Pandemic News/Awareness - Thread 2

Vietnam reports new suspect case:

http://afludiary.blogspot.com/2007/06/vietnam-reports-new-suspect-case.html

In Egypt, siblings of the 4 yr old and as well as two other cases hospitalized with suspected bird flu:

http://afludiary.blogspot.com/2007/06/egypt-hospitalizes-additional-suspects.html

This letter/article is written by a research scientist with a friend at the CDC. He gives you his reasons for why you should stock your pantry for 3 months worth of goods including water, and prescription meds. I agree with him that 3 months, not 2 days, or 2 weeks, but 3 months minimum if you can do it is the best option. It is worth doing without some luxuries, IMO to reach this level of security for your family and yourself.

http://209.85.165.104/search?q=cache:G0y8fc8Hf0AJ:www.mpnnow.com/news/view_story.php%3FarticleId%3D394

www.mpnnow.com/news/view_story.php%3FarticleId%3D394][/url]

...predictive models run at the CDC show that the social disruption from a serious pandemic would include a breakdown of the medical system and the food distribution systems. Power systems and water systems in some locations would be in jeopardy as well. The models also show that the resources of the federal government will be insufficient to avert these problems.

With this as a backdrop, I think we should do all we can at the local level to prepare. This is in line with a statement made by U.S. secretary of Health and Human Services, Mike Leavitt. He said, “There's no cause for panic, but Americans need to prepare for a possible worldwide epidemic of influenza by stockpiling food, water and basic first aid” and that “local preparedness is the foundation of overall pandemic readiness.”

According to Secretary Leavitt, people should stockpile at least a two weeks' supply of non-perishable food, water, and essential household items, so that they can avoid having to visit public places during the pandemic. Considering that the waves of a pandemic are expected to last two to three months each, my own belief is that stockpiling a two to three month supply of food is necessary. I also recommend keeping a 90-day supply of any essential prescription medications on hand, if possible.

H5N1 spreads in Bohemia and infects not just swans, ducks or poultry, but

seagulls. I would think that most birds are susceptible, as are many mammals:

http://www.flutrackers.com/forum/showpost.php?p=88433&postcount=42

http://www.recombinomics.com/News/06280702/H5N1_Czech_More.html

What do you think the chances are that the dead seagulls are just a nearby coincidence?

Major Russian bird die off, just a coincidence, nothing to worry about:

http://www.flutrackers.com/forum/showpost.php?p=88445&postcount=1

Unfortunately, we can not link to the original source. Perhaps ProMed might

be covering this at some point.

North America

I have not the slightest idea what the cause could be. No one else seems to know either, but it is more than a little strange:

http://www.flutrackers.com/forum/showpost.php?p=88087&postcount=7

http://www.flutrackers.com/forum/showpost.php?p=88405&postcount=8

Commentary from Effect Measure, reproduced with permission from the authors:

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.

When headlines make bird flu

Category: Bird flu * Media

Posted on: June 28, 2007 6:57 AM, by revere

You can't look at the bird flu news without seeing a new outbreak somewhere, whether it's in Bangladesh, Ghana, Togo, the Czech Republic, or Germany, or of course the old standbys, Vietnam, Indonesia and Eqypt. Lots of it around and I didn't give anywhere near the whole list. So it's curious to find this headline, "UN finds progress in tackling bird flu" in an AP story in the Houston Chronicle by Marta Falconi (same story and headline in Washington Post):

Scientists and officials gathering in Rome for a three-day technical meeting on bird flu said that in most cases the virus is rapidly detected and kept under control, as most countries are equipped with improved response systems. However, in nations that combine a high density of population and unsafe poultry management, the situation remains serious. (AP)

Seems like a mixed report: there's progress but the situation remains serious. But the glass in the headline was definitely half full.

Here's another headline: "Bird flu virus still a serious threat, despite improved response, UN warns." Same meeting, but this article, it turns out, is from the UN itself:

The United Nations Food and Agriculture Organization (FAO) warned today that although the global response to the deadly H5N1 avian influenza virus has significantly improved over the past few years, the virus remains entrenched in several countries and will continue to spread.

According to FAO's Chief Veterinary Officer, Joseph Domenech, the virus was rapidly detected and eliminated or controlled in some 15 countries in Asia, Eastern Europe and the Middle East where it was introduced during the past six months.

Speaking at a press conference at the agency's headquarters in Rome, he said most affected countries have been very open about new outbreaks. "This shows that countries are taking the H5N1 threat seriously. They are better prepared today and have improved their response systems."

At the same time, Mr. Domenech stressed there was no room for complacency, and said a potential human influenza pandemic could not be ruled out as long as the virus continued to exist in poultry. (UN)

Is this glass half empty? Or maybe even 3/4 empty? You decide. It's a sobering thought, though, that many of us get our impressions of what's going on in the world from headlines. Nothing much that can be done about it. Just an observation.

USDA is the agency tasked with detecting and informing of the presence of avian influenza. Here is the website for this information:

http://wildlifedisease.nbii.gov/ai/LPAITable.pdf

As some on the flu forums have pointed out " the USDA's track record in isolation successes remains intact"

"Their isolation failure rate remains high." Ever wonder why? Probably not, as most of the public are

oblivious to this health issue, and blindly accept whatever pronouncements are issued if they are even listening.

"We have no NA segment of any US H5N1 virus ever detected in the US in the last 100 years."

How can you detect H5 and N1 as the website indicates, but not isolate the virus?

Answer:

http://www.flutrackers.com/forum/showpost.php?p=87058&postcount=11

Bird flu hits Germany and Czech Republic:

http://www.flutrackers.com/forum/showpost.php?p=88468&postcount=3

In the Czech Republic the deadly H5N1 form of the disease has infected broilers, which were to be culled by today. The bird flu virus was found in 60 out of 27,800 broilers bred in Norin, according to local press reports.

An outbreak also occured at a turkey farm in the region, where 6,000 birds were culled. Officials also reported discovering the virus in a dead swan found in Lednice, south Moravia.

The Czech Republic was hit with its first bird flu case in March 2006. Since then the country has registered another 13 cases of H5N1 infection of swans. The current outbreak was the first infection of domestic birds in the country.

Last weekend Germany confirmed that H5N1 was found in six wild birds found dead near Nuremberg, and then reported on Tuesday that three wild swans in the east of the country were also infected.

Earlier this year outbreaks in Hungary led the government to shut down poultry sales from the affected regions.

Meanwhile experts at a meeting of the Food and Agriculture Organisation (FAO) this week in Rome warned that avian flu seems to be entrenched as new outbreaks appear.

Joseph Domenech, the FAO's chief veterinary officer, said the response to the virus has improved significantly over the past three years, but it remains entrenched in several countries and will continue to spread.

"Recent H5N1 outbreaks in Bangladesh, Ghana, Togo, the Czech Republic and Germany are a clear reminder that the virus still succeeds in spreading to new or previously already infected countries," Domenech said. "What makes the battle against avian influenza so difficult are the many high risk poultry production and marketing practices that still continue in many countries."

A potential human influenza pandemic can not be ruled out as long as the virus continues to exist in poultry, he added.

At a conference last week in Toronto, international experts also warned that the persistent outbreaks of the deadly H5N1 virus in some regions indicates that it may become endemic.

In Europe and the Russian Federation, "the reemergence of the virus in a number of countries does suggest we are moving toward endemicity" even though some countries have deployed vaccinations against the disease, Ian Brown, a scientist at the UK's Veterinary Laboratory Agency, told the conference.

Vaccinating poultry and ducks to contain avian flu has been controversial. It reduces birds' clinical symptoms, keeping them alive and preserving their economic value-though not necessarily their utility as a trade good, because some countries refuse to import vaccinated chicken. It also decreases viral shedding, slowing disease transmission, but it does not block infection entirely, potentially allowing the virus to spread silently, the experts said.

According to scientists at the conference, vaccination may be driving the virus to evolve. Samples gathered in northern Vietnam in December 2005 were found to be more virulent than earlier samples, but less likely to be controlled by vaccines that once contained the virus successfully, said David Suarez of the Southeast Poultry Research Laboratory.

http://www.recombinomics.com/News/06280703/H5N1_Czech_Lednice.html

Reproduced with permission of the editors from Effect Measure

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.

Vetting the bird flu problem

Category: Bird flu * Pandemic preparedness

Posted on: June 29, 2007 6:59 AM, by revere

Emerging infectious diseases don't appear out of thin air. Mostly (75%), they come from animals. In the language of science, they are zoonoses. So veterinary pathologists see themselves on the front line of early warning against emerging disease and runaway pandemic disease. Consider bird flu:

So is the threat real? "Whether the bird flu virus will spread to North America is unpredictable at this time," says Corrie Brown, Diplomate of the American College of Veterinary Pathologists (ACVP) and a University of Georgia professor of veterinary medicine. "Although the likelihood of this mutation is unlikely, history cautions us to the possibility. The longer the bird flu virus is in circulation, the greater the risk for a pandemic." (PharmaLexicon)

Hmmm. Possible but not likely but we can't predict. OK. Not sure what the evidence for the likelihood estimate is, but I'll take that as an expression of professional judgment. Here's some more:

Most emerging diseases are infectious with zoonotic (animal-to-human) potential, occurring at the interface between wildlife, domestic species, and humans. Why are zoonotic diseases more prevalent today? The main reasons are:

(1) Increasing numbers of humans

(2) Expanding globalization of trade

The tripling of international commerce over the past 20 years, combined with runaway population growth, has created a synergy for microorganisms to move freely and quickly from their commonly inhabited domains into unexpected niches, often with lethal results.

Wouldn't quarrel with those two points but I'd also add a third:

(3) Increasing encounters of humans with animals they had only rarely, if ever, encountered before. When the rain forests in Indonesia are cut down for wood or agriculture, humans insert themselves into new habitats with new disease reservoirs. Ebola and HIV are likely examples.

The American College of Veterinary Pathologists has its own list of "Bird Flu Facts" and it's interesting to see what they are from their perspective:

The biggest threat is to the poultry industry

Reduced production would impact everyone's pocketbook

The U.S. Department of Agriculture has stringent control measures in place at the borders and is working closely with the poultry industry to boost biosecurity

We still need to be concerned about it infecting wild birds

Mortality of mute swans, ducks, geese, raptors and other wild species associated with the bird flu virus infection in Europe has led to a number of deaths among meat-eating species, including tigers, leopards, domestic cats and humans, who most likely contracted the virus by feeding on carcasses of infected domestic or wild birds

Risk of human infection with the virus in its current form appears to be quite low, as is human-to-human transmission. The virus could become easily transmissible among humans through mutation or reassortment with a human influenza virus

Two deserve some mention. There seems to be quite a bit of faith that the US Department of Agriculture is on top of this problem. A General Accountability Office report last week questioned this and the USDA seemed to acknowledge they might not quite "have their ducks in a row" (sorry). The second is the implication that meat-eating species, "including tigers, leopards, domestic cats and humans" contracted H5N1 infections from "feeding on carcasses of infected domestic or wild birds." Do the veterinary pathologists believe there is risk from eating infected poultry? Many veterinary pathologists have poultry producers as clients. I wonder how this slipped by.

Maybe we weren't supposed to notice.

Study shows dogs can shed H5N1 virus:

http://afludiary.blogspot.com/2007/06/study-dogs-can-shed-h5n1-virus.html

Why should you care? Think about it...

As some on the flu forums have pointed out " the USDA's track record in isolation successes remains intact"

"Their isolation failure rate remains high."

"We have no NA segment of any US H5N1 virus ever detected in the US in the last 100 years."

Supposedly here on the North American continent, we are assured that the only H5N1 virus found here is just the low pathogenic form LPAI that is not dangerous to humans. Now this is in stark contrast to the rest of the planet where the highly pathogenic form of H5N1 or HPAI was always found prior to the LPAI being found in other words, this continent has a different history than everywhere else that H5N1 has been found. USDA is the agency tasked with detecting and informing of the presence of avian influenza. Here is the website for this information:

http://wildlifedisease.nbii.gov/ai/LPAITable.pdf

The USDA Report documents finds of low pathogenic avian influenza (LPAI) in wild birds spreading into other states.

It is important to realize why they are testing, and why would you want to know about this?

Assurances to the public that LPAI is not a problem are somewhat misleading. LPAI is a problem if poultry become infected because of the very real potential for it to mutate to a highly pathogenic form, and the possibility of human infection. They would not be monitoring and testing if it was not an issue.

In contrast to govt reassurances is this article:

Penn State Poultry Expert Explains Changes | Lancaster Farming

Originally Posted by http://www.lancasterfarming.com/node/257

Penn State Poultry Expert Explains Changes | Lancaster Farming]

The importance of containing LPAI is that the virus can mutate into a highly pathogenic form (HPAI). This is what happened in Pennsylvania and Virginia in 1983-1984 when about 17 million birds were euthanized because of a deadly HPAI outbreak.

There are two types of avian influenza (AI) that are identified as H5N1. A difference exists in the virus classification; one is low pathogenic (LPAI) and the other is highly pathogenic (HPAI). Pathogenicity refers to the ability of the virus to produce disease.

HPAI H5N1, often referred to as the "Asian" H5N1, is the type causing worldwide concern. LPAI H5N1, often referred to as the "North American" H5N1, is of less concern. Following is an explanation of the differences between them.

LPAI H5N1 ("North American" H5N1)

LPAI, or "low path" AI, commonly occurs in wild birds. In most cases, it causes minor sickness or no noticeable signs of disease. It is rarely fatal in birds. LPAI strains are not a human health concern. This includes LPAI H5N1.

Evidence of LPAI H5N1 has been found in wild birds in the United States in recent years and is not closely related to the more severe HPAI H5N1 circulating overseas. Examples of historical reports of LPAI H5N1 received by USDA include:

1975 - LPAI H5N1 was detected in a wild mallard duck and a wild blue goose in Wisconsin as part of routine sampling, not as a result of noticeable illness in the birds.

Some info from the CDC that will help you to understand why even low pathogenic avian flu is still a cause for concern in wild birds since it can infect domestic birds:

http://www.who.int/csr/disease/avian...ndex.html#isit

Quote:

www.who.int/csr/disease/avian_influenza/avian_faqs/en/index.html#isit][/url]

On present understanding, H5 and H7 viruses are introduced to poultry flocks in their low pathogenic form. When allowed to circulate in poultry populations, the viruses can mutate, usually within a few months, into the highly pathogenic form. This is why the presence of an H5 or H7 virus in poultry is always cause for concern, even when the initial signs of infection are mild.

Domestic ducks can now excrete large quantities of highly pathogenic virus without showing signs of illness, and are now acting as a "silent" reservoir of the virus, perpetuating transmission to other birds. This adds yet another layer of complexity to control efforts and removes the warning signal for humans to avoid risky behaviours.

* When compared with H5N1 viruses from 1997 and early 2004, H5N1 viruses now circulating are more lethal to experimentally infected mice and to ferrets (a mammalian model) and survive longer in the environment.

* H5N1 appears to have expanded its host range, infecting and killing mammalian species previously considered resistant to infection with avian influenza viruses.

* The behaviour of the virus in its natural reservoir, wild waterfowl, may be changing. The spring 2005 die-off of upwards of 6,000 migratory birds at a nature reserve in central China, caused by highly pathogenic H5N1, was highly unusual and probably unprecedented. In the past, only two large die-offs in migratory birds, caused by highly pathogenic viruses, are known to have occurred: in South Africa in 1961 (H5N3) and in Hong Kong in the winter of 2002-2003 (H5N1).

So, why should we be concerned if they keep telling us that only the low pathogenic form of H5N1 is on the North American continent?

Let's look at H5N1 in North America again.

Is there evidence that it exists on this continent in its highly pathogenic form

(HPAI)? No one can deny that it is certainly here in several states in the low pathogenic form (LPAI) as the govt has the website tracking it on this continent.

Why be misleading about the evidence of HPAI? Why have some agencies in North American mishandled specimens, hid behind privacy issues, tested only dead birds, tested only from the cloaca and not from the trachea etc.? Why did they call it low pathogenic avian flu (LPAI) for example, at Prince Edward Island in the August of 2005 but offered the humans exposed there Tamiflu when their goslings died? LPAI seldom kills birds as these reports reveal but those goslings died. Why did they wait a week before sending the specimens which by then had to be degraded? Why did they refuse to reveal the size of the insert used in testing when a large insert would have revealed that it was in fact HPAI?

http://www.flutrackers.com/forum/showpost.php?p=77563&postcount=58

www.flutrackers.com/forum/showpost.php?p=87058&postcount=11][/url]

The local labs that perform initial testing for avian influenza in live or dead birds take samples from feces or from throat swabs and then use a rapid test PCR (polymerase chain reaction) to look for H5 or H7 or N1 viruses. Within three to six hours they can detect these viruses, but cannot tell for certain whether they are the highly pathogenic variety. The PCR tests are fairly sensitive and can pick up both low volumes of virus, as well as inactive viruses.

Isolation of the virus (step two confirmation) is performed only at the USDA's National Veterinary Services Lab in Ames, Iowa. It is Biosecure Level 3. It injects the viral samples into embryonted chicken eggs and within seven to ten days can "grow" the virus if it was in large enough quantities and was active. Analysis from the virus cultures (if they were successful in the isolation process) can specifically determine the virus strain (eg H5N1), but only subsequent viral sequencing can spot the poly basic amino acids at the HA clevage site which would represent the high path variety virus.

Having said that, to Dr. Niman's point, one really has to want to find these viruses. It takes diligence because the process is not all that simple and subject to a lot of problems along the way. I would be concerned that an agency whose primary job is to protect the beef and poultry industry might lack a certain level of independence necessary to seek out and find a virus that could cause significant economic disruption to the very food industry that it supports. To my point, please note the following excerpt from the USDA's strategic plans:

"USDA has created a strategic plan to implement its vision. The framework of this plan depends on these key activities: expanding markets for agricultural products and support international economic development, further developing alternative markets for agricultural products and activities, providing financing needed to help expand job opportunities and improve housing, utilities and infrastructure in rural America..."

For the general public, those constant reassurances probably work great.

But, welcome to flublogia, and the world of today where large groups of people with a specialized interest spend far more time than any govt agency could on researching one subject. So USDA, we have to say that your conflict of interest is making us skeptical of how hard you are trying to find HPAI, and that skepticism includes your opposite numbers in Canada. You are not trying hard enough, and we think that we know why you won't be.