Tuesday, March 31, 2009

The Balita deceased the Kuantan VII Positif Flu Burung Origin

Selasa, 31 Maret 2009

Wahyu was stated positive bird flu after results of his sample that was taken some time before evidently positive. Regrettably, City Health Service did not yet get official results.

Riauterkini-Pekanbaru-Wahyu (2.9), that died last week was stated positive bird flu after the sample of his blood was accepted Health Service Provinsi Riau.


Positive him the revelation died because bird flu was sent Head of the Health Service Riau, Mursal Amir via his mobile phone. We just received the sample this morning.

Wahyu was positive bird flu, said Mursal. The temporary assumption, Wahyu was affected by the bird flu virus from the poultry that died was not far from his house.

Concerning the step in anticipation against this case, Diskes (= Health Service, ed) , continued Mursal, has collected data on people that was round Wahyu. Both the closest person and the paramedic who treated Wahyu during in the hospital.

In the meantime, Plt Kadiskes Pekanbaru, Rini Hermiyati that was contacted in the place was separated admitted to not yet getting the report produced by the sample. I still could not the report. Knew from where? , he said. If quite positive, he continued, has been protap dealt with the case of bird flu.

How if positive, or the negative. That was certain, continued Rini, while 21 days were carried out by observation for people that had been round Wahyu during still lived. The certain number, I did not know. From the close family had 6 people.

That not to mention from the paramedic RSUD Arifin Ahmad, he added. Did not close the possibility, these people suffered the sign was the same as Wahyu.

Rini like definitely was not yet there are those that had the hot and feverish sign high although he could get the report. The sign, yesterday was available... Later I asked previously that the observer, said Rini without continued said-he said .
hat-tip Dutchie

[Here is part of the above article, I ran thru QDT]:

Meanwhile, the Plt Kadiskes Pekanbaru Rini Hermiyati that connected in room apart/isolated
confess not yet get report outcome same. "I not yet can report to know of what type or kind?," he said.

When certainly positive, next as continued, already there is permanent procedure for handling bird flu patient cope with cases flu burung.

How so if positive, or negative. Who certain, continued Rini, as long as 21 days carried out observation for people that have be in surrounding area Wahyu when still to be alive. "total number certain, I not know. From family near there is 6 people. Not yet more from paramedic RSUD Arifin Ahmad," he added.

Not close prospect, people aforementioned suffer symptom like Wahyu. Rini as not yet definite there is that to have symptom hot and fever high even though he have a chance to get report. "Indication, yesterday there is...Presently I question earlier who monitoring," said Rini without continue word he said.

Monday, March 30, 2009

RSHS Kembali Merawat Pasien ”Suspect” Flu Burung RSHS,

On Tuesday, March 31 2009
the Handsome Sadikin Hospital (RSHS) again treated the patient suspect bird flu, that is RA (27), the resident of the Sand Village of RT 02/RW 05, Street.
Key sand to the Sarijaya Village, Kec. Majalaya, Kab. Karawang. Beforehand, RSHS treated the patient suspect bird flu, UR (23), the resident of the Hill of Pelamunan Bekasi.
RA entered isolation space around struck 20,00 WIB, on Sunday (29/3), because experienced breathless and feverish.

RA could get the maintenance in the Clinic of Dewi Sri Bekasi, before being reconciled to RSHS. Menurut the wife of the patient, Raisem (40), worried terjangkit the bird flu virus, RA was treated in RSHS. Terlebih, there was the RA story experienced direct contact with the poultry. He explained, his 4 property chickens died suddenly, even so several tails of his neighbouring chicken experienced the similar matter. "This month of many chickens in my area died suddenly." Therefore, when the husband was sick, immediately was brought by me to the clinic to be checked, he said. Was different from RA yag had the story brought by me to the clinic to be checked, he said. Was different from RA yag had the story of direct contact with the poultry, UR on the contrary. Moreover the father UR, Sardjo (67), did not yet know the illness what actually was suffered by his daughter. UR underwent the maintenance since Tuesday (24/3), after receiving reconciliation from RS Medirossa Cikarang, Bekasi. According to information of Dr. Hadi Yusuf, the doctor who handled UR said, there was the affected assumption of dengue fever dengue fever (DBD), bird flu, and the compilation of the lungs. When arriving in RSHS, Hadi explained, flu that was suffered by UR was serious enough. Besides this, the RS Medirossa side that reconciled UR to RSHS also asked that this patient was treated in Flamboyan Space. Whereas the team's member penangganan suspect RSHS bird flu, Dr. Uun Sumardi that was met by the reporter, on Monday 30/3), said, the two patients were still getting the intensive maintenance and his condition began to be stable. This we were still being waiting for results of the laboratory of the hall of the central inspection (Jakarta), after we sent the sample of the patient's blood, he said.
Was difficult the difference of the behaviour In the meantime, Section Head Peternakan and fisheries (Disnakan) the Bandung Regional Government, Ernawan Santika that was met "GM", on Monday (30/3), said, changed the behaviour of the community was one of the main hindrances in pressing the spreading of bird flu in the Kab territory. Bandung. At first, since long ago the community could not have been separated from the poultry. The "maintenance" of the "good poultry," including the pen and the environment around it, could press the spreading figure" of the "bird flu illness." Unfortunately, the behaviour like this, not yet all the communities carried him out, he said. According to Ernawan, from the data in 2008, the poultry population in Kab. Bandung around 5,495,853 tails. "On the other hand this number was good because the poultry became supreme the economy" of the "community."

But on the other side meant the impact of the spreading of bird flu was very high, he said. To control the spreading of bird flu, continued Ernawan, his side already has carried out various programs, including forming the PDSR Team (Participatory Disease Surveillance and Response). The team that consisted of the doctor and this paramedic, to respond since early the spreading of bird flu in Kab. Bandung. "Since being formed by this team in 2006, praise the Lord the spreading" of "bird flu could be pressed," he acknowledged while adding, this team also involved the community. Said by Ernawan, although having the case of bird flu, but up to now in Kab. Bandung had never had fatalities. "In Kab." Bandung had never had fatalities. "In Kab." Bandung had never had fatalities, he said.

Ha Tinh: Bùng of disease described in pigs

March 30, 2009 Tin Xã Hội , Xã Hội March 30, 2009 Social News, Social

Have hundreds of pigs in Quang Cam, Cam Xuyen district, Ha Tinh tả infected and died than in bulk over a week.

Outbreaks began to appear from the farm family's Nguyen Thi Yen in 1 with 92 pigs died. Next, to 28 / 3, in the farm family's Tran Thi Bich, thôn 4, appear to 11 infected pigs and more. Animal health agencies and local government have emergency move all of the pigs destroyed to prevent disease to spread on a large scale.

Pham Thanh Binh, Director Department Animal Health Department of Ha Tinh, said the agency is directing the emergency destruction, regional dập and fold in place, spraying chemicals in the target, killing at places found disease. Sector also created animal quarantine core, prohibits the slaughter, transport, trade sick pigs to other areas, and urgently to statistical support for raising the level of VND 10,000 per kg pigs quite extinct.

On May 2, 2000, and also Bùng play here more than 200 pigs died. Many people brought pigs die in beach dispose of garbage in the situation that makes environmental pollution around the region become more severe.

Egypt Air warns of polio virus

Monday, March 30, 2009 - 11:05

أ Sent the Department of the Ministry of Health Quarantine of the General Department of quarantine in Cairo air a list of African countries and others, warns that all medical workers to quarantine the implementation of all measures of preventive health-vaccinated children from the surrounding countries, Arab Republic of Egypt, once the port of arrival and the Cairo International Airport.

ي The list included the following States, "Pakistan, Afghanistan, Nigeria, Sudan, India, Niger, Benin, Burkina Faso, Mali, Togo and Kenya"; and Dr. Ibrahim Hassan Shaban, director of the quarantine port of Cairo's air, to all workers to vaccinate children from the States mentioned statement to the age of 15 years.

28 susp

الأثنين، 30 مارس 2009 - 10:38
Monday, March 30, 2009 - 10:38

Increasing incidence of avian influenza Menoufia

Dr. Ahmed Fouad, director of Veterinary Medicine Ghneim Menoufia, the inventory of some 28 cases of suspected infection during the month of March, according to the statistics of the Committee to Combat Bird Flu in the Office of the province, including one case of positive girl Habiba Mahmoud Mohamed Mahmoud (18 months) metropolitan district Mnov Center, which corresponded to the recovery and left hospital two days ago, the Tamiflu drug, and returned to her home after receiving treatment for the exercise of their natural lives.

The WHO has chosen the province of Menoufiya best to fight the disease control program, and asked to distribute it to all provinces to adopt it in the announcement of the transparency of information and situations and full coordination between all stakeholders of the disease, health, agriculture, veterinary medicine and the local units, in addition to the security agencies to control to the vehicle, the transfer of birds and licenses necessary to prevent the spread and transmission of the disease from province to province, in addition to leading a program to educate rural women and the people, especially in villages, on the nature of the disease and methods of prevention.

Recombinomics: Novel Clade 7 H5N1 Cleavage Sites Raise China Concerns

Recombinomics Commentary 21:19
March 30, 2009


The novel HA cleavage sites in the recently released H5N1 clade 7 sequences from northern Vietnam are cause for concern. The isolates from Vietnam are most closely related to clade 7 sequences from Shanxi and Hunan in China. All have the same basic cleavage site REGGRRKR. However, the two isolates from Vietnam have added an R to produce a cleavage site that is REGGRRRKR. This additional basic amino acid may make the H5N1 more virulent and expanded tissue tropism, because the cleavage is facilitated by tissue specific proteases and the extended cleavage site may offer additional specificities. Moreover, the most recently released sequence, A/chicken/Vietnam/NCVD-03/2008 has duplicated the firts two positions to produce an even larger cleavage site, REREGGRRRKR, which may be linked to even greater virulence and tissue tropism. This isolate also has an upstream 3 BP deletion, although neither recent isolate from Vietnam has the 3 BP deletion identified in the clade 7 isolates from Hunan and Shanxi.

This increase in genetic instability is likely linked to recombination driven by vaccine escape. The latest WHO update on vaccine targets notes that the two isolates from Vietnam were antigenically distinct and both were chosen as clade 7 vaccine targets, even though both came from 2008 Vietnam isolates. Selection of clade 7 vaccine targets is limited by the withholding of clade 7 sequences. China has yet to release sequences from the January cases, even though the sequence of A/Beijing/1/2009 was discussed in media reports in January. The WHO update was glaringly silent on this case, which was the first in the series of nine confirmed cases in China in January, which abruptly stopped in February.

China has acknowledged that the poultry outbreak in December, 2008 was clade 7, which created vaccine resistance problems, leading to new vaccinations in adjacent areas. However, the human cases were widespread throughout China, raising concerns that vaccine resistant H5N1 extended beyond provinces adjacent to Jiangsu. This is supported by the recent clade 7 sequences from Vietnam, which have a large number of non-synonymous changes that would compromise prior vaccines. Moreover, it is not clear that clade 7 is included in vaccines in Vietnam, which would facilitate H5N1 spread and instability.

Release of recent H5N1 sequences from patients and poultry in China and Vietnam would be useful.

RSHS treated two patients the Assumption of Bird Flu

Senin, 30 Maret 2009
BANDUNG - The Hasan Sadikin hospital (RSHS) Bandung again treated two patients who were expected experienced suspect Avian Influence (AI) alias bird flu. UR (23), the resident of the Pelamunan IX Hill, Bekasi was before treated in Poinciana Tree space, RSHS since last March 24. UR was treated after experiencing the breathless and feverish sign high. Now, one other patient, R (50), the resident of the Village of key Sand RT08/RW03, the Sarijaya District, the Majalaya Subdistrict, the Karawang Regency, was treated in Poinciana Tree space since March 30. Raisem (40) the wife R said, before being treated in RSHS, casualties could be run off with to the Lamerta Clinic and RS Dewi Sri, Kabupaten Karawang. However, on reconciliation of RS Dewi Sri, casualties it was recommended immediately were run off with to RSHS because this RS did not have the implement to merwat the assumption patient suspect bird flu. The "side's RS words, was seen from his signs, the temporary assumption was affected by bird flu." But the doctor here (RSHS) did not yet give information anything, explained Raisem when being met by the reporter in the Poinciana Tree waiting room, on Monday (30/3/2009).

According to him, two weeks before his husband showed the sign of bird flu, the poultry around his house many that died suddenly. Kluarganya personally maintained seven chickens, four including dying suddenly some time before. He admitted that his husband carried out direct contact with the poultry that died. "After the chickens died, my husband exiled him to the time." In our village many that died suddenly because of my neighbour also many that maintained the chicken, he said. He said, initially the family was not suspicious of this incident. His article, after experiencing the fever and breathless, casualties could recover several days before finally showed the sign came back. Raisem said, his husband only showed the breathless and feverish sign, without being accompanied unconscious.

According to him, there was no other resident who experienced the similar incident like his husband. Raisem hoped, results of his husband's check-up did not show the impact that bruruk. "I only submitted what results" of the "doctor's inspection, but yes hopefully the assumption was untrue," hoped he. At this time, said he, was carried out by spraying anti AI in the Sarijaya village.

In the meantime, the chairman of the team of the control doctor of RSHS bird flu, Hadi Yusuf said, the two patients were treated by the reason contracted the illness with signs of bird flu. However this matter still could not diapstikan. His article, the blood inspection of the two patients maish continued to be carried out by the team of the doctor. "Sample blood of one of the patients has been sent by us to Jakarta to be checked." The temporary assumption, the first patient contracted DBD. Sedangkan the second patient did not yet go out results, explained Hadi.

Human bird flu outbreak: lack of exposure to primary medical problem, such as old

More on this case:
Human infection of bird flu reported in central China

BEIJING, Jan. 31 (Xinhua) -- A 21-year-old female farmer was confirmed as infected with bird flu in central China's Hunan Province, said the provincial health authority on Saturday.
The patient was found sick on Jan. 23 and hospitalized on Jan. 26. So far she has been in stable condition and recovering.
http://news.xinhuanet.com/english/2009-01/31/content_10741532.htm





March 30, 2009
Source: "Chinese Hospital" magazine Author: Liu Wei Xiu Jinlai

Editor's note: in January this year, before and after our country people confirmed eight cases of bird flu. In 2008, however, total number of reported cases only three cases.
Human avian flu disease outbreak-intensive, so that groups of infectious diseases suddenly serious situation.

As with many infectious diseases, there is the fear of bird flu virus is still unknown from it. "Atypical pneumonia" after the country set up a public health emergency response system, the frequency of bird flu virus attack, and finally there is the opportunity to let the system from paper directly to accept the reality test.

However, in this life to eight patients with final exams for the price of life and death, we found that the original was the emergency system Chao-Gang奉若did not seem the United States, not only failed to resist the brute force approach of avian flu virus, it has been revealed dislocation at the system, such as primary health care of old vacancy problem.

Battle xupu

Health Bureau and the CDC, two of infectious disease reporting system at the requirements and have a dislocation between reality, so that the people溆浦县hospital dilemma.

If it is not because of bird flu, should flower舒荣anonymous work or a sister. Chinese New Year this year happened to go home, let her out of one accident many hats - Human bird flu.

Flower舒荣Xiangxi溆浦县at home, rolling mountains and the people are mixed poultry paradise for generations. There will always nameless chickens and ducks died, the locals used to dying poultry board made of chicken slaughtered in advance pressed salted duck, eat or keep guests.

On the eve of Chinese New Year, Back from Guangzhou Flower舒荣homeland, the village poultry are once again beginning of life and death cycle of her own chickens and ducks have also been involved. In order to avoid all the dead chickens and ducks, she helped kill chickens ducks at home. New Year's Eve, two days before the beginning of flower舒荣fever, by the village barefoot doctor has not improved after treatment, his condition舒荣spend more and more weight, accompanied by their families, the people in the New Year's Day arrived溆浦县hospital.

Unexpected virus

"If the first two days of the morning did not come DENG Hong-hua hospital rounds, the patient was perhaps a missed diagnosis."溆浦县Liu Xiaopeng, vice president of People's Hospital, a lingering fear.

January 26 (New Year's Day) afternoon, the hospital treated up to a temperature of 40.06 ℃ flower舒荣. Liu Xiaopeng knew this day patients, the doctor on duty told him the phone, patients with serious and difficult home, proposed to allow transfers. Liu Xiaopeng did not agree to require a doctor first checks the basic condition to make a decision after the master clear.

舒荣reception flower has two doctors for her to do the routine and chest CT. CT film shows that there is one-third of patients with right lung is changed, there is also left scattered infiltration point - with severe pneumonia, common diseases, because doctors did not particularly care about.

January 27 (the two early) morning to the hospital within two rounds DENG Hong-hua, director of Flower舒荣look at medical records and found a strange phenomenon: the past舒荣Healthy flower, blood does not clear, as with the chest, interleukin value has declined. DENG Hong-hua was aware that it is virus infection.

"The First People's Hospital of Huaihua just a person who died of bird flu patients, the clinical manifestations舒荣flower like the disease, severe, such as low blood and poultry from infected areas, in line with unexplained pneumonia, diagnostic criteria, which are caused by I attach great importance to the main reason. "DENG Hong-hua memory.

Subsequently proved that the DENG Hong-wah on high alert, for the successful treatment舒荣key step in laying a flower. By asking, DENG Hong-hua舒荣flower was found to have a history of exposure to poultry, there is all the more disturbing her mind immediately reported to the medical quality control phone chief Leung Yeung Chau.

Yeung Chau Leung clearly remember the time the call is at 11 o'clock on January 27 many. "I see patients go to the wards and at the same time to report to the Vice-President Liu Xiaopeng." Leung Yeung Chau of "Chinese Hospital" journalist said: "Although people Having never been involved in avian influenza, but I highly doubt that this disease . "

On the eve of Chinese New Year, the Board requested溆浦县area health care institutions each day零报告制度report all diagnosed cases of pneumonia of unknown causes, must be submitted in strict accordance with the provisions, in particular, people should pay attention to avian flu. Hospitals meeting stressed the need to pay attention to cases of pneumonia of unknown causes. Since the outbreak of the hospital Rapporteur vacation, Liu Xiaopeng on the job as temporary. Received a phone when exactly Liu Xiaopeng and Liu County Health Secretary million conversations at work, they immediately reported orally.

Very nervous the next time. 12:00 the same day, the hospital organized a large hospital consultation, the view that the consultation: the diagnosis of severe pneumonia in very clear, consider belong to virus infection, people do not rule out avian influenza, pneumonia of unknown causes in line with the conditions reported. 1 hour later, doctors from the Health Bureau溆浦县shares lead organization governance County People's Hospital, the county and the county hospital of Chinese medicine experts CDC's largest county consultation, consultation findings.

However, the problem out quickly.

According to the procedures, the people溆浦县hospital within two hours in the Chinese Disease Control and Prevention through the information system directly pneumonia of unknown causes at the network's medical history reported to flower舒荣situation, Liu Xiaopeng has a dilemma. "Although the CDC under the Public Health Bureau, but also its own system. The results of consultation, the County CDC CDC immediately reported to the city, the provincial city of CDC CDC also reported phone. Provincial CDC requirements At our 2 hours at straight. But the views of the county health bureau, the first under the Huaihua溆浦县Municipal Health Bureau reported that the request of municipal experts from consultation, if people do not rule out bird flu, and then reported to straight. Administration of the Department of Health to consider many aspects, but the CDC's report, I did not dare go against. "

Health Bureau and the CDC, two of infectious diseases reported to the system with the reality at the wrong leads. This leads to the multi-management issues, so that confusion Liu Xiaopeng.

15:00 the same day, the hospital network in accordance with the requirements of direct reports finish. At this point, the county collected in patients with CDC were car-related specimens sent to the provincial capital Changsha. Health溆浦县put forward at that time, county CDC did not according to plan, submitted too soon, fearing a negative impact on society.

Our source has told,溆浦县Health concerns also received from the stress, "The First People's Hospital of Huaihua recently the case of reception from the people in Guizhou imported cases of avian flu to hospital with severe pneumonia admitted to hospital . Later, in line with the hospital found that patients with the diagnosis of pneumonia of unknown causes, then we have to ask the province of the expert consultation, and reported to the relevant state department. Leaders at all levels, experts come to the hospital an additional workload, from the reception to the death 4 days, the hospital received more than 10 million fee to spend the money.老少边穷region for medical institutions, are spending a small fortune. With the warning, the more inadequate funding for health authorities to溆浦县say, natural to consider their own capacity, hoping to wait until municipal expert opinions issued after more precise Direct Network Report. "

Huaihua City Health Bureau convened the Expert Group was rushed to the emergency xupu. To the way traffic when the city of Huaihua, vice president of First People's Hospital, Department of Respiratory Medicine贻秋Zhang suddenly think of the experts, that the hospital in the rescue of people in Guizhou input of patients with avian flu, the Ministry of Health experts in the treatment of people brought about by the effects of avian flu drug Tamiflu has not yet run out, they immediately ordered the driver make a U-turn, back to Huaihua taking Tamiflu.

Until 6:30 p.m. that day, the Group 3 and his people finally arrive xupu. After consultation, the Group believes that the people溆浦县hospital diagnosis of "well-founded", the diagnosis is still considered a severe viral pneumonia, a high degree of people suspected of bird flu, but the department must wait until the test results superior to the final diagnosis.

Yeung Chau Leung explained that "people because bird flu finally diagnosed the country required the test results issued by CDC, even if there is no diagnosis of Hunan Province right to CDC. The city of the expert group decided to isolate the bird flu in accordance with the treatment of people, brought from the Huaihua preventive medicine Tamiflu has also been applied to patients and nursing staff. "

"The first suspect, the first report, the first treatment, the first referral," the management of a social capital by the creation of county-level public hospitals in the treatment of bird flu person's "4 the most."

The turbulent transfer

"Patients with serious illness, we do not have ICU wards, there is no breathing machine, but there are no special medicines. In accordance with the provisions of Department of Health Administration, critically ill patients should be referred to the three-hospital treatment." Liu Xiaopeng said.

"If bird flu are people, belong to Group B of infectious diseases management, in accordance with the provisions of the spot should be treated in isolation. If the person is not bird flu, the city can receive this one hospital patients, but pre-medical costs 100,000 yuan. "The First People's Hospital of Huaihua insist.

Consultation to discuss at the meeting, the two hospital because a dispute over transfer problem. More difficult is that I heard at another hospital to pay 10 yuan, after lying in the intensive care unit舒荣Flower depression, begin to resist treatment, "not to die."

"Take care of patients with small loss of her mother, grew up and has been out working hard to make a living at home, admitted only 1,000 yuan to pay the money to be spent CT on 270 and there is no ability to renew. If people are not suffering from Avian influenza, severe pneumonia, often hundreds of thousands a few hundred thousand dollars of medical expenses, home can not stand. "DENG Hong-hua was the scene memory.

Costs, about a flower舒荣can achieve transfer. Close to midnight, the two sides are still unable to reach an agreement, decide to wait for test results issued by the provincial CDC after consultation.

Well settled experts, Liu Xiaopeng deep shallow kick back kick to hospital. A few hundred meters of the road, he kept thinking of things to do after dawn: Human bird flu, if not, insist on the transfer; people if the bird flu are on the arrangements of the other two branches of patients with metastasis, and stop receiving new patients .

January 28 (the beginning of the year three), transfer to other hospital patients are busy, the second舒荣flower CT results are in: The right lung is the change from one-third into a two-thirds of the left lung infiltration by point into a sheet, his condition markedly increase. DENG Hong-wah said: "The overall impression is that patients with symptoms and signs do not obviously change, but the results of examination to change very rapidly."

Noon, Hunan CDC reports first results of testing negative, continuing the dignified atmosphere for a long time to relax a bit first. However, the provincial CDC also stressed that for caution's sake, have to wait for second, third test results. Prior to worry because there is no valuable specimens collected from Huaihua City CDC collected samples are being sent to the third way in Changsha. 16:00, Huaihua City Health Bureau and the Government溆浦县xupu at a joint meeting,

City Health Secretary raised the tension out, the Government attaches great importance to pneumonia of unknown causes, not only medical problems to consider, we must also consider the social impact. Regardless of whether patients with avian flu patients who are transferred must do its utmost to treatment.

First off the voice, the silent hall.

Ultimately, the deputy governor of溆浦县position, cost of treatment by the government to advance, but no time 10 million settlement of batches required, Huaihua City, First People's Hospital also, where necessary, agree to receive a flower舒荣. During a meeting of the Hunan province Telephone CDC informed that the second time the test results remain negative, and the atmosphere was relaxed again. Since members of the Group are the backbone of hospital, they run at night after supper Huaihua back.

"Oh, no, it is positive!" 9 o'clock that evening, the third director of the city of CDC CDC received a call from the province, immediately facing the rest of the people are ready said, relaxing atmosphere have been put back again nervous. Tension Phone orders go out immediately on the road at top speed back to the experts. After a moment, then called the Ministry of Health related to the leadership of the phone call will be transferred to patients located in Changsha Xiangya Hospital of Central South University.

January 29 (the beginning of the year four) shortly after midnight, Liu Xiaopeng怀揣him to the county civil affairs bureau 40,000 yuan of medical expenses, led by the people溆浦县hospital medical staff, composed of the best escort team fell Changsha .

No less than the ambulance ride because all the staff, temporary requisition Escort Group Secretary for the county health official cars and an ambulance on the arrangements at the two drivers take turns driving. "City Health Secretary is very concerned about the situation on the road, asked me to call every 1 hour is necessary to report the situation, I do not sleep chant." Liu Xiaopeng excited, more nervous.

"Fortunately, patients can still remain relatively stable body temperature gradually decreased at all the way. Because we found that early and get treatment early, and younger patients with strong resistance, at that time I will definitely be on the estimated cure patients." At the end of the first 7 calls, the escort vehicle group arrived in Changsha, Liu Xiaopeng raised his arm, watch the 7:00 point. Xupu at this time, but also一夜无眠.

达湘雅the hospital, the perianth舒荣specialized in the hospital setting for treatment of human avian influenza wards. Xiangya Hospital spokesman, medical director of mine told Sinorama "Chinese Hospital," in January 2009 because of bird flu person-frequency hair, Xiangya Hospital before the Chinese New Year on the establishment of the relevant expert groups, medical groups, nursing groups and disinfection isolated group, and, in particular, a vacant 50-bed ward, as a ward for treatment of bird flu person.

Xiangya Hospital Consultation Group of Experts found that flower舒荣not only damage the lungs, but also appeared in the liver and heart damage, they used to support therapy for the treatment of organ protection. After 20 days of hospital treatment, the disease gradually舒荣smooth flower until cured.

hat-tip Florida1

Recombinomics: Unstable Clade 7 H5N1 In China Raises Concerns


Commentary


Recombinomics Commentary 10:34
March 30, 2009

A recent clade 7 HA sequence from a chicken in Vietnam, A/chicken/Vietnam/NCVD-03/2008 was released at Genbank under the title, "Characterization of a highly pathogenic avian influenza H5N1 sublineage in poultry seized at ports of entry into Vietnam". It was proposed as a vaccine target in the recent WHO update because it was antigenically distinct from another recent clade 7 target, A/chicken/Vietnam/NCVD-016/2008, which was isolate in northern Vietnam near the border with China. Both of these sequences have a cleavage site similar to clade 7 isolated in 2006 in China, except the cleavage site has a 3 BP insertion, encoding for an additional basic amino acid.

However, the recent sequence also has a duplication of sequences encoding the two amino acids at the beginning of the cleavage site, creating the novel cleavage site, REREGGRRRKR. The sequence also has an addition 3 BP deletion, which is distinct from the 3 BP deletion found in earlier clade 7 isolates from China, as well as clade 2.2 isolates in Egypt.

The selection of two 2008 clade 7 targets from Vietnam is unusual, but follows a spate of cases in China in January. These cases followed confirmed clade 7 outbreaks in poultry in Jiangsu in December, 2008 and strongly suggest that most of the human cases in China were clade 7.

The sequences form these patients have not been released and have only been described in general terms in reports from China. The WHO report was silent on all cases from China except for two that were the Fujian strain (clade 2.3.2 and 2.3.4), further supporting concerns that vaccine resistant clade 7 is widely circulating in China.

The recent sequences from northern Vietnam demonstrate considerable genetic instability that involves a large number of non-synonymous changes as well as insertions and deletions in the HA sequence.

Release of sequences from the Jiangsu poultry outbreaks in China, as well as recent human cases in China and northern Vietnam would be useful.

Media Links

Suspected Cases Of Bird Flu Infection In Dakahliya .. The Girl Recovered and the Detention Of 3 In Menoufia

Ghada wrote Abdalhafez and Hind Mohamed Hamdi Ibrahim, 3-30-2009

Mansoura Chest Hospital was arrested yesterday on suspicion of two cases with symptoms of bird flu disease bird: the Marwa Ahmed El-Shahat «22 years», housewife, from the railway Sndob Egypt, Mohamed Diab transfer «18 years», a fisherman, from the rain, showing signs of illness Avian influenza.

In Monoufia detained Shebin hospitals and educational Echmoun year 3 new cases of two women and a man on suspicion of contracting bird flu after they showed signs of illness: the hopes Labib Abdel Rasul «20 years», housewife, from the village of Mit Siraj Bakuesna, Mr. Hassan «30 years »from the village of Essam Manshiyat Center Shebin, and Jihan Abdel Aziz al-Sharif on the« 28 years »from the village of Alnanaip Echmoun Center and found that the cause of injury due to the breeding birds in the house. The Committee of Veterinary Medicine culling poultry infected with the three houses had been buried in a safe, taking samples and sending them to the central Ministry of Health laboratory for analysis.

On the other hand, I left the girl Habiba Mahmoud Mohamed Mahmoud Bakry Cairo hospital and returned to the village the status of metropolitan Mnov after recovery from disease, avian flu, Dr Ahmed Fuad, the director of the Directorate of Veterinary Medicine, visit and check on their situation to make sure to recover, as was the case only positive During the month of March in addition to the 28 cases were the result of suspicion analyzes negative.

In Qena, culled teams fight bird flu the Directorate of Veterinary Medicine in coordination with the Investigation of Supply 800 birds Samala Abushok village and the scarcity of the sterilization of 32 houses after the deadly avian flu.

4 farms were closed as the status of birds in Esna to work without a license are: farms «King of the cheap Nasser» and «Mr. Mahmoud Mansour» and «Hamid Mohamed Salah» and «Cila Azmy Sefen» 2800 birds were culled these farms and the issuance of the decision to close them, in addition to subject to the closure of 16 birds and Naga Hamadi, Qena and Esna to sell live birds in the assignee without a license.
hat-tip Dutchy

Lao province at risk of bird flu outbreak

2009-03-30 16:27:52

HANOI, March 30 (Xinhua) -- Many areas of Phongsaly province of Laos are at risk of infection from the H5N1 bird flu virus as local people are continuing to bring in poultry and eggs illegally from neighboring countries, the Lao newspaper Vientiane Times reported Monday.

Provincial authorities find it hard to identify when and where there's a virus outbreak as people can walk or drive across and engage in casual trade of poultry easily at border areas without checkpoints, said provincial Livestock and Fisheries Deputy Head Somnith Keoboun-ngune.

Last month there was an outbreak of the virus in Khua district, Phongsaly province. Now the outbreak is over and the district was declared bird-flu free today, said Somnith.

To prevent the spread of the virus to other districts, the provincial avian influenza control committee together with district and village committees culled about 2,600 poultry in 11 villages and set up checkpoints, said Somnith.

The provincial livestock and fisheries sector will work with the sectors concerned in leading a public campaign about bird flu, said Somnith.

Suspect Flu Burung Asal Karawang Dilarikan to RSHS

Senin, 30/03/2009 11:25 WIB

Bandung - A resident of the Pasir Konci Desa Sarijaya Kecamatan Majalaya Kabupaten Karawang Village, R (50) was suspected of contracting the bird flu virus. R entered RS Hasan Sadikin struck 20,00 WIB, on Sunday (29/3/2009), on reconciliation from the clinic of Dewi Sri in Karawang.

According to the wife R, Raisem (40), on Saturday (28/3/2009), R natural the fever and breathless.

Then R was carried to the Ramerta clinic and was reconciled to the Clinic of Dewi Sri.

The "doctor's words in the Clinic of Dewi Sri, there were the sign" of "bird flu but still could not be ascertained because enggak had his implement," he said in RSHS, Street Pasteur, on Monday (30/3/2009).

Initially wanted to be reconciled to RS in Jakarta, but because of getting the news was full, finally R was reconciled to RSHS.

Raisem explained before natural the fever and crowded on Saturday (28/3/2009), his husband could then experience the fever and crowded a week beforehand that is on Saturday (21/3/2009).

However on Monday (23/3/2009), the fever and crowded him recovered again.


Raisem said for the last two weeks, many chickens died suddenly in his village. "My four property chickens died suddenly."

Have the neighbour also many, there are those that five, there are those that 10 tails that died, obviously him.

Raisem admitted to having seven chickens and four died suddenly. He claimed to be the number of chickens died that did not make himself and the other resident suspicious.

Raisem then claimed did not report to the local livestock breeding service. "My husband who experienced this, that was other enggak," said he. (ern/ern)
hat-tip Dutchy

Sunday, March 29, 2009

Norovirus Outbreak Sickens 100 Students, Shuts Down Massachusetts College


ShareThis

March 29, 2009 1:02 p.m. EST

Windsor Genova - AHN News Writer

Wellesley, MA (AHN) - One hundred students of Babson College in Wellesley, Massachusetts have suffered from norovirus gastrointestinal illness prompting school officials to shut down the institution on Saturday.

The infected students suffered from nausea, vomiting and diarrhea. A few severely ill students have been hospitalized so they can be intravenously rehydrated, Shepard Cohen, the health board chairman, told Boston.com.

Mary Suresh, director of the Wellesley Health Department, said the college may reopen on Wednesday.

Dr. Alfred DeMaria, state epidemiologist, said in a news conference at the department that the source of the outbreak on Wednesday has not yet been identified, according to Boston.com.

Meanwhile, precautions to prevent the spread of the virus have been taken. Classes and campus activities have been suspended. Students living on campus have been told not to leave school. Maintenance staff are sanitizing campus facilities and students have been provided with cleaning supplies to clean their rooms.

Health workers told to monitor rural China to prevent HFMD

2009-3-29 CHINA'S Health Minister Chen Zhu urged grassroots level medical staff yesterday to fan out across the countryside to detect and prevent cases of hand-foot-mouth disease (HFMD), which has killed at least 19 children this year.

The staff should visit every village and even every household to detect HFMD quickly, he told a tele-conference of disease prevention in the central provinces of Henan and Hubei and the eastern province of Shandong.

The ministry said 41,846 cases of HFMD had been detected by March 27 in 30 provinces and regions, except Tibet. Most cases were in rural areas.

In Shandong's Heze City alone, the disease killed five babies in the week ended yesterday.

Chen urged local health authorities to report cases promptly to the ministry and take effective measures if an outbreak occurred or seemed likely to occur.

Experts should be sent to areas with a high incidence of HFMD to offer help with treatment, and training of local medical staff, he said.

The Health Ministry established a work team headed by Chen and Vice Minister Ma Xiaowei to oversee prevention work.

According to the ministry, HFMD can be caused by a host of intestinal viruses, most commonly EV71.

HFMD usually starts with a slight fever followed by blisters and ulcers in the mouth and rashes on the hands and feet. Those with EV71 often show serious symptoms. HFMD can also cause meningitis, encephalitis, pulmonary edema and paralysis in some children. There is no vaccine.

PRO / RUS> virus influenza A (H1N1), resistance to ozeltamiviru (02): northern hemisphere

Archive Number 20090327.71213
Published Date 27-MAR-2009
Subject
Influenza virus A (H1N1), resistance to ozeltamiviru (02): northern hemisphere
************************************************** ***********************

Date: March 27, 2009
Source: WHO: Epidemic and Pandemic Alert and Response (EPR), influenza, March 21, 2009 [translation edited with English site ProMED] [Moderator NP]
http://www.who.int/csr/disease/influenza/H1N1webupdate20090318% 20ed_ns.pdf

Influenza virus A (H1N1), resistance to ozeltamiviru (02): 2008/2009 season, northern hemisphere
-------------------------------------------------- ------------
Within 1-4 weeks (December 28-January 24, 2009), the total level of flu activity in the world increased.

Most European countries have reported regional or widespread activity of influenza viruses with a dominance of influenza A (H3).

On the widespread activity of influenza A (H1 and H3) was reported from Japan.

In Canada, Hong Kong, the United States influenza activity also increased, but remained relatively low. Sporadic incidence of influenza was observed in Brazil (A), Croatia (H1, H3, B), Greece (H1, H3, B), Iran (H1, H3), Mongolia (A), Portugal (H1, H3, B), Serbia (H1, H3, B), Singapore (H1, H3, B), Slovakia (H3) and Turkey (H3, B).
During this period, a total of 30 countries from all WHO regions have reported resistance to ozeltamiviru in 1291 out of 1362 studied isolates of viruses A (H1N1). The spread of resistance to ozeltamiviru very high in Canada (52 of 52 samples), Hong Kong SAR (72 out of 80), Japan (420 of 422), Republic of Korea (268 out of 269) and the United States (237 of 241).
The relatively low prevalence of resistance observed in China (6 out of 44 surveyed). In Europe, the H1N1 virus in circulation during this period was low, but the spread of resistance was high: France (12 out of 12 surveyed), Germany
(66 of 67), Ireland (9 of 10), Italy (16 of 16), Sweden (11 out of 12) and the United Kingdom (61 of 62).

WHO is collecting global data about this phenomenon from multiple laboratories participating in the Global network for influenza surveillance
[]. Data from European countries participating in EISS [European Project for influenza surveillance, ] prepared EISS and VirGil [draft control viral sustainability]
[]. This aggregate table is updated every 4 weeks.

Data on resistance to ozeltamiviru based on phenotypic and genotypic analysis
Complete the table on the sustainability of the virus A (H1N1) to ozeltamiviru (4 quarter 2008-31 January 2009) is shown on the site http://www.who.int/csr/disease/influenza/H1N1webupdate20090318% 20ed_ns.pdf

[Comment Maud. Craig Pringle. It should be noted that in Europe for 11 weeks [9-15 March] 2009, all tested viruses A (H3N2) (predominant epidemic virus) were resistant to M2 inhibitors, but sensitive to ozeltamiviru and zanamiviru (). Consequently, the emergence of resistance to ozeltaviviru depends on the genotype of the virus and can not be directly related to the use of inhibitors neyraminidazy .. - Mod.CP]

[Comment Mod.NP. Information from Research Institute of influenza RAMS complementary message data for Russia. Http://www.influenza.spb.ru/index.php?newsid=1206371733 arising from the dissemination of information in the countries of Western Europe, strains that are resistant to the inhibitor neyraminidazy -- ozeltamiviru, Research Institute of Influenza RAMS, a study of this trait among 12 viruses A (H1N1), isolated in Moscow (2 strains), St. Petersburg (8 strains) and Kaliningrad (2 viruses). According to the results of sequencing the gene neyraminidazy in 7 of 8 strains isolated in St. Petersburg, found mutations leading to replacement of histidine at position 274 to tyrosine (H274Y), telling the virus resistant to ozeltamiviru. The remaining 5 strains of the mutation did not have. Thus, in Russia, as in other countries, noted the emergence of strains resistant to ozeltamiviru. - Mod. NP]

Four que storm corpse day star annoys the birds and beasts epidemic disease to be panic


Caption: que the corpse is put in the paper box to wait examines. Under bird flu haze, intermediate belt Starferry Wharf to outlet nearby, yesterday afternoon about 12:00, some passers-by discovered that four wild que corpses, fear que the corpse infection virus, then reports to the police seeks help, and three close streets que the corpse will put in the paper box, avoids suffering the way vehicles to run over, other que corpse still lay down the roadside.
Yuhushu sends out to wear afterward protects gown's staff member, walks with the plastic bag four que postmortem examinations, and cleans the road surface and spurts 灑 the disinfection liquid medicines. This bureau spokesperson said that later will carry on the bird flu for que the corpse to test, by determined whether to infect the virus.

Case reports of death have to be submitted within three hours

2009-03-30 05:56:00 Source: Great River - Henan Daily (Zhengzhou) thread 0

商报讯 Daily (Reporter Huiyan even) the province in the treatment of hand, foot and mouth disease to be strictly enforced when discussing the deaths, and three hours to submit an analytical report.

昨 Yesterday, the Provincial Health Office of the province's hand, foot and mouth disease on the medical treatment issued by the management of supplementary notice requiring the strengthening of medical staff around the hand, foot and mouth disease clinics business training, proficiency in the Ministry of Health's "Guide to Hand, Foot and Mouth Disease Clinic," children of the reception treatment measures must be targeted.

{SNIP}

Scribes sensitised to bird flu at Kolkata meet


By Our Staff Reporter
IMPHAL, Mar 29: A meeting on sensitisation of regional media about avian influenza participated by around 40 media persons from the North Eastern States, Bihar, Delhi, Jhar-khand, Orissa and West Bengal was held at Hotel Taj Bengal at Kolkata on March 27.
Addressing the gathering, Special Director General of Health Services and Director of the National Institute of Communicable Diseases, Government of India, Dr Shiv Lal said that the Govt has formulated a strategic plan to tackle the disease.
The plan is based on checking spread of H5NI virus which causes the disease to man.
To facilitate intensified collaboration between Animal and Health Departments both at Central and State levels in the event of the outbreak of the disease, the Ministry of Health and Family Welfare has stock-piled one million doses of the drug Oseltamivir (also known as Tamil Flu) as well as requisite quantities of personal protection equipment (PPE), he said.
The Serum Institute of India has been entrusted to manufacture pre-pandemic and pandemic vaccines to face any eventuality in case there is any extensive outbreak of avian influenza.
In the aftermath of the outbreak of avian influenza in Maharastra in February 2006, the WHO has designated the National Institute of Virology Pune as the Regional Reference Labo- ratory.
Moreover, the Ministry of Health and Family Welfare has been conducting integrated disease surveillance in public health institutions and laboratories, Dr Shiv Lal said. On the other hand, the Government of India has already trained Rapid Res- ponse teams at Central and State levels.
Joint Secretary of the Ministry of Health and Family Welfare Dr RS Shukla also appreciated the role taken by media when the diseases was first reported in West Bengal in 2008.
During the workshop jointly organised by the Ministry of Health and Family Welfare, WHO, FAO and UNICEF also deliberated on the possible roles the media should take and measures that may be taken up by the relevant Departments in case of the outbreak of the disease and the pandemic threat it posed to human lives.
The workshop discussed in detail the possible steps that may be taken up by media when the highly pathogenic H5NI virus infects thousands of people and the situation reaches a pandemic stage when there are large human casualty, schools are closed, movement of people restricted and even cremation of dead bodies is prohibited.
The media persons conducted group discussion and made presentations to the Ministry and UNICEF to implement their observations.
The meeting agreed on formulating a strategy to create awareness among the people extensively on the issue of avian influenza.
It further discussed on the media acting as catalysing agents towards changing the attitude of backyard poultry farmers, producers, traders and sellers regarding the disease.
Taking part in the workshop Chief of Communication, UNICEF India Country Office Angela Walker said that FAO and WHO as UN’s leading technical agencies for animal and human health, have the lead roles in communicating technical information on the progression of virus. However, because children account for nearly half of all reported human cases and impact of avian influenza goes well beyond the immediate risk to their health, UNICEF has an obligation to advocate for the specific needs of children. Further adding the roles of international agencies such as UN as a part of broader strategy for prevention and containment of avian influenza, it aims to communicate relevant information at various stages of AI and pandemic preparedness.

Wind spreads disease faster than thought

CORVALLIS, Ore. (Map, News) - Plant and human diseases that travel with the wind can spread more quickly than previously believed, according to a study at Oregon State University and elsewhere. The findings cause concern not only for some human diseases but also a new fungus that threatens global wheat production.

The research concludes that invading diseases do not always progress in an orderly, constant rate and that some airborne pathogens can actually accelerate as they move.

"It's now becoming clear that some types of diseases can spread more rapidly and widely than we anticipated," said Chris Mundt, a professor of plant pathology at OSU. "This makes it especially important, in some cases, to stop a spreading disease quickly if you hope to stop it at all."

The studies explain, in part, how West Nile Virus spread so rapidly across the United States when experts had been expecting a slower movement.They help analyze the progression of some historic disease problems, such as the potato blight that led to the Irish potato famine of the mid-1840s. And they suggest that a new fungal wheat pathogen that emerged a few years ago in Uganda may be a bigger threat to world production than first thought.

Mundt, an international expert on pathogens of several important food crops, has studied wheat stem rust for years.

"If we didn't have crops that could resist wheat stem rust, we pretty much wouldn't have a wheat industry," Mundt said. "From this pathogen we've learned a lot about plant disease resistance in general.

"And this new study confirms that it is crucial to get prepared for the rapid spread of a new variety of wheat stem rust that appeared in Uganda in 1999."

The new wheat stem rust, Mundt said, could attack 75 percent of the world's known wheat varieties, and in a bad year might cause up to 50 percent crop losses in some areas.

"We don't want to suggest that the sky is falling, but major losses could occur if the right set of conditions converges," Mundt said. "This is something that we shouldn't take a chance on. It's already spread to Iran, and the new research shows that its global spread may be about to pick up speed."

He said there is little time to waste. "This wheat disease problem could be global within a few years," Mundt said. "We would be foolish to ignore it."

Most plant and animal diseases spread by contact or proximity tend to move in a fairly predictable way, researchers say. But some carried by wind-carried spores or migrating birds can spread rapidly.

From 2004-06 the avian bird flu spread across parts of Africa, Europe and Asia through migrating birds. From New York City in 1999, the West Nile Virus spread across most of North America within three years.

"It was surprising to see how closely the spread of very different plant, animal and human diseases followed the same mathematical relationship," Mundt said. "This is giving us a better ability to predict how various types of diseases may move, and hopefully prepare for them."

The study was published recently in The American Naturalist, a professional journal.

Egypt: Detention of 5 women and a girl Damanhour hospital Mehalla on suspicion of bird flu infected

[Note the date]

Khalid Ketbhaabrahim decorated, in March 21, 2009 Time: 18:03 PM

Damanhour hospital fevers detained five women on suspicion of being infected by bird flu, and the women in detention are: «Hoda Hassan Mohamed satarist» 34-year resident of the village Brdlp Center Kafr Al-Dawar and «Al-Safaa Mohammed Abdulrahman» 42-year resident of the village tribal Alsoualem Center Itai gunpowder and «Rasha Hamid Ibrahim» 30 years and «Hanan Mohamed Abdel Halim al-Sharqawi» 20-year resident of the village point of view of the Center for Ghazal Damanhour and «the gift of Muhammad Shaaban» 22-year village resident Oren of the center and all Cbrakhitt housewives

Was keeping them from hospital after they reported symptoms of high fever, sore throat and difficulty in breathing, where the sample was taken from the infected and sent to central laboratories for testing.

The Department of preventive medicine and health management and veterinary medicine, accompanied by a security clearance from the Directorate of homes and living with their families and examination of the surrounding houses had been taking samples from poultry houses located adjacent to them for laboratory examination.

In Western analysis revealed that the Ministry conducted a factor in the emergence of agriculture the focus of a new, positive avian influenza status of the village of Tanta supporters.

Dr «Ahmed Saeed» Director of the Directorate of Veterinary Medicine over the course of that meeting Sunday attended by a committee of immunization status of the village of Tanta supporters of vaccination of domestic birds against avian influenza was a random sampling of chickens in a house suspected of being infected with the virus was sent to the Agriculture Ministry's labs for analysis , and positive tests confirmed that the sample was immediately on the execution of the rest of the bird house and buried the cemetery by the health district of lime, as was to take the necessary action in this regard, as well as the contacts of the vaccinated birds Altamflo the drug to ensure that no transmission of the disease to humans.

On the other hand was holding a little girl, aged two years Smonod Mahallah fevers in the hospital on suspicion of being infected with avian influenza, which has been taking a blood sample and swab hours to analyze the extent of her illness or not.

China: the situation of the HFMD epidemic has worsened, avian influenza re-starts

Date: 28-03-2009

According to Lyuy Fan and Xiong Bin, correspondents NTD, a situation of epidemic HFMD * in China has worsened. Until March 20, only in the province of Henan has already registered 2512 cases of HFMD. From Hainan and Shandong provinces also reported the 366 and 502 cases of infection.

Information on HFMD epidemic first appeared only on the Internet. Local residents of the province of Shandong have argued that since the end of last year, in the province have been cases where children died from infection HFMD.

One eyewitness of the Fujian Province reported that the area Nanpin also had a lot of child deaths from the disease, but all the media are silent, as if nothing happened. The Government should immediately inform the people about the epidemic, so that the residents were able to take appropriate measures and prevent infection. Concealment of such information - it is a crime.

In recent days residents of the area Mintsyuan Henan reported online that the hospital falsified medical records to hide the epidemic, and the local administration has ordered to prohibit the communication of the situation with the epidemic and the numbers of deaths from the disease.

At the same time, a woman from Henan Province, Ms. Chen, said in an interview that it might be among the dead, not all are infected with HFMD, and that most quickly, again beginning of the epidemic of avian influenza.

According to Ms. Chen, after the Chinese New Year, many of them residents of the area began to ache. Then came the group care workers, which in each village had a disinfection, explained that this is related to chickens, geese and other poultry.

hat-tip Helblindi

Hawaii working on list of who gets shots first in flu pandemic Public's input wanted on who'll be vaccinated first if outbreak strikes

Posted on: Sunday, March 29, 2009

By Dan Nakaso
Advertiser Staff Writer

State health officials want the public's views on deciding who should get vaccinated — and who should not — against the next flu pandemic that reaches the Islands.

So far, a wide-ranging advisory group of about a dozen community members representing religious groups, the chamber of commerce and even an expert in mediation have been working to set up a system that will help determine who will be inoculated first and who will have to face the pandemic unarmed, at least until more vaccine can be manufactured and shipped to Hawai'i.

The final determination will rest with Gov. Linda Lingle.


"The decision is with the governor," said Lingle spokesman Russell Pang.

There is no way to stockpile vaccine for an unknown virus that has yet to arrive. And no way to calculate how much vaccine will be needed, how many people will be infected and how many could die, according to Bill Gallo, senior management official with the Centers for Disease Control and Prevention in Honolulu.

So it could take months before federal officials isolate the virus, create a vaccine for it and send it to Hawai'i.

By then, untold lives could be lost.


"It is a very sobering scenario to be thinking about," said Jim Tollefson, president and CEO of the Chamber of Commerce of Hawai'i who sits on the advisory committee. "But it's best to be prepared and educated."

The 20th century saw three pandemics and several more "pandemic threats" that ranged from the Spanish Flu that killed 50 million people worldwide and at least 1,300 people in Hawai'i between 1918 and 1920, to the modern-day threat that the avian flu could spread from Asia to the Islands.

Several hundred people were infected with avian flu in Asia, six died and more than 1 million chickens were slaughtered in an attempt to control the spread of the disease.

"If (the next pandemic) is not here now, it will be here someday," said Dr. Vivek Nerurkar, interim chairman of the department of Tropical Medicine and Infectious Diseases at the University of Hawai'i's John A. Burns School of Medicine. "When a pandemic comes to Hawai'i, it's going to affect a considerable amount of people, especially the elderly and children."

Nerurkar is not involved with the planning and preparations to decide who will be vaccinated first but supports the effort by state health officials.


"It's very important to involve the community," he said. "They are the people who are being affected. It is a huge task. It is not a simple task. We need to have a consensus. ... It should not be a unilateral decision."
public campaign

To that end, the Health Department plans a public education campaign that will begin next month to explain the project and get community opinions.

"We're responsible for making science-based decisions all the time," said Dr. Sarah Y. Park, state epidemiologist and chief of the Disease Outbreak Control Division. "Without neglecting the scientific basis for our state's pandemic planning, this project gives us a unique opportunity to focus on the values-based aspects of some of our decision-making. We encourage everyone to participate in the public activities and let their voice be heard."


Park is the principal investigator for Hawai'i's pandemic priorities grant.

Hawai'i's position as a gateway to and from Asia makes any potential pandemic of particular concern since air travel could quickly spread the disease. To guard against such problems, a disease surveillance and quarantine system was begun at Honolulu International Airport in 2005. It was the nation's first such system, and it screens sick passengers as they arrive for signs of serious illness.

Hawai'i and five other states have been chosen to participate in a federal program to carry out further pandemic planning.


The advisory group has found itself working on a subject with more variables than facts, such as when the Islands would be touched by a pandemic, or global disease outbreak.

"Is Hawai'i on the front end or the back end of an epidemic?" Gallo asked. "It's an important issue. If it was later in the epidemic, there could be enough vaccine to vaccinate everyone."


Even without a pandemic, deciding which flu strain to vaccinate against every year relies on estimates.

"The vaccine has to be reconfigured each year to accommodate the newly evolving strains," Gallo said. "It's very difficult to do. It requires a meeting of the minds about what kind of flu to expect for the next year. ... A pandemic would set the wheels in motion for getting the exact strain isolated and reproducing a new vaccine in large qualities. You would first need a portion of the actual germ or bug to produce the actual vaccine."

Members of the advisory group, such as Elizabeth Kent, director of the Center for Alternative Dispute Resolution, are focusing less on the science and more on the values that Hawai'i wants to protect during a pandemic.

"We want to be careful and considerate of everybody's rights," she said. "What we're talking about is the fabric of society and how you keep the fabric as intact as possible. You may have some special hobby that contributes so much to the fabric of our society or have a job that does. Trying to take all of that into account is very important. That part has been for me quite challenging, thinking about how to make those decisions."
federal guidelines

In the event of a severe pandemic, federal guidelines from the U.S. Department of Health and Human Services and U.S. Department of Homeland Security recommend that the first people inoculated should be "deployed and mission critical personnel,"
public health workers, inpatient healthcare providers, outpatient and home health providers, first responders such as paramedics, firefighters and police, manufacturers of pandemic vaccine and antivirals, pregnant women and children under age 3.

But Hawai'i health officials want to solicit a broad variety of opinions to put together a list of people — or, more likely, job categories and demographic guidelines — of who should be inoculated first.

"It's a very interesting question: Who's going to get the vaccine in the event of shortages?" said Jason Seaborn, who is working on the project for the state Department of Health. "We're trying to elicit information from the public to see what values are specific to Hawai'i residents. As you work through each group, it raises questions such as, 'Should you vaccinate morgue workers? What are you going to do when the bodies start piling up?' "


In an e-mail, Seaborn wrote that the Health Department wants to "get feedback from Hawai'i's residents on what they value (i.e. — canoe carvers? Single moms? Elderly? Young? Teachers? Garbage collectors?)"

Gallo also sits on the advisory group and believes "it says a lot for the state of Hawai'i how serious they take this kind of planning and want to hear community input. They want to make sure their unique needs are heard in Washington."

But ultimately, the person who decides the priority list most likely will be Hawai'i's governor, Gallo said.


"Are we playing God?" asked Kent, a member of the advisory group. "No. Somebody else is going to make the hard decision. But we're trying to make a very hard decision that much easier in a thoughtful way."

# Three live one-hour broadcasts on KHNL in April. A panel of speakers will discuss who should get vaccinations during a pandemic and solicit viewer opinions on air and via e-mail. The shows are tentatively scheduled from 8 to 9 p.m. April 15, 22 and 29.

# An "Alternate Reality Game" will be available in late April or early May. Details are still being worked out, but the game is aimed at Island residents. People on the Mainland probably will be able to access the game as potential tourists.

# Community-based meetings around O'ahu from April through May 30, still to be scheduled.


Reach Dan Nakaso at dnakaso@honoluluadvertiser.com
hat-tip Shiloh

Two-year-old girl contracts bird flu

AFP/Cairo
A two-year-old Egyptian girl has contracted bird flu, the 60th reported case since the first outbreak of the disease in the country in 2006, a health ministry spokesman said yesterday.
The toddler has been taken to hospital and is in stable condition, said ministry spokesman Abdel Rahman Shahin.
Twenty-three people have died of bird flu in Egypt. Most of the victims have been young girls or women, who are generally in charge of looking after poultry in rural areas.
Shahin said the percentage of fatalities from bird flu in Egypt is less than in other countries that have seen outbreaks of the disease.
The World Health Organisation (WHO) called earlier this month for an investigation into why many of the victims have been young children.
Egypt hosted an international conference on bird flu in October, when Washington pledged an additional $320mn to the fight against the disease amid fears it may yet escalate into a global pandemic.
The H5N1 strain of the virus that is most dangerous to humans first emerged in Asia in 2003 and has since caused nearly 250 deaths, according to WHO figures.

Pasien Suspect Flu Burung Negatif

[This is Wawan (33)]

INDRAMAYU - The patient suspect bird flu from the Karangjaya Bloc, Desa Mangunjaya, Kecamatan Anjatan, Was (33 years), was stated by the bird flu negative. Moreover, the patient who originally was treated in RSUD Indramayu on Wednesday (25/3) that was permitted to come home him. Was based on the laboratory inspection, results of negative,"ujar Dirut RSUD Indramayu, Dr Dedi Rohendi to Republika, Ahad (29/3). Moreover, continued Dedi, this patient then his condition increasingly improved. According to him, the patient only suffered the sign of the common fever and is currently stated recovered. As being reported by Republika beforehand, anxious was stated suspect bird flu because suffered was sick with the sign took the form of the high and breathless fever. Not only that, anxious then beforehand experienced direct contact with his property chicken that died suddenly. In RSUD Indramayu, Was was placed in special observation space. In the place, anxious then received the intensive maintenance from several doctors.

In the meantime, one of the staffs in the Peternakan Field in the Pertanian Service and Kabupaten Indramayu Livestock Breeding, Drh Dian Daju, explained, after receiving existence information of the patient suspect bird flu, his side at once involved the official to the Mangunjaya Village. In this place, his side carried out investigation against the chicken that died. Was based on the resident's story there, the chicken that died that has been buried, said Dian. However, continued the Lamp, to anticipate the spreading of bird flu, his side carried out spraying of the disinfectant substance against the available poultry around the patient's residence. Moreover, his side then continued to carry out the monitoring and to give handling counselling of the poultry that was expected terjangkit flu burung.lis/kpo

Saturday, March 28, 2009

Durham's power plants ready for pandemic

OPG plans for absenteeism of up to 40 per cent

Mar 23, 2009 - 10:16 AM

By Reka Szekely

DURHAM -- Pandemic plans are in place at Durham's nuclear plants to keep the electricity flowing in the event of an outbreak of infectious disease such as a deadly flu.

In the wake of the SARS outbreak in 2003, Ontario Power Generation (OPG) went through a lengthy process to prepare a plan for a pandemic both at the corporate level and at its business units, including Pickering and Darlington nuclear plants.

"(SARS) was a real eye opener not just for the electricity industry and OPG, but many folks around the province," said Jim Coles, manager of emergency preparedness, speaking to the Pickering nuclear plant's community advisory council. "There were a lot of lessons learned around that event."

After more than two years of work, OPG was declared pandemic-ready in 2007 and will continue to review its plan on a regular basis. Among the long list of areas considered are communications, security, health surveillance and the management of antivirals and vaccines. OPG now has enough antiviral medication on hand for all staff.

The company looked at what would happen if there was 20-, 30- and 40-per cent absenteeism as a result of an outbreak. Even at the high risk rate of 40 per cent, the plants could continue to produce electricity, OPG says.

However, it would depend how the illness was distributed within the company. If, for example, 50 per cent of the nuclear operators were unable to work, it would force a shutdown.

OPG considered what routine activities could be delayed when the risk was lower and putting training staff back on the front lines. Another option is moving staff between the Pickering and Darlington plants if they were qualified to work at both. The Darlington plant has a greater electricity output and would be a bigger priority.

The biggest risk, said Mr. Coles, is the supply chain from the outside. OPG has identified its dependencies on critical suppliers and has been working with them to create pandemic plans or review existing ones. In 2006, only a small fraction had a plan but that rate has been rising.

"We can also say it's a condition of you doing business with us that you have a pandemic plan in place," Mr. Coles said.

A member of the council asked how certain Mr. Coles was that there would be a need for the plans in the next 10 or 20 years.

"I would suggest to you, in my opinion, it's a certainty," responded Mr. Coles, adding that pandemics crop up about three times every 100 years. "As I recall, 1968 was the last one we had."

U.S. program ups bioterror readiness

SANTA MONICA, Calif., March 25 (UPI) -- A federal program designed to help U.S. metropolitan public health agencies prepare for bioterror or pandemic improves readiness, researchers said.

A Rand Corp. study found that the federal Cities Readiness Initiative -- a program active in 72 metropolitan areas -- appears to have improved agencies' ability to rapidly and widely dispense life-saving medications and other medical supplies in the event of a large-scale bioterror attack or a naturally occurring infectious disease outbreak.

The study said there is merit in extending the program to other cities so the impact can be further monitored, although the analysis did not assess the cost-effectiveness of the effort or compare it to other public health priorities.

"The Cities Readiness Initiative has helped agencies in the nation's most-populous regions become better able to dispense life-saving medication following a bioterrorism event or after an infectious disease outbreak," lead author Henry Willis, a policy researcher at the Rand Corp., a nonprofit research organization based in Santa Monica, Calif., said in a statement.

The researchers said the initiative has helped increase the number of local public health staff members working on medication dispensing planning, strengthened partnerships between public health officials and local first-responder agencies and helped pay for new equipment such as mobile drug dispensing units.

BAFRA steps up for bird flu

28 March 2009

The border town of Phuentsholing was the latest to possess one at its main gate where over 800 vehicles ply each day, to and from the Indian border towns. Such improved disinfectant facilities have already been put to use in the border towns of Samtse, Gomtu, Gelephu and Samdrup Jongkhar.

According to officials at Bhutan Agriculture and Food Regulatory Authority (BAFRA), the improved facility was more effective in disinfecting vehicles and other risks compared to the existing power sprayer machines.

“The disinfectants will be sprayed from every angle on the vehicles. The steel frames are not permanent. And disinfectants from all the directions will not be used always. It will be used only during critical times, such as an outbreak across the border.” said a BAFRA official.

Dr Sithar Dorji of BAFRA said that the frames of the vehicle disinfection system could be dismantled when the disease outbreak subsided and the risk of the entry of the virus was minimal. In case of an emergency, it could also be assembled within an hour.

He said the construction was completed in critical time when there are widespread epidemic outbreaks of bird flu continuing in the neighbouring district of Assam and West Bengal, very close to Bhutan borders.

The facility in Phuentsholing was also expected to minimise the traffic congestion and inconvenience caused to the travellers at the main gate.

The cabinet approved the construction of the vehicle disinfection facilities at all the main border entry points during the 15th session of Lhengye Zhungtshog held on August 26, 2008.

Although import of poultry products are banned in Bhutan, it is observed that chicken is sold openly just a few metres away from the boundary walls on the Indian side of the border. Many Bhutanese live in rented houses in Jaigoan, West Bengal, India, due to shortage of houses in Phuetnsholing.

The Agriculture Minister Pema Gyamtsho inaugurated the vehicle disinfection facilities in Phuentsholing on Tuesday, March 24.

Map of Béhéra [Al Buhayrah] (governorate), Egypt

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The girl died of bird flu and the detention of four suspected injury in the Fayoum and Damanhour

And the discovery of two things meeting Sunday attended by two of the disease

The girl died «بسملة Mohamed Rabia» 45 days of the city of Fayoum Alhawwatm after being infected with bird flu, and the girl had been detained for a day Fayoum General Hospital, where he was transferred to a hospital after Fayyoum fevers suspected bird flu, and fever to transfer the management of the hospital directly from the reception Tamiflu drug to the hospital, where she died hours later the girl Fimazalt of the samples being tested to make sure that the cause of death is bird flu or other disease.


The hospital admitted Fayyoum detained on suspicion of two women got sick, where they were detained «Soha Sayed Ismail» 18 years of the dipper and the city of Fayoum «dignified Ramadan Secretary» 35 years of Oboxa Center Ibcoai, two samples were taken for analysis, where the initial analysis was negative, With a hospital official source confirmed that the cases are still detained pending the receipt of the final analysis of samples from the Ministry of Health.

In Damanhour hospital diets detained on suspicion of two infected by bird flu, and two: «Amal Mohamed Ezzat» 20 housewife year resident of the village Alhouc Center and the girl child Damanhour «Nada Ali Zein» 5-month resident of the village of Cain to the same place,
after the emergence of their symptoms are similar to the disease, fever and inflammation of the throat and narrow bone pain, respiratory, blood samples were taken from the injured and sent to central laboratories for testing.

Whereas factor analysis conducted by the Ministry of Agriculture on samples of the two things the discovery of new bird flu virus bird Btnta Berma meeting Sunday attended by the village.

And Dr. Ahmed Saeed - Director of the Directorate of Veterinary Medicine meeting Sunday attended - that the initial focus has been discovered within the market wisdom Btnta during the passage of a committee formed to immunize birds in markets and homes, where suspected members of the Committee in the chicken before the sale was to take samples for analysis, a factor of the Ministry of Agriculture, at a time which was to take the necessary precautionary measures has been confirmed by a positive test sample was the formation of a committee of health and veterinary medicine, the environment and the city council security, security Kerdoun been imposed on the market and the relevant bodies to clear the place and the execution of all the birds under the supervision of Dr. Sharif Hammouda - Undersecretary of the Ministry of Health meeting Sunday attended by -- to ensure that no transmission of the virus to humans.

In the same context, the discovery of the focus of analysis within the market of the village after Berma suspicion in some birds for sale, with the imposition of Kerdoun security on the market and cleared by the health officials, veterinary medicine and the environment has been the liberalization of the record of this.

Egypt first in the world of bird flu in 2009


28/03/09

Egypt topped the list of countries most affected by avian flu in 2009, after a Ministry of Health 9 injuries since the beginning of this year, compared with 8 cases over the last year, the Ministry announced on Monday, injuring a girl from Qena, bringing the total casualties in Egypt since the beginning of the epidemic to 60 cases.

Dr. Abdel Rahman Shahin, spokesman of the Ministry of Health, said that despite the high number of casualties, Egypt is the least in the proportion of deaths, saying that among the casualties of the 23 cases there have been 60 deaths and only recognized that the virus is endemic in Egypt, and he left them and elimination of a many years, perhaps decades, and that if it mutates into a more severe type of «is strongly», explaining that it was now no way out of the crisis, however, the transformation of society to the frozen birds.

In Qena, the Department of health is a state of emergency in the hospital after the fever in the central laboratories of the Ministry of Health wounded girl «Israa Saad Shafi», which developed the symptoms of the disease last Monday and was taken to the hospital.

In Alexandria, executed the Directorate of Veterinary Medicine million birds, because of the lack of certificates to prove they are free of the disease have been seized in raids on intensive farms, bird shops in the east and west of the city.

In Fayoum, Dr. Hussein Sophie Abutaleb, Under-Secretary, Ministry of Health, the death of the girl child بسملة Mohammed «45 days» Tamiflu drug in a hospital after being transferred from the hospital yesterday evening fevers Fayyoum I, on suspicion of being infected with the disease, explaining that he had been sampled and sent to central laboratories, but they died before the results of the analysis, pointing out that the samples were withdrawn from her family as a precaution.
hat-tip Helblindi

Czech Republic-BSE (Mad Cow ) disease confirmed

28/03/2009 01:52:59


Czech state veterinarians said on Friday they had found a new case of bovine spongiform encephalopathy (BSE) in a six-year-old cow on a farm near the northern border with Poland.
Also known as mad cow disease, BSE first emerged in Britain in the 1980s and has been found in herds in several European and other countries.

Scientists believe it is transmitted through infected meat and bone meal fed to cattle and may cause deadly vCJD in humans.

Here are some key facts:

ORIGINS:

* First surfaced in Britain in 1985 when a black-and-white dairy cow was seen staggering and head-butting other cattle. It was diagnosed as BSE in November 1986.

* Known formally as bovine spongiform encephalopathy, the disease swept through Britain in the 1980s and early 1990s, causing millions of animals to be slaughtered and burnt.

* Scientists blamed waste produced in slaughterhouses and used to make animal feed for its spread. Cattle feed usually contained wastes obtained from the slaughter of other cows.



THE COST:

* Britain destroyed 3.7 million cattle in the 1980s and 1990s because of BSE. Between 1986 and 2002, 181,376 cases were confirmed in Britain.

During that time Britain spent more than $6 billion, excluding job losses, in sorting out the crisis.

* By 1988 Britain realised BSE was a serious problem. EU authorities banned high-risk materials such as spinal cord from use in feed and tighter labelling was also introduced.

* British beef exports were banned worldwide.

* The ban on British beef exports was partially lifted in 1999. In March 2006, EU experts agreed to a complete lifting of the embargo, nearly 10 years to the day after it was imposed.

* In 2007, BSE surveillance has identified 15 cases in North America, three BSE cases in the United States and 12 in Canada.

* Canada confirmed its 15th case of mad cow disease since 2003 in November 2008.




CREUTZFELDT-JAKOB DISEASE:

* vCJD is strongly linked with exposure to BSE. BSE can pass to people who eat infected beef products causing the related condition called variant Creutzfeldt-Jakob disease or vCJD.

* vCJD is a rare and fatal human neurodegenerative condition. As with Creutzfeldt-Jakob disease, vCJD is classified as a Transmissible Spongiform Encephalopathy (TSE) because of characteristic spongy degeneration of the brain and its ability to be transmitted. vCJD is a new disease that was first described in March 1996. To date it has killed more than 160 people in Britain.