[AI] Avian Flu Daily Thread 03.10.05

LMonty911

Deceased
http://health.news.designerz.com/bird-flu-mystery-casts-shadow-over-vietnamese-province.html?d20050310

THUY LUONG, Vietnam, (AFP) Thursday March 10, 2005

Vietnam's northern province of Thai Binh has become the frontline in the country's war against deadly bird flu, but with fresh cases day after day authorities are baffled as to how the virus is spreading.



AFP
"The local people are very worried of bird flu. Even local authorities are also very worried because more cases of human bird flu are reported whereas poultry did not die on a large scale as last year," said Dang Duc Rieu, director of the provincial animal health department.

"We are closely monitoring the infected people and places where the poultry outbreaks were reported," he said.

"What worries us the most is that people don't have enough information on bird flu transmission and on poultry raising."

The authorities on Wednesday announced that an 81-year-old grandfather had tested positive for the H5N1 virus, with his grandson, 21, and granddaughter, 14, also hospitalised in Hanoi.

It was not clear whether the elderly man, named Nguyen Huu Kim, caught the disease from his grandchildren or infected poultry, but the possibility of a human-to-human infection will spark concern among health authorities.

Experts fear a worldwide pandemic if bird flu mutates to be easily transmissible between people.

The old man tested positive for bird flu despite displaying no symptoms of the disease.

According to a preliminary test carried out by the Institute of Epidemiology in Hanoi, another woman, the widow of a victim who died in February, is also healthy despite carrying the virus.

In January two brothers were contaminated, one died while the other recovered.

To date, at least eight people have tested positive in the province, of whom two died.

While the number of bird flu cases is falling across the country and the outbreak which appeared at the end of December seems to be weakening, the province continues to be a worry.

Nothing seems really under control. Since December, outbreaks have been discovered in small backyards far away from each other, with veterinarians unable to identify the process by which the virus has spread.

For months, including more recently at an international meeting in Ho Chi Minh City, experts have recommended a clear separation between human and animals.

But old practices will be hard to change in a country where the majority of poultry breeders are family farmers who raise three or four chickens to supplement their income.

In the commune of Thuy Luong, where the old man and his two grandchildren contracted the disease, an AFP journalist saw poultry continuing to run freely and hygiene standards appeared lacking.

Canals were black and full of refuse while about 30 metres (yards) from the house of the two young victims, an open-air rubbish dump was overflowing.

In the commune, 240 poultry were destroyed, mostly ducks, according to local official figures.

The provincial authorities do what they can within their means to continue the fight against the disease. Samples were taken from 20 people in the family circle, according to Pham Gia Lai, deputy manager of the provincial department of health.

"We wonder whether they got infected from the poultry or between themselves," he said.

"We are sure that the three carriers had direct contact with the poultry."

The rest of the scientific procedure is out of his hands.

"At the local level, we can only send the throat samples of the infected people and their relatives to Hanoi for tests. We cannot implement the test as we lack equipment and skills," he said.

Le Thi Nhuan, 35, daughter-in-law of the infected old man, said life had become more difficult for the family since the two young people fell ill.

"I heard that the health department will give us masks but no one has given us anything yet," she said.

"Ever since they were discovered to be infected (with the bird flu virus), villagers don't want to stay close to us. We always return home immediately from the fields."

But for some villagers, there is no option than to keep raising poultry. Talking about the two young patients, a peasant said: "I am not scared. If they fell sick, too bad. We'll keep doing the same."
 

LMonty911

Deceased
http://www.turkishweekly.net/news.php?id=5981
Concern at Vietnam bird flu cases
Two elderly Vietnamese people who are related to victims of bird flu have themselves contracted the disease, according to local health officials.

The new cases, neither of which had shown any symptoms, will add to concerns the disease may be spreading more readily between humans.

Experts are worried the virus could eventually combine with human flu and risk a deadly pandemic.

Bird flu has killed at least 46 people in South East Asia since December 2003.

"We are aware of these [new] cases and we are investigating this further," a World Health Organization spokeswoman said.

One of the new cases, a 61-year-old woman whose husband died of bird flu, had no other known contact with the disease.

"She said she ate only pork and all four chickens raised in her house tested negative for bird flu," an official at the health clinic in her village in Thai Binh province told Reuters.
The other case, an 81-year-old man, is the grandfather of two teenage siblings who also have the disease.
It was not clear if he caught the disease from contact with infected poultry or with his grandchildren.

A 26-year-old nurse who looked after one of the teenagers is also now sick with bird flu.

The fact that the widow and the grandfather are apparently healthy, despite testing positive for the disease, suggests that there could be more bird flu cases than previously thought.

This concern was also raised on Tuesday, when the WHO announced that seven Vietnamese who initially tested negative for bird flu had now been found to have carried the virus.

"There's no doubt. The WHO accepts that we are missing cases. It's quite possible that some people are falling sick and their symptoms are very light and they don't end up in hospital," said WHO regional spokesman Peter Cordingley.

The World Health Organization warned last month of "the gravest possible danger of a pandemic".

During an international conference on bird flu in Ho Chi Minh City, Vietnam promised to overhaul its poultry industry, as part of efforts to stamp out bird flu.

Story from BBC NEWS
 

JPD

Inactive
New type of Bird Flu found H16

INFLUENZA A VIRUS, EUROPEAN GULLS, NEW HA TYPE (H16)
***********************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>



Date: Wed 9 Mar 2005
From: ProMED-mail <promed@promedmail.org>
Source: Journal of Virology, Vol. 79, Issue 5, 2814-2822, March 2005 [edited]
<http://jvi.asm.org/cgi/content/abstract/79/5/2814>



A 16th hemagglutinin (HA) subtype of influenza A virus
-----------------------------------------------
[The influenza viruses are segmented genome RNA viruses classified in the
family _Orthomyxoviridae_. They constitute 3 of the 5 genera of the family
and are designated the genera _Influenzavirus A_ , _Influenzavirus B_, and
_Influenzavirus C_. Each is represented by single virus species: _Influenza
A virus_, _Influenza B virus_, and _Influenza C virus_.


The influenza A viruses exist as several distinct subtypes, defined by the
hemagglutinin (HA) and neuraminidase (N) surface antigens, which infect
humans and a range of avian and mammalian species. In contrast, the
influenza B viruses do not exhibit subtype variation and appear to infect
humans only, causing epidemics but not pandemics, presumably because there
is no reservoir of novel antigenic variation in non-human hosts. The
influenza C viruses infect humans and have also been isolated from pigs in
China, but these viruses are not associated with either epidemic or
pandemic disease in the human population.


The influenza A viruses exist in greatest profusion in waterfowl. Until
recently, 15 distinct HA and 9 distinct N antigenic types have been
recognized. It is generally accepted that feral aquatic birds are the
reservoir for influenza A viruses and that influenza viruses in aquatic
birds has achieved "evolutionary stasis," meaning that the internal genes
of the viruses show little genetic variation. In feral aquatic birds
virtually all combinations of HA and N subtypes exist as a result of
apparently unrestricted reassortment of the HA- and N-encoding genome
subunits, whereas only a few combinations have been found in terrestrial
and marine mammals (humans, horses, some carnivores, seals and whales) and
domestic fowl. The avian influenza viruses causing disease in domestic
poultry are predominantly viruses of HA5 and HA7 subtypes. Strains of low-
(LPAI) and high- (HPAI) pathogenicity avian influenza virus of each subtype
exist. Pathogenicity is determined in part by the presence of multiple
basic amino acids (arginine and lysine) at the cleavage site of the H
protein. Cleavage of the H molecule is necessary for infectivity of the
virus, and the susceptibility of the H molecule to specific cellular
proteases determines the tissue tropism and virulence of the virus.


A significant new finding has been the identification of a 16th
hemagglutinin subtype, which is described in a paper in the current issue
of the Journal of Virology. The paper is entitled: "Characterization of a
Novel Influenza A Virus Hemagglutinin Subtype (H16) Obtained from
Black-Headed Gulls," authored by Ron A. M. Fouchier and 8 others. - Mod.CP]


The Abstract of the paper states that: "In wild aquatic birds and poultry
around the world, influenza A viruses carrying 15 antigenic subtypes of
hemagglutinin (HA) and 9 antigenic subtypes of neuraminidase (NA) have been
described. Here, we describe a previously unidentified antigenic subtype of
HA (H16) detected in viruses circulating in black-headed gulls in Sweden.
In agreement with established criteria for the definition of antigenic
subtypes, hemagglutination inhibition assays and immunodiffusion assays
failed to detect specific reactivity between H16 and the previously
described subtypes H1 to H15. Genetically, H16 HA was found to be distantly
related to H13 HA, a subtype also detected exclusively in shorebirds, and
the amino acid composition of the putative receptor-binding site of H13 and
H16 HAs was found to be distinct from that in HA subtypes circulating in
ducks and geese. The H16 viruses contained NA genes that were similar to
those of other Eurasian shorebirds but genetically distinct from N3 genes
detected in other birds and geographical locations. The European gull
viruses were further distinguishable from other influenza A viruses based
on their PB2, NP, and NS genes. Gaining information on the full spectrum of
avian influenza A viruses and creating reagents for their detection and
identification will remain an important task for influenza surveillance,
outbreak control, and animal and public health. We propose that sequence
analyses of HA and NA genes of influenza A viruses be used for the rapid
identification of existing and novel HA and NA subtypes."


--
ProMED-mail
<promed@promedmail.org>
 

LMonty911

Deceased
thanks for the contribution, JPD!


http://newpaper.asia1.com.sg/top/story/0,4136,84354,00.html



The New Paper - 11 Mar 2005


On the verge of another killer disease?

By Ng Wan Ching
wanching@sph.com.sg


LIKE the pieces of a jigsaw puzzle, the elements needed for a deadly flu pandemic are beginning to fall in place and some experts are worried.

For a flu pandemic to start, three elements must be present:

a virus that can affect human beings;

effective human-to-human transmission; and

a susceptible group of people.

And two of the elements are already there.

Associate Professor Leo Yee Sin, clinical director of the Communicable Disease Centre, told The New Paper:

MISSING ELEMENT

'The current situation is that we have a new virus and a very susceptible population worldwide as people have no immunity against that virus.

'This is because the virus H5N1 is something new to the human species. What is missing now is effective human-to-human transmission.'

But that missing element could show up too. The signs are already there.

Said Prof Leo: 'What is happening right now, with the latest medical publications from Thailand and Vietnam, is that they are suggesting that there have been cases of human-to-human transmission for H5.'

It has been reported that in Vietnam, two brothers had contracted the virus and one died.

The younger brother, who is recovering, was known to have provided bedside care for his sibling who has died.

NO CONTACT


Evidence also suggested an 11-year-old Thai girl transmitted the disease to her mother and aunt last year.

The girl probably acquired the virus from exposure to infected poultry.

But her mother, a garment factory worker who travelled from another province to care for her daughter, had no contact with birds.

'Even though there is no conclusive evidence, it is still very worrying. We already have two out of three criteria needed for a pandemic,' said Prof Leo.

'The third factor is just sitting on the fence, so you could say we are at 2 1/2 criteria now,' she added.

Prof Leo said the virus that has swept through bird populations in Asia could evolve into a deadly pathogen for humans.

It could become as deadly as the ones that killed millions during three influenza pandemics of the 20th century.

But she does not want to create any panic.

Said Prof Leo: 'We realise that it is beyond humans to predict when the next big one is going to come and in what form it will come.'

Although cases of human-to-human transmission have been rare, 'our assessment is that this is a very high threat' based on the known history of the flu virus, she said.

She is not the only one warning about the next pandemic.

According to AP, Dr Shigeru Omi, World Health Organisation's head in Asia, said at a bird-flu conference in Vietnam last month that the world is perilously close to a deadly pandemic stemming from bird flu.

Top health officials like him are saying that governments need to start drafting emergency plans for the disease.

Dr Omi said: 'If the virus becomes highly contagious among humans, the health impact in terms of deaths and sickness will be enormous, and certainly much greater than Sars.'

The death rate is very high - about 72 per cent of identified patients.

The avian flu now spreading in Asia is part of what is called the H1 family of flu viruses. It is a pathogen that is notorious in human history.

In 1918, H1 appeared and millions died worldwide.

In 1957, the Asian flu was an H2, and the Hong Kong flu in 1968 was an H3.

There had been small appearances of the H1-type of avian viruses in other years, but nothing like the H5 now affecting birds in Asia.

NO IMMUNITY

Said Dr Leo: 'We are seeing a highly pathogenic strain of influenza virus and may see the emergence of a new strain to which the human population has no immunity.

'But it is very difficult to predict when it will happen. If you look at H5N1, it has been around since 1997 till now.

'The virus has been in circulation for some time, but it hasn't been evolving to affect humans in a big way. We don't know why and whether this H5 will be the one.'

She feels the issue of the flu pandemic should be addressed at the national, regional and international levels.

'Regionally and internationally, conference after conference, including the Asean ministers' meeting, are all talking about how to curb the threat of bird flu.

That is widely recognised as a threat to human beings. There are many things in discussion.

WANT TO LESSEN IMPACT

'The next flu pandemic could wipe out a significant proportion of the human species and we want to see that the impact is lessened,' said Prof Leo who had just attended the bird flu conference in Vietnam last month. What should people do?

'We know we have to prepare for the pandemic judging from past history. The national preparedness effort should be at ministry level,' she said.

But it is also important that people are educated on what exactly is influenza.

'The clinical symptoms can be overlapping with things like the cold and other respiratory tract infections and confusing to the public,' said Prof Leo.

Copyright © 2005 Singapore Press Holdings Ltd. All rights reserved.
 

LMonty911

Deceased
Sanofi pasteur Delivers Investigational Pandemic Influenza Vaccine for NIAID Clinical Trials

http://www.pharmalive.com/News/index.cfm?articleid=219823&categoryid=10
Part of sanofi pasteur's global pandemic initiatives

SWIFTWATER, Pa., March 10, 2005 /PRNewswire/ -- Sanofi pasteur (formerly Aventis Pasteur), the vaccines business of the sanofi-aventis Group , has completed production and delivered more than 8,000 investigational doses of a vaccine to protect against the H5N1 influenza strain that public health experts believe could precipitate a global pandemic. According to the World Health Organization (WHO), there have been 55 cases with 42 laboratory- confirmed deaths from the H5N1 avian influenza virus between January 28, 2004 and February 2, 2005.



The investigational doses were shipped on March 2 and 3 to the U.S. National Institute of Allergy and Infectious Diseases (NIAID), part of the U.S. National Institutes of Health (NIH). In May 2004, the NIAID contracted with sanofi pasteur to produce the investigational vaccine.

"The production of the 8,000 investigational doses is one of sanofi pasteur's several initiatives that support efforts by governments and global organizations to prepare for an influenza pandemic," said Michel DeWilde, executive vice-president, research and development at sanofi pasteur. "We believe that each project helps bring about greater understanding of how to face this serious public health threat."

An influenza pandemic is a global epidemic of an especially virulent virus with the potential for severe morbidity and mortality. According to the WHO, the next pandemic is likely to result in 1 to 2.3 million hospitalizations and 280,000 to 650,000 deaths in industrialized nations alone. Its impact will most likely be even more devastating in developing countries.

The contract with NIH to produce the investigational doses is one of several initiatives being undertaken by sanofi pasteur, namely:

* FLUPAN: Sanofi pasteur is the only vaccine manufacturer to participate
in this collaboration funded by the European Union (E.U.) with the
U.K.'s National Institute for Biological Standards and Control (NIBSC)
and the University of Reading. FLUPAN is intended to improve the level
of pandemic preparation in the E.U. The company will produce pandemic
influenza vaccine that will be used in a FLUPAN clinical study.

* Sanofi pasteur has also decided to produce avian influenza vaccine
candidates for use in clinical studies to determine safety,
immunogenicity and proper dosage of a pandemic vaccine. Sanofi pasteur
will complete production of clinical lots of an H5N1 egg-based
influenza vaccine using a strain provided by NIBSC. This program
conducted in collaboration with the French health authorities, NIBSC
and EMEA (European Medicines Evaluation Agency), will lead to the
submission of a mock dossier to the EMEA to accelerate the license
approval process in the event of a pandemic. This is part of sanofi
pasteur response to the WHO pandemic preparedness plan.

* In addition to the NIH contract for production of the investigational
doses, sanofi pasteur has entered into two other agreements with the
U.S. government. This past September sanofi pasteur signed a contract
with the U.S. Department of Health and Human Services (HHS) to produce
two million doses of bulk vaccine derived from the H5N1 viral strain.
In November 2004, the HHS awarded a separate contract to sanofi
pasteur for the establishment and maintenance of flocks of egg-laying
hens to ensure the company's ability to manufacture pandemic influenza
vaccine at current full capacity on a year-round basis.
 

LMonty911

Deceased
HK$254m planned for flu drug stockpile

www.chinaview.cn 2005-03-10 10:39:21

BEIJING, Mar. 10 (Xinhuanet)-- The Hong Kong Special Administrative Region Government is to spend HK$254 million (US$33.1 million) stockpiling flu drugs, which could treat an estimated 1 million people in the event of a pandemic.

In a paper to be discussed next Monday, the amended flu preparation plan calls for the phased stockpiling of 20,568,000 doses of the Tamiflu treatment over the next six to 12 months.

A spokesman for the Health, Welfare and Food Bureau said it planned to increase by 5.5 times the current stockpile of 3.7 million capsules in line with the recommendations of World Health Organization (WHO). The measure would also contribute to “a more favorable perception of Hong Kong as safe place for the international community to do business,” he said.

The flu plan, to be discussed at Legco’s health services panel, projects that 15 percent of Hong Kong’s population would fall ill with avian flu during a pandemic. Scientists and WHO officials have warned that H5N1 bird flu was the most likely strain to cause the next flu pandemic.

Since last December, the human strain of H5N1 has claimed 14 lives in Vietnam.

“We propose to adopt a rate of 15 percent, which was reported to be the attack rate of Hong Kong during the ... pandemic in 1968,” the paper said.

The flu drugs would be given to healthcare workers and other essential workers to prevent massive disruptions to service in the event of a pandemic. Preventive drugs would also be provided to high-risk groups living in institutions, including the elderly and the handicapped as well as poultry workers.

(Source: Shenzhen Daily/Agencies)
 

LMonty911

Deceased
http://www.alertnet.org/thenews/newsdesk/HAN343110.htm
Symptom-free bird flu cases pose no risk - WHO


By Nguyen Nhat Lam

HANOI, March 10 (Reuters) - Two elderly Vietnamese who tested positive for the deadly bird flu virus yet remained healthy pose no significant risk to other people, a World Health Organization expert said on Thursday.

"In most infections, or many infections, it is not unusual to get people who have either mild or asymptomatic infections," Hanoi-based WHO medical epidemiologist Peter Horby told Reuters.

"There is no evidence that asymptomatic infection like this poses any significant risk of onward transmission, so it is not alarming in that sense," he said.

The two elderly Vietnamese, both from the northern province of Thai Binh where a cluster of cases is causing great concern about the possibility of human-to-human transmission of the H5N1 virus, had relatives who caught the virus.

"We certainly need to look into circumstances of how they might have got their infection, whether from poultry, a contaminated environment or from another infected person," Horby said.

What worries the experts most is the possibility of the virus mutating into a form which could pass easily between humans and set off a pandemic in a world without immunity to it and kill millions.

So far, there has been no evidence that mutation has occurred and the only previous probable case of human-to-human transmission occurred in Thailand, where a mother died after cradling her sick daughter in her arms for hours.

MYSTERIES

The 47 people it has killed since sweeping through large parts of Asia in late 2003 are believed, like those who recovered, to have caught the virus directly from infected poultry.

But Vietnamese experts are investigating the Thai Binh cases to see if the two old people caught the virus from prolonged contact with other victims.

The old man, the grandfather of a brother and sister who contracted the disease, drank raw duck blood during the Tet Lunar New Year festivities last month, health officials in his village said.

But the only contact established so far with the virus for the other, a 61-year-old woman, was her husband, who died of bird flu last month.

"It could be that and it could be from the contaminated environment," Horby said. "That's certainly a possibility that needs to be investigated."

Health officials from the woman's village said she ate only pork and all four chickens raised in her house tested negative for bird flu.

There were cases of people caught the H5N1 virus during its first appearance, in Hong Kong in 1997, without showing symptoms but the elderly man and woman were the first known cases in Vietnam, Horby said.

Vietnamese health officials said the two must have had the virus, which usually displays symptoms in three to 10 days, for about a month, but Horby cast doubt on that.

"You would not expect somebody to carry influenza infection for that length of time and it is impossible to tell how long they've had it," Horby said.

The H5N1 virus has killed 34 Vietnamese, 12 Thais and a Cambodian since it swept across large parts of Asia at the end of 2003.

It has recurred several times despite the slaughter of millions of poultry and has spread across about half of Vietnam since the latest outbreak began in the Mekong Delta of Southern Vietnam.

It sprang up again around the same time in Thailand, where the government said it had spread to 19 of the country's 76 provinces but had not infected any more people.
 
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