Influenza Virus Mashup

Thanks to Mike Coston at Avian Flu Diary for passing along a tip about a hastily convened press conference to deal with a problem in a Bremen hospital. I did a little digging and found this item in the Weser Kurier: Drei Frühchen sterben im Klinikum Mitte. [Three premature babies die in Bremen-Mitte Hospital] A Google translation:

According to information from the Weser-Kurier three premature babies died. Currently, a crisis team at the Robert Koch Institute site, shares the clinic with a press release. At a press conference on the afternoon of the State Health Department and the management of the hospital and the hospital group Bremer will inform about the details. (AP, gor)

At this point, we will keep you in the course of the day about what's going to date.

We will learn more in the next hour or so.

Update: A report in Frankfurter Allgemeine Zeitung doesn't have information from the press conference but says at least two of the babies were killed by a "contaminated nutrient solution."

Update 2: Welt Online has more, in German, which confirms Gert's helpful comments below this post. Evidently two babies died in August (which now means someone failed to report promptly) and another died recently. Ten babies are ill and the premature ward has been closed. Still nothing from the press conference.

(Wed, 02 Nov 2011 12:32:00 +0000)

 

# 5935

 

 

A little over 4 years and nearly 5,000 blogs ago (Nov. 1, 2007 to be precise) I posted an essay called Hickory Farms Will Hate Me For This, where I suggested that instead of buying ugly neckties, holiday-themed sweaters, or an assortment of unidentifiable cheeses for the people on your holiday gift-giving list - that you give them preparedness items instead.

 

This epiphany came to me one fall day a few years back when I was rummaging through a local warehouse closeout store and found a bin of `shake’ LED flashlights on sale for .77 cents each. You know the type, you shake for a few seconds and it powers the flashlight for several minutes.

 

 

 

I bought 40 of them on the spot, and that Christmas they ended up as `stocking stuffers’ for all of my friends.  Since then, whenever possible, I give preparedness gifts.

 

The great thing is, many of these items can often be had for just a few dollars, yet they can be lifesaving (or at least important to have) in an emergency.

 

A couple of years ago I ran across a deal on LED headlamps, and bought about 20 of them for $2 apiece.  The following year, I found LED Cap lights (they clip to the bill of a baseball style cap) for $3 each, which I confess I like even better.

 

 

 

Hands free light can be a real plus in a crisis.  These too ended up in a number of people’s Christmas and birthday packs.

 

During the year I keep my eye out for bargains such as these, and stock up when I find things on sale. A couple of years ago I picked up a number of LED lanterns for $3 apiece at a closeout store. They are particularly nice, and run about 40 hours on a set of AA batteries.

 

 

But this year, I found a newer item; a combination LED lantern/flashlight that sells for about $5, and it is rapidly become my new favorite.  Lightweight, versatile, and cheap.  A hard combination to beat.

 

 

This year, I’m seeing a lot more variety in LED lanterns and flashlights, providing a lot more bang for the buck. Not only do LEDs run a long time on a set of batteries, unlike gas lanterns, they don’t pose a fire safety hazard.

 

Every home should have a battery operated radio, yet many do not. A few years ago I bought my daughter a combination windup-battery-solar AM/FM/SW radio for under $40, and she uses it every day.

 

 

Last year, I found a combination AM/FM Weather ALERT radio at a discount store for under $20. Again, every home and business should have an emergency alert radio.

 

 

A pair of the FRS radios, like the ones I highlighted in this blog, would make an excellent gift for many families, and can be had for less than $25.

 

 

For Christmas a couple of years back I put together some first aid kits, and distributed them to a number of friends and relatives. You can either put one together yourself, or purchase one already assembled.

 

 

Living as I do in hurricane country, I’m always aware of the need to store water for emergencies. One of the items I’ve purchased for friends (and myself) are those collapsible 5-gal water carriers. For only about $5, you can store 5 gallons of water, and when not in use they fold up for storage. 

 

 

Although a bit pricier, I’ve also purchased emergency water filter/purification systems for several friends over the years. Here you’ll find a number of options ranging from purification tablets (chlorine or iodine based) for under $10, to high capacity filtration systems like the one below for about $200.

 

 

In between you’ll find a lot of filtration options in the $40-$60 range.

 

Even MREs can make an excellent gift, and a couple of years back I found cases of them heavily discounted at my local Costco warehouse. 

 

 

 

Battery chargers, or an inverter to turn any 12 volt battery into a 120 volt electrical source make wonderful gifts as well. 

 

 

Two summers ago, on a particularly hot Florida afternoon, we had a power outage that lasted more than 6 hours.  I wrote about it in Sweltering In Place.

 

While I was already set up with a 12 volt fan, my Sister and Father weren’t so lucky. . . . they ended up driving across town to sit in an air-conditioned restaurant for several hours.

 

The next day, I went out and bought them each a battery operated personal cooling fan, one that will run for nearly 24 hours on 4 D-Cells.

 

I paid about $12 each for them.

 

Something as simple, and as utilitarian, as a multifunction `Swiss’ army knife or a `Multi-tool’ makes a great preparedness gift.

 

 

 

Another inexpensive gift idea: For under $10 you can buy a box of exam gloves, and a box of facemasks.

 

 

Joel over at Preparedness and Response came up with what I consider to be an excellent preparedness idea, giving USB flash drives to family and friends and instructions on how to back up their important papers and documents.

 

Inexpensive USB Drives start under $10.

 

He explains it in  his essay Helping others prepare (Personal Preparedness), where he gives his rationale for going with the durable mil-spec and encrypted, but fairly pricey IronKey brand.

 

My thanks to Joel for a terrific idea.

 

And lastly, I’ve put together CD’s of preparedness videos, along with copies of online manuals and preparedness guides.  For the cost of a blank CD or DVD, and a little bit of my time, I’ve at least put this valuable information into my friend’s hands.

 

I may just copy all of this info on to the USB drives I’m giving out this year instead of on CDs.  

 

These are all useful, indeed, potentially lifesaving items, that most people simply don’t think about needing until it is too late.

 

Giving them as gifts, instead of more traditional items,  not only helps prepare the people you love and care about for an emergency, it opens the door for conversations about pandemic preparedness.

 

We need to cultivate a culture of preparedness in this country, and around the world.

 

We can start doing that, one gift at a time.

 

And one last reminder for the upcoming Holiday Season.

 

This year, when we think about ways to give back to our community, remember that more people will be relying on community food banks than in years past.

 

In addition to anything else you might do, this is a good time to go through your pantry and donate foodstuffs that are approaching (but not exceeding) their `use by’ date.

(Wed, 02 Nov 2011 10:37:43 GMT) Mr. Hall will be a guest speaker on Flu Wiki Nov. 9, 2011, from 7-9pm. It is a Q & A for everyone. Mr. Hall is the author of American Fever: A tale of Pestilence and Romance, a pandemic novel due out very soon.

Save the date!

(Tue, 01 Nov 2011 22:37:00 +0000)

 

 

# 5934

 

 

Reassortant H3N2 virus detected in Pennsylvania,Indiana & Maine – Source CDC

 

Although it doesn’t seem to happen terribly often, every once in awhile an avian or swine influenza virus manages to infect a human host.

 

Usually after direct close contact with a bird or or pig.

 

This is a pattern we’ve seen with the avian H5N1, H9N2, and H7N7 viruses, and we’ve also seen it a couple of dozen times since 2005 with SOIV (swine origin influenza virus) trH1N1 and trH3N2 strains. 

 

Most of the time, these infections turn out to be dead end transmissions, as the virus is only partially adapted to human physiology.

 

Occasionally, we’ve seen evidence of limited secondary transmission albeit not in a sustained and efficient manner.

 

A recent `exception to this rule’ was the 2009 H1N1 pandemic virus, which after bouncing around in the swine population for years, finally evolved into an easily transmissible human pathogen.

 

If it were an easy thing for viruses to do, we’d be hip deep in pandemic viruses all of the time. It apparently takes a lot of evolutionary trial and error before a virus can `get it right’.

 

 

Although few of these avian and swine viruses have adapted well enough over the years to pose a serious public health threat, we watch them with great interest because the potential exists for them to eventually `figure us out’.

 

Over the past 90 days or so, we’ve been keeping up with a new SOIV virus has been detected among a small handful of people across three states. This virus is a reassortment of a swine trH3N2 and the 2009 pdmH1N1 virus.

 

You can find earlier coverage of these cases in A 5th trH3N2 SOIV Report & CDC Update On trH3N2 Cases.

 

Today the state of Maine’s website has news of their 2nd case detected during the month of October. It can be found in their weekly influenza surveillance report dated November 1st.

 

Novel Influenza A Virus

•  Maine confirmed a second case of swine origin novel influenza A virus. The first case was confirmed on October 17th , and the second case was confirmed October 31st. Both cases had multiple exposures to pigs.

 

These cases are the 5th and 6th recognized cases of human infection with S-OtrH3N2 with the M segment gene from the pH1N1virus.

 

More information can be found in a Health Alert, released 10/19/2011 accessible through:  http://www.maine.gov/tools/whatsnew/attach.php?id=313425&an=1. 

 

 

Epidemiological investigations into these cases continue. 

 

While sporadic cases such as these are not particularly alarming, we do watch these infrequent viral escapees from the farm for signs of adaptation.

 

As long as they are not able to transmit efficiently among humans they pose a very low public health threat. 

 

The concern is that the odds favor that the next pandemic virus will come from a farm – where large numbers of animals intermingle, swap viruses, and come in daily contact with humans.

 

Which is why so many scientists are calling for more comprehensive testing and surveillance on farm animals. 

 

For more on the reassortment potential of avian, swine, and human flu viruses, you can’t do better than  Helen Branswell’s excellent Scientific American article from last December called Flu Factories, or her SciAm Podcast interview.

 

For some of my earlier posts on this newly discovered trH3N2 swine flu virus, you may wish to revisit:

 

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

MMWR: Two Novel trH3N2 Flu Infections

(Tue, 01 Nov 2011 12:51:00 +0000)

 

 

# 5933

 

Most years, H5N1 bird flu activity declines over the summer months and begins to pick up again in the fall.  The peak of the season usually occurs in late winter or early spring. 

 

Which means that between now and the end of April, we are likely to see an increasing number of outbreaks reported. Most of these will involve wild birds, or poultry, but with these avian outbreaks also come a greater number of human cases as well.

 

You can easily see the pattern in the FAO chart below, which lists confirmed human cases by month and country.

 

 

 

HPAI poultry outbreaks in the the two countries that have seen the greatest number of human cases – Egypt and Indonesia –  follows this seasonal pattern closely.

 

 

Source FAO

 

The H5N1 virus, while thus far found only in Europe, Asia, and Africa, has been detected in more than 60 countries since 2003, although human infections have only been confirmed in 15 nations.

Source WHO

 

These charts represent known, reported cases.  There are areas of the world where surveillance, testing, and reporting are nearly non-existent, so other cases may well have gone unreported.

 

As expected, over the past month bird flu activity has begun to pick up again – particularly in Indonesia. 

 

We’ve seen 2 confirmed H5N1 fatalities, with another strongly suspected bird flu death, on the island of Bali in October. Additionally, local hospitals have isolated and treated more than 2 dozen `suspect cases’ (see Watching Bali Again).

 

Those who have followed bird flu in past years are aware that many of these suspect cases will turn out to have something other than `bird flu’.

 

Seasonal influenza, RSV, pneumonia, and other viral agents tend to circulate during the same time of the year as bird flu, and all of those can produce clinical symptoms indistinguishable from H5N1.

 

So we tend to get a lot of `false alarms’ in the press.  Of course, sometimes they turn out to be bird flu.

With that in mind, we’ve another report (picked up yesterday morning by Gert van der Hoek on FluTrackers (see thread) that indicates a large number of poultry deaths have occurred in East Java, and somewhere between 7 and 9 people have been treated for suspected `bird flu symptoms’.

 

Ida at BFIC has a brief update on the story this morning as well.

 

Jember, East Java ::: Hundreds of chickens die of H5N1. People develop flu signs.

Posted by Ida on November 1, 2011

Jember – Hundreds of chickens had died suddenly in Karang Baru village, Silo sub-district, Jember, East Java. A total 76 chickens from 17 households are H5N1 positive.

 

Seven residents are suspected of having bird flu infection, where 3 have recovered and 2 are still under treatment. Those people developed flu signs following to contact with dead chickens. Health Service has distributed masks for people living near the outbreak.

 

Suspects have been treated with Tamiflu.

 

Health Service has collected the swab sample of suspects, Monday (31/10), to be sent to Health Center Laboratory in Surabaya.

 

Livestock Service has controlled the situation by disinfecting the chicken cages which possibly infected with bird flu.

(Continue . . . )

 

 

We’ll have to wait for lab reports to know if any of these cases are actually due to the H5N1 virus. For now, they are just `suspect cases’.

 

Reports like these tend to come fast and furious during the winter months, sometimes generating a great deal of media buzz, speculation, and alarm. 

 

Most will turn out to something other than bird flu.  At least that’s been the history to date. 

 

But scientists continue to worry that the virus will eventually learn to adapt to human physiology.  And so we watch reports like the ones above closely for signs of that happening.

 

Particularly this time of year.

Via Ida's Bird Flu Information Corner, a translated report from the Bali Post: Denpasar, Bali ::: Two suspects test negative. But a new suspect is now in hospital.

A mother and daughter bird flu suspects from Abiansemal, Badung, have been discharged from Sanglah hospital after laboratory test showed negative H5N1. 

Sanglah hospital received another bird flu suspect patient which was referred from Kapal hospital, Saturday (29/10). Patient is a 6-year-old with initial JS, resident of Mengwi, Badung. 

Patient is exhibiting influenza-like illness (ILI) signs such as fever, and coughing lasting for 10 days after numbers of chickens found dead in the neighbourhood. 

JS is still under intensive treatment, and laboratory examination is still ongoing.

Via The Jakarta Globe: Most Bali Hospitals Not Prepared to Handle Bird Flu. Excerpt:

Most of the hospitals in the resort island of Bali have not yet ready to handle the referral of patients infected with bird flu virus, a local health official has said. 

Bali provincial health department chief dr Nyoman Sutedja said here on Sunday that type B hospital could handled bird flu virus infected patients but most of the hospitals in the province were type-C and could not do so. 

Nyoman said that Bali only had three reference type-b hospitals for bird flu, namely Sanggala hospital in Denpasar, Tabanan hospital in Tabanan, and Sanjiwani hospital in Gianyar but the rests were type-C. The biggest hospital in Bali is Sanglah Central Hospital in the downtown of Denpasar. 

According to him, type-C hospitals in Bali were unable to handle the patients infected with bird flu virus because they did not have sophisticated infrastructures and facilities nor capable medical experts. 

"The specialist doctors for bird flu are mostly in the cities and only a few are at the hospitals in the regions," Nyoman Sutedja said, adding that the reference hospitals also needed specialist doctors who were able to use sophisticated instrument to treat the bird flu patients.

(Mon, 31 Oct 2011 12:23:00 +0000)

 

 

# 5932

 

Global Spread of Dengue

 

Dengue is a rapidly expanding mosquito-borne virus that is estimated to infect around 50 million people every year. Tens of thousands die annually, and as yet, there is no effective vaccine.

 

The explosive growth of Dengue around the world is well illustrated by the following graph from the World Health Organization.

 

What this graph doesn’t indicate is another doubling of dengue cases has taken place over the past 5 years

Nearly a year ago I wrote about the controversial release of genetically modified mosquitoes (see The Cayman Island Mosquito Trials) by the Oxitec company in a bid to learn how to reduce these Dengue vectors.

 

Oxitec’s genetically altered terminator mosquitoes have been bio-engineered to carry a lethal gene that the males can pass on to their progeny that causes them to die in the larval stage.

 

And the early results were very promising.

 

An 80% reduction of mosquitoes in a 25 acre test area after 19,000 males mosquitoes were released over a 4-week period in 2010.

 

Since this  research was conducted quietly, with little publicity, some public concern has since risen. The Cayman Island government produced this short video explaining the process in an attempt to allay any fears.

 

 

 

 

Oxitec has a short  FAQ page on their technology, which you can access here.

 

This research was published yesterday in the Nature Biotechnology journal.

 

Field performance of engineered male mosquitoes

Angela F Harris, Derric Nimmo, Andrew R McKemey,Nick Kelly, Sarah Scaife, Christl A Donnelly, Camilla Beech, William D Petrie & Luke Alphey

 

 

Yesterday the New York Times and The BBC both carried extensive stories on this research. Of the two, the NYT’s article adopted a bit more of a cautionary tone. 

 

Concerns Are Raised About Genetically Engineered Mosquitoes

By ANDREW POLLACK

Published: October 30, 2011

 

While the BBC article simply states that the World Health Organization is `cognizant that genetic engineering is a technology that carries the potential for risks as well as benefits’, and is working on guidelines.

 

GM mosquitoes show fever promise

By Richard Black  30 October 2011

 

Both articles provide useful background.

 

Oxitec’s GM process isn’t the only bid to modify mosquitoes to reduce disease transmission. 

 

Earlier this year in A Mosquito STD To Fight Dengue I wrote about a project to infect mosquitoes with Wolbachia, a bacteria commonly found in fruit flies that – for reasons that aren’t entirely clear - inhibits a mosquito’s ability to transmit Dengue Fever.

 

Around the beginning of the year scientists in Queensland, Australia began releasing thousands of Wolbachia infected mosquitoes each week into the remote communities of Gordonvale and Yorkeys Knob.

 

The hope being that infected mosquitoes would eventually supplant the uninfected native mosquito population.  Helping this project along is the way that Wolbachia is transmitted among mosquitoes. 

 

You see . . .  among mosquitoes, Wolbachia is essentially an STD, a sexually transmitted disease.

 

The bottom line:  Within a matter of a few months the Wolbachia infected mosquitoes overran the uninfected mosquito population in these two test environments.

 

While extremely encouraging, more tests are needed, including confirmation that this process works against all dengue serotypes. The Gates Foundation is providing further funding to support the release of Wolbachia mosquitoes in Australia, Vietnam and Thailand.

 

While there are safety issues that must be addressed - and getting the public to accept genetically modified  mozzies may be an issue - the creation of a Brave New Mosquito may someday contribute to the reduction of Dengue, Malaria, and other mosquito-borne diseases around the world.

 

At least, that’s the hope.