Pandemic News/Awareness - Thread 3

South Korea

http://afludiary.blogspot.com/2008/10/south-korea-testing-ducks-at-farm-for.html

Here's hoping that this is not H5N1. South Korea had great difficulty

controlling the virus the last time that it appeared. They never exactly

admitted that one of their soldiers contracted the disease either just

that he was positive for an H5 virus. There is only one H5 virus that

humans have ever tested positive for that I know of...

Starting on April 1st of this year, and for roughly the next seven weeks,

South Korea waged its biggest battle to date against the bird flu virus,

culling 8 million birds at dozens of infected farms around the nation.

The outbreak was declared over by the end of June, and South Korea

announced they were Bird Flu Free on August 17th.

http://www.recombinomics.com/News/10040801/H5N1_Korea_Fujian_Return.html

...the spring outbreak signaled the movement of H5N1 to the north via

wild bird infections. Although H5N1 was not reported in northeastern

Siberia or Alaska, excessive poultry deaths were reported in Kamchatka.

Birds that migrated north in the spring, would be returning to the region

at this time, so an outbreak in waterfowl in South Korea at this time of

the year would not be unexpected. Similar outbreaks in the region have

been reported in 2003, 2006, and 2007, so the current outbreak was

expected.

New Zealand

Two weeks ago, New Zealand found a low pathogenic form of H5N1.

This virus is found in wild birds in the US also, but was never noted

in New Zealand prior to these cases.

http://www.scottmcpherson.net/journal/2008/9/17/new-zealand-detects-low-path-h5n1-for-first-time.html

http://www.recombinomics.com/News/09170801/H5N1_New_Zealand.html

Why should this be of interest? Think of all these birds mingling with

each other as they migrate from continent to continent bringing virus

with them. It is clear from the data base that viruses are being

exchanged between humans, pigs and birds from all of these areas

which is what Dr. Niman is saying in this post. He also makes the

point that the assays may not pick up highly pathogenic avian

influenza (HPAI) because they are not sensitive enough for this

type of testing. If they want to find HPAI, they will have to commit

to going all out to look for it with more sensitive testing, and looking

at a whole lot more live birds. Finding it early, and then taking

countermeasures to protect poultry would be the sensible course

because birds are migrating from areas where HPAI H5N1 is known

to occur.

These assays however lack sensitivity, especially for high path H5N1.

Several full sequences...[including] those from two recent isolates

from Aomori have been published...

Monitoring of the newly acquired polymorphisms in these sequences

identifies multiple locations in the East Asian flyway, stretching from

Australia and New Zealand in the south, to Alaska and the rest of North

America to the north. Include were a number of polymorphisms in PB1,

which were recently published from Korean swine, which had many

clear examples of homologous recombination, including the PB1 gene.

In the swine the PB1 gene was human and it had recombined with avian

sequences from low path wild birds or clade 2.2 H5N1.

The PB1 gene in the clade 2.3.2 sequences had a large number of

polymorphisms from H3 isolates from New Zealand and Australia...

raising concerns that the PB1 in the H5N1 was also acquiring

polymorphisms from human serotypes.

These data highlight the importance of monitoring these acquisitions

and expanding the wild bird database in New Zealand and Australia,

including the recently described H5N1 isolates.

From an old post on low path H5N1 testing in North America:

https://allnurses.com/forums/2275552-post12.html

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?

Testing for Avian Flu in New York State

http://www.flutrackers.com/forum/showpost.php?p=183782&postcount=1

Taking advantage of duck hunter's kills, the DEC in NY State is testing

for H5N1 in migratory ducks for the USDA as part of the national

early warning system.

It is good to know that they are swabbing both throat and cloaca. But,

are their assays going to be sensitive enough to pick up highly

pathogenic avian influenza (HPAI)?

Early detection is key. If forewarned of the presence of the virus, then

biosecurity measures might be able to protect US poultry before any

outbreaks occur here. Unfortunately, poultry deaths are usually the first

indication that many countries have that the virus is present. By the time

this happens, it is very expensive as well as very difficult to eradicate it.

The very fact that this testing is going on is indicative of how seriously

the threat is being taken by these agencies. They are expecting it to

come here eventually.

As waterfowl hunters visited the headquarters of the Perch River

Wildlife Management Area on Saturday, they did not just report their

take as required, they also assisted a national program watching for

avian influenza.

William S. Huffman, a fish and wildlife technician from the state

Department of Environmental Conservation's Albany office, took swab

samples from waterfowl. DEC is the state partner in the U.S.

Department of Agriculture's Highly Pathogenic Avian Influenza Early

Detection Data System.

UPDATE

South Korea - It's Not HPAI

It's not the highly pathogenic H5N1 virus that is causing the

current problem in South Korea, but a low path H5N2.

I stand corrected for saying that there is no other H5 virus

that humans could have antibodies for as this report indicates.

http://afludiary.blogspot.com/2008/10/south-korean-ducks-low-path-h5n2.html

Low path H5N2 isn't viewed to be as serious as the highly pathogenic

H5N1 virus. It is, however, a reportable disease and can mutate

into a highly pathogenic form.

Over the years there have been several H5N2 outbreaks in the

United States, and around the world, that resulted in large economic

losses to poultry raisers.

The danger to humans from this virus, for now at least, is considered

minimal.

While no active human infection with the H5N2 virus has ever been

documented, in 2006 77 poultry workers in Japan tested positive for

antibodies to the virus.

as the chief information officer for the florida house of representatives,

scott mcpherson does not blog often. he is a very busy guy. he is

very knowledgeable about a great many subjects, infectious disease issues

being just one of them. here are two of his posts from this week.

hugh loss for influenza research

as millions and millions of dollars are being spent on preparing for the

next expected pandemic with the concern that it might possibly be a

catastrophic event, the loss of an important researcher in this field

is very unfortunate.

http://www.scottmcpherson.net/journal/2008/10/7/loss-of-a-giant.html

dr. laver was one of the modern pioneers in the field of influenza research,

and his work helped pave the way for n-class antivirals such as tamiflu and

relenza.

"with the 2 vital discoveries that graeme made, he really worked out the

major foundation of influenza biology in that period of 20 years and how to

control it," ...

...an interview with washington university's virology history department

in st. louis, missouri, helps showcase his life's work. the interview is

fascinating and informative and also helps us better understand the dynamics

of the 1968 pandemic of h3n2.

"graeme laver, the maverick of influenza research in australia, was always

prepared to challenge authorities. he established the biochemical basis of

antigenic drift and shift in seasonal and pandemic influenza viruses and

played a key role in the development of the antiinfluenza drug relenza.

it was graeme's contention that antiviral drugs (relenza and tamiflu) should

be available in everyone's medicine cabinet. his argument is that many will

die in an influenza pandemic before available stockpiles could be distributed.

birmingham, alabama -- the new influenza research capital of the us?

http://www.scottmcpherson.net/journal/2008/10/8/sweet-home-alabama.html

it is interesting that birmingham has attracted lots of money and research

on influenza. read scott's link to found out what's been going on there.

i also found it a strange coincidence that scott was blogging over at flutrackers

on an influenza outbreak that put six kids in the icu in birmingham in december

2006. at the time, i thought it was such an unusual event in that a cluster of

unrelated children were so severely ill from influenza that they needed major

critical care intervention due to multi organ failure that i did a thread on it

here also. anyway, it all happened in birmingham.

http://www.flutrackers.com/forum/showpost.php?p=55911&postcount=1

https://allnurses.com/forums/f8/6-alabama-kids-were-life-support-flu-197370.html

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Flu as child killer

http://scienceblogs.com/effectmeasure/2008/10/flu_as_child_killer.php#more

...methicillin resistant Staphylococcus aureaus (MRSA) is a surprisingly

common accomplice in pediatric flu deaths.

The number of children who have died from a combination of influenza

infection and bacterial pneumonia--in many cases due to the superbug

methicillin-resistant Staphylococcus aureus (MRSA)--has risen sharply

over the past few years, federal epidemiologists say in a new report that

urges flu shots as a preventative.

[snip]

Staph pneumonia is not a new phenomenon... but those pneumonias tend

to occur in the elderly and immune-impaired. And the severity of

simultaneous staph and flu infections has been documented after each

influenza pandemic, in which large numbers of deaths were attributed to

bacterial pneumonia.

But the staph pneumonias recorded by the new reporting system

represent an apparently new development, because they occurred in

previously healthy children infected with a seasonal flu virus that

presumably does less damage to the lungs and immune response than

a novel pandemic one. And they appear to be occurring at the same

time as a rapid rise in MRSA colonization in the United States, which

doubled between 2001 and 2004.

The flu virus may be turning healthy children into immunocompromised

children (at least locally in the lung), accounting for the increasing

MRSA superinfections, whose rate has been increasing year on year:

The relative absence of pneumococcal pneumonia may be related to

availability of a vaccine against this bacterial agent. There is no vaccine for

MRSA. But there is an influenza vaccine, and children 6 months and older

have been added to the list of those for whom flu vaccination is recommended.

Stay Home if You Are Sick, Please

http://afludiary.blogspot.com/2008/10/up-close-and-little-too-personal.html

We say this every year. I know, I know, you can't stay home because

your workplace insists that you come in. So here's what happens

when you bring those germs to work:

http://afludiary.blogspot.com/2008/10/up-close-and-little-too-personal.html

germany

http://www.recombinomics.com/news/10090801/h5n1_germany_fujian.html

authorities say a duck at a farm in eastern germany has tested positive for

the h5n1 strain of the bird flu virus.

the social affairs ministry in the eastern state of saxony says the farm

near goerlitz on the polish border has been sealed off.

the ministry said thursday that the farm has more than 1,000 birds,

including turkeys and geese.

the above comments on confirmed h5n1 in germany (see satellite map) are

curious. in the past, outbreaks in germany have predated subsequent

infections in europe.

the latest outbreak may be signaling early arrivals from siberia and mongolia,

which may include a new sub-clade for europe, clade 2.3 (fujian strain).

last spring clade 2.3.2 was responsible for outbreaks in south korea, japan,

and southeastern russia. in northern japan there were multiple outbreaks

in whooper swans, which would be expected to create opportunities for

migration of h5n1 to the same areas that gave rise to clade 2.2.3. thus,

the sequences of the h5n1 would be of interest. previously, all h5n1 west of

china has been clade 2.2. if the h5n1 in germany is clade 2.3, it would

signal a major global expansion of this sub-clade, which has been

responsible for all reported human cases in china, as well as recent

cases in vietnam.

http://www.bloomberg.com/apps/news?pid=20601202&sid=anbjevsz43tu&refer=healthcare

authorities began killing poultry at 4 a.m. and have set up a three-

kilometer (1.9 mile) quarantine, said ralph schreiber, a health ministry

spokesman in the german state of saxony. the sick duck was found in

an area with several poultry farms, including one with 70,000 animals,

schreiber said.

how the duck caught the virus remains a mystery...

http://www.recombinomics.com/news/10100801/h5n1_saxony_fujian.html

...comments from the recently file oie report, and the media translation

described the hpai h5n1 outbreak in saxony (see satellite map) . the

h5n1 pcr positive was initially found in one duck, but the media report

indicates more birds have tested positive, and throat swabs have been

collected with humans linked to the outbreak.

NAMRU-2 is still up and running

http://crofsblogs.typepad.com/h5n1/

Naval Medical Research Unit-2, run by the US Navy, is located in a

strategicly important area of interest, in the country where the

most human fatalities have occurred secondary to infection with bird

flu. It is a matter of grave concern that Indonesia is actively censoring

information and refuses to share viral samples of H5N1 with the rest of

the planet. That govt has also been threatening to close down NAMRU-2,

and news reports indicated that this had occurred but, apparently those

pronouncements were not correct.

BTW, NAMRU-3 is located in Cairo, Egypt, another country of some

interest where bird flu is now endemic and where human fatalities also

have occurred.

"Retno Marsudi, Indonesian directorate general for America and Europe

relations, said the contract with Washington to operate the lab had not

been terminated."

In addition, feedback from informed sources indicates that, "While the

Minister of Health continues to report that they have closed, they continue

to operate and to negotiate with the President's Office on continuing

operations." We regret any confusion.

The Mission

http://www.geis.fhp.osd.mil/GEIS/Training/namru-2asp.asp

The mission of the NAMRU-2 Jakarta, Indonesia is to support American

medical research interests in the Pacific Theater and advance U.S.

diplomacy in the region by studying infectious diseases of critical public

health importance to the United States, Indonesia, and other regional

partners. NAMRU-2 provides our country with a continued forward

presence that combines virology, microbiology, epidemiology,

immunology, parasitology, and entomology into a comprehensive

capability to study tropical diseases where they occur. Only in this

environment can new preventive measures and treatments be tested

and evaluated to provide better health measures for U.S. Government

personnel working in the region and to collaborate with our host country

colleagues in improved public health capacity-building.

The Controversy

Nationalist grandstanding, profiteering or both by Supari, the Health

Minister, she holds the world hostage by refusing to share viral samples

of H5N1

http://www.thejakartapost.com/news/2008/04/28/editorial-namru2-who.html

The lab, with its American and Indonesian researchers, has been accused

of engaging in intelligence operations after a quiet existence for decades

in a densely populated part of the city.

Avian influenza was the trigger for the controversy, as over the past

year bird flu samples were sent to the lab, situated in the compound

of the national health institutes under the Health Ministry. The laboratory

provided a short-cut in the otherwise long process of confirming suspected

cases of bird flu, which has taken 107 lives across the country. Earlier,

samples had to be sent to the facility of the World Health Organization

in Hong Kong.

Health Minister Siti Fadilah Supari eventually gained a reputation of being

the Cabinet's nationalist, refusing to continue sharing samples despite

a global consensus to the contrary.

Bangladesh

http://pandemicchronicle.com/2008/10/h5n1-bangladeshi-poultry-outbreak/

DHAKA - BANGLADESH authorities said on Sunday they have detected

fresh bird flu at a poultry farm four months after the deadly virus was

last reported in the country.

Livestock department spokesman Salahuddin Khan said at least 300

birds were destroyed in a farm in the northern Naogaon district last

week after the deadly H5N1 strain of avian influenza was detected.

Hong Kong

http://pandemicchronicle.com/2008/10/hong-kong-crow-h5n1/

A house crow found dead in a crowded district in Hong Kong last week

has tested positive for the highly pathogenic H5N1 bird flu virus, a

government spokeswoman said on Monday.

The appearance of the virus in Hong Kong, more active in the cooler

months between October and March, is closely watched as it may

indicate the level of activity of the virus in mainland China, which has

a poultry population of 13 billion.

USGS: Genetic Evidence Of The Movement Of Avian Influenza Viruses

From Asia To North America

http://afludiary.blogspot.com/2008/10/usgs-genetic-evidence-of-movement-of.html

Finally, they admit to some what has been happening between this

continent and Asia. I suspect that there is even more evidence that

we are not seeing as scientists who have access to the genetic sequences

of our human seasonal influenza cases, continue to hoard information.

The pintails migrated from an area in Japan where H5N1, in its highly

pathogenic form has been present.

As part of a multi-pronged research effort to understand the role of

migratory birds in the transfer of avian influenza viruses between Asia

and North America, scientists with the U.S. Geological Survey (USGS),

in collaboration with the U.S. Fish and Wildlife Service in Alaska and the

University of Tokyo, have found genetic evidence for the movement of

Asian forms of avian influenza to Alaska by northern pintail ducks.

In an article published this week in Molecular Ecology, USGS scientists

observed that nearly half of the low pathogenic avian influenza viruses

found in wild northern pintail ducks in Alaska contained at least one (of

eight) gene segments that were more closely related to Asian than to

North American strains of avian influenza.

Laos

http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/nov0408birds.html

The outbreak occurred in Donngeun village in Xayaboury province, where the

Avian Influenza Control Committee yesterday ordered that all birds within a

1-kilometer radius of the outbreak site be destroyed to stop the spread of the

virus, Vietnam News Agency reported.

The Vientiane Times, a Lao newspaper, reported that the culling area

encompasses seven villages, according to a report today by Xinhua, China's

state news agency. Officials established a 5-kilometer yellow zone around the

outbreak location and advised villagers to destroy birds at the first sign of

illness without waiting for them to be tested. None of the media reports said

what type of birds were involved in the outbreak.