Saturday, January 17, 2009

China says 2-year-old girl confirmed with bird flu

Sun Jan 18, 2009 2:43am GMT

BEIJING (Reuters) - A two-year-old girl has been confirmed to be infected with bird flu in north China's Shanxi Province, Xinhua news agency said on Sunday, citing a provincial government official, in the second case in as many weeks.

The girl, surnamed Peng, was found ill on January 7 in central Hunan Province and was taken to hospital in Luliang City of Shanxi on January 11, Xinhua said, citing an unnamed official with the Shanxi provincial health department.

The girl had tested positive for the H5N1 strain of avian influenza and "was in critical condition," Xinhua cited the official as saying.

"All people who have had close contact with her are under strict medical observation ... Up to now, no abnormal symptoms have been found," a statement on China's Health Ministry website ( said.

The Health Ministry had notified the World Health Organisation, authorities in Hong Kong and Macau, and some other countries, the statement said.

China confirmed earlier this month a woman infected with bird flu had died in Beijing after buying nine ducks at a market in Hebei province, which surrounds the Chinese capital, sparking emergency checks of local poultry markets.

The H5N1 remains largely a disease among birds but experts fear it could change into a form that is easily transmitted from person to person, and spark a pandemic that can kill millions of people worldwide.

At least 21 people have died of bird flu out of 32 people infected in China.

Source ::: Philippine Star
A Nepalese health worker spraying disinfectant on a motorcycle entering from India at the Nepalese border town of Kakarbhitta yesterday. Nepal reported its first outbreak of bird flu in poultry, confirming a case of the deadly H5N1 strain of the virus in the eastern region.

Recombinomics: H5N1 Case in Hunan China Raises Pandemic Concerns

Recombinomics Commentary 19:46
January 17, 2009

The girl, surnamed Peng, was found ill on Jan. 7 in the central Hunan Province.

The above comments describe the most recent H5N1 confirmed case in China. She was infected right after the patient in Beijing died, who was infected a couple weeks after the outbreaks Jiangsu. All three incidents (see updated map) involved H5N1 confirmed hosts in the absence of dead poultry.

The outbreaks in Jiangsu were detected during routine surveillance. As noted in the OIE report, there were no dead birds. The H5N1 in the Jiangsu outbreaks was clade 7. Clade 7 is quite distinct from clade 1 and clade 2 which are the two clades that have accounted for the vast majority of human cases and outbreaks. However, clade 7 had caused the first confirmed case in China in Beijing in 2003. It has been reported in poultry outbreaks in northern China are provinces near Beijing, as well as Hunan province.

The history of outbreaks and the temporal relationship to the Beijing case suggest clade 7 may have been involved in the Beijing infection(s). The same is true for the Hunan case.

Clade 7 is cause for concern because it has caused at least one human case previously and was in asymptomatic birds in Jiangsu. Moreover, it has caused problems previously in vaccinated flocks. The genetic differences between clade 7 and clade 1 or 2 can produce vaccine mismatches which generate asymptomatic birds which shed H5N1 that can infect other birds and humans. This creates conditions fro silent transmission in birds and cases that have no clear linkage to dying poultry.

China has not filed any OIE reports since the Jiangsu outbreak in December, suggesting H5N1 was not detected in poultry culled in the Beijing area. Detecting H5N1 in asymptomatic birds is difficult, so the absence of H5N1 positive birds does not necessarily signal the absence of H5N1.

The widespread detection of H5N1 in China in the absence of dead or dying poultry is cause for concern.

Shanxi has the girl to dye ="has" the birds and beasts epidemic disease again

18/01/2009, on Sunday in the morning 09:47

Has early after Beijing the young girl infects the bird flu death, Shanxi again has two year-old girls to confirm the infection bird flu, at present the situation is serious, the inland Department concerned is being taken bad the domesticated fowl contact history before the girl to carry on the investigation. This is inland in two weeks, the second humanity diagnoses the infection bird flu case. Hong Kong Department of health health protection center spokesperson indicated that will continue with inland will maintain close contacting, understands the details.
According to the National Medical department website announces, the sick girl family lives in the Shanxi Luliang, on the seventh of the month sends in Hunan sickness, on 11th returns to Shanxi along with the family member, the aggravation of disease, treats to 14th to the Shanxi Province Fenyang hospital, in the evening passes along the Shanxi Province Pediatric hospital again. The China CDC carries on the examination to the girl, confirmed that assumes the positive reaction to the bird flu H5N1 virus.

Shanxi Province, confirmed the first case of human bird flu cases

"Financial" reporter Wang Chao
[At 8:56 on January 18, 2009]

At present, two-year-old critically ill patients are still in the rescue, this is also China since 2003, the first 32 cases of human infection of highly pathogenic avian influenza cases in early January this year, Beijing has just one, therefore the death of patients
January 17 evening 22:42, Shanxi Province Health Department issued a formal briefing, said the province has been confirmed case of human infection of highly pathogenic (H5N1) bird flu.
It is reported that this is the first in Shanxi Province have been confirmed human avian influenza cases in China since 2003 was confirmed the first 32 patients.
Before, on January 5, had been infected with H5N1 bird flu, 19-year-old Wong Yan-qing just passed away in Beijing Chaoyang District.
Bulletin, the patient彭某, F, two-year-old and currently residing in Xiaoyi City, Luliang Prefecture, Shanxi Province. Patients January 7, 2009 the incidence in Hunan, January 11 with the grandparents back to Shanxi, condition worsened after the January 14 Fenyang treatment in hospitals in Shanxi Province, with no significant symptomatic improvement after treatment, was on the 14th later transferred to Children's Hospital of Shanxi Province.
At present, children in a critical condition, the health sector in Shanxi Province is under the guidance of the Ministry of Health expert group to carry out rescue efforts.
January 17, the Chinese Center for Disease Control and Prevention and the Chinese Academy of Medical Sciences review of patient samples for testing, the results for the H5N1 avian influenza virus nucleic acid positive.
According to World Health Organization of human infection of highly pathogenic avian influenza confirmed case definition and diagnostic criteria of China, the Ministry of Health human avian influenza prevention and control expert group to determine the cases of human infection of highly pathogenic avian influenza confirmed cases.
The cases of the situation, the Ministry of Health has the World Health Organization, Hong Kong, Macao and Taiwan regions and part of national communications.
Epidemic occurred, the local government attaches great importance to Shanxi Province, in accordance with the "human infection of highly pathogenic avian influenza contingency plans", in January 17, 2009 to start a public health emergency Ⅱ-class emergency response and take the appropriate prevention and control measures for the implementation of all the close contacts of strict medical observation, and actively carry out a comprehensive epidemiological investigation. As the evening of the 17th, all close contacts are not unusual clinical manifestations.

According to "Financial" reporter has learned that as early as November 2005, Shanxi Luliang Xiaoyi City Tie-cheng breeding new high-Town Park, on the H5N1 outbreak occurred in poultry. After 2006, the city of Yangquan, Shanxi, Changzhi City also have occurred in poultry in the epidemic, but people did not cause illness.
January 9, the Chinese Center for Disease Control and Prevention held in Beijing news conference, the Center's director of the Center for National Influenza舒跃龙reminded that each year in November to March the following year, a variety of influenza (including avian flu ) high season, he hopes the public to remain vigilant.

Recombinomics: H1N1 Tamiflu Resistance Spreads Across Japan


H1N1 Tamiflu Resistance Spreads Across Japan
Recombinomics Commentary 12:30
January 17, 2009

In the survey, local public health institute data was compiled by the National Institute of Infectious Diseases, which operates under the ministry. Data showed that 303 of the 671 influenza patients had the Hong Kong-A strain, and 243, or about 36 percent, had the Soviet-A strain. The other 125 had B-type influenza.

The Institute separately examined samples of the Soviet-A strain taken from 35 patients in 11 prefectures, and found that Tamiflu was ineffective for 34 of the patients, or 97 percent.

The above comments provide an update on oseltamivir resistance in Japan. The “Soviet-A” strain is H1N1 clade 2B Brisbane/59, which was phylogenetically described for three isolates from an elementary school outbreak in Sendai. Those sequences matched sequences in the United States from HI, TX, PA. An earlier WHO report indicated 13/14 H1N1 isolates had H274Y. the above report extends the resistance to 34/35 isolates collected from 11 prefectures, indicating the resistance is widespread.

The results from Japan match those of Korea. Where H1N1 cases have exploded and 16/17 H1N1 isolates had H274Y. Similar results have been described for the United States and Canada in North America, as well as England and many countries in Europe.

Since the H1N1 with H274Y in Japan is called the “Soviet –A” strain, it is likely that resistance levels in Russia and China are similar to Europe, North America, and Korea/Japan.

Media Links

AQSIQ issued to prevent human infection of highly pathogenic avian influenza spread of Notice

2009-1-17 10:59:26

AQSIQ on the prevention of human infection of highly pathogenic avian influenza spread Notice
2009年第1号 2009 No. 1

According to the Ministry of Health January 6, 2009 briefing, Beijing confirmed one cases of human infection of highly pathogenic avian influenza deaths. According to the World Health Organization (WHO) 2008 report on 12 years, this month, Egypt Assiut province, Riau Province of Indonesia, Cambodia emerged of human infection with highly pathogenic avian influenza cases. At present, highly pathogenic avian influenza being high season, in order to prevent human infection of highly pathogenic avian influenza transmission, to protect the health and safety of immigration officers, according to "People's Republic of Frontier Health and Quarantine Law" and its implementation details of the relevant provisions are Notice is as follows:

First, from the human infection of highly pathogenic avian influenza endemic areas of personnel, if fever, cough, headache, general malaise and other symptoms, immigration should take the initiative to exit inspection and quarantine agencies oral declaration. After entering the above symptoms should immediately seek medical treatment, and doctors note the recent travel history to receive timely diagnosis and treatment.

Second, ports and quarantine personnel to strengthen these areas from the immigration officers temperature monitoring, medical and other health inspection and quarantine work on-site inspection of a declaration or found to have the above symptoms should careful investigation of those who found the highly pathogenic Avian Infected Infected influenza or suspects, it is necessary to take timely medical measures.

Third, to those of human infection of highly pathogenic avian influenza endemic areas of personnel, be able to exit inspection and quarantine institutions and their international travel health care center or visit the AQSIQ Web site ( Health quarantine and travel health column, understanding the epidemic in the region to grasp the bird flu prevention methods. Travel or travel after the discovery of avian flu-related symptoms should immediately seek medical treatment, and entry and exit inspection and quarantine institutions to declare.

Fourth, inspection and quarantine agencies shall strengthen bird flu prevention and control ports knowledge publicity and education work, and enhance awareness of the immigration officers disease.Personnel to these areas should avoid contact with bird flu patients, infected poultry and their excreta or contaminated with the feces of lime, earth; avoid eating raw or cooked poultry meat; in the outbreak, the poultry breeding, sale, slaughtering, processing establishments to be taken such as wearing masks and gloves protective measures; washing hands frequently; to the bird flu virus could contaminate the region, disinfection items.

This notice issued since the date of 3 months effective.

January 8, 2009

H5N1 Confirmed Case in Hunan China

Recombinomics Commentary 19:46
January 17, 2009

F, 2-year-old and currently residing in Xiaoyi City, Luliang Prefecture, Shanxi Province.

January 7, 2009 the incidence in Hunan, January 11 with the grandparents back to Shanxi, condition worsened after the January 14 Fenyang treatment in hospitals in Shanxi Province, with no significant symptomatic improvement after treatment, was on the 14th later transferred to Children's Hospital of Shanxi Province.

The above translation describes a confirmed H5N1 patient who is in critical condition. She is currently in Shanxi, although the initial incident is said to have been in Hunan. This case follows the fatal case (19F) in Beijing, which may have been part of a cluster involving a health care worker at the hospital.

Although it is unclear where the patient resided in Hunan, clade 7 has been isolated from both regions previously. Clade 7 was reported in Jiangsu last month and has caused a previous case in Beijing (in 2003).

More information on the circumstances surrounding the infection would be useful. China has not recently reported H5N1 in poultry in Hunan or Shanxi, raising concerns about the source of the infection, as well as reporting of H5N1 in poultry or wild birds in China.

More information on the circumstances associated with this case, as well as sequence data associated with the fatal case in Beijing would be useful.

The Hong Kong receives the Shanxi girl to dye"has" the bird flu case

2009-01-17 23:28

[ special news]The health protection center evening receives the National Medical department to notify, refers to Shanxi to have a human exposure bird flu H5N1 diagnosis case. The patient is 2 year-old girls, on the 7th of the month is taken bad in Hunan, goes see a doctor on the 11th of the month to Shanxi, now the situation is seriously injured. The health protection center spokesperson indicated that will continue with the National Medical department will maintain close contacting, understands the case the details.

Notification of a human case of avian flu in Shanxi Province

************************************************** **********
The Centre for Health Protection (CHP) of the Department of Health received notification from Ministry of Health (MoH) tonight (January 17) concerning a confirmed human case of avian influenza H5N1.

A CHP spokesman said the patient was a two-year-old. She developed symptoms on January 7 in Hunan and was brought to Shanxi for medical treatment on January 11. She is now in critical condition.

Laboratory tests on the patient's specimen by Chinese Centre for Diseases Control and Prevention yielded positive to H5N1.

Further investigations on her contact history with poultry before the onset of symptoms are on-going.

The CHP is maintaining close liaison with the MoH to obtain more information on the case.

The spokesman reminded members of the public to remain vigilant against avian influenza infection and to observe the following measures:

* Avoid direct contact with poultry and birds or their droppings; if contacts have been made, they should wash hands thoroughly with soap and water;
* Poultry and eggs should be thoroughly cooked before eating;
* Wash hands frequently;
* Cover nose and mouth while sneezing or coughing, hold the spit with tissue and put it into covered dustbins;
* Avoid crowded places and contact with sick people with fever;
* Wear a mask when you have respiratory symptoms or need to take care of patients with fever;
* When you have fever and influenza-like illnesses during a trip or when coming back to Hong Kong, you should consult doctors promptly and reveal your travel history.

For further information on avian influenza, please visit the CHP website:

Ends/Saturday, January 17, 2009
hattip Dutchy

Shanxi Province confirmed case of human infection of highly pathogenic avian influenza cases

January 17, 2009 23:46:13 Source: Xinhua

Reporter January 7 am in Sanhe City Yanjiao palace to see the live poultry markets, live poultry trading region have all been shut down, pulling up a cordon at the scene, animal husbandry, disease control departments of the staff being disinfected palace other commodities trading market normal business.
Xinhua Taiyuan January 17 (Xinhua Gao Feng) press the evening of the 17th Shanxi Provincial Health Department informed indirectly, Shanxi confirmed case of human infection of highly pathogenic avian influenza cases.
Bulletin, the patient彭某, F, 2-year-old and currently residing in Xiaoyi City, Luliang Prefecture, Shanxi Province.
Patients January 7, 2009 the incidence in Hunan, January 11 with the grandparents back to Shanxi, condition worsened after the January 14 Fenyang treatment in hospitals in Shanxi Province, with no significant symptomatic improvement after treatment, was on the 14th later transferred to Children's Hospital of Shanxi Province.
At present, children in a critical condition, the health sector in Shanxi Province is under the guidance of the Ministry of Health expert group to carry out rescue efforts.

January 17, the Chinese Center for Disease Control and Prevention and the Chinese Academy of Medical Sciences review of patient samples for testing, the results for the H5N1 avian influenza virus nucleic acid positive.
According to World Health Organization of human infection of highly pathogenic avian influenza in China confirmed case definition and diagnostic criteria, the Ministry of Health human avian influenza prevention and control expert group to determine the cases of human infection of highly pathogenic avian influenza confirmed cases.

After the outbreak, the local government attaches great importance to have been in accordance with the "human infection of highly pathogenic avian influenza contingency plans", in January 17, 2009 to start a public health emergency Ⅱ-class emergency response and take the appropriate prevention and control measures All close contacts of the implementation of strict medical observation, and actively carry out a comprehensive epidemiological investigation.

Up to now all close contacts are not unusual clinical manifestations.
According to the briefing, the case of the situation, the Ministry of Health has the World Health Organization, Hong Kong, Macao and Taiwan regions and part of national communications.

Nepal steps up culling in first bird flu outbreak

Fri Jan 16, 2009 11:52pm EST

By Gopal Sharma

KATHMANDU, Jan 17 (Reuters) - Dozens of veterinary workers in protective suits descended on a town in east Nepal on Saturday to intensify culling of poultry to prevent the spread of bird flu after the H5N1 virus was first detected in the Himalayan nation.

"Teams with safety masks, head covers, body gowns, shoes, gloves and goggles have already been sent and they will intensify culling today or tomorrow," said Prabhakar Pathak, chief of the department of livestock services in Kathmandu on Saturday.

Bird flu was detected in chickens and ducks in the densely populated town of Kakarvitta, 275 km (172 miles), southeast of capital Kathmandu, authorities said on Friday, piling on problems for the Maoist-led government in the impoverished country.

The government, formed after the former Maoist guerrillas won the election in April last year, is already struggling with an acute shortage of electricity in the midst of a harsh winter, prompting several anti-government protests.

About 13,000 poultry would be culled in five days to control the virus within a 3 km radius of the town, and the government would pay up to $5 for each chicken or duck that is culled, Pathak said.

Flu symptoms had not been seen among people in the affected area yet, authorities have said.

"The outbreak is limited to one place and we have banned the movement of any poultry and products from there," Pathak said.

According to the World Health Organization, the H5N1 bird flu has infected more than 390 people in 15 countries and killed at least 247 of them since the virus resurfaced in Asia in 2003.

The epicentre of Nepal's outbreak is close to India's West Bengal state which has been fighting to contain intermittent outbreaks of the virus in poultry since last year.

India has culled millions of chickens and ducks to contain the virus since the first outbreak in 2006, but has reported no human infections. (Editing by Rina Chandran and Valerie Lee) (For the latest Reuters news on Nepal see:, for blogs

Another Suspect H5N1 Cluster in Tangerang Indonesia

Recombinomics Commentary 11:57
January 17, 2009

Nafisah (43) the resident Street Pentogelan, the Javanese Alley of RT 01/04, the Cengkareng District, of Jakarta West died it was suspected resulting from terjangkit the bird flu virus. Dadi (22) casualties's child said his mother already four days had a temperature, breathless and the cough.

The doctor in this hospital said the mother was positive bird flu, he said sadly.

In the meantime the Lily (47) the husband of casualties said his wife was sick along with the child the three of them. However his child recovered after being brought to the Community Health Centre.

The above translation describes another suspect H5N1 cluster in Tangerang, near Jakarta. The mother (43F) was transferred to an infectious disease hospital after failing to respond to treatment. She died within hours of admittance. The comment by the attending physician is likely based on a infleunza A positive rapid test, but there has been no official confirmation. This is a common pattern for H5N1 cases and clusters in Indonesia.

Moreover, three family members also had symptoms, but recovered. The likelihood that they will test positive is near zero. Indonesia has had a case fatality rate near 80%, which it has had since 2005. The high rate is due in part to testing / reporting issues. The MOH has already commented on a lowering of cases due to Tamiflu treatment. However, Tamiflu treatment should lower the case fatality rate, not the number of confirmed cases unless there was frequent human to human transmission, treatment generated a false negative, or both. Since there are dozens of examples of both, including the cluster described above, the artificial lowing of confirmed cases and clusters, the true extent of human H5N1 in Indonesia remains unclear.

The continuing failure of WHO to exercise oversight in Indonesia remains hazardous to the world’s health.

Because of the victims died Bird Flu increase

Saturday, 17 January 2009 - 20:09 wib

TANGERANG - The victim died due to bird flu grow again. Nafisah (43), residents Pentogelan Road, Gang Java RT 01/04, Kelurahan Cengkareng, West Jakarta died due to suspected avian influenza virus infected aka bird flu.

Dadi (22), son of the victim said her mother has been four days fever, shortness of breath and coughing.
Next Nafisah with his family brought to the health of the region. But there also does not change, even Nafisah strain-strain. "Mother has been to bring in health-round but I recovered," he said at the General Hospital Regional Tangerang, Saturday (17/1/2009).

See the condition of the critical Nafisah, Nafisah was finally RSU Tangerang morning and go directly to the IGD isolation for intensive treatment. But as much 10:00 WIB, Nafisah against last breath. "Doctors at the hospital said the mother of positive bird flu," he said sad.

Meanwhile, Lili (47), the victim's husband said his wife, sick with the same three children. But after her son was brought to recover health. "Before being taken to my wife RSU strain-strain," he said.

According to Lili, his wife will be brought to the house and dimakamkan be directly in the public cemetery not far away from home.

hattip Shiloh

Resident Died It Was Suspected Infected By Bird Flu

Tangerang -- MI: A resident had the initials Na (43) from Pendongkelan behind RT 01/14, Cengkareng East, Jakarta West, died in the Public Hospital (RSU) Tangerang, Banten, because of being suspected of being infected by the bird flu virus or avian influenza (AI) the kind H5N1, on Saturday morning (17/1).

"Information that was accepted by the family from one of the doctors in RSU Tangerang, mentioned Na died because of being expected tertular the bird flu virus," said the mother of casualties, Wastiah (65) in Tangerang. However Wastiah did not learn, the identity of the doctor who gave assumption information of his child was infected by this deadly virus.

Wastiah explained, initially Na experienced the high fever, breathless and the difficult cough since the last four days or on Tuesday (13/1), a day later casualties were carried to the Cengkareng Community Health Centre.

After taking medicine to the closest Community Health Centre, the condition for casualties also did not improve in fact increasingly worsened with experienced breathless difficult, in fact Na did not have the story of the illness that had the respiratory tract or asthma relationship.

After three days took medicine to the Community Health Centre or on Saturday (17/1) around struck 03,00 WIB, the initiating family brought Na to RSU Tangerang got the maintenance and underwent the diagnosis.

Because his condition was serious and experienced breathless, the high fever and the difficult cough as well as was diagnosed it was suspected to be infected by the bird flu virus, finally Na underwent the maintenance in space of the bird flu isolation in RSU Tangerang began to strike 05,00 WIB.

However after undergoing the maintenance around four hours or around struck 09,00 WIB, Na blew out the last breath and the doctor stated the mother of four children has died.

While RSU Tangerang Director, Makentur JN Mamahit could not be it was confirmed related the existence of the assumption of the patient who died because of being infected by bird flu.
hattip Dutchy

IRC responds to Ebola epidemic in Congo

Date: 16 Jan 2009

Kasai Occidental, Democratic Republic of Congo 16 Jan 2009 - The International Rescue Committee is contributing essential drugs to emergency interventions in the Kasai Occidental province of the Democratic Republic of Congo in response to an epidemic of Ebola hemorrhagic fever.
The Congolese minister of public health declared an epidemic in the Mweka health zone on Sept. 10, 2008. Since that date, Ebola has been the cause of 13 deaths; there are currently 42 suspected cases, according to the World Health Organization.
"One confirmed case of Ebola is considered an epidemic because of the extremely contagious nature of the virus and the lack of any vaccine or treatment to cure the disease," says Dr. Pascal Ngoy, the IRC's senior health coordinator.
Curbing the spread of the virus is critical. To this end, the IRC is expanding its relief efforts beyond the 13 clinics in the affected area. To minimize population movement, the IRC has distributed fever-reducing anti-pyretic, IV fluid, oral rehydration salts, antibiotics and anti-malarials to Demba, Lukongo and Mutoto health zones, all of which are in close proximity to the Mweka zone.
IRC staff members are also educating at-risk communities about Ebola in the affected health zones. We hope to provide 500,000 people with crucial information about Ebola—how to recognize signs and symptoms and how to prevent further spread of the disease.
"When we find a suspected case of Ebola, all of the patient's belongings are burned and they are isolated from others for 21 days," explains Dr. Ngoy. Because of the severe poverty in Congo, families resist destroying items like mattresses and blankets. Community information sessions help family members of Ebola patients understand the necessary steps to contain the disease.
Response to outbreaks like this one is complicated by poor roads connecting remote areas in Congo. IRC mortality surveys have demonstrated the link between lack of access to health care and high mortality from preventable diseases. The IRC, which supports 55 health clinics in three health zones, has been working in Kasai Occidental since 2002 with funding from the United Kingdom's Department for International Development. We responded with logistical support and medical supplies to a previous Ebola outbreak in Congo in 2007.

Friday, January 16, 2009

When careful Tourism on the occasion of Tet

Van Nguyen Viet report Thursday, 1/16/2009, 12:00:00 AM

When careful Travel Vietnam on the occasion of Chinese New Year

(Santa Ana) - People traveling to the Chinese New Year festival to the national report on the case with avian influenza A (H5N1) should carefully before you go, the trip and the trip Travel their calendar.

- Between the travel, avoid direct contact with animals have wings, including chickens and ducks are wild birds and do not visit the farm raising chickens or ducks to you is where birds of all kinds keep raising flyer alive. Wash hands frequently with soap and water, oil or wash your hands with the characteristics of alcohol (alcohol gel hand-bases) where not available soap and water. Make sure all food from chickens to ducks, including cooked eggs should be cooked before you actually eat.

To protect the entire health, tourists need more careful as to prevent the mosquitoes bite, avoid eating food and drinking poison, and avoid contact with animals. Visit the website for the electronic traveler's control Dịch Center (CDC) for more information.

- After returning, tracking their health in 7 days. If you have hot fever accompanied by cough, or are very difficult breathing, contact your doctor and provide details of the symptoms, where you have to travel and if you ever direct contact with chickens ducks or with patients.

- The physician practice in Orange County for treatment of patients with symptoms of respiratory road travel each previous 7 days in the region occurred cases with avian influenza A (H5N1) and then to have the symptoms of the disease, it should immediately contact the Office of Public Health (Public Health) at (714) 834-8180 to discuss the test properly.

Bird flu comes to Nepal, confirms UK laboratory:13,000 birds to be culled in 5 days

Kathmandu/Jhapa January 16:

There has been an outbreak of bird flu for the first time in the country today. The deadly H5N1 strain of virus has been detected at Kakarbhitta, which shares a border with West Bengal in India, in Jhapa district.
An emergency cabinet today meeting declared the affected zone ‘bird flu crisis-hit area’.
No bird flu symptoms in human have been detected till now. But we are planning to monitor the health of the people in the affected area. Preliminary estimates suggest that the virus will be eliminated within a month,” said Tek Bahadur Thapa, secretary, Ministry of Agriculture and Cooperatives (MoAC).
The government has decided to cull 13,000 chickens and birds in a radius of three-km area
over the next five days. The government has also promised to give compensation to
the poultry owners.
A blanket ban has also been imposed on rearing and consuming poultry products in the affected area for the next three months. Health and surveillance teams from the capital are being dispatched to tackle the crisis.
“The Rapid Response personnel are coming from Kathmandu. The affected area has a local and broiler chicken population of 2,000 and 10,000, respectively,” said Dr Dilip Sapkota, chief, District Livestock Services Office.
Seven samples were sent for test to OIE Reference Laboratory, Weybridge, UK, on January 11. The results proved to be positive today.
Initially, the test was conducted at the Laboratory of Department of Livestock Services, Tripureshwor, on January 7.
Mysterious death of 11 chickens, which belonged to Ramesh Karki, a resident of Mechinagar Municipality, triggered panic. Subsequent, samples were sent for test.
The government is yet to figure out the source of the virus. We will urge the Indian government to help stop the import of poultry products,” said Dr Prabhakar Pathak, director general, Department of Livestock Services.
Nepal has banned import of poultry products from India on January 5 after the outbreak of the disease was reported at Matigara in neighbouring Darjeeling district. It is about 36 km from Kakarbhitta.
According to Thapa, the poultry industry accounts for four per cent Gross Domestic Product. Around 65,000 people are associated with the trade.

HHS Opens U.S. Food and Drug Administration Offices in India

HHS Secretary Mike Leavitt and Commissioner of the HHS Food and Drug Administration (FDA) Andrew C. von Eschenbach, M.D., today marked the opening of the HHS/FDA offices in New Delhi, and Mumbai, India.

"Through these offices, we can work more closely with manufacturers to share best practices and ensure producers build quality and safety into food and medical products," Secretary Leavitt said. "Consumers in India and the United States will benefit from the enhanced safety of food, drugs and medical devices. If called upon, we are also prepared to work with the Indian government as it strengthens its own regulatory institutions."

HHS/FDA will post 10 experienced officials in India to work closely with industries that ship food and medical products to the United States, to improve safety and quality, which will facilitate the smooth flow of trade. Along with the Office Director, HHS/FDA will have four inspectors and five senior technical experts who will cover food, medical devices and medicines.

These HHS/FDA personnel will provide technical advice, conduct inspections of facilities that export to the United States, and work with Indian government agencies and the private sector to develop certification programs to allow the efficient flow of safe HHS/FDA-regulated goods between the United States and India.

These offices are part of HHS/FDA's Beyond Our Borders Initiative, which will place 35 HHS/FDA personnel in 14 locations around the world, mostly connected to U.S. Embassies, Consulates and Missions. This initiative will expand HHS/FDA consumer-protection efforts beyond the United States to form collaborative partnerships with governments and industry on product safety.

In January 2008, Secretary Leavitt and Commissioner von Eschenbach visited India to start discussions with Indian industry about the issue of product safety, and with the Indian government on the potential of posting HHS/FDA personnel to the U.S. Embassy in New Delhi and the U.S. Consulate in Mumbai. The goal of these discussions was to establish a pathway to improve regulatory cooperation for the benefit of American and Indian consumers. While in India, they toured food- and pharmaceutical-manufacturing facilities.

India is the fourth-largest exporter by volume of drugs and biologics, especially generic pharmaceuticals, to the United States. India is also a significant exporter of food products.

With the opening of these offices, HHS/FDA now has an in-country presence in China, Central America, India, and Europe. HHS/FDA also plans to post FDA personnel to several more locations in 2009 -- México, South America, Europe and the Middle East.

Preparing For An Avian Flu Pandemic

Editorials - The following is an editorial reflecting the views of the U.S. government
Preparing For An Avian Flu Pandemic
16 January 2009
Many infectious diseases have originated as animal diseases that are transmitted to humans. For some diseases, the nature of the disease-causing organism may lead to widespread transmission in humans and cause a global disease outbreak, or pandemic, resulting in many deaths.

The United States is concerned that the ongoing outbreaks of H5N1 avian influenza in birds, or bird flu, have the potential to turn into a human influenza pandemic. Whenever or wherever a pandemic begins, everyone around the world will be at risk.

To fuel a pandemic, a virus must be able to easily spread from person to person. And although currently the H5N1 virus does not spread easily from human to human, its mortality rate in humans is so high-over 60 percent-that we cannot take the chance that it will not do so in the future. Several influenza pandemics have occurred during the last century. The pandemic in 1918-1919 spread to every continent, and caused at least 40 million deaths world wide.

The effects of a pandemic can be lessened if preparations are made ahead of time. Working through the International Partnership on Avian and Pandemic Influenza, the U.S. Government and others in the international community have developed national and international programs to prevent, detect, and limit the spread of the avian flu virus.

Central to that effort is building infrastructure, including laboratory capacity and international rapid response mechanisms; a global surveillance and warning system; a coordinated plan of intervention; and of course, the development of vaccines. The U.S. has pledged $ 949 million in support of these efforts.

Preparing for a pandemic is difficult but necessary. "We need to maintain our sense of urgency with respect to the pandemic threat if the momentum of preparedness and capacity building is to be maintained," says Ambassador John Lange, Special Representative on Avian and Pandemic Influenza for the U.S. Department of State.

"Capacity building doesn't garner headlines, but the threat persists and large-scale injections of resources and energy are still needed to prepare for and respond to a potential pandemic."

Thailand ups bird flu vigilance

BANGKOK, Jan 16 (TNA) - Thailand's public health ministry has added 14 provinces in bird flu prone areas out of 76 provinces to the nine provinces already monitored for better disease prevention in wider areas and effective healthcare for patients.

Dr. Paijit Warachit, Deputy Permanent Secretary for the Public Health presided over a meeting of 200 executives and health officials in 14 provinces aimed at stepping up surveillance against any possible bird flu outbreak and measures to offer medical treatment to the suspected bird-flu patients effectively.

Meanwhile, Director-general of the Department of Disease Control, ML Somchai Chakrabhand, said the department had set the new standard to closely monitor avian influenza-prone areas.

The new standard cover the provinces where the confirmed human cases were found between 2004-2008, where a bird flu outbreak was repeated and where suspected birdflu cases were detected most.

The new standard, which will help health officials to handle the possible outbreak from the outset, covers 14 provinces, including Bangkok, Nonthaburi, Pathum Thani, Ayutthaya, Lop Buri, Chai Nat, Prachin Buri, Nakhon Nayok, Suphan Buri Kanchanaburi, Nakhon Ratchasima, Chaiyaphum, Khon Kaen and Nong Bua Lam Phu.

Nine provinces were already under alert since December: Sukhothai, Uthai Thani, Phitsanulok, Uttaradit, Nakhon Sawan, Kampaeng Phet, Pichit, Phetchabun and Tak.

The Friday's meeting also reviewed existing measures to improve implementation for fast access to local communities in order to detect and contain the disease if occurs.

The meeting also discussed equipment preparation and personnel training for fast response to the possible outbreak.

Vietnam: Trời rét, children, elderly hospitalized increased

Thứ sáu, 16/1/2009

Trời rét, children, elderly hospitalized increased

Low temperature, especially the difference in temperature between day and night in the past has prevented many children, old people falling sick. The hospital in Hanoi to more than talent.

TS. Le Thanh Hai - Deputy Director of Children's Hospital T.U - for only 3 days rét bold, average daily BV have to 1400-1600 to examine patients, increased 30% compared with the previous day. Patients hospitalized children mainly due to the flu disease, inflammation and respiratory road diarrhea by Rotavirus.

Currently, in many of the scientific BV, the sick children had to be found pair 2-3 child / beds. Account digestive, always in a state overloaded when only 25 beds but the number of patients to hospital every day from 70 to 110 grandchildren. Not only the number of patients increased, he fell to below 3 years old but most of the patients are quite heavy, high fever, non lot, diarrhea continued to lose water, electricity resolution disorders.

In BV Bach Mai, according to Dr. Nguyen Tien Dung - Chief of Pediatrics, the number of patients to examine also increased 2-3 times normal, in which nearly 30% of patients were diarrhea Rotavirus level. BV in Saint Paul, the number of children to examine at BV in 1 week through about 250-300 children a day, of which 60-70% of children to be bronchitis, pneumonia, many cases must be treated with antibiotics long day.

Those who fear rét and uncomfortable rét other is the old man. Dr. Tien University - Faculty of examination, the Lao national science - that, on average each day, about 40-50 patients to examine, more than 30% decrease compared with the previous period. But most of the serious diseases: hypertension, disaster brain blood vessels, vành circulatory disease, bone joint disease. Patients from various provinces, city, but only those of very serious diseases can not be treated at home was brought to BV.

Dr. Do Thi Khanh Hy - Vice Director of the Lao Institute of Health - said the science inpatient treatment have more than 80 patients are located treatment, mainly the elderly over 70 years old and are in very serious condition.

Day 14 - 1, Minister of Health Nguyen Quoc Trieu has sent official health sector of the province, city required to arrange the time of 24/24 hours, ensuring capable timely processing of cases emergency, traffic accidents, birth in the New Year. Local medical need proactive in prevention and disease, especially preventive and H5N1, we can Bùng play again, the infectious disease and other causes. Closely control the use of additives in food processing, hygiene and implementation of food safety in order to reduce the maximum number of food poisoning occurred in the Tet festival (Lao slide 15 / 1).


[They call chickens "children"]

On 15/1/2009. Update at 10 h 39 '

As rét bold, rét harmful long has been a disease reproductive disorders, respiratory on poultry. According Its italy (Department of Agriculture and Rural Development in Hanoi), the city has more than 14.2 million children influenza, the number of poultry breeding industry with the disease Respiratory increased 21.5% compared with the same period in before, causing great damage to farm livestock.

Its italy recommended raising the enhanced care, feeding poultry, farm hygiene chuồng clean, spray insecticide periodically, to keep warm for influenza, using all kinds of vaccines vaccinated patients. When birds are manifestations of illness, death quickly notice immediately for veterinary facilities to guide care, treatment. Do not hide the disease, served sale, selling or removing the poultry slaughter as the disease spread disease.

Recombinomics: Likely H5N1 Spread to South Sikkim


Likely H5N1 Spread to South Sikkim
Recombinomics Commentary 20:05
January 16, 2009

Around 30 chickens have died in rural areas of Ravangla subdivision in South Sikkim in the past two days triggering fears of bird flu outbreak in the state.

Official sources here said the chickens had died in three areas of Ravangla and its adjoining areas. The first death of chickens was reported on January 14 after which State Animal Husbandry officials had taken the samples to Bhopal as the cause of the deaths.

The above comments describe the likely spread of H5N1 South Sikkim (see updated map). Today Nepal confirmed H5N1 near its borders with West Benal and Bihar. H5N1 has also been confirmed in multiple areas of Darjeeling, including the Darjeeling Hlls which are just south of Sikkim.

H5N1 in Sikkim would not be a surprise. The outbreaks in Suliguri are surrounded nature reserves and wild animal sanctuaries, and birds migrate to the south as the temperature drops.

Testing in India however remains suspect. H5N1 has been reported in or around Qinghai Lake in China in every year since 2005, and birds from Qinghai Lake spend the winter in northern India, yet India has never reported H5n1 in a wild bird.

The outbreak in Nepal, which was confirmed in England, raised concerns about H5N1 surveillance in the area due to minimal testing of tissues in dead or dying birds, and throat swabs in at risk individuals.

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Vietnam: Rét, many hospital

Thứ Năm, 15/01/2009, 08:18
Rét, many hospital

TP - The price rét past, overloaded patients hospitalized for inflammatory disease on respiratory, cardiovascular, blood pressure due to low temperature is the state of many hospitals in both Hanoi and Ho Chi Minh.

Children injected antibiotics at BV Children T.U

Doctor Middle England - the science Lao Vietnam (based in Hanoi), said the number of patients examined at the hospital increased by 30% compared with normal. Patients hospitalized primarily because of cardiovascular disease, blood pressure, bronchitis.

There are up to 50% of patients hospitalized in serious condition. In the mainly cardiovascular diseases as hypertension, disaster brain blood vessels, vành circulatory disease, bone joint disease. Most older patients hospitalized in the price rét this money to have a chronic disease, the face of cold weather disease recurrence and severity.

At Children's Hospital T.U, Dr. Nguyen Thanh Liem - Director of Hospital, said in the rét bold, average per day from 1400 to 1600 to examine the patient, a 30% increase compared with the previous day. Patients hospitalized children mainly due to flu, respiratory inflammation road and by Rotavirus diarrhea. Temp low rates make patients hospitalized due to the relatively more hen.

Dr. Dao Minh Tuan - Faculty respiratory (Children's Hospital T.U), hen that waste management is the process of chronic inflammation in line with the respiratory disease first raised cause acute pet hen. In many children, the illness or occur at night when the weather changed from hot to cold, each time with the northeast monsoon carry on the northern provinces.

The Department of Children's Hospital in T.U always overloaded situation when only 25 beds but the flow of patients into the day in average about 80 grandchildren. Dang alarm most children are hospitalized in fairly serious condition, high fever, non lot, diarrhea continued to lose water, electricity resolution disorders.

Doctor Hoang Minh Thu - Head of Pediatrics, Saint Paul Hospital (Hanoi), said the nearly 300 children to the examination in a week, 60 - 70% of children with bronchitis, pneumonia. Many of the patients treated with antibiotics from 5 - 7 days.

TPHCM: increased disease

The number of patients hospitalized for illness related to the respiratory tract is also in on cold weather to last. At respiratory Science, Children's Hospital of 1, 14 / 1, with 150 children are treated, 50% of which were inflamed primary waste management is due to the weather.

Besides the number of children hospitalized because of increased diarrhea and respiratory tract, from 1 to early this month, in Vietnam the number of fever in the blood (SXH) still has not stopped. On 14 / 1, doctor Nguyen Dac Tho - Deputy Director of Health Center for Vietnam, said Vietnam has all the 170 wards and communes have SXH.

The number of outbreaks SXH Bùng not only to play outside, but also appear in the district to as District 1, 6, 11, Tan Binh, Binh Thanh District. Since the beginning of the year to date, Vietnam recorded 515 cases.

Recorded at Children's Hospital of 1, 2 TPHCM on 14 / 1 that a week ago back to children hospitalized with diarrhea increased. According to doctor Pham Thi Ngoc Tuyet-Dean digestive Children's Hospital of 2 years from the beginning until now, here, over 900 child hospital treatment. Average daily ward received 100-120 grandchildren, mainly under the age of three, in which more than 80% were diarrhea level.

Faculty at The Children's Hospital and co-1, a day also received nearly 40 you have diarrhea hospital treatment, 50 patients from the provincial move to. The reasons, according to doctors, the virus infection in food, drink and the air.

Children infected respiratory increase road

Date 16.01.2009 Time 14:03
Return of cold

Children infected respiratory increase road

Cold Weather unusual and prolonged than the last two weeks are causing many people familiar with the warm weather better. Hospital, and the clinic from being overloaded patients to examine the diseases related to cold weather, such as cough, cold, the nose, sore throat. The Children's Hospital also in the situation at the respiratory ward.

From early January to now, the child hospitalization, inpatient treatment for the disease Respiratory increasing. Children's Hospital 1 Dong statistics last time the average daily received 4500 turns sick children, most of the Respiratory Diseases. In addition to examining the child feel as cough, runny nose, hot, fever, the doctor Tran Anh Tuan, chief scientific respiratory hospitals callisthenics 1, children often inflamed by the primary waste management, pneumonia and Asthma.

According to Children's Hospital of Dong Dong Nai, each day has more than 1,000 of the examination, in which more than 50% of children have the disease Respiratory. Especially respiratory ward of the hospital every day and receiving treatment for more than 100 sick children mainly have the pneumonia patients, hen, bronchitis, concentrated in age from birth to age two, up more than the same period of years ago.

With predictions of doctors, first cold air has caused disease and inflammation of primary wasted common in children but high points last season but not decreased but increased again higher. Diseases due to a respiratory virus road caused the ability to spread and very common in children under two years old. Initially, children were only sneeze, cough, runny nose, then the rattling, rapid breathing, breathing can drag chest, respiratory failure. For children under three months old, primary inflammatory disease often wasted on the fast progress. Children infected inflamed primary wasted a lot of times, are not treated early risk transfer to asthma.

Is alarming is the last time many children under two years old have also proven hen waste management, in the past, the most common disease in children 3 to 4 years old. To cold weather conditions are favorable for making young pet hen. The children of the raucous, but withdrawn. In young adults breathing the killing, even talk also difficult, to break many times there say the new round me. Asthma is also the cause of child deaths caused in the cold season. According to doctor Nguyen Phuong Hoa Binh, chief scientific examination earn Dean respiratory 1, Children's Hospital Dong 2, have the parents see their child stertorous have to buy medicine for sick children drink made worse because the medication not correct the disease.

According to recommendations of the hospital, during the cold weather moving, parents need to keep warm attention for children, especially at night, avoid bringing children to the people, kids eating enough nutrients . When children have symptoms of cough, breathing tired, eating poorly, to put children to visit the health facilities, not for child medication without specified by your doctor.

Recombinomics: H1N1 Tamiflu Resistance Spreads Across Europe

[As Dr. Niman notes, and we note here:, H3N2 is dominant in Europe this season]


H1N1 Tamiflu Resistance Spreads Across Europe
Recombinomics Commentary 16:54
January 16, 2009

More countries have reported on antiviral susceptibility based on genotyping (Norway, Spain, Sweden), phenotyping (Italy) or both techniques (UK).

Fifty-one of 52 influenza A(H1N1) viruses analysed (98%) were resistant to oseltamivir

The above comments from the week 2 EISS report indicates H1N1 Tamiflu resistance is spreading across Europe. Although H3N2 is the dominant influenza A serotype in Europe, H1N1 is widespread and at or near 100% Tamiflu resistant.

The UK week 2 report indicted 39/40 H1N1 isolates had H274Y. Thus, at least 12 H1N1 isolates in the EISS report are in countries outside of the UK, and all such isolates are resistant. The above list includes Spain and Italy as countries testing for antiviral resistance, so if the testing included H1N1, resistance would have been confirmed in those countries.

It is likely that all or most H1N1 in Europe will be resistant because the only sensitive isolate in the UK was among the first 10 tested, so all of the most recent 30 isolates in the UK are resistant. Similarly, all 23 of H1N1 isolates tested in Canada are also resistant, and the level is close to 100% in the United States, South Korea, and Japan.

Therefore, because all of the northern hemisphere countries have reported levels close to 100%, it is likely that other countries in Europe reporting H1N1 also have resistance. In the latest FluNet update, H1N1 has been confirmed in Belgium, Bulgaria, Denmark, Estonia, Germany, Greece, Portugal, Russia, and Slovenia. Therefore it is likely that H274Y is present in all of these countries as well as other countries in Europe who have not submitted serotype data.
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Bird flu found in chickens smuggled in from China


The provincial animal health department has provided more than nine tonnes of sterilizers for animal health workers at districts and communes across the province. Sterilisation will be a focus at poultry smuggling “hot spots” along the border such as Bao Lam, Coc Nam and Tu Mich.

Meanwhile, in Ho Chi Minh City, local authorities have uncovered more than 400 stores involved in the illegal trading of poultry products at 80 markets in 24 districts, particularly in districts 8, 12, Go Vap, Binh Tan, Tan Phu and Binh Chanh.

Local citizens consumed an average of 176 tonnes of frozen poultry products each day, reported the municipal animal health department. Since Jan. 5, food safety and hygiene inspectors have handled 136 cases of violations, seizing more than 1,400 live fowls and 41,000 eggs, said the department.

Free antibiotics: The wrong prescription for cold and flu season

Infectious Diseases Society of America

Free flu shots are a better option

With an epidemic of antibiotic-resistant infections growing, experts are warning grocery-store pharmacies that antibiotics giveaways are an unhealthy promotional gimmick. If grocery stores want to help customers and save them money during cold and flu season, the Infectious Diseases Society of America (IDSA) says, they should offer free influenza vaccinations instead.

Giant, Stop & Shop, and other grocery stores have recently begun offering free antibiotics at their pharmacies. Most concerning are promotions such as Wegmans' that link antibiotics to the winter cold-and-flu season—despite the fact that antibiotics will have no effect on these viral illnesses and carry risks of serious side effects.

"While it may make good marketing sense, promoting antibiotics at a time when we are facing a crisis of antibiotic resistance does not make good public health sense," said IDSA President Anne Gershon, MD. "On the other hand, grocery stores would be doing a tremendous service if they help more people get their flu shots."

A new study in the February 1 issue of Clinical Infectious Diseases shows that workers age 50-64 who received influenza vaccine lost substantially fewer days of work and worked fewer days while ill. But influenza vaccine is underutilized. Millions of doses were thrown away at the end of the last two flu seasons.

"The opposite is true for antibiotics," said Lauri Hicks, DO, medical director for the "Get Smart: Know When Antibiotics Work" program at the Centers for Disease Control and Prevention (CDC). "Each year tens of millions of antibiotics are prescribed for viral conditions, like the common cold, for which antibiotics are totally ineffective. Overuse of antibiotics is jeopardizing the effectiveness of these essential drugs."

For example, in some parts of the country methicillin-resistant Staphylococcus aureus (MRSA) is the leading cause of emergency room visits for skin and soft tissue infections. To make matters worse, there are very few new antibiotics under development to fight resistant bacteria.

In addition, the risks associated with antibiotics are under-appreciated. Allergic reactions and other adverse events cause an estimated 142,000 emergency room visits annually, according to a recent study by CDC.

"Most doctors know better than to prescribe antibiotics when they are not needed," Dr. Gershon added. "But many find it hard to say 'no' to sick patients who think antibiotics will make them feel better. We are concerned that these pharmacy marketing efforts will encourage patients to ask for antibiotics prescriptions."

IDSA urges grocery store pharmacies to partner with the CDC's "Get Smart" program. CDC and its partners educate the public and health care providers about when antibiotics will and won't work and the dangers of antibiotic resistance. For more information, see the Get Smart website.

"Lowering customers' health care costs is an admirable goal," Dr. Gershon said. "But singling out antibiotics for promotion when we are facing a crisis of antibiotic resistance is the wrong way to do it. On the other hand, free influenza vaccinations could make a real contribution to public health."


The Infectious Diseases Society of America (IDSA) is an organization of physicians, scientists, and other health care professionals dedicated to promoting health through excellence in infectious diseases research, education, prevention, and patient care. The Society, which has more than 8,600 members, was founded in 1963 and is based in Arlington, VA. For more information, visit

Blood Samples From Philippines Sent To US To Check For Ebola


MANILA (AFP)--Blood samples from swine and farmhands in the Philippines have been sent to the Centers for Disease Control in the U.S. to test for the Ebola-Reston virus, Health Secretary Francisco Duque said Friday. The samples were collected by a joint team from the Food and Agriculture Organisation, the World Organisation for Animal Health and the World Health Organistion from two pig farms where the Ebola-Reston virus had been detected.

Germany: Another bird flu case

15. Jänner 2009

Cloppenburg / Friesoythe - Because of a new bird flu case in a turkey stock in Friesoythe in the northwest German state of Lower Saxony has the Landkreis Cloppenburg more nearly 38,000 animals killed.

The stock had infected 14,700 turkeys included, informed the district on Thursday. There was the danger for humans H5N3 virus has been detected. In addition would total 23,000 animals from two farms in a neighboring town, which had to die precautionary reasons.

The circle was directed around the affected farms Sperrgebiet a new one. Since December, the virus in 29 stocks have been demonstrated. A total of around 500,000 turkeys killed. (APA / dpa)
hat-tip Helblindi

Quarantine vs Ebola still in effect

Jenny F. Manongdo

Government officials said the quarantine order of the two hog farms where the Ebola Reston virus was found last year remains until laboratory results from the Center for Disease Control and Prevention (CDC) in Atlanta, Georgia confirm that there is no threat to human and animal health.

Last week, a joint mission composed of experts in human and animal health belonging to the Food and Agriculture Organization (FAO), the World Organization for Animal Health (OIE), the World Health Organization (WHO) and their national counterparts arrived in the two farms to conduct an investigation on the Ebola Reston virus (ERV) in pigs in the Philippines.
The first discovery of ERV in the Philippines was in 1989 when exported monkeys to the US and Italy were found to have the virus, World Health Organization (WHO) records indicate.

Department of Health (DoH) secretary Francisco T. Duque III said ERV is found only among Philippine monkeys. This is the first time the virus has been seen among swine, Duque said.

The team of experts conducted risk assessment, field investigations and collection of samples in the two affected pig farms in Pandi, Bulacan and another in Manaoag, Pangasinan.

Duque said result of the laboratory test is due in the next few weeks.

The joint mission also conducted an assessment test on the laboratory capability of the Research Institute on Tropical Medicine (RITM) and the Bureau of Animal Industry (BAI). Duque said the team of experts has committed 'to help capacitate these laboratories in improving diagnostic proficiency and bio-safety standards for detecting and managing similar Zoonotic (animal) diseases.

Meanwhile, in a joint statement with the DoH, Agriculture secretary Arthur Yap said he has also ordered the continued voluntary export ban of raw and processed swine products which began last December.

"We decided to keep the farms in quarantine and suspend the export of our hogs until we have a better grasp of the extent, nature and consequences of the Reston virus to the health of animals and humans," Yap explained.

"I have ordered the Bureau of Animal Industry (BAI) to strengthen the routine monitoring functions of all existing veterinary quarantine check points to ensure that only healthy pigs are sold for slaughter. The National Meat Inspection Service (NMIS) was also instructed to reinforce its efforts in safeguarding meat entering markets," he added.

The government has also vowed to review food safety protocols for the improvement of that will ensure that food is safe from farm to plate.

Duque and Yap again reminded the public to purchase meat that has been approved by the National Meat Inspection Service (NMIS) so they can be assured that is has been properly inspected and declared safe to eat by experts.

Nepal reports first H5N1 bird flu outbreak

By Gopal Sharma

KATHMANDU, Jan 16 (Reuters) - Nepal said on Friday it had found the H5N1 bird flu in poultry, the first time the deadly virus has surfaced in the Himalayan nation, prompting culling operations in the country's southeast.

"The virus has been found in chicken and ducks. We have confirmed it is H5N1 virus," Agriculture Minister Jai Prakash Prasad Gupta told Reuters.

Bird flu was reported in poultry from the crowded southeast Nepal town of Kakarvitta, bordering India, officials said.

"We have declared that area crisis-hit," said Krishna Bahadur Mahara, minister for communication and information.

The epicentre of the outbreak is close to India's West Bengal state which has been fighting to contain intermittent outbreaks of the virus in poultry since last year.

Hari Dahal, a Nepalese agriculture ministry spokesman, said no bird flu symptoms had been noticed among people in the affected area.

Veterinary workers were sent to the region on Friday to cull poultry to try to control the virus within a 3 km (1.8 miles) radius of the town.

"They have started killing all birds in the area," Gupta said. "Since the outbreak in India, we were already alert."

Officials said they sent seven dead birds for testing in a laboratory in London after dozens died mysteriously in Kakarvitta about a week back.

"We got the confirmation today and are now seeking international help to fight the outbreak," Gupta added.

Neighbouring India has culled millions of chicken and ducks to contain the virus since its first outbreak in 2006, but has reported no human infections.


HCMC on alert for bird flu recurrence

13:23' 16/01/2009 (GMT+7)
VietNamNet Bridge – HCMC’s Department of Health will launch inspections of food hygiene and poultry trading at the city’s wholesale markets in the lead up to Lunar New Year holidays, or Tet, said deputy director Le Truong Giang.

He said, “The inspections are aimed at raising awareness of possible bird flu outbreaks and prevent food poisoning in the Lunar New Year.”

Along with the inspections, Giang added, the department has ordered all hospitals to store Tamiflu, a drug used for treatment of bird flu patients, and prepare isolation areas for those inspect with the H5N1 strain of the bird flu virus.

The HCMC government has recently signed a decision tightening the monitoring of bird flu and of poultry transportation which is traditionally active ahead of Tet.

Under the decision, the relevant agencies, including the Animal Health Department, market monitors and the health department must tighten their coordination to keep a close watch of the disease and the transportation of poultry into the city from the affected areas.

Market monitoring forces must join hands with animal health workers to supervise the trading and transportation of poultry at markets in a number of districts including Binh Chanh, Binh Tan, 4 and 7, according to the decision.

The city has ordered the establishment of inspection teams to check poultry transportation by water in districts 4, 7 and Can Gio. One more team will be set up to monitor border areas in Long An.

The health department said the city now had over 400 areas where the trading and transportation of poultry was active, mainly in districts Binh Chanh, 8, 12, 3, and 2.

According to the department, it is now difficult to check the rampant trading and transportation of unquarantined poultry.

The National Department for Animal Health said no new outbreaks had been detected since early this year and that Thanh Hoa and Thai Nguyen were the only two provinces still affected by bird flu at the moment.

Lang Son Province’s Animal Health Department reported on Monday that they had detected the H5N1 virus in domestic birds smuggled in from China after they took 16 samples for testing.

Lang Son has set up five inspection teams to control the spread of the disease and prevent the smuggling of poultry from China to Vietnam.

Nepal records 1st bird flu case; govts orders control measures

16 Jan 2009, 1407 hrs IST, PTI

KATHMANDU: Nepal has detected its first bird flu case of the season in a district bordering India, a Cabinet meeting chaired by Prime Minister Prachanda said on Friday.

The bird flu virus was detected in samples from an eastern Nepalese Mechinagar municipality bordering India.

The cabinet meeting officially confirmed that bird flu was found in Ward No 10 of the municipality, according to cabinet sources.

The government has directed the concerned authorities to immediately take measures to confine and control bird flu, Minister for Science and Technology Ganesh Shah said.

After bird flu was tested in birds in the eastern Nepal municipality near Kakarbhitta, Nepal government has decided to send "rapid group" to the area to take necessary measures as per international standard, he said.

The rapid group is a team of experts and quarantine officials that would take all necessary steps to prevent spreading of the disease.

The government has directed the authorities to isolate the area from other areas and to quell all the birds found within three kilometre radius of the place so that the virus could not spread to other areas.

Nepal has earlier, banned import of birds and poultry products as the bird flu was found in various districts of India bordering Nepal.
hat-tip Helblindi

Thursday, January 15, 2009

DR Congo: Ebola haemorrhagic fever in Kasai Occidental, Situation Report No. 13 of 14 January 2009

Source: World Health Organization (WHO)

Date: 14 Jan 2009

Rapport_complet (pdf * format - 70.3 Kbytes)


The epidemiological situation, to date, is as follows:

- New cases: 0; new deaths: 0.

- Total number of suspected cases: 47 including 34 female, 17 suspected cases are under the age of 15 years, 30 were aged 15 and over.

- Total number of deaths: 14, CFR: 30%.

- Residence of patients: 35 to Kaluamba 1 to Mweka, 1 Nsungi Munene, 2 Kabao, 6 and 1 to Kampungu Bakatombi and 1 Mwanyika.

- Total number of contacts under surveillance: 155, all were seen today by the monitoring teams.

- Number of patients currently in isolation: 4.

- Investigations into suspected cases reported in Kinshasa are continuing and charges were made.

Tackling the invasion of Ebola Reston virus

By Floro M. Mercene

LAST week, an international team of human and animal health experts arrived in Manila to conduct an epidemiological study relative to the reemergence of the Ebola Reston virus in local swine.

The 10-day investigation now being conducted by a team from the World Health Organization, Office International des Epizootes and the Food and Agriculture Organization was in response to a call by Secretary Arthur Yap of the Department of Agriculture for these experts to help the Philippines craft a national surveillance plan as well as a diagnostics and disease prevention program to beat this virus for good.***

The Ebola Reston virus was detected late last year in a few hogs in Bulacan and Pangasinan. The Department of Agriculture and the Department of Health won praise from international experts and local industry leaders last December for what Dr. Soe Nyunt-U, the WHO country representative in the Philippines, had described as the Arroyo government’s "appropriate action" in dealing with this animal health risk.

A potential health crisis was nipped in the bud owing to the swift and decisive measures taken by the DA in response to the reemergence of the virus, which first surfaced in the world in 1989 in the Ferlite monkey farm in Calamba, Laguna.

*** Secretary Yap had ordered the quarantine of the farms in Pangasinan and Bulacan where the virus was detected. He directed the Bureau of Animal Industry to closely monitor the movement of hogs and pork meat by setting up hog checkpoints.

He also instructed the National Meat Inspection Service to check for the presence of any contaminated pork meat in the market and slaughterhouses and to strict in the issuance of health certifications on animal shipments.

As an extra precautionary measure, Yap also ordered the temporary suspension of the country’s first-ever pork export to Singapore until such time that the Reston problem has been fully checked.

The BAI has also requested the FAO for assistance in testing 10,000 heads of domestic swine for the possible presence of the virus and to determine the source of the infection.


US Department of Health and Human Services Awards Novartis $486 Million Contract to Build Manufacturing Facility for Pandemic Flu Vaccine

Holly Springs, North Carolina site will have capacity to provide 150 million doses of pandemic vaccine within six months of declaration of influenza pandemic

Novartis novel cell-based manufacturing technology vital alternative to traditional egg-based vaccines production

Commercial production of pre-pandemic and seasonal flu vaccines planned after completion in 2012

Plant to provide 300 highly skilled jobs at opening

BASEL, Switzerland, January 15, 2009 -- Novartis announced today that the US Department of Health and Human Services, Biomedical Advanced Research and Development Authority (HHS, BARDA) has awarded Novartis Vaccines a contract for up to USD 486 million over eight years to support the design, construction, validation, and licensing of U.S. cell-based influenza vaccine manufacturing facilities in Holly Springs, North Carolina, to provide a pre-pandemic supply of influenza vaccine and to provide the capacity to manufacture 150 million doses of pandemic vaccine within six months of declaration of an influenza pandemic.

"I am delighted that Novartis Vaccines' facilities in Holly Springs will be able to support the US Government's ability to respond quickly to a potential pandemic, as well as contribute to America's vaccine infrastructure for seasonal flu," said Dr. Joerg Reinhardt, Chief Operating Officer of Novartis. "We believe that this contract award underscores the US Government's commitment to ensure pandemic vaccine supply, and reflects their confidence in Novartis."

A major advantage of Holly Springs' future influenza cell culture production is that it will not rely on the availability of eggs. Avian influenza virus is currently considered the most likely source of the next pandemic - and it is lethal to both chickens and their eggs. Without eggs, traditional influenza manufacturing techniques cannot produce vaccines, so the Holly Springs flu cell culture production capabilities would be a vital alternative.

"This HHS contract builds on the strategic investment made by Novartis in vaccines innovation, and reinforces the significant financial and technology investments we have already committed to Holly Springs," added Dr. Andrin Oswald, CEO of Novartis Vaccines and Diagnostics. "We currently anticipate that by 2012 the site will provide jobs for more than 300 highly skilled people with the capability to produce cell-based seasonal flu vaccine, pre-pandemic vaccine and 150 million doses of pandemic vaccine within six months of the declaration of an influenza pandemic."

Under the contract, Novartis is responsible for, among other things, pre-construction document development, land use and zoning, construction, commissioning, validation and licensing of the facilities (which are already under construction in Holly Springs, North Carolina), with the goals of regulatory licensure, manufacture and release of seasonal and pre-pandemic vaccine, as well as provision for pandemic vaccine supply in the event of a pandemic. The contract also requires Novartis to provide two commercial-scale annual lots of pre-pandemic vaccine for a minimum of three years. In addition, HHS has the right to exercise options to purchase additional influenza vaccine over 17 years.

About influenza

Influenza is a contagious, potentially serious respiratory illness caused by influenza viruses that attack the upper respiratory tract. It can cause mild to severe illness, and can lead to death. Influenza viruses easily spread from person to person in respiratory droplets created by coughing and sneezing. According to the World Health Organization (WHO), every year an estimated 3 to 5 million people worldwide become seriously ill from influenza, and as many as 500,000 - primarily children and the elderly - die from ensuing complications[1]. A recent study conducted by researchers at the Centers for Disease Control and Prevention (CDC) concluded that, in the US alone, the total economic burden (including direct medical costs, lost wages and impacts on productivity) imposed by such epidemics averages somewhere in the neighborhood of USD 87 billion every year[2].

About pandemic influenza

Pandemic influenza occurs when a new influenza virus emerges that causes serious illness and is easily transmitted among humans. In this situation, the virus can result in a worldwide outbreak of disease, or pandemic. Pandemic influenza occurred three times in the last century. Avian influenza, or "bird flu," does not normally infect humans, but recent outbreaks of H5N1 avian influenza have resulted in hundreds of human cases, with a mortality rate of more than 50%. Billions of birds have been destroyed in an effort to contain the virus, which is now considered endemic in parts of Asia.

Turkeys culled in bird flu outbreak

Jan 15, 2009, 15:57 GMT
Cloppenburg, Germany - Around half a million turkeys have been culled since December in a bird flu outbreak sweeping an area of northern Germany, officials said Thursday.

Some 38,000 birds were killed this week on three farms near the town of Cloppenburg, about 100 kilometres south of Hamburg.

Some 14,700 of the birds were infected with the H5N3 strain, which is not harmful to humans. The others were put to death as a precaution.

Officials set up an exclusion zone around the affected farms.


Date: Thu 15 Jan 2009
Source: The Times online, Agence Franc-Presse report [edited]

Seven more people have tested positive [by laboratory testing] for the
deadly Ebola virus in the Democratic Republic of the Congo [Congo DR],
bringing the toll of suspected and confirmed cases to 46, according to the
medical group Medecins sans Frontieres [Doctors without Borders].

14 people have died, all exhibiting symptoms of the hemorrhagic fever, but
only one of the deaths has been confirmed [by laboratory analysis] as
resulting directly from Ebola virus infection. The deaths were all in
western Kasai [Kasai Occidental province], a remote province where about
187 people died of Ebola fever last year [2008].

Ebola kills up to 90 per cent of the people it infects and is spread
through direct contact with blood and secretions, or via contaminated objects.

On Tue 6 Jan 2009, neighbouring Angola shut down its north eastern border
with the Democratic Republic of the Congo in a bid to stop the spread of
the deadly Ebola virus.

communicated by:
HealthMap Alerts via
ProMED-mail <>

[As reported in the previous report from the Democratic Republic of the
Congo, the number of laboratory confirmed cases of Ebola hemorrhagic fever
remains at 7. The total of confirmed and suspected cases has risen to 46.
There have been 14 deaths of patients exhibiting signs and symptoms of
Ebola hemorrhagic fever, but only one of these fatalities has been
confirmed by laboratory analysis. There is a continuing suspicion that the
outbreak may be more complex and involve more than a single etiological agent.

A map of the Democratic Republic of the Congo can be accessed at
<>, and the
HealthMap/ProMED-mail interactive map is available at
<,22,5>. The location of
Mweka District (the site of the outbreak) can be found at
<,_Democratic_Republic_of_the_Congo> or
by downloading the pdf file of the ICRF report at
<>. -

CDC Statement on Oseltamivir (Tamiflu®) Resistance and Antiviral Recommendations

Media Statement

For Immediate Release: January 9, 2009
Contact: CDC Division of Media Relations, Phone: (404) 639-3286

On December 19, 2008, CDC issued interim guidance for health care professionals on the use of influenza antiviral medications this flu season. The guidance was issued in response to early data from a limited number of states indicating that a high proportion of influenza A (H1N1) viruses are resistant to the influenza antiviral medication oseltamivir (Tamiflu®). Worldwide, the proportion of H1N1 viruses that are resistant to oseltamivir has been increasing so this development is not surprising.

Recent media reports may have led some to believe that these developments mean physicians are without influenza treatment options for the 2008-2009 flu season.

At this time, it’s not possible to predict how common H1N1 viruses will be during the rest of this flu season, as there are many different flu viruses and every influenza season is different. The current samples studied come from a handful of states, and may not be indicative of how the rest of the season will progress or what viruses will circulate in other states. However the circulation of oseltamivir-resistant viruses does have treatment implications for health care professionals. CDC is continuing to monitor this situation very closely, but has issued interim guidance for health care professionals to guide their treatment decisions in the current situation.

In fact, the interim CDC guidance provides advice for clinicians on how to treat patients with influenza antiviral medications this season. Clinicians can use influenza test results and information, if available, about which viruses are circulating, to help decide which antiviral(s) should be used. If H1N1 viruses are circulating in the community, or it’s not clear which viruses are circulating, health care providers are recommended to use an alternative antiviral, zanamivir (Relenza®), or to use combination therapy of oseltamivir and rimantadine. Use of zanamivir or dual therapy with oseltamivir and rimantadine would provide effective treatment against all circulating influenza viruses. In some instances, oseltamivir alone can still be used, such as when influenza B is diagnosed, or H1N1 viruses are not circulating.

It is important to remember that CDC recommends annual influenza vaccination as the first and best step in preventing the flu. It is not too late to get vaccinated and this year′s influenza vaccine is expected to be effective against currently circulating oseltamivir-resistant influenza A (H1N1) viruses.

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