Pandemic News/Awareness - Thread 3

Published

Due to circumstances beyond my control, computer glitch (?), the length

of the former thread (Thread 2), and the tremendous amount of new

information coming in at this time, it is probably necessary to start a new

thread on Avian Influenza Awareness.

I pulled out the following commentary from an earlier thread regarding

a rather chilling video (at least to me), given by Dr. Margaret Chan. The

information is not current as the video was shot in February 2007, but

what she has to say is still pertinent considering how much further the

spread of H5N1 has grown. It is now on three continents with a CFR (case

fatality rate) for human beings of over 60%. It is still however, primarily

a bird disease, but that may be changing.

From Margaret Chan MD, Director-General of the World Health Organization:

I did not attend the CIDRAP Conference in February, 2007 where this video

was shown. I almost got there, but changed my plans at the last minute.

Dr. Chan will appear in a screen to your right. You do not have to press

any buttons, just wait for the screen to appear, and for her presentation

to begin. You do not have to be a subscriber for the video to play.

Just be patient for a few seconds and view it.

I have to say that even though everything Dr. Chan is saying in this

presentation is well known to me, just hearing her speak so

clearly and honestly of what might occur, has shaken me. Though

many who research this information will say that her estimates

of the possible future cases may be too conservative, the numbers are

still hugh. This event will change the world, and challenge all of us.

The video will take 16 minutes of your time. I hope that the

very serious nature of Dr. Chan's message will cut thru the apathy and

disbelief about the possibility of H5N1 triggering the next pandemic,

and encourage some individual planning and family preparation.

Share it with people that you care about.

https://umconnect.umn.edu/chan

(hat tip crofsblog)

Reservoirs for H5N1

The World Wildlife Fund (WWF) continues to claim that Avian Influenza is NOT primarily transmitted by wild migratory birds. Here is an excerpt from a news article by the Lahore (Pakistan) branch of the WWF from Feb 16, 2008.

Migratory birds not main source of bird flu: WWF

Staff Report

LAHORE: Wild migratory birds may suffer from Avian Influenza (commonly known as bird flu), but they are not the main source of the disease's outbreak in Pakistan, according to a study statement issued by the World Wildlife Fund (WWF) Lahore chapter on Friday.

The statement said that the statements about migratory birds being the main reason for the latest outbreak of bird flu in Pakistani poultry farms might have serious repercussions against the birds and their habitats. It said since the recent outbreak of bird flu in Sindh, WWF Pakistan had been in contact with BirdLife International, which carried out research on the role of wild birds, including migratory species, in the spread of HPAI H5N1.

The WWF said there were no sound grounds to support the allegations that migratory birds were solely responsible for the spread of H5N1. It said the Food and Agriculture Organisation (FAO) collected samples from between 300,000 to 350,000 wild-birds across the world. None of these were found H5N1 positive. Likewise, sampling of 5000 water birds after the outbreak in Nigeria during 2006 found no traces of the virus (according to the Wildlife and the Environment Web). Despite increased sampling around the world, no fully documented migratory wild birds have tested positive for H5N1.

http://www.dailytimes.com.pk/default.asp?page=2008%5C02%5C16%5Cstory_16-2-2008_pg13_8

Yet contrast this news article with the following scientific abstract from scholars at the Chinese Academy of Sciences in a current edition of the Journal of General Virology.

H5N1 avian influenza re-emergence of Lake Qinghai: phylogenetic and antigenic analyses of the newly isolated viruses and roles of migratory birds in virus circulation

Abstract

Highly pathogenic avian influenza H5N1 virus has swept west across the globe and caused serious debates on the roles of migratory birds in virus circulation since the first large-scale outbreak in migratory birds of Lake Qinghai, 2005. In May 2006, another outbreak struck Lake Qinghai and six novel strains were isolated. To elucidate these QH06 viruses, the six isolates were subjected to whole-genome sequencing. Phylogenetic analyses show that QH06 viruses are derived from the lineages of Lake Qinghai, 2005. Five of the six novel isolates are adjacent to the strain A/Cygnus olor/Croatia/1/05, and the last one is related to the strain A/duck/Novosibirsk/02/05, an isolate of the flyway. Antigenic analyses suggest that QH06 and QH05 viruses are similar to each other. These findings implicate that QH06 viruses of Lake Qinghai may travel back via migratory birds, though not ruling out the possibility of local circulation of viruses of Lake Qinghai.

J Gen Virol 89 (2008), 697-702; DOI 10.1099/vir.0.83419-0

Full article here. http://vir.sgmjournals.org/cgi/reprint/89/3/697

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Another H5N1 Death in Indonesia Yesterday (Friday): A 3 Year Old Child

Indonesian boy dies of bird flu, putting death toll to 105

Special report: Global fight against bird flu JAKARTA, Feb. 17 (Xinhua) -- A three year-old Indonesian boy from South Jakarta has died of avian influenza, putting the total fatality to 105 out of 129 cases in the hardest-hit country, health ministry said here.

Indonesian health ministry's director general for illness control and environmental health I Nyoman Kandun said Sunday all examinations on the boy's blood samples had showed that he was contracted by H5N1 virus. "Both laboratory tests has indicated that he is positively infected," Kandun told Xinhua. . . . .

http://news.xinhuanet.com/english/2008-02/17/content_7617429.htm

Not only has Indonesia suffered the most human cases of H5N1, but the CFR in Indonesia is an astounding 81%.

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Specializes in Too many to list.

WHO Admits 25% of Bird Flu Cases Have Unknown Means of Transmission

http://www.flutrackers.com/forum/showpost.php?p=134314&postcount=1

It could be that small particles of virus-contaminated fluid stuck to surfaces, they said. Or perhaps fertilizer made from infected bird feces somehow carried the virus into people's noses or mouths.

"It is unknown whether influenza A (H5N1) virus infection can begin in the human gastrointestinal tract," they wrote.

"In several patients, diarrheal disease preceded respiratory symptoms, and virus has been detected in feces."

Government and health officials have stressed that well-cooked chicken cannot infect people. "Drinking potable water and eating properly cooked foods are not considered to be risk factors, but ingestion of virus-contaminated products or swimming or bathing in virus-contaminated water might pose a risk," the WHO team of bird flu experts noted.

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Specializes in Too many to list.

China

Why do the Chinese always report these deaths a month later? A 22 year

old man is the latest case.

http://afludiary.blogspot.com/2008/02/china-reports-human-bird-flu-fatality.html

Bangaladesh

Meanwhile, right there in the capital city of Dhaka, they are slaughtering thousands of poultry to try to prevent a worse case scenario. Already 43 out of 64 districts in the country are affected.

It's an economic disaster for many:

http://afludiary.blogspot.com/2008/02/bangladesh-culls-150k-birds-in-capital.html

http://www.flutrackers.com/forum/showpost.php?p=134698&postcount=1

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Additional news -

Another outbreak of bird flu in poultry in Tibet.

http://www.china.org.cn/english/health/243208.htm

An 18 year old high school student in Riau Province is suspected with bird flu and is under intensive treatment with worsening lung conditions.

http://www.flutrackers.com/forum/showpost.php?p=134871&postcount=82

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From 2006, CDC GUIDELINES AND RECOMMENDATIONS

Interim Guidance for Airline Flight Crews and Persons

Meeting Passengers Arriving from Areas with Avian

Influenza A (H5N1)

This includes Airline Flight Crew, Transportation Security Administration (TSA), and Customs and Border

Protection (CBP) personnel

This updated interim guidance is intended to inform airline flight crews and personnel meeting arriving passengers about recommended precautions in the event that they must interact with a person suspected of having H5N1 avian influenza. Recommendations are based on standard infection control practices used in health care settings and on available information about the virus that causes H5N1 avian influenza.

General Infection Control Measures

All airline personnel should always follow basic hygiene practices to prevent becoming ill.

Handwashing is an important and effective means of preventing the delivery of infectious material (e.g., nasal secretions, saliva or other body fluids that may contain viruses) from soiled hands to the mouth, nose or eyes, where it can enter the body. Cleaning one's hands with soap and water removes potentially infectious material from one's skin. Hands should be cleaned before preparing food, eating, or touching one's face and after handling soiled material (e.g., used tissues, lavatory surfaces), coughing or sneezing, and using the toilet. Waterless alcohol-based hand gels may be used when soap is not available and hands are not visibly soiled.

If airline personnel are ill, the following steps should be taken:

Avoid traveling unless traveling locally for health care.

Cover mouths and noses with a tissue or hands when coughing or sneezing.

Put used tissue in a waste basket.

Clean hands with soap and water or an alcohol-based hand gel immediately after coughing or sneezing.

CDC does not recommend the routine use of personal protective equipment (PPE), such as respirators, gloves, or surgical masks, for protection against avian influenza exposure, except in health care-related situations. However, gloves are recommended when cleaning potentially contaminated surfaces. . . .

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Specializes in IM/Critical Care/Cardiology.

LBA:

Thanks for the article. I see it was written in 2006. And the link prior from IG's post states the family would not give "any further info". This totally blows me away. How many flights go overseas daily to China, VietNam, etc? I feel we've been sooooo lucky or blessed or both.

I had a patient come in from returning from China. He was febrile, cough, wife was sick, guide was sick (over there) and I immediatley quarrantined the room and informed the doc. The concern then was the SARS breakout. Thank God he did not have this, but I jumped all over it. Doc checked with the CDC for latest news that was 11 minutes old at the time. I was very impressed.

I wonder if an airline stewart has the option of wearing a mask, "I have a cold", or just simply statng a personal preference. It would be interesting to find out if that action is prohibited policy from the airline flying to known destinations of H5N1.

Food for thought.

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Specializes in Too many to list.

H5N1 Detected In Thailand's Mosquitoes

This is important information. This could be very bad news if the mosquitoes can pass on the virus. One would think that it should be relatively easy to test for this possibility so what are are they waiting for?

http://afludiary.blogspot.com/2008/02/h5n1-detected-in-thailand-mosquitoes.html

Infection and replication of this virus in the C6/36 mosquito cell line was confirmed by quantitative real-time PCR.

*However, transmission by mosquitoes was not evaluated, and further research is needed. Collecting and testing mosquitoes engorged with the blood of domestic or wild animals could be a valuable tool for veterinary and public health authorities who conduct surveillance for H5N1 virus spread.

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Who Update on Candidate H5N1 Human Vaccines

Antigenic and genetic characteristics of H5N1 viruses and candidate H5N1 vaccine viruses developed for potential use as human vaccines.

February 2008

The development of representative H5N1 candidate vaccine viruses by the WHO Global Influenza Programme is being conducted as one component of the overall global strategy for pandemic preparedness. This summary provides an update on the characterization of H5N1 viruses circulating in birds, those that have caused human infections and the current status of the development of candidate H5N1 vaccine viruses. This information may be used to guide national authorities as regards decisions on procurement of H5N1 vaccines. H5N1 vaccines are continuing to be developed by manufacturers using clade 1 and clade 2 viruses that have been modified by reverse genetics. Clinical trials have been conducted or are under way in several countries and stockpiles of clade 1 and clade 2 vaccines are being acquired by a number of countries (www.who.int/entity/vaccine_research/diseases/ari/final_report_stockpile_meeting.pdf). Because it is not known if the next influenza pandemic will be caused by H5N1 viruses or which of the clades or subclades of H5N1 would be responsible, should one occur, clinical trials using both clade 1 and clade 2 viruses should continue as an essential element in pandemic preparedness, to maximize data available on priming, cross-reactivity and cross-protection by vaccine viruses from different clades and subclades. . . .

full report at: http://www.who.int/entity/csr/disease/avian_influenza/guidelines/H5VaccineVirusUpdate20080214.pdf

credits to ironorehopper

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Fighting bird flu is not "rocket*science"

http://www.scottmcpherson.net/journal/2008/2/18/fighting-bird-flu-is-not-rocket-science.html

An excellent interview with one of Indonesia's top influenza researchers reveals refreshing candor and focus. A tip of the cap to multiflusite poster AlaskaDenise for the link: http://www.thejakartapost.com/detail...218.H05&irec=4

Specifically, writer Emmy Fitri of the Jakarta Post sat down with Udayana University-based virologist and microbiologist I Gusti Ngurah Mahardika for a chat after the nation of 18,000 islands experienced its 103rd confirmed human fatality from H5N1. This, sadly, was before the nation reported, in rapid-fire succession, its 104th and 105th deaths over the weekend.

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Specializes in Too many to list.

China

Confirmation of another human case for this month, that of a 41 yr old male.

He died on 20 February.

http://www.flutrackers.com/forum/showpost.php?p=135467&postcount=14

Vietnam

Another man in his forties is a suspected case of H5N1:

http://crofsblogs.typepad.com/h5n1/2008/02/vietnam-another.html

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After more than a year Indonesia is finally again sharing human bird flu samples with the CDC.

Indonesia Sends Bird Flu Samples to WHO

By ZAKKI HAKIM - 1 hour ago

JAKARTA, Indonesia (AP) -- Indonesia sent 12 bird flu samples to a World Health Organization laboratory this week after receiving assurances its rights to any vaccines produced from them would be recognized, the health minister said.

Indonesia had been refusing to send samples to WHO since January 2007, saying poor nations needed guarantees that any pandemic vaccines developed from the virus would be affordable and available to them.

It was unclear whether Indonesia would now routinely share samples, a move that would effectively end a standoff that experts have said could jeopardize global efforts to battle bird flu.

Health Minister Siti Fadilah Supari told The Associated Press late Thursday that 12 samples from recent bird flu patients were sent on Tuesday to the WHO-affiliated Centers for Disease Control and Prevention in Atlanta, the United States.

"This is just for risk assessment," Supari said. "If they want to develop them into a seed virus they must notify us. If they make them into a vaccine our rights over (the vaccine) will be recognized." She did not elaborate. . . .

http://ap.google.com/article/ALeqM5i...m5qUAD8UV5AEG0

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