H5N1

WHO: World AIDS Day message

You are probably reading this on December 1, so I invite you to read the World AIDS Day message from WHO's Acting Director-General, Dr. Anders Nordström. Here is an excerpt:

We have a very long way to go still in the provision of medicines to those who need them. To be able to do that, we must also know who needs treatment and care.

The latest AIDS epidemic update from WHO and the UNAIDS Secretariat, released on 21 November, gives us the most accurate picture of the epidemic to date. HIV surveillance remains weak in almost all regions, particularly among marginalized groups. Those at highest risk—men who have sex with men, sex workers, and injecting drug users—are not reliably reached through HIV prevention and treatment strategies.

At the Toronto Conference there was a powerful drive to address the needs of those who bear the greatest burden of the AIDS epidemic - women and girls. Some 40% of new HIV infections now occur among young people aged between 15 to 24 years. The most striking increases in the number of people living with HIV have occurred in East Asia, Eastern Europe and Central Asia.

We all have AIDS.

From WHO Indonesia

A WHO news release:

Jakarta Workshop Training Regional Experts to Combat Human Pandemic Influenza

JAKARTA, INDONESIA (1 December 2006) – A workshop opened this week in Jakarta to train an international team of experts to develop more effective rapid international and national responses and national containment strategies to combat human pandemic influenza at its source when it first erupts.

The five-day meeting, which opened on Monday, organized by the World Health Organization (WHO) and supported by a grant from the Asian Development Bank (ADB), is being attended by over 50 technical experts from the region.

The workshop is part of ADB’s initiative – adopted in a grant project valued at US$38 million – to counter the growing threat of avian influenza in the Asia and Pacific region. The project was launched jointly with its partners – WHO, the UN Food and Agricultural Organization (FAO), and Association of Southeast Asian Nations (ASEAN) – in Bangkok, Thailand, in March.

ADB has so far disbursed more than $11 million from the grant project to the ASEAN Secretariat, FAO and WHO. The project aims to help ADB's developing member countries respond efficiently to the avian influenza threat and prepare for a possible human pandemic.

"Experts agree that the most desirable way to address a potentially deadly influenza pandemic from spreading globally is to stop the disease at its source by detecting it swiftly, preventing the illness from spreading to neighboring areas, and treating those affected in the field," says Dr. Keiji Fukuda of WHO.

"WHO is responding to this need by organizing this international workshop on rapid response and containment."

H5N1 avian influenza outbreaks continue to affect the poultry sector and threaten Asia's progress in reducing poverty, particularly for small farmers and rural households with backyard chickens.

"ADB is committed to carefully coordinating its program and activities with other development partners, such as WHO, to boost efficiency and help governments get the best out of donor assistance," says Dr. Bindu Lohani, Director General of ADB's Regional and Sustainable Development Department.

"Our support aims at adequately addressing emergency health needs and strengthening cooperation and capacity to address avian influenza and other emerging infectious diseases in the region."

While it remains primarily an animal disease, human infections with H5N1 virus are appearing, taking a worldwide toll so far of 154 deaths from 258 cases, according to recent WHO figures. During 2006, Indonesia was among the countries most badly affected, with 45 deaths out of 55 cases occurring this year.

Indonesia was thus chosen as the venue for the first regional training sessions because of its extensive first hand experience in dealing with avian influenza outbreaks in a populous and diverse country.

A change in the virus to one that is easily transmissible among humans could trigger a pandemic, which, according to an ADB report, could cause an economic shock that would send the global economy into recession and reduce growth in Asia to near zero.

Korea: H5N1 alert goes from "attention" to "precaution"

Via the Korea Times: Avian Influenza Alert Upgraded. Excerpt:

The government upgraded the alert level on avian influenza from "attention" to "precaution" Thursday in an attempt to raise people’s awareness of the highly virulent H5N1 virus following two outbreaks in Iksan, North Cholla Province, 280 km south of Seoul.

After holding consultations with the National Security Council (NSC) and relevant institutions, the government decided to upgrade the official alert level even though the second highly virulent bird flu case was detected within the "surveillance zone"— a 10-kilometer radius of the initially infected farm.

There are four steps in the alert levels and they are determined by the seriousness of the situation —"concern," "attention," "precaution" and "serious."

Related to this, Minister of Agriculture and Forestry Park Hong-soo said the government has decided to expand the radius of the area for culling bird flu-infected poultry from 500 meters to 3 kilometers.

As a result, an additional half a million fowl will be slaughtered in a bid to prevent the spread of the deadly strain of bird flu, government officials said.

Three more Egyptians suspected of having bird flu

Via Yahoo News: Three more Egyptians suspected of having bird flu. Excerpt:

A woman and her two children are suspected of contracting the deadly H5N1 strain of bird flu in Upper Egypt, a veterinary official reportedly said.

The 25-year-old mother, her 12-year-old son and daughter, 10, from a village in Sohag governorate, were hospitalized after showing the first symptoms of the sickness, the province's veterinary services chief Mohammed al-Masri told the official MENA news agency.

They are currently undergoing tests to determine whether they are suffering from H5N1 which has killed seven people in Egypt this year, he added.

"Preventive measures have been taken and samples were taken from poultry raised at their home before the animals were killed. The house and chicken coops were disinfected," Masri added.

Egypt -- the Arab world's most populous state -- is on a major route for migratory birds and has seen the third highest number of H5N1 cases after Indonesia and China according to Dr David Nabarro, the UN official charged with battling bird flu.

The H5N1 strain of bird flu was first diagnosed in birds in Egypt in February, and the first case in humans was announced on March 18.

WHO's cumulative number of confirmed H5N1 cases

WHO has published its latest Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1): 258 cases since 2003, with 154 deaths, for a case fatality ratio of 59.6%. The CFR for Indonesia (74 cases, 57 deaths) is 77%.

South Korea triples chicken cull

Via CNN.com: South Korea triples chicken cull. Excerpt:

South Korea's Agriculture Ministry said Thursday that authorities would cull another 609,000 chickens to try and stem the spread of bird flu, more than triple the previous amount designated for slaughter.

Originally, some 155,000 birds had been slated for death, but the ministry said it was expanding the slaughter in the wake of a second outbreak of the deadly H5N1 strain of the disease in the area of Iksan, about 250 kilometers (155 miles) south of Seoul.

With the latest decision -- affecting birds within a 3-kilometer (1.9-mile) radius of the outbreak sites, both in Iksan -- a total of 764,000 poultry at 40 farms will be culled, the ministry said in a statement. It was not immediately clear the expansion of slaughter would also affect non-poultry animals in the area.

Quarantine officials have already killed more than 150,000 chickens, along with 426 pigs and four dogs, since the initial outbreak was confirmed last week, according to city officials. More than 6.7 million eggs have also been destroyed, they added.

South Korea culled about 5.3 million birds during the last known outbreak of bird flu in 2003.

Tamiflu leaves 10 Canadians dead

Here's some unwelcome news via the Vancouver Sun: Bird flu vaccine leaves 10 Canadians dead. (Never mind that Tamiflu isn't a vaccine—headline writers don't know anything.) Excerpt:

Ten Canadians have died and at least 74 had adverse reactions after taking Tamiflu, but Health Canada didn't issue a public update about the flu drug until Wednesday.

The update came more than two weeks after international warnings were posted of adverse reactions to the medication among children and youth.Wednesday's Health Canada information update said people in other countries -- particularly children and teens in Japan -- exhibited strange behaviour, including hallucinations and self-injury, after taking the drug.

Among those exhibiting this behaviour, there have been 25 reported deaths around the world in the most recent one-year period.

Health Canada said it has "not received any such reports" of abnormal behaviour among young people in Canada.

But it has asked Hoffmann-La Roche to include updated information about possible adverse reactions on its Canadian labels.

The information about young people on Tamiflu behaving strangely was widely publicized in Canadian media more than two weeks ago after the U.S. Food and Drug Administration and drug-maker Hoffmann-La Roche Ltd. issued a warning about the drug on Nov. 13.

Auditor-General Sheila Fraser's report released Tuesday included criticism that Health Canada doesn't issue timely and accurate health warnings to the public on a variety of issues.

The criticisms were voiced by Health Canada managers who said mismanagement and insufficient funds in a variety of areas, including drug programs, could jeopardize public health and safety.

Health Canada's bulletin said that since February 2000, 84 Canadians have had adverse reactions after taking the drug, including 10 who died and seven adults who reported "psychiatric adverse events."

I hope we learn more about this, and especially about how many have taken Tamiflu without harmful effects.

Indonesia makes a good point, and I hope I do too

Via Antara, a story with a valid point: Indonesia worried TB fight might be overshadowed. Excerpt:

Indonesia's battle against tuberculosis, which kills one person every four minutes in the country, should not be overshadowed by other high-profile diseases such as bird flu, the health minister said on Wednesday.

Indonesia has the most deaths from bird flu with 57 fatalities since 2005 and has become one of the frontlines of the battle to prevent a possible human pandemic in which millions could die.

Much funding and attention, including from international donors, have been directed at efforts to tackle the spread of the H5N1 bird flu virus in Indonesia. In contrast, about 140,000 Indonesians die every year from tuberculosis (TB).

"We do not prioritise a fight against one disease and set aside others," Health Minister Siti Fadilah Supari was quoted by Reuters as saying a news conference after opening a regional meeting on tuberculosis.

"At the moment, the bird flu fight is taking a lot of attention but we have other sections within the ministry that also deal with TB or other diseases," she said.

"The world is focusing on Indonesia for many competing health issues, with the danger that tuberculosis may be forgotten."

This is a useful reminder: H5N1 is potentially a catastrophe. Pre-existing diseases like tuberculosis and AIDS are already horrendous, and have created a vast population that would be very unlikely to survive a flu pandemic. We should be working steadily to combat those diseases as well—and we should take note that December 1, Friday, is World AIDS Day.

So anything that improves public health around the world is a good thing and an additional bulwark against all diseases, including avian flu.

In this connection, I have a suggestion for your Christmas gift list: A Gift of Hope from Foster Parents Plan. (Note: This is the Canadian website of an international organization. You can probably Google Foster Parents Plan to find a site in your own country. The site doesn't welcome Safari users, but other browsers should work fine.)

Your sister or son-in-law gets a card; in their name, someone in need overseas gets clean water or schoolbooks or a goat. It makes a lot more sense to me than just buying more ... stuff.

And it could be the best possible kind of flu prep.

Freelancing a flu drill in Vancouver

This just arrived via the mail list of the Canadian Association of Journalists, and I hasten to pass it along. If you're a freelance writer in the Vancouver area, this could be of interest:

The Conference Publishers is seeking freelance writers to cover the 2006 National Forum on Emergency Preparedness and Response in Vancouver. Writers are needed to produce 1800 word summaries of a pandemic flu exercise scheduled for December 14, 2006 (9 a.m. to 3 p.m.); turn-around time for reports is three working days.

To learn more about our company please visit The Conference Publishers.

If you are available and interested, please contact Biljana Zelenovic at [email protected] or 1-800-265-3973 x226.

I wish I could cover it myself, and if at all possible I'll link to the reports.

Branswell: Flu rumours "totally untrue"

The rumour spread with remarkable speed this morning, but Helen Branswell was just as fast: Internet rumours of bird flu case in Rimouski, Que., are "totally untrue." Excerpt:

The power of the Internet rumour mill slammed up against a hospital in Rimouski, Que., on Wednesday, leaving doctors and administrators bewildered by claims they were treating a boy gravely ill with H5N1 avian flu.

If he had existed, the nine-year-old with pneumonia would have been North America's first human case of H5N1 flu. It also would have ignited continental concern over how a child could have come in contact with a virus not yet found in North America.

If he had existed.

"This is totally untrue. There is no case of respiratory illness in any children right now in the hospital. No cases at all," said Dr. Patrick Dolce, head of microbiology for the hospital in Rimouski, called the Centre de sante et services sociaux de Rimouski-Neigette.

Just as Orson Welles scared radio listeners with his 1930s invasion from Mars, someone started a silly rumour and the Internet amplified it. And in both cases, the audience was primed for it.

In 1938 the whole world was jumpy at the thought of a new world war. An invasion from Mars was bizarre, yet close enough to the anticipated war to trigger panic in some listeners.

Today, we Flublogians have been anticipating a pandemic for months or years, but I would bet that the people who accepted the rumour and passed it on were those with just a little knowledge. Anyone knowing the details of the spread of H5N1 over the past year, would have dismissed Rimouski as an utterly unlikely launching pad for human H5N1 in the western hemisphere.

But some folks enjoy releasing computer viruses into the Internet, and others enjoy passing along hoax warnings about bogus viruses. No doubt we'll get a few idiots who will think it's a riot to concoct a more plausible rumour: Six nurses with H5N1 in Sulianti Saroso Hospital, for example. That would shake up a lot of us.

The Rimouski rumour has actually done us a favour. It's reminded us that when anxiety levels are high, and real information levels are low, it's easy to jump at every false alarm. The more believably scary the report, the more confirmation we should demand of it.