H5N1, Bird Flu Updates

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Tracking Bird Flu Cases

Bird flu deserves its own thread for tracking suspected and confirmed cases. It's not the pandemic virus, but it is still an ongoing and significant threat because of its virulence. As Margaret Chan, the Director General of the WHO says, we do not know how H5N1 will react under pressure from the pandemic virus, H1N1. All of the countries with endemic H5N1 are also reporting cases of swine flu. As everyone should know by now, the new concern revolves around what will happen if the two viruses co-infect the same host. Flu viruses exchange genetic material with each other all of the time. Right now we have a pandemic virus that is very transmissible, but does not kill the majority of people infected. Bird flu, on the other hand has a case fatality ratio (CFR) of around 60%.

In the past year, something different began to happen in Egypt. We started seeing many cases of young toddlers infected with mild cases of bird flu there. But, we also saw some older children and adults that had fatal cases. No one has yet explained why the disease began to change in Egypt. Just prior to the beginning of the swine flu cases appearing in the US and Mexico, the WHO was going to send in a team to Egypt to investigate why this was so. And, then the swine flu pandemic began in earnest, leaving this question unanswered. Why this situation has changed in Egypt but not in Indonesia, is most likely very important information.

Egypt continues to try to isolate swine flu cases. At some point, they won't be able to contain that virus, and will have to bow to the inevitable. Nobody knows what will happen then, but the Egyptians are clearly concerned. Remember, this is the country that slaughtered its entire pig population a few months ago to international dismay. Maybe they were right to do so, as we are now finding swine flu in pigs in Canada, Argentina and Australia. Pigs, the perfect mixing vessels for influenzas, may have been harboring the current swine flu for years undetected because they are almost never tested in most countries unless they are sick. This lack of disease surveillance is now being compensated for by a heightened awareness and increased testing of pig herds in many countries.

With all of that being said, here is a translation regarding a new case of bird flu, H5N1 in another child in Egypt. They do not state the child's age in this article, and some translations are saying that this is a male child. They would have isolated her anyway with bird flu, but with swine flu also in Egypt, they are likely to be very worried. Descriptions of these cases almost always mention dead birds being found in the same location. That of course, is going to be helpful in determing which flu they are dealing with at least for now, but maybe not later...

Egypt - Case #82

http://www.flutrackers.com/forum/showpost.php?p=272110&postcount=1

D. Abdel-Rahman Shahin, official spokesman of the Ministry of Health

The Ministry of Health on Sunday, a new human case of bird flu, a girl from a province of Kafr el-Sheikh for a total of 82 case of injuries so far.

A statement by the Ministry of Health said on Sunday that the new situation of the girl child is Muhammad Mustafa Ahmed Rania from the village of "Sidi Ghazi," the Department of Kafr El-Sheikh governorate of Kafr el-Sheikh.

The statement pointed out that the disease developed symptoms on July 24 of this hospital was incorporated in fevers of Kafr el-Sheikh on July 25 with a high temperature, running nose and cough after exposure to dead household birds, suspected of being infected with bird flu.

He also pointed out that the statement was given the drug "Tamiflu" as soon as the suspicion of being infected with the disease and her condition is stable and satisfactory communications are being carried out and procedures for the transfer to the hospital in the capital Cairo for the completion of treatment.

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OIE Report: H5N1 In Israeli Poultry

So, what's the OIE? Well, the OIE is to animal health globally, what the WHO is to human health. In fact, the two organizations have certain similiarities. Many of our diseases originate in animals, and human health is often impacted by the health of the animals around us. By agreement, member states are required to report disease outbreaks such as H5N1 in birds and animals in their countries.

http://www.oie.int/eng/oie/en_oie.htm

Status

The OIE is an intergovernmental organisation created by the International Agreement of 25 January 1924, signed by 28 countries. In March 2009, the OIE totalled 173 Member Countries and Territories

Missions

To ensure transparency in the global animal disease situation

To collect, analyse and disseminate veterinary scientific information

To provide expertise and encourage international solidarity in the control of animal diseases

Within its mandate under the WTO SPS Agreement, to safeguard world trade by publishing health standards for international trade in animals and animal products

To improve the legal framework and resources of national Veterinary Services

The Office is placed under the authority and control of a World Assembly of Delegates consisting of Delegates designated by the Governments of Member Countries.

The day-to-day operation of the OIE is managed at the Headquarters situated in Paris, placed under the responsibility of a Director General elected by the International Committee. The Central Bureau implements the resolutions passed by the International Committee and developed with the support of elected Commissions:

The OIE's financial resources are derived principally from regular annual contributions backed up by voluntary contributions from Member Countries.

Israel saw their first outbreaks of H5N1 in 2006, with a return in 2008. Their last OIE report was filed in August 2008.

The reassurance from the Health Ministry that `the strain of bird flu discovered earlier would not infect humans’, now rings hollow given the OIE report above.

While the danger to humans may be low, it certainly isn’t zero. Which makes this less than a sterling example of good risk communication.

More at: http://afludiary.blogspot.com/2010/01/oie-report-h5n1-in-israeli-poultry.html

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Egyptian Media Reports 93rd & 94th Bird Flu Cases

http://afludiary.blogspot.com/2010/01/egyptian-media-reports-93rd-94th-bird.html

I knew about case #93, but #94 was news to me as well.

A 3-year old male patient in Assiut Governorate was confirmed as the 93rd human case of H5N1 infection in Egypt. The boy presented high fever, cough, runny nose and he was admitted to the Al-Ghanaem Hospital. Exposure to HPAI-infected birds is suspected.

[3] Ash Sharqiyah: 94th case

Date: Sat 23 Jan 2010

Source: youm7.com [in Arabic, machine trans., edited]

The Ministry of Health [MOH] and national sources reported the 94th confirmed human avian influenza (AI) case in a 45-year-old Ash Sharqiyah man. Additionally, 8 suspect human AI cases were recorded between 20 and 23 Jan 2010.

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Singapore to Stockpile Bird Flu Vaccine

http://afludiary.blogspot.com/2010/01/singapore-to-stockpile-bird-flu-vaccine.html

THE Health Ministry will be buying about one million doses of H5N1 avian flu pre-pandemic vaccine soon.

The World Health Organisation's director-general, Dr Margaret Chan, had recently said that countries remain ill-prepared for mass outbreaks of the bird flu virus, which affects humans in contact with sick birds.

It has a mortality rate of more than 60 per cent, leading to fears that a pandemic with this strain of virus could prove lethal. Scientists also fear that it could achieve efficient human-to-human transmission at any time and trigger a pandemic.

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Avian Influenza A (H5N1) in Humans: Lessons from Egypt

...in the group of the 20-39-year-olds, women had a greater tendency to be infected and more women died post infection. Fifteen of 21 infected women in this age group died. These groups face the highest risk of exposure as it is mainly they who are involved in home slaughtering and defeathering of chicken and preparation of food, farm work and visits to infected farms. A recent study has analysed the age and sex bias with regards to the situation in Egypt [4], and it has been reported that farmers from other infected African countries believe that there is little or no risk of infection from culling, defeathering, home slaughtering and visit to infected premises [8,9]. In addition, failure of the government to pay compensation in Egypt for culled birds and the practice of keeping of poultry on rooftops and in close association with humans may have played a role. Although no association has yet been established between the level of exposure to avian influenza A(H5N1) and fatalities in Egypt, reports on workers in Asia showed that a high prevalence of infection in the poultry population is associated with a higher incidence of infection in humans, and that controlling such outbreaks of H5N1 influenza in the poultry flocks can stop human infection [7,10,11]. In addition, genetic characterisation of viruses from both the human and avian populations in Asia revealed that the viruses from both species were very similar [9,10].

According to our analysis, early hospitalisation following infection increased the chances of recovery. Children tend to be hospitalised earlier than adults and this may have contributed to the significantly lower death rate in the children (only two cases in children under the age of 10 years were fatal). Similarly, although 62 of the 85 cases were under 19 year-olds, this does not represent national demography since only approximately 32% of the population are 15 years and younger [12]. In most parts of Africa, people are known to visit a hospital less frequently as they advance in age, and supposedly non life-threatening conditions such as seasonal influenza are often treated at home and therefore underreported [8].

The overall case fatality in this study was 32% (27/85). This percentage may appear small when compared with statistics from other places, for example 82% in Indonesia (115/141), 68% in Thailand (17/25), 66% in China (25/38) and 50% in Vietnam (56/111). Nevertheless, with the exceptional surge in number of cases (especially in children) arising in Egypt in 2009 and the recent reoccurrence of human cases of avian influenza A(H5N1) in China and Vietnam despite an intensive control programme in the poultry populations, the pandemic potential of this virus is still very evident. Case fatality was significantly higher in females compared with males, but whether this is related to exposure dose can not be confirmed in this analysis.

(hat tip crofsblog)

This research study available at: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19473

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Indonesia: Residents Worry Over Poultry Deaths

http://afludiary.blogspot.com/2010/01/indonesia-residents-worry-over-poultry.html

Residents in South Lampung are panicking following the sudden deaths of thousands of chickens owned by poultry company PT Central Avian Pertiwi, despite the birds having been previously cleared of avian flu.

However, after samples were re-tested at the Lampung Livestock and Animal Husbandry Agency lab, they were tested positive for H5N1.

The egg-laying hens, totaling more than 12,000, have currently been culled and tens of thousands of others have been isolated.

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Indonesia: Changes in the H5N1 Virus

This is a discussion on the controversial but widespread practice of using vaccines to protect poultry from H5N1. The consequences of this practice are becoming more apparent. The results are potentially dangerous for all of us. Read the full commentary at the link to understand why this is a cause for concern.

Poultry vaccination against the H5N1 bird flu virus has been the subject of considerable debate over the years, with many scientists warning that the the overuse of vaccines could backfire.

Vaccination, it is feared, could hide the infection and allow it to silently spread, and may actually drive the evolution of the virus.

For developing countries with poverty and food insecurity issues, however, vaccination is often considered preferable to wholesale culling.

In Avian influenza and vaccination: what is the scientific recommendation?, the OIE reiterates their strong recommendation that humane culling be employed to control avian influenza, and advising that vaccines should only be used as a temporary measure.

More at: http://afludiary.blogspot.com/2010/02/indonesia-changes-in-h5n1-virus.html

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cambodia: h5n1 outbreak in ducks?

http://crofsblogs.typepad.com/h5n1/2010/02/cambodia-h5n1-outbreak-in-ducks.html

via the phnom penh post: fowl play: takeo orders destruction of ducks. ducks are known carriers of h5n1, but it doesn't always kill them--or even make them sick. so this outbreak is of interest.

the takeo province agriculture office has ordered the farmers of domesticated ducks across the province to incinerate their birds and temporarily suspended the sale of the animals' meat until the results tests for the h5n1 virus (also known as bird flu), come back from phnom penh this week following mass deaths of the fowl.

thai ly, takeo province's chief officer of domesticated animals, said that 16,442 ducks had died since the outbreak began, and that roughly 31,000 more have fallen sick.

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West Bengal, India

http://www.meattradenewsdaily.co.uk/news/030210/india___avian_flu_coats__birds_to_date_.aspx

West Bengal government officials have stated that so far, approx. 95,493 birds have been culled and over 10,189 eggs destroyed, reports state.

After the state government reported return of the bird flu H5N1 on January 17, 2010, the government has asked the West Bengal government to undertake culling of all poultry within a radius of 3 km from Murshidabad district, the centre of the bird flu outbreak.

"A 3-member central rapid response team is stationed at Murshidabad to assist the state health authorities. Containment measures have been initiated as per the contingency plan of the department of animal husbandry, dairying & fisheries (DADF)," ministry of health and family welfare said.

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Indonesia: A Bad Month for Bird Flu

http://crofsblogs.typepad.com/h5n1/2010/02/indonesia-a-bad-month-for-bird-flu.html

About 2,751 chickens had died of bird flu virus within previous month in Riau. This has folded the number of bird flu cases in chicken by 600 percent compare to number at same period of last year outbreak, 441 chickens.

Head of Livestock Service of Riau Province, Patrianov said massive chickens deaths had been reported from six municipals/cities in Riau: Kampar 1,995 chickens; Siak 351, Indragiri Hilir 234, Indragiri Hulu 128, Rokan Hulu 22, and Pekanbaru 14. The shift of rainy season had influenced the replication of the virus.

Several areas in Riau were still drowned by flood which had increased the rate of virus spread, added Patrianov. In the days of flood, people had trouble to diminish or bury dead chickens, so they preferred to dispose the chicken's body to flowing water or puddle around their residences.

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cambodian duck mystery solved

http://afludiary.blogspot.com/2010/02/cambodian-duck-mystery-solved.html

sample tissue from ducks in takeo province that died in an outbreak of a disease officials could not identify earlier this week have tested positive for the h5n1 virus, commonly known as bird flu, officials at the ministry of health and the ministry of agriculture, forestry and fisheries said tuesday.

in light of the test result, officials said they will move ahead with monday's order from the provincial agriculture department to destroy all live ducks and halt duck meat sales in the affected area. since the outbreak began last month, 16,442 ducks have died and at least 31,000 live ducks are exhibiting symptoms of the virus.

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Pokhara, Nepal

http://www.thehimalayantimes.com/fullNews.php?headline=London+tests+confirm+avian+flu+in+Pokhara&NewsID=225697

Detection of bird flu in Pokhara has spread panic in the Lake City. Ministry for Agriculture and Cooperatives, in a press meet held in Kathmandu today, stated that ducks and chickens were dying in Pokhara due to bird flu and a high alert has been sounded in Pokhara and the surrounding areas.

They had to be sent to London as there were no facilities for such tests in Kathmandu. Spokesperson for the ministry, Dr Hari Dahal, stated that the preliminary report of the tests showed that the ducks and chickens had died due to bird flu (H5N1 virus). Dr Dahal said the Rapid Response Team had begun its task to curb the spread of the disease in the affected area. Claiming that the flu would be controlled within seven days,

...the police had already stopped the movement of birds in and out of Pokhara and security personnel had been deployed on major highways and roads connecting Pokhara with other parts of the nation.

Many migratory birds come to Pokhara, increasing the threat of bird flu. District Veterinary Office has assured the poultry entrepreneurs that the disease can be prevented if proper measures are adopted.

(hat tip pfi/pixie)

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media report: two more bird flu cases in egypt

if confirmed, this would make the 7th case reported in 2010, getting egypt off to a fast start in the new year. last year, egypt reported a total of 39 cases (4 deaths). the year before, just 8 cases (4 fatalities).

machine translations into english, whether from arabic, chinese, or any other language, can sometimes be difficult to decipher. nuances and details don't always survive the translation process.

which is why i use them only cautiously, accepting the fact that some of the details may be `muddy' or inaccurate. still, they have been a valuable tool as well watch disease activity around the world.

we are fortunate, therefore, to have twall - a moderator at flutrackers - who lives in egypt, is fluent in arabic, and who offers this clarification:

this group of words (التاميفلو المقاوم للمرض ) really means that tamiflu is used to treat the diseases of bird flu.

it also reads like they were forced to transfer the person because of how sick they were.

more at: http://afludiary.blogspot.com/2010/02/media-report-two-more-bird-flu-cases-in.html

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