H5N1

Tourism fallout feared from Thai bird flu outbreak

Via Yahoo News, an AFP story: Tourism fallout feared from Thai bird flu outbreak. Excerpt:

Tourism agencies worry that the possible spread of bird flu in Thailand, as well as neighboring Laos, could hurt the industry just as it is rebounding from the effects of the December 2004 tsunami.

"Now we have received bookings for high season, which are normally made a few months in advance," Suparerk Soorangura, former president of the Association of Thai Travel Agents, told AFP.

"If Thailand fails to make it clear right now that the country can control the bird flu, tourists will panic about the outbreak and decide not to come to Thailand later this year," he said.

Pandemic? Not to worry

Via Yahoo News, a HealthDay report: Bird Flu Pandemic May Not Develop.

A bird flu pandemic might not be imminent, as many health experts have feared, U.S. researchers now say.

When government researchers tried to combine the deadly H5N1 strain of bird flu with a common strain of flu that infects humans, they were unable to produce a strain that could be transmitted easily.

Health officials across the globe have worried that the bird flu virus that has killed 134 people worldwide might mutate, possibly in tandem with a more common flu virus, unleashing a new type of flu virus that could prove even more deadly because people's immune systems would not be able to fend off the disease.

The U.S. research, conducted with ferrets, offers some hope that a bird flu pandemic may not strike in the foreseeable future, if at all. But, the scientists cautioned, the genetics of flu viruses are unpredictable, and this study was based on one combination of viruses, when more than 50 possible combinations exist.

"Simple combinations of genes from both parent viruses have not led to enhanced transmissibility in the ferret," Dr. Julie Gerberding, director of the U.S. Centers for Disease Control and Prevention, said at a press briefing Friday. "These data do not mean that H5N1 cannot develop into a pandemic strain. It means that the genetics of that transformation are more complicated than a simple one-to-one exchange. We are far from out of the woods on a global scale," she added.

While the finding doesn't mean the previous alarm has been much ado about nothing, it may have been "much ado about theory, about something speculative," said Dr. Marc Siegel, author of Bird Flu: Everything You Need to Know About the Next Pandemic, and a clinical associate professor of medicine at New York University School of Medicine.

"This does add emphasis to my previous analyses that multiple steps may be necessary before this particular bird flu can become a pandemic strain, and we would be wise to not take those steps for granted," Siegel said. "This doesn't prove that H5N1 can't be the pandemic virus either, but it shows that there seem to be several steps involved."

This seems to me to be better news for ferrets than for humans. As a serious piece of health journalism, it's dead on arrival: H5N1 can't cause a pandemic but maybe it could after all.

Thailand: Bird-flu alert for entire country

From The Nation, a story that helps explain some of the confusion in today's earlier posts about Thailand: Bird-flu alert for entire country. Excerpt:

As the number of suspected bird-flu cases increases nationwide, Caretaker Agriculture Minister Sudarat Keyuraphan yesterday declared all 76 provinces of the country animal epidemic control areas, with stricter rules on the transport of poultry and handling of dead birds.

The move follows the mass culling of 300,000 chickens at 78 farms in Nakhon Phanom province on the weekend.The Public Health Ministry is closely monitoring 765 people who took part in the slaughtering, fearing they might have been exposed to the potentially deadly bird-flu virus.

Caretaker Public Health Minister Pinij Charusombat said all 633 people involved in the culling, plus 111 farm workers, 18 people in the families that operated the farms and three other villagers were put on the provincial bird-flu watch list.

The minister was speaking during a trip to Na Klang district in the north-eastern province where the H5N1 virus was detected.

All 765 people on the list would be monitored for 14 days.

So far, six people had developed a high fever, Pinij said. Two of them had influenza symptoms and had received oseltamivir, the only anti-viral drug that can be used to treat people infected with H5N1. The other four had tested negative for the influenza virus.

By all means read the whole story.

Thailand: 765 villagers under medical surveillance

The news out of Thailand continues to surprise. Via ThaiDay, a story that confuses even more than the story just below: 765 villagers under H5N1 surveillance. Here's the whole story:

Some 765 villagers in bird flu-infected Nakhon Phanom province have been put under medical surveillance for 14 days to establish if any of them have contacted the H5N1 virus, Health Minister Phinij Jarusombat said yesterday.

All of the villagers have either been in direct contact with dead chickens or lived in areas where they died.

Six of the villagers were reported to have high fever yesterday, but laboratory tests were still being conducted to verify whether any of them had the deadly bird flu virus.

A Medical Science Department mobile-lab vehicle was scheduled to arrive at the Nakhon Phanom provincial hospital yesterday evening, and would immediately commence operations.

At a meeting with senior public health officials in Bangkok yesterday, Phinij gave instructions to all public health and medical personnel in Nakhon Phanom to be on the alert around the clock with no days off, even during the weekends, until the spread of the virus in the northeastern province bordering Laos is under control.

The discovery of bird flu in the province last week caught public health and livestock authorities by surprise because the virus had been reported mainly in Central Plains provinces in earlier outbreaks.

Meanwhile, Deputy Agriculture Minister Charan Trinwutthipong said initial findings indicated that the virus might have been spread to Nakhon Phanom by unscrupulous egg traders who switched eggs from restricted zones in the Central Plains for sale in the Northeast. He confirmed that the latest bird flu outbreaks remained restricted to Phichit and Nakhon Phanom provinces.

In a separate incident, Uttaradit provincial livestock officer Phanom Meesiripan reported that officials yesterday found more than 50 dead ducks in a roadside ditch. They were apparently dumped by duck farmers who feared their entire flocks would be culled if they reported the dead birds to the authorities.

So we have a dispute between local authorities who say they've identified two H5N1-positive patients, and a "caretaker" health minister who says it's "influenza A" (isn't H5N1 a form of influenza A?). Yesterday, the Nakhon Phanom outbreak was on one farm near the Laotian border, and 122 villagers were known to have had contact with chickens. But only two were suspected of having avian flu.

Now they're observing 765 villagers in that province alone, apart from those in the rest of the province.

And in Uttaradit, the farmers are dumping their dead ducks to avoid a mass cull.

Quite apart from avian flu, something is administratively wrong in Thailand.

Thailand: Positive human cases or not?

A Bangkok Post story reflects some confusion in provinces fighting avian flu: Phinij: Two patients don't have H5N1—but Nakhon Phanom officials say otherwise. Excerpt:

Two out of six villagers suspected to have contracted bird flu in Nakhon Phanom have tested positive for influenza A, not H5N1, caretaker Public Health Minister Phinij Jarusombat said yesterday.

The minister inspected the bird flu situation in tambon Ban Klang of Nakhon Phanom's Muang district yesterday and later told senior health officials in Bangkok of the results of laboratory tests on the two patients in the bird flu-hit northertheastern province.

However, his statement contradicted information obtained from local authorities yesterday that the two villagers had caught the lethal bird flu virus.

Earlier, H5N1 was found in samples from chicken carcasses, making Nakhon Phanom the second province to be hit by the current round of bird flu after the central province of Phichit. This is the fourth avian flu outbreak since January 2004, with one human fatality so far.

So is the public health minister right, or are the local authorities?

Further confusion: Yesterday I reported that the number of suspected human H5N1 cases had fallen from 113 to 80. But this story says the number of persons under surveillance has reached 134, with Phichit now having 44. The story then compounds confusion by ending: "Initial tests on them [the 44?] had come back negative for bird flu, however."

The Thais are not covering this story as effectively as they might.

Monday update for July 31

SciDev.Net has posted its Bird Flu Update for July 31. It's a useful summary of events in the past week.

Thailand: B2B spreading, suspected B2H falling

Apparently some 33 suspected bird-to-human H5N1 cases have been removed from yesterday's list of 113. Meanwhile, bird-to-bird H5N1 is spreading, according to this story in the Bangkok Post. Excerpt:

Mass killings of up to 300,000 chickens are underway in tambon Ban Klang in Nakhon Phanom's Muang district after a laboratory test confirmed the area had been hit by the bird flu outbreak. The province has mobilised 1,500 health officials to carry out the cull on 70 farms.

The Public Health Ministry yesterday put the number of patients suspected of having bird flu at 80, from 19 provinces nationwide. The number has fallen from the 113 suspected cases reported on Saturday.

This will be the second cull in Nakhon Phanom in as many days. Late last week, 40,000 chickens were slaughtered as a precautionary measure, after poultry died mysteriously.

Governor Nikhom Kerdkhanmak said samples of chicken carcasses were sent to the Centre for Veterinary Research and Development in Khon Kaen for tests, and the result showed the dead chickens were infected with bird flu.

To prevent further spread of the disease, all chickens in the community would be culled, he said.

Health workers would set up checkpoints to spray disinfectant on vehicles. A ban on poultry movements has also been imposed along the Thai-Lao border.

Chaweewan Liewwijak, deputy chief of the Livestock Department, said the outbreak of bird flu was worrying. All chickens must be killed to contain the disease as quickly as possible.

Every household would be sprayed with disinfectant while residents have been put under surveillance, Ms Chaweewam said during an inspection trip at tambon Ban Klang yesterday.

Peera Areerat, an expert attached to the public health office in Nakhon Phanom, said 122 villagers had records of being in contact with chickens. Two were suspected of having bird flu and were placed under supervision. Denchai Sorakit, chief of public health in Nakhon Phanom, said the two suspected patients were boys, both aged 14. He said initial tests showed they did not have avian influenza.

''Blood samples of the patients were sent to a medical science centre in Ubon Ratchathani and the results are expected in hours,'' said Dr Denchai.

The Public Health Ministry yesterday gave a provincial breakdown of the 80 patients suspected of having bird flu. Phichit has the highest number of suspected cases with 18, followed by Sukhothai, 14; Phitsanulok and Suphan Buri, nine each; Nan, seven; Nakhon Sawan, four; Phetchabun and Uttaradit, three each; Nakhon Pathom and Nonthaburi, two each; Bangkok, Kanchanaburi, Kamphaeng Phet, Chachoengsao, Nakhon Nayok, Pathum Thani, Prachin Buri, Lamphun and Uthai Thani one each.

Vietnam soldiers on

Via Thanh Nien Daily: Vietnam pushes up fight against bird flu.

An official at the Vietnamese Ministry of Agriculture and Rural Development Thursday instructed local authorities to finish the two poultry vaccination drives by October to fight bird flu.

Deputy Minister Bui Ba Bong released the instruction at a working session in Tien Giang province where southern administrations gathered in the Mekong Delta to discuss water fowl management in the region.

Bong also asked local administrations to strictly observe requirements on standard poultry slaughter-houses.

He reminded local authorities to timely report to responsible agencies outbreaks in their localities in order to exact the the necessary response.

The ministry early this month allowed the resumption of chicken farming but maintained a ban on waterfowl till February 2007.

The Vietnamese must be thinking a lot about Thailand these days, and how easy it is to lose the ground you've gained.

Authorities

Down the right-hand column you'll find a new list: H5N1 Authorities. I'm defining "authorities" as persons who through expertise or office have some influence on H5N1-related policies and actions. The links will give you at least a little background on these persons, which may be helpful when their names turn up in news stories.

If you can think of others who might belong on the list, please let me know. (I wanted to include Indonesian Health Minister Siti Fadilah Supari, but the only profile I could find is in Bahasa Indonesia.)

Thailand confirms second B2B outbreak

Via Forbes.com: Thailand confirms second bird flu outbreak.

Thai officials ordered the slaughter of 300,000 chickens after the second outbreak this year of the deadly H5N1 bird flu virus was discovered on a farm in the northeast.

"The H5N1 virus was found in chickens in a local farm," Charal Trinvuthipong, assistant to the agricultural minister, told Agence France-Presse.

The outbreak at a farm in Nakhon Phanom province, 740 kilometers northeast of Bangkok, follows the death on Wednesday of a boy from bird flu -- Thailand's first such death in seven months.

"It is the second outbreak (this year) following the one in Phichit province," Charal added.

He said more than one hundred volunteers had been deployed to cull about 300,000 chickens near the affected area.

Authorities earlier threatened people with a 2,000 baht fine for failing to report any sick or dead poultry.

Agriculture ministry officials said the measures, due to be officially announced tomorrow, would be enforced across the country.

The story has not yet appeared in The Nation or Bangkok Post, but Reuters has more details here.