Wednesday, January 28, 2009

CARE's AI & Pandemic Influenza Capacity Map

What did we all do before Google?

Thanks to Google Maps, you can now visualize the work that CARE is doing in AI and pandemic influenza preparedness around the world. Some of you may have seen this map embedded at CARE's AI website, but we thought you might appreciate seeing it here on the blog.

Explore, learn and enjoy!

View Larger Map

Tuesday, January 27, 2009

New Human H5N1 Cases in Egypt

Two new human cases of H5N1 have appeared in Egypt since 2009. Behind Indonesia and Vietnam, Egypt has the third highest number of human cases of AI in the world. These two most recent cases bring the overall tally of human H5N1 infections in Egypt to 53.

Shebin Elkom District: A 2-year old girl developed influenza symptoms on January 23rd; she was admitted to a local hospital the same day and treated with Tamiflu. Laboratory diagnostics confirmed influenza A H5N1 infection, and the mother verified that the girl had previous contact with sick poultry. Health authorities reported the girl to be in stable condition on January 26th.

Kerdasa District: A 21-month old infant was brought in to a local hospital on January 10th after developing influenza symptoms one day earlier. Tamiflu administration followed diagnostics confirming infection with H5N1 on January 12th. The girl was reported to be stable and recovering on January 14th. Although the infant's family admitted to keeping sick, unvaccinated poultry that died the previous week, none of the other family members tested positive for H5N1.

Source: Strengthening Avian Influenza Detection & Response (SAIDR)

For more information, see the World Health Organization: Situation in Egypt

Monday, January 26, 2009

Economic Impacts of Recent Outbreaks Felt as Global Bird Culling Continues

The recent reports of bird culling around the world to contain AI outbreaks contain little mention of the economic impact on poultry farmers and their communities. While many governments offer some form of financial compensation for the loss of poultry, the exchange is not always equal, and farming communities often find themselves in a financial deficit. Below are some culling figures featured most recently in the news:

Nepal: After strains of H5N1 were found in dead poultry on January 16th, the Nepalese government ordered mass bird culling to contain the outbreak. To date, nearly 13,000 birds have been culled in the Jahpa district, the location of the outbreak.
Source: DNI Daily Digest

British Columbia: Canadian inspectors discovered strains of an H5 virus in turkeys on a poultry farm in Abbotsford over the weekend. Today, nearly 60,000 turkeys will be gassed in effort to quell the threat of an outbreak.
Source: The Vancouver Sun

India: Rapid Response Teams (RRT) were deployed on January 19th in a week-long effort to contain bird flu outbreaks in the Ravangla region of Sikkim. Culling procedures stopped Jan. 23rd after 3,900 birds were eliminated.
Source: The Morung Express

Thursday, January 22, 2009

Questions about tamiflu resistance

Jackie (from Cambodia) recently sent me a question regarding the recent news about influenza viruses being more resistant to tamiflu and whether this might have an impact on our own staff safety plans and guidelines. As it so happens, we have a new a Senior Director for Health Programs from CARE USA, Dr. Benjamin Schwartz who also happens to be an expert in pandemic influenza issues! He previously worked at HHS (Department of Health and Human Services) and CDC. He was the lead at HHS for pandemic vaccine and antiviral drug planning and the author of the national recommendations on antiviral drug use. So, I've asked Ben to answer Jackie's question

From Ben:

“The emergence and spread of Tamiflu resistant influenza viruses have led to questions on whether pandemic planning and preparedness should change. Before answering those questions, it's important to understand a bit about antiviral drug resistance among influenza viruses. Resistance occurs due to a chance mutation occurring at the active site where the neuraminidase inhibitor drug (e.g., Tamiflu) binds to the virus. Historically, resistant viruses did not spread between people because the mutation also reduced the fitness of the virus, reducing its transmissibility. The newly emerged resistant virus (which can spread between people) is a specific influenza A (H1N1) clone that has a mutation not only at the neuraminidase inhibitor active site but also another "compensatory" mutation that restores the virus's fitness. All other circulating influenza viruses - with the exception of this H1N1 clone - remain susceptible to Tamiflu. The resistance mutations cannot spread from one influenza virus to another; and the likelihood of these mutations developing in another influenza virus is very small.

Given this understanding, the emergence of the resistant H1N1 has no direct implications on whether a pandemic virus may become resistant to Tamiflu to or Relenza (the other antiviral drug in the same neuraminidase inhibitor class). A fit and resistant pandemic influenza virus remains highly unlikely. U.S. policy on antiviral drug stockpiling and plans for pandemic use have not changed (and in fact, antiviral drug recommendations recently were expanded to include preventive ["prophylactic"] use). Some have suggested stockpiling Relenza rather than Tamiflu. However, there is an FDA warning on the use of Relenza in people with airway disease such as asthma or emphysema and there is not the same body of evidence that Relenza is effective in preventing severe or fatal influenza seasonally or with H5N1 (whereas such data do exist for Tamiflu). The U.S. national stockpile includes 80% Tamiflu and 20% Relenza. Such diversification may be prudent. If the proposed antiviral drug use strategy is prevention (as opposed to treatment), both drugs have been equally effective and a greater proportion of Relenza could be considered. If there are any questions about strategy or drug choice, I'd be glad to provide further thoughts.”

Wednesday, January 21, 2009

Rising Concern for Bird Flu Outbreaks as Chinese New Year Approaches

An excerpt from The Telegraph:

"Hundreds of millions of Chinese are preparing to travel home during Chinese New Year this weekend, and the authorities are concerned that the world's biggest human migration could help spread the disease further.

After not reporting a single human death from bird flu since 2003, the last two weeks have seen three cases in three separate provinces. The Agriculture Ministry said it was moving quickly to quarantine anyone who came into contact with the victims.

"As the Spring Festival approaches, there are frequent movements of poultry products and the risk rises of virus outbreaks and transmission," the ministry said in a statement. "We have already asked the relevant provinces to strengthen their bird flu prevention work," it added...

More than 180 million Chinese will travel home on the rail network for Chinese New Year, with several million more flying. Dishes prepared from freshly slaughtered chicken and duck feature prominently in celebration feasts. This means a potentially greater risk of exposure to sick birds as people shop in markets and handle poultry or when the birds are transported to be sold, the World Health Organisation said.

Health Ministry spokesman Mao Qun'an said last week that the public should minimise contact with poultry, especially sick or dead ones, and that medical institutions should step up surveillance of flu cases."

For the full story, go this site:
The Telegraph

See also:
Reuters AlertNet
BBC News

Tuesday, January 20, 2009

China H5N1 Cases in the News

A quick update on the most recent human cases of avian influenza in China:

Courtesy of the World Health Organization and CrofsBlog.

Shanxi Province- A 2-year old girl (surname Peng) was hospitalized after developing persistent influenza symptoms on January 7th. Laboratory tests have confirmed infection with H5N1, but health officials remain unaware of the source of her infection. The toddler is currently in critical condition.

Hunan Province- A 16-year old boy (surname Wu) who had been infected with H5N1, died early Tuesday morning on January 20th. Wu developed influenza symptoms on January 8th after contact with dead poultry and was hospitalized January 16th.

Shandong Province: A 27-year old female died of H5N1 infection on January 17th. She was hospitalized after developing symptoms around January 5th. Health officials do not know if she had contact with poultry and are currently investigating the possible sources of her infection.

For more information, please see:
World Health Organization

Wednesday, January 14, 2009

8-Year Old Bird Flu Patient Released from Hospital

An update on Bui Thi Thao, the 8-year old girl who gathered the unfortunate title of Vietnam's first bird flu patient of 2009:

Bui Thi Thao is continuing her recovery and has been released from the hospital, according to VOV News. The girl was admitted to the hospital on January 2nd with influenza-like symptoms and tests revealed infection with H5N1. Her sister was hospitalized shortly after with similar symptoms but died before diagnostics could confirm if bird flu was the cause.

To see the full story:

VOV News:

Reuters AlertNet:

Monday, January 12, 2009

Update: Human Cases in China & Vietnam

No further spread of the virus in Beijing, say Chinese health officials:

After a 19-year old woman died from AI on January 5 (the first such death since 2003), the Chinese authorities took swift action placing under medical observation 200 people that had been in close contact with her. Today, they discharged all 200 contacts with no further reports of AI-related illness. Also today, Chinese health workers completed a survey of 358,820 high-risk target groups in Beijing, including migrant workers and those involved in poultry farming, slaughtering, and sales - finding no sign of AI-related symptoms.

See related article from China View:

Similar case-contact observation turns up negative results in Vietnam, but mass poultry deaths reported in 6 of 12 villages in young victim's commune

Vietnamese officials recently released 37 people from medical observation after they came into contact with an 8-year-old girl infected with AI (currently recovering at hospital), saying they show no signs of the illness. However, the young girl's sister died recently after the 8-year-old became infected. Officials cannot confirm if the sister's death was AI-related. No case-contact surveillance and observation has been reported for contacts of the second young girl.

Health officials have reported that 6 of 12 villages in the young girls' commune in Thanh Hoa Province have had mass poultry deaths in the past month. Further investigation is ongoing.

More on the story can be found at Thanhnien News:

Friday, January 9, 2009

Sister of Vietnam’s first Avian Flu Patient of 2009 Dies

Several days ago we reported that Vietnam had confirmed its first AI patient of the year, an 8-year old girl from the Than Hoa province. Vietnamese health authorities now believe that the 13-year old sister of the girl also died of bird flu on January 2nd. Although diagnostic tests were not available, doctors who treated the girl reported similar symptoms to her sister. The director of the hospital where the patient was admitted has said, "We suspect that it was bird flu that caused her death.”

The victim’s 8-year old sister is still hospitalized and recovering.

For more information, please click on the below link:

Wednesday, January 7, 2009

New H5N1 outbreak in poultry in India

A fresh outbreak is being reported in Darjeeling with 31,000 birds being killed so far.

Two human cases of H5N1 in China and Vietnam

Vietnam has released information about their first case of human H5N1 infection since last March. An 8 year old girl from Than Hoa province was hospitalized on January 2nd. Authorities report that she had contact with sick and dead poultry prior to infection

A 19 year old woman from Beiging passed away on Jan. 5th after being infected with H5N1, presumably from ducks she purchased from a local market.

Monday, January 5, 2009

Bird Flu Resurfaces in the State of West Bengal

West Bengal’s fourth H5N1 outbreak has just been confirmed in India.

Over the past week, poultry began to die off at alarming rates in the village of Mathigarah in Darjeeling. State authorities confirmed that the dead poultry tested positive for H5N1 infection and ordered the culling of 60,000 birds beginning Sunday (1/9/08).

Despite the past spread of H5N1 among poultry in 14 of West Bengal’s 19 districts alone, India has yet to report its first case of human H5N1 infection.

Check out the following websites for more information about this outbreak:

Crofs Blog

AFP's Blog

Newstrack India