Influenza Virus Mashup

Via The Wall Street Journal: North Korea Fights H1N1. Excerpt:

North Korea sent out a nationwide alert in recent days about the apparent worsening spread of H1N1 flu there, according to an aid group with contacts in the country. 

The notice by the Seoul-based Buddhist aid group Good Friends follows the South Korean government’s shipment of 400,000 doses of the flu treatment Tamiflu and 100,000 doses of the treatment Relenza to its impoverished neighbor earlier this month amid fears that a delayed response to the disease in the North could lead to serious consequences for the South. 

Good Friends said this week that North Korean officials had issued a statement that said patients suffering from the disease should be given priority. The group said the statement was of a type issued only twice before, for seriously wounded soldiers during the 1950-1953 Korean War and for a deadly skirmish with South Korea in 2002. 

The true picture within highly restrictive North Korea is difficult to determine. Officials there couldn’t be reached.

(Wed, 30 Dec 2009 13:40:00 +0000)

# 4202

Via Ida at BFIC (Bird Flu Information Corner)  –a  joint venture between Kobe University in Japan and the Institute of Tropical Disease, Airlangga University, Indonesia – we get this translation of the first confirmation of human H5N1 infections and deaths out of Indonesia for 2009.

Indonesia has adopted a policy of only rarely providing updates (the last was in January) of the total number of Human infections from bird flu.   

According to this report, 19 of 20 known cases died.

Indonesia ::: H5N1 situation update 2009

December 30, 2009

Since 1 January to 28 December 2009, a total 20 H5N1 cases reported in Indonesia. Of those confirmed cases, 19 have been fatal. First H5N1 case was reported from Bogor on 9 January, and latest was reported from South Jakarta on 23 September 2009.

 

Total cumulative number of H5N1 in Indonesia since 2005 to 2009 is 161 with 134 deaths.

 

This information is broadcasted by Public Communication Center, General Secretary Ministry of Health. Further information is available at: phone 021-52907416-9, fax 52921669, call center 021-30413700, or e-mail puskom.publik@yahoo.co.id, info@puskom.depkes.go.id, kontak@puskom.depkes.go.id.

 

Source: Ministry of Health Republic of Indonesia.

http://www.depkes.go.id/index.php?option=news&task=viewarticle&sid=3663

South Jakarta and Bogor, Java, Indonesia

===AvianInfluenzaIndonesia===

The World Health Organization continues to show no cases out of Indonesia for 2009, with its last update on December 21st. 

(Wed, 30 Dec 2009 13:07:00 +0000)

# 4201

Although the North Korean government has had very little to say about it, reports continue to filter out of that closed, impoverished country that suggest the pandemic virus is having a serious impact.

Earlier this month, in a humanitarian gesture, South Korea offered emergency supplies (including Tamiflu) to the north, to help them fight the pandemic (South Korea Offers Pandemic Humanitarian Aid To The North).

Today, the Wall Street Journal has a report – gleaned from information provided by the Good Friends aid group working in North Korea – that suggests the situation in that country may be more serious than previously thought.

     DECEMBER 30, 2009, 6:50 A.M. ET

North Korea Fights H1N1

By JAEYEON WOO

North Korea sent out a nationwide alert in recent days about the apparent worsening spread of H1N1 flu there, according to an aid group with contacts in the country.

 

The notice by the Seoul-based Buddhist aid group Good Friends follows the South Korean government’s shipment of 400,000 doses of the flu treatment Tamiflu and 100,000 doses of the treatment Relenza to its impoverished neighbor earlier this month amid fears that a delayed response to the disease in the North could lead to serious consequences for the South.

 

Good Friends said this week that North Korean officials had issued a statement that said patients suffering from the disease should be given priority. The group said the statement was of a type issued only twice before, for seriously wounded soldiers during the 1950-1953 Korean War and for a deadly skirmish with South Korea in 2002.

 

The true picture within highly restrictive North Korea is difficult to determine. Officials there couldn’t be reached.

(Continue . . . )

(Wed, 30 Dec 2009 12:50:00 +0000)

# 4200

Were it not for concerns over the potential for the pandemic H1N1 virus to acquire additional genetic changes via reassortment, the discovery of the virus in swine would be a non-story by now.

After all, as a swine-origin influenza virus, novel H1N1 is understandably pretty comfortable in a swine host.

Just yesterday we saw a report of a 16th pig farm in South Korea reporting the infection.  In recent months farms in Europe, North and South America, and Asia have reported all livestock infections.  

 

Pigs are susceptible to a variety of human, avian, and swine influenza viruses.  They can even be infected by two different flu viruses at the same time.  

As such, they are considered to be good `mixing vessels’ for viruses, and could help produce a hybrid `reassorted’ virus.  One that could potentially have pandemic potential.

Of course, that’s a pretty rare occurrence.  

You not only need two compatible flu viruses to inhabit the same cell at the same time, it needs to produce a `fit’ hybrid.  One that replicates well, is adapted to human receptor cells, and is easily transmitted.

It appears that our 2009 pandemic virus bounced around in pigs for many years, picking up multiple mutations (via reassortment), before it found the right combination to jump to humans.

It could take years, perhaps decades, before we see that sort of thing happen again.  

Or it could happen tomorrow.

The infected swine detected in this report from Hong Kong came from the Chinese mainland where little or no testing occurs, and bio security on farms often leaves much to be desired.

Other influenza viruses, including the H5 and H9 avian viruses, are also known to circulate among domesticated livestock in that region, and that has some scientists concerned.

The good news here is that testing so far has shown no gene reassortment to have occurred, and the virus detected remains genetically similar to the H1N1 pandemic virus.

This from News.gov.hk.

 

Pigs test positive for human swine flu

December 30, 2009

The University of Hong Kong’s influenza virus surveillance programme found five samples taken from pigs at the Sheung Shui Slaughterhouse on December 17 tested positive for the human swine influenza virus, the Food & Environmental Hygiene Department said today.

 

This is the third time the programme uncovered positive samples. No gene reassortment has occurred and the virus remained genetically similar to the human swine flu viruses regularly found in people. The flu virus is believed to have been transmitted from people to pigs.

 

The concerned samples were taken from pigs imported from the Mainland. The department informed the Mainland authorities, and they have strengthened monitoring of registered farms that supply live pigs to Hong Kong.

 

The World Health Organisation, World Organisation for Animal Health, Food & Agriculture Organisation of the United Nations and World Trade Organisation state that pork and pork products which are handled properly and thoroughly cooked are not a source of human swine flu infection.

(Continue . . .)

Via Xinhua: A/H1N1 death toll rises to 53 in Vietnam. Excerpt:

Vietnam confirmed one more death from the A/H1N1 influenza, bringing the country’s total number of flu deaths to 53 so far this year, said a report of the website of the Vietnamese Ministry of Health on Wednesday.     

The patient was a 64-year-old Vietnamese man from the northern Hung Yen province. He had a history of high blood pressure.     

The man showed symptoms of fever and coughing on Dec. 6. He was taken to the country’s Army Central Hospital 108 three days later with diagnosis of pneumonia.     

The patient was then transferred to the National Hospital for Tropical Diseases on Dec. 18 due to his health condition deterioration.     

The patient died on Dec. 25. His samples tested positive to theA/H1N1 virus, said the report.

Via a very good blog called Swine flu in Italy: Second peak, maybe. Excerpt:

According to the last report of the Italian Ministry of Health, updated on December 24th, in Italy the deaths are 188. Campania accounts for 25% of the fatal cases (47 deaths). But Campania accounts for only 10% of the Italian population.

I’ve been fretting about Latin America, but Europe has been an oddly under-reported region of this pandemic. And Italy has been among the most under-reported countries in Europe. I’m glad to have this resource.

Via The Himalayan Times: Hospitals asked not to disclose swine flu deaths. Excerpt:

Janamaitri Hospital today revealed that as per the request of the government, the hospital did not make public the patients who succumbed to Pandemic Influenza A (H1N1). 

“Although we have reported first case of death to Ministry of Health and Population, World Health Organisation and Avian Influenza Control Project (AICP), they have requested us not to reveal it,” said Dr Ajay Pradhan, consultant physician of the hospital. He said that such a decision was taken since it was likely to cause panic among people. 

The government on Monday disclosed the incomplete report after they confirmed that two persons have died of swine flu in the country thus far. 

Addressing a press conference here, Dr Pradhan said that the 31-year-old female from Chitwan who succumbed to the disease had been admitted on November 5 and had been kept on a ventilator for 25 days. He also accused the government of its inability in detecting the cases on time and that many hospitals were giving the medicine for pneumonia to swine flu patients. 

He revealed that the two people who succumbed to the disease were given Tamiflu but said others were given general care. 

“The performance of National Public Health Laboratory is not satisfactory as it takes around seven days in sending confirmed reports,” Pradhan said, adding that the treatment against swine flu should start within 48 hours of infection. 

He further said that the rapid test kit was not reliable for confirming the flu. He also warned that the second wave of swine flu could strike any time and that the government should be prepared to combat it. 

Dr Shyam Sundar Mishra, coordinator of AICP, however, said that they could not officially declare the death as they were complicated and needed further investigation in a subtle way.

Via Xinhua: A/H1N1 death toll rises to 49 in Hungary. Excerpt:

Hungary reported Tuesday three more deaths from influenza A/H1N1, bringing to 49 the death toll caused by the epidemic in the country, according to local media.     

Two men aged 93 years and 30 years respectively died from A/H1N1 flu in Vas county. The third victim was an infant in the southern city of Szeged.

Via The Globe and Mail, a long and fascinating report on how vaccines became big business: The rise of Flu Inc. Excerpt:

It was not the talk Dr. Michael Ossi planned to give when he was summoned to Washington in the fall of 2003 to brief health officials on Capitol Hill. 

Dr. Ossi, an infectious disease expert with British pharmaceutical giant GlaxoSmithKline PLC, had been asked to meet with government officials on how to respond to a deadly problem unfolding halfway around the world. 

In Asia, entire flocks of birds were dying from a virus called H5N1, better known as avian flu. A particularly virulent strain of influenza, H5N1 had for years been confined mostly to birds because their higher body temperatures provided an ideal environment for the bug to proliferate. 

But pockets of people were becoming infected in Asia, setting off alarm bells for health officials around the globe. When it spread among humans, the consequences were unusually fatal. Roughly 60 per cent of those infected with H5N1 died, making it three times deadlier than the 1919 Spanish Flu, according to the World Health Organization. 

Dr. Ossi came to the hastily arranged gathering of health officials and academics expecting to talk to them about his company’s research into anti-viral drugs and flu vaccine. 

But the health experts clustered around a handful of tables were not interested in hearing about the science behind such products. They had much more pressing concerns. 

They only had one question, Dr. Ossi recalls: “How much can you make and how fast can you make it?”