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