H5N1

Another flu blog

Thanks to the reader who tipped me off to Pandemic Flu Central. It's evidently been around since March, but my blog searches failed to find it. I'm adding it to the H5N1 Bloggers list.

If anyone is aware of blogs in the hot-zone countries that deal even occasionally with H5N1, please let me know.

Supari: Disasters often cause health crisis

Via Antara: Minister: disasters often cause health crisis.

Health Minister Siti Fadilah Supari said floods, droughts, landslides, whirlwinds, volcanic eruptions and tsunmis often caused health crisis, so that all elements of the nation need to be more involved in handling these disasters.

"We ask all parties involved in the handling of disaster-related health crisis," the minister said when installing around 4,500 officials of a disaster task force at a [meeting] in Semarang, Central Java on Thursday.

Disasters could trigger a health crisis, such as huge number of victims, refugees, lack of drinking water, affected sanitation, infectious diseases, poor health services and post traumatic stress.

In 2006, there were 162 disasters and 205 in 2007. The empowering of the youngster to be ready for emergence assistance still needed the support from all elements in the community.

Younsters are the only potential elements in the community to play an active role in the handling of disasters, especially in giving a hand to the needy during a disaster.

The health minister often monitored natural disasters which also triggered health problems, so that giving quick, proper and efficient assistance is the right step.

No comment.

Nigeria working to control new B2B H5N1 outbreaks

Via allAfrica.com, a report from The Daily Trust in Abuja: Nigeria: Agency Strategises Against Fresh Outbreak of Bird Flu. Excerpt:

The Kano State office of the Avian Influenza Control and Human Pandemic Preparedness Project (AICP) has swung into action to control the recent outbreak of the avian influenza detected in Dawakin Tofa Local Government Area of the state and Kadarko village in Katsina State.

A statement from the AICP Kano office signed by the project communication desk officer, Alhaji Surajo Ibrahim Gaya stated that immediate actions had been adopted by the AICP to put the outbreak of the disease under control.

The statement said, "The affected farms have been depopulated and disinfected by an expert team led by the state project desk officer, Animal Health Component, Dr Sarki B. Muhammad."

This, according to the statement, is in addition to the detailed epidemiological investigation that is on to trace the source of the outbreak with a view to addressing the situation before it is too late.

FAO working to raise awareness in Egypt

Via Daily News Egypt: FAO workshop highlights importance of biosecurity in fighting avian flu. Excerpt:

Biosecurity is vital in combating avian flu, said officials from the Food and Agricultural Organization (FAO).

Professor Nick Taylor from the University of Reading said that biosecurity is about minimizing the risk of spreading the virus within the farm and from one farm to another.

In cooperation with the General Organization of Veterinary Services (GOVS), the FAO organized a workshop in Cairo on Wednesday to discuss the deadly virus.

Explaining the possible scenarios of a viral outbreak, Taylor said the transmission of the virus can be prevented by identifying the critical control points of each scenario to minimize the risk.

The discussions focused on combating the virus in privately-owned farms that are commonly found inside homes in rural areas. In these villages, there is no awareness about biosecurity and the implementation of practical steps to prevent the spread of the virus.

“We have two sectors of poultry farms: the private sector, also known as the commercial sector, where biosecurity is given due attention and where sufficient funds are available to implement biosecurity measures," Mona Mehrez, head of the Central Laboratory for Poultry Monitoring at the Ministry of Agriculture and Land Reclamation, told Daily News Egypt.

"On the other hand, there are the rural areas where poultry is raised inside the houses, and where, unfortunately, people are not educated enough or do not have the sufficient funds," she added.

Participants highlighted the proximity between farms and the continuous presence of visitors as some of the major contributors to the spread of the disease.

“We try to provide these producers with funds and create awareness, but the efforts of the public sector are necessary because they have better access to these people,” she added.

Mehrez emphasized the need to change people's perception about biosecurity, explaining that change has to be initiated at the grassroots level because the law is not enough.

A new, improved Relenza?

Via Bloomberg: Longer-acting Relenza fights flu as well as Tamiflu, study says. Excerpt:

Daiichi Sankyo Co.'s longer-acting version of GlaxoSmithKline Plc's flu drug, Relenza, was as effective as a course of Tamiflu, a patient study found.

The safety and efficacy of a single dose of the inhaled medicine was "statistically indistinguishable'' from a twice-a- day dose of Roche Holding AG's Tamiflu taken for five days, said Melbourne-based Biota Holdings Ltd., which is developing the drug with Japan's Daiichi Sankyo.

The study, involving "several hundred'' patients with seasonal flu, was the second of three stages of human trials usually needed for regulatory approval.

The companies plan to start final-stage tests in Japan, Taiwan, Hong Kong and South Korea by the Northern Hemisphere winter, Biota said in a statement today. If approved, the medicine could provide a new treatment for flu, a disease causing 250,000 to 500,000 deaths worldwide a year.

Previous studies also showed the medicine fights the H5N1 version of bird flu, which world health officials say might set off a lethal pandemic.

The long loud silence out of Indonesia

It's July 31 in Indonesia, and we were told that Dr. Supari would condescend to advise the world about now on any recent human H5N1 cases.

So far, the only Indonesian flu site that's been recently updated is Bidang Komunikasi Komnas FBPI. It does have some new links, though they all seem to be in Bahasa Indonesia—or they're under construction, or they've exceeded their bandwidth.

Maybe by August 1 the Indonesians will get around to informing WHO and the rest of us of what's happened in the past month or two. I hope so.

Visitors of a certain age may recognize an allusion in the headline of this post. In 1952, Wilson Tucker published The Long Loud Silence, a pretty good SF novel about a nuclear/biological attack on the US east of the Mississippi. (Why the western US was spared was never made clear.)

I must have read it when I was 11 or 12, so my literary judgment may be a little dubious. But the silence out of Indonesia grows longer and louder with every passing day.

The Bali exercise

Last spring, Indonesia conducted a flu drill in Bali. I wrote to one of the participants, and today received a poster from him summarizing the findings of the drill. Here it is, a Word file: Download poster_for_tjandra.doc

A letter to the editor

Via Coulee News in West Salem Wisconsin, a letter to the editor: We can’t wait for a pandemic to hit. Excerpt:

According to biologists and epidemiologists, a bird flu pandemic is a certainty. A look at the recent www.dailykos.com article will educate skeptics. A look at www.pandemicflu.gov will do the same.

My concern is: What is La Crosse doing about preparing for it? I know there have been some preparations, but what are they? Is there a vaccine for everyone?

There are vaccines in production but they are for the current form of the current H5N1 virus, which will not be the mutated form that will spread human to human. Of the 385 humans who have caught the virus, from infected bird droppings, about 63 percent, 243, have died. Those odds, if the eventual human to human variety is as powerful, are terrifying.

I propose the following: our city leaders should educate themselves on the pandemic subject now, not later. And they should then immediately explore the new vaccine technology of Novavax Inc.

Novavax will produce the strain-appropriate vaccine through its innovative virus-like-particle technology once the new strain comes into existence. Their non-egg manufacturing method is being championed by a partnership with General Electric Healthcare Inc.

Perhaps the writer of the letter has a stake in Novavax, but what interests me about this letter is its rarity. Daily scans of the news gatherers turn up almost nothing like this.

Perhaps Flublogians should write an occasional note to their local papers, just to remind their communities that bird flu is still out there.

Thailand: Four test negative for H5N1

Via The National: Four test negative for bird flu. Excerpt:

Four people in Phichit province who were suspected of having contracted the birdflu virus have tested negative for the disease, the Public Health Ministry said yesterday.

Deputy permanent secretary Dr Paijit Warachit said he ordered the mobile rapid diseaseinvestigation unit to collect blood samples from the four for testing against the H5N1 strain of the virus at Nakhon Sawan's provincial Science Centre.

The laboratory results found that none of the four had the H5N1 virus, which can be lethal to humans. Three of them are suffering from seasonal influenza, while the fourth has no flu whatsoever.

The four people tested were Krisada Tiangtham, six years old, Nadda Tiangyoo, 10, Tabtim Promsri, 62, and Wanna Toramram, 70. They all remain under observation in Phichit's Sam Ngam Hospital. Krisada does not have the flu.

The four reported they had come into contact with dead chickens in their village before falling ill. Three days later, they had a high fever, and it was feared they had been infected with the H5N1 strain of the birdflu virus.

Paijit has asked healthcare volunteers in Sam Ngam district to monitor the symptoms of the relatives of the three patients with seasonal flu for the next 12 days. If any suspicious symptoms are found, they will also be sent to hospital immediately.

Not only is this good news, but it's a slap in the face to Indonesia's deliberate smothering of flu coverage.

These cases were reported at once (and in English-language media). The Thais' medical system jumped into action and got fast results, and the Thai media reported those results.

The moral I draw is that the Thais are acting like responsible grown-ups about a potentially serious problem. The Indonesians are not.

Japan: 40% of workers might have to stay home in flu pandemic (updated)

Via The Daily Yomiuri: 40% of workers might have to stay home in flu pandemic. Excerpt:

The Health, Labor and Welfare Ministry estimates that up to about 40 percent of the workforce would be forced to stay home in the event of an influenza pandemic.

The ministry estimates that the pandemic also could cause social and economic problems, such as medicine shortages and power outages.

For the first time, the ministry released estimates of problems that could be caused by a flu pandemic, hoping companies and other organizations would draw up preparatory measures.

The ministry also released a revised outline of suggested actions for companies in case of an outbreak.

Estimates were based on the human suffering figures in government's pandemic relief action plan--revised in October. The plan estimates 25 percent of people would suffer from a new influenza pandemic, with a fatality rate of 2 percent.

Since Japan's population is currently around 127 million, that would imply 31 million cases of H5N1 and about 635,000 deaths. The estimates on attack rate and case fatality ratio are likely drawn by analogy with worldwide statistics for Spanish flu.

According to Wikipedia,

In Japan, 257,363 deaths were attributed to influenza by July 1919, giving an estimated 0.425% mortality rate, much lower than nearly all other Asian countries for which data are available. The Japanese government severely restricted maritime travel to and from the home islands when the pandemic struck.

Japan's flu statistics for 1919 raise some questions. If a quarter-million people died with such a low CFR, that suggests something like 50 million Japanese must have caught Spanish flu.

And since the population of Japan circa 1920 was about 56 million, either everyone caught the flu in Japan, or the CFR was a lot higher than 0.425%.

The impact of the 1918-19 pandemic on Asian countries doesn't seem to have been studied very closely, but if anyone can point me to some good sources, I'll be glad to post them.

Update: SophiaZoe has a thoughtful response to the Yomiuri story.