Thursday, September 29, 2005

September 29 Flu Update

Nightline is kicking off an avian flu story as I write...

Effect Measure has a report on the number of cases in Indonesia (63), and a full accounting of the definitions of cases (confirmed, suspected, etc) and how discrepancies can emerge.

Here's a Forbes report confirmed the 63 number.

ProMed on the four new cases.

Along the same lines, VOA has this report where a WHO spokesman says flu cases in Indonesia may actually be overstated.

Recombinomics takes on the testing reliability issue.

Here's the WHO source report VOA was using.

WHO appoints Brit David Nabarro to lead world flu efforts.

CIDRAP on Nabarro appointment.

Nabarro says the potential exists for 150M deaths from bird flu.

He said this, too:

"We expect the next influenza pandemic to come at any time now, and it's likely to be caused by a mutant of the virus that is currently causing bird flu in Asia," he said.

Where have we seen this before? Indonesia embarks on eradication effort.

People in Asia are still eating chicken....

Vietnam says it is going to build two bird flu labs, constructed to International standards.

In Thunder Bay, Ontario, they are gearing up for the bird flu at local agencies.

The Pan American Health Organization released its pandemic response plan...don't expect too much.

Eureka, CA asks if its ready for the bird flu.

FoxNews has the news on scientists in a "desperate" race on the bird flu.

Very interesting article in MacLeans, saying that the real enemy is "fear." Without endorsing its claims, it is a thoughtful piece, especially where it talks about how secure societies actually seek out theoretical things to be afraid of.

Oh, and he had some comments on flu blogs.

Helping to accelerate bird flu mania is a growing band of flu bloggers -- techno-agitators and armchair epidemiologists who see each new flu report or update as a call to arms, and use their blogs as a medium to inform and scare the daylights out of each other. "I got on the pandemic flu beat in 1997 when H5N1 was first identified," says Virginia-based Melanie Mattson, a 51-year-old writer and the proprietor of the flu blog Just a Bump on the Beltway. Mattson feels the mainstream media isn't doing enough to warn the masses. She and others say we can't trust our public institutions to save us. (Just look at what happened in New Orleans!) "What we're trying to do," Mattson declares, "is save lives."

The amount of effort that goes into flu blogging is astronomical: one of Mattson's regular posters is a woman named CanadaSue, a nurse from Kingston, Ont., who has constructed a 23-part scenario that details what her city of 112,000 would look like during a pandemic. "Flu bloggers have developed a kind of online community," says Crawford Kilian, a 64-year-old communications teacher from Vancouver who started out blogging about SARS, but has since switched his focus to H5N1. "But now, after watching what's happened in New Orleans, I began biting my lip about 'what if' and 'what's more,' " he says. "What if we get something like a hurricane and we get avian flu? How do we cope with it then?"

Note that Crawford Killian is Crofsblogs. And there are no arms in the chair I use!

In Australia, they are pushing for over-the-counter tamiflu sales.

Recombinomics says there's a cluster outside Jakarta, which could indicate more evidence that Stage 5 is here.

Effect Measure has some very interesting news from a few scientific journals. What they say is that statins (cholesterol medicine) could help to prevent the cytokine storm that is believed to be a major factor in the bird flu virulence.

Majority Leader Bill Frist wrote this on bird flu in Washington Times--its not his first. The Senate passed avian flu spending bill tonight (for tamiflu), and this is not the first Frist has written on it. (Crofsblogs)

Helen Branswell of CP on the US vaccine article from yesterday.

Wednesday, September 28, 2005

September 28 Flu Update

In Australia, people are concerned about bird flu regulations--who will be the first to get Tamiflu and when.

Beijing unveiled its bird flu response plan. Readers will enjoy the DHS-like use of colors. Of course, what the world fears most is a lack of transparency. On this, the report says:

“The most serious level, red, will be announced in case of a consistent and rapid spread of new sub-type flu virus among the people, or if the World Health Organisation announces the outbreak of a flu pandemic,” the ministry said.

A red alert would entail daily public updates from the government.

More on preparation, this time in the Philippines...

and in the US, per the San Francisco Chronicle.

In Australia, the government says a pandemic isn't probable anyway.

More on South Korea's expected warning.

Also in Australia, the police are preparing to play a role in bird flu.

Forbes says there are 57 suspected cases of bird flu in Indonesia.

Another report says 54.

Crofsblogs has 4 cases outside Jakarta, via the Jakarta Post.

NAIAD announces funding for bird flu vaccine development.

Reuters notes that the key point to this vaccine is that it is "jabless."

CIDRAP gives a nice, layman-version of the new vaccine approach.

In Australia, they are asking people not to personally stockpile Tamiflu.

Here's an op-ed in the Jakarta paper on the bird flu.

Vietnam notes no flu cases in two months.

Indonesia has a bird flu prevention team.

Effect Measure on being "foolish" when looking at flu in Indonesia. Again, he notes that getting the real story is hard. Nonetheless: would be foolish to do anything but assume the evolving Indonesian story is anything but extremely serious and bird flu is possibly epidemic in the country.

Unfortunately, foolish attitudes are quite common these days.
Yesterday, we cited this editorial from Thailand on bird flu.

Today, Effect Measure wonders if it is thoughtful, or just provoking. Revere notes some questionable assumptions and other flaws in the editorial.

Recombinomics on the lack of solid data being generated in Indonesia--and therefore, a nagging sense of a problem without really knowing.

Tuesday, September 27, 2005

September 27 Flu Update

BBC News interviews Indonesians on the street about their feelings about the bird flu--bottom line is that they worry if the government can deliver.

On the funding front, ASEAN may be proposing a regional fund to fight bird flu.

In Singapore, scientists say they have invented a test to detect bird flu in birds in hours. This could clearly help surveillance efforts.

A scientist in Australia is urging her government to not rely only on Tamiflu, in the event a resistant strain emerges, as has been seen. This is an excellent point.

A physician in Manchester says his government is unprepared for bird flu....

while MEPs in Brussel say the EU has been too slow to act.

India continues to develop response plans for bird flu, directing Assam, one of its states, to develop a plan in advance of the arrival of migratory birds.

Wikipedia on Assam.

Hawke's Bay, New Zealand, is planning a desktop drill on a pandemic.

The Jakarta Post says there are some basic hygiene techniques which can help fight the flu, but no one was told in time.

More news on cases in Indonesia.

Alert reader send along the address of the WHO Director-General at the Pan American Health Organization. Its interesting...WHO is good at warnings, but never seems to think they're coming true. "A brewing storm," he says.

At the same meeting, Secretary Leavitt said that we are all global neighbors.

"When it comes to influenza, we live in a global community, neighbor to neighbor, because a threat against one nation is a threat against the entire world," he said. "Our task now is to make sure when the first influenza pandemic of the 21st century strikes, as it surely will, that the global community is ready. It may be H5N1 or something else."

A Chinese report on the four stages needed to fight the bird flu.

Singapore says Indonesia has a lot more work to do on the bird flu.

Recombinomics with some machine translated text on young brothers admitted to the hospital with flu.

He says:

It seems likely that the number infected at the zoo is large, and only the most severe cases are being admitted. The possibility of widespread silent transmission of H5N1 has not been adequately addressed. Zoo visitors with symptoms appear to be increasingly likely to be H5N1 positive.
Crofsblogs has South Korea planning a bird flu alert when migratory birds arrive next month.

The Guardian contrasts flu prep in Thailand as compared to Indonesia (crofsblog).

Crofsblog relays this from the Bangkok Post--a must read editorial.

The United Arab Emirates has a flu plan.

The Oakland Press (MI) has a story on tamiflu shortages.

September 26 Flu Update

Apologize for lateness, connectivity problems.

They are saying 42 flu cases in Indonesia, with 10 lab confirmed cases. There are now a total of six deaths.

Crofsblogs on the questionable translations of this report.

ABC News on the sixth death.

Recombinomics on the sixth death. Note also, that Recombinomics is always looking for 1918-style misdiagnoses that aren't in the numbers.

CIDRAP on the new death reports, and other news across the horizon.

The UN says that bird flu funding is perilously low, as countries focus on stockpiling Tamiflu rather than human and animal containment strategies.

The Foreign Minister of Australia says that Indonesia has been caught off guard by the bird flu, but is making progress now.

Hungary claims it could make 50M bird vaccines.

In Iran, they fear wintering waterfowl will bring bird flu. (Apparently, it was illiteration day at Reuters.)

In Russia, 14 towns are still under quarantine.

Bird flu affecting share prices in Indonesia, though not too much.

Time Magazine on how Indonesia's luck ran out on bird flu.

Jamaica considers its bird flu response, noting that it doesn't expect help from major countries who are unable to help themselves.

More communities could use this. The University of California-Davis is doing a community briefing on the bird flu today (Tuesday)

Interesting little snippet, as Tourism New Zealand wonders what it would do with foreign tourists in the event of a bird flu outbreak.

Countries are scrambling to track down tamilfu.

Helen Branswell, as usual, hits the nail on the head with this probing, insightful story on factors that are keeping new, cheaper antivirals from market.

Formulas for new, inexpensive influenza drugs that could expand the world's tiny arsenal of weapons against pandemic flu are gathering dust because the pharmaceutical industry isn't interested in developing them, scientists say.

They believe governments should fund the testing and development of the drugs, side-stepping big pharma and bringing them to market as cheap generic medications.

And they point to the story of Relenza - one of only four flu drugs currently sold - as evidence public-sector involvement will be needed if crucial new flu drugs are ever going to hit pharmacy shelves.

Mark von Itzstein, who led the team that invented Relenza, says he has three compounds that are ready to be tested in animals and could be available on a commercial basis in three to five years for about $10 a treatment course. (Relenza and the more popular Tamiflu sell for about $55 in Canada.)

But under the existing profit-driven model of pharmaceutical production, where the next sexual dysfunction drug is more highly prized than a new life-saving antibiotic, cheap flu medications simply aren't on the priority list.

Effect Measure on the Indonesian situation, and on actions finally being taken by that nation. (Note the quote of the day: "As long as you can't confirm something, it must not be happening.")

Effect Measure also found this excellent BBC report on the cultural bias against culling in Indonesia, equating it to killing people's pet dogs and cats in the US.

As I have said elsewhere, the flu virus will always find our political, cultural and moral weaknesses, like water finds a crack in the ceiling.

Crofsblogs on the problems with openness in fighting the flu--first Ibsen reference ever on this blog.

Crofsblogs on a NEJM article on probably H2H in Thailand.

Crofsblog has this on a National Geographic story on Killer Flu.

Dateline Jakarta, bird sales down, fish sales up (Crofsblog)

Sunday, September 25, 2005

September 25 Flu Update

China is cracking down on Internet posts that don' t provide "news."

Australia is searching entry bags and customs for bird, feathers and eggs. No one can say this king of thing wasn't predicted, and this is actually happening--not a doomsday scenario.

FYI, a reader sent me this by email:

This isn't a change in policy. It has been illegal to
import untreated animal and vegetable products into
Australia for many years. I know that they've been x-raying
all passengers' luggage for at least three years.

Boston Herald says that a bird flu pandmeic is inevitable, according to experts.

H5N1 is confirmed in an 8-year old boy in Indonesia.

Hong Kong is urging people to be on guard against bird flu--including staying away from chickens while travelling.

Australia is supplying medicine to Indonesia.

This news source says when a fresh supply of Tamiflu arrived in New Zealand, it was gone very quickly.

A Malysia newspaper tells its readers that a threat to humanity is right next door.

Recombinomics continues to collect and parse data from the zoo in Jakarta, and conclude that Phase 5 has arrived.

Effect Measure continues to criticize WHO for not taking a stand, and for protecting member nations.

ProMed on some cases in birds in Japan, and why the moderator thinks it was a result of an illegal vaccine.

Crofsblog has a survey of healthcare workers in New York--most would not come to work during a SARS outbreak.

Crofsblog also lines up the Jakarta Post, which has an update from today on the situation in their nation.

Saturday, September 24, 2005

September 24 Flu Update

ProMed says 17 people are hospitalized with suspicious of bird flu in Indonesia as of Friday. It also says the five year old girl who died did not test positive for H5N1.

Crofsblog has a media report saying 21 as of Saturday PM.

The Philippines are strengthening their efforts to prevent the bird flu there.

Swiss reports say their nation is part of a European effort to test migratory birds for bird flu. These results should be very interesting.

An Australian company says it expects to have a bird flu vaccine by August 2006.

Here's something we haven't seen before. Anxious Kiwis are causing a run on Tamiful in a town in New Zealand.

Cirekon (an Indonesian province) is looking to prevent bird flu from travelling in.

Thailand is planning a Regional Bird Flu Centre to coordinate activities.

The situation in Jakarta is causing a mixed reaction elsewhere in Indonesia.

Another article on "growing fear"--this time from Australia.

Business article on the litigation between the companies who are jointly involved in Tamiflu.

The Financial Times on the "nightmare scenario."

The Jakarta Post says people there are in a "fowl." Contains important to know reminders that chickens are a vital part of the economic survival of people there.

Recombinomics has the story you don't get elsewhere--increased admissions to the hospital in Jakarta.

Recombinomics says a total of 12 admissions linked to the Rangunan Zoo.

Effect Measure comments on the "Heading for the Hills" post we linked yesterday. (These are excellent--must read, especially Lisa the GP on why the virus could become more transmittable without becoming less virulent).

An oddly quirky ProMed post--on one hand, it notes that tourism is down. On the other, it says that hundreds showed up to watch a pig cull.

Promed on a recent conference in Russia, international cooperation, etc.

Crofsblogs has a story from Sri Lanka calling for education, but not panic.

Crofsblog on the belief among some that a 21-day window for supressing a pandemic exists--this is the containment strategy rearing its head again.

Crofsblog also has a post on the lack of information being provided to the nursing field on H5N1.

Crofsblog also found this--panicked Indonesians rushing a hospital ER. Gee, could this happen here?

The Future Pundit has attempted to estimate national Tamiflu stockpiles.

September 23 Flu Update

VOA says the world is "waking up" to the idea the bird flu isn't an Asian problem--insert WHO snooze alarm joke here.

VOA says the world is "waking up" the ide
ird flu isn't an Asian problem--insert snooze alarm joke here.

Australia is sending funds for tamiflu to Indonesia, but also warning its citizens not to travel to Asia without access to tamiflu.

Column from Australia combines the above story with the Lancet story on drug effectiveness, and gets a nice result.

Italy budgets 20M Euro to the bird flu.

Indonesia is "beefing up" (unintentional MSM meat-pun) its bird flu protection efforts.

US and Japan are offering technical aid to Indonesia.

Canadian Press story (non-Branswell) notes the transformation of tamiflu from obscure medication to world wide star.

Australia is attempting to use border checks to help protect against the bird flu.

Shocking--there are expected tourism losses in Indonesia.

Canadian take on the lancet story.
In Ireland, the media notes that avian flu could swamp the NHS.

WHO has warned Indonesia of more deaths on the way.

Vietnam says it has things under control, and is working on a vaccine (?!)

From Berkeley, CA--its just a matter of when.

Sanofi-Aventis is expecting more orders of its bird flu "vaccine."

Recombinomimcs on the emergence of new cases in Indonesia--zoo related.

Usual excellent Effect Measure post, on heading for the hills in a pandemic. Bringing Shakespeare and the evacuation of Houston to bear, Cervantes wonders about public panic in a pandemic, and notes that its key how it is communicated. Finally, he wonders if people are thinking this through.

Cervantes also notes (on Effect Measure) that if Indonesia suffers financially from its bird flu outbreak, other nations may be less transparent.

Recombinomics has other machine translations of reports of new admissions.

Crofsblog has this on the bird flu being declared endemic in animals in Indonesia.

Crofsblog on a conference in Pittsburgh that looks at the effects of a flu pandemic.

Crofsblog also pointed readers to this--a US State Department page that says it has "removed" an Indonesian alert about bird flu.

Friday, September 23, 2005

September 22 Flu Update

WHO announces a new case--a young boy--in Indonesia.

CIDRAP has this as well--noting that Indonesia says lab reports say the virus has not mutated.

Australians living in Indonesia are putting a run on supplies to fight bird flu.

Australia notes bird flu is on the door step.

There was another bird flu death in Vietnam.

WHO says the increase in cases in Indonesia could be an effect of increased surveillance.

The Economist on preparing for the pandemic. Good overview, with a good metaphor. Scientists are running a marathon with new technology like universal vaccines, but the H5N1 is a sprint.

EU experts were convening in Brussels Thursday to talk flu.

While the EU experts were together, they talked coordination.

WHO update 31 says there is "no evidence" that the virus is spreading "easily" from person to person.

Effect Measure wishes we had someone like Tom Ridge at WHO.

Effect Measure writes about WHO, calling them the World Reassurance Organization. States view that efficient transmission is going on in Indonesia, and wonders what WHO/WRO would have to see to change its view.

The head of the Pandemic Panel in Australia says that he has "been advised" that the pandemic has not started.

Here's a local Wisconsin story on the Lancet drug resistance research.

In Australia, a firm is starting a trial of bird flu vaccine.

A paper in Charlotte, Florida wonders if tamiflu will equal survival.

Nice article in the Bangkok Post notes more on the debate over migratory birds.

County Health Official in the US are calling for a universal vaccine.

Understatement of the week--CNN reports UN as saying flu could be worse than SARS.

Recombinomics has this machine translation of a post that says 115 people with mild symptoms who had visited the Ragunan zoo were turned away from the hospital.

Recombinomics also claims there were nine other admissions today, based on a machine translated post. His view is that the epidemic is racing toward Stage 6.

ProMed on the cull in Indonesia, and the debate within the veterinary community about whether to not respond.

ProMed notes that other Asian zoos might want to protect their bird exhibits from what occurred in Jakarta.

ProMed on WHO blaming "age old" farming techniques for starting flu, launches five year plan to remove this virtual flu petri dish from the world.

ProMed runs the gamut on the news, with its usual cautious commentary.

ProMed on the Dutch lifting their controversial "indoor chicken" rule, and other vet prep in Europe.

Crofsblogs has the latest from Helen Branswell, which is a computer model which says border screening will not work.

Crofsblog is quoted in this community story in Vancouver, but wants us to note the medical community remains divided.

Wednesday, September 21, 2005

September 21 Flu this it?

Big, big news day. Be sure to read all the way to the end...some of the biggest stories from today where not from Indonesia.

Early today, the Indonesian Health Minister said bird flu an epidemic in her country.

"This can be described as an epidemic. These (cases) will happen again as long as we cannot determine the source," Supari told reporters, but she insisted it would be wrong to label it a "frightening epidemic".
She later retracted that statement, saying if things worsened it would be an epidemic.

Helen Branswell of CP says WHO is trying to "dial back" concern.

Despite reports of a number of suspect cases, there are currently no plans to convene the meeting of experts that would be needed before the organization could declare the world had moved one step closer to a flu pandemic, Dick Thompson said from Geneva.

"We're not anywhere close to that. We see no relationship between any of these ... suspect cases," said Thompson, communications director for the agency's communicable diseases branch.

"The level of anxiety is higher in Indonesia. It is not in Geneva."


Thompson also moved to dispel reports the WHO was getting ready to deploy a supply of antiviral drugs to Indonesia.

The WHO has been promised a stockpile of three million treatment courses of the drug oseltamivir or Tamiflu to be used as a pandemic fire blanket. The agency has committed itself to trying to stop or slow a pandemic once a strain emerges that seems to have the capacity to spread in sustained fashion from person to person.

Thompson said a small number of treatment courses were sent to Indonesia in July when a cluster of what were thought to be three cases in one family was identified. But there are currently no plans to draw down the stockpile for Indonesia, he insisted.

"No, definitely not."

Indonesia will cull where the bird flu is most intense.

Lost in all this is another bird flu death, a young girl.

ABC News has the story on the Indonesian crisis.

ABC News also has this--is it cause for alarm?

CIDRAP on the fears in Indonesia.

Effect Measure on whether Indonesia is boiling, or simmering.

Effect Measure on international experts converging on Indonesia.

Recombinomics has this concern on a false positive.

Recombinomics on three new admissions in Indonesia.

Not surprisingly, Recombinomics says the events in Indonesia are due to recombination.

Recombinomics says that a young girl was denied admission to the hospital in Jakarta, based on a machine translation.

ProMed on the Indonesian situation.

More from ProMed on Indonesia.

From Australia, the question over whether this is the start of pandemic.

Two of our favorites, Michael Osterholm and Helen Branswell, did a symposium last night at the Wilson Center in Washington. Here's the audio link, here's the video link, and here's the .ppt.

Here's a news story from VOA on the event. Every word is a must read.

Osterholm said:

In general terms, we are not much better able to handle acute respiratory distress syndrome, in any number of cases today, than we were in 1918," he said. "So, do not go back and say, well, it is different today, it is not 1918. Unfortunately, folks, it is 1918 all over again, even from a clinical response standpoint.

Outside Jakarta, the Irish decided to test their culling prowess by taking out 10,000 birds.

Malaysia says it is flu-free, despite being a neighbor of Indonesia.

Annals of Internal Medicine has this editorial, which is a reasonable assessment, if a little conservative. They note at the end that the recommendation is enough Tamiflu for 50% of the US population.

This might be the most important article today. For those who think (or whose friends tell you) that the vaccine is on the way, the New York Times has this from the vaccine front. Two studies in The Lancet point out the weaknesses of the approach.

Even so, the research is alarming because it demonstrates how quickly and unexpectedly flu viruses can become impervious to medicines once they are put into common use, as they would be in the case of a pandemic. Also, at their best, antiviral medicines do not cure influenza. They cut down on transmission of the disease and reduce somewhat the symptoms and complications in those already infected, including the high rate of associated pneumonias.

Called for comment, a spokesman for the World Health Organization, Dick Thompson, said that the group could neither support nor deny the findings of the analysis of vaccine studies at this point, noting only that some experts criticized the researchers for "not including some important past studies" in their sample.

Helen Branswell has her take on the same story.

Reuters on bird flu fact sheet.

The Houston Chronicle says that the Bush bird flu speech was for the birds.

Effect Measure has a Nature article from Declan Butler that says the US doesn't live up to the sharing of data called for in the Bush UN Address.

Tuesday, September 20, 2005

September 20 Flu Update

Indonesia is planning a major "cull," somewhat against their best wishes. (Sandman says we should say they plan to "kill a bunch of birds.")

The OIE notes that the world might be better served by spending a little more on the animals to keep it from spending a lot more on the people.

From Forbes, a WHO expert notes that once the pandemic hits, there are only 2-4 weeks to contain it--and it will probably take that long just to figure out its happening.

Oshitani said that in some affected countries like Cambodia and Vietnam, detection of bird flu cases could take weeks, if not months, making containment all the more difficult.

'So we have to implement some control measures in a very short time period,' he said, adding, though, that a human vaccine could take months to develop, by which time the disease could have spread uncontrollably.

'A prototype vaccine is available but the problem is the vaccine strain is based on the virus isolated in Vietnam last year. The virus continues to change and we don't know which virus will cause pandemic,' he said.
EU tells farmers to prepare for bird flu--be ready to surveillance and mass culls.

US has some work to do at the APEC summit--pushing for further action at the source.

Indonesia stocks tumbled--a sign of things to come.

This story warns of two more cases in Jakarta, but those may be the two zoo workers we reported on yesterday.

CIDRAP on the zoo workers.

This story is an interview with Micah Fink, the producer of PBS Documentary H5N1:killer virus.

PBS Link to documentary. (I missed it--did anyone see it?)

Vietnam is now vaccinating all poultry.

The Independent in the UK answers readers questions about protecting themselves from the bird flu.

The Miami Herald has a nice story, titled, "The Next Flu Pandemic. Are we ready? (You don't want to know).

Recombinomics says there are three zoo workers in the hospital.

Effect Measure has an excellent post. First, he asks what if bird flu is transmitted through feces rather than air droplets. Then, he notes that past pandemics have come in waves, and what if we already had the weak wave.

Effect Measure summarizes and comments on what we know in Indonesia.

Recombinomics on the emerging clusters in Indonesia.

Recombinomics says Phase 5 Flags are raised in Jakarta.

ProMed has the Dutch advice to the Indonesians--they once had HPAI at a zoo, too.

Crofsblog has a nice, reflective post, similar to the thoughts I have been having as I wrote this tonight.

Maybe we'll look back on the summer of 2005 the way our grandparents and great-grandparents looked back on the summers of 1939 and 1914: as the last sweet summer before the darkness. I hope I'm mistaken.
Check this site out--he's grabbing our whole update everyday!

Monday, September 19, 2005

September 19 Flu Update

The keyword for today's news is "Jakarta." More on the zoo closing.

Three children are hospitalized in Indonesia with suspected bird flu.

Recombinomics has a later report that says four children are hospitalized.

The Health Minister in Indonesia says bird flu is an "extraordinary national case."

CIDRAP on the Indonesian situation.

Recombinomics on reported cases among children in Indonesia.

Recombinomics says two zoo workers are H5N1 positive.

Recombinomics also says that there are asymptomatic birds at the zoo.

ProMed on the zoo story. Note the mod comments asked how the birds were infected.

Effect Measure on whether human-human transmission is underway in Indonesia.

ProMed says Indonesia is reporting that 15 neighbors of the sick people all tested negative for H5N1, meaning the disease is still not easily passed from person to person, in their view.

ProMed notes that the reports of hospitalized children are perplexing.

Another warning from a WHO official.

Vietnamese farmers are on the front line of the bird flu fight, but they note that its a world-wide fight. Nice Reuters story.

Vietnam is importing more vaccine, as well.

In the Altai region of Russia, bird flu restrictions are staying in place until the cold weather hits.

Julie Gerberding of CDC is the next to sound the alarm. She says:

"We've never seen so much influenza in so many birds in such close proximity to humans in so many places," said Ms Gerberding. "If ever there was a time when the risk [of a pandemic] was higher than usual it is now."
This story is on preperation in Australia, including quarantining entire airplanes of travelers.

IC Wales has fact and fiction on bird flu.

WHO Situation update says a man who died in Vietnam in July is now confirmed as H5N1.

ProMed reports this, with an updated tote board.

There's been a business recovery for the manufacturers of Tamiflu.

In a related story, WHO says it is not looking for a generic Tamiflu.

Recombinomics notes that bird flu may have been imported into Kuwait.

Sunday, September 18, 2005

September 18 Flu Update

At 9:02 pm EDT, this was the most viewed story on Yahoo! News.

Even though its the only place in the world with known emerging human cases, it has problems getting medicine to the right places.

A big flu meeting is coming up this week. Vigilance and prevention are on the agenda.

The Ministry in Jakarta believes one of the cases we reported here in the last 48 hours is H5N1.

There is a suspected case in Indonesia--a child.

Forbes reports two new children sick--and closing of the zoo in Jakarta because of 19 dead birds.

Recombinomics comments on the new cases--and the Zoo--in Indonesia.

An earlier Recombinomics story on the Zoo in Jakarta.

Recombinomics says the situation in Indonesia is approaching Stage 6.

Check here to see what Stage 6 is.

Oh, they are vigilant in Brunei. Are they ever.

A symptom of things to come? In Bangladesh, they banned the import of chickens in various forms to protect against the flu. Now, the spectre of trade laws is being raised.

Thailand says no human cases in 2005.

A new flu test in Pleasanton, CA, promises to cut the detection time to a couple hours from days. Obviously, this could be helpful in the government's containment strategy.

ProMed on the Jakarta Zoo.

ProMed has the story we had earlier in the week that said LPAI could be transmitted to people.

ProMed on the plan to move chicken farms outside the city---their mod thinks its a good idea.

ProMed on the new cluster in Indonesia. One of the children was a neighbor to the woman who died.

September 17 Flu Update

Indonesia continues to promise tough action on bird flu.

The Health Minister in Italy says we should be cautious, but not alarmed.

Bush Flu Alliance--Australia is in!

Local story from Raleigh-Durham (NC) on worries about avian flu.

Canadian PM Paul Martin says the Canadian Flu Conference will show how the UN can work.

Here's one you are going to love. Bill Mattos, President of the California Poultry Association, says no one needs to worry about bird flu hitting California.

Austin local TV has an avian flu story.

The Talking Points is one of the highest-profile political blogs, and Jae Kennedy writes in the Talking Points Cafe about the story, how the Democrats should respond, but with a strong air of "this is all chicken little".

Recombinomics on the continued spread of wild bird flu.

Recombinomics on a sixth potential case in Indonesia.

Here's an interesting Recombinomics report on using Tamiflu/amantadine in a cocktail to get the effects of both approaches.

Recombinomics--the fifth case in Indonesia is confirmed.

A US delegation is heading to SE Asia to increase surveillance.

Crofsblogs has this report on the Indonesian idea of moving the chicken farms outside the city.

Crofsblogs also found this, a British report which mirrors the recent Canadian report predicting mass economic chaos if the pandemic hits.

Saturday, September 17, 2005

September 16 Flu Update

Yesterday's big flu news, really, was that ABC News Primetime did a story on the potential for tamiflu shortages.

UPDATE: This is nothing new for long-time readers, but this article is a must-read for anyone who wonders what the fuss is about. These people are not nuts--Bill Frist, Foreign Affairs, Dr. Osterholm. These people in the mainstream are talking about casket shortages......

Although Recombinomics still says they got it wrong, it has driven people to seek info on the web about AI, including here. People in the blogosphere are negative about the MSM, but they still have the power to drive mass audience. Crofsblog wrote on this here and here.

Speaking for ourselves, we had the most hits we had in a single day since we were linked on in February of this year.

So, if you're here because of the ABC story, welcome. Feel free to look around, and check back often. We update flu news links every day. Thanks for your interest.

The IHT notes that with repeated strong statements from WHO in the past week, and President Bush's address at the UN, the global drive on the bird flu is stepping up.

Reuters has this on business preperation for the flu--companies may be preparing more realistically than government.

As if on cue, Italy is stepping up its bird flu protection.

In Australia, bird smuggling is discouraged.

Russia has backed President Bush's flu partnership plan.

Australia is also joining the global flu fight.

Vietnam says September has brought no new cases of bird flu.

WHO update 29 confirms that the Indonesian case was H5N1.

Glaxo gets some local pub in Philly for being part of Presidential Pandemic Plan.

The New Scientist says that trials of a low-dose H5N1 vaccine are underway. If you will recall, amidst the media celebration of August's vaccine news there was the cautionary tale that the promising results were generated by giving two 90-microgram doses four weeks apart. Trials today include doses as low as 3.5 micrograms.

CIDRAP on the US flu plan.

CIDRAP on the confirmed death in Indonesia.

Recombinomics says 16 nations have hopped onto the President's plan.

Recombinomics has the news of the concerns raised by the confirmation of H5N1 in Indonesia.

Recombinomics also says the Indonesian case is a geographic cluster.

Effect Measure comments on the Canadian flu conference story we ran a couple days ago.

ProMed on the Indonesian confirmation.

Crofsblog notes that Bloomberg has stories of a fifth case in Indonesia.

Friday, September 16, 2005

September 15 Flu Update

Here we go...mass production of flu vaccine set to begin, US orders $100 million.

Forbes on the business side of this deal--delivery supposedly by the end of October.

The EU Health Commissioner warns Europe is not ready for the flu vaccine.

WHO again issues stern warning on flu.

Reuters feature on St. Jude's at the front lines of the flu war.

Here's a State Department link to a press release on the bird flu announcement President Bush made at the UN.

Effect Measure would like some specifics, but isn't too dismissive.

Recombinomics reacts with approval to the Bush plan.

Several bloggers have noted that Cherthoff was reportedly distracted from the New Orleans flooding by a meeting on bird flu (imagine the odds!)

Crofsblog has this from a doctor in Pittsburgh, who draws lessons from the bird flu from Katrina.

H5N1, Silviu, has this on Doctors in New Jersey acting as "Sentinels."

Three states in Germany have asked farmers to keep their chickens protected in structures or similar area.

US has promised to fund $2.5M for Vietnemese surveillance.

Bird flu is having a chilling effect on the Falcon hunting industry.

A new village is struck by bird flu in Russia.

This is an interesting Reuters story on the "over-reaction" of the Dutch government to bird flu. Remember--there's been bird flu there before, and it adds context.

Senior officials in Asia are endorsing bird flu plans.

There are waiting lists for Tamiflu in Scotland.

Recombinomics writes about viral influenza deaths in Nepal, and how they should be verified.

Recombinomics also sees some wild bird deaths in Japan, and wonders if it signals H5N1 there.

Recombinomics has 31 chickens dying of H5N1 in Chelyabinsk, and wonders if this puts the disease to the Caspian Sea.

Here is wikipedia on

Finally, if you listen to the podcast This Week in Tech, you will be familiar with the cutting humor of John Dvorak ("He gets no Spam!") Anyway, he blogged on the flu, pointing out a key thing from other comments based on the President's comments. You can't vaccinate after the disease hits, and we're not good at prevention.

Wednesday, September 14, 2005

September 14 Flu Update

In China, an expert is warning of a flu pandemic, and he's the same guy who blew the whistle of SARS.

Jakarta is offering free medical treatment to anyone with the flu.

The EU is urging governments to purchase flu medication before the pandemic hits.

There's an herbal brew remedy to the flu in Jakarta.

The BBC has a story which is very good. It talks about the rapid spread of the bird flu if clusters in Asia got large, and how, essentially, nothing could be done about it.

Dr Edmunds said: "This time we would expect it to be spread more quickly than it did last time because we have a lot more flights and there's a lot more contact between people these days.

"If it's spreading widely in south east Asia, then a few weeks is really all we could expect before the pandemic arrived here.

"So there isn't much time."

But he said analysis showed travel restrictions were likely to buy very little time, and be very expensive.

Screening people coming into the UK would be "very ineffective", and likely to pick up few cases because during a flu pandemic, people with symptoms would not be allowed to board a plane anyway, he said.

But many of those who did travel could be incubating flu but not showing any signs, meaning screening, say for high temperatures, on arrival in the UK would not stop cases getting through.

Dr Edmunds said: "There is only one thing that can be done to stop it, and that is to stamp it out at source and if you're lucky you can stop a pandemic developing at the source."

A Helen Branswell story is always welcome---this one is on a recently announced International Flu Conference in Canada.

Good news--the ostrich population in South Africa is bird flu free.

In Thailand, they feel like they are making progress on a flu vaccine.

Recomobinomics writes that the lack of human cases in Indonesia could be a lack of testing.

Tuesday, September 13, 2005

September 13 Flu Update

Chapter 85 of the "dead birds don't migrate" debate resurrects the argument over whether migratory birds are spreading the flu. Recombinomics feels strongly that it is, and he's being broadly attacked on some message boards (ridiculed, really) for these beliefs.

I'm not here to sort it out. But let's look at what National Geographic (presumably a credible source) has to say (Answer: nothing definitive, but they clearly take the idea seriously).

But there is another possible carrier of the virus far more difficult to control than domesticated chickens: migratory birds.

Migrating birds may have caused the outbreak of avian flu that killed thousands of domestic fowl in Siberia this summer. Scientists have also found birds on Lake Qinghai in China, where many birds come to migrate, to be infected with the strain.

If avian flu is introduced to North America by migrating birds, "Alaska is the most likely state where it would first arrive, because that's where the … flyways intersect," said Hon Ip, director of the U.S. Geological Survey's (USGS) virology lab in Madison, Wisconsin. His lab is handling some of the tests.


Recent outbreaks of avian flu in Kazakhstan, Mongolia, and southwestern Siberia in Russia have been attributed to H5N1. The incidents mark the first time the virus has extended into the regions, though there is no confirmation that migratory birds brought the disease there. But a study of birds found sick or dying on China's Lake Qinghai last spring showed that they carried H5N1. The lake is a breeding center for migrant birds from Australia to Siberia.

So far, there is no evidence of avian flu in North America. But Ip worries that it might just be a matter of time before the disease spreads out of Asia.

"The longer the virus persists in poultry, the greater the chance that, at some point, it will spread to species of wild birds that can carry the virus to new areas," the USGS virologist said. "It is like playing Russian roulette—time is not on our side."

Reuters says that the bird flu exposes a rich-poor gap in the world.

Indonesia is aggressively checking people who had contact with dead woman for bird flu.

Italy is allocating more money to bird flu.

A quarantine remains in effect in Russia.

A researcher at Purdue has a novel vaccine delivery technique for the flu.

Purdue molecular virologist Suresh Mittal and his collaborators are investigating a new way to provide immunity against avian influenza viruses, or bird flu, the most lethal of which, H5N1, has a 50 percent fatality rate in humans. Under a $1.6 million grant from the National Institute of Allergy and Infectious Diseases (NIAID), the researchers are focusing on using a harmless virus, called adenovirus, as a transmitting agent for a vaccine to fight off highly virulent strains of the avian influenza viruses.

<>Current vaccines are designed for strains of flu found in local areas and are effective only as long as the virus doesn't change form. Existing vaccines will have limited success against new strains of avian influenza, he said. Every time a bird flu mutates, vaccines must be redesigned.

<>Australia says bird flu could kill more than terrorism.....I guess you have to put things in relevant terms.

There's an influenza conference in Malta. They are worried.

Vietnam media story on WHO Official Margaret Chan speaking out on flu.

CDC Influenza Branch Chair Dr. Nancy Cox will chair the Options for the Control of Influenza VI International Conference in Toronto, Canada, June 17-23, 2007.

Must-read from the Orlando Sentinel. Takes the Effect Measure message of Katrina as metaphor for flu preperation, and shows how unprepared we really are for things that upset our systems.

Roche presented a paper at Malta, which said that two studies show Tamiflu reduces death from flu.

Recombinomics writes that investigations in Jakarta are slow and incomplete, marked by false reassurances to the public.

CIDRAP reports on a European paper that, for the first time, shows that people can catch LPAI as well as HPAI.

Effect Measure on the Chan comments.

Crofsblogs has this from Marc Siegel, who says we always fear exotic stuff more than everyday stuff and that the avian flu today won't evolve like the 1918 flu, which took advantage of war conditions. I could swear I saw this somewhere before, but I can't figure out where.

Monday, September 12, 2005

September 12 Flu Update

More on yesterday's Indonesian flu death--reported first from Jakarta.

Calm is urged in Jakarta.

Conversely, WHO is saying to expect more cases in Indonesia.

CIDRAP reports the new death.

Recombinomics reports that the dead woman was an immigration agent.

Recombinomics says there is minimal monitoring of bird flu in Indonesia.

Effect Measure writes on the insistence in the country there there is NO human-human transmission.

ProMed covers this story as well.

Margararet Chan of WHO says there is still time to stop the flu--or its spread, but that the signals are worrisome.

Reuters with an ongoing story on Europe's anti-flu actions.

Russia continues to say bird flu is subsiding there.

Reuters on the perfect incubator--China.

The Times unleashes the Urban Worrier on bird flu.

An upcoming medial conference will feature results from nano bentonites, which reportedly have anti-viral capability.

For those of you who wondered what the hell a bentonite was.

The University of Georgia College of Veterinary Medicine has research on a new vaccine for birds.

Recall last month we posted a link to a Canadian investment firm which had discussed the economics of the bird flu--here is an interview with the authors, via crofsblogs.

Sunday, September 11, 2005

September 10-11 Flu Update

There is a suspected bird flu death in Indonesia.

Recombinomics has his take on the news from Jakarta.

Effect Measure comments as well.

ProMed weighs in, too.

The pressure is on to prepare for bird flu in the United Arab Emirates.

Recombinomics on false negatives in Indonesia and the concerns that creates.

Crofsblogs has a take on an angle that has been discussed before--that in a flu crisis, your healthcare workers may not show up for work.

Crofsblogs also has The International Herald Tribune saying that US and China might be signalling bird flu cooperation.

Here's a Chinese media story on the same topic.

Crofsblogs tracked down this from Business Week Online, which has a scenario of an American businessman bringing the flu home from a business trip to Vietnam. Interesting, and, as pointed out, helps to put flu in the minds of the US private sector.

In our first ever ESPN link, the flu brought an early bird season to Russia.

WHO is urging Asia to do more.

Saturday, September 10, 2005

September 9 Flu Update

Flu resistant to Amantadine is spreading, according to research published by the St. Jude Children's Hospital in SE Asia.

In Australia, there is criticism of the government over its bird flu complacency.

Here's an interesting one from Taiwan. This column makes the argument that Taiwan shouldn't prepare for the bird flu.

An article in Science this week is calling for a global surveillance network for all animal infections. Article notes that as many as 70 percent of infections come from animals, and also notes slow reporting in Asia of SARS and flu.

Holland has ordered more tamiflu. If they ever receive their order, they will have enough for 30 percent of their population.

CIDRAP on the WHO warning from this week, more sick birds in Thailand, and the Netherlands Tamiflu order.

CIDRAP writes on a CDC report that calls for more resources to quarantines--meaning, in this case, the entire nation at its ports of entry.

"CDC quarantine stations and the broader quarantine system serve as the nation's insurance policy against catastrophes that might arise from the importation of naturally occurring infectious agents, such as the SARS virus, or man-made threats like an attack using a dangerous biological agent," Georges Benjamin, executive director of the American Public Health Association and chairman of the committee that wrote the report, stated in the news release. "But no single entity currently has the responsibility, authority and resources to orchestrate all the activities of the quarantine system and the traditional responsibilities of quarantine personnel are no longer sufficient to meet the challenges posed by the rapidly increasing pace of global trade and travel and the emergence of new microbial threats."

Recombinomics notes more wild bird flu in Tomsk, Russia.

The ongoing ProMed "dead birds don't migrate debate" goes on, with NPR running a story which features the claims of some scientists that migratory birds don't present a threat. This link leads to a transcript which includes a direct audio link.

Note this:

Karesh: We picked Mongolia because it was right in the middle
of those 2 outbreaks, halfway in between, and we figured
same birds are in Mongolia that are in both Russia and China.

KNOX: Karesh's group counted 55 species of wild birds on
the Mongolian lake...about 65 000 individual birds.

Karesh: None of the healthy birds so far have turned
up to be positive. The live birds don't look like
they're positive. It's only in one dead swan that
we actually found the virus.
The Village Voice has a review of "The Monster at our Door" which is available through Amazon by clicking the link on the right hand side of this page.

Silviu looks at a couple papers which show worrisome changes in the H5n1 virus.

Friday, September 09, 2005

September 8 Flu Update

As the Dutch go...Germany has two states now requiring chickens to be kept in pens.
Recombinomics has the same story, saying move is "wise."

According to this report, Iran has banned wheat from Kazhakstan due to bird flu

Russia reports no new cases in Altai.

However, ProMed cites a report that says that in addition to earlier reports of bird flu in 47 villages, there are another 80 with suspected bird flu problems.

In what I suspect is a translation error, a Morrocan official is quoted as saying his nation is no longer "subject" to the bird flu.

Helen Branswell (Fluitzer nominee) covers the GSK purchase of a vaccine producer, cited in this space yesterday. The company purchased was Canada's only native vaccine producer, and government officials are sure all its contracts will be honored.

Effect Measure on yesterday's "Stage Four" story from WHO.

H5N1 has two links to FAO reports on migratory fowl and bird flu.

H5N1 also has the Guardian, saying that were scaring ourselves into inaction.

Check out this site, noted in comments yesterday. Good bird flu coverage.

Wednesday, September 07, 2005

September 7 Flu Update

Another slow, slow news day.

BBC says Northern Ireland has a low risk of bird flu, though they are carrying on some wild bird surveillance...hear that ProMed?

WHO says a flu pandemic isn't an "if" its a "when." WHO also says that only Thailand is preapred to deal with it....

"We may be at almost the last stage before the pandemic virus may emerge," Dr. Jai P. Narain, Director of WHO's communicable diseases department told a news conference on the sidelines of a Southeast Asia health summit in the Sri Lankan capital.
Glaxo Smith Kline is acquiring a vaccine company in order to increase its production capacity.

Yesterday, we talked about a report from Europe on the bird flu threat, one that idenfied that some areas of Europe are at higher risk than other areas. Effect Measure has its take today.

The "Dead Birds Don't Migrate" debate continues at ProMed.

ProMed asks if there is evidence that domestic chickens could also be a reservoir for flu.

Tuesday, September 06, 2005

September 6 Flu Update

In Finland, they've hatched a theory that you can avoid the bird flu by baking it in a sauna. Fight the flu with someone you love.

The BBC wonders if Pet Fairs might be a source of bird flu.

Reuters had this updating Europe's response to the bird flu. One interesting point--they do recognize that lifestyles in some European countries make them more susceptible than in other countries.

In Poland, they are closely watching for bird flu. They have containers at the airports for non-EU tourists to throw their meat into.

India and Bangladesh are flu free todate, but how long with that last?

In a press release, Ampligen is said to make tamiflu more effective against avian influenza.

Wabash IN has a story on the flu pandemic.

Medical News Today says that bird flu in Russia may be sensitive to Amantadine.

Crofsblog has this--bird lovers deny birds start bird flu.

The Opposition Tories in the UK are criticizing the government on bird flu.

Al Jazeera has a story on the flu pandemic (via Crofsblogs).

Monday, September 05, 2005

September 5 Flu Update

A 1.5 million bird cull is on tap in Japan.

Ulster is planning to spend 5 million pounds on flu protection.

Interfax says no change in flu status is Russia from 9/2-5. This is odd, since yesterday there were claims that things were getting better.

Similar Russian wire report says bird flu in 45 villages.

The Scotsman has an article by Joel Levy, who has written a new Doomsday book.

The BBC weblog feature looks at flu blogs, beginning with the Nature mockblog from this summer, and then looking at what's behind the bird flu blogs, mentioning several by name, though not this one!

Dutch farmers are speaking out against restrictions in place from the Dutch government.

Yesterday, we had a piece saying that a Thai expert had said that the pandemic had crossed in Phase 4. Apparently, we underplayed that story a little. Apparently, the scientist in question has published leading research on human-human transmission, as noted here by Effect Measure.