 - France confirms H5N1 at a farm in the east where thousands of turkeys have died. It is the first case of the virus in domestic farm birds in the EU.

May 11 - Djibouti announces its first case of human H5N1,

the first confirmed case in a person in the Horn of Africa.


July 26 - Pharmaceuticals group GlaxoSmithKline Plc says a bird flu vaccine for humans that uses only a very low dose of active ingredient has proved effective in clinical tests.

Aug 8 - China says its first H5N1 human case was in 2003, and not in 2005 as it had originally reported.

Sept 26 - WHO's new influenza pandemic task force calls on countries to share all virus samples and genetic sequencing data, key to developing a vaccine against a bird flu pandemic.

Sept 28 - China shares long-sought samples of H5N1, in what many scientists view as a breakthrough in cooperation, WHO says.

Oct 16 - WHO confirm new deaths in Indonesia. The global death toll stands at 151, with six victims in Egypt, four in Turkey, 55 in Indonesia, six in Cambodia, 14 in China, 17 in Thailand, 42 in Vietnam, two in Iraq and five in Azerbaijan.

CAN WE GET A QUARENTEEN AROUND INDONESIA PLEASE?

Indonesian Woman Dies of Bird Flu​

http://www.washingtonpost.com/wp-dyn/content/article/2006/10/16/AR2006101601327.html

The Associated Press
Monday, October 16, 2006; 10:12 PM

JAKARTA, Indonesia -- A 27-year-old woman was killed by bird flu _ Indonesia's third death from the virus in as many days _ bringing the nation's toll to 55, the World Health Organization said Tuesday.

The woman from Central Java province died Friday, five days after she developed symptoms of the disease and one day after she was hospitalized, the WHO said in a statement posted on its Web site.

"The source of her exposure is currently under investigation," it said.

According to WHO, of the 72 cases confirmed to date in Indonesia, 55 have been fatal.

An 11-year-old boy succumbed to the disease in a Jakarta hospital on Saturday and a 67-year-old woman died Sunday in the West Java town of Bandung, Indonesian health officials announced earlier this week.

The H5N1 virus has killed at least 151 people worldwide since it began ravaging Asian poultry stocks in late 2003, according to WHO.

Most of those killed have been infected by domestic fowl, but WHO fears the virus could mutate into a form that easily spreads among humans, sparking a pandemic with the potential to kill millions.

Indonesia, the world's fourth most populous country and home to millions of backyard chickens, is considered a hot spot for that to happen.

The government has been criticized for failing to aggressively deal with the virus in poultry stocks, either by mass slaughters or vaccination.

H5N1 Fatality in Banyumas Central Java ​

http://www.recombinomics.com/News/10160604/H5N1_Banyumas_Indonesia.html

Recombinomics Commentary
October 16, 2006

startled by the death of the patient with the sign of bird flu in RSU Banyumas from the Sigedang Village, the Kaliurip Village, the Madukara Subdistrict, Mistinem (32), on Friday (13/10).

More again startled when knew had a citizen of the Krinjing Village, the Lightning Village, of the Purwonegoro Subdistrict that currently also is treated in RSU Banyumas with the same sign.

The Krinjing village that beforehand had not canned be heard his name, currently suddenly became attention of the community.

A party of the official from the Health Service of the Regency (ET AL) also checked the condition for the Parimun house (17), the new patient RSU Banyumas.

The above translation describes the confirmed H5N1 fatality in Banyumas in Central Java, as indicated in today’s WHO update. Local media describe a second hospitalized patient who also transferred to RSU Banyumas from RSUD Banjarnegara. The second patient was from a neighboring village, Krinjing.

The two cases in Central Java as well as the confirmed cases from South Jakarta and Bandung died on consecutive days. These three confirmed H5N1 deaths in three regions on Java are cause for concern.

Although the vast majority of confirmed H5N1 cases in Indonesia are from Java, a source of infection has not been identified. All human cases, except one from an infection in August, 2005 have been infected with H5N1 with a novel cleavage site. These patients fall into two groups. One, consisting of three patients infected in 2005 map to the upper branch of the bottom of the phylogenetic tree presented at a WHO meeting in Jakarta in June. The vast majority of Java cases however, map to the lower portion of the tree. All human sequences that have been made public since the meeting, also map to the lower portion. This lower portion has no avian isolates.

The match failure was noted at the meeting, and 91 recent samples were sent to a WHO affiliated lab in Australia, Over 50 bird sequences have been made public from these recent samples and only one bird isolate from Java had the cleavage site. However, it match the small group of three patients from 2005. This duck isolate was from Indramayu, but the patients from Indramayu mapped with the majority of cases, which are on the lowest branch.

Two chicken isolates did map to the lower branch. By these isolates were from 2005 in Central Sumatra, far from the human cases on Java, which have stretched from East Java to West Java and isolated during a time from from the index case in July, 2005 through the most recent deposits, from the summer of 2006.

The origin of these infections is unknown. The only non-human Java match was from cat, also from Indramayu. That sequence was closely related to the human sequences, including those from Indramayu.

The failure to identify the source of the H5N1 infections in Indonesia remains a cause for concern.

Egypt bird flu case​

http://www.ameinfo.com/99172.html

Egypt has detected its first case of bird flu since May, in a woman who raised ducks from her home, according to the BBC. There have been fifteen cases of the H5N1 virus in Egypt since February, with six people dying. Eight recovered after being treated with Tamiflu. Egypt is a major route for migratory birds.

48.6% Of All Global Human Bird Flu Infections
Happened In Indonesia This Year​

http://www.medicalnewstoday.com/healthnews.php?newsid=54254

Main Category: Bird Flu / Avian Flu News
Article Date: 16 Oct 2006 - 8:00am (PDT)

There have been 256 cases of people infected with the H5N1 bird flu strain since the beginning of 2003 worldwide. 109 have become infected this year. 151 people have died since 2003, of which 73 died this year. 48.6% of all confirmed human infections this year have occurred in Indonesia.

Total Human H5N1 Bird Flu Cases and Deaths (WHO)

Azerbaijan
Cases - 8 (all this year)
Deaths - 5 (all this year)

Cambodia
Cases - 6 (2 this year)
Deaths - 6 (2 this year)

China
Cases - 21 (12 this year)
Deaths - 14 (8 this year)

Djibouti
Cases - 1 (1 this year)
Deaths - 0 (none this year)

Egypt
Cases - 15 (all this year)
Deaths - 6 (all this year)

Indonesia
Cases - 72 (53 this year)
Deaths - 55 (43 this year)

Iraq
Cases - 3 (all this year)
Deaths - 2 (all this year)

Thailand
Cases - 25 (3 this year)
Deaths - 17 (3 this year)

Turkey
Cases - 12 (all this year)
Deaths - 4 (all this year)

Viet Nam
Cases - 93 (none this year)
Deaths - 42 (none this year)

Total
Cases - 256 (109 this year)
Deaths - 151 (73 this year)

Warning over global bird flu plan​

http://news.bbc.co.uk/1/hi/health/6054810.stm

A third of countries which have drawn up flu pandemic plans have failed to set out how they would distribute medical treatment, a report has found.

Researchers at the John Hopkins Bloomberg School of Public Health and Ben Gurion University Israel studied 45 national pandemic plans.

They warned resources would be scarce, so decisions on who should get drugs or vaccines should be made in advance.

They said prioritising treatment could help reduce death and disease.

The World Health Organisation (WHO) has urged every country to develop and maintain a national plan on bird-flu.

It also recommends nations prioritise the allocation of pharmaceutical resources among the population.

Rationing

Researchers looked at 19 plans from developed nations and 26 from developing countries. In total, these represented around two-thirds of the world's population - 3.8bn people.

The countries included the US, Norway, Australia, India, China, Serbia, Bahrain, Israel, South Africa, UK, Mexico, Venezuela, Hong Kong, Thailand and Singapore.

The report, Priority Setting for Pandemic Influenza: An Analysis of National Preparedness Plans, found almost half of the plans they examined favoured antiviral medications, such as Tamiflu, while 62% prioritised giving citizens a flu vaccine.


Individual countries have not consistently prioritised population groups for vaccines and antivirals.

Lori Uscher-Pines

This was an unexpected finding, researchers said, as antiviral treatment may be the only pharmaceutical intervention available in some countries.

"We cannot expect to vaccinate more than 14% of the world's population within a year of pandemic."

Lead author of the study, Lori Uscher-Pines, said resources would need rationing if there was a flu pandemic.

"We learned that individual countries have not consistently prioritised population groups for vaccines and antivirals.

"No countries prioritised population groups to receive ventilators, face masks and other critical resources," she said.

The study also found allocation decisions for different groups varied widely from country to country.

Most countries - including the UK - prioritised health care workers for the vaccine and antiviral treatment, but policies varied on other groups such as the elderly, essential service workers and children.

Key interventions

It also found almost half of the countries studied had prioritised children, despite a WHO recommendation against it.


Only once the disease is moving will we know who it's targeting
Professor John Oxford

The report said it was also unclear why vaccine and antiviral medications had been singled out for treatment when there is likely to be a shortage of many resources.

It said further guidance was needed to address whether schemes for ventilator masks and hospital beds are necessary.

It is the first study to look at prioritisation decisions in developed and developing countries.

Professor John Oxford, a virologist at Queen Mary School of Medicine, London, said he was not surprised at the variations in plans betweens countries.

"Only once the disease is moving will we know who it's targeting. There's going to be an element of 'wait and see'."

He said antivirals, vaccines and hygiene levels were all key to intervening in a pandemic.

He added the study could potentially be a "huge contribution" towards helping countries further develop their plans.

The Department of Health said it has taken steps to prepare.

It has purchased 14.6m courses of Tamflu and 2.5m doses of H5N1 vaccine. PCTs have also been asked to draw up local contingency plans to respond to a pandemic, which the department will audit.

"The World Health Organisation has said that the UK is at the forefront of preparations internationally for a pandemic influenza," a spokesperson said.

"Preparing for a pandemic is ongoing and we are constantly reviewing and developing our plans as new information emerges."

Is your business pandemic-ready?​

http://www.nob.on.ca/industry/health/10-06-pandemic.asp

By Ian Ross

It’s too late to begin planning for a flu pandemic when the first employee goes down sick or the World Health Organization declares an emergency, says a leading workplace hazards expert. “This does take time, so now is the time to start planning,” says Joan Burton, the Industrial Accident Prevention Association’s health strategy manager.

Prior planning by businesses for a potential wave of avian flu could keep employees on their feet and off their backs. Should a pandemic influenza outbreak occur, businesses will play a vital role in protecting the health of their employees as well as limiting their exposure to the community and protecting the economy.Certain organizations like Ontario Power Generation that handle critical infrastructure service such as power, telecommunications and health care-related institutions have a legislated responsibility to continue operating in a crisis with an emergency plan.

While health care experts have little idea when a pandemic flu will strike North America, how bad it will be, or what form it will take, many say the H5N1 bird flu looks like a likely candidate.

Unlike SARS in 2003, ordinary businesses weren’t affected that much since the disease was contained in Toronto hospitals. But Burton says flu strains are everywhere.

One topic she lectures on is the misunderstandings about how the flu spreads.

Of the five ways any infectious disease can spread, the flu has only two of them, by direct and indirect contact, through eyes, nose and mouth, and by droplet. But it’s not airborne.

A flu-sufferer who’s coughing or sneezing creates large droplets that fall to the ground. Burton says that won’t effect someone on the far side of a room.

With airborne diseases like tuberculosis, measles or mumps, the droplets are tiny particles, less than five microns in size, that can float in the air for hours.

“A sick person can be coughing and sneezing, leave the room, and someone else catches the virus ten minutes later still floating around,” says Burton. But that doesn’t happen with the flu.

The flu virus can live up to 24 to 48 hours on hard surfaces like counter tops and doorknobs.

What businesses can do to protect themselves is pay attention to “environmental cleaning” to cover the droplet spread and keep respectable social distances, says Burton.

People sharing workstations and phones are important areas that require attention.

After SARS, Burton found some companies bought large volumes of anti-bacterial soap, but ordinary soap and water works still works best. Hand sanitizers are a good idea when you can’t wash your hands.

Burton says how well a business can keep functioning during a health emergency will depend upon prior planning.

Companies need to know their essential services and prioritize what functions must be maintained and what can be postponed for a few weeks. “Each wave of pandemic is likely to last up to eight weeks,” says Burton, and the avian flu will likely come in two or three waves.

“It will take time, but the key thing to do is examine vulnerable positions and imagine if a large percentage of your staff are off sick, which of your critical functions is going to be in trouble.

“If you only have one or two people to do payroll and they both get sick at the same time, you could be in major trouble.” Cross-training is important and it’s especially critical to consult with unions in cases where job classifications may require shifting staff to different positions.

Burton suggests companies should consider scheduling more teleconferences rather than face-to-face meetings.

Businesses should also investigate the options of employees working at home and consider improving sick time policy to cover eight weeks of a flu wave to leave no financial penalty for people staying at home when they’re sick.

“You don’t want people coming into work sick because they can’t afford to stay home.” says Burton. “That will decimate your workforce worse than anything.”

Associate Medical Officer of Health for the Sudbury and District Health Unit, Vera Etches says pandemic planning can pay huge dividends for businesses and their suppliers down the road.

“Business needs to have some way of adjusting to any type of emergency that comes along,” says Etches. “A lot of the thinking that goes into it will be useful for other types of emergencies.

“It’s not an expensive process to create a list of essential services and think about what staff needs cross-training,” says Etches, who sits on the City of Greater Sudbury’s emergency planning group. The Sudbury health unit can provide a pandemic preparedness checklist for small business offered by the Retail Council of Canada.

But Etches suggests one way to prepare is stocking up on hand sanitizers.

The health unit is formulating a business awareness campaign this winter beginning with a pandemic planning exercise in early December where they’ll improvise scenarios for organizations and companies to work through their pandemic plans.

Sadly, despite all the dire predictions, the IAPA’s Burton says the message isn’t sinking in with many businesses. She was scheduled to speak at a pandemic planning seminar in Sault Ste. Marie on Sept. 18 but wasn’t sure if the event would go ahead because registrations were so low.

She says a particular cause for concern if the avian flu mutates to affected humans and goes global is that it may prove fatal to a larger population demographic.

“If that strain becomes a pandemic strain, it could be average healthy people in the workforce that could actually die from it.”

The 1918-19 Spanish flu killed millions in the 20 to 40-age bracket. “The thing about a pandemic stream is that nobody has any immunity to it.”

Americans piled up Tamiflu on bird flu fear​

http://today.reuters.com/news/artic...TAMIFLU.xml&WTmodLoc=NewsArt-C2-NextArticle-1

CHICAGO (Reuters) - Fears of an outbreak of bird flu led Americans to hoard the anti-viral medicine Tamiflu in 2005, with prescriptions spiking most sharply when media coverage rose, a study released on Tuesday said.

Filled prescriptions for Tamiflu rose nearly five-fold between September and October of 2004 and the same period in 2005, according to the analysis by the U.S. Centers for Disease Control and Prevention (CDC) and pharmacy benefits manager Medco Health Solutions Inc..

Because there was little or no influenza activity reported during these periods, researchers said the data suggest patients were stockpiling the drug over fears of an epidemic.

The study adds weight to anecdotal reports of patient hoarding a year ago, when governments around the world were scrambling to build up supplies of Roche Holding AG's and Gilead Sciences Inc.'s Tamiflu, one of only two drugs that can treat avian, or bird flu.

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Roche suspended Tamiflu shipments to the United States last October because of fears people were hoarding it.

The H5N1 avian influenza is still primarily a bird disease, but has infected about 252 people and killed 148 people in 9 countries. The virus has not yet been found in North or South America.

The report found that Tamiflu prescriptions filled rose to about 134 claims per 100,000 enrollees in 2005, from about 27 prescriptions per 100,000 enrollees in 2004.

Researchers also analyzed media references to Tamiflu and found it tracked neatly with the boost in prescription rates.

"The correlation between the heightened U.S. media coverage around Tamiflu and the prescription activity for the drug between September and November in 2005 is uncanny," said Robert Epstein, chief medical officer at Medco, which fills prescriptions for 55 million people in the U.S.

Last year, United States ordered 5 million treatment courses of Tamiflu and GlaxoSmithKline Plc's Relenza, both antiviral drugs that can prevent and treat influenza if used very quickly.

India

Bird flu season back, but govt sleeps​

http://timesofindia.indiatimes.com/articleshow/2191782.cms

NEW DELHI: A senior health ministry official's comment couldn't have been more apt "Nothing works in India till there's an emergency."

Just last February, when India announced that the deadly H5N1 avian influenza virus had arrived in the country, the threat of a human pandemic was more than real. Officials hurried containment plans. And then suddenly, all was forgotten.

With October, the bird flu season is back once again and India stands hopelessly unprepared for another outbreak. Five Bio Safety Level (BSL) III labs to test animal samples for H5N1 virus were announced.

Not one has come up till now. The High Security Animal Disease Laboratory in Bhopal, which tested thousands of suspected samples for the virus early this year, continues to be the only hope.

Three labs to test human samples were also announced. Only one National Institute of Communicable Diseases BSL-III lab will soon be functional. At present, only National Institute of Virology, Pune, has an accredited BSL-III lab that can test human samples.

HSADL, Bhopal, which had isolated the bird flu virus, is yet to share the virus with Indian Council of Medical Research. The two institutes were supposed to "jointly undertake studies to better understand the virus". India has not even sent the virus to Australia for validation.

According to international norms, once a country declares an H5N1 outbreak, it has to send the virus samples to another country for validation. Sources said officials from Centre for Disease Control, Atlanta, have repeatedly asked India to send the samples to Australia. But HSADL has refused to share the virus.

Scientists say though government's attention towards bird flu has dipped, the virus remains just as dangerous and just as able to cause a worldwide outbreak like the one seen since 1918, when 50 million people died.

More tests confirm low-risk bird flu in Illinois​

http://news.yahoo.com/s/nm/20061017/ts_nm/birdflu_illinois_dc

WASHINGTON (Reuters) - A second round of tests on ducks in central Illinois confirmed the birds have a low-pathogenic form of avian influenza, the U.S. government said Tuesday.
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The low-pathogenic H6N2 virus was found in five of the 11 samples collected from wild Green-winged Teals in Fulton County, Illinois, the U.S. Agriculture Department and the Department of Interior said in a joint statement. Early testing on September 29 indicated it might be the low-pathogenic strain of H5N1.

The low-pathogenic avian influenza virus commonly occurs in nature, but usually results in minor sickness or no noticeable disease for birds.

Low-pathogenic bird flu has been confirmed in the United States this year including in Michigan, Montana, Pennsylvania and Maryland.

In an effort to detect the high-pathogenic H5N1 strain that has killed 151 people overseas, USDA and the Department of the Interior are working with the states to collect between 75,000 and 100,000 wild bird samples in addition to more than 50,000 environmental tests throughout the United States.

Kenya issues alert as bird flu reported in southern Sudan​

http://english.people.com.cn/200610/18/eng20061018_312825.html

Kenyan authorities have issued an alert following a recent outbreak of the deadly H5N1 bird flu virus in southern Sudan.

The ministry of health's head of promotive services Nicholas Muraguri said teams of health workers and veterinarians are carrying out tests on people and poultry especially in Turkana and Lokichoggio districts bordering southern Sudan.

"Apart from a surveillance, Kenya has banned poultry and poultry products imports from Sudan and other affected countries as a preventive measure against the bird flu," Muraguli told Xinhua by telephone on Tuesday.

Officials say Kenya and other east African countries are at risk because birds that have already brought the deadly H5N1 strain from eastern Europe are flying to the region and beyond to escape the northern hemisphere winter.

Sudan reported outbreaks of bird flu in Khartoum and Jazeera provinces in the north in April. Sudanese government officials said they had eradicated the virus. But health officials in southern Sudan said they received more complaints on Sept. 9 of death and sickness among domestic birds including duck but the test results for those cases were not yet ready.

Muraguli said Kenya has set up 11 centers in public hospitals where health workers are carrying out surveillance on patients suffering from flu-like illnesses.

"People should not touch, eat, sell or transport poultry or wild birds found dead. They should instead report such cases to the nearest veterinary or public health office," said Muraguli.

He said all tests carried out showed that there was no bird fly virus in Kenya and urged people to continue eating poultry without fear. He said tests on 560 dead birds were negative.

Chicken is a staple source of protein across rural Africa. Concerns about the spread of avian flu center on watering spots that domestic poultry share with migrating waterfowl.

Kenya banned poultry imports from affected nations in October last year and said it had made arrangements with the World Health Organization for access to anti-viral drug Tamiflu in case of an avian flu outbreak.

Doctors warn against pandemic fear-mongering​

http://www.ctv.ca/servlet/ArticleNe...ndemic_book_061017/20061018?hub=Specials&pr=0

Updated Wed. Oct. 18 2006 7:36 AM ET

Mary Nersessian, CTV.ca News

Two Canadian emergency room physicians are urging against complacency in the wake of an imminent flu pandemic. But at the same time they warn against falling victim to fear-mongering.

"We have heard a variety of misconceptions. The first one that we commonly hear is the apocalyptic scenario in which people are concerned that the sky is going to fall and there will be anarchy in the streets," said Dr. Vincent Lam, co-author of the new book "The Flu Pandemic and You."

"On the flip side, another misconceived view in our opinion is the notion that it is a non-issue and just people making a lot of fuss over nothing. That is also untrue," the Toronto-based emergency room physician told CTV.ca.

Instead, the truth lies somewhere in between, Lam said.

The right response to the prospect of an influenza pandemic is a healthy dose of concern tempered with the knowledge that outbreaks date back to the times of Romans.

"We take some sense of perspective from this big picture of the centuries," said Lam, who was recently shortlisted for the 2006 Giller prize.

"Ultimately, this is part of the life cycle of influenza and human illness. Fortunately ... we have more tools than we have ever had in human history, so if we apply those tools well, we are better positioned historically than we have ever been in the past to respond meaningfully."

The SARS outbreak of 2003, which killed 44 Canadians, has given the health-care community some hints of what to expect.

In some ways, it was an opportunity for health-care workers to experience a new kind of infectious disease outbreak and learn how to respond to it, he said, citing practices that isolate patients with respiratory illnesses and that advocate frequent hand washing.

But the SARS crisis also laid bare a disquieting revelation.

"One of the things we were also able to see quite starkly during SARS is that the Canadian health-care system, while excellent in many respects, is really presently pushed to the limit."

Though the medical community can say with some confidence that an influenza pandemic is imminent, it's impossible to pinpoint the exact timing and origin, Lam said.

"Although there are current valid and legitimate reasons to be concerned about the H5N1 strain of (bird flu), we also can't predict with any certainty whether that strain will actually cause the pandemic."

Health experts fear the H5N1 virus will eventually mutate into a form that spreads easily among people, potentially sparking a global bird flu pandemic.

So far, however, most human cases have been traced to contact with infected birds or their droppings.

When the pandemic wings its way to Canada, experts say it's possible that it will first make an appearance in major urban centres.

"Vancouver and Toronto will arguably be the two cities that will most likely receive the first case of the pandemic flu strain mainly because historically most influenza viruses, including the pandemic strain, have come from Asia," said Dr. Colin Lee, the book's co-author.

"As you know we have large populations who travel between Vancouver and Asia and also between Toronto and Asia. Therefore just looking at the chances of the first case being in Asia and possibly boarding a plane and coming to Canada, it is more than likely going to land in Vancouver and Toronto," said Lee, also an emergency room physician and public health physician.

But he dismissed ominous warnings suggesting chaos will erupt on Canada's streets, prompting urban animal massacres and absentee police officers.

"There is no doubt that at the beginning there will be people who will be afraid but hopefully with the kind of education and preparedness we are undergoing right now, people won't be surprised, like when SARS arrived," he said.

Canada was one of the first countries to develop a pandemic influenza preparedness plan, Lam pointed out.

"So in that respect, we are ahead of many countries, another facet in which we are perhaps more fortunate than other countries is that Canada has a contract with a vaccine supplier," he said.

"In the event of an influenza pandemic, there is a clear understanding that the vaccine supplier will as soon as possible produce vaccinations for Canadians," he said.

But the Public Health Agency of Canada says on its website that it could take 6 to 12 months -- depending on the number of doses required -- to produce enough vaccine to protect all Canadians.

Though the physicians warn against jumping to any conclusions, they recommend putting together an emergency preparedness kit with basic supplies that will include:

* Foods such as rice, lentils, beans, canned meats, high-energy protein bars, dry cereal and fruit, canned juices and bottled water
* Prescribed medications and equipment such as needles for diabetics
* Soap and/or alcohol-based hand sanitizer
* "Comfort" medicines such as acetaminophen, ibuprofen, and Gravol
* Thermometer, multivitamins, contraceptives, oral rehydration fluids
* Soap and detergent for clothes and dishes
* Flashlight, batteries, candles and matches
* Portable radio, which is preferably a wind-up one
* Manual can opener
* Telephones that do not require an electrical outlet
* Surgical or procedure masks and gloves
* First aid kit;
* Cash
* Bicycle
* Warm clothing and blankets

"A kit like this is something that any household will find very useful in a range of emergencies, whether a blackout or ice storm or influenza pandemic," Lam said.

The SARS outbreak prompted health-care professionals not only to rethink their pandemic preparedness strategy, but also inspired soul-searching, he said.

"Before the SARS outbreak we did not factor in to our workplace equation the notion that we might become ill from our patients ... it was not in the forefront of our minds," he said.

What the outbreak really brought home to many of them, he said, was that they were at personal risk simply for doing their job.

"For many of us health-care workers this really prompted a kind of self-examination, and we asked ourselves, why are we doing this and how far are we willing to put ourselves on the line for the good of our patients and society," he said.

"I am honoured to be among the Canadian health workers who are in the vast majority and decided they would continue to go to work, and that they would take precautions and take care of sick people as is our calling," he said.

Glaxo Says Switzerland Orders Flu Vaccine for All​

http://www.bloomberg.com/apps/news?pid=20601085&sid=aatm0mUeDtUs&refer=europe

By Etain Lavelle

Oct. 18 (Bloomberg) -- GlaxoSmithKline Plc said Switzerland became the first country to order enough influenza vaccine to treat its entire population in preparation for a possible pandemic outbreak sparked by bird flu.

The order of 8 million doses of the H5N1 vaccine will be delivered early next year after the Swiss regulator, Swissmedic, approves the application, the London-based drugmaker said today.

Glaxo has submitted a ``mock dossier'' to the regulators in the absence of further data on cross protection, spokeswoman Gwenan White said in a telephone interview today. The vaccine may be filed with European regulators by yearend once the cross- protection data has been submitted, White said.

Europe's largest drugmaker said in June that a low-dose of its H5N1 vaccine protected 80 percent of adults against the avian flu strain. Glaxo's vaccine is made with a new adjuvant, or additive, which helps to boost its effectiveness.

``This is the first major contract that Glaxo has signed for its candidate h5N1 vaccine,'' Andrew Whitty, head of pharmaceuticals in Europe, said in a statement. ``Our vaccine, which has already demonstrated strong immunogenicity at the lowest dose seen with a split cell vaccine, provides an attractive option for Governments currently considering how best to combat the threat of a flu pandemic.''

About 30 companies worldwide, including Paris-based Sanofi- Aventis SA and Novartis AG's Chiron unit, are working on pandemic vaccines and other treatments as world health officials track the spread of H5N1. Earlier this year, Chiron asked European Union regulators to approve a pandemic flu vaccine, following Glaxo's application in December 2005.

Bird flu pandemic 'not if, but when'​

http://www.theage.com.au/news/Natio...not-if-but-when/2006/10/18/1160850990504.html

October 18, 2006 - 6:30PM

Australia has been warned to boost its preparedness for a bird flu outbreak by identifying new strains of the virus as they develop overseas.

Professor Mark von Itzstein, who helped develop the world's first anti-flu drug Relenza, also said it was not a matter of "if" but of "when" Australia would be at the centre of an influenza pandemic.

He said while the nation was "very well placed" in its preparedness plan, it could do better.

"It's quite clear that one of the things that needs to be done is an improvement in surveillance and profiling of influenza virus that emerge every season," Prof von Itzstein said.

"We know that, for example, bird flu's emerge every year out of the Asian region, and that's most likely where the threat will come from.

"Currently what happens in terms of that surveillance is that samples are collected as you could imagine, but they rarely go further than that.

"We do need to do better than that."

Prof von Itzstein, the executive director of Griffith University's Glycomics Institute, said Australia was vulnerable to outbreaks given its proximity to bird flu hot spots such as Vietnam, Indonesia and Cambodia, where new strains of influenza viruses were continuing to emerge.

"Because of our location we are particularly vulnerable to influenza outbreaks, especially from strains that are resistant to existing drugs and to the new emerging strains or mutants of the H5NI avian influenza virus," he said.

He said that the risk of human-to-human transmission was extremely real.

The Glycomics Institute is working closely with similar organisations in Cambodia and Hong Kong to identify new strains as part of a rapid response program.

"That in my view ... will add an enormous amount of information to the emerging viruses and how vulnerable the world will be to these viruses as they come along," Prof von Itzstein said.

"We have already developed compounds to test on emerging influenza strains in Asia, because we need an alternative drug to combat those viruses which have become immune to Tamiflu, which is used around the world to fight influenza."

Prof von Itzstein will present a public lecture on the issue at Griffith University's Gold Coast campus on November 1.

H5N1 Isolation Failures at USDA Raise Pandemic Concerns​

http://www.recombinomics.com/News/10180601/H5N1_USDA_Failures.html

Recombinomics Commentary
October 18, 2006

The USDA National Veterinary Services Laboratories (NVSL) confirmed the presence of H6N2 through virus isolation in a pool of five samples of the 11 samples collected from wild Green-winged Teals in the Rice Lake Conservation Area of Fulton County, Illinois. Initial screening results announced on Sept. 29 indicated that H5 and N1 subtypes might be present in the collected samples, but further testing was necessary to confirm the H and N subtypes as well as pathogenicity.

The failure to isolate the H5N1 in the Green-winged Teal samples from Illinois is cause for concern. This failure may be due in part to pooling of samples, which can lead to an isolation failure because of overgrowth by a serotype not detected in the testing of the pooled samples. A similar failure was reported for Northern pintail samples from Montana. One sample was positive for H5N1, but H5N3 was detected even though sixteen samples were H5 positive. It remains unclear if the H5N3 serotype was from samples that were H5 positive but N1 negative, or was from the H5N1 positive sample. In any even, no isolation of H5N1 in Montana was reported.

The number of isolation failures remains unclear. H5N1 has been isolated in Maryland, Michigan, and Pennsylvania. H5 was detected in a live market in New Jersey, but no mandatory OIE report was filed. Media reports suggested it was not H5N1, but all H5 infected poultry, regardless of N serotype, requires an OIE report. Similarly, media reports indicate H5 has been found in California, Washington State, and possibility Alaska, but addition detail from the USDA have not been announced. Similarly, serotypes other than H5N1 are announced only for H5N1 positive samples. It is unclear what, if anything is isolated from the H5 positive samples.

These isolation failures raise concerns that low levels of HPAI H5N1 could be missed due to pooling of samples, low sensitivity in the isolation procedure, or other technical issues including collection / transport / degradation issues.

Isolation of HPAI H5N1 from health wild birds is rare. Although such isolations have been reported in Russia, the vast majority of H5N1 isolates have come from dead birds or live poultry on farms that have fatal H5N1 infections.

Thus, although isolation of HPAI H5N1 from live wild birds is rare, the above protocol involves pooling samples, lowering the sensitivity of the isolation procedure. Repeated failures to isolate any H5N1 from H5N1 positive samples raise concerns about assurances on the detection of low path H5N1.

The USDA testing cannot exclude mixtures of low path and high path H5N1 in samples that are H5N1 positive.

H5 was detected in a dead gosling on Prince Edward Island. Only one dead goose was tested, but four died suddenly after displaying bird flu symptoms. Low path H5 rarely causes sudden death in waterfowl, although the Qinghai strain of H5N1 is known to kill waterfowl, including thousands of bar headed geese at Qinghai Lake in May, 2005. This strain has been transported and transmitted by long range migratory birds into Europe, the Middle East, and Africa. The H5N1 has been found in flyways that connect to northwestern and northeastern North America. Sequence data from North American H5 isolates have polymorphisms that are predominantly found in Asia. Similarly, North American polymorphisms have been found in the Qinghai stain in Asia.

Recent sequence data from China, shows that recombination is extensive in H5N1 infect poultry and wild birds. These recombination events have moved sequences into Indonesia and have generated swine H5N1 sequences with polymorphisms found in the Qinghai strain of H5N1 as well as H5N1 found in human isolates on Java as well as isolates from the Karo cluster.

Thus far, only four genes of an H5N2 isolate from British Columbia in August, 2005 has been released. This isolate has acquired North American swine sequences, as well as HPAI H5N1 sequences from Asia. These acquisitions indicate dual infections and associated recombination is common in H5 in North America. No other H5 sequences from 2005 isolates in Canada or any 2006 H5 isolates from the United States or Canada have been released. The explosion in the detection of H5 in Canada last year, as well as Canada and the United State this year raises concerns about the evolution of H5 in North America as well as the repeated isolation failures at the USDA.

Experimental Vaccine Protects Mice Against Deadly 1918 Flu Virus​

http://www3.niaid.nih.gov/news/newsreleases/2006/1918vax.htm

Federal scientists have developed a vaccine that protects mice against the killer 1918 influenza virus. They also have created a technique for identifying antibodies that neutralize this virus, a tool that could help contain future pandemic flu strains. These findings are important, the researchers say, to understanding and preventing the recurrence of the H1N1 influenza virus that caused the 1918 pandemic and to protecting against virulent flu strains in the future, including the H5N1 avian flu virus. Details of the research are available online this week in Proceedings of the National Academy of Sciences.

Gary J. Nabel, M.D., Ph.D., director of the Vaccine Research Center (VRC) at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), led the research team in developing the experimental vaccines and conducting the immunological studies in mice. Terrence Tumpey, Ph.D., of the Centers for Disease Control and Prevention (CDC) conducted vaccine studies in mice involving the live, reconstructed 1918 flu virus in a biosafety level 3-enhanced laboratory at the CDC in Atlanta—one of four types of specialized biosafety labs where scientists study contagious and potentially deadly materials under high-level safety and contamination precautions designed to protect the researchers and prevent microorganisms from entering the environment.

“Understanding why this influenza virus was so deadly is an extremely important question,” says NIAID Director Anthony S. Fauci, M.D. “By building upon earlier research where scientists successfully reconstructed the 1918 pandemic flu strain, Dr. Nabel and his colleagues have demonstrated that this virus is vulnerable to intervention. This knowledge will help further our continued efforts to develop treatments and vaccines to protect us against another deadly flu pandemic.”

The 1918-1919 influenza pandemic was the most deadly flu outbreak in modern history, killing 50 million or more people worldwide.

“A key to containing pandemic flu viruses is to understand their vulnerabilities and determine whether they can evade immune recognition,” says Dr. Nabel. “What we learn about the H1N1 virus that caused the 1918 pandemic is pertinent to other pandemic viruses and to the development of effective and universal vaccines.”

Using the genetic sequence information for the 1918 flu virus, Dr. Nabel and his VRC colleagues created plasmids—small strands of DNA designed to express specific characteristics—carrying genes for the virus’ hemagglutinin (HA) protein, the surface protein found in all flu viruses that allows the virus to stick to a cell and cause infection. The researchers created two types of plasmids: one to reflect the HA found in the original 1918 flu virus; the other an altered HA protein designed to attenuate (weaken) the virus.

Mice were then injected with a DNA vaccine containing both types of plasmids to determine whether they would generate immune responses to the 1918 virus. The researchers found significant responses both in terms of production of T-cells, the white blood cells critical in the immune system’s battle against invading viruses, as well as the production of neutralizing antibodies.

To determine the vaccine’s protective effects, the CDC’s Dr. Tumpey intranasally exposed a group of mice to live, reconstructed 1918 virus 14 days after they were immunized with the experimental DNA vaccine. All 10 vaccinated mice survived the challenge with the deadly virus. To explore how the vaccine protected the animals, the researchers first depleted other mice of T-cells; however, this had no effect on the immunity of the vaccinated mice to the 1918 virus. In contrast, the researchers discovered that transferring antibody-rich immunoglobulin (IgG) from immunized mice to non-immunized mice resulted in antibody levels in the animals at levels only slightly lower than those that were immunized. Further, when the animals were exposed to the reconstructed 1918 flu virus, 8 of 10 mice that received antibodies from the immunized mice survived; none of the 10 mice that received IgG from the unvaccinated control group survived.

“By using an existing pandemic flu strain, this research will provide the basis for design of alternative vaccines against influenza viruses with enhanced virulence,” says Dr. Tumpey.

Although the researchers are not discounting the potential role T-cells may have in combating flu viruses, they concluded that in this study, the experimental DNA vaccine protected the mice by stimulating antibodies capable of neutralizing the 1918 flu virus.

“Who would have imagined five years ago that we’d be able to create a vaccine that protects against one of the deadliest forms of influenza the world has ever seen?” adds Dr. Nabel. “It’s because the 1918 flu virus has been reconstructed that we are now able the further understand it. Hopefully, this virus will help us to develop effective vaccine strategies for current pandemic influenza virus threats.”

To evaluate the vaccine’s antibody-inducing capabilities while minimizing exposure of lab personnel to the 1918 flu virus, Dr. Nabel and his VRC colleagues also created artificial viruses, or pseudoviruses, featuring the HA of the 1918 flu virus but stripped of the ability to cause infection. The pseudoviruses were then incubated with antibody-containing blood samples from the mice immunized with the DNA vaccine and those that were not. The researchers found that the antibodies from the immunized mice neutralized the pseudoviruses while the blood samples from the mice that were not immunized had no effect. This method was also effective in identifying neutralizing antibodies to the H5N1 avian flu virus and could be used to screen for monoclonal antibodies that may be used as an antiviral treatment, according to Dr. Nabel.

“This technique would be very useful in defining evolving serotypes of flu viruses like H5N1 to develop immune sera and neutralizing monoclonal antibodies that may help to contain pandemic flu,” says Dr. Nabel.

The study authors indicate that further testing will be needed to determine whether DNA vaccination can confer immune protection in people similar to that seen in the study mice. Additionally, the use of DNA-based vaccines are being explored as a potential strategy for creating vaccines to protect against the H5N1 avian flu virus.

This research activity is part of a broader effort by the Department of Health and Human Services to accelerate the development and production of new technologies for influenza vaccines within the U.S., including a $1 billion investment earlier this year to support the advanced development of cell-based production technologies for influenza vaccines and will help to modernize and strengthen the nation’s influenza vaccine production by creating an alternative to producing influenza vaccines in eggs.

NIAID grantee Adolfo García-Sastre, Ph.D., of the Mount Sinai School of Medicine in New York, also contributed to the study through his work in reconstructing the virus. In addition to Dr. Nabel, other VRC scientists who contributed to the study include: Wing-Pui Kong, Ph.D.; Chantelle Hood; Zhi-yong Yang; Ling Xu; and Chih-Jen Wei.

NIAID is a component of the National Institutes of Health. NIAID supports basic and applied research to prevent, diagnose and treat infectious diseases such as HIV/AIDS and other sexually transmitted infections, influenza, tuberculosis, malaria and illness from potential agents of bioterrorism. NIAID also supports research on basic immunology, transplantation and immune-related disorders, including autoimmune diseases, asthma and allergies.

The National Institutes of Health (NIH)—The Nation's Medical Research Agency—includes 27 Institutes and Centers and is a component of the U. S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov

###
Reference:

WP Kong et al. Protective immunity to lethal challenge of the 1918 pandemic influenza virus by vaccination. Proceedings of the National Academy of Sciences DOI: 10.1073/pnas.0607564103 (2006).

Western Negev: Bird flu back?​

http://www.ynetnews.com/articles/0,7340,L-3316992,00.html



Western Negev: Bird flu back?

Letter sent by sanitation department in southern community to poultry farmers warns against second round of disease

Tzvi Alush
Published: 10.19.06, 11:00

Residents of communities in southern Israel fear that bird flu is back. A letter from the sanitation department of the Eshkol Regional Council to poultry farmers, many of whom were hurt by the March 2006 outbreak of the disease, warns against a second round of bird flu, apparently following information on the nesting of the flu in southern Egypt and the Gaza Strip.

The poultry farmers were asked to prepare for the possibility of a renewed outbreak of the disease and were asked to designate in advance burial locations for the infected birds.

The sanitation department further demanded that the farmers inform the sanitation department of the location of the burial grounds by the end of October.

One of the framers who received the letter said that another outbreak of the bird flu will completely destroy his business.


"Of the two large farms I had with tens of thousands eggs, I was left with one farm that I just reopened," he said.

A Ministry of Agriculture official said that the indication of the existence of the disease in southern Egypt requires the government to take precautionary measures.

EC to pump millions more into avian flu research projects​

http://www.meatinfo.co.uk/articles/...n-flu-research--projects.aspx?categoryid=9045

The European Commission has announced €28.3m will be spent on 17 research projects into avian and pandemic influenza.

The new projects cover human and animal health, and address research needs identified by organisations such as the World Health Organisation, the World Organisation for Animal Health and the Food and Agriculture Organisation.

The €28.3m allocated to these projects comes in addition to €21m already allocated.

Janez Potocnik, European science and research commissioner said: “It is important that the EU is able to target its research programme to meet new needs that arise. We have shown that we are able to do this. The involvement of so many international partners shows that Europe is leading the global fight against avian and pandemic flu.”

The €28.3m is evenly divided between human and animal health projects. Researchers will examine how the flu virus works in humans and will carry out clinical research into vaccine development.

The projects addressing animal health will cover vaccines, better diagnosis and early warning systems, increased knowledge of the avian influenza virus itself, technology transfer to third countries and a network for monitoring migratory birds.

Nine of the research projects involve companies from countries such as Russia, China, Vietnam, Australia, the US, Canada and Croatia, several of which have been directly affected by recent outbreaks of avian influenza.

Stock up to fight flu​

http://www.news.com.au/couriermail/story/0,23739,20611271-3102,00.html

EVERY Queensland household will be urged to stock up on canned food, cereals and dried fruit as well as basic medicines in case of a sudden outbreak of bird flu.
As part of the State Government's new detailed plan to tackle bird flu, to be released today, people will be asked to prepare their homes if they are forced to stay indoors.

Business will be told to put in place strategies to track absenteeism, allow potentially infected people to remain home or be isolated from other workers.

According to the state's Enhancing Queensland's Preparedness plan, a worse-case scenario could see more than one in three people infected, causing 24,154 hospital admissions and 5964 deaths.

The release of the plan follows last week's Exercise Cumpston, a massive simulated bird flu crisis which was played out on Brisbane streets.

The mock outbreak, involving more than 1000 actors, medical and support staff, police, emergency services personal, ambulance officers and government staff, was staged over three days this week.

Premier Peter Beattie said the Government was preparing as best it could for an outbreak of avian flu in Queensland. "All these measures – this week's exercise, the plans, new funding and legislation – make Queensland much better prepared to deal with a pandemic influenza," Mr Beattie said.

"I urge Queenslanders and businesses to familiarise themselves with information and put in place strategies to cope and continue business should a flu pandemic strike."

Mr Beattie said an additional $11.7 million in new money would be spent preparing Queensland, including the purchase of disposable stretchers, enhanced lab testing facilities and protective masks for health and emergency staff.

In the event of an outbreak, Queenslanders will be told to avoid other people where possible and regularly disinfect common surfaces, such as doorknobs and taps.

"If you need to use public transport, it will be sensible to wear a surgical mask or other form of nose and mouth covering," the plan states.

As well as non-perishable food stuffs, people will be told to prepare by buying vitamins, plastic bags, soaps and a thermometer.

Business will be told to identify staff who can work from home and core people required for work, cross train staff and assess the feasibility of bulk purchasing.

The H5N1 avian influenza virus still mostly infects birds, but it has killed 151 people in nine countries.

H5N1 Swine Evolution Via Recombination in China​

http://www.recombinomics.com/News/10190601/H5N1_China_Swine_Evolution.html

Recombinomics Commentary
October 19, 2006

In the past few weeks, the Beijing Genome Institute has released a series of complete H5N1 sequences from poultry, wild birds, and swine in China. Most of the sequences are from isolates collected between 1997 and 2005 in northeastern China. Many sequences were initially deposited at GenBank on February 28, 2005 under the title, “A cohort of AIV H5N1 subtypes isolated from wild aquatic birds and domestic poultry revealed rapid transmission, frequent reassortment, and identifiable recombination events.” Those sequences were made public on February 2, 2006 and had many clear cut examples of recombination.

The current series confirms the earlier sequences and provide a roadmap of recombination events between 1997 and 2005. These sequences define the evolution of H5N1 in China and highlight the critical role of recombination and migratory birds. The sequences trace back to low path isolates in Hong Kong in the late 1970’s and show how H5N1 is evolving since the first reported sequence from a 1996 goose in Guangdong.

Of interest are two H5N1 swine sequences from Guangxi and Henan provinces. These sequence demonstrate the transmission and transport of H5N1 genetic information into the Qinghai strain, which has now been transmitted and transported to most countries in Europe, the Middle East, and Africa. This strain is recombining with wild birds and poultry in China and swine appear to add additional selection and acquisition of mammalian polymorphisms.

The swine sequences can be found in dog, cat, and wild cat isolates from Thailand, as well as human isolates in Thailand, Vietnam, China, and Indonesia. The movement of pieces of genes into Indonesian patients, including those on Java as well North Sumatra (the Karo cluster) is striking, and provides additional insight into the evolution and adaptation of H5N1 in mammals. Some of the swine data is discussed here and here.

The data demonstrates the value in a database of full influenza sequences. These data add considerably to H5N1 evolution in China and the spread to southeast Asia and Indonesia. The data also demonstrate movement of sequences to and from North America.

The data clearly show that H5N1 is evolving vioa recombination in a predictable manner that involves migratory birds, dual infections, and exchange of small and large bits of genetic information via recombination.

The database however, still has a large number of holes. Much of the prior sequences of H5N1 in Hong Kong, China, and southeast Asia are partial sequences, or sequences for one or two of the eight gene segments. The filling in of those holes would create a more robust database. The NIAID has a flu sequencing project which will generate full sequences on all eight gene segments at no charge. The first H5n1 sequences from that project were also released for the first time in the past several weeks. In addition, full sequences from human isolates in Indonesia have been released ad the number of poultry sequences for one of the eight gene segments has also been increased. However, sequences collected in Europe beginning in October of 2005 have been withheld as have H5 sequences collected in Canada. These large sets of withheld data also create large holes in the sequence database.

In addition to withheld data, there are also significant limits on collections. The data from Indonesia indicate the vast majority of poultry H5N1 isolates do not match the human isolates. However, there are no swine or wild bird sequences from Indonesia. There is one cat sequence, which does match the human sequences, and media reports indicate additional cat positives have been found, but none of the sequences have been released.

Similarly, Canada and the United States have now isolated H5 from wild birds in 2005 and 2006, but thus far only 4 of 8 sequences from one H5N2 sample, collected over a year ago in August, 2005 in British Columbia has been released. It has evidence of recombination and acquisition of North American swine H1N1 sequences and Asian H5N1 Qinghai sequences, demonstrating rapid evolution of low path H5 in North America. Full sequences of the recent H5N1 isolates in Canada and the United States would provide information on nthe source and rate of this evolution and provide more information on the false negatives recently announced by the USDA.

The predictable evolution of H5N1 is now abundantly clear, and the release of full sequence data is long overdue.

http://www.news-daily.com/local/local_story_292003334.html


A possible pandemic

Avian Flu could spell disaster if it mutates

By Eric Hudson

ehudson@news-daily.com



Dr. Lisa Eichelberger, dean of Clayton State University’s School of Health Sciences, said a pandemic is certain and the Avian Flu, also known as the bird flu, may be the cause.

“We don’t know if the Avian Flu will be the first pandemic of the 21st Century, but we know there will be a pandemic, we have had one in every other century,” Eichelberger said during a public lecture on the bird flu at the college’s campus in Morrow Wednesday.

She said there have been 256 cases in world where humans have contracted the bird flu. More than 150 of those people died. Eichelberger said there is concern about this virus because it could mutate and infect large numbers.

The Avian Flu remains a very rare disease in people, but concerns health officials nonetheless, because all influenza viruses have the ability to change, according to the Center for Disease Control. The CDC said scientists are concerned the Avian Virus one day could be able to infect humans and spread easily from one person to another.

Eichelberger said the 1918 Spanish Flu, which killed more people than World War I, was also a virus carried by birds and could serve an example of what could happen.

“We prepare for the worst and pray for the best,” said Eichelberger.

She said there are certain precautions residents and businesses can take to prepare for a pandemic.

She suggested residents stay informed, are well stocked with food and medicine, and get a seasonal flu shot.

“Obviously we don’t have a vaccine for the Avian Flu, but the reason we want you to get a flu shot is you are susceptible to the seasonal flu. We want you to stay healthy,” Eichelberger said. “One of the ways for the Avian Flu can mutate to a form that is easily spread to other people is for a person to get both the seasonal flu and Avian Flu at the same time where the viruses could commingle and take on the characteristics of the seasonal flu which is easily spread.”

The Centers for Disease Control said the most cases have occurred in previously healthy children and young adults that had direct contact infected poultry.

Eichelberger said once a person was infected with the Avian Flu, it would likely be three or four days before they realized they were sick. She said the infected person would show symptoms of the seasonal flu and would be contagious before there were any symptoms.

CDC, touting basic flu steps, asks how would you handle outbreak​

http://seattlepi.nwsource.com/health/288387_birdflu12.html

By MARILYNN MARCHIONE
THE ASSOCIATED PRESS

SAN FRANCISCO -- Could you work from home for weeks at a time? How long could you hole up without needing to go to the grocery or drugstore? Would you be willing to wear a face mask and isolate yourself from others?

Harvard researchers are surveying Americans on questions like these as the government wraps up work on a plan to use primitive infection-control measures to deal with a killer flu outbreak until drugs and vaccine become available.

The federal Centers for Disease Control and Prevention is pitching the plan at medical meetings and aims to send it out for review by the end of the year. State and local governments have asked for unusually detailed and specific advice on such matters as closing schools and canceling public events, one CDC official said.

This week, the CDC awarded $5.2 million in grants related to the plan, including research on whether to recommend face masks to the public. The CDC also asked the Institute of Medicine, a group of scientific advisers, to meet on these measures later this month.

"We can't afford to neglect some of the traditional approaches to contagion control because we very well may find ourselves in a situation where that's all we've got for a period of time," said the CDC's quarantine chief, Dr. Marty Cetron.

However, skeptics say parts of the plan amount to wishful thinking with little evidence they would work.

"A lot of these things sound good, but they lack practical application," said Michael Osterholm, a University of Minnesota health expert involved in the planning.

Advising people in big office buildings to avoid elevators and stay 6 feet away from one another is impractical, and people can't stay in their homes for weeks or months without needing insulin and other medications, he noted.

The nationwide survey by the Harvard School of Public Health is an attempt to get a handle on how Americans would follow such advice.

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The bird flu that has ravaged poultry in Asia and killed at least 140 people is "still smoldering" as a human threat, showing no signs yet of morphing into one that spreads easily among people, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

If it does, severe travel restrictions would delay its spread in the U.S. by only a week or two and at extreme cost, the CDC's Dr. David Bell said at a recent meeting of public health and disease experts in San Francisco.

Thermal scanning to try to detect people with fevers during the outbreak of severe acute respiratory syndrome, or SARS, turned up no cases and caused many false alarms. But voluntary quarantine, voluntary isolation of infected people and hygiene measures such as hand-washing, "cough etiquette" and face masks did help and might for flu too, Bell said.

Dr. Frederick Hayden, a University of Virginia virologist currently working on global flu planning for the World Health Organization, agreed. "The classic public health measures did work in SARS," he said. They won't be enough to stop a flu pandemic but could prolong and spread out its impact to prevent hospitals from being swamped and running out of respirators to keep the sickest alive.

Deadly bird flu not forgotten by U.S health officials​

http://www.kentucky.com/mld/kentucky/news/nation/15799776.htm

By Tony Pugh
McClatchy Newspapers

WASHINGTON - Less than a year ago, Americans could barely turn on the television, surf the Internet or pick up a newspaper without finding a doomsday story about deadly avian flu.

By last November, President Bush had asked Congress for $7.1 billion to help develop a vaccine, stockpile antiviral medications and fund state preparations for a possible pandemic.

Now, with the disease still centered in Asia and the failure of migratory birds to spread the illness to Europe and North America, the H5N1 virus has dropped out of the media spotlight. The dearth of coverage has prompted some to think that the threat of a pandemic has passed.

Nothing could be further from the truth, however.

So far this year, a person dies from the disease roughly every four days, compared with about once every nine days last year, according to World Health Organization data. Of the 108 confirmed human cases of bird flu thus far this year, 73 have been fatal. That's up from 97 cases and 42 deaths in all of last year.

"We're as worried now as we ever have been," said Michael Osterholm, the director of the Center for Infectious Disease Research & Policy at the University of Minnesota.

Avian flu currently is transmitted mainly from animal to animal, mostly among birds. People can contract the disease after contact with infected animals and - in isolated cases - infected humans.

The fact that the virus hasn't made its way to U.S. soil is of little comfort to Americans, because it could mutate into a form that spreads easily from person to person, making geographic borders meaningless.

Most bird flu deaths are clustered in Asia, where billions of wild birds, domestic birds and humans live in close contact, increasing the chances of infection.

Indonesia, which is fighting an epidemic of avian flu in poultry, is the world's hotspot. Three deaths just this week upped the nation's number of confirmed human cases so far this year to 53, with 43 deaths.

Earlier this month, the Food and Agriculture Organization of the United Nations announced that tests on infected Indonesian poultry found that the virus wasn't mutating toward a more lethal strain. However, there've been isolated instances of person-to-person transmission in Indonesia. "But not in an explosive way," said Bruce Gellin, the director of the national vaccine program at the U.S. Department of Health and Human Services.

"Still, every one of these cases have to be investigated because you're never sure if this is the one where the virus has changed enough to become readily transmissible among humans," Gellin said.

Health officials were surprised when flocks of migratory birds that had flown south to Africa and then back to Europe last spring didn't carry the H5N1 virus as expected. Neither did birds that wintered in Asia and flew to Alaska last summer to breed. International bird monitors also found no widespread deaths from the virus among migratory birds.

Many experts now think that wild migratory birds are only bit players in the spread of the disease. More likely culprits are humans who clean, feed and house infected domestic birds and those who prepare infected birds and transport them to commercial markets, said Rick Kearney, wildlife program coordinator with the U.S. Geological Survey.

"Migratory birds may contract the disease and continue in their migration, but they clearly don't play a major or single role in spreading the disease," Kearney said.

When birds or other animals in the U.S. are suspected of carrying the deadly virus, trace samples are sent for final confirmation to the National Veterinary Services Laboratories in Ames, Iowa. The facility has found no traces of the deadly H5N1 virus so far.

Six companies are researching a cell-based flu vaccine that could be made available to everyone in the U.S. within six months of a flu outbreak. Each company is planning a U.S. production facility, but construction is years away.

Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, is optimistic that the pace of vaccine science has picked up in the last year. He's particularly heartened by recent data from several studies indicating that vaccinations against one subtype of H5N1 might provide protection against other subtypes.

"That has caught my attention," Fauci said. "Just looking at the baseline lab data, you wouldn't have guessed that."

He cited new research by John Treanor of the University of Rochester in New York, who presented his findings Oct. 13 in Toronto at a meeting of the Infectious Diseases Society of America. Treanor and his colleagues had studied people who'd received two vaccinations against the Hong Kong strain of the H5N1 virus in 1998. Each was vaccinated again this year with a booster shot to fight the strain found in Vietnam. A second test group received only shots for the Vietnam strain in 2005.

Researchers found that more people who'd gotten shots in 1998 and 2006 developed antibodies to fight the Vietnam strain than those in the second test group.

"We need more data, but the concept is rather encouraging because if you give pre-vaccinations with one subtype you actually prepare much better for a vaccination or an exposure to a different subtype," Fauci said.

Health officials also hope to have 26 million courses of the antivirals Tamiflu and Relenza by year's end, and 81 million courses - enough to treat more than 25 percent of the U.S. population - by the end of 2008. Antivirals lessen the effects of the flu. Viruses eventually can develop resistance to widely used antivirals, and that's already occurred in isolated instances with Tamiflu.

Gellin said it was unclear whether the development was clinically significant, but added, "it does raise the issue of the need to look at other antiviral candidates." HHS will issue $200 million in contracts to develop more antivirals. The agency is evaluating proposals, Gellin said.

Bird flu-hit Indonesia to ban city backyard poultry​

http://www.alertnet.org/thenews/newsdesk/JAK227558.htm

By Yoga Rusmana

JAKARTA, Oct 20 (Reuters) - Indonesia, the country with the highest number of bird flu deaths in the world, intends to bar city residents from keeping chickens and other poultry in their backyards, ministers said on Friday.

Indonesia has become a frontline in the battle against the virus that has killed 55 people in the sprawling country, where millions of chickens roam freely in urban residential areas.

Despite the rising human death toll, the government has resisted mass culling of birds, citing the expense and impracticality in the developing country of 220 million people, where the bird flu threat is not seen as a high priority by many.

"There are laws banning poultry in cities in Thailand and Hong Kong. We will also carry that out soon," Indonesian Health Minister Siti Fadilah Supari told reporters without giving a timeline.

"Principally, I think human beings and poultry need to be separated," he added.

Agriculture Minister Anton Apriyantono said a set of legal guidelines were being worked out. "We need law enforcement. We have issued ministerial edicts regulating that poultry in urban areas need to be in cages," he told reporters.

Bird flu has now killed 151 people in nine countries since 2003, according to figures from the World Health Organisation (WHO). Scientists fear the virus could mutate into a form that can be passed easily between people, leading to a possible human pandemic which could kill millions.

However, Indonesia's chief welfare minister Abrizal Bakrie said there were no indications this would happen soon.

"There is no indication leading to a pandemic. There has been no mutation and the spread is still from poultry to humans," he said after ministers met to discuss bird flu developments.

Statement from Sir John Skehel at the
Medical Research Council’s National Institute for Medical Research
and the World Health Organisation.​

http://www.mrc.ac.uk/NewsViewsAndEvents/News/MRC001726

“The genetic and antigenic analyses of viruses recovered from two fatal cases of H5N1 influenza in Turkey have been completed at the WHO International Influenza Centre at the MRC’s National Institute for Medical Research in Mill Hill, London.

These viruses are very closely related to current avian H5N1 viruses in Turkey, and also to those isolated at Qinghai Lake in Western China last year.

The gene sequences of the viruses indicate that they are sensitive to the antivirals Tamiflu and amantadine.

Virus from one of the human cases contains mutations in the receptor binding protein, haemagglutinin. One of these has been observed before in viruses from Hong Kong in 2003 and Vietnam in 2005. Research has indicated that the Hong Kong 2003 viruses preferred to bind to human cell receptors more than to avian receptors and it is expected that the Turkish virus will also have this characteristic”.

For further information, contact the MRC Press Office on 020 7637 6011.

Note to Editors
# 1. 1. The Medical Research Council (MRC) is a national organisation funded by the UK tax-payer. Its business is medical research aimed at improving human health; everyone stands to benefit from the outputs. The research it supports and the scientists it trains meet the needs of the health services, the pharmaceutical and other health-related industries and the academic world. MRC has funded work which has led to some of the most significant discoveries and achievements in medicine in the UK. About half of the MRC’s expenditure of approximately £500 million is invested in its 40 Institutes, Units and Centres. The remaining half goes in the form of grant support and training awards to individuals and teams in universities and medical schools.

Link to new thread:

HEALTH - 10/21-10/27/06 | Weekly Bird Flu Thread:Egypt detects new human H5N1 bird flu case

http://www.timebomb2000.com/vb/showthread.php?t=215856