Swine H1N1 Fatalities in Mexico

Recombinomics Commentary 16:27
May 8, 2009

The official noted that the highest peaks (for deaths) of the days of the epidemic were 25 and April 26. Cordova reiterated that the age at which most deaths were recorded between 20 and 29 years.

The above comments are from an update on cases in Mexico. The samples are being retested for swine H1N1 and the testing is reconfirming earlier reports. In addition, sequences are being generated from outbreaks worldwide (see updated map), and these sequences match those from Mexico (well over 99% identical).

These data suggest that the number of cases is much higher than reported in official numbers and raise concerns that similar fatality levels will be recorded as the swine H1N1 spreads worldwide. The country reporting the most cases in the United States, but new cases are appearing in the southern hemisphere, raising concerns that the virus will expand and evolve.

The targeting of previously healthy young adults repeats data from 1918, as does the movement of swine H1N1 into a human population (as seen in the list below).

Concerns that the virus will recombine with seasonal flu and acquire key changes such as oseltamivir resistance (H274Y), as well as PB2 E627K highlight the importance of sequence surveillance.

The continuing spread of H1N1 remains a cause for concern.

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Swine flu will devastate Africa

Saturday, 09 May 2009

JOHANNESBURG – An American researcher last week said he hoped to have a vaccine for the new H1N1 flu in three weeks, as the World Health Organisation (WHO) warned the virus would have a bigger impact on Africa than it has had anywhere else should it break out on the continent. Purdue University professor Suresh Mittal said last Thursday that the vaccine for H1N1 flu or swine flu could be ready for testing in mice in two to three weeks and possibly production in a few months. "We would like to have a vaccine in two to three weeks to start testing in mice," said Mittal, a professor of comparative pathobiology in the School of Veterinary Medicine. Mittal and collaborators at the Centres for Disease Control and Prevention (CDC) will use a method he developed for dealing with the H5N1 bird flu to accelerate work on the H1N1 swine flu. They will use a common cold virus to carry a gene of the H1N1 flu virus and stimulate cells to create both antibodies and cell-based protection that will guard against mutated forms of the flu virus. "The adenovirus is incapable of replicating and does not seem to cause disease in humans," Mittal said in a press release. "That makes it a suitable virus to work with for flu vaccines." The vaccine Mittal created for the bird flu worked on three different strains isolated over a seven-year period and was described in papers for the Journal of Infectious Diseases and the journal Clinical Pharmacology and Therapeutics. "If things go well, and we achieve full scale production, it will be several months until the vaccine will be available," a spokesperson for the CDC cautioned. A number of different institutions, both private and public, are working on the development of a vaccine for swine flu. According to WHO, 2 371 cases of H1N1 flu have been reported by 24 countries. Forty-six people have died; 44 of them in Mexico and two in the United States. The WHO said H1N1 flu would have devastating impact on Africa should it breakout on the world’s poorest continent where surveillance systems are weaker and resources lacking. No cases have been confirmed in Africa, but doctors are investigating five potential cases -- one in Benin and four in the Seychelles, according to the world health watchdog. "If the epidemic hits Africa the impact may be more serious," WHO Africa director Luis Gomes Sambo told reporters at a meeting of African ministers for health in the Ethiopian capital Addis Ababa. "The surveillance systems are weaker and the resources that are required are just not sufficient, so we are now in the process of preparation." African ministers discussed plans to combat any possible outbreak of H1N1 during the two-day health conference that ended last Friday at African Union (AU) headquarters in Addis Ababa. Sambo said WHO was distributing 1,000 doses of Tamiflu, the only drug that has been shown to be effective against the strain, to every African country to boost their capacity to respond to any emergency outbreak of swine flu. Sub-Saharan Africa is already grappling with epidemics such as HIV/AIDS and malaria. Sambo said poor health conditions on the continent could help H1N1 spread. "If we have this new type of influenza, it may compromise the already poor health conditions of people in Africa," said Sambo. "Particularly those that are most vulnerable, those with immune deficiencies from HIV or malnutrition." MDC-M suspends officials HARARE – The Arthur Mutambara faction of the Movement for Democratic Change (MDC) has suspended six officials, including two Members of Parliament Abednico Bhebhe and Sijabuliso Mguni. The other four are Job Sikhala, Norman Mpofu, Alex Goosen and Gift Nyandoro. MDC spokesman Edwin Mushoriwa said last Friday that the six were suspended for misconduct, adding that they would be brought before party disciplinary committee in due course. “MDC advises that it has suspended the six members from the Party with immediate effect, pending their appearance before the national disciplinary committee on charges of misconduct,” said Mushoriwa. Bhebhe, the legislator for Nkayi South, caused a stir in the MDC-M after Prime Minister Morgan Tsvangirai, who heads the main formation of the MDC, nominated him as Minister of Water Development. Together with Sijabuliso Mguni, the legislator for Lupane, they stand accused by the MDC-M of voting for MDC-T legislator Love Moyo for the job of Speaker of Parliament instead of backing their party’s candidate, Paul Themba Nyathi. Sikhala has in recent weeks mounted a campaign against Mutambara, who he has accused of leaning too close to President Robert Mugabe.

Swine Flu Virus Lacks Killer Traits of 1918 Pandemic, Bird Flu

May 9 (Bloomberg)

From this article we learn that of those that died in Mexico:

11% died from complications.....heart disease
24% died from diabetes or obese, and

56% had the cytokine storm

Quotes from Anne Schuchat, interim deputy director for science and public health of the U.S. Centers for Disease Control and Prevention:

“The good news so far is that the virulence markers for the 1918 and H5N1 influenza viruses do not appear in the H1N1 strain,”

“What we don’t know is whether there may be other virulence markers. Remember the first wave of the 1918 virus was mild and the next wave was devastating.”

“It’s too soon to say things are getting better. We’re still accelerating,”

Quotes from Sylvie Briand, acting director of WHO’s global influenza program:

"“We’re still trying to understand who are the high-risk groups for this disease,”

“The more we know about this disease, the more we’ll be able to have better control measures.”

Canadian farm culls 500 swine flu-infected pigs

5/9/2009, 5:51 p.m. EDT The Associated Press

(AP) — TORONTO - Five-hundred hogs quarantined on an Alberta farm after they were diagnosed with swine flu have been culled because of overcrowding.

Authorities said Saturday that the quarantine left the farm unable to ship hogs to market, resulting in an overpopulation of pigs.

They say it was the best course of action for the herd's welfare.The remaining herd of 1,700 pigs is still under quarantine.

US confirms 2,254 swine flu cases, 104 hospitalizations

US health officials said Saturday that swine flu was continuing to spread in the country, with the number of confirmed cases rising to 2,254, with 104 people hospitalized.

Anne Schuchat of the US Centers for Disease Control and Prevention

The cases were confirmed in 44 of the nation's 50 states and the capital Washington but health authorities were now focusing on the characteristics of the new virus and on developing a vaccine, said Anne Schuchat of the US Centers for Disease Control and Prevention (CDC).

On Friday, there had been 1,639 confirmed A(H1N1) influenza cases in the United States, which has recorded two deaths so far in patients with underlying health issues.

Most of the hospitalized patients, Schuchat said, also had other health problems. US health officials have said they expect to find confirmed cases in all 50 states.

Mexico is at the epicenter of the global A(H1N1) epidemic, with 48 deaths recorded there compared to two US deaths, but the United States has overtaken its southern neighbor to become the country with the most number of patients.

"I know that in every state, it's really easy to focus on the numbers, but I think right now, the numbers don't tell us as much as the trends," said Schuchat, CDC's interim deputy director for science and public health.

"Our assessment is that transmission here in the US is ongoing, that this is a very transmissible virus, similar to the seasonal influenza viruses."

Despite almost 3,000 probable and confirmed cases now in the United States, Schuchat told reporters that "fortunately, the severity of illness that we are seeing at this point doesn't look as terrible as a category five kind of pandemic or the severity of impact that some had feared."

Noting that the "influenza virus is unpredictable, it can change over time," she said that health officials should focus on how the virus is spreading, developments in the southern hemisphere, which is just starting its flu season, and anticipating the virus's impact during the northern hemisphere's fall.

US President Barack Obama warned Friday that the autumn and winter flu season later in the year could be "even worse" and see cases spike again.

"So a lot of our emphasis here in the US is still understanding the epidemiology, transmission, severity and viral characteristics, but also working with partners internationally to really prepare and evaluate issues in their countries," said Schuchat.

The potentially deadly virus is a hybrid drawn from strains found in pigs, birds and humans. Meanwhile, some countries are still affected by the H5N1 bird flu strain, which first emerged in Asia in 2003 and has since caused nearly 250 deaths, according to WHO figures.

"So we do think this is an unusual and difficult circumstance to have circulation of this H1N1, the regular seasonal flu viruses and in certain countries, the H5N1," Schuchat said.

Scientists fear that a mutation of the bird flu virus resulting in a strain easily transmitted among humans could create a pandemic, potentially affecting up to one fifth of the world's population.

The swine flu outbreak has now been reported in 29 countries with a total of 3,440 cases before the latest US numbers, according to the World Health Organization.

Costa Rica sees 1st swine flu death

May 9, 2009, 1:33PM

SAN JOSE, Costa Rica — Costa Rica reported the death of a 53-year-old patient with swine flu on Saturday, the first death from the epidemic outside of a North American nation, while Japanese authorities scrambled to limit contacts with their first confirmed cases of the disease.

The Costa Rican man, who also had diabetes and chronic lung disease, was one of eight swine flu cases in the Central American country that have been confirmed by the U.S. Centers for Disease Control and Prevention, Health Minister Maria Luisa Avila told The Associated Press.

Mexico has recorded 48 swine flu deaths, two have been reported in the United States and Canadian officials say a woman who died last month had swine flu.

Avila said officials had been unable to determine how the man who died became infected, but she said he had not recently travelled abroad. Many flu sufferers in other countries have been linked to recent trips to the United States or Mexico.

In Japan, authorities quarantined a high school teacher and two teenage students who returned Friday from a school trip to Canada after they tested positive at the airport. Australia and Panama joined the list of countries with confirmed cases of swine flu.

The chief medical officer for the Canadian province of Alberta, Andre Corriveau, said Friday that a woman who died on April 28 had been infected with the virus. The woman, who was in her 30s, had other health problems.

Officials said she had not left the country recently, but could not confirm whether she was in contact with anyone who had recently returned from Mexico. Corriveau said 300 people who attended the woman's wake were being monitored for signs of the illness.

The World Health Organization has that said based on past outbreaks, it is possible that a third of the world's population, or about 2 billion people, could become infected if this outbreak turns into a two-year pandemic. Independent experts agreed it was possible but pointed out that many would not show any symptoms.

People with chronic illnesses are at greatest risk for severe problems from flu, along with the elderly and young children. So far, however, most of Mexico's victims have been aged 20 to 49 and the disease has claimed few lives among the very young and very old.

A report by the U.S. CDC said America's two swine flu deaths — a toddler and a pregnant woman who both died in Texas_ each suffered from several other illnesses.

Mexico's federal Health Department said Friday that about a quarter of those who died there were obsese or suffered from diabetes, while 11 percent had cardiovascular problems and 9 percent smoked.

It listed no complicating factors for most of Mexico's first 45 deaths, however, and none of them were reported to have respiratory ailments or other infectious diseases.

Hard-hit Mexico said only one new infection has been reported in the past four days and the country was gradually lifting a nationwide shutdown of schools, businesses, churches and soccer stadiums. It raised its count of confirmed cases to 1,626 based on tests of earlier patients.

Japan's national laboratory confirmed the virus in a teacher and two students who arrived in Tokyo Friday on a Northwest Airlines flight from Detroit. The Health and Welfare Ministry said it was working with the World Health Organization to contact at least 13 people on that flight who had gone on to other destinations in transit.

Local news media reported that as many as 11 people on the flight avoided screenings for swine flu.

Japanese Health and Welfare Minister Yoichi Masuzoe acknowledged it would be difficult to trace all those who came into contact with the three infected Japanese, who visited Ontario on a home-stay program with about 30 other students. The three were isolated and recovering at a hospital near Narita International Airport.

"There are limitations to what we can do, but we will continue to monitor the situation and strengthen or relax such measures as needed," he told reporters.

Public broadcaster NHK TV urged people who were aboard the flight to call a special telephone number for consultations. So far, 49 have been traced and will be monitored for 10 days, officials said.

But a handful of cases have cropped up in the region, including in South Korea and Hong Kong. The Chinese territory quarantined more than 200 people in a hotel after confirming its first case in a guest a week ago. They were released on Friday, and many were unable to contain their delight as they poured from the building for the first time in seven days. One man hugged a police officer and broke into song.

Australia reported its first case on Saturday in a woman it said was no longer infectious. She first noticed her symptoms while traveling in the U.S., federal Health Minister Nicola Roxon told reporters.

New Zealand — the first country in the Asia-Pacific region to confirm cases — reported two more on Saturday for a total of seven. The two high school students returned last month from a school trip to Mexico. Six of the country's cases were in students and a teacher on that trip; the seventh traveled on the same plane as the group.

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5 cases of suspected bird flu Mehalla and Naga Hammadi, Fayyoum

السبت، 9 مايو 2009 - 16:25 Saturday, May 9, 2009 - 16:25

Emergency situations in hospitals diets to counter the threat of bird flu infection

Detained hospital fevers Mahala 3 suspected cases of bird flu after an outbreak of the disease with symptoms similar to a high temperature, difficulty breathing, sore throat, where they were detained from the village of Elham Abbas dead Sarraj Center area and Bakr Ibrahim, Tharwat and guidance from the Center for the place.

. Hospital admitted and detained Naga Hammadi Shafik Karam anniversary (21 years) resident of the village Bhgeorp Assiut after a case of severe fatigue and symptoms similar to bird flu, fevers and detained hospital Fayyoum Zainab Syed Abdul Basit (35 years) resident village housewife Srsena Center housewife met Monday on suspicion of being infected with avian influenza, which turned out to be in contact with birds and were immediately taken blood samples, including Pap hours and sent to central laboratories and drug Altaymflo given.

Philippines free of hog flu despite rise in cases

THE Philippines remains free of the swine flu despite an increase in the number of suspected H1N1 cases, the Health Department said yesterday.

The disease has killed 44 people and infected 2,271 others in 24 countries, but the Philippines remained free of it, Health Undersecretary Mario Villaverde said.

He said the number of people being observed for the flu had increased, but 13 had already been discharged after they tested negative.

“Only four more people are awaiting the results of their laboratory tests,” Villaverde said.

Two additional cases were reported to the Health Department on Thursday, and they were a 21-year-old woman from Italy and a 40-year-old man from United States. Both are confined at the Asian Hospital and Medical Center in Muntinlupa City.

The two other pending cases are a 58-year-old American woman and a 12-year-old American boy.

RP remains free of Influenza A/H1N1; WHO praises ASEAN response to new virus

by Lyndon Plantilla

Quezon City (9 May) -- No sign of Influenza A/H1N1 virus.

As of Friday, Health Undersecretary Mario Villaverde said that the country has zero case of Influenza AH1N1 though they have 17 persons under observation.

Thirteen of the cases have tested negative and were discharged.

The remaining persons under observation were quarantined at the Research Institute for Tropical Medicine (RITM), Asian Doctors Hospital and in a hospital in Cagayan De Oro.

Meanwhile, World Health Organization (WHO) lauded efforts of Association of Southeast Asian Nations (ASEAN) and some neighboring countries to prevent the spread of H1N1.

WHO Western Pacific Regional Director Dr. Shin Young Soo said ASEAN responded well when the virus broke through the American and European continents by activating surveillance systems and creating protocols for care and treatments.

Shin took note of the improved screening measures that Laos and Cambodia have put up.

He made the statement during the ASEAN health ministers’ meeting in Bangkok chaired by Secretary Francisco T. Duque III.

Before he left for Thailand, Duque explained that the meeting intends not just to compare notes among and between countries but to achieve consensus on how the region will deal with H1N1 virus.

Lao Airline reduces air flight

KPL) Lao Airline decided to reduce international and domestic flight due to a decreasing number of passengers.
Head of Trade Division of Lao Airline Mr Lada Sounthone, said that Lao Airline this year faced a high pressure from the global financial crisis and now the spread of swine influenza epidemic (H1N1) leading to the number of passengers have sharply decreased.
Last year, more than 361,000 passengers flew with the Lao Airline if compared to 2007 it increased by 7 percent.
The figure proved the increment of passengers considered low amount if compared to the target plan, said Mr Lada.
He said that Lao economy also could not reach the goal leading to the Lao Airline’s passenger disappeared.
Normally, there are many international and local arrivals come to use Lao Airline’s service during high season starting from the beginning of the year to the Lao New years but this year less number of passengers, he said.
There was only four routes from Vientaine capital - Luang Prabang a day during the Lao New Year, he said.
Every Lao New Year, the Lao Airline had at least 10 routes per day, he said.
It showed that the passengers are getting downward, he said.
He added that the most worry thing at the present is the spread of the new swine flu (H1N1), which has made the tourists are scared.

Thai from Mexico may have had flu

By: Bangkokpost.com

Published: 9/05/2009 at 03:37 PM

Public Health Minister Witthaya Kaewparadai admitted on Saturday there was one patient under quarantine suspected of having had H1N1 flu, but the person had already been treated and was fit to return home. The minister indicated there was no possibility of the person spreading the virus after he was released from quarantine.

Mr Witthaya said the lab results on the patient had been sent to the United States in order to have it matched with the H1N1 influenza 2009 virus samples there, as Thailand did not have samples of the virus.

The person under suspicion was among a group of returning Thais entered into quarantine after having visited Mexico. The public health minister said 10 persons remained under quarantine.

The minister’s announcement came after he presided over a meeting of Public Health Ministry officials convened to determine Thailand’s responses to the latest outbreak situation of the virus.

Influenza A(H1N1) - update 22

8 May 2009 -- As of 16:00 GMT, 8 May 2009, 25 countries have officially reported 2500 cases of influenza A (H1N1) infection. Mexico has reported 1204 laboratory confirmed human cases of infection, including 44 deaths. The United States has reported 896 laboratory confirmed human cases, including two deaths. Related links Map of the spread of Infuenza A(H1N1): number of laboratory confirmed cases and deaths [jpg 548kb] As of 8 May 2009, 16:00 GMT Influenza A(H1N1) web site Daily updates will be posted on this site. The following countries have reported laboratory confirmed cases with no deaths - Austria (1), Brazil (4), Canada (214), China, Hong Kong Special Administrative Region (1), Colombia (1), Costa Rica (1), Denmark (1), El Salvador (2), France (12), Germany (11), Guatemala (1), Ireland (1), Israel (7), Italy (6), Netherlands (3), New Zealand (5), Poland (1), Portugal (1), Republic of Korea (3), Spain (88), Sweden (1), Switzerland (1) and the United Kingdom (34). WHO is not recommending travel restrictions related to the outbreak of the influenza A(H1N1) virus. Individuals who are ill should delay travel plans and returning travelers who fall ill should seek appropriate medical care. These recommendations are prudent measures which can limit the spread of many communicable diseases, including influenza. Further information on the situation will be available on the WHO website on a regular basis.

Japan, Australia Confirm First Swine Flu; China Proposes Summit

By Simeon Bennett

May 9 (Bloomberg) -- Japan and Australia confirmed their first cases of swine flu, as Hong Kong released 351 people from a week-long quarantine and China proposed hosting an international scientific conference on the virus.

China’s proposal comes after Asian health ministers called on the World Health Organization to review its criteria for declaring a flu pandemic. The Association of Southeast Asian Nations said the Geneva-based WHO should include a broader range of indicators such as the severity of illness a virus causes and whether it’s mutated to make it more virulent, Asean said in a statement distributed to reporters in Bangkok yesterday.

Disease trackers are monitoring 88 cases in Spain and 34 in the U.K. to determine whether the virus has established itself outside North America. Such a finding would prompt the WHO to declare a pandemic, the first since 1968, the agency has said. Asean said that may cause people to panic over a virus that so far has caused symptoms no worse than seasonal flu and only 44 confirmed deaths.

“We are at level 5, but there is some evidence this may be just like seasonal influenza,” Kamnuan Ungchoosak, an official at the Thai Health Ministry’s Department of Disease Control, said in an interview yesterday. “The perception is that, once you raise from one level to another level, it means there is more danger, more severity, a greater threat,” he said.

WTO Panel

A World Health Organization panel will meet May 14 to decide whether drugmakers should begin producing hundreds of millions of doses of a vaccine against the new illness. Keiji Fukuda, the WHO’s assistant director-general of health, security and environment, said swine flu may spread to at least one-third of the world’s 6 billion people in the next year. The virus, formally known as H1N1, has infected at least 2,500 people in 28 nations, including Japan and Australia.

Two students and a teacher returning from Canada tested positive for swine flu, Japan’s first confirmed cases, and the government quarantined 49 people from the same flight, Health Minister Yoichi Masuzoe said today.

The male students and a teacher in his 40s at an Osaka high school arrived at Narita airport outside Tokyo yesterday from Detroit after traveling to Ontario, Canada, on April 24 for an exchange program, Masuzoe said at a news conference in Tokyo.

The three, with symptoms including fever and coughs, are in isolation at a hospital near the airport. The students are recovering, while the teacher is being treated with the antiviral drug Tamiflu, Masuzoe said.

Passengers, Crew

Forty-nine passengers and crew from the flight are in 10- day quarantine at nearby hotels, the minister said.

Australia confirmed its first case of swine flu in a woman who returned on a flight to Brisbane from Los Angeles last week, Health Minister Nicola Roxon said in Canberra today.

The woman had been unwell in late April before she returned to Australia on Qantas Airways Ltd. flight QF16 and was swabbed at Brisbane Airport on May 7. The tests confirmed a “mild case” of swine flu, Roxon said.

“We have a person who had contracted the disease overseas and had fully recovered by the time they had returned to Australia,” Roxon told reporters. “We will be contacting people sitting a few rows in front of her and a few rows behind, but she was most likely to have been no longer infectious.”

Hong Kong released 286 people quarantined in a downtown hotel that was the site of the city’s first confirmed swine flu case. A further 61 were allowed to leave a holiday village and four were discharged from a local hospital.

Guests and staff at the Metropark Hotel in the Wanchai district were permitted to leave at 8:30 p.m. local time yesterday as their quarantine order expired and they showed no flu-like symptoms, said York Chow, secretary for food and health.

“They sacrificed freedom for seven days to give confidence to Hong Kong people,” Chow told reporters outside the hotel. Donald Tsang, the city’s chief executive, spoke to guests and staff before they left the hotel and was seen bowing as he addressed them in the lobby.

was expected by Pig Flu, the white person was treated in RSPIJAKARTA

On Saturday, May 9 2009 07:06 WIB
(the City Post) - was suspected of being affected suspect pig flu or swine influenza, a white person from Australia, Jhon Mcbright,53, still was undergoing the maintenance in roses space in RSPI Sulianti Saroso, Jakarta North, till this Saturday (8/5).
Director RSPI Sulianti Saroso, Sardikin Giiputro, permitted the existence of one foreign resident to be treated. But he denied it when being said by this patient positive was affected by the virus of pig flu. Because still in the intensive inspection.
In the meantime, the Special Capital District of Jakarta Provincial Government appealed to his resident to not panic with the existence of a foreign resident was treated in DKI. Kasus suspect the pig flu still in the process of the doctor's diagnosis. And not necessarily pig flu, nevertheless the RS Sulianti Saroso side already meng-quarantine the person (Jhon-red) to receive the further handling. “Jadi did not need to worry, we continued to carry out the increase in vigilance by increasing the implement screening in the strategic entrance in the Soekarno-Hatta Airport and the Cape port Priok,” clear Special Capital District Governor, Fauzi Bowo, separately. Other information mentioned, the spread of this virus of pig flu could through air or through contact lansgung with the sufferer. Generally attacked the adult and spread from the living pig to humankind. At this time was reported the spread from humankind to humankind happened.

3 Kasus Suspect Flu Babi Ditemukan di Indonesia!

Sabtu, 09/05/2009 15:38 WIB

detikNews

Foto: reuters

Jakarta - totalling 3 cases suspect flu H1N1 was detected in Indonesia. However, after being carried out by the inspection, the three patients were stated by the negative suffered the illness that beforehand was acknowledged as the pig flu. "For Indonesia personally has been 3 suspect because was detected by thermal detector," said Health Minister Siti Fadillah Supari in the press conference in the Department of the Health, Street HR Rasuna Said, Kuningan, Southern Jakarta, on Saturday (9/5/2009).

The press conference was spread out upon arrival Menkes from the agenda of Health Minister Special Meeting ounce A influenza (H1N1) on May 7-8 yesterday. The meeting that was held in Bangkok, Thaland, that, was attended by the Health Minister more than one ASEAN +3 (China, Korea, and Japan). According to Siti, the three sufferers suspect flu H1N2 that was the Indonesian guest worker from East Java that just came home from Thailand had the initials SM, and two more merupkan the foreign citizen had the initials J and L. L was a reporter that currently was in Bali. "All of them were detected by the negative from the virus H1N1 and all of them have come home respectively," explained the woman from Solo, Central Java, that. Explained by him, at this time the virus H1N1 has cleared to 33 countries and totalling 3000 people was infected. However, only 1,8 percent of the sufferer that died. According to Siti, the figure was considered to be very small and a little. "In fact in the USA, every year the person died 36,000 because of flu", pungkas him.

Indonesia Propose WHO Revision of the Status of the Pandemic of Pig Flu

On Saturday, 09/05/2009 16:29 WIB
Indonesia Propose WHO Revision of the Status of the Pandemic of Pig Flu of Muhammad Taufiqqurahman -
Reuters Jakarta - Indonesia became one of the participants Health Minister Special Meeting ounce A influenza (H1N1) in Bangkok, Thailand. In this opportunity of Indonesia proposed so that the health body of the world or the World Health Organization (WHO) revised the status of the flu pandemic H1N1. "Indonesia proposed that WHO revised the parameter in determining the status" of the "pandemic." Because of the status pendemi that was appointed by WHO to be able to carry the consequences that were difficult for a country, for example Mexico enough, said Health Minister Siti Fadillah Supari.
That was sent by him after attending the meeting that joined menkes more than one ASEAN +3 (China, Korea, Japan) on May 7-8 yesterday that. Upon arrival from Bangkok Siti at once held the press conference in the Department of the Health, Street HR Rasuna Said, Kuningan, Southern Jakarta, on Saturday (9/5/2009). According to him, the determination of the status of the virus pandemic H1N1 in the level 6 preferably not only was based on the spread between humankind then. But also must consider the clinical determinant and the determinant of virology high or low pathogenic.

Said by Siti, the meeting between Menkes produced several agreements.
Firstly, the political commitment that was high as well as the ASEAN solidarity +3 to face the threat outbreak from influenza H1N1. All delegation that was present agreeing to increase vigilance at his country was their respective in facing the virus.
"It was second, all member-state agreed that outbreak this time did not yet achieve the status 6 pandemics." All agreed that pendemi this clinically light, but continue to we must be on the alert, he explained. Two important points, continued Siti, also was produced. That is, increased the effectiveness of communication so that the community does not panic.
Then, considered the system in ASEAN +3 to facilitate the availability of the supply when the state of emergency happening. "Indonesia also warned, despite the world was facing outbreak influenza H1N1." ASEAN +3 will continue to complete the process of the Indonesian struggle in the virus sharing and benefit sharing in WHO, pungkas him.

Minimise the SPREADING of the VIRUS H1N1

; Pig Livestock Breeding needed Direlokasi
08/05/2009 11:03:55
Jakarta (KR) - Although not yet having the case that was found, but big the possibility of the virus of pig flu (H1N1) entered Indonesia. So, the medical experts reminded the possibility of the entry of this virus to Indonesia.
According to Perhimpunan Doctor Paru Indonesia Faisal Yunus General Chairman, Indonesia indeed was not yet experienced towards flu H1N1, but has many experiences towards bird flu. “Seperti was learnt by us Indonesia was the most country the case of flu burung,” he said in the press conference in RS Persahabatan Jakarta, on Thursday (7/5). The head of the Pulmologi Department and Medicine of Respirasi FKUI Priyanti ZS said, the bird flu death rate was indeed higher compared to H1N1 but his spreading was faster. “H1N1 indeed was easy to spread but not mematikan,” he said.
Concerning the amount of pig livestock breeding in Indonesia, according to Priyanti necessarily the government merelokasi all pig livestock breeding to minimise the spreading of the virus. “Lingkungan very influential against penyebarannya,” he stressed. The Agriculture Minister Dr Ir Anton Apriyantono also proposed necessary needed the relocation of pig livestock breeding. According to him, pig livestock breeding could be moved to the other location that was isolated for example in the Bulat Island. “Secara the principle, the regional government also at once could descend and monitored so that his location livestock breeding far from the settlement. However until this did not yet have the report on livestock breeding that was infected by the flu virus babi,” he stressed ended spoke in studium generale about food endurance that was spread out by the Association of the Pascasarjana UGM Student in University Club (UC) UGM, yesterday.
In the meantime, the Mexican government asked all the country to help overcame pig flu there, like help of the medicine, the equipment and the medical staff. This request has been continued to the Foreign Affairs Department and was continued to the Department of the Health. “Saat this Indonesia was making preparations to take part in helping. But his problem, up to now the government does not yet find the form of help what could be given to Meksiko,” deputy words the Co-ordinating Minister the Economy of the Pertanian Field and Marine Bayu Krisnamurthi in Jakarta.

Three Suspect Pig Flu in Indonesia, the Negative

on Saturday, May 09 2009 Jakarta - the Virus of pig flu (swine flu) that currently official was mentioned H1N1 did not yet touch Indonesia.{edit}Lie Three people suspect flu H1N1 in Indonesia that could make worried the community after being checked was stated by the negative. They were John, the Australian citizen; Li Xiau Yu, the journalist from Tiongkok that covered the Asian Development Bank session (ADB) in Bali; and the resident had the initials SN that could be treated in RSUD Dr Soetomo..
snip

Indonesia sprays the zoo to prevent Swine flu

On Friday, May 08 2009
Vaccine H5N1prevented Pig Flu birds and the Pig Divaksin Prevent H1N1 with the :
birds and the pig in the Garden and the Kinantan Culture of the Fauna Clan (TMSBK) or the Bukittinggi zoo was sprayed with vaksi H5N1 to prevent the virus of pig flu. This tourist attraction would busy was visited by tourists during the week end and the holiday.

Bukittinggi, Padek -- Better Safe Than Sorry. Apparently so that was carried out Pemko Bukittinggi to protect his community from the attack of pig flu. Although this case was not yet was found, but Kasubdin Taman Marga Satwa and the Kinantan Culture (TMSBK) Bukittinggi tried to carry out the step in anticipation of pig flu by spraying the vaccine H5N1 that usually to prevent bird flu. The head of TBS-BK Bukittinggi, Ma'ruf Amin mentioned, at this time did not yet have the vaccine H1N1 for pig flu was given by the government. The reason for the time being his side used the vaccine H5N1, because of the work system of this vaccine was almost same.
snip

Indo Heath Minister Siti Jackass Supari

Indonesian Health Minister Siti Fadilah Supari is not just a jackass but a fraud and a dangerous Islamic freak the world needs to see the back of, along with the Republic of Indonesia itself.

While Indonesian language TV programs broadcast outside (on youtube) but of course not inside the RI the fact Siti Fadilah Supari is not a true doctor as her phoney doctorate "Drs" title alludes, because she never went to university and her "degree" is conferred (bought), Islamic nutter Siti was spurting off her latest "research" revelations regarding swine flu.

First came her revelation that Indonesia was safe from swine flu because a) The RI is tropical and swine flu was from colder regions and would hopefully not survive in the tropics; the fact it emanated from very hot Mexico was somehow lost on this genius, and b) because Indonesians have different physiology's to non-Indonesians; you will not find me disagreeing on that score you dumb mutt but even if it were true, swine flu can and does jump species.

Then, former cardiologist and with that fact reason enough for never seeking medical help in Indonesia, the mad Muslim madam went on to blurt swine flu was man made, which by her definition means it did not come from Indonesia. Of course Siti is well known for her anti-infidel rhetoric about the origins of viruses, having previously claimed H5N1 Bird Flu was made as a weapon by the USA!

All this is fine for me except that it risks the lives of many Indonesians and also human beings; OK, OK, many Indonesians are human beings, just not Siti and her cohorts. You may remember Siti not so long ago tried to claim intellectual rights to H5N1, so she could make a profit from it; she even went so far as to stop vital infection samples being sent to the WHO in case some western pharmaceutical company made money from them! Then, because Indonesia's handling of the bird flu problem was so kak handed, the publicity of which being bad for pride and business, she blocked the reporting of new infections so the Indonesian tourism industry would not suffer. Like all bad news that affects pride and business in the RI, it is covered up. Thing is, what is worse? The Indonesian Health Minister for doing this, the foreign governments who do not warn their citizens of this subterfuge, or the dumb Aussie and other tourists who go to Bali because of a false sense of safety?

Kept quiet by the WHO this time and lost on most too is the risk of highly human-to-human contagious H1N1 swine flu becoming an unreported pandemic in Indonesia, like SARS was where Indonesia claimed never to had an infection while thousands of sick Indonesians went to hospital and never returned. The WHO is petrified, as they should be, if someone catches both viruses, that H1N1 swine flu could mutate with deadly H5N1 bird flu and then give the world something to remember Indonesia by; billions of people dead worldwide suffering horribly in the process.

This is why we need our governments to get rid of the illegal state of Indonesia, to ensure its people are given their legal right to self-determination, to get rid of the mutts and monkeys kept in power by a sordid blend of corruption and human rights abuse. With Islamic psychopaths like Siti Fadilah Supari running Indonesia's health system, surely people can see there is no future past death and destruction from Jakarta. Don't just boycott Indonesia including Bali to help bring on the end of this sick pariah regime, tell your politicians it is time to act against this human garbage. Indonesia militarily is weak and inept, how about some regime change down under? Annexing everything outside Java and Sumatra like Jakarta did in reverse in the 50's and 60's. Giving the people of West Papua, Sulawesi, the Moluccas and Bali some hope for the future, and the rest of us some peace of mind and good conscience. Come on, do your bit to get rid of Islamic wacko Indonesia and the problems it increasingly poses to the world.

6 suspected cases of bird flu meeting Sunday attended and Sohag

السبت، 9 مايو 2009 - 14:03

Saturday, May 9, 2009 - 14:03

يبلغ عمر أحد المصابين عامين ونصف

One of the injured, aged two and a half

هند عادل - محمود مقبول

India just - Mahmoud acceptable

احتجز مستشفا حميات المحلة وطنطا 4 حالات جديدة للاشتباه بإصابتهم بمرض أنفلونزا الطيور، وذلك بعد شعورهم بارتفاع فى درجة الحرارة وضيق بالتنفس وآلام شديدة بالعظام، حيث قامت حميات المحلة باحتجاز هدى عبد الرحيم (27 سنة) من قرية كفر حجازى مركز المحلة ومحمود محمد صبرى عامين ونصف من قرية الراهبين مركز سمنود.

Detained hospital admitted Tanta area and 4 new cases of suspected infected with bird flu, after the sense of high temperature and lack of breathing and severe bone pain, fevers, where the detention Mahallah Huda Abdul Rahim (27 years) from the village of Kafr Hegazy Center area and Mahmoud Mohamed Sabry two and a half from the village of monks Smonod Center.

كما احتجز حميات طنطا حالتين أخريين لكل من جلال ياسر من ميت يزيد مركز السنطة وعواطف أبو الفتوح (36 سنة) من كتامة مركز بسيون.

Tanta fevers also detained two other cases, each of Yasser Jalal over the status of the dead and Awatif Alsentp Abu Fotouh (36 years) of the Center Ktamp Besion.

وأكد الدكتور شريف حمودة وكيل وزارة الصحة بالغربية، أنه تم حجز الحالات الأربعة بالأماكن المخصصة لحالتهم، ووضعهم تحت الملاحظة وأخذ عينة دم ومسحة حلق وإرسالها للمعامل المركزية الخاصة بوزارة الصحة للتأكد من إصابتهم بالمرض من عدمه، كما تم إعطاؤهم عقار "التايمفلو".

And Dr. Sharif Hammouda Undersecretary of the Ministry of Health meeting Sunday attended by the cases that were reserved for the four places of their condition, and placed under observation and the taking of blood samples, survey hours and sent to the central laboratories of the Ministry of Health to make sure whether the disease has also been given the drug "Altaymflo."

من جهة أخرى احتجز مستشفى حميات سوهاج، على البدرى أحمد (34 سنة) عامل، وأسمهان حسن حامد (23 عاماً) ربة منزل للاشتباه فى إصابتهما بمرض أنفلونزا الطيور بعد ظهور أعراض المرض عليهما من ارتفاع بدرجة الحرارة ورشح.

The other hand, the hospital admitted Souhag held on Badri Ahmed (34 years) workers, and Asmahan Hassan Hamed (23 years) housewife on suspicion of bird flu after an outbreak of flu symptoms by high temperature and running.

تم أخذ عينات من الحالتين استعداداً لإرسالها إلى المعامل، وتم إعطائهما عقار التايمفلو وتم تطهير المكان بالكامل.

Sampling of cases ready to be sent to the laboratory, were given the drug Altaymflo were cleaning up the place entirely.

كما تمكنت الأجهزة الأمنية بمعاونة الطب البيطرى من ضبط السيارة رقم 77892 نقل سوهاج قيادة المدعو مينا فخرى (30 عاماً) أثناء تحميلها بالطيور وتهريبها، فيما كانت قادمة من قنا فى اتجاه سوهاج وبها عدد 1300 دجاجة.

It also has the help of the security services of the veterinary control car No. 77892, Sohag, the transfer of the leadership of a certain proud Meena (30 years) during the loading and smuggling of birds, as she was coming from in the direction of Qena, Sohag, and by 1300 the number of chickens.

تم التحفظ عليها وإرسالها للمذبح وأخذ عينات منها للتأكد من مدى إصابتها، وفى حالة عدم إصابتها يتم تسليم الطيور لمالكها.

Been taken into custody and sent to the altar and sampling to ascertain the extent of her, and in case of non-infected birds will be delivered to the owner.

وتم تحرر المحضر رقم 833 إدارى العسيرات وتم إخطار النيابة العامة بالواقعة، والتى أمرت بسرعة استعجال تقرير المعامل المركزية.

Was liberated record No. 833 has been notified of administrative Alasirat the Public Prosecutor's incident, which ordered the report quickly rush the central laboratory.

8 cases in detention on suspicion of Dakahliya injured bird flu ..

And the governor: Mandnac pigs

09/05/2009 09/05/2009

الدقهلية: صالح رمضان: Dakahliya: Saleh Ramadan: احتجز مستشفي حميات المنصورة أمس حاله جديدة للاشتباه في إصابتها بمرض إنفلونزا الطيور وهي حنان حسين أحمد 37 سنة من قرية ميت عاصم بعد إحالتها من المستشفي المركزي بمنية النصر. Mansoura University Hospital, was arrested yesterday admitted new cases were suspected of being infected with avian influenza, Hanan Ahmed Hussein, 37 years from the village of Mit Assem after transmission of the Central Hospital Bmnip victory. وكان المستشفي قد احتجز 7 حالات سابقة للاشتباه في الإصابة بالمرض وهي زينب رمضان شحاتة 16 سنة من قرية ميت طريف والطفل أدهم العريان إبراهيم 3 سنوات من طلخا وفرج الله عبدالسلام البحيري 46 سنة من قرية شها ورمضان جمعة أحمد 35 سنة The hospital had been 7 cases had been detained on suspicion of previous infection of Ramadan, Hassan Shehata, a 16 years of the village is dead and the child Tarif Adham Ibrahim al-Arian 3 years of line and Abdul Salam Faraj Allah Buhairi 46 years from the village of Sha and Ahmed Ramadan Juma, 35 years وفرج الله مصطفي مرسي 40 سنة من منشية صبري أبو علم وإبراهيم رزق محمد 35 سنة من قرية الخيارية وإيمان أحمد حامد 20 سنة من المنصورة.. And Faraj Allah Mostafa Morsi Manshiyat 40 years of science and Sabri Abu Rizk Mohamed Ibrahim 35 years of options, the faith of the village of Hamid Ahmed from Egypt 20 years .. حيث تم أخذ عينات ومسحات من الحلق لإرسالها للمعامل المركزية بوزارة الصحة لفحصها. Where they were taking samples and swabs from the throat to be sent to the central Ministry of Health laboratories for examination. وفي سياق متصل أشاد اللواء سمير سلام - محافظ الدقهلية- بسلامة الإجراءات المتبعة لمواجهة إنفلونزا الطيور للمحافظة علي صحة المواطنين في الدقهلية التي قال عنها إنها خالية تماماً من أي إصابات بإنفلونزا الطيور.. In a related context, Major General Samir praised the peace - Dakahlia governor - Safety procedures to address the avian influenza virus to preserve the health of citizens in Dakahliya which he said was completely free of any cases of bird flu .. فيما لم ينس إنفلونزا الخنازير حيث أكد أنه لا يوجد خنازير بالمحافظة نهائياً خلال اجتماعه مع أجهزة الطب البيطري والمجلس المحلي والتموين والصحة إلا أنه عاد وشدد علي ضرورة قيام الطب البيطري بتوفير الملابس والأدوات الواقية للأطباء والفنيين وأفراد الشرطة. With swine flu has not forgotten where he stresses that there is no preservation of pigs during the final meeting with the Veterinary Council and the local supply and health, however, he stressed the need for veterinary medicine to provide protective clothing and tools for doctors, technicians and police officers.

Travel-associated influenza A (H1N1) with a virus containing a mutation in PB2

Date: Fri 8 May 2009
From: Marcel Jonges

In the Netherlands, the 2nd laboratory confirmed human case of
influenza A (H1N1) virus infection was reported on 7 May 2009. A
53-year-old woman returned on the 30 Apr 2009 from Cancun, Mexico.
During the flight she developed an unproductive cough. Then, 2 days
later on 2 May 2009, she had a temperature of 38.6C and a sore throat
and consulted a general practitioner. Samples were submitted for
diagnostic evaluation and both the patient and her husband were
treated with oseltamivir. The patient recovered completely and
uneventfully, and samples collected 4 days later tested negative. The 
virus was analyzed for presence of antiviral resistance markers in 
the neuraminidase and for human adaptation markers in the PB2 protein 
by direct sequencing.

The sequence data suggested that the virus was susceptible to both 
oseltamivir and zanamivir. The amino acid 627 in PB2 (glutamicacid) 
was not human-host-adapted, similar to recent swine influenza A 
(H1N1) viruses. However, a glutamic acid to glycine amino acid 
substitution was detected at position 677 in PB2. This mutation was 
not observed in any of the A (H1N1) sequences submitted since 27 Apr 
2009. Lam et al. (2008) postulated that this substitution could
reflect adaptation to mammalian hosts of highly pathogenic avian
influenza A (H5N1) viruses (1), as it was found to be under positive
selection based on phylogenetics of Indonesian viruses. Based on the
position of the mutation it might contribute to more efficient
human-to-human transmission by enhanced replicative efficiency of the
polymerase of the influenza A (H1N1) virus in humans [PB2 is a
polymerase component. - Mod.CP]. Experiments are underway to test the
relevance of this finding.

Reference:
----------
(1) Lam TT, Hon CC, Pybus OG, Kosakovsky Pond SL, Wong RT, Yip CW,
Zeng F, Leung FC, Evolutionary and transmission dynamics of
reassortant H5N1 influenza virus in Indonesia, PLoS Pathog. 2008 Aug
22;4(8):e1000130.
-snip-
hat-tip Science Teacher

Tamiflu - will it get to all who need it?

07-05-2009

The World Health Organisation (WHO) has begun distributing 2.4 million treatment courses of Tamiflu. The virus inhibitor will be given to 72 countries in order to combat the threatened Mexican (swine) flu pandemic. However, the chance that the millions of people living in developing countries will ever get the antiviral medication is extremely small.

Professor Ivan Wolffers (pictured) of Amsterdam's Free University Medical Centre (VUMC) says the WHO's efforts are "a stopgap measure". According to Professor Wolffers, who specialises in health care in developing countries, a mountain of problems will arise if the feared influenza pandemic does indeed break out. The professor says that if there is a pandemic, the majority of influenza victims will be in southern Africa:

"Samples will have to be sent abroad for analysis, it is impossible to isolate patients, there are no distribution networks for the necessary drugs and there are no specially trained doctors to explain to patients how to take the medication."

Stockpiles

The authorities in Vietnam and Indonesia are slightly better prepared as they learned a great deal from the 2004 avian influenza outbreak. The World Health Organisation trained doctors and hospitals are prepared for infectious diseases. Despite that, neither country has sufficient supplies of antivirals.

The huge supplies of Tamiflu that Vietnam and Indonesia stockpiled as a precaution against the bird flu epidemic have now passed their expiry 28.

"Do these countries have to spend even more money?" asks Professor Wolffers. The authorities in several countries in the region, such as Bangladesh, are just as ill-prepared as their African colleagues".

Power factor

In recent years, numerous developing countries privatised health care in order to reduce government spending and concentrate on economic growth. Professor Wolffers believes that the successful middle classes in those countries could prove to have significant political clout:

"If the middle classes are afraid and demand government measures, then the government will have to act ".

However, government action will ultimately prove fruitless says Wilbert Bannenberg, director of Medicine Transparency Alliance (MeTA):

"The world has neither the resources nor capacity to provide everyone with antiviral medication or a vaccine. Even though China and India have been licensed to produce antivirals, the demand is still far greater than supply. That also applies to the raw materials needed to produce antivirals and vaccines".

Distribution of a limited amount of Tamiflu will not help says Professor Wolffers, adding, "manufacturing a drug isn't the biggest problem, quality control and distribution are far greater problems".

Scarcity

Tamiflu reduces the severity of the influenza infection but only a vaccine can offer complete protection. Western countries, driven by the scarcity of antiviral medication, will distribute the drugs to their own populations first. MeTA's director says,

"The Dutch government has already reserved production time with the vaccine manufacturer Solvay. Only when that order has been filled, will other countries get their orders filled".

The only way to get a large amount of vaccine on the market is to develop an extremely strong medication, that way a very small dose will be sufficient to protect people.

Western countries can do very little to improve preparedness in developing countries. The WHO emergency protocols are freely available and the most basic measures such as hand washing and staying at home do not cost anything. Non-governmental aid organisations are not doing anything about Mexican flu either; Jules van Os from Oxfam-Novib, the largest aid organisation in the Netherlands, says,

"We concentrate on long-term projects. Our emergency aid division has no plans to tackle Mexican flu".

Whooping cough

It is questionable whether extra help would actually be effective. Mr Bannenberg sums it up:

"Under normal circumstances, some 2 billion people across the globe have no access to antibiotics. Measles and whooping cough kill 14 million children annually and both diseases are preventable".

They are distressing statistics. Western countries appear unable to meet the Millennium Goals, including good affordable health care for all.

"Everybody knows it, but nobody wants to be the one with such a negative message".

Crime

All hope is now centred on reports from US scientists that the virus causing Mexican flu is not as aggressive as earlier feared. The number of infections has not risen exponentially and it hasn't killed very many people.

Professor Wolffers believes that the outbreak won't be as bad as previously feared and a global action programme won't be necessary:

"Spending millions on a pandemic that doesn't happen is also a crime. With that amount of money you could save the 500,000 women who die from complications during pregnancy in developing countries every year".

On Wednesday, the WHO announced that UN Secretary-General Ban Ki-moon will meet with major drug manufacturers on 19 May to ensure that any Mexican flu vaccine will be made available to developing countries.
_________________

How to Prepare for a Pandemic

By Bryan Walsh
Monday, May. 18, 2009

Excerpts:

H1N1 makes clear how vulnerable our interconnected globe is to emerging diseases. As a result of jet travel and international trade, a new pathogen managed to seed itself in more than 20 countries in less than two weeks.
-snip-
Why should we spend scarce medical resources swabbing the inside of pigs' nostrils, looking for viruses? Because new pathogens--including H5N1 bird flu, SARS, even HIV--incubated in animal populations before eventually crossing over to human beings. In the ecology of influenza, pigs are particularly key. They can be infected with avian, swine and human flu viruses, making them virological blenders.
-snip-

The occasional pathogen will get through even the most vigilant early-warning system. Viruses, after all, are pretty good at what they do.

A new flu pandemic is all but inevitable, and while the response to H1N1--the rapid deployment of Tamiflu, the blizzard of advice from the Federal Government--shows we're better prepared for a pandemic than ever before, it doesn't mean we're truly prepared.

A virulent flu pandemic--one that spreads throughout the world and sickens 25% to 30% of Americans--would cause our health-care system to crash like an overloaded website. Partly because of recession-fueled budget cuts that have led to the loss of 10,000 jobs in state and local health agencies over the past year, our hospitals have little in the way of surge capacity--excess beds and ventilators--that would allow them to handle a sudden influx of sick patients.

And there's no guarantee that those hospitals could remain staffed during the peak of a pandemic. "We haven't tested what would happen if one-third of the public-health workforce were not available because they were sick or taking care of family members," says Robert Pestronk, executive director of the National Association of County and City Health Officials.

The disruption that a pandemic might cause outside the health sector--what Michael Osterholm, who heads the Center for Infectious Disease Research and Policy (CIDRAP), terms "collateral damage"--could be even worse.

The "just in time" supply chain on which so many U.S. corporations rely leaves little slack and could buckle during a pandemic.

In a report last year, CIDRAP noted that 40% of the U.S. coal supply, which generates half the nation's electricity, is shuttled from mines in Wyoming to the rest of the country by train.

If a pandemic simultaneously sickened enough coal workers--or the tiny number of engineers qualified to operate those trains--supplies of coal could dwindle fast, switching off the lights in much of the country.

"We'd be dealing with two calamities if a pandemic hit," says Osterholm. "The human morbidity from the flu and the collateral damage for the just-in-time economy."
-snip-

AVIAN INFLUENZA, HUMAN - MBDS REGION (16):) WHO VIET NAM (THANH HOA

Date: Wed 6 May 2009
Source: WHO Epidemic and Pandemic Alert and Response (EPR) disease
outbreak news [edited]
<http://www.who.int/csr/don/2009_05_06c/en/index.html>


Avian influenza situation in Viet Nam - update 6
------------------------------------------------
The Ministry of Health has reported a new confirmed case of human
infection with the H5N1 avian influenza virus. The case has been
confirmed at the National Institute of Hygiene and Epidemiology (NIHE).

The case is a 23 year old woman from Quan Hoa District, Thanh Hoa
Province. She developed symptoms on [16 Apr 2009], was hospitalized
on [21 Apr 2009], and died on [22 Apr 2009].

Investigation into the source of infection indicated poultry died of
influenza A/(H5N1) around her household.

Of the 111 cases confirmed to date in Viet Nam, 56 have been fatal.

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

[The death of a 23 year old female from Thanh Hoa province (see prior
PRO/MBDS posting Avian influenza, human - MBDS region (15): Viet Nam
(Thanh Hoa) 20090426.1573) has been confirmed by WHO to be due to
H5N1 avian influenza infection.

A concurrent H5N1 outbreak in poultry was reported from Quan Hoa
district, Thanh Hoa province, and confirmed by the Department of
Animal Health in Viet Nam (see prior PRO/MBDS posting Avian influenza
- MBDS region (22): Viet Nam (Quang Ngai, Thanh Hoa) 20090430.1627).

The cumulative number of confirmed human cases of avian influenza A
(H5N1) reported to WHO and dated 6 May 2009, is available at
<http://www.who.int/csr/disease/avian_influenza/country/cases_table_2009_05_06/en/index.html>.
Viet Nam has reported 4 cases and 4 deaths of H5N1 infection during
2009, and a total of 111 cases and 56 deaths since the beginning of 2003.

For maps of Viet Nam with provinces, see
<http://www.lib.utexas.edu/maps/middle_east_and_asia/vietnam_admin01.jpg>
and <http://www.angelfire.com/co/hongnam/vnmap.html>. The interactive
HealthMap/ProMED-mail with direct links to other outbreaks in Viet
Nam and surrounding countries reported on ProMED-mail and PRO/MBDS
can be accessed at <http://healthmap.org/r/00bm>. - Mod.YMA]

AVIAN INFLUENZA, HUMAN (86): EGYPT, AGE-SPECIFIC RATES

Date: Thu 7 May 2009
Source: Eurosurveillance, Volume 14, Issue 18 [edited]
<http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=1919>


Age-specific infection and death rates for human A(H5N1) avian
influenza in Egypt. By J. P. Dudley, Science Applications
International Corporation, Modeling and Analysis Division, Rockville,
Maryland, United States
-----------------------------------------------
The age-specific infection and death profiles among confirmed human
cases of influenza A(H5N1) infection in Egypt differ markedly from
those recorded in other countries. The case fatality rate among human
H5N1 cases in Egypt is 34 percent, versus an average of 66 percent in
other countries. In Egypt, children younger than 10 years comprise 48
percent of reported cases, nearly twice the global average of
approximately 25 percent, and no H5N1 fatalities have been confirmed
among individuals in this age group as of 23 Apr 2009. Females
outnumber males among confirmed H5N1 cases by a factor of nearly 2:1,
and 90 percent of reported fatalities in Egypt have been females. The
evident age and sex biases in morbidity and mortality among H5N1
cases in Egypt are phenomena that warrant further investigation and analysis.

Introduction:
The 1st cases of human infection with avian influenza type A(H5N1)
were reported from Egypt in March 2006, and a cumulative total of 67
confirmed cases including 23 fatalities have been reported as of 23
Apr 2009 [1]. There are evident anomalies in the age distribution and
sex ratio of human mortality from influenza A(H5N1) in Egypt relative
to those reported from other countries that warrant detailed
investigation and analysis.

Methods:
Published information on human H5N1 cases in Egypt was analysed to
develop a 1st order comparative analysis of age-specific and
sex-specific infection and mortality patterns between human H5N1
cases in Egypt and those in other areas of the world. The age and
case history data of patients with confirmed influenza A(H5N1)
infection in Egypt used in this analysis were derived from reports
published by the United States Naval Medical Research Unit No. 3 in
Cairo, Egypt [2] and the World Health Organization (WHO), available
as of 23 Apr 2009 [1].

Results:
Human H5N1 cases in Egypt are most frequently reported among children
younger than 10 years, and approximately 80 percent of all reported
cases have occurred among individuals under the age of 30 years. In
Egypt, children under the age of 10 years comprise 48 percent of all
reported cases, nearly double the current global average of
approximately 25 percent [3]. A median age of 8 years has been
reported for human H5N1 cases in Egypt between March 2006 and March
2009 [2], versus a median age of 18 years for WHO-confirmed human
cases globally between November 2003 and November 2006 [4].

The age-specific infection and death profiles among confirmed human
A(H5N1) cases in Egypt differ markedly from those recorded in Asia
and Indonesia when compared to cumulative data for countries
worldwide other than Egypt, Nigeria, and Turkey [These data are
illustrated by 2 figures in the original text.]. The case fatality
rate from human H5N1 cases in Egypt confirmed as of 23 Apr 2009 is
only 34 percent (23 of 67), versus an average of 66 percent among
WHO-confirmed cases from all countries other than Egypt (234 of 354
cases as of 23 Apr 2009) [5].

Human mortality from H5N1 in Egypt is highly biased towards females
(90 percent: 21 females, 2 males), with confirmed mortality only
reported among individuals older than 9 years. Although the sex ratio
of cases in most countries is approximately 1:1, females outnumber
males among confirmed cases in Egypt by a factor of nearly 2:1 (43
females: 24 males). Although the average case fatality rate from H5N1
among children aged 0-9 years from all countries other than Egypt and
Turkey is 59 percent, no confirmed fatalities among 33 children in
this age cohort have been reported from Egypt as of 23 Apr 2009. A
similar pattern is evident for H5N1 cases in Turkey during January
2006; although 11 of 21 confirmed H5N1 cases in Turkey were children
in the age group 0-9 years, no confirmed fatalities were reported in
this age cohort [6].

Discussion:
There is increasing concern that undetected H5N1 cases may be
occurring in Egypt, given the evident anomalies in observed age-
specific and sex-specific case incidence and fatality rates. Although
there appears to be no compelling evidence for human-to-human
transmission of H5N1 in Egypt, family clusters have been observed in
Egypt, and H5N1 clusters involving highly probable human-to-human
transmission have been documented in China, Thailand, Viet Nam,
Indonesia, and Pakistan [7].

The most characteristic presentation of humans with fatal H5N1 virus
infections is severe lower respiratory disease accompanied by
hypercytokinaemia of the alveolar tissues. The pathology of most
fatal H5N1 cases resembles those of fatal human severe acute
respiratory syndrome (SARS) infections, and a suspected SARS case in
China during November 2003 was subsequently confirmed as a fatal H5N1 case [8].

The existing anomalies with regard to age and sex may be attributable
in part to the existence of undetected fatal or non-fatal atypical or
asymptomatic human H5N1 infections. Although human infections with
the H5N1 virus are typically associated with respiratory symptoms,
the clinical spectrum of H5N1 infections in humans is extremely
broad, and H5N1 virus has been recovered from lung, brain, large
intestine, small intestine, cerebrospinal fluid, kidney, spleen,
liver, pharynx, blood, and placental tissues [9]. Fatal atypical
human H5N1 infections involving only gastrointestinal and
neurological symptoms have been documented from patients in Viet Nam
and Thailand [10]. Asymptomatic human infections with H5N1 have been
reported from China, Viet Nam, Japan, Thailand, and Korea [11].

Clinically mild illness from highly pathogenic avian influenza (HPAI)
H5N1 virus infection has been reported from children in most
countries, but the early detection and treatment of possible cases
may be a factor in the overall lower case fatality rate reported for
H5N1 cases in Egypt. Although a median time of 4 days from symptom
onset to hospitalization has been reported for H5N1 cases worldwide
[4], nearly 50 percent of confirmed cases in Egypt are admitted to
hospitals within 24 hours after the 1st onset of symptoms, and
approximately 70 percent are hospitalized within 72 hours after
symptom onset [2].

Conclusions:
The evident age and sex biases in the incidence of infection and
mortality among H5N1 cases from Egypt are phenomena that have not
been fully explained and merit further in-depth investigation and
analysis. Further research is needed to understand the immediate and
long-term health risks of avian influenzas for human populations and
to identify those members of exposed populations who are at greatest
risk of infection and serious disease from avian influenza viruses.
Although most cases in Egypt can be linked to contact with diseased
poultry, increasing numbers of confirmed human H5N1 cases with no
evident history of direct exposure to diseased poultry or birds are
being reported from China and Indonesia. Efforts need to be made to
evaluate potential background rates of asymptomatic and mild cases of
human avian influenza in communities where human H5N1 clusters have
been documented and to evaluate potential instances of human-to-human
transmission of H5N1 in Egypt.

References:
(1) World Health Organization. Epidemic and Pandemic Alert and
Response (EPR). Disease outbreaks by country. Egypt. Geneva: World
Health Organization; 2009 Apr 23. Available from:
<http://www.who.int/csr/don/2009_04_23a/en/index.html>.
(2) United States Naval Medical Research Unit No. 3. Influenza
Activities Report. February-March 2009. Egypt. Available from:
<http://www.geis.fhp.osd.mil/GEIS/SurveillanceActivities/Influenza/Reports/NAMRU3_March_2009.pdf>.
(3) World Health Organization Western Pacific Regional Office. Avian
Influenza A(H5N1) Cases by Age Group and Outcome. Geneva: World
Health Organization Western Pacific Regional Office; 2009 Mar 23.
Available from:
<http://www.wpro.who.int/NR/rdonlyres/FD4AC2FD-B7C8-4A13-A32C-6CF328A0C036/0/Slide4.jpg>.
(4) Peiris JSM, de Jong MD, Guan Y. Avian influenza virus (H5N1): a
threat to human health. Clin Microbiol Rev. 2007;20(2):243-67. Available from:
<http://cmr.asm.org/cgi/content/full/20/2/243#Transmission_and_Epidemiology>.
(5) Epidemic and Pandemic Alert and Response (EPR). Cumulative Number
of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO.
Geneva: World Health Organization; 2009 Apr 23. Available from:
<http://www.who.int/csr/disease/avian_influenza/country/cases_table_2009_04_23/en/index.html>.
(6) World Health Organization. Epidemic and Pandemic Alert and
Response (EPR). Disease outbreaks by country. Turkey. Available from:
<http://www.who.int/csr/don/2006_01_18/en/index.html>.
(7) Nicoll A. (Yet) another human A/H5N1 influenza case and cluster -
when should Europe be concerned? Euro Surveill.
2008;13(15):pii=18833. Available from:
<http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=18833>.
(8) Zhu QY, Qin ED, Wang W, Yu J, Liu BH, Hu Y, et al. Fatal
infection with influenza A (H5N1) virus in China. New Engl J Med.
2006;354(25): 2731-2. Available from:
<http://content.nejm.org/cgi/content/full/354/25/2731>.
(9) Ng WF, To KF. Pathology of human H5N1 infection: new findings.
Lancet 2007;370(9593):1106-8.
(10) de Jong MD, Hien TT. Avian influenza A (H5N1). J Clin Virol.
2006;35(1):2-13. Available from:
<http://www.prbo.org/cms/docs/birdflu/deJong_and_Hien_2006_J%5B1%5D._Clinical_Virology.pdf>.
(11) Dudley JP. Public health and epidemiological considerations for
avian influenza risk mapping and risk assessment. Ecology and Society
2008;13(2):21. Available from:
<http://www.ecologyandsociety.org/vol13/iss2/art21/>.

Reports suggest elderly Alberta woman with swine flu has died

hursday, May 7, 2009 6:11 PM MT Comments8Recommended14

CBC News

Reports emerged Thursday night that an elderly woman who had swine flu has died in northern Alberta.

It's not clear whether she had any other underlying conditions.

CBC News put the question to Alberta's health minister at 2:30 p.m. MT, and he stated at that time that he had no information about the case.

Vical shares rise on U.S. Navy deal for H1N1 flu vaccine

Last Updated: 2009-05-07 14:00:34 -0400 (Reuters Health)

By Vidya L Nathan

BANGALORE (Reuters) - Shares of Vical Inc surged 31 percent, after the biotechnology company said it was in pact with the U.S. Navy for the development of a vaccine against the H1N1 strain of influenza virus and posted a narrower quarterly loss.

On Wednesday, the company said the development program aims to advance a Vaxfectin-formulated H1N1 DNA vaccine into clinical testing as quickly as possible. [ID:nBNG448760]

Vaxfectin is the company's experimental influenza product. Vical did not disclose the terms of the agreement.

The deal will help Vical get partners for its influenza vaccine in its early-stage study, Rodman & Renshaw analyst Reni Benjamin said.

"(Vical) will clearly need more funding to develop this, going forward, but with the U.S. Navy willing to have a co-development deal with the company, chances are better in securing funding," Benjamin said.

If the vaccine is successful, it would translate into recurring revenue for the company through government contracts, the analyst said.

"It really depends on the government and how severe this (swine flu) scare is, whether this becomes a full blown pandemic. But if (the vaccine) is successful, then it could become part of the stockpiling effort."

However, Needham & Co analyst Alan Carr said it is too early for the company to say whether these recent events would help its strategy in the influenza area.

On Thursday, Vical posted a net loss of $8.2 million, or 20 cents per share, for the first quarter, compared with a net loss of $9.6 million, or 24 cents a share, a year ago.

Shares of the company touched a high of $2.75 before paring some gains to trade up 13 percent at $2.38 in morning trade, making them one of the top percentage gainers on Nasdaq.