H5N1

WHO didn't let the dogs out?

I've been accustomed to checking WHO | Situation updates - Pandemic (H1N1) 2009 every Friday for the latest survey of swine flu around the world. It hasn't been very informative, and WHO persists in presenting its news in great long dull unreadable paragraphs, but it's the most reliable information we've got.

Nothing today. Maybe someone's gone on holiday, or the authorities have decided to skip it this time because on Monday they're going to declare the pandemic over. I'll update this post if and when something turns up.

WHO: The latest H5N1 tally

WHO has published its latest Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1): 502 cases, 298 of them fatal, since 2003, for a worldwide case fatality ratio of 59.3 percent.

The new death is the 13-year-old in Indonesia, where the CFR is 82.6 percent. Compared to just today's deaths from malaria, HIV, and even H1N1, these are negligible numbers. But the threat of H5N1 remains potentially disastrous. If this virus ever learns how to travel well as H1N1 and other flu viruses have, and it keeps its ability to kill three or four out of five of its victims, the Spanish flu of 1918-19 will look like sniffles in a kindergarten.

Dominican Republic: Anti-dengue program begins today in La Cienega

Via the English-language version of DiarioLibre.com: Anti-dengue program begins today in La Cienega. Excerpt:

A new, national anti-dengue campaign for the prevention of the disease gets underway today. It will continue through Sunday, headed by the Ministry of Public Health and other state institutions, and aimed at stopping the propagation of the disease in the population. 

The scenario chosen for the beginning of the outreach is the La Cienega barrio in the National District, where, starting at 8:00 a.m. the brigades from Public Health, headed by the Minister, Bautista Rojas Gomez, will go around spraying, eliminating breeding areas of the mosquito vector, and handing out "Abate", a product that kills mosquito larva.

Since "La Cienega" (or cienaga) means "the swamp," this seems like a good place to start.

A new analysis of the 1918-19 pandemic

Via PLoS ONE, a report from Portuguese researchers: Influenza Infectious Dose May Explain the High Mortality of the Second and Third Wave of 1918–1919 Influenza Pandemic. The abstract:

Background 

It is widely accepted that the shift in case-fatality rate between waves during the 1918 influenza pandemic was due to a genetic change in the virus. In animal models, the infectious dose of influenza A virus was associated to the severity of disease which lead us to propose a new hypothesis. We propose that the increase in the case-fatality rate can be explained by the dynamics of disease and by a dose-dependent response mediated by the number of simultaneous contacts a susceptible person has with infectious ones. 

Methods 

We used a compartment model with seasonality, waning of immunity and a Holling type II function, to model simultaneous contacts between a susceptible person and infectious ones. In the model, infected persons having mild or severe illness depend both on the proportion of infectious persons in the population and on the level of simultaneous contacts between a susceptible and infectious persons. We further allowed for a high or low rate of waning immunity and volunteer isolation at different times of the epidemic. 

Results 

In all scenarios, case-fatality rate was low during the first wave (Spring) due to a decrease in the effective reproduction number. The case-fatality rate in the second wave (Autumn) depended on the ratio between the number of severe cases to the number of mild cases since, for each 1000 mild infections only 4 deaths occurred whereas for 1000 severe infections there were 20 deaths. A third wave (late Winter) was dependent on the rate for waning immunity or on the introduction of new susceptible persons in the community. If a group of persons became voluntarily isolated and returned to the community some days latter, new waves occurred. For a fixed number of infected persons the overall case-fatality rate decreased as the number of waves increased. This is explained by the lower proportion of infectious individuals in each wave that prevented an increase in the number of severe infections and thus of the case-fatality rate. 

Conclusion 

The increase on the proportion of infectious persons as a proxy for the increase of the infectious dose a susceptible person is exposed, as the epidemic develops, can explain the shift in case-fatality rate between waves during the 1918 influenza pandemic.

US: Woman catches dengue fever while visiting Key West

Via HeraldTribune.com, an AP report: Woman catches dengue fever while visiting Key West. Excerpt:

Health officials say a Broward County woman caught dengue fever during a trip to Key West. 

 Lorelei Happel says she learned Wednesday that lab results showed she had the disease. The 51-year-old says she started feeling sick soon after she arrived home in Wilton Manors from her trip. 

The Broward County Health Department is now investigating three probable cases.

Indonesia: Cull goes on in East Jakarta

Via BeritaJakarta.com: Thousands of poultry culled in East Jakarta. Excerpt:

East Jakarta Municipal Administration is very serious to protect its citizens from the threat of the H5N1 virus of bird flu. It can be seen from the number of poultry of various types culled by the local husbandry and fishery agency from January until July 2010, reaching 1,309. 

The thousands of destroyed poultry consisted of 524 chickens, 345 ducks, and 440 pigeons. Of the number, most destroyed poultry was recorded in Kramatjati sub-district (403), followed by Cakung (195), Cipayung (179), Pasarrebo (130), Jatinegara (106), Pulogadung (102), Ciracas (65), Durensawit (63), Makassar (59), and Matraman (7). In the poultry destruction procedure, the slaughtered poultry are returned to the owners. 

In addition to culling poultry, the officers also dismantle and burn poultry cages located within a radius of several meters from residential areas. It is considered necessary to reassure that public are really free from poultry. These measures are in line with Bylaw No.4/2007 on Poultry Control and Distribution in Jakarta area. 

Head of the agency Ahmad Adnan explains every citizen who lives in Jakarta is banned from raising poultry within a radius of 25 meters from residential areas. "Our officers will directly take action on poultry roaming in residential areas," said Adnan, Friday (7/30).

Restoring the dead birds to their owners might seem bizarre, but these were healthy birds—they were just being kept in the wrong place.

India: 2,500 Mumbai police in sick bay

Via Mumbai Mirror.com: 2500 cops in sick bay as malaria hits police force.

Against malaria, policemen are as helpless as the aam aadmi. Over the past two months, with the city firmly in malaria-grip, more than 2,500 policemen have been hospitalised. 

The mosquitoes didn’t even spare Director General of Police D Sivanandhan, who was discharged from the hospital recently after undergoing a five-day treatment for dengue. 

Mumbai police sources said every month, around 1,700 personnel out of 35,000 report ill. The number has gone up between 2,000 and 2,500 in June-July, and more than 90 per cent are malaria cases. 

Joint Commissioner of Police (Traffic) Sanjay Barve, in a meeting with the BMC authorities last week, said around 15 per cent among the traffic police department are battling malaria. 

Then there are cases of malaria in policemen’s family, keeping them away from duty. The number of policemen and members of their family visiting the 12 police dispensaries in the city stands on an average at 300 per day in the past two months - an increase by almost 100.

How the cholera bacteria works

Via Medical News Today.com: The Mysterious Workings Of The Cholera Bacteria Revealed By Rensselaer Professor. Excerpt:

Researchers have found that an enzyme in the bacteria that causes cholera uses a previously unknown mechanism in providing the bacteria with energy. Because the enzyme is not found in most other organisms, including humans, the finding offers insights into how drugs might be created to kill the bacteria without harming humans. 

Blanca Barquera, a Rensselaer associate professor of biology, led a team (including research professor Joel Morgan and postdoctoral fellow Oscar Juarez) whose findings were published in the Proceedings of the National Academy of Science. 

The team studied Na+-NQR, an enzyme that is essentially two linked machines to create energy from food and electrically charge the cell membrane of Vibrio cholerae, powering many cellular functions.

Honduras: New dengue death reported

Via ElHeraldo.hn: Reportan nueva muerte por dengue en Honduras.[New dengue death reported in Honduras] Excerpt, with my translation:

Personal sanitario confirmó este jueves una nueva víctima del dengue en Honduras. 

Health personnel this Thursday confirmed a new dengue victim in Honduras.

Se trata de un hombre de 36 años, que ingresó ayer a Hospital Escuela, con un cuadro avanzado de dengue hemorrágico y falleció esta mañana, alrededor de las 8:00 AM. 

He was a 36-year-old man, admitted yesterday to School Hospital with an advanced case of hemorrhagic dengue; he died this morning about 8:00 a.m.

El hombre fue identificado como Melvin Alexander Gallego Padilla, un árbitro de fútbol residente en la colonia Torocagua de Comayagüela. 

He was identified as Melvin Alexander Gallego Padillo, a football referee living in Torocagua de Comayagüela.

La muerte se suma a otras 35, de las cuales 31 han sido certificadas por Salud y cuatro continúan en evaluación. 

The death is added to 35 others, of which 31 have been confirmed by Health and 4 continuing under study.

Ayer falleció una joven madre en el mayor centro asistencial de Honduras, junto al pequeño que logró alumbrar pero al que tampoco pudieron salvar los médicos.

Yesterday a young mother died in the major hospital in Honduras, next to the baby she had just delivered, but the doctors could not save the baby either.

India: '2nd wave of swine flu has arrived'

Via The Times of India: '2nd wave of swine flu has arrived'. Excerpt:

The second wave of the pandemic H1N1 influenza has struck and its infection rate is likely to be higher than the first wave, according to the National Institute of Virology (NIV). 

The wave is currently strong in Mumbai, Pune and Bangalore, an NIV official said, adding that there's no need to panic as anti-H1N1 vaccines are available in the market. 

"We are in it now. The second wave of the virus arrived in mid-July and will continue until September. We need to be prepared for whatever surprises this nasty new virus delivers," NIV director A C Mishra told TOI.