Monday, October 31, 2005

October 31 Flu Update--is bird flu in Canada?

In Canada some birds may have bird flu. Canada is confident, while tests are completed, that it is not HPAI.

Helen Branswell on the Canadian story.

Thailand has confirmed a 20th death to bird flu. CIDRAP writes.

Australia is warning Asian countries that it won't tolerate any cover ups of bird flu.

Pakistan says there's no bird flu there.

The Dead Parrot incident has Britain reviewing its quarantine procedures for incoming birds.

In Thailand, they are cracking down on bird flu vaccine smuggling at its borders.

The Indianapolis Star has its state officials saying no cause for alarm yet, but a plan is in place.

Hong Kong is under pressure to revive its plans for a central slaughterhouse for chicken.

Wales publication on the "killer that fell from the sky."

Australian Broadcasting Corporation surveys the Asian situations on the last day in October.

An APEC meeting is going on about bird flu, where apparently there are some divisions.

Limited supplies of Tamiflu are headed for Kiwi pharmacies.

CNN Money notes the financial windfall to Tamiflu, even extended to Donald Rumsfeld.

The Seattle PI says the Bush plan may stress a vaccine.

Reverse genetics vital to developing bird flu vaccine.

Forbes has this on fighting the flu...and good investing.

One long shot in the race against avian flu is BioCryst Pharmaceuticals, a company that designs novel enzyme blockers. Its shares have shot up 70% in less than three weeks. Behind this rise: a chance that BioCryst's small-molecule drug peramivir will be able to pick up the slack on a potential shortage of Tamiflu, the antiviral drug developed by Gilead Sciences and marketed by Roche. Tamiflu is the drug most widely stockpiled by governments globally, while BioCryst's drug has faltered since 2001, when developmental partner Johnson & Johnson called it quits.

CIDRAP on experts warning against hoarding Tamiflu.

CIDRAP catalogs its new influenza links over the past two weeks.

Effect Measure looks back at the news of October.

Recombinomics on Canada.

Recombinomics looks at the genes behind wild bird flu in Russia.

Sunday, October 30, 2005

October 30 Flu Update--what makes some people sick and others not...and a preview of US bird flu plan.

Excellent story on why some people get sick from bird flu and some don't. Must read. Admitting its guesswork, here are some theories.

Farrar said it's possible some people could have a pre-existing immunity protecting them, but there has been no research to prove that. He also said the type of contact between people and poultry could play a role.
Pre-existing immuity...interesting.

President Bush will go to NIH on Tuesday, and announce the final flu plan. Reports say:

The Bush administration's long-awaited plan on how to fight the next superflu probably will include beefed-up attempts to spot human infections early, both here and abroad, and how to isolate the sick.
Osterholm, as always, notes:

"Understand that a lot of the things we need to do to prepare are not related to magic bullets," said Michael Osterholm of the University of Minnesota, an infectious-disease specialist who has advised the government on preparations for the next worldwide flu outbreak but has not seen the final version of the plan.

How to provide food supplies, everyday medical care for people who do not have the superflu, basic utilities and even security must be part of the plan, Osterholm and others have counseled the Bush administration.

"In this day and age of a global economy, with just-in-time delivery and no surge capacity and international supply chains -- those things are very difficult to do for a week, let alone for 12 to 18 months of what will be a very tough time," he said.

The AMA (The Australian Medical Associaton) warns against bird flu overreaction, noting to the public that efforts are in place to deal with something that it is not a problem yet. Whether you think its imminent, potential, or unlikely is a matter of perspective.

NE Thailand had an outbreak among birds recently, in an area where no previous outbreaks have occurred. Authorities were surprised.

Business is way down at Chinese poultry markets.

The Economic Times of India wants to know why there is so much "hulabaloo" over bird flu.

In Australia, experts continue to study what would happen in a pandemic. Among their conclusions is that the international travel would cease, an implication cited by Osterholm and others on the human-inflicted toll of bird flu.

In Hong Kong, dry toilet drains are cited as a potential bird flu source.

Reuters reiterates that Iraq is said to be bird flu free.

Russia continues to have bird flu problems, this time in the central part of the country.

Although they are watching closely, there is no HPAI in India.

Preperations reported on in Alabama.

The Pittsburgh Trib-Review is the latest to say that the nation is unprepared...

and that the bird flu is coming faster than expected (Niman quoted here.)

In Grand Rapids, MI, a 100-year old woman talks about what it was like to face the 1918 flu.

"You didn't want to be up, you had such a terrible headache," she said. "I stayed in bed. You didn't care for food. When you're ill like that you don't care. You don't care if you live or die."
There's new technology on a DNA vaccine that may be the best bet to beat the bird flu.

100 companies have contacted Roche to ask about a Tamiflu license...

and WHO is backing the Vietnemese request to make bird Tamiflu.

Effect Measure notes what may become a typical International bird flu transaction. Columbia is forthcoming on some LPAI, and other countries are critical for damaging poultry sales on the continet. As Effect Measure says, "just watch."

October 29 Flu Update...Mask sales skyrocket in US

A picture of our times. The run just isn't on Tamilfu...the nation's mask producers are seeing massive demand for their product.

Vietnam reports two new potential deaths this week (new coverage, but not new deaths from yesterday)

In Taiwan, they are calling for more honesty on the bird China.

In Aftrica, countries are banning European poultry.

The Scotsman writes on something others have written on as well---that a pandemic could shut down air travel.

Hong Kong is working harder getting the word out about bird flu.

Yunnan, a Chinese province, is said to be on alert for bird flu.

OK....the Saudi poultry industry is suffering from disinvestment due to bird flu.

The Australian Health Minister says that patent laws are not restricting supplies of Tamiflu.

A professor at Imperial College feels Britain is "as prepared as anyone" for the bird flu...he's not sure its going to happen anyway.

Sales are down at poultry markets in China.

An epidemiologist in Tennessee says a flu pandemic could cause 2,000-5,000 deaths there.

China says no human bird flu there.

The Philippines is looking for WHO permission to violate Tamiflu patent.

And WHO says that it will help Vietnam get permission to make its own Tamiflu.

Yemen says it found Newcastle disease not bird flu.

Orissa, India, has announced a bird flu alert, due to 300,000 migratory birds on the way.

Remember Greece--the sick Turkey there does not have avian flu.

In Singapore, they say they found some birds poisioned, not flu.

Australia talks about mass graves.....

Donald Rumsfeld is not participating in some administration flu decisions because he still owns stock in Gillead, the company that created Tamiflu.

Anthony Fauci says the adjuvant used in Chiron's proposed vaccine is "promising."

MF59, known as an adjuvant, is a mixture of water with a type of oil that can be found in the body. Chiron adds the mixture to the bird flu vaccine before injection. Tests showed that people who got it made more antibodies against the bird virus, and that those antibodies recognized and killed the virus, Rappuoli said.
Effect Measure notes that the flu in Iraq was LPAI.

Recombinomics says that the China situation--even with the pneumonia diagnosis--is worrying.

ProMed provides a timeline--going back to 1996--of the H5N1 spread.

ProMed on Iraq and Greece negative determinations.

ProMed on the two deaths in Vietnam.

A full report on the Japanese outbreak of H5N2 in August, via Promed.

Crosblogs has this on a novel approach to bird flu---build a better chicken.

Crofsblogs notes that this story about a famous parrot in quarantine in Croatia.

Crofsblogs also has this on a frank comment from within China about their "grave" bird flu situation.

Tip of the hat to Crofsblog, who found this in the Globe and Mail from the social trends reporter. The article talks about people's need to do something in the face of fear--even if its only getting rid of their bird feeder. Must read.

Saturday, October 29, 2005

October 28 Flu Update--Two new deaths in Vietnam?

The focus shifts back to Vietnam, where there are reports of two more human deaths.

It's very, very clear that all the critical symptoms pointed to bird flu," Dr Nguyen Ngoc Tai, the director of the Vietnam-Cuba Hospital in Dong Hoi, central Vietnam, told Reuters.
As we noted yesteday, China is ruling out bird flu in the young girl's death in Hunan.

They also continue to insist there is no human infection in China.

Based on China's track record, WHO is pressing them for more information.

"After SARS they know they should really provide timely information about what is going on," WHO spokeswoman Fadela Chaib told a news briefing in Geneva.

ProMed has the official report on this item.

Australia to expats: be ready to evacuate immediately if bird flu hits your country, or you could be stranded.

"If the threat of sustained human-to-human transmission appears serious, we will advise Australians in affected countries to consider leaving," the travel bulletin warns.

"If they don't leave when first advised to do so, they may be prevented from leaving later.

"Borders may be closed, commercial air services may be curtailed or halted and quarantine requirements may further restrict options for leaving."

The warning also revealed Australian travellers should not assume embassies and consulates would provide them with anti-bird flu drugs.

"Australian travellers, long-term residents and businesses are responsible for securing their own supply of influenza anti-viral medicine," DFAT warned.

Congress continues to appropriate more $ for the bird flu.

French Tourists on Reunion Island do not have bird flu.

Motley Fool ponders the value of the Chiron contract to investors.

Article from Seattle PI says that bird import pans are unproductive, and could serve to confuse the public (about eating chicken), and strain international tension.

The Australian notes that the flu scare has been bad news for people who use Tamiflu during normal seasonal flu.

In Cebu City, Philippines, they are in a "disaster preparedness" mode, buying up masks, gowns, etc.

A bird flu plan is due in Japan by the end of November.

OIE continues to press for containing flu in animals, but reminds the "cullers" that they have to use the right techniques.

A paper in Nepal briefs the public on bird flu and says what should be done.

WHO warns Africa it could be next--CIDRAP reports.

CIDRAP also notes that just as the US is purchasing more flu vaccines, WHO is saying that the virus is changing.

"Recent investigations have indicated that H5 haemagglutinins (HA) genes of viruses from birds in China, Indonesia, Japan, Mongolia, Russia, South Korea and Turkey, and 3 viruses from humans in Indonesia are genetically distinguishable from the prototype strains selected last year for influenza pandemic vaccine development," the WHO said. "There is also evidence of antigenic variation among the HA of recent viruses. However, their geographical spread and pathogenicity in human populations remain unclear."

The WHO said it does not recommend changing the H5N1 prototype strains chosen previously for vaccine development. But the agency said its "H5 Reference Laboratory Network" has begun developing H5N1 vaccine prototype strains from the recent viruses.

There is no guarantee that the experimental H5N1 vaccines now under development would work in the event of a pandemic, since the virus is likely to evolve further before that happens. But experts hope that the vaccines would be close enough to the pandemic strain to provide at least some cross-protection. The viral changes reported by the WHO seem to suggest that the vaccines now in development would be less likely to work well, though the WHO didn't say that.

Helen Branswell reports that in Canada, polling shows 25% of people are concerned about the bird flu.

In Australia, there is cautious optimism on the prospect of a vaccine.

Scientists are ready to pounce on the pandemic when it starts--its the virulence that worries them.

Docs are frustrated that HHS has no position on dispensing Tamiflu.

In Norway, docs have been asked to stop prescribing Tamiflu.

Vietnam says it will produce its own Tamiflu under pandemic conditions.

Revere at Effect Measure notes that his comments on the US and bird flu don't change much--because the government doesn't do much.

Effect Measure surveys the news that interested him yesterday.

Recombinomics on the negative results in China.

Recombinomics has some ironic news. People often say that the WWI conditions enabled the 1918 pandemic--crowded train cars, etc. They often also say that such things aren't happening now. Today, Niman reports that there may be bird flu in Iraq--where our troops are, and where people travel back and forth every day.

Recombinomics reports on Wild Bird Flu effecting humans in Indonesia.

ProMed with OIE reports from multiple countries.

This is a must read--ProMed comprehensive scan. Note reference to potential or likely bird flu in Lebanon and a spread to a new part of Romania.

Crofsblogs notes that there were dead chickens in Israel as well---circumstantial evidence clearly begins to indicate the Middle East is in play now, as well.

Thursday, October 27, 2005

October 27 Flu Update--test results on sick Chinese girl are in

The Chinese girl reported sick yesterday does not have bird flu, according to authorities, although tests are unconfirmed.

Furthermore, a French tourist just returned from Thailand also tested negative.

Europe has a vaccine....for H7N1.

Taking a page from Thailand's playbook, Indonesia is sending citizen volunteers looking for bird flu.

The government in the Philippines is taking further bird flu protection steps.

The UN warns that Africa is next, as birds migrate. Still, people in Africa don't treat their birds like people in Asia do.

"You don't have export poultry industries in Africa near the scale of what you see in Asia," Morrison said. South Africa is the main exception, he added.

The US has issued a $62.5M contract to Chiron for making a flu vaccine. Many have asked how you can make a vaccine when the strain isn't identified. Here is the answer, from the article.

The vaccine will be a "pre-pandemic" formulation that Chiron and other companies have been working on for more than a year now, Chiron said. Doctors and health officials hope it will be useful as a "priming dose" that would help jumpstart an immune response to be fine-tuned by a second vaccine.

GSK has its own approach, announcing a promising adjuvant program.

Meanwhile, in Canada, vaccine negotiations are bogged down.

Helen Branswell covers this story as well.

Indonesia is looking into whether cats are spreading bird flu. This is because they can't figure out how some people got sick.

Indonesia's human bird flu outbreak is puzzling experts because several victims do not work or live around poultry, prompting an investigation into whether other animal hosts, perhaps cats, are to blame for the disease's spread.

Indonesia has also confirmed that it has shown interest in Hungary's vaccine program.

The EU has some more flu meetings.

From Malta, recognition of serious flu threat.

Editorial says generic drugs the only answer to bird flu.

The Netherlands has made its UN flu donation.

CBC story on virus experts who think Canada doesn't have as much Tamiflu stored up as it thinks it does.

India is prepared to suspend patent laws under "severe emergency" clause.

Vietnam more or less says it would do the same thing.

Its not just governments--companies are scrounging for Tamiflu also.

CIDRAP on Roche suspending Tamiflu sales.

Effect Measure on the Democrat's frustrating and disingenuous response to the bird flu.

Effect Measure on the "Ghosts of 1976." I agree with this post entirely--the Swine flu situation is the elephant in the room in all of the nation's bird flu preperations, and it is why, in my opinion, we will not be able to do any mass vaccination until the threat is present.

The dead mallard in Sweden was H5N3. ProMed reports.

ProMed has a story which talks about the mass concern in Europe--and that the birds, while not a good thing, don't mean human disease will follow right away.

Wednesday, October 26, 2005

October 26 Flu Update--Hong Kong Paper reports girl dies in Chinese village known to have bird flu

A paper in Hong Kong says a 12-year old girl has died of suspicious symptoms after eating a chicken that had died. She lived in Hunan, an area where birds had been reported dying.

The UPI reports that there are three new cases in Thailand and Indonesia.

Outside Asia, on the French Island of Reunion (Indian Ocean), three tourists have been tested since returning from Thailand. Initial tests are positive for bird flu, which would be the first cases outside Asia.

Recombinomics says this is clear evidence of a pandemic at level 5 or 6.

The British government is preparing more bird flu regulations.

The possibility of instructing poultry farmers to bring free range chickens indoors is being urgently discussed by ministers with the industry and a register of commercial poultry producers will be established, Environment Secretary Margaret Beckett said.

Indian government is planning to stockpile Tamiflu.

In the City of Beijing, they are preparing four levels of alerts for bird flu, using (how novel) colors to symbolize the different risks.

ABC News on the confirmation of bird flu in Croatia, and reaction from the rest of Europe.

In Rome, they handed out free chicken to show it was safe. Chickens sales had plummeted since bird flu took center stage.

Ongoing reports on the Canadian flu conference.

Hong Kong has reserved strong powers in the case of flu, and they are ready to implement.

Spammers are now finding more and more bird flu opportunities.

Positive words have been spoken about Thailands 1 million local bird flu monitors. They have now been activated.

In Europe, WHO says 46 of 52 nations have a flu plan.

Fiji has a bird flu plan. post on bird flu, with link to a new book.

Business Week details the response to bird flu coming to Europe. Their term is "panic."

If you read here often, you will notice that there are a lot of flu meetings. Regional, continental, and international--there seem to be a lot of meetings. WHO is calling another meeting in Geneva November tie the pieces together from all the other meetings.

The EU has banned the import of captive live birds from third (presumably non-European) countries.

Australia has donated money to Vietnam to help it fight the bird flu.

Thailand is getting fairly real about the bird flu--they are planning to care for the sick in 40 special care units in four hospitals.

Helen Branswell on pledges of global cooperation at the Canadian conference...

and on the suspension of Tamiflu retail sales we carried yesterday.

Hungary says its bird flu vaccine will be available for use in March.

The top Medical Officer in Canada tells people to stop hoarding Tamiflu...

and the same advice was given in Thailand.

Vietnam is joining the list of nations producing its own Tamiflu.

The CBC has the story of Tamiflu reigniting the controversey over Internet pharmacies in Canada, with a leading trade group calling on an end to exports of drugs.

Effect Measure comments on a Kiwi blog which wonders about the collision of employment law and the flu...can an employer require employees to stay home?

Recombinomics says wild bird flu confirmed in Moldova.

Recombinomics on a familial cluster in Thailand....

and the fatal case in Hunan.

ProMed weighs in on the cross-protection issue with typical flu vaccines. The final conclusion appears to be that it is unlikely.

ProMed on news from around the world. There are dead birds in Bali that are believed to be H5N1 related, and Britain said their appear to be two dead parrots.

ProMed on the Croatian Confirmation.

ProMed on the Hunan case, and a suspected case in Germany (in a bird).

Crofsblog points us to an article on what researchers today can learn from the 1918 flu.

Tuesday, October 25, 2005

October 25 Flu Update--HHS Secretary Says Flu Could Hit US Next Year

Secretary Leavitt says bird flu might hit US next year.

A WHO official said on a radio talk show that personal stockpiles of Tamiflu might help families survive.

Later the same day, in the face of soaring personal sales, Roche has suspended Tamiflu sales.

Indonesia has confirmed its fourth flu death, and China is reporting a new outbreak in Eastern Anhui.'
Here's an official press release on the Indonesian situation.

Bird Flu has hit Germany, with dead birds being tested. The only question is whether it is H5N1.

Bloomberg says 30 nations are looking to loosen their patent laws to get Tamiflu produced--intersting on an economic, and a viral front. Is there too much focus on something the virus can literally just step around?

USA Today has the same story.

Concern is beginning to focus on the global trade in birds as a flu carrier, thanks to the parrot incident in Britain.

Thailand is planning a national flu workshop.

Canada hosts flu summit, and the PM speaks.

The British delegate to the same conference says people should "not panic."

The US and Canada have re-stated that they are committed to cooperation in fighting the bird flu.

If it wasn't clear before, it is now. Migratory birds are carrying bird flu.

Dr. Walter Boyce, is the director of the Wildlife Health Center at the University of California, Davis. He says the migrating birds in the Pacific flyway on the west coast of the United States often began their journey as far away as Siberia.

"Clearly bird flu is on the move. Our concern is wild birds as they migrate, might carry the bird flu with them. Our goal is to detect what viruses they are carrying and basically have an early warning that something might be getting ready to happen"

Increasingly, African states are stepping up import bans and surveillance programs to monitor bird flu. One nation where migratory birds have already arrived is testing fowl for birds.

Hong Kong is preparing for the flu--based on what it learned from SARS.

China is getting mixed reviews for handling the bird flu.

Here's the official Chinese press version of the nation's efforts on bird flu.

Helen Branswell on Canada increasing its Tamiflu stock--and adding Relenza as well.

Relenza - the trade name for the drug zanamivir - is sold by GlaxoSmithKline. Some antiviral experts believe the drug may be better for some people, including pregnant women, than Tamiflu because it goes directly to the site of infection and less drug is absorbed into the blood stream.

CIDRAP has this on the FAO going to Indonesia to help "jump start" lethargic flu efforts there.

A reader emailed this link to me--its Martin Luther on the ethics of fleeing in the face of disease--in his case, the plague, but with lessons applicable to today.

Wendy Orent, a favorite target in the flu blogosphere, had this to write in the LA Times. She is in the "don't worry" school of thought. Check it out for yourself.

Effect Measure takes on the Orent article...he doesn't think much of it.

Recombinomics has this indigenous report that says that 1,134 Thais are suspected of having bird flu. If true, this would clearly have major implications.

Recombinomics has news of a suspicious human case in Portugal, which would be a first in Europe.

HPAI confirmed in Hunan.

ProMed on the private bird importer who was importing the dead parrot, and on news from Thailand.

ProMed with a report on Germany.

Crofsblogs on North Korea reporting that it is fighting the bird flu.

Monday, October 24, 2005

October 24 Flu Update--the Flu marches on with new deaths in Thailand and Indonesia.

One new human death in Thailand, and two deaths in Indonesia.

The WHO situation report on Thailand and Indonesia.

CIDRAP on the newest deaths in Asia.

Recombinomics says the Indonesian deaths are a suspect family cluster.

ProMed with the Thailand and Indonesia story.

Recombinomics wonders why officials are so sure a new case in Indonesia isn't H2H.

In Tambov, 250 miles SE of Moscow, there is more bird flu.

The WHO says that its still Asia where people should worry--not Europe, which is "well positioned" to contain the flu.

The same WHO official emphasizes the to stop the flu, countries should support the fight in Asia--where the flu began.

CTV seperates bird flu fact from fiction.

The Indian Home Ministry is making plans to monitor for bird flu.

In Hong Kong, they are carefully watching pet bird shops for bird flu.

Following up on the parrot death in England, the EU is considering banning pet imports.

In Australia, they are realizing that Tamiflu is not covered under the Prescription Benefit Scheme--meaning you want it, you buy it.

Scientific America has a probing article on the flu, comparing to our closest known disaster--Hurricane Katrina.

The threat of a flu pandemic is more ominous, and its parallels to Katrina more apt, than it might first seem. The routine seasonal upsurges of flu and of hurricanes engender a familiarity that easily leads to complacency and inadequate preparations for the "big one" that experts admonish is sure to come.

This article from Canada quotes the Public Health Minister as saying preparing for the flu is like "studying for an exam." You could always study more, but there's a time you are prepared...or so goes the metaphor. (The good minister wasn't with me in college). Anyway, I might add that its like studying for an exam when you don't know when its going to be held.

From Korea--flu could be more deadly than SARS.

Debora McKenzie, a New Scientist contributor, writing in the San Francisco Chronicle (SanFranChron). She notes"

We have a lovely synthetic-flu virus that will probably make a fine vaccine. Scandalously, we've had it since June 2004, yet only one vaccine company has manufactured it in enough quantity to do substantial tests in humans. And even those tests wasted time on a formulation that didn't work very well -- as scientists had actually predicted. Other companies and countries are only starting now.


First, governments are reluctant to prepare, expensively, for a disaster when scientists can't say exactly when or how it will happen. But it's companies that make drugs and vaccines. So the preparations have been left largely to the private sector. What happened then is what economists call "market failure."

No corporate interest can pay to test a vaccine if it can't tell its shareholders there is sure to be a market for it. Nor can it relinquish patent control, or scale up to make billions of the pills it can barely give away in a normal flu year. Not unless governments pay.


In a globalized economy, disease anywhere hurts everywhere.

An English professor is calling for the protection of bird flocks during the next few weeks, during the migration season.

Taiwan is moving ahead with its Tamiflu work, with or without patent.

While Forbes says they are talking with Roche.

Americans and Europeans are hitting Canadian pharmacies for Tamiflu.

Another race metaphor--man against virus.

Sweden has started Tamiflu rationing--immediately.

CIDRAP on the fear of fake Tamiflu.

Effect Measure on the National Journal article that, essentially, tells it Congressional staff/readership that the response to a pandemic will be all local.

Recombinomics notes HPAI in an OIE report in a new region in China, and, with it, a continuing increase in the reach of the disease.

A large number of chickens died in Yemen, and that looks like more H5N1 (recombinomics)

ProMed has this OIE story from Croatia, where swans died in a new region of the country.

ProMed follows up on other developments from around the world.

Crofsblogs has this article on why the human version of the flu is not a given.

Crofsblog has this from time--access to a flu database will soon be cut off by the US.

Crosflogs on the rapid response team at HHS.

Finally, we have a returner to the flu site commuity. is back online. Always worth checking out.

Sunday, October 23, 2005

October 23 Flu Update--English Parrot is H5N1

Recombinomics has the news on the dead parrot, which was found to be H5N1. While the parrot was being imported from South America, it was quarantined with some birds from Taiwan.

Here's the Dutch version of the Bird Flu FAQ.

Doctors in Australia have a story to tell that sounds familiar--their patients are demanding Tamiflu.

The same problem is occuring here in the US....

and the State of New Hampshire is urging physicians not to fill those Rx requests.

Reuters goes around the horn on the bird flu in Europe, with a report on several nations.

The UN is urging that Indonesia take stronger action against the bird flu. While we were watching Europe, the situation here has steadily deteriorated. They consider Indonesia one of the weak links in Asia. Note this:

With avian influenza now diagnosed among birds in two-thirds of the country's provinces, Indonesia must begin the immediate culling of poultry in infected areas and revamp its campaign to vaccinate fowl against the virus, according to officials from the U.N. Food and Agriculture Organization.

There's a new case reported in Thailand, from a man who ate a sick bird.

Sweden says the dead bird has LPAI.

An international consultancy is telling businesses to prepare for a pandemic that gives them 30% absenteeism.

An article in Malta, noting if travel is banned, an island like Malta is especially isolated.

The Ann Arbor News has a Michigan-based interview on the bird flu pandemic. Michigan has been working on a flu plan for a year.

Conversely, this paper says New Jersey has no plan for a pandemic, beyond hoping for a vaccine. Article notes US origins of Spanish Flu in New Jersey.

The lead paper in Arkansas looks at bird flu from the home of Tyson Chickens.

You will recall that Gilead and Roche are currently in litigation over Roche, with Gilead trying to take back the rights to Tamiflu. Here is Gilead's latest salvo in that battle.

In Vietnam, new bird vaccine is easing fears.

ProMed has a roundup of the day's news. Most interesting is a small debate on an issue debated here, which is whether the "normal" flu vaccine will provide cross-protection to bird flu. Some have said yes, the mod here says no.

More MSM news--Crofsblogs says that Newsweek's cover is bird flu this week. Its content rich, though likely to be nothing new for people more steeped in flu issues.

October 22 Flu Update

Long-time readers know that one of the key aspects of the flu isn't what the virus does, but what people do to respond to the virus....the effects we create intentionally. Closed borders is one of them...this Reuters report says the Chinese are prepared to close their borders in the event of a single H2H case in that country.

To enhance that strategy, the Chinese have also implemented new surveillance measures.

On the human behavior front, Reuters writes on the economic shock of the bird flu. (Emphasis added)

"Substantial loss of life would obviously lead to a decline in economic output but we believe fear of infection, leading to drastically altered behavior, would result in the greatest economic damage," said Rob Carnell, economist at ING bank. "We cannot begin to quantify the potential damage in terms of gross domestic product, but a realistic scenario might be GDP declines in the tens of percent," said Carnell. "In the case of slower growing economies such as Europe or Japan, a decade's economic growth could be wiped out."

Effect Measure has this piece on the recent quarantine/border plans you've seen here and elsewhere, including Australia's six-day holding plan. Basic point: while inevitable, they are doomed to fail.

It is inevitable that these kinds of restrictions will come into play if a pandemic is starting. It is just as inevitable they will be costly and will fail. It isn't even sure they will slow things up much. This is apparently an obligatory response that can't be stopped. But it shouldn't also prevent us from beginning the kind of community mobilization that will really make a difference in managing the consequences of a pandemic, should one come.

In Thailand, they have ruled out H2H in the case of the little boy, and he has fully recovered.

ProMed has this story as well.

Despite the parrot, Britain says it is still bird flu free.

Taiwan continues to say it will defy international patent law on Tamiflu.

Tanzania recognizes that its on the migratory bird route, and is taking steps to protect itself against the bird flu.

Earlier, we reported a first case in Croatia...the other shoe is dropping as culling begins.

Bird flu continues its persistence in Russia, despite relatively modern culling techniques. This case has more birds testing positive in the Southern Urals.

On the other hand, Pravda says there is no bird flu in Russia--its all a master plan to damage the poultry industry in Russia.

Crofsblog has this on the potential for bird flu being found in Sweeden.

More examples of flu bringing people together--Cyprus and Turkey cooperating on bird flu measures.

Tamiflu shortages could exist for a year.

The Germans are racing to stockpile Tamiflu.

WaPo writes on local doctors who have decided as a policy not to prescribe Tamiflu to people who ask for it.

On BBC, the chief Medical Officer for Britain does a bird flu Q&A,

This Australian story says the Chinese created the flu crisis by feeding amantadine to chickens.

A rift is developing between the Canadians and the Australians over a ban on birds imposed in Australia--the Esteemed Helen Branswell reports.

Effect Measure on a high science-content article on the H2H shift at the cell level.

Recombinomics comments on the same article.

Wall Street Journal competes--with an Avian Flu news tracker (courtesty H5N1).

ProMed has this OIE report on an outbreak from Inner Mongolia.

A ProMed OIE report from Russia, noting an interesting anamoly in fatality rates in the birds.

ProMed on the Chiense/Taiwanese border situation.

Friday, October 21, 2005

October 21 Flu Update

CIDRAP has today's big news--a parrot in quarantine Britain has H5. Also news on the Thai death.

Thanks to Craig, who pointed me to this article in today's edition of The Week, one of the best magazines available. Its their cover story on the flu.

Taiwan says it has its own anti-flu drug.

Victoria, Australia, says its ready for the bird flu.

More from Australia, where their final flu plan was announced. In the event of a pandemic, travellers could be held at the airport for six days prior to being allowed entry into the country.

Reuters covers the bird flu in Europe, country-by-country.

Secretary Leavitt says that bird flu travels along migratory bird routes.

CNN on the possibility of a bird flu vaccine without eggs.

Hungary says its getting interest in its bird flu vaccine from around the world

The New Scientist on the new rash of flu outbreaks.

The Financial Times on the first death in Thailand (reported here previously).

New Zealand says borders will close if the flu breaks out.

NBC's George Lewis has this report from Asia--including talk of what closing borders would do to the economy.

UPI with a good story on how IT could be used to help fight bird flu, but how some health departments could still be using index cards.

The AP asks if the "Tamiflu bottleneck" has been ended.

This health IT pub notes that Britain already published the second generation of its bird flu plan, while the US struggles to publish the first.

More on the International Flu Meeting scheduled by and in Canada.

In Connecticut, there's a local analysis of what the flu would mean there.

The state's 31 hospitals would run out of beds. They would face extreme staff shortages with at least 35 percent to 50 percent of their medical personnel out sick, caring for family members or refusing to jeopardize their health to treat droves of flu patients.
A similar story from across the world, in New Zealand, where the projection is compared to the 1918 flu.

In South Africa, they are DETERMINED to stay bird flu free.

The EU has approved further bird flu protective measures.

Cyprus is speeding up its own bird flu measures.

Another voice...anti-AIDS activists are calling for Tamiflu to be released from patent protection.

The Patent Baristas says there are new complications on who owns the Tamiflu patent--Roche, or Gilead.

The economic and social effects have been commented here time and time again over the past few weeks. Here, Effect Measure notes that recent flu news has caused soybean futures to fall.

Effect Measure has news of a new toy--a chicken you can kill yourself, if you think it has the flu.

Recombinomics says wild bird flu is confirmed in Croatia.

ProMed has confirmation of the reports--including almost immediate plans of the EU to ban Croatian poultry.

Recombinomics notes the clusters in Indonesia, and that they begin to look like more H2H than has been reported.

ProMed on a new, suspected case in Romania.

The Family cluster in Indonesia is not lab-confirmed...ProMed.

Thursday, October 20, 2005

October 20 Flu Update

Thailand experienced its first bird flu death in more than a year yesterday, and the man's son is also sick, though not as sick. Today, the family is ripping the government for trying to cover up the cause of death.

Here's Reuters on the death in Thailand.

Bloomberg is reporting on the latest death in Thailand, and why the illness of the son is raising H2H concerns in that country.

Family clusters in Indonesia are causing other H2H concerns.

The Globe Mail covers the day's flu news, including reports that the dead man ate a neighbor's sick chickens.

CIDRAP on Thailand's death.

Recombinomics on Thailand.

The drug industry is concerned that the flu could net bad PR for them...and they are taking steps.

A flu Q&A from NPR.

Russia is working to keep bird flu from stretching from Tula to Moscow, all the while talking about how unlikely flu is to move from Tula to Moscow. Tula provides most of the poultry to Moscow.

The British government is undertaking an idea that has been suggested before--they are advancing funds to pharmaceutical companies.

Time has a report from the frontlines of the flu--in Romania.

When people living in the remote Danube Delta villages of Ceamurlia de Jos and Maliuc heard last week that their chickens and ducks would have to be destroyed to help prevent the spread of the Avian flu virus, they reacted in different ways. Some wept and prayed as they handed over their birds; others tried to hide them. Said Ceamurlia resident Gina Braileanu, "My uncle was caught hiding a hen close to his chest. He had to give it up."

Others immediately slaughtered their flocks, stuffing them into freezers for later consumption. But in the end there was no hiding place...

91,000 birds (corrected) were culled in China after the latest outbreak.

The Economist has a long bird flu story that is probably nothing new to long-time flu observers, though it appears to be accurate and realistic.

A teleconference is being held on the economic reaction to the flu pandemic--before it even begins.

Dr. Elizabeth Whalen, of the American college of Science and Health is beginning a national tour to discuss "the nature of a potential outbreak of avian influenza, the shortage of anti-viral medicines such as Tamiflu and the lack of an effective vaccine."

EU Health ministers held another meeting on the bird flu.

Here's the official WHO update on the situation in Thailand.

Helen Branswell is back again, with this article quoting a Canadian Health Official as saying that sharing knowledge helps everyone--based on the SARS situation.

A UK unit is coordinating an EU bird flu exercise.

A local official in Atlanta comments on pandemic response in that area.

Roche is continung to back down--agreeing to meet with potential generic producers of Tamiflu.

Since the patent is still pending in India, they might be able to start now.

Bosnia and Herzegovina is allocating $ for Tamiflu.

A company willing to produce copious amount of generic Tamiflu has jumped into the fray.

Report from Wales say bird flu drug stockpile will be ready in one year.

Flu brings Israel and Jordan together to fight----the flu.

Effect Measure wonders if all this news is really more news, or just a lower bar to get into the paper...or whether all this news is only the tip of the iceberg.

Recombinomics looks at OIE data and says the case is closed---H5N1 is in Romania.

Recombinomics has translation data of two familial clusters admitted to the hospital on the same day in Jakarta.

ProMed on Taiwan's import issue.

ProMed on Thailand, and Indonesia, including the new potential clusters.

ProMed on Thailand.

Wednesday, October 19, 2005

October 19 Flu Update

China is reporting large numbers of dead birds--2,600 in the Northern grasslands. Sure to raise ongoing concerns about their openness over the past few weeks.

This Australian news service has the story of the bird flu re-emerging in Russia, China, and elsewhere--note at the end of the story a reference to fear of the disease landing in Africa.

Here's a direct UN story on risk to the Middle East and Africa--note that humans living in close proximity to poultry is the key element.

Britain has announced plans to buy enough vaccine to cover every single person in the country--even at two jabs/person.

Meanwhile, in Australia, the Health Minister has had to backtrack on a similar suggestion.

In Russia, hundreds of birds were found dead in a region south of Moscow, and preliminary evidence of H5N1 has been reported.

CIDRAP on Russia and China.

Link to an NPR update on bird flu.

The Esteemed Helen Branswell has this from Canada, where the Health Minister has said Canada will donate 10% of its drug stockpile to needy countries--and call on others to do the same.

More scientists look for the carrier of the bird flu in what might be an impossible challenge.

The vast new geographical expansion of the dangerous H5N1 virus has avian influenza experts worried a bird version of the Stealth Bomber may be at play.

And they readily admit that finding the asymptomatic culprit or culprits from among thousands of species of birds may be a herculean challenge.

"If this is a . . . virus that seems to have fixed itself in some species and we don't know which species it is -- but maybe it's not showing any clinical sign in this particular species -- how do we find this guy?" Michael Perdue, avian influenza expert with the World Health Organization, asks with evident anxiety in his voice.

The realization that some mystery migratory birds are spreading the Asian virus suggests future unwanted appearances in Europe cannot be ruled out.

San Jose Mercury News with a summary story.

Bloomberg on Russia, and a second site in Romania.

EU reaction to the alarming news from Tula, south of Moscow.

A bank in Australia is accusing the government of downplaying the effect of bird flu on the economy.

I get a lot of inquiries about drugs, vaccines, tamiflu, etc, here. The New York Times has a must read today on this topic. Read all the vaccine talk in this blog today, and then read this--emphasis added.

Most of the drugs have never been used to control outbreaks, and it is not even clear how well they would work against the dreaded H5N1 virus if it should jump from birds to humans. It is also unclear whether a vaccine currently under production would have any effect against an emergent pandemic strain, even its manufacturer, Sanofi Pasteur, admits.
There is huge uncertainty about how best to prepare for such a pandemic, and fundamental questions remain unanswered. If, for example, governments were to treat 20 percent to 40 percent of their populations with antiviral medicines - the strategy outlined by many European countries - the virus could quickly become resistant to available drugs, making it even more dangerous.

The Swiss Interior Minister has decried bird flu hysteria.

A new contingency plan from the British government reportedly says that a pandemic would hit Britain one month and overwhelm the NHS.

The Fort Wayne (IN) News Sentinel has an editorial with what might be one of the most elegant phrases on what the current plan is.

The most effective step the world could take is to establish a comprehensive global surveillance system capable of swiftly detecting and reacting to a human outbreak....That will require the pocketbook of rich nations, which can best afford to create a surveillance system, and the cooperation of poor nations, where a bird flu outbreak is most likely to occur.

The BBC says that the Hungarian vaccine shows promise. Here's an interesting quote:

Hungary's health minister Jenö Rácz was among several dozen Hungarians who underwent tests of the trial H5N1 vaccine.

He said: "The results are preliminary but I can say with 99.9% certainty that the vaccine works."

An IPSOS poll says the Spanish the and Italians are most bird-flu worried.

Indian drug companies see a windfall coming.

The paper in Lancaster (PA) talks to poultry farmers in that area who are concerned about bird flu.

CBC analysis piece from Sandra Donaldson--giving tips and advice.

Roche sales projections for upcoming year.

CIDRAP's Michael Osterholm warns people not to over-rely on Tamiflu.

"It's being sold right now as almost the Cipro of post-9/11," said Osterholm, referring to mass purchases of the antibiotic ciprofloxacin, after mailed anthrax attacks killed 5 people in the United States in the fall of 2001.

This TV station in Oklahoma City ("Family Television") has noted that the rush is on for Tamiflu.

Branswell is interviewed on bird flu coverage which has passed the tipping point and gone thermonuclear.

Effect Measure has a commentary on reduced public health funds from the Bush Administration.

A new angle from Effect Measure--what about bird flu in jails?

Recombinomics has the Russian and Chinese OIE reports from today.

Recombinomics on bird flu in European Russia.

ProMed on the Russian and Chinese OIE reports.

Crofsblogs has this on an idea in Bulgaria to use ultrasound to divert migratory birds.

Crofsblogs has preperations for bird flu in South Korea...

and Brazil.

Tuesday, October 18, 2005

October 18 Flu Update

Here's a great Reuters story on the various flu scenarios, what could happen, and how it could all start in one, tiny place. The quote below is from a Mayo Clinic physician, which is chilling for its simplicity. (emphasis added).

In a few potential scenarios, the world gets lucky and officials act quickly to vaccinate populations and distribute lifesaving antiviral drugs. The damage, while enormous, is limited and economies recover after a few months.

But health experts are unusually united in warning that if H5N1 makes the jump from birds to people in the next two years, it will cause an unprecedented disaster.

"I want to emphasize the certainty that a pandemic will occur," Dr. Gregory Poland of the Mayo Clinic Medical School in Rochester, Minnesota, who represents the Infectious Diseases Society of America, told a briefing last week of Congressional staffers and lobbyists.

"When this happens, time will be described, for those left living, as before and after the pandemic."

The EU nations had a meeting today, and they declared bird flu to be a global threat. They are walking a difficult tightrope between the "don't panic" message and they "we have to do something message."

Roche has promised to build a plant in the US to increase Tamiflu production, but that has failed to quiet critics who are demanding they give up their monopoly rights to the drug.

Meanwhile, WHO is warning Europeans not to hoard Tamiflu, noting that it is not a vaccine.

A human bird flu trial is underway in Australia, with 400 participants.

More on the arrival of bird flu in the EU--Greece.

In Thailand, the bird flu is ruled out in the case of a man with a respiratory disease.

Recombinomics notes that they have a history of such reports, and that he suspects a familial cluster.

MSNBC has the story of anxious Americans on bird flu. Note some of the questions that have reached the CDC. (You can't blame people for not understanding. Its a complicated topic, and the job of everyone to help them understand what to be afraid of, and what not to be afraid of.)

Officials at the Centers for Disease Control and Prevention have been handling numerous fearful phone calls from the public and the media, fielding such questions as "Is it safe to have a bird feeder in my yard?" and "Is it still OK to have turkey at Thanksgiving?"

“It’s been insane,” said Dave Daigle, a spokesman for the CDC, which has been getting an average of 447,000 hits a day on its avian flu information Web page.

Here's the answer to the question the title proposes:

"Short of obtaining [antiviral] drugs, there’s not really much we can do to prepare," says Webby. "My expectation is that [bird flu] would spread within community, like a normal human flu. The transmission of that virus, the mechanism, would be similar, so normal precautions would be the same."

That means regular hand washing and staying home if you feel ill. Beyond that, about all someone can do is to get vaccinated for the regular flu.

The vaccine for the upcoming flu season wouldn't offer protection against bird flu. But protecting people against conventional flu could make them stronger against a new illness, some health experts say.

Thailand will start human vaccine trials in 2006.

The Esteemed Helen Branswell has the preview of an upcoming journal article which will cite 15 family clusters of bird flu (correction courtesy commenter Damien).

The EU said that the presence of bird flu in Europe doesn't increase the chances of a pandemic...

and said that panic is "premature."

EBay has halted the sale of tamiflu on its website.

There are reports from all over the place about Tamiflu buying frenzies. Here's one.

The Internet drug trade is a place with many drawbacks.

A Dutch country is now looking to produce a human bird flu vaccine...

As is a company in France.

Here's a letter to the editor in Arizona sending readers to recombinomics.

Recombinomics says there are some dead birds in Russia, which, combined with all the other news, raises concerns.

You may recall over the past few weeks we've carried some debate here about whether migratory birds could carry bird flu--"dead birds don't migrate." The most current news appears to be putting that to rest, as H5N1 notes, with an article from the New Scientist.

Bloomberg has a great article on avian flu, Y2K, and what real preperation would look like.

British Tories are calling for a minister to coordinate all responses to the bird flu. surveys the entire flu scene, including some Branswell articles.

October 17 Flu Update

The Washington Post has a summary of bird flu developments from yesterday. Notably, WHO is saying that even with bird flu in Europe, the threat to human health remains in Asia.

Bird flu has a new European home....Greece.

Here's a bird flu fact sheet from Reuters.

WHO and Roche are talking about upping Tamiflu production.

In Africa, South Africa is preparing for the bird amidst internal criticism,...

just as their minister declares the nation bird flu free...

And Kenya is also making preperations.

WHO says to expect more bird flu in other nations.

The Times of London says to take bird flu scare with a pinch of salt.

Currency speculators are trying to speculate on where the economic damage of bird flu might fall, and invest accordingly.

In counterpoint to the don't worry messages, the EU is sounding the alarm over shortages of anti-virals.

Press release from Wave Biotech on strategic alliances with drug companies to use the Wave Bioreactor.

The media in Malta covers bird flu precautions.

The BBC reports that the Scottish Executive has a 67-page flu contingency plan.

Canada has 16 M doses of Tamiflu, and says it is ready.

The European Public Health Alliance surveys the issue from the perspective of a citizen.

The Czech Republic is protecting its Tamiflu stockpile by banning retail sale of the drug.

Roche is donating a small portion of Tamiflu to Romania, and selling a larger amount to Turkey.

The Department of Health in Taiwan has asked for permission to license Tamiflu.

Singapore says it has a good stockpile of Tamiflu....

Meanwhile, the Thais are jumping in with both feet to produce their own generic Tamiflu

Dr Thawat downplayed concerns over intellectual property rights, saying that the government would introduce a compulsory license allowing the country to produce the drug on the grounds of urgent public health needs.

The National Review on how litigation and regulation killed the US vaccine program.

The EU hopes for a bird flu vaccine next winter.

CIDRAP on Greece....

and on Romania.

Effect Measure looks into the commonly used phrase that we are "overdue" for a pandemic.

Effect Measure on Greece, and upbeat news.

Effect Measure on the continuing mystery of "secret" Bush Administration bird flu briefings to members of Congress.

Effect Measure captures a blog debate over the generic Tamiflu issue.

Recombinomics says there has been a bird flu cover up in Europe.

There's dead birds in Macedonia, causing concern (Recombinomics)

Recombinomics on the Ragunan Zoo back in the news, and another possible zoo-related case.

ProMed on Greece and Romania.