Thursday, June 30, 2005

June 30 Flu Update

Today's news...Dateline Cambodia.

Avian Flu says two babies in Cambodia have died of the flu, 1,000 said sickened.

Here's the media link

Here's an odd quote:

He said the illness appears to be a form of human flu, not the avian influenza that has killed dozens of people in neighboring countries and has health officials on edge over concerns the bird flu virus could mutate to more easily infect humans.

Also, courtesy H5N1, Morton Kondracke (bigfoot columnist and McLaughlin group member) who says the flu could be major issue in the 2008 Presidential election.

The first paragraph below is the most perceptive thing I have heard from a US politician in a long time.

[Sen. Brownback speaking]"There will be 9/11-style commissions all over the place and hundreds of Richard Clarkes testifying that they warned about what was coming and higher-ups didn't listen," he said, referring to the former White House counter-terrorism aide who charged that the Bush administration initially ignored Al Qaeda.

Frist, clearly, is not ignoring the problem. In his lecture at Harvard, he said that national leaders "will not be able to look away from what could be coming soon -- a front of unchecked and virulent epidemics, the potential of which could rise above your every other concern."

"For what the world could soon face it did not see even in the great wars of the last century," he said. "These epidemics ... could be devastating beyond imagination."

Frist said, "I propose an unprecedented effort, a 'Manhattan Project for the 21st century' to defend against destruction wreaked by infectious disease and biological weapons.

Singapore is considering travel restrictions if bird flu comes back....this is something Dr. Osterholm has been predicting.

Globe and Mail on the Chinese reports...

Vietnam announces mass vaccination program.

Here's a CBC Story with a headline that will become the "take away" from yesterday's China news. Except a downturn in MSM coverage over the next few weeks as this becomes CW:

WHO says fear of global bird flu pandemic easing

Singapore has masks and other flu staples on hand.

CIDRAP on yesterday's China news.

Effect Measure contrasts the US and EU flu responses.

ProMed on the Chinese reports.

Here's a good article from the Nation on the flu crisis and out government's inaction.

Courtesy H5N1, another death in Vietnam. This was a 73-year old man.

Here's the direct news link. pointed to this article about Portugal ordering Tamiflu...they are behind 25 countries and will take delivery in one year. Still hot on the tamiflu containment plan?

Here's more on the Tamiflu fight between Gilead and Roche. A number of issues, one of which is (shockingly), the underpayment of royalties...and to think money was behind it all.

Wednesday, June 29, 2005

June 29 Flu Update

The upshot appears to be that WHO found worse bird flu and a lack of human cases in their trip to China.

Media report where WHO says it can rule out immediate pandemic after visiting China.

Australia has the same news, saying that its the first time large numbers of migratory birds have died.

Wall Street Journal on a guy whose speciality is culling birds.

Recombinomics on a machine translated web post that seems to indicate 700 human cases in China. This is very unverified.

The EU meets on a coordinated flu response.

CP writer Helen Branswell writes that a new study says that Tamiflu returns $3.50 for every $1.00 invested, making stockpiling a good call. Now, if only there were the supplies to allow stockpiling.

Bloomberg puts a good twist on the China next--"experts say it may spread."

Recombinomics on the WHO recommendation that a database be set up to study bird flu in China and help prepare for the pandemic.

Recombinomics on the lack of testing in China.

Recombinomics with more news on the lethality of the h5n1 in China.

CIDRAP on the Trust for America's Health Report.

CIDRAP on ongoing problems with flu in China.

Effec Measure writes on the larger bird die off in China.

H5N1 links to international flu blogs.

Recombinomics writes on the need to update primers and reduce false test results.

WHO Situation Update on a new human case in Northern Vietnam.

Avian Flu on WHO's words of reassurance from China.

Tuesday, June 28, 2005

June 28th Flu Update

Vietnam is confirming 60 cases since December 2004.

The Japanese are looking for new bird flu detection methods.

Article lists how Vietnam is spending money on bird flu, including compensation for culled birds.

US Senator Carper talks about need for bird flu action from the government.

In Indiana, they're also worried about bird flu.

Recombinomics tells us the WHO is going to have a 6/28 presser to discuss what they found in Qinghai. He says that the rumors are they will say there are no human cases.

Recombinomics on the presser. Apparently a massive bird kill-off, but no evidence cited of human disease.

CIDRAP on the Japan cases.

CIDRAP with a good article on the future of cell culture--instead of egg culture--of flu vaccines.

Here's the transcript to the Congressional testimony.

Effect Measure with a Day 1 report on the Flu Wiki. Huge hits on the first day.

Courtesy Epidemica, free range birds in Thailand to go on--the chickens are simply too tied to subsistence.

Also courtesy Epidemica, the Scots are planning six-month quarantines for bird flu.

h5N1 found this article from an Australian magazine for CFOs on the economic consequences of bird flu.

Sadly, based on Ms. Garrett's comments in the Foreign Affairs events, companies are channeling their efforts into private medicine stockpiling rather than pressuring the government to act.

Here's a nice piece from a Citizen journalist trying to raise awareness on bird flu.

Monday, June 27, 2005

June 28 Flu Wiki is UP

Flu Wiki is up, via Effect Measure and others.

June 27 Supplement

Recombinomics on the silent spread of flu in North Vietnam, and looking ahead....

Note this...

This H5N1 is silently spreading mild disease in human and asymptomatic infections in poultry, which would more the pandemic to phase 6. The seeding of the human population with H5N1 sets the stage for further recombination in the fall when migratory birds bring in new sequences, which will cause new problems.

(There is a consistent trend in people's writing that the thrust of the pandemic may still be three months or more away.)

Sunday, June 26, 2005

June 26 Flu Update

The Agriculture Minister in Vietnam says the flu virus is mutating toward human transmission.

Washington Post reports on experts in Vietnam looking for bird flu intelligence.

Officials in Britain have identified bird flu to be as serious a threat to nation as terrorism.

The Philadelphia Inquirer on experts who find the situation in Vietnam "alarming." Note the expectations for the disease (ie, gone in months) and what has happened.

Recombinomics on the Philly story, saying that the trend (bad) is right, but questions the science about mutation and recomibination.

Here's the Chicago Sun-times on a report from the Trust for Health, who send modest projections of 500,000 flu deaths in the US.

Here's the TFH report. Not reassuring.

Recombinomics on the recent admission in Vietnam that there are probably many false negatives. Note this:

Media reports suggest that these changes set the stage for the explosion in admissions this month in northern Vietnam. These patients, which have a milder disease, also have sore throats, suggesting the new H5N1 can more efficiently infect the upper respiratory tract, which could result in more efficient human-to-human transmission.

On the investigation in drug misuse in China.

A media report from Vietnam on the bird flu outbreak in the central part of the country.

Flu Star Writer (can she win a Fluitzer?) Helen Branswell on the worries caused over the legal fight over tamiflu rights.

Here's news about a antiviral that was thought to have failed, but is now being brought in from the bullpen in a crisis.

Recombinomics on the sick birds in Central Vietnam.

Recombinomics on another report out of China on the dead geese.

Effect Measure talks about the British declaration of bird flu, and notes that we are hampered because our administration believes evolution is a secular fantasy.

Note, the FluWiki is due tomorrow.

You number jockies can do your own flu mortality projections for your state, right here, courtesy of the CDC.

There's a Recombination report for H5N2 flu killing birds in Japan.

And I almost forgot, courtesy of Silver Lining, we have the story of doctors in Canada stockpiling tamiflu for their families.

Finally, H5N1 writes about blogs on the flu, and the role we can play. Some of his recommendations may be folded into the wiki.

Anyway, he also said this.

I admire the terseness of the anonymous creator of The Coming Flu Pandemic? (which can probably drop the question mark).

Thank you for the mention.

Friday, June 24, 2005

June 23 Flu Update

Quick notice: we'll be on a short hiatus until Monday. A Sunday post is a remote possibility.

Its amazing what can get into the news....experts from WHO are in Vietnam trying to ascertain if the "H5N1 bird flu virus may be evolving into a form that might trigger a human pandemic." Still, its good they are there. Hopefully, they will look closely in the north.

Hopefully, they will see the results of this...Recombinomics on the possibility that there are many, many more cases in North and Central Vietnam then have been reported.

Effect Measure on the same story.

Perhaps today's most far reaching story comes from California, where Gilead has terminated its agreement with Roche to produce Tamiflu. The article details the agreement and concerns about how Roche is marketing and producing Tamiflu. The process could take 18 months. Must read. One interesting point to call out:

Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases in Bethesda, has said talks are under way with Roche and "the highest levels" of the U.S. government on a plan to build a Tamiflu plant in the United States. (emphasis added).

Although no agreement has been announced, Roche spokesman Terry Hurley said Thursday that he expected a U.S. plant to be "up and operating by fall.

New York Times covers the Roche/Gilead story.

Here's the offical press release.

Effect Measure has links to the expiration dates of foods you, too, can store for a flu pandemic.

In Vietnam, a local media report about bird flu in Central Vietnam.

Recombinomics comments....

Singapore has opened a major new animal health center.

York, Ontario says its ready...

The New Scientist has an article on more questionable behavior from the Chinese, citing reports in an investigative paper in China. Report also cites the Tacheng cluster which came to ProMed via a reliable source, quoted here earlier.

Finally, for your night time reading, a transcript (excellent) of a flu roundtable sponsored by Foreign Affairs.

Thursday, June 23, 2005

June 22 Flu Update

Hong Kong Standard on the ongoing China amantadine story.

Indian paper writes flu article.

Recombinomics on amantadine and the Z genotype.

Helen Branswell of CP says that sceintists are now asking if the Chinese used tamiflu in their chicken's water.

Effect Measure writes on the tamiflu angle. (Oh, and the WHO officials have had their travel restrictions loosened in China, apparently.

Effect Measure notes that the problem of giving birds anti-microbial drugs isn't just in China.

There is another bird flu outbreak in China--Promed version.

The CDC has updated its travel guidance to Asia.

H5N1 on a story in the Guardian about flu blogs, missing some of the more prominent ones.

H5N1 on the Guardian blogging story. Nice piece, IMO. Here's a snip...

We're like ham radio operators when a storm or earthquake has knocked out the phones, or the person with a cell phone in a skiing party cut off by an avalanche. In other words, we're a convenience—at least if we keep our facts straight and don't push our egos into the story. Otherwise we're just volunteering to make matters worse.

After a few weeks' acquaintance with the individuals and blogs that are covering this story, I'm deeply impressed with their thoughtfulness and skepticism. People are just trying to report the facts as they become available, and to draw careful conclusions from those facts. Flu bloggers are setting a very high standard for one another; this is a classic example of an online community of practice and interest.

Epidemica found this ProMed link about a mass cattle death event in Bangladesh, with no known cause.

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):

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

Monday, June 20, 2005

June 20 Flu Update

The moment we have been waiting for...UN teams have entered China.

CBC with the ins and outs of the bird flu situation in Vietnam.

The UN is expressing strong concern over Chinese actions with anti-viral medicines.

Report in Vietnam on two more new cases.

The media in Kazakhstan is worried about dead birds in China near the border.

Phillipines Q&A on bird flu.

Osterholm in Foreign Affairs

China says use of anti-virals "must stop."

CIDRAP on the Chinese use of anti-virals.

Recombinomics on what he refers to as "an alarming and unprecedented number of 28 conformed or suspect cases at the Institute of Tropical Diseases."

Effect Measure on the alarming case increases in Vietnam.

Recombinomics on the timeline for the development of the pandemic, phase by phase.

n addition to the new outbreaks in Vietnam, there have been two significant outbreaks in western China. The first outbreak was discovered in early May at Qinghai Lake Nature Reserve. Initially the deaths were limited to 180 bar headed geese, but quick rose to over 1000 dead birds representing at least 5 species of migratory birds. This outbreak was unusual in size and the fact that the H5N1 confirmed infection was lethal in geese. The outbreak in Qingahi was followed by an outbreak of domestic geese in Tacheng near the Kasakhstan border in Xinjiang, China. This H5N1 confirmed outbreak again involved lethal infections in geese.

The two outbreaks in western China were accompanied by third party reports on infections in humans. In Qinghai there were reports of deaths of 6 tourists and 121 residents in 18 communities. The reports of human cases have been denied by China, but new fever clinics were established. Another third party report described a pneumonia outbreak involving patients and health care workers in Tacheng. China again denied human cases. WHO requested permission to visit Qinghai, but there have been no reports of that request being granted.

The large number of reported human cases in Qinghai and the isolation of health care workers in Tacheng would signal phase 6, if confirmed. It is likely that the H5N1 would be carried to Kasakhstan and Russia by the migrating birds, although there have not been reports of H5N1 in the neighboring countries.

Thus, at this time it looks like H5N1 is moving from phase 5 to phase 6 in northern Vietnam, and may be doing the same in western China, if reports of human fatalities are accurate.

Yesterday, we ran a Canadian Press article on an autopsy on a flu victim. CP's point was that it took too long to get the results, and that more are needed. Here, Effect Measure looks deeper into the victim's body.

Of particular interest was evidence that the virus was present and replicating in the intestinal tract, although evidence of viral proteins weren't detected there. In addition, the pathologic damage was more or less confined to the extremities of the respiratory tree (the Wiki will also explain this). In other influenza infections (like the common H1 and H3 infections) there is evident damage to the upper respiratory tract, giving rise to the symptoms of running nose and hacking cough we associate with the disease. In this case it was just the areas where gas exchange takes place that were infected (the type II pneumocytes), with fluid in the spaces between the gas exchange sacs (interstitial pneumonia). There was also sign of a secondary fungal infection of the lungs, possibly a terminal event. While there was evidence of replicating virus in the intestines, the tissues looked normal. In keeping with other findings, there were increased levels of certain cytokines (chemical signalling substances induced by infection). While only suggestive, this is consistent with a role for a dysregulated defense reaction playing a part in making the infection more severe.

The presence of the virus in the intestinal tract raises the question of whether stool is infective in these patients, an important point for transmission. The localization of the virus to the lower respiratory tract also suggests that the usual nose and throat specimen swabs may be less reliable for H5 infection than for other influenza viral subtypes.

Here's the autopsy paper.

H5N1 reviews the Zuckerman article from yesterday. He was upset that Zuckerman felt compelled to entice Bush Administration action by comparing the flu to 9/11. He doesn't feel that kind of manipulation should be needed. See what you think.

Avian flu reviews today's news.

Sunday, June 19, 2005

June 19 Flu Update

We've had some good traffic here over the past four-five days, and I hope people keep coming back. Some came through blogdex, which claimed this site was part of what was "contagious" on the web, and also through a link on Saturday's Masslive "Blog Beat." As always, thanks for reading.

Back to work....

Today's lead story is from Helen Branswell of the Canadian press. Ms. Branswell may well be the most faithful and reliable influenza journalist today. This article is on an autopsy of one of bird flu's human victims. She adds her voice to the frustration of the lack of reliable, on-the-ground data.

Slated for publication in the July issue of Emerging Infectious Diseases, their findings of an atypical pattern of infection - deep in the lungs, away from the tracheal lining where virus could easily be coughed out at others - may help explain why H5N1 influenza doesn't yet spread easily among people.

But the very fact that a paper containing autopsy data from a single case is still desirable to journal editors a year-a-half into the H5N1 outbreak underscores a problem that has been plaguing the scientific world's pursuit of knowledge about this dangerous strain of influenza.

This article from the Phillipines reminds us that bird flu is a potential health problem.

And this article says the Phillipines are prepared.

Here's an idea--in Myanmar, they're recommending VIGILANCE.

Recombinomics again tries to tell the complex story of the Amantadine resistance story that the Washington Post broke.

Effect Measure with the latest on the fluWiki.

Saturday, June 18, 2005

June 18 Flu Update

After the storm for the last days, a normal weekend slowdown in flu news.

Bird Flu prediction article from India.

News on 6,000 dead birds in Southern Vietnam, as the flu crisis in Vietnam worsens.

Recombinomics on the report from South Vietnam, and on the entire situation in the country and Asia.

The Daily Telegraph (UK) says China has "ruined" the best chance to stopping a bird flu pandemic.

Mort Zuckerman in US News and World Report has an excellent, not because its writing is new to anyone who is a frequent observer here, but because of who is saying it and where they are saying it. This is a must read.

Should we sound the alarm for a worldwide epidemic that might not occur? There is no choice with the avian flu emerging from Asia.

I call this the swine flu question, and I believe anyone trying to act seriously prior to the danger being obvious everyone will be stopped short by the Fox News set spewing mistrust of government and citing the swine flu situation. Leaders are needed.

Recombinomics finds news of hundreds of dead birds washing ashore on the Carolina coast, and says its a cause of concern.

ProMed Mail on the latest news.

Friday, June 17, 2005

June 17 Flu Update

Yesterday, Revere @ Effect Measure tantalized us with a promise of what he thinks needs to be done. Its here, and we're supportive. We'll try to continue to be a news resource to people. Don't forget, the web is about interaction...put your comments in.

The big news today is from Vietnam...

Physician in Vietnam catches bird flu. (This is a Stage 6 hallmark).

Just as alarmingly, Recombinomics reports that 23 new cases are in the hospital in North Vietnam.

Here's the original media report about the 23 cases.

WHO is reporting four additional cases.

Effect Measure writes, effectively as always, that its hard to tell if these are four new cases, some of the six announced yesterday, etc. (I thought it was just me).

Here is the single thing that got me interested in the flu.

Under the surface, the serious public health situation of responding to an impending pandemic reveals a deeper connection with matters of war, peace and crimes against humanity. Something to ponder, even as we scramble to prepare for avian influenza.

CIDRAP confirms that WHO doesn't know if these are new cases or not.

Recombinomics has the same complaints. Note this interview snippet at the start of the article.

LIZ FOSCHIA: The World Health Organisation says news of the infections is being reported locally in Vietnam.

Peter Cordingly is based in the organisation's Asia-Pacific headquarters in Manila.

PETER CORDINGLY: We've seen media reports of six people in a hospital in Hanoi being tested positive for H5N1. In fact we're not quite sure whether it's six patients plus one doctor, or five patients plus one doctor. The media reports are a little bit contradictory, and we don't have any official information from the Vietnamese to work on.

So basically we have to do our best guess work on this one. And this does worry us a little bit. If six people are infected in one hospital, this would be the first time we've seen this. There's no evidence so far, not even in the media reports, or anything we've seen to date, that suggests that there is human-to-human transmission going on in Vietnam.

But this one we will be looking at very carefully........

LIZ FOSCHIA: Is it the fact that it's a group of six people that's concerning?

PETER CORDINGLY: Yes. Clusters always send our blood pressure up. This is the biggest one. The previous one was five, so it's not an enormous jump, but they do catch our attention.

And we need to have very swift information on this, because while we don't know how a pandemic will start, it will almost certainly start through a cluster, so every cluster has to be very closely examined.

I should say that every one that has been closely examined to date has shown that poultry was the source of infection, and that may well be the case here as well. So basically we have to do our best guess work on this one. And this does worry us a little bit. If six people are infected in one hospital, this would be the first time we've seen this. There's no evidence so far, not even in the media reports, or anything we've seen to date, that suggests that there is human-to-human transmission going on in Vietnam.

Later in the day, Recombinomics wrote about wishful thinking at ProMed, and what could well be a "sudden explosion" of cases in North Vietnam.

ProMed has an update on the Vietnam situation that includes a short discussion of the efforts to model a flu containment strategy.

ProMed reports more on Vietnam.

Finally, Recombinomics has the story of a bird flu outbreak (non-human) in South Vietnam and works to connect the dots.

Other updates from yesteday....

I think the fact that tamiful was the only antiviral available for bird flu was well known, but the Washington Post today has a big story on how it got there. Apparently, the Chinese used it to treat chickens, against international convention. Interesting read, also provides historical context from SARS.

Recombinomics says that the resistance issue is a little more complicated than suspected.

The Guardian on flu incubators in pigs.

Story on a swamp in the Phillipines that hosts many migratory birds, could be flu hotspot.

India is wisely beginning meetings on the bird flu pandemic.

CIDRAP has the news of the Infectious Disease Society saying US tamiflu stocks are woefully inadequate.

WebMd picks up the Osterholm story from yesterday.

Thursday, June 16, 2005

June 16 Flu Update--"We're Screwed Addition"

"We're Screwed"

Dr. Michael Osterholm, Director, of Center for Infectious Disease Research and Policy, University of Minnesota, quoted in US News and World Report.

Comments on Effect Measure...

Minneapolis Star Tribune on the story flu on the same story. follows up with an angle you might not have production. Consider this from Dr. Osterholm.

Osterholm said the "just-in-time" delivery model by which modern corporations operate means food distribution networks don't have warehouses brimming with months worth of inventory.

Most grocery store chains have only several days worth of their most popular commodities in warehouses, he explained, with perhaps 30 days worth of stock for less popular items.

He pointed to the short-term shortages that occur when winter storms threaten communities, then suggested people envisage the possibility of those shortages dragging on for somewhere between 18 months and three years as the expected successive waves of pandemic flu buffet the world.

"I think we'll have a very limited food supply," he said in the interview.

"As soon as you shut down both the global travel and trade . . . and (add to it) the very real potential to shut down over-land travel within a country, there are very few areas that will be hit as quickly as will be food, given the perishable nature of it."

Meanwhile, back in Asia...

The news from Indonesia continues to reverbereate, here in USA Today.

As does the news from from inside Vietnam...

And here from

And recombinomics notes that a small correction in Promed might make all the difference in determining if we've hit phase 6 of the pandemic. The recent outbreaks in China corroborate indigenous Chinese Internet reports and are located near an H5N1 geese cull.

For reference, the six pandemic stages from wikipedia (note, six is the highest.)

This time, from Nepal, Recombinomics notes that there are unexplained diseases in Nepal on the flightpath of the geese that died in China. As you will recall, Recombinomics reminds us that the 1918 flu often presented with aytpical flu symptoms.

ProMed looks now at one step forward, one step back in China. Recently, a willingness to let the WHO in and, a chilling warning.

WHO says media reports of six news cases in Vietnam appear to be accurate.

Effect Measure notes that there is silence in Vietnam from officials...

And we close with an absoulutely fascinating must read on modelling from some people who know their stuff.

Wednesday, June 15, 2005

June 15 Flu Update--The Flu Finds a New Home

CIDRAP has today's lead story--human cases confirmed in Indonesia and six new cases in Vietnam.

Effect Measure on the same topic.

Washington Post on the Indonesian case.

Here's the original report from Vietnam.

Recombinomics on the new cases in North Vietnam, noting as did Revere, that this shows the spread of the mild, pandemic causing version. Also, probably means the case count is off.

Recomobinomics on the new case in Indonesia.

Next, Recombinomics says that there is a pneumonia cluster reported in China, but they're acting like it might be something else again.

ProMed on Indonesida.

ProMed on Vietnam.

The Phillipines are strengthening bird flu defenses in order to protect a small windfall they've experienced due to bird flu in other countries.

They are preparing for the flu in Naples, Florida.

The Scotman says the keep to stopping the flu is to share information.

H5N1 on the preperations in Vermont.

On a personal note, AvianFlu has a scan here of a story in Investor's Business Daily on flu blogs that mentions this sight, among others.

Tuesday, June 14, 2005

June 14 Flu Update

The Scotsman, perhaps the world's most loyal MSM flu outlet, has this on a conference in Liverpool on infectirous disease.

Here, we appear to have news of poultry in South Africa with H5...

Press Release touting good news on a recombinant flu vaccine...

CIDRAP yesterday on the downside of our Tale of Two Vaccines. Covered here are ongoing concerns about the Vietnemese human vaccine trials...

The seed virus used for Vietnam's vaccine was mixed with cancer cells to boost replication, and then grown in monkey kidney cells, a method the article describes as highly unorthodox. It is not the same seed virus as the one approved by the World Health Organization (WHO) for H5N1 vaccine development.

"People could get cancer from the vaccine," according to a TIME quote attributed to Klaus Stohr, head of the WHO's global influenza program.

I don't know how they will get this by the IRB, but I guess that's their problem.

WHO has an update with three new cases (mild) in Northern Vietnam.

Recombinomics on the cases in Northern Vietnam---note comment that they follow the North's trend of mild, wide clusters.

Recombinomics on the lack of H5N1 testing in India with meningitis cases.

A duck in New York has H7.

Recombinomics asks how we can contain a pandemic when we have no idea where it is.

ProMed Mail on the new WHO report.

Monday, June 13, 2005

June 13 Flu Update

A tale of two was the best of shots, it was the worst of shots.

They've been warned this isn't a good idea, but this article says the Vietnemese are going to test their vaccine on humans. Wouldn't it be ironic if human efforts to fight the disease actually caused a pandemic.

Here's the official story from Vietnam....they are thrilled with their success to date.

Science magazine says they are tracking the bird flu in China.

TIME magazine on the vaccine...

On the home front, a scientist at Wistar Institute has a lead on a long-last flu virus that would be effective against a broad range of strains.

Recombinomics on reports that the flu in China is much like one from the year before.

June 12 Flu Update

In Australia, they have a quick bird flu test developed.

Minimal German flu preperations are underway.

Baltimore Sun on Maryland's flu preperations. Recommended.

Interesting story from The Nation in Thailand on a volunteer health system they have set up for dengue fever, which is a model for H5N1. Except the volunteers say it doesn't work.

Recombinomics on the recombination of bird flu virues in China.

A clip:

These changes in the pathogenicity of H5N1 are due to recombination. Although the sequences have not been released by the Harbin lab in China, which used the sequence of the HA cleavage site to classify H5N1 isoalted from both outbreaks as HPAI (Highly Pathogenic Avian Influenza), H5N1 has been evolving and expanding its host range via recombination, ever since it was initially isolated in Asia from a 1996 infection of a goose in Guangdong.

H5N1 has Medline flu links, if you are interested.

Declan at Connotea has a link to web-published pandemic plans.

Epidemica on the latest from China, and what it means.

Sunday, June 12, 2005

June 11 Flu Update

The New York Times weighs in on the Chinese situation, with concern about the virus, but discrediting of the reports of human cses:

Note this:

For the last two weeks, rumors circulated on some Web sites tracking infectious diseases that more than 120 people, including six tourists, had died of avian flu in Qinghai, and that hundreds had been quarantined.

However, they all proved traceable to a site run by antigovernment dissidents, which said it could not verify information members had posted anonymously. Pictures on the site purporting to show hundreds of dead birds were grainy, and allegations that the site's "reporters" had been arrested were unconfirmed.

Effect Measure comments on the Times story.

Note Revere's further comments on the area where the reports originated, and what happens when trust is hard to regain.:

As we noted earlier, Qinghai province is a politically complex mixture of muslim, Chinese and Tibetan ethnicities, and the source of the reports was a dissident ex-patriate site that warned its reports were unverified. On the other hand, given the stakes, the situation and China's past record in the 2003 SARS episode, some amount of skepticism is warranted when Chinese officials deny such reports. It is a graphic example of the extraordinary difficulty of regaining trust once it is lost.

From England, a story on the bird flu fears, millions could die.

Hidden nugget here, WHO official acknowledges that transparency is important to fighting the bird flu.

A bird flu vaccine is a race against a clock, Thai response, which is gearing up to produce vaccine. They claim US efforts are not getting the job done.

H5N1 on the Thai story.

CBC on more bird flu cases in China.

Recombinomics reports on cattle dying mysteriously in India, wonders if anyone is checking for H5N1.

Saturday, June 11, 2005

June 10 flu update

Today's lead story is from WHO, which wants to go to China because the virus is so virulent there, in contrast to its human transmissibility characteristics in China.

"All of this shows the virus remains unstable, unpredictable and very versatile," Reuters quoted Omi as saying. "It may have new and unpleasant surprises in store for all of us."

Recombinomics on the WHO statement.

Here's a report from the Hong Kong business press on the WHO statement, courtesy of H5N1.

Yesterday, there was a report about the flu in Brunei. Brunei denies its there.

The Chinese are continuing to slaughter fowl to control the flu.

The CBC on more bird flu in China.

The Chinese say everything is under control.

Effect Measure reviews the Sharp anti flu air machine.

ProMed on the latest on those new/old cases in Vietnam. ProMed says the report shows these people were infected in May, not April as WHO said. They are not believed to be human tranmission cases. Finally, it notes that China has said it will allow WHO in.

Thursday, June 09, 2005

June 9 Flu Update

Confirmation that deadly bird flu has spead in China.

CIDRAP on the new outbreak in China.

Effect Measure on the new Chinese news.

In Chinese public statements, its important to read between the lines, as Recombinomics does here to relay that bird flu may be in Tibet, too.

WHO wants to visit Qinghai...finally.

H5N1 joins a growing bit of conventional wisdom that what's going on in China might be much ado about nothing. Note here.
Since such rapid and widespread infection and mortality are unusual with avian flu, it may even be that something else is behind the deaths. The article points out that H5N1 isn't known to exist in India at the moment, and infected wildfowl migrating from India would likely have died before reaching Qinghai.

Now there are dead crows in India, and Recombinomics thinks they should be tested.

Wednesday, June 08, 2005

June 9 Flu Update

Leading the news today, a WHO update. Three new official cases in Vietnam, with one death...after a lull. interprets the WHO report...not new cases, just cases moved from unofficial to official.

Recombinomics on the fowl cases in China. Its virulent, and the flu is normally asymptomatic in them.

Meanwhile, H5N1 reports an Asian news channel is reporting spread of bird flu to a new area.

From the story:

It was understood that there were about 1,042 geese with signs of illness, of which 460 died," the Hong Kong government information service reported late Wednesday, citing a spokesman for the city's Health, Welfare and Food Bureau.

Swiss company overbooked for sales of tamiflu.

ProMed Mail on the new report from Vietnam.

June 8 Flu Update

Recombinomics says the third Chinese photo listed below is doctored.

Sharp Industries of Japan has an air purifier that kills bird flu in a controlled enviornment. Its called the plasmacluster.

Mainland China says it would provide support to Hong Kong in the event of a communicable disease crisis.

Effect Measure on the Obama/Lugar OP-ed in the Times. They are complimentary of their effort, which advocates an internationalist approach and using our resources to stop the disease in Asia.

...the Senate Foreign Relations Committee unanimously approved legislation to direct President Bush to form a senior-level task force to coordinate US foreign policy on the threat of an avian influenza pandemic

H5N1 has an interesting article about collateral damage. When flu devours the healthcare resources of a country, what happens to people who are critically ill with other diseases? has this interesting set of commentary and new and improved translations from China on the unconfirmed reports there.

Tuesday, June 07, 2005

June 6 Flu Update

The Indianapolis Star has a story on public health's "Nip it in the Bud" plan

USA Today on the same topic....note the phrase "may be easier contained than originally thought."

Australia says its is prepared as it can be for bird flu.

Salt Lake City Tribune on bird flu

Monday, June 06, 2005

June 5 Flu Update

Recombinomics now has the local Chinese website which has been reporting the bird flu deaths and human cases now saying that those who posted the pictures to the web have been arrested. Again, none of this has been confirmed.

Recombinomics with another story on the reported arrests in China.

Finally, Recombinomics analyzes a third photo, shown below

Last week, we covered some criticism of Pennsylvania having secret pandemic plans. Now Effect Measure has discovered Ohio has done the same thing.

Saturday, June 04, 2005

June 4 Flu Update

Slow day would be an understatement.

ProMed mail with some reports from China.

Here's a flu distribution map which gives you a nice idea of the geography. Hint! Its clickable.

An interesting article from a new blogger, who is looking at flu as a wildlife issue. Here, he wonders, among many things, whether the H5N1, which is often in migratory fowl, was incidential to death of birds in China.

Foreign Affairs has this excerpt on the potential pandemic

Foreign Affairs on preparing for the flu epidemic.

Here's an excerpt:

The pandemic-related collapse of worldwide trade and its ripple effect throughout industrialized and developing countries would represent the first real test of the resiliency of the modern global delivery system. Given the extent to which modern commerce relies on the precise and readily available international trade of goods and services, a shutdown of the global economic system would dramatically harm the world's ability to meet the surging demand for essential commodities such as food and medicine during a crisis. The business community can no longer afford to play a minor role in planning the response to a pandemic. For the world to have critical goods and services during a pandemic, industry heads must stockpile raw materials for production and preplan distribution and transportation support. Every company's senior managers need to be ready to respond rapidly to changes in the availability, production, distribution, and inventory management of their products. There is no model for how to revive the current global economy were it to be devastated.

June 3 Flu Update

Recombinomics reports on photos of birds dead from the flu in China.

More updates, more photos from Recombinomics.

Recombinomics has an additional indigenous report from China that says hospitals are exanding their wards in preperation for....the flu?

A Doctor in Hong Kong is warning that taking needless tamiflu could hasten the disease's spread.

The CDC likes a Colorado program to track hospital patients in flu-like symptoms.

CIDRAP on the Chinese early warning system.

Friday, June 03, 2005

June 2 Flu Update

Unconfirmed reports continue to flood in from China...this one says there are 8,000 dead birds in China--Recombinomics on the case.

Work on Pandemic preparedness is beginning at wikipedia. Check it out here....

Thailand and Vietnam pledge closer cooperation.

Thursday, June 02, 2005

June 1 Flu Update

There are sick birds in Brazil, but they say bird flu has been ruled out.

New Scientist reports on the prospects of Tamiflu.

China is working on its early warning system for bird flu.

H3 bird flu in British Columbia.

We noted here a while back that Effect Measure wrote a piece on the Pennsylvania Health Department's Secret Flu Plan (he used the word "idiots") and now there's actually public outcry on the secret flu plan.

The Globe and Mail says pandemic planning is lacking (which may be why Pennsylvania wanted to keep it secret.

Effect Measure on the Canadian report.

CIDRAP reports on legitimate scientific information that grapes might help fight the flu.

Recombinomics reports on more unconfirmed indigenous reports on human disease in China.

The first MSM article on bird flu blogging.

Effect Measure recaps the 411 on tamiflu.

Wednesday, June 01, 2005

May 31 Flu Update

WHO says bird flu also endemic in Indonesia.

New Mexico making bird flu plans.

Vietnam preparing facilities for the next wave.

Recombinomics on the Indonesia endemic.

Effect Measure joins in as well.