Wednesday, November 30, 2005

November 30 Flu Update

If you were here yesterday, you saw that WHO was fearing a three-person family cluster in Indonesia, with one fatality. Indonesia today confirmed the fatality as bird flu, and media reports say they are investigating the cluster, though the other families members cannot be tested because they were cremated after they died.

CIDRAP on Indonesia.

This step has the potential to be helpful. International health regulators are going to meet early next year to talk about how they can cooperate to speed the development of a vaccine.

Thailand is about to declare itself bird flu free.

The Medical Research Fund (UK) is planning to put in excess of 10M pounds into a bird flu fund.

China has lifted a quarantine in Hubei Province.

Interesting statement from China. The Health Minister says they national government is not covering anything up, and doesn't think the local governments are...but...

"What I am afraid of is the low level of competency and technical expertise of hospitals, clinics and medical personnel at the grassroots level, who may not detect cases as quick as they should."

Malaysia has a bird flu strategy, outlined below.

A Doctor interviewed in the Canadian Jewish News says that fear and panic about the flu are premature.

WaPo says the US will have 8 million doses of experimental vaccine stockpiled by February. You know the drill--it takes two doses, so that's enough for 4 million people. They are apparently testing a dilution strategy to try and stretch it word about an adjuvant.

From Vietnam, the report is that nearly 200 communes have bird flu outbreaks.

In Vietnam, a minister reminds everyone about the value of good environmental hygiene.

There's a hemisphere-wide meeting going on in Brazil to create a bird flu strategy.

In Oregon, they're keeping an eye out for bird flu, with an idea that its not time to panic yet.

The American Enterprise Institute asks if bird flu is "The One." Its a good article, questions the containment strategy, and talks about the same effects Dr. Osterholm does--disruption of supply chains, etc.

Next is China--the country is negotiating to make its own Tamiflu.

Here's something I haven't seen before. Apparently 20 states have laws against the use of thimerosal, which is a mercury based preservative. These bans are called a "significant" barrier to vaccine production.

Most doctors say thimerosal is safe and studies have shown there is no association between vaccines of any type and neurological diseases such as autism. Experts say the type of mercury used in thimerosal does not affect the body in the same way as mercury found in pollutants. But several groups dispute this and some high-profile books have claimed that mercury is causing an epidemic of neurological disease. They claim that U.S. health officials have covered up evidence of this.

ProMed on the Indonesian case.

ProMed on the story about the ineffectiveness of culling wild birds, and an exact zoological accounting of the sick birds in Romania.

Crofsblog found this poll that says US citizens have diminished confidence in their government to fight a pandemic.

Crofsblog also has this on 9 Chinese arrested for producing fake bird flu vaccine.

Tuesday, November 29, 2005

November 29 Flu Update--More Flu in China

The Chinese have reported two new flu outbreaks. That makes 24 since October 19.

A lack of testing may have hidden a family cluster in Indonesia, WHO reports.

A 16-year-old boy confirmed as Indonesia's 12th human case of bird flu had two brothers who died from similar symptoms days before he was taken to hospital, the World Health Organisation (WHO) said on Tuesday. The brothers died on Nov. 11 after being diagnosed with typhoid fever, but they were never tested for the deadly H5N1 bird flu virus, leaving questions hanging over the cause of death, WHO spokeswoman Maria Chang said. "They had similar symptoms, fever and respiratory distress, but we don't have samples. We'll probably never have a definite diagnosis," Chang said, adding that the possibility of human-to-human transmission of bird flu could not be ruled out.
CIDRAP on the cluster report in Indonesia.

Do bird flu vaccines help stop the spread of the flu in poultry. This question lies at the heart of global strategies to stop the disease before it moves to human transmission. Research in the Netherlands has shown that vaccines can be an effective tool to stop a virus in birds. (If I can add an implication, it might mean less culling, and therefore less economic impact in Asia on small farmers.)

WHO officials are in China studying the circumstances around China's second human death.

WHO experts made an inspection in the hospital, where a 35-year-old female farmer surnamed Xu died of bird flu infection. They also visited Shandou Village where the dead lived, inquiring about the details of the victim's condition before and after getting infected.

WHO update on China and Indonesia.

A couple days ago, we read about the Vietnemese poisoning wild birds. The UN Food and Agriculture Office today said that killing wild birds is not part of any strategy, and it not likely to be effective.

Now that migratory birds have returned to a sanctuary in Tamil Nadu (India), a bird flu alert has been announced.

Investment bankers in Britain are issuing provacatively titled reports on the implications for a pandemic...clearly indicating the downsides, but, as always in the dark science, seeing some "opportunities" as well.

The US has relaxed its Canadian poultry ban.

Australia is preparing for two large scale national simulations. One will look at an outbreak in flu, and the other--slated for the second half of 2006--would look at a human pandemic.

The FAO recently did an educational workshop in Kabul, which is apparently a major crossroads of poultry traffic.

Here's a FAQ on what the EU is doing to prepare.

Helen Branswell on the Canadian government finally signing a contract for flu vaccines. The bad news is no vaccine will be ready for testing until late 2006.

CIDRAP on a Minnesota Chamber of Commerce event on the flu pandemic, where Dr. Osterholm told the assembled group that "this is not an optional planning exercise."

Doctors in California are the latest to be urged not to prescribe Tamiflu.

It had to happen...a US company has submitted an application to produce Tamiflu.

Effect Measure on the announcement of the existence of a pandemic plan in Pennsylvania. Of course, the plan is still secret.

A detailed report on the outbreak in Romanian outbreak, right down to the bird species.

Crofsblogs has a story on a hunting ban instituted in Pakistan.

Monday, November 28, 2005

November 28 Flu Update--Is North Korea hiding a bird flu outbreak?? Meanwhile, China says the flu virus is mutating.

As North Korea announces more bird flu protection measures, it makes the world wonder if they aren't having outbreaks.

The Chinese say the virus as it has effected humans in China is different from the virus in Vietnam.

Its the signal seminal question we ask everyday in monitoring the it human to human yet. CIDRAP summarizes research from the CDC that highlights the relatively large number of family clusters, which could indicate H2H transmission.

Family clusters don't necessarily mean the virus is spreading from person to person, the report notes. They may simply mean that relatives were exposed to H5N1-infected poultry at the same time.

However, in three family clusters, all in Vietnam, the first and second patients fell ill more than a week apart, which suggests that they probably didn't acquire the virus from the same source at the same time, the report says.

To be fair, for all you Recombinomics haters out there, this is a point he has been making for a year.

To date, word was that bird flu was in 23 of 33 Indonesian provinces. Today, officials there concede the numbers is probably even higher. They also confirmed a dead man there was the nation's eighth fatality.

Furthermore, there is a new human case in Indonesia.

As promised, WHO experts are in Anhui, China.

CIDRAP sums up the news for the last few days, over the long US Holiday Weekend.

Interesting story on a meeting of Canadian medical ethicists who are asking for ethical standards to be set up before the pandemic, based on experiences with SARS.

The report concludes that flu pandemic plans universally need to address four key issues, including health workers' duty to provide care during a communicable disease outbreak; restricting liberty in the interest of public health by measures such as quarantine; priority setting, including the allocation of scarce resources such as medicines; and global governance implications, such as travel advisories.

Helen Branswell has this story, as well.

Australia will be hosting a bird flu drill as well.

In France, the poultry industry is saying that bird flu scares are costing the poultry industry 100M euros.

What's bad for the poultry industry is good for anise industry? Sales are skyrocketing in China for star anise, which produces the acid that is the key ingredient in Tamiflu
The Netherlands was the first nation in Europe to adopt strong bird flu protection measures, and they will be relaxed in January.

MSNBC says companies are taking a wait-and-see attitude toward bird flu. Until then, its business as usual.

Thailand and the Philippines are free to make Tamiflu, says Roche.

India will be producing Tamiflu by the middle of next year.

Meanwhile, in New Zealand they are out of Tamiflu.

Baxter, an international Rx firm, is going to help Indonesia try to develop a human bird flu vaccine.

Rob Webster, MD, native Kiwi and US flu expert is in his native land telling them they should, on an emergency basis, be prepared to develop and produce their own bird flu vaccine.

ProMed surveys the news in Indonesia and Romania from the last 24 hours.

ProMed also has a comment that when looking at migratory birds, the scope needs to be beyond waterfowl--including sparrows that drink water from ponds where migratory birds have been.

Crofsblog has this report that the bird from may be in the Camerooons.

Effect Measure notes that WHO is doing a seroprevalence study in a "healthy " Indonesian village, looking for evidence of past infection. Revere feels its important work, and should be done throughout SE Asia.

Happy Anniversary to Effect Measure--one year! (Our is less than one month away). Congratulations on a site that is always enlightening and stimulating. No one interested in this subject should miss it for even one day.

Sunday, November 27, 2005

November 27 Flu Update

In Vietnam, they held what is called an "elaborate" drill on a flu pandemic. Peter Horby of WHO says "They have got a plan. They have involved lots of different agencies. The broad brush, it looks very good. I think it is just done to the detail, really, and how you'd implement it in practice," he said.

If you're flying into Shanghai, you're going to get some questions about how close you've been to poultry.

Romania continues to cull, as it continues to find bird flu.

Note wryly:

The outbreak occurred in the local mayor's farm.

Bangladesh is taking flu steps.

Australia is preparing for the bird flu, too.

Early next year, Beijing will host a "donor's conference" to raise funds for the pandemic fight.

Bird flu fears have caused a Japanese importer to switch his supply source from China to India. (This is exactly the kind of thing that leads countries to hiding flu.)

Crofsblog has this, which says that poultry is only 2% of China's GDP, but employs 14 million people.

N. Korea continues to state that it has no human cases of bird flu.

On the domestic front, Lebanon, MO is preparing for a pandemic.

Same thing in Lawrence, MA.

Canadian writer says he's now interested in the health of chickens, and he looks to some alternative therapies.

ProMed on yesterday's report of sick fowl in Romania, but outside the Danube.

Crofsblogs must read. Excellent commentary on a story which chastises the West for a slow flu response. As he points out, there's nothing to be gained from that. Sempre avanti--Always Forward

If you follow Britain, you knew this was coming--A GM chicken that can't get the flu.

Here's a NY Times review of Monster at the Gate--its a positive one. Book is available through the link on the right.

Must, must read from the San Francisco Chronicle, a profile on Rino Rappuloli, who is a vaccine expert at Chiron. He says viruses shape history:

Work on the Siena Cathedral wall never resumed, and the once-flourishing medieval city faded just as the Renaissance dawned. To this day, Siena has about half the population it had in the mid-14th century. Infectious diseases take a toll that is greater than just the life lost at the moment, Rappuoli said.


Siena, he says, was once very much like California. "People wanted to get there, because the future was there," he said.

Artists and architects flocked to Siena to build and embellish its ornate cathedral, the Duomo di Siena. The sculptor Giovanni Pisano designed its lower facade, and his father Nicola Pisano produced its massive pulpit. Construction began on the wall for a towering new nave that would have completed the cathedral's cross-shaped design.

But the plague killed many of the cathedral artisans, Rappuoli said, depleting the resources and the expertise needed to finish the wing that would have made the Duomo one of the largest church buildings of its time. "They'd lost the knowledge," he said.

Rappuoli said he now sees the AIDS virus rolling back the clock in Africa to the Middle Ages, as life expectancies drop and a generation is left orphaned. "They have no mentors," he said.


"Fatti non fummo per viver come bruti ma per seguir virtute e conoscenza," Rappuoli quotes Dante. "We (mankind) were not born to live relaxed in ignorance like animals, but to explore the universe to learn its secrets ... and improve our knowledge, and use it to improve the quality of life," he interprets the passage.

Saturday, November 26, 2005

November 26 Flu Update

New York Times interviews Roche CEO on many topics, including Tamiflu.

Confirmation of bird flu outbreak in Inner Mongolia (China).

ProMed notes that the number of outbreaks makes it the most impacted known area in China. In addition to the quote below, ProMed calls attention to a call for local governments to "strike hard" at people making fake vaccines.

Health authorities yesterday intensified an information campaign on prevention of human infections, using prime-time TV slots and major newspapers urging people to maintain a hygienic and healthy lifestyle and process poultryproducts with caution.

ProMed has the OIE report from China.

ProMed has the official report on the new case in Vietnam (via WHO) reported earlier.

A turkey in Romania has H5--first case outside the Danbue Delta. N1 has to be confirmed.

Indonesia has a new human case (I believe same as reported yesterday), and other news from around the world.

Via Crofsblogs, there's another potential new case in Indonesia. (He notes its getting hard to keep up and he's right.)

In Aceh (Ind0nesia), a small cull was held.

In India, they are preparing for a public education campaign.

In Oregon, bird flu is not considered an "imminent" threat.

Meanwhile, Colorado is watching carefully.

A flu monitoring campaign has started in Tanzania.

Indonesia producing Tamiflu, Roche OK so long as it isn't exported.

The Canadian government has advised travellers to see a Dr. about precautions to take if travelling abroad.

A Kuwaiti official is asking people to remain alert, but calm.

Effect Measure with a whimsical look at the poisoning pigeons.

Friday, November 25, 2005

November 25 Flu Update

New outbreaks in China and Vietnam--and the Indonesians are producing their own Tamiflu, which they say has no patent protection there.

Inner Mongolia (in China) has a new flu outbreak.

WHO confirmation of new human case in Vietnam.

Also, there's a new outbreak in a province in Vietnam.

A new twist on culling--Vietnam is poisoning piegons.

ProMed on the new Chinese outbreak, the Vietnemese pigeon program, and China providing 1.5M Yuan to Vietnam for bird flu prep.

The controversey over the Japanese scientists--what he said and what he didn't say--continues. This should be the end, though, as it turns out he wasn't in China recently, etc. Certainly he was not providing corroboration of underground "tip of the iceberg" reports.

A WHO official on a mission to Central China notes that there are still many challenges to helping people understand the bird flu, and that education continues to be a big challenge.

The Chinese flu vaccine--through entering human trials now--is a year away from market.

Tests in Nova Scotia found H5 positive ducks, but no word if they are N1. (These generally tend to be LPAI.)

Recombinomics on reports of continuing cases in the Volga Delta.

Yesterday, we cited a Recombinomics report that says there may be a human H5N1 case in Israel. Today, Recombinomics writes on data that suggests that the version of H5N1 the Israeli may have could closed to human adaptability.

ProMed confirming the Israeli case---the patient has survived.

Taiwan has required Roche to license Tamiflu to the National Board of Health.

The Sultan of Brunei is putting $12M into flu prevention.

The Toronto Board of Health is doing some planning for a pandemic. Very interesting stuff, excerpted below. Based on this report, and the Council of Foreign Relations conference earlier this week, the magic phrase is "surge capacity." Repeat it and win.

Toronto does not have the capacity to deal with the number of patients that would flood into the city's health-care facilities if a flu pandemic struck, the Toronto Board of Health says.

As many as 14,000 people could require hospitalization during the first wave of an influenza pandemic, according to the draft version of the health board's pandemic plan, released yesterday.

But a survey of Toronto hospitals found "there is no surge capacity to deal with the expected volume of patients who will seek medical attention during a pandemic influenza. There will be a shortage of health-care providers to keep the doors of Toronto hospitals open," the draft plan states.

Dr. Michael Fitzpatrick, a GP from Britain, has this article saying the flu issue is a drama turned into a crisis.

Yesterday we reported that was bird flu in the Indonesian province of Aceh. Follow up story to remind us this was the first outbreak in the region, which is also where the tsunami hit.

Tamiflu will not be available in New Zealand until May.

In Trinidad, there's a festival coming, but this year it will be without the colored bird feathers imported from Asia. And all because of the bird flu.

Thursday, November 24, 2005

November 24 Thanksgiving Flu Update (Here in US)....Is the expert recanting on Chinese cases?

Effect Measure has the Japanese scientist from our last update who said that there were hundreds of unreported human flu deaths in China. Revere had been holding off reporting these rumors because he wanted some independent confirmation, which the scientist appeared to be providing. According to this statement, he was just repeating the rumors we have all seen.

Here is the direct ProMed report.

Meanwhile, China has reported a new flu outbreak, its 21st in recent weeks.

WHO has a situation update on the 35F farmer from Anhui...note the Chinese invitation for WHO to come in and investigate.

WaPO on the outbreak as well.

Inonesia reports an outbreak among bird in Aceh.

Recombinomics cites a report that an Israeli may have H5N1.

Standard and Poor's reports a $US200B impact on the insurance industry in a pandemic.

Meanwhile, the Globe and Mail sorts out the winners and losers in a pandemic--from the recession to the Rx.

The 15M in Vietnam is reportedly feeling better.

The EU has decided the birds must be kept indoors until May 2006.

Kannapolis, NC is preparing for a pandemic.

Roche is allowing local Tamiflu production in the Philippines...without compensation.

Crofsblogs found this review of Monster at the Door in the British Medical Journal. Apparently, its not good, but if you want to read the book yourself, you can purchase it at the link to the right.

Finally, a Thanksgiving treat. The Times (UK) Abroad in America column contains a funny story in which the columnist works through her paranoia on the bird flu, right up to the turkey on the table.

November 23 Flu Update--Second Death in China Reported

In China, a 35 year old farmer died of bird flu. Elsewhere in the country, a male schoolteacher was found not to have H5N1.

There are also more flu outbreaks reported in birds in China (Xinjiang).

If you've been here for the last few days, you know there is debate on what is really going on in China. Official reports are as listed above--a literal handful of cases. Underground web reports are saying there are hundreds of cases. Effect Measure has been trying to avoid spreading rumors while awaiting something which elevates the info beyond rumors, and today notes that an outside (Japanese) virologist is corroborating the underground claims. Obviously, must be monitored.

ProMed on the China cases.

"There is no proof of human-to-human transmission of bird flu in the world so far," Chen Xianyi, head of the contingency office of the Ministry of Health, told the Xinhua News Agency in an interview.

Promed with news from East Asia and China.

A boy in Vietnam has H5--tests will determine if it is N1.

News reports on outbreaks in China and Russia.

CIDRAP on China and Vietnam.

CIDRAP also reports on Russia and Canada news.

Also, via Crofsblog, a New England Journal of Medicine article looks back at what we can learn from 1918. Note that the article says the flu may have been circulating in humans since 1900. There has been speculation about whether the Spanish flu was really as "sudden" as it seemed...if true the implications for our current situation are obvious...a must read. I moved this up higher once I had the chance to review it.

Things seem to have slowed down in Indonesia, and they are using the time to set up a flu task force in case it happens again.

UPI status update on H2H transmission--not there yet.

Must read: Robert Webster of St. Jude's is in his native New Zealand to talk bird flu.

A critical phase in the evolution of a bird flu pandemic could play out in China in the coming weeks, world bird flu expert Robert Webster said in Dunedin yesterday.

The University of Otago-educated virologist is in Dunedin at the New Zealand Microbiology Society's annual conference this week.

He said a campaign in China to vaccinate its 14 billion poultry flock could precipitate a worst case scenario.

The doomsday scenario was that the Chinese would use a poor-quality vaccine that did nothing more than force the virus to mutate into something more lethal.

"The international community has no way of knowing whether China will use a good one," Professor Webster said.

"There is a big argument that they will simply help the virus to evolve to become a human pathogen."


The recent discovery of the virus in flamingoes in Kuwait indicated it was moving down toward Africa, which could provide the perfect environment for the critical mutation to human-to-human transfer.

"If it gets into the backyard flocks in Africa...that's a real worry," he said.

People whose immune systems were already compromised by HIV, which is widespread in Africa, either died quickly or went on shedding a virus for weeks.

If the former happened, that was tragedy, but if it were the latter, it might be even more dangerous, Prof Webster said.

"It gets the chance to adapt to the human and pick up the characteristics of receptor specificity," he said.

Good CIDRAP article follows up on the Chinese bird vaccination angle to this quote--why it may be impossible, and may do harm.

This is pretty big news...officials in Saudi Arabia are considering calling off the hajj, a January pilgrimmage of nearly two million people due to flu concerns.

The EU kicked off a pandemic planning exercise on Wednesday.

Hong Kong is stepping up its bird flu controls.

In Sequin Township, Ontario, there was a local session on preparing for the bird flu.

From The (Toledo) Blade, an excellent letter to the editor from Dr. Donna Woodson of the local Academy of Medicine who details the risks of "just in case" Tamiflu.

There's also flu attention in Antigua.

The Director of the Danvers Board of Health in Massachusetts says that the arrival of the flu in the US is one year away.

Interesting story from New Zealand. Apparently, the government has a legal obligation to provide safe working conditions--what implication does that have on Tamiflu distribution to healthcare workers.

Business Week looks at the bird flu scenarios, and how various business sectors would be affected.

There have been many reactions to the US bird flu plan. Here's one from the UK in Scientist magazine.

In addition to allotting insufficient funds for areas like surveillance in Asia, the UPMC document argues, the plan places too heavy a burden on U.S. state and local authorities with minimal funds, personnel, and political influence. The plan calls for states to handle the bulk of the response, from identifying influenza strains to monitoring hospital admissions, and makes them responsible for individually stockpiling anti-viral medication, bearing 75% of the cost at an estimated $500 million. "There are some parallels [with Hurricane Katrina]," Inglesby said. "Assuming that the states can mount the kind of effort that's required I think is not very realistic," said Monto.

Monterey, CA paper helps its readers understand the bird flu.

The Chinese detailed their vaccine development plan.

Chinese researchers obtained the seed virus from the World Health Organization (WHO) and planted it in chick embryos in seven-day-old eggs. They then ensured the embryos grew normally in the eggs before the embryos were extracted after three days of growth.

Effect Measure has a good article on how controls on air travel are being constructed as a key bird flu protective barrier, proposing a Maginot line metaphor.

Crofsblog points us here--bird flu has cut economic growth in Vietnam.

In France, they are launching a public education program to keep people eating chicken.

Tuesday, November 22, 2005

November 22 Flu Update--China calls flu a "serious epidemic"

China officials say the flu is a serious epidemic there, with two new outbreaks of the disease. The assumption is that the cases are bird cases, though the direct answer is not clear.

WaPo on the same story. China is taking pains to try and be open, but who knows what's going on in the vast, rural areas of that country.

China says its not planning to close its borders.

Recombinomics notes these outbreaks are earlier in the year than normal.

There's a new flu case in Vietnam--a teenage boy.

In Indonesia, the health minister says there are likely more cases then they are reporting due to poor surveillance in isolated rural areas. (Indonesians inhabit more than 6,000 islands).

More on the dead Russsian swans.

Will AIDS victims in Africa help spread the flu? Theory is that since the primary reaction to the bird flu is cytokine storm--an immune response--an AIDS victims are immuno-suppressed, they could carry the virus but not experience the storm.

China reports two goals for bird flu.

One of the goals is to effectively prevent bird flu from jumping to human beings, and the other is to maintain the normal order of production and living of the people, Gao said during a meeting with French Health Minister Xavier Bertrand in Shanghai on Monday.

Antigua is keeping an eye on the flu. (There are no small pandemics, only small...)

I'll bet five people asked me today if they could eat a Turkey on Thursday. Here's a poultry industry site to answer questions like that.

We noted yesteday some differing terminology in Chinese statements on the flu. We thought maybe it was a translation problem, but Effect Measure has a different outlook.

China continues work on its home-grown human flu vaccine, which is said to be ready for clinical trials.

From the Scotsman...advice on getting Tamiflu.

Two firms in South Korea are making generic Tamiflu--seperately.

Taiwan says it has extracted the acid vital to Tamiflu in local plants.

In Hong Kong, they are hedging their bets by stocking up on herbs along with Tamiflu.

But Hong Kong herbalist Wong Chi-sun is putting his trust in what looks like a plastic zip-lock bag full of some really bad weed. He's selling a blend of some classic Chinese fever-fighting remedies: squiggly yellowish buds of honeysuckle flowers, brown seed shells from the weeping forsythia, crumpled black Dyers Woad leaves and dried chips of Isatis root.

It's not a bunch of mumbo jumbo and quackery, the Chinese medicine practitioner says from his store-front clinic filled with earthy, musky smell of herbs and other things like dried sea horse and deer antlers.

"Western medicine is about treating symptoms," said Wong, who wears his hair slicked back and walks around in flip flops. "Chinese medicine is about treating the person."

Bird flu panic has caused a shortage in season influenza vaccines in Britain.

Reuters notes that the problem isn't limited to Britain.

The Village Voice weighs in on the pandemic flu--robber baron Rx companies and large countries ignoring the disease at the animal level...

In Asia, people love chicken, but they are growing hesitant to eat it.

The Philippines still say they are bird flu free.

Its still non-lethal, but there's more of it in BC--Avian Flu, that is.

A Kiwi expert says masks and Tamiflu are useless.

CIDRAP has some new updates to the CDC's travel restrictions, which are built on the SARS experience, and designed to provide some control at the border.

Effect Measure passed along the 29Ps of Pandemic Preparation without comment, as do I.

Breaking News--Official calls flu in China "serious epidemic"

"Serious" flu epidemic in China.

Monday, November 21, 2005

November 21 Flu Update--China Crisis is "severe," and getting worse

China continues to as flu hotspot, as the flu hits its 21st outbreak, and problem is termed "severe."

In response, the country is tightening its flu controls even more.

Bird flu (H5N1) was found in Romania again as well.

North Korea is also stepping up its bird flu campaign.

In BC, Canada, the bird flu found there is not H5N1.

Promed reports on the bird flu in BC.

ProMed also has OIE reports from Japan and China.

The news was reverberating today with the story of a new death in Indonesia, reported here yesterday.

In Vietnam, there are five new bird flu cases reported.

Vietnam also said it will produce 50M doses of flu vaccine.

Follow up: I'm surprised we haven't heard this earlier--veterinary staff in Vietnam are reported by Recombinomics to have bird flu.

A Senator in the Phillipines is suggesting that the country not spend its own money on pandemic protection, but use a US loan. (Odd, since the US Congress hasn't approved using more here yet, either.)

There are some novel genetic markers in an H5N1 positive swan in Mongolia. This will mean their migration will be easier to track. (Recombinomics).

Crofsblog has noted that the Official US Pandemic website is updated less often than his site (and this one, for that matter) and that's a disappointment.

Corn future prices were down today, because of fears that AI would reduce worldwide feed demand.

Belize is taking steps against bird flu.

On a trial basis, a company is producing generic Tamiflu in South Korea.

Tamiflu and Bird flu are already causing a different kind of viral activity--SPAM.

In Taiwan, they are reporting that there are three plants which can substitute for star anise and its key acid in making Tamiflu.

Promed with news from Asia, including a hygiene campaign in Hong Kong.

Media report from Reuters on the hygiene program in Hong Kong--cover your mouth....

WHO says Thailand and Indonesia are ready to fight the bird flu.

Effect Measure has a US-China bird flu comminique, which does not appear to be impressive to Revere.

Spencerport, NY looks back at the flu in 1918.

Sunday, November 20, 2005

November 20 Flu Update--Human Death toll continues to rise

A 35M died in Indonesia yesterday of what local test results indicate is the bird flu. More tests from Hong Kong are expected for final confirmation.

The Australian PM says there was calm determination, not panic, over flu at APEC.

The Chinese Health Minister says bird flu is contained and under control.

Could be a translation thing...this story quotes the minister as saying it is 'controllable.'

A WHO official stressed the importance of global surveillance on Meet the Press today. Note the last sentence...encapsulating what used to be the computer model driven containment strategy in "small possibility."

`We need to know when this pandemic virus emerges and we need to know quickly,'' which may be difficult because some Asian nations have weak disease-surveillance systems, said Mike Ryan, the World Health Organization's director of epidemic and pandemic alert and response. ``There's a small possibility we may be able to throw a fire blanket on this virus as it emerges,'' he said.
Here's the full Meet the Press transcript. Included is Dr. Fauci with this on the current state of the vaccine--its production, but he seems unconcerned about the virus mutating since the strain was identified 18 months ago.

MR. RUSSERT: ...but there is no vaccine to deal with the bird flu, correct?

DR. FAUCI: That's--in some respects, correct, but in others not. We do have a vaccine that was developed from a virus that was isolated from a Vietnamese patient about a year and a half ago. At the NIH, we've been in clinical trials with this H5N1 vaccine. It has been shown to be safe and it has been shown to be able to induce an immune response that would be predictive of being protective. We're doing the studies in individuals who are healthy. We're moving to elderly. The critical issue, and this is the constraining issue, is that we don't have the vaccine production capacity at this time to make enough vaccine for the people who might need it. That's really the problem.

The early warning system is looks at the routes of migrating birds and where they rest. It should be six months.

From Australia, the current flu plan is viewed as strong on chilling predictions, but weak on a single, unified surveillance system.

Delaware is putting its pandemic plan into test mode.

Scotland estimates a pandemic pricetag at 26B pounds in two years.

Excellent (Toledo) Blade article on the paths of migrating birds, the most likely pathways into North America and Ohio.

The European Medicines Agency is watching Tamiflu.

Roche tries to protect its "golden ticket" by protecting patents and increasing production. Part of doing so is trying to tamp down concern by referring to avian flu as an "animal welfare" issue in its current state. Note this:

But John Oxford, a professor of virology at Queen Mary's University of London, who said he would receive a fee for speaking at the Roche briefing, insisted much of the burden rested with Tamiflu.

"We need plans and ammunition and Tamiflu is at least half of our ammunition," Oxford said, adding there was a clear relationship between the current H5N1 strain and the deadly Spanish flu virus of 1918-1919. "Without Tamiflu, we would be going into this naked."

He also warned that bird flu was "like the Scarlet Pimpernel: You never know where it's going to appear. And it's got a greater spectrum of variety than any other flu virus we've ever seen before."

The South Coast Times (MASS), is taking flu seriously, and hopes the current vaccine might be partially effective.

ProMed with reports of birds and all manner of other living fish and mammals comingling in Vietnam, Taiwan's accusation that the birds that died in quarantine in Britain were Chinese birds smuggled through Taiwan, and an answer to how the Kuwaiti flamingo got the flu (migratory bird droppings).

Crofsblogs notes this from the New York Times--an editorial on the inadequate Bush Flu plan. Apparently, Secretary Leavitt made big news today saying the US was "unprepared" for the pandemic. It is surprising that this is news....he has said it over and over again.

Crofsblog also found this--the IHT notes that the ambitious Chinese efforts to vaccinate 14B poultry could actually make the disease worse by tracking the virus from farm to farm with the vaccination team.

He then pulls out a word I didn't know existed for something I have long been fascinated with--injuries caused by efforts to heal. I have called it dying from the cure--the actual word is iatrogenic.

Finally, Crofsblog says enterpising readers sent him this transcript of an 11/16 pandemic confernece sponsored by the Council of Foreign Relations, led by Laurie Garrett, one of our favorites here. I'm going to peruse it tonight, but here's the link for your own use.

Saturday, November 19, 2005

November 19 Flu Update--More Flu in China

China reports two flu outbreaks, hundreds of miles apart (Courtesy an anonymous commenter from yesterday).

Excellent AP story on why we get so little help from studying the history of flu pandemics.

Studies of past pandemics don't reveal how the switchover from bird virus to human scourge will happen in the next one. Instead, they illustrate there are two routes. The virus can make the genetic changes on its own. Or it can pick up genes from a human flu virus, perhaps in a person who became infected simultaneously with the bird and human viruses. This gene-swapping process is called reassortment.

Taubenberger, who is studying the genetic makeup of the 1918 pandemic virus, said that germ appears to have mutated on its own. In contrast, the viruses behind the other two pandemics of the 20th Century were apparently products of reassortment, he said.
The APEC summit has concluded, with a resolution that includes progress and ambition on the bird flu.

APEC preparation includes a simulation to test the plan.

FWIW, the full text of the APEC "Busan Declaration."

ProMed reports on two new outbreaks in Vietnam, and about Chinese pledges of cooperation with APEC.

Geoffrey York of the Globe and Mail weighs in with a must read on the question of transparency in China. His conclusion is that any lack of transparency is as much at the local and regional level as part of a national strategy.

Beijing is desperately trying to educate its local officials and health officers about the realities of the disease, but the first instinct of many Chinese bureaucrats is to conceal and cover up. The greatest danger is that those same bureaucrats might even conceal a case of human-to-human transmission, the potential trigger of a global bird-flu epidemic that could kill millions of people.

After repeated denials, China finally confirmed its first human cases of bird flu this week, including two deaths where bird flu is confirmed or strongly suspected.

Evidence of a cover-up has already emerged in at least two regions of China. In Hunan province, reporters were arrested when they tried to investigate rumours of a bird-flu outbreak. Officials declared last month that the case was "closed," and then were forced to admit this week that the outbreak was indeed caused by bird flu.

In Liaoning province, where three bird-flu outbreaks have erupted, it was revealed this week that a bureaucrat has been arrested for trying to cover up the illnesses of chickens at local farms.

Zhao Yonghe, head of veterinary services in a village in Liaoning, was allegedly giving certificates to local farmers to verify that their chickens were healthy, though he knew they had contracted the bird-flu virus.

Onto this emerging stage steps Helen Branswell, who writes that China is hesitant to share actual viruses, even though they are sharing viral sequences--again, for reasons which may not be based on a national strategy.

Lubroth says China's slowness to share viruses reflects a concern there that the country's researchers do not receive adequate credit for their scientific contribution.

Brown can understand that point of view, saying scientists the world over hoard their data in order to ensure they get credit for their findings, which is key to ensuring ongoing research funding.

"You don't give away your data because the big labs will take it, they'll take the credit and you're sitting there writing a grant application without having the work published by yourself," he says.

Effect Measure notes that these reasons are plausible from the viewpoint of a practicing researcher.

Effect Measure also has insights into whether H2H is happening in Indonesia, asking whether the only acceptable proof of H2H is when it is already happening on a large scale.

ProMed with the news angle to the same story (along with reports on the China debate cited above.

Firstly, although the majority (but not all) of the human cases can be related to contact with diseased poultry, the number of human cases of illness must be a very small proportion of all contacts between humans and diseased poultry. Other as-yet-unrecognized factors must be involved.

Secondly, nucleotide sequence analysis is useful in unravelling the epidemiology of separate outbreaks. But sequence variation has to be correlated with biological experiments to make predictions about the imminence of changes in transmissibility and virus virulence. Mutations tend to be deleterious unless there is some external selective pressure favouring survival of a particular phenotype.
The Philippines says it should be a model for fighting the bird flu.

The BBC was in Vietnam, where officials voice optimism at beating the bird flu, but the reporter leaves skeptical of their ability to win.

From the White House, here is a "fact sheet" on US leadership in Avian Influenza.

Duck in British Columbia is bird flu positive, though the exact strain has not been determined yet. Quarantining is taking place.

Recombinomics comments on why we don't know yet if this is HPAI.

The BBC reports on the US clearing Tamiflu.

In Australia, they are training students to give flu shots.

China has agreed to supply India with shikimic acid, the rare and secret ingredient in Tamiflu.

Recombinomics reports there is a low pathogen mode of H5N1 in Manitoba.

Crofsblogs chimes in with a late Branswell article confirming what Recombiomics published on this.

Recombinomics with more on Canada--results appear to point to LPAI.

Recombinomics passes along boxun reports that there are 77 human fatalities in Liaoning, China, from H5N1.

ProMed on the safety of Tamiflu.

Friday, November 18, 2005

November 18 Flu Update

China says that it has two new flu outbreaks, but no new human cases. In fact, dozens of farmers and villagers were released from medical observation.

FDA says no evidence Tamiflu is behind deaths.

In Vietnam there were three new provinces with flu, and in China there was a new outbreak. Reuters summarizes the news of the day.

More on China and Vietnam news from today. (The virus marches on).

Beijing has designated two hospitals for treatment of flu victims.

The APEC flu and trade summit wrapped up.

For the umpteenth time, world leaders have pledged to work together to fight the bird flu.

This AP story asks how you prepare without panic.

The Council on Foreign Relations wonders whether potential liability is slowing down the production of a flu vaccine.

Effect Measure comments on Congressional rejection of the pandemic planning $.

Effect Measure on some actions which could work against the Chinese desire to be seen as transparent.

From Australia, an interesting article recounting the 1918 flu there, and what we can learn from it today.

The Lancet has an important article on what governments have to do for citizens to avoid flu panic....common sense from a credible source...

"But if governments are to avert widespread panic, they must admit to uncertainty, act transparently, issue guidance on disease protection, and make sure information is disseminated to the public as quickly as possible.

Peterborough, UK, covers pandemic preperations.

In Hawaii, Governor Lingle is asking for $15M to fight bird flu.

Recombinomics on the rapidly increasing number of flu outbreaks in China.

Recombinomics citing to show that H2H transmission is widespread in China.

ProMed with news from China and Vietnam.

Hungary is making political hay out of the bird flu.

Analyst report questions whether two much is being invested in Tamiflu.

ProMed with a survey of SE Asia, including bird flu techniques that worked in one province in Thailand.

ProMed on Tamiflu--both the FDA, and a request for clinical experiences with Tamiflu in Asia.

Breaking News--FDA says no evidence Tamiflu tied to deaths in Japan

FDA report says no link between Tamiflu and Japan deaths.

Thursday, November 17, 2005

November 17 Flu Update--Roche denies upgraded Tamiflu victim toll and WHO issues warning on vaccines being developed.

As I noted earlier, 12 children in Japan are now said to have died after taking Tamiflu. The FDA is investigating. (Other reports say there are 75 other cases around the world of skin and mental problems, five in the US).

Roche denies a link.

"Roche doesn't believe there's a link between Tamiflu and those deaths, and we are confident that Tamiflu can be used safely both by children and adults," a spokesman for Roche in the United States, Al Wasiewski, told AFP.
WHO issued a warning today that many people have noted before--that vaccines being developed today could be of no use in a pandemic.

'The current virus is not able to become a human pandemic. Even if H5N1 might become the precursor of a human has to go through some changes,' Bekedam told a news conference.

'Those changes might be so substantial that this current virus -- the vaccine (for which) they're working on, might not work,' Bekedam said.

'On the other hand it might work... We hope it might work.'

In Washington, the US Congress rejected a call for $7.1B in emergency flu funds, on the grounds that it should be offset with cuts to other parts of the government.

Meanwhile, the flu marches on.

Two more Indonesian deaths have been linked to the bird flu--note these deaths occurred earlier in November.

China reports its 12-13 flu outbreaks.

WHO update on China and Indonesia.

Effect Measure on whether the human cases in China were really the first human cases.

Note: Recombinomics has also questioned how open the Chinese are really being. Here reports on experts who say that China's efforts shine in comparison to SARS.

APEC Summit story on the flu being on the list for discussion.

Cuba is thinking about making a bird flu vaccine, now.

Britain has reinstated bird shows.

In China, you can now buy bird flu insurance.

From WI--influenza and bird flu are not the same thing.

WHO says it expects bird flu cases in China to rise in humans.

A CDC official writes in the leading Native American publication about the bird flu.

The Alabama public health official is seeking funding for Tamiflu.

Effect Measure of reassortment, recombinomics and genetic drift, and how the presence of H3 and H4 in poultry in Vietnam is raising the spectre of reassortment.

ProMed with a report on the findings in Vietnam and other news from China.

ProMed on a WHO statemet of no evidence of H2H transmission of the flu in China, along with news from Indonesia.

Breaking News....FDA probing Tamiflu, potential 14 deaths in Japan

Are there 14 Tamiflu deaths in Japan? The FDA is probing.

Wednesday, November 16, 2005

November 16 Flu Update--China cases dominate the news

ProMed on the dramatic Chinese announcement--girl dead, brother spared.

Wire reports on the Chinese announcement.

CIDRAP on the Chinese announcement. There had been a poultry outbreak in their village.

In other news, flu is reported in three more provinces in Vietnam.

Reuters adds the new developments to the bird flu timeline.

APEC is promising tighter coordination on the bird flu.

CIDRAP on this week's cytokine storm research

Another region heard from...the Caribbean is urged to prepare for bird flu.

The Jakarta Post notes something which will be a trend if a pandemic starts--protection of healthcare workers.

It sounded relatively simple. Test Canadian Geese to see if they have the flu. Alas, as Helen Branswell reports, it was not as simple as first thought.

It's proving harder than anticipated to type the avian flu viruses wild ducks sampled in Canada were carrying because a number were co-infected with several strains, creating a viral "soup" that is difficult to separate down to its basic ingredients, government officials have admitted.

They say, however, that it appears that none of the viruses are highly pathogenic, a finding that would support the suggestion none of the birds were carrying the worrisome Asian H5N1 flu virus, which is a so-called high path virus.

Peace has broken out in the Tamiflu war between Roche and Gilead.

India is asking China for raw materials for Tamiflu.

More news that should give pause to the Tamiflu bandwagon--more research is needed to determine the correct dose.

From Vietnam, this report says that the flu is already Tamiflu resistant. (With that in mind, a caveat....these stories crop up from time to time and often spring from the same semi-accurate source. Read accordingly.)

Vietnam is ready to mass produce a flu vaccine in early '06.

I have written before that China is doing better on transparency, because their tendency is to say there are NO cases. However, its not transparent if you say there are three cases and there are 300. It sounds like they are being straight.

Recombinomics has another view, saying that the admission of three cases validates boxun claims of widespread H5N1 deaths. has the boxun report, for your review. (via crofsblog)

Taiwan doubts that the birds in Britain died of H5N1.

CIDRAP says England disagrees.

New Zealand begins to enact its bird flu plan.

Breaking news--China reports three human cases

Reuters says China has reported three human cases of bird flu.

Tuesday, November 15, 2005

November 15 Flu Update--China confirms its first human case, and says it will vaccinate 14B poultry,

China is going to vaccinate 14B poultry for bird flu. You read that right.

CIDRAP on this ambitious plan.

ProMed has this on the first confirmed human case in China.

The 10th and 11th flu outbreaks in China have been announced.

5o birds being imported to Britain from Taiwan died of bird flu in quarantine.

In Indonesia, they are planning to use volunteers and soliders to go door-to-door checking for sick birds.

The regular seasonal flu is getting slighted by the bird flu.

APEC has a plan to finance the bird flu fight.

Reuters updates its bird flu Q&A.

A local task force in Bellingham, WA, is planning for the pandemic.

Occasionally, we refer to Avian Flu, What we need to know, a flu blog. The author has developed a 40-page policy analysis on bird flu. You can get it here. (I have not read it.)

Here is the executive summary:

To combat a possible avian flu pandemic, we should consider the following:

1. The single most important thing we can do for a pandemic—whether avian flu or not—is to have well-prepared local health care systems. We should prepare for pandemics in ways that are politically sustainable and remain useful even if an avian flu pandemic does not occur.

2. Prepare social norms and emergency procedures which would limit or delay the spread of a pandemic. Regular hand washing, and other beneficial public customs, may save more lives than a Tamiflu stockpile.

3. Decentralize our supplies of anti-virals and treat timely distribution as more important than simply creating a stockpile.

4. Institute prizes for effective vaccines and relax liability laws for vaccine makers. Our government has been discouraging what it should be encouraging.

5. Respect intellectual property by buying the relevant drugs and vaccines at fair prices. Confiscating property rights would reduce the incentive for innovation the next time around.

6. Make economic preparations to ensure the continuity of food and power supplies. The relevant “choke points” may include the check clearing system and the use of mass transit to deliver food supply workers to their jobs.

7. Realize that the federal government will be largely powerless in the worst stages of a pandemic and make appropriate local plans.

8. Encourage the formation of prediction markets in an avian flu pandemic. This will give us a better idea of the probability of widespread human-to-human transmission.

9. Provide incentives for Asian countries to improve their surveillance. Tie foreign aid to the receipt of useful information about the progress of avian flu.

10. Reform the World Health Organization and give it greater autonomy from its government funders.

We should not do the following:

1. Tamiflu and vaccine stockpiling have their roles but they should not form the centerpiece of a plan. In addition to the medical limitations of these investments, institutional factors will restrict our ability to allocate these supplies promptly to their proper uses.

2. We should not rely on quarantines and mass isolations. Both tend to be counterproductive and could spread rather than limit a pandemic.

3. We should not expect the Army or Armed Forces to be part of a useful response plan.

4. We should not expect to choke off a pandemic in its country of origin. Once a pandemic has started abroad, we should shut schools and many public places immediately.

5. We should not obsess over avian flu at the expense of other medical issues. The next pandemic or public health crisis could come from any number of sources. By focusing on local preparedness and decentralized responses, this plan is robust to surprise and will also prove useful for responding to terrorism or natural catastrophes.

Company announces partnership with NIH to evaluate the Universal Viral Inactivation Method.

US Rep Nita Lowey writes about the need to plan in The Hill.

The historical society in Lexington, VA, is going to do a presentation on the 1918/19 flu.

Via Crofsblogs, Vietnemese investigators are testing flu vaccines on themselves.

Also via Crofsblogs, a nice Jakarta Post story on the hospital there where the flu patients end up.

In Grande Prairie, Alberta agree vaccinating birds can help prevent the disease from spreading.

Colorado also has a statewide bird flu task force.

Here's a news release on the poultry industry website on avian flu.

Here's a link to the website.

UK story about bird flu not interfering with Christmas turkeys.

CIDRAP on a lack of funds hampering bird flu efforts in Asia. (I can understand some of the countries, but does China really not have any money?)

BBC on the question of Tamiflu-related suicides in Japan.

Qatar is going to regulate the sale of Tamiflu to prevent panic buying.

If you're wondering why personal stockpiling of Tamiflu doesn't make sense, check out this WSJ article syndicated in the Pittsburgh Post Gazette.

But there are several reasons why it is impractical for individuals to stock up on flu drugs. First, we don't yet know what an adequate dose is. While 10 pills of Tamiflu -- two pills a day for five days -- is typically enough to battle regular flu, rodent studies suggest we might need more than that to battle H5N1. In August, the Journal of Infectious Diseases reported that the standard five-day dose protected only 50 percent of mice infected with H5N1. Eight days of treatment boosted survival to 80 percent.

In addition, the flu drugs protect you only as long as you are taking them. If you are the only one in your neighborhood taking Tamiflu during an outbreak, it isn't going to do you much good because you will be as vulnerable as everyone else the moment you stop taking the drug.

"You can't keep on using Tamiflu forever," says Suresh Mittal, a virology professor at Purdue University in West Lafayette, Ind. "It's not a vaccine. As soon as someone stops the drug, they are equally capable of getting the infection."

Taiwan will begin producing Tamiflu in March.

A British expert warns his government that its order should be 20X bigger for flu vaccine.

November 14 Flu Update--Flu Outbreaks Continue Across Asia this morning

Human cases of bird flu continue across Asia. Indonesia says a 20F died of suspected bird flu. Other countries are also reporting human cases. Note the false negative, listed below.

There are at least a dozen other suspected cases as governments in Asia struggle to control outbreaks in poultry to prevent more people from catching the virus, which experts fear could trigger a pandemic.

Vietnam and China say they have more suspicious cases in people, while Thailand says a toddler infected with bird flu is recovering.

In the Indonesian capital, Jakarta, a Health Ministry official says tests confirm the woman died from H5N1 and that tests are being conducted on samples from a 13-year-old girl.

Both died over the weekend in the Sulianti Saroso Hospital, Jakarta's hospital for treating bird flu patients.

Initial tests on the girl were negative.

ProMed surveys cases in Asia.

ABC News follows up on this story as well.

China is reporting its ninth outbreak of bird flu. The outbreak is in Huainan. WHO is also in China to try and determine if a young girl who died had bird flu. Note continuing Chinese transparency.

ProMed on the case in China.

Here's a story on the case in Vietnam.

China is also concerned about another poultry worker in Liaoning.

WHO on the lab-confirmed case we reported earlier in Bangkok.

CIDRAP on the outbreaks in Asia.

They'd love to talk about trade at the APEC, but the flu and terrorism keep getting in the way.

South Dakota State University is opening a bird flu testing center.

The Japanese have a bird flu plan, which includes closing schools.

The London Times reports a story that is bouncing around the world---did Tamiflu induce suicides in Japanese teenagers?

Roche says there is "no clear evidence" of a link between the drug and the suicides.

Roche Holding AG (ROG.VX: Quote, Profile, Research) said it had reported the cases of two boys who had taken the drug to Japanese health authorities and that they had been listed as examples of so-called adverse events in the packaging supplied with the antiviral pill.

Concerns over the side effects of the medicine had weighed on shares in Roche and its Japanese partner Chugai Pharmaceutical Co. on Monday after local media said that health authorities in Japan were investigating the deaths.

One teenager died after falling from the window of an apartment block in February while another was killed after walking in front of a truck in February 2004, David Reddy, Roche's head of pandemic sales of Tamiflu, told reporters.

In the case of the boy who fell, there was insufficient evidence to tell whether he had intended to kill himself, Reddy said. The boy had been taking another drug, known to affect the central nervous system, before switching to Tamiflu.

"One of the issues faced in determining the background for any incident is determining the potential contribution of a drug or the contribution of the underlying illness," Reddy said.

"We do not see an imbalance in these types of neuro-psychiatric events for Tamiflu versus the background associated with influenza," he said. "We have not seen an increased rate (of abnormal behaviour)."

Notwithstanding this, the Japanese are still buying Tamiflu.

A company's stock fell in Japan due to the suicide/Tamiflu story.

Effect Measure notes that there is a new line of thinking emerging in the discussions about the US bird flu plan. It started with the idea each community was on its own, and has now moved toward the idea that each home is on its own. And its reached mainstream sources like Ted Koppel.

WHO is pressing Africa to take the bird flu more seriously.

The Milwaukee Journal-Sentinel continues its ongoing strong coverage of bird flu. Here columnist Tom Saler talks about the economic effects of the bird flu.

A Dutch company announces bird flu vaccine efforts.

Ukiah, CA writes on "effective" Tamiflu.

In Ho Chi Minh City, people are told there is "no need" to hoard Tamiflu.

Website tells owners of pet birds not to worry about the bird flu.

Fears of bird flu have sharply reduced attendance at a bird watcher festival in Taiwan.

Interesting bit from Effect Measure. A survey says 80% of people say they go to work sick, but their bosses don't see it that way. The question is, how would that play out during the bird flu...companies short staffed, but people need to stay home. Plus, schools could be closed.

Crofsblogs has this from Romania, where the flu has been found in chickens.

Front page story in USA Today on how US poultry industry fights bird flu.