In Pakistan, only 1 case from the suspected cluster can be confirmed

So far, NAMRU-3, the official lab were the samples from the suspected cluster in Pakistan were sent, has only been able to confirm one case.

Experts still believe that limited human to human transmission between family members probably occurred and ended in November. Failure to get positives on the rest of the samples from the cluster could be due to either degradation of samples and/or the high sensitivity of the tests used in Pakistan, which may produce false positives.


More from WHO:
http://www.who.int/csr/don/2007_12_27/en/index.html

Two more human cases of H5N1in Egypt,

Only a day after the latest victim's passing, two more human cases were identified in Egypt

"There are two cases today, one in Damietta and one in Menoufia... Today lab results confirmed that they are infected with bird flu," Amr Kandeel, head of communicable disease control at the health ministry, told Reuters.
The two new cases, both of whom are currently receiving treatment in hospital, bring the total number of human bird flu cases in Egypt to 41, Kandeel added.
State news agency MENA said the Menoufia case was 22-year-old Nora Aboul Abbas Mohamed, but gave no details for the second case."

http://www.reuters.com/article/healthNews/idUSL279306320071227

Egyptian Woman Succumbs to H5N1

From: http://www.disasternews.net/news/article.php?articleid=3577

"In Egypt, a 25-year-old woman died Christmas day after being hospitalized on Dec. 21. The woman, from Bany Suwef Governorate, was the first case in Egypt since July, WHO officials said. The source of her exposure was being investigated." According to a Reuters report published yesterday, the woman had had contact with birds thought to be infected.

Egypt has 39 confirmed cases of bird flu, with 16 of them fatal, since 2006.

Vietnamese Boy Dies from H5N1

From: http://news.bbc.co.uk/2/hi/asia-pacific/7160976.stm

"A four-year-old boy has died of bird flu in Vietnam, becoming the country's fifth reported victim of the virus this year, health officials said. The deadly H5N1 virus was found in samples taken from the child. He died after being admitted to the hospital with high fever and pneumonia, state media reported. The child is believed to have eaten chicken before falling sick in the northern province of Son La.
H5N1 has killed 47 people in Vietnam since 2003."

94th H5N1 Death in Indonesia

"A 24-year-old Indonesian woman from West Jakarta has died from avian influenza, putting the total fatalities in the country to 94, the Indonesian Health Ministry said Tuesday.

The woman died on Tuesday morning at Cengkareng Hospital in the capital and both of her laboratory tests showed that she was positively infected by H5N1 virus, said Nyoman Kandun, director of the ministry.

He said that it is not clear whether the woman had historical contact with fowls as investigation is underway.

The woman first showed the symptoms of the disease on Dec. 14, and six days later, she was treated at the hospital, said Kandun."

Full story here: http://news.xinhuanet.com/english/2007-12/25/content_7312656.htm

Retrieved from: http://crofsblogs.typepad.com/h5n1/

WHO suspects limited human to human transmission of H5N1

From Reuters,

"The World Health Organisation (WHO) suspects there has been only limited human-to-human transmission of the H5N1 virus in Pakistan, but international test results are still pending, a top official said on Friday.David Heymann, WHO assistant director-general for health security and environment, also said that no new suspect human bird flu cases had emerged in Pakistan since Dec. 6, signalling there had been no further spread.Global health experts fear that bird flu could mutate into a form that spreads easily from one person to another, triggering a pandemic that could kill millions of people.Pakistan announced last week that 8 people had been infected since late October, including a veterinarian involved in culling whose two brothers died. A WHO team has investigated the outbreak, and international laboratory results on samples taken are now expected at the weekend."The team feels that this could be an instance of close contact human-to-human transmission in a very circumscribed area and non-sustained, just like happened in Indonesia and Thailand," Heymann told a news briefing in Geneva."

http://www.reuters.com/article/americasCrisis/idUSL21458541

A new project focused on community based efforts against AI

There's a new project in town that's sure to benefit us all! See the announcement below and check out this website for more information on community based efforts on AIP: http://www.adpc.net/communityAHI-Asia/

PROJECT ANNOUNCEMENT: STRENGTHENING COMMUNITY-BASED APPROACHES TO MANAGEMENT OF AVIAN AND HUMAN INFLUENZA (AHI) IN ASIA

The AHI-NGO-RC/RC Asia Partnership, comprising the Asian Disaster Preparedness Center (ADPC), CARE, the International Federation of Red Cross and Red Crescent Societies (IFRC) and the International Rescue Committee (IRC) and supported by the Asian Development Bank (ADB) began implementation of the project on ‘Strengthening Community-Based Approaches to Management of Avian and Human Influenza in Asia’ in November 2007.

The Project’s Specific Objectives are to:

• Develop a regional tool-kit for community-based management of AHI from the experiences of organisations working in Asia
• Conduct regional training workshops and study tours to build capacity and share experience of community-based AHI control and prevention in Asia
• Strengthen communication with and coordination of community level organisations in the management of AHI in Asia
• Institutionalise community-based strategies and interventions in the prevention and control of avian and human influenza.

The project seeks to strengthen partnerships between communities, NGOs, governments, UN organisations, the private sector and academic institutions in their efforts to manage AHI. In particular, the project seeks to strengthen the capacities of non-government and community organisations working with communities in managing AHI in the Asian region. It will also increase the capacity of community-based organisations to engage with governments to integrate homegrown solutions into national policies for AHI prevention and control.
Fur further information, please refer to the Project Brief, available at www.adpc.net/communityAHI-Asia/
For questions or further information, please contact ADPC: phe@adpc.net or +66-2 516 5900 (extension 351)

New swine flu virus combined with avian influenza genes

In 2006, two separate groups of pigs at different production facilities in the United States fell ill with an unkown virus. Researchers from the USDA ARS recently released their findings that the virus was a strain of swine flu that had mutated to incorporate avian influenza genes. Both groups of pigs drank from the same watersource - one frequented by waterfowl.

"In the newly isolated swine H2N3, the avian H2 and N3 gene segments mixed with gene segments from common swine influenza viruses. This exchange—and additional mutations—gave the H2N3 viruses the ability to infect swine ... [and] also mice and ferrets."

The avian influenza strain incorporated with this strain of swine flu is not the highly pathogenic H5N1 that's infected poultry, wild birds, and humans in more than 60 countries worldwide.

"These findings provide further evidence that swine have the potential to serve as a “mixing vessel” for influenza viruses carried by birds, pigs and humans. It also supports the need to continue monitoring swine—and livestock workers—for H2-subtype viruses and other influenza strains that might someday threaten swine and human health. "


Full story from USDA Agricultural Research Service: http://www.ars.usda.gov/is/pr/2007/071219.htm

How did H5N1 spread to humans in Pakistan? WHO says it could be a mix

From Reuters -

"The eight suspect human bird flu cases in Pakistan are likely a combination of infections from poultry and limited person to person transmission due to close contact, a top World Health Organisation expert said on Tuesday. Keiji Fukuda, coordinator of WHO's global influenza programme, said while unconfirmed, any human to human spread seemed similar to previous outbreaks in Thailand and Indonesia -- affecting close family members caring for sick loved ones.There was no immediate cause for alarm and the United Nations agency was not raising its level of pandemic alert for the time being, he said, adding it was very reassuring that "we are not seeing large increases in the number of cases"

http://www.reuters.com/article/latestCrisis/idUSL18866730

Meanwhile, CIDRAP is reporting that 30 contacts of the index cases were tested as a precaution and all have tested negative, which is very good news.

http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/dec1807flu.html

Finally, some deeper investigation into possible Human to Human transmission in Indonesia

If you've read the recent cases coming out of Indonesia, you might have noticed a reoccurring theme - people contracting H5N1 while neighborhood poultry all test negative.

Finally someones decided this merits a closer look.

"Indonesia's National Avian Influenza Committee says in the last three to four months there have been four cases where poultry in the victim's neighbourhoods tested negative for the virus.
It says the number is significant enough for investigations to be stepped up to gain a more accurate explanation.

Last year, 20 per cent of confirmed cases in 2006 were inconclusive, meaning there was no direct contact with poultry. This year the figure has increased to 30 per cent."

http://www.radioaustralia.net.au/news/stories/s2122292.htm

A busy day for H5N1 outbreaks

First off, the reported outbreak in Benin has been confirmed by labs in Italy, making it the first H5N1 outbreak ever to strike Benin, though neighboring countries such as Nigeria, Niger, Togo & Burkina Faso have experienced multiple outbreaks.

Saudi Arabia is again culling poultry due to new outbreaks that started on November 12th - 14 outbreaks occurred. Germany identified H5N1 in poultry this weekend.

More info about these outbreaks at CIDRAP: http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/dec1707benin.html

Meanwhile Poland has confirmed it's 7th outbreak in poultry. It's interesting to note that last year H5N1 detection in Europe was more often wild birds and this year we've seen several already in farms

For more on the Poland outbreaks: http://www.reuters.com/article/africaCrisis/idUSL17640074

What's going on in Pakistan?

There's a lot of news coming out of Pakistan right now and it makes for a very confusing story. Here are the basic facts so far:

1. A WHO team is on the ground to investigate possible human to human transmission since there is a cluster of cases involving relatives

2. The clusters appear to be from a small town in northern Pakistan, four brothers and two of their cousins were/are suspected of being infected. Two of the brothers passed away. Two others from the same town, a man and his neice, are also suspected cases.

3. WHO has announced there are 8 suspected cases, but further testing is still needed for confirmation.

4. There are reports that the brothers were involved in chicken culling and/or were studying at a vetrinary school, but the details are still sketchy. Simillarly, there are reports that the man and his neice had also been involved in slaughtering poultry

5. There was a relative from the U.S. that attended one of the funerals and, when he returned home, voluntarily reported to a doctor and quarantined himself. CDC reported that he tested negative (100% sure)

Pakistan to United States: Human to Human H5N1 transmission?

In Pakistan Friday, "Health officials ... were investigating a possible human-to-human transmission of bird flu among four brothers in north-west Pakistan, two of whom later died."

A poultry farmer in Manshera, North-West Frontier Province was confirmed to have contracted H5N1. That man survived the virus, but now officials fear he may have infected three of his brothers. None of his brothers had ever been to the farm nor were they believed to have been in close contact with sick birds, Pakistan's Health Minister, Khushnood Akhtar, told the press.

"Two of the brothers died from pneumonia-like symptoms but were buried by family members before health officials could take blood samples to test for the virus."

The third brother, living in the United States, was visiting the area at the time and tested positive for bird flu. "He survived and has since returned to the US," the Minister said. The ministry does not have any further information about where in the US the third brother lives.

Pakistan's Ministry of Health has called for an investigation into the matter by the WHO, which has not commented on the case.

Full Story: http://www.earthtimes.org/articles/show/158727.html

New H5N1 outbreaks in Poland, Vietnam, Saudi Arabia & Russia

The winter season has begun and with it, increases in the daily reports of outbreaks around the world.

http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/dec1207avian.html

Poland has discovered both more wild birds infected and experienced outbreaks on farms

http://www.polskieradio.pl/thenews/human-interest/?id=71537

Vietnam is still battling outbreaks in the duck population, this time in Bac Giang Province
http://news.xinhuanet.com/english/2007-12/12/content_7234358.htm

Indonesia confirms 115th human case

Yet another case from Tangerang, a satellite city of Jakarta


"Jakarta (ANTARA News) - A 47-year-old man from the outskirts of the Indonesian capital has been confirmed as the 115th person to be infected with bird flu, the health ministry said Wednesday.The man is being treated in a Jakarta hospital for the deadly disease, which has claimed 92 lives in Indonesia.Two laboratory tests on the man showed that he was infected with the highly pathogenic virus, a statement from the ministry's bird flu information centre was quoted by AFP as saying.Two positive results of tests on blood and tissue samples from a victim are needed before Indonesian authorities can confirm a bird flu infection.The man, who is from the satellite city of Tangerang, was first admitted to a private hospital there on December 5, three days after he began to feel ill.He was referred to the Jakarta hospital on December 10.The ministry statement said it had not confirmed if the man had any contact with infected poultry."

http://www.antara.co.id/en/arc/2007/12/12/indonesia-confirms-115th-human-bird-flu-infection/

92nd Death Confirmed in Indonesia

A young woman in Tangerang died from H5N1 infection, bringing the nation's deaths from the virus to 92. Currently, the source of infection in unkown, though the government is testing poultry near the woman's home. Also, the woman worked as a plant seller and could have come in contact with the virus through contaminated fertilizer (though at this point possible sources of infection are speculation only).


"A 28-year-old mother has died of bird flu at a Jakarta hospital, bringing the total death toll from the disease to 92 in Indonesia, the local press said Tuesday.
The woman, a mother of two in the Jakarta suburb of Tangerang, died during treatment at the Persahabatan Hospital early on Monday, reported major national newspaper Kompas.
Her relatives said she had suffered respiratory problems, high fever and severe pneumonia since last week.
When she was admitted to the hospital, her conditions were already at worst.
"Test results by the Health Ministry's research and development center confirms that (she) is positive of having H5N1 virus," I Nyoman Kandun, a senior official with the ministry, told the newspaper."



http://news.xinhuanet.com/english/2007-12/11/content_7229757.htm

Eggs from H5N1 affected farms went on sale in Poland

Even European countries have difficulties in protecting the food supply during an outbreak, as we've seen several times...

"40,000 eggs from the H5N1-infected farms in Zuromin have been discovered on sale in groceries of Warmia and Mazury, north-east Poland.
2,500 were sold on Sunday, whereas 5,000 were withdrawn from sale.
A list of the shops where the eggs were available has been posted on the website of Sanepid, State Sanitary Inspectorate.
Since yesterday Sanepid has also been monitoring the shops where H5N1-infected eggs may be available."

http://www.polskieradio.pl/thenews/news/?id=71473

Suspected H5N1 Outbreak in Benin

Two suspected H5N1 outbreaks were discovered late last night in Adjarra, about nine miles north of the capital Porto Novo, and on a farm in the commercial capital Cotonou of the West African country Benin. Several dead birds tested positive for H5N1, but the reports have yet to be confirmed by further testing. Samples have been sent to Italy; however, health officials are convinced that "these (bird) deaths are due to the H5N1 strain of bird flu." Several hundred birds have been culled as a result of the findings. In addition, farms in a 5 mile radius have been cleaned and disinfected and the import of poultry has been banned.
Full story: http://africa.reuters.com/wire/news/usnL07605997.html

Foreign donors pledge $406 million to combat H5N1

"Foreign donors have pledged $406 million in additional funds for efforts to combat bird flu, but another $800 million is still needed and countries still need to be better prepared for any pandemic, officials said on Thursday.

The funds were pledged on the final day of a three-day summit in New Delhi, India, of experts on avian influenza from across the world, aimed at coordinating strategies to combat the disease.

Last year at a similar meeting around $475 million was pledged by donors, but experts played down the apparent shortfall in funding, saying they were confident further funds would be forthcoming.

The United States, the largest donor in the fight against bird flu, raised its pledge to $629 million, an additional $195 million in funding."

Full story: http://in.reuters.com/article/health/idINDEL16049420071206

H5N1 death in mainland China: What was the source?

"A 24-year-old man, who had no known contact with infected or dead poultry, died from avian flu on Sunday."

Mainland ministry of health officials are trying to piece together what exposure he may have had to the virus. Sixty-nine of his contacts in the days leading up to his death are being closely monitored. None have shown signs of H5N1 symptoms. Officials are cautioning people not to jump to conclusions and that there is no current evidence to point to human-to-human transmission.

Questions have been raised, particulalry by virologist Julian Tang Wei-tze, about the man's contact history with poultry, noting that it may have simply been incomplete.

Full Story: http://www.thestandard.com.hk/news_detail.asp?we_cat=4&art_id=58026&sid=16579988&con_type=1&d_str=20071204&fc=2

H5N1 on a farm in central Poland

Two poultry farms in central Poland were confirmed to have outbreasks of H5N1 among their flocks, prompting the culling of over 10,000 turkeys.

Though Polish authorities noted that there is no need to expand the so-called "danger zones" surrounding the two farms, other countries fear the virus may be spreading.

Ukraine, China, and most EU countries have banned Polish poultry imports.

Full Story: http://www.polskieradio.pl/thenews/human-interest/?id=70967

H5N1 outbreak in Romania

"Romania became the seventh country in Europe reporting avian influenza outbreaks this year, a month after a United Nations agency said the lethal H5N1 strain may be more prevalent in the region than previously thought.

The H5N1 virus killed 31 poultry on a farm in eastern Romania two days ago, the national veterinary and food safety authority in Bucharest said in a report yesterday to the World Organization for Animal Health. An additional 49 birds were destroyed to control the outbreak on the farm in Tulcea, near the border with Ukraine, the report said.

The source of infection can't yet be confirmed, Stefan Nicolae, the authority's director general, said in the report. The most recent of Romania's previous 162 avian influenza outbreaks ended in July 2006.

The Czech Republic, France, Germany, Hungary, Russia and the U.K. are the other European countries that have reported new outbreaks this year, according to the Paris-based World Organization for Animal Health."

Full story here: http://www.bloomberg.com/apps/news?pid=20601102&sid=af7KisIy0YxA&refer=uk

Poultry dying en masse in Vietnam not H5N1

More than 50,000 chickens have died in southern Vietnam's Tien Giang province, but not from H5N1. The highly pathogenic avian influenza virus has been ruled out, though the cause has not been definitively determined.

Officials think the birds are dying of Marek's disease, for which there is no cure.

"The disease’s spread (is linked to) unhygienic conditions and cramped space where the fowls are raised. Recently, chicken prices have been rising, prompting locals to cramp more and more chickens into small quarters for better profit, which inadvertently worsened the situation," said Le Minh Khanh, deputy head of the province’s Animal Health Department.

Full story via H5N1 blog: http://english.vietnamnet.vn/social/2007/11/756691/

Indonesian minister witholding specimens from WHO

Indonesia's health minister said over the weekend that the World Health Organization would not receive bird flu specimens from Indonesia unless assurances were given to poorer nations that any pandemic vaccines would be affordable for them.

"Siti Fadilah Supari made the comments on her return from Geneva, where the WHO held an intergovernmental conference aimed at rebuilding a global system for sharing flu viruses following a months-long standoff with Indonesia.

'The meeting failed to come up with a material of transfer agreement,' she told reporters in the city of Bandung.

'So we have no obligation to send bird flu virus samples to the World Health Organization.'"

Full Story via H5N1 blog: http://www.crofsblogs.typepad.com/h5n1/

H5N1 detected at poultry farm in Saudi Arabia

"The lethal H5N1 strain of bird flu has been detected at a poultry farm in Saudi Arabia and 50,000 birds have been culled, the agriculture ministry said.
It said tests were carried out after 1,500 birds died in a farm of the Al-Kharj region, 150 kilometres south of Riyadh.
All the birds on the farm were subsequently culled and the area disinfected, with measures taken to ensure other farms in the area were not affected, the ministry said in a statement carried by the official SPA news agency.
It said no human case has been found and an investigation was taking place to determine the origin of the illness.
The kingdom banned all live poultry imports after bird flu was last detected in Saudi Arabia in March.
In April, neighbouring Kuwait culled 1.7 million birds after the strain was found, but there no reports of human cases."

Story from: http://abc.net.au/news/stories/2007/11/15/2091242.htm?section=justin

UK Outbreak: H5N1 Confirmed

The British government and the EU confirmed that sick poultry on a Suffolk farm is infected with the H5N1 strain, one similar to strains found in Germany and the Czech Republic this past summer. The similarities suggest that wild birds may be the source of this strain. It is early for bird migration and there have been no reports of sick or dying wild birds in the area, raising questions as to the true source.

There are many poultry farms and a high density of poultry in the area, and officials fear the virus may have spread and that there may be resistance to disclosure of sick birds. Thousands of turkeys are being culled this week and officials have set up a 3km protection area and a 10km surveillance area to prevent further spread of the disease. Trade restrictions have also been imposed to ensure no infected poultry are shipped within or outside the area.

Responding to farmers' concerns Fred Landeg, the chief veterinary officer, said: "Outside of the restricted zone poultry farms will be able to trade freely within Europe. Within the restricted zone there is a complex series of measures which will allow some trade to continue under certain conditions."

This is the fourth H5N1 outbreak among poultry in the UK this year.

Full Story: http://www.reuters.com/article/healthNews/idUSBRU00612320071113;
http://www.guardian.co.uk/birdflu/story/0,,2210303,00.html

New vaccine trial ready

"Researchers from the National Institutes of Health and University of Maryland report that a new vaccine that protects monkeys against the avian influenza virus is now a candidate for clinical trial in humans. The rate of transmission of the highly pathogenic avian influenza virus (HPAIV) from birds to humans is rapidly increasing.
In the study researchers developed a live vaccine incorporating the avian Newcastle disease virus (NDV), which expresses a common gene found in the H5N1 avian influenza virus, and tested it in African monkeys. The vaccine was administered both intranasally and through the respiratory tract in two doses with a 28-day interval in between.
Response after one dose showed low amounts of virus shedding indicating protection. Following two doses, high levels of neutralizing antibodies were present in all immunized monkeys. A substantial response to either dosage was noted in the respiratory tract indicating a likely reduction in transmission in the event of an outbreak.
'In this study, we have developed a vaccine candidate, NDV-HA, for immunization against H5N1 HPAIV and have tested it in a nonhuman primate model,' say the researchers. 'The vaccine was well tolerated and induced substantial local and systemic immune responses, demonstrating that NDV has potential as a live virus candidate vaccine against HPAIV.'"

Full article here: http://www.sciencedaily.com/releases/2007/11/071108180449.htm

H5N1 kills 590 ducks in northern Vietnam

From Reuters: Bird flu kills 590 ducks in northern Vietnam. Excerpt:
"Bird flu has killed 590 ducks in a northern Vietnam province, the fifth to have reported outbreaks among poultry within about a month, the government said on Wednesday.
The two-month-old ducks started dying on Monday at a farm in Ha Nam province.
Tests confirmed on Wednesday the presence of the H5N1 bird flu virus, the Animal Health Department said in its daily report.
Further tests also found the H5N1 virus in samples taken from two dead chickens dumped in a river in Ha Nam province, 60 km (37 miles) south of Hanoi, the report said. The case in Ha Nam brought to five the number of provinces that have confirmed bird flu in poultry since early October. Three of the provinces are in the north, one is in the southern Mekong delta, while the fifth is in the central province of Quang Tri.
Floods that affected Quang Tri in the past two weeks could help spread the virus to nearby areas, an Agriculture Ministry official said.
No human infections have been reported in Vietnam since the virus killed a teenager in early August, one of four deaths among seven Vietnamese known to have been infected this year. Since 2003, bird flu has killed 46 people in Vietnam."

90th death in Indonesia

"An Indonesian woman has died of bird flu, taking the country's death toll from the disease to 90, an official at the health ministry's bird flu centre said on Monday.
Suharda Ningrum said it was not yet clear whether the 30-year-old victim had been in contact with sick fowl, but chickens belonging to a neighbor had died suddenly. The woman lived in Tangerang, west of the capital Jakarta.

Indonesia, which has now had 112 confirmed cases of the disease in humans, has suffered more fatalities than any other country."

Full story at Reuters: http://uk.reuters.com/article/healthNews/idUKJAK23047320071105?rpc=401&

Outbreak in Bangladesh

"Bangladesh culled some 6,000 chickens after bird flu infected three more farms in the northern part of the country, officials said on Friday.
'The chickens were buried over the last two days after H5N1 virus was detected at three farms in Dinajpur, Jaipurhat and Lalmonirhat districts,' an official of the livestock department said.
Bird flu was first detected near the capital in March and has since spread, mostly to northern districts.
Nineteen out of Bangladesh's 64 districts have been affected by the virus, forcing authorities to cull 268,000 chickens and destroy nearly three million eggs."

From: http://crofsblogs.typepad.com/h5n1/2007/week44/index.html

H5N1 in Pakistan

"Over 45 thousands chicks were burnt and buried by Buttle Ehtsham Breeder Farm after having confirmed that they were suffering from Bird Flu, The Post learned here on Thursday.
According to details, on October 26, the Ehtsham poultry farm got a report about the spread of Bird Flu, the Livestock Director Mansehra Ali Akbar Khan sent the samples to Islamabad for testing.
Later after receiving positive reports, over 45 thousands chicks were burnt and buried so that the virus might not affect other poultry farms. The farm manager informed the media people about the loss and said that if the poultry farms owners do not take proper measures, the virus can cause huge losses."

From: http://crofsblogs.typepad.com/h5n1/2007/week44/index.html

Adjuvants: Concerns temper the promise of the vaccine technology

In recent months, two major vaccine manufacturing power-houses (GSK and Sanofi-Pasteur) have announced results of clinical trials of pre-pandemic H5N1 vaccine using adjuvant, an antigen-sparing technology that may exponentially increase the manufacturing capacity of vaccine - particularly critical in a pandemic situation. In light of use of adjuvants, the WHO ramped up its forecast of available vaccine courses from a few hundred million to 4.5 billion (2 billion short of the projected global need, assuming mechanisms are in place to distribute the vaccine to everyone).

"(Adjuvants are chemicals that are incorporated in some vaccines to improve response to the vaccines' active ingredient. Adjuvants make it possible to reduce the dose of antigen in a vaccine without dampening the immune response.)"

Adjuvant presents obstacles though - some immunologic and others regulatory. The tradeoff of a possibly less safe vaccine may be acceptable in a pandemic - and regulatory hurdles (a particular problem in the US) are likely to be bypassed or sped up in a pandemic. Even so, concern remains.

"While adjuvants hold the greatest promise for dose-sparing, they also provoke trepidation because they are by definition immune-system activators. While many have been tested over the years, few have entered the market, because they proved too reactogenic to be acceptable to consumers or safe. Only one set of adjuvants, aluminum salts or alum (aluminum hydroxide, aluminum phosphate, and potassium aluminum sulfate), is licensed in the United States. Aluminum adjuvants and MF59, an oil-in-water emulsion that contains squalene (an oil found in some fish oils), are licensed in Europe."

"I have heard a lot of people say they expect problems with adjuvanted vaccines," said Hedwig Kresse, an associate analyst for infectious diseases with the British-based market analysts Datamonitor. "It is a technology that definitely has some potential, but there are a lot of issues that need to be addressed first".

Full story: http://www.cidrap.umn.edu/cidrap/content/influenza/panflu/news/oct3007panvax4.html

Pandemic hysteria leads to overstocking of Tamiflu

During the height of hysteria about the possibility of a pandemic flu, New Zealanders began placing orders en masse for the best known defense against a possible pandemic: Tamiflu. Many other nations experienced similar reactions.

"Between 12 and 18 months ago, people had rushed to place orders for Tamiflu, saying they would wait up to six months for the drug to arrive. However, interest in bird flu seems to have waned "

Now, many pharmacy shelves are overstocked with the drug, as many of those rushing to place orders last year no longer want it.

"Pharmacy Guild of New Zealand president Steve Wise said ironically about a year ago you could not get Tamiflu "for love nor money", but there was now a surplus."

New Zealand doesn't expect to be able to exhaust its current stocks through treatment of seasonal flu. The current stocks expire in 2010, and the over-purchasing of the drug has raised concerns that much of the stocks will simply go to waste.

Full story: http://www.stuff.co.nz/4253690a11.html

Indonesian Boy Tests Positive for H5N1

A three-year-old Indonesian boy has tested positive for H5N1. The boy is from the same neighborhood in Tangerang, a city west of the capital of Jakarta, as the five-year-old girl who died of bird flu last week. Her death was the 89th fatality in Indonesia due to the virus. Fortunately, the boy has only experienced mild flu symptoms and is receiving treatment at Sulianti Saroso hospital in Jakarta.

"Indonesia, which has now had 111 confirmed cases of the disease in humans, has suffered more fatalities than any other country.
Excluding the latest case, there have been 204 deaths and 332 cases globally since 2003, according to World Health Organization data. "

Story from Reuters AlertNet: http://www.alertnet.org/thenews/newsdesk/JAK14415.htm

Burmese junta bans news on H5N1

Censorship boards of the Burmese junta have banned news broadcasts within the nation regarding a new outbreak of H5N1 in Burma, an outbreak confirmed by journalists on October 20.

"The latest H5N1 bird flu outbreak was reported to the OIE-World Organization for Animals on October 24 by the regime's Livestock Breeding and Veterinary Department, according to the OIE Web site. The Burmese report sent to the OIE said the bird flu outbreak killed 400 chickens and ducks. The authorities reportedly killed 33,459 fowl to try to contain the virus."

This is the first reported outbreak among foul since July.

Full story: http://www.irrawaddy.org/article.php?art_id=9138

Another Outbreak in Vietnam

More than 290 ducks were found dead at a small farm in the central province of Quang Tri, Vietnam that tested positive for H5N1. The dead ducks were part of a flock of 600 5-day-old ducklings that had not been vaccinated. The rest of the flock was culled to prevent further spread of the disease, the farm was disinfected, a ban has been placed on poultry transport from the farm, and poultry at neighboring farms have been vaccinated. Earlier in October there was an outbreak reported in the Mekong Delta province of Tra Vinh which was the first in Vietnam in more than two months.

"Vietnam's aggressive poultry vaccination program has been seen as key to controlling the disease in birds and deny it opportunity to jump to humans.
So far this year, Vietnam has vaccinated 62.6 million birds, including 39.4 million ducks and 23.2 million ducks."

http://www.bangkokpost.com/breaking_news/breakingnews.php?id=122965

H5N1 may become endemic in parts of Europe

After German scientists discovered the H5N1 virus in dead domestic ducks, experts are recommending that Europe prepare for future outbreaks of avian influenza. If it persists in wild waterfowl throughout the year, Europe could become the third continent where the H5N1 strain is endemic. "It could well be that there is more virus circulation in Europe than currently assumed," said Food and Agriculture Organization (FAO) senior animal health officer Jan Slingenbergh.

"FAO veterinary experts said they were particularly concerned about the Black Sea area where a high concentration of chickens, ducks and geese is comparable with virus-entrenched Asia.
Experts urged the European countries to boost their H5N1 monitoring and surveillance schemes in all regions with big duck and geese production."

"We are not saying that the virus is widely spread in European countries, in fact most of the countries are currently virus-free. But undetected localised virus spots in countries with significant waterfowl may pose a continuous risk."

Full story at: http://uk.reuters.com/article/topNews/idUKL2510016520071025

89th Death in Indonesia

The Ministry of Health has reported the 89th death in Indonesia, a four year old girl from Tangerang.

http://www.depkes.go.id/en/2410an.htm

Reuters reports that poultry had died in the girl's neighborhood a week before -

"The four-year-old girl died on Monday after being admitted to hospital two days earlier, health ministry spokeswoman Lili Sulistyowati said by telephone. The girl, who had been suffering from fever, died after being transferred to Persahabatan hospital in Jakarta.

Officials were still investigating the case, but four chickens had previously died in the girl's neighbourhood, another official at the ministry's bird flu centre said.

Contact with sick fowl is the most common way for humans to contract the deadly H5N1 strain of the virus.

Bird flu is endemic in bird populations in most parts of Indonesia, where millions of backyard chickens live in close proximity with humans.

Indonesia, which has now had 110 confirmed cases of the disease in humans, has suffered more fatalities than any other country."

http://www.alertnet.org/thenews/newsdesk/L23739948.htm

Good News on Pandemic Flu Vaccine?

Massive investments in vaccine manufacturing capacity and innovative vaccine technologies have paid off, says the WHO. Now the world's capacity to manufacture vaccine in the event of a pandemic is far greater than predicted last year.

"Last spring, the World Health Organization (WHO) and vaccine manufacturers said that about 100 million courses of pandemic influenza vaccine based on the H5N1 avian influenza strain could be produced immediately with standard technology. Experts now anticipate that global production capacity will rise to 4.5 billion pandemic immunization courses per year in 2010."

Even with this heartening advance, this is still 2 billion courses short of what would be needed in the first 6 months for the world.

From WHO: http://www.who.int/mediacentre/news/releases/2007/pr60/en/index.html

The new Communications Initiative Website

The Communications Initiative has recently updated and revamped their websites so they are more user friendly. Their avian influenza website is fantastic! I would definitely bookmark and visit often. It has great tools and information about AI & Pan flu work around the world. You can also sign up to receive their AI updates.

http://www.comminit.com/en/avianinfluenza.html

In the event of a pandemic, who will be first priority for a vaccine?

The International Herald Tribune posted this story on the US plan for vaccinations during a pandemic.

"Pregnant women, babies and toddlers would join doctors, emergency workers and soldiers at the head of the line for scarce vaccine if a super-strain of flu triggers the next pandemic, says a draft U.S. government plan to be released Tuesday.

Once more vaccine is brewed, older children along with workers who keep the electricity, water and phones running could be next to roll up their sleeves.At the end of the line: The elderly and healthy younger adults.

It is a priority list quite different from the usual winter pleas for older Americans to get vaccinated against regular flu. And it reflects growing agreement that curbing a super-flu would require protecting workers who care for the sick and maintain crucial services — plus targeting the people most likely to spread flu, not just die from it.

"Children are not only highly susceptible to influenza, children are also very good at spreading it," said William Raub, emergency planning chief at the Department of Health and Human Services. "Protecting them also protects those in the population."

http://www.iht.com/articles/ap/2007/10/22/america/NA-GEN-US-Pandemic-Vaccine.php

Vietnamese government to communities: Vaccinate and remain alert

Vietnam's director of the ministry’s Animal Health Department, Bui Quang Anh, said today that another H5N1 outbreak among poultry is likely and that, together, diligence, vaccination , and keeping smuggled poultry from entering the country are key to preventing future outbreaks.

After the government provided 90 million doses of vaccine for poultry to communities, half of 64 targeted cities have completed vaccination - ahead of schedule. However, in localities slow to vaccinate and prepare for H5N1, there have been more outbreaks.

"We have learned that in the areas where local authorities have carefully guided people to prevent outbreaks and given timely financial support, the outbreaks have been better controlled," Anh said.

The ministry has asked that for reprimands of "chairmen of provincial people’s committees who have not carried out vaccination programmes, causing the return of bird flu."

In addition, authorities plan to relocate poultry and egg hatcheries to areas "outside city limits, away from residential areas, universities, schools, hospitals, markets, offices and public areas" to reduce the risk of further spread and transmission to humans. It is not clear how the government plans to implement this policy.

Full story: http://vietnamnews.vnagency.com.vn/showarticle.php?num=03AGR191007

Indonesia's reported 89th H5N1 death NOT H5N1, says Minister of Health

A young girl, testing positive for H5N1 after an initial test, was said to be Indonesia's 89th human death from H5N1. However, after a second test was performed, the Ministry of Health is now reporting that she did not die of H5N1, though they have not reported an alternate cause of death.

"The 10-year-old was admitted to hospital on Saturday suffering symptoms that led doctors to suspect she could be carrying the H5N1 virus ..."

If the ministry result is positive, a second test is carried out at a separate laboratory before a patient is confirmed as infected with bird flu in Indonesia.

The young girl's aunt, who presented with similar symptoms, also died over the weekend.

Full story, via H5N1 blog: http://news.yahoo.com/s/afp/20071022/hl_afp/healthfluindonesia_071022161333;_ylt=A9G_Rz3P0hxHFEcBjiWTvyIi

Demand for animal products will increase the need for food safety

As the population of the world continues to expand by about 78 million people per year, the demand for animal products will also increase. With this increase comes the necessity for ensuring the safety of our food resources.
"The growing population will increase the demand for animal products coming from developing countries" said Francois Le Gall, of the World Bank. Le Gall also agrees with Bernard Vallat, the director of the World Organization for Animal Health, that only 40 out of 200 countries could respond to a health crisis that originates from animal disease."
For instance, to date, avian influenza has forced the culling of about 100 million birds in Asia, especially in Vietnam. Other problems include farmers embracing antibiotics a little too fully, and causing antibiotic resistance in their livestock.
Anni McLeod of the UN Food and Agriculture Organization (FAO) says "more genetic diversity may be needed in the future. In poultry, for example, there are about three or four companies that control most of the poultry breeds in the world. If nothing is done to prevent diseases in livestock for human consumption the world could face a major crisis in the next 10 years."
In order to meet this coming challenge, international organizations are working together on several fronts of the issue such as "food safety, veterinarian services, packing, and transportation."

Click here to view the full story: http://www.flulab.com/overview.php?a=2007-10-16-fl54

Summit on Business Preparedness for Pandemic Influenza

This speech, given by WHO Director-General Margaret Chan, was delivered February 5, 2007 at CIDRAP's Summit on Business Preparedness for Pandemic Influenza in Orlando, FL. It remains an up-to-date statement which addresses two main issues: "the assessment of threat as perceived by staff and experts at WHO, and a description of what might occur during the first influenza pandemic of the 21st century."
In assessing the pandemic, the Director-General said "H5N1 has been circulating in poultry in Asia since at least mid-2003. It has caused the largest outbreaks in birds and the highest number of human cases on record for any avian influenza virus. Over the years the virus has lost none of its persistence in nature and non of its virulence for humans. Experts concluded that the threat is not likely to diminish in the near future and that the virus has evolved in alarming ways in domestic poultry, migratory birds, and humans in the past four years. Also, H5N1 survives longer in the environment and at higher temperatures, and are more lethal to chickens. Yet another alarming development is that we've lost one of our warning signs to the virus. Domestic ducks can now become infected and excrete large quantities of lethal virus, yet show no signs of illness. "
In her description of what we might expect to see during a pandemic, Dr. Chan said the following: "all countries will be affected, international spread will be rapid, widespread illness will occur, excess mortality will occur, medical supplies will be inadequate, hospital capacity will be inadequate, and economic and social disruption will occur."

For the full presentation, please visit: https://umconnect.umn.edu/chan/

Updated guidelines from WHO

WHO has recently updated their guidelines for containing an outbreak in the initial stages of a pandemic

"Changes to this version of the protocolThis document replaces previous versions of the protocol. In brief, key changes include:

• More emphasis on rapid containment and less on rapid response which is covered in WHO guidelines for invetigation of human cases of avian influenza A(H5N1) published in 2007.
• An expanded discussion of the decision-making process.
• Refinement of the containment strategy emphasizing the localized geographical approach and describing the key activities for Containment and Buffer Zones.
• A proposed approach for estimating the duration of a containment operation.
• New or updated annexes on ethical issues, non-pharmaceutical interventions, communications and laboratory preparedness.
• Annexes on antiviral stockpile planning and preparedness issues are under revision and and will be added in the near future.

The protocol will be updated and revised as new information becomes available and more detailed guidance and tools are developed."

Updated WHO Interim Protocol: Rapid operations to contain the
initial emergence of pandemic influenza at
http://www.who.int/csr/disease/avian_influenza/guidelines/draftprotocol/en/

12 year old boy dies of H5N1 in Tangerang

The 12 year old boy with H5N1 in Tangerang, a city near Jakarta, passed away this weekend.

"The child, identified as Irfan, was brought to a local midwife on Oct. 3 after suffering from fever for three days, Head of Communicable Disease Control and Prevention Section at the Tangerang District Health Office dr Yuliah Iskandar said on Monday.As his health condition deteriorated, Irfan was later transferred to Tangerang Regional Hospital where he underwent a medical test on Oct. 8, Yuliah said.He was later moved to Persahabatan Hospital in Jakarta on Oct. 9 for further medical treatment as he had tested positive for bird flu based on the result of a laboratory test conducted by the Health Research and Development Agency and the Eijkmann Institute, she said.To anticipate the possible spread of the H5N1 virus in the area, the district health office had sent officers to Ceger village to take samples of the blood of Irfan`s relatives and neighbors, she said.Yuliah said Irfan did not have contact with dead chicken before being infected with the bird flu virus. Neither did his parents raise poultry in their backyard."But there is backyard poultry about 500 meters from the victim`s house," she said."

From Antara News: http://www.antara.co.id/en/arc/2007/10/15/ai-takes-another-life-in-tangerang/

More on how viruses interact with bacteria

Many deaths from influenza are actually caused by secondary bacterial infections. However, the link between influenza viruses and bacteria are not well understood. Researchers at St. Jude's are studying this question, which has public health preparedness implications for stockpiling antibiotics to prevent excess mortality.

"Dr. Jonathan A. McCullers from the Department of Infectious Diseases at St. Jude Children's Research Hospital in Memphis, Tennessee and colleagues examined this interaction by studying a newly discovered influenza A virus (IAV) protein, called PB1-F2. The gene encoding PB1-F2 is present in nearly all IAVs, including highly pathogenic avian IAVs that have infected humans and the IAV associated with the 1918 pandemic. "PB1-F2 was recently shown to enhance viral pathogenicity in a mouse infection model, raising questions about its effects on the secondary bacterial infections associated with high levels of influenza morbidity and mortality," explains Dr. McCullers.

The finding that PB1-F2 promotes lung pathology in primary viral infection and secondary bacterial infection also provides critical information for the future. "Given the importance of IAV as a leading cause of virus-induced morbidity and mortality year in and year out, and its potential to kill tens of millions in the inevitable pandemic that may have its genesis in the viruses currently circulating in southeast Asia, it is imperative to understand the role of PB1-F2 in IAV pathogenicity in humans and animals," says Dr. McCullers. "These findings also reinforce the recent suggestion of the American Society for Microbiology that nations should stockpile antibiotics for the next pandemic, since many of the deaths during this event are likely to be caused by bacterial super-infections."

New human H5N1 case in Indonesia

From Reuters: http://www.alertnet.org/thenews/newsdesk/JAK196146.htm

"A 12-year-old Indonesian boy has tested positive for bird flu, and is being treated in a Jakarta hospital, a health ministry official said on Thursday. The ministry's bird flu centre's Muhammad Nadirin said it was not clear how the boy from Tanggerang city in West Java, contracted the virus, but some chickens had died in his neighbourhood.
The most common way to contract the deadly virus is through sick fowl.

The disease is endemic in the bird population in most parts of Indonesia, where millions of backyard fowl are kept in close proximity to humans and where education campaigns often do not reach remote areas.

Muchtar Ichsan, a doctor at the hospital, said the boy has been taken to an isolated room and was on a respiratory device.

Indonesia has 109 confirmed cases of human bird flu, 87 of them fatal, the highest in the world.
Scientists are concerned the H5N1 virus could mutate into a form that passes easily between humans, triggering a pandemic in which millions could die."

Ghana: No compensation without bio-securiity measures

The Ghanan government announced today at the outset of a three-day workshop on prevention of H5N1 that it would no longer compensate farmers for lost or culled birds due to H5N1 if those farmers did not observe

During the last outbreak, the government compensated farmers for more than 27,000 lost birds without taking preventive measures into account. Since then, the Veterinary Services Directorate has begun training farmers on appropriaite measures to keep their poultry secure.

The workshop and simulation are co-sponsored by the Ghanan government with the Food and Agriculture Oragnisation (FAO) and USAID.

Full story: http://www.accra-mail.com/mailnews.asp?id=2848

Developments in Indonesia

Eight people suspected of being infected with H5N1 in Medan were all declared free of the virus. No new cases have been reported since the death last week of Linda Tismeri.

Tismeri, the 87th confirmed H5N1 death in Indonesia, traveled from her home in rural Riau to Jakarta to visit family after contracting the virus, raising concerns that she may have passed it on to others. The Indonesian government is following up her contacts to ensure there was no spread of the virus.

There is no evidence at this time of any spread.

Full story, via H5N1 blog: http://www.scottmcpherson.net/display/ShowJournal?moduleId=1366394&categoryId=116462

87th H5N1 death in Indonesia

"A 44-year-old woman from Indonesia's Sumatra island has died of bird flu, raising the toll in the nation worst affected by the disease to 87, the health ministry said Monday. Two samples taken from the woman tested positive for the H5N1 virus, the health ministry's bird flu information centre said in a press release."

"The ministry statement said it had not confirmed if the woman had been in contact with infected poultry, the usual method of transmission."

From Channel News Asia: http://www.channelnewsasia.com/stories/afp_asiapacific/view/304443/1/.html

Vietnam: All levels of government must participate in H5N1 prevention

At a seminar in Hanoi on October 5 attended by the Vietnam Ministry of Health and the US Centers for Disease Control and Prevention, the Director of the Preventive Health Department announced that though H5N1 is "temporarily under control", all levels of government - from the commune to the provincial level - must join together to ensure long-term prevention of H5N1 transmission.

The seminar was held to unveil modifications and additions to the government's plan to prevent human transmission of H5N1.

In addition to allowing local communities to take part in the implementation of avian influenza control, the Ministry announced it will establish 15 influenza management offices to monitor surveillance, take samples, and offer guidance and quarantine control to local officials.

Full text available online, via H5N1 blog: http://english.vietnamnet.vn/social/2007/10/748067/

An additional story on the seminar: http://www.nhandan.com.vn/english/life/061007/life_s.htm

Indonesia: Holidaymakers to help spread the word on H5N1 prevention

During the Idul Fitri holidays, more than 25 million Indonesians are expected to travel to their hometowns, many from Jakarta. The USAID-funded Community-Based Avian Influenza Control (CBAIC) program capitalized on the opportunity by approaching travelers at bus stations and terminals in Jakarta to encourage them to talk to their family members in their hometowns about avian influenza and ways to prevent its spread.

In addition, CBAIC provided the Primajasa bus company, which travels to many of the provinces affected by H5N1, with 21,000 seat covers containing a quiz and more detailed information about prevention of H5N1. CBAIC hopes this strategy will encourage discussion about H5N1 and spread prevention methods from urban centers to more rural areas.

http://www.thejakartapost.com/detailgeneral.asp?fileid=20071006173939&irec=13

Virus circulating in Africa and Europe could be more threatening to humans

Scientists at the University of Wisconsin-Madison are reporting important mutations in the H5N1 virus circulating in Africa and Europe

"Birds usually have a body temperature of 41 degrees Celsius (106 degrees F), and humans are 37 degrees C (98.6 degrees F) usually. The human nose and throat, where flu viruses usually enter, is usually around 33 degrees C (91.4 degrees F).
'So usually the bird flu doesn't grow well in the nose or throat of humans,' {Dr. Yoshihiro Kawaoka of the University of Wisconsin-Madison} said. This particular mutation allows H5N1 to live well in the cooler temperatures of the human upper respiratory tract."

Recent samples of the virus taken in Africa and Europe all had this particular mutation

http://www.alertnet.org/thenews/newsdesk/N04393544.htm

86th H5N1 death in Indonesia

From Komnas (http://www.komnasfbpi.go.id/berita_eng.php?id=16)


"Test results from the Health Research and Development Center of the Ministry of Health confirmed that a 21-year old man, known as "AR" from Cengkareng area in West Jakarta, is the most recent confirmed H5N1 case in Indonesia. Overall, Indonesia has now recorded 107 confirmed human H5N1 cases with 86 fatalities. The case fatality rate now stands at 80.37%. Up to today, DKI Jakarta has recorded 26 bird flu positive cases with 23 fatalities.
AR, experienced onset of illness on 18 September 2007. He was examined at Sumber Waras Hospital on 25 September 2007, where 2 days later he was moved to the ICU. AR died 28 September 2007 at Sumber Waras Hospital."

Free of H5N1, Ghana reports

Full story: http://www.modernghana.com/GhanaHome/NewsArchive/news_details.asp?menu_id=1&id=VFZSUmVrOVVhekU9

The Ministry of Food and Agriculture (MOFA) yesterday announced that the nation is officially free of H5N1 in birds. After detecting H5N1 on small poultry farms in three separate districts between early April and late May of this year, the MOFA set up a quaratine and surveillance area around the farms, where more than 13,000 birds died from the virus. Nearly 30,000 more birds were culled to prevent spread of the disease.

Three weeks is the typical period between disinfection and a declaration of this nature, however the government extended this period by a couple of weeks to allow for greater surveillance.

The government recently began an education campaign for farmers on biosecurity to prevent future outbreaks and encourage the reporting of sick and dead birds. Ghana has also set up a compensation system to incentivize farmers to promptly report possible outbreaks of H5N1.

Bird flu in Canada is NOT H5N1

A large Saskatchewan poultry farm is under avian flu quarantine, but Canadian health and animal control officials report that the avian flu subtype, infecting these birds is H7N3, a strain not typically harmful to humans. There is no evidence of H5N1, the strain health authorities fear may mutate into a pandemic form, in Canada at this time.

Though H7N3 is not harmful to humans, it is quite deadly in poultry. All 50,00 birds at the farm will be culled to prevent further spread to poultry in the region.


Full story available from the Star Pheonix, via the H5N1 blog: http://www.canada.com/saskatoonstarphoenix/story.html?id=50600535-f009-4219-b605-4675d47646d9&k=20218

Outbreaks of H5N1 in Russia & Bangladesh

From Ria Novosti: http://en.rian.ru/russia/20070926/81001133.html

"About 250,000 birds are to be culled at a poultry farm in south Russia's Krasnodar Territory following an outbreak of bird flu earlier this month, Russia's agriculture watchdog said Wednesday.
A total of 170,600 birds have been slaughtered at the Lebyazh-Chepiginskoye farm and the remaining 77,500 are due to be culled in the near future, Alexander Skorikov, the head of the animal health department at Russia's agriculture watchdog said.
September 5 about 22,000 birds were culled at the farm after a regional laboratory identified the lethal H5N1 virus in dead birds at the farm."

From Xinhua: http://news.xinhuanet.com/english/2007-09/26/content_6797589.htm

"Some 6,000 chickens were culled at Sahapur village in Sadar sub-district in Bangladesh's northwestern Bogra district, 170 km of capital Dhaka Tuesday night following the detection of avian influenza virus in a poultry farm.
The private news agency UNB on Wednesday reported that Nakul Saha, owner of the poultry farm, took several dead chickens for laboratory test on suspicion that they might have died of bird flu. "

Rapid diagnostics for H5N1 in humans - at a lower price

From Medical News Today: http://www.medicalnewstoday.com/articles/83386.php.

"Scientists in Singapore say they have invented a quick and cheap bird flu test in a hand held kit that can detect the deadly H5N1 virus in under 30 minutes."

Scientists from Singapore's Institute of Bioengineering and Nanotechnology have been developing an easily deployed, rapid diagnostic test for H5N1 for the past year. Health experts believe that a diagnostic tool such as this may be the key to identifying clusters of H5N1 in humans if it begins to mutate into a pandemic form - particularly in countries with less developed health infrastructures where time is wasted while cultures are shipped to and tested in central labs.

Using the droplets from a throat swab, this CD-like device can "isolate, purify, and amplify" the culture and scan it for the virus in under 30 minutes. Not only is the device easily portable but trials have shown it to be as effective at identifying the virus as equipment in central labs. The kit would also be about "5,000 percent cheaper" than currently available tools. It is not clear when the device will be available.

The study was published in the journal Nature Medicine: "Catching bird flu in a droplet."Juergen Pipper, Masafumi Inoue, Lisa F-P Ng, Pavel Neuzil, Yi Zhang, and Lukas Novak. Nature Medicine Published online: 23 September 2007.

H5N1 outbreak in Nasarawa State, Nigeria

Froam allafrica.com http://allafrica.com/stories/200709200338.html

"Over 1,052 birds have so far been culled in Panda Development Area of Nasarawa State in the wake of Avian Influenza (Bird Flu) that affected the area just as the people of the area were commended for reporting early signs of the flu.

UNICEF field officer for Avian Influenza, Alhaji Bala Hassan who visited the affected area from their headquarters in Bauchi said the efforts of the people of the area in reporting cases of sick or dead birds as well as their contributions towards the depopulation exercise was commendable.

Bala who was in Nasarawa weekend and visited Kondoro and panda district areas where the incident occurred cautioned the people against taking sick or dead birds for granted and should ensure that poultry meat and eggs are properly cooked before consumption."

Good news - Chlorine kills H5N1

From Emerging Infectious Diseases (http://www.cdc.gov/ncidod/EID/)

With waterfowl being significant carriers of H5N1, there are definite concerns about H5N1 being transmitted to other poultry and humans through water.

A recent study published in EID demonstrated that Chlorination, the most common form of water treatment, does indeed kill H5N1

"The results of this study confirm that avian influenza (H5N1) is readily inactivated by
chlorination... For drinking water disinfection at conditions similar to those used in this study, the US Environmental Protection Agency specifies free chlorine Ct values of 6 and 8 mg-min/L to achieve enteric virus inactivation of 3 and 4 orders of magnitude, respectively (14). According to our results, these Ct values would be more than sufficient to inactivate HPAI (H5N1) in the
water environment. The information on chlorine disinfection presented here should be helpful for developing risk management procedures regarding the role of water in the transmission of the virus to humans and poultry."

Low Dose H5N1 Vaccine: Improving Ability to Stockpile?

Sanofi Pasteur, which developed the first FDA-approved pre-pandemic vaccine in April, recently released results of a clinical trial of a new antigen-sparing, low-dose H5N1 vaccine, which they said produced an immune responses in a significant (70-80%) number of the adults in the trial.

The guidelines for the first vaccine from Sanofi would have recommended a dose of 90ug of antigen to produce an immune response to the virus, whereas annual flu vaccine contains about 45ug of antigen.

This new low-dose vaccine could contain only 1.9 to 3.75ug of anitgen, significantly increasing the number of doses manufacturers could deliver in a shorter time period, which would be particularly important in the event of a pandemic.

The vaccine is still in Phase 1 trials in the United States and Sanofi has not commented on how long they believe it will take before the vaccine is ready for licensure or manufacturing.

Full story available online:
http://www.outsourcing-pharma.com/news/ng.asp?n=79839-sanofi-pasteur-vaccine-h-n-influenza

Good stuff from AED - advocacy guidelines and participatory research on AI

New tools from AED...

Advocating for Change: Raising Awareness for Avian Influenza

"The objective of this guide is to reach individuals, communities, and organisations working to advocate for public health awareness of avian influenza. The guide provides an overview of the advocacy process and its components - from planning and information gathering, to evaluating success - and suggests strategic activities and messages that can be used to reach different audiences. It can be used by organisations of any size."

http://www.comminit.com/materials/ma2007/materials-3394.html


Participatory Action Research on Avian Flu Communication

"This summary report and recommendations reflects the findings of participatory action research conducted by UNICEF and the Academy for Educational Development on avian flu in six communities - one urban/periurban community and one rural community in three locations: Burkina Faso, Lagos State Nigeria, and Kano State Nigeria. Five key findings emerged from the research:

* Chickens are more important for food security than they are for food. For example, in Burkina Faso families use income from selling chickens to purchase foodstuffs, especially grain, and to purchase seed and agricultural implements at the beginning of the planting season.
* Chickens play a critical role in rituals and social ceremonies. People do not identify possible alternatives to poultry in religious and other cultural practices. Reminding people that avian flu can threaten their ceremonies may motivate them to engage in preventive behaviours.
* Community knowledge about how avian flu is transmitted is low. Community members have many different ideas about the source of avian flu infection.
* Some of the recommended behavioural interventions - "Report, Separate, Wash, and Cook" - are not feasible in communities where enabling factors are absent. This research confirmed the difficulty of changing practices to prevent and control avian flu in poultry. Reducing human exposure to infection will also be challenging, especially if people are unaware of the risks.
* Strategic use of a mix of mass media and interpersonal channels will be most successful in reaching people and persuading them to change behaviours. Mass media messages can quickly reach large numbers of people but must be realistic and practicable in the local context. They also need to be complemented by interpersonal communication from trusted sources in the community.

Several key recommendations, based on the above findings, are noted in the report."

http://www.comminit.com/strategicthinking/st2007/thinking-2417.html

Massive culling underway in Guangdong province

Following China's first poultry outbreak of H5N1 since May, officials in Guangdong province announced that more than 100,000 ducks will be culled in the next few days, following the culling of more than 36,000 ducks surrounding five farms in the Panyu district of Guangdong.

Officals also tried to allay fears that this H5N1 outbreak was the result of a resistant strain, given that the ducks in the area had been vaccinated for the virus.

Guangdong Animal Epidemic Prevention Center Director Yu Yedong said the outbreak occured, "because there wasn't enough time for the vaccinations to produce sufficient antibodies before the ducks caught the virus, and most of the birds were baby ducks." He also noted that it typically takes up to 21 days for the vaccine to take hold.

As a precautionary measure, all public hospitals in the area have been placed on alert to report any abnormalities in patients that could be related to the outbreak.

Full stories from The Standard and The Washington Post, via H5N1 blog:
http://www.thestandard.com.hk/news_detail.asp?we_cat=4&art_id=53652&sid=15422261&con_type=1&d_str=20070918

http://www.washingtonpost.com/wp-dyn/content/article/2007/09/17/AR2007091702587.html

A mutated form of H5N1 found in ducks in China???

Since September 5, an outbreak of H5N1 among ducks on five farms in the southern Chinese province of Guandong has led directly to the deaths of 9,800 ducks and the culling last week of more than 32,000. Hong Kong authorities will suspend importation of chilled and frozen ducks and geese from the area for a week and shipment of live poultry for three weeks, while it begins more inspections of local farms further from the outbreak.

Full story from The International Herald Tribune:
http://www.iht.com/articles/ap/2007/09/17/asia/AS-GEN-China-Bird-Flu.php


In a related story, Hong Kong officials fear that H5N1 in these ducks could be a mutated virus, or evidence of a faulty or ineffective vaccine. All 9,800 ducks infected with H5N1 in this outbreak had been vaccinated against the virus.

"According to Guangdong Animal Epidemic Prevention Center director Yu Yedong, the 9,800 ducks that died at Sixian village had been vaccinated. But he added the first vaccination could only be 65 percent effective, while a second shot would have made it 90 percent. He believed the birds were infected after the first shot."

In addition to traditional containment measures, quarantine and disinfection of all nearby farms, officials are broadening their focus and stepping up inspection and testing at all farms within a 15-mile radius of the initial outbreak.

Poultry sales from the area have fallen 20 to 30 percent since the outbreak began.

Full story from The Standard, via H5N1 blog:
http://www.thestandard.com.hk/news_detail.asp?we_cat=4&art_id=53586&sid=15407483&con_type=1&d_str=20070917

Canada cuts deal to ensure it receives anti-pandemic vaccine

Canadian Health Minister, Tony Clement, announced yesterday that Canada has signed a 10-year agreement with Glaxo-Smith Kline (GSK) to ensure Canada receives anti-pandemic vaccine in the event of an influenza pandemic. This agreement is contingent on a $199 million Canadian investment to double the capacity of GSK vaccine plants in Quebec City, allowing GSK to produce up to 225 million doses of an anti-pandemic vaccine.

Full story available online via the National Post:
http://www.canada.com/nationalpost/news/story.html?id=6033fffe-9783-422b-a31c-5d7ff583a664&k=19352

WHO Says H5N1 Fatality Rate: 61%

World Health Organization authorities announced September 12 that the current official case fatality rate (CFR) for H5N1 in humans is 61 percent.

"A total of 328 human cases and 200 deaths from avian influenza had been reported in 12 countries worldwide since 2003, with a case fatality rate of 61 per cent," Shigeru Omi, WHO's regional director for the Western Pacific, said at the 58th WHO Western Pacific Regional Committee meeting held on Jeju Island, South Korea's southernmost island.

Full story available at Asia Pulse Yahoo News, via H5N1 blog:
http://au.news.yahoo.com/070912/3/14ept.html

A New 3-Year Strategy for Indonesia?

After a two-day summit attended by 150 participants from 11 countries, UN and Indonesian authorities met to discuss the UN's drafted three-year plan for ramping up efforts to prevent spread of H5N1 in Indonesia. This plan revolves around six previously recommended strategies to contain H5N1.

Indonesian Coordinating Minister for People's Welfare Aburizal Bakrie said that Indonesia has already begun implementing the six recommended strategies, but that the rollout will take time. These steps emphasize better communications to the public about the dangers of becoming infected and preventing transmission to humans handling domestic poultry.

"One-point-five billion poultry, which seem to be suffering from quite large numbers of outbreaks of highly pathogenic avian influenza: that is clearly the big issue ... because it is ... bird flu in the birds that (is) then leading to humans getting H5N1 infection, and that is giving us the risk of the emergence of a pandemic virus. And we need a pretty intensive new drive in order to get it fully under control, and it will take probably a two- to three-year period," said David Nabarro, the senior United Nations coordinator for avian and human influenza.


Full story can be found below, via VOA and H5N1 blog:
http://www.voanews.com/english/2007-09-12-voa17.cfm
http://news.avian-influenza.info/linkout/o.php?out=http://us.rd.yahoo.com/dailynews/rss/search/bird+flu+indonesia/SIG=11pbqa1t7/*http%3A//english.people.com.cn/90001/90782/6260631.html

In a related story, Indonesia announced at the summit with international health authorities that it will now begin manufacturing oseltamivir (tamiflu) domestically at a rate that will dramatically (or completely) reduce the amount of Tamiflu they must import. The Minister of Health has yet to designate a company that will produce the medicine.

Full story:
http://news.avian-influenza.info/linkout/o.php?out=http://us.rd.yahoo.com/dailynews/rss/search/bird+flu+indonesia/SIG=11tqih2sr/*http%3A//www.bernama.com/bernama/v3/news_lite.php?id=284606

UN Authorities Assessing Indonesia's Preparedness

A two-day meeting convened in Bali with Indonesian authorities and representatives of the United Nations' Avian and Human Influenza program will assess the progress and gaps in Indonesia's preparedness and surveillance programs for H5N1.

A new set of guidelines for Indonesian programs to combat H5N1, updated based on these discussions, is expected to be released Wednesday evening.

Full story from VOA news, via H5N1 blog:
http://www.voanews.com/english/2007-09-11-voa8.cfm

Vietnam Battles Chicken Smugglers

Chickens, being smuggled into Vietnam from China, have created a dire situation in Vietnam. Surveillance and disinfection efforts are having difficulty adequately screening chickens throughout the nation, especially given the massive number of unscreened chickens entering Vietnam illegally. Local residents along the borders have been drawn into work as porters, making more transporting smuggled chickens into Vietnam than in farming.

In two provinces this year alone, authorities have confiscated and destroyed more than 110 tons of chickens from smugglers . Unvaccinated birds smuggled through these routes have been blamed by Vietnamese authorities for rapidly spreading the disease.

Full story link from the China Post, via H5N1 blog:
http://www.chinapost.com.tw/news/2007/09/11/122150/Vietnam-seizes.htm

Frozen duck meat with H5N1 suspected to have been sold to consumers in Germany

Scandal in Bavaria? German consumers may have been sold duck meat contaminated with H5N1, according to the statement of a Bavarian government official yesterday. A sample of poultry taken from a slaughterhouse in a Bavarian town that recently witnessed an outbreak of H5N1 found 18 frozen birds with the virus.

Bavaria took quick action to cull over 120,000 suspected birds after the August 1 outbreak in Wachenroth; another 200,000+ were culled after the recent discovery at the plant, as a precaution. It’s unlikely that the meat will pose a threat even if consumed, since cooking meat properly generally renders the virus inactive; a greater risk comes from the handling of uncooked contaminated meat.

Full story link below from CIDRAP, via H5N1 blog.

http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/sep1007ducks.html

Malaysia declared free of H5N1

The World Organisation for Animal Health (OIE) gave Malaysia the green-light to declare the nation once again free of H5N1 after an outbreak among domestic poultry in early June 2007. Malaysia was also declared free from H5N1 in June 2006. This outbreak, the first in nearly a year, resulted in the culling of more than 4,200 chickens near the country's commercial capital, Kuala Lumpur.

The OIE requires that a country experience no new outbreaks of H5N1 for three consecutive months after the last culling and disinfection campaigns before it can be considered free of the disease.

"Almost 80,000 birds were culled since the first bird flu case was detected in 2004. The government has so far spent almost RM10 million in compensation to the affected poultry rearers."

Malaysia has already begun to reap the benefits of this new declaration as poultry exports have started to resume, albeit slowly.

http://www.bernama.com/bernama/v3/news.php?id=284200

http://hosted.ap.org/dynamic/stories/A/AS_MED_MALAYSIA_BIRD_FLU_ASOL-?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2007-09-10-05-20-37

Even if it's not the birds....

... a pandemic flu is going to hit sooner or later. So, no, preparedness is not a waste of time and money, says Margaret Chan:

"I am often asked if the effort invested in pandemic preparedness is a waste of resources," director general Margaret Chan told a regional meeting of the [World Health Organisation].

"Has public health cried wolf too often and too loudly?" she said in a speech.

"Not at all. Pandemics are recurring events. We do not know whether the H5N1 (avian influenza) virus will cause the next pandemic. But we do know this: the world will experience another influenza pandemic sooner or later."

From a talk today, via YahooNews. Full link below:
http://news.yahoo.com/s/afp/20070910/hl_afp/healthwhoasiapacificfludisease_070910075313;_ylt=AkBpWCI0c2uGPgc.ziEq49KTvyIi

Another death in Indonesia

Death number 85 in Indonesia, confirmed less than an hour ago. From Yahoo News:

JAKARTA (AFP) - A 33-year-old Indonesian man from Sumatra island died of bird flu on Thursday, bringing the death toll in the world's worst-affected nation to 85 and the global toll to 200, health officials said.

The plantation worker died at 2:00 pm (0700 GMT), the doctor treating him at the state general hospital in the city of Pekanbaru, Azizman Daad, told AFP.

A health ministry official earlier confirmed that the man was infected with the deadly H5N1 virus, after two tests came back positive.

H5N1 is endemic in birds across nearly all of Indonesia.

The archipelago nation has now reported 106 cases overall, including the 85 deaths.
Daad said it was not clear whether the man had come into contact with infected poultry, but he had bought two live chickens at a local market.

Russia confirms third outbreak this year

Via H5N1 blog, a Reuters report:


MOSCOW, Sept 4 (Reuters) - Russia on Tuesday reported its third outbreak this year of the deadly H5N1 strain of bird flu after 410 birds died on a poultry farm in the country's south, but the growing poultry sector is set to withstand the scare.

Another 414 birds were culled and strict quarantine measures were in place at the farm in the Krasnodar region after local laboratory tests confirmed the presence of the virus in dead birds, Russia's animal and plant health watchdog said.

"It's serious enough to bring in strict measures, including quarantine, to make sure it doesn't spread," Alexei Alexeyenko, spokesman for the Rosselkhoznadzor agency, said.

"An investigation is being carried out to determine the source of the infection."


http://www.alertnet.org/thenews/newsdesk/L04737276.htm

Wild birds and AI transmission

Via crofsblogs' H5N1 blog, a link to an article from Hong Kong's The Standard that reports 350,000 wild birds tested worldwide have tested negative for the H5N1 virus:

During global wildlife surveillance, 300,000 to 350,000 "healthy, wild birds have been sampled looking for this virus," said Scott Newman, the international wildlife coordinator for the UN Food and Agriculture Organization.

http://www.thestandard.com.hk/news_detail.asp?we_cat=6&art_id=52725&sid=15216482&con_type=1&d_str=20070904

The same article mentions that researchers presenting at the Avian Influenza and Wildlife Surveillance conference in Bangkok this week report that the information on wild bird transmission of H5N1 is inconclusive. From Flulab.com:

Experts meeting in [Bangkok] say they have been dealing with data that might be unreliable because there is no uniform system of checking H5N1 infection among wild birds. The Food and Agriculture Organization brought together more than 70 experts from 12 countries.

http://www.flulab.com/overview.php?a=2007-09-03-fl29

Vaccine trials to start for bird flu

Via Fluradar.com:

The vaccine centre of the University of Tampere is seeking 200 volunteers to take part in trials of a vaccine for humans against the H5N1 bird flu virus.

The vaccine to be tested is a "model" vaccine which the National Public Health Institute signed an agreement on purchasing for the entire population from the Dutch company Solvay Pharmaceuticals.

Full text of the article here: http://www.fluradar.com/viewNews.php?id=1002

Why CARE's programs educate the community on how to report

This letter was published in the Jakarta Post - It's the frustrations of an expat living in Bali who tried to report a dead bird in his back yard.

Often, there' s big disconnect between the national system for surveillance and communities. The story also highlights the need for avian flu response to be multisectoral - this man called the hospital, police, media and his village chief! None of them knew how to report a dead bird!

"On Aug. 26 I found a dead wild bird in my yard. I am living in Bali near the area where bird flu related deaths have occurred. Since I was worried about the possible risk connected with dead birds, I tried to contact some authority to guide me on how to handle this situation.

I tried to reach the main hospital in Bali, Sanglah, and the answer was to go there if sick but they do not know anything regarding dead birds or chickens.

Next I tried to contact 110, the emergency number of the police: there was no answer. I tried then with the health and animal departments: again no answer.

I then called a newspaper office and spoke with a journalist there: she did not know of any special procedure in place to handle the bird flu-related problems neither she was aware of any emergency number.

I tried then to contact the head of my village (in the Kerobokan area) and his reaction was: "Just bury the bird, there is no problem." How would he know?

Eventually I obtained, through a friend, the personal cell phone number of a doctor nice enough to put me in touch with two nice guys from the animal department who came to my house to check the bird four hours after I began my search for information. Well this does not seem anywhere near a coordinated response to the bird flu problem."

http://www.thejakartapost.com/detaileditorial.asp?fileid=20070829.F07&irec=6

An H5N1 outbreak in poultry in Germany, contaminated straw believed to be the source

160,000 birds were culled in Northern Bavaria after H5N1 was confirmed in domestic poultry. Though there is limited details, it's believed that contaminated straw could be the source.

http://www.iht.com/articles/ap/2007/08/27/europe/EU-GEN-Germany-Bird-Flu.php

Though Western European countries often detect H5N1 in wild birds found dead, it's rare to see it in domestic poultry.

Two more provinces in Vietnam affected by H5N1

Poultry outbreaks in Vietnam and human cases in Indonesia have been fairly regular events in 2007, with reports every few weeks at least. More from the latest poultry outbreak in Vietnam...

From Reuters:

"The outbreak of H5N1 in the northern province of Thai Nguyen and Dong Thap to the south brought to four the number of provinces on the government's current bird flu watchlist.
Vietnam has 64 provinces.
A total of 150 ducks and 35 chickens fell sick on Wednesday in Thai Nguyen, 80 km (50 miles) north of Hanoi, and tests have confirmed they had the H5N1 virus, the ministry's Animal Health Department said in a report.
The virus also struck a farm in the southern Mekong delta province of Dong Thap where 250 chickens were found dead on Sunday, it said."


http://www.alertnet.org/thenews/newsdesk/HAN236817.htm

Is South Asia becoming the new AI hot spot?

We're seeing more and more poultry outbreaks in Bangladesh, India & Pakistan, though no human cases have yet to be detected. Though Southeast Asia still gets most of the attention, more frequent outbreaks in South Asia deserve our attention.

This week in Pakistan authorities killed over 35,000 birds after 14,000 died from H5N1.


"ISLAMABAD, Aug 21 (Reuters) - Pakistani authorities have detected an outbreak of the H5N1 strain of bird flu at a poultry farm in a northwestern town and have culled more than 35,000 birds, a government official said on Tuesday.
Several outbreaks of H5N1 strain of avian influenza have been found in birds this year in Pakistan, where the virus first appeared in early 2006. Pakistan has had no human cases.
The new outbreak was found in late July at a big farm in Mansehra town, 80 km (50 miles) north of the capital, Islamabad.
"Samples were tested after reports of the death of about 14,000 chickens," said Food and Agriculture Ministry official, Rafiq-ul-Hassan Usmani.
"The remaining 35,000 birds were culled after the samples tested positive," he said. "

http://www.alertnet.org/thenews/newsdesk/ISL76664.htm

WHO updates the clinical management guidelines for treating AI in humans

For more info, go to:

http://www.who.int/csr/disease/avian_influenza/guidelines/clinicalmanage07/en/index.html

Indonesia - New poultry and human cases across the islands

The second human fatality from H5N1 in bali has been confirmed. The 28 year old woman was a poultry trader.

http://www.alertnet.org/thenews/newsdesk/JAK170091.htm

Meanwhile, we're actually starting to get more and more reports of poultry outbreaks in Indonesia, which used to be a rarity. Hopefully this indicates that surveillance is improving along with general awareness.

"Despite health authorities` efforts to contain a two-week-old bird flu outbreak in Palu, Central Sulawesi`s provincial capital, the virus proves to have spread to neighboring Donggala district, a local official said. The provincial administration had conducted a number of measures to prevent the virus from spreading to other areas, Greesje Kuhu, head of veterinarian health affairs at South Sulawesi`s agricultural, plantation and animal husbandry office, said here on Monday.A total of 208 chickens were found dead in Palu recently. Rapid tests were conducted to find out the cause of the sudden deaths and the results of the tests showed that 29 chickens had died of bird flu (Avian Influenza) virus or H5N1."


http://www.antara.co.id/en/arc/2007/8/20/bird-flu-in-palu-spreads-to-donggala-central-sulawesi/

West Africa struggles to contain H5N1

From Voice of America, a firsthand look at the difficulties of providing compensation...

"Alex Thiermann, a director at the Paris-based World Organization for Animal Health, says people who raise animals in sub-Saharan Africa tend to be among the poorest, which makes it hard to convince them to kill their livelihood.

"It is very difficult to explain to them that we need to destroy birds because we worry about a potential pandemic," he said. "They do not have time to worry about the potential. They have so many problems to fight on a daily basis so unless there is a good incentive program where there is an assurance they will not lose anything by reporting, then it is hard to guarantee full participation."

Fowl vendors wait for buyers in a fowl market in Lagos, Nigeria, 06 February 2007Donors have promoted paying farmers as one way to encourage fast reporting. But there have been problems paying farmers for their lost poultry because it is not easy to prove ownership.
Olga Jonas, the World Bank's economic advisor for influenza programs who coordinates bird flu donor giving, says local officials need to identify poultry farmers and inventory their stock to prevent corruption.

"When there is an outbreak, you do not get into a lot of discussion about whether somebody did or did not have the poultry they are now claiming compensation for," she said.
But she admits it is hard to track small producers who live in remote areas. Noncommercial family-owned poultry farming is common in West Africa, where people often live in close contact with their birds"


http://www.voanews.com/english/2007-08-18-voa16.cfm

Maid with little opporunity for contact with birds is Indonesia's latest fatality

"The Health Ministry's laboratory has confirmed a Tangerang domestic helper died from the bird flu virus Friday, bringing the country's death toll to 83.
The victim died at Tangerang's Sari Asih Hospital on Tuesday after two days of treatment for a high fever and acute pneumonia, a release made available for The Jakarta Post confirmed Saturday.

The maid's employers, Wahyu Proyato and Winda Amalia, who are residents of Perumnas II in Tangerang regency, said they had no idea how their maid contracted the virus because there were no fowl at their home or in the neighborhood"




http://www.thejakartapost.com/detailcity.asp?fileid=20070820.C04&irec=3

Good news in the search for vaccine solutions

The latest study on the GSK vaccine efforts showed surprisingly good progress when using an adjuvant, an additive that makes it possible to use less vaccine. Also, the vaccine was able to produce an immune response to multiple strains of the virus.

"In fact, the dose needed for a good response was almost four times lower than that used normally in influenza vaccines, meaning limited supplies would stretch to more people.
The researchers also found the vaccine produced immune responses against H5N1 subtypes from Vietnam and Indonesia.

Potentially, the vaccine, made by GSK, could be produced in advance before it was known what strain was causing a pandemic, they said. "

http://news.bbc.co.uk/1/hi/health/6949465.stm