[AI] Avian Flu Daily Thread 03.14.05
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http://www.reuters.com/home.jhtml http://www.reuters.com/newsArticle.jhtml?storyID=7887774&type=worldNews javascript:window.close()Bird flu clusters may signal virus change - WHO
Mon Mar 14, 2005 12:45 AM ET
HANOI (Reuters) - A cluster of human bird flu cases among relatives and possibly health workers in Vietnam may show the virus is changing into a form that can be passed on by humans, the World Health Organization said.
The WHO is worried that bird flu, which has killed 47 people in Asia, could mutate into an easily spread form that sparks the next influenza pandemic, killing millions.
"Such cases can provide the first signal that the virus is altering its behaviour in human populations and thus alert authorities to the need to intervene quickly," the WHO said in a statement seen on Monday.
The main concern of the WHO was a series of cases of the deadly H5N1 bird flu virus in a family in the northern Vietnam province of Thai Binh and the possible infection of two nurses who cared for one of the patients.
It also said it had received confirmation of an additional 10 cases of human infections from Vietnam's Health Ministry.
"Full information on new cases, including those that may be closely related in time and place, is critical to ongoing assessment of the pandemic risk posed by the H5N1 virus," the U.N health agency said in a statement.
The new cases were detected in early March or through re-examination of older cases, some of which dated back to late January and three of which had been fatal, the WHO said.
Since the H5N1 virus, which spread across much of Asia in late 2003, erupted again in Vietnam in December, 24 people have been confirmed to have contracted it and 13 have died.
Earlier, there had only been one probable case of human-to-human transmission of the virus, that of a Thai woman who cradled her infected and dying daughter in her arms for hours.
Now, medical experts are investigating whether two nurses who treated a bird flu victim in Thai Binh caught it from their patient.
In the Thai Binh cases, one male nurse tested positive for bird flu after tending a patient who had drunk raw duck blood.
At the weekend, Thai Binh health officials said a second nurse who had tended the patient was in hospital with symptoms of the disease and they were awaiting the results of tests being conducted in Hanoi.
The patient, whose 14-year-old sister and grandfather were also infected, remained in a critical condition, but his sister was recovering and his grandfather had shown no signs of illness despite testing positive.
The H5N1 virus has killed 34 Vietnamese, 12 Thais and a Cambodian and has recurred several times despite the slaughter of millions of poultry.
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Mon Mar 14, 2005 12:45 AM ET
The WHO is worried that bird flu, which has killed 47 people in Asia, could mutate into an easily spread form that sparks the next influenza pandemic, killing millions.
"Such cases can provide the first signal that the virus is altering its behaviour in human populations and thus alert authorities to the need to intervene quickly," the WHO said in a statement seen on Monday.
The main concern of the WHO was a series of cases of the deadly H5N1 bird flu virus in a family in the northern Vietnam province of Thai Binh and the possible infection of two nurses who cared for one of the patients.
It also said it had received confirmation of an additional 10 cases of human infections from Vietnam's Health Ministry.
"Full information on new cases, including those that may be closely related in time and place, is critical to ongoing assessment of the pandemic risk posed by the H5N1 virus," the U.N health agency said in a statement.
The new cases were detected in early March or through re-examination of older cases, some of which dated back to late January and three of which had been fatal, the WHO said.
Since the H5N1 virus, which spread across much of Asia in late 2003, erupted again in Vietnam in December, 24 people have been confirmed to have contracted it and 13 have died.
Earlier, there had only been one probable case of human-to-human transmission of the virus, that of a Thai woman who cradled her infected and dying daughter in her arms for hours.
Now, medical experts are investigating whether two nurses who treated a bird flu victim in Thai Binh caught it from their patient.
In the Thai Binh cases, one male nurse tested positive for bird flu after tending a patient who had drunk raw duck blood.
At the weekend, Thai Binh health officials said a second nurse who had tended the patient was in hospital with symptoms of the disease and they were awaiting the results of tests being conducted in Hanoi.
The patient, whose 14-year-old sister and grandfather were also infected, remained in a critical condition, but his sister was recovering and his grandfather had shown no signs of illness despite testing positive.
The H5N1 virus has killed 34 Vietnamese, 12 Thais and a Cambodian and has recurred several times despite the slaughter of millions of poultry.
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H5N1 found in flies- now this is a concerning issue! Wether or not the flies are a vector is not mentioned, or even speculated about- but I'd guess he is implying that it is a possiblity. Will be watching for more on that development.
http://vietnamnews.vnagency.com.vn/showarticle.php?num=01INN130305
http://vietnamnews.vnagency.com.vn/showarticle.php?num=01INN130305
The race against a bird flu pandemic
(13-03-2005)
Professor Hoang Thuy Nguyen is well known for his contribution to Viet Nam’s successes in researching and producing different varieties of vaccines for such diseases as polio and hepatitis B. Nguyen talks with Xuan Quang about the present effort to develop a vaccine for avian flu by the end of this year.
Professor Hoang Thuy Nguyen was born in the capital city’s outlying district of Tu Liem in 1929. He has been awarded the Ho Chi Minh Prize, the Labour Hero Order and many other noble prizes for his contributions to the country’s medical sector.
Inner Sanctum: After several weeks of injecting into monkeys with bird flu vaccine in the northern province of Quang Ninh, could you tell us about the condition of the animals?
All of the monkeys are strong after three weeks of vaccination. It means that the vaccine effectively immunised the monkeys against bird flu.
Our target with this trial injection is to prove the immunological safety and efficacy of the vaccine. I believe the vaccine has passed the test because the monkeys have had no adverse reaction. We have already administered trial doses to 45 rats and 15 chickens, all with good results.
The trial vaccination on monkeys is significant because the animals’ bodies resemble humans’. This is the final stage of the vaccination trial process. Success at this stage means our research phase is nearly complete.
Inner Sanctum: How do you plan to carry out trial vaccinations on people? Who will be the volunteers?
We will take the trial vaccination ourselves. We have researched and produced the vaccine so that we understand it and we are comfortable with volunteering to inject the vaccine into our own bodies. Of couse, we must exercise caution before making any trial vaccinations on people. This extends past science to touch on medical ethics.
Inner Sanctum: When will you be able to widely produce the vaccine against the H5N1 virus?
We expect to have the vaccine available very soon. Recently, Japan has discovered H5N1 virus in flies, indicating that the virus has already infected insects. If we have no means to prevent the disease, the danger of epidemic is very high. Nevertheless, we must exercise caution in developing and testing vaccines before producing them widely.
Inner Sanctum: What vaccines have you taken part in researching and producing?
My first vaccine research was for polio 43 years ago.
In 1959, a polio epidemic occurred, and many died. I set to work immediately in 1960 and successully tested a vaccine two years later. In 1962, we brought monkeys to breed on Reu Island, known as Monkey Island, in order to create an environment for testing polio vaccine and, later, many other kinds of vaccine.
The research contributed to Viet Nam entirely eradicating polio by 2000.
Inner Sanctum: SARS is another disease that is worrying people all over the world and in Viet Nam. Do you have a plan to develop a vaccine for the disease?
We will research and produce a SARS vaccine after the H5N1 vaccine. Some other scientists and I have isolated and identified the SARS virus. I can say that we have sufficient premises to make a vaccine against SARS. The process to produce SARS vaccine will be quicker than that for H5N1 because we have self-confidence, a group of skilled scientists, and the capacity and methods in place. However, we may not implement the SARS plan this year because the need for a bird flu vaccine is more urgent.
Inner Sanctum: Could you tell us about your team?
The team of vaccine researchers gathers volunteer scientists. Our job began in 2004, and we have already achieved incredible results.
The team has eight members from the National Institute of Hygiene and Epidemiology and Vabiotech Company. Each of them has a specific speciality such as biochemistry, vaccines, virology, microbiology, immunology and chemistry necessary for vaccine research.
I have gathered them, and, if we were a team of filmmakers, then I would be the director. The team is very young, but they have been methodically trained and love the job. I highly value their working results.
We work following a parallel method. For example, the trial vaccination has taken place on monkeys, chickens and rats at the same time with the growth of cells in the monkey’s kidneys to produce the vaccine.
We are racing against the development of an epidemic.
Inner Sanctum: Could you tell us a little bit about yourself?
I joined the army in 1949 when I was studying at the College of Medicine. At a break in the war with France, in 1952, I moved from the armed forces to the National Institute of Hygiene and Epidemiology and was put in charge of work on combating biological warfare.
In 1954, I joined the Dien Bien Phu campaign by building a laboratory in the battle front.
Six years ago, I fainted while attending a conference. Some days later, I awoke and found my arms and legs were paralysed due to a brain haemorrhage.
Now I have recovered a lot. I feel stronger when I research a bird flu vaccine. I think that the more I work, the more I recover. - VNS
Asia: FEATURE-Lack of cash hobbles Cambodia's bird flu battle
http://www.keralanext.com/news/indexread.asp?id=148678
2 Hour,53 minutes Ago
[Asia News]: KOMPONG TRACH, Cambodia, Since her daughter became Cambodia's first confirmed bird flu victim, 42-year-old Tim Ran has stopped eating chicken.
Worryingly for international health experts, her decision is not based on fear of the H5N1 avian flu virus that has claimed at least 47 lives in Southeast Asia and has the potential to mutate into a form which could unleash a global killer flu pandemic.
She just doesn't have any chickens left.
"At first I was afraid, but then my test results came back and showed no signs of bird flu, so I don't believe it any more," she told Reuters while gutting fish outside her stilted wooden house near the border with Vietnam.
"The doctors said you catch bird flu from being close to birds, but I'm the one who prepared and cooked the chickens while the others were away in the rice fields. So how come they got it and not me?" she said.
As she tries to rebuild her family following the death of her 25-year-old daughter, Tit Sakhan, at the end of January doctors are struggling to convince the likes of Tim Ran that H5N1 is real and that stopping it is of international importance.
The virus, first found in Hong Kong in 1997, has killed around 70 percent of the people known to have been infected, but does not pass easily from birds to humans.
However, experts fear it will eventually combine with a common-or-garden variety of human flu to become a highly contagious virus capable of killing millions of people worldwide.
The longer it sits in communities in developing countries such as Cambodia or neighbouring Vietnam, where poultry and people live on top of each other, the higher the chances of this happening.
But getting that message across in one of Asia's poorest nations, where the annual health budget is $3 a head, is far from easy. Many fear Cambodia has become the soft underbelly of the world's assault on bird flu.
Announcement
Click Here for India - Pakistan Cricket Live Scores
Tit Sakhan's death sparked a flurry of activity in southeast Cambodia as doctors used anything at their disposal to educate villagers about the basics of bird flu, its symptoms and how to avoid it.
Radio stations ran eight broadcasts a day, giant speakers mounted on pick-up trucks blared warnings across the rice fields and doctors toured villages on bicycles spreading the word -- and pre-pay mobile phone-cards -- to officials.
"I've given my number to all the village chiefs and private clinics and asked them to call me if they see anybody with symptoms," said Som Sambo, a Russian-educated doctor in Kompong Trach, 100 km (60 miles) south of Phnom Penh.
The two-week public information campaign, for which doctors were paid a bonus of $1 per day, certainly had some success.
Un Thouk, an 8-year-old in charge of a flock of 250 ducks wandering through parched, dry season rice fields -- the former "Killing Fields" of Pol Pot's Khmer Rouge -- knew exactly what to do if all his birds suddenly died.
"I have to dig a big pit and bury them," he said.
But with just $2,500 in funding from the Ministry of Health, the campaign's impact was short-lived and most villagers admitted they slipped back to old habits the moment doctors or ad hoc village health volunteers turned their backs.
"I did follow the guidelines for a bit, but when the doctors left, I ate dead chickens. Chickens always die at this time of year and I need the meat," said Tim Ran's neighbour, Khan Sa An, sitting beneath her house with her infant son.
A few scrawny chickens which had managed to avoid bird flu and an official cull pecked at the dust around their feet.
In the market at Kompong Trach, a haphazard collection of wooden shacks in the middle of town, traders lament that chickens have become scarce -- and therefore expensive -- since bird flu struck, but deny the virus is to blame.
"It's not true. Those who died of bird flu really died of AIDS and then talked about bird flu. I've been a chicken seller for a long time, working every day, and I've had no problems," said poultry dealer Lao Kuy, 32.
"It can happen in Vietnam and other countries, but it cannot happen here in Cambodia. My chickens are fine," she said.
LIMITED RESOURCES
The World Health Organisation (WHO), which is leading a push for $829,000 in international funding for bird flu surveillance, says Cambodia will be unable to prepare adequate defences against bird flu without outside help.
</FONT>
"Clearly the tools here are limited," said Jim Tulloch, head of the WHO in Phnom Penh, saying that Cambodia cannot be expected to divert already meagre public health funds away from its other myriad woes.
"When you look at the other pressing problems here -- maternal mortality, child mortality, HIV/AIDS -- you have to ask how much of that $3 per capita per year Cambodia can spend on preventing an outbreak of bird flu," Tulloch said.
But until money arrives, Cambodia and the world will have to rely on the informal mobile phone and radio tip-off network set up by the Disease Surveillance Bureau, headed by 37-year-old doctor Ly Sovann.
"People are more alert now," he said, sitting in his tiny office in the Health Ministry, surrounded by files, faxes and phone lists pinned to the walls.
"Every village reports when somebody dies, no matter what the cause. We haven't found any bird flu -- they all died of something else, TB or high blood pressure -- but at least it shows the system is working," he said.
http://www.keralanext.com/news/indexread.asp?id=148678
2 Hour,53 minutes Ago
[Asia News]: KOMPONG TRACH, Cambodia, Since her daughter became Cambodia's first confirmed bird flu victim, 42-year-old Tim Ran has stopped eating chicken.
Worryingly for international health experts, her decision is not based on fear of the H5N1 avian flu virus that has claimed at least 47 lives in Southeast Asia and has the potential to mutate into a form which could unleash a global killer flu pandemic.
She just doesn't have any chickens left.
"At first I was afraid, but then my test results came back and showed no signs of bird flu, so I don't believe it any more," she told Reuters while gutting fish outside her stilted wooden house near the border with Vietnam.
"The doctors said you catch bird flu from being close to birds, but I'm the one who prepared and cooked the chickens while the others were away in the rice fields. So how come they got it and not me?" she said.
As she tries to rebuild her family following the death of her 25-year-old daughter, Tit Sakhan, at the end of January doctors are struggling to convince the likes of Tim Ran that H5N1 is real and that stopping it is of international importance.
The virus, first found in Hong Kong in 1997, has killed around 70 percent of the people known to have been infected, but does not pass easily from birds to humans.
However, experts fear it will eventually combine with a common-or-garden variety of human flu to become a highly contagious virus capable of killing millions of people worldwide.
The longer it sits in communities in developing countries such as Cambodia or neighbouring Vietnam, where poultry and people live on top of each other, the higher the chances of this happening.
But getting that message across in one of Asia's poorest nations, where the annual health budget is $3 a head, is far from easy. Many fear Cambodia has become the soft underbelly of the world's assault on bird flu.
Announcement
Click Here for India - Pakistan Cricket Live Scores
CALL ME IF YOU GET SICK
Tit Sakhan's death sparked a flurry of activity in southeast Cambodia as doctors used anything at their disposal to educate villagers about the basics of bird flu, its symptoms and how to avoid it.
Radio stations ran eight broadcasts a day, giant speakers mounted on pick-up trucks blared warnings across the rice fields and doctors toured villages on bicycles spreading the word -- and pre-pay mobile phone-cards -- to officials.
"I've given my number to all the village chiefs and private clinics and asked them to call me if they see anybody with symptoms," said Som Sambo, a Russian-educated doctor in Kompong Trach, 100 km (60 miles) south of Phnom Penh.
The two-week public information campaign, for which doctors were paid a bonus of $1 per day, certainly had some success.
Un Thouk, an 8-year-old in charge of a flock of 250 ducks wandering through parched, dry season rice fields -- the former "Killing Fields" of Pol Pot's Khmer Rouge -- knew exactly what to do if all his birds suddenly died.
"I have to dig a big pit and bury them," he said.
But with just $2,500 in funding from the Ministry of Health, the campaign's impact was short-lived and most villagers admitted they slipped back to old habits the moment doctors or ad hoc village health volunteers turned their backs.
"I did follow the guidelines for a bit, but when the doctors left, I ate dead chickens. Chickens always die at this time of year and I need the meat," said Tim Ran's neighbour, Khan Sa An, sitting beneath her house with her infant son.
A few scrawny chickens which had managed to avoid bird flu and an official cull pecked at the dust around their feet.
In the market at Kompong Trach, a haphazard collection of wooden shacks in the middle of town, traders lament that chickens have become scarce -- and therefore expensive -- since bird flu struck, but deny the virus is to blame.
"It's not true. Those who died of bird flu really died of AIDS and then talked about bird flu. I've been a chicken seller for a long time, working every day, and I've had no problems," said poultry dealer Lao Kuy, 32.
"It can happen in Vietnam and other countries, but it cannot happen here in Cambodia. My chickens are fine," she said.
LIMITED RESOURCES
The World Health Organisation (WHO), which is leading a push for $829,000 in international funding for bird flu surveillance, says Cambodia will be unable to prepare adequate defences against bird flu without outside help.
</FONT>
"Clearly the tools here are limited," said Jim Tulloch, head of the WHO in Phnom Penh, saying that Cambodia cannot be expected to divert already meagre public health funds away from its other myriad woes.
"When you look at the other pressing problems here -- maternal mortality, child mortality, HIV/AIDS -- you have to ask how much of that $3 per capita per year Cambodia can spend on preventing an outbreak of bird flu," Tulloch said.
But until money arrives, Cambodia and the world will have to rely on the informal mobile phone and radio tip-off network set up by the Disease Surveillance Bureau, headed by 37-year-old doctor Ly Sovann.
"People are more alert now," he said, sitting in his tiny office in the Health Ministry, surrounded by files, faxes and phone lists pinned to the walls.
"Every village reports when somebody dies, no matter what the cause. We haven't found any bird flu -- they all died of something else, TB or high blood pressure -- but at least it shows the system is working," he said.
Bird Flu False Negative for Second Nurse in Thai Binh?
[font=Arial,Helvetica]Recombinomics Commentary[/font]
March 13, 2005
>> Test results provided by the Center for Tropical Diseases in Hanoi showed the nurse was free of H5N1, the deadly strain of the avian influenza, said Vietnam's Central Institution of Sanitation and Epidemiology on March 13.
The nurse, who worked in a hospital in the Red River Delta province of Thai Binh, was previously thought to be infected and hospitalized for treatment. <<
Additional tests on the nurse at Thai Binh is warranted in view of her relationship to four other H5N1 confirmed cases, and the history of false negative or inconclusive results of patients in clusters in Thai Binh.
The first cluster was in January of 2004. The index case in the cluster was never tested, but his two sisters who cared for him were tested. Their initial results were inconclusive, but they subsequently tested positive, and unique H5N1 sequences were obtained for each. All three patients died. One of the sisters had one of the first confirmed cases that did not present as a respiratory illness.
The second cluster was about a year later. The index case had been at home for a week before going to the hospital on January 1, 2005. The hospital had a small holiday staff, so it is not clear exactly when he was first tested, but he was tested twice while he was alive, and both tests were negative. He died on January 9 and was positive at autopsy. His brother developed symptoms on January 9, and he too tested negative initially. He subsequently tested positive and recovered.
The nurse described above is linked to the third Thai Binh cluster. She and another nurse had contact with the index case. The index case's sister also tested positive, although some media reports indicated that she too tested negative in initial tests.
Thus, at least one confirmed positive in each of the first Thai Binh clusters initially tested negative for H5N1.
False negatives have also been reported for patients in southern Vietnam. Seven samples that had previously given negative results at the Pasteur Institute in Ho Chi Minh City were positive when tested in Japan. Four of these samples were then positive when retested in Vietnam. Three however, tested negative again in Vietnam, and the assay is being replaced with one that is more sensitive.
Details on the assay in Thai Binh would be useful. Many of the first cases in December, 2003 in Hanoi were positive on an influenza A test. This test might help determine if the bird flu symptoms were due to influenza A. The virus can evolve quickly, and genetic changes can reduce the sensitivity of assays.
The nurse's history of contacts with co-workers and patients raises the suspicion level and suggests that her bird flu symptoms are due to influenza A. If the infection is due to a recombinant or reassortant, then the virus may not be detected with the standard H5N1 reagents.
World health officials plan for coming flu pandemic
http://www.newstarget.com/005628.html
Dr. Anthony Fauci, director of the National Institute of Health’s Institute of Allergy and Infectious Diseases, writes that the risk of the avian flu now spreading through Asia turning into a human pandemic is highly probable. Global health officials are working on contingency plans that could minimize the death toll should a pandemic occur, including stockpiling vaccines, establishing monitoring stations, and working on ways to rapidly decode new viruses to new drugs. To learn more on this topic, be sure to also read the related article, Why the world isn't ready for the coming influenza pandemic, World Health Organization warns.
- Staff writers
News summary:
Source: http://washingtontimes.com/commentary/20050302-094958-7576r.htm
http://www.newstarget.com/005628.html
Dr. Anthony Fauci, director of the National Institute of Health’s Institute of Allergy and Infectious Diseases, writes that the risk of the avian flu now spreading through Asia turning into a human pandemic is highly probable. Global health officials are working on contingency plans that could minimize the death toll should a pandemic occur, including stockpiling vaccines, establishing monitoring stations, and working on ways to rapidly decode new viruses to new drugs. To learn more on this topic, be sure to also read the related article, Why the world isn't ready for the coming influenza pandemic, World Health Organization warns.
- Staff writers
News summary:
Source: http://washingtontimes.com/commentary/20050302-094958-7576r.htm
- The 2004-2005 influenza season thus far has been relatively mild in the United States, and public health officials hope current trends will persist through the end of the season.
- However, a much greater flu threat worries world scientists and health officials -- a possible influenza pandemic caused by an emerging, highly virulent avian influenza virus.
- In the 20th century, mankind faced three influenza pandemics: the devastating 1918 "Spanish Flu" pandemic, as well as two less severe influenza pandemics in 1957 and 1968.
- Most worrisome is the H5N1 influenza virus that first emerged in Hong Kong in 1997, infecting 18 people -- virtually all of whom had direct contact with domestic fowl.
- More than 50 confirmed human cases of H5N1 avian influenza have been reported since January 2004 in Vietnam, Thailand and Cambodia, and have resulted in the deaths of more than 40 people.
- In addition, the virus has killed millions of chickens and has expanded its host range by infecting other birds, pigs, tigers, leopards and domestic cats.
- To start with, there is no probability of a pandemic caused by H5N1 influenza if the virus does not exist in birds or other animals.
- This is greatly compounded if the virus can efficiently spread from human to human.
- In addition to ongoing surveillance of H5N1 outbreaks and the evolution of the virus, scientists throughout the world, including those supported by the CDC and the National Institutes of Health (NIH), are developing techniques for rapidly isolating and identifying new viral strains and cell-culture methods for more predictably and reliably growing the virus and upgrading vaccine production capacity.
- As a result of recent research advances, we are far better prepared to produce vaccines and antivirals to contain the virus than we were just a year ago.