Influenza Virus Mashup

(Tue, 24 Jan 2012 15:50:00 +0000)

# 6097

The newshounds on the major flu forums do an incredible job searching for, translating, and analyzing media reports of infectious diseases from all over the world. I’ve said it before, but much of what I do in this blog is only possible due to their efforts.

In terms of organization, quality, and volume of information, it would be hard to find a more impressive repository of emerging disease news than one can find at FluTrackers.com.

With two recent high profile human infections from the H5N1 virus in China (and others being reported in Indonesia, Cambodia, Egypt, and Vietnam), along with the ongoing controversy over the merits and dangers of H5N1 research, media attention has once more turned towards bird flu.

Sharon Sanders, Editor of FluTrackers, has distilled the combined efforts of the FluTrackers team into a handy overview of the H5N1 risks in China based on information they have been able to accumulate.

Anyone wanting a crash course on the H5N1 situation in China need only follow the embedded links to get a grasp of the situation. As this overview emphasizes, state control of local media makes making definitive statements difficult.

FluTrackers.com Risk Assessment of H5N1 type influenza in China

The FluTrackers Team
January 24, 2012

We feel that we can not say with 100% certainly what the exact situation is but this is our opinion based on the facts as we ascertain them as of this date and time.

Humans are at continuous risk of exposure to H5N1 poultry.

1) China has an endemic H5N1 problem in poultry. We know this for several reasons:

a) There have been warnings over the years to clean eggs shells due to surface contamination including H5N1:

China - Experts Call for More Stringent Standards for Cleaning Eggs - Avian Flu Mentioned As Risk May 2011

China - Nutrition Society warns on poultry egg shells, meat, and storage due to avian influenza H5N1 contamination January 2012

2) There are numerous H5N1 drills to train emergency personnel how to react to human and poultry outbreaks. A sample of recent drills includes:

China - Human Bird Flu H5N1 Drill held in Qinzhou, Guangxi province – January 2012

China - CDC Holds Suspected Human H5N1 Emergency Drill in Binzhou City, Shandong province December 2011

China - Emergency Poultry Bird Flu Drill Held in Rizhao City, Shandong province December 2011

China - Major H5N1 Poultry Farm Drill Held in Jangmen, Guangdong province November 2011

 

3) There are recent H5N1 poultry outbreaks in countries that border China: Tibet, Vietnam (Human), Vietnam (poultry), Hong Kong (wild bird), Hong Kong (poultry), Bhutan, & Nepal

4) The Russian health minister warned citizens on January 4, 2012 to be vigilant about H5N1 when traveling in China here.

5) Other hints and tips in the Chinese press regarding H5N1 status:

China - "Raw" poultry not allowed on trains in Shenzhen due to bird flu fears January 15, 2012

Ministry of Health: human infection of highly pathogenic avian influenza surveillance will be strengthened for the sporadic cases January 2012

China - Shanghai public health requires all medical institutions to monitor carefully for unexplained pneumonia November 2011

6) No country, where H5N1 has become endemic in the environment, has been able to successfully eliminate this disease. Indonesia, Vietnam, and Egypt, each experiencing current poultry and human H5N1 cases, are the most outstanding examples of this unfortunate phenomena. Therefore, despite the fact that China is not reporting any current H5N1 outbreaks in poultry we believe they occur and this is a constant threat to human health.

We see no evidence of sustained and efficient H5N1 infection between humans in China. However, we feel this risk is unknown since China is not forthcoming, generally, about its disease status.

 

On June 14, 2011 the Ministry of Health announced a creation of a “black list” for media that do not report government sanctioned information. We feel this represents a risk to human health, in general, in China.

The risk of human contamination from H5N1 positive wild birds is unknown in China.Hong Kong reports sporadic cases of H5N1 in wild birds but there are no corresponding human infections that result from contact with such wild birds.

The risk of human contamination from animals (other than poultry), or the environment, in general, is not known.

 

Many studies have demonstrated that animals can harbour the H5N1 virus, including domestic cats and dogs. In an H5N1 endemic environment, it should be assumed that there are many possible vectors for infection.

It is unclear how the most recent human cases of H5N1 were infected here and here. The government of China denied any human-to-human transmission in the Shenzhen case. The government also denied H5N1 poultry as the source. There were some press announcements that contact with a wild bird may have been the cause of the human case in Shenzhen. If this is true, then, logically, there must be many human cases of H5N1 in China amongst people who frequent parks and other outdoor venues. We feel this scenario, while possible, is not likely.

In conclusion, we feel there is a risk to the human population in China from H5N1 type influenza. A culture of hand washing, avoidance of wild birds and poultry, sanitary contact with domestic pets, and social distancing in public is advisable.

(Tue, 24 Jan 2012 12:40:00 +0000)

# 6096

Generation X – that is, the generation born after the post-war baby boom - comprise about 80 million Americans who are now in their 30s and 40s.

The University of Michigan’s Institute for Social Research - in conducting their Longitudinal Study of American Youth -  has collected data from roughly 3,000 participants aged 36 to 40 on how they perceived and reacted to the 2009 H1N1 pandemic.

While this study reports that Gen X responded reasonably well to the pandemic, only about 20% appear to have availed themselves of the flu shot.

And despite believing they were `well informed’ on the subject of pandemic flu, overall they scored only moderately well when tested on 5 areas of general flu knowledge.

Gen Xers indicated they trusted their family practitioner, and the NIH the most when it came to flu information, and Youtube videos, drug companies the least.

Here is the press release, I don’t find the study available yet on the Lsay.org website.

Generation X: How young adults deal with influenza

ANN ARBOR, Mich. — Only about one in five young adults in their late 30s received a flu shot during the 2009-2010 swine flu epidemic, according to a University of Michigan report that details the behavior and attitudes of Generation X.

 

But about 65 percent were at least moderately concerned about the flu, and nearly 60 percent said they were following the issue very or moderately closely.

 

Using survey data collected from approximately 3,000 young adults during the 2009-2010 H1N1 influenza epidemic—the first serious infectious disease this group had ever experienced—The Generation X Report explores how Americans ages 36-39 kept abreast of the issue and what actions they eventually took to protect themselves and their families.

 

"These results suggest that young adults in Generation X did reasonably well in their first encounter with a major epidemic," said Jon D. Miller, author of The Generation X Report. "Those with minor children at home were at the greatest risk, and they responded accordingly, with higher levels of awareness and concern."According to Miller, understanding Gen X reactions to this recent threat may help public health officials deal more effectively with future epidemics.

 

The results show that a majority of Generation X young adults felt that they were "well informed" or "very well informed" about the issue. However, they scored only moderately well, overall, on an Index of Influenza Knowledge, a series of five items designed to test the level of knowledge about viral infections generally and about the swine flu epidemic specifically.

 

Miller directs the Longitudinal Study of American Youth at the U-M Institute for Social Research. The study, funded by the National Science Foundation since 1986, now includes responses from approximately 4,000 Gen Xers—those born between 1961 and 1981.

 

Among the other findings:

• Young adults with minor children at home were most likely to follow the news about influenza closely and were most concerned about the swine flu epidemic.
• Young adults were most likely to report getting information about the epidemic from friends, co-workers and family members. In the month before the survey, they reported having about nine such conversations, compared to getting news about the flu less than three times via print or broadcast media, and about five times from searching the Internet.
• The most trusted sources of information about the influenza epidemic were physicians, followed by the National Institutes of Health, pharmacists at local drug stores and nurses from county health departments. The least trusted sources were YouTube videos, drug company commercials and Wikipedia articles.

(Continue . . . )

The tireless Sharon Sanders at FluTrackers has posted some details about the case: China, Man, 39, dead from H5N1 Bird Flu - 59 contacts being monitored - Guizhou province - FluTrackers. The victim, Liao Xu, was evidently the owner of a car-rental agency in Guiyang. Her chronology of his case:

It appears: 

January 6 - admitted into Fourth People's Hospital of Guiyang 

January 19 - transferred to Guiyang Medical College Affiliated Hospital 

January 21 - blood sample sent to China CDC for analysis

January 21 - H5N1 confirmed by China CDC 

January 21 - antibody serum treatment begun 

January 22 - death

This is Lunar New Year's Day, giving the Chinese media another reason not to pay too much attention to a case that will make local and national officials very uncomfortable. Thanks to Sharon and her FluTracker colleagues for finding as much as they have.

Via the Fort Frances Times Online, a report by Helen Branswell of The Canadian Press: Small meeting in mid-Feb to take first crack at bird flu research impasse: WHO. Excerpt:

A small — in relative terms — group of technical experts will be invited to Geneva in mid-February to begin the difficult task of trying to break an impasse arising from the proposed publication of controversial bird flu research, the World Health Organization revealed Saturday. 

The controversy was ignited when a U.S. government panel recommended two scientific journals be asked to withhold parts of studies that reportedly show how the H5N1 flu virus can be made more transmissible. 

A senior WHO official said the meeting will likely involve fewer than 50 people and is tentatively slated for Feb. 16 and 17, though the dates aren’t yet firm. Participants will include representatives of the Dutch and American research teams that conducted the studies, experts from WHO’s network of influenza laboratories and people with first-hand involvement in the dispute. 

“We are not setting this up as a political meeting. We are setting this up as a meeting of extremely knowledgeable technical people,” said Dr. Keiji Fukuda, assistant director-general for health security and environment. 

The aim of the gathering will be to identify the short- and long-term issues that need to be resolved and start work on those that are most critical. 

“In a sense it’s a way to tease through the complexity and make this a discussion that can lead to some — hopefully — good solutions,” Fukuda said in an interview from Geneva.

I've just run across Professor Ed Rybicki's ViroBlogy, a blog based at the University of Cape Town. While it's supposed to be "mainly for students," I think it deserves a wider audience. He's dealing with the issues that concern Flublogia, and we need the perspective of experts in the hot zones. ViroBlogy is going into the Bloggers list.

Via WorldPoultry.net: East Java to prevent bird flu. Excerpt:

The agency of animal husbandry of the province of East Java girds itself for another onset of bird flu in the territory after a case of bird flu in Jakarta recently. East Java province is known as one of the broiler and egg production centers in Indonesia. 

Head of the agency of animal husbandry of East Java province, Suparwoko Adisumarto, said that they have prepared about three million doses of bird flu vaccine for poultry and 133,000 liter of disinfectants. These vaccines and disinfectants will be distributed to 38 districts in East Java, according to Adisumarto. 

Adisumarto added that they would also optimize their LDCC (Local Disease Control Centre) team to prevent bird flu in the 38 districts. 

“The LDCC team of 250 people will directly monitor backyard and commercial poultry. They will report their findings to PDSR (Participatory Disease Surveillance and Response) team,” he said. 

In 2011, the agency of animal husbandry of East Java province noted that there have been as many as 53 cases of bird flu in the territory with a total of 17,139 birds having been culled.

Via Kuensel Online: Bird flu contained, surveillance stepped up. Excerpt:

The 40 poultry owners at Changedaphu, Thimphu would receive Nu 83,916 [US$1,675] either today or tomorrow for the birds and eggs that were culled and destroyed to contain the bird flu outbreak in the capital. 

Following a confirmation of the outbreak on January 13 in Changedaphu (Kalabazar), a total of 284 birds were culled, 372 eggs and two empty egg trays were disposed. 

The National Incident Command Centre for bird flu decided not to compensate for the 42 coops that were also destroyed. 

“Since the coops in the labour camp were temporary and made of cartons, we decided not to compensate the dismantled coops,” dairy chief of livestock department and focal person for bird flu Dr Tashi Dorji said. 

The compensation amount for the culled birds and eggs is based on 75 percent of the market rate. The amount is slightly higher than the one paid to Tsimasham poultry owners, where the first flu outbreak was reported in the country. 

In Tshimasham, the team compensated the 131 poultry owners with Nu 502,809 [US$10,039] for the 1,585 culled birds, 6,785 eggs and 57 coops and 1,315 kg of commercial feeds that were disposed. 

Poultry owners in Thimphu are getting Nu 285 [US$5.69] for a culled chicken and Nu 8 [US$0.16] for each egg disposed. So far no new cases of sick or dead birds have been reported in Thimphu as well as in other parts of the country.

(Mon, 23 Jan 2012 14:11:00 +0000)

(Mashup of an original map from USGS depicting 3 areas and 4 major earthquakes over the past year on the ring of fire)

# 6095

Just before noon on September 1, 1923 a massive - and by all reports long-duration - 7.9 magnitude earthquake struck beneath Sagami Bay devastating Tokyo, the port city of Yokohama, and several nearby prefectures.

The timing of the quake, at lunchtime, meant many people were cooking when it struck, and that – combined with winds from an offshore typhoon – contributed to the firestorm that swept Tokyo.

Estimates vary, but more than 100,000 people are believed to have perished.

 

Since 1960, September 1st has been designated as an annual "Disaster Prevention Day" in Japan.

With the horrific events from last year’s Tohoku 9.0 earthquake, tsunami, and resultant nuclear crisis still fresh, the prospect of Japan enduring another great quake continues to haunt.

The Japanese government has stated that there is a 70% of a strong earthquake striking the capital over the next 30 years, but some academics see the threat as being much closer in time.

Over the past year, seismologists have detected an increase in the number of small quakes in and around the nation’s capital. A scenario not unlike what was seen in the lead up to last year’s massive quake.

This from the Tokyo Times.

The “Big One” was preceded by 1,000 smaller quakes

Monday, January 23, 2012

More than a thousand small, repeating earthquakes migrated towards the epicenter of the 2011 Tohoku Quake in the month before the disaster, scientists have learned.

(Continue . . . )

Today, the news wires are filled with stories on a report issued from researchers at the University of Tokyo that claims the likelihood of a strong (7+) Tokyo quake is greater than the government has maintained.

Major Tokyo quake more likely than government says: academics

(Reuters) - A major earthquake is far more likely to hit Tokyo in the next few years than the government predicts, researchers at the University of Tokyo said on Monday, warning companies and individuals to be prepared for such an event.

 

There is a 70 percent chance a magnitude 7 quake will jolt the southern part of the Tokyo metropolitan area in the next four years, the university’s Earthquake Research Institute said.

(Continue. . .)

As I wrote last year in Divining Japan’s Seismic Future, Japan does not lack for devastating earthquake potential.   

The most widely anticipated seismic event is the Tokai Earthquake – expected to be an 8+ magnitude, and forecast to occur between the Bay of Suruga and Cape Omasezaki in Shizuoka Prefecture sometime in the near future.

 

 

 

Major earthquakes have occurred in this region every 100-150 years, with the most recent recorded in 1498, 1605, 1707 and 1854.

 

That puts the Tokai region 157 years since their last major quake, and in the estimation of Dr Kiyoo Mogi – Japan’s leading seismologist – well overdue for another.   In 1969, Dr Mogi began warning that the Tokai area was particularly vulnerable, and today the area is monitored continually by the JMA.

Which is why the Prime Minister of Japan called upon Chubu Electric to shut down its No. 4 and No. 5 reactors at the Hamaoka nuclear plant last May, located roughly 200 km south-west of Tokyo.

As for the seismic threat to the Tokyo region, Shinichi Sakai - associate professor at the earthquake research institute  - is quoted today as saying:

"The government, individuals and corporations should make preparations for that now"

For more on earthquakes, you may wish to revisit:

UN Agency Warns On Global Seismic Risks

The Great Central U.S. Shakeout:2012

NPM11: Are You Earthquake Prepared?

Via The New York Times: China Reports 2nd Bird Flu Death in Month. This discusses both today's death and that of the Shenzhen bus driver on December 31. Excerpt and then a comment:

Both deaths were notable because neither victim reported any contact with birds in the month preceding his illness. The virus is known to spread through contract with infected birds, eggs or bird feces, but experts said a pandemic could occur were it to mutate into a form that was more easily spread. 

In the latest case, the victim “did not report obvious exposure history to poultry before the onset of symptoms,” according to the bulletin from Hong Kong. But the Chinese authorities, who are monitoring 71 people known to have been in contact with the victim, have found no other evidence of flu, the ministry reported. 

People who were in contact with the Shenzhen victim also have remained symptom-free, leading some experts to conclude that neither case involved transmission among humans. 

On Sunday, Chinese censors generally blocked Internet users from reading reports of the latest death.

Weekends are usually very slow for flu news, and big agencies like WHO fall silent (it's Sunday night in Geneva, so we won't get any official response for at least 12 hours or so). What's more, it's already Lunar New Year in East Asia, and most Chinese are involved in their annual struggle to get home to see the family. This of course raises some anxiety about millions of sneezing, coughing, over-stressed people crammed into trains and buses in the dead of winter.

Thanks to Sharon Sanders at FluTrackers for compiling this eye-opening list: Global Confirmed H5N1 Bird Flu Cases December 1, 2011 +. She also notes that WHO belatedly confirmed another Egyptian H5N1 case on January 19: a two-year-old in late October who recovered.