H5N1

Canada: Negligence to blame for C. difficile outbreaks, B.C. doctors allege

Via The Globe and Mail: Negligence to blame for C. difficile outbreaks, B.C. doctors allege. Excerpt:

Eighty-four patients died and hundreds more suffered serious complications following outbreaks of a highly infectious superbug at a Metro Vancouver hospital over the past two years. Now physician whistleblowers are saying the lack of infection control borders on medical negligence. 

The infection rates of the bacteria clostridium difficile at Burnaby Hospital have been two or three times the national average over the past two years and on par with the deadly outbreak in hospitals in the Niagara region that led to government reviews and reporting changes in Ontario. 

“Such is the degree of the [C. difficile] problem and the ineffectual response to it, that we believe it could objectively be considered medical negligence,” pathologist Shane Kirby wrote in a Jan. 9 letter to the Fraser Health Authority. “This breach in duty resulted in injuries.” 

The doctors representing the hospital’s Infection Control Committee say the contagion rate led to unprecedented medical unit closures – in July, 2011, and again in late November – yet requests for enhanced cleaning of the infected units were not implemented. 

In all, 473 serious cases of infection were recorded between 2009 and mid-2011, and that does not include the outbreak in November. 

“We would characterize current [C. difficile] infection control management at Burnaby Hospital, at best, as a serious hazard to the patient population,” Dr. Kirby wrote in the letter, released Wednesday in the B.C. legislature. 

Burnaby General is far from the only hospital in B.C., or Canada, to recently deal with a C. difficile outbreak, but the scale of the outbreak reported by the doctors is significant.

I have an appointment at Burnaby General in the morning.

H5N1 controversy: Dr. Rybicki weighs in

Via the blog Trade Secrets, South Africa's Dr. Ed Rybicki weighs in: We Will Speak for You. He's unhappy that scientists are taking advice from just one country on the H5N1 issue. Excerpt from a lively post:

Consider the following: 

• H5N1 HPAI is endemic in countries such as Indonesia, Vietnam, Thailand, possibly Cambodia and Turkey, and almost certainly in China – and NOT in western Europe, or the USA; 

• while a US agency may have funded the research, the viruses used certainly came from outside of the USA – and at least half of the research was done outside the USA; 

• results of the research would be of immediate use to countries where the virus is endemic, in informing surveillance efforts, as opposed to being of only academic interest in countries where the virus does not occur. 

Yet, authorities in one country – the USA – are presuming to dictate to everyone just what can be disseminated, on the grounds that the information MAY be useful to terrorists who could “weaponise” H5N1. 

Consider further: the mutated viruses have NOT been shown to be: 

• transmissible to humans, 

• to be aerosol-transmitted between humans, or 

• to cause severe disease in humans, 

yet it is being taken as a given that all of these are true, because it is true in ferrets.

H5N1 controversy: Fouchier says his mutant virus not so dangerous

Via The New York Times: Maker Says Bird Flu Virus Not as Dangerous as Thought. Excerpt:

The scientist who made a deadly bird flu virus transmissible in mammals, touching off public fears of a pandemic, said Wednesday that the virus he created was neither as contagious nor as dangerous as people had been led to believe. 

His new revelations have prompted the United States government to ask that the experiments be re-evaluated by a government advisory panel that recommended in December that certain details of the work be kept secret and not published, for fear that terrorists could use them to make bioweapons. Critics of the work had also warned that the virus might leak out of the lab accidentally and start a pandemic. 

“We heard many times that this virus would spread like wildfire if it would come out of our facility,” said Ron Fouchier, the leader of the team that genetically altered the flu virus, at Erasmus Medical Center in Rotterdam, the Netherlands. “We do not think this is the case.”

Pakistan: Hospital denies reports of H5N1 cases

Via the Daily Times: Reports on bird flu cases denied.

RAWALPINDI: A Holy Family Hospital spokesman has denied reports regarding bird flu cases in the hospital. 

He said that some reports had been published in a section of the press that suggested that the disease had once again surfaced and cases were being reported at the hospital, “which are absolutely false and baseless”. 

The Holy Family Hospital medical superintendent told the media that no such case had been reported in the hospital, and “all arrangements have been made to meet any emergency situation on this count”.

Haiti: Dr. Carroll on water in Cité Soleil

Via the Peoria Journal Star, Dr. John Carroll writes about Precious Water in the Haitian Slum. Excerpt:

This was an anonymous comment to my post about Cite Soleil, its water problems, and cholera.   

Wharf Jeremy is part of Cite Soleil and is absolutely inhumane.     

Please read this:   

There are also gang members who sit around the pipes and charge extra money for the water and its has become too expensive for many local people who don't have any money to buy water.  

We have spoken with many of the women and girls who have learned to have sex with the water gangs so they can have fresh water for their family.    

When we first created the We Advance health clinics in Wharf Jeremy, Cite Soleil we had no fence around our clinics and people were stealing water out of our tank daily. We let it happen because if things were so rough in here that they had to steal water to survive then let it be so. Now we have a fence and we order a water truck once a week (which usually costs around 35$ to 40$) but in scarce petrol times it surges to sometimes 68$ a week.    

The truck fills up our tank for our clinics and as our tanks are small there is usually water in the truck left over so we have bath day for all the children and then share the rest with our community who, when they hear there is free water come running for it like a Black Friday Thanksgiving sale at Macys. 

Bangladesh: A fourth human H5N1 case

While I was away from the internet this afternoon, Mike Coston at Avian Flu Diary posted this item: Bangladesh: Reporting Their 4th H5N1 Case. Rather than repeat the news, I'll just suggest you click through and get both the news and Mike's always-sensible analysis and background.

Hong Kong: Second Cheung Chau bird flu scare in days

Via The Standard: Second Cheung Chau bird flu scare in days. Excerpt:

A dead oriental magpie robin, which was found in Cheung Chau, has tested positive for the H5 bird flu virus in preliminary checks, the Agriculture, Fisheries and Conservation Department said yesterday. 

This is the second bird of the species found with the H5 virus on the island within two days this month. 

In the latest incident, the robin, which is common to Hong Kong, was found and collected at Hok Loo Lane. The department is now conducting further confirmatory tests to check if the virus is the deadly H5N1.

A dead oriental magpie robin was found on the rooftop of a building on Hing Lung Back Street in Cheung Chau on Saturday. 

Testing also revealed H5 and confirmatory test results are pending. 

"It is not a huge surprise that the two birds of the same species were found dead in Cheung Chau within two days, especially in winter," said Billy Hau Chi-hang, University of Hong Kong assistant professor in biodiversity and conservation. 

"One bird may come in contact with another which has already contracted the H5 avian influenza virus." 

The department also announced on Tuesday that a crested goshawk, which is not common to Hong Kong, also tested positive for H5.

Zimbabwe: Typhoid spreads nationwide

Via allAfrica.com, a report from The Herald: Zimbabwe: Typhoid Spreads Nationwide. Excerpt:

The typhoid outbreak has spread to other centres with more cases reported in two provinces. 

Government has indicated that it does not have adequate resources to deal with the outbreak. 

Typhoid cases have since been reported in Bindura, Mashonaland Central and Norton and Zvimba in Mashonaland West. 

Epidemiology and Disease Control director in the Ministry of Health and Child Welfare Dr Portia Manangazira said this when she appeared before the Parliamentary Portfolio Committee on Health and Child Welfare. Murehwa North legislator Cde David Parirenyatwa chairs the committee. 

Dr Manangazira said weekly reports on the outbreak show cases have risen from around 30 to more than 200. 

"We actually have an outbreak that is raging, it is important to note that diarrhoeal cases usually precede serious outbreaks like what happened when we had that cholera outbreak," Dr Manangazira said. 

She said in the past week, 93 new cases had been reported in Kuwadzana (20), Mufakose (31), Bindura 29 and Crowbrough (23). 

Thirty-three more cases were reported in other areas through out the country. She attributed the outbreak to poor sanitation and lack of water. Dr Manangazira said there were poor sewer management systems at most local authorities.

Australia: Big wet bears down on NSW

Via ABC News, a report datelined March 1: Big wet bears down on NSW. Click through to watch a video. Excerpt:

One of the biggest weather events in New South Wales for decades is starting to make its presence felt, with a massive rain system bearing down on southern and central parts of the state. 

The region has already seen torrential downpours, evacuation alerts and warnings of flash flooding. 

In Goulburn, the State Emergency Service (SES) says residents were not evacuated on Wednesday night as previously expected. 

But there are concerns about low-lying areas of Cooma and Cowra, while west of Sydney the Warragamba Dam is at risk of overflowing. 

About 70 people in Cowra have been evacuated due to flooding. 

The SES issued the evacuation order yesterday afternoon, asking the affected residents to put their names down at the local library before finding accommodation with family. 

Remaining residents are getting ready to protect their homes, using sandbags as a first line of defence as the rain continues to fall. 

"It's hard to tell because it's constant," one resident said. "But it's not going to be flash flooding like last time. So it could get bad, but it might not." 

A severe weather warning remains in place for almost half of the state. 

"We've got a very serious situation developing in New South Wales, about 75 per cent of the state is flood-affected or in flood watch," SES spokesman Dieter Geske said. 

"This rain band has been an extraordinary event as in we rarely see rain of this magnitude in this part of the state, and we rarely see a low trough hang around for as long as this trough's going to."

H5N1 controversy: Biosecurity group to review new avian flu data

Via Nature News Blog, a post by Susan Young: Biosecurity group to review new avian flu data. Click through for the full report and many links. Excerpt:

The National Institutes of Health wants a biosecurity review board to reconsider the fate of two unpublished H5N1 avian flu virus studies in light of new data and clarifications. 

Dr. Anthony Fauci, director the NIH’s National Institute of Allergy and Infectious Diseases (NIAID) made the announcement in an early morning panel discussion of the H5N1 papers at the American Society for Microbiology Biodefense and Emerging Diseases Research Meeting, in Washington, DC. The studies show that lab-altered versions of the H5N1 virus can be passed between ferrets, a lab model of human flu infection, through aerosol transmission (sneezes and coughs). 

The National Science Advisory Board for Biosecurity (NSABB) recommended in  December that the two studies only be published if essential experimental details are removed. On 17 February, a meeting of experts convened by the World Health Organization (WHO) came to a different conclusion: that the papers should be published in full (see Avian flu controversy comes to roost at WHO). 

Investigators on the two detained manuscripts presented new data to the WHO meeting attendees and provided substantial clarification of the original data, especially the data from Ron Fouchier of Erasmus Medical Center in Rotterdam, Netherlands, said Fauci. The WHO panel recommended the investigators revise their manuscripts with the new data and clarifications. 

While the NIH continues to support the NSABB’s original recommendation to publish redacted versions of the original studies, they also “support revision of the manuscripts to include new data and elicit clarifications of old data,” said Fauci. The agency also would like the NSABB to reconvene to examine the revised manuscripts.