One voice, one opinion

Sad editorial from Bangladesh

Protect our small farmers from bird flu
SM Abdur Rahman

The problem: Bird flu has now spread from Biman's farm in Savar to seven districts. If the spread of this virus is not stopped, it will eventually wipe out all the small poultry farmers in Bangladesh. Small farms are owned by rural families, and have been set up with minimal investment. They are extremely vulnerable to bird flu infection for the following reasons:

* Small farms have open sheds, which are easily infected (because wild birds can easily enter the sheds).
* They sell their eggs and broiler chickens to traders. Traders' vehicles visit many farms everyday, and manure sticks to their wheels. As manure from infected farms carries the bird flu virus, the movement of traders' vehicles can spread bird flu very quickly from one farm to another.

Large poultry farms are far better protected against bird flu infection because they have invested in bio-secure facilities (facilities into which bacteria and viruses cannot easily enter).

* Large farms have closed tunnel-ventilated sheds. Closed sheds are unlikely to become infected by wild birds.
* Large farms own their own vehicles, whose wheels are washed and disinfected before they enter the farm. So large farms are less likely to be infected by vehicle movement.

Of course, the outbreak at Biman's farm proves that a large farm that is poorly managed (i.e. which has not implemented the above bio-security measures) can still become infected.

The initial outbreak at Biman was probably caused by a combination of two factors: poor bio-security (open poultry sheds) and the presence of large numbers of migratory waterfowl (which can carry the bird flu virus) on the nearby Jahangirnagar University campus.

The solution: To protect the livelihoods of small farmers, the spread of bird flu must be stopped. This can be accomplished by implementing the National Avian Influenza Plan (prepared last year with FAO/WHO assistance).

The plan requires the government to take strong action whenever there is a bird flu outbreak on any farm.

1. A no-movement zone must be established within a 10 km radius of the outbreak. No chickens, eggs or chicks can be allowed to leave this no-movement zone.

2. All chickens (backyard and farm) within a 3 km radius of the outbreak must be culled (killed). Even if these chickens appear healthy, it is likely that they are already infected. Culling them is necessary to stop the spread of the virus.

3. Farmers whose chickens are culled must be compensated, or they will not cooperate with the culling program.

Unfortunately, the plan has not been fully implemented in handling any of the outbreaks to date.

* Culling of poultry was carried out within 1 km of the Biman outbreak. This is less than the 3 km radius suggested by the plan.
* A 10km no-movement zone was not immediately established. This is why the disease has spread to so many districts after the original Biman outbreak.
* Subsequent outbreaks in Tangail, Jamalpur, Naranyanganj and Jessore were handled even more poorly. Poultry present within 1 km of infected farms were not culled, and a 10 km no-movement zone was not effectively established.

Necessary steps: The government is apparently not implementing the National Avian Influenza Plan because shortage of funds is making it difficult to compensate farmers. Without compensation, the culling policy cannot be implemented, and the spread of bird flu cannot be stopped. Funds must be requested from donors so that farmers can be compensated.

However, if that is the government's decision, it should be implemented strictly in all outbreaks. If the culling policy is to be less conservative, establishment of a 10 km no-movement zone becomes even more critical. These zones must immediately be established whenever and wherever there is a new outbreak.

S M Abdur Rahman is a freelance contributor to The Daily Star.

Be sure you know how to use that mask...

Study shows knowledge gaps in N-95 respirator use

Apr 9, 2007 (CIDRAP News) – N-95 respirators are regarded as a key tool for protecting people from airborne influenza viruses in the event of a pandemic, but a recent study suggests that without special instruction, most people are likely to wear the devices incorrectly, limiting their effectiveness.

To gauge the public's current knowledge of how to use N-95 respirators, the researchers randomly questioned 538 people in New Orleans about their experience with the devices during hurricane clean-up and asked them to demonstrate putting on a respirator. Conducted by occupational safety experts from the Centers for Disease Control and prevention, the study appears in an early online edition of Emerging Infectious Diseases.

N-95 respirators, designed to stop at least 95% of small airborne particles, are used, among other purposes, to prevent the transmission of communicable diseases in healthcare settings and to reduce exposure to mold during flood cleanups. Donning a respirator improperly is likely to promote the leakage of unfiltered through gaps between the respirator and the skin, the authors note.

Among those interviewed for the study, 42% (233) had used a certified respirator for mold clean-up after Hurricane Katrina and 35% (192) had used N-95 models.

The respirators used in the study included written and pictorial instructions, but the volunteers were not given any additional instructions before putting them on, the report says.

In watching participants don the respirators, investigators found that only 24% (129 of 538) wore the devices properly. The most common errors were not tightening the nose clip (71%), incorrectly placing the straps (52%), and wearing the respirator upside down (22%).

Factors associated with properly wearing an N-95 respirator included male gender, Caucasian race, and being a homeowner. Proper donning technique was also associated with having had previous experience with respirators, including owning them and undergoing fit testing.

The researchers concluded that educational efforts, particularly in the workplace, could increase the public's knowledge of proper N-95 respirator use and that labeling on the respirators (as opposed to separate instructions in the package) could promote proper donning technique.

"A unique opportunity exists to enhance protection of the public through interventions, such as educational campaigns, training sessions, and respirator design modifications, aimed at improving the public's ability to don a respirator correctly," the authors write.

The US Department of Health and Human Services (HHS) has stockpiled 20 million N-95 respirators for use during an influenza pandemic and plans to add 87 million more by the end of September, according to information on the HHS Web site.

Cummings KJ, Cox-Ganser J, Riggs, MA, et al. Respirator donning in post-hurricane New Orleans. Emerg Infect Dis 2007 May (early online release);13(5): [Full text]

CSULB has plan too!

Campus emergency plan isn't for the birds
Jonathan Oyama
Issue date: 4/10/07 Section: News



There is an emergency plan for Cal State Long Beach students should there be an avian flu outbreak, said a representative of the Housing & Residential Life office Monday.

Although the avian flu has not yet been carried over into the United States, as was predicted would happen in October of last year, there have been more than 200 reported cases of the avian flu in Asia from 1997 to 2006.

Director of Housing & Residential Life Stan Olin said that Maryann Rozanski, director of Safety, Risk Management and Information Security, was involved in the planning in case the avian flu spreads to CSULB.

According to Olin, Rozanski was the representative in a task force meeting at the CSU system Chancellor's Office. In the meeting, Rozanski and other representatives of the CSU system discussed what to do in case an avian flu outbreak occurs.

"CSU as a whole was trying very hard not to ignore this," Olin said. "What they had done essentially was set up lines of communication and some scenarios of what we could do if [an avian flu outbreak occurs]."

Olin said that if the avian flu spreads to the CSULB campus, the university's Emergency Operations Center has a response team that would handle the campus in case of a disaster and form a plan. University Police Chief Jack Pearson would head the center.

The Emergency Operations Center's plan states that if a disaster occurred, Pearson or his designee, Sgt. Scott Brown, would be responsible for activating the Emergency Operations Center. He would then ask the incident commander, CSULB President F. King Alexander, to start the plan.

Olin also said that one of the most difficult aspects of planning in case of a future disaster is that no one can predict what will actually happen in an emergency situation.

"If something bad happens, what we don't know is which people are going to get sick, who's not going to be here, how many people are going to be sick," Olin said. "So you have a little trouble making exact plans."

The avian influenza virus is found in wild birds' intestines and is very contagious among birds, according to the Centers for Disease Control and Prevention (CDC) Web site. The virus is spread through infected birds' saliva, nasal secretions and feces.

The CDC Web site also states that symptoms of avian influenza include typical symptoms of the flu, as well as eye infection, pneumonia, severe respiratory disease and other severe and life-threatening conditions.

However, Health Resource Center Coordinator Nop Ratanasiripong said that it is very unlikely that the avian flu would spread from Asia to Long Beach.

"It will be very unlikely, because…we have a very good prevention plan with the department of health of Long Beach," Ratanasiripong said. "The poultry industry is also very careful on [handling] poultry products like chickens, ducks and those kinds of things."

Ratanasiripong said that the FDA has regulations for foods imported into the United States and that the food is tested carefully.

Bird flu and the University

University Of Alaska Fairbanks Awarded $3.8M For Bird Flu Research
Main Category: Bird Flu / Avian Flu News
Article Date: 10 Apr 2007 - 1:00 PDT


The University of Alaska Fairbanks has announced a $3.8 million award for its role in one of six National Institutes of Health Centers of Excellence for Influenza Research and Surveillance to study influenza viruses with pandemic potential, such as avian influenza H5N1.

UAF is a partner in an $18.5 million NIH National Institute of Allergy and Infectious Diseases award made to the University of California, Los Angeles for creation of the Center for Rapid Influenza Surveillance and Research.

"Our initial focus is on known avian reservoirs of influenza-A viruses such as waterfowl and shorebirds," said Jonathan Runstadler, Institute of Arctic Biology assistant professor of biology and wildlife and the lead CRISAR investigator for UAF. "However, little is known about the role of the environment and about other groups of birds in the maintenance and evolution of influenza viruses worldwide.

"We want to understand how influenza viruses evolve, adapt and are successfully transmitted in nature," said Runstadler. "No one fully understands how these viruses move around between species and in our environment."

"Alaska is recognized as a prime location for transmission and reassortment of influenza-A virus strains between birds that migrate north from both eastern and western hemispheres," said George Happ, CRISAR co-investigator and director of the NIH IDeA Network for Biomedical Research Excellence at UA, which has supported UAF's avian influenza work since 2004.

More than 450 species of migratory birds from six continents come to Alaska to nest each spring and summer. Scientists say that could provide an opportunity for exchange of bird flu viruses which could then infect humans.

"Our major goal is to understand the genetic changes of flu viruses and how those changes relate to their success in animal hosts and their persistence in the environment," said Happ. "Alaska is a critical location to study the evolution of new strains of influenza in wild birds and their movement along avian flyways. The research of Kevin Winker at the University of Alaska Museum of the North and of our CRISAR group will include surveillance to isolate potentially pandemic strains of the influenza virus."

UAF researchers expect to collect and test 4,000 samples from Alaska and another 4,000 samples from Russia and northern Japan each year for five years beginning this May. Fieldwork in the Russian Far East will be coordinated by Falk Huettmann, IAB assistant professor of wildlife ecology. Samples which test positive will be further characterized by the CRISAR group that includes UAF; University of California, Davis; UCLA; Wildlife Conservation Society; and the Los Alamos National Laboratory.

"At UAF, we will use the genetic information from UC Davis to continually refine existing studies and develop new research on the ecology of the influenza virus and the immune response of birds," Runstadler said.

The CRISAR partners together plan to collect and screen at least 20,000 cloacal samples from wild and domestic animals at key sites in the western United States and Asia each year.

###

Morbus escensio

New Bird Flu Findings in Indonesia and Egypt
USAgNet - 04/10/2007

A new case of bird flu has been reported in Egypt as Indonesia reports its 74th human death from the disease. A 15-year-old Egyptian girl has been diagnosed with bird flu, according to media reports. The teenager, Marianna Kameel Mikhail from Cairo's Shubra district, was admitted to hospital last Thursday.

She is being treated with Tamiflu and is apparently in a stable condition; she had, it seems, been in contact with infected birds.

This is Egypt's 34th human victim of bird flu. Thirteen Egyptians have died.

Indonesia, meanwhile, has confirmed a 29-year-old man died of H5N1 bird flu infection, according to reports from various media outlets. This is the 74th human death in Indonesia from the virus.

Government officials say the man was hospitalized for nearly a week before passing away last Thursday. The man lived in Central Java Province, and officials believed that he might have contracted bird flu through close contact with infected poultry.

Nature continues on relentlessly

Indonesian man dies of suspected bird flu


An Indonesian man who has developed bird flu symptoms died Thursday at a hospital in the Central Java town of Solo and could be the 73th bird flu casualty in the country if his blood sample is tested positive.

The patient, identified only as Suramto, 29, died at the Moewardi Hospital after being treated since March 30, reported leading news website Detikcom.

His body was packed in a plastic bag and relatives were banned from opening the coffin, a standard procedures for bird flu victims, the report said.

Source: Xinhua

Good idea, now let's just do it!

State seeks volunteers for future disaster duty

By Staff and wire reports, April 4, 2007

Last updated: Wednesday, April 4, 2007 3:20 PM EDT
*

HARRISBURG — The state Health Department wants to know who would be willing to lend a hand in the event of a statewide emergency as it joins a nationwide effort to establish a registry of potential volunteers.

The department on Tuesday unveiled the State Emergency Registry of Volunteers in Pennsylvania, or SERVPA, during a news conference on emergency preparedness. The online registry will help the state build a database of volunteers with a wide range of backgrounds — including doctors, nurses, contractors and law enforcement — who can be mobilized when disaster strikes, Health Secretary Dr. Calvin B. Johnson said.

“If you have a skill or service to provide that may well be needed in the event of a disaster... we would love to have you be a part of it,” Johnson said.

The system is intended primarily for the registration of health care professionals, but states have the option of broadening their volunteer bases, Wolfson said. At least 24 other states have established registries, including Florida, Ohio, Michigan and New Jersey, he said.

The federal government’s focus on health professionals is a tip-off, according to Karen Kirk — a member of a committee organized by Cumberland County Emergency Services to prepare for the potential of an Avian flu pandemic.

“It’s a subtle point, but you’ve hit the nail on the head if you think this is aimed at Avian flu,” Kirk says. She contends there are other subtle indicators that Avian flu is a real threat.

Kirk says she saw a poster in a drug store advertising “normal tips” for avoiding seasonal flu. At the bottom of the poster, in small print, was a Web site for information on Avian flu pandemic. Kirk says larger packages of products like rice, flour and sugar are appearing on grocery store shelves — another subtle hint, she says.

“Everyone is being careful not to cause a panic,” Kirk says. But she believes official sources must become more aggressive in educating the public about the difference between seasonal flu and pandemic flu, and increasing public awareness of the potential for disaster.

Checking in advance

Tom Moriarty, another member of the county committee, has a different perspective.

He says conditions in the aftermath of Hurricane Katrina in August 2005 fuel the volunteer registry effort as a tool for any disaster.

He says the goal is to line up people with specific backgrounds who may not be retired or no longer working in their profession.

“After Katrina, doctors and nurses came to the disaster area, but they were not allowed to help because they weren’t certified in that place,” Moriarty says. “Doing this in advance will create a roster of professionals. The advance training will be to identify what a large-scale disaster will look like. How things will be handled differently if you have 10,000 people who have to be treated quickly.”

All 50 states are developing statewide volunteer registries under legislation passed by Congress in 2002 in response to the Sept. 11, 2001, terrorist attacks and the anthrax attacks that followed. The federal government is spending about $10 million on the program, dividing the money about evenly among all the states.

“There was such an outpouring of people that wanted to help, they said, ‘We really need a way of tracking them,”’ said Marc Wolfson, a spokesman for the U.S. Department of Health and Human Services.

Eliminating confusion

Pennsylvania’s online registration takes about 10 to 15 minutes. Registrants are asked whether they belong to or would like to join medical-assistance teams, how far they are willing to travel, and their occupations.

“We’d like to get people in there ahead of time, so we can check their credentials, we can do background checks, and we can even provide them with some advanced training ... so they’re prepared to deploy,” said Meghan Treber, director of the state Office of Public Health Preparedness.

Evaluating volunteers’ credentials is a critical component of the program, Johnson said. He noted that in situations such as the terrorist attacks and the aftermath of Hurricane Katrina, emergency responders sometimes had difficulty accepting help from people who simply arrived on the scene.

“Without (prior) knowledge of their skills, of their legitimacy as health-care providers or other skills, it’s hard to use them as effectively and appropriately as possible,” Johnson said. “Preparation for that in this kind of registry eliminates that kind of confusion.”

Who am I to judge?

Results today; Shatti ‘mum’ on ‘bird flu positive’

KUWAIT CITY: Kuwait on Wednesday sent samples of the four Bangladeshi bird handlers to WHO laboratory in Cairo for confirmation of test results conducted in Kuwait, says Dr Ahmad Al-Shatti, spokesman for the Health Ministry. According to Dr Al-Shatti, the test results are expected on Thursday. The four workers were earlier referred to the Infectious Diseases Hospital after they showed bird-flu symptoms. Dr Al-Shatti refused to be drawn into the outcome of the preliminary tests conducted in the country. “We have sent the samples of the bird handlers to the WHO laboratory in Cairo and unless we get the results, I am not in a position to say anything. We are the sole body entrusted with announcing the outcome of positive cases of bird flu both in humans as well as in birds,” he added.

Describing the bird flu situation in the country as under control, Dr Al-Shatti said: “The bird handlers are in good health and there is no cause for concern. We have plans in place to deal with any emergent situation.”
Kuwait has so far not detected any human bird flu case. Kuwait reported outbreak of bird flu in late February and since then the authorities are combating the disease on a war-footing.
In this regard, around 1.6 million birds have been slaughtered and the four bird handlers were members of a team that is tasked with slaughtering birds mainly in Wafra area, where a majority of the positive cases were discovered.
Kuwait has around 10 million capsules of Tami flu, an anti-viral drug. Since the outbreak of bird flu in the country, the authorities have shut down the bird market in Shuwaikh in addition to banning sale of poultry products in all residential areas.
The Public Authority for Agricultural Affairs and Fish Resources together with the Ministry of Health (MoH) have formed numerous teams which visit farms across the country in order to fumigate and take samples of birds.
Agencies add:
A total of 106 cases of the strain have so far been confirmed in birds.
In November 2005, the Gulf state announced the first case of a bird infected with the H5N1 strain — a flamingo at a seaside villa.
The H5N1 strain, the most aggressive form, has killed 170 people worldwide, according to WHO, and seen millions of birds destroyed.
H5N1 is an avian influenza subtype with pandemic potential, since it might ultimately adapt into a strain that is contagious among humans.
According to samples tested by Health Ministry, no human bird flu cases were confirmed in Kuwait within the last 24 hours, said Dr Al-Shatti.
Last night, he said, the committee held its annual meeting headed by Health Minister Dr Maasouma Al-Mubarak and reviewed reports submitted by the ministry and Public Authority for Agriculture Affairs and Fish Resources (PAAAFR) regarding the flu’s latest developments.

The committee was informed about the referral of four Asian workers who interacted with birds to the Contagious Diseases Hospital, said Al-Shatti who noted that a total of 22 persons were referred to the hospital during the last five weeks. Al-Mubarak informed the committee about Kuwait leadership’s decision to compensate the owners of birds for their losses and PAAAFR’s assignment of setting guidelines for these compensations. The committee’s members lauded these steps, hoping they would boost cooperation and precautionary measures against the disease.

By Francis A. Clifford Cardozo
Arab Times Staff

So many involved in poultry industry

Bangladesh says bird flu spreads despite struggle
04 Apr 2007 13:01:04 GMT


DHAKA, April 4 (Reuters) - Bangladesh said on Wednesday that bird flu had spread to a new poultry farm despite the best efforts of struggling veterinary and health workers.

"The latest farm confirmed to have H5N1 virus is in northern Jamalpur 200 km (125 miles) from the capital Dhaka," an official of the Fisheries and Livestock ministry said.

Some 72,000 chickens have been culled so far from 26 farms since the avian influenza was detected in six farms at Savar near the capital March 22.

More than 500 workers at the infected farms have been given a local version of the Tamiflu anti-viral drug as a precaution, health ministry officials said.

No humans have tested positive for the disease in the country.

Bangladesh says it has sufficient Oseflu, a local version of Tamiflu, produced and marketed by a local firm since last year.

At least 170 people have died of bird flu in 11 countries, mostly in Asia, since 2003.

Health experts fear the virus could trigger a pandemic if it mutates to form a strain that can transmit between humans.

Bangladesh has 125,000 small and large poultry firms producing 250 million broilers and 6 billion eggs annually.

About four million Bangladeshis are directly or indirectly associated with poultry farming.