Influenza Virus Mashup

Via TuoiTreNews.vn: 2012’s second bird flu death confirmed. Excerpt:

The Mekong Delta’s Soc Trang Province has reported another bird flu death, the 2nd case in 2012, according to the Department of Preventive Medicine under the Ministry of Health. 

This is also the 2nd person having succumbed to H5N1 virus in the Mekong Delta this year after the case in Kien Giang Province, said Nguyen Van Binh, head of the department. 

The 26-year-old female patient in Thanh Tri District was brought to the local hospital on January 23 after showing fever symptoms. 

She was then transferred to Bac Lieu Province General Hospital on January 25 with viral pneumonia diagnosis since the illness still persisted. She died in the hospital three days later. 

Test conducted by Pasteur Institute in Ho Chi Minh City has showed that patient was infected with Influenza A virus subtype H5N1, also known as "bird flu". 

According to a recent epidemiological investigation, the patient had slaughtered and eaten infected meat, in the area where there was phenomenon of mass poultry death.

(Wed, 01 Feb 2012 15:02:00 +0000)

# 6114

With the recent flap over the creation of two highly transmissible laboratory strains of the H5N1 virus, there have been calls to restrict this kind of research to labs with only the highest levels of biosecurity.

In the United States, this level of containment is called Biosecurity Level 4 (BSL-4) or sometimes BL-4, but in other parts of the world similar high containment labs go by different names. 

In Australia, they are designated "PC4,” which stands for "physical containment 4”, while in Canada, these labs are called Containment Level 4 (CL-4).

 

While most of these facilities boast truly impressive biosecurity precautions, there are no universally mandated standards, and so practices and techniques may vary from one country to the next.

Today, the Public Health Agency of Canada has issued a Biosafety Advisory for working with transmissible strains of the H5N1 virus, relegating such work to their highest containment (CL-4) labs.

 

Biosafety Advisory: Efficiently Transmissible Engineered Influenza A H5N1 Viruses

February 01, 2012

This biosafety advisory is being provided by the Public Health Agency of Canada ( PHAC ) in response to recent publications of efficiently transmissible engineered Influenza A H5N1 viruses. The Pathogen Regulation Directorate ( PRD ) has developed this advisory based on current scientific evidence available on this pathogen and is subject to review and change as more information becomes available. The Risk Group ( RG ) of efficiently transmissible Influenza A H5N1 viruses is RG4.

1. Background

Influenza A H5N1 is a highly pathogenic avian influenza virus that emerged as a human pathogen in 1997 when it was transmitted from avian populations to humans in Hong Kong^(1,2). Since then, various countries around the world have reported human infections, particularly in Southeast Asia, the Middle East, and Africa. From 2003 to 2011, 574 human cases and 337 deaths have been confirmed by the World Health Organization; this correlates to a mortality rate of 59%⁽³⁾. H5N1 can cause death in healthy individuals with no pre-existing medical conditions.

In November 2011, three independent studies on H5N1 transmission in ferrets were either published online or submitted for publication. These studies have received a significant amount of attention due to their relative success in producing engineered H5N1 viruses capable of efficient transmission in ferrets, including via the air^(4-10). Ferrets are considered a good model for studying human influenza viruses⁽¹¹⁾. The engineered transmissible H5N1 viruses are not currently in circulation, but it is widely agreed that if released, the clinical and economic impact could be devastating.

2. Biosafety Requirements

The following table summarizes the containment requirements for laboratories working with efficiently transmissible engineered Influenza A H5N1 viruses. No containment requirements are stipulated for non-proliferative clinical/diagnostic activities based on the fact that this virus is currently not in circulation. Laboratories should refer to the Laboratory Biosafety Guidelines, 3^rd Edition, 2004 for a complete listing of the biosafety requirements.

H5N1 viruses capable of efficient human-to-human transmission, including via aerosols or the airborne route, are considered Risk Group 4 human pathogens and require Containment Level 4 physical containment and operational practices.

3. Additional Risk Considerations

If an efficiently transmissible H5N1 virus was introduced into circulation, a risk assessment would be necessary to determine the regulatory requirements for different types of work, such as non-proliferative clinical/ diagnostic activities.

(Continue . . . )

Down in the humid swamps of Florida, Mike Coston at Avian Flu Diary has beaten me to a story on my own turf: Canada Issues Biosafety Advisory For H5N1 Research. Excerpt:

Today, the Public Health Agency of Canada has issued a Biosafety Advisory for working with transmissible strains of the H5N1 virus, relegating such work to their highest containment (CL-4) labs.

As always, Mike has the story plus useful background information.

(Wed, 01 Feb 2012 12:33:00 +0000)

Photo Credit PHIL

# 6113

ACIP, the CDC’s Advisory Committee on Immunization Practices, has published their revised recommendations for adult immunizations today in the February 1st edition of the Annals of Internal Medicine.

Among the changes, ACIP now recommends routine HPV vaccination for males aged 11 to 12 years, and has broadened their recommendations for administering the Hepatitis B vaccine.

The entire recommendation can be read at:

Recommended Adult Immunization Schedule: United States, 2012*

1. Advisory Committee on Immunization Practices†

But for the short version, we have this press release from the American College of Physicians.

 

2012 adult immunization schedule broadens recommendations for HPV and hepatitis B vaccinations

Annals of Internal Medicine early release article for Feb. 1, 2012

Philadelphia, February 1, 2012 – The CDC’s Advisory Committee on Immunization Practices (ACIP) now recommends routine HPV vaccination for males aged 11 to 12 years and catch-up vaccination for males aged 13 to 21. These are just two of the changes to the 2012 Recommended Adult Immunization Schedule being published February 1 in Annals of Internal Medicine (www.annals.org), the flagship journal of the American College of Physicians (ACP).

 

In addition to the changes in the HPV vaccine, the ACIP now recommends vaccination against Hepatitis B for adults younger than age 60 who have diabetes, as soon as possible after diabetes is diagnosed. Hepatitis B vaccinations should also be given to adults with diabetes aged 60 years or older based on a patient’s need for assisted blood glucose monitoring, likelihood of acquiring hepatitis B, and likelihood of immune response to vaccination.

 

The ACIP is comprised of the ACP and 16 other medical societies representing various medical practice areas. Each year, the ACIP reviews the CDC’s Recommended Adult Immunization Schedule to ensure the schedule reflects current clinical recommendations for licensed vaccines. The recommendations are intended to guide physicians and other clinicians about the appropriate vaccines for their adult patients. In October 2010, the ACIP adopted an evidence-based process that considers quality of evidence, benefits and harms, values and preferences of affected populations, and economic impact. Voting to expand routine HPV vaccination to males and hepatitis B vaccinations to young adult diabetics was the first exercise of this approach.

 

Changes were also made to when mothers should receive the tetanus, diphtheria, and acellular pertussis (Tdap) booster that is designed to protect infants from pertusiss. According to the 2012 schedule, women should receive the vaccine during pregnancy, preferably after 20 weeks of gestation. Protective maternal antibodies will pass to the fetus.

 

Adult patients should continue to be vaccinated against influenza. Egg allergy is no longer a contraindication, but patients with an egg allergy should get the inactivated flu shot because that is what has been studied.

 

A footnote was added to the schedule directing readers to links for the full ACIP vaccine recommendations. Specific vaccine recommendations for travelers also were added. In another new addition, the schedule now includes a table summarizing precautions and contraindications for vaccines.

###

The full 2012 Recommended Adult Immunization Schedule can be viewed at www.annals.org.

Via ColomboPage.com: Suspected avian flu case in Sri Lanka. Excerpt:

Sri Lanka's Ministry of Health has issued a warning that there may be a threat of avian (bird) flu after a large number of fowl had died of an apparent infection at a farm in Bingiriya, Kurunegala in the North Western Province. 

The Ministry has alerted that one of the dead birds had the symptoms of avian flu. 

The Additional Director General of the Department of Animal Production and Health Dr. A.D.N.Chandrasiri has confirmed that the fowl deaths were due to Avian Influenza caused by a strain less lethal than the potentially deadly H5N1 strain, News First reported. 

Following a meeting with the officials of Livestock and Animal Production Department yesterday, the Additional Secretary to the Health Ministry Dr. Palitha Mahipala has said that the Ministry has already taken steps to raise awareness among staffs of hospitals in Kurunegala, Bingiriya and Chilaw about the avian flu.

On his virology blog, Dr. Vincent Racaniello has posted The NSABB speaks on influenza H5N1. Excerpt from his detailed response to the NSABB:

Next the NSABB describes their consideration of risk assessment of the H5N1 ferret studies. Their conclusion: 

We found the potential risk of public harm to be of unusually high magnitude. Because the NSABB found that there was significant potential for harm in fully publishing these results and that the harm exceeded the benefits of publication, we therefore recommended that the work not be fully communicated in an open forum. 

But there is no description of how they reached this conclusion. What data did they consider when making this decision? What were the benefits and the potential harms, and how did they weigh them? Apparently we must take the word of the panel that they reached the right decision, even though we cannot know what information they used. To convey their decision in this manner is unacceptable and sends the message that the committee did not consider specific data during their deliberations. 

They conclude: 

The life sciences have reached a crossroads. The direction we choose and the process by which we arrive at this decision must be undertaken as a community and not relegated to small segments of government, the scientific community, or society.  

This is precisely why the decision to redact publication should not have been made by the NSABB or any small group of individuals. I agree that this is an ‘Asilomar moment’, a time when scientists must meet to decide what types of microbial research should be regulated. This should be a discussion among a large group of scientists, not bioterrorism policy analysts. 

I understand the need to regulate certain types of experiments on microbes. But when I balance the benefits and risks of the H5N1 ferret transmission experiments, it does not make sense to stamp them as dual use and restrict publication of the results. Let publication proceed and then decide how to decide on how to move forward.

Via People's Daily Online, a Xinhua report: Bangladesh destroys 140,000 birds, eggs after flu virus detection since November. Excerpt:

Bangladesh's authorities destroyed nearly 140,000 birds and eggs until last month since mid November when this season's first outbreak of bird flu was detected, an official said Wednesday. 

Ataur Rahman, assistant director at the control room of Bangladesh's Fisheries and Live Stock Department, told Xinhua that "Some 67,327 birds, including 12,714 at the latest on Tuesday, were culled in about a dozen flu-hit farms since the middle of November last year." 

During the same period, he said, "A total of 69,390 eggs were also destroyed." 

An official had earlier said risky factors of bird flu disease usually rise with the fall in temperature during January and February in Bangladesh which is considered a high-risk country with respect to Highly Pathogenic Avian Influenza (HPAI) as the South Asian nation of over 160 million people is especially vulnerable to virus perpetuation because of insufficient biosecurity, rearing of chickens and ducks together, selling of live birds, and deficient disease surveillance.

(Wed, 01 Feb 2012 12:10:00 +0000)

# 6112

Despite few reports of infected wild birds from mainland China (no doubt due to less than robust surveillance and reporting), most years we hear of a dozen or more H5N1 infected migratory birds making it into Hong Kong.

With each announcement, calls go out to increase biosecurity measures at local poultry farms, and for citizens to avoid contact with sick or dead birds.

In December of 2008 Hong Kong saw their first outbreak of H5N1 in domesticated poultry in nearly 6 years. In early 2009 it was announced that the H5N1 outbreak was `likely’ caused by infected migratory birds.  See Wild Birds Eyed As Likely Source Of Hong Kong Bird Flu Outbreak.

Since them, local authorities have become even more diligent in their surveillance and testing of dead birds.

Today, the Hong Kong government has announced the discovery of two more birds, from two different locations in the city, that have tested positive for the H5 virus in preliminary testing. 

Peregrine falcon and black-headed gull test positive for H5 virus

February 1, 2012 Issued at HKT 18:47

Preliminary testing of a dead peregrine falcon in Tung Chung and a dead black-headed gull in Yuen Long have tested positive for the H5 avian influenza virus, a spokesman for the Agriculture, Fisheries and Conservation Department (AFCD) said today (February 1), adding that further confirmatory tests are being conducted.

 

On January 30, the dead peregrine falcon and black-headed gull were found and collected in the park of Seaview Crescent, Man Tung Road, Tung Chung and Chun Yin Square Playground, Yuen Long respectively.

 

Peregrine falcons are rare winter visitors to Hong Kong, while the black-headed gull is a common visitor.

 

The spokesman said there were no poultry farms within three kilometres of where the dead peregrine falcon was found, but four chicken farms are within three kilometres of where the dead black-headed gull was found.  AFCD staff inspected the farms and found no abnormal mortality or symptoms of avian influenza among the chicken flocks. These farms will be put under enhanced surveillance.

 

In view of these cases, the AFCD has phoned poultry farmers to remind them to strengthen precautionary and biosecurity measures against avian influenza. Letters have been sent to farmers, pet bird shop owners and licence holders of pet poultry and racing pigeons reminding them that proper precautions must be taken.

 

The spokesman said the department would conduct frequent inspections of poultry farms and the wholesale market to ensure that proper precautions against avian influenza have been implemented. The department will continue its wild bird monitoring and surveillance.

 

"People should avoid personal contact with wild birds and live poultry and their droppings. They should clean their hands thoroughly after coming into contact with them. The public can call 1823 for follow-up if they come across suspicious sick or dead birds, including the carcasses of wild birds and poultry," the spokesman said.

 

(Continue . . . )

China ranks 174th in Reporters without Borders Press Freedom Index 2011/2012 (out of 179), while Hong Kong places 54th (not far below the United States which ranks 47th).

Which may help explain (in part, anyway) why most years we hear of more H5N1 infected birds from within the 426 sq. miles of Hong Kong than we do for the entire 3,704,426 sq. miles of mainland China.

(Tue, 31 Jan 2012 16:32:00 +0000)

# 6112

About an hour ago a 3-page PDF statement from the NSABB appeared on Science/ AAAS.org’s Public Health, Biosecurity, and H5N1 Forum, providing that committee’s rationale for requesting the redaction from science journals of key portions of recent controversial `dual use’  H5N1 research.

30 JANUARY 2012 | POLICY FORUM

Adaptations of Avian Flu Virus Are a Cause for Concern

K. I. Berns et al.

Members of the National Science Advisory Board for Biosecurity explain its recommendations on the communication of experimental work on H5N1 influenza.

• Full Text (PDF)
• Comments

Meanwhile, mBio has published four views on all of this from Paul S. Keim, Vincent R. Racaniello, Robert G. Webster, and Arturo Casadevall & Thomas Shenk.

I’m headed there now to read:

 

Mammalian-Transmissible H5N1 Influenza: the Dilemma of Dual-Use Research

Robert G. Webster doi:10.1128/mBio.00005-12

 

Science Should Be in the Public Domain

Vincent R. Racaniello  doi:10.1128/mBio.00004-12

 

The NSABB Recommendations: Rationale, Impact, and Implications

 

Paul S. Keim  doi:10.1128/mBio.00021-12

 

The H5N1 Manuscript Redaction Controversy

Arturo Casadevall and Thomas Shenk doi:10.1128/mBio.00022-12

And on Thursday night, many of the major players in the world of influenza virology and biosecurity will convene for a 2 hour panel discussion, to be webcast by the New York Academy of Sciences (this appears to be a Pay-per-view event for non-members).

Here is the Press Release from the New York Academy of Sciences

Dual use research: H5N1 influenza virus and beyond

Experts to discuss controversial studies on avian flu virus at live event

WHAT: Dual Use Research: H5N1 Influenza Virus and Beyond

WHEN: Feb. 2, 6pm to 8pm

WHERE: The New York Academy of Sciences

REGISTER: www.nyas.org/H5N1

The US National Science Advisory Board for Biosecurity (NSABB) recently recommended that journals Nature and Science remove certain methodological details from controversial studies on the avian influenza virus (H5N1) to minimize the risk of these findings being misused by would-be bioterrorists. On February 2 from 6pm to 8pm, the Emerging Infectious Diseases & Microbiology Discussion Group of the New York Academy of Sciences presents Dual Use Research: H5N1 Influenza Virus and Beyond, a discussion between scientists, publishers, and legal experts that will explore the myriad issues surrounding the impending publication of these two studies and measures that will need to be undertaken to ensure the security of future such research.

 

To weigh in on matters of censorship and public safety, W. Ian Lipkin, MD, Center for Infection & Immunity at Columbia University, will moderate a panel discussion with Arturo Casadevall, MD, PhD, Albert Einstein College of Medicine, and member, NSABB; Laurie Garrett, PhD, Council on Foreign Relations; Barbara R. Jasny, PhD, Science; Veronique Kiermer, PhD, Nature Publishing Group; Michael T. Osterholm, PhD, MPH, Center for Infectious Disease Research and Policy, University of Minnesota, and member, NSABB; Peter Palese, PhD, Mount Sinai School of Medicine; Vincent Racaniello, PhD, Columbia University; and Alan S. Ruldolph, PhD, Defense Threat Reduction Agency.

###

Attendees must register at www.nyas.org/H5N1. Media must RSVP to Diana Friedman, dfriedman@nyas.org.

The Washington Post takes note of the debate: Recommendation to censor bird flu research driven by fears of terrorism. Excerpt and then a comment:

Citing fears of an “unimaginable catastrophe,” a government-appointed board on Tuesday explained why it recently recommended censoring details of new research on deadly H5N1, or avian, influenza. 

“Our concern is that publishing these experiments in detail would provide information to some person, organization, or government that would help them to develop similar … viruses for harmful purposes,” the 23 voting members of the National Science Advisory Board for Biosecurity wrote in a statement published jointly by the journals Science and Nature. 

The potential harm of publishing the work in full exceeded the potential benefits, the board wrote, adding its decision was unanimous.

 “We do not believe that widespread dissemination of the methodology in this case is a responsible action,” they wrote. 

The board compared the new research on H5N1 to the development of the atomic bomb in the 1940s. In that decade, physicists also confronted the dilemma of how much of their work to make public.

The argument by analogy with the A-bomb is a shaky one. Having recruited top physicists into the Manhattan Project, J. Robert Oppenheimer accepted the top-secret regime on them imposed by General Leslie Groves. But he worried that the silence in the physics journals would give the game away.

So the ferret is already out of the bag. Just as the atomic bomb was discussed well before World War II even broke out, the mutation of H5N1 has been so widely debated that anyone interested in using Fouchier and Kawaoka to weaponize H5N1 is doubtless already working hard but discreetly. (And dementedly.) 

Such researchers would also have to develop and test and distribute an effective vaccine before they dared to launch a weaponized H5N1, and that procedure would draw a great deal of attention…some of it from those fine young men in the US Navy Seals.