It has been my own personal project to follow H5N1 for the last 3 years simply because it interests me. Attracted to this type of information like a magnet, I've been watching this relatively new influenza virus to see where it will go, how it will change itself, and possibly change our world. I have followed its country by country outbreaks, and watched for the important viral mutations such drug resistance or changes that allowed it to more specifically target mammals.
Keeping in mind at all times that we will be cleared impacted as HCW, as well as being members of our communities, and having families of our own to care for, I wanted to start the new year by opening a single focused pandemic thread that would also look at what we are doing nationally to prepare for a future pandemic. Is this the virus to spark the next pandemic? No one can answer that question. We can look back at the past to the last few pandemics, and in particular to the most devastating one in 1918, and extrapolate useful information about them, but we can not predict the future. We can only make comparisons with our situation now, and learn what worked to lessen morbidity and mortality in those past events. And, we can look at those other viruses, and compare them with what we are seeing now. For example, H5N1 is a Type A virus. We know that all pandemics are caused by Type A viruses. It is also an avian virus. The deadly 1918 virus, H1N1 was also an avian virus.
For this thread, as in the previous threads, I will be making use of news sources, scientific studies, govt bulletins such as the MMR, as well as flu forums and blogs devoted to this subject for my sources. Because press information, particularly the foreign press, is not always available for later access when I am looking back to check recent historical information, the use of these blogs and forums are important because archived information quoting the media and all other sources is always fully and easily available there with no worries about information disappearing or no longer being available. They also fully document their sources or I would not be using them.
With this link from Avian Flu Diary, a well researched source that I highly recommend, we can read the words of outgoing HHS Secretary Leavitt on our state of preparedness. Leavitt has done an admirable job during his tenure, but admits that there is much left to do.
A scant 33 months ago, I sent my first message about a race that HHS had just begun. As I said then, it was a race against a fast-moving virulent virus with the potential to cause an influenza pandemic. Since then, we have mobilized experts and resources across the country and around the world. I now send you this final message, as I look back at the unprecedented progress we have made in energizing a national pandemic influenza preparedness movement in those 33 months.
Today, many people mistakenly think influenza pandemics are a thing of the past, but influenza has struck hard in the era of modern medicine – much harder than most people realize. And it will strike again. Pandemics are hard things to talk about. When one discusses them in advance, it sounds alarmist. After a pandemic starts, no matter how much preparation has been done, it will be inadequate.
I would be remiss if I did not point people towards what can be done to prepare for a catastrophic situation such as a severe pandemic. One of the best educational links that will help you most easily is the Readymom material. Yes, it was started by mothers with kids. Why? Because just telling you the ongoing history of influenza and bird flu in particular is not going to help you protect your family. You need practical and simple to implement advice.
Maybe you think that all of this information is a waste of time because none of this has happened yet. A pandemic sparked by bird flu, H5N1 is only a possibility, you say. But, what if you are wrong, and you have children? Please open the link below the description of who the readymoms are. If you read nothing else on this page, open the fluwiki link to the pamphlet on kids at risk. Hopefully you'll come to understand our concern about the well being of the kids in this country.
Look at the numbers. Think about what they represent, and take some steps to protect your family.
ReadyMoms Alliance is a U.S. nonprofit and the collaborative work of volunteers including parents, physicians, and emergency management professionals. We encourage citizen engagement in planning and preparedness. Our volunteers work directly with the public and through local governments, organizations, and businesses to present information on pandemic influenza, its impact on families and communities, and ways to prepare for a pandemic and other disasters. We invite professionals and informed volunteers in every community to download our materials and use them to help foster preparedness that will save lives and enhance community resilience in the next pandemic or any other emergency.
Scientists speculate that H5N1 may become less lethal should it cause the next pandemic. However, even a much-weakened H5N1 will cause decades of child and adolescent deaths in one season.
I have added another link only to point out that the insurance industry is taking this threat very seriously, and that it is not just kids that are at risk. Comparing the case fatality ratio of the 1918 pandemic which was 2% with the H5N1 CFR of over 60%, this is what they had to say, and has been reformatted to read more easily.
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'
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.
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.
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.
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.
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.
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.
Specializes in ER, Labor and Delivery, Infection Contro.
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!
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...
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.
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.
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.
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.
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
"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
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.
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.
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.
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
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?
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.
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.
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.
sirI, MSN, APRN, NP
17 Articles; 45,868 Posts
Thank you for the continued updates, indigo girl. We appreciate all your hard work to keep allnurses.com informed.