Thursday, November 29, 2007

November 29 Flu Update

An initial report says the recent UK outbreak might have been carried by wild birds (!!)

Migratory birds are also blamed in Romania. (Quick question: is blaming migratory birds just easier than looking at import patterns).

As bird flu hits 60th country, Nabarro warns pandemic is still out there.

The cull in Saudi Arabia is up to 200,000 birds.

Flu Prep is ongoing in the Cayman Islands.

Revere blogs the latest article on non-pharmaceutical interventions--this one appears to be a little weak in the knees.

Promed on Saudi Arabia banning imports from the Sudan.

ProMed commenter clarifies the situation in Saudi Arabia.

Merck and Sanofi are building vaccine plants abroad.

Oklahoma City is preparing for a pandemic.

Wednesday, November 28, 2007

November 28 Flu Update

Avian outbreak in Romania....

ProMed on Romania, including an OIE report.

More culling in Saudi Arabia.

CIDRAP has the update from Romania, Saudi Arabia, Myanmar, etc.

EU compensation policies could mean big losses to poultry farmers during an outbreak.

The Media may have lost interest in bird flu, but these IT managers have not.

Bob Kallas, director of computer support services at a company he didn't want named, says his firm conducted a test a few months ago to see how many workers it could support remotely. The company picked a day and then told several hundred employees to work from home. "We want to measure readiness to be able to support the company," he says.

Snohomish County has its pandemic plan.

A new disinfectant is available to fight the bird flu.

More on the physical barrier issue. Australia's government is promoting physical barriers.

Official US State Department release on the Geneva meeting. Goal was to improve surveillance network.

In Uganda, journalists go to school on covering the bird flu.

A regional bird flu center (centre?) will open in India soon.

Tuesday, November 27, 2007

November 27 Flu Update

Must read--CIDRAP and John Barry talk about quarantines during the 1918 flu. Foreward by Dr. Osterholm.

Since publication of his book in 2004, Barry has been involved in the preparedness effort and continued to do research on NPIs. Most of this work has expanded on findings in the book, and some of it has caused him to revise views expressed there. Since the Markel publication in JAMA, Barry has raised serious challenges to the data used by Markel's group to justify their conclusions about the public health actions they reported to have been taken in 2 of the 43 cities (New York City and Chicago). These are the only two cities among the 43 for which Barry did such follow-up research. Barry wrote what I believe to be a convincing and well-supported letter to JAMA with his concerns. Last week his letter and Markel's response were published in JAMA.

Revere blogs this article as well. Must read. (My note: this is so important because when a pandemic comes, we are likely to be in a poor frame of mind for making decisions. And, rash actions will be taken, including the ones debated here.)

Baxter's contract for non-egg vaccine production has been extended.

More poultry interceptions in Saudi Arabia.

Japan is donating a lab to Indonesia.

Article says Massachusetts group led the way to ensure fire fighters got the first pandemic vaccines.

An Iowa pandemic expert will speak at Drake University.

"One city, St. Louis, did the right thing and escaped with a much smaller mortality rate than Philadelphia which, their leaders fiddled around and didn't enact the right kinds of policies to prevent the spread of the disease," Gilchrist says. She says personalities, politics and economics can all come into conflict and cost lives.

Monday, November 26, 2007

November 26 Flu Update

Nature is reporting that a post-conference deal is being negotiated that might result in sharing of virus samples.

CIDRAP says a deal was elusive but work planned to continue (note, probably posted before news from above).

ProMed says egret in Hong Kong was H5N1, more outbreaks in Saudi Arabia, and outbreaks in Burma.

Another province in Vietnam reports mass chicken deaths.

Kuwait says it is prepared for bird flu.

States using seasonal flu vaccine to prepare for pandemic is detailed.

Sanofi is building a new vaccine plant in China.

Bangladesh warns people to keep their poultry away from migratory birds.

November 25 Flu Update

Indonesia comes out of the world flu conference with strong statements about not sharing viruses until the proper agreements are in place.

OT: Indonesia blasts a doctor for a similar transgression related to a skin disease.

The recent bird deaths in South Vietnam do not appear to be bird flu.

Yemen says its recent situation was not bird flu.

Pakistan notes the importance of "responsible" journalism and the bird flu.

Sacramento TV stations answers question on what happened to the bird flu.

Saudi Arabia is working harder at fighting the bird flu. They recently stopped truckloads of smuggled birds.

Pakistan has implemented a surveillance program.

Revere on the third birthday of Effect Measure. (Our own is coming in December). Congrats to him. His blog is educational, accessible, and always helps cut through the confusing clutter and bad headlines. Thanks to Revere for having this whim while Thanksgiving dinner was in the oven.

Sunday, November 25, 2007

November 24 Flu Update

More Asian outbreaks....

In Hong Kong, an egret in the park.

Also new outbreak in Burma

Culling in South Korea.

Revere has the continuing work of Ed Hammond, an NGO who has been reporting from the virus sharing conference. (Summary: complicated diplomatic affair, maybe some positive results, if only that the conversation is still going on).

Interesting slashdot post on what we don't know about bird flu.

Saturday, November 24, 2007

November 23 Flu Update

WHO virus sharing talks fail to reach agreement.

"Nobody can fault you for not trying ... It is so close, yet so far away," WHO director-general Margaret Chan told the final session of a four-day meeting.

However, according to these dispatches to Revere, there was "qualified success" after Reuters wrote its article.

New Scientist says world bickers as virus evolves (preview article, subscription required)

DEFRA lifts bird flu restrictions.

Low Path bird flu is reported in South Korea.

Suspicious bird deaths are now occurring in Vietnam.

There's culling in Myanmar due to a potential outbreak.

Dubai says its Falcons are bird flu free.

WHO adviser says weather is perfect for bird flu in Pakistan.

Problems in Saudi Arabia have Bahrain on high alert.

Friday, November 23, 2007

November 22 Flu Update

Welcome Helen Branswell back to the flu beat: WHO meeting battling long odds on virus sharing.

Revere has the best posts on the WHO meeting, running dispatches from someone on the are the day 2 updates. The US and Indonesia are really going at it.

Indonesia has not said that it will not participate in a mandatory virus sharing, mandatory benefit sharing system. It has said, and other countries such as Brazil have agreed, that whether or not virus sharing should be mandatory should remain in brackets until the result of other negotiations here are clear. Until the whole package is apparent. The US attack and subsequent inflexibility left it isolated on the issue and ended the day (at 9:30PM) on a relatively sour note.

And here's the update from Day 3.

Second, this meeting is not getting very far. The results appear unlikely to move us very far forward. Not only is there too much hotly contested text resulting in too little time to properly work through the issues, but the main players that need to pony up their ideas for fixing the GISN (namely, the US, EU, and Indonesia) are not articulating solutions.

Text of Margaret Chan's address to the WHO meeting.

I fully support any effort that leads to greater and more equitable access to pandemic vaccines. Vaccines are the best insurance policy for public health. They are our best protection against the risk that the next pandemic will negate or set back our hard-won achievements in health development. The meeting will also address the sharing of viruses. The sharing of viruses serves public health in ways that go beyond the development of pandemic vaccines.

ProMed on UK and Yemen. Note possible outbreak in Yemen.

The UK released its plans for vaccinating the entire nation.

The UK's antiviral stock is also to be doubled....

Which Roche reports it can handle with ramped up production.

The Guardian (UK) does a Q&A on pandemic flu.

The Scottish Government reports on pandemic prep to its parliament.

Journalists in Ghana receive lessons in bird flu reporting.

Azerbaijan checks in: situation stable.

After four months, Hong Kong is importing Malaysian poultry again.

The Astrology of the 1918 Pandemic is detailed...

Wednesday, November 21, 2007

November 21 Flu Update

Happy Thanksgiving to all. See you on Friday.

Culling is ongoing on a sixth farm in UK. ProMed reports.

Longtime flu star Laurie Garrett and Dave Fidler have this to say about how to handle Indonesia refusing to share bird flu viruses.

Garrett and Fidler offer a novel proposal to overcome the virus sharing impasse. They propose that annually updated supplies of more than 500 million doses of highly specific influenza vaccine, plus antiviral medicines, protective masks and gloves, and germicide washes be stockpiled in Hong Kong. They select Hong Kong, they say, because it has shown "absolute transparency regarding disease emergences going back several decades," it is a dynamic center of virus research and response, and it sits in the middle of the ecological zone that has spawned the bulk of all flu strains known to have emerged over the last three decades.

Revere on fighting bullshit with bullshit....the debate with Indonesia about bird flu viruses.

3.2M birds have been culled in Saudi Arabia. Note reference to rumors of human infection.

OK, you can admit it. You didn't know there was a Delaware model for fighting bird flu. But there must be, because people are traveling from Bulgaria to learn it.

Yaaaawwwwwwnnnnnnn....South Dakota is using seasonal flu shots to test its pandemic response.

Practice and pandemic prep in small town Virginia.

Tuesday, November 20, 2007

November 20 Flu Update

Sorry for no update....other things intervened

US and Indonesia square off at world flu conference.

John Lange, U.S. special representative for avian and pandemic influenza, said "there should not be a one-to-one relationship between sharing of a particular sample and accruing a specific benefit".

"Countries that do their duty and share information and samples should not expect to receive something concrete each and every time they share," he said.

Revere blogs this issue, noting that solutions exist, but may never be executed.

It is not clear this problem will be resolved. There is no reason it must be resolved, only many good reasons why it should be resolved. In my view, the international community is reaping the whirlwind of its profligate use of the intellectual property system and in some sense is getting what it deserves. Indonesia has the virus and we don't. They make the call.

UK confirms second case of bird flu in animals, and there is apparently a new outbreak in a Saudi Arabian market (ProMed)

WHO SG Chan says that we have been given a gift--warning of a pandemic. And preparedness is the key.

“Vulnerability is universal,” WHO Director-General Dr. Margaret Chan said today at the opening in Geneva of the Intergovernmental Meeting on Pandemic Influenza Preparedness. “A pandemic will, by its very nature, reach every corner of the earth, and it will do so within a matter of months.”

UK held some culls at farms that ended up testing negative.

The EU is imposing tighter bird flu controls on the UK.

The United Arab Emirates is preparing to ward off bird flu.

The UK is preparing to ask farmers to pay their share of the costs of managing animal diseases.

If we had a pandemic, we'd be 10 billion doses of vaccine short.

OIE says that India is bird flu free.

Pacific Island Nations are meeting about bird flu.

Sunday, November 18, 2007

November 18 Flu Update

Oregon's state vet has been to Egypt to study fighting pandemic flu.

In UK, they are pushing the government to consider mass immunization.

Also in UK, companies are not prepared for the bird flu.

ProMed on story from yesterday that said that immunizations in UK are not being offered to the poultry workers.

Nepal recognizes it is on the front line for bird flu.

November 17 Flu Update

CIDRAP on research that says wild birds unlikely to bring bird flu to North America. (I have said before...when bird flu reaches North America, it will be in a human).

Dead swan found in UK.

ProMed on outbreak in Bangladesh and updates from UK.

Bahrain says it is safe from bird flu, though it has banned Saudi poultry.

Bird flu surveillance in Thailand has been stepped up.

A Canadian presentation tells local citizens that bird flu pandemic is a matter of "when"

People in UK who own caged birds are reassured that they are safe.

Saturday, November 17, 2007

November 16 Flu Update

ProMed on a suspected cluster in Vietnam that doesn't pan out.

A Dutch transport is stopped on suspicion of transporting bird flu to UK.

Article on poultry workers in Britain not receiving a bird flu vaccine....excuse me? What vaccine?

The second farm in Britain is apparently flu-free.

A poultry show has been canceled in Britain.

UK Farming group critiques government efforts...

Cull in Saudi Arabia now reaches 90,000 birds.

Report on bird flu precautions in Kuwait.

Surveillance in Alaska reveals no bird flu.

UK RAF base talks about its pandemic plan.

Flu meeting touts importance of education in North and South America.

Blog reader Dr. Greger discusses A Virus of Our Own Hatching in Mother Jones.

Friday, November 16, 2007

November 15 Flu Update

A second outbreak in Britain is feared.

Economist talks, as always, realistically and in an informed sense about how bird flu could effect British poultry, given the stubborn nature of animal diseases.

Barbados has banned UK poultry.

Workers near the outbreak in Saudi Arabia have tested negative.

Meanwhile, 50,000 birds have been culled.

Bird flu is also back in Bangladesh.

WHO meeting is coming up to rebuild virus sharing system worldwide.

It is unclear whether the Geneva meeting will make enough progress towards setting up such a system to get Indonesia sending samples again. But "we need to know what is happening to the Indonesian virus," says Dave Heymann, head of flu at the WHO.

In Hong Kong, a health official is inspecting bird reserves to check on surveillance measures.

Revere on recent research that casts doubt on the idea you need Tamiflu within 48 hours of infection to have the drug be effective.

A Seniors Group in Illinois will hear about bird flu at its dinner meeting.

Thursday, November 15, 2007

November 14 Flu Update

I could run nothing but stories from the media onslaught in Britain, which is largely repetitive.

Here's what you need to know:

The cull has been broadened....

Fleet Street is freaking out.....

Officials are forced to assure neighbors that the lab where the samples are being tested is not a public hazard....

Very good column on the crisis---how it might be hitting free range farms more, and what level of panic is appropriate.

In other news....

Revere points out that at least we know what is going on in the UK, and then notes conflicting stories from China, where the notorious secrecy machine has been fired up again. Note concern over Olympics next year.

Bird flu was also found at a poultry farm in Saudi Arabia.

Turkey posts article on what we can learn from their bird flu outbreak.

Shanghai is urging officials to be on the lookout for unidentified pneumonia cases.

Marathon County (Wausau, WI) is practicing its pandemic plan.

Very Cool magnified images of H5N1 virus.

Tuesday, November 13, 2007

November 13 Flu Udpate

Confirmed: H5N1 is back in poultry in England.

An Indonesian woman is reported to have bird flu symptoms.

After UK outbreak, Ireland introduces control measures.

CIDRAP on the UK outbreak.

BBC on the UK Outbreak.

Concern about whether the poultry industry could be effected during the highly profitable holidays.

China says it has sent bird flu strains to WHO.

Flight scare in Auckland reminds public that its consciousness on the bird flu has waned.

US Highway Safety agency releases guidelines for EMS during a pandemic.

US Sen Daniel Akaka urges US to act on pandemic flu, partly as an employer of 1.8 million people.

Rome, GA Rotary Club meeting hears bird flu talk.

The Times (UK) talks about a world race to get Tamiflu.

Revere on using Wal-Mart to educate on the bird flu and how it worked for one woman.

Monday, November 12, 2007

November 12 Flu Update

Bird flu back in England. H5 confirmed.

CIDRAP has this as well.

More reports of sick fowl in Vietnam.

CIDRAP on the weekend's Indonesian death.

The man was a hospital administrator at Permata Hati Hospital in Riau province's Duri district and was treated at the hospital before he was transferred, according to a Nov 8 report in the Jakarta Post that was published before the man's avian flu results were known. The article did not say if the hospital where the man worked had recently treated any H5N1 case-patients.

A North Carolina County is having a pandemic summit.

A bird flu scare held up air traffic in Auckland.

Guardian (UK) Q&A on pandemic prep.

Sunday, November 11, 2007

November 11 Flu Update

As winter begins, Bahrain has reactivated its bird flu system.

AMA notes that GPs will be at the center of the bird flu pandemic, and need to understand infection control.

Revere renews his plea for us to prepare for a pandemic as communities, and not as islands.

November 10 Flu Update

ProMed on the recent death in Riau.

Profile of University of Texas researcher who is working on a new antiviral.

The UK continues to realize there is not enough Tamiflu.

Louisiana editorial says preparation is key to fighting a pandemic.

Recombinomics is silent on further news from Riau.

Friday, November 09, 2007

November 9 Bird Flu Update

The UN says that there are likely to be a sharp increase in cases as cold weather hits the Northern Hemisphere.

Bird flu in Northern and Southern Vietnam.

CIDRAP on the spread of the disease in Vietnam.

I often don't do this, but I bring forward this from Wulfgang's comment. Recombinomics on what appears to be a suspect cluster in Riau. (Note, sooner or later one of these will be true.....but we've seen a few of these machine translations over time. Read and decide what you think).

Indonesia does confirm a death in Riau.

Excellent Revere column compares antivirals and vaccines to the Maginot Line, and reminds readers we need boots on the ground--real rebuilding of the public health system.

No bird flu in Iran.

Nigeria seems to think it has an avian vaccine.

Nigeria says it culled 1.3M birds.

November 8 Flu Update

Revere with the most important story of the day. A recent study shows that H5N1 can mutate to be Tamiflu resistant without becoming a less effective organism.

If you're familiar with the Indonesian virus situation, you know that the battle over who owns virus samples has gone back and forth, and is important for international health. I saw this, and I couldn't believe it. Indonesia wants samples they sent back. I kid you not. (Link courtesy of Crofsblog. Its very difficult to link to the Jakarta Post.)

Bird flu continues to spread in Vietnam.

Also here.

proMed on Vietnam.

proMed on the Korean who died in Vietnam of suspicious symptoms, but unlikely to be bird flu, in my own opinion.

Manipur, India declares itself bird flu free.

I think this is interesting, could a call center help during a pandemic.

A bird flu vaccine is ready----for monkeys.

Editorial in student paper at the University of Nevada Las Vegas gives an excellent education on the challenge of communicable diseases.

The Red Cross in Tallahassee held a pandemic rehearsal.

Pacific Island countries hold a bird flu workshop.

Article uses Bali's battles with bird flu to illustrate how the disease works.

Wednesday, November 07, 2007

November 7 Flu Update

Outbreak kills 590 ducks in Vietnam.

There is flooding in Vietnam, which always raises bird flu concerns.

A Korean man died of suspected bird flu in Southern Vietnam. (Note: this is unlikely to actually be bird flu).

The US government has pledged $10.5M to Vietnam for bird flu fight.

Interesting...federal government discusses telework--and a pandemic is one reason why.

David Nabarro points out bird flu trouble spots.

He says the virus continues to spread in Bangladesh, Indonesia and Vietnam in Asia, and Egypt and Nigeria in Africa.

A Vietnamese officials claims the flu vaccine is working.

Uganda says its going to keep bird flu outbreaks more secret.

Meanwhile, Indonesia is still not sharing flu samples.

A communicable disease conference in Vietnam covers bird flu.

Blog on Nature asks if you're going to be lucky when the US hands out vaccines.

Gina Kolata of the New York Times (who wrote the book that turned me on to the flu) spoke at Washington State.

Throughout her discussion, Kolata compared the 1918 pandemic to modern concerns. She spoke about the hysteria the United States was involved in after the Sept. 11 terrorist attacks. Among the list of potential disasters were the Avian Bird Flu, bioterrorism threats and anthrax scares.

“Flu isn’t the only biological threat which the government worries about,” Kolata said.

Tuesday, November 06, 2007

November 6 Flu Update

A CDC official doctor talked in Albany about the possibility of a flu pandemic.

Effect Measure on some new thinking on ER triage, and what impact it might have in a pandemic.

ProMed on the recent death in Indonesia.

Experts in Bangkok say small farmers can survive avian influenza.

Fort Worth is giving emergency health workers a pandemic response kit.

Australia is producing children's books to fight bird flu.

Cincinnati Children's Hospital receives huge infectious disease grant, including pandemic flu.

Monday, November 05, 2007

November 5 Flu Update

CIDRAP on the recent death in Indonesia.

Revere is disappointed in a paper published by some med students on pandemic flu.

Montreal "truth telling" health series turns its focus onto a pandemic.

This time, its an Arkansas town that's using seasonal flu shots to see how quickly they can vaccinate people in a pandemic.

Sunday, November 04, 2007

November 4 Flu Update

Sorry for the slow pace of updates, there is a lot going on. More regular this week, I hope.

A 30 year old Indonesian woman died Saturday, before we even knew she was sick.

ProMed on this death...she had been around hundreds of dead chickens.

ProMed on Bangladesh, Vietnam and Pakistan, as reported here yesterday.

Azerbaijan says not bird flu here.

Arab story reviews the effect bird flu could have on the exotic bird trade.

Canadian local government talks about teamwork required in pandemic.

Saturday, November 03, 2007

November 2 Flu Update

In Indonesia, the parents of the three year old child with bird flu have removed the child from the hospital, against medical advice. (Compliance will be a problem during a pandemic)

Margaret Chan issues warning in China--pandemic threat still exists.

6,000 chickens culled in Bangladesh after bird flu scare.

An additional province in Vietnam has been hit with bird flu as well.

CIDRAP on poultry outbreaks, including Pakistan as well.

Article in Lancet says that Africa has little to no hope of meeting WHO bird flu standards.

CIDRAP reports on GAO report on US pandemic prep.

The US will hold pandemic town halls in five US sites.

Clinical vaccine trials are being held at Stony Brook University.

Local reports aims to educate readers in Nigeria about bird flu.

Canada announces its plans for how to handle bird flu in pandemic poultry.

Canada also talks about the North American infectious disease plan.

CIDRAP reports on this as well.

Article in Alabama aims to do the same.

The University of Nebraska-Kearney is holding a bird flu Town Hall.

You have to remember that emergency workers sent to deal with the bird flu have worries, too. Here, two police officers are suing their force for not protecting them in UK during a pandemic scare.

CIDRAP wraps out its outstanding bird flu series....

Part 6 on novel technologies...

Because they contain live virus, live-attenuated vaccines provoke multiple types of immunity. In studies they have been shown to protect against both the strains from which vaccine candidates were derived and against drifted (slightly mutated) strains as well—characteristics that make them highly appealing to pandemic planners (see Bibliography: Belshe 2004). They also grow in eggs at a much higher volume than inactivated vaccines (see Bibliography: Monto 2007). But their live-virus content is responsible for the vaccines' greatest potential danger: the possibility that they might lead to reassortment between the vaccine virus and circulating flu strains.

and Part 7 on a "Manhattan Project"

Those calling for a Manhattan Project–like effort say that what is needed is much broader than what NIAID or all of NIH could deliver. It requires active coordination among all the federal health agencies along with cooperation from congressional funders, plus parallel efforts in other countries. "Pandemic vaccine development has been viewed primarily as a vaccine problem that should be addressed with better science," Fedson said, "but fundamentally it is a global public health problem that requires better management" (see Bibliography: Fedson and Dunnill 2007: From scarcity to abundance).

And, they say, it is urgent that such an effort be established soon, because there is no way of predicting accurately when a pandemic might arrive. If it arrives soon rather than later, the lack of vaccine in most of the world will create a divide between haves and have-nots that could corrupt international relations long after the pandemic ends.

Thursday, November 01, 2007

October 31 Flu Update--Spoooooookkkkyyyy

Part 5 of the CIDRAP vaccine series--the value of pre pandemic vaccines.

To achieve prepandemic vaccines, researchers would have to ascertain the right dose and dose interval, determine how long priming lasts, and solve the puzzle of measuring primed immunity. Further, regulatory authorities would have to determine the trial design that could deliver those answers, the public discussion that would be necessary for prepandemic vaccines to be accepted, and the safety data that would need to be gathered once the vaccines went into use (see Bibliography: Goodman 2007).

Funeral directors met in Wheeling, WV to discuss pandemic prep.

ProMed on the recent case in Indonesia.

Pakistan says it doesn't see a threat of bird flu.

Corporations are urged to include legal departments in pandemic planning.

Florida is testing for bird flu in ducks.