Posted on 05/09/2005 10:18:08 AM PDT by 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.
Outstanding posts! Thank you very much for bringing us these articles, I appreciate it.
Pinging everyone to the articles Molly posted just above (3 of them I think) and to this one below:
http://www.nigms.nih.gov/news/releases/08032005.html
____________________________________________________________
News Releases & Research Briefs
EMBARGOED FOR RELEASE
Wednesday, August 3, 2005
1:00 p.m. EDT
Researchers Model Avian Flu Outbreak, Impact of Interventions
A carefully chosen combination of public health measures, if implemented early, could stop the spread of an avian flu outbreak at its source, suggest two international teams of researchers in Nature (August 3) and Science (August 5).
This is a snapshot taken about 60 to 90 days after the first case of an uncontrolled outbreak of transmissible avian flu in people living in Thailand. Red indicates new cases while green indicates areas where the epidemic has finished. The accompanying movie (requires free RealPlayer) shows the spread of infection and recovery over 300 days in Thailand and neighboring countries.
This is a snapshot taken partway through a controlled outbreak of transmissible avian flu in people living in Thailand. Red indicates areas of infection while blue indicates areas where a combination of control measures has been implemented. The accompanying movie (requires free RealPlayer) shows that this approach contains the infection in 90 days, before it spreads elsewhere.
All graphics are reproduced from supplementary information on this work published in Nature and are courtesy of Neil M. Ferguson of Imperial College in London.
The researchers used computer modeling to simulate what might happen if avian flu were to start passing efficiently between people in Southeast Asia. They found that antiviral treatment is a critical component of any multi-pronged approach.
The computer simulations are part of the Models of Infectious Disease Agent Study (MIDAS) research network funded by the National Institute of General Medical Sciences (NIGMS), a component of the National Institutes of Health. The overall goal is to develop computational models of disease spread that will aid the development of effective control strategies.
“These new models illustrate how the fundamental features of infectious disease spread can be captured to predict possible outcomes and the potential impact of interventions,” said Jeremy M. Berg, Ph.D., director of NIGMS. “As these modeling approaches develop, they will offer policymakers and researchers powerful tools to use in strategic planning.”
The H5N1 strain of the avian flu virus, found in birds throughout Southeast Asia, has infected a number of species, including domestic poultry, pigs, and people. Scientists fear that a genetic exchange between bird and human flu viruses or the accumulation of H5N1 mutations could soon make efficient person-to-person transmission possible.
The avian flu strain represents a particular threat because it is so deadly, said Neil M. Ferguson, D.Phil., a computational biologist at Imperial College in London and lead author of the Nature paper. “A large percentage of animals and people infected with this virus have died,” he explained. “The consequences of an H5N1-based pandemic could be catastrophic.”
With bird flu continuing to spread in Southeast Asia, the MIDAS network decided to model a hypothetical human outbreak of H5N1 in this region.
“The pressing questions are if and how we can contain an outbreak of avian flu at the source before it becomes a pandemic,” said Ira M. Longini, Jr., Ph.D., a biostatistician at the Emory University Rollins School of Public Health in Atlanta and lead author of the Science paper.
To enhance reliability, both models were based on detailed data for Thailand, such as population densities, household sizes, age distribution, and distances traveled to work. The models also included information about the flu virus, such as the possible contagiousness of an infected person. Ferguson and Longini noted that actual contagiousness would not be known before an outbreak.
Although the models differed in the specific scenarios they simulated and the intervention strategies they tested, the general conclusions were similar and confirm current knowledge of how diseases spread: Preventing a pandemic would require a combination of carefully implemented public health measures introduced soon after the first cases appear.
The model presented in Nature simulated 85 million people living in Thailand and bordering regions of neighboring countries. It tested the effectiveness of giving courses of antiviral treatment to everyone, socially or geographically targeting who received them, and combining these drug-sparing approaches with other interventions, such as restricting travel.
The results suggest that an international stockpile of 3 million courses of flu antiviral drugs, combined with other interventions, could contain a pandemic. Treating infected individuals and everyone in their vicinity, along with closing schools and workplaces, could have more than a 90 percent chance of stopping the spread of a pandemic virus, according to the model. Ferguson emphasized that successful containment would depend on the early detection of the first cases and the rapid implementation of public health measures.
The model described in Science simulated 500,000 people living in rural Southeast Asia and relied on information about how those individuals move within their communities. Containment strategies included giving antiviral medication to people in the same social networks, vaccinating before an outbreak with a vaccine that is not well matched to the strain that emerges, quarantining the houses or neighborhoods of infected people, and combinations of these approaches.
Giving a low-efficacy vaccine to just half the population before the start of a pandemic would greatly enhance the success of other containment strategies, according to the model. Longini reported that a combination of targeted antiviral treatment and quarantine introduced two weeks after the first case had the potential to successfully contain disease spread, resulting in less than one case per 1,000 people.
Both models demonstrated that the need for additional public health measures greatly increased as the virus became more contagious. “Each measure can have a significant effect, but it can’t contain spread on its own,” said Ferguson, adding that targeted antiviral treatment was a crucial component of all combined strategies.
While the researchers said that implementing such a combination of approaches would be challenging and require a coordinated, international response, they offered this good news: The models show that containing an avian flu pandemic at its source is feasible.
Because computer models cannot capture all the complexities of real communities and real outbreaks, the MIDAS researchers will continue to refine their simulations and test different scenarios as new information becomes available. By developing a collection of models, they can compare and contrast different interventions, leading to more accurate predictions.
Other researchers involved in this work represent Johns Hopkins Bloomberg School of Public Health; the University of Hong Kong; the Ministry of Health in Thailand; and INSERM, the French National Institute of Health and Medical Research.
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My only comment is that I think some of the modelling results are a bit optimistic...
Thanks for the ping! Here's the daily from http://www.thepoultrysite.com/LatestNews/?AREA=LatestNews&Display=6187 Again, follow the link to read the articles
Daily Bird Flu News Updates:
Xinhuanet - 4th August 2005
Bird flu case suspected in east Japan
JAPAN - A case of bird flu was suspected in east Japan's Fukushima Prefecture, Nihon Keizai reported Thursday. According to the Japanese economic daily, the prefecture announced Wednesday that the blood serum of some chickens in a local hennery tested positive for a bird flu virus and the National Institute of Animal Health in Ibaraki Prefecture is now conducting confirmation tests.
I really like those dailies. Incidently, I think Vietnam's vaccination effort is best, and I really hope it works. If it does, then VAST amounts of food will have been saved...if not, famine may follow the death of millions of chickens...
I like them too. I like the overview and consolidated information. Sometimes it repeats what's been posted here already sometimes it picksup something we missed. I didn't see the Japan article here or the UK article.
"Of those confirmed infected with the bird flu, almost half
have died."
Far far worse than 1918...
Thank you both for the excellent articles.
Thanks for the ping :-) I was saying the same thing at the beginning of the thread. All our research concurs with this approach, vaccination in conjunction with protein inhibitors.
However why do they suggest using a low specificity and low efficacy vaccine (which will have limited cross immunity benefit and will not lead to a "critical mass" herd immunity) typically a monovalent vaccine when with but a little extra cost a much more specific higher efficacy vaccination could be offered? this makes no sense to me at all.
One 'cure all' flu jab for life
The vaccine is aimed to protect against all flu strains
Scientists are making a vaccine that could give lifelong protection against all types of flu in a single jab.
Currently, at risk people in the UK - the elderly and ill - need annual flu jabs, and there is no jab available yet guaranteed to beat bird flu.
Biotechnology firm Acambis, in Cambridge, the UK, says it hopes its jab will target numerous mutations that presently allow flu to evade attack.
However, the work is very early and is years off being tested in humans.
One-off jab
Each year winter flu kills around 4,000 people in the UK.
Globally, between 500,000 and one million people die each year from influenza.
If the bird flu virus currently circulating in Asia were to mutate and spread from person to person it could kill as many people as the 1918 Spanish flu, which claimed between 20 and 40 million lives, experts have warned.
Current flu vaccines work by giving immunity to two proteins called haemagglutinin and neuraminidase, which are found on the surface of flu viruses.
We aim to avoid the need for annual re-engineering and manufacture of the new product
Dr Thomas Monath, chief scientific officer at Acambis
However, these proteins keep mutating which means doctors have to keep making new vaccines to keep up.
Scientists at Acambis' laboratory in the US, together with Belgian researchers at Flanders Interuniversity Institute for Biotechnology, are focusing their efforts on a different protein, called M2, which does not mutate, as well as other technology that they cannot disclose yet for commercial reasons.
Early days
If successful, a single shot of the vaccine could protect a person against all strains of influenza virus, they believe.
Dr Thomas Monath, chief scientific officer at Acambis, said: "We aim to avoid the need for annual re-engineering and manufacture of the new product, something that is not yet possible with existing vaccines.
"The need to develop a new vaccine each time a different influenza strain emerges often results in long delays before a population can be protected.
"The technology also has special importance as a potential means of protecting human populations against pandemic influenza strains."
So far the vaccine has only been tested in animals. The scientists said it would take several years before large-scale human trials could be done.
Professor Maria Zambon, a flu expert at the Health Protection Agency, said: " We welcome advances in the process of developing novel flu vaccines and vaccination techniques.
"However this vaccine is still very early in a vaccine development pipeline and it will take some time to establish how this vaccine performs in human trials and whether it can proceed to being licensed for use in the UK."
Professor Karl Nicholson, professor of infectious diseases at Leicester University, said: "It would be enormously helpful to mankind to have just the one vaccine but sadly I think it is a long way off."
He said it might be 10 years before any such product could be ready for widespread use in humans.
http://news.bbc.co.uk/1/hi/health/4747909.stm
"Current flu vaccines work by giving immunity to two proteins called haemagglutinin and neuraminidase,"
Not a good description of the immune response
not a lot of hope, either...but I thought it was interesting....
Well, we know that's what science is aiming for--a different kind of vaccine targeted to a different flu marker that is ubiquitous to all strains.
Not a bad idea. Hope it works.
Multi-organ failure increases mortality of pig-borne disease
Short latent period and multi-organ failure are ultimate causes for the higher-than-expected mortality rate of the pig-borne disease in southwest China's Sichuan Province, a health specialist has said.
"Most patients suffered failures in the kidneys, livers, lungs and heart shortly after they were contracted, and some of them died before timely treatment," said Chen Zhihai, head of the expert panel sent by the Ministry of Health to the epidemic-hit regions.
The latent period of the disease is so short that some patients died within 10 hours after infection, he said in an interview with Xinhua on Thu 4 Aug 2005. "In one case, a man died 2 hours after slaughtering a sick pig." In comparison, it normally takes a week or 2 for an ordinary bacterial infection to break out, he said.
"On the other hand, the disease was caused by _Streptococcus suis_ type 2, the deadliest of all the 35 forms of pig-borne _S. suis _ bacteria," he added. [These are different capsular types of _S. suis._ Type 2 has always represented the most virulent type in both swine and humans. - Mod.LL]
Chen said antibiotics are effective in tackling the organism, but not after it has led to multi-organ failure, which is largely to blame for the high morality rate of the disease. "The mortality rate was particularly high in the early phase of the outbreak, as many patients took it [to be a] cold or flu," said Chen.
Earlier symptoms of the disease are similar to those of flu, with high fever, fatigue, nausea and vomiting, but many patients became comatose shortly afterwards and had bruises under their skin.
The epidemic broke out in late June 2005, 1st in Ziyang and Neijiang, and later spread to 10 cities, including Jianyang and the provincial capital Chengdu.
The Ministry of Health disclosed that the disease had claimed 38 lives in the province by midday Wed 3 Aug 2005, and the number of confirmed and suspected cases had risen to 165 and 41 respectively.
Excerpted, more at link:
Recombinomics Commentary
August 5, 2005
Cases of bird flu have been reported in two districts in the east of Russia's Kurgan region, sources in the local branch of the Federal Veterinary Control Service told Interfax.
"Cases of the disease have been reported in the Petukhovo and Chastoozyorsk districts among both wild and domestic fowl," one of the sources said.
The outbreak affected domestic birds in the village of Butyrino as well as seagulls and wild ducks in a nearby area.
The report above confirms rumors of dead waterfowl in the Kurgan region, generating alerts in Yakaterinburg in the Ural Mountains separating Europe and Asia. The above report places outbreak in the northwest corner of Kurgan, near Tyumen, Omsk, and the major Kazahkstan city of Petropayloysk. The city has Omsk to the east, Tyumen to the north, and Kurgen to the west, further suggesting that the westward migration along the southern border of Russia involves the regions comprising the northern border of Kazahkstan, which include East Kazakhstan, Pavlodar, and North Kazakhstan.
The identification of infected wild and domestic birds has paralleled the suspect human cases in Kazahkstan. The first case is a poultry worker in Golubovka in the Irtysh region, where H5 positive bird deaths were reported to OIE. The area is just south of the Chany Lake region where Russia reported dead birds to the OIE. Media reports indicate the poultry worker has pneumonia, which is an advanced condition of bird flu infections. Also in the area is a family of four who developed symptoms after eating goose meat. To the east in Eastern Kazakhstan are 15 people hospitalized after eating chicken cutlets at a dining hall. This are is due north of Tacheng, Xinjiang, where an OIE report from China described dead geese.
All of the OIE reports cite migratory birds as the cause of the outbreaks in domestic birds. The outbreaks cover almost 1000 miles of the Russian Kazahkstan border.
Butyrino is most western area reporting cases. It is about 200 miles west of Europe and about 800 miles northeast of the Caspian Sea.
http://www.recombinomics.com/News/08050501/H5N1_Kurgan_Region.html
Recombinomics Commentary
August 5, 2005
Roy Wadia, a WHO spokesman in Beijing, said China had been giving the organization updates from Sichuan province on the disease blamed on the Streptococcus suis bacteria. But more tests were needed to "eliminate other possible scenarios," he said.
"Doing tests of different sorts is something we would recommend ... in any outbreak situation, especially in one of this scale," Wadia said.
Some 208 people have become ill in dozens of villages and towns in Sichuan province since June, China's Health Ministry said Friday, mostly farmers who butchered or handled sick pigs. Fifteen remain in critical condition.
WHO's request for more testing on the Sichuan cases is welcome. It is clear that another agent is involved. The infections spread too quickly and the case fatality rate is too high for a sudden change in a bacteria that rarely infects humans.
The symptoms and sudden onset match those of pandemic influenza of 1918. Although China has stated that the patients were negative for H5N1, China has never reported a human H5N1 cases, raising questions about their willingness of ability to detected H5N1 in humans. H5N1 infections can lead to bacterial infections, so third party tests of samples would be useful. Boxun reports have also raised the possibility that an Ebola recombinant is involved. Since both H5N1 and Ebola share a short region of identity, investigation of viral recombinants is warranted.
http://www.recombinomics.com/News/08050502/WHO_Sichuan_More_Tests.html
(Aug. 05, 2005)
Boxun News
Sichuan
Up to Aug. 4th, the official numbers are:
Two more infected, no new death.
Unofficial messages (as people post the messages may face punishment, it is better to believe what they say):
Dead pigs were seen in river, the source of drinking water. The local government seems more focused on covering information than solving the problem.
Official news has never given the details about which city, how many. It only gives a total number, it is about 1 infected in the each of the total 180 plus villages. In last two days, the official news release did not even give the number of cities and villages. In previous release, it did not given full city names (last number of city names was 10).
If the disease is under control and disappears, everything will be easy for government; otherwise, it will repeat the process of SARS - government will release more information and give warning to outsdie world.
Qing Hai Bird Flu:
Annoymous source said military troops are withdrawing from the temporary camps.
http://www.peacehall.com/news/gb/english/2005/08/200508050144.shtml --------------------------------------------------------------------------------
The official number of infected Streptococcosis Suis increased to 212 by August 5. No new death.
But the people from that area pointed out those numbers are not correct.
Message 1: Many of my relatives live in that area, what I heard tells me that the number of deaths is not true, the infected is increasing.
Message 2: AnXian has about 20 infected, why not report?
Message 3: PengZhou City has about 20 infected.
http://www.peacehall.com/news/gb/english/2005/08/200508060247.shtml
http://www.thepigsite.com/
Friday, August 05, 2005:
Vietnam bans pig, pork import from neighborhood as epidemic rages
VIETNAM - The Vietnamese government ordered Friday an immediate halt to import of pork and live pigs from countries in the region which are being ravaged by a fatal swine disease.
An emergency communication from the Prime Minister has instructed federal government agencies to work with provinces bordering the affected countries, including China, to crack down on smuggling of pork and pigs.
Animal health and market management agencies have been ordered to tightly screen the trade of pig and pork.
“If live pigs and pork products are found originating from those countries, they must be confiscated and destroyed immediately," the communication said. Besides, the importers involved would have to pay for destroying them.
Source: thanhniennews.com
The latent period of the disease is so short that some patients died within 10 hours after infection, he said in an interview with Xinhua on Thu 4 Aug 2005. "In one case, a man died 2 hours after slaughtering a sick pig." In comparison, it normally takes a week or 2 for an ordinary bacterial infection to break out, he said.
He died two hours after exposure???
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