Drug resistant, the H1N1 virus mutated in Singapore and Australia

June 12, 2011 04:04
Singapore - Researchers to the World Health Organization (WHO) states that the H1N1 flu virus that has swept the world in 2009 has been mutated, and now appeared in Singapore and Australia.

New H1N1 virus has a stronger genetic so it is more resistant to drugs such as Tamiflu and Relenza, which is believed to be the mainstay drugs to cope with the H1N1 virus.

Page channelnewsasia.com states, WHO hypothesis was obtained after the researchers found that given the suspect bird flu drug Tamiflu and Relenza was no longer able to cope with the virus attack.

The researchers said the H1N1 virus resistant to Tamiflu, and patients with weak immune eventually died.

But laboratory tests showed the drug was still effective Peravimir flu virus H1N1 overcome.

WHO also reveal new variants in other parts of Asia Pacific. It is feared that if the new form will trigger the spread of swine flu H1N1 virus resistant to the drug would be more serious.

Germany blames sprouts for E. coli outbreak, experts say cook them first to be safe

Excerpt:

E. coli can stick to the surface of sprout seeds.

"They can lay dormant on the seeds for months," said Stephen Smith, a microbiologist at Trinity College in Dublin.

Unfortunately for sprout-eaters, the germs are then inside the sprout as well as outside.

At that point, "washing has no effect," Smith said.

The European Food Safety Authority doesn't recommend avoiding certain foods, but advises consumers to take basic precautions, like washing all fruits and vegetables with clean water and peeling or cooking them when possible.

For now, German authorities are recommending people avoid all sprouts.

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Cambodian girl dies of H5N1

English.news.cn 2011-06-10 17:51:51

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PHNOM PENH, 2011-06-10 17:51:51 June 10 (Xinhua) --

Cambodia's Ministry of Health and the World Health Organization announced Friday that a seven- year-old girl from the eastern province of Prey Veng has died of avian influenza H5N1.

The girl died on June 7 as a result of respiratory complications after contracting human avian influenza virus H5N1, said a joint statement sent to the media.

"The girl is the 16th person in Cambodia to become infected with the H5N1 virus and the 14th person to die from complications of the disease since 2005," it said.

The patient became sick on May 24 and she was initially treated by private practitioners; however, her condition continued to worsen and she was later brought to Kantha Bopha Children Hospital in Phnom Penh for treatment on May 31, where she died on June 7.

"Avian influenza is still a threat to the health of Cambodians. Compared to last year, we have seen more H5N1 cases this year and children appear to be most vulnerable," the Minister of Health Mam Bunheng said in the statement.

"I would like to urge parents and guardians to keep children away from sick or dead poultry and if they develop signs of respiratory infections, they should be brought to medical attention at the nearest health facilities as soon as possible," he added.

German tests link bean sprouts to deadly E. coli

10 June 2011 Last updated at 05:14 ET

New data released in Germany strongly suggest that locally produced bean sprouts were, as suspected, the source of the deadly E. coli outbreak.

"It's the bean sprouts," said Reinhard Burger, head of Germany's centre for disease control

New data released in Germany strongly suggest that locally produced bean sprouts were, as suspected, the source of the deadly E. coli outbreak.

"It's the bean sprouts," said Reinhard Burger, head of Germany's centre for disease control.

"People who ate sprouts were nine times more likely to have bloody diarrhoea than those who did not," he added.

He warned that the outbreak, which has killed 29 people and sickened some 3,000, was not over.

It also generated a crisis for EU vegetable-growers, with Spanish cucumber producers wrongly blamed for the contamination.

Mr Burger, who heads the Robert Koch Institute, told reporters on Friday that even though no tests of the sprouts from a farm in Lower Saxony had come back positive, the epidemiological investigation of the pattern of the outbreak had produced enough evidence to draw the conclusion.

The institute, he added, was lifting its warning against eating cucumbers, tomatoes and lettuce, but keeping it in place for the sprouts.

Virus hits Queen Elizabeth's swans

08 June 2011

More than 180 of Britain's Queen Elizabeth's swans have died on the River Thames due to an increase in the duck virus enteritis.

Around 180 of Britain's Queen Elizabeth's swans have died due to an increase in duck virus enteritis.

The mute swan population of the River Thames in South East England have suffered as a result, and David Barber, the queen's swan marker, believes fewer cygnets will be born as a result.

He said: "Unfortunately more than 180 swans were found either dying or dead on the river between Reading and Windsor, with over 115 deaths being reported in the Windsor area alone.

The dead swans included many of the Thames' new breeding pairs and we anticipate that fewer cygnets will be born this year as a result of the outbreak.

"The dead swans included many of the Thames' new breeding pairs and we anticipate that fewer cygnets will be born this year as a result of the outbreak."

The harsh winter in the UK and a rise in the number shot by yobs has also contributed to the increase in deaths.

He added: "Vandalism is one of the primary causes of fatalities among mute swans and young cygnets.

"The number of attacks has continued to increase over the past year. Shootings by youths with air rifles and catapults cause horrific injuries and slow deaths."

Cucumbers back in E coli spotlight

• June 09, 2011 6:16AM

CUCUMBERS are back on the radar of German health authorities as the possible cause of an E coli outbreak in Europe that has killed at least 26 people and sickened more than 2700 others.

Two weeks ago, investigators blamed cucumbers from Spain for the deadly outbreak and then later ruled them out as the source.

Then, the focus shifted to sprouts from northern Germany, but none that were tested turned out to be contaminated with the bacteria strain blamed for the outbreak.

Now, suspicions have fallen on a cucumber of an unknown country origin that sickened a family in eastern Germany.

The cucumber - the first food found to be contaminated with the strain that has sickened thousands - was in the family's compost, but there is no conclusive evidence that it's the source.

"It's unclear whether the cucumber infected the people, or the people the cucumber," said Holger Paech, the spokesman for Saxony Anhalt state's health ministry.

The father of the family had diarrhoea, the mother was admitted to hospital for several days and their 22-year-old daughter is among about 700 people across Europe with a severe complication that can lead to kidney failure.

She has been in hospital for almost two weeks.

"The family was sick," Mr Paech said. "So, they could have contaminated the cucumber instead of the other way round."...

Genetic drift evolution under vaccination pressure among H5N1 Egyptian isolates

The highly pathogenic H5N1 is a major avian pathogen that intensively affects the poultry industry in Egypt even in spite of the adoption of vaccination strategy. Antigenic drift is among the strategies the influenza virus uses to escape the immune system that might develop due to the pressure of extensive vaccination.

H5N1 mutates in an intensified manner and is considered a potential candidate for the possible next pandemic with all the catastrophic consequences such an eventuality will entail.

Methods:
H5N1 was isolated from the pooled organ samples of four different affected flocks in specific pathogen free embryonated chicken eggs (SPF-ECE). A reverse transcriptase polymerase chain reaction (RT-PCR) was performed to the haemagglutingin and neuraminidase.

Sequencing of the full length haemagglutingin was performed. Sequence analyses of the isolated strains were performed and compared to all available H5N1 from Egyptian human and avian strains in the flu data base.

Changes in the different amino acid that may be related to virus virulence, receptor affinity and epitope configuration were assigned and matched with all available Egyptian strains in the flu database.

Results: One out of the four strains was found to be related to the B2 Egyptian lineage, 2 were related to A1 lineage and the 4th was related to A2 lineage. Comparing data obtained from the current study by other available Egyptian H5N1 sequences remarkably demonstrate that amino acid changes in the immune escape variants are remarkably restricted to a limited number of locations on the HA molecule during antigenic drift.

Molecular diversity in the HA gene, in relevance to different epitopes, were not found to follow a regular trend, suggesting abrupt cumulative sequence mutations. However a number of amino acids were found to be subjected to high mutation pressure.

Conclusion: The current data provides a comprehensive view of HA gene evolution among H5N1 subtype viruses in Egypt.

Egyptian H5N1-AIVs are constantly undergoing genetic changes and reveal a complex pattern of drifts. These findings raise the concerns about the value of using influenza vaccines in correlation with the development of antigenic drift in influenza epidemics.

Author: Ahmed Abdel-MoneimManal AfifiMagdy El-Kady
Credits/Source: Virology Journal 2011, 8:283

Another Outbreak of E. Coli in Germany

June 7, 2011

Another 94 people have been infected with E.coli in Germany. That figure comes as European ministers meet in Luxembourg to hold emergency talks on the outbreak and how to deal with it. Video courtesy Sky News.

No source of killer bug as toll hits 25

• June 08, 2011 6:13AM

GERMANY was no closer overnight to discovering the source of the killer E. coli bug that has so far killed 25 people, after tests on a suspected source proved negative.

The latest confirmed victims were two elderly women from Lower Saxony who died from complications linked to the bacteria. The number of sick people has climbed to more than 2300, AFP reported.

The number of sick Americans has also risen from four to six, The Wall Street Journal said. Two were US military personnel who were based in Germany. The other four were travelling in Hamburg in May. Three developed hemolytic-uremic syndrome and were admitted to hospital while the fourth developed bloody diarrhea...

Has E.coli claimed its first life in America? Fears after Virginia girl dies

A two-year-old girl in America who died at the weekend was found to have E.coli, prompting fears the killer bacteria has reached the U.S. 'The lab results confirm the presence of E.coli 0157:H7,' Mr Parker said.

The child, from Dryden, Virginia, died at Johnson City Medical Center Sunday after being exposed to the lethal strain.

According to Tricties.com, Virginia Department of Health Public Information Officer Robert Parker said tests proved the bacteria was in the child

'That's a strain of E.

The website says a Washington County, TN Sheriff's Office Coroner's Report says the child was brought to the medical center Pediatric Intensive Care Unit with bloody diarrhea after she was 'believed to be exposed to E. coli from a contaminated pool.'

Her brother was also been brought in with similar symptoms.

So far the bug has killed at 22 people and left 2,300 seriously ill.

And the virulent strain shows no sign of stopping as more cases of people falling ill from E.coli are confirmed in America.

Tricities.com reported the Northeast Regional Health Office Medical Director Dr. David Kirschke confirmed a similar severe strain in Northeast Tennessee.

Dr. Kirschke said a Northeast Tennessee child is suffering complications in a Knoxville hospital and there are seven other confirmed cases of E. coli from four Northeast Tennessee counties.

'Everyone is doing fine,' Dr. Kirschke said of the seven people. 'From the initial tests, these look like the less severe type of E coli. We are treating it like an outbreak. We are investigating it like an outbreak.'

Authorities have instructed people to thoroughly cook their meat, wash raw fruits and vegetables, and avoid swimming in places like rivers and lakes that could have access to agricultural run-off.

coli that causes severe illness.'

Germany says no proof organic sprouts caused E. coli outbreak; expert calls probe a 'disaster'

HAMBURG, Germany (AP)

First they pointed a finger at Spanish cucumbers. Then they cast suspicion on sprouts from Germany. Now German officials appear dumbfounded as to the source of the deadliest E. coli outbreak in modern history, and one U.S. expert called the investigation a "disaster."
Backtracking for the second time in a week, officials Monday said preliminary tests have found no evidence that vegetable sprouts from an organic farm in northern Germany were to blame.
The surprise U-turn came only a day after the same state agency, Lower Saxony's agriculture ministry, held a news conference to announce that the sprouts appeared to be the culprit in the outbreak that has killed 22 people and sickened more than 2,330 others across Europe, most of them in Germany, over the past month.
Andreas Hensel, head of Germany's Federal Institute for Risk Assessment, warned, "We have to be clear on this: Maybe we won't be able anymore to identify the source."
Last week, German officials pointed to tainted cucumbers from Spain as a possible cause, igniting vegetable bans and heated protests from Spanish farmers, who suffered heavy financial losses. Researchers later concluded the Spanish cucumbers were contaminated with a different strain of E. coli.

EHEC recommended: Early neurological therapy

Hundreds of people are currently using a hemolytic-uremic syndrome in German hospitals, particularly in the north. Note the neurological disorders. The professional society recommends therefore, neurologists involved early in the therapy.
BERLIN (NES). The current wave of EHEC is special - not only because of the rare pathogen and the size of the outbreak, but also because of the neurological consequences for patients.
The German Society of Neurology (DGN) reported about half of patients with hemolytic-uremic syndrome (HUS), which may suffer from severe and sometimes irreversible neurological disorders.
As alarming call it the two Hamburg neurologist Professor Joachim Roether and Professor Christian Gerloff, that the neurological condition in spite of early plasmapheresis does not improve or even deteriorating.
Gerloff is director of neurology at the University Hospital Hamburg-Eppendorf (UKE), Roether is Chief of Neurology at the Asklepios Clinic Altona. Hamburg, Schleswig-Holstein to the trouble spot of the current wave of EHEC.
Apparently striking is the early appearance of neurological symptoms.
Gerloff, 'You can already develop simultaneously with renal and gastroenterological symptoms. " Crucial features of HUS are bloody diarrhea, hemolysis, and renal dysfunction.


On the neurological symptom complex in HUS the first professional association is one of confusion, reduced vigilance, irritability and delirium. There are also many cases in aphasia and apraxia, and disturbances of the brain stem functions. In severe cases, patients develop myoclonic seizures and sometimes that can lead to coma. The neurologists suspect the cause of these symptoms in the Shiga toxin 2, the EHEC releases. In addition to the hemolytic effect of the toxin leads to a swelling of the vascular endothelium. As a result, the toxin could also lead to a widening of the intracranial vessels and a disturbance of autoregulation in the kidneys.
Also could play the complement cascade at the neurological deficit involved. Nephrologists suggest that Shiga toxin can activate the cascade, such as by binding to the C3 convertase of the alternative activation pathway.

One therapeutic approach is the monoclonal antibody eculizumab, which inhibits the C5 convertase and therefore interrupts the terminal cascade. Initial success in the current HUS cases were hospital doctors reported already. Whether the drug is a general treatment option, however, so far the doctors can not yet be estimated.
The neurologist and Gerloff Röther argue, given the severe neurological responses for 'drastic therapeutic measures'. Also, she said eculizumab should be considered in each case. UKE on 30 patients treated so far are just that, at the Asklepios Clinic in Hamburg-Altona five. At the first neurological abnormalities to speak both in favor of early anti-shock therapy, such as anti-epileptic levetiracetam. Diagnostic method of choice is the MRI, the findings are more sensitive than CT.


[link to www.aerztezeitung.de]
A Hatttip to Tetano

E.coli in Canada

3:32 PM
TORONTO – An Ontario man has Canada's first suspected case of E.coli linked to the deadly outbreak in Europe.


The Ministry of Health and Long-Term Care says the Peel Region man travelled to Germany earlier this spring where he ate local salad products.

The outbreak has also spread to the U.S. where four people in Atlanta were apparently sickened by the bacteria while visiting northern Germany last month.
In Canada, some farmers fear the outbreak is already proving bad for business.

The organization that represents Ontario's greenhouse vegetable growers says some of its members have reported a drop in sales as demand slips on news the source of the deadly bacteria remains unknown.

Sprouts from northern Germany were ruled out as the cause of the outbreak, as were contaminated cucumbers from Spain last week. Officials are focusing tests on tomatoes, cucumbers and lettuce from the EU to pinpoint the cause of the outbreak that has sickened thousands and left over 20 people dead

A spokesman for the Ontario Greenhouse Vegetable Growers ..

Official: Mich. resident sickened in outbreak

Jun 6, 2011 5:39am

DETROIT (AP) — A heath official says a Michigan resident who recently was in northern Germany is among four people in the U.S. apparently sickened by the food poisoning outbreak in EuropeKelly Niebel, a spokeswoman for the Michigan Department of Community Health, tells The Detroit News for a Monday story that the person is recovering in southeast Michigan.
The Centers for Disease Control and Prevention on Friday announced that three of the four were hospitalized with kidney failure, a complication of E. coli that has become a hallmark of the outbreak. The News reports the person from Michigan had kidney failure.
The E. coli outbreak in Europe that's linked to vegetables has killed 22 people and sickened more than 2,200.

E. COLI O104 - EUROPEAN UNION (11): CASE UPDATE, POSSIBLE SPROUT

05-JUN-2011
Subject	PRO/AH/EDR> E. coli O104 - EU (11): case update, poss. sprout source

SOURCE
Date: Sun 5 Jun 2011
Source: Associated Press [edited]
<http://news.yahoo.com/s/ap/20110605/ap_on_he_me/eu_contaminated_vegetables_europe>


Initial tests have confirmed that bean sprouts grown in northern
Germany are the likely cause of an _E. coli_ [O104:H4] outbreak that
has killed at least 22 people and sickened over 2200, an agriculture
official said Sun 5 Jun 2011.

Different kinds of sprouts from one organic farm in the greater
Uelzen area, between the northern cities of Hamburg and Hanover, could
be traced to infected persons in 5 different German states, Lower
Saxony Agriculture Minister Gert Lindemann told reporters. "There were
more and more indications in the last few hours that put the focus on
this farm," Lindemann said at a press conference in Hanover.

"Many restaurants that suffered from an _E. coli_ outbreak had those
sprouts delivered," his spokesman, Gert Hahne, told The Associated
Press. The farm was shut down Sunday [5 Jun 2011], and all of its
produce, including fresh herbs, fruits, flowers and potatoes, was
recalled. At least one of the farm's employees was also infected with
the _E. coli_ bacteria, the minister said.

Lindemann said 18 different sprout mixtures were under suspicion,
including sprouts of beans, broccoli, peas, chickpeas, garlic lentils,
mungo beans and radish. The sprouts are often used in mixed salads.
Lindemann urged Germans to not eat sprouts until further notice and
said definitive test results would be available Monday [6 Jun 2011].
He said authorities could not yet rule out other possible sources for
the outbreak and urged Germans to continue avoiding tomatoes,
cucumbers and lettuce until further notice.

Sprouts have been implicated in previous _E. coli_ outbreaks,
particularly one in Japan in 1996 where tainted radish sprouts were
found to have killed 12 people and reportedly sickened more than 12
000 others.

The current crisis is the deadliest _E. coli_ outbreak in modern
history.

The head of Germany's national disease control center raised the
death toll to 22 people on Sunday [5 Jun 2011], 21 in Germany and one
in Sweden, and said another 2153 people in Germany have been sickened.
That figure included 627 people who have developed a rare, serious
complication of the disease that can cause kidney failure. Ten other
European nations and the USA have reported a total of 90 other
victims.

[Byline: Kirsten Grieshaber and Tomislav Skaro]

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[As the overall number of cases continues to accumulate, it is now
reported that German-grown sprouts may well be the major vehicle. It
is not clearly stated whether the outbreak organism has been isolated
from sprouts, but it is reported that a worker from the farm acquired
the infection. If this farm is the primary source of the organism, the
next step is to find out from where the presumed manure fertilizer
source was obtained. The organism itself is distinctly unusual, and
efforts should be made to try to assess how Mother Nature put the bug
together. - Mod.LL]

EHEC outbreak: Update 8

05-06-2011

In Germany the outbreak of enterohaemorrhagic E. coli (EHEC) continues.

Haemolytic uraemic syndrome (HUS)

As of 05 June at 10:00 CET, Germany had reported 627 cases of HUS (including 15 fatalities): 54 more than the previous day.

Enterohemorrhagic Escherichia coli (EHEC)

As of 05 June at 10:00 CET, 1536 cases of EHEC infection (without HUS) had been reprted in Germany (with 6 fatalities): 108 more than the previous day.

Other countries

As of 05 June at 18:00 CET, 11 other European countries had reported a total of 31 HUS (with 1 fatality) and 71 EHEC cases (with 0 fatalities):

Country	HUS	EHEC
Austria	0	2
Czech Republic	0	1
Denmark	7	11
France	0	10
Netherlands	4	4
Norway	0	1
Poland	1	0
Spain	1	0
Sweden	15	31
Switzerland	0	3
United Kingdom	3	8

In addition, the Centers for Disease Control and Prevention in Atlanta, United States of America, had earlier published information on 2 cases of HUS in the United States linked to this outbreak.

All except 1 of the above HUS and EHEC patients had travelled to or from Germany during the incubation period for infection, typically 3–4 days after exposure (range 2–10 days). An increasing number of cases is laboratory confirmed as EHEC serotype O104:H4 or, more precisely, a strain of enteroaggregative verocytotoxin-producing E. coli (EAggEC VTEC) O104:H4. All of the affected countries are reporting their cases to the German authorities and WHO. European Union countries are also sharing information through the secure Early Warning and Response System (EWRS).

Note

EHEC and HUS have exclusive notification categories, so case numbers should not overlap. The figures in any rapidly evolving outbreak, however, are provisional and subject to change for a variety of reasons.

killer germ EHEC - shoots suspected

Source appears to be a factory in Lower Saxony

Sprouts from a production facility in the district of Uelzen (Lower Saxony) are, according to Lower Saxony's agriculture minister Gert Lindemann (CDU) is a recognizable source of EHEC epidemic. When an employee therefore an EHEC infection was detected, another staff member was also suffering from diarrhea.

However, the minister said: ". We can not recognize that the farmer with a fault in the development of" some sprout mixtures of the operation thus imports from abroad.

The conclusions drawn from 19 different types of seed sprouts have been supplied to restaurants and bars as well as health food shops and weekly markets. According to initial findings, but they were not included in other retail outlets.

In the press conference as Minister of the product among others, the suspected "Sprossfit mild blend ', and it contains sprouts from alfalfa, fenugreek, mung beans, lentils, adzuki beans.

The sprouts were supplied directly or through intermediaries of restaurants in Hamburg, Schleswig-Holstein, Mecklenburg-Western Pomerania, Hesse and Lower Saxony - the spreading area of ​​the intestinal disease!

The operation of the district Uelzen is closed since Sunday, the product was recalled.

Nor the EHEC pathogens in sprouts is not established, however, in the laboratory. So far, the study results are based solely on the trade routes.

Nevertheless, it was certain that a "very strong track down the source of infection" had. "The sequence of events shows very, very strongly that the rungs of a very, very likely to be a clear source of the pathogen," said Lindemann.

The first six major outbreaks of EHEC pathogen can be, according to the Lower Saxony State Office for Consumer Protection (LAVES) supplies the manufacturer shoot back.

According to the Office three canteens in Hesse and North Rhine-Westphalia and three catering establishments in Lower Saxony and Schleswig-Holstein, intermediaries from the nursery in Bienenbüttel district Uelzen were supplied.

The Ministry recommends to refrain currently on the consumption of sprouts. It can not be excluded that the contaminated with EHEC pathogens goods had already been fully processed and sold.

The manager of the establishment concerned, Klaus Verbeck said the "New Osnabruecker Zeitung" that he could make no sense to the allegations against its products. The salad bars would grow only from seed and water and were not fertilized at all. In other divisions of the court will not use animal manure, not even horn meal, Verbeck said the newspaper.

Both samples were investigated in the past two weeks on your own behalf, as well as studies of the food control had been no EHEC strain result of its products. According to Lindemann, the shoots are produced in the operation in 38 degree hot water vapor. "Optimal conditions for the growth of EHEC pathogen," said Lindemann. The pathogen could have been imported already with the seed from which the shoots were produced.

According to Lindemann at the start, shaft and shoots were investigated as a possible cause already.

"But then there was a restriction on three types of vegetables," he said, referring to the warning of cucumbers, tomatoes and lettuce. In a total of 500 samples of vegetables so far no EHEC pathogens through the Lower Saxony State Office has been established. Lindemann did not lift yet on Sunday, the consumption warning tomatoes, cucumbers and lettuce.

Meanwhile, 21 deaths to be associated with EHEC. Nationwide, more than 1,500 cases of EHEC and 620 HUS cases have been reported.

Sprouts were already in Japan 1996 fall associated with EHEC disease is suspected. A final confirmation of the suspected but had not revealed Michael Kuehne said of LAVES. A wave of disease by shoots in Europe is not the LAVES known, he said.

Germany: Sprouts likely cause of E. coli outbreak

HAMBURG, Germany (AP) -- Health authorities say locally grown beansprouts in northern Germany have been identified as the likely cause of an outbreak of E. coli that has killed at least 22 people and sickened hundreds in Europe.
Lower Saxony agriculture ministry spokesman Gert Hahne told The Associated Press his state is sending an alert warning people to stop eating the sprouts, which are often used in mixed salads.
Hahne said official test results have not yet conclusively shown that the Lower Saxony-grown sprouts are to blame but "all indications speak to them being" the cause.

E. Coli Outbreak Now at 22

The death toll linked to Germany’s E. coli outbreak has risen to 22, the European Centre for Disease Prevention and Control said in an e-mailed statement today.