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.

[Gritty]

"Deaths" are in parenthesis, total cases are the first number.

[Iowa Granny]

thanks

[EternalHope]

Here's an update on Indonesia. The numbers do NOT match the CIDRAP numbers.

Bird flue: 54 Indonesians ill

Bird flu: 54 Indonesians ill
28/09/2005 15:12 - (SA)

Jakarta - At least 54 people were being treated on Wednesday for suspected bird flu in Indonesia, where the disease had already claimed six lives, said officials.

Deputy director of Jakarta's Sulianto Saroso hospital, Sardikin Giriputro, said they would soon discharge three of 20 suspected bird flu patients after tests gave them a clean bill of health.

He said the three, two adult men and one two-year-old infant would be able to leave the hospital once a clearance was obtained from the health ministry.

Giriputro said: "Once the clearance... is received on Wednesday, they will be returned home tomorrow."

The latest suspected case - a 23-year-old man from the capital - was admitted to the hospital late on Tuesday.

Blood and mucus samples from the patients were being tested locally and any results indicating bird flu would be sent to World Health Organisation (WHO) laboratories in Hong Kong for confirmation.

Since Monday, the hospital had released five people who were suspected of contracting bird flu, but tested negative.

Health ministry spokesperson Sumardi said on Wednesday that a shipment of some 20 000 doses of Tamiflu, an anti-viral medication that could stop flu if administered promptly, would arrive in the country on Friday.

He said: "This medicine will be sold commercially at pharmacies." So far, it had only been available in hospitals.

Six Indonesians had died of bird flu, bringing to 65 the number of people in Southeast Asia known to have been killed by the H5N1 strain of the virus since 2003.

Vietnam had recorded 43 deaths, Thailand 12 and Cambodia four.

The WHO feared H5N1 would mutate, acquiring genes from the human influenza virus that would make it highly infectious and lethal to millions in a global pandemic.

But, it had also urged calm, saying investigations in Indonesia had produced no evidence that H5N1 was spreading easily from person to person.

[Judith Anne]

Gee, the last sentence in that article is so reassuring--NOT!

[redgolum]

If I remember right, you post or lurk on CurrentEvents Online.

Monkeyes2 posted a preliminary graph of the cases so far.

[Smokin' Joe]

bookmark bump

[teawithmisswilliams]

Ping

[Judith Anne]

I saw that on CE. But I prefer the CIDRAP information. Not sure if that's where the CE poster gets his info or not.

[EternalHope]

Recombinomics has four new H5N1 articles for today, plus one from yesterday, all of which are worth reading.

Recombinomics articles

My personal conclusion from these articles:
1. Very poor sample collection means we have no idea how many cases there are in Indonesia.
2. That we are at stage 5 looks very likely, but we are not at stage 6.
3. It is spreading more easily from birds to humans, including casual contact. Eating an infected bird is not necessary.
4. The general population currently includes many infected people. If it is now capable of sustained human to human transmission, we will know soon, perhaps within a week.

[unseen]

If you look at the Map on the site. It shows 2 international airports within the outbreak zone. In fact one of the sick worked at the airport. This virus is one plane trip away. The cases are also exploding from the reports. It looks like clusters within clusters are occurring. And the WHO and Indonesia government are powerless to stop the spread. Hopefully this evolution path of the virus will burn itself out but I am very worried. This is just the start of the winter months in the area.

[Oorang]

Saw my doctor just a few days ago and at the end of the appointment I asked her for a script for Tamiflu. No problem at all and my insurance did pay for the normal percentage. Yesterday my husband called his doctor (same clinic as mine) requesting a script for Tamiflu. His dr's assistant called back with a emphatic "No". My husband is now changing doctors. Ugh.

[CaptainK]

His dr's assistant is probably hoarding it.

[Oorang]

WHO expert to work with the UN system on avian and human influenza

Position critical as world speeds up preparation for an influenza pandemic

29September 2005

The United Nations Secretary General has appointed Dr. David Nabarro, one of the most senior public health experts at the World Health Organization (WHO), to lead coordination of the UN response to avian influenza and a possible human influenza pandemic.

The appointment is critical as the world is fast recognizing the risk of an imminent human influenza pandemic, and is taking steps to reduce the risk and to get prepared. To this end, the World Health Organization has sent all countries detailed guidance on actions they need to take. Implementing these actions requires coordination across UN agencies, countries, civil society, across sectors within countries and the private sector. Implementation also requires funding.

As Senior UN system Co-ordinator for Avian and Human Influenza, Dr. Nabarro will be responsible for ensuring an effective and coordinated contribution by the UN system to controlling the current epidemic of avian influenza that is particularly affecting countries in Asia. He will also ensure that the UN system supports effective local, national, regional and global preparations for a potential human influenza pandemic - so as to reduce the human toll, as well as the economic and social disruption, that this pandemic could cause.

"The WHO has been very clear about the imminent threat of a human influenza pandemic. The world is responding, and is moving quickly to get prepared. However, coordination of these efforts is critical to ensure all stakeholders are giving the best of what they have to offer, and that countries receive the support they urgently require," said Dr LEE Jong-wook, Director-General of the WHO. Dr. Nabarro, of the United Kingdom, has held several leadership positions in WHO, including on malaria, environmental health, food safety and most recently in crisis operations. His 30 years experience includes work in community-level and government health programmes, particularly in Asia, in the administration of development assistance, as well as the management of scientific research, the building of development partnerships and engagement with non-governmental organizations.

Currently, the outbreaks of a highly-pathogenic avian influenza virus in poultry and other birds in several Asian countries pose the greatest threat of sparking a human influenza pandemic. WHO warns that this animal virus (H5N1) could change into a form which spreads easily from person to person. As people would have no natural immunity, a new influenza virus could cause widespread death, illness, social and economic disruption.

In recent weeks, several countries have joined forces to coordinate preparation. The United States announced a new International Partnership on Avian and Pandemic Influenza at the World Summit in New York. The initiative is moving forward with several countries, with a planning meeting 7-8 October in Washington. Canada is also hosting a ministerial meeting on October 25 and 26, to discuss a range of policy issues to support the work of the partnership. On 7-8 November the World Health Organization is hosting a meeting of all partners to coordinate the funding needed.

All of these efforts aim to ensure countries are equipped with national influenza pandemic preparation plans, that efforts to stop the outbreaks of avian influenza are accelerated, and that health tools, such as a vaccine are available as quickly as possible.

http://www.who.int/mediacentre/news/releases/2005/pr45/en/index.html

[redgolum]

From CNN
Bird flu 'resistant to main drug'

Friday, September 30, 2005; Posted: 7:33 a.m. EDT (11:33 GMT)



HONG KONG, China (Reuters) -- A strain of the H5N1 bird flu virus that may unleash the next global flu pandemic is showing resistance to Tamiflu, the antiviral drug that countries around the world are now stockpiling to fend off the looming threat.
http://www.cnn.com/2005/WORLD/asiapcf/09/30/birdflu.drugs.reut/index.html

Not good.

[Iowa Granny]

here's the Free Republic link to the story which states the H5N1 strain currently present in North Vietnam is resistant to Tamiflu:

http://www.freerepublic.com/focus/f-news/1494292/posts

[EBH]

Daily Bird Flu News Updates:

Reuters - 30th September 2005
Taiwan tech firms begin bird flu precautions
TAIWAN - Stung by the SARS outbreak two years ago, some of Taiwan's top technology firms are beginning to take precautions against bird flu in case the virus evolves into an even deadlier form and threatens operations. Taking a page from the measures adopted against the Severe Acute Respiratory Syndrome (SARS) in 2003, electronics firms said an outbreak of the H5N1 avian flu in China could have serious consequences on their factories there. http://www.thepoultrysite.com/LatestNews/Default.asp?AREA=LatestNews&Display=8420

---

BBC - 30th September 2005
Bird flu 'could kill 150m people'
GLOBAL - A new flu pandemic could happen at any time and kill between 5-150 million people, a UN health official warned. David Nabarro, who is charged with co-ordinating responses to bird flu, said a mutation of the virus affecting Asia could trigger new outbreaks. "The consequences in terms of human life when the pandemic does start are going to be extraordinary and very damaging," Dr Nabarro told the BBC. Bird flu has swept through poultry and wild birds in Asia since 2003. It has killed huge numbers of birds and lead to more than 60 human deaths. http://newsvote.bbc.co.uk/mpapps/pagetools/print/news.bbc.co.uk/1/hi/world/asia-pacific/4292426.stm

[Oorang]

Thank you both for that info and the links. Who knows if anything will work by the time it recombines and hits America. Ack.

[Oorang]

The BBC article is real uplifting (sarcasm). At least the msm is waking up, finally.

[EBH]

Yeah, I know it is such a great uplifting article! (/sarcasm)

Ok all our experts out there, I have a question. I've been contemplating the cultural differences that could affect an outbreak or perceived pandemic. I know Asians handle the idea of 'pets' and animals with a very different attitude than most westerners. Now we know that the avian flu is moving through the bird populations at an astonishing rate and that migratory birds are the carriers. We are starting to see people being infected by just being around the birds and droppings. So, here are my questions:

* Pigeons, especially in large cities where it is common for them to be fed by people and in close contact with people, will we see them as something to be eradicated and if so what political outrage will occur?

* Bird Lovers, the people who feed the birds in their backyards, could be our first indicators of a problem infecting an area. What should they be doing after identifying the problem, can they continue to safely feed the birds, who should they report problems to? More importantly there may be a species of bird resistant to the avian flu and should that species be identified for researchers? Are they at risk from handling, cleaning, and filling their busy winter feeders?

* Ducks, geese et al. In my nice suburban area we have several pond areas where people go to see and feed wild ducks. Even with signs posted for Do Not Feed, people still bring feed with them for the ducks/geese. Again, people are coming in close contact with the birds, feathers, and feces. What should the managers of these wildlife areas be doing now to enforce/remind people of the hazards they are introducing to themselves or the ecosystem?

[stockpile]

Interesting CBS Article on Avian Bird Flu:

(CBS/AP) An infectious disease expert says a doomsday scenario is awaiting the nation if it experiences an avian flu pandemic.

Michael Osterholm, head of the University of Minnesota's Center for Infectious Disease Research and Policy">University of Minnesota's Center for Infectious Disease Research and Policy, warns an avian flu pandemic in the U.S. could claim many more lives than Hurricane Katrina.

"It is not if it [avian flu] is going to happen," he said. "It is when, and where, and how bad," Osterholm said at the Woodrow Wilson International Center for Scholars in Washington.

So far, avian flu has killed about 60 humans in Asia, while being mostly restricted to birds. But experts expect the virus to change enough to spread from human to human. Osterholm said it would likely claim around 1.7 million Americans in the first year, as vaccine was slowly produced.

Canadian medical journalist Helen Branswell said she feels no one, including the World Health Organization, is ready to deal adequately with an avian flu pandemic.

"Welcome to my nightmare," she said at the conference.

The World Health Organization is prepared to begin distributing large-scale quantities of an antiviral drug to treat bird flu in humans "if and when a pandemic starts," a top WHO official said Wednesday.

Dr. Shigeru Omi, director for WHO's Western Pacific region, said the U.N. agency was ready to open its stockpile of oseltamivir, an antiviral drug, to help avert a global pandemic of the disease.

The announcement came as Indonesian Health Minister Siti Fadila Supari on Wednesday warned of a possible bird flu epidemic just hours after the death of a 5-year-old girl who was hospitalized with symptoms of the disease.

A bird flu outbreak there could quickly turn into an epidemic, the health minister warned.

Bird flu has killed at least four people in Jakarta and is suspected of sickening several others, prompting Agriculture Minister Anton Apriyantono to declare a mass cull of chickens in areas found to be "highly infected" with avian influenza.

WHO currently maintains a stockpile of about 80,000 treatment courses of oseltamivir, known commercially as tamiflu, Omi told reporters outside a WHO conference in New Caledonia.

Asked if WHO was prepared to send tamiflu to Indonesia, Omi replied: "If and when a pandemic starts, we can send this (drug)."

The organization regards a pandemic as a multi-country outbreak of bird flu, in which the disease has been passed from human to human.

The H5N1 strain of bird flu has swept through poultry populations in large swaths of Asia since 2003, killing at least 63 people and resulting in the deaths of tens of millions of birds. Most of the human deaths have been in Thailand, Vietnam and Indonesia. Health officials in parts of Russia and Kazakhstan are also monitoring its spread.