Tuesday, June 21, 2005

June 21 Flu Update

China says it did not order misuse antivirals.

The CBC has new information on an outbreak in China.

Recombinominics on the new Chinese cases.

And there are two new cases in China.

Indonesian farmer with bird flu said to be "taking it in stride."

CIDRAP on the news in China and Vietnam. Note this...

More information about the migratory bird outbreak may be forthcoming, as teams of experts from the World Health Organization (WHO) and FAO arrived in Qinghai province yesterday to inspect the outbreak area, according to Bloomberg news service. The teams obtained permission for the trip last week, but China rejected their request to travel to Xinjiang province. (Bold is mine).


AMA Lobbying to get more pandemic funding from Congress.

Recombinomics reports on a new clinical presentation in North Vietnam from the two cases listed above.

This is a continuing story. We noted a couple days ago on the autopsy results reported in CP, that said the disease might be located deep in the lungs, making it harder to transmit through cough. Then, Effect Measure picked up the ball yesterday with a solid analysis of the autopsy story.

Today, Recombinomics has this--ominous in its own right.

The two were among five people admitted to a hospital in Hanoi with sore throat or bronchitis, the Saigon Giai Phong daily quoted hospital officials as saying. <<

The above description may signal a new clinical presentation signaling efficient transmission of bird flu. A sore throat and bronchitis were not among the symptoms reported for 10 cases from last years outbreak, as reported in the New England Journal of Medicine. Similarly, a recent report on the autopsy of a patient who died of bird flu in Thailand last year also noted the absence of virus in the upper respiratory system.

The H5N1 from last season had a high case fatality rate, but was poorly transmitted. Sore throat and bronchitis are symptoms of human flu, which is efficiently passed from human to human. The alarming increase of human cases in northern Vietnam has suggested the pandemic may be evolving into phase 6.

The sore throat and bronchitis in bird flu patients in northern Vietnam may reflect an improved ability of H5N1 to grow in the upper respiratory tract, leading to more efficient spread of the virus including human to human transmission.


Effect Measure covers the Recombinomisc news yesterday (flu timeline) and new cases today.

ProMed on Vietnam.

ProMed on the Chinese anti-viral story.

Note this...I've said for a couple of days that it wasn't news that amantandine wasn't effective against H5. Here's a ProMed quote.

On top of that, the efficacy of such treatment is doubtful. According to
information included in posting 20050309.0697, the WHO Collaborating Center
for Reference and Research on Influenza and the WHO H5 Reference Laboratory
in the National Institute of Infectious Diseases, Japan found that all 9
tested viruses isolated from specimens collected from confirmed and
suspected H5N1 human cases in southern Viet Nam between 24 Dec 2004 and 29
Jan 2005 showed genetic resistance to amantadine. Previously, several avian
influenza virus strains of hemagglutinin subtype 5 were found to exhibit
resistance against amantidine (Wainright, et al Avian Dis 1991; 35(1):
31-9).


Here's a link to previews of articles appearing in Foreign Affairs.

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