From the beginning of the year, the province of Quang Tri several outbreaks occur in poultry farming in Hai Lang district, Vinh Linh, Gio Linh. Beginning in June alone, there have been four outbreaks of avian flock of 7 on 9 households in Hai Lang district and Gio Linh district.
By this time in Quang Tri province has more than 23,000 children have been infected poultry culled. Next time, SDAH Quang Tri continue vaccinating 1 million doses of vaccine in poultry in all districts and cities in the province, especially in risk areas of high bird flu outbreak. Information on VNA.
Saturday, August 20, 2011
CDC Asks to Sample Virginia Waters for Deadly Amoebaba
Published August 20, 2011
RICHMOND, Va. – Federal authorities are asking for samples of Virginia waterways in an attempt to develop a test for detecting deadly microscopic amoeba.
Health officials say two children and a young man nationwide have died this summer from a fatal infection known as primary amoebic meningoencephalitis stemming from a brain-eating amoeba that lives in water.This month, a 9-year-old Virginia boy died a week after he went to a fishing day camp. Christian Alexander Strickland had visited several bodies of water during
The Richmond Times-Dispatch reports that The Centers for Disease Control and Prevention is asking Virginia for help to sample waters for Naegleria fowleri.
The free-living amoeba gets up the nose, burrows up into the skull and destroys brain tissue. It's found in warm lakes and rivers during the hot summer months, mostly in the South."It's a terrible disease that we would like to know more about and be able to tell the public more about from a prevention standpoint," said Michael Beach, the federal agency's associate director for healthy water. "We are trying to learn more, but it's a tough one because it's such a rare occurrence."
It's a medical mystery why some people who swim in amoeba-containing water get the fatal nervous system condition while many others don't, experts say."That's the million-dollar question," he said. "We have no idea."....
Vietnam: Prevention H5N1 Hanoi
"Management" tight to prevent disease outbreaks in poultry
Hanoi Department of Animal Health and Veterinary Station facilities have enhanced inspection of eggs supply, sanitation and veterinary facility for professional organizations and hatching eggs, providing bulk seed to farmers in Hanoi and other provinces and neighboring cities.
Department of Animal Health in Hanoi, said: In the area of poultry production scale in suburban areas, farmers tend to expand farming, increasing rapidly to meet market demand in the months. However, before the weather with rain and sunshine mix, very high humidity caused disease outbreaks in the herds. In recent days, bird flu has reappeared in several provinces to farmers in Hanoi as not subjective, neglected stage of disease prevention for pets.
Therefore, the Hanoi Department of Animal Health and Veterinary Station facilities have enhanced inspection of eggs supply, sanitation and veterinary facility for professional organizations and hatching eggs, provided large number of seeds to farmers in Hanoi and other provinces and neighboring cities. Also timely handling of cases of transportation and trading of poultry and poultry products of unknown origin, did not have enough valid quarantine certificate and suspension facilities hatching eggs are not eligible veterinary hygiene
Particularly in Phu Xuyen district, where more than 100 establishments specialized in breeding birds on a large scale, Department of Animal Health in Hanoi to coordinate with local government training for all under-hatched regulations the law on veterinary services, hygienic conditions during the import of poultry eggs, hatching into the oven and selling animals.
Hanoi Department of Animal Health and Veterinary Department suggested the provinces and neighboring cities shall regularly exchange information about the disease situation, a list of households specializing in transportation of cattle, poultry in Hanoi and from Hanoi to other provinces as well as large numbers of violations for coordinated management.
According to the Department of Veterinary City: Hanoi which provide seed sources for large poultry breeding areas of the capital and provinces nearby. Only in Phu Xuyen district - which they call the "oven" to provide the same bird under the largest has almost 500 incubators are operating at full capacity, each year provides hundreds of thousands of birds like the country farmers
Friday, August 19, 2011
Cambodian girl dies from H5N1 infection
Lisa Schnirring 
Aug 19, 2011 (CIDRAP News) – Cambodia's health ministry has confirmed that a 6-year-old girl died from an H5N1 avian influenza infection, the World Health Organization (WHO) announced today.
The girl, from Kampong Cham province in eastern Cambodia, got sick Aug 7 and was first treated by local healthcare providers, the WHO said. After her condition didn't improve she was admitted to Kantha Bopha Children's Hospital in Phnom Penh on Aug 12, where she died 2 days later.
Her infection and death raise Cambodia's H5N1 toll to 18 cases and 16 deaths, the WHO said.
Cambodia has reported eight H5N1 cases this year, all of them fatal. Though a recent report from German researchers noted that the overall case-fatality rate for the disease has declined over the past 5 years, it has been lethal in Cambodia, which reported its first cases in 2005 and has had only two patients who survived their infections.
Cambodia's latest case raises the world's H5N1 total to 565 cases, which include 331 deaths.
An investigation into the source of the girl's illness suggests that she had been exposed to sick poultry. There were recent reports of poultry die-offs in the girl's village.
National and local response teams are conducting an outbreak investigation, according to the WHO report. So far none of the girl's contacts have tested positive for the H5N1 virus.
Tuesday, August 16, 2011
World too complacent on bird flu
Last week, Egyptian officials reported to the World Health Organization that a 6-year-old girl was successfully treated for avian influenza, which she is suspected to have contracted as a result of exposure to diseased poultry. A week earlier Cambodian officials confirmed that a 4-year-old girl from a farming village in that country died of avian influenza after being exposed to an infected chicken. According to World Health Organization statistics, these girls are the 563rd and 564th humans to be infected with bird flu, and the Cambodian girl was the 330th to die of it.
Most remarkable about these cases are just how unremarkable it has become to learn that bird flu has jumped the species barrier. When it first became apparent that avian influenza took a human life in Hong Kong in 1997, it was big news. The Centers for Disease Control and Prevention mobilized experts to conduct an on-site investigation. WHO officials went into crisis mode. And newspapers around the world reported on the events.Since then, bird flu has become endemic among poultry in many countries, including China, Indonesia, Egypt and Vietnam, and it has killed nearly 60 percent of the humans it has infected. Nonetheless, the reports during the past two weeks of two recent infections and another death raised little concern except among public health officials.
The fact that bird flu in developing nations receives little public attention reveals that the world has become complacent about this threat. Not that we have been sitting idle. Countries have pledged more than $4 billion to combating bird flu since 2005, and developing nations have....
Vietnam - Avian influenza outbreaks have very high risk
16/08/2011 20:55:00
Spray disinfection of poultry trade in the region.
At its meeting the National Steering Committee for Avian Influenza Prevention pm 16 / 8, Hoang Van Nam, Director General for Animal Health warned that the risk of outbreak of new bird flu outbreak in this period is very high if the local does not control the outbreak, lax supervision of shipping and integrated disease prevention.
Weather changes, unexpected developments in the many poultry reduced resistance also causes an increased risk of contributing to the spread of disease.
Steering Committee of local requirements enhance communication to farmers, trade, slaughter and consumption of poultry to reduce risk behaviors arise and spread. Also, the local implementation of synchronous prevention services such as livestock biosecurity, hygiene organizations, disinfection, sterilization livestock sector, the transport, slaughter and trade in poultry market especially from areas with outbreaks.
So far, the country also two provincial bird flu is less than 21 days Nghe An and Quang Tri.
In Nghe An, translations appeared in 11 communes and towns of the four Nghi Loc district, Dien Chau, Yen Thanh Hung Nguyen, and with the total number of birds killed and destroyed more than 8,000 children. In Quang Tri, avian influenza appears in the small farming households in Gio Linh district of the total bird deaths and the destruction of nearly 1,000. Avian influenza occurs in the two provinces mainly on ducks.
Ministry of Agriculture and Rural Development has made two provinces on vaccines for RE5 to serve prevention.
As reported by the Veterinary Department, blue ear disease and foot and mouth disease in cattle is temporarily controlled the whole country, not a locality notice is translated.
Spray disinfection of poultry trade in the region.
At its meeting the National Steering Committee for Avian Influenza Prevention pm 16 / 8, Hoang Van Nam, Director General for Animal Health warned that the risk of outbreak of new bird flu outbreak in this period is very high if the local does not control the outbreak, lax supervision of shipping and integrated disease prevention.
Weather changes, unexpected developments in the many poultry reduced resistance also causes an increased risk of contributing to the spread of disease.
Steering Committee of local requirements enhance communication to farmers, trade, slaughter and consumption of poultry to reduce risk behaviors arise and spread. Also, the local implementation of synchronous prevention services such as livestock biosecurity, hygiene organizations, disinfection, sterilization livestock sector, the transport, slaughter and trade in poultry market especially from areas with outbreaks.
So far, the country also two provincial bird flu is less than 21 days Nghe An and Quang Tri.
In Nghe An, translations appeared in 11 communes and towns of the four Nghi Loc district, Dien Chau, Yen Thanh Hung Nguyen, and with the total number of birds killed and destroyed more than 8,000 children. In Quang Tri, avian influenza appears in the small farming households in Gio Linh district of the total bird deaths and the destruction of nearly 1,000. Avian influenza occurs in the two provinces mainly on ducks.
Ministry of Agriculture and Rural Development has made two provinces on vaccines for RE5 to serve prevention.
As reported by the Veterinary Department, blue ear disease and foot and mouth disease in cattle is temporarily controlled the whole country, not a locality notice is translated.
Avian influenza outbreak in eight communes and towns of Quang Politics
SDAH Ha Tinh province, said the province has more than five million birds, but more than a million children have been vaccinated by the lack of bird flu vaccine. Room service initiative, the province increased control of the trading and transportation of poultry from the province of Nghe An and Quang Binh. National Highway 1A, set up two checkpoints in the south of Ben Thuy bridge, north of Pass Horizontal. At the same time ending up second in Tien Son commune, Huong Son Commune Lien Minh, Duc Tho district of Ho Chi Minh. As of 16-8, the area eight communes and towns, the two districts of Gio Linh and Hai Lang (Quang Tri) has more than 23 thousand poultry deaths and destruction caused by avian influenza. In the village States Truc, Quang Gio (Gio Linh) appear more new outbreak on a flock of 600 children households. Through the test results positive for influenza virus H5N1.Chi provincial Veterinary Bureau has coordinated the districts to monitor and monitored flocks, prohibits the sale and transportation of poultry from areas.
More than 23,000 avian influenza A/H5N1 infection
Tuesday, 16/08/2011 18:04
ANTD - 16-8 Day, from Veterinary Bureau said Quang Tri Province, to the present time the province had 23,120 birds have died and destruction caused by influenza A/H5N1 infection. The number of infected poultry is concentrated in eight communes and towns in two districts of Gio Linh and Hai Lang.
Shortly after the outbreak, SDAH Quang Tri was quickly coordinate with the local implementing disease control measures, the total destruction of infected poultry; emergency vaccination on herd animals in two districts of Gio Linh Hai Lang and simultaneously prepare for vaccinating the entire poultry in the province.
By this time, Hai Lang district did not detect more poultry outbreaks, Gio Linh district separately discovered a new outbreak on the household's flock 600 Hoang Van Vinh village States Architecture, Gio Quang, check survey results were positive for H5N1 virus.
The Quang Tri province is leading the local monitoring and surveillance of poultry at local, prohibited the sale and transportation of poultry in the epidemic areas, conduct and reporting process as soon as you sign Disease name
ANTD - 16-8 Day, from Veterinary Bureau said Quang Tri Province, to the present time the province had 23,120 birds have died and destruction caused by influenza A/H5N1 infection. The number of infected poultry is concentrated in eight communes and towns in two districts of Gio Linh and Hai Lang.
Shortly after the outbreak, SDAH Quang Tri was quickly coordinate with the local implementing disease control measures, the total destruction of infected poultry; emergency vaccination on herd animals in two districts of Gio Linh Hai Lang and simultaneously prepare for vaccinating the entire poultry in the province.
By this time, Hai Lang district did not detect more poultry outbreaks, Gio Linh district separately discovered a new outbreak on the household's flock 600 Hoang Van Vinh village States Architecture, Gio Quang, check survey results were positive for H5N1 virus.
The Quang Tri province is leading the local monitoring and surveillance of poultry at local, prohibited the sale and transportation of poultry in the epidemic areas, conduct and reporting process as soon as you sign Disease name
Eurosurvellance: Avian influenza A(H5N1) in humans: new insights from a line list of World Health Organization confirmed cases
Eurosurveillance, Volume 16, Issue 32, 11 August 2011
Research articles
Avian influenza A(H5N1) in humans: new insights from a line list of World Health Organization confirmed cases, September 2006 to August 2010
L Fiebig ()1,2, J Soyka1,2, S Buda1, U Buchholz1, M Dehnert1, W Haas1
Robert Koch Institute, Department for Infectious Disease Epidemiology, Respiratory Infections Unit, Berlin, Germany
These authors contributed equally to this article
Excerpt:
Case fatality
Fifty-six percent (132/235) of confirmed cases died. The CFR differed across countries ranging from 28% (27/98) in Egypt to 87% (71/82) in Indonesia. The cCFR and the 19-month rCFR indicated a decline in case fatality over the study period (Figure 1). Whereas the cCFR was little affected by the outcome of new cases and had only slightly decreased, the rCFR had steeply declined in the period from April 2008 to April 2009. Until mid 2008, a large proportion of cases occurred in Indonesia (country with highest CFR) and shifted thereafter to Egypt (country with lowest CFR). Accordingly, country-specific rCFRs for Indonesia and Egypt were less steep than the overall rCFR. The 19-months rCFR was privileged as it was less affected by case-free periods than rCFRs calculated over shorter periods (not shown).
In Egypt, fatal cases had a median age of 25 years, which was, at significant level, higher than the age of cases who survived (four years, p<0.001; Table 2). The CFR in Egypt was significantly higher in women than in men, (39% (22/56) vs 12% (5/42) respectively, p=0.003), which was not observed elsewhere (China: 63% (5/8) in women vs 70% (7/10) in men, p=1.0; Indonesia: 84% (43/51) vs 90% (28/31), p=0.521; Vietnam: 58% (7/12) vs 69% (9/13), p=0.688; remaining countries: 80% (4/5) vs 40% (2/5), p=0.524, respectively).
A significant difference in time from symptom onset to hospitalisation between survivors and fatal cases was only found in Egypt (one day vs four and a half days respectively, p=0.001, Table 3). All 19 cases worldwide hospitalised eight days after symptom onset or later had died.
Figure 3 shows the CFR in function of the time from symptom onset to hospitalisation, stratified by Egypt and Asian countries (grouped).
Figure 3. Time from confirmed avian influenza A(H5N1) human cases’ symptom onset to hospitalisation and case fatality rate stratified for Egypt and Asian countries, September 2006–August 2010 (n=197)
The median time from symptom onset to death was nine days (N=118), irrespective of the patients’ sex (p=0.605), and without significant difference across age groups (p=0.564, data not shown) or reporting countries (p=0.213).
The multivariable logistic regression revealed that odds of fatal outcome increased by 33% with each day that passed from symptom onset until hospitalisation (OR: 1.33, 95% CI: 1.11–1.60, p=0.002). In relation to children of 0–9 years, odds of fatal outcome were more than six times higher in 10–19 year-olds and 20–29 year-olds (OR: 6.06, 95% CI: 1.89–19.48, p=0.002 and OR: 6.16, 95% CI: 2.05–18.53, p=0.001, respectively), and nearly five times higher in patients of 30 years and older (OR: 4.71, 95% CI: 1.56–14.27, p=0.006).
Using Indonesia as a reference, odds of dying were lower elsewhere, namely by 92% in Egypt (OR: 0.08, 95% CI: 0.03–0.22, p<0.001), by 81% in China (OR: 0.19, 95% CI: 0.04–0.90, p=0.036), and by 79% in Vietnam (OR: 0.21, 95% CI: 0.06–0.75, p=0.016), but not in the grouped remaining countries (OR: 0.23, 95% CI: 0.04–1.27, p=0.091). Exposure to poultry was not significant and none of the interaction terms significantly improved the model fit. They were thus not retained in the final model.
Discussion and conclusions
With this study, we summarised the current global AI situation in humans. It is, to our knowledge, the first study that not only analysed human AI cases worldwide on the basis of a line list collected over several years but in addition made these case-based data available online. We found that a longer delay from symptom onset to hospital admission and belonging to older age groups were associated with higher mortality in AI patients, and that the situation in Egypt differed markedly from other countries with highest AI incidences in children and lowest CFR.
With our line list, cumulative case numbers published by WHO [4] could be largely reproduced: 235 of 256 WHO confirmed cases (92%) and additional 59 unconfirmed cases were captured between September 2006 and August 2010. The identified median reporting delay of 11 days after symptom onset may partly be explained by a deferred presentation to healthcare facilities as well as by the time needed for pathogen confirmation. About 52% of confirmed cases had been reported elsewhere in a median of three days prior to the WHO report. Because delays in availability of information could hamper investigations of the source of infection and of clusters of human cases [30], it could be beneficial to report and document probable cases in parallel with confirmed ones [31].
Confirmed cases had a median age of 18 years, which is consistent with earlier findings, although investigation periods and affected countries varied [2,19,21]. The identified predominance of female cases in Indonesia and Egypt and the low age median among Egyptian cases support findings from previous studies [2,23-25]. Schroedl [32] examined the mean age of cases in Egypt over four seasons between August 2006 and July 2009 and found a declining age-based pattern over time, but did not address sex-specific differences. We found, in line with other studies, a significantly older age of female cases than male cases, whose proportion had increased since 2008 in Egypt [24,25]. Chen et al., analysing AI cases worldwide before June 2006, also identified sex-specific differences in the age-groups of 4 to 6 years (95% male) and 25 to 30 years (83% female) [33]. They assumed particularly high levels of exposure in pre-school boys playing outdoors and housewives taking care of fowl and frequenting live markets. Fasina et al. suggested a similar explanation for the situation in Egypt [25].
Ninety-six percent of the cases had reportedly direct or indirect contact to potentially infected poultry, recognised as the most important risk factor for humans AI [8,34]. The WHO Clinical Case summary Form [35], where e.g. “poultry” can be checked as “most likely source of infection” has enhanced the systematic collection of information since 2007. However, currently reported information yields little insights into the actual source of infection and the intensity and quality of exposure needed to infect humans [36-38].
The median time from symptom onset to hospitalisation was four days, which is remarkably stable when compared to earlier studies [19,21]. If time to hospital admission is regarded as an indicator for monitoring case management and patients’ awareness [31], no progress would be evident from a global perspective so far.
The cases’ average CFR was 56%, which is widely consistent with findings from earlier investigation periods [2,19,23]. Using a 19-month rolling CFR, we found a clear decrease in case fatality, which persisted when stratifying for Egypt and Indonesia. It could thus not simply be explained by a predominance of Egyptian cases since 2009. Regarding the decreasing CFR in Egypt, Schroedl [32] suggested that the circulating AI virus strain may have become less virulent and more apt to spreading among children.
Analytical results revealed lowest odds of dying for Egyptian cases, even when adjusted for age, sex and time to hospitalisation. Thus, the high proportion of survivors in Egypt cannot be entirely explained – as often assumed – by sex-specific differences in CFR [21,24] and the high proportion of children among AI patients in Egypt [5], as well as short delays from symptom onset to hospitalisation [25].
It cannot be ruled out, that different virus clades circulating in Egypt (clade 2.2) and Asia (clades 2.1 and 2.3) shape the country-specific epidemiological features [2,23]. Differences in CFR across countries and changes over time might also partly be explained by differences in intensity and quality of exposure, health-seeking behaviour, reporting attitudes, overall performance of the surveillance system, and access to diagnostics and medical care [23,27,39,40], such as the time to start of oseltamivir treatment, the antiviral recommend by WHO for human infections with AI virus [2]. However, country-specific details on its administration are widely unknown and it remains controversial up to how many days after symptom onset the application of the antiviral reduces mortality [30,41]. In our study all patients hospitalised eight or more days after symptom onset died. This suggests a rather narrow time window for antiviral drug administration.
Our study was solely based on data from publicly available case reports and is subject to several limitations. Our monitoring instrument was only entirely implemented in August 2006 and thus trend analyses were not exploited to its full extent. Within the used reports, negative values, e.g. “case not hospitalised”, were not systematically mentioned, which may lead to biases. Time specifications, e.g. on dates of exposure or hospitalisation, needed for time-to-event analyses, were often incomplete. Case reports did not systematically contain details on medical care and specific antiviral treatment. Therefore, analyses were restricted to “hospitalisation” as general indicator for access to medical care. Given the sparse information on possible contact with infected individuals and clusters of human AI cases available from the serial reports within the investigated period, clusters could not be evaluated as initially planned. Other studies reporting on clustered cases had mostly accessed additional case-investigation reports and patient interviews [23,30]. We based our analyses on WHO confirmed cases, although unconfirmed cases had been recorded in our line list, due to lacking information for probable and suspected cases. Including probable cases in our analyses did, however, not change the cases’ sex ratio or CFR substantially when compared to confirmed cases only.
Our study points out that data extracted from the public domain already yields pertinent epidemiological information for assessing the current situation and developments of AI in humans. A line list format as provided would enhance the analysability of key data, their updating, and the evaluation of variables needed. Several countries monitor the global AI situation, whether they currently face human AI cases, e.g. Egypt [25], or not, e.g. France [27]. This indicates a common interest in data and if they were directly provided in such format, this would help to save time and resources for public health authorities and researchers.
A line list needs to be flexible in view of potential new information to be entered. New variables and parameter values might come up, when the minimum dataset suggested Bird and Farrar [31] on direct and indirect exposures to avian influenza A(H5N1) confirmed and non-confirmed poultry and human exposures would be implemented or when results from prospective studies involving exposed and unexposed individuals as designed by Kayali et al. [34] are available. Unconfirmed cases would ideally be recorded as systematically as confirmed cases, either in a common or separate database as suggested by Bird and Farrar [31].
Presenting cases in the format of a line list is not a goal in itself, but a prerequisite for targeting surveillance and identifying risk factors, as well as a starting point for prospective studies, e.g. investigating potential human-to-human transmission, the transmissibility of avian influenza viruses, and host-related factors including age-dependent immunity in humans [33,42].
We would like to encourage that an anonymised case-based database for AI in humans is directly placed publicly and continuously updated, e.g. by an internationally renowned organisation such as WHO. Open access to analysable data might accelerate the identification and implementation of research questions and surveillance priorities and thus enhance our understanding of – still mostly fatal – AI in humans and permit the rapid detection of epidemiological changes with implications for human health.
[Click on title for full document]
Research articles
Avian influenza A(H5N1) in humans: new insights from a line list of World Health Organization confirmed cases, September 2006 to August 2010
L Fiebig ()1,2, J Soyka1,2, S Buda1, U Buchholz1, M Dehnert1, W Haas1
Robert Koch Institute, Department for Infectious Disease Epidemiology, Respiratory Infections Unit, Berlin, Germany
These authors contributed equally to this article
Excerpt:
Case fatality
Fifty-six percent (132/235) of confirmed cases died. The CFR differed across countries ranging from 28% (27/98) in Egypt to 87% (71/82) in Indonesia. The cCFR and the 19-month rCFR indicated a decline in case fatality over the study period (Figure 1). Whereas the cCFR was little affected by the outcome of new cases and had only slightly decreased, the rCFR had steeply declined in the period from April 2008 to April 2009. Until mid 2008, a large proportion of cases occurred in Indonesia (country with highest CFR) and shifted thereafter to Egypt (country with lowest CFR). Accordingly, country-specific rCFRs for Indonesia and Egypt were less steep than the overall rCFR. The 19-months rCFR was privileged as it was less affected by case-free periods than rCFRs calculated over shorter periods (not shown).
In Egypt, fatal cases had a median age of 25 years, which was, at significant level, higher than the age of cases who survived (four years, p<0.001; Table 2). The CFR in Egypt was significantly higher in women than in men, (39% (22/56) vs 12% (5/42) respectively, p=0.003), which was not observed elsewhere (China: 63% (5/8) in women vs 70% (7/10) in men, p=1.0; Indonesia: 84% (43/51) vs 90% (28/31), p=0.521; Vietnam: 58% (7/12) vs 69% (9/13), p=0.688; remaining countries: 80% (4/5) vs 40% (2/5), p=0.524, respectively).
A significant difference in time from symptom onset to hospitalisation between survivors and fatal cases was only found in Egypt (one day vs four and a half days respectively, p=0.001, Table 3). All 19 cases worldwide hospitalised eight days after symptom onset or later had died.
Figure 3 shows the CFR in function of the time from symptom onset to hospitalisation, stratified by Egypt and Asian countries (grouped).
Figure 3. Time from confirmed avian influenza A(H5N1) human cases’ symptom onset to hospitalisation and case fatality rate stratified for Egypt and Asian countries, September 2006–August 2010 (n=197)
The median time from symptom onset to death was nine days (N=118), irrespective of the patients’ sex (p=0.605), and without significant difference across age groups (p=0.564, data not shown) or reporting countries (p=0.213).
The multivariable logistic regression revealed that odds of fatal outcome increased by 33% with each day that passed from symptom onset until hospitalisation (OR: 1.33, 95% CI: 1.11–1.60, p=0.002). In relation to children of 0–9 years, odds of fatal outcome were more than six times higher in 10–19 year-olds and 20–29 year-olds (OR: 6.06, 95% CI: 1.89–19.48, p=0.002 and OR: 6.16, 95% CI: 2.05–18.53, p=0.001, respectively), and nearly five times higher in patients of 30 years and older (OR: 4.71, 95% CI: 1.56–14.27, p=0.006).
Using Indonesia as a reference, odds of dying were lower elsewhere, namely by 92% in Egypt (OR: 0.08, 95% CI: 0.03–0.22, p<0.001), by 81% in China (OR: 0.19, 95% CI: 0.04–0.90, p=0.036), and by 79% in Vietnam (OR: 0.21, 95% CI: 0.06–0.75, p=0.016), but not in the grouped remaining countries (OR: 0.23, 95% CI: 0.04–1.27, p=0.091). Exposure to poultry was not significant and none of the interaction terms significantly improved the model fit. They were thus not retained in the final model.
Discussion and conclusions
With this study, we summarised the current global AI situation in humans. It is, to our knowledge, the first study that not only analysed human AI cases worldwide on the basis of a line list collected over several years but in addition made these case-based data available online. We found that a longer delay from symptom onset to hospital admission and belonging to older age groups were associated with higher mortality in AI patients, and that the situation in Egypt differed markedly from other countries with highest AI incidences in children and lowest CFR.
With our line list, cumulative case numbers published by WHO [4] could be largely reproduced: 235 of 256 WHO confirmed cases (92%) and additional 59 unconfirmed cases were captured between September 2006 and August 2010. The identified median reporting delay of 11 days after symptom onset may partly be explained by a deferred presentation to healthcare facilities as well as by the time needed for pathogen confirmation. About 52% of confirmed cases had been reported elsewhere in a median of three days prior to the WHO report. Because delays in availability of information could hamper investigations of the source of infection and of clusters of human cases [30], it could be beneficial to report and document probable cases in parallel with confirmed ones [31].
Confirmed cases had a median age of 18 years, which is consistent with earlier findings, although investigation periods and affected countries varied [2,19,21]. The identified predominance of female cases in Indonesia and Egypt and the low age median among Egyptian cases support findings from previous studies [2,23-25]. Schroedl [32] examined the mean age of cases in Egypt over four seasons between August 2006 and July 2009 and found a declining age-based pattern over time, but did not address sex-specific differences. We found, in line with other studies, a significantly older age of female cases than male cases, whose proportion had increased since 2008 in Egypt [24,25]. Chen et al., analysing AI cases worldwide before June 2006, also identified sex-specific differences in the age-groups of 4 to 6 years (95% male) and 25 to 30 years (83% female) [33]. They assumed particularly high levels of exposure in pre-school boys playing outdoors and housewives taking care of fowl and frequenting live markets. Fasina et al. suggested a similar explanation for the situation in Egypt [25].
Ninety-six percent of the cases had reportedly direct or indirect contact to potentially infected poultry, recognised as the most important risk factor for humans AI [8,34]. The WHO Clinical Case summary Form [35], where e.g. “poultry” can be checked as “most likely source of infection” has enhanced the systematic collection of information since 2007. However, currently reported information yields little insights into the actual source of infection and the intensity and quality of exposure needed to infect humans [36-38].
The median time from symptom onset to hospitalisation was four days, which is remarkably stable when compared to earlier studies [19,21]. If time to hospital admission is regarded as an indicator for monitoring case management and patients’ awareness [31], no progress would be evident from a global perspective so far.
The cases’ average CFR was 56%, which is widely consistent with findings from earlier investigation periods [2,19,23]. Using a 19-month rolling CFR, we found a clear decrease in case fatality, which persisted when stratifying for Egypt and Indonesia. It could thus not simply be explained by a predominance of Egyptian cases since 2009. Regarding the decreasing CFR in Egypt, Schroedl [32] suggested that the circulating AI virus strain may have become less virulent and more apt to spreading among children.
Analytical results revealed lowest odds of dying for Egyptian cases, even when adjusted for age, sex and time to hospitalisation. Thus, the high proportion of survivors in Egypt cannot be entirely explained – as often assumed – by sex-specific differences in CFR [21,24] and the high proportion of children among AI patients in Egypt [5], as well as short delays from symptom onset to hospitalisation [25].
It cannot be ruled out, that different virus clades circulating in Egypt (clade 2.2) and Asia (clades 2.1 and 2.3) shape the country-specific epidemiological features [2,23]. Differences in CFR across countries and changes over time might also partly be explained by differences in intensity and quality of exposure, health-seeking behaviour, reporting attitudes, overall performance of the surveillance system, and access to diagnostics and medical care [23,27,39,40], such as the time to start of oseltamivir treatment, the antiviral recommend by WHO for human infections with AI virus [2]. However, country-specific details on its administration are widely unknown and it remains controversial up to how many days after symptom onset the application of the antiviral reduces mortality [30,41]. In our study all patients hospitalised eight or more days after symptom onset died. This suggests a rather narrow time window for antiviral drug administration.
Our study was solely based on data from publicly available case reports and is subject to several limitations. Our monitoring instrument was only entirely implemented in August 2006 and thus trend analyses were not exploited to its full extent. Within the used reports, negative values, e.g. “case not hospitalised”, were not systematically mentioned, which may lead to biases. Time specifications, e.g. on dates of exposure or hospitalisation, needed for time-to-event analyses, were often incomplete. Case reports did not systematically contain details on medical care and specific antiviral treatment. Therefore, analyses were restricted to “hospitalisation” as general indicator for access to medical care. Given the sparse information on possible contact with infected individuals and clusters of human AI cases available from the serial reports within the investigated period, clusters could not be evaluated as initially planned. Other studies reporting on clustered cases had mostly accessed additional case-investigation reports and patient interviews [23,30]. We based our analyses on WHO confirmed cases, although unconfirmed cases had been recorded in our line list, due to lacking information for probable and suspected cases. Including probable cases in our analyses did, however, not change the cases’ sex ratio or CFR substantially when compared to confirmed cases only.
Our study points out that data extracted from the public domain already yields pertinent epidemiological information for assessing the current situation and developments of AI in humans. A line list format as provided would enhance the analysability of key data, their updating, and the evaluation of variables needed. Several countries monitor the global AI situation, whether they currently face human AI cases, e.g. Egypt [25], or not, e.g. France [27]. This indicates a common interest in data and if they were directly provided in such format, this would help to save time and resources for public health authorities and researchers.
A line list needs to be flexible in view of potential new information to be entered. New variables and parameter values might come up, when the minimum dataset suggested Bird and Farrar [31] on direct and indirect exposures to avian influenza A(H5N1) confirmed and non-confirmed poultry and human exposures would be implemented or when results from prospective studies involving exposed and unexposed individuals as designed by Kayali et al. [34] are available. Unconfirmed cases would ideally be recorded as systematically as confirmed cases, either in a common or separate database as suggested by Bird and Farrar [31].
Presenting cases in the format of a line list is not a goal in itself, but a prerequisite for targeting surveillance and identifying risk factors, as well as a starting point for prospective studies, e.g. investigating potential human-to-human transmission, the transmissibility of avian influenza viruses, and host-related factors including age-dependent immunity in humans [33,42].
We would like to encourage that an anonymised case-based database for AI in humans is directly placed publicly and continuously updated, e.g. by an internationally renowned organisation such as WHO. Open access to analysable data might accelerate the identification and implementation of research questions and surveillance priorities and thus enhance our understanding of – still mostly fatal – AI in humans and permit the rapid detection of epidemiological changes with implications for human health.
[Click on title for full document]
Sunday, August 14, 2011
Vinh Long: Destruction of 2,500 chickens have bird flu.
According to the provincial Veterinary Bureau, has worked with local organizations and destruction of 2,500 chickens was avian households in two communes of Hoi Chanh (Mang Thit district). From this year, the province has nearly 20,000 chickens have bird flu treatment destroyed. However, avian influenza vaccination for chickens phase I/2011 was only 40.8% of the plan (flock reaches 116% of plan).
UAE intensifies efforts to contain cholera in Somalia
15 August 2011
MOGADISHU - As an outbreak of cholera threatened tens of thousands of people fleeing the famine-hit areas of Somalia to pack into the crowded camps in the country’s capital, Mogadishu, the UAE fortified its medical efforts to contain the spread of the epidemic.
UAE’s mobile hospital continued to provide its ambulatory and medical services to the patients in the makeshift camps in and around the capital.
The Emirati mobile hospital has been welcomed as a great humanitarian service by the people in the region and is a worthy addition to the achievements in the vital initiatives of this kind.
The single hospital in Mogadishu is virtually helpless to cope up with the increasing number of patients being brought into it. According to the UN World Health Organisation, several people have died from suspected cholera cases in the hospital in Mogadishu, and there have been many other confirmed cholera outbreaks across the country.
Since the mobile hospital was inaugurated last week, it has visited the refugee camp in the suburbs of Mogadishu to give treatment to more than 820 patients suspected to be suffering from Cholera.
Cholera is caused by a bacteria that infects the small intestine and is spread through dirty water.
It is easily treated with oral rehydration salts and antibiotics. But many health centres in Somalia lack even these basic supplies. As a result, those who get cholera, especially children, can die of dehydration within days or even hours of being infected.
Since day one of its opening, the mobile hospital continues to receive increasing number of patients, many of whom are women and children.
Saturday, August 13, 2011
Chicken Breeders Suspected Bird Flu Suspect
Saturday, August 13, 2011
MordiadiRuang isolation Ra isolated place in the High Care Room Abdul Aziz Hospital Singkawang since two days laluSingkawang -
One chicken farmer in the area of Bukit Batu Singkawang, Ra, 70, was isolated in the High Care Room, Abdul Aziz Hospital Singkawang since two days ago. Grandfather allegedly infected with bird flu (Avian Influenza).
"Initially, he complained of cough and shortness of breath and feel chills when if we touch his body, feels hot," said Rus, daughter of Ra found in front of the High Care Room, Abdul Aziz Hospital Singkawang, yesterday (12 / 8).
The symptoms presented Rus occurred since four days ago, because the more severe, and her father was taken to Hope Joint Health Center. "The Hope Together suspect that my father was infected with bird flu," said Rus.
Because bird flu was suspected of being infected, the Joint Hope suggested that Ra was referred to Abdul Aziz Hospital. "They were taken to the hospital, because they do not have the equipment to check for infected or not from bird flu," said Rus.
On the advice of the Joint Health Center's Hope, was rushed to District Hospital Ra Abdul Aziz. "From the results of the examination while, according to the treating doctor, my father was not infected with bird flu, just that its development remains to be seen again a few days, hopefully not," please Rus.
He told us, suspected bird flu infection is strengthened because of what happened two months ago, when dozens of chickens died suddenly tail. "We do not report it, because as it was considered normal. Moreover, a neighbor's chickens also died, as was the season so, "said Rus.
In addition, Rus added, if the cause is due to Ra frequent contact with chickens, of course, can be contagious to people at home with him. "But in a house consisting of five people, only my father who was coughing and shortness of breath," he says.
Separately, Internal Medicine Specialist Hospital Abdul Aziz, Dr Dewa, a specialist who treats Ra explains, because the patient's house never happened chickens died suddenly about two months earlier, then the relevant secured in isolation. "This we do as precautions, until today (yesterday, red) after two days he was treated in isolation," he said.
Since being treated in isolation, the Ra examined intensively. Among them, about who complained of symptoms such as coughing and shortness of breath, body temperature that feels cold when touched was hot.
Furthermore, examination of samples in the laboratory to determine whether Ra infected with bird flu or not. "Until now we can not assure that patients infected with bird flu or not, we still need to see progress. In the meantime, we have not lead to bird flu, "said God.
Having convinced through observation and others against Ra, then God will provide certainty regarding the condition of patients. Take at least another week.
God explained, cases like this the first time in Singkawang. final last year, namely infection of swine flu, not bird flu. "If avian influenza has never been, only this time there are suggestions that patients infected with bird flu," he concluded.
But this is still conjecture, so that God expects people not to panic response. Just remain vigilant against this deadly disease and to understand the early symptoms of the infected, in order to know early on and can be assigned the action as quickly as possible.
MordiadiRuang isolation Ra isolated place in the High Care Room Abdul Aziz Hospital Singkawang since two days laluSingkawang -
One chicken farmer in the area of Bukit Batu Singkawang, Ra, 70, was isolated in the High Care Room, Abdul Aziz Hospital Singkawang since two days ago. Grandfather allegedly infected with bird flu (Avian Influenza).
"Initially, he complained of cough and shortness of breath and feel chills when if we touch his body, feels hot," said Rus, daughter of Ra found in front of the High Care Room, Abdul Aziz Hospital Singkawang, yesterday (12 / 8).
The symptoms presented Rus occurred since four days ago, because the more severe, and her father was taken to Hope Joint Health Center. "The Hope Together suspect that my father was infected with bird flu," said Rus.
Because bird flu was suspected of being infected, the Joint Hope suggested that Ra was referred to Abdul Aziz Hospital. "They were taken to the hospital, because they do not have the equipment to check for infected or not from bird flu," said Rus.
On the advice of the Joint Health Center's Hope, was rushed to District Hospital Ra Abdul Aziz. "From the results of the examination while, according to the treating doctor, my father was not infected with bird flu, just that its development remains to be seen again a few days, hopefully not," please Rus.
He told us, suspected bird flu infection is strengthened because of what happened two months ago, when dozens of chickens died suddenly tail. "We do not report it, because as it was considered normal. Moreover, a neighbor's chickens also died, as was the season so, "said Rus.
In addition, Rus added, if the cause is due to Ra frequent contact with chickens, of course, can be contagious to people at home with him. "But in a house consisting of five people, only my father who was coughing and shortness of breath," he says.
Separately, Internal Medicine Specialist Hospital Abdul Aziz, Dr Dewa, a specialist who treats Ra explains, because the patient's house never happened chickens died suddenly about two months earlier, then the relevant secured in isolation. "This we do as precautions, until today (yesterday, red) after two days he was treated in isolation," he said.
Since being treated in isolation, the Ra examined intensively. Among them, about who complained of symptoms such as coughing and shortness of breath, body temperature that feels cold when touched was hot.
Furthermore, examination of samples in the laboratory to determine whether Ra infected with bird flu or not. "Until now we can not assure that patients infected with bird flu or not, we still need to see progress. In the meantime, we have not lead to bird flu, "said God.
Having convinced through observation and others against Ra, then God will provide certainty regarding the condition of patients. Take at least another week.
God explained, cases like this the first time in Singkawang. final last year, namely infection of swine flu, not bird flu. "If avian influenza has never been, only this time there are suggestions that patients infected with bird flu," he concluded.
But this is still conjecture, so that God expects people not to panic response. Just remain vigilant against this deadly disease and to understand the early symptoms of the infected, in order to know early on and can be assigned the action as quickly as possible.
Patient Isolation Room Sign
Saturday, August 13, 2011, 11:55:00
Singkawang Singkawang-A resident of Central, the initials R had treated in isolation rooms Abdul Aziz Hospital since Thursday (11 / 8) night. The 70-year-old grandfather in suspected bird flu. Specialists in internal medicine Abdul Aziz Hospital, Dr. Dewa said previously admitted patients had a history of chickens died suddenly at his home two months ago. Then also complained cough for four days. Accompanied by fever. "We still observe the patient or her neighborhood. So it was still suspected that the patient is suspected of bird flu, "said God, Friday (12 / 8) told reporters when met at the hospital.
Long observation time, is said to god, also depends on the patient. And in one week later. Conclusions will be drawn. Because when taken to the hospital, patients no longer have a fever. "We continue to observe, and hopefully within one week of the existing conclusions can be drawn," katanya.Dugaan bird flu, he added, is the first time this has happened in RS Abdul Azis. As one of the referral hospital of bird flu in West Kalimantan. RS Abdul Aziz, better facilities and medicines are all available. "We are equipment and drugs ready. Because of this hospital as a referral Bird flu in West Kalimantan, "he said. For security and safety of all parties. patients should be treated in isolation space. Dr. Dewa was expecting her to the whole community. Equally pray for the good of the patient.
One Child R, Rus confirmed that two months ago his father's chickens died suddenly. Some neighbors had chickens experiencing the same thing. But what happened is considered normal. Thus did not report this incident. "Chickens that died were taken care of by the father (R), he just quietly alone. After the incident, the next two months. The father suffered chest tightness accompanied by body heat. Strangely, when held his body was cold. Seeing the incident, the family immediately brought to hospitals Singkawang Hope Together. "With Hope Hospital is the first time to diagnose bird flu is suspected. So that the private hospital and even then advised to immediately bring to the hospital Abdul Aziz, "Rus said, when met at the hospital to accompany his father outdoors. The family itself, he added, was surprised when his father suspected of having bird flu. But after in-patient at the Abdul Aziz Hospital, has improved. Body condition is no longer a fever.
Singkawang Singkawang-A resident of Central, the initials R had treated in isolation rooms Abdul Aziz Hospital since Thursday (11 / 8) night. The 70-year-old grandfather in suspected bird flu. Specialists in internal medicine Abdul Aziz Hospital, Dr. Dewa said previously admitted patients had a history of chickens died suddenly at his home two months ago. Then also complained cough for four days. Accompanied by fever. "We still observe the patient or her neighborhood. So it was still suspected that the patient is suspected of bird flu, "said God, Friday (12 / 8) told reporters when met at the hospital.
Long observation time, is said to god, also depends on the patient. And in one week later. Conclusions will be drawn. Because when taken to the hospital, patients no longer have a fever. "We continue to observe, and hopefully within one week of the existing conclusions can be drawn," katanya.Dugaan bird flu, he added, is the first time this has happened in RS Abdul Azis. As one of the referral hospital of bird flu in West Kalimantan. RS Abdul Aziz, better facilities and medicines are all available. "We are equipment and drugs ready. Because of this hospital as a referral Bird flu in West Kalimantan, "he said. For security and safety of all parties. patients should be treated in isolation space. Dr. Dewa was expecting her to the whole community. Equally pray for the good of the patient.
One Child R, Rus confirmed that two months ago his father's chickens died suddenly. Some neighbors had chickens experiencing the same thing. But what happened is considered normal. Thus did not report this incident. "Chickens that died were taken care of by the father (R), he just quietly alone. After the incident, the next two months. The father suffered chest tightness accompanied by body heat. Strangely, when held his body was cold. Seeing the incident, the family immediately brought to hospitals Singkawang Hope Together. "With Hope Hospital is the first time to diagnose bird flu is suspected. So that the private hospital and even then advised to immediately bring to the hospital Abdul Aziz, "Rus said, when met at the hospital to accompany his father outdoors. The family itself, he added, was surprised when his father suspected of having bird flu. But after in-patient at the Abdul Aziz Hospital, has improved. Body condition is no longer a fever.
Friday, August 12, 2011
Vietnam-Avian Flu threatened middle provinces
Because of the complicated weather, do not have vaccines for vaccination, plus routine small animal, avian influenza H5N1 was again strong in the central provinces.
Report of the Animal Health Agency Region III, to the date of 08.09.2011, the area of North Central has 11 bird flu outbreak less than 21 days.
In the province of Nghe An eight communes with a total of 5,081 birds were culled and the three communes of Quang Tri province has a total of over 4,000 children.
Report of the Animal Health Agency Region III, to the date of 08.09.2011, the area of North Central has 11 bird flu outbreak less than 21 days.
In the province of Nghe An eight communes with a total of 5,081 birds were culled and the three communes of Quang Tri province has a total of over 4,000 children.
Rusminah Fearing Bird Flu
Friday, August 12, 2011 20:31
Singkawang - Residents of Bukit Batu Village, Rusminah was worried about parents', R (70).
For when Rusminah take Mr. R to RS Hope Together, Thursday (11/08/2011) night, hospital officials declare R as suspect bird flu (H5N1).
That same evening, R directly referred to Dr. Abdul Aziz Hospital. After one night her parents to undergo treatment, Rusminah received good news from the hospitals.
"Last night I was worried. But now it's quiet. He said, my parents do not anything," said Tribune Rusminah when met at the Hospital Dr. Abdul Aziz, on Friday (08/12/2011).
According Rusminah Thursday night R fever. While since three days earlier, R cough and shortness of breath. Conditions so that makes Rusminah parents checked into the hospital.
R Rusminah and live different house, a distance of only a dozen meters. "In that house, my father lived with his mother and family my brother. There were five people in the house, but only the father is sick. Other good health," he said.
Rusminah said, his parents kept chickens in the number of tens. Two months ago there were dozens of dead chickens. On Tuesday (8/16/2011) and when R had fallen ill, a chickens also died without known cause.
According Rusminah, chicken deaths for residents in the neighborhood, was common. Including when two months ago her parents died a dozen chickens.
"Every year is like that. Not only my father is dead chicken, the chicken was also a lot of neighbors who died," he said.
Singkawang - Residents of Bukit Batu Village, Rusminah was worried about parents', R (70).
For when Rusminah take Mr. R to RS Hope Together, Thursday (11/08/2011) night, hospital officials declare R as suspect bird flu (H5N1).
That same evening, R directly referred to Dr. Abdul Aziz Hospital. After one night her parents to undergo treatment, Rusminah received good news from the hospitals.
"Last night I was worried. But now it's quiet. He said, my parents do not anything," said Tribune Rusminah when met at the Hospital Dr. Abdul Aziz, on Friday (08/12/2011).
According Rusminah Thursday night R fever. While since three days earlier, R cough and shortness of breath. Conditions so that makes Rusminah parents checked into the hospital.
R Rusminah and live different house, a distance of only a dozen meters. "In that house, my father lived with his mother and family my brother. There were five people in the house, but only the father is sick. Other good health," he said.
Rusminah said, his parents kept chickens in the number of tens. Two months ago there were dozens of dead chickens. On Tuesday (8/16/2011) and when R had fallen ill, a chickens also died without known cause.
According Rusminah, chicken deaths for residents in the neighborhood, was common. Including when two months ago her parents died a dozen chickens.
"Every year is like that. Not only my father is dead chicken, the chicken was also a lot of neighbors who died," he said.
Thursday, August 11, 2011
Bird Flu Attack One Village at Sidrap
Thursday, August 11, 2011 19:42:32 PM 70 HITS
IST
"I have not said whether Sidrap sterile from bird flu virus attacks. In fact, one another village which was originally declared it safe to influenza virus has been infecting one another village," said Head of Department of Livestock and Fisheries District Sidrap, Abd Aziz on Wednesday, 10 August.
Aziz lamented the lack of public awareness of the dangers of bird flu disease to livestock. In fact, beber Azis, the institute has conducted the socialization and education about the dangers and prevention of Avian Influenza in high-risk areas or areas that do not terwabah.
"But, it turns out there are still people who do not realize this by removing the chickens that died of bird flu in the river," he complained.
, The Head of District Health Office Sidrap HA Irwansyah, say, Sidrap declared bird flu endemic areas and resulted in the death of 235,000 poultry birds. Bird flu has attacked the 11 districts in Sidrap.
However, Irwansyah have not found any indication of the citizens affected by the AI virus. "Until now, not found in Sidrap residents who suspect bird flu," he said.
In Pinrang, public awareness of bird flu is quite high. It is recognized veterinarian, Elvi Martina. In fact, he explained, the AI virus had spread to the border Baranti (Sidrap) to Tiroang (Pinrang) and District Mattiro Bulo (Pinrang).
"In Pinrang, quickly controlled because the level of public awareness of the faster response. They immediately report any poultry that died suddenly had even one tail," said Elvi
IST
IST
Lying. Avian Influenza Control Officer Hj PDSR Syamsiar, while combing the farm declared endemic Avian Influenza (AI) or bird flu H5N1 in the village causes Tanete, Kec.Maritenggae, Wednesday, August 10.
Sidrap, DAWN - District Sidrap the egg and chicken production centers in South Sulawesi is not completely sterile from the H5N1 virus causing bird flu.
Information obtained DAWN, bird flu has been endemic in a village in the North Bulo Sidrap previously declared safe from viruses.
Lying. Avian Influenza Control Officer Hj PDSR Syamsiar, while combing the farm declared endemic Avian Influenza (AI) or bird flu H5N1 in the village causes Tanete, Kec.Maritenggae, Wednesday, August 10.
Sidrap, DAWN - District Sidrap the egg and chicken production centers in South Sulawesi is not completely sterile from the H5N1 virus causing bird flu.
"I have not said whether Sidrap sterile from bird flu virus attacks. In fact, one another village which was originally declared it safe to influenza virus has been infecting one another village," said Head of Department of Livestock and Fisheries District Sidrap, Abd Aziz on Wednesday, 10 August.
Aziz lamented the lack of public awareness of the dangers of bird flu disease to livestock. In fact, beber Azis, the institute has conducted the socialization and education about the dangers and prevention of Avian Influenza in high-risk areas or areas that do not terwabah.
"But, it turns out there are still people who do not realize this by removing the chickens that died of bird flu in the river," he complained.
, The Head of District Health Office Sidrap HA Irwansyah, say, Sidrap declared bird flu endemic areas and resulted in the death of 235,000 poultry birds. Bird flu has attacked the 11 districts in Sidrap.
However, Irwansyah have not found any indication of the citizens affected by the AI virus. "Until now, not found in Sidrap residents who suspect bird flu," he said.
In Pinrang, public awareness of bird flu is quite high. It is recognized veterinarian, Elvi Martina. In fact, he explained, the AI virus had spread to the border Baranti (Sidrap) to Tiroang (Pinrang) and District Mattiro Bulo (Pinrang).
"In Pinrang, quickly controlled because the level of public awareness of the faster response. They immediately report any poultry that died suddenly had even one tail," said Elvi
Sidrap,Indonesia ..likely 400,000 birds dead so far
Sentra's Largest Animal Attacks Bird Flu
FRIDAY, 11 AUGUST 2011
Sidrap - Tanete Village, District Maritengngae known as one of the largest centers of layer chicken farms in the district Sidrap again attacked by the bird flu outbreak.
This is well proved, that the deaths of poultry from bird flu had been declining, but by no means been declared sterile. H5NI deadly virus is thought to re-plagued large number of farms in the village of Tanete, District Maritengngae,. Even so, employers chickens at the site of the largest egg sac was closed and seemed reluctant to report a dead chicken.
Indication of the H5N1 virus outbreaks re Tanete or location in the village centers of the largest farms in this Sidrap, allowed the Head of Animal Husbandry Department (Disnak) Sidrap, H Abd Azis. "No ethical entrepreneur's name, but the suspicion of bird flu in the village was almost true. Therefore, today we have dropped the entire stock of 60 thousand doses of vaccine over there," Aziz said when contacted Wednesday, August 10, yesterday.
The issue today, advanced Azis, not all employers chickens, laying hens, especially farmers in the village of Tanete would open with what happened to him. In fact, the information is necessary no matter how small government. "That's the problem. Maybe with his closed it, deems could help them from losses due to bird flu. In fact, the facts do not, but the evidence is endemic egg and chicken prices remained stable and even increased," Azis palm. Aziz explained so far, cases of poultry deaths was far fewer than a few days ago.
Total poultry deaths has reached 235 thousand whole tail. These data, beyond the dead chickens that were not reported to Disnak residents. "According to the data that goes into the dead birds as much as 235 Disnak tail. But I expect that all, including dead chickens that are not reported to reach approximately 400 thousand heads." Azis said. Based on the calculations, the loss of farmers over bird flu outbreak in Sidrap reached more than Rp20 billion. "Count-count by comparing the average price of such worth Rp60 thousand laying hens, broilers and chicken Rp25 Rp30 thousand thousand each tail," he said. Compared to last 2005 events, where the chicken deaths of nearly 400 thousand birds, the current outbreak is much worse.
The assumption, said Aziz, the current population is very much compared to 2005, but not before residents can barely do anything and no terms of vaccine. The difference is now the virus can be overcome, "ketusnya.
FRIDAY, 11 AUGUST 2011
Sidrap - Tanete Village, District Maritengngae known as one of the largest centers of layer chicken farms in the district Sidrap again attacked by the bird flu outbreak.
This is well proved, that the deaths of poultry from bird flu had been declining, but by no means been declared sterile. H5NI deadly virus is thought to re-plagued large number of farms in the village of Tanete, District Maritengngae,. Even so, employers chickens at the site of the largest egg sac was closed and seemed reluctant to report a dead chicken.
Indication of the H5N1 virus outbreaks re Tanete or location in the village centers of the largest farms in this Sidrap, allowed the Head of Animal Husbandry Department (Disnak) Sidrap, H Abd Azis. "No ethical entrepreneur's name, but the suspicion of bird flu in the village was almost true. Therefore, today we have dropped the entire stock of 60 thousand doses of vaccine over there," Aziz said when contacted Wednesday, August 10, yesterday.
The issue today, advanced Azis, not all employers chickens, laying hens, especially farmers in the village of Tanete would open with what happened to him. In fact, the information is necessary no matter how small government. "That's the problem. Maybe with his closed it, deems could help them from losses due to bird flu. In fact, the facts do not, but the evidence is endemic egg and chicken prices remained stable and even increased," Azis palm. Aziz explained so far, cases of poultry deaths was far fewer than a few days ago.
Total poultry deaths has reached 235 thousand whole tail. These data, beyond the dead chickens that were not reported to Disnak residents. "According to the data that goes into the dead birds as much as 235 Disnak tail. But I expect that all, including dead chickens that are not reported to reach approximately 400 thousand heads." Azis said. Based on the calculations, the loss of farmers over bird flu outbreak in Sidrap reached more than Rp20 billion. "Count-count by comparing the average price of such worth Rp60 thousand laying hens, broilers and chicken Rp25 Rp30 thousand thousand each tail," he said. Compared to last 2005 events, where the chicken deaths of nearly 400 thousand birds, the current outbreak is much worse.
The assumption, said Aziz, the current population is very much compared to 2005, but not before residents can barely do anything and no terms of vaccine. The difference is now the virus can be overcome, "ketusnya.
Sunday, August 7, 2011
Medicago reports positive Phase II final results for its avian flu pandemic vaccine
QUEBEC CITY, Jun 30, 2011, 2011
- Phase II part B confirms results obtained in Phase II part A -
- Company's results continue to be amongst the best for influenza vaccine manufacturing technologies -
Medicago Inc. (TSX: MDG) a biotechnology company focused on developing highly effective and competitive vaccines based on proprietary manufacturing technologies and Virus-Like Particles (VLPs), today reported positive final results from a Phase II human clinical trial with its H5N1 Avian Influenza VLP vaccine candidate ("H5N1 vaccine"). The vaccine induced a solid immune response and was found to be safe and well tolerated.
"These positive Phase II clinical trial results continue to demonstrate that our rapid plant-based vaccine technology produces VLP vaccines that are safe and among the most effective of the industry," said Andy Sheldon, President and CEO of Medicago. "Our Phase II part B data confirms the solid results obtained in Phase II part A for optimal dosing. In addition, our results demonstrated similar efficacy in the older and younger volunteer age groups which is a potential differential advantage over other technologies."
"We soon expect to have the capacity to commercially produce these vaccines as our U.S. vaccine facility in North Carolina will be operational this fall. In addition, we believe these results further support the effectiveness of our rapid plant-based vaccine platform and the development of our seasonal flu vaccine candidate which we intend to proceed with a U.S. clinical trial in the second half of the year," continued Mr. Sheldon.
[click on title for full article]
- Phase II part B confirms results obtained in Phase II part A -
- Company's results continue to be amongst the best for influenza vaccine manufacturing technologies -
Medicago Inc. (TSX: MDG) a biotechnology company focused on developing highly effective and competitive vaccines based on proprietary manufacturing technologies and Virus-Like Particles (VLPs), today reported positive final results from a Phase II human clinical trial with its H5N1 Avian Influenza VLP vaccine candidate ("H5N1 vaccine"). The vaccine induced a solid immune response and was found to be safe and well tolerated.
"These positive Phase II clinical trial results continue to demonstrate that our rapid plant-based vaccine technology produces VLP vaccines that are safe and among the most effective of the industry," said Andy Sheldon, President and CEO of Medicago. "Our Phase II part B data confirms the solid results obtained in Phase II part A for optimal dosing. In addition, our results demonstrated similar efficacy in the older and younger volunteer age groups which is a potential differential advantage over other technologies."
"We soon expect to have the capacity to commercially produce these vaccines as our U.S. vaccine facility in North Carolina will be operational this fall. In addition, we believe these results further support the effectiveness of our rapid plant-based vaccine platform and the development of our seasonal flu vaccine candidate which we intend to proceed with a U.S. clinical trial in the second half of the year," continued Mr. Sheldon.
[click on title for full article]
FDA Authorizes New Hemispherx Biopharma Clinical Trial of Intranasal Ampligen(R) With Seasonal Influenza Vaccine
Press Release Source: Hemispherx Biopharma, Inc. On Wednesday July 20, 2011, 8:00 am EDT
First Clinical Application of Ampligen(R) Intranasally
Excerpt:
PHILADELPHIA, July 20, 2011 (GLOBE NEWSWIRE) -- Hemispherx Biopharma, Inc. (NYSE Amex:HEB) (the "Company" or "Hemispherx") today announced it has received U.S. Food Drug Administration (FDA) authorization to proceed with the initiation of a new clinical trial of intranasal Ampligen(R) [rintatolimod; poly(I).poly(C12,U)] used in conjunction with commercially approved seasonal influenza vaccine. The FDA authorization also requests that certain protocol amendments and pre-clinical items be filed to the Investigational New Drug (IND) Application; these requests are not expected to affect the implementation or timing of the clinical study which will involve healthy volunteers. The primary objective of this study is to evaluate the safety of three cycles of intranasal Ampligen(R) administered three days following each intranasal dose of seasonal influenza vaccine. Other objectives include evaluation of various immune responses to the trivalent seasonal influenza vaccine administered intranasally with and without Ampligen(R). Ampligen(R), a toll-like receptor 3 (TLR3) agonist, is an experimental therapeutic in advanced clinical development for the potential treatment of Chronic Fatigue Syndrome (CFS), an enigmatic disorder which may have certain viral "footprints".
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A similar study of Ampligen(R) and a seasonal influenza vaccine in mice resulted in cross-protection of the mice against a pandemic form of avian influenza (H5N1). Evidence for cross-reactivity against pandemic forms of avian H5N1 influenza virus will be investigated as one of the objectives of this study. One goal of this approach is to generate protective mucosal immunity against newly emerging strains of H5N1 with pandemic potential using Ampligen(R) as a mucosal adjuvant with trivalent seasonal influenza vaccine.
First Clinical Application of Ampligen(R) Intranasally
Excerpt:
PHILADELPHIA, July 20, 2011 (GLOBE NEWSWIRE) -- Hemispherx Biopharma, Inc. (NYSE Amex:HEB) (the "Company" or "Hemispherx") today announced it has received U.S. Food Drug Administration (FDA) authorization to proceed with the initiation of a new clinical trial of intranasal Ampligen(R) [rintatolimod; poly(I).poly(C12,U)] used in conjunction with commercially approved seasonal influenza vaccine. The FDA authorization also requests that certain protocol amendments and pre-clinical items be filed to the Investigational New Drug (IND) Application; these requests are not expected to affect the implementation or timing of the clinical study which will involve healthy volunteers. The primary objective of this study is to evaluate the safety of three cycles of intranasal Ampligen(R) administered three days following each intranasal dose of seasonal influenza vaccine. Other objectives include evaluation of various immune responses to the trivalent seasonal influenza vaccine administered intranasally with and without Ampligen(R). Ampligen(R), a toll-like receptor 3 (TLR3) agonist, is an experimental therapeutic in advanced clinical development for the potential treatment of Chronic Fatigue Syndrome (CFS), an enigmatic disorder which may have certain viral "footprints".
-snip-
A similar study of Ampligen(R) and a seasonal influenza vaccine in mice resulted in cross-protection of the mice against a pandemic form of avian influenza (H5N1). Evidence for cross-reactivity against pandemic forms of avian H5N1 influenza virus will be investigated as one of the objectives of this study. One goal of this approach is to generate protective mucosal immunity against newly emerging strains of H5N1 with pandemic potential using Ampligen(R) as a mucosal adjuvant with trivalent seasonal influenza vaccine.
Harnessing the immune system's arsenal: producing human monoclonal antibodies for therapeutics and investigating immune responses
Abstract
Monoclonal antibody technology has undergone rapid and innovative reinvention over the last 30 years. Application of these technologies to human samples revealed valuable therapeutic and experimental insights. These technologies, each with their own benefits and flaws, have proven indispensable for immunological research and in our fight to provide new treatments and improved vaccines for infectious disease.
Introduction
Excerpt:
This article will explore the history and current state of monoclonal antibody technology and how it has contributed to therapeutics, both through direct clinical treatments and by providing valuable insights into host–pathogen interactions. Importantly, we will highlight how these technologies help identify factors that produce broadly neutralizing antibodies—antibodies that by virtue of binding to certain epitopes important in the viral life cycle, are able to bind many disparate viral strains and prevent them from infecting their target cells. These antibodies are vital in effective therapeutics and, ultimately, successful vaccine design.
In conclusion
Excerpt:
The current state of monoclonal antibody technology is enabling exciting advancements in immunotherapies and understanding of host–pathogen interactions. Maybe more importantly, it is now evident that insight into our natural immune responses can facilitate rational vaccine development. Thus, the most important lessons may be those we’ve garnered from our bodies’ natural responses; not only can we can capitalize on our strengths, such as targeting of specific pathogenic epitopes, but we can also compensate for our inherent weaknesses, such as the rarity of our most powerful antibodies. In the end, the information we gather from monoclonal antibody technology may be more important than the direct attainment of therapeutics (borrowing from an old adage, catch a man a fish and he’ll eat for a day, but teach a man to fish and he’ll eat for a lifetime). Similarly, by studying what antibodies can teach us, we may someday produce vaccines that eradicate many infectious diseases that have a profound impact on human health such as influenza, hepatitis, or HIV.
Monoclonal antibody technology has undergone rapid and innovative reinvention over the last 30 years. Application of these technologies to human samples revealed valuable therapeutic and experimental insights. These technologies, each with their own benefits and flaws, have proven indispensable for immunological research and in our fight to provide new treatments and improved vaccines for infectious disease.
Introduction
Excerpt:
This article will explore the history and current state of monoclonal antibody technology and how it has contributed to therapeutics, both through direct clinical treatments and by providing valuable insights into host–pathogen interactions. Importantly, we will highlight how these technologies help identify factors that produce broadly neutralizing antibodies—antibodies that by virtue of binding to certain epitopes important in the viral life cycle, are able to bind many disparate viral strains and prevent them from infecting their target cells. These antibodies are vital in effective therapeutics and, ultimately, successful vaccine design.
In conclusion
Excerpt:
The current state of monoclonal antibody technology is enabling exciting advancements in immunotherapies and understanding of host–pathogen interactions. Maybe more importantly, it is now evident that insight into our natural immune responses can facilitate rational vaccine development. Thus, the most important lessons may be those we’ve garnered from our bodies’ natural responses; not only can we can capitalize on our strengths, such as targeting of specific pathogenic epitopes, but we can also compensate for our inherent weaknesses, such as the rarity of our most powerful antibodies. In the end, the information we gather from monoclonal antibody technology may be more important than the direct attainment of therapeutics (borrowing from an old adage, catch a man a fish and he’ll eat for a day, but teach a man to fish and he’ll eat for a lifetime). Similarly, by studying what antibodies can teach us, we may someday produce vaccines that eradicate many infectious diseases that have a profound impact on human health such as influenza, hepatitis, or HIV.
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