New bird flu cases suggest the danger of pandemic is rising

[Harlequin]

New bird flu cases suggest the danger of pandemic is rising

Infections in Egypt raise scientists' fears that virus will be spread by humans

By Geoffrey Lean, Environment Editor

Sunday, 12 April 2009

First the good news: bird flu is becoming less deadly. Now the bad: scientists fear that this is the very thing that could make the virus more able to cause a pandemic that would kill hundreds of millions of people.

This paradox – emerging from Egypt, the most recent epicentre of the disease – threatens to increase the disease's ability to spread from person to person by helping it achieve the crucial mutation in the virus which could turn it into the greatest plague to hit Britain since the Black Death. Last year the Government identified the bird-flu virus, codenamed H5N1, as the biggest threat facing the country – with the potential to kill up to 750,000 Britons.

The World Health Organisation is to back an investigation into a change in the pattern of the disease in Egypt, the most seriously affected country outside Asia. Although infections have been on the rise this year, with three more reported last week, they have almost all been in children under the age of three, while 12 months ago it was mainly adults and older children who were affected. And the infections have been much milder than usual; the disease normally kills more than half of those affected; all of the 11 Egyptians so far infected this year are still alive.

Experts say that these developments make it more likely that the virus will spread. Ironically, its very virulence has provided an important safeguard. It did not get much chance to infect other people when it killed its victims swiftly, but now it has much more of a chance to mutate and be passed on.

The WHO fears that this year's rise in infections among small children, without similar cases being seen in older people, raises questions about whether adults are being infected but not falling ill, so acting as symptomless carriers of the disease. Its investigation, due to start this summer, will see if this is happening by testing the blood of people who may have been in contact with infected birds, but who have not themselves become sick.

John Jabbour, who works with WHO in Cairo, told Reuters last week: "There is something strange happening in Egypt. Why in children now and not in adults? We need to see if there are sub-clinical cases in the community." He added that if the research did find such cases, they would be the first to be discovered anywhere in the world.

Though he stressed that there was still no evidence of the disease passing from person to person, other experts are also becoming alarmed. Professor Robert Webster, of St Jude Children's Research Hospital in Memphis, Tennessee – who is the world's leading authority on the disease – told The Independent on Sunday that, while he himself had not seen firm data, the WHO in Egypt was raising "a very, very important issue" which should receive "maximum attention". He added: "I hope to hell they are wrong. If this damn thing becomes less pathogenic, it will become more transmissible."

And Professor John Oxford, of Queen Mary, University of London, said that any evidence that H5N1 was becoming less deadly would be serious, as the greatest cause for concern was the disease's ability to spread.

Even a much less virulent strain of the virus could result in a devastating pandemic. Studies show that an outbreak that killed as few as 5 per cent of those it infected could still cause hundreds of millions of deaths around the world.

[Tetra Grammaton Cleric]

H5N1 just won't leave the radar screen will it?

This is one of the reasons why I prep for a bug in.
-

[mad scientist]

Oh no.... now you've gone and done it! Before too long Erik is going to fly up in here like the Tazmanian Devil and start ripping you to pieces for being scared of the bird flu. Then Kathy'll jump in to get your back. Then, a massive debate over the virus erupts. Which means that I, once again, will have to sit back with some popcorn and enjoy myself while watching the flames fly.

[propdoc]

That's scary as shit, I was hoping for at least a few more years of prep before the pandemic.

Time to nuc Cairo, before it spreads. We can blame it on the Iranians. Launch from the straits near their shore and blame them because the missile misses Israel and hits Cairo instead.

[Kathy in FL]

Oh no.... now you've gone and done it! Before too long Erik is going to fly up in here like the Tazmanian Devil and start ripping you to pieces for being scared of the bird flu. Then Kathy'll jump in to get your back. Then, a massive debate over the virus erupts. Which means that I, once again, will have to sit back with some popcorn and enjoy myself while watching the flames fly.

To be honest, the changes in the Egyptian version of the virus is not unexpected. Any loss of morbidity in H5N1 is a good thing. When I first started watching it the morbidity was 80 to 100% in some areas. Some of the loss of morbidity could be attributed to wider testing and a willingness to be slightly more transparent with the numbers, emphasis on slightly.

But, as the virus loses its morbidity it increases the opportunity for the virus to occur in larger H2H and H2H2H ... etc. It bears watching, but then, it has all along.

[SwampRat]

+ bug in

That's what I'm talking about.

[Ovationman]

link?

[TC]

link?

+1


Thanks for the heads up though. I usually try to stay on top of Bird Flu news, but sometimes something slips past. This sort of thing does worry me, because I think it is a real threat but one that I just cannot adequately prep for in my current location. Not good...

[Kathy in FL]

I'll post some links of recent info, the first is with regard to the Egyptian cases:

http://www.cidrap.umn.edu/cidrap/conten ... asymp.html

[Kathy in FL]

Here are additional, recent "flu stuff" from http://www.cidrap.umn.edu/cidrap/conten ... an-jw.html

Egyptian woman sick with H5N1 infection
A 33-year-old Egyptian woman from the northern province of Kafr el-Sheikh is sick with an H5N1 avian influenza infection, Reuters reported today. Health Ministry spokesman Abdel Rahman Shahine said the woman had fallen ill on Apr 7 after coming into contact with dead birds, said the report, which cited the Egyptian news agency MENA. The woman's illness is Egypt's fourth H5N1 case this month, and she is the first adult infected after a string of cases in children in recent weeks. As of last week, Egypt had had 12 H5N1 cases with no deaths so far this year, as compared with 4 deaths out of 8 cases last year, according to World Health Organization (WHO) data. The WHO recently sent a team of experts to Egypt to assess whether the virus is changing in some way.
[Apr 15 Reuters report]

Researchers identify new H5N1 inhibitor candidate
Against a backdrop of concern about influenza resistance to oseltamivir (Tamiflu), researchers from Canada and Hong Kong yesterday at a press conference in Hong Kong described a new compound that inhibits the H5N1 avian influenza virus, according to a report from Xinhua, China's state news agency. The researchers' findings appear in today's issue of the Journal of Medical Chemistry. Using computational molecular docking, the researchers screened 230,000 compounds and found 20 potential H5N1 inhibitors. One of the compounds, referred to as "compound 1," showed an ability to inhibit neuraminidase at levels similar to oseltamivir. The compound was also effective in a variety of cell-line assays and with both H1N1 and H5N1 viruses, according to the journal article abstract.
[Apr 15 Xinhua story]
[Apr 15 J Med Chem abstract]

[Kathy in FL]

more from http://www.cidrap.umn.edu/cidrap/conten ... an-jw.html

Indonesian province reports H5N1 outbreaks
District officials in Indonesia's Riau province reported that the H5N1 avian influenza virus recently struck chickens at several sites, according to an Apr 11 report in the Jakarta Post. The reports of poultry deaths follow the late March confirmation by a hospital official that a 2-year-old boy from Riau province died of an H5N1 infection after he reportedly had contact with dead birds.
[Apr 11 Jakarta Post story]



Tokyo gauges pandemic-related worker absences
A survey from Tokyo's transportation ministry revealed that 25% of those who commute to their jobs in central parts of Tokyo from surrounding areas would not report to work during an influenza pandemic, the Yomiuri Shimbun, an English-language newspaper in Japan, reported today. The findings included 2,000 responses to an online survey, which was conducted to estimate transport capacity during an influenza pandemic. Of those who said they wouldn't report to work, 17% said they'd stay home, though their companies don't have pandemic-related attendance policies. Seven percent said their companies would prohibit them from coming to work during a pandemic scenario.
[Apr 14 Yomiuri Shimbun story]



Hawaii to prompt pandemic discussions with online game
In its efforts to encourage public discussion about pandemic preparedness and vaccine allocation, the Hawaii State Department of Health (HSDH) will sponsor an alternate reality online game starting in mid May, according to an Apr 12 report on the Alternate Reality Gaming Network Web site. The game, funded by the US Centers for Disease Control and Prevention, is titled Coral Cross and features a pandemic scenario that takes place on the island of Oahu. Though anyone can play, the main audience is Hawaii residents. In addition to the computer game, the HSDH will also host dialogues on vaccine allocation and a live TV panel.
[Apr 12 ARGNet story]

[Kathy in FL]

http://www.bloomberg.com/apps/news?pid= ... mwbqDeHpvE

Egypt Seeks UN Bird-Flu Probe After Non-Fatal Cases (Update1)
by Jason Gale

April 13 (Bloomberg) -- Egypt asked the World Health Organization to help investigate an outbreak of bird flu after a dozen non-fatal cases of the disease this year prompted speculation the virus may be becoming less virulent.

Two WHO doctors and a scientist will travel to Cairo later this week at the request of Egypt’s Ministry of Health, said Gregory Hartl, a spokesman for the United Nations agency in Geneva, in an interview today. The UN team will assist local authorities identify how the patients were infected with the H5N1 strain of avian influenza and whether there have been any significant changes in disease patterns or in the virus itself.

Scientists have been following H5N1 for more than a decade because of concern it could spark a pandemic if it becomes as infectious for humans as it is for poultry. A less lethal strain could be more contagious because people would have longer to transmit it through coughing and sneezing. None of the 12 Egyptian cases reported to the WHO this year has been fatal.

“These data do indeed suggest that there may have been a reduction in the virulence of the outbreak strain, and there is a perceived risk of progression of the virus to a less virulent but more transmissible form,” the International Society for Infectious Diseases said today in an e-mail via its ProMED-mail program.

The survival of H5N1 patients in Egypt also may reflect early treatment with antiviral medicines, ProMED said.

At least 417 people in 15 countries have contracted the virus since 2003. Three of every five cases worldwide were fatal. Most cases were caused by contact with infected poultry, such as children playing with them or adults butchering them or plucking feathers, according to WHO.

FAO Assistance

H5N1 is continuing to circulate in poultry in Egypt, though there is no evidence so far of any significant changes in the virus, said Joseph Domenech, chief veterinary officer with the Food and Agriculture Organization. The Rome-based UN agency has also agreed to a request by Egypt’s government to provide technical assistance, Domenech said in an interview today.

Egypt has the highest number of avian-flu cases outside Asia, with 63 cases reported to WHO since 2006 of which 23 were fatal. In comparison, more than 80 percent of the 141 people reported to have been infected in Indonesia died.

Roche Holding AG says its Tamiflu antiviral medicine can reduce the severity and duration of flu symptoms if taken within 48 hours of the onset of disease. Early treatment for H5N1 may improve survival, some uncontrolled studies have shown.

[Kathy in FL]

From http://www.cidrap.umn.edu/cidrap/conten ... 9scan.html

H5N1 strikes another Egyptian child
Egypt's health ministry said yesterday that a 6-year-old boy from Qalyubiya governorate, just north of Cairo, is hospitalized in critical condition and on a ventilator with an H5N1 avian influenza infection, Egypt-based Strengthening Avian Influenza Detection and Response (SAIDR) reported yesterday. He got sick on Mar 22, was hospitalized on Mar 28, and received oseltamivir (Tamiflu) on Apr 3. The report did not say if the boy had been exposed to sick or dead poultry. If the World Health Organization (WHO) confirms the boy's case, he will be listed as Egypt's 63rd H5N1 case-patient, of which 23 have died of their infections.
[Apr 5 SAIDR report]



Kentucky and Germany report H7 at poultry farms
Agriculture officials in Kentucky announced on Apr 3 that they were investigating a suspected low-pathogenic avian influenza outbreak at a broiler/breeder farm in the western part of the state. The farm processes hatching eggs for Perdue Farms, Inc., which in mid March noted a drop in egg production and found that the birds had antibodies for avian influenza. Testing by the National Veterinary Services Laboratory (NVSL) in Ames, Iowa, found evidence suggesting exposure to an H7 virus, and further tests confirmed the finding. Perdue plans to cull 20,000 chickens from two of the farms' barns, and state agriculture officials are conducting surveillance within a 2-mile radius of the farm. Elsewhere, animal health officials in Germany will cull 17,000 turkeys at a commercial farm in Kleve district in the western part of the country near the border with Holland after a low-pathogenic H7 virus was detected in preliminary tests, according to a translation of a German media report that appeared on ProMed mail, the Internet-based reporting system of the International Society for Infectious Diseases. The samples are undergoing further testing at the Friedrich Loeffler Institute on the Isle of Riems.
[Apr 3 Kentucky Department of Agriculture press release]
[Apr 3 ProMed mail post]



Japanese researchers find raccoons had H5N1 exposure
Japanese researchers said today that they have detected H5N1 avian influenza antibodies in 10 wild raccoons, the first such finding in the country's mammals, the Daily Yomiuri reported today. They presented their findings at a conference of the Japanese Society of Veterinary Science and warned that infected raccoons could spread the virus to chicken farms. They based their findings on blood from 998 raccoons that were collected since 2005 from three locations in western Japan and one site in the eastern part of the country. They said that the 10 raccoons that showed H5N1 antibodies were probably infected by eating the carcasses of sick birds or inheriting the antibody from a parent. In December 2008, US researchers reported in Emerging Infectious Diseases (EID) that they found antibodies to a variety of influenza subtypes in raccoons. When they experimentally infected the raccoons, they found that the animals can become infected with avian and human influenza A viruses, shed and transmit the virus to other animals, and seroconvert. Raccoons have avian- and human-type cellular receptors, which could make the animals a mixing vessel for creating novel flu strains.
[Apr 7 Daily Yomiuri story]
[Dec 2008 EID report]



Malaysia conducts pandemic containment exercise
Malaysia's health ministry today began a 2-day exercise to test the country's ability to respond quickly to the early signs of an influenza pandemic, according a report from Bernama, the national news agency. Today officials from the health ministry and the WHO primarily were testing decision-making processes, said Dr. Mohd Ismail. Tomorrow's plans call for a table-top exercise to test the government's operational capacity to implement rapid containment measures.
[Apr 6 Bernama report]

[Kathy in FL]

There's more, like the above posts but that will at least get you back to the first week of April. News carriers like Yahoo and AOL don't always feature those stories. CIDRAP puts them out, but you have to go looking for them. AP, Reuters, etc. do as well but they don't always get picked up ... you just kinda have to be a newshound to find them.

[TC]

Egyptian boy dies of bird flu - MENA

CAIRO, April 21 (Reuters) - A six-year-old Egyptian boy has died of the H5N1 bird flu virus, the 24th human fatality of the disease in Egypt, state news agency MENA said on Tuesday.

Ali Mohamed Ali Somaa from Qalyubia died of respiratory failure, Egypt's first bird flu fatality of 2009, MENA quoted a health ministry spokesman as saying.

The spokesman also said a 4-year-old boy from Sohag province had contracted bird flu and was in hospital. (Writing by Aziz El-Kaissouni; Editing by Charles Dick)

[Emberfox]

Just when I had thought about having chickens

[TC]

Looks like the lady died...

Egyptian woman dies of bird flu - MENA

CAIRO, April 24 (Reuters) - A 33-year-old Egyptian woman has died of the H5N1 bird flu virus, the 26th human fatality of the disease in Egypt, state news agency MENA said on Friday.

The woman, Saadiya Mohamed Abdel Latief Hamed, died in Kafr El-Sheikh province, according to MENA, the third bird flu fatality in a week in the Arab world's most populous country.

By the way, if you go to the Reuters AlertNet page, you can set up an email alert for various things. I have one set up to receive important information about Bird Flu across the world. Just thought it might be something readers of this thread might find handy when trying to stay up to speed on this.

[propdoc]

By the way, if you go to the Reuters AlertNet page, you can set up an email alert for various things. I have one set up to receive important information about Bird Flu across the world. Just thought it might be something readers of this thread might find handy when trying to stay up to speed on this.

Tried that but seems they only allow members of certain NGOs to register. Do you have a link? I went to http://www.alertnet.org/

[yale]

Hey Moderators, We have 3 threads on this same subject. Can someone merge them? Please?

[TC]

By the way, if you go to the Reuters AlertNet page, you can set up an email alert for various things. I have one set up to receive important information about Bird Flu across the world. Just thought it might be something readers of this thread might find handy when trying to stay up to speed on this.

Tried that but seems they only allow members of certain NGOs to register. Do you have a link? I went to http://www.alertnet.org/

http://mobile.alertnet.org/services/pro ... &service=5

Put your email address in, put yourself down as a student or none of the above or something, then select the frequency of the emails and what you want them to be about. Hope this helps.

Hey Moderators, We have 3 threads on this same subject. Can someone merge them? Please?

Actually this thread is not related to the swine flu threads, so it should be kept separate. So far, there is no connection between H5N1 in Egypt and H1N1 in North America. The other threads are so big that a merge now would create all kinds of continuity problems too, but that's not really up to me to decide.

[yale]

Hey Moderators, We have 3 threads on this same subject. Can someone merge them? Please?

Actually this thread is not related to the swine flu threads, so it should be kept separate. So far, there is no connection between H5N1 in Egypt and H1N1 in North America. The other threads are so big that a merge now would create all kinds of continuity problems too, but that's not really up to me to decide.

TC,
You are correct. Sorry for the mistake. I've been up working all night and all of these pandemic threads are starting to blur my fragile mind.

[TC]

Hey Moderators, We have 3 threads on this same subject. Can someone merge them? Please?

Actually this thread is not related to the swine flu threads, so it should be kept separate. So far, there is no connection between H5N1 in Egypt and H1N1 in North America. The other threads are so big that a merge now would create all kinds of continuity problems too, but that's not really up to me to decide.

TC,
You are correct. Sorry for the mistake. I've been up working all night and all of these pandemic threads are starting to blur my fragile mind.

Hey, don't worry about it. I kinda thought that the threads should be merged to start with. Maybe having them separate will allow people to specifically discuss the situation on different sides of the border, which could help make things a bit easier to follow.

[propdoc]

http://mobile.alertnet.org/services/pro ... &service=5

Put your email address in, put yourself down as a student or none of the above or something, then select the frequency of the emails and what you want them to be about. Hope this helps.

Thanks that worked

[Kathy in FL]

Yeah, the potential for chaos in Mexico City is a lot higher than it is here in the USA right now. And the H1N1 is not a "bird flu." Its a swine flu that happens to have mixed with some avian influenza sequences some where along the way.

Hey Moderators, We have 3 threads on this same subject. Can someone merge them? Please?

Actually this thread is not related to the swine flu threads, so it should be kept separate. So far, there is no connection between H5N1 in Egypt and H1N1 in North America. The other threads are so big that a merge now would create all kinds of continuity problems too, but that's not really up to me to decide.

TC,
You are correct. Sorry for the mistake. I've been up working all night and all of these pandemic threads are starting to blur my fragile mind.

Hey, don't worry about it. I kinda thought that the threads should be merged to start with. Maybe having them separate will allow people to specifically discuss the situation on different sides of the border, which could help make things a bit easier to follow.