Saturday, January 12, 2013

FDA: Current Drug Shortages: Oseltamivir Phosphate (Tamiflu) for Oral Suspension (6mg/mL 60 mL) (Initial Posting Date) – 1/10/2013

[I could not copy the whole block into one screen shot.  Click on link below for the whole thing].

US Food & Drug Administratiion - Current Drug Shortages O - R (alphabetized)
The information provided in this section is provided voluntarily by manufacturers.  FDA cannot require firms to report the reason for shortage or duration of the shortage or any other information about shortages.  FDA appreciates all information provided by manufacturers.  We post information about shortages as soon as we receive it from the manufacturers.  To report information about shortages or supply issues, manufacturers can send updates to  Healthcare professionals and patients are also encouraged to notify us of shortages at

**Listed by Generic name or Active Ingredient**
Oseltamivir Phosphate (Tamiflu) for Oral Suspension (6mg/mL 60 mL) (Initial Posting Date) – 1/10/2013 


Friday, January 11, 2013

Minister of Agriculture: endemic bird flu in Egypt, "Shame"

Wrote: Fatin Solomon
Dr. Salah Abdul Momin, the Minister of Agriculture and Land Reclamation has been completed, providing space for a large poultry farms in the New Valley governorate in order to get out of the block, and limit, which may cause the disease.
He pointed out that those spaces were completed divided on cut and will be announced soon, pointing out that the crisis facing the ministry at the moment is the high proportion of farms offense, and which exceed 60%, as is random those farms to work without a license and randomly, which puts us in major crisis.
He described endemic bird flu in Egypt as a "disgrace", adding it is also a shame not to deal with the problems that Egypt is going through national Kmchklat Vllqdhae must all join together to confront them.
He stressed that since the emergence of the disease in Egypt have been taken many precautionary measures to curb the spread of the disease, including the need to stop backyard poultry and transport of live birds between provinces and trafficking, these problems bear their burden everyone where it is system is not borne by the government alone.

FluView Week 1 ending January 5, 2013

[I will place last weeks information in brackets in green color, after this weeks information.  All editing below is mine.]

2012-2013 Influenza Season Week 1 ending January 5, 2013

As a result of the end of year holidays and elevated influenza activity, some sites may be experiencing longer than normal reporting delays and data in previous weeks are likely to change as additional reports are received.


During week 1 (December 30-January 5), influenza activity remained elevated in the U.S., but may be decreasing in some areas.
  • Viral Surveillance: Of 12,876 specimens tested and reported by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories, 4,222 (32.8%) were positive for influenza. 
    [Of 9,363 specimens tested and reported by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories, 2,961 (31.6%) were positive for influenza.]
  • Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was slightly above the epidemic threshold.  [The proportion of deaths attributed to pneumonia and influenza (P&I) was below the epidemic threshold. ]
  • Influenza-Associated Pediatric Deaths: Two influenza-associated pediatric deaths were reported. One was associated with an influenza A (H3) virus and one was associated with an influenza A virus for which the subtype was not determined. 
    [Two influenza-associated pediatric deaths were reported and were associated with influenza B viruses.]
  • Outpatient Illness Surveillance: The proportion of outpatient visits for influenza-like illness (ILI) was 4.3%; above the national baseline of 2.2%. Nine of 10 regions reported ILI above region-specific baseline levels. Twenty-four states and New York City experienced high ILI activity; 16 states experienced moderate ILI activity; 5 states experienced low ILI activity; 5 states experienced minimal ILI activity, and the District of Columbia had insufficient data. 
    [The proportion of outpatient visits for influenza-like illness (ILI) was 5.6%; above the national baseline of 2.2%. Nine of 10 regions reported ILI above region-specific baseline levels. New York City and 29 states experienced high ILI activity; 9 states experienced moderate ILI activity; 4 states experienced low ILI activity; 6 states experienced minimal ILI activity, and the District of Columbia and 2 states had insufficient data.]

Pneumonia and Influenza (P&I) Mortality Surveillance:

During week 1, 7.3% of all deaths reported through the 122 Cities Mortality Reporting System were due to P&I. This percentage was slightly above the epidemic threshold of 7.2% for week 1.

Influenza-Associated Pediatric Mortality:

Two influenza-associated pediatric deaths were reported to CDC during week 1. One was associated with an influenza A (H3) virus and occurred during week 52 (week ending December 29, 2012) and one was associated with an influenza A virus for which the subtype was not determined and occurred during week 1 (week ending January 5, 2013). This brings the total number of influenza-associated pediatric deaths reported during the 2012-2013 season to 20. Additional data can be found at

Influenza-Associated Hospitalizations:

The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts population-based surveillance for laboratory-confirmed influenza-related hospitalizations in children younger than 18 years of age (since the 2003-2004 influenza season) and adults (since the 2005-2006 influenza season).
The FluSurv-NET covers more than 80 counties in the 10 Emerging Infections Program (EIP) states (CA, CO, CT, GA, MD, MN, NM, NY, OR, TN) and additional Influenza Hospitalization Surveillance Project (IHSP) states. The IHSP began during the 2009-2010 season to enhance surveillance during the 2009 H1N1 pandemic. IHSP sites included IA, ID, MI, OK and SD during the 2009-2010 season; ID, MI, OH, OK, RI, and UT during the 2010-2011 season; MI, OH, RI, and UT during the 2011-2012 season; and IA, MI, OH, RI, and UT during the 2012-2013 season.

Data gathered are used to estimate age-specific hospitalization rates on a weekly basis, and describe characteristics of persons hospitalized with severe influenza illness. The rates provided are likely to be an underestimate as influenza-related hospitalizations can be missed, either because testing is not performed, or because cases may be attributed to other causes of pneumonia or other common influenza-related complications.
Between October 1, 2012 and January 5, 2013, 3,710 laboratory-confirmed influenza-associated hospitalizations were reported. This is a rate of 13.3 per 100,000 population. The most affected group is people ≥65 years. Among all hospitalizations, 3,198 (86.2%) were associated with influenza A and 484 (13.0%) with influenza B. There was no virus type information for 22 (0.6%) hospitalizations. Among hospitalizations with influenza A subtype information, 767 (98.7%) were attributed to H3 and 10 (1.3%) were attributed to 2009 H1N1. The most commonly reported underlying medical conditions among hospitalized adults were metabolic disorders, cardiovascular disease, obesity, and chronic lung disease (excluding asthma). Among 55 hospitalized women of childbearing age (15-44 years), 10 were pregnant. The most commonly reported underlying medical conditions in hospitalized children were asthma, neurologic disorders, and immune suppression. More than 40% of hospitalized children had no identified underlying medical conditions. Additional FluSurv-NET data can be found at: and

These are only a few of the reports featues.  For the full document including many charts, click on the link below.  The weekly reports can be easily accessed by links provided on the right side-bar, scrolling down to Worldwide Update Influenza Activity. 

EuroFlu Weekly Electronic Bulletin

Summary, week 1/2013 Levels of influenza activity in countries in the WHO European Region are heterogeneous, with widespread activity mainly in the western and northern parts of the Region and no or sporadic activity in the eastern part, but a gradual increase overall. Influenza A(H1N1)pdm09, A(H3N2) and type B viruses continue to co-circulate, but the proportion of A(H1N1)pdm09 relative to A(H3N2) is increasing. The number of reported hospitalizations due to severe acute respiratory infection (SARI) remains stable, with 8% of cases being associated with influenza detection.

Full Document:

Seasonal Flu: Ohio: 1 Child Died; 22yo Died w/no underlying health conditions; Couple got flu despite being vaccinated this season...


An Ohio child has died from complications of the flu, and hospitalizations continue to climb here and across the country.
State health officials have learned of one child’s death this season, said Ohio Department of Health spokeswoman Tessie Pollock. She said she could not share the county in which the child lived, or the child’s age or gender. The child was not from central Ohio.

Officials in Greene County did discuss the Tuesday death of a 22-year-old Wright State University student. Public-health officials are investigating the flu-related death of Amelia Catherine Perry of Fairborn for possible contributing health conditions, but the woman appeared otherwise healthy, according to the Dayton Daily News.

Theibert and his wife, Suzanne Cotton, both were smacked by flu despite getting shots earlier in the season. They were sick for a week, he said.

...Dr. Dennis Cunningham, an infectious-disease specialist at Nationwide Children’s Hospital.
Cunningham said that in November and December, the hospital system and its urgent-cares were diagnosing flu in about 600 kids a week through lab tests.
“Right now we’re at about 240 kids a week who are testing positive,” he said.

“We’re actually having more inpatients with flu this year than back when we had H1N1.”

Full Article:


WHO looks for more info on new coronavirus

By Helen Branswell

The WHO is hosting a meeting on Monday and Tuesday in Cairo, pulling together researchers who work on coronaviruses, public health officials who have been involved in the outbreak and others who can help to flesh out what is known so far.
Among those attending will be people who led responses to other emerging disease outbreaks, such as the 2003 SARS crisis. Someone from Canada has been invited to attend to discuss the country’s SARS experience, but the WHO won’t reveal the list of the invitees.
In part, a WHO official admits, the aim is to encourage more sharing of information than has occurred up to date. Between 25 and 30 people have been invited, and the meeting will be held behind closed doors.
“Often what we find is that people who are involved in research are reluctant to share preliminary findings,” said Dr. Anthony Mounts, the WHO’s point person for the coronavirus investigation.
“(It’s) partly because they want to publish but I think also because there’s a reluctance to share stuff that they’re not quite confident in yet, because it’s still preliminary. But we find that when they come to meetings like this they’re much more willing to share it openly.”
Among those expected to attend is Dr. Ian Lipkin, director of the Center for Infection and Immunity at Columbia University’s Mailman School of Public Health in New York. Lipkin is an expert on emerging infectious diseases; a brief biography on his centre’s website says he has identified at least 400 previously unknown viruses in the past decade.
Lipkin travelled to Saudi Arabia last fall to try to find the source of the new coronavirus, and a comment he made to the journal Nature suggests he found something. But he hasn’t shared that information in any depth and most observers believe a publication is probably pending. (Scientific journals typically won’t publish findings that have already been reported elsewhere.)
The Nature article, published in early December, said Lipkin revealed he had discovered that partial genetic sequences of a virus from bats match the new coronavirus. “The finding gives insight into the original source of the virus,” he told Nature.

Full article:

Reminder: CDC Weekly Influenza Surveillance Report Availability

You can get the CDC Weekly Influenza Surveillance Report (FluView) by scrolling down this page,  and looking at the right side-bar.  It's located under "Worldwide Update On Influenza Activity".  4th listing.

Iowa: Flu patients flooding Des Moines medical centers

For the first time since the H1N1 virus caused a flu pandemic in 2009-10, Des Moines-area hospitals have issued a joint appeal urging patients to stay away from local emergency rooms if they need nonemergency medical care.

The Mercy and Iowa Health systems and Broadlawns Medical Center cited heavy volumes of patients and long wait times at their emergency rooms and increased hospital admissions due to an unusually early spike in flu cases.

The hospitals are directing individuals with non-life-threatening illnesses to seek treatment at walk-in and urgent care clinics to keep emergency rooms available for serious cases. The hospitals also are restricting patient visitors.


Official: Flu deaths continue to rise among children

January 11, 2013
Atlanta (CNN) -- The spread of the flu across the United States appears to have slowed in portions of five states in the South and Southeast, a federal official told CNN early Friday, even as a National Institutes of Health director warned of the onset of "a classic flu epidemic."
The news came hours before the Centers for Disease Control and Prevention was due to release its flu advisory report for December 30 to January 5, which according to the official with knowledge of the findings will also show the number of flu-related deaths for children climbed by two last week.

Seasonal Flu: New York in Midst of Flu Epidemic

January 11, 2013
A ferocious flu “epidemic” has New Yorkers rushing to doctors, hospitals and drug stores — with emergency-room visits up 150 percent over last year, city health officials said yesterday.
“It’s a bad year. We’ve got lots of flu,” said city Health Commissioner Dr. Thomas Farley, who noted influenza-related cases spiked from 2 percent of all emergency-room visits for the peak of last year’s flu season to 5 percent this year.


Thursday, January 10, 2013

Seasonal Flu: Minnesota flu outbreak rivals deadly pandemic of 2009

January 10, 2013
Minnesota appears to be in the midst of the worst flu outbreak since the 2009 H1N1 pandemic, health officials said Wednesday.
A record number of children -- 123 -- tested positive for the flu at Children's Hospitals and Clinics of Minnesota in the first week of January, and 16 were hospitalized, according to Patsy Stinchfield, the director of infectious diseases.
The numbers, she said, are higher "than our highest week in the H1N1 pandemic.''
New statewide numbers are expected to be released Thursday, but one Health Department official said Wednesday that more than 900 people have been hospitalized so far this season -- a big spike just in the past week. By comparison, only 552 people were hospitalized in Minnesota during the entire last flu season.


Seasonal Flu: Michigan Confirms 4 Deaths

January 10, 2013
LANSING, MI - Michigan health officials have confirmed the fourth flu-related death of a child this season - a teenager from Central Michigan.
The Michigan Department of Community Health confirmed Tuesday night that the 15-year-old’s death was due to the flu, spokeswoman Angela Minicuci said Wednesday, Jan. 9.
Other children who have died from the influenza virus include an infant and a 6-year-old from Southwest Michigan and a 13-year-old from Central Michigan.


Seasonal Flu: 6 New Flu Deaths Reported In Oklahoma

Jan 10, 2013

The number of flu deaths in Oklahoma jumped by six in one week, according to data released Thursday by the Oklahoma Department of Health.
On Thursday, January 3, only two influenza deaths had been reported. For the week ending January 8, the OSDH reports eight flu-related deaths.
Three of those death have occurred in Tulsa County; one more from a week ago.
The other deaths occurred in Creek, Mayes, Muskogee, Pittsburg and Rogers counties. Each county recorded one influenza death from January 2-January 8.
The data does not say if the deaths were male or female, but it shows four were between the ages of 19-64 and the rest were 65 or older.
The OSDH has seen 345 hospitalized cases of flu since September 30, 2012. Ninety-two of those cases were reported January 2-January 8, 2013.


Iraq: 2 Died of Bird Flu in Hillah #H5N1

Died old girl 28 years old, and the other did not exceed 25 years on Thursday, bird flu in the city of Hilla province of Babylon. 
medical source said at the hospital of Hilla surgical Agency (news): The girl first live neighborhood Hussein central city of Hilla, and died in the hospital and was "holder", noting that models of laboratory tests received from Public Health Laboratory of the Ministry of Health confirmed infected with bird flu. The source added: that the girl the second died today also before the arrival of the analysis results to sent to Baghdad on Wednesday, and continued: will be sampling Allamso two girls to take health measures. / end / 14. n. p / 

Healing 4 people in Gaza from bird flu

The Ministry of Health in Gaza Monday evening healing four cases including two women were infected with bird flu after receiving care hospitals sector said general manager primary care at the Ministry of Health Fouad Issawi said that his ministry has routinely sampling Laboratory randomized patients expected to have complications from the flu. 
pointed out that out of the total samples taken from the patients were discovered analyze positive for four cases of them two women, were treated at the hospital. 
confirmed Issawi that there have been no deaths related to the virus in the Gaza Strip, referring to the that hospitals and health centers on the readiness fully to deal with any infection. 
said Issawi The National Commission for the control of infectious diseases at the Ministry of Health is studying infectious diseases and control any rise abruptly in proportions and put prevention strategies and activities to combat these diseases. 
explained Issawi that there is a system monitor continuously All infectious diseases and report weekly by the Ministry of Health representative primary care and Relief Agency, based on indicators such monitoring is measured any problems emergency or spread any contagious disease. 
rose mortality resulting from this virus in the occupied West Bank to 12 cases, while the number of injuries installed to 352 so far. 

Indonesia: #H5N1 Clade

Could Bird Flu Virus Transmitted to Humans from Ducks

Since it was found in October 2012 to Tuesday (8/1), bird flu virus subgroup 2.3.2 has spread in 69 regencies / municipalities in 11 provinces. The virus has caused 242,000 ducks died in Java, Sumatra, Sulawesi and Bali. In fact, on December 26 a new virus that killed 150,000 ducks in 50 districts / cities in nine provinces.

Deputy for Health, Population and Family Planning at the Coordinating Ministry for People's Welfare Agustiono Emil said, poor traffic control inter-regional and inter-island trade ducks make flu rapid spread of bird duck. Officers transportation agencies and veterinary centers in the area have the authority to inspect poultry entering an area. "If good traffic control birds, should not spread as quickly as this," he said.  

Azhar added that the bird flu virus in ducks can move to the other birds, such as wild duck and chicken. The virus is transmitted through snot and dirt ducks. This virus can be carried by air and water to spread everywhere. If the virus is spread to commercial poultry, certainly very high economic losses. Increasing number of variations of the bird flu virus that attacks a variety of birds, the government is certainly more difficult to control. 

 Moreover, if the virus is transmitted to humans. Not only detrimental to the economy, said Emil, it can threaten the security of the country.

HPA: Weekly update of norovirus activity

[You can obtain the weekly updates by looking at the right side-bar of the blog, under the title of "Weekly Updates of Norovirus Activity" under the title of Norovirus Sydney 2012.
We should have another update this week.  This update states that during the 2 week period they recorded 29 hospital outbreaks and 76% of those 29 reports led to ward/bay closures or restrictions to admissions.  That is quite a bit.

Report date: 31 December 2012
Hospital outbreak reports

In the two weeks between 17/12/2012 and 30/12/2012 the HPA hospital outbreak reporting scheme (HNORS) recorded 29 suspected or confirmed outbreaks of norovirus. Of these, 22 (76 percent) led to ward/bay closures or restrictions to admissions and 11 (38 percent) outbreaks were recorded as laboratory confirmed due to norovirus. In this season (since week 27 2012) 590 outbreaks have been reported, 517 (88 percent) of which reported ward/bay closures or restrictions to admissions and 358 (61 percent) were reported as laboratory confirmed norovirus outbreaks. In the last season (week 27 2011 – week 26 2012) there were 1653 outbreaks of which 1291 (78 percent) led to ward closures and 1075 (65 percent) were laboratory confirmed as due to norovirus*.

There is also a worrisome report here:

Syndromic surveillance data
Syndromic surveillance data is a useful indicator for the level of gastrointestinal disease in the community. The syndromes are not specific diagnoses however, the proportion of calls to NHS direct for vomiting has been shown to be a useful indicator of increased levels of norovirus activity in the community.
The latest HPA/NHS syndromic surveillance bulletin (no. 117) reports that the proportion of calls for diarrhoea and vomiting are stable and within seasonally expected levels. Note there is currently an issue with syndromic calls data in the under 1 year age group, see the syndromic surveillance web page for further details.
From the above link:
Data for 17 December 2012 – 23 December 2012
PLEASE NOTE that due to the ongoing transition of urgent care services across England, including the introduction of NHS 111, the volume of NHS Direct syndromic calls is gradually declining (figure 1), particularly in those areas where NHS 111 is currently operational. Please see notes for further details.
The national level of NHS Direct cold/flu and fever calls has been rising steadily over the past three weeks (Figure 2). Experience from several years’ surveillance of NHS Direct calls has shown that rises in cold/flu calls (all ages) and fever calls (5-14 yrs), above calculated threshold levels, may indicate a rise in influenza/influenza-like illness in the community. The weekly and daily call proportions for fever 5-14 years and cold/flu calls are now above the influenza threshold (speedometer below). These findings are consistent with other influenza indicators such as national laboratory reports of influenza B in those aged 5-14 years and reported school outbreaks.

Health Protection Agency (HPA): New Strain of Norovirus

[This will also be located on the right side-bar under the heading "Norovirus Sydney 2012", for future reference.]

9 January 2013
A scientific paper published in Eurosurveillance on January 3 described a new variant of norovirus (genotype G11 – 4) called Sydney 2012.
As part of its surveillance for norovirus the Health Protection Agency (HPA) carries out genetic testing of norovirus strains from cases in England and Wales.
Testing carried out when cases started to rise in October revealed a cocktail of different strains that were circulating including Sydney 2012 and another called New Orleans 2009, although no one strain was dominant.
The latest testing of the most recent outbreaks, completed this week, has now shown that Sydney 2012 has overtaken all others to become the dominant strain.
Syndey 2012 was first seen in Australia (and takes its name from the place it was first identified) and has also been seen in France, New Zealand and Japan.
This new strain does not cause more serious illness than others and the methods of managing cases and outbreaks are the same for any strain of norovirus. These measures include washing the hands thoroughly and regularly particularly after using the toilet and before eating.
Dr David Brown, Director of Virology Reference Department at the HPA said, “It is always difficult to predict the norovirus season and this year is no different.
“Noroviruses mutate rapidly and new strains are constantly emerging. At the start of the season it is normal for outbreaks to be caused by a range of different strains. However as the season progresses particular strains are more successful and become dominant. The emergence of a new strain does not mean that it causes more serious illness and managing outbreaks and those will the illness remains the same.
“There is no specific treatment for norovirus infection other than to let the illness take its course, with symptoms usually lasting around two days. Keeping hydrated is very important and you can take over-the-counter medicines to relieve headaches and aches and pains.”

Notes to editors:

1. The latest norovirus report can be found here:
2. The Eurosurveillance paper can be found on their website:
3. The Health Protection Agency is an independent UK organisation that was set up by the government in 2003 to protect the public from threats to their health from infectious diseases and environmental hazards. In April 2013, subject to the usual approvals procedures for establishing new bodies, the Health Protection Agency will become part of a new organisation called Public Health England, an executive agency of the Department of Health. To find out more, visit our website: or follow us on Twitter @HPAuk or ‘Like’ us on Facebook at
4. For more information please contact the national HPA press office at Colindale on 0208 327 7901 or email Out of hours the duty press officer can be contacted on 0208 200 4400.

Last reviewed: 8 January 2013

New strain of norovirus spreads around the world

In addition to this year's Seasonal Flu, we also have this Norovirus circulation.  That's a double whammy. 

January 09, 2013
A new strain of the winter vomiting disease norovirus has spread to France, New Zealand and Japan from Australia and is overtaking all others to become the dominant strain in Britain, health officials said on Wednesday.

The norovirus variant, known as Sydney 2012, was identified in a scientific paper last week and Britain's Health Protection Agency (HPA) said genetic testing showed it was now causing more cases in England and Wales than other strains.

Sydney 2012 does not carry worse symptoms than others but, like other norovirus strains, it can cause violent and projectile vomiting, diarrhea and sometimes fevers, headaches and stomach cramps.

Norovirus cases have risen earlier than expected this winter in Britain, across Europe, Japan and other parts of the world.

"The emergence of a new strain does not mean that it causes more serious illness, and managing outbreaks and those with the illness remains the same," said David Brown, director of the virology reference department at the HPA.
"Noroviruses mutate rapidly and new strains are constantly emerging. At the start of the season it is normal for outbreaks to be caused by a range of different strains. However, as the season progresses, particular strains are more successful and become dominant."
There is no specific treatment for norovirus infection other than to let the illness take its course and try to stay hydrated by drinking regularly. Symptoms usually last around two days.

Wednesday, January 9, 2013

Seasonal Flu: Indiana flu deaths this season have risen to 10

Jan 9, 2013
The number of Indiana flu deaths this season has risen to 10, up from seven at this time last week.
A weekly health department report says eight of those who died were older than 50 and two were under 18.
Health officials reported four influenza outbreaks in long-term care facilities, but didn't say whether any deaths occurred there.

Full Article:

H7N3 poultry outbreaks return to Mexico

Back in July, there were several articles posted here at this blog, regarding H7N3 in Mexico.  They can be found here:  H7N3 in Human Post Clarification, Mexico to vaccinate 1 Millions Chickens Against Bird Flu, Mexico Bird Flu Contained to 10 Farms, H7N3 in Texas...A While Back, H7N3 Mexico

This is reported today by CIDRAP:
Officials culled almost 300,000 poultry after highly pathogenic H7N3 avian influenza killed 740 birds on one layer farm and the virus was detected on another farm in the area, according to a report today from the World Organization for Animal Health (OIE). Both farms are in Aguascalientes state in central Mexico. The outbreaks are Mexico's first since a series of H7N3 outbreaks led to the culling of millions of poultry last summer in the adjacent state of Jalisco and caused egg prices to soar. In the current outbreaks, "Timely notification from the farmer and surveillance activities allowed immediate depopulation of the two affected production units, reason why both outbreaks identified are closed," the OIE report said. The first outbreak involved 2,990 sick and 740 dead poultry and led to the culling of the remaining 146,755 birds on the farm. The second outbreak was detected during active surveillance by the state and involved the culling of 138,000 additional birds. In sum, 284,015 poultry were culled. Workers have decontaminated both farms.
Jan 9 OIE report

H5N1 found in 20% of environmental samples from Cambodian bird markets

About 20% of environmental samples from Cambodian live-poultry markets were positive for H5N1 avian flu in a recent study, according to a report yesterday in Emerging Infectious Diseases. Cambodian researchers collected samples for 7 weeks in 2011 from poultry cages or stalls housing chickens and ducks at four live-poultry markets. Two of the markets were in Phnom Penh, one in Takeo province, and one in Kampong Cham—all in south-central Cambodia. Of the 502 environmental samples tested, 90 (18%) were H5N1-positive by polymerase chain reaction, and 10 (2%) by virus isolation, with water samples yielding the highest rates of positive findings. The researchers write that environmental sampling of these markets would better detect H5N1 than the current method of using cloacal or throat swabs, which they say rarely detects the virus.

18 flu deaths reported across Massachusetts this season

Cranston said most of the deaths have been in older patients.

"We’ve seen 18 deaths reported to us so far this season associated to influenza-like illness overwhelmingly amongst older individuals, which is not atypical," he said.

Anita Barry, the Director of the Infectious Disease Bureau for the Boston Health Department, said so far this year, there has been 10 times as many flu cases reported versus the number of cases recorded for all of last year.

Seasonal Flu: Flu influx causes Chicago hospitals to turn away patients

Editing is mine
January 8, 2013
CBS Chicago reports that some local hospitals are turning away emergency room patients because they are flooded with patients who come in sickened by influenza.
The station reports University of Chicago, Northwestern and Swedish Covenant were among eight Chicago area hospitals directing ambulances elsewhere because they were treating so many patients with the flu. Advocate Christ Medical Center in Oak Lawn, Ill., lifted its ambulance bypass order at 9 p.m. on Monday.

"We aren't seeing very sick people. We're just seeing more sick people," Mary Alice Lavin, director of infection, prevention and control with Rush University Medical Center, told CBS Chicago. "The viruses that were included in the vaccine this year are the ones that are circulating this year but studies have shown that the vaccine is only effective in 60 percent of people."
In Illinois alone, 147 people have been admitted to intensive care units at hospitals, six of whom have died, Illinois Public Health Director Dr. LaMar Hasbrouck told CBS Chicago.

Full Article:

Seasonal Flu: Flu Surge Leads To Boston Public Health Emergency

January 9, 2013
Surging influenza infections has led Boston to declare a public health emergency Wednesday. Massachusetts has reported 18 flu-related deaths so far.
Frederica Williams, president of the Whittier Street Health Center in Boston's inner-city Roxbury neighborhood, said her facility had opened a special flu clinic and was using social media and sending letters to residents urging them to come in and get flu shots.
"We serve a vulnerable population that is at risk for all kinds of health issues, so we put out a broadcast to our patients even before the mayor made the (emergency) announcement because we saw an increase in the number of people coming to our clinic for services."
Baystate Health, which operates Baystate Medical Center in Springfield and two other hospitals in western Massachusetts, announced Wednesday that it was changing its visitor policy. The hospitals will no longer allow visitors younger than 14 and are recommending no more than two people visit a patient at one time.
"This is the worst in several years," said Dr. Sarah Haessler, an infectious disease specialist at Baystate. She said the flu outbreak has strained the hospital's resources and helped to fill its beds to capacity.
Full Article: 

Indonesia: More than 25,500 fowl die in S. Sulawesi

More than 25,500 fowl have died in Sidenreng Rappang (Sidrap) regency in South Sulawesi over the past month. The number is believed to be increasing.
Sidrap Husbandry Agency head Asis Syam said on Tuesday that the actual number could be higher as it was possible that many farmers had not yet filed reports with the agency.
“The dead fowl were positive for bird flu,” he added.
Of the 25,500 dead fowl, most were ducks (21,100). More than 4,000 were chickens.
Sidrap regency is one of the biggest poultry producers in South Sulawesi and has previously experienced a bird flu epidemic. Hundreds of fowl die of bird flu every year in the regency.
According to the agency, the fowl population stood at 7.3 million.
Asis said the agency had called on farmers to immediately burn the carcasses of dead fowl, adding that the agency did not have enough vaccines to inoculate the fowl.
“We still need around 7.3 million vaccines,” he pointed out.

Indonesia: C. Java to distribute new bird flu vaccines in Feb

hat-tip Pandemic Flu Information []

January 09 2013
The Central Java administration will start distributing in February vaccines for a new strain of bird flu, identified as H5N1 clade 2.3.2, that has killed thousands of ducks in Yogyakarta, Central Java and East Java.
Central Java Animal Husbandry Agency chief Whitono said on Wednesday that the master seed of the vaccines--discovered last December in Sukoharjo, Central Java--was currently being produced by the Agriculture Ministry’s Animal Husbandry Department.
“It takes between a month and a month and a half to multiply the vaccines. God willing the new vaccines will start circulating within the first week in February,” he said.
In the meantime, poultry farmers are obliged to comply with appropriate bio-security measures, especially after directly handling poultry, according to Whitono.
They were also advised to use the vaccines for the older avian flu strain of clade 2.1.3 which killed chickens before the new vaccines arrived, he added.
The agency reported that more than 196,233 ducks had died from the new virus in 28 regencies and cities in the province.

H1N1 pandemic fears to maintain lofty US flu vaccination levels, says GlobalData

January 8, 2013
US demand for influenza vaccines will remain high in the coming decade, following a post-flu pandemic spike, predicts business intelligence provider GlobalData in its latest epidemiology report, which finds that seasonal influenza vaccine demand will increase from the 142 million expected for 2012 to 158 million in 2022, representing an annual growth rate (AGR) of 1.2%.


Seasonal Flu: Ohio: 8 Times Amount Hospitalized than last Year - Sandorsky County

You may want to look up the flu in your neck of the woods. This article is out of Sandorsky, Ohio.

Jan 8, 2013
During December, eight times as many people were hospitalized in Sandusky County for the flu than during the same time last year, a health official said.   

“It’s a pretty significant increase,” said Mary Dennis, Sandusky County Health Department director of environmental health. “A majority of those were children.” 

Indonesia: Poultry Confirmed Postive #H5N1 in Tanjungpriok, Jakarta North

As an effort to prevent bird flu virus or avian influenza (A1) H5N1, the ranks of West Jakarta Livestock and Fishery Sub-Department plan to raid poultry owners in Kalideres and Cengkareng sub-districts. This is conducted because many people in both regions are nurturing poultry, such as chickens, ducks, and wild ducks. Moreover, the virus had been found in North Jakarta.
As previously reported, nine chickens owned by Hasanudin Darwis atau Ato (35), a resident of Jalan Swasembada Barat VX No 61 RT 004/14 Kelurahan Kebonbawang, Kecamatan Tanjungpriok, Jakarta Utara were suddenly dead due to positif flu burung. Until Monday (1/7), 47 chickens and 50 birds in Kebonbawang Urban Village had been burned in order to prevent the spread of bird flu virus. 

Vietnam: Deputy Dir. Dept. Animal Health: Warning "42% Chickens Smuggled from China Contain Avain Influenza Virus"

From on 1/8/13
8/1  representative of the Ministry of Industry and Trade said basically control the smuggling of poultry waste in China. However, the current status advantage of the provisions are not mandatory quarantine and control the transport and trade of less than 50 birds for illegally smuggled poultry in Hanoi. Dam Xuan Thanh, Deputy Director Department of Animal Health warnings, 90% of samples were discarded chicken smuggled from China contain toxic residue and more than 42% of the samples avian influenza virus.

Tuesday, January 8, 2013

LVH Sets Up Separate ER for Flu Patients

In one of the worst flu outbreaks in years, Lehigh Valley Hospital-Cedar Crest in Salisbury Township will open a separate emergency room Tuesday, Jan. 8 for patients experiencing flu-like symptoms.
The hospital has set up a mobile tent outside the ER to handle an additional influx of patients suffering from flu-like illness, it said in a news release issued Monday.
Patients who are experiencing flu-like symptoms should still report to the main ER entrance for triage, a hospital spokesman said.
St. Luke’s University Health Network's six emergency rooms is currently seeing about 20 patients a day with flu-like symptoms but does not see a need to expand patient capacity at this time, said Dr. Jeffrey Jahre, chief of infectious diseases.
The Centers for Disease Control said the 2012-2013 flu season, which typically runs October through May, is shaping up to be a bad one and the strain may be more virulent. Jahre said this flu season is worse than the previous two, which were particularly light, but not the worst he has seen.
In Pennsylvania, the flu season was off to an early start and was considered widespread in the last half of December, according to the state Department of Health. 
In Pennsylvania, there were 7,181 flu cases and four deaths reported from Oct. 2 to Dec. 29, according to the state Department of Health. Lehigh County reported 355 flu cases and Northampton County reported 328 flu cases for the same period. The health department will report updated numbers on Jan. 8.
Influenza—more commonly known as simply "the flu"—is a contagious respiratory illness caused by viruses infecting the nose, throat and lungs. It spreads via infected people coughing, sneezing or talking, though people can also get infected by touching something with the flu virus on it before touching their mouth, eyes or nose.
Symptoms of the flu include muscle or body aches, headache, cough, sore throat, fatigue, fever or chills, and vomiting and diarrhea (the latter two are more common in kids). The flu can also worsen chronic medical conditions or cause death.
Jahre urged those who have not gotten a flu vaccine to get one – particularly the elderly and children – and those who are often in contact with them.
“It is absolutely not too late to get the vaccine,” he said.

PA Hospital Establishes 'Mobile Surge Tent' For Flu Cases

Jan 07, 2013 9:33 PM EST
The severity of this year's flu season in our area has led one Pennsylvania hospital to create a "mobile surge tent" to handle the number of incoming flu cases.
The tent was set up at the Lehigh Valley Hospital in Allentown.
The hospital says patients who are experiencing flu-like symptoms should still come to the emergency room.
Hospital administrators tell FOX 29's Dave Kinchen the tent will help to triage the most serious cases.
Health officials say about 3,000 people in Pennsylvania have the flu and 700 of them are in the Lehigh Valley.

Egypt: Warnings of the spread of pneumonia in poultry due to cold wave


Poultry Division warned the Federation of Chambers of Commerce, the spread of pneumonia in poultry, under the cold wave that hit the country, and demanded the Division, the Minister of Petroleum, providing pipe butane farms to keep poultry in that period.
Dr Abdulaziz al-Sayed, head of the division, Al-Masri Al-Youm, that the Ministry of Petroleum required to raise the prices of the tube large commercial 5-fold, brought from 12 pounds to 60 pounds, and promised to provide to farmers licensed and unlicensed.
He pointed out that the number of poultry farms increased from 26 thousand to 90 thousand farm, 60% of which is licensed, pointing out that the heating is necessary to keep poultry flocks.
He explained that the coastal areas in Kafr El-Sheikh, and status , and Port Said, are the most vulnerable areas for 'bird flu' pandemic and other infectious diseases, stressing that educators must provide immunization and heating on a regular basis. 

Egypt: Put on high alert to cope with bird flu and swine in North Sinai

North Sinai - Ashraf Sweilem said Director of Preventive Medicine in North Sinai, Dr. Mohammed Abdullah, that the Department of Preventive Medicine and all hospitals in North Sinai and Quarantine, has raised the full readiness to face the swine flu and bird flu. Abdulla was lifting the state surveillance and anticipation within hospitals, and active surveillance to monitor any cases where, especially those who have inflammation in the respiratory tract and hotter and severe symptoms nominated severe are dealing with these cases very seriously and is withdrawn sampled and sent to the laboratories of the Ministry of Health in Cairo. director added preventive medicine that samples were taken from some cases in northern Sinai, and sent samples to the laboratories of the Ministry of Health in Cairo and were all negative outcome, as we follow people from any foreign country especially on the Palestinian side and people who have contact with poultry farms or expatriates to maintain follow with preventive measures.


 For his part, Dr. Tarek Khater, Undersecretary of the Ministry of Health in northern Sinai, we raised the state of emergency medical private areas bordering with eastern border private crossing "Auja" central Sinai and the Rafah crossing, through tighter preventive measures through preventive medicine and quarantine, and there scrutiny being of travelers coming from the Gaza Strip, and take preventive measures in accordance with the ministerial instructions from the Ministry of Health.

China: two deaths from H1N1 flu

Tuesday, 08.01.2013, 13:59
Two Chinese women have died of H1N1 flu in Beijing for 10 days, the Beijing Daily newspaper quoted officials said on 7/1.
These are the first deaths because the flu virus in the Chinese capital since 2010.
Beijing Daily  quoted the Center for Disease Control and Prevention China said a 65-year-old cancer patient died on 5/1 and a 22-year-old migrant worker died on 27/12/2012. Health authorities in Beijing said the women were inherently in a state of poor health.
The flu cases in Beijing is at its highest level in five years and the dominant H1N1 strain. Number of flu cases increase was due to record low temperatures in Beijing, and many regions in China.
H1N1 swine flu vaccine had caused fear in 2009 when the global outbreak in the United States and Mexico and then spread around the world in the last six weeks. Initially, the World Health Organization (WHO) said the number of deaths as epidemic spreads around the world at about 18,500 people, but a study in June said the number of flu deaths up to 284500-579000 people, according to Reuters.
H1N1 swine flu is said to be directly transmitted from pigs to humans. From 2009-2010, the H1N1 virus has killed 80 people in Beijing.

Indonesia: Dir. Animal Borne Disease Control: "Farmers Wear Mask & Gloves When Cleaning Cages" #H5N1 Clade 2.3.2

KBRN, Jakarta: Indonesia's government insists no cases of the H5N1 virus commonly known as bird flu, which attacks humans. The assertion was followed by social unrest caused mass deaths of ducks suspected of bird flu in several regions in Indonesia.
Director of Animal Borne Disease Control, Ministry of Health, Rita Kusriastuti, in dialogue with Pro 3 RRI time explaining Bird flu is a new strain that has variant code 2.3.2, while bird flu occurred in 2003 with a code variance 2.1.
Suspected virus originated in China, but until now, both in Indonesia and in other countries there are no reports of humans exposed to avian flu. Although there was, there were only 1 or 2 and it was not in Indonesia.
"Not to attack humans. No humans were infected with bird flu-like symptoms at the moment, "said Rita Kusriastuti, Tuesday (01/08/2013).
Recognized the impact of bird flu, as poultry farmers have lost Itiknya died suddenly. Despite not infect humans, he urged the public to remain vigilant and keep clean.
For farmers, it is suggested to wear a mask and gloves when cleaning cages and then wash your hands with soap and water immediately change clothes.
As for the others, especially housewives who used to shop at the market, immediately wash your hands thoroughly after holding a chicken or a duck. If found people with a high fever, chills and shortness of breath after holding a duck or dead duck found in large quantities in the environment around, it must be immediately brought to the clinic as soon as possible.
"We will be given the drug and sampled," says Rita.