5/7/08- 5/14/08|Weekly Bird Flu Thread: Pandemic Flu Threat Remains Substantial

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Pandemic Flu Threat Remains Substantial, Health Experts Say

http://www.washingtonpost.com/wp-dyn/content/article/2008/05/06/AR2008050601265.html

By ELIANE ENGELER
The Associated Press
Tuesday, May 6, 2008; 4:27 PM

GENEVA -- The world still faces a substantial threat of a flu pandemic and countries need to speed up preparations for a global outbreak, health experts said Tuesday.

"We can't delude ourselves. The threat of a pandemic influenza has not diminished," said Keiji Fukuda, coordinator for the World Health Organization's Global Influenza Program.

Fukuda spoke to a meeting of around 150 health experts from governments, WHO and other agencies to update WHO's pandemic influenza preparedness plan.

Scientists fear that the H5N1 strain of bird flu virus _ which began ravaging Asian poultry stocks in late 2003 _ could mutate into a form that spreads easily among humans, potentially sparking a pandemic that kills millions. So far, most human cases have been linked to contact with infected birds.

Fukuda said more than 150 countries had some kind of national preparedness plans but some of them were merely a piece of paper acknowledging the risk.

He said it was crucial that all levels of society were involved in the preparations and that everyone knows where to go for information.

"If somebody is sick in the family for example and it's difficult to get to hospital, they need to know what sort of advice might be available," Fukuda told The Associated Press.

WHO says 382 people have come down with bird flu since 2003, and that 241 of them have died. Indonesia, with 108 of the deaths, is seen by experts as a potential hotspot for a pandemic.

WHO is updating its 2005 preparedness plan to include progress in research on flu viruses, stronger international cooperation and experience with human cases of bird flu.

"Our understanding of the virus, the effects on people, the epidemiology how viruses move around the world, is much greater than it was a few years ago and this continues," Fukuda said.

Stockpiles of antivirals have been built since 2005, he said. WHO has stockpiled a total of 5 million antiviral treatment courses ready to be handed out if a pandemic breaks out.

He said the development of a possible pandemic vaccine have made significant strides.

"A few years ago it would not have been possible to talk about pandemic vaccines," he said. "All of a sudden we have new things to work with."

Experience and research over the last few years have led experts to believe that it is possible to stop a pandemic influenza right at the beginning of the outbreak, said Fukuda, adding that they recognized it will be difficult.

Fukuda said WHO will take into account the revised International Health Regulations in updating its pandemic preparedness plan, which is expected to be published by the end of the year.

Max Hardiman from WHO's secretariat for the health regulations said the agreement, which took effect in 2007, should help the world to know about a pandemic outbreak as soon as possible.

The health regulations oblige countries to report new disease threats with global public health significance, such as new flu subtypes. They also allow the WHO to act on credible information sources, rather than being reliant strictly on official government channels.

Hardiman said measures to contain a pandemic should avoid unnecessary travel restrictions.

Under the health regulations countries are putting in place measures to curb the spread of a pandemic, he said. These include assuring access to medical centers, control of airports and other points of entry and preparations to isolate sick people and quarantine contacts.

"One day we will face a pandemic but we don't know when," Fukuda said.
 

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Residents seek check-ups after Seoul's first bird flu case

http://news.yahoo.com/s/afp/2008050...ea_080507071800;_ylt=A9G_R3ZugiFIPogAsCOTvyIi

SEOUL (AFP) - The first bird flu outbreak in South Korea's capital Seoul was caused by the virulent H5N1 strain, the agriculture ministry said Wednesday, as residents in the affected district scrambled for medical checks.
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The case at an aviary in the eastern district of Gwangjin brings to 34 the number of bird flu cases nationwide since April. Not all have been confirmed to be H5N1, which is potentially deadly to humans.

Quarantine officials have slaughtered all 53 chickens, turkeys and pheasants at the aviary, and also poultry at a nearby public park in the same district and at an amusement park in southern Seoul.

No outbreak has been reported except in Gwangjin.

The Korea Center for Disease Control and Prevention said it asked all hospitals in Seoul to keep a close eye on their patients and immediately report any suspected cases of human bird flu.

The public health clinic in Gwangjin said Wednesday it had been swamped with inquiry calls or visits by residents, some with a high fever and headache, for medical checks. No bird flu infections were reported.

"They all turned out to be completely irrelevant to bird flu," Mo Hyun-Hee, head of the clinic, told AFP.

South Korea has not recorded any human cases of bird flu. A soldier taken to hospital last month was found not to have the disease.

The agriculture ministry said quarantine authorities were continuing to decontaminate all aviaries and poultry farms in the city. Public access has been limited to those areas.

It was also trying to trace poultry dealers and farms which had sold birds to a market at Seongnam south of Seoul, which was the suspected supplier of infected pheasants to the Gwangjin aviary.

More than six million chickens and ducks have been slaughtered since the country's latest bird flu outbreak was reported on April 1. The previous outbreak was between November 2006 and March last year.

The H5N1 strain has killed more than 240 people worldwide since late 2003.
 

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Japan confirms fresh case of deadly bird flu

http://www.todayszaman.com/tz-web/detaylar.do?load=detay&link=141083

Japan has confirmed a fresh case of the deadly H5N1 strain of bird flu, this time in a dead swan on the island of Hokkaido, the prefectural government said.


Local authorities have begun an inspection of five chicken farms within a 30 km radius of the spot where the dead bird was found on April 24, Kyodo news agency said.
 

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WHO To Update Guidelines for Possible Flu Pandemic

http://www.voanews.com/english/2008-05-07-voa9.cfm

By Lisa Schlein
Geneva
07 May 2008

Schlein report - Download (MP3) audio clip
Schlein report - Listen (MP3) audio clip

About 150 experts from governments, the World Health Organization, and other organizations are meeting to work on new guidelines to help nations confront and combat a potential influenza pandemic. The World Health Organization, which is hosting the week-long meeting, says governments must be prepared. Lisa Schlein reports for VOA from the opening of the conference in Geneva.

The World Health Organization says it is certain that one day the world will face a human influenza pandemic. But, it adds no one knows when that will happen.

Dr. Keiji Fukuda
The Coordinator of WHO's Global Influenza Program, Keiji Fukuda, says the near term risk of an avian influenza pandemic breaking out among humans is anyone's guess. Therefore, he says, it becomes all the more important that governments be prepared to help their people survive a disease that could potentially kill millions.

"If we are able to detect the first emergence of a pandemic early enough, then we will try to contain it and we will have a short window to do that. And, if we do not contain it or if it is beyond our ability to even try to do it from the beginning, then we will enter into a pandemic period, which will be the spread of what is now a human virus around the world. We are talking about trying to stop the first emergence, to slow the first emergence of a pandemic influenza," he said.

H5N1, the virus that causes bird flu, is largely an animal disease. Humans that have become sick have had close contact with infected poultry. Scientists are worried that one-day H5N1 will mutate into a form that can be easily transmitted from human to human.

To prevent this from happening, the World Health Organization is leading a global effort to make sure all nations are prepared to meet this challenge.

Dr. Fukuda says the world is in a much better position to deal with the flu threats now than it was before. He says scientists have a number of concepts and tools that were not available a few years ago.

"We are in a period in which information on a number of different aspects of influenza is just burgeoning. In many ways, we are in a kind of scientific renaissance, but the technical information about a number of different issues have really increased at a huge pace ... So our understanding of the virus, the effects on people, the epidemiology, how viruses move around the world is much greater than it was a few years ago and this continues," he said.

Dr. Fukuda says advances have been made in the development of an H5N1 vaccine and in anti-viral drugs. He says the World Health Organization has a large stockpile of these drugs and plans are afoot to increase the supply of future vaccines.

The meeting this week will focus on areas such as disease control, surveillance, medical interventions, and the role of communications during an influenza pandemic.

Dr. Fukuda says the World Health Organization expects to publish new guidelines by the end of the year to help nations prepare for flu outbreaks.
 

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Man's Death A Mystery

http://www.wowt.com/news/headlines/18675589.html

22-year-old enters hospital with flu-like symptoms, dies hours later
Posted: 9:33 PM May 5, 2008
Last Updated: 9:55 AM May 6, 2008

A 22-year-old Lincoln man checked into the hospital, thinking he had the flu. Hours later he was dead, leaving behind a grieving father and many unanswered questions.

Mack Backus' son Bryan was a lucky one. "That was one of the amazing things about him. He would take up he was going to do something and he would do it."

Bryan loved bicycles. His father says his son could get lost anywhere in the country for days, photographing America and all its wonders. When Bryan bought a bike shop at 33rd and B streets, his father says he was happy. Until last Wednesday.

"They had him in the emergency room all wired up and tubed up. We each got to talk to him for a minute or two." Mack's only son checked himself into the hospital with flu-like symptoms. Seven hours later, Bryan was gone.

"I saw two or three of the doctors coming from that direction. I knew, I knew what they were going to say.”

What would you say to your son if you unexpectedly had only a few minutes left with him? That was the challenge a father faced. "He lived a lot in that 22 years. He did so many things, went so many places, had so many friends that he couldn't have done much better with the 22 years he had."

The family says a team of seven doctors worked on Bryan trying to save him in his final moments. No one can explain why Bryan is gone. "I couldn't imagine he could have been well yesterday and die in a day's time,” says Mack.

The family says the Centers for Disease Control and Prevention and the coroner are waiting on toxicology results before being able to determine exactly what happened. That could take several weeks.

Bryan's funeral is set for Saturday.
 

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Five suspected H5N1 human cases reported in Seoul

http://news.xinhuanet.com/english/2008-05/07/content_8120871.htm

SEOUL, May 7 (Xinhua) -- At least five suspected H5N1 human cases have been reported to local authorities as of Wednesday morning in Seoul after the outbreak of the fatal disease was confirmed in Seoul earlier, South Korea's Yonhap News Agency reported.

The health authorities said five people have reported symptoms of fever or cough since Tuesday.

The authorities have conducted blood tests on the five people to confirm whether they are positive to the deadly H5N1 strain, Yonhap said.

The Ministry for Food, Agriculture, Forestry and Fisheries announced Tuesday that quarantine officials detected the highly virulent H5N1 strain in dead chickens from a bird vivarium located at the Gwangjin ward office in eastern Seoul.

It was the first time that the highly virulent H5N1 strain hits Seoul since a new round of spread of bird flu was confirmed in late March in the country.

The outbreak in the capital city has added worries that authorities are unable to contain the spread of the disease that has caused about 6 million birds to be culled so far.
 

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H5N1 Uvs Lake Migration to Japan

http://www.recombinomics.com/News/05060802/H5N1_Japan_Uvs.html

Recombinomics Commentary 14:35
May 6, 2008

The results showed that the K11 strain had above 99 percent homology with the other three strains for all gene segments, suggesting that all four strains are closely related. In addition, homology with two strains from last year's outbreak of highly pathogenic avian influenza in South Korea was also above 99 percent, and homology with the A/whooper swan/Mongolia/2/2006 virus isolated from whooper swans in Mongolia was also above 99 percent for all segments, indicating that these viruses are closely related.

Analysis of the HA gene of the H5N1 highly pathogenic avian influenza virus isolated from the mountain hawk-eagle found the virus to have the G-E-R-R-R-K-K-R amino acid sequence in the HA cleavage region typical of virulent types. As for homology with other H5 viruses, it is most homologous (at least 99.7 percent) with the virus isolated from wild birds in Mongolia in 2006. A phylogenetic tree for the HA gene was created in order to analyze the details of relationships with other viruses (see attached figure). It is closest to the A/chicken/Miyazaki/K11/07 strain isolated in Miyazaki, demonstrating that this virus is also a Qinghai Lake-type.

The above comments from a report on the 2007 outbreak of H5N1 in Japan (see isolates below) confirm that the H5N1 was closely related to the H5N1 from South Korea in late 2006, which was related the Uvs Lake outbreak in Mongolia and Siberia in the summer of 2006. The pattern in 2006 / 2007 was similar to 2003 / 2004. H5N1 in South Korea at the end of the calendar year was subsequently found in Japan a month or two later.

This year that pattern has probably repeated, although the outbreak in South Korea began as wild birds began migrating to the north, and the dead and dying wild birds in Japan were discovered under enhanced surveillance. It is likely that the H5N1 in both countries represents the latest version of the Uvs Lake strain in the region.

However, this year the H5N1 in South Korea is a record levels, and the location of the H5N1 positive swans in Japan are in Akita and Hokkaido (see satellite map), which are where there has not been previously reported outbreaks. These northern locations suggest H5N1 will migrate into northeastern Siberia, which may lead to migration into North America.

The record levels of H5N1 in South Korea follows record outbreaks in India and Bangladesh, which may signal a higher endemic level and further geographic spread of H5N1 via migrating birds.

A/Ck/Miyazaki/S749/07
A/Ck/Miyazaki/H358/07
A/Ck/Miyazaki/K11/07
A/Mountain hawk-eagle/Kumamito/1/07
A/Ck/Okatama/T6/07
 

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Bill Gates to help Indonesia develop human bird-flu vaccine

http://story.irishsun.com/index.php/ct/9/cid/3a8a80d6f705f8cc/id/356654/cs/1/

Jakarta, May 7 (Xinhua) Bill Gates, founder of the Microsoft Corporation, will help Indonesia develop a human bird-flu vaccine, the Jakarta Post reported Wednesday.

According to the report, the funds will be provided through the aid agency Bill and Melinda Gates Foundation.

Gates is expected to arrive at this Indonesian capital Thursday for talks with the government. He will also deliver a lecture here Friday, the report said.

His visit will help in promoting investments in the country. The government is seeking to obtain one million computers from Microsoft for educational purposes, the report quoted welfare minister Aburizal Bakrie as saying.

'In the higher and junior high schools, there is only one computer for every 1,000 students. We want to improve this to at least one computer for every 20 students,' he said.
 
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FWIW:

CNN has a segiment on H5H! *And the need for people to have preps for it*

(IMHO) Time to start worrying; when it makes the morning MSM shows...
 

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Pigeons Strike Fear Into Citizens

http://www.koreatimes.co.kr/www/news/nation/2008/05/113_23894.html

By Bae Ji-sook
Staff Reporter

``Are these pigeons safe?'' Citizens express fear towards pigeons and magpies on the streets after dead birds found at an aviary in Gwangjin, eastern Seoul, were confirmed to have the H5N1 strain of the bird flu virus that can be deadly to humans.

At parks, plazas or apartment complexes where birds flock, pedestrians dodge the menacing birds like something out of Hitchcock's movie - The Birds. Some people cover their nose or eyes and a few even wanted to slaughter them all.

``This morning I told the kids never to touch the birds nor feed them,'' said a 68-year-old woman who took her kid to Boramae Park in Seoul, Thursday. ``You get very cautious after hearing that the bird flu may be just around the corner.''

At Seoul Station plaza, where hundreds of pigeons live and walk around, people tried to keep their distance, bracing themselves against walls if one came too close. A citizen said, ``Let's just get rid of all the pigeons like we killed chickens or ducks if there was the slightest possibility of them carrying the disease.''

Local public health offices are receiving hundreds of phone calls from people asking about the precise symptoms of bird flu and saying they might have caught it. Especially those who had visited the children's park next to the aviary, who complained of soar throats, high fever and other ailments. ``Many of them just had cold,''' a staff member at the office said.

The government set out several measures to ease people's anxiety. They have shut down the aviary and given only limited access to the children's park and traditional open market where the dead pheasants were sold. Quarantine officials and volunteers also tried to isolate 40 birds in Ilgam Pond inside Konkuk University, right next to the aviary.

It has also been decided that the zoo inside Seoul Grand Park in Gwacheon will be shut down should a case of bird flu be reported within three kilometers.

The government has begun informing people of the avian influenza. ``Experts say the virus could be carried in the air, but it does not mean all surrounding air contains the virus,'' a city government spokesman said.

It also told citizens to refrain from touching birds at parks or ponds in the neighborhood.

The spokesman asked parents to take extra care of their children. ``There are chicks sold in front of elementary school front gates. We know many children want to buy or touch them because they look cute. But they may touch their excrement, the most likely thing to contain contagious materials,'' he said.

Prof. Kim Jae-hong of Seoul National University said there is little chance people will get infected by such a virus by simply passing by them or being in the same open area. ``I think the reason there were cases of human contraction in Southeast Asian countries such as Vietnam is because their culture is to breed such animals indoors and therefore they get in contact with their excrement easily,'' he said.
 

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Seoul hospitals on alert for bird flu

http://news.xinhuanet.com/english/2008-05/08/content_8126540.htm

SEOUL, May 8 (Xinhua) -- Hospitals in Seoul were put on alert for bird flu after health officials issued emergency warnings to all hospitals in the capital city to watch out possible bird flu symptoms, the Korea Herald reported on Thursday.

The Korea Center for Disease Control and Prevention has urged medical institutes in the capital to make immediate reports of any patients who have symptoms of the H5 avian influenza virus, such as a high fever, severe coughing, a sore throat and difficulty in breathing, the daily newspaper said.

"Detailed examinations of patients will be conducted and cooperation measures between government branches will be strengthened," Lee Jong-ku, head of the KCDCP said Wednesday.

"We will also distribute the antiviral drug Tamiflu to regional offices and make efforts to secure the necessary budget to deal with the matter," he said.

Blood tests will be done on patients who may have been infected by the virus, the official said.

The measures came after the government confirmed an outbreak of deadly H5N1 strain of bird flu in eastern Seoul on Monday. It is the first time that bird flu has been discovered in the capital city.

According to the Ministry of Food, Agriculture, Forestry and Fisheries, a total of 34 cases of the highly pathogenic avian influenza, which could lead to disease in people, have been confirmed nationwide.
 

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Vietnam spots new bird flu outbreak

http://news.xinhuanet.com/english/2008-05/08/content_8128344.htm

HANOI, May 8 (Xinhua) -- Bird flu has stricken fowl flocks in Vietnam's southern Can Tho city over the past few days, raising the total number of affected localities in the country to three, according to Vietnam's Department of Animal Health on Thursday.

The bird flu outbreak killed 1,131 poultry, including 1,070 chickens raised by a household in the city's Phong Dien rural district. Local veterinary forces on Wednesday culled the remainders of 829 healthy fowls in the affected flocks to prevent the disease's spread.

Vietnam currently has three localities having poultry being hit by bird flu: northern Son La province, southern Vinh Long provinceand southern Can Tho city, the department said.

Bird flu outbreaks in Vietnam, starting in December 2003, have killed and led to the forced culling of dozens of millions of fowls in the country.
 

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Bird Flu Outbreaks Spread Through Most Of S Korea - Ministry

http://www.nasdaq.com/aspxcontent/N...eadlinereturnpage=http://www.international.na

SEOUL (AFP)--Bird flu outbreaks have spread to most of South Korea despite the massive culling of chickens and ducks across the country, the agriculture ministry said Friday.

The latest outbreak reported last weekend in the eastern city of Chuncheon is now confirmed to have been caused by the highly pathogenic H5N1 virus, the ministry said.

This brings to 35 the total number of bird flu cases in South Korea. The outbreak has spread as far north as Seoul and to the southeastern cities of Ulsan and Daegu.

The ministry said also that two suspected cases had been reported in the southeastern city of Busan, the country's largest port.

More than 6.7 million chickens and ducks have been slaughtered since the latest bird flu outbreak was reported on April 1. The previous outbreak was between November 2006 and March last year.

South Korea has not recorded any human cases of bird flu. A soldier taken to hospital last month was found not to have the disease.

The agriculture ministry said quarantine authorities are continuing to decontaminate all aviaries and poultry farms in Seoul and public access has been limited to those areas.

The H5N1 strain has killed more than 240 people worldwide since late 2003.
 

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Concurrent H5N1 Aquistions Confirmed and Extended

http://www.recombinomics.com/News/05090801/H5N1_Concurrent_Extended.html

Recombinomics Commentary 06:18
May 9, 2008

The earlier report on the concurrent acquisition of the same polymorphism in three distinct locations, Egypt, Russia, and Ghana, has been confirmed and extended in the latest version, available at Nature Precedings. The initial report described the acquisition of NA polymorphism G743A on a variety of clade 2.2 (Qinghai strain) genetic backgrounds.

In February, 2007 H5N1 outbreaks in Egypt was being closely monitored. A few months earlier the Gharbiya cluster was reported. Three family members died and the H5N1 sequences had two receptor binding domain changes (V223I and M230I) as well as Tamiflu (oseltamivir) resistance, N294S. Consequently, H5N1 surveillance was enhanced. Three sequences from chickens in Gharbiya were collected in mid-February and all three sequences had G743A. This change was of interest because it had not been seen previously in any of the isolates from Egypt.

One of the February sequences was closely related to the Gharbiya sequences, while the other two mid-February sequences were distinct and closely related to H5N1 collected in the summer of 2006. Although these two sets of sequences were quite distinct, both had acquired the same polymorphism, G743A.

The sample that was closely related to Gharbiya was cloned (plaque purified) because the initially sequences had some mixed signals. The cloning confirmed that the chicken was infected by two major H5N1 species. The dominant strain was closely related to the Gharbiya cluster, while the minor species matched the other two mid-February sequences. Thus, although there were two distinct sequences in the same host, both sequences had acquired G743A. Two distinct sequences acquiring the same change at the same time was not easily explained by random mutations, the current explanation for the genetic drift prevalent in influenza evolution.

The random mutation explanation was further challenged by an outbreak in Moscow, which was also in mid February. Sequences from that outbreak were released and those sequences were quite distinct from the clade 2.2.1 sequences in Egypt. The Moscow sequences were clade 2.2.3 and were most closely related to 2006 sequences from Azerbaijan. However, like the changes in Egypt, the 2007 sequences in Moscow had also acquired G743A.

Shortly after the outbreaks in Egypt and Russia, Ghana reported its first H5N1 outbreak. The sequences from Ghana were closely related to sequences from an outbreak in the Ivory Coast at the end of 2006. These sequences were quite distinct from the clade 2.2.1 in Egypt or the clade 2.2.3 in Russia, but the Ghana sequences had also acquired G743A.

Moreover, in March there were additional outbreaks in Egypt that were distinct from the sequences in Gharbiya. The sequences were from patients in southern Egypt and were closely related to earlier sequences from southern or central Egypt, yet those sequences had also acquired G743A.

Thus, the concurrent acquisition of G743A onto multiple genetic backgrounds in three distance location in Russia, Egypt, and Ghana was the basis for the original report in the summer of 2007.

However, in the past several months additional sequences from earlier outbreaks have been released. In mid-February there was also an outbreak in Kuwait. The sequences in Kuwait were clade 2.2.3, but were distinct from the sequences in Moscow. The Kuwait sequences were closely related to sequences from Uvs Lake, which led to a massive die off of wild birds in the summer of 2007. That strain was subsequently linked to the outbreak in South Korea at the end of 2006 as well as Japan at the beginning of 2007. The sequences from Uvs Lake and South Korea did not have G743A, yet the mid-February outbreak in Kuwait did have G743A, showing that G743A had been appended onto yet another genetic background.

The outbreak in Kuwait was followed by outbreaks in Europe in the summer of 2007. The sequences from domestic and wild birds in the Czech Republic have been released as have sequences from wild birds at multiple locations in Germany. All NA sequences had G743A and all were the Uvs Lake strain. Sequences from Krasnodar were also released from wild and domestic birds and those sequences were also the Uvs Lake strain and had G743A.

Similarly, in early 2007 there were outbreaks in Nigeria. These sequences were distinct from those in Ghana, yet a subset of these sequences also had G743A.

Thus, these latest sequences confirm and extend the earlier observations. In addition to Russia, Egypt, and Ghana, Kuwait and Nigeria also had H5N1 outbreaks that included the acquisition of G743A.

In each of the examples above, precursor sequences were reported that lacked G743A. The 2007 sequences had acquired 2-6 changes, and in each case one of these small numbers of changes was G743A. Explaining these acquisitions by random mutation is difficult, yet that is the current dogma used to explain H5N1 evolution.

The data is much more easily explained by recombination with a common source that had G743A.
 

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SKorea doubles Tamiflu stockpile over bird flu fears

http://news.yahoo.com/s/afp/20080510/hl_afp/healthfluskorea

SEOUL (AFP) - South Korea will double its stockpiles of antiviral flu medicine Tamiflu as avian flu has spread through most the country, health officials said Saturday.
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South Korea has not recorded any human cases, however the deadly H5N1 strain was detected in an aviary in Seoul this week, the first time bird flu has been found in the capital.

The state-run Korea Center for Disease and Control said that it would secure Tamiflu reserve for 2.5 million treatment courses by the end of this year, up from the current reserve set for 1.24 million.

The decision came after South Korean President Lee Myung-Bak on Saturday told his cabinet to increase stockpiles of anti-viral drugs to ease public fears about bird flu.

"The people are increasingly concerned about human infection of avian influenza," Lee was quoted as saying at a meeting of cabinet ministers by Yonhap news agency.

"The government has to devise sufficient countermeasures, including expansion of antiviral flu drug imports," he said.

The H5N1 strain has killed more than 240 people worldwide since late 2003.

The agriculture ministry said quarantine authorities were decontaminating all aviaries and poultry farms in Seoul and public access had been limited to those areas.

The butchering of chickens and ducks at traditional markets and restaurants should be prohibited to contain the spread of bird flu, the ministry said.

"Traditional markets where chickens and ducks are sold and butchered in unsanitary conditions are suspected of having contributed to spreading the avian flu," said Kim Chang-Seob, chief veterinary officer at the agriculture ministry.

As of Friday, more than 6.8 million chickens and ducks had been slaughtered since the latest bird flu outbreak was reported on April 1. The previous outbreak was between November 2006 and March last year.
 

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Bird flu in Darjeeling, culling begins

http://ia.rediff.com/news/2008/may/10bird.htm

Culling of birds began in 42 villages on Saturday in the mountain foothill areas of Darjeeling district where avian flu has been detected.

District Magistrate Rajesh Pandey said 283 birds were reported to have died in and around Sukna area between April 27 and May 4 following which samples were sent to High Security Diseases Laboratory in Bhopal, which confirmed the outbreak of avian flu.

The report reached the district authorities on May 8 and culling of birds began on Saturday morning, he said.

Pandey said 25 culling teams spread to 41 villages -- 10 at Sukna in Kurseong sub-division and 31 others in adjacent Matigara, Atharokhai and upper and lower Bagdogra gram panchayat area where 18,000 chicken was targeted to be killed.

Trading and business of poultry products was banned in the area as per orders, he said.
 

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H5N1 bird flu detected in another dead swan in Hokkaido

http://www.japantoday.com/category/...flu-detected-in-another-dead-swan-in-hokkaido

SAPPORO —

The deadly H5N1 strain of avian influenza has been detected in a dead swan found Monday beside Lake Saroma in eastern Hokkaido, the Hokkaido prefectural government said Saturday.

It is the third H5N1 case confirmed this year in Japan, following a dead swan found April 24 in the Notsuke Peninsula in eastern Hokkaido and in three out of four swans found dead or dying near Lake Towada in Akita Prefecture on April 21.
 

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Coping with new strains of flu

http://search.japantimes.co.jp/cgi-bin/ed20080511a1.html

The Diet has passed revisions to the Infectious Disease Law and the Quarantine Law to effectively cope with a possible outbreak of new types of influenza. There is fear that deadly new types of influenza will emerge, since the H5N1 bird flu is spreading mainly in Southeast Asia and bird-to-human infection is increasing. If a bird flu virus mutates into one capable of human-to-human transmission, a large number of people are expected to die. The government estimates that a new type of flu with the same lethality rate as the 1918 Spanish flu could kill up to 640,000 Japanese.

The law revisions will enable the government to segregate or forcibly hospitalize those who have developed symptoms of, are infected with, or are suspected of being infected with new types of flu. The government can prohibit such people from going to work.

The government has also decided to conduct a clinical test this fiscal year in which some 6,000 doctors, quarantine inspectors, other medical and health professionals and immigration and customs officials will be inoculated with stockpiled "pre-pandemic" vaccine based on the H5N1 virus strain. It also will inoculate 120 children at least 6 months old and younger than 20 with the same vaccine. If the vaccination proves safe and effective, it plans to vaccinate 10 million people whose work is related to maintaining basic functions of society.

The government, which has stockpiled a solution to produce pre-pandemic vaccine for 20 million people, plans to increase the stock to cover an additional 10 million people. It also plans to develop new technology to shorten from 1 1/2 years to six months the time to produce vaccine based on new virus strains.

The use of the pre-pandemic vaccine before an outbreak of a new flu type is the first in the world. But the government must carefully execute the clinical test inoculations, especially for children. Dangers from side effects and aftereffects cannot be ruled out. The government also should consider effective measures against ordinary flu.
 

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H5N1 False Negative Soldier in South Korea Causes Concern

http://www.recombinomics.com/News/05100801/H5N1_Korea_Soldier_False.html

Recombinomics Commentary 13:21
May 10, 2008

A South Korean soldier tested for bird flu did not contract the deadly virus and will be released from hospital, according to a statement obtained on Friday.

"The soldier, who was quarantined after showing symptoms of bird flu, has tested negative. We have determined his condition was caused by bacterial pneumonia," the Korea Centre for Disease Control and Prevention said in a news release.

Inspectors at the center said yesterday that even though initial examinations detected a small amount of the H5 virus in the patient’s body, including the HA gene that indicates the presence of the virus, they could not find any indicators of the highly contagious H5N1 strain — the HA and NA genes — after more detailed tests. H5N1 is one of four strains of the virus that affects humans.

°We think that the H5 virus in the patient’s body was unstable, said Lee Joo-yeon, an inspector at the center. °It was too weak to prompt the symptoms of bird flu. Also, he did not have the N1 strain of the virus."

Inspectors participating in the tests said that human cases of avian influenza are confirmed when the H5 virus, including the HA gene, and the N1 strain, including the NA gene, are all detected, under the guidelines of the World Health Organization.

The above comments on the H5 confirmed soldier in South Korea raise serious transparency issues. The detection of H5 in a soldier culling H5N1 infected poultry leaves little doubt that the solder was infected with H5N1. The WHO guideline for confirming H5N1 infections do not require the isolation of the virus. Two labs independently confirming H5 is a confirmed cases. Many H5N1 confirmed cases have failed to yield an isolated virus. Since the soldier was under oseltamivir (Tamiflu) chemoprophylaxis and was quickly treated with an increased dose, the failure to isolate virus is not a surprise. Most of the H5N1 isolates from patients are from fatal cases and from samples collected near the time of death when the viral load is high.

There are many examples of false negatives in H5N1 cases. These examples are most obvious when the H5N1 infection involves clusters. In Turkey, the first confirmed cases were among four siblings who presented with symptoms. Although three of the four were unconscious, like the soldier above, they all initially tested negative for H5N1. The three siblings that were unconscious died, and were confirmed with samples collected from their lungs. However, virus was only isolated from 2 of the 3. Moreover, the fourth sibling was never confirmed. However, the lack of confirmation was not unusual. Turkey lab confirmed 21 cases. However, only 12 of 21 were confirmed by the WHO reference lab, and WHO acknowledged that samples had degraded. Moreover, of the 12 confirmed cases, only four yielded H5N1 virus.

Similar results were obtained for the outbreak in Pakistan. Local lab testing yielded 10 H5 positives, but on site testing by a WHO reference lab only confirmed one case. However, since the initial positives included four brothers who developed pneumonia, it was clear that many or all cases lab confirmed on Pakistan were true positives. Eventually two of the brothers were confirmed because of H5N1 antibodies. However, antibody test are optimal when convalescent serum samples collected 3-4 weeks post symptoms are used. Clearly such tests have not been conducted on the soldier above since symptoms began on April 20, yet South Korea has falsely declared the patient negative.

Thus, South Korea is defining new requirements for H5N1 confirmation, which raises serious transparency issues regarding lab confirmation of H5N1 in patients and poultry in Korea.
 

JPD

Inactive
All poultry in Seoul killed after bird flu outbreak

http://news.yahoo.com/s/ap/20080512/ap_on_he_me/skorea_bird_flu

SEOUL, South Korea - South Korean officials said Monday they have killed all poultry in Seoul, the capital, to curb the spread of bird flu following a new outbreak of the disease in the city.
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Quarantine officials destroyed 15,000 chickens, ducks, pheasants and turkeys raised in farms, restaurants, schools and homes in the capital, said Kim Yoon-kyu, a Seoul Metropolitan Government official.

The Seoul government said the slaughter was necessary to contain the disease. It said it will now focus on preventing live poultry from being brought into the capital.

The slaughter began Sunday night, hours after authorities confirmed Seoul's second outbreak of bird flu in less than a week.

The slaughter did not affect parrots, parakeets and canaries because they have little chance of spreading the disease, Kim said.

Government tests were under way to determine whether the outbreak was caused by the virulent H5N1 virus, said Kim Chang-seop, an official at the Agriculture Ministry. He said test results would be available as early as Monday night.

Outside Seoul, two outbreaks of the H5N1 virus were reported Sunday in poultry farms in Busan and Ansung, Kim said. He said it was the first time the virus has been found in Busan, the country's second largest city.

They were the 27th and 28th confirmed outbreaks of the H5N1 virus, Agriculture Ministry spokesman Yoon Young-ku said.

Bird flu began sweeping southern parts of the country last month for the first time in more than a year, forcing the slaughter of about 6.8 million birds.

The virus remains hard for people to catch, but scientists worry it could mutate into a form that spreads more easily between humans, with the potential to kill millions worldwide.

Worldwide, at least 241 people have died from bird flu since 2003, according to the World Health Organization. Most human cases have been linked to contact with infected poultry.
 

JPD

Inactive
Bird flu hits one more Vietnamese locality

http://news.xinhuanet.com/english/2008-05/12/content_8150884.htm

HANOI, May 12 (Xinhua) -- Bird flu has recently hit Vietnam's southern Long An province, raising the total number of localities currently affected by the disease to five, according to local newspaper Pioneer Monday.

Specimens from 290 died ducks out of a flock of over 2,000 fowls raised by two households in the two districts of Tan Thanh and Thanh Hoa were tested positive to bird flu virus strain H5N1, the paper quoted the provincial veterinary agency as reporting.

However, the country's Department of Animal Health has yet to confirm the outbreaks in Long An. Now, bird flu is hitting Son La, provinces of Vinh Long and Tra Vinh, and Can Tho City in the southern region, the department said Sunday.

Bird flu outbreaks in Vietnam, starting in December 2003, have killed and led to the forced culling of dozens of millions of fowls in the country.  
 

JPD

Inactive
Police Will Step Up Fight Against Poultry Smugglers

http://www.koreatimes.co.kr/www/news/nation/2008/05/113_24098.html

Police said they will strengthen crackdowns on smugglers of poultry in the region infected by bird flu and those ignoring the authorities' preventive measures to keep the spreading avian influenza under control.

The National Police Agency said Tuesday that those violating anti-bird flu measures will be fined up to 15 million won ($15,000) or face up to three years in prison.

This move came after a series of reports that some culled poultry and those waiting to be killed were smuggled out and illegally traded in conventional markets. The government sees that these dealings could easily transmit the deadly virus to other regions.

Last Wednesday, police arrested six poultry dealers in North Jeolla Province on charges of circulating bird-flu infected chickens and ducks.

According to police, some 2,000 affected ducks were illegally smuggled out to feed dogs and a dealer sold 740 questionable chickens to retailers without the government's permission. In another case, more than 10,000 chicks that were raised at a virus-affected chicken farm were also smuggled out.

The government's measures against the epidemic done in a cursory manner are blamed for having contributed to the spread.

Seoul Metropolitan Government Sunday said it completed the culling of an estimated 15,000 chickens and ducks raised in the capital.

But it was not that difficult to see chickens and ducks in cages on the outskirts of Seoul.

A citizen residing in Guro-gu, western Seoul, said ``I found dozens of hens only 100 meters away from the place where slaughtered poultry was buried.''

The citizen said several ward office officials swept the location for days but failed to learn about the remaining chickens.

``We completed the mission today by killing more than 16,600 birds in Seoul,'' Kim Yun-kyu, Seoul government official in charge of the slaughter, told The Korea Times. ``Remaining poultry in 100-square-meter area or under facilities is not subject to obligatory report to the government. Therefore, we will continue gathering information about remaining poultry.''

Since the first outbreak of bird flu this year, more than 6.6 million birds have been culled with 55 billion won paid in compensation.
 

JPD

Inactive
Bird Flu Medicine Toxic for Teens

http://www.koreatimes.co.kr/www/news/nation/2008/05/117_24103.html

Concerns over effects on the mental health of teenagers who may have to take the bird flu drug tamiflu are rising amid growing fears over avian influenza being transmitted to humans.

Tamiflu is Swiss-based Hoffman-La Roche's antiviral for general influenza A and B but is also used to combat bird flu. However, worries have surfaced about the possibility of the medicine causing mental disorders among teenagers.

With fear of the H5N1 virus sweeping the nation, the government has doubled the quantity of the drug in storage, as it is the most effective treatment against avian influenza.

Whether to prescribe the pills with risks of side-effects such delusions or other disorders is being widely discussed among medical experts.

Although the drug has been the only medicine accredited to be effective against the H5N1 virus strain by the World Health Organization (WHO), the Japanese and Korean governments restricted its being prescribed to teenagers last year.

The Korea Food and Drug Administration announced that the drug should not be prescribed to those between 10 to 19 years old except for emergencies.

According to Roche, there has not been a reported case of side effects here, but the Seoul Shinmun, a local daily, reported that a woman in her 30s said she had nightmares after taking the drug in 2005.

The government's decision came after Japanese health authorities banned its prescription for teenagers in March 2007.

Japan has imported the drug since 2001, long before its effect on bird flu was acknowledged.

However, since then, there have been 1,268 cases of extraordinary behavior reported, of which 85 percent were from teenagers. They reportedly committed suicide by jumping out of buildings or into cars.

Health experts admit to the dilemma and said when necessary, it should be prescribed with extra prudence.

``We will have no option but to give out the pill once someone contracts the disease. But for teenagers we need to be extra careful and make sure it is prescribed at the most appropriate time,'' Korean Pharmacists for a Democratic Society spokesman Shin Hyeong-geun said. ``Let's hope we will never have to worry about that.''
 

JPD

Inactive
Is Bird Flu Becoming Endemic in Northeast Asia?

http://english.chosun.com/w21data/html/news/200805/200805130009.html

Another suspected case of bird flu has broken out at a duck farm in Songpa-gu in southeastern Seoul, possibly also is of the highly pathogenic strain that can spread to humans, it emerged Sunday.

The Seoul city government in an emergency meeting decided to cull all poultry being raised outdoors within the city perimeter to prevent the spread of avian influenza. The city government mobilized about 600 officials to cull the poultry. Currently, the number of poultry being raised in Seoul is about 15,200 -- 11,700 chickens and 3,500 ducks.

With even Seoul being affected, now three Northeast Asian nations -- South Korea, China and Japan -- are being attacked by the highly pathogenic strain of avian influenza. Some worry that like Southeast Asia, Northeast Asia could be placed under constant threat of highly pathogenic bird flu.

Ducks, which had been relatively immune to bird flu, have turned out to be the source of the mutating disease. This has given rise to a vicious cycle of ducks spreading the disease to wild birds, which in turn infecting poultry again. Ducks are walking time bombs since they show no symptoms for a considerable time. Unless Korea succeeds in preventing the spread of the disease via ducks and traditional poultry markets, the country could come under a permanent bird flu threat, experts worry.

This year's virulent strain is different from that of 2003 and 2004, and of 2006 and 2007 in that ducks have succumbed en masse this year, said Kim Chang-seob, chief veterinary officer of the Ministry for Food, Agriculture, Forestry and Fisheries. Mo In-pil, a professor of veterinary medicine at Chungbuk National University, said, "The original avian influenza virus didn't kill ducks. But it seems the mutant virus is."

Showing no symptoms, infected ducks can still be sold and bought at traditional poultry markets and spread bird flu across the country, Mo said. From them, the virus can spread to wild birds, in which the virus can mutate into a new strain; and this new strain then infects poultry and is capable of mutating yet again.

Experts believe China is already living constantly with a highly pathogenic bird flu virus by way of this vicious cycle of mutation. In China, large numbers of ducks have been infected by bird flu of a virulent strain, from Guangdong in May 2007, Tibet in January 2008 to Guizhou in February, and Guangdong and Tibet again in March..

Kim Jae-hong, a professor of veterinary medicine at Seoul National University, said, "China is already under constant bird flu attack because it has failed to prevent infected ducks from being sold at traditional markets. If Korea fails to take proper care of ducks and traditional markets, we too could find ourselves under constant attack."

It seems that the virus that caused domestic ducks to die en masse this year was imported from overseas. But if the virus mutates as the disease spreads, it is possible that a new highly pathogenic strain can break out without coming from overseas, Kim said.

In Akita and Hokkaido, Japan in April, wild swans died of bird flu of a virulent strain. But Kim Chang-seob said, "The Japanese don't raise many ducks, so there is little chance of bird flu spreading through ducks there."
 

JPD

Inactive
Vietnamese H5N1 In South Korean Outbreak

http://www.recombinomics.com/News/05140801/H5N1_Korea_Vietnam.html

Recombinomics Commentary 11:00
May 14, 2008

A government official said a highly pathogenic virus that caused bird flu in North Jeolla Province last month was confirmed to have DNA similar to that of a Vietnamese strain.

Experts predict the nation will likely suffer bird flu throughout the year if it fails to exterminate what they call the "southern-type virus."

The above comments suggest that some or all of the H5N1 in South Korea is a new clade related to H5N1 in Vietnam. This definition is somewhat unclear because there have been two distinct clades in Vietnam previously. In 2004/2005 clade 1 dominated, but more recently clade 2.3 from China (Fujian strain) has become dominated. Therefore, the genetic composition in South Korea is unclear, but several local media stories also refer to a Vietnamese (or southern strain). Clade 1 was noted for its ability to asymptomatically infect ducks and grow to high levels in the duck’s intestine, creating significant control problems.

Genetically, there is also prior evidence for exchanges between Vietnam and South Korea / Japan. The 2003 / 2004 isolates were precursors to clade 2.2 (Qinghai strain), which has become dominant in migratory birds that summer in Siberia and Mongolia. All H5N1 west of China has been clade 2.2 which was also true for South Korea and Japan in the 2006/2007 season.

However, the 2003/2004 isolates form South Korea / Japan had a novel cleavage site RERR_KKR (delected an R), which was subsequently found in northern Vietnam in early 2005. This acquisition was appended onto a clade 1 genetic background, indicating it was acquired by recombination. The change was associated with larger clusters and milder H5N1 cases.

Media reports in South Korea also suggest that the US CDC has confirmed H5N1 in patient(s) in South Korea, as had been previously seen in the soldier that was H5 positive. Korea claimed the soldier was H5N1 “negative” because they couldn’t confirm the N1. However, they did not deny confirmation of H5, which meets the WHO definition of a confirmed case. It seems that the confirmation by the CDC is being withheld, and a Friday meeting is planed to discuss the development.

These developments may be related to recent WHO comments on sharing of research results. The withholding of this information remains hazardous to the world’s health.
 

JPD

Inactive
Has Bird Flu Made a Permanent Home in Korea?

http://english.chosun.com/w21data/html/news/200805/200805140017.html

With the latest outbreaks in Seoul and Busan, avian influenza has now spread throughout virtually the entire country. More than 6.8 million chickens and ducks have been culled so far. Bird flu may have become "indigenous" not only in rural areas, but in major cities in Korea. "Indigenous" means that the virus has mutated to become completely adapted to the conditions of a particular region. If that is the case, then bird flu can break out at any time of the year, regardless of foreign sources of infection such as migratory birds. That's what happened in Southeast Asia, and China has entered this phase as well.

Once it is indigenous, it becomes impossible to prevent the spread of bird flu by culling poultry near infected areas. When the virus spread to humans back in 1997 and killed six out of 18 infected people in Hong Kong, the government there had to cull its entire chicken population of 1.5 million. In Korea, around 1,000 poultry farms raise 9.5 million ducks and 120 million chickens.

But quarantine officials are not doing enough. In Songpa-gu in southeastern Seoul where bird flu has been confirmed, residents have been raising 8,200 chickens and ducks in efforts to secure lucrative compensation payments from developers who purchase their land for construction projects. But the Seoul city government and the Songpa-gu district office had no idea such farms existed. Until last month, the National Veterinary Research and Quarantine Service, which is Korea's only agency that can determine bird flu infections, had only one official in charge of bird flu detection.

At this rate, not only chickens and ducks, but pigeons, sparrows and other wild birds may get infected too. If that happens, then the entire public must live in fear of possibly contracting the deadly virus.

First, we must investigate the transmission route of avian influenza among ducks across the country. Chickens die just three to four days after contracting the virus. But ducks have a lengthy incubation period before they show symptoms of avian influenza and this makes it essential to conduct a comprehensive investigation on the route of infection. You cannot come up with measures without first knowing how far the disease has already spread.
 

JPD

Inactive
Bird Flu Confirmed in Songpa and Busan

http://english.chosun.com/w21data/html/news/200805/200805140005.html

Less than a week since the first case of bird flu was confirmed in Seoul, the deadly H5N1 strain of the virus was found again, this time in Songpa, a district in the southeastern part of the capital.

As a containment measure, Seoul has put down more than 15,000 birds, including more than 8,000 in the area of the latest outbreak.

The metropolitan city government is now considering banning live chickens and ducks from entering Seoul and forbidding the breeding of them within the city limits.

This deadly strain was also confirmed in the southeastern port city of Busan, where more than 17,000 fowl were culled as an emergency measure to contain the spread.

The city of Busan has now adopted anti-epidemic measures such as forbidding the sale and movement of live poultry in markets.

Last week Korea's agriculture ministry and the ruling Grand National Party announced guidelines to ensure the safety of the public against the disease.

Officials warned citizens to immediately report any pet birds showing abnormalities and to keep away from wild birds such as pigeons.

But officials agree that although the disease is dangerous in live fowl, once poultry is cooked to over 75 degrees Celsius for more than five minutes it is safe to consume.
 

JPD

Inactive
Nigerian H5N1 Sequences Support European Migration in 2005

http://www.recombinomics.com/News/05130801/H5N1_Nigeria_Europe.html

Recombinomics Commentary 22:36
May 13, 2008

Sequences from all eight gene segments from isolates in Nigeria are being released at Genbank (A/chicken/Nigeria/228-5/2006, A/chicken/Nigeria/228-6/2006, A/chicken/Nigeria/228-10/2006). These isolates were collected in early 2006, but are just now being made public. They are closely related to previously released sequences from Lagos, Nigeria. These sequences have a number of polymorphisms shared with isolates in Europe as well as Egypt/Gaza. Although the sequence data is not unique, the collection dates in January and February of 2006 raise considerable doubts regarding the denials of H5N1 infections in Europe in late 2005, as well as the spread of H5N1 in Nigeria due to trade and smuggling.

After H5N1 spread to Russia and Mongolia in the summer of 2005, a further expansion of H5N1 into Europe, the Middle East, and Africa was predicted based on migration from the summer regions for the long range migratory birds. Although H5N1 was subsequently detected in the fall of 2005 in Romania and Turkey as well as Ukraine at the end of 2005, EU countries in central and western Europe denied H5N1 infections. Similarly, countries in the Middle East and Africa also denied H5N1 infections in 2005. However, the subsequent detection of H5N1 in a healthy teal in the Nile Delta, which was collected in December, 2005 raised considerable doubt with regard to detection failures in Europe, since the sequences of the teal isolates were closely related to Austrian sequences, which were collected in 2006, and in the fall of 2005 the migration is from north to south.

At the beginning of 2006, human cases were reported in eastern Turkey and these clusters were followed by clusters in Iraq in late January. After these cases were confirmed, H5N1 was widely reported in Europe, the Middle East, and Africa. In Europe, the detection failures in 2005 were said to be linked to migration of birds in dead of winter in 2006 from eastern Europe into central and western Europe in search of open water.

However, the sequence data from one set of isolates localized to southern Germany, Switzerland, and France, as well as another set found in northern Germany, Denmark, Sweden, and Scotland raised serious doubts about the open water explanation because the sequences were not reported in isolates form eastern Europe.

The latest sequences from southwestern Nigeria casts further doubt on the “open water” explanation of the detection failures in Europe in 2005. The sharing of polymorphisms in Egypt/Gaza as well as isolates in the Czech Republic and Italy suggest that the isolates in Nigerian in January, 2006 had been in Europe and the Middle East in the fall of 2005. These sequences in southwestern Nigeria also refute the claim that H5N1 in Nigeria was linked to an initial reported outbreak in northern Nigeria and was spread by trade and smuggling, since the sequences in southwestern Nigeria were easily distinguished from the sequences in the north.

Thus, the recently released sequences, which were from isolates collected over two years ago support introductions via migratory birds that were in Europe and the Middle East in the fall of 2005, and migrated to western Africa at the beginning of 2006 (these recently released sequences were from collections were in January and February, 2006)..

The two year delay in the release of this data is yet another example of the hoarding of sequences that delay the resolution of “controversies” that have impeded advances for the past two years.
 
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