Thursday, August 31, 2006

August 30 Flu Update

Five people have been put in the hospital on Sulawesi Island, Indonesia, as suspected bird flu patients. As always, five patients at once will make people think "cluster."

In addition, two patients are now being treated in West Java.

ProMed says these patients are also part of a potential cluster--note comments near bottom of post.

Nicholas Zamiska of the Wall Street Journal has the story of Peter Bogner, the non-scientist behind the flu sequence sharing agreement.

A journal will soon publish the news that a dog in Asia caught bird flu from eating a dead chicken. Answer is not to get rid of the dog--just bury chickens deeper to keep the dog away from them.

Indonesia has restored budget funds for fighting bird flu, after receiving criticism for proposing fund cuts.

Effect Measure weighs in on the blood tranfusion story. Notes "desperation" and that it would be hard to employ a strategy in a full-scale pandemic.

This is one of those ideas that sounds good on paper until one thinks of bodies stacked up like cordwood outside of emergency rooms. As a strategy, except in exceptional circumstances, this seems like a pretty weak reed to lean on. The time to investigate it and try it is now, when cases are few and this method might be used in resource scarce Indonesia, Thailand or China. In these instances, if effective, it might save someone's little girl or big brother. It should be tried.

Ducks continue to be a problem in Vietnam (this time in the capitol). This story says Vietnam has banned the further hatching of ducks. (How do you stop a duck from hatching? Destory the eggs?)

CIDRAP: H5N1 not present in Alaskan birds.

The Chinese have busted a fake Tamiflu ring.

Dutch respond to ProMed: All four birds in the zoo were not H5N1.

A bird lover in Pretoria says there is no threat of bird is all hysteria.

The UN is trying to help Latin American farmers prevent avian influenza.

WHO has also warned Africa that the flu is here to stay.

The Arkansas Times has a long article on the flu and what could happen.

Recombinomics has links between the bird flu from Indonesia and that found in birds in Southern Canada.

Tuesday, August 29, 2006

August 29 Flu Update

Is there a new treatment for bird flu? Annals of Internal Medicine says that studies were done shortly after the 1918 pandemic that tested the use of blood/serum from recovered flu patients to treat sick patients. Interesting.

This issue contains news of an alternative approach from an unlikely source: research reports published shortly after the 1918 pandemic. In a thorough review and analysis of the historical literature, Luke and colleagues (6) document the effects of passive immunotherapy. They found 8 studies that evaluated the effects of therapy with serum or plasma from convalescent patients on the course of clinically diagnosed influenza pneumonia during the 1918 Spanish influenza pandemic. Although the quality of these studies was relatively poor by modern standards, they all reached similar conclusions. In 6 of these studies, treatment was compared with a control group that received standard care, and in each of these reports, the mortality rate was lower in treated patients, although the decrease was statistically significant in only 3 reports. Two of the studies also compared the outcomes in those who received early treatment and those who received late treatment. An additional 2 reports compared early and late therapy but did not have an untreated control group. These studies demonstrated that only those who received early intervention experienced a beneficial effect of serum therapy, which is consistent with reports of serotherapy for other human infectious diseases. Luke and colleagues discarded multiple other reports that did not meet the methodologic criteria for inclusion in their meta-analysis. These weaker studies also supported the hypothesis that passive serotherapy was useful in treating Spanish influenza.

The Times of London has this story as well.

On a more conventional note, GSK continues to have good results on its vaccine, and could be in commercial production by the end of the year. The antigen level continues to sink, but cross-protection is still being evaluated.

“There is still a lot more to be done with this programme, but this validation of our approach provides us with the confidence to continue developing the vaccine, including assessment of its ability to offer cross-protection to variants of the H5N1 strain.

Thailand will head the bird flu fight for ASEAN nations.

CIDRAP has the official WHO definitions of bird flu.

China is preparing its bird flu vaccine for mass production. It will be interesting to see how the inoculation process goes.

Yesterday, the story ran about Tamiflu being given to a pregnant woman to test the reaction. We were skeptical. So is Effect Measure.

The Australian Treasurer reminds people in that country that a pandemic would be an economic catastrophe.

Hungary is lifting its bird flu restrictions.

India is exporting eggs again.

Saskatchewan Indian reserves are not ready to fight the bird flu.

A trial of people acccused of selling fake Tamiflu in China is ready to commence.

The Princeton Public Library and Health Department are going to do flu seminars to help educate the public.

CIDRAP on the microchip test for bird flu.

The Protein Science Corporation has a deal to distribute bird flu vaccine in Japan. The Recombinant Virus received expedited approval from FDA, according to the release.'

Apparently, a South Korean drug company wants to make a vaccine, but they are not allowed....because there is no bird flu in South Korea. Thailand is offering to let them do it in their country.

Medford, OR is doing local flu planning.

"When you look back at the 1918 flu, you realize it would be very foolish not to do lots of planning," Shames said.

Monday, August 28, 2006

August 28 Flu Update

Scientists in Taiwan have advanced knowledge of the bird flu virus and how it replicates.

About 52 key genetic changes distinguish avian influenza strains from those that spread easily among people, according to researchers in Taiwan, who analyzed the genes of more than 400 A- type flu viruses. The analysis will help scientists trace the mechanism for infection and how the viruses replicate in different species, according to a report appearing in the September edition of Emerging Infectious Diseases.

Another step forward. The University of Colorado has developed a microchip that can determine if a person has bird flu, and what the subtype is, in 12 hours. Obviously, in terms of isolation and containment, this is of great help if applied effectively.

China says its human flu vaccine is safe and effective.

Official press release on the Chinese vaccine.

CIDRAP on experts reviewing US state pandemic plans. Results show some basic items are universal, but others (like antivirals) are far from it. Also, non-drug answers like telecommuting should be higher focused.

ProMed on the pregnant woman receiving Tamiflu in Indonesia--and an OIE report on the disease in Thailand.

Effect Measure bemoans the fact that a science journalism award was given, the the great Helen Branswell didn't win it. Laurie Garrett did, and she has respect, too. (Revere also notes that he/she is not Branswell or Garrett.)

Indonesian editorial criticizes local governments for taking culling funds and not performing culls.

Ducks in Ben Tre, Vietnam, now have bird flu.

Officials in Kansas say that education will be the only key during a pandemic.

The State of Ohio is taking steps to fight pandemic flu.

Final verdict: Michigan swan not HPAI.

Sunday, August 27, 2006

August 27 Flu Update

The Rotterdam Zoo story continues apace. Promed reporting, zoo officials say H5N1 cannot be confirmed, but they are talking two birds when there were initially four birds....

Plannning is being done in Torres Strait, Australia.

South Africa is culling millions of birds to prevent bird flu.

There will also be more culling in Indonesia.

A pregnant woman in Indonesia who is suspected of having bird flu has agreed to take Tamiflu...and from her, we might learn some things about Tamiflu. (Are there no better ways to test things like this?)

India would like to develop a bird flu vaccine, but lacks a lab with clearance to hold the virus.

Tuesday, a flu conference will be held in Cleveland.

While data are sparse on whether any of the prevention strategies being considered today were effective in saving lives nearly a century ago, historical records suggest that timing was key in cutting infection rates in some communities. "The death rates in American cities during the 1918 Spanish flu varied," said Bell. "The city with the highest death rate was Philadelphia and the lowest was St. Louis."

August 26 Flu Update

Bird flu was found on a Vietnemese farm--second time this month.

Indonesia, under fire for cuttting bird flu spending, has asked the world for financial support.

Wellfleet, MA, on Cape Cod, did a bird flu exercise ("birdfluplex") that simulated the first week of a pandemic. They believe they are ready.

A bird flu exercise was also held in the Philippines.

South Africa will continue to cull illegally imported poultry.

Turkey will hold a bird flu drill.

California continues to prepare for bird flu.

Effect Measure follows up on the idea of discounted vaccines for countries with sequences in the public domain--calling for leadership in public health.

ProMed on whether flu in South Africa is H5N1 or not.

An article on the bird flu from the perspective of medical ethics. Article is critical of a recent article on triage criteria, and states that since young people are most vulnerable, perhaps they should receive medication first.

Azerbaijan has ended its bird flu monitoring program.

Saturday, August 26, 2006

August 25 Flu Update

Three potential cases are reported in Central Indonesia. Indonesia says that there is no evidence of human-human transmission. Pro Med Reports.

Vietnam is working with Laos to exchange flu information and experience.

The price tag in Indonesia for bird flu is estimated at $170 million.

Thailand is evaluating the bird flu situation in Phitsanulok province.

The University of Pittsburgh is testing a genetically engineered vaccine in clinical trials.

Australia has developed two bird vaccines.

California and Arizona are working together as border states to fight bird flu. This is smart. Ground transport from Mexico is more likely (IMO) than wild geese.

Effect Measure has praise for this effort. Note: Mexico is involved as well.

This is a follow up to an idea that came up as part of the genetic sharing contoversey. Poor countries are talking about patenting strains found in their country, and then using them to leverage lower vaccine costs from the drug companies.

EU regulators have approved the use of Relenza in fighting influenza A and B.

Just when you think there is nothing new, here's a commercial aspect we hadn't thought of. Apparently, they use hackle from chickens in tying flies for fly fishing. And apparently, bird flu fear is hitting the chicken hackle business.

CIDRAP on GISAID being founded.

The letter to Nature that started it all.

GISAID news release....

and story in Nature.

The US government has launched a web tool that will help track wild bird surveillance.

Recombinomics says Qinghai sequences are in Indonesia.

Thursday, August 24, 2006

August 24 Flu Update

A 35 year old woman in Indonesia now has bird flu. ProMed reports. She is not from Garut, but health officials continue to go door to door in Garut, but without reported results.

Indonesia is being criticized for cutting its bird flu spending. This is pretty hard to believe--that they did it, not that they are being criticized for it.

70 scientists wrote a letter to Nature asking for increased sharing of bird flu data. This is the single most important preventative step that could be taken for the bird flu, and it is amazing it has not happened.

In its press release, Nature went further accusing some scientists and organizations of "hoarding" sequence data, often for years, so as to be the first to publish it in academic journals.

"We propose to expand and complement existing efforts with the creation of a global consortium -- the Global Initiative on Sharing Avian Influenza Data (GISAID) -- that would foster international sharing of avian influenza isolates and data," wrote the scientists, who include six Nobel laureates.

Effect Measure has high praise for this agreement.

ProMed with more on the GISAID agreement.

The CDC has (better late than never) announced this it is releasing its sequences. The mere fact that the US is only just doing this is only proof of how bad this has been.

Vietnam is setting up bird flu task forces. Rewards are being offered for reporting an outbreak.

Effect Measure with a must read on the (now) slow, less perceptible spread of bird flu in animal populations, proposing the idea that it is too late to eradicate it.

Recombinomics has translations of reports that say that there are three sick siblings which could be a potential cluster.

The Netherlands is easing its bird flu restrictions.

Hospitals in South Africa are planning for bird flu wards and infection control, even though their experts say it isn't necessary.

A Taiwanese bird flu shelter has been established. Interesting use of building design to seperate confirmed sick from suspected sick--and also ensure that staff do not move between the two groups, either.

CIDRAP has a story that has bounced around for some time--does use of Tamiflu mask bird flu?

A study of Vietnamese H5N1 cases in a September 2005 issue of The New England Journal of Medicine found that genetic evidence of the H5N1 virus could not be detected in throat swab samples until between 2 and 15 days (median 5.5 days) after illness onset.

"If a patient is on oseltamivir for 3 days before the first swab is taken for diagnostic testing, it's possible the result will be negative, but the patient could be infected," he told Bloomberg News.

Link to New England Journal Medicine that CIDRAP is citing.

Jackson Hole, Wyoming paper says that it is safe to hunt despite bird flu, though wearing gloves is always a good practice.

Interesting. I had not seen this. India has a pretty broad poultry ban in place.

The University of Iowa has $1.2M for bird flu research.

The ever-hip Asheville NC is preparing for bird flu.

“This is not science fiction. It will happen again. There will be no existing vaccine to treat it,” Salyers warned an assembly of the WNC Communities meeting Thursday at Asheville-Buncombe Technical Community College’s Enka campus.

Yorkshire, England, reminds readers that bird flu is not gone.

Tuesday, August 22, 2006

August 22 Flu Update

More on the expert determination that H2H is not happening in Indonesia.

A 6-year old girl is now said to have H5N1 in Indonesia. She does not live in the area where cases have been "clustered" recently.

Recombinomics says there is evidence of Human-human transmission in Indonesia.

Recombinomics ground level reports now say that Tamiflu is blanketing villages where flu has been breaking out in humans.

The Sinar Harapan newspaper says there are 17 cases in the supposed Indonesian cluster.

Indian editorial reminds its readers that the bird flu might be gone for now, but it could be back.

Experts praise bird flu prep in New Zealand.

The Washington Post reviews bird flu kits.

If properly fitted to the face, N95s filter out 95 percent of airborne particles such as viruses. "When, in the hospital, we want the best available protection, we generally wear N95 respirators," said Schaffner.

In upstate New York, a school district is doing bird flu planning.

In the case of an outbreak, however, it's likely Fauquier's schools will be called upon to do more than just distribute pamphlets. Options include using the county's buses to deliver meals to quarantined people or employing the facilities themselves as overflow space for community hospitals.

"There are some very interesting, creative possibilities for the schools," said Murray.

Vietnam says bird flu could break out from its 8 million geese.

More on mutations making vaccine efforts more challenging.

A paper asks if bird flu will hit Foster farms in the Western US.

Bird migration begins: bird flu warnings are issued in Turkey.

August 21 Flu Update

Preliminary results are in from WHO's look at the possible cluster in Indonesia. They say no evidence of human transmissibility or easier bird-human transmissibility.

Revere writes on the cluster situation, though apparently without benefit of the WHO report...saying that Indonesia doesn't do the follow up necessary to provide data to help promote understanding of what is going on.

Meanwhile, Recombinomics continues to cite increasing local cases as evidence the cluster continues to grow.

With the recent death in Indonesia, bird flu deaths in 2006 have exceeded 2005.

FAO says that bird flu continues to spread around the globe.

"We don't expect to eradicate the H5N1 virus from possible wild bird reservoirs but we can contain and control it fully in the poultry sector," FAO's chief veterinary officer Joseph Domenech said.
Celera Genomics has funding to develop a new test for bird flu.

"An accurate, standardized, and robust test would enable testing in more locations, and most importantly, enable investigators to make meaningful comparisons between laboratories quickly and reliably across the globe," says Celera Chief Scientific Officer Tom White.

Bird flu monitoring will be done in Azerbaijan.

Russia has banned poultry imports from Holland.

New Zealand will be stockpiling masks for industrial workers.

Macomb, IL is getting ready to fight the bird flu.

3 hospitals in Port Huron, MI are conducting bird flu exercises.

I have been waiting for these theme to emerge. I believe that the spectre of the "failure" of the swine flu program will hang over any effort to vaccinate people for bird flu in the US. Fox News will go nuts, and I don't believe it can get done, absent a clearly present pandemic already in motion. My opinion.

Niman is presenting at a flu conference on recombinomics.

Ohio has launched a website for pandemic flu, and they are promoting it with banner ads.

Saturday, August 19, 2006

August 19 Flu Update

ProMed reports three new patients in Indonesia due to bird flu. The newest case is a pregnant villager from Garut, home of the potential cluster.

The woman (35) from last week is now lab confirmed.

Recombinomics says there are clusters within the clusters, and cites evidence to back the point up.

Even more interesting, same article. Thailand says that the virus has grown more complex due to exposure to Tamiflu, and that has complicated lab testing.

More ProMed. Thailand and Laos studies show that the recent outbreaks in birds were the result of both new and old viruses. New viruses resembled those in Southern China. (Also includes OIE reports from Egypt and China)

China responds that the disease did not originate in China.

The LA Times on the flu's newly discovered "weak spot."

There is LPAI in Jamaica.

August 18 Flu Update

Another woman has died in Indonesia, as cluster concerns continue to grow.

Indonesia is continuing to investigate the cluster. My note: in this one, the people don't all live in the same house, so it if is a cluster, it would seem to indicate a higher level of contagiousness.

As both men developed symptoms on the same day, epidemiologists assume that they acquired their infection from a shared environmental source, the WHO said.

``The currently recognized incubation period for H5N1 infection of 2 to 8 days makes human-human transmission between the two highly improbable,'' it said.

Effect Measure notes this, and how confusing it is to sort out the exact situation with media reports. Revere is waiting for the dust to settle.

ProMed on the Indonesian cases. Note the mod comment:

The 2 young men could have acquired their infection from a shared environmental source. The currently recognized incubation period for H5N1 infection of 2 to 8 days made human-human transmission between the 2 highly improbable.

Recombinomics has a local translated report on another potential new case.

A Thai scientist says that bird flu in that country is not closer to human transmission.

The UN has warned that bird flu in endemic in Asia, and this compounds the problem with the disease in people.

To wit: more outbreaks in birds in Cambodia.

Some have said that vaccine makers are using too many old versions of the bird flu virus in developing their vaccines. There is evidence that the virus is diversifying in real time. WHO has now joined this chorus--of course, with a caveat not to be alarmed about the diversification, but plan for it when developing better vaccines.

CIDRAP has this story as well, which may be the most significant of the day.

Michael T. Osterholm, PhD, MPH, a leading pandemic preparedness expert, said recognition of the three subclades demonstrates how diverse the virus is and how dynamically it is evolving. He said the WHO notice is more important for the questions it raises than for the vaccine guidance it contains. "Does that mean H5N1 is closer to becoming an agent that can readily transmit human-to-human? That's the billion dollar question," he told CIDRAP News. Osterholm is director of the University of Minnesota's Center for Infectious Disease Research and Policy, publisher of the CIDRAP Web site.

Many experts who follow the ongoing analysis of the H5N1 virus sequences are alarmed at how fast the virus is evolving into an increasingly more complex network of clades and subclades, Osterholm said. The evolving nature of the virus complicates vaccine planning. He said if an avian influenza pandemic emerges, a strain-specific vaccine will need to be developed to treat the disease.

Effect Measure weighs in on this, as well.

Effect Measure says we need to understand the full range of animals who can get and transmit bird flu. He wonders what effect dogs, cats, rats, etc, might play in the transmission of the disease.

Of course H5N1 could be infecting many other animal species (cats, rats, etc.) but they still might not be important sources of human infection if the virus is not easily transmitted from them to humans. But some of them might be important, depending on the various modes and pathways of infection. Moreover, a virus which currently is not easily transmitted from some non-poultry source could become so as it adapts to its new biological and ecological environment. More information on viral survival in the environment, transmissibility by other routes than inhalation, and a broader consideration of affected species is urgently needed. Efforts might usefully be concentrated on animal species commensal with humans, such as companion animals and domesticated livestock and small rodents that live in human settlements.

Interesting: Thailand has noted that screening a healthcare facilities is not effective, because some working class people go straight to the pharmacy. So, pharmacies are being enlisted to screen for bird flu and other infectious diseases.

An article in Nature says that if you are going to vaccinate a flock, you should at least vaccinate 95% of them to be effective.

An article by two Chinese scientists in the British Medical Journal attempts to draw lessons from SARS and apply them to bird flu.

Zimbabwe has banned poultry imports from outside the Southern Africa Development Community.

The Chairman of the Gordon County Board of Health (GA) has warned local people that bird flu would be a big problem in US.

Lee County FL is preparing its bird flu plan.

"I still believe in a place called Hope" Arkansas is doing bird flu planning.

Training is underway in Piggot, AR, too.

Vietnam is tightening its bird flu quarantines as it desperately tries to remain bird flu free.

IBM and South Florida are looking for $18M to develop a supercomputer to help fight the bird flu.

The supercomputer would be used to study bird flu and other infectious diseases. Eventually, it could help to transform the city into a research mecca with a university-affiliated Center for Emerging Infectious Diseases at its hub, attracting scientific and technological talent and businesses who want access to the King Kong computer.

Vietnam is banning the internal transport of poultry on public vehicles.

Thursday, August 17, 2006

August 17 Flu Update

China's death announced yesterday has an "unknown" infection source.

More on the 9 year old girl who died in Indonesia.

ProMed on Indonesia and Thailand. Note that WHO teams and underway to the site of the recent deaths to assess, we assume, exposure routes and cluster potential.

CIDRAP with more on the investigation of the potential cluster in Indonesia. Note this:

The WHO said rumors of additional late July and early August deaths from respiratory disease in the hamlets are being investigated.

Recombinomics cites local reports that say the cluster may have reached nine.

Recombinomics also has a local translation that says the sequence in Garut is novel...not the same as seen elsewhere.

Vietnam says it has a lot of bird flu projects underway.

For insomniacs only: a transcript of the USDA presser on bird flu.

Wednesday, August 16, 2006

August 16 Flu Update

A new weakness of the bird flu virus has been found. British researchers are reporting that there is a second set of neuriminidase that has four instead of five. This opens up a new playing field in the development of anti-virals.

"Those drugs were designed using the structure from one group of neuraminidases and, it turns out, genetically, there's another group," said John Skehel, senior author of the study and director of the National Institute of Medical Research in London. "The first group contains five neuraminidases, and the second group contains four."

"What we've done is determine the structure of three of those four, which hadn't been done before and, it turns out, they show some structural differences from the group that was used to develop Tamiflu and Relenza," he continued. "The major difference is the presence of a cavity next to the active site of the enzyme. In this group, the cavity is a constant feature."

This suggests that it may be possible to design or identify other compounds that would block neuraminidase activity.

"Relenza and Tamiflu work, so the idea is that this difference in structure might be used to develop new drugs which would block the neuraminidase just in this group," Skehel explained. "It may also well be that they block activity in both groups."

A 9-year old girl has been confirmed dead in Indonesia of bird flu. She lives in the village where there are some cluster suspicions.

Skagit Valley, WA, is doing wild bird surveillance for bird flu.

Matsu, a remote island in Taiwan, is completing a bird flu exercise today.

The Health Director in DeSoto County, FL, went to the paper to make sure people did not panic over the bird flu situation in Michigan.

Jasonville, IN, will hold its final informational meeting for the public.

Knox County IL held a tabletop influenza simulation.

Four countries in Southern Africa are preparing to keep the bird flu from entering the region.

York and Adams Counties, in Pennsylvania, and conducting joint pandemic planning.

Missouri is preparing for Tamiflu purchases for the state.

Effect Measure looks at a paper on a cytokine storm in another disease, and what lessons it could provide for H5N1. (Cytokine Storm is a disregulation of the immune system that is part of the lethal force of bird flu.)

Recombinomics says that town in Indonesia with three cases may have a fourth.

The Snomish County Health District is preparing to stockpile Tamiflu, for its employees and families.

Breaking News--Korea Bans US Poultry

Korea has banned US poultry based on the two swans in Michigan, with LPAI. Unless there is something we do not know, this is a ridiculous overreaction.

Tuesday, August 15, 2006

August 15 Flu Update

A 17 year old girl has died of bird flu in Indonesia. Her neighbor had the disease as well.

ProMed: the neighbor, a 9 year old girl, is also dead.

Note the mod comment: [This report does not mention the deceased girl's degree of contact with poultry, other than that she lived in a rural village in the district of Garut where the most recent confirmed case (a 17-year-old) resides.

The 17 year old Indonesian raises some interesting ethical questions--can you refuse treatment for a pandemic disease, are their undocumented cases, and are other animals (dogs being infected). Excellent Effect Measure.

Recombinomics says the cluster may have grown to 3.

China is also reporting a new bird flu human death.

In Central China, 1,800 ducks died on a farm in Central China, and another 210,000 birds were culled.

In Thailand, two people were released after it was confirmed that they did not have bird flu.

Effect Measure notes that Thailand, once praised, is now being asked to re-evaluate its bird flu program.

Is this recognition that eating or preparing infected poultry is a risk factor? It sounds like it to us. It also raises the old questions about the consequences of reassortment of H5N1 with human adapted viruses.

Vietnam is looking to import poultry vaccines, and they are looking to Russia.

Vietnam is on high alert. Poultry farming has been "banned" and everyone is supposed to be vigilant.

The Avian Flu Centre at the World Bank has given its first grant to Laos.

Cornell University is building an $80 million lab to help fight pathogens, including bird flu, in that state.

Jackie Chan has made an educational advertisement on bird flu, but it is unclear if it will be seen in Hong Kong.

South Carolina is preparing for the bird flu.

The Health Ministry in Antigua is planning a bird flu pandemic planning session.

Recombinomics cites the genetic diversity of bird flu, and wonders if testing programs are keeping up with the virus.

Ducks died in Pullen Park, NC, but it wasn't bird flu.

Monday, August 14, 2006

August 14 Flu Update

News reverberating on the Michigan front. Lots of media attention. Unique takes only are included.

CIDRAP on the Michigan situation. Important note: birds are healthy, and found as part of routine surveillance. It seems sure it is LPAI.

An analysis of genetic sequences at the NVSL has already suggested that the avian influenza virus in the swans is similar to the low-pathogenic avian flu virus identified previously in North America. Routine sampling in wild ducks in the United States showed evidence of low-pathogenic H5N1 in 1975 and 1986. The virus has also been detected in Canada as recently as 2005.

"These results are not unexpected in a given surveillance activity," DeHaven said at the media briefing.

Recombinomics is calling for the sequences to be made public from Michigan, to check on the Qinghai isolates.

13 dead birds were also found in Essex, UK, but botulism is to blame

The July 12th death in China is now confirmed H5N1. CIDRAP on that case, and the 17 year old from Indonesia.

ProMed on the Indonesian case, noting the prevalence of sick birds in most bird flu cases.

Revere writes on India's claim to be bird flu free, and the limited WHO definition that lets a claim like that be technically true.

Thailand wiill continue bird flu measures until the end of 2006.

The Health Department in Des Moines, Iowa is buying up Tamiflu.

A lecturer in India notes the potential harm of avian flu on the financial system there.

A Czech scientist says that he has discovered a "compound" that is effective against the bird flu.

But Havlas said work is needed on a 'transport' mechanism. 'It must be chemically modified to get it into target cells and the viruses' which is 'very hard work,' he said.

Gilead is now responsible for taking the research to the next level, although Havlas said the work could take 'several years.'

Breaking News--White House Announces bird flu in Michigan is not H5N1

The government says that birds found in SE Michigan, between Monroe and Detroit, along Lake Erie, were NOT H5N1, though they contained both the H5 and the N1 subtypes. It was two wild swans that were carrying what is described as low pathogenic avian influenza. Time will tell--official denials are nearly always the first story.

(Thanks to Tipster Dave on this one).

Sunday, August 13, 2006

August 13 Flu Update---Back in the saddle.

Back at the helm here at the World Headquarters of The Coming Influenza Pandemic? I go away for a week and the situation in Asia appears to be much worse.

46 people remain under observation in Thailand under suspicion of having bird flu. 96 people are still awaiting test results.

Thailand has made an official statement saying that there has been no bird flu during this outbreak in the nation's capital.

On Friday, the minister said some 7,500 volunteers would be mobilized this month to search for sick chickens and people across Bangkok after the deadly H5N1 strain of the bird flu virus recently re-emerged to infect some of the country's poultry and led to the death of a teenaged boy in the lower North.

A 17-year old in Indonesia now has bird flu and is refusing treatment at a local hospital.

A village in Cambodia has had an H5N1 outbreak, and it will be closely monitored for 30 days.

Vietnam is carefully guarding its flu-free status. Recently, H5N1 was found in some smuggled poultry from Laos, and steps were immediately taken.

As the disease has a resurgance in Asia, APEC countries are holding meetings to figure out a response plan.

In Europe, two owls in the Rotterdam Zoo are now suspected of having died of bird flu, based on early results.

The Chinese are touting a flu survival based on serving ginseng soup.

Excellent New Jersey Star Ledger story on the race to be a modern day Jonas Salk--by creating the vaccine that will cure the flu.

India has an offical announcement. It is bird flu free.

A survey of NW Wisconsin businesses say that they aren't concerned about bird flu and are not prepared.

Countries in the Gulf Region of the Middle East realize they will have to work together to control all diseases.

Friday, August 04, 2006

Vacation Hiatus

We'll be in the North Woods of Michigan from August 4 until the 14th. Looking forward to the break and the respite. The next update of the Coming Influenza Pandemic? will be the 15th or 16th.

Thanks for reading and keeping in touch.

Thursday, August 03, 2006

August 3 Flu Update

A second patient has died of suspected bird flu in Thailand.

Local reports say that the six people in Sumatra, Indonesia who were suspected of having bird flu actually do not, based on preliminary tests.

She said the investigation showed the patients to be suffering from the common flu that normally affects humans.
ProMed on the hospitalized Indonesian patients.

In a shocking reversal, Indonesia says it will now share flu data. CIDRAP reports.

Effect Measure on the Indonesian situation. Note the addendum on the clearing of the cases, including US Naval Lab confirmation. Also, check out the reaction the officials received when they entered the village with the suspected cases.

The health, welfare and agriculture ministers traveled to the area but were greeted by hostile villagers who ripped off the ministers' masks and forced them to remove their protective suits. The planned cull of local birds had to be called off and the army was needed to restore order.

CIDRAP with a summary of the latest from Asia. Note that there is a potential case in Vietnam.

Recombinomics on the suspected case in Vietnam.

Outbreaks in Thailand and Laos are spreading bird flu fears.

The two patients from Thailand have been placed in isolation. They both worked at a poultry slaughterhouse.

Thailand claims to have produced generic Tamiflu.

Laos claims it has "basically" contained the bird flu.

Recombinomics reports H5N1 in the Dresden Zoo.

Reuters reports that the Chinese truck driver who survived bird flu remains at the center of a mystery. Where did he catch it?

Missouri is preparing for a pandemic.

Minnesota farmers say they are ready to fight the bird flu.

Call Center workers are now stocking towlettes to help keep the flu from spreading on their equipment.

The company is buying the disinfecting wipes by the millions for use by employees of its 72 call centers across the world. The world's largest call center outsourcing company, which also provides human resources and billing services, considers the towelettes a first line of defense against the threat of a global pandemic from bird flu or other highly contagious disease.

Wednesday, August 02, 2006

August 2 Flu Update

3 children are suspected of having bird flu in Indonesia (confirming Recombinomics report from yesterday.) This is the province that was home to THE human cluster. These are two siblings and a neighbor, and you have to wonder if we have another cluster.

Recombinomics is reporting now six patients in a cluster pattern.

Recombinomics notes that the Thailand situation is beginning to look like a cluster.

Revere on the situation in Thailand. Widely fluctuating numbers of cases under observation are the order of the day. Hard to draw conclusions right now...

After the first confirmed human case in 9 months last week one might expect the index of suspicion to be ramped up considerably and many cases of pneumonia and respiratory disease with fever are now being placed in the "rule out bird flu" category to make sure, accounting for the sudden appearance of these cases.

Recombinomics is reporting a second confirmed human case in Thailand.

Thailand is increasing surveillance and monitoring. Clearly, the alert level is increasing.

Thailand has focused its attention on the Central Plains.

Based on what's going on in neighboring countries, Vietnam recognizes that there is increasing risk of bird flu there.

We all remember the big news from this week--that scientists had tried to reassort the bird flu virus, and found H2H hard to accomplish. Revere has read the paper, and has this to say:

I have now had a chance to read the PNAS paper by Maines et al. and it is surprising in two respects. The first is it isn't that interesting. The second is related to the first. Why did they bother to hold a press conference about it? Even more, why did the press conference focus on the reassortment question when that didn't establish much. Anyway, that's how I read it.

ProMed on the PNAS paper.

An OIE/FAO group has pledged to immediately publishing its genetic sequences, and says everyone else should do the same.

The Region of Waterloo, ON, is preparing for a pandemic, including with a business continuity guide.

Thailand insists it has ample supplies of Tamiflu.

Apparently, the Feds will pay for states to have Tamiflu for 15% of the population. Wisconsin wants 25% (based on a CDC guideline) and wants the Feds to pay for it.

Alameda County, California, is holding bird flu summits.

Tuesday, August 01, 2006

August 1 Flu Update

Bird flu is back in Indonesia, among birds. 1,500 have died in two provinces.

CIDRAP announces that the entire Thai nation is under bird flu alert.

ProMed says Thailand has 112 potential cases in 14 provinces.

Recombinomics reports that there are six people hospitalized in Indonesia under suspicion of bird flu, based on a translation of a local document.

Tourism operators in Thailand are concerned about the impact of the bird flu on their business.

Farmers in Thailand who do not report bird flu face jail time.

Two additional outbreaks are reported in Laos.

A sample of what the coverage looks like...bird flu concerns now "muted" by Federal study.

Abt Associates has a contract for consulting in the sub-Mekong Valley.

Officials in San Bernardino County are hoping to add four positions to help pandemic preparation.

Recombinomics reports that the big transmissible study reported yesterday showed flu near the upper respiratory tracts in the ferrets. That would make it different from the previous flu in the lower parts of the lung, and, in theory, easier to transmit.

Turkey warns its citizens of another bird flu outbreak this Autumn.

Italy issues a similar warning, pegged to the return of migratory birds.

Wisconsin is also stocking up on Tamiflu.

Recombinomics says that the virus in Sudan has some novel characteristics----proof of recombination.

Recombinomics....same story, just England this time.

July 31 Flu Update

The bombshell news today is a scientific study that attempted to replicate the mutations it would take for bird flu to become transmissible between people. The results (on ferrets) show that simple genetic changes are not enough. Good news. Of course, it could still happen, it's just not a simple process. And, replicating nature is always tricky. Still, this is important knowledge, because it means we may have more time than we suspected.

But at a telephone news conference on Friday, an author of the study, Dr. Jacqueline M. Katz, said the scientists had tested only a few of the many hybrids that could be created. Further studies will examine more.
Helen Branswell is on the story (yeah!). Here article gives strong voice to those who are talking about the study's limitations.

To test what might happen in nature, scientists would have to conduct what are called classical reassortment studies, where H5N1 and human flu viruses are allowed to co-mingle in a lab dish, producing naturally occurring offspring viruses. CDC is currently conducting such work with more current H5N1 viruses, Katz said.

The results could be different, said Dr. Frederick Hayden of the World Health Organization's global influenza program.

"We may see surprises and different gene reassortant patterns there. But until you actually do the experiments, that would just be a matter of speculation," said Hayden, who echoed Gerberding in saying this study doesn't offer any insight about how likely or unlikely H5N1 is to cause a pandemic.

CIDRAP also has this report.

The CDC officials were asked whether reassortment "dumbs down" or weakens the virus. Katz replied that the hybrids were less virulent than H5N1, but cautioned that the results apply only to the 1997 strain.

Gerberding commented, "The pandemics of 1957 and 1968 were caused by reassortant viruses. Those were not dumb viruses."

In answering other questions, Katz said some scientists believe the 1918 pandemic virus, unlike the 1957 and 1968 viruses, arose through slowly accumulating mutations in an avian virus rather than through a reassortment event. "We're looking at the approach of the 1957 and 1968 pandemics where there was a more sudden change," she said.

The most important lesson of the research so far, according to Katz, is "the knowledge that this process isn't simple, the procedure for the virus to acquire the properties of transmissibility."

Effect Measure weighs in. He hasn't read the paper yet, but notes that the headlines are racing ahead of the actual science, and that we still don't know much more than we did.

This virus is capable of amazing parlor tricks and parlor tricks often look impossible until you see how they are done. Then they look simple.
Recombinomics says that there were no results because it isn't reassortment that causes mutations anyway--its recombination.

There are now 131 cases "under suspicion" in Thailand.

Thailand (which has often boasted of its bird flu prowess) is blaming Laos for this outbreak.

Thai editorial reminds readers that even with past success, flu requires constant vigilance.

ProMed on Thailand's accusations (and an offer to "help" Laos), and Bulgaria's fear that it will get bird flu from Romania.

CIDRAP on Thailand.

Thai OIE report on bird outbreaks.

Novarax also has successful bird flu news.

UN FAO official says that fighting bird flu in Asia is hampered by a lack of aid.

A second roundtable was held in Rochester NY to prepare for the bird flu.

There is still one region in Russia which has active bird flu.

A Winipeg lab has been named a WHO reference lab.

Iowa is stocking up on Tamiflu.

Dr. Gerberding will give the Oppenhemier lecture at Los Alamos.

Effect Measure uses cuts in substance abuse funding to illustrate his point that fighting flu is all about an overall commitment to a public health infrastrcture.

Bird flu is effecting the quality of shuttlecocks.