Re: Pandemic Awareness/Preparation

Malaysia Receives Prepandemic Vaccine

http://www.farminguk.com/?show=newsArticle&id=12288

This article is of interest because of its discussion of pandemic versus prepandemic vaccines. Needless to say, the pandemic vaccine is going to give more protection. The prepandemic is also likely to be in short supply and would not be given to the majority of a population in most countries so I would wonder just how many people they are planning to vaccinate, and under what circumstances.

Originally Posted by www.farminguk.com

Malaysia is the first country outside Europe to approve a pre-pandemic avian influenza vaccine called Prepandrix.

GSK Pharmaceutical Malaysia MD Francis Del Val said the company’s Prepandrix is a pre-pandemic drug to vaccinate populations prior to a H5N1 avian influenza pandemic. It is designed to provide cross-protection against a range of avian influenza caused by H5N1 strains.


A pandemic vaccine carries the actual pandemic strain and is produced after it has been isolated. The problem with this is that it can take 4-6 months to produce, leaving populations highly vulnerable during the initial period of a pandemic.

Pre-pandemic vaccines are produced before an influenza pandemic and are based on current circulating avian H5N1 influenza viruses.

(hat tip PFI/pixie)

Re: Pandemic Awareness/Preparation

Better Drugs Needed To Fight A Pandemic

http://afludiary.blogspot.com/2009/0...-to-fight.html

For those interested in influenza, whatever Robert Webster of St. Judes Childrens Hospital in Memphis says is to be taken seriously. If he says that we should be concerned about something then we really should be. In several posts the phenomenon of recent Tamiflu resistance to one of our seasonal influenzas has been discussed, and the implications that this could have in the event of a pandemic have been explained. This warning carries much more weight when someone like Dr. Webster talks about it. The other virologist of note in this link is Malik Peiris, part of a world class virology team at University of Hong Kong, one those researchers that played a part in the hunt for the cause of the SARS outbreak. These two men are notifying us that there is a problem that must be solved.

Originally Posted by www.alertnet.org

Many advanced countries stock up on oseltamivir and zanamivir, two varieties of the same class of drugs that stops the H5N1 virus from multiplying. But oseltamivir has proven to be largely useless in fighting the H1N1 seasonal human influenza virus and experts are questioning how well, and how long, the drug would stand up against the H5N1 virus, should it unleash a pandemic.

"We have been extremely foolish on our policies of stockpiling drugs. We have been stockpiling two varieties of the same drug," virologist Robert Webster at the St Jude Children's Hospital in the United States said at a medical conference in Hong Kong.
He said the resistance of the H1N1 virus to oseltamivir was as high as 98 percent worldwide.
"The likely scenario is that the (H5N1) virus will become resistant when you start using more and more (of one) drug, you get resistant (H5N1) mutants," he told Reuters later.

Malik Peiris a microbiologist with the University of Hong Kong said: "There is a need for developing new antivirals (drugs). Some are in very early clinical trials but development should be stepped up so there is a diversification of options."

Re: Pandemic Awareness/Preparation

Egypt

http://www.straitstimes.com/Breaking...ry_344830.html

Originally Posted by www.straitstimes.com

A TWO-YEAR-OLD Egyptian boy has contracted the bird flu virus and is in critical condition, the state-run news agency quoted the Health Ministry as saying on Sunday, becoming the 56th case in the Arab country.
The Middle East News Agency (MENA) quoted Assistant Health Minister Nasr el-Sayyed as saying the boy, Youssef Abdel-Azim from the province of el-Fayoum in central Egypt, showed symptoms on Wednesday after coming into contact with dead birds.

He was administered the antiviral drug Tamiflu and remains in crticial condition on an artificial ventilator at a hospital in Cairo, Sayyed said, according to the agency.

Re: Pandemic Awareness/Preparation

Indonesia's Climbing Case Fatality Ratio

Indonesia continues to withhold information making it difficult to determine the real number of humans cases of bird flu in that country. Here are a few links about deaths and illnesses that occurred going back into January. The number of cases of infected humans is most likely underreported. The Recombinomics link makes clear that we are hearing about fatal cases for the most part, but that there have to be other cases not being counted of people who were sick but recovered, and we know that there are misdiagnosed index cases who died, and whose family members subsequently tested positive. Does it matter that we don't know just how many cases there really are? If human to human transmission is occurring more frequently, then yes, clearly it does matter.

http://afludiary.blogspot.com/2009/0...indonesia.html

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

http://afludiary.blogspot.com/2009/0...nts-under.html

http://www.recombinomics.com/News/03...1_Indo_CC.html

Originally Posted by www.recombinomics.com

When Indonesia announced their news blackout on confirmed cases, WHO offered assurances on timely updates. International Health Regulations require notification within 24-48 hours of confirmation and previously WHO had issued updates within a day or two of the death or discharge of confirmed cases. If Indonesia is abiding by these regulations, then WHO is withholding the data for weeks or months after they are notified. Ironically, when WHO offered its assurances last year, they noted that the Indonesian confirmed cases were not part of a cluster. Yet the news blackout came after the third cluster was confirmed. In each cluster the index died, but was diagnosed with something other than H5N1 (lung inflammation, dengue fever, or typhus) and when a family member was H5N1 confirmed, the misdiagnosis was not upgraded, so the official case count underrepresented both cases in clusters.

This undercount continues today. On Java the past 16 confirmed cases have been fatal. A case fatality rate of 100% signals an under-representation of infected cases that recover. In the latest confirmed cases from Bogor, two siblings died (see updated map). However, a third sibling who survived refused testing. Similarly, three paramedics affiliated with the hospital that treated the confirmed fatality in Surabaya developed symptoms and were in critical condition. At the end of last month they were still hospitalized and unconfirmed, but the likely three cases would create another cluster that included surviving contacts of an H5N1 confirmed case.

These latest likely clusters raise concerns that the H5N1 in Indonesia is evolving toward an H5N1 that is more efficiently spread to humans. The recent WHO report on H5N1 vaccine targets included an HA phylogenetic tree with four isolates from Indonesian patients. These isolates continued to evolve away from this initial 2005 isolate from Tangerang, and raise concerns that vaccines directed against the 2005 isolate will offer limited protection.

Thus, the continuing rapid evolution of H5N1 in Indonesia, coupled with frequent larger H5N1 clusters continues to increase pandemic concerns, while the level of WHO transparency on cases and clusters declines.

Re: Pandemic Awareness/Preparation

A Viral Detective Story

http://crofsblogs.typepad.com/h5n1/2...ive-story.html

It is a strange mystery why H1N1, the virus that caused the 1918 pandemic disappeared after 1950 then came back, and caused yet another, though far less serious pandemic again in 1977. It was most unusual.

Do you think that lab accidents happen?

Originally Posted by crofsblogs.typepad.com

Why were the viral genomes of the 1977 H1N1 isolate and the 1950 virus so similar? If the H1N1 viruses had been replicating in an animal host for 27 years, far more genetic differences would have been identified. The authors suggested several possibilities, but only one is compelling:

…it is possible that the 1950 H1N1 influenza virus was truly frozen in nature or elsewhere and that such a strain was only recently introduced into man.

The suggestion is clear: the virus was frozen in a laboratory freezer since 1950, and was released, either by intent or accident, in 1977. This possibility has been denied by Chinese and Russian scientists, but remains to this day the only scientifically plausible explanation.

Re: Pandemic Awareness/Preparation

Egypt reports 57th human case of bird flu

http://news.xinhuanet.com/english/20...t_10944869.htm

At least this little kid is in stable condition.

Originally Posted by news.xinhuanet.com

An Egyptian boy at the age of two years and eight months has contracted bird flu virus, bringing the number of human case of the avian influenza to 57 in the country, a Health Ministry spokesman said Wednesday.

The boy, Abdullah Nagy Amran, comes from the northern Egyptian governorate of Alexandria, some 220 km northwest of Cairo, the state MENA news agency quoted the spokesman Abdel Rahman Shahine as saying.

The boy showed symptoms after contacting with dead birds on Wednesday, and he is in a stable condition after being admitted to a hospital and given the antiviral drug Tamiflu, said Shahine.

This is the second human case of bird flu less than a week in Egypt, where millions of families raise poultry as a source of food and income.

You can check out the new bird flu website in Egypt, SAIDR . The second link is to a map from their site indicating how pervasive the H5N1 virus is in Egypt.

"SAIDR (Strengthening Avian Influenza Detection & Response) is a USAID-funded effort in support of the Government of Egypt’s national program to detect and respond to avian and pandemic influenza. SAIDR is a partnership between Egypt’s Ministry of Health & Population (MOHP) and Ministry of Agriculture & Land Reclamation (MALR), the UN Food and Agriculture Organization (FAO), and the USAID project Communication for Healthy Living implemented by the Johns Hopkins University Center for Communication Programs. Allied organizations include UNICEF Egypt, the United Nations Development Program, the Egyptian Red Crescent Society, and Save the Children Egypt."

http://www.saidr.org/

http://www.saidr.org/en/map.php

(hat tip Avian Flu Diary}

Re: Pandemic Awareness/Preparation

How much human bird flu in Indonesia?

http://scienceblogs.com/effectmeasur...flu_in_ind.php

That is the unanswerable question because of the censorship in that country. If I worked in public health there, I would be ashamed. It is a terrible thing not to be allowed to tell the truth. Just like the doctors in China that were forbidden to speak out about SARS, they know exactly what is at stake because this is influenza, and it is not just about Indonesia. We are all held hostage by this secrecy.

Originally Posted by scienceblogs.com

If I were a tourist or a company and I wanted to act prudently. For tourists and travel agencies, I'd cancel trips to Bali or other tourist destinations, and for businesses, I'd do what Panasonic announced it was going to do regarding the threat of a bird flu pandemic: recall all dependents of employees, until we were assured of accurate information from the Indonesian government. We are now all on notice that Indonesia, the world's hot spot for human cases of bird flu and a plausible location for the start of a pandemic, is covering up the true number of cases of the disease.

The Editors of Effect Measure are senior public health scientists and practitioners.

Re: Pandemic Awareness/Preparation

Zions Bank to ready residents for pandemic

http://www.sltrib.com/news/ci_11845247

This is an original way to help prepare the public.

Originally Posted by www.sltrib.com

If a flu pandemic or bioterrorism attack strikes the Wasatch Back, the Summit County Health Department wants residents to be ready.

As such, it is partnering with Zions Bank to pass out emergency medication disaster kits at bank drive-up lanes in Coalville and Kamas on Saturday. The exercise is scheduled from 10 a.m. to noon at the two Zions branches, each located on the towns' Main streets.

To encourage people to participate, Zions Bank will give each child a $1 presidential coin. There also will be drawings for Jazz tickets, golf at Thanksgiving Point and 72-hour emergency kits.

The practice run for distributing antibiotics or anti-viral medication via drive-thru windows marks the first exercise of its kind in the nation. It is funded by a grant from the Cities Readiness Initiative of the Centers for Disease Control and Prevention.

(hat tip flutrackers/laidback al)

Re: Pandemic Awareness/Preparation

Egypt

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

Originally Posted by afludiary.blogspot.com

...Egypt's Health Ministry has announced their 58th human H5N1 infection, and the 7th one of 2009 - that of a 1-1/2 year-old girl from the Minufiya governorate.

This is the third case announced out of Egypt in the past 10 days.

http://afludiary.blogspot.com/2009/0...se-counts.html

Originally Posted by afludiary.blogspot.com

The World Health Organization has updated their website with the latest (#58) confirmed case of avian influenza reported in Egypt yesterday, and has updated their cumulative cases count chart.

Still missing, however, are the 4 cases reported by the head of Indonesia's Bird Flu Commission, Bayu Krisnamurthi, more than a week ago.

Re: Pandemic Awareness/Preparation

Indonesia

http://www.flutrackers.com/forum/sho...89&postcount=1

A translation from Indonesian media indicating that Indonesia is going to be building their own bird flu vaccine plant. Can't say as I blame them considering that they have the highest rate of infection and fatalities from bird flu. They have steadfastly refused to share viral samples with the rest of the world saying that they would not benefit from any vaccines produced from their gifting of samples, and would not be able to afford the vaccines.

They are also censoring information about how many cases there have been. Some of the missed information may also be due to not bothering to test on the part of local physicians. If bird flu is suspected, they just go ahead and start the patients on Tamiflu. Other cases are misdiagnosed as dengue and other diseases. It is impossible to know what is going on over there anymore.

They admit upfront in this link that they will not be able to produce enough vaccine to protect their entire population, but then no one else will either, at least initially if a category 5 pandemic situation occurs. Category 5, like the hurricane categories, is a worse case scenario such as the 1918 pandemic. Of course, the 1918 virus, H1N1 had only a 2% CFR while H5N1 has a 63% case fatality ratio. It is entirely possible that 1918 might not be the worse case scenario.

Originally Posted by www.flutrackers.com

...the company's human bird flu vaccine plant will begin construction in April of this year, is scheduled to begin operation in 2011.


Company has the western counties in Bandung and Bandung Chi City Road, Basseterre Bio Pharma AG Selma law in the vicinity of the original factory set up two locations.

The Indonesian government has agreed to this up to 360 billion rupiahdollars one Indonesian Rupiah) of human bird flu vaccine factory in construction investment.


The factory is first of all have to build infrastructure, raw materials as a vaccine with egg plant, and then building a pharmaceutical factory in Biot law Selma's Factory Factory production of vaccines or other vaccines equipment.

Isa said that the vaccine's main raw materials to the composition of cells and eggs. Chi沙鲁亚company will construct two main raw materials production equipment. Vaccine plant set a production target for the year25 million doses of drugs, which can only supply of vaccine in Indonesia 10% of the total population. 20,000,000 ~ He hoped that after the Factory can be developed to enhance vaccine production capacity, as against the domestic bird flu pandemic, preventive measures.

He said that if a major pandemic, vaccine supplies may be insufficient, but the positive side, domestic production of bird flu vaccine prices will be cheaper.