11/04-11/10/06 | Weekly Bird Flu Thread:Study says new H5N1 strain in southern China

Link to last week's thread:

http://www.timebomb2000.com/vb/showthread.php?t=216744

Johns Hopkins on influenza:

http://www.iom.edu/Object.File/Master/33/450/Rashid Chotani.pdf

National Avian Influenza Surveillance Information:

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

Study says new H5N1 strain pervades southern China​

http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/nov0306China.html

Robert Roos * News Editor

Nov 3, 2006 (CIDRAP News) – A new subtype of H5N1 avian influenza virus has become predominant in southern China over the past year, possibly through its resistance to vaccines used in poultry, and has been found in human H5N1 cases in China, according to researchers from Hong Kong and the United States.

The rise of the "Fujian-like" strain seems to be the cause of increased poultry outbreaks and recent human cases in China, according to the team from the University of Hong Kong and St. Jude's Children's Research Hospital in Memphis. The researchers also found an overall increase of H5N1 infection in live-poultry markets in southern China.

"The predominance of this [Fujian-like] virus appears to be responsible for the increased prevalence of H5N1 in poultry since October 2005 and recent human infection cases in China," says the report, published this week in the Proceedings of the National Academy of Sciences.

But other disease experts said they could see no evidence that the new strain increases the risk of a human influenza pandemic or is more virulent than other H5N1 strains. Meanwhile, Chinese authorities rejected the report, while a World Health Organization official in China renewed previous complaints that the Chinese have been stingy with information about H5N1 in poultry.

Infection rate in market poultry rises
The research team, including Yi Guan of the University of Hong Kong and Robert Webster of St. Jude's, tested more than 53,000 birds from live-poultry markets in six southern Chinese provinces from July 2005 through June 2006. About 2.4% of the birds (1,294 of 53,220) tested positive for the H5N1 virus, more than double the 0.9% positive rate in the preceding 12 months, according to the report.

The researchers analyzed the genomes of 390 (30%) of the 1,294 virus isolates and found that 68% (266 of 390) of them were in the new Fujian-like lineage. The prototype of this lineage was detected in March 2005, and few viruses like it were found in the ensuing few months. But the prevalence of the strain increased dramatically starting in October 2005, until it constituted 103 of 108 isolates tested from April through June of this year.

The team also determined that the hemagglutinin genes of five recent human H5N1 viruses from different Chinese provinces belong to the new strain. In addition, 16 poultry and wild-bird viruses from Hong Kong and two poultry isolates from Laos and Malaysia were of the same type.

To assess the effects of China's poultry vaccination program, the scientists tested serum samples collected from 1,113 market poultry in two provinces between November 2005 and April 2006. Hemagglutination inhibition testing showed that 16% (180) of the samples had antibodies against a 2002 strain of H5N1.

A subset of 76 of the 180 positive samples was then tested for neutralizing antibodies against the Fujian-like strain and two other recent H5N1 strains. Most of the samples had low levels of antibodies against the Fujian-like strain, though they had relatively high levels for the other two strains. The findings suggest that chickens in southern China "are poorly immunized against [Fujian-like viruses in comparison with other sublineages," the report states.

All the analyzed Fujian-like viruses had molecular characteristics that indicated sensitivity to oseltamivir, the first-choice antiviral drug for H5N1 infection. In addition, only six of the viruses had a mutation that confers resistance to amantadine, an older antiviral drug used to treat flu.

The authors contend that their findings show that the spread of the Fujian-like strain "has initiated a new transmission wave in Southeast Asia," comparable with the first wave in the region in early 2004 and the spread of H5N1 to Europe and Africa following China's Qinghai Lake outbreak in the spring of 2005. They say it is to blame for recent poultry outbreaks in Laos, Malaysia, and Thailand and for recent human cases in Thailand.

They also argue that poor results in China's poultry immunization program might have contributed to the rise of the new strain. "Serological studies suggest that H5N1 seroconversion in market poultry is low and that vaccination may have facilitated the selection of the Fujian-like sublineage," they write.

"The predominance of this virus over a large geographical region within a short period directly challenges current disease control measures," the authors conclude.

Experts see no effect on pandemic risk
But the new findings do not signal an increase in the already serious risk of a human flu pandemic, according to Michael T. Osterholm, PhD, MPH, director of the University of Minnesota Center for Infectious Disease Research and Policy, publisher of the CIDRAP Web site.

"The key piece to the situation documented in this paper is that while there is a new strain, there's no evidence that it's more pathogenic or virulent than other existing strains, and there's no evidence that somehow we've selected out for a strain that is more likely to be transmitted to and by birds," Osterholm said.

"At this point, I see no data that support that this will contribute to increasing the risk of a human pandemic or worsening the situation with wild birds and domestic poultry in Asia," he added.

Michael Purdue of the World Health Organization's global influenza program expressed similar views, according to an Oct 30 Bloomberg News report. "We know that strains of flu supplant and replace other subtypes over time," he told Bloomberg. "In terms of human risk, there's nothing to suggest that there's more or less risk than there was before."

Joseph Domenech, chief veterinary officer for the United Nations Food and Agriculture Organization (FAO), said the FAO is checking whether vaccines in China are effective against the Fujian-like strain, according to the Bloomberg story.

Chinese officials reject study
Chinese officials rejected the study this week. The nation's Agriculture Ministry called the researchers' claims "totally different from the real situation," according to a report yesterday by China Daily.

"Gene sequence analysis shows that all the variants of the virus found in southern China share high uniformity, meaning they all belong to the same gene type," the ministry said. "No distinctive change was found in their biological characteristics."

The research report prompted Julie Hall, a WHO official in Beijing, to complain that China has been too reluctant to share H5N1 virus information and samples from poultry, according to news services.

"There's a stark contrast between what we're hearing from the researchers and what the Ministry of Agriculture says," Hall told the Associated Press. "Unless the ministry tells us what's going on and shares viruses on a regular basis, we will be doing diagnostics on strains that are old."

The Agriculture Ministry, in the statement quoted in China Daily, insisted it has been freely sharing virus information and related developments with the world.

Smith GD, Fan XH, Wang J, et al. Emergence and predominance of an H5N1 influenza variant in China. Proc Natl Acad Sci 2006 (published online Oct 30) [Abstract]

Bird flu confusion in China worries WHO ​

http://www.thepeninsulaqatar.com/Di...November2006&file=World_News2006110412042.xml

Web posted at: 11/4/2006 1:20:42
Source ::: AFP

beijing • China’s lack of transparency over its handling of bird flu is making it difficult to determine if the deadly virus is mutating and spreading, a leading World Health Organisation (WHO) official said yesterday.

“The situation in China is quite confusing and there is some conflicting information,” Julie Hall, the WHO’s coordinator of epidemic alert and response in China, said.

“We really don’t know how many strains of bird flu there are in China because we have limited amounts of information shared with us by the Ministry of Agriculture and the virus samples we have asked for have not been shared.”

Hall was speaking after China rejected on Thursday claims by scientists in Hong Kong and the United States that a new strain of the virus — dubbed the “Fujian-like” strain — had emerged and was having an impact in southern China.

China’s Ministry of Agriculture said the findings, contained in a report in an American academic publication, “did not completely conform with facts.”

The ministry said the strain of the bird flu in southern China was consistent with earlier strains.

“The researchers are not saying that a new (strain) of the virus was emerging, they are saying that one particular strain has become dominant,” Hall said, when asked to comment on China’s reaction to the scientists’ report.

Virus are always mutating and changing with every new generation and new strains and substrains are always appearing, but what was crucial was to try to understand which strains were becoming dominant, Hall said.

CHINA: China still reneging on bird flu data​

http://www.asiamedia.ucla.edu/article.asp?parentid=56934

Agriculture Ministry failed to share a new strain of the H5N1 bird flu virus with the World Health Organization

Taipei Times
Friday, November 3, 2006

The WHO said its efforts to track the spread of bird flu have been complicated by the failure of China's Agriculture Ministry to share samples of a newly discovered strain of the virus.

Scientific research released this week said that the new strain, called H5N1 Fujian-like, had spread widely over the past year, being found in almost all poultry outbreaks and some human cases in China, and now becoming prevalent in Hong Kong, Laos, Malaysia and Thailand.

Despite that prevalence, the ministry has not given the WHO any samples of the new strain, said Julie Hall, an infectious disease expert at the WHO's Beijing office.

"There's a stark contrast between what we're hearing from the researchers and what the Ministry of Agriculture says," Hall said. "Unless the ministry tells us what's going on and shares viruses on a regular basis, we will be doing diagnostics on strains that are old."

While new strains of viruses emerge regularly, health experts need to know when one becomes dominant in order to develop methods to detect and fight the disease, Hall said.

The ministry's reluctance has been an ongoing source of aggravation at the WHO. International health experts have repeatedly complained about Chinese foot-dragging in cooperating on investigating emerging diseases like bird flu and the SARS virus.

Telephones at the Agriculture Ministry were not answered on Wednesday and it did not immediately respond to faxed questions.

Some countries are slow to share genetic information or samples of viruses because they fear they will be pushed aside in the global race to produce a lucrative vaccine.

"This is a new disease. Nobody knows how to tackle it, nobody in the world has all the answers," Hall said. "But if they share, then we will all gain from that."

She said the ministry has not shared bird flu virus samples from poultry since 2004, a key impediment in developing diagnostic tools and vaccines.

Released this week, the year-long study by Chinese and US scientists found that, since June last year, one out of every 30 geese and one out of every 30 ducks in live markets tested positive for H5N1 in six southern Chinese provinces.

In that same period, however, the ministry reported only three outbreaks in the same provinces, Hall said.

The study was conducted in Fujian, Guangdong, Guangxi, Guizhou, Yunnan and Hunan -- densely populated provinces where people live in close proximity to ducks, pigs and other farm animals, making the area a common breeding ground for flu viruses.

Out of 108 virus samples taken from infected poultry between April and June of this year, 103, or 95 percent, had the H5N1 Fujian-like strain, according to the results of the study reported in Tuesday's issue of Proceedings of the National Academy of Sciences.

The H5N1 flu has devastated poultry in China and several other Southeast Asian countries and has also claimed more than 150 human lives. Most of the people affected lived close to flocks of chickens or other poultry.

Public health authorities fear that the virus will mutate into a form that can spread easily among people, raising the potential for a worldwide pandemic that could kill millions.

Emergence of a New Sublineage of Avian Influenza Viruses
in Southeast Asia​

http://www.upmc-cbn.org/index.html

By Eric Toner, M.D., and Luciana Borio, M.D., November 3, 2006

In an article in the Proceedings of the National Academies of Science published online on October 30, 2006, G. J. D. Smith and colleagues report on the emergence of a new, previously uncharacterized H5N1 influenza virus sublineage in southern China [1]. A virus from this sublineage was first identified in a specimen from a duck in Fujian province, China, in March, 2005, and hence it is called the Fujian-like (FJ-like or FJ-H5N1) sublineage. Since early 2006, it has rapidly become the predominant H5N1 influenza virus sublineage in southern China and has spread to Hong Kong, Laos, Thailand, and Malaysia. Influenza viruses from the new sublineage have also been implicated in 5 human cases of H5N1 infection in different provinces of China.

Ongoing Surveillance Detects Third Wave of H5N1 Panzootic

The authors have previously reported that, since 2003, avian influenza H5N1 viruses of multiple genetically and antigenically distinct sublineages had become established in poultry in different geographical regions of Southeast Asia [2]. Smith’s new report updates the results of ongoing surveillance of poultry from live-poultry markets in 6 provinces of southern China.

From July 2005 to June 2006, 2.4% of poultry in the markets (mostly domestic ducks and geese) were carriers of H5N1. The overall prevalence had significantly increased from 0.9% the previous year. Of poultry that tested positive, the prevalence of the FJ-H5N1 strains increased from 3% of poultry specimens obtained in the summer of 2005 to 95% in the spring of 2006. Thus, FJ-H5N1 sublineage has replaced those previously established multiple sublineages in different regions of southern China.

The authors believe it is likely that the spread of this new sublineage represents a third wave of the H5N1 panzootic. The first wave occurred in early 2004, primarily in Southeast Asia. The second wave started with the outbreak in migratory waterfowls at Qinghai Lake in the spring of 2005 and spread to Europe and Africa. Now this FJ-like sublineage is replacing the previously predominant H5N1 strains throughout much of southern China.

Reasons for the Emergence and Predominance of the New Strain are Still Unclear

In September 2005, China instituted a compulsory national program to vaccinate all poultry against H5N1 influenza; presumably, all of the poultry tested in this study had been vaccinated. However, a seroprevalence survey of 1,113 chickens from 2 provinces, conducted from November 2005 to April 2006, indicated that only 16% (180) of the birds had detectable HI antibodies (HI titer > 20) against a reference H5N1 virus (Ck/HK/YU22/02). Thus, seroconversion rates are still low.

Of the positive sera, a subset of 76 was randomly selected for a neutralization test. Of those, 55 showed little or no neutralization to the tested FJ-like strain (Dk/FJ/1734/05). The authors state that “chicken in southern China are poorly immunized against FJ-like viruses in comparison with other sublineages,” and speculate that the widespread use of a vaccine that provided immunity to some H5N1 viruses but not FJ-H5N1 created a selective advantage for the FJ- H5N1 sublineage to become predominant. They state that “predominance of FJ-like viruses may be associated with immune escape from the current vaccine strain in poultry.” However, as noted above, only 16% of all the poultry had seroconverted. The paradox of how vaccination could create such selective pressure with such low seroconversion rates is unexplained.

The New Strain of H5N1 is Expected to be Sensitive to Oseltamivir

Molecular characterization of viruses from the FJ-H5N1 sublineage indicated that they are expected to be sensitive to oseltamivir since they had histidine at position 274 of the neuraminidase protein. Most, but not all, seemed to be sensitive to amantadine as well. In addition, molecular characterization revealed no mutations associated with increased affinity for human cell surface receptors, meaning that there is no reason the think that this strain is any more likely to cause human infection than other H5N1 strains.

The World Health Organization’s Reaction

The WHO criticized the Chinese government for not sharing viral samples of the new sublineage. In a press report [3], a WHO employee in China stated, “Unless the ministry tell us what's going on and shares viruses on a regular basis, we will be doing diagnostics on strains that are old." Delays in sharing also make it impossible for manufacturers to access the expected efficacy of vaccine candidates under development.

Conclusions

The emergence of a new H5N1 sublineage and the increase in human infections in 2006 suggest that highly-pathogenic avian influenza viruses have not been effectively contained. H5N1 viruses continue to be panzootic. This new report highlights the inherent difficulty in controlling influenza: The virus mutates in a way that allows it to “escape” vaccine, especially when vaccines are poorly immunogenic or not effective against a broad range of strains.

It is not possible to identify sources of human infection if systematic influenza surveillance in poultry is not undertaken. As the authors of this article conclude, control of this outbreak will likely require a much more extensive surveillance network for both humans and animals in which real-time virological and genetic information is integrated with rapid diagnostic testing and vaccine production.


References

1. Smith GJ, Fan XH, Wang J, et al. Emergence and predominance of an H5N1 influenza variant in China. Proc Natl Acad Sci 2006. Available at http://www.pnas.org/cgi/content/abstract/0608157103v1 ahead of print. Assessed November 2, 2006.
2. Smith GJ, Naipospos TS, Nguyen TD, et al. Evolution and adaptation of H5N1 influenza virus in avian and human hosts in Indonesia and Vietnam. Virology 2006;350:258-68.
3. WHO blasts Chinese government for not sharing samples of new bird flu strain. The Associated Press. November 1, 2006.

Evolution and Spread of Fujian H5N1 In China​

http://www.recombinomics.com/News/11030601/H5N1_Fujian_Spread_Evolution.html

Recombinomics Commentary

November 3, 2006

The authors believe it is likely that the spread of this new sub-lineage represents a third wave of the H5N1 panzootic. The first wave occurred in early 2004, primarily in Southeast Asia. The second wave started with the outbreak in migratory waterfowls at Qinghai Lake in the spring of 2005 and spread to Europe and Africa. Now this FJ-like sub-lineage is replacing the previously predominant H5N1 strains throughout much of southern China.

“Unless the ministry tell us what's going on and shares viruses on a regular basis, we will be doing diagnostics on strains that are old." Delays in sharing also make it impossible for manufacturers to access the expected efficacy of vaccine candidates under development.

The above comments indicate a review of the history and status of the Fujian H5N1 in southern China is in order. The strain is characterized by the novel HA cleavage site LRERRRK_R, which, relative to the most common HA cleavage site in Asia, QRERRRKKR, has changed Q to L and dropped a K. The first isolate with the novel cleavage site, A/duck/Fujian/1734/2005(H5N1) was isolated in April 2005 and deposited at Genbank on June 16, 2005 in association the the July, 2005 publication in Nature. Fujian spread in China was evident in the human sequences from China (A/Anhui/1/2005, A/Anhui/2/2005, A/Guangxi/1/2005), which were first deposited at Genbank on January 20, 2006. All human isolates had the novel cleavage site. Those deposits were also described in a January 6, 2006 report by the Chinese ministry of health. The report included addition human isolates, which all had the novel cleavage site. Similarly, sequences from multiple poultry outbreaks were compared to the prototype isolate and most were over 98-99% homologous, indicating that the H5N1 in China in early 2006 was primarily the Fujian strain.

Additional sequences from Laos and Malaysia, deposited at Los Alamos in March 2006 also had the novel cleavage site as did wild bird isolates from Hong Kong deposited in June, 2006. In August WHO came out with pandemic target recommendations, which included the Fujian strain, which was classified as Clade 2 sub-clade 3.

Thus, although the recent PNAS publication provided data on increasing frequency of detection of the Fujian strain in China, as well as the low antibody titers to the Fujian strain, the presence of the Fujian strain in China has not produced major changes in long range migratory birds carrying the Qinghai strain to Russia, Mongolia, India, Afghanistan, Europe, the Middle East or Africa. Similarly, there has not been an impact on the Indonesian strain of H5N1 in Indonesia.

The sequences of the Fujian strain may impact these strains, but there has been no evidence of the Fujian strain replacing these endemic strains outside of eastern China or Southeast Asia. However, these is evidence of exchange of genetic information via recombination, The missing K in the Fujian cleavage site was first reported in H5N1 from a duck being smuggled from Fujian province to Taiwan. This H5N1 was isolated in December of 2003 and the sequence of all eight gene segments was made public in January 2004. It had many of the genetic features that were subsequently reported throughout eastern Asia in 2004, including human isolates in Vietnam and Thailand.

The Fujian strain also has regions of identity found in 1997 isolates from northern China, which were made public last month by the Beijing Genome Institute, including the 20 amino acid deletion in NA, Additional regions of identity are found in the Qinghai strain as well as the human isolates from Honk Kong patients who became infected while in Fujian province in 2003. Other regions of identity are found in Indonesian isolates. These regions of identity highlight the role of recombination in the generation of these strains, but the data do not indicate the Fujian strain is replacing either the Qinghai strain or the Indonesian strain.

Although the Qinghai strain was isolated in May, 2005 at Qinghai Lake in China, there are no reported isolates of the Qinghai strain in eastern China. The Qinghai strain has a characteristic cleavage site of QGERRRKKR, which was detected in Jiangxi and Hubei provinces, but the Qinghai strain also has PB2 E627K,, which was not in the eastern China isolates. However, virtually all of the H5N1 HPAI isolates to the west of China, as described above were the Qinghai strain.

Thus, the surveillance in eastern and southern China has not picked up the Qinghai strain until 2006, when the first and only isolate was deposited at Genbank in association with the PNAS publication. It is closely related to the Qinghai isolates from Qinghai Lake, but the less common polymorphisms are found in east Asian H5N1 instead of the Qinghai isolates to the west. Thus, there is no evidence that the Fujian strain is replacing the Qinghai strain in southern China because the Qinghai strain has only been detected once in eastern China, and that isolate was from 2006.

Similarly, there is no evidence of the Indonesian strain being replace by either the Qinghai or Fujian strain. On Bali isolate had the Qinghai cleavage site on an Indonesian genetic background, but there have been no H5H1 isolates outside of southern China and southeast Asia that have had the Fujian cleavage site.

Thus, the Fujian strain may be replacing the H5N1 isolate like the 2003 prototype cleavage site lacking the K, or the original Guangdong goose cleavage site as was seen in the Qinghai strain (QGERRRKKR) or the Indonesian strain in humans (QRESRRKKR), but there is little data to support comments that the presence of the Fujian strain in China was withheld (although sequences have been withheld), or that the Fujian strain is replacing the Qinghai strain, which was recently reported in Russia / Mongolia (in and around Tuva), Afghanistan, and Egypt. It is also likely that recent H5N1 outbreaks In Kalmayka. Crimea, and Sudan are also the Qinghai strain based on the positive reports this season from the locations west of China..

Flu's Misery May Lie in the Genes:
Certain DNA could spur worse symptoms​

http://www.cbc.ca/cp/HealthScout/061103/6110312U.html

21:29:35 EST Nov 3, 2006
Canadian Press: AMANDA GARDNER /HEALTHDAY REPORTER

(HealthDay News) - If the flu hits you especially hard this season, blame it on your DNA.

A new study of flu-infected mice found that certain genes spurred a strong immune response in the lungs that led to much more severe illness. Mice that didn't exhibit such an immune response were more likely to recover, the researchers found.

The findings may help humans not only survive the annual flu season but also an avian flu pandemic, should it ever arise.

"The long-term implications would fit into the idea of genetically based preventive medicine," explained co-researcher Dr. Linda Toth, associate dean of research at Southern Illinois University School of Medicine in Springfield. "To know that some people are predisposed to any kind of disease, we would be able to better advise or monitor those people so as to limit their health risk."

This knowledge might also help public health officials allocate precious resources.

"In the case of influenza, viral treatments and vaccine are in limited availability and if we had this kind of information, it could potentially be used to target the resources to those most at risk," Toth said.

She and co-researcher Rita Trammell, an assistant professor of internal medicine at Southern Illinois University School of Medicine, were expected to present the findings Friday at a meeting of the American Physiological Society, in Fort Lauderdale, Fla.

Another expert said the research has implications for the treatment of flu.

"It brings up the question of whether anti-inflammatories have a role in treating a flu with a lot of inflammation," said Dr. Marc Siegel, author of Bird Flu: Everything You Need to Know About the Next Pandemic and clinical associate professor of medicine at New York University School of Medicine in New York City. "It also brings up the question of 'Does genetics allow you to anticipate which group is going to have a more deleterious inflammatory response?' That would be very helpful epidemiologically."

The question of who dies of influenza has been a hot topic since at least the 1918 pandemic, which killed millions of people around the world. At the time, doctors noted that the immune systems of young, robust adults often "overreacted," resulting in a severe and often deadly inflammation of the lungs.

"This has been a long-time concern of scientists since 1918, when the theory was that people drowned in their own secretions," Siegel explained. "The body sees influenza and responds with a strong immunological response, and that response can lead to a lot of secretions."

The 1918 pandemic and the current avian flu - which has so far killed only a small number of humans - have some similarities: Both cause an intense inflammatory and immune response in the lungs of mice and people.

"With the current avian influenza as well as the influenza from the 1918 pandemic, the influenza caused a really enhanced and intense inflammatory and immune response in the lungs which killed the mice," Trammell said. "This was really important in determining why they died. We wanted to look at the background genetics of mice, how they reacted differently."

In their research, Trammell and Toth infected two strains of laboratory mice - called Types "B" and "C" - with an influenza A virus. Past work had shown that about half of the Type B mice would die, compared to about 10 percent of the Type C mice.

When lung tissue from the mice was examined about 30 hours after infection, the authors found that levels of all the pro-inflammatory cytokines (with one exception) were elevated and were much higher in the sensitive mice. This indicates a more severe inflammatory response, the researchers said. Cytokines are proteins that can cause inflammation when an immune response is mounted.

Despite the variation in inflammation, the level of the virus in the rodents' lungs was about the same in both groups.

A second, related study found that levels of immune-related messenger RNA (mRNA) in Type B mice were on average 24 times higher (and sometimes 100 times higher) than in uninfected mice. The mRNA levels in Type C mice increased less than three-fold after infection.

The next step?

"We want to try to identify specific genes or the array of genes that contribute to either the resistance or the severe response to the virus," Toth said. "Right now, we have some ideas, but we haven't nailed that down definitively."

Trammell said that this type of information, "would have enormous implications for understanding and avoiding the fatality associated with influenza virus."

Possible pandemic flu should prompt crisis preparation​

http://www.htrnews.com/apps/pbcs.dll/article?AID=/20061105/MAN03/611050442/1397/MANbusiness

By Charlie Mathews
Herald Times Reporter

MANITOWOC —The Boy Scouts' motto is "Be Prepared," and that was the principal theme of Larry Smith's "Tourism Crisis Management" presentation Thursday at the Holiday Inn, sponsored by the Wisconsin Department of Tourism.

"When businessmen and women think about crises, they think about fires, explosions and strikes, but there are so many other things that can go wrong," said Smith, president of the Louisville, Ky.-based Institute for Crisis Management.

One crisis that may develop, whose origins are totally out of control of tourism and other business sectors, would be a pandemic flu outbreak.

Smith sounded the alarm, but not without justification.

An Oct. 26 news release from the Harvard School of Public Health stated, "Currently, there is no pandemic flu, but health officials are concerned that the H5N1 avian flu which has caused about 250 illnesses and deaths among people in Asia, Africa, and Europe could become a pandemic flu."

A 1918 pandemic flu caused 50 million deaths worldwide, with many of those healthy young adults. The development of global air travel might exacerbate a pandemic, with virus transmission between passengers around the world.

The current Mayo Clinic newsletter spends eight pages describing "Why you should prepare now for bird flu," including the ominous statement, "Because the last pandemic took place in 1968, the thinking is that we're due for another one."

Smith explained why such a health crisis would be important to the tourism industry, in the Lakeshore area and beyond.

"Employees would be too ill to work," Smith said. "Others would stay home in fear. Health care would be strained. Vendors would be unable to deliver. Tourists would be afraid to travel."

Smith urged the approximately 40 in attendance to plan ahead in numerous areas, including:

# "What's the minimum workforce with which you can operate?

# "Where will you find replacements?

# "How long will it take to train them?

# "When vendors face the same sickness and absenteeism, and delivery services are slowed, what will you do?

# "Will you pay staff if you halt operations?

# "What and how will you communicate with employees, vendors, tourists and guests?"

"I was impressed with the importance of knowing about a possible pandemic," said Sandra Weidling, of Sam's Fine Foods and Spirits in Valders. "There are more crises than just terrorism and earthquakes and floods."

Doug Day, owner of a Two Rivers-based public relations agency, said, "It's not that hard to prepare for a crisis and doesn't take a great, big plan. It is a matter of thinking ahead and identifying those risks that may be linked to your industry.

"Hardly anyone ever wakes up saying, 'I'm going to have a crisis today,'" Day said. "So, you have to be prepared whether it's a snow storm, or related to the economy. Being prepared is the key."

H5N1 Fujian Qinghai Recombinant in Romania​

http://www.recombinomics.com/News/11040601/H5N1_Fujian_Qinghai_Romania.html

Recombinomics Commentary

November 4, 2006

Romania has released a partial sequence of a duck isolate from 2005, A/duck/Romania/2005(H5N1). Like the vast majority of HA sequences from H5N1 in Europe in 2005 and 2006, it has the common cleavage site of GERRRKKR. However, the first 60 BP do not match any other Qinghai isolate, but does match 2005 and 2006 Fujian bird isolates from a number of provinces in China as well as Fujian isolates outside of mainland China. These sequence are also found in the human isolates from China, again show recombination between Qinghai and Fujian sequences.

The number of sequences released from H5N1 isolates in Europe has been limited, by phylogenetic trees of the isolates sent to Weybridge indicate they are all the Qinghai strain. However, a number of isolates from Romania for a separate branch and it seems likely that the newly released sequence falls on this branch (see tree). Although many of the samples were collected in 2005 and early 2006, Weybridge continues to hoard the sequences. Thus far, from 80 sequences on the tree, only one has been released.

Recently WHO has complained about China hoarding sequences. However, WHO maintains a private database at Los Alamos which are password protected. In August the government of Indonesia requested that the sequences from Indonesian patients be released, and the sequences were available at Los Alamos as soon as the password protection was removed.

The sequences released by Weybridge (one turkey and five patients) were released by simply removing the password protection. Clearly, the sequences currently be hoarded could just as easily be released. The Fujian / Qinghai recombinant released from Romania was the second sequence from Romania. Recently sequences from Slovenia and Slovakia were released. Previously, sequences from Italy, France, Germany, Denmark, Czech Republic and Croatia were released, so it seems that the European sequence hoarded by Weybridge are being password protected at the WHO database solely for publication reasons.

Similarly, the China sequences released by Hong Kong / St Jude in association with this weeks PNAS paper included 404 HA sequences. However, only 152 PB2 sequences were released and no sequences were released for the other 6 gene segments even though the MP sequences had to have been generated to describe which sequences were and were not sensitive to Amantadine.

Thus, although China should release full sequence for bird and human H5N1 from 2005 and 2006, the complaint by WHO lacks validation because it is hoarding more sequences than China.

The time for release of the hoarded sequences, and completion of the partial sequences already released is long past due. WHO and China should released the hoarded sequences immediately, which in many instances involves a simple removal of the password protection on the WHO private H5N1 database.

Chinese scientists reject claims of new bird flu strain​

http://www.channelnewsasia.com/stories/health/view/239671/1/.html

Posted: 06 November 2006 1710 hrs

BEIJING: China published a report on Monday rejecting claims by US and Hong Kong scientists that a new strain of the bird flu virus had emerged in the south of the country and branding the study "unscientific".

The so-called "Fujian-strain" of the virus - named after a province in southeast China, where it is believed to have originated - could create a new wave of bird flu outbreaks, the US and Hong Kong scientists have warned.

Their research, published in the US-based Proceedings of the National Academy of Sciences, said the Fujian strain may have been unwittingly created by the program to vaccinate all poultry in China and that it may be resistant to current vaccines.

The Fujian strain was now the primary variant of the fast-changing virus throughout Asia, and was quickly replacing strains that had emerged in Hong Kong and Vietnam, according to their research.

China's agriculture ministry issued a brief statement last week rejecting the claims but Monday's report, carried by the official Xinhua news agency, offered a more detailed response.

"The so-called 'Fujian-like virus' is not a new variant of the virus," the director of the National Bird Flu Reference Laboratory at the Chinese Academy of Agricultural Sciences, Chen Hualan, said in the report.

"Gene sequence analysis of the virus shows that it shares high conformity with the H5N1 virus that was isolated in Hunan (province) when bird flu broke out in early 2004."

Chen said in 2005 and this year, the laboratory had isolated some viruses in waterfowl in southern China, and that was reported to the Food and Agriculture Organisation and the World Organisation for Animal Health.

"These viruses all remain steady in gene type and there is no marked change in their biological characteristics," she said.

Chen said the US and Hong Kong scientists' research "lacks scientific proof". - AFP/ra

Chinese scientists identify deadly gene in H5N1​

http://today.reuters.co.uk/news/CrisesArticle.aspx?storyId=HKG277591&WTmodLoc=World-R5-Alertnet-4

Mon 6 Nov 2006 9:56:09 GMT

HONG KONG, Nov 6 (Reuters) - Chinese scientists have identified a gene in the H5N1 bird flu virus which they say is responsible for its virulence in poultry, opening the way for new vaccines.

There are many different strains of H5N1, some of which kill more than half the people they infect, while others do little or no harm.

"We can now understand how this virus becomes lethal and the molecular basis for its pathogenicity," Bu Zhigao at the Harbin Veterinary Research Institute told Reuters.

The Chinese researchers zeroed in on the virulent gene after analysing two closely related strains of the H5N1 obtained from infected geese in southern Guangdong province in 1996 -- one highly pathogenic in chickens and the other harmless.

Differences between the two strains were located in four genes, they found.

The scientists designed four genetically modified viruses each containing one of the four genes in question and tested them on laboratory chickens.

Only chickens infected with the modified virus containing the highly pathogenic gene died. The other chickens had no signs of disease, the scientists wrote in the November issue of the Journal of Virology.

"Now that we know the special role of the (highly pathogenic) NS1 gene, we can think about developing a vaccine," Bu said, adding that a vaccine which neutralises the gene known as NS1 could be quickly designed.

"Technically, that can happen very soon, but it is the tests and other procedures that will take a long time."

The scientists are from the Ministry of Agriculture's Animal Influenza Laboratory, the National Key Laboratory of Veterinary Biotechnology, Chinese Academy of Agricultural Sciences, and the Harbin Veterinary Research Institute.

H5N1 remains largely a disease in birds although it has killed over 150 people, mostly in Asia, since 2003. Experts fear that it can spark a pandemic and kill millions of people if it begins to transmit efficiently among humans.

H5N1 Sequence Hoarding By The WHO and China​

http://www.recombinomics.com/News/11050601/H5N1_Hoarding_WHO_China.html

Recombinomics Commentary

November 5, 2006

Virus are always mutating and changing with every new generation and new strains and substrains are always appearing, but what was crucial was to try to understand which strains were becoming dominant, Hall said.

A dominant strain of the bird flu virus could be an indication that it was becoming resistant to vaccines given to poultry. China vaccinated up to 8.2 billion poultry from January to September this year.

"Right now, there is not enough data to make a firm conclusion... but this is what the data is indicating," Hall said.

The WHO would like to see the "hundreds, if not thousands of (bird flu) gene sequences" uploaded by the Ministry of Agriculture on a public data base, she said.

The above comments by the WHO are ironic, since WHO likely has more sequences in its password protected private database than China has withheld. In August, Indonesia asked WHO to release over 700 sequences form human H5N1 isolates, which were password protected on WHO’s private H5N1 database at Los Alamos. These sequences became public instantly when the password protection was removed.

However, the number of sequences that have been withheld by WHO dwarfs these numbers or the numbers mentioned in the quote above regarding sequences in China. The comments above were precipitated by the recently published PNAS paper which has HA and PB2 sequences from 405 isolates collected in China in 2005 and 2006. Since each isolate has eight gene segments, these isolates contained 3240 sequences. However, only 556 sequences were released.

Thus, from this 2005/2006 series alone, 2684 sequences were withheld. Released sequences included 404 full or partial sequences from HA and 152 full sequences from PB2. No sequences were released for six of the eight gene segments, even though amantadine sensitivity of the M2 gene product was discussed in the published paper. Peer review journals generally require desposit of sequences discussed so the data can be independently verified.. Moreover, only a subset of the PB2 sequences were released, and most of the HA sequences were partial sequences.

Similarly, earlier H5N1 sequences from the two labs who generated the above sequences, St Jude and Hong Kong University, have only released partial sequences of H5N1 isolates from Hong Kong, China, and Vietnam, even though these sequences have been published and some date back to 2000.

Remarkably, full sequences can be generated at no cost under the NIAID flu sequencing program, and St Jude has sequenced low path bird and human isolates under that program, but they have not completed any of the published H5N1 sequences under the NIAID program.

The influenza sequencing project, which recently complete full H5N1 sequences on samples submitted by the Capua lab (172 sequences have been released and 40 more are in the validation stage), requires publication of the data in a public database, as requested by WHO.

Most of the samples from the Capua lab were from Qinghai isolates collected in 2006 from countries that sent samples for confirmation by an outside lab. Many countries in Europe sent samples to the WHO affiliated lab in Weybridge. These sequences were placed in the WHO database, but only 8 sequences from one turkey have been released, in addition to 40 human sequences. Data presented at the WHO sponsored meeting in Italy however, discussed over 700 samples from Europe that were H5N1 positive, including the 80 isolates listed on phylogenetic trees. Thus, over 600 European H5N1 sequences have been hoarded and restricted from public access by the WHO database at Los Alamos.

Recently, over 300 sequences from H5N1 in China were released by the Beijing Genome Institute. These releases were from H5N1 isolates from poultry, wild birds, and swine in northern China collected between 1997 and 2004. Clearly, similar full sequences from all eight gene segments from birds from 2005 and 2006 would compliment the sequences that are public, as well as the sequences sequestered in the WHO private database. Moreover, H5N1 sequences from fatal infections in China in 2005 and 2006 have been released, but full sequences are lacking in these isolates as well as additional human and bird isolates described in Chinese Ministry Of Health report from the beginning of this year.

The released sequences contain clear evidence of transmission and tranportaion of H5N1 over a wide geographical region within China and to locations as far away as Europe and Africa. These are also regions of Asian genes in North American isolates, highlighting the role of recombination in the evolution of H5N1 worldwide.

The time for release of the sequences held in China, as well as the WHO private database, is long overdue. WHO should start by releasing the sequences it is hoarding and encourage its consultants to finish the sequences from published isolates and make those data public as soon as possible, which can be done in weeks through the free NIAID influenza sequencing project.

U.S. approves firefighting foam to fight bird flu outbreak​

http://www.theglobeandmail.com/serv...dflu1106/BNStory/specialScienceandHealth/home



Associated Press

Washington — The U.S. government has approved the use of firefighting foam to quickly kill chickens if there is an outbreak of deadly bird flu in commercial poultry.

The Agriculture Department says water-based foam can be an alternative to carbon dioxide, which has traditionally been used to quickly kill large quantities of birds.

Gassing involves more workers and exposes them to potentially infected birds, and it can be difficult to maintain a high enough concentration of gas to kill the bird, according to the department's Animal and Plant Health Inspection Service.

Foam can be used to suffocate floor-reared flocks — chickens and turkeys raised primarily for meat — to contain deadly bird flu, APHIS spokeswoman Karen Eggert said. Foam can also be used in outbreaks of rapidly spreading disease, such as Exotic Newcastle, when state or federal officials deem it necessary.

And it can be used when birds are in structurally unsound buildings, such as a building damaged by a hurricane or other natural disaster, she said.

Animal health officials in North Carolina and Delaware researched use of the foam to kill chickens quickly.

“Whenever you have a new solution to an old problem, it's probably because the old solution had a number of shortcomings or was not idea,” said Marty Zaluski, North Carolina Agriculture Department veterinarian.

“Using gas was not safe for people, it was more intensive as far as personnel and it was not as humane for the animals,” Mr. Zaluski said.

Toggle Text From Indonesian:

SUSPECT FLU BURUNG ASAL BANJARNEGARA MENINGGAL
[Banjarnegara: patient suspect bird flu died (Central Java) ]​

http://www.metrotvnews.com/berita.asp?id=27481

Metrotvnews.com, Banjarnegara: Other the patient suspect bird flu died.

This time casualties were named Juanto, villagers Kalimindi, Purworejo Klampok, Banjarnegara, East Java.

This man died when being treated in Margono Sukarjo space of the isolation of the regional Public Hospital, Purwokerto, East Java.

Beforehand casualties were the reconciliation patient from the Hospital of Emmanuel Banjarnegara.

After being ascertained died, the Juanto body then was wrapped and put into the coffin by the official RS Margono.

According to casualties's family, Juanto could experience the high fever was accompanied by coughs since the week set.

Now the RS Margono Sukarjo side decisive, if being seen from his clinical sign, positive casualties were attacked by the bird flu virus.

Juanto became the patient suspect sixth bird flu that came from Banjarnegara and second casualties that died.

Below:
The Juanto body, villagers Kalimindi, Purworejo Klampok, Banjarnegara.
(Metro the TV)

H5N1 Fujian Cleavage Site Evolution​

http://www.recombinomics.com/News/11060601/H5N1_Fujian_Cleavage.html

Recombinomics Commentary

November 6, 2006

But Chen Hualan, director of China's National Bird Flu Reference Laboratory, said they "lack scientific proof" and that her lab hasn't found one strain to be more prevalent than the others.

"The so-called 'Fujian-like virus' is not a new variant of the virus," Chen was quoted as saying by the China Daily newspaper.

"Gene sequence analysis of the virus shows that it shares high conformity with the H5N1 virus that was isolated in Hunan when bird flu broke out in early 2004," said Chen, whose lab does isolation and gene sequence analysis on samples from every domestic bird flu outbreak.

The above comments highlight differing views between researchers in mainland China and Hong Kong on the evolution and significance of the Fujian strain of H5N1 in China. Some of this disagreement may be related to the definition of the Fujian strain. The first H5N1 isolated if Asia was from a goose in Guangdong in 1996. It had an HA cleavage site of QRERRRKKR. Subsequently, various stains of H5N1 have emerged and they can be grouped by changes in the HA cleavage site, which are associated with additional changes throughout all eight gene segments.

Last weeks PNAS paper added 404 HA sequences to the database, which allows for easy tracing of the HA cleavage site. The Fujian strain has two changes. The first change involved the loss of one K, producing a cleavage site of QRERRRK_R. This cleavage site was first reported in late 2003 in a duck in Taiwan that was being smuggled from Fujian province, A/duck/China/E319-2/03, as well as a duck in Hunan, A/Dk/HN/5806/2003. Thus, as noted above, the missing K was detected in 2003. Moreover, the missing K can also be found in a 1998 H7N1 isolate from a peregrine Falcon in the United Arab Emirates, A/peregrine falcon/U.A.E./188/234/98. The list of H5N1 isolates with the missing K can be seen here. In addition to southern China, isolates in Indonesia in 2004 and Vietnam in 2005 were also found.

However, in the spring of 2005, a duck that had the missing K and the Q-->L change was also found. The list of isolates with both changes is found here. The motif with the two changes spread rapidly throughout southern China, and included wild bird isolates in Hong Kong as well as isolates from Laos and Malaysia. Moreover, all human isolates from China in 2005 and 2006 had this change as did additional 2006 human isolates described in a report by China's Ministry Of Health.

These Fujian isolates have regions of identity with the Qinghai strain and highlight the evolution of H5N1 via recombination. The HA cleavage site with just the dropped K was found in Indonesia H5N1 which was on an Indonesian genetic background, which was also seen in the 3' half of the cleavage site which was also detected on an H7 genetic background. Similarly, one of the Indonesian isolates also had a Qinghai cleavage site on an Indonesian background.

However, it is recombination in wild birds between Qinghai and Fujian sequences that is driving the emergence of the new strain in China. Fujian sequences have also been detected in a Qinghai isolate in Romania, further highlighting the evolution of H5N1 via recombination.

H5N1 in New York​

http://www.recombinomics.com/News/11060602/H5N1_NY.html

The United States Department of Agriculture (USDA) National Veterinary Services Laboratories (NVSL) confirmed the presence of LPAI H5N1 from 2 of 27 mallard ducks collected from the Tonawanda Wildlife Management Area in Niagara County on Oct. 21

To date, New York has collected more than 845 wild bird samples for testing. No other LPAI detections have been found.

The above comments describe detection of H5N1 in mallards in Niagara County in New York. Since the announcement by the USDA on the halt of press releases on initial detections of H5N1, the number if locations reporting H5N1 has increased significantly. H5N1 in mallards have recently be reported for three locations in Grundy county, Illinois and St Clair Michigan. H5N1 has also been reported in Green winged teal Tuscola County, Michigan.

The recent frequent and widespread detection of H5N1 is cause for concern. The USDA table only includes samples that have tested positive for both H5 and N1. Media reports describe additional samples that are H5 positive. Although all H5 report thus far has been positive for low path North American H5, these isolates can add to the genetic diversity of HPAI H5N1 via homologous recombination. Moreover the H5N1 low path can mask low levels of Qinghai H5N1, which is frequently found in dead wild birds, but is rarely =detected in live wild birds.

The H5 detected in a dead goose on Prince Edward Island raises sifgnificant concern about the Qinghai strain in North America, and the frequent detection of low path H5N1 increases the likelihood of recombination.

These sequences of these low path H5 isolates should be released

New book on Avian Influenza HPAI H5N1 and more:

http://www.birdflubook.org/

Another Indonesian villager dies of bird flu-like symptoms​

http://english.peopledaily.com.cn/200611/07/eng20061107_319034.html

A 17-year old resident of Kalimandi village in Banjarnegara, in Indonesia's Central Java province, died of a disease suspected of bird flu Monday morning.

The results of tests conducted on Juwanto's blood had shown that there was reason to believe he was suffering from bird flu, Hartono, director of the local Margono Soekarjo Hospital said. Juwanto was previously a patient of Immanuel Hospital in Banjarnegara.

"We are now still waiting for the results of a test on samples of Juwanto's blood by the Health Ministry in Jakarta," Antara news agency quoted Hartono as saying.

He said Juwanto was immediately put in an isolation ward after being admitted to Margono Soekarjo Hospital on Sunday evening as he was in a very weak condition.

Juwanto was showing symptoms associated with bird flu such as high fever, breathing problems and coughing when he entered the hospital.

His parents meanwhile said that Juwanto started developing the symptoms on Wednesday after being treated at Immanuel Hospital for a week. "We did not believe that he had contracted bird flu. Initially, we thought he was only suffering from a lung infection, " they said.

Mistinem, 32, a resident of Kaliurip village, also in Banjarnegara district, died of bird flu last Oct. 13. She died after being treated for 12 hours at the Margono Soekarjo Hospital. She had been ill since Oct. 8.

JPD said:

H5N1 in New York​

http://www.recombinomics.com/News/11060602/H5N1_NY.html

The United States Department of Agriculture (USDA) National Veterinary Services Laboratories (NVSL) confirmed the presence of LPAI H5N1 from 2 of 27 mallard ducks collected from the Tonawanda Wildlife Management Area in Niagara County on Oct. 21

To date, New York has collected more than 845 wild bird samples for testing. No other LPAI detections have been found.

The above comments describe detection of H5N1 in mallards in Niagara County in New York. Since the announcement by the USDA on the halt of press releases on initial detections of H5N1, the number if locations reporting H5N1 has increased significantly. H5N1 in mallards have recently be reported for three locations in Grundy county, Illinois and St Clair Michigan. H5N1 has also been reported in Green winged teal Tuscola County, Michigan.

The recent frequent and widespread detection of H5N1 is cause for concern. The USDA table only includes samples that have tested positive for both H5 and N1. Media reports describe additional samples that are H5 positive. Although all H5 report thus far has been positive for low path North American H5, these isolates can add to the genetic diversity of HPAI H5N1 via homologous recombination. Moreover the H5N1 low path can mask low levels of Qinghai H5N1, which is frequently found in dead wild birds, but is rarely =detected in live wild birds.

The H5 detected in a dead goose on Prince Edward Island raises sifgnificant concern about the Qinghai strain in North America, and the frequent detection of low path H5N1 increases the likelihood of recombination.

These sequences of these low path H5 isolates should be released

Click to expand...

Okay, I need someone to explain this to me. Isn't this saying that the deadly birdflu is in New York? Or am I reading this right?

I am still looking for the URL for this. It is a cross post from a post at Free Republic.


Bird flu business plan now a must
06Nov06

THERE are business plans and there are plans to save your business.

If the bird flu virus gets to Australia, the Gold Coast and the rest of South East Queensland are likely to be in the front line.

Our proximity to the biggest risk area, Asia, and our international airports put us at particular risk.

Experts believe that if a bird flu pandemic struck, more than half the workforce would die, with the 20-to-45 age group likely to be the most susceptible.

While many busi nesses had plans in event of an outbreak, they needed to ensure these were not made in isolation, said Brisbane corporate health specialist Toby Ford.

As well as considering how to manage their own surviving staff, they needed to think wider afield.

"You might think 10 of your workers aren't coming to work tomorrow and some of them might not even live, and that's going to threaten your financial viability," he said.

"But it's not only your workforce.

"Your IT support company might be just as hard hit and you have to consider how you are going to cope with that."

And not only other suppliers. Businesses should also ensure their pandemic plans linked in with local, state and federal government ones.

The Commonwealth Government would drive any response and could enact new legislation.

"The quality of information also becomes important," he said.

"There's a ton of information out there for businesses and much of it changes daily.

"That IT supplier needs to have been contacted and know what you're doing so they can work that in with what they are doing."

Potential treatments were 'not very sophisticated' and authorities would be careful not to release until absolutely necessary key drugs capable of blocking its spread.

"The challenge will then be who will then get this medication, when, and how will they use it," said Dr Ford.

But before any virus got here, businesses could still put simple prevention measures in place, such as ensuring employees knew to wash their hands, keep cups clean and not cough at other people.

Links to useful pandemic planning sites can be accessed through

Seabird said:

Okay, I need someone to explain this to me. Isn't this saying that the deadly birdflu is in New York? Or am I reading this right?

Click to expand...

It is LPAI, low pathogenic avian influenza not HPAI, Highly pathogenic avian influenza A. Still H5N1 but supposedly not a threat to humans.

JPD said:

It is LPAI, low pathogenic avian influenza not HPAI, Highly pathogenic avian influenza A. Still H5N1 but supposedly not a threat to humans.

Click to expand...

Thank you, JPD! I thought I was going to have to panic there for a moment. I realize this is probably going to be an issue eventually, but no matter what preparations you do, it's still a shock.


Thanks again!
Seabird

Seabird,

The LPAI H5N1 in the USA is evolving rapidly.

It can become HPAI on its own overtime or in combination with other viuses in a mutual host. The above article is cause for immediate concern.

Do a search of Tb2K archives on LPAI H5N1 evolution and you will see that JPD and others have posted many articles stating the LPAI version can become the HPAI version on short notice.



'

Three million body bags may be stockpiled in disaster plans​

Last Updated: 1:17am GMT 06/11/2006



Secret plans to stockpile millions of body bags to be used in the event of a flu pandemic, terrorist attack or other disaster are being considered by the Government and health experts, according to a senior minister.

The proposals reflect mounting concern at the lack of space to store bodies in morgues and bury them in the event of mass deaths.

A senior member of the Government involved in policy planning for a flu pandemic told The Daily Telegraph that "various scenarios" involving hundreds of thousands of deaths had been outlined to ministers by health advisers.

advertisementIt is understood that local councils and health authorities are also involved in discussions about how to minimise the spread of infection. Sources said that a major concern was that a flu pandemic could coincide with another disaster, putting intolerable pressure on resources.

One idea was to order around three million body bags to be kept at hospitals or by local authorities to ensure that the spread of viruses and infection could be reduced, said the minister.

"Ordering body bags is one of the measures that we could go for. It has been put to us. This is the dominant public health worry of the moment," he said.

A Home Office insider added: "I am sure it would have been discussed. You have to keep bodies safely if there are not enough places to bury or store them."


http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2006/11/06/nbody06.xml

US citizens in HK told to stockpile for bird flu outbreak ​

http://www.mb.com.ph/MAIN2006110779051.html

Hong Kong (dpa) - US citizens in Hong Kong have been advised to build a three-month stockpile of food, medicine and water in their homes in case of a bird flu pandemic, a news report said Tuesday.

An advisory has been sent out to all 60,000 registered US citizens in the former British colony urging them to prepare the stockpiles ahead of the coming winter flu season.

It suggests stockpiling 4.5 litres of water per person per day and to prepare water purification equipment in case of ''complete infrastructure breakdown,'' the South China Morning Post reported.

The advisory also suggests they stock up on non-perishable foods, soap, alcohol-based hand wash, medicines, vitamins, flashlights and a portable radio, the newspaper said.

Six people died and 12 others were infected in the first modern outbreak of bird flu to jump the species barrier and attack humans in Hong Kong in 1997.

Since then, however, the city of 6.8 million has built up sophisticated safeguards against the virus and avoided further human cases despite a spate of regional outbreaks.

Hong Kong has carried out mass culls of birds and ducks when cases have been detected among poultry and birds imported from mainland China are screened for the virus.

Scientists believe bird flu may cause deaths on a global scale greater than the Spanish Flu of 1918 which killed up to 40 million if the virus mutates to jump from human to human.

Killer pandemic 'going to happen"​

http://www.torontosun.com/News/World/2006/11/07/2264961-sun.html

World must prepare for the worst, expert warns

By KEVIN CONNOR, TORONTO SUN

Bird flu may no longer make huge headlines but a killer pandemic is on the way and the world has to be prepared for the worst, an expert told a health conference yesterday.

Today, the H5N1 virus isn't readily transmitted to humans, Dr. Michael Osterholm, director at the Centre for Infectious Disease Research and Policy, told the Ontario Hospital Association conference.

"We have to worry about the next one that can make the jump (to humans)," Osterholm said.

"We don't know when or how bad the mortality will be, but a pandemic influenza is going to happen and it's going to be tough," he said.

1 BILLION COULD DIE

"I can't say what strain it will be, but I wouldn't bet my family's life that it won't be H5N1," Osterholm said.

Some experts predict the next pandemic could kill more than one billion people. The current influenza technology represents technology from the 1950s and the results are disappointing, Osterholm said.

If the fight is against a new influenza strain, a vaccine wouldn't be ready for six months and then it would be limited for the duration of the outbreak, he said.

"We don't know which will emerge as the pandemic strain," Osterholm said.

An outbreak won't be anything like a natural disaster such as Hurricane Katrina, where other areas can send relief.

'IN THE SAME SOUP'

"We will all be in the same soup "... no military troops will come in to help," he said.

To do nothing to battle the next pandemic is unacceptable, but to promise protection against an outbreak is irresponsible, Osterholm said.

Are we ready for pandemic flu?​

http://news.bbc.co.uk/2/hi/uk_news/6123156.stm

How will the world cope if the H5N1 bird flu virus mutates and a humanised strain materialises?

Many scientists believe this is an almost certain event. It is not if, it is when. Are we prepared? Who will be saved? Is this a 21st Century plague?

In a 90-minute docu-drama, BBC Two's Horizon programme paints an apocalyptic vision of the future, portraying the horror of a modern-day influenza pandemic in terrifying detail.

The film reveals the latest developments in flu research and reveals the US government is asking its citizens to stockpile medicines and food in preparation for an outbreak.

The British government's Influenza Pandemic Contingency Plan paints a scenario of up to three quarters of a million British deaths. The US is predicting close to two million fatalities.

Horizon tells the story of how a pandemic could unfold.

Cities silent

It predicts hospitals and emergency services will be overwhelmed, with insufficient capacity to dispose of the bodies of those who die.

The world's once busy cities will lie eerily silent. A quarter of the workforce will be absent. Public transport will all but disappear, schools will close and public gatherings will be banned.

This vision is not science fiction. It is based on the latest scientific research, which forms the basis for government policy across the globe. Contingency plans for pandemic flu predict millions of deaths, economic meltdown and society in chaos.

The public perception is that only the elderly and weakest members of society die from influenza. But a devastating flu pandemic may target people in the prime of life - the 20 to 40 age range.

Prof Peter Dunnill

If a virus does arrive, it will take five to six months to produce a working vaccine.

Professor Peter Dunnill, of University College London, says: "The amount of pandemic vaccine that we produce globally is quite small.

"We can only vaccinate about 600 million people from every six months of global production. To put that in perspective, that's about 9% of the global population."

At present, government plans talk of the need to manage public expectation and list key workers who will qualify for early vaccination.

The final order of priority has yet to be confirmed - deciding who goes where on the list will not be a task for the faint-hearted.

It has been suggested that the elderly and very young should be denied vaccine until after all other groups have been vaccinated because they have either had a full life, or have not been invested in.

Difficult decisions

Prof Dunnill says: "You have to give vaccine to frontline medical staff, because they're going to be face-to-face with the people who are plainly infected.

"But if you get to a situation where you have to make decisions within the public, it's much more difficult. Scientists have suggested that two-year-olds may not be people that have high priority because, as yet, there hasn't been a sizeable investment.

"Now those are brutal decisions but people are having to think in those sorts of terms."

Prof Dunnill also questions the effectiveness of anti-viral drug Tamiflu.

"At the present time, of course, Tamiflu is used for ordinary flu and we know that even there it has to be used quickly to be effective.

Prof John Oxford

"What we don't know is what would happen with H5N1. The present evidence coming from Vietnam and Indonesia and countries like that is not particularly good but of course, a lot of the patients are travelling considerable distances before they're treated.

"We still don't have evidence of any real detail on the effect when Tami-flu is given very quickly."

The H5N1 virus bares a striking resemblance to the influenza pandemic that struck after the First World War, killing 50 million people.

The H5N1 virus has an extra piece of genetic code that some scientists say makes it much more deadly than 1918 virus.

Pandemic will be shown on BBC Two 7 November at 2100 GMT as part of the Horizon series.

H5N1 S227N in Egyptian Patient ​

http://www.recombinomics.com/News/11070601/H5N1_S227N_Egypt.htmlRecombinomics Commentary
November 7, 2006

HA sequences from 8 human H5N1 isolates from Egypt were released today by the US Naval Medical Research Unit 3 in Cairo (see list here). These sequences were from the H5N1 outbreak in the spring. Previously, one human sequence from a mild case in the spring, as well as a fatal case who died this month have been released. The recent case has a change, M230I, near the receptor binding domain.

Changes in the receptor binding domain are of concern because of potential changes in binding to receptors on the surface of cells, which could affect transmission. One such change, S227N, was reported for human isolates from Hong Kong in 2003. This change increased the affinity for receptors found in the upper respiratory tract of humans, and decreased affinity for receptors found in birds.

Analysis of donor sequences in the Middle East identified donor sequences on H9N2, which is endemic to the Middle East. Dual infections involving Qinghai H5N1 and H9N2 endemic in the Middle East, could generate S227N via recombination. Therefore a warning was issued on October 22, 2005. At that time, no human H5N1 infections involving the Qinghai strain had been reported.

In January, human H5N1 cases were reported in Turkey and H5N1 isolated from the index case was the Qinghai strain with the S227N acquisition. Although S227N was not found in an isolate from the sister of the index case, it was found in a second human case from Turkey. Thus, of the four human sequences released from Turkey, two had the S227N change. WHO issued an update Febraury 20, 2006 indicating S227N had not been fixed in the Qinghai strain, but the number of human sequences released was limited to one case from Egypt, Iraq, and Djibouti. Subsequently the sequence from one human case from Azerbaijan was also released.

However, the culture conditions can influence the isolation of H5N1 with receptor binding domain changes that favor binding to mammalian cells, which may have led to the failure to detect S227N in the isolate from the sister of the index case. Similarly, the sequences of the receptor binding domain for most human cases in the Middle East have been withheld.

The release of eight sequences from Egyptians infected last spring has identified another Qinghai isolate, A/Egypt/2947/NAMRU3/2006 from the Middle East that has S227N. Thus, the number of H5N1 Qinghai isolates with S227N has risen to three, but the total number remains unknown because most sequences outside of Egypt have not been released. In Turkey 21 cases were H5N1 positive, bit only 12 were confirmed by Weybridge and only four sequences from these 12 confirmed cases were released. Similarly, only one Azerbaijan sequence has been released and the role of culture conditions in the detection of S227N in the released sequences remains unclear.

Changes in the receptor binding domain can have significant effects of the ease of transmission from human to human. Sequences released from birds in southern China identify additional changes. An isolate from a duck from Shantou, A/goose/Shantou/2086/2006, has also changed position 227 from S--->R. Moreover, the same isolate has a novel cleavage site, QRERRKKR, and two additional changes in or near the receptor binding domain, K222R and V223I.

The above changes significantly increase the likelihood of H5N1 increasing the efficiency of human to human transmission without decreasing the high case fatality rate, which remain causes for concern.

H5N1 Receptor Binding Domain Changes in Shantou China ​

http://www.recombinomics.com/News/11070602/H5N1_RBD_Shantou.html

Recombinomics Commentary
November 7, 2006

H5N1 sequences from patients in Egypt were released today. The S227N change in the receptor binding domain was reported for one of the eight sequences, bringing the number of human Qinghai sequences with S227N to three. This change was predicted on October 22, 2005 in a warning issued for an increase in the efficiency of H5N1 transmission in humans. S227N was subsequently confirmed in the index case for Turkey in January 2006 and was also found in a second isolate from Turkey.

To date, only four human sequences from Turkey have been released, so the number of patients positive for S227N remains unknown to the public. Similarly, only one sequence from the cluster of fatal infections in Azerbaijan has been released. The three S227N positive patients in Turkey and Egypt suggests additional unreported sequences from the beginning of 2006. At this time more H5N1 will be migrating into the Middle East, increasing the likelihood of additional acquisitions from H9N2 infected poultry, since H9N2 is endemic to the region.

Sequences released last week also show receptor binding domain changes in H5N1 from a goose in Shantou. The three changes, K222R, I223V, and S227R, within such a small region, suggests these changes were also acquired by recombination. The high level of H5N1 detected in China raise concerns that additional recombination events will further increase the genetic diversity. The Shantou goose isolate, A/goose/Shantou/2086/2006 also has a novel HA cleavage site, QRERRKKR, again signaling rapid genetic change, which is a characteristic of increased frequencies of recombination among genetically diverse viruses. Moreover, the Qinghai strain, A/Guinea fowl/Shantou/1431/2006, is also present in Shantou, increasing the likelihood of acquisition of PB2 E627K by recombination or reassortment.

H5N1 RBD Changes Increase Pandemic Concerns in China ​

http://www.recombinomics.com/News/11070603/H5N1_RBD_China_Pandemic.html

Recombinomics Commentary
November 7, 2006

The recent H5N1 sequences from China include four sequences from geese in Shantou (A/goose/Shantou/2086/2006, A/goose/Shantou/239/2006, A/goose/Shantou/2104/2006, A/goose/Shantou/7775/2006) that have four non-synonomous changes in or near the receptor binding domain (V214M, K222R, V223I, and S227R). Changes at position 227 (S227N) have been associated with increased affinity for human 2,6 receptors and decreased affinity for avian 2,3 receptors. Although affinity chnages for this particular combination of chnages, the presence of this number of changes in or near the receptor binding domain.

These chnages appear to have been generated via recombination because two of the changes are circulating in northern China (K222R in A/goose/Jilin/hb/2203(H5N1)) or Japan (V223I in A/chicken/Yamaguchi/7/2004(H5N1)) and recombination between H5N1 in northern China nad Japan is not uncommon.

As the diversity in receptor binding domain sequences increase, the potential for additional chnages via receombination also increases. Thus, circulation of a large number of receptor binding domain sequences co-circulating in H5N1 creates a serious pandemic concern.

This concern is increased by the withholding of current sequences as well as a questionable surveillance system, since only one Qinghai sequences has been reported in eastern China.

The sequences from avian and human H5N1 isolates from China in 2005 and 2006 should be released immediately. H5N1 sequences from 1997-2004 demonmstrate frequent recombination in northern China, and a robust database is required to determine the likelihood of additional recombination.

" .... <span style="background-color: yellow;"> <b><font size=5 color=blue> The above changes significantly increase the likelihood of H5N1 increasing the efficiency of human to human transmission without decreasing the high case fatality rate, which remain causes for concern.</font> </b> </span> .... "

Increased H2H transmissibility with lethality running very high WITH VENTILATORS AND MEDICATION AND FULL SUPPORT.

Bird flu expert set to lead WHO ​

A Chinese expert on bird flu is set to become the next head of the World Health Organization.

The WHO's top decision making body, the World Health Assembly is expected to approve the appointment of Margaret Chan on Thursday.

As WHO director-general, Dr Chan will become the first Chinese person to head a major UN agency.

She will replace South Korea's Lee Jong-wook who died suddenly last May three years into his five-year term.

Dr Chan beat off challenges by Mexico's Health Minister Julio Frenk, Japan's Shigeru Omi, a senior WHO official, Spain's Health Minister Elena Salgado and another top WHO official, Kuwait's Kazem Behbehani in final voting on Wednesday.

Dr Chan has been overseeing the WHO's response to the threat of bird flu, and a possible flu pandemic.

Extensive experience

Previously, she spent nine years as director of Hong Kong's department of health, where she won praise for helping fight the world's first outbreak of bird flu in 1997.


Her decision to cull about 1.5m poultry in the face of opposition was seen as crucial in helping to stem the spread of the virus.

She also has experience in dealing with another deadly respiratory disease, Sars, which spread from Asia into other parts of the world in 2002-2003.

However, she was criticised at home for allegedly failing to get speedy information from mainland China where the disease began

During her campaign, Dr Chan said that if she became director-general she would focus on fighting chronic diseases such as Aids and tuberculosis.

She said: "No other international or national agency can get to an outbreak scene within 24 hours or marshal such technical expertise so fast."

Dr Chan's appointment may help to consolidate China's relationship with the WHO although some critics are concerned it could also complicate her dealings with China which is playing an increasingly pivotal role in global health.




Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/health/6128220.stm

Published: 2006/11/08 10:55:15 GMT

Yudhoyono, Bush to focus on education and bird flu​

http://www.thejakartapost.com/detailnational.asp?fileid=20061108.H04&irec=3

Tony Hotland, The Jakarta Post, Jakarta

Indonesia will focus on pursuing education opportunities in the United States for its citizens and curbing the spread of bird flu when President Susilo Bambang Yudhoyono meets President George W. Bush later this month.

The two leaders will discuss the issues with five Indonesian figures that are experts in the two fields, presidential spokesman Dino Patti Djalal said Tuesday.

Terrorism and military issues will not be on the agenda as the two topics were exhausted during Bush's last visit, in 2003, Dino said.

Yudhoyono is scheduled to meet with Bush on Nov. 20 at the Bogor Presidential Palace, one day after the Asia-Pacific Economic Cooperation meeting in Hanoi, Vietnam, ends.

Dino said Yudhoyono would also meet Bush at the APEC forum during the U.S.-Southeast Asia talks.

He said Yudhoyono would use the Bogor meeting to push for more scholarship and educational opportunities for Indonesians in the U.S.

"Bush donated some US$157 million for education the last time he visited ... we want to get more schemes for education and training programs in the U.S.," Dino said.

He said the five experts to be invited to the meeting were still being selected.

While it was not clear if Indonesia would seek financial aid from the U.S. to combat bird flu, Dino said the disease would be a key topic for both leaders.

With 55 deaths from bird flu, Indonesia now has the world's highest number of deaths from the disease.

Dino said other issues expected to be on the table included investment, particularly in the energy sector, biofuel development, natural disaster mitigation and information and technology.

He said Bush' visit was key to relations between the two countries, with the U.S. considering Indonesia its "strategic partner" in the region.

"The U.S. sees us as the world's third biggest democracy, the most populous Muslim nation, the biggest economy in Southeast Asia, with potential and a strategic location. We, on the other hand, are looking outward as we seek to polish our image and play a bigger role in the international scene," he said.

Before Bush, Indonesia also welcomed this year U.S. Secretary of State Condoleezza Rice and U.S. Secretary of Defense Donald Rumsfeld.

A total of 18,000 police personnel will be deployed to thwart demonstration the visit is expected to provoke.

There have also been criticisms of the overly tight security measures Bush's detail is demanding, which include the construction of two helipads near the Bogor palace, which some say will damage the surrounding environment.

WHO tells bird flu scientists to stop squabbling​

http://today.reuters.com/News/CrisesArticle.aspx?storyId=SP78957

Wed 8 Nov 2006 4:39 AM ET

By Tan Ee Lyn

HONG KONG, Nov 8 (Reuters) - The World Health Organisation has urged Chinese and foreign scientists to stop squabbling and share information to figure out how to combat a new H5N1 bird flu virus strain that is spreading unchecked in poultry flocks.

Henk Bekedam, WHO's representative for China, said that instead of battling it out in the media, scientists from the Chinese government, Hong Kong and elsewhere should sit down and study the details.

"This is an ideal opportunity to get a better idea what is happening in China and assess strategies that have been effective and develop even more targeted strategies if there is a need," he said.

Chinese officials and scientists rejected a paper published last week by Hong Kong and U.S. scientists in the U.S. Proceedings of the National Academy of Sciences (PNAS) which said a new vaccine-resistant "Fujian-like" H5N1 strain had emerged in poultry in China and may spread across Asia and Europe.

In an interview with Chinese media published on Tuesday, two Chinese scientists fired strongly worded rebuttals, saying there was "no scientific basis" for the views and conclusions in the paper.

They accused the foreign researchers of "unscientific methods" and said China's vaccination programme was effective.

But they gave no details or data, something that Bekedam says is badly wanting.

"Right or wrong, this goes to a level of details that you have to talk to scientists, people who look at gene sequencing and give us clues as to what is happening," he told Reuters.

"If viruses are substantially different, then it is very important for us to make some re-adjustment in the diagnostics, to consider if we might need to come up with a new vaccine."

H5N1 remains a disease in birds although it has killed over 150 people since late 2003. However, experts fear it could start a pandemic and kill millions if it ever mutates to transmit efficiently among people. Research so far into the Fujian strain shows it poses no heightened danger to people.

China's Ministry of Agriculture and two scientists will hold a news conference on Friday in Beijing to discuss the PNAS paper.

CONTRADICTIONS

China's position in the saga so far has been inconsistent, and contradictory statements made by senior Chinese government officials have led to confusion.

Its health ministry previously shared H5N1 samples isolated from six victims with WHO, and gene sequencing showed they were infected with the Fujian strain in 2005 and 2006.

But after the paper was published, China's foreign ministry said the country had found no evidence of the Fujian strain. One of the Chinese scientists also rejected that the strain was responsible for recent human infections in China.

Experts are keen to see evidence and data from China.

"Although, in my opinion, the PNAS paper does seem to show the Fujian-like virus is a new strain of avian H5N1 influenza in birds ... their implications for human disease and pandemic potential can only be speculation at this point," said Julian Tang, a microbiologist at the Chinese University in Hong Kong.

"There is no evidence from this paper that this new virus is any more transmissible to or between humans, or that it is any more resistant to antiviral drugs.

"In fact the authors state that all their identified Fujian-like viruses were predicted to be sensitive to oseltamivir," Tang said, referring to an antiviral drug that has been used to fight H5N1 in people.

This is on the website of the U.S. Consulate General in Hong Kong and Macau as related to the post quoted below by Bill P:

Pandemic Influenza -- Preparing for Possible Shelter-In-Place​

http://hongkong.usconsulate.gov/ci_avian_2006110301.html

U.S. Consulate General for Hong Kong and Macau

November 3, 2006

The U.S. Department of State recently sent a cable to all diplomatic and consular posts entitled "Pandemic Influenza: Preparing for Possible Shelter-In-Place". The cable's main intent was to provide guidance to all staff regarding "shelter-in-place". That is, in the event of severe pandemic influenza with high morbidity, the public may be advised to self-quarantine. Therefore, current guidance notes that families should be prepared to "shelter-in-place" for up to twelve weeks, and maintain sufficient food and water supplies to accommodate that entire period.

Just as in the United States, U.S. government employees and their families overseas have primary responsibility for maintaining adequate supplies of food to shelter-in-place. This also applies to private U.S. citizens. For the long term, families are advised to store foods that are non-perishable, do not require refrigeration, or preparation (including the use of water), or cooking. The cable also advises that families should store one gallon of water per person per day.

Potable Water

Please note that at this time, Hong Kong's water supply is potable. In the event of complete infrastructure breakdown, water supply that is currently potable in some areas or countries may not remain so. However, water can be purified in several ways. Boiling is a reliable method for killing microbes and parasites. Bring water to a rolling boil and continue boiling for at least ten minutes. Also, regular Clorox Bleach isn't just a laundry-aid, it's a lifesaver (use only regular Clorox bleach, not Fresh Scent or Lemon Fresh). In an emergency, one gallon of Regular Clorox Bleach purifies 3,800 gallons of drinking water. First, let water stand until particles settle. Filter the particles if necessary with layers of cloth, coffee filters, or fine paper towels. Pour the clear water into an uncontaminated container and add Regular Clorox Bleach per the below indicated ratio, mix well, and wait 30 minutes. Water should have a slight bleach odor.

Ratio of Clorox Bleach to Water for Purification:

2 drops of Regular Clorox Bleach per quart of water
8 drops of Regular Clorox Bleach per gallon of water
1/2 teaspoon Regular Clorox Bleach per five gallons of water If water is cloudy, double the recommended dosages of Clorox Bleach.

To insure that Clorox Bleach is at its full strength, rotate or replace your storage bottle every three months. Also, don't forget to sanitize the water storage containers. To sanitize containers and utensils, mix one tablespoon of Regular Clorox Bleach with one gallon of water, creating a Sanitizing Solution. Always wash and rinse the items first, then let each item soak in Clorox Bleach Sanitizing Solution for two minutes. Drain and air dry.

Please remember that water in dehumidifiers is also potable, but be sure to sanitize the dehumidifier water container.

Emergency Supply List

The U.S. Government's "one-stop" web site on avian influenza, www.PandemicFlu.gov, provides a sample list of foodstuffs and other emergency supplies for stocking:

Examples of food and non-perishables:

Ready-to-eat canned meats, fish, fruits, vegetables, beans and soups Protein or fruit bars Dry cereal or granola Peanut butter or nuts Dried fruit Crackers Canned juices Bottled water Canned or jarred baby food and formula Pet food

Examples of medical, health and emergency supplies:

Prescribed medical supplies such as glucose and blood-pressure monitoring equipment Soap and/or alcohol-based (60% - 95%) hand wash Medicines for fever, such as acetaminophen or ibuprofen Thermometer Anti-diarrhea medication Vitamins Fluids with electrolytes Cleansing agents Flashlight Batteries Portable radio Manual can opener Garbage bags Tissues, toilet paper

To better help plan for "shelter-in-place", all U.S. citizens are encouraged to refer to the www.PandemicFlu.gov website, as well as the World Health Organization website (www.who.int/en/). Please also visit the U.S. Consulate General website for further information: Avian Flu.

We will continue to distribute and share pertinent information on Influenza Pandemic Preparedness as we receive it.

Bill P said:

US citizens in HK told to stockpile for bird flu outbreak ​

http://www.mb.com.ph/MAIN2006110779051.html

Hong Kong (dpa) - US citizens in Hong Kong have been advised to build a three-month stockpile of food, medicine and water in their homes in case of a bird flu pandemic, a news report said Tuesday.

An advisory has been sent out to all 60,000 registered US citizens in the former British colony urging them to prepare the stockpiles ahead of the coming winter flu season.

It suggests stockpiling 4.5 litres of water per person per day and to prepare water purification equipment in case of ''complete infrastructure breakdown,'' the South China Morning Post reported.

The advisory also suggests they stock up on non-perishable foods, soap, alcohol-based hand wash, medicines, vitamins, flashlights and a portable radio, the newspaper said.

Six people died and 12 others were infected in the first modern outbreak of bird flu to jump the species barrier and attack humans in Hong Kong in 1997.

Since then, however, the city of 6.8 million has built up sophisticated safeguards against the virus and avoided further human cases despite a spate of regional outbreaks.

Hong Kong has carried out mass culls of birds and ducks when cases have been detected among poultry and birds imported from mainland China are screened for the virus.

Scientists believe bird flu may cause deaths on a global scale greater than the Spanish Flu of 1918 which killed up to 40 million if the virus mutates to jump from human to human.

Click to expand...

Association Files to Exclude 'Virus or Bacteria' Related Diseases​

http://www.insurancejournal.com/news/national/2006/11/07/74032.htm

November 7, 2006

The American Association of Insurance Services (AAIS) is filing a new "virus or bacteria" exclusion designed to exclude losses that arise from organisms that can cause disease.

The exclusion, now being filed countrywide under AAIS commercial lines and farm insurance programs, was developed in light of the possibility of a pandemic of avian flu. However, it addresses contamination from any disease-causing agent, including, but not limited to, SARS, rotavirus, listeria, legionella, and anthrax.

Specifically, the endorsement states that coverage is excluded for loss, cost, or expense caused by, resulting from, or relating to any virus, bacterium, or other microorganism that causes or is capable of causing disease, illness, or physical distress.

In addition, the exclusion explicitly applies to any loss, cost or expense arising from denial of access to property because of any virus, bacterium, or other microorganism.

The virus or bacteria exclusion also states that, with respect to disease-causing agents, it supersedes the terms of any other exclusions, such as those addressing pollutants and contamination, and coverage limitations, including those addressing fungus and related perils.

"Property policies were never intended to a source of recovery for losses arising from organisms that cause disease," says Alma Gordon-Smith, AAIS director of inland marine and one of the developers of the virus and bacteria exclusion.

"With the possibility of a pandemic, there is concern over potential efforts to create an avenue for loss payment where none was originally intended."

AAIS is a national advisory organization that develops policy forms and rating information used by more than 600 P/C companies throughout the U.S. The virus or bacteria endorsement is being filed with a proposed effective date of May 1, 2007 in most states under the following AAIS programs: Agricultural Output; Artisans; Businessowners; Commercial Inland Marine; Commercial Output; COP-XL; Commercial Properties; Developers Output; Farmowners; Farm Properties; and Inland Marine Guide.

Source: AAIS

SRI wins U.S. contract for treatments​

http://www.insidebayarea.com/business/ci_4622960

By John Lauerman, Bloomberg News
Article Last Updated:11/08/2006 06:54:22 AM PST

SRI International, a Menlo Park nonprofit research group, won a $56.9 million U.S. government contract to help develop treatments for bird flu, SARS and other contagious diseases. Berkeley-based Xoma Ltd. will share in about half the contract.

The five-year contract calls for formulating, producing and testing drugs to treat infectious diseases such as hepatitis, avian influenza and West Nile virus, SRI said Tuesday. The agreement with the National Institute of Allergy and Infectious Diseases also covers germs such as anthrax and smallpox that can be used as weapons.

SRI, which provides research support to government and private industry and has developed nine drugs that reached human testing, will help prepare new medicines for applications to the Food and Drug Administration for market clearance.

"We haven't been given the first drug yet, but it's anticipated that a large number of drugs will pass through this program," said Walter Moos, SRI's vice president of biosciences.

The group has the capacity to develop as many as 30 drugs with the time and money allotted under the contract, Moos said. Each drug takes about one to two years to prepare for human testing, he said.

Biotech company Xoma will perform as much as $28.1 million of the work under the SRI contract with the Bethesda, Md.-based institute, which is part of the National Institutes of Health. Xoma and SRI are negotiating the final terms of their agreement, Xoma said in a separate statement.

Including the contract awarded Tuesday, Xoma has won $60 million in government work since March 2005, the company said. The company agreed Nov. 1 with Takeda Pharmaceutical Co. to collaborate on developing immune proteins, called monoclonal antibodies, to treat diseases. Payments to Xoma under the agreement might reach as much as $100 million.

The SRI contract doesn't include tests in humans that are needed before drugs are approved for sale in the U.S. and other countries.

Researchers said last month at a World Health Organization meeting that the H5N1 bird flu spreading in Asia, which kills about 60 percent of those infected, might become contagious in people without losing its lethal power.

The flu has infected 256 people, killing 152 of them. Health experts have said it might kill millions more if it mutates to spread quickly in humans.

Drugs, such as Roche Holding AG's Tamiflu and GlaxoSmithKline Plc's Relenza, have been shown to fight the bird flu virus. Companies including BioCryst Pharmaceuticals Inc. are testing additional drugs in people.

A group of West Coast industrialists and Stanford University founded SRI as Stanford Research Institute in 1946, according to the organization's Web site. The nonprofit became independent of Stanford University in 1970.

Turkey Allocates $55 Million to Bird Flu Prevention ​

http://www.zaman.com/?bl=economy&alt=&trh=20061108&hn=38073

Wednesday, November 08, 2006
zaman.com

Turkey launched a new $55 million initiative to combat the bird flu over the next four years.

Over $34 million in funding for the Bird Flu Preparation and Prevention Project came from the World Bank through a long-term loan, with the European Union donating $12.7 million and an additional $1 million from the United States.

The Turkish government and the private sector will contribute to the project with $7 million. An advertising campaign is planned under the project as well as intensive studies over the 2006-2010 period.

H5N1 Bird Flu Virus Is Changing​

http://www.pharmalive.com/News/index.cfm?articleid=389742&categoryid=40

FAO and OIE Recommend Increased Surveillance When Vaccinating

WASHINGTON and PARIS and ROME, November 08, 2006 /PRNewswire/ -- According to a report in last week's Proceedings of the National Academy of Sciences on the identification of a new H5N1 virus sublineage in poultry, this new virus sublineage, called Fujian virus, appears to have become the dominant strain of the H5N1 avian influenza circulating in parts of Asia. If the report is confirmed, this does not come as a surprise, FAO and the World Organization for Animal Health (OIE) said today.

While there is a wide variety of avian influenza strains in animals, and influenza viruses in general have a high rate of change from season to season and from year to year, OIE Director-General Bernard Vallat and FAO's Chief Veterinary Officer Joseph Domenech warn that with new antigens developing continually in avian influenza viruses, vaccines currently in use for poultry need to be assessed regularly.

The two organizations continue to recommend that vaccination control measures need to be accompanied by surveillance and post-vaccination monitoring. They also stressed the need to immediately report to veterinary authorities any unexpected poultry deaths.

Careful monitoring of vaccination campaigns recommended

Vaccination remains part of the FAO-OIE strategy to contain avian influenza and both organizations say that vaccination campaigns should be applied appropriately and carefully monitored according to FAO and OIE technical guidelines, including the use of a cold chain in order to protect the vaccine. Vaccination must be carried out along with other disease control measures, such as improved hygiene on the farm, animal movement management or market inspection and culling in case of outbreaks, said Dr. Domenech.

According to Dr. Vallat, "Commitment is needed from all governments to implement prevention and control programs such as surveillance of virus circulation and, where appropriate, vaccination programs in countries where the virus is endemic or where there is a high risk of introduction of the virus."

FAO and OIE are already supporting such programs in key countries where the virus is still circulating. But, they say more information on control programs based on vaccination is needed and urge more research be funded to better understand the epidemiology and genetic changes of the H5N1 virus

Data sharing

FAO, the OIE and a myriad of scientific experts on avian influenza have repeatedly called upon scientists around the world to share their findings and virus strains in a timely and transparent fashion. The OIE/FAO Avian Influenza Laboratory Network with its secretariat in Padova, Italy (OFFLU - http://www.offlu.net) is a platform where member countries and scientists can share valuable information with the international veterinary and medical community. It is imperative that global health concerns and timely information sharing override lags in the scientific publications approval process, which may take from a few months to more that a year.

It is essential during outbreaks that pathogens, such as highly pathogenic avian influenza virus, be isolated from clinical cases and that any changes in the character of the virus be monitored to ensure that vaccine manufacturers are producing vaccines complying with OIE standards which are effective against virus strains in circulation, said Dr. Domenech.

Should the changes be significant enough to warrant reformulation of the vaccine, FAO and the OIE say it would be in the best interest of global health for this to be done by national governments and commercial vaccine companies.

Scientists from such institutes as Istituto Zooprofilatico Sperimentale (Italy), Veterinary Laboratories Agency (UK), Southeastern Poultry Research Laboratory (USA), Australian Animal Health Laboratory, and Friedrich Loeffler Institute (Germany) have voiced their support for the FAO and OIE position that vaccine delivery alone is insufficient to halt virus circulation and to protect animal or human health.

"In an area where poultry populations have been vaccinated, well-planned serological studies must be conducted with full disclosure of the modalities of vaccination use in the poultry population, including the use of the cold chain and types of vaccines and date of last vaccination so results can be clearly interpreted," Dr. Vallat said.

For more information on the work of FAO go to: http://www.fao.org

CONTACT: Michael Hage, Media Relations of FAO, +1-202-653-0011, or+1-202-468-8800, michael.hage@fao.org

Web site: http://www.fao.org/english/newsroom/http://www.offlu.net/

BBC Birdflu Drama Documentary (Horizon) Viewable​

http://www.bbc.co.uk/sn/tvradio/programmes/horizon/broadband/index.shtml

BBC2 UK TV aired a 'what if' H5N1 pandemic scenario intercut with interviews.

The full program can be watched as a video stream here.

http://www.bbc.co.uk/broadband/medi...ackage=4588190&nbram=1&bbram=1&nbwm=1&bbwm=1#