Sunday, April 30, 2006

April 30 Flu Update

Bird flu suspected in New Jersey...not H5N1--Low Pathogenic Avian Influenza.

ProMed on culling in Pakistan, wild birds in Germany, and H7N3 in England.

They say that the number of flu cases in the Sudan has dropped.

From Thailand, article says the world is watching the bird flu....and while Thailand has done a good job controlling it, no one can afford to be complacent.

Officials in the US increasingly worry about animal smuggling and infectious disease.

The "Student Operated Press" covers recent bird flu outbreaks.

The Public Health Institute looked at some troubling flu scenarios at a recent conference.

Here's how a worldwide flu epidemic might start:

A sales manager for a multinational corporation returns to his California office from a business trip to Vietnam, feeling sick.

Within days, this otherwise healthy man is near death. Other employees come down with a flulike illness. A cleaning woman dies.

Tests show he has infected his co-workers with a form of bird flu that originated in Asia. Public health officials fear the worst: an outbreak of deadly pandemic flu.

What responsibility does the multinational corporation have to its workers? Can public health officials make residents stay in their homes to prevent the spread of disease? Can the government commandeer a local doctor's supply of Tamiflu for people who need it most, or force nurses to be vaccinated? What if frightened nurses refuse to work?

Interesting Chicago Tribune article on Wall Street (Citigroup) picking pandemic winners and losers. For example...good for health firms....bad for airlines.

Kentucky story on local RN working on pandemic planning committee.

April 29 Flu Update

Very slow news period. Management (?) has been working to figure out how to handle the British outbreak of H7. We held a meeting of our editorial board (Ha, ha), and decided that while covering it at first was OK due to the possibility of two strains mixing, it isn't going to cause a pandemic, so it is not something we plan to spend a lot of time linking, too.

Crofsblogs notes the same..."No news is bad news."

The minister for Health in Punjab is going to be very unpopular with local chicken farmers. He said while there was no bird flu there, people still shouldn't eat chicken.

An anti-flu conference is scheduled for Bangkok.

Monroe County, WI is making local preparations for the bird flu.

The health department has been working on bio-terrorism and infectious disease practices. It will conduct an exercise Aug. 23 in Brodhead, in conjunction with local law enforcement agencies and Monroe Clinic. The department will set up a fake clinic and call on the state's Interim Pharmaceutical Stockpile, a strategy to purchase, store and distribute pharmaceuticals to hospitals and local public health departments.
Louisiana is doing the same thing....however, given their hurricane experience, they have an odd perspective.

It's not like it's going to be a huge wave that's going to wash over us like Katrina, but you need to be alert and you need to be aware that there's a possibility."

A letter to the editor in Bangladesh urges the goverment to be proactive on the bird flu.

They are also preparing in Northwest Arkansas.

ProMed on England, and a report on birds from Germany.

Promed with a story on bird smuggling in Vietnam. It is clear that smuggling and migratory birds both play a role, and smuggling may have a larger effect than originally suspected. This is important, since (as mod notes below) it effects bird vaccination programs.

If the above report is correct -- and there is no reason to doubt it -- it is clear that Vietnam will have to consider a regular poultry vaccination policy to protect itself. Los Angeles (San Pedro) Harbour is one of the largest container traffic ports in the world. One must wonder how many containers have come through it in the past 12 months with hidden chicken parts. If they have, so far we have been fortunate, as have other Pacific-facing ports in the Americas.
Effect Measure on Harvard developing a new way to synthesize Tamiflu.

Friday, April 28, 2006

April 28 Flu Update

30 year old man dies in Indonesia of bird flu. Said to have had contact with sick chickens.

Vietnam says it needs $400M to fight bird flu. Half is expected from foreign sources. Note emphasis on smuggling.

China objects to WSJ article on China's openness on flu cases. They claim article said they were hiding cases, which is not exactly the way I read it.

If you go to the Hoquiam bird watchers festival, you don't need to worry about bird flu, say organizers.

Effect Measure notes that a recent study shows one hour waits are common in US Emergency Rooms, and wonders about during a pandemic.

The G8 health officials are in Moscow to discuss bird flu.

The recent Neil Ferguson study is being used to advise Britain's government to administer Tamiflu sooner in the disease course.

FAO says Latin America has lowest bird flu risk.

Russia says if bird flu goes H2H, it can have a vaccine cranked up in one month.

Wood County, Ohio, is engaging the public on bird flu.

The Waterloo Region (Canada) has set up a website for pandemic preparation.

OK, in case you wondered, you can't wash and reuse a flu mask if supplies get short.

Effect Measure covers this story, too.

Direct link to Waterloo site.

A leading infectious disease expert in British Columbia says that the bird flu risk is serious.

“The reason we’re concerned about it is the extent of the spread around the world is truly unprecedented,” Skowronski said in an interview.

Loudon VA is also making local flu preparations.

April 27 Flu Update

An 8-year old girl is sick in China, and bird flu is confirmed. This is China's 18th case.

Macedonia says its suspected case was negative.

Myanmar says it has bird flu under control, and will life poultry bans.

There is a suspected case in a 13 year old boy in Pakistan that is heading to the lab.

Culling underway in the Ivory Coast.

CIDRAP on China and the Ivory Coast.

ProMed on the Ivory Coast.

Recombinomics on the Fujian Strain in the Chinese case.

ProMed on China and the vet in India who wasn't H5N1.

Nature publishes a rebuttal today on Jeffrey Tauenberger's work earlier in the year that said the 1918 flu came from birds--not through another species. Meet Mark Gibbs, who says that is wrong, and we need to extend our surveillance to other species.

Seven Asian nations are pledging to work together on bird flu.

Interesting article from Britain...businesses are trying to prepare, but you're preparing for something for which there are no solid predictions, no idea what to expect (this is right, in my opinion).

A telltale sign...the H7 case in England was caused be feces on a boot...calls biodefenses into question.

Recombinomics notes that co-circulation of H5 and H7 is a potential problem.

ProMed on Britain, and Germany, where a stork is dead of flu in Saxony (sounds like Dr. Suess).

Rural Texas paper notes that forms of the bird flu have been there before.

The Guardian (UK) has a bird flu Q&A.

Oakland County (MI) has a bird flu plan.

The CDC traveller data plan is drawing more fire..CIDRAP reports.

Bunch of stuff today on the computer modelling. I've only pulled out two with a unique perspective. First, the Houston Chronicle

And second, Effect Measure. Typical strong analysis, and a must read.

GlaxoSmithKline profits up 27%, expects bird flu vaccine clinical trial results in June.

Analysts remain bullish on Gilead as well.

Thursday, April 27, 2006

April 26 Flu Update

Nick Zamiska is in today's Wall Street Journal with a story that some have been watching there undereporting of cases in China? The story says that local governments may not have reported human cases to the Central Government.

Local health officials in China have failed to report possible human
cases of bird flu to the central government, according to a person
familiar with the matter, raising the possibility that some officials
may be concealing suspected cases and that the death toll in China is
higher than the official tally of 12.

Nature has a computer simulation out today--the stopping the bird flu.

Reuters has a slightly more optimistic report on this study.

Their findings, reported in the journal Nature, suggest household prophylaxis, along with stockpiling vaccines and immunising children early, would have a significant impact. "Put those two measures together and you can get an almost two-thirds reduction in illness rates," Ferguson said.

A Macedonian man is being tested for the bird flu.

Three potential cases are being tested in India, too.

Pakistan says 57 suspected human cases are negative.

Birds have flu in Britain, but it appears to be H7.

More culling and positive tests in Bali.

More avian outbreaks--bird flu reported in the Ivory Coast.

Recombinomics notes that the Ivory Coast is on a flyway that leads to Europe and North America.

Educational column written by UN on next pandemic, run here in South Africa.

KFC is putting a sticker on all its food to help ward off bird flu fears.

The small stickers are being put on the lid of every bucket of chicken that KFC sells in the U.S.

The seal is a pre-emptive campaign assuring customers that the chicken is "rigorously inspected, thoroughly cooked, quality assured."

"While it doesn't specifically mention avian flu, for deliberate reasons, it reassures our customers that our food is perfectly safe," said Jonathan Blum, a spokesman for Yum Brands Inc., the parent of KFC.

A Nigerian state has set a budget to fight the bird flu.

The University of Tennessee is making bird flu plans.

The US has donated personal protective equipment to Vietnam.

The Wisconsin AgSec is pushing for a registration program, and he says bird flu is a good reason why (it strikes me that this is exactly the kind of rudimentary data gathering people should do in the pre-crisis period).

Another interesting local article on the preparations in Woodstock, Canada.

The Magical Mystery Flu Tour is now in Louisiana, where the usual messages were delivered.

Recombinomics says that bird flu could be migrating through Kazhakstan, a small thing that could indicate migration toward Western Europe and North America.

Effect Measure on a new blog--on local pandemic planning in King County, WA.

Another intersting Effect Measure article. The CDC is looking for personal data on people who travel, they say so they can contact people if a pandemic breaks out and someone on their flight might have been the carrier. Might sound reasonable enough, but everyone, from ACLU to the airlines, is objecting.

ProMed on Afghan, Russian and Bali news reported yesterday here.

Clearly, the flu will be no fun--Hawaii says in a pandemic, hugging and kissing will have to be limited.

Tuesday, April 25, 2006

April 25 Flu Update

There was bird flu on Bali due to smuggling, and a cull was carried out.

Two human cases are possible in Pakistan.

Russia's chief epidemiologist says that the country is the epicentre of bird flu.

Pakistan is shaken up by bird flu fear...or at least some people are, and some are not.

Housewife Naila Qamar wasn't perturbed even though she lives on the edge of a restricted zone.

"Look. Look. Our freezers are full of chickens. We are eating. Nothing happened to us. We are healthy in front of you," she laughed, pulling open her fridge door.

TESCO, Britain's largest retailer, says poultry sales have fallen 5% due to bird flu fears.

MedBlog in the Houston Chronicle looks at the Effect Measure/Marc Siegel debates.

Frustration in India over the falling poultry business. Here's a classic example of the mixed messages people get.

"The correct information hasn't been reaching consumers," says Venkateswara Hatcheries CEO O P Singh. On the one hand, government would say eating well-cooked chicken and eggs was safe but then, Parliament, Railways and the airlines stopped serving these.

Although Thailand is doing a good job protecting its own people, it worries about bird flu on the borders.

Reuters FactBox on the EU poultry sales.

Canada's international aid agency is investing $1M into a study of the effectiveness of five different approaches to the bird flu (in birds) in Asia.

The Magical Mystery Flu Tour hit Michigan.

Wake Forest University has orders from the President---make bird flu plans.

Princeton held a conference on bird flu prep for hospitals, but "uncertainty" dominated.

Effect Measure on recent poultry importation rules concerning meat processed in China.

Recombinomics on spreading bird flu in Afghanistan, and what he believes lies ahead for Europe.

Monday, April 24, 2006

April 24 Flu Update

Pakistan has mounting cases of bird flu.

A fourth province of Afghanistan reports bird flu.

The home of the latest Chinese flu victim has stepped up its bird flu protection measures.

The World Bank loaned $34M to Turkey to help combat the bird flu. Its part of their $500M pool of funds.

Though they say they are not expecting an outbreak, South Carolina is ready for a flu outbreak anyway.

Thailand is urged to remain vigilant, despite bird flu success.

Outsider enters poultry farms, learns more about hygiene rituals than they ever wanted to.

BioSante says preclinical studies reveal that adjuvant vaccine doubles potency of bird flu drug.

The leading poultry producer on the West Coast says preparedness is the key.

French poultry sales are down, leading to stockpiling of poultry.

Effect Measure skeptically looks at yesterday's pigeon story.

Effect Measure gives high marks to a columnist named John Maxwell from Jamaica.

Haven't seen one of these for a while...a 1918 bird flu history of Fremont, Nebraska.

And in Fremont, more than 1,400 influenza cases were reported by January, with more than 20 deaths. It also killed dozens of local rural and small-town residents.
Looks like a Web2.0 app ready to tackle a pandemic.

The solution is the first on the market to integrate professional services, project and collaboration tools, and process templates for executing enterprise-wide pandemic planning and preparedness efforts.

CIDRAP on last week's Lancet study on gaps in European planning.

They had a bird flu summit in Guam.

Sunday, April 23, 2006

April 23 Flu Update

Two more farms in Pakistan are bird flu positive.

If you live in a city, this should be a relief. Pigeons are not believed to be a big bird flu problem.

"Pigeons aren't a big worry," said Rex Sohn, a wildlife disease specialist at the U.S. Geological Survey's National Wildlife Health Center in Madison, Wis. "But to make absolute predictions that pigeons won't be susceptible to this virus, in whatever form it arises in North America, is not something you want to say."

The EU is set to bail out poultry farmers impacted by the bottom dropping out of the market from the bird flue scare.

In Jordan, poultry sales are back to normal after brief flu scare.

Did the bird flu in Scotland cause a tourist boom to a seaside area?

Yesterday, we reported a vet might have bird flu in India, where he had supervised cullings. This report says negative.

A union official says that Homeland Security employees at airports are undertrained to fight the bird flu at the border.

Oddly, a similar report from the poultry industry. They call it biosecurity. Industry complains about new measures for "nothing," labor wonders if enough has been done.

Lake Charles, LA is preparing for the bird flu, by hosting vaccine production in the city limits.

Editorial in AZ warns against panic during bird flu.

Proud local paper. Dayton Daily news on Fairborn OH grad (in the Dayton area) leading US biodefense efforts.

Q&A with the native Daytonian.

ProMed on bird control measures....culling in Pakistan, and (interestingly) vaccinations in Norway (where no disease has even been) and Holland for hobby and free-range owners.

ProMed on reports to WHO of deaths in China and Egypt.

Saturday, April 22, 2006

April 21 Flu Update

Welcome everyone. The blog may not be updated again until Sunday night due to a little overnight trip tonight. We'll see how it goes.

Another note: not a lot of sexy "new case" news today, but its content rich. Science magazine with a major section, an assessment of US attitudes to flu, some answers to the "unreported case" question....there's some good long-term content in this update.

A vet has died in India, and bird flu is suspected. He supervised culling.

CBS News reports that worldwide bird flu cases have passed the 200 mark.

Here's the link to the official WHO case count.

ProMed on China, Egypt and Indoensia.

CIDRAP looks at the world. Noting that eight Egyptian cases pushed the case count above 200, and denial of an eight-person cluster in Indonesia.

AP reports that fear of bird flu is widespread in the US. (Note: we cannot overestimate how much Katrina has to do with showing people how thin a line there is between us and chaos.)

CIDRAP notes that most people don't trust the US government to handle a flu crisis.

Draw your own conclusions: Dr. Fauci and Julie Gerberding are travelling the country telling people that their fears may be overstated.

Effect Measure draws his conclusions.

Direct link to poll results.

Science magazine says there is no basis for culling wild birds to prevent the spread of the bird flu.

More from Science Magazine...very cogent article on the need for quick and simple detection capability.

Finally, I'm just going to link to the main page containing articles from Science Magazine....all of which I am sure are excellent, but which I haven't read yet.

Branswell on board, reviewing the Science magazine article that says "wader" birds may play a bigger role than thought in the spread of the flu.

Effect Measure post on seroprevalence study from Cambodia. We've wondered if there were lots of mild unreported cases that were distorting the fatality rates of the disease. Other studies have said there are not, and this one confirms it. Based on this, bird flu is very, very deadly...and very, very hard to transmit, even from bird to human.

MSNBC: Scientists race to battle the bird flu. Must read.

Link to MSNBC graphic showing spread of bird flu (MSNBC has an excellent collection for MSM of bird flu materials).

To wit: MSNBC contributor asks how the government thinks it can handle bird flu when it "botched" seasonal flu vaccines.

8 penguins in a Norwegian aquarium are the first birds in that country to be vaccinated against the bird flu.

A commenter to a Medblog in the Houston Chronicle suggests who should get the bird flu first.

Pakistan continues to say that it has no bird flu, and it is culling.

A Swiss research team has used a mathematical model to determine that the flu will develop resistance to Tamiflu.

"If you are going to use neuraminidase inhibitors such as Tamiflu as a prophylactic then, in my view, the inevitable consequence will be the likelihood of a faster emergence of resistance," he said.

"Reviewing the [medical] literature we had the feeling that a considerable fraction of the medical community hoped that with neuraminidase inhibitors the situation would be different."
A merger effects how the leading vaccine plant in the UK is owned.

ProMed reports OIE data on animal outbreaks in a few areas.

Thursday, April 20, 2006

April 20 Flu Update

The sick man in China is now a bird flu fatality, the 12th reported in China.

Bird flu scare in Pakistan has led to a large cull.

The case in the Sudan is reported to be negative.

CIDRAP on the Sudan and China.

ProMed on the Sudan...

and other reports from around the world.

The World Organization for Animal Health (OIE) and FAO confirm that the animal species playing a role in the transmission and spread of highly pathogenic avian H5N1 influenza virus are essentially domestic and wild birds.

Although some 50 non-domestic bird species have proved susceptible to infection with the virus, it would appear from the epidemiological data currently available that, among the wild birds implicated in the transboundary spread of the virus, aquatic birds play a major role.

This could be a consistent event Denmark, a plane from Singapore was quarantined when a passenger was suspected of having the bird flu. False alarm, go aboutt your daily business.

Amid praise and self-congratulation, Britain lifts its bird flu restrictions.

The Red Cross/Crescent is raising $13.4M to help fight the bird flu.

Very interesting AP article on how difficult to detect the bird flu might be in birds during surveillance programs. Note: article states that there is "growing" agreement that the bird flu is being spread more by smuggling.

A bird conservation official in Africa reiterated an argument that migratory birds cannot be blamed for the spread of the flu.

NBC says that the US is making up for lost time on preparing for the bird flu, citing vaccine and other preperations.

A little airtime on MSNBC for the flu skeptics. Wendy Orent on the case....

"We don’t have anything that makes us think this bug will go pandemic,” Orent said. “Yes, it’s virtually certain in human history there will be another pandemic strain … but there’s no reason for it to happen now, or 10 years from now or 20 years from now.”

New Zealand is offering an online pandemic preperation course for businesses.

A flu summit was held to unveil the national plan of Brunei.

Effect Measure writing on hospitals telling HHS that its all well and good not to expect any help from the Federal Government, but the hospitals are saying they don't have the resources either.

Effect Measure looks at Indonesian claims that it is "winning" against the bird flu, and compares them to US claims that it is winning in Iraq.

Yesterday, Tyson sliced its outlook, today its stock falls. Lower exports due to bird flu are to blame.

An analyst says that the bird flu might double the vaccine market.

Wednesday, April 19, 2006

April 19 Flu Update

A UN Team is headed to the Sudan to study cases there.

The 24th death in Indonesia is confirmed by WHO.

CIDRAP on the Sudan, Indonesia and China.

ProMed on the Sudan confirmation.

WHO confirms China...

and issues infection control guidelines for healthcare facilities.

Secretary Leavitt is at it again...warning states (Texas, this time) that they'd better be prepared and not expect the Federal Government to save them.

Elsewhere, a boycott was planned of poultry markets in Hong Kong.

The BBC reports on The Lancet study that Nick Zamiska had last week. Everyone needs to work together.

Roche's profits are way up....and so are Gilead's.

Effect Measure on the study that healthcare workers wouldn't show up for work.

The idea we are all in this together is an ideological notion, of course. It opposes the equally ideological one that says it's every person for themselves. There are good reasons to believe we are better off as a society if we work cooperatively, but no one can guarantee for any individual person they are better off. If you hold as a moral position that a person's only concern should be to look after him or herself, then you should also be prepared to forfeit the help of others when you need it.

APEC will meet in early May in Vietnam for more flu planning.

FoxNews covers what you can do to prepare for the bird flu at home.

Consumers in Kyrgyzstan are staying away from poultry, even though bird flu not reported there, but in neighboring Kazhakstan and China.

On a similar note, Tyson has cut is forecasts due to reduced exports due to bird flu.

My father used to tell me that if you asked a stupid question, you'd get a stupid answer. To wit, the question from MSNBC: "Should you fret about the bird flu?"

The US is prepared to do quick culling (even before tests are positive) to stamp out the bird flu.

3 more negative tests in Pakistan.

Roche turned over 3 million courses of Tamiflu to WHO.

In Australia, poultry farmers are urged to vaccinate poultry.

Here's a perspective I have not seen...A Christian Scientist look at the response to the bird flu.

Marc Siegel (a perspective we have all seen) was at work in Arizona again. Here's a professor of microbiology with a rebuttal.

Tuesday, April 18, 2006

April 18 Flu Update

Vietnam poster educates on thorough cooking of chicken.

A new country hit---The Sudan reports one human and five bird cases.

A 21M, a Chinese migrant worker, is critically ill with bird flu.

CIDRAP on China and the Sudan.

ProMed on China and Sudan, and a world overview.

The H5N1 avian influenza virus has spread to 20 new countries in just 6 weeks, Nabarro said. "We think it probably went into Cote D'Ivoire, or Ivory Coast, in the past few days," he said. [So far, the outbreak in Ivory Coast remains to be confirmed; see further also about suspected outbreaks in Sudan, Africa's largest country. - Mod.AS]

"It's a most extraordinarily rapid movement that we have seen," he told the conference. The virus seems to be carried partly by the poultry trade and partly by migrating birds, Nabarro said.
Recombinomics on the Sudan.

Whatever happened to the migratory bird debate...the EU's Food Safety group issued a statement that settled the whole thing.

According to the AHAW Panel, some species of wild birds (mainly waterfowl such as ducks and swans) are definitely carrying H5N1 and are considered to be responsible for its introduction in the EU. There is increasing evidence that H5N1 can be present in several species of wild birds (e.g. ducks, sparrows, swans) without them showing clinical signs. There is therefore a high probability that the virus could be carried over long distances by wild birds (especially migratory birds).

Paul Wolfowitz says $500M has been set aside at the World Bank to help the bird flu fight, citing potential economic disaster.

Late last year I got some emails from An American living in the Czech Republic...and I fully understood the fear that you could get trapped in a foreign country, unable to travel home. Britain is now sending similar messages to its expat community.

Yesterday, countries were saying that they wondered if they could ever be H5N1 free...yet Indonesia says it will be bird flu free and is winning the battle.

India is continuing its flu control efforts.

International experts are travelling to Vietnam to learn how to fight the bird flu.

Very odd Nigerian fact sheet on bird flu.

CIDRAP on yesterday's report about healthcare workers staying home in a pandemic.

A market study says the flu therapy market is being driven by fear and a constrained market.

Effect Measure on the loss of wetlands, how it relates to the flu, and how it may drive birds closer to people.

Roche revenues up 61% over Q1 05.

$1million was invested in a green vaccine process.

ABC has unveiled is top secret sweeps project....A BIRD FLU MADE FOR TV MOVIE! It will have to work to be as good as the CBC version.

Monday, April 17, 2006

April 17 Flu Update

Northern Nigeria has a fresh bird outbreak, killing 200 birds.

Asian countries begin to resign themselves to the flu...once its there, does it every go away?

There's an apparent dispute over an Indonesian death....the country says bird flu, WHO says no.

FoxNews fixes in on one of the more interesting parts of the reported US pandemic plan--drive through examinations.

Poultry workers around the infected farm in Pakistan test negative.

Elsewhere, Pakistan says no human cases.

CIDRAP is sponsoring another symposium to help business journal in Twin Cities reports.

Russia says that bird flu is on the wane in the southern part of the country (they have said this before).

CIDRAP on the "waxing" and "waning" flu virus.

McDonald's protects the franchise, requiring free range chickens to be raised indoors, among other things.

"We are now imposing standards which require that those free range chickens that are producing free-range eggs be brought into houses because of the threat of the spread of avian influenza," said Catherine Adams, vice president worldwide quality at McDonald's.

Houston Chronicle blog on who should get flu vaccine first. Interesting thought--if children spread it, should they get it first?

From the Scotsman...we've wondered this before. Would 66% of healthcare workers really fail to show up for work if a pandemic struck?

Effect Measure said something nice about Julie Gerberding at CDC, which he regrets shortly thereafter.

Via Crofsblogs, Laurie Garrett says bird flu in US by October.

In the US, a survey says the figure is 40%.

Helen Branswell on the same study, attributing the absenteeism to a lack of understanding for hospital workers on their role during a pandemic.

This is IT can play into pandemic response.

Planning is going on in Washington State. Same message....don't expect the Federal government to come pick you off your roof.

Similar story from the Chief Medical Officer in Colorado. Katrina x 50, no chance for Federal response...likens bird flu prep to preparing to ride out a blizzard.

Roche is increasing production of Tamiflu's active ingredient at a plant in SC.

Sunday, April 16, 2006

April 16 Flu Update

Last night, we ran the WaPo story on the US pandemic plan. Suffice it to say its all over the news today, with not much variation. Until we see more, I'm going to avoid running repetitive stories.

Pakistan has its third outbreak since the beginning of April.

ProMed on Pakistan (second story on this link).

ProMed with yesterday's Danish news (good) and Egyptian news bad (death).

ProMed with OIE---Germany (59 cases in wild birds), UK surveillance plans and the Ivory Coast.

The Ivory Coast confirms dead birds not H5N1.

A Philly-area company has seen its fortune soar on a novel and promising vaccine approach.

"We are very excited about Novavax's approach," said Terry Tumpey, senior microbiologist at the CDC, which is working with more than a dozen smaller companies on new technologies to narrow the time it takes to make an avian-influenza vaccine.

Novavax has a different way of making flu vaccine, using virus-like-particle technology (VLP) that extracts protein genes from influenza virus and turns them into particles that mimic the virus and trick the immune system into creating antibodies.

The recombinant particles can be customized into a vaccine in about two to three months, instead of the six to nine months it takes to create a conventional flu vaccine in chicken eggs.

In East Africa, a doc answers questions--including about tourism.

This article is a bit less reassuring---the "full scale" of the threat to East Africa.

In India, flu has hit small farmers the hardest.

Following a cull of 300,000 birds, flu is said to be under control in Gaza.

In Afghanistan, WAPO reports that "plucky" (they should be ashamed of themselves) women are leading the fight against the flu.

From Delaware, consensus that small business would be hit the hardest, yet few are ready. Includes a funeral director showing off his protective equipment.

The Royal Brunei Armed Forces conducted a desktop pandemic exercise.

"Now we know what to do about this new disease. We wash and boil eggs before eating them, we keep the pens clean and change the soil," said Abida, one of 300 widows in the Kabul district of Charai Qamber who raise poultry at home, with chicks and training provided by CARE International.

The Health Director in Pueblo, CO, says that education is the key to fighting the bird flu.

Effect Measure with a press release from the American Fire Fighters, showing they get the flu risk--and what should be done about it.

Saturday, April 15, 2006

April 15 Flu Update

Quiet Holiday weekend. Have a good Easter.

Apparently, President Bush is ready to sign a pandemic plan. WaPo has the story. We can digest later, but it appears to include some strong actions. (This is a must read)

The Treasury Department is poised to sign agreements with other nations to produce currency if U.S. mints cannot operate. The Pentagon, anticipating difficulties acquiring supplies from the Far East, is considering stockpiling millions of latex gloves. And the Department of Veterans Affairs has developed a drive-through medical exam to quickly assess patients who suspect they have been infected.

Helen Branswell is back again with another must read. The seminal question is this: its been 10 years since H5N1 was pandemic yet. Why? Does it mean it won't happen? (Branswell can even make a "no one knows" story interesting).

"I think that the best answer is that we do not understand the rules under which influenza pandemics form," says Taubenberger, the American scientist who led the team that found and sequenced the 1918 Spanish flu virus.

"And therefore we don't actually know if there are biological constraints limiting particular strains and particular subtypes, that they either can or cannot adapt to humans and cause pandemics," Taubenberger, chief of molecular pathology at the U.S. Armed Forces Institute of Pathology, explains in an interview.

Here's a hint of things to come. A story in Scotland complains that anti-virals produced there are being shipped to other countries---even though Scotland has a shortage.

They're still coloring Easter Eggs in Switzerland, despite bird flu fears.

Qatar reports 6,000 negative tests on birds.

Northern Ireland is thinking about what it will do to fight bird flu in prisons.

Scottish columnist with rambling opus on bird flu.

Officials from Kodiak AK returned home from a flu summit.

A Dr. in Bahrain told people there that hot Middle Eastern summers would kill the bird flu virus.

Governor Rendell of Pennsylvania has told the poultry industry that their leadership is preparing the state for the bird flu.

Another warning on illegal Internet Tamiflu.

Guernsey says it has enough Tamiflu for 20,000 people.

ProMed with a set of OIE reports.

ProMed on the suspected (and now negative) Danish case.

April 14 Flu Update

Yesterday, news was that the 18F in Egypt was said to have stablilized, but now she has died. Egypt says she was in close contact with birds.'

Five dogs ate some dead birds in Ivory Coast, and they died, too. H5N1 is feared.

Connecticut officials talk about bird flu preparation, including a daily check for hospital admissions for respiratory problems or diarrhea.

As migratory birds arrive in three weeks, bird flu should show up in US, according to these experts.

Via ProMed, IHT writes an interesting story on bird smuggling, as part of the migratory bird vs. bird trade debate.

Japan is putting H5N1 into its most dangerous viral category.

Alaska is the next stop on the HHS Flu Tour.

In Britain, a swan was found shot nine times, perhaps over bird flu fears.

Here's a switch. Residents in the Scottish town where the swan was found say that the attention is good for the town, putting them on the map, and will lead to increased tourism.

Oakland County (MI) is preparing for the bird flu, too. They are IDing sites for vaccinations.

Here's a link to their flu brochure.

Bird flu has brought Relenza back from market death.

Letter to Editor in Asbury Park, NJ asks if they are ready for the bird flu.

CIDRAP on recent reports where the role of cats in bird flu was downplayed.

Effect Measure tracks the story arc of a false alarm.

Effect Measure also weighs in on the WSJ article we ran yesterday about the variability in EU flu it the plan or the planning that matters?

An alert reader pointed me to a string of stories on a mumps outbreak in Iowa (summarized here via Effect Measure), where they have 600 cases as opposed to a normal annual total of 5. 1/4 of the sick people were vaccinated. What does that have to do with the flu...well, beyond a statement on the over-reliance on science to fight a virus, there is also this:

To try to keep the outbreak from widening further, the CDC announced yesterday that officials are working to track down 222 airline passengers who sat near two people from Iowa who developed the mumps after traveling on nine flights from March 26 to April 2. One flew from Tucson to Cedar Rapids, Iowa, stopping in Arkansas and St. Louis. The second, a 51-year-old woman on a trip to lobby the Iowa congressional delegation, flew from Waterloo, Iowa, to Washington and back, stopping in Detroit and Minneapolis.

Friday, April 14, 2006

April 13 Flu Update

Egypt's latest case, a woman who has now stabilized.

WHO Update on Egypt.

ProMed on Egypt--note case count discrepancy in mod comment.

WHO is close to declaring Jordan bird flu free.

Nigeria says it has inspected 236 farms and certified them to be flu free, meaning their chickens could be consumed. Also, culling has been going on.

Nigeria has also closed 76 poultry farms.

ProMed has OIE report indicating new outbreaks in Cambodia.

Good NYT story on bird flu preying on "ignorance and poverty" in the Nile Delta.

Effect Measure gives a grade card to US officials for bird flu prep, including a good grade for Secretary Leavitt, and others who need to do their homework more.

A minister in Ghana says that bird flu is not present there.

A veterinary report in Britain emphasizes the dynamic nature of the flu, but says to date Britain has done all it could.

ProMed also has a DEFRA scientist defending how Britain tested wild birds.

Bird flu restrictions will stay in place 30 days in Scotland, and then run their course if new cause for concern does not arise.

ProMed on Russia, compensation for culled birds in Israel, and guidelines on protecting cats.

The Times of London says an epidemic of bird flu phobia is on the way.

Experts says that Alaskan natives are most likely to be exposed to bird flu.

Canada's Finance Ministry says a pandemic would hit the economy less than predicted.

Key West is famous for its always present chickens....and some people wonder if that could be a problem during a pandemic.

The Shetland News with practical advice, including how to handle a dead bird.

Pitt is holding a bird flu symposium.

Egypt is also sponsoring bird flu training.

Kiwi expert says that Vietnam is leading the way on research on the spread of bird flu.

Antigua joins its region in preparing for the bird flu.

Nabarro praises Thailand.

Baxter is going to begin producing 2 million doses of cell based vaccine for the UK.

"Calm but vigilant" is the advice for local residents near the coast in Britain.

You've probably heard of distributed computing, where a central organization uses idle computers to work on a research project. Distributed computing is being used in Holland on bird flu.

CIDRAP on FDA advice for bird flu tests.

Letter from Rx exec to shareholders touts new anti viral work.

Recombinomics on reassurances in Britain.

Wednesday, April 12, 2006

April 12 Flu Update

WHO report on Indonesia.

A note here that Indonesia has a new bird flu case, but David Nabarro is backing the local government's decision not to cull birds, calling in impractical (which it may well be.)

Seven suspected cases has been quarantined in India.

Nick Zamiska is back in the Wall Street Journal, with a less than comforting review of pandemic plans in Europe. They are not consistent and not comprehensive, as significant numbers don't address veterinary services, and significant numbers of others do not look at service provision.

"It's like looking at the wiring diagrams of a Maserati and a Ferrari, and looking at which one handles better on the road without turning on the ignition," said Angus Nicoll, influenza coordinator for the European Centre for Disease Prevention and Control in Stockholm, who was sent an early draft of the study for review. However, he called the study "a useful piece of work."

ProMed looks around the world....

[1] Azerbaijan - confirmation of suspected case in Salyan
[2] China - suspected case in Guangdong
[3] Indonesia - suspected case confirmed

The two Azeri girls have been released from the hospital.

There was a mass outbreak in Southern Russia among birds that were already vaccinated.

Myanmar says the bird flu is under control.

Afghanistan says a third province now has a bird outbreak.

Somewhat strange article from Russia on clinical vaccine trials.

They are doing local preparation for a pandemic in Hattiesburg, MS.

Yesterday, we noted New Scientist criticism of British flu surveillance. Effect Measure comments....

As does Recombinomics.

From ProMed this is actually pretty good reading. The one sick swan in Scotland (end of tongue twister) could have floated over from Germany. Or, it could have circulated around the island prior to dying. The answer clearly matters. Doesn't help that they misidentified the species.

CIDRAP on Dr. Fauci, who says that the bird flu wouldn't have the same impact is US as it has in poorer countries.

African report on environmental factors in flu pandemic--which, generally, are really agricultural practices.

Effect Measure on the unanswered--and, for now, unanswerable--question of whether you can get the bird flu by eating an infected bird. Entire industries hang on this question.

USA Today editorial..."Things to Know, not fear."

Promed on yesterday's news from Indonesia and three other countries.

Promed with all the avian detail any person could need.

Turkmenistan was praised by WHO for its flu program.

Cambodians say they were unaware of bird flu risk.

When a flu report brought culling to a Cambodian village, the people who made the report were ostracized.

Vietnam says poultry smuggling is a big problem.

Alaskans are making bird flu plans....

as are people in Mt. Shasta, WA...

and California.

Every day there's a story on Tamiflu, shikimic acid and the sweetgum tree, which generally I don't pass along, but here's a new one.

April 11 Flu Update

Sorry we're late today. Things seemed to conspire against me (including there being a huge amount of news)....

A 41F in Southern China is being tested for bird flu after reporting with symptoms.

A poultry worker in Indonesia is sick with the bird flu.

There's also a 12th case in Egypt.

An additional non-fatal human case in Azerbaijan has been identified retrospectively.

CIDRAP with the news from around the world.

CIDRAP looks at FAO reports, with an eye on the situation in Myanmar.

Locals says dead sparrows in Japan are unlikely to have bird flu.

Seven polutry farmers in India have committed suicide because of bird flu impact on business.

Perhaps today's biggest news...New Scientists is questioning how Britain drew samples to develop negative tests on birds there, calling into question the extent of bird flu in the UK.

Effect Measure blog the New Scientist story.

At the same time, the British papers are full of the news that the bird died elsewhere and floated to the UK, making it a "one off" occurence.

Here's a new perspective....wetlands restoration and its role in the bird flu.

Anthony Fauci on MSNBC tries to inoculate (sorry) the public against a strong reaction to the first time an H5N1 bird is found in the US.

UN warns against a growing complacency in Asia.

The US begins to study low dose vaccines.

USA Today looks ahead to the day when bird flu is found in US, and predicts that poultry sales will take a hit. Article talks about cooking chicken and about industry protection to the bird flu.

Classic USA Today Factoid collection.

This story runs every two weeks it seems. "EU says Europe fully prepared for bird flu."

A Singapore based company continues to take its flu test to market.

Reuters on Chinese chicken markets...suffice it to say that the locals (like many people will daily exposure to a risk) are less worried than you'd think.

A woman who runs the tiny convenience store next to the feed depot by the market's exit feels the same way. "The chickens aren't afraid, so why should we be?"
Same for Indonesian farmers....

"If I die from bird flu, that is my destiny. But if I have to wear shoes, gloves and masks, my work becomes slow and my impatient customers will go somewhere else," he said while cleaning the guts of a chicken with his bare hands. "If that happens, I'll be dead," said the 28 year-old Jamal, who has worked at a market itn a Surabaya slum for a decade.

Report on how the bird flu has hit the Polish Poultry Industry.

IMF predicts major impact on world economy if pandemic hits. Great descriptive phrase: "Low probability, high impact."

Russian scientists say they are developing an oral flu vaccine.

The Scottish executive says it will not release any more flu results until the end of the week.

As things quiet down in France, the country eases flu rules.

Brazil is announcing new bird flu measures.

Toronto says it would vaccinate all residents against bird flu, but probably after the first wave hits.

Scotland was going to crack down on noisy, annoying seagulls, but now won't since they are afraid their volunteers will get bird flu.

A Maryland health educator says bird flu is serious, but no reason to panic (I swear, when anyone says it is time to panic, it will be my lead story).

In Fort Morgan, CO, local health officials discuss quarantines and other pandemic responses.

Algeria is producing Tamiflu.

The BBC looks back at how Germany reacted to its first H5N1 bird.

A while ago we had a story on a study that said even an imperfect flu vaccine would help fight a pandemic. CIDRAP has a good analysis of that idea.

"A moderately effective vaccine would work if you could get it into enough people," said Poland, who directs the Mayo Vaccine Research Group and Program in Translational Immunovirology. "This current vaccine, if we used the whole world manufacturing capacity, offers enough doses for somewhere around 37.5 million people. So that's not an answer." He added that it may be necessary to make more than one vaccine, given the different clades (families) of H5N1 virus that have emerged.

Poland also said no one knows how contagious the next pandemic virus will be. "My understanding is that the estimated R number for the 1918 pandemic was right around 3," higher than the maximum of 2.4 used in the study, he said. "You wonder now if we truly have a novel subtype that's easily transmissible, given the travel we have, if we wouldn't have higher numbers. The average family is bigger than two people."

Effect Measure looks at Britain's high level dispute over the pandemic.

The infected swan is being labeled an "isolated case."Maybe. But highly improbable. And if I were a resident of the UK I would much rather authorities erred on the side of caution than on the side of optimism.

ProMed summarizes worldwide OIE reports.

Monday, April 10, 2006

April 10 Flu Update

Effect Measure, noting perhaps out of control outbreaks in Myanmar, says the genie is out of the bottle.

There may well be unconfirmed human cases in Western Africa, where a very poor health system could make detection difficult.

ProMed on more cases in Czech Republic, 2,400 dead bird reports in Scotland each day, calls for calm, and ultra-secretive Myanmar says more than 100 outbreaks there.

The UN says there is no reason to think two children died of bird flu in Afghanistan.

David Nabarro continues to speak in Asia--generally positively about the efforts there.

He emphasized the "good practices" of the government in terms of the transparency of bird flu test results and sharing of virus samples with the international scientific community.
The University of Illinois College of Veterinary Medicine is holding some public forums on the bird flu.

A Chinese Pharma company has completed its first round of vaccine tests.

Two part series in the Ottawa Sun assesses Canadian readiness at the national, provincal and local level, with some scary anecdotes thrown in. Part I...

and Part II.

The Region of Peel (Brampton) is preparing for the pandemic.

Kansas releases its pandemic plan.

Hawaii, with lots of Asian access, could be considered a flu trouble spot. They are thinking seriously and ambitiously about what to do.

Officials have launched an airport screening program, planned limited quarantines and amassed a supply of protective gear for doctors and nurses. Next month, the state will hold a seminar to help employers learn how a pandemic could affect their workers and businesses.

The Leavitt tour hits Tennessee.

WHO issues guidelines for flu prevention in refugee populations.

Effect Measure weighs in on the issue of dogs and cats eating raw birds, and calls for more systematic surveillance.

Yesterday, we ran some British flu deniers who were certainly overstated their certainty about how low the chances of a pandemic are. Effect Measure weighs in.

To wit, two leading British scientists are at "loggerheads" on the issue. (I do not understand why intelligent people argue about whether this is going to happen, as if they know).

Meanwhile, bird restrictions in Scotland await further testing.

No decline in poultry consumption in Britain to date.

Recombinomics notes a new cluster in Indonesia.

The Chinese Chief Veterinary Official today said that due to 4.75B bird flu vaccines administered, a massive outbreak there is unlikely.

The same expert has offered to share China's successful flu methods with the world.

Bird flu experts speaking in Cleveland are asking engineers to help figure out ways to make vaccine faster.

Sunday, April 09, 2006

April 9 Flu Update

A month after finding the flu, Niger begins to cull.

ProMed with 3 reports from around the world.

Conservationists say that bird flu is giving wild birds a bad name.

Because the role of migratory birds is a very obvious one, it's often very tempting to say that migratory birds are bringing the disease," Robert Hepworth, executive secretary of the Convention on Migrating Species, told Reuters.

"Migratory birds have been involved of course, but the actual evidence of migratory birds spreading this disease across continents on a large scale is very patchy."

More from Britain, where it is safe to say this week's cabinet document release has caused a shockwave (combined with the arrival of the flu). Note how they plan to deal with transport problems, one of Osterholm's bigger concerns.

There are also reports that off-duty firefighters and retired lorry drivers will be pressed into service to ensure deliveries of essential food supplies in the event of a pandemic.

Who's to say they will show up for work?

I know from time to time people in the flu blogosphere are accused of scare-mongering. Isn't this statement from Britain's scientific authority equally bad--sure of something he doesn't know?

In an odd counterpoint, the British Tory party is distancing itself from an MP who ridiculed the idea bird flu could hit humans.

A British vet objects to the Times calling UK response to bird flu "sloppy."

The Scottish First Minister is defending the government's response.

Finally, the Queen is taking action to protect her birds. (via Crofsblogs).

More on the new methods to develop vaccines, beyond eggs.

Bird flu to be a factor in holding up the development of the Asian economy.

Sir David King said that it was “totally misleading” to suggest that a global flu pandemic in humans was inevitable. His attempt to ease public concern coincided with the leak of documents detailing government plans to deal with a widespread outbreak of a human form of the virus.

April 8 Flu Update

Very interesting AP report talks about a California lab that is the go to lab for suspected flu cases. Story reveals a number of times that bird flu was suspected in humans in California (mostly from travellers returning from Asia).

There's another suspected human case in India.

More sick birds in India, more culling.

Vietnam has more bird cases, near the Chinese border. ProMed reports. Also, birds now sick with flu in Zagreb.

Vietnam is tightening border controls, with flu now in Cambodia.

``The trading in live birds across borders is one of the main causes of the spread of H5N1,'' said David Nabarro, the United Nations' senior coordinator for avian and human influenza, speaking to journalists today in Hanoi at the end of a visit to the country. ``In Vietnam, it is being very clearly stressed to us that the border controls are going to be intensified.''

No flu in Spain yet, but they are on the alert.

Story says in Australia, their plans are so far along that they are trying to figure out what to do with the bodies. (??--not sure maybe they shouldn't work on getting a little farther along on the other fronts.)

The SPCA is afraid pet dumping will result from bird flu.

A British expert says bird flu will be the end of organic farming.

A top scientist says there is no bird flu crisis, and Britain is better prepared than most.

Another article touting Britain as having the best scientists fighting the bird flu.

The Telegraph is critical of government secrecy on bird flu, as well as how drugs will be rationed.

Effect Measure comments on FDA rules to protect against antiviral resistance in flu..

The second part of Canada's pandemic plan--the one that says how and when things would happen--is due out soon.

DeSoto County has a pandemic plan (NC).

Saturday, April 08, 2006

April 7 Flu Update

Absolute must read from Effect Measure. Reviews a journal article that looks at mortality rates for influenza--finding years in which seasonal flu was actually more deadly than a pandemic strain.

A well-known flu researcher said to me recently he thought knew more about flu 20 years ago than he does now. With the publication of this paper, we might say we also know less about seasonal influenza now than we did last month.

The two sisters (18 mos and 6 yrs) in Egypt will survive the bird flu.

There's an eighth case in birds in the Czech Republic.

ProMed has an update from Scotland, but also from Nigeria, where bird flu has landed in Lagos, in a backyard farm and in a commercial farm.

This is what happens. Scottish grocers are under pressure for allegedly cancelling orders from Scottish poultry producers after the bird flu hit. (Note the story says nine of 14 birds tested were negative.)

And there were claims that on Thursday - the day after it first emerged Scotland could be suffering a possible outbreak - a number of major supermarkets cancelled orders of chicken from a Scottish supplier for this weekend. All the supermarkets contacted by The Scotsman denied the claim.
More updated testing news from the BBC.

Britain "holding its breath" (at least they didn't say "breathless") awaiting test results.

Crisis Commitee in Portsmouth meets, says no crisis yet.

Effect Measure says to note the stiff upper lip in Britain.

News4 in Britain has bird flu dos and don'ts.

The FDA issued guidelines for bird flu testing that should help to detect flu faster.

FAO points to Vietnam, says bird flu fight can be won.

From Britain, the Chelsea Manager says the bird flu has given him perspective on the pressures of Premier League football.

"I am serious. You are laughing but I am serious. I am more scared of the bird flu than football. What is football compared with life? A swan with bird flu, for me, that is the drama of the last two days. I have to buy some masks and stuff. I am serious. Maybe for my team as well."
In Britain, a conservation committee says that the bird flu in Scotland validates its position on the flu issue.

A British vet authority says issues a policy paper on bird flu in cats and other mammals. Bottom line: risk is from eating birds, and non-avian animals are not reservoirs.

Ansell (a company specializing in "barriers" like protective clothing and masks, etc), has flu recommendations for ag and healthcare.

Gilead stock recommendations are up based on HIV and Tamiflu franchises.

Pakistan says no human cases there.

Recombinomics continues to argue that H5N1 is moving closer to human transmission. Note this based on our recent "deep lung" conversations.

Recent experiments measuring binding of H5N1 to cells of the upper and lower respiratory tract also showed that the tested Hong Kong isolate could bind to both cell types, also suggesting that such properties would increase transmission to humans. This isolate was also cultured on MDCK cells.

Recombinomics says now that the bird flu is in Lagos, its in the East Atlantic Flyway.