H5N1

H7N9 and surfing the Chinese media

After years of rolling my eyes at computer-translated news reports, and using them only with extreme reluctance, I confess that H7N9 has made me see the error of my ways. (Now FluTrackers can roll their eyes at me.)

Again and again, surfing the provincial Chinese-language media has turned up details that never make it up the ladder to Xinhua. The translations aren't always clear, but they get the basic message across. It takes some patience and willingness to experiment; using Google Chrome as your browser, set on automatic translation, makes it easier.

Some websites display images of the paper page by page, rather than translating headlines. Even then, you can find the articles (as I did with the Zhejiang post earlier today) by looking for "H7N9" in a mass of Chinese ideograms. When you do, click on the story and it will pop up.

The place to start is ABYZ News Links, and in particular the page China Newspapers - China Newspaper News Media Guide. This will give you a host of foreign, national and provincial links, listed alphabetically by the cities they serve. Scroll down and explore. A few provincial links will be dead, but most should give you something.

When a news item from Xinhua mentions a particular city or province, my instinct is to go there, or as close as possible. I don't expect to find a contradiction of the Xinhua story, but vivid and useful details often turn up.

Good luck. If you find any notably good sources, please let me know. And if you find a better way to surf these sites, so much the better.

Surfing for H7N9 news

Judging from traffic, a lot of new people have been coming here since I posted this item back on April 2: Following H7N9 on your own. The links there are ones I'm still using, and many of them are now in the H7N9 Resources list in the right-hand corner. 

An additional word about ABYZ News: It provides links to newspapers and other news resources in countries all over the world. Go to China, and you'll see it breaks down into nationwide and provincial sources—most of them, of course in Chinese. If you use Google Translate, you can copy and paste stories to convert them to (sort-of) English text.

Better yet, if you use Google Chrome as your browser, go to Advanced Settings in its Preferences and check "Offer to translate pages that aren't in a language I read." Then, when you land on a Chinese page, Chrome will ask if you want it translated (and if you want it done automatically every time you land on such a page).

The translations sure aren't pretty, and sometimes they're baffling, but you'll get a better sense of what's being said in China.

Halfway through our third week of H7N9, I continue to be impressed by the sheer collegiality of this new flu community. Even the experts are groping for answers, and sharing their highly educated guesses with the rest of us. It speaks very well for the whole global-health system.

A webinar on H7N9

I'm sorry to be so late in posting this: International SOS is running a one-hour webinar on H7N9, starting at 2:00 p.m. Eastern Daylight Time (11:00 a.m. Pacific Daylight Time). Click through for the details on registration.

China: No threat from Sichuan dead duck dumping: official

Thanks to Bruce Weaver for sending a link to a story I should have picked up sooner. Bruce's link is a to a HuffPost story; here's the original March 25 Xinhua report: No threat from Sichuan dead duck dumping: official.

A local official said Monday that rotten ducks found floating in a river in Pengshan County of southwest China's Sichuan Province have been disposed of safely and will pose no threat to human and livestock along the river banks. 

More than 1,000 ducks had been fished out of the Pengshan section of the Nanhe River as of Monday morning, said Liang Weidong, an official with the county's publicity office. 

Tucked in some 50 plastic woven bags, the corpses were disinfected and buried three meters underground in a designated area, according to Liang. 

The dead birds have been handled safely, posing no threat to local residents and livestock, the official added. 

Local authorities have not identified the cause of their death, and further investigation is under way to identify any farm responsible for the dumping. 

The incident comes after the discovery earlier this month of thousands of dead pigs floating in the Huangpu River in Shanghai, an incident that has sparked great panic as well as satire among the public. 

The Nanhe River, along the middle reaches of the Minjiang River in Sichuan, is not a source of drinking water, according to the local authorities.

Dr. Carroll in Haiti: You don't lose them all

 Via his blog at the Peoria Journal Star, Dr. John Carroll writes: Haitian Hearts has Two Patients Accepted for Surgery. Click through for the full report and some of Dr. Carroll's beautiful, powerful photos:

Thirty-four year old Memose was just accepted by a medical center in the United States for reconstructive surgery of her jaw.   

Thirteen years ago Haitian Hearts brought Memose to this same medical center for cancer of her right lower jaw. The cancer was resected and her fibula was used as a bone graft to make her a new jaw bone.  It is held together by a titanium plate and screws. After surgery Memose underwent radiation therapy and did very well and returned to her family in Haiti.   

Unfortunately, after the 2010 earthquake Memose was lost to follow up. However, she resurfaced on Facebook and let her host family in the States know that she was not doing well. She said that she had a hole in her jaw with recurrent infection at the site of her previous surgery.   

In October of 2012, I examined Memose in Port-au-Prince. She looked well aside from her right jaw. As the photograph shows, she has a five centimeter opening over her right mandible which exposes the plate and screws. Memose has radiation induced osteonecrosis which is a known complication of radiation exposure.   

After my exam, I sent photos and a history and physical to her surgeon in the States. He immediately responded and said he would do all he could to reconstruct Memose's jaw. And the medical center agreed to accept Memose as well. Her wonderful host family from thirteen years ago has her room in their home ready for her. We are working on obtaining her visa now for return to the United States.   

I really don't care for Facebook but Facebook is how Memose communicated with her host family and it is the main way we communicate with her. Facebook played a big role in the Egyptian revolution and is playing a big role in saving Memose's life.

Butler: When Google got flu wrong

Via Nature News & Comment, a fascinating report by Declan Butler: When Google got flu wrong. Excerpt (but read the whole thing):

When influenza hit early and hard in the United States this year, it quietly claimed an unacknowledged victim: one of the cutting-edge techniques being used to monitor the outbreak. A comparison with traditional surveillance data showed that Google Flu Trends, which estimates prevalence from flu-related Internet searches, had drastically overestimated peak flu levels. 

The glitch is no more than a temporary setback for a promising strategy, experts say, and Google is sure to refine its algorithms. But as flu-tracking techniques based on mining of web data and on social media proliferate, the episode is a reminder that they will complement, but not substitute for, traditional epidemiological surveillance networks. 

“It is hard to think today that one can provide disease surveillance without existing systems,” says Alain-Jacques Valleron, an epidemiologist at the Pierre and Marie Curie University in Paris, and founder of France’s Sentinelles monitoring network. 

“The new systems depend too much on old existing ones to be able to live without them,” he adds.

Indonesia: A new interactive HIV/AIDS website

Via The Jakarta Globe: Activists Launch Interactive HIV/AIDS Website. Excerpt:

A website providing a directory of medical services and other resources for people living with HIV/AIDS in Indonesia was recently set up to help patients more easily access treatment and information about the disease. 

"We decided to set up this portal and mobile application we call AIDS Digital because there has not been a comprehensive service that could facilitate the AIDS-affected community or the public in general who want to know more about HIV testing, antiretroviral [therapy and drugs], reference hospitals or any other sexual transmitted disease,” Aditya Wardhana, the executive director of the Indonesia AIDS Coalition, told the Jakarta Globe on Saturday. 

Aditya said even with the growth of the Internet and access to it, proper information about HIV/AIDS in Indonesia was scarce. Even those able to access the information found it difficult to ask further questions because few websites providing information about HIV/AIDS were interactive.

This is a very impressive site. It's in Bahasa Indonesia, but if you're using Chrome you can have it translated into English (or any other language). I'm putting a link to it in the General International list. If you know of similar sites in other countries, please let me know.

PAHO's new cholera page

I've found PAHO's missing posts. You can find them here: One Team Against Cholera. The old site seems to have been taken down. The new site has the posts I couldn't find on Saturday, but nothing new, so it's already almost two months out of date: The latest item says it was published January 10, but it's dated December 11. Such as it is, it still gets a link in the Hot Zone Sources list as the PAHO Hispaniola cholera page.

Cholera may have sickened over 640,000 Haitians, and killed almost 8,000 of them, but it doesn't seem to be a very high priority with PAHO.

ECDC: Effective risk communication for the prevention and control of communicable diseases in Europe

ECDC has published Effective risk communication for the prevention and control of communicable diseases in Europe. Click through to download the full report. Excerpt:

ECDC has published a new review of the current literature on risk communication related to communicable disease, which identifies best practice in this field as well as current gaps. 

Risk communication is seen as one of the essential ways of limiting morbidity and mortality, as well as the damage to national economies and public health infrastructure caused by communicable diseases. 

The review highlights the particular challenges faced by a multi-cultural and multi-lingual Europe when designing effective risk communication strategies. National and international collaboration is identified as being vital to deal with these challenges as well as further development of cross-sectoral risk preparedness strategies. 

Although there are many resources available to risk communicators today, limitations have been exposed once they have been tested. Gaps which the report identified include risk communication messages often failing to reach the intended targets and a lack of resources to meet the new and changing needs of more web-based societies.

US: Tracking flu on Google

Via Slate: Flu shot time? Google Flu Trends predicts worst season on record. Excerpt:

By the CDC’s latest “outpatient surveillance” estimates, roughly 5.6 percent of Americans visiting the doctor are reporting respiratory illnesses, or flu-like symptoms. That’s a large number, significantly higher than the national baseline of 2.2 percent or the 2.3 percent peak of last year’s mild flu season. 

But it’s not entirely out of the ordinary. The figure approached 6 percent in the moderately severe 2007-2008 season and topped out at 7.7 percent in October 2009 in the midst of the H1N1 pandemic. 

But here’s the thing: The CDC’s current estimates aren’t all that current. Because they are based on after-the-fact reports from more than 3,000 health care providers around the country, the numbers can tell us only how many people were suffering from the flu a couple weeks ago. Today’s CDC FluView figures, for instance, come from the week of Dec. 23. We won’t know until Friday how many people visited the doctor with respiratory symptoms during the week that began on Dec. 30. 

That’s where Google comes in. In fall 2008, the company’s charitable arm, Google.org, unveiled Flu Trends, a site that scans millions of Google searches from around the world to track flu activity in near real time. 

According to a study published in Nature in February 2009, the system can detect outbreaks nearly two weeks before they show up in the official CDC reports. And the site can tell you on any given day what countries, states, and even cities are likely seeing the largest number of cases. 

Today, Flu Trends is painting a foreboding picture. On a global scale of green (minimal flu activity) to bright red (intense flu activity), the United States is the reddest country in the world. Zoom in, and the red stretches are almost unbroken across the country’s eastern two-thirds. (Hang in there, Connecticut!) Boston, New York, Philadelphia, Houston, and Denver are among a slew of cities tagged with the “intense” rating.