South Korean farms hit

A highly infectious form of bird flu was discovered in a duck 90 kilometres south of Seoul in the fourth farm in South Korea to be hit with avian influenza in a month, the Agriculture Ministry said Friday.

More tests were required to see whether the latest case at a duck farm in Asan represented an infection with the H5N1 strain of bird flu, which has proven dangerous to people, a worker in the ministry's department of animal health said.

About 770,000 birds have already been culled in Iksan, south of Asan, after H5N1 infections were discovered at two poultry operations there. Another 365,000 birds were killed nearby in Gimje, also because of an H5N1 outbreak.

About 23,000 poultry are also to be killed in a 3-kilometre radius from the affected Asan farm. The Agriculture Ministry said bird flu also broke out on the duck farm in February 2004.

According to the UN's World Health Organization, 258 people have been infected with H5N1 in 10 countries in Asia and Africa since late 2003. Of them, 154 have died.

No human cases of the disease have been reported in South Korea, but from 2003 to 2004, a bird-flu outbreak among poultry there led to the killing of 5.3 million birds in an effort to stop the spread of the disease, which is virulent among poultry.

It's transmission to people is more difficult, and most human patients have contracted the disease through close contact with infected birds. Health experts fear, however, that the virus could mutate into a form that could spread from human to human.

© 2006 DPA

Multiple outbreaks in Vietnam

Vietnam battles three bird flu outbreaks

Hanoi (dpa) - Authorities in Vietnam have identified three new outbreaks of bird flu in the Mekong Delta, raising fears of a larger-scale return of the deadly H5N1 virus after a year of relative calm, an official said Friday.

No human cases of bird flu have been reported, but chickens and ducks have died of bird flu in three new areas in the Mekong Delta provinces of Ca Mau and Bac Lieu, which this week reported the first confirmed cases in more than a year.

"The situation is alarming," said Hoang Van Nam, director of the Epidemic Unit under Vietnam's Ministry of Agriculture and Rural Development.

Thousands of chickens and ducks in the affected areas have been slaughtered as authorities try to limit the spread of the virus, which has killed hundreds of millions of chickens and at least 42 people in Vietnam since 2004.

"Our assessment is that bird flu is likely to spread far outside the outbreak confirmed localities," Nam said. "Once the virus spread to the environment, other provinces will be affected."

Nam said the onset of winter represents heightened vulnerability for infection in both poultry and humans - especially as the coming lunar new year celebrations usually see families slaughtering chickens for feasts.

The H5N1 strain of bird flu is not easily contagious among humans, but people can be infected through close contact with infected poultry.

The virus has raised fears among scientists because up to 60 per cent of people known to have been infected have died.

International health organizations warn that H5N1 also could someday mutate into a new human influenza pandemic strain.

A new flu pandemic - which hasn't been seen since the 1960s - could kill as many as 62 million people, according to a study published this week in the medical journal The Lancet.

Most efforts in preventing a pandemic have focused on controlling the virus in domestic poultry, which would deny H5N1 the contact with humans that would make it most likely to mutate.

Vietnam has been one of the most successful countries in controlling the virus through an aggressive programme of poultry vaccinations, which took the country from having outbreaks in all 63 provinces in 2005 to no reported cases in poultry or humans for more than a year.

This week's reported outbreaks apparently were at small farms that had avoided the government-mandated vaccinations, officials said.

Interactive map of avian flu

This is a great graphical representation of the growth of bird flu brought to you by MSNBC. Check it out!

10 high tech isolation beds in Nebraska

Quarantine unit prepares for wave of infection
Nebraska facility ready to isolate first carriers of bird flu, other diseases

Updated: 11:18 a.m. PT Dec 17, 2006 MSNBC

OMAHA, Neb. - Consider it a biomedical Fort Knox, a fortress for germs instead of gold.

On a quiet floor of the Nebraska Medical Center in Omaha, the most advanced containment system available forms a bulwark against the release of deadly infectious diseases such as the feared bird flu.

The Nebraska Biocontainment Unit has only 10 beds yet is the largest of three quarantine facilities in the country. They would be of no use once a flu pandemic was raging. But if someone shows up with an unusual contagious killer, they might help avert an outbreak.

Nothing is left to chance.

“If we ever had a situation, they certainly would be equipped to handle it,” said Von Roebuck, a spokesman for the Centers for Disease Control and Prevention.

A special set of double doors is installed, with one door closed and locked at all times to prevent bad air from escaping. Hospital staff can use an access system to safely drop off medical supplies or meals by leaving items between the doors for employees inside the unit to retrieve.

A separate staff entrance allows doctors and nurses to walk directly to a locker room where they can change into sterile scrubs. Hooded suits with self-contained air systems are available for cases of severe risk.

A decontamination shower is a required stop before anyone can re-enter the locker room.

The unit’s separate air system uses High Efficiency Particulate Air filters and ultraviolet rays to destroy germs. The filtered air is released outside rather than into the hospital’s ventilation system.

Then there are the tornado-proof windows and fire walls.

The Nebraska facility and two-bed germ-containment units at the U.S. Army Medical Research Institute of Infectious Diseases at Fort Detrick, Md., and Emory University Hospital in Atlanta are meant to nip a dangerous outbreak in the bud.

It is not known how many beds are enough to isolate the very first carriers of disease. Early detection will be critical if bird flu or any such deadly disease comes to the United States.

But these defenses, and plans to turn more space into quasi-containment units should the need arise, would be quickly overrun in a widespread outbreak.

In the event of a bird flu pandemic, federal officials estimate 30 percent of the population could fall ill — perhaps 90 million people.

Depending on the severity of the strain, 865,000 to 9.9 million could require hospitalization and 209,000 to 1.9 million could die, according to these estimates.

The Nebraska unit has not been used since it opened in 2005. The Fort Detrick one has been activated 20 times in 34 years for quarantine of people under observation for exposure to exotic hemorrhagic viruses such as Lassa fever and Ebola. The Atlanta unit, operated by the federal Centers for Disease Control and Prevention, has been used twice since it opened in 2002.

© 2006 The Associated Press.

Update from all over

Avian Influenza from USGS



H5N1 in Wild Birds
Unpublished data presented at a meeting in Singapore this week showed that in experimental infections of sparrows, pigeons and starlings, the H5N1 virus can be found in the respiratory and digestive tract. "Saliva swabs from the birds' beaks are much better for detecting bird flu virus particles, while fecal samples are the ‘least sensitive,’" Robert Webster of St. Jude Children's Hospital said, who presented the new data in Singapore. According to news reports, although there was viral shedding in inoculated birds, mortality was seen only in sparrows, but not in the starlings and pigeons. There was no transmission to other birds in all three species. Webster suggests that keeping small birds such as those tested in these experiments away from poultry is necessary so they do not carry the virus from chicken house to chicken house.

A mortality event at the Nalabana Bird Sanctuary at the Chilika Lake, on the eastern coast of India, has killed over 80 birds with another 277 sick. Birds involved are mainly pintails, but also included shovelers, gadwalls, bar-headed geese and sea eagles. The saline lake is habitat for as many as 300,000 migratory birds from as far away as Iran, Iraq, Afghanistan, Tibet, and Siberia. The cause of death has not been determined and H5N1 has not been ruled out.

The government of Myanmar announced this week that migratory birds stopping at the Maha Nanda Lake, near Shwebo are being observed as of last week to monitor for the possibility of them carrying bird flu into the country and the rearing of livestock in the area has been banned as a precaution.

In China, the Zhalong State Nature Reserve for the red-crowned cranes (Grus japonensis) has been placed on high alert according to Wang Wenfeng, the deputy head of administration at the reserve, because the reserve lies along a bird migratory route. The Zhalong reserve is China's largest artificial breeding preserve for the highly endangered red-crowned cranes.

H5N1 in Domestic Animals
A third outbreak of HPAI within the same month has been reported in Gimje, North Cholla province, South Korea. The farmer reported on 12/10/06 to the authorities that over 1,000 quail died over a 4-day period. The farm raises over 290,000 quail. Some experts and local farms suspect the disease might have spread along the major local highway, Route 23, but an unnamed provincial official is quoted in a Korean news report as saying “Quail are hardy birds, and it seems the infected birds got the virus from migratory birds at the same time as the poultry in Iksan and fell ill after the full incubation period of 21 days." Before the movement of poultry from the farm was halted, over 100,000 quail eggs had been sent to market. Quail eggs are not washed before sale and authorities fear the fecal contamination might contain virus. Also, 15,000 young quail were sent to a farm in Koksong, South Cholla on 12/9/06. No evidence of disease has been reported at Koksong; 360,000 poultry within 500 m of the Gimje farm will be culled. So far, over a million birds have been or will be culled in the three outbreaks this year in South Korea.

The Veterinary Department in Vietnam announced that the country has not had any H5N1 outbreaks for over a year. The last outbreak, according to the news report, was 12/15/2005.

H5N1 in Humans
There were no new human cases this week.

Mold the culprit in duck deaths

USDA: Moldy Grain, Not Bird Flu, Caused Idaho Duck Deaths

WASHINGTON (Dow Jones)--Moldy grain, not bird flu, caused a large mallard duck die-off in Idaho, a U.S. Department of Agriculture spokeswoman said Friday. Tests conducted at the National Wildlife Health Center, which is operated by the U.S. Geological Survey, found no avian influenza, said USDA spokeswoman Angela Harless.

Instead, it’s been determined that the birds were sickened by eating mold on corn, she said. Mold produces a toxin that can sicken wildlife when ingested. As many as 2,500 mallard ducks died along a southeastern Idaho creek bed, state officials have said.

The ducks mysteriously began dying last week around Land Springs Creek, about 180 miles southeast of Boise. Mark Drew, a wildlife veterinarian with the state Department of Agriculture told The Associated Press earlier this week the ducks likely were exposed to a single contamination source and gathered at the creek, their mutual roosting point, to die.

State officials had said since the investigation into the die-off began that bird flu was unlikely to be the cause.

How Nebraska prepares

Avian Flu Preparations
Human outbreak called likely

Nebraska health officials continue to gear up for what many experts say is inevitable -- a human outbreak of avian flu.

Pandemic Preparedness

Dr. Taronna Maines, a microbiologist with the CDC, conducts an experiment with an H5N1 avian influenza virus.

Nebraska, which has received national recognition for its pandemic planning, has been aggressively preparing for bird flu for the past two years. The government's most recent efforts include implementing a statewide surveillance system, talking with communities about the effects of an outbreak and testing wild birds for signs of the disease.

"We have been working very diligently on this for a long time," said Dr. Joann Schaefer, the state's chief medical officer. "There's always room for improvement. There's always room for more planning.

"I would be hesitant to say we would ever be fully prepared," she said.

Schaefer highlighted Nebraska's new surveillance system as a unique tool in pandemic preparedness. It could be used as a prototype for other states.

The computer model monitors factors such as absenteeism at schools and businesses, weather patterns and animal behavior, alerting health officials to anomalies.

For example, dead birds found in the same area where a large number of students are ill may indicate an avian flu outbreak.

Most human cases of the virus have been linked to close contact with sick birds or their droppings carrying the H5N1 strain. Experts fear the virus could mutate into a form that spreads easily from person to person, causing a worldwide pandemic.

The human strain of bird flu will be "a brand new virus that we've never seen before," said Sharon Medcalf, the associate director of the state's Center for Biopreparedness Education. "It happens to be a very lethal one."

The U.S. Department of Health estimates 209,000 to 1.9 million Americans could die in a pandemic situation. In Nebraska, that figure is projected to be 1,181 to 10,832.

Until the human strain emerges, researchers cannot create a vaccine specifically for it. Two anti-viral medications, Tamiflu and Relenza, are believed to be effective in treating bird flu.

The federal government has allotted Nebraska 258,923 doses of vaccine, according to Leah Bucco-White, a spokeswoman with the state Health Department.

The state Legislature, she said, will be asked to authorize the purchase of 45,600 more.

Lt. Gov. Rick Sheehy, who handles the state's homeland security efforts, said Nebraska has a universal plan in place to respond to emergencies as varied as terrorist attacks and pandemics.

"We have a great plan in place," he said, adding that the government needs to continue to educate emergency responders and the public about how to respond to a pandemic.

When that pandemic could emerge is anyone's guess.

Michael T. Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said a human outbreak could surface tomorrow or four to five years down the road.

It's "not a matter of if, just when and where," he said.

The H5N1 virus, he said, is developing the same way the Spanish flu did in 1918. That virus moved from birds to other animal species and then to humans.

Fifty million to 100 million people are believed to have died worldwide from the Spanish flu. An estimated 1,500 died in Nebraska.

Medcalf said the United States should be on alert for avian flu this winter as birds travel south from Alaska. Those birds, she said, have been mingling with birds from southeast Asia and could carry bird flu.

The Nebraska Game and Parks Commission is already on the lookout for infected birds.

Since June, more than 2,000 samples have been taken from Canada geese, mallard ducks and other migratory birds in Nebraska, according to the commission.

All of the samples have tested negative for H5N1, said Mark Vritska, manager of the commission's waterfowl program.

Nonetheless, Nebraskans are being told to prepare.

Bucco-White said the Health and Human Services System is stressing "personal preparedness."

Be prepared!

Flu preparation is critical

By The Sentinel, December 17, 2006

The state and federal governments are planning for it. The world, through the United Nation's World Health Organization is, too.

Now local emergency response agencies are asking: What are you doing to prepare for a possible flu pandemic?

If we learned anything from disasters such as Hurricane Katrina, these local leaders point out, it's that the best defense in times of trouble is the planning and preparation you do at home - well ahead of time.

Few alive today remember the great flu pandemic of 1918, but the lessons of that history are harsh. The so-called Spanish influenza claimed 50 million lives worldwide, half a million in the U.S.

In Pennsylvania, according to information provided by the U.S. Department of Health & Human Services on its Web site, www.pandemicflu.gov, the flu struck quickly and without warning.

On Sept. 27, 1918, a few cases were reported. But by Oct. 4, disease was epidemic in Pittsburgh and Philadelphia. Nearly 15,000 cases were counted in the first 18 days of October.

In the hardest-hit city, Philadelphia, essential services collapsed, as police officers, firefighters, garbage collectors and city administrators succumbed.

In many ways, we may be even more vulnerable to a pandemic today. Our food distribution system is complex, with food sources hundreds and thousands of miles away. The majority of us depend on public utilities to supply our homes with heat, light and water. What would we do if there were no one to drive or unload the trucks, stock the shelves or operate the plants?

If we aren't prepared, our lives - apart from the flu - would be at risk.

In Cumberland County, a Pandemic Action Community Task Force began meeting in November. Last week, it started getting the word out that, while people shouldn't panic, they should do a better job of anticipating what could happen.

And it's not just the flu to be feared, notes the county's chief of public safety, Eric Hoerner: “If we had a winter storm coming through that closes the roadways or causes a long-term power outage, you would need the same supplies as for avian flu planning.”

Preparation is simple - stockpile two to four weeks' worth of nonperishable food, water, prescription drugs, medical supplies and sanitizers.

And watch for the 12-page guide the task force is issuing in January to educate the public. “Pandemic Flu” covers symptoms, the nature of the disease, what a pandemic would be like, preparedness, prevention, treatment and caregiving tips.

The task force plans to distribute 20,000 copies at post offices and other places were people are likely to come across it.

Hopefully, the best-laid and best-executed plans will never be needed. But in case a widespread disaster such as a pandemic were to strike our area, it's far better to be ready.

Flu shot research has implications for bird flu

SCIENCE NEWS
December 13, 2006
Flu shot doesn't need perfect virus match, study says

By Gene Emery

BOSTON (Reuters) - The annual influenza vaccine can protect against illness even if it isn't perfectly attuned to the flu strain going around, researchers said in a finding that may have implications for protecting people against bird flu.

Flu viruses mutate over time, a process called "drift." So viruses that sweep across the country may not always be those selected each February as the basis for the annual vaccine.

The study, to be published in Thursday's New England Journal of Medicine, found that the flu vaccine works even when drift has occurred.

Suzanne Ohmit of the University of Michigan School of Public Health and her colleagues found that in the fall of 2004, Sanofi-Pasteur's FluZone vaccine was 77 percent effective and MedImmune Inc.'s Flumist worked in 57 percent of the cases even though the flu strain making the rounds that year was not selected for the vaccine.

"We were surprised to learn that it worked as well as it did in a year when we might have thought it would have been less effective," said Arnold Monto of the University of Michigan School of Public Health, another member of the team. "It is ideal to have a vaccine match what is circulating. But even when it doesn't match exactly, you can get protection."

Monto told Reuters that the finding carries lessons for treating the predicted bird flu pandemic. Researchers are working on a vaccine, but there is no guarantee that the virus will match the strain that causes an outbreak.

Instead of stockpiling the vaccine, it might be wise to start inoculating people now, he said.

'PRIME THE PUMP'

Bird flu is expected to be so novel nobody will have any immunity to it, said Monto. As a result, people are going to need two doses of the vaccine, just as children who have never been exposed to regular influenza need two doses of the flu vaccine to be protected.

"Because we're all naive to this and we're going to be all like little children," he said, "it may be wise for us to get the first shot of whatever's available, which may give us some protection and will, in that case, prime the pump" and make inoculation more effective when a properly tuned vaccine is distributed.

A second team of investigators, also reporting in the Journal, said that when school-age children are vaccinated against the flu, it blocks the spread of illness to others.

James King of the University of Maryland and his colleagues gave the inhaled Flumist vaccine to nearly half the children in schools in Maryland, Texas, Minnesota and Washington state a year ago. MedImmune sponsored the test.

While 52 percent of the children developed a fever or flu-like illness in the schools where the vaccines weren't given, the rate was 40 percent in the schools where many of the youngsters were vaccinated. A similar decline in illness was seen in the adults in those families.

"Despite vaccinating less than half the kids, we showed an impact on all the families in that school, not just the targeted kid," King told Reuters.

He said universal vaccination of healthy youngsters in elementary school should be strongly considered.

"You're protecting the kids but more importantly you're protecting the families and communities," he said.

King added that school-based vaccination programs would also create a system making it easier to vaccinate the rest of the population if a bird flu pandemic loomed.