H5N1

China's response to disaster

Go to Xinhua's website and you'll see an avalanche of news stories about the Sichuan earthquake, and especially about the government's rapid response. Premier Wen Jiabao shot out of Beijing like a rocket, and he's been all over the disaster area. Meanwhile President Hu Jintao has been on the phone with President Bush, talking about the earthquake.

You'll also see stories about Burma's ongoing horror, in which the junta's response has assured it some of the hottest holes in Hell.

A great natural disaster is one of those cases in which simple decency is brilliant politics. After the flak China has taken about Tibet and the Olympic torch, the government now looks good—both compassionate and competent.

Putting Sichuan and Burma/Myanmar on the same web page should also send a message to General Than Shwe and his fellow-thugs in brass hats. After all, they're clients of Beijing, and China's response is a heavy hint: Shape up or we'll ship you out.

I doubt that President Hu told Bush that China had learned a lot from Katrina and New Orleans. He wouldn't have been that tactless. But China is certainly putting the most positive possible spin on the catastrophe, and judging from this report in the UK's Independent, it's working:

Chinese Prime Minister leads new era of openness. Excerpt:

The death toll from Chinese natural disasters was a state secret until only three years ago.

In a sign of the political changes inside the country that will host the Olympic Games in three months' time, the Chinese authorities have been swift and transparent in announcing the scale of the Sichuan earthquake.

The Prime Minister, Wen Jiabao, has featured prominently on state television after rushing to the scene on Monday. In contrast to the generals in Burma, the Chinese government yesterday reacted to the international offers of aid by welcoming foreign assistance and expressing gratitude.

Yet it has taken decades for China's Communist Party to cast off its secretive instincts. It took three years before the authorities confirmed that at least 240,000 people had died in the 1976 Tangshan earthquake.

As recently as 2003, China faced stiff criticism from its neighbours after initially covering up the Severe Acute Respiratory Syndrome (Sars) outbreak, which originated there.

Last year, the Chinese were accused of failing to share sufficient information about bird flu by the World Health Organisation.

The National Administration for the Protection of State Secrets can classify any information as secret – even if it has already been made public.

In this case, China threw its "state secrets" out the window. I hope they'll decide that H5N1 should be reported with equal or better transparency.

India: Vets in Andhra Pradesh get H5N1 training

Via The Hindu, a story from Andhra Pradesh state: Training for veterinarians on bird flu gets under way. Excerpt:

Training for the second batch of veterinarians on ‘Avian Influenza’ commenced here on Tuesday.

Poly Veterinary Institute Deputy Director Radhakrishnamurthy was the chief guest. The programme was sponsored by the Union Government and co-sponsored by the Southern Regional Disease Diagnostic Laboratory and Veterinary Biological Research Institute, Hyderabad.

Addressing the gathering, Veterinary Biological Research Institute assistant directors V. Anuradha and S. Sai Leela underlined the need for being in a state of preparedness, control and containment, if any traces of bird flu appear in the State.

Although there have been no traces bird flu in the State till now, the Centre had embarked on a programme to raise awareness among the Veterinarians on the infectious disease, they pointed out.

Practical demonstrations on the culling of birds and safety requirements would be held on Wednesday.

Still more H5N1 confirmed in South Korea

Via Chosun Ilbo: Bird flu confirmed in Songpa and Busan. Excerpt:

Less than a week since the first case of bird flu was confirmed in Seoul, the deadly H5N1 strain of the virus was found again, this time in Songpa, a district in the southeastern part of the capital.

As a containment measure, Seoul has put down more than 15,000 birds, including more than 8,000 in the area of the latest outbreak.

The metropolitan city government is now considering banning live chickens and ducks from entering Seoul and forbidding the breeding of them within the city limits.

This deadly strain was also confirmed in the southeastern port city of Busan, where more than 17,000 fowl were culled as an emergency measure to contain the spread.

The city of Busan has now adopted anti-epidemic measures such as forbidding the sale and movement of live poultry in markets.

Last week Korea's agriculture ministry and the ruling Grand National Party announced guidelines to ensure the safety of the public against the disease.

Officials warned citizens to immediately report any pet birds showing abnormalities and to keep away from wild birds such as pigeons.

Meanwhile, the Korea Herald reports that, predictably, Bird flu scare hits poultry businesses

New Zealand: Barriers keep threats, flu and cold at bay

Via Stuff.co.nz, a report I'm not sure I take seriously: Barriers keep threats, flu and cold at bay. Excerpt:

Security screens have been installed at Christchurch City Council headquarters to protect staff from abusive customers.

The plastic screens were installed at a cost of $11,600 after incidents in which customers abused staff working at the payment and information counters in the Tuam Street council building.

Council customer services general manager David Dally said staff were "ecstatic" about the "cheap-as-chips" screens.

"We have had a few incidents, nothing really bad, but staff have felt threatened.

"We have some interesting people coming in from time to time and staff can feel quite threatened. Some customers can get quite threatening and staff feel a lot more protected if there is a physical barrier.

"It provides that level of protection. They feel so much safer because they have got barriers," he said.

Dally said there had not been any assaults but some people had been abusive to counter staff.

Customer services team leader Margaret Finnie said that rather than rate rises and higher rents, the main trigger of angry outbursts was parking tickets.

"Everybody who works in the public arena is a little vulnerable at times. It is not just customers - a number of people wandering the streets come in sometimes," she said.

The barriers also have been installed to tackle a more insidious threat - bird flu.

The gap in the transparent plastic barriers could be sealed in the event of a pandemic so staff could still deliver vital services without the risk of infection, Dally said.

"When the pandemic arrives we will very easily be able to place a physical barrier to control contact ... so if customers have the virus it will not affect people on the other side of the barrier. It is future proofing and forward planning," he said.

But what happens when infected Kiwis stagger in to pay their parking tickets and then drop dead at the wicket? Who's going to drag the bodies out? Or is that not a "vital service"?

South Korea worries about Tamiflu and teens

Via The Korea Times: Bird Flu Medicine Toxic for Teens. Excerpt:

Concerns are rising over side effect of bird flu drug Tamiflu on teenagers.

Tamiflu is Swiss-based Hoffman-La Roche's antiviral for general influenza A and B but is also used to combat bird flu. However, worries have surfaced about the possibility of the medicine causing mental disorders among teenagers.

With fear of the H5N1 virus sweeping the nation, the government has doubled the quantity of the drug in storage, as it is the most effective treatment against avian influenza.

Whether to prescribe the pills with risks of side-effects such delusions or other disorders is being widely discussed among medical experts.

Although the drug has been the only medicine accredited to be effective against the H5N1 virus strain by the World Health Organization (WHO), the Japanese and Korean governments restricted its being prescribed to teenagers last year.

The Korea Food and Drug Administration announced that the drug should not be prescribed to those between 10 to 19 years old except for emergencies.

According to Roche, there has not been a reported case of side effects here, but the Seoul Shinmun, a local daily, reported that a woman in her 30s said she had nightmares after taking the drug in 2005.

The government's decision came after Japanese health authorities banned its prescription for teenagers in March 2007.

Japan has imported the drug since 2001, long before its effect on bird flu was acknowledged.

However, since then, there have been 1,268 cases of extraordinary behavior reported, of which 85 percent were from teenagers. They reportedly committed suicide by jumping out of buildings or into cars.

Health experts admit to the dilemma and said when necessary, it should be prescribed with extra prudence.

South Korea suffers from West Bengal syndrome

The news gatherers are full of reports on the total cull of poultry in Seoul, but according to this report in The Korea Times, the cull isn't going very well: Police Will Step Up Fight Against Poultry Smugglers. Excerpt:

Police said they will strengthen crackdowns on smugglers of poultry in the region infected by bird flu and those ignoring the authorities' preventive measures to keep the spreading avian influenza under control.

The National Police Agency said Tuesday that those violating anti-bird flu measures will be fined up to 15 million won ($15,000) or face up to three years in prison.

This move came after a series of reports that some culled poultry and those waiting to be killed were smuggled out and illegally traded in conventional markets. The government sees that these dealings could easily transmit the deadly virus to other regions.

Last Wednesday, police arrested six poultry dealers in North Jeolla Province on charges of circulating bird-flu infected chickens and ducks.

According to police, some 2,000 affected ducks were illegally smuggled out to feed dogs and a dealer sold 740 questionable chickens to retailers without the government's permission. In another case, more than 10,000 chicks that were raised at a virus-affected chicken farm were also smuggled out.

The government's measures against the epidemic done in a cursory manner are blamed for having contributed to the spread.

Seoul Metropolitan Government Sunday said it completed the culling of an estimated 15,000 chickens and ducks raised in the capital.

But it was not that difficult to see chickens and ducks in cages on the outskirts of Seoul.

A citizen residing in Guro-gu, western Seoul, said "I found dozens of hens only 100 meters away from the place where slaughtered poultry was buried.''

The citizen said several ward office officials swept the location for days but failed to learn about the remaining chickens.

Medical headhunting as a crime against humanity

Via allAfrica.com, a report from The East African worth pondering: Africa: International crime. Excerpt:

Should the world develop a global treaty to regulate the emigration of African medical personnel to the rich West?

The jury is still out, but this is an issue that is likely to gain prominence in coming years as thousands of African health workers - trained at a great cost by their impoverished countries - flock en masse to developed countries lured by higher salaries, better working conditions and more training opportunities.

The human costs of the migration, some activists now contend, are so horrendous that they are comparable to crimes against humanity.

"Active recruitment of health workers from African countries is a systematic and widespread problem throughout Africa and a cause of social alarm," Edward J. Mills of the British Columbia Centre for Excellence in HIV/Aids and nine co-authors wrote recently in The Lancet. "The practice should, therefore, be viewed as an international crime."

According to this team, those facilitating the transfer should be tried at the International Criminal Court, since their trade deprives poor countries of much-needed medical personnel, resulting in millions of deaths each year.

The outward flow of nurses and doctors from sub-Saharan Africa, medical analysts say, is particularly devastating, because the region carries 25 per cent of the global disease burden, yet has only three per cent of the world's health workers.

According to the World Health Organisation, Africa's cash-strapped health systems actually need 1.5 million new health workers to resolve the existing shortages. These would require at least $3.3 billion annually to train in the next eight years.

Crime or not, recruiting third-world medical experts to come and look after us looks pretty stupid.

We'd serve ourselves better by paying those experts to stay in Kenya or Pakistan or Nigeria, keeping their own people healthy and building an infrastructure that would prevent diseases from migrating to us.

Still looking for Mahmoud Ramadan

Almost a month ago, I asked: Whatever happened to Mahmoud Ramadan?

He is (or was) a 2-year-old who fell ill on April 13 and went into hospital the next day. He was confirmed as a human H5N1 case, and WHO reported his case in its Egyptian update 10 on April 17.

Here it is May 12, and we have heard nothing more about this case. If the boy recovered, the Egyptians and WHO should have told us. If he died, they should have told us.

This is sloppy journalism and sloppy public health. Egypt and WHO should both be ashamed.

South Korea: The extent of the cull

Via Yonhap News: Birds raised in school vivariums culled to prevent spread of avian influenza. Excerpt:

All birds raised in school vivariums in Seoul have been culled as a precautionary measure against the spread of avian influenza, the government said Tuesday.

The move comes as a virulent strain of bird flu was confirmed in Songpa, southeastern Seoul and a suspected case was reported earlier in the day in Gyeongsan, North Gyeongsang Province, the Ministry for Food, Agriculture, Forestry and Fisheries said.

The Songpa outbreak is the second confirmed report of the H5N1 bird flu in the capital city following a case in Gwangjin ward last week. The H5N1 is a highly pathogenic bird flu strain that has killed people in the past.

"Roughly 15,000 birds have been culled in Seoul due to the latest outbreak, while 250 have been destroyed in Busan where two separate H5N1 outbreaks were confirmed," said a ministry official.

He said a further 4,000 birds are to be culled during the day in Busan as a precautionary measure.

The latest reports bring the total of bird flu reports to 67 since April 1, with 40 having been confirmed as being caused by the virulent strain and 25 as due to other diseases. State laboratories are running tests on two reports.

Bird flu remains low risk to Australia

Good news for Oz, via ABC Rural: Bird flu remains low risk to Australia.

The bird flu virus, H5 N1 remains a low risk to Australian poultry and human populations.

Dr Ian Barr, of the World Health Organisation's Centre for Influenza will tell a conference in Canberra today, Australia is fortunate there aren't many backyard chooks and our poultry farms are very secure.

Although some batches of the bird flu vaccine are about to expire, Dr Barr says there's no cause for concern and it's unlikely the virus will be the world's next pandemic.

"Things haven't changed too much in the last four or five years when this virus has been circulating through South East Asia and parts of Europe and Africa," he says.

"I think the virus is still very avian like and it's mainly a problem for poultry and wild birds at this stage."

China's response to the Sichuan quake

Via Xinhuanet: Strong earthquake jolts SW China. This is a page of reports that seem to be frequently updated. I hope it's the kind of coverage we can expect if H2H influenza ever breaks out in China.

CIDRAP on the Korean outbreaks

CIDRAP has a good roundup of the news from South Korea: H5N1 plagues Seoul, prompts outbreaks in other cities. Excerpt:

On May 7, the ministry confirmed that birds at a Seoul aviary were infected with the H5N1 virus, signifying the first detection of H5N1 in the city, according to previous reports.

Kim told that AP that two other H5N1 outbreaks at poultry farms outside of Seoul were reported yesterday: one in Busan, South Korea's second largest city, and the other in Ansung. Busan is a port city on South Korea's southeastern coast, and Ansung is in Gyeonggi province, about 50 miles south of Seoul.

Meanwhile, Stars and Stripes, the US military newspaper, has a story suggesting that Bird flu may be endemic to S. Korea. And Chosun Ilbo is also on the story.

Learning from canine influenza

Thanks to the reader who alerted me to this PDF report not yet published in Emerging Infectious Diseases: Influenza A Virus (H3N8) in Dogs with Respiratory Disease, Florida. The abstract:

In 2004, canine influenza virus subtype H3N8 emerged in greyhounds in the United States. Subsequent serologic evidence indicated virus circulation in dog breeds other than greyhounds, but the virus had not been isolated from affected animals.

In 2005, we conducted virologic investigation of 7 nongreyhound dogs that died from respiratory disease in Florida and isolated influenza subtype H3N8 virus. Antigenic and genetic analysis of A/canine/Jacksonville/2005 (H3N8) and A/canine/Miami/2005 (H3N8) found similarity to earlier isolates from greyhounds, which indicates that canine influenza viruses are not restricted to greyhounds.

The hemagglutinin contained 5 conserved amino acid differences that distinguish canine from equine lineages. The antigenic homogeneity of the canine viruses suggests that measurable antigenic drift has not yet occurred.

Continued surveillance and antigenic analyses should monitor possible emergence of antigenic variants of canine influenza virus.

The silence of the Indonesians

Earlier this spring, it looked as if the Indonesian authorities were making an effort to raise awareness about H5N1 and to keep the rest of us informed about that effort. Komnas FBPI, the National Committee to Combat Bird Flu, launched a new bilingual blog: Bidang Komunikasi Komnas FBPI.

But as you'll see if you click through, the site hasn't been updated since April 23. Antara and The Jakarta Post seem to have dropped the flu story as well. The ministry of health posted a notice about the last human death, a 3-year-old, on April 30. It's been silent since then, at least about avian flu.

While the newshounds have toggletexted some Bahasa Indonesia reports about suspected cases (and deaths), the story seem to have evaporated from the English-language media.

This seems to me a very mistaken policy. If political action depends on fresh reports of dead toddlers, then no public-awareness campaign is going to succeed. And if Indonesia's public isn't aware, more toddlers (and adults) will die in the next wave of B2H cases.

Like justice, public-awareness campaigns must not only be done; they must be seen to be done.

Disasters, surge and pandemics

I missed this in Sunday's Daily Kos: Disasters, Surge and Pandemic is another excellent report by DemFromCT.

Burmese junta hijacks disaster aid

Via The Bangkok Post: Aid hijacked. Excerpt:

Privy Councillor Surayud Chulanont is to fly to Burma on Sunday, the ninth day of the cyclone disaster, to try to convince the Burmese dictatorship that the world wants to help devastated people.

On Saturday, the junta reached a new level of cynicism, pasting huge labels on aid packages from Thailand to claim the help was from the top generals, rather than the Thai people.

The regime plastered names of the top generals on the aid boxes, as part of the propaganda and intimidation campaign it is running to back its referendum seeking to perpetuate the 46-year military control of the country.

The Associated Press reported that state-run television inside Burma continuously ran images of elaborate cemonies where top generals - including the junta leader, Senior Gen Than Shwe - handed out boxes of Thai aid disguised so as to appear it came from the junta, to survivors of the tragedy.

One box seen in the videos bore the name of Lt Gen Myint Swe, a rising star in the government hierarchy, in bold letters, overshadowing a smaller label which barely could be read:: "Aid from the Kingdom of Thailand."

If you can get through to the junta's news site, New Light of Myanmar, you'll see that it hasn't been updated since May 2. You'll also find a May 1 story about the Burmese prime minister paying a courtesy call on King Bhumibol of Thailand. It reflects the junta's cozy relationship with Thailand, which helps keep the generals in power.

I hope the Thais (and the Indians and Chinese) reconsider their ties with the junta.

West Bengal: Darjeeling cull going badly

Via Sahara Samay.com: Culling slow in Darjeeling, fresh deaths reported. Excerpt:

Amidst a slow culling operation in avian flu affected Darjeeling district due to non-cooperation by owners of fowls, a fresh report of birds' death worsened the situation.

District Magistrate Rajesh Pandey today said that the deadline was extended till tomorrow as only 9,500 birds were culled against the target of culling 18,000 birds by yesterday.

Animal Resources Development department sources said that the progress of culling was not as expected because of non-cooperation by poultry owners in some areas.

The target was now increased to 20,000 and was expected to be completed by tomorrow, the sources said.

To encourage poultry owners, the department announced revised compensation for birds culled -- Rs 75 for a duck, Rs 50 for a layer, Rs 40 for a broiler, Rs 35 for a duckling, Rs 20 for a chick and Rs two for an egg.

The situation, however, turned worse following reports of death of a crow, two swallows and seven fowls from Bijanbari area in Darjeeling yesterday. Unofficial report, however, claimed death of 100 birds.

Canada: Blood clot caused Via rider's death, police say

Via The Globe and Mail: Blood clot caused Via rider's death, police say. Excerpt:

Brenda Buckley, a 43-year-old South African tourist travelling alone on a cross-Canada rail journey, died from a pulmonary embolism, authorities say. The condition, the worst-case outcome of a lesser malady known to travellers as deep-vein thrombosis, can result from protracted periods of sitting.

The condition has been known to arise on long-haul flights, but many observers are surprised it is being linked to rail travel. "This is not a condition Via [Rail] has ever encountered on any of its trains," Catherine Kaloutsky, a spokeswoman for the company, said last night. She said Via Rail doesn't warn passengers about the risk of thrombosis, but will review practices.

The rarity of the condition on train journeys may have contributed to the case's initial aura of inexplicability, which fuelled the infectious-disease speculation that garnered global headlines.

All poultry in Seoul killed after bird flu outbreak

Via Associated Press: All poultry in Seoul killed after bird flu outbreak. Excerpt:

South Korean officials said Monday they have killed all poultry in Seoul, the capital, to curb the spread of bird flu following a new outbreak of the disease in the city.

Quarantine officials destroyed 15,000 chickens, ducks, pheasants and turkeys raised in farms, restaurants, schools and homes in the capital, said Kim Yoon-kyu, a Seoul Metropolitan Government official.

The influence of class and ethnicity on a pandemic

Via Emerging Infectious Diseases: Pandemic Influenza Planning and Health Disparities. Abstract, re-paragraphed:

We explored how different socioeconomic and racial/ethnic groups in the United States might fare in an influenza pandemic on the basis of social factors that shape exposure, vulnerability to influenza virus, and timeliness and adequacy of treatment.

We discuss policies that might differentially affect social groups' risk for illness or death.

Our purpose is not to establish the precise magnitude of disparities likely to occur; rather, it is to call attention to avoidable disparities that can be expected in the absence of systematic attention to differential social risks in pandemic preparedness plans.

Policy makers at the federal, state, and local levels should consider potential sources of socioeconomic and racial/ethnic disparities during a pandemic and formulate specific plans to minimize these disparities.

Don't worry only about H5N1

Thanks to the reader who tipped me off to this article in Emerging Infectious Diseases: Transmission of Avian Influenza Virus (H3N2) to Dogs. Abstract, re-paragraphed:

In South Korea, where avian influenza virus subtypes H3N2, H5N1, H6N1, and H9N2 circulate or have been detected, 3 genetically similar canine influenza virus (H3N2) strains of avian origin (A/canine/Korea/01/2007, A/canine/Korea/02/2007, and A/canine/Korea/03/2007) were isolated from dogs exhibiting severe respiratory disease.

To determine whether the novel canine influenza virus of avian origin was transmitted among dogs, we experimentally infected beagles with this influenza virus (H3N2) isolate. The beagles shed virus through nasal excretion, seroconverted, and became ill with severe necrotizing tracheobronchitis and bronchioalveolitis with accompanying clinical signs (e.g., high fever).

Consistent with histologic observation of lung lesions, large amounts of avian influenza virus binding receptor (SAα 2,3-gal) were identified in canine tracheal, bronchial, and bronchiolar epithelial cells, which suggests potential for direct transmission of avian influenza virus (H3N2) from poultry to dogs.

Our data provide evidence that dogs may play a role in interspecies transmission and spread of influenza virus.

Burma: "A race against time"

Via The Irrawaddy, an AP report by Margie Mason, one of the best medical reporters in the business: Preventing Disease Outbreaks is 'Race against Time.' Excerpt:

Getting supplies to survivors of Cyclone Nargis in Burma is now a "race against time" to prevent a disease disaster, as many impoverished victims continue to await aid a week after the storm, experts warn.

Reports of diarrhea and skin problems have already surfaced, and health officials fear waterborne illnesses will emerge because of a lack of clean water, along with highly contagious diseases such as measles.

Children, including those orphaned by the storm, face some of the greatest risks.

The threat is heightened because many people in the worst-affected Irrawaddy delta were already in poor health prior to the cyclone. The storm has killed some 23,000 people and left about 37,000 missing, according to state media. Hundreds of thousands more were left homeless in the military-run country, which has one of the world's worst health care systems.

"The fact that there are people we still haven't gotten to is very distressing to all of us. We don't know how many that is," Tim Costello, president of the aid agency World Vision Australia, said by telephone on Saturday from Rangoon. "The people are all exposed to the elements, and they are very, very vulnerable. It's a race against time."

In the badly hit town of Laputta, family members were forced to use rusty sewing needles to close wounds at a hospital where no doctors or supplies were visible. One man lay dying from a lack of care after his foot was cut off in the cyclone.

The World Health Organization has reported children suffering from upper respiratory diseases, and with next week's forecast calling for rain, there was yet another urgent reason to move quickly.

Fears of mosquito-borne diseases such as malaria and dengue fever, which are endemic to the area, have also heightened. However, outbreaks would not be expected for another week or longer because the mosquitoes need time to breed in stagnant water left from the storm, said Osamu Kunii, UNICEF's chief of health and nutrition in Rangoon.

Cholera remains another concern, but there have been no diagnosed cases. Kunii said Burma's health ministry also agreed to start a mass vaccination campaign against measles.

"Once those diseases start, it's very hard to control," he said, adding that food and water were reaching more survivors, but not everyone.

Meanwhile, the junta's website New Light of Myanmar hasn't been updated since May 1. Good luck even getting access to it.

The Burmese generals are clearly unmoved by appeals to decency and common sense. Like Stalin, they regard one death as a tragedy and a million as a statistic.

They have remained in power for forty endless years, in large part because their neighbours—China, Thailand, and India—have made money out of dealing with them.

If the rest of the world wants to see real change in Burma, pressure on those neighbours seems like the best way to achieve it.

Fuyang: HFMD "under control"

Via China Daily: Viral outbreak in worst-hit city under control - ministry. Excerpt:

The hand-foot-mouth disease (HFMD) outbreak in Fuyang in East China's Anhui Province is under control, the health ministry said on Sunday.

No fatalities was reported from May 2 to May 10 in Fuyang, an official surnamed Yang with the Ministry of Health told Xinhua.

The city reported the initial HFMD outbreak in the country and 22 deaths caused by the disease by May 10.

"The incidence of HFMD in Fuyang is on the decline. The majority of patients in critical conditions in Fuyang have recovered," he said.

The ministry said on Thursday that patients discharged in Fuyang has outnumbered those checking in to hospitals for the first time.

Bird flu vaccine as contraband

Via The Bangkok Post: Bird flu vaccine intercepted. Excerpt:

More than 100 bottles of bird flu vaccine, worth six million baht [US$188,000], were seized at Chiang Saen port yesterday. Customs staff found 120 bottles of 250cc vaccine on a Chinese cargo ship, Hongta, which travelled from China.

The captain denied any knowledge of the vaccine. He said he was asked to ship the packages from China, but did not know the contents.

The customs chief said searches of cargo ships from China would be stepped up. He suspected more orders had been placed for the Chinese version of the bird flu vaccine.

Use of the bird flu vaccine is prohibited in Thailand for fear that it might hurt poultry exports and disrupt the national bird flu control scheme.

Five bird flu outbreaks have occurred since it first surfaced in January 2004. The latest round was reported in Nakhon Sawan and Phichit province in late January.

Vietnam: Encouraging early results for human vaccine

Via VietNamNet Bridge: Positive results for Vietnam’s bird flu vaccine. Excerpt:

Vietnam is hoping to prevent bird flu in humans following good results from the first tests of made-in-Vietnam H5N1 influenza vaccine.

The vaccine, produced by the Health Ministry’s Vaccine and Bio-technology Products Company No. 1 (VABIOTECH), has been tested on a group of 30 students from the Military Medical Institute.

The students are reportedly in good health and waiting for a second shot on May 17, scheduled for 28 days after the first shot.

VABIOTECH Director Professor Nguyen Thu Van said Vietnam is among a few countries successful in producing H5N1 vaccines, currently in human testing stages and not yet to have received licences.

Vietnam has developed the vaccine using monkey kidney cells which, Van says, are more productive, cheaper and safer than a vaccine using the culture on embryonic chicken eggs as is currently being developed by other countries.

Meanwhile, Antara reports that Indonesia's state pharmaceutical company, BioFarma, is also getting into the human-vaccine business.

Dead Via Rail passenger identified

Via The Globe and Mail, a Canadian Press report: Dead Via Rail passenger identified. Excerpt:

Ontario police say the woman who died aboard a Via Rail Train on Friday, setting off a massive biohazard response, was a 43-year-old from South Africa.

While a post-mortem examination determined Brenda Buckley's death was the result of natural causes as earlier reports have suggested, there's been much speculation as to her age and country of origin.

Authorities had initially given the woman's age as 60, and later said she was 86 years old.

Police say six other passengers who reported feeling ill around the same time have since been diagnosed with the common flu.

More on the Seoul outbreaks

Via The Korea Herald: Korea struggles to contain spread of avian influenza. Excerpt:

Government officials yesterday scrambled to come up with ideas to contain the outbreak of avian influenza that hit the country last month.

The government and the ruling Grand National Party held an emergency meeting to step up the fight against bird flu, which has spread to all regions of the country except Jeju Island.

At the meeting, officials decided to prohibit the sale of live chickens and ducks to consumers and merchants at markets nationwide, since they are the locations most vulnerable to diseases.

A registration system for transportation vehicles of farm products will be set up and measures will be taken to beef up control over unauthorized butchering of birds at private stores or restaurants.

The National Veterinary Research and Quarantine Service confirmed that the highly pathogenic avian influenza was discovered in dead ducks and chickens in Chuncheon, Gangwon Province.

Decontamination facilities were established at 47 locations in Chuncheon and regional officials vowed to move forward with sanitation efforts in cooperation with the central government. On Thursday, 358 chickens sold at 10 different places within the region were slaughtered, officials said.

As of yesterday, there were a total of 35 cases of avian influenza, which can be transmitted to humans, according to the Ministry of Food, Agriculture, Forestry and Fisheries.

In Seoul, the city government announced that avian influenza was only discovered in the Gwangjin district after conducting a two-day examination of 18,647 birds across the city earlier this week.

Officials also said the two dead pheasants found at a nature learning center in Gwangjin, eastern Seoul, caught the virus while being moved to the Moran market from infected chicks and ducks that came from Anseong, Gyeonggi Province.

"According to test results, a truck from the Anseong farm stopped at 13 different markets during the transportation process. We believe the virus was spread in this process and that the truck played a significant role," said Lee Sung, chief of the economic competitiveness bureau at the city government.

About 830 veterinarians will be dispatched to conduct checks at sites where birds can commonly be found. The areas will be cleaned and decontaminated up to three times a day, city officials said.

West Bengal: "Paltry" compensation sparks fresh cases of bird flu

Via Thaindian News: Paltry compensation for culled birds sparks fresh cases of bird flu in West Bengal. Excerpt:

While officials in West Bengal blame residents for the outbreak of the bird flu virus, resident complain that they are not being compensated enough for the culled birds.

Veterinary workers started culling thousands of backyard poultry to contain an outbreak of bird flu in the region, which has struggled to control the virus since January, but then they say that the residents are not cooperating.

“The response that we are getting is not good. People are still eating the chickens. The problem is that they are not earnest and they are lying. It is only when we tell them that the police raid them that they begin to cooperate,” said Samir Rai, Block Livestock Development Officer.

Around 300 birds mysteriously died last week in Sukna area near the bustling town of Siliguri, officials said.

But seemingly naive residents said that the compensation that is being provided to them is not enough and hence they refused to cooperate.

“It is our livelihood, how can we kill them? They pay us just Rs 50 per bird whereas in the market we fetch around Rs 120 per bird. This won’t work,” said Ajay Raut, a villager.

The State briefly contained the outbreak by culling more than four million birds in 14 of its 19 districts, but the virus has intermittently resurfaced.

A second B2B H5N1 outbreak in Seoul

Via Xinhuanet: New outbreak of bird flu confirmed in Seoul. Excerpt:

The South Korean government on Sunday confirmed a new outbreak of the deadly H5N1 strain of bird flu among live poultry in the capital city of Seoul.

The Agriculture Ministry said over 8,000 ducks and chickens were immediately culled on an illegally-run farm in the southeastern Songpa-gu district after the affected poultries in the farm had been tested positive for the deadly H5N1 strain.

The bird flu has spread throughout the country since the government confirmed an outbreak of the epidemic in southwestern part of the country in early April.

In Seoul, where more than 10 million people live, the government confirmed an outbreak of deadly H5N1 strain in the eastern part of the city on May 5. It was the first time that bird flu has been discovered in the capital city.

The Korea Times has more details.

Running out of food?

Via The Guardian, a fairly detailed look at the impact of rising food prices on Britain: While stocks last. Excerpt:

While our parents and grandparents dreaded not having enough food to put on the plate, we have had the luxury of worrying about quality.

A series of scares - mad cow disease, bird flu, pesticide residues and more - has left us with an almost unhealthy preoccupation with the risks, real or imagined, that lurk in the food we eat.

But one risk has barely registered on our radar. It is so fundamental that we barely clocked it, and yet it is the biggest food scare yet. Are we running out of food?

Meanwhile, Antara reports that Surging food prices bite across Asia.

Japan's plans for a pandemic

An editorial in The Japan Times: Coping with new strains of flu. Excerpt:

The Diet has passed revisions to the Infectious Disease Law and the Quarantine Law to effectively cope with a possible outbreak of new types of influenza.

There is fear that deadly new types of influenza will emerge, since the H5N1 bird flu is spreading mainly in Southeast Asia and bird-to-human infection is increasing. If a bird flu virus mutates into one capable of human-to-human transmission, a large number of people are expected to die. The government estimates that a new type of flu with the same lethality rate as the 1918 Spanish flu could kill up to 640,000 Japanese.

The law revisions will enable the government to segregate or forcibly hospitalize those who have developed symptoms of, are infected with, or are suspected of being infected with new types of flu. The government can prohibit such people from going to work.

The government has also decided to conduct a clinical test this fiscal year in which some 6,000 doctors, quarantine inspectors, other medical and health professionals and immigration and customs officials will be inoculated with stockpiled "pre-pandemic" vaccine based on the H5N1 virus strain.

It also will inoculate 120 children at least 6 months old and younger than 20 with the same vaccine. If the vaccination proves safe and effective, it plans to vaccinate 10 million people whose work is related to maintaining basic functions of society.

HFMD kills two children on Hainan Island

As with the Burma post just below, I mention this report from The Standard because it gives us some sense of how the authorities in hot-zone countries are dealing with disease outbreaks: Virus claims Hainan pair. Excerpt:

Authorities on Hainan reported two deaths yesterday from the severe strain of hand, foot and mouth disease, taking the national toll from the outbreak to 30 - all of them young children.

And another 4,000 cases were reported nationwide. That means nearly 20,000 cases across the country this year, and the usual peak season for the disease is not until June and July.

But Xinhua News Agency said the apparently high number is due to better reporting of the outbreak. "The rising number is not a sign of a deteriorating situation," it said.

So is reporting improving for outbreaks of other diseases? If so, we should expect Xinhua to let us know about them.

Burma as a foreshock of disaster

Via The Irrawaddy: The Smell of Death and Destruction. Excerpt:

Thirty-five miles from Rangoon, the air smells of death. Dead bodies and the rotting cadavers of buffaloes lie in the gutters of this town, so near Burma’s largest city and the country’s once proud capital.

Overhead, a cruel sun beats down on the homeless who seek shelter amid the ruins of their houses.

Pu Suu, 14, cowers under a tattered umbrella, as she cooks a pot of rice to feed the other five survivors of her family. A younger sister lies sick and crying in her mother’s arms.

“This might be our last pot of rice,” says Pu Suu with resignation.

Four thousand of Kungyangone’s residents are thought to have died when the cyclone hit one week ago.

The survivors have been assured by the authorities that the town has enough supplies to feed all. One member of the town’s Union Solidarity and Development Association
said the organization is delivering enough rice to the storm victims, pointing at the sacks of rice in his house. Building materials were being handed out to people to rebuild their demolished homes, he said.

Yet his neighbor Ko Tin, 40, whose house was swept away by the storm, said he and the five members of his family had received only four cans of rice a day. Burma people use an empty condensed milk can as a measurement, and one person normally requires more than one and a half of cans of rice per day. They had not received any building materials, he said.

A woman in her fifties said her household of 18 people was also receiving just four cans of rice a day. Her children and grandchildren lay hungry on the floor around her.

“I tell them to go in search of food and wood and fetch it by hook or by crook.”

The Irrawaddy, published by Burmese exiles, has much more coverage of the disaster here.

South Korea: Tracking H5N1 to Seongnam market

Via JoongAng Daily: Seoul's first bird flu case linked to the Seongnam market. Excerpt:

Seoul's first confirmed H5N1 strain of bird flu came from the nation's largest open market in Seongnam near the capital city, a government body said yesterday. The Seoul city government announced yesterday that two pheasants found dead on April 28 in an aviary located in the Gwangjin District Office in eastern Seoul had been infected with the H5N1 strain of avian influenza in the Moran market in Seongnam, Gyeonggi, which is only 26 kilometers (16 miles) south of the city.

City officials say they have confirmed that several infected ducks, which came from the infected Anseong farm in Gyeonggi infected the two pheasants while they were in the open market. Both birds were together for about 10 days, officials said.

The district office purchased the two pheasants on April 24, and four days later they died. Officials at the market have closed its poultry section.

"We have to stop selling chickens, ducks, and geese," said a market official who declined to be named. "We don't know when we will be able to reopen."

Back to normal, with tweaks

Thanks for all your comments and suggestions about the changed design of the site. After considering them, and living with the design for a few days, I've decided to go back to the original design, but with some changes.

The gray links in the new design were really unacceptable, and since this was a standard TypePad design I couldn't change it (at least not with my primitive HTML skills). I didn't like the wider text column either.

So I've gone back to the original design, with a couple of changes. The text of posts is now in Times New Roman, a serif font that should be more readable, and I've increased the size of the text. The headers for the link lists are also larger, and I hope the links themselves are easier to find and use.

Thanks also for your patience while I fiddle with the site. If you have any other suggestions for making it more useful, I'd love to hear them.

More on the VIA Rail incident

Today's Globe and Mail has a good account: How one death, sick passengers led to fears of pandemic.

André Picard, the Globe's superb medical-affairs columnist, has an excellent analysis: Health team's