Saturday, April 4, 2009

6 residents Cipatat was expected by Burung Flu

Minggu, 05 April 2009

Six residents were expected suspect (was expected) bird flu in the Halteu Village, RT 1 RW 19, the Cipatat Village, Kec. Cipatat, Kab. Bandung was West. They experienced the hot sign, the cough, pilek, breathless, after holding and eating the chicken was sick. The six residents came from two families that that was neighbours. They were IN (2), whereas five other people came from one family that is AT (65), AG (25), the twin WI and WE (2.5), and FS (14 months). AT was the father from AG and the grandfather the three AG children that is FS, WI, and WE. In the meantime, in the environment of the sufferer's residence suspect the bird flu was found seventy poultries died, that is in RW 2, RW 5, and RW 19. The death of this poultry has been reported by the resident since last March 31.
That was sent by Kasie Kesehatan of the Dinas Peternakan Animal and Kab fisheries. Bandung was Barat, drh. Wiwin Aprianti through his mobile phone, on Saturday (4/4). According to him, after having the report from the resident, his side at once descended to the field. Further, the official took the example of a poultry died and did rapid test. "Results were proven, the sample" of the "poultry died that positive was affected by the virus H5N1." Afterwards we carried out selective depopulation or the limited extermination against the poultry that a pen, a yard, and that was seen was sick, he said. Wiwin explained, the death of this poultry was around the sufferer's house suspect bird flu. According to the acknowledgment of the wife AG, his family ate the poultry was sick that was fried. Moreover, his twin had held the poultry that was sick.

According to Wiwin, his side co-operated with Dinkes in his control. The three children AG have been carried to the Hospital of Hasan Sadikin Bandung on Saturday (4/4) struck 12,30 of WIB. Sebelumnya, on Friday struck 22,00 WIB AG has been reconciled more previously to RSHS. Sedangkan DI and AT still was treated in their house was their respective. According to him, the bird flu findings in this village were the first time. Beforehand, had been found by the similar case in Kec. This Cipatat but in the different territory. Membaik In the meantime, the Secretary of the Kab Health of the Service. Bandung was Barat, Iwan Mulyawan said, six people suspect bird flu was reconciled to RSHS. Mereka was treated in Flamboyan Space.

Up until Saturday afternoon, according to Iwan, the AG condition began to improve. "This condition not yet endemi and lest endemi," he said. That was also justified by Tim Doctor Penanggulangan Chairman of RSHS Bird Flu, Dr. Hadi Jusup, Sp.P.D.-KPTI. Menurut he, the condition for the patient suspect the resident's bird flu Cipatat Kab. Bandung gradually got better. The "patient AG entered Space of Flamboyan RSHS Bandung, on Saturday (4/4), struck 3,00 of WIB. Dia came with the cough complaint, pilek, and hot." The condition was like that experienced by AG since three days ago, said Hadi Jusup. Whereas FS that was the child from AG, entered RSHS several hours at intervals of, with the condition for the cough and hot. "The two patients were put into Flamboyan Space." The two patients have been taken the sample of blood and apus the throat, henceforth was sent to Balitbangkes Pusat, he said. (A-62/A-183/A-187) ***

RSHS Rawat Ayah and the Child Suspect Flu Burung Bandung

04/04/09 20:01 (Antara News) - Great (25) and Firman (14 months), the Father and the child of the Village of the Village Stop of Cipatat RT01 RW04 of the resident's uterus the Bandung Regency West be forced in treated in RSHS Bandung because susfect (was expected) Bird Flu. The head of the Cipatat Community Health Centre, drg Wahyu, on Saturday, said, before being reconciled to RSHS Bandung, yesterday (3/4) Great and Firman could receive the maintenance from his side. "Beforehand we indeed came to the father's residence Firman and after being checked indeed had affected signs" of "bird flu like the cough, breathless and feverish," he said. According to him, knew the existence of signs of bird flu, his side at once reconciled Firman to RSHS Bandung to get the maintenance was more intensive. The "night yesterday, around struck 09,30 nights, we brought Firman to RSHS Bandung whereas his child of Firman was carried this morning around 10.00 the morning" he said. He explained, on the Monday (30/3) then, his side got the report from the Kesehatan Service of the Regency Bandung Barat that in the area of the Halte Village often was found by the chicken died suddenly. On "last Monday, Dinas Kesehatan carried out the surprise inspection to the Halte Village related the report" on the "resident who stated many chickens died suddenly," said drg Wahyu. Knew this matter, the Kesehatan Service and Livestock Breeding of Kabupaten Bandung immediately did penyemporatan the liquid disinfektan in the Halte Village. At this time, the two patients susfect bird flu was from this Halte Village treated in Poinciana Tree space of RSHS Bandung. The side of RSHS Bandung, went through the Team of the Handling of Bird Flu, Dr Hadi Yusuf confirmed that there is two patients susfect bird flu from Cipatat, Kabupaten Bandung Barat in treated in Poinciana Tree space of RSHS Bandung. It was "true that had the new patient suspect bird flu that in treated here, his initials of A his age" 25 years and F his age 14 months, both of them that the father and the uterus child," he said short. He explained, that two patients could carry out direct contact with the poultry in his residence that died suddenly. The "poultry in the patient's residence many that died, suddenly, were frightened by them was affected by bird flu," said Dr Hadi. (*)

Quang Ninh declared free of bird flu disease

April 4, 2009

Nhan Dan –The People’s Committee of northern province of Quang Ninh on April 2 declared that the province had been free from bird flu and foot-and-mouth diseases.

However, the provincial unit in charge and local authorities are assigned to enhance further the control over the poultry and cattle slaughter, monitor food safety and hygienic conditions for poultry trading in the province.

The risk of infected wild slaughter of dogs, cats

Thói quen ăn thịt chó phổ biến Habits eat dog common
ở nhiều nước châu Á. in many Asian countries.
NDĐT - Tạp chí phản biện y học quốc tế PLoS Medicine vừa công bố một nghiên cứu cho thấy nguy cơ mắc bệnh dại từ việc giết mổ chó và mèo. NDDT - Journal reflective action international medical PLoS Medicine has published a study showing the risk of infected wild slaughter of dogs and cats.

Trong nghiên cứu công bố ngày 18-3 trên tạp chí PLoS Medicine, TS Heiman Wertheim thuộc Mạng lưới nghiên cứu lâm sàng các bệnh truyền nhiễm ở Đông – Nam Á* và các đồng nghiệp thuộc Viện Các bệnh truyền nhiễm và Nhiệt đới Quốc gia và Viện Vệ sinh Dịch tễ Trung ương ở Hà Nội, đưa tin hai người bệnh phải nhập viện với triệu chứng bệnh dại và sau đó đều tử vong. In research published on 18-3 on the magazine PLoS Medicine, Dr. Heiman Wertheim Network clinical research of infectious diseases in East - South Asia * and colleagues under the Institute of Infectious Diseases and Tropical Country Institute of hygiene and epidemiology in central Hanoi, says two people to hospital with symptoms of the disease and then is death. Cả hai không hề bị các động vật có khả năng truyền bệnh dại cắn những tháng trước đó. Both are not animals can transmit diseases to wild bites months previously.

Người bệnh thứ nhất là một công nhân xây dựng 48 tuổi, giết mổ và ăn thịt con chó bị xe chẹt chết trên đường hai tháng trước khi nhập viện. Patients first is a construction worker 48 years old, slaughter and eat dogs were dead car died on the road two months before hospitalization. Bệnh nhân kể, khi giết mổ con chó này, ông có đi găng tay bảo hộ lao động. Including patients, the slaughter this dog, he has gloves to protect workers. Ông không cho rằng mình đã bị xướt xát hay đứt tay khi làm thịt chó. He does not believe that they have been xuot xát or break your hands when making dog meat. Những người khác ăn thịt chó hôm đó đều vẫn khoẻ mạnh. Others eat the dogs that are still healthy. Thịt chó đã được nấu kỹ trước khi ăn. Dog meat has been cooked thoroughly before eating.

Người bệnh thứ hai là một nam nông dân 37 tuổi, giết mổ và ăn thịt con mèo bị ốm từ ba ngày trước đó. The second patient is a male age 37 farmer, slaughter and eat the cat was sick three days before. Ba tuần sau khi ăn thịt mèo, ông phải nhập viện. Three weeks after the cats eat, he must be hospitalized. Những người khác ăn thịt mèo hôm đó vẫn bình thường. Others eat the cat is still normal.

Các chuyên gia không thể kiểm nghiệm các con vật bị giết thịt có mắc bệnh dại hay không nên không hoàn toàn khẳng định những con vật này là nguồn bệnh. Experts can not test the animals are killed meat with infected wild or not it is not completely confirmed the source of this disease. Tuy nhiên, họ lưu ý, việc giết thịt các con chó/mèo chưa được tiêm vaccine ở những nước vẫn còn bệnh dại có thể là yếu tố dẫn đến truyền bệnh. However, they note, the meat to kill the dog / cat has not been injected vaccine in the country is still wild disease may be factors leading to disease transmission.

TS Wertheim và các đồng nghiệp cho rằng, việc lây bệnh nhiều khả năng do giết mổ chứ không phải do ăn thịt, bằng chứng là nhiều người khác cũng ăn thịt những con vật đó nhưng vẫn khoẻ mạnh. Dr. Wertheim and colleagues believe that the spread the disease more likely to slaughter do not eat the meat, evidence that many other people also eat the animals that are still healthy.

“Chúng ta cần cảnh báo cả người dân và các thầy thuốc lâm sàng về nguy cơ chung quanh việc giết mổ và chế biến thịt chó, mèo. "We need to alert the people and their doctors about clinical risk around the slaughter and processing of dog meat, cat. Người dân không nên giết mổ những con vật có thể đã mắc bệnh dại. People should not slaughter the animals may have infected wild. Bệnh dại có thể phòng ngừa bằng vaccine và những người phơi nhiễm với bệnh dại có thể đi chủng ngừa sau phơi nhiễm, nhưng phải càng sớm càng tốt. Diseases we can prevent with vaccine and cure infection with the disease can go wild immunized infected after exposure, but as soon as possible. Một khi đã xuất hiện triệu chứng của bệnh dại thì hầu như cầm chắc tử vong. Once symptoms appear the disease is long, they most certainly as death. Các bác sĩ Việt Nam đã coi việc giết mổ là yếu tố nguy cơ dẫn đến lây truyền bệnh dại nhưng điều quan trọng là các cán bộ y tế khác, các nhà hoạch định chính sách, cả ở trong và ngoài Việt Nam, nhận thức được yếu tố nguy cơ này,” TS Wertheim nói. Doctors Vietnam has seen the slaughter as risk factors to disease spread wild but it is important that health staff other, the policy, both in and outside Vietnam, awareness be factors this risk, "said Dr. Wertheim.

Ở Việt Nam, những người làm việc ở các lò mổ chó được tiêm vaccine phòng bệnh dại theo chương trình phòng chống bệnh dại quốc gia. In Vietnam, people who work in the furnace open to the injected vaccine with prevention programs to prevent disease wild country. Tuy nhiên, việc giết mổ chó, mèo tại nhà còn khá phổ biến. However, the slaughter dogs, cats at home are quite common.

Bệnh dại rất nguy hiểm và hầu hết các trường hợp mắc bệnh đều tử vong. Wild disease is dangerous and most cases are fatal. Ước tính ở châu Á, khu vực có nhiều nước còn phổ biến thói quen ăn thịt chó, mỗi năm có hơn 30 nghìn người tử vong vì bệnh dại. Estimated in Asia, the area also have many common habits eat dog, every year more than 30 thousand people died because of disease wild.

Triệu chứng bệnh dại gồm co giật , sốt, sợ nước và không còn phản xạ uống, cuối cùng là tử vong. Disease symptoms include wild CONVULSIONS, fever, fear and no longer drink reflexes, ultimately death. Các con vật có thể truyền bệnh dại qua vết cắn của mình là chó, mèo và dơi. The animals may transmit disease long traces bite your dog is, and move cats. Thời gian ủ bệnh thường kéo dài từ một đến ba tháng. Time ủ disease usually lasts from one to three months.

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* Mạng lưới nghiên cứu lâm sàng các bệnh truyền nhiễm ở Đông – Nam Á do Quỹ Wellcome Trust của Anh (chuyên tài trợ các nghiên cứu về y sinh) và Viện Nghiên cứu Quốc gia về các bệnh dị ứng và truyền nhiễm, Viện Y tế Quốc gia của Mỹ tài trợ. * Network clinical research of infectious diseases in East - South Asia Fund by Wellcome Trust UK (specialist funded research on medical students) and Research Institute of the National allergic disease and infection, health Nationality in American funding.

Philippines-Foot and Mouth restrictions.

04/04/2009 01:50:27
Enforcement agents of the Bureau of Customs will be on alert against imported cattle and meat products from Taiwan and Lebanon following the reported outbreak of foot and mouth disease in the two countries.
This was stressed by Intelligence and Enforcement Group (IEG) acting chief Jairus Paguntalan who said that it is part of the Bureau’s standard operating procedure to circularize any memorandum from any government agency and issue their own memorandum to alert their personnel, especially if it concerns the health and safety of the Filipino consumers.
Customs Intelligence and Investigation Service (CIIS) OIC at the Port of Manila Johnny Martinez said that even without the ban, they are already very vigilant against the entry of contaminated food products.
"This is a year round activity, we are monitoring all shipments but we are especially wary of the entry of any poultry products contaminated by bird flu and also, for meat—for those contaminated by foot and mouth disease," he said.
Martinez also said that refrigerated containers bearing such goods are also required to undergo x-ray scanning and 100 percent examination in accredited cold storage facilities of the National Meat Inspection Services (NMIS).
In compliance to the ban order, Martinez said that incoming meat shipments from the two countries will immediately be placed on alert, until such time clearance is granted by the Bureau of Animal Industry (BAI).
Agricultural goods are regulated items that require import permits from government line agencies such as the Bureau of Plant Industry and the BAI prior to importation. Absence of the document would immediately deem the shipment as contraband, subject to seizure and forfeiture.
The Department of Agriculture (DA) has ordered a ban on the importation of cattle and other animals from after the World Animal Health Organization (WAHO) confirmed the outbreak in Taiwan and Lebanon.
FMD was detected in a dairy cattle farm in the province of Kamed El-Iouz in Lebanon while the disease was discovered among swines in the Maoliao township, Yun-Lin and Beidou town in Chang-hua, Taiwan

RSHS Again treated 2 Suspect Flu of Burung Tya Eka Yulianti -

Saturday, 04/04/2009 18:04 of WIB detik
Bandung Bandung - came back Rumah Sakit Hasan Sadikin (RSHS) Bandung received two patients who were expected terjangkit bird flu. The two patients this was the resident Cipatat, Kabupaten Bandung Barat, and one family. According to Chairman Tim of the Handling of Bird Flu, Dr Hadi Yusuf, the patient A (26) and F (14 months) was the recommendation from the community health centre in Cipatat. From both of them was found by the story of contact with the poultry. "Their neighbouring chicken there are those that died suddenly, was frightened by him was affected by bird flu," said Hadi. It was further that Hadi said, the two patients when entering RSHS in the hot situation high was accompanied by the cough. "But was not crowded (the breath)," said Hadi. At this time was second this patient was treated in poinciana tree space of RSHS Bandung. Hadi said the condition both of them in the good situation and was not installed respiratory aids.

Egypt: a threat to the transformation of crows bird flu pandemic

Hamida Mohammed from Cairo
source warned the Institute of Plant
Protection Research Center of Agricultural Research of a disaster, because millions of Araban epidemic spread widely prevalent in a large number of governorates of Egypt, the source said that the center of the Ilaf received many complaints, especially from the provinces affected farmers according to the channel is broad and sustained large losses due to the proliferation of crows, which feed on crops and plants, he said, adding that turned into crows from eating the carcass, which is available in the provinces of the Canal during the war to have their crops at this time.
What constitutes a serious capacity of these crows fly friction and poultry production plants, which could lead to carry the avian influenza virus result feels poultry, and the result is disaster, epidemic," said the source.

The bird flu arrived in Egypt to the alarming level of the global health community having reached the number of human cases of the disease to 60 people since it appeared in Egypt in 2006, is the children and women victims of avian flu in Egypt, which is one of the countries with high rates of infection due to the proliferation of breeding birds indoors, particularly in rural areas and the occurrence of Egypt on the path of migratory birds carrying the disease.

The Government has begun to deal with the disease in an unorthodox manner, after years of negligence in the prevention of the disease to the accusations of an international health organizations as long as the reports confirmed the inadequacy of the Egyptian efforts in dealing with the problem. The Environment Ministry has decided to use a sophisticated system for monitoring the disease, which carried by migratory birds comes to the natural reserves in Egypt, using satellites, a move was delayed for several years, according to some.
This method relies on the development of precision machines for migratory birds and follow-up of the use of satellites anywhere in the world and track their migration routes, in order to know the extent of its proximity or remoteness from the sources of infections disease.
Minister of Environment Maged George - the development of precision machines in the feet of birds and follow-up of 45 satellites, and use this system, China, Nigeria and Kenya. 2B4%2B2009%26tq%3D%25D8%25A7%25D9%2586%25D9%2581%2 5D9%2584%25D9%2588%25D9%2586%25D8%25B2%25D8%25A7%2 B%25D8%25A7%25D9%2584%25D8%25B7%25D9%258A%25D9%258 8%25D8%25B1%2B4%2B%25D8%25A3%25D8%25A8%25D8%25B1%2 5D9%258A%25D9%2584%2B2009%26sl%3Den%26tl%3Dar%26st art%3D10

More, Dead Poultry Mendadak

Saturday, April 04, 2009, 07:07:00

PEKANBARU (RP) - Based on the findings of Public Health (Diskes) Pekanbaru Friday (3 / 4), found two people fell ill on the road Rejosari fever heat. Officers also found two chickens that died suddenly poultry. This location is just 500 meters from the place of Ibn Wahyu Saputra, victims of bird flu.

But Kasi Observation and Disaster Diskes Pekanbaru, SKM Naviri can not ensure that the birds died suddenly with this because if the bird flu virus.

Identisifikasi still need to be more about the death of this bird.

Identisifikasi''in the field, we have the findings of the two residents fever heat. From the results of the health check, only two people this fever are common. But we still give tamiflu drug,''said Naviri to Riau Pos, Friday.

According to him, the death of Revelation are very psychological impact on the residents. Most residents feel fear again mewabahnya bird flu virus in humans. These problems are diminimalisir by the City Government (Pemko) Pekanbaru.

Diskes as institutions that have any obligation to do prevention, continued, until Saturday (11 / 4) future, Diskes akan conduct in the supervision. Home residents, especially the distance of 500 meters.

''Agriculture and Public Health Pekanbaru given the task to handle specific problems this bird flu virus. Distan also make your own disinfectant and depopulasi, housing residents who have poultry,''he said.

It is feared bird flu could become more frightening

M. Azis Tunny , THE JAKARTA POST , RANTEPAO, TORAJA Sat, 04/04/2009 10:21 AM Headlines

There is a need to raise awareness of bird flu because of a real threat: It could turn into something much more frightening than the H5N1 virus.

The frightening thing would be if the virus caused a pandemic if and when it became able to spread among humans, Coordinator of Surveillance and Monitoring at the National Commission on Bird Flu Control and Awareness on Influenza Pandemic (Komnas FBPI) Heru Setijanto said Friday.

Setijanto said Indonesia was currently ranked highest in the world in the number of deaths from bird flu, and was unprepared as to how to deal with a pandemic.

“The incubation period of the virus is very fast and deadly when contracted by humans. We are
not ready to face a pandemic if the situation arises,” Setijanto told The Jakarta Post on the sidelines of a national seminar on a Bird Flu Pandemic Response Simulation in Toraja, South Sulawesi.

He said Indonesia was ill-equipped to face the bird flu pandemic because training was only provided so far to personnel at government ministries and agencies.

“When it turns into a pandemic, it becomes a multi-sector problem and would involve every sector. We are unprepared as of now, especially for other sectors to [cope with] the epidemic,” he said.

According to Setijanto, the bird flu virus will always mutate and this is a cause for grave concern.
When contracted by humans, the incubation period of the H5N1 virus could cause death rapidly, in as little as five days.

Indonesia so far remains on top of the world chart with the highest number of deaths from H5N1.

Data at the Health Ministry showed 121 of the 145 patients diagnosed as infected with the virus had died, a very high fatality rate.

He added a bird flu pandemic could claim many lives and that 30 percent of the world’s population could be at risk.

In Indonesia, said Setijanto, a bird flu epidemic from the H1N1 viirus once took place in Toraja. The disease, then termed a mysterious breathing disease, reportedly claimed 210,000 lives.

Head of the Makassar office of the United Nations International Childrens’ Education Fund (UNICEF) Purwanta Iskandar told the Post that bird flu should not be taken lightly.

The disease has been recorded over the past 100 years and has claimed millions of lives throughout the world, including in Indonesia. For example, in Toraja in 1918, about 10 percent of the local population reportedly died from lung disease.

“Experts have said that it is highly likely that we will experience it again in the near future, although the exact time remains unclear. Our assumption is that a pandemic is very likely to infect 30 percent of the population,” said Purwanta.

In the framework of preparing in anticipation of a pandemic, Komnas FBPI has worked together with UNICEF, the Canadian government and the South Sulawesi provincial administration to help organize the national seminar on a Bird Flu Pandemic Response Simulation in Toraja from April 1 to April 4.

Friday, April 3, 2009

Alert over sore throat bug that has killed more than 100 people in three months

More than 100 people have died from a bug that normally causes sore throats as cases rise by two thirds and all GPs are warned to be on the look out for signs of the infection.

Officials have warned cases of invasive Streptococcal A have risen sharply this year, a more deadly strain of the bug is circulating and it is thought to have claimed the lives of one in four of those infected.

Strep A normally causes sore throats but in some cases it can infect other parts of the body causing meningitis, pneumonia, sepsis and septic arthritis and other complications. One in five people die within a week, rising to between 40 and 50 per cent of those who suffer toxic shock syndrome, another possible complication of invasive Strep A.

In the letter Prof Brian Duerden, Inspector of Microbiology and Infection Control, said between November last year and February there have been over 500 cases, a 62 per cent increase on the same period in the previous year.

He said: "This is of particular concern as initial reports suggest a possible increase in the case fatality rate to around 25 per cent."

Cases are spread out and not found in clusters with the disease striking all ages but older people are at greatest risk, Prof Duerden said.

People who have skin lesions, have recently had chickenpox, had a child recently or have had a respiratory infection are at greater risk along with people suffering from long-term conditions such as heart disease, cancer, diabetes, alcoholism or have a weakened immune system.

Prof Duerden told GPs: "Suspected invasive group A Streptococcal cases should be assessed rapidly in hospital and treated promptly.

"Clinical deterioration in patients with iGAS can be very rapid. Early recognition of possible signs and symptoms of iGAS and prompt treatment may be life saving."

He listed symptoms as general malaise, high fever, severe muscle aches, unexplained diarrhoea and vomiting, dizziness, low blood pressure, confusion, localised muscle tenderness or severe pain out of proportion to external signs and a flat red rash over large areas of the body.

Previous strep throat infection should be considered and close contacts of confirmed cases should be given antibiotics if they have symptoms, the letter said.

The Health Protection Agency monitors invasive group A streptococcal infection which normally affects around 1,200 people each year.

Dr Robert George, from the Health Protection Agency, said: "Group A strep is a common bacterium found in the throat and on the skin and may be carried for long periods of time without causing any illness. The infections we are talking about here remain uncommon and are at the severe end of the spectrum.

"Invasive strep infections can be treated with antibiotics and clinicians have received a timely reminder of the signs and symptoms of this infection and how to treat it.

"The current increases we're seeing may be attributable to the natural cycle of the disease with some 'quiet' years followed by a year of high incidence.

"The HPA is monitoring the situation closely."

Scientist ill from dengue virus

Michael McKenna April 04, 2009

DENGUE fever claimed its first victim outside the sub-tropics when a Brisbane-based scientist fell ill while working on concentrated strains of the virus.

It is not yet known how the Queensland Institute of Medical Research scientist contracted the virus 10 days ago.

Queensland Health said yesterday there was "no risk" of dengue spreading to the southeast corner of the state.

Chief Health Officer Jeanette Young said tests were being conducted on other QIMR researchers and stricter safety protocols had been ordered at the laboratory at Herston, in Brisbane's inner north.

"From a public health point of view there is no risk at all," Dr Young said. "For a member of the public to be infected with the virus, they must be bitten by an Aedes aegypti mosquito that is carrying the virus. This mosquito does not currently inhabit southeast Queensland."

The male researcher was admitted to hospital and has since been released. Dr Young said there were strict safety protocols at the laboratory, including multiple air-lock doors.

"He was working on a concentrated strain of the virus," she said. "We don't know how he has actually been infected but we are enhancing personal protection in the laboratory."

The Brisbane infection follows a summer-long outbreak of the disease, which last month claimed the life of an 82-year-old Cairns woman.

It was the first death in Australia associated with dengue fever since two Torres Strait Islanders died in 2004.

Since a dengue outbreak was declared in Cairns last December, there have been more than 560 people confirmed to have contracted the virus.

Another 70 people have been infected in a separate outbreak in Townsville and small clusters of cases have been reported in Port Douglas, Yarrabah, Injinoo and Innisfail, Queensland.

ten of Kecamatan Terserang Flu Burung Jember

On Saturday, April 04 2009]
- the Jember Resident ought to be on the alert with increasingly spread him the bird flu illness in the Jember territory. This considering, the Peternakan Service data, Perikanan, and Marine the Jember Regional Government mentioned, has been found by the spreading of bird flu in 10 subdistricts. Covered Kecamatan Jenggawah, Kalisat, Sukorambi, Panti, Ambulu, Ajung, Sumbersari, Patrang, Tempurejo, and Pakusari. This was revealed by Siti Nurul Hayati, Head of Sector Kesehatan of the Animal in the Peternakan Service, Perikanan, and Marine the Jember Regional Government. On the reality so, his side continued to make an effort to carry out the prevention so that the spreading of the bird flu illness does not increasingly spread. One of them by spraying the poultry animal with medicine glutanol that was sold in the Gebang market of the District chicken, Kecamatan Patrang, yesterday. According to Nurul, spraying that was carried out yesterday, in fact has been carried out some time before. "Spraying in Gebang this the routine activity." In one month was carried out by four spraying times. This to anticipate expanded him the bird flu illness, he said. According to Nurul, that most had difficulty being anticipated It is not surprising when in the Jember territory, said he, has had several positive areas terjangkit bird flu. Then from so, so that the spreading of bird flu does not increasingly spread, said he, his side at once carried out spraying against the chicken that was brought in from outside Jember. "Moreover, many chicken traders from outside the city entered Jember," he explained. Moreover, chickens that entered Jember, partly also were thrown again to Banyuwangi and Lumajang. "This that caused difficulties for the official," he revealed. Nurul added, his side did not only carry out spraying in several poultry markets. The traders and the owner of the poultry were also given bird flu medicine free. Nurul hoped, if in the environment around was found many poultries that died suddenly, then immediately reported that. This had the intention, if evidently was caused by bird flu, as soon as possible could be prevented so as his spreading not until spread. (jum)


Pekanbaru Officially Kesehatan Pekanbaru stated the residence territory of Wahyu Ibnu Saputra (2.9) in the extraordinary condition (KLB) bird flu. In the location that was in Street Kuantan Street Kuantan VII, RT 7, RW 4, the Tanjung Rhu District, Kecamatan Limapuluh this, the Kesehatan Service carried out three programs continued as the step in the prevention to spread him the bird flu virus. This was revealed by Plt Dinas Kesehatan (Diskes) Pekanbaru, Dr Rini Hermiyati to Riau Pos, on Thursday (2/4). In the prevention became an epidemic him the virus H5N1, Diskes more he, berkerja was the same as the Pertanian Service (Distan) Pekanbaru. Was based on the Kesehatan Service data (Diskes) Pekanbaru, was recorded by three people died because terjangkit the virus H5N1. In 2007 happened in the Rumbai Subdistrict and Marpoyan Damai, to the number of cases died duani two people. In 2008 was not available. Afterwards in 2009 improved other in the Limapuluh. Subdistrict (new)

For 2009, already 9 cases Suspect Bird Flu in Riau

on Thursday, April 2 2009 07:39
the Father casualties Bird Flu suffered the Fever The bird flu virus it was worried about spread post the death of Ibnu Wahyu Saputra resulting from this deadly illness. At this time the deceased's father was suffering the fever. Riauterkini-Pekanbaru- the Ordeal for the Haryono family, the resident Street Kuantan VII RT 07/ RW 04 Keluarahan the Hru Cape, the Subdistrict of fifty still brlanjut. After on Thursday (26/3/09) then the only one of the family's sons, Wahyu Ibnu Saputra (2,5) dies resulting from bird flu, currently Haryono suffered the fever. Since last Tuesday Haryono experienced the sign of the fever. His family worried his fever of Haryono not only the common fever, but the fever resulting from tertular the virus of H5N1 Avian Ilfluenza or bird flu. Because of that the very fast family memeriksakan Haryono. It was lucky that results of the medical Haryono inspection only suffered the common fever. "Results" of the "inspection pointed out the patient ( only suffered the common fever, not mengindap the bird flu virus," said the Co-ordinator the Control of RSUD Arifin Achmad Bird Flu, Azizman Saad. In the meantime as the handling follow-up post he confirmed Wahyu's death resulting from bird flu, the Kesehatan Service at once carried out several steps. In part with took sempel blood 20 people that once direct contact with Wahyu when undergoing the maintenance period. They consisted of the family close to the deceased but also several nurses in RS Ibnu Sina and RSUS Arifin Achmad, the place of the deceased underwent the medical maintenance. Moreover, the Service of Peternakan Pekanbaru also at once took the step in the prevention with destroyed uanggas-poultry around Wahyu's house. Only the extermination of the poultry by means of being burnt this did not go maximal. At least had eight residents who denied their kept poultry was destroyed. *** (mad)

For 2009, already 9 cases Suspect Bird Flu in Riau

since early January 2009, in Riau nine cases has happened suspect bird flu. From respectively this case, 1 among them died, 1 case was waiting for results of the research of Jakarta. Whereas the rest of them were stated by the bird flu negative. The staff Surveilanc Flu Burung Dinas Kesehatan of the Province Riau Pebliaji, said that when being met in his office the road of Cut Nya Dien. Respectively this case among them, Pekanbaru 1 person, Siak 2 people, Rohul 1 person, Dumai 3 people and Pelalawan 2 people. For Pekanbaru, the bird flu patient on behalf of Wahyu Ibnu Sahputra that still was 2.9 years old died some time before. These casualties were stated positive after through the testing of the sample of blood in Jakarta.

For Pelalawan, to be precise in the village A Kijang, the man was 15 years with SP initials at this time also old was stated suspect bird flu. However to confirm whether SP really positive, at this time still was waiting for results of the testing of the sample of blood in Jakarta.


Pekanbaru, Riau ::: Exceptional bird flu status (KLB)

April 3, 2009

Pekanbaru, Riau – Health service of Pekanbaru announced exceptional bird flu status (KLB) on neighborhood of bird flu victim, Wahyu Ibnu Saputra (2.9), Jalan Kuantan Jalan Kuantan VII, RT 7, RW 4, Kelurahan Tanjung Rhu, Kecamatan Limapuluh. Health service conducts three standard programs for prevention of bird flu virus spreading.

Actions taken are: Area monitoring to Jalan Kuantan VII, RT 7, RW 4, Kelurahan Tanjung Rhu, Kecamatan Limapuluh; Proclaiming bird flu alert status to people who had contact history with victim; and Giving tamiflu and hospital recommendation to people who develop high fever.

This is mentioned by Pekanbaru health service officer, dr Rini Hermiyati Thursday (2/4). For this prevention purpose, Health service is working together with Agriculture service Pekanbaru.

“People with high fever will receive Tamiflu administration and recommendation for regional hospital. This is done for bird flu exceptional circumstances status areas”, said Rini. Investigation and preventive measures will be done for 30 days started from Monday (30/3) to neighborhood 500 meter around victim’s house.

Bird flu H5N1 virus has killed 3 people in Riau since 2007. Two fatalities reported in 2007 at Kecamatan Rumbai and Marpoyan Damai; and one fatality in 2009 at Kecamatan Lima Puluh.
hat-tip Dutchy

Egyptian toddler contracts bird flu virus

03 Apr 2009 17:20:09 GMT
Source: Reuters
CAIRO, April 3 (Reuters) -

An Egyptian toddler has contracted the highly pathogenic bird flu virus, the latest in an upswing of cases in the most populous Arab country, state news agency MENA said on Friday.

The case brings to 62 the number of confirmed cases of the H5N1 avian flu virus in Egypt, which has been hit harder by bird flu than any other country outside of Asia and has reported seven human infections since March 1.

The 21-month-old boy, Hassan Gamil Hassan Mohamed, is from the province of Beheira in northern Egypt and was in a "good" condition after being treated with the antiviral drug Tamiflu, MENA reported.The new infection came several days after a two-year-old boy from the same province contracted the virus.MENA did not say how Mohamed contracted the virus, but most Egyptians who have fallen ill with bird flu are believed to have contracted the virus from infected household birds.

Egypt is one of the few countries affected by bird flu that does not compensate farmers when poultry is destroyed, though many experts say this is the best way to ensure the rapid detection of new outbreaks.

Since 2003 the H5N1 avian influenza virus has infected at least 410 people in 15 countries and killed 254 of them. It has killed or forced the culling of more than 300 million birds in 61 countries in Asia, the Middle East, Africa and Europe.

Some 23 Egyptians have died after contracting the virus, most after coming into contact with infected domestic birds in a country where roughly 5 million households depend on domestically raised poultry as a significant source of food and income.

While H5N1 rarely infects people, experts say they fear it could mutate into a form that people could easily pass to one another, sparking a pandemic that could kill millions.

(Writing by Cynthia Johnston)
hat-tip ironorehopper

Flying in the face of challenge

2 - 8 April 2009

Published in Cairo by AL-AHRAM established in 1875

According to a World Health Organisation report, Egypt is on the front line in the battle against avian flu. Reem Leila examines the threat


Two-year-old Israa Saad Abdel-Shafi is the 60th case of the H5N1 strain of avian flu virus recorded in Egypt since the first outbreak of the disease in 2006 and the ninth victim since the start of the year. Twenty-three out of the 60 have died, the majority young girls or women from rural areas who raise fowl domestically.

In early March the World Health Organisation (WHO) called for an investigation into why Egypt is seeing increasing numbers of victims. The WHO has identified the country as being at the forefront of the spread of the disease though Abdel-Rahman Shahin, official spokesman to the Ministry of Health, points out that despite the high number of victims the percentage of fatalities from bird flu in Egypt is still less than in other countries that have seen outbreaks of the disease.

Egypt has reported nine cases since the beginning of the year, with zero fatalities. There were eight cases with four fatalities in 2008. Vietnam has reported two fatalities, and China seven victims with four fatalities. Shahin argues the figures indicate the disease is being controlled in Egypt.

"This year we do not have any fatalities whereas last year it was 50 per cent. The fatality rate in China this year is more than 50 per cent, and in Vietnam it is 100 per cent. The situation in Egypt is improving, not deteriorating."

Bird flu presents a massive challenge to the government given the uncertainty about the course of any possible pandemic. The virus has become endemic and it could take years to rid the country of the most virulent strain. The government, says Shahin, has prepared a detailed national plan to be implemented in case of a pandemic according to which half of Egypt's 150,000 hospitals beds will be reserved for avian flu patients.

Hamid Samaha, head of the General Authority for Veterinary Services, says the government is focussing on comprehensive public health efforts -- monitoring outbreaks in order to identify any change in the virus, increasing anti-viral stockpiles and building a more robust capacity for vaccine production.

Settlement patterns in Egypt, where 95 per cent of the population is concentrated on five per cent of the land, has serious implications for any pandemic outbreak. The virus has been found at nearly 300 sites and is now "rooted in the Egyptian environment" says Shahin, who now believes that following the first incidents of avian flu Egypt should have culled all poultry and taken draconian measures to stamp out the continued domestic rearing of birds.

"The whole country must resort to consuming frozen chicken instead of purchasing fresh birds. We cannot afford to implement such a scheme at the moment, but the least we must do is ensure that in cities people abide by the regulations and limit direct and indirect communication with poultry."

Shahin suggests the mortality rate resulting from bird flu infections is decreasing due to growing awareness in the wake of information campaigns conducted by the Ministry of Health.

The WHO is still concerned that human infections have escalated over a relatively short period of time, leading some experts to accuse the government of inadequate planning. Health officials, they say, are endeavouring to enforce preventive measures but are incapable of ensuring they are strictly implemented.

"Government planning is random. It is using the wrong vaccine to combat the virus," insists Talaat Khatib, professor of veterinary medicine at Assiut University. "American scientists have already confirmed the H5N1 virus has evolved into two genetically distinct strains, potentially increasing the risk to humans." Khatib believes public awareness campaigns to date have been too weak and Egypt should have begun to plan its preventative measures when the virus was first reported in the country in February 2006.

In Egypt, where poverty and illiteracy rates are high and urban rooftop and backyard rearing of poultry has long been a way of life, a more systematic approach to monitoring the disease needs to be put in place, says Samaha. "People do not respect instructions from the authorities. They consider poultry capital for which it is worth risking their health, and the health of their neighbours."

Egypt is one of very few countries affected by bird flu that does not offer compensation to farmers when poultry is destroyed. Since 2003 412 human cases of the virus have been reported in 15 countries, resulting in 256 deaths. More than 300 million birds have been culled worldwide.

Hundreds of chickens in Cianjur died was attacked by Bird Flu

Cianjur -- noodles: the Peternakan Service, Perikanan and Marine Kabupaten Cianjur, confirmed that the poultry that died in four subdistricts, as a result of the virus avian influenza (AI) or bird flu. At least 132 poultries of the chicken kind talk to was found died suddenly in the period several last days in four territories, respectively the Mande Subdistrict, Sukaluyu, Cilaku, and Campaka. Whereas 12 tails among them, were based on results rapid test (the fast test) was stated positive was infected by the bird flu virus. These results were reinforced with the existence of the resident who it was suspected was infected by this virus. Ade (50), one of the residents of the Cikeukeup Village, Desa Cidadap, of Kecamatan Campaka, it was suspected was infected by the AI virus.
His article, was based on results of the report on the official participatory diseas survailance and the response (PDSR), he suffered the sign that headed in suspect AI. Meski Demikian, Dinas Peternakan, Perikanan and Marine, still could not conclude whether the sign that was experienced by Ade headed in suspect AI or not. The head of the Kesehatan Field of the Animal and the Verteriner Masyarakat Dinas Peternakan Health, Perikanan and Marine Kabupaten Cianjur, Ir Adiyanto Wahidin, justified this matter. Hundreds of tails of the chicken that died suddenly this was spread in four subdistricts. In the Cidamar Village, Desa Bobojong, Kecamatan Mande, the number of chickens that died totalling 76 tails. The village of Cikeukeup RT 06/09, the Cidadap Village, the Campaka Subdistrict (26 tails), in the Kamiran Round Village, the Selajambe Village, the Sukaluyu Subdistrict (23 tails). And in the Rahong Village, Desa Munjul, Kecamatan Cilaku (7 tails).

"From results rapid test that was carried out in four subdistrict territories, totalling 12 chickens among them that was in the Mande Subdistrict, Sukaluyu, and Campaka, was stated positive," he said. Whereas in the Rahong Village, Desa Munjul, Kecamatan Cilaku, results rapid test against two tails of the chicken carcass was stated by the negative. He justified the existence of the report from the officials PDSR that mentioned that one of the residents was in the Cikeukeup Village expected terindikasi the virus of AI. Saat Ini, this resident was getting the maintenance in one of the hospitals in Sukabumi. "Indeed was based on his report, he experienced the sign that headed in the infection of AI. Tapi this was not yet certain, because still in the inspection," he said. For the process of his handling according to him hundreds of tails of the poultry that experienced this sudden death most had been buried and burnt (depopulation), to the spreading of his virus could diminimalisasi. (Ant/OL-03)

Tuesday, March 31, 2009


From the post below:

RSHS Kembali Merawat Pasien ”Suspect” Flu Burung RSHS,
On Tuesday, March 31 2009
the Handsome Sadikin Hospital (RSHS) again treated the patient suspect bird flu, that is RA (27), the resident of the Sand Village of RT 02/RW 05, Street.

RA entered isolation space around struck 20,00 WIB, on Sunday (29/3), because experienced breathless and feverish.
RA could get the maintenance in the Clinic of Dewi Sri Bekasi, before being reconciled to RSHS. Menurut the wife of the patient, Raisem (40),
This has to be R (50). Same wife, same village, same adm. date.

The Balita deceased the Kuantan VII Positif Flu Burung Origin

Selasa, 31 Maret 2009

Wahyu was stated positive bird flu after results of his sample that was taken some time before evidently positive. Regrettably, City Health Service did not yet get official results.

Riauterkini-Pekanbaru-Wahyu (2.9), that died last week was stated positive bird flu after the sample of his blood was accepted Health Service Provinsi Riau.

Positive him the revelation died because bird flu was sent Head of the Health Service Riau, Mursal Amir via his mobile phone. We just received the sample this morning.

Wahyu was positive bird flu, said Mursal. The temporary assumption, Wahyu was affected by the bird flu virus from the poultry that died was not far from his house.

Concerning the step in anticipation against this case, Diskes (= Health Service, ed) , continued Mursal, has collected data on people that was round Wahyu. Both the closest person and the paramedic who treated Wahyu during in the hospital.

In the meantime, Plt Kadiskes Pekanbaru, Rini Hermiyati that was contacted in the place was separated admitted to not yet getting the report produced by the sample. I still could not the report. Knew from where? , he said. If quite positive, he continued, has been protap dealt with the case of bird flu.

How if positive, or the negative. That was certain, continued Rini, while 21 days were carried out by observation for people that had been round Wahyu during still lived. The certain number, I did not know. From the close family had 6 people.

That not to mention from the paramedic RSUD Arifin Ahmad, he added. Did not close the possibility, these people suffered the sign was the same as Wahyu.

Rini like definitely was not yet there are those that had the hot and feverish sign high although he could get the report. The sign, yesterday was available... Later I asked previously that the observer, said Rini without continued said-he said .
hat-tip Dutchie

[Here is part of the above article, I ran thru QDT]:

Meanwhile, the Plt Kadiskes Pekanbaru Rini Hermiyati that connected in room apart/isolated
confess not yet get report outcome same. "I not yet can report to know of what type or kind?," he said.

When certainly positive, next as continued, already there is permanent procedure for handling bird flu patient cope with cases flu burung.

How so if positive, or negative. Who certain, continued Rini, as long as 21 days carried out observation for people that have be in surrounding area Wahyu when still to be alive. "total number certain, I not know. From family near there is 6 people. Not yet more from paramedic RSUD Arifin Ahmad," he added.

Not close prospect, people aforementioned suffer symptom like Wahyu. Rini as not yet definite there is that to have symptom hot and fever high even though he have a chance to get report. "Indication, yesterday there is...Presently I question earlier who monitoring," said Rini without continue word he said.

Monday, March 30, 2009

RSHS Kembali Merawat Pasien ”Suspect” Flu Burung RSHS,

On Tuesday, March 31 2009
the Handsome Sadikin Hospital (RSHS) again treated the patient suspect bird flu, that is RA (27), the resident of the Sand Village of RT 02/RW 05, Street.
Key sand to the Sarijaya Village, Kec. Majalaya, Kab. Karawang. Beforehand, RSHS treated the patient suspect bird flu, UR (23), the resident of the Hill of Pelamunan Bekasi.
RA entered isolation space around struck 20,00 WIB, on Sunday (29/3), because experienced breathless and feverish.

RA could get the maintenance in the Clinic of Dewi Sri Bekasi, before being reconciled to RSHS. Menurut the wife of the patient, Raisem (40), worried terjangkit the bird flu virus, RA was treated in RSHS. Terlebih, there was the RA story experienced direct contact with the poultry. He explained, his 4 property chickens died suddenly, even so several tails of his neighbouring chicken experienced the similar matter. "This month of many chickens in my area died suddenly." Therefore, when the husband was sick, immediately was brought by me to the clinic to be checked, he said. Was different from RA yag had the story brought by me to the clinic to be checked, he said. Was different from RA yag had the story of direct contact with the poultry, UR on the contrary. Moreover the father UR, Sardjo (67), did not yet know the illness what actually was suffered by his daughter. UR underwent the maintenance since Tuesday (24/3), after receiving reconciliation from RS Medirossa Cikarang, Bekasi. According to information of Dr. Hadi Yusuf, the doctor who handled UR said, there was the affected assumption of dengue fever dengue fever (DBD), bird flu, and the compilation of the lungs. When arriving in RSHS, Hadi explained, flu that was suffered by UR was serious enough. Besides this, the RS Medirossa side that reconciled UR to RSHS also asked that this patient was treated in Flamboyan Space. Whereas the team's member penangganan suspect RSHS bird flu, Dr. Uun Sumardi that was met by the reporter, on Monday 30/3), said, the two patients were still getting the intensive maintenance and his condition began to be stable. This we were still being waiting for results of the laboratory of the hall of the central inspection (Jakarta), after we sent the sample of the patient's blood, he said.
Was difficult the difference of the behaviour In the meantime, Section Head Peternakan and fisheries (Disnakan) the Bandung Regional Government, Ernawan Santika that was met "GM", on Monday (30/3), said, changed the behaviour of the community was one of the main hindrances in pressing the spreading of bird flu in the Kab territory. Bandung. At first, since long ago the community could not have been separated from the poultry. The "maintenance" of the "good poultry," including the pen and the environment around it, could press the spreading figure" of the "bird flu illness." Unfortunately, the behaviour like this, not yet all the communities carried him out, he said. According to Ernawan, from the data in 2008, the poultry population in Kab. Bandung around 5,495,853 tails. "On the other hand this number was good because the poultry became supreme the economy" of the "community."

But on the other side meant the impact of the spreading of bird flu was very high, he said. To control the spreading of bird flu, continued Ernawan, his side already has carried out various programs, including forming the PDSR Team (Participatory Disease Surveillance and Response). The team that consisted of the doctor and this paramedic, to respond since early the spreading of bird flu in Kab. Bandung. "Since being formed by this team in 2006, praise the Lord the spreading" of "bird flu could be pressed," he acknowledged while adding, this team also involved the community. Said by Ernawan, although having the case of bird flu, but up to now in Kab. Bandung had never had fatalities. "In Kab." Bandung had never had fatalities. "In Kab." Bandung had never had fatalities, he said.

Ha Tinh: Bùng of disease described in pigs

March 30, 2009 Tin Xã Hội , Xã Hội March 30, 2009 Social News, Social

Have hundreds of pigs in Quang Cam, Cam Xuyen district, Ha Tinh tả infected and died than in bulk over a week.

Outbreaks began to appear from the farm family's Nguyen Thi Yen in 1 with 92 pigs died. Next, to 28 / 3, in the farm family's Tran Thi Bich, thôn 4, appear to 11 infected pigs and more. Animal health agencies and local government have emergency move all of the pigs destroyed to prevent disease to spread on a large scale.

Pham Thanh Binh, Director Department Animal Health Department of Ha Tinh, said the agency is directing the emergency destruction, regional dập and fold in place, spraying chemicals in the target, killing at places found disease. Sector also created animal quarantine core, prohibits the slaughter, transport, trade sick pigs to other areas, and urgently to statistical support for raising the level of VND 10,000 per kg pigs quite extinct.

On May 2, 2000, and also Bùng play here more than 200 pigs died. Many people brought pigs die in beach dispose of garbage in the situation that makes environmental pollution around the region become more severe.

Egypt Air warns of polio virus

Monday, March 30, 2009 - 11:05

أ Sent the Department of the Ministry of Health Quarantine of the General Department of quarantine in Cairo air a list of African countries and others, warns that all medical workers to quarantine the implementation of all measures of preventive health-vaccinated children from the surrounding countries, Arab Republic of Egypt, once the port of arrival and the Cairo International Airport.

ي The list included the following States, "Pakistan, Afghanistan, Nigeria, Sudan, India, Niger, Benin, Burkina Faso, Mali, Togo and Kenya"; and Dr. Ibrahim Hassan Shaban, director of the quarantine port of Cairo's air, to all workers to vaccinate children from the States mentioned statement to the age of 15 years.

28 susp

الأثنين، 30 مارس 2009 - 10:38
Monday, March 30, 2009 - 10:38

Increasing incidence of avian influenza Menoufia

Dr. Ahmed Fouad, director of Veterinary Medicine Ghneim Menoufia, the inventory of some 28 cases of suspected infection during the month of March, according to the statistics of the Committee to Combat Bird Flu in the Office of the province, including one case of positive girl Habiba Mahmoud Mohamed Mahmoud (18 months) metropolitan district Mnov Center, which corresponded to the recovery and left hospital two days ago, the Tamiflu drug, and returned to her home after receiving treatment for the exercise of their natural lives.

The WHO has chosen the province of Menoufiya best to fight the disease control program, and asked to distribute it to all provinces to adopt it in the announcement of the transparency of information and situations and full coordination between all stakeholders of the disease, health, agriculture, veterinary medicine and the local units, in addition to the security agencies to control to the vehicle, the transfer of birds and licenses necessary to prevent the spread and transmission of the disease from province to province, in addition to leading a program to educate rural women and the people, especially in villages, on the nature of the disease and methods of prevention.

Recombinomics: Novel Clade 7 H5N1 Cleavage Sites Raise China Concerns

Recombinomics Commentary 21:19
March 30, 2009

The novel HA cleavage sites in the recently released H5N1 clade 7 sequences from northern Vietnam are cause for concern. The isolates from Vietnam are most closely related to clade 7 sequences from Shanxi and Hunan in China. All have the same basic cleavage site REGGRRKR. However, the two isolates from Vietnam have added an R to produce a cleavage site that is REGGRRRKR. This additional basic amino acid may make the H5N1 more virulent and expanded tissue tropism, because the cleavage is facilitated by tissue specific proteases and the extended cleavage site may offer additional specificities. Moreover, the most recently released sequence, A/chicken/Vietnam/NCVD-03/2008 has duplicated the firts two positions to produce an even larger cleavage site, REREGGRRRKR, which may be linked to even greater virulence and tissue tropism. This isolate also has an upstream 3 BP deletion, although neither recent isolate from Vietnam has the 3 BP deletion identified in the clade 7 isolates from Hunan and Shanxi.

This increase in genetic instability is likely linked to recombination driven by vaccine escape. The latest WHO update on vaccine targets notes that the two isolates from Vietnam were antigenically distinct and both were chosen as clade 7 vaccine targets, even though both came from 2008 Vietnam isolates. Selection of clade 7 vaccine targets is limited by the withholding of clade 7 sequences. China has yet to release sequences from the January cases, even though the sequence of A/Beijing/1/2009 was discussed in media reports in January. The WHO update was glaringly silent on this case, which was the first in the series of nine confirmed cases in China in January, which abruptly stopped in February.

China has acknowledged that the poultry outbreak in December, 2008 was clade 7, which created vaccine resistance problems, leading to new vaccinations in adjacent areas. However, the human cases were widespread throughout China, raising concerns that vaccine resistant H5N1 extended beyond provinces adjacent to Jiangsu. This is supported by the recent clade 7 sequences from Vietnam, which have a large number of non-synonymous changes that would compromise prior vaccines. Moreover, it is not clear that clade 7 is included in vaccines in Vietnam, which would facilitate H5N1 spread and instability.

Release of recent H5N1 sequences from patients and poultry in China and Vietnam would be useful.

RSHS treated two patients the Assumption of Bird Flu

Senin, 30 Maret 2009
BANDUNG - The Hasan Sadikin hospital (RSHS) Bandung again treated two patients who were expected experienced suspect Avian Influence (AI) alias bird flu. UR (23), the resident of the Pelamunan IX Hill, Bekasi was before treated in Poinciana Tree space, RSHS since last March 24. UR was treated after experiencing the breathless and feverish sign high. Now, one other patient, R (50), the resident of the Village of key Sand RT08/RW03, the Sarijaya District, the Majalaya Subdistrict, the Karawang Regency, was treated in Poinciana Tree space since March 30. Raisem (40) the wife R said, before being treated in RSHS, casualties could be run off with to the Lamerta Clinic and RS Dewi Sri, Kabupaten Karawang. However, on reconciliation of RS Dewi Sri, casualties it was recommended immediately were run off with to RSHS because this RS did not have the implement to merwat the assumption patient suspect bird flu. The "side's RS words, was seen from his signs, the temporary assumption was affected by bird flu." But the doctor here (RSHS) did not yet give information anything, explained Raisem when being met by the reporter in the Poinciana Tree waiting room, on Monday (30/3/2009).

According to him, two weeks before his husband showed the sign of bird flu, the poultry around his house many that died suddenly. Kluarganya personally maintained seven chickens, four including dying suddenly some time before. He admitted that his husband carried out direct contact with the poultry that died. "After the chickens died, my husband exiled him to the time." In our village many that died suddenly because of my neighbour also many that maintained the chicken, he said. He said, initially the family was not suspicious of this incident. His article, after experiencing the fever and breathless, casualties could recover several days before finally showed the sign came back. Raisem said, his husband only showed the breathless and feverish sign, without being accompanied unconscious.

According to him, there was no other resident who experienced the similar incident like his husband. Raisem hoped, results of his husband's check-up did not show the impact that bruruk. "I only submitted what results" of the "doctor's inspection, but yes hopefully the assumption was untrue," hoped he. At this time, said he, was carried out by spraying anti AI in the Sarijaya village.

In the meantime, the chairman of the team of the control doctor of RSHS bird flu, Hadi Yusuf said, the two patients were treated by the reason contracted the illness with signs of bird flu. However this matter still could not diapstikan. His article, the blood inspection of the two patients maish continued to be carried out by the team of the doctor. "Sample blood of one of the patients has been sent by us to Jakarta to be checked." The temporary assumption, the first patient contracted DBD. Sedangkan the second patient did not yet go out results, explained Hadi.

Human bird flu outbreak: lack of exposure to primary medical problem, such as old

More on this case:
Human infection of bird flu reported in central China

BEIJING, Jan. 31 (Xinhua) -- A 21-year-old female farmer was confirmed as infected with bird flu in central China's Hunan Province, said the provincial health authority on Saturday.
The patient was found sick on Jan. 23 and hospitalized on Jan. 26. So far she has been in stable condition and recovering.

March 30, 2009
Source: "Chinese Hospital" magazine Author: Liu Wei Xiu Jinlai

Editor's note: in January this year, before and after our country people confirmed eight cases of bird flu. In 2008, however, total number of reported cases only three cases.
Human avian flu disease outbreak-intensive, so that groups of infectious diseases suddenly serious situation.

As with many infectious diseases, there is the fear of bird flu virus is still unknown from it. "Atypical pneumonia" after the country set up a public health emergency response system, the frequency of bird flu virus attack, and finally there is the opportunity to let the system from paper directly to accept the reality test.

However, in this life to eight patients with final exams for the price of life and death, we found that the original was the emergency system Chao-Gang奉若did not seem the United States, not only failed to resist the brute force approach of avian flu virus, it has been revealed dislocation at the system, such as primary health care of old vacancy problem.

Battle xupu

Health Bureau and the CDC, two of infectious disease reporting system at the requirements and have a dislocation between reality, so that the people溆浦县hospital dilemma.

If it is not because of bird flu, should flower舒荣anonymous work or a sister. Chinese New Year this year happened to go home, let her out of one accident many hats - Human bird flu.

Flower舒荣Xiangxi溆浦县at home, rolling mountains and the people are mixed poultry paradise for generations. There will always nameless chickens and ducks died, the locals used to dying poultry board made of chicken slaughtered in advance pressed salted duck, eat or keep guests.

On the eve of Chinese New Year, Back from Guangzhou Flower舒荣homeland, the village poultry are once again beginning of life and death cycle of her own chickens and ducks have also been involved. In order to avoid all the dead chickens and ducks, she helped kill chickens ducks at home. New Year's Eve, two days before the beginning of flower舒荣fever, by the village barefoot doctor has not improved after treatment, his condition舒荣spend more and more weight, accompanied by their families, the people in the New Year's Day arrived溆浦县hospital.

Unexpected virus

"If the first two days of the morning did not come DENG Hong-hua hospital rounds, the patient was perhaps a missed diagnosis."溆浦县Liu Xiaopeng, vice president of People's Hospital, a lingering fear.

January 26 (New Year's Day) afternoon, the hospital treated up to a temperature of 40.06 ℃ flower舒荣. Liu Xiaopeng knew this day patients, the doctor on duty told him the phone, patients with serious and difficult home, proposed to allow transfers. Liu Xiaopeng did not agree to require a doctor first checks the basic condition to make a decision after the master clear.

舒荣reception flower has two doctors for her to do the routine and chest CT. CT film shows that there is one-third of patients with right lung is changed, there is also left scattered infiltration point - with severe pneumonia, common diseases, because doctors did not particularly care about.

January 27 (the two early) morning to the hospital within two rounds DENG Hong-hua, director of Flower舒荣look at medical records and found a strange phenomenon: the past舒荣Healthy flower, blood does not clear, as with the chest, interleukin value has declined. DENG Hong-hua was aware that it is virus infection.

"The First People's Hospital of Huaihua just a person who died of bird flu patients, the clinical manifestations舒荣flower like the disease, severe, such as low blood and poultry from infected areas, in line with unexplained pneumonia, diagnostic criteria, which are caused by I attach great importance to the main reason. "DENG Hong-hua memory.

Subsequently proved that the DENG Hong-wah on high alert, for the successful treatment舒荣key step in laying a flower. By asking, DENG Hong-hua舒荣flower was found to have a history of exposure to poultry, there is all the more disturbing her mind immediately reported to the medical quality control phone chief Leung Yeung Chau.

Yeung Chau Leung clearly remember the time the call is at 11 o'clock on January 27 many. "I see patients go to the wards and at the same time to report to the Vice-President Liu Xiaopeng." Leung Yeung Chau of "Chinese Hospital" journalist said: "Although people Having never been involved in avian influenza, but I highly doubt that this disease . "

On the eve of Chinese New Year, the Board requested溆浦县area health care institutions each day零报告制度report all diagnosed cases of pneumonia of unknown causes, must be submitted in strict accordance with the provisions, in particular, people should pay attention to avian flu. Hospitals meeting stressed the need to pay attention to cases of pneumonia of unknown causes. Since the outbreak of the hospital Rapporteur vacation, Liu Xiaopeng on the job as temporary. Received a phone when exactly Liu Xiaopeng and Liu County Health Secretary million conversations at work, they immediately reported orally.

Very nervous the next time. 12:00 the same day, the hospital organized a large hospital consultation, the view that the consultation: the diagnosis of severe pneumonia in very clear, consider belong to virus infection, people do not rule out avian influenza, pneumonia of unknown causes in line with the conditions reported. 1 hour later, doctors from the Health Bureau溆浦县shares lead organization governance County People's Hospital, the county and the county hospital of Chinese medicine experts CDC's largest county consultation, consultation findings.

However, the problem out quickly.

According to the procedures, the people溆浦县hospital within two hours in the Chinese Disease Control and Prevention through the information system directly pneumonia of unknown causes at the network's medical history reported to flower舒荣situation, Liu Xiaopeng has a dilemma. "Although the CDC under the Public Health Bureau, but also its own system. The results of consultation, the County CDC CDC immediately reported to the city, the provincial city of CDC CDC also reported phone. Provincial CDC requirements At our 2 hours at straight. But the views of the county health bureau, the first under the Huaihua溆浦县Municipal Health Bureau reported that the request of municipal experts from consultation, if people do not rule out bird flu, and then reported to straight. Administration of the Department of Health to consider many aspects, but the CDC's report, I did not dare go against. "

Health Bureau and the CDC, two of infectious diseases reported to the system with the reality at the wrong leads. This leads to the multi-management issues, so that confusion Liu Xiaopeng.

15:00 the same day, the hospital network in accordance with the requirements of direct reports finish. At this point, the county collected in patients with CDC were car-related specimens sent to the provincial capital Changsha. Health溆浦县put forward at that time, county CDC did not according to plan, submitted too soon, fearing a negative impact on society.

Our source has told,溆浦县Health concerns also received from the stress, "The First People's Hospital of Huaihua recently the case of reception from the people in Guizhou imported cases of avian flu to hospital with severe pneumonia admitted to hospital . Later, in line with the hospital found that patients with the diagnosis of pneumonia of unknown causes, then we have to ask the province of the expert consultation, and reported to the relevant state department. Leaders at all levels, experts come to the hospital an additional workload, from the reception to the death 4 days, the hospital received more than 10 million fee to spend the money.老少边穷region for medical institutions, are spending a small fortune. With the warning, the more inadequate funding for health authorities to溆浦县say, natural to consider their own capacity, hoping to wait until municipal expert opinions issued after more precise Direct Network Report. "

Huaihua City Health Bureau convened the Expert Group was rushed to the emergency xupu. To the way traffic when the city of Huaihua, vice president of First People's Hospital, Department of Respiratory Medicine贻秋Zhang suddenly think of the experts, that the hospital in the rescue of people in Guizhou input of patients with avian flu, the Ministry of Health experts in the treatment of people brought about by the effects of avian flu drug Tamiflu has not yet run out, they immediately ordered the driver make a U-turn, back to Huaihua taking Tamiflu.

Until 6:30 p.m. that day, the Group 3 and his people finally arrive xupu. After consultation, the Group believes that the people溆浦县hospital diagnosis of "well-founded", the diagnosis is still considered a severe viral pneumonia, a high degree of people suspected of bird flu, but the department must wait until the test results superior to the final diagnosis.

Yeung Chau Leung explained that "people because bird flu finally diagnosed the country required the test results issued by CDC, even if there is no diagnosis of Hunan Province right to CDC. The city of the expert group decided to isolate the bird flu in accordance with the treatment of people, brought from the Huaihua preventive medicine Tamiflu has also been applied to patients and nursing staff. "

"The first suspect, the first report, the first treatment, the first referral," the management of a social capital by the creation of county-level public hospitals in the treatment of bird flu person's "4 the most."

The turbulent transfer

"Patients with serious illness, we do not have ICU wards, there is no breathing machine, but there are no special medicines. In accordance with the provisions of Department of Health Administration, critically ill patients should be referred to the three-hospital treatment." Liu Xiaopeng said.

"If bird flu are people, belong to Group B of infectious diseases management, in accordance with the provisions of the spot should be treated in isolation. If the person is not bird flu, the city can receive this one hospital patients, but pre-medical costs 100,000 yuan. "The First People's Hospital of Huaihua insist.

Consultation to discuss at the meeting, the two hospital because a dispute over transfer problem. More difficult is that I heard at another hospital to pay 10 yuan, after lying in the intensive care unit舒荣Flower depression, begin to resist treatment, "not to die."

"Take care of patients with small loss of her mother, grew up and has been out working hard to make a living at home, admitted only 1,000 yuan to pay the money to be spent CT on 270 and there is no ability to renew. If people are not suffering from Avian influenza, severe pneumonia, often hundreds of thousands a few hundred thousand dollars of medical expenses, home can not stand. "DENG Hong-hua was the scene memory.

Costs, about a flower舒荣can achieve transfer. Close to midnight, the two sides are still unable to reach an agreement, decide to wait for test results issued by the provincial CDC after consultation.

Well settled experts, Liu Xiaopeng deep shallow kick back kick to hospital. A few hundred meters of the road, he kept thinking of things to do after dawn: Human bird flu, if not, insist on the transfer; people if the bird flu are on the arrangements of the other two branches of patients with metastasis, and stop receiving new patients .

January 28 (the beginning of the year three), transfer to other hospital patients are busy, the second舒荣flower CT results are in: The right lung is the change from one-third into a two-thirds of the left lung infiltration by point into a sheet, his condition markedly increase. DENG Hong-wah said: "The overall impression is that patients with symptoms and signs do not obviously change, but the results of examination to change very rapidly."

Noon, Hunan CDC reports first results of testing negative, continuing the dignified atmosphere for a long time to relax a bit first. However, the provincial CDC also stressed that for caution's sake, have to wait for second, third test results. Prior to worry because there is no valuable specimens collected from Huaihua City CDC collected samples are being sent to the third way in Changsha. 16:00, Huaihua City Health Bureau and the Government溆浦县xupu at a joint meeting,

City Health Secretary raised the tension out, the Government attaches great importance to pneumonia of unknown causes, not only medical problems to consider, we must also consider the social impact. Regardless of whether patients with avian flu patients who are transferred must do its utmost to treatment.

First off the voice, the silent hall.

Ultimately, the deputy governor of溆浦县position, cost of treatment by the government to advance, but no time 10 million settlement of batches required, Huaihua City, First People's Hospital also, where necessary, agree to receive a flower舒荣. During a meeting of the Hunan province Telephone CDC informed that the second time the test results remain negative, and the atmosphere was relaxed again. Since members of the Group are the backbone of hospital, they run at night after supper Huaihua back.

"Oh, no, it is positive!" 9 o'clock that evening, the third director of the city of CDC CDC received a call from the province, immediately facing the rest of the people are ready said, relaxing atmosphere have been put back again nervous. Tension Phone orders go out immediately on the road at top speed back to the experts. After a moment, then called the Ministry of Health related to the leadership of the phone call will be transferred to patients located in Changsha Xiangya Hospital of Central South University.

January 29 (the beginning of the year four) shortly after midnight, Liu Xiaopeng怀揣him to the county civil affairs bureau 40,000 yuan of medical expenses, led by the people溆浦县hospital medical staff, composed of the best escort team fell Changsha .

No less than the ambulance ride because all the staff, temporary requisition Escort Group Secretary for the county health official cars and an ambulance on the arrangements at the two drivers take turns driving. "City Health Secretary is very concerned about the situation on the road, asked me to call every 1 hour is necessary to report the situation, I do not sleep chant." Liu Xiaopeng excited, more nervous.

"Fortunately, patients can still remain relatively stable body temperature gradually decreased at all the way. Because we found that early and get treatment early, and younger patients with strong resistance, at that time I will definitely be on the estimated cure patients." At the end of the first 7 calls, the escort vehicle group arrived in Changsha, Liu Xiaopeng raised his arm, watch the 7:00 point. Xupu at this time, but also一夜无眠.

达湘雅the hospital, the perianth舒荣specialized in the hospital setting for treatment of human avian influenza wards. Xiangya Hospital spokesman, medical director of mine told Sinorama "Chinese Hospital," in January 2009 because of bird flu person-frequency hair, Xiangya Hospital before the Chinese New Year on the establishment of the relevant expert groups, medical groups, nursing groups and disinfection isolated group, and, in particular, a vacant 50-bed ward, as a ward for treatment of bird flu person.

Xiangya Hospital Consultation Group of Experts found that flower舒荣not only damage the lungs, but also appeared in the liver and heart damage, they used to support therapy for the treatment of organ protection. After 20 days of hospital treatment, the disease gradually舒荣smooth flower until cured.

hat-tip Florida1

Recombinomics: Unstable Clade 7 H5N1 In China Raises Concerns


Recombinomics Commentary 10:34
March 30, 2009

A recent clade 7 HA sequence from a chicken in Vietnam, A/chicken/Vietnam/NCVD-03/2008 was released at Genbank under the title, "Characterization of a highly pathogenic avian influenza H5N1 sublineage in poultry seized at ports of entry into Vietnam". It was proposed as a vaccine target in the recent WHO update because it was antigenically distinct from another recent clade 7 target, A/chicken/Vietnam/NCVD-016/2008, which was isolate in northern Vietnam near the border with China. Both of these sequences have a cleavage site similar to clade 7 isolated in 2006 in China, except the cleavage site has a 3 BP insertion, encoding for an additional basic amino acid.

However, the recent sequence also has a duplication of sequences encoding the two amino acids at the beginning of the cleavage site, creating the novel cleavage site, REREGGRRRKR. The sequence also has an addition 3 BP deletion, which is distinct from the 3 BP deletion found in earlier clade 7 isolates from China, as well as clade 2.2 isolates in Egypt.

The selection of two 2008 clade 7 targets from Vietnam is unusual, but follows a spate of cases in China in January. These cases followed confirmed clade 7 outbreaks in poultry in Jiangsu in December, 2008 and strongly suggest that most of the human cases in China were clade 7.

The sequences form these patients have not been released and have only been described in general terms in reports from China. The WHO report was silent on all cases from China except for two that were the Fujian strain (clade 2.3.2 and 2.3.4), further supporting concerns that vaccine resistant clade 7 is widely circulating in China.

The recent sequences from northern Vietnam demonstrate considerable genetic instability that involves a large number of non-synonymous changes as well as insertions and deletions in the HA sequence.

Release of sequences from the Jiangsu poultry outbreaks in China, as well as recent human cases in China and northern Vietnam would be useful.

Media Links

Suspected Cases Of Bird Flu Infection In Dakahliya .. The Girl Recovered and the Detention Of 3 In Menoufia

Ghada wrote Abdalhafez and Hind Mohamed Hamdi Ibrahim, 3-30-2009

Mansoura Chest Hospital was arrested yesterday on suspicion of two cases with symptoms of bird flu disease bird: the Marwa Ahmed El-Shahat «22 years», housewife, from the railway Sndob Egypt, Mohamed Diab transfer «18 years», a fisherman, from the rain, showing signs of illness Avian influenza.

In Monoufia detained Shebin hospitals and educational Echmoun year 3 new cases of two women and a man on suspicion of contracting bird flu after they showed signs of illness: the hopes Labib Abdel Rasul «20 years», housewife, from the village of Mit Siraj Bakuesna, Mr. Hassan «30 years »from the village of Essam Manshiyat Center Shebin, and Jihan Abdel Aziz al-Sharif on the« 28 years »from the village of Alnanaip Echmoun Center and found that the cause of injury due to the breeding birds in the house. The Committee of Veterinary Medicine culling poultry infected with the three houses had been buried in a safe, taking samples and sending them to the central Ministry of Health laboratory for analysis.

On the other hand, I left the girl Habiba Mahmoud Mohamed Mahmoud Bakry Cairo hospital and returned to the village the status of metropolitan Mnov after recovery from disease, avian flu, Dr Ahmed Fuad, the director of the Directorate of Veterinary Medicine, visit and check on their situation to make sure to recover, as was the case only positive During the month of March in addition to the 28 cases were the result of suspicion analyzes negative.

In Qena, culled teams fight bird flu the Directorate of Veterinary Medicine in coordination with the Investigation of Supply 800 birds Samala Abushok village and the scarcity of the sterilization of 32 houses after the deadly avian flu.

4 farms were closed as the status of birds in Esna to work without a license are: farms «King of the cheap Nasser» and «Mr. Mahmoud Mansour» and «Hamid Mohamed Salah» and «Cila Azmy Sefen» 2800 birds were culled these farms and the issuance of the decision to close them, in addition to subject to the closure of 16 birds and Naga Hamadi, Qena and Esna to sell live birds in the assignee without a license.
hat-tip Dutchy

Lao province at risk of bird flu outbreak

2009-03-30 16:27:52

HANOI, March 30 (Xinhua) -- Many areas of Phongsaly province of Laos are at risk of infection from the H5N1 bird flu virus as local people are continuing to bring in poultry and eggs illegally from neighboring countries, the Lao newspaper Vientiane Times reported Monday.

Provincial authorities find it hard to identify when and where there's a virus outbreak as people can walk or drive across and engage in casual trade of poultry easily at border areas without checkpoints, said provincial Livestock and Fisheries Deputy Head Somnith Keoboun-ngune.

Last month there was an outbreak of the virus in Khua district, Phongsaly province. Now the outbreak is over and the district was declared bird-flu free today, said Somnith.

To prevent the spread of the virus to other districts, the provincial avian influenza control committee together with district and village committees culled about 2,600 poultry in 11 villages and set up checkpoints, said Somnith.

The provincial livestock and fisheries sector will work with the sectors concerned in leading a public campaign about bird flu, said Somnith.