Encephalitis affects bird flu victim in Indonesia

Bird flu patient has encephalitis

Yuli Tri Suwarni, The Jakarta Post, Bandung

A 67-year-old woman from Cisarua in Lembang, West Java was tested positive for bird flu Wednesday and is likely to be the country's first victim to suffer from brain inflammation due to the virus.

Head of the West Java Health Office, Yudi Prayudha, said Wednesday that he received confirmation of the woman's tests through a text message from a staff member of the Health Ministry's research and development laboratory in Jakarta, who said the results were confirmed after the third test.

"SM, 67, female, is currently being treated at Hasan Sadikin hospital in Bandung. The third sample shows she is bird flu positive," Yudi said, quoting the text message he received.

The woman's case is unique, as it is the first time in the country that the H5N1 virus has been reported to have caused encephalitis, or the inflammation of the brain. A similar condition was reported to have caused the deaths of two siblings in south Vietnam in 2004.

Yudi said that based on preliminary information from the hospital, the bird flu patient has been placed in isolation after suffering a fever for two days following the sudden death of her chickens.

When she was first admitted to the hospital Saturday afternoon, she was in poor health, suffering from a high fever, breathing problems and a loss of consciousness.

However, the hospital's team of doctors, led by Hadi Jusuf, did not find indications that her loss of consciousness was due to acute respiratory distress or pneumonia like other bird flu patients treated at the hospital.

"There's a strong indication that the virus has entered the victim's brain membrane. A sample of fluid from her spinal cord has been taken to confirm the nature of the virus," Yudi said.

Hadi Yusuf said the first test was negative but the lab then conducted the tests five times. The tests included serology tests as well as swabs from her throat and lungs and cerebrospinal fluid from her spinal cord.

"If the tests show she is infected with H5N1, then this will be the first reported Avian Influenza case that has caused brain inflammation in the country," Hadi told The Jakarta Post.

He admitted, however, he had not received an official report from the Health Ministry's laboratory.

Examinations by the hospital's neurology team, he said, has shown that MK is suffering from brain inflammation caused by a virus.

The patient was still in poor health Wednesday although it seemed like she had started regaining consciousness after briefly moving her hand.

Yudi asked people to remain calm about the latest bird flu development. "It's very rare that H5N1 causes brain inflammation, so there's no need to worry. Just follow instructions to prevent Avian Influenza infection," he said.

According to the Health Ministry, a total of 69 people have contracted bird flu across the country. Of those, 52 have died. West Java has so far recorded the highest number of fatalities. MK is the province's 24th bird flu victim, of which 17 have died.

The H5N1 virus made the first known jump to humans in Hong Kong in 1997, infecting 18 people and killing six of them.

LA fakes bird flu outbreak

L.A. simulates an outbreak of the bird flu
Underfunding, confusion over roles among issues
BY TROY ANDERSON, Staff Writer
Article Last Updated:10/11/2006 09:29:58 PM PDT

At first, officials report a single suspected human case of the bird flu in Los Angeles. By the fourth day, that person has died and officials begin scrambling to decide what to do.

No vaccine will be available for months and there is only a limited supply of antiviral medications. By day seven, officials start closing schools and employers are confronted with rising absenteeism.

By the 25th day, about 3,700 people have died in Los Angeles County, 59,000 residents are infected and the National Guard is called out to keep order.

That hypothetical scenario unfolded Wednesday as health experts and business leaders held their first broad exercise designed to prepare for a bird flu pandemic in the Los Angeles area.

"L.A. became the kind of epicenter of the pandemic and it moved across the United States," said Dr. Jonathan Fielding, the county Department of Public Health director, said after the exercise. "I think we handled it as well as could be expected."

But even as experts worked to develop emergency plans, they warned that little money has been provided and there is still confusion over the roles of federal, state and local governments during a pandemic.

"(We) have a tremendous amount of confusion over roles - which leads to paralysis of action in many instances, or overlap, or strategies that just don't get completed because no one knows who in fact is supposed to do exactly what," said Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University.

First discovered in Asian poultry in 1999, the avian virus has since infected millions of migratory and domesticated birds and at least 140 people.

In its current form, avian flu can be transmitted to people only through contact with infected birds. Scientists, however, believe it's only a matter of time before it mutates into a strain that can spread among humans.

Since late last year, the federal government has given local and state governments $325 million to prepare for a flu pandemic, including $24 million for California and an additional $10 million for Los Angeles County.

But Redlener said the U.S. health system needs $1 billion for annual maintenance and $5 billion to increase capacity and purchase ventilators just to be able to handle a flu pandemic.

Sandra Shewry, director of the California Department of Health Services, said the Legislature has provided $200 million to purchase mobile field hospitals, 9.1 million doses of anti-viral medications and 2,500 ventilators.

"It's not something you want people to worry about every day, but you don't want them to forget about it," said Fielding. "They've heard about it so much, we're concerned people may say that's last year's issue. We don't want that to happen. We want people to understand, it's not a question of whether it will happen. It's a question of when."

In California, a flu pandemic on the scale of the 1918 pandemic could infect up to 30 percent of the population and result in nearly 200,000 deaths.

Redlener said hospitals would be overwhelmed with patients, many who would need intensive care and ventilators that are now in short supply.

"No community in America has ever experienced anything that we might see in terms of pediatric fatalities and illnesses that really paralyze the community's ability to function emotionally and effectively in any kind of a disaster," Redlener said.

"Hopefully, Katrina, 9-11, anthrax and the other things we've experienced in these last few years will become true wake-up calls and not just snooze alarms that they've been so far."

troy.anderson@dailynews.com

(213) 974-8985

China says its working to defeat bird flu cooperatively

12 Oct 2006
Stringent Bird Flu Monitoring Accelerated In China

Stringent bird flu monitoring on a daily basis has been stepped up in China, the official Xinhua news agency has reported.

Following two out breaks of the much dreaded Avian influenza or “bird flu” caused by H5N1 strain virus, reported in China’s north-west regions two weeks ago. China has accelerated efforts to monitor bird flu status on a daily basis. At 86 monitoring stations. The public at large and officials have been urged to keep an alert vigil and report any incident off illness ,death of poultry or other migratory birds. A huge influx of more than 100,000 migratory birds is expected to cross the country in search of warmer climes from Russia and Mongolia. Beijing’s Muncipal Park Bureau has reported that it has so far monitored 122,000 migratory birds but no evidence of an avian influenza outbreak has been elicited so far.

Yet another report by Xinhua news agency informs that about three million domestic bird have been inoculated so far in Mongolia after the last outbreak of bird flu in the northwestern regions of Inner Mongolia and Ningxia which concurrently also led to the culling of over 2000 birds there. Although China did no face any loss of human lives during this outbreak officials do not want to take any chances as China has already lost 14 people due to this deadly viral infection in previous outbreaks.

Egyptian disease spreading

Egypt: Another Human Case of Bird Flu
UN Integrated Regional Information Networks

October 12, 2006
Posted to the web October 12, 2006

Cairo

Egyptian health officials on Thursday blamed the most recent case of human bird-flu infection in Egypt on poor observance of government regulations aimed at stamping out the virus.

This came after it was confirmed on Wednesday that a 39-year-old woman in the Nile Delta province of Gharbiya had contracted avian influenza, also known as the H5N1 virus.

"People are sticking to their habits and they are forgetting our message," said Sayyid Abbasi, Ministry of Health spokesperson.

Earlier this year, the Egyptian government and international agencies embarked on a nationwide campaign to persuade the population not to keep poultry inside their homes.

Hanan Aboul Magd is the latest victim to be infected with avian flu in Egypt. She was admitted to hospital on 4 October after she reportedly contracted the virus after buying and slaughtering infected ducks at her home.

Magd is the 15th human case of bird flu in Egypt since the first signs of the outbreak were seen in the country in February. Six of those patients have since died.

Hanan is reported to be in a stable condition, and her family is being tested for the virus.

Egypt's densely populated Nile Valley saw the worst concentration of bird flu infection this year outside Asia. The Valley lies on major routes for migratory birds, and has a large rural population that has traditionally reared poultry for food and income.

The government has overseen the culling of some 30 million birds over the past eight months, and has put into place tough restrictions on poultry keeping. So-called 'backyard birds', which are chickens or ducks kept in small numbers in low-income homes for extra food or cash, have been outlawed.

"It is a matter of changing behaviour. People are sometimes not honest [about keeping birds]. They know they are in danger but for other reasons they still have them," said Dr John Jabbour of the Communicable Diseases Surveillance Department at the World Health Organization's regional office in Cairo.

Dr Jabbour added that the government has succeeded in removing poultry from the homes of people in Cairo "but in more rural areas people are not accepting that they have to get rid of backyard birds".

Minister for Health and Population Hatem el-Gabali said on Tuesday that hospitals across Egypt had been put on a high state of alert.

Egypt

Abbassi, the Ministry's spokesman, said the government was "working to 'recharge' the media message, through all the available channels".

An incidence of the virus among poultry was also recorded last month in the Upper Egypt town of Edfu, although no human infection was reported.

[ This report does not necessarily reflect the views of the United Nations ]

Emergency response time to improve

FAO launches disease crisis center

Oct 12, 2006 (CIDRAP News) – To speed emergency responses to avian influenza and other animal and plant diseases, the United Nations Food and Agriculture Organization (FAO) inaugurated a new crisis management center (CMC) at its Rome headquarters today.

The center, founded with the World Organization for Animal Health (OIE), is supported by advanced communication technology and will operate around the clock, 7 days a week, the FAO said in a press release. The center is staffed by up to 15 specialists and veterinarians who will continuously update and monitor disease information.

If a suspected outbreak is reported, the crisis management center can dispatch experts anywhere in the world in less than 48 hours, the FAO said. The center can react quickly to emergencies involving plant pests or food safety, as well as diseases, officials said.

"The CMC represents a significant leap forward in FAO's ability to help member nations prevent and cope with disease outbreaks," said Dr Jacques Diouf, director-general of the FAO, in the press release.

Speed is of the essence in the international fight against avian flu, Diouf said. "Alert must be lighting quick. Reaction must be immediate in combating a disease, which can move across borders and continents terrifyingly fast."

The CMC is headed by Dr Karin Schwabenbauer, Germany's former chief veterinary officer. Dr Gary L. Brickler, from the US Department of Agriculture, is deputy director. Animal health emergency response will be handled by the FAO's chief veterinary officer, Dr Joseph Domenech, and the FAO's Emergency and Rehabilitation Division will handle the CMC's operational support.

The United States donated $5.1 million and three veterinarians to the CMC; other donors include Germany, France, Sweden, Switzerland, Norway, Saudi Arabian, China, Greece, and Jordan.

Meanwhile, Thailand and the United Nations Children's Fund (UNICEF) launched a school-based campaign this week to protect children and their families from the spread of avian flu, according to a United Nations announcement yesterday.

Thailand has the third highest number of human H5N1 cases (25), and the disease has killed 17 people, including 11 children younger than 18.

The campaign covers all of the country's 40,000 elementary and secondary schools. The curriculum will help ensure that children understand what they can do to help prevent the spread of avian flu, such as washing their hands frequently and reporting sick or dead poultry.

Four million posters and pamphlets containing prevention and awareness messages will be distributed; elementary schools will receive 300,000 bars of soap. The campaign was produced by UNICEF and funded by Japan.

Killers on the way to England

8 October 2006
KILLER BIRD FLU ALERT AS 3M FLOCK IN
By Henry Austin

MILLIONS of potential killers carrying deadly bird flu are heading to Britain.

More than three million birds have started their annual migration from Scandinavia, Russia and Canada to spend winter in our milder climate.

And experts warn that some will have the lethal HN51 strain of bird flu which has killed at least 76 people worldwide.

In Russia last year 13,000 birds died of the disease and 113,000 were culled to prevent further outbreaks.

Britain's deputy chief veterinary officer, Fred Landeg, said: "Far from going away, there is an increased likelihood of finding the virus here. We must be vigilant. We're ready to deal with outbreaks."

The disease could also devastate poultry farms.

The National Farmers

Union's Charles Bourn said: "It would be an absolute nightmare for us. We're always worried about it coming here."