Wednesday, January 18, 2006

January 18 Flu Update--Has the Flu Hit Kurdish Iraq?

As we reported earlier, officials are investigating a case of possible bird flu in Kurdish Iraq. There's a dead 15 year old girl. Apparently, birds that eventually end up in Turkey will stop in this area.

ProMed on this situation.

Recombinomics on Iraq.

Me on Iraq: quick note, just to say that for those readers for whom history--and 1918--are the main points of interest, the introduction of the flu into a war zone is almost scary.

There is apparently a fifth flu death in Turkey. It was an 11 year old girl who died on the way to the hospital.

ProMed on Turkey.

Declan Butler of Nature is one of the leading science journalists writing on the flu, and he's tied into social networking on Connotea, too. Via Crofsblogs, here is a troubling story on the "alarms over bird flu mutations." Entire article is a must read.

Scientists studying virus samples from the human outbreak of avian flu in Turkey have identified three mutations in the virus's sequence. They say that at least two of these look likely to make the virus better adapted to humans.

The Turkey outbreak is unusual, because of the large family clusters of cases; the fact that many of those infected have only mild symptoms; and the speed with which infections have arisen — twenty cases, including four deaths, in less than two weeks. So scientists are urgently trying to establish whether the virus is behaving differently in this outbreak from previous ones in Asia. In particular, international teams are investigating the possibility that the virus is moving between people.

Recombinomics, citing an OIE report, says that there has been an "explosion" of bird flu in poultry in Turkey, and feels human cases will soon follow.

Recombinomics also looks at the clusters in Turkey, and says the virus is becoming better at transmission.

There's a six death in China, as well. She was a 35F poultry butcher.

ProMed on this case--noting that if confirmed it would be the first case in Sichuan.

ProMed writes that the case fatality rate in Turkey is much lower than that in Asia--but I ask if that's because of more comprehensive case reporting.

World leaders have coughed up (sorry) the $1.9B that it was said was needed to fight the bird flu.

CBC on the bird flu conference.

A good Reuters story on the striking real impact of bird flu on those for whom poultry are a way of life.

The UN's FAO has this warning for Europe--there's plenty of ways for the bird flu to spread around.

"FAO - says FAO Director General David Harcharik - is concerned that new areas may be contaminated as a result of traffic involving goods, people and animals, as well as through bird migrations".

Malaysia says it needs $213M to fight the bird flu.

The UN says every country is needed to fight the bird flu.

An official with the Ministry of Health in Singapore has a good observation. Asia will see more flu cases, because the fundamental conditions--people living in close proximity of birds--haven't changed.
The Taiwanese talk about what they learned at a bird flu conference sponsored by WHO in Taipei.

From the Sydney Morning Herald, a contrarian view from a writer who says the only pandemic is panic.

Malta says a pandemic is unlikely this winter.

The British Medical Journal Lancet will hold an Avian Flu conference in Singapore.

Lancet also warned strongly that too much up reliance is being placed on Tamiflu to prevent a pandemic. Note these strong words for a medical journal.

In a paper published online by the British journal The Lancet, the experts say they see no evidence that the top-selling drug worked against H5N1 avian influenza and fear the treatment could be of limited use if the H5N1 virus ever mutates into a feared pandemic form.

Asia wants more Tamiflu.

How to distribute Tamiflu is an ethical question for companies.

Singapore is hedging its best, and adding Relenza to its stockpile.

In Turkey, a doctor has said that with enough funding the country could have a human vaccine in 2-3 months.

At St. Louis University, they are studying flu vaccines for children--timely given the proportion of infected children.

Vietnam is working on a vaccine, as well.

Effect Measure has a story that I first saw on a great comment from yesterday's update--the H5N1 may cause systemic infections in cats. Among other interesting points, this could explain the spread of virus from farm to farm.

(From the BBC) Writing in Science, the researchers say: "The implications are that, during H5N1 virus outbreaks, domestic cats are at risk of disease or death from H5N1 virus infection, either due to feeding on infected poultry or wild birds, or due to contact with infected cats.

"Second, the role of cats in the spread of H5N1 virus between poultry farms, and from poultry to humans needs to be re-assessed.

"Third, cats may form an opportunity for this avian virus to adapt to mammals, thereby increasing the risk of a human influenza pandemic."

Professor John Oxford, an expert in virology at Queen Mary College, London, told BBC News Online the study was "very significant and slightly alarming".

He said there was little evidence at present that cats could be infected with other forms of human flu virus, and so the possibility that H5N1 could mix with a human virus inside a cat and produce a deadly new strain was probably slim.

However, he agreed that it was possible that cats could be responsible for avian flu spreading from farm to farm - a phenomenon which has baffled scientists.

Professor Oxford said there was also work to suggest that pigs could be infected with H5N1, and, unlike cats, they could also harbour human versions of the virus.

"H5N1 is getting more and more worrisome," he said.

"If any virus is going to cause a great human pandemic in the near future, then it is likely to be H5N1."

Part II of Effect Measure's fascinating story of what a cell is, and how it is infected, and how it mutates.


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