Friday, September 29, 2006

Research into 1918 virus can help bird flu fight

(Sep. 28, 2006) New insights into tackling the threat posed by bird flu have been made in a study into the 1918 flu pandemic, published today.

The outbreak of the 1918 virus - which was described as Spanish flu and is known to scientists as H1N1 - resulted in the deaths of up to 25 million people around the world.

Today's study, published in the science journal Nature, involved infecting mice with a recreation of the virus.

The results suggest the deaths were the result of an immune system overreaction. Previously, it had been believed that the scale of mortality in 1918 had been due to a second wave of infection that struck those already hit by flu.

However, the new findings indicate that deadly inflammation, triggered by an out of control immune response, could have been the real cause.

Researchers, led by Dr John Kash at the University of Washington, in Seattle, studied what happened to the lung cells of mice infected with the reconstructed virus.

Immune system genes were strongly activated, but the animals developed lung disease and died. Other mice infected with more benign flu viruses did not develop such a powerful immune response, and more of them survived.

"We think the host's inflammatory response is being highly activated by the virus, and that response is making the virus much more damaging to the host," Dr Kash said.

"The host's immune system may be overreacting and killing off too many cells, and that may be a key contributor to what makes this virus more pathogenic."

Scientists said the findings suggested that focusing on the immune system would be key to tackling the H5N1 bird flu virus.

Ordinary seasonal flu typically hits children, the elderly and those with weakened immune systems the hardest, but the 1918 virus infected many young and healthy adults.

Scientists have long questioned why the 1918 flu strain proved so deadly and why so many victims were people not normally vulnerable to flu.

Similar patterns of mortality have been observed in those infected by bird flu, although the virus has yet to develop into a disease that spreads from person to person.

Dr Christopher Basler, a co-author of the study from Mont Sinai School of Medicine, in New York, said the findings "could help us develop more targeted therapies to combat pathogenic infections, including different types of influenzas or perhaps avian influenza".

Professor Karl Nicholson, the professor of infectious diseases at the University of Leicester, said learning more about "the cause of the high morbidity of H1N1 ... might then open the way for alternative methods of treatment". (from www.guardian.co.uk)

Bird flu diagnosis 'very unlikely': NSW Health

(September 27, 2006) NSW Health says it is extremely unlikely a man rushed to hospital from an international flight at Sydney Airport this morning has bird flu.

The man aged in his 30s was isolated by quarantine officers at Sydney Airport after falling ill on a Vietnam Airways flight from Hanoi via Ho Chi Minh City with flu-like symptoms.

The man whose nationality is unknown has been taken to St George Hospital for bird flu testing.

NSW Health Communicable Diseases director Jeremy McAnulty said the man had been quarantined as a precaution but initial tests showed it was unlikely he was suffering from bird flu.

"It turns out that that is a very unlikely diagnosis.'' Dr McAnulty said.

"But the person's still being assessed in hospital.

"Our concern is whether a person has a quarantinable disease or avian influenza and at this stage it seems very unlikely that that's the case.''

The man's recent history of being in an area with chickens in Vietnam and having a previous influenza like illness had sparked concern, Dr McAnulty said.

Mildly unwell when he boarded the plane, the man but had become "difficult to rouse" when the flight touched down in Sydney, Dr McAnulty said.

Quarantine officers wearing protective clothing had boarded the aircraft, isolated the man and escorted him to a waiting ambulance.

He was being assessed by experts but bird flu was "way down the bottom" of the list of possible diagnoses, Dr McAnulty said.

He said the chances of the man's travelling companion or other passengers on the flight being infected were the illness bird flu was extremely low.

"At this stage we think that the likelihood that he'd be infectious to other people is extremely low," he said.

"However, if that changes, then we have mechanisms in place to follow up other passengers, but at this stage we don't believe (there is) any risk."

As a routine precaution, the details of the man's immediate neighbours had been taken and if the risk assessment changed these would be followed up.

Despite the relatively low risk of human transmission, authorities took the threat of bird flu very seriously, Dr McAnulty said.

"It's very rare for people to get infected from avian influenza, even if they have close contact with chickens or other birds that are infected with it," he said.

"But rarely it does occur and if people do get infected with avian influenza they could get seriously unwell, so on balance we take it very seriously."

If the man was diagnosed with bird flu he would be placed on anti-influenza drugs and a communicable disease response activated, Dr McAnulty said.

"From a public health point of view, the risk of person-to-person transmission is extraordinarily low, there's only really been one or two of those possibilities around the world in the past," he said.

"However, as a precaution, we'd be contacting (those who had) close contact."

A full diagnosis was expected later this afternoon. (www.theaustralian.news.com.au)

Tuesday, September 26, 2006

Thai man who bred fighting cocks dies of bird flu

(Sep. 26, 2006) BANGKOK (AP): A 59-year-old Thai man who bred and raised fighting cocks in northeastern Thailand contracted the H5N1 bird flu virus and has died, bringing the country's human death toll from thedisease to 17, health officials said Tuesday.

The man, from Nong Bua Lamphu province, had been treating his sick fighting cocks with herbal medicines when he was exposed to the disease, said Thawat Suntrajarn, director-general of the Department of Communicable Disease Control. He became ill on July14 with fever and aches, and died on Aug. 10, said a statement from the Health Ministry.

"He didn't give his full history to the doctor - that he raised chickens, that they were sick, and that they had died," Thawat told The Associated Press. "He was scared that the agriculture officials would kills his birds."

The H5N1 strain of bird flu has killed at least 146 people worldwide since it started ravaging poultry stocks in Asia three years ago, according to the World Health Organization, not including the most recent death in Thailand.

Most human deaths have been traced to direct contact with sick birds, but experts fear the virus could mutate into a form that can easily be passed from human to human, potentially causing adeadly global pandemic.

Indonesia has been the hardest hit nation by the virus with 51 fatalities. The latest victim was a 9-year-old boy, who died Monday from bird flu hours after he was admitted to a hospital in the Indonesian capital Jakarta.

The country also reported another suspected death, while four patients showing symptoms of the virus were being treated in hospitals.

In Thailand, Thawat said he had about 50 fighting cocks on his farm and assumed that since there weren't any bird flu outbreaks in the area near his home, his birds couldn't possibly have died of bird flu.

"His wife finally confessed 14 days after he became sick," Thawat said, adding that officials have gone to the man's farm to cull poultry according to standard protocol.

Cock fighting is hugely popular in Thailand, and owners have resisted previous culls by hiding their expensive birds. (from www.thejakartapost.com)

Indonesia probes possible bird flu cluster in family

(Sep. 26, 2006) JAKARTA (Reuters) - Indonesia is investigating a possible cluster of bird flu cases after a man died and his brother and sister were hospitalized, one of them testing positive for bird flu, a doctor said on Tuesday.

The man, 25, died on Sunday with bird flu symptoms after being treated at a Christian hospital in Bandung, the capital of West Java province, said Hadi Yusuf, head of the bird flu ward at the city's Hasan Sadikin hospital.

The dead man's brother, 20, and sister, 15, were being treated in Hasan Sadikin hospital and tests carried out by a government laboratory showed the surviving brother had bird flu, Yusuf said.

It was not clear if samples from the dead brother had been taken for tests when he was treated, the doctor said.

"The condition of the (other) brother is not good. He's on a ventilator," Yusuf told Reuters by telephone.

Results for the girl were expected on Wednesday, he said.

The brothers often bought dead chickens to feed their dog, but the girl had no known history of contact with chickens, the doctor said.

"If it is true that the youngest did not touch chickens at all and she had bird flu, we need to suspect she got it from the brothers," he said.

But he expressed disappointment at the slow flow of funds pledged by international donors to Indonesia for the effort.

Health experts and scientists say it is crucial to control the virus from spreading in poultry to limit the chances of more people contracting the disease. The more it spreads, the greater the risks of the virus mutating into a form that can easily pass between humans.

WHO names experts who will advise when pandemic risk appears to be rising

(Sep. 25, 2006) The World Health Organization has announced the membership of the panel of experts it will turn to for advice if it believes the threat of a flu pandemic is mounting.

The list of 20 or so international disease experts includes leading avian influenza expert Dr. Robert Webster of St. Jude's Research Hospital in Memphis, Tenn., Dr. Ab Osterhaus, a veterinary virologist at the Erasmus University in Rotterdam, and Dr. Nancy Cox, director of the influenza division at the U.S. Centers for Disease Control in Atlanta.

Dr. Theresa Tam, director of the Public Health Agency of Canada's respiratory infections division, is also on the committee, which convened for the first time Monday in Geneva.

The panel's mandate is to advise the director general of the WHO whenever it appears that there has been a change in the risk of a flu pandemic emerging. This group would review the evidence on patterns of infection and possible human-to-human spread and issue a recommendation on whether it believes it is time to change the pandemic staging level.

The final decision on whether to move up - or down - the pandemic alert ladder rests with the director general.

The WHO's pandemic phasing document is a six-step scale from no known pandemic threat (Phase 1) to a full-blown pandemic (Phase 6). The WHO's current assessment is that the world is in Phase 3 - a novel flu virus that has pandemic potential is causing sporadic human cases but only very limited human-to-human spread.

Evidence of some clustering of cases of human infections of H5N1 avian flu virus in Indonesia and elsewhere this year has led to questions from some quarters about whether the WHO ought to raise the pandemic alert level to Phase 4, characterized as "evidence of increased human-to-human transmission."

This new committee would be the body that would advise on that issue, if asked. But Monday's meeting was not called for that purpose, WHO officials have said. Instead, this meeting is a chance for the experts to hammer out a procedural framework for future deliberations.

Membership is drawn from the six administrative regions of the World Health Organization: Africa, the Americas, Southeast Asia, Europe, the Eastern Mediterranean and the Western Pacific.

Other members of the task force include Dr. Maria Zambon from Britain's public health agency; Dr. Martin Cetron, head of the global migration and quarantine division at the CDC; Masato Tashiro, director of Japan's National Institute of Infectious Diseases; and Russian virologist Dmitri Lvov. (from The Canadian Press)

Indonesia records 51st bird flu fatality following boy’s death

AKARTA - A 9-year-old Indonesian boy who died shortly after being admitted to a Jakarta hospital has tested positive for bird flu, bringing the country’s human toll from the H5N1 virus to 51, health officials said on Monday.

The boy, from Pondok Pinang suburb in southern Jakarta, died less than an hour after being admitted to Sulianti Saroso Infectious Disease Hospital last week, which is designated to treat suspected bird flu cases, said Ningrum, an official at the Indonesian Health Ministry’s bird flu monitoring centre.

‘The boy was admitted ... at about 9:15 p.m. on September 22 and died at around 10 p.m. on the same night,’ Ningrum told Deutsche Presse-Agentur dpa.

The boy had already spent two days at a police hospital in Jakarta, Ningrum said, adding that tests from two laboratories confirmed he was infected with the avian influenza virus.

The boy had recently been in contact with chickens infected with the virus, said other health ministry officials.

Indonesia has the world’s highest death toll with 51 fatalities from 67 confirmed cases.

Most of the victims had direct or indirect contact with chickens, but scientists fear the virus could mutate into a form easily transmissible among humans, sparking a global pandemic that could kill millions.

The highly pathogenic virus has spread to 29 of Indonesia’s 33 provinces since being discovered here in 2003, killing millions of birds. (from www.khaleejtimes.com)

Friday, September 22, 2006

World Bank clears $13 million to fight bird flu in West Bank and Gaza

(Sep. 22, 2006) The World Bank has approved a $13 million (€10.1 million) grant to help combat the threat of the deadly bird flu in the West Bank and Gaza, the development institution announced Friday.

The money will be used to help minimize any threats of the bird flu posed to people from the area's domestic poultry industry, it said.

The money "will assist the Palestinian Authority to improve their readiness and protect the citizens from a potentially devastating threat as the migration season is around the corner," said Arif Zulfiqar, head of the World Bank's department's that handles grant applications.

The World Bank said that in April the bird flu virus was confirmed across eight locations in Gaza.

"The proximity of outbreaks in neighboring countries, coupled with a large volume of bird migrations, increases the probability of a spread of the virus among domestic poultry and thus places the West Bank and Gaza at high risk," the development bank said.

The virulent H5N1 strain of bird flu has killed at least 144 people worldwide since it started ravaging poultry stocks in Asia three years ago, according to the World Health Organization.

Most of the human deaths from bird flu have been linked to close contact with infected birds, but experts fear the virus could mutate into a form easily spread from person to person and spark a worldwide pandemic.

Of the $13 million being provided in Friday's announcement, $3 million (€2.3 million) is coming from the World Bank's Avian and Human Influenza Facility, a multidonor financing mechanism set up earlier this year, while the remaining $10 million (€7.8 million) is coming from the World Bank's own resources. (from www.iht.com)

WHO takes bird flu as top health danger


(Sep. 22, 2006) Avian influenza remains the No. 1 danger for global public health, said Richard Nesbit, World Health Organization's Acting Regional Director for the Western Pacific, on Friday.

He made the remarks at the conclusion of WHO's Western Pacific Region meeting held in Auckland, New Zealand.

The WHO (World Health Organization) 57th annual meeting calls on its member countries to step up their defenses against emerging diseases, including bird flu, and to devote more resources to counter the growing threat from noncommunicable diseases.

Earlier this week, Nesbit urged member country delegates to do more to prepare for an outbreak of bird flu, saying no nation would be immune.

He said WHO lacked about half of the funds needed to help countries prepare for and fight bird flu.

WHO spokesman Peter Cordingley said many countries did not have the money or resources to implement full emergency plans.

The five-day meeting on Sept. 18-22 also endorsed a regional strategy designed to stem the exodus of health care workers from poorer countries in the region to more affluent nations.

Other issues examined included universal access to HIV/AIDS treatment, prevention and control of tuberculosis, and program updates on measles elimination, hepatitis B control and polio eradication, as well as tobacco control, mental health and environmental health.

The 58th session of the Regional Committee for the Western Pacific will take place in South Korea, in 2007. (from chinaview.cn)

Indonesian boy dies of bird flu

(Sep. 22, 2006) JAKARTA (Reuters) - An 11-year-old Indonesian boy has died of bird flu, the health ministry said Friday, taking the country's death toll from the disease to 50.

The boy died on Monday at a hospital in Tulungagung in East Java province, said Runizar Ruesin, the head of the ministry's bird flu information centre.

Tests by two local laboratories confirmed he had bird flu, he said.

"He had contact with dead chickens. Chickens have died in his house," Ruesin told Reuters, adding that the ministry would send officials to the area where the boy lived to investigate.

Indonesia has the highest bird flu death toll of any nation. Not including the latest death, the H5N1 avian flu virus has killed 144 people worldwide, the World Health Organisation says.

The H5N1 virus mainly affects birds but experts fear it could mutate into a strain capable of killing millions of people in a global pandemic.

Indonesia has been criticised for not doing enough to combat the disease, endemic in birds in most of the giant archipelago's provinces.

The United Nations bird flu coordinator, David Nabarro, said last week that Indonesia had made progress in its fight against the virus.

But he expressed disappointment at the slow flow of funds pledged by international donors to Indonesia for the effort.

Thursday, September 21, 2006

Institutes to supervise bird flu in Southeast Asia

Health institutes in China, Vietnam, Cambodia, Laos and France will, late this year, start a four-year project on keeping surveillance on bird flu outbreaks among humans in Southeast Asia.

Under the project funded by the French Development Agency, Pasteur institutes in Vietnam's Ha Noi capital, central Nha Trang city and southern Ho Chi Minh City, China's Shanghai, France's Paris, and Cambodia, and a laboratory in Laos will reinforce their standard labs and national disease response networks, exchange data and specimens relating to bird flu, and put forth measures to contain outbreaks.

The total investment for the project stands at 6 million euros (over 7.6 million U.S. dollars).

Vietnam's Health Ministry has recently assigned 14 hospitals in major cities to closely supervise and promptly cope with any bird flu outbreaks among people. The hospitals and preventive medicine centers are to ensure the operation of disease surveillance systems around the clock, and the sufficient supply of facilities for treatment of bird flu patients.

To date, Vietnam has detected 93 bird flu patients, the ministry said on Wednesday, noting that it has seen no new human cases of infections since mid-November 2005. (from chinaview.cn)

Wednesday, September 20, 2006

Iraqi Boy Was Country's Third Bird Flu Case: WHO

GENEVA (Retuers) - A three-year-old Iraqi boy in Baghdad has been confirmed as having survived a mild case of bird flu last March, the first confirmed human infection in the capital, the World Health Organization (WHO) said on Tuesday.

"The Ministry of Health in Iraq has retrospectively confirmed the country's third case of human infection with the H5N1 avian influenza virus," the WHO said in a statement.

Initial testing on samples taken from the boy had been inconclusive, possibly due to their deterioration during shipment, but repeated tests using different methods has confirmed the presence of the virus, according to the United Nations health agency.

Iraqi officials said in March that the H5N1 virus had been found in poultry in Baghdad, but to date there had been no human case confirmed in the war-ravaged capital.

An Iraqi teenage girl and her uncle, both of whom died in January in the northern province of Sulaimaniya, were the country's first known human cases.

The WHO said on Tuesday that Iraq's outbreak was "now considered over." The disease affects mainly animals but experts fear the virus could mutate into a pandemic strain capable of killing millions of people.

The latest confirmed case brings the global total to 247 cases in 10 countries since 2003, with 144 deaths, WHO said.

WHO lacks half the funds to battle bird flu

The World Health Organisation still lacks about half the funds it needs to help countries fight bird flu, the acting director-general said yesterday.

"We have still not been able to fill the gap. There's still a shortfall," Anders Nordstrom, acting head of the Geneva-based UN health agency, said.

"We still are able to respond when there are outbreaks, but to be able to really work with countries to build up good surveillance systems and information systems, we do need more resources."

Shortfall

Nordstrom said WHO needs $90 million (Dh330 million) to $100 million (Dh367 million) over a two-year period, but has only received about half of that amount.

He said countries themselves also need to come up with more funding to help strengthen surveillance and rapid response systems within their borders.

Nordstrom spoke on the sidelines of the annual WHO Western Pacific regional meeting in Auckland, New Zealand, which brings together health officials from across the Asia-Pacific to set the organisation's strategic agenda for coming years.

Bird flu and the fear of a global pandemic has remained a top item on the meeting's agenda for the third straight year. Health experts fear the H5N1 virus will mutate into a form that spreads easily among people, potentially sparking a pandemic. So far, most human cases have been linked to contact with infected birds.(from gulfnews.com)

Monday, September 18, 2006

Bird flu still threat, says WHO director

(Sep. 18, 2006) Bird flu remains a threat three years after scientists first raised alarms of a possible human pandemic, says the World Health Organisation's acting regional director.

Dr Richard Nesbit, speaking yesterday on the eve of the WHO's 57th regional committee meeting in Auckland, said as long as the avian flu virus remained in the environment, its threat to human life could not be dismissed.

Avian influenza and non-communicable diseases such as cancer will be among issues discussed when health officials from 27 countries meet at Aotea Centre today for the week-long meeting. Other items on the agenda include the emergence of multidrug resistant tuberculosis, prevention and control of HIV/Aids and the exodus of skilled health workers to wealthier countries.

But bird flu remains an ever-present threat to the region since it reappeared in 2003, spreading to Europe, the Middle East and Africa and leading to the culling of millions of domestic poultry.

With new poultry outbreaks in Cambodia and Thailand and the virus still claiming lives in Indonesia, fears are that the disease will reappear across Asia and elsewhere in the cooler months of the northern hemisphere. "In our view, the risk of a pandemic continues unabated," said Dr Nesbit.

He was, however, encouraged by the progress in planning, citing that the last human case in Vietnam was in November last year. "Scattered outbreaks" in poultry and wild migrating birds were still likely, he said.

"As long as avian influenza is endemic in the environment, there is a risk of a human pandemic."

The outbreak has infected 241 people and killed 141 around the world. Indonesia has had 60 cases and 46 deaths. (from nzherald.co.nz)

Sunday, September 17, 2006

Bird flu pandemic could cost $2 trln: World Bank

(Sep. 17 2006) SINGAPORE (Reuters) - A severe bird flu pandemic among humans could cost the global economy up to $2 trillion, the World Bank said on Sunday, sharply raising earlier estimates.

The comments came as a senior World Health Organization official said the threat from the H5N1 avian flu virus was just as real today as it was six months ago, even if the headlines were not as scary.

Jim Adams, vice-president for East Asia and the Pacific and head of the Bank's avian flu taskforce, said a severe pandemic could cost more than three percent of the global economy's gross national product.

"We estimate this could cost certainly over $1 trillion and perhaps as high as $2 trillion in a worst-case scenario. So the threat, the economic threat, remains real and substantial," he told reporters at the annual IMF-World Bank meetings in Singapore.

He said earlier estimates last year of about $800 billion in economic costs were basically written on the back of an envelope. But more recent financial modeling had revealed a sharper threat should the virus mutate and pass easily among people.

He said it was crucial to develop strong anti-bird flu programs around the world to strengthen health and veterinarian services as well as improve public education and transparency.

"We have been working in virtually all of the countries, developing countries, that have been affected by an avian flu outbreak, providing advice and financing in the development of projects to tackle the challenge," he said.

Financing totaling about $150 million had been committed for projects in 11 countries, ranging from Albania to Laos and Turkey to tackle the disease, which has killed at least 144 people since it re-emerged in Asia in 2003.

An additional $15 million in grant aid had also been finalized for cash-strapped Indonesia, Adams said, as part of a wider package to help that country control the virus. Bird flu has killed nearly 50 people in Indonesia, the world's highest national toll, and the virus is endemic in poultry in most provinces of the southeast Asian nation.

RISKS REMAIN

David Nabarro, the WHO's avian flu coordinator, said one only had to look at the resurgence of bird flu in Thailand and Laos in past months to understand the risks posed by H5N1.

"The only difference between now and six months ago is not that the problem doesn't exist, it is perhaps headline writers have got used to it," he told reporters when asked if bird flu had turned into the Y2K of the viral world.

Fears of mass computer breakdowns due to glitches associated with Y2K, the turn of the millennium in 2000, proved unfounded.

Nabarro expressed satisfaction at the way governments around the world had responded to bird flu and that country-specific programs were well under way in most, creating confidence for donors that their money would be well spent.

At a donors' conference in Beijing in January, nearly $1.9 billion was pledged. So far about $1.2 billion had been committed for projects and over $300 million disbursed as loans or grants.

Nabarro agreed there was a shortage of funds but it was crucial to focus on the fact that "we now have got in countries good ways of spending resources so we get results".

Saturday, September 16, 2006

U.S. offers more bird flu funding

(Sep. 16, 2006) JAKARTA: The U.S. pledged Friday to provide an additional US$3.2 million to help fight bird flu in Indonesia, which has recorded 49 deaths, the world's highest number.

Building on a $14.65 million bird flu prevention and control program, USAID will provide the $3.2 million for enhanced surveillance, response and prevention, the U.S. embassy said.

Of that amount, $2.2 million will be supplied in the form of personal protective gear and disinfection kits.

After meeting with Coordinating Minister for the People's Welfare Aburizal Bakrie, USAID Avian Influenza director Dennis Caroll said that the U.S. was pleased with the Indonesian government's redefined bird flu priorities. (from thejakartapost.com)

S.Korea says 5 more infected with bird flu 2003-04

(Sep. 15, 2005) SEOUL - Five more South Koreans were infected with the H5N1 bird flu virus about three years ago but none of them developed any serious illnesses, officials said on Friday after recently completed testing on old samples.

South Korea, which did not have comprehensive testing at the time, sent samples of 318 poultry industry workers taken during an outbreak in late 2003 and early 2004 to the U.S. Centers for Disease Control and Prevention in 2005 for further examination.

Of those workers, four South Koreans were infected, the CDC has said. The government said in February the four did not develop major illnesses.

The results prompted South Korean health officials to send samples to the CDC from another 2,109 people and of these, five were also infected, the health agency said on Friday.

"The five did not develop major illnesses and have no strain to transmit bird flu," the Korea Centre for Disease Control and Prevention said in a statement.

About 400,000 poultry at South Korean farms were infected by bird flu between December 2003 and March 2004, but no human cases were reported at that time.

All of the samples sent by South Korea to the United States were from people involved in the culling of about 5 million poultry.

There have been no reported cases of bird flu in South Korea since the 2003-2004 outbreak.

The World Health Organisation said on Thursday two cases in Indonesia had been recognised retroactively, including one where human-to-human transmission could not be ruled out.

The latest number of cases globally stands at 246 since 2003 not including the South Korean cases, with 144 deaths. (from Reuters)

Thursday, September 14, 2006

Sudan reports bird flu outbreak

(Sep. 14, 2006) Juba - Authorities in autonomous southern Sudan said on Wednesday that they had confirmed an outbreak of the H5N1 strain of bird flu in poultry, with two other suspected cases of the virus potentially fatal to humans.

They said the outbreak, confirmed by laboratories in the federal capital, Khartoum, and Britain, had not infected any people, but had prompted an alert in neighbouring Uganda amid fears it could spread to humans.

Louis Morris Kyanga of south Sudan's ministry of animal resources and fisheries said the tests confirmed that several chickens from a residential backyard in the southern Sudanese capital of Juba had died from H5N1 on August 03.

Further tests 'are conducted'

He said: "We received the results of the tests, and unfortunately all the samples have proven to be positive", adding that further tests were being conducted on the carcasses of 18 ducks found in two backyards on September 09.

Kyanaga said: "Samples from those have been sent again to Khartoum and the United Kingdom, as we don't have the laboratory facilities here, but they are suspected to be avian flu just by the signs."

H5N1, which had killed nearly 140 people, mostly in Asia, since 2003, was reported in northern and central Sudan in April, but had not spread to the south.

Sudan shared a lengthy border with Egypt, which had suffered more from bird flu than any other country outside Asia since the virus began spreading worldwide earlier this year.

Scientists 'fear global flu pandemic'

The only human case thus far reported in sub-Saharan Africa had been in the Red Sea state of Djibouti.

While the virus didn't spread easily among people, the chance of a mutation that would allow it to do so was heightened as more humans catch it from infected birds.

Scientists feared that if this occurred, a global flu pandemic with a massive death toll could result.

Africa was considered particularly at risk due to the close proximity between poultry and humans on small family farms such as the affected homesteads in Juba.

Kyanga said southern Sudan authorities were taking steps to contain the flu, but had not yet resorted to culling.

He said: "A surveillance team has been sent to the affected areas and there is a ban on the movement of birds." (from news24.com)

Indonesia records 49th death from bird flu

AKARTA, Sept 13 (Reuters) - A five-year-old Indonesian boy who died in March had bird flu, a health official said on Wednesday, raising the country's death toll from the virus to 49.

The boy died at Jakarta's Sulianti Saroso Hospital, the country's main bird flu treatment centre. He was from Bekasi on the eastern outskirts of the capital Jakarta.

The World Health Organisation (WHO) last week recognised three more cases of bird flu in Indonesia, one from June and two dating to 2005. The boy has also been included after the WHO issued new definitions for human infections of the H5N1 avian flu virus, said Runizar Ruesin, head of the health ministry's bird flu information centre.

Prior to the recent revision of the WHO's definitions for H5N1 infection, the cases had not met the UN health agency's criteria for serologically confirmed avian influenza infection.

The Health Ministry said no one else in the boy's family was known to have been infected, although it was unclear how he caught the virus. Contact with infected poultry is the usual mode of transmission.

Indonesia has now recorded 64 cases of H5N1 infection. The national death toll is the world's highest.

Bird flu remains essentially an animal disease, but scientists fear the virus, which has killed at least 143 people since late 2003, could mutate and pass easily among humans, possibly killing millions.

Indonesia has been criticised for not doing enough to combat the disease, which is endemic in birds in most of the country's 33 provinces.

The government has so far refused to conduct mass culling of poultry, citing the expense and logistical difficulties in capturing and killing millions of backyard fowl.

Tuesday, September 12, 2006

Study Shows Immediate Treatment Needed for Bird Flu Cases

(Sep. 12, 2006) Avian flu kills in much the same way the global flu pandemic of 1918 did, by drowning victims in fluid produced in their own lungs, a new study has found. The study also suggests that immediate treatment with antiviral drugs is crucial, because the virus reproduces so quickly that, if not suppressed within the first 48 hours, it tends to push victims into a rapid decline to death.

“The paradigm ‘hit hard and hit early’ probably is very true for H5N1 influenza,” said Dr. Menno D. de Jong, an Oxford University virologist and the study’s lead author. However, he added, because the body’s own immune response does part of the damage, doctors should consider giving anti-inflammatory drugs along with antivirals like Tamiflu.

Although the results of the relatively small study are precisely what flu experts had predicted from laboratory work, Dr. Anne Moscona, a professor of pediatrics and immunology at the Weill Cornell Medical College, called it a “major advance,” because so little clinical information had previously been gleaned from the 241 known cases of the disease.

Many of those cases have been in rural villages in Asia, where victims pick it up from backyard chickens and are buried before the virus that killed them is even identified. Provincial hospitals have done few autopsies and little genetic analysis.

This study, which appears in the October issue of Nature Medicine, was led by an Oxford research team in Ho Chi Minh City, Vietnam, and compared 18 people with the A(H5N1) avian flu in 2004 and 2005 to 8 people infected with seasonal human flus.

It found that the avian flu patients, and particularly the 13 who died from it, had unusually high levels of the virus in their bodies. Consequently, they also had high levels of the chemicals, known as cytokines and chemokines, that set off the immune system’s inflammatory response.

Those chemicals, some of which are produced in cells lining the narrowest passages in the lungs, draw in white blood cells to attack invaders. But doing so too vigorously can flood the lungs, causing deadly pneumonia.

The effect, known as the “cytokine storm” is the leading theory as to why so many young, previously healthy people died in the 1918-19 pandemic, known as the Spanish flu, which killed tens of millions of people. Seasonal flus tend to kill the very old and very young, who usually die from bacterial infections that develop days after the milder flu virus has irritated their lung tissue.

The avian flu virus was easier to detect in throat swabs than in nasal swabs, Dr. de Jong said, which is the opposite of how seasonal flu is detected, and useful for doctors doing flu tests. And the virus was found in rectal swabs, which is important for hospitals to know because it means diarrhea, common among flu patients, can also spread the disease.

Flu experts were surprised that such high concentrations of the virus were found in nose and throat swabs. Earlier studies had suggested that the avian flu is not easily transmitted between humans because, unlike seasonal flu, it attaches primarily to receptors found deep in the lungs.

Dr. de Jong said there could be several explanations: the throat swabs could have picked up virus coughed up from the lungs. Different receptors are spread up and down the breathing tract. And it is possible — though unproved — that some people may simply be born with receptors more amenable to the virus. That theory has been offered by epidemiologists who note that, even in villages where all the chickens are sick, human outbreaks tend to cluster in families.

The study also showed that some of the flu strains isolated in Vietnam had particular genetic changes that virologists have been watching for, fearing that these changes would make them more lethal.

But those changes appeared in only some patients, and in those who died as well as those who lived, “so I wouldn’t make too much of it,” Dr. Moscona said.

Henry L. Niman, a Pittsburgh biochemist who has been tracking viral changes and raised earlier alarms about E627K, agreed.

“Lethality in the virus may rely on several changes,” he said. “But it’s got several different paths to the same end. That’s what makes it so efficient.” (from The New York Times)

Southern Vietnam to check passenger temperature to prevent bird flu

(Sep. 12, 2006) Vietnam's southern Ho Chi Minh City has assigned its International Quarantine Center and the Tan Son Nhat International Airport to check body temperature of international arrivals to the locality amid recent bird flu outbreaks in some countries, local media reported Tuesday.

Remote temperature-measuring machines using infra-red rays and specialized thermometers are installed, ready to operate around the clock, newspaper Agriculture said.

Those who have temperature of over 38 Celsius degrees will be invited to enter isolation rooms for bird flu diagnosis.

Vietnam's Health Ministry has assigned 14 hospitals in major cities to closely supervise and promptly cope with any bird flu outbreaks among people. The hospitals and preventive medicine centers are to ensure the operation of disease surveillance systems around the clock, and the sufficient supply of facilities for treatment of bird flu patients.

The Vietnamese government has recently instructed state agencies and localities nationwide to intensify prevention of and fights against bird flu, including placing a temporary ban on import of live poultry and related products from countries hit by the disease.

Bird flu outbreaks, starting in Vietnam in December 2003, have killed and led to the forced culling of dozens of millions of fowls. The last outbreak of bird flu among poultry in the country was in December 2005, according to the Department of Animal Health under the Vietnamese Ministry of Agriculture and Rural Development.

To date, Vietnam has detected 93 bird flu patients, the Health Ministry said on Monday, noting that it has seen no new human cases of infections since mid-November 2005. (from Xinhua)

Give city residents bird flu jabs first, say researchers

(Sep. 12, 2006) City residents should be the first to receive treatments or vaccinations against major transmissible disease outbreaks, an infectious disease scientist from the University of NSW says.

The implication for this country is that city residents should receive bird flu vaccinations before their rural counterparts if an outbreak of the deadly disease were to hit Australia, David Wilson, who led the team the team conducting the research, told smh.com.au today.

The scientist, who specialises in HIV intervention strategies in Africa, said this would be the most effective way of containing the risk to the community.

"The capital cities of every state should come first because they act as the major hub of transmission," Dr Wilson said.

"If we can stop it while it's mainly in cities, hopefully that would prevent it reaching out to rural areas."

This would reduce the ethical dilemma that would arise if city residents were given priority over Australians living in the bush.

The research findings, published today in the US scientific journal, Proceedings of the National Academy of Science, were based on a study of the HIV-AIDS crisis in South Africa.

A quarter of that nation's AIDS-related deaths and infections could be averted within four years if the limited supply of anti-retroviral therapies was distributed inequitably, said the researcher, who is now based at the university's Centre for Vascular Research.

He conducted the AIDS research when he was working at the University of California Los Angeles, along with Professor Sally Blower and Dr Jim Kahn of the University of California San Francisco.

"The South African Government is facing a moral dilemma," Dr Wilson said.

"We have shown it is most efficient to distribute the drugs to the cities only, leaving rural areas even more disadvantaged."

The findings showed that 1400 lives would have been saved and 15,000 new infections prevented in just one province in South Africa by 2008 if the city-focused strategy had started in 2004.

Applying this methodology to Australia, concentrating the distribution of bird flu vaccines in cities would be "far more effective at containing the outbreak".

The deadly H5N1 strain of avian influenza has devastated chicken and other poultry flocks in parts of Asia, hitting Thailand and Vietnam hardest.

The only human deaths so far have been people who have had close contact with sick birds, but there are fears the virus could mutate so it could spread from person to person. (from www.smh.com.au)

Monday, September 11, 2006

Vietnam prepares for potential bird flu outbreaks among humans

(Sep. 11, 2006) Vietnam's Health Ministry has assigned 14 hospitals in major cities to closely supervise and promptly cope with any bird flu outbreaks among people, according to local newspaper Labor on Monday.

The hospitals and preventive medicine centers are to ensure the operation of disease surveillance systems around the clock, and the sufficient supply of facilities for treatment of bird flu patients.

The ministry said if the outbreaks spread, general hospitals in provinces had to form an isolation area at their infectious disease departments, and mobilize healthcare workers and equipment from first aid and pediatrics departments. Each hospital should set aside 10-20 beds for receiving bird flu patients.

The Vietnamese government has recently instructed state agencies and localities nationwide to intensify prevention of and fights against bird flu, including placing a temporary ban on import of live poultry and related products from countries hit by the disease. It has urged relevant ministries and People's Committees of localities to speed up bird flu vaccination among fowls nationwide, and maintain operation of anti-bird flu steering committees at all levels in preparation for potential outbreaks of bird flu among both fowls and humans.

Bird flu outbreaks, starting in Vietnam in December 2003, have killed and led to the forced culling of dozens of millions of fowls. The last outbreak of bird flu among poultry in the country was in December 2005, according to the Department of Animal Health under the Vietnamese Ministry of Agriculture and Rural Development.

To date, Vietnam has detected 93 bird flu patients, the country 's Health Ministry said on Monday, noting that it has seen no new human cases of infections since mid-November 2005. (from Xinhua)

WHO Confirms 48th Human Bird Flu Death in Indonesia

(Sep. 11, 2006) The World Health Organization (WHO) has confirmed another human fatality from bird flu in Indonesia, raising the country's death toll to 48.

The WHO says the latest case involves an eight-year old girl from the outskirts of Jakarta, who died in July last year. In a statement released Saturday, the organization says it re-examined the dead girl's blood samples after revising its rules for confirming bird flu cases.

The girl's 38-year-old father also died of bird flu in July 2005. The man was Indonesia's first confirmed human case of the virus.

The WHO is also confirming that a 45-year-old Indonesian man from central Java contracted bird flu in November last year, before recovering.

Both of the newly-confirmed bird flu cases have already been reported by the Indonesian Health Ministry.

Indonesia has recorded the highest number of bird flu deaths since a regional outbreak began in 2003. (

EU approves two veterinary bird flu vaccines

(Sep. 11, 2006) The European Commission said Monday it has approved two vaccines to be used against the bird flu virus in the EU member states.

The vaccines, the first to be approved by the EU executive, are Nobilis Influenza H5N2, for use in chickens, and Poulvac FluFend H5N3 RG, for use in both chickens and Pekin ducks, the most common breed of duck used for commercial meat.

Both vaccines also offer protection against the H5N1 strain of the disease, which has decimated poultry stocks in Asia and killed humans, the European Medicines Agency said.

They are administered by injection and have been found to reduce the death rate of chickens exposed to infection.

The commission said there are no outbreaks of bird flu in domestic or wild birds in the EU at the moment, but the risk of the disease will increase in the coming weeks as the autumn migration period begins. (thestaronline.com)

Sunday, September 10, 2006

What is Bird Flu?

Avian flu (also "bird flu", "avian influenza", "bird influenza"), means "flu from viruses adapted to birds".

All known avian flu viruses belong to the species of virus called Influenza A virus. All subtypes (but not all strains of all subtypes) of Influenza A virus are adapted to birds, which is why for many purposes avian flu virus is the Influenza A virus (note that the "A" does not stand for "avian").

Avian flu viruses are noninfectious for most species. When they are infectious they are usually asymptomatic, so the carrier does not have any disease from it. Thus while infected with an avian flu virus, the animal doesn't have a "flu". Typically, when illness (called "flu") from an avian flu virus does occur, it is the result of an avian flu virus strain adapted to one species spreading to another species (usually from one bird species to another bird species). So far as we know the most common result of this is an illness so minor as to be not worth noticing (and thus little studied). But with the domestication of chickens and turkeys, we have created species subtypes (domesticated poultry) that can catch an avian flu virus adapted to waterfowl and have it rapidly mutate into a form that kills in days over 90% of an entire flock and spread to other flocks and kill 90% of them and can only be stopped by killing every domestic bird in the area. Until H5N1, this was basically the whole story of avian flu so far as anyone knew or cared (outside of the poultry industry). Now with H5N1, we have a whole new ballgame with H5N1 inventing new rules as it goes with behaviors never noticed before, and possibly never having occurred before. This is evolution right before our eyes. Even the Spanish flu virus did not behave like this.

As of 2006, "avian flu" is being commonly used to refer to infection from a particular subtype of Influenza A virus, H5N1, which can cause severe illness in humans who are infected. Currently, this strain is transmitted by contact with infected birds, and has been transmitted from one person to another only in a few cases. H5N1 flu is therefore not pandemic now and is not currently capable of causing a pandemic. Only if H5N1 mutates into a form that can be readily transmitted from one person to another could it cause a pandemic. (from wikipedia.org)

Thursday, September 07, 2006

Low-Dose Bird Flu Vaccine Effective But With Side Effects

(Sep. 6, 2006) A vaccine being developed in China to protect humans against the H5N1 bird flu virus is safe and effective at low doses, researchers there report. However, pain, swelling, and fever were the most common side effects reported by study participants who received the vaccine.

A previous study found that 30 micrograms of the vaccine (which contains part of the H5N1 virus) given in two doses with an "adjuvant" (an additive that can increase effectiveness) produced a good immune response in humans.

However, this 30-microgram dose -- that has to be given in two doses -- means manufacturers would only be able to provide enough vaccine for 225 million people. A lower-dose vaccine may make it possible to vaccinate more people, the researchers reported Wednesday in the online edition of the journal The Lancet.

The vaccine tested in this new study contains a modified form of the whole H5N1 virus plus the adjuvant aluminum hydroxide. Vaccines created with whole viruses trigger a stronger immune response than vaccines made out of a part of the virus. However, whole-virus vaccines can cause more side effects.

This latest study included 120 people, ages 18 to 60, who received either two doses of a placebo or of the whole-virus vaccine at either 1.25, 2.5, 5, or 10 micrograms. After 56 days, all the different doses prompted the production of antibodies against the H5N1 virus. However, the best response was seen in people who received the 10-microgram dose of vaccine. (from forbes.com)

Swans fitted with transmitters in bird flu fight

(Sep. 6, 2006) Outfitting swans with super-light Teflon backpacks containing solar-powered GPS satellite transmitters is the latest way scientists and researchers are trying to fight the spread of avian influenza.

Ten whooper swans were captured in far eastern Mongolia, near the borders of Russia and China, by an international team of scientists in early August as part of a study to shed light on how wild birds may be involved in spreading bird flu.

The whooper swans were chosen for the experiment because large numbers of the species have died in Mongolia and western China in the past two years. Tests verified that some of them were infected with highly pathogenic avian influenza. The H5 and H7 types of avian influenza cause very high death rates in poultry and are blamed for the vast majority of bird flu cases in humans, with the H5N1 bird flu strain killing an estimated 141 people.

An international team of scientists will track the birds' migration routes to glean information to aid in the fight against bird flu.

"Although poultry and bird trade are probably the primary routes of movement (of avian influenza), migratory birds are likely involved in some areas," Dr. Scott Newman, a spokesman for the United Nations Food and Agriculture Organization, said in a statement on Wednesday.

The team also involves scientists from the Wildlife Conservation Society, the Mongolian Academy of Sciences and the U.S. Geological Survey.

After capture, each of the 18-pound (8-kg) large swans were fitted with backpack harnesses carrying 2.3-ounce (70-gram) transmitters. The harnesses are made of Teflon ribbon that deteriorates and falls off within a few years. "

Although we are sampling wild birds for avian influenza in the field, we will not be able to fully understand their role in this disease unless we better understand their movements," Wildlife Conservation Society spokesman William Karesh said. (from Reuters)

Tuesday, September 05, 2006

Bird flu hits eastern Ukraine

(Sep. 4, 2006) Bird flu has been discovered in the Poltava Region in eastern Ukraine, local television said Monday.

"Epidemiologists have found the H5 strain in the blood of wild ducks in Poltava," Channel Five said.

Poltava is located 330 kilometers (205 miles) southeast of the Ukrainian capital, Kiev.

The H5 strain of the virus is considered to be less dangerous than the H5N1 sub-strain that has already claimed dozens of human lives across the world.

The local administration has banned the hunting of wild migratory birds.

The first cases of bird flu were discovered in Ukraine late last year in the Black Sea autonomy of Crimea. The authorities introduced a state of emergency on the peninsula. No human cases were registered. (from Ria Novasti)

Shanghai Police Break Fake Tamiflu Operation

(Sep. 2, 2006) CHINA – Shanghai police have broken a fake Tamiflu drug manufacturing operation. The police confiscated more than 400 kg. (882 lbs.) of fake Tamiflu and 46 tons of raw materials. They arrested 13 suspects and froze bank accounts containing more than 4.6 million yuan (US$575,000).

The Oriental Morning Post reported that a criminal group had sold more than 400 kg. (882 lbs.) of fake Tamiflu over the internet. Profits from the fake medicine were more than 1.6 million yuan (US$200,000). It is known that internet sales were made to people in Heilongjiang, Liaoning, Jiangsu, and Guangdong Provinces in China, as well as other countries in Southeast Asia. At present, authorities are still tracing other sales.

The suspects have an educational background in science or chemistry. It is reported that one of the main suspects, Wang Xun, has a chemical engineering degree. He was previously investigated by police in Taizhou, Zhejing Province, for making fake medicine.

After moving to Shanghai, Wang Xun registered two businesses, Shanghai Xidi Pharmaceutical Co. and Xinwei Chemical Industry Co., LTD. He discovered last year that Tamiflu demand was so high that a large unmet demand could easily make him rich. He illegally obtained the Tamiflu manufacturing process and started production in Shanghai last December.

Roche Licenses Tamiflu in China

Swiss pharmaceutical giant Roche owns the Tamiflu patent rights. Initial tests in Asia indicate that Tamiflu may be effective for preventing and treating bird flu infections. After discussions with China's Ministry of Health, Roche decided to sell Tamiflu for government distribution to the public.

Because Roche does not have the manufacturing capacity to meet worldwide demand for Tamiflu, it has agreed to grant licenses for suitable enterprises to produce Tamiflu globally. Currently, only two companies in China have been licensed, Shanghai Pharmaceutical Group and Shenzhen HEC Group. Tamiflu production by the two companies is limited to distribution in China.

U.S. Finds Low-risk H5N1 Bird Flu Strain in Ducks

(Sep. 2, 2006) WASHINGTON—Mallard ducks in Maryland have tested positive for bird flu, apparently a common, less pathogenic strain that poses no risk to humans, the U.S. Agriculture and Interior departments said on Friday.

The H5N1 avian influenza virus was found in fecal samples from "resident wild" mallards in Queen Anne's County in Maryland, on the U.S. central Atlantic coast.

"Testing has ruled out the possibility of this being the highly pathogenic H5N1 strain that has spread through birds in Asia, Europe and Africa," said USDA in a statement. "Test results thus far indicate this is low pathogenic avian influenza, which poses no risk to human health."

Five to 10 more days will be needed for definitive tests to confirm whether low-pathogenic H5N1 bird flu was found in the United States for the second time this year. On August 14, the virus was found in two mute swans in Michigan. Scientists say low pathogenic avian influenza commonly occurs in wild fowl.

The Maryland mallards did not appear sick so the samples, collected on August 2 as part of a research project, were not given high priority when sent to USDA labs for testing.

"The birds are alive and well," said a USDA spokeswoman.

The low-pathogenic strain of H5N1 has been found six other times in the United States since 1975. Mild and low pathogenic strains of bird flu are common in the United States and other countries.

The H5N1 bird flu strain has killed an estimated 141 people and forced hundreds of millions of birds to be destroyed, mostly in Asia. As a precaution, the U.S. government stepped up testing of wild birds for avian influenza in the continental United States this year. (from theepochtimes.com)

Friday, September 01, 2006

400 volunteers needed for 2nd trial of bird flu vaccine

(Aug. 31, 2006) China will need up to 400 volunteers for the second trial of a bird flu vaccine, after the first phase of clinical trials showed that it is safe for human use.

The second phase of clinical trials, being considered by the State Food and Drug Administration (SFDA), would test how long the vaccine would protect the human body against the deadly H5N1 virus, said Lin Jiangtao, a leading doctor of the program at the Sino-Japanese Friendship Hospital where the first phase clinical trials took place.

"The second phase will need 300 to 400 volunteers," said Lin, adding that the exact number would be decided by the SFDA.

Results from the first round, which ended in June, showed the 120 people who were vaccinated had no serious adverse reactions.

Lin said some individual cases of mild fever after inoculation were among normal reactions.

The first phase trials indicated a 10-microgram dosage of the vaccine had the best result, stimulating 78.3 percent of protective antibodies, exceeding the European Union standard of 70 percent for a flu vaccine.

The second phase would test similar dosages on volunteers to find out the best procedure to reach the most antibodies, which required a larger pool of volunteers, Lin said.

Prospective volunteers should be aged 18 to 65, but children, people older than 65 or pregnant women will not be accepted.

The vaccine must undergo three phases of clinical trials before being allowed on the market, researchers said.

Sinovac Biotech Limited, which jointly developed the vaccine with the Ministry of Science and Technology and the Center for Disease Control and Prevention, announced earlier this week that it would expand production facilities to produce massive quantities of human bird flu vaccine once the drug passes two more rounds of clinical trials.

Bird flu remains essentially an animal disease, but experts fear that the H5N1 virus could mutate into a form that could pass easily among humans.

The virus has killed 14 people in China since 2003 and 21 Chinese have contracted the virus. (from chinaview.cn)

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