Influenza Virus Mashup

Via Bernama: Only 20,000 Doses Of H1N1 Vaccine Left - Ismail.

The Health Ministry has urged those in the high risk group such as pregnant mothers, people with asthma and diabetes and those suffering from heart or kidney ailments to obtain H1N1 vaccinations. 

Health Director-General Tan Sri Dr Mohd Ismail Merican said at the moment there were only 20,000 doses of the vaccine available throughout the country, of which nearly 10,000 doses could be obtained from Johor. 

“The vaccine can be obtained from facilities run by the ministry and the private sector,” he said in a statement. 

He said that up till June 25 this year, 354,482 people had been vaccinated comprising the ministry’s 97,272 frontline staff, 90,883 frontline staff from other agencies such as the police, immigration and armed forces, and 166,327 members of the public. 

He said 60 new cases were confirmed during the week between June 20 and 26 compared to 81 cases during the previous week, making a total of 15,212 cases in the country so far. 

One death was reported during the week, involving a three-year-old child, bringing the total death recorded in the country so far to 89 cases.

Via The Pnom Penh Post: Swine flu strikes PM, five other officials. Excerpt:

Prime Minister Hun Sen contracted the A(H1N1) influenza virus late last week, and five other government officials – including a deputy prime minister and two senior ministers – have since exhibited signs of it, according to a statement issued Tuesday by Health Minister Mam Bunheng. 

According to the statement, Hun Sen was likely exposed to the virus, commonly known as swine flu, during or immediately after a meeting at the Council of Ministers last Friday. 

He has since received treatment from “very professional Cambodian doctors”, and “the health of Samdech is recovering”, the statement reads. 

It goes on to say that tests conducted on all officials who attended Friday’s meeting have revealed “the positive sign of AH1N1” in five officials: deputy prime minister Yim Chhai Ly, senior ministers Chhay Than and Tao Seng Hour and officials Kim Ith and Ith Mith. 

The virus caused Hun Sen to miss Monday’s celebrations marking the 59th anniversary of the Cambodian People’s Party, and “some programmes of Samdech were also cancelled”, according to the statement. 

Council of Ministers spokesman Phay Siphan said Tuesday that he could not provide any information beyond what was included in the statement.

Via Ida at Bird FLu Information Corner, an Antara report: Boyolali, Central Java ::: A man possibly dies of bird flu. Excerpt:

Syamsudin (27), a resident of Desa Paras, Kecamatan Cepogo, Kabupaten Boyolali allegedly died of bird flu/avian influenza H5N1 infection. 

Head of Boyolali Health Service, dr Yulianto Prabowo, mentioned patient had been treated in Pandan Arang Boyolali regional public hospital before the death. 

Patient was diagnosed as bird flu suspect, and  in critical condition that must be referred to Dr. Moewardi hospital in Solo. He died during treatment in Dr Moewardi hospital and diagnosed to have respiratory infection. 

Previously, hundreds of chickens died in Dukuh Bandung, Desa Beji, Kecamatan Andong, Boyolali. However, officials faced difficulty in diagnosing the cause of death because no dead chickens left for sample.

In another post, Ida reports that the boy suspected last week of having bird flu has tested negative and been released from hospital. But four other children are also suspected H5N1 cases and are being cared for in isolation.

(Wed, 30 Jun 2010 12:50:00 +0000)

# 4687

Medpedia is an open platform connecting people and information to advance medicine. Medpedia is created in association with Harvard Medical School, the Stanford School of Medicine, The University of Michigan Medical School, the UC Berkeley School of Public Health, and leading health organizations around the world.

For more information, visit Medpedia.com.

For nearly a year now my blog (along with many others) have been syndicated through the Medpedia family of news and analysis sites that are mirrored on the Medpedia web portal. 

Over the past year the site has been continually expanding its offerings. 

In A Medpedia Family Way

Medpedia Unveils 3 New Resources

Visitors to the site can browse the various blog feeds by category. You’ll find Avian Flu Diary under the Public Health listings.

Browse News & Analysis by Channel

• General Medicine

• Health News

• Health Technology

• Diseases and Conditions

• Science and Research

• Medical Specialties

• Public Health

Yesterday Medpedia announced the opening of a new Rare Childhood Disease community.  Since this is something that would be of interest to some of my readers, I’ve reproduced portions of the press release below.

By all means, check it out.  And if you haven’t perused Medpedia recently, give it a look.

 

MEDPEDIA PLATFORM EXPANDS WITH ADDITION OF RARE DISEASE COMMUNITY

RareSpace Leverages Medpedia’s Technology Platform

SAN FRANCISCO, CA (June 29, 2010) –Medpedia today announces RareSpace, an online knowledge sharing platform designed in partnership with the R.A.R.E. Project and the Children’s Rare Disease Network to advance research and share information about the rare childhood diseases that affect 22.5 million American families. This resource is available now on Medpedia at http://www.medpedia.com/communities/274-RareSpace.

 

“RareSpace is a unique and valuable tool for families caring for children with rare diseases,” says Jonathan Jacoby, CEO of the R.A.R.E Project. “With the help of Medpedia.com, RareSpace will become a safe place to share important information aggregated from the rare disease community at large, which is vital to finding hope for children.”

 

Parents, physicians, medical researchers, patients, advocates and others interested in rare diseases are encouraged to participate in discussions and share information about genetic diseases, innovations in research, standards of care, and best practices in treating rare diseases and disorders. RareSpace also includes translational research and discussions of possible cures for diseases. Medical professionals in RareSpace will answer questions about treatment, best practices, and how to best help these children and their families. Anyone with an interest in rare diseases is invited to join at http://www.medpedia.com/communities/274-RareSpace.

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(Wed, 30 Jun 2010 12:04:00 +0000)

# 4686

Of primary interest to clinicians, I suppose, but we’ve a new study showing the wide divergence of sensitivity of RIDTs (Rapid Influenza Detection Tests) sometimes called IRDTs to various strains of influenza A and B – including avian strains.

These tests are generally used in doctor’s offices, clinics, and ERs to quickly (less than 30 minutes) test for the influenza virus.  

Their accuracy has come under increasing fire over the past couple of years, however.

A few blogs on the subject include:

A Tale of Two Headlines

PLoS Currents: Improving Diagnostic Efficiency Of H1N1

No Doesn’t Always Mean No

According to the CDC:

The rapid tests vary in terms of sensitivity and specificity when compared with viral culture or RT-PCR. Product insert information and research publications indicate that:

• Sensitivities are approximately 50-70%
• Specificities are approximately 90-95%

The two main measures of the accuracy of a diagnostic test are sensitivity and specificity.

• Sensitivity is defined as the ability of a test to correctly identify individuals who have a given disease or condition.

• Specificity is defined as the ability of a test to exclude someone from having a disease or illness.

The various RIDTs are designed to show if someone tests positive for the Influenza A or B virus, but not the strain of flu.

Today from the Journal of Microbiology, we look at a side-by-side comparison of 20 different IRDTs available in Japan.  

Sensitivity of influenza rapid diagnostic tests to H5N1 and 2009 pandemic H1N1 viruses

Yuko Sakai-Tagawa, Makoto Ozawa, Daisuke Tamura, Quynh Mai Le, Chairul A. Nidom, Norio Sugaya, and Yoshihiro Kawaoka

J. Clin. Microbiol. published ahead of print on 16 June 2010, doi:10.1128/JCM.00439-10

 

Abstract

Simple and rapid diagnosis of influenza is useful to treatment decision-making in the clinical setting. Although many influenza rapid diagnostic tests (IRDTs) are available for the detection of seasonal influenza virus infections, their sensitivity for other viruses, such as H5N1 viruses and the recently emerged swine-origin pandemic (H1N1) 2009 virus, remains largely unknown.

Here, we examined the sensitivity of 20 IRDTs to various influenza virus strains, including H5N1 and 2009 pandemic H1N1 viruses. Our results indicate that the detection sensitivity to swine-origin H1N1 viruses varies widely among IRDTs, with some tests lacking sufficient sensitivity to detect the early stages of infection when the virus load is low.

Viruses tested include seasonal H1N1, seasonal H3N2, seasonal Type B, 16 different (human and avian) H5N1 viruses, H5N2, H5N3, H9N2, H7N7, and 3 clades of pandemic H1N1.

You’ll find that that these tests all are not created equally, and that it is important to match the test to the virus you are testing for.   As stated in the report:

Our findings emphasize the importance of selecting the right IRDT for rapid diagnosis of non-seasonal
influenza viruses, since the sensitivity of the IRDTs we tested varied by as much as 100-fold.

 

Obviously, we are in need of better, more accurate, rapid influenza tests – particularly when it comes to picking up novel or avian strains of the virus.

This is a detailed report and well worth reading, particularly if you are involved in the selection of RIDTs for your practice.

(Wed, 30 Jun 2010 11:24:33 GMT) This diary is to track and discuss news regarding Indonesia.

The previous Indonesia News Diary is here.

Indonesia, New Case Diary: Makassar Susp. Clust.; Nov 11, 2008 is here

Indonesia, New Cases list: Oct. 30, 2008 to… is here.

Indonesia, New Cases list: Oct. 9, 2008 to Oct. 30, 2008 is here.

Indonesia, New Cases list: August 31, 2008 to October 8, 2008 is here.

Indonesia, New Cases list: June 21, 2008 to August 26, 2008 is here.

Indonesia, New Cases list: May 19, 2008 to June 21, 2008 is here.

Indonesia, New Cases list: April 10, 2008 to May 19, 2008 is here.

Indonesia, New Cases list:  March 13, 2008 to April 10, 2008 is here.

Indonesia, New Cases list:  Jan. 26 - March 18, 2008 is here.

Indonesia, New Cases list: Oct. 30, 2007 to Jan. 25, 2008 is here.

Indonesia, New Cases list: Jan 25, 2007 to Oct. 30, 2007 is here.

The Indonesia maps by Okieman and the Newshounds are here.

(Wed, 30 Jun 2010 10:34:00 +0000)

# 4685

Ida at BFIC – a joint effort between Kobe University in Japan and the Institute of Tropical Disease, Airlangga University, Indonesia – has translations of a couple of recent articles from the Indonesian press regarding two suspected incidents of bird flu.

As stated often in this blog, the Indonesian government is less than anxious to discuss their bird flu situation (see Indonesia To Stop Announcing Bird Flu Deaths), and rarely confirms or comments on these media reports.

Suspected cases, however, are simply that.   There are a number of diseases to be found in Indonesia that can produce `bird flu-like’ symptoms. 

Laboratory confirmation is required before a case can be attributed to the H5N1 virus.   Lab tests for bird flu, however, are not always reliable and multiple tests are required.

With that preface in place, the two translated reports from the Bird Flu Information Corner.

Boyolali, Central Java ::: A man possibly dies of bird flu

Posted by Ida on June 30, 2010

Boyolali – Syamsudin (27), a resident of Desa Paras, Kecamatan Cepogo, Kabupaten Boyolali allegedly died of bird flu/avian influenza H5N1 infection.

 

Head of Boyolali Health Service, dr Yulianto Prabowo, mentioned patient had been treated in Pandan Arang Boyolali regional public hospital before the death.

 

Patient was diagnosed as bird flu suspect, and  in critical condition that must be referred to Dr. Moewardi hospital in Solo.

 

He died during treatment in Dr Moewardi hospital and diagnosed to have respiratory infection.

 

Previously, hundreds of chickens died in Dukuh Bandung, Desa Beji, Kecamatan Andong, Boyolali. However, officials faced difficulty in diagnosing the cause of death because no dead chickens left for sample.

 

So far, no report of bird flu signs in human, but area monitoring is still ongoing.

Source: Indonesia news office, ANTARA-JATENG.

This next report concerns the isolation of 4 children who are exhibiting flu-like symptoms after exposure to sick and dying chickens in West Kalimantan.

This province is one of the few in Indonesia that has been certified as bird flu free.  In recent weeks, however, they’ve begun reporting poultry deaths.

West Kalimantan Province, Indonesia

A week ago we had a report of a 4 year-old hospitalized from this region with suspected H5N1 (see Indonesia: Bird Flu Suspect).  That child, according to this report, tested negative and has been released from the hospital.

 

Pontianak, West Kalimantan ::: 4-year-old negative bird flu. Four other children under isolation

Posted by Ida on June 30, 2010

Pontianak – Following to avian influenza (AI) outbreak in chickens, four people from different areas in Pontianak are under intensive treatment of alleged bird flu infection. Patients were reported to develop fever and flu symptoms after chickens suddenly died around their neighborhood.

 

Patients are being treated in dr Soedarso hospital, Pontianak. A patient has recovered and discharged from hospital, while four patients are still isolated, Ad (10), Ap (15), Da (10) and Wt (9). Da and Wt are cousins, and neighbors of Ap residing in Karya Bhakti street. Ad is resident of Pak Benceng of Pontianak city.

 

Head of Medic and Non-Medic Service Division, Dr Soedarso hospital, Dr Hj Tita Selati said patients had been taken care according standard procedure (protap). “They are isolated and given Tamiflu”, said Tita.

 

In the meantime, patients’ swab samples have been sent to research and development laboratory of Ministry of Health (Litbangkes) in Jakarta for bird flu confirmation.

 

Ap was referred from Gang Sehat public health center and Wt was from Purnama public health center.

 

Previously, Dd (4.5), a bird flu suspect patient in dr Soedarso had been confirmed negative by Litbangkes, and discharged from hospital.

Source: Indonesia local newspaper, Equator News

Reports such as these come out of Indonesia, and other bird-flu endemic regions, sporadically.  Some will turn out to be H5N1, while others will not.   And it is likely that some cases are never detected.

H2H (Human to Human) transmission of the virus remains exceedingly rare, and most of the cases still appear to be due to contract with infected birds.

Still, these reports are a valuable reminder that the H5N1 virus remains active in some parts of the world, and its potential for causing a pandemic sometime in the future has not diminished.

My thanks to Ida at the BFIC , and the other newshounds around the world who diligently pour through hundreds of news sources every day looking for obscure items of interest, and then translating and posting them.

Via Google News, an AFP report: AFP: Cambodian PM infected with swine flu: government. Excerpt:

Cambodian premier Hun Sen and several top officials have been infected with swine flu, a government spokesman said Tuesday. 

“I can confirm he and several ministers have tested positive with the virus,” spokesman Khieu Kanharith told AFP, while a letter from health minister Mam Bunheng said the prime minister was now recovering. 

The premier was found to be carrying the A(H1N1) virus after his weekly cabinet meeting on Friday and medics subsequently tested all ministers and officials attending the meeting, according to the letter. 

It said tests found Deputy Prime Minister Yim Chhay Ly, two senior ministers and two officials were also infected with the virus and are now being treated carefully by doctors, although it did not give their whereabouts.

(Tue, 29 Jun 2010 16:28:00 +0000)

# 4684

With hurricane conditions possible along the south Texas coast in roughly 36 hours, a lot of people may find themselves without electrical power for hours or possibly even days.  

And when that happens some of the food that people have in their homes can go bad quickly.   Particularly during the heat of summer.

The USDA maintains a Food Safety and Inspection website with a great deal of consumer information about how to protect your food supplies during an emergency, and how to tell when to discard food that may no longer be safe to consume.

First, an audio podcast (5 minutes).

Surviving a Power Outage: Don’t Be in the Dark When it Comes to Food Safety (Jun 2, 2010; 4:45) | Script
FSIS Food Safety staff discusses tips on how to be food safe during a power outage.

Next, an extensive fact sheet on food safety during an emergency, such as a hurricane, flood, or earthquake.

 

Keeping Food Safe During an Emergency

Did you know that a flood, fire, national disaster, or the loss of power from high winds, snow, or ice could jeopardize the safety of your food? Knowing how to determine if food is safe and how to keep food safe will help minimize the potential loss of food and reduce the risk of foodborne illness. This fact sheet will help you make the right decisions for keeping your family safe during an emergency.

 

ABCD’s of Keeping Food Safe in an Emergency

Always keep meat, poultry, fish, and eggs refrigerated at or below 40 °F and frozen food at or below 0 °F. This may be difficult when the power is out.

Keep the refrigerator and freezer doors closed as much as possible to maintain the cold temperature. The refrigerator will keep food safely cold for about 4 hours if it is unopened. A full freezer will hold the temperature for approximately 48 hours (24 hours if it is half full) if the door remains closed. Obtain dry or block ice to keep your refrigerator as cold as possible if the power is going to be out for a prolonged period of time. Fifty pounds of dry ice should hold an 18-cubic foot full freezer for 2 days. Plan ahead and know where dry ice and block ice can be purchased.

(Continue . . . )

You’ll also find numerous charts (like the one below) showing different food items, and how to know when they must be discarded.

It doesn’t require a major disaster like a Hurricane to knock out the power to your home for 24 hours or longer.  A strong thunderstorm is perfectly capable of taking down power lines.

So whether you are in the path of a storm or not, it’s not such a bad idea to visit this site and glean what you can while the power is still on.

Via Sify.com: Swine flu alert in Tamil Nadu districts bordering Kerala. Excerpt:

With 21 swine flu cases being reported in the state and 14 in Kanyakumari district alone, the Tamil Nadu government has alerted district administrations bordering Kerala to watch out for people with swine flu symptoms. 

Speaking to reporters, Health Minister M.R.K. Pannerselvam said: ‘Government hospitals have been told to keep an exclusive ward for swine flu patients.’ 

He assured the availability of Tamiflu tablets for treating swine flu.