8 April 2009 -- The Ministry of Health in Viet Nam has reported a new confirmed case of human infection with the H5N1 avian influenza virus. The case has been confirmed at the National Institute of Hygiene and Epidemiology (NIHE).
The case is a 3 year old boy from Chau Thanh District, Dong Thap Province. He developed symptoms on 12 March, was hospitalized on 13 March, and died on 19 March.
Investigations into the source of infection indicated a history of close contact with sick and dead poultry prior to the onset of symptoms.
Of the 110 cases confirmed to date in Viet Nam, 55 have been fatal.
Wednesday, April 8, 2009
Recombinomics: WHO H5N1 Transmission Omissions in Beheira Egypt
Commentary
Close contacts of both boys have been identified and none has shown symptoms of the infection .
The above comments from the latest WHO update represent glaring commission by omission. The update claims “contact with sick/dead poultry”, but fails to give results of testing of such poultry. The SAIDR site, which has poultry results through April 3 does not include any confirmed poultry cases in the proximity (see updated map) of the Beheira cluster.
Moreover, the above comments imply that neither confirmed case has transmitted H5N1 to any contact, yet the update fails to mention that the two confirmed cases live "in adjacent houses", and are cousins.
The four day gap in disease onset dates leaves little doubt that the index case infected his cousin, who lives text door. This toddler to toddler transmission is cause for concern, because both cases had mild H5N1, including the index case, who began oseltamivir treatment after the recommended 48 hours after disease onset.
These mild bird flu cases in Egypt are not new, and were cause for concern in 2007, when children between the ages of 3-10 rapidly recovered and were infected with H5N1 sequences that were virtually identical and signaled extensive human to human transmission because the cases with identical H5N1 sequences were not epidemiologically linked.
Although WHO has recently acknowledged concern for silent transmission of H5N1, the above commissions by omission of an obvious case of human to human transmission raises serious pandemic concerns about WHO’s ability to analyze scientific data and transparently present results of such analysis.
Recombinomics Commentary 17:44
April 8, 2009
Close contacts of both boys have been identified and none has shown symptoms of the infection .
The above comments from the latest WHO update represent glaring commission by omission. The update claims “contact with sick/dead poultry”, but fails to give results of testing of such poultry. The SAIDR site, which has poultry results through April 3 does not include any confirmed poultry cases in the proximity (see updated map) of the Beheira cluster.
Moreover, the above comments imply that neither confirmed case has transmitted H5N1 to any contact, yet the update fails to mention that the two confirmed cases live "in adjacent houses", and are cousins.
The four day gap in disease onset dates leaves little doubt that the index case infected his cousin, who lives text door. This toddler to toddler transmission is cause for concern, because both cases had mild H5N1, including the index case, who began oseltamivir treatment after the recommended 48 hours after disease onset.
These mild bird flu cases in Egypt are not new, and were cause for concern in 2007, when children between the ages of 3-10 rapidly recovered and were infected with H5N1 sequences that were virtually identical and signaled extensive human to human transmission because the cases with identical H5N1 sequences were not epidemiologically linked.
Although WHO has recently acknowledged concern for silent transmission of H5N1, the above commissions by omission of an obvious case of human to human transmission raises serious pandemic concerns about WHO’s ability to analyze scientific data and transparently present results of such analysis.
Recombinomics: Confirmation of Toddler H5N1 Transmission in Beheira Egypt
Commentary
The above comments on the Beheira cluster leave little doubt that the infections involved toddler to toddler transmission, based on the four day gap in disease onset dates. Local media reports indicated the two cases were next door neighbors, and the above comments state that they were cousins, yet neither the SAIDR updates, nor the WHO update by its Mediterranean branch mention that these two cases were cousins and almost certainly had contact, supporting human to human transmission.
The failure of these government agencies to include this most relevant information, and the delay in posting situation updates for the three most recent confirmations in Egypt by WHO in Geneva, creates significant cause for concern.
Media Links
Confirmation of Toddler H5N1 Transmission in Beheira Egypt
Recombinomics Commentary 16:24
April 8, 2009
The above comments on the Beheira cluster leave little doubt that the infections involved toddler to toddler transmission, based on the four day gap in disease onset dates. Local media reports indicated the two cases were next door neighbors, and the above comments state that they were cousins, yet neither the SAIDR updates, nor the WHO update by its Mediterranean branch mention that these two cases were cousins and almost certainly had contact, supporting human to human transmission.
The failure of these government agencies to include this most relevant information, and the delay in posting situation updates for the three most recent confirmations in Egypt by WHO in Geneva, creates significant cause for concern.
Media Links
Arbor Vita Receives FDA Clearance of Its AVantage(TM) A/H5N1 Flu Diagnostic First Rapid Test for Avian Influenza in Humans
SUNNYVALE, CA -- (Marketwire) -- 04/07/09 -- Arbor Vita Corporation (AVC), a biopharmaceutical company developing both diagnostics and therapeutics, announced that it has received 510(k) clearance from the U.S. Food and Drug Administration for its AVantage(TM) A/H5N1 Flu Test. This is a non-invasive rapid diagnostic device for the specific detection of the avian influenza A/H5N1 virus in humans. AVC's AVantage A/H5N1 Flu Test detects the influenza virus nonstructural protein 1 (NS1) in specimens from throat swabs or nose swabs collected from patients with flu symptoms.
"We applaud the FDA's efforts to foster fast, early identification of the avian influenza A/H5N1 virus in humans. Rapid, early detection of avian influenza is paramount to early treatment and containment of a deadly disease with pandemic potential," said Peter S. Lu, M.D., Founder and Chief Executive Officer of Arbor Vita Corporation. "We are excited to receive FDA clearance for the first rapid test to diagnose patients with this serious respiratory infection."
While the AVantage flu test is highly sophisticated, it is easy-to-use. It is a rapid test that can detect the presence of the avian influenza A/H5N1 virus in less than 40 minutes, without complicated sample preparation.
The U.S. Navy was an integral partner in evaluating this flu test for FDA clearance, with the Naval Health Research Center (NHRC) in San Diego, CA providing testing on both archival and prospective clinical specimens to ensure the specificity of the test, while Navy Medical Research Unit-3 (NAMRU-3) provided invaluable access to avian influenza isolates for development and testing.
"This new rapid test will provide an extra level of protection for not only the general U.S. population, but for our forward-deployed troops in areas with avian influenza activity," commented Dennis Faix, M.D., Commander, NHRC.
Christopher A. Myers, Ph.D., Laboratory Director, Department of Respiratory Diseases Research, NHRC continued, "This test can help detect an isolated case or outbreak in an austere environment, allowing for the rapid, targeted interventions necessary if we hope to contain or slow an avian influenza outbreak."
About AVantage A/H5N1 Flu Test
The AVantage A/H5N1 Flu Test is the first rapid diagnostic device that will be used to detect the H5N1 virus strain from throat swabs or nose swabs collected from patients with flu symptoms. In studies conducted in collaboration with NHRC and NAMRU-3, the AVC flu test demonstrated exceptional sensitivity and specificity for the H5N1 subtype of influenza A. The AVC flu test utilizes the company's proprietary PDZ protein technology to uniquely detect the virulence factor NS1 protein from A/H5N1 viruses, which accounts for the excellent sensitivity and specificity of this diagnostic device.
About Influenza Viruses
As of March 30, 2009, the World Health Organization (WHO) had reported 413 confirmed human cases of avian influenza A/H5N1 virus in 15 countries, with 256 deaths. Influenza is one of the most common acute, highly contagious respiratory infections in humans, caused by immunologically diverse single-stranded-RNA viruses. Among the three types of influenza viruses: A, B, and C, type A viruses are the most prevalent and are associated with most serious epidemics. There are many subtypes of type A influenza viruses, distinguished on the basis of different surface proteins (hemagglutinin [HA] and neuraminidase [NA] proteins). The H5N1 subtype of influenza A is known to cause life-threatening illness and to date has a high death rate in excess of 60%.
Symptoms of avian influenza virus in humans have included typical influenza-like symptoms (e.g., fever, sore throat, cough, and muscle aches) which progress to more severe respiratory conditions such as pneumonia and acute respiratory distress and other complications.
About NHRC
Naval Health Research Center (NHRC) serves as a leading research and development laboratory for the Department of Defense. NHRC manages and executes expeditionary operational medical research, development and test and evaluation programs for the Naval Medical Research Command, Silver Spring, MD, Navy Medicine Support Command, Jacksonville, FL and the Navy Bureau of Medicine and Surgery (BUMED).
About NAMRU-3
The Naval Medical Research Unit No. 3 (NAMRU-3), based in Cairo, Egypt, conducts infectious disease research, including the evaluation of vaccines, therapeutic agents, diagnostic assays and vector control measures, and performs public health activities, principally aimed toward improved disease surveillance and outbreak response assistance. NAMRU-3 works closely with the Egyptian Ministry of Health, the U.S. National Institutes of Health (NIH), the World Health Organization (WHO), the U.S. Agency for International Development (USAID) and the U.S. Centers for Disease Control and Prevention (CDC).
About Arbor Vita Corporation
Arbor Vita (www.arborvita.com) is a biopharmaceutical company pioneering the discovery, development and commercialization of novel drugs and diagnostics through a new family of targets -- PDZ proteins. PDZ proteins are key cellular organizers in human signaling pathways. Recruited by viral pathogens, PDZ proteins are highly conserved and provide an ideal platform for identification of diagnostic markers for cancers, infectious diseases and other complex diseases. The company capitalizes on its unique mix of expertise, intellectual property, and novel PDZ drug discovery platform to accelerate discovery and development programs for both therapeutics and diagnostics. Arbor Vita's current programs address major health areas including complex diseases such as cervical cancer and stroke, as well as infectious diseases such as influenza.
hat-tip AlaskaDenise
"We applaud the FDA's efforts to foster fast, early identification of the avian influenza A/H5N1 virus in humans. Rapid, early detection of avian influenza is paramount to early treatment and containment of a deadly disease with pandemic potential," said Peter S. Lu, M.D., Founder and Chief Executive Officer of Arbor Vita Corporation. "We are excited to receive FDA clearance for the first rapid test to diagnose patients with this serious respiratory infection."
While the AVantage flu test is highly sophisticated, it is easy-to-use. It is a rapid test that can detect the presence of the avian influenza A/H5N1 virus in less than 40 minutes, without complicated sample preparation.
The U.S. Navy was an integral partner in evaluating this flu test for FDA clearance, with the Naval Health Research Center (NHRC) in San Diego, CA providing testing on both archival and prospective clinical specimens to ensure the specificity of the test, while Navy Medical Research Unit-3 (NAMRU-3) provided invaluable access to avian influenza isolates for development and testing.
"This new rapid test will provide an extra level of protection for not only the general U.S. population, but for our forward-deployed troops in areas with avian influenza activity," commented Dennis Faix, M.D., Commander, NHRC.
Christopher A. Myers, Ph.D., Laboratory Director, Department of Respiratory Diseases Research, NHRC continued, "This test can help detect an isolated case or outbreak in an austere environment, allowing for the rapid, targeted interventions necessary if we hope to contain or slow an avian influenza outbreak."
About AVantage A/H5N1 Flu Test
The AVantage A/H5N1 Flu Test is the first rapid diagnostic device that will be used to detect the H5N1 virus strain from throat swabs or nose swabs collected from patients with flu symptoms. In studies conducted in collaboration with NHRC and NAMRU-3, the AVC flu test demonstrated exceptional sensitivity and specificity for the H5N1 subtype of influenza A. The AVC flu test utilizes the company's proprietary PDZ protein technology to uniquely detect the virulence factor NS1 protein from A/H5N1 viruses, which accounts for the excellent sensitivity and specificity of this diagnostic device.
About Influenza Viruses
As of March 30, 2009, the World Health Organization (WHO) had reported 413 confirmed human cases of avian influenza A/H5N1 virus in 15 countries, with 256 deaths. Influenza is one of the most common acute, highly contagious respiratory infections in humans, caused by immunologically diverse single-stranded-RNA viruses. Among the three types of influenza viruses: A, B, and C, type A viruses are the most prevalent and are associated with most serious epidemics. There are many subtypes of type A influenza viruses, distinguished on the basis of different surface proteins (hemagglutinin [HA] and neuraminidase [NA] proteins). The H5N1 subtype of influenza A is known to cause life-threatening illness and to date has a high death rate in excess of 60%.
Symptoms of avian influenza virus in humans have included typical influenza-like symptoms (e.g., fever, sore throat, cough, and muscle aches) which progress to more severe respiratory conditions such as pneumonia and acute respiratory distress and other complications.
About NHRC
Naval Health Research Center (NHRC) serves as a leading research and development laboratory for the Department of Defense. NHRC manages and executes expeditionary operational medical research, development and test and evaluation programs for the Naval Medical Research Command, Silver Spring, MD, Navy Medicine Support Command, Jacksonville, FL and the Navy Bureau of Medicine and Surgery (BUMED).
About NAMRU-3
The Naval Medical Research Unit No. 3 (NAMRU-3), based in Cairo, Egypt, conducts infectious disease research, including the evaluation of vaccines, therapeutic agents, diagnostic assays and vector control measures, and performs public health activities, principally aimed toward improved disease surveillance and outbreak response assistance. NAMRU-3 works closely with the Egyptian Ministry of Health, the U.S. National Institutes of Health (NIH), the World Health Organization (WHO), the U.S. Agency for International Development (USAID) and the U.S. Centers for Disease Control and Prevention (CDC).
About Arbor Vita Corporation
Arbor Vita (www.arborvita.com) is a biopharmaceutical company pioneering the discovery, development and commercialization of novel drugs and diagnostics through a new family of targets -- PDZ proteins. PDZ proteins are key cellular organizers in human signaling pathways. Recruited by viral pathogens, PDZ proteins are highly conserved and provide an ideal platform for identification of diagnostic markers for cancers, infectious diseases and other complex diseases. The company capitalizes on its unique mix of expertise, intellectual property, and novel PDZ drug discovery platform to accelerate discovery and development programs for both therapeutics and diagnostics. Arbor Vita's current programs address major health areas including complex diseases such as cervical cancer and stroke, as well as infectious diseases such as influenza.
hat-tip AlaskaDenise
The government is ignoring the bird flu crisis !
8/4/2009
Warning of the collapse of the poultry farms * .. The data from the Health and Agriculture
Nasser Fayad wrote *: government ignored the report of the World Health Organization in the occupation of Egypt, the first number in the world, * human cases of bird flu *. Calendar ago the Council of Ministers of the reference to the seriousness of the spread of * * injuries and losses * of the infected poultry farms in Lower Egypt *. ignore the last two meetings of the Council of Ministers the high incidence of bird flu *. ago as the meeting of the Council's agenda tomorrow * * » Thursday *« reference to the subject * *. the owners of poultry farms sharply criticized Association * * poultry producers because of its failure to take action to combat the disease, * and raise a memo to senior producers * Amin Abaza, Minister of Agriculture * demanding compensation for the loss of educators, * and * * reached 100% * * spots in injury * Qaliubiya provinces and the lake, Dakahliya, western and other provinces *.
The Ministry of Health has just the announcement of human cases, * developments and the spread of the disease on the way * * Socialist Union without the announcement of a joint plan * with the Ministry of Health to combat *. The * Spokesman of the Ministry of the injury, No. * 63 * Qaliubiya province, injuring a baby and was preceded by less than two years old in the province, the lake * *. warned the collapse of agricultural sources of the poultry industry and the closure of a large proportion of the poultry farms because of fears of disease, * and the high cost of production, * and the escalation of prices of chickens, * and doubling the price of * » vaccine immunization *« against the disease, * and * useless because of several types of mutation of the virus that causes the disease *. noteworthy that the number of poultry farms Official * a * 17 * alpha, * * to the rural homes by raising chickens on the roofs of houses, * As a result, high rates of home injuries, * * and the spread of infections and its transition to * many farms
hat-tip Florida1
Warning of the collapse of the poultry farms * .. The data from the Health and Agriculture
Nasser Fayad wrote *: government ignored the report of the World Health Organization in the occupation of Egypt, the first number in the world, * human cases of bird flu *. Calendar ago the Council of Ministers of the reference to the seriousness of the spread of * * injuries and losses * of the infected poultry farms in Lower Egypt *. ignore the last two meetings of the Council of Ministers the high incidence of bird flu *. ago as the meeting of the Council's agenda tomorrow * * » Thursday *« reference to the subject * *. the owners of poultry farms sharply criticized Association * * poultry producers because of its failure to take action to combat the disease, * and raise a memo to senior producers * Amin Abaza, Minister of Agriculture * demanding compensation for the loss of educators, * and * * reached 100% * * spots in injury * Qaliubiya provinces and the lake, Dakahliya, western and other provinces *.
The Ministry of Health has just the announcement of human cases, * developments and the spread of the disease on the way * * Socialist Union without the announcement of a joint plan * with the Ministry of Health to combat *. The * Spokesman of the Ministry of the injury, No. * 63 * Qaliubiya province, injuring a baby and was preceded by less than two years old in the province, the lake * *. warned the collapse of agricultural sources of the poultry industry and the closure of a large proportion of the poultry farms because of fears of disease, * and the high cost of production, * and the escalation of prices of chickens, * and doubling the price of * » vaccine immunization *« against the disease, * and * useless because of several types of mutation of the virus that causes the disease *. noteworthy that the number of poultry farms Official * a * 17 * alpha, * * to the rural homes by raising chickens on the roofs of houses, * As a result, high rates of home injuries, * * and the spread of infections and its transition to * many farms
hat-tip Florida1
China's Capacity to Manage Infectious Diseases: Global Implications
Apr 8, 2009
During the Seventeenth Party Congress in October 2007, it was made clear that improving health care in China had become a political priority for the country’s leadership. Three decades of double-digit economic growth had not been matched by progress in China’s ability to prevent and treat diseases. The rudimentary Maoist-era health care infrastructure had largely collapsed in the reformist years of Deng Xiaoping and Jiang Zemin, and by the time Hu Jintao took office in 2002, it was in tatters, particularly in rural China.
At the same time, the socioeconomic changes wrought by China’s economic explosion and openness to the outside world created enormous new health care challenges and strains on the country’s capacity to manage them. As part of his government’s efforts to reduce social inequities resulting from 30 years of breakneck economic growth, Hu made improving China’s health care system a priority. The SARS crisis of 2003 was a catalyzing period for China, and since then Beijing’s blueprint for national health care has been drawn and redrawn several times. The problems are deep and multifaceted; identifying solutions is not easy, no matter how high a priority the task is considered.
If China cannot meet its health care challenges, it will further tax an already strained international infrastructure. On the other hand, if China is successful, it can not only short-circuit an international spread of disease but also become a net donor to the global health community. To that end, the Freeman Chair in China Studies at the Washington D.C.-based Center for Strategic and International Studies (CSIS) assembled a group of international experts to address the current health care situation in China, China’s efforts to tackle the problems of infectious disease and health care reform, and the regional and global dimensions of these reform efforts. This report is intended as a tool to help international policymakers and practitioners--as well as Chinese officials and academics--meet the challenges of health care in China head on.
Free PDF download:
http://www.csis.org/media/csis/pubs/090325_freeman_chinacapacity_web.pdf
From the CSIS website:
http://www.csis.org/component/option,com_csis_pubs/task,view/id,5378/type,1/
During the Seventeenth Party Congress in October 2007, it was made clear that improving health care in China had become a political priority for the country’s leadership. Three decades of double-digit economic growth had not been matched by progress in China’s ability to prevent and treat diseases. The rudimentary Maoist-era health care infrastructure had largely collapsed in the reformist years of Deng Xiaoping and Jiang Zemin, and by the time Hu Jintao took office in 2002, it was in tatters, particularly in rural China.
At the same time, the socioeconomic changes wrought by China’s economic explosion and openness to the outside world created enormous new health care challenges and strains on the country’s capacity to manage them. As part of his government’s efforts to reduce social inequities resulting from 30 years of breakneck economic growth, Hu made improving China’s health care system a priority. The SARS crisis of 2003 was a catalyzing period for China, and since then Beijing’s blueprint for national health care has been drawn and redrawn several times. The problems are deep and multifaceted; identifying solutions is not easy, no matter how high a priority the task is considered.
If China cannot meet its health care challenges, it will further tax an already strained international infrastructure. On the other hand, if China is successful, it can not only short-circuit an international spread of disease but also become a net donor to the global health community. To that end, the Freeman Chair in China Studies at the Washington D.C.-based Center for Strategic and International Studies (CSIS) assembled a group of international experts to address the current health care situation in China, China’s efforts to tackle the problems of infectious disease and health care reform, and the regional and global dimensions of these reform efforts. This report is intended as a tool to help international policymakers and practitioners--as well as Chinese officials and academics--meet the challenges of health care in China head on.
Free PDF download:
http://www.csis.org/media/csis/pubs/090325_freeman_chinacapacity_web.pdf
From the CSIS website:
http://www.csis.org/component/option,com_csis_pubs/task,view/id,5378/type,1/
INTERVIEW-Concerns arise over symptomless Egypt bird flu cases
By Cynthia Johnston
Wed Apr 8, 2009 11:13am GMT
CAIRO, April 8 (Reuters) - The World Health Organisation is concerned some Egyptians may carry the highly pathogenic bird flu virus without showing symptoms, which could give it more of a chance to mutate to a strain that spreads easily among humans.
Whether such cases exist still has to be put to the test and will be the focus of a planned Egyptian government study backed by the global health body, said John Jabbour, a Cairo-based emerging diseases specialist at WHO.
"This is a concern only, now. It is a question to be asked," Jabbour told Reuters. He said a change in the pattern of human bird flu infections this year in Egypt had raised concerns about the existence of so-called sub clinical cases.
The most populous Arab country, which has been hit harder by bird flu than any other country outside of Asia, has seen a surge in infections this year.
While the H5N1 virus only rarely infects people, experts fear it could mutate into a form that humans could easily pass to one another, sparking a pandemic that could kill millions.
The emergence of symptomless human carriers of the virus would be a worrisome development because it could allow the virus, undetected and untreated, more time to mutate inside the human body, Jabbour said.
"If there is any sub clinical case in Egypt, the aim is to treat immediately to stop the reproduction of the virus. Because whether (through) mutation or reassortment, this will lead to the pandemic strain," he said.
Of the 11 Egyptians infected with bird flu this year, all but two have been children under age three while adult cases have all but dried up. All have survived.
That is starkly different from the same period a year ago, when seven people -- mostly adults and older children -- contracted the virus and three died.
'SOMETHING STRANGE HAPPENING'
Jabbour said the rise in infections in children without similar cases among adults had triggered questions as to whether adults were being infected with the virus but not falling ill.
"There is something strange happening in Egypt. Why in children now and not in adults?" he said. "We need to see if there are sub clinical cases in the community."
Jabbour said there had been no known instances of sub clinical bird flu cases in humans in other countries where the disease was present. Some birds, like ducks, are known to carry and spread the virus without showing symptoms, he said.
The Egyptian study, which Jabbour said should begin in the coming months, would test the blood of people who may have been in contact with infected birds but had not become sick.
Since 2003 the avian influenza virus has infected more than 400 people in 15 countries and killed 256 of them. It has killed or forced the culling of more than 300 million birds across Asia, the Middle East, Africa and Europe.
Some 23 Egyptians have died after contracting the virus, most after contact with infected domestic birds in the country where roughly 5 million households depend on domestically raised poultry as a major source of food and income.
But Jabbour said there was still no evidence of the disease being passed from person to person in Egypt.
He added that two toddlers from the northern province of Beheira infected within days of one another in March were cousins. But he said the boys were believed to have contracted the virus from the same sick birds, not from each other.
"There is no change in the virus at all in the virus strain in Egypt. It is the same since the beginning of the outbreak. There is no mutation, nothing," he said.
(Writing by Cynthia Johnston)
hat-tip Pixie
Wed Apr 8, 2009 11:13am GMT
CAIRO, April 8 (Reuters) - The World Health Organisation is concerned some Egyptians may carry the highly pathogenic bird flu virus without showing symptoms, which could give it more of a chance to mutate to a strain that spreads easily among humans.
Whether such cases exist still has to be put to the test and will be the focus of a planned Egyptian government study backed by the global health body, said John Jabbour, a Cairo-based emerging diseases specialist at WHO.
"This is a concern only, now. It is a question to be asked," Jabbour told Reuters. He said a change in the pattern of human bird flu infections this year in Egypt had raised concerns about the existence of so-called sub clinical cases.
The most populous Arab country, which has been hit harder by bird flu than any other country outside of Asia, has seen a surge in infections this year.
While the H5N1 virus only rarely infects people, experts fear it could mutate into a form that humans could easily pass to one another, sparking a pandemic that could kill millions.
The emergence of symptomless human carriers of the virus would be a worrisome development because it could allow the virus, undetected and untreated, more time to mutate inside the human body, Jabbour said.
"If there is any sub clinical case in Egypt, the aim is to treat immediately to stop the reproduction of the virus. Because whether (through) mutation or reassortment, this will lead to the pandemic strain," he said.
Of the 11 Egyptians infected with bird flu this year, all but two have been children under age three while adult cases have all but dried up. All have survived.
That is starkly different from the same period a year ago, when seven people -- mostly adults and older children -- contracted the virus and three died.
'SOMETHING STRANGE HAPPENING'
Jabbour said the rise in infections in children without similar cases among adults had triggered questions as to whether adults were being infected with the virus but not falling ill.
"There is something strange happening in Egypt. Why in children now and not in adults?" he said. "We need to see if there are sub clinical cases in the community."
Jabbour said there had been no known instances of sub clinical bird flu cases in humans in other countries where the disease was present. Some birds, like ducks, are known to carry and spread the virus without showing symptoms, he said.
The Egyptian study, which Jabbour said should begin in the coming months, would test the blood of people who may have been in contact with infected birds but had not become sick.
Since 2003 the avian influenza virus has infected more than 400 people in 15 countries and killed 256 of them. It has killed or forced the culling of more than 300 million birds across Asia, the Middle East, Africa and Europe.
Some 23 Egyptians have died after contracting the virus, most after contact with infected domestic birds in the country where roughly 5 million households depend on domestically raised poultry as a major source of food and income.
But Jabbour said there was still no evidence of the disease being passed from person to person in Egypt.
He added that two toddlers from the northern province of Beheira infected within days of one another in March were cousins. But he said the boys were believed to have contracted the virus from the same sick birds, not from each other.
"There is no change in the virus at all in the virus strain in Egypt. It is the same since the beginning of the outbreak. There is no mutation, nothing," he said.
(Writing by Cynthia Johnston)
hat-tip Pixie
Stock Gone of AI Vaccine
At this time, the Magelang Regency, Central Java, in no way had vaccine supplies avian influenza (AI).
Apart from not yet getting help from the government of the centre and the Central Javan Provincial Government, the Magelang Regional Government could not also prepare the procurement of the AI vaccine because of the limitations of the APBD fund 2009. ”Dengan the stock emptiness of the vaccine at this time, the only method that could be carried out to prevent the spread of the bird flu virus being with biosecurity,” said Section Head Peternakan and fisheries Tri Agung Sucahyono, on Monday (6/4) in the Magelang Regency.
In 2008, the regency got help of the AI vaccine from the government of the centre totalling 400,000 doses. (EGI)
Apart from not yet getting help from the government of the centre and the Central Javan Provincial Government, the Magelang Regional Government could not also prepare the procurement of the AI vaccine because of the limitations of the APBD fund 2009. ”Dengan the stock emptiness of the vaccine at this time, the only method that could be carried out to prevent the spread of the bird flu virus being with biosecurity,” said Section Head Peternakan and fisheries Tri Agung Sucahyono, on Monday (6/4) in the Magelang Regency.
In 2008, the regency got help of the AI vaccine from the government of the centre totalling 400,000 doses. (EGI)
Pointed out as RS Rujukan Flu Burung
Rabu, 08 April 2009
The Bojonegoro Regional Government might be proud. Because, RSUD Dr R Sosodoro Djatikoesoemo Bojonegoro was indicated by the Health Minister (menkes) as the hospital (RS) bird flu reconciliation. That is, to serve the bird flu patient from the Bojonegoro territory, Lamongan and Tuban.
Public relations of RSUD drg Thomas Djaja said, beforehand the patient who was stated positive infected the bird flu illness must be sent to RS reconciliation. That is, beforehand only was in RSU Dr Soetomo Surabaya.
"From this year, the handling" of the "bird flu patient was enough to be carried out in Bojonegoro," explained he to this newspaper reporter yesterday (7/4).
According to Thomas, post penunjukkan that menkes also sent a set of medical equipment to handle the bird flu patient. In part, concentrate oxygen, the ventilator, X raay mobile, the monitor patient and APD (the protective equipment himself). Especially for APD, said he, only could be used to very much with.
-snip-
The Bojonegoro Regional Government might be proud. Because, RSUD Dr R Sosodoro Djatikoesoemo Bojonegoro was indicated by the Health Minister (menkes) as the hospital (RS) bird flu reconciliation. That is, to serve the bird flu patient from the Bojonegoro territory, Lamongan and Tuban.
Public relations of RSUD drg Thomas Djaja said, beforehand the patient who was stated positive infected the bird flu illness must be sent to RS reconciliation. That is, beforehand only was in RSU Dr Soetomo Surabaya.
"From this year, the handling" of the "bird flu patient was enough to be carried out in Bojonegoro," explained he to this newspaper reporter yesterday (7/4).
According to Thomas, post penunjukkan that menkes also sent a set of medical equipment to handle the bird flu patient. In part, concentrate oxygen, the ventilator, X raay mobile, the monitor patient and APD (the protective equipment himself). Especially for APD, said he, only could be used to very much with.
-snip-
Tuesday, April 7, 2009
24 chickens in Cipatat was destroyed
OFFICIALLY Livestock Breeding and Bandung Regency fisheries West (KBB) yesterday destroyed (depopulation) around 24 chickens belonging to Isom Sopandi, 70, the resident of the Village of Andir RT 02/14, the Village of Cipataharja,Kecamatan Cipatat, KBB, that was infected by the bird flu virus.
The official was forced to dig up the cemetery 14 chickens that have been buried and killed the hen as well as his child that was numbering 10 tails that still to be alive. Official also destroyed two chicken coops belonging to Isom. The official of the Health of the Animal and the Health of the Veteriner Community of the Section (Kesmavet) the Livestock Breeding Service and fisheries KBB the smoke of Setiawan mengatakan,depopulasi selective or limited by being burnt this was carried out so that the virus that has descended on chickens and his pen did not spread. Since, worried this bird flu virus infected the community around especially that was directly neighbours with the Isom family. ”Depopulasi this was carried out to kill the virus that already penetrate to the animal including his pen. The total chicken that has been destroyed by us around 24 of ekor,”kata Asep in process gaps of depopulation yesterday. In the same opportunity, the Village Head Ciptaharja M. Iyas said, in his territory was gotten by the chicken population or the poultry in large quantities.
Therefore, his side worried if being not carried out by depopulation and disinfectant, this bird flu virus will spread and about the other poultry. He estimated the chicken belonging to the resident reached 25,000 tails. The number not yet including the chicken that was gotten in livestock breeding of PT Poskar that reached approximately 60,000 tails. Iyas admitted to contacting the poultry farm manager and ask for to carry out anticipation so that the bird flu virus does not spread to their animal of the property livestock. He also asked for the livestock breeding side mengarantina chickens including the normal official cleaned the chicken coop. Because, if they already infected, will be easy to spread him to the other animal or humankind. ”Karena the poultry population in this territory many, then must be carried out by the prevention immediately. This depopulation was the matter that must be done and sterilised the place of the incident because worried still had the livestock or the pen that already terkontaminasi,” said Iyas.
Isom personally admitted to not objecting the chicken togethered with his pen dimusnahkan. Hal that to prevent so that the illness that fell on his chicken does not spread to humankind. He claimed worried because of seeing the case that struck the resident in the neighbouring village that infected bird flu from his kept chicken. (superior haryanto)
The official was forced to dig up the cemetery 14 chickens that have been buried and killed the hen as well as his child that was numbering 10 tails that still to be alive. Official also destroyed two chicken coops belonging to Isom. The official of the Health of the Animal and the Health of the Veteriner Community of the Section (Kesmavet) the Livestock Breeding Service and fisheries KBB the smoke of Setiawan mengatakan,depopulasi selective or limited by being burnt this was carried out so that the virus that has descended on chickens and his pen did not spread. Since, worried this bird flu virus infected the community around especially that was directly neighbours with the Isom family. ”Depopulasi this was carried out to kill the virus that already penetrate to the animal including his pen. The total chicken that has been destroyed by us around 24 of ekor,”kata Asep in process gaps of depopulation yesterday. In the same opportunity, the Village Head Ciptaharja M. Iyas said, in his territory was gotten by the chicken population or the poultry in large quantities.
Therefore, his side worried if being not carried out by depopulation and disinfectant, this bird flu virus will spread and about the other poultry. He estimated the chicken belonging to the resident reached 25,000 tails. The number not yet including the chicken that was gotten in livestock breeding of PT Poskar that reached approximately 60,000 tails. Iyas admitted to contacting the poultry farm manager and ask for to carry out anticipation so that the bird flu virus does not spread to their animal of the property livestock. He also asked for the livestock breeding side mengarantina chickens including the normal official cleaned the chicken coop. Because, if they already infected, will be easy to spread him to the other animal or humankind. ”Karena the poultry population in this territory many, then must be carried out by the prevention immediately. This depopulation was the matter that must be done and sterilised the place of the incident because worried still had the livestock or the pen that already terkontaminasi,” said Iyas.
Isom personally admitted to not objecting the chicken togethered with his pen dimusnahkan. Hal that to prevent so that the illness that fell on his chicken does not spread to humankind. He claimed worried because of seeing the case that struck the resident in the neighbouring village that infected bird flu from his kept chicken. (superior haryanto)
Two Suspect Flu Burung Kabur from RSHS Bandung
[Toggletext and dictionary]
Tuesday, 07 April 2009
Two patients suspect bird flu that was treated in the Hasan Sadikin Hospital (RSHS) Bandung escaped. AM, 26, and Fai, 14 months, the patient from the Village/the Subdistrict of Cipatat,Kabupaten Bandung West (KBB), was known left special maintenance space of bird flu (the Poinciana Tree) last Monday (6/4) around struck 12,00 WIB. The escape of the two patients was acknowledged by the Managing Director RSHS Bandung Dr Cissy RS Prawira Kartasasmita. He said, both of them made use of the official's carelessness of the security unit and the nurse of Poinciana Tree space. ”Mereka not bolted, but went out without permission. He (AM) has come home had. At that time, the official and the nurse were having lunch, possibly he made use of torque tersebut,” said Cissy to the reporter in RSHS Bandung yesterday.
When bolting, AM patient brought his child, Fai. Although the two patients suspect this bird flu bolted, the RSHS side will not carry out the search. ”Because, the laboratory side has stated the negative to the two patients those,” he said. Now, when both of them positive bird flu, his side will at once drop the team off to look for them because of being worried infected the other resident. ”If the positive patient, we will bring returned to the hospital. Although in this manner, we coordinated Officially Health Department local to monitor them,” firm Cissy. According to him, if the patient wanted to come home had to have to to continue to say goodbye to the official. However, the security unit's member who was on duty at this room also did not know that the two patients escaped. Uptil now Poinciana Tree space was minded by one of the security unit's members, whereas the gate headed there was not locked.
The incident just the first time was experienced by RSHS. Karena, his side will tighten the security, including increasing the guard's personnel. ”We will increase the guarding but also important parts like the window or the door would restricted,”ujar him.
Nginap in the Parent-in-law's House
In the meantime, after bolting from RSHS Bandung, AM and Fai learned by now to be at house parent-in-law [a parent of a person’s spouse] in the Village of Cikokosan RT 01/06, the Village/the Cipatat Subdistrict, KBB, that be at a distance around 8 km to the north from casualties's house in the Halte Village of RT 1/19 the Village/the Subdistrict Cipatat. On arrival they were at once reported by the resident to the government side of the local village. Village apparatus then at once headed the location by bringing one ambulance. The village head Cipatat Darya Sugangga said, at this time his side was persuading AM in order to want to return to the hospital. Darya worried if being not treated in the hospital, the condition for the health of the two patients will be increasingly bad, especially his youngest child, Fai, that still was 14 months old. Nevertheless for the sake of pleasantness process “abducting” to return suspect bird flu above-mentioned will carried out day this around hour 10:00 WB.
Escaped whether second positive or negative contracted bird flu, both of them continued to have to undergo the maintenance in the hospital. He admitted to accepting escape information of his two residents from the doctor who treated them. ”We still tried to persuade casualties so that wanted to return. To him, we stressed, they were not yet it was said positive bird flu because at this time results of the inspection of the doctor's laboratory did not yet go out. For the sake of the security and the health service that good, he was asked to return to the hospital and that will be carried out tomorrow (today) ,” said Darya when being contacted SI through his cellular phone. Contacted was separated, the Sub-district Head Cipatat Eriska regretted the weakness of the security in RSHS that caused two patients to be able to slip away from observation and bolted easily. That was very dangerous moreover if being proven both of them positive infected the bird flu virus because of could spread quickly to the other resident.
“Hopefully guarding carelessness of the patient in RSHS this was not repeated in afterwards hari,” said Ersika. He suspected, the AM escape and F from RSHS because worried with the size of the maintenance cost during in the hospital that must be borne by his family. In fact, all the maintenance fees have been borne by the government. His side then issued the certificate of the poor family the area (gaki you) for casualties so as to be able to be freest from the medical treatment cost. As being reported, AM was reconciled the Cipatat Community Health Centre to RSHS Bandung last Friday (3/4) around struck 23,00 of WIB. Sementara his child, Fai, entered on Saturday (4/4) around struck 12,30 of WIB. Keduanya immediately was treated intensive in Poinciana Tree space. When arriving in RSHS, his condition in the hot situation was high enough to be accompanied by the cough. The RSHS side at once examined the two patients because of being worried by them indeed infected the virus H5N1 because beforehand they had contact with the poultry and had the poultry belonging to their neighbour who died suddenly.
Apart from AM and his child, four other residents who were the family and the AM neighbour also infected suspect bird flu. The four of them suffered was sick with the sign like hot, breathless, pilek, and the cough. The four people namely At, 65, that was the AM father; Wir, 2, and Wel, 2, both of them the AM twin; also the AM neighbour, Dik, 2. Beforehand, as many as 70 chickens died suddenly in the Halte RT Village 1 RW 19, the Cipatat Village, Kecamatan Cipatat, KBB, since Wednesday (1/4) to the end of last week. The chickens were based on results rapid test positive infected bird flu and infected six residents. At intervals of two days, around 11 chickens belonging to Isom Sopandi, 70, the resident of the Village of Andir RT 02/14 the Ciptaharja Village, the Cipatat Subdistrict, also died suddenly. Now, his eight property chickens that still were living, after being carried out rapid test, positive contracted bird flu. (yugi prasetyo/superior haryanto)
Tuesday, 07 April 2009
Two patients suspect bird flu that was treated in the Hasan Sadikin Hospital (RSHS) Bandung escaped. AM, 26, and Fai, 14 months, the patient from the Village/the Subdistrict of Cipatat,Kabupaten Bandung West (KBB), was known left special maintenance space of bird flu (the Poinciana Tree) last Monday (6/4) around struck 12,00 WIB. The escape of the two patients was acknowledged by the Managing Director RSHS Bandung Dr Cissy RS Prawira Kartasasmita. He said, both of them made use of the official's carelessness of the security unit and the nurse of Poinciana Tree space. ”Mereka not bolted, but went out without permission. He (AM) has come home had. At that time, the official and the nurse were having lunch, possibly he made use of torque tersebut,” said Cissy to the reporter in RSHS Bandung yesterday.
When bolting, AM patient brought his child, Fai. Although the two patients suspect this bird flu bolted, the RSHS side will not carry out the search. ”Because, the laboratory side has stated the negative to the two patients those,” he said. Now, when both of them positive bird flu, his side will at once drop the team off to look for them because of being worried infected the other resident. ”If the positive patient, we will bring returned to the hospital. Although in this manner, we coordinated Officially Health Department local to monitor them,” firm Cissy. According to him, if the patient wanted to come home had to have to to continue to say goodbye to the official. However, the security unit's member who was on duty at this room also did not know that the two patients escaped. Uptil now Poinciana Tree space was minded by one of the security unit's members, whereas the gate headed there was not locked.
The incident just the first time was experienced by RSHS. Karena, his side will tighten the security, including increasing the guard's personnel. ”We will increase the guarding but also important parts like the window or the door would restricted,”ujar him.
Nginap in the Parent-in-law's House
In the meantime, after bolting from RSHS Bandung, AM and Fai learned by now to be at house parent-in-law [a parent of a person’s spouse] in the Village of Cikokosan RT 01/06, the Village/the Cipatat Subdistrict, KBB, that be at a distance around 8 km to the north from casualties's house in the Halte Village of RT 1/19 the Village/the Subdistrict Cipatat. On arrival they were at once reported by the resident to the government side of the local village. Village apparatus then at once headed the location by bringing one ambulance. The village head Cipatat Darya Sugangga said, at this time his side was persuading AM in order to want to return to the hospital. Darya worried if being not treated in the hospital, the condition for the health of the two patients will be increasingly bad, especially his youngest child, Fai, that still was 14 months old. Nevertheless for the sake of pleasantness process “abducting” to return suspect bird flu above-mentioned will carried out day this around hour 10:00 WB.
Escaped whether second positive or negative contracted bird flu, both of them continued to have to undergo the maintenance in the hospital. He admitted to accepting escape information of his two residents from the doctor who treated them. ”We still tried to persuade casualties so that wanted to return. To him, we stressed, they were not yet it was said positive bird flu because at this time results of the inspection of the doctor's laboratory did not yet go out. For the sake of the security and the health service that good, he was asked to return to the hospital and that will be carried out tomorrow (today) ,” said Darya when being contacted SI through his cellular phone. Contacted was separated, the Sub-district Head Cipatat Eriska regretted the weakness of the security in RSHS that caused two patients to be able to slip away from observation and bolted easily. That was very dangerous moreover if being proven both of them positive infected the bird flu virus because of could spread quickly to the other resident.
“Hopefully guarding carelessness of the patient in RSHS this was not repeated in afterwards hari,” said Ersika. He suspected, the AM escape and F from RSHS because worried with the size of the maintenance cost during in the hospital that must be borne by his family. In fact, all the maintenance fees have been borne by the government. His side then issued the certificate of the poor family the area (gaki you) for casualties so as to be able to be freest from the medical treatment cost. As being reported, AM was reconciled the Cipatat Community Health Centre to RSHS Bandung last Friday (3/4) around struck 23,00 of WIB. Sementara his child, Fai, entered on Saturday (4/4) around struck 12,30 of WIB. Keduanya immediately was treated intensive in Poinciana Tree space. When arriving in RSHS, his condition in the hot situation was high enough to be accompanied by the cough. The RSHS side at once examined the two patients because of being worried by them indeed infected the virus H5N1 because beforehand they had contact with the poultry and had the poultry belonging to their neighbour who died suddenly.
Apart from AM and his child, four other residents who were the family and the AM neighbour also infected suspect bird flu. The four of them suffered was sick with the sign like hot, breathless, pilek, and the cough. The four people namely At, 65, that was the AM father; Wir, 2, and Wel, 2, both of them the AM twin; also the AM neighbour, Dik, 2. Beforehand, as many as 70 chickens died suddenly in the Halte RT Village 1 RW 19, the Cipatat Village, Kecamatan Cipatat, KBB, since Wednesday (1/4) to the end of last week. The chickens were based on results rapid test positive infected bird flu and infected six residents. At intervals of two days, around 11 chickens belonging to Isom Sopandi, 70, the resident of the Village of Andir RT 02/14 the Ciptaharja Village, the Cipatat Subdistrict, also died suddenly. Now, his eight property chickens that still were living, after being carried out rapid test, positive contracted bird flu. (yugi prasetyo/superior haryanto)
Serang bird flu the Child the Egyptian Resident
[This is from The Infection hospital Prof. Dr. Sulianti Saroso site, infeksi.com, out of Indonesia, regarding Egypt]
06/04/2009
A Egyptian male child who was six years old was attacked by the deadly bird flu virus, the sixth case in this month in the Arabian country have a population solidest, said the MENA News Agency. MENA identified the child as Ali Mahmoud Ali Somaa, that came from the province Nile Delta Qalyubia. Penjangkitannya increased the number of cases was confirmed the virus avian influenza H5N1 became 63 in Egypt, that was attacked more serious compared with the other country outside Asia. The spokesperson the Ministry of the Health Egyptian Abdel Rahman Shahine said, Somaa began to show signs of the illness of two last week and was treated in the hospital a week afterwards, where he was given medicine antivirus tamiflu, said MENA. Somaa was in the critical condition and breathed with help of the respirator, added the news agency.
On Friday, Egypt reported that a baby was 21 months old teserang bird flu. Since 2003, the virus H5N1 infected at least 410 people in 15 countries and killed 254 people from them. The virus killed or forced elimination more than 300 million poultries in 61 countries in Asia, the Middle East, Africa and Europe.
Approximately 23 Egyptian residents were killed resulting from terjangkit this virus, most after carrying out contact with the poultry piaraan that was attacked in the country, where around five million families begantung to the livestock animal as the important source of food and the income. Although H5N1 rarely infected the person, the experts revealed the concern that the virus would bermutasi became a form that was easy to be contagious from humankind to humankind, that possibly lighted the plague that could kill millions orang./kompas
06/04/2009
A Egyptian male child who was six years old was attacked by the deadly bird flu virus, the sixth case in this month in the Arabian country have a population solidest, said the MENA News Agency. MENA identified the child as Ali Mahmoud Ali Somaa, that came from the province Nile Delta Qalyubia. Penjangkitannya increased the number of cases was confirmed the virus avian influenza H5N1 became 63 in Egypt, that was attacked more serious compared with the other country outside Asia. The spokesperson the Ministry of the Health Egyptian Abdel Rahman Shahine said, Somaa began to show signs of the illness of two last week and was treated in the hospital a week afterwards, where he was given medicine antivirus tamiflu, said MENA. Somaa was in the critical condition and breathed with help of the respirator, added the news agency.
On Friday, Egypt reported that a baby was 21 months old teserang bird flu. Since 2003, the virus H5N1 infected at least 410 people in 15 countries and killed 254 people from them. The virus killed or forced elimination more than 300 million poultries in 61 countries in Asia, the Middle East, Africa and Europe.
Approximately 23 Egyptian residents were killed resulting from terjangkit this virus, most after carrying out contact with the poultry piaraan that was attacked in the country, where around five million families begantung to the livestock animal as the important source of food and the income. Although H5N1 rarely infected the person, the experts revealed the concern that the virus would bermutasi became a form that was easy to be contagious from humankind to humankind, that possibly lighted the plague that could kill millions orang./kompas
Officials quarantine western Kentucky poultry farm after bird flu discovered
April 7, 2009
FRANKFORT, Ky. (AP) - State and federal authorities are investigating an outbreak of bird flu on a poultry farm in western Kentucky.
State Veterinarian Robert C. Stout said the strain discovered is "nonpathogenic or low-pathogenic" and poses a minimal risk to human health. Stout said it is not the "high pathogenic strain" associated with human and poultry deaths in other countries.
Stout quarantined the farm, which produces hatching eggs for Perdue Farms Inc. He said some 20,000 chickens have been euthanized.
"It does occur naturally in wild birds and it can spread to domestic birds, which is why we have the occurrence in Kentucky," said Cindy Ragin, a spokeswoman for the U.S. Department of Agriculture. "This is something that is not uncommon."
Stout declined to identify the farm, but he said it is near Brownsville in Edmondson County.
"The state and federal government and Perdue are acting aggressively to contain and eliminate the disease," Stout said. "There is no evidence that any infected poultry are in the human food supply as a result of this infection. We will do what is necessary to minimize the disruption to overseas trade."
Already, Stout said, Japan and Russia have banned imports of poultry from Kentucky.
The Kentucky Department of Agriculture is conducting surveillance on backyard flocks within a two-mile radius of the farm.
"The people of Kentucky and our trading partners should rest assured that we are doing everything possible to address the situation," Agriculture Commissioner Richie Farmer said.
Stout said a minimal drop in egg production at the farm was noticed in mid-March. Perdue's veterinary services laboratory took samples from chickens at the farm and found antibodies for avian influenza.
Testing by the National Veterinary Services Laboratory in Ames, Iowa, resulted in a presumptive positive finding for the H7 strain. Subsequent testing by NVSL and the Breathitt Veterinary Center in Hopkinsville confirmed the finding.
Stout said it was the first confirmed case of bird flu in Kentucky.
In 2007, two outbreaks occurred in turkey farms in Virginia and West Virginia. Some 25,000 turkeys had to be euthanized on each farm after the pathogenicity avian influenza was discovered.
Bird flu is a virus that affects domestic poultry and some wild birds. It is spread by direct contact with infected birds.
Needed RS [Hospital] Fast Preceptive during the Disaster
7/4/09
Rumah Sakit (RS) or health facilities and the health power in the middle of an emergency became the theme of the Health Se- Dunia Day warning on April 7 this year.
The organisation of the Health of the World (WHO) focussed on RS, to be precise RS that was safe in the middle of the disaster, as well as the preceptive health power the disaster.
According to Director General WHO Dr Margaret Chan, when RS or other health facilities collapse when the disaster happening, the life that depended on the maintenance in emergency could be lost. In the condition for the emergency, like the flood, the earthquake, several countries lost the RS capacity as far as 50 percent exact at the time of the service critically urgent really was needed. The RS security included construction endurance, planning, and the preceptive training of the emergency.
Moreover, said Margaret, RS readiness must be in the disaster situation begun from the simple early-warning system, protected equipment and equipment to prepare the staff helped casualties in the mass number and did not lose important was the control of the infection.
-snip-
Foundation/Base/Rational
Beside the natural disaster, the plague of infectious diseases also became the cause of the death. In 12 months till May 31 2008, 162 plagues of the infection happened, a third him happened in South Africa. Especially in overcoming the plague of the illness that the level of his spread was high, like bird flu (Avian influenza), was needed by RS that had facilities that were good for treated the patients, including protecting the health power from the spread.
An emergency did not only have an impact on humankind, also had a big impact on RS, the clinic, and other health facilities. Even, when destruction of the infrastructure of health facilities, precisely happening health facilities were most needed. For example when the tsunami in Aceh, happening 61 percent broken of health facilities. In Singapore, for example, there was RS that especially for infectious diseases, namely RS Tan Tock Seng, Di Jakarta, there was RSPI Sulianti Saroso. In Hong Kong, the local government built RS with modern technological facilities to anticipate infectious diseases, learned from the plague of the acute respiratory syndrome serious (severe acute respiratory syndrome/SARS).
Damage could also happen in the middle of the conflict. Why must health facilities stay safe in the situation kedaruratan? According to WHO, there were three reasons. Firstly, health facilities and the health power helped rescued the life and protected the health. Secondly, protected investment, because constructive repeated RS that was broken made the burden of economics bigger. Thirdly, maintained the social stability. RS was the protected place for the community while the conflict, and RS were neutral.
Rumah Sakit (RS) or health facilities and the health power in the middle of an emergency became the theme of the Health Se- Dunia Day warning on April 7 this year.
The organisation of the Health of the World (WHO) focussed on RS, to be precise RS that was safe in the middle of the disaster, as well as the preceptive health power the disaster.
According to Director General WHO Dr Margaret Chan, when RS or other health facilities collapse when the disaster happening, the life that depended on the maintenance in emergency could be lost. In the condition for the emergency, like the flood, the earthquake, several countries lost the RS capacity as far as 50 percent exact at the time of the service critically urgent really was needed. The RS security included construction endurance, planning, and the preceptive training of the emergency.
Moreover, said Margaret, RS readiness must be in the disaster situation begun from the simple early-warning system, protected equipment and equipment to prepare the staff helped casualties in the mass number and did not lose important was the control of the infection.
-snip-
Foundation/Base/Rational
Beside the natural disaster, the plague of infectious diseases also became the cause of the death. In 12 months till May 31 2008, 162 plagues of the infection happened, a third him happened in South Africa. Especially in overcoming the plague of the illness that the level of his spread was high, like bird flu (Avian influenza), was needed by RS that had facilities that were good for treated the patients, including protecting the health power from the spread.
An emergency did not only have an impact on humankind, also had a big impact on RS, the clinic, and other health facilities. Even, when destruction of the infrastructure of health facilities, precisely happening health facilities were most needed. For example when the tsunami in Aceh, happening 61 percent broken of health facilities. In Singapore, for example, there was RS that especially for infectious diseases, namely RS Tan Tock Seng, Di Jakarta, there was RSPI Sulianti Saroso. In Hong Kong, the local government built RS with modern technological facilities to anticipate infectious diseases, learned from the plague of the acute respiratory syndrome serious (severe acute respiratory syndrome/SARS).
Damage could also happen in the middle of the conflict. Why must health facilities stay safe in the situation kedaruratan? According to WHO, there were three reasons. Firstly, health facilities and the health power helped rescued the life and protected the health. Secondly, protected investment, because constructive repeated RS that was broken made the burden of economics bigger. Thirdly, maintained the social stability. RS was the protected place for the community while the conflict, and RS were neutral.
CIDRAP: News Scan
Apr 6, 2009
H5N1 strikes another Egyptian child
Egypt's health ministry said yesterday that a 6-year-old boy from Qalyubiya governorate, just north of Cairo, is hospitalized in critical condition and on a ventilator with an H5N1 avian influenza infection, Egypt-based Strengthening Avian Influenza Detection and Response (SAIDR) reported yesterday. He got sick on Mar 22, was hospitalized on Mar 28, and received oseltamivir (Tamiflu) on Apr 3. The report did not say if the boy had been exposed to sick or dead poultry. If the World Health Organization (WHO) confirms the boy's case, he will be listed as Egypt's 63rd H5N1 case-patient, of which 23 have died of their infections.
[Apr 5 SAIDR report]
Kentucky and Germany report H7 at poultry farms
Agriculture officials in Kentucky announced on Apr 3 that they were investigating a suspected low-pathogenic avian influenza outbreak at a broiler/breeder farm in the western part of the state. The farm processes hatching eggs for Perdue Farms, Inc., which in mid March noted a drop in egg production and found that the birds had antibodies for avian influenza. Testing by the National Veterinary Services Laboratory (NVSL) in Ames, Iowa, found evidence suggesting exposure to an H7 virus, and further tests confirmed the finding. Perdue plans to cull 20,000 chickens from two of the farms' barns, and state agriculture officials are conducting surveillance within a 2-mile radius of the farm. Elsewhere, animal health officials in Germany will cull 17,000 turkeys at a commercial farm in Kleve district in the western part of the country near the border with Holland after a low-pathogenic H7 virus was detected in preliminary tests, according to a translation of a German media report that appeared on ProMed mail, the Internet-based reporting system of the International Society for Infectious Diseases. The samples are undergoing further testing at the Friedrich Loeffler Institute on the Isle of Riems.
[Apr 3 Kentucky Department of Agriculture press release]
[Apr 3 ProMed mail post]
Japanese researchers said today that they have detected H5N1 avian influenza antibodies in 10 wild raccoons, the first such finding in the country's mammals, the Daily Yomiuri reported today. They presented their findings at a conference of the Japanese Society of Veterinary Science and warned that infected raccoons could spread the virus to chicken farms. They based their findings on blood from 998 raccoons that were collected since 2005 from three locations in western Japan and one site in the eastern part of the country. They said that the 10 raccoons that showed H5N1 antibodies were probably infected by eating the carcasses of sick birds or inheriting the antibody from a parent. In December 2008, US researchers reported in Emerging Infectious Diseases (EID) that they found antibodies to a variety of influenza subtypes in raccoons. When they experimentally infected the raccoons, they found that the animals can become infected with avian and human influenza A viruses, shed and transmit the virus to other animals, and seroconvert. Raccoons have avian- and human-type cellular receptors, which could make the animals a mixing vessel for creating novel flu strains.
[Apr 7 Daily Yomiuri story]
[Dec 2008 EID report]
hat-tip Carol@SC
CIDRAP: Agencies build partnerships to dispense emergency medications
CIDRAP
Editor's Note: CIDRAP's Promising Practices: Pandemic Influenza Preparedness Tools (www.CIDRAPpractices.org) online database showcases peer-reviewed practices, including useful tools to help others with their planning. This article is one of a series exploring the development of these practices. We hope that describing the process and context of these practices enhances pandemic planning.
Apr 6, 2009 (CIDRAP News) - When dispensing a large number of medications during an emergency, one site might not be enough. Many US communities are seeking alternate methods of dispensing. One such method, which involves distributing medication through some agencies to reduce the influx at public sites, is called the "Push Partner Program."
The Centers for Disease Control and Prevention (CDC) has identified the need for communities to provide prophylaxis to 100% of their population within 48 hours. Some planners feel general public point-of-dispensing (POD) sites could not meet such high demand in a short time. The Push Partner Program, which is being used in several states, is one way to ease the burden on public POD sites.
This dispensing strategy involves "pushing" medications to partner agencies, such as community-based organizations and private businesses. These agencies then dispense the medication to the people in their organizations such as employees, employee family members, and even clients, if applicable. Unlike the general PODs, partner agencies are not open to dispense to the general public during an emergency.The National Association of County and City Health Officials (NACCHO) is conducting a survey on the partnership between local health departments and their push partner agencies, said Katie Dunkle, a NACCHO program manager. She said she believes the alternate dispensing option is becoming increasingly popular.
"It is pretty overwhelming to hand out medications to the entire public within such a short period of time. A lot of health departments have started looking to community organizations and businesses to partner with to better accomplish this task in the event of an emergency," Dunkle said.
The Oklahoma and Oregon departments of health have had Push Partner Programs for more than 2 years, which may reduce demand at the regular PODs during an emergency.
Mark Schultz, LPN, MSM, is the western district coordinator for the Oklahoma State Department of Health. "Our largest push partner is Oklahoma University. They are able to dispense medication to up to 60,000 people during an emergency," he said. Continued-snip-
hat-tip Carol@SC
Karen Grech Hospital to become avian flu emergency facility
Map of Gwardamanġa, Malta
Click on map
07 April 2009
Click on map
07 April 2009
The Karen Grech Hospital in Gwardamangia will be set up specifically to take care of any potential pandemic avian flu outbreak that many experts are certain will surface sooner or later.
During a press conference held at Mater Dei for World Health Day, Parliamentary Secretary for Elderly and Community Care Mario Galea and Parliamentary Secretary for Health Joe Cassar outlined Malta’s plans in case of natural emergencies, such as a pandemic avian flu outbreak.
Cassar said how the government was following advice from the European Centre for Disease Prevention and Control (ECDPC), and guidance from World Health Organisation (WHO) on how to address a possible pandemic avian flu outbreak, adding that Health Plans are being devised in a way that if a virus starts spreading, priority cases take precedence, while emergency operations are carried out and priority care is provided.
Cassar explained how, during a conference which he attended in Egypt recently, many experts were of the opinion that an avian flu outbreak was imminent, and that the only question was of when it would start spreading.
In this light, he said the government’s plans are based on various models of possibilities of how the pandemic flue could affect the country, particularly taking into considering the percentage of the population affected by the virus.
Principally, the plans aim for prevention and control, Cassar said. In case of a pandemic flu outbreak, the first priority would be to limit mass activities. Schools would be closed, he said citing an example, to limit the spread of the infection.
He added that, where possible, the virus would be treated and controlled by primary health workers and only bad cases would sent to hospital for intensive care.
Cassar also said how the Health division already has a stock of virus medication that is checked periodically.
The present stock of 25% he said, however, would expire shortly.
The present stock of 25% he said, however, would expire shortly.
He spoke of the government’s plans to equip the Karen Grech hospital to deal with an outbreak should one surface, adding that the hospital would be fitted with temperature chillers and oxygen piping.
He explained that the decision was reversed in recent months because authorities preferred to first complete patient and staff migration. Since it has now settled down, following the completion of the migration, Cassar said that the hospital was now ready to be converted specifically to cater for a potential pandemic avian flu outbreak.
He added that the Government has already made arrangements with medicinal companies to obtain a vaccine for the virus as soon as one is developed.
-snip-
He added that, during emergencies, pharmacies and medical supplies would also be very important. In Mater Dei, he said, rucksacks and aluminium cases containing pre-prepared medical equipment are present which emergency workers can simply pick up and take to emergency areas.
Should an emergency arise, he added, parts of the hospital were built appropriately so that they can change according to the needs of the emergency, Cassar said, adding that one particular recovery area could be turned into an ITU bed ward.
Cassar also spoke how working priorities for staff would change during emergencies to focus on emergency cases. Elective surgery facilities would become trauma centres, and staff would take up emergency-related duties. He added that hospital staff was already trained to this aim, and protocols are already in place.
hat-tip DryHeat
hat-tip DryHeat
Japan: 10 raccoons discovered with bird flu antibodies
The Yomiuri Shimbun - (Apr. 7, 2009)
UTSUNOMIYA--"Ten wild raccoons have been found with signs of previous H5N1 bird flu infections, according to a joint study by Tokyo University and Yamaguchi University. This is the first time mammals in this country have been found with bird flu virus antibodies, which develop as a result of infection. Before the discovery, only birds had been found with bird flu antibodies.
The research team, which presented a paper on its findings at a conference of the Japanese Society of Veterinary Science in Utsunomiya on Saturday, warned that infected raccoons could introduce the virus into chicken farms and noted that countermeasures were needed. It is believed that the H5N1 strain of the bird flu virus is highly likely to mutate into a new type of influenza. In Japan, there have previously been reports of domestic chickens, wild whooper swans, jungle crows and mountain hawk-eagles infected with the virus.
The research team collected and examined blood from 988 raccoons captured since 2005 at three locations in western Japan and one location in eastern Japan. In the blood of 10 raccoons from three of the locations, the team found antibodies that had developed after past H5N1 infections. In two of the three places, not even birds had been found with the antibodies before this time." - excerpt
hat-tip Rickk
Recombinomics: Toddler to Toddler H5N1 Transmission in Beheira Egypt
Commentary
Boy, age 2, began experiencing fever, cough and runny nose on March 31.
The above comments describe the two most recently H5N1 confirmed toddlers in Egypt. These two cases were next door neighbors in the Kom Hamada district of Beheira and represent toddler to toddler transmission of H5N1. This cluster follows a spate of toddler cases in Egypt this year. 10 of the 12 confirmed cases have been toddlers and 9 of the 10 toddler cases have been mild. Both patients above are described as being in "good general condition" and will likely be discharged soon. None of the H5N1 cases this year in Egypt have died, which is similar to the mild cases of H5N1 in Egypt in the spring of 2007. However, unlike earlier cases, which included 6 toddlers over a three year period, the percentage of toddler cases has dramatically increased in 2009.
Although the two cases above are said to have had contact with dead or sick poultry, the confirmation of neighboring cases who developed symptoms four days apart is unlikely to be due to two independent poultry infections. There have been no confirmed poultry cases in the Kom Hamada area. Since March 1 there were 24 confirmed H5N1 poultry outbreaks in Egypt, and although 7 were in Beheira, these outbreaks were well to the north and not near the toddler cluster (see updated map). Over 60 outbreaks have been confirmed this season, and none were close to Kom Hamada. Similarly, the toddler case preceding the cluster was in Qena, and there have been no confirmed poultry outbreaks in Qena this season (see updated map).
Although there are clearly more H5N1 outbreaks than those confirmed, the targeting of toddlers raises concerns that old age groups have developed protective immunity, signaling a significant silent spread of H5N1 in Egypt. Over 6000 patients with poultry links have been hospitalized, but less than 1% have tested positive. However, it remains unclear if the low confirmation rate is due to an aggressive testing program, or a lack of sensitivity in the testing.
Confirmed H5N1 clusters have been rare in Egypt have been rare. The largest was the Ghabiya cluster at the end of 2006, but the prior clusters were among relatives and did not have the gap in disease onset dates. The Beheira cluster has the classical gap and there has been no indication that the two toddlers were related. Although it is likely that mild H5N1 has was transmitted human to human, based on the sequence identity between isolates from unrelated cases, the current cluster has the time and space signature associated with human to human transmission.
Sequences from this cluster, as well as testing of toddlers that have symptoms but lack a poultry link would be useful.
Media Links
Recombinomics Commentary 18:29
April 7, 2009
Boy, age 2, began experiencing fever, cough and runny nose on March 31.
The above comments describe the two most recently H5N1 confirmed toddlers in Egypt. These two cases were next door neighbors in the Kom Hamada district of Beheira and represent toddler to toddler transmission of H5N1. This cluster follows a spate of toddler cases in Egypt this year. 10 of the 12 confirmed cases have been toddlers and 9 of the 10 toddler cases have been mild. Both patients above are described as being in "good general condition" and will likely be discharged soon. None of the H5N1 cases this year in Egypt have died, which is similar to the mild cases of H5N1 in Egypt in the spring of 2007. However, unlike earlier cases, which included 6 toddlers over a three year period, the percentage of toddler cases has dramatically increased in 2009.
Although the two cases above are said to have had contact with dead or sick poultry, the confirmation of neighboring cases who developed symptoms four days apart is unlikely to be due to two independent poultry infections. There have been no confirmed poultry cases in the Kom Hamada area. Since March 1 there were 24 confirmed H5N1 poultry outbreaks in Egypt, and although 7 were in Beheira, these outbreaks were well to the north and not near the toddler cluster (see updated map). Over 60 outbreaks have been confirmed this season, and none were close to Kom Hamada. Similarly, the toddler case preceding the cluster was in Qena, and there have been no confirmed poultry outbreaks in Qena this season (see updated map).
Although there are clearly more H5N1 outbreaks than those confirmed, the targeting of toddlers raises concerns that old age groups have developed protective immunity, signaling a significant silent spread of H5N1 in Egypt. Over 6000 patients with poultry links have been hospitalized, but less than 1% have tested positive. However, it remains unclear if the low confirmation rate is due to an aggressive testing program, or a lack of sensitivity in the testing.
Confirmed H5N1 clusters have been rare in Egypt have been rare. The largest was the Ghabiya cluster at the end of 2006, but the prior clusters were among relatives and did not have the gap in disease onset dates. The Beheira cluster has the classical gap and there has been no indication that the two toddlers were related. Although it is likely that mild H5N1 has was transmitted human to human, based on the sequence identity between isolates from unrelated cases, the current cluster has the time and space signature associated with human to human transmission.
Sequences from this cluster, as well as testing of toddlers that have symptoms but lack a poultry link would be useful.
Media Links
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