Influenza Virus Mashup

Via Ida's Bird Flu Information Corner, a translated report from Seputar Indonesia: Sukabumi, West Java ::: Bird flu outbreaks in 3 subdistricts. Excerpt:

Bird flu H5N1 outbroke in 3 sub-districts (kecamatan), Jampang Tengah, Bojong Genteng and Parakan Salak, in Sukabumi, West Java province. 

Spokesman of Livestock Service in Sukabumi mentioned 5 small-scale farms in 3 subdistricts tested positive H5N1 by rapid test. It was mentioned that Livestock Service sent the dead chicken samples to the Veterinary Disease Investigation Center, suggesting the outbreak has caused chickens death.

(Wed, 30 Nov 2011 12:21:00 +0000)

# 5984

When it comes to flu and/or infectious disease-related reporting, CIDRAP NEWS is high up on my (admittedly) short list of media sources that I consider to be sane, credible, and reliable.

Eschewing hyperbole and unsubstantiated speculation, News Editor Robert Roos & staff writer Lisa Schnirring do a terrific job cutting to the chase, without leaving out important details.

Last night Lisa put together an overview of the emerging trH3N2 story, including some news we’d not seen before; that USDA sponsored surveillance has detected a number of reassortant H3N2 viruses in swine recently, including 8 that display the 2009 H1N1 matrix (M) gene.

This M gene is the same one shared by the trH3N2 virus that has – at last count – infected at least 10 people across four states over the past few months.

At this point I’ll simply step aside and direct you to:

New details emerge in novel H3N2 reports

Lisa Schnirring Staff Writer

Nov 29, 2011 (CIDRAP News) – New details about the three most recent human infections with a novel swine-origin influenza virus have emerged over the past few days, along with a preliminary report of similar viruses in a few pigs.

(Continue . . .)

If you have not already done so, I would invite you to read Helen Branswell’s terrific SciAm feature from last December called Flu Factories which looks at the potential for novel flu viruses to emerge from the farm. 

It is an absolute must read.

Flu Factories

The next pandemic virus may be circulating on U.S. pig farms, but health officials are struggling to see past the front gate

By Helen Branswell  | December 27, 2010 |

Via CIDRAP: FLU NEWS SCAN: Egyptian H5N1 case, avian flu outbreaks, US flu update. Excerpt:

A 31-year-old woman in Egypt is in critical condition with an H5N1 avian flu infection, the World Health Organization (WHO) reported today. 

The woman, from Dakahlia governorate, developed symptoms Nov 10, was hospitalized Nov 16, and is now on a ventilator. She was exposed to sick and dead poultry in her backyard, the agency said. The Egyptian Central Public Health Laboratories, a WHO-affiliated national influenza center, confirmed her case on Nov 21. 

The country has now had 153 H5N1 cases since 2006, 52 of which have been fatal. Egypt has confirmed 34 H5N1 cases this year, including 12 deaths. The global H5N1 count has now reached 571 cases and 335 deaths, for a case-fatality rate of 58.7%.

(Tue, 29 Nov 2011 20:55:00 +0000)

# 5983

My thanks to Helen Branswell for tweeting the link to this new risk assessment from the ECDC on the recent trH3N2 cases detected in a handful of people (mostly children) across four states here in the US (see MMWR Dispatch: Limited H-2-H Transmission Of Novel A(H3N2) Virus.)

The 7-page PDF document considers the current threat these reassorted swine viruses pose to public health in Europe to be low.

They concede, however, that `It is possible that these triple reassortant infections will appear in Europe, particularly if there is more human-to- human  transmission, which could lead to imported cases.’

ECDC rapid risk assessment: Swine-origin triple Reassortant influenza A(H3N2) viruses in North America

29 Nov 2011

Centers for Disease Control and Prevention (CDC) has reported recent infections in children in North America with a swine-origin triple reassortant influenza A(H3N2) virus that includes a genetic component from the pandemic 2009 virus, and with probable human-to-human transmission with these viruses.

 

ECDC has conducted a rapid risk assessment to evaluate the implications for public health in Europe.

ECDC rapid risk assessment: Swine-origin triple reassortant influenza A(H3N2) viruses in North America (29 November 2011)

A few excerpts from the summary follow, but the entire document is worth reading:

 

Conclusions and recommendations

Following recent infections in children in North America with a swine-origin triple reassortant influenza A(H3N2) virus that includes a genetic component from the pandemic 2009 virus, and with probable human-to-human transmission of these viruses, ECDC has come to the following preliminary opinion:

•  These viruses are known to be found in pigs in North America but they have not been found in pigs in Europe (EU/EEA countries). However, surveillance for influenza in pigs is weak in both North America and Europe, and surveillance for infections in humans in close contact with pigs is notably weak in Europe. Hence all such statements on the epidemiology of swine influenzas must be treated with caution.   

 

•  Most of the US cases experienced only mild disease. Those hospitalised had underlying conditions and all patients recovered completely.

•  These viruses are susceptible to the neuraminidase inhibitors (oseltamivir and zanamivir) though the current A(H3N2) component of seasonal influenza vaccines is unlikely to provide protection. Older people are likely to have some protection from exposure to earlier vaccines.

•  It is considered by the United States Centers for Disease Control (CDC) that there had already been some very limited human-to-human transmission of these and similar viruses in the US. 

•  Unlike in March 2009 (the start of the pandemic) there are no reports of numbers of unexplained influenza infections elsewhere in the Americas. Hence it is unlikely that these US cases represent outliers for a larger phenomenon. 

•  Overall, therefore, the immediate direct threat to human health in Europe is low.

•  ECDC staff are following the situation closely and are in direct contact with the WHO, the US CDC and relevant experts in EU Member States.

•  There is a need to ensure that these infections could be detected through  diagnostic testing in European national influenza laboratories. 

•  There are strong public health arguments for more active virological surveillance of pig herds in Europe (and North America) including active surveillance of infections in humans that are in direct or indirect contact with pigs.  

 
•  Equally justified are more formal approaches to assessing emerging influenza viruses for their pandemic potential and such virological risk assessments should continue to be developed. 

 

•  Unusual influenza viruses should continue to be referred to National Influenza Centres and on to the WHO Collaborating Centre in Europe, along with relevant clinical and epidemiological data.   

For more on this emerging  story, you wish to revisit some of these earlier blogs:

Pseudo Pandemics And Viral Interlopers

CDC Update On trH3N2 Swine Infections

CDC Update On trH3N2 Cases

CDC Update On Recent Novel Swine Flu Cases

MMWR: Swine-Origin Influenza A (H3N2) Virus Infection in Two Children

This seems to be a big day for H5N1 news, and it gets around fast in Flublogia. Someone tipped off Mike Coston about WHO | Avian influenza - situation in Egypt - update 57, and I picked up the story from him.

The Ministry of Health and Population of Egypt has notified WHO of one case of human infection with avian influenza A (H5N1) virus. 

The case is a 31 year-old female from Meet Salseel district, Dakahlia governorate. She developed symptoms on 10 November 2011 and was hospitalized on 16 November 2011. She is in critical condition and is provided with ventilation support. 

Investigations into the source of infection revealed that the case had exposure to sick and dead poultry in her backyard. 

The case was confirmed by the Egyptian Central Public Health Laboratories, a National Influenza Center of the WHO Global Influenza Surveillance Network on 21 November 2011. 

Of the 153 cases confirmed to date in Egypt, 52 have been fatal.

That's a 33.9 percent case fatality ratio—disastrous, but far better than Indonesia's 82 percent. I wish I knew why the H5N1 CFR varies so wildly, especially in countries with years of experience in dealing with the disease.

Via ekantipur.com: Bird flu confirmed in Bhaktapur. Excerpt:

Authorities have confirmed an outbreak of Bird flu at a poultry farm in Madhyapur Thimi Municipality in Bhaktapur district on Tuesday. 

The Veterinary Epidemiology Center in Tripureshwor  confirmed the ourtbreak of avian flu at a local poultry farm of Chandra Bahadur Tamang, situated on the banks of Manahara River in the municipality. 

An expert team dispatched from Department of Livestock Services under the Ministry of Agriculture and Cooperatives has initiated necessary works to prevent the spread of disease. 

Tamang had complained at the office of the livestock services after 35 of his chickens died on Nov 9 and 10. 

A sample of the dead chicken was sent to England for confirmation test after the veterinary center suspected the outbreak. The test has confirmed that the chickens died of Bird flu.

Surprising that they had to send the sample all the way to England rather than to India.

(Tue, 29 Nov 2011 14:55:00 +0000)

# 5982

My thanks to Lisa for the head’s up this morning on this World Health Organization Global Alert and Response (GAR)  update from Egypt.

 

Avian influenza - situation in Egypt - update 57

29 November 2011 - The Ministry of Health and Population of Egypt has notified WHO of one case of human infection with avian influenza A (H5N1) virus.

 

The case is a 31 year-old female from Meet Salseel district, Dakahlia governorate. She developed symptoms on 10 November 2011 and was hospitalized on 16 November 2011. She is in critical condition and is provided with ventilation support.

 

Investigations into the source of infection revealed that the case had exposure to sick and dead poultry in her backyard.

 

The case was confirmed by the Egyptian Central Public Health Laboratories, a National Influenza Center of the WHO Global Influenza Surveillance Network on 21 November 2011.

 

Of the 153 cases confirmed to date in Egypt, 52 have been fatal.

Mike Coston at Avian Flu Diary has an excellent post today: The Bird Flu Research Debate Continues. The media have been in a tizzy about experiments making H5N1 more transmissible (at least among ferrets). I've been avoiding such reports because they don't add much to our understanding, but Mike does a very good job of explaining both sides of the issue.

Treyfish at H5N1 Pandemic Information News has a very interesting report: IRAQ #bird flu #h5n1 looks like 2 dead,4 others under observation.

(Tue, 29 Nov 2011 14:46:00 +0000)

# 5981

The hyperbolic headlines of the past few days would have the casual observer believing that the world’s bird flu researchers are a bunch of crazed scientists about to unleash a plague upon all of humanity.

A few examples taken from the NewsNow feed of the past 72 hours include:

Engineered Avian Flu Could Kill Half the World’s Humans [Science] Gizmodo

 

Man-made deadly flu virus could wipe out humanity New Kerala

 

Mad Scientists Create H5N1 GM BioTerrorism Virus Conspiracy Planet

Based on the first two headlines, there is apparently some dispute over whether this research will be the death of all of us, or just half of the worlds population.

A minor technical point, I admit. But of interest, I would think, to at least 3.5 billion people.

There are legitimate questions to be asked regarding the safety and wisdom of many avenues of scientific research, but the truth is far less Strangelovian than some in the media would have us believe.

There is frankly little incentive for scientists to unleash a species killing plague, as it would make getting future research grants nearly impossible.

 

 

Since some in the media seem intent on pillorying bird flu researchers in general, and Ron Fouchier in particular, I thought it was only fair – for balance, if for no other reason - if I directed my readers to `the other side’ of this story.

My thanks to Gert van der Hoek on FluTrackers for posting the following link to Erasmus University’s Bird Flu Research FAQ.

FAQ Birdflu

Why does Erasmus MC carry out this type of research?

Erasmus MC carries out research to improve public health which is precisely why it is essential to conduct research on these viruses. A pandemic could cost many lives. Only by conducting these studies can we determine the risks caused by viruses and devise strategies to mitigate the risks, for example, by developing vaccines and medication to curtail the spread of the virus and by developing diagnostic tests. If these studies are not carried out as a precaution but once the virus has started to spread, it is too late. Research and the development of tests, vaccines and medication are very time consuming. The outcomes of this study will also be benficial in earlier recognition of dangerous variants of the virus in outbreaks.

You’ll also find their answers to the following questions on this webpage.

 

How big is the risk that the virus will spread among humans?

Could this dangerous virus escape from a laboratory or fall into the hands of people intending to cause harm, such as bioterrorists?

Can researchers become infected with the virus and then spread it?

Would it not be better to stop this type of research?

 

While some aspects of the media are unfairly painting bird flu researchers as a bunch of `mad scientists’ with a Gilbert Chemistry set, a sick chicken, and a dream - the reality is that nature continues to work 24/7 to develop more efficient pathogens. 

Researchers are trying to stay one step ahead of this process, in order to mitigate, or perhaps even avert, the next pandemic.

There are risks involved, of course. 

But those risks are also present in dozens of BSL-3 and BSL-4 labs all over the world, where scores of deadly pathogens are stored and experimented with every day. 

According to a CIDRAP report from last night (see Biosecurity panel said to be reviewing another H5N1 transmissions study) another well respected researcher’s work is under scrutiny by the US National Science Advisory Board for Biosecurity (NSABB), and there are discussions over how (or even whether) to publish the results.

Granted, genuine concerns exist over the wisdom of releasing the full details on these experiments, and some compromise regarding the publication of key elements to this research may well be needed.

But censoring the scientific community is a bad idea in principle, and as history has shown, rarely works in the long run. 

Knowledge is a difficult genie, no matter how closely held, to coax back into the bottle.