Blog.BirdFluSmart.com

CDC Recommends Actions for California & Texas Residents as Swine Flu Outbreak Grows

2009-04-24T20:20:00Z

The Center for Disease Control has the following recommendations for residents of Residents of California and Texas:
CDC has identified human cases of swine influenza A (H1N1) virus infection in people in these areas. CDC is working with local and state health agencies to investigate these cases. We have determined that this virus is contagious and is spreading from human to human. However, at this time, we have not determined how easily the virus spreads between people. As with any infectious disease, we are recommending precautionary measures for people residing in these areas.

Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.
Try to avoid close contact with sick people.
If you get sick, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.
Avoid touching your eyes, nose or mouth. Germs spread that way.

There is no vaccine available at this time, so it is important for people living in these areas to take steps to prevent spreading the virus to others. If people are ill, they should attempt to stay at home and limit contact with others. Healthy residents living in these areas should take everyday preventive actions.

People who live in these areas who develop an illness with fever and respiratory symptoms, such as cough and runny nose, and possibly other symptoms, such as body aches, nausea, or vomiting or diarrhea, should contact their health care provider. Their health care provider will determine whether influenza testing is needed.

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The CDCs recommendations for a swine flu pandemic are the same as they are for a avian flu pandemic ( Bird Flu). The World Health organization (WHO) raised the level of pandemic alert today also. Preparation is key to any emergency situation Bird Flu Smart & Ready Smart urge you to ensure your family and business are prepared as pandemic & emergency supplies are limited once the outbreak or disaster occurs.

China's recent H5N1 cases raise transmission questions

2009-01-26T02:39:00Z

China's recent spike in human H5N1 avian influenza cases [see
ProMED-mail archived reports below - Mod.CP] appears to lack the
hallmark of nearby poultry outbreaks, a development that some public
health officials worry could signal asymptomatic infections in birds.
Veterinary experts, however, suggest the pattern could point to
surveillance gaps or the consequences of routine vaccination. China
has reported 4 human cases so far this year [2009], 3 of them fatal.
According to World Health Organization (WHO) reports:

- The 16-year-old boy [treated in] Hunan province who died yesterday
[20 Jan 2009] had been exposed to sick and dead poultry [in Guizhou province].

- Investigators found that a 19-year-old girl from Beijing who died
on 5 Jan 2009 had contact with poultry before she got sick, but they
did not say whether the birds were ill.

- Authorities are still investigating the virus source in the other 2
cases, a 2-year-old girl from Shanxi province who is in critical
condition and a 27-year-old woman from Shandong province who died on
17 Jan 2009. The country's agriculture ministry said on 18 Jan 2009,
after the 2-year-old's infection was confirmed, that no H5N1
outbreaks have been detected in Shanxi or Hunan provinces [see
ProMED-mail reports, archived below - Mod.CP].

York Chow, Hong Kong's secretary for food and health, has called on
China to release more epidemiologic information on the recent human
infections and said that an apparent lack of poultry outbreak reports
against the backdrop of human cases raises questions about a possible
change in the virus or that asymptomatic H5N1-infected chickens might
be contributing to the spread of the virus. Chinese officials have
said they have found no evidence that the virus has mutated to allow
easier human-to-human transmission, according to media reports.

This isn't the 1st time that health officials have voiced their
suspicions about asymptomatic poultry infections in China. In 2006,
Zhong Nanshan, director of the Guangzhou Institute of Respiratory
Diseases, suggested that 2 victims might have caught the virus from
chickens that were carrying it asymptomatically.

Avian influenza experts say the size and nature of China's poultry
population creates a difficult surveillance task. Jan Slingenbergh, a
senior animal health officer for the United Nations Food and
Agriculture Organization (FAO) told CIDRAP News that China has
roughly 4.6 billion chickens, 700 million ducks, and 300 million
geese that are distributed somewhat unevenly throughout the country.
He said the ducks gravitate toward the double-crop rice growing areas
in southern and southeastern China, which are thought to be the main
risk areas because the H5N1 virus keeps circulating in ducks. Geese
head toward single-crop rice growing areas in the less rainy
northeastern and extreme western part of China, Slingenbergh added.
Meanwhile, he said chickens are kept everywhere people live,
particularly in urban areas and coastal ports.

Slingenbergh links the low level of poultry outbreak reports to
China's poultry vaccination policy. "The entire national flock is
kept under a rigid vaccination blanket amounting to 11 billion
applications per annum," he said.

He said he doubts that H5N1 in China is evolving toward a low-
pathogenic virus. "Vaccination creates a rather sparse geospatial
mosaic of susceptibles, which may even enhance the pathogenicity
level," he said, adding that evidence from Viet Nam, where most
Chinese viruses spread to, suggests that the virulence increased
between 2002 and 2007 when measured by infecting and gauging shedding
in young mallards.

Vincent Martin, a senior technical adviser in the FAO's Beijing
office, told CIDRAP News that Chinese officials obtain a lot of
samples from farms and live bird markets each year to monitor
asymptomatic H5N1 infections among the birds. "Regularly, they find
the virus but do not detect any outbreak in the surrounding areas,"
he said. However, a combination of factors makes detecting the virus
difficult, Martin said. Several strains of the virus are circulating
in China, and ducks can excrete the virus without showing symptoms or
only exhibiting mild ones. In addition, suboptimal vaccination can
mask the symptoms without stopping viral shedding.

More intensive surveillance and monitoring efforts are needed in
China to detect new outbreaks and identify viral circulation that is
going unnoticed, Martin said, "to avoid a situation where humans
serve as sentinels and reveal infection in birds. The concern is,
therefore, that the current surveillance is unable to provide a
complete picture of the [high-pathogenic avian influenza]
epidemiological situation in domestic birds and should be
strengthened and improved in order to meet the challenge we are
currently facing," he said.

Three Chinese government ministries yesterday [20 Jan 2009] issued a
joint order for local health, agriculture, and commerce offices to
work together to improve surveillance and management of the country's
live poultry markets, Xinhua, China's state news agency, reported
today [21 Jan 2009]. The government urged local offices to close live
poultry markets in urban areas, if possible, or disinfect the markets
daily if they can't be shuttered. The offices were also ordered to
conduct daily surveillance and reporting and collaborate when they
detect the H5N1 virus.

Les Sims, from Australia's Asia-Pacific Veterinary Information
Services and a consultant to the FAO, said though humans are once
again acting as sentinels for infections in poultry, so far there is
no evidence to support asymptomatic disease as the reason for absence
of reported poultry outbreaks in China. "Vaccination will alter the
clinical appearance of disease if the flock is infected, but on a
flock basis, some disease will be detected. Infection is not silent,"
he said. He added that infected vaccinated flocks, for example, have
lower mortality rates with fewer birds showing classical symptoms of
the disease. "If vaccines are used, veterinary and medical
authorities have to accept that one of the signals they used to rely
on for detecting infection in poultry -- high mortality -- needs to
be modified," Sims said. Infected poultry can still shed small
amounts of the virus, even when the vaccine is a good match and the
birds are vaccinated properly, he said. "This has always been the
case and so can't explain the current situation in China."

The issue of less severe infections in vaccinated poultry is creating
negative sentiments about the measure, Sims said, but he added that
China has maintained a close match between the circulating strains
and the vaccine antigen, which greatly diminishes the viral load in
poultry. "The benefits of vaccination in reducing viral load need to
be considered and balanced against the changes in disease appearance
that will occur if a vaccinated flock is infected," he said. "The
situation in China would almost certainly be much worse if
vaccination was not used."

Sims said he's not surprised that some poultry infections go
undetected, given the size and make-up of China's poultry population,
along with the modified appearance of the disease in vaccinated
poultry. He suspects, though, that under-reporting of the disease
might be one factor that keeps the number of outbreak reports low.
Farmers who raise poultry for their livelihood have little incentive
to report the disease. A seasonal surge in poultry and human H5N1
cases in the winter isn't unexpected, he said. "Winter peaks have
been seen previously and are probably linked to the increased trade
in poultry for various festivals and enhanced viral survival due to
cooler conditions," Sims said.

[Byline: Lisa Schnirring]

Source: CIDRAP News [edited]
<http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/jan2109birds-jw.html>

China seeks to ease fears over bird flu threat

2009-01-22T02:33:00Z

China sought Wednesday [21 Jan 2009] to allay fears over the threat
of a bird flu pandemic after 3 people died from the disease this
month [January 2009] and a 4th person remained critically ill. There
was no evidence that the potential for an outbreak of the disease was
on the rise, China's health ministry said in a statement faxed to
AFP. "The 4 cases separately came from different provinces; there is
no epidemiological connection between them; they are sporadic cases,"
the ministry said.

A 16-year-old boy died on Tuesday [20 Jan 2009] from the H5N1 strain
of avian influenza in the central province of Hunan [See above,
infection contracted in Guizhou province.].

A 27-year-old woman also succumbed to the disease on Saturday [17 Jan
2009] in the eastern province of Shandong, while the 1st fatality
occurred on 5 Jan 2009 when a 19-year-old woman died in Beijing.

A 2-year-old girl, meanwhile, is still critically ill in the northern
province of Shanxi, the health ministry said. The toddler's mother
died this month [January 2009] of severe pneumonia, sparking concern
that she may actually have had bird flu and passed it on to her
daughter. The health ministry said it was unable to do tests to
confirm whether the mother had died of avian influenza, as no samples
were collected when she passed away. But it added it was unlikely the
girl caught bird flu from her mother. "We cannot be sure that the
patient's mother had bird flu, and investigations show the patient
had been exposed to live poultry markets," the statement said.
"Therefore, we believe the patient's infection most likely came from
a live poultry market or another unknown exposure."

China is considered one of the nations most at risk from bird flu
epidemics because it has the world's largest poultry population, and
many chickens in rural areas are kept close to humans.

The World Health Organisation says about 250 people have died from
bird flu worldwide since 2003. The total number of reported deaths in
China since the virus re-emerged in 2003 now stands at 23.

Source: Agence France-Presse (AFP) report [edited]

Article Source:
http://www.google.com/hostednews/afp/article/ALeqM5jsEhZC8Kj_VGJEltw0sx4xIh7GMg

Prepared for Bird Flu? Americans aren’t ready for any emergency

2007-06-06T18:31:00Z

I took a step back from blogging about Bird Flu as I found that people were just not prepared for any kind of emergency. Only 14% of Americans are prepared for a three-day disaster, allow an Avian Influenza Pandemic that may have waves lasting 2 months at a time.

Reflecting on this I have spent the last few months working in the community on general emergency preparedness and starting a new emergency preparedness web site ReadySmart.com. We have been conducting public forums and working with neighborhood associations and city government to increase the publics awareness on emergency preparation. People are receptive to emergency preparedness once they better understand the need for it.

It is each of our responsibilities to prepare for our families and ourselves. Even the best-prepared cities will not be able to care for its citizens in a major disaster. Everyone needs to have a three-day kit to provide for the basics of food, water, shelter, sanitation, and first aid. Three-day kits should be supplemented with personal items such as medication, cash in small denominations, and definitely clean underwear.

The American Red Cross has "get a kit" as their number one step to preparation. This overcomes the inertia most of us experience at putting together a kit and is economical too. Another benefit of commercial kits is that they provide supplies that are designed for an emergency such as food that does not invoke thirst and has a five-year shelf life thus simplifying kit maintenance for ease of kit maintenance.

If you live in an area prone to hazards such as fire, severe storms, flooding or urban areas where you may be subject to shelter in place warnings then you should have a Public Alert Certified Radio. These radios are great as they will turn themselves on to alert you to the hazard and can be easily programmed to alert you to hazards only in your area. So if you don't have the TV on or are sleeping you will not miss the Alert that could give you precious minutes to take action.

The real trick to being prepared is to act now. Don't put off the preparation to another day or that day may end up being to late. Instead take steps today to prepare, knowing you can become even better prepared tomorrow.

Dogs and Cats Killed in Attempt to Thwart a Bird Flu Outbreak

2006-11-29T04:41:00Z

A second outbreak of bird flu has been confirmed in a poultry farm in Iksan 155 miles south of Seoul, South Korea. In an attempt to thwart an outbreak similar to the devastating outbreak of 2003 an aggressive culling of poultry and animals is underway.

Officials began the slaughter on Tuesday. Park Kyung-hee, an Iksan city official, indicated the culling would include 677 dogs raised on a farm for their meat and 300 pigs. Numbers of other dogs and cats including pets to be exterminated were not estimated. The culling will go as far as killing the mice in the area.

The World Health Organization has confirmed 253 human cases of bird flu resulting in 153 deaths, a staggering 59% death toll. To date there has been no documented evidence to suggest that the H5N1 form of bird flu can be spread to humans by dogs, cats or pigs.

It is clear however that pig to human transmission of seasonal flu occurs and authorities are being cautious. Most animals that have become infected are believed to have acquired the virus by eating infected raw birds or poultry. Cats are known to be able to spread the infection to other cats and it is believed that at least some of the tiger deaths have been due to tiger to tiger transmission as well.

Kim Chang an official with the health ministry said that other Southeast Asian countries also cull dogs, pigs and cats, but just haven’t publicized it. Kim stated that all mammals are potentially a source of the virus and that South Korea was just trying to take all precautionary measures to contain the virus.

European countries have issued guidelines to pet owners in areas where exposure to bird flu may occur. Recommendations include keeping cats indoors and dogs on leash. Bird flu is known to be present in bird excrement and carcasses both of which should be avoided.

One of the often unappreciated dangers of the H5N1 version of avian influenza is its’ ability to infect many non-avian species. This broad host spectrum is something that’s not common amongst flu viruses. Cats for example are usually not infected with influenza A viruses.

H5N1 has been associated with death in many mammalian species including, dogs, cats, pigs, ferrets, tigers, snow leopards and fox. According to the Center for Disease Control other mammals may be susceptible as well. The virus is continually evolving and appears to be expanding its’ host range.

Studying the evolution of H5N1 Dr Kawaoka, of the University of Wisconsin, has found isolates of the virus from humans that have acquired two mutations that make them better suited to infecting humans. He said, “We are watching this virus turn itself into a human pathogen.”

The tragic death of dogs and cats in Korea has stirred the hearts of many and made headlines. This drastic action serves as wakeup call to prepare and protect our loved ones including the furry ones. The time to act though is now as a much larger tragedy will ensue if the virus continues to evolve to a pandemic strain.

About the Author

Dr. Ferea is a published scientist whose research at Stanford University focused on the evolution of microbial genomes. As a concerned citizen she has used her scientific knowledge to educate the public on Bird Flu by writing articles, publishing a website, giving seminars and working with community groups.

She founded Bird Flu Smart on the principle that it is imperative to educate people on the importance of preparing for a pandemic and to bring to market high quality products that facilitate this process. Bird Flu Smart is a division of the Mountain View based company Phoenix Improving Life, LLC. For more information about Bird Flu Smart or pandemic preparedness please visit http://www.BirdFluSmart.com/.

This article may be republished in its entirety as long as the resource box and website location remain intact.

IMPACT OF A BIRD FLU PANDEMIC HITS HOME

2006-10-30T01:40:00Z

If the avian flu virus mutates so that the disease can be transmitted from one human to another, we will face a pandemic with the potential to kill a billion people worldwide. It is important for people to educate themselves, their family and their neighbors about bird flu and the concrete steps they can take now can to lessen the spread of the disease.

Waiting to prepare for a pandemic is like waiting for a category five hurricane to come ashore before racing to the lumber yard for plywood. A pandemic is even more dangerous than a localized natural disaster because a virus can be transported by airplane to virtually anywhere in the world within a matter of days.

Pandemic preparation has two integral components. First, you should have a basic 3 day emergency kit, just as you would for an earthquake, storm, hurricane, or other disaster. The only difference in preparing for a pandemic is that you should extend the level of preparation to last much longer. The flu lasts approximately two weeks, but it can conservatively take 6-8 weeks for it to go through a population. During this time you will need to be prepared for disruption of services just as with other large scale emergencies.

Second, is the preparation for “infection control,” it involves hygiene and barriers to contamination. Hygiene includes hand washing, covering sneezes and coughs, and daily disinfection of surfaces such as doorknobs, keyboards, and faucets. The “barrier method” of infection control requires that sick individuals be isolated and that others wear protective clothing. Only by wearing the appropriate quality masks, gloves, and goggles can the flu virus be prevented from entering through the mucosal membranes of the eyes, nose, and mouth.

Dr. Fenstersheib, the Public Health Officer for Santa Clara County, California, predicted that in the event of a pandemic, 25-35% of the population would become ill. He said, "With the burden this will place on the healthcare system and the government infrastructure, it is clear that each individual and family in our community must take on the responsibility to be prepared to care for sick family members during a pandemic. With proper supplies and instruction, home preparedness will go a long way to lessen illness and save lives.”

About the Author

Hand Washing Is The Beginning Of Infection Control

2006-09-15T01:21:00Z

We were told from the time that we were little kids to wash our hands. "Did you wash your hands before dinner"? Our mothers would ask. "Wash up before bed" our parents often commanded. "Johnny, stop picking your nose. Now go wash up before you eat" I'm sure that most of us out there have heard these shouts or something similar to them from our parents as we were growing up. What is the big deal about this anyway? Well, that is what this article about.

The Center of Disease Control (CDC) in Atlanta cites five common ways in which those disease- causing germs can be transmitted on our household. The first is hands to food. Here, the germs are transmitted from dirty hands to food. You or someone else eats the food and possibly gets sick. Another way is changing an infants diaper. Obviously, there is a multitude of germs in an infant's stool. Without washing, these germs cam be transmitted anywhere and onto anything. Another was if from food to hand. Here the person is handling raw uncooked foods. If they do not wash their hands, they can spread these germs anywhere even back onto other foods, which are then consumed. Nose, mouth, eyes is another way of transmitting germs. Hand washing can prevent all of the above.

What is the big deal you ask? Well, the incidence of hospital- borne infections is on the rise. Why? One of the reasons is that hospital staff is not washing their hands the way that they should. Properly, hospital staff should wash their hands in between touching every patient. I need to tell you that is not the case. As a matter of fact, that is no where near the case. A surgical hand wash for instance, use to take about a good 10 minutes, we would start at the elbows and work down, scrubbing each finger individually to its tip. I would venture to guess that isn't happening much today. There was a recent article in the Sunday San Diego Union newspaper that discussed just that fact. It talked about how people were getting preventable infections unnecessarily because hands were not properly washed. Do we care now as much as we did even 10 years ago about what we do to others? I don't think so.

Hand washing is the beginning of infection control. This is an indisputable fact. Not simply a statement. Also, does it matter how we wash our hands, I think so. Simply rinsing you hands with water isn't good enough. You need to wash your hand with both soap and water and the temperature needs to be on the hot side. Why? Because of the oils on your skin, the germs can adhere to your skin so simply rinsing with water will not get rid of them. The soap forms a bond with the oils and will take the germs with them. Also, the heat of the water opens the skin pores and releases some of the bacteria in them.

Here are some interesting facts:

One half of bacterial infections don't respond to antibiotics any longer.
Only an estimated 22-63% of medical personnel wash their hands between patient contacts.
There are an estimated 1.5 million infections per year that occur in long term care facilities.
Direct touching transmits 80% of common infections.
There are approximately 22 million cases of food poisoning with 10,000 deaths per year, which the FDA say is, cause by lack of hand washing. Seniors and the disabled are 10 times more likely to die from food poisoning than the rest of the population. This accounts for 1/3 of the US population.
The top cause for food borne illnesses is poor hygiene
The top cause for poor hygiene is lack of hand washing.

The above stats weretaken from the Food and Drug Administration and the Center for Disease Control.

Living in a fast paced society leaves little time for many people to stop and wash their hands. They are not thinking about the consequences of their lack of action. However, you as the disabled person must pay attention. Why? Because as I stated above, you are 10 times more likely to die from food poisoning than the general population. This is a fact folk not fiction. Most individuals who are disabled are exposed more frequently to health care providers from doctors to nurses' aids. Not all of them take the time to wash their hands, thus exposing you to infection. The remedy here is to ask the medical provider whether they are a doctor or an orderly to wash their hands before they touch you. Don't take a no for an answer.

Let's take a look at the above facts. Fact One; over half of the bacterial infections don't respond to antibiotics any longer. Because of the overuse of antibiotics, many of bacteria have become resistant to them. It used to be when I was growing up (I'm in my mid- 40's) the doctors wouldn't give us an antibiotic usually penicillin unless our fever lasted more than three days. This gave our body a chance to fight off the infection. The antibiotics were used only if we couldn't do it on our own. Today however, people don't want to be inconvenienced, they don't have the time to come back if they don't get better, so they pressure the doctors to give them medication. The result is bacterial that becomes resistant to the antibiotic.

Fact Two; only an estimate 22-63% of medical personnel wash their hands between patient contact. This scares the heck out of me. As disabled people, we deal with medical personnel very often. How do we know that the nurse who cleaned out the colostomy bag from the patient in the other room right before she came in to perform a procedure on you washed her hands? Its simple, ask. If she says that she didn't, don't let her touch you with doing so. Do not be ashamed to speak up. You may be saving yourself an infection. I can tell you from working in a hospital that there is so much work to do that sometimes they simply forget. Even if it is your doctor, speak up.

This leads us into Fact Three; that there is an estimated 1.5 million infections that occur in long term care facilities per year. These facilities do not have the same ratio of trained medical personnel that hospitals do. They usually hire medical assistants or nurse's aides to perform the direct patient care. These individuals may not fully understand the full ramifications on not washing their hands. That is why you better.

Fact Four; direct touching transmits 80% of common infections. It has been said and proven that our hands touch every part of our body a number of times every day. So it is easy then to comprehend how when we rub our eyes after touching bloody meat from the grocery store without washing our hands that we can cause an infection. Common infections include but are not limited to: colds, sore throats, eye infections, the flu, other viruses…

Fact Five; the FDA says that there are approximately 22 million cases of food poisoning with approximately 10,000 deaths per year that is caused by a lack of hand washing. In my opinion, you have to be very suspicious of the food handlers in restaurants or fast food chains. Who are the food preparers? Are they illegal immigrants from a third world country and possibly sick? Being hired simply because of cheap labor. You need to ask those questions about the food establishments that you frequent. Also, don't discount yourself. Preparing your own food with dirty/contaminated hands can also cause food poisoning.

Fact Six; seniors and the disabled are 10 times more likely to die from food poisoning than the rest of the population. This to me is a very scary fact. Whether we like it or not, most disabled people have compromised immune systems. This either because of medications that they are taken, or appliances that you are using, or because you are sedentary. Either way, this should be a huge incentive for you to make sure that your hands are washed.

Facts Seven and Eight; the top cause of food borne illnesses is poor hygiene and the top cause of poor hygiene is lack of hand washing, speak for themselves.

Many of the germs that we are talking about here are what we call opportunistic. This means that they usually will not cause disease. They actually live on your skin or in your bowels. However, if your health is compromised because of a disability or a common cold, these germs can do great harm.

Many of you who are disabled have compromised immune systems. Either from your illness, or from medications that you may be taken or simply because you live a sedentary life. Because of this, you are more susceptible to infection. It is simple to wash you hands isn't it? Well do it! It could save your life.

by Diana Corso of www.NutritionalUpdates.com

Diana Corso is the founder and publisher of Nutritional Updates. Diana has a BS in Biology and an MBA. Diana is also the founder of disABLEDperson Inc. which is a non profit charity whose mission is to connect the disabled with employers.

Article Source: http://www.articlehealthandfitness.com/authors/149/Diana-Corso

Technorati Profile

2006-08-26T02:30:00Z

Technorati Profile

World Bird Flu Death Toll Rising

2006-08-18T15:40:00Z

Indonesia recorded its 44th human bird flu death this week, according to the World Health Organization. This surpasses that of neighboring Vietnam with 42 deaths.

This makes 2006 the deadliest year since the H5N1 version of bird flu started spreading rapidly amongst the bird population, and brings this year’s worldwide death toll to 62 out of 93 reported cases (67%).

This number is only for confirmed cases and the actual death toll is likely higher. The World Health Organization indicated this week that another likely case remained unconfirmed due to the inability to collect samples prior to the mans death. This man was the neighbor of the 44th confirmed case. Another neighbor has also died and confirmation of bird flu as cause of death is pending the laboratory results.

So far most people who have become ill have had close contact with poultry. Indonesia has some 2 billion chickens and the virus is endemic in these birds in 27 of the 33 provinces.

Culling this many birds would require massive compensation to farmers and chicken owners. Indonesia has been criticized for not carrying out such an effort. Its neighbor Vietnam has carried out an aggressive culling campaign and has not had a confirmed case of the bird flu in 2006.

Currently Thailand officials are conducting a large-scale culling of chickens in an attempt to curb the spread of the disease. On Sunday the public health minister reported that this weekend 46 people, from 16 different provinces, were put under “medical close watch” while awaiting results of tests to determine if their bird flu like symptoms are the result of the deadly H5N1 form of the virus.

The battle ground is currently set in Asia and possibly Africa against this viral enemy. The more opportunities H5N1 has to mix with the typical human seasonal flu, the greater the likelihood it will acquire the mutations that allow it to spread easily amongst humans. Experts agree if this happens within 6 weeks the worldwide population will be fighting a pandemic battle that will be one for the history books. Technorati Profile

Roundup: Exercise promotes Singapore's preparedness for flu pandemic

2006-08-04T18:23:00Z

Singapore's first nation-wide flu pandemic exercise ended Saturday after testing the interoperability among various government agencies and the effectiveness of the country's Flu Pandemic Readiness and Response Plan.

Code-named Sparrowhawk II, the two-day exercise involved more than 1,000 personnel from 21 ministries and agencies, over 10,000 medical workers, as well as volunteers and members of the public.

Simulating a flu pandemic caused by the bird flu infection in human, the exercise aimed to strengthen the public health defense and to gear up the national surveillance, response and operational capabilities, the Ministry of Health (MOH) said earlier.

During the exercise, the MOH raised the color-coded flu pandemic alert level from green to orange on the first day and then to the red alert on the second day. Under this warning system, an orange alert means clusters of people have been infected while a red one, the highest level, indicates a full pandemic situation in the state.

Several people were found having a "fever" upon their arrivals at the Changi Airport, the Tuas Land Checkpoint and the Tanah Merah Ferry Terminal, where thermal scanners were installed to check passengers' body temperatures.

Immediately isolated at nursing stations, they had their temperatures taken at 15 minute intervals. Those whose high temperatures ran on among other flu symptoms were sent to the Tan Tock Seng Hospital, the designated hospital for treating flu patients in the event of a pandemic.

Meanwhile, other passengers were asked to fill up health declaration forms to facilitate contact tracing.

The scenario seemed familiar to these immigration checkpoints as similar measures had been taken there during the outbreak of the severe acute respiratory syndrome (SARS) in the region in 2003.

A major difference between a SARS pandemic and a flu pandemic is that SARS patients are infectious only after they exhibit symptoms like fever while flu patients are infectious before the symptoms are observed, local news reports quoted doctors as saying.

At the Tan Tock Seng Hospital, medical staff wearing full protective clothing, including masks, visors, shower caps, gowns and gloves, screened these suspected flu cases and classified them as either high-risk for admittance or low-risk for discharge.

Each of the cases was handled in about 20 minutes, a goal set by the hospital itself for the purpose of effectively dealing with a large number of patients expected in a real pandemic, local news reports said.

It is estimated that as many as a quarter of Singapore's some 4 million population would be knocked down by a flu pandemic outbreak, about 11,000 people would need to be hospitalized and the death toll could reach 2,000.

Procedures like temperature screening, visitor registration, as well as mask distribution and wearing were also practiced in other participating hospitals, polyclinics and private medical institutions during the exercise.

The drill also helped enhance students' awareness and knowledge about a flu pandemic as over 3,000 students from two schools took and recorded their temperatures in class on Friday and were told to practice good hygiene.

Teachers also identified and isolated students who felt unwell, informed their parents to take them to the hospital, and made reports to relevant government agencies.

Media reports quoted parents and school staff as saying that such exercise was necessary and helpful.

Singapore's Deputy Prime Minister Wong Kan Seng said Friday after witnessing the drill at the Tan Tock Seng Hospital that "the exercise is one of those which we will conduct to test the system to find out what else we need to do to improve it."

Recommendations have already come out even before participants in the exercise have a chance to pool their feedback, according to media reports.

Private doctors are seeking for supports in terms of manpower, equipment and medication, saying that their clinics, mostly run by a single doctor with few assistants, could not withstand a surging volume of patients in a real pandemic.

With the help of the exercise, the MOH will also fine-tune its plan for dispensing Tamiflu, an anti-viral drug for treating avian flu. Singapore's stockpile of Tamiflu is expected to reach some 1 million doses by the end of this year.

Though no bird flu infection, either in poultry or in human, has been reported in Singapore so far, the government has always kept an eye out for the threat, which is lingering in an increasing number of countries worldwide including those surrounding the state. More exercises, of large or small scale, will be held in the future.

Source: Xinhua

Unless we act now, bird flu may win

2006-07-07T16:38:00Z

Laurie Garrett International Herald Tribune

SUNDAY, FEBRUARY 26, 2006

NEW YORK Despite the commitment of billions of dollars to the fight against pandemic influenza, the world may lose the battle against avian flu, for lack of an effective strategy. Much of the money - nearly $4 billion from U.S. taxpayers, alone - is being spent inappropriately. For far less money, strategically deployed in a global campaign, the world could be a safer place for the coexistence of man and microbe.

H5N1 avian flu has reached Nigeria, Iran, Iraq, all the Black Sea nations and now Austria, Denmark, Bulgaria, Italy, Slovenia, Hungary, Switzerland, India, Egypt, France and Germany. There is a sense of panic in the air, as Asians, Europeans and Africans alike imagine a catastrophic human pandemic.

It could happen, but humanity ought not simply consider the event inevitable and frantically stockpile Tamiflu and other drugs of dubious efficacy. A definitive report in the Jan. 28 issue of the medical journal The Lancet concludes, "We could find no credible data on the effects of [Tamiflu] on avian influenza." The Italian and Australian authors of the report warn that, "Over-reliance on a pharmacological solution to the ravages of influenza may impede the development and implementation of broader intervention strategies based on public-health measures."

It is urgent that public health leaders and policy makers step back from the breech and consider how this bird pandemic is spreading, and what can be done about it. We know enough about influenza to develop and execute a rational strategy. It will require some significant feats of diplomacy and foreign policy, but it is achievable.

First, let's stop pretending nature is mysterious, and concentrate on what we know. H5N1, though deadlier and potentially far more devastating than any other influenza seen in nearly a century, has followed a fairly clear set of biological, predictable principles since it first surfaced in Hong Kong in 1997.

Thanks to the brilliant work of scientists like Robert Webster, Malik Peiris, Kennedy Shortridge and K.Y. Yuen, we now understand that influenza is naturally an aquatic migratory bird virus that is carried by ducks, geese and a small list of other waterfowl. Influenza infection is usually harmless to these world travelers, but can kill other types of birds, such as chickens, domestic ducks and swans.

The vulnerable birds contract their infections when the migrating species land on farms or ponds, and pass influenza fecally. We now know that the H5N1 virus is particularly robust, and can survive suspended in fecal material for more than a month, making it possible that a flock of dead chickens spotted today may actually have become infected as a result of pecking its way through feces deposited weeks ago by a passing goose.

So far the only tactics being deployed once H5N1 turns up in domestic animals are slaughter, culling millions of animals that are suspected of being infected, or mass vaccination. If peasant farmers cannot afford to keep domestic animals indoors, away from wild birds' contaminating viruses, an alternative is to keep the migrating birds away from the farms.

For at least a decade H5N1 has circulated among a small pool of migrating birds, mostly inside China, and occasionally broken out in other animals and people. Last May, however, more than 6,000 avian carcasses piled up along the shores of Lake Qinghai, in central China, one of the world's most important bird breeding sites. Most of the dead included species that hadn't previously evidenced influenza infection.

The Lake Qinghai moment was the tipping point in the bird flu pandemic. The virus mutated, evidently becoming more contagious and deadly to a broader range of bird species, some of which continued their northern migration to central Siberia. By June, Russia's tundra was, for the first time, teeming with H5N1-infected birds, intermingling with southern European species that became infected before flying home, via the Black Sea.

Not surprisingly, by October countries from Ukraine to Greece were rumored to have H5N1, but only the Romanian government responded with swift transparency, culling tens of thousands of chickens and ducks. Most of the governments in the region did not confirm their H5N1 contaminations until Turkey, after at least three months of denial, was forced on Jan. 6 to admit that the virus had infected birds in a third of the country's provinces, and had caused several human infections and deaths.

Since then, we have learned of confirmed bird and/or human H5N1 cases in Iraq, Azerbaijan, Iran, Greece, Spain, Italy, Croatia, Austria, Hungary, Slovenia, France, Germany, Denmark, Bulgaria and, most disturbingly, Nigeria, Egypt and India.

Not a single one of these countries' outbreaks ought to have been surprises. Each of them is located along either the Black Sea/Mediterranean migratory bird flyway, which starts in Siberia and, at its southernmost point, ends in Nigeria and Cameroon, or the European flyway, which overlaps the former, and stretches from northernmost Siberia to Nigeria.

Anybody tracking the birds could have seen it coming. Several countries along the flyway between Saudi Arabia (which has confirmed H5N1 infections in falcons) and Nigeria have not reported H5N1 cases, but much of the region is North Africa's sparsely populated Sahara Desert. Egypt reported widespread bird infection last week, and it is likely that infected birds have landed along the few waterways in the area, such as the Nile, Lake Chad and the Red Sea.

We should not be astonished to learn of H5N1 outbreaks in birds or people in the next few weeks in nations located along the East Africa flyway, which overlaps with the already contaminated Black Sea/Mediterranean one: Cameroon, Chad, Ethiopia, Sudan, Uganda, Rwanda, Burundi, Tanzania, Gabon, Angola, Namibia, South Africa, Madagascar, Mozambique, Malawi and the rest of the eastern African countries.

Because H5N1 has been confirmed in Nigeria, Egypt, Germany and Spain, which straddle the intersections of the Black Sea/Mediterranean and the East Atlantic flyways, over the next six weeks we should not be surprised to hear of H5N1 bird and even human cases in several northern European nations, including Britain and Iceland.

By June or July, if the biological imperatives continue to follow their course, H5N1 should turn up in eastern Siberia, and then Alaska, via the East Asia flyway. It might also at that time jump from Iceland, via Greenland, to northern Canada. Once in the Arctic zones of the Americas, H5N1 will be able to follow any, or all, of the four primary north/south flyways that span the Americas, from the Arctic to Tierra del Fuego. It is in the realm of reasonable probability that H5N1 will reach the United States this summer or early autumn.

Instead of simply sitting back and watching nature take its course, the global community should be proactive. Being ahead of the virus is akin to being ahead of the migrating birds. Instead of waiting for dead birds, and even dying people, to turn up in new areas, political leaders should heed the warnings from science and act accordingly - as, apparently, Sweden and the Netherlands are doing. The Swedes and Dutch looked at their maps, plotted the movements of infected birds, and last week ordered farmers to bring their flocks indoors, out of harm's way. In poorer regions of the world, where indoor facilities for animals may be unaffordable, simple nets and fences can radically decrease contact between wild and domestic birds, and mass public education campaigns warning people to avoid contact with sick birds or carcasses may decrease the likelihood of avian-to-human transmission of H5N1.

One of the best untapped resources in this epic battle against influenza is bird-watchers, who are among the most fanatic hobbyists in the world. The major bird-watching organizations and safari clubs ought to work with the World Health Organization and OIE, the World Organization for Animal Health, to set up Web-based notification sites, where birders could report sightings of groups of dead birds, and the movements of key migrating species.

Ornithologists and climate experts should immediately sit down with pandemic planners and virologists, creating lists of known H5N1 carriers and plotting their most likely global movements. As the birds appear in new regions of the world, birders and professional wildlife surveillance personnel should issue alerts, which should be swiftly confirmed and form the basis of government response.

When carrier species are sighted in a region, swift action should be taken to minimize contact between the wild birds and their domestic kin. In such a way, it might be possible to limit avian deaths to susceptible wild birds, such as the dying swans of Europe.

While the H5N1 virus remains an avian killer, wealthy nations and biomedical companies should work hard on developing a rapid, simple method of diagnosing flu infections in people. Currently, many of the delays in reporting human cases around the world are due to the tedious laboratory procedures necessary to diagnose H5N1 infection. We urgently need a quick infection test that can be performed by nonprofessionals.

Rather than waiting for a tide of H5N1 to wash over the world's birds, mutate, and then move in a tidal wave over humanity, we should create lines of defense that start with the wild animals, move next to protect poultry, and then rely on rapid screening of human beings to determine who is, and is not, infected with the virus.

In the absence of these sound footings, everything else is just wasted billions of dollars.

(Laurie Garrett, a senior fellow for global health at the Council on Foreign Relations, is the Pulitzer Prize-winning author of "The Coming Plague.")

Bird Flu Fatalities Almost Triple, Spurring Need for Treatments

2006-06-29T03:29:00Z

June 28 (Bloomberg) -- Bird flu fatalities have almost tripled this year as the lethal virus spread across Asia, Europe and Africa, prompting calls for increased supplies of medicines to fight the virus and any pandemic it might spawn.

Since January, at least 54 people have died from the H5N1 avian influenza strain in Azerbaijan, Cambodia, China, Djibouti, Egypt, Indonesia, Iraq and Turkey, according to the World Health Organization. That compares with 19 fatalities in Vietnam and Cambodia in the first six months of 2005. Human cases create opportunity for the virus to mutate into a lethal pandemic form.

``The situation worldwide remains as serious as ever,'' said Ian Jones, a professor of virology at the University of Reading in the U.K. ``Screening and preventative measures are as appropriate as ever.''

Pharmaceutical companies, including Sanofi-Aventis SA, GlaxoSmithKline Plc, MedImmune Inc., Vical Inc., Acambis Plc and CSL Ltd. are racing to produce pandemic flu treatments amid concern over H5N1, which was found for the first time in wild birds and domestic poultry in 38 countries since February.

``We have seen three major pandemics in the last century,'' Albert Osterhaus, the head of the Department of Virology at the Erasmus Medical Center in Rotterdam, Netherlands, said in a June 22 phone interview. One in 1918 known as Spanish flu ``killed 1-2 percent of the world population. If the threat is there, we should be prepared,'' he said.

Flu Conference

Tomorrow Osterhaus, whose laboratory was the first to identify human infection from the H5N1 strain, will co-chair the opening session of the First International Conference on Avian Influenza in Humans in Paris.

The two-day conference at the Institut Pasteur will bring together more than 200 health experts, policy makers, researchers and drugmakers to discuss the latest advances in therapies aimed at treating and preventing avian flu and averting a pandemic.

``Our aim is to launch the discussion between the different actors involved in the fight against avian influenza starting from medical and scientific specialists to government crisis management specialists,'' said Marvin Edeas, chairman of a committee organizing the meeting. ``We will try to answer many questions: is the medical profession ready to fight against a pandemic? Is the world ready to face a human avian flu pandemic?''

The rate of new infections has almost doubled to one every two days this year, from almost two a week in 2005. Since late 2003, at least 130 of the 228 people known to have been infected with H5N1 have died, according to the Geneva-based WHO.

`Virus Pressure'

The rising human tally ``continues to reflect the underlying virus pressure in both domestic and, to some degree, wild birds,'' Michael Osterholm, director of the University of Minnesota's Center for Infectious Disease Research and Policy, said in a June 22 interview from Minnesota.

``We're in what is an unfolding experiment of Mother Nature,'' Osterholm said. ``We're trying to explain it as if we've already done the bench work and can tell you what's going to happen. That's just not the case.''

Before 1997, when the first known human H5N1 case occurred, scientists didn't believe an H5 subtype of the flu virus could infect people. Pandemics last century were caused by viruses of the H1, H2 and H3 subtype.

More than 209 million poultry have died or been culled worldwide in the past 30 months because of outbreaks of the H5N1 virus, the Food and Agriculture Organization of the United Nations said last week.

Severe Winter

A severe winter in Russia and the Caucasus area at the end of last year pushed migratory birds south and westward, the FAO said. By February, initial outbreaks in wild birds and poultry were reported in Iraq, Nigeria, Bulgaria, Slovenia, Greece, Italy, Azerbaijan, Iran, Germany, India, Egypt, Austria, Bosnia-Herzegovina, France, Slovakia, Switzerland and Niger.

The following month, Hungary, Serbia and Montenegro, Pakistan, Albania, Poland, Georgia, Cameroon, Myanmar, Denmark, Sweden, Israel, Afghanistan, Jordan and the Czech Republic reported initial outbreaks. They were joined by Burkina Faso, Palestine Authority, U.K., Sudan and Ivory Coast in April and Djibouti in May.

In contrast, no initial outbreaks were reported in the first half of last year. In the first half of 2004, Vietnam, Japan, Thailand, Cambodia, Hong Kong, Laos, Indonesia and China reported H5N1 for the first time.

To contact the reporter on this story:
Jason Gale in Paris at j.gale@bloomberg.net