Key Facts About Avian Influenza (Bird Flu) and Avian Influen

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Key Facts About Avian Influenza (Bird Flu) and Avian Influen

Post#1 » Mon Jun 20, 2005 5:22 pm

CDC: Key Facts About Avian Influenza (Bird Flu) and Avian Influenza A (H5N1) Virus
March 18, 2005
This fact sheet provides general information about bird flu and information about one type of bird flu, called avian influenza A (H5N1) that is infecting birds in Asia and has infected some humans.
What is avian influenza (bird flu)?


Bird flu is an infection caused by avian (bird) influenza (flu) viruses. These flu viruses occur naturally among birds. Wild birds worldwide carry the viruses in their intestines, but usually do not get sick from them. However, bird flu is very contagious among birds and can make some domesticated birds, including chickens, ducks, and turkeys, very sick and kill them.
Do bird flu viruses infect humans?

Bird flu viruses do not usually infect humans, but several cases of human infection with bird flu viruses have occurred since 1997.
How are bird flu viruses different from human flu viruses? Updated March 18

There are many different subtypes of type A flu viruses. These subtypes differ because of certain proteins on the surface of the flu A virus (hemagglutinin [HA] and neuraminidase [NA] proteins). There are 16 different HA subtypes and 9 different NA subtypes of flu A viruses. Many different combinations of HA and NA proteins are possible. Each combination is a different subtype. All subtypes of flu A viruses can be found in birds. However, when we talk about “bird flu” viruses, we are referring to those flu A subtypes that continue to occur mainly in birds. They do not usually infect humans, even though we know they can do so. When we talk about “human flu viruses” we are referring to those subtypes that occur widely in humans. There are only three known subtypes of human flu viruses (H1N1, H1N2, and H3N2); it is likely that some genetic parts of current human flu A viruses came from birds originally. Flu A viruses are constantly changing, and they might adapt over time to infect and spread among humans.
What are the symptoms of bird flu in humans?

Symptoms of bird flu in humans have ranged from typical flu-like symptoms (fever, cough, sore throat and muscle aches) to eye infections, pneumonia, severe respiratory diseases (such as acute respiratory distress), and other severe and life-threatening complications. The symptoms of bird flu may depend on which virus caused the infection.
How does bird flu spread?

Infected birds shed flu virus in their saliva, nasal secretions, and feces. Susceptible birds become infected when they have contact with contaminated excretions or surfaces that are contaminated with excretions. It is believed that most cases of bird flu infection in humans have resulted from contact with infected poultry or contaminated surfaces.
How is bird flu in humans treated?

Studies suggest that the prescription medicines approved for human flu viruses would work in preventing bird flu infection in humans. However, flu viruses can become resistant to these drugs, so these medications may not always work.
What is the risk to humans from bird flu?

The risk from bird flu is generally low to most people because the viruses occur mainly among birds and do not usually infect humans. However, during an outbreak of bird flu among poultry (domesticated chicken, ducks, turkeys), there is a possible risk to people who have contact with infected birds or surfaces that have been contaminated with excretions from infected birds. The current outbreak of avian influenza A (H5N1) among poultry in Asia (see below) is an example of a bird flu outbreak that has caused human infections and deaths. In such situations, people should avoid contact with infected birds or contaminated surfaces, and should be careful when handling and cooking poultry. For more information about avian influenza and food safety issues, visit the World Health Organization website.
What is an avian influenza A (H5N1) virus?

Influenza A (H5N1) virus – also called “H5N1 virus” – is an influenza A virus subtype that occurs mainly in birds. It was first isolated from birds (terns) in South Africa in 1961. Like all bird flu viruses, H5N1 virus circulates among birds worldwide, is very contagious among birds, and can be deadly.
What is the H5N1 bird flu that has recently been reported in Asia?

Outbreaks of influenza H5N1 occurred among poultry in eight countries in Asia (Cambodia, China, Indonesia, Japan, Laos, South Korea, Thailand, and Vietnam) during late 2003 and early 2004. At that time, more than 100 million birds in the affected countries either died from the disease or were killed in order to try to control the outbreak. By March 2004, the outbreak was reported to be under control. Beginning in late June 2004, however, new deadly outbreaks of influenza H5N1 among poultry were reported by several countries in Asia (Cambodia, China, Indonesia, Malaysia [first-time reports], Thailand, and Vietnam ). It is believed that these outbreaks are ongoing. Human infections of influenza A (H5N1) have been reported in Thailand and Vietnam during both of these outbreak periods.
What is the risk to humans from the H5N1 virus in Asia?

The H5N1 virus does not usually infect humans. In 1997, however, the first case of spread from a bird to a human was seen during an outbreak of bird flu in poultry in Hong Kong. The virus caused severe respiratory illness in 18 people, 6 of whom died. Since that time, there have been other cases of H5N1 infection among humans. Most recently, human cases of H5N1 infection have occurred in Thailand and Vietnam during large H5N1 outbreaks in poultry. The death rate for these reported cases has been about 70 percent. Most of these cases occurred from contact with infected poultry or contaminated surfaces; however, it is thought that a few cases of human-to-human spread of H5N1 have occurred.

So far, spread of H5N1 virus from person to person has been rare and spread has not continued beyond one person. However, because all influenza viruses have the ability to change, scientists are concerned that the H5N1 virus could one day be able to infect humans and spread easily from one person to another. Because these viruses do not commonly infect humans, there is little or no immune protection against them in the human population. If the H5N1 virus were able to infect people and spread easily from person to person, an “ influenza pandemic ” (worldwide outbreak of disease) could begin. No one can predict when a pandemic might occur. However, experts from around the world are watching the H5N1 situation in Asia very closely and are preparing for the possibility that the virus may begin to spread more easily and widely from person to person.
How is infection with H5N1 virus in humans treated?

The H5N1 virus currently infecting birds in Asia that has caused human illness and death is resistant to amantadine and rimantadine, two antiviral medications commonly used for influenza. Two other antiviral medications, oseltamavir and zanamavir, would probably work to treat flu caused by the H5N1 virus, though studies still need to be done to prove that they work.
Is there a vaccine to protect humans from H5N1 virus?

There currently is no vaccine to protect humans against the H5N1 virus that is being seen in Asia. However, vaccine development efforts are under way. Research studies to test a vaccine to protect humans against H5N1 virus are expected to begin in April 2005. (Researchers are also working on a vaccine against H9N2, another bird flu virus subtype.) For more information about the H5N1 vaccine development process, visit the National Institutes of Health website.
What is the risk to people in the United States from the H5N1 bird flu outbreak in Asia?

The current risk to Americans from the H5N1 bird flu outbreak in Asia is low. The strain of H5N1 virus found in Asia has not been found in the United States. There have been no human cases of H5N1 flu in the United States. It is possible that travelers returning from affected countries in Asia could be infected. Since February 2004, medical and public health personnel have been watching closely to find any such cases.
What does CDC recommend regarding the H5N1 bird flu outbreak in Asia?

In February 2004, CDC provided U.S. health departments with recommendations for enhanced surveillance (“detection”) in the U.S. of avian influenza A (H5N1). Follow-up messages (Health Alert Network) were sent to the health departments on August 12, 2004, and February 4, 2005, both reminding health departments about how to detect (domestic surveillance), diagnose, and prevent the spread of avian influenza A (H5N1). It also recommended measures for laboratory testing for H5N1 virus. CDC currently advises that travelers to countries in Asia with known outbreaks of influenza A (H5N1) avoid poultry farms, contact with animals in live food markets, and any surfaces that appear to be contaminated with feces from poultry or other animals.
Attached link: http://www.iwar.org.uk/news-archive/2005/03-18-4.htm

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WHO probes China's reported use of flu drug on birds

Post#2 » Mon Jun 20, 2005 5:22 pm

WHO probes China's reported use of flu drug on birds
20 Jun 2005 03:45:56 GMT
(LINK) http://www.alertnet.org/thenews/newsdesk/PEK33544.htm
Source: Reuters
BEIJING, June 20 (Reuters) - The World Health Organisation is seeking clarification from China about reports it urged farmers to use a human anti-viral drug to treat birds infected with a deadly strain of avian flu, breaking international guidelines.

Scientists fear the bird flu, which is infectious in birds but does not spread easily among humans, could mutate into a form capable of generating a pandemic in which millions of people without immunity could die.

The Washington Post reported on Saturday that Chinese farmers, acting with government encouragement, had tried to suppress major bird flu outbreaks among chickens with amantadine, possibly making it useless in fighting human influenza.

"We would certainly be seeking more information on this topic and would hope to have more clarification from China on this issue," said Roy Wadia, a spokesman for WHO in China.

"The use of drugs, not just in China but also around the world, should be carefully monitored and we have seen over the years that improper administration of medication or drugs can lead to drug resistance in the case of other diseases."

He declined to comment further.

The U.N. Food and Agriculture Organisation also declined to comment.

Researchers had determined that the H5N1 bird flu strain in Vietnam and Thailand had become resistant to amantadine, the Post said, adding they suspected it had been due to the drug's use on farms.

The Post, quoting international researchers, said the drug would no longer protect people in case of a worldwide avian flu epidemic.

The WHO has said the virus that first surfaced in poultry in Hong Kong and China eight years ago is "unstable, unpredictable and very versatile".

It has killed at least 37 people in Vietnam, 12 in Thailand and four in Cambodia.

China has culled thousands of birds this year to curb the spread of the disease.

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(H5N1)Pandemic=A Worldwide Outbreak

Post#3 » Mon Jun 20, 2005 5:26 pm

Pandemic: A Worldwide Outbreak of Influenza
(CDC Link)
An influenza pandemic is a global outbreak of disease that occurs when a new influenza A virus appears or “emerges” in the human population, causes serious illness, and then spreads easily from person to person worldwide. Pandemics are different from seasonal outbreaks or “epidemics” of influenza.

Seasonal outbreaks are caused by subtypes of influenza viruses that are already in existence among people, whereas pandemic outbreaks are caused by new subtypes or by subtypes that have never circulated among people or that have not circulated among people for a long time. Past influenza pandemics have led to high levels of illness, death, social disruption, and economic loss.

Appearance (“Emergence”) of Pandemic Influenza Viruses
There are many different subtypes of Influenza or “flu” viruses. The subtypes differ based upon certain proteins on the surface of the virus (the hemagglutinin or “HA” protein and the neuraminidase or the “NA” protein).

Pandemic viruses appear (or “emerge”) as a result of a process called "antigenic shift,” which causes an abrupt or sudden, major change in influenza A viruses. These changes are caused by new combinations of the HA and/or NA proteins on the surface of the virus. This change results in a new influenza A virus subtype. The appearance of a new influenza A virus subtype is the first step toward a pandemic, but the new virus subtype also must spread easily from person to person to cause a pandemic. Once a new pandemic influenza virus emerges and spreads, it normally becomes established among people and moves around or “circulates” for many years as seasonal epidemics of influenza. The U.S. Centers for Disease Control and Prevention and the World Health Organization have large surveillance programs to monitor and “detect” influenza activity around the world, including the emergence of possible pandemic strains of influenza virus.

Influenza Pandemics During the 20th Century
During the 20th century, the emergence of new influenza A virus subtypes caused three pandemics, all of which spread around the world within 1 year of being detected.

1918-19, "Spanish flu," [A (H1N1)], caused the highest number of known influenza deaths: more than 500,000 people died in the United States, and up to 50 million people may have died worldwide. Many people died within the first few days after infection, and others died of complications later. Nearly half of those who died were young, healthy adults. Influenza A (H1N1) viruses still circulate today after being introduced again into the human population in the 1970s.
1957-58, "Asian flu," [A (H2N2)], caused about 70,000 deaths in the United States. First identified in China in late February 1957, the Asian flu spread to the United States by June 1957.
1968-69, " Hong Kong flu," [A (H3N2)], caused about 34,000 deaths in the United States. This virus was first detected in Hong Kong in early 1968 and spread to the United States later that year. Influenza A (H3N2) viruses still circulate today.
Both the 1957-58 and 1968-69 pandemics were caused by viruses containing a combination of genes from a human influenza virus and an avian influenza virus. The origin of the 1918-19 pandemic virus is not clear.

Stages of a Pandemic
The World Health Organization (WHO) has developed a global influenza preparedness plan, which defines the stages of a pandemic, outlines WHO’s role and makes recommendations for national measures before and during a pandemic. The phases are:

Interpandemic period

Phase 1: No new influenza virus subtypes have been detected in humans. An influenza virus subtype that has caused human infection may be present in animals. If present in animals, the risk of human infection or disease is considered to be low.

Phase 2: No new influenza virus subtypes have been detected in humans. However, a circulating animal influenza virus subtype poses a substantial risk of human disease.

Pandemic alert period

Phase 3: Human infection(s) with a new subtype, but no human-to-human spread, or at most rare instances of spread to a close contact.

Phase 4: Small cluster(s) with limited human-to-human transmission but spread is highly localized, suggesting that the virus is not well adapted to humans.

Phase 5: Larger cluster(s) but human-to-human spread still localized, suggesting that the virus is becoming increasingly better adapted to humans, but may not yet be fully transmissible (substantial pandemic risk).

Pandemic period

Phase 6: Pandemic: increased and sustained transmission in general population.

Notes: The distinction between phase 1 and phase 2 is based on the risk of human infection or disease resulting from circulating strains in animals. The distinction is based on various factors and their relative importance according to current scientific knowledge. Factors may include pathogenicity in animals and humans, occurrence in domesticated animals and livestock or only in wildlife, whether the virus is enzootic or epizootic, geographically localized or widespread, and/or other scientific parameters.

The distinction between phase 3, phase 4 and phase 5 is based on an assessment of the risk of a pandemic. Various factors and their relative importance according to current scientific knowledge may be considered. Factors may include rate of transmission, geographical location and spread, severity of illness, presence of genes from human strains (if derived from an animal strain), and/or other scientific parameters.

Vaccines to Protect Against Pandemic Influenza Viruses
A vaccine probably would not be available in the early stages of a pandemic. When a new vaccine against an influenza virus is being developed, scientists around the world work together to select the virus strain that will offer the best protection against that virus, and then manufacturers use the selected strain to develop a vaccine. Once a potential pandemic strain of influenza virus is identified, it takes several months before a vaccine will be widely available. If a pandemic occurs, it is expected that the U.S. government will work with many partner groups to make recommendations to guide the early use of vaccine.

Antiviral Medications to Prevent and Treat Pandemic Influenza
Four different influenza antiviral medications (amantadine, rimantadine, oseltamivir, and zanamivir) are approved by the U.S. Food and Drug Administration for the treatment and/or prevention of influenza. All four work against influenza A viruses. However, sometimes influenza virus strains can become resistant to one or more of these drugs, and thus the drugs may not always work. For example, the influenza A (H5N1) viruses identified in human patients in Asia in 2004 and 2005 have been resistant to amantadine and rimantadine. Monitoring of avian viruses for resistance to influenza antiviral medications is continuing.

Preparing for the Next Pandemic
Many scientists believe it is only a matter of time until the next influenza pandemic occurs. The severity of the next pandemic cannot be predicted, but modeling studies suggest that its effect in the United States could be severe. In the absence of any control measures (vaccination or drugs), it has been estimated that in the United States a “medium–level” pandemic could cause 89,000 to 207,000 deaths, between 314,000 and 734,000 hospitalizations, 18 to 42 million outpatient visits, and another 20 to 47 million people being sick. Between 15% and 35% of the U.S. population could be affected by an influenza pandemic, and the economic impact could range between $71.3 and $166.5 billion.

Recent examples of avian influenza outbreaks and infections in Hong Kong in 1997, 1998, and 2002 and the ongoing widespread outbreaks of avian influenza among poultry in Asia, show the importance of preparing for a pandemic. It has been 36 years since the last pandemic.

Influenza pandemics are different from many of the threats for which public health and the health-care system are currently planning:

The pandemic will last much longer than most other emergency events and may include “waves” of influenza activity separated by months (in 20th century pandemics, a second wave of influenza activity occurred 3 to 12 months after the first wave).
The numbers of health-care workers and first responders available to work can be expected to be reduced; they will be at high risk of illness through exposure in the community and in health-care settings, and some may have to miss work to care for ill family members.
Resources in many locations could be limited because of how widespread an influenza pandemic would be.
Because of these differences and the expected size of an influenza pandemic, it is important to have completed planning and preparedness activities to be able to respond promptly and adequately. For this reason, the U.S. Department of Health and Human Services (HHS) supports pandemic influenza activities in the areas of surveillance (“detection”), vaccine development and production, antiviral stockpiling, research, and public health preparedness. In addition, a draft National Pandemic Influenza Preparedness Plan was issued by HHS for public comment in August 2004. To view the draft plan or to obtain more information about pandemic influenza, visit the HHS Web site at LINK).
http://www.dhhs.gov/nvpo/pandemics/

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(H5N1) The 6 Phases of a Pandemic

Post#4 » Mon Jun 20, 2005 5:27 pm

Stages of a Pandemic
(LINK-CDC http://www.cdc.gov/flu/avian/gen-info/pandemics.htm
The World Health Organization (WHO) has developed a global influenza preparedness plan, which defines the stages of a pandemic, outlines WHO’s role and makes recommendations for national measures before and during a pandemic. The phases are:

Interpandemic period


Phase 1: No new influenza virus subtypes have been detected in humans. An influenza virus subtype that has caused human infection may be present in animals. If present in animals, the risk of human infection or disease is considered to be low.

Phase 2: No new influenza virus subtypes have been detected in humans. However, a circulating animal influenza virus subtype poses a substantial risk of human disease.

Pandemic alert period

Phase 3: Human infection(s) with a new subtype, but no human-to-human spread, or at most rare instances of spread to a close contact.

Phase 4: Small cluster(s) with limited human-to-human transmission but spread is highly localized, suggesting that the virus is not well adapted to humans.

Phase 5: Larger cluster(s) but human-to-human spread still localized, suggesting that the virus is becoming increasingly better adapted to humans, but may not yet be fully transmissible (substantial pandemic risk).

Pandemic period

Phase 6: Pandemic: increased and sustained transmission in general population.

Notes: The distinction between phase 1 and phase 2 is based on the risk of human infection or disease resulting from circulating strains in animals. The distinction is based on various factors and their relative importance according to current scientific knowledge. Factors may include pathogenicity in animals and humans, occurrence in domesticated animals and livestock or only in wildlife, whether the virus is enzootic or epizootic, geographically localized or widespread, and/or other scientific parameters.

The distinction between phase 3, phase 4 and phase 5 is based on an assessment of the risk of a pandemic. Various factors and their relative importance according to current scientific knowledge may be considered. Factors may include rate of transmission, geographical location and spread, severity of illness, presence of genes from human strains (if derived from an animal strain), and/or other scientific parameters.

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Timeline on H5N1Bird Flu Pandemic Move to Phase 6

Post#5 » Mon Jun 20, 2005 5:28 pm

Timeline on H5N1Bird Flu Pandemic Move to Phase 6
Recombinomics Commentary
June 20, 2005
(LINK) http://www.recombinomics.com/News/06200 ... eline.html
Since the 2005 flu pandemic is entering the final phase 6, a review of the H5N1 pandemic timeline is useful. H5N1 progressed in Asia from a bird flu in 1996 to a human pandemic in 2005.

H5N1 was first detected in Asia in 1996 in a duck from Guangdong Province, which moved the pandemic to phase 2.

The following year there were 18 human cases of H5N1in Hong Kong. This moved the pandmeic into phase 3 defined by human infections. The H5N1 was similar to the 1996 goose isolate in H and N. The H had a poly-basic cleavage site and the N had a 19 amino acid deletion. However, the new strain was a reassortant, with several internal genes that matched genes from H9N2 and H6N1 isolates. In addition there was evidence for recombination, with polymorphisms normally found in mammalian isolates. The acquisition of these polymorphisms was called "humanization".

The pandemic moved into early phase 4 when antibodies to H5N1 were found in health care works. These health care workers did not show signs of illness, indicating the virus could transmit to humans, but very inefficiently. All poultry in Hong Kong was culled, eliminating this particular constellation of genes.

Between 1997 and 2003 H5N1 did considerable evolution via recombination and some reassortment and in 2003 it re-emerged in humans. The human cases were a Hong Kong family vacationing in Fujian province. The daughter died in China, but the father and son returned to Hong Kong. The father died, but H5N1 was isolated from both. The H5N1 was similar to the 1997 version in H, but there was no deletion in N and the constellation of genes was designated as the Z+ genotype. In addition, the M2 had an amantadine resistant change at position 31 in the M2 gene. However, this gene was more closely related to M2 from amantadine resistant swine isolates The human cases were limited to the family, keeping the pandemic at early phase 4.

In 2004 H5N1 exploded across Asia. There were reported bird infections in China, Japan, South Korea, Vietnam, Thailand, and Indonesia (as well as several additional countries in the area where no virus was isolated and sequenced). In addition there were human cases in Vietnam and Thailand. The various isolates were similar to 2003, but had a 20 amino acid deletion in NA. This deletion overlapped the 19 amino acid deletion seen in 1997, but was slight further downstream.

This constellation of genes was designated as the Z genotype. Although all of the genes were similar, there were regional differences in all of the isolates. A very small number had the amantadine resistant marker at position 31, but were more distant from the earlier swine isolates. In contrast, all isolates from Vietnam and Thailand were amantadine resistant at position 31 and they had a second marker at position 26. The second marker was not found in any isolates outside of Vietnam and Thailand. In addition, these isolates from Vietnam and Thailand had a number of polymorphisms not seen in the other H5N1 isolates. These markers were found in mammalian isolates. The only reported human H5N1 cases in 2004 were in Vietnam and Thailand.

In 2004 the pandemic phase moved solidly into phase 4 with human-to-human transmission resulting in death. There were several small familial clusters of 2-4 family members. All of these clusters were bimodal. Additional family members would develop symptoms 5-10 days after the index case. One of the largest clusters was in Thia Binh in January 2004 involving a groom and his two sisters. All three died. The two sisters had cared for their brother. The most well documented transmission was in Thailand last summer. The pattern was the same, but the index case was living with her aunt and the mother was several hundred miles away in a Bangkok office. The mother developed symptoms after she visited her daughter in the hospital. The aunt also became infected. Only the aunt survived. Thus, human-to-human transmission of a fatal H5N1 was well established in 2004. The case fatality rate in 2004 was approximately 70% in Vietnam and Thailand at the beginning and middle of 2004.

The pandemic moved to phase 5 at the beginning of 2005. There were reported outbreaks in birds in Vietnam, Thailand, Cambodia, and Indonesia. The reported human cases were limited to Vietnam and Cambodia. However, the demographics began to change within Vietnam. The southern cases had a case fatality rate approaching 100%, while the fatality rate in northern Vietnam fell to 10-20%. The cases in the north also covered a wider age range and the clusters grew larger. Transmission extended to health care workers and five members of a single family tested positive for H5N1, but all recovered.

This change in demographics and size of cluster s was accompanied by genetic recombination which created a version in the north with an HA cleavage site found in China and Japan in 2003 and 2004. This newer version of H5N1 was found in northern Vietnam and Thailand, although Thailand did not report human cases in 2005. A second version of H5N1 was found in southern Vietnam and Cambodia, where the case fatality rate was close to 100%, but clusters were smaller and less frequent.

This month there has been a new outbreak in northern and central Vietnam. The cases are again milder, but now the number of cases has jumped markedly, with 28 cases admitted this month. Many of most have no history of exposure to dead poultry, and most of the poultry is raised in the south, where there are also new cases of H5N1 in chickens. The large increase of mild cases in at least 6 provinces in northern and central Vietnam may represent a small percentage of the H5N1 infection because these patients have a milder disease, and more non-hospitalized H5N1 infections are likely. Thus, although the increased admissions may signal phase 6, the fatality rate is markedly below the rate in the south or the rate in 2004.

In addition to the new outbreaks in Vietnam, there have been two significant outbreaks in western China. The first outbreak was discovered in early May at Qinghai Lake Nature Reserve. Initially the deaths were limited to 180 bar headed geese, but quick rose to over 1000 dead birds representing at least 5 species of migratory birds. This outbreak was unusual in size and the fact that the H5N1 confirmed infection was lethal in geese. The outbreak in Qingahi was followed by an outbreak of domestic geese in Tacheng near the Kasakhstan border in Xinjiang China. This H5N1 confirmed outbreak again involved lethal infections in geese.

The two outbreaks in western China were accompanied by third part reports on infections in humans. In Qinghai there were reports of deaths of 6 tourists and 121 residents in 18 communities. The reports of human cases have been denied by China, but new fever clinics were established. Another third party report described a pneumonia outbreak involving patients and health care workers in Tacheng. China again denied human cases. WHO requested permission to visit Qinghai, but there have been no reports of that request being granted.

The large number of reported human cases in Qinghai and the isolation of health care workers in Tacheng would signal phase 6 if confirmed. It is likely that the H5N1 would be carried to Kasakhstan and Russia by the migrating birds, although there have not been reports of H5N1 in the neighboring countries.

Thus, at this time it looks like H5N1 is moving from phase 5 to phase 6 in northern Vietnam and may be doing the same in western China if reports of human fatalities are accurate.

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Pandemic? "It is Getting Real and Imminent"

Post#6 » Mon Jun 20, 2005 5:29 pm

IT IS GETTING real and imminent!
June 19 2005
(LINK) http://www.sunstar.com.ph/static/bag/20 ... guing.html
World Health Organization (WHO) scientists and health experts are calling for stepped-up surveillance of avian influenza in Southeast Asia and that includes the Philippines, after reports surfacing from northern Vietnam suggest that the deadly virus may be evolving into something more easily transmitted to humans.

At this juncture, we would like to remind our readers that while meningococcemia is a bacterial infection, bird flu is a viral infection like the equally-dreaded Sars.

While stressing that there is no proof as yet of human-to-human transmission of the so-called H5N1 strain of the virus, scientists who met five weeks ago in Manila concluded there are numerous signs that the virus is undergoing an evolutionary change. "If action is delayed until there is unmistakable evidence that the virus has become sufficiently transmissible among people to allow a pandemic to develop, then it most likely be too late to implement effective focal, national or regional response," - a warning statement from the Manila WHO summit.

A WHO team that assessed the Vietnam bird flu cases last April was alarmed that it called for an urgent review of the situation. A report was synthesized from the two-day Manila summit and was circularized to many health agencies.

The report strongly recommends "immediate steps" to improve monitoring and urged nations "to move ahead as quickly as possible" on pandemic preparedness plans. It urged the WHO to make experimental vaccines for bird flu available to affected Asian countries and said antiviral drugs should be stockpiled. At the moment, the Roche drug Tamiflu is being considered but the present supply may not be enough, if indeed a pandemic may occur.

Bird flu has infected at least 92 humans since December 2003, killing 52 of them. It is the high probability that the lethal virus be readily passed among humans that worry health experts. In Northern Vietnam, reports suggest that the virus is behaving differently than it has in the south or in other parts of Southeast Asia. This year, there have been eight clusters of cases in the north and only two in South Vietnam. People of all ages have come down with bird flu in the north while no one over the age of 40 was stricken in the south. "These changes" warm WHO experts, "were all consistent with avian virus possibly adapting to a human host." The Spanish flu of 1918, which killed at least 20 million people, was fatal to just 2.7% of those it infected. This is the paradox about a milder form of bird flu being more dangerous because many people would catch it. In Northern Vietnam, the death rate among 47 patients who contracted the bird flu was 34% while the death rate in the south was 63 percent among 24 cases.

Microbiologists have also discovered that the surface proteins on viruses found in Northern Vietnam are slightly different from the ones in the south. One strain isolated this year is "anti-genetically distinct" from the strain being used as a basis for making an experimental vaccine. "The greater age spread, the genetic divergence from north to south and the molecular changes are all things that people have to been concerned about" said Dr. George Rutherford, director of the Institute for Global Health. However, Rutherford was quick to emphasize that "no scientists can be sure whether what is being observed is the birth of a pandemic of simply the normal behavior of avian flu strain that has never been observed so closely.

That notwithstanding, Dr. Larry Drew, director of the Virology Laboratory of the University of California in San Francisco, said the latest WHO findings underscore the need for pandemic planning. This report may help to convince the necessary people that the threat is imminent," he said. "Vaccine development has to accelerate... the most achievable goal is to rapidly build a worldwide stockpile of antiviral drug."

As I've written in past issues, there is no recorded case of bird flu yet in the Philippines but the absence of case does not translate to a unique resistance of the Filipinos to the virus. There may be a vast sea that separates the Philippines from affected countries like Vietnam and Thailand, but then remember that the virus can be carried by migratory birds seeking warmer climes in our lands during the winter. On top of that, let us not forget that air travel has made the world become smaller. Now, do you get the whole picture?

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N5N1 Autopsy Report

Post#7 » Tue Jun 21, 2005 7:02 pm

It is important to read and pay attention to the comments of the moderator in reading this PROMED posting.


AVIAN INFLUENZA, HUMAN - EAST ASIA (92): AUTOPSY REPORT
*******************************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Mon 20 Jun 2005
From: Christian Griot
Source: Canadian Press, Sun 19 Jun 2005 [edited]



Avian influenza - autopsy report
--------------------------------
In a soon-to-be-released issue of a scientific journal, researchers from
Thailand and Hong Kong will report the findings of an autopsy of a 6 year
old Thai boy who died from avian influenza. Scheduled for publication in
the July 2005 issue of Emerging Infectious Diseases
, their findings of an atypical
pattern of infection -- deep in the lungs, away from the tracheal lining
where virus could easily be coughed out at others -- may help explain why
avian H5N1 influenza virus doesn't yet spread easily among people.

But the very fact that a paper containing autopsy data from a single case
is still desirable to journal editors a year-a-half into the H5N1 avian
influenza outbreak underscores a problem that has been plaguing the
scientific world's pursuit of knowledge about this [potentially] dangerous
strain of avian influenza virus. While at least 54 people have died from
H5N1 infections since December 2003, autopsies have been performed on fewer
than a handful of cases. For cultural and other reasons, body after body
has been buried or cremated, robbing pathologists of the precious chance to
chart the havoc the virus wreaks on its victims.

"That's one of the reasons why it's so difficult to understand what the
virus does in the body," says Dr Klaus Stohr, who heads the World Health
Organization's global influenza program. "Did it do more damage on the
intestine? Is the heart affected? Encephalitis: Yes? No? What is the damage
in the lung? That's why postmortems are so important. But ... there are
less than 5 done, I think, so far. And all in Thailand." Thailand hasn't
reported a human case in the most recent wave of infections, which began in
December 2004. That means science has no autopsy data with which to try to
explain the worrisome changes in infection patterns that have been observed
over the last 6 months in Viet Nam, changes which flu experts fear mean the
virus is becoming more transmissible and more likely to spark an influenza
pandemic.

Without information that can only be gathered through autopsies, scientists
devising treatment options and potential vaccines are working, if not in
the dark, then in a dim light, experts say. "If we want to test vaccine or
antiviral strategies for intervention, we would like to know what the
disease looks like in humans," explains Ab Osterhaus, head of virology at
the Eramus Medical Center in Rotterdam, the Netherlands. Drugs and vaccines
are tested in animals before being administered to people. But without
having a clear picture of what the disease does in humans, it's difficult
to select the appropriate animal model, Osterhaus says. Animals used as
models must experience a pattern of infection that closely mimics human
disease in order for scientists to feel secure that what they are learning
might apply to people. Determining which organs the virus is attacking is
also crucial from an infection control point of view, because it helps
identify possible modes of transmission. In some [avian] species, massive
amounts of the H5N1 virus are excreted in feces, Osterhaus notes.

Excreted virus isn't a threat with human flu viruses. But if H5N1
replicates in the human gastrointestinal tract, patients who experience
diarrhea could contaminate their environments in ways health care workers
might not expect from a respiratory virus. "So that's very important
information," Osterhaus says.

The autopsy on the Thai boy found viral replication in the intestine.
Autopsies could also show whether the virus is being spread through the
blood supply to other organs, says the Toronto pathologist who performed
the 1st autopsy done on a SARS patient in Canada. "You want to see whether
the cause is in the blood supply and therefore may be a systemic or
body-wide problem, or if it's organ-specific," explains Dr Jagdish Butany,
who insists autopsies provide a wealth of information for those who treat
patients and those who study viruses. "The information we continue to get
out of autopsies is totally unbelievable [sic!]," says Butany, a
pathologist at the city's University Health Network. But he acknowledges
that, in certain cultures and religions, getting permission from relatives
to conduct autopsies is virtually impossible. And in steamy climates like
that of Southeast Asia, prompt disposal of corpses is the norm.

Even if more people were willing to authorize postmortems, there is another
problem, notes Earl Brown, a virologist who specializes in influenza
virulence at the University of Ottawa. H5N1 influenza isn't claiming its
victims fast enough. "The problem is you have to wait for the people to
die, and they're just not dying early enough," Brown explains. "They die
after several weeks in intensive care, and all the (viral) tracks are gone.
Getting people who die from rapid, fulminant disease early to look at when
everything's sort of fresh is the trick."

[byline: Helen Branswell]
--
Christian Griot


[This article contains arguments for and against the value of autopsies in
understanding disease processes following infection of humans by avian
influenza viruses. As a virologist, the constraints expressed by Dr Earl
Brown seem to me to have the most relevance. Others may come to different
conclusions. - Mod.CP]



“It’s insulting” she said. “I was absolutely distraught. I need reassurance that the damage isn’t permanent. All I want is to know if it is going to get better.

“I still have falls, and I can’t return to work or drive. I’ve never signed on the dole in my life but I have had to now.”

King’s College Hospital said in a statement that it recognised that an 80-week wait for scans was unacceptable. It had recently received funds to expand its services, with the aim of getting waiting times down to 26 weeks by next March.

Patients identified as clinically urgent by referring doctors would be seen sooner, the statement said. It added that the handwritten note had been included because Ms King had discussed with her consultant the possibility of going private.

“It is not considered best practice to have handwritten additions to letters and internal processes will be reviewed in the light of this letter,” it said.

Steve Webb, the Liberal Democrat Shadow Health Secretary, said: “It is simply appalling that while ministers crow about the drop in treatment waiting times, there are still thousands of people languishing for months, or even years, on hidden waiting lists.

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Anti-Viral Potential of Tarvacin(TM) at BIO 2005

Post#8 » Wed Jun 22, 2005 7:21 pm

http://biz.yahoo.com/prnews/050622/law007.html?.v=12

Press Release Source: Peregrine Pharmaceuticals, Inc.


Peregrine Pharmaceuticals Presents Data Supporting Broad Spectrum Anti-Viral Potential of Tarvacin(TM) at BIO 2005
Wednesday June 22, 7:00 am ET
Data Presented Shows That Tarvacin(TM) Binds to Viruses Belonging to Six Different Virus Families; Inhibits Replication of Multiple Virus Types; and Protects Against Lethal Viral Infections in Pre-Clinical Animal Models of Two Different Viruses


TUSTIN, Calif., June 22 /PRNewswire-FirstCall/ -- Peregrine Pharmaceuticals, Inc. (Nasdaq: PPHM - News), today presented new data at the Biotechnology Industry Organization 2005 (BIO 2005) annual meeting in Philadelphia, PA. supporting the broad anti-viral potential of Tarvacin(TM). The data presented at BIO 2005 showed that Tarvacin(TM) binds to enveloped virus particles representing 6 different virus families, binds to virally infected cells and inhibits viral replication in multiple virus systems. The data also indicated that Tarvacin(TM) provided significant protection against Cytomegalovirus (CMV) and Pichinde virus (an in vivo Lassa fever model) infections.

Data presented at the conference demonstrated:

* Tarvacin(TM) binds to viruses from six different enveloped virus
families, including specific binding to HIV 1 and 2, Influenza A
and B, Measles, Respiratory Syncitial Virus (RSV), Bovine Viral
Diarrhea (a surrogate in vitro Hepatitis C virus model), and
Pichinde virus.

* Tarvacin(TM) binds to cells infected with Influenza, Vaccinia (a model
for Smallpox) and Pichinde viruses.

* Anti-Phosphatidylserine antibodies inhibited replication of RSV,
Vesicular Stomatitis Virus and Pichinde viruses.

* Anti-Phosphatidylserine antibodies provided significant protection in
animals infected with cytomegalovirus (CMV) with 100% of the Anti-
Phosphatidylserine antibodies treated animals surviving and only 20%
of animals receiving control treatment surviving.

* Tarvacin(TM) provided significant protection in animals administered
lethal viral loads of Pichinde virus (a model of Lassa fever) with 50%
of the Tarvacin(TM) treated animals surviving and none of the animals
receiving control treatment surviving.

* Animals lethally infected with Pichinde virus that survived following
Tarvacin(TM) therapy had long term immunity to reinfection.

"These data further illustrate why we are excited about the Tarvacin(TM) anti-viral program," stated Steven King, president and CEO of Peregrine. "We are looking forward to initiating the Tarvacin(TM) Hepatitis C clinical trial, continuing our collaboration with National Institute of Allergy and Infectious Diseases (NIAID) and expanding into other collaborations to further explore the potential of the program for the treatment of viral infections."

Peregrine received FDA approval to begin a Tarvacin(TM) phase I clinical trial in Hepatitis C infected patients in late May 2005. In April of 2005, Peregrine and the National Institute of Allergy and Infectious Diseases (NIAID) entered into a collaborative effort to screen Tarvacin(TM) for activity both in vitro and in vivo against a wide variety of enveloped viruses of health and bioterrorism concern including Hepatitis C, influenza and SARS. Peregrine is continuing to evaluate Tarvacin(TM) for the treatment of a variety of viral infections that could lead to additional therapeutic indications in this area. In addition, Peregrine is currently recruiting patients in a Tarvacin(TM) phase I clinical trial that is open to patients with advanced solid tumor cancer.

About Tarvacin(TM)

Anti-Phospholipid Therapy is Peregrine's novel approach to treating cancer, viral infections and certain other diseases. It is based on the finding that aminophospholipids, which are basic components of the inner surface of the cellular membrane, become exposed in certain disease states. Tarvacin(TM) is a chimeric monoclonal antibody that binds to the phospholipid, phosphatidylserine, and is part of Peregrine's Anti-Phospholipid Therapy platform. Tarvacin(TM) binds directly to tumor blood vessels to inhibit growth and development of solid tumors. Tarvacin(TM) has also shown promise in the treatment of viral infections and is expected to recognize a broad spectrum of enveloped viral types. Tarvacin(TM) is currently being evaluated for the treatment of both cancer and viral diseases. Peregrine has received FDA approval to initiate two separate Phase 1 clinical trials in advanced solid cancer and chronic Hepatitis C virus indications.

About Enveloped Viruses

A large number of viruses significant to global health and security possess an "envelope" derived from their host cell membrane. The outer shell of the virus is known as the viral envelope. Since viruses lack the means to maintain structural organization of the envelope, amino-phospholipids such as phosphatidylserine (PS) and phosphatidylethanolamine (PE) become exposed on the surface of these viruses, making them a potential therapeutic target. Peregrine Pharmaceuticals, together with its collaborators, has developed a series of monoclonal antibodies, including Tarvacin(TM), directed against aminophospholipids to take advantage of this property.

About Peregrine Pharmaceuticals, Inc.

Peregrine Pharmaceuticals, Inc. is a biopharmaceutical company with a broad portfolio of products under development directed towards the treatment of cancer, viruses and other diseases. The company has opened patient enrollment in a Tarvacin(TM) clinical trial for the treatment of all solid cancers and has received clearance from the FDA to initiate a Tarvacin(TM) Phase I clinical trial for the treatment of Hepatitis C virus infection, its first viral indication. In addition, Peregrine is in the process of initiating patient enrollment in a Cotara® clinical trial for the treatment of brain cancer. Peregrine Pharmaceuticals is also developing Vascular Targeting Agents, Anti-Angiogenesis, and Vasopermeation Enhancement Agents (VEAs) for the treatment of cancer and other diseases.

Peregrine Pharmaceuticals also has in-house expertise to develop and manufacture antibodies and recombinant proteins through its wholly-owned subsidiary, Avid Bioservices, Inc., (http://www.avidbio.com). Avid is engaged in providing contract manufacturing services and development of biologics for biopharmaceutical and biotechnology companies, including Peregrine.

Copies of Peregrine Pharmaceuticals press releases, SEC filings, current price quotes and other valuable information for investors may be found at http://www.peregrineinc.com.

Statements in this press release which are not purely historical, including statements regarding Peregrine Pharmaceutical's intentions, hopes, beliefs, expectations, representations, projections, plans or predictions of the future are forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. The forward-looking statements involve risks and uncertainties including, but not limited to, the uncertainties that pre-clinical binding studies of Tarvacin(TM) against various enveloped viruses may prove to be ineffective during clinical testing. It is important to note that the company's actual results could differ materially from those in any such forward-looking statements. Factors that could cause actual results to differ materially include, but are not limited to, uncertainties associated with completing pre-clinical and clinical trials for our technologies; the early stage of product development; the significant costs to develop our products as all of our products are currently in development, pre-clinical studies or clinical trials; obtaining additional financing to support our operations and the development of our products; obtaining regulatory approval for our technologies; anticipated timing of regulatory filings and the potential success in gaining regulatory approval and complying with governmental regulations applicable to our business. Our business could be affected by all of the foregoing and a number of other factors, including the risk factors listed from time to time in the Company's SEC reports including, but not limited to, the annual report on Form 10-K for the year ended April 30, 2004, and the quarterly report on Form 10-Q for the quarter ended January 31, 2005. The Company cautions investors not to place undue reliance on the forward looking statements contained in this press release. Peregrine Pharmaceuticals, Inc. disclaims any obligation, and does not undertake to update or revise any forward-looking statements in this press release.

Investor Inquiries Media Inquiries
Hawk Associates, Inc. Rachel Martin
Frank Hawkins and Ken AuYeung Edelman
(800) 987-8256 (323) 202-1031/(323) 893-9047
info@hawkassociates.com Rachel.Martin@edelman.com


Source: Peregrine Pharmaceuticals, Inc.

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Japanese officials say avian flu outbreak may have been more

Post#9 » Wed Jun 29, 2005 3:30 pm

Japanese officials say avian flu outbreak may have been more extensive earlier
Canadian Press
Tuesday, June 28, 2005
TOKYO (AP) - Japanese agricultural officials said Tuesday they suspect that cases of avian flu at a farm in northeastern Japan may have been part of a larger outbreak that has since receded.

The Agriculture Ministry said Sunday that some of the more than 800 chickens that died since April at a farm in Mitsukaido City in Ibaraki prefecture (state), just northeast of Tokyo, had been infected with the H5N2 strain of avian flu, considered less dangerous than the H5N1 strain that ravaged Asia last year.

On Tuesday, lab tests found that chickens at the five farms closest to the infected farm had developed antibodies to the virus in their blood, ministry official Hiroaki Ogura said. Blood tests were conducted on chickens at all 16 farms within a five-kilometre radius of the farm with the outbreak, which are banned from shipping any birds or eggs until officials can confirm there are no further infections.

Chickens at the remaining 11 farms tested negative, according to results late Tuesday, Ogura said.

The blood tests indicated that some chickens at nearby farms were exposed to avian flu but survived, Ogura said. The tested birds no longer had the virus, he said, indicating that the outbreak could have been more widespread at one point but later receded.

With no virus found at the other farms, officials believe there is no need for culling at the five farms where birds have avian flu antibodies. The ministry will hold a meeting of experts on Wednesday to discuss further steps, Ogura said.

Officials began culling chickens at the farm with the outbreak on Monday, and so far have killed about half of its 25,000 chickens.

The H5N2 strain has not been known to infect humans, according to the ministry, unlike the H5N1 strain that crossed over to humans and killed a total of 54 people in Vietnam, Thailand and Cambodia. The U.S. Centers for Disease Control and Prevention have said the risk of human infection from H5N2 is likely to be low.

Examinations of workers at farms in the affected area showed no signs of human infection, Ogura said.

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Bird flu tests to cover more species

Post#10 » Wed Jun 29, 2005 3:32 pm

Bird flu tests to cover more species
http://news.xinhuanet.com/english/2005- ... inaview.cn
BEIJING, June 29 -- The central government has agreed to test more species of migratory birds for avian flu in Qinghai Province, international health experts said in Beijing yesterday.

"The outbreak is declining and the number of birds dying is reducing," said Julie Hall, a Beijing-based senior World Health Organization (WHO) official, who visited the province last week.

But birds are still dying in Qinghai Province at the rate of 20 a day, said Hall, adding that the government has agreed to test other birds to see if they are carriers capable of infecting species in other areas and to share test results with the international community.

China confirmed the bird-flu outbreak in Qinghai on May 21, saying early reports showed that the deaths of wild birds were caused by the H5N1 virus, which could mutate into a strain that could be fatal to humans.

Samples of 12 dead birds have been sent to the national laboratory in Harbin, Northeast China's Heilongjiang Province, for testing.

The migratory birds are still on the island but they will begin flying to other parts of China and neighbouring countries in about a month, Hall said. "This (testing of more species) is vital if we are to give early warning to other provinces and countries," said Hall, noting that limited tagging and mapping of migratory routes was a hurdle.

The local government has culled domestic birds and vaccinated all poultry 2-3 million in the province and closed all live poultry markets.

Another issue is that few people have turned up for testing at township clinics despite an educational campaign - only two of the nearly 600 people who had contact with the wild birds were tested for flu because the population is so dispersed.

Noureddin Mona, Food and Agriculture Organization (FAO) representative in China who also went to Qinghai, said that measures China had taken there were effective.

The WHO-FAO team was accompanied by officials from the Chinese Ministry of Health, Ministry of Agriculture and the State Forestry Administration.

"We see full commitment from governments at all levels in combating the disease," Mona said.

"The mission was very successful and fruitful, diminishing the gap between what is and what should be done in the region," said Henk Bekedam, WHO representative.

"Dealing with wild birds in China can be used as a model for other countries for prevention and control," Bekedam said.

Some of the recommendations made by the team are

For birds:

Testing as many species as possible

Tagging and tracking for early warning

Testing "resident" species

Environmental sampling and decontamination.

Domestic animals:

Protection from wild birds

Testing of horses and pigs

For humans:

All samples should be sent to Beijing for more advanced tests.

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H5N17-24-5 CDC: Key Facts About Avian Influenza (Bird Flu)

Post#11 » Sat Jul 23, 2005 5:18 pm

CDC: Key Facts About Avian Influenza (Bird Flu) and Avian Influenza A (H5N1) Virus
March 18, 2005
This fact sheet provides general information about bird flu and information about one type of bird flu, called avian influenza A (H5N1) that is infecting birds in Asia and has infected some humans.
What is avian influenza (bird flu)?


Bird flu is an infection caused by avian (bird) influenza (flu) viruses. These flu viruses occur naturally among birds. Wild birds worldwide carry the viruses in their intestines, but usually do not get sick from them. However, bird flu is very contagious among birds and can make some domesticated birds, including chickens, ducks, and turkeys, very sick and kill them.
Do bird flu viruses infect humans?

Bird flu viruses do not usually infect humans, but several cases of human infection with bird flu viruses have occurred since 1997.
How are bird flu viruses different from human flu viruses? Updated March 18

There are many different subtypes of type A flu viruses. These subtypes differ because of certain proteins on the surface of the flu A virus (hemagglutinin [HA] and neuraminidase [NA] proteins). There are 16 different HA subtypes and 9 different NA subtypes of flu A viruses. Many different combinations of HA and NA proteins are possible. Each combination is a different subtype. All subtypes of flu A viruses can be found in birds. However, when we talk about “bird flu” viruses, we are referring to those flu A subtypes that continue to occur mainly in birds. They do not usually infect humans, even though we know they can do so. When we talk about “human flu viruses” we are referring to those subtypes that occur widely in humans. There are only three known subtypes of human flu viruses (H1N1, H1N2, and H3N2); it is likely that some genetic parts of current human flu A viruses came from birds originally. Flu A viruses are constantly changing, and they might adapt over time to infect and spread among humans.
What are the symptoms of bird flu in humans?

Symptoms of bird flu in humans have ranged from typical flu-like symptoms (fever, cough, sore throat and muscle aches) to eye infections, pneumonia, severe respiratory diseases (such as acute respiratory distress), and other severe and life-threatening complications. The symptoms of bird flu may depend on which virus caused the infection.
How does bird flu spread?

Infected birds shed flu virus in their saliva, nasal secretions, and feces. Susceptible birds become infected when they have contact with contaminated excretions or surfaces that are contaminated with excretions. It is believed that most cases of bird flu infection in humans have resulted from contact with infected poultry or contaminated surfaces.
How is bird flu in humans treated?

Studies suggest that the prescription medicines approved for human flu viruses would work in preventing bird flu infection in humans. However, flu viruses can become resistant to these drugs, so these medications may not always work.
What is the risk to humans from bird flu?

The risk from bird flu is generally low to most people because the viruses occur mainly among birds and do not usually infect humans. However, during an outbreak of bird flu among poultry (domesticated chicken, ducks, turkeys), there is a possible risk to people who have contact with infected birds or surfaces that have been contaminated with excretions from infected birds. The current outbreak of avian influenza A (H5N1) among poultry in Asia (see below) is an example of a bird flu outbreak that has caused human infections and deaths. In such situations, people should avoid contact with infected birds or contaminated surfaces, and should be careful when handling and cooking poultry. For more information about avian influenza and food safety issues, visit the World Health Organization website.
What is an avian influenza A (H5N1) virus?

Influenza A (H5N1) virus – also called “H5N1 virus” – is an influenza A virus subtype that occurs mainly in birds. It was first isolated from birds (terns) in South Africa in 1961. Like all bird flu viruses, H5N1 virus circulates among birds worldwide, is very contagious among birds, and can be deadly.
What is the H5N1 bird flu that has recently been reported in Asia?

Outbreaks of influenza H5N1 occurred among poultry in eight countries in Asia (Cambodia, China, Indonesia, Japan, Laos, South Korea, Thailand, and Vietnam) during late 2003 and early 2004. At that time, more than 100 million birds in the affected countries either died from the disease or were killed in order to try to control the outbreak. By March 2004, the outbreak was reported to be under control. Beginning in late June 2004, however, new deadly outbreaks of influenza H5N1 among poultry were reported by several countries in Asia (Cambodia, China, Indonesia, Malaysia [first-time reports], Thailand, and Vietnam ). It is believed that these outbreaks are ongoing. Human infections of influenza A (H5N1) have been reported in Thailand and Vietnam during both of these outbreak periods.
What is the risk to humans from the H5N1 virus in Asia?

The H5N1 virus does not usually infect humans. In 1997, however, the first case of spread from a bird to a human was seen during an outbreak of bird flu in poultry in Hong Kong. The virus caused severe respiratory illness in 18 people, 6 of whom died. Since that time, there have been other cases of H5N1 infection among humans. Most recently, human cases of H5N1 infection have occurred in Thailand and Vietnam during large H5N1 outbreaks in poultry. The death rate for these reported cases has been about 70 percent. Most of these cases occurred from contact with infected poultry or contaminated surfaces; however, it is thought that a few cases of human-to-human spread of H5N1 have occurred.

So far, spread of H5N1 virus from person to person has been rare and spread has not continued beyond one person. However, because all influenza viruses have the ability to change, scientists are concerned that the H5N1 virus could one day be able to infect humans and spread easily from one person to another. Because these viruses do not commonly infect humans, there is little or no immune protection against them in the human population. If the H5N1 virus were able to infect people and spread easily from person to person, an “ influenza pandemic ” (worldwide outbreak of disease) could begin. No one can predict when a pandemic might occur. However, experts from around the world are watching the H5N1 situation in Asia very closely and are preparing for the possibility that the virus may begin to spread more easily and widely from person to person.
How is infection with H5N1 virus in humans treated?

The H5N1 virus currently infecting birds in Asia that has caused human illness and death is resistant to amantadine and rimantadine, two antiviral medications commonly used for influenza. Two other antiviral medications, oseltamavir and zanamavir, would probably work to treat flu caused by the H5N1 virus, though studies still need to be done to prove that they work.
Is there a vaccine to protect humans from H5N1 virus?

There currently is no vaccine to protect humans against the H5N1 virus that is being seen in Asia. However, vaccine development efforts are under way. Research studies to test a vaccine to protect humans against H5N1 virus are expected to begin in April 2005. (Researchers are also working on a vaccine against H9N2, another bird flu virus subtype.) For more information about the H5N1 vaccine development process, visit the National Institutes of Health website.
What is the risk to people in the United States from the H5N1 bird flu outbreak in Asia?

The current risk to Americans from the H5N1 bird flu outbreak in Asia is low. The strain of H5N1 virus found in Asia has not been found in the United States. There have been no human cases of H5N1 flu in the United States. It is possible that travelers returning from affected countries in Asia could be infected. Since February 2004, medical and public health personnel have been watching closely to find any such cases.
What does CDC recommend regarding the H5N1 bird flu outbreak in Asia?

In February 2004, CDC provided U.S. health departments with recommendations for enhanced surveillance (“detection”) in the U.S. of avian influenza A (H5N1). Follow-up messages (Health Alert Network) were sent to the health departments on August 12, 2004, and February 4, 2005, both reminding health departments about how to detect (domestic surveillance), diagnose, and prevent the spread of avian influenza A (H5N1). It also recommended measures for laboratory testing for H5N1 virus. CDC currently advises that travelers to countries in Asia with known outbreaks of influenza A (H5N1) avoid poultry farms, contact with animals in live food markets, and any surfaces that appear to be contaminated with feces from poultry or other animals.
Attached link: http://www.iwar.org.uk/news-archive/2005/03-18-4.htm
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H5N1 - In all It's Flavors.....
I am doing something, I do not do - I am posting this with out a URL. It is a listing compiled by someone else. I think it may be important to know/read
Dutchman

Since the first appearance of bird flu, the Chinese government has made some detailed classification for the mutated virus. Contrary to most speculations, related government departments have taken necessary measures to contain and counter the spreading of the virus. However, the Chinese government is worried about the anti-communist movement may be able to put more pressure to the control of the communist government at this moment.

Since 2004, the government has classified most infected or death cases caused by the virus, supplemented with the information gathered in Qinghai. For non-fatal infectious diseases, the Chinese government targeted at controlling information and quarantine measures. For infectious diseases, which are fatal to human, the focus of the government is whether the virus can be converted to a biological weapon or not. The military will first research on the controllability of the virus. In some occasions, the virus may even be released to the public in order to test the effectiveness of the vaccines and preventive measures.

So far, the bird-flu virus strains that are fatal to human are classified into 7 different categories. The H5N1 is the original version while others are mutated from the original H5N1.

1. H5N1
This is the one that most people know about, only effective to birds, especially chickens and ducks and thus unable to infect and pose any threat to human.

2. H5N1 7B
This is first discovered in human in June 2004, also spread through domestic birds. However, unlike the original version, the bird itself is only the carrier of the virus, without any symptoms even after being infected. Human can be infected if consumed infected poultry products. Symptoms of human include allergic reactions, reduction of immunity, easier to be infected by other influenza and sudden seizure or epilepsy of heart muscles. Infected birds will have a drastic increase in appetite without obvious weight increase. The virus infects only through physical contact.

3. H5N1 9A
This is discovered in Shantou in November 2004, infection is done through physical contact. Not much difference from H5N1. However, the feces of the infected birds seem to be infectious to fish. In some part of china, feces from domestic birds and pigs are dumped to fishponds. It seems like fish infected by the virus is more aggressive and becomes somewhat toxic. Bones of the fish are softened but reason is still unknown. These results were found in a laboratory.

4. H5N1 L33
This is a mutated version of H5N1 discovered in 2004. So far no vaccine or medication is effective against this virus, other symptoms remain the same as the original version. This virus can survive within insects under certain temperature and humidity. However, there is still no reported case of infection to human. So far the only measure to deal with it is to incarnate the infected items.

5. H5N1 R12
This is found in Xinjiang and Guangdong areas. It is spread among poultry and can infect human. However, only minor flu symptoms will be found in human. Non-fatal to both poultry and human, it can be treated with ordinary medications. It is under the R series, where R denotes “red”, indicating that human can be infected by it.

6. H5N1 RW4
This is discovered in 2004 and 2005. Human can be infected by in from poultry, and can be fatal to human if not handled properly. Minor h2h ability is found in infected patients. This virus is extremely dangerous to poultry, with a 100% death rate. The incubation period ranges from 2 to 60 days. Eggs of the infected poultry also contain another type virus derived from the H5N1 RW4. Currently, veterinary medications are found to be useless in infected poultry. However, medication used by human, in small dose, can suppress and eliminate the virus in infected birds.

7. H5N1 RK7
First sampled in Qinghai, this is the most powerful strain found so far. This can be transmitted from poultry to human and from human to human. However, this strain of virus is unable to transmit from human to poultry. The diagnosis of this virus is extremely complicated. Incubation period is short and causes of deaths are mainly misdiagnosis.

There are still 3 strains of H5N1 under research; they are named as the X series.

8. H5N1 X1
Sampled in 2004 from human influenza virus, can infect poultry,

9. H5N1 X2
Sampled in Qinghai, continuously mutating, a derivative of H5N1 RW4, current medications are not too effective against this strain.

10. H5N1 X3
Sampled in Qinghai, Hunan and Ningxia, recombination occurred after patients infected by H5N1 RK7 as well as other infectious diseases. This can be transmitted from poultry to human and human to poultry.

There is currently no further information available regarding these 3 types of virus. With H5N1 RW4, H5N1 RK7, these 3 strains are tightly contained from the media by the Chinese government. These 3 strains are believed to be R series as well.

Mutated strains from H5N1 have become very obvious (?), especially in diagnosis, which is still not that reliable. The current active strains in China are undergoing faster re-combinations due to cross infection. The time for completing recombination has decreased from 7 months (in 2003) to 4 months. The mutation of the virus varies in different geographical areas.

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Russia finds bird flu in three more Siberian villages

Post#12 » Tue Jul 26, 2005 7:01 am

Russia finds bird flu in three more Siberian villages
Monday • July 25, 2005
The deadly bird flu virus has broken out in four rural districts of Siberia according to preliminary evidence, the head of Russia's veterinary surveillance service was cited by Interfax as saying.

Following the discovery of a first outbreak last week in the village of Suzdalka, new evidence suggests outbreaks have occurred in three more districts of the western Siberian region of Novosibirsk -- Dovolnoe, Kupino and Chistozernoe, the surveillance service's head, Sergei Dankvert, said Monday.

"The flu virus... is circulating among bird stocks" in the three districts, Dankvert said.

Authorities in neighbouring Kazakhstan have been informed as the three districts lie close to the Kazakh border, Dankvert said.

The discovery of avian influenza follows measures by Russia to try to prevent the virus entering the country, including a ban on poultry imports from many Asian countries.

The H5N1 strain of bird flu has so far been mainly transmitted between animals. But it has killed at least 58 people in Southeast Asia since 2003 -- 39 Vietnamese, 12 Thais, four Cambodians and three Indonesians.

Experts fear it could mutate into a highly infectious strain that could be easily transmitted from animals to humans, or from humans to humans. — AFP

pokerkid
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Flu viruses can quickly swap genes -study

Post#13 » Tue Jul 26, 2005 7:03 am

Flu viruses can quickly swap genes -study
Monday, July 25, 2005
Health and Science Correspondent
WASHINGTON (Reuters) - Strains of the influenza virus are constantly swapping genes among themselves and giving rise to new, dangerous strains at a rate faster than previously believed, U.S. researchers reported on Monday.

They found that slightly mutated influenza A strains in New York that circulated between 1999 and 2004 gave rise to the so-called Fujian strain that caused a troublesome outbreak in the 2003-2004 flu season.

Such events probably are what lead to the occasional pandemics of flu that can kill millions of people, David Lipman and colleagues at the National Institutes of Health found.

They hope their findings, published in the journal Public Library of Science Biology, will help scientists better predict which viral strains will attack during upcoming flu seasons and design better vaccines.

Influenza viruses are notorious for trading genes back and forth and mutating. Scientists previously believed that the gene swapping occurred gradually but the new study shows that several genes can be exchanged at once, causing sudden changes in important characteristics of the virus.

This is why a new flu epidemic sweeps the world every year, killing between 250,000 and 500,000 globally and 36,000 people in the United States alone every year.

Each year, experts must predict which strains will be most common and design a new vaccine to fight them. Some years, such as in 2003-2004, the vaccine does not include the most common strain.

Lipman and colleagues sequenced the genomes of 156 influenza A viruses, named H3N2, that were collected by New York State public health officials between 1999 and 2004.

"We found that there are co-circulating minor variants that are not infecting many people," Lipman said in a statement. "One of these can cause the next major epidemic."

They found "at least four reassortment events occurred among human viruses during the period 1999-2004" -- meaning there was an exchange of genes four different times.

LURKING UNDER THE RADAR

The newly mixed viruses, previously unnoticed because of their low virulence, suddenly became capable of infecting thousands of people.

This suggests that scientists need to study circulating flu viruses more carefully because important mutations can occur suddenly and without warning, the researchers said.

Experts say a new and deadly flu pandemic is certain to come but it is impossible to predict when. The H5N1 avian flu virus, which arrived in Asia in late 2003, has so far killed more than 50 people in the region including Vietnam, Thailand and Cambodia.

It does not easily pass from person to person yet but health officials say it can acquire this ability at any time and if it does, it could kill millions.

A second study, published in the Proceedings of the National Academy of Sciences, found that an early wave of the 1918 "Spanish Flu" pandemic may have hit New York City several months before a big epidemic exploded globally.

The 1918-1919 pandemic was the worst in recorded history, killing as many as 40 million people.

An outbreak at the end of the previous flu season may have killed 3,000 children and young adults, Donald Olson of the New York City Department of Health and colleagues found.

"The historical lesson from 20th-century influenza pandemics is that they occur in multiple waves," Olson said in a statement.

pokerkid
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Mysterious Illness Spreads In Sichuan China

Post#14 » Tue Jul 26, 2005 7:05 am

Mysterious Illness Spreads In Sichuan China
Recombinomics Commentary
July 25, 2005
Preliminary probe shows the unknown disease in Sichuan was caused by a kind of a swine virus known as streptococosis II.

The province has reported 80 cases of the infection as of Monday, including 67 confirmed cases and 13 suspected cases. Nineteen people have been reported dead and 17 people are in critical condition. Four have been discharged from hospital, according to the Ministry of Health.

The patients came from 75 villages in 40 townships in cities and counties including Ziyang City, Jianyang City, Lezhi County and Zizhong County in Neijiang City.

Judging from the symptoms and tests of the dead pigs, experts reached the preliminary conclusion that the disease was caused by swine streptococosis II.

The above comments are confusing at best. The bacterium is called a virus and the rapid spread signals a virus. The high mortality (19 of the 23 outcomes have been death) decreases the likelihood of bacterial infections, which are rare in humans.

It is also unclear what a "confirmed" case is. There is no indication that the bacteria have been isolated from patients, so a confirmed case seems to be a farmer with symptoms and sick or dying pigs. Although the pigs may have a bacterial infection, that doesn't mean that the pig and/or person is not infected with a virus.

The mechanism for rapid spread of bacteria is also difficult to imagine since the number of affected villages is so large and spread over a large area.

Although boxun reports have focused on Ebola, the timing and location of this outbreak continue to raise suspicions about H5N1 bird flu migrating to or from Qinghai Lake.

pokerkid
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Posts: 7781

FIP: US researchers: Flu Viruses Mutate Quicker Than Thought

Post#15 » Thu Jul 28, 2005 1:09 am

FIP: US researchers: Flu Viruses Mutate Quicker Than Thought
July 26 2005
Flu viruses can swap many genes rapidly to make new resistant strains, US researchers have found. Scientists previously believed that gene swapping progressed gradually from season to season.

The National Institutes of Health team found instead, influenza A exchanged several genes at once, causing sudden and major changes to the virus.

The findings in PLOS Biology suggest strains could vary widely each season, making it potentially harder to treat. They also increase concerns about bird flu mutating to spread readily between humans.

Each year, experts must predict which strains will be most common and design new vaccines to fight them.

Dr. David Lipman and colleagues looked at strains of influenza A that had circulated between 1999 and 2004 in New York. These strains had given rise to the so-called Fujian strain H3N2 that caused a troublesome outbreak in the 2003-2004 flu season because the vaccine made that winter was a poor match for the virus.

Dr. Lipman's team found wide variations in the 156 strains that they analyzed. Some of the strains had at least four gene swaps that had occurred in a short time period.

"The genetic diversity of influenza A virus is therefore not as restricted as previously suggested," said the researchers. This suggests that scientists need to study circulating flu viruses more carefully because important mutations can occur suddenly and without warning, they said.

Scientists have been particularly worried recently about avian flu mutating and acquiring the ability to spread from human to human. If it does, it could kill millions worldwide.

Last week, the British government announced it would stockpile two million doses of vaccine to combat the H5N1 strain of bird flu currently circulating in Asia to protect key medical and emergency workers across Britain against a possible global pandemic.

Dr. Maria Zambon, flu expert at the Health Protection Agency said: "This research confirms the genetic diversity of influenza viruses and underscores potential for reassortment."

Professor John Oxford, a virologist at Queen Mary's School of Medicine, said: "Their work shows that, overall, the virus is a lot more busy swapping genes than we ever thought it was. "The situation could be similar in the bird flus as well."

Dr. John Moore-Gillon, spokesman for the British Lung Foundation, said: "We need to find a way to attack the flu virus so it will takcle a wider range of virus. "Currently, flu vaccination is very narrow. We have to predict what the strains are going to be, then make the vaccine.

"This work shows that the virus is wider than we thought."

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