China's Shandong quarantines 23, declares health emergency

(Xinhua)
Updated: 2009-05-14 13:12

JINAN - Health authorities in east China's Shandong Province put 23 people under home or hospital quarantine Thursday morning to check for symptoms of A (N1H1) influenza, the provincial health department said.

The 23 had been in close contact in a Beijing-Jinan train with a male resident of Shandong who health officials said Wednesday had tested positive for the disease.

The provincial health authorities are seeking 20 other passengers who were in the same car of train D41, from Beijing to the provincial capital of Jinan, on Monday.

After the man was diagnosed, Shandong Province declared China's first swine-flu health emergency at about 6 pm Wednesday.

Wang Suilian, vice governor of the eastern province, said Shandong declared the second-level health emergency, which will involve many departments coordinating to contain the disease and keep the public informed.

Shandong's flu case, the second known case on the Chinese mainland, involved a 19-year-old student surnamed Lv who arrived in Beijing from Canada on May 8 and traveled to Jinan three days later.

Lv was hospitalized Monday. He was recovering with a normal body temperature on Wednesday, when he was taken off intravenous feeding.

"We only prescribed some anti-influenza medicine like Tamiflu for Lv," Dr. Ma Jiren, who is also deputy director of Jinan's Health Bureau, said Thursday.

Lv is in an isolation ward in the Jinan Hospital of Infectious Diseases.

Zong Lin, chief of the disease control and prevention section of the Shandong Provincial Health Bureau, said health officials were sending text messages and running notices on TV to find the remaining passengers

A security guard holds a security line outside a sealed-off hotel where Lv, China's second confirmed case of the new H1N1 strain of flu, had stayed at in Beijing May 13, 2009. [Agencies]

A health official surnamed Zhang said that the second-degree emergency declaration was the highest-level response available to provincial governments. A first-degree emergency declaration would be up to the central government.

Beijing launched a second-degree emergency response against bird flu in January after a 19-year-old woman died of the disease in the capital. The city's poultry markets were closed and disinfected, and disease control staff went door-to-door in suspected infection areas to check flu patients.

"A second-degree emergency can be declared when an A-class infectious disease is confirmed. The A (H1N1) influenza is currently classified as B-class infectious disease in China.

"However, the health department proposed the emergency be declared immediately, because the scientific community is still unclear about how the virus spreads and there is a high risk of a mass outbreak," he said.

The mainland's first A (H1N1) flu patient, who has been at the Chengdu Infectious Diseases Hospital in southwest Sichuan Province for four days, was making a rapid recovery.

All 147 passengers who had been exposed to that patient on Northwest Airlines flight NW029 from Tokyo to Beijing, had been contacted by the Beijing Health Department, said the department on Wednesday.

Australia watching flu risk for Indonesian pigs

Thursday, 14/05/2009

Australia is worried that the Indonesian pig population could be struck down with a new form of flu.

Senator Joe Ludwig has told Federal Parliament that after Canadian pigs caught swine flu from humans, there's now concern swine flu could spread to Indonesia and mix with bird flu within the pig population.

"Evidence to date about the bird flu virus is that its ability to mix with other viruses is limited compared with the ability of seasonal viruses - that is, those which are H1 and H3 - to mix," he said.

"Nonetheless, this is an important concern that needs close monitoring

Bird flu hits another province of Vietnam

2009-05-14 11:15:49

Print

HANOI, May 14 (Xinhua) -- Another Southwestern province Dong Thap of Vietnam was confirmed of being hit by the bird flu, said are port of the Vietnam's Department of Animal Health under the Ministry of Agriculture and Rural Development on Thursday. The bird flu broke out in a local farm on May 10, killing 49 out of a flock of 142 ducks, said the report. Local animal health authorities had been implementing measures to curb the spread of the bird flu virus to nearby areas. Currently, Vietnam reported three provinces hit by avian flu including two central provinces of Thanh Hoa and Quang Ngai and a newly-confirmed Mekong Delta province of Dong Thap, said the department. Vietnam has reported five human cases of bird flu so far this year, four of them died.

State confirms swine flu sickened cruise worker

The Associated Press
Published: May 12th, 2009 09:33 PM
Last Modified: May 12th, 2009 09:33 PM
State health officials say tests have confirmed that swine flu sickened a cruise ship crew member. The testing was done at the Washington State Public Laboratory and results were verified on Sunday, but it wasn't until Tuesday that the lab was formally authorized by the Centers for Disease Control and Prevention in Atlanta to issue confirmations.



The female crew member aboard the Serenade of the Seas became ill on May 2 and has since recovered after a course of treatment and CDC-recommended seven-day period of isolation.
No others aboard the ship have reported symptoms determined to be swine flu.
Alaska health officials say the case can't be considered Alaska's first case for several reasons, including that the woman became ill before entering state waters.

/13/2009 11:57:00 PM
CAIRO - Editor Masrawy - confirmed on Wednesday No. 70 of infection with avian influenza for children aged 4 years from the eastern province of Kafr Saqr and his condition was good and stable.

This was stated by Dr. Amr Kandil and Undersecretary of the Ministry of Health Affairs, prevention, said the boy admitted to the Hospital of Zagazig, with a high temperature, showing symptoms of Alatvlonza, decided to convert it to a hospital in the Tamiflu drug, which analysis has shown a result of the disease usually infected domestic birds, and treated with Tamiflu.

Despite the strain, "said the 5 H 1" of the bird flu virus rarely affects humans express experts fear it could mutate into a virus that can infect easily from person to person, sparking a pandemic could cause the deaths of millions of people.
Most people living in Egypt had been in contact with infected domestic birds in a country where the adoption of some five million families on the poultry kept at home as an important source of food and income.

The World Health Organization said it feared that some of the Egyptians may have avian influenza virus without showing any symptoms, which may give the virus a greater chance of turning into a strain easily spread among humans.

Influenza pandemic planning needed to assure adequate care for pregnant women and newborns

May 13th, 2009

Pregnant women and newborns are at greatest risk in a flu epidemic, but more planning must be done to ensure that they receive priority treatment should an outbreak occur, according to a University of Pittsburgh Medical Center (UPMC) and University of Pittsburgh study. The findings, published online in Emerging Health Threats Journal, raise concerns about the ability of hospitals to adequately treat this vulnerable population, particularly in light of the current H1N1 flu outbreak.

"Although it is not clear how well modern medicine will be able to prevent devastation during a large-scale infectious disease outbreak, it is widely recognized that advance planning may lessen the negative impact," said study author Richard Beigi, M.D., Department of Obstetrics, Gynecology and Reproductive Sciences at Magee-Womens Hospital of UPMC. "This is especially important for pregnant women, fetuses and neonates, all of whom are often left out of national level consideration."

The study was based on an Internet survey of the 12-member Council of Women's and Infants' Specialty Hospitals, a national organization of non-profits that share information and operational data to improve maternity and newborn care. Member hospitals account for over 120,000 deliveries annually. Seven of the nine are free-standing maternity hospitals and the other two are maternity hospitals within large health systems.

"A major concern we found was how to ethically ration limited medical resources when faced with too many patients and not enough medical supplies and personnel," said Dr. Beigi, who is an assistant professor in the Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Reproductive Infectious Diseases and Immunology, University of Pittsburgh School of Medicine.

He added, "Although 56 percent of hospitals report that they have begun to address this issue, none have any formal plan yet in place. Another complicating factor is that despite the likelihood that this population will have an increased susceptibility to influenza during a pandemic, little data exist on the safety of vaccines and treatments to combat infectious disease in pregnant women and newborns."

The encouraging news is that 78 percent of the hospitals that responded have formal written plans in place to address communications, a surge in patient volume and possible degradation of non-essential medical services. All facilities planned to provide care to their own employees despite the potential for significant shortages of both personnel and supplies, and 56 percent of the hospitals planned to provide augmented day-care services for employees' children to help workers continue to work.

An additional area of concern is coordination with local, state and federal government public health agencies. Many hospitals, particularly private ones, are uncertain how they would interact with public health agencies.

Still, public health agencies will play a critical role in providing information, medications and vaccine dissemination since they will be supplied by the federal strategic stockpile and may have the most accurate information as a pandemic unfolds, Dr. Beigi reported.

Although it is difficult to predict when the next influenza pandemic will occur, large scale outbreaks have been reported every 10 to 40 years. The emergence of H5N1 avian influenza in 1997 and the fact that nearly 40 years have passed since the last outbreak makes the threat of a severe pandemic a realistic possibility in the near future.

"Many challenges remain if we are to improve on our efforts to optimize outcomes for pregnant women and newborns during the next influenza pandemic," he said. "It is hoped that this study will stimulate planning efforts for all hospitals providing maternity care in preparation for this apparently inevitable infectious disease outbreak."

4 detention of suspected cases of bird flu in the lake

Wednesday, May 13, 2009 - 14:13


Avian influenza threatens the Egyptian disaster


The hospital admitted Damanhour and Alexandria 4 persons detained on suspicion of having bird flu, after the emergence of symptoms of the disease are similar to them, with a high temperature, sore throat and difficulty in breathing.

Received the Major General, Magdi Abu Amar, director of security of the lake, a notice of the detention hospital fevers Damanhour Mei Mohamed Zaki (4 years) Mahmudiya resident, Mohamed Ghoneim, Ibrahim (23 years) Bobouhms resident, Mohamed Ahmed Tamer (5 months) the new resident of the village kindergarten. In Alexandria, the hospital admitted the detention of Alexandria Attiyat Fahmy (26 years old housewife), where blood samples were taken for analysis of the injured central labs in Cairo.

And were immediately set up a committee of health, veterinary medicine and the local units and the preservation, accompanied by the security forces to check all the houses of the injured and the houses around them, and cleared, and was taking a sample of birds infected with the existing houses to demonstrate the positive and to ensure their safety.

Egypt-3 suspected cases of swine flu

الأربعاء، 13 مايو 2009 - 19:54 Wednesday, May 13, 2009 - 19:54

New suspected cases of swine flu Bhmyat Imbaba

. Received hospital fevers Imbaba day, Wednesday, three suspected cases of swine flu, including an important figure in the hospital officials refused to disclose the identity.

Three cases of the same family, were on a trip to the United States for a month, the beginning of a mutated virus and its transmission among humans, and returned to Cairo this week, but they are suspected of contracting the infection, in particular showing signs of high temperature.

Three cases have been detained in a special ward excellent therapy department, pending the report of the examination of blood samples and throat of the central laboratories of the Ministry of Health, to determine whether the incidence of positive or negative.

Increase in the number of suspected cases of bird flu

Amounted to 44 cases, according to the Ministry of Health ..

الأربعاء، 13 مايو 2009 - 12:13 Wednesday, May 13, 2009 - 12:13

The Ministry of Health, the high number of suspected cases of bird flu in humans to 44 cases, and the results of laboratory tests have a negative rate of 8 cases of the Governorate of Cairo, Alexandria and 8 cases and 5 cases in each of Menoufiya and West, and 3 cases of the eastern region, Damietta, two Rawash Qalubia, and one each in Fayoum, Menya, the lake and Dakahliya.

This brings the number of suspected cases of bird flu in humans since the disease in Egypt in 2006 to the 7179 case, the infection was confirmed for 69 of them died, including 26 cases of disease, while 42 corresponded to the situation of recovering.

NAMRU-3: Avian Flu in Egypt Reached High Risk Stage

By Mohamed Talaat el-Hawari 11/ 5/ 2009

The Map A report issued by the Third Medical Research Unit of the US navy (NAMRU-3) said Egypt is the most country infected with avian flu outside of Asia, despite control measures. The report, of which Al-Masry Al-Youm got a copy, said 71% of the infected patients received medical treatment within 3 days of the symptoms. It also said the government sent NAMRU-3 941 samples in February and March, of which 934 samples were under the Seasonal Influenza Control Program, and 7 samples to be examined for (H5 N1) and (HPAI). It pointed out that among the 63 confirmed cases recorded in Egypt between March 2006 and March 2009, there were 23 serious infections. The report used the term 'epidemic curve' when it addressed the evolution of the disease in Egypt, where the number jumped from 18 cases in 2006 to 12 cases in the first quarter of this year alone. It revealed that infections have increased among children less than 5 years of age and females between 10 and 39 years, pointing out that female infection reached 60%, a rate that is much greater than the global rates. It said Egypt ranked third in the global infection rate with a 14% infection rate as registered by the World Health Organization in March. Indonesia is ranked first with 34% and Vietnam second with 26%. The report also said the infection covered all of Egypt in 2007, when it was only in the Delta in 2006.

Swine flu vaccine won't be ready for next wave

Editorial: Beware the return of swine flu

A VACCINE against the Mexican swine flu sweeping the world is likely to arrive too late for most people, vaccine officials told New Scientist between a flurry of high-level industry meetings this week.

The World Health Organization is now considering whether to advise the world's vaccine makers to switch from ordinary flu vaccine to the Mexican H1N1. As New Scientist went to press, a pandemic was officially on the cards, but even if the WHO gives the go-ahead, vaccine will arrive too late for many.

Studies so far suggest that H1N1 has been only slightly more lethal than ordinary flu (see "Preparing for when swine flu returns"). But while regular seasonal flu hits the very elderly hardest, this virus affects the young (see chart). And there are fears that it could become worse in subsequent waves like previous pandemics. "We are starting experiments to see what changes make this virus more dangerous," says Ab Osterhaus of Erasmus University in Rotterdam, the Netherlands.

Vaccine makers are left with a dilemma. "If we make ordinary vaccine and the pandemic comes instead, we will be blamed," says Norbert Hehme, chair of the industry's flu vaccine task force. "If we make pandemic vaccine and get ordinary flu, we will have a shortage of ordinary vaccine, so we will also be blamed."

So the industry will not switch to H1N1 vaccine without WHO approval and the go-ahead from governments with vaccine contracts, says Bram Palache, chair of the European Vaccine Manufacturers (EVM) flu vaccine group. And even if that happens soon, there will be none before September because of the time needed to produce it.

First companies need "seed" virus containing two genes for antigens, or surface proteins, from H1N1 and the rest from a standard vaccine strain. That was expected this week from labs working with the WHO. "We were told Monday we won't get it till the end of May. I don't know why," says Luc Hessel of the EVM.

It then takes three weeks to make enough seed to grow in eggs - or at one Czech plant, in cell culture. None of the modern cell-culture plants planned in response to bird flu have been built - they would have made it possible to produce much more vaccine. Last year, the Belgian firm Solvay cancelled one planned for the US, citing insufficient demand for ordinary flu vaccine. "Potential demand for pandemic vaccine cannot justify the investment," Palache says.

"It only takes three days to grow the virus in eggs, but weeks for testing and formulating," Hessel adds. That means no vaccine until September, and no real quantities until October. Then countries have to administer millions of doses, which take weeks to take effect. In 1918, the worst wave of the pandemic hit in September.

It takes weeks for testing and formulating. That means no vaccine before September

The first to get pandemic vaccine will be the 15 countries who have pre-ordered a total of about 250 million doses. "We can't say how long making them will take," Palache warns. It partly depends on how much virus is needed per dose. In theory, countries that place new orders now might get vaccine in November. In 1918, the autumn wave was nearly over by then.

The 15 countries with advance purchase agreements include Canada and Australia, which have vaccine plants, New Zealand, and 12 European countries including the UK. Europe has 70 per cent of the world's manufacturing capacity. Other countries, including Japan and China, plan to produce their own.

The US has one vaccine plant, owned by French drug giant Sanofi-Aventis, which could in theory produce enough for the US population. However, the US has no advance purchase order in place.

مازالت الحملات المكثفة في مكافحة انفلونزا الطيور مستمرة وإعلان حالة الطواريء في جميع مستشفيات الحميات بالمحافظات لاستقبال حالات الاشتباه والاحتجاز إلي جانب عمليات الاعدام للطيور داخل المزارع وإزالة العشش من المنازل بالقري والمدن ورغم كل الاجراءات فالخطر لايزال قائما‏.‏ Intensive campaigns are still in the fight against bird flu and continuing the declaration of a state of emergency in all hospitals in the governorates to receive the diets of suspected cases of detention by the executions of the birds in the farms and the removal of the nests of the houses in villages and towns and in spite of all the proceedings of the danger still exists. والتقرير يوضح الوضع الحالي في بعض المحافظات‏..‏ The report explains the current situation in some provinces .. في أسوان ـ من موفق أبو النيل‏:‏ In Aswan, the Nile of Abu Mowaffaq: يشهد مطار أسوان اجراءات طبية متشددة مع ركاب رحلات الطيران العارض‏(‏ الشارتر‏)‏ القادمة مباشرة من المطارات الأوروبية إلي مطار أسوان الدولي وخاصة ركاب الرحلات القادمة من دول أعلن عن وجود اصابة بها بمرض انفلونزا الخنازير‏.‏ Aswan Airport is radical medical procedures with a passenger charter flights (charter) coming directly from European airports to Aswan International airport and passenger flights, especially coming from countries declared by an injury, disease, swine flu. وطلب المحافظ مصطفي السيد وضع مطاري أسوان وأبوسمبل في درجة الاستعداد القصوي وكذلك ميناء السد العالي‏.‏ The governor also asked Mr. Mostafa develop airports Simple city near Aswan, in the high state of alert, as well as the port of the High Dam. وأعلن الدكتور محمد صلاح الدين وكيل وزارة الصحة باسوان ان الادارات الطبية باسوان كانت قد احتجزت سائحة اسبانية بمستشفي الحميات باسوان لمدة‏24‏ ساعة للاشتباه في اصابتها بأنفلونزا الخنازير وقد تم السماح لها بمواصلة رحلتها السياحية بعد أن جاءت نتيجة التحاليل للعينات التي أخذت من السائحة سلبية ودرجة حرارتها طبيعية وقال انه يتم متابعة السائحين يوميا طوال فترة زيارتهم للمحافظة ثم يتم اخطار المحافظات الأخري التي يتوجهون إليها للقيام بالمتابعة ويستمر ذلك حتي يغادروا مصر وذلك من أجل حماية البلاد من وصول العدوي‏.‏ And Dr. Mohamed Salah Eddin, Under Secretary of the Ministry of Health medical departments Paswan Paswan had detained a Spanish tourist Paswan fever hospital for 24 hours on suspicion of bird flu in pigs have been allowed to continue its journey after the tourist were the result of analysis of samples taken from the tourist and the degree of negative temperature is normal and he is the follow-up of tourists every day for the duration of their visit to the province, and then notice the other provinces to go for a follow-up and continue to leave Egypt in order to protect the country from the arrival of the infection. وفي المنوفية من ـ رفعت أبوسريع‏:‏ In Monoufia Refaat Obossria: أكد المهندس سامي ياسين أمين الحزب الوطني بالمنوفية تشكيل الأمانة العامة للحزب الوطني للجنة برئاسة السيد جمال مبارك أمين السياسات بالحزب الوطني لتوعية المواطنين بمخاطر مرض انفلونزا الطيور والخنازير والاتفاق علي متابعة أمانة التنظيم تنفيذ خطة التدريب والتوعية‏.‏ Engineer Sami Yassin Menoufia National Party Secretary General of the Secretariat of the party's national committee, headed by Gamal Mubarak, Secretary of the National Democratic Party's policy to educate the public on the dangers of bird flu, pigs and agreed to follow up the implementation of the plan of management training and awareness-raising. ومن جانبه أعلن المهندس سامي عمارة محافظ المنوفية أنه تم اعدام‏32‏ ألفا و‏527‏ طائرا في جميع مراكز المحافظة بداية من حملة الاستنفار التي بدأتها المحافظة في الحادي والعشرين من الشهر الماضي بالاضافة إلي إغلاق‏143‏ محلا لبيع الطيور والدواجن وقطع الكهرباء والمياه عنها وهدم‏417‏ عشة أعلي المنازل بالقري وضبط‏18‏ سيارة تنقل الطيور بدون ترخيص مشيرا إلي أنه تم ضبط‏417‏ بائعا متجولا‏,‏ كما أشار الدكتور هشام عطا يوسف وكيل وزارة الصحة بالمنوفية إلي أنه تم حجز حالتين جديدتين للاشتباه بانفلونزا الطيور وهما حنان عبدالعزيز السيد صوافي‏(42‏ سنة‏)‏ من البتانون وسامية محمد عمر الشيمي‏(42‏ سنة‏)‏ من الباجور وتم أخذ العينات وإرسالها للمعامل‏.‏ For his part, Sami al-Amara Monoufia governor that the execution was 32 thousand and 527 birds in all the positions of the beginning of a campaign to maintain the alert launched by conservative atheist twenty last month, in addition to the closure of 143 shops for the sale of birds and poultry, and cut off electricity and water 417 and the demolition of shanty houses the highest 18 villages and seized a car carrying birds without a permit, pointing out that control the 417 street vendors, as pointed out by Dr. Hisham Youssef Atta, Deputy Minister of Health Menoufia reservation had been two new suspected bird flu Hanan Abdul-Aziz, and two ofSoavi (42 years old), and Samia Alaptanon Shimi Mohammed Omar (42 years) of the Alpajur sampling and were sent to the labs. Mr. وفي سوهاج ـ من محمد مطاوع ونيفين مصطفي‏:‏ In Sohag, Mohamed Mostafa Mutawe and Nivine: قرر السيد محسن النعماني محافظ سوهاج تشكيل لجنة من مديريات الزراعة والصحة والطب البيطري والبيئة والوحدات المحلية للمرور علي المزارع الملاصقة للكتلة السكنية واتخاذ إجراءات الغلق لها وعدم تشغيلها‏.‏ Mr. Mohsen decided Numani Sohag governor to form a committee from the departments of agriculture, health, veterinary medicine, the environment and local units of the passage of the farms adjacent to the residential block and take action, and closure of non-operation. كما قرر المحافظ التأكد من عملية غلق محلات بيع الطيور الحية والريشات وضبط الطيور الحية واعدامها‏..‏ جاء ذلك خلال اجتماع اللجنة العليا لمكافحة مرض انفلونزا الطيور‏.‏ It also decided to make sure the governor of the closure of shops selling live birds, Downs and control of live birds and culling .. This came during a meeting of the Higher Committee to combat bird flu. وقال الدكتور أبوالقاسم زهرة وكيل وزارة الزراعة بسوهاج أن مديرية الزراعة قامت بعمل حصر لمزارع الدواجن الملاصقة للكتلة السكنية‏.‏ " Dr. Abu al-Zahra, undersecretary of Agriculture, Sohag Directorate of Agriculture has done an inventory of poultry farms adjacent to the residential block. ومن ناحية أخري تم حجز طفل من المخالطين لطيور منزلية بمستشفي حميات سوهاج لاشتباه اصابته بمرض انفلونزا الطيور وهو عبدالعزيز يسري عبدالمنعم‏(‏ سنة و‏8‏ شهور‏)‏ من قرية أولاد نصير بمركز سوهاج وتم أخذ عينة ومسحة وإرسالها للمعامل المركزية بوزارة الصحة للفحص والتحليل‏.‏ On the other hand, has been reserved for the contacts of the child domestic birds Souhag admitted to hospital suffering a suspected bird flu, which applies Abd Aziz (one year and 8 months) from the village boys champion was the status of Sohag, survey sample and sent to the central Ministry of Health laboratories for examination and analysis. وفي كفر الشيخ ـ من علاء عبدالله‏:‏ In Kafr el-Sheikh Alaa Abdullah: تم احتجاز‏5‏ حالات جديدة داخل مستشفي الحميات بكفر الشيخ للاشتباه في اصابتهم بمرض انفلونزا الطيور وذلك بعد شعورهم بآلام شديدة في العظام وإرتفاع في درجة الحرارة وسعال دائم ورشح من الأنف وتم علي الفور حجزهم في الجناح المخصص لحالات الاشتباه بهذا المرض وهم شروق ماهر سعد عامين وعبدالسلام أحمد دياب‏62‏ سنة ومحمد أحمد السيد‏45‏ سنة وشريف عرفه عاطف‏11‏ شهر فقط وأحمد جمعه إبراهيم‏(6‏ سنوات‏)‏ وهم من أبناء المحافظة من عدة مراكز حيث تم الحصول علي عينة من دمائهم ومسح حلق وإرسالها إلي المعامل المركزية التابعة لوزارة الصحة بالقاهرة‏.‏ Been detained, 5 new cases of fever in a hospital in Kfar-Sheikh on suspicion of having bird flu, after feeling severe pain in bones and a rise in temperature and a cough lasting and ran from the nose was immediately confined in the ward for suspected cases of the disease they are two years Shoroq Maher Saad and Abdul Salam Ahmed Diab, 62 years and Mr. Mohammed Ahmed Sharif, 45 years and knew of only 11 Atef Ahmed Juma Ibrahim (6 years) who are the sons of the province, where several stations were obtained from a sample survey of hours and their blood and send to the central laboratory of the Ministry of Health in Cairo. وفي الفيوم ـ أحمد طلعت‏:‏ In Fayoum, Ahmed Talaat: بالرغم أن محافظة الفيوم خالية تماما من تربية الخنازير إلا أنه تم عمل حجر صحي في الدور الرابع بالمستشفي العام بمدينة الفيوم لمواجهة حدوث أية طوارئ لمرض انفلونزا الخنازير صرح بذلك الدكتور حسين أبوطالب مدير عام الصحة موضحا أنه تم ايضا توفير‏700‏ ألف كمامة لمواجهة حدوث تحور فيروس مرض انفلونزا الخنازير‏,‏ من ناحية أخري احتجزت مديرية الصحة حالة اشتباه بانفلونزا الطيور لسيدة تدعي شريفة محمد‏30‏ سنة ربة منزل لمستشفي الحميات للاشتباه في اصابتها بانفلونزا الطيور وتم ارساله عينات لتحليلها بوزارة الصحة‏.‏ Although the province of Fayoum, completely devoid of pig-raising, however, was the work of quarantine in the fourth round the city of Fayoum General Hospital to cope with any emergency swine flu, said Dr. Hussein Abutaleb Director-General of Health said it was also the provision of 700 thousand to meet the muzzle of a mutation swine flu virus, on the other hand held the Directorate of Health bird flu suspected case of a woman claims that Muhammad, honest 30 year housewifefever hospital on suspicion of bird flu samples were sent for analysis, the Ministry of Health. of the وفي بورسعيد ـ من خضر خضير‏: ‏ In Port Said Khadr Khdair of: في الوقت الذي تبذل فيه الدولة مساعيها ومجهوداتها الكبيرة لتأمين مصر من خطر وصول انفلونزا الخنازير اليها‏,‏ لحماية البلاد من طاعون العصر‏,‏ وذلك عبر إحكام الرقابة علي منافذ الجمهورية البرية والبحرية والجوية‏..‏ سجلت الأهرام ثغرة لم يلتفت اليها أحد وتتعلق بما يقرب من‏100‏ عامل من العاملين بشركة الرباط وأنوار السفن الذين يتعاملون عن قرب مع جميع الأجانب من جميع الجنسيات من خلال صعودههم علي السفن والبواخر العابرة للقناة شمالا وجنوبا وهم أكثر المواطنين تعرضا للإصابة بالمرض اللعين ومن الممكن أن ينقلوه إلي أقرب الناس إليهم بالاضافة إلي كل المتعاملين معهم وهو ما يهدد‏600‏ ألف مواطن بورسعيدي‏,‏ حيث تتطلب طبيعة عملهم صعودهم علي تلك السفن والبواخر ولم يتم اتخاذ اجراءات لحماية هؤلاء العمال باجراء الفحوصات الدورية عليهم‏.‏ At a time when the State is making its big and its efforts to secure from the threat of Egypt and the arrival of the swine flu, to protect the country from the plague of the times, through tighter control over access to the Republic's land, sea and air gap-Ahram reported .. have not been heeded by anyone concerned approximately 100 employees working at Rabat and lights on the ship who work closely with all foreigners of all nationalities through Saudham on ships crossing the canal north and south of citizens who are more vulnerable to the dreaded disease could pass to the closest people to them in addition to each client with a threat to 600 thousand citizens Pursaidy, where the nature of their work on the rise, those ships were not to take measures to protect these workers have a regular check-ups.

Reservation 3 suspected bird flu cases meeting Sunday attended by

الأربعاء، 13 مايو 2009 - 20:44
Wednesday, May 13, 2009 - 20:44

Suspected new cases of bird flu in the West


The Mahalla and Tanta fevers, the detention of three new cases of suspected bird flu, with fevers held Mahala, Safiya Mohamed Suleiman (32 years old housewife), and held the morning of Tanta fevers Abdel Hamid (35 years old housewife), and Ramadan, Hussein Abdel-Naim (39 years ).

Blood samples were taken and sent them to the central laboratory to confirm the illness or not.



The results of another sample of 20 samples of suspects who were detained at the county level are negative, and received permission to leave the hospital, according to the statement made by Dr. Sharif Hammouda Undersecretary of the Ministry of Health meeting Sunday attended.

Flu developing resistance

[I guess it took this long since the H1N1 Flu outbreak to start talking about what's really important.]
May 13, 2009

GENEVA - DEVELOPMENT of a swine flu vaccine was partly triggered by evidence that seasonal influenza strains are developing resistance to antiviral drug Tamiflu, a World Health Organisation expert said on Tuesday.

Nikki Shindo said relatively high rates of hospitalisation for swine flu in the United States and Mexico 'rightly' prompted vaccine development 'because we are also facing the risk of having resistant viruses.' 'Last year we have seen widespread evidence of oseltamivir resistance in seasonal influenza,' said the pandemic flu expert at a daily WHO briefing on the outbreak of influenza A(H1N1).

'So given that we have winter in Southern American countries and also the other parts of the southern hemisphere, there will be a risk of having viruses that will be highly resistant to antivirals.' Flu outbreaks are at their most active during winter.

Oseltamivir is the active ingredient in Tamiflu, an antiviral made by Swiss pharmaceutical manufacturer Roche which is at the centre of global precautions - led by the WHO - against influenza and a possible pandemic.

In the absence of an efficient vaccine against influenza A(H1N1) for now, only Tamiflu and Relenza, made by GlaxoSmithKline, are considered efficient drugs to keep the virus in check.

Data from the United States and Mexico suggested that nine to 10 per cent of confirmed cases of swine flu require hospitalisation, Ms Shindo said, adding: 'This clearly is different from what we see from seasonal influenza, that's for sure.' However, the WHO is preparing to publish clinical guidance to doctors and nurses on the new A(H1N1) virus this week highlighting the fact that most patients would not require hospitalisation or antiviral therapy, she said.

Mexico and the United States, where the outbreak was first uncovered last month, together account for nearly 90 percent of the 5,251 cases of the A(H1N1) virus confirmed by the WHO in 30 countries.

However, there were hints this week that the virus might have already been circulating more widely there when it was first uncovered.

Anne Schuchat, the interim deputy director for science and public health at the Centres for Disease Control said the 2,600 confirmed cases in the United States represented just the tip of the iceberg of actual infections. The vast majority of people who became ill with the virus tended to recover in the same way as with seasonal flu and probably did not seek laboratory testing, she explained.

Science magazine also released online a study by the WHO Rapid Pandemic Assessment Collaboration, which includes CDC scientists, which estimated that 23,000 people had been infected by the A(H1N1) virus in Mexico. -- AFP

Recombinomics: Swine H1N1 Outpaces Seasonal Flu In the United States

Recombinomics Commentary 21:51
May 12, 2009
The week 17 CDC report on seasonal flu in the United States was striking. The normal bell shaped curve of cases detected by CDC sentinel labs was suddenly interrupted by a sharp spike. Although the height of the spike was driven somewhat by increased surveillance due to the detection of H1N1 swine, the composition of the bar representing week 17 was a clear signal that swine H1N1 had taken change of influenza cases in the US. The initial data for influenza had 334 and 300 positives for H1 and H3, respectively, but there were 326 and 304 isolates for swine H1N1 or untypable influenza A (which is swine H1N1 that has not yet been confirmed). The updated data posted this week was even more striking, with 370 and 342 isolates for H1 and H3 respectively, while swine H1N1 and untypable influenza A were 524 and 259. Thus, there was more swine H1N1 than the combination of H1 and H3 seasonal flu.

The spike in H1N1 swine cases created a backlog at the CDC, which could be seen in a map of confirmed and probable cases (see US map). The confirmatory testing was handed off to the state labs to eliminate the backlog, but soon state labs were acknowledging that the samples tested were the tip a very large iceberg, and future testing would target more serious cases.

This movement of swine H1N1 into the human population is cause for concern. The increase over seasonal flu may be driven by the avian PB2 gene in the swine isolate. Position 627 is E, which favors growth at the higher body temperature of birds. Seasonal flu has a K at position 627, which allows for more rapid replication at a lower temperature, which is consistent with the internal temperature of a human nose in the winter.

The presence of avian PB2 may offer a selective advantage over the summer, when seasonal flu falls to barely detectable levels. However, the swine H1N1 that moves south in the upcoming months will be growing under colder conditions, which may favor the acquisition of E627K though reassortment or recombination. This change could create a more virulent H1N1 in the fall in the northern hemisphere.

Thus, the swine H1N1 may be launching a two virus strategy. The H1N1 with avian PB2 will dominate in the northern hemisphere over the summer, while the H1N1 in the southern hemisphere will acquire E627K and establish dominance during the winter months.

Thus, the spread of H1N1 is in high gear, as WHO debates if a swine H1N1 is a swine H1N1 and if a pandemic at phase 6 is really at phase 6.

Swine H1N1 doesn't read WHO press releases.

It just gains transmission efficiencies via homologous recombination.

Media Link

A Pandemic of Confusion About Flu's Death Rates The CDC's Figure of 100 Influenza Deaths a Day Is Flawed, but That Doesn't Stop People From Spreading

Excerpt:


Dr. Shay and colleagues attempted to compensate for this perceived underreporting of flu deaths by looking for clues in seasonal mortality patterns. If flu's human toll is uniquely resistant to measurement, it is also uniquely measurable by statistical sleuthing, according to Dr. Shay. That's because flu's activity varies each year, in time of onset, duration and severity.

More interactive graphics and photos In a paper earlier this year, he and his co-authors unveiled four different statistical models for measuring flu deaths. Some of these models made use of lab tests from around the country, correlating the fluctuation in positive flu-test results with the waxing and waning in respiratory and circulatory deaths. All four models came up with similar estimates: Tens of thousands of people dying each year from the flu. One of the models produced a 10-year average through the 2002-2003 flu season of 36,171, the basis for the 36,000 figure now ubiquitous in public-health campaigns and media coverage.

This estimate has its skeptics. It's based on lab testing of people who primarily are ill, and not a representative sample of the population, Jimmy Efird, a statistician with the University of North Carolina's Center for the Health of Vulnerable Populations, points out. And it makes use of the same death-certificate data whose flaws necessitated the research, potentially replicating the errors.

Peter Doshi, a graduate student at the Massachusetts Institute of Technology, has gone further in his critique. In a 2005 article in the British journal BMJ provocatively titled "Are US flu death figures more PR than science?" Mr. Doshi criticized the CDC for sometimes confusing deaths caused by the flu with those where the infection was one contributing factor. In an article last year, Mr. Doshi compiled recorded deaths from the flu for the past century and found that the numbers in years of notable outbreaks within the past 60 years weren't that different from years just before and after them.

Dr. Shay defends his measurements but acknowledges they aren't exact, noting, for instance, that his models don't take into account temperature and air pollution, which themselves can affect the incidence of respiratory illness.

If people make decisions based on faulty information, says Mr. Doshi, "then this is important and needs fixing."
-snip-
hat-tip Pixie

Sulianti Saroso Received 2 Patients Suspect Pig Flu

Wednesday, 13 Mei 2009 - 06:59 wib
Ahmad Dani - Okezone

Jakarta - the Virus H1N1 began to threaten Indonesia. Reported two citizens China that visited to Indonesia were run off with to RSPI Sulianti Saroso, because of suffering the clinical sign like Pig Flu.

"Yes overnight had two patients who it was suspected experienced the sign H1NI1," said an official was on duty at RSPI Sulianti Saroso to okezone, on Wednesday (13/5/2009).

According to the official guarded this, two patients were the foreign citizen who indeed was visiting to Indonesia. "Two patients the citizen China," he explained.

At this time, the condition for the two patients suspect the pig flu was still undergoing the medical maintenance in Mawar Space that was set aside for the patient who experienced the sign like H1N1.

Beforehand, the Hasan Sadikin Hospital (RSHS) Bandung treated a patient who was expected (suspect) contracted type influenza of A H1N1 or pig flu/Mexican flu.

The patient had the initials RES was 39 years from Surabaya old was treated in normal space of Poinciana Tree quarantine was used for the bird flu patient. RES it was known was professional as Co-pilot of the airline AirAsia that just flew from Kuala Lumpur, Malaysia and landed in the Husein Sastranegara International Airport, Bandung.

Tim Doctor Penanganan Chairman of the Khusus RSHS Hadi Yusuf Infection explained, RES entered Poinciana Tree space on Monday May 11 struck 17,26 WIB was delivered by the team of the health of the Husein Sastranegara Airport.
hat-tip dbg

Many Swine Flu Cases Have No Fever

Many people suffering from swine influenza, even those who are severely ill, do not have fever, an odd feature of the new virus that could increase the difficulty of controlling the epidemic, said a leading American infectious disease expert who examined cases in Mexico last week.

Fever is a hallmark of influenza, often rising abruptly to 104 degrees at the onset of illness. Because many infectious disease experts consider fever the most important sign of the disease, the presence of fever is a critical part of screening patients in an influenza outbreak.

But about a third of the patients at two hospitals in Mexico City where the American expert, Dr. Richard P. Wenzel, consulted for four days last week had no fever when screened, he said.

“It surprised me and my Mexican colleagues because the textbooks say that in an influenza outbreak the predictive value of fever and cough is 90 percent,” Dr. Wenzel said by telephone from Virginia Commonwealth University in Richmond, where he is chairman of the department of internal medicine.
While many people with severe cases went on to develop fever after they were admitted, about half of milder cases did not; nearly all patients had coughing and malaise, Dr. Wenzel said.

Also, about 12 percent of patients at the two Mexican hospitals had severe diarrhea in addition to respiratory symptoms like coughing and breathing difficulty, said Dr. Wenzel, who is also a former president of the International Society for Infectious Diseases. He said many such patients had six bowel movements a day for three days.

Dr. Wenzel said he urged his Mexican colleagues to test the stools for the presence of the swine virus, officially named A(H1N1). “If the A(H1N1) virus goes from person to person and there is virus in the stool, infection control will be much more difficult,” particularly if it spreads in poor countries, Dr. Wenzel said.

He said he also urged his Mexican colleagues to perform tests to determine whether some people without symptoms still carry the virus.

Dr. Wenzel said he examined patients and data at the invitation of Dr. Samuel Ponce de Leon, who directs Mexico’s national vaccination program.

Dr. Wenzel said that an unusual feature of the Mexican epidemic, which complicates the understanding of it, is that “in recent months five different influenza viruses have been circulating in Mexico simultaneously.”

Pneumonia rates at one of the hospitals Dr. Wenzel visited, the Institute for Respiratory Illness, reached 120 per week recently compared to 20 per week during the last two years, suggesting a possible relation to the swine flu.

The pneumonias that the flu patients developed did not resemble the staphylococcal lung infections that were believed to be a common complication in the 1918-1919 influenza pandemic, he said.

Dr. Wenzel said the two Mexican hospitals were well prepared for an outbreak of respiratory disease. “We have a lot to learn from the Mexican experience,” he said.

For example, when the first cases were detected and the virus seemed particularly severe, Mexican doctors activated a program to allay anxiety among staff members. One doctor went home and cried because of fears that his family would die along with many other people.

Hospital officials made it clear that they would care for staff members, offering them information brochures, a hotline, psychological support and medical examinations.

“This aspect of epidemic response is not well appreciated in the United States in my estimation, yet is critical for success,” Dr. Wenzel said, adding, “We haven’t put nearly enough into managing fear among health workers.”

Hospital officials had good measures to screen workers and arriving patients, including supplies of alcohol sponges for people to clean their hands. Non-essential healthy workers were told to go home. Hospital officials also made sure there were enough breathing machines and oxygen canisters for patients with respiratory distress.

Dr. Wenzel said he intended to draw on such experiences in revising plans for infection control of an influenza epidemic in Richmond.
hat-tip: http://afludiary.blogspot.com/

WHO: Influenza A(H1N1) - update 27

13 May 2009 -- As of 06:00 GMT, 13 May 2009, 33 countries have officially reported 5728 cases of influenza A(H1N1) infection.

Mexico has reported 2059 laboratory confirmed human cases of infection, including 56 deaths. The United States has reported 3009 laboratory confirmed human cases, including three deaths. Canada has reported 358 laboratory confirmed human cases, including one death. Costa Rica has reported eight laboratory confirmed human cases, including one death.

The following countries have reported laboratory confirmed cases with no deaths - Argentina (1), Australia (1), Austria (1), Brazil (8), China (3, comprising 1 in China, Hong Kong Special Administrative Region, and 2 in mainland China), Colombia (6), Cuba (1), Denmark (1), El Salvador (4), Finland (2), France (13), Germany (12), Guatemala (3), Ireland (1), Israel (7), Italy (9), Japan (4), Netherlands (3), New Zealand (7), Norway (2), Panama (29), Poland (1), Portugal (1), Republic of Korea (3), Spain (98), Sweden (2), Switzerland (1), Thailand (2), and the United Kingdom (68).

WHO is not recommending travel restrictions related to the outbreak of the influenza A(H1N1) virus.

Individuals who are ill should delay travel plans and returning travelers who fall ill should seek appropriate medical care. These recommendations are prudent measures which can limit the spread of many communicable diseases, including influenza.

Further information on the situation will be available on the WHO web site on a regular basis.
hat-tip FrenchieGirl

Indonesia: The patient pig Flu could recover without taking medicine

May 13, 2009 by admin

Geneva, Swine flu: the Expert from the Kesehatan Body of the World (WHO) said the patient's majority that contracted the virus H1N1 or the virus of pig flu did not need medical treatment antivirus to recover. They could it was thought recover only by resting and mengonsumsi much water.

But, the development of the vaccine for this virus continued to be needed if the virus is not vulnerable to available medicine now.

Nikki Shindo, the medical official for the global WHO flu program, said to the reporter that 10 percent of the person who was infected by the virus H1N1 in Mexico and the United States needed was treated in the hospital compared with other kind flu.

According to Shindo, the patient's majority could recover only by resting and mengonsumsi much water or hydration. Therefore, these patients did not need mengonsumsi medicine like Tamiflu, Ralenza, and the medicine antivirus other.

Shindo added better medicine supplies antivirus this was utilised for the woman was pregnant and the patient with the diabetes illness. “Kami will recommend the use of the medicine antivirus this for risky groups tinggi,” said Shindo.

WHO personally, said Shindo, immediately will launch the new escort to treat the patient with the virus that became an epidemic.

China confirms second case of H1N1 flu

Wednesday May 13, 2009

BEIJING (Reuters) - China on Wednesday confirmed its second case of the new H1N1 strain of flu, a man in eastern Shandong province who had recently arrived from Canada.

"The suspected case of A/H1N1 flu in Shandong has been confirmed, which is the second confirmed case in our country," the Health Ministry said in a statement on its website (www.moh.gov.cn).

The Chinese man flew from Canada, where he was studying, on May 8 and then took a train from Beijing to Jinan, the capital of Shandong province. He was immediately isolated and sent for treatment after reporting flu-like symptoms on the train.

The patient with China's first confirmed case of H1N1, a 30-year-old man who flew to the country from the United States via Japan, was recovering, Xinhua said on Tuesday.

Hong Kong again suspected cases of influenza A

May 13, 2009 11:48

Hong Kong Secretary for Food and Health York Chow said Hong Kong had found a suspected Influenza A H1N1 cases, test results will be announced later.

Margaret patients currently residing in an isolation ward.

Reservation Egyptian Italian and Russian suspicion of having bird flu in pigs

Wednesday, May 13, 2009 - 12:49

Dr. Abdel Rahman Shahin, official spokesman of the Ministry of Health, said the ministry was detained yesterday, Tuesday, 4 suspected human cases infected with HIV global pandemic H1N1, bringing the total to 48 cases suspected case, pointing out that among the detainees, and one Egyptian soldier at the age of ( 21 years old), and tolerance and Mithat Fadi Adam, was booked hospital milk fevers, and two hold Italian citizenship, namely, Amela Kara (59 years) and Bergourgo Sanmabla (59 years), were Hdzhma the Sharm el-Sheikh International Hospital, and the fourth case of a person is alleged to Yoshngan Gore Alersy from Russia was admitted Abbasiyah detention hospital, and the laboratory analysis of these cases, negative for the disease.

وقال إن عدد الاستفسارات والبلاغات التى تلقاها الخط الساخن 105 أمس، فقط بلغت 1909 اتصالات ما بين استفسار عن مرض أنفلونزا الطيور والخنازير وبين الإبلاغ عن تربية خنازير أو طيور خارج المزرعة وحالات نفوق، هذا ما اعتبره شاهين ارتفاعا فى وعى المواطن المصرى والتزامه بالخطة الرسمية للتعامل مع الأوبئة.

He said that the number of inquiries and reports that are received by the hotline on 105, only amounted to 1909 contacts between a query about the bird flu reported among pigs and pigs for breeding birds or outside the farm and deaths, that is what he SHAHEN rise in the consciousness of the Egyptian citizen and its commitment to the official plan to deal with epidemics.

WHO urges restraint on Tamiflu in swine flu cases

By KENT KILPATRICK and MARK STEVENSON
MEXICO CITY (AP) -- With swine flu still spreading, the U.N. health agency is warning countries to limit their use of antiviral drugs to only high-risk patients to ensure adequate supplies in case the virus should mutate and become more dangerous.

The global outbreak appears mild, but skittishness is evident. Not long after Switzerland lifted its advisory against travel to Mexico and the United States on Tuesday, the Japanese national women's soccer team canceled a tour to North America, where most swine flu cases have been reported.

In Mexico's Baja California state, on the U.S. border, 5,689 children were turned away from schools when classes resumed Monday because they had symptoms like runny noses, headaches or sore throats, the state education department reported Tuesday.

Three more nations - Cuba, Thailand and Finland - reported their first confirmed swine flu cases, all in people who had traveled to Mexico. And China confirmed its second case of swine flu on the mainland, in a man who had recently returned from Canada.

There are now 33 countries reporting an estimated total of 5,915 confirmed swine flu cases, including 3,009 in 45 U.S. states, 2,282 in Mexico and 358 in Canada.

The death total is relatively low - 63, of which 58 were in Mexico, three in the U.S., one in Canada and one in Costa Rica.

But health experts worry about the chance that the virus might become more lethal in the coming months, saying it is important not to overuse antiviral drugs since supplies are limited.

The World Health Organization said Tuesday that antiviral drugs should be given to only patients most at risk.

Its comments appeared aimed at European countries, which have been using antiviral drugs such as Tamiflu and Relenza much more aggressively than the U.S. and Mexico, administering them whenever possible in an attempt to contain the virus before it spreads more widely.

A WHO medical expert, Dr. Nikki Shindo, said the U.N. agency thinks antivirals should be targeted mainly at people already suffering from other diseases or complications - such as pregnancy - that can lower a body's defenses against flu.

The U.S. Centers for Disease Control and Prevention also said pregnant women in particular should take the drugs if they are diagnosed with swine flu - even though the effects on the fetus are not completely known.

Pregnant women are more likely to suffer pneumonia when they catch flu, and flu infections have raised the risk of premature birth in past flu epidemics. A pregnant Texas woman who had swine flu died last week, and at least 20 other pregnant women have swine flu, including some with severe complications.

For all these reasons, risks from the virus are greater than the unknown risks to the fetus from Tamiflu and Relenza, said Dr. Anne Schuchat of the CDC.

"We really want to get the word out about the likely benefits of prompt antiviral treatment" for pregnant women, she said.

Shindo, at WHO, said each country's health experts must decide if infected people should immediately be treated with antivirals - a decision that also must take into account how many antivirals are available.

"As part of pandemic preparedness plans, we urge countries to plan for prioritization," Shindo said.

Swiss pharmaceuticals company Roche Holding AG announced it was donating enough Tamiflu for 5.65 million more people to WHO. A further 650,000 packets containing smaller doses of the drug will be used to create a new stockpile for children.

Mexican authorities had enough Tamiflu for 1 million people at the start of the outbreak and have received more, building reserves of 1.5 million courses.

Mexico is giving Tamiflu to anyone who has had direct contact with a person infected with swine flu, Health Secretary Jose Angel Cordova said. And now that schools are back in session, authorities plan to give Tamiflu to any children who show symptoms and are suspected of being infected.

CDC officials said that while the swine flu may seem mild now, there is a danger the virus will mutate into something more dangerous - perhaps by combining with the more deadly but less easily spread bird flu virus circulating in Asia and Africa.

Another concern is that it will combine with the northern winter's seasonal H1N1 virus. While not unusually virulent, it was resistant to Tamiflu, and health officials worry it could make the new swine flu resistant to Tamiflu as well.

Cordova said the worst appears over in Mexico. He said the two swine flu deaths reported Tuesday, along with additional confirmed cases, was a result of a backlog in testing. The last confirmed infection occurred Friday, he said.

-snip-

20 Japanese now quarantined by China over flu

BEIJING (Kyodo) The number of Japanese isolated for medical observation in China after coming into contact with a Chinese man infected with swine flu climbed to 20 on Tuesday, the Japanese Embassy in Beijing said.

While the isolation of one of 19 Japanese nationals who had been under observation ended Tuesday, two others were newly isolated after authorities managed to contact them, the embassy said.

According to the embassy, no one in isolation has shown flu symptoms and officials are in phone contact with them.

There were 25 Japanese on the same flight as the Chinese man, traveling from Tokyo to Beijing.

Of the 25, five had already returned to Japan. Authorities have confirmed that the five have no flu symptoms.

Those under observation in China include 14 in Beijing, three in Xian and one in Wuhan. Two family members of passengers on the flight were also isolated.

Authorities have yet to contact the remaining two Japanese passengers in China, according to the Japanese Embassy.

Swine flu passes through Yukon Territory

From correspondents in Ottawa, Canada

May 13, 2009 09:39am

THE swine flu has reached Canada's far north, as health officials confirmed the first case of H1N1 virus in the Yukon Territory in a woman who had recently travelled to Mexico.

Authorities reported 28 new cases nationally, bringing the total number of people infected with the virus in Canada to 358.

Last week, officials announced a woman had died of swine flu complications in late April and a young girl was recently hospitalised with severe symptoms, but was recovering.

All other Canadian cases have been mild.

Only Canada's island Newfoundland province in the North Atlantic so far remains untouched by the virus.

Malaysia issues flu travel advisory

KUALA LUMPUR, May 12 - The Foreign Ministry today issued a caution with regard to Influenza A (H1N1) to all Malaysians travelling to the United States, Mexico, Canada, Spain and Britain.

Stating that 96.8 per cent of the reported cases of Influenza A (H1N1) were in these five countries, it urged Malaysians to defer travelling to places where the virus had hit the hardest, such as Illinois, Wisconsin and California in the United States.

For unavoidable overseas travel, Malaysians should consult their physicians to take the seasonal flu vaccination, it said.

The travel advisory also outlined the need to obtain the latest information if there was any outbreak or new cases of the flu at their destinations.

It also advised to avoid contact with those who were ill and said those suspected to have the flu were required to avoid close contact with others as much as possible and stay home or in hotel rooms and to immediately contact the local health authority. - Bernama

H5N1 in Egypt Raises Pandemic Concerns

Recombinomics Commentary 14:58
May 12, 2009


A five-year-old Egyptian girl has contracted the highly pathogenic bird flu virus after coming into contact with infected birds, the state news agency MENA reported on Sunday.

The case brings to 69 the number of people confirmed to have contracted the H5N1 avian influenza virus in Egypt, which has been hit harder than any another country outside Asia.

The above comments describe the most recent confirmed H5N1 case in Egypt. Although the pace of confirmed cases has slowed in Egypt, local media reports continue to detail the hospitalization of suspect cases, although less than 1% of hospitalized cases are PCR confirmed for H5N1.

The low confirmation rate, coupled with mild symptoms, has raised concerns of silent spread of H5N1. The recent outbreak of swine H1N1 worldwide may allow the issue of H5N1 in asymptomatic cases, or those with lower viral loads, may allow this issue to be resolved.

In Egypt, H5N1 testing is limited to cases claiming poultry contact. However, if a swine contact was required for H1N1 swine testing, the initial positives in the United States would have gone undetected because none of the confirmed cases has a swine contact.

The H1N1 has led to enhance surveillance, although much of the testing has been limited to travelers originating in North America. However, the heightened awareness of H1N1 may lead to broader testing. Seasonal H1N1 and H3N2, as well as swine H1N1 and avian H5N1 will all give a positive on an influenza A test. Swine H1N1 and avian H5N1 however, will not sub-type with standard reagents, which are directed against human seasonal flu.

These swine H1N1 isolates are confirmed with additional tests that are specific for swine H1N1. However, H5N1 will also test negative on the swine H1N1 test, which will signal another serotype (or evolution of the swine H1N1) and require additional testing.

Such testing may lead to the discovery of widespread H1N1 in local populations in Egypt.

Release further analysis of non-typable influenza A positive samples in Egypt would be useful.

Many Swine Flu Cases Have No Fever

May 13, 2009

Many Swine Flu Cases Have No Fever

By LAWRENCE K. ALTMAN

Many people suffering from swine influenza, even those who are severely ill, do not have fever, an odd feature of the new virus that could increase the difficulty of controlling the epidemic, said a leading American infectious disease expert who examined cases in Mexico last week.

Fever is a hallmark of influenza, often rising abruptly to 104 degrees at the onset of illness. Because many infectious disease experts consider fever the most important sign of the disease, the presence of fever is a critical part of screening patients in an influenza outbreak.

But about a third of the patients at two hospitals in Mexico City where the American expert, Dr. Richard P. Wenzel, consulted for four days last week had no fever when screened, he said.

“It surprised me and my Mexican colleagues because the textbooks say that in an influenza outbreak the predictive value of fever and cough is 90 percent,” Dr. Wenzel said by telephone from Virginia Commonwealth University in Richmond, where he is chairman of the department of internal medicine.

While many people with severe cases went on to develop fever after they were admitted, about half of milder cases did not; nearly all patients had coughing and malaise, Dr. Wenzel said.

Also, about 12 percent of patients at the two Mexican hospitals had severe diarrhea in addition to respiratory symptoms like coughing and breathing difficulty, said Dr. Wenzel, who is also a former president of the International Society for Infectious Diseases. He said many such patients had six bowel movements a day for three days.

Dr. Wenzel said he urged his Mexican colleagues to test the stools for the presence of the swine virus, officially named A(H1N1). “If the A(H1N1) virus goes from person to person and there is virus in the stool, infection control will be much more difficult,” particularly if it spreads in poor countries, Dr. Wenzel said.

He said he also urged his Mexican colleagues to perform tests to determine whether some people without symptoms still carry the virus.

Dr. Wenzel said he examined patients and data at the invitation of Dr. Samuel Ponce de Leon, who directs Mexico’s national vaccination program.

Dr. Wenzel said that an unusual feature of the Mexican epidemic, which complicates the understanding of it, is that “in recent months five different influenza viruses have been circulating in Mexico simultaneously.”

Pneumonia rates at one of the hospitals Dr. Wenzel visited, the Institute for Respiratory Illness, reached 120 per week recently compared to 20 per week during the last two years, suggesting a possible relation to the swine flu.

The pneumonias that the flu patients developed did not resemble the staphylococcal lung infections that were believed to be a common complication in the 1918-1919 influenza pandemic, he said.

Dr. Wenzel said the two Mexican hospitals were well prepared for an outbreak of respiratory disease. “We have a lot to learn from the Mexican experience,” he said.

For example, when the first cases were detected and the virus seemed particularly severe, Mexican doctors activated a program to allay anxiety among staff members. One doctor went home and cried because of fears that his family would die along with many other people.

Hospital officials made it clear that they would care for staff members, offering them information brochures, a hotline, psychological support and medical examinations.

“This aspect of epidemic response is not well appreciated in the United States in my estimation, yet is critical for success,” Dr. Wenzel said, adding, “We haven’t put nearly enough into managing fear among health workers.”

Hospital officials had good measures to screen workers and arriving patients, including supplies of alcohol sponges for people to clean their hands. Non-essential healthy workers were told to go home. Hospital officials also made sure there were enough breathing machines and oxygen canisters for patients with respiratory distress.

Dr. Wenzel said he intended to draw on such experiences in revising plans for infection control of an influenza epidemic in Richmond.

Expert says virus 'very unstable'

2009-5-13

A LEADING virologist has described the swine flu virus as "very unstable," meaning it could mix and swap genetic material when exposed to other viruses.

The new virus, which has infected 5,495 people in 30 countries and killed 63, has displayed great efficiency in spreading among people, said Guan Yi, a microbiologist with the University of Hong Kong.

"This virus has been around only a few months, it is very unstable ... and we know that its presence is dramatically increasing in human population, so the chance of it meeting with H5N1 is actually increased," Guan said in an interview yesterday.

"Both H1N1 and H5N1 are unstable so the chances of them exchanging genetic material are higher, whereas a stable (seasonal flu) virus is less likely to take on genetic material."

While swine flu appears to be mild so far, with many infected people recovering without treatment, the H5N1 has a mortality rate of between 60 and 70 percent.

Experts are fearful about the emergence of a hybrid which combines the killing power of the H5N1 with the efficient transmissibility of H1N1.

"Already it appears to be more virulent than seasonal flu because it is killing younger people," Guan said.

Influenza A(H1N1) - update 26

Previous Post:

The U.S. Centers for Disease Control, for instance, use a scale similar to a five-point hurricane index, with the Spanish Flu (which killed upwards of 50 million people in 1918-19) at the low end of five.

The CDC hasn't yet determined where the H1N1 outbreak lies on that scale, said Dr. Francisco Averhoff, chief of quarantine and border health services in the division of global migration and quarantine.

12 May 2009 -- As of 06:00 GMT, 12 May 2009, 30 countries have officially reported 5251 cases of influenza A(H1N1) infection.

Mexico has reported 2059 laboratory confirmed human cases of infection, including 56 deaths. The United States has reported 2600 laboratory confirmed human cases, including three deaths. Canada has reported 330 laboratory confirmed human cases, including one death. Costa Rica has reported eight laboratory confirmed human cases, including one death.

The following countries have reported laboratory confirmed cases with no deaths - Argentina (1), Australia (1), Austria (1), Brazil (8), China (2, comprising 1 in China, Hong Kong Special Administrative Region, and 1 in mainland China), Colombia (3), Denmark (1), El Salvador (4), France (13), Germany (12), Guatemala (1), Ireland (1), Israel (7), Italy (9), Japan (4), Netherlands (3), New Zealand (7), Norway (2), Panama (16), Poland (1), Portugal (1), Republic of Korea (3), Spain (95), Sweden (2), Switzerland (1) and the United Kingdom (55).

WHO is not recommending travel restrictions related to the outbreak of the influenza A(H1N1) virus.

Individuals who are ill should delay travel plans and returning travelers who fall ill should seek appropriate medical care. These recommendations are prudent measures which can limit the spread of many communicable diseases, including influenza.

Further information on the situation will be available on the WHO web site on a regular basis.

WHO working on a severity scale to accompany pandemic alert phases

Written by: Helen Branswell, Medical Reporter,
May. 11, 2009

TORONTO - The World Health Organization is devising an index to gauge the severity of the threat posed by a potential pandemic influenza virus, the agency's top flu expert said Monday.

The WHO hopes to introduce the new scale soon, said Dr. Keiji Fukuda, who said the tool could help national authorities make decisions about how aggressively they want to respond with measures like closing schools and discouraging public gatherings.

"These are hard decisions for country authorities to make. And so they really want as much guidance as possible," Fukuda, acting assistant director general for health security and environment, said in an interview.

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"And I think this provides some guidance, some help. But they're still difficult decisions to make."

Shortly after revealing a severity scale was in the works, the WHO posted an assessment of the situation to date with the new H1N1 swine flu virus. It noted that outside of the outbreak in Mexico - which is still not completely understood - the new virus typically causes "very mild illness in otherwise healthy people."

According to the WHO, there are about 4,800 confirmed cases in 30 countries, including 331 in Canada.

The WHO has faced criticism from some quarters that its pandemic alert scale has no mechanism to reflect the fact that a flu pandemic might cause mild, moderate or severe illness and trigger varying levels of societal disruption.

The agency has been stressing since the swine flu incident began that the term pandemic relates to the scope of transmission, not the severity of disease caused by a new spreading virus.

But after years of media focus on the dangerous H5N1 avian flu virus - which draws parallels to the 1918 Spanish Flu - there may be a mistaken public perception that high levels of severe disease and deaths must go hand-in-hand with a pandemic strain.

In reality, the two most recent pandemics - 1957 and 1968 - caused widespread illness and higher-than-normal numbers of deaths. But they were not catastrophic.

"Pandemics are not created equal," said Dr. Peter Palese, a leading influenza expert at Mt. Sinai Medical Center in Manhattan.

Fukuda said a group of experts that helped the WHO rewrite its pandemic preparedness guidelines has been working on a severity scale. While the aim is to have something simple - with categories such as mild, moderate and severe - the WHO is aware that outbreaks may play out differently in different places.

"On the one hand, it is important to have a very straightforward simple approach to describing it. On the other hand, one shoe doesn't necessarily fit all feet," Fukuda said.

And even in mild pandemics, such as the 1968 Hong Kong flu, lots of people will get infected. Of those, an as-yet unknown proportion will become severely ill and some will die.

"In a sense, it is almost illogical to be describing something like a pandemic as mild when you're spreading it over the number of people that will get infected," Fukuda said.

An infectious diseases expert welcomed the effort to try to make the situation clearer.

"The current pandemic phase model really needs one additional piece, namely that of disease severity," said Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

"By combining both transmission and severity characteristics it will provide for a much more accurate assessment of the status of any emerging pandemic."

Some countries already have a severity index in their pandemic plans. The U.S. Centers for Disease Control, for instance, use a scale similar to a five-point hurricane index, with the Spanish Flu (which killed upwards of 50 million people in 1918-19) at the low end of five.

The CDC hasn't yet determined where the H1N1 outbreak lies on that scale, said Dr. Francisco Averhoff, chief of quarantine and border health services in the division of global migration and quarantine.

But based on what has been seen to date, the CDC has dialled down some of its recommendations on so-called social distancing measures. Where initially it recommended closing schools when H1N1 cases were found, now it says infected kids should stay home but schools should stay open.

Meanwhile, disease investigators have been trying to get a clearer picture of just how bad an actor the new virus is.

An article published electronically on Monday by the journal Science estimated that 23,000 people in Mexico had been infected with the new virus by the end of April and that the case fatality rate - the proportion of cases that end in death - was about 0.4 per cent. In comparison, the case fatality rate for the Spanish flu was upwards of 2.5 per cent.

The authors, from a number of universities and the WHO, said the early signs were that the disease severity with the new virus was in the range of that seen during the 1957 and 1968 pandemics.

"The transmissibility looks like the less severe pandemics of '57-'58 and '68-'69, not a 1918 - at least currently," said Dr. Ira Longini, an expert in mathematical modelling at the University of Washington. Longini was not involved in the study.

Detention of suspected case of influenza in Luxor

الأثنين، 11 مايو 2009
Shorter hospital fevers detained a suspected case of bird flu, the hospital had received shorter fevers Hefnys Mohammad Mahjoub (17 years) from the village of Almdamod west of Luxor, with a high fever and symptoms similar to bird flu and the hospital administration decided to detention and sampling, and sent to the central factor Cairo to the illness or not.

In a related context Luxor International Hospital granted exit permits for the Japanese tourists and an Egyptian tour guide was a free of swine flu, a Japanese tourist Iitap Luxor Hotel inmate has been informed of the management of the hotel Bchke in the illness after an outbreak of swine flu symptoms, and of which the high temperature was transferred to Luxor International Hospital with a tour guide, who was accompanied by were subjected to medical examinations and tests and found free of the disease, the authorities refused to give out the names of the tourist guide and tourism.

Two new suspected bird flu in the Fayoum and Monoufia

Detained, hospital diets and fevers Fayyoum Mnov two new suspected bird flu, which entered the honorable Muhammad (30 years) from the village was built in favor of the status of Fayoum Fayoum fever in a hospital, and hospital fevers Mnov detained, housewife, on suspicion of being infected with bird flu, following the emergence of symptoms of the disease.

Pointed out. Hesham Atta, Deputy Minister of Health, the situation of a woman named Samia Omar Shimi (42 years) and assess the housewife Jraun County Center Alpajur.

Blood samples were taken for examination of the injured was a factor and the Ministry of Health show that the cause of their infection has been raising birds at home to move to the place of residence and health through cleaning up the place safe.

In the same context Quesna of Investigation has seized a car No. 72545 Qlliopip command transfer spring Mohamed Gad (40 years) transported the driver of the number of 160 chickens without a permit and reservation to the car
And the quantities seized and the investigation by the prosecutor.