H5N1

WHO plans revision of pandemic guidelines

Via WHO: WHO consultation on revision of pandemic influenza preparedness guidance.

WHO's guidance to assist countries in preparing for the next influenza pandemic was developed in 2005. After several important developments, it will be revised at a meeting in Geneva during 6-9 May 2008.

Since 2005, there have been scientific advances, such as the development of H5N1 vaccines and greater experience with clinical treatment of H5N1 cases. Moreover, legal developments such as the entry into force of the new International Health Regulations will influence how Member States and WHO respond to potential and actual pandemic influenza threats.

WHO's experience in working with Member States on pandemic influenza preparedness has highlighted areas that need greatest support. At the meeting, about 150 experts from governments, WHO and other organizations will work on the final content of the revised guidelines.

Working groups will focus on areas such as disease control, surveillance, medical interventions, non-medical interventions (such as continuation of emergency services, organization of mass gatherings and school closures) and the role of communications during an influenza pandemic. Once the content is agreed upon, new draft guidelines will be circulated for comment.

The guidelines are expected to be published expected by the end of 2008.

The site has a link to WHO's current global influenza preparedness plan.

The Italian report

Sandra, one of my favourite commenters, wrote about the preceding story:

Glad the the Italian news agency Ansa wrote the article anyway.

I'm anxious for journalists to start stepping up to the plate on every single issue that affects our globe.

And why wouldn't WHO be advising people on such a serious possible scenario?

With affection and respect, I'll have to disagree.

During the SARS outbreak, WHO issued a travel advisory against going to Toronto. It had a disastrous economic impact. The city finally imported The Rolling Stones, at huge expense, to hold a concert that would bring people back to the city.

Were any lives saved by the travel advisory? Probably not. Toronto simply learned, at great expense, what can happen when a scary new disease breaks out in a big city.

So I would not expect WHO to issue a warning about taking Tamiflu to Beijing. If a real H2H outbreak of H5N1 had been documented in Beijing, a travel advisory would be appropriate, but almost irrelevant. No one would go to China anyway.

So Ansa stepped up to the plate, all right, and then whacked the umpire across the head. It was sheer misinformation.

I wouldn't be surprised to find out it was conscious disinformation: A deliberate attempt to embarrass the Chinese and compromise the Olympics.

Having lived in China during the great campaign against "spiritual pollution" in 1983-84, I am no fan of the Beijing government. I have not forgiven them for Tiananmen Square. I consider the Olympics themselves a pretext for an orgy of pointless national hysteria by all participants.

But something smells about this story, just as something smells about the sudden eruption of Tibet liberationists as that stupid torch was schlepped about the planet.

Having lived to the age of 67 without the blessing of a failing memory, I can vividly recall bogus protests that led to the overthrow of governments the United States found inconvenient: Iran in 1953, Guatemala in 1954, Chile in 1973, even sorry little Grenada in 1983. Other governments, like those of Japan, Germany and Italy, were simply bought and paid for, like the allegiance of the Afghan warlords in 2001.

I'm sorry if I offend some of my American readers, but the role of the CIA in undermining other countries is all too well documented—by Americans.

In one of the greatest ironies in modern history, "communist" China is now bankrolling the imperial adventures of its old foe the US. The rulers of Beijing may not be serious reds any more, but they remember Lenin's famous dictum: "The capitalists will sell us the rope that we hang them with."

The well-educated folks in Langley, Virginia have read their Lenin too, but they also remember another old proverb: "When you owe the bank a thousand dollars and you can't pay it, you have a problem. When you owe the bank a million dollars and you can't pay it, the bank has a problem."

Giving China a discreet kick in the shins, on the eve of the Olympics, is an obvious way to remind Beijing that the US can make life hard for its adversaries (and creditors) without sending in the cruise missiles and Marines.

When I start surfing my sources every morning, I do so with an attitude of skepticism verging on paranoia. I have spent almost seven decades being lied to by champions, and I expect an outbreak of pandemic flu long before I expect an outbreak of government honesty—whether Chinese, Vietnamese, Indian, or American. Lying, after all, got those governments where they are today. Why should they abandon a winning policy?

We are going to have enough confusion, fright and misinformation in a pandemic even under the best of conditions. Skepticism about scare stories like the Ansa report is just basic mental hygiene.

WHO denies advising Beijing-bound tourists to pack bird flu drug

Via Canadian Press: WHO denies advising tourists to China for Olympics to pack bird flu drug. Excerpt:

The World Health Organization denies it is recommending that visitors to China for this summer's Olympic Games should pack an antiviral drug to protect themselves against avian flu.

The denial comes in the wake of a report Monday by the Italian news agency Ansa, which said WHO is warning tourists going to Beijing for the August sports event to arm themselves with the drug Tamiflu "in case of exposure to the disease virus."

The Ansa story quotes Walter Pasini, director of the WHO Collaborative Centre of Medicine for Tourism in Rimini, Italy.

But WHO spokesman Gregory Hartl said Wednesday that Pasini does not work for the international agency itself and the report quoting him has "set off alarm bells" because it is erroneous.

"We would categorically deny that WHO's ever made any kind of recommendation to this effect or that there would be any need or justification ... in any context, including going to the Olympics in Beijing," Hartl said.

Pasini could not be reached for comment late Wednesday.

The official word on Indonesia's 108th flu death

Via the Indonesian ministry of health: Be careful of dead chicken. Excerpt:

Today, source of avian influenza (H5N1) virus transmission still comes from birds to human. MS (m, 3 years) is positive of AI based on laboratory examination of National Institute of Health Research & Development (Litbangkes) and Eijkman Institute, Jakarta , and previously had contact with dead chicken. About 10 chickens died in his neighboring.

MS lived at Bero Village, Manyaran Subdistrict, Wonogiri District, Central Java and started getting ill with symptoms of difficulty in breathing since April 17, 2008. On April 23, 2008, he went to Muwardi Hospital, Solo, but died in the same day.

Meanwhile, The Jakarta Post also covers the story, but in five short, perfunctory paragraphs followed by four longer paragraphs of routine background plus a rehash of the Bali flu drill.

WHO also reports the case as update 42 in its Indonesia situation reports.

The authorities took a week to report the child's death, and then the major media and the World Health Organization shrug it off with a few paragraphs.

You'd think a disease with a worldwide case fatality ratio of 63%, and an Indonesian CFR of 81.2%, would get more respect.

Japan: Local governments act to contain bird flu

Via Daily Yomiuri: Govts act to contain bird flu / All Akita Pref. chicken farms inspected to counter outbreak. Excerpt:

Following the confirmation that the deadly H5N1 strain of avian influenza was detected in dead and dying swans near Lake Towada in Akita Prefecture, local governments and residents have been working to prevent the infection from spreading.

Three dead ohakucho swans, or whooper swans, and a dying swan were found in an area with a 500-meter radius south of the lake on April 21.

The Akita prefectural government is especially concerned that the deadly bird flu virus outbreak may affect sales of Hinai-jidori chicken, a nationally known delicacy, and other local products.

The Akita prefectural government started inspecting 15 poultry houses belonging to 14 chicken farmers and one egg collector within a 30-kilometer radius of the lake, which includes Odate, Kazuno and Kosakamachi in the prefecture, on Wednesday and Thursday.

Officials are checking whether the poultry houses have taken measures to prevent possible bird flu infection. The moves include setting up guard nets to prevent wild birds from entering the facilities and tanks containing disinfectant to sterilize shoes at farm entrances.

Tripura worries about bird sanctuary

Via Tripurainfo.com: Bird flu: precautionary measures in Sipahijala Zoo. Excerpt:

Scare of Bird Flu has cast a shadow over bird population of Sipahijala wildlife sanctuary, which falls within five km radius of the mass slaughter of affected birds in Bishalgarh subdivision.

Sipahijala Zoo authority has imposed restriction on visitors from yesterday according to the advice made by the Central Zoo Authority (CZA) in Delhi. CZA was given a detailed guideline to follow as preventive measure against Bird Flu.

Nestled in the quiet environs of reserve forest over 18 square kms area beside the national highway, thirty five kms south of Agartala, Sipahijala is home to 21 bird species and large number of migratory birds from Arunachal Pradesh during winter.

South Korea: More H5N1, more uncertainty

Via JoongAng Daily: Bird flu keeps spreading in worst-ever outbreak here. Excerpt:

The worst outbreak of bird flu ever to strike the nation continues to spread. A government body yesterday confirmed the first-ever case in southeastern Korea.

The flu originated in southwestern Korea at the beginning of the month and almost all 29 confirmed cases so far have been in that area.

The Ministry for Food, Agriculture, Forestry and Fisheries yesterday confirmed a new positive test at the Ulju chicken farm in the city of Ulsan, about 395 kilometers (245 miles) southeast of Seoul.

According to the ministry, 104 chickens died at the farm during the past week, leading to the slaughter of the remaining 16 chickens there.

The story goes on to say that tests have yet to determine if Corporal Cho actually fell ill with H5N1.

Cairo meeting discusses migrants' avian flu

Via afrol News: Cairo meeting discusses migrants' Avian flu. Excerpt:

Govenment ministers, UN agencies, civil society and other stakeholders are taking part in a round table meeting that aims to fine tune Avian flue preparedness activities targeting migrants.

Chaired by the International Organisation for Migration [IOM], the Wednesday round table meeting is held in the Egyptian capital Cairo.

IOM has already begun to implement a three year programme in Egypt similar to one in Cambodia and Vietnam supported by USAID through a fund managed by UNDP in collaboration with the UN System and Partners' Avian and Human Influenza Consolidated Action Plan.

"In Egypt, the project is primarily focused on avian influenza preparedness and response for urban Sudanese migrants in the Cairo governorate," IOM news release said.

"With the possibility of Sudanese migrants returning to a post-conflict South Sudan, it is important they are informed about avian flu and measures to prevent an outbreak in case they go back home."

IOM is expected to conduct a baseline survey to profile the migrants and to determine knowledge of the virus and the practices and beliefs of this group. Besides, it will use its collected information to adapt existing materials to prepare communities against avian flu and for a training manual for community workers in a bid to strengthen community efforts and capacity to deal with an outbreak.

Meanwhile, Vietnam News Agency reports on the IOM project as it affects southeast Asia.

EV71: China tries to calm fears

Via the Guardian Unlimited: China tries to calm fears over virus outbreak. This is of interest because it shows how China is detecting and responding to unexpected diseases. Excerpt:

The Chinese government has dispatched medical experts to eastern Anhui province in a bid to curb a rapidly spreading outbreak of an intestinal virus that has killed at least 20 children.

But officials sought to calm fears amid reports that almost 1,900 children have been taken ill with enterovirus 71, or EV71, which can cause hand, foot and mouth disease.

Newspapers have published scathing criticism of local officials, attacking them for waiting weeks to raise the alarm, and even calling for them to be sacked.

The issue is particularly sensitive because of the uproar caused by the authorities' handling of the Sars epidemic of 2003. Then, they sacked the health minister and pledged to construct an "open and transparent" reporting scheme after it emerged that they had not told the World Health Organisation (WHO) of the outbreak until news emerged independently.

Today central government officials said the outbreak could not be compared to Sars and added that it had taken time to discover the cause of the outbreak.

"You can't talk about EV71 and Sars in the same breath. Sars was a new infectious disease, and anyone could be infected. Sars was also very deadly," Yang Weizhong, deputy chief of the Chinese Centre for Disease Control and Prevention, said in a webcast.

"In the initial stages of [this] probe a lot of effort was expended, to rule out some serious infectious diseases like Sars, bird flu and meningitis," he added.

The first cases of EV71 emerged in Fuyang city in early March, but the outbreak was only reported on Sunday - 40 days later. Since then, the number of recorded infections has soared, with hundreds more emerging daily and reports of cases in neighbouring Henan province.

Mongolia gets into the battle

Via Montsame.mn, a Mongolian news source: Bird flu to be prevented.

There is a high risk of spreading of the bird flu in territories of Mongolia through neighboring China and Russia as well as by migratory birds.

In connection with a number of records of bird flu outbreak in China and Russia, the government approved steps to prohibit a import of live birds, various species of game, chicken, eggs and other game half-processed in Chinese provinces where bird flu case is recorded.

Moreover, an observation will be conducted on rivers and lakes attracting much number of migratory birds, a detailed line itinerary of migratory birds will be made, a permission to hunt for or catch the birds will not be issued and given permissions will be suspended temporarily.