HEALTH 3/15-3/22/10 Bird&Other Flu Weekly Thread:Potential Pandemic H1N1 Vaccine Mismatches

JPD

Inactive
Link to last weeks thread:

3/6-3/14/10 Bird&Other Flu Weekly Thread:Norway H1N1 D225G/N Refutes WHO Position

http://www.timebomb2000.com/vb/showthread.php?p=3666348#post3666348

Please See:

Confirmed cases of Swine Flu and maps
http://www.timebomb2000.com/vb/showthread.php?t=330689

Comprehensive Flu Thread, Latest reports, States, Countries, Closings.

http://www.timebomb2000.com/vb/showthread.php?t=330395

Useful Links:

Avian Influenza (Bird Flu)
http://www.cdc.gov/flu/avian/gen-info/facts.htm

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/
 

JPD

Inactive
Potential Pandemic H1N1 Vaccine Mismatches Raise Concerns


http://www.recombinomics.com/News/03151001/H1N1_Vac_Mismatch.html

All of the 19 influenza A (H1) viruses were A/Solomon Islands/3/2006-like, a recent antigenic variant of A/New Caledonia/20/99 and the strain recommended by WHO as the influenza A (H1) component for both the 2007--08 Northern Hemisphere influenza vaccine and the 2008 Southern Hemisphere influenza vaccine.

The above comments are from the CDC's MMWR report on initial analysis of seasonal H1N1 in the 2007-2008 season based on a poor reference anti-sera that failed to identify low reactors. The above isolates were actually Brisbane/59/2007-like isolates which were designated low reactors when appropriate anti-sera was used. The target was changed to Brisbane/59 the following season. However, Tamiflu resistance gained a foothold in Brisbane/59 that season, and went to 100% in the following season.

Parallels with the 2009-2010 pandemic H1N1 season are striking and of significant concern.

Recently released HA sequences (at GISAID) by CDC have G158E, which has been linked to low reactor status. Two German isolates, A/Bayern/62/2009 and A/Bayern/69/2009, each have only one recent non-synonymous polymorphism, which is G158E. Mill Hill designated both isolates as “low reactors”. One of the two was also tested by the CDC, and it was again designated a “low reactor”. Analysis of isolates that escaped from neutralizing monoclonal antibodies also had G158E, as well as changes at the adjacent upstream position (K157E and K157Q). Similarly, the first two US low reactors identified by the CDC each had 4 changes, but in both cases one of the four was N159D, which is at the adjacent downstream position. All three positions (157-159) map to the same antigenic site, strongly supporting the involvement of G158E in immunological escape, as indicated by a “low reactor” status.

However, although the identification of G158E has been made by multiple independent approaches involving three labs, including the CDC, the CDC antigenic characterization of these more recent isolates did not have the “low reactor” designation. Recently WHO has acknowledged inter-lab variations and has produced an international standard using pooled human anti-sera. Although it is not clear if the absence of low reactor status for recent isolates is due to the use of the international standard, or some change or variation in the CDC assays, the failure to detect low reactors has been detailed previously, as noted above.

In the 2007/2008 season a new H1N1 target was selected. Previously, the target was New Caledonia/20/1999, which was clade 1 and the CDC correctly predicted that New Caledonia would be replaced with clade 2, and Solomon Islands/3/2006 was selected as the target. However, by fall Solomon Islands/3, which was clade 2A, had been replaced by two other sub-clades. Brisbane/59/2007 (clade 2B) and Hong Kong/2562/2006 (clade 2C). The CDC had developed a ferret anti-sera against Solomon Islands/3 which could distinguish clade 1 from clade 2, but could not distinguish between the three clade 2 sub-clades. Consequently, as noted above, all isolates were called Solomon Island-like, even though Solomon Islands/3 was not circulating. However, other labs had antibodies that could better distinguish the three sub-clades and soon these other sub-clades were designated low reactors. Using an 8 fold reduction in titer as the cut-off, both Mill Hill and Australia were finding that approximate 46% and 45%, respectively, of H1N1 isolates were low reactors while the CDC was only finding 4% (see slide 7). However, phylogenetic analysis showed that both HA (see slide 8) and NA (see slide 9) had significant non-synonymous changes when either clade 2B or clade 2C were compared to clade 2A or each other, while clade 2B differences between H1N1 isolates from the United States or Europe were minimal (see isolates with LR label in phylogenetic trees), so data generated by the CDC should have been similar. Moreover, the minimal differences between clade 2B isolates suggested the number of isolates showing a four fold reduction in titer would be similar to the number giving an 8 fold reduction (the difference was due to a 2 fold variation in the assay), and the number of low reactors in clade 2B was close to 100%. In addition the appearance of Tamiflu resistance was highest in clade 2B, so the vaccine mismatch may have contributed to the fixing of H274Y.

The phylogenetic data was confirmed when Australia then made two anti-sera against Brisbane/59. One immunization used Brisbane/59 grown in eggs, while the other used virus from mammalian cells. The egg based anti-sera extensively cross reacted with the three clade 2 prototypes, but the anti-sera against Brisbane/59 grown in mammalian cells gave very clear cut results. The titer against clade 2B was 320, but fell to 40 (8 fold) when tested against clade 2C, and gave now reaction (titer less than 40) when tested against clade 2A or clade 1 (see slide 5). Thus, the antigenic characterization data supported the phylogenetic data which predicted major differences between the three clade 2 sub-clades, and anti-sera against Solomon Islands/3 would offer minimal protection against Brisbane/59-like viruses of Hong Kong/2652-like virus. Thus, although the target was a mismatch because the wrong clade 2 target was selected, initial characterizations published in MMWR claimed a match by stating that the vaccine was directed against Solomon Islands/3 and all 2007 isolates in the 2007/2008 season were Solomon Islands/3-like. Thus, the CDC data was really generated from an answer (match) in search of an assay.

There is considerable concern that the answer in search of an assay approach is being applied to pandemic H1N1. California/7/2009 also appears to be a mismatch or is close to a mismatch. It has 5 amino acid differences with the consensus H1N1 sequence, so although the consensus is not labeled a mismatch, single changes can push the H1N1 into the low reactor category. This happened when Mill Hill declared a Ukraine isolate, A/Lviv/N6/2009 a low reactor. It had only one additional HA change, D225G. Similarly, two German isolates which just had G158E were also designated low reactors by Mill Hill, and one, A/Bayern/59/2009 was also tested by the CDC and also designated a low rector. Concerns about an answer in search of an assay were raised when the CDC tested an isolate from the Lviv/N6 patient. The CDC isolate had both G158E and D225G yet the CDC said it was not a low reactor raising serious concerns about sensitivity of the assay. Similarly, US isolates with G158E were also not labeled low reactors by the CDC, suggesting the assay had changed. At about the same time the WHO announced the creation of an “International Standard” created by pooled anti-sera from human patients. The use of pooled anti-sera also raises questions about an answer (no 4 fold drop in titer) in search of an assay.

Thus, the parallels between H1N1 seasonal flu antigenic characterization tests and associated anti-sera in 2007/2008, and inter-lab variations in pandemic H1N1 in the 2009/2001 season, raise serious concerns that the failure of the CDC to designate samples with G158E or D225G as low reactors is more closely related to the assays being used rather than the actual ability of the 2009/2010 vaccine to effectively recognize such variants. The concerns were increased by vaccine failures in the US and Europe.

These failures are clearly hazardous to the world health.
 

JPD

Inactive
Avian influenza - situation in Egypt - update 32

http://www.who.int/csr/don/_2010_03_12/en/index.html

12 March 2010 -- The Ministry of Health of Egypt has announced two new cases of human H5N1 avian influenza infection.

The first case is a 20 year-old pregnant female from El Khanka district, Qaliobia Governorate. She was hospitalized on 5 March where she received oseltamivir treatment and died on 9 March.

The second case is a 1 and a half year-old male from Elhamool district, Kfr Elsheikh Governorate. He was hospitalized on 2 March, where he received oseltamivir treatment. He is in a stable condition.

Investigations into the source of infection indicated that the two cases had exposure to sick and dead poultry.

The cases were confirmed by the Egyptian Central Public Health Laboratories, a National Influenza Center of the WHO Global Influenza Surveillance Network (GISN).

Egyptian authorities have also reported the death of a previously announced case; the 53 year-old male from Shobra Elkhima district, Qaliobia Governorate who developed symptoms on 27 February.

Of the 106 laboratory confirmed cases of Avian influenza A(H5N1) reported in Egypt, 32 have been fatal.
 

JPD

Inactive
Bird flu spreading fast in Parasi

http://www.thehimalayantimes.com/fu...d+flu+spreading+fast+in+Parasi+&NewsID=232897

KATHMANDU: The government has been keeping the public in the dark despite the outbreak of bird flu in different parts of the country on the rise, it was learnt today.

Around 500 backyard birds have died in Jhyalbas and Deurali VDCs of Nawalparasi district in the past few weeks.

Following the outbreak, a team of veterinarians led by senior officer at the Animal Health Directorate (AHD), Dr Narayan Prasad Ghimire, was sent to the VDCs for a stamping out operation following verbal orders from Dr Ram Krishna Khatiwada, the programme director, AHD,yesterday.

The team comprised Dr Dayaram Chapagain of Department of Livestock Service (DLS), Chitwan, Dr Laxman Bahadur Dhakal, Chief of DLS Nawalparasi, Dr Damodar Neupane and a technician from the National Avian Laboratory, Chitwan.

However, the team had to return from the VDCs without any job done as they failed to receive a written order from the Department of Livestock Services (DLS) to carry out the same. It is learnt that Dr Khatiwada had assured the team members of the written order from the centre. However, in the last hour, Dr Khatiwada directed the members to return.

Dr Khatiwada said that the report of the sample was not ready. “It might come by Sunday evening,” he said.

When asked about the team sent to the site, he said that was for the diagnosis and to make preparation for culling if the result was found to be positive. “We need to prepare for several things including financial matters before culling the birds in order to maintain international norms,” he said.

One of the team members said the condition in those areas was ‘horrible’ as more birds are being infected and dying fast.

Sources said the birds of local resident Bal Bahadur Bakwal (Magar) of Jhyalbas tested positive for H5N1 virus in the central veterinary laboratory, Tripureswor.

However, the authorities are reluctant to reveal the truth. As per the Bird Flu Control Order- 2064 BS, the government needs to declare “Crisis Zone” after a sample tests positive for H5N1 Avian virus either in the Central Veterinary Laboratory, Tripureswor or in any of the World Organisation for Animal Health reference laboratory. Nepal used to send the samples to the reference laboratory in Waybridge, London, for confirmation.

The government had earlier failed to declare the outbreak in Budhabare-Jhapa, Chainpur-8 in Chitwan, Buddhanagar in Rupandehi and Fultekra in Nepalgunj on time.

It may be noted that the authorities had revealed the outbreak only after The Himalayan Times reported that the government had been keeping the public in the dark.

Nepal Veterinary Association (NVA), Chitwan chapter, has condemned such act of the government and the DLS.

In a statement, the Chitwan chapter of NVA said that the department is being run in an “unethical manner” and at the cost of public health.

The government is once again trying to hide the outbreak of Bird flu in Nawalparasi district.
 

JPD

Inactive
Bird flu hits northern province of Vietnam

http://english.people.com.cn/90001/90782/90880/6920374.html

Bird flu is occurring in the northern province Bac Ninh of Vietnam, raising the total number of affected provinces in the country to six, according to the Department of Animal Health of Vietnam's Ministry of Agriculture and Rural Development on Monday.

The bird flu struck a local farm of Bac Ninh province, causing 200 fowls out of 400 die, said the department.

Samples of death fowls were tested positive to the H5N1 virus, said the department.

The local animal health bureau and authorities have been taking measures to prevent the spread of the H5N1 virus to nearby areas. These measures include slaughtering infected animals and sterilizing the affected areas and their neighborhood.

Amid a number of bird flu outbreaks in the country, Vietnam's Deputy Minister of Agriculture and Rural Development Diep Kinh Tan asked the provincial agencies to start a new round of vaccinating poultry in March and closely monitor free-range ducks in Mekong Delta provinces to contain bird flu.

Currently, Vietnam reports six provinces nationwide hit by avian flu including three southern provinces namely Ca Mau, Khanh Hoa and Ben Tre, one central province of Nghe An and two northern provinces of Tuyen Quang and newly-reported Bac Ninh, said the department.

Vietnam has confirmed three human cases infected with H5N1 influenza so far this year, with one of them dead, according to the Vietnamese Ministry of Health.
 

JPD

Inactive
Swine To Swine Transmission of Pandemic H1N1 In MN IL IA

http://www.recombinomics.com/News/03151002/H1N1_Swine_MN_IL_IA.html

Release of sequences from recent swine pandemic H1N1 isolates indicates the virus is now transmitting between swine herds in the United States. The two most recent isolates had low reactor G158E, which has been found in low reactors. However, that change was appended onto a sub-clade in Minnesota and Illinois, indicating the H1N1 is transmitting between swine in those two states. The swine sub-clade in MN and IL was linked to isolates frequently found in Ukraine, Russia, and Norway which also had strong associations between D225G/N and fatal human cases. In addition, another pandemic H1N1 sub-clade found in a patient in San Diego has also been found in swine in Illinois and Iowa (see list here here here), providing additional evidence for pandemic H1N transmission between swine herds in IL and IA.

Earlier reports of pandemic H1N1 jumping from humans to swine appeared to be isolated. The swine outbreaks were linked to humans associated with the farms. However, these latest examples are clear evidence for transmission from swine to swine over a wide area in the United States. The swine isolates have unique polymorphisms not found in human cases but found in published sequences from three gene segments (HA, NA, MP). In the most recent series, the same virus is in A/swine/IL/5265-1/2010, A/swine/IL/5265-2/2010, and A/swine/IA/35573/2009.

The multiple examples of H1N1 in swine over a wide geographical area raise concerns that pandemic H1N1 could become endemic in swine. It is easily passed from swine to swine and generally produces mild or asymptomatic infections. These jumps into swine lead to acquisition of new swine polymorphisms, and the genetically modified H1N1 in swine can jump back into human populations because the HA is easily transmitted to and between humans.

The changes in pandemic H1N1 raise concerns that the genetic evolution could follow the same path as 1918, which has an equal mix of human and swine H1N1 polymorphisms in all eight gene segments. The sequences required multiple recombination events, as is being observed in the 2009/2010 pandemic H1N1 isolates from swine.

These recent isolates, which are largely collected in 2010, highlight the need for additional surveillance in swine herds in the US and worldwide.

The parallel evolution of H1N1 in swine and human populations is cause for concern.
 

JPD

Inactive
H1N1 PB2 E627K In Three Patients In India

http://www.recombinomics.com/News/03161001/E627K_India.html

The swine flu virus isolated from the throat swab samples of three H1N1-infected patients at the National Institute of Virology (NIV) has shown a small genetic mutation in the polymerase 2 (PB2) gene, NIV director A C Mishra told TOI on Monday.

The PB2 mutation has previously been associated with increased efficiency of replication and possible virulence changes in other influenza A viruses.

The above comments indicate E627K has been detected in three patients in India. E627K has been found in all human influenza since 1918, so acquisition of the polymorphisms is not a surprise. Some had speculated that it would be acquired from seasonal flu via reassortment, but there have been no reports of any change in the original constellation of genes in pandemic H1N1, which had only one human flu gene, PB1, which was acquired in 1993. The above description indicates the acquisition was a single nucleotide change and was likely due to recombination. The finding of the same change in three patients indicates E627K is transmitting. Prior reports of one isolate in Shanghai or two isolate in The Netherlands did not lead to additional reported transmissions. However, the simultaneous detection in three patients in India suggests the E627K will become widespread.

Multiple reports in the US are signaling recent upticks in H1N1 cases, and it is likely that the new wave will select multiple changes. Increasing rates of acquisitions have been noted, including D225G/N and G158E in HA as well as H274Y in NA.

These recent acquisitions raise concerns of increases in severe and fatal cases. The acquisition of E627K will likely lead to higher levels of H1N1, which would also create more severe cases. E627K allows for more efficient replication at lower temperatures which is linked to more efficient transmission via the upper respiratory tract, while additional HA changes lead to higher levels of H1N1 in lung. Many of the significant polymorphisms have been associated with mixtures, and a mixture of PB2 with E627 and E627K could lead to increases in transmission as well as increases in lethality.

Sequence data in these three patients and relationships to each other would be useful.
 

JPD

Inactive
Ducks destroyed after virus found: State poultry group
buys flock in order to have the fowl eliminated

http://www.gonzalesinquirer.com/articles/2010/03/15/news/news01.txt

Around 3,500 ducks in Gonzales County had to be destroyed earlier this year by an order from state officials.

The ducks, owned by Gonzales resident Steve Hendershot, were located on County Road 238 north of Gonzales.

The Gonzales Inquirer has been working on this story for more than a month. State officials at first said they were unaware of the issue and refused any comment. However, after a phone call from the office of Rep. Edmund Kuempel, R-Seguin, officials released the entire story about what happened.

State officials said the flock had to be destroyed because of positive tests for a bird virus.

Andy Schwartz, state epidemiologist for the Texas Veterinary Medical Diagnostic Laboratory (TVMDL), said last week the situation began last November during random testing of the duck flock.

Schwartz said new rules in the state require random testing of flocks when birds from those flocks are sold at live bird markets in Texas. Such was the case with the ducks in Gonzales County.

He said state officials did a "routine sampling" and those samples were sent to the diagnostic laboratory at Texas A&M University in College Station.

Schwartz said when the tests were conducted, "it came up positive" for possible Avian flu virus. However, he also said that "any influenza will trip the test."

Because of the positive test, the samples were then sent to the National Veterinary Services facility in Ames, Iowa.

"They repeated the same result and found the matrix positive," said Schwartz.

At that time, he said they "attempted to isolate the virus."

Schwartz said more samples were then tested. They were "particularly concerned" about two strains which "could cause an outbreak in the poultry industry."

Those two strains are H5 and H7, he said, and the samples tested negative for those two strains.

At that time, Schwartz said state officials "assessed the situation" and put the entire flock on a "hold order" until they got the results back.

"We didn't have sick ducks," he said.

Once those results were received, Schwartz said the state "decided to allow controlled marketing where he (Hendershot) could move the live ducks to the markets in Houston."

Schwartz said that Hendershot had two houses of birds. The first house had the positive test but he said the second house "continued to test negative for several months."

However, in late December of last year, he said the state "got a positive" test on the second house.

"We stopped movement of all birds," he said.

What that meant, said Schwartz, was "we no longer let him send them to the market."

Schwartz said the state felt "it was sort of a difficult situation. We didn't feel like we could stop it permanently."

It was at that time when the Texas Poultry Federation "agreed to come up with the money to buy out the flocks."

Once that happened, Schwartz said all of the ducks, somewhere in the neighborhood of 3,500, were "humanely destroyed."

Schwartz said Hendershot was "having to feed the ducks and not able to market them."

James Grimm, executive vice president of the Texas Poultry Federation, confirmed last week they did enter into an agreement with Hendershot.

"He had a concern about putting them down and we had a concern about them not being put down," said Grimm. "We came to a mutual agreement."

During a luncheon last week, Dr. Tammy Beckham, director of the TVMDL, said there are eight million birds in the greater Gonzales area, making it the largest concentration of poultry in the state.

Grimm said his group considers these situations "case by case," but that it is not uncommon for them to step in when necessary.

"Any time if effects poultry we have a huge concern about it with all of the poultry in the Gonzales area," said Grimm.

Asked if notices were sent to the major poultry producers in the county, Schwartz said that was done through the Texas Poultry Federation. That group, he said, likely notified the local poultry producers in the area.

It was known that a local poultry supply company had a mechanism in place where people had to disinfect their shoes before entering the building.

Schwartz said poultry industry businesses are normally "urged to tighten their security" when a bird flu disease tests positive in an area.

He said the process for getting the ducks usually means the hatchlings are purchased from an out-of-state hatchery. Schwartz said he wasn't sure exactly how the birds were shipped but thinks they were flown into Austin and then picked up and brought to Gonzales County.

Schwartz said the chicks are then grown locally before being taken to the various markets around the state. He said there are about 10 markets in Texas, most of them in the Houston area.

He said no fines are levied in cases like this, rather, the state is focused on trying "to stop the spread of disease."

Once the birds were destroyed, Schwartz said state officials then developed a "plot plan" for the location. That requires removal of the litter and requires cleaning of the houses "where the infected birds were."

Once that takes place, he said there is then a 30-day waiting period before any more birds can be placed in those houses.

As of last week, Schwartz said he was not sure if the cleaning and disinfectant had taken place. He did say the state has to be notified when it is completed.

"I don't know if the 30-day clock has started," he said.

Schwartz also said state officials were on the site after the virus was detected and continue to monitor the situation.

Hendershot is a former Gonzales city councilman and just recently filed as a candidate in the May election for another city council post.

Information in this story was given following a public information request by The Gonzales Inquirer.
 

JPD

Inactive
Nepal Reports More Bird Flu Outbreaks

http://www.thepoultrysite.com/poultrynews/19737/nepal-reports-more-bird-flu-outbreaks

NEPAL - Four more outbreaks of highly pathogenic avian influenza (HPAI) have been reported in Nepal.

The veterinary authority sent Follow Up Report No. 1 dated 14 March to the World Organisation for Animal Health (OIE).

The report describes four new outbreaks of HPAI in the central southern regions of Rapti, Lumbini and Narayani. All four outbreaks involved backyard flocks, totalling 1,471 birds. Of these, 639 died and 838 were destroyed.

The presence of the H5N1 sub-type of the virus has been confirmed.
 

BlueNewton

Membership Revoked
Thank you, JPD, for keeping us informed. That bird flu appears to be getting a bit out of control.

BN--watching and waiting
 

JPD

Inactive
H1N1 E627K In India Increases Pandemic Concerns

http://www.recombinomics.com/News/03161002/E627K_India_3.html

The swine flu virus isolated from the throat swab samples of three H1N1-infected patients at the National Institute of Virology (NIV) has shown a small genetic mutation in the polymerase 2 (PB2) gene

The above comments and additional media remarks strongly suggest that E627K has been detected in at least three patients in India. Although there have previous reports of E627K in Shanghai and The Netherlands, the earlier reports were in the first and second waves in the northern hemisphere, when there was little selective pressure because wild type H1N1 was spreading rapidly.

However, at the start of the third wave, there is significantly more pressure because of the establishment of immunity to wild type pandemic H1N1 in a significant percentage of the target population.

E627K increases polymerase activity at lower temperatures and therefore favors increased replication in the mammalian upper respiratory tract. All human flu since 1918 has had E627K, further supporting its selective advantage. The presence of E627K in three patients signals transmission, and it is likely that E627K will become much more common in the upcoming weeks.

The start of a new wave in the northern hemisphere leads to increases in a range of genetic changes. Increases in G158E, D225G/N and H274Y have been noted and such increases are likely to accelerate in the third wave in the northern hemisphere.

E627K can lead to higher levels in the upper respiratory tract and more efficient infections associated with higher viral loads. An increase in viral load can significantly impact the course and severity of the infection.

When H1N1 jumps species, as seen in pandemic H1N1, there are a series of adaptations that lead to more efficient replication and spread in the new host species. E627K is a modification that is linked to efficient growth and spread in humans.

Thus, the report of E627K in three patients in India is significant and cause for concern.
 

JPD

Inactive
Fixing PB2 E627K In Pandemic H1N1

http://www.recombinomics.com/News/03171001/H1N1_E627K_Fix.html

They added that the clinical and epidemiological significance of the mutation is unclear and that experimental infection of ferrets with the H1N1 virus containing the mutation did not suggest increased shedding, virulence, or transmissibility.

Shaw said nothing stood out about the Dutch patients—the mutation didn't appear to give the virus a transmission advantage. If the mutation described by the Indian researchers turns out to be the E627K in PB2 mutation, "it's an interesting observation, but probably irrelevant clinically," he said.

The above comments further support the interpretation that the PB2 change in three patients in India is E627K. The above comments rely upon negative ferret data to suggest the change has no clinical relevance, even though all human seasonal flu since 1918 has E627K, indicating it offers significant selective advantage for multiple human sero-types and clades including pandemic H1N1 from 1918.

The CDC also cited negative ferret data to downplay the significance of D225G even though 2 of 5 isolates from fatal cases in 1918/1919 have D225G and 27/37 fatal lung samples in Ukraine have D225G/N and virtually all samples positive for D225G/N in Ukraine and several other countries are from fatal or severe cases.

The use of animal models which fail to replicate natural history to refute natural history is rather bizarre, but is used again and again by the CDC and WHO consultants to offer assurances and set policy, which continues to be hazardous to the world’s health.

Pandemic H1N1 is a swine virus adapting to a human host. All prior seasonal flu’s have had E627K, so the acquisition of the same change by pandemic H1N1 is not a surprise. Last spring, when E627K was found in an isolate from Shanghai or last fall when E627K was found in two Dutch patients, there was little selection pressure, which is also true for the experimental ferrets.

Now that the second wave has ended, much of the target population has some immunity, so there will be a selection pressure for H1N1 that can evade the human immune response, and E627K may pair up with one or more additional adaptations to human hosts. The finding that three patients already have this change may indicate that such a pairing has already happened. Therefore, the spread of E627K is expected, as is the fixing of E627K, ferret experiments notwithstanding although the ferret data did show a decline in the 1918 virus when E627K was changed to E627.

Full sequences from these patients as well as the earlier cases in The Netherlands would be useful.
 

JPD

Inactive
Romania Reports First EU Outbreak of Bird Flu

http://www.thepoultrysite.com/poultrynews/19741/romania-reports-first-eu-outbreak-of-bird-flu

ROMANIA - Romania is the first EU country this year to report an outbreak of highly pathogenic avian influenza (HPAI).

The veterinary authority sent an Immediate Notification dated 16 March to the World Organisation for Animal Health.

The report describes a single outbreak of HPAI in a village flock in the state of Tulcea, which lies in the east of the country and borders the Black Sea. All 47 birds in a backyard poultry flock died.

The disease was suspected on 13 March 2010 in two birds in two backyards with a population of 47 birds. The village of Letea is a small locality in the Danube Delta, on a land isolated by water, composed of 165 backyards, access being achieved by boat.

Samples were taken and sent to the National Reference Laboratory for confirmation and, on 15 March 2010, a positive result for H5N1 subtype was confirmed by RT-PCR.
 

JPD

Inactive
Bird flu detected in Nawalparasi

http://www.nepalnews.com/main/index...l/4783-bird-flu-detected-in-nawalparasi-.html

The Avian Influenza (H5N1) virus has been detected in Nawalparasi. The government had sent samples for test to UK laboratory some days back following death of chickens and ducks in the area.

Following lab test results that confirmed bird flu, the local authorities have restricted transportation of the birds within 500 meters in Dheurali VDC of the district, some 8 km north of the east-west highway.

Large numbers of chicken and ducks have died in Jhyalbas, Guheri, Beluwa, Dihi and Ruksi villages. The dead birds have been thrown into water bodies.

The local authority is preparing to dispatch more medical and technical staffs for culling of birds. nepalnews.com
 

JPD

Inactive
Vietnam records second bird flu death this year

http://news.ph.msn.com/regional/article.aspx?cp-documentid=3967117

A three-year-old girl on Wednesday became the second person to die of bird flu this year in Vietnam, a doctor said.

The child succumbed after about a week in a Ho Chi Minh City pediatric hospital with a severe lung infection, said Phan Van Nghiem, of the city's health department.

The girl, from southern Binh Duong province, was Vietnam's 59th human fatality from bird flu, also known as H5N1.

A 38-year-old woman in southern Tien Giang province died from the virus in late February.

Vietnam has the world's second-highest bird flu death toll after Indonesia, according to the World Health Organization.

The H5N1 virus typically spreads from birds to humans via direct contact, but experts fear it could mutate into a form easily transmissible between humans, with the potential to kill millions in a pandemic.
 

JPD

Inactive
New suspected case of A/H5N1 in HCM City

http://english.vietnamnet.vn/Health/201003/New-suspected-case-of-A/H5N1-in-HCM-City-899262/

VietNamNet Bridge - The Ho Chi Minh City Department of Health announced a suspected case of bird flu virus on March 16.

Bird flu recurs in northern, southern Vietnam

Bird flu epidemic returns

First death from bird flu in 2010 reported

The patient, a 3-year-old child from Thuan An district, Binh Duong province, was hospitalised with symptoms of petechial fever, but she then tested positive for the A/H5N1 virus and is now under quarantine for treatment at Nhi Dong hospital, Ho Chi Minh City.

“There are many poultry breeders around the patient’s house,” said her family.

The Hospital for Tropical Diseases and Pasteur Institute have sent medical experts to Nhi Dong hospital for consultation and samples have been taken for medical tests. The final result will be announced on March 17.

The Pasteur Institute will send officials to the patient’s living quarters for inspection and put those who have contact with her in quarantine.
 

JPD

Inactive
Record Jump In H1N1 Hospitalizations In Georgia

http://www.recombinomics.com/News/03181001/H1N1_GA_Hosp.html

Georgia has reported 80 H1N1 hospitalizations for the week of 3/3-3/9, which is one shy of the record number in week 9/23-9/29. The current jump of 42 from the prior week is the largest weekly increase recorded for Georgia and extends earlier increases seen in region 4. Moreover, the doubling of hospitalizations threatens to significantly impact health care deliveries if the rate of increase continues.

Today marks the 1 year anniversary of the first confirmed H1N1 case in Mexico, and a third wave has been predicted, as has been seen in the three most recent pandemics in 1918, 1957, and 1968.

The record jump in hospitalized cases comes at a time when Georgia and several states are reporting regional activity, indicating the hospitalization rate is markedly higher than earlier waves. Recent genetic changes, including the increase in D225G/N as well as H274Y have raised concerns that a new wave would have a higher frequency of severe and fatal cases.

The latest report from Georgia is consistent with this prediction.
 

JPD

Inactive
PB2 E627K In Experimental H1N1 Raises Concerns

http://www.recombinomics.com/News/03181002/H1N1_E627K_Exp.html

We show that in both A549 cell culture and in a mouse model of influenza infection, two of these changes, PB2-E627K and –D701N, do not potentiate the replication or virulence of a virus containing the 2009 pandemic RNP. Rather, both of these changes significantly impair the
replication of the virus and diminish the histopathological consequences of infection. Our findings suggest that if the 2009 pandemic virus were to acquire these changes, greater virulence would be an unlikely consequence.

The above comments are from the paper, The PB2 E627K Mutation Attenuates Viruses Containing the 2009 H1N1 Influenza Pandemic Polymerase. The results in the paper have been cited in comments on the recent report of a PB2 alternation in pandemic H1N1 from three patients in India. Although the paper provides data showing the E627K can impair replication and pathology of a virus containing the ribo-nuclear protein (RNP) complex (PB2, PB1, PA, NP) from A/California/04/2009, on a seasonal H1N1 genetic background from A/New York/312/2001, there is no data comparing the actual pandemic virus with and without E627K.

Since E627K has been reported in H1N1 from three patients in India, the above reductions in the experimental reassortant lack relevance to pandemic H1N1 because it is unlikely that a virus with significantly impaired ability to replicate would be transmitting as seen in the E627K positive H1N1 in India. Thus, the experimental findings are not predictive of the results of the effect of the acquisition of E627K on pandemic H1N1, and there is no data from a predictive model to support comments on E627K on pandemic H1N1 virulence.

The use of data from experimental models which are not predictive of clinical data are continuously cited by WHO and consultants to discount actual data, which was also done for D225G after the extraordinary high frequencies had been reported in samples from fatal or severe cases.

Both E627K and D225G were found in fatal 1918 cases. E627K has been found in all human seasonal flu since 1918, and D225G was in 2 of the 5 fatal samples from 1918/1919. This historical data has relevance to the 2009/2010 pandemic, which also involves the jump of swine H1N1 to a human population. The presence of E627K in all prior seasonal flu’s signals strong selection pressure by human hosts and suggests the number of pandemic H1N1 infections with E627K will increase, which could lead to increased levels of pandemic H1N1. These increased levels can lead to more efficient transmission in a human population that is no longer naïve. Similarly, a higher viral load can increase the level of H1N1 in the lung, especially if the virus also has D225G/N.

These adaptations to a human host continue to be cause for concern, experimental models notwithstanding.
 

JPD

Inactive
Research shows bird flu could become more deadly

http://english.vietnamnet.vn/Health/201003/Research-shows-bird-flu-could-become-more-deadly-899959/

VietNamNet Bridge - Recent research shows rapid changes have occurred to the bird flu virus (A/H5N1), which could lead to a more deadly, drug-resistant strain of the disease, the Virus Department of the National Institute for Hygiene and Epidemiology has reported.

New suspected case of A/H5N1 in HCM City

Bird flu recurs in northern, southern Vietnam

Bird flu epidemic returns

First death from bird flu in 2010 reported

Dr. Nguyen Huy Nga, head of the Preventive Health and Environment Department, said that at least seven antigen groups have appeared in the bird flu virus since it was first detected in Vietnam, and that the virus’s future development would be hard to predict.

She made the announcement on March 12 during a national conference in Hanoi on avian influenza.

However, the ability to transmit the virus from human to human remains low, Dr. Nga said.

She also warned that a bird flu (A/H5N1) epidemic is at high risk of recurrence due to poor pubic awareness of the disease.

Dr. Nguyen Tran Hien, director of the Virus Department of the National Institute for Hygiene and Epidemiology, said that in addition to raising awareness about genetic mutations related to the bird flu virus, people must be educated about how to prevent the disease.

Dr. Nga said that in remote areas, local people still slaughter and eat meat from sick chickens. This may cause the disease to spread further, she added.

The Environment and Preventative Medicine Department has asked people to take strict measures to prevent another outbreak of A/H5N1. The department also stressed the need to tighten control of poultry transport, trading and slaughtering activities.

Anyone who suspects they may have contracted bird flu is advised to seek immediate medical treatment, the department added.

According to experts, the most effective measure to prevent an outbreak of the deadly disease is to promote information dissemination. Public awareness of the virus has remained relatively low since bird flu first broke out in Vietnam seven years ago.

Since the beginning of this year, five people in Vietnam have contracted the A/H5N1 virus, of whom two died.

Bird flu has claimed the lives of 60 people in Vietnam since December 2003.
 

JPD

Inactive
Bird flu reported in Romania

http://www.fwi.co.uk/Articles/2010/03/22/120442/Bird-flu-reported-in-Romania.htm

The EU has confirmed its first case of H5N1 avian flu since March last year, in Romania.

The outbreak was discovered in a backyard flock near the border with Ukraine a week ago, according to a statement from the Commission.

All the birds on the affected farm have been killed and the authorities have set up a three-kilometre (two-mile) protection zone and a larger surveillance zone.

"The presence of the virus was confirmed on two hens that were found dead on a small private farm," said Raul Balogh of the Romanian veterinary service. "No other case has been discovered since."

Mr Balogh said tests were regularly made on poultry in the Danube delta because of the presence of migratory birds, which are believed to be vectors of the virus.

The EU's last confirmed case was identified in a wild duck in Bavaria in March 2009.
 

NWPhotog

Veteran Member
A week ago Friday last, I woke up in the middle of the night w/terrible chills. Sure enough I had a full blown flu for 6 days. DW caught it 3 days later and had nearly identical symptoms for the identical amount of days. DD came over yesterday and now had her own flu today.

Tricky stuff, this flu!
 
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