Influenza Virus Mashup

(Tue, 23 Aug 2011 12:02:00 +0000)

# 5774

Nearly thirty years ago I made a fairly good living as a computer programmer. Of course, things weren’t quite as sophisticated as they are today.

The Internet didn’t exist, an IBM-PC with two floppy drives for storage and 256K of RAM was the hot computer of the day, and we wrote laborious code using stone knives and a BASCOM 1.0 compiler.

While the technology has long since passed me by (the languages that I once knew are now only found in museums), I still have a deep appreciation for the programmer’s art.

So I’m delighted that Lisa at CIDRAP sent me a link to the following contest, offered by the HHS, for the development of preparedness apps for FACEBOOK,

Here are some excerpts from the press release.

News Release

FOR IMMEDIATE RELEASE
August 22, 2011

Contact: HHS Press Office
(202) 690-6343

HHS sponsors contest for Facebook personal preparedness applications

Federal officials are challenging software application developers to design new Facebook applications to help people prepare for emergencies and get support from friends and family after an emergency strikes – from personal medical emergencies to natural or man-made disasters.

 

The U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response (ASPR) issued the ASPR Lifeline Facebook Application Developer Challenge in collaboration with the Federal Emergency Management Agency (FEMA), a health-focused online community of developers, designers, patients, providers, health care organizations that promotes health technology innovation.

 

The online challenge runs throughout National Preparedness Month in September and the remainder of the 2011 hurricane season, closing Nov. 4.

 

“After disasters, a tremendous number of people use Facebook to post and share information,” said Assistant Secretary Nicole Lurie, M.D., a rear admiral in the U.S. Public Health Service. “We’re challenging our country’s most innovative developers to create apps that help people use Facebook not only to reach out to friends and family for any kind of help they may need after emergency but also to become better prepared in the first place.”

 

The person or team developing the best application will receive $10,000 from HHS and free admission from Health 2.0 to the 2012 Health 2.0 conference, and will be invited to an HHS event with Dr. Lurie. Second place will be awarded $5,000, and third place will receive $1,000.

 

(Continue . . . )

As noted above, September is National Preparedness Month, and you are encouraged to join the NPM coalition.

(Tue, 23 Aug 2011 11:18:00 +0000)

Photo Credit NOAA GOES East

# 5773

Having avoided crossing the mountainous terrain of Hispaniola, Hurricane Irene continues to intensify and move towards the Bahamas as a CATAGORY 2 storm. 

Model guidance has finally consolidated, and for now the news is much improved for Florida and the Gulf of Mexico, but not so good for those residing further up the Eastern seaboard.

But first, Irene is expected to move across the entire length of the Bahamas as a major hurricane.

Although most of Florida is now out of the forecast track, the NHC  reminds the public not to focus on the exact forecast track . . . especially at days 4 and 5 . . . since the most recent 5-year average errors at those forecast times are 200 and 250 miles respectively.

Since this forecast track could change further, it is important for all interests along the Atlantic seaboard to follow the National Hurricane Center’s tracking of this storm.

For now, the thinking is that Irene will become an unusually large storm, with Category 3 winds, and that it will likely cross the Bahamas over the next 48 hours and threaten the coastline from Georgia north to Virginia over the weekend.

From the 8/23 5am NHC Discussion

Those residing even hundreds of miles from the forecast track may experience significant effects from this storm, including high winds and heavy rains - and along the coast - beach erosion and rip currents.

The latest Tropical Storm Force Wind Probabilities map includes a good sized chunk of the Southeast.

And even those living hundreds of miles inland need to be paying attention to this storm, as I wrote in You Don’t Have To Live On The Coast, inland flooding can be a major cause of death and destruction from these landfalling hurricanes.

Tornadoes can spin up from these landfalling systems, often hundreds of miles inland, as well. 

As always, the National Hurricane Center website should be your primary source of forecast information, but if you are on Twitter, you should also follow @FEMA, @CraigatFEMA, @NHC_Atlantic, @NHC_Pacific and @ReadydotGov for the latest Emergency information.

To become better prepared as an individual, family, business owner, or community to deal with hurricanes, tornadoes, floods, or any other type of disaster: visit the following preparedness sites.

FEMA http://www.fema.gov/index.shtm

READY.GOV http://www.ready.gov/

AMERICAN RED CROSS http://www.redcross.org/

(Mon, 22 Aug 2011 12:03:00 +0000)

Photo Credit CDC – Sleep and Sleep Disorders

# 5772

Over the past year we’ve seen numerous reports linking GSK’s Pandemrix vaccine to an increased incidence of narcolepsy in children and adolescents. This recently led the EMA to recommend that the vaccine not be given to anyone under the age of 20.

Somewhat mysteriously, epidemiological investigations have confirmed elevated levels of childhood narcolepsy among Pandemrix vaccine recipients in some countries, but not in others.

 

And last year Iceland reported a similar surge in narcolepsy among children who had not received the vaccine.

 

Leaving many to question exactly what is going on here.

Today, in a study that appears in the Annals of Neurology, we’ve a new study that now suggests a link between contracting an upper respiratory infection and developing narcolepsy.

I’ve listed the full citation below, but as of this posting the link is not live.

“Narcolepsy Onset is Seasonal and Increased Following the H1N1 Pandemic in China.” Fang Han, Ling Lin, Simon C Warby, Juliette Faraco, Jing Li , Song X. Dong, Pei. An, Long Zhao, Ling H. Wang, Qian Y. Li, Han Yan, Zhan C. Gao, Yuan Yuan, Kingman P. Strohl and Emmanuel Mignot, Annals of Neurology; Published Online: August 22, 2011 (DOI:10.1002/ana.22587). http://doi.wiley.com/10.1002/ana.22587

We do have a pair of press releases, however, that provide a fair amount of background on this intriguing finding.

And what these researchers found was: that in China, among a largely unvaccinated population, the incidence of Narcolepsy increased dramatically in the Spring, after the winter flu season. And that this increase was most pronounced following the emergence of the H1N1 swine flu virus in 2009.

Study finds narcolepsy cases in China peak in early spring

Significant spike following H1N1 pandemic not linked to vaccines

New research shows that the occurrence of narcolepsy in China is highly correlated to a seasonal pattern, with onset most frequent in April. A significant increase in narcolepsy cases was also observed following the 2009-2010 H1N1 pandemic, but the findings now available in Annals of Neurology, a journal of the American Neurological Association and the Child Neurology Society, report flu vaccination was unlikely the cause of the increase.

(Continue . . . )

Stanford study draws connection between narcolepsy and influenza

STANFORD, Calif. — The onset of narcolepsy appears to follow seasonal patterns of H1N1 and other upper airway infections, according to a new study of patients in China that was led by Stanford University School of Medicine narcolepsy expert Emmanuel Mignot, MD.

 

The findings, which will be published online Aug. 22 in Annals of Neurology, a journal of the American Neurological Association and Child Neurology Society, show that a peak in narcolepsy cases occurred five to seven months after a peak in flu/cold or H1N1 infections in the country.

 

“Together with recent findings, these results strongly suggest that winter airway infections such as influenza A (including H1N1), and/or Streptococcus pyogenes are triggers for narcolepsy,” Mignot, a professor of psychiatry and behavioral sciences, and his colleagues wrote in the paper.

 

The study follows recent reports that a particular H1N1 vaccine, not one used in the United States or China, seemed to lead to narcolepsy. This new paper, however, found no correlation between vaccination and narcolepsy among the patients studied in China. “The new finding of an association with infection, and not vaccination, is important as it suggests that limiting vaccination because of a fear of narcolepsy could actually increase overall risk,” the authors wrote.

 

(Continue . . . )

The results of today’s study is reminiscent to one we saw last year (see Lancet: The Influenza - Guillain Barré Syndrome Connection) that suggested the risks of developing GBS – another type of autoimmune disease - were far greater following a bout of the flu, than from receiving the flu vaccine.

And two years ago, Helen Branswell reported on a study that suggested that some influenza infections may set up some people to develop Parkinson’s disease later in life (see More On The Influenza-Parkinson’s Link.)

One of the authors of today’s study, Dr. Emmanuel Mignot with the Stanford Center for Sleep Sciences and Medicine in Palo Alto, California, is quoted as saying:

 

“These findings are reminiscent of the encephalitis lethargica epidemic that followed the great Spanish influenza pandemic of 1917-1918. Not only narcolepsy, but also psychosis and Parkinson’s disease may follow winter infections, and further research is needed in the area of autoimmune diseases of the brain.”

The epidemic of Encephalitis lethargica that swept the world between 1915 and 1926 remains one of the great medical mysteries of the last century, although a link to the Pandemic virus of 1918 has often been suggested.

As the press release states: The paper doesn’t show cause and effect, but it does show a strong correlation between narcolepsy onset and this seasonal pattern.

More research is obviously needed, but this is more evidence that the real danger lies with contracting the flu, not with taking the vaccine to prevent it.

(Mon, 22 Aug 2011 10:48:00 +0000)

# 5771

Irene reached hurricane status overnight as she moved over the island of Puerto Rico, and now appears poised to miss most of the mountainous terrain of Hispaniola which should allow her to strengthen. 

The consensus track puts Irene as a strong hurricane moving along the eastern seaboard of Florida by the end of the week. It should be noted that there is still a fair amount of uncertainty on this forecast path and the models have been shifting with every run.

5am EST 8/22 Computer models

The National Hurricane Center in their 5am advisory, released this intensity forecast, but cautioned that this might be conservative depending upon the storm’s interaction with the mountains of Hispaniola.

The bottom line, despite some remaining uncertainties regarding her track and intensity, residents and interests from the Florida Keys, up along the Florida coastline, and even further north along the eastern seaboard need to be getting ready just in case Irene decides to visit.

Only two hurricanes have impacted the northeast coast of Florida over the past thirty years, and so millions of residents – from Melbourne to Jacksonville –  have yet to experience a serious hurricane.

 

Hurricane David (1979) and Hurricane Charlie (2005) tracks.

Credit – NOAA Historical Hurricane Tracks

For emergency managers all along the coast, the next 120 hours are going to be a tense and hectic time. More than a dozen Florida counties are under the gun in this latest forecast track, and Georgia, the Carolinas, and points north are not out of danger.

NOW is the time to review your emergency plan, including where you will go if you are ordered to evacuate, and to make any last minute additions to your emergency kit.

To help in this regard, a couple of short videos from the Pinellas County Office of Emergency Management on preparing for a hurricane.

 

Build Your Survival Kit

Time: 3 min. 30 sec.

Building a hurricane survival kit doesn’t have to break the bank.  Learn how to put together a well-stocked kit inexpensively.

Tape Strikes Out

Time: 4 min.

When a storm blows in, you put masking tape on your windows and you’re fine right? We’ll show you just how wrong that assumption can be.

The National Hurricane Center website should always be your primary source of forecast information, but if you are on Twitter, you should also follow @FEMA, @CraigatFEMA, @NHC_Atlantic, @NHC_Pacific and @ReadydotGov for the latest Emergency information.

To become better prepared as an individual, family, business owner, or community to deal with hurricanes, tornadoes, floods, or any other type of disaster: visit the following preparedness sites.

FEMA http://www.fema.gov/index.shtm

READY.GOV http://www.ready.gov/

AMERICAN RED CROSS http://www.redcross.org/

(Sun, 21 Aug 2011 15:36:00 +0000)

# 5770

The 11 am advisory notes some small changes to the forecast track of Tropical Storm Irene, and the National Hurricane Center has issued an important reminder in their latest discussion:

THERE IS A FAIR AMOUNT OF SPREAD IN THE TRACK GUIDANCE MODELS…ESPECIALLY AT DAYS 4 TO 5. FOR EXAMPLE…THE GFDL MODEL TAKES IRENE TO THE  WEST OF THE FLORIDA PENINSULA WHILE THE HWRF MODEL TAKES IT THROUGH THE NORTHWESTERN BAHAMAS.

INTERESTS IN FLORIDA ARE ADVISED NOT TO FOCUS ON THE EXACT FORECAST TRACK BECAUSE OF THE INHERENT UNCERTAINTIES IN LONGER-RANGE FORECASTS.

This track may well shift several times over the next couple of days. It is also important to note that severe weather conditions can often occur more than 100 miles away from where the center of these storms pass.

Latest `spaghetti’ computer runs 11am 8/21/11

We’ll have a much better idea of where Irene will go, and how strong she may become, after this system clears the islands of Puerto Rico, Hispaniola, and Cuba.

Interests in Florida, and along the Gulf coast and Atlantic seaboard, should stay on top of this storm’s progress and make sure their hurricane plans and preparations are in order.

Via The Jakarta Post: Airlangga University produces first ever locally-produced bird flu vaccine seed.

Researchers at Airlangga University in Surabaya, East Java, have succeeded in creating a bird flu vaccine seed that could potentially kill the deadly virus if it were contracted by humans. 

According to university laboratory head Chairul Anwar Nidom, the project to create the vaccine started six months ago after presenting the bird flu vaccine prototype to Vice President Boediono. 

The eventual vaccine seed, which cost Rp 2 billion (US$234,000) to produce, resulted from the collaboration of molecular biologists from Airlangga University and others in Japan, he said on Sunday. 

“This is a first for Indonesia, because the seed resulted from the reconstruction of a bird flu virus found in Indonesia, in addition to being the first seed to be produced by Indonesian experts,” he added, as reported by tempointeraktif.com. 

There are an estimated 170 variants of bird flu found in Indonesia, which affect both humans and birds. 

“There is no more reason why research has to be conducted abroad because research could be conducted locally,” he said.

Mike Coston at Avian Flu Diary has some useful commentary on this development.

(Sun, 21 Aug 2011 13:14:00 +0000)

# 5769

Dr. C. A. Nidom and Airlangga University in Surabaya, East Java have been often mentioned in this blog as they represent the vanguard of bird flu research in Indonesia.

Regular readers of this blog will recognize Dr. Nidom as being the researcher who did serological testing on stray cats in Indonesia a number of years ago and found 20% had antibodies to the H5N1 virus.

 

You can read about his research here, here, and here.

 

Dr. Nidom has also been a vocal opponent of relying on poultry vaccines to control Indonesia’s bird flu problem (see Indonesia: Debate Over Poultry Vaccination) rather than culling.

Today, the Jakarta Post is reporting that they have created the first locally developed seed vaccine against the H5N1 bird flu virus.

Airlangga University produces first ever locally-produced bird flu vaccine seed

The Jakarta Post, Surabaya | Sun, 08/21/2011 6:54 PM

Researchers at Airlangga University in Surabaya, East Java, have succeeded in creating a bird flu vaccine seed that could potentially kill the deadly virus if it were contracted by humans.

(Continue. . . )

We’ve talked about concerns over the growing diversity of the H5N1 virus – particularly in Indonesia – and this article references the detection of 170 local variants to date.

Perhaps we’ll get more information from the Bird Flu Information Corner in the coming days, as they are part a joint initiative between Japan’s Kobe University and the Institute of Tropical Disease, Airlangga University, Indonesia.

(Sun, 21 Aug 2011 12:19:00 +0000)

# 5768

Photo Credit University of Iowa

HFMD (Hand Foot Mouth Disease) is a relatively common, and usually mild, viral illness seen mainly in children under the age of 10 (although adults are vulnerable as well) and may be caused by several of the non-polio enteroviruses.

The 60+ non-polio enteroviruses identified to date are among the most prevalent viral infections in the world, probably only second to the myriad and ubiquitous variants of Rhinovirus (`common cold’) that circulate every year.

The two most common causes of HFMD are the Coxsackie A16 virus, and the Enterovirus-71 (EV-71).

The disease caused by the Coxsackie A16 virus is generally the milder of the two, rarely causes serious illness, and outbreaks are not uncommon in childcare facilities. 

EV-71 HFMD is most commonly found in the Asia, with serious outbreaks recorded over the past dozen years in places like China, Malaysia, Hong Kong and most recently, Vietnam.

This version of the HFMD can sometimes be quite serious, with viral meningitis - and less commonly, encephalitis – complicating matters.

This summer Vietnam has seen an explosion of HFMD cases, and has recorded more than 80 deaths. Although the headline in the following story from Than Nien News uses the term `pandemic’, this outbreak would be better described as an `epidemic’.

Hand, foot and mouth disease spreads to pandemic levels

Last updated: 8/19/2011

Official re-classifies the outbreak as death toll reaches 81

The Ministry of Health is considering declaring hand, foot and mouth disease (HFMD) a pandemic, as more than 32,000 cases of the illness have killed 81 across the country so far this year.

 

According to the ministry, the disease has hit 52 of 62 cities and provinces, mostly in the southern and central regions. Some 96 percent of the fatalities have been children under the age of five.

(Continue . . . )

According to a recent VOA Vietnamese news report, about 1/3rd of the cases reported in Vietnam have been due to the more serious virus; EV-71.

For more on HFMD, we turn to the CDC’s webpage, which offers advice on prevention, and treatment, focusing primarily on the mild version more likely to be encountered outside of Asia.

 

Hand, Foot, and Mouth Disease

 

Hand, foot, and mouth disease is a contagious viral illness that commonly affects infants and children. While there is no vaccine to prevent the disease, there are simple steps you and your family can take to reduce the risk of getting sick.

 

Hand, foot, and mouth disease (HFMD) is a contagious viral illness that commonly affects infants and children in the U.S. and abroad. In the U.S. and other countries with temperate climates, HFMD occurs most often in summer and early autumn. While there is no vaccine to prevent the disease, there are simple steps you and your family can take to reduce the risk of getting sick.

HFMD

• Usually causes fever, sores in the mouth, and a rash with blisters.
• Is moderately contagious.
• Mostly affects children younger than 10 years of age, but people of any age can be infected.
• Has no specific treatment.
• Infection risk can be reduced by practicing good hygiene, such as washing hands frequently.
• Is not the same as foot-and-mouth disease.

(Continue . . . )

 

The CDC also offers a short (4 minute) audio podcast on HFMD, which may be listened to HERE.

Two major genotypes of EV-71, EV-71 B and EV-71 C, have been identified as being responsible for a number of severe outbreaks in Australia, Japan, China, Malaysia, and Taiwan since 1997.

Last year, the Virology Journal, published an analysis of an EV-71 HFMD virus that caused a major disease outbreak in Fuyang City, China in 2008 that showed it was due to an emerging recombinant virus (see China: A Recombinant EV-71).

Viruses are always changing.

 

Normally mild viral diseases like HFMD can sometimes mutate or pick up genetic material from other viruses and become more virulent or more transmissible as a result.

 

While serious cases are uncommon in Europe or the United States at this time, there is no reason to believe we are immune to an importation of a more severe version of HFMD.

More than enough reason to pay close attention to what is happening in Asia today.

(Sun, 21 Aug 2011 10:36:00 +0000)

# 5767

Tropical Storm Irene, the 9th named storm of the 2011 Atlantic Tropical season, formed several hundred miles east of the Lesser Antilles late yesterday and is now lashing the Northern Leeward Islands with squalls and heavy rains.

It’s forecast path puts Puerto Rico, the island of Hispaniola, and Cuba under the gun over the next 96 hours, and most models have it posing a threat to South Florida five days from now.

 The solid white area depicts the track forecast uncertainty for days 1-3 of the forecast, while the stippled area depicts the uncertainty on days 4-5.

Forecasts can change, and the cone of uncertainty is hundreds of miles wide 5 days out. Still, Floridians need to be making plans now for how they will deal with Irene should she come our way.

For the beleaguered residents of Haiti and the Dominican Republic, this will be the second tropical system to visit in less than a month. You’ll recall that a disheveled T.S. Emily dropped more than 20 inches of rain on parts of that island earlier this month, causing heavy flooding and several fatalities.

Conditions are somewhat better now for storm intensification, and Irene is forecast to reach hurricane strength before crossing the coastline of Hispaniola . . .  either late Monday or early Tuesday.

The mountainous terrain of Hispaniola and Cuba are both famous for taking the punch out of tropical systems, and so Irene’s strength after passing these natural barriers is likely to be somewhat diminished.

How much, and how well can it recover once back over the warm waters of the Florida straits, is the question on a lot of Floridian’s minds right now.

 

 

The 5am discussion from the National Hurricane Center suggests that Irene will likely regain hurricane strength rapidly after clearing the islands of the Caribbean.

THE UPPER-LEVEL ENVIRONMENT IS EXPECTED TO BE QUITE FAVORABLE FOR STRENGTHENING THROUGHOUT THE FORECAST PERIOD AS A RESULT OF LOW SHEAR AND A MID-OCEANIC TROUGH TO THE EAST ACTING AS A MASS SINK
FOR THE OUTFLOW IN THE EASTERN SEMICIRCLE. 

 

HOWEVER…THE INTENSITY FORECAST IS HEAVILY DEPENDENT ON HOW MUCH INTERACTION IRENE HAS WITH THE MOUNTAINOUS TERRAIN OF HISPANIOLA AND WHAT THE INNER CORE OF THE CYCLONE BECOMES AFTER IT EMERGES OFF THE NORTHEAST COAST OF CUBA IN ABOUT 4 DAYS.

 

ONCE OVER THE FLORIDA STRAITS…HOWEVER…  IRENE WILL HAVE AT LEAST 24 HOURS OVER SOME OF THE WARMEST WATER IN THE ATLANTIC TO TAP INTO. THE OFFICIAL FORECAST REMAINS ON THE CONSERVATIVE SIDE DUE TO LAND EFFECTS AND IS CLOSE TO A BLEND OF SHIPS AND LGEM STATISTICAL INTENSITY MODELS.

 

FORECAST POSITIONS AND MAX WINDS

INIT  21/0900Z 16.4N  61.3W   45 KT  50 MPH
12H  21/1800Z 17.0N  63.7W   50 KT  60 MPH
 24H  22/0600Z 17.5N  66.7W   60 KT  70 MPH
36H  22/1800Z 18.0N  69.2W   70 KT  80 MPH
48H  23/0600Z 18.6N  71.5W   50 KT  60  MPH  … INLAND
72H  24/0600Z 20.3N  75.3W   50 KT  60 MPH… INLAND
96H  25/0600Z 22.8N  78.2W   60 KT  70 MPH… OVER WATER
120H  26/0600Z 26.1N  80.7W   75 KT  85   MPH  … INLAND 

With the exception of the UKMET and GFDL models, most of the computer runs are in close agreement as to the future path of Irene. 

A Hurricane watch has been issued for Puerto Rico and surrounding islands, and it seems likely that Hispaniola will be dealing with a strong tropical storm or minimal hurricane in less than 48 hours where flooding and mudslides are always a major concern.  

 

There also remain tens thousands of people who still live in scores of flimsy tent-and-tarp settlements that sprang up after Haiti’s 7.0 Earthquake in early 2010.

For Haiti, and to a lesser extent the Dominican Republic, heavy rains may further exacerbate their recent Cholera outbreaks, and could also help increase the number of mosquitoes that carry Dengue fever.

Other Interests in the Caribbean, and in the Southern United States, need to keep track of this storm’s progress as well.  As always, the National Hurricane Center is your best source of information.  

 

If you are on Twitter, you should also follow @FEMA, @CraigatFEMA, @NHC_Atlantic, @NHC_Pacific and @ReadydotGov.

 

NOAA’s NWS National Hurricane Center in Miami also has a Facebook page, where you can keep up with the latest tropical developments.

Of course, knowing about an approaching storm is important, but you need to be prepared as well.

To help you along, NOAA, FEMA, and the American Red Cross have released an updated preparedness guide for the 2011 tropical season.

(Sat, 20 Aug 2011 19:01:33 GMT)

Reminder: Please do not post whole articles, just snippets and links, and do not post articles from the Las Vegas Review-Journal. Thanks!

Australia

?  Flu season hits early (Mid-North Coast) (Link)

United States

?  MA: State supplying fewer vaccines this year (Link)

?  MO: Public schools won’t offer flu vaccinations this year (Link)

?  H (Link)

News for August 20, 2011 is here.

Thanks to all of the newshounds! Special thanks to the newshound volunteers who translate international stories - thanks for keeping us all informed!

Other useful links:

WHO A(H1N1) Site

WHO H5N1 human case totals, last updated August 19, 2011
Charts and Graphs on H5N1 from WHO
Google Flu Trends
CDC Weekly Influenza Summary
Map of seasonal influenza in the U.S.
CIDPC (Canada) Weekly FluWatch
UK RCGP Weekly Data on Communicable and Respiratory Diseases
Flu Wiki Main Page