New study show surprising diversity of H5N1 virus

CIDRAP has posted a summary of a new study of H5N1 in Vietnam.

"H5N1 influenza viruses found in chickens seized at Vietnam's border with China in 2008 show a surprising level of genetic diversity, suggesting that the viruses are evolving rapidly and raising questions about disease surveillance and the effectiveness of prepandemic H5N1 vaccines, according to a team of Vietnamese and US scientists.

The findings suggest that the subgroup of viruses identified in the study has been circulating in the region either undetected or unreported for a "considerable amount of time," the report says. The viruses are in clade 7, a group that has not been found in an outbreak since one in China's Shanxi province in 2006. "

As a background for those of you who may not know much about the H5N1 viruses and what a clade is, I suggest the wikipedia entry on H5N1 http://en.wikipedia.org/wiki/H5N1

To read the whole entry from CIDRAP, go to:

http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/apr1409vietnam.html

New materials from the Asian Disaster Preparedness Center

The Asian Disaster Preparedness Center (ADPC) partnered with CARE and others this past year to bring together the major organizations working on preparedness and prevention of Avian and Human Influenza (AHI) in the region. The goal of this partnership was to highlight the best practices and lessons learned from organizations developing and testing new approaches to managing AHI at the community level. These organizations agreed on best practices and approaches to develop into a comprehensive resource package and week-long workshop to train community practitioners in these approaches. The workshop was developed by ADPC, CARE, AED, IRC, IFRC, Kyema Foundation, among others, and piloted in November of last year. The materials were evaluated by participants and facilitators, revised, and then finalized at a second workshop this past February.

CARE was specifically asked highlight our new approach to community-based surveillance, in addition to helping identify other important organizations and approaches. The materials produced from this workshop represent the first comprehensive compilation of best practices, lessons learned, and new approaches for community-management of AHI from a broad-based partnership. As a follow-up to these workshops, ADPC has now made available online all the background resources and materials: http://adpcahi.hostrator.com/.

These resources can be incredibly useful in developing, informing, or refining AHI programs, taking particular note of the lessons learned and best practices from the different approaches.

The website (http://adpcahi.hostrator.com/) includes links to organization websites, training guides and manuals, some IEC materials, and case studies for the 5 major topics covered at the workshop:
1) using research to inform program practice;
2) communication for mobilizing individual and social change for AI prevention;
3) biosecurity;
4) community-based surveillance; and
5) community preparedness and response.

We'll be updating CARE's website soon with our training materials on Community-based surveillance, including facilitator guides!

. . . And in Malaysia, An Answer for Resistance to Culling?

The new Agriculture Minister in Malaysia, Datuk Noh Omar, announced a pilot project to insure poultry and padi fields in Johor and Kedah to protect farmers (and the nation's economy) from economic losses due to floods and H5N1.

“I have seen chicken breeders and padi farmers suffering huge losses when their animals died from bird flu and padi fields are destroyed by floods.

“I believe the insurance scheme is the best solution to prevent them from incurring further losses,” he told reporters after launching the ministry’s Cultivation Month Programme yesterday.

For more on the story, see The Star: http://thestar.com.my/news/story.asp?file=/2009/4/13/nation/3683137&sec=nation

Resistance to Culling Aiding Spread of H5N1 in Indonesia

Over the weekend, Indonesian officials announced that H5N1 has spread to poultry in at least three villages in Sungai Apit district in Siak regency, Riau. The outbreak was first detected following the death of a young child at the end of March, but die-offs of poultry in the boy's village were occurring for at least a week before he became ill. Lab tests have confirmed H5N1 is present in these villages, and may have spread throughout the subdistrict.

Reluctance among poultry farmers and residents to report suspected H5N1 and continued resistance by farmers to cull their sick poultry are aiding the spread of the infection, health officials said. The main factor behind such resistance is lack of compensation for farmers and residents that cull their poultry.

"It's not that we don't want to, but the district office has no such budget for the purpose (culling compensation). For now, we can only remind the residents, including through sermons at mosques, of the risks of bird flu. We cannot force the residents to cull their poultry if they don't want to," he (District chief Indra Atmaja) said.

For more on this story see the Jakarta Post: http://www.thejakartapost.com/news/2009/04/11/bird-flu-virus-spreads-riau-after-boy039s-death.html

Silent/Subclinical H5N1 Infections in Egypt?

CIDRAP published an interesting article Wednesday about the possiblity of subclinical infections in Egypt, sparking fears that untreated subclinical infections could allow the virus more time to mutate and reassort to form a strain with pandemic potential. The Egyptian government, in partnership with the WHO, will soon start a study to investigate whether subclinical cases have been occurring. The study will include "testing the blood of people who were potentially exposed to infected birds but had not gotten sick."

"The recent series of H5N1 avian influenza cases in Egyptian children yet very few in adults has raised concern that some Egyptians may be getting infected without getting sick, according to a Reuters news report published today. If there is any subclinical case in Egypt, the aim is to treat immediately to stop the reproduction of the virus," he told Reuters. "Because whether [through] mutation or reassortment, this will lead to the pandemic strain."

The Reuters story said that all but two of the 11 Egyptians infected with H5N1 this year have been children under age 3 , as opposed to the cases last year which all occurred in adults and older children. When this many cases occur in children without similar cases in adults, it raises the question of whether adults were being infected without falling ill.

"Tim Uyeki, MD, a medical epidemiologist in the Influenza Division at the Centers for Disease Control and Prevention, told CIDRAP News that limited studies in several countries over the past few years have found little serologic evidence of asymptomatic or unrecognized cases of H5N1 virus infection. "

For the full story see:
http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/apr0809asymp.html

Community mobilization against avian flu in Tangerang

Just a little clip of our CARE Indonesia team leading a community event with local women's groups. This is a march through the neighborhoods designed to attract attention so the women's groups can handout information about avian flu. Also, they have the best avian flu inspired hats!

FDA Approves Rapid Diagnostic Test for H5N1 in Humans

On Tuesday, the FDA approved a rapid diagnostic test developed by Arbor Vita Corporation to diagnose H5N1 in humans in about 40 minutes.

"'The test, called AVantage A/H5N1 Flu Test, detects influenza A/H5N1 in throat or nose swabs collected from patients who have flu-like symptoms,' the FDA said in a statement."

This test was hailed by the FDA as a major step forward, particularly as the AVantage test is the fastest test (compared to 4 hours for the next fastest) to accurately diagnose the particular H5N1 influenza strain. It's also apparently easier to use.

Thus far, Arbor Vita has only announced plans to use the rapid diagnostic test for the US population (if necessary) and forward-deployed US military personnel. No information regarding per-test cost was readily available from news sources or Arbor Vita's site.

For more information:
http://www.flutrackers.com/forum/showthread.php?p=217880

http://www.arborvita.com/news_PR13.html

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