Saturday, October 20, 2012

Uganda gov't dispatches medical team to southwestern region over Marburg outbreak

KAMPALA, Oct. 19 (Xinhua) -- Uganda's ministry of health on Friday dispatched a team of experts to the south western district of Kabale where an outbreak of the deadly Marburg hemorrhagic fever has been confirmed.

The ministry in a statement issued here said the team will support both the clinical and public health investigations, adding that the National Ebola Task-force has reactivated its rapid response committees to quickly act to any emergencies.

"The surveillance team has commenced the active tracing and listing of all possible contacts that were exposed to the suspects and confirmed cases," the statement said.
The ministry early on Friday confirmed the outbreak of the highly infectious viral hemorrhagic fever after laboratory tests of three samples turned positive.

It said that preliminary reports from Kitumba Sub County indicate that four members of the same family had allegedly died of a strange disease since Oct. 4.
The ministry urged the public to avoid unnecessary public gatherings, direct contact with body fluids of a person suffering from Marburg and also report any suspected patient to a nearby health unit.
"The ministry of health calls upon the public to stay calm as all possible measures are being undertaken to control the situation," the statement said.

The Marburg virus was last reported in Uganda in 2008.
The killer disease is spread through direct contact with wounds, body fluid like blood, saliva, vomitus, stool and urine of an infected person.

A person suffering from the disease presents with sudden onset of high fever with headache, vomiting blood, joint and muscle pains and bleeding through the body openings.
Although it is a highly contagious disease and kills in a short time, it can easily be prevented, according to the ministry.

Knowledge, Attitudes, Practices and Emotional Reactions among Residents of Avian Influenza (H5N1) Hit Communities in Vietnam

October 19, 2012
by Toshie Manabe, Tran Thuy Hanh, Doan Manh Lam, Do Thi Hong Van, Pham Thi Phuong Thuy, Dinh Thi Thanh Huyen, Tran Thi Mai Phuong, Dang Hung Minh, Jin Takasaki, Ngo Quy Chau, Ly Quoc Toan, Koichiro Kudo

Awareness of individuals’ knowledge and predicting their behavior and emotional reactions is crucial when evaluating clinical preparedness for influenza pandemics with a highly pathogenic virus. Knowledge, attitude, and practice (KAP) relating to avian influenza (H5N1) virus infection among residents in communities where H5N1 patients occurred in Vietnam has not been reported.

Methods and Principal Findings
Face-to-face interviews including KAP survey were conducted in Bac Kan province, located in the northeast mountainous region of Vietnam. Participants were residents who lived in a community where H5N1 cases have ever been reported (event group, n = 322) or one where cases have not been reported (non-event group, n = 221). Data on emotional reactions of participants and healthcare-seeking behavior after the event in neighboring areas were collected as well as information on demographics and environmental measures, information sources, and KAP regarding H5N1. These data were compared between two groups. Higher environmental risk of H5N1 and improper poultry-handling behaviors were identified in the event group. At the time of the event, over 50% of the event group sought healthcare for flu-like symptoms or because they were scared. Awareness of the event influenced KAP scores. Healthcare-seeking behavior and attention to H5N1 poultry outbreaks diminished in the event group as time passed after the outbreak compared with the non-event group. Factors that motivated participants to seek healthcare sooner were knowledge of early access to healthcare and the risk of eating sick/dead poultry, and perception of the threat of H5N1.

Awareness of H5N1 patients in neighboring areas can provoke panic in residents and influence their healthcare-seeking behavior. Periodic education to share experiences on the occurrence of H5N1 patients and provide accurate information may help prevent panic and infection and reduce mortality. Local conditions should be taken into account when emphasizing the need for early access to healthcare. 

Friday, October 19, 2012

Vietnam: Bird flu appears in Dien Bien province

Dien Bien provincial People's Committee has decided to publish bird flu in communes Noong Luống, huyện Điện Biên. Cao Thi Tuyet Lan, Director of the Department of Animal Health of Dien Bien province, bird flu be found in the commune equivalent of Dien Bien district on 12/10 in two households Team 12 commune with nearly 720 chickens and ducks infected then three days, at a livestock farmers in team 15 communes equivalent of, the authorities continue to detect nearly 400 chickens and ducks infected with H5N1 avian influenza. Up to the present time, in the commune Noong Luống, authorities discovered and the destruction of more than 1,000 birds correct technical procedures, hygiene. Dien Bien province prohibit the movement of poultry operations and products bird out of the area; prohibit the processing, sale and use of infected poultry products; tightly controlled slaughter, trade, movement of poultry, and poultry products in communes, wards and townships, districts, towns and cities. Dien Bien People's Committee initiative to mobilize forces in communes, districts to monitor detection, inspection, traffic control, trade, transport, slaughter poultry and poultry products in the area; destruction of infected poultry organizations as prescribed. District People's Committee of Dien Bien organization and implementation of measures enclosure, control area services, prevent the introduction of poultry out of the area to consume; prohibit raising ducks drop; statistical organization of poultry, especially ducks are raised in the region outbreak and the communes of Muong Thanh basin to proactively plan and control. Department of Agriculture and Rural Development to guide deployment timely measures enclosure, control, epidemic accordance current, determined not to spread wide; supply and chemical disinfection time for the epidemic in the area. Department of Health actively monitoring measures to prevent and respond to A/H5N1 flu epidemic ... /.

Indonesia: Government Asked to Handle Bird Flu More Seriously

October 19, 2012

JAKARTA- The case of H5N1 bird flu that has been going on since 2005 seems to have stopped in 2012. Of 198 cases recorded 158 of them were killed. To that end, the Director of Research and Investigations Indonesia Recoplan Research Institute, Daniel Pago Sitohang, asked the government to be more serious in handling this deadly virus. The reason for this government seemed cool calm handling cases of bird flu.   "To that end, the government through the Ministry of Health (MoH) has to work extra in dealing with these problems," Daniel said when contacted by reporters on Friday (10/19/2012). Daniel said, in dealing with the bird flu virus is when the government gets grants from several countries and international institutions. fact, he said, like what happened in Tangerang, referring to the decision of the Minister of Health of Indonesia No. Rebublik. 23 / Minister / SK / II / 2009, concerning the implementation of the pilot project of bird flu control. "In July 2012 there was another bird flu yesterday so that makes the victim was killed.  [[Original:  "Pada Juli 2012 kemarin flu burung ada lagi sehingga membuat korbannya tewas"] [Toggletext:  In July 2012 yesterday bird flu was again so as to make his casualties be killed]  If it has been running a pilot project might not be like this," he said. According to him, the pilot bird flu control project in 2010 did not succeed and there is a tendency for corruption. "Though funds coming from international agencies have received grants and made ​​the state budget," he added. Moreover, Daniel suggested that the government should socialize treatment, and prevention of bird flu still running. "MoH should think how bird flu cases in Indonesia not to happen," he concluded. (ugo)

Thursday, October 18, 2012

Vietnam: Khanh Hoa Province with #H5N1 Avian Influenza in Poultry

Wednesday, 17.10.2012
17-10, the People's Committee of Vinh Ngoc Nha Trang city, Khanh Hoa has destroyed 25 pigs, bringing the total number of blue-ear pig disease locally destroyed over 132 children. Local also buried 238 chickens, ducks, H5N1.
The same day, the Vinh Hai, Vinh Hoa, Vinh Phuoc, Phuoc Hai also held the destruction of 91 pigs. Nguyen Hong Africa, Chairman Vinh Ngoc said: From 6-10 people took the initiative to tell the local authority about the status of blue-ear pig disease manifestations. After force veterinary inspection, sampling tests have identified 13 pig farms tested positive for the disease. In addition, the phenomenon of dead chickens series has also appeared in Vinh Ngoc từ ngày 13-10.
Nha Trang People's Committee, said from day 1-10 so far, the city has eight communes appear blue ear disease in pigs; 3 communes appear H5N1 in poultry. The city has held the destruction of more than 1,400 chickens and 323 pigs with a total weight of 18 tons. The hard disease scattered in communes, wards of the environs of the city. City People's Committee has directed the functional organization zoning epidemic; veterinary active force shall review and examine the households raising drive for early detection of the disease.

The New Coronavirus: Uncertainty, And How To Talk About It

Maryn McKenna
October 17, 2012

 Without underestimating the importance of those outbreaks, it raises the possibility that novel organisms may now be identified before they become a widespread threat. That’s provided, of course, that alert health care personnel recognize what is going on, and sound the alarm:
The detection of HCoV-EMC… probably forecasts an increasingly common theme in which new pathogens are identified before they may develop the potential for efficient human-to-human transmission. From past experience, an astute clinician, public health official, or laboratory worker will recognize an unusual event and contact the appropriate health officials, who will investigate the event. Good communication between the clinic, laboratory and public heath community is important. (NEJM Anderson 2012)
This is somewhat reassuring — but it also raises so many questions. What happens, on the one hand, if recognition doesn’t take place, or communication is not swift? (Recall that, though the Saudi hospital contacted the Erasmus lab quickly, most of public health did not learn of the case until 3 months had gone by.) And what happens if, on the other hand, all those communications work well enough to raise public alarm — and then nothing further happens? (Recall that, in 2009, public reaction to the generally mild presentation of pandemic  H1N1 was generally that authorities were crying wolf.)

It is of course — of course — far better to have early warning of novel threats, than not. Yet as much as that brings some reassurance, it also poses new challenges in communicating the risks of novel organisms to the public. With luck, this novel coronavirus will remain a blip, and not an outbreak, and public health will be granted some time to think these issues through.

Full article:

New Eng. Journal of Medicine: Isolation of a Novel Coronavirus from a Man with Pneumonia in Saudi Arabia

[The full article is available at the link.  An excerpt from it]:
The patient's findings on chest radiography together with the clinical symptoms indicated acute respiratory distress syndrome (ARDS) with multiorgan dysfunction syndrome (MODS), similar to what has been described in severe cases of influenza and SARS.19-21 These pneumonic changes did not respond to antibacterial treatment.22

Ali Moh Zaki, M.D., Ph.D., Sander van Boheemen, M.Sc., Theo M. Bestebroer, B.Sc., Albert D.M.E. Osterhaus, D.V.M., Ph.D., and Ron A.M. Fouchier, Ph.D.
October 17, 2012DOI: 10.1056/NEJMoa1211721

A previously unknown coronavirus was isolated from the sputum of a 60-year-old man who presented with acute pneumonia and subsequent renal failure with a fatal outcome in Saudi Arabia. The virus (called HCoV-EMC) replicated readily in cell culture, producing cytopathic effects of rounding, detachment, and syncytium formation. The virus represents a novel betacoronavirus species. The closest known relatives are bat coronaviruses HKU4 and HKU5. Here, the clinical data, virus isolation, and molecular identification are presented. The clinical picture was remarkably similar to that of the severe acute respiratory syndrome (SARS) outbreak in 2003 and reminds us that animal coronaviruses can cause severe disease in humans.

Wednesday, October 17, 2012

When competition is intense, viruses spill over into new hosts

 October 16th, 2012
When you think about viruses, you might wonder how they infect, how they spread, and how they kill. These questions are of natural interest—you, after all, could play host to a grand variety of lethal viruses. But do remember: it’s not all about you.

A virus’ world contains not just potential hosts, but other viruses. It has competition. This simple fact is often ignored but it has profound implications. In a new study, Lisa Bono from the University of North Carolina has shown that competition between viruses can drive them to spill over into new hosts, imperilling creatures that they never used to infect.

Rather than focusing on the viruses we know and dread, Bono worked with phi6, a virus that infects and kills bacteria. This bacteriophage (hereafter just ‘phage’) looks like a lunar lander, that docks onto the surface of bacteria with spindly ‘legs’ and injects its genetic material through a syringe-like tube. Bono worked with a phage strain that infects Pseudomonas syringae, a bacterium that causes disease in plants. It favours this species above all others.


Investigation of influenza polymerase activity in pig cells

From the American Society for Microbiology - Journal of Virology


Reassortant influenza viruses with combinations of avian, human and/or swine genomic segments have been frequently detected in pigs. As a consequence, pigs have been accused of being a “mixing vessel” for influenza viruses.

This implies that pig cells support transcription and replication of avian influenza viruses in contrast to human cells in which most avian influenza virus polymerases display limited activity.

Although influenza polymerase activity has been studied in human and avian cells for many years using a minigenome assay, similar investigation in pig cells has not been reported. We developed the first minigenome assay in pig cells and compared activities of avian or human influenza-origin polymerases in pig, human and avian cells. We also investigated in pig cells the consequences of some known mammalian host range determinants that enhance influenza polymerase activity in human cells such as PB2 mutations E627K, D701N, G590S/Q591R and T271A. The two typical avian influenza virus polymerases used in this study were poorly active in pig cells, similar to what is seen in human cells and mutations that adapt the avian influenza polymerase for human cells also increased activity in pig cells. In contrast, a different pattern was observed in avian cells. Finally, highly pathogenic avian influenza H5N1 polymerase activity was tested because this subtype has been reported to replicate only poorly in pigs. H5N1 polymerase was active in swine cells, suggesting that other barriers restrict these viruses from becoming endemic in pigs.  

 [editing is mine] 

BARDA Announces CBRN Medical Countermeasures Conference

The Biomedical Advanced Research and Development Authority (BARDA) has announced an upcoming conference for industry to learn more about U.S. government medical countermeasure requirements, interact with BARDA, and network with other private sector colleagues. The event will take place Oct. 29-31 in Washington, D.C.

BARDA supports the advanced research & development, manufacturing, acquisition, and stockpiling of medical countermeasures against chemical, biological, radiological, and nuclear (CBRN) WMD threats, pandemic influenza, and emerging infectious diseases.

2nd Article:

HHS Announces Pandemic Preparedness Contracts to Top Pharma

The U.S. Department of Health and Human Services (HHS) has taken historic steps to support the nation’s pandemic preparedness efforts by awarding three-year contracts to five U.S.-licensed influenza vaccine manufacturers to produce master vaccine seed stocks for viruses with pandemic potential.

The contracts will be overseen by the Biomedical Advanced Research and Development Authority (BARDA) and are awarded to Sanofi Pasteur of Swiftwater, Pa., Novartis in Cambridge, Mass. and Holly Springs, N.C., GlaxoSmithKline of Philadelphia, Pa., Commonwealth Serum Laboratories of Melbourne, Australia, with Merck of West Point, Pa., and MedImmune of Gaithersburg, Md.

The effort allows HHS to purchase cell-based vaccine in addition to conventional egg-based vaccine. Cell-based vaccine production could more easily meet surge capacity needs because cells could be frozen and stored in advance of an epidemic, or developed rapidly in response to an epidemic. This option may assist HHS in providing more pandemic influenza vaccine sooner.
The contracts also support clinical trials and stockpiling of vaccine and adjuvants, enabling HHS to respond quickly to flu outbreaks and pandemics. Although current licensed seasonal flu vaccines do not contain adjuvants, clinical trials using adjuvants is an important part of pandemic preparedness, according to HHS. Adjuvants can be added to influenza vaccine to lower the amount of the active ingredient needed for the vaccine to produce an immune system response. Adding adjuvant results in more doses of vaccine being available during a pandemic.
Initially HHS will commit a total of $4.4 million for the companies to produce master vaccine seed stocks and $7.3 million for the companies to store pre-pandemic vaccines.
“These contracts build on the lessons learned from the 2009 H1N1 pandemic and nearly a decade of stockpiling avian flu vaccines,” stated BARDA Director Robin Robinson, Ph.D. “The increased national manufacturing capacity for pandemic influenza vaccines afforded by this effort is derived from successful public-private partnerships resulting in more U.S.-based vaccine manufacturing facilities and innovative vaccine technologies.”
The award was made under Solicitation Number: 11-100-SOL-00020.


Government to Amend Select Agents and Toxins List

[I missed this when it was posted at the beginning of the month] 
Posted on October 3, 2012

The federal government this week unveiled plans for a new “tiered” designation of pathogens on the Select Agent and Toxins List. The changes require more stringent precautions at scientific facilities holding any of the newly designated “Tier 1″ agents, which include Bacillus anthracis, Burkholderia mallei and pseudomallei, Foot-and-mouth disease virus, Ebola, Marburg virus and plague.
The revision requires installations dealing with Tier 1 agents to enhance the frequency and of investigations on personnel with access to the materials. Such facilities must also establish an auxiliary power mechanism and no fewer than three physical “security barriers” for agent holding areas, as well as institute procedures limiting agent access to federally vetted personnel. (Source: NTI GSN)
“Such tiering of the list allows for the optimization of security measures for those select agents or toxins that present the greatest risk of deliberate misuse with the most significant potential for mass casualties or devastating effects to the economy, critical infrastructure, or public confidence,” stated the notice.
The reorganization comes as part of the biennial review of the Select Agents program required under the Agricultural Bioterrorism Protection Act of 2002.  The notice will be published in the Federal Register on Friday, available here.

DHHS: Influenza Viruses Containing the Hemagglutinin from Goose/ Guangdong/1/96 Lineage Request for information and comment

[Federal Register Volume 77, Number 201 (Wednesday, October 17, 2012)] [Proposed Rules] [Pages 63783-63785] From the Federal Register Online via the Government Printing Office [] [FR Doc No: 2012-25377] ======================================================================= ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES 42 CFR Part 73 [Docket: CDC-2012-0010] Influenza Viruses Containing the Hemagglutinin from the Goose/ Guangdong/1/96 Lineage AGENCY: Centers for Disease Control and Prevention (CDC), Department of Health and Human Services (HHS). ACTION: Request for information and comment. ----------------------------------------------------------------------- SUMMARY: The Centers for Disease Control and Prevention (CDC) within the Department of Health and Human Services (HHS) announces the opening of a docket to obtain information and comments from the public to questions concerning highly pathogenic avian influenza (HPAI) H5N1 viruses that contain a hemagglutinin (HA) from the Goose/Guangdong/1/96 lineage, and their potential to pose a severe threat to public health and safety. This information will be considered in a determination of whether such viruses should be listed as HHS select agents, by revising the HHS Select Agent Regulations (42 CFR Part 73). DATES: Electronic or written comments should be received on or before December 17, 2012. ADDRESSES: You may submit comments identified by Docket Number CDC- 2012-0010, by any of the following methods: Federal eRulemaking Portal: Follow the instructions for submitting comments. Mail: Division of Select Agents and Toxins, Centers for Disease Control and Prevention, 1600 Clifton Road NE., Mailstop A-46, Atlanta, Georgia 30333, Attn: Docket Number: CDC-2012-0010. Instructions: All submissions received must include the agency name and docket number (CDC-2012-0010) for this notice. All relevant comments received will be posted without change to, including any personal information provided. For access to the docket to read background documents or comments received, go to FOR FURTHER INFORMATION CONTACT: Dr. Robbin Weyant, Director, Division of Select Agents and Toxins, Centers for Disease Control and Prevention, 1600 Clifton Road NE., Mailstop A-46, Atlanta, Georgia 30333. Telephone: (404) 718-2000. SUPPLEMENTARY INFORMATION: I. Background Since late 2003, the World Health Organization (WHO) has reported over 600 cases of human infection with highly pathogenic avian influenza (HPAI) H5N1 viruses with a mortality rate that exceeds 50 percent in hospitalized patients (Ref 1). Current epidemiologic evidence indicates that, once transmitted into a human host, H5N1 viruses may result in more severe disease in humans than other subtypes of influenza. One important factor that can account for some of the increased pathogenicity is the hemagglutinin (HA) molecule. Cleavage of the HA molecule by host proteases (chemicals that can break amino acid bonds) enables influenza viruses to productively infect cells (i.e., replicate). For human influenza viruses, replication is restricted to the respiratory tract. However, HPAI H5N1 viruses contain a polybasic amino acid sequence in the HA molecule that is not found in human influenza viruses. This feature allows the molecule to be cleaved by a wider variety of proteases throughout the body and consequently, HPAI H5N1 viruses can replicate systemically in avian species. Extrapulmonary dissemination of HPAI H5N1 virus has been documented among some fatal human HPAI H5N1 virus infections. The HA molecule mediates binding of the influenza virus to host cells in the respiratory tract. Human influenza viruses preferentially bind to different receptors than avian influenza viruses (Ref 2). While human influenza virus receptors are more prevalent in the upper respiratory tract, the receptors that bind avian viruses are present in the lower respiratory tract of humans. The ability of H5N1 viruses to bind and infect cells within the lung may contribute to the severity of H5N1 induced viral pneumonia (Ref 3-5). Furthermore, a change from avian- to human-type receptor-binding specificity, as seen with the pandemic strains of 1918 (H1N1), 1957 (H2N2), [[Page 63784]] and 1968 (H3N2), is thought to be a critical step in the adaptation of avian influenza viruses to humans and the ability to transmit efficiently among humans (Ref 6-8). In two recent independent studies (Ref 9 and Ref 10), investigators have shown that laboratory modified HPAI H5N1 influenza viruses with certain mutations can be transmitted via the respiratory route between ferrets. Ferrets are widely considered to provide the best animal model for exploring these aspects of influenza virus pathogenicity as they might relate to human infection (Ref 11). We recognize that all HPAI H5N1 influenza virus clades found in humans to date have been derived from the Goose/Guangdong/1/96 lineage, and the HA molecule enables the virus to infect a host cell. Thus, we are interested in receiving information and comments on whether the influenza viruses that contain a hemagglutinin (HA) from the Goose/ Guangdong/1/96 lineage have the potential to pose a severe threat to public health and safety (Ref 12). Currently, all HPAI H5 subtype viruses are regulated by the U.S. Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) whose oversight focuses on the threat to animal health and safety. Listing influenza viruses that contain an HA from the goose/Guangdong/1/96 lineage as an HHS select agent will ensure that the focus of regulation will also be on the potential impact of these viruses on human health as well as agriculture. While USDA sets biosafety measures that may also be more generally beneficial to public health, its focus with respect to select agent designation is primarily on risks to agricultural animals, rather than direct effects on human health. There is precedence (e.g., Bacillus anthracis) for including agents that have both human and agricultural impacts on both the HHS and USDA Select Agent Lists. Designating HPAI containing an HA from the Goose/Guangdong/1/96 lineage an HHS select agent, in addition to its status as a USDA select agent, may help to ensure that HPAI strains that have the greatest potential for major direct effects on human health will be regulated with a focus on protection of human health. The question of whether the influenza viruses that contain an HA from the Goose/Guangdong/1/96 lineage pose a severe threat to public health and safety was considered by HHS/CDC's Intragovernmental Select Agents and Toxins Technical Advisory Committee (ISATTAC). The ISATTAC is comprised of Federal government scientists from HHS/CDC, the Biomedical Advanced Research and Development Authority (BARDA) within the Office of the Assistant Secretary for Preparedness and Response (HHS/ASPR) in HHS, the National Institutes of Health (HHS/NIH), the Food and Drug Administration (HHS/FDA), USDA/APHIS, the USDA/ Agricultural Research Service, the USDA/Center for Veterinary Biologics, the Department of Homeland Security (DHS), and the Department of Defense (DOD). The criteria used by the ISATTAC in its review were the degree of pathogenicity, communicability, ease of dissemination, route of exposure, environmental stability, ease of production, ability to genetically manipulate or alter, long-term health effects, acute morbidity, acute mortality, available treatment, status of host immunity, vulnerability of special populations, and the burden or impact on the health care system. ISATTAC made the recommendation that the influenza viruses containing an HA from the Goose/Guangdong/1/96 lineage do have the potential to pose a severe threat to public health and safety. In making its recommendation to HHS/CDC, the ISATTAC considered both the historical data regarding the Goose/Guangdong/1/96 lineage and data from current in vitro and in vivo animal studies. The virulence of viruses of this lineage, the data showing transmissibility of genetically modified H5N1 viruses among ferrets, together with the fact that the level of immunity in the general population is low were all considered. Further, in its recommendation the ISATTAC voiced concern that an influenza pandemic caused by viruses containing an HA from the Goose/Guangdong/1/96 lineage, could potentially overwhelm the health care system. The ISATTAC also recognized that the study of the Goose/Guangdong/1/96 lineage-derived viruses could lead to significant public health benefits for understanding pandemic influenza, improved diagnostics, and the development of more effective countermeasures. Therefore, the risks posed by these viruses need to be weighed against any adverse impact that a regulation will have on legitimate research. On July 2, 2010, the President signed Executive Order 13546, ``Optimizing the Security of Biological Select Agents and Toxins in the United States'' that directed the Secretaries of HHS and USDA to designate a subset of the select agents and toxins list (Tier 1) that presents the greatest risk of deliberate misuse with the most significant potential for mass casualties or devastating effects to the economy, critical infrastructure, or public confidence. The Executive Order 13546 also established the Federal Experts Security Advisory Panel (FESAP) to advise the HHS and USDA Secretaries on the designation of Tier 1 agents and toxins. In December of 2010, the FESAP provided the HHS and USDA Select Agent regulatory programs with recommendations on updating the HHS and USDA Select Agent and Toxin lists, including a subset of agents and toxins recommended for Tier 1 designation. On October 3, 2011, HHS/CDC published a notice of proposed rulemaking (76 FR 61206) in which we proposed a list of select agents and toxins that should be considered Tier 1 select agents and toxins. The proposed Tier 1 agents and toxins that were based on Executive Order 13546 and the recommendations from FESAP were scored against 20 criteria by over 60 Subject Matter Experts representing the Federal life sciences, public health, law enforcement, security, and intelligence communities. The criteria included: The relative ease with which a particular select agent or toxin might be disseminated or transmitted from one human to another or into the environment where it could produce a deleterious effect upon human health; The potential for a high mortality rate; The potential for a major human health impact; Select agents or toxins whose misuse might result in public panic or other social or economic disruption; and Select agents or toxins whose use might require Federal, State, and/or local officials to take special action in planning for major human health disasters. We proposed that the following agents should be designated as Tier 1 agents: Bacillus anthracis, Botulinum neurotoxin, Botulinum neurotoxin producing species of Clostridium, Burkholderia mallei, B. pseudomallei, Francisella tularensis, Marburg virus, Variola major virus, Variola minor virus, and Yersinia pestis. On the same day, USDA/ APHIS published a companion rule in the Federal Register proposing its list of select agents and toxins that should be considered Tier 1 select agents and toxins. Although USDA/APHIS regulates HPAI viruses as select agents, they did not propose to designate HPAI viruses as Tier 1 select agents. Given the above criteria used by the FESAP, we would welcome comment on whether HPAI H5N1 influenza viruses containing the HA from the Goose/Guangdong/1/96 lineage should be listed as a Tier 1 select agent. The final determination of whether or not to designate this particular lineage [[Page 63785]] of H5N1 HPAI as Tier 1 would be a collaborative process between HHS and USDA. HHS and USDA would continue to work closely together whether or not both HHS and USDA designate these viruses as Tier 1 Select Agents. II. Establishment of a Docket and Request for Specific Input on Certain Topics We are establishing a docket to provide an opportunity for interested persons to submit comments, research data, and other information that will better inform us about the risk posed by HPAI H5N1 influenza viruses containing the HA from the Goose/Guangdong/1/96 lineage to public health and safety. In particular, we welcome comment on the following questions: (1) Do HPAI H5N1 influenza viruses containing the HA from the Goose/Guangdong/1/96 lineage pose a severe threat to public health and safety? (2) Are there other influenza strains containing HA from Goose/ Guangdong/1/96 lineage that would also pose a severe threat even if they were not fully of HPAI H5N1 origin? (3) Are there any other HPAI H5N1 influenza strains that have been identified to pose a severe threat to public health and safety? (4) Should these viruses be regulated as HHS select agents? (5) If these viruses should be regulated as HHS select agents, should these viruses be designated as Tier 1 select agents? (6) Should special precautions (i.e., safety and containment measures) be considered when working with diagnostic specimens suspected of containing HPAI H5N1 influenza viruses containing the HA from the Goose/Guangdong/1/96 lineage (i.e., any precautions versus none at all, precautions beyond those usual for clinical samples and/or laboratory microbes, etc.)? and (7) Should special precautions (i.e., safety and containment measures) be considered when working with strains of HPAI containing the HA from the Goose/Guangdong/1/96 lineage that have been shown to be transmissible between mammals beyond those recommended for non- mammalian transmissible HPAI (Ref 13 and Ref 14)? III. References 1. WHO, Cumulative number of confirmed human cases for avian influenza A(H5N1) reported to WHO, 2003-2011; 2. Fukuyama S, Kawaoka Y. The pathogenesis of influenza virus infections: The contributions of virus and host factors. Curr Opin Immunol. 2011 Aug;23(4):481-6. Epub 2011 Aug 11. 3. Shinya K, Ebina M, Yamada S, Ono M, Kasai N, Kawaoka Y. Avian flu: Influenza virus receptors in the human airway. Nature. 2006 Mar 23;440(7083):435-6. 4. Nicholls JM, Chan MC, Chan WY, Wong HK, Cheung CY, Kwong DL, Wong MP, Chui WH, Poon LL, Tsao SW., Guan Y, Peiris JS. Tropism of avian influenza A (H5N1) in the upper and lower respiratory tract. Nat Med. 2007 Feb;13(2):147-9. Epub 2007 Jan 7. 5. Van Riel D, Munster VJ, de Wit E, Rimmelzwaan GF, Fouchier RA, Osterhaus AD, Kuiken T. H5N1 Virus Attachment to Lower Respiratory Tract. Science. 2006 Apr 21;312(5772):399. Epub 2006 Mar 23. 6. Matrosovich, M., et al. Early alterations of the receptor-binding properties of H1, H2, and H3 avian influenza virus hemagglutinins after their introduction into mammals. J Virol 74, 8502-8512 (2000). 7. Stevens, J., et al. Glycan microarray analysis of the hemagglutinins from modern and pandemic influenza viruses reveals different receptor specificities. J Mol Biol 355, 1143-1155 (2006). 8. Connor, R.J., Kawaoka, Y., Webster, R.G. & Paulson, J.C. Receptor specificity in human, avian, and equine H2 and H3 influenza virus isolates. Virology 205, 17-23 (1994). 9. Masaki Imai,1 Tokiko Watanabe,1, 2 Masato Hatta,1 Subash C. Das,1 Makoto Ozawa,1, 3 Kyoko Shinya,4 Gongxun Zhong,1 Anthony Hanson,1 Hiroaki Katsura,5 Shinji Watanabe,1, 2 Chengjun Li,1 Eiryo Kawakami,2 Shinya Yamada,5 Maki Kiso,5 Yasuo Suzuki,6 Eileen A. Maher,1 Gabriele Neumann1 & Yoshihiro Kawaoka. Experimental adaptation of an influenza H5 HA confers respiratory droplet transmission to a reassortant H5 HA/H1N1 virus in ferrets. Nature. 2012 May 2;486(7403):420-8. 10. Russell CA, Fonville JM, Brown AE, Burke DF, Smith DL, James SL, Herfst S, van Boheemen S, Linster M, Schrauwen EJ, Katzelnick L, Moster[iacute]n A, Kuiken T, Maher E, Neumann G, Osterhaus AD, Kawaoka Y, Fouchier RA, Smith DJ. The potential for respiratory droplet-transmissible A/H5N1 influenza virus to evolve in a mammalian host. Science. 2012 Jun 22; 336(6088):1541-7. 11. Belser JA, Szretter KJ, Katz JM, Tumpey TM. Use of animal models to understand the pandemic potential of highly pathogenic avian influenza viruses. Adv Virus Res. 2009;73:55-97. 12. WHO/OIE/FAO H5N1 Evolution Working Group. Continued evolution of highly pathogenic avian influenza A (H5N1): updated nomenclature. Influenza Other Respi Viruses. 2012 Jan; 6(1): 1-5. doi: 10.1111/ j.1750-2659.2011.00298.x. Epub 2011 Oct 29. 13. Guidelines for Avian Influenza Viruses ( 14. Biosafety in Microbiological and Biomedical Laboratories ( Dated: October 9, 2012. Kathleen Sibelius, Secretary. [FR Doc. 2012-25377 Filed 10-16-12; 8:45 am] BILLING CODE 4163-18-P

Feds Seek Comments On Bird Flu Safety Fears

Tuesday, 10/16/12 1:38pm

Here's your chance to weigh in on mutant forms of bird flu that have been in the news — the U.S. government wants to know just how scary you think these new viruses are.
The Department of Health and Human Services posted a call for public comments today requesting information on whether the lab-created bird flu viruses "have the potential to pose a severe threat to public health and safety." The government is also asking whether any special precautions need to be considered when scientists work with these viruses.
The move comes after some have criticized officials for not having enough public discussion about these controversial viruses, which were created in the lab as part of an effort to understand how highly pathogenic H5N1 bird flu viruses out in the wild might mutate and start a pandemic in people.


Tuesday, October 16, 2012

Indonesia: Health Minister Still Wants Bird Flu Vaccine Project Continues

In addition, Nafsiah also warned that bird flu pandemic could later endanger public
October 16, 2012 
Skalanews - Minister of Health, Nafsiah Mboi insisted on running the equipment procurement project bird flu vaccine. He reasoned if not passed, then the project would cost the state. addition, Nafsiah also cautioned that a bird flu pandemic could later endanger the public. If it is not passed, the people could not telindungi [sheltered; protected; shielded; safeguarded]. So the project should be followed up. "Yes it is pity that the assets anyway, so do not be wasteful he will be broken, because it will cost the state a very large," said Nafsiah in the House, Jakarta, Tuesday (16/10). was why the Commission IX Nafsiah asked to consider it. However, Nafsiah not questioned if the Commission IX to form working committees related to the case first. Having studied the situation in depth, he hopes the project was no follow-up. "When the legal process ahead, live alone. Which takes precedence save state assets if it did not proceed because it redundant," he said.


I previously reported on this, here.
excerpt from that post:
A new medical surveillance system, in development, testing and proving for more than 10 years, has identified an outbreak of influenza type B virus infection in Laredo (Texas), a major port of entry between Mexico and the United States.
Date: Mon 15 Oct 2012
The Texas Department of State Health Services has not confirmed an outbreak of influenza in Laredo, Texas. Routine surveillance did identify some early season influenza B cases in the community. Based on these findings, the local health department sent a health advisory to local healthcare providers reminding them of the importance of influenza prevention, treatment and diagnosis. --
 Carol M Davis, MSPH, CPH
Emerging and Acute Infectious Disease Branch
Texas Department of State Health Services
 Mailcode 1960
Austin, TX 78714-9347 USA

[ProMED-mail post entitled: Influenza (99): USA (TX) type B outbreak, archive number 20121013.1341462, relayed a report on PRWeb that the Texas Department of State Health Services had confirmed an outbreak of influenza B virus infection in Laredo. This information is incorrect. The influenza B cases were identified in the community in early season surveillance only. ProMED-mail apologises for propagating this misinformation and thanks Carol Davis for providing this correction. - Mod.CP]

Monday, October 15, 2012

Nature: Mixed flu strain in Mizo man

Published online 15 October 2012

Researchers from the National Institute of Cholera and Enteric Diseases (NICED) in Kolkata have spotted a classical case of 'sporadic reassortment' — mixing of genetic material from swine and human origin viruses — in an influenza A viral strain with H1N2 subtype.1 The study supports the possibility of 'reassortment events' during influenza season when infectivity is high and two different subtypes of the virus circulate together in the same geographical location.
The mixed strain circulated during the swine flu pandemic in 2009-2010 and has been found from a 25-year-old man in Mizoram. The strain has been named A/Eastern India/N-1289/2009.
Influenza A viruses of the H1N2 subtype were isolated previously in India and Japan during 2001–02. They were reassortants of the human H1N1 and H3N2 viruses and distinct from the H1N2 swine influenza viruses. However, repeated attempts to isolate the recombinant virus had failed. The researchers say this could have been due to the 'loss of viability' as the samples came from Mizoram (about 1219 kms from Kolkata) by courier and took more than 48 hrs to reach the NICED lab.
Reassortment is responsible for some major genetic shifts in the history of the influenza virus. The 1957 and 1968 pandemic flu strains were caused by reassortment between an avian virus and a human virus. The 2009 H1N1 swine flu virus has been found to have an unusual mix of swine, avian and human influenza genetic sequences.
After sequencing the full genome, the researchers found the unique reassortment event where the N-1289 virus acquired its hemagglutinin (HA) gene from a 2009 pandemic H1N1 virus with swine origin and the other genes from H3N2-like viruses of human origin.
Co-circulation of both these influenza viruses during 2009 and complete disappearance of seasonal H3N2 and H1N1 strains in 2010 was also observed in eastern India. Such co-circulation is the prime cause of the generation of genetically reassortant viruses, the researchers say.
  • References

    1. Mukherjee, T. R. et al. Full genomic analysis of an influenza A (H1N2) virus identified during 2009 pandemic in Eastern India: evidence of reassortment event between cocirculating A(H1N1)pdm09 and A/Brisbane/10/2007-like H3N2 strains. Virol. J. doi: 10.1186/1743-422X-9-233 (2012)

The Armageddon virus


Why experts fear a disease that leaps from animals to humans could devastate mankind in the next five years

  • Warning comes after man died from a Sars-like virus that had previously only been seen in bats
  • Earlier this month a man from Glasgow died from a tick-borne disease that is widespread in domestic and wild animals in Africa and Asia


One leading British virologist,  Professor John Oxford at Queen Mary Hospital, University of London, and a world authority on epidemics, warns that we must expect an animal-originated pandemic to hit the world within the next five years, with potentially cataclysmic effects on the human race.
Such a contagion, he believes, will be a new strain of super-flu, a highly infectious virus that may originate in some far-flung backwater of Asia or Africa, and be contracted by one person from a wild animal or domestic beast, such as a chicken or pig.

[I looked up the Profile of Professor John Oxford]
Full article:

Nepal: Bird flu confirmed in Bode farm

BHAKTAPUR: At least 1,200 chickens have died of bird flu at a poultry farm in Bode-3 of Madhyapur Thimi in Bhaktapur till Monday noon.

The Animal Health Directorate collected samples of dead chickens from the farm after its owner, Om Bahadur Khadka, reported death of chickens.

Khadka’s poultry farm used to inhabit 2,000 fowls.

It has been confirmed only today that the fowls had died of bird flu.

With confirmation of bird flu, the Animal Health Directorate has declared the area a crisis zone for 90 days and intensified surveillance for the deadly flu strain.

Khadka's farm first recorded fowl deaths on October 11. 

Nepal: #H5N1 Bird Flu Suspected at Poultry Farm

BODE: Authorities in Bhaktapur’s Bode have culled more than 1500 chickens following a suspected outbreak of bird flu, health officials said.

The outbreak of avian influenza initially killed 500 chickens out of 2000 at the poultry farm of a local Om Khadka.

A meeting of health officials is underway at Bhaktapur to confirm whether the reported case is of bird flu.

Sunday, October 14, 2012

FAB’ENTECH launches a Phase I clinical trial in Singapore for its new product against H5N1 Avian Influenza

[Red editing is mine]
October 12, 2012

Specific anti-H5N1 polyclonal immunoglobulins developed by Fab’entech raise the prospect of a new approach to the treatment of H5N1 Avian Influenza in humans

LYON, France--()--Fab’entech, a French biopharmaceutical company specialized in developing specific polyclonal immunoglobulins against emerging infectious diseases announces that the company is launching its first clinical trial in humans for its product against the H5N1 Avian Influenza virus. If promising results from animal testing are confirmed, these immunoglobulins may provide a new specific approach for the treatment of subjects infected by or exposed to the H5N1 virus.
“The phase 1 clinical trial represents an important milestone in providing a potential innovative solution to combat H5N1 virus infections in humans”
This approach is based on passive immunotherapy which consists in injecting patients with specific antibodies (immunoglobulins) capable of recognizing, targeting and neutralizing the virus. Based on an already validated and well-established production process at industrial scale, Fab’entech is able to provide highly purified immunoglobulins to neutralize the virus.
"The phase 1 clinical trial represents an important milestone in providing a potential innovative solution to combat H5N1 virus infections in humans," said founder and CEO of Fab’entech, Dr. Bertrand Lépine, MD. "The clinical trial will take place in Singapore, located in the Asia-Pacific region where the risk of propagation of H5N1 virus is one of the highest in the world. The injection of specific anti-H5N1 polyclonal immunoglobulins is likely to provide immediate protection for people who have been infected with or exposed to the virus."
The good safety profile and the efficacy of this product have been extensively documented in animal studies conducted in collaboration with the INSERM Jean Mérieux BSL-4 Laboratory of Lyon (France). The clinical trial in Singapore will involve 16 healthy adult volunteers who will be monitored for 5 weeks. It will be a double blinded, placebo controlled study, performed in strict compliance with Good Clinical Practices (GCP).

About Avian Influenza H5N1
Avian influenza is an infectious disease caused by the A(H5N1) strain of the influenza virus, which occurs primarily in birds (particularly wild water birds, but sometimes also poultry). Historically, human infections with avian influenza viruses have been extremely rare but certain H5N1 strains can cause serious infections in humans with a mortality rate that can reach 60-80% in some regions, particularly in Asia.
According to World Health Organisation (WHO), 608 human cases have been reported since 2003, including 30 human cases in the first half of 2012. The scientific community estimates that an H5N1 influenza pandemic remains a real threat, particularly if the H5N1 virus were to mutate and become transmissible between humans.

Texas State Department of Health (TSDH) confirms a Laredo influenza outbreak in Texas -- 6 times higher than 2011

ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Sat 13 Oct 2012

TSDH confirms Laredo flu outbreak
The Texas State Department of Health (TSDH) confirms a Laredo influenza outbreak in Texas -- 6 times higher than 2011 -- in contrast to the absence of flu activity elsewhere in the United States. Laredo Health and school officials are alerting families and recommending immediate action.

A new medical surveillance system, in development, testing and proving for more than 10 years, has identified an outbreak of influenza type B virus infection in Laredo (Texas), a major port of entry between Mexico and the United States. The Texas State Department of Health Services in Austin has confirmed the outbreak, with cases running 6 times higher than at this time in the 2011 influenza season in Laredo. The outbreak is in sharp contrast to a recent report of sparse influenza activity in the United States by the national Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, which is now conducting further confirmatory testing.

[This report contrasts with recent surveillance reports of influenza virus activity in the rest of the northern hemisphere. The most recent WHO Epidemiological Analysis reports that: "Influenza transmission in all reporting countries in the temperate regions of the northern hemisphere is still minimal, that is, at inter-seasonal levels. In the United States of America, one additional laboratory-confirmed human case of influenza A(H3N2)v infection was reported since the last update, but no on-going human-to-human transmission has been identified. More information can be found at:

Throughout Europe, 23 countries reported data but influenza activity is still at inter-seasonal levels. During the 1st week of the 2012-2013 influenza season, there was no evidence of significant influenza activity in Europe according to the European Centre for Disease Prevention and Control (ECDC).

During weeks 38 to 39, influenza activity remained low throughout most parts of the world. Influenza A(H3N2) viruses remained the predominant circulating virus subtype globally, followed by influenza B and A(H1N1)pdm viruses. However, in Central and South America, influenza B was the predominant circulating virus in the region. It may be that the outbreak in Laredo, an entry port between Mexico and the United States, represent spill-over from Central and South America (see: )