Surprising diversity found in H5N1 in Asian chickens

Robert Roos News Editor

Apr 14, 2009 (CIDRAP News) – H5N1 influenza viruses found in chickens seized at Vietnam's border with China in 2008 show a surprising level of genetic diversity, suggesting that the viruses are evolving rapidly and raising questions about disease surveillance and the effectiveness of prepandemic H5N1 vaccines, according to a team of Vietnamese and US scientists.

The findings suggest that the subgroup of viruses identified in the study has been circulating in the region either undetected or unreported for a "considerable amount of time," the report says. The viruses are in clade 7, a group that has not been found in an outbreak since one in China's Shanxi province in 2006.

Also, given the degree of difference between these clade 7 viruses and those used to make human H5N1 vaccines, "it is unclear whether or not humoral antibodies elicited by current vaccine candidates will have cross-neutralization activity against the new viruses," says the report, published recently in Virology.

The study was conducted by scientists from Vietnam's National Center for Veterinary Diagnostics in Hanoi and the US Centers for Disease Control and Prevention (CDC), with the CDC's Ruben O. Donis as the senior author.

Vietnam bans the importation of poultry from H5N1-infected countries. The viruses analyzed in the study came from imported illegal chickens seized at border control stations in Vietnam's Lang Son province, on the Chinese border. Authorities confiscated 495 chickens at the border stations in the first 5 months of 2008 and tested them for avian flu. Fifteen birds were found infected with H5N1 virus, and two others had an H9N2 virus.

The authors extracted RNA from the 15 H5N1 isolates, amplified it, and analyzed the sequence of the hemagglutinin (HA) genes. They found that all 15 HA genes fit within a subgroup of previously identified clade 7 viruses. They determined that 13 of the 15 HA genes fell into two further subgroups, which they labeled A and B.

The isolates within groups A and B were very closely related, but the groups differed considerably from each other, with an average divergence of 4.05% in HA nucleotide sequences and 5.69% in amino acid sequences, the report says. The authors also determined that the isolates differed by an average of 3.67% and 5.81% from the most closely related previous clade 7 isolate, which came from a chicken in China's Shanxi province in 2006.

In comparing the viruses with representatives of other H5N1 clades, the investigators found they were most closely related a clade 4 virus (a 2006 isolate from Guiyang province of China) and most distantly related to a clade 1 virus, a 2004 isolate from Vietnam. The respective differences in amino acid sequences were 8.20% and 9.07%.

The genetic distance between the HAs of these clade 7 viruses and the isolates used to make prepandemic vaccines raises doubt as to whether antibodies generated by the vaccines would react with the clade 7 viruses, the authors write. They say the viruses used in the vaccines represent clade 1 (from Vietnam, 2004), clade 2.1.3 (Indonesia, 2005), clade 2.2 (Qinghai province, China, 2005), and clade 2.3.4 (Anhui province, China, 2005).

The authors used ferret serum samples to test whether antibodies generated against five of the clade 7 viruses would cross-react with viruses from other clades and vice versa. Using hemagglutination inhibition assays, they found that samples (antisera) with antibodies against clades 1 and 2.3.4 did not cross-react with a clade 7 virus, and antisera against that same clade 7 virus did not react with clade 1 and clade 2.3.4 viruses. Also, antisera to the clade 7 virus showed limited cross-reactivity with each of four other clade 7 isolates, suggesting "some, albeit minimal" antigenic similarity among the viruses.

The authors write that the identification of two distinct subgroups (groups A and B) of clade 7 viruses "may suggest that these viruses originated from two distinct regions or host populations isolated from each other."

They say the isolates they analyzed were remarkably diverse, given that other studies of H5N1 viruses in a single clade have shown a nucleotide divergence of no more than 1.5%. They also observe, "The high degree of genetic divergence from previously identified clade 7 viruses also indicates that this subgroup of viruses has likely been circulating undetected or unreported for a considerable amount of time as poultry outbreaks caused by clade 7 H5N1 viruses were last reported in Shanxi province, China in 2006."

The findings point up the need for border controls and strong virologic surveillance to detect and prevent the spread of "exotic" H5N1 viruses from country to country, the authors conclude.

Dr. Les Sims of Australia's Asia-Pacific Veterinary Information Services called the study "an important piece of work" that offers another sign of gaps in avian flu surveillance systems in Asia.

"Unexplained gaps in the evolution of H5N1 virus HA genes suggest that surveillance systems have not been able to detect all cases of infection," Sims, who is a consultant to the United National Food and Agriculture Organization, told CIDRAP News by e-mail.

Other signs of holes in surveillance efforts include the detection of H5N1 virus in humans before finding it in nearby poultry, finding the virus in intermittent testing in poultry markets, and infected dead poultry washing up on Hong Kong's beaches, Sims said.

Clade 7 viruses have been found in various places in China, including Shanxi, Yunnan, and Hebei provinces, he reported, adding, "One of the recent human cases in Jiangsu was apparently due to a clade 7 virus, based on newspaper reports."

"The antigenic variation is not surprising given that clade 7 viruses have been shown to be antigenic variants previously," Sims said. But the findings from the ferret sera should be tested further with challenge trials in poultry vaccinated with existing vaccines, he added.

The difference between a 2006 clade 7 virus found in China—cited in the study as the closest previously identified relative of the viruses the authors analyzed—and existing vaccine antigens "led to the incorporation of a new antigen into some Chinese poultry vaccines," he said. "These vaccines containing a clade 7 antigen have been used extensively in China." He added that there have been no reports of vaccine failures in Vietnam resulting from antigenic variants.

Sims said the antigenic changes in the clade 7 virus might potentially have been spurred by poultry vaccination efforts. "We need to balance measures to reduce the amount of circulating virus, which vaccination of poultry can do, against the potential 'harm' that might occur if antigenic variants emerge," he stated. "We should expect antigenic variants to emerge and ensure that appropriate measures are in place to detect these at an early stage."

Nguyen T, Davis CT, Stembridge W, et al. Characterization of a highly pathogenic avian influenza H5N1 virus sublineage in poultry seized at ports of entry into Vietnam. Virology 2009 (early online publication) [Abstract]

hat-tip Sally

Riau: Suspect Bird Flu died because of the Inflammation of the lungs

[This is the first mention of this person. We have very quick results. Yet, in West Sumatra, Fitri is still waiting on those results, after being admitted on 4/5.....]

Rabu, 15 April 2009
Was based on the direct checking to the field that was carried out by the Surveilance Team from the Health Service of the Pekanbaru City, Gusti Iman Hulu (2.9) the resident Street Yos Sudarso Rumbai that was expected suspect bird flu died not was caused by bird flu but because of the inflammation of the lungs. That was explained by Kasi Pengamatan of the Illness of Bencana/Wabah Dinas of the Pekanbaru Health, M. Napiri to Riau Pos, on Tuesday (14/4) in his office. He explained, in accordance with the last diagnosis and direct observation to the field by the Dinas Team of the Health, was learnt that casualties died as a result of the inflammation of the lungs (bronchi) and dengue fever (DBD). It was related that that more Napiri, after the direct checking to the field beforehand approximately a previous month, in the sufferer's house was received by the chicken that died suddenly but also the environment of the sufferer's house was received by the processing of bricks/bedeng. [bedeng = shed; hut; barn, dirt embankment]

‘’Victim died not because of bird flu and in accordance with results of direct observation to the field and was carried out by the diagnosis tarnyata casualties died resulting from the inflammation of the lungs (bronchi) and DBD,’’ clear Napiri.

Regarding that was explained also that, beforehand to 4 Apri then, fever casualties, the cough and pilek and took medicine to the doctor's clinic 24 hours. On April 5, casualties and his friend played wild birds that were sick. On April 11, casualties were increasingly breathless and struck 12,00 WIB, casualties were carried to RSUD Arifin Achmad. On April 12, struck 01,00 WIB, casualties died. ‘’Berdasarkan results of the direct field cheque by the Dinas Team of the Health, before dying casualties were sick the fever, and took medicine to the doctor's clinic 24 hours produced by the RSUD Arifin Achmad diagnosis, casualties suffered bronchi and DBD,’’ jelasnya. (cr4/hen)

H5N1 Receptor Binding Domain Changes In Egypt

Dr. Niman wrote a commentary from this document, that was posted previously here at the blog:

http://pandemicinformationnews.blogspot.com/2009/04/characterization-of-conserved.html

and I also posted some excerpts from it here:

http://pandemicinformationnews.blogspot.com/2009/04/excerpts-from-characterization-of.html

Commentary

H5N1 Receptor Binding Domain Changes In Egypt
Recombinomics Commentary 04:27
April 15, 2009

Similarly the results of H5N1 strains from Egypt (Figure 2) may be indicative of a possible viral evolution towards receptor usage similar to that of H1N1 viruses, which efficiently replicate in the upper respiratory tract. The protein domain, which seems to be involved in this subtle change, corresponds to amino acid domain 99-132.

The above comments, from “Characterization of conserved properties of hemagglutinin of H5N1 and human influenza viruses: possible consequences for therapy and infection control” describe a subset of H5N1 sequences from Egypt that have chacteristics that match H1N1 seasonal flu. These matches include sequences from the Ghabiya cluster, as well as two Qena siblings with mild H5N1 in the spring of 2007. The sequences from the siblings had a 3 BP deletion that produce S129del, which is within the region listed above, Although the disease onset date of the index case was withheld from the WHO update, the hospital admission dates were four days apart, signaling the infection of the brother (4M) by his sister (6F). The sequences from the Qena siblings were identical, further supporting H2H transmission. Moreover, additional family members had symptoms, but tested negative.

This year there has been another cycle of mild cases in Egypt, but instead of affecting children between the ages of 3 and 10, like the siblings above, 10/12 cases are toddlers. However, like the cases in the spring of the 2007, the case fatality rate is low (in 2007 only 1/17 died, and this year 0/12 have died) and most patients did not develop pneumonia. These mild cases, coupled with the younger age group, raise concerns that H5N1 spread in the past two year was far more extensive than indicated by the confirmed cases, and were missed by current testing, which requires a poultry contact for H5N1 PCR testing.

Although NAMRU-3 has not released any human or poultry sequences this year, the first two human isolates were represented in a recent HA tree of vaccine targets. Although public sequences are not on the branch with the 2009 isolates, the location of the branch suggests these isolates also have the 3 BP deletion and are closely related to the sequences in the siblings from 2007.

The four day gap in admission dates for the Qena siblings, matches the four day gap in the disease onset dates for two cousins (both 2M) from Beheira. The cousins are next door neighbors, and the four day gap also indicated human to human transmission, further supporting the spread of mild H5N1.

The 3 BP deletion produces S129del and position 129 is in the receptor binding domain. This deletion maps to the region in H5N1 with similarities with H1N1, suggesting more efficient transmission, consistent with the clusters in Qena and Beheira.

Release of the sequences from the H5N1 cases this year would be useful. If these sequences have the same deletion as seen in the Qena cluster, an extensive screening of toddlers without a poultry connect is critical.

The failure to recognize the significance of the mild cases in 2007 is cause for concern. The failure to aggressively act at this time is beyond scandalous, and is hazardous to the world’s health.
Media Links

Veterinary Unit in the "injustice" and exclude the existence of a "bird" flu zone

Ruled out the injustice in the veterinarian to be cases of bird flu in the region after the death of 20 birds from migratory birds, these assurances came after growing concerns of the population of a village in the north of the injustice and those who told the authorities that the dead migratory birds developed some strange symptoms before they died which casts doubt on the positive for bird flu.

The dissemination of avian influenza among children of Trustees of the orders of the police

المصريون : بتاريخ 14 - 4 - 2009 Egypt: On 14-4 - 2009

Focus after the discovery of avian flu, Helwan governorate, parallel in other parts of the hearts of two of the Trustees of the police of any mercy or humanity, They ordered the children to keep working to get microbuses poultry infected with the disease, although doctors caution that the approach of infected poultry without the use of tools and protective

NEWS AND STAVROPOL STAVROPOL TERRITORY

Stavropol is struggling with the illegal street vendors
Yesterday, 09:56
In accordance with the Law of the Stavropol region «of Administrative Violations in the Stavropol region», to the citizens of trading in undesignated places, measures of administrative influence.

Only in February and March this year estimated 70 minutes at the citizens, merchants in undesignated areas, and work to combat and eradicate illegal street trading will continue until the establishment in the city of the civilized market of goods and services, today reported IA «Tatar-inform» press Service Administration Stavropol.

To ensure people living in areas with poor infrastructure, with the March administration of the city began to organize «Fair Weekend», with the producers and the city of the province, as well as wholesale businesses.
In addition to the urban markets for summer residents and citizens who want to realize a surplus of fruits and vegetables, there are places to trade.

Unauthorized trading constitutes a threat to life and health of the population, leading to contamination of urban streets, restricts the movement of pedestrian flows. Citizens engaged in trade on the streets, sell the goods without documents confirming the origin and quality of products. Often the trade is from the ground, cardboard boxes, boxes with the violation of sanitary norms and rules.

When purchasing meat, milk, eggs, fish, vegetables of unknown origin in the street, people are at risk of contracting diseases common to humans and animals, such as salmonellosis, leptospirosis, avian influenza, brucellosis, etc.

Our recent management Rospotrebnadzor of Stavropol Krai considered a resident of the city complain about the acquisition of live fish with worms. Foods should be sold in major markets where they are tested in the veterinary and sanitary laboratories.

To organize a system for the elimination of street vendors increased the number of offshore teams from the staff of the Committee for Economic Development and Trade, the structural divisions of administration and operational areas of the district departments of the Interior of the city. Approved schedules and routes of infiltration.

Russia: In the Kirov region will be the first for 16 years, the regional law on veterinary medicine

14.04.2009 / 17:21
Reads: 19 CONFIRMED
After 16 years since the adoption of a federal law on veterinary medicine in the Kirov region will own. April 14, the government approved a bill area and referred it to the deputies Zaksobraniya.

The draft law includes 12 articles, establishes the legal basis of the veterinarians, their credentials, as well as funding various programs. According to the head of the Department of Agriculture and Food Alexei Kotlyachkova, the need for adoption of the law justified the emergence of natural foci of rabies in the southern parts of the Kirov region, as well as the emergence of the need to protect our region from the arrival of an African plague, avian influenza and the need to impose tighter controls over imported products.

This Alexey stresses that since 1993 Kirovske veterinarians treated the rules of federal law, but among others there is a need to define the responsibilities of legal entities, individual entrepreneurs and citizens to ensure the welfare of epizootic area, and security in the veterinary and sanitary products of animal husbandry.

Similar laws adopted in 50 regions of Russia, told Kotlyachkov.

AVIAN INFLUENZA, POULTRY VS MIGRATORY BIRDS (02): ENVIRONMENTAL TRANSMISSION

A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: 14 Apr 2009
Source: PLoS Computational Biology [edited]
<http://www.ploscompbiol.org/article/...l.pcbi.1000346>


The Role of Environmental Transmission in Recurrent Avian Influenza Epidemics
-----------------------------------------------------------------------------
Abstract
--------
Avian influenza virus (AIV) persists in North American wild
waterfowl, exhibiting major outbreaks every 2-4 years. Attempts to
explain the patterns of periodicity and persistence using simple
direct transmission models are unsuccessful. Motivated by empirical
evidence, we examine the contribution of an overlooked AIV
transmission mode: environmental transmission. It is known that
infectious birds shed large concentrations of virions in the
environment, where virions may persist for a long time. We thus
propose that, in addition to direct fecal/oral transmission, birds
may become infected by ingesting virions that have long persisted in
the environment. We design a new host-pathogen model that combines
within-season transmission dynamics, between-season migration and
reproduction, and environmental variation. Analysis of the model
yields 3 major results. 1st, environmental transmission provides a
persistence mechanism within small communities where epidemics cannot
be sustained by direct transmission only (i.e., communities smaller
than the critical community size). 2nd, environmental transmission
offers a parsimonious explanation of the 2-4 year periodicity of
avian influenza epidemics. 3rd, very low levels of environmental
transmission (i.e., few cases per year) are sufficient for avian
influenza to persist in populations where it would otherwise vanish.

Citation: Breban R, Drake JM, Stallknecht DE, Rohani P (2009) The
Role of Environmental Transmission in Recurrent Avian Influenza
Epidemics. PLoS Comput Biol 5(4): e1000346.
doi:10.1371/journal.pcbi.1000346

--
Communicated by:
ProMEDmail Rapporteur Mary Marshall

[It is nice to see a past LSU graduate student, David Stallknecht,
returning to the topic of his dissertation (1989) which was on the
shedding of LPAI wild viruses by migrating ducks. After presenting an
analysis of the very large number of isolates he had obtained by
cloacal swabbing of ducks shot by hunters, he was asked how long did
the virus survive in the fresh and brackish waters where these birds
fed and slept. To cut a long story short, at the right water salinity
and temperature they were immortal. The moral of this story is beware
of simple questions posed by your professors. The above paper is
worth reading in its entirety. - Mod.MHJ]

Training courses to combat bird flu Cairo International Airport

الأحد، 29 مارس 2009 - 19:12

Sunday, March 29, 2009 - 19:12

مطار القاهرة ينظم دورات تدريبية لمواجهة فيروس أنفلونزا الطيور

Cairo Airport, organize training courses to address the avian influenza virus

كتبت إحسان السيد

Mr. Ahsan wrote

جوى فى منع انتشار فيروس أنفلونزا الطيور، بدأت اليوم أولى الدورات التدريبية لمواجهته، حيث تقام بمستشفى معهد ناصر وتستمر حتى غد الاثنين، بينما تقام الدورة التدريبية الثانية فى يومى 5،6 أبريل المقبل بحضور بعض العاملين بالحجر الصحى بالمطار.

In the framework of the efforts of the Ministry of Civil Aviation, and the Department of quarantine in Cairo Airport to prevent the spread of bird flu, the first day of training courses to address it, there are Nasser Institute Hospital, and will continue until Monday, while the second training session will be held on April 5,6 the presence of some of the airport quarantine.

hat-tip Sally

Russia: In the Rostov region abolished duck hunting because of the danger of avian flu

14.04.09

Rostov Region is one of the regions, which could threaten the bird flu. In this regard, canceled duck hunting, are monitoring the study. Spring waters at the edge of the Don stop after a long flight of thousands of birds nest and local. Any of these birds may be infected with the virus H5N1.

Find out whether the bird was sick, you can only conducting the monitoring study. Those employees engaged in the regional department of the protection of animals. To do so, a shooting birds, after which the material is studied in the laboratory. The virus could be migratory birds from North and East Africa and infect the local cruise. So this year, even duck hunting banned.

Since the beginning of March until mid-April, during the migration of birds, Rostov Region, as well as the Krasnodar Region and Dagestan, is among the regions at risk of avian influenza. Therefore, the monitoring carried out almost all year round, except summer months, when the young. During the first quarter has already surveyed more than 200 wild waterfowl, may have a dangerous special virus detected.

Spread of the virus from wild birds to the home can be avoided only prevention. On poultry farms, and farms are regularly carried out checks on compliance with veterinary requirements. The owners of poultry in the season of migration recommend include chickens and ducks in enclosed spaces.

....Announced the idea of...

The World Health Organization ..announced its support for the idea of an inquiry into the growing seriousness of bird flu in Egypt,..
Sometimes these translated stories bring out the plain truth in a story.

So glad they decided to join the party.

The death of 20 birds in the darkness of immigrants and veterinary exclude «flu»

[A continuation of this story]

The number of deaths of birds and poultry injustice North

18 Rabi II 1430 is identical April 13, 2009
Eid Al-Otaibi - injustice

A source in the branch of agriculture the status of the injustice he received a communication by a group of citizens to serve the relevant points of the number of deaths of migratory birds and poultry in a northern abandonment injustice, which casts doubt on bird flu virus after it emerged that some strange symptoms and subsequently confirmed by the source of the communication has been received Citizens Task Force has been sent by the branch of agriculture as the injustices of samples taken from dead birds were sent to a branch of agriculture in the province of Taif after transfer to the laboratories in Jeddah and to ascertain the cause of death and awaiting the final results to the Ministry of Agriculture to provide a mobile veterinary clinic, supported by veterinary Btbibin driver with all test equipment and veterinary medicines, and to inspect the conditions of livestock Ahilan village - north of injustice in order to diagnose diseases of livestock and the disclosure and exchange of needed medications.

April 14, 2009
Mohammed bin Hras injustice:
استبعدت الوحدة البيطرية بظلم أن تكون هناك حالات لمرض أنفلونزا الطيور بعدما وردهم بلاغ يفيد بنفوق 20 طيرا مهاجرا شمال ظلم وتحديدا في مركز الرفائع وقد جرى تشكيل لجنة بإشراف الدكتور حشر البقمي وبمتابعة مدير الوحدة البيطرية بظلم الاستاذ عبدالله راشد الشهراني وقد اتضح من المعاينة الأولية وجود كسور في أجنحة تلك الطيور وآثار دم ومن الأرجح انها تعرضت لمطاردة من هواة الصيد خصوصا انها تهاجر هذه الايام بحثا عن الأجواء الباردة. Veterinary Unit unjustly excluded that there will be cases of bird flu after the death of beneficial response communication 20 birds immigrants north, specifically in the injustice of the status of Alrvaia has been to set up a committee under the supervision of Dr. Hasher Baqmi and follow-up to the injustices of the unit director of veterinary professor Abdullah Al-Shahrani was clear from the initial inspection and a broken wings of birds and that the effects of the blood is more likely she was to chase the fishing enthusiasts, especially these days, they migrate in search of a cold climate. كما جرى أخذ عينة من تلك الطيور لارسالها للمختبر ومعرفة النتائج النهائية وأكد الدكتور البقمي أنه سبق وأن حدثت حالة مماثلة في العام الماضي واتضح بعد التحليل أنها مصابة بمرض (النيوكاسل). It was also taking a sample of those birds to be sent to a lab and see the final results, Dr. Baqmi that had occurred in a similar situation last year, after analysis found infected with the (Newcastle). وأكد أنه جرى توفير عيادة بيطرية متنقلة مدعومة بطبيبين بيطريين وسائق ومزودة بجميع أجهزة الفحص والأدوية البيطرية اللازمة. He emphasized that the provision was supported by a mobile veterinary clinic, veterinary Btbibin driver with all the organs of examination and the necessary veterinary medicine.

World Health Organization to support an investigation on the spread of bird flu in Egypt

14/04/2009

.. وتؤكد أن بقاء المصابين علي قيد الحياة ينذر بتحول المرض إلي وباء And confirms that the survival of the persons under life threatening disease to shift and B

كتب - أحمد بدر: Books - Ahmed Badr:

أعلنت منظمة الصحة العالمية عن دعمها فكرة إجراء تحقيق حول تزايد خطورة مرض إنفلونزا الطيور في مصر بعدما ازدادت حالات الإصابة به في الفترة الأخيرة بشكل ملحوظ، ونقل موقع «كونتينوتي فورم» الطبي الأمريكي تأكيد المنظمة ضرورة إجراء هذا التحقيق مع مسح شامل لعدد حالات الإصابة وكيفية حدوثها وفترة العلاج في مصر. The World Health Organization announced its support for the idea of an inquiry into the growing seriousness of bird flu in Egypt, the incidence increased in the recent period has increased dramatically, and the transfer of the site «Contnote Forum» U.S. medical organization to confirm the need for such an investigation with a thorough survey of the number of cases and how they occur and the period of treatment in Egypt.
وقال الموقع الطبي الأمريكي إن منظمة الصحة العالمية تحاول جاهدة أن تحد من مخاطر المرض في كل دول العالم خاصة مصر التي تثير المخاوف بسبب انتشار المرض فيها بشكل ملحوظ إلي درجة يشبه معها الوباء، The Web site said that the American Medical World Health Organization is trying hard to reduce the risk of the disease in all countries of the world, particularly Egypt, which has raised fears over the spread of the disease which is marked to the extent that it resembles the epidemic,

وأكدت منظمة الصحة العالمية أن هناك أمرًا طيبًا وهو أن معظم الحالات المصابة في مصر مازالت علي قيد الحياة ولكن هذا الأمر يعتبر - إكلينيكيًا- خبرا غير مبشر. The WHO has confirmed that there is a good thing is that most of the cases infected in Egypt is still alive, but this is - clinically - a promising non-story. وفسرت المنظمة ما تعنيه بقولها إنه أمر غير مبشر بأن الحالات المصابة بمرض إنفلونزا الطيور تعاني حاليا أعراضًا تقل في حدتها عن الأعراض التي تسببها الإصابة بالفيروس، وبالتالي فإن فيروس إنفلونزا الطيور أصبح قادرًا علي تطوير نفسه ليصبح أقل حدة، ويعني في الوقت نفسه قدرته علي تطوير قدراته وأعراضه لينتشر ويصبح وباءً. And I explained what the organization is not saying that the missionary that the cases infected with bird flu symptoms are suffering less from the severity of symptoms caused by HIV infection, and therefore the bird flu virus become able to develop itself to become less acute, which means at the same time, his ability to develop its The symptoms of the spread and become epidemic. وقال الموقع الأمريكي إن هذا التطور في خواص الفيروس المسبب لمرض إنفلونزا الطيور قد يكون مقدمة واضحة لمرحلة أكثر تطورًا، فشراسة أعراض الفيروس في البداية كانت أحد العوامل التي قللت من الإصابة به، أما الآن فإن أعراضه الأقل قد تمكنه من الانتشار والتوسع بين الناس، بمعني أنها قد تصبح عملية تبادلية، ففي حين تقل حدة الأعراض تتزايد احتمالات انتشار الفيروس بشكل أكبر. The Web site said that the U.S. development of the properties of the virus that causes bird flu could be a prelude to a clear and a more advanced stage, Fsharasp symptoms of the virus at the outset was one of the factors that reduced the infection, but now the symptoms may be less able to spread and expansion among the people, the sense that they may become a reciprocal process, while less severe symptoms, increasing the risk of further spread of the virus. وأكد الموقع الطبي المعروف أن انخفاض حدة الفيروس في مصر تعني أنه قادر علي تطوير نفسه بشكل فردي، فالشائع أن الفيروس يسبب وفيات كما حدث في الصين التي مات فيها 57% من المصابين به بينما ماتت كل الحالات التي أصيبت في فيتنام، أما في مصر فإن الاثنتي عشرة حالة التي أصيبت نجت كلها من الوفاة، وهو أمر قد يبدو مبشرًا من الناحية النظرية، الا أنه يقلق من ناحية تطوير الفيروس لنفسه ولقدراته. The site known to the medical unit reduced the virus in Egypt means that it is able to develop the same individual, the virus that causes Vahaia mortality as was the case in China, where he died 57% of the patients died, while all cases that have been in Vietnam, while in Egypt, the viral ten the case that have been spared all of the death, which may seem promising in theory, but is concerned that the development of the virus on the one hand for himself and his abilities.

Indo: The patient Threaten came home

[This is Fitri Oktavianti, from Dharmasraya, West Sumatra. She had the onset of symptoms somewhere during the week of March 30 - April 4th. She was admitted on April 5th. They still have not sent in the results of the lab tests.]
April 14, 2009

A week got the maintenance in RSUP M. Djamil Padang, the patient's family suspect ”FO” bird flu from Kenagarian Timpeh began to be restless. His article, till at this time did not yet have the clarity about the assurance of the illness that was suffered by ”FO”. The only assurance produced by the laboratory inspection RSUP M. Djamil Padang, ”FO” positive suffered pneumonia (the acute infection in the lungs). ”Belum had the explanation from the doctor about whether positive not him my child suffered the bird flu illness. Besides this, the condition for our finance was limited. Everything had a basis information of a nurse, the family will be affected by the burden of the maintenance cost if the patient did not suffer flu burung,” said parents “FO”, Marsiah. The ”FO” condition, according to Marsiah still was weak, the temperature of his body tended unstable. Even so with the breath, often experienced crowded suddenly and still needed help of oxygen. Moreover, the hospital was still giving help of the liquid and medicine through the infusion.

The head of the Layanan Medis RSUP Field M. Djamil Padang, Irayanti said, his side also still was waiting for results of the PCR inspection and Swap the throat from Balitbang Department of Health RI. Jika the positive patient contracted bird flu, results would fast was known. However if results were initially negative, will be repeated again by his Labor Party inspection. It was related that the assurance whether the patient must pay the maintenance cost, if the patient was stated by the negative suffered bird flu, Irayanti stated the free patient the maintenance cost.

Circulated, Surat People's Representative Council Minta Namru-2 was opened by Kembali

[The link shows a picture of the letter]
Selasa, 14/04/2009

Naval Medical Research Unit (Namru) -2 were still being stopped now by the government because controversial. However, the People's Representative Council (the People's Representative Council) ask for Namru-2 was opened again.

This People's Representative Council request was included from the letter that circulated in the mass media circle. The letter that headed People's Representative Council was numbered PW.01/1173/DPR RI/II/2009 and was aimed at the Foreign Affairs Minister. The letter that was made in February 19 2009 that was signed by Vice Chairman DPR Soetardjo Soerjogoeritno . And ditembuskan to headed by the People's Representative Council, Pimpinan of the Commission of I People's Representative Council, the Health Minister, and RI People's Representative Council Secretary General. His contents stated that the Commission of I People's Representative Council met the Association Pegawai Indonesia Namru -2 on February 5.

In this audience was sent concerning the stopping of the research activity and the activity in the project Namru-2, that had an impact on the development of the research in the health field as well as continuation of the status of the Indonesian civil service of the researcher's staff in Namru-2, was like this the opener paragraph that was included in the letter. Afterwards, the People's Representative Council then ask for to the government about 3 matters. Basically, the People's Representative Council ask for so that the activity Namru-2 was opened, although the agreement or negotiations that were carried out by the government with Namru-2 was going.

Along with the contents of this letter:

Firstly, asked that the government sped up talks MoU Namru-2 with the mutually beneficial principle and closed the gap that contained the damaging potential for the national Indonesian interests.

Secondly, while talks took place so that the activity Namru-2 in the research field/the training of the health continued to be carried out by continuing to make full use of and increase the researcher's Indonesian professionalism.

Thirdly, so that the Government cq the Foreign Affairs Department extended permission remained and worked for the American researchers in Namru-2 until had the other provisions that were produced from talks MoU this.

Beforehand, Namru-2 was frozen by his activity by the government last by mid 2008. Namru-2 was pointed out stole the sample of the bird flu virus strain Indonesia by taking the resident's Indonesian blood that infected without the existence of permission from the authority of the Indonesian health, in this case the Department of Health.

The ease of access was to this resident increased by the position Namru-2 that was directly joined with the Body of Penelitian Dan Pengembangan Department of Health in Street Percetakan Negara, Jakarta Pusat.

Namru-2 also asked for the addition of diplomatic immunity for all of his foreign researchers, although not undertaking the diplomatic mission. In fact, the immune status diplomatic has been obtained headed by Namru-2. The existence Namru-2 below Department of Health RI was also questioned, because in the United States (the USA), the laboratory belonging to the US Navy the identity under the Department of the Defence (Dephan) the USA. The government froze Namru-2 and evaluated him whether being closed or continued. When being continued by the government asked the condition to be more just and mutually beneficial for Namru-2 and RI.

Scientists rule out spreading of bird flu by migrant birds in India

NEW DELHI, April 14 (Xinhua) -- International researchers have recently ruled out the spreading of avian influenza or bird flu virus by migratory birds through a review of migratory bird movement, reported local daily Mail Today Tuesday.

All samples studies for virus strain H5N1 on migrant birds so far were found to be negative, said the report.

The researchers monitored in real time the movement of migratory birds from India in a northward direction using satellite tracking technology. They ruled out the possibility of involvement of migratory birds in avian influenza spreading in India, said the report.

The satellite monitoring gave valuable data about the movement of migratory birds in the region and has enabled scientists to determine whether the locations of these birds and outbreaks of bird flu are related along the birds' migratory pathways, according to the report.

The project began last December when scientists captured, sampled and marked 70 water birds with "satellite tags" at Chilika Lagoon in India, where over 8,900,000 migratory and resident water birds used to live as their temporary or permanent residence, said the report.
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The government recognizes: the financial and human resources allocated to the fight against avian influenza is not sufficient

2009/04/13 02:24:50 pm


Asked Dr. Ahmed Nazif, Prime Minister, leaders of the General Authority for services of veterinary re-evaluation of the plan in place to cope with bird flu and to identify deficiencies and strengthen the positive to be able to surround the disease, which is heading to the epidemiological situation in Egypt.
-snip-
He added that the immunization is not considered a factor in the eradication of the disease, but a factor of resistance.
-snip-
The home of the first and is the reason behind the spread of hot and sick all of the demands raised in the memorandum submitted by the High Commission of bird flu, which, in turn, presented to the Prime Minister

وأضاف: "طالبنا بشراء 1350 سيارة جديدة علاوة علي 170 سيارة قمنا بشرائها لدعم فرق المكافحة". He added: "We called for the purchase of 1350 new cars in addition to 170 car, we buy to support the teams control."

وكشف سماحة أن عمل فرق المكافحة يعتمد علي البلاغات التي نتلقاها من المواطنين ومن وزارة الصحة التي تبلغنا بحالات اشتباه. The generosity that the work of the task control depends on the communications received from citizens and the Ministry of Health, which inform us of cases of suspicion.

وأكد أن الهيئة رصدت 53 بؤرة مرضية منذ بداية هذا العام منها 50 بؤرة في التربية المنزلية و3 بلاغات مضبوطات سيارات فيها طيور الرومي وتم تحليل العينات واكتشفنا أنها ايجابية. The body 53 is made the focus of a satisfactory since the beginning of this year, including 50 in the center of home communications, and 3 birds in which seizures cars turkey samples were analyzed and found to be positive.

Incident had occurred in the Helwan .. بأمر الشرطة.. Order of Police .. A child holding a chicken infected with

Tuesday, April 14, 2009 - 11:21


Child Ibrahim Adel

الثلاثاء، 14 أبريل 2009 - 11:21


الطفل إبراهيم عادل
Child Ibrahim Adel
كتبت أميرة وهبة Written by Amira Wahba

تم اكتشاف بؤرة أنفلونزا الطيور بمنطقة حكر التبين بمحافظة حلون، وقد تم تشكيل حملة تفتيش من الإدارة البيطرية، وعلى رأسها نائب الإدارة، ومعه اثنان من أمناء الشرطة، مستقلين ميكروباص وقاموا باستغلال طفل يدعى إبراهيم عادل (10 سنوات)، يعمل تباعا على ميكروباص لحمل الدواجن المصابة بالمرض، بالرغم من أن الأطباء أنفسهم يحذرون من الاقتراب من الدواجن المصابة دون استخدام أدوات وقائية، لعدم إصابتهم بالمرض، إلا أنهم لم يهتموا ببراءة إبراهيم وبما يصاب به. Been the focus of the discovery of avian flu in the province Hlon identification monopoly, has been the formation of a search of the veterinary department, and chaired by the Vice-management, along with two secretaries and the police, independent microbuses and exploitation of a child who just named Ibrahim (10 years), working respectively on the microbus to get the poultry infected, although the doctors themselves warn of approaching the infected poultry without the use of preventive tools and, in the absence of illness, but they did not bother Ibrahim's innocence and catch it.

وتقدمت زينب خير، المدير التنفيذى للجمعية المصرية للحقوق الاقتصادية والاجتماعية، بشكوى رقم 56402، للخط الساخن على رقم "16 أ" لحماية الطفل حول الواقعة، كما تنوى تقديم شكوى لمحافظ حلوان محمد القويضى بصفته المحافظ، ورئيس لجنة حماية الطفولة فى المحافظة، ووفقا للقانون، لمنع حدوث مثل هذه الأمور وانتهاك حقوق الطفل. Advanced Zeinab Kheir, executive director of the Egyptian Society of economic and social rights, complaint No. 56402, the hotline number, "a 16" for the protection of the Child on the incident, also intends to file a complaint to the Governor of Helwan Alqweidy Muhammad as governor and Chairman of the Committee for the Protection of Children in the county, and in accordance with the law, to prevent the occurrence of such matters and violation of the rights of the child.

President of the Federation of Poultry Producers * ‬ * ‬ warns of disaster * .. ‬ accuse the government of default

Books Nasser Mohammad Fayyad tiger *: ‬ sources warned of an increase in infections of bird flu in poultry * ‬, * ‬ and the occurrence of more human cases, especially with the virus, which mutates * ‬ become more aggressive and lethal *. ‬ Dr. Nabil Darwish, head of the General Federation of Poultry Producers * ‬ non-governmental organizations to complete the procedures required to stop the spread of infections in * ‬ farms and rural homes *. A

dmitted ‬ * »‬ Darwish *« ‬ * ‬ in exclusive statements to Al »delegation *« ‬ bad the situation in Egypt * ‬, * ‬ and he * ‬ * ‬ trying for months to establish the principle of compensation for affected people to no avail *. ‬ and * ‬ referred to the bankruptcy of the General Union of Poultry Producers * ‬, * ‬ and the absence of * »‬ millimes one *«.

‬ He said Amin Abaza, Minister of Agriculture * ‬ invited to a meeting in his office during the hours as a matter of urgency to discuss ways to rescue available to prevent the spread of infections * ‬ *. He ‬ * »‬

Darwish *« ‬ expressed disappointment in the failure of attempts * ‬ Federation for the collection of * ‬ 1% * ‬ input from the poultry industry, officials * ‬ wards and maternal grandparents and the whiteness of the financing activities of the Union and the definition of affected *. ‬ The objection to a number of legal collection * ‬ percentage of non-constitutionality, * ‬ and the need for enactment of legislation by the parliament, * ‬ * ‬ This need for a long time not * ‬ * ‬ of relief in these circumstances *. ‬ The source body for veterinary services »delegation *« ‬ * ‬ current situation of avian influenza that * »‬ catastrophic *« ‬, * ‬ turned to the scene and B * ‬, * ‬ collapse and ways to combat the disease, * ‬ and educators have lost their Ali * ‬ * ‬ position in the light of government action on * ‬ paper, resulting in the exacerbation of HIV infection, said Dr. Saber Abdel Aziz, director general of the Department of epidemics in poultry, * ‬ fourth national campaign to vaccinate poultry against bird flu in poultry farms * ‬ education and household even rural end * ‬ * »‬ March *« ‬ * ‬ last resulted in the vaccination of millions * 8 ‬ and * 923 ‬ alpha and Ktekuta * 529 ‬ * ‬ than one day and the home of nearly * ‬ * 42 ‬ A chick *. ‬ has been since the beginning of * »‬ January *« ‬ even * »‬ April *« ‬ * 221 ‬ examine farm only, * ‬ and take * ‬ 1858 * ‬ samples * 43 ‬ domestic breeding area and the provinces of East * 6 ‬ October, Sohag and Fayoum and Beni * ‬ Suef, Qena, Assiut, Minya and the West Lake and Qaliubiya *. The ‬ * »‬ Saber *« ‬ * ‬ to the power of the General Directorate of Veterinary Services is * 31 ‬ A doctor, * ‬ force and the actual * 6 ‬ thousands just because of all the doctors leave without pay for the business, particularly outside the body in the area * ‬ poultry, * ‬ * ‬ in * ‬ time when we need a strong army * ‬ * ‬ doctors not least * ‬ * ‬ 34 * ‬ A doctor * ‬ addition to huge quantities of syringes, disinfectants and pin and transfer in addition to doctors * ‬ and technicians

hat-tip Florida1

Suspected cases of bird flu in Fayyoum citizen and the Governor of Kafr El-Sheikh recognize some farms the disease, injury

Mohamed Magdy Farghali Oboualainin 4-13-2009

احتجز مستشفى حميات الفيوم أمس إبراهيم على إبراهيم (٥٠ سنة) للاشتباه فى إصابته بأنفلونزا الطيور.

Detained hospital admitted yesterday Fayyoum Ibrahim Ibrahim (50 years) suspected of having bird flu.

وقال الدكتور حسين صوفى أبوطالب، وكيل وزارة الصحة بالمحافظة، إن الحالة من قرية الناصرية، مركز إبشواى، ودخل المستشفى يعانى من ارتفاع شديد فى درجة الحرارة، وأخذت عينات منه لإرسالها للمعامل المركزية بالوزارة لبيان ما إذا كان مصاباً بالفيروس من عدمه.

"Said Dr Hussein Sophie Abutaleb, Under-Secretary, Ministry of Health to preserve, the situation of the village of Nasiriyah, Ibcoay Center, and was admitted to hospital suffering from a very high temperature, samples were taken from the plants to be sent to the central ministry to know whether he was infected with the virus or not.

وأشار الدكتور محمود جودة عقل، مدير عام الطب البيطرى بالمحافظة، إلى أنه تم تشكيل لجنة من المديرية انتقلت لمنزل المواطن، وقامت بإعدام الطيور المنزلية الموجودة به، وبالمنازل المجاورة، كإجراء وقائى بعد سحب عينات منها لتحليلها لبيان ما إذا كانت حاملة للفيروس من عدمه.

The quality of the mind, Dr. Mahmoud, Director of Veterinary Medicine in the government, was formed from the Directorate of the Commission moved to the house of the citizen, and the execution of the existing domestic birds, and the neighboring houses, as a precautionary measure following the withdrawal of samples for analysis to indicate whether the carrier of the virus or not.

وفى كفر الشيخ اعترف المحافظ المهندس أحمد زكى عابدين بإصابة بعض المزارع بأنفلونزا الطيور، وأشار أمام الجلسة الأخيرة لمجلس محلى المحافظة، رداً على السؤال المقدم من العضو أحمد النحاس، إلى ما يتردد من وجود إصابات بأنفلونزا الطيور بكثافة فى أنحاء المحافظة يتم التعتيم عليها من الجهاز التنفيذى، وأنه يتابع الحالة يومياً ويكلف الدكتور حسين عبدالعظيم، وكيل وزارة الطب البيطرى، بالانتقال بنفسه لأماكن الإصابة المبلغ عنها من الأهالى وآخرها بقرية سعفان بسيدى سالم، حيث اتضح إصابة مزرعة دواجن وتم إعدامها.

In Kafr el-Sheikh admitted conservative Abdin Ahmed Zaki injured some farms with bird flu, and pointed to the recent session of the local province, in response to a question submitted by a member Ahmed copper, to the rumors of the existence of bird flu in parts of heavily blacked out, is the preservation of the executive branch and that, following the situation daily and cost-Azim Al-Hussein, Undersecretary of the Ministry of veterinary medicine, the transition to self-reported places of infection of people, the latest Safan Sidi Salem village, where the injury turned out a poultry farm was destroyed.

98% ‬ of the poultry farms and the lack of safety standards we demand where new residents are far from integrated

98% ‬ of the poultry farms and the lack of safety standards we demand where new residents are far from integrated ويقترح نقلها فى الصحراء‬ It is proposed to transfer in the desert كتب ـ عماد خيرة*:‬ اعترف الدكتور حامد سماحة رئيس الهيئة العامة للخدمات البيطرية بأن ضعف إمكانيات فرق المكافحة،* ‬وعدم التزام أصحاب مزارع الدواجن بمعايير الأمان الحيوى،* ‬وراء انتشار الاصابات بمرض انفلونزا الطيور*. Emad wrote the best *: ‬ admitted, Dr. Hamed Samaha Chairman of the General Authority for Veterinary Services to control the vulnerability of the potential difference, * ‬ and lack of commitment by the owners of poultry farms bio-safety standards, * ‬ infections and the spread of bird flu *. ‬قال سماحة فى تصريح لـ* »‬الوفد*« ‬إن* ‬98٪* ‬من مزارع الدواجن علي* ‬مستوى الجمهورية لا تطبق معايير الأمان الحيوى اثناء دخول وخروج ونقل الطيور والتخلص من السبلة،* ‬كما اعترف سماحة بأن فرق مكافحة انفلونزا الطيور لم تصل حتى الآن لمعاينة مزارع الخنازير التي* ‬تعتبر حلقة فى سلسلة الاصابة بالمرض،* ‬وقال إن هيئة الخدمات البيطرية لايمكنها انجاز تقدم علي* ‬صعيد مكافحة المرض وهى تعمل بصورة منفردة ودعا جميع الجهات المختصة مثل الصحة والبيئة والمحليات بزيادة التعاون من أجل حماية البلاد من هذا المرض وردًا على سؤال حول مدى جدوى حملات التحصين*. ‬ Samaha said in a statement to Al * »‬ delegation *« ‬ The * ‬ 98% * ‬ Farms poultry * ‬ level of the republic is not bio-safety standards are applied during the entry and exit, transfer and disposal of birds Sblp, * ‬ Samaha also acknowledged that the combat teams Bird flu has yet to arrive to inspect pig farms that * ‬ considered a disease in a series, ‬ He said that the veterinary services could not complete the ‮ ‬ progress in the fight against the disease, which is working alone and called on all relevant actors, such as health, environment and increase local cooperation in order to protect the country from the disease and response to a question about the feasibility of immunization campaigns ‮. ‬Samaha ‬ confirmed that immunization with the owners of a farm bio-security procedures are not fruitless, ‬ and demanded the transfer of poultry farms Samaha residential areas, ‮ ‬ farms and building new construction is far from the condition for the integration of the massacres of the poultry house and forage plants, ‮ ‬ also demanded the transfer of the head of the pig farms to residential areas to ‮ ‬ places far from home to the citizens as the transmission of the disease ‮ . ‬وطالب جميع الجهات التي‮ ‬تعمل فى‬ and demanded that all those ‮ ‬ operate in the fight against bird flu and transparent declaration of all the real data for the disease so ‮ ‬ clear picture to the relevant resistance ‮. ‬ confirmed the central administration of the affairs of the Ministry of preventive health of suspected cases in the past five days in an unprecedented ‮ ‬, ‮ ‬ registered lists of those suspected of having bird flu on-- Monday, ‮ ‬ ‮ ‬ 6 ‮ ‬ April ‮ ‬ 12-- ‮ ‬ case of two in the lake was in front of Damanhour fevers and cases of 4 ‮ ‬ Menoufia placed Bhmyat Mnov, ‮ ‬ and one each in Qena West, Menya, and olives in Cairo and Alexandria and Ameriya Bilbeis eastern region, ‮ ‬ The list of suspects injured on-- Tuesday ‮ ‬ ‮ ‬ 7 ‮ ‬ April ‮ -‬ 15 -‮ ‬ case of them ‮ ‬ 4 ‮ ‬ Menoufia cases and 3 ‮ ‬ situations in the lake and two in Alexandria and two County ‮ ‬ 6 ‮ ‬ October and one each in Qena, Sohag and surged Bulaq in Cairo and Mahalla were meeting Sunday attended by the deposit of all cases of hospital personnel specialized ‮. ‬ recorded statements of the General Administration for the control of infectious diseases in the Ministry of Health ‮ ‬ ‮ ‬of suspected injury -‮ ‬ 16- case of-- Wednesday, ‮ ‬ 8 ‮ ‬ April were reported ‮ ‬ placement and fever hospitals, including two provinces of the lake, Cairo, Port Said and Dakahlia, ‮ ‬ and one in each of the governorates of Kafr El-Sheikh, Alexandria, Monoufia Qalubia, Menya, Qena and Aswan West ‮. ‬ And the Health Ministry on Thursday, April 9 -12-suspected cases ‮ including two in April and two in Alexandria, Aswan, ‮ ‬ and one each in Beni Suef, Qena, Sohag, Suez, Damietta, lake ‮. ‬ reached toll of suspected cases-- Friday ‮ ‬ 10 ‮ ‬ April - five only - two cases in the East and two in the Wadi Natrun Mehalla the lake and the state had been brought all the major hospitals diets ‮. ‬

Singaporean flu haunted the Elite's Housing

Selasa, 14 April 2009

Depok -- After being stirred up by the bird flu attack last February, the turn of Singaporean flu began to spread in the Depok City, West Java. As many as eight pre-schoolers were in the region of the elite's housing stated suspect or terindikasi the virus attack that in Singapore until claimed this life. The eight pre-schoolers lived in RT 01, 02, and 03, RW 8, Housing of Bella Cassa, Kelurahan Tirtajaya, Sukmajaya. They experienced the same sign in turns. 'My child's' body 'was hot through to 38 levels celcius was accompanied the red colour spot on the palm foot and his hands, as well as experienced the thrush', said one of the parents of pre-schoolers suspect, Elhida (31), on Monday (13/4).

The child Elhida, Shiva (5), became the only one suspect Singaporean flu that could be carried to RS Hermina, Depok, and was diagnosed contracted this illness last April 4. Shiva recovered five days afterwards after being given medicine oles, anti the virus, and medicine kumur. The manager posyandu local, Pipit, explained, suspect other Singaporean flu this time also experienced the same sign. But, finally recovered with the maintenance in the house. He told, how the case started from the Faqih illness (1) on April 3. Afterwards, spread to several pre-schoolers around it that only be at a distance 100 metre. These pre-schoolers, among them, the older brother was siblings Malva (4) and Algez (1.5), the Crescent Moon (1), and Desi (2). According to Head of Sector Pengendalian of the Illness and Lingkungan Sanitation (P2PL) the Service of Kesehatan Depok, Ani Rubiani, that monitored the location, terjangkit him these pre-schoolers because of several possibilities. The cause especially, because of the RNA virus (ribonucleic acid) that spread through air and contact antarmanusia through body fluids, like pilek, the saliva, and excrement.

The condition for the eight children has been good. This Singaporean flu illness in fact not telalu was dangerous for pre-schoolers, but needed the intensive maintenance till 10 days, said Section Head Kesehatan of the Depok City, Hardiono. However, this virus had become an epidemic in Singapore and the Asian region other until causing many deaths. This illness was expected because of the high mobility of the family's member overseas. Officially Kesehatan Depok recorded, the case of Singaporean flu had happened in 2003. At that time, his sufferer's two pre-schoolers also lived in the region of the elite's housing, the Khayangan Attraction. To prevent the spread of this illness, the Kesehatan Service of the Depok City, descended to the field and carried out the high action calorie high protein (TKTP). The method is, suggested the cadre posyandu to give counselling so that parents of pre-schoolers raised the level of calorie and protein in asupan food. With 'raised the level of calorie and protein, the child had body resistance to the Singaporean flu attack', said Hardiono.

The KTM
The illness the medical world, according to the site infeksi.com, Singaporean flu was known as the infection hand, foot, and mouth disease (HFMD) or the illness foot, the hands, and the mouth (KTM). His cause was the virus of RNA. Penyakit this really spread and often happened in the hot season. His target was age children two weeks up until five years or sometimes up until 10 years. When being vomited, diarrhoea, or dehydration and weak or the other complication, the sufferer must be treated. To the baby or young children even must be reconciled to the hospital when emerging the difficult sign, like the temperature of the body more than 39 levels celcius, the fever did not descend-descended, lazy at eating, vomited or diarrhoea with dehydration, pain in the neck, arms, and foot, as well as cramps. C84/zam

Agriculture: 40% of the existing poultry market is currently infected with bird flu!

13/04/2009

Report of clean of the Bureau International des warns of the danger of the spread of the disease in Egypt .. It is recommended to take further action to reduce it

Books and loyalty Sheikh:

Informed sources said the Ministry of Agriculture of the «constitution»: The reports from the departments of veterinary medicine GOVERNORATES different stresses that there is the most serious bird flu in different governorates, both currently of domestic birds or poultry in commercial farms.

The sources pointed out that the directorates of the samples taken from the veterinary poultry farms and poultry in the markets has shown that 40% of the poultry in the markets currently infected with the different governorates of avian flu, and why Ordjan in the presence of this virus to the infected poultry farms in the market, although it infected.

The sources pointed out that the International Office of Epizootics, Paris sent a report to Prime Minister Ahmed Nazif last week warning of the danger of bird flu in Egypt during the current period, the report recommended the need to immunize all the birds at one time instead of the vaccinated in several stages, as well as increasing numbers of workers vaccinated birds, since their numbers were no more than 4 thousand of them 3 thousand vet assistants and the rest, while that required the appointment of at least 34 A, a veterinarian and an assistant to contribute to the vaccination virus.

For his part, Dr. Sami Taha, a member of the Board of the Association that veterinarians to reduce the spread of the disease, it must begin immediately in the application of bio-security standards within the farm, as well as work on the removal of pigs from farms within the residential blocks within the Greater Cairo and transfer to the outside of Cairo, where it has been proven that the scientific work on the spread of pig disease.

Population migration in the neighborhood of Mecca: "stagnant" and the weakness of the spray causes distress

[Dengue Fever]

18 Rabi II 1430 is identical April 13, 2009


Mohamed Suleiman fourth - Mecca

Relatives and residents of the southern migration Mecca the Holy City and the health of surrounding the causes that lead to the spread of dengue fever and infectious diseases, and said: The stagnant water in the streets of the neighborhood are significantly and remarkably attention. They said: The spread of dengue fever in several districts of Mecca, the result of the weakness of the aerial spraying and ground and eliminate the causes of transmission.

A tour of "the city" on the proliferation of neighborhood immigration swamps and overflow of sewage in a number of sites and the main streets in the densely populated neighborhood, and we met a number of people who have confirmed their suffering ..

Muhammad Al-Ghamdi said: "The danger of the spread of dengue fever and other infectious diseases threaten the residents of migration due to a lack of control and aerial spraying of insecticide sites collect stagnant water and asked the secretariat of the Holy City and the health of surrounding the causes that lead to the spread of dengue fever and infectious diseases, adding that there were trees The bushes on both sides of the road result of stagnant water and this increases the danger to local residents who suffer from the absence of insecticide spraying.


He called for citizen Abdul Rahman Saleh authorities to address the flooding and the rapid provision of sewerage systems, home to the neighborhood for more than three thousand citizens and resident .. At the time confirmed that the citizen in favor of the Zahrani district migration suffers these days from the spread of mosquitoes, swamps and mosquitoes collected in the night, we can not sit outside the house or leave the windows open and some were forced to bring private companies to his own spraying swamps adjacent to his home and not every citizen who is willing to bring the company to spray , and due to the municipality that is responsible for the spraying of pesticides and is totally absent on the performance of its role in the scheme.

The Under-Secretary of the Holy City Services Engineer Abdul Salam Bin Sulaiman scorched: The intensive program addresses the awareness of the causes of dengue fever in addition to intensifying the fight against insects, especially mosquitoes Btorih (Alergi and insecticide) in order to maintain the environmental sanitation and the removal of anything that could pose a threat to the health of and safety of residents and visitors to Mecca, he said, adding that the secretariat is currently focusing in the process of control through the use of integrated scientific methods to eliminate insects, with a three control methods, the first is the mechanical control is the elimination of hotbeds and breeding Alkada or by mechanization of labor and the suction backfilling of the water or get rid of mosquito larvae, and the second is biological control, which has been the use of certain types of bacteria or fish to get rid of mosquito larvae, while the third is the way in which chemical control is the use of pesticides to eradicate insects and insect Btoreha Alergi devices, equipment and skilled labor.

Ali said: The secretariat covering all regions of Mecca and of the villages and sacred feelings of the number of teams through the intensification of control and follow-up to the contractor during the morning and afternoon shifts throughout the week, and there is follow-up and coordination with the affairs of health capital in order to follow all of the holy district and the search for sources of breeding that may exist within the home and control aphid is also coordination with the Ministry of Agriculture branch in Mecca for the implementation of a number of Sprinkles the air on the outskirts of Mecca and the holy feelings and non-populated areas.

The branch manager of the Ministry of Agriculture in Makkah, Hisham Al-Halawani, the Ministry of Agriculture's efforts in combating the infection sites in cities outside the barns and farms to prevent the spread of the launch of the effects of dengue fever.

The media spokesman for the health of the Holy City Fayeq Hussein to the Directorate of Health Affairs in Mecca, making an effort in educating the people of dengue fever, its causes and how to prevent it and there are continued efforts in hospitals and health centers in order to clarify the true picture of dengue fever and symptoms, and asked everyone to take preventive measures that lead to fever, infection, There is a program to eliminate the causes of the spread of mouth awareness and methods of treatment and direct cases immediately.

The number of deaths of birds and poultry injustice North

18 Rabi II 1430 is identical April 13, 2009
Eid Al-Otaibi - injustice

A source in the branch of agriculture the status of the injustice he received a communication by a group of citizens to serve the relevant points of the number of deaths of migratory birds and poultry in a northern abandonment injustice, which casts doubt on bird flu virus after it emerged that some strange symptoms and subsequently confirmed by the source of the communication has been received Citizens Task Force has been sent by the branch of agriculture as the injustices of samples taken from dead birds were sent to a branch of agriculture in the province of Taif after transfer to the laboratories in Jeddah and to ascertain the cause of death and awaiting the final results to the Ministry of Agriculture to provide a mobile veterinary clinic, supported by veterinary Btbibin driver with all test equipment and veterinary medicines, and to inspect the conditions of livestock Ahilan village - north of injustice in order to diagnose diseases of livestock and the disclosure and exchange of needed medications.

INSUFFICIENT RESOURCES TO COMBAT AVIAN FLU, SAY EXPERTS

[This article is much easier to understand than the article I posted earlier today]
By Tamim Elyan
First Published: April 13, 2009

CAIRO: Vaccines available against avian flu only cover 36 percent of 300 million birds in rural farms, according to a workshop held Sunday by the UN Food and Agriculture Organization (FAO) and the General Authority for Veterinary Services.

Titled “Evaluation of the National Campaign to Combat Avian Flu,” the workshop brought together experts who said that veterinary authorities’ efforts only cover 10 percent of poultry production.

They also criticized the inefficiency in testing for other diseases and monitoring animal slaughterhouses.

"The amount of vaccinations is barely sufficient to cover the workforce that will distribute them and the responsive farmers who are willing to vaccinate their birds," Saber Abdel Aziz, head of the epidemic and poultry diseases at the General Authority for Veterinary Services, told Daily News Egypt.

Abdel Aziz said that 600 million doses are needed to cover the entire poultry sector; however, the authority can only afford to provide 120 million doses.

Participants at the workshop criticized the lack of sufficient human and financial resources and called for a more active role by the veterinary services authority in combating the virus.

"Out of 13,000 registered veterinarians, we only have 6500 available, 70 percent of which are unqualified for field work because they are over 50 years old. We end up with only 1,200 veterinarians while at least 5,000 are needed," Abdel Aziz said

He explained that no new veterinarians have been appointed since 1994 because of the lack of funds.

Abdel Aziz added that there is a lack of preventive equipment such as special vests or cars to transfer veterinarians. “We only have 1,350 cars, that’s one car for every 20 veterinarians.”

Hamed Samaha, head of the General Authority for Veterinary Services said that Minister of Agriculture Amin Abaza filed a request to Cabinet, asking them to assign the faculty of veterinary medicine graduates to work in various governorates to contain avian flu.

“Only two percent of poultry farms apply bio-security measures,” Samaha said.

According to Abdel Aziz, in 2006 the first avian flu campaign vaccinated 90 million birds. However, subsequent campaigns didn't achieve the same level of success because farmers were unresponsive.

"It is a problem of awareness," he said.

"At first farmers were concerned so they cooperated with the authorities but now they are more confident so they don't respond to our efforts,” he said.

He was, however, optimistic about efforts this year.

Recombinomics: H5N1 Emergency Near Qena Egypt

Commentary

Recombinomics Commentary 17:34
April 13, 2009

Red Sea Governorate announced a state of emergency and tightened control over the southern port cities of Safaga and the short to fight with any suspected cases of avian influenza.

The Secretary-General Majid Obwafattouh Sunday to maintain the continued control campaigns and tighter control of the port 85 km, which connects between Safaga and Qena to prevent the entry into or the circulation of live poultry to maintain and remove all the nests near the house to prevent the breeding of poultry and intensify campaigns Investigation of Supply and veterinary control of vehicles carrying poultry.

The above translation describes efforts to limit poultry movement between Safaga and Qena, Egypt. Although no confirmed H5N1 infected poultry has been reported in Qena, a recently confirmed toddler (case #60) is from Qena and local media reports have described a large number of suspect cases and clusters hospitalized in Qena in recent days.

The events have precipitated a state of emergency in the area that involve tightened controls in Safaga, which is 85 km from Qena (see updated map) and signal additional concerns that the number of H5N1 in poultry and patients is significantly higher than the one confirmed toddler.

Antibody testing of sera collected from the hospitalized patients 3-4 weeks after symptoms should begin immediately. The possibility of false negatives in PCR tests remains high, and antibody testing of recovered symptomatic patients in Egypt is long overdue.

Media Links

Note veterinary services expose the government's plan to fight the disease

Emad wrote the best : asked Dr. Ahmed Nazif, Prime Minister, leaders of the General Authority for Veterinary Services to re-evaluate the plan in place to cope with bird flu, and monitoring gaps and strengthen the positive elements to reach began the siege of the disease, which tends to epidemiological situation in all governorates of Egypt, agreed Dr. » clean « Ali appointment 1500 vet teams to strengthen the body fight against bird flu, Dr. Hamed Samaha chief of veterinary services that the difference in the fight is not enough to cover all governorates Egypt, said we 1200 immune and we need 34 A fortified outposts to cover the sick and the target areas to implement the plan of immunization 3 times a year and admitted that the potential for the generosity of veterinary services are not currently adequate to cover 30% of the target areas, His immunization is not a factor eliminate the disease, but a factor of resistance . ‬ The home of the first and is the reason behind the spread of hot and sick that he collected all of the demands in the memorandum presented to the High Commission avian flu which, in turn, presented to the Prime Minister and asked where to buy 1350 addition to new car 170 car we have purchased to support the teams control, revealed that the tolerance control work of the task depends on communications received from citizens and the Ministry of Health, which inform us of cases of suspicion, The body is made 53 focus satisfactory Since the beginning of this year, including 50 focus in education and household 3 reported seizures of vehicles by the birds, turkey samples were analyzed and found to be positive . and Dr. Saber Abdel Aziz, director of central administration of the General Authority for Poultry Veterinary Services, with farm owners to report injuries from the disease on their farms in order to avoid losses could have been positive if the disease proved to have been culled poultry without the adoption of the government to compensate them, demanded Dr. Saber pay adequate compensation to the owners of farms demonstrated disease so encourage them to report in the case of injuries, The official source of the General Authority for Veterinary Services are useless vaccine immunization H5N1 Under these circumstances, and said that the weakness of the past confirm the feasibility of immunization, He said that the immunization be at the beginning of Omar poultry is again a month later, how this is done immunization teams are not enough to cover 30% target .

Conflicting change strain of bird flu in Egypt

Strain of the virus requires a change of new vaccines
Monday, April 13, 2009


Dr. Mustafa Orhan, former director of the Regional Office of avian flu, the WHO in a statement to the seventh day there have been some changes in the strain of the bird flu virus in Egypt, and it changed from year to year, but said he could not be sure that those changes on the avian virus mutates birds in Egypt, which allows the form by moving from person to person.

Orhan emphasized that the strain of the disease change from year to year, requires a change in the types of vaccines used in combat, confirming that the virus has not mutated, however, now fully transformed into an epidemic of people going through. It was necessary to adhere to the infected countries, particularly Egypt and bio-safety standards in the poultry, poultry farms and slaughtered, and others.

Orhan, Mustafa said, the alleged ineffectiveness of the vaccines used in Egypt is not accurate, because the rate of effectiveness of any vaccine does not exceed 90% in less than 50%, indicating that helps the spread of the disease in Egypt is a great education for slum birds.

For his part, admitted that Fattuh Darwish Director of the Preventive Medicine Department of Veterinary Services Authority, bad situation in Egypt said it was for reasons related to the way birds in the houses and farms and the extensive spread of shops selling live birds. Darwish pointed out that the avian influenza virus has not mutated, and has not changed its lineage, or take any other forms, pointing out that he is still in position and which does not allow him to move from one person to another.

Noteworthy that the number of cases infected with the disease in Egypt reached 63 cases, died, including 23 so far.

The British Independent newspaper has noted in its recent report to the symptoms of bird flu in Egypt has started to take a different form from last year, which raised doubts in the World Health Organization that the virus could be on his way to a mutation in Egypt, especially after his appearance on a number of children in Shortly after his affects adults, children and adults, which may mean that the virus may be latent in the adults, without showing any symptoms of the disease, and pointed out that the World Health Organization supports the search for the time being in Egypt aims to ensure that developments reached by the virus, through examination of the blood of persons who come into close contact with infected birds.

Recombinomics: Suspect H5N1 Custers in Qena Egypt Raise Pandemic Concerns

Commentary

Recombinomics Commentary 15:34
April 13, 2009

Detained hospital fevers QENA both happy Rizq "28 years" of the Naga village of solar modules and David Nasser Zaghloul Khulud "4 years" of the Naga village of Duma Mahrousa and Muhammad Arif Mahmood, "years and 4 months" from the village of Dandara, Nabil Abdalenaim Alhawwal "8 years" from the village of solar modules on suspicion of contracting bird flu virus.

Said Ayman Abdel-Moneim, Under-Secretary, Ministry of Health Rawash said Saturday the detention of children was Nabil Abdel-Naim (eight years), Muhammad Arif (six years), we inaugurated the Center of the hospital admitted Qena

QENA detained in hospital diets 5 people suspected of contracting the disease are: Omaima Fatehy «41 years», housewife, and her baby Ahmed Yacoub, two, and Zeinab Mahmoud Alhenwany «40 years», housewife, and Suad Abdullah Hamid, «40 years», and the Princess Razeq Abulhasan, «21 years», housewife, on suspicion of having bird flu

In Qena, the Directorate of Health announced a state of emergency in a hospital after the fever in the central laboratories of the Ministry of Health wounded girl, "Israa Saad Shafi," which showed symptoms of the disease last Monday and was taken to the hospital.

Detained hospital fevers QENA woman on suspicion of being infected with bird flu, which entered the El-Shafei Bkhittp (48 years old), a housewife from the village of Qena, the status of solar modules, in a very weak condition,

Detained hospital fevers Qena, two cases of suspected bird flu virus, which entered both happy Rizq Bayoumi, (28 years) Bahadjirat housewife and Khulud El Nasr (4 years), the hospital in case of extremely weak and suffering from high temperature,

The above translations describe some of the patients hospitalized in Qena recently. It is unlikely that these patients will be confirmed, because less than 1% of patients hospitalized with bird flu symptoms and stated contact with dead or dying poultry are confirmed. This low confirmation rate leads to a lack of correspondence between suspect hospitalized patients described in media reports and those that are confirmed, because even if 10% of the hospitalized patients are covered in media reports, it is likely that the suspect cases will be the 99% of patients who test negative.

However, the survival of all confirmed cases this year and the concentration of cases among toddlers (10/12 confirmed cases) has raised concerns that the number of H5N1 infections in Egypt is markedly higher than the number of confirmed cases, and a significant number of the hospitalized patients produce false negatives in the PCR testing done to determine which patients eventually are confirmed.

These concerns have been heightened further because of two cousins who are next door neighbors and developed bird flu symptoms four days apart, signaling human to human transmission between the toddlers. Moreover, there have been no confirmed H5N1 poultry cases in the Beheira neighborhood of the two toddlers (see updated map), and the toddler confirmed prior to the cousins in Beheira was in Qena, where there has also been no confirmed poultry cases (see updated map).

The confirmation of H5N1 in toddlers that are not linked to confirmed poultry cases raises concerns of silent transmission among symptomatic patients that had relatively mild cases or respond to oseltamivir treatment, which is given to suspect patients prior to test results.

The analysis of clusters provides insight into potential false negatives. The largest confirmed cluster to date in Egypt was in Gharbiya in late 2006. Three family members were fatally infected, but only two were PCR positive, demonstrating that even symptomatic fatal cases could test negative on PCR testing.

Similar concerns were generated when NAMRU-3 investigated a cluster in Pakistan. Only one family member was PCR positive. He died, as did a brother who was not tested. However, the index case, who survived but developed pneumonia , tested negative in the PCR test, yet was found to have an H5N1 titer of 2560, a very high number. Moreover, another brother who survived had an H5N1 titer of 320, again giving a clear signal of H5N1 infection by the first brother to die. Moreover, a fifth brother, who was asymptomatic also tested negative by PCR, but also had a titer of 320. Thus, of the four brothers who were tested and were clearly infected with H5N1, only one was PCR positive (and that isolate was sequenced and found to be clade 2.2.3).

However, these false negatives are not limited to cases in Egypt or cases tested by NAMRU-3. The first four suspect siblings in Turkey in late 2006 also initially tested negative in PCR testing of throat swabs, but fluid collected when the first three cases were near death were PCR positive and clade 2.2 sequences were released from two of the siblings. Moreover, H5N1 was never confirmed in the fourth sibling.
Thus, the prior false negatives in clade 2.2 infections, raises concerns of false negatives in clade 2.2 infections in Egypt.

Therefore, in addition to testing of asymptomatic patients for neutralizing antibodies, the symptomatic patients who were PCR negative but had bird flu symptoms and poultry contacts should be among the first tested for H5N1 antibodies.

Similarly, at risk groups such as toddlers with symptoms but no reported poultry contacts should also be tested by PCR, as well as neutralizing antibodies in convalescent serum collections.

The confirmation of H5N1 in mild cases in toddlers, coupled with the large number of patients hospitalized with bird flu symptoms, should lead to much more aggressive testing of patients in Egypt.

Media Links

Egypt Seeks UN Bird-Flu Probe After Non-Fatal Cases (Update1)

By Jason Gale
April 13 (Bloomberg) -- Egypt asked the World Health Organization to help investigate an outbreak of bird flu after a dozen non-fatal cases of the disease this year prompted speculation the virus may be becoming less virulent.

Two WHO doctors and a scientist will travel to Cairo later this week at the request of Egypt’s Ministry of Health, said Gregory Hartl, a spokesman for the United Nations agency in Geneva, in an interview today. The UN team will assist local authorities identify how the patients were infected with the H5N1 strain of avian influenza and whether there have been any significant changes in disease patterns or in the virus itself.

Scientists have been following H5N1 for more than a decade because of concern it could spark a pandemic if it becomes as infectious for humans as it is for poultry. A less lethal strain could be more contagious because people would have longer to transmit it through coughing and sneezing. None of the 12 Egyptian cases reported to the WHO this year has been fatal.

“These data do indeed suggest that there may have been a reduction in the virulence of the outbreak strain, and there is a perceived risk of progression of the virus to a less virulent but more transmissible form,” the International Society for Infectious Diseases said today in an e-mail via its ProMED-mail program.
The survival of H5N1 patients in Egypt also may reflect early treatment with antiviral medicines, ProMED said.

At least 417 people in 15 countries have contracted the virus since 2003. Three of every five cases worldwide were fatal. Most cases were caused by contact with infected poultry, such as children playing with them or adults butchering them or plucking feathers, according to WHO.

FAO Assistance
H5N1 is continuing to circulate in poultry in Egypt, though there is no evidence so far of any significant changes in the virus, said Joseph Domenech, chief veterinary officer with the Food and Agriculture Organization. The Rome-based UN agency has also agreed to a request by Egypt’s government to provide technical assistance, Domenech said in an interview today.

Egypt has the highest number of avian-flu cases outside Asia, with 63 cases reported to WHO since 2006 of which 23 were fatal. In comparison, more than 80 percent of the 141 people reported to have been infected in Indonesia died.

Roche Holding AG says its Tamiflu antiviral medicine can reduce the severity and duration of flu symptoms if taken within 48 hours of the onset of disease. Early treatment for H5N1 may improve survival, some uncontrolled studies have shown.

To contact the reporter on this story: Jason Gale in Singapore at j.gale@bloomberg.net