Thursday, January 31, 2008

January 30 Flu Update

Bird flu is spreading in West Bengal.

India is raising the compensation for culled birds.

Human bird flu is ruled out in an Indian school. (The high profile of bird flu will bring forward people who are afraid they have bird flu, but don'thuman cases).

As in this case....

Dead birds are also reported in India.

ProMed has the WHO update on the latest from Indonesia.

CIDRAP updates on new outbreaks in Tibet and Saudi Arabia.

Hong Kong has closed some aviaries due to bird flu.

Bahrain is now monitoring poultry and egg imports.

CIDRAP runs one of its best practice articles, this time from Kentucky.

Nigeria says communication is the key to bird flu.

Perth County, Ontario, is exercising its pandemic plan.

Oakland article on Kaiser testing vaccine.

Wednesday, January 30, 2008

January 29 Flu Update

New death in Indonesia, #101.

India is spraying markets and roads to try and prevent bird flu from spreading.

Orissa (India) samples of poultry and humans are negative.

Reports are now that bird flu is reaching urban areas in India.

India is now considering becoming the fourth nation in a bird flu surveillance network.

Indian magazine notes that humans were spared in bird flu.

Reports notes reasons for panic in India, as bird flu heads toward teeming capital.

There is another outbreak in Saudi Arabia. Thousands of birds are culled.

New bird cases noted in Bangladesh.

China reports an outbreak in Tibet.

More birds are dying in Thailand, causing concern.

ProMed looks at several countries.

Hygiene is discussed in Vietnam.

University of Pittsburgh reports success on bird flu vaccine.

Helen Branswell on Tamiflu resistance.

Scientific American on Tamiflu resistance.

Revere on Tamiflu "resistance." As always, the actual science is more nuanced and complex than how it is reported.

Toronto is urged to spend $27M on pandemic prep.

Tuesday, January 29, 2008

January 28 Flu Update

With four new cases and two bird flu deaths over the weekend, there are now 100 deaths in Indonesia. (CIDRAP).

With the 100th death in Indonesia, an expert says bird flu there is "out of control"

This article says no further spread of bird flu in West Bengal

A new case is described here, however.

CIDRAP looks at the spread of cases around the world.

The US has offered to help West Bengal.

Panic is breaking out in areas near West Bengal.

Birds bought from neighbouring West Bengal being buried alive.

Bangladesh is taking measures to prevent bird flu spread.

The US government is helping Bangladesh combat the bird flu.

As Tamiflu resistance in Europe is announced, GSK, the maker of Tamiflu, accepts the study, and the notion that governments would be wise to stockpile more than one anti-viral.

A needle-less flu vaccine......under the tongue.

Even with 50% absenteeism, firms in financial services are confident they can weather a pandemic.

Canada is helping owners of backyard poultry.

Monday, January 28, 2008

January 27 Flu Update

A 9 year old boy died in Indonesia.

Some European flu strains are Tamiflu resistant.

The border between India and Bangladesh is closed. Bird flu rampant in area.

India says bird flu crossed the border from Bangladesh.

BBC bird flu update---13 of 19 regions in W. Bengal, disease nears Calcutta.

Hello ACLU, India is holding poultry raids.

Bangladesh is also going door to door.

326,000 birds in Bangladesh effected by bird flu (!!).

17 cows die in bird flu region of India. Bird flu unlikely.

Government claim "belies" the bird flu.

Given that there is some cross-protection between seasonal flu vaccines and H5N1, Revere wonders why more employers don't vaccinate critical employees.

ProMed has this report as well. Note mod comment, as always.

Indian editorial on bird flu.

Wrestlers in Indian are cutting down on their training diet due to bird flu.

31 people are being watched in Thailand....not likely to be a big deal.

Bird flu political conspiracy alleged in India.

More on Kaiser's genetically based vaccine.

More on Hawaii's bird flu prep.

Sunday, January 27, 2008

January 26 Flu Update

There are no fresh bird flu reports in Eastern India.

In Western India, however, the spread continues, and rains are making culling more difficult.

A bird society in India says migratory birds not responsible.

Free Onions are being used to entice poultry buyers in Western India.

Another swan has tested positive in India.

ProMed reports on India and Thailand, with a close look at the contents of some OIE reports.

There's isn't as much media in Bangladesh, so it doesn't have the volume that the Indian situation does, but things are bad there, too.

ProMed has wild birds blamed for outbreak in Turkey.

A bird flu quarantine was lifted in China.

Hawaiian officials says the would do "OK" in a pandemic, but that isn't good enough.

Interesting: bird flu experts are now calling for the stockpiling of adjuvants.

"There's a lot of discussion to vaccinate people against H5N1 with adjuvanted vaccines. We might do that, but it's very expensive and it might well be that the pandemic outbreak may not be caused by H5N1 but by H7, H9 or H2" viruses, he said.

Saturday, January 26, 2008

January 25 Flu Update

Today's most significant story, from the flu conference. CIDRAP reports that there is evidence of subclinical disease in Cambodia. This would have huge implications for H5N1--both its transmissibility (higher than thought) and its lethality (lower than thought).

Revere blogs this, noting that it is a positive development.

Not all H5N1 cases are serious or fatal disease.

ProMed also has this story. Note mod comment from the ever-skeptical CP:

This is an interesting observation, but difficult to interpret in the absence of
quantitative data. The analysis is limited by the fact that there have been few human cases of H5N1 avian influenza in Cambodia (since the beginning of 2005 only 7 and all fatal). The study would have been more productive if conducted in a country with greater exposure to the disease. The 100 percent fatality rate in Cambodia and the occurrence of a low frequency of inapparent infection in children is compatible with some degree of inherent resistance of the majority of the population to the H5N1 virus.

Two more districts in West Bengal are reporting flu outbreaks.

A total of 11 districts have been hit.

Low compensation is part of the problem in India, as noted previously.

State is calling for "all possible help" for flu.

Seasonal rains are hitting India, and they hope it helps with bird flu spread.

Nepal is afraid that bird smuggling will bring bird flu over from India.

Interesting stuff on CIDRAP. You will recall the recent study that said non-drug interventions saved lives in 1918. A debate between John Barry, who wrote "The Book" on the pandemic and the authors has erupted over whether New York City used quarantines has emerged.

Kaiser is testing a genetically engineered vaccine.

Along the lines of what has been mentioned before, Crucell has developed ideas on how to use blood from infected people to develop antibodies.

No new cases noted in the UK.

A Phase I test of a universal flu vaccine has been completed.

Story on vaccine testing site in Halifax.

Finland has picked Glaxo to supply its pandemic vaccine.

There's a parrot joke in here. Belarus killed some parrots on fear they had bird flu.

Friday, January 25, 2008

January 25 Flu Update

WHO confirms deaths in Vietnam and Indonesia.

The Bird Flu is said to be getting worse in Bangladesh.

Thailand has a new avian outbreak.

W. Bengal, India, says it did not delay fighting bird flu (my note: this will just underscore that the usual petty bickering will continue to be a feature of a pandemic).

Authorities are fervently trying to prevent bird flu from reaching Calcutta.

ProMed looks at news from Indonesia and Vietnam, and also looks at the possibility of swallows as flu vectors.

The UN says bird flu remains a global threat at global conference.

CIDRAP has this as well...noting that the virus continues to have pandemic potential.

Effect Measure blogs this as well. Note that no one claims to know the answers, but Revere wonders why we wouldn't take action based on those who say a pandemic could happen.

Some mutual aid between states is designed to help fight the bird flu in India.

Raising the spectre of viral resistance, docs in US are continuing to prescribe old antivirals against standards. (CIDRAP)

China confirms father-son flu transmission.

Earlier this week we learned that WHO was tracking flu viruses. Note here via ProMed is a link to the resulting document.

Thursday, January 24, 2008

Off the air today

Back on tomorrow.

Wednesday, January 23, 2008

January 22 Flu Update

There has been a fatal human case in Vietnam, the first in some time.

A new human case has emerged in Indonesia.

CIDRAP has this as well.

In a report that echoes what many people have said, the US government says that drugs cannot be expected to forestall a pandemic on their won.

India concedes that it is losing ground in its battle with the bird flu.

India continues to maintain there are no human cases.

Calcutta says it is bird flu free.

CIDRAP looks at cases around the world.

More from scientists who say that we cannot neglect the bird flu

CIDRAP reports on the WHO virus tracking system.

The Gates Foundation names Director to oversee global health, including pandemic prep.

Tuesday, January 22, 2008

January 21 Flu Update

Three children are in the hospital in Indonesia with suspected bird flu.

There's an avian outbreak in Turkey.

The situation in India continues to deteriorate. There are reports of people eating sick birds or selling them at discounts, and yet the outbreak continues. Here, we see 5 people with bird flu symptoms...time will tell, often these are panic-induced.

A seventh district in India is now effected.

ProMed looks at the issue in India with some alarm. Note mod comment.

The extensive spread of H5N1 in India, reportedly involving very large number of small backyard holdings, is bad news, from the perspectives both of disease control and of potential infection in humans. The Indian authorities will have to make soon a decision between continuing the stamping-out policy and the possible implementation of mass vaccinations.

A porous border between India and Bangladesh is part of the problem for bird flu.

Random sampling of humans shows no human interaction with bird flu, according to report.

Nepal has banned imports of Indian poultry.

Today's most reflective story. Donald McNeil of the New York Times looks at the declining media coverage of the bird flu, and what is really going on today. Note Nabarro optimistic, Osterholm less so.

Dr. Paul A. Offit, a vaccine specialist at Children’s Hospital in Philadelphia, was one of those who, he jokes, “dared to be stupid” by bucking the alarmist trend in 2005.

“H5 viruses have been around for 100 years and never caused a pandemic and probably never will,” he said.

Progress on the virus sharing front. Apparently, more than 700 strains have been shared, and there is now a system in place to track viruses as they go through the system.

Effect Measure blogs this report, noting progress but that some larger systems are still broken.

Revere notes that whenever someone says the virus is stable, things are certain to go crazy.

A poll in Canada says that people are worried about pandemic prep in that country.

China says it still supports WHO (note yesterday's story about Taiwan being out of WHO meetings).

The United Arab Emirates are strengthening their bird flu defenses.

Article from Carnegie Mellon student paper on bird flu.

Monday, January 21, 2008

January 20 Flu Update

Bird flu continues to spread in India.

A poultry farmer apparently committed suicide because his sales had fallen so much.

The situation on the ground in India appears to be chaotic--word to the wise.

Egypt says infection rates have fallen since the middle of the month.

Indian poultry has been banned from Nepal.

Is there a medical fabric that can block bird flu?

Vietnam is importing 500 million doses of avian vaccine.

Taiwan complains that it is excluded from world meetings about health issues like the flu pandemic.

Nash County, NC is preparing for a flu pandemic.

Sunday, January 20, 2008

January 19 Flu Update

There appears to be a new human case in Vietnam.

The Indian Medical Association will be sending help to effected areas.

It is hard to tell where reports overlap, but it seems safe to say that the flu continues to spread in India.

Same here....

ProMed on India (bird flu spreading) and a report from Iranian media on outbreak.

Bird sanctuaries are also worried....

Blood sampling is going on in India....

Public meeting on bird flu in India draws standing room only crowd.

Excellent Revere post on a ridiculous article stating that a shortage of thermometers could pose a problem. As a Father, I agree 100%. We'd use a thermometer in a squirming child and get two readings that were 3 degrees apart. Put your hand on the forehead....the person either has a fever or they don't.

Saturday, January 19, 2008

January 18 Flu Update

An eight year old boy died of the bird flu in Indonesia.

Effect Measure looks at the NEJM article, which summarizes what is known about bird flu. Pretty much assigned reading for flu junkies. Note especially that the report notes that there is no evidence that mild cases are being misdiagnosed, leaving a shockingly virulent virus.

The outbreak in India is a big deal there....minister uses the word "grave concern."

There are also some recriminations, as leaders are said to have missed "telltale" signs more than a month ago.

Internet rumors to the contrary, India says the capital is safe.

The New York Times also has a little update on the turmoil caused in India.

CIDRAP summarizes news from around the world.

So does ProMed. Note that reference in mod comment to a normal seasonal surge.

ProMed also looks at Iran...note mod comment on confusion over dates.

A bird flu summit will be held in Bali later this year.

Labs in Thailand are testing birds for the bird flu.

CIDRAP on ACLU concerns over pandemic plan.

Disaster exercise in Florida includes flu.

Friday, January 18, 2008

January 17 Flu Update

There's a new avian outbreak in the Ukraine.

CIDRAP with news from Iran, India, and UK.

ProMed on what appears to be a continuing spread of the disease in India.

West Bengal, India, is criticized for not compensating farmers for culled birds.

Poultry sector in India suffers from bird flu scare.

Vet teams are conducting flu surveillance in India.

India struggles with literacy and poverty issues in fighting bird flu.

A public bird flu meeting was held in the UK.

Meanwhile, the UK won't be exporting any poultry to the Cayman Islands.

Meet Frances Day of Middletown OH, who is one of the few people alive today who almost died in the 1918 pandemic, which hit when she was 7. Here is her story.

Louisiana bird flu surveillance reports....

Georgia professor to speak in Singapore on bird flu.

Thursday, January 17, 2008

January 16 Flu Update

Very important story. This report says that bird flu has been misdiagnosed in cases in Asia, much as it often was early in the 1918 pandemic. This has delayed treatment, possibly exaggerating the lethality of the virus. It also effects the quick response required for the world's containment strategy.

``There are substantial challenges to a rapid diagnosis,'' said Frederick Hayden, a doctor with World Health Organization's Global Influenza Program in Geneva and one of the study's 11 authors. ``We don't have right now an efficient, highly predictive and sensitive point-of-care diagnostic test for H5.''

Furthermore, lethality could be effected by the different variants of the disease that are circulating.

It reports that ongoing examination of the genetic structure of viruses shows they have evolved widely, currently breaking out into 10 separate families or clades.

Additionally, CIDRAP reports that a study shows that infection sources are unclear in 25% of cases. This is a must read, as it summarizes Tamiflu resistance, the cytokine storm, etc.

Link to the full report, for those interested.

Along these lines, there is some thought the virus might be kicked up in dust or stick to surfaces to infect people.

The OIE chief clarifies, but does not entirely retract his controversial comments from the other day.

Revere jumps in to say that the OIE chief didn't quite make it safely home with his new statement.

Iran says it has an avian breakout among free range chickens.

A fourth swan tests positive in the UK.

Culling has stopped in West Bengal while additional testing is done.

This article says the outbreak in India is the worst the country has seen

There's also an outbreak in another part of India.

India says Bangladesh caused the most recent outbreak.

Apparently, there is talk of vaccinating all free range poultry in the UK. Here is a debate over whether that will help.

Revere has new data on whether dogs and cats can be involved in avian flu. Note that, as always, we need more data.

Wednesday, January 16, 2008

January 15 Flu Update

Another bird flu death is reported in Indonesia....this is the sick 16 year old girl.

An Egyptian minister says poultry there is at high risk of bird flu.

Bird flu has hit another area of Bangladesh.

Poultry sales are down in an area near where there were flu outbreaks in India.

India will not ban poultry exports after bird flu outbreak.

CIDRAP has the news from India, where the flu has killed 35,000 poultry.

ProMed catches an interesting trend in OIE data for wild birds. Note mod comment.

Vietnam has a new bio safety lab.

The Cayman Islands look at business problems if the bird flu hits.

Q&A answers questions from India.

Note here that UK is looking up to Tamiflu coverage from 25% to 50%.

Iran and Indonesia are going to produce a bird flu vaccine.

The United Arab Emirates is tightening border controls due to bird flu concerns.

Tuesday, January 15, 2008

January 14 Flu Update

Woman died of bird flu in Indonesia. She died at home after leaving the hospital AMA. They are said to have had chickens in their back yard.

CIDRAP has this as well. Note also that the most recent case is still on a respirator.

Finally, ProMed, including the grim stats behind the story.

Bird flu found in Bengal, India. Culling to begin.

Bill Gates is putting $39M into flu protection.

The ACLU wants to know in pandemic plans threaten civil liberties.

The ACLU said it was worried that the plan called for military and police involvement in enforcing a quarantine.

Revere notes that this is not completely far-fetched, and that most experts say quarantines won't work anyway.

CIDRAP also has last week's big story on new understanding on how flu binds to human tissue.

"This study was what was needed to put together what type of sialic acids the influenza viruses bind to and what was really available for binding within the respiratory tract," Nicholls told CIDRAP News via e-mail. "As a note of caution, the analysis of what glycans are present in the respiratory tract has been done on cells grown in culture . . . and the question arises to what extent these represent normal human adult and paediatric trachea and bronchi, so clearly we need to move from this in vitro model to the in vivo setting."

The Dominican Republic says bird flu is under control.

Note: according to this, it will take a few days for H5N1 to be confirmed.

Azerbaijan is soliciting proposals for bird flu education.

Fox News dude takes victory lap now that bird flu's "real" experts have said it was over-hyped.

CIDRAP's best practices looks at bird flu measures being employed along the Mexican border in Texas.

Monday, January 14, 2008

No Update Today

Events conspired to the contrary.

Sunday, January 13, 2008

January 12 Flu Update

UK is afraid bird flu will hit their famous black swans.

11 peacocks are dead in India, but they say there's no bird flu.

An Air Force base in Guam continues to work on bird flu containment.

Saturday, January 12, 2008

January 11 Flu Update

CIDRAP covers the firestorm over reported comments from OIE on whether pandemic risk was "overblown." Two notes--first, media reports differ on what he said. Second, regardless, here's what Dr. David Fedson says:

"The statement [suggesting the risk of a pandemic is minimal] ignores history," said Fedson, who also is on the IDSA's Pandemic Influenza Task Force. "The history is a pandemic coming out of nowhere in 1918 and causing great global disruption. . . . A statement like this, if people pay attention, has the practical effect of telling people they don't need to worry, they don't need to be prepared."

Fedson said infectious diseases have caused major die-offs in several mammalian species in recent years, and humans are subject to the same threats. For example, about a third of the lions on Africa's Serengeti Plain died of distemper virus in the early 1990s, and more than 50% of gorillas and chimpanzees have died of Ebola virus infection in this decade, he said.

"Given what we know of the capability of flu viruses in general and this virus in particular, we have to take it seriously and . . . prepare for a pandemic that could cause a very high mortality," Fedson said. "We have to recognize that we're as vulnerable as the gorillas and chimps."

CIDRAP on the recently reported illness in Indonesia.

A Guam official was training for a pandemic in Hawaii.

Welsh officials say they are workin' the plan.

British officials say that the sick swans flew in from Europe during a December cold snap.

There's more outbreak news from Vietnam.

This gives you an idea of the cultural battle to be fought with bird flu. Egyptians believe that it was god, not birds that killed people there. Mix in anti-government feelings, and you have trouble getting compliance.

The Inspector General from the Department of Energy casts pandemic warning.

Poultry farmers in Ireland are warned to be careful for bird flu.

France elevates its flu threat level to moderate.

Friday, January 11, 2008

January 10 Flu Update

The Director General of OIE says that fears of bird flu were overblown.

Fears of a flu pandemic originating from the deadly H5N1 bird flu virus were overblown, the head of the World Organization for Animal Health said Thursday.

The Paris-based body — an intergovernmental organization responsible for improving animal health worldwide — has been at the forefront of global efforts to monitor and fight H5N1, which scientists have tracked because they fear it may mutate into a human flu virus that starts a pandemic.

But "the risk was overestimated," said Bernard Vallat, director general of the animal health organization, also known as the OIE.

Vallat said the H5N1 virus has proved extremely stable, despite concerns that it could mutate into a form that could spread easily among humans.

"We have never seen such a stable strain," Vallat said.

Effect Measure weighs in with a thoughtful response on this statement.

The first part is that the virus is extremely stable, meaning in this context, stable in terms of changes that might turn it into an animal virus that becomes easily transmissible to and between people. Maybe Director General Vallat knows what those changes are. If he does he should tell the scientific community. I, for one, would certainly like to know. Without knowing that, how could be possibly know how stable the virus is? It does change and adapt. So it isn't stationary.

Anybody has the right to shoot off their mouth without first engaging their brains. But the Director General of OIE isn't just anybody.

Meanwhile, WHO's David Nabarro is singing a different tune.

"Most countries have now focused on pandemic as a potential cause of catastrophe and have done some planning. But the quality of the plans is patchy and too few of them pay attention to economic and social consequences," he told BBC radio.

Girl is hospitalized with bird flu in Indonesia.

Two dead swans signal return of H5N1 to Britain.

ProMed has this as well.

ProMed follows up on Chinese and Pakistani human-human issues.

Kerala, India, has a road map to fight bird flu.

Trinidad and Tobago also have rules now to keep the flu out.

Doc from the Peter Sandman lab writes letter to editor to Caribbean publication on errors in a story.

Limestone, AL, asks if it is ready for the bird flu.

A report is issued on 25 public meetings held on bird flu in Kansas City. Called "helpful."

International Security publication looks bird flu, ready to "explode."

In Benin, they are fighting bird flu with voodoo.

Bangladesh has heightened concern over the bird flu.

Thursday, January 10, 2008

January 9 Flu Update

A teenager is hospitalized with suspected bird flu.

ProMed has this also. Note mod comment on 81% reported fatality rate in Indonesia, as opposed to 47% in Vietnam.

The last two cases in China were apparently due to human-human transmission in "close contact." We've certainly seen this before, but is it more common now, or are we being fooled by randomness?

Revere blogs a new test for flu, which should help us learn how the disease spreads and contribute to our knowledge base.

Polish bird flu is under control, it is said.

A culling exercise was held in Singapore to prepare for the bird flu.

Tests confirm that US man who attended bird flu funeral in Pakistan never had the virus.

A University of Minnesota lab is now ready for the fight against bird flu.

The Federal Government in Nigeria is releasing funds to a state for bird flu fight.

Wednesday, January 09, 2008

January 8 Flu Update

5% of poultry in Vietnam has bird flu infection. If accurate, this gives us an excellent stake in the ground in terms of where we stand.

Kebbi, Nigeria, has a local bird flu publicity committee.

Haiti has banned bird imports from the Dominican Republic because H5N2 is present there. I mention this only to show the kinds of things we could easily see during a pandemic, and how--in fact--illogical it could be, since it is highly likely that H5N2 is all over that island.

CIDRAP has an interesting study---live operators make a difference in reporting urgent disease matters to health departments.

There is going to be a session on influenza pandemic at the JP Morgan Healthcare conference, going on now.

Bird flu and the immunocompromised.....

Tuesday, January 08, 2008

January 7 Flu Update

China says its latest outbreak is under control.

Helen Branswell on the story about MIT researchers discovering why bird flu infects some people and not others.

"I think it's a significant piece of the puzzle in terms of what may be going on in the upper respiratory tract versus the lower with the avian-like viruses," said Michael Perdue, deputy director of the influenza and emerging diseases program of the U.S. Department of Health and Human Services' Biomedical Advanced Research and Development Authority. Perdue was not involved in the research.

Effect Measure also blogs this story. As usual, tempering some media headlines with a little realism.

This is fascinating work but we are still at the beginning. It has implications for how research is carried out in the future, for example, how glycan microarrays are characterized and populated. But the headline that we now "know" the secret to what determines human infection is perhaps an exaggeration. What we now know is that the linkage itself may not be that important and we are further directed to some very fruitful areas to look to see what is important.

Nepal recognizes bird flu risk.

Zoo is Bangladesh has bird flu alert.

Dr. Capua, an Italian vet who has had a lead in flu efforts and the Indonesian situation wins an award from Scientific American.

Apparently there is progress on a milk based vaccine.

Monday, January 07, 2008

January 6 Flu Update

Revere has a strong post. The blogosphere is buzzing with rumors of many suspect cases in Egypt, most of which has not hit the media yet. He reviews the situation, taking the approach of a realist.

Asian economies are worried about "climate of fear" due to avian flu.

Vietnam says flu outbreak is under control.

The Philippines have banned bird imports from South Korea.

Topeka Schools say they are preparing for the worst.

Another county uses seasonal flu to test its ability to vaccinate in a pandemic.

Sunday, January 06, 2008

January 5 Flu Update

Research at MIT claims to conclude how humans catch bird flu, and it has to do with the type receptor in the human lung.

With bird flu in Israel, Lebanon is on alert.

ProMed says H5 found in birds in Portugal. Further tests being done.

Saturday, January 05, 2008

January 4 Flu Update

There's a new outbreak in Western China.

Excellent article in Egypt criticizes government awareness efforts to fight bird flu.

ProMed on Israel (kindergartners did not come into contact with birds), Bangladesh outbreak and China outbreak, see above.
Note ProMed correction to Israel post here.

ProMed with news from Egypt and Pakistan.

Article says bird flu absent from headlines, but still a threat.

CIDRAP on the recent "universal flu vaccine" announcement from the UK.

However, ACAM-FLU-A is a recombinant vaccine linked to a hepatitis B core that targets M2e, a conserved region of all influenza A strains, the company said.

Excellent Revere posts looks at UK article on living at risk which employs a popular fairy tale metaphor. To which Revere says....

Instead of preparing for an imagined Big Bad Wolf, why not do as the wisest of the Three Little Pigs did, build a strong brick house that will protect us against the Wolf, the Wolf's cousins and the worst of bad weather as well.

Chattanooga officials say that area is prepared for bird flu.

Testing in Nebraska yields no evidence of bird flu there.

Bird flu wrecks the cockfighting season in Puerto Rico.

Letter to Editor to Jakarta Post says that the country must focus on prevention.

Article about vet lab at Kansas State.

Friday, January 04, 2008

January 3 Flu Update

ProMed reports on two potential new cases in Egypt, though identities may be confused. Also looks at possible wild bird infection in Vietnam. Note mod comment below:

It is not unreasonable to assume in the absence of demonstrable H5N1 virus infection in domestic poultry that infection could have been introduced into the household via the carcasses of wild birds. However the evidence is no more than circumstantial as there has been no confirmation (in this case or any other case to my knowledge) that H5N1 virus has been contracted by humans from wild birds, dead or alive. Furthermore it has not been confirmed that the wild birds involved actually carried the virus. If transmission had occurred it would imply that the young child was genetically susceptible to infection whereas the family members who hunted and exhibited no
illness were not.

People have been asking for proof that the genetic structure--and not just the circumstantial evidence--shows no evidence of mutation in Pakistan. Apparently, that has now been provided.

CIDRAP has this story as well.

Bird flu found in chickens at a kindergarten in Israel.

CIDRAP looks at outbreaks around the world.

Egypt says its a not a pandemic in that country.

UK story on universal flu vaccine developed by Cambridge firm.

Indonesia says it will certify farms as bird flu free, based on sound practices.

There's another outbreak in Vietnam.

Editorial in Bangladesh urges country to protect the poultry sector.

If you are interested in that sort of thing, I can tell you that over on Effect Measure, there has been a raging debate over Revere's post defending WHO field workers. Today, he continues by running an email from the man he criticized, specifically. To his credit, the answer is non-defensive, rational, and demonstrates that poor reporting might be the cause. Note, the kicker, which is the final portion of his statement.

Thursday, January 03, 2008

January 2 Flu Update

There was a bird flu death in Vietnam, but this one could be different...wild birds may have been involved.

Another outbreak in Bangladesh, near the Indian border.

IHT story on the outbreak in Bangladesh.

Pakistan lists more actions against bird flu.

ProMed on Egypt and Bangladesh.

Revere on flu in Egypt. Key point follows:

The other interpretation, of course, is more dire. This could be the start of a more widespread outbreak, involving many more people than previously and possibly signaling a change in the epidemiologic characteristics of the virus. The problem, of course, is that in the initial phases it is impossible to distinguish the two. The best we can do is wait to see how events unfold and that is what we will do in this case. At this point there is no reason to think this is unusual. Probably most of the suspect cases will turn out negative. The reason to think that is because that is the way it has turned out in the past. It's not forced on us by logic or biology. But if I were a wagering man . . .

The United Arab Emirates say they are ready for bird flu if it lands there.

Wednesday, January 02, 2008

January 1 Flu Update

Egypt is working harder on flu after recent deaths.

ProMed on Egypt, noting that claims that the disease is spreading despite mass vaccination are not valuable until more is known about how vaccination was done.

Also, why the 100% fatality in Egypt when in the past there has been success treating the disease there. (Note mod comment below, illustrating just how confounding this problem is and how hard it is to develop a fact base.)

The 100 percent mortality rate for the 4 cases reported during the past week, in contrast to the more favourable outcomes achieved by the Egyptian Health Ministry previously is being attributed to delayed diagnosis (in part due to reluctance of patients to come forward for treatment) and consequent late initiation of Tamiflu treatment, rather than to any increased virulence of the H5N1 virus.

South Vietnam has had an outbreak in Geese.

DHS says the "last mile" is where trouble would start in telecom during a pandemic.

This is very funny.....drunken man causes panic claiming he has bird flu.

Tuesday, January 01, 2008

December 31 Flu Update

Happy New Year!!

CIDRAP reports---2 to 3 new deaths in Egypt.
ProMed on Egypt.

Three of the 43 cases of human H5N1 avian influenza recorded in Egypt since the beginning of 2006, and 3 of the 18 deaths, have occurred during the past 7 days. The 3 cases appear to be unconnected. The high mortality rate is worrying in view of the previous success of the Egyptian authorities in treating avian influenza virus patients. Hopefully this is a statistical aberration and it does not herald the appearance of a virus endowed with enhanced virulence for humans.

For pessimists only....MSNBC says 2008 already worth forgetting.

Bangladesh says bird flu has now spread to more farms.

New outbreak in Burma as well.

Revere year end post on pandemic potential, with his rock-solid message: prepare for flu by building communities and public health systems. Note:

...we also don't know the relationship between transmissibility and virulence. They are logically and biologically independent in general, but changes that affect transmissibility might also affect virulence. Because we don't know any of these things (and lots more besides), it is not possible at the moment to quantify the probability of one or another (or any) subtype to "go pandemic."
Because perseveration is a characteristic and privilege of the aged, we will repeat again in this last bird flu post of 2007 what we have been saying here since late 2004. The best way to prepare for an influenza pandemic is to do those things which make for a robust community, especially building and strengthening the public health and social service infrastructure.