Avian Flu Surveillance Project

Various ^ | May 9, 2005 | Vanity

[Dog Gone]

Some folks suggested that we begin a thread similar to the Marsburg Surveillance Project for monitoring developments regarding Avian Flu.

The purpose is to have an extended thread where those interested can post articles and comments as this story unfolds.

If we're lucky, the story and this thread will fade away.

[Kelly_2000]

"My recollection (the software is not what it once was) is that in man, S. suis serotype 2 can cause arthritis, fever, meningitis, and permanent hearing loss."

There are 36 serotypes of Strep suis, serotype 2 as I say is one of the most virulent, you have missed the fact that nearly ALL strep and staph infections can lead to this complication. It is observed in humans especially as I say with serotype 2 and less commonly 4 as well as an as yet untyped variant of strep suis that can cause septicemia,this WIL and does result in systemic shock or Toxic Shock Syndrome as it is clinically diagnosed (TSS). Death will result from multi organ failure. Although due to my line of work I am familiar with this fact, I will post some references here to corroborate my point:

In pigs IAI :

"Streptococcus suis is an important cause of meningitis, septicemia, arthritis, and sudden death in young pigs (6, 32). It can also cause meningitis in humans... "

In Humans CDC/WHO :

"Although rarely diagnosed in Europe, there is some evidence that Streptococcus suis is a not uncommon cause of bacterial meningitis in humans residing in some parts of South-east Asia...."

"Another possible consequence of infection is the occurrence of toxic shock syndrome (TSS). This syndrome is also associated with other streptococcal and staphylococcal infections. This may lead to severe damage of many vital organs, including the liver, kidneys and circulatory system. TSS is only partially responsive to treatment with antibiotics, and intensive supportive care is required. If TSS, occurs the outcome is likely to be worse."

"

Sudden onset and chronic symptoms due to TSS

: "The incubation period ranges from a few hours up to three days....."

I am sure that the outbreak is real in terms of strep suis but there is still a real and present danger posed by H5N1 within Chinese borders and now thanks largely to their ineptness and deceit a growing problem in neighboring and European countries.

It appears that a number of pathogens are causing concern and disease clusters in China this is a result of poor health care policy in an overburdened corrupt culture. The level of deceit and secrecy only exacerbates this problem.

[EchoFoxtrot1]

Str. suis serotype 2 is known to infect and cause the following complications in infected humans: -Meningitis -Respiratory tract infection -Septicemia (also known as sepsis) Sepsis can lead to: -Systemic inflammatory response -Sever sepsis(sepsis with acute organ dysfunction) -Septic shock(sepsis with refractory arterial hypotension) Refractory arterial hypotension: Refractory: 2 a : resistant to treatment or cure b : unresponsive to stimulus c : IMMUNE, INSUSCEPTIBLE Arterial hypotension: Abnormally low blood pressure in the arteries If we're talking about death <24 hours after onset of symptoms, then I believe septic shock, which is capable of causing multiple organ failure, is more than capable of doing the job.

[EchoFoxtrot1]

Dang, sorry that's a mess. Don't know why, but lost all the spacing I put in. Then again, it's 5:45 am so mistakes were sure to abound...

[Kelly_2000]

"If we're talking about death <24 hours after onset of symptoms, then I believe septic shock, which is capable of causing multiple organ failure, is more than capable of doing the job."

I concur Thanks for your addition and corroboration

[Kelly_2000]

Hi EH :-)

"Hmmm... Not to argue, but my understanding is that Strep Suis is "quite common" in pigs"

I agree this is what I stated earlier it is endemic to most rural regions and most countries of the world. Be advised there are 36 serotypes and serotype 2 and 4 are the most virulent and dangerous for humans, these are not common. Further serotype 2 and 4 can and do produce less virulent and even non virulent strains. So you can see an anomalous statistic where proximity to porcine populations exists and 3rd hygiene protocols are in operation. (read China and parts of Asia in general)

The low human fatality statistic is not a safe one, detection is by PCR assay and in most cases we are able to diagnose this cause of death only recently. It is likely that a large proportion of bacterial meningeal fatalities in rural areas of developing countries can be attributed to S.suis infections, also TSS can claim many immune depressed. In short we do not have the resources to determine the causative agent for all bacterial meningeal and TSS fatalities the world over. In the main the likelihood of human infection from Strep suis is most likely to occur in countries where the resources and desire to discover these details is not present. In china's case the recent scrutiny over H5N1 is providing them a reason to draw attention away form H5N1 which is bad for trade to a slightly lesser problem of Strep suis.

[EBH]

Chinese officials fired for pig disease cover-up

CHINA - Four officials have been sacked for trying to cover up the trail of dead pigs early in an outbreak of a swine-borne disease that has killed 39 people in southwest China, Xinhua news agency said on Monday.


The officials, all from near Neijiang in Sichuan province, had fabricated reports and deceived inspectors and reporters tracing the spread of the Streptococcus suis bacteria, Xinhua said on its English Web site, www.chinaview.cn.

More than 200 people have contracted the disease in Sichuan from slaughtering, handling or eating infected swine.

After 78 pigs died in Zizhong county in mid-July, the head of the county animal husbandry and food bureau and three colleagues wrote a report falsely claiming all the dead swine had been safely buried or their whereabouts were unknown and they lied to investigators and state television reporters, Xinhua said...

---

Physicals suggested for pig slaughters, transporters
CHINA - Health experts in Guangdong has suggested conducting physical checkups on pig slaughters and transporters to find potential patients of a pig-borne epidemic that killed nearly 40 people.

At a health forum held Saturday by the provincial health department and Zhongshan University, also known as Sun Yat-sun University, experts with the provincial center for disease prevention and control (CDC) advised the provincial forestry and health departments to carry out the checkups, the Southern Metropolis Daily reported. The report did not explain how the potential patients could be singled out.

The experts said sick pigs should be collectively slaughtered and buried to avoid possible human infections, as learned from Hong Kong's collective slaughtering of sick ducks and chickens during bird flu outbreaks. They also said hygiene should be improved at pig stys and chicken farms while regular vaccinations should be conducted on the animals.

---

Pig Disease Toll Increases to 39
CHINA - On August 6, two new infections of Streptococcus suis and one new death were reported in Sichuan province, China. The number of human infections has risen to 214 cases and the death toll has hit 39.

According to China News Agency, Sichuan’s Health Department announced two new cases of Streptococcus suis. Pi county in Chengdu city and Pengzhou city each had one case diagnosed at a clinic.

Shuangliu county in Chengdu city reportedly had one new death who was originally in critical condition. The statement revealed a total of 214 cases, including 44 cases diagnosed by a laboratory, 131 diagnosed at a clinic, and 39 suspected cases. Among the 214 infections, 39 have died, 58 were cured and released from the hospitals, and 117 are in the hospitals with 12 still critically ill.

Source: theepochtimes.com

---

All three articles available at: http://www.thepigsite.com/

[EBH]

Bird flu vaccine works on people, U.S. tests suggest
CBC News via Sympatico.MSN.CBC.ca ^ | 07 Aug 2005 22:55:23 EDT | CBC News


Posted on 08/08/2005 3:08:34 AM PDT by FYREDEUS
http://www.freerepublic.com/focus/f-news/1458995/posts

[Kelly_2000]

Thanks for the heads up EBH ;-) amazing the levels of deciet that exist in China, it is not even safe to accept this version of events.

I do think that Strep suis is emerging in China this year it may be the result of opportunistic environment that is causing the emergence of this virulent strain of Strep suis. The porcine population is under stress form influenza outbreaks with high mortality, this could account for this atypical Strep suis outbreak. However this is a result of negligence within China's health ministry of that there is no doubt.

[Logical Extinction]

Thank you both for bringing me up to speed on this aspect of Streptococcus suis infection.

I will add this citation to the ones you have posted.

WHO - An outbreak in Sichuan Province, China, associated with high mortality

Many cases are not serious, but in a significant minority, severe manifestations, including meningitis and toxic shock syndrome (TSS) can occur and may result in death.

However, outbreaks of Streptococcus suis infection are unusual.

In addition, although many of the clinical features described in the outbreak are consistent with Streptococcus suis infection, the apparent proportion of patients showing severe illness and the level of mortality appear relatively high.

However, this may reflect the easier identification of more serious cases at the beginning of the investigation

Any outbreak that shows unusual or previously unreported features requires a thorough clinical, laboratory investigation to obtain a complete picture.

[Kelly_2000]

Hi EF1:-)

Thanks for your psot I think this supports what we have both presented:

"However, this may reflect the easier identification of more serious cases at the beginning of the investigation .."

Identification and improved process is often the cause of statistical "outliers" all epidemiologists are aware of this. I mentioned this in my earlier posts.

[Iowa Granny]

marking spot

[EternalHope]

Thanks for your input.

Any thoughts on China moving 50,000 "healthcare" workers into the H5N1/Strep Suis 2 afflicted region?

[Kelly_2000]

Hi EH

"Any thoughts on China moving 50,000 "healthcare" workers into the H5N1/Strep Suis 2 afflicted region?"

Hmm the whole thing is suspiciously secretive and covert, the threat response is out of proportion so they are obviously NOT reacting to the S. Suis outbreak.

I think the smart money is on the emergent suspected recombinant VHF/ influenza pathogen

[Oorang]

H5N1 Bird Flu Evolution and Spread Outpace Pandemic Vaccine

Recombinomics Commentary
August 7, 2005

Medical experts in Asia, where all of the human and poultry cases of bird flu have occurred, cautioned on Sunday that formidable obstacles remained before the new vaccine would become a useful tool in preventing a pandemic.

The biggest impediment may be the rapid evolution of the virus itself.

Dr. Guan Yi, a Hong Kong University microbiologist, said that the flu virus that has just appeared this summer among migratory birds roosting on an island in Qinghai Lake in western China had quite a few genetic differences from previous viruses that had circulated in Southeast Asia.

The previous viruses appear to have been used in the successful vaccine tests this spring and summer in the United States.

"It keeps changing, it keeps evolving," he said. "We don't know how much the vaccine matches."

The above comments confirm the concerns about the ability of the pandemic vaccine that is being developed worldwide to have utility against the H5N1 that has emerged from Qinghai Lake and is now rapidly spreading across southern Russia and northern Kazakhstan.

This version of H5N1 is considerably different than the H5N1 in Vietnam and the current vaccine is unlikely to have significant activity. The new vaccine requires at least 2 injections of 90 micrograms. The 180 micrograms is 12 times higher then the amount used for a human flu isolate. Moreover, the dose response is border-line, so a third injection may be required. Thus, almost 20 times the normal dose may be necessary, and the H5N1 has a tendency to kill the chicken eggs, reducing the yield. Thus, the availability of chicken eggs could severely limit the amount of vaccine produced and could conceivable require 50 times the number of eggs required to make a vaccine against one human isolates (the current human trivalent vaccine is made against three viruses using 15 micrograms each).

These data suggest that the vaccine under development may not work well against the 2005 H5N1 in Vietnam, which only has 4 amino acids changes in HA, because the vaccine against the immunizing isolate is so weak.

As H5N1 closes in on Europe and threatens to spread throughout Asia and beyond, it is clearly time to rethink and retool vaccine development, which uses technology developed shortly after the first human flu virus was isolated in 1933. The techniques used in 2005 are strikingly similar to the technology of the 1940's, and the case fatality rate of the 2005 H5N1 is 10 to 20 times higher than the 1918 pandemic virus.

Although efficient human-to-human H5N1 transmission has not been confirmed, the rapid evolution of H5N1 and its increased host and geographical range, creates a very unstable genetic situation.

This instability could have dire consequences in the very near term.

http://www.recombinomics.com/News/08070504/H5N1_Vaccine_Outpaced_By_H5N1.html

[Oorang]

US Considers a Third H5N1 Bird Flu Pandemic Vaccine Dose

Recombinomics Commentary
August 8, 2005

Doctors at these centers drew blood from the volunteers to document that they had no antibody to A(H5N1) before they received the first of two injections of the vaccine. Then the doctors drew another blood sample four weeks later when the volunteers received a second injection of the vaccine.

Fauci said his team was considering drawing a fourth blood sample to measure the antibody response over a longer period. He also said that the team was considering adding a third dose of vaccine to determine the maximum response that the vaccine could elicit.

The consideration of a third dose strongly suggests that two doses of 90 micrograms each, generated a response that was far from ideal. This is of concern for a number of reasons.

The above data was generated using younger adults injected with a 2004 reverse engineered version of H5N1 from Vietnam. The group tested will likely generate the best response, so the response in the over 65 group or children may be weaker. Since this is a pandemic vaccine, requiring three shots over an extended time period is also less than ideal, especially if the vaccine has to be used under pandemic conditions.

The borderline response is also of concern with regard to supply. The amount of an individual virus required in the human flu vaccine is 15 micrograms. At the highest doses tested, 180 micrograms were used, which is 12X the amount used for a human virus. A third shot would raise that total to 18X per person. Since the FDA approved method of antigen preparation involves growing the reverse engineered virus in chicken eggs, the number of eggs currently limits supply. This limitation may be exacerbated by poor growth of the virus, which has a tendency to kill the chicken embryo.

A borderline response also raises concerns about utility of the vaccine against an evolving H5N1. Sequences from early 2005 isolates from Vietnam show that HA has 4 amino acid differences with the vaccine prototype strain and NA has 3 differences. Although these differences are modest, they could be enough to make the border line pandemic vaccine ineffective.

Of even greater concern, however, is the H5N1 traveling and transmitting in Russia, Kazakhstan, and Mongolia. These strains almost certainly are linked to the Qinghai Lake outbreak. Isolates from Qinghai Lake have been sequenced and they differ from the pandemic strain at 18 amino acid positions in HA and 13 positions in NA. These changes a similar to differences between the 1997 H5N1 from Hong Kong and 2004 H5N1 from Vietnam. Because of these large numbers of changes, the 1997 pandemic vaccine was not considered a candidate for development against the 2004 H5N1 outbreak.

Thus, the pandemic vaccine results are similar to the results from treating mice with oseltamivir (Tamiflu). The treatment did generate a dose response curve, but even though the amount of Tamiflu used was 5X the FDA approved amount for treatment (and 10X the amount approved fro prevention, 50% of the mice died, even though they were infected after the Tamiflu flu treatment had been initiated.

Therefore, both pandemic vaccine and H5N1 anti-viral data indicate significantly more work is required and the existing treatments will do little to blunt a raging pandemic.

As H5N1 approaches Europe and the summering migratory birds in northern China and southern Russia prepare to head south to recombine with endemic H5N1 in areas like southeast Asia and probably China and India, there is considerable cause for concern.

http://www.recombinomics.com/News/08080501/H5N1_Vaccine_Third_Dose.html

[Oorang]

Bird Flu Migration to Mongolia Confirmed

Recombinomics Commentary
August 8, 2005

Director of the GAEM P. Dash said a total of 76 swans and wild geese had been found dead near the Erhel Lake in the Hovsgol province since late July but the strain of the bird flu has not been identified.

No humans nor poultries have been infected, Dash said, adding all the contracted were migratory birds.

Although the strain of bird flu has not been identified, the dead migratory geese in a Mongolian reserve north of Qinghai Lake almost certainly indicate the bird flu was H5N1. Many birds that nest or rest at Qinghai Lake spend the summer further north in areas like southern Siberia. In late July wild and domestic bird deaths were also noted in Russia and Kazakhstan and they were H5N1. The description of sequences from nine isolates from Novosibrsk indicated the H5N1 was similar to H5N1 in Vietnam but distinct. That description matches the sequences from the H5N1 isolates from Qinghai Lake.

Birds heading north from Qinghai Lake bifurcate and head to the east and west. The group heading to the west is leaving a trail of dead birds along the southern border of Russia and northern border of Kazakhstan. The dead geese and swans may represent a corresponding eastern trail along the southern birder of Russia and northern border of Mongolia.

The trails of dead birds 800 to 1000 miles to the north of Qinghai Lake indicates that the H5N1 did not burn itself out at Qinhai Lake and instead is being transported by migratory birds. The birds will soon head to the south, spreading H5N1 throughout Asia and Europe.

http://www.recombinomics.com/News/08080502/H5N1_Mongolia_Confirmed.html

[EternalHope]

Therefore, both pandemic vaccine and H5N1 anti-viral data indicate significantly more work is required and the existing treatments will do little to blunt a raging pandemic.

So much for yesterday's news about a successful vaccine.

As H5N1 approaches Europe and the summering migratory birds in northern China and southern Russia prepare to head south to recombine with endemic H5N1 in areas like southeast Asia and probably China and India, there is considerable cause for concern.

It still does not seem to spread easily from human to human. I wonder if something about H5N1 makes that fundamentally difficult?

Otherwise, it could be a really rough ride.

[Oorang]

Top-secret: The Sichuan pork dissemination plague, the casualty already surpassed 200

Please look at the abundant news hot spot:Sichuan ¹Ö²¡ (Abundant news on August 09, 2005)

According to the reliable information, Sichuan as disseminated the carrier plague take the pork already to surpass 200 people to the end of the last week.

Sichuan, the Chongqing area basis central instruction spirit, disseminates the news regarding the plague to carry on the close control. The absorption recently the sars lesson, the central authorities already announced the discipline to various local authority leader: Does not permit to appear in the papers, does not permit publicly.

It is reported, takes this measure the basic consideration is raises the pig is two places farmers' main source of income, the government worried if the plague disseminates the news causes panic, the pork is unable to sell, on hundred million farmers' lives will receive the fatal blow, the initiation society turmoil. (Abundant news boxun.com)

The plague is spreading........

Until now, some any medicine experts proposed solution and the forecast, in front of this plague, the Chinese government is completely helpless. Thus has adopted this kind of control news but is not the control is cut off the infection source barbaric ignorant policy, sets at people's safety not to attend to, tows one day to calculate one day.

May ÅÔÖ¤ the plague disseminate the sign which far has not passed is, until today, not any Sichuan or the Chongqing municipal government's senior official acts on behalf of to eat the pork to demonstrate the pork security to the people, because they knew does not have the means inspection pork is safe.

But on in last year, occurred when the chicken pest, Chongqing mayor has the demonstration to eat the chicken the example.

All signs indicated that, the plague is far has not passed, has not received the control, but also only was just starts...........

Above is the abundant news duty reporter's report above, the abundant news edition is unable to verify the news. _ (abundant news reporter: Land gentry) (abundant news boxun.com)

http://world.altavista.com/babelfish/trurl_pagecontent?lp=zh_en&trurl=http%3a%2f%2fwww.peacehall.com%2fnews%2fgb%2fchina%2f2005%2f08%2f200508090013.shtml

[Oorang]

Yesterday I had such high hopes for the vaccine. Oh well, I can always have hope for tomorrow.

[ThanhPhero]

Health care workers or population control troops?