Clinical and Virological Factors Associated with Viremia in Pandemic Influenza A/H1N1/2009 Virus Infection

September 27th, 2011 |

by Herman Tse, Kelvin K. W. To, Xi Wen, Honglin Chen, Kwok-Hung Chan, Hoi-Wah Tsoi, Iris W. S. Li, Kwok-Yung Yuen

Background

Positive detection of viral RNA in blood and other non-respiratory specimens occurs in severe human influenza A/H5N1 viral infection but is not known to occur commonly in seasonal human influenza infection. Recently, viral RNA was detected in the blood of patients suffering from severe pandemic influenza A/H1N1/2009 viral infection, although the significance of viremia had not been previously studied. Our study aims to explore the clinical and virological factors associated with pandemic influenza A/H1N1/2009 viremia and to determine its clinical significance.

Methodology/Principal Findings

Clinical data of patients admitted to hospitals in Hong Kong between May 2009 and April 2010 and tested positive for pandemic influenza A/H1N1/2009 was collected. Viral RNA was detected by reverse-transcription polymerase chain reactions (RT-PCR) targeting the matrix (M) and HA genes of pandemic influenza A/H1N1/2009 virus from the following specimens: nasopharyngeal aspirate (NPA), endotracheal aspirate (ETA), blood, stool and rectal swab. Stool and/ or rectal swab was obtained only if the patient complained of any gastrointestinal symptoms. A total of 139 patients were included in the study, with viral RNA being detected in the blood of 14 patients by RT-PCR. The occurrence of viremia was strongly associated with a severe clinical presentation and a higher mortality rate, although the latter association was not statistically significant. D222G/N quasispecies were observed in 90% of the blood samples.

Conclusion

Presence of pandemic influenza A/H1N1/2009 viremia is an indicator of disease severity and strongly associated with D222G/N mutation in the viral hemagglutinin protein.

Minister of Health, who heads the delegation of Palestine will participate in the meeting of the Executive Office of the Council of Arab Ministers of

30 September 2011
Ramallah Ali Samoudi heads the Minister of Health, Dr. Fathi Abu boiled delegation of Palestine, who will be tomorrow, Saturday, at a meeting of the Executive Office of the Council of Arab Ministers of Health, which is held at the headquarters of the Secretariat of the League of Arab States in Cairo, Egypt.

The meeting will discuss, many of the issues that concern the health status of the Arab, including the construction of the Arab Authority for the adoption of health institutions and Arab integration in the pharmaceutical industry, will also consider the roles of qualified health migratory strengthen the health sector in Arab countries in addition to the Millennium Development Goals for maternal health .

On the other hand headed by Dr. Fathi Abu boiled delegation of Palestine, which includes: Director General of the General Administration of Hospitals, Dr. Naim Sabra, and Director General of Primary Health Care and Public Health, Dr. Asad Ramlawi, for meetings of the session 52 of the Regional Committee Eastern Mediterranean World Health Organization to be held in Cairo in the period from 2 to 5 October, where he will discuss many of health topics of interest to the Eastern Mediterranean Region and view reports on polio eradication, and the Tobacco Free Initiative, and the fight against malaria and disposal, and prevention of cancer, and the regional situation of injuries resulting from traffic accidents,

Will also be at this conference discussed a number of technical issues relating to the use of pesticides impact on public health, namely, dengue fever and mental health strategies.

«WHO» intends to open an office of the WHO Representative and the Regional Center for Environmental Health Activities in Amman

Saturday, 01 October 2011
Amman - the way
Involved and the Minister of Health, Dr. Abdul Latif Wreikat, heading a delegation from the ministry in the work of fifty-eighth session of the Regional Committee for the Eastern Mediterranean to be held at the headquarters of the Regional Office in Cairo during the week.

Wreikat, will meet during his visit to Cairo Regional Director of WHO, Dr. Hussein, Algeria to discuss the arrangements for the opening of the new building of the Office of the WHO Representative and the Regional Centre for Environmental Health Activities in Amman.

The ministry said in a statement that the agenda of the fifty-eighth session of the Regional Committee for the Eastern Mediterranean contains a number of issues related to Castisal polio and the Tobacco Free Initiative and the Millennium Development Goals and the fight against malaria, disposal and prevention of cancer and control and emergency response.

Also on the agenda raised issues related to pandemic influenza H1N1 and injuries from road accidents and the impact of the use of pesticides on health and disease, dengue fever, and the expanded program of immunization against diseases and mental health strategy and research for health.

The delegation includes Director of Health Care Management, Dr. Bassam Hijjawi and Director of the Directorate of International Relations and General Mustafa Qasim, Salman Issa of the Directorate.

Pakistan: More Articles Re: Dengue Fever Deaths

2 Articles

High mortality of dengue fever in Pakistan
24/9/2011
Eight people died in the Pakistani city of Lahore after viral infection of dengue fever, bringing the death toll to 83 people, according to a media report. According to the website of the channel, "Geo News" News of Pakistan that there are 9781 confirmed cases of the virus in the Punjab province alone.

Experts said that in the medical field hospitals - it seems - is able to absorb this huge number of patients, which required the government to take extraordinary measures "before it is too late."

The World Health Organization said in its latest statistics there are 2726 confirmed cases of dengue fever virus in Pakistan.

[continued] http://tinyurl.com/63q23xv

2nd Article:

29/9/2011
Pakistan is currently facing a new threat is in an unprecedented wave of dengue fever has killed 126 people were killed in less than a month because of this disease, with 12 thousand others carrying the virus that causes it.

Experiencing overcrowded hospitals of Lahore, a major center of wide panic among the population, as it were wounded when one of them I think it is a fever dengue fever, which causes confusion in the case of large hospitals, forcing departments to set up tents outside the building to receive the injured.

Earlier, experts in the medical field hospitals in the city of Lahore, is able to absorb this huge number of patients, which required the government to take extraordinary measures "before it is too late." In addition to the territory of Punjab, the other parts of the country has recorded many cases of dengue fever, killing at least six were killed by the illness suffered by 130 others in the territory of Khaibar Bactunjua (north west). In Sindh province (south), the disease killed six people, while the 400 recorded injury.

[continued, click on title]

WHO is working with Pakistan in the face of disease, dengue fever is rampant in Punjab

30/09/2011

World Health Organization reported that it had been recorded nearly twelve thousand five hundred case of dengue fever, and one hundred and twenty-five deaths linked to the disease in Pakistan in the period between the first of January, the twenty-eighth of September / September.

According to WHO, there have been all cases in Punjab only. Tariq says spokesman Jasrvek World Health Organization:

"The number of cases registered last year, higher than the recorded cases in the past five years combined in Pakistan. The organization is trying to help national authorities to respond to outbreaks of disease, and there was a meeting on the thirteenth of September with the participation of representatives from all provinces and regions. And the results of the meeting that sub-groups were formed, the organization is to facilitate the management of special groups of dengue fever, and the media and communications, community mobilization, and control and means of transmission of the disease. "

The WHO has provided new evidence for the clinical management of cases, developed by Pakistani doctors on the basis of the study was retrospective, based on information from the experiences of Pakistani hospitals, and international and regional experiences. FAO has also facilitated training and support to deal with cases of dengue fever in a number of provinces.

Pakistan: 4 die of DF in Lahore; 530 infected in 24 hrs. in Punjab Province

30/9/2011

Excerpt:
In Pakistan, four people died in the city of Lahore, following a viral infection of dengue fever, raising the death toll to 106 so people, according to a media report. The channel "Aaj" News of Pakistan that was recorded 530 cases infected with the virus during the twenty-four hours in the province of Punjab. Dengue fever has turned to the "B" in the province of Punjab and its capital Lahore, where there are long queues of patients to emergency wards in hospitals.

Reassortant H9N2 Influenza Viruses Containing H5N1-Like PB1 Genes Isolated from Black-Billed Magpies in Southern China

Guoying Dong1,2#, Cong Xu3#, Chengmin Wang1, Bin Wu1, Jing Luo1, Hong Zhang1, Dale Louis Nolte4, Thomas Jude Deliberto4, Mingxing Duan5, Guangju Ji2*, Hongxuan He1*

1 Key Laboratory of Animal Ecology and Conservation Biology, National Research Center For Wildlife Born Diseases, Institute of Zoology, Chinese Academy of Sciences, Beijing, China, 2 National Laboratory of Biomacromolecules, Institute of Biophysics of Chinese Academy of Sciences, Beijing, China, 3 College of Food Science, Southwest University, Chongqing, China, 4 National Wildlife Disease Program, USDA/APHIS/Wildlife Services, United States Department of Agriculture, Fort Collins, Colorado, United States of America, 5 State Key Laboratory of Biomembrane and Membrane Biotechnology, School of Life Sciences, Tsinghua University, Beijing, China


Abstract

H9N2 influenza A viruses have become endemic in different types of terrestrial poultry and wild birds in Asia, and are occasionally transmitted to humans and pigs. To evaluate the role of black-billed magpies (Pica pica) in the evolution of influenza A virus, we conducted two epidemic surveys on avian influenza viruses in wild black-billed magpies in Guangxi, China in 2005 and characterized three isolated black-billed magpie H9N2 viruses (BbM viruses). Phylogenetic analysis indicated that three BbM viruses were almost identical with 99.7 to 100% nucleotide homology in their whole genomes, and were reassortants containing BJ94-like (Ck/BJ/1/94) HA, NA, M, and NS genes, SH/F/98-like (Ck/SH/F/98) PB2, PA, and NP genes, and H5N1-like (Ck/YN/1252/03, clade 1) PB1 genes. Genetic analysis showed that BbM viruses were most likely the result of multiple reassortments between co-circulating H9N2-like and H5N1-like viruses, and were genetically different from other H9N2 viruses because of the existence of H5N1-like PB1 genes.

Genotypical analysis revealed that BbM viruses evolved from diverse sources and belonged to a novel genotype (B46) discovered in our recent study.

Molecular analysis suggested that BbM viruses were likely low pathogenic reassortants.

However, results of our pathogenicity study demonstrated that BbM viruses replicated efficiently in chickens and a mammalian mouse model but were not lethal for infected chickens and mice.

Antigenic analysis showed that BbM viruses were antigenic heterologous with the H9N2 vaccine strain.

Our study is probably the first report to document and characterize H9N2 influenza viruses isolated from black-billed magpies in southern China. Our results suggest that black-billed magpies were susceptible to H9N2 influenza viruses, which raise concerns over possible transmissions of reassortant H9N2 viruses among poultry and wild birds.

Uganda: Officials Warn of Bird Flu Outbreak #H5N1

28 September 2011

Health officials have warned of a possibility of the bird flu virus entering Uganda.

Uganda continues to stay free of the H5N1 virus that causes Avian influenza, even as it remains pronounced in Asian nations. On the continent, it is mostly registered in Egypt. Health officials recently addressed journalists on how to take precautions and report accurately about the virus.
-snip-
Uganda is surrounded by multiple water bodies which could easily provide a haven for birds that later spread the virus. "We do not have the disease but there is a possibility and we do not want to be caught off guard," Dr Victor Tugumizemu, an official from the ministry of Health said.

The ministry has instituted preparatory measures through the Avian Human Influenza Preparedness and Response Project (AHIP) in case of an outbreak. Among the measures is; educating the media on fact finding reporting and averting unnecessary panic among the public according to Dr Paul Kaggwa, assistant commissioner Health Education and Promotion in the ministry of Health. Dr Tugumizemu told journalists that isolation centres have been identified at Mulago and Entebbe hospitals as a preventive action to isolate flu victims.

Vietnam: Phu Tho: Many birds died of unknown cause

29/09/2011
Destruction of chickens infected with influenza A H5N1. Artwork. (Source: Tran Le Lam / VNA)

Veterinary Bureau said Phu Tho province has added 771 birds died of unknown causes duplex Minh Coi Commune, Ha Hoa district.

The number of dead birds have symptoms limp, eat less tired, went defecates green manure, white, some with polio.

Department took samples of the Center for Veterinary diagnostic laboratory Central, pending results.

Soon after discovery, the provincial Veterinary Bureau to coordinate with the Ha Hoa district has directed the branches and localities in the district zoning measures, stamping service; advocating people not to panic, do not hide translation and guide the farmers to take measures to sterilization, disinfection, quarantine sick birds, dead bird disposal.

The Department has issued a mask, gloves, protective clothing and to make 48 liters HanIodine disinfection in the commune.

From March 10 to 16 / 7, in the commune the Public (Ha Hoa district) appear bird mortality at 12 farms in 5 / 7 administrative area of ​​the commune, killing 1,569 birds.

Accordingly, the Department has granted 436 liters of pasteurized 7000 leaflet issued against bird flu, 400 masks, 600 pairs of gloves and other supplies and equipment to prevent spread wide.

Thus far not incurred additional dead poultry, the outbreak has been basically controlled.

Thus, to end on 19 / 7 Ha Hoa district had 2,340 sick birds. In particular, in the commune of the two sample tests on the birds killed were positive for avian influenza virus serotype H5.

Mr. Nguyen Tat Thanh, director of the provincial Veterinary Bureau, said all the dead birds were destroyed and in fact the first child will be supported 23,000 VND / child as prescribed by the Government.

Provincial Agriculture has established the Task Force implement prevention and suppression H5N1 avian influenza in the commune of the order not to limit the spread of epidemics on a large scale. /.

Vietnam: In 1 Week, 5,000 Cases - HFMD

Nearly 5,000 people infected with hand, foot and mouth
27/09/2011
According to the Department of Preventive Medicine, from day 15 to day 22-9, the number of cases of hand, foot and mouth disease has increased, from 52,300 cases to 57,055 cases of the disease in 61 localities. Thus, within a week, nearly 5,000 new cases of this disease.

Some provinces have a high number of infected limbs mouth of the week as Quang Ngai province (232 cases), Ho Chi Minh City (225 cases), Dong Thap (165 cases), Peace (142 cases), Dong Nai (215 cases) ...

Since the beginning of the day 22-9 in 2011, the country recorded 111 deaths in 24 provinces and cities. Remarkably hand, foot and mouth disease in the past week was a case of pediatric deaths in Hanoi.

This is the first deaths in Hanoi has caused a stir public opinion and force many parents worry about the possibility of spread of disease.

After the incident, the Preventive Medicine Center of Hanoi has investigated but not yet determine the source of infection.

The center also conducted taking 12 samples of picking a patient's throat (10), where the class teacher in charge of sending patients attending the Institute of Hygiene and Epidemiology is not tested and the results were handled in accordance with the outbreak.

Hand, foot and mouth disease situation in the past week also are rather serious in Bac Lieu province, Dak Nong, when a number of kindergartens have been temporarily closed.

According to the Vietnam News Agency in Bac Lieu, on 22-9, the administration Kindergarten Lieu has decided to temporarily shut down 10 days (to October 20-10) to prevent hand, foot and mouth disease for nearly 1,000 kindergarten students and youth groups are studying at this school.

Deputy Director of Preventive Medicine, said Tran Thanh Duong, hand, foot and mouth disease and gastrointestinal infection by direct contact, especially healthy people carry the infection rate high, infectious diseases are complex.

In addition, the participation of all branches and mass organizations in the prevention of hand foot and mouth disease in the locality is not positive, but mainly entrusted to the health sector to this epidemic is spreading quickly in the community.

For prevention initiative for children, parents need to raise awareness of, voluntarily implement measures to prevent and fight hand, foot and mouth disease through sanitation and clean for children.

Vietnam: The avian influenza virus variants dangerous: Press immediately after this outbreak

29/09/2011
* New virus has emerged a year

This is the only way for Vietnam to deal with avian influenza virus variants dangerous, not in the context of a specific vaccine to control.

Talking NNVN yesterday 5 / 9, TS.Van Register - Head of Epidemiology (DAH) states, the type Vigilance, timely detection and extinguishing immediately outbreak CGC is the most important measures now avian flu vaccine shot before this popular in Vietnam (H5N1 vaccines-Re5) effective virus protection for new branch is very low, almost no effect. Therefore, the Food and Agriculture Organization of the United Nations (FAO) has also obtained information from the U.S. to warn, especially in the U.S. conditions is not currently available vaccines to control this new branch virus, if the outbreak occurs, the would be very dangerous. However, TS.Ky that branching clade 2.3.2 virus is not emerging in Vietnam but was DAH closely monitored from May 9 / 2010. Clade 2.3.2 ominous is rapidly changing and developing into two tributaries are major differences in antigen: a sub division called 2.3.2-A widely circulated in almost every province, and branch called sub-2 2.3.2-B (FAO called H5N1 - 2.3.2.1) do not have effective vaccines against it are concerned FAO warned. Laboratory results of the Department of Animal Health Branch related to clade 2.3.2 viruses have shown, after the virulent intensity: 100% of chickens died within 3 days and 20% ducks died within 7 days. So can see, this new virus is toxic branches with less toxic to birds and ducks (old branch can kill 60 to 70% duck). This new branch virus currently circulating across much of North, Central Coast and Highlands alternative to the old 2.3.4 branch virus. Most recently, the Department of Animal Health has detected an outbreak of avian influenza virus clade 2.3.2 appeared in Quang Tri, Nghe An and Phu Tho. Quang Tri specifically detects bird flu in the district of Hai Lang and Gio Linh districts with more than 2,200 sick birds. In Nghe An, epidemic occurred in Nghi Loc district with a total of 1494 birds is infected children. In Phu Tho bird flu have occurred in Ha Hoa district with 1,500 children infected poultry. However, due to veterinary surveillance for early detection, focused spray disinfection in all households in the service, and also deployed more drastic measures to control the spread of disease and promotion People do not report sales or slaughtering and eating infected poultry should have controlled the outbreak, the spread. According to the FAO warned, the key issue when dealing with bird flu in Vietnam is the lack of hygiene and biosecurity on farms, from the buyers in the market and poultry, as well as in slaughterhouses. Therefore, Vietnam needs to promote improved processing and trade of poultry. Regarding bird flu vaccine, TS.Ky said, Vietnam has embarked on the study vaccine specific for the virus clade 2.3.2 branch from the past several months, but still not successful. Before this situation, the Department of Animal Health has contacted the two "great powers" for vaccine production are China and Mexico, but the results are not better. Also yesterday, Nguyen Xuan Binh - Director of the Regional Veterinary VI said, in the south has not appeared in any avian influenza virus clade 2.3.2 branch. "If the outbreak, we will address the genetic code to determine the right branch of any virus, can mutate or not to take remedial measures immediately." However, Mr. Binh has said from now until the end of HPAI (virus including new branch) will move and appear in the south by two reasons: U.S. is not bird flu vaccination phase 1 (early 2011) and cold weather combined with livestock density thicker (for holidays, New Year) should translate very easily happen. TS.Van registered, said the new DAH government would import another 60 million doses of H5N1 vaccine-Re5 still work with older avian virus clade 1 (no new virus branch of clade 2.3.2) and are concentrated in the southern province to vaccination in the future. Particularly with the new branch without virus-specific vaccines, TS.Ky warning: time in Cambodia has had eight cases of bird flu have died and in a short time. Thus, U.S. must also be careful. Veterinary Department has warned that bird flu virus and the changes can always occur, especially in the context of vaccine is not effective with the new virus branch. Source www.nongnghiep.vn

International cooperation to strengthen public health systems

September 28, 2011

By Charlene Porter, editor at the location of any IBM Digital

Washington - passed the United States and the World Health Organization to a higher level of cooperation, through the consolidation of their resources to assist other countries in strengthening the infrastructure of health for the benefit of its citizens and the rest of the world.

The two sides signed in September 19 / September in New York is officially called the "Memorandum of Understanding" to help developing countries improve their capacities in the field of public health and to achieve better compliance with international health regulations (IHR). Obama has emphasized its commitment to this endeavor in his speech before the General Assembly of the United Nations.

Obama said in his speech on September 21 / September, "we must unite our efforts to prevent, detect and combat all types of biological threats."

And the United States and WHO have a long record of cooperation and mutual support in working together to contain outbreaks of infectious diseases, and expand coverage of vaccines, and to reduce mortality rates of infants and children. Based on the official in the Office of the Assistant Secretary for the preparation of the conditions of emergency health (ASPR) in the Ministry of Health and Human Services, this agreement to raise the level of cooperation "approach adopted by the government as a whole."

Dr. Jose E.. Fernandez, Acting Deputy Director for the preparation of the conditions of emergency health (ASPR) in the global health security, "it comes to any event that may have a negative impact on public health in the world. And will form the radioactive emissions, and leaks of chemical, and outbreaks of food-borne disease , and pandemic flu are all examples of "events that have the ability to move quickly across borders and causing harm to people regardless of their nationality.

Organizations have taken an expanded form in recent years that the reason for the sudden outbreak of severe acute respiratory syndrome (SARS) and avian influenza cases, a major panic in the scope of public health, and demonstrated how you can transport systems and the expansion of globalization, the development of the disease on the path of rapid progress.

And signed a four hundred and ninety-state systems, global health, but Fernandez says that many countries need some help to raise their capacity to identify and diagnose diseases, and monitoring and follow-up, response and confrontation.

United States is working for some time to train and assist the professionals in the field of medicine from the developing world. Notably, it holds the U.S. Centers for Disease Control and Prevention (CDC) network of international centers for disease detection throughout the world to work directly with countries and WHO to strengthen capacity for disease surveillance and response. The Medical Research Unit of the U.S. Navy in Cairo has brought teams of specialists from several African countries during the panic caused by bird flu in order to train them on how to detect the disease.

Fernandez stressed that "the laboratory [Defense Department] alone and provided a massive amount of general support to countries and institutions." But the newly signed Memorandum of Understanding seeks to reach new levels in the area "to improve, enhance, and protect global health security successfully."

This new level of commitment to global health systems at the same time when the government implemented the Obama Global Health Initiative, which strives to invest in more effective health care programs. Fernandez explained that helping countries to build more capacity to meet the responsibilities imposed by the World Health systems conform with the initiative of Obama.

Fernandez added, "When we do such activities in capacity building, should be associated with the ownership of the country itself to these activities, must also be sustainable capacity, and this means that it must address the health needs of the general day to day."

WHO seeks to raise the capacity of all countries in the areas of assessment, reporting, and responding to infectious disease threats, and works in order to achieve this level of efficiency by the year 2012.

Jordan: The discovery of bird flu case [poultry]

Thursday 29 \ 09 \ 2011
A source had been discovered a healthy case of bird flu to poultry, but the Directorate of communicable diseases at the ministry of those injuries are not considered
Indication of the seriousness of the spread of the disease and is expected to be recorded in the other in winter.
The source said the bird flu committee will meet soon to discuss the epidemiological situation of the disease and prepare for any emergency
During the coming winter.

Kuwait: Preparing to Close Live Chicken Shops in anticipation of H5N1 Bird Flu

5/09/2011

And signed a maintenance contract and Beauty Landscaping in the first area
«Agriculture» of the Municipality: closed shops live chickens «avian flu» ... Beats doors


Detection Chairman and General Manager of the Public Authority for Agriculture Affairs and Fish Resources Engineer Jassim Al-Bader that the Authority addressed the Kuwait Municipality on the closure of all shops live chickens in various regions of Kuwait in the final, and in light of the confluence of indicators for the invasion of bird flu in the coming period, while will be to allow the owners of the establishment of poultry farms slaughterhouses within their farms rather than within residential areas, pointing out that the Authority has completed a full preparations in this regard from the responsibility of achieving food security.

This came during a press conference held Bader yesterday on the sidelines of a contract landscaping of the area first with the company projects the agricultural environment, and in the presence of Deputy Director General for Finance and Administration Hanadi Bastaki, Deputy Director General for Agriculture cosmetic Toufic Haddad, Director of Public Relations and Media Shaker Awad, Director Enterprises in the agricultural environment Salah Asousi.

Egypt: Disease preparations for Friday "recovery of the revolution"

September 29, 2011

Ministry of Health raised the alert in fear of any harm
The Minister of Health Dr. Ahmed Helmy willingness Jum'a recovery revolution by lifting the state of preparedness in hospitals near Tahrir Square to receive the cases that happened and also sent the letter of each Mdreatt Health Affairs to prepare Jum'a recovery revolution by lifting the state of preparedness in hospitals and departments of emergency and ambulance station and prevent the leaves.

And also be notified of all hospitals in all parts of the republic for lifting the state of readiness at the same time in anticipation of any circumstances that there are a large number of ambulances in the field of editing ranges from the 35 ambulance and there is also a large number of mobile clinics in all aspects of the field of editing has been processing of those cars in all of medicine, equipment and blood bags with a large number of nurses and the rapid deployment teams.

There is an extensive plan to secure the demonstrations by the spread of ambulances in certain areas to secure a comprehensive demonstrations of these areas to come on the Shura Council, Abdel Moneim Riad Square, and the field of Simon Bolivar.

W. Bengal: H5N1 Poultry Spreads From 2 to 13 Villages

September 20:

The directive comes after bird flu, or Avian influenza, was confirmed in two villages in Nadia district in West Bengal. Samples were forwarded to the ERDDL, Kolkata and High Security Animal Disease Laboratory (HSADL), Bhopal where they tested positive for H5 strain of avian influenza.

http://tinyurl.com/6ywmcxu

September 29:
Bird flu has struck Bengal yet again and culling of poultry birds started across 13 villages of Nadia's Tehatta I block on Tuesday.
State animal resources development minister Nure Alam Chowdhury went on a recce of the affected Tehatta I block on Tuesday. "Around 51,000 hens and ducks will be culled within a 3-km radius of the affected zone," said A K Agarwal, secretary of the ARD department, at Writers' Buildings on Tuesday. Besides culling, surveillance will continue within a 10-km radius of the affected area.
Twenty teams have been deployed for culling across the five affected panchayat areas.The hens and ducks are being buried in Lalbazar, a desolate area near the Bangladesh border. The border is being monitored to prevent the disease spreading, the minister said.


Around a month ago, there had been a scare arose in Nadia after bagfuls of chicken carcasses - which allegedly having come came from across the Bangladesh border- were seen flowing down Mathabhanga and Churni rivers. Chowdhury, however, suspects migratory birds may be behind the outbreak this time. "There is a huge waterbody in Tehatta which is flocked by migratory birds around this time of the year. They may have brought the virus."

Indonesia: Masamba, South Sulawesi Chickens H5N1 Bird Flu

September 29, 2011

Masamba – Chicken farmers in Mappedeceng and Masamba, in Luwu Utara regency burned dozens of suddenly died chickens to prevent disease spreading to other farm animals. Additionally, farmers also disinfected the surviving chickens.

Further test conducted by Veterinary Disease Investigating Center laboratory, in Maros, showed the chickens died of bird flu H5N1.

Due to the high prevalence of bird flu in chicken, local livestock service stated extraordinary event status. Officials are now isolating the infected area, dispatching officers to the field for helping farmers to control diseased chickens.

Fourth International Influenza Conference highlights gap between vaccination recommendations and practice

septembre 28 2011
The Fourth International Influenza Conference in Malta underlined the need to forge closer links between science and policy, and to address the ongoing dichotomy between the recognised need to vaccinate at-risk groups and the reluctance of individuals - including health professionals - to comply with WHO and EU recommendations.

EPHA was invited to attend the Fourth International Influenza Conference in Malta, which brought together leading scientists, academics, policy makers and industry representatives active in influenza research, vaccination, pandemic preparedness and health threats from communicable diseases.

The three-day conference was organised by EPHA member - the European Scientific Working Group on Influenza (ESWI).

As a follow-up to the discussion that took place at the First European Influenza Summit held in Brussels earlier this year, and EPHA’s ongoing work on health threats and pandemic preparedness - EPHA to the European Commission consultation on health security in the EU, and the EPHA briefing on health threats from communicable diseases, including well-prepared health systems) - the conference allowed for deeper insights and reflection on vaccination, its history and current uses, as well as on pandemic surveillance, health risk management and risk communication.

ESWI Chair Dr Ab Osterhaus opened the conference by reminding participants of the timeliness to discuss issues related to vaccination and pandemic preparedness in the light of the ongoing ’’lessons learnt from H1N1’’ evaluation, and the likelihood that another pandemic will strike European health systems in the future.

European Commissioner for Health and Consumer Policy, John Dalli sent a video message in which he stressed the urgent need for improved and equitable access of vaccines at EU level. Notably, he announced that the European Commission would present a foundation for a Joint Procurement Mechanism at the end of 2011 so that EU citizens are better protected from cross-border health threats in the future. He also said that the Commission is making an increased effort to work with the Member States and the ECDC to promote vaccination coverage, especially amongst health care workers and people at risk.

To illustrate, Dr Ron Fouchier (Erasmus MC, Netherlands) demonstrated in his keynote speech how the avian H5N1 (’’bird flu’’) virus has evolved substantially as a result of genetic variation, which had led to an increase in disease and death in Indonesia and other countries. The ability of viruses to reassort and undergo antigenic drift (the continuous process of genetic and antigenic change among flu strains) also means that the WHO needs to continuously update its database of vaccines stacks.

EPHA also participated in the new ’’science policy interface’’ made up of seven interactive sessions in which leading scientists presented the latest available data ’translated’ into policy terms by the moderators. Please find some highlights below :

SP 1 : ’’Why should influenza be a public health priority ?’’

Dr Ab Osterhaus named migrating birds as the source of most influenza A viruses, with an ever-expanding host range (e.g. dogs, horses, etc.) over the years. He also explained how international air traffic routes had compounded the worldwide spread of the H1N1 pandemic. He asked participants to ’’expect the unexpected’’ as influenza viruses could reassort and co-circulate with seasonal flu, in the process changing their virulence and acquiring antiviral resistance. He said it was not a question of whether there would be another pandemic but of when it would happen.

Dr Caroline Brown, Programme Manager at the WHO Regional Office for Europe elaborated on the WHO recommendations to protect at-risk patients (especially health care workers, pregnant women, and those aged 6-months+ with underlying chronic conditions) and presented the preliminary results of a survey on pandemic vaccination policies and coverage in WHO MS. The survey uncovered some common reasons for refusing to vaccinate, such as doubts over vaccine safety and pandemic severity, lack of health workers’ confidence in vaccine efficiency, and sketchy risk communication. The WHO would therefore place increased emphasis on targeted campaigns for risk groups, availability of vaccination, and improved communication to the public, which also included working with the media.

SP 2 : ’’Misconceptions in Influenza’’

This session served to discuss the widespread public confusion over influenza given that many other respiratory illnesses displayed similar symptoms. As a result of this, a lot of people are reluctant to take vaccines, either because they believe that they do not not work or out of fear that they will get (instead of combat) seasonal flu as a side effect. Furthermore, many people do not view the flu as a severe enough disease to worry about, especially those not belonging to at-risk groups. The session also compared the different approaches to health worker vaccination in the USA and in Europe (e.g., the policy of HCW vaccination or mandatory use of face masks in the States). The panel of international flu experts admitted that vaccines are never perfect and need to be constantly improved, however the evidence was clear that fewer lives are lost as a result of vaccination.

SP 5 : ’’Will there be another flu pandemic ? Should we be prepared ?’’

Dr Sylvie Briand from the WHO informed the participants of the lessons learnt from the 2009 H1N1 crisis for improving pandemic preparedness. She argued that overall, a broader multi-hazard approach was needed given that some actions were common to all crises (e.g., risk communication). The response to a pandemic has to be 1) sized to the threat, 2) flexible over time, and 3), preparatory efforts have to be maintained over time so that gaps do not occur, especially in economically challenging times. Given that it takes 4-6 weeks to produce a flu vaccine, it is crucial to strengthen the health system response, including the use of antivirals for which the WHO has developed new guidance. She also underscored the need to improve access to vaccines and antivirals as per the Pandemic Influenza Preparedness Framework adopted in May 2011 at the 64th World Health Assembly.

John Ryan, head of DG SANCO’s health threats unit at the European Commission traced the EU’s increased involvement in coordination measures in pandemic preparedness since the 1990s, including the Early Warning and Response System set up in 1998, and the 2005 EU pandemic preparedness plan which took into account the WHO’s revision of pandemic phases and the creation of the ECDC. The EU had a role to play in monitoring and assessment (mainly through the ECDC, which prepared risk assessments), but also in prevention and mitigation. While Member States decided their health system responses at national level, the EU provided preparedness coordination (e.g. health system response plans, hospital emergency plans). Regarding communication, the EU also had public communication plans for each phase and level, and it provided media briefing materials, and strategically deployed the ECDC and the Council’s Health Security Committee. The 2008 Council Conclusions re : upgrading pandemic preparedness planning were followed in 2010 by a call for the inclusion of the joint procurement of vaccines, which was in the process of becoming a realilty, something that had already been achieved in Asia . Ryan stressed that the 2011 Health security initiative included pandemic preparedness so that it would become obligatory at Member State level and the EU can match the legal framework of the WhO International Health Regulations (IHR).

Indonesia: Restricted Stock, Restricted Bird Flu Vaccine Help

Wednesday, 28 Sept 2011
BETWEEN - Department of Agriculture Klaten, Central Java, is now limiting the amount of aid preventive vaccine for poultry because of bird flu in addition to limited availability, as well as to prevent the farmers ask for the number of unnatural.

"Today every farmer is limited only get a maximum dose of 5000 because the number of bird populations is not proportional to the availability of a vaccine that only 400,000 doses a year," said Head of Livestock Department of Agriculture Sri Muryani Dwi Atmini in Klaten, Wednesday.

It is said, ration bird flu vaccine for this year's Klaten district that only 400,000 doses a year are not sufficient to be given to all birds whose numbers reach one million head.

The number of poultry farmers in Klaten, he said, about 1,000 people and almost all of them rely on government assistance vaccine, so that when the vaccine came, the farmers are often scrambling to get the appropriate amount of livestock owned.

"If not restricted, farmers often ask for high amounts of so many other breeders who do not miss out. Whereas the average farmer is a businessman who could afford to buy the vaccine itself," he added.

Therefore, he said, imposed restrictions on aid to equitable distribution to all farmers in this region.

Egypt: Detention of a child suspected of having bird flu Menoufia

28-9-2011

Director of Health announced Menoufia, that Khalid Ibrahim Tariq (3 years) resident in the city Menouf Menouf Fever Hospital on suspicion of having bird flu, where he showed symptoms of the disease through high temperature, sore throat and vomiting.
Dr. Ayman Omar, Deputy Minister of Health Menoufia, that a child due to mixing of dead birds as a result of education at home is safe, and was taking a sample of his blood and sent to labs central Ministry of Health for analysis were culled domestic birds and buried buried safe and vaccinate contacts of family members [?]

Egypt: Workshop to Promote Coordination Bird Flu Pandemic

Workshop to promote sectoral coordination to address the avian flu Hodeidah
27 / September / 2011
Hodeidah started today a workshop to strengthen sectoral coordination of cooperating community in the face of the implications of the avian influenza pandemic planning Office of Public Health and Population to maintain cooperation with the pandemic preparedness of the United Nations.

Seminar aims involving 40 participants from 16 governmental entity with a relationship for four days to develop plans for addressing the implications of the avian influenza pandemic and how to deal with and integrated into a unified plan and submit to the Ministry of Public Health and Population.


In the opening episode pointed Director of the Office of Public Health of the population to maintain Dr. Osman Hussein Baidhani and managing director of epidemiological surveillance and disease control, Dr. Sultan Maqtari to the importance of coordination between the relevant authorities to cooperate in the face of the implications of the avian influenza pandemic and the like pandemics, the other the fact that the bird flu cure for a disease and affect the health of society, economically and socially.

In the workshop reviewed a number of important points was the importance of strengthening ties between the actors involved to strengthen the coordination mechanism between the actors and the importance of involving the entire community to prepare and plan for the pandemic and how to involve the entire community and the importance of coordination between all sectors and preparedness at all levels locally and nationally, regionally and globally.

Also reviewed the risk caused by the outbreak of the avian influenza pandemic due to the sudden and significant shortages of personnel who are responsible for providing basic services and how to find alternatives that promote the continued delivery of basic services.

Vietnam: Distinguish the fever, foot and mouth disease virus hand rash

28/09/2011
This time in Hanoi and some northern provinces have fever virus, while the hand, foot and mouth epidemic is still in circulation. Fever, rash are common symptoms in both diseases, and the parents if no note is unmistakable.

As the recent deaths in Hanoi, she onset with fatigue, vomiting, fever and was diagnosed with fever virus monitoring. However, a day after she did not have a fever, began to appear as dotted notes rash on the hands, hand, foot and mouth suspected problems. Then the results of samples tested positive for young hands, foot and mouth virus EV71.

Dr. Tran Minh Dien, deputy director of the Central Pediatrics Hospital, said hand, foot and mouth disease diagnosis is based primarily on clinical manifestations, rather than waiting to test. So, doctor, people can even distinguish the two diseases. Specifically:

Fever virus:

- Starting from the period is 6 months old infants with fever virus, sometimes a high fever 38.5 degrees, 39.5 degrees, continuous fever. Antipyretic medication, the child support, but then fever, fever may last 2-4 days, even 6 days.

- In addition to fever, the child may be accompanied by the expression on respiratory tract infections such as cough, runny nose ...

- But in terms of the whole situation, the child still awake, playing well, examination found no signs of infection in the throat, lungs, intestinal tract ...

- After the fever, rash youth, but can the thin, scattered, but also the whole body grows, the alternating red, at least as papules, often with glands behind the ears.

- Fever virus can go away in 2-4 days. Children may have fever virus back with a frequency of 2-3 times, even 5-6 times a year.

- The disease can occur in any age.

Hand, foot and mouth

- Depending on the disease that can manifest typical or not. Children can be continued high fever 39, 40 degrees C and does not meet antipyretics, but children are only a mild fever.

For example, with fulminant disease progression is very rapid, with severe complications such as circulatory failure, respiratory distress, coma leading to death within 2-4 days. For example they can not sign a rash of unknown or only the mouth sores or symptoms of neurological, cardiovascular, respiratory, mouth ulcers, but no rash.

- However, most children will experience four stages of the disease typically include incubation, onset (fever, fatigue, sore throat ...), all development stages (oral ulcers, in the form of water simulation palms, feet, knees ...) and remissions. Also, despite being a fever but touching his arms and legs feel cold rejuvenated.

- Children often rash with fever, while virus fever is a rash after the fever.

- 3-5 days after onset, the child recovered completely without complications.

- If there are complications usually occur the first day or two things such as encephalitis (negative signs of consciousness, vomiting young paddy vomiting ...), myocarditis, tired children fainting, rapid heart beat ...

- More common in children under 5 years old, especially concentrated in the age group under 3 years.

In addition to fever virus, also need to distinguish hand, foot and mouth disease with skin rash such as:

- Allergic reactions: erythema multiforme, no water burns.

- Latex dermatitis: a red, painful, pus.

- Chickenpox: simulation of water, found in many age groups, scattered all over.

- Dengue haemorrhagic fever: petechiae, bruising of the blood, mucous membrane bleeding.

Just because some patients with atypical hand foot mouth to Dr. Case also recommended, if the fever is continuous fever despite what should be taken to the doctor immediately. It is important when children are fever, parents should not only depend on the need to antipyretics to children in an environment where fresh air, warm towel wipe the armpit, groin, forehead ... for children to reduce fever.

In these cases indicated in the treatment (only oral ulcers, and may include skin lesions), their parents should pay attention to provide adequate nutrition, nursing infant to continue breast feeding fever 6 hours one way, oral hygiene. In addition to your baby to rest, avoid excitement, again re-examined in 1-2 days 5-10 days of illness.

Besides, when severe signs such as fever higher than 39 degrees C, rapid breathing, shortness of breath, myoclonus, distressed, run more, fussy, restless sleep, coma, convulsions .. shall be re-examined immediately.

With the kids away, no re-examination conditions, with severe manifestations such as tachycardia, myoclonus, go unsteadiness, drowsiness, high fever ... the hospital will be appointed.

PositiveID Corporation Expands Its Biological Detection Capabilities to Address Avian Flu and Other Pandemic Viruses

With the Company's MicroFluidic Systems Technology, It Can Quickly and Specifically Adapt Its Platform to Test for Any Bacteria or Virus and Provide Results in Minutes
Press Release Source: PositiveID Corporation On Wednesday September 14, 2011, 4:30 pm EDT

DELRAY BEACH, Fla., Sept. 14, 2011 (GLOBE NEWSWIRE) -- PositiveID Corporation ("PositiveID" or the "Company") (OTCBB:PSID.OB - News), a developer of medical technologies for diabetes management, clinical diagnostics and bio-threat detection, announced today that it is expanding its biological detection capabilities to include the detection of H5N1, or avian flu, amid signs that a mutant strain of the deadly bird flu virus is spreading overseas. Through its MicroFluidic Systems ("MFS") subsidiary, PositiveID has the biological capability to detect virtually any virus, bacteria or toxin in an environmental or clinical environment.

PositiveID is completing a test to rapidly and cost-effectively identify the mutant strain of H5N1 and expects to have its laboratory development completed in the fourth quarter of this year. The Company has created and proven both highly modular, smart, "plug and play" components and integrated solutions for practical, high utility biological analysis applications. Its products are able to rapidly process complex samples with a high level of sensitivity and accuracy.

William J. Caragol, PositiveID's CEO, said, "Our biological sample preparation and detection platform is highly adaptable, and the process of expanding our detection capabilities to test for new viruses and bacteria can be accomplished in a very short period of time. Therefore, not only can we be ready very quickly to test for this mutant strain of bird flu, but we can be ready for future outbreaks, whether it is swine flu or some other pandemic virus. Our unique solutions reduce costs, increase reliability and produce timely results, which is of critical importance when diagnosing pandemic viruses to improve outbreak containment measures."

The United Nations is urging people to be ready against a possible but major resurgence of the avian flu. The H5N1 virus has infected 565 people since it first appeared in 2003, killing 331, according to World Health Organization figures. Since 2003, H5N1 has killed or forced the culling of more than 400 million domestic poultry and caused an estimated $20 billion of economic damage across the globe before it was eliminated from most of the countries infected at its height in 2006. According to the U.S. Centers for Disease Control and Prevention, of the few avian influenza viruses that have crossed the species barrier to infect humans, the mutant strain of bird flu has caused the largest number of detected cases of severe disease and death in humans.

[continued]

270 thousand cattle, poultry suffering from dangerous diseases

270 thousand cattle, poultry suffering from dangerous diseases28/09/2011 0:51


On 27.9, the Minister of Agriculture and Rural Development Cao Duc Phat has issued a directive on promoting the prevention of animal disease, avian end of the year.According to Play, beginning in 2011 until now, the country has 21 provinces appear outbreak of bird flu, 35 Provincial foot and mouth outbreak and 9 provinces with PRRS, making a total of 270 thousand cattle, infected poultry and destroyed. Currently the country is still five provinces where bird flu, four provinces have foot and mouth epidemic and a provincial PRRS, while forecasting the end of this year, the risk of some dangerous diseases in the animals continue to arise and spread is very high. Minister Cao Duc Phat asked the provinces to organize disease surveillance, to detect outbreaks rapidly and timely organization, not to offer spread; regular sanitation, disinfect stables farms, abattoirs, regional livestock trade, the outbreak areas and high risk areas and boosting the work of quarantine, movement control and strictly handle cases of http://www.thanhnien.com.vn/Pages/20110928/270-ngan-gia-suc-gia-cam-mac-dich-benh-nguy-hiem-28-9-2011.aspx