Re: Pandemic Awareness/Preparation

Indonesia

Here are three links on recent suspected human cases.

http://afludiary.blogspot.com/2009/0...ang-again.html

Originally Posted by afludiary.blogspot.com

Tangerang is a city in Banten, Indonesia located about 20 km west of the Jakarta.

It has been the site of a number of human cases, both confirmed and suspected, with the most recent confirmed case being a 29-year-old female who developed symptoms on December 11th, was hospitalized on the 13th, and died three days later.

Today's report, which appears on okezone.com, concerns two children suspected of being infected by the H5N1 virus, one of which has died.

I underline `suspected' because, while the article mentions a positive laboratory test (twice), we've seen no official announcement from Depkes, the Health Ministry.

The fatality, a child named Kaila Nabila, died after three days in the hospital, on February 17th. Kaila was initially diagnosed with DBD (Dengue) which is a common viral fever in Indonesia.

According to the news report, the Hospital has not released a diagnosis, but the father has been told by `village staff that Litbangkes said my child terjangkit the bird flu virus'

http://afludiary.blogspot.com/2009/0...t-case-in.html

Originally Posted by afludiary.blogspot.com

Today, we learn via the Bird Flu Information Corner, of a another child from the area who is hospitalized and suspected of H5N1 infection. This translation apparently comes from local TV news reports.

http://afludiary.blogspot.com/2009/0...e-workers.html

Originally Posted by afludiary.blogspot.com

This is related with the flash news from AI lab unair, posted 4th of February. A doctor (anesthesiologist) and 4 paramedics of Dr Sutomo hospital Surabaya were quarantined due to bird flu-like symptoms on early February.

This is right after one Surabaya bird flu victim (St/18) was treated in that hospital. Further test revealed that the doctor and one of paramedic tested negative bird flu infection.

Up to last Sunday (22/2), three other paramedics are still in critical condition.

Re: Pandemic Awareness/Preparation

The Influenza Pathogenesis Study

What happens when you become infected with the flu? Exactly how does a flu virus invade your immune system to cause the symptoms that make you sick, and can even kill you?

Thanks to my friend, FLA Medic over at Avian Flu Diary, we now have a very readable analysis of an important study that explains this. Maybe you had trouble in your microbiology class or never even took one, but yes, you too can understand the progression of infection by taking a few minutes to check out this three part analysis written in layman's terms.

After reading this, you should have a sense of why the H5N1 avian influenza virus is truly in a class of its own. No other known influenza virus has ever been as virulent as this one.

http://afludiary.blogspot.com/2009/0...sis-study.html

http://afludiary.blogspot.com/2009/0...-study_15.html

http://afludiary.blogspot.com/2009/0...-study_16.html

Originally Posted by afludiary.blogspot.com

Both in terms of quantity, and duration, the H5N1 virus elicits an extreme immune response in the host animals.
The authors refer to this as early, sustained, and relentless.
Which pretty well describes it.

Originally Posted by www.pnas.org

In conclusion, H5N1 virulence is a multipronged mechanism that causes severe lung pathology with potentially permanent tissue damage within 24 h

Re: Pandemic Awareness/Preparation

Hospitalized Indonesian Paramedics Raise Pandemic Concerns

http://www.recombinomics.com/News/02...aramedics.html

Reports of health care workers becoming infected with bird flu is a cause for concern. The original report came via a boots on the ground collaborative source. Also included here is a commentary from the Recombinomics website of Dr. Henry Niman.

Originally Posted by Birdflucorner.wordpress.com

Birdflucorner.wordpress.com is a weblog developed based on collaboration work between Kobe University, Japan and Institute of Tropical Disease, Airlangga University, Indonesia in bird flu research field.

This weblog provides bird flu related informations in Indonesia which derived from Indonesia cyber news, local newpapers and also international media such as ProMed and WHO website. All of the informations here can be re-directed to the source or references for authenthification. Since some of the posts are in Indonesia language, these will be summarized in English. For any mis-interpretation or additional information, we will appreciate your posts.

Originally Posted by www.recombinomics.com

If the patient and health care workers are H5N1 infected, they would represent one of the largest H5N1 clusters in Indonesia reported to date. Health care workers are rarely infected with H5H1 because they are aware of hazards H5N1 infected patients prevent. Moreover, they are quickly treated, so they rarely progress to a critical state. The report of three health workers in critical condition is alarming.

Re: Pandemic Awareness/Preparation

Indigo girl,
I have been keeping up with your posts over time-thank you so much for your diligence in keeping up with and reporting on this vital information. I use to do infection control for a rural hospital and because of that role, was hooked into the various agencies related to the flu. I am amazed at the apathy around us and yet encouraged by people like you. Keep up the good work-it is not going unnoticed. And will probably help save many lives. If there is any way I can help you or support you-let me know!
Blessings
alwayslearnin

Re: Pandemic Awareness/Preparation

Officials investigate how bird flu viruses were sent to unsuspecting labs

An almost unbelievable story of how a major vaccine manufacturer somehow contaminated a seasonal flu vaccine (H3N2) with the H5N1 bird flu virus. They don't admit to using live virus but, with dead ferrets as a result it could only have been live virus that killed them. The 30 or so employees unwittingly exposed were covered with the inevitable Tamiflu blanket and have tested negative.

Baxter still is refusing to divulge details on just how this happened. I just don't have a warm and cozy feeling about them anymore...

http://allnurses.com/world-news-curr...ml#post3448097

http://chealth.canoe.ca/channel_heal...hannel_id=1020

Originally Posted by chealth.canoe.ca

Accidental release of a mixture of live H5N1 and H3N2 viruses - if that indeed happened - could have resulted in dire consequences. Nicoll said officials still aren't 100 per cent sure the mixture contained live H5N1 viruses. But given that ferrets exposed to the mixture died, it likely did.

H5N1 doesn't easily infect people, but H3N2 viruses do. They are one of two types of influenza A viruses that infect people each flu season.

If someone exposed to the mixture had been co-infected with H5N1 and H3N2, the person could have served as an incubator for a hybrid virus able to transmit easily to and among people. That mixing process, called reassortment, is one of two ways pandemic viruses are created.

Research published last summer by scientists at the U.S. Centers for Disease Control found that in the laboratory, H5N1 and H3N2 viruses mated readily. While less virulent than H5N1, a number of the offspring viruses appeared to retain at least a portion of the killing power of their dangerous parent.

Re: Pandemic Awareness/Preparation

Questions about bird flu contaminated vaccine -- or something

http://scienceblogs.com/effectmeasur...conta.php#more

The Reveres over at Effect Measure weigh in on the controversy over the bird flu contaminated vaccine sent to three different countries in Europe by vaccine manufacturer, Baxter.

Originally Posted by scienceblogs.com

Maybe this isn't the mess it sounds like. It would be nice to have more information from European health authorities. US CDC is apparently not playing any role, which suggests no US seasonal vaccines are involved. But the source of the contaminated sample was a US company, so inquiry from some US authorities seems appropriate.

That's not happening as far as we are told. Why not? Lots of questions. Few answers.

The Editors of Effect Measure are senior public health scientists and practitioners. Paul Revere was a member of the first local Board of Health in the United States (Boston, 1799). The Editors sign their posts "Revere" to recognize the public service of a professional forerunner better known for other things.

Re: Pandemic Awareness/Preparation

Soap and Water Hand Washing Superior to Alcohol-Based Rubs in Reducing Presence of Influenza A

http://www.medscape.com/viewarticle/...4&uac=127954CG

It does not sound like much of a difference to me. Are they are saying that HCW might be too busy to use the soap and water method anyway so using the gel is just about as good?

When I think about organisms like C. Diff in which the gel is NOT effective, I think I prefer the soap and water method most of the time anyway. But, I do carry those little gel bottles around in my lab coat pocket for when a sink is not close by, and there is no hand sanitizer on the wall.

Originally Posted by www.medscape.com

Among those participants with detectable H1N1 after the 2-minute drying period, the 3 alcohol-based hand rubs as well as soap and water hand washing were effective in reducing the viral concentration on participants' hands. However, soap and water hand washing was shown to be statistically superior (P < .001) to the alcohol-based hand rubs. The actual difference, though, in viral concentration on the healthcare worker’s hands with soap and water hand washing vs the alcohol-based hand rubs was only 1-100 copies/µL.

"We believe that our findings have potentially important public health implications, because simple hand washing with unmedicated soap and water appears to be highly effective in removing influenza virus from hands and is, therefore, likely to be effective in preventing transmission of influenza, as long as [hand hygiene] is undertaken appropriately," the authors conclude. "For busy HCWs for whom the number of [hand hygiene] opportunities is likely to be very high, the use of [alcohol-based hand

Re: Pandemic Awareness/Preparation

Webster on China's Silent Bird Flu Infections

http://afludiary.blogspot.com/2009/0...-bird-flu.html

Originally Posted by afludiary.blogspot.com

A leading virologist said on Thursday that ducks are to blame for the resurgence of the H5N1 bird flu virus in China and Vietnam, and called for wider surveillance and vaccination of ducks to stop the problem.

The virus has infected at least 14 people in both countries since the start of this year, killing seven of them.

Experts said what was mystifying about the latest round of outbreaks was the absence of the disease in poultry in China despite the human infections. H5N1 is passed primarily from animal to human.

Robert Webster, a leading H5N1 expert, told a medical conference in Hong Kong that 'silent infections' of H5N1 in ducks may be the reason behind the human cases in China.

Most types of ducks are not sickened by the virus and in most countries in Asia, they mingle freely with chickens, providing ample opportunity for the virus to jump between species.

India

http://www.flutrackers.com/forum/sho...45&postcount=1

Originally Posted by www.flutrackers.com

Authorities in West Bengal have said about 5,000 birds would be culled after Siliguri reported cases of H5N1 strain of bird flu virus.

The cases were sent to a testing lab in Bhopal and results were positive. Officials said they would begin culling soon.

The culling operation will be carried out within a three kilometers radius. We have not yet received information on bird census. Tentatively 5,000 need to be culled, said Kausturi Sengupta, acting Sub Divisional Officer, Siliguri.

Vietnam

http://news.xinhuanet.com/english/20...t_10900838.htm

Originally Posted by news.xinhuanet.com

Bird flu continues to spread wide in Vietnam with another newly-infected northern Dien Bien province, raising the number of Vietnamese provinces hit by the virus to 11, according to Vietnam's Department of Animal Health under the Ministry of Agriculture and Rural Development on Thursday.

In Dien Bien province, bird flu has broken out in two communes of the province, leading to the culling of about 1,460 ducks and more than 1,000 their eggs, said the department, Vietnam watchdog of bird flu.

Laos

http://www.bernama.com/bernama/v5/ne....php?id=369422

Originally Posted by www.bernama.com

The Lao authorities have confirmed a bird flu outbreak in Donngeun village in Laos' northwestern province of Xayaboury that shares a border with Thailand, Vietnam News Agency (VNA) reported.

The Xayaboury provincial Avian Influenza Control Committee on Monday (Nov 3) declared a red zone which covers areas within a 1km radius of the outbreak.

All birds in the area will be destroyed to prevent the virus from spreading

Re: Pandemic Awareness/Preparation

Second bird flu death in Vietnam

http://news.bbc.co.uk/2/hi/asia-pacific/7914044.stm

That hugh sign in the background of this story is ominous. Can't imagine seeing a bill board like that while driving down a highway in the US. A few years ago, probably neither could they.

The latest human cases in Vietnam have clear links to poultry. But, aren't all the ducks supposed to have been vaccinated against bird flu?

Originally Posted by news.bbc.co.uk

The patient, 32, died on 25 February," said Nguyen Van Thai, head of the intensive care unit at Hanoi's tropical diseases institute.

Vietnam's latest victim battled the disease for two weeks. He had become ill after slaughtering and eating ducks his family raised in Ninh Binh, about 100 km (60 miles) south of Hanoi.

Re: Pandemic Awareness/Preparation

Baxter: Product contained live bird flu virus

http://www.torontosun.com/news/canad...7/8560781.html

So Baxter Labs did use live bird flu virus, and they did inoculate ferrets with a mix of H5N1 and a seasonal flu virus. It probably scared the living daylights out of the staff when the ferrets started dying. Can you believe that this actually happened? It's like science fiction.

We keep getting bland assurances that all is well, but no details on how the incidents happened in which three different countries received the mix of the two viruses. I would have a lot more respect for Baxter if they just told the whole truth about what happened. The fact that they are leaving out information makes this so much worse. In the absence of facts, we get to imagine all kinds of scenarios like that maybe it was a deliberate act on the part of an employee, an act of bioterrorism, or whatever. Just give us ALL of the facts, please.

Originally Posted by www.torontosun.com

The contaminated product, a mix of H3N2 seasonal flu viruses and unlabelled H5N1 viruses, was supplied to an Austrian research company. The Austrian firm, Avir Green Hills Biotechnology, then sent portions of it to sub-contractors in the Czech Republic, Slovenia and Germany.

The contamination incident, which is being investigated by the four European countries, came to light when the subcontractor in the Czech Republic inoculated ferrets with the product and they died. Ferrets shouldn’t die from exposure to human H3N2 flu viruses.

Public health authorities concerned about what has been described as a “serious error” on Baxter’s part have assumed the death of the ferrets meant the H5N1 virus in the product was live. But the company, Baxter International Inc., has been parsimonious about the amount of information it has released about the event.

On Friday, the company’s director of global bioscience communications confirmed what scientists have suspected.

“It was live,” Christopher Bona said in an email.

Accidental release of a mixture of live H5N1 and H3N2 viruses could have resulted in dire consequences.

While H5N1 doesn’t easily infect people, H3N2 viruses do. If someone exposed to a mixture of the two had been simultaneously infected with both strains, he or she could have served as an incubator for a hybrid virus able to transmit easily to and among people.

That mixing process, called reassortment, is one of two ways pandemic viruses are created.