HEALTH - 3/2/08-3/8/08|Weekly Bird Flu Thread: Egypt confirms new human bird flu case

Link to last weeks thread:

HEALTH - 2/24/08-3/1/08|Weekly Bird Flu Thread: Pakistan finds new bird flu outbreak

http://www.timebomb2000.com/vb/showthread.php?t=278500&highlight=bird

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
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Egypt confirms new human bird flu case​

http://news.xinhuanet.com/english/2008-03/02/content_7698075.htm

CAIRO, March 1 (Xinhua) -- Egypt on Saturday confirmed that a 25-year-old woman was infected with bird flu virus, which was the 45th human infection case in the populous Arab country, the official MENA news agency reported.

The woman had been transferred from a local hospital in Fayyum,85 km south to Cairo, to a hospital in the capital after having developed the symptom of high fever and been treated with the antiviral drug Tamiflu, Health Ministry spokesman Abdel Rahman Shaheen was quoted as saying.

This is the second human bird flu case detected in a week in Egypt after a four-year-old girl on Monday was confirmed being infected with bird flu virus in El Minya governorate, Upper Egypt, some 220 km south of Cairo.

The girl is now still under treatment at Manshiat al-Bakri hospital in Cairo with her condition in stable, according to MENA.

The Egyptian government has exerted more efforts to prevent further spread of bird flu since the fatal virus caused four human deaths in less than a week in late December, 2007.

Among a total of 45 human cases in Egypt, 19 deaths have been reported since the country detected the first H5N1 virus in dead poultry in February 2006 and the first human case in March of the same year.

Indonesian father and son suspected of bird flu infection: doctor​

http://www.physorg.com/news123663461.html

A nine-year-old boy and his father have been admitted to a hospital in Indonesia, suspected of having bird flu, a medic said Sunday.

Both were admitted to the Dr. Muwardi general hospital in the Central Java city of Solo on Saturday showing all the symptoms of infection, Reviono, who heads the hospital's bird flu unit, told AFP.

He said the pair had buried chickens that had died after being infected with H5N1, while several chickens in their neighbourhood had also tested positive for the disease.

Both have been put in the hospital's isolation ward and blood and tissue samples will be sent to the health ministry laboratory in Jakarta on Monday, he added.

Two positive results are needed before Indonesian authorities confirm a human bird flu infection.

Indonesia has the highest number of human bird flu casualties in the world, with 105 killed by the disease.

The father and son were referred from a hospital in nearby Klaten district where they live, Reviono said.

Experts fear the virus, which is usually spread directly from birds to humans, could mutate into a form easily transmissible between people, sparking a deadly global pandemic.

Eleven people have died of bird flu in Indonesia this year, 10 of them from Jakarta and its surrounding areas.

Accelerated H5N1 Evolution in Egypt​

http://www.recombinomics.com/News/03010802/H5N1_Egypt_Evolution.html

Recombinomics Commentary 21:21
March 1, 2008

The recently released H5N1 poultry sequences from Egypt demonstrate an accelerated rate of genetic change, coupled with a high frequency of non synonymous changes, which include positions which have changed to multiple amino acids. The dramatic changes signal vaccine escape.

These developments have been recent and appear to be associated with an expanded vaccine program. The dramatic increase in genetic diversity is cause for concern.

Egypt has had over 1000 outbreaks described in OIE reports and the two confirmed cases this week raise the number of reported cases to 45, the highest in any country outside of Asia. Moreover, the two cases this week developed pneumonia, in contrast to the cases reported a year ago.

The recent HA sequences have multiple positions which have changed to more than one amino acid. Position 144 has had three recent changes, R144K, R144I, and R144S. Similarly, position 158 has changed to two amino acids, D158N and D158G. This type of rapid change may signal escape from recent vaccines.

These data raise serious concern about the rate and direction of H5N1 evolution in Egypt. Release of the human H5N1 from cases at the end of 2007, as well as the two cases reported this week would be useful.

Rapid H5N1 Evolution in Egypt Raises Pandemic Concerns​

http://www.recombinomics.com/News/03020801/H5N1_Egypt_Evolution_Pandemic.html

Recombinomics Commentary 05:21
March 2, 2008

New H5N1 poultry sequences have been released by the National Lab of Veterinary Quality Control on Poultry Production in Egypt (see list here). The eighteen HA sequences are largely from isolates collected in December, 2007 or January 2008. Included in this collection are H5N1 sequences from vaccinated flocks. These sequences have an alarming number of new polymorphisms, most of which are non synonymous. As noted earlier, the sequences released from NAMRU-3 had a number of non synonymous changes at targeted positions. The sequences from the National Lab extend these observations.

There are now multiple positions which have changed to two or more amino acids. Position 144 which had changed to three different amino acids (R144K, R144I, and R144S), now includes a fourth amino acid change, R144G. Similarly other positions with two or more changes include K123R and K123N, D158N and D158G, M230I and M230V.

The above changes are seen in a limited analysis. The number may go higher. However, many of these changes are not just in vaccinated flocks. They are present in subsequent collections at a variety of locations in the Nile Delta, raising concerns that these changes are being driven by poorly matched vaccines and these changes are becoming widespread.

This dramatic increase in genetic diversity raises serious pandemic concerns. H5N1 evolves via recombination, and the large number of diverse sequences concentrated in regions fed my the Nile in Egypt increases co-infections and the rate of evolution, which presents significant problems for vaccination programs.

The National Labs in Egypt are to be commended for releasing these sequences in a timely matter. These sequences define a serious problem in Egypt.

Release of the H5N1 sequences from the human cases from the same time period would be useful.

Bird Flu case found in S. Iraqi city of Basra​

http://www.kuna.net.kw/NewsAgenciesPublicSite/ArticleDetails.aspx?id=1888496&Language=en

BAGHDAD, March 2 (KUNA) -- A case of Bird Flu has been discovered on Sunday in the southern Iraqi city of Basra.

An Iraqi higher committee Secretariat in combating Bird Flu from the Iraqi cabinet council said the new discovery is in Al-Fedagiya village in the Fao area.

The committee, based on the discovery, prohibited all transfers of poultry and live birds to other provinces before getting permission from local Vet hospitals.

The committee also issued an order prohibiting the selling and dealing of birds and poultry in the area, including taking all the precautionary measures needed.

The committee also called on citizens in the area to avoid bird hunting the area for their own safety. (end) ahh.mb KUNA 022103 Mar 08NNNN

Man suspected of contracting bird flu in Thai northeast​

http://news.xinhuanet.com/english/2008-03/03/content_7710247.htm

BANGKOK, March 3 (Xinhua) -- A man was suspected of having contracted bird flu after eating sick chicken and fell ill in Thailand's northeastern province Chaiyaphum, according to local media Monday.

Promma Kulkasem, 57, was admitted to the Chaiyaphum Hospital Monday after falling sick with high fever and other flu-like symptoms since last Saturday, said the news network The Nation.

Promma said that he roasted and ate some of his chicken which died from illness and died before he himself fell ill.

The patient was closely watched in the intensive care unit (ICU)and a lab test is being conducted to determine whether he had caught bird flu.

Promma was the second suspected human-contracting-bird-flu case reported this year. In early February, a 32-year-old man in northern province Phichit was also suspected of contracting bird flu with high fever after contact with dead chickens. But lab tests later cleared him of the danger.

Thai public health authorities nationwide has been put on alert for bird flu outbreak after a flock of chicken which died in January at a farm in northern province Nakhon Sawan were confirmed to have contacted the H5N1 virus, prompting a culling of thousands of poultry and a quarantine in the region.

Earlier in March 2007 a bird flu outbreak was reported in northeastern province of Mukdahan bordering Laos. Last September, the Phichit province also reported detection of H5N1 virus that killed dozens of chickens raised by a villager.

The latest wave of bird flu outbreaks in Thailand since 2004 has seen 25 people infected with the deadly H5N1 virus, 17 of whom died.

No human bird flu case has been reported this year.

Bird flu outbreaks reported in two more provinces​

http://www.nhandan.com.vn/english/life/030308/life_b.htm

Nhan Dan - Bird flu outbreaks have been reported in Phu Tho and Ha Nam province, announced the Veterinary Department under the Ministry of Agriculture and Rural Development on March 2.

This has brought the number of the epidemic-hit cities and provinces to nine, including Thai Nguyen, Quang Ninh, Hai Duong, Nam Dinh, Tuyen Quang and Ninh Binh in the north and Vinh Long in the south.

Long An has been allowed to declare free from bird flu after having been free from new bird flu outbreak for 21 days.

The H5N1 virus was found in Cam Khe district,Phu Tho province on February 28.

Meanwhile, the disease was detected in Duy Tien district of Ha Nam province on February 29.

Bui Ba Bong, deputy minister of agriculture and rural development and officials from the Veterinary Department on March 1 paid a working visit to Ninh Binh province to examine and guide the province's prevention of the bird flu.

Reports of Increased Survival in Bird Flu Patients Taking Tamiflu​

http://www.boursonews.com/increased_survival_118493_news-bourse.html

BASEL, Switzerland, March 3 /PRNewswire/ — Physicians from countries worst-affected by the deadly bird flu (H5N1 influenza virus) have reported an increased survival rate in patients treated with the oral antiviral Tamiflu (oseltamivir). These data reinforce the World Health Organization (WHO) advisory that Tamiflu is the only antiviral strongly recommended for the treatment of humans infected with the H5N1 virus. The physicians’ report was revealed this week at the International Symposium on Respiratory Viral Infections (ISRVI) in Singapore.(1)

According to the WHO the H5N1 virus has already killed 234 people in 12 countries.(2) Tamiflu is the only antiviral reported to have been used against H5N1 in humans outside the laboratory and actually in the field.

In Indonesia, of the total of 119 H5N1 human cases reported, 22 survived - an 18 percent survival rate overall. Of these, 33 patients received no Tamiflu, all of whom died. Tamiflu was administered to 86 patients with a 26 percent survival rate overall. Time from onset of illness to initiation of treatment appeared to influence survival. Of the 2 patients who received Tamiflu within 24 hours of illness onset both survived. 55 percent survived if given the drug within four days (6/11), and 35 percent survived if given Tamiflu within six days (13/37)3. The survival rate of those receiving it later than 6 days after illness onset was 18 percent (9/49)2 Recent information on 8 Vietnamese patients infected with H5N1, was also presented. All 8 patients received Tamiflu. However, all 8 patients presented to the hospital later than 5 days after onset of illness. Only 3 of the 8 patients survived reinforcing that treatment benefit is reduced for patients that receive the drug later in the course of illness. (3),(4) In 2 patients who were unable to take the drug orally due to the severity of their illness physicians administered the drug by nasogastric tube and found it was well absorbed and there was a reduction in H5N1 virus in these patients.

Susceptibility of circulating H5N1 strains to Tamiflu

These clinical findings are supported by new animal data, also presented at ISRVI, which shows that oseltamivir treatment was effective against H5N1 influenza viruses representing different clades/subclades. However higher doses were required for the more pathogenic H5N1 viruses.(5)

etquot ;Multiple factors can affect the susceptibility of antiviral therapy with highly pathogenic H5N1 influenza viruses and it is reassuring that oseltamivir, in mouse models, demonstrates activity even to the most pathogenic circulating strains,etquot ; comments study author Dr. Elena Govorkova, St. Jude Children’s Research Hospital, Memphis, US. etquot ;Antiviral drugs are an essential component for the early control of an influenza pandemic.etquot ;

Data also confirms the low level of resistance reported to date with Tamiflu to H5N1 avian influenza in the field ; there are only five cases of published reports of H5N1 resistance or reduced susceptibility to Tamiflu to date.(6),(7),(8) Laboratory results have shown 96 percent of H5N1 strains (53 out of 55) tested in the laboratory were sensitive to Tamiflu.(9)

This compares to the around 14 percent of isolates tested this year of the seasonal influenza A H1N1 virus showing resistance to Tamiflu, reported at the conference.(10) It is important to note that these increased levels of resistance have only been reported spontaneously in this year’s H1N1 (Solomon Islands) seasonal strain, and not an avian strain such as H5N1 and not in patients who have been administered Tamiflu.(11)

etquot ;Currently, we are seeing that Tamiflu has been used as part of the clinical management of patients infected with H5N1 with only isolated cases of resistance being reported,etquot ; comments Dr David Reddy, Global Pandemic Task Force Leader at Roche. etquot ;This is reassuring for governments that have stockpiled Tamiflu for pandemic use. It is however critical that both Roche and the medical community remain vigilant so that we can understand this mutating virus and be best prepared for defence against a potential pandemic strain.etquot ;

Roche has undertaken several research initiatives to study the use of Tamiflu against the evolving H5N1 avian influenza virus, including collaborations with the National Institutes of Health (NIH), the Southeast Asia Influenza Clinical Trials Research Network and other research institutions.

Note to Editors :

Difference between a pandemic strain of influenza and seasonal influenza

A pandemic strain of influenza is always of the A variety and is a completely new strain to which there will be no immunity whereas a seasonal strain of influenza is one that has previously been circulating, which may have changed slightly (antigenic drift) and to which a level of immunity exists.

About pandemic influenza

An influenza pandemic occurs when a new strain of influenza A virus appears, against which the human population has no immunity resulting in several, simultaneous epidemics worldwide with enormous numbers of deaths and illness. The most severe influenza pandemics to date include : ’Spanish flu’ A (H1N1) : 1918 caused in excess of 30 million deaths worldwide, ’Asian flu’ A (H2N2) : 1958 caused 1 million deaths worldwide, ’Hong Kong flu’ A (H3N2) : 1968 caused 800,000 deaths worldwide in six weeks. The WHO believes that we are as close to the next pandemic as we have been any time in the past 37 years, with two of the three widely-recognised prerequisites for a human pandemic met to date in the avian influenza outbreak in East Asia. Firstly, a new influenza virus strain has emerged (H5N1), and secondly, the virus has spread to humans. The final barrier will be the transmission of the virus from human to human.

About Tamiflu

Tamiflu is designed to be active against all clinically relevant influenza viruses and works by blocking the action of the neuraminidase (NA) enzyme on the surface of the virus. When neuraminidase is inhibited, the spread of the virus to other cells in the body is inhibited. It is licensed for the treatment and prophylaxis of influenza in children aged one year and above and in adults. The most frequently reported adverse events in clinical studies were nausea, vomiting, and diarrhea. Tamiflu is available for the treatment of influenza in more than 80 countries worldwide.

Tamiflu was approved based on studies in seasonal influenza. The magnitude of effect of Tamiflu in treating and preventing novel strains of influenza (such as those that may be involved in a pandemic or associated with avian flu) cannot be predicted. The WHO has recommended that higher doses and longer duration may be required

Roche and Gilead

Tamiflu was invented by Gilead Sciences and licensed to Roche in 1996. Roche and Gilead partnered on clinical development, with Roche leading efforts to produce, register and bring the product to the markets. Under the terms of the companies’ agreement, amended in November 2005, Gilead participates with Roche in the consideration of sub-licenses for the pandemic supply of Tamiflu in resource-limited countries. To ensure broader access to Tamiflu for all patients in need, Gilead has agreed to waive its right to full royalty payments for product sold under these sub-licenses.

About Roche

Headquartered in Basel, Switzerland, Roche is one of the world’s leading research-focused healthcare groups in the fields of pharmaceuticals and diagnostics. As the world’s biggest biotech company and an innovator of products and services for the early detection, prevention, diagnosis and treatment of diseases, the Group contributes on a broad range of fronts to improving people’s health and quality of life. Roche is the world leader in in-vitro diagnostics and drugs for cancer and transplantation, a market leader in virology and active in other major therapeutic areas such as autoimmune diseases, inflammation, metabolism and central nervous system.

Additional information

- Roche Health Kiosk, Influenza : http://www.health-kiosk.ch/start_grip.htm

- About Tamiflu : http://www.roche.com/med_mbtamiflu05e.pdf

- About influenza : http://www.roche.com/med_mbinfluenza05e.pdf

- WHO : Global influenza programme : http://www.who.int/csr/disease/influenza/en/

- WHO : Avian flu : http://www.who.int/mediacentre/factsheets/avian_influenza/en/

References

————————————————-

(1) Antivirals and therapeutics session, X International symposium on Respiratory Viral infections, Singapore, Sunday 2nd March 2008

(2) World Health Organization. Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO. 28 February 2008 http://www.who.int/csr/disease/avian_influenza/country/cases_table_2008_02_28/en/index.html

(3) Sedyaningsih ER. The Indonesian Experience, X International symposium on Respiratory Viral infections, Singapore, Sunday 2nd March 2008

(4) Wertheim HFI. The recent Vietnamese Experience, X International symposium on Respiratory Viral infections, Singapore, Sunday 2nd March 2008

(5) Govorkova E. Influenza Antivirals in H5N1 Disease, Animal Model, X International symposium on Respiratory Viral infections, Singapore, Sunday 2nd March 2008

(6) Writing Committee of the Second World Health Organization Consultation on Clinical Aspects of Human Infection with Avian Influenza A (H5N1) Virus. Update on Avian Influenza A (H5N1) Virus Infection in Humans. N Engl J Med 358 ;3

(7) de Jong MD, Thanh TT, Khanh TH, et al. Oseltamivir resistance during treatment of influenza A (H5N1) infection. N Engl J Med 2005 ;353:2667-72

(8) Saad MD, Boynton BR, Earhart KC, et al. Detection of oseltamivir resistance mutation N294S in humans with influenza A H5N1. In : Program and abstracts of the Options for the Control of Influenza Conference, Toronto, June 17-23, 2007:228. abstract.

(9) Hurt AC. et al. Susceptibility of highly pathogenic (H5N1) avian influenza viruses to the neuraminidase inhibitors and adamantanes. Antiviral Research 73 (2007) 228-231

(10) World Health Organization. Influenza A (H1N1) virus resistance to oseltamivir - Last quarter 2007 to 28 February 2008. 28 February 2008.

http://www.who.int/csr/disease/influenza/H1N1ResistanceWeb20080228.pdf

(11) World Health Organization. WHO/ECDC frequently asked questions for Oseltamivir Resistance. Last updated 15 February 2008.

Roche
F. Hoffmann-La Roche AG, CH-4070 Basel, International Communications Manager, Helen Walicka, Tel. +41-(0)79-263-9701, http://www.roche.com

H5N1 Spread in Iraq​

http://www.recombinomics.com/News/03030804/H5N1_Iraq_Spread.html

Recombinomics Commentary 20:30
March 3, 2008

The morning Jassim Mozan general manager of the company General Veterinary teams are investigating the epidemic of avian influenza infection diagnosed the disease in a third village Alfdaekaya along the Iraqi-Iranian border south of Basra, a region previously recorded by the injury earlier this epidemic.

He added that the difference veterinary Mozan has burned thousands of poultry and birds in the area of injury and the surrounding area.

The above translation describes the spread of H5N1 in southern Iraq (see satellite map) and associated culling efforts. The area being culled is large and the above translation indicates at least two villages have tested positive.

The above is supported by other local media reports on new outbreaks in the area.

It is likely that the H5N1 is clade 2.2.3. Clade 2.2.3 was responsible for the 2007 outbreak in Kuwait and is also involved in the more recent outbreak in Saudi Arabia.

Similarly, recently released sequences confirm the Uvs Lake strain in the Czech Republic over the summer. In addition, a partial sequences from the 2008 outbreak in the Ukraine is also from clade 2.2.3.

Although clade 2.2.3 has become increasingly common in Europe and the Middle East, the H5N1 in Egypt is still clade 2.2.1, although the recent sequences in Egypt have acquired clade 2.2.3 polymorphisms.

Aggressive H5N1 in Egyptian Patients​

http://www.recombinomics.com/News/03030801/H5N1_Egypt_Aggressive.html

Recombinomics Commentary 12:38
March 3, 2008

The Ministry of Health and Population has declared a new AI H5N1 human case, a female 25 years old from Sennoris district, Fayum governorate. The symptoms started on 24 February 2008 and hospitalized in Fayoum Fever Hospital on the 27th of the same month. The case was referred to Giza chest hospital on 28 February 2008. The field investigation is still ongoing to indicate the source of infection. The general condition of the patient is critical and she is on ventilator.

The above comments are from the WHO Eastern Mediterranean report on the most recent confirmed case in Egypt. The above dates suggest that the H5N1 was very aggressive, even though the patient was hospitalized three days after disease onset. The patient has pneumonia in both lungs and is in critical condition.

This rapid progression may reflect genetic changes in the H5N1. Last season the case fatality rate was markedly different in the fall than the spring. In late 2006, early 2007, the first seven confirmed H5N1 cases died. In contrast, there was only one fatality in the following seventeen case, which peaked in the spring. Many of the spring cases were in central or southern Egypt and patients did not develop pneumonia.

There were clear genetic differences between the cases in the fall, which were primarily in northern Egypt, and the spring cases. Three of the fatalities were family members of the Gharbiya cluster. Sequences from this group had two receptor binding domain changes, V223I and M230I, and were Tamiflu resistant due to N294S.

Subsequently, poultry sequences similar to the human sequences were found in Gharbiya, A/chicken/Egypt/1892NAMRU-3 HK-49/2007, or Beni Suef, A/chicken/Egypt/F6/2007. Although both HA sequences had V223I and M230I, the Gharbiya chicken did not have N296S and the NA sequence from the Beni Suef chicken has not been released.

This season, NAMRU-3 released another series of sequences which were similar to the Gharbiya sequence from last season, including V223I and M230I, but there were also a large number of additional non synonymous changes raising concerns that H5N1 in Egypt was being driven in part by the vaccination program.

The concern over mismatched vaccines is also increased due to recent sequences released by the national veterinary lab in Egypt. Sequences from vaccinated farms also had a large number of newly acquired polymorphisms, which were predominantly non synonymous. Similar sequences were found at additional locations in the Nile Delta in isolates from December, 2007 and January, 2008.

Last season, all reported H5N1 infections with M230I were fatal. This season, four of the five confirmed cases in late 2007 were fatal, but sequences from these cases have not been released. The recent sequences released from the National labs had M230V, which may also be linked to a higher case fatality rate.

The two confirmed patients in the past week have developed pneumonia, and the most recent cases is in critical condition.

Release of the human H5N1 sequences from the seven confirmed cases this season would be useful.

Bird flu kills 23-year-old woman in northern Vietnam​

http://www.thecanadianpress.com/eng...ame=x022515A&newsitemid=25634019&languageid=1

HANOI, Vietnam - Bird flu killed a woman from northern Vietnam in the country's 51st fatality from the disease and health officials fretted Tuesday that the virus would spread further.

The 23-year-old teacher from Phu Tho province, some 80 kilometres northwest of Hanoi, died in a Hanoi hospital Monday morning, said Nguyen Huy Nga, director of the Health Ministry's Preventive Medicine Department.

Test results showed she was infected with the H5N1 bird flu virus. It was the country's 51st bird flu death reported since the virus began raging across Asia in late 2003 and the 233rd death reported globally.

"We still report bird flu outbreaks among poultry," Nga said Tuesday.

"The risk of bird flu infection among people remains very high and we expect more human cases."

The woman developed bird flu symptoms Feb.14 and died Monday after being treated at the National Tropical Disease Hospital for four days, Nga said.

Nguyen Duc Mao, director of Phu Tho's Preventive Medicine Bureau, said health authorities are still unclear how the woman was infected.

"A few hundred chickens died in the school neighbourhood but they tested negative for the bird flu virus," Mao said.

"We still don't know how she was infected."

Bird flu remains hard for people to catch but health experts worry the virus could mutate into a form that passes easily among humans, sparking a pandemic. So far, most human cases have been linked to contact with infected birds.

At least 232 people have died worldwide from the virus, the World Health Organization said. Vietnam's latest bird flu death was not included in the WHO's tally.

Kowloon Bay China

CHP investigates 29 school children with influenza-like illness​

http://www.scmp.com/portal/site/SCM...0a0aRCRD&vgnextfmt=teaser&ss=Hong+Kong&s=News

The Centre for Health Protection (CHP) said on Tuesday afternoon it was investigating an outbreak of an influenza-like illness – affecting as many as 29 pupils of a Kowloon Bay primary school....

Indonesia

Bird flu outbreak​

http://bangkokpost.net/News/04Mar2008_news27.php

PHATTHALUNG :Two districts were yesterday declared disaster zones after an outbreak of bird flu was detected in four tambons. The four tambons are Prang Moo, Phraya Khan and Chaiburi in Muang district and tambon Pantae in Khuan Khanun district.

According to the Livestock Development Department, more than 1,000 open-range ducks in tambon Phraya Khan and tambon Chaiburi were culled. The agency is also keeping a close watch on a possible outbreak in Talay Noi of Khuan Khanun district and Koh Kob of Pak Phayun district.

Indonesia

Man suspected of contracting bird flu in Chaiyaphum​

http://nationmultimedia.com/breakingnews/read.php?newsid=30067089

Chaiyaphum - A man was suspected of having contracted bird flu here after he ate ill chicken and fell ill with high fever, health officials said.

Promma Kulkasem, 57, was admitted to the Chaiyaphum Hospital Monday after falling sick with high fever and flu-like symptom since Saturday.

Promma told officials that his chicken fell ill and dead and he roasted and ate them before he fell sick.

Promma was closely watched in the intensive care unit and a lab test is ongoing to determine whether he had caught bird flu.

New case raises Egypt's H5N1 count to 45​

http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/mar0308egypt.html

Mar 3, 2008 (CIDRAP News) – Health officials in Egypt announced on Mar 1 that a 25-year-old woman who is hospitalized with severe respiratory symptoms has an H5N1 avian influenza infection.

Abdel Rahman Shaheen, spokesman for Egypt's health ministry, said in a statement from MENA, the country's state news agency, that tests on Mar 1 confirmed that the woman's samples were positive for the virus, according to a report from Reuters. If the woman's illness is confirmed by the World Health Organization (WHO), she will be listed as Egypt's 45th H5N1 case-patient.

Shaheen said the woman had been transferred from Fayoum governorate, about 53 miles south of Cairo, to a hospital in the country's capital, where she is being treated with oseltamivir (Tamiflu), an antiviral medication, Reuters reported. He said she had a high fever and inflammation of both lungs.

News reports on the woman's illness gave no details on the source of her infection.

The woman is the second Egyptian patient in a week to be reported as sick with an H5N1 infection. On Feb 26 health officials announced that samples from a 4-year-old girl from Menia governorate in upper Egypt were positive for the H5N1 virus.

In a Feb 28 statement, the WHO said the girl got sick on Feb 21 and was hospitalized 3 days later. The statement from MENA said the girl is still hospitalized in Cairo, where she is in stable condition, according to a report yesterday from Xinhua, China's state news agency.

An investigation into the source of the girl's infection revealed that she had contact with sick poultry the week before she became ill, according to the WHO statement. She is listed as Egypt's 44th case-patient. The disease has been fatal in of those.

Bird flu well entrenched in Asia: WHO​

http://news.yahoo.com/s/afp/20080305/wl_asia_afp/healthfluasiawho

MANILA (AFP) - The bird flu virus is "firmly entrenched" in Asia and a pandemic among humans remains possible, a World Health Organization (WHO) expert warned Wednesday.
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While Asian countries are more prepared to react to any outbreaks than before and have vaccine stockpiles, deaths and infections have continued, noted Takeshi Kasai, the WHO's regional adviser in communicable disease surveillance and response unit.

"The virus has been firmly entrenched in this region, I'm afraid," Kasai told reporters during an exercise to test the Philippines' preparations against the disease.

"The virus itself keeps changing, so the risk of pandemic persists."

Experts fear the virus, which is usually spread directly from birds to humans, could mutate into a form easily transmissible between people, sparking a deadly global pandemic.

Three people have died in China this year of bird flu while a boy and his father were admitted this week to a hospital in Indonesia on suspicion of having the disease.

Since the first human cases were reported in 2003, at least 200 people have died from the H5N1 virus around the world, the WHO said. Indonesia is the world's worst-hit country, with 11 deaths so far this year.

Brunei, Singapore and the Philippines remain the only countries in the region where the flu, either in birds or humans, has not been detected.

Kasai praised China for being more transparent in reporting suspected cases.

"I think China now is very open and has been positively sharing information, including lab results," he said.

China has been highly criticised in the past for withholding information relating to the spread of Severe Acute Respiratory Syndrome (SARS) that ravished the region several years ago.

Egyptian woman dies of bird flu​

http://www.vnanet.vn/Home/EN/tabid/119/itemid/238788/Default.aspx

Cairo (VNA) - A 25-year-old woman has died of bird flu, becoming the 20 th victim of the deadly virus in Egypt over the past two years, the Health Ministry said on March 4.

Suzanne Ali Salah from Faiyum, southwest of Cairo, died in a Giza hospital in the suburbs of the capital where she was admitted on February 27, according to news agencies.

She was the 44 th case of the H5N1 bird flu virus reported in Egypt since the first outbreak was announced in February 2006.

Earlier of the same day, the ministry confirmed that an 11-year-old boy was infected with the deadly virus. The boy was admitted on February 26 to Monouf Fever hospital, suffering from fever, respiratory problems and pneumonia.-Enditem

Pneumonia in H5N1 Patients in Egypt ​

http://www.recombinomics.com/News/03040807/H5N1_Egypt_Pneumonia.html

Recombinomics Commentary 21:13
March 4, 2008

The Ministry of Health of Egyptian human infection No. 46 avian influenza illness of a child age 11 in the village of dams Menoufiya Governorate.

The ministry said in a statement today that the situation has entered a hospital salt worries on February 26 last to suffer from high temperature and shortness of breath and pneumonia

The above translation indicates the most recent confirmed H5N1 case in Egypt has developed pneumonia. Thus, all three confirmed Egyptian cases in the past week have been more severe than the cases at this time last year.

Last year, the H5N1 sequences in the south were markedly different than the sequences in the Nile Delta. One change, M230I, was widespread in the north, and all patients with M230I died. This year the recently released poultry sequences indicated M230I and M230V are widespread, especially in the north.

Moreover, the recent sequences have a large number of non synonymous changes, which may be associated with a more aggressive H5N1. At the end of 2007 there were five confirmed cases. Four of the five died, but the H5N1 sequences have not been released..

The situation in Egypt is growing more serious. There have been three confirmed pneumonia cases in a week. None of the patients have been discharged and one has died.

The sequence data from vaccinated flocks signal significant problems, and the WHO report on vaccine selection fails to appreciate the degree of heterogeneity in Egypt or the rapid H5N1 evolution. The sequences from the Gharbya cluster are not only not targeted, they are not included in the phylogenetic tree in the report.

Release of the human H5N1 sequences as well as the NA sequences from the poultry isolates would be useful.

Indonesia says H5N1 samples show no signs of mutation​

http://africa.reuters.com/commodities/news/usnJAK150528.html

HONGKONG/JAKARTA, March 5 (Reuters) - Bird flu virus samples that Indonesia sent to a World Health Organisation laboratory last month have not shown signs of any mutation, a health ministry spokeswoman said on Wednesday.

Scientists need to share and analyse H5N1 virus samples to see if they have mutated to become more easily passed between people as that could mean the start of a pandemic that can kill millions of people.

Such analyses are also needed in the making of vaccines, a chief weapon in the fight against a pandemic.

"CDC has received the samples and run tests on the samples. The result is it is still H5N1. It hasn't mutated. Meaning it is endemic among fowl and can be transfered from fowl to human," said Lily Sulistyowati, the health ministry's spokeswoman.

The lack of mutation means the virus remains hard for humans to catch. Worldwide, the virus has infected 368 people in 14 countries since 2003, killing 234 of them, or 64 percent.

But it has killed millions of poultry. Since late 2003, when the virus resurfaced in Asia and has since spread to Europe, the Middle East and Africa, hundreds of millions of birds have died from the disease or have been culled to try to stop it spreading.

Indonesia sent H5N1 bird flu virus samples in February to the U.S. Centers for Disease Control and Prevention (CDC) after a nearly 6-month hiatus when it won assurance that it would have access to affordable vaccines.

Jakarta said it sent 12 samples, although the CDC said it received 15 samples from 2 positive H5N1 cases from the country. Indonesia is the nation worst hit by the disease, which has infected 129 of its people so far, killing 105 of them.

Indonesia drew international concern when it defied protocol and refused to share its virus samples last year, saying it wanted guarantees from richer nations and drugmakers that poor countries would get access to affordable vaccines derived from their samples.

Talks hosted by the WHO last year in Geneva failed to reach an agreement on a new virus-sharing system, and the impasse only seemed to ease when it handed over the samples last month.

The WHO says it has begun to disclose how and where samples it receives are used in response to poor countries' demands for more transparency. (Reporting by Mita Valina Liem; Writing by Tan Ee Lyn; Editing by David Fogarty)

Early H1N1 Tamiflu Resistance in the United States ​

http://www.recombinomics.com/News/03040803/H1N1_Tamiflu_US_Early.html

Recombinomics Commentary 15:43
March 4, 2008

The sudden appearance of Tamiflu (oseltamivir) resistance in H1N1 has “startled” influenza “experts”, as noted earlier. Analysis of H1N1 public sequences at Los Alamos indicated that H274Y began appearing in the United States in 2007. However, closure of the Los Alamos data to the public has lead to movement of many of the sequences from Los Alamos to Genbank. Out of almost 1500 H1N1 human sequences at Genbank, six had H274Y (two were from the same patient).

The recent movement of sequences from Los Alamos was accompanied by newly released sequences, so the number of H1N1 sequences with H274Y has grown to 14 (from 11 patients), and like the sequences at Los Alamos, represent both H1N1 strains in circulation, New Caledonia/20/1999 and Solomon Island/3/2006 (which has largely been replaced by Brisbance/59/2007). The new sequences move the first appearance back to 2006 in Georgia and raise the number of New Caledonia sequences with H274Y to seven (from five patients). The number of sequences with H274Y has grown to seven (from six patients), and expanded the number of states from one (Hawaii), to four (Arizona, Illinois, New Jersey).

The presence of the same change on two different genetic H1N1 backgrounds in addition to H5N1 genetic backgrounds decreases the likelihood that the acquisitions are linked to unrelated independent events, and moves the sudden appearance of Tamiflu resistance closer to the broader application of Tamiflu blankets to treat H5N1.

New Caledonia-like sequences

Georgia/20/2006
Kansas/UR06-0104/2007
Massachusetts/05/2007
Minnesota/23/2007
Texas/31/2007

Solomon Island (Brisbane/59)-like sequences

Arizona/03/2007
Illinois/10/2007
New Jersey/15/2007
New Jersey/16/2007
Hawaii/21/2007
Hawaii/28/2007

Thank you for keeping your eye and our attention on this issue, JPD!

Minister forecasts massive bird flu outbreak in May​

http://www.thanhniennews.com/society/?catid=3&newsid=36434

Bird flu epidemic may break out in many provinces nationwide this May, an animal health official warned at a Tuesday meeting in Hanoi.

Head of the Ministry of Agriculture and Rural Development’s Animal Health Department Bui Quang Anh said the deadly strain of H5N1 bird flu virus still persisted in many provinces nationwide.

Lax control over trade and transportation of poultry in many provinces threatens to spark bird flu recurrence.

The risks will increase as the weather gets warmer due to resumption of fowl farming.

The bird flu epidemic has hit 10 provinces so far this year, half of which are northern provinces of Quang Ninh, Ninh Binh, Phu Tho, Ha Nam, and Thai Nguyen. Southern provinces affected include Tra Vinh, Long An and Vinh Long, along with the two central provinces of Quang Binh and Quang Nam.

H5N1 has killed four people in Vietnam this year, bringing the total number of deaths caused by the virus to 51 in the country since 2003.

WHO says Egypt reports 46th case of bird flu​

http://www.iht.com/articles/ap/2008/03/05/europe/EU-GEN-UN-Egypt-Bird-Flu.php

GENEVA: Egypt has reported its 46th case of bird flu in a human being after an 11-year-old boy tested positive for the H5N1 strain, the UN health agency said Wednesday.

The boy from Menofia governorate was hospitalized with symptoms on Feb. 26, the World Health Organization said on its Web site.

Egypt is one of the countries most affected by the H5N1 strain outside Asia, where the outbreak began in 2003. The country lies on a main route for migratory birds, which are believed to have brought the disease. Experts also link outbreaks in countries such as Egypt to a lack of financial resources and public awareness about the disease.

The H5N1 strain has hit 45 countries and led to the culling of millions of birds worldwide. The virus has infected more than 340 people and killed at least 212 since 2003, mostly in Asia.

In Egypt, 20 people have so far died from the virus.

Hospitalized Suspect H5N1 Patients in Egypt ​

http://www.recombinomics.com/News/03050801/H5N1_Egypt_Hospitalized.html

Recombinomics Commentary 19:36
March 5, 2008

The case is an 11-year-old male from Menof District, Menofia Governorate. He was hospitalized with symptoms on 26 February and was confirmed as being infected with A(H5N1) by the Central Public Health Laboratory and NAMRU-3 on 4 March. He remains in a critical condition.

To the present, the hospital dietary and chest in a large number of provinces, yesterday, the detention of dozens of cases suspected of carrying avian influenza.

The above comments on the latest confirmed case in Egypt are from the latest WHO update, confirming that the case is in critical condition. Thus, all three recent confirmed cases have developed pneumonia. One (25F) has died, one (11M) is in critical condition, and one (4F) is in stable condition.

However, the above translation from local media describes a large number of hospitalized suspect cases. It is unclear if these additional cases have also develop pneumonia, or if they are hospitalized as a precaution. Earlier this year large numbers of patients were hospitalized following confirmation of H5N1 cases in late December. Those cases did not test positive for H5N1 and many were said to have had seasonal flu. Thus, the coincidence with seasonal flu season at this time may indicate that these are patients hospitalized due to an abundance of caution.

More details on the condition of these patients, including their pneumonia status, would be useful.

Cumulative Number of Confirmed Human Cases of Avian Influenza
A/(H5N1) Reported to WHO​

http://www.who.int/csr/disease/avian_influenza/country/cases_table_2008_03_05/en/index.html

371 cases/235 dead. For details see link.

Bird flu pandemic still possible, warns world expert​

http://www.dailymail.co.uk/pages/li...ain.html?in_article_id=527491&in_page_id=1774

The bird flu virus is "firmly entrenched" in Asia and a pandemic among humans remains possible, a World Health Organisation (WHO) expert has warned.

While Asian countries are more prepared to react to any outbreaks than before and have vaccine stockpiles, deaths and infections have continued, said Takeshi Kasai, the regional adviser on communicable disease surveillance and response.

"The virus has been firmly entrenched in this region, I'm afraid," Kasai said.

"The virus itself keeps changing, so the risk of pandemic persists."

His statement came as Egypt reported its 46th human case of bird flu in an 11-year-old boy. Three people have died in China this year of bird flu while a boy and his father were admitted this week to a hospital in Indonesia on suspicion of having the disease.

Experts fear the virus, which is usually spread direct from birds to humans, could mutate into a form easily transmissible between people, causing a deadly global pandemic.

Since the first human cases were reported in 2003, 231 people of the 371 diagnosed with the H5N1 virus have died, the WHO said. Indonesia is the world's worst-hit country, with 10 deaths so far this year.

The deadly strain of bird flu first reached Britain's shores in April 2006, when a swan with the H5N1 strain was found dead. There was a further outbreak among turkeys at a Bernard Matthews farm in Suffolk in February 2007 and in January 2008 three mute swans were found dead with the virulent strain in Dorset. Protection measures were put in place after each incident and there have been no human cases in Britain to date.

Vietnam runs short on Tamiflu as avian influenza spreads​

http://www.thanhniennews.com/healthy/?catid=8&newsid=36442

The stock of Tamiflu at Vietnam’s leading institute for treating bird flu is dated while the epidemic is growing increasingly out-of-control, the institute’s deputy director said at a meeting Wednesday.

Nguyen Hong Ha from the National Institute of Infectious and Tropical Diseases said the stock, which had been donated by Taiwan in 2005, was expired not only at the institute but also in several provinces such as Hai Duong and Phu Tho.

Northern provinces of Hai Duong and Phu Tho where bird flu cases have been reported recently are also running low on the medicine which serves as the sole effective treatment for human cases of avian influenza.

The Ministry of Health said it was searching for new supplies and would use medicine produced by Vietnam (Osetavimin) as a temporary replacement in the interim.

Hien said a shortage of Tamiflu would be disastrous for Vietnam, adding that “severe bird flu outbreaks are occurring more often and an increasing amount of deaths are reported from infected people.”

The total number of H5N1 human casualties in Vietnam, with 105 cases in all, is high among the list of affected countries in the world.

The Central Hygiene Epidemic Institute reported 48 cases of acute pneumonia suspected of stemming from avian influenza this year, including four deaths, bringing the total number of deaths from the virus in Vietnam to 51 since 2003 – the second highest figure after Indonesia.

The bird flu epidemic has hit nine provinces so far this year, half of which are in the north including Quang Ninh, Ninh Binh, Phu Tho, Ha Nam, and Thai Nguyen.

Tra Vinh and Vinh Long southern provinces along with Quang Binh and Quang Nam central provinces are also plagued.

In related news, Zuellig Pharma Vietnam (ZPV) has donated a stock of Tamiflu costing over VND120 million (US$7,500) to a few hospitals around the country.

Bird flu detected in Vietnam's capital​

http://www.earthtimes.org/articles/show/190660,bird-flu-detected-in-vietnams-capital.html

Hanoi - Bird flu has killed more than 2,000 ducks and chickens in Vietnam's capital city of Hanoi, raising the number of provinces with avian influenza outbreaks this year to 10, an official said Friday. More than 2,000 ducks and chickens were found dead at a farm in Hanoi's outlying district of Soc Son between March 3 and 4, and tests Thursday showed they were positive for the H5N1 virus, according to Tran Manh Giang, head of the city's animal health department.

"Most of the poultry at the farm were ducklings and chickens under 10 days old, and had thus not been vaccinated yet," Giang said.

Giang said authorities had culled the remaining 1,660 chickens and ducks at the farm, disinfected the area, and banned the transport of poultry from the neighborhood.

"We are afraid the outbreak will expand to other farms in the district, in spite of the measures we have taken," Giang said.

Bird flu outbreaks have been detected in 10 provinces since the beginning of this year, prompting local authorities to cull tens of thousands of ducks and chickens, according to the Agriculture Ministry's Animal Health Department.

Bird flu has infected 105 people in Vietnam and killed 51 of them since it first appeared in the country in late 2003.

H5N1 mainly affects poultry and wild birds, but can infect humans who have close contact with sick fowl. Scientists fear that if it spreads unchecked, the disease could mutate into a form which could be transmitted between humans, leading to a worldwide pandemic that could kill millions.

Extensive H5N1 Spread in Bangladesh ​

http://www.recombinomics.com/News/03060801/H5N1_Bangladesh_Extensive.html

Recombinomics Commentary 22:56
March 6, 2008

More 15,783 chickens were culled and 19,402 eggs were destroyed in Sylhet, Narayanganj, Munshiganj and Jessore in the last two days.

With the culling, total number of culled chicken reached 1,239,093 while the number of destroyed eggs stands at 1,548,015 in the last 13 months since avian influenza was detected in the country.

The above comments describe recent H5N1 culling in Bangladesh. However, the H5N1 spread and culling have been increasing at a dramatic level in the past month. The Ministry of Fish and Livestock report of March 5 detailed culling of 405 farms since the outbreak began 13 months ago. One month ago the number of culled farms was at 175, so more culling was done in the past month than the prior year. The culling was widespread and involved most of the 46 districts positive for H5N1 since the start of the outbreak (see satelite maps here here here).

While H5N1 was dramatically spreading in Bangladesh, neighboring West Bengal maintained that H5N1 was under control and there were no new outbreaks after an extensive culling was conducted in most of the west Bengal districts.

Many of the outbreaks in Bangladesh were in areas border West Bengal and involved both poultry and resident wild birds which were H5N1 confirmed. The lack of transmission of H5N1 across the border by the wild birds seems unlikely.

The sharp differences between H5N1 in the adjacent regions raise serious transparency issues.

Thanks JDP. It just keeps on keeping on doesn't it.

LC

LC said:

Thanks JDP. It just keeps on keeping on doesn't it.

LC

Click to expand...

Yes, it keeps on going.

Dead bird found in HK tests positive for H5N1​

http://news.xinhuanet.com/english/2008-03/08/content_7743471.htm

HONG KONG, March 8 (Xinhua) -- An oriental magpie robin found dead earlier in Hong Kong has tested positive for the deadly H5N1 strain of the bird flu virus, the Agriculture, Fisheries and Conservation Department of Hong Kong Special Administrative Region said in a press release Friday.

"An oriental magpie robin was confirmed to be H5N1 positive after a series of laboratory tests," said the Department.

The dead bird was collected on Feb. 29 near a management center in Tai Po Kau Nature Reserve in the northern district of New Territories, a government spokesman said, adding that the oriental magpie robin is a common resident in Hong Kong.

Hong Kong has reported nine cases of bird infections of the H5N1 virus since November. The H5N1 strain typically gets more active during the cold and dry winters.

Authorities in Hong Kong have been on alert against the virus, with contingency plans and education programs aimed at informing the public about bird flu.

More than 300 people from government departments, the Hong Kong International Airport and airline held an exercise in Hong Kong Friday, simulating a suspected case of H5N1 avian influenza on a plane at the Hong Kong International Airport.

The government spokesman also reminded the public to observe good hygiene Friday.

"They should avoid personal contact with wild birds or live poultry and clean their hands thoroughly after coming into contact with them," he said.

WHO warns against bird flu complacency​

http://www.dailytimes.com.pk/default.asp?page=2008\03\08\story_8-3-2008_pg7_11

* Urges preventive measures against the disease
* Says 2 billion dollars investment in poultry industry is at risk

By Akhtar Amin

PESHAWAR: The World Health Organisation (WHO) on Friday warned against complacency regarding bird flu, saying that more precautionary measures needed to be enforced because the disease still posed a potential threat to humans.

Dr Fawad Khan, Human Avian Influenza coordinator at WHO Pakistan, said at a media workshop titled ‘Media retreat on bird flue prevention and control’ that people must report sick birds and personal illness to health authorities immediately.

Preventive measures: Dr Khan said that avian influenza had entered its third phase and there was therefore more likelihood of it infecting humans. In such a scenario, the only option was to adopt preventive measures.

He said that wild and tame birds; raw and cooked; and sick and healthy birds should be kept separately. Washing hands, he said, was an important precautionary measure against avian influenza. He added that the disease’s mortality rate was 62 percent, three times higher than SARS, another fatal disease. He said the threat of a human epidemic in Pakistan was still persisting through human influenza viruses, as these viruses were prevalent in all South Asian countries.

Investment at risk: He also warned that Pakistan’s 2 billion dollar investment in the poultry industry was at risk from avian influenza if proper protection were not taken in this regard.

The government, he said, was taking steps to avoid the transmission of the H5N1 bird flu virus from birds to humans and from human to human, by imparting awareness to poultry workers.

National Reference Laboratory for Poultry Senior Scientific Officer Dr Zaheer Ahmed said that Pakistan recorded its first epidemic of bird flu in 1994, and the second, in 2003, which killed 3.5 million and caused Rs120 million losses to the expanding poultry sector. The country, he said, experienced 48 outbreaks in 2006, 59 in 2007, and 8 this year so far. “About 128 people suspected of carrying the virus were tested for H5N1 in 2006, 146 in 2007, and 11 in 2008, of which only one patient tested positive,” he added.

He said that the government had established one reference laboratory and obtained the services of three private sector diagnostic outlets which would ensure the results of samples of suspected patients in 48 to 72 hours.

The results given by these laboratories would not need verification by international labs, he added. He said that the government was also in the process of registering all poultry farms and outlets, and was introducing a law to put in place maximum bio-safety measures.

Forty new labs are being set up in the cities to promptly diagnose and treat suspected bird flu patients, he added. He said that 19 persons, including 10 from government and 9 from the private sector, had been trained at the national level and would now be imparting training to others at the provincial and district levels.

Dr Saeed Akbar Khan, WHO operations officer for the NWFP and the Federally Administered Tribal Areas (FATA), said that it was a misconception that bird flu is spread through eating cooked chickens, eggs and other poultry products.

Furthermore, he said that canned poultry products, frozen poultry meat, liquid and powdered eggs were safe for human consumption.

Dr Mukhtiar Zaman Afridi, a local pulmonologist, said that the government, in collaboration with the WHO, was establishing one respiratory isolation units in Peshawar and one in Abbottabad each to provide treatment facilities to suspected bird flu patients.

He said that they had imparted training to the doctors and health personnel regarding the management of suspected bird flu patients.

Suspect H5N1 Patient In Bangladesh Quarantined​

http://www.recombinomics.com/News/03070802/H5N1_Bangladesh_Quarantine.html

Recombinomics Commentary 20:11
March 7, 2008

A poultry farmer was quarantined at Rajshahi Medical College Hospital as doctors suspect that he might be infected with bird flu virus.

Ashraf Hossain, 32, of Terokhadia Pashchimpara in Rajshahi was admitted to the hospital on Wednesday as he showed multiple symptoms of the disease. His blood sample was sent to Dhaka for test.

The above comments describe a suspect H5N1 case in Bangladesh. Such a case would not be a surprise. Recent culling efforts in Bangladesh have been high, reflecting the continuing spread of the virus (see satelite maps here here here).

Late last year, H5N1 was confirmed in Pakistan, and it is likely that the H5N1 in Pakistan and Bangladesh is clade 2.2.3. In 2006, the clade 2.2.3 in Azerbaijan resulted in multiple clusters.

Although neighboring West Bengal did not have any confirmed cases, many villagers had mild symptoms and testing in India remains suspect.

More information on the suspect case in Bangladesh would be useful.

Link to next weeks thread:

HEALTH - 3/9/08-3/15/08|Weekly Bird Flu Thread:Fresh outbreak of bird flu confirmed in India

http://www.timebomb2000.com/vb/showthread.php?t=280534