Thursday, June 29, 2006

June 29th Flu update

Nature has an editorial today calling for an immediate release of flu data. Editorial itself is behind the paywall, but Declan Butler passed some parts on in his blog. Note the defense of hiding data, translated from French.

“You have to know that, paradoxically, if these data were shared from the outset by the scientific community, we would encounter many difficulties in collaborating. These data can’t be published in prestigious scientific journals if they have been made public before. Whereas these publications are the essential criteria assuring the financing of future research.”

Recombinomics comments on this, as well.

Reuters has an on the ground report from Indonesia, and the reporter is treading warily.

During SARS in 2003, as it is with bird flu now, we were under orders from our editors not to go into hospitals and areas where there were outbreaks of the respiratory disease, which killed close to 800 people. However, there were a few occasions when news conferences or interviews would take place in what were supposed to be "safe wings" of hospitals taking care of SARS patients in Hong Kong, where I am based. Coming away from the hospital, we would dispose of our surgical masks and gasp gratefully for air. From then on, I would count the days and stay well away from social functions until the incubation period of seven to 10 days for the SARS virus was safely over.

Jim Rogers, a Soros Partner, advises investments in commodities during a pandemic.

The paper in Culpepper, VA, reports on a meeting held by local police to talk about the effects of the bird flu...on local police.

A seminar in Thailand gave the usual warnings--massive absenteeism, travel restrictions, shortages, infrastrcture failures. And they were told that preparation is the key.

More on Hungary trying to test its flu vaccine--they are asking the police to volunteer.

The USDA has released its 180-day update on flu programs, listing many activities.

Here's a direct link to the report...

Hong Kong has changed its bird flu alert system.

ProMed on the Chinese "investigation" of the 2003 case.

It is perhaps not surprising that a human case (or cases) of H5N1 avian influenza was not recognised in 2003 when the concern was containment of the novel SARS-associated virus. However, clarification of the situation is urgently required to determine when and where the first detection of human H5N1 avian influenza virus infection occurred in mainland China. - Mod.CP]

June 28th Flu Update

China claims it is strenthening its surveillance of bird flu outbreaks.

ProMed reports that the outbreak in Siberia is intensifying.

International experts cite Indonesia's failure in fighting bird flu. Note the reuse of protective gowns.

Key among those, they said, was a shortage of protective equipment that might have led to the infection in hospital of the last family member to die and the unchecked movement in and out of hospital of patients.


Jakarta has asked for $900m (£494m) in grants over three years to finance a plan it submitted to an international donors conference in Beijing. But international experts argue $200m a year is far more realistic. More-over, many of the things Jakarta is asking for are things it should be prepared to pay for itself, they add.

“It’s a little bit absurd. I don’t know why people don’t call them on this,” said one expert. “What is this money going to be used for? It’s going to be used to build government institutions that should be there in the first place. It’s not [bird flu] specific. It’s things . . .  any civilised country should have.”

Romania says it has lowered the number of flu outbreaks to 21.

Switzerland is ordering 8 million "pre pandemic" doses of flu vaccine, which will be mis matched, but may slow down a pandemic. The question is, when do yu give it?

China says it is also investigating the 2003 bird flu case. (CIDRAP reports).

An Australian vaccine is moving forward in testing.

Reuters has this interesting story on the economic impact of a pandemic. In many ways, it will boil down to how people reaction--rationally, or in a panic mode. Also, the article points out that you have to look beyond the initial reaction--which is bound to be strong, and focus on the recovery.
"The (economic) effects tend to be lower than you'd expect because people are good at adjusting," said Donald Marron, acting director of the U.S. Congressional Budget Office, citing the U.S. economy's resiliency after the Sept. 11, 2001, attacks and last year's Hurricane Katrina. "A lot depends on the public reaction, which is difficult to predict," Marron added.

A US official says closing borders is low on the priority list.

Utah did a tabletop drill to prepare for the bird flu.

North Bay Parry Sound (Ontario) released its pandemic plan.

Here's an op-ed from the Canadian minister of health on what Canada is doing to prepare for a pandemic.

Now here's the REAL question...will bird flu kill the Internet. Notably, could the bandwidth handle the massive telecommuting?

You know you've heard this...isn't bird flu another "false alarm" like Y2K, West Nile, SARS, etc. Effect Measure looks through each of these, with an eye toward two things. First, some of these things did happen. And two, when you are preventing something, you never know for sure if you really prevented it or if it would never have happened on its own accord.

Effect Measure also has this, when follows right along. The first six months of this year were the worst for the bird flu. This virus is less a false alarm than it was last year.

Conditions for a possible pandemic continue to ripen. The virus is geographically distributed in ever new and different environmental niches, has produced the largest cluster of human cases to date, with solid evidence of human to human to human transmission, and has infected other mammalian species in which to experiment with new lifestyles and genetic endowments.

This is the first time in history the world has been able to watch what might be an evolving influenza pandemic, so we don't know what we are looking at. So far what we see is both frightening and fascinating -- the horrible fascination of watching a trainwreck in slow motion.

Tuesday, June 27, 2006

June 27 Flu Update

A new outbreak of bird flu has hit birds in Western Siberia.

Recombinomics wonders if this isn't the start of a new geographic reach for the disease, as it was the last time outbreaks started in Siberia.

Zambia insists that it wasn't bird flu....

German researchers have concluded that the seven cases in Azerbaijan came from wild birds, the first known example of this transmission. Effect Measure reports.

The First International Conference on Avian Influenza in Humans opens tomorrow in Paris. Here is what is on the agenda.

Sidney, MT is doing some local planning on the bird flu.

A Pan African Action Statement for a pandemic was released.'

Robeson, NC also has some planning on the agenda, but always being careful not to overreact.

“You have a better chance of being hit by a car,” said Greg Britt, owner of Sunshine Farms in McDonald. “It's something that needs to be looked at and addressed, and we need to be cautious, but I'm not that worried about it.”

More talk about high-tech imaging to track and fight the bird flu (my comment--we need to use everything we have, with an appropriate balance of realism and hope).

'Tis the season for economic projections. Bird flu @180M Euros for Europe.

Michigan is testing geese for bird flu.

Jakarta Zoo had bird flu, and Milwaukee is determined to avoid the same fate.

Roche writes a letter to the editor refuting a previous article that Tamiflu it was not known if Tamiflu would be effective in an H5N1 Pandemic (it seems to me this is not known--and not knowable).

The Annals of Internal Medicine reviews pandemic planning, noting the biggest deficiency in the most important area--regional planning.

China has announced that media outlets reporting on "sudden events" without approval of the government could be fined. Effect Measure protests.

June 26 Flu Update

A lot of birds are dead in Siberia, though an expert says he doubts its bird flu.

Russia has banned Hungarian poultry over bird flu concerns.

Using a computer grid and a network of scientists, Scottish scientists are able to evaluate bird flu "cures" faster than the old trial and error methods.

The University of Massachusetts is developing a DNA vaccine for bird flu.

In New Zealand, a company is stocking up on antibiotics in preparation for bird flu. Yes, they know its a virus, but they are also worried about secondary infections.

This story reminds me that we used to have "death estimate" stories all the time, but its been a long time. This one in Australia projects 40,000 deaths even in a mild pandemic.

Different take on same story--potential for 6.8% reduction in economy.

OIE reports say France and Malaysia are bird flu free.

Malaysia is bird flu free, and internal poultry restrictions have been lifted.

The Mayor of Beijing visited the Sinovac plant....

Wild Bird surveillance story from Nova Scotia.

Bangladesh says it has an emergency program to fight the bird flu.

Cedartown GA is doing local preparations for the bird flu.

The Prime Minister of Pakistan has a bird flu select committee.

We've had stories about the bird vaccine that combines with a vaccine for Newcastle Disease. Effect Measure says it should be in the public domain.

Recombinomics is concerned that the bird flu in Indonesia is acquiring Qinghai sequences.

Monday, June 26, 2006

June 25 Flu Update

Australia wants to help Indonesia set up a proper compensation system for people who lose birds to culling. (In my opinion, this is a needed step. Right now, the population is resisting flu measures, and for basic reasons like survival).

Arizona's business leaders met with the Governor to discuss pandemic preparations.

West African ministers have developed a regional plan to fight the bird flu.

The European Food Safety Organization is warning that Bangladesh is at risk of bird flu due to migratory birds.

In a public forum in California, a local official uses a Katrina metaphor to define a pandemic.

Quincy, IL, is also holding local meetings to prepare for the bird flu.

There's been some talk about reporters in Indonesia being nervous about catching bird flu while covering the story--yet people won't talk to them if they wear masks. Effect Measure understands their concerns.

Recombinomics reviews the data from the flu conference in Indonesia. Note his prediction that the two Indonesian strains may require two vaccines.

Recombinomics also notes that the conference revealed that the strains in that country are amantadine resistant, eliminating a cheap antiviral therapy.

Promed with OIE reports from Niger, Ukraine, and China.

Saturday, June 24, 2006

June 23 Flu Update

In the big flu news for the day, WHO has announced that the virus did mutate in the family cluster in Indonesia. There are strong statements that the mutation DID NOT make it more able to pass from human to human (what would you expect?) Still, its the first evidence we have seen of a mutation of that kind...and, (my view), no one really knows what the virus needs to do to flip the switch. Here, we link to Helen Branswell.

"As far as we know they don't correlate with any particular functional changes about the virus," Dr. Keiji Fukuda, co-ordinator of the WHO's global influenza program, said in an interview from Jakarta. "It doesn't confer any greater transmissibility or any greater pathogenicity."


Tracking single cases or small clusters is like watching sparks. Each one might trigger a fire - but to date WHO sees no signals that's happening, Fukuda said.

Here's a wire story on the same topic. US experts say that it is "noteworthy" but not enough to change the pandemic phase. Note also, the wonder at being able to do this kind of detection in a remote Indonesian village...(my note) can we really not say that technology and connectivity is giving us a significant advantage over past pandemics?

Promed on the cluster story. Note mod comment (CP) that says asks, first, what initiated the cluster, and second, what made this family so susceptible?

Finally, CIDRAP covers this story.

The other big news from yesterday was the Chinese scientists writing a letter to NEJM that said China had H5N1 two years earlier than they had ever admitted. Then, the scientists (or some) tried to withdraw the letter. Branswell again.

The story gets stranger. The researcher in whose name the retraction email was sent says he didn't send it...making you wonder who did?

On Wednesday, the journal said it had received an e-mail signed with the researcher's name that requested the letter reporting the case be withdrawn from publication. Wu has since telephoned the journal's editors and sent a fax denying he had made any such request.

WHO has asked China to clarify the facts around this case.

Effect Measure writes on the twists and turns in this story.

Helen Branswell is back one more time, with a story on the Chinese flu vaccine which is showing some results.

A Chinese-made H5N1 flu vaccine has been shown to provoke good immune responses at significantly lower doses than those made by most western vaccine manufacturers - an early finding that could help other companies learn to stretch the limited global vaccine supply in the case of a flu pandemic.

But the formula used by the Chinese company - vaccine made using whole viruses, rather than viruses broken into particles - is no longer commonly made by western flu vaccine manufacturers.

And they appear hesitant to shift gears on their year-to-year vaccine manufacturing processes to improve their output for a pandemic - an extraordinary event the timing and severity of which cannot be predicted.

"Companies that have been making split-virus vaccines are reluctant to test whole-virus vaccines because this would require them to get new regulatory approval for their process and this would cost them a great deal of money . . . for a specific product that they may never market," said Dr. David Fedson, a retired academic and flu vaccine industry expert who lives in France.

Bird flu panic has hit Zambia, and like everywhere else, chicken consumption is down.

Indonesia is upgrading a bird flu lab to meet WHO standards.

Burma is going to restock areas hit by bird flu culling.

The European Food Safety Authority has determined that there is no evidence of bird flu being transmitted through the normal consumption of chicken and eggs.

More on wild bird surveillance in Oregon.

CIDRAP has this report from a study that says that mass vaccination programs make it hard to detect human cases, and that when you have areas with low human cases and high vaccination, you should interpret results carefully. Report also notes that there have been strong warnings that bad vaccination programs are dangerous.

Surveillance for H5N1 cases in humans," the authors write, "is becoming harder where poultry immunization is widely but imperfectly implemented, because the marker of local poultry deaths for human case detection is being lost.

"Declines in the number of sporadic human cases in countries with poultry vaccination programs should therefore be interpreted cautiously."

Letter to editor in Chattanooga says that we should vaccinate for bird flu with what we have now--what could it hurt.

Promed on OIE reports from Hungary--more bird outbreaks of H5.

ProMed reports the June 2 Danish case was H5N2.

Recent sequences released show evidence of recombination--from Recombinomics.

Friday, June 23, 2006

June 22 Flu Update

Back on board...

While I was out, the news broke that there may have been an H5N1 case in China two years before the previous earliest date in China. It was originally announced as SARS. News came out in a NEJM article from eight scientists, some of whom asked to be removed from the article just prior to publication.

Here's the actual letter from NEJM.

CIDRAP reports on this story, including a shocked WHO demanding some answers.

Story cries out for Helen Branswell. And here she is.

The eight wrote of the case of a 24-year-old man, apparently from Beijing, who had pneumonia and respiratory distress in November 2003. In that period, when the entire world was anxiously waiting to see if severe acute respiratory syndrome would re-emerge with the arrival of cold and flu season, doctors thought he was suffering from SARS.

The man tested negative for the SARS coronavirus. But H5N1 was found in tissue from his lungs. The letter does not state when the testing was done or how long it has been known that the man died from H5N1.


Flu watchers aren't surprised that China had cases as early as 2003. In fact, outside China it has been widely assumed, given that three people from Hong Kong became infected with the virus during a visit to Fujian province in February 2003.

The retracton angle is interesting. You can guess it had something to do with internal political pressure, but we need to hear more to be sure.

Effect Measure comments, noting that Revere's IP is banned in China, but is critical of Chinese government.

ProMed on China and Indonesia. (Note mod comment: news from China does not surprise any observer, or so it seems).

The 98 contacts of the recent flu victim in China have been released after being under observation for one week. (ouch).

WHO is conceeding H2H among the family cluster in Indonesia. CIDRAP reports.

Biotech stock shares rose on this news.

Zambia is testing dead birds for H5N1. WHO is appealing for calm.

Malaysia says it is bird flu free, wants to export chickens again.

All of Southern Africa is on a bird flu alert.

GlaxoSmithKline is preparing to seek approval this year for its flu vaccine. On matching strains, it says:

The vaccine should be able to protect people even if the H5N1 virus mixes with a strain of human flu, Stephenne said.

``If you compare H5N1 isolate to the flu virus that created the flu pandemic in 1918, we know it's only a little difference,'' he said. ``This little difference will not change the quality of the vaccine."

During the three-day bird flu meeting in Indonesia, that country finally admitted that it has a severely limited ability to respond.

Bird flu prep kits are being given to schools in Contra Costa, CA.

Manitoba, Canada, has assessed that its poultry and swine are at low risk for bird flu.

Manitoba's pandemic preparedness plan.

Bird flu scare caused a huge glut in the poultry and egg markets in Europe, and the EU is rushing in to help support prices.

More on bird flu pledges falling short. US had pledged $1.9B, has forked over only $300M to date.

These stories come out every once in a while. Grassroots Balinese are not worried about the bird flu...nor are they very knowledgable about it. I think that some people have such difficult lives its hard to have the luxury to worry about non-immediate threats.

Dr. Mary Emmerichs, a professor at UW-Sheboygan, thinks people don't learn the lessons of history. Specifically, about the bird flu. She is giving a talk in Fond du Lac, WI, on a local perspective on the 1918 pandemic, as part of a local effort to educate on H5N1. In my opinion, this is an excellent approach. The 1918 story creates context and limits what is otherwise an abstract threat.

A public meeting on the flu in Indiana revealed...the need to have another meeting.

Local planning is also ongoing in Santa Rosa County, FL.

Stanford is looking for volunteers to participate in trials to test a vaccine produced in Australia.

India is still banning retail Tamiflu sales.

Thursday, June 22, 2006

Storm Break

Heavy storms have hit the area, and its effecting connectivity and electrical power. Next update tomorrow.

Tuesday, June 20, 2006

June 20 Flu Update

WHO confirms an Indonesian teenager died of bird flu last week, taking national death toll to 39 (case originally reported a couple of days ago).

CIDRAP on the Indonesian case.

ProMed on the Indonesian case, with a mod call for sequences from the cluster.

An expert flu consultation will begin in Indonesia tomorrow (or, given time differences, now, focusing partly on the cluster. WHO official report.

Effect Measure cites the environment people are faced with in Indonesia. Volcanoes, earthquakes, even tetanus is getting the better of the country. So, how can it tackle the bird flu?

Conflicting reports. Some reports say Canadian gosling was LPAI, while others say test was inconclusive.

ProMed on the LPAI side of the ledger.

Recombinomics draws attention to the organ damage in the Canadian birds.

Zambia is testing for bird flu after dead chickens were discovered.

The Department of Veterans Affairs says that during a pandemic it might have to close 120 military cemeteries.

The Ohio State University is preparing for The Arrival of the Bird Flu Pandemic.

In Arkansas, (appropriately, the "Rice and Duck Capital,") bird flu warnings are issued, if incorrectly (not the warning that weak immune systems will fall first).

Small attendance but large amounts of common sense surround bird flu meeting in Greene County, IN.

USAID is leveraging private public dollars to help fight flu in Vietnam.

A Federal audit says the USDA does not have a good plan for fighting bird flu, and that too much reliance might be placed on the states.

The Institute of Medicine says that the US is underprepared for major disasters, including bird flu. (via CIDRAP).

The Macon GA Telegraph is doing a three-part bird flu series. In this part, it talks about how care might be rationed in the worst days of a pandemic.

We have a significant population in this country who believe emergency health care is a right, not a privilege," said Andrea Sellers, a critical-care nurse educator and emergency planner at Coliseum Medical Center in Macon. "I'm sure that patients we cannot help we'll simply make comfortable. As nurses, that's hard for us to do because we've been taught our whole career to cure."

Part I of the Macon series.

Part II of the Macon series.

Westerly, RI is preparing for the bird flu.

Oregon is participating in the surveillance efforts among wild birds.

Article from India says that the St. Jude internasal flu vaccine is akin to striking a gold mine.

There has been lots of talk lately about stockpiling a mismatched flu vaccine, on the theory that even a little protection in the transmission chain would save lives. Effect Measure doesn't discount the idea, but raises a couple of problems, including production capacity and timing.

ProMed reports on a feline case in Indonesia.

June 19th Flu Update

Northern China has a new bird flu outbreak.

ProMed on China...quarantine measures are being undertaken.

CIDRAP reports on the Canadian case, as well as an outbreak in Hungary.

New Scientist with an excellent article on the state of the vaccine wars, and why we might need to stockpile pre-pandemic strains.

ProMed also says China has cleared all close contacts of the latest case. Also, note mod comment that says there has been no bird flu in that area, but perhaps as a truck driver he picked it up elsewhere.

Canada is taking more measures to keep bird flu on PEI.

Health experts say Indonesia needs to cull, not vaccinate birds.

Even though Revere doubts the latest Chinese case is from a mutated virus, China should still share the isolates--and not just the sequences.

Serbia is implementing measures to protect its Hungarian border against bird flu.

The Catholic News Service urges Churches and Families to prepare for the bird flu.

Myanmar is worked with the Red Cross/Crescent to do flu education programming.

USDA is training international scientists to detect bird flu.

France is now bird flu free.

Sinovac (China) announces it has completed phase I of its vaccine testing.

An Academy reviewed Arizona's pandemic plan, and says it could be improved in several ways.

Hong Kong is cracking down on bird smuggling (via ProMed).

Sunday, June 18, 2006

June 18th Flu Update

Helen Branswell on Indonesia bringing world experts to the country to finally try to put the bird flu problem to rest. It is seen as a good sign.

"I think calling this meeting is a step towards recognizing that they have got a problem and they do have a responsibility to the rest of the world in terms of trying to deal with it," says Lance Jennings, a virologist and epidemiologist at Christchurch Hospital in New Zealand.

Still, it isn't clear that all the effort will bring changes on the ground.
"I think what's concerning is if the answer is 'You need to change your devolved veterinary services,' that's a big tanker to turn around," he says bluntly. "That might not be a terribly easy or welcome piece of advice for them to get."

Canada has quarantined another backyard chicken flock.

Recombinomics feels that this is evidence of H5N1.

Another article on how US business is preparing for the bird flu.

Georgia (US), home to millions of chickens, is preparing for the worst if bird flu comes.

Detailed op-ed in Indian paper gives nice overview of what has happened to date with H5N1.

Revere found an unglamarous article on the H5N1 in chicken poop. UV light has so effect over four hours, through heat does.

Saturday, June 17, 2006

June 17 Flu Update

China confirms its latest case, a 31M which has been reported before.

This is interesting. WHO spent time studying the big cluster in Indonesia, but the results haven't been released. Part of the reason appears to be the objection of local residents....strong objections.

Dozens of residents staged a protest on Wednesday at the North Sumatra governor's office, demanding that the governor should ask the WHO team to leave the area within three days. They were threatening to personally tell the team to leave Karo if the government took no action by Friday.

In Myanmar, people are urged not to drop their guard against the bird flu.

500 volunteers are testing the Hungarian flu vaccine.

Roche has posted resources to help people protect themselves from fake Tamiflu.

Recombinomics on Qinghai isolates showing up in Indonesia.

Poultry sales are coming back in the Middle East as flu fears ebb.

North Africa lacks the expertise the bird flu--as if to illustrate, story has picture of a soldier and another man trying to catch a pheasant to cull it.

Western Governors were in Sedona, and they were told the nation is not ready for the bird flu.

FAO has made donations to the Seychelles (of equipment) to help fight bird flu.

June 16 Flu Update

WHO confirms the recent Chinese case has H5, and a June 14th death in Indonesia is reported. CIDRAP reports.

Canada has reported a case of H5 on Prince Edward Island....N1 confirmation still coming.

This release details the initial government response.

A Canadian agency says it is unlikely it is H5N1, via ProMed.

While Recombinomics says there is evidence of H5N1.

Helen Branswell on volunteers in US taking a new internasal H5N1 vaccine.

But the flip side of the impressive list of potential positives is one big potential negative: scientists aren't sure it will induce enough of a protective response in humans to be worthwhile -- although they think so.

Its not just the Chinese....apparenntly, Denmark waited two weeks to notify WHO about an outbreak.

ProMed has a complete report on the situation in Denmark, past and present.

Must read editorial from the Bangkok Post, with an interesting perspective. Is too much attention being given to H5N1?

Serious thought should be given to a plea issued on Wednesday by scientists around the world calling on the G8 leaders not to get so caught up in the potential threat of bird flu that they divert their attention from the real global killers: TB, HIV/Aids and malaria. They issued the appeal ahead of the G8 summit in St Petersburg next month, which will have a bearing on the allocation of funds.

USA Today with a high profile story on the surveillance going on in Alaska.

Via Crofsblogs, a report has been received that the young girl who died in West Sumatra may have had two sisters who died of bird flu as well.

Apparently, culled birds in Maharashtra were not disposed of properly, and there are fears the bird flu could come back after the Monsoon season.

Russia has a bird flu program to propose at the G8 summit.

The Red Cross says donors are not responding to its call for support for a possible pandemic, and it could effect response.

Forbes has this on how to align your portfolio for the pandemic.

...the moment the WHO shifts the alert level to Phase 4, expect a literal overnight collapse of the Asian markets similar to the currency crisis of 1997. That crisis started in July 1997 in Thailand, but it caused a global financial domino effect. That is what we are looking at with a Phase 4 warning.

Maine is testing its birds...on the Alaska plan.

Reporters are told how to reduce their chances of getting the bird flu.

A group of veterinary virologists are working together with a pledge to release bird flu sequences.

Effect Measure writes on this story as well...noting that while it is an important step forward, none of the signees are from China. Further....

It is time for US government policy to require all NIH and NSF grantees to deposit avian influenza sequences into GenBank immediately as they are obtained and certainly for CDC to do likewise.

There are a bunch of local stories today (or, Friday is a tough day to find local news stories :-):

Knox County, TN, is preparing for the bird flu.

A health district in Alberta is doing some public education.

Public meetings have been held in Greene County, IN.

Roanoke,VA Red Cross also has someone working on the case.

They are also planning in Memphis, TN.

The local health director is commenting in Albany, GA.

Op-Ed piece from two state health directors gives recommendations for public health preparation.

Thursday, June 15, 2006

June 15 Flu Update

China says it tested 98 contacts of the newest flu victim, and they were all negative.

The 7 year old girl who died in Indonesia June 1 is a confirmed positive H5N1 death. Here's a comment in the WHO update:

"The newly confirmed case is one of several where exposure occurred despite a clear signal of a high-risk situation arising from poultry deaths. Pending better control of the disease in animals, WHO and officials in the Ministry of Health see an urgent need to improve public awareness of this disease, the risk factors for infection, and the behaviours that should be avoided."

Skeptical of actually getting compensation, people in Indonesia are not cooperating with the government's flu containment program.

The esteemed Helen Branswell has this on Canadian flu preparations.

Conference Board vice-president Prem Benimadhu suggested the findings were "a bit surprising," especially given only 28 per cent of the businesses asked to respond to the survey even bothered to answer.

"The surprise is the gap between concern and execution," he said.

Macao is on bird flu alert.

A Doc and health board member in Lincoln (MA) had this to write about the bird flu for local readers.

Canada says it will limit its Tamiflu stockpiles to a relatively low population ratio, saying a vaccine is key.

Revere writes on the difficulty of local news reports (oh, so available with the Internet) to get reliable info, as he has human translations of two different stories on a sick reporter who might have been H5N1. Of course, a sick reporter would be H5N1 fear, but is that what it is?

Here's Recombinomics on the same reporter (heavy user of machine translations).

We've written here about Secretary Leavitt and the Magical Mystery Flu Tour. Apparently, WaPo is criticizing him for too much use of the plane. Revere comes to his defense.

Finally, Effect Measure notes the case in China, saying that it appears to be another sporadic infection--and its a mystery on who gets sick and who doesn't.

Recombinomimcs notes neurological involvement in a case from the Sumatra cluster, which leads to some genetic inferences.

China is trying to evaluate whether past bird immunization efforts have been effective.

Polk County (IA) is holding its final bird flu forum.

Cuba says it is ready to detect and fight bird flu anywhere in the country.

New Zealand apparently has some live H5N1 for case detection purposes, and its being kept under heavy, heavy biosecurity.

We reported a couple days ago on the story about protecting pets from bird flu. Here's an interesting an acerbic mod comment on ProMed.

It is clear that the UC Davis faculty found a ready listener in Ms Tansey and it is now summertime. If this risk were real, we would have had reports (plural) from Europe of infected domestic cats.

Wednesday, June 14, 2006

June 14th Flu Update

600 domestic fowl have died of H5 in Hungary.

Alaska passes a law with new powers to quarantine and test animals in the wake of flu fears.

Flu experts are on their way to Shenzhen, China, where a new human case has emerged.

Yesterday, we had the story about the reason for the high death rate among young people--the often mentioned cytokine storm. CIDRAP covers this today.

Scientists have suggested that the cytokine storm played a role in the high death rate in the 1918 Spanish flu pandemic and is playing a similar role in human cases of H5N1 infection today. Autopsies of H5N1 avian flu victims in Vietnam and elsewhere have revealed lungs choked with debris from excessive inflammation triggered by the virus. Similar severe lung damage was frequently reported in victims of the 1918 pandemic, which disproportionately killed people with the strongest immune systems—young, healthy adults.

CIDRAP on China's new case, and on some technical reviews in Indonesia.

Recombinomics has a translation of three suspect bird flu deaths in Sumatra.

Could a mask made out of a T-shirt help in a serious bird flu pinch.

"A simple, locally made, washable mask may be a solution if commercial masks are not available," Virginia Dato, David Hostler and Michael Hahn wrote in the journal Emerging Infectious Diseases.
China says it has a new detection method for bird flu and new flu vaccines (for birds) as well.

Local government officials are telling federal officials in NZ that they may need some new laws--or relaxation of some other laws.

Among them would be regulations governing the establishment and maintenance of cemeteries, registration of funeral directors, certification of mortuaries and provision for the handling and transportation of dead bodies - all of which are administered by local authorities.

Thursday, Voice of America will host a program on bird flu.

A state lab in Alaska is now certified to do flu tests.

Mt. Olive (NJ) says the area is unprepared for the bird flu pandemic--raising the hurricane metaphor again.

The University of Iowa has released its pandemic preparedness plan.

Pharmacy in China will stock Tamiflu soon.

MedImmune updated its investors on progress on a number of fronts, including bird flu.

Tuesday, June 13, 2006

June 13th Flu Update

After long periods of quiet, there is a reported new human case in China.

Quarantine measures are in place in a Ukranian village.

A world animal health organization says that Indonesia's reports greatly underestimate the presence of bird flu in animals there, and that is hurting the overall pandemic effort.

CIDRAP reports on more vaccine news, which appears to grow more positive each day. St. Jude showed protection against three H5N1 strains in ferrets.

Recombinomics says that the man in China is in an area where the Fujian strain was prevalent.

ProMed on the Chinese case--man had recently visited a wet market, reports say.

A new study (via ProMed) reports what has been reported before...some flu strains appear to provoke strong immune responses, which do more harm than good. Young people with robust immune systems therefore have higher fatality rates.

ProMed on Ukraine. Note mod comment that says prediction of hibernation of the bird flu were, apparently, "premature."

USAID has contributed $5M to a fund to help bird flu surveillance around the world.

A Shanghai company will be producing generic Tamiflu.

Oh, Horror! The Japanese have banned Hungarian poultry imports, curtailing the foie gras supply.

In Roanoake, VA, the consensus seems to be that business is unprepared for the bird flu.

A two-day conference in Kazakhstan covering bird flu in Central Asia ended.

"Preventing pandemic and mitigating current economic losses requires collaboration and commitment from everyone – international organizations, governments, the private sector, the media and local communities," Nabarro said. "Families at risk have the right to expect no less of us."

A Canadian company is introducing a mass-market Pandemic Preparedness Package.

Statins--the wonder drug. Study suggests they may help with the flu (unless I am mistaken, this has been reported before).

Luke Shockman of the (Toledo) Blade reports on a local pandemic planning meeting in Lucas County. Sparsely attended, but the Law Director in Maumee, Ohio, is taking action...

Some public officials have paid little attention to bird flu, as evidenced by low attendance at a forum yesterday for Lucas County elected officials.

But not Sheilah McAdams.

Ms. McAdams, Maumee's law director, is working on an amendment to her city's charter that would outline "continuity of government" steps that could be taken if bird flu sickens or kills city leaders.

The last time the city took such an unusual step? During the 1962 Cuban Missile Crisis.

A similar meeting took place in Huntington, WV.

Effect Measure helps laypeople define infectivity, pathogenicity, virulence and transmissibility.

Effect Measure on an official in Indonesia who denies what appears to be obvious. Bird flu passed H2H.

June 12th Flu Update

Northern Ukraine has reported its first outbreaks (in birds).

After a recent outbreak, China has announced new emergency bird flu controls.

US scientists are looking for more research on the role of cats and dogs in flu spread...before the flu gets to the US.

Excellent Effect Measure post, noting how a traveller brought the measles to an office building in Boston and infected 11 people. Note this, which I believe is often missed in the flu debate:

While scientists are up in Alaska swabbing rectums in migratory birds for H5N1, most epidemiologists believe that if the virus becomes easily transmissible anywhere in the world, the most likely way for it to enter the US is on a human being, not a bird.

The Asia-Pacific news says that China's ability to handle the bird flu could affect the whole world.

The World Bank warns that bird flu could threaten the economy in Indonesia.

Unicef is going to do an educational program on bird flu.

In Ghana, the AgSec has told journalists they do not "have the power" to announce flu outbreaks.

In the UK, a committee of scientists called on DEFRA to increase bird flu research.

Pakistan allocates funds for bird flu protection.

Story on the Dutch company with a bird vaccine for Newcastle and bird flu. (This is a spray vaccine, which makes sense to me--as compared to injecting chickens)

A Perth conference says that hygiene is better than medicine (personal note: I'd like to try both, if that's OK).

On Zanzibar, which is a semiautonomous island from Tanzania, they are attempting to control the importation of chickens.

Winipeg has a new pandemic checklist for business. Imagine this: your get isolated--at work!

WHO and China are setting up a joint center (or, centre) to fight bird flu. Does this herald openness from China.

The establishment of the WHO Collaborating Centre for Surveillance, Research and Training on Emerging Infectious Diseases will be formally announced at a ceremony tomorrow in the provincial capital, Guangzhou, the United Nations health agency said in an e-mailed statement today.

A Houston company has a vaccine project as well. This is experimental, but is designed to increase immune response.

The Institut Pasteur in Paris will host a major flu therapy and prevention conference in Late June.

Finally, I am not sure how I missed this, but it showed up in the local paper today. Apparently people at like to stamp money and track it around the world. Now, some epidemiologists are wondering if they can't use that information to simulate worldwide flu spread.

Sunday, June 11, 2006

June 11th Flu Update

An Australian expert says bird flu H2H is only a matter of time.

Bahrain is continuing its bird flu fight, even though it believes the virus will be dormant in the summer.

This AP story details some US Corporate prep work for the bird flu.

For example, DuPont Co is considering giving employees kits with masks and disinfectant and is assessing ways to continue manufacturing with reduced staffing. Sun Microsystems Inc plans to keep workers informed over its intranet radio station.

Long Island businesses are also preparing for the pandemic.

The Walgreens pharmacy chain, on the other hand, is concerned. Spokeswoman Tiffani Bruce said pharmacists in its Long Island stores would be expected to help with vaccine distribution and inoculation if necessary, and they would also help make sure customers get their medicines. Walgreens plans to distribute masks, gloves and gowns to employees deemed critical to the operation.

Similar article tells us that many businesses won't be ready if the flu hits.

In India, the Centre is asking the Union government to have a plan ready for the flu by September, when migratory birds are expected.

Seattle-area paper highlights the activity of local companies in pandemic prep.

The Stanford Progressive asks if bird flu will be the nation's next challenge--and answers, yes, it will, and its a test of our national ability to respond to the warnings we have.

The Director of the Maine Center for Disease Control writes about pandemic flu prep, with a call to the spirit of the people of Maine.

David Heyman of WHO has this thought-provoking article...H5N1 will not be the last challenge for world public health, but the SARS situation could be a roadmap.

Crofsblogs notes what I have as well. Weekends tend to be slow. This weekend...especially slow. Took a long walk in the park and worked in the yard today.

Saturday, June 10, 2006

June 10 Flu Update

Indonesia says that limited H2H transmission occurred in the country. They go farther in their self-defense than anyone else has....

"Limited human-to-human transmission may have occurred in small clusters in the country. It has not only happened in several regions in Indonesia but also in Azerbaijan and other places in the world," Coordinating Minister for the People's Welfare Aburizal Bakrie said Friday after a meeting with agencies involved in curbing the spread of the disease.
China says it has contained its latest outbreak.

More on HPAI in Hungary, with H5N1 being confirmed.

ProMed on Hungary.

eThekwini Municipality in South Africa is preparing for the bird flu.

As soon as it decides whether to put flouride in the water, the health board in Corning NY will work on the bird flu.

Fitchburg, MA recognizes it needs many volunteers for the bird flu.

Porter County, IN, had a bird flu summit as well.

Secretary Leavitt urged Central America to prepare for the bird flu pandemic.

Effect Measure on WHO and their lack of information. Member states don't participate, but WHO is also not pushing. In fact, in this post, they appear outright passive.

ProMed OIE reports for five countries.

Recombinomics sees more reason for recombination soon.

Friday, June 09, 2006

June 9 Flu Update

In Indonesia, tests are said to be inconclusive on a 7-year old girl. She died June 1, and lab results are said to differ.

Effect Measure on why you have to be careful being an epidemiologist on the Internet.

In SE Hungary, a new outbreak on a goose farm has occured. 300,000 birds to be culled.

Dr. Gerberding was in Boston, and she reinforced the message the federal government has had since the beginning. Don't count on us.

‘‘Local planning is really the frontline, I can’t say it enough,’’ said Dr. Julie Gerberding at the Massachusetts Health Policy Forum at the Radisson Hotel in downtown Boston.

Secretary Leavitt again reminds an audience that for six months there will be no vaccine, and states will be in charge.

APEC says its drill was a success in Australia. CIDRAP writes.

ProMed with news from China and Romania. In China, the new outbreak is noted, along with openness from the Chinese government, but still major obstacles to getting the information out. In Romania, a new outbreak site.

More on the upcoming African bird flu meetings.

Medics have warned the Irish government to have a bird flu plan.

More on the Alaskan surveillance that has captured the medi'a attention. Prisoners and eskimos have been enlisted.

The incidence of bird flu in the EU in wild birds has fallen.

IBM now has a consulting service to help companies plan for the bird flu.

The Wildlife Conservation Society has formed a group to monitor for bird flu--funded by USAID.

Malta is gearing up for pandemic flu.

Recombinomics on what WHO might refer to as "signficant."

Effect Measure has moved, BTW, to a new home. Link is here.

Thursday, June 08, 2006

June 8 Flu Update

Dead birds found in Romania, near the only power plant in the country. Its quarantined, and workers may have to live there.

ProMed on outbreaks in China and Romania.

US bird surveillance is going on in the Alaska.

He laid a fresh one there. We really want the freshest stuff," said Rossi, Alaska district supervisor for the USDA's wildlife services.

Wild Geese were also tested in Colorado.

The US and Pakistan are working together to fight the bird flu.

Canadian Business Summit gives an interesting message--proper handling of poultry by farmers is the key to financial survival.

The EU meeting on pandemic flu ended in Vienna.

Commenting on the conference, Dr Bernard Vallat stated that resources pledged in Beijing had to be tranferred very soon. ‘The evaluation of the financial needs presented by the OIE in Beijing to control avian influenza at its animal source worldwide are still the same, except for Africa ” he said. ‘As of today, the OIE only received 32% of the total needs. Other intergovernmental organizations are in a similar situation. The political commitment worldwide is crucial if we really want to achieve our goals'.

OIE urges African nations to report bird flu in the wild.

There was also a flu conference in Central Asia.

CIDRAP has updated CDC guidelines on when to test people for bird flu, and on lab standards.

The Hungarian flu vaccine continues to get abused.

From Canada, a frenetic editorial on bird flu from The Whistler Question.

Americans are going to Tijuana to buy Tamiflu.

Recombinomics on genetic differences in the receptor binding in Jakarta.

Recombinomics with a translation of a 2 year old with symptoms in Indonesia.

June 7 Flu Update

A fresh outbreak has struck China, where an unknown number of birds are sick.

Indonesia has started a bird flu education program. It seems to me that this is very important, as people's response there has made fighting the disease even harder.

Things are quiet in India--no new cases since March.

UN and FAO are strengthening surveillance in Afghanistan. (I suspect there are things going on in that country we don't know, because the level of concern always seems out of proportion with what we have heard).

The EU has dropped plans to stockpile Tamiflu, on the objections of three members, who apparently objected due to financial reasons.

CIDRAP on the Vical DNA vaccine news from yesterday. Vaccine protected ferrets against H5N1 and also may be cross-protective.

"A vaccine that provides cross-protection against more than one strain of flu is important for addressing a pandemic flu threat because it is likely that the H5N1 virus could mutate before it becomes transmissible from human to human," said Richard Webby, PhD, of St Jude Children's Research Hospital, as quoted in a Vical release.

Secretary Leavitt says that states will be responsible for rationing vaccine in the beginning six months of a pandemic. Here's the "ration"ale.

"...this is a battle that'll be fought in thousands of communities simultaneously. What's working in one community may not work as well in another," Leavitt said in a joint interview with Agriculture Secretary Mike Johanns.

Africa says it will need $760M over the next three years, much more than designated by the International Aid Fund.

Meanwhile, the EU and World Bank have agreed to a $70M bird flu assistance fund.

The World Bank says South Asia is at highest risk for bird flu.

The World Bank has also granted Armenia $6.25M to combat a pandemic.

Excellent Guardian (UK) article on where the bird flu came from and how it spread.

ProMed with a similar article--Industry caused bird flu, it says.

Roche says companies should be stockpiling Tamiflu for themselves.

Hong Kong participated in the APEC drill, noting it was primarily designed to study communication.

In Pennsylvania, the Banking Secretary has asked the financial institutions in the state to have a plan for pandemic flu.

Here's an article on pandemic planning in Ontario.

DeWitt, Arkansas is also preparing for the bird flu.

Good article from the San Jose Mercury News that says that the bird flu isn't just a public health issue--it could effect business as well.

Article in Malaysia gives readers the 411 on bird flu.

Recombinomics writes about mutations in the bird flu in Northern Sumatra--some reports did say that the disease was more in the nose than previous strains, which would appear to make it more H2H friendly.

Fear of bird flu is spiking sauerkraut sales in Germany.

Tuesday, June 06, 2006

June 6 Flu Update (666)

Four nurses tested in Indonesia were negative. Obviously, if they are positive, that's a bad sign for a pandemic. Also, as negatives, they keep known clusters in families.

Recombinomics says these tests were conducted too soon to be as "convincing" as WHO portrays them to be.

CIDRAP on Indonesia.

ProMed on Indonesia--15 year old boy died May 30, confirmed H5N1. Also covers the nurses.

Indonesia faces challenges in fighting bird flu.

The government has carried out only limited culling, saying it can't afford the compensation.

"We can afford to pay only 10,000 rupiah ($1) a chicken," said Krisnamurthi.

A full-grown chicken costs 35,000 rupiah in Jakarta, prompting some poor villagers to keep quiet and eat dead birds rather then give them up for culling.

Effect Measure on the Indonesians unwillingess to cull, and other things...

A Chinese scientist says that China must improve its bird flu efforts.

Secretary Leavitt says a pandemic is inevitable--sometime, and we should prepare, even if we're not sure.

Leavitt also says that we'll have no vaccine for six months, and chances of containing the disease are "low."

Even though Thailand hasn't had a case in 200 days, it is stepping up its prevention efforts.

Canadian retailers are being urged to prepare for the bird flu.

Panama is hosting a regional bird flu meeting.

Bird flu--and fear of bird flu--may be causing a poultry shortage in Vietnam.

An Oxford (UK) company's DNA vaccine has passed safety tests and is moving on for other testing. All 36 volunteers produced an immune response.

The virus's genetic material DNA is coated with gold particles which are propelled into the skin with helium gas, instead of using a needle.

An instant detection system for the flu is unveiled.

Black November: The Flu in New Zealand in 1918 is published.

ProMed with the latest from the migratory bird debate...note mod comment calling for bettter "field work"

ProMed with OIE report from Denmark.

Greece tested 5,000 birds over the past 8 months. None had avian flu.

Monday, June 05, 2006

June 5 Flu Update

WHO confirms the death of the 15 year old boy was H5N1. That's 37 in the country.

Animal activists are asking for humane culling of birds suspected of having H5N1.

ProMed on the situation in Indonesia, noting that the negative test for the nurse means clusters remain in blood relatives.

Russia says it will have results from its vaccine tests in two weeks. Note this:

But he cautioned the vaccine had been created on the basis of a non-pandemic H5N1 bird flu strain and could not stop a pandemic of avian influenza.

MSNBC on companies who aren't ready for the bird flu. Story focuses on Intel, which is really trying to be ready. Check this out from the overboard department.

The company went so far as to consider purchasing infrared thermal scanning devices to detect elevated body temperatures in employees as they enter a building. But that's where precautions can start getting out of hand. What if an employee runs across a parking lot to make a meeting? "All of a sudden we have to do something with them," Mr. Nierkerk chuckles.

Letter to the editor in Jakarta asks, when will Tamiflu be available here...and what happened to all the Tamiflu production that was supposed to go on?

Indiana is holding a seminar for its media outlets.

Recombinomics with a good one on pandemic phases. Notes that, really, WHO is saying they won't alter the phases until we hit phase 6.

Recombinomics also looks at the situation in Indonesia, noting that the source of infection is unclear, and that there appear to be three flu strains in the country.

Report on the relief operation in Afghanistan.

On June 7, an APEC-wide pandemic simulation will be held.

A pandemic briefing in Rhode Island broke down into fighting and squabbling.

CIDRAP on the slow arrival of flu aid funds.

ProMed has this interesting piece from an author who wonders whether "integrated" fish farming is part of the bird flu problem.

Effect Measure also writing on flu aid funds...keyword: pathetic.

Sunday, June 04, 2006

June 4 Flu Update

Today's leading flu news comes from the New York Times, which writes that H2H may exceed official estimates. What's fascinating about the story is that it features Dr. Niman of Recombinomics, and gives him some credit for a recent WHO change. Note this:

While Dr. Niman is an irritant to public health officials, his digging sometimes pushes them to change conclusions, as it did in the recent Indonesia case. The W.H.O. at first said an undercooked pig might have infected the whole family, but Dr. Niman discovered that the hostess of the barbecue was sick two days before the barbecue and the last relative was infected two weeks after it.

His prodding, picked up by journalists, eventually led the W.H.O. to concede that no pig was to blame and that the virus probably had jumped from human to human to human.

The Indonesian nurse who fell ill after treating two boys suspected of having H5N1 is said to be H5N1 negative, based on local tests.

Afghanistan says it needs $1M to fight the bird flu.

Meanwhile, donors have pledged $60M to help fight the flu in Vietnam.

Finally, the World Bank says pledges are way behind in the fight against bird flu.

Here's a Wendy Orent article that made its appearence while I was on vacation. I note that Revere gave it mostly good reviews.

In a casino, the house usually wins, but occasionally someone hits the jackpot. It's the law of large numbers -- given enough time and enough opportunity, viral mutation will toss up a deadly combination. No one wants to win the bird flu slot-machine game. If the genes happen to line up and a vulnerable human happens to be the host in the right place, the disease takes off and a pandemic explodes. Given how mutable the H5N1 virus is, the thinking goes, at some point this is inevitable.

But as Brown knows, evolution doesn't work this way. Gene mutation isn't in the driver's seat. Rather, it's Darwin's charioteer -- natural selection -- that drives evolution. Mutations are the raw material of evolutionary change. They don't determine which direction the chariot will go.

Vietnam notes no new outbreaks in six months.

Riverside, CA, will be having a bird flu summit this week.

ProMed with an OIE report from Djibouti.

Recombinomics says that statements by David Nabarro essentially phase out two pandemic phases.

June 3 Flu Update

We wrote yesterday on the dead boy in Indonesia, and his dead brother, who was never tested. Recombinomics reports now that their parents also had bird flu symptoms, and says this looks like a cluster. Also noting that two versions of flu appear to be running around in Indonesia.

FAO is going to use satellites to track migratory birds to try and determine their role in bird flu spread, and predict outbreaks.

The Health Editor of the Observer in the UK says human trials are the only way to stop the pandemic--so she's signed up to be in a trial.

A bird flu emergency drill was held in the United Arab Emirates.

Poultry farmers in Maine had a summit (first in the country, they said) on keeping flocks safe.

Effect Measure on the Hungarian flu vaccine--is it vaporware?

ProMed on bird flu activity in Egypt.