Vietnamese woman dies from H5N1 infection

A 22-year-old woman from the northern province of Ha Tay in Vietnam passed away from H5N1 this weekend.* Authorities have not yet pin pointed the source of her infection as no bird outbreaks were reported around the area where she lived.

http://www.theage.com.au/news/World/Vietnamese-woman-dies-of-bird-flu/2007/07/31/1185647898181.html

*WHO confirmation still pending

Outbreak in Manipur, India gets bigger

The outbreak in Manipur appears to be on a bigger scale than previously thought.

Currently, 11,350 birds have been culled in 34 localities in both Imphal East and Imphal West district


http://www.kanglaonline.com/index.php?template=headline&newsid=38799&typeid=1&Idoc_Session=827c9dd1ba985f97a83358cd78ebaded

New H5N1 outbreak in Myanmar

The outbreak occured on farms in the Mon State, which is in the southeastern part of the country.

"The report said that authorities have taken measures to contain the outbreak, including culling more than 300 chickens o­n the two poultry farms where the H5N1 virus was identified."

http://www.irrawaddy.org/article.php?art_id=8035

Seasonality in flu - how important is it?

Many people are aware that flu is supposedly a seasonal disease, waxing and waning with temperature and seasons. But whose seasons? When CARE first started working on AI, Maryann and I looked into understanding the "flu season" in other parts of the world, especially Africa and Asia.

The truth is, no one really knows a lot about the seasonality of flu in the southern hemisphere or in tropical climates. It's not a well studied phenomena there.

So, what does that mean for a potential pandemic? Researchers had previously been working under the assumption that colder months would be more likely for reassortment (where, in one host, the H5N1 virus may mix genetic material with a human flu virus, making it more powerful and possibly creating a pandemic). With this new article from CIDRAP, researchers are assuming less about seasonality and pointing to other important characteristics.

Read more at:

"Researchers warn H5N1 reassortment can occur beyond winter months"

http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/jul2507seasonal.html

India experiences H5N1 outbreak in Manipur state

"NEW DELHI (Reuters) - The Indian government confirmed on Thursday that the latest outbreak of bird flu in poultry in the remote northeast of the country was of the dangerous H5N1 strain.

"It has been confirmed as the H5N1 strain," Joint Secretary in the Ministry of Health Vineet Chawdhry told Reuters.

Hundreds of health workers will fan out in Manipur state to check on the health of some 450,000 people in and around the affected poultry farm in the village of Chingmeirong on the outskirts of Imphal, the state capital. None of the people in the poultry unit or veterinary workers dealing with the outbreak are showing flu symptoms, but they have been put on the anti-flu drug Tamiflu just in case, Chawdhry said.The confirmation of the H5N1 strain came after authorities received the results from two government laboratories.

India declared itself bird flu free last August after two major outbreaks of the H5N1 virus in chickens in western India. It culled around a million birds to contain those outbreaks.
It plans to slaughter some 150,000 poultry in a 5 km (3 mile) radius around the affected farm."

http://www.reuters.com/article/environmentNews/idUSDEL33094120070726

2 humans die from pig disease in Vietnam

One of the reasons CARE is inovled in fighting H5N1 is that we believe diseases arrising from animal origin will be an increasingly important public health problem as the numbers of humans living in close proximity to livestock is higher than ever before (meaning there are more opportunitites for virsuses like H5N1.

The death of two people from pig disease plus new H5N1 outbreaks is what's worrying Vietnamese health and animal health officials today...

"Two people have died in northern Vietnam from a pig disease while another virus has been killing thousands of pigs in recent weeks in the central region, government and media reports said on Monday. Bird flu has also returned to the central region, killing hundreds of ducks at a farm at the weekend, they said.

Twenty two people, most from northern areas, have been taken to a Hanoi hospital so far this year after they fell sick from the Streptococcus suis bacteria, the Vietnam News Agency said on Monday.

Two of the infected had died, it said without giving more details.
People infected by the bacteria suffer from rapid internal haemorrhage and high fever after they eat pork from a sick pig or inhale the air near the sick swine, doctors said.
Another pig disease, the Porcine Reproductive and Respiratory Syndrome (PRRS) virus, also known as Lelystad virus, had struck more than 16,000 pigs in the central province of Quang Nam since June 25, the Agriculture Minister Cao Duc Phat said on July 14."

http://www.alertnet.org/thenews/newsdesk/HAN235672.htm

An important component of CARE's work is improving cooperation between animal and human health sectors at all levels. This cooperation will become increasingly important to control zoonotic diseases locally before they become a threat globally.

Vietnam begins testing human H5N1 vaccine in August

"Tests on some 600 volunteers would be conducted by the Army Medical Academy within six months, said Nguyen Thu Van, director of Vaccine and Bio-medical Products Company 1, which produces the H5N1 virus vaccine.

Van said this vaccine had been preliminarily tested for safety and effectiveness by the National Center for Checks on Vaccines and Bio-Medical Products. Once on the market, the vaccine is expected to cost around VND30,000 (nearly US$1.9) per dose. A person would need two doses to ensure immunity to the virus."

http://www.thanhniennews.com/healthy/?catid=8&newsid=30253

Egyptian woman tests postive for H5N1

The woman tested positive after exposure to dead birds at her house. She is Egypt's 38th case.

http://africa.reuters.com/commodities/news/usnL22401749.html

In Nigeria, control options for H5N1 52 times better than no action

This is from a study in Zoonoses and Public Health

"In January 2006, an outbreak of a highly pathogenic avian influenza (HPAI) was recorded in Nigeria for the first time. This present work describes an estimation of possible costs associated with a vaccination-based control policy added to other measures to restrict HPAI H5N1 virus infections.

The evaluations used epidemiological and production data, including budgets necessary for the vaccine acquisition, distribution and administration in arriving at the final costs. Using decision tree and cost benefit analysis the economical benefits for Nigeria and countries with similar veterinary infrastructures, biosecurity and farming systems are calculated.

The result indicated that a halting in the continued spread of the virus through effective control measure will be 52 times better than taking no action. This should help policy makers in deciding in favour of vaccination combined with other tools as an effective means of controlling avian influenza H5N1.

• Control of HPAI H5N1 will best be understood by policy makers in financial terms.
• Effective control through vaccination of poultry is much cheaper and reduces the chances of human zoonoses.
• Poultry vaccination combined with other control measures will be the most effective means of control in most developing economies."

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1863-2378.2007.01044.x

New guide for the Media from Unicef

UNICEF has just released a helpful guide on training the media on avian and pandemic flu. Included are helpful three day workshop agendas, guidelines for field visits, suggestions for handouts, etc.

pdf available at: http://www.unicef.org/eapro/activities_7065.html

New outbreak in poultry in Vietnam

Dong Thap is the latest Province to have an outbreak, which leaves six provinces still infected (Bac Gian, Thai Binh, Ca Mau, Ninh Binh). An area can only be declared bird flu free when there have been no cases in 21 consecutive days

http://www.thanhniennews.com/healthy/?catid=8&newsid=30115

Halting the "cytokine storm" may not decrease mortality in humans

One of the more disturbing characteristics of the 1918 pandemic influenza was that the virus disproportionally killed the young and healthy, leading researchers to believe that an overreaction by the immune system, the "cytokine storm" could be the cause of many deaths.

Researchers recently ran trials both with genetically altered mice and mice given suppressants for their immune system. Unfortunately, both had higher mortality rates than the baseline, which is not good news for treating either H5N1 infections or pandemic flu

http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/jul1607cytokine.html

A Visit to a Medium-Sized Chicken Farm in Ubon Ratchathani, Thailand

Travelling towards Sisket in Ubon Ratchathani, I decided to randomly stop and look at some chicken farms. (The area was supposed to be a big poultry hub, but I didn't see any chickens at all, just some poultry processing plants.)

As I stepped out of the car, a farmer named Nulang Kampon came out and graciously allowed me to interview her. It seemed odd at the time, but apparently she was used to it because I had stumbled onto the first successful, closed poultry farm in the area. A closed poultry system entails keeping the chickens in their own isolated enclosure with their own water supply at all times. There is a fan inside the farm to cool the chickens during the hot summers and enough room to not overcrowd 7,000 chickens. Only Nulang and her husband feed, and clean the water and area of the chickens, and they must shower before and after entering the enclosed and seperate chicken enclosure and wear special equipment during their time with the chickens. After 45 days for the chickens to mature, the poultry company returns to claim the chickens in trucks that are disinfected before and after entering the farm area, and Nulang's family has a full month to clean the area before they bring in new hatchlings to start the cycle again.

About four or five years ago, Nulang and her family had an open farm system, but the neighboring poultry plant came to her and asked if she would consider being a contract farmer for them. In return for providing technical assistance (workshops on how to make the transition and avian flu prevention), machinery, equipment, and the chicken hatchlings, the poultry industry would get a percentage of her revenue. With a substantial loan from a bank, Nulang and family began the transition of closing the chicken farm, which took about a month. The government checks on the farm about once a month to ensure everything is on the up and up.

Nulang says she prefers the closed system since less chickens die. Traditional free roam chickens are exposed to the heat, dust, pollution, wild birds, unclean water sources and more. Now with the closed system, only an average of 300 chickens out of 7,000 die instead of nearly half. Nulang makes approximately 20,000 to 40,000 baht a cycle and can send her daughter to college.

When I asked if she had any advice for other farmers who were also concerned about avian flu, she said to ask nearby companies if they want to work together. Many Westerners, farming students, neighbour farmers, and even Japanese farmers have come to her farm to learn how to convert their farming style. It should take less time than she did (since she was the pilot).

I thought Nulang's story was a great example of government, the private sector and farmers all working towards the same goal.

Success story from CARE Vietnam

In May 24th and 25th AI outbreak occurred in Dinh Cao commune, Phu Cu district of Hung Yen province, where CARE is working. Sick and dead ducks were found in one household that normally has a flock of 300. On 29th May 2007 the sub department of animal health arrived to take a sample from the flock for tests and requested that the family bury the ducks. However, the head of the family refused to comply. In this situation, the local authority and animal health department were very anxious as there is no policy to force the family to comply.

This incident happened to occur during a CARE AI campaign in the commune with different mass organizations involved in the communications campaign. The commune AI committee intervened and applied their skills and knowledge convinced the man of the dangers of not complying, eventually the man agreed to destroy the flock. On the same day the National Institute for Hygiene and epidemiology confirmed that the outbreak was H5N1

H5N1 spreads in Bangladesh and surfaces on 2 Czech farms

H5N1 has hit Naogoan district, where vetrinary workers culled 2,000 chickens. 17 of 64 districts in Bangladesh have been hit with the virus.

http://in.today.reuters.com/news/newsArticle.aspx?type=topNews&storyID=2007-07-15T165506Z_01_NOOTR_RTRMDNC_0_India-284830-1.xml&archived=False

Meanwhile, one of the largest preventative culls I've seen, over 70,ooo, birds, took place around 2 infected farms this past week. Authorities estimate the compensation will be aroudn $1.46 million USD.

http://www.khaleejtimes.com/DisplayArticleNew.asp?xfile=data/theworld/2007/July/theworld_July323.xml§ion=theworld&col=

6 year old boy is Indonesia's 81st H5N1 victim

"A 6-year-old Indonesian boy died of bird flu at the weekend, bringing the country's death toll from the disease to 81, officials said on Monday. The boy, from the city of Cilegon in Banten province, suffered from high fever and breathing difficulties before he died of multi-organ failure on Sunday, said Tuty Hendrarwardati, the spokeswoman of Jakarta's bird flu hospital. "

The report says that his family and neighbors did not keep chickens, so it is not known how we contracted the disease

http://www.alertnet.org/thenews/newsdesk/JAK1907.htm

Community Volunteers Report H5N1 Cases

CARE is working to establish community based surveillance systems to improve detection and reporting of H5N1 outbreaks in birds and human cases. In Vietnam, were we've been working for several years to improve the capacity of local AI Committees to respond to H5N1. Recently, we launched a training program that uses community volunteers to look for cases and report.

After only a month of operating, Tien Minh Commune volunteers reported suspected outbreaks in ducks and humans. The human cases, thankfully, were not H5N1. The ducks, however, were. Because of their training, Tien Minh volunteers reported the case quickly and their Commune AI Committee was able to take all of the correct actions to stop the virus from spreading and clean up the outbreak.

Examples are starting to emerge that really demonstrate the value of community based work in stopping H5N1. Let's continue to share these!

And congratulations to Tien Minh Commune!!

walking on a tight rope

Media attention and public concern over avian flu seems to be decreasing even though the threat of human illness from bird flu outbreaks is on the rise. This article highlights how U.S. citizens in particular are not as worried as they used to be about bird flu.

Why is this a problem? Many countries, organizations and companies are urging people to prepare for a pandemic.

This is quite like walking a tight rope. How should governments and organizations best prepare people without scaring them?


http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/jul0607ipsos.html

Word Bank partners with Bangladeshi NGO, BRAC, to fight avian flu

The private sector arm of the World Bank Group, ICF, has partnered with a leading Bangladeshi NGO, BRAC, in order to promote bio-security, poultry productivity, reduce costs and the increase income of 10, 000 small scale farmers and retailers. BRAC (http://www.brac.net/index2.htm) specializes in health, economic development, education, social development and human rights

"IFC has global experience dealing with the avian influenza. We are using our expertise and BRAC's experience and outreach in the sector to help protect farmers, small and medium enterprises, and other stakeholders," said Deepak Adhikary, deputy general manager of IFC-SEDF.

“The poultry industry, the country's fastest-growing livestock sector, employs at least five million people, and millions of households rely on poultry production for income generation and nutrition. The industry has about 220 million chickens and 37 million. Last week, health workers culled 78,000 chickens over the past six days after bird flu”

Source: http://www.fluradar.com/viewNews.php?id=581

BRAC: http://www.brac.net/coreprogs.htm

"Poultry dealers adopt tricks to sell products"

This recent story on GhanaWeb discuses how traders are getting around the live bird ban, with people hunting for buyers in the market and then bringing them to private houses to make the deal.

This story and others just emphasize how important it is that any type of AI prevention and control measures take place with a high degree of participation from communities. Participation and giving the communities input into what measures will be taken is the only way we'll get compliance.


http://www.ghanaweb.com/GhanaHomePage/NewsArchive/artikel.php?ID=126462

Two new human cases of H5N1 confirmed in Vietnam

"The World Health Organization (WHO) officially confirmed two Vietnamese human bird flu cases on Friday. The cases date back to late May. The recognitions raise the WHO’s Vietnam H5N1 count to 95, while the number of fatalities remains at 42 for now."

http://www.thanhniennews.com/healthy/?catid=8&newsid=29566