H5N1

Holiday cheer

We've just had a wonderful Christmas Eve dinner with friends, and blogging on Christmas morning will be predictably light. But I want to wish you a very happy holiday, and a prosperous new year full of surprises that make you laugh. Your continued interest in this blog makes me very grateful, and I hope to continue it for many more pandemic-free years.

India: NCDC team advises health officials how to fight H5N1 virus

Via The Times of India: NCDC team advises health officials how to fight H5N1 virus. Excerpt:

JAMSHEDPUR: A four-member team from the National Communicable Disease Centre (NCDC) Delhi on Saturday trained health officials on how human and poultry products could be protected from contagious disease with research reports concluding that H5N1 virus was behind the abnormal rise in the death of crows in the Steel City. 

The team, which was led by director Vina Mittal, arrived here on Friday. It chaired a meeting at the district civil surgeon's office on Saturday. In the light of humans and poultry products potentially susceptible to the H5N1 disease, the NCDC members trained the health officials on how to protect them from the disease. 

Although there is no precedence of the disease spreading directly from a bird (crow) to a human body and poultry products so far, but the team advised the health personnel to be on alert. 

"There are some gaps in our ongoing programme to prevent the spread of the disease (H5N1) to poultry (and humans). The visiting team advised us on bridging the identified gaps," said Swaran Singh, the district surveillance officer. 

Representatives of Jusco, a city-based utility services firm, notified area committee officials and health officials led by civil surgeon Vibha Saran attended the meeting. 

During the meeting, the health officials have been asked to advise the people not to touch the carcass of dead crow barehand and rather inform the health department or an authorized agency to clean the site. 

"The idea is how humans could protect themselves from this disease. Second, maximum attention should be on maintaining clean environs at the poultry for it is more susceptible to the H5N1," said a member of the NCDC team that visited a poultry firm in Hata on Friday.

E. coli: Spanish firm sues Hamburg over false cucumber warning

Via TerraNet, an AFP report: Spanish firm sues Hamburg over false cucumber warning. Excerpt:

A Spanish company is suing the German city of Hamburg for more than two million euros after its cucumbers were wrongly blamed for a deadly E.coli outbreak, officials said Thursday. 

Frunet, a Spanish organic fruit and vegetable company, has lodged a 2.3-million-euro ($3.0 million) claim against the northern port city's health and consumer protection authority. 

"The Office for Health and Consumer Protection rejects these claims since the warning about the company's cucumbers was necessary and right," the health office said in a written statement. 

Insisting it believed it had taken the right course of action in issuing a warning with the information it had at the time, it said: "Protecting health comes before economic interests of companies."

Christchurch braces for a bumpy Christmas

Via NZ Herald News: ChCh braces for a bumpy Xmas. Excerpt:

Cantabrians are likely to be in for a bumpy Christmas Eve as the "intense'' aftershock sequence continues to rumble, says a seismologist. 

Christchurch was yesterday shaken by a 5.8 magnitude quake at 1:58pm followed by a 6.0 earthquake at 3:18pm, which resulted in the temporary evacuation of malls, buildings and homes across the city and cutting power supply to Sumner and Redcliffs suburbs. 

Following the two major shocks, the city had been rattled by "hundreds and hundreds'' of earthquakes, said GNS seismologist Bill Fry. 

By 3:30 this afternoon, the GNS website listed 23 quakes in the Christchurch area since midnight and one magnitude 3.2 quake measuring 7km deep, 10km south of New Plymouth. 

Of those 23 recorded in the Canterbury region, most ranged between 3.0 magnitude to a peak of a 5.1 quake, recorded 10km east of Diamond Harbour at a depth of 8km, at 6:37am today. 

Mr Fry said this amount of activity was to be expected for the region, and more was likely to follow. 

"[Today I've seen] the aftershocks from the event yesterday. Most of them are thrust earthquakes, which means you have one block that's thrust over another block.'' 

"Commonly after you get a large earthquake then along the edges of the fault that ruptured in the large earthquake, you get smaller earthquakes that are of a similar mechanism.'' 

He said the earthquakes in the Christchurch area appeared as if they were all occurring along a same Pacific plate faultline, but the earthquake recorded south of Taranaki occurred along the Australian plate. 

He said while the aftershocks were lessening since the two major shakes yesterday, more quakes were expected as the activity was a continuation of the Darfield sequence.

Branswell: US finds new human infection with swine H3N2 flu

Via CTV News, a Canadian Press report by Helen Branswell: U.S. finds new human infection with swine H3N2 flu. Excerpt:

U.S. public health officials have found another case of human infection with a swine-origin H3N2 virus, this time in a child from West Virginia. And they also reported finding a human infection with a new swine influenza virus never before seen in humans, in a person in Wisconsin who had contact with pigs. 

The Wisconsin case seems to be a one-off infection, with no signs of further spread. But the investigation into West Virginia case suggests the child was infected by another person, not a pig and that some amount of human-to-human spread of the virus took place in the unnamed community where the child lives, according to details released Friday by the U.S. Centers for Disease Control. 

The H3N2 case is the 12th -- in five states -- reported in the U.S. since this new virus was first spotted in July. And the CDC acknowledges there are probably more cases that haven't been picked up by the country's flu surveillance systems. 

"We don't think these are all" the cases, said Dr. Joe Bresee, head of the influenza epidemiology team in the CDC's Influenza division. 

To date no other country has reported seeing human infections with this virus, which has also been isolated from pigs in the U.S.

Mike Coston at Avian Flu Diary has some good commentary on the situation.

Malaysia: Two deaths among 522 dengue cases

Via The Star Online, a Bernama report: Two deaths among 522 dengue cases.

A total of 522 dengue cases were reported across the country from Dec 11 to 17, with the disease claiming the lives of a 31-year-old lorry attendant in Selangor and a 44-year-old cleaner in Johor.

Hong Kong: Chow says H5N1 risk "stabilized"

Via China Daily: Flu risk stabilized: Chow. Excerpt:

Dead chicken with virus proved an isolated case 

Poultry wholesalers will be required to record the source of any birds that die while waiting to go to market, before discarding the carcasses. 

The new regulation will become effective when a 21 day ban on the sale of live chickens ends on January 12. 

The announcement follows a massive cull of 19,451 chickens at the wholesale market on Wednesday after a chicken carcass discarded at the market was tested positive for avian flu H5N1, the day before. 

The sick bird so far has proven an isolated case. Of 180 samples taken from chickens culled at the wholesale market, all tested negative for the flu virus strain. Also, the 900 bird samples collected from 30 local poultry farms in Hong Kong proved negative. 

Medical checks of 250 wholesale workers and farm keepers also turned up no sign of flu. 

York Chow, Secretary for Food and Health, said the finding showed that actual risk of a flu outbreak has stablized. He stressed, however, that even one sick bird still presents a relatively high risk.

The University of Hong Kong is working out the genetic makeup of the virus found on the dead chicken. Chow said the process will be completed in a couple of days to determine if a mutation occurred within the virus potentially capable of disarming vaccine. 

The response from government has earned the praise of experts. Leo Poon Lit-man, Assistant Professor at the School of Public Health of the University of Hong Kong, credited the cull for containing a possible outbreak and the vaccination for keeping most chickens healthy. 

Poon said the high risk of bird flu has always been in the wild, particularly during winter from migratory birds. As long as people stay away from dead birds they come across, the risk of human infection remains low. 

The origin of the dead chicken remains a mystery. A spokeswoman for Agriculture, Fisheries and Conservation Department said the dead chicken weighed slightly more than the average birds favoured by locals. The larger birds are favored by restaurants. But there is no clue as to its origin.

Hong Kong: An H5N1 update from York Chow

Via the excellent blog Arkanoid Legent, a news release from the Centre for Health Protection: Hong Kong : Opening remarks by SFH on avian flu. Excerpt:

Following is the translation of the opening remarks by the Secretary for Food and Health, Dr York Chow, at a media stand-up session after attending the meeting of the Steering Committee on Avian Influenza today (December 23): 

I have just convened the second meeting of the Steering Committee on Avian Influenza (AI) to take stock of follow-up actions arising from the findings of a chicken carcass sample from the Cheung Sha Wan Temporary Wholesale Poultry Market (the Wholesale Poultry Market), which was tested positive for H5N1 AI virus on December 20. 

The meeting was attended by representatives from the Agriculture, Fisheries and Conservation Department (AFCD), the Food and Environmental Hygiene Department (FEHD), the Centre for Health Protection (CHP), the Customs and Excise Department (C&ED), and the Hospital Authority. 

The Food and Health Bureau (FHB) and relevant departments have been actively pursuing measures to prevent and control AI over the past few days. I would like to highlight some major developments: 

First, AFCD successfully completed a culling operation at the Wholesale Poultry Market on December 21. A total of 19 451 poultry was destroyed. All 180 samples of live poultry taken by AFCD before the culling were all tested negative for H5 AI virus. 

Second, AFCD completed inspections on all 30 chicken farms in Hong Kong yesterday to ensure farmers have strictly complied with bio-security and environmental hygiene requirements. No abnormality with regard to the chickens has been detected. AFCD has also tested about 900 samples collected from local farms and all were found negative for H5 AI virus, indicating normal health conditions of local chickens.

Bangladesh gets used to chikungunya

Via The Daily Star: Chikungunya fever emerging: Know the facts. Excerpt:

Chikungunya is a viral fever spread by mosquitoes. The disease was first reported in Bangladesh on December 2008. The disease manifests some clinical signs as of dengue, and can be misdiagnosed in areas where dengue is common. 

Chikungunya is characterised by an abrupt onset of fever frequently accompanied by joint pain which is the prominent feature. Other common signs and symptoms include muscle pain, headache, nausea, fatigue and rash. The joint pain is often very debilitating, but usually ends within a few days or weeks. 

Most patients recover fully, but in some cases joint pain may persist for several months, or even years. The disease caused by Chikungunya virus that is transmitted from human to human by the bites of infected female mosquitoes — Aedes aegypti and Aedes albopictus, two species which can also transmit dengue. The disease is self-limiting and any fatal complication is unusual. 

There is no specific treatment for chikungunya. Supportive therapy those help ease symptoms, such as administration of Paracetamol, non-steroidal anti-inflammatory drugs and getting plenty of rest, may be beneficial. There is no commercial Chikungunya vaccine available.

H5N1 controversy: How human are ferrets?

Via CIDRAP, a must-read article by Robert Roos: Fears about mutant H5N1 hinge on ferrets as flu model. Excerpt:

Despite all of these parallels, there are some differences between flu in ferrets and humans, researchers say. 

For example, Lowen commented, "Ferrets sneeze frequently when infected with seasonal influenza viruses, whereas humans tend to cough and not to sneeze." Also, she said, "Seasonal influenza in ferrets is perhaps milder than in humans, given that the ferrets in question are naive hosts (analogous to children infected for the first time)." 

Another difference is that flu causes neurologic signs more often in ferrets, according to Peter Palese, PhD, professor and chair of the Department of Microbiology at Mount Sinai School of Medicine in New York City, who has been critical of the NSABB move to suppress details of the Fouchier and Kawaoka studies. 

"Ferrets have a lot of neurologic symptoms with flu, and that certainly doesn't happen in humans," he said. "There's plenty of evidence that ferrets are a much too sensitive system." 

He pointed to a 2007 study in the Journal of Virology, in which ferrets that were inoculated with high doses of H5N1 strains from Vietnam showed neurologic signs before dying. Also, in an earlier study, published in Avian Diseases in 2003, scientists found that ferrets infected with the 1997 strain of H5N1 from the first human cases ever confirmed, in Hong Kong, had neurologic manifestations of the infection.

Another researcher who has studied flu in animals, Daniel R. Perez, PhD, of the University of Maryland, agreed that neurologic manifestations are more common in ferrets than what the literature says about human cases. Perez is an associate professor of virology in the Department of Veterinary Medicine in the university's College of Agriculture and Natural Resources and program director for the Avian Influenza Cooperative Agricultural Project there. 

Perez said there's a further difference: "In general, I'd say ferrets are more susceptible than humans to H5N1. The manifestations of the disease seem to be a lot more dramatic and noticeable in ferrets than humans. So the human immune system tends to handle the infection better than ferrets." 

But he cautioned that not all strains of H5N1 have been tested in ferrets, and the animals are exposed to the virus in controlled laboratory conditions, unlike humans, making comparisons tricky. 

He also observed that scientists face some technical limitations in studying the immune response of ferrets: "We are limited in making parallels between what happens in humans and ferrets in terms of the immune responses. We don't have reagents that are ferret-specific that allow us to study immune responses in ferrets the way we've studied them in mice."