This is interesting and hopeful...

Molecule blocks flu infection, U.S. researchers say

Wed Oct 4, 7:59 PM ET

CHICAGO (Reuters) - A fragment of a human protein that blocks influenza viruses -- including avian flu -- from attaching to and infecting cells holds promise if laboratory experiments are borne out, researchers said on Wednesday.

The discovery of the peptide by University of Wisconsin scientists, which published their findings in the Journal of Virology, may lead to an entirely new antiviral drug that could thwart H5N1 and other virulent flu strains that pose a threat of a global epidemic.

In tests on mice and in laboratory cultures, the molecule provided total protection against infection by influenza viruses, including H5N1. It also halted the spread of viruses in animals that were in the early stages of infection.

The molecule, known as an "entry blocker," is a fragment of a larger human protein that helps things pass through membranes such as those that encapsulate cells.

Though its precise mechanism is not fully understood, the peptide blocks the virus' ability to latch onto a key cell surface molecule it uses to get inside cells. To survive in a host, a virus needs to infect more cells to produce more infectious particles that spread to still more cells.

"It attacks a completely different part of the virus life cycle" than current antiviral drugs, said study co-author Curtis Brandt of the University of Wisconsin.

"The virus can't even get into the cell. The peptide is blocking the very earliest step in infection," he said in a statement.

Much work remains to determine how well a drug based on the molecule would work, the optimal dosage, and its safety, before it is tested on humans, the researchers said. It might become part of a drug "cocktail," much like those used to combat the
AIDS virus.

Vaccines are considered the best defense against flu viruses, though a vaccine against H5N1 or some other virulent strain takes time to produce. Scientists fear avian flu will evolve into a form that passes easily from person to person and kill millions of people.

An antiviral based on the entry blocker could allow the body time to develop immunity to the viral particles that remain, the researchers said.

Current antiviral drugs do not cure a flu infection but are designed to reduce the number of days a person is sick and make the illness less severe.

There are already signs that the H5N1 virus can develop resistance to these drugs. There are two antiviral drugs known to work against H5N1 flu -- Roche Holding AG's and Gilead Sciences Inc's Tamiflu, known generically as oseltamivir, and GlaxoSmithKline's Relenza, known generically as zanamivir.

Chinese have more dead chickens from ProMed Mail

A new outbreak of bird flu has killed about 1000 poultry in northern China
in the 2nd such case in a week, state media reported. Some 72 930 domestic
poultry have been slaughtered and the outbreak is now under control, Xinhua
news agency said. Laboratory tests had confirmed the H5N1 strain of the
virus, which can be deadly to humans, it added.

The outbreak, in Henan New Village in Yinchuan, regional capital of the
desert-like Ningxia Hui region, follows a similar occurrence in
neighbouring Inner Mongolia. Beijing banned chicken exports from the Baotou
region of Inner Mongolia after H5N1 killed about 1000 chickens and ducks
there. Xinhua said on Tuesday that the Baotou outbreak, which came to light
on 27 Sep, had been brought under control. It was the 1st incidence
reported in China in 6 weeks.

According to official figures, 21 people in China have contracted bird flu
and 14 of them have died. The most recent fatality occurred in July in the
western region of Xinjiang. The latest case in Ningxia Hui brings to 40 the
number of bird flu outbreaks among poultry in China since October 2005.
China confirmed in August that its 1st human bird flu victim died in late
2003, 2 years earlier than previously reported.

--
Dan Silver


[from the submitter:

Don't touch the dead chickens!

Possible bird flu cases in Makassar

Andi Hajramurni and Suherdjoko, The Jakarta Post, Makassar, Semarang

Seven people showing symptoms of bird flu have been admitted to a hospital in Makassar, South Sulawesi.

The patients, most less than 10 years old, were being treated in the Pakis isolation room at Wahidin Sudirohusodo Hospital on Thursday for high fever and vomiting.

"Our preliminary clinical diagnosis was that they were infected with the bird flu virus, so we moved them to the isolation room," said M. Halik, who is responsible for bird flu treatment at the hospital.

Halik said the seven patients' blood had tested negative for the H5N1 bird flu virus. To be certain of the diagnosis, however, he said doctors needed the results of tests on the patients' nasal mucus from a laboratory in Jakarta.

"We've sent the specimens to Jakarta and are waiting for the test results," he said.

Family members said chickens near the patients' homes had been falling ill and dying rapidly without any clear reason, Halik added.

The Wahidin Sudirohusodo Hospital is somewhat overwhelmed by the increasing number of suspected bird flu patients it is treating. Two isolation rooms designed to hold two patients each have had to accommodate twice the number.

According to the Ministry of Health, a total of 69 people have contracted bird flu in Indonesia. Of those, 52 have died.

Meanwhile, in Central Java, many chickens have fallen ill and died in recent days in a possible outbreak of the disease.

The H5N1 virus is believed to be killing poultry in 17 kampongs in the Central Java regencies of Semarang, Temanggung, Purbalingga, Pekalongan and Pemalang, according to Kurmaningsih, the head of the Central Java Livestock Husbandry Office.

Rapid tests on dead chickens in Lebdosari kampong, Gisikdrono, in Semarang, indicated they had the virus. Local authorities later culled 35 other chickens in the kampong to prevent the disease from spreading.

Kurmaningsih said her office had asked for 10 million more doses of H5N1 vaccine from the central government.

"We currently have 12 million doses of the vaccine, but we want more in order to be ready for a much bigger outbreak," she said in Semarang on Thursday.

Kurmaningsih explained that despite the massive poultry vaccination drive launched earlier this year through a program called the National Movement against Avian Influenza, the infections which started hitting the province in 2003 have continued to spread.

Kurmaningsih said under the program, her office distributed 50 million doses of vaccine to poultry owners in the province in 2004, 14 million doses in 2005 and another 22 million doses this year.

"We culled chickens in Boyolali in 2004. But now we have no plans to do so because the social impacts (of culling) are so widespread. Besides that we still don't know whether there will be compensation for the culled chickens," she explained.

In a related development, the Ministry of Health plans to build modern laboratories in North Sumatra to diagnose bird flu infections, Aswin Soefi Lubi, dean of the School of Medicine at the Islamic University of North Sumatra, said Thursday.

Aswin said one of the laboratories will be built at his medical school. They will be used to test blood from suspected bird flu victims without having to send the samples to Jakarta.

Apriadi Gunawan contributed to this article from Medan, North Sumatra.

Korean paper reports on Indonesia

Will Bird Flu Go Pandemic?
More victims in more Indonesian cities
Aloysius Wisnuhardana (wisnuhard) Email Article Print Article
Published 2006-10-06 11:58 (KST)
After 52 deaths in Indonesia from bird flu virus through September, several new cases were treated in several cities this month, including Medan, Bandung, Jakarta, Semarang, and Makassar.

In Makassar, six patients (children, aged from 1.5 to 11 years) have had to get medical treatment since Oct. 3 and should undergo lab tests. Local health officials in Makassar want to conduct lab tests on those who live with the sick and their neighbors, but people locked their doors against health care workers there who wanted to take blood samples. After an exchange of words, the officials asked the village chief to intercede, eventually getting samples within a few hours.

In Semarang on the other hand, neighbors of two patients suspected of infection actually urged health officials to take samples from them and urged veterinary officers to vaccinate all poultry in their area. Meanwhile, hundreds of chickens found dead near their houses a few days ago have already been burned.

The situation may have to be taken more seriously now that the Head of the West Java Animal Husbandry Office, Rachmat Setiadi, as quoted in The Jakarta Post, revealed that his aide had tested over 20 chickens in the house of two men who had died of flu (aged 23 and 20 years), having bought dead chickens from the market for their dogs.

Four healthy chickens were found to be infected with H5N1, or "bird flu" virus. He added that we should be more cautious, since even healthy birds could be carriers of bird flu. Meanwhile, over 11 dogs kept by bird flu cluster families tested negative.

The new fact may complicate the situation even more since the last 10 days of Ramadan will start soon (the last day is Oct. 23), when Moslem communities will end fasting and celebrate the great day of Idul Fitri. Traditionally, most Moslems in Indonesia celebrate by having a party with their family and visiting other families, so that the demand for food, especially poultry and chickens, increases significantly.

The traffic in chickens and poultry cannot be controlled because the demand is so high, which traders will do anything to meet. Traders in Bogor confessed that they would bring chickens in from anywhere, such as Bandung and Sukabumi, and that sometimes their stocks would be bought by traders from Tangerang or Jakarta.

Government officials are not empowered to interfere with this traffic, but at the same time they must campaign about how dangerous bird flu virus is.

Another problem is that infected areas have recently been spreading day by day, with the result that the government has not been able to isolate the outbreaks. For example, almost half the regencies in Central Java were infected by the virus, or 17 of the 35 regencies in that province. More than 600,000 chickens have died and tens of thousands slaughtered.

According to Health Ministry data, as of Sept. 29 there had occurred 248 bird flu cases around the world, in which 146 people had died. Of these, 69 cases had occurred in Indonesia, including 52 fatalities.

The next question is: How to stop the spread of bird flu virus if it becomes a pandemic? Would it be possible to destroy every chicken alive? How would any government fund this activity, as there are so many things to be done: campaigning, providing vaccines and medical treatment for victims, research, and subsidizing the farmers and people who raise chickens?

The Indonesian government and World Health Organizations have so far appointed North Sumatra Islamic University as a Center for Bird Flu Research, but in the short run we will have to try something else.
©2006 OhmyNews

Storms and floods cause Thai government to urge vigilance regarding bird flu

Bird flu outbreak possible after storms and floods
BANGKOK, Oct 3 (TNA) - Thai authorities are warning of a possible bird flu outbreak after the recent rainstorms and floods, followed by the impending arrival of cool season which brings migratory birds.

Yukhon Limlamthong, Director-General of the Livestock Development Department said freak weather in Thailand has brought about persistent rains and floods, intensifying the risk of another bird flu outbreak.

Although no signs of an outbreak have been detected to date, Mr. Yukhon said he is concerned that after the monsoon season--with some areas being persistently under water, poultry and other birds may weaken and become vulnerable to the virus.

Compounding the situation is the arrival of cool season which follows the rains, and both domestic poultry and wild birds must adapt to another round of change.

He urged Thais to be especially cautious in the month of October, by reporting unusual deaths of chickens to the authorities.

The Livestock Development Department plans another round of fumigation on a national scale in November, he said.

Data at end of September showed no new case of bird flu, from the last known cases found in Phichit and Nakhon Phanom provinces in July. (TNA)-E007

Czech Republic Prepares for Avian Flu

CzechRep gets prepared for autumn wave of bird flu
Prague- The Czech Republic is preparing for a another wave of bird flu in connection with the autumn migration of birds, the daily Mlada fronta Dnes (MfD) writes.

"We of course reckon with it. In summer, bird flu arrived in Romania and Hungary. It therefore seems clear that the virus will get to our country when the critical autumn time of bird migration again comes," spokesman for the State Veterinary Administration, Josef Duben, told the paper.

The H5N1 strain is likely to appear especially in regions where water fowl living in the open gather.

"But one cannot exclude that there will be another virus or that H5N1 will somehow mutate," Duben said.

Experts hope that the number of infected birds would be lower than last winter when some 14 cases were detected. In the critical areas, special measures were introduced.

The current supply of antiviral medicines is enough for 13 percent of the population. The country's aim is to have medicines for 20 percent of Czechs. The supplies are to increase next year as the government earmarked 350 million crowns for the purchase of medicines, the paper writes.



Author: ČTK.

Chinese Apparent Transparency in Report on Avian Flu

China reports bird flu outbreak, second for the week
04 Oct 2006 08:51:15 GMT

BEIJING, Oct 4 (Reuters) - An outbreak of bird flu has killed 1,000 domestic poultry in a village in China's northwest, state television said on Wednesday, a day after the report of another outbreak in a nearby region.

The Agriculture Ministry said scientists had confirmed that the poultry near Yinchuan, capital of the Ningxia region, were killed by the H5N1 avian flu virus, China Central Television reported.

Another 72,930 fowl were culled to stop the virus spreading, it said.

"Now the outbreak has been effectively controlled," it added.

On Tuesday, Beijing authorities banned poultry from an area in Inner Mongolia, a region neighbouring Ningxia, after a thousand birds there died from bird flu.

The H5N1 virus has spread through much of Asia's poultry flocks and infected large numbers of wild birds, particularly water fowl, which can act as carriers of the virus.

Bird flu has since spread to Europe, Africa and South Asia, killing at least 148 people worldwide since late 2003, when the virus resurfaced in Southeast Asia.

Scientists fear the virus could mutate into a form that could pass easily from person to person, sparking a global pandemic.

With the world's biggest poultry population and millions of backyard birds roaming free, China is at the centre of the fight against bird flu. There have been 21 human cases, including 14 deaths, from virus and dozens of outbreaks in birds that have led to the culling of millions of fowl.

The latest report did not mention any human infections, nor explain the source of the outbreak.

AlertNet news is provided by

How to get flu shot now

Flu Shot Locator on American Lung Association's LungUSA.org Aims to Reduce Infections, Deaths

Flu May Lead to Dangerous Complications but Still Too Few Receive Shots

Flu Season About to Begin


New York, N.Y. – As the flu season is about to begin, the American Lung Association launched its online "flu shot locator" at www.lungusa.org to help more people find and obtain flu vaccinations in their neighborhoods.

"Approximately 200,000 hospitalizations and 36,000 deaths are due to influenza-associated illness each year, so it is imperative for people to receive the flu shot annually, and October and November is the time to do it," said John Kirkwood, president of the American Lung Association. "That’s why the American Lung Association launched this online flu shot locator tool, and we are working overtime to make sure that as many people as possible use it before flu season swings into high gear. Even if you miss the best time to receive the flu shot, you can still get a shot at anytime throughout the season."


Flu Shot Locator


"People who receive the flu shot have greatly reduced their chances of contracting not only the flu, but infectious complications of the flu," said Norman H. Edelman, MD, the American Lung Association’s consultant for medical affairs. "Vaccination with the flu shot has been associated with reductions in physician visits, hospitalizations and death among the elderly, young children and people with chronic conditions, including those with asthma.

In addition, the introduction of SARS and the Avian Flu has increased the need for the flushot since symptoms of all three diseases are similar. Receiving the flu shot can help your doctor determine the true cause of illness and prescribe the correct medical course." The Lung Association’s "flu shot locator is the largest interactive web site of its kind, enabling individuals to find the most convenient location to obtain a flu shot from more than 20,000 locations across the country. Prices for the flu shot vary throughout the U.S. and can cost up to $20. Insurance companies usually cover the shot, and individuals can contact their local health departments for more information.

"We are pleased to be working with the American Lung Association to include the locations of CDC-funded public health providers and clinics to give Americans the best resource possible to find a flu vaccine," said Ray Strikas, M.D., Associate Director for Adult Immunization at the Centers for Disease Control National Immunization Program. "By making it easier to find a flu vaccine we hope that people will be more inclined to be vaccinated."

When the American Lung Association launched the flu shot locator last year, millions of people visited the Lung Association web site, typed in their zip codes and found where they could go to obtain flu shots. This year, the Lung Association updated the flu shot locator to include thousands more locations. The upgrade announcement came at a press conference held today by the National Foundation for Infectious Diseases.

New Flu Shot Locator Features

The expanded locator now includes more than 20,000 different locations across the United States and can search within a 50-mile radius of the desired zip code. In addition, new features enable consumers to set up reminders about when a flu vaccination site is coming to their area, and a "send a friend" option allows consumers to tell their friends and family members about the locator.

Seniors Remain Largest Group at Risk of Dying from Influenza

Influenza and pneumonia is the seventh leading cause of death in the United States overall and the fifth leading cause of death for people 65 and older.

Although a national objective for the year 2010 is to increase influenza vaccination levels greater than 90 percent among persons aged 65 years and older, the current percentage is only 68.7 percent indicating that further improvements in vaccine coverage levels are needed.

Children Ages 6-23 Months

Rates of infection are highest in children, but those aged 6 to 23 months are at increased risk of influenza-related hospitalizations. Therefore, the ACIP has recommended, for the first time, that children ages 6 to 23 months and household contacts of these children should be vaccinated with the flu shot annually. Older children with high risk medical conditions are also recommended to receive the flu shot annually.

The Flu Vaccine and Asthma

Vaccination rates among people with asthma are low since some medical professionals and the public believe receiving the flu vaccine may worsen or exacerbate asthma. However, the American Lung Association Asthma Clinical Research Center network found that the opposite was true and that receiving the flu vaccine is safe for people with asthma. They did not find that the vaccine causes higher rates of side effects for people with asthma compared with people who did not receive the vaccination. As a result, the Lung Association is urging those with asthma to get a flu shot.


###

Through the mouths of babes

Bird flu campa ign in West Java to involve school children

Yuli Tri Suwarni, The Jakarta Post, Bandung

The West Java provincial administration is mulling the possibility of involving school children in its campaign about the spread of the deadly bird flu virus, an official said Monday.

Fatimah Resmiati, head of the West Java Health Office's environmental sanitation unit, said that the plan to involve school children had been adopted as the current campaign had been ineffective, as shown by the increasing number of people falling sick from bird flu.

The campaign would concentrate on the dissemination of information about bird flu with the help of school children, including those attending Muslim boarding schools, Fatimah explained.

She said that West Java had the highest number of bird flu cases, with 23 patients having tested positive for the virus, and 19 having died.

By comparison, the total number of people who had been infected with the virus stood at 69, of whom 52 had died, she said, explaining that cases of bird flu-infected fowl livestock had been detected in 23 out of the 26 regencies and municipalities in West Java.

"As we've already become the 'top scorer', we badly need a better prepared campaign to help prevent more fatalities," Fatimah said in Bandung after attending a coordinating meeting with representatives of the Ministries of Health and Agriculture.

Over the next two days, Fatimah said officials from the relevant offices would discuss the possibility of establishing a regional bird flu prevention commission.

"We have to admit that we all walk by ourselves so that whenever there is news about a new case that requires quick handling, we haven't been able to respond to it as soon as possible," she said.

A similar concern was expressed by Fatum Basalamah, head of standardization at the zoonosis subdirectorate of the Ministry of Health, who underlined the importance of involving school children as a means of conveying information on the bird flu danger to their parents and the public at large.

Fatum said that the existing anti bird-flu campaign through the mass media had not been able to heighten public awareness.

"Despite the huge coverage, the public have not been persuaded to act better. In Bandung, there were patients who were found to have fed their dogs with dead chickens. We have to open our eyes about the problem," she said.

Fatum explained that the exact details of the children's campaign remained to be worked out.

A similar campaign involving children was waged by the West Java Health Office during an outbreak of dengue hemorrhagic fever two years ago, when school children were involved in eradicating the mosquito larvae.

Tamiflu prevents pneumonia in children , study find

WASHINGTON (Reuters) - Children with flu who are given Tamiflu, Roche AG's influenza pill, are 53 percent less likely to develop pneumonia than untreated children, the company reported on Friday.

And a second study showed that giving Tamiflu to very sick adults with influenza reduced their risk of death by 71 percent.

The studies, presented at the Interscience Congress on Antimicrobial Agents and Chemotherapy, held in San Francisco, bolster earlier studies that show the drug can prevent the most serious consequences of influenza.

Seasonal flu affects hundreds of millions of people every year. In the United States alone, the Centers for Disease Control and Prevention estimates that flu kills 36,000 people every year and puts up to 200,000 in the hospital.

Around the world, influenza kills between 250,000 and 500,000 people every year. Most of the severe illnesses and deaths are due to pneumonia, sometimes caused by a bacterial or secondary infection.

Tamiflu, or oseltamivir, made by Roche under license from Gilead Sciences, can reduce the severity of infection, as can a rival drug, Relenza, made by GlaxoSmithKline. Older flu drugs no longer work well and are not recommended.

Researchers studied the health insurance records of more than 15,000 children aged one to 12. About 2.6 percent of them came down with pneumonia.

Children who received Tamiflu within one day of an influenza diagnosis were 53 percent less likely to develop pneumonia, compared with children who were not given the drug.

"This study suggests that early treatment with Tamiflu can have a significant impact on pneumonia, one of flu's most serious complications, which takes a considerable toll on children," said Dominick Iacuzio, medical director at Roche.

A second study presented at the same conference showed Tamiflu could reduce deaths in severely ill adults with flu. "Treatment of infected adults was associated with a 71 per cent reduction in mortality," the company said.

Dr. Allison McGeer and colleagues at Mount Sinai Hospital in Toronto, Canada studied 512 patients admitted to hospital with influenza.

They said 84 percent were treated with antibiotics, which are aimed at stopping bacterial infections, and 32 percent got antivirals, mostly Tamiflu, but the older drug amantadine was also administered to a few.

"Of all adult patients, 6.4 percent of patients died and these deaths were attributed to influenza," Roche said.

But those given an antiviral were much less likely to die.

Many countries are stocking up on Tamiflu because of the risk of H5N1 avian flu. It mainly affects birds but experts fear it could mutate into a strain capable of killing millions of people in a global pandemic. It has killed 148 people out of 251 infected in 10 countries since 2003.

Tamiflu is now routinely given to bird flu victims and doctors say if given quickly enough, it appears to save lives.

The
CDC says the best protection against flu is an annual vaccine, but that does not prevent influenza perfectly, especially in older adults, and many people fail to get immunized.

I just knew it...

Airborne flu viruses threaten health workers, expert says

Robert Roos * News Editor

Sep 29, 2006 (CIDRAP News) – A microbiologist who reviewed the evidence about how influenza viruses spread says that some official guidelines, including the US pandemic influenza plan, may not go far enough in protecting healthcare workers who take care of flu patients.

Writing in Emerging Infectious Diseases, Dr. Raymond Tellier of the University of Toronto says there is good evidence that flu viruses often spread via tiny airborne particles, despite a common belief that they travel mainly in large droplets that quickly fall to the ground after a flu patient coughs or sneezes.

Good protection from airborne particles requires the use of an N95 respirator. Yet the US, Canadian, and British pandemic flu plans advise healthcare workers to use simple surgical masks, which are much less effective, Tellier contends.

"Compelling evidence in the literature indicates that aerosol transmission of influenza is an important mode of transmission, which has obvious implications for pandemic influenza planning, and in particular for recommendations about the use of N95 respirators as part of personal protective equipment," he writes.

"Airborne particles" are usually defined as particles about 5 microns or less in diameter, Tellier says. Particles larger than about 10 to 20 microns fall quickly to the ground, while those smaller than 3 microns essentially do not settle. Coughing and sneezing generate particles in a range of sizes, many of them small enough to stay airborne for a long time. Airborne particles can penetrate into the lungs, whereas the larger particles and droplets are more likely to be trapped in the upper respiratory tract.

Experiments have shown that mice, monkeys, and human volunteers can be infected by exposure to aeorosol flu viruses, according to Tellier. In addition, various epidemiologic observations indicate that aerosol transmission is important. One example was a 1979 outbreak on an airliner with a defective ventilation system.

Tellier says many guidelines and review articles state that large droplets appear to be the main vehicle for flu virus transmission, but they offer little supporting evidence. "Despite extensive searches, I have not found a study that proves the notion that large-droplets transmission is predominant and that aerosol transmission is negligible (or nonexistent)," he writes.

Further, he says, infection control experts often argue that large-droplet precautions have proved adequate to stop flu outbreaks. But he contends that several factors cast doubt on the evidence for this view. For example, without laboratory diagnosis, what is believed to be a flu outbreak can be some other virus; serologic studies often are omitted, and asymptomatic flu infections in healthcare workers are probably missed; many people have partial immunity to seasonal flu viruses; and surgical masks provide some limited protection against aerosols.

Tellier goes on to say that evidence suggests that current strains of H5N1 avian influenza predominantly infect the lower respiratory tract, which in turn suggests that airborne particles are involved, since large droplets don't reach into the lungs.

"Given the strong evidence for aerosol transmission of influenza viruses in general, and the high lethality of the current strains of avian influenza A (H5N1), recommending the use of N95 respirators, not surgical masks, as part of the protective equipment seems rational," he states.

The current US pandemic influenza plan, according to Tellier, "acknowledges the contribution of aerosols in influenza but curiously recommends surgical masks for routine care; the use of N95 respirators is reserved for 'aerosolizing procedures.'"

In contrast, the Centers for Disease Control and Prevention's (CDC's) current infection control guidelines for healthcare facilities treating avian flu patients say that workers should use a fit-tested respirator at least as good as the N95 type when in a patient's room.

Bill Hall, a Department of Health and Human Services (HHS) spokesman in Washington, said today that the infection control guidance in the US pandemic flu plan is being updated. "We are conducting a rather in-depth process by which we'll be reviewing the science that is available on masks and the various positions out there," he told CIDDRAP News. "This journal article certainly adds one more data source to inform the decision-making."

"There's still a lot of debate on how flu is transmitted, whether it's aerosol or large droplets," Hall said. "The [pandemic] plan issued in November last year was based on current science and information at that point in time," but it is subject to change, he added.

Hall said HHS plans to cooperate with the Institute of Medicine to hold some workshops to discuss "community mitigation" in a pandemic, meaning measures such as closing schools, canceling public events, and recommending the use of masks. But no dates or other details have been decided.

Tellier R. Review of aerosol transmission of influenza A virus. Emerg Infect Dis 2006 Nov;12(11) (early online publication) [Full text]

See also:

CDC interim guidance on use of masks to control influenza
http://www.cdc.gov/flu/professionals/infectioncontrol/maskguidance.htm

CDC interim infection control guidelines for healthcare facilities treating people with avian flu
http://www.cdc.gov/flu/avian/professional/infect-control.htm

WHO taskforce meeting to fight avian flu

WHO task force on Bird flu up and running

The temporary task force meant to inform and advise the UN health agency about bird flu and possible pandemic influenza held its first meeting in Geneva last week.

The Influenza Pandemic Task Force (IPTF) will operate until the World Health Organization’s (WHO) International Health Regulations 2005 (IHR) come into force on 15 June 2007. Then an emergency committee will be created if and when needed to advise bigger catastrophes.

Dr Guenael Rodier, WHO Director responsible for IHR, said: "By bringing this group of experts together and ensuring that we have established effective means of working together… we can ensure that we are getting both the best advice for WHO and building a platform of shared knowledge.

"The Task Force is up and running. It will complement other technical partnerships and networks… and ensure that the IHR improve global health security," added Dr Mike Ryan, Director of WHO's Department for Epidemic and Pandemic Alert and Response.


Europaworld

New drug looks promising

New drug boosts bird flu survival in animals

30 Sep 2006 19:10:30 GMT

Source: Reuters

By Maggie Fox, Health and Science Correspondent WASHINGTON, Sept 30 (Reuters) - A drug being developed to fight bird flu and seasonal flu helps animals to survive H5N1 avian flu infection, BioCryst Pharmaceuticals Inc. said on Saturday. The drug, called peramivir, protected mice and ferrets, which are considered the species closest to humans in terms of susceptibility to influenza.

The result, reported to the Interscience Conference on Antimicrobial Agents and Chemotherapy in San Francisco, should boost the company's efforts to win U.S. Food and Drug Administration approval to treat infected humans with the drug. The FDA accepts data on two animal species in lieu of human data in certain cases when deadly infectious agents are involved. Peramivir is still in experimental trials but is considered the next-line drug to fight influenza of all sorts, after Tamiflu and Relenza.

Experts want to have several antivirals to choose from in fighting flu because the virus mutates quickly, and because no drug has been completely effective. A team at Birmingham, Alabama-based BioCryst and at the University of Texas Medical Branch in Galveston used a high-security lab to test whether the drug could prevent deaths from H5N1 infection in 41 mice and 20 ferrets.

'VERY EFFECTIVE'

A single injection allowed 70 percent of the mice to survive, and five days of injections boosted survival to 80 percent. Only 36 percent of untreated mice survived, the researchers told the meeting. Among the ferrets, 86 percent survived when injected for five days, versus 43 percent of untreated animals. "They found at blood levels that we can achieve very easily in humans, the drug is very effective at protecting animals from death," Dr. Charles Bugg, chairman and chief executive officer of BioCryst, said in a telephone interview.

On Friday the company showed the drug could be safely given to people in high doses, although there is no ethical way to infect people with H5N1 and see how well they survive. H5N1 mainly affects birds but experts fear it could mutate into a strain capable of killing millions of people in a global pandemic. It has killed 148 people out of 251 infected in 10 countries since 2003. At least half of infected patients have died, and there is no vaccine yet.

Immediate treatment with Roche and Gilead Sciences Inc's Tamiflu, also known as oseltamivir, appear to save many patients and Tamiflu is now routinely given to bird flu victims. Relenza, made by GlaxoSmithkline under license from Australia's Biota , is an inhaled drug that also appears to treat both types of flu.

AlertNet news is provided by

Bird flu inChina

China Reports New H5N1 Bird Flu Outbreak

Saturday, September 30, 2006

(09-30) 08:01 PDT BEIJING, China (AP) --
A new outbreak of the deadly H5N1 strain of bird flu killed 985 chickens in China's northern region of Inner Mongolia, a state news agency reported Saturday.

The discovery in a village near the city of Baotou prompted authorities to destroy 8,990 other chickens to prevent the virus from spreading, the Xinhua News Agency said.

A laboratory confirmed Friday that the dead birds had the H5N1 strain of the virus, Xinhua said.

The strain has killed at least 148 people worldwide since it started ravaging poultry stocks in Asia three years ago, according to World Health Organization figures.

China has reported dozens of H5N1 outbreaks in its vast poultry flocks and has destroyed millions of birds in an attempt to stop the spread of the virus.

Veterinary experts believe the virus is spread by wild fowl that migrate across China.

Health experts have warned that China is bound to suffer more human cases if it can't stop further outbreaks in poultry.

China has suffered 13 human deaths from bird flu, including a soldier who died in 2003 but whose infection was only confirmed in August this year through genetic testing.

Eight earlier poultry outbreaks were recorded this year in central China and areas of the north, east and southwest, according to Xinhua.

The most recent was in Changsha in the central province of Hunan, when 1,805 ducks were killed, the agency said. It said a quarantine on the area was lifted Sept. 6 after no new cases were found after three weeks.

New H5N1 outbreak among birds in China

Bird flu risk this year

Bird Flu: Sky Reveals Risk To Britain

Last Edited: Monday, 02 Oct 2006, 2:00 PM CDT

Created: Sunday, 01 Oct 2006, 7:00 PM CDT

As the migratory season begins, Sky News has learned that the risk of a deadly bird flu pandemic hitting Britain this winter is even higher than last year. In a series of exclusive reports, our correspondents and reporters have been looking into the threat that H5N1 poses to the UK. Two migratory routes cut across the country and as the days get colder, the chances of infected birds arriving on our shores gets higher. Farmers are being urged to watch flocks carefully and even the public is being asked to remain vigilant. Health Correspondent Thomas Moore says that if the virus arrives in the country it could be in every British city within a fortnight. "And with no in-built immunity to such a new virus, it would be open season for the bug," he said. Some 56,000 people could die in a pandemic, with at least a quarter of the population falling sick. "That's not scare-mongering," he said. "That's the bottom end of the Department of Health's predictions." Sky News Environment Correspondent Robert Nisbet says the Government is targeting specific areas for surveillance in a bid to minimise the risk. But he added that it is "impossible to monitor the skies".

We all need to cooperate to fight avian flu

Avian-flu samples on the way to CDC

By John Zarocostas
THE WASHINGTON TIMES
October 2, 2006

GENEVA -- After 18 months of stalling and repeated calls for cooperation by international health officials, China is expected to deliver a batch of animal virus samples of the lethal avian influenza virus H5N1, senior global health officials say.
The Centers for Disease Control and Prevention (CDC) laboratory in Atlanta expects the samples to arrive "in the coming days," said Mike Purdue, head of a team that is studying how influenza moves from animals to humans on behalf of the World Health Organization (WHO).
Dr. Purdue told The Washington Times that the necessary paperwork was completed by Chinese authorities last week, but one carrier did not want to haul the samples, so they will be shipped by another company for WHO.
WHO first asked China to share the samples in the spring of 2005, after thousands of migratory birds died in the province of Qinghai. The 10 samples expected by the CDC are from Qinghai and other regions, Dr. Purdue said.
International health officials and diplomats have long been frustrated by Beijing's failure to send the samples promptly, despite its public pledges of full cooperation after its reluctance to share information aggravated a crisis over severe acute respiratory syndrome (SARS) in 2003.
The sharing of specimens is essential if researchers are to find a vaccine and more effective anti-viral drugs against bird flu. Since 2003, there have been 251 human cases of the avian influenza virus in 10 countries, of which 148 resulted in deaths.
Some Asian and Western health diplomats attribute the delay to a bureaucratic turf war between China's Ministry of Agriculture, which has been reluctant to share the samples, and the Ministry of Health, which has been more willing to co-operate. The same sources said Chinese authorities were now fully sharing human samples from victims of bird flu and HIV/AIDS.
Despite its dynamic economy and huge foreign reserves, China offered only $10 million at a pledging conference in Beijing in January aimed at strengthening global preparedness against a human avian influenza pandemic.
Senior Western diplomatic sources said China initially offered no contribution at all and only came forward with the $10 million pledge when pressure was put on its political leaders. However, diplomats are cautiously optimistic that China is moving in the right direction on global health issues.
In a significant move, China has put forward Margaret Chan, a senior WHO official, for the top post of the global health agency, which is vacant after the sudden death in May of the incumbent, Lee Jong-wook. This is the first time that China has nominated a candidate for a major global agency.
Dr. Chan, formerly Hong Kong's top health official, played a pivotal role in stamping out an avian-flu outbreak in the city in 1997. In July 2005, she publicly scolded China for stalling on vital cooperation over the outbreak of bird flu.
Another leading candidate in a crowded field is Shigeru Omi, a Japanese national and WHO regional director for the Western Pacific. Asian diplomats described fierce behind-the-scenes lobbying by Tokyo and Beijing for their respective nominees. The outcome is to be decided on Nov. 9.

Time to get flu shot (and pneumonia)

Oct. 1, 2006, 11:26PM
Flu season opens with reminder: Get a shot
No shortage of vaccine is seen, but some venues don't yet have it

By LEIGH HOPPER
Copyright 2006 Houston Chronicle

Stan Burton will line up today for a flu shot, even if he has to duck out from his job. That's because his 12-year-old daughter, Jennie, came down with the virus earlier this month, providing an up-close reminder of the illness's severity.

"She wanted to crawl under a rock and disappear for about a week. She got up to where she had energy to go to school, and even then came home and went straight to bed," said Burton, whose daughter attends Schindewolf Intermediate in the Klein school district. "The whole crew was given Tamiflu so we wouldn't catch it and spread it around."

Today marks the beginning of flu-shot season, with vaccination clinics under way at Houston pharmacies, senior living centers and elsewhere. Flu season typically lasts from October to March, and can drag on into May.

Scattered reports of flu, such as Jennie Burton's, are cropping up, although it's unclear whether any rapid tests used to diagnose illness have been confirmed by laboratory tests. Texas Children's Hospital, which monitors flu closely, hasn't reported any lab-confirmed flu. Rapid flu tests can produce false positive results.

"It's really hard to know. If it's early flu, we're probably going to be in trouble," said Dr. Melanie Mouzoon, director of immunization practice for Kelsey-Seybold.

"The flu vaccine is going to be here shortly. It's trickling in now."

'A little more urgent'

Most physician offices are still awaiting shipment of their flu vaccine orders. Kelsey-Seybold's supply usually comes in October, and the plan has been to push the vaccine in November.

"If flu is out there, it makes it a little more urgent," Mouzoon said.

Unlike previous years, there's no shot shortage expected — federal authorities say there will be 100 million doses available, 17 million more than last year. October or November is the best time to get vaccinated, according to the U.S. Centers for Disease Control and Prevention, but getting vaccinated in December or even later will protect against circulating flu virus.

In addition, there's no rationing of shots — you don't need a health condition that puts you at special risk to secure a place in line. The CDC urges just about everyone to get a flu shot, including children age 6 months to 59 months, people age 50 and above, as well as household contacts of these individuals.

Still watching bird flu

A different type of flu — avian influenza — remains a threat, even if public hysteria has subsided. Global health experts are watching Indonesia and Thailand, where there have been 93 human cases including 69 deaths in recent weeks. The concern is that the virus will mutate into a form that spreads easily among people.

Dr. Paul Glezen, a flu expert at Baylor College of Medicine, says two out of the last three flu pandemics were caused by bird flu genetically mixing with human flu. Flu shots are a way of helping prevent that.

"Obviously, the less human flu that circulates, the less chance of avian (mixture) with the human flu virus," he said.

The Associated Press contributed to this report.

leigh.hopper@chron.com