12/23-12/29/06 | Weekly Bird Flu Thread:Lancet Flu Similar to 1918 Kill 62 Million

Link to last week's thread:

http://www.timebomb2000.com/vb/showthread.php?t=222189

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/

CDC
http://www.cdc.gov/flu/avian/index.htm

WHO
http://www.who.int/csr/disease/avian_influenza/en/index.html

CIDRAP
http://www.cidrap.umn.edu/

Official U.S. Government Web site
http://www.pandemicflu.gov/

FAO
http://www.fao.org/ag/againfo/subjects/en/health/diseases-cards/special_avian.html

Public Health Agency of Canada
http://www.phac-aspc.gc.ca/influenza/avian_qa_e.html

European Union
http://ec.europa.eu/dgs/health_consumer/dyna/influenza/country_en.htm

The World Bank
http://web.worldbank.org/WBSITE/EXT...68427~piPK:64168435~theSitePK:1793593,00.html

Pandemic Flu Similar to 1918 Would Kill 62 Million (Update1)​

http://www.bloomberg.com/apps/news?pid=20601103&sid=a6tRoyQugAAo&refer=us

By Andrea Gerlin

Dec. 22 (Bloomberg) -- The pandemic flu outbreak that struck in 1918-1920 would probably kill about 62 million people, or as many as died during World War II, if it happened today, according to a report in the Lancet medical journal.

Between 51 million and 81 million people would die if a virus similar to the one that caused the earlier pandemic emerges now, the researchers said. About 96 percent of the deaths would occur in poor countries that lack access to vaccines, antiviral drugs such as Roche Holding AG's Tamiflu and GlaxoSmithKline Plc's Relenza, other treatments for symptoms and secondary infections and proper nutrition, they said.

``If something along the lines of the 1918 scenario played out again, the impact would be devastating in the developing world and major, if not catastrophic, in the developed world,'' Kenneth Hill, a co-author of the study and a visiting professor at the Harvard Center for Population and Development Studies in Cambridge, Massachusetts, said in a telephone interview.

The 62 million figure in the study is a median estimate. Previous estimates of the number of deaths from a flu pandemic have ranged from 2 million to 1 billion, the report said. The World Health Organization estimates a global outbreak would kill 2 million to 7.4 million people, based on the death toll from a pandemic in 1957. The 1918 outbreak killed as many as 50 million people, the Geneva-based WHO said on its Web site.

Victims of a flu pandemic would be mostly aged from 15 to 29 years, followed by those under 14 years and from 30 to 44 years old, the study found. Deaths would be slightly higher among males. If all the fatalities forecast occur in a single year, worldwide deaths would more than double.

`Resources Don't Exist'

The impact of a pandemic in Asia would be 33 million deaths and in Africa 18 million deaths, the study found.

``The brunt of the disease would be in the developing world,'' Hill said. ``It's where planning ought to be focused but, of course, it's where the resources don't exist to plan for such an event.''

The Lancet study analyzed vital statistics from 27 countries, 24 U.S. states and nine Indian provinces from 1915 to 1923 and extrapolated the findings to population data from 2004. It excluded data from countries where World War I or civil wars were known to have led to more deaths in the time period studied.

Among the factors that might affect the number of deaths from an influenza pandemic today are the 35 million people worldwide whose immune systems have been weakened by HIV, Neil Ferguson of Imperial College in London wrote in an accompanying comment. The potential roles of HIV, malaria and malnutrition in a pandemic need to be further studied, he wrote.

Wealthier Countries Prepared

``In one sense, this conclusion is academic since we will never see a precise rerun of the 1918 pandemic,'' Ferguson wrote. ``But it highlights the stark fact that health inequity is scarcely less now than in 1918, and the medical advances of the past 90 years are unlikely to benefit much of the developing world in any future pandemic.''

Other experts have already warned that wealthier countries were better prepared for a possible influenza pandemic and that poorer ones would be less likely to have access to vaccines and antiviral drugs. Roche donated more than 5 million treatment courses of Tamiflu to the WHO in 2005 and 2006 to help build regional stockpiles in case of a pandemic.

``We must do everything we can to make sure that developing countries have access to stockpiles of antiviral medicines and the vaccines,'' David Nabarro, the United Nations' pandemic flu coordinator, said in a telephone interview. ``If the pandemic starts in a developing country, we've got to make sure that the stocks are available for use at the point where it starts and are not kept in reserve in an attempt to protect rich nations.''

Health officials are tracking the spread of the H5N1 virus that causes avian influenza in case it spawns the next pandemic. The virus has infected 258 people and killed 154 of them since late 2003, according to the WHO.

Vietnam, South Korea, Nigeria battle avian flu​

http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/dec2206birds.html

Dec 22, 2006 (CIDRAP News) – More poultry have died of H5N1 avian influenza in Vietnamese provinces where the virus recently re-emerged, and the disease has spread to another province in South Korea and 3 more Nigerian states, according to news reports.

News services said today that fresh outbreaks were detected this week in Vietnam's Ca Mau and Bac Lieu provinces in the southern Mekong Delta, the sites of recent outbreaks that represented the first major reappearance of the disease in almost a year. Deutsche Presse-Agentur (DPA) reported today that 3 new outbreaks among chickens and ducks occurred in those areas.

"The situation is alarming," Hoang Van Nam, director of the epidemic unit for the Vietnam Ministry of Agriculture, told DPA. "Our assessment is that bird flu is likely to spread far outside the outbreak confirmed localities."

Vietnam's deputy prime minister, Nguyen Sinh Hung, ordered animal health workers to finish culling poultry in the affected areas by the end of tomorrow, Nam told Reuters today.

Earlier news reports said the outbreaks occurred on farms where poultry had not undergone mandatory vaccination and some birds were hatched illegally. The country instituted tough avian flu prevention efforts after widespread outbreaks in 2004 and 2005 led to the culling of 66 million birds and 93 human cases, the world's highest.

Meanwhile, in South Korea, the Ministry of Agriculture and Forestry reported that ducks at a farm in Asan, South Chungchong province, tested positive for avian flu, the Korea Times reported yesterday. But a ministry official said it wasn't clear whether it was the virulent H5N1 virus.

In late November, H5N1 avian flu was found at farms in North Jeolla province, south of the current outbreak area. The outbreaks were South Korea's first in about 3 years.

The agriculture ministry said it would cull about 23,000 poultry within a 3-km radius around the farm in Asan to prevent the spread of the disease, according to the Times report.

In Nigeria, government inspectors found H5N1 avian flu in poultry samples from 3 more states, according to a United Nations report obtained by Bloomberg News. The states are Delta in the south, Kwara in the west, and Borno in the northeast. All Nigerian states have now had avian flu outbreaks, Bloomberg reported yesterday.

Reuters news service reported today that within the last 2 months the disease has also resurfaced in Kano and Ogun states.

In February, Nigeria became the first African nation to report an avian flu outbreak. Public health officials fear that the disease will be difficult to contain in Africa, where many people have backyard poultry and veterinary services are weak. At a recent donors' conference in Mali, the World Bank put Africa at the top of the priority list for aid because countries there are economically weaker and less able to respond to avian flu threats.

Study Finds Much Bird Flu Planning is Misplaced​

http://www.consumeraffairs.com/news04/2006/12/bird_flu_planning.html

December 22, 2006

Bird Flu

No one knows when or if a bird flu pandemic will strike, but international health officials are spending billions, feverishly preparing for one.

Now, a Harvard study claims to have analyzed just where such a pandemic would have the most impact. Their findings show most of the planning is directed in the wrong place.

A team of researchers from Harvard School of Public Health (HSPH) and the University of Queensland in Australia have re-analyzed data from 27 countries around the world to estimate both the global mortality patterns of the deadly 1918 pandemic and, based on 2004 population data, how a similar pandemic would affect the world today.

These findings, to be published in the December 23, 2006 issue of The Lancet, show that mortality rates for the 1918-1920 pandemic were disproportionately high in communities where per capita income was lowest. If the same pandemic were to occur today, approximately 96 percent of deaths would occur in developing countries.

"This is the first time there has been this sort of systematic analysis based on vital statistics, such as death registration data, from the 1918-1920 period," said lead author Christopher Murray, Professor of Population Policy at HSPH and Director of the Harvard Initiative for Global Health. "These findings are particularly alarming when you consider that all the policy protection is aimed at the high income world. Very few strategies are being thought through that are primarily targeting poor countries."

For many decades, published epidemiological literature assumed that mortality rates from the 1918-20 pandemic were distributed fairly equally. A simple population count from that period would lead to the conclusion that about 20 percent of all fatalities occurred in the developed world. "But when you look at the data," said Murray, "that number shrinks to about three or four percent."

The disparities between the developed and developing worlds during this period are striking. For example, in Denmark 0.2 percent of the population succumbed to the flu. In the United States, that figure is 0.3 percent (based on data from 24 states).

In the Philippines, the mortality rate was 2.8 percent, in the Bombay region of India, 6.2 percent, and in central India, 7.8 percent, which was the highest rate of the countries and regions analyzed. According to this data then, from Denmark to central India, death rates from the 1918-1920 flu pandemic varied more than 39-fold.

The researchers then took the relationship observed in 1918 between per capita income and mortality and extrapolated it to 2004 population data. After adjusting for global income and population changes, as well as changes in age structures within different populations, the research team estimated that if a similarly virulent strain of flu virus were to strike today, about 62 million people worldwide would die.

The researchers say this could represent a devastating impact on global mortality, more than doubling deaths from all causes in a single year. However, only four percent of these fatalities would occur in the developed world. The developing world would absorb the remaining 96 percent of deaths--an estimate that the researchers believe is actually conservative.

"We all know that the poor tend to have higher mortality," said Murray, "but we never expected that so much of the cross-country and cross-community variation would be related to economic status."

The researchers caution that per capita income only explains about half of the wide mortality range seen among--and in many cases within -- particular countries. Other unique community attributes that influenced mortality are still unknown.

Nevertheless, Murray is clear about the study's implication: "Quite simply, much more of the international attention needs to focus on how we can protect the poorer countries should this virus reoccur."

Asian nations scramble to prevent bird flu from spreading amid outbreak in S.Korea​

http://mdn.mainichi-msn.co.jp/international/news/20061223p2g00m0in018000c.html

SEOUL, South Korea -- Asian countries scrambled to limit the spread of bird flu following a fresh outbreak among poultry in South Korea, as health officials welcomed a drop in the number of human deaths from the H5N1 virus in Indonesia.

South Korean quarantine officials completed the slaughter of 23,000 poultry Saturday within three kilometers of the outbreak site on a duck farm in Asan, about 90 kilometers south of Seoul, said Agriculture Ministry official Lee Joo-won.

The ministry confirmed that the outbreak -- South Korea's fourth in less than a month -- involved the H5 strain, but said further tests were needed to determine whether it was the deadly H5N1 virus.

South Korea has suffered three outbreaks of H5N1 at chicken and quail farms since November. Authorities have ordered the slaughter of more than 1 million birds in an attempt to keep the disease from spreading.

Although some complained, South Korean farmers have been largely cooperative in the slaughter because the government has compensated them financially.

But in Vietnam, which this week reported its first bird flu outbreak in a year, some poultry farmers have been unwilling to comply with a government-ordered slaughter, endangering other flocks and themselves. More than 6,000 chickens and ducklings have died from H5N1 in the past two weeks in Ca Mau and Bac Lieu provinces.

At least 154 people have died from H5N1 worldwide, according to the World Health Organization.

Most of those who died came into direct contact with infected birds, but experts fear the virus could mutate into a form that becomes easily passed among people, potentially sparking a human pandemic.

Indonesia, the nation worst hit by H5N1, also initially balked at slaughtering birds in infected areas and vaccinating flocks, citing a lack of funds. International experts have accused the country of not doing enough to tackle the virus.

But it recently launched a large-scale public education campaign, including TV commercials urging people to wash their hands after coming into contact with poultry and to report sick or dying birds to authorities.

The aggressive campaign has apparently paid off, with the number of human deaths from the virus slowing markedly over the last three months. But WHO said it was too soon to draw conclusions.

Stopping the spread in Indonesia, a sprawling island nation of 220 million people, is a priority because it has been the only country regularly reporting new human cases. It has now logged 74 human infections since 2005, 57 of them fatal.(AP)

Vietnamese gov't takes urgent anti-bird flu measures​

http://news.xinhuanet.com/english/2006-12/23/content_5524091.htm

HANOI, Dec. 23 (Xinhua) -- The Vietnamese government has required relevant ministries, sectors and localities nationwide totake drastic measures to battle and prevent bird flu outbreaks among fowls and humans, local newspaper Youth reported Saturday.

Vietnamese Prime Minister Nguyen Tan Dung on Dec. 22 requested them to intensify surveillance of fowl farms to early spot new outbreaks, cull all affected poultry, disinfect and detoxificate affected farms to stamp out the disease.

He also asked relevant agencies to implement vaccination for all fowls in high-risk areas, and tighten control of transport, trade and slaughtering of poultry and related products. Cases of illegal import of fowls and related products must be strictly punished.

The government criticized the two southern provinces of Bac Lieu and Ca Mau for their failure to timely detect and report the recurrence of bird flu, and asked them to complete the culling of all affected poultry on Dec. 23.

Since early December, the disease has stricken four communes in three districts in Ca Mau and Bac Lieu, killing and leading to the forced culling of 8,394 chickens and 7,302 ducks, the newspaper quoted the Department of Animal Health under the Vietnamese Ministry of Agriculture and Rural Development as saying.

Bird flu outbreaks, starting in Vietnam in December 2003, have killed and led to the forced culling of dozens of millions of fowls. The last outbreak of bird flu among poultry in the country in 2005 was in December.

Three members of extended family in Egypt
test positive for bird flu, WHO says​

http://www.iht.com/articles/ap/2006/12/24/africa/ME_GEN_Egypt_Bird_Flu.php

The Associated Press
Published: December 24, 2006

CAIRO, Egypt: Three members of an extended family living together in the same house in Egypt have tested positive for the bird flu, a World Health Organization official said on Sunday.

A sister, 15, and brother, 26, and a 30-year-old woman were diagnosed over the past week with the lethal H5N1 virus, said Hassan el-Bushra, a WHO regional adviser.

The three lived with 30 other family members in the same house in the Gharbiya province, north of Cairo, with several ducks, three of which died recently, he said.

The 30-year-old woman was hospitalized on Dec. 17 but did not tell health officials until a few days later that she had been in contact with birds. The two others were hospitalized shortly after, el-Bushra said.

All three have been transferred to a hospital in Cairo, and the 30-year-old woman was in good condition. El-Bushra did not know the conditions of the other two and said the rest of the family is being monitored.

The latest cases bring the number of Egyptians who have contracted the avian flu to 18, el-Bushra said. Seven have since died.

Bird flu was first detected in Egypt in February and has spread to at least 19 of the country's 26 provinces. Egypt lies on a migratory route for wild birds.

The discovery of avian flu in the Middle East has led to widespread culling of birds. The H5N1 strain has hit at least 45 countries and killed more than 150 people worldwide.

Pigs, Chickens Culled As Bird Flu Spreads​

http://times.hankooki.com/lpage/200612/kt2006122419054668040.htm



By Park Chung-a
Staff Reporter

Quarantine officials yesterday culled more than 4,000 pigs and 2,000 chickens in Asan, South Chungchong province, the site of the latest outbreak of avian influenza.

According to the province, about 100 quarantine officials were dispatched early Sunday to cull 4,177 pigs from one pig farm located within a 500-meter radius of the outbreak site and 2,000 chickens from one farm located about 3-kilometers away.

Consequently, after the fourth outbreak of highly virulent bird flu was found in Asan late Thursday, about 21,000 ducks, 2,820 chickens and 4,177 pigs have been culled there.

``Although pigs were originally exempted as subjects for quarantine measures along with dogs, since they are vulnerable to respiratory diseases and might transmit a transformed strain of the virus, we have decided to cull pigs within 500-meter radius of the infected zone,’’ said an official from the Ministry of Agriculture and Forestry.

He emphasized that it was a measure to block any possibility for further spread of the infection.

``I accepted the government’s proposal to slaughter my pigs as they said that all the poultry within 500-meter radius from the outbreak site should be slaughtered to block any possibility of the spread of the virus according to quarantine regulations,’’ said the owner of a pig farm, only identified by his last name Koo. ``However, I expect proper compensation from the government for my loss.’’

Also, quarantine officials have collected 1,000 samples of excrement from migratory birds near affected areas, including Chonsu Bay and Pungse Stream, to find out if the virus is present in them.

In addition, they have blocked the transportation of rice straw in farmlands located near the habitats of migratory birds in the region. Experts have been claiming that feeding rice straw to cows from farmlands near habitats of migratory birds should be blocked since the possibility that migratory birds could be the source of the bird flu has not been ruled out yet.

Hundred tones of rice straw from farmlands that are located near habitats of migratory birds such as Chonsu Bay, Sapkyo Lake, Sokmun Lake and Kumgang Bank have been supplied to farmlands nearby to be fed to their livestock on a daily basis until the government’s move.

The government has also banned the movement of chickens, ducks and eggs within a 10-km radius of the affected area.

South Korea reported three separate outbreaks of the disease before the latest incident in Asan, about 90 kilometers south of Seoul. The first outbreak was reported on Nov. 22 in Iksan, North Cholla Province.

H5N1 Familial Cluster in Nile Delta Raises Concerns​

http://www.recombinomics.com/News/12230602/H5N1_Egypt_Cluster.html

Recombinomics Commentary
December 23, 2006

Tanta - Atef Deibis: The Ministry of Health laboratories revealed the injury of a young man "25 years" and his cousin 15 years with "my wedding procession" by the bird flu disease and have been transferred yesterday to the hospital of the Abbasid fevers and with them the sister of the first injured and who has been detained under the suspicion.

The Health Department by the western has detained in 17 December Farid Abdul Halim's victory 30 years and its brother Reda 25 years in "my wedding procession" fevers hospital and in 20 December detained their cousin Shafika Farid 15 years under the suspicion and taking samples took place from them for its sending to the ministry laboratories. Revealed yesterday due to the examination of conditions Reda Farid's injury and his cousin Shafika by the bird flu disease which led to causing a panic and the fear of citizens and especially after the detention of two new conditions took place in Tanta

The above translation indicates the two H5N1 confirmed cases are cousins and were hospitalized three days apart. The index case (25M) was hospitalized December 17 and his cousin (15M) , hospitalized December 20 have confirmed H5N1. The sister of the index case has also been hospitalized with symptoms. There appear to be two more suspect cases hospitalized, indicating the three member familiar cluster may be part of a five member geographical cluster.

Clustering in the same Gharbiya govenorate as the earlier case is cause for concern. The current cluster as well as the initial case had linkages to ducks and the H5N1 from the first case had M230I. This polymorphism is found in all three strains of human flu (H3N2, H1N1, and influenza B), all of which are efficiently transmitted human-to-human. The earlier H5N1 is an exact match with positions 226-230 influenza B (QSGRI). The first indication of efficient transmission is a familial cluster, as described in the translation above.

More details on condition of the sister and any relationship with the other two hospitalized patients would be useful (as would tesing and sequencing updates).

Co-Circulation of Qinghai H5N1 RBD Changes in Nile Delta​

http://www.recombinomics.com/News/12230603/H5N1_Egypt_RBD.html

Recombinomics Commentary
December 23, 2006

The report of a growing H5N1human cluster in the Nile Delta is cause for concern. The first case for this season in the region was a patient who live 12 miles north of the current cluster. That patient was hospitalized at the end of September and was confirmed in the middle of the month. Within days of the confirmation, the HA sequences was deposited at GenBank by US NAMRU3, the US Naval Research lab in Cairo. The sequence produced evidence for evolution via recombination. The Egyptian regional polymorphisms defined last season when human isolates were reported in February. The recent isolate also had a number of additional polymorphism which were in other Qinghai isolates in Europe and Africa.

The acquisition of polymorphisms via recombination creates additional concerns because of the receptor binding changes in Qinghai isolates in the region. PB2 E627K has become fixed in the Qinghai strain. This mammalian polymorphism allows H5N1 to grow more efficiently at lower temperatures, as found in humans (37 C) relative to birds (41 C). The preference for a lower temperature selects for E627K in humans. All human influenza isolates have E627K.However. isolates from last season had a number of additional changes in the receptor binding domain. Lab experiments identified several changes that increase affinity for human receptors. These include S227N was has been detected in human Qinghai isolates in Egypt and Turkey. Similarly, N186K has been found in H5N1 from patients in Azerbaijan. In Iraq the same position is changes to N186S in all human isolates, and two had the additional change of Q196R, which has been shown to synergize with S227N.

Moreover, the recent isolate from Egypt has M230I, which is found in all human flu isolates (H1N1, H3N3, influenza B. Thus, further recombination between co-circulating Qinghai isolates can lead to more efficient human-to-human transmission. In the past, there have been few clusters reported in Egypt. The confirmed cluster of two is the largest in Egypt. If the sister of the index is H5N1 positive, the current cluster will be the largest reported for Egypt. The patients also appear to be developing symptoms sequentially, providing additional evidence for human-to-human transmission. It is unclear if the two additional patients are related to the three described in more detail. However, all five either live or have been hospitalized in a region that is close to the first confirmed case with M230I. These three confirmed and one suspect case all live adjacent to the Nile and have a linkage to ducks.

Last year at this time, low path H5 and Qinghai H5N1 were identified in wild ducks (teal) in Egypt. It is likely that H5N1 is widespread in the region, although only Egypt, Sudan, and Nigeria have reported cases in Africa. None of the countries in the Middle East have reported H5N1, although H5N1 was widespread in Turkey at this time last year and was subsequently found in neighboring countries such was Azerbaijan, Iraq, Iran, and Israel.

The extent of H5N1 spread in these regions in this year is unclear because these countries have not detected or report the H5N1 which is clearly circulating in the area. This lack of transparency in the region, coupled with a confirmed human cluster in Egypt is cause for concern.

One year ago the first human cases of Qinghai infections were reported in Turkey. Neighboring countries subsequently began reporting H5N1 infections In January and February of this year. The first fatality in Egypt did not lead to widespread reporting of H5N1 outbreaks in the area. However, the current cluster may lead to more transparency in the region.

H5N1 does not read press releases or media reports. It continues to acquire new polymorphisms via recombination, and the number of such changes in the receptor binding domain of Qinghai H5N1 co-circulating in the Middle East, including Egypt, remains alarmingly high.

Eighth Egyptian dies of bird flu: WHO​

http://www.smh.com.au/news/World/Eighth-Egyptian-dies-of-bird-flu-WHO/2006/12/25/1166895225844.html

December 25, 2006 - 6:54AM

An Egyptian woman died of bird flu on Sunday, hours after tests confirmed she and two other members of her extended family had been suffering from the highly pathogenic virus, a World Health Organisation official said.

The WHO regional adviser for communicable diseases surveillance, Hassan el-Bushra, said the 30-year-old woman had been in hospital since December 17, but doctors had not immediately suspected bird flu as she denied having had contact with poultry.

The woman was part of an extended family of 33 living in a single house in a village near the town of Zifta in Gharbiya province, about 80 km north of Cairo, and was the third family member diagnosed with bird flu in 24 hours.

Earlier on Sunday, Bushra confirmed two siblings from the same house, a brother, 26, and sister, 15, had the virus.

Bushra said the family raised ducks in their home, and the brother and sister had slaughtered the flock after a number of ducks had become sick and died.

When officials realised the woman was part of the same family, they tested her for bird flu and confirmed she was infected with H5N1, and she was moved to a Cairo hospital, but died shortly thereafter.

The two siblings are in hospital in Cairo and have been treated. The rest of the family is under close medical surveillance, Bushra said.

Her death brings the number of human deaths from H5N1 in Egypt to eight, and the number of human cases to 18 since the virus first surfaced in Egyptian poultry in February.

The initial bird flu outbreak caused panic in Egypt, where poultry is a major source of protein, and poor families frequently breed chicken and ducks domestically in cities and rural areas to supplement their diet and income.

The Egyptian cabinet announced last month the country's poultry production had recovered to almost the same level as before the deadly virus surfaced in February.

An official with the Food and Agriculture Organisation had said in October the onset of cooler weather could cause a flare-up of cases in poultry.

Vietnam decodes bird flu virus genes​

http://news.xinhuanet.com/english/2006-12/25/content_5528934.htm

www.chinaview.cn 2006-12-25 12:44:08

HANOI, Dec. 25 (Xinhua) -- Vietnamese scientists have successfully decoded genes of bird flu virus strain H5N1, paving the way for production of vaccines used among humans, local media reported Monday.

The Ho Chi Minh City Pasteur Institute has decoded genes of 24 samples of the viruses which killed fowls and people in Vietnam's southern region in the 2004-2005 period, said Youth newspaper.

The decoding shows that there have been some changes in the genes. Based on the decoding, the institute in southern Ho Chi Minh City is facilitating the production of H5N1 vaccines to be used among humans.

In November, Vietnam's Nha Trang Institute of Vaccines and Biological Products in central Khanh Hoa province announced it has successfully turned out 5,000 doses of H5N1 vaccine for humans in labs, which have yielded good results after being tested on white mice, guinea-pigs and cockerels. The institute will produce another 5,000 doses of the vaccine in early 2007 for tests at international verification centers.

Vietnam has detected 93 bird flu patients, including 42 fatalities, in 32 localities since the disease started to hit the country in December 2003, the Vietnamese Health Ministry said on Dec. 25, noting that it has seen no new human cases of infections since mid-November 2005.

Since early December, bird flu has stricken six communes in four districts in the two southern provinces of Ca Mau and Bac Lieu, killing and leading to the forced culling of 1,141 chickens and 7,929 ducks, Vietnam Agriculture newspaper on Monday quoted the Department of Animal Health under the Vietnamese Ministry of Agriculture and Rural Development as saying.

Egypt reports ninth human bird flu death
​

http://news.xinhuanet.com/english/2006-12/26/content_5531012.htm

CAIRO, Dec. 25 (Xinhua) -- The Egyptian Health Ministry said Monday that a 15-year-old girl died of the H5N1 strain of bird flu, which brought the death toll of the disease in Egypt to nine, the official news agency MENA reported.

The girl was admitted to a Cairo fever hospital after contracting the disease on Dec. 23 and was administered the Tamiflu drug, said it.

She was put on a life support system on Saturday but she died earlier on Monday, said the Egyptian Health Ministry. The girl's death came one day after a 30-year-old woman, called Intisar Farid Abdel-Hamid, died of the deadly bird flu virus, after failed attempts to resuscitate her heart.

Both the girl and the woman were from the same family living in the Egyptian Delta governorate of Gharbiya, some 90 km north of Cairo.

Besides the two, a 26-year-old man from the family was also tested positive of the deadly virus. All the three infections were confirmed on Saturday.

With the three infections, Egypt has reported a total of 18human bird flu cases.

Egypt found the first bird flu case in dead poultry on Feb. 17,2006 and then the virus spread to 20 of the country's 26governorates.

The populous Arab country reported first human bird flu case on March 18 of 2006. Since then, nine people have died of the fatal virus in the country.

Second H5N1 Fatality in Gharbiya Cluster in Nile Delta​

http://www.recombinomics.com/News/12250601/H5N1_Gharbiya_Fatal_2.html

Recombinomics Commentary
December 25, 2006

A 15-year-old girl has died from the H5N1 strain of bird flu, the second such death in as many days in Egypt, the health ministry in Cairo said.

The above comments describe the death of the second family member and third H5N1 fatality this season. This increased fatality rate coupled with the largest cluster to date in Egypt, are cause for concern. Last season, Egypt reported fourteen confirmed H5N1 cases, including six fatalities. This season the first case was hospitalized on Sept 30. She was H5N1 confirmed on October 11 and US NAMRU-3 deposited the HA sequences at Genbank on October 13.

The sequence had many polymorphism found in human and bird cases from the earlier cases in the spring. However, there were also a number of additional polymorphisms found in recent Qinghai isolates in Europe and Africa, indicating the new isolate had recombined with other Qinghai isolates in the area and acquired the new polymorphisms.

Most alarming was the acquisition of M230I, which is found in human H1N1, H3N2, and influenza B strains. This acquisition created a region of identity between positions 226-230 (QSGRI) of the influenza B receptor binding domain. Influenza B is efficiently transmitted human-to-human. Moreover, Qinghai isolates have PB2 E627K, which is another mammalian polymorphism that increases polymerase activity at lower temperatures. This polymorphism is present in all human isolates, including the 1918 pandemic strain, and has become fixed in the Qinghai strain..

The death of the cousin of the index case keeps the case fatality rate at 100% in Egypt this season. This increased CFR may be related to the genetic changes seen in the HA sequence from the earlier case. The recent cases lived 12 miles earlier case with the M230I. Release of the sequences from the three recent cases would be useful,

US NAMRU-3's rapid release of the sequence from the first cases is to be commended. Similar timely releases from the current cluster would be useful. Additional receptor binding domain changes in Qinghai isolates from the region, including S227N in Egypt and Turkey, N186S and Q196R in Iraq, and N186K in Azerbaijan, were reported in human cases from last season.

Acquisition of these changes by H5N1 isolates from Egypt would be cause for additional concern.

Bird Flu Kills Woman in Egypt, Infects Family Members​

http://www.bloomberg.com/apps/news?pid=20601085&sid=aVw4.HxBKoSk&refer=europe

(Update2)

By Jason Gale

Dec. 26 (Bloomberg) -- Bird flu killed a woman in northern Egypt as authorities attempt to eradicate the lethal virus that infected two other members of the woman's family. The infection killed a teenage girl in Cairo, Agence France-Presse reported.

The woman from Zifta, in the northern province of Gharbia, had been in contact with infected poultry, Egypt's Ministry of Health said in a statement on its Web site today. Fowl kept by the family and neighbors have been culled, and people in contact with the birds are being tested, the ministry said in a separate statement on Dec. 24.

A 15-year-old girl died from the H5N1 strain of avian flu in a Cairo hospital, AFP reported yesterday. She was transferred from a hospital in the Nile delta province of Garbiya, where she was admitted Dec. 20, AFP said.

World health experts are trying to control the H5N1 virus, which risks infecting humans and mutating to become more contagious. A virus that spreads among people as easily as seasonal flu could spark a deadly pandemic capable of killing millions of people, health authorities have said.

The H5N1 strain is known to have infected 258 people in 10 countries during the past three years, killing 154 of them, the World Health Organization said on Nov. 29, when it reported the last fatality.

Avian flu has infected 19 people in Egypt -- including the four cases recorded during the past week -- killing nine of them. Infections in Egyptian poultry were reported for the first time in February.

``Bird flu has been placed under control, and vaccination campaigns have covered all poultry populations throughout Egypt,'' Minister of Agriculture and Land Reclamation Amin Abaza said, adding that the virus will be a threat for three years.

Women at Risk

All of the nine fatalities in Egypt have been female, suggesting women are more at risk of avian flu than men, the United Nations' Integrated Regional Information Network reported yesterday.

``Women in the countryside are traditionally in charge of looking after domestically kept birds, which are the most likely to be infected with bird flu,'' the UN news service quoted Hamdi Abdel Wahed, a health ministry spokesman, as saying.

Egypt's government has banned the rearing of backyard poultry in urban areas to reduce the risk of avian-flu infection. The restrictions aren't extended to rural areas, where backyard poultry are a more important source of income.

Porous Bird Flu Quarantine Sparks Concerns​

http://english.chosun.com/w21data/html/news/200612/200612260020.html

The quarantine system designed to stem the spread of highly pathogenic avian influenza is anything but watertight, authorities have found. Gyeonggi Province reported Monday that 5,600 heads of chickens transported from a farm in Chonan, South Chungcheong Province to a Hwaseong slaughterhouse two days earlier were culled since they were found to have come from a bird-flu infected area.

The Chonan chicken farm lies within the quarantine radius of an Asan duck farm infected with a highly pathogenic bird flu strain. The farm was within 10 km of the infected area, the radius where all transport and release of poultry are restricted. The chickens were transported without the required release documents. Worse, they were infected with Newcastle disease, a class 1 animal communicable disease.

Byung-gyu Lim, a quarantine official with the Gyeonggi provincial government, said the chickens were transferred while awaiting inspection results from the National Veterinary Research and Quarantine Service after around 10,000 chickens died of respiratory and central nervous problems since Dec. 21, two days before the transport of the chickens from Chonan. He said South Chungcheong Povince and the Chonan city government are investigating how 5,000 chickens were permitted outside the area under such conditions.

Unlike bird flu, Newcastle disease is not communicated to human beings, yet infected birds are under transport ban and must be culled immediately.

Vietnam scrambles to keep bird flu in check after recurrence​

http://www.thanhniennews.com/society/?catid=3&newsid=23627

The Agriculture and Rural Development Department in the southern province, one of the two localities suffering from the recurrence, on Tuesday said the infection in Hoa Binh district’s Vinh Binh commune had been brought under control.

Nearly one year since the last outbreak in Vietnam, the southern province was forced to slaughter over 1,500 fowl in the district.

Meanwhile, the other infected province, southernmost Ca Mau, still has four communes belonging to three districts dealing with the disease.

The Ca Mau government a day earlier reported some 6,000 birds had been culled.

In related news, Nguyen Ba Thanh, director of the Can Tho City’s Animal Health Center Tuesday attributed the recurrence to local government’s failures in curbing large-scale restocking and mismanagement that allowed ducks to wander freely from one region to the other.

He called for urgent vaccination of all the birds reaching 15 days old, large-scale disinfections and strict control on fowl transportation.

Just two days earlier, agriculture minister Cao Duc Phat visited the two provinces, instructing local authorities to exercise strict vigilance on illegal transportation, hatching, and purchase of poultry from infected areas and to duly punish violators.

Vietnam has had no human bird flu cases since late 2005, but lost 42 people to the disease since it originally broke out in 2003, second only to Indonesia's 57.

The disease has killed 154 people out of 258 infected globally.

Additional H5N1 Suspect Cases in Northern Egypt​

http://www.recombinomics.com/News/12260601/H5N1_Egypt_North_More.html

Recombinomics Commentary
December 26, 2006

Pathological cases suspected of being infected with a new avian influenza in Beni Suef and Western [Al Gharbiyah]. Doctors at the hospital were surprised pathogenesis of Beni Suef appearance of the symptoms of the disease known Hoda Abdel-Hamid of the village of Blvia Amal Mohammad Omar from the village of Riyadh Pasha was accorded some medicines and drugs.

This brings the number of suspected cases of avian influenza in the bee Bank to 7 cases including 4 in the pathogenesis of hospital Mahala and 3 Hospital pathogenesis of Tanta.

The above translation describes four new suspect bird flu cases in two Egyptian governates, increase the total to seven. These cases are in addition to the four confirmed cases in Egypt this season. All four were withing 15 miles of Tanta, the capital of Gharbiyah, which is were three of the seven suspect cases are hospitalized.

These additional hospitalizations increase concerns. Three of the first four confirmed patients have died and the sequence of HA from the first case had acquired a number of polymorphisms found in other Qinghai isolates in the area. In addition, the first sequence has M230I, which is found in all three human influenza strains, H1N1, H3N2, and influenza B.

Additional information on these new suspect cases would be useful.

Vietnam

Minister cautions of possible bird flu spread​

http://www.thanhniennews.com/healthy/?catid=8&newsid=23664

Minister Agriculture and Rural Development Cao Duc Phat warned that bird flu is likely to spread throughout the Mekong Delta provinces and may reoccur in localities in the Red River delta and border areas.

The minister made the alert at a meeting between the National Steering Committee for Bird Flu Prevention and Control and authorities of concerned ministries and northern provinces in Hanoi on Tuesday.

He urged the localities to keep the disease under surveillance at its source – breeding farms – in order to promptly contain it.

At the meeting, representatives of the Trade Ministry's Market Management Department said its forces have bolstered inspections of trade, slaughtering and sales of poultry and poultry products, especially at high-risk and populated areas.

Market management forces were also instructed to cooperate with customs officers and border guards to prevent the flow of smuggled poultry into the country.

In fear of new outbreaks of bird flu, which already re-emerged in the southernmost province of Ca Mau and neighboring Bac Lieu province, authorities of Ho Chi Minh City ordered the employment of all measures to halt the spread of the disease.

Chairmen of the communal and district people's committees were required to take control of slaughtering and trade of illegal poultry and eggs in their locations.

Meanwhile, veterinary forces were ordered to maintain round-the-clock inspections at animal quarantine stations.

The authorities of the country's biggest economic hub also asked the healthcare service to prepare medicines for the fight against avian influenza in humans in case it occurs in the city and neighboring provinces.

Municipal healthcare officials have also been ordered to increase food hygiene inspections in the city.

The municipal market management forces have coordinated with other forces to tighten the control on transport of waterfowl and poultry into the city from both the waterway and inter-provincial land routes.

The veterinary departments of the 10 northern provinces and cities, including Bac Ninh, Bac Giang, Ninh Binh, Nam Dinh, Ha Tay and Hanoi, have announced they vaccinated more than 90 percent of the total poultry in the region.

Speaking at the meeting in Hanoi Tuesday, head of the Veterinary Department Bui Quang Anh also warned of the possible spread of the human form of aviation influenza in the coming time.

Anh stressed the infection of bird flu in southern provinces of Ca Mau and Bac Lieu has temporarily been brought under control. All poultry in the infected areas, reported at around 9,000 fowl, were culled.

Vietnam has had no human bird flu cases since late 2005, but lost 42 people to the disease since it originally broke out in 2003, second only to Indonesia's 57.

The disease has killed 154 people out of 258 infected globally.

Egyptian man dies of bird flu, 10th death​

http://www.alertnet.org/thenews/newsdesk/L27508270.htm

CAIRO, Dec 27 (Reuters) - A 26-year-old Egyptian man died of bird flu on Wednesday, the third member of his extended family to die of the virus, a World Health Organisation (WHO) official told Reuters.

Brick factory worker Rida Farid Abdel Halim from the Nile Delta province of Gharbia had been in hospital for 10 days, Hassan el-Bushra, WHO regional adviser for communicable diseases surveillance, said.

It was the 10th death from bird flu in Egypt since an outbreak of the virus started in February.

Bushra said Egypt had no other bird flu patients receiving treatment. Eight Egyptians had contracted the disease and recovered.

A 15-year-old girl from the factory worker's family died on Monday and a female relative died the day before, raising concerns about the possibility of human-to-human transmission.

But John Rainford, a spokesman at WHO headquarters, said: "The evidence that we have so far seems to be putting it into a context similar to other cases that have emerged since February... What we do know so far seems to suggest that the cases do not necessarily stand out."

The family had raised ducks at home, and the brother and sister had slaughtered the flock after ducks fell sick and died.

The man showed symptoms of the disease on Dec. 14 and was admitted to a rural hospital three days later. He started receiving Tamiflu treatment on Dec. 20 after a second case appeared in his family and the medical staff learned that he may have come into contact with poultry, Bushra said.

Bird flu has killed at least 156 people worldwide since 2003, according to WHO figures. People can contract the virus by coming into contact with infected poultry but experts fear the virus could mutate into a form that passes easily from human to human, sparking a pandemic that could kill millions.

The outbreak of bird flu did extensive damage to the Egyptian poultry industry this year but preventive measures appear to have contained the disease.

Before the latest three deaths, only one person had died of the disease in Egypt since May.

Third H5N1 Fatality in Gharbiya Cluster in Nile Delta​

http://www.recombinomics.com/News/12270601/H5N1_Gharbiya_Fatal_3.html

Recombinomics Commentary
December 27, 2006


Brick factory worker Rida Farid Abdel Halim was the third member of an extended family in the Nile Delta province of Gharbiyah to die of the disease, said Hassan el-Bushra, WHO regional adviser for communicable diseases surveillance.

The above comments indicate the case fatality rate in Egypt's Gharbiyah governate remains at 100%. There have been four confirmed cases, who lived within 12 miles of each other, and all four have died. The first case was hospitalized on September 30 and the sequence of the HA H5N1 was deposited at Genbank on October 13. In addition to polymorphisms in H5N1 from Egyptian isolates from earlier cases, the isolate had a number of additional polymorphisms, acquired via recombination with other Qinghai isolates migrating through the region.

In addition, the isolate had M230I, which is found in all three human influenza strains, H1N1, H3N2, and influenza B. The acquisition creates a region of identity in the receptor binding domain of influenza, QSGRI (positions 226-230). This identity match with influenza B indicates that H5N1 need not change positions 226 and 228 to generate a receptor binding domain match with a human influenza strain that is efficiently transmitted human-to-human, since influenza B has that property with Q (glutamine) and G (glycine) at positions 226 and 228, respectively.

The presence of this change, or the conservation of the additional acquisitions would be of interest. Release of the sequences from H5N1 from the current cluster of three fatal cases in the Gharbiyah governate would be useful.

Avian influenza in Egypt​

http://www.who.int/csr/don/2006_12_27a/en/

27 December 2006

The Egyptian Ministry of Health and Population has informed WHO of three new human cases of avian influenza A(H5N1) virus infection. All three cases belong to one extended family in Gharbiyah province, 80 kilometres northwest of the capital city, Cairo. While being transferred and cared for at the country's designated avian influenza hospital, a 30 year-old female, a 15 year-old girl and a 26 year-old male died. The most recent death occurred on 27 December. The cases reportedly had contact with sick poultry (ducks).

Clinical specimens from the three cases were tested positive for avian influenza A(H5N1) virus by Egyptian Central Public Health Laboratory. The virus was also detected in specimens from two of the three patients by US Naval Medical Research Unit No.3 (NAMRU-3). The samples will be sent to WHO Collaborating Centre for further testing including virus characterization.

The Egyptian Ministry of Health and Population is conducting further investigations and has initiated public health measures. The other family members remain healthy and have been placed under close observation.

Egypt's 10th bird flu death this year, 3rd in extended family​

http://www.iht.com/articles/ap/2006/12/27/africa/ME_GEN_Egypt_Bird_Flu.php

CAIRO, Egypt: A brick factory worker is Egypt's tenth bird flu fatality, Egypt announced Wednesday, and the third member of his extended family to die of the deadly strain of H5N1.

Egypt's official Middle East News Agency reported that a Health Ministry statement identified the latest fatality as Ridha Abdelhaleem, 26.

Abdelhaleem was the third member to die in an extended family that lives in a single dwelling in Gharbiya province, north of the Egyptian capital, a Health Ministry official told the MENA agency.

Abdelhaleem lost a sister, 15, and a 30-year-old female cousin to the disease during the past week. All three were hospitalized in Cairo after testing positive for H5N1.

Bird flu was first detected in Egypt in February and has spread to at least 19 of the country's 26 provinces. Eighteen human cases of the disease have been confirmed in Egypt, which lies on a migratory route for wild birds.
Today in Africa & Middle East

The discovery of avian flu in the Middle East has led to widespread culling of birds. The H5N1 strain has hit at least 45 countries and killed more than 150 people worldwide.

Avian flu jumps to humans in Egypt​

http://www.iht.com/articles/2006/12/27/news/egypt.php

By Donald G. McNeil Jr.
Published: December 27, 2006

Several cases of avian flu have spread from poultry to humans in the Nile Delta, the Egyptian health authorities said this week as they worked to halt the outbreak among chickens and ducks.

A 15-year-old girl died Monday, a day after the death of a woman in her 30s whose family members showed symptoms of infection.

Egypt has reported nine confirmed human deaths from H5N1 avian flu since it was first found in birds in February and in a person in March.

At that time, the health and veterinary authorities canceled duck-hunting season, banned imports of live birds and forbade city dwellers to raise birds at home.

Officials also began culling diseased flocks and vaccinating healthy ones. They ran into early problems, like vaccine shortages and widespread disregard for the new regulations by poor rural people who could ill afford to lose birds raised for food and sale.

An Egyptian newspaper, The Daily Star, reported that 30 million birds had been slaughtered since then, mostly from the poultry industry, which suffered major losses.

Reports of the disease tapered off over the summer, but reappeared in September in the delta, an important stopover for migrating birds, with many moving through in December. The disease peaks in cooler months.

The Egyptian Health Ministry offered sketchy details on the deaths. It sometimes takes the World Health Organization several days to confirm cases.

Local news media reports suggest that there have been about 20 suspected human cases in the northern part of Egypt.

At least 3 were among 33 members of an extended family that lived in a compound in Hanut in Gharbiya Province. The woman who died last weekend, her brother and a niece were said to have fallen ill after slaughtering ducks for a cousin's wedding.

Local reports said the authorities had declared an emergency and were trying to kill all the birds for 400 meters, or about a quarter-mile, around the compound, but were frustrated by residents who had hidden birds under beds.

NAIA intensifies bird-flu watch​

http://www.abs-cbnnews.com/storypage.aspx?StoryId=60748

By JONATHAN HICAP, The Manila Times Reporter

The Manila International Airport Authority has intensified its watch against bird flu following reports of continued outbreaks in several countries.

In a memorandum issued on December 27, Alfonso Cusi, MIAA general manager, ordered all airport personnel to continue the use of thermal scanning for incoming passengers and flight crew and the use of footbath to prevent the entry of the virus from affected countries.

Cusi said the Ministry of Health in Indonesia confirmed the country’s 57th death from the bird-flu virus. A 35-year-old female died of the virus on November 28. Indonesia confirmed 57 deaths of the 74 cases of bird flu.

He also ordered the full staffing of medical personnel detailed at the MIAA-Bureau of Quarantine and the continuous coordination with offices to ensure that guidelines are followed.

The World Health Organization said there are 258 confirmed bird-flu cases in the world with 154 confirmed human deaths.

“We cannot allow any risk or threat that will imperil our nation’s present condition,” Cusi said in the memo.

Bird Flu Deaths in 2006 Exceed Prior 3 Years​

http://www.bloomberg.com/apps/news?pid=20601087&sid=a6zIRAzHuUmc&refer=home

By Jason Gale and John Lauerman

Dec. 28 (Bloomberg) -- Bird flu killed three members of a family in Egypt, pushing the number of fatalities worldwide this year to 79, more than reported in the previous three years combined.

The Egyptian Ministry of Health and Population confirmed that the H5N1 strain of avian influenza had infected the three, who belong to an extended family in Gharbiyah province, 80 kilometers (50 miles), northwest of the capital, Cairo, the World Health Organization said in a statement yesterday.

``While being transferred and cared for at the country's designated avian influenza hospital, a 30-year-old female, a 15- year-old girl and a 26-year-old male died,'' the United Nations health agency said in the statement on its Web site. The most recent death occurred yesterday, the agency said.

The patients had all been in contact with sick ducks, WHO said. Egypt has struggled to control H5N1 outbreaks in poultry, first reported in February, leading to at least 18 human cases, including 10 deaths.

Diseased birds increase the opportunities for human infection and provide chances for H5N1 to mutate into a form more dangerous to people. Millions could die if H5N1 becomes easily transmissible between people, sparking a lethal pandemic.

Human Cases in Decline?

The H5N1 virus is known to have infected 261 people in 10 countries in the past three years, killing 157 of them, WHO said yesterday. Last year, 42 fatalities were confirmed, after 32 in 2004 and four in 2003. Six of every 10 reported cases have been fatal and a majority of cases has occurred among children and young adults.

Since July, 26 human cases have been reported in four countries, compared with 88 infections in eight countries in the first half of the year.

``In the second half of 2006, there was a steep decline in the number of case reports, although similar declines occurred in 2004 and 2005, but were then followed by resurgences,'' the influenza team at the European Centre for Disease Surveillance and Control in Stockholm wrote in a Dec. 21 report in Eurosurveillance Weekly.

A few slow months in cases doesn't mean that the threat of pandemic is at an end, said Peter Sandman, a risk communication specialist in Princeton, New Jersey.

``When you install a smoke alarm in your house and then go a year without a fire, that doesn't mean you were foolish to install a smoke alarm,'' said Sandman, who consults to the U.S. Department of Health and Human Services on pandemic communication. ``It means it's time to change the batteries.''

Infection Frequency

Analyzing the frequency of infections over the short term ``is like trying to look at the stars under a microscope,'' said Michael Osterholm, director of the University of Minnesota's Center for Infectious Disease Research and Policy in Minneapolis.

Infectious disease is linked to factors including aspects of the environment, such as temperature and humidity, or the length of light in a day, Osterholm said in a Dec. 21 interview.

``Any changes in those can by themselves have an impact, and we see lots of normal variation in diseases as a result,'' he said. ``The question is how do you distinguish long-term changes from what we might consider chance variation. That's what's happening with influenza.''

The virus can now be found in both domestic and migratory bird populations in Asia, even in areas where there have been no large outbreaks, Osterholm said. That may result in opportunities for humans to become infected, and in greater chances for a mutation-driven change, he said.

Women Over-represented

Females are over-represented among H5N1 patients aged 10-29 years, possibly because it is usually young people and women who look after domestic poultry, the ECDC's influenza team said in Eurosurveillance.

``Human-to-human transmission, as indicated by cluster size, is still extremely inefficient, as it was a decade ago when the first human-to-human transmission took place in Hong Kong,'' the researchers said.

Indonesia, with 74 human H5N1 cases to date, including 57 fatalities, is the country worst affected by the virus. Outside Asia, Egypt has the most cases.

``There is evidence that H5N1 viruses have now become entrenched in backyard poultry in Indonesia, and perhaps also Egypt,'' the report in Eurosurveillance said.

Egyptian Cases

Specimens from the most recent three Egyptian cases tested positive for avian influenza A (H5N1) virus by the country's Central Public Health Laboratory. The virus was also detected in specimens from two of the three patients by the U.S. Naval Medical Research Unit No.3 (NAMRU-3), WHO said.

The samples will be sent to a laboratory that works with WHO for further testing including characterization of the virus, the Geneva-based agency said.

The Egyptian Ministry of Health and Population is further investigating the bird flu cases and has implemented measures to protect public health, WHO said in its statement. The other family members remain healthy and have been placed under close observation, the agency said.

Bird flu spreads in Vietnam's Mekong delta​

http://www.alertnet.org/thenews/newsdesk/HAN169266.htm

28 Dec 2006 09:00:35 GMT
Source: Reuters

HANOI, Dec 28 (Reuters) - A third Vietnamese province on Thursday recorded an outbreak of bird flu in poultry, a day after the Agriculture Ministry said the disease had been contained.

The Animal Health Department said tests confirmed the presence of the H5N1 virus in a flock of 450 ducks in Hau Giang province, adjacent to Bac Lieu and Ca Mau where more than 9,000 ducks and chicken have been slaughtered since bird flu was identified there on Dec. 11.

The virus first arrived in Vietnam's Mekong Delta in late 2003 and has since killed 42 of the 93 people infected in Vietnam.

Vietnam, which has had no human bird flu cases since late 2005, has a human death toll second only to Indonesia's 57, according to the World Health Organisation (WHO).

WHO says bird flu has killed 154 people out of 258 infected globally since late 2003.

Bird flu hits one more Vietnamese province​

http://news.xinhuanet.com/english/2006-12/28/content_5544434.htm

HANOI, Dec. 28 (Xinhua) -- Bird flu has stricken southern Hau Giang province, raising the total number of localities in Vietnam to three, Central Vietnam Television reported Thursday evening.

The disease either killed or sickened over 1,100 ducks in two flocks in the province's Long My district on Dec. 26. Specimens from the dead waterfowls that had not been vaccinated against bird flu viruses have been tested positive to virus strain H5N1.

Early this month, bird flu hit the two southern provinces of Ca Mau and Bac Lieu, resulting in the forced culling of more than 11,000 chickens and ducks so far.

On Dec. 28, Cao Duc Phat, Vietnamese minister of agriculture and rural development and chairman of the Central Steering Committee on Bird Flu Prevention, asked local steering committees and localities nationwide to focus their anti-disease activities on surveillance, detoxification, vaccination, quarantine, and control over transport and trade of poultry and related products, the TV report said.

They have been tasked to conduct bird flu surveillance at household level to early spot outbreaks, detoxification at high-risk areas, farms, slaughterhouses and markets, and vaccination among unvaccinated fowls, including those unlawfully hatched and raised by residents; resume operation of domestic animal quarantine; establish mobile quarantine checkpoints at main roads and waterways; tighten management over the transport and trade of fowls and related products; and intensify cross-border poultry smuggling.

Bird flu outbreaks starting in Vietnam in December 2003 have killed and led to the forced culling of dozens of millions of fowls. The last outbreak of bird flu among poultry in the country was in December 2005.

Vietnam has detected 93 bird flu patients, including 42 fatalities, in 32 localities, the country's Health Ministry said on Dec. 27, noting that it has seen no new human cases of infections since mid-November 2005.

Egypt faces grim bird flu situation​

http://news.xinhuanet.com/english/2006-12/29/content_5544665.htm

CAIRO, Dec. 28 (Xinhua) -- Egypt witnessed three human bird flu death cases in only four days, the death toll of the human bird flu cases in the country rose to 10 and aroused some worries about spreading of the deadly disease.

Reda Abdel Halim Farid, a 26-year-old man from a big family living in the Egyptian Delta governorate of Gharbiya, some 90 km north of Cairo, died of the deadly H5N1 virus on Wednesday, became the third casualty in a week after another two members of the family, a 30-year-old woman and a 15-year-old girl, who died on Sunday and Monday respectively.

On the current bird flu situation in Egypt, Egyptian Health Ministry spokesman Abdel Rahman Shahine told Xinhua that the situation seems to be dangerous but it is under control, specially as people start to recognize how dangerous the virus is and directly inform the authorities of any suspected cases.

"H5N1 is a serious threat in Egypt and we set up a plan to take measures in cooperation with other ministries to deal with this problem," Shahine said.

He added that Egypt is cooperating with the World Health Organization and the EU among others to provide some vaccines to face the disease.

For his part, Egyptian Ministry of Environment senior official Ahmed el-Emary said that there would be serious problems during next March, the birds immigration season, when hundreds of birds come from the EU through Egypt on their way to Africa.

As for measures taken by the Egyptian government to deal with the grim situation, Egyptian cabinet spokesman Magdi Radi said that the country has designed a comprehensive plan in order to face the issue and a big number of Tamiflu, a kind of medicine against the bird flu disease, have already been imported.

Meanwhile, Radi asked people to stop buying alive birds to eat, recommending that it is better to change their habits and buy slaughtered birds which have been done under the supervision of the authorities.

The first bird flu case in Egypt was found in dead poultry on Feb. 17, 2006 and then the virus spread to 20 of the country's 26governorates, with the first human bird flu case in the Arab country reported on March 18, 2006.

Since then, a total of 18 reported human bird flu cases have been reported, among which 8 persons were cured.

Vietnam sets up checkpoints to contain bird flu outbreaks ​

http://rawstory.com/news/2006/Vietnam_sets_up_checkpoints_to_cont_12292006.html

dpa German Press Agency
Published: Friday December 29, 2006

Hanoi- Vietnam has banned transport of poultry and set up road checkpoints in parts of the southern Mekong Delta in hopes of controlling a spreading outbreak of bird flu among flocks, an official said Friday. The deadly H5N1 virus spread to a third southern province this week after re-emerging in Vietnam 10 days ago, and Minister of Agriculture Cao Duc Phat issued urgent instructions to provinces to try to contain the outbreak.

"We have been instructed to cull birds in the infected areas, disinfect the farms, set up checkpoints to stop the transport of poultries from infected areas and continue to vaccinate birds," said Nguyen Hien Trung, head of the animal department of Hau Giang province.

Authorities hope to contain the avian influenza virus, which previously killed 42 people and millions of chickens in Vietnam, before it has a chance to become endemic in poultry and infect more humans.

Vietnam had declared itself free of bird flu earlier this year after an aggressive poultry vaccination programme for 126 million chickens and ducks.

But the virus reappeared in two provinces last week and was confirmed Thursday in Hau Giang, 220 kilometres southwest of Ho Chi Minh City. Officials have been slaughtering chickens and ducks in the affected districts as well as in nearby Bac Lieu and Ca Mau provinces, where the virus reappeared in Vietnam after more than a year's absence.

The three provinces have so far culled nearly 14,000 ducks and chickens in and around the infected areas after 4,500 birds have been found dead since early this month, according to Hoang Van Nam, head of the Epidemic Unit under the Department for Animal Health.

Officials warned that the measures might not be enough to contain the virus and that Vietnam could see a return to high levels of disease in poultry.

"The possibility for the outbreaks to spread further is very high as the weather will keep cool, which is perfect for H5N1 virus to proliferate," Nam said.

"In addition, this season is the migration season of wild birds in the region. Local farmers still underestimate the danger of an epidemic, and as the traditional lunar new year is approaching, local people will transport more birds," he said.

Although bird flu has devastated Vietnam's poultry industry, the real concern is that its return in domestic poultry could infect more humans, who can catch it through close contacts with infected birds. At least 160 people have died of the disease worldwide since 2003.

While H5N1 is not easily contagious among people, scientists fear that if the virus is left unchecked it could mutate to allow human-to-human transmission, which threatens the lives of millions of people who would have no natural immunity to a new influenza strain.

Bird Flu Cases Decline, Raising New Risk: Complacency​

http://www.bloomberg.com/apps/news?pid=20601101&sid=aH72rK5F_ueg&refer=japan

By Jason Gale and John Lauerman

Dec. 29 (Bloomberg) -- Bird flu infected fewer humans in the second half of the year, prompting experts to point to a new enemy in the fight against a possible pandemic: complacency.

The lethal H5N1 strain of avian influenza was reported in people every two days in the first half. Since July, the number of cases has slowed to about one a week and scientists say the virus hasn't yet found a way to easily infect humans.

Governments should continue to track and eradicate the disease, even as public perception shifts and a pandemic poses no immediate threat, said David Nabarro, the United Nations coordinator for avian and pandemic influenza. The flu spread in domestic poultry and wild birds across 38 countries in Asia, Africa and Europe since February, offering the virus more chances to mutate into a form dangerous for humans.

``You don't stop airport security screening because there have been no hijacks for two years,'' Nabarro said in an interview from New York last week. ``The danger of a pandemic is as profound now as it was a few years ago.''

Since January, countries including the U.S. and Japan have pledged about $2.5 billion to fund efforts to monitor, manage and eradicate H5N1 and to prepare for a possible pandemic. Those efforts may have helped, according to Nabarro.

``It would be nice to think that the enormous amount of work that's been put into this is having an impact,'' he said. ``I think it's a bit early to tell.''

Hiccups Kills More People

The flu pandemic that struck in 1918 would probably kill about 62 million people nowadays, as many as died during World War II, the Lancet medical journal said last week.

The H5N1 bird flu strain has killed 157 people since 2003, according to the World Health Organization. This year, 114 cases, including 79 deaths, were reported, with 88 of the new infections counted between January and June.

While scientists agree on the need to track the virus and prepare for a pandemic, they are divided over whether the H5N1 strain is a likely trigger. Some say governments and doctors should focus on being prepared for any pandemic -- not just a bird flu one -- and work to reduce the impact of seasonal flu, which contributes to the death of as many as 500,000 people each year.

``One could make the argument more people die of hiccups'' than of avian influenza, says Peter Palese, chair of Mount Sinai School of Medicine's department of microbiology in New York. ``The virus hasn't really gone in a major way into humans. That is a very important fact, which makes it doubtful that H5N1 is really the next pandemic strain.''

Spreading Undetected

It could take millions of years for H5N1 to mutate into a pandemic form, and panic over the virus is being fanned by ``an avian flu bureaucracy'' egging on governments to provide ever more money, U.S. science writer Michael Fumento wrote in an article appearing in the Dec. 25 edition of the Weekly Standard.

Still, concern prompted some consumers to stockpile Roche Holding AG's Tamiflu antiviral drug and spurn chicken and duck meat in the past year. In France, Europe's largest poultry supplier, producers hurt by a slump in demand lost about 40 percent of their income in the first quarter, according to the World Bank.

The reduction in reported infections and a decline in media coverage don't mean the virus is no longer continuing to circulate in many countries, according to virologist Ilaria Capua, whose laboratory in Padova, Italy, handles some of the avian flu screening for the World Organization for Animal Health.

``At the beginning of the year there was a sort of race to show the world that even Africa had the problem, and African countries were very outspoken,'' Capua said in a telephone interview on Dec. 23. Some outbreaks were mistakenly diagnosed, hurting trade and tourism and making countries more reluctant to acknowledge the disease, she said.

Ups and Downs

In February, Nigeria became the first of eight countries in Africa to report outbreaks in poultry. Last week, the UN reported that H5N1 had been found in 17 of Nigeria's 36 states.

``I am pretty confident that if it's widespread in some countries like Nigeria, then it is also widespread in other countries,'' Capua said.

More than 700 outbreaks of H5N1 among wild birds and domestic poultry were reported to the World Organization for Animal Health this year.

``We're in a situation of low incidence, but I'm sure we're going to see some peaks of infection in the future,'' said Peter Roeder, an animal health officer with the UN's Food and Agriculture Organization, who helped Indonesia set up its bird surveillance. ``How important they will be, how serious they will be it's not possible to say right now.''

New Virus, No Immunity

The lethal strain of H5N1 was traced to a farmed goose in the southern Chinese province of Guangdong in 1996. It was found in South Korea in December 2003, before spreading across eastern Asia the following year and to Eastern Europe in 2005.

``H5N1 viruses have been around for nearly a decade and it might be tempting to conclude that if they were going to proceed to form or contribute to a pandemic strain, they would have done so by now,'' the influenza team at the European Centre for Disease Surveillance and Control said in a report last week.

Still, the strain that sparked the 1918 pandemic ``had been around for some years before it became part of a virus that could efficiently transmit between humans,'' they said.

A pandemic can start when a novel A-type flu virus, to which almost no one has natural immunity, emerges and begins spreading. H5N1 has put the world closer to another pandemic than at any time since 1968, when the last of the 20th century's three major outbreaks occurred, according to the WHO.

``Sooner or later there will be a highly lethal form of influenza and who knows when sooner or later is?'' Kenneth Hill, a visiting professor at the Harvard Center for Population and Development Studies in Cambridge, Massachusetts, said in an interview last week. ``I don't think we should be complacent.''

Link to next weeks thread:

HEALTH - 12/30/06-1/5/07 | Weekly Bird Flu Thread:Lancet:China Health alert pig farmers die

http://www.timebomb2000.com/vb/showthread.php?p=2169298&posted=1#post2169298