Sunday, July 30, 2006

July 30 Flu Update

From Thailand, among the 44 suspected cases, there are at least five cases with symptoms which appear to be H5N1.

A new outbreak along the Laotian border in Thailand has prompted the culling of 310,000 news.

Local Thai report on what is going on there. Still unclear if these cases are highly precautionary or under a reasonable suspicion.

Another local report says 80 patients under observation.

Colorado-area companies are preparing their pandemic plans. As always, interesting stuff:

Boston Market Corp. is developing and testing alternative menu items at its Golden headquarters.

Officials at Red Robin Gourmet Burgers Inc. are prepared to substitute pictures of burgers for those of chicken sandwiches on the company's menus and signs.

Executives at Red Bird Farms Co. in Englewood have drafted a nine-point plan for communicating the safety of their product.

The FAO says bird flu has cost Asia $10B.

An honest statement on bird flu prep from a Pittsburgh area local official. Article notes one school district and one city have a flu plan in the area.

"I don't even know what I don't know," said Pepe, borough manager for Zelienople, Butler County. "I don't know what resources I need."

A pandemic planning summit will be held in SW Utah.

Saturday, July 29, 2006

July 29th Flu Update

113 people are now suspected of having bird flu in Thailand. I sense a need for caution here...this would be the fastest ramp up of the virus if true, but it seems like it might be panic. Thailand says it is not "worrisome."

The ministry said 75 suspected patients were in Phichit, 14 in Sukhothai, five in Kanchanaburi, three in Nakhon Sawan, three in Suphan Buri, two each in Bangkok, Phitsanulok, and Phetchabun and one each in Kamphaeng Phet, Nakhon Nayok, Nakhon Pathom, Nonthaburi, Maha Sarakham, Uthai Thani and Uttaradit.

2,000 chickens in Laos died of H5N1 in the Mekong Valley, based on government reports.

The controversey over the Indonesian samples--unreleased by the government there--continues unabated. Declan Butler weighs in to say that not only have no human isolates been shared, but also no avian isolates until very recently.

Experts say that without thorough genetic sequencing of bird viruses from the area it is difficult to tell whether the virus is mutating, or how the human cases correspond to birds in the area. There have been some human viruses found in Java that so far have no obvious avian counterparts: perhaps simply because matching strains in birds have not been sequenced, or perhaps not.
Effect Measure comments on this. Note the following if you're ready for a shock:

(from original article): The Jakarta teams alone have discovered an average of 24 previously unknown infected locations a week between January and May. "The community surveillance system is starting to work," says Roeder.

(Revere) You read that right. Not 24 new infected locations in all. 24 infected locations a week over five months! The place is a f***ing (edit mine) bird flu fermentation vat and they are withholding sequences and isolates?

ProMed has it as well. Note the mod comment.

A report says GSK alone could produce 1 billion doses of its new flu vaccine.

Minnesota is buying Tamiflu under the federal program.

Hong Kong is now banning poultry imports for 14 days after an outbreak, not 21.

WaPo on a gateway for getting flu into Southeast Asia....illegal bird smuggling out of China.

As bird flu continues to spread across the Eastern Hemisphere, international health experts warn that illegal trade in poultry, poultry products and other birds is often the primary cause.

Japanese researchers are now doing bird flu testing on monkeys.

The experiment could shed light on aspects of the infection mechanism of the viral strain that remain a mystery, and pave the way for a human vaccine, the researchers said.

"The highly virulent H5N1 strain virus could kill mice and chickens when they were infected with it but it remains unknown what exactly would happen for monkeys," Kazumasa Ogasawara, a Shiga professor, said.

"Monkeys have immune system cells akin to those of humans, so the research should also be useful in devising measures against infection in humans," he said.

July 28 Flu Update

The big news today is that there are 11 more suspected human cases in Phichit, Thailand, where there has already been one death. Obviously, this is a big group, and if confirmed, people will be looking for clusters. Warning: with the death, panic and fear could be a possible cause. ProMed reports:

11 more suspected bird flu cases were reported in Thailand's lower northern province of Phichit on Thu 27 Jul 2006. Dr. Prajak Wattanakul, head of the Phichit Provincial Public Health Office, said that the 11 patients, mostly children aged between 4-14, are suspected of being infected with avian influenza virus and were admitted to 5 different hospitals in the province on Thu 27 Jul 2006. Some of them had contact with dead poultry and others live in areas where a large number of fowl died of unknown causes.
Thailand says it will begin to use Tamiflu in suspected flu cases prior to actual lab confirmation.

This local story says there are actually 22 suspected cases. It also says the Thai government is afraid that Tamiflu will be overused and a resistant strain will emerge.

CIDRAP on Thailand and Laos. Says there are reports of 44 suspected cases.

ProMed on Thailand and Laos.

Recombinomics on Thailand.

The 44 suspect cases described above in Thailand is alarming, especially in view of past surveillance. H5N1 has now also been acknowledged in neighboring Laos. In February, H5N1 was detected in both Laos and Malaysia, but neither country, nor neighboring countries file mandatory OIE reports.

Questions of surveillance have been raised for over two years, and the failure to monitor and report may now be manifesting itself in significant human infections and spread.

We've often wondered what would happen if....people looked for the bird flu. In Indonesia, vets have been looking--hard--for new outbreaks.

In just six months, teams of veterinarians marching along dusty, twisting paths in the remote villages of this sprawling country have uncovered more flu outbreaks among birds than experts had even imagined.

"It's still just the tip of the iceberg," said Jeff Mariner, an animal health expert from Tufts University who has been working with the effort since it began in January.


"This is presently the best option because it can detect that our reporting is very weak," said Elly Sudiana, who oversees the program for the Ministry of Agriculture. "So, through this ... early detection can be improved and response can be improved."

India is preparing to declare itself bird flu free.

India is also declaring that Asia needs $500M more to fight the bird flu.

Asian countries have signed the "Delhi Declaration." This will outline the regional cooperation envisioned to fight the bird flu.

UN confirms bird flu on Laotian farm.

Interesting article. Claims that recent scientific research says that the real killer of the 1918 flu might have been undetected tuberculosis.

Link to the direct report.

International Medical Corps' Director of Evidence-Based Research, is traveling to Mongolia, China, Thailand, and the surrounding Mekong countries to meet with various UNICEF country teams focusing on Avian Influenza research and behavioral change plans.

Wildlife monitoring will be taking place in Chattanooga.

Effect Measure comments on a report that the Indonesians are nearly bragging (my perception) about having bird flu isolates and keeping them for their own research. By the way, their own secret research says there is no human adaptability going on.

Amador County, CA, will hold a pandemic exercise.

Hempstead County, AR, is doing bird flu planning.

CIDRAP reports on the duck hunter study from earlier in the week.

Friday, July 28, 2006

July 27 Flu Update

Based on the recent death, people in Thailand are apparently afraid that dengue fever has mutated with H5N1.

Interesting article. Thailand was the model of how to fight the bird flu. But, the virus proves difficult to finally put away.

Effect Measure says he is willing to "bet" that the flu has been present in Thailand since December, and merely flying beneath the radar.

The Thai Prime Minister says that the outbreak is the fault of local villages who attempted to cover up the disease.

Recombinomics has a translation of a local report that says there are 44 potential cases in Thailand.

I could easily have run 25 articles on the GSK vaccine story. This story includes an interesting quote from WHO:

"While this is encouraging and promising, these results were obtained with a proprietary adjuvant, so access for other companies to use it will most likely be limited," says Dr. Klaus Stohr, the World Health Organization's special adviser on influenza pandemic vaccines.

From a public health perspective, Stohr says an effective vaccine developed with an adjuvant easily available to other pharmaceutical companies would be preferable, as it would expand global vaccine production capacity. More than 20 clinical trials involving potential H5N1 vaccines are being underaken by some 13 companies.

Laos is reporting birds dying of bird flu.

ProMed on Laos: H5N1 not confirmed.

Secretary Leavitt and Mayor Bloomberg appeared at a New York City pandemic planning forum.

South Africa culls 8,000 ostriches, declares bird flu under control.

WHO says better communication is needed to fight bird flu.

Minnesota is among states looking to stockpile Tamiflu.

Iowa has demonstrated that hunters can catch bird flu--though it was not H5N1.

Wednesday, July 26, 2006

July 26 Flu Update

Today's big news is on the vaccine front. GlaxoSmithKline has reported strong success in developing a flu vaccine. Not surprisingly, GSK used an adjuvant to bring dosage levels down (and production capacity up), but it still required two seperate doses.

In a release, the company said it was able to achieve the level of protection demanded by regulators using two separate doses of 3.8 micrograms each of the antigen, and an ingredient called an "adjuvant" that allows the company to use less antigen.
Here's the key question...what about cross-protection? If the virus mutates, what are the chances this virus still protects. Here is what GSK says.

Asked by BBC Radio if the vaccine could handle a possible mutation in H5N1 that increases its likelihood of spreading between people, JP Garnier, the company's chief executive officer, replied: "If you had a mutation that is closely connected to the H5N1 virus, the answer is probably yes."

Official company press release.

Thailand confirms bird flu death of 17 year old man, reported yesterday.

Promed with news on the cases in Thailand. As you will recall, a large number of cases were outstanding...5 have now been diagnosed as seasonal flu, according to reports.

These reports identify an 8th suspected human case of H5N1 avian influenza in Thailand. However, 5 other suspected cases previously reported have now been diagnosed as cases of seasonal influenza virus infection.

Official WHO report on this death.

CIDRAP on the death.

China is getting ready to test the man who died in 2003, and is now said to have died of bird flu...causing a major controversey in the medical community. China has invited WHO to observe the tests.

Three children were tested for the bird flu in Turkey, but they were negative. However, note this social dynamic.

Three children suffering from what doctors suspected was the bird flu were transferred to Van University Hospital from Hakkari Hospital, where their health condition had initially worsened.

When the parents of the children refused to transfer them to Van, police intervened and forcibly transferred them to Van University Hospital.

Ghana has been declared a model for how to fight the bird flu.

South Africa culls ostriches, but it's H5N2.

Bulgaria is continuing to test for bird flu.

Bulgaria has also declared three areas to be bird flu free.

North Dakota is stockpiling Tamiflu.

Recombinomics on the growing reach of the Qinghai strain.

Marion County, IL, held its first bird flu summit meeting. Their group will continue to meet quarterly.

A local Ontario physician is urging local businesses to prepare for the bird flu.

Employee illness and absenteeism will easily rise to 35 per cent or higher, supply chains will be disrupted, and customers will also be ill.

"For most of us, that's a huge impact," she said of the high levels of absenteeism.

Nolan added at the same time more employees and customers are ill, increased demand for their service will be added.

"Let's ask ourselves these tough questions now," she said. "It's the responsible thing to do."

Tuesday, July 25, 2006

July 25 Flu Update

Recombinomics says that a 17-year old in Northern Thailand has died from possible bird flu symptoms.

Thailand confirms that there is bird flu among birds in the Northern part of the country.

Effect Measure on Thailand....question is, was the flu there all along, or did it just reappear? Seems safe to say it has been there longer than the government admits.

Effect Measure writes that there is a new paper that suggests that many cases in cats may have been missed (probably were), and cat-cat transmission therefore cannot be ruled out.

The UN is reminding the Americas that they have to prepare for bird flu, too.

Bulgaria says a water basin where wild birds gathered could be the source of the bird flu.

Vermont held a mock bird flu drill. It's a week long exercise looking at a wide variety of scenarios.

A group in New Zealand says it has a bird flu mapping program that will allow instant containment of an outbreak...they also say the government is stifling its development.

CIDRAP on Roche being criticized for selling Tamiflu to business when governments are short their allocations.

Recombinomics says that bird flu isolates in Ivory Coast show increasing genetic diversity in Africa.

A company has a whitepaper on business continuity planning during a pandemic.

Here's the actual whitepaper.

Monday, July 24, 2006

July 24 Flu Update

First, Thailand reports 5-7 new potential human cases. Now, the possibility of more sick birds (there were also reports of sick birds earlier this month.

As usual, CIDRAP has the best summary of the confusing developments in Thailand.

ProMed on the new potential human cases. I believe this story actually indicates one confirmed case, one new suspected case, and pending lab work on seven more, for a total of nine suspected cases.

Promed on the "dove eaters" mentioned in the comment from Slovenia in yesterday's post.

Indonesia is reporting a 44 year old man died yesterday of bird flu, suspected.
Although Bulgaria has its first case of bird flu (in birds), there have not been any other identified infections.

If you live in North Dakota, you are being told hunting is safe, even with the bird flu around.

Cayman officials met with the Pan American Health Organization to discuss bird flu planning.

Fiji is also considering a pandemic flu plan.

Johns Hopkins is sponsoring a pandemic planning meeting as well.

Others have noted that Roche is offering Tamiflu to companies when there isn't enough for governments. Revere critiques this, noting the business pays full freight, while governments get a price break.

Indonesia's bird flu policy is under fire from all from Revere.

The central government gave up almost all power to local fiefdoms and is rampant with corruption, so these pronouncements have no moral or substantive authority. This is what passes for Indonesian bird flu policy.

July 23 Flu Update

Big news today is five reported human cases in Thailand. The two sisters we reported yesterday, and three more in another area, including two older men. ProMed notes that whether these cases have been id'd on symptoms or lab tests is not clear, and Thailand has been flu free for nearly a half a year.

On the other hand, a leading Thai scientist is casting doubt on the reporting of potential cases in poultry in Thailand.

"From my experience, when they say 'no, nothing' it means 'yes, it is' [bird flu]," he told The Nation in a telephone interview after returning from a trip to Phitsanulok, one of the provinces where mass deaths of poultry have been reported recently.

"I will give it 8 out of 10 that what has caused such an abnormal pattern of poultry deaths was it [the bird-flu virus]."
Effect Measure blogs on this story.  Time to find out for sure.

The one survivor from the Indonesian cluster that was confirmed H2H has finally gone home from the hospital.

India has begun to mass produce its poultry vaccine.

Russia says it will have flu vaccine on September 10th.

APEC is continuing to upgrade its flu protocols. This one is important, if done:

This APEC initiative aims at establishing an information and liaison network across the region which helps create effective and transparent supervision and closer co-ordination and co-operation among member economies.
St. Petersburg, FL, school officials are doing some impressive planning.

New Zealand finished an extensive testing program--their poultry is flu free.

The San Francisco Chronicle says that the US National Tamiflu Stockpile is not even adequate for hospitalized patients, much less for healthcare workers, etc. Adequate supplies are not expected until the end of this year.

In a related story, we noted before that Roche is urging companies to order Tamiflu directly. Given shortages, people are starting to wonder if that makes sense.

Not surprisingly, Roche had an excellent quarter.

Planning is going on in Albany NY.

While KeyBank and other companies say that, internally, they're in control, it's the external factors that have them worried. Will the power continue to flow? Will deliveries be made? Will the water be safe to drink? Will the Internet service providers continue to function?

Saturday, July 22, 2006

July 22 Flu Update

World Headquarters safely relocated, we are back.

Two new human cases are suspected in Uttaradit, Thailand.

A 67-year-old man and his 35-year-old son-in-law were recently admitted to Uttaradit Provincial Hospital. They had developed symptoms similar to those caused by the bird-flu virus after eating spotted doves, said Dr Boonrieng Chuchaisaengrat, head of the provincial health office.
China says the bird flu killed more than 3,000 birds in Aksu, and 357,000 birds were culled there to contain an outbreak.

It appears the bird flu in Bulgaria is not H5N1.

US Senators are critical of USDA plans for voluntary testing of poultry flocks for flu.

Effect Measure notes that this places the US behind Indonesia.

The 44 year old man who died of bird flu July 12 put Indonesia in the lead for bird flu.

Blame game continues in Indonesia. VP says it is all the fault of local government.

Singapore has completed its first comprehensive flu exercise.

They also completed an exercise in Evansville, IN, to much success.

Monday, July 17, 2006

July 17 Flu Update

Brief hiatus is coming. Right now I am sitting at my computer, surrounded by boxes that stretch over my head. Yes, we are moving the world headquarters of the Coming Influenza Pandemic to a new City. The most likely scenario is that the blog will not be updated again until Sunday, the 23rd of July, but other posts could find their way in. Thanks for reading, and we will see you on the other side. (Timing is actually working out OK....things are very slow on the flu news front).

CIDRAP on the recent death in Indonesia.

Effect Measure on the recent death, as well.

Roche--the people who brought you Tamiflu--has released a pandemic planning book for businesses.

Here is the link to the page with the downloads on the Roche website.

Effect Measure found a blog post that suggests there may be laws in Indonesia preventing the sharing of genetic material. Revere is unpersuaded.

The Virginia Game Department has established a plan....what would it do if it found bird flu in a wild bird?

WHO says a pandemic could cost $800B the first year.

Alabama is urging localities to plan for the bird flu.

Monroe County, MI is planning a bird flu symposium.

Oregon is looking for bird flu in wild birds.

India has developed a vaccine for birds.

Sunday, July 16, 2006

July 16 Flu Update

Little story, big potential impact...a Senator in Thailand suspects that bird flu is back among poultry in that country.

ProMed on the Indonesian death reported yesterday. The government insists that he had contact with a dead chicken.

Russia wants a bird flu centre in its borders...and the G8 agrees.

Russia says it will have 60 million doses of bird flu vaccine for humans available in September.

India has developed a vaccine for birds, too.

The New Hampshire Department of Health and Human Services is releasing guidelines for how people can prepare for the bird flu.

Cincinnati Enquirer contains a guest column from two Miami University faculty members that says that the bird flu is worse than the threat of terrorism. This is, truth be told, what first got me interested in the flu. With all the focus on terrorism, the flu could really cost some lives.

July 15 Flu Update

A 44 year old man died in Indoneisa Sunday (local time), and it is believed to be H5N1. He has also believed to have had contact with sick birds. Once it is lab confimed, it will tie Indonesia with Vietnam for bird flu deaths.

Michigan inspectors say there is no sign of bird flu from the smuggled Chinese birds.

Effect Measure notes that this case is drawing criticism. A great deal of the evidence was apparently destroyed before being tested.

ProMed on this story as well. Note mod comment on disconnect between public health and customs.

Vietnam, Thailand and Indonesia are going to cooperate to test if higher doses of Tamiflu (150 mg and opposed to 75) will help improve outcomes.

WHO continues to urge that the pace of vaccine development be stepped up. Note the phrase "unexpected adverse events." Good to see someone considering that things don't proceed as they do on paper.

Although a vaccine against the H5N1 virus is under development in several countries, none is ready for commercial production and no vaccines are expected to be widely available until several months after the start of a pandemic, the WHO said.

``Effectiveness of pandemic vaccines will not be known before the pandemic and possibly only after it is over,'' the report in the Weekly Epidemiological Record said. ``In addition, unexpected adverse events, whether coincidental or vaccine- related, will occur that may lead to anxiety and may affect vaccine uptake.''

Russia says it will coordinate bird flu monitoring in Eastern Europe and Central Asia.

The Health Editor of the Observer (UK) is taking part in a flu clinical trial. She says it has been a "positive experience" with few side effects.

The FDA is requiring RFID tracking of high-cost drugs, including Tamiflu.

Recombinomics says that sequences from Niger indicate the Qinghai sequence is continuing to change.

Major series of flu articles in Guam. What to watch for, what people can do to prepare, and what the government is doing to prepare.

Friday, July 14, 2006

July 14 Bastille Day Flu Update

The three year old girl who died of bird flu on July 6 is now lab confirmed, as expected, as an H5N1 death.

CIDRAP on the Indonesian girl.

WHO official release on the Indonesian girl. Grim stat: 53 reported cases in that country. 41 fatalities.

Indonesia is reporting that chickens are responsible for 100% of its human bird flu infections.

No noticeable dent in chicken consumption due to bird flu in US.

Thailand has id'd seven provinces as being under special bird flu watch and controls.

Effect Measure on the Indonesian official who took the fall for the flu....not likely to make much difference, he says. This is a time for serious people.

After some prodding, the EU says cash is now flowing on bird flu pledges.

CIDRAP on USDA/FAO joint flu action center (centre?) in Rome.

More from the Great Smuggled Michigan Goose Guts Caper. The guts cannot be found.

Berkeley CA is preparing for the bird flu.

Enid, OK is planning a flu summit.

Thursday, July 13, 2006

July 13 Flu Update

The top Indonesian animal health officer has taken the fall for the bird flu problems there.

Another Indonesian doctor says that the key to bird flu in humans is a faster test. He says:

"The only effective treatment right now is Tamiflu, but it has to be given within 48 hours after the symptoms appear, after that the effectiveness is going down," Soeroso told Reuters on the sidelines of a symposium on bird flu.

Birds were found dead of unknown causes in NE Thailand.

Effect Measure on a Nature article from Declan Butler. We've linked to stories already about the mutations in the familial cluster in Indonesia. Butler writes that the results have been known for over a month, and then he and Revere both point out (yet again) that secrecy on genetics is hampering the fight against the bird flu.

Here's Butler's blog link on the article.

CIDRAP on Michigan tracking smuggled poultry, the top vet in Indonesia has been reassigned, and in Romania, culling appears to be paying off.

ProMed on Indonesian genetics and the state of play in China.

ProMed on the purloined Chinese meat.

Roche says 100 companies have contacted it about getting Tamiflu for employees in the case of a pandemic.

China says (again) that bird flu in under control in the area where the recent human case was found.

Taurenga (NZ) finalizes its bird flu plan.

FAO warns Africa of ongoing pandemic risk.

Suffolk County (NY) is also finalizing its bird flu plans.

Belgium is going to hold a large-scale bird flu exercise.

The Crown Prince of Brunei is calling for better cooperation on the bird flu.

Companies are urged to plan for a pandemic in a trade paper.

Article says Romania is a case study for the effects of bird flu cases--many poultry farmers are near bankruptcy.

Yet another story from the media's fascination with wild bird surveillance.

DEFRA in Britain is looking for bids for more bird vaccine.

Wednesday, July 12, 2006

July 12 Flu Update

More on the Indonesian family that saw the flu mutation. Apparently, the virus mutated rapidly even between family members. CIDRAP reports.

The magazine says that 21 mutations were identified in a virus from the father of the 10-year-old boy, involving seven of the virus's eight genes, suggesting that the virus was evolving rapidly as it spread. In addition, from one to four mutations were found in viruses collected from five other patients.

The story says one of the mutations confers resistance to the antiviral drug amantadine, a finding not reported by the WHO.

However, the virus did not spread beyond the extended family, as the article notes. "Many of the genetic changes did not result in the use of different amino acids by the virus," the story says. "And there were no amino-acid changes in key receptor binding sites known to affect pathogenicity and transmissibility."

Official WHO report. Many of you are not going to believe this next phrase.

All confirmed cases in the cluster can be directly linked to close and prolonged exposure to a patient during a phase of severe illness. Although human-to-human transmission cannot be ruled out, the search for a possible alternative source of exposure is continuing.

Frozen poultry was smuggled into the US--as far as Detroit--from areas in China known to have bird flu. It was intercepted, and investigations are now underway.

Indonesian vets say they need a uniform approach to fighting the bird flu.

The Indonesian Veterinarians Association (PDHI) said the government erred by allowing regional administrations and their officials to take different approaches to dealing with infected fowl.

"Such a variety of approaches has proven to be ineffective because it allowed the virus to reemerge in regions that already culled their sick chickens," PDHI chairman Budi Tri Akoso told reporters ahead of the 15th national congress of veterinarians, held from Tuesday to Thursday in the Indonesian capital, Jakarta

First New York, now London. Mayor Livingstone releases flu plan.

A Rochester NY doc writes about an alarming conversation he had with a colleague involved in the pandemic preparation system. He proposes a car insurance metaphor....

While the chance of a serious pandemic is not high, less than one in three and perhaps much less than that, the consequences of a pandemic for which we are unprepared would be catastrophic. I consider preparing for a possible pandemic to be like buying car insurance, something I hope I will never need but, nevertheless, would be foolish to not have. We may have only a few weeks notice of a pandemic and preparation is best done now. Hoarding and shortages will undoubtedly occur at the first announcement, making needed supplies impossible to get.

French and American scientists ran a scientific model, and say that rapid detection and culling is the best way to protect against the spread of the bird flu.

Thailand is reopening its bird flu centre with cool weather on the way.

A leading virologist from New Zealand says more research is needed into anti-virals.

If it isn't one thing, its another. Vietnam says bird flu under control, but foot and mouth now a problem.

A Hungarian paper says that some poultry were ground to death while alive during culling operations.

In Mississippi, a presentation was done to educate the public on preparing for the bird flu.

Federal money has arrived in West Virginia and Oregon.

Tuesday, July 11, 2006

July 11 Flu Update

In China, a man who reported an avian flu outbreak has been sent to prison for three and a half years...on other charges.

Mayor Bloomberg of New York unveiled the Big Apple's Flu Plan.

An EU official was surprised to find bird flu in Spain at this time, and they are looking to learn more about the case.

HHS is releasing $225 million to help fight the bird flu.

Official HHS release.

ProMed on Spain. A duck is not a grebe, and not all grebe's are alike, and we can't really understand what we have in Spain until we understand more about the bird.

Revere writes that the bird flu picked up speed during the first half of the year, and with the cold season coming in the Northern Hemisphere, it could pick up speed on top of that. He views a pandemic strain as "more and more likely."

A common Effect Measure theme. Its one thing to say that the localities are on their own in a pandemic...its another to strip the public health system of its entire infrastructure.

ProMed with stories from Nigeria, where the bird flu gets worse, and there really are problems trying to fight it. (Talk about no public health infrastructure).

People in New Zealand are told their town could be a ghost town if a pandemic strikes.

So, you think you're serious about preparing for the bird flu. Meet Dan Billings of Duluth, MN.

Billings is so passionate about preparing for a bird flu pandemic that he has given up nights, weekends and holidays with his family and is going door to door in his neighborhood. At each house he hands out information in hopes of teaching people what they can do if a pandemic strikes.
A Bangladesh Flu Testing Centre will be opened up soon.

The British Government is ordering bird flu vaccine (for birds) despite previously stating concerns about the downsides of vaccinating birds, including masking the spread of the disease. The change appears to be at the request of the organic farmers. Obviously, the vaccination questions pits public policy against those who want to vaccinate birds and avoid culling later.

Case in point. Note this from India, with this editorial supporting farmer's position that birds should be vaccinated near bodies of water.

Australian companies are now writing travel insurance policies that say that they will not provide coverage for avian influenza caught overseas.

July 10th Flu Update

David Nabarro, the best headline-maker in the flu business, is back to putting flu news on the headlines.

"I would say it is certainly moving into more and more countries, with a speed that is, for me, and for my colleagues, a continuing and serious cause of concern," he said.

Dr. Chan is also worried about mortality.

"Now this is, in terms of avian influenza, a very devastating disease," he said. "We have never seen, what we call, such a high case-fatality rate. That means more than…50 percent of people affected by the infection eventually succumb to the disease."
Interesting perspective from Africa, which feels like bird flu has been stopped in Asia and Europe and is only thriving in Africa.

Yet another story on migratory bird testing, this time in Maine.

A needle-free flu vaccine is being worked on in Britain. It blasts particles into the skin.

Donations still trail pledges in global bird flu fight.

Botswana is working to prepare for the bird flu, with a committee that meets regularly.

Here's a new perspective....Stanford is looking for a test to protect the blood supply in the event of a pandemic.

India is close to its own poultry vaccine.

Cardinal Health of Dublin, OH, has an agreement with Roche to help produce Tamiflu.

Hawaii has applied for its full allotment of Tamiflu.

Georgia is weighing spending $14M for flu protection.

ProMed on the confirmation of H5N1 in Spain, and details on a rapid response from the Spanish Government.

Monday, July 10, 2006

July 9th Flu Update

New Jersey schools are preparing for what they would do during a pandemic, and confronting some tough questions in the meantime.

Surreal scenarios have already emerged: Instantly quarantined students. Schools closed and students getting home lessons by Internet for up to two months. Grief counseling.
And people accuse us of being alarmists--this Peoria story tells readers to stock up on food and water, virus could be there by September...(They meant in a migratory bird).

An Iranian official responded to rumors of bird flu in the northern part of the country by denying the rumors.

Cape Coral, FL, is preparing. They've spent $15,000 in three months.

Business preparations are ongoing in Australia.

Voice of America on the three strains in Nigeria, a natural mixing bowl for a recombined virus.

Researchers say Nigeria may have been hit by different strains of bird flu, raising the risk of human contagion. Experts warn that, unless the Nigerian outbreak is effectively dealt with immediately, there is now a real chance that the virus could become transmissible among humans, leading to the possibility of a pandemic.

From Bryan and College Station, TX, reminders that early warnings are important to save your commercial flocks.

Columbus, IN, also has a pandemic strategy.

Sunday, July 09, 2006

July 8 Flu Update

News is slow on the flu front.....

Not surprisingly, Spain says that the H5N1 bird is an isolated case.

There is bird flu in South Africa, but it is said to be H5N2.

Bird flu surveillance is conducted by bird lovers in Westchester County, NY.

A hospital in India hosted a bird flu educatiion program.

Contingency plans are being made in Chester County, PA for the bird flu.

More news on states trying to meet the August 1 deadline for Tamiflu reimbursement...

including Wyoming and Alabama.

Saturday, July 08, 2006

July 7 Flu Update

A 3 year old girl has died in Indonesia, and local labs are confirming H5N1. She died nine hours after getting to the hospital. She may have played with dead chickens in her neighborhood. CIDRAP reports.

There is also an 18 year old woman in Egypt who is dead, and suspected to have died of bird flu. ProMed reports (includes the Indonesian story as well.)

The other big news is that Spain has confirmed its first case of H5N1. Its in a wild bird (grebe) in a Northern part of the country.

CIDRAP on Spain.

ProMed with extensive commentary on Spain. This area is their biggest tourist area. Birdlife weighs in to say that an African connection is unlikely. Finally, mod notes that this is the season to expect cases in wild birds.

Recombinomics notes that the dead bird was found six weeks ago.

EU scientists gave the "bird flu is inevitable" speech again. (You know, not when, but if...)

Shenzhen has removed its emergency warning instituted when a human case was discovered in June.

Denmark is culling birds with H5, even though it is not N1. (proMed)

The UK reminds people that during the August-November migration, the risk of bird flu re-emerging there is higher.

Here's the full text of the DEFRA report.

Thailand says it will be bird flu free in three years.

Thailand also says it will test a human bird flu vaccine by next year.

More on this--Thailand says it is winning the battle vs. bird flu.

H5N1 was found on November 9 last year. There had been no reports of the virus in poultry since.

"This is because of our intense surveillance," he claimed.

The Conference Board says 3/4 of International Companies have bird flu plans in place or in process.

The Interior Minister of Pakistan says there is no risk of bird flu there.

75% of people surveyed in South Africa are worried about the bird flu.

Local story on how Nigeria ended up with three flu strains--notes (correctly, IMO) that a role for migration and trade is possible.

ProMed also has a long report on this from Nigeria. Note the mod comment that drastic measures will be needed to stamp out bird flu in that country.

Socorro County (NM) is preparing a bird flu plan, and has allocated nearly $7 ,000 for the effort.

In Sharon, PA, officials were told that there's no reason to worry now, but a worldwide pandemic is a real threat.

The Federal Government recently announced it would help states buy Tamiflu. They are paying 1/4 of the cost, but orders must be approved by August 1. Newsweek reports that states are taking them up on the offer.

Here are similar Tamiflu purchase stories from New York, Alaska and Maine.

Nature (Declan Butler) did a report on prominent and popular science blogs. Effect Measure likes the effort, but questions the criteria.

Thursday, July 06, 2006

July 6 Flu Update

WHO says human cases could increase sharply later this year or early next year.

CIDRAP on yesterday's report about three migrations of bird flu into Nigeria.

The amino acid sequence at the cleavage site of the hemagglutinin protein of the two Lagos H5N1 strains matched that of strains found in Europe, Russia, and central Asia, the reports says.

Further, analysis of the complete hemagglutinin gene of the two Lagos strains showed they most closely resembled strains from Astrakhan in Russia and from Egypt. The sample from northern Nigeria most closely matched a strain from Kurgan in Russia.

Also, the virus from one of the Lagos area farms was more closely related to the northern Nigeria sample than to the virus from the other Lagos area farm, less than 50 kilometers away, the scientists report. The data ruled out a Southeast Asian origin for any of the viruses.

Recombinomics seizes on the migratory bird angle of this WHO report, and tracks sequences from Qinghai Lake around the world, and notes further opportunity for recombination later this year.

OK, we've all seen that Vietnam is boasting of its lack of bird flu cases. Effect Measure notes that Vietnam undertook a wide bird vaccination program, which can mask the spread of the disease (as birds act as a sort of early warning system). Then, he notes that there is widespread dengue fever, which is often a misdiagnosed flu, and concludes "one wonders."

Despite Thailand's good record of bird flu control, the PM is calling for better integration.

An Ontario company is working on generic Tamiflu using used Christmas Tree needles as a shikimic acid source.

A Winipeg lab says its unable to confirm or deny that bird flu was present in the geese on PEI.

Taiwan is urged to put SARS behind it and face the future, including bird flu.

The G8 will tackle bird flu and infectious disease at this year's summit in St. Petersburg.

The Pan American Health Organization is conducting a bird flu seminar in Grenada.

Minnesota is taping PSAs in six languages aimed at people who raise chickens in their homes.

The Western Cape Ag Department in South Africa is surveying to detect bird flu.

The Public Relations Society of America has this info on communicating bird flu threats within a company.

Sanofi Pasteur is set to conduct human bird flu tests in Thailand, including children from six months to 18 years, to reflect the bird flu's infection profile.

In addition to setting the record for the most words per square inch on any website I ever saw, this link is intended to educate people in Trent Hills, ON about bird flu and why there isn't anything to worry about right now.

ProMed with OIE reports from around the world.

Wednesday, July 05, 2006

July 5 Flu Update

An article in Nature says that bird flu may have entered Nigeria three times, making it more efficient than many people had thought. As for the migratory bird debate...

"We think the most likely explanation is that it came by migratory birds, but we can't exclude the other possibilities," said Albert Osterhaus of the Erasmus Medical Center in Rotterdam, The Netherlands, an author of the paper.

The Chinese say that a recent bird flu outbreak has been contained.

A girl in Thailand had suspicious symptoms, which the government now says were not H5N1. Nonetheless, 200 chickens were culled.

The 31M from China who contracted bird flu on June 15th is doing well, according to reports.

Canada finally rule out bird flu from its backyard flock.

CIDRAP reports that HHS says its has enough vaccine for 4 million people and enough antivirals for 6.3 million. 15 million more courses of Tamiflu are expected by December. Report also cites efforts on cell-based vaccines.

Here's a direct link to the HHS report.

Russia says it will soon have a bird vaccine that can be distributed with food and water.

OIE report from Hungary says that H5N1 geese were located in area of heavy commercial poultry production.

Maryland is testing geese for bird flu.

Effect Measure on bird flu immunity, this time for respirator manufacturers.

Wichita Falls just got a $29,000 grant to fight the bird flu.

Baxter is continuing work on its bird flu vaccine.

A budget fight in New York State is delaying the stockpiling of Tamiflu.

John Bersia, from the Orlando Sentinel was surprised recently when he was on a flight in Turkey, and was told that chicken would not be served due to bird flu concerns. At first he was shocked, and then he thought maybe caution was advisable. Here's the interesting part: he asked his readers to weigh in...what do they think is or should be done?

Some critics do not believe that governments are doing enough and maintain that in the event of a human influenza pandemic, people should not count on much help beyond what they provide for themselves. What would that entail? A 30-day supply of essential goods? A 60-day supply? A 90-day supply? And, if so, how can those of limited financial means hope to take care of themselves?

Still other critics tend to dismiss the idea of a human influenza pandemic as improbable, suggesting that governments have simply come up with another gimmick to distract people from "real" issues.

I am interested in what readers have to say about the avian influenza issue and the threat of a human influenza pandemic. Is it real? Is it hype? Do you care? Are you prepared? If so, how have you prepared? Do you have faith in what the U.S. government and others are doing to monitor the problem?

Kindly direct your thoughts, observations and strategies to me at, and I will summarize the responses in a future column on avian influenza.

Tuesday, July 04, 2006

July 4th Flu Update

Just back from the town fireworks. (OOOOHhhhhh! Ahhhhhhh!)

Yesterdays news about the confirmation of bird flu in the five year old boy in Indonesia is examined by Effect Measure. Closest sick poultry was 15 metres from his house, calling into question the phrase "close contact with poultry is required." Other cases do the same. We may not understand exactly how the flu is transmitted, so perhaps we should stop being so certain about it.

Recombinomics has the same concerns, and notes some genetic data would be useful.

Twenty villagers in Thailand are under observation after they ate poultry that died of unknown causes.

The EU is investigating whether Italy broke state aid rules with its plans to prop up the poultry industry during a bird flu scare.

Recombinomics says that the bird flu continues to evolve in humans, yet genetic data is kept away from prying eyes by WHO.

ProMed with FAO report on bird flu outbreaks in eight countries in Africa, summarizing status and containment measures taken.

Mozambique is now doing surveillance of wild birds for the flu.

The OIE is establishing a bird flu control centre to help with the fight against flu in birds there.

In Japan, a boy jumped to his death after taking Tamiflu...sure to fuel the critics once again.

A meeting will be held July 11th in Cincinnati to discuss planning for the flu, right down to the school and church level.

Europe has prolonged its regimen of protective measures.

ProMed on H5N2 in South Africa.

Brevard County (FL) is preparing for bird flu.

Health officials went through a three-day training program for bird flu in the United Arab Emirates.

July 3 Flu Update

Sorry things have been a little irregular. Internet connectivity issues. We're back in the saddle.

The five year old boy who died in Indonesia last month is H5n1 confirmed, the 40tth such death in that country.

CIDRAP on Indonesia, the latest Chinese outbreak, and confirmation of a new outbreak of H5N1 in Nigeria.

ProMed on Indonesia.

WHO has also published a study that says that the bird flu is following the seasonal patterns of the...well, seasonal flu.

Pennsylvania continues to push localities to plan for bird flu.

South Africa finds H5N2 in ostriches.

The EU is holding a seminar with journalists on bird flu risk communication.

Here's an article asserting that the bird flu vaccine should go first to younger people, who are at highest risk.

Butler County (KS) will hold a bird flu tabletop exercise on July 11th.

The schools of Marshall, MO are doing similar work.

CIDRAP on the WHO study comparing H5N1 to the Spanish Flu.

US plans to increase its antiviral stockpile are good news for Biota, who make Relenza.

Editorial from Thailand says that the human spread of bird flu is "ominous" and issues this call to action.

What remains to be done is to develop a contingency plan for use in the event a sudden pandemic threatens to paralyse the country's economic activity, exhaust public-health resources and disrupt key public services like transport systems. Not to mention residual effects like a global economic slowdown. All of this the government and private sector must discuss, in order to ensure effective crisis management if and when worse comes to worst.

Effect Measure on the issues of transparency in China, citing an Economist story that pins blame on the ultra-secret agriculture ministry.

Recombinomics says recent flu sequences released in Indonesia call some WHO reports into question.

Sunday, July 02, 2006

July 1 Flu Update

The Chinese have reported a new bird flu outbreak (among birds) in Zhongwei.

Recombinomics says that the spring flu this year (includingg this recent Chinese case) will point to problems for the Fall.

Secretary Leavitt says there are 53 countries with bird flu. This is the highest number I recall seeing.

Helen Branswell on yesterday's report about flu hitting teens and young adults.

The US government is doing to spend $159M to help subsidize Tamiflu purchases by the 50 states.

Interesting stories on pre-pandemic vaccine efforts--one of the more interesting things going on.

The Australian Health Minister praised Vietnam for bird flu efforts (if all is as it seems, Vietnam has gotten some results with its bird flu program.

The US has stashed Tamilfu in Asia at an undisclosed location.

A ministerial meeting is being held in Laos to discuss the bird flu.

Shortland Street, a TV drama in New Zealand is going to take on the bird flu.

Winston County, MS, is doing bird flu planning.

Saturday, July 01, 2006

June 30th Bird Flu Update

WHO published a report Friday that said that bird flu is most dangerous to young adults and teens. This has been observed for some time, related to the idea of the cytokine storm. WHO also notes echoes of the Spanish Flu.

Here's a summary from WHO, along with the complete document.

Effect Measure notes this story, but remains shocked at how little we know about bird flu.

At the Avian Flu conference in Paris, an expert said a viable bird flu vaccine is 10 years away. Must read, and should be kept in mind while companies and countries around the world brag about their vaccine success.

He [Dr. Fedson] told BBC News: "Right now, worldwide, we can produce 300 million doses of seasonal flu vaccine, but it turns out that the H5N1 vaccine is so poorly immunogenic and replicates so poorly that... we could immunise globally, with six months of production, about 100 million people.

"From a public health point of view this is catastrophic," the former professor of medicine at the University of Virginia School of Medicine, US, said.

Dr. Fedson also talked about the role of statins in mitigating symptoms, CIDRAP reporting.

Full Text of Dr. Fedson's speech.

WHO also reminded us that a mutation is still a strong risk.

Bird flu has spread to a new state in Nigeria.

Interesting perspective, and probably thoughtful. In order to keep the lights on, Alaska is including utility workers in the first round of pandemic medications.

Who wants to pet a chicken anyway? Chickens are removed from petting farm at the National Zoo.

Surprise. They won't be testing the bird flu vaccine on policeman in Hungary.

Forbes looks at new laws that are taking effect on July 1 in states around the country--bird flu law in Minnesota, Nebraska and Alaska.

Nebraska (Nebraska!) is testing wild birds.

Guam conducted a tabletop pandemic exercise (event went "smoothly.")