Bird Flu Watch

Suspect H5N1 Clusters in Egypt Exceed Official Count

Link: Suspect H5N1 Clusters in Egypt Exceed Official Count.

The above translations describe a continuous rise in hospitalized suspect H5N1 cases in Egypt (see detail in satellite map).  The first estimate is the official composite number of 15 patients in 5 governorates, but the descriptions in local media indicate the number is significantly higher.  One list details eight new patients admitted to one hospital in Qena, while another report breaks down the admission of over twenty patients into three or more hospitals in Gharbiya.  Another paper details four new patients admitted into Ash Sharqiyah, which is not one of the five governorates listed.  Thus, the number admitted yesterday was 2-3 times the 15 listed in the official composite. Although the number of hospitalized patients continues to accelerate on a daily basis, there have been no announcements of confirmed cases in over a week.  Although these admissions follow announcements of new poultry cases, they may represent increased awareness due to government announcement for early treatment, coupled with daily media reports of new confirmed H5N1 outbreaks in poultry (see satellite map on poultry outbreaks).

No bird flu pandemic despite recent deaths

Link: IRIN Middle East | Middle East | Egypt | EGYPT: No bird flu pandemic despite recent deaths - health officials | Avian Flu | News Item.

Four humans have died of bird flu in Egypt in the past week but health officials deny the country is gripped by an influenza pandemic. “There is still no fear that the virus has transformed into an influenza pandemic,” John Jabbour, a medical consultant for emerging diseases at the World Health Organization (WHO) regional office for the Eastern Mediterranean, told IRIN. Sixteen other suspected cases were admitted to hospital on 2 January, according to Amany Nakhla, the regional planning assistant for the UN Office for the Coordination of Humanitarian Affairs (OCHA) regional office, in Cairo. According to media reports, the H5N1 strain has been detected among poultry in the Nile Delta, especially those reared in homesteads. All four deaths in the past week were of women from the Nile Delta region and they brought to 19 the number of people who have died of the H5N1 strain of avian flu since avian flu was first detected in Egypt in 2006. Three of the four women were infected by domestic birds in their homes. The fourth was a poultry seller.

WHO: initial analysis of Pakistani H5N1 suggests no dangerous mutations

Link: CIDRAP >> WHO: initial analysis of Pakistani H5N1 suggests no dangerous mutations.

An official from the World Health Organization (WHO) today shared results of initial genetic sequencing tests on H5N1 avian influenza samples from a man who died of the disease in Pakistan that suggest the strain doesn't have the capacity for widespread transmission. John Rainford, a WHO spokesman in Geneva, told CIDRAP News that the genetic sequencing involved two clinical samples from a 25-year-old man from the Peshawar area who was recently announced as the first confirmed human H5N1 case-patient and fatality in Pakistan. The man was part of a family cluster of suspected H5N1 cases which sparked global concern that the virus had mutated into a form that could enable widespread human-to-human transmission. However, the WHO said in a previous statement that while the Pakistani cases suggest a rare instance of human-to-human transmission, the virus did not spread beyond the family. Rainford said preliminary sequencing of the hemagglutinin and neuraminidase genes from the specimens was performed at the WHO collaborating center in London. Tests completed so far show the hemagglutinin amino acid sequence is identical to some of the recent clade 2.2 viruses that have been isolated from chickens in other outbreaks in the region, he said. WHO virologists say the findings, along with recent field investigations, suggest that the H5N1 viruses in Pakistan have not gained the capacity for widespread human-to-human transmission, reported Rainford.

Sixteen New Suspect H5N1 Cases in Egypt

Link: Sixteen New Suspect H5N1 Cases in Egypt.

The above translation describes 16 new suspect cases in 5 governorates, which are in addition to the cases announced in the past few days (see satellite map).  This dramatic rise increases pandemic concerns.  Although Egypt has had a large number of suspect cases previously, the numbers generally track with seasonal flu and peak in March or April.  The rise in suspect cases many be due in part to heightened awareness stemming from the dramatic increase in H5N1 on commercial farms and backyard holdings (see satellitle map), as well as the four deaths in the five confirmed cases which were recently announced. As noted, samples have been sent to central labs for testing, and new confimed cases have not been announced since the beginning of the week, but there have been few announcements of patients testing negative.

Dominance of H5N1 Tamiflu Resistance in Egypt

Link: Dominance of H5N1 Tamiflu Resistance in Egypt.

The WHO has said some of those who died having contracted the H5N1 virus strain showed moderate resistance to Tamiflu, the antiviral drug. The above comments on moderate resistance to Tamiflu in some of the fatal cases are cause for concern.  Since there are only four confirmed fatalities, at least half are Tamiflu resistant.  The “moderate” resistance is almost certainly due to N294S, the genetic change found in the Gharbiya cluster a year ago.  N294S was present in samples collected prior to treatment, indicating it was circulating in Egypt.

Bird flu scare in Binyamina petting zoo

Link: Bird flu scare in Binyamina petting zoo - Israel News, Ynetnews.

Agriculture Ministry officials suspect that the bird flu virus may have infected chickens at a petting zoo in a Binyamina kindergarten, following the death of 18 of the 25 chickens in the place. The poultry had been culled and a 6-mile quarantined area has been declared around the site to prevent the possible spread of the virus. Laboratory tests are currently being carried out to determine the cause of the fowls' death. The kindergarten has been closed until further notice.

UK flu vaccine could help control pandemic

Link: UK flu vaccine could help control pandemic - Times Online.

Unlike existing vaccines, it does not have to be reformulated year by year to match the prevalent strains of flu, so could be stockpiled in advance and used as soon as a pandemic strain emerged. Nor does it need to be grown on fertilised hen’s eggs, as the existing vaccines do. It can be produced by cell culture, a technique that is not restricted by the supply of eggs. Related Links     * The sick-note season opens     * Black Swans and Bird Flu     * Flu brings heart attack risk The new results, announced today by Acambis, show that in human volunteers the ACAM-FLU-A vaccine was safe and produced an immune response against its target, a small protein (peptide) called M2e that is found on the surface of all A strains of the flu

Growing H5N1 Clusters in Egypt Raise Pandemic Concerns

Link: Growing H5N1 Clusters in Egypt Raise Pandemic Concerns.

The above translations define two more geographical clusters of confirmed or suspect H5N1 cases in Egypt.  Two suspect cases have been hospitalized in Mahalla in Gharbiya, while a new suspect case was in Beni Suef, the location of the first confirmed case this season. It addition to the two geographical clusters above, there is a large cluster in Menoufia, which contains one familial and two geographic clusters.  There is also a familial suspect cluster in Port Said (see satellite map). All of these clusters have developed in the past week, raising concerns that the H5N1 circulating in Egypt is transmitting more efficiently than H5N1 in prior outbreaks in Egypt.  Thus far, the fatalities have been concentrated in the confirmed cases, where four of the five have died.  Although there is only one fatality among the suspect cases, most were hospitalized in the past few days, so they haven’t been lab confirmed, and more time is needed to determine if they are positive and / or fatally infected. More information should be forthcoming in the next several days,

Wild Birds behind human case?

Link: Reuters AlertNet - PRESS DIGEST - Vietnam newspapers - January 3.

Wild birds are suspected of giving bird flu to the four-year-old boy who died last month, Vietnam's latest victim of the H5N1 virus, animal health officials said after tests showed poultry at his house did not carry the virus.

Spike in H5N1 Confirmed and Suspect Cases in Egypt

Link: Spike in H5N1 Confirmed and Suspect Cases in Egypt.

n the past week the number of confirmed and suspect H5N1 cases has increased dramatically in Egypt (see satellite map).  Following a lull in cases over the summer and fall, the first confirmed H5N1 fatality was reported a week ago,  In contrast to the end of last season, when one of seventeen infections were fatal, four of the first five cases have died.  The number of suspect cases has also increased steadily in the past several days, including one fatal case in Cairo. Two of the confirmed cases were in Menoufia, which also has the largest concentration of suspect cases.  Included in this geographical cluster, is a familial cluster of two (father and daughter).  The concentration of the cases in the same governorate suggests some or most of these cases represent H5N1 infections. In additional to the cluster in Menoufia, there is another familial cluster in Port Said involving a family of four, as well as a hospitalized health care worker.

Bird Flu kills 61% of those who get it

Link: Effect Measure : Pandemic influenza subtypes: end of the year musings.

Out of 103 cases of the non-H5 subtypes there has been only one fatality (H7N7, one fatality with 88 non-fatal cases), whereas the current official tally for H5N1 gives 213 deaths in 346 cases (61%). Which is why the H5N1 gorilla weighs 800 pounds. This influenza/A variant is a remarkably virulent virus. Is it the most likely virus to cause the next influenza pandemic?

Is Egyptian strain more virulent?

Link: Promed.

Three of the 43 cases of human H5N1 avian influenza recorded in Egypt since the beginning of 2006, and 3 of the 18 deaths, have occurred during the past 7 days. The 3 cases appear to be unconnected. The high mortality rate is worrying in view of the previous success of the Egyptian authorities in treating avian influenza virus patients. Hopefully this is a statistical aberration and it does not herald the appearance of a virus endowed with enhanced virulence for humans.

Further bird flu death in Egypt

Link: Further bird flu death in Egypt - MSN News UK - news & weather.

Egyptian health officials have reported the deaths of two women from bird flu, bringing to 19 the number of fatalities since the lethal H5N1 strain first appeared in the country last year.

The deaths, along with those of two other women just days ago, bring to four the number of women who died from the strain in a single week.

The Health Ministry first reported the death of Fardous Mahammed Hadad, 36, from Menoufia, 40 miles north of Cairo.

Ms Hadad, who was said to have contracted the disease from domestic fowl, was admitted to hospital on Sunday with breathing difficulties and high fever and later tested positive for the H5N1 strain of bird flu, the ministry said.

Too early to call re Pakistani human to human transmission

Link: Effect Measure : Now I'm the one complaining about WHO (again).

The World Health Organisation on Friday ruled out any mutation of the potentially fatal H5N1 strain of the bird flu virus after a case of inter-human transmission of bird flu may have been detected in Pakistan.     "There is no suggestion that the virus has changed into a form that poses a broader risk," WHO spokesman John Rainford told AFP. "If that had been the case, we would have witnessed more cases of human transmission."     Rainford said that the genetic sequencing of the virus involved in the latest case was being continued. (Agence France Presse)

What's wrong with this? Suppose (for the sake of argument) it takes two changes to turn a virus into one that "poses a broader risk" and only one has occurred in this case. We wouldn't know this by seeing if there were more cases. We would only know this if we looked at the sequence and further, we knew what to look for (which two changes to track). It isn't clear that the viral sequence in this case has been examined completely (and we hope that when it is examined, the sequence will be deposited immediately into a publicly accessible database like GenBank). It is also quite clear we don't know what to look for, so a categorical statement that "a mutation" has been "ruled out" isn't true and cannot be true at this point.

Eighteenth bird Egypt flu death

Link: BBC NEWS | World | Middle East | Eighteenth bird Egypt flu death.

A woman has died of bird flu in Menoufiya province in the Nile Delta - the third person in Egypt to have died of the virus in the past week. The official Egyptian news agency said the woman contracted the virus after coming into contact with poultry infected with the H5N1 strain. Eighteen people have now died of bird flu in Egypt in the past two years.

Indonesian woman dies from bird flu

Link: Indonesian woman dies from bird flu�|�Science&Health�|�Reuters.co.uk.

An Indonesian woman who bought a live chicken from a market died from bird flu on Christmas Day, the Health Ministry bird flu centre said on Wednesday, taking the total number of deaths from the disease in Indonesia to 94. The 24-year-old woman from Jakarta who died on Tuesday morning had tested positive for bird flu after being treated for several days in a hospital, said an official at the centre. "The woman bought a live chicken in the market and slaughtered the chicken there before taking it home. But we're still investigating the cause," the official said.

Tamiflu medicine will lose impact rapidly

Link: A Study into Tamiflu Abuse.

Tamiflu is not a cure, but as an antiviral drug, it helps lessen the symptoms of the virus and shorten the duration of illness. It is also the main weapon we have against avian flu. While it cannot prevent people from contracting bird flu, Tamiflu does drastically reduce the risk of death if contracted and is most effective if given ahead of time, like a vaccine. In his study, Jerker Fick tested the ability of the antiviral molecules to survive in the sewers. This study, which took place at the Umea University in Sweden, had disturbing results. The scientist checked three different sewage treatment options to see if Tamiflu would break down or be destroyed by any or all of them. The three samples included raw sewage without any treatment at all, sewage that had been chemically treated and filtered, and “activated sludge”, sewer water which contained microbes intended to break down the waste. The Tamiflu molecules survived all three treatment processes. The fear sparked by this scientific examination of sewage is that the antiviral drug will be poured into rivers, lakes and even the ocean. From there, it can easily be ingested by water birds, particularly ducks who tend to forage near sewage outlets. If these birds ingest sufficient quantities of the treatment, it is quite likely that the avian flu will be able to adapt and become resistant to this form of antiviral medicine, leaving humans wide open to a pandemic.

New Swine Flu Has Avian Flu Genes

Link: New Swine Flu Has Avian Flu Genes | Lancaster Farming.

The group studied an unknown pathogen — first identified by University of Minnesota veterinary diagnostician Marie Gramer — that infected two groups of pigs at separate production facilities in 2006. Both facilities used pond water frequented by migrating waterfowl. Molecular studies indicated the unknown pathogen was an H2N3 influenza virus that is closely related to an H2N3 strain found in mallard ducks. But this was the first time it had been observed in mammals. Influenza viruses have eight gene segments, all of which can be swapped between different virus strains. Two of these gene segments code for virus surface proteins that help determine whether an influenza virus is able to infect a specific host and start replicating — the first step in the onset of influenza infection. In the newly isolated swine H2N3, the avian H2 and N3 gene segments mixed with gene segments from common swine influenza viruses. This exchange — and additional mutations — gave the H2N3 viruses the ability to infect swine. Lab tests confirmed that this strain of H2N3 could also infect mice and ferrets.

H5N1 is 20 times more virulent than 1918 killer flu

Link: Letter: Prevent Human-To-Human Birth Flu Not Cure Flu and Cold.

Indeed, the avian flu strain is 20 times more virulent than the 1917/18 Spanish flu that killed between 50 million and 100 million people, but where this time, literally hundreds of millions will perish with this ill thought out strategy by our political leaders and governments.  What should have been undertaken is that this highly contagious disease should have been addressed at its source (prevention) and where history again will confirm this eventual conclusion. Unfortunately by then, this terrible event will have taken place. Governments should rethink therefore before it is too late and adopt predominantly a ‘field’ strategy, for this is the only strategy that will work and stop the unimaginable happening. Governments have been warned continuously, but where they do not wish to listen due to the powerful overtones delivered to our political leaders by the giant pharmaceuticals in their quest for profits (or selfish greed dependant on which point-of-view one wishes to take).  One has to remember also that since 2003 the human mortality rate through the bird flu virus has been 62% and where only 38 people on average out of every hundred has survived.

Burma Reports New Bird Flu Outbreak

Link: VOA News - Burma Reports New Bird Flu Outbreak.

Burma has reported an outbreak of bird flu among chickens in the country's eastern Shan state. The official "New Light of Myanmar" newspaper said Saturday that authorities confirmed the outbreak of the deadly H5N1 virus on Thursday, after an unspecified number of chickens had died in Yankham village. Officials said they determined that the virus was spread to the area from Kengtung Township, where bird flu broke out in December 18. Burma and the World Health Organization had earlier confirmed the country's first human bird flu case, when a seven-year-old girl was hospitalized in late November. The girl survived the disease and was discharged in early December.

No sign of bird flu mutation after Pakistani dies

Link: AFP: No sign of bird flu mutation after Pakistani dies: WHO.

The World Health Organisation on Friday ruled out any mutation of the potentially fatal H5N1 strain of the bird flu virus after a case of inter-human transmission of bird flu may have been detected in Pakistan. "There is no suggestion that the virus has changed into a form that poses a broader risk," WHO spokesman John Rainford told AFP. "If that had been the case, we would have witnessed more cases of human transmission." Rainford said that the genetic sequencing of the virus involved in the latest case was being continued. Laboratory tests have already established that the Pakistani man had been infected with H5N1, even though he had not been in contact with contaminated poultry. "Because we have an individual not directly exposed to sick birds suggests a limited human-to-human transmission," Rainford had told AFP on Thursday.

4 year old dies in Vietnam

Link: Viet Nam News.

Preventive Medicine Department director Nguyen Huy Nga said the death of a four-year-old child infected with the deadly H5N1 virus showed inspection remained lax. The child had died even though the local veterinary office had reported dead poultry in his precinct two months ago. The boy, from northern Son La Province, died in Ha Noi’s National Paediatric Hospital last Tuesday.

China's latest bird flu patient discharged from hospital

Link: China's latest bird flu patient discharged from hospital_English_Xinhua.

The latest bird flu patient was discharged from an unidentified hospital on Dec. 26 in the eastern province of Jiangsu, local health authorities said.     After being treated for about 20 days, the patient, surnamed Lu, 52, had recovered sufficiently to leave under the care of family members, the Jiangsu Provincial Health Department said.     Lu, father of a young man who died from the H5N1 strain of bird flu in the same city, developed a fever days after his son's death was confirmed as having been from bird flu. Medical experts immediately sent the elder man to a designated hospital for treatment.

17th Egyptian dies of bird flu

Link: Egyptian woman dies of bird flu, 2nd in week: Scientific American.

A 25-year-old Egyptian woman died of bird flu on Sunday, the second fatality among humans in Egypt in less than one week, the Health Ministry said. Fatma Fathi Mohamed died in hospital in the Nile Delta city of Mansoura, three days after she was admitted to a smaller local hospital with a high temperature and difficulty breathing, it said in a statement carried by the state news agency MENA. Her death was the 17th in Egypt since the virus was first detected in February 2006.