WHO report startles some

WHO issues startling bird flu report



The World Health Organization has just completed a report that raises startling concerns about the so-called Bird Flu.

While the virus has killed millions of birds, mostly in Asia, overseas there has been a minute number of human infections. To date, according to the WHO, 256 people have been infected and 152 of those have died. That's nearly a 60 percent death rate.

And in the new report, the WHO says if the virus becomes easily transmissible between people as a result of mutation,".. then the present high lethality could be maintained during a pandemic."

The report also raises concern about vaccine. It says, "Efforts to develop a vaccine that confers adequate protection have been greatly complicated by the emergence of ... diverse viruses..."

The report adds ".. Decisions about which vaccines to stockpile may be premature."

Infectious Disease expert Dr. Michael Osterholm says, "We have no evidence that these vaccines will protect, and on top of it, we just don't have the production capability." So even if an effective vaccine is created, it most likely can't be manufactured fast enough to be distributed to all those who would need it.

To date, the virus in question has not been found in North America.


By Greg Vandegrift, KARE 11 News

Dangerous times in Vietnam

Danger of bird flu outbreak builds up


VietNamNet Bridge - Even though there has been no reported case of bird flu in Vietnam for nearly a year, the risk of a fresh outbreak here is high now that the disease is popping up in several neighboring countries.

A report from the Health Ministry’s Pandemic Control Department says the virulence and spread of Type-A Influenza is hard to pin down as the conditions differ from region to region.

In Indonesia, for example, the disease is spreading quickly at the moment.

The World Health Organization is warning that scientists have discovered a virulent strain of the H5N1 virus in China’s poultry flocks and it is spreading fast too.

In Vietnam, one of the worrisome aspects is that several government agencies tasked with preventing an outbreak of the disease have been alarmingly negligent in their work.

On Wednesday an official from the Ho Chi Minh Animal Health Service pointed out how illegal trading in live water fowl and poultry products was increasing in some places, and some households had started raising poultry again without permission from the government.

In some markets, he added, vendors were selling uninspected live chicks and eggs.

Also discovered was the smuggling of poultry into Ho Chi Minh City along highways 1A and 22 and Road No. 10.

In all, the police had dealt with 134 incidents of illegal poultry transportation, he said, along with 31 cases of illicit incubation in District 8, Go Vap, Cu Chi, Nha Be and Can Gio.

Since Vietnam is hosting the Asia Pacific Economic Cooperation summit very soon, the Health Ministry wants to see a big improvement in terms of publicizing the dangers of bird flu, monitoring the situation and being alert for the first signs of infection, whether in poultry or humans.

The ministry has delivered a wake-up call by sending its people to 55 provinces and cities to warn of the dangers and explain the idea of a quick response.

The ministry has also worked with the World health Organization to run 19 training courses on SARS, flu and bird flu for doctors and nurses from across the nation.

A system of online consultation has been installed at the Preventive Medicine Service and the four Pasteur Institutes of Hygiene and Epidemiology have been linked up.

(Source: SGGP)

Role of migrating ducks revealed in new study

WASHINGTON, Nov 2 (Reuters) - Migrating ducks, geese, and swans spread the H5N1 bird flu virus from Russia to Romania, Turkey and Ukraine, researchers said on Thursday.

A careful analysis of the spread of the virus from central Asia into eastern Europe in the autumn of 2005 shows that wild birds, especially mallard ducks, were the chief spreaders of the virus.

"We conclude that the spread of (highly pathogenic avian influenza) H5N1 virus from Russia and Kazakhstan to the Black Sea basin is consistent in space and time with the hypothesis that birds in the Anatidae family have seeded the virus along their autumn migration routes," the researchers wrote in the journal Emerging Infectious Diseases.

Anatidae include geese, ducks and swans, some of which are killed by H5N1, and other species of which often show no ill effects from the virus but which can spread it. Mallard ducks are the main suspect.

Bird flu remains mainly an animal disease, but has infected 256 people since late 2003, killing 152 of them, according to the World Health Organization.

Experts fear the virus could mutate and spark a human influenza pandemic, which could kill millions.

Domestic ducks and chickens can spread the virus to people, and the poultry trade is held responsible for some spread, but experts have also long believed that wild birds also can carry the virus over long distances.

Marius Gilbert of the Free University of Brussels and colleagues used satellite data to figure out the start of the autumn migration, and plotted known seasonal migration pathways against the actual outbreaks of H5N1.

They noted that adult birds can transmit the virus easily to juveniles during the molting season, when they cannot fly, and also noted that the virus can survive in cold standing water -- where many species of birds congregate while molting.

"The initial outbreaks of (highly pathogenic) H5N1 virus in Romania, Turkey, and Ukraine occurred close to wetlands frequented by overwintering migratory waterfowl," they wrote.

"These locations were clearly far from any known location where ... H5N1 virus had been recorded, while the timing and location match the autumn wildfowl migration ahead of the approaching wave of frost."

Bird experts around the world are testing many different species to see which ones carry and transmit the virus.

The researchers said that their study "by no means excludes the role of the poultry trade as an important, complementary transmission pathway."

U.S. and Canadian officials say they expect highly pathogenic strains of H5N1 to eventually arrive in the Americas, saying it is only a matter of time.

Confusion in China again about H5N1 virus

Ministries refute bird flu virus rumour
By Li Fangchao (China Daily)
Updated: 2006-11-03 06:48

Citing a statement from the Ministry of Agriculture, Foreign Ministry spokesman Liu Jianchao yesterday refuted reports that a new strain of bird flu has emerged in southern China.

An article in Tuesday's issue of the US-based Proceedings of the National Academy of Sciences (www.pnas.org) said a new strain of the H5N1 bird flu virus, called the "Fujian-like virus," because it was first found in Fujian Province, has emerged in southern China and become prevalent in the Hong Kong Special Administrative Region, Laos, Malaysia, and Thailand.

News of the new virus was widely reported in foreign media.

Quoting the statement, Liu said: "China has noticed recent publications by some foreign academic publications about the bird flu situation in southern China, but their claims are totally different from the real situation.

"Since 2004, China has been keeping a close eye on the bird flu situation in its southern regions.

"Gene sequence analysis shows that all the variants of the virus found in southern China share high uniformity, meaning they all belong to the same gene type.

"No distinctive change was found in their biological characteristics."

In response to accusations from WHO experts that China is reluctant to share information and samples of bird flu, the statement said: "China has always actively participated in the prevention and control of bird flu and has maintained good co-operative relations with international organizations, and shares with the international community all the latest developments in the bird flu situation and virus information in the country in a timely manner."

We heard this before, but doggone it bears repeating

Bird flu kills Thai dog, a bad sign for humans
Bloomberg News
Tucson, Arizona | Published: 11.03.2006

Bird flu killed a dog in Thailand after infecting its lungs, liver and kidneys, highlighting the potential for pets to contract the lethal virus and spread it to humans, researchers in the country said.
The dog probably picked up the H5N1 avian influenza strain from infected duck carcasses in the central province of Suphanburi two years ago, the researchers said in a study published in this month's Emerging Infectious Diseases journal. Five days after feeding on the carcasses, the dog developed high fever, panting and lethargy, and died a day later.
The dog's systemic H5N1 infection provides more evidence of the virus's ability to kill mammals. Disease trackers are monitoring for signs the virus is changing into a form more dangerous to people after it killed at least 74 people this year, as many as reported in the previous two years combined.
"Despite the low probability of H5N1 infection in domestic animals, the possibility of humans' acquiring H5N1 infection from direct contact with infected cats and dogs warrants concern and highlights the need for monitoring domestic animals during H5N1 outbreaks in the future," said the authors, including Thaweesak Songserm from Kasetsart University and Alongkorn Amonsin from Chulalongkorn University.
The H5N1 virus is known to have infected 256 people in 10 countries in the past three years, killing 152, the World Health Organization said on Oct. 31. Last year, 42 fatalities were confirmed, after 32 in 2004 and four in 2003. Millions could die if H5N1 becomes easily transmissible between people.

It keeps growing and spreading, but slowly

November 3, 2006


Avian Flu risk remains high throughout areas of the world
By Conrad Wilson

the risk of an influenza pandemic is not likely to decrease in the future, according to a report released Thursday by the World Health Organization.

Currently, the greatest threat for a possible pandemic comes from the H5N1 form of the avian flu virus. The report said additional complications resulting from the new forms of the virus are "now circulating in different parts of the world."

Since appearing in Hong Kong in 1997, the H5N1 strain of avian flu has affected 256 people worldwide and killed 152. It devastated much of Southeast Asia's poultry population and continues to spread.

"The global picture of influenza viruses in the avian world has changed significantly since 2002," the report said. "The massive die-off of migratory birds at Qinghai Lake in mid-2005 was unprecedented, and migratory birds now appear to be contributing to geographical spread of highly pathogenic virus."

The report is important for many reasons, said Marguerite Pappaioanou, a University epidemiology professor.

It noted the economic dependence many of the countries with infected birds have on poultry, she said.

The public-health world needs to understand that farmers' livelihood and national economies depend on this poultry, Pappaioanou said.

"That's good protein," she said. "Those working in animal health must find new ways to fight the virus without devastating those people and economies."

The report stressed the need to monitor viral resistance to antiviral drugs.

Because of the genetic diversity in different forms of influenza, researchers are struggling to develop a vaccine.

"To date, results from clinical trials of candidate pandemic vaccines have not been promising, as these vaccines confer little protection across the different genetic groups," the report said.

A separate WHO report issued in October said the world is on course for a massive vaccine shortage.

"We are presently several billion doses short of the amount of pandemic influenza vaccine we would need to protect the global population," Dr. Marie-Paule Kieny, director of WHO Initiative for Vaccine Research, said in the October report. "This situation could lead to a public health crisis."

As the virus continues to evolve in humans and animals, the report stressed the need for a field test to quickly diagnose the H5N1 virus.

Researchers also said more needs to be done to contain the virus in animals, including culling and vaccinating infected birds.

Just this week, Egypt reported its seventh death from the H5N1 virus. The 39-year-old woman most likely contracted the virus from infected ducks she defeathered and slaughtered. Her death raises this year's toll to 74 people, up from 42 deaths last year.

The extensive spread of the virus to poultry is linked to waterfowl, namely ducks and geese, rather than chickens.

"Recently, studies have demonstrated that the virus is now moving both ways in relay transmission, from poultry to migratory birds and back again," the report said. "This finding might help explain some of the continuing geographical spread."

Blame it on your parents

Genetic factors influence human bird flu infection
www.chinaview.cn 2006-11-03 06:10:31

GENEVA, Nov. 2 (Xinhua) -- Genetic factors might influence human infection of bird flu, which may explain why some people get the disease and others don't, and why it remains rare, the World Health Organization (WHO) said on Thursday.

Scientists suspect some people have "a genetic predisposition" for bird flu infection, and others don't, the UN agency said in a report, which generalized conclusions of a WHO expert meeting in September.

The theory is based on data from rare instances of human-to-human transmission in genetically-related persons.

"This possibility, if more fully explored, might help explain why human cases are relatively rare, and why the virus is not spreading easily from animals to humans or from human to human," the WHO said.

The evidence to the theory is mainly from a family cluster of cases last May in North Sumatra, Indonesia, when seven people in an extended family died.

Only blood relatives were infected in the Karo district of North Sumatra, the largest cluster known to date worldwide, "despite multiple opportunities for the virus to spread to spouses or into the general community," the WHO said.

Bird flu has infected 256 people since late 2003, killing 152 of them, according to the WHO.

Although it remains mainly an animal disease, experts fear the virus could mutate and spark a human influenza pandemic, which could kill millions.

The present situation is still serious and the risk that a pandemic virus might emerge is not likely to diminish in the near future, the agency has warned.

According to the WHO, the development of a pandemic vaccine has become more difficult following the divergence of circulating viruses into distinct genetic and antigenic groups.

"To date, results from clinical trials of candidate pandemic vaccines have not been promising, as these vaccines confer little protection across the different genetic groups," it said in the report.

International standards, or "benchmarks", for evaluating the efficacy of vaccines are urgently needed, and integrated studies of sera from individuals being vaccinated in various clinical trials would be equally useful - for industry as well as for national authorities, it added.

Evolution of bird flu virus

SCIENCE NEWS
October 30, 2006
New Strain of Bird Flu Takes Over

FLU IN FLUX: Samples taken from poultry in southern China indicate that the H5N1 bird flu virus continues to evolve, keeping alive the threat of a global pandemic.

Despite mass vaccinations of poultry in China, the bird flu virus continues to evolve. Samples collected from poultry markets in southern China over the last year show that a variant of the virus has spread outward from a single province and supplanted strains in the rest of the region, researchers report. The result calls into question the steps taken so far to contain the virus, which public health officials fear could give rise to a deadly worldwide flu pandemic.

In early 2004 the H5N1 bird flu virus spread from poultry in China to southern Asia and has since been identified in birds as far away as Europe and north Africa. In principle, vaccination of domestic chickens and other birds could limit the virus's transmission and thereby its ability to evolve into a more transmissible form. With that goal in mind, China announced last November that it would begin vaccinating 14 billion domestic chickens against H5N1.
Since that time, however, the virus seems to have become even more entrenched in domestic poultry, report Chinese and American researchers in a paper published online October 30 by Proceedings of the National Academy of Sciences USA. The team collected samples from over 50,000 seemingly healthy birds between July 2005 and June 2006 at live poultry markets in six provinces of southern China. They identified H5N1 in 2.4 percent of birds, primarily domestic ducks and geese, up from 0.9 percent the year before.

To identify the source of the ongoing transmission, the researchers selected 390 virus samples from infected birds, determined their genetic sequence and compared these sequences with known variants of the virus. One strain, hailing from the province of Fujian, appeared in only 3 percent of birds collected up to September 2005. Between April and June of 2006, however, Fujian-like viruses were responsible for 95 percent of infections. "It means that the virus is still evolving," says co-author Robert Webster of St. Jude Children's Research Hospital in Memphis. "It means that the problem is not under control." Offshoots of the Fujian variant were isolated in the 22 human cases of bird flu reported in China since last November, and the strain has sickened birds in Laos, Malaysia and Thailand, where it also infected people, the group notes.

A weakness in China's vaccine may have allowed the previously local variant to become widespread, the researchers surmise. They analyzed serum samples from 76 chickens for signs of antibodies against three H5N1 variants, including the Fujian-like strain. The presence of antibodies is a sign that a vaccine has taken effect. Almost all of the samples displayed two to four times more antibodies to the other two variants than to the Fujian virus, suggesting that the vaccine given to the chickens was less effective against that strain, the researchers point out. The result highlights the need to supplement vaccination with other measures, says veterinary researcher Richard Slemons of Ohio State University. The former can be effective if part of a broader program of monitoring vaccinated chickens with surveillance afterward, agrees Webster. Vietnam has vaccinated its poultry and saw no new human cases of bird flu this year. --JR Minkel

LOOKING AT THE NUMBERS

Bird Flu Deaths in 2006 Match Prior 2 Years Combined (Update1)

By Jason Gale and Vesna Poljak

Nov. 1 (Bloomberg) -- Bird flu killed a 39-year-old woman in Egypt, pushing the number of fatalities worldwide this year to 74, as many as reported in the previous two years combined.

Egypt's Health Ministry confirmed the country's seventh death from the H5N1 strain of avian influenza, the World Health Organization said in a statement yesterday. The woman's death on Oct. 30 was linked to diseased poultry she helped slaughter at her home on the Nile Delta in September.

Diseased birds increase the opportunities for human infection and provide chances for H5N1 to change into a form more dangerous to people. The virus is reported to have killed a person about every four days this year, more than double the 2005 rate. Millions could die if H5N1 becomes easily transmissible between people, sparking a lethal pandemic.

``As the distribution among poultry populations increases, more humans are getting exposed and these increased human cases and fatalities are a sign that this is an ever-developing situation,'' David Nabarro, the senior United Nations system coordinator for avian and pandemic influenza, said in a telephone interview from Bangkok last month.

The H5N1 virus is known to have infected 256 people in 10 countries in the past three years, killing 152 of them, the WHO said yesterday. Last year, 42 fatalities were confirmed, after 32 in 2004 and four in 2003. More than five of every 10 reported cases were fatal.

Indonesian Patients

Doctors in Indonesia, the country with the most H5N1 fatalities, are testing three more people for the virus. A 3- year-old girl and her 14-year-old brother are being treated in an isolation ward at Hasan Sadikin Hospital in the West Java city of Bandung, said Hadi Yusuf, a doctor at the hospital.

The siblings from the Banjarnegara district had contact with diseased poultry, Yusuf said. A 62-year-old man from Bandung is also suffering from avian-flu-like symptoms, he said.

Almost all human H5N1 cases have been linked to close contact with sick or dead birds, such as children playing with them or adults butchering them or plucking feathers. While the virus doesn't spread easily between people, some human-to-human transmission may have occurred.

Disease trackers are monitoring for signs the virus is becoming adept at infecting humans, not just birds. The lethal H5N1 strain was first detected in a farmed goose a decade ago in Guangdong, the same province of China where severe acute respiratory syndrome, or SARS, was reported in 2003.

`Poorly Infectious'

H5N1 is ``still poorly infectious in humans,'' said Peter Doherty, an immunology professor at the University of Melbourne who was awarded a Nobel prize in 1996 for discoveries surrounding the specificity of cell-mediated immune defense. ``The longer it goes on, the longer it looks as though we probably ducked a bullet.

``The question is, if it does change to be highly infectious to humans, will it be as pathogenic?'' Doherty said in an interview last month.

More perilous would be a virus that causes less debilitating disease in humans and fewer fatalities, enabling people to spread to more widely in droplets shed through coughing and sneezing, he said. ``What would be dangerous is if we get an intermediate virus that's not killing 50 percent, but killing 5 percent'' of those infected.

$2 Trillion Cost

He said such a virus would resemble the so-called 1918 Spanish flu pandemic, which killed about 50 million people. A similar pandemic could cause global economic losses of as much as $2 trillion, the World Bank said in June.

The H5N1 virus is reported to have spread in wild birds and domestic poultry to at least 38 countries this year. More than 209 million poultry have died or been culled worldwide since January 2004 because of H5N1, the UN's Food and Agriculture Organization said in a June 19 report.

``The virus in birds continues to move at a rapid rate, causing major damage to the poultry industry,'' Nabarro said.

``The work that has been done by many countries to stamp out avian influenza has meant that the human cases and fatalities are unfortunately confined to a few nations,'' he said. ``We have to further increase our efforts to stamp out the virus in poultry and other bird populations and at the same time do more to reduce the contact between humans and sick birds.''

To contact the reporters on this story: Jason Gale in Tokyo at j.gale@bloomberg.net ; Vesna Poljak in Sydney at vpoljak@bloomberg.net .
Last Updated: October 31, 2006 23:00 EST

Advances in technology assist in bird flu fight

British scientists create new bird flu map
[Wednesday 01 November 2006]

AS THE late autumn migrations of millions of birds to Europe begins to gather pace, bringing with it new fears about the spread of deadly avian 'flu, British scientists announced today (November 1) that they have created a new map of migration patterns which could act as an early warning system should the disease threaten Britain.

We can now provide much better information to Defra to help them target their surveillance

Dr Phil Atkinson - BTO

Migrating birds from South East Asia and the southern steppes were last year accused to bringing the deadly strain of H5N1 strain which has killed humans in Asia to Europe, but there were no reported cases of the infection spreading to people here.

However, warning bells rang because epidemiologists fear that the H5N1 strain to crossbreed with human flu strains and produce a killer strain against which there are no effective vaccines.

Scientists from the rural affairs department Defra turned for help to the British Trust for Ornithology (BTO), which has some 650,000 movements on its data base of birds ringed by hundreds of volunteers. And working together for the past year, they have now come up with an early warning computer model which, the experts hope, will allow them to predict the arrival of infected birds in Britain.

Announcing the creation of the new technology today, Dr Phil Atkinson, who took the lead in the research, commented: "We were pleased that Defra recognised that we have excellent data about the movements of birds due to the huge efforts of bird ringers, working as part of the BTO's ringing scheme.

"We have used this information to develop a 'migration mapping tool' to give an easy to understand picture of the timing of migration and the areas from which migratory waterfowl that visit Britain and Ireland originate, or through which they travel.

"We can now provide much better information to Defra to help them target their surveillance for a potential avian flu incursion, given an outbreak of the disease in another country."

Egyptian woman dies: 7th death from bird flu in Egypt

Cairo - An Egyptian woman died of bird flu on Monday, marking the country's seventh fatal case of avian influenza in humans, said the health ministry.

"It is the seventh death due to bird flu," health ministry spokesperson Abdel Rahman Shaheen was quoted as saying by the official Mena news agency.

"The lady contracted the disease while slaughtering domestic poultry, and was taken to hospital on October 4 after suffering from fever," said Shaheen.

The virus was first detected in Egypt in February.

Egypt, the most populous country in the Arab world, is on a major route for migratory birds and is the hardest-hit non-Asian country since the bird flu epidemic broke out in 2003.

The H5N1 strain of bird flu, its most aggressive form, has killed more than 150 people worldwide, according to the world health organisation (WHO).

Did you get your flu shot yet? I did!

WASHINGTON, DC, United States (UPI) -- With winter and transmissible illnesses arriving soon, it`s time to boost your immune system and schedule your annual flu shot, experts say.

'We`re expecting an average flu season. The joker out there is, of course, avian flu. If that virus emerges, all bets are off,' said Dr. Neil Schachter of Mount Sinai Medical Center and author of 'The Good Doctor`s Guide to Colds & Flu.'

But even an average flu season can leave between 5 percent and 20 percent of the U.S. population sick, according to the Centers for Disease Control. Laid up with symptoms such as high fever, headache, runny or stuffy nose, sore throat, muscle aches, extreme tiredness and occasionally stomach symptoms (more prevalent in children), the flu sufferer is usually ill for five to seven days.

While most healthy people will recover from the influenza virus, other at-risk individuals may have flu-related complications that can lead to hospitalization and even death.

'There`s no question that the flu vaccine is the single best way to avoid catching or passing the virus,' said Dr. Jane Siegel, an infectious disease specialist at University of Texas Southwestern Medical Center. Other preventive remedies may be beneficial, Siegel said, but the only tried and true measure is the vaccine.

Siegel stressed that while a healthy adult may not be concerned about catching the flu, the individual can help protect others by getting vaccinated. 'A healthy adult can pass the influenza virus to at-risk individuals' in the workplace or at home, Siegel said.

The CDC says individuals who should be vaccinated include:

-- Children aged 6 months to 5 years.

-- Pregnant women.

-- People 50 years of age and older.

-- People of any age with chronic medical conditions.

-- People who live in nursing homes and other long-term-care facilities.

'Avoiding the spread of viruses that cause colds or influenza is particularly important since these viruses do not respond well to antibiotics,' said Schachter.

For all its benefits, however, the influenza vaccine does not protect against other viruses that are prevalent at this time of year. Whether or not you take the doctors` advice and schedule your flu shot, there are simple yet important doctor-recommended behaviors that can help protect you from seasonal bugs.

-- Wash your hands regularly. Siegel said that proper hand-washing technique entails rubbing your hands together with soap and warm water, making sure to cover all surface areas, for 'the length of time it takes to sing the `Happy Birthday` song.'

-- Cleanse your hands with anti-microbial gel. Doctors agree that alcohol-based hand sanitizers greatly reduce the spread of cold and flu-causing germs. Be sure to use enough gel to cover all surfaces of your hands and rub for 15-20 seconds.

-- Wipe down shared appliances with anti-viral cleanser. Viruses can survive for up to two hours on objects such as computers keyboards, telephones and doorknobs in your home and office.

-- Avoid crowds. Viruses are typically transmitted over a distance of 3 feet, so when possible, avoid contact with people who are sick, said Siegel. Keep your distance from others when you are feeling ill.

-- Practice 'respiratory hygiene etiquette.' Cover your mouth and nose with a tissue when you cough and sneeze, and throw away the tissue, explained Siegel. Avoid touching your eyes, nose or mouth because germs often spread this way.

-- Supplement with vitamin C, zinc and herbal remedies. Medical science hasn`t fully proven the immune-system-boosting powers of herbal supplements, but as Schachter said, 'I use them myself.' In small doses, dietary supplements may help reduce symptoms and shorten the duration of a virus. For example, Schachter recommended 250-500 mg of vitamin C and two lozenges of zinc per day.

-- Utilize products such as vinyl gloves and ear loop masks. These products help limit the wearer`s exposure to and spread of germs from touching objects, coughing and sneezing. 'As people`s lives continue to get busier, it`s important to help make healthy habits more convenient,' said Peter Kjome, the marketing manager at Nexcare, one company that is selling the pre-assembled kits. 'The Nexcare Health Preparedness Kit and Go-Pak are ideal for home, car, purse, travel or wherever they may be needed.'

Considering the prevalence of transmissible illnesses at this time of year and the close quarters we share in offices and planes, many of us will inevitably succumb to the dreaded cold and flu viruses. Consider the following advice when you notice that itch at the back of your throat or are feeling overly tired and achy.

-- Rest. All other remedies will be less effective if not paired with good nights` sleep. Seriously consider staying home from work to both rest and prevent your illness from spreading to co-workers.

-- Force the fluids. Even if you don`t feel particularly hungry or thirsty, it`s important to stay well-hydrated by consuming plenty of liquids. Hot soups and teas can be soothing and beneficial. A number of doctors endorsed chicken soup as an effective remedy: 'Some of the oils in the warm soup have been shown to reduce cytokines, the proteins that cause aches and pains,' Schachter said.

-- Relieve the symptoms with over-the-counter medications. While anti-histamines and decongestants do not affect the duration of the illness, 'there`s nothing wrong with making yourself feel better,' Dr. Schachter said.

Copyright 2006 by United Press International

Pennjoe blogging basics of bird flu

Bird Flu: Symptoms and Treatment Information

What is avian influenza (bird flu)?


Bird flu is an infection caused by avian (bird) influenza (flu) viruses. These flu viruses occur naturally among birds. Wild birds worldwide carry the viruses in their intestines, but usually do not get sick from them. However, bird flu is very contagious among birds and can make some domesticated birds, including chickens, ducks, and turkeys, very sick and kill them.


Infection with avian influenza viruses in domestic poultry causes two main forms of disease that are distinguished by low and high extremes of virulence. The “low pathogenic” form may go undetected and usually causes only mild symptoms (such as ruffled feathers and a drop in egg production). However, the “highly pathogenic” form spreads more rapidly through flocks of poultry. This form may cause disease that affects multiple internal organs and has a mortality rate that can reach 90-100%, often within 48 hours.


How does avian influenza spread among birds?


Infected birds shed influenza virus in their saliva, nasal secretions, and feces. Susceptible birds become infected when they have contact with contaminated excretions or with surfaces that are contaminated with excretions or secretions. Domesticated birds may become infected with avian influenza virus through direct contact with infected waterfowl or other infected poultry or through contact with surfaces (such as dirt or cages) or materials (such as water or feed) that have been contaminated with the virus.


Do bird flu viruses infect humans?


Bird flu viruses do not usually infect humans, but more than 100 confirmed cases of human infection with bird flu viruses have occurred since 1997. The World Health Organization (WHO) maintains situation updates and cumulative reports of human cases of avian influenza A (H5N1). Please visit these and previous WHO situation updates and cumulative reports for additional information.


How do people become infected with avian influenza viruses?


Most cases of avian influenza infection in humans have resulted from direct or close contact with infected poultry (e.g., domesticated chicken, ducks, and turkeys) or surfaces contaminated with secretions and excretions from infected birds. The spread of avian influenza viruses from an ill person to another person has been reported very rarely, and transmission has not been observed to continue beyond one person. During an outbreak of avian influenza among poultry, there is a possible risk to people who have direct or close contact with infected birds or with surfaces that have been contaminated with secretions and excretions from infected birds.


What are the symptoms of avian influenza in humans?


Symptoms of avian influenza in humans have ranged from typical human influenza-like symptoms (fever, cough, sore throat, and muscle aches) to eye infections, pneumonia, severe respiratory diseases (such as acute respiratory distress syndrome), and other severe and life-threatening complications. The symptoms of avian influenza may depend on which specific virus subtype and strain caused the infection.


How is avian influenza detected in humans?


A laboratory test is needed to confirm avian influenza in humans.


What are the implications of avian influenza to human health?


Two main risks for human health from avian influenza are 1) the risk of direct infection when the virus passes from the infected bird to humans, sometimes resulting in severe disease; and 2) the risk that the virus – if given enough opportunities – will change into a form that is highly infectious for humans and spreads easily from person to person.


How is avian influenza in humans treated?


Studies done in laboratories suggest that the prescription medicines approved for human influenza viruses should work in treating avian influenza infection in humans. However, influenza viruses can become resistant to these drugs, so these medications may not always work. Additional studies are needed to determine the effectiveness of these medicines.


Does the current seasonal influenza vaccine protect me from avian influenza?


No. Influenza vaccine for the 2005-06 season does not provide protection against avian influenza.


Should I wear a surgical mask to prevent exposure to avian influenza?


Currently, wearing a mask is not recommended for routine use (e.g., in public) for preventing influenza exposure. In the United States, disposable surgical and procedure masks have been widely used in health-care settings to prevent exposure to respiratory infections, but the masks have not been used commonly in community settings, such as schools, businesses, and public gatherings.


Is there a risk for becoming infected with avian influenza by eating poultry?


There is no evidence that properly cooked poultry or eggs can be a source of infection for avian influenza viruses. For more information about avian influenza and food safety issues, visit the World Health Organization website .


The U.S. government carefully controls domestic and imported food products, and in 2004 issued a ban on importation of poultry from countries affected by avian influenza viruses, including the H5N1 strain. This ban still is in place. For more information, see Embargo of Birds, http://www.cdc.gov/flu/avian/outbreaks/embargo.htm .


We have a small flock of chickens. Is it safe to keep them?


Yes. In the United States there is no need at present to remove a flock of chickens because of concerns regarding avian influenza. The U.S. Department of Agriculture monitors potential infection of poultry and poultry products by avian influenza viruses and other infectious disease agents.


What precautions can be taken to reduce the risk for infection from wild birds in the United States?


As a general rule, the public should observe wildlife, including wild birds, from a distance. This protects you from possible exposure to pathogens and minimizes disturbance to the animal. Avoid touching wildlife. If there is contact with wildlife do not rub eyes, eat, drink, or smoke before washing hands with soap and water. Do not pick up diseased or dead wildlife. Contact your state, tribal, or federal natural resource agency if a sick or dead animal is found.


Avian Influenza A (H5N1)


What is the avian influenza A (H5N1) virus that has been reported in Asia and Europe?


Influenza A (H5N1) virus – also called “H5N1 virus” – is an influenza A virus subtype that occurs mainly in birds, is highly contagious among birds, and can be deadly to them.


Outbreaks of avian influenza H5N1 occurred among poultry in eight countries in Asia (Cambodia , China, Indonesia, Japan, Laos, South Korea, Thailand, and Vietnam) during late 2003 and early 2004. At that time, more than 100 million birds in the affected countries either died from the disease or were killed in order to try to control the outbreaks. By March 2004, the outbreak was reported to be under control.


Since late June 2004, however, new outbreaks of influenza H5N1 among poultry have been reported by several countries in Asia (Cambodia, China [Tibet], Indonesia, Kazakhstan, Malaysia, Mongolia, Russia [Siberia], Thailand, and Vietnam). It is believed that these outbreaks are ongoing. Influenza H5N1 infection also has been reported among poultry in Turkey and Romania and among wild migratory birds in Croatia .


Human cases of influenza A (H5N1) infection have been reported in Cambodia, China, Indonesia, Thailand, Turkey, and Vietnam. For the most current information about avian influenza and cumulative case numbers, see the World Health Organization website at http://www.who.int/csr/disease/avian_influenza/en/.


What are the risks to humans from the current H5N1 outbreak in Asia and Europe?


H5N1 virus does not usually infect people, but more than 140 human cases have been reported. Most of these cases have occurred from direct or close contact with infected poultry or contaminated surfaces; however, a few cases of human-to-human spread of H5N1 virus have occurred.


So far, spread of H5N1 virus from person to person has been rare and has not continued beyond one person. Nonetheless, because all influenza viruses have the ability to change, scientists are concerned that H5N1 virus one day could be able to infect humans and spread easily from one person to another. Because these viruses do not commonly infect humans, there is little or no immune protection against them in the human population.


If H5N1 virus were to gain the capacity to spread easily from person to person, an influenza pandemic (worldwide outbreak of disease) could begin. No one can predict when a pandemic might occur. However, experts from around the world are watching the H5N1 situation in Asia and Europe very closely and are preparing for the possibility that the virus may begin to spread more easily from person to person.


How does H5N1 virus differ from seasonal influenza viruses that infect humans?


Of the few avian influenza viruses that have crossed the species barrier to infect humans, H5N1 virus has caused the largest number of reported cases of severe disease and death in humans. In the current situation in Asia, more than half of the people infected with the virus have died. Most cases have occurred in previously healthy children and young adults. However, it is possible that the only cases currently being reported are those in the most severely ill people and that the full range of illness caused by the H5N1 virus has not yet been defined.


Unlike seasonal influenza, in which infection usually causes only mild respiratory symptoms in most people, H5N1 infection may follow an unusually aggressive clinical course, with rapid deterioration and high fatality. Primary viral pneumonia and multi-organ failure have been common among people who have become ill with H5N1 influenza.


How is infection with H5N1 virus in humans treated?


Most H5N1 viruses that have caused human illness and death appear to be resistant to amantadine and rimantadine, two antiviral medications commonly used for treatment of patients with influenza. Two other antiviral medications, oseltamivir and zanamavir, would probably work to treat influenza caused by H5N1 virus, but additional studies are needed to demonstrate their current and ongoing effectiveness.


Is there a vaccine to protect humans from H5N1 virus?


There currently is no commercially available vaccine to protect humans against the H5N1 virus that is being detected in Asia and Europe. However, vaccine development efforts are taking place. Research studies to test a vaccine that will protect humans against H5N1 virus began in April 2005, and a series of clinical trials is under way. For more information about the H5N1 vaccine development process, visit the National Institutes of Health website .


What does CDC recommend regarding H5N1 virus?


In February 2004, CDC provided U.S. public health departments with recommendations for enhanced surveillance (“detection”) of H5N1 influenza in the country. Follow-up messages, distributed via the Health Alert Network, were sent to the health departments on August 12, 2004, and February 4, 2005; both alerts reminded public health departments about recommendations for detecting (domestic surveillance), diagnosing, and preventing the spread of H5N1 virus. The alerts also recommended measures for laboratory testing for H5N1 virus. To read the alerts, visit Health Updates on Avian Influenza .


Does CDC recommend travel restrictions to areas with known H5N1 outbreaks?


CDC does not recommend any travel restrictions to affected countries at this time. However, CDC currently advises that travelers to countries with known outbreaks of H5N1 influenza avoid poultry farms, contact with animals in live food markets, and any surfaces that appear to be contaminated with feces from poultry or other animals. For more information, visit Travelers' Health update.


Is there a risk in handling feather products that come from countries experiencing outbreaks of avian influenza A (H5N1)?


The U.S. government has determined that there is a risk to handling feather products from countries experiencing outbreaks of H5N1 influenza.


There is currently a ban on the importation of birds and bird products from H5N1-affected countries in Asia and Europe. The regulation states that no person may import or attempt to import any birds (Class Aves), whether dead or alive, or any products derived from birds (including hatching eggs), from the following countries: Cambodia, Indonesia, Japan, Laos, Kazakhstan, Malaysia, People's Republic of China, Romania, Russia, South Korea, Thailand, Turkey, Ukraine, and Vietnam (current as of December 29, 2005). This prohibition does not apply to any person who imports or attempts to import products derived from birds if, as determined by federal officials, such products have been properly processed to render them noninfectious so that they pose no risk of transmitting or carrying H5Nl and which comply with the U.S. Department of Agriculture (USDA) requirements. Therefore, feathers from these countries are banned unless they have been processed to render them noninfectious. Additional information about the import ban is available on the USDA website.


Is there a risk to importing pet birds that come from countries experiencing outbreaks of avian influenza A (H5N1)?


The U.S. government has determined that there is a risk to importing pet birds from countries experiencing outbreaks of H5N1 influenza. CDC and USDA have both taken action to ban the importation of birds from areas where H5N1 has been documented. There is currently a ban on the importation of birds and bird products from H5N1-affected countries in Asia. The regulation states that no person may import or attempt to import any birds (Class Aves), whether dead or alive, or any products derived from birds (including hatching eggs), from the following countries: Cambodia, Indonesia, Japan, Laos, Kazakhstan, Malaysia, Peoples' Republic of China, Romania, Russia, South Korea, Thailand, Turkey, Ukraine, and Vietnam. (current as of December 29, 2005) .


Can a person become infected with avian influenza A (H5N1) virus by cleaning a bird feeder?


There is no evidence of H5N1 having caused disease in birds or people in the United States . At the present time, the risk of becoming infected with H5N1 virus from bird feeders is low. Generally, perching birds (Passeriformes) are the predominate type of birds at feeders. While there are documented cases of H5N1 causing death in some Passeriformes (e.g., house sparrow, Eurasian tree-sparrow, house finch), in both free-ranging and experimental settings, most of the wild birds that are traditionally associated with avian influenza viruses are waterfowl and shore birds.

Would you panic in the face of a pandemic flu?

Oct. 27, 2006
(AP)



"If things go wrong, people are going to change their behavior."
Robert J. Blendon, author of the report and a professor of health policy
at the Harvard School of Public Health


(WebMD) A large majority of Americans would comply with government orders to avoid work, school, or other public places in the event of a flu pandemic, according to a survey released Thursday.

The results suggest public health officials could easily convince most people to temporarily alter their daily lives in a bid to stem the spread of influenza.

But researchers warn such willingness would likely erode after just a few weeks as lost wages, food shortages, and runs on medical attention mounted.

"You would find significant levels of cooperation early on," says Robert J. Blendon, author of the report and a professor of health policy at the Harvard School of Public Health. "The question is, how are we going to provide essential services as they [the public] can't go to normal places?"

More than 90 percent of the 1,700 U.S. adults surveyed said they would postpone air travel and avoid public venues like movie theatres and shopping centers if asked by public health officials.

Ninety-four percent said they would stay home for 7 to 10 days to help authorities control disease spread.

Federal, state, and local officials have been planning for the possibility of a flu pandemic since bird flu began infecting humans in Southeast Asia in 2003.

The highly aggressive strain H5N1, though it is not easily spread between humans, had sickened 256 and killed 151 people as of Oct. 16, according to the World Health Organization.

Government researchers and private companies have collaborated on developing an effective bird flu vaccine against the H5N1 strain since 2004.

But there is no guarantee that the H5N1 virus would be the one to spark a pandemic. Even if it is, vaccine manufacturers say it would take them at least six months to make enough vaccine for all Americans.

"I think we can say safely we will not have a vaccine for at least the first wave of an epidemic, and probably will have inadequate vaccine for a second year," says D.A. Henderson, a scholar at the University of Pittsburgh Center for Biosecurity, who is a government advisor on epidemics and bioterrorism.

That means basic measures like hand washing and social distancing are likely to be the most effective ways of stemming an outbreak in its early stages, Henderson says.

Blendon says findings in Thursday's study would give government officials a cushion for gaining the public's help in controlling a pandemic.

But there were also warning signs.

One-quarter of those surveyed said they have no one at home to care for them if they get sick. Roughly the same number said they would likely lose their job if they stayed away from work for a week to 10 days. In each case, those people were more likely to be low-income or hourly wage-earners.

Those results are an alert that government officials must plan early for how to provide food, schooling, and other services to low income citizens, Blendon says.

The aftermath of Hurricane Katrina showed that poor residents are much more vulnerable when disaster strikes. It also showed that chaos can ensue when people perceive signs that their government is not helping them.

A similar lack of planning for the potential upheaval of a major flu outbreak would quickly undo the public's initial goodwill, Blendon told a panel convened by the Institute of Medicine.

"The people that are going to run out of gas first are very low income, they're hourly workers." Blendon said.

"If things go wrong, people are going to change their behavior," he warned.

In issuing federal guidelines for pandemic planning last year, federal health officials said they would serve mostly a coordinating role during a pandemic. Detailed planning for hospital services, school closings, and emergency response would remain the responsibility of state and local planners, they said.

But Henderson says local planning waned sharply after media attention on the threat of pandemic flu faded in the spring.

Few hospitals have planned for the surges in patients that would likely turn up for medical attention in the first wave of a pandemic, Henderson says. Few have stockpiled filtration masks or other medical supplies.

"Here we have fallen down almost completely," Henderson says.


SOURCES: Pandemic Influenza Survey, Harvard School of Public Health Project on the Public and Biological Security, Oct. 26, 2006. Robert J. Blendon, professor, Harvard School of Public Health. World Health Organization: "Cumulative Number of Confirmed Human Cases of Avian Influenza (H5N1) Reported to WHO," Oct. 16, 2006. D.A. Henderson, scholar, University of Pittsburgh Center for Biosecurity.

By Todd Zwillich
Reviewed by Michael Smith
Copyright 2006, WebMD Inc. All rights reserved.

Who gets what and when in pandemic

WHO to report on ethical issues in pandemic planning

Robert Roos * News Editor

Oct 27, 2006 (CIDRAP News) – The World Health Organization (WHO) plans to issue a report in January on ethical issues raised by pandemic influenza planning, such as how to provide fair access to available drugs and vaccines, WHO officials said today after 2 days of meetings in Geneva.

More than 30 leading experts on pandemic flu, ethics, and public health attended the meetings Oct 24 and 25, WHO spokesman Gregory Hartl said at a news teleconference today.

"This was not designed to reach any conclusions, but to raise issues," Hartl said. "The idea was to get people talking about these issues before the pandemic started."

Dr. Alex Capron, a professor of law and medicine at the University of Southern California, said the discussions focused on four main topics: equitable access to therapeutic and prophylactic measures; ethical aspects of interventions such as quarantine and social distancing; what healthcare workers should be expected to do during an outbreak and what obligations are owed them; and issues that arise between governments when developing a multilateral response to a pandemic.

The WHO report will stress the need to have broad public involvement in decisions and to base choices on an accurate understanding of the pandemic, officials said.

"The recognition that emerged very strongly [at the meetings] was that it was going to be essential to have public engagement in all aspects of planning and a frank and candid recognition that the questions of the pandemic are going to be not just technical questions, but also ethical questions," Capron said.

He said the WHO is not aiming for "a single set of prescriptions for all circumstances." Instead, everyone involved in planning will be dealing with "the need for trading off among a number of different ethical values."

He cited several examples: the principle of utility, which stresses the need to "maximize welfare"; the principle of fairness, which emphasizes justice; the principle of liberty, which says individuals should be able to make their own choices as much as possible; and the principle of reciprocity, which says that people who contribute to the public good are owed something in return.

"These may point in different directions," Capron said.

In response to a question about vaccine rationing, Capron said, "One of the things that emerged very strongly is the necessity for good ethics to rest on good facts." Some at the meeting challenged the assumption that children and elderly people will be at greatest risk, and suggested, he said, that health agencies may need "contingency plans depending on what the virus turns out to be like, how it behaves."

In an apparent reference to suggestions that the pandemic may hit young, healthy adults hardest, as occurred in the 1918 pandemic, Capron added, "The assumption that the youngest or oldest are most at risk is the assumption that applies to seasonal influenza, [which] may or may not be the case here."

Dr. Elaine Gadd, a senior medical officer and ethics specialist with the United Kingdom Department of Health, seconded Capron's comments. "It's very important that any plans are responsive to the actual characteristics of the pandemic, which we do not know in advance. Any plan must be capable of amendment in light of the actual facts."

In response to another question about vaccine allocation, Dr. Richard Heymann, the WHO director-general's acting special representative for pandemic flu, said the groups that will most need protection include health workers and their families along with police and fire fighters.

As for journalists, Heymann said he hopes they can be protected too. "But it has to be decided by the local community and the countries," he added. "WHO just meets and makes broad recommendations and studies the issues." (Experts say no vaccine well-matched to the pandemic virus will be available for at least the first several months of a pandemic, and after that it will be in short supply.)

A report on the ethics meeting will be drafted and circulated to participants and other stakeholders in November, with a goal of publishing the report and some "guiding points" in January, said Dr. Andreas Reis, a WHO technical officer for ethics and health.

The mighty sparrow carriers

Bird flu reportedly found in Chinese sparrows

By China correspondent Stephen McDonell

Chinese scientists have reportedly found bird flu in sparrows.

It is the first time the virus has been discovered in common, non-migratory birds on the Chinese mainland.

It was thought the H5N1 bird flu was transmitted by migratory water fowl, but this finding indicates ordinary, non-migratory birds can also carry and transmit the virus.

Scientists tested excrement samples from sparrows after a bird flu outbreak in Henan province, and some tested positive.

Health officials have stressed there is still no indication that sparrows pose a risk to humans.

China has reported 21 human bird flu infections since 2003; 14 of those are reported to have died.

USDA Downplays Significance Of Low-Pathogenic Bird Flu

WASHINGTON (Dow Jones)--The U.S. Department of Agriculture will, as of this week, stop issuing press releases on the discoveries of low-pathogenic bird flu, but will continue to compile findings and data from its surveillance program on government Internet sites.

The U.S. Department of Agriculture and U.S. Department of Interior are conducting the nationwide surveillance in an effort to detect the deadly, high-pathogenic H5N1, or "Asian" strain of bird flu. So far, only low-pathogenic forms of H5N1 have been found, and the government has announced each discovery.

"Because these (low-pathogenic) H5N1 detections are common and pose no threat to human health, USDA and DOI are transitioning to a new method of notifying the public," the USDA said. "Low-pathogenic strains of avian influenza occur naturally in wild birds and typically cause only minor sickness or no noticeable signs of disease in birds. These strains are common in the U.S. and around the world."

If government officials see indications of a possible high-pathogenic infection, the public will be alerted, the USDA said.

"In the event of a presumptive H5N1 test result involving a large number of sick or dead birds, or other circumstances that suggest the possibility of a highly pathogenic virus, USDA and DOI will issue a news release or conduct a technical briefing to notify the media and the public," the USDA said.

The high-pathogenic Asian H5N1 bird flu has spread through Asia, Europe and Africa and killed humans, but it has never been found in the U.S.

Source: Bill Tomson, Dow Jones Newswires; 202-646-0088; bill.tomson@dowjones.com