Influenza Virus Mashup

(Fri, 29 Jan 2010 14:38:00 +0000)

# 4205

For readers who may not have followed bird flu outbreaks and reports of human infections in the past, the next few months may seem like a bit of a roller coaster ride.  January through April is traditionally the height of the bird flu season, and reports often come in a staccato fashion.

Some of these reports will turn out not to be H5N1, while others may simply never be officially verified by their host countries.   Reporting and surveillance still leaves much to be desired, and there are political elements involved as well.

Today we’ve a series of reports out of Indonesia, including a report of two neighbor children in Riau suspected of having the H5N1 virus. These reports come via the considerable efforts of Ida at The Bird Flu Information Corner.

Pekanbaru, Riau ::: Two babies suspected of having bird flu

January 29, 2010

Pekanbaru – Arifin Achmad regional hospital in Pekanbaru received two more bird flu (H5N1) suspect patients from Kabupaten Indragiri Hulu, Riau Province.

Those patients were AN, six months old, and YL, three years and six months old. They both referred to Arifin Achmad hospital on Thursday afternoon and evening.

Both patients were neighbors, resided in Kecamatan Kelayang, Indragiri Hulu. They had contact history with dead chickens.

Patients are now under intensive treatment.

 

(Continue . . . )

This article goes on to relate some details of two other bird flu cases that Arifin Achmad hospital has treated in the past month.  One recovered, while the other died.

Two more reports from BFIC include:

Purbalingga, Central Java ::: Thousands of layer chicken positively die of bird flu infection

January 29, 2010

Purbalingga – Avian Influenza (AI) or bird flu killed thousands of layer chickens in Desa Tegalpingen and Tumanggal, Kecamatan Pengadegan, Purbalingga, Central Java. It had been two weeks where people were found to burying and burning bird flu infected birds.

 

Total number of culled chickens within these 2 weeks had reached 5,500 layer chickens within the productive age, 16-18 months. “Each day I burn about 50-60 dead layer chickens,” admitted a local of Desa Tegalpingen who had lost about 500 chickens within these couple of weeks.

 

Depopulation was done by burning the dead chicken to prevent possible transmission to other farms because Pengadegan is one of layer chicken central.

 

(Continue . . .)

 

 

Indramayu, West Java ::: Bird flu attacks chickens and birds

January 29, 2010

Indramayu – Hundreds of chicken and birds suddenly died in Desa Pasekan and Brondong, Kecamatan Pasekan, Kabupaten Indramayu. Died chickens showed discharge from nose and bluish carcass. One of the farmers testified that he found his chickens had died in the morning whereas they appeared healthy on the previous day.

 

Officials have done control measures by burying dead chickens and spraying disinfection to chicken’s houses.

(Continue . . .)

 

Meanwhile on FluTrackers, Shiloh and Dutchy (about as good a newshound tag-team as exists anywhere) have picked up on an article from Poskota, a Jakarta based newspaper, that warns of the dangers of buying or illegally transporting `uncertified’ chickens which may harbor the H5N1 virus.

In a bit of a cautionary tale, the bottom of the story carries a description of a suspected H5N1 death in Jakarta on the 26th of January, supposedly after the victim bought and slaughtered uncertified chickens.

This is an excellent example of how the newshounds work together and build on each other’s contributions.  For the full translation of the entire article, and analysis, you can visit the FluTrackers thread HERE.   

Via Balkan Insight.com: Romania H1N1 Death Toll Reaches 119. Excerpt:

The number of people dead due to swine flu reached 119 in Romania, while the number of infections stands at 6,938, according to data released by the Health Ministry on Friday. 

One more person died and seven new infections of the A/H1N1 flu virus were reported over the past 24 hours in Romania. 

Most cases of the virus were registered in Bucharest.

(Fri, 29 Jan 2010 12:47:00 +0000)

# 4304

The World Health Organization has updated their H5N1 case count, adding the four cases which we’ve discussed here, and on the flu forums, over the past several weeks. 

Thus far, Egypt is the only country to officially report human infection with the H5N1 virus in 2010, although Indonesia and Vietnam have both had `suspected’ cases mentioned in their local press.

Curiously, the Arabic press reported the first victim – the 20-year-old female from Baniswief governorate – as having died more than a week ago.   We’ll have to wait to see if there is a clarification forthcoming on this case. 

Avian influenza - situation in Egypt - update 27

 

28 January 2010 — The Ministry of Health of Egypt has announced four new cases of human H5N1 avian influenza infection. The cases are not linked epidemiologically.

 

The first case is a 20-year-old female from Baniswief governorate. She developed symptoms on 6 January and was hospitalized on 11 January, where she received oseltamivir treatment.

 

The second case is a 1-year-old male from Dakahalya governorate. He developed symptoms on 7 January and was hospitalized on 12 January, where he received oseltamivir treatment.

 

The third case is a 3-year-old male from Assuit governorate. He developed symptoms on 19 January and was hospitalized on 21 January, where he received oseltamivir treatment.

 

The fourth case is a 45-year-old male from Shargea governorate. He developed symptoms on 12 January and was hospitalized on 19 January, where he received oseltamivir treatment.

 

All four are currently in a stable condition in hospital. Investigations into the source of infection indicated that all four cases had exposure to sick and dead poultry.

 

The cases were confirmed by the Egyptian Central Public Health Laboratories, a National Influenza Center of the WHO Global Influenza Surveillance Network (GISN).

 

Of the 94 laboratory confirmed cases of Avian influenza A(H5N1) reported in Egypt, 27 have been fatal.

The WHO has also updated their global case count table. As it is now too large to display properly in this blog, I’ve edited out the years 2003-2006.  

Edited Table (click to view in entirety)

From Helen Branswell (CP_Branswell) on Twitter:

Egypt: 4 new cases of H5N1 aka #birdflu. Cases not linked, all had contact w/ poultry. Boy, their case count keeps on rising. #3 w/ a bullet

I don’t know her source—I can’t find anything in my usual Egyptian sources—but no doubt we’ll have details in the morning.

Update: WHO has published Update 27 on avian flu in Egypt, reporting the four new cases. All are said to be in stable condition.

WHO has also published its first cumulative tally of human H5N1 cases for 2010, including the Egyptian cases but reporting no new cases in Indonesia.

Our chief medical officer of health gave a wrap-up news conference today, effectively signalling the end of the second wave of H1N1 in British Columbia. Here’s how the Vancouver Sun reported it: B.C. residents encouraged to get H1N1 vaccine so third wave avoided. Excerpt:

With 40 per cent of B.C’s population immunized against the H1N1 flu virus provincial health authorities are hoping there will be no significant “third wave” outbreak of the flu within the next few months. 

Dr. Perry Kendall, the B.C. Medical Health Officer, said Thursday that the province had a plentiful supply of H1N1 vaccine and persons not yet vaccinated should have the jab in order to reduce the likelihood of a third wave. 

With the Olympics about to begin and with the hundreds of thousands of visitors, athletes and media coming to Vancouver persons not yet immunized should do so, he said. 

“This vaccine will offer long lasting protection and is a good insurance policy,” said Kendall. 

He said vaccinations will be available to Olympic visitors. 

The first wave of infections occurred in May last year with the second more serious wave peaking in late October. 

Kendall said the virus caused 55 deaths in B.C. with 1,032 persons hospitalized — 20 per cent of whom needed intensive care. Most of the persons affected by H1N1 were persons under the age of 20. 

There have been no deaths reported in the last week.

Via The Jakarta Post: Bird flu outbreak kills fowl in Lampung regency. Excerpt:

Local husbandry agency in East Lampung regency, Lampung, reported Friday that bird flu outbreak has killed hundreds of fowl in three districts during the first month of the year. 

Dewanto, a top official at the agency, told Antara news agency that at least 1,176 fowl died of the deadly flu in seven village in the Sukadana, Purbolinggo and Marga Tiga districts during January. 

The number was bigger than the total number of  fowl killed by bird flu throughout last year, which was 708.

Meanwhile, Ida at Bird Flu Information Corner has two reports on separate B2B H5N1 outbreaks in different parts of Java, as well as two babies in hospital in Pekanbaru with suspected H5N1.

Via The Star: Beware! Swine flu on its way back. Excerpt:

Swine flu is expected to hit Christchurch well before winter, and medical authorities are looking to vaccinate health workers from next week. 

The second wave of the highly infections H1N1 virus is expected here by April, following an early strike of the virus in the northern hemisphere. 

Canterbury Medical Officer of Health Alistair Humphrey said medical workers were being encouraged to get the single strain vaccine for the virus now so the public health service would continue to operate when the virus hit. 

A second vaccine that will cover the swine flu virus and two seasonal flu strains would arrive in early March. This would go to “at risk” groups first - pregnant women, vulnerable children in low decile or Maori or Pacific communities, and people with certain medical conditions. 

The bulk of the second vaccine would be made available to the general public in late March or early April. Historically, the second wave of a flu virus can be worse. Dr Humphrey said tests were currently being conducted on this, but they did not yet know if the virus would be worse this year. 

He said in the United States, it was more severe in areas unaffected during the first wave. 

“We have got to get the vaccine out quickly to those who need it most,” he said. 

“Last year all we had was Tamiflu … If everyone gets vaccinated (this year) nothing will happen.”

I love the expression “low decile communities.” Demographers divide populations into deciles, or tenths, based on income. So a low decile community must mean “poor people.”

(Fri, 29 Jan 2010 02:26:00 +0000)

# 4303

While the H5N1 bird flu virus has thus far not managed to adapt to humans well enough to spread among them easily, there are scientists and governments around the world who believe that may still happen.   

With a CFR (Case Fatality Ratio) that has run 50% or greater in some countries, an outbreak would be far worse than anything the H1N1 virus has produced.  

Although the probability of this happening is unknown, having a vaccine on hand would greatly reduce the impact of an outbreak.

Singapore, with a population of roughly 5 million and neighbor to bird flu endemic Indonesia, is looking to stockpile roughly 1 million doses of H5N1 vaccine.

This is a bit of a gamble, of course, since vaccines have a limited shelf life; generally 18 months to 2 years.  

This from the Singapore Times.

Jan 29, 2010

1m doses of bird flu vaccine

 

By Jessica Jaganathan

THE Health Ministry will be buying about one million doses of H5N1 avian flu pre-pandemic vaccine soon.

 

Health Minister Khaw Boon Wan revealed yesterday that his ministry is evaluating a tender to stock up on the vaccine.

 

‘It’s one of those insurance policies that we have to buy and we will stock it up and hope never to have to use it,’ he said.

 

‘The virus is still out there and it may flare up, so we cannot afford not to do anything.’

 

The World Health Organisation’s director-general, Dr Margaret Chan, had recently said that countries remain ill-prepared for mass outbreaks of the bird flu virus, which affects humans in contact with sick birds.

 

It has a mortality rate of more than 60 per cent, leading to fears that a pandemic with this strain of virus could prove lethal. Scientists also fear that it could achieve efficient human-to-human transmission at any time and trigger a pandemic.

Via The Globe and Mail, a report by Caroline Alphonso: Canada to donate H1N1 vaccine to WHO. Excerpt:

Canada will donate five million doses of H1N1 vaccine to the World Health Organization as demand drops off among Canadians and flu activity slows down in the country. 

The federal government said Thursday that the donation will help the Geneva-based international body in its efforts to redistribute the vaccine to developing countries that couldn’t afford their own supplies. The donation amounts of 10 per cent of the Canada’s total vaccine order and is in line with that of other developed countries, the government said. 

“We are fortunate to be in a position to contribute H1N1 flu vaccine to the WHO to help developing countries now that we have met Canada’s immediate needs,” Canada’s Minister of Health, Leona Aglukkaq, said in a statement. 

Until today’s announcement, the federal government has remained mum on what it would do with its excess supply despite repeated questions from reporters. Other countries, including Germany and Spain, had already announced plans to sell or donate their excess vaccine or scale back their orders. 

The federal government ordered 50.4 million doses from pharmaceutical company GlaxoSmithKline when it was believed that each person needed two shots to be protected. But subsequent clinical trials determined only one dose would be needed to provide immunity. 

Also, appetite for the vaccine has plummeted since December as the second wave of the H1N1 virus has passed. Roughly 45 per cent of Canadians have been vaccinated. 

Even after this donation to the WHO, Canada will be left with tens of millions of unclaimed doses. The federal government could choose to donate more down the line, or it can keep some of the remaining vaccine in reserve in case the virus returns. The vaccine has a shelf life of 18 months.