I am sooo afraid this is where it will mutate...

Bengkulu, (ANTARA News) - At least 10 Indonesian provinces in Sumatra have been hit by deadly bird flu or avian influenza illness, an official of the Agriculture Ministry said here Saturday.

"Total number of Indonesian province hit by the bird flu disease is 20, with 10 of them are in Sumatra," husbandry health functional official of the Agriculture Ministry's Husbandry Directorate General, Didin, told a coordinating meeting on bird flu.

The bird flu-hit provinces are Lampung, Bengkulu, North Sumatra, West Sumatra, Bangka Belitung, Jambi, South Sumatra, Aceh, Riau and Riau islands.

Didin said his office depopulated or killed 154 poultry in bird flu-prone provinces from January to August this year.

"The government has allocated Rp1.57 billion to compensate poultry farmers whose animals were culled. The government compensated Rp12,000 for each poultry," he said.

The Agriculture Ministry, he said, formed avian influenza controlling units to assess fund to combat the deadly illness across the country.

The campaign against the avian influenza was carried out door-to-door as the disease was indeed found in backyard farm, he said.

Bird flu in Indonesia grabbed the world's attention in May when seven members of a single family in North Sumatra province died of the virus - the largest recorded cluster to date.

The WHO concluded that limited human-to-human transmission likely occurred, but the virus did not spread beyond the blood family members.

It said the avian influenza virus that has killed at least 135 people worldwide (excluded Indonesia) as of early last August since it began ravaging Asian poultry stocks in late 2003.(*)

COPYRIGHT © 2006 ANTARA

Thailand producing CD to teach about avian flu

The Agriculture and Cooperatives Ministry has spent 12 million baht producing four songs to educate the public on bird flu disease.

Caretaker deputy minister Adisorn Piangket (อดิศร เพียงเกษ) said 30,000 CDs will be distributed to radio and television stations and broadcasting towers across the country.

Mr. Adisorn said the songs, performed by several famous singers free of charge, teach people not to eat chickens with diseases or chickens which havew died mysteriously.

Avian Flu in US in 2 years

Bird flu expected to hit U.S. in 2 years

By Jim Maniaci
Cibola County Bureau

GRANTS — The world's most deadly flu epidemic is expected by the best guesses currently available to hit the U.S. within two years.

This was the warning given to the Grants-Milan Rotary Club on Tuesday by a University of New Mexico specialist helping organize pilot projects in two of the state's 33 counties, Cibola and Grant.

Meetings in the area will take place from September to November, Margo White said. The sessions are aimed at "turning a paper plan into a community effort... You don't know how many talents you have to share from the group itself, (talents) which will be needed. We won't have the system as usual; we won't have life as usual."

White said, "You don't want to be exchanging business cards at the time the disaster starts. You need to know people in the community, and who does what beforehand. You need to develop your talents and your skills, including time care. The hospitals cannot manage it. They will have their limited capacity.

"Everyone in the community will need to work together, to be supportive when school closes, when students are home, when child care is no longer possible. In the community, people will be on their own. Helping others who can't stockpile, you should be able to do it. I don't have a lot of solutions, but people will come up with solutions, given the opportunity to do it."

Vince Ashley, Cibola General Hospital's administrator, said his staff has been stockpiling so much of what will be needed, for instance masks, that CGH has run out of storage space.

"We'll look like a fortress," he predicted, because everyone entering will have to be screened. With a staff which he expects will be decimated by the deadly illness, he said emergency triage ranking patients in the order to be treated based on their condition will have to be imposed.

White repeated what might happen, as well as her theme of everybody has to help everybody else, many times.

She also distributed a sheet on the characteristics and challenges. It said in the 20th Century the U.S. lost a half-million people in the 1918 flu pandemic the shorter term used to describe a world-wide epidemic with 70,000 Americans dying from the flu in 1957 and 34,000 in 1968.

White said the problem is "unprecedented."

The virus H5N1 infects birds, which fly long distances. Wild birds can infect domestic flocks and then get passed on to humans when they come into contact with the domestic birds.

She compared a virus to a bunch of hoodlums who go into an expensive neighborhood looking for clothing because they expect to find huge closets in a big house. "They mix and match and swap until they get what they want," she said.

And when they depart they trash the place because, "It's all they know how to do."

Because of, among other things, the world's transportation system, it will spread widely, health care systems will be overloaded, medical supplies will be inadequate and there will be disruptions to the economy and society. For instance, she said, schools will have to be shut down and automatic teller machines will run out of currency because there won't be enough people to refill them.

She called the situation "an opportunity to begin to mobilize all the resources that you have and all the known skills, unknown skills, forgotten skills (such as) preserving and canning food, developing new capacities for home care that we all can learn."

The flu is expected to hit in two or three waves, each lasting up to two months, he cautioned.

WASH YOUR HANDS!

Global Survey Shows Canadians Understand the Value of Hand Washing Better Than Anyone

    <<>>

TORONTO, Aug. 31 /CNW/ - An international survey on hygiene practices
conducted in nine countries reveals 74 per cent of Canadians view hand washing
as the most effective way to prevent the spread of germs in the home, compared
to 68 per cent in the U.S. and a low 24 per cent in Italy. When it comes to
protection against the flu, 83 per cent of Canadians link hand washing to
protection, compared to 80 per cent in the U.S. and 47 per cent in the U.K.
However, one third of Canadians admit they may not wash their hands properly
after sneezing or coughing.
The survey is part of a global initiative led by the Hygiene Council, an
international think tank of leading practitioners in the fields of
microbiology, virology, infectious diseases and public health. The results
were released in Toronto today at a presentation hosted by the Chair of the
Hygiene Council, Prof. John Oxford (U.K.) Professor of Virology at St.
Bartholomew's & The Royal London Hospital, Queen Mary's School of Medicine and
Dentistry and Canadian member Dr. Donald E. Low, microbiologist-in-chief at
Mount Sinai Hospital in Toronto.
The international survey examines hygiene habits and awareness levels of
infectious disease transmission of more than 9,000 people in Canada, the U.K.,
Germany, Italy, the U.S., Malaysia, India, South Africa and the United Arab
Emirates. The Canadian portion of the survey, conducted by TNS Canadian Facts
and commissioned by Reckitt Benckiser, also shows that 60 per cent of
Canadians believe hands are the largest carriers of germs, yet 36 per cent
admit they might not wash their hands properly after handling animals or pets.
Twelve per cent of Canadians (one in eight) say they might not wash their
hands properly before eating or handling food; nine per cent admit they may
also fail to practice good hygiene after visiting the washroom.
"Without a doubt, the heightened awareness among Canadians about the
value of hand washing is our legacy from the SARS outbreak a few years ago,"
says Dr. Low. "However, the survey findings suggest that while Canadians have
a good understanding of proper hygiene in the home and community, there's
still room for improvement when it comes to putting theory into practice."

<<>>

Recognizing the need to provide advice to the public about good hygiene
practice in the wake of infectious diseases such as SARS and bird flu, the
Hygiene Council held its first meeting in London, England this spring to
discuss aspects of hygiene practice in both developed and developing nations,
measures of prevention and control of avian and pandemic influenza, hygiene
measures in the home, the role of disinfectants, and protection from
micro-organisms. Council chair Prof. Oxford is teaming up with fellow Council
members in eight countries to share their findings and recommendations as part
of the Hygiene for the 21st Century initiative.
"Globally, people need to be better prepared to understand and meet the
challenges that public and personal health poses," says Prof. Oxford. "Good
hygiene practices are preventative measures against disease transmission,
which includes home, community and hospital-based hygiene."

Guidelines put forth by the council encompass many areas including
kitchen hygiene, bathroom hygiene and hand washing. Examples include:

<< - Clean hands can be the most powerful weapon on earth for defeating infection - it's vital that hands are cleaned correctly and thoroughly. When water is not available, the use of alcohol-based disposable hand wipes or sanitizers is a recommended alternative. - Cover the nose and mouth when coughing or sneezing - ideally using the crook of the arm rather than the hand, unless hands can be washed immediately. - Kitchen surfaces, which are prone to cross-contamination, should be cleaned and disinfected regularly to kill bacteria which may cause gastrointestinal infections. - Germ transmission from toilets can be avoided by adopting the habit of flushing with the lid down as germs are dissipated during flushing in water droplets and could settle anywhere in the bathroom. - Commonly touched surfaces, such as door handles, light switches, taps, telephones, and toys should be disinfected often to remove viruses, such as the rhinovirus (the leading cause of the common cold). - Pets and animals should not be allowed in the kitchen or food preparation areas. Children should be discouraged from allowing pets to lick their faces, or to sleep with them. >>

More information about the Council can be found at www.hygienecouncil.com

Sickness expands in Indonesia

Four treated in Indonesia for H5N1 symptoms

Thu 31 Aug 2006 4:46 AM ET

JAKARTA, Aug 31 (Reuters) - Four people have been admitted to an Indonesian hospital with bird flu symptoms in an area of West Java that has seen a series of confirmed and suspected cases in humans, officials said on Thursday.

At least two people in Cikelet, about 90 km (55 miles) south of the provincial capital of West Java, Bandung, have been confirmed to have died from the H5N1 virus in recent weeks.

"Three people with symptoms including breathlessness have been hospitalised since last night at Dr. Slamet hospital," said Hendi Budiman, head of administration at the Garut Health Office, the district where Cikelet is located.

"They come from Cikelet. Two are neighbours, but they are not related."

Yogi Prayogi, a spokesman at Dr Slamet hospital, said blood samples had been sent to Jakarta for testing.

"Three people showing symptoms will be allowed to return today. But they will be monitored," he said, adding that the three lived around chickens and dead fowl had been seen.

He said an 8-year-old boy with bird flu symptoms had also been admitted. Indonesia has so far recorded 60 bird flu cases, 46 of them fatal. The country's death toll is the highest in the world.

Separately, a local health ministry official said three out of five people admitted to hospital on Indonesia's Sulawesi island this week with bird-flu like symptoms were related.

"Three are related, they are cousins," said Ida Bagus Yadnya Putra, head of communicable disease control at the health ministry in Central Sulawesi province.

The official said that dead chickens had been found around their homes.

"They came to hospital to get medicine but refused to stay for treatment. They didn't come to the hospital at the same time. Now, they are getting better."

Blood samples from the five had also been sent to Jakarta for testing.

Fears that the virus had mutated into a form that could pass easily between humans heightened in May when seven people from an extended family died of the disease in Indonesia's North Sumatra.

Scientists worry that the H5N1 virus that has killed around 140 people and millions of birds since 2003 as it spread from Asia to Europe and Africa could mutate into a strain that could spark a human pandemic.

Indonesia has seen a steady increase in human bird flu deaths this year and the virus is endemic in poultry in nearly all of the provinces of the sprawling archipelago.

The country, which has been criticised for not doing enough to stamp out H5N1, has shied away from mass culling of poultry so far citing the expense and the logistical difficulties because of the millions of backyard fowl.

Indonesia tries to contain bird flu outbreak

Indonesia Struggles to Contain Bird Flu
By Chad Bouchard Kaben Jahe, Indonesia 31 August 2006

Bouchard report - Download 642k
Listen to Bouchard report

Chickens on a farm in central Java, Indonesia

Indonesia is struggling to contain the spread of the deadly bird flu virus in people and poultry. The country now has the world's largest number of human bird flu deaths, and critics say it needs to do more to eradicate the disease. But, as Chad Bouchard reports from the Indonesian island of Sumatra, the government's efforts are hampered by limited resources and resistance from local communities.

In the isolated mountain community of Dairi in north Sumatra, about 200 villagers file into a packed meeting house. Everybody is talking about a frightening rumor that has been circulating all day.

Bupati Tumanggor, head of the local Dairi district, addresses the restless crowd over a loudspeaker.

He confirms that someone from the village has been hospitalized for avian influenza. Five chickens have tested positive for the H5N1 virus as well. He tells them the next morning all birds within a one-kilometer radius will be killed, to keep the virus from spreading.

A man works on a chicken farm in Central Java, Indonesia

Other countries hard hit by the H5N1 virus, such as Vietnam and Thailand, have made significant progress against the disease by killing large numbers of poultry once an outbreak is detected.

In August Indonesia recorded its 60th case of bird flu in humans, 46 of which have been fatal, the highest human death toll from the disease.

And some scientists are concerned this high death rate is partly due to Indonesia's reluctance so far to cull birds.

Indonesia

Tumanggor acknowledges Indonesia has had a difficult time stopping bird flu. But he says the country faces unique challenges. Its population is spread over 17,000 islands, domestic fowl roam everywhere, and there is widespread resistance to the central government among many of its diverse cultures.

"Criticism from other countries is normal," he said. "But sometimes the critics assign blame because they don't really understand Indonesia. Information in the media about this country is not complete. But if they looked at the whole picture, people would understand how difficult our task is, and that we are doing our best with what we have."

John Weaver is an advisor on avian flu with the United Nations Food and Agriculture Organization, which is helping Indonesia fight the disease. He says Jakarta's culling program is not rigorous enough. In some cases only 30 or 40 percent of the birds in an area are killed because villagers do not cooperate.

"You know village poultry are recognized as a valuable asset both in terms of their food value, but also they're a liquid asset in that they can be sold to pay school fees or some medical fees, or something like that, so they are valued within the system. One needs to work within communities and address the fact that this is a potential loss to them," said Weaver.

Compensating villagers for their poultry is expensive, and the government currently pays only half the market price for birds that are culled. Some villagers fail to report outbreaks of disease in poultry or they hide their birds during a cull.

Vendor unloads crates of chickens from truck at chicken market in Jakarta

Indonesia says the high cost of compensation is one of the biggest barriers to controlling the virus. The government says it needs $900 million for bird flu containment programs over three years but can only afford $150 million.

But international donors have been reluctant to commit funds. Donor nations have asked for details of how the money will be spent but the Indonesian government has so far failed to provide a plan.

Indonesia also caused concern in August when it reduced its annual budget for bird flu programs from $57 million to $46 million. The World Bank said the cuts sent the wrong message to international donors.

Under pressure from the international community, Jakarta has agreed to restore funding to its previous level.

The U.N.'s Weaver says getting the virus under control in Indonesia will require sustained support from donors.

"It's not going to be a quick fix," he said. "It's not a one or two year program, it's a five to ten year program. And it's very resource dependent. And it's dependent on both the commitment of the resourcing within Indonesia - but one has to recognize that that's finite - and the response that's expected is beyond the capacity within Indonesia. So there has to be greater international commitment."

Back in Dairi, police demand residents bring out their chickens to be destroyed. Health workers dressed in sterile white clothes, masks and hoods sweep the village, slaughtering captured birds in the streets.

At the end of a dusty road, a woman who goes by the honorary title of Nandetedi, or "grandma" in the local dialect, says the villagers do not understand.

"You know, we don't even have words for 'avian influenza' in the local language," she said. "We do not know how and why the chickens die. We only know the chickens are sick. All of us are healthy. Moreover, I'm an old person, and I'm not afraid of chickens."

Once the police and health workers have gone, simmering resentment remains over the loss of birds and the damage to the economy.

Indonesia has announced it will expand the culling of backyard poultry, and the country is rolling out a widespread public awareness campaign about bird flu on television and radio stations.

The H5N1 virus cannot spread easily among people but there are fears a mutation may occur that will allow it to do so if more humans catch the disease from infected birds.

And as long as an estimated 300 million chickens continue living in close contact with people, the chance remains for a deadly epidemic in Indonesia. But for now, many bird owners remain unconvinced of that risk.

Alaska birds free of H5N1 so far

Tests find no H5N1 avian flu in Alaskan birds

Aug 30, 2006 (CIDRAP News) – No highly pathogenic H5N1 avian influenza virus has turned up in any of the 13,000 wild migratory birds that federal and state officials have tested since Apr 26, the US government announced yesterday.

The US Department of Agriculture (USDA) said about 113 birds tested positive for other types of avian flu. Those results were expected, officials said, because there are 144 avian flu subtypes, most of which pose no threat to domestic poultry or humans and do not produce noticeable illness in wild birds.

"Although no high-path H5N1 virus has yet been detected, we must remain vigilant and thorough in this important detection and early warning program," said Interior Secretary Dirk Kempthorne, who is visiting a sampling camp near Barrow, Alaska, this week.

The Alaska sampling has targeted 26 species whose migratory patterns would have likely put them in contact with the H5N1 virus before arriving in Alaska, the USDA said.

The national wild bird surveillance plan is part of the administration's National Strategy for Pandemic Flu. President Bush allocated $29 million in the fiscal year 2006 avian flu supplemental funding package for wild bird monitoring, which was recently expanded to the lower 48 states, Hawaii, and Pacific territories. The sampling program goal is to test 75,000 to 100,000 migratory birds and 50,000 bird feces samples this year.

In other avian flu news, an H5 avian flu virus was detected this week in a flock of ducks in a Hanoi suburb, according to an Agence France-Presse report today. The two ducks that tested positive were from a market; a total of five were tested, all in good health. The neuraminidase (N) component of the virus had not yet been identified.

"This discovery shows that the virus is still circulating among poultry, especially waterfowl," Agriculture Minister Hoang Van Nam told AFP. The geographic origin of the ducks could not be determined. Though live poultry trade in Hanoi's inner district is prohibited, the ban is loosely enforced.

Vietnamese health officials said 2 days ago that the H5N1 virus was found on a small duck farm in the southern Ben Tre province, and an H5 virus resurfaced in ducks and storks in the past month. Though Vietnam has the highest number of human H5N1 cases (93), no human cases have been reported this year.

To help prevent avian flu in Latin America and the Caribbean, the United Nations Food and Agriculture Organization (FAO) announced today the release of a new handbook aimed at the region's small-scale poultry farmers. The guide focuses on simple, inexpensive methods to ensure farm biosecurity and prevent contact between domestic poultry and wild birds, according to an FAO press release.

The guidebook, to be widely distributed and available free on the FAO's Web site, is similar to a guide that was published for poultry farmers in Southeast Asia.

The threat to Latin American and Caribbean poultry from migratory birds is the same as for North America. The FAO said that if it reached North America, the H5N1 virus would follow north-south migration routes from the Arctic to Tierra del Fuego, the archipelago at the southern tip of South America. Domestic poultry smuggling, informal trading, and cockfighting contests could all contribute to the spread of avian flu, the agency said.

Though the Asian H5N1 strain has never been detected in the Americas, other strains (H5N2 and H7N3) have caused disease outbreaks in Canada, Chile, the United States, and Mexico in recent years, the FAO noted.

An appearance of H5N1 avian flu in Latin America and the Caribbean would threaten the food security of the most vulnerable groups in the region, where poultry accounts for more than 70% of animal protein consumption, the FAO said.

In related news, media reports said today that seven more people in Indonesia have been hospitalized on suspicion of having avian flu. Two of the patients, a 17-year-old and a 39-year-old man, are from the Garut district of West Java, where health authorities recently investigated the possibility of human-to-human disease transmission, according to an AFP report today.

Five people from the Indonesian island of Sulawesi were hospitalized this week, according to a Reuters report today. An avian-flu information official told Reuters that samples from the patients were sent to a government lab for testing. No other details about the patients were available.

See also:

Aug 29 USDA press release on results of wild bird testing in Alaska

Watch those migration flyways

	Avian flu reported among migrating birds in West Siberia
	14:25 | 30/ 08/ 2006

NOVOSIBIRSK, August 30 (RIA Novosti) - Bird flu has been registered among migrating birds in West Siberia, a local veterinary watchdog reported Wednesday.

An epidemic of the deadly virus broke out in five Siberian and 11 southern regions this year, resulting in the deaths and culling of about 1.5 million birds. And a regional branch of the Federal Service for Veterinary and Phytosanitary Oversight said the most dangerous strain of the disease had been identified in a region more than 1,500 miles east of Moscow.

"Lab tests showed H5N1 strain in wild fowl on 14 lakes in the Omsk Region," a representative said.

But the representative said all outbreaks of the virus among domestic fowl had been eradicated and quarantine restrictions lifted across Siberia.

The disease, which scientists fear could mutate into a form that passes between humans and spark a global pandemic, has spread worldwide since it was first spotted in Asia in 2003 and has claimed dozens of human lives. No human fatalities have been reported in Russia.

5 new cases in Indonesia of H5N1

JAKARTA, Aug 30 (Reuters) - Five people have been admitted to hospital on Indonesia's Sulawesi island with bird flu-like symptoms and local authorities have sought funds from the government to help cull poultry, officials said on Wednesday.

Samples from the patients in Palu, the capital of Central Sulawesi province, have been sent to a government laboratory in Jakarta to be tested for bird flu, said Runizar Ruesin, head of the ministry's bird flu information centre.

No further details about the five people were available.

Indonesia has so far recorded 60 bird flu cases, 46 of them fatal. The country's death toll is the highest in the world.

Zulkarnain Hassan, a coordinator at the agriculture ministry's Avian Influenza Crisis Centre, said that there had been bird flu cases in poultry in West and South Palu district and the provincial capital of Palu city.

An official of the agriculture ministry in Palu said the local government did not have enough money to compensate farmers for culling their birds and had asked Jakarta for more funds.

"(Culling) is something that must be done," he said, adding that some slaughtering had started in the region on Wednesday.

He did not say how many chickens needed to be killed or how much the work would cost.

Bayu Krisnamurthi, head of the national bird flu control commission, said the central government would reimburse funds spent by local governments or compensate farmers.

Separately, the government will on Friday embark on a new campaign to raise awareness about bird flu through television and radio advertisements, leaflets, posters and billboards, said Tri Satya Naipospos, deputy chief of the National Committee for Avian Influenza Control and Pandemic Preparedness.

"So far our campaign has been spotty. We realise that human cases have occurred in regions where people are ignorant about bird flu and they don't have the means to support our efforts," she said, declining to give the cost of the campaign.

Experts said public ignorance, along with official ineptitude and lack of money, are hampering efforts to stamp out the disease in the country of 220 million.

Farmers often oppose the destruction of their fowl because of low compensation.

A full-grown chicken sells for 35,000 rupiah ($3.85) in Jakarta, but the government only offers between 10,000-12,500 for each fowl killed.

Although bird flu remains essentially an animal disease, experts fear it could mutate into a form that can pass easily among humans, killing millions.

New fears that the virus had mutated into a form that can easily pass between humans arose this month after a series of confirmed or suspected cases in West Java's remote Cikelet village, where bird flu is rife in poultry.

The World Health Organisation (WHO) said there has been no evidence that human-to-human transmission had occurred in the area.

Vietnamese ducks test positive for avian flu

HANOI, Vietnam (AP) - Vietnam's government detected the bird flu virus in live ducks at a market and has banned any further hatching of ducks after Friday in an effort to prevent the virus from spreading, officials said Wednesday.

Two random samples recently tested positive for bird flu in specimens taken from five ducks in a market on the outskirts of Hanoi, said Hoang Van Nam, deputy director of the Animal Health Department.

Waterfowl have been a major concern in Vietnam because they can be infected with the H5N1 virus without showing symptoms.

To help reduce the population, Agriculture Minister Cao Duc Phat has ordered that all ducks hatched before Friday must be raised in fenced farms and given bird flu vaccine, Nam said. Those hatched after Friday must be destroyed under the order.

Last year, the government imposed a similar ban on hatching and raising waterfowl, but it was largely ignored by farmers. It's unclear how the government would enforce the order this time.

Nguyen Dang Vang, director of the Breeding Department said there are 220 million poultry in Vietnam as of April, including 50 million ducks and 8 million geese.

The duck population is estimated to increase sharply over the past two months as farmers in the southern Mekong Delta, the country's main duck producer, hatched many ducks to eat rice leftover from the paddy harvest, Vang said.

Officials also are worried about geese being a source of new flare-ups because there is currently no vaccine available for them.

Vietnam had not reported any outbreaks in poultry this year until the virus was detected through random testing in a handful of poultry in southern Ben Tre province earlier this month. Vietnam has not reported any human cases in nearly a year.

The country remains on high alert following a bird flu resurgence in neighboring China, Laos and Cambodia.

Local media have reported that authorities confiscated more than 70 tons of chickens smuggled in from China so far this year. Far more chicken crossed the border undetected.

Bird flu ravaged poultry farms in Asia in late 2003. It also jumped to humans, killing at least 141 people worldwide. Most human cases have been linked to contacts with sick birds, but experts fear the virus will mutate into a form that spreads easily among people, potentially sparking a pandemic.

© 2006 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

H5N1 and Dogs again, this time Thailand

Dog contracts avian flu

Hospital vet calls on public not to panic or abandon pets after Suphan Buri case

A dog in Suphan Buri contracted bird flu after eating infected ducks, new findings show.

Prof Dr Yong Pooworawan, a lecturer at Chulalongkorn University's Faculty of Medicine, released the findings at a seminar at the university yesterday.

According to Yong, a researcher at Kasetsart University's Kamp-haengsaen campus found that a dog had contracted bird flu.

The findings will be published in a foreign journal, Emerging Infectious Diseases, soon, Yong said. He declined to elaborate on the findings.

Since 2004, Thai researchers have studied the genetic codes of nearly 200 bird-flu strains and have finally been able to identify the cause of resistance to Tamiflu, a medicine used to treat avian influenza in humans, Yong said.

Following yesterday's seminar, Rattathan Pattanarangsan, a veterinarian from Mahidol University, called on people not to panic over the emergence of bird flu in dogs.

"Please do not abandon your dogs in public places. You can prevent them from getting bird flu.

"Make sure you bury dead or ill chickens deep in the ground," he said.

Rattathan said it would be very difficult for infected dogs to pass on the bird-flu virus to humans.

Earlier, news reports that cats had contracted bird flu led panicking pet owners to abandon their cats.

Meanwhile, Medical Sciences Department director-general Paijit Warachit yesterday said the Public Health Ministry would link up with Chinese health officials to develop a vaccine against human influenza.

He said China was ready to pass on its know-how to Thailand.

"We hope to establish a vaccine factory within the next three to five years. Our factory will have capacity to produce two million vaccine doses a year," he said.

Paijit said the Public Health Ministry would next week convene a meeting on the issue with the Government Pharmaceutical Organisation and the Thai Red Cross Society.

He said there had been no reports of human-to-human transmission of bird flu to date.

However, were such human-to-human transmission to take place, the country would have a supply of up to 10 million doses of the vaccine against human influenza.

New test for flu

New test may enable more labs to subtype flu viruses

Robert Roos News Editor

Aug 29, 2006 (CIDRAP News) – Government-funded researchers say they have developed a test that may enable more laboratories to fully identify influenza viruses than is possible with existing tests.

The FluChip test involves a microarray of genetic material—hundreds or thousands of short sequences of known DNA or RNA deposited on a microscope slide, according to a news release from the Centers for Disease Control and Prevention (CDC). The sequences are used to "capture" matching sequences from viruses in samples gathered from patients.

In a study reported in the Journal of Clinical Microbiology, the test determined the type and subtype of more than 70% of 72 flu viruses, including H5N1 avian flu, in less than 12 hours. The study was led by Kathy L. Rowlen, PhD, of the University of Colorado, with assistance from the CDC and funding from the National Institute of Allergy and Infectious Diseases (NIAID).

The test doesn't require the same level of biological security as other tests used to gather detailed information on flu viruses, including the subtype and clade, or family, according to the CDC. That means more labs can use the test.

"Because the sample is inactivated and you're not amplifying the virus, you don't have to use a BSL-3 [biosafety level 3] lab to do the diagnosis," Dr. Nancy Cox of the CDC, a coauthor of the study, told CIDRAP News. The test can be used in BSL-2 labs, a category that includes many clinical labs, said Cox, who is director of the CDC's influenza division.

Rapid tests now used in clinical practice can identify flu viruses in less than 30 minutes, but, at best, they can only detect a virus and determine whether it is type A or type B; they can't identify the subtype, such as H3N2. More sophisticated tests, such as polymerase chain reaction, immunofluorescence, and viral culture, provide more information but are more difficult to conduct and take from several hours to several days, according to the CDC.

The developers of the FluChip test hope to reduce the time required to subtype a flu virus to less than an hour, the news release said. Their journal article says the methods most widely used to subtype flu viruses typically take about 4 days.

The FluChip used in the study contained 55 sequences of RNA representing a variety of type A and type B flu viruses, including H5N1 avian flu and two of the most common seasonal flu subtypes, H3N2 and H1N1. The process for selecting these sequences is described in a companion article in the August issue of the Journal of Virology. The article explains a new method for combing through large amounts of viral genetic information to find sequences that are most helpful for distinguishing between different types and subtypes.

"Our goal was to develop an efficient method for mining large databases to identify regions of the flu genome that are largely the same from strain to strain, as well as strain-specific sequences," Rowlen said in the CDC news release.

To test the FluChip, Rowlen and colleagues used it to analyze 72 unlabeled flu virus samples provided by the CDC, including strains from humans, birds, horses, and pigs. The researchers used RT-PCR to amplify some of the viral genes and then chemically fragmented them. The FluChip then was exposed to a solution containing the gene fragments.

Bits of viral RNA or DNA, when they come in contact with a microarray such as FluChip, will bind to, or be captured by, matching sequences on the microarray, according to the CDC. Researchers then can identify the pathogen by analyzing the pattern of captured targets.

Rowlen and colleagues ran two rounds of tests on the sample viruses. In the first round, they correctly identified the virus type and subtype (type A or B and the hemagglutinin [H] and neuraminidase [N] number) of 66% of the samples. They identified the correct type and the correct H or N number for another 17% of the viruses, and identified only the correct type for 12%.

In the second round, the test correctly typed and subtyped 79% of the samples. The average results for the two rounds were as follows: correct type and subtype, 72% of samples; correct type and partly correct subtype, 13%; correct type only, 10%; false-negatives, 4%; and false-positives, 1%.

About a third of the faulty results occurred because the viruses supplied by the CDC were not covered by the RNA sequences on the FluChip, the article says. Many of the other incorrect results occurred because the attempt to amplify the viral RNA failed, leaving too little to detect.

"We were surprised and pleased at how well the chip performed in these early tests," Rowlen commented in the news release.

"This paper is a proof-of-concept paper that this approach will be quite useful," Cox told CIDRAP News.

"Depending on the design of your capture sequences [on the microarray], you can get more or less information about the viruses," she added. For example, she said, the test could be designed to identify particular strains of the H5N1 avian flu virus, such as subgroups within clade 2. "It’s a very versatile approach to obtaining information about the viruses."

Cox said the test will have to be commercialized to be brought into wide use, and there are private companies interested in it, though she declined to name any. She estimated it will take at least 2 years of development to make the test ready for commercial use.

"If it can be made inexpensively, it would be an ideal tool to use for regular seasonal flu as well as for strains such as H5N1 which are novel to humans," she said. "The aim is to make it competitive with, if not less expensive than, the commercial tests, which cost between about $14 and $20 per test. The aim is to make this less expensive but provide more information."

Townsend MB, Dawson ED, Mehlmann M, et al. Experimental evaluation of the FluChip diagnostic microarray for influenza virus surveillance. J Clin Micro 2006;44(8):2863-71 [Abstract]

Mehlmann M, Dawson ED, Townsend MB, et al. Robust sequence selection method used to develop the FluChip diagnostic microarray for influenza virus. J Clin Micro 2006;44(8):2857-62 [Abstract]

According to World Health Organization

INFLUENZA >> AVIAN INFLUENZA >> NEWS >>

Printable Page WHO issues definitions for human H5N1 cases Aug 29, 2006 (CIDRAP News) – The World Health Organization (WHO) today released a list of case definitions for human H5N1 avian influenza infection to improve reporting and tracking of the disease. The WHO said the use of standard definitions will help national and international authorities report and classify human cases, promote better communication, and allow the comparison of data across time and between places. The agency worked with several partners to develop the definitions. Officials listed several caveats about using the terminology. The case definitions apply only to the current phase of pandemic alert (phase 3, no or very limited human-to-human transmission) and may change as new information emerges about the disease or its epidemiology. National authorities should notify the WHO only about probable or confirmed H5N1 cases. The definitions are not intended to provide complete case descriptions, but to standardize case reporting. Clinical decisions about the care of patients who may have H5N1 infection should be based on clinical judgment and epidemiologic reasoning, not on the case definitions, the WHO said. The agency said that although most patients with H5N1 infection have had fever and lower respiratory symptoms, the clinical spectrum is broad. The case definitions include: Person under investigation: A person whom public health authorities are investigating for possible H5N1 infection. Suspected H5N1 case: A patient who has unexplained acute lower respiratory illness with a fever greater than 38°C (100.4°F) and cough, shortness of breath, breathing difficulty, and one or more of the following exposures 7 days before symptom onset: Close contact within 1 meter (eg, caring for, speaking with, or touching) with a person who is a suspected, probable, or confirmed H5N1 case Exposure to (eg, handling, slaughtering, defeathering, butchering, or preparing for consumption) poultry or wild birds, their remains, or their feces where H5N1 infections in animals or humans have been suspected or confirmed in the last month Consumption of raw or undercooked poultry where H5N1 infections in animals or humans have been suspected or confirmed in the last month Close contact with a confirmed H5N1-infected animal other than poultry or wild birds (eg, cat or pig) Handling human or animal samples suspected of containing the H5N1 virus in a laboratory or other setting. Probable H5N1 case (notify WHO): Definition 1: A person who meets the criteria for a suspected case and has either (1) evidence of acute pneumonia on a chest radiograph plus respiratory failure (hypoxemia, severe tachypnea) or (2) laboratory confirmation of influenza A but insufficient laboratory evidence for H5N1 Definition 2: A person dying of an unexplained respiratory illness who is epidemiologically linked by time, place, and exposure to a probable or confirmed H5N1 case. Confirmed H5N1 case (notify WHO): A patient who meets the criteria for a suspected or probable case and has had one of the following test results from a national, regional, or international influenza laboratory whose H5N1 test results are accepted by the WHO: Isolation of an H5N1 virus Positive H5 polymerase chain reaction (PCR) results from tests using two different PCR targets (eg, primers specific for influenza A and H5 hemagglutinin) A fourfold or greater rise in neutralization antibody titer for H5N1 based on testing of an acute serum specimen (collected 7 days or less after symptom onset) and a convalescent serum specimen. The convalescent neutralizing antibody titer must be 1:80 or higher A microneutralization antibody titer for H5N1 of 1:80 or greater in a single serum specimen collected at day 14 or later after symptom onset and a positive result using a different serologic assay, such as a horse red blood cell hemagglutination inhibition titer of 1:160 or more or an H5-specific Western blot positive result. See also: Aug 29 WHO statement on case definitions for human H5N1 infections

Scientists Move Closer to Understanding Flu Virus Evolution

By Jason Gale

Aug. 28 (Bloomberg) -- Scientists tracking bird flu moved closer to understanding the evolution of the viruses and the genes that make them more infectious to people in a new study.

About 52 key genetic changes distinguish avian influenza strains from those that spread easily among people, according to researchers in Taiwan, who analyzed the genes of more than 400 A- type flu viruses. The analysis will help scientists trace the mechanism for infection and how the viruses replicate in different species, according to a report appearing in the September edition of Emerging Infectious Diseases.

Interest in influenza viruses has been bolstered by the spread of the H5N1 avian flu strain, which has infected at least 241 people in 10 countries during the past three years, killing 141 of them. The virus may kill millions if it changes into a pandemic form that can be passed from human to human.

``How many mutations would make an avian virus capable of infecting humans efficiently, or how many mutations would render an influenza virus a pandemic strain, is difficult to predict,'' wrote Guang-Wu Chen and colleagues at Taiwan's Chang Gung University.

The researchers analyzed the gene sequences of 306 human and 95 avian influenza viruses to molecularly identify the host species. The data was crosschecked with 15,785 more sequences from the National Center for Biotechnology Information.

Spanish Flu

``It is the type of work that everyone has thought of doing, but no one has had the time to do,'' Ron Fouchier, a virologist at the Erasmus University in Rotterdam, said in an e-mail today. ``The number of mutations in the viruses that correlate with host species is much larger than I initially suspected.''

There are dozens of influenza subtypes, many of which weren't analyzed in the study. This may have influenced findings, Fouchier said.

``Using reverse genetics technology, and with the information collected from the systematic analysis of mutations in published genome sequences as described in this paper, it should now become possible to test the effects of each of the described mutations, and start to understand how avian influenza viruses adapt to the human host,'' Fouchier said.

Experts believe that a pandemic in 1918, which may have killed as many as 50 million people, began when an avian flu virus jumped to people from birds. The study by the Taiwan scientists indicate that the H1N1 virus responsible for the 1918 pandemic, known as Spanish flu, is more closely related to avian influenza than other human influenza viruses.

``As a signature for the first species jump, the study does not offer much new,'' said Ian Jones, a professor of virology at the University of Reading in the U.K. ``As something that adds to understanding the long-term evolution of these viruses, it is useful.''

To contact the reporter on this story: Jason Gale in Singapore at at j.gale@bloomberg.net

Last Updated: August 28, 2006 06:38 EDT

What is your state's plan?

Experts critique state pandemic plans

Aug 28, 2006 (CIDRAP News) – Now that most states have issued preliminary or final plans for dealing with pandemic influenza, a group of experts who looked at the public health strategies in the plans has given them a mixed review.

The US Department of Health and Human Services (HHS) issued guidelines in November 2005, but left it to states to make specific plans. HHS Secretary Mike Leavitt has warned states not to rely on the federal government for much help during a pandemic. Since then, most states have released drafts or final versions of their pandemic plans.

Public health experts from three Research Triangle Institute International sites reviewed pandemic plans of 49 states. (Lousiana, which had its pandemic planning summit in April, has not yet released a plan.) They evaluated each state's approach to three activities: vaccination, early epidemic surveillance and detection, and containment. The researchers published their findings in the September issue of Emerging Infectious Diseases.

The researchers found that all 49 plans generally agree about the vaccination priority groups recommended by the Advisory Committee on Immunization Practices (ACIP) and the HHS. The recommendation is to vaccinate healthcare workers first, followed by patients who have chronic or high-risk medical conditions, people aged 65 years or older, close contacts of those who are ill or likely to become ill, and all others.

For surveillance and detection, all states rely on the National Sentinel Physician Surveillance, the 122 Cities Mortality Reporting System, or both. All but two states indicated they would evaluate reports of local clusters or unusual influenza-like cases; 40 (82%) said they would evaluate reports of laboratory-confirmed influenza. Relatively few (12) have or anticipate using real-time syndromic surveillance of influenza-like illness.

Eight states (16%), including California, New York, and Hawaii, are developing procedures for screening international travelers. Other international entry points, such as Seattle, Portland, Chicago, and Atlanta, do not yet have any plans for traveler quarantine and testing.

In their approach to containment measures, most states did not include personal contact-avoidance steps such as staying home from work and keeping sick children at home. Seventeen (35%) states recommend or are considering urging such contact-avoidance steps. Eighteen (37%) cite federal or state regulations about closing schools, businesses, and other institutions during a severe outbreak. Fifteen (31%) indicate the legal ability to quarantine people, households, or institutions.

Only 12 states (25%) plan to use or are considering using preventive antiviral treatment or vaccination of close contacts of flu patients, given the high cost and limited supply of neuraminidase inhibitors and the uncertain supply and effectiveness of future vaccines.

In their conclusions, the researchers write that the state vaccination strategies are aimed more at preventing deaths than at stopping or slowing a pandemic, because for several more years there is unlikely to be enough vaccine to reduce disease transmission.

They also note that neither of the surveillance networks that most states are depending on will be likely to detect a local influenza outbreak sooner than 2 weeks into the event. At the same time, the authors say that earlier detection may not improve control or slow an outbreak.

Concerning community containment measures, the authors say the national pandemic plan sets a nonspecific precedent and that more practical nonpharmacologic containment steps, such as handwashing and avoiding mass gatherings, need to be considered for inclusion in national and state pandemic plans. "Even in this increasingly computer-based economy, in which a considerable percentage of persons can work from home most of the time, this simple stratagem is not addressed in most state plans," the article states.

The authors suggest that states can improve their pandemic plans by addressing these concerns in their final drafts. However, they add that to improve pandemic planning, answers to several key epidemiologic questions are needed, such as whether wearing masks and closing schools or other institutions helps stem the spread of flu.

Holmberg SD, Layton CM, Ghneim, GS, et al. State plans for containment of pandemic influenza. Emerg Infect Dis 2006 Sept; 12(9) [Full text]

See also:

Jul 19 CIDRAP News article "Governors group issues pandemic planning guide for states"
http://www.cidrap.umn.edu/cidrap/content/influenza/panflu/news/jul1906governors.html