Saturday, April 22, 2006

THE OTHER SIDE OF THE STORY


From Forbes:

U.S. Bird Flu Threat May Be Overstated, Experts Say04.21.06, 12:00 AM ET

FRIDAY, April 21 (HealthDay News) -- As the Bush administration puts the final touches on a massive response plan for a potential avian flu pandemic, experts -- including top-level administration officials -- are predicting that if and when the avian flu reaches American shores, it's not likely to be the disaster most once feared.
"It is impossible to predict whether we're going to have an H5N1 [the current strain of avian flu] pandemic and, if so, how severe it's going to be," Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, told HealthDay.
Fauci had earlier told the Associated Press that he thought it "very unlikely that there is going to be the type of situation [here that] we see everywhere, from Nigeria to Indonesia."
That sentiment was echoed by Dr. Julie Gerberding, head of the U.S. Centers for Disease Control and Prevention. Speaking to attendees at a recent meeting in Tacoma, Wash., she said "there is no evidence it [bird flu] will be the next pandemic."
For Fauci, however, planning for a worst-case scenario remains a necessity, even if, realistically, it is highly unlikely to transpire.
"We, the public health people, in order to make sure that we don't tragically undershoot our preparedness, must assume that the worst-case scenario will occur even though the fact is there really is no guarantee that it will occur," Fauci said. "The American people should not be worried. They should execute some degree of reasonably intelligent, non-panicky, non-hysterical preparedness, which really means 'have a plan for your family.'"
Another expert believes panic over a possible pandemic is unwarranted.
Dr. Marc Siegel, author of False Alarm: The Truth About the Epidemic of Fear and a clinical associate professor of medicine at New York University School of Medicine in New York City, said, "There's a complete psychosis here."
"The whole problem with the topic is the blurring of the distinction between birds and people. I'd be worried if I was a bird -- maybe. But not even all birds should be worried," Siegel said.
The current H5N1 virus has generated more fear than normal because of its virulence and ease of transmission among flocks of domestic birds, said Dr. Alan I. Hartstein, professor of clinical medicine at the University of Miami Miller School of Medicine.
So far, bird flu has killed 110 people in nine countries, the lion's share in Vietnam, Indonesia and other parts of Asia. More than 200 million domestic fowl have been killed worldwide to help stem the spread of the illness.
Human casualties remain largely confined to Asia and to people who have had close and prolonged contact with infected birds, such as poultry farm workers. But one-third of Americans polled said they personally feared becoming infected with the bird flu.
That fear may be intensified with the looming threat that migrating birds may soon bring the virus to American shores. The U.S. Fish and Wildlife Service and Alaska's Fish and Game Department are setting up more than 50 camps to screen birds for the virus, the AP reported.
There's no question that this is a very serious infection -- for birds. "This is a pretty bad one, probably the worst one we've seen in birds, but that doesn't correlate to what's going to happen to humans," Siegel said.
But the fact remains that what people are seeing is still the bird flu, he said.
"The threat to people is minimal," Siegel said. "In Asia, people have gotten sick because they had such close contact with birds. In Europe, we haven't seen a single case in humans. There's no reason to believe that there's an imminent threat to human beings."
So far, the virus has shown no ability to jump from human to human. To gain that ability, it would need to undergo genetic mutations.
"Any influenza virus that can cause a pandemic must gain the ability to be easily transmitted from person to person," said Hartstein. "Thus far, the H5N1 viruses do not have this capability and cannot cause a pandemic."
There may not even be much of a threat to poultry, as long as U.S. farmers keep their birds separate from wild species. As reported by the AP Wednesday, federal officials said any commercial poultry flock even suspected of being infected with H5N1 would be killed off immediately, before test results confirming infection came in.
Said Fauci, "Would I be surprised if sometime in the future a migratory bird somewhere within the borders of the U.S. was found to be infected H5N1? No. Is it inevitably going to happen? I have no idea. If it did happen, would there be infection of chicken flocks? There is a chance. Do I think there will be massive contamination of domestic flocks? That would be unlikely because we're much more analogous to Europe than we are to developing nations."
So, is the U.S. government's preparedness plan an overreaction?
Not at all, Hartstein said.
There were three flu pandemics last century. "The threat of a new influenza pandemic is real and thought to be inevitable at some point in time," Hartstein said. "People can only guess when this will occur."
One question is whether the plan will include the elements many experts deem crucial.
"When I think of human preparedness, I think of long-term preparedness," Siegel said. "We need to improve how we make vaccines using 21st century technology so that, instead of reacting, we could anticipate a threat." Wetlands also need to be preserved, he added, so that migratory birds have a place to go that is geographically removed from poultry.
"We're better off now than we were six months ago, and it's extremely likely that six months or a year from now we'll be even better prepared," Fauci said. "Is anybody in the world optimally prepared for the worst-case scenario? The answer is an unqualified no."
More information
For more on bird flu, visit the U.S. Centers for Disease Control and Prevention.

How the mumps spreads...another virus story



Exposure to Mumps During Air Travel --- United States, April 2006
Please note: An erratum has been published for this article. To view the erratum, please click here.
On April 11, this report was posted as an MMWR Dispatch on the MMWR website (http://www.cdc.gov/mmwr).
The state of Iowa has been experiencing a large mumps outbreak that began in December 2005 (1). As of April 10, 2006, a total of 515 possible mumps cases have been reported to the Iowa Department of Public Health (IDPH) during 2006 (2). This outbreak has spread across Iowa, and mumps activity, possibly linked to the Iowa outbreak, is under investigation in six neighboring states, including Illinois (n = four), Kansas (n = 33), Minnesota (n = one), Missouri (n = four), Nebraska (n = 43), and Wisconsin (n = four) (CDC, unpublished data, April 10, 2006). The reasons for this outbreak are under investigation.
Mumps is an acute viral infection characterized by a nonspecific prodrome, including myalgia, anorexia, malaise, headache, and fever, followed by acute onset of unilateral or bilateral tender swelling of parotid or other salivary glands (2). An estimated 60%--70% of mumps infections produce typical acute parotitis (3). Approximately 20% of infections are asymptomatic, and nearly 50% are associated with nonspecific or primarily respiratory symptoms. Complications include orchitis, oophoritis, or mastitis (inflammation of the testicles, ovaries, or breasts, respectively), meningitis/encephalitis, spontaneous abortion, and deafness. Transmission occurs by direct contact with respiratory droplets or saliva. The incubation period is 14--18 days (range: 14--25 days) from exposure to onset of symptoms. The infectious period is from 3 days before symptom onset until 9 days after onset of symptoms.
IDPH has identified two persons who had mumps diagnosed and were potentially infectious during travel on nine different commercial flights involving two airlines during March 26--April 2, 2006. The commercial airline flights identified with a potentially infectious traveler are listed below by date, carrier, and flight number:
Northwest Airline (NWA) flights:
March 26 NWA (Mesaba) #3025 from Waterloo, Iowa to Minneapolis, Minnesota
March 26 NWA #760 from Minneapolis, Minnesota, to Detroit, Michigan
March 27 NWA #0260 from Detroit, Michigan, to Washington, DC--Reagan National
March 29 NWA #1705 from Washington, DC--Reagan National to Minneapolis, Minnesota
March 29 NWA (Mesaba) #3026 from Minneapolis, Minnesota, to Waterloo, Iowa
American Airline (AA) flights:
April 2 AA #1216 from Tucson, Arizona, to Dallas, Texas (DFW)
April 2 AA #3617 from DFW to Lafayette, Arkansas (Northwest Arkansas Regional [NAR])
April 2 AA #5399 from NAR to St. Louis, Missouri
April 2 AA #5498 from St. Louis, Missouri, to Cedar Rapids, Iowa
Persons on these flights who have symptoms consistent with mumps within 21 days of travel should be evaluated for mumps by a health-care provider. Health-care providers should remain vigilant for mumps among persons with parotitis or other salivary gland inflammation. Cases of suspected mumps should be reported immediately to public health officials.
A multistate investigation has been initiated by CDC and the state health departments in affected states to notify potentially exposed passengers (i.e., those seated in close proximity to the index cases). This investigation is using a new software application, eManifest, developed by the CDC Division of Global Migration and Quarantine (DGMQ) to securely import, sort, and assign passenger-locating information to jurisdictions to facilitate timely identification of exposed persons. These data are securely transmitted to state and territorial health departments via the Epidemic Information Exchange (Epi-X) Forum (available at http://www.cdc.gov/mmwr/epix/epix.html) for notification of potentially exposed passengers.
Incidence of mumps in the United States began to decrease after vaccine introduction in 1967 and recommendations for routine vaccination of children in 1977. Since the 1990s, a further decrease in the reported incidence of mumps has occurred, which is thought to be attributable to the implementation of the second dose of measles, mumps, and rubella vaccine (3). The risk for transmission of respiratory infectious diseases during air travel might depend on several factors, including 1) immunity of passengers; 2) infectiousness of the organism; 3) degree of shedding of the pathogen by infected passengers; 4) hygienic practices of infectious passengers; 5) proximity of others to infectious passengers; 6) hygienic practices of the other passengers/crew; 7) flight duration; and 8) cabin environment of the aircraft (4). Transmission of other respiratory pathogens during air travel has been reported (5--9). Exposure and transmission of mumps during commercial air travel has not been described previously.
Reported by: P Quinlisk, MD, Iowa Dept of Public Health. S Redd, G Dayan, MD, National Center for Immunization and Respiratory Diseases; N Gallagher, Geographic Medicine and Health Promotion Br, P Lutz, K Marienau, MD, F Averhoff, MD, Quarantine and Border Health Svcs Br, Div of Global Migration and Quarantine, National Center for Infectious Diseases, CDC.
References
CDC. Mumps epidemic, Iowa, 2006. MMWR 2006;55:366--8.
Iowa Department of Public Health, Center for Acute Disease Epidemiology. Iowa mumps update. Des Moines, Iowa: Iowa Department of Public Health; 2006. Available at http://www.idph.state.ia.us/adper/common/pdf/mumps/mumps_update_041106.pdf.
Plotkin SA, Orenstein WA, eds. Vaccines. 4th ed. Philadelphia, PA: WB Saunders; 2003:441--69.
Mangili A, Glendreau M. Transmission of infectious diseases during commercial air travel. Lancet 2005;365:989--96.
World Health Organization. Tuberculosis and air travel: guidelines for prevention and control. 2nd ed. Geneva, Switzerland: World Health Organization; 2006:5--7. Available at: http://www.who.int/docstore/gtb/publications/aircraft/PDF/98_256.pdf
CDC. Postexposure prophylaxis, isolation, and quarantine to control an import-associated measles outbreak---Iowa, 2004. MMWR 2004; 53:969--71.
Moser MR, Bend TR, Margolis HS, et al. An outbreak of influenza aboard a commercial airline. Am J Epidemiol 1979;110:1--6.
Klonz KC, Hynes NA, Gunn RA, et al. An outbreak of influenza A/Taiwan/1/86 infections at a naval base and its association with airplane travel. Am J Epidemiol 1989;129:341--8.
Marsden AG. Influenza outbreak related to air travel. Med J Austral 2003;179:172--3.
Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of Health and Human Services.
References to non-CDC sites on the Internet are provided as a service to MMWR readers and do not constitute or imply endorsement of these organizations or their programs by CDC or the U.S. Department of Health and Human Services. CDC is not responsible for the content of pages found at these sites. URL addresses listed in MMWR were current as of the date of publication.

National Institutes of Health News


FOR IMMEDIATE RELEASEWednesday, April 19, 2006


CONTACT:John Makulowich301-402-8614
Interregional spread of influenza through United States described by virus type, size of population and commuting rates and distance
Researchers at the National Institutes of Health (NIH) conclude that the regional spread of annual influenza epidemics throughout the United States is more closely connected with rates of movement of people to and from work than with geographical distance or air travels. They also found that epidemics spread faster between more populous locations.
"This valuable study highlights new approaches to using historical data sources and statistical analysis to create epidemiological models. These models not only help us understand the transmission of influenza but also could guide policy for its control" said Dr. Elias A. Zerhouni, NIH Director.
The research results, published this week in Science Express, is based on 30 years of weekly data from the National Center for Health Statistics on influenza-related mortality in different States since 1972.
"This study quantifies the spread of influenza based on three decades of data. We can correlate interstate spread with population size, commuting, and virus type. The key point about our paper is that we synthesize long-term data about disease incidence and human movements using models," said Dr. Mark Miller, Associate Director for Research at the Fogarty International Center (FIC), part of NIH.
The investigators reached their conclusions by building a mathematical model of influenza spread in the United States based on the historical pattern of epidemics. The results suggest that when disease is imported into the United States in a well-connected state, one with many inflows and outflows of workers, for example, California, disease spreads much faster than if disease is imported in a less-connected state, for example, Wyoming. In observed epidemics, the initial focus of infection varies from year to year, but epidemics tend to emerge more often from California than other less populated states.
The model can simulate influenza pandemic spread, a situation where the greatest majority of the population is susceptible to a new virus. In this case, transcontinental spread could occur more quickly. Infection could reach all states within 2-4 weeks, instead of the 5-7 weeks for annual epidemics, if seeded in a highly connected state.
Past research highlighted the role of children in the local spread of influenza, in particular, in schools and households. This study, by contrast, suggests that adults are responsible for the regional spread of influenza because they travel farther and more frequently.
Although the current modeling approach allowed researchers to reproduce the spread of annual influenza epidemics in the United States, there are caveats to extending the model to predict pandemic influenza. While it is impossible to predict how an entirely new strain of influenza would behave, comparison of the spread of influenza between pandemic and epidemic seasons based on historical data might shed some light on their differences. As the speed of influenza spread between states is affected by work-related population movements and transmissibility, interventions which limit inter-regional routine travel might slow epidemic spread.
The researchers did not study the effect of specific interventions, for example, school closure or travel restrictions to mitigate or delay the spread of influenza. Describing the mechanisms of local spread of influenza within cities or states is a key area for future work and would provide insight into which control strategies might be effective to control epidemic and pandemic influenza — in particular, social distancing measures.
The study, supported by FIC, results from a collaboration among researchers at FIC, the Center for Infectious Diseases Dynamics (CIDD) at Pennsylvania State University and the National Institute of Allergy and Infectious Diseases (NIAID, part of NIH). Study authors are Cécile Viboud, PhD (FIC); Ottar N Bjørnstad, PhD (CIDD, FIC); David J Smith, PhD, (FIC); Mark Miller, MD, (FIC); Lone Simonsen, PhD, (NIAID); and Bryan T Grenfell, PhD (CIDD, FIC).
The John E. Fogarty International Center for Advanced Study in the Health Sciences (FIC) is the international component of the NIH. The center addresses global health challenges through innovative and collaborative research and training programs and supports and advances the NIH mission through international partnerships. For more information about FIC and its programs, visit http://www.fic.nih.gov/.
The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov/.

Avian Flu on Dateline


Avian Flu from ABC News


Protect yourself from Avian Influenza, or Bird Flu

Chickens with bird flu walk near a grave of burning chickens. Click here to learn about the Dangers, Symptoms and Prevention of Bird Flu. Courtesy of Abilene Reporter-News.

(ABC15) -- These pages provide background information about Avian Influenza, commonly referred to as Bird Flu, and what you can do to keep you and your family safe.

This virus has been spreading through Asia, and has been reported in the European part of Turkey. The virus has world health authorities warning of a worldwide pandemic unseen since World War I.

The Bush administration is discussing quarantines and other methods to control its spread should it arrive in the United States, but for the moment (3/14/06), bird flu remains only a potential threat.

To learn more about the Bird Flu, please click on the Related Links listed below.



Related links:
What you need to know about Avian Influenza
Questions and Answers on the Bird Flu
Is it OK to eat chicken? Should I report a dead bird?
Bird Flu, travel and airplanes
Centers for Disease Control website: Info on Avian Influenza (Bird Flu)
Health Information for Travelers to Countries in Southeast Asia
ABCNews.com - Bird flu: fears, facts and fiction
What to do when you've found a bird: www.fallenfeathers.org
The Arizona Influenza Pandemic Response Plan

Friday, April 21, 2006

CHINA : AVIAN FLU NEWS

Avian influenza – situation in China – update 10

21 April 2006

The Ministry of Health in China has informed WHO of the country’s 12th death from H5N1 avian influenza. The death occurred in a previously reported case, a 21-year-old man from Hubei Province. He died of severe respiratory disease on 19 April.

Of the 17 laboratory-confirmed cases in China, 12 have been fatal.



Cats and avian flu news



Susceptibility of animal species to the H5N1 Asian strain
Joint statement by the OIE and the FAO
----------------------------------------------
The World Organization for Animal Health (OIE) and FAO confirm that
the animal species playing a role in the transmission and spread of
highly pathogenic avian H5N1 influenza virus are essentially domestic
and wild birds.

Although some 50 non-domestic bird species have proved susceptible to
infection with the virus, it would appear from the epidemiological
data currently available that, among the wild birds implicated in the
transboundary spread of the virus, aquatic birds play a major role.

Epidemiological findings and experimental studies have demonstrated
that some mammal species, particularly cats, may be susceptible to
the virus. However, from the data that have accumulated since the
start of the current avian influenza crisis (end of 2003), cats do
not appear to play any discernible role in the transmission of the
virus in the natural setting.

The OIE and the FAO can thus confirm the statement issued by the
World Health Organization (WHO) on 28 Feb 2006 that "there is no
present evidence that domestic cats can play a role in the
transmission cycle of H5N1 viruses".

Nevertheless, in view of the susceptibility of certain individuals of
this species, it is recommended that cats in infected zones and
surveillance zones set up around avian influenza outbreaks be kept indoors.

--
FAO Media Office
Rome, phone (+39) 06 570 53625

Online news from FAO

Thursday, April 20, 2006

AvianFlu research article


Research
The Trojan Chicken Study, Minnesota

Sandra R. Olson*†Comments and Gregory C. Gray*
*University of Iowa College of Public Health, Iowa City, Iowa, USA; and †University of Wisconsin-Madison, Madison, Wisconsin, USA

Recently, the Centers for Disease Control and Prevention (CDC) declared avian influenza to be the world's number-1 health threat (1); in particular, the wide and rapid spread of the H5N1 strain has heightened concerns. All H5N1 cases to date have been associated with direct contact with poultry, but recently, human-to-human transmission has been purported in Thailand (2). Previously healthy children and young adults seem to be especially susceptible to this illness (3). As of February 27, 2006, a total of 173 confirmed human cases of avian influenza A (H5N1) and 93 deaths have been reported to the World Health Organization, for a case-fatality rate of 53.8% (4).

Close contact with live poultry has been implicated in recent outbreaks of avian influenza in humans in Southeast Asia and elsewhere (2,5–8). In the 1997 Hong Kong outbreak, live bird markets were implicated as the source of exposure to the virus (8). In the United States, live bird markets are a known reservoir for avian influenza (9–11), but thus far they have not been associated with human avian influenza infection. Live bird markets involve a mixing of birds from diverse areas, crowded conditions for humans and livestock, mixing of different species of animal, and often a lack of proper sanitation, thus providing opportunity for outbreaks of disease. Transport of animals to market is a source of stress than can induce increased shedding of infectious agents. Stressed birds are also more susceptible to infections (12).

While live bird markets are uncommon in the Midwest, animal exhibits such as those at county fairs are quite common. Such exhibits are similar to live bird markets in that they involve transport and mixing of animals from different locations, crowded conditions, and a general lack of sanitation. Approximately 125 million people visit agricultural fairs every year in the United States (13). Fairs usually involve close proximity of food vendors to animal exhibits. Many animal exhibits encourage or allow visitors to touch animals. Small children are frequent visitors to county fairs and animal exhibits, and children also engage in behavior such as nail biting that may make them more likely to ingest infectious agents. Live animal exhibits such as petting zoos and open farms, which are in many ways similar to county fairs, have also been implicated in outbreaks of Escherichia coli O157:H7 and other bacterial diseases (13,14).

Proper handwashing is recommended to protect persons from infection (15). However, animal exhibits often lack adequate handwashing facilities, and many persons may be unaware of the risk such exhibits pose. Direct contact with animals, indirect contact with contaminated objects, or inhalation of aerosolized virus could contribute to transmission of pathogens in such settings.

Because little is known about the possible spread of pathogens at county fairs, and because most cases of avian influenza have resulted from close contact with poultry, a study was undertaken to model interspecies transmission of pathogens at county fair poultry shows. The specific aims of this study were to determine the proportion of human poultry show participants who demonstrate hand contamination by a surrogate marker for an avian pathogen and to determine possible risk factors associated with such contamination.
We conducted a study in the summer of 2004 at county fairs in the Midwest to investigate the role poultry exhibits have in spreading avian pathogens to humans. A nearly invisible powder (pathogen surrogate) that fluoresces under UV light was surreptitiously sprinkled each day on 1 show bird at each of 2 fairs. A UV light box was used to daily examine the hands of 94 poultry-exhibit participants (blinded regarding UV box results) for up to 4 days during the poultry shows. Enrollment and end-of-study questionnaires collected data on pathogen risk factors. Eight (8.5%) of 94 participants had evidence of fluorescent powder contamination (95% confidence interval 2.76%–14.26%). This contamination and infrequent handwashing practices suggest that county fairs are a possible venue for animal-to-human pathogen transmission.

Wednesday, April 19, 2006

Health Care Workers May Not Work


I admit, this is a topic I am concerned about and mentioned briefly previously.


Many Health Care Workers Won't Show Up in Flu Pandemic


By Steven Reinberg
HealthDay Reporter

TUESDAY, April 18 (HealthDay News) -- With many Americans worried about their safety should a flu pandemic occur, there's little reassurance from a survey that finds that close to half of U.S. public health-care workers would not show up for work if such a pandemic occurred.

In fact, two-thirds of the 308 employees polled said their work would put them at risk of contracting the potentially deadly flu should an outbreak come to pass.

"Forty-two percent of the health care workers surveyed said they would not respond in the event of a flu pandemic," said study co-author Dr. Daniel J. Barnett, an instructor at the Johns Hopkins University Center for Public Health Preparedness in Baltimore.

"The most important factor, in terms of showing up for work, was how much the individual employee perceived his or her role [to be] in the agency's response," he added. The less important an employee thought his or her role was, the less likely they were to report for work, Barrett said.

Just 40 percent of the employees felt that they would be asked to show up should a pandemic become a reality.

In addition, only 33 percent thought they were knowledgeable about the health impact of pandemic flu, Barnett said.

The survey was conducted between March 2005-July 2005 and involved employees of three Maryland county health departments. The findings appear in the April issue of the journal BMC Public Health.

The willingness to report for work was lowest among technical and support staff, Barnett said. These include computer data entry staff, clerical workers and receptionists. "In many cases, these are some of the people who will be on the frontline interfacing with the public," he noted.

The implication of these findings is that more training of health care workers is needed. "We need to do a better job of training the public health workforce," Barnett said. "Not just in ability to respond, but in willingness to respond," he added.

"We need to focus on giving each worker a better sense of the pandemic scenario and the importance of his or her personal role in responding to it as a health department employee," Barnett said. "In addition, we need to give workers confidence that the agencies will give them adequate personal protective equipment."

Barnett assumes that these findings would be the same throughout the United States. "The health departments we surveyed are consistent with a vast majority of health departments in the country," he said.

The public should be concerned with these findings, Barnett said, since the system can't function during a pandemic if many of the key health care workers don't show up. "This is a wake-up call of preparedness training to address willingness to respond," he said.

One expert is not surprised by these findings.

"Reluctance to report to work in a variety of settings will probably be an issue during a pandemic," said Dr. John Treanor, a professor of medicine, microbiology and immunology at the University of Rochester, N.Y. "It makes sense that if someone does not believe that they play an important role in whatever organization they work for, they are less likely to brave risks and hardship to go to work."

Education will be an important component of pandemic planning, Treanor said. "I would be interested to know the extent to which this would be impacted if the employees believed that they would receive an effective preventative, whether that was a drug or vaccine or something else, that would reduce or eliminate their personal risk," he said.

Another expert doesn't think these findings can predict the actual response during an actual crisis.

"The findings are potentially misleading because anticipating one's response to a genuine crisis is difficult," said Dr. David L. Katz, an associate professor of public health and director of the Prevention Research Center at Yale University School of Medicine.

"Completing a survey about hypothetical scenarios evokes none of the emotional intensity of a true crisis," he said. "Stating you might resist the call to duty in the advent of such a crisis does not induce the conflict or cognitive dissonance of actually doing so," he said.

However, he said, the findings should not be ignored.

"The findings are worrisome, though, because they suggest that the legions of public health workers around the country do not feel sufficiently informed about the threat of pandemic avian flu to respond to its arrival with confidence," Katz said. "Health departments can and should develop clear and coordinated response plans, and raise the prevailing level of flu knowledge among staff."

More information

For more on avian flu, head to the U.S. Center for Disease Control and Prevention (www.cdc.gov ).

SOURCES: Daniel J. Barnett, M.D., M.P.H., instructor, Johns Hopkins Center for Public Health Preparedness, Johns Hopkins Bloomberg School of Public Health, Baltimore; John Treanor, M.D., professor, medicine, microbiology and immunology, University of Rochester, N.Y.; David L. Katz, M.D., M.P.H., associate professor, public health, and director, Prevention Research Center, Yale University School of Medicine, New Haven, Conn.; April 2006, BMC Public Health

Copyright © 2006 ScoutNews LLC. All rights reserved.

Sunday, April 16, 2006

Planning in the US for a Pandemic Flu


US readies flu pandemic response plan: report
Sun Apr 16, 2006 3:33 AM BST164
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WASHINGTON (Reuters) - The U.S. government would expand the Internet and possibly permit foreign countries to print U.S. currency during a flu pandemic, under a national response plan that could be approved within days by President George W. Bush, the Washington Post reported on Saturday.

An article on the newspaper's Web site said the document is the first to spell out how the government would detect and respond to a flu outbreak and continue to function through what could be an 18-month crisis capable of killing up to 1.9 million Americans.

The 240-page response plan identifies more than 300 specific tasks for federal agencies, including determining which frontline workers should be vaccinated first and expanding the Internet to accommodate a likely flood of people working from their home computers.

The newspaper said the Treasury Department is poised to sign agreements with other nations to produce currency if U.S. mints cannot operate.

The Pentagon, anticipating difficulties acquiring supplies from the Far East, is considering stockpiling millions of latex gloves.

The article, which was also to appear in the Post's Sunday editions, said the Department of Veterans Affairs has developed a drive-through medical exam to quickly assess patients who suspect they have been infected by the virus.

Bush is expected to approve the plan within a week, the article said.

The White House is eager to show it can manage the medical, security and economic fallout from a major outbreak following its widely criticized to Hurricane Katrina, the Post said. Concern about a possible pandemic has grown with the emergence of the H5N1 avian flu, the most dangerous strain in decades.

Bush is expected to adopt post-Katrina recommendations that a new interagency task force coordinate the federal response and a high-level Disaster Response Group resolve disputes among agencies or states, the newspaper said. Neither entity has been created.

When the response plan is issued, the Post said U.S. officials intend to announce several vaccine manufacturing contracts to jump-start an industry that has declined in recent decades.

To keep the 1.8 million federal workers healthy and productive through a pandemic, the Bush administration would tap into its secure stash of medications, cancel large gatherings, encourage schools to close and shift air traffic controllers to the busier hubs.

The newspaper said retired federal employees would be summoned back to work, and National Guard troops could be dispatched to cities facing possible insurrection.


© Reuters 2006. All Rights Reserved.

HAPPY EASTER


For me, Easter and Spring is a time of new growth, new hope and new intentions. What does it mean to you? My Latin teacher used to say "The road to Hell is paved with good intentions." Oftentimes my intentions are never acted upon and lay at the wayside of my life. Business, fun, family and housework get in the way of getting things done. But these are really just excuses I use to justify my lack of willingness to commit to my good intentions.
May your Spring be filled with good intentions and actions to propel them forward.

news from the wall street journal for this week







AVIAN FLU: PREVENTING A PANDEMIC

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Avian Flu News Tracker

April 16, 2006 6:32 a.m.

Updated regularly with news on avian-flu precautions, research and outbreaks. All times EST.

Sunday, April 16


6:30 a.m.: Palestinian health workers contained an outbreak of bird flu in the Gaza Strip after culling more than 360,000 birds exposed to the illness, Gaza Governor Mohammed al-Kidwa said. The flu was detected in Gaza near the border with Israel on March 22 and later spread to five farming locations. U.N. officials have warned that the virus will deal a severe blow to Gaza's already shaky economy.

Saturday, April 15


10:00 a.m.: Azerbaijan's authorities said that they lifted the last quarantine imposed to prevent the spread of bird flu in the ex-Soviet Caspian Sea nation, where the disease has claimed five lives. The government body in charge of combating bird flu said that the final restrictions had been lifted in the village of Banovshalar, in the western Agdam region.
[Global Flyways promo]

Friday, April 14


12:40 p.m.: A growing number of avian-flu cases in Indonesia, both in birds and humans, suggests there is a breakdown somewhere in the country's crackdown on the disease, the WHO said. While other southeast Asian countries have brought bird flu under control using existing tactics, "something is not working" in Indonesia, the WHO's Alex Thiermann said. "The situation needs to be investigated." Indonesia has the second-highest human-fatality rate from bird flu, reporting 31 human infections and 23 fatalities. See the WHO's latest report on human H5N1 cases.

10:45 a.m.: In about three weeks, migratory birds will begin to arrive in Alaska for mating. Amid concern that they may bring bird flu with them, U.S. and Alaskan wildlife officials are setting up more than 50 remote, backcountry camps throughout the state, where tests on both living and dead birds will be conducted. Samples will be sent to one of 40 labs around the U.S.; the main lab is in Madison, Wis. See Alaska's avian-flu site.

9:25 a.m.: Hawaii is ahead of many U.S. states in preparing for possible global-flu pandemic. With many visitors from Asia, where the latest outbreak of bird flu originated, Hawaii was the first state to start an airport flu-monitoring program. Officials also have plans for limited quarantines and have amassed a supply of protective gear for doctors and nurses. Next month, the state will hold a preparedness seminar for employers. Read Hawaii's pandemic-preparedness plan.

Thursday, April 13

4:50 p.m.: A fourth Egyptian has died of bird flu, the Ministry of Health reported. Samah Mandouh Abdel Ghaffar, 18 years old, died today in a hospital in the Nile Delta province of Manoufiya. She had been admitted to the hospital on April 10 and was on life support at the time of her death. In all, Egypt has reported 12 humans infected with bird flu. Four -- all women -- have died. Five have recovered and three remain in the hospital.


3:20 p.m.: Key West, Fla., is famous for its roaming chickens but the island's birds may soon be cooped up. Worried about bird flu, City Commissioner Bill Verge wants the city to begin rounding up the island's 2,000 to 3,000 chickens. He's going to have a tough job, though, amid tough critics. Katha Sheehan likened a Key West without chickens to "New Orleans without the jazz and San Francisco without the cable cars."

10:40 a.m.: Russia reported two new outbreaks of bird flu in the southwestern part of the country. H5N1 was determined as the cause of death for 25 chickens in the Volgograd region, and in the Rostov region, H5N1 was found in dying wild birds. The government says bird flu has been detected in 43 locations in 11 regions in southern Russia.
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10:25 a.m.: The Czech Republic reported four new cases of H5N1. A reference lab in Prague confirmed that four swans found dead in the southern part of the country were infected with the virus. Another four swans tested positive for H5 and are being tested for H5N1. A total of seven cases of H5N1 have been confirmed so far in the country.

12 a.m.: WSJ's Nicholas Zamiska reports. A coming Lancet study ranks 21 European countries according to their national plans for coping with a human outbreak of bird flu, likely raising politically sensitive questions. Of 21 national plans examined, seven don't mention the role of veterinary services, many don't include a strategy for containing an original outbreak and fewer than half address how to maintain essential services in the event of a pandemic, according to the study.