Bird Flu Update

[Mojorabbit]

No flames please but there is a lot of news today...
http://news.yahoo.com/s/nm/20060522/sc_nm/birdflu_iran_dc;_ylt=A9G_RwIXCXJE4gcAbgchANEA;_ylu=X3oDMTA5aHJvMDdwBHNlYwN5bmNhdA--
Tests on two dead Iranians show H5N1 bird flu
TEHRAN (Reuters) - Tests in
Iran on the dead bodies of a 41-year-old man and his 26-year-old sister showed they had the lethal H5N1 strain of bird flu, an Iranian medical official who requested anonymity told Reuters on Monday.
snip
ISNA quoted a doctor at Kermanshah's medical university as saying four patients had been tested, two of whom had died and one of whom was in a critical condition


http://news.yahoo.com/s/afp/20060522/wl_afp/healthfluromania_060522183100
Thousands of people quarantined in Bucharest as Romania battles bird flu
BUCHAREST (AFP) - Some 13,000 people were quarantined in a quarter of the Romanian capital Bucharest as troops and police sealed off streets in response to the city's second bird flu outbreak, officials said.

The mayor of the southern fourth district, Adrian Inimaroiu, said residents would be cut off and all businesses in the area would be closed during the quarantine period of up to three weeks

The move came after the agriculture ministry earlier Monday confirmed the presence of the H5 bird flu virus in dead chickens found in the neighbourhood, the latest of dozens of outbreaks of avian flu in Romania this spring.

"About 40 streets have been blocked" in the Luica quarter, Inimaroiu said, urging residents to stay calm.

He said the quarantine would last for a "period of a week to 21 days and all the institutions in this quarter will be closed".

US sends Tamiflu stockpile to Asia
GENEVA (AP) - The United States is sending a stockpile of the antiviral drug Tamiflu to Asia as a first defense against a possible flu pandemic, the U.S. health chief said Monday.

Mike Leavitt, U.S. secretary of health and human services, said Washington has shipped treatment courses of Tamiflu to a secure location in an unnamed Asian country
snip
"It is a stockpile that would belong to the United States and we would control its deployment," Leavitt told reporters in Geneva, where he was attending the World Health Assembly, the annual meeting of the U.N. health agency's 192 members.

He declined to say how many courses had been sent but said the shipment would arrive later this week.

The courses sent to Asia will be used to support international containment efforts in the event of a human pandemic, but the United States could redirect the stocks for domestic use should it become clear that containment overseas was not feasible.
http://www.620ktar.com/?nid=36&sid=184517

Promed summary
An 18-year-old East Java shuttlecock maker has been diagnosed with bird
flu, according to local test results announced on Sun 21 May 2006.


Also from promed
Indonesia: 2 More Suspected Human Avian Influenza Deaths
-----------------------------------------------
Local tests have confirmed 2 more people have died of bird flu in
Indonesia, a senior health ministry official said on Mon 22 May 2006. One
of the victims belonged to a Sumatran family at the center of fears of
human-to-human transmission, after 6 members of the family died this month
of avian influenza. "One man from the same Sumatra cluster died
this morning <22 May 2006>. He is the father of the child who died on 13
May 2006. He ran away after he received Tamiflu," said I Nyoman Kandun,
director-general of communicable disease control at the health ministry.
"He was found in the village later but refused treatment," Kandun told
reporters.

snip
Kandun said a 38-year-old man from Jakarta who died last week had also been
declared positive for bird flu by local tests.
(so now we have cases north central and south of the island chain ..mojo)


Weat Africa
Burkina Faso: Bird flu continues to spread(in poultry)

The deadly H5N1 strain of bird flu that can infect and kill humans is spreading in Burkina Faso with new cases confirmed in the capital Ouagadougou and second city Bobo-Dioulasso, according to the government.


The minister for animal resources, Tiemoko Konate, said on Friday that “157 samples were collected and sent to laboratories in the UK for testing… those results just back today confirmed the presence of H5N1.”

Some of the samples came from the central capital Ouagadougou, the southwestern trade centre of Bobo-Dioulassao, and Sabou in the province of Boulkeimde in western Burkina Faso, said Konate.
snip
The Burkina government’s bird flu eradication programme comes with a US $10 million price tag, a substantial sum for a country that ranks as the third poorest in the world, according to the UN.

And the government is struggling to muster the cash, even with contributions from China and technical assistance from former colonial power France, said Marcel Nagalo head of the government’s national plan to tackle bird flu
http://www.andnetwork.com/index?service=direct/0/Home/recent.fullStory&sp=l35726

[Warpy]

1. Bucharest would seem to be overreacting

to public fear because even they aren't saying it's an effective human to human pathogen yet.

Like I said, it bears close watching. There is no need to panic, not yet.

I don't think I'd like to be in close quarters with poultry, though, not in Europe, Asia or Africa.

[Mojorabbit]

2. It makes me wonder

as I had read last week that there were four people in the hospital with suspected bird flu
http://www.daily-news.ro/article_detail.php?idarticle=26494
then no more news on them unless I missed it. Yes, it does on the face of it seem to be an overreaction. I hope those poor people are given supplies to live on. No panic here but I find it interesting that we are deploying Tamiflu given we have such a limited supply.

[RufusEarl]

3. I have no intentions of flaming anyone,

i's pretty clear that the fear machine is being started and it's ready for full throttle. This is one of many tactics the admin plans to use on it's on citizens, come Nov 06 and Nov 08.

[Mojorabbit]

5. I don't understand what infections in Iran and Indonesia

have to do with our elections. Unless you think they are watching how Romania is handling it and picking up more ideas?

[RufusEarl]

7. Thats my point,

I believe thats what they're doing. I can also see how putting national guard along our border with Mexico, has something to do with the overall scheme of things.

[Mojorabbit]

11. Well the people there are not taking it lying down

"At Jorasti, Vrancea County, over 300 persons protested on Saturday and Sunday against the culling of the birds in their households. The local population went out in the street with clubs, pitchforks and axes requesting to stop the culling of the chicken"

[sarcasmo]

13. Rufus we think alike. My feeling is that the border patrolling National

Guard will be used for Quarantine not for border patrol. Imagine this scenario. Bird Flu breaks out in Phoenix. The CDC and National Guard move in to seal off the city. The time of month is actually October 06, or October 08 and poof you have a suspended election. Long live the Decider.
Tin foil hat thinking, I know, but I would put nothing past these warmongers who control the populous by using fear.

[Avalux]

4. All infections are clusters.

The surveillance data hasn't shown transmission outside of clusters, so there's no indication the virus has jumped species yet. Quarantining 13,000 people does seem a bit drastic considering no one has been infected yet. But remember they live in a different world than we do and are in very close proximity to their livestock.

Not sure why we've sent Tamiflu to Asia; the stuff isn't going to work anyway in all likelihood - and there certainly won't be enough if there's a pandemic. Maybe they're stockpiling it for the 'important people'.

[Mojorabbit]

9. This came out today from the Geneva meeting

GENEVA, Switzerland, May 22 (UPI) -- Besides Tamiflu, the World Health Organization has now endorsed the older drugs amantadine and rimantadine for treating bird-flu patients.

The endorsements come after months of study of data suggesting older drugs may also be effective in fighting the H5N1 bird-flu virus which could become a pandemic among humans, the Wall Street Journal reported.

The Journal said Tamiflu, made by Switzerland's Roche Holding AG, has been the U.N. agency's drug of choice but concerns over its supply has led Roche to agree to license its manufacture to other companies.

With the recommendations of the older drugs, doctors will have two more weapons to fight the disease, the report said. The newspaper says doctors might consider giving patients either amantadine or rimantadine, which are less expensive, in addition to Tamiflu.
http://www.upi.com/NewsTrack/view.php?StoryID=20060522-115149-5940r

[Avalux]

10. The experts are conflicted on this.

These drugs, antivirals, block a virus's ability to replicate; don't actually kill the virus. They are sometimes effective against similar viruses, human influenza A, etc. Some think they MAY be effective against H5N1 when and if it jumps species, but since the virus isn't here yet, the operative word is MAY.

The recommendations are based on what we know, what we can study. But still - there are a lot of unknowns and others think these antivirals will not work at all.

[Mojorabbit]

6. More from Romania

http://www.daily-news.ro/article_detail.php?idarticle=26494
Around 2,500 persons live in the two quarantined areas from Bucharest. Those people will not be allowed to leave the isolated areas and will receive Tamiflu. Over 3,500 poultry (930 chicken and 181 pigeons) will be culled in District 2, and 2,420 chicken in District 4.
snip

We cannot but notice the absolute chaos in Bucharest, on Saturday, when the Agriculture minister, Flutur, the general mayor, Adriean Videanu, and the mayors of districts 2 and 4, Nicolae Ontanu and Adrian Inimaroiu, competed with one another, in giving all sorts of contradicting statements throughout the day about the avian influenza in Bucharest. The general impression was of total chaos, at least as far as the statements were concerned.

snip
Doctor Adrian Streinu Cercel, the hospital’s director, said he saw virus influenza cases in humans as unlikely, yet he expected that many people would come to the doctor if they had the slightest symptoms that might appear related to the disease. For now, six persons presenting symptoms resembling those due to avian influenza are still being hospitalised at the Matei Bals Institute of Infectious Diseases. Among them a four-year old child that suffers from a pulmonary disease. Preliminary tests conducted on the six patients refuted the presence of the avian flu virus. Three of the patients have been submitted to additional testing in order that the suspicions are definitely ruled out

snip
The Social Democratic Party, which last week proposed the establishment of a parliamentary investigation committee on the bird flu crisis, wants to find out the culprits for this situation. According to Victor Ponta, author of the parliamentary investigation committee initiative, there is information that authorities had known about the virus ten days before it was made public.

[savemefromdumbya]

8. Same thihg will happen here

[Viva_La_Revolution]

15. no it won't

we don't live with our chickens.

slight posibility if it does make it to North America, then some of the Chicken factories might get some cases.

Until it spreads human-human we are ok.

[Mojorabbit]

16. They think it might be limited human to human

but only limited.
http://www.bloomberg.com/apps/news?pid=10000087&sid=az9_wKmYoyxY&refer=top_world_news
The number of reported bird flu fatalities this month climbed to 13, the highest since February 2004, as scientists investigate whether the virus has undergone changes enabling it to spread more easily between people.

Limited human-to-human transmission can't be ruled out as the cause of infection in seven members of an Indonesian family found with avian influenza this month, Indonesia's Ministry of Health said yesterday. Six of the people died. Investigators haven't found infected poultry or pigs near where they lived.

``An extremely high priority should be to determine whether the virus has undergone any significant genetic changes,'' Jennifer McKimm-Breschkin, a virologist at Australia's Commonwealth Science and Industrial Research Organization (CSIRO) in Melbourne, said in a phone interview today.
snip
With no animal identified as yet as the source of infection, this cluster raises the suspicion of human to human transmission,'' McKimm-Breschkin said. ``It warrants further urgent investigation, especially of people who may have come into contact with the infected people.''

and
from Helen Branswell the best flu reporter

http://www.cbc.ca/cp/world/060522/w052252.html
Human-to-human spread suspected in latest Indonesian bird-flu death
19:15:48 EDT May 22, 2006
HELEN BRANSWELL

(CP) - The World Health Organization appears to be edging closer to suggesting that an Indonesian man who died from H5N1 avian flu Monday may have been infected by his 10-year-old son, not through exposure to sick poultry or some other environmental source.

WHO officials had earlier expressed the theory that a thorough investigation might reveal a potential source of contagion in the community, such as use of contaminated chicken feces as manure. But expert disease investigators seem to be ruling out that possibility, a spokesperson for the WHO said from Geneva.
snip
"There's no supporting evidence to suggest that this is a continuing environmental source that we've uncovered yet in the investigation," said WHO spokesperson Dick Thompson.

"The investigation is still ongoing. We wouldn't discount the possibility that it is human-to-human transmission."

Limited spread of the virus among people is believed to have happened on several previous occasions. But in each of these suspected cases, transmission of the virus petered out. Sustained human-to-human spread of the virus would be needed to trigger a pandemic.

[Viva_La_Revolution]

17. I see they don't think it's spread by manure...

what about eating it? Possible that family shared a chicken dinner.

[Mojorabbit]

18. I have no idea

I think that is the million dollar question. I think the experts are learning as they go. There is still a whole lot they do not know about viruses.
Effect Measure the public health blog had a bit of a write up on it today
http://effectmeasure.blogspot.com/

One of the most repeated "facts" about the human cases of bird flu is that virtually all cases to date come from intimate contact with sick poultry. But the evidence does not show this.

One third of the Vietnamese cases are said to be without an adequate history of poultry contact, at least a third (if not more) of the Indonesian cases, and many of the Chinese cases. WHO continually repeats the necessity of the poultry connection but knows better. The Vietnamese figure is from WHO epidemiologist Peter Horby (personal communication reported in EFSA Monograph; see earlier post here). WHO is quite familiar and distressed about the situation in Indonesia
snip

Yet WHO continues to say publicly all evidence so far shows the principal connection is from close contact with sick or dead birds.

WHO should not say the evidence shows "close contact" with sick or dead birds is required. We don't know that and it probably isn't true. If it were it wouldn't be so hard to elicit histories of poultry exposure in so many cases. The other possibilities are less close contact through poultry dust, feces, feathers, etc. If WHO wants to call this "close contact with sick or dead poultry" they are free to do so but they are using a private language. And it is largely an inference based on the fixed idea that almost all human cases can be traced back more or less directly to birds.

Given the evidence, we should keep our minds open to other possibilities, namely, contaminated food or water, an as yet unidentified animal reservoir or vector, and of course person to person transmission. At this point I believe WHO is probably right in substance: most cases probably are of proximate bird origin. But they don't have the evidence that they claim and I find that bothersome.

This is the way obvious facts are missed: we don't see what is staring us in the face until hindsight dramatically improves our vision.

[savemefromdumbya]

19. what happens if some evil terrorist?

has a nasty version of it?

[MercutioATC]

12. Every human infection increases the chance of human-human mutation.

THAT'S the primary danger here, IMO.

In its current form, I'm not overly concerned about H5N1. However, there are some animals (human and swine come to mind) that are breeding grounds for both avian and human viruses. When they become infected, the chance of a human-human mutation multiplies.

As with any issue, the universal rules apply...

Don't panic.

Stay informed.

Be prepared.

[Mojorabbit]

14. The Iranian cluster is close to bagdad

http://www.nzherald.co.nz/section/story.cfm?c_id=2&ObjectID=10383142
The two - a 41-year-old man and 26-year-old woman - were among five members of the same family who became sick after returning from a trip to the town of Marivan, close to their home in the northwestern city of Kermanshah.

The three surviving relatives were in hospital and one of them remained dangerously ill, the official, who spoke on condition of anonymity, told Reuters. It was not clear when the brother and sister died.

Samples have been sent to international laboratories for further tests, and if the initial results are confirmed, these would be the first human bird flu deaths in Iran.

Confirmation of H5N1 could deal a major blow to Iran's poultry industry. The Union of Chicken Meat Farmers says the industry employs 600,000 people directly but as many as 3 million people are dependent on it.
snip
A third family member, aged 30, had slipped into a coma in hospital in Kermanshah, which is 100 km from the Iraqi border in the mountainous Kurdish territories of Iran.