Recombinomics: Explosion in Argentina Pandemic H1N1 Fatalities

Recombinomics Commentary 17:17
July 6, 2009
According to data provided by the Situation Room, there are more than 2,000 cases reported, of which 400 were confirmed as positive.Of the 15 deaths corresponding to node Rosario, Santa Fe to two and the rest of the Venado Tuerto.

The Ministry of Health in the province of Santa Fe reported tonight, through the Situation Room that operates under the Contingency Plan prepared in connection with the pandemic influenza A (H1N1), the total number of reported cases with Epidemiological fact sheets exceeds 2000, with 400 confirmed and 18 deaths, 15 of which belong to Node Rosario, one of the Venado Tuerto and two of Santa Fe

This record corresponds to the information available to date Sunday July 5 to 20 hours.

The above translation describes 18 confirmed fatalities in Santa Fe Province, including 15 deaths in Rosario, as of Sunday night (see updated map). A national report which reported no deaths in Santa Fe last week has an updated number of 9 for Santa Fe, and 60 for the entire country, most of which is from cases in adjacent Buenos Aires Province. The 60 confirmed cases is a marked increase from the 26 reported last week However, the 60 reported cases do not include other recent fatalities cited in media reports which included 11 deaths in Corrientes, 5 deaths in Neuquen, and at least one death in Tierra del Fuego, Jujuy, Cordoba, San Juan, Salta, La Pampa, Rio Negros, Entre Rios, and Santiago del Estero. The national totals do not include any fatalities in the above provinces, raising concerns of a rapid rise in cases that has not been reported beyond the local media reports.

These data indicate the death tally has tripled in the past week and is among the highest in the world (behind the United States and Mexico). However, the cases in Argentina developed very recently, raising concerns that the virus has changed.

To date, there is only one partial pandemic H1N1 MP sequence at Genbank or GISAID. It was collected in April and is identical to a large number of public sequences. However, there are no sequences representing the recent fatalities or June precursors to H1N1 associated with the recent fatalities.

The rapid rise in cases and the failure to provide timely sequence data continues to increase pandemic concerns of an evolving H1N1 that is largely missed by current surveillance approaches.

Recent reports out of Hong Kong described oseltamivir resistance in a traveler from San Francisco who had not taken Tamiflu, raising concerns of resistance in the US. Although no such case has been identified to date, the Hong Kong case was mile and recent (detected June 11) and US efforts have been directed away from mild cases. Moreover, none of the sequences from resistant cases in Denmark, Japan, and Hong Kong have been made public, even though sequences were generated weeks ago.

The failure to promptly disclose these sequences is also cause for concern. In Japan, notification was reportedly delayed while a manuscript was being submitted to the Journal of Infectious Diseases, although release of sequence data would not prevent publication.

The delays in release of important sequence data from pandemic H1N1 are hazardous to the world's health.

Argentina: 65 Deaths Swine Flu - 60 reported yesterday

In the country and 65 people were killed by influenza A
2009-07-06
Minister of Health of the Nation will meet today with the owners of the area around the country to unify criteria for placement and care of cases of influenza. Evaluated massive virus H1N1.


BUENOS AIRES .- The Federal Health Council, composed of ministers of the area across the country today unify criteria and clinical protocols for care and placement for people with influenza A.

Be the first meeting of that body with Minister Juan Manzur and assess "the mass has taken and what is in the patterns of influenza A virus," he said.

According to Ministry of Health reported the country, are now 65 dead and 2,800 infected with the H1N1 virus. These values mean that the Argentina in the first place in the region by the number of victims. So far, 123 countries have confirmed 409 deaths due to influenza A.

Manzur reported that the 14 will meet all provincial health ministers to discuss "different regional realities.

On the agenda are expected to play several points, as the prevalence of an accurate and detailed technical report on the epidemiological curve that we are from week 19, "he said.

"The 85% of cases of flu in the country by the new virus," said Manzur. He added that the virus is not as dangerous as many people cree and 90% of people who had influenza A, he stressed, was recovered with no problems.

Regarding preventive measures, the minister clarified that is at a health expressing the need to close shops, supermarkets and other busy sites.

He also announced that in the next few hours will be delivered 300,000 treatments and that on Wednesday morning and another 500,000 will be distributed taking into account health, population and reporting of various diseases.


A vaccine itself

The Health Minister said that along with his pair of Science and Technology, Lino Barañao, "we are working to decode the genome of the virus." He explained, is making progress in the characterization of the virus to see if this is the same as in other countries. "We are in search of a vaccine applied to the virus circulating in Argentina," he said.

"This is the first time we have the presence of the H1N1 virus in Argentina, which is already present in 119 countries.

Meanwhile, Health Minister bonaerense, Claudio Zin, found that the influenza A vaccine will be available by year's end or for the coming winter "and said that" the first tests were done in healthy volunteers and first results will be in four weeks. "

Anyway, Zin cautioned that may not be equal to the virus circulating in Europe or United States in the spring, which is present in Argentina.

No classes throughout the country

Kindergartens, primary and secondary schools and universities around the country suspended from school today and for two weeks. Thereby extending the winter break around the country to contain the infection by influenza A in the field of education. The resolution was adopted last week.

Given the emergency, the Ministry of Education reported that the website launched www.aprenderencasa.educ.ar, which suggests general activities for teachers and students keep up to date their knowledge.
hat-tip Dutchy

Egypt: 5 cases of detention of suspected Swine Flu Lakes and Qena

Monday, July 6, 2009

قال د.يسرى مبروك وكيل وزارة الصحة بالبحيرة، إنه تم احتجاز 4 أشخاص للاشتباه فى إصابتهم بأنفلونزا الخنازير، بعد ظهور أعراض تتشابه مع أعراض المرض عليهما من ارتفاع مفاجئ فى درجة الحرارة وألم فى العظام واحتقان فى الحلق ورشح فى الأنف وسعال وألم فى العضلات وإجهاد شديد.

D said. Yosri Congratulations, Undersecretary of the Ministry of Health the lake, said that 4 people were detained on suspicion of having bird flu in pigs, after the emergence of the symptoms are similar to the symptoms of the disease, their sudden rise in temperature and pain in bones, sore throat and runny nose, cough and pain in muscles and strain .

واحتجزت مستشفى كفر الدوار العام إيناس منصور (31 سنة) وعبد الوهاب السيد (33 سنة) وندى شرف شحاتة (4 سنوات)، براء أشرف شعبان شحاتة (9 شهور) وتم احتجازهما بالمستشفى وعزلهما عن باقى المرض بعد أخذ عينة دم منهما ومسحة حلق لتحليلها وبيان مدى إصابتهما بالمرض، وقال مبروك إنه تم الاشتباه فى إصابة الحالات عقب عودهم من أداء العمرة.

Detained and Kafr Al-Dawar General Hospital Enas Mansour (31 years) and Mr. Abdul Wahab (33 years) and Nada Sharaf Shehata (4 years), had nothing to Ashraf Shaban Shehata (9 months) have been detained in hospital and isolated from the rest of the disease after a blood sample taken two hours, survey and analysis of the statement the disease, the extent of their injuries, said he was suspected of Congratulations injury cases in the following promises to perform Umrah.

واحتجز مستشفى حميات قنا خضرى محمد شنهورى للاشتباه فى إصابته بمرض أنفلونزا الخنازير، بعد دخوله المستشفى فى حالة إعياء شديد ويعانى ارتفاعا فى درجة الحرارة والتهاب فى الحلق وأعراض مشابهة لمرض أنفلونزا الخنازير، وتبين أنه قادم من السعودية بعد تأديته العمرة.

Hospital admitted and detained QENA Chowdhury Mohammad Cnhory suspected of being infected with swine flu, after entering the hospital in case of severe fatigue and suffering a rise in temperature and a sore throat and symptoms similar to bird flu pigs, and found to be coming from Saudi Arabia after performing Umrah.

وقال د.أيمن عبد المنعم وكيل وزارة الصحة، إنه تم حجز المريض وإعطائه عقار التاميفلوا وأخذ عينه منه وإرسالها إلى المعامل المركزية للتأكد من الإصابة بالمرض من عدمه.

D said. Ayman Abdel-Moneim, Under-Secretary, Ministry of Health, had been booking the patient and give Altammivloa property and taking a sample of it and send it to the central laboratory to ascertain the incidence of the disease or not.

Egypt: 7 cases of suspected bird flu and queens and the West

Monday, July 6, 2009
احتجزت مستشفى حميات المنيا 5 حالات اشتباه بالإصابة بمرض أنفلونزا الطيور من مراكز مغاغة وبنى مزار وسمالوط بعد ظهور الأعراض عليهم، وتم أخذ عينة من كل منهم، وإرسالها إلى معمل التحليل المركزى بالقاهرة.

Detained hospital fevers Minya 5 suspected cases of bird flu disease centers and the Beni Mazar Megaga Samalut and after the onset of symptoms have been taking samples from each of them, and sent to a laboratory analysis of central Cairo.

وأكد مصدر مسئول بمديرية الصحة بالمنيا، أنه تم احتجاز كل من علاء عاشور مرسى (18 سنة) أبا الوقف مركز مغاغة ومحمد محمد منير (23 سنة) قرية كوم الراهب مركز بنى مزار وسناء سيد عثمان (12 سنة) طحا مركز سمالوط ونجوى على علوبة (18 سنة) مركز سمالوط وجاد على إبراهيم (14 سنة) مركز مغاغة.

The official source at the Directorate of Health and queens, he was detained by the Alaa Ashour Marina (18 years) stay Maghagha father, Mohammed Munir Mohammed (23 years) the status of the village of Kom monk built a shrine and Sana Syed Usman (12 years) and Taha Najwa Samalut Center on Allouba ( 18 years) and the Center for Samalut serious Ibrahim (14 years) the status of a bell.

وصرح د.عصام عثمان مدير إدارة الطب الوقائى بالغربية أن مستشفى حميات طنطا احتجز حالتين للاشتباه فى إصابتهما بمرض أنفلوانزا الطيور، بعد ارتفاع درجة حرارتهما، وظهور أعراض المرض عليهم، وتم أخذ عينة دم ومسحة حلق وإرسالها للمعامل المركزية الخاصة بوزارة الصحة للتأكد من مدى إصابتهما بالمرض من عدمه.

A d. Essam Othman, Director of the Department of Preventive Medicine meeting Sunday attended by the hospital admitted Tanta detained two suspected bird flu disease, bird, after a high degree of Hrarthma, and the emergence of symptoms, blood samples were taken and the melancholy hours, and sent to the central laboratories of the Ministry of Health to ascertain the extent of the disease, infected or not.

حيت تم احتجاز كل من بدران جمال بدران مصطفى (20 سنة) من قرية ميت حواى مركز السنطة وسماء طارق رشيد حامد (عام و8 شهور)، وتم حجزهما بالأماكن المخصصة لذلك، لحين التأكد من إصابتهما بالمرض من عدمه وتم إعطاؤهما عقار "التايمفلو" لحين ورود نتيجة العينات الخاصة بهم.

Was hailed by the detention of Jamal Badran Badran, Mustafa (20 years) from the village is dead and the Q Center Alsentp sky Tariq Rashid Hamid (year 8 months), Hdzhma places were allocated to it, until they got to make sure whether the disease has been identified as a drug "Altaymflo" pending receipt of a result of their own samples.

NZ: Swine flu death toll tipped to rise

July 6, 2009

More deaths from swine flu are expected, Health Minister Tony Ryall said today.

The country's first three deaths from the virus were announced on Saturday, and today five other people remained in critical condition, including an otherwise healthy young woman.

Mr Ryall told Radio New Zealand people with underlying medical conditions were most likely to suffer more severe forms of swine flu, and it was important that those suffering severe cases call their GP or Healthline, where registered nurses were answering calls 24/7, on 0800 611 116.

When asked if more New Zealanders were expected to die from the virus, he said "sadly, that is the case".

"Every year we lose just over 400 New Zealanders to flu or flu-related complications [and] swine flu is going to increase that number ... we will have potentially more cases."

Mr Ryall expected significant pressure on hospitals and their emergency departments and said people had to be prepared to be patient when seeking medical attention.

He said health authorities were expecting a peak in swine flu cases but were unsure when that would happen because the virus was relatively new and there was low immunity to it.

Calls to Healthline had risen by 40 percent after the Ministry of Health announced the three deaths.

A young girl who died yesterday morning in Wellington Hospital and a 42-year-old man who died on Thursday in Christchurch both had underlying medical conditions.

The coroner will investigate whether any medical conditions played a part in the death of Zachary Wilson, 19, from Hamilton, who died at home last Sunday without having been diagnosed with swine flu.

As of yesterday, 961 cases of swine flu had been confirmed in New Zealand, up from 945 a day earlier.

New Zealand: More possible swine flu deaths

July 6, 2009

The Chief Coroner is investigating whether three more New Zealanders have died from swine flu.

There are already three confirmed deaths from the virus, but all three victims had underlying medical conditions.

Chief Coroner Neil MacLean says there has been a number of false alarms, but they are remaining vigilant.

"The police, everybody, are more alert to just checking out any indication of flu-like symptoms ... and if we become alert to that, then we make sure that's passed on to the coronial pathologists."

Judge MacLean says if the pathologist reports back with a high probability of H1N1, the samples will be sent away for analysis.

Swine Flu Pandemic: What May Lie Ahead

Listen Now [3 min 39 sec] add to playlist | download

All Things Considered, July 5, 2009 · Swine flu has been out of the headlines lately, but it's still making people sick in more than 100 countries. In fact, the World Health Organization recently named it the first official pandemic since 1968.

NPR's Richard Knox gives host Guy Raz an update on the virus.

The opportunistic flu virus

Posted on: July 6, 2009 6:36 AM, by revere

Flu virus is opportunistic. It takes advantage of any weakness. Seasonal flu picks on the very old and the very young, but pandemic flu has found us old folks tough and the younger amongst us quite tasty. No natural resistance seems to be a flavor enhancer. And pre-existing medical conditions? Quite delectable. So how full is the menu in the prime age range? CDC has just released one of their Quickstat summaries based on household interviews with a sample of the civilian, noninstitutionalized, adult U.S. population. The question the sample was asked was whether a doctor or other health professional had ever said they had any of a list of chronic conditions. If the answer to asthma was "yes," the follow-up question was, "Do you still have asthma?" Here are the results for young adults, those between the ages of 18 and 29 years old, also a prime age group for the swine flu virus:

Source: QuickStats: Percentage of Young Adults Aged 18--29 Years with Selected Chronic Conditions, by Sex --- National Health Interview Survey, United States, 2005--2007

Even in this relatively young and healthy age group, about one in six people has an underlying medical condition that might put them at greater risk for an adverse outcome from swine flu. The most frequent is asthma, a pulmonary condition of special pertinence for a virus that infects the respiratory tract. Women are more likely than men to have one of these conditions and not on the list is a physiologic condition that increases the risk from flu: pregnancy. There are about 500,000 women pregnant in any one month, a good fraction in this age group. Of course having a medical condition or being pregnant is not a requirement for a bad flu outcome. Around a third of the hospitalizations and a significant number of fatalities are in younger people without any pre-existing medical conditions. While for most people infected the clinical course is uncomplicated and self-limited, there are many for whom that is not the case.

It's a numbers game. The more lottery tickets, the more "winners." The problem with a pandemic is that the ticket holders are much younger than we are used to with seasonal influenza. Something to think about.

Changes To HPA Pandemic Flu Media Updates, UK

06 Jul 2009

Government's announcement that the UK is moving to a new phase in the response to the current pandemic flu virus means there will be a change to the surveillance information that the Health Protection Agency will be able to provide to the media in future.

The Agency has been carrying out laboratory testing of suspected cases of pandemic flu (H1N1v) since the outbreak came to light in April. The Agency's daily update has been based, since then, on the number of positive test results being confirmed through the Centre for Infections and the Agency's regional network of laboratories.

The new policy moves from measures to try and contain the pandemic flu virus to focussing on providing appropriate treatment to people with H1N1v flu. This means that, nationally, clinicians will now rely on patients' symptoms rather than laboratory tests to diagnose illness. Although we will continue to test a proportion of patients to ensure we keep getting up to date information about the virus, the daily reporting of laboratory confirmations will no longer be an accurate way to record the spread of infection, as it will not include the vast majority of cases.

The HPA will, therefore, no longer be providing a daily update of the numbers of cases confirmed through laboratory tests. From next week, the Health Protection Agency's Centre for Infections press office will instead issue a weekly media alert covering the various surveillance systems the Agency will be using to monitor the ongoing situation. This will also be available in the News section of the Agency's website at http://www.hpa.org.uk. The exact day these new weekly alerts will start will be confirmed next week.

This country has well established, and internationally respected, surveillance systems for monitoring the levels and impact of flu, which have operated through the 'normal flu season' over the last few years. These systems have proved effective for informing policy and planning and are included in existing pandemic preparedness plans as central to surveillance in a pandemic situation.

These existing systems will be augmented by additional surveillance activities, relevant to the H1N1 pandemic situation, that will continually assess the severity of disease associated with this novel virus and monitor changes in the characteristics of the virus.

The approach to surveillance in this new treatment phase will not provide a definitive figure of the number of cases nationally or regionally at any one time, as this will no longer be possible when widespread laboratory testing ceases. Instead, the updates will be providing a variety of indicators of overall flu activity in the population (i.e. aggregate measures of rates of illness). This will be supported by sample-based surveillance to detect and monitor particular characteristics of the virus or the illness that it causes. This is broadly the same approach as is taken to monitoring seasonal flu. This surveillance will provide:

- The collection of data from a network of GP surgeries across the country which provide consultation rates for patients presenting with flu-like illness.

- A 'syndromic surveillance' system, operated by NHS Direct in collaboration with HPA, which provides information on numbers of callers reporting cold/ flu symptoms and fever.

- Data from sample laboratory testing of some patients from community and hospital sources, providing information on the flu virus types circulating in the community.

The Agency has used this set of very comprehensive surveillance mechanisms over many flu seasons to accurately predict flu levels, monitor new and emerging viruses and identify trends in activity. This experience means we can confidently continue to monitor the incidence and distribution of this pandemic virus over the summer and beyond. The agency remains committed to keeping people up to date with the current situation on swine flu.

Further information on swine flu is available on the Health Protection Agency's website at http://www.hpa.org.uk/swineflu.

Israeli Health announced the discovery of 140 new cases of swine flu

06/07/2009

Strip - 6-7 (KUNA) - The Israeli Ministry of Health this morning, the discovery of 140 new cases of swine flu in Israel in recent days.

واضافت الوزارة في بيان لها "ان حالة جميع المصابين بالمرض طفيفة ومطمئنة ولا تبعث على القلق".

The ministry said in a statement that "the status of all people living with the disease, and reassuring in a slight cause for concern."

واشارت الى انه بذلك يرتفع عدد مصابي انفلونزا الخنازير في اسرائيل الى 681 اصابة.

She said that the number of swine flu patients in Israel to 681 injured.

يذكر انه لم تسجل في اسرائيل اي حالة وفاة نتيجة هذا المرض منذ بدء تفشيه في انحاء مختلفة من العالم قبل حوالي شهرين.(النهاية) م ت /ش ط كونا060914 جمت يول 09

Noted that Israel had not been recorded in any event of the death of the outcome of this disease since the start of the epidemic in different parts of the world, about two months ago. (End) EX / u i KUNA 060914 GMT Jul 09

New Zealand orders swine flu vaccine

Mon, 06 Jul 2009 06:05:36 GMT

Wellington - New Zealand has ordered a stock of untested and unapproved swine flu vaccine for health workers, police and other emergency staff but it is not likely to be used until December at the earliest, Prime Minister John Key announced on Monday.

An initial supply of 300,000 doses had been ordered from the international company Baxter Healthcare Limited for delivery within the month, he told a news conference after New Zealand's first three deaths from the disease were revealed at the weekend.

Key said the vaccine would have to be licensed by the government's Medsafe agency which assesses the safety and efficacy of all medicines. Health Minister Tony Ryall said clinical trials of the vaccine would be held in Europe and the purchase was strategic given that the H1N1 influenza virus pandemic could last up to two years.

"We want to be in the position of having the vaccine and not needing it, rather than the other way around," he said. He said that when approved two doses of the vaccine would be offered to 150,000 doctors, nurses, police, firefighters and other frontline health and emergency workers.

Ryall said that New Zealand had 1,059 confirmed cases of H1N1 influenza, also known as swine flu, but there had been many more because testing was limited. Most people suffered only a mild illness which could easily be treated at home, but it was very contagious.

The Medsafe assessment and vaccination programme could be accelerated if the situation worsened, he said. About 435 people die from influenza in New Zealand, which is now in winter, every year and Ryall said more deaths were expected because of the H1N1 pandemic.

Aceh ::: Bird flu suspect

Kuala Simpang – Yudi Anggara (14), a resident of Kampung Alur Nunang, Kecamatan Banda Mulia, Aceh Tamiang, is suspected to contract bird flu virus. Victim has contact history with dead chicken, when he disposed dead chickens into a river nearby his house.

Currently, victim is being treated in Adam Malik hospital, Medan, South Sumatera. Until now, victim has not recovered yet, and he is prohibited to return to his village before test result issued by Jakarta laboratory.

Health service staff, dr Zuheini said that victim had fever after disposing dead chickens belong to his family. The chickens were found suddenly died with bluish appearance.

Victim was then rushed to local public health center, and from then was referred to Tamiang regional hospital. Furthermore, Agriculture Service officers have done further test to the dead chickens done, and showed positive bird flu infection.

Because Tamiang regional hospital did not have equipment to confirm the cause of disease, victim was then referred to Adam Malik hospital, Medan, for treatment and further examination.

MOH indicate Siaga Full of Antarmanusia Already There

Sunday, July 05, 2009, 11:07:00




Jakarta, Padek - Signal yellow switched Department of Health (MOH) related merebaknya new virus H1N1 (swine flu). Department under the command of Menkes Siti Fadilah Supari stated that the mode of virus H1N1. That has happened because of transmission of swine flu among humans in Indonesia. Total 20 patients who already have a disease is positive. Two of them are contagious from the other patients.

"There is now the case of transmission between humans. Patients have been treated and infect other people, "said Tjandra Yoga Adhitama, Director General of Disease Prevention and Environmental Penyehatan (P2PL) office in the MOH MOH, Rasuna Said street, yesterday the journalist. Tjandra explains, the latest data have 12 new patients positive H1N1 virus. Consists of, 8 WNI and 4 WNA.

They berinisial AR-male aged 23, RA-male berusia10 months, HR-women aged 40 years, IG-male aged 33 years, N-aged women, 34 years, BE-male aged 50 years, TD-male aged 65 years, F-male aged 14 years, RW-male aged 23 years, BA-male aged 22 years, JO-male aged 43 years, and NN.

Six of the patients treated in the Infectious Diseases Hospital (RSPI) Sulianti Saroso, each 1 in the RS and RS Gatot Subrot Bintaro International, and 4 patients treated at the hospital Sanglah Denpasar. To suspect swine flu itself grows. Tjandra can not mention the amount of course. "If the suspect can not be limited. Cough-cough and cold can be considered suspect and conducted inspections, "explained. Especially for those newly arrived from abroad or from an infected country.

Although the number of suspect lots, said Tjandra, they do not necessarily have a positive H1N1 virus. "Because the results are still awaiting checks from the MOH," augment him. Tjandra explains, H1N1 merebak quickly around the world. Up to now, there is no vaccine to prevent the virus. According to the plan, production of new vaccines will be done in six months. "Until now handling swine flu tamiflu with just enough," he explained.

Tjandra ask that people do not panic. For, from 20 patients revealed positive swine flu, 95 percent do not have a chronic condition. In addition, 90 percent of patients who have a swine flu in the world choose not to treatment hospital. This means, in addition to 20 can be stated that the patient is positive, there is still other patients. Because, they choose not to go to the hospital.

Tjandra said, for handling the problem, the mask digalakan. However, at this time the mask was not specified by the department where. "The department set up a cross," he said. He describes, in general, there are four protap that apply to passengers in the airport. Specifically, they come from a new foreign country. That is, must go through thermo scanner to find out someone's body temperature, wear masks, put on health alert card, and reported the matter to the passengers coming from countries where.

At this time, not only Jakarta and Bali are infected with the virus. Also, Makassar and Medan. In two areas, the number of flu suspect growing pigs. Five new suspect in Medan in the middle of treatment. Their blood sample examined Batlitbangkes MOH. Including, patients who expressed a positive swine flu in Jakarta currently treated in the Infectious Diseases Hospital Suliati Saroso.

"All the results we are still carefully. Any development that occurs we will report it, "said Tjandra. Bird flu experts from Airlangga University requested that the government immediately map the H1N1 type of virus infecting the patient stated that the positive carry disease. Thus, it can be known whether the virus is on the patient from Indonesia was the country dituju or original infected in Indonesia alone.

"This is very important in mind. So, the MOH can map the types of the virus, "said Prof. drh CA. Nidom, head of a bird flu laboratory Unair. He explains, there must be research on the virus-the virus that has been menginfeksi patients. "The virus that should have been reviewed again," he said. For example, a virus that the citizens of Australia who currently treated in the hospital Sanglah, Bali.

"The problem, if it does not matter how virusnya in Australia. But if true? That need to be feared that if the virus adapts to the patient, "he said. Nidom also recommends that the virus also carried out investigations against the WNI currently treated in Singapore or other countries. "We have a sample that can be virusnya kinship virusnya," said Nidom. Because, he said, each virus has a different representative. There is a more violent or otherwise.

Therefore, he said, in the laboratory examination should be conducted. Efforts to prevent the leakage of the virus. Nidom explained, efforts to map out the relationship H1N1 virus at the same time to prevent the virus bergabungnya with the H5N1 virus. "We can do the simulation, the simulation since the beginning," says lecturer at the Faculty of Veterinary Medicine Unair it.

By doing the research, said Nidom, H1N1 can spread opportunity prevented. For, can be known types of viruses and how to address them. Moreover, the various parties about the possibility bersatunya virus H1N1 and H5N1. "That's reasonable, because the impact on health is quite dangerous," he said. (kit / jpnn)

Argentina: Deaths from influenza A in the province are already 18

05-07-2009

Reported Sunday evening that the provincial Ministry of Health


According to data provided by the Situation Room, there are more than 2,000 cases reported, of which 400 were confirmed as positive.Of the 15 deaths corresponding to node Rosario, Santa Fe to two and the rest of the Venado Tuerto.

The Ministry of Health in the province of Santa Fe reported tonight, through the Situation Room that operates under the Contingency Plan prepared in connection with the pandemic influenza A (H1N1), the total number of reported cases with Epidemiological fact sheets exceeds 2000, with 400 confirmed and 18 deaths, 15 of which belong to Node Rosario, one of the Venado Tuerto and two of Santa Fe

This record corresponds to the information available to date Sunday July 5 to 20 hours.

New Protocol

In relation to the cases reported by epidemiological record, stated that under the new protocol has been performed only for severe cases confirmed virological and interned.

On the deceased, the report states that all have virologic confirmation Influenza A (H1N1) and ages ranging from 6 to 59 years (11 women and 7 men).

Also, the total deaths, 12 had risk factors and 6 had no prior record of risk.

Lower the amount of international consultations and

Provisional data on the production of services because it was noted that in the last week can be seen coming down the outpatient visits in health centers and hospital guards, while the amount internments.

30,000 claims from outpatient care, and guards have internments 13,000 influenza-like disease diagnosis.

Behavior of the epidemic

Regarding the evolution of the pandemic influenza A (H1 N1) in the provincial territory, the behavior varies in different geographical areas, which has already begun to overlap with the high incidence of respiratory disease which is the seasonal period.

There is a group of cities among which are Venado Tuerto, Santa Fe, Rosario and other locations in the metropolitan area where there has been movement from one person to another influenza virus, while another group does not report suspected cases or are isolated cases that can be linked directly with patients in close contact with these other cities in the province of Buenos Aires or.

Intervention Strategies

For these reasons the strategies have been adapted to the time evolution of the epidemic in each place, giving rise to two protocols of intervention:

For the first group of cities virological diagnosis in the public network (for laboratory confirmation of cases) is no longer used only for inpatients, and therefore all cases of disease that occur with temperature of 38 º and flu symptoms are considered generically as "influenza-like illness."

For the second group of cities, it continues with the approach of all laboratory-confirmed cases to generate suspicion, leading to the categorization that until now was used to transmit information on the epidemiological situation as if "suspect" or "confirmed" influenza.

Epidemiological

This heterogeneity, added to the difficulties offered by the epidemiological surveillance underreporting or delays in the transfer of files complaint, determined that the party has lost its epidemiological daily value it had at the beginning of the epidemic as a document for communication to the public of developments across the province.

That is decided in accordance with the decision by the Ministry of Health of Nation, an update of epidemiological day by hand, appealing to the mass media to disseminate news to the community in terms of new measures containment social lethal cases or changes in the protocols.

Source: Ministry of Communications.
hat-tip Shiloh

Argentina: 60 Deaths from Swine Flu (up from 55 reported yesterday)

RA Buenos Aires, July 5 (Telam) .- The Ministry of Health of the Nation today reported 60 deaths in Argentina due to influenza A and 2485 confirmed cases in all sample provinces, using data from the Institute Malbrán .

Meanwhile, the Ministry strengthens the equipment and supplies in the provinces for the care of patients suffering from Influenza A H1N1 in different hospitals and primary care centers, including 800 thousand complete treatments of antiviral oseltamivir, breathing and pulse oximeters.

The disease continues to have greater impact on the City of Buenos Aires and the Province of Buenos Aires, where there are total of 1870 cases.

The distribution of deaths by jurisdiction shows bonaerense territory with 42 deaths; Federal Capital with 6 dead; metropolitan unspecified, 1 died, Santa Fe, Misiones and 9, 2.

Influenza A in the world recorded 91,633 cases of human infection by the virus in 123 countries have confirmed with 409 deaths.

The region of South America reported 12,547 positive cases of Influenza A H1N1 infection, of which Chile, with 7342 cases and 14 deaths, and Argentina, are listed with the highest incidence of the disease .- (Telam).

rb-da
hat-tip Shiloh

Rabies, animal, human - Russia (02): (MOW)

05-JUL-2009
Subject	PRO/AH/EDR> Rabies, animal, human - Russia (02): (MOW)

RABIES, ANIMAL, HUMAN - RUSSIA (02): (MOSCOW REGION)

Date: Thu 2 Jul 2009
Source: IA Moscow news [trans, abbreviated, Mod.NP, edited]
<http://www.newsmsk.com/article/02Jul2009/privivka.html>

According to RosSelhozNadzor (The Federal Agency for Veterinary and
Phytosanitary Supervision), the numbers of stray dogs and cats, the vectors
of rabies, have continued to increase throughout the Moscow region.

The number of rabies cases among animals during 2008 was 2.5 times their
number during 2007. 80 per cent of the cases involved wildlife, of which
the population growth is uncontrolled. The other 20 per cent involved pets.
During the 1st 5 months of 2009, 11 000 persons applied for post-exposure
treatment. This is an 11 per cent more than in the same period of 2008.

--
communicated by:
ProMED-RUS
<promed@promedmail.org>

[According to VmDaily <http://www.vmdaily.ru/article.php?aid=79755>, 13
cases of human rabies have been recorded within the Moscow region since
1987; 9 of them died during the last 5 years. - Mod.NP

Clearly, the reservoirs of the virus in the Moscow region are wild animals;
according to previous postings, these are predominantly raccoon dogs
(_Nyctereutes procyonoides_) and foxes. Stray or unvaccinated pet dogs
(and, to a lesser extent, cats) exposed to wildlife deliver the fatal virus
into the human population.

The reported increase in the number of rabies cases in animals (probably
referring to both wildlife and domestic pets) deserves some explanation; it
could also reflect intensified monitoring. The increased number of exposed
(and subsequently treated) people may, however, reflect a growth in the
stray animal population or deficient vaccination coverage of pets.

Oral vaccination of wildlife is the recommended mode for spatial rabies
control. Several of the vaccines which have been long demonstrated as
highly effective and safe in controlling the disease in foxes -- in western
Europe and elsewhere -- have been tested in raccoon dogs as well, with
similarly satisfactory results. - Mod.AS]

PARAINFLUENZA VIRUS TYPE 3 - CANADA: (ONTARIO) NEONATES

	05-JUL-2009
Subject	PRO/EDR> Parainfluenza virus type 3 - Canada: (ON) neonates

Date: Fri 3 Jul 2009
Source: The Hamilton Spectator [edited]
<http://www.thespec.com/News/Local/article/593666>


Respiratory virus outbreak contained at Mac's neonatal ICU unit
---------------------------------------------------------------Hamilton health officials have declared an outbreak at McMaster hospital's
neonatal intensive care unit after 3 newborns became ill with a respiratory
virus. The premature babies were confirmed to have parainfluenza type 3
virus infection. It is a seasonal virus associated with respiratory
symptoms such as a cough and fever. There have been no new cases since
then, according to hospital officials. The neonatal intensive care unit,
which has 44 babies, remains open to visitors and patient admissions and
the 3 affected babies are in isolation and being monitored closely. All are
recovering, said hospital spokesperson Lillian Badzioch.
The virus is not a flu virus and not associated with the H1N1 swine flu
virus that is spreading in the community, according to Dr Chris Mackie,
Hamilton associate medical officer of health. Mackie said although
parainfluenza type 3 virus doesn't carry the same risks as regular seasonal
influenzas, it does pose a risk for preemies [babies born prematurely].
Most cases do not require treatment and the virus is commonly seen in
infants during spring and summer months. It can mimic the symptoms of the
flu, Mackie said.
Badzioch said, "It is very common in children under 2." But, she added,
because it is in an intensive care unit and because the babies are all
preemies, the hospital declared the outbreak and erred on the side of
caution to prevent further spread. "We're already dealing with a fragile
population and we wanted to take all the precautions."

The hospital confirmed the cases on Saturday [27 Jun 2009], declared the
outbreak on Monday and informed parents of babies in the unit, but only
notified the general public yesterday [Thu 2 Jul 2009]. "If this was a
serious disease with any risk to the public, this (declaring an outbreak)
would have happened right away," Mackie said. "We don't expect any further
cases."

[byline: Carmela Fragomeni]

--
communicated by:
HealthMap Alerts via ProMED-mail
<promed@promedmail.org>

[The 1st parainfluenza virus discovered was Sendai virus (parainfluenza
virus type 1) in 1952 in Japan. In 1955 type 2 was isolated from children
with acute laryngotracheobronchitis (croup). In 1985 type 3 was isolated
from children with respiratory tract infection. In 1960 type 4 was isolated
from children with mild respiratory tract infections. The human
parainfluenza viruses are pathogens that primarily affect young children,
in whom the pathogenic spectrum includes upper and lower respiratory tract
infections. The human parainfluenza viruses are responsible for 30-40 per
cent of all acute respiratory tract infections in infants and children.
These conditions include common cold with fever, croup, bronchiolitis, and
pneumonia. They are also a cause of community-acquired respiratory tract
infections of variable severity in adults.

Human parainfluenza virus type 3 is 2nd only to respiratory syncytial virus
as a cause of pneumonia and bronchiolitis in infants and young children.
Outbreaks of HPIV-3 infections occur yearly, mainly in spring and summer,
and last longer than outbreaks of the other types of parainfluenza virus.

Reinfection with human parainfluenza viruses can occur throughout life,
with elderly and immunocompromised persons being at a greater risk of
serious complications of infections.

The location of the city of Hamilton in the south of the province of
Ontario can be found in the map of Ontario at
<http://atlas.nrcan.gc.ca/site/english/maps/reference/provincesterritories/ontario/map.jpg>.
- Mod.CP]

Peru reports first swine flu deaths, region's cases swell

1 hr 57 mins ago

LIMA (AFP) – Peru on Sunday reported its first two swine flu fatalities and Uruguay and Paraguay saw their death tolls rise, as South America grappled with mounting cases and measures to contain the spread of the virus.

The American continent remains the world region worst affected by the A(H1N1) flu virus, which first appeared in Mexico in late April.

The virus, declared a global pandemic last month by the World Health Organization, has infected 89,921 people in 125 countries and territories and caused 382 deaths worldwide, according to the latest World Health Organization (WHO) figures.

But concerns have risen in South America in recent days, following the Argentine Health Ministry's estimate that some 100,000 people have contracted the A(H1N1) virus since the first case was discovered in the country in May.

Fifty-five people have died of swine flu there, but the ministry said 95 percent of those who were infected with the virus have recovered.

Peruvian Health Minister Oscar Ugarte said a 38-year-old woman died Friday after checking into a Lima hospital with pneumonia on June 29, when tests confirmed she had contracted the virus.

"She received standard antiviral treatment but unfortunately she died," Ugarte said.

The second death was of a four-year-old girl who had Down Syndrome and was admitted to hospital with severe respiratory problems. She died June 28, but laboratory results of her infection were confirmed only recently, Ugarte said.

The Andean nation has confirmed more than 810 A(H1N1) infections and has become the seventh South American country to report deaths linked to the virus.

The region, currently in the grips of winter, is being closely watched by health experts as it could be a harbinger of things to come north of the equator, when North America, Europe and much of Asia enter their winter at the end of the year.

All 13 South American nations except Guyana and French Guiana have reported swine flu cases.

The death toll meanwhile rose to four in Uruguay, where Health Minister Maria Julia Munoz warned that "there could be thousands" of A(H1N1) cases in the small country sandwiched between Argentina and Brazil.

There are presently 163 people hospitalized for swine flu in Uruguay, with 68 of them confirmed cases.

The virus has now become endemic in the country, and represented more than 50 percent of the number of seasonal flu cases, Munoz said.

In Paraguay, an eight-year-old girl with pneumonia became the country's second swine flu death, health officials confirmed Sunday.

"What's happening in Argentina is what we have to prevent," said Ernesto Weber of Paraguay's Social Welfare Institute, referring to the 55 deaths reported in Argentina, the highest death toll in South America.

Bolivia was considering a temporary closure of part of its 773-kilometer (480-mile) border with Argentina to help stem the spread of the disease, Health Minister Ramiro Tapia said Sunday.

He said the first step was to "double the number of doctors along this section of the border, because if we see that the (flu) cases are coming from Argentina, then we'll have to close the border for three, four or five days to prevent the spread of the virus."

Bolivia reported 393 swine flu infections as of Sunday, 74 more than the day before.

Medical conference in Port Said discusses Chest

Sunday, 05 July 2009 22:10

Conference held in Port Said Port Said annual chest diseases, held in the period from 2 to July 4 in conjunction with The Egyptian Society for chest diseases, the Conference has included a selection of distinguished professors, Sadr has been in Egypt to discuss what is new in the methods of prevention, diagnosis and treatment of chest diseases, particularly avian and swine influenza and infections of the upper and lower respiratory disease, as well as the sensitivity of the chest, especially in the elderly, pregnant women Source: Port Online

Fears of «marriage Jenny» between avian and swine influenza, seasonal produces «devastating virus»

كتب مروى ياسين ٥/ ٧/ ٢٠٠٩ Marwa Yassin wrote 7-5 / 2009

«Some science professors agreed that the HIV virus «H1N1» swine flu, is subject to confusion or mating with the bird flu and normal seasonal influenza, the expectation of the new strain to be more virulent, and some emphasized that «Tamiflu» does not eliminate the virus, as is common, but only reduces the transmission of the virus to other cells or from one person to another, and be the first «48 hours» from the onset of symptoms. "Said Dr Hussein Hassanein, Professor and Chairman, Department of Veterinary Medicine, Faculty of viruses, Cairo University, said that the expectation of a mutation of the virus and the emergence of certain new strains, especially that Egypt has become« settlement »the bird flu virus, had the flu cases to the Pigs by seasonal influenza, and pointed out that this confusion could lead to a new high-intensity virus, confirming that the real problem is that Egypt is free of laboratories equipped to research the virus, which causes weakness in controlling the spread of the virus through research, studies, and sufficient only to receive information from abroad. He added: coefficient only in Egypt, which is doing research on these viruses is a factor of «Nmro 3», of the American navy, while the central laboratories of the Ministry of Health is dependent on its diagnosis, and research and the discovery of important results, which protects us from the idea of the random expectations of future events of the virus it is non-existent. . Hassanein said that the Faculty of Veterinary Medicine on the way for the establishment of a special virus. He expected Dr. Hossam Rifai, Professor of Microbiology and Immunology, Institute Altanasliat, the emergence of 256 new strain of swine flu virus at a theoretical level, because the DNA of the virus has more to renew and change the strain, and pointed out that the production of a vaccine for this virus to no avail because it changes every time. . He pointed out that the real fear of the swine flu virus is linked to winter because of the potential of a marriage between the viruses to the emergence of a new strain, such as fast-spreading swine flu. Taleb Rifai, and the establishment of a Supreme Council for the fight against viruses and epidemics of the seriousness of the situation, particularly as there is a new virus strains showed resistance to Tamiflu, which underlines the importance of the establishment of specialized bodies to combat these viruses. According to Dr. Ahmed Snoussi, deputy dean of the Faculty of Veterinary Medicine for Graduate Study and Research, Cairo University professor of viruses, the greatest danger is in the elimination of pigs once and for all, despite a campaign of executions carried out by the government «theory». Process emphasizes the fact that a large number of pigs has already fled to remote places, he said and continued: «disaster arise here because the nature of the pig virus immune animals receiving weak, it can be established inside the marriage between the viruses of avian and swine influenza and human influenza virus to produce a new devastating to humans move quickly ».

Japan: Journal was told of flu mutation first

Monday, July 6, 2009

OSAKA (Kyodo) The Osaka Prefectural Government sent a research paper to a U.S. medical journal on the first case in Japan of a genetic mutation of swine flu resistant to Tamiflu about a week before making the finding public, officials said Sunday.

"It's not that we intentionally placed priority on the manuscript and delayed the announcement," said Tatsuya Oshita, an official in the prefectural government's health and medical care department. "As it turned out, we dealt with the matter in a way that could be criticized and we are sorry."

The H1N1 virus resistant to Tamiflu was found in a woman in her 40s in Osaka Prefecture on June 18 — two weeks before the announcement — through virus sample analysis at the Osaka Prefectural Institute of Public Health, the officials said.

A staff member of the institute submitted a manuscript on the analysis result to the U.S. journal June 24, but it had not been run in the magazine as of Sunday, the officials said.

The prefectural government reported the case to the Health, Labor and Welfare Ministry last Wednesday, a week after it sent the manuscript to the U.S journal, and held a news conference the next day to make it public based on advice from the ministry, the officials said.

The prefectural government had said its report to the ministry was delayed because it took some time to study the methods for examining abnormalities in viruses.

Japan: "Drug resistance", Osaka, first paper, published two weeks with

2009 July 5

In resistance to Tamiflu-resistant virus from the treatment of patients living in the new swine flu, Osaka, Osaka Prefectural Institute of Public Health found no published two weeks, I posted the first paper to study the U.S. found. 8 papers from the post had been announced by the Ministry of Health advised the following day. World Health Organization (WHO), released promptly at the time of virus resistance, and asked to report, have been criticized by experts.

Prefectural Institute of Public Health, May 29, the incidence of women in Osaka Prefecture had the prophylactic administration of Tamiflu, Tamiflu resistance was incredible. Examined the gene of the virus was confirmed June 18 that indicates the gene mutation resistant to Tamiflu. However, July 2, did not disclose until Sunday late-night news conference.

According to the Government, a research center, said officials at the Institute of Infectious Diseases, were asked to fast from the ministry announced.

Government in the late-night press conference, why was not released, was waiting to be confirmed in experiments using cells or truly resistant viruses have been described. However, officials of the three prefectural Institute of Public Health June 24, and were Tamiflu resistant gene mutation, American Journal of Medicine "DIJIJIZU INFEKUSHASU emerging," the Post article. Issued when the papers would be published in April, had not yet decided.

The paper was first posted, the Vice-President Takahashi Kazuo prefectural Institute of Public Health "to the general public was ahead of the publication, and thought to incite fear and uncertainty in the publication, and I can understand if experts . It was not a post in a hurry with no ambition. to the future of reflection. "

June 22 Ooshita Tatsuya deputy director of the medical health office had received a report from the Institute and in the "if you look to work with colleagues and researchers府民, and pleading before the tribunal can not. The government was soon to be released. really sorry, "he said.

The WHO International Health Regulations, and the incidence of resistant virus, was confirmed in the case could become a public health emergency and are set to report soon. The ministry received a report in the mail from the government three days to日夕have reported to WHO. WHO is June 29, announced the resistant virus was found in Denmark, also in Japan "the world's first confirmed cases" were reported.

Japan: Flu virus resistant to Tamiflu verified

THE ASAHI SHIMBUN

2009/7/4

A mutated form of the new swine flu virus that is resistant to the drug Tamiflu was confirmed in a woman in Osaka, health officials said Thursday.

It was only the second detection of such a virus in the world, following one in Denmark in late June.

The National Institute of Infectious Diseases will examine the mutated virus in detail.

According to the Ministry of Health, Labor and Welfare and the Osaka prefectural government, the female teacher in her 40s started receiving Tamiflu from May 18 as a preventive measure because she had been in close contact with a person infected with new swine flu.

But she developed a slight fever May 24, and was confirmed infected with what was then believed to be the new swine flu virus on May 29.

She later recovered after receiving the drug Relenza.

The Osaka Prefectural Institute of Public Health conducted genetic examinations of her virus samples and found that the disease was in fact a mutated form of new swine flu that is resistant to Tamiflu.

Officials of the Osaka prefectural institute said the swine flu virus underwent a sudden genetic mutation when she was receiving Tamiflu.

Health officials said there is no reason to panic. They noted that the mutated virus has not been detected in other people who were also in close contact with the same person.

"Mutations are often seen in seasonal H1N1 flu viruses, so we had expected a similar mutation would occur in the new swine flu virus," said Yoshinobu Okuno, director of the Kanonji research institute of the Osaka University's Research Foundation for Microbial Diseases.

"But if Tamiflu is not effective for patients with serious symptoms, it could be a big problem. Medical institutions that treat high risk patients should prepare not only sufficient amounts of Tamiflu but also Relenza," he said.

Nearly 100 percent of seasonal Type A Soviet Union flu viruses have mutated into ones resistant to Tamiflu.

Health officials said the Osaka woman was not infected by any of those viruses.(IHT/Asahi: July 4,2009)

NZ-No underlying symptoms in critical case

Published: 6:13AM Monday July 06, 2009
Source: Newstalk ZB




ONE News

A young woman is in critical condition with swine flu in Wellington Hospital in what is the first case of a previously healthy patient with no underlying medical conditions becoming critical.
However, health officials say as far as they are concerned nothing has changed with New Zealand's swine flu situation since three people died last week.
Two men and a young girl confirmed as having the virus died, and the Chief Coroner believes swine flu was a major contributing factor in at least two of the deaths.
Canterbury's Medical Officer of Health Ramon Pink says the deaths were not entirely unexpected.
He says it is no cause for alarm because in most cases, swine flu is still very mild.
Pink says it is hard to say exactly how many more people will die from swine flu-related illness.
Director of Public Health Dr Mark Jacobs says the situation is not really any different than it was last week, before the deaths were confirmed.
He says it is an infection which is spreading quickly in some parts of the country, but not others.

Jacobs says an increase in the number of calls to Healthline shows good community awareness of swine flu.
He says the volume of calls to Healthline went up 40% after the deaths were announced on Saturday.
He says there will be times when people who ring Healthline will have to wait for their call to be answered, but he's urging them to patient.
Jacobs says there's no reason to be more concerned now than before the three deaths.
Focus on respiratory illness
Parents with children who have respiratory illnesses are being told to do what they can to protect them from swine and other types of flu.
An eight year old girl with swine flu who died in Wellington Hospital over the weekend is thought to have also suffered from Cerebral Palsy.
Paediatric Society chairman Johan Morreau says children with underlying conditions are as much in danger from swine flu as from seasonal influenza, and parents should be concerned.
He says it's going to be difficult for people to avoid exposing their children.
Morreau says he's not overly worried by the impact of swine flu on children at the moment, but he will be if the virus mutates.
Meanwhile health officials in Christchurch admit they over-planned for swine flu, just to be safe.
Pink says they over-planned because they had been expecting an aggressive strain like bird flu.
If anyone has any concerns they can contract the swine flu hotline on 0800 611-116.

__________________

Nepal-Diarrhoea kiled 50 in Jajarkot; Salyan sees five deaths

5 Jul 2009

The number of people dying from diarrhoea in remote Village Development Committees of Jajarkot district has reached 51 with the death of five more people in the last two days.

Kalika Shah (7) of Portang-2 died on Saturday morning while Seema Kumari Rokaya (25) of Thalaraikar-9, Kare Bhat Chhetri of Thalaraikar-4, Jayarupa Shahi (40) of Jungathapachaur-3 and Naini Badi (25) of Jungathapachaur-4.

Many people in Thalaraikar and Jungathapachaur VDCs have been affected by diarrhoea, according to Narendra Shahi, a local school teacher. The VDCs are a three days' walk from district headquarters Khalanga.

People in more than 16 VDCs in the district, including Chapra, Portang, Suwanauli, Naikbadh and Rokayagaon, have been affected from diarrhoea from the last two months.

District Public Health Office (DPHO), Jajarkot, has already confirmed the death of 41 persons by the disease. "The number could go up as the data about the deaths in remote VDCs have not arrived yet," an official at the office said.

The DPHO said the diarrohea outbreak was beyond their control.

According to District Administration Office, Jajarkot, it had already informed the Ministry of Health and Population about the outbreak.

Five die of diarrhoea in Salyan

As many as five people died from diarrhoea in Suikot VDC, Salyan district over the past two days.

Public Health Office in the district informed that three, Bhim Bahadur Buda, Basanta Bista and Dal Bahadur Bista, who had been ill due to diarrhea, died this morning.

Two persons had died of the same cause on Saturday.

Diarrhoea has spread in Suikot VDC-6 and 7 and some adjoining VDCs in the district.

Health professionals have said that contaminated drinking water is behind the spread of the disease.

Nepal-Youth suspected of swine flue admitted to hospital; 3 return home after treatment

Nepalmountainnews Report

5 Jul 2009

A 23-year-old youth, who returned Bardia from Qatar four days ago, has been admitted to a hospital after he was suspected to be suffering from swine flu.

Bhim Bahadur Chaudhary of Nayagau-8, Bardiya, has been taken to Nepalgunj-based Bheri Zonal Hospital in the district with suspected swine flu symptoms.

Police took Chaudhary, who was at large from Tribhuvan International Airport, under control and admitted to the hospital.

Chaudary is kept in isolation and under observation.

However, blood test reports are awaited and a case of swine flu is yet to be ascertained, said Dr. Shyam Sundar Yadav, chief of the zonal hospital.

Till now no case of H1N1 virus has been detected in this area.

Swine flu victims recovered

Three persons diagnosed with swine flue last month have been cured after a treatment in isolation for five days, health officials say.

The patients were given a full course of Tamiflu for five days and their disease have been cured completely, said Dr Senendra Raj Upreti, director of Epidemiology and Disease Control Division. They need not be kept in isolation anymore as they are not capable of transmitting the disease to others now.

Three members of a family, a 44-four year old man, a 38-year old woman and an eight-year old child, who entered Nepal on June 21 from the USA via Doha were found infected with the Pandeminc Influenza ‘A’ H1N1. They were treated in isolation at their home.

Later two other persons who had come in contact with the victims were also diagnosed with swine flu. They are still undergoing treatment.

FACTBOX-Worldwide spread of H1N1 flu

Sat Jul 4, 2009 7:41am EDT

July 4 (Reuters) - New Zealand has had its first fatalities linked to the H1N1 flu, with three deaths in the last week, the Ministry of Health said on Saturday.

Here are details about the spread of the new H1N1 flu, a mixture of swine, bird and human viruses which has infected more than 79,000 people, according to the latest World Health Organisation (WHO) and local health authority tallies.

The WHO has declared an influenza pandemic and advised governments to prepare for a long-term battle against the virus.



DEATH TOLL: 387

CONFIRMED CASES: The number of confirmed cases of H1N1 is now at least 89,954.



COUNTRIES WORST AFFECTED:

DEATHS CASES

UNITED STATES 170 33,902***

MEXICO 119 10,262*

ARGENTINA 26 1,587++

CANADA 25 7,983

CHILE 14 7,376**

AUSTRALIA 9 4,568+

BRITAIN 4 7,447****

THAILAND 3 1,414

NEW ZEALAND 3 945

COSTA RICA 2 227

GUATEMALA 2 254

DOMINICAN REPUBLIC 2 108

COLOMBIA 2 101

PHILIPPINES 1 1,709

SPAIN 1 760

BRAZIL 1 737

URUGUAY 1 195

HONDURAS 1 123

PARAGUAY 1 103

NOTES: WHO figures sometimes lag local confirmations covered by Reuters.

* = Mexico Ministry of Health figures.

** = Chilean health authorities.

*** = U.S. Centers for Disease Control and Prevention.

**** = British Health Protection Agency figures.

+ = Australian government.

++ = Argentina's health ministry.

Sources: Reuters/WHO.

The announcement of the discovery of the first swine flu case in Libya..Again

Tripoli - AP - The Minister of Health and Environment Mohammed Alhijazi on Sunday the discovery of the first cases of HIV (AH-1 to 1) swine flu, known in Libya.

He told the Alhijazi (Jamahiriya News Agency) said that "a person with a Thai citizen, allegedly von Moon Bnfim (52 years) and works in one of the companies operating in Libya, had arrived last night from Dubai after his vacation in his country."

He pointed out that the patient in the continuous improvement and good condition after receiving treatment in hospital.

"The flight of all passengers are being followed and disclosures of health for them through the committees in charge of the medical" he said, adding that drugs are available in all hospitals

Egypt: 5 suspected cases of bird flu children Behira

Detained hospital fevers Damanhour, 5 people suspected of having bird flu, following the emergence of the disease with symptoms similar to a high temperature and pain in the bones and difficulty in breathing, sore throat.

تلقى اللواء مجدى أبو قمر مدير أمن البحيرة، إخطاراً من مستشفى حميات دمنهور بالاشتباه بإصابة أحمد ياسر هنداوى(7 شهور)، رضا سعد جمعة (9 سنوات)، علاء سعيد أمين (18 شهر)، محمد محمود إبراهيم (3 سنوات)، وفاء حسين جمعة (3 سنوات)، وعلى الفور تم عزل الحالات وقائياً بالمستشفى بعد أخذ عينة دم منهم لتحليلها بالمعامل المركزية بالقاهرة لبيان مدى إصابتهم بالمرض.

Major-General received the Director Majdi Abu Amar security lake, a notification from the hospital fevers suspected injury Damanhour Hendawi Yasser Ahmed (7 months), Saad Reda Gomaa (9 years), Alaa El-Said, Secretary (18 month), Mohamed Mahmoud Ibrahim (3 years), the Q's Fri (3 years), and were immediately isolated and preventive cases in hospital after blood samples were taken for analysis, central labs in Cairo, with the extent of their disease.

وانتقلت لجنة من الطب البيطرى والصحة وقوات الأمن لمنازل المرضى لتطهيرها، وتطهير المنازل المجاورة لهم، وكذا المخالطين لهم وأخذ عينات من الطيور الموجودة بالمنازل لفحصها.

Turning to the Committee of Veterinary Medicine, health and security forces to the homes of patients cleared, clearing houses and their neighbors, as well as contact them and take samples of domestic birds to be tested.

India: Update on Possible Case of Resistance H1N1: Man Tests Negative

Man on Tamiflu tests negative for H1N1, discharged from hospital

5 Jul 2009,

CHENNAI: Officials at the state health department heaved a sigh of relief on Saturday when they received a message from the National Institute of
Communicable Diseases, New Delhi, stating that a 29-year-old man who had remained positive for H1N1 virus despite being on Tamiflu treatment has tested negative.

He was discharged from the Communicable Diseases Hospital (CDS) here on Saturday.

Earlier, directorate of public health staff had expressed concerns when the man was discharged on Friday by CDH despite having remained positive for H1N1. He was brought back to the quarantine ward on Saturday and even his family members were instructed to start a course of anti-viral therapy to prevent infection.

Doctors were awaiting orders from the NICD on the further course of treatment for the patient - either another course of Tamiflu or another drug, Relenza.

"We are relieved that he is not a carrier anymore. He has been discharged. However, we have asked laboratories to investigate and let us know if there has been any mutation of the virus. We can't help the suspicion; it took him two courses of Tamiflu, against the normal one course, to recover," said director of public health Dr S Elango.

The man and his wife had arrived in Chennai airport on July 18. They were kept in quarantine at CDH after they showed symptoms of H1N1. Two days later, they were put on a course of Tamiflu treatment after laboratories confirmed they had tested positive for the viral infection.

They were given two 75 mg Tamiflu tablets, one in the morning and the other at night.

While the woman tested negative a week later, the man continued to be positive. He was then started on a second course of Tamiflu.

"We want to know why it took him so long to recover. It could be because of a mutation of the virus," Dr Elango said. The National Institute of Virology in Pune will now investigate why it took the patient almost a fortnight for recovery.
hat-tip Dutchy

Tamiflu resistant H1N1 from Hong Kong more worrying than earlier findings

By Helen Branswell

TORONTO — All cases of Tamiflu resistance are not created equal. So while the first three instances of swine flu infection with Tamiflu-resistant viruses were reported in the past week, it was Number 3, not Number 1 that put influenza experts on edge.

Public health authorities in Hong Kong announced Friday they have found a case of Tamiflu resistance in a woman who hadn't taken the drug. That means she was infected with swine flu viruses that were already resistant to Tamiflu, the main weapon in most countries' and companies' pandemic drug arsenals.

The two earlier cases, reported from Denmark and Japan, involved people who had been taking the medication. While always unwelcome, that type of resistance is known to occur with seasonal strains and may be less of a threat to the long-term viability of this key flu drug.

"It was not at all surprising to see resistance in patients on treatment but seeing it in someone who was not treated, it certainly is more concerning," says Dr. Malik Peiris, a flu expert at the University of Hong Kong.

There is currently no evidence Tamiflu-resistant viruses are spreading widely. Still, some experts see the Hong Kong case as a warning Tamiflu's role in this pandemic may not be as long-lived as pandemic planners would like.

"I think it's too early to judge," says Dr. Frederick Hayden, an expert on influenza antivirals who teaches at the University of Virginia. "But I think that possibility has existed from the beginning."

"And it's something that needs to be certainly considered in making determinations about things like antiviral stockpiling, management of patients with more serious illness in hospital and how the available drugs will be used."

Some experts say this early sign of resistance should prompt a rethink of how often and in which circumstances Tamiflu is used to battle the novel H1N1 virus.

"It ... probably highlights the importance of not using these antiviral drugs indiscriminately, given that the disease is relatively mild," says Peiris, whose hospital monitored the woman who was found to be carrying the resistant virus.

"In people who don't have underlying risk factors, it probably should not be treated with Tamiflu, basically."

Others suggest countries should limit how often they use the drug to prevent infection, a regimen known as prophylaxis. In prophylaxis, people who've been exposed to the virus are given one pill a day for 10 days, compared to the treatment regime of two pills a day for five days.

Some countries, including Canada, have been reserving prophylaxis for people at high risk from this flu, such as pregnant women.

But others have taken a different approach, using Tamiflu to try to curb spread of the virus. For instance, Britain has made the drug widely available to contacts of confirmed cases, though it announced this past week it was changing that policy.

The World Health Organization is drafting guidance for countries on the use of antivirals. While the WHO advises rather than instructs, it has been stressing that saving these drugs for treatment makes the most sense, says Dr. Keiji Fukuda, the agency's top flu expert.

"In general we have been pushing the advice that using these drugs for treatment is definitely the priority use of them," says Fukuda, the acting assistant director general for health security and environment.

"And I think this is not just from a theoretical resistance perspective, but also from the fact that if you have limited amounts of antiviral drugs, then you need to make some choices about how you use them."

From their first sighting, the new H1N1 viruses have been resistant to two older flu drugs, amantadine and rimantadine. That left the only two other influenza drugs, oseltamivir (Tamiflu) and zanamivir (Relenza), as the sole options for treatment and prophylaxis.

There is a risk inherent in using the drug to prevent illness. If people who are already infected but aren't yet experiencing symptoms are put on prophylaxis, there won't be enough drug in their systems to kill all the viruses they house. Those that survive develop resistance to the drug.

And that, it appears, maybe what happened in the resistance cases in Denmark and Japan. In both instances the women involved had been given Tamiflu prophylaxis after a contact developed swine flu.

But the Hong Kong case was different. A 16-year old girl travelling from San Francisco was stopped in Hong Kong's airport in mid-June after setting off a fever detection device.

She was taken to hospital where she tested positive for swine flu. She had not been taking antivirals and declined to be treated with the drug. She was kept in isolation until she recovered.

Dr. Jennifer McKimm-Breschkin, an influenza expert from Australia and a member of the team that developed Relenza, says this case shows resistant swine flu viruses can spread.

It was previously thought flu viruses that developed resistance to the drug would be crippled in the process and would not transmit to others. But that belief was shattered in 2008 when it was discovered Tamiflu-resistant versions of the seasonal H1N1 viruses were spreading rapidly around the globe. They have since all but wiped out Tamiflu-susceptible seasonal H1N1 viruses.

"This is a patient that hasn't been treated, who has gone from San Francisco to Hong Kong. What that means is that she has caught a resistant virus in San Francisco," says McKimm-Breschkin, virology project leader at the Commonwealth Science and Research Organization - known as CSIRO - in Melbourne. (McKimm-Breschkin does not receive royalties for sales of Relenza.)

"So that means this virus has been transmitted from somebody who's presumably been treated. Which means it's been fit enough to transmit. And that is of a lot more concern than just resistance in a treated patient."

Experts have worried the seasonal H1N1 viruses might reassort or swap genes with the swine H1N1. If swine flu picked up with neuraminidase gene - the N in a flu virus' name - from the seasonal H1N1, it would acquire the resistance its seasonal cousin has developed.

Authorities in Hong Kong have not yet told the WHO whether that is what has happened in this case.

But whether the Hong Kong resistance case is due to reassortment, or from the fact that some swine flu viruses have developed resistance on their own, the situation demands careful monitoring, Fukuda and others say.

"The really big question for any finding of antiviral drug resistance with these viruses is whether it's an isolated event or whether it's a tip of a larger phenomenon," he explains.

"The bottom line, as is so often the bottom line with influenza, is that the real answer to the current situation is monitoring as closely as possible - which in this instance is really being done since an extraordinary number of viruses are being collected and looked at."


The Canadian Press
hat-tip Shiloh

Australia: Swine flu cases double in 10 days in NSW

July 5, 2009 - 11:46AM

Swine flu is spreading faster in NSW with the number of confirmed cases doubling to more than 1,200 in 10 days.

The steep climb has outstripped the rate of increase in national figures and includes 142 cases admitted to hospital - eight of whom have been placed in intensive care.

NSW Health confirmed on Saturday that 1267 people in the state have contracted the virus since the worldwide outbreak of H1N1 influenza.

The numbers represent a 114 per cent increase from June 25, when NSW's total cases reached 592.

Australia's total is also on the rise from 3000 to 5254 over the same period, which represents a substantial increase but at a rate slower than NSW has experienced.

Ten people in Australia infected with swine flu have died.

Egypt: Fears of Devastating Virus due to 'Genetic Marriage' between Bird, Swine and Seasonal Flu

5/ 7/ 2009

Some professors of virology have agreed that the H1N1 virus, known as swine flu, may combine with bird and normal seasonal influenzas.

They expect the new strain to be more virulent and some emphasized that Tamiflu does not kill the virus, as commonly believed, but only reduces the transmission of the virus to other cells or from one person to another within 48 hours from the appearance of the symptoms.

Dr. Hussein Ali Hassanein, Professor and President of the Department of Virology at the Faculty of Veterinary Medicine of Cairo University, said the virus is expected to mutate into new strains.

He added that Egypt has now become a "settlement" for bird flu, while some cases of swine flu have also appeared as well as the seasonal influenza.

He pointed out that this combination could lead to a new highly virulent virus, and affirmed that the real problem is that Egypt does not have laboratories equipped to carry out researches on virus. As a result, the country cannot very much control the spread of the virus through researches and studies; instead, it just receives information from abroad.

He added: "The only laboratories in Egypt carrying out these researches on viruses are the American Navy NAMRU3. As for the central laboratories of the Ministry of Health, they just diagnose, while no research is carried out and no important result is achieved that can spare us from random expectations of how the virus may behave in the future.

Dr. Hassanein said that the Faculty of Veterinary Medicine is going to set up a building devoted to virology.

Dr. Hossam El-Rifai, Professor of Microbiology and Immunology at the Institute of Reproductive Sciences, said 256 new strains of swine flu may appear in theory, as the DNA of the virus can change and lead to new strains.

He also pointed out that it is no use producing a vaccine against the current virus as the latter continuously changes.

He pointed out that the real source of concern regarding swine flu virus is linked to winter, as the viruses may merge and create a new fast-spreading strain like swine flu.

El-Rifai called for setting up a supreme council against viruses and epidemics given the seriousness of the situation, particularly as there are new strains of the virus which are resistant to Tamiflu. He said this stresses the importance of setting up specialized bodies to combat these viruses.

Dr. Ahmed El-Sinoussi, Deputy Dean of the Faculty of Veterinary Medicine for Higher Studies and Research and professor of virology at Cairo University, said the greatest danger is that not all pigs have been culled in spite of the government's campaign.

Indeed, he said many pigs have fled to remote places. "The disaster is due to the fact that pigs are by nature easily affected by viruses due to their weak immune system," he said. "Inside their bodies, bird, swine and human influenzas can combine and produce a new devastating virus quickly spreading to human beings."
hat-tip Twall