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Posted by Nancy Nurse on Wednesday, September 27, 2006 11:27:24 AM
Bird flu case confirmed in possible cluster

The Jakarta Post, Bandung, Jakarta

Health officials said Tuesday they were examining possible intra-human transmission of bird flu in West Java, where a hospitalized 20-year-old male resident of Bandung tested positive for the virus.

It brings bird flu cases to 67 in Indonesia, which holds the world record of 51 deaths, including 40 this year.

The director of Hasan Sadikin General Hospital in Bandung, Cissy Rachiana Prawira, said Tuesday the central laboratory in Jakarta confirmed the young man was infected with H5N1.

His 23-year-old brother had died Sunday afternoon before he could be taken to hospital for testing. Their sister, aged 15, was admitted to the hospital Monday night after developing a fever and cough.

It has led to speculation that it is a cluster infection, with the family possibly infected from the same source.

Hadi Jusuf, who heads the bird flu team at Hasan Sadikin, said the younger brother's condition had not improved since his treatment began in an isolation ward at the hospital.

He remains unconscious and showed signs of respiratory distress, Hadi said. His white blood cell level is still under 2,000.

"He's still on a ventilator and we are watching him closely. The pneumonia which was previously only found on the lower side of his left lung has now spread to both sides."

The parents of the three are still in shock, especially with the investigation into their eldest son's infection with H5N1 focusing on the family's feeding of dead chickens to their dogs.

"I don't want my youngest child to be sick either. That's why when she complained that she had fever, headache and cough, I immediately took her to the hospital," the mother told journalists at home, as the Bandung agriculture office took blood samples of 13 chickens and four ducks they kept to see if the animals were infected with H5N1.

The head of the Bandung health office, Gunadi S. Bhinekas, said his office would increase its public awareness campaigns about bird flu and sanitation to keep the virus from spreading. Poultry infections in Bandung have been found in 14 subdistricts.

"We are working with the agriculture office to closely watch the slaughterhouses and to do mapping of the areas with bird flu cases in poultry."

The head of the Bandung agriculture office, Yogi Supardjo, said his office had difficulty in monitoring the traffic of poultry in the West Java capital.

"We can't monitor it all the time, so we're asking people to take the initiative to vaccinate their poultry and maintain proper sanitation."

Meanwhile, the Indonesian Committee for Bird Flu Control and Influenza Pandemic Preparedness said the government was investigating the latest bird flu fatality, a nine-year-old boy who died Friday in Jakarta.

The boy, believed to have had contact with sick chickens, died in a hospital nine days after he first showed symptoms of the virus, including high fever and difficulty breathing.

In a statement released on Monday night, the committee also urged local figures and leaders to be involved in the campaign to raise public awareness about bird flu.
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Heroin, not bird flu?

Posted by Nancy Nurse on Wednesday, September 27, 2006 10:49:37 AM



Bird flu man may have been drug courier




A man who sparked a bird flu scare when he became ill on a flight to Sydney from Vietnam may have been a drug courier whose illness was caused by a heroin-filled condom bursting in his stomach.

Neither the Australian Federal Police (AFP) nor the Ambulance Service of NSW would comment on media reports the man was a drug courier trying to smuggle heroin into Sydney.

Ambulance officers saved the man by administering Narcan, which is used to treat heroin overdoses, the reports on the Seven and Nine networks said.

The man, aged in his 30s, was placed in quarantine after being stretchered off a Vietnam Airlines flight which arrived at Sydney Airport from Hanoi via Ho Chi Minh city about 8.30am (AEST).

NSW Health Communicable Diseases director Jeremy McAnulty said initial tests at St George Hospital showed it was very unlikely he had the deadly avian influenza.

NSW Health Minister John Hatzistergos said he did not want to comment on the matter as the AFP had become involved.

The AFP said the man was a person of interest but would not comment on the drug courier allegations.

"This man is now a person of interest to the AFP and investigations are continuing," a spokesman said.

Dr McAnulty said the man's recent history of being in an area with chickens in Vietnam and having a previous influenza-like illness had sparked concern when he arrived in Sydney.

"It turns out that is a very unlikely diagnosis," Dr McAnulty told reporters.

"But the person's still being assessed in hospital.

"Our concern is whether a person has a quarantinable disease or avian influenza and at this stage it seems very unlikely that that's the case."

Mildly unwell when he boarded the plane, the man had become "difficult to rouse" when the flight touched down in Sydney, Dr McAnulty said.

Quarantine officers wearing protective clothing had boarded the aircraft, isolated the man and escorted him to a waiting ambulance.

He said even if the man had contracted avian flu, the chances of his travelling companion or other passengers being infected were extremely low.

"At this stage we think that the likelihood that he'd be infectious to other people is extremely low," he said.

"However, if that changes, then we have mechanisms in place to follow up other passengers, but at this stage we don't believe (there is) any risk.

"... the risk of person-to-person transmission is extraordinarily low. There's only really been one or two of those possibilities around the world in the past."

The federal government has developed a detailed plan to combat the flu if it reaches Australian shores.

About 50 million surgical masks and 40 million syringes have been stockpiled along with mass quantities of anti-virals including Tamiflu, widely regarded as the best drug for combating bird flu.

© 2006 AAP
Brought to you by aap
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Lengthy, but good, article on bird flu

Posted by Nancy Nurse on Wednesday, September 27, 2006 10:19:36 AM




Health
Bird flu: A threat to humanity
By Mehdi Pervez
Sat, 23 Sep 2006, 10:07:00



Over centuries natural calamities have hit this earth in many shapes. Sometimes in the form of floods sometimes in the form of volcanic eruptions and sometimes in the form of epidemic of deadly diseases. Every instance has caused the lives of hundreds and thousands of human lives. Even at the prime time of medical science an old disease is re-emerging with its deadliest threats. We are thinking about none other than bird flu. Bird flu is nothing new or uncommon. It first pandemically occurred in 1918 immediately after World War I and killed more than 40 million people. The later outbreaks were in 1957 and 1968. All of the attacks from bird flu killed about 100 million people around the world. Though this is not actually a human disease but its scourge of killing 10 crore people in only 87 years is a fearful matter. For more than a century, bird flu has circulated among birds, particularly domesticated fowl, but recent attention has been called to avian influenza since some strains infected humans. No longer is bird flu relegated to pigs and birds, as the virus has strengthened and mutated, resulting in a contagion that can move from bird to human. Human cases of bird flu have caused infections and death across the globe as scientists struggle to identify the dangerous strains and prevent a fatal pandemic.

Now let us discuss some of the microbiological aspects of Flu Virus. "Flu" is short for "influenza". The name goes back hundreds of years when the disease was thought to be caused by supernatural "influences". Many describe any nasty lung infection as flu, but only specific lab tests can give a proper diagnosis. There are several different viruses (and bacteria) which may infect the lung, but true flu is caused by orthomyxoviruses, of which there are three types, designated A, B, and C. An influenza virion has about 500 "spikes" sticking out from its lipid envelope. About 80% of the spikes are a glycoprotein peplomers-rod shaped viral protein called hemagglutinin (or simply, HA) which are homotrimers of class I membrane glycoprotein's. This was first identified by its ability to cause red blood cells, which carry a molecule called "heme", to agglutinate (stick together). We now know that HA is influenza's receptor-binding protein. It plays the critical role of attaching the virus to the host cell. The other 20% of the spikes are a mushroom shaped viral protein called neuraminidase (NA), which is tetramer of a class II membrane protein. This protein is an enzyme that destroys a host cell molecule called neuraminic (or sialic) acid. NA might play a part in getting the virus into the cell, but its most important function is that it helps the newly made influenza virions to easily escape from the host cell so they can infect others[1]. The virulent avian influenza H5N1 strains differ from other avian strains in that, there lies a link between HA cleavage and degree of virulence. In virulent strains the HAs contain multiple basic amino acids at the cleavage site, which are cleaved intracellularly by endogenous proteases. In contrast, in case of avirulent avian strains as well as non-avian influenza A viruses, the HAs lack the basic amino acid residues, hence not subjected to cleavage by such proteases. Moreover, all types of influenza A viruses are antigenically labile, well adapted to evade host defenses and lack mechanisms for "proof reading"; hence constant, permanent and small changes in antigenic composition are very common, which is known as antigenic drift. Another important characteristic of great public health concern is antigenic shift which results from reassortment of genetic material from different species resulting in variability of HA spikes, keeping the basic structure of the virus constant [2].

Influenza viruses that infect birds are called avian influenza viruses. Only influenza A viruses infect birds, and all known subtypes of influenza A viruses can infect birds. However, there are substantial genetic differences between the subtypes that typically infect both people and birds. Within subtypes of avian influenza A viruses there also are different strains. 13 different kinds of HA and 9 different kinds of NA genes in type A influenza is known[3].

They evolve! Molecular evolution (the evolution of molecules) is a fascinating area of evolution and of prime concern to any scientist wanting to understand viruses and how they spread. All genetic material can mutate, that is change its nucleic acids. The mutations are random, but their selection is not. "Selection" is another word for how well they survive and reproduce. Selection ensures that the mutations that increase a virus' ability to survive and reproduce will be represented in even greater numbers in the next generation. Mutations are the "fuel" for evolution because they provide the genetic variation on which selection acts. This is simply Darwin's old theory of evolution by means of natural selection, but on a microscopic scale.

All influenza viruses (all orthomyxoviruses) have RNA as their genetic material. When RNA is replicated it tends to have more errors than when DNA is replicated. These extra errors provide extra mutations upon which selection may act. That means RNA viruses (not just influenza viruses but all RNA viruses) have a high mutation rate and can evolve quickly - faster than a DNA virus or even a DNA human! Over time these mutations accumulate and eventually the virus evolves into a new strain. This progressive accumulation of individual mutations is called antigenic drift, because the shape of the antigen (the viral protein) slowly drifts into a different shape with each generation of virus. Eventually they drift so much that the original antibody can no longer bind to it.. All viruses show antigenic drift, but RNA viruses mutate faster so they drift faster. Antigenic drift is responsible for many of the localized outbreaks of different strains of influenza, especially influenza B.

Importantly, type A - but not B or C - undergo a kind of gene swapping or genetic reassortment to give it its proper name. If a cell is simultaneously infected by two different strains of type A influenza, the offspring virions may contain mixtures of each parents' genes! This really complicates things and makes it very easy for influenza A to quickly evolve new combinations of HA and NA genes. To better understand what I mean you need to learn a little bit about how we keep track of all this reassortment. We know of 13 different kinds of HA and 9 different kinds of NA genes in type A influenza. All these different kinds have evolved by antigenic drift as described earlier. Any one virion can contain only one HA and one NA. For example then an influenza A strain designated H1N1 can be produced. (We drop the "A"s at the end to make it clearer.) Along comes another virus with different kinds of HA and NA genes, let's say it is H3N7. If these two different virions infect the same cell at the same time they may produce offspring not only like themselves (H1N1 and H3N7) but also with a mixed combination (H1N7 and H3N1).

This is only a small sample of the many possible new combinations that might be made. All eight segments may take part in the reassortment. These newly created mixed genomes are very different from their parents and (probably) have never been "seen" by your immune system - or for that matter, anyone else's. This form of viral evolution is called antigenic shift, to differentiate it from antigenic drift (which occurs slowly and without a change in the gene associations). These new combinations present us with such a unique strain of virus that our immune system has to start all over to make new antibodies to combat it[1].

Since now we have seen that there are many strains of flu virus. But the strain that is mostly infecting people since 1997 is the H5N1 strain. This strain, in many ways, different and dangerous from other flu strains which we will try to explain below.

A report by a World Health Organization (WHO) committee says avian flu may have a longer incubation period and is more likely to cause diarrhea than typical flu viruses are, among other differences.

Published in the Sep 29 New England Journal of Medicine, the review was written by experts from several countries, including Vietnam, Cambodia, Thailand, the United States, the United Kingdom, Hong Kong, and Myanmar. They reviewed 71 published studies and reports, including details on 41 confirmed human cases from Vietnam, Thailand, Cambodia, and Hong Kong.

Researchers from Hong Kong report that lung cells growing in a laboratory responded much more intensely to the H5N1 virus than to an ordinary flu virus, even though the viruses reproduced at about the same rate, according to the report published online by Respiratory Research.

The H5N1 viruses were "more potent inducers" of cytokines and chemokines-chemical messengers that trigger inflammation-than H1N1 viruses were, says the report by a team led by J.S.M. Peiris of the University of Hong Kong. A flood of inflammation-triggering chemicals released by the immune systems has been referred to as a "cytokine storm."

They found that all the H5N1 viruses caused cells to secrete significantly higher levels of IP-10 (interferon-gamma-inducible protein 10), interferon beta, a type of T cell known as RANTES, and interleukin-6 than the H1N1 virus did. In addition, the 2004 versions of H5N1 caused cells to release more IP-10 at 6 hours than the 1997 version did.

"We have found that infection with H5N1 viruses led to the production of 10 times higher levels of cytokines from human cells than normal human flu viruses," said Peiris, as quoted Nov 12 in The Standard, a Chinese business newspaper.

The most alarming news about this H5N1 virus is that, Scientists reported findings which may help explain what made the 1918 pandemic influenza virus so deadly and that reveal similarities between that virus and the H5N1 avian influenza virus now circulating in Asia. The 1918 flu pandemic, regarded as the worst in history, killed as many as 100 million people

"The new studies could have an immediate impact by helping scientists focus on detecting changes in the evolving H5N1 virus that might make widespread transmission among humans more likely," the statement said[4].

Avian influenza viruses circulate among birds worldwide. Certain birds, particularly water birds, act as hosts for influenza viruses by carrying the virus in their intestines and shedding it. Infected birds shed virus in saliva, nasal secretions, and feces. Susceptible birds can become infected with avian influenza virus when they have contact with contaminated nasal, respiratory, or fecal material from infected birds. Fecal-to-oral transmission is the most common mode of spread between birds.

Most often, the wild birds that are host to the virus do not get sick, but they can spread influenza to other birds. Infection with certain avian influenza A viruses (for example, some H5 and H7 strains) can cause widespread disease and death among some species of domesticated birds[3].

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 virus[3]. Avian influenza A viruses may be transmitted from animals to humans in two main ways:

Ø Directly from birds or from avian virus-contaminated environments to people. Almost all these casualties were directly exposed to infected fowl, making contact with the virus through the birds' saliva, nasal secretions and feces, which become dry, pulverized and are then inhaled.

Ø Through an intermediate host, such as a pig[3].

A new study indicates that H5N1 avian influenza viruses are becoming less deadly to ducks, permitting them to carry the viruses for days or weeks and spread them to more susceptible birds and potentially to humans.

The findings "suggest that the duck has become the 'Trojan horse' of Asian H5N1 influenza viruses," says the report by an international team led by researchers from St. Jude Children's Research Hospital in Memphis. "The ducks that are unaffected by infection with these viruses continue to circulate these viruses, presenting a pandemic threat."

The researchers experimentally infected ducks with various H5N1 viruses, most of them dating to 2003 and 2004. About half of the infected ducks survived while shedding the virus for as long as 17 days, according to the report, published online today by the Proceedings of the National Academy of Sciences[4].

Avian influenza virus lacks the ability to 'hop' easily between people, which have probably helped to contain the problem. However, in the future, it is possible that the process of genetic reassortment could occur in a human who is co-infected with avian influenza A virus and a human strain of influenza A virus. The genetic information in these viruses could reassort to create a new virus with a hemagglutinin from the avian virus and other genes from the human virus. Theoretically, influenza A viruses with a hemagglutinin against which humans have little or no immunity that have reassorted with a human influenza virus are more likely to result in sustained human-to-human transmission and pandemic influenza. Therefore, careful evaluation of influenza viruses recovered from humans who are infected with avian influenza is very important to identify reassortment if it occurs[3].

Symptoms of Avian Influenza

Infected bird will get fever with rigor; diarrhea, paralysis then the bird will be unable to stand and keep the head up and ultimately die in 1-2 days[5].

The reported symptoms of avian influenza in humans have ranged from typical influenza-like symptoms:

1. fever (usually high)

2. headache

3. extreme tiredness

4. dry cough

5. sore throat

6. runny or stuffy nose

7. muscle aches

8. Stomach symptoms, such as nausea, vomiting, and diarrhea, also can occur but are more common in children than adults

9. Conjunctivitis is seen in some patients

Life threatening complications like viral pneumonia, respiratory distress syndrome, worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes and multi organ failure may result in the death of the patient[3].

Laboratory Testing Procedures

Rapid antigen detection by immunofluorescence assay and enzyme immunoassay, virus isolation by culture in HeP-2, RD cells or MDCK cell lines and identification by immunofluorescence assay using specific monoclonal antibody and haemagglutination inhibition assay have been used for diagnosis. Detection of influenza- specific RNA by reverse transcriptase-polymerase chain reaction, by using primer sets specific for HA sequence of influenza A/H5 and of N1 are some of the other tests that have been developed. Serological identification by measuring the specific antibodies by haemagglutination inhibition test, enzyme immuno assay and the virus neutralisation test, more specifically the micro neutralisation test, have also been developed. Following kits are presently available:

1. Immunoflourescence assay- WHO influenza reagent kit for the identification of Influenza A/H5 virus (1997-1998, 2003 or 2004 version) which includes influenza type A/H5- specific monoclonal antibody pool along with influenza B, A/H1 and A/H3 subtype specific monoclonal antibodies.

2. Virus culture - Madin-Darby Canine Kidney cells (MDCK). ATCC CCL34.

· Inactivated virus, goat serum to A/Term/South Africa/61/H5, and chicken pooled serum to A/Goose/Hong Kong/437-4/99.

· WHO influenza reagent kit: reference antigens and reference antisera.

· Receptor destroying enzyme (RDE)[3].

Highly pathogenic avian influenza A (H5N1) is classified as a select agent, and culturing of clinical specimens for influenza A (H5N1) virus must be conducted under laboratory conditions that meet the requirements for Biosafety Level (BSL) 3 with enhancements. These enhancements include controlled access double-door entry with change room and shower, use of respirators, decontamination of all wastes, and showering out of all personnel. Laboratories working on these viruses must be certified by the U.S. Department of Agriculture. 4 recommends that virus isolation studies be conducted on respiratory specimens from patients who meet the above criteria only if requirements for BSL 3 with enhancements can be met[3].

3. Polymerase chain reaction - Gene primers from Hong Kong, Government Virus Unit.

All laboratory results for influenza A/H5N1 should be confirmed by a WHO collaborating center for influenza or by another WHO- recommended reference laboratory. The WHO reference laboratories are as below:

1. Queen Mary Hospital, University of Hong Kong.

2. National Influenza Center, Kowloon, Hong Kong.

3. National Institute of Infectious disease, Tokyo, Japan.

4. National Institute of Medical Research, UK.

5. Department of Infectious disease, Memphis, USA.

6. Centers for Disease Control and Prevention, Atlanta, USA[2].

Clinical specimens from suspect influenza A (H5N1) cases may be tested by PCR assays under standard BSL 2 conditions in a Class II biological safety cabinet. In addition, commercial antigen detection testing can be conducted under standard BSL 2 conditions used to test for influenza[3].

The range of antiviral drugs is small, but especially so when it comes to bird flu. Four different influenza antiviral drugs (amantadine, rimantadine, oseltamivir, and zanamivir) are approved by the U.S. Food and Drug Administration (FDA) for the treatment of influenza; three are approved for prophylaxis. All four have activity against influenza A viruses. (4). Two of them, amantadine and rimantadine, are ineffective against H5N1. The other two are zanamavir (commercialized as Relenza) and the widely-stockpiled oseltamivir, commercialized as Tamiflu. These medications are called neuraminidase inhibitors, which block the virus from replicating. If taken within a couple of days of the onset of illness, they can ease the severity of some symptoms and reduce the duration of sickness[6].

No definitive vaccine against the viral threat is available, because no-one knows the precise shape that it will take after mutating to the feared highly contagious form. Several prototypes are being explored, but the risk is that they could be only partially effective or even useless because the virus' genetic shape will have changed and will not be recognized by antibodies. If a pandemic does occur, one worry is about manufacturing capacity and distribution: making enough of the vaccine and getting it on time and to the right people, without causing panic or a black market or leaving poor countries helpless[6].
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China predicts problems in winter with bird flu

Posted by Nancy Nurse on Tuesday, September 26, 2006 7:38:59 AM



Avian flu 'may strike' in winter


Top influenza scientists warned on Friday of the big possibility of a major bird flu outbreak in China this winter or next spring.

Such an outbreak, which would hit poultry and human beings, would probably take place as common flu cases reach their peak, said Zeng Guang, chief epidemiology scientist at China's Centre for Disease Control and Prevention.

Zeng said that the three major bird flu outbreaks over the past three years had all taken place during the winter or spring.

Great attention must be paid to the possible occurrence of common flu and bird flu peaks at the same time, Zeng told a forum jointly held by Sanofi Pasteur and the Chinese Preventive Medicine Association in Beijing.

It remains difficult to determine how the H5N1 virus will develop, said Zeng, but he noted there was a possibility it may form a hybrid with other flu viruses.

Possible crossbreeding may result in a new form of virus which could be transmitted between humans, he noted.

Currently, all human cases of bird flu have been infected by sick birds. There is no evidence to suggest that the virus can be passed from person to person, according to World Health Organization (WHO).

WHO experts have repeatedly warned there is a major risk that the bird flu virus may be transmitted between humans, which would result in a global pandemic.

Zeng said that the three flu pandemics over the past century were all caused by a hybrid virus.

Flu pandemics generally take place three or four times per century.

The last major pandemic took place in 1918-1919 and killed an estimated 40-50 million people across the globe.

Flu viruses can be divided into three groups A, B and C. Only A, which infects many animal species such as birds and swine, and B, which only affects humans, can cause severe disease and lead to epidemics.

Bird flu is an infectious disease caused by A viruses.

Highly pathogenic bird flu, such as that caused by the H5N1 strain currently circulating in Asia and other parts of the world, is characterized by its sudden onset, severe illness, and generally quick death.

The H5N1 strain is of particular concern because it mutates rapidly and can acquire genes from viruses infecting other animal species. This highly pathogenic strain is now known to cause severe disease and death in humans.

As the disease increases among birds and humans, the likelihood also increases that a human concurrently infected with human and bird flu strains will serve as the "mixing vessel" for a new influenza subtype that can be transmitted easily from person to person, thus sparking a flu pandemic, according to the WHO.

At present, there remains one prerequisite for the start of a pandemic that the current H5N1 virus has yet to meet sustained and efficient transmission among humans.

Currently, about 250,000 to 300,000 people die across the globe every year as a result of complications caused by various types of influenza, he said.

In this regard, it is vital to prevent common influenza in the war against a possible bird flu epidemic or pandemic, he added.

In China, around 130 million people are infected with influenza every year.

From November 2003 to September 14 this year, a total of 246 people had been infected by H5N1 in 10 countries, resulting in 144 fatalities. A total of 21 people in China have been infected by the virus, with 14 losing their lives.

Evidence to date indicates that close contact with sick or dead birds, such as slaughtering or de-feathering, is the principal source of infection.

Worldwide, about a dozen companies are currently conducting clinical trials on bird flu vaccines.

As scientists still do not know enough about the virus, public education is an important way to prevent a bird flu outbreak, said Zhang Bin, an official from the Ministry of Health.

Source: China Daily
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Update from hard hit Indonesia

Posted by Nancy Nurse on Tuesday, September 26, 2006 7:34:09 AM



Avian influenza ? situation in Indonesia ? update 32

As of 25 Sep 2006, the Ministry of Health in
Indonesia has confirmed 2 additional cases of
human infection with the H5N1 avian influenza virus. Both cases were fatal.

The 1st case occurred in an 11-year-old boy from
East Java Province. He developed symptoms of
fever and cough on 16 Sep [2006], was
hospitalized on 18 Sep [2006], and died the same
day. Poultry in the child's household began dying
in the month prior to symptom onset, and poultry
deaths continued thereafter in his neighborhood.

The 2nd case occurred in a 9-year-old boy from
South Jakarta. He developed symptoms of fever and
a runny nose on 13 Sep [2006], was hospitalized
on 20 September, and died on 22 September. His
history showed recent contact with sick chickens, which he kept as pets.

Of the 67 cases confirmed to date in Indonesia, 51 have been fatal.

--
ProMED-mail
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US government to help with bird flu

Posted by Nancy Nurse on Tuesday, September 26, 2006 7:30:43 AM



USDA to help farms cover costs of avian flu

Sep 25, 2006 (CIDRAP News) – The US Department of Agriculture (USDA) said last week it would, under certain conditions, reimburse commercial poultry farms for the cost of stopping low-pathogenic H5 and H7 avian influenza outbreaks.

Under a new rule, the USDA promised to provide "100 percent indemnity for specified costs" involved in eradicating H5 and H7 viruses at commercial poultry operations that participate in the National Poultry Improvement Program (NPIP), a voluntary federal, state, and industry program to prevent the spread of poultry diseases.

Until now, the states usually handled reimbursement for the costs of fighting avian flu, and the provisions varied, the USDA said.

"This program expansion strengthens U.S. protections against poultry diseases such as avian influenza," said Dr. Ron DeHaven, head of the USDA's Animal and Plant Health Inspection Service (APHIS). He said the change also helps ensure US compliance with international animal health guidelines that require countries to report all H5 and H7 virus detections.

The program expansion will encourage testing and provide incentives to report outbreaks. It also demonstrates the USDA's commitment to openness about H5 and H7 viruses in the country's bird populations, officials said.

Low-pathogenic avian flu poses no risk to human health, but the USDA's policy is to eradicate H5 and H7 viruses because they can mutate into highly pathogenic forms, the agency said.

The NPIP, dating back to the 1930s, is a coordinated effort to certify poultry flocks as free of diseases. Until now, only breeder flocks could be included in NPIP avian flu programs. The new rule expands the program to include commercial production flocks, including "table-egg layers, meat-type chickens, and meat-type turkeys."

To be eligible for full indemnification, commercial poultry facilities and states must meet certain requirements. The main requirements are that:

* States must have a surveillance program for all poultry.
* States must have APHIS-approved plans spelling out response and containment efforts in case of an H5 or H7 outbreak.
* Industry must maintain active surveillance that includes testing of birds and eggs.

The new rule takes effect Sep 26, when it will be published in the Federal Register, the USDA said.

In other developments, the USDA confirmed Sep 23 that the avian flu virus found in mallard ducks in Pennsylvania last month was the low-pathogenic North American strain of H5N1.

Screening results announced Sep 2 pointed to a mild form of H5N1 virus in samples from mallards in Crawford County, Pa., but further testing was necessary, the agency said. Genetic testing excluded the possibility of the lethal Asian strain of H5N1 in the ducks.

Mild forms of H5N1 have also been found recently in mallard ducks in Maryland and in two swans in Michigan.
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Herbs and avian flu

Posted by Nancy Nurse on Tuesday, September 26, 2006 7:28:33 AM

Will medicinal herbs hold an answer for avian flu?


Progress in search for 'bird-flu herbs'

Identifying the right herb as an alternative treatment for the bird-flu virus could take years, as it would not be simple to narrow down the list and complete testing, researchers have said.

Until recently, they were concerned about the cost of using the conventional tissue-culture method on 30,000 substances derived from 150 types of herbs to decide which could be effective.

But a new development has been helping in the fight - Kasetsart University's "Chemiebase", an Internet database of herbal extracts which could be used in simulating tests on whether certain herbal substances were worth further trial.

Containing about 100,000 3D chemical structures of herbal substances, the new database allows scientists to find herbal medication to fight bird flu.

With this "virtual screening" of 30,000 structures, it was found that only about 40 were actually worth further investigation, according to Chak Sangma of Kasetsart University's Chemino-fomatic Research Unit said.

This technique has just been introduced to herbal research in Thailand, although the programme has been widely used in the other countries such as China and India where herbal research is very advanced, said Chak, who is involved in Biotec's research.

Out of the 40 likely substances taken from a few types of plants, only one turned out to be effective in suppressing the H5N1 strain of bird flu, said Prof Pilaipan Puthavathana of Siriraj Hospital's Department of Microbiology, who tested the substances for Chak.

"This is the way to go. Even with the help of this programme, it took me several months to finish," she said. "I can't imagine how long and how impractical it would be to do a tissue culture on all of those substances to eventually get only one worth further investigation."

Developed by Kasetsart's Facul-ty of Science, the database is available free of charge at "http://chemiebase.ku.ac.th".

The researchers have decided to withhold the name of the herbal substance which in preliminary tests has proven effective in the fight against the bird-flu virus.

They were also still testing a few other substances which showed promise like the one already tested by Siriraj, according to Chak, who warned: "Don't hold your breath. It's not time to open the champagne just yet."

The researchers also have to bear in mind a drug that can effectively fight the virus in the laboratory might not always work when used on humans. So it could take 10 to 15 years to develop one herbal drug.

Arthit Khwankhom

The Nation
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Indonesia has big problems

Posted by Nancy Nurse on Tuesday, September 26, 2006 7:26:59 AM

More grief for Indonesia


Indonesian man sickened by the H5N1 bird flu virus, new family cluster feared
The Associated Press

Published: September 26, 2006
JAKARTA, Indonesia An Indonesian man hospitalized with symptoms of bird flu has the disease, health officials confirmed Tuesday, pointing to a possible new family cluster in the nation hardest hit by the virus.

The older brother of the 20-year-old patient — who is being treated in the city of Bandung — died Sunday with symptoms of the disease before samples could be taken, said Fatimah Resmiati, a West Java health official.

Their 15-year-old sister has a high fever and respiratory problems and is also being treated as a suspected bird flu case, officials at Hasan Sadikin hospital said.

Resmiati suggested that the siblings could represent a new family cluster of the disease.

Experts closely monitor such cases for signs that the virus may have mutated into a form more easily passed between humans.

The H5N1 strain of bird flu has killed at least 146 people worldwide since it started ravaging poultry stocks in Asia three years ago, hitting Indonesia the hardest, according to the World Health Organization.

At least 51 people have died across the sprawling archipelago, most of them on the densely populated island of Java, and another 17 patients have been sickened.

At present it is difficult for people to catch — with most infections being linked to close contact with infected birds or their droppings. But experts fear the virus could mutate into a form that is more easily transmissible between humans.

Gunawan, the cousin of the three family members believed to have been affected in recent days, said the siblings had been in contact with chicken carcasses, feeding them to their pet dog.

It was not immediately clear if the dead birds were infected with bird flu.
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