Influenza Virus Mashup

Via The Argus: Four-year-old dies from swine flu in Brighton. Excerpt:

A little girl has become the first person to die from swine flu in Brighton and Hove. 

Tests carried out on the unnamed four-year-old from Brighton have shown the youngster lost her life after developing complications as a direct result of the virus. 

The youngster, who had no underlying health problems, was taken to the Royal Sussex County Hospital in Brighton after falling ill in November and passed away shortly afterwards. 

Health bosses today urged people to stay calm, be aware of the symptoms of Swine flu and to get vaccinated as soon as they were invited to.

Meanwhile, according to STV News, an adult in Scotland has died of H1N1.

Via MCOT: No new A(H1N1) deaths in health ministry’s weekly report. Excerpt:

No new fatalities related to Influenza Type A(H1N1) have occurred during the past week, said the Public Health Ministry in its weekly report. The country’s total swine flu death toll stands at 198. 

Dr Siriwat Thiptharadol, deputy permanent secretary for public health said the ministry targets  finish giving two million doses of vaccines to high risk groups within March. 

Meanwhile, 30 health staff were infected with Influenza Type A(H1N1) last week. 

Dr Opas Karngawinphong, director of the Bureau of General Communicable Diseases, said 43 more private hospitals are joining the H1N1 vaccine campaign, raising the total number of private hospitals in the vaccination programme for pregnant women to 255. 

So far 53,000 people across the country have been vaccinated, while the highest figure, or 2,000 was recorded in the northern province of Chiang Rai.

(Wed, 27 Jan 2010 12:16:00 +0000)

# 4296

Last night there were a pair of news briefs out of Israel regarding a `bird flu’ outbreak discovered in that country.  These early reports mostly sought to reassure and provided scant details.

Both come from Arutz Sheva, an Israeli news media. 

Bird Flu Discovered at Kibbutz

Reported: 22:45 PM - Jan/26/10

(IsraelNN.com)

An outbreak of bird flu was discovered Tuesday night at a henhouse in Kibbutz Ein Shemer. The disease was found in a henhouse containing about 43,000 hens. Agriculture Ministry workers began Tuesday night marking off the birds to be culled. All agricultural production in the area has been shut down until further notice.

This report was followed by a statement from the Health Ministry.

Health Ministry: No Danger to Humans from Bird Flu

Reported: 23:45 PM - Jan/26/10

(IsraelNN.com)

The Health Ministry said Tuesday that the strain of bird flu discovered earlier would not infect humans. The Ministry said that it had taken steps to protect workers dealing with culling the infected birds, and that in previous incidents of bird flu no humans had been affected.

This muddle of a second statement seeks to reassure that the virus detected posed no danger to humans, but stressed the protective measures workers were taking to prevent infection.   

Not necessarily a contradiction, of course.  Protective measures are taken even when dealing with a LPAI (Low Pathogenic Avian Influenza).

Today we learn from the required OIE filing that the virus is not some LPAI as the initial reports might suggest, but that it is HPAI (Highly Pathogenic) H5N1.

A hat tip to Ironorehopper who posted a summary of  this OIE Report on FluTrackers overnight. 

The link below is to the FT summation.

Highly pathogenic avian influenza, Israel

Information received on 26/01/2010 from Dr Moshe Chaimovitz, Director , Veterinary Services and Animal Health, Ministry of Agriculture and Rural Developement, BEIT DAGAN, Israel

• Summary
  • Report type Immediate notification
  • Start date 24/01/2010
  • Date of first confirmation of the event 26/01/2010
  • Report date 26/01/2010
  • Date submitted to OIE 26/01/2010
  • Reason for notification Reoccurrence of a listed disease
  • Date of previous occurrence 04/01/2008
  • Manifestation of disease Clinical disease
  • Causal agent Highly pathogenic avian influenza virus
  • Serotype H5N1
  • Nature of diagnosis Suspicion, Clinical, Laboratory (basic), Laboratory (advanced), Necropsy
  • This event pertains to the whole country

• New outbreaks
  • Summary of outbreaks
    • Total outbreaks: 1
    • Location(s) - HAIFA (EN SHEMER, HADERA)
      • Total animals affected: Species - Susceptible - Cases - Deaths - Destroyed - Slaughtered
        • Birds - 43000 - 700 - 100 - 0 - 0

• Outbreak statistics
  • Species - Apparent morbidity rate - Apparent mortality rate - Apparent case fatality rate - Proportion susceptible animals lost*
    • Birds - 1.63% - 0.23% - 14.29% - 0.23%
    • * Removed from the susceptible population through death, destruction and/or slaughter

• Epidemiology
  • Source of the outbreak(s) or origin of infection
    • Unknown or inconclusive

• Epidemiological comments
  • The epidemiological investigation is in process.

Israel saw their first outbreaks of H5N1 in 2006, with a return in 2008.  Their last OIE report was filed in August 2008.

The reassurance from the Health Ministry that `the strain of bird flu discovered earlier would not infect humans’, now rings hollow given the OIE report above.  

While the danger to humans may be low, it certainly isn’t zero.  Which makes this less than a sterling example of good risk communication.

The two big concerns right now, however, are whether this virus has spread to other farms, and exactly how did it happen to re-emerge in Israel after an absence of 17 months.

The question of why the virus continues to be reintroduced into an area months or even years after eradication is one that remains largely unanswered.

 

Migratory birds?  Illicit Poultry Trade?   An unknown host reservoir?  

It may well be that all three have been responsible at one time or another.  Or perhaps some other mechanism we are unaware of.

While in the global scheme of things this outbreak may prove to be more of a nuisance than a danger to Israel, it illustrates that the bird flu problem hasn’t gone away.  

Even in countries where the virus isn’t considered endemic.

The Mexican Secretariat of Health on January 25 published its latest update on H1N1. While the total number of confirmed cases is approaching 70,000 and the number of deaths is almost 1,000, it does look as if swine flu is beginning to fade out in Mexico.

Via CNN.com: Canada’s Olympic-sized plan to fight H1N1. Excerpt:

The prospect of potential virus carriers converging on Vancouver, British Columbia, next month from all corners of the world has prompted Canadian and U.S. authorities to exercise abundant caution. 

The U.S. Olympic Committee is strongly urging all its athletes traveling to Vancouver to get the flu vaccination. But some athletes are ignoring the committee’s recommendation, and officials can’t make the vaccines mandatory. 

Although 40 percent of Vancouver-area residents have been vaccinated, these games still offer the virus a nice, big playpen, say health officials. They point out that the West Coast city of more than 2 million is the largest host of any Winter Olympics. 

Like troops advancing across a battlefield, H1N1 has produced two global waves so far. The pandemic’s first wave in April 2009 got the attention of Olympic hopefuls, who often tend to be young. “More young people were being hospitalized and ended up staying in hospitals longer,” said Dr. Reka Gustafson, director of communicable disease control for Vancouver Coastal Health, the regional health care provider. 

H1N1 has claimed 10 lives and led to the hospitalization of more than 250 people in the Vancouver area since the pandemic began, she said. 

“I don’t expect influenza to be a major issue during the Olympic Games,” said Gustafson. “However, you can’t count on that.” 

As a result, officials are preparing for the possibility of a third wave. “We figure that we’ll be able to blunt it quite a bit,” said Vancouver Coastal Health spokeswoman Anna Marie D’Angelo. 

Experts say as few as a dozen flu carriers traveling to attend all 16 days of the games could spread H1N1 to hundreds of people. 

In an extreme scenario, illness could force Olympics coaches to dig deeply into their player reserves for replacements, depending on each sport’s rules, which are set by international governing boards. 

Would flu fears force officials to cancel Olympic events? “In all of pandemic planning it has been recognized for some time that cancellation of mass gatherings is not an effective way to control influenza,” Gustafson said. “I can categorically say that we are not planning that.”

Via the Chicago Tribune: Swine flu: Chicago woman back from brink of death. Excerpt:

After trying for five days to shake “a little cold,” Lisa Amoruso went to the doctor in early November. She complained of chills, aches, fatigue, fever spikes and labored breathing. 

Dr. Jeffrey Nekomoto, her internist, suspected she had swine flu, but the effervescent 40-year-old mother of two from Chicago’s Bridgeport neighborhood didn’t seem that sick. She was talking and joking with him as he measured the oxygen in her blood. 

“His eyes opened up wide, almost bulged out,” said Joe Amoruso, 50, her husband. “He said her blood oxygenation was way too low and that she had to go to an emergency room. Right away. Right now.” 

Though health experts had been warning for months of the H1N1 flu pandemic, Lisa Amoruso had been among those who decided the swine-flu vaccine was too risky for her family. Suddenly she was in Rush University Medical Center’s intensive-care unit, on the verge of becoming one of an estimated 11,000 Americans to die of the virus over the last year. 

She was hooked up to a ventilator to keep her breathing and to a dialysis machine for her failing kidneys. Then, to keep her absolutely still, her doctors put her into an induced paralytic coma. 

The ordeal, which continues despite Amoruso’s emotional homecoming just 11 days ago, was devastating for her family and friends. For weeks, Joe Amoruso, an insurance broker, would be driven to tears repeatedly. As much as he prayed for his wife of 14 years to live, he was frightened that the powerful treatments needed to keep her breathing would leave her in a vegetative state. 

Doctors say that what happened to Lisa Amoruso should be a cautionary tale about how swiftly swine flu can turn lethal. The virus has been in retreat since peaking in November, but it continues to hospitalize people and still kills some. Last week, the Illinois Department of Public Health reported two new deaths and 161 new hospitalizations because of H1N1. In all, 91 Illinoisans have died and 2,894 have been hospitalized. 

Though relatively mild in most cases, the H1N1 virus has differed from the seasonal flu by aggressively targeting younger, otherwise healthy, children and adults, like Amoruso, rather than the elderly. Concerned about another, wintertime spike, medical experts continue to urge the public to get vaccinated.

Just moments ago I discovered the Guardian’s new data bank, World Government Data. I haven’t had a chance to explore it yet, but it could be a remarkable resource for flu and other health issues. Explore it and let me know what you think.

(Wed, 27 Jan 2010 02:51:00 +0000)

# 4295

CIDRAP news tonight has in depth coverage of the Council of Europe hearing into the WHO’s (World Health Organization’s) handling of the H1N1 pandemic.   

Lisa Schnirring, who was up way before I was this morning, monitored the proceedings.

Lisa not only brings us the details of that hearing, she draws on the considerable expertise of two of the best risk communication experts in the world for some analysis of how the WHO might have handled things differently.

Dr. Peter Sandman along with his wife and colleague  Dr. Jody Lanard, M.D.  are risk communications consultants who have produced a wealth of invaluable risk management advice on their website:

I’ve highlighted their work on numerous occasions, including:

Peter Sandman: Swine Flu For Grownups

Experts: `Mild’ Is A Misleading Term For This Pandemic

Peter Sandman On Pandemic Risk Communication

Lisa does her usual terrific job of reporting here, so follow the links to read the article in its entirety.

 

European hearing airs WHO pandemic response, critics’ charges

 

Lisa Schnirring Staff Writer

Jan 26, 2010 (CIDRAP News) – Officials from the World Health Organization (WHO) and a vaccine-maker trade group at a public hearing today defended themselves against allegations from some European politicians that they exaggerated the H1N1 pandemic threat to benefit drug companies.

 

The hearing was conducted by the Council of Europe’s Committee on Social, Health and Family Affairs on the second day of the group’s parliamentary assembly. Yesterday the council rejected a request that the committee’s former leader made to schedule a debate on the theme “False pandemics: a threat to health.” Dr Wolfgang Wodarg, a German physician and epidemiologist, is no longer a council member, because he lost his race in Germany’s September federal election. However, he has been serving as an advisor.

 

The theme of today’s hearing was transparency issues that arise in a pandemic setting. The Council of Europe, a separate entity from the European Union, is known for working on broad issues such as civil rights, economics, and democracy. The group was established after World War II and is made up of elected officials from 47 nations.

 

(Continue . . .)

(Wed, 27 Jan 2010 02:35:00 +0000)

# 4294

Via The Bird Flu Information Corner tonight we get this translation of an article from solopos.com which provides details on the death of a 22 year-old who is suspected to have contracted H5N1.   

This death appears to have occurred on Thursday of last week. 

The victim, who died in a hospital in Kranganyar, had recently traveled from Cirebon, where it is assumed he contracted the virus.

Yesterday, BFIC had a report of another resident of Cirebon, a 40 year-old agricultural extension worker – who is hospitalized with suspected bird flu symptoms.  There is no word at this time of any other links between these two cases.

Ida, at BFIC has posted a map showing the two cities. 

Karanganyar, Central Java ::: Patient presumably dies of bird flu

Karanganyar – A resident of RT 03/ RW XVI Dukuh Josari Desa Wonorejo Jatiyoso, Wardi, 22 years old, presumably died of bird flu or avian influenza (AI) infection on Thursday (21/1).

 

Investigation of local newspaper Espos mentioned victim had high fever and lung infection. Head of Disease Control and Environment Health, Health Service of Kabupaten Karanganyar, Fatkhul Munir, confirmed the information above.

 

Fatkhul assumed victim had contracted bird flu virus in Cirebon. He had been sick when he returned back to Karanganyar, and finally died after had been admitted to hospital.

 

“Report mentioned victim had high fever and lung damage. Wardi also had contact history with birds,” said Fatkhul.

Ida at Bird Flu Information Corner has a report translated from Solo Pos: Karanganyar, Central Java ::: Patient presumably dies of bird flu.

A resident of RT 03/ RW XVI Dukuh Josari Desa Wonorejo Jatiyoso, Wardi, 22 years old, presumably died of bird flu or avian influenza (AI) infection on Thursday (21/1). 

Investigation of local newspaper Espos mentioned victim had high fever and lung infection. Head of Disease Control and Environment Health, Health Service of Kabupaten Karanganyar, Fatkhul Munir, confirmed the information above. 

Fatkhul assumed victim had contracted bird flu virus in Cirebon. He had been sick when he returned back to Karanganyar, and finally died after had been admitted to hospital. 

“Report mentioned victim had high fever and lung damage. Wardi also had contact history with birds,” said Fatkhul.