Penumbra Pandemia

Deaths Caused by Avian Flu Confirmed in Lagos
From Chuka Oditah in Abuja
www.thisdayonline.com
1 Feb 2007
The multi-sectoral steering committee on Avian Influenza in Nigeria has confirmed that the deaths of two Nigerian women who died during the Christmas holidays in Lagos were caused by the dreaded avian flu virus.
In a statement issued yesterday, the committee said that an emergency meeting at the Avian Influenza Crisis Management Centre was held where it considered a report of virologists and laboratory experts that investigated the suspected human cases of Avian Influenza (AI) infection in Lagos.
The results of the tests conducted by Nigerian scientists using in-country laboratory facilities confirmed the first human case of Avian Influenza fatality in a 22-year old female who died in Lagos, Nigeria on January 17, 2007.
Another female member of the victim's household, earlier diagnosed with the clinical presentation of Avian Influenza virus (A/H5), is however responding to treatment.
The committiee stated that ìas demanded by international protocol the World Health Organisation (WHO) and the Centre for Diseases Control (CDC) have received samples from the fatal case and contacts for independent assessment and confirmation. The outcome of their investigations will be made available as soon as it is available.”
Allaying concerns over the possibility of a pandemic, the committee assured that the Federal Government is strengthening surveillance efforts across the country with particular emphasis on monitoring human contacts with poultry populations to prevent animal-to-human and human-to-human infection. The surveillance system is also being extended to cover all health institutions including private facilities. Public health containment actions, especially risk communication, emergency medical care and infection control measures are being put in place. Training of personnel in the areas of laboratory, surveillance and clinical management is also receiving priority,î added the committee
It urged the general public to immediately report sick chickens to local veterinary and health officials, thoroughly cook chicken meat, wash hands thoroughly after touching chicken and/or other poultry products.
Also state and local governments were advised to strengthen their various committees on the management of Avian Influenza and also restrict intra and inter state movement of poultry as a containment measure.
Poultry were workers further advised to strictly observe appropriate biosafety and biosecurity measures."

Akseli Hemminki
Helsingin Sanomat
page 2, 1 Feb 2007
"--- Olisi hyödyllistä, jos varautumissuunnitelmassa esitettyjen varokeinojen lisäksi meillä olisi käytettävissä rokote, jota voitaisiin tuottaa nopeasti suuri määrä ja joka antaisi hyvän suojan, vaikka Suomeen päätyvä kanta olisi jo hiukan erilainen kuin pandemian alkaessa.
Geenitekniikkaan perustuva influenssarokote saattaa antaa perinteisiä rokotteita laajemman suojan eri viruskantoja vastaan, koska rokotteen valmistuksen viimeinen vaihe tapahtuu rokotetun omissa soluissa.
Yleisimmin käytössä oleva geenikuljetin on adenovirus, sillä se on turvallinen, tehokas ja sitä on mahdollista tuottaa miljoonia annoksia muutamassa viikossa. Sitä onkin käytetty muun muassa tuhansien ihmisten kokeelliseen rokottamiseen hiviä vastaan. Myös influenssarokotekokeista on saatu lpaavia tuloksia.
Adenovirukseen perustuvalla geenikuljettimella voidaan tuottaa virusproteiinien sijasta esimerkiksi syöpäsoluille ominaisia proteiineja. Syöpärokotteista onkin saatu viime vuosina hienoja alustavia tuloksia.
Alle miljoonan euron vuotuisilla kustannuksilla olisi mahdollista kehittää adenoviruspohjainen mallirokote ja tutkia sen teho vapaaehtoisiin koehenkilöihin. Samalla saataisiin valmius tuottaa tarvittaessa täsmärokote huomattavan nopeasti kaikille suomalaisille. Jos rokote on valmistettu Suomessa, ei ole pelkoa, että pandemian alettua rokotetta ei saataisikaan ulkomailta.
Influenssarokotteen tuotantoon tarvitaan nimenomaan tähän tarkoitukseen kohdennettu määräraha osana pandemiaan valmistautumista, sillä Suomen Akatemian myöntämät projektiapurahat ovat tähän tarkoitukseen liian pieniä. Julkinen rahoitus varmistaisi sen, että rokotetta voitaisiin jatkuvasti kehittää ilman, että olisi tarvetta toimintaa rajoittavaan patentointiin ja voitontavoitteluun.
Kirjoittaja on dosentti, joka toimii ryhmänjohtajana Syövän geeniterapia -tutkimusryhmässä Helsingin Yliopistossa."
*****
Briefly in English:
With a genetically recombined adenovirus vector it is possible to develop an influenza vaccine that can be produced in large amounts quickly and without need for living animal tissues like chicken eggs or embryos. The money needed for develping such a vaccine is under one million euros yearly.

Nigeria H5N1 situation looks like H2H2H and spreading
Niman, post #131
in thread Bird flu resurfaces in Nigeria
at www.curevents.com room FluClinic
31 Jan 2007 05:03 PM
"Reuters this morning described 4 fatal cases that are almost certainly H5N1 positve. One has been confirmed in Lagos. She died January 17, while her mother died January 4. Earlier reports indicated the first three fatalities were influenza A positive. These data strongly indicate all three initial cases were H5N1 positive. This morning a fourth fatality was mentioned.
The two cases with date of death were in Lagos. Now a third family member is responding to treatment. Since this family member is alive and responding and said to also be positive, it would seem that the number of cases is five and counting, with three or more in the same family. The fact that the third family member is alive, and new samples are being collected from family members / contacts, raise question of more transmission from the confirmed case, who died January 17, to other contacts.
To muddy the picture, there are now statements that the 22F died from a chicken, but that story conveniently leaves out the death of the mother on January 4.
Right now it looks like H2H2H and spreading, but the media really is not addressing the key issues (disease onset dates and symptoms / hospitalization in recent contacts as well as infirmation to support that the hospitalized family member is also infected)."

"Kenya: Rift Valley Fever Appears in Decline; Conflict Hampers Control in Somalia - UN
www.allafrica.com
UN News Service (New York)
January 31, 2007
Posted to the web January 31, 2007
The months-long outbreak of Rift Valley Fever (RVF) in Kenya appears to be in decline after more than 500 suspected cases, 169 of them fatal, there and in Somalia, the United Nations health agency reported today. In Somalia continued conflict is hampering control measures.
The UN World Health Organization (WHO) has been working with other UN agencies, Kenyan Government ministries and non-governmental organization (NGO) partners to develop key public health messages that have been disseminated in the local community in an effort to curb the viral haemorrhagic disease, which can cause serious economic losses in livestock, particularly sheep and cattle.
The latest outbreak began in north-eastern Kenya in November, and UN agencies have warned that climate change with successive droughts and floods, some of it human-caused, could increase the disease's 5-15 year cyclical frequency. Outbreaks often follow major flooding, since heavy rains trigger a kind of wake-up call for the mosquitoes that carry the disease.
---
As of 30 January, 411 suspected human cases, including 121 deaths, a case-fatality rate of 29 per cent, have been reported in Kenya, and 100 suspected cases, including 48 deaths, in Somalia.
The NGO Médecins sans Frontières is facilitating transport of samples in Somalia and the WHO country office has held training sessions with medical officers on how to detect and contain the disease, but deteriorating security in the war-torn country continues to hamper control measures in the affected area, WHO reported."
*****
Usually approximately only 1% of human sufferers of Rift Valley Fever die of the disease. Now the death rate seems to be almost 50 %. Just wondering, have they tested for H5N1.

Read more

"Uganda: Malaria Hits Kasese District
New Vision
Kampala
January 16, 2007 / Posted to the web January 17, 2007
MOST health units in Kasese district have been flooded with malaria patients in an unprecedented outbreak of the disease, reports John Nzinjah.
'The situation is so pathetic. We have not experienced a similar situation in the last five years,' an officer at Kilembe Hospital said on Sunday.
The hospitals' acting medical superintendent, Dr. Kacucu Atwooki, on Sunday reorganised the duty roster to increase the medical staff.
Many patients were seen lying along the corridors and verandas of the wards.
Another official said: 'Our staff are not enough to handle the situation. We are, however, lucky that we have a nursing school that has offered us some trainees.'
'Yesterday, we admitted over 100 people. We had to admit only those who were in critical condition,' a nurse said.
In the children's ward, drip bottles were hanging everywhere. Some were being suspended from windows, others from six-inch nails hammered into the walls."
*****
Not that there would be H5N1, but they had time to test those critical conditioned feverish patients?

"Nigeria records bird flu deaths
Hanifah Namuleme
SomaliNet
January 31, 2007 12:27 pm.
Nigeria’s health ministry has received alarming news from bird flu experts that there is a high possibility that four Nigerians lost their lives to the deadly bird flu.
However, only one of the deaths has been empirically attributed to H5N1 bird flu. Conclusion in the other instances has been based on speculation.
One of the experts, Abdulsalam Nasidi, confirmed that the three cases are from Nigeria’s Borno, Taraba and Lagos cities. ---"
*****
If the cases in three different cities, then three different H5N1 clusters?
Editors' comment: Taraba and Borno are districts, not cities.

"Nigeria reports bird flu cases in humans
BASHIR ADIGUN
Associated Press
Wed, Jan. 31, 2007
ABUJA, Nigeria
Health officials reported Nigeria's first cases of bird flu in humans Wednesday, saying one woman had died and a family member had been infected but was responding to treatment.
The 22-year-old woman died Jan. 17 in Lagos, Information Minister Frank Nweke said. He added that the government was boosting surveillance across Africa's most-populous nation after the infections in Lagos, Nigeria's biggest city.
The World Health Organization did not immediately confirm the case.
Nigerian health officials earlier said 14 human samples were being tested. Nweke made no mention of those cases Wednesday.
An outbreak of H5N1 bird flu hit Nigeria last year, but no human infections had been reported until Wednesday. Until the Nigerian report, Egypt and Djibouti were the only African countries that had confirmed infections among people. Eleven people have died in Egypt.
---
Amid a new H5N1 outbreak reported in recent weeks in Nigeria's north, hundreds of miles from Lagos, health workers have begun killing poultry. --- The H5N1 strain had been confirmed in 15 of Nigeria's 36 states.
---
Since bird flu cases were first discovered in Nigeria last year, Cameroon, Djibouti, Niger, Ivory Coast, Sudan and Burkina Faso have also reported the H5N1 strain of bird flu in birds. There are fears that it has spread even farther than is known in Africa because monitoring is difficult on a poor continent with weak infrastructure.
There also is concern that millions of people with AIDS in sub-Saharan Africa will be particularly vulnerable, especially in rural areas with little access to health facilities. Many people keep chickens for food, even in densely populated urban areas."
*****
How many millions of people die every year from malaria? What about different kinds of feverish gastroenteritis? How many people fevery with AIDS? How many countries in Nigeria and sub-Saharan counries have strength and resources to diagnose, which fever is which?

"Bird flu registered in Russia's south - watchdog
RIA Novosti
29/ 01/ 2007 at 20:14
MOSCOW
Bird flu has been registered in Russia's southern Krasnodar Territory, Rosselkhoznadzor, the agricultural watchdog, said Monday.
'Deaths of domestic fowl were registered at three farmsteads. Lab analysis revealed the H5N1 bird flu virus strain,' press secretary Alexei Alekseyenko said.
Russia banned Hungarian poultry imports Friday following the discovery of bird flu in the Central European country.
---
In 2006, an epidemic of the deadly virus broke out in five Siberian and 11 southern regions, resulting in the deaths and culling of about 1.5 million birds. No human fatalities have been reported in Russia so far."

"AVIAN INFLUENZA, HUMAN (25): INDONESIA, WHO
Archive Number 20070129.0382
Published Date 29-JAN-2007
Subject PRO/AH/EDR> Avian influenza, human (25): Indonesia, WHO
From: Mary Marshall
Source: Antara News online, Mon 29 Jan 2007 [edited]
The Dr Sardjito hospital here have received 2 more suspected bird flu
patients after it earlier received 4 patients. 'A patient identified as DS
(14) from Depok, Sleman, was admitted on Saturday evening while DF (1) from
Prambanan, Sleman, on Sunday afternoon,' member of the Bird Flu Control
Team of the hospital, Dr Amalia Setyati, said here on Sun 28 Jan 2007. The result of a quick test shows that DS had been infected with the bird flu
virus, while DF was not.
'This was the result of a quick test with an accuracy rate only 50 percent.
So for the time being the diagnosis must not be used as reference. For
certainty we still have to send their blood samples to the Health
Ministry's research and development center for further and more intensive
tests,' she said.
She said 5 [suspected?] bird flu patients were currently being treated at
the hospital. 'They were admitted on Friday but YD who was admitted on
Saturday was allowed to go home. However we will only send their blood
samples for the tests to the Health Ministry`s research and development
center on Mon [29 Jan 2007],' she said.
She said 13 medical personnel who had dealt with bird flu patients at the
hospital also had their blood tested as a precaution. 'This is merely an
anticipation, because we had direct contact with the patients,' she said. A
6-year-old girl who died at the hospital on 19 Jan 2007 had been positive
diagnosed with bird flu [see above]. Her death brought the number of people
killed by bird flu in Indonesia to 63. ---"

"Tests Equivocal on Qinghai H5N1 Cluster in Lagos Nigeria
Recombinomics Commentary
January 30, 2007
''The tests we ran yesterday produced inconsistent results, said David Olaleye, who is taking part in the testing at a laboratory in the capital Abuja.
Olaleye said two initial rounds of tests over the weekend had proved negative but results from Monday's third round of tests had produced a pattern that was "unreliable" and did not allow him to make a clear call on the outcome.
'That is why we have pulled out a fresh batch of samples from the same people and we have started a completely new set of tests,' he said.''
The above comments raise concerns on H5N1 in patients in Nigeria. H5N1 false negatives are common. The above comments suggest that a third test of samples from three patients and contacts has produced a positive result. Prior media reports indicated that influenza A was confirmed in the three fatal cases, and an alternate serotype has not been described.
Recent reports indicate that H5N1 in Nigerian poultry is widespread. The re-emergence in Nigeria parallels the re-emergence in Egypt, which has reported human cases this season and last season.
All H5N1 in Europe, the Middle East, and Africa is the Qinghai strain (Clade 2.2). Several polymorphisms in Egyptian isolates are also in Nigerian isolates. --- Last season H5N1 was confirmed in Nigeria, Niger, Ivory Coast, Burkino Faso, and Cameroon in western Africa. ---
Recent cluster members in Egypt had the Tamiflu resistance polymorphism, N294S. This marker was present in samples collected prior to Tamiflu treatment, raising concerns that N294S is circulation in Qinghai H5N1 in migratory birds. ---"

"Nigeria mum on new human bird flu tests
January 31 2007 at 01:54AM
Abuja
By Felix Onuah
A laboratory in Nigeria on Tuesday ran new tests for the deadly bird flu virus on samples from 14 people after earlier checks proved inconclusive ---
Nigeria, Africa's most populous country, was the first on the continent to detect bird flu in poultry last year but it has not had a confirmed human case.
David Olaleye, a World Health Organisation scientist involved in testing at a laboratory in the capital Abuja, declined to comment on the results of Tuesday's tests on samples taken from 14 people, including three people who died.
It was the fourth round of tests on the samples and had been expected to clarify whether the H5N1 virus was present.
Two initial tests over the weekend proved negative, but results from a third round on Monday produced a pattern that was 'unreliable' and did not allow experts to make a clear call, Olaleye said.
Olaleye said some of Monday's results had shown positive and some negative for H5N1 but that the data were not reliable. He did not comment on Tuesday's results."

"China meeting warns of bird flu mutation risk
1/31/2007 1:38:22
REUTERS - BEIJING
The deadly H5N1 form of the bird flu virus is rapidly mutating and the world must be on guard even though the disease has yet to be transmitted between humans, experts told a meeting in Beijing, Chinese media said yesterday.
The closed door conference, attended by experts from the Chinese and US centres for disease control and the World Health Organisation among others, opened on Monday, the official newspaper of the Chinese Health Ministry reported.
'The experts said that despite there being no evidence yet of human-to-human transmission of bird flu, the highly pathogenic H5N1 form of the virus is continuing to rapidly mutate, and human infections keep happening,' the Health News reported. 'H5N1 is a virus that has the potential for mass transmission, and people cannot slacken off in their control efforts,' it added in a front-page story."

"Nigeria sends bird flu test reports on human samples to Europe
AFP News brief
30/01/07 22h43 GMT
Nigeria has sent the reports of tests conducted on 14 human samples for suspected bird flu to experts in Britain and Italy, officials said.
'The samples are being cross-checked in London and Rome,' and final reports are being expected in Nigeria Wednesday or Thursday, Information Minister Frank Nweke told told reporters.
The samples include blood or tissue from at least two people who died after suffering flu-like symptoms.
Nweke said preliminary reports had not confirmed that deaths occurred as a result of bird flu.
'They had respiratory system problems and were treated for pneumonia. We are exploring the possibility they may have had contact with poultry,' the acting health commissioner for Lagos state, Jide Idris, said. ---"

ISDA's Comprehensive Set of Principles to Prepare for Seasonal, Pandemic Flu
Infectious Diseases Society of America
http://www.idsociety.org
ALEXANDRIA, VA 30 Jan 2007
"As part of its own continuing commitment to assist in preparing for this serious threat, IDSA has compiled 12 principles for action on pandemic and seasonal influenza:

1. Establish a Pandemic Influenza Vaccine Master Program. An effective vaccine will be the best protection against the next pandemic. The United States needs to lead a large, coordinated, multinational, public-private program on the scale of the Apollo space project. IDSA is calling for an investment of at least $2.8 billion for 2007 alone.

2. Boost R&D and stockpiling of antibiotics and antivirals. Public health authorities should have enough medicines to respond to a pandemic on hand ahead of time. New drugs need to be developed. Currently available antivirals are only moderately effective, and resistance to them is emerging.

3. Improve diagnostic tools. Influenza shares symptoms with a wide range of other illnesses. Better tools are needed that can distinguish flu from other diseases quickly and affordably, and can be used even in small medical centers with limited resources.

4. Improve the financial, legal, and regulatory environment for developing anti-flu products. New funding for drug development authorized under the Pandemic and All-Hazards Preparedness Act will need to be targeted to the right products based on the advice of infectious diseases experts. The pharmaceutical industry will likely need additional incentives such as tax credits for R&D and manufacturing, and enhanced intellectual property rights to entice companies back into the anti-infectives field. The regulatory approvals process needs to be streamlined and standardized among international partners.

5. Update plans for distributing and prioritizing anti-flu supplies. During a pandemic, there may not be enough flu-fighting supplies for everyone who is sick or at risk. If so, who should receive them? This question needs to be answered in a transparent and ethical way well before a pandemic hits. (IDSA recently wrote a comment letter to the Secretary of Health and Human Services on this subject. The letter is online at www.idsociety.org.)

6. Improve seasonal influenza response. Use seasonal flu to prepare for a pandemic. In addition to mandating vaccination for health care workers, new policies to increase flu vaccination among the public should be adopted. These measures will improve the market for flu vaccine and make it more attractive to industry. Each flu season should also be used to test vaccine distribution plans and procedures.

7. Protect Health Care Workers During a Pandemic. Health care workers and other first responders are the community’s first line of defense in any public health emergency. Their work also puts them at high risk of illness. They should be prioritized to receive anti-flu drugs and vaccines.

8. Build health care systems capable of responding to mass casualty events. National, regional, and local health systems capable of responding to sudden surges of patients are needed. The federal government should develop materials to help train public health and medical personnel, and should also develop guidelines on allocation of scarce resources, liability protection, modified standards of care during an emergency, and other key issues.

9. Develop and test 'community mitigation' measures: closing schools, sending workers home, isolation and quarantine, and so on. In the absence of enough vaccine or antivirals, these may be the only measures available to protect the public. But how well would they work? And how should they be used? National guidance on these issues needs to be worked out through continued consultation with experts.

10. Improve and coordinate surveillance. A viable, global early warning system is needed to detect an outbreak of pandemic influenza.

11. Continue to strengthen leadership, international collaboration, and communication. Continue clarifying lines of authority, holding tabletop exercises, issuing national standards and guidance, and involving experts and stakeholders in discussions and decision-making.

12. Commit funding for the long term. Influenza is a yearly hazard. An influenza pandemic could strike at any time. Although recent infusions of funding have been beneficial, a sustained, long-term commitment is needed.

'We’ve spent the last several decades downplaying the problem of seasonal flu, and ignoring the threat of pandemic flu,' Dr. [Andrew T.] Pavia [MD, chair of IDSA’s National and Global Public Health Committee] said. 'We’re better prepared now than we have been, but we have a very long way to go. We can’t take our eye off the ball now.'"

"Flu Experts Call for Mandatory Shots for Health Care Workers
Infectious Diseases Society of America
http://www.idsociety.org
ALEXANDRIA, VA 30 Jan 2007
The top professional society of infectious diseases experts is insisting that all physicians, nurses, and other health workers caring for patients be vaccinated against influenza each year or decline in writing. It is the strongest call yet to plug a critical weakness in the nation’s flu preparations.
The Infectious Diseases Society of America (IDSA) is issuing the call to Congress and the Administration as part of a new set of recommendations to better prepare the nation and the world for an inevitable influenza pandemic, as well to improve responses to the perennial threat of seasonal influenza.
The document is one of the most complete assessments to date on the major outstanding issues surrounding flu preparations. IDSA intends its principles to complement Congress’ and the Administration’s efforts in enacting the Pandemic and All-Hazards Preparedness Act in December 2006. IDSA’s principles support many of the concepts found in the new law, but provide additional direction and a level of specificity not found in the Act.
The Centers for Disease Control and Prevention estimates that about 226,000 people are hospitalized with influenza and 36,000 people die from it every year in the United States alone. Even a 'mild' influenza pandemic is expected to kill 100,000 to 250,000 Americans, and a severe pandemic could kill 2 million.
Health care workers caring for sick patients are routinely exposed to influenza virus and often spread it around. Yet each year fewer than two in five health care workers get a flu shot.
'It’s our professional duty to first do no harm,' said Andrew T. Pavia, MD, chair of IDSA’s National and Global Public Health Committee. 'Voluntary systems haven’t brought immunization rates up far enough. For the sake of our patients, all health care workers must get a flu shot every year or they must be required to opt out in writing.' ---"

"Nigeria tests 14 human samples for bird flu
AFP News brief
29/01/07 20h17 GMT
Nigeria is testing 14 human samples for suspected bird flu, including blood or tissue from at least two people who died after suffering flu-like symptoms, health officials said.
'So far we have 14 blood samples' for testing, Director of Public Health Abdullahi Nasidi told AFP, adding that the samples 'came mostly from Lagos,' the country's commercial capital.
The acting health commissioner for Lagos state, Jide Idris, said the samples included 'blood samples from two people who died a couple of weeks ago.'
'They had respiratory system problems and were treated for pneumonia. We are exploring the possibility they may have had contact with poultry,' Idris said.
He did not say whether the other 12 persons from whom samples were taken had been in contact with the two who died.
A statement from Information Minister Frank Nweke said that preliminary tests appeared to indicate common influenza rather than avian influenza.
'Tissue samples obtained from the suspected victims have tested positive to Influenza virus type A which is the same virus that causes the common cold,' the statement said.
'Confirmatory tests are in progress to establish the exact strain of the virus and the federal government will make further statements as soon as the results are received,' it said.
The deadly H5N1 strain was first reported in Nigeria in February 2006. After a lull it resurfaced earlier this month among poultry in the northern states of Katsina, Sokoto and Kano.
Nigeria's Department of Veterinary Research said that since the start of the outbreak last February a total of 945,862 birds have been lost, 602,160 of which were culled, but no human cases have so far been reported.
Health experts worry that if human cases appeared in Nigeria they would be very difficult to contain given the poverty in which many Nigerians live and the rampant corruption that makes measures and bans difficult to enforce."
*****
Read more

Pandemic Influenza Preparedness Efforts
by big critter on "News Reports for January 29" thread at
New Flu Wiki
Mon Jan 29, 2007 at 21:52:35 PM EET
"On Thursday 2/01, USA Today is expected to run a significant piece by Anita Manning pandemic influenza preparedness at the state, local and federal levels. CDC efforts and experts are likely to be included in the story.
Interim Guidelines on Community Mitigation Strategies for Pandemic Influenza; On Thursday 2/01, Dr. Gerberding, Dr. Marty Cetron and Secretary Leavitt will participate in a press conference at CDC that will release the interim guidance document for community activities to reduce the impact of an influenza pandemic. This press event will also release HHS Public Service Announcements related to Pandemic Influenza preparedness. A press release or media advisory will also be issued to alert reporters.
(Indirectly via a CDC source)"

"Bird flu in pigs poses human risk
English.eastday.com / Xinhua news
26/1/2007 9:35
Scientists said two pigs on the Indonesian island of Bali had become infected with the bird flu virus, again raising concerns the deadly flu virus could become transmissible between people.
Speaking at a China-Japan infection prevention conference in Guangzhou, a leading Chinese medical expert said the pigs generated a variant of the bird flu virus after they contracted bird flu.
The pigs acted as a kind of mixing vessel in which genetic material from avian flu viruses combined with other influenza strains, said Zhong Nanshan, a renowned medical expert and academician with the Chinese Academy of Engineering.
Some pig organs are similar to human organs, suggesting that a similar mixing of flu genetic material could occur in humans, said Zhong.
The best way to prevent bird flu is to dispose of infected birds as quickly as possible, establish stringent quarantine requirements and treat human patients rapidly, Zhong said."

Recommendations for influenza vaccines
www.who.int web page
Thu 25 Jan 2007
"--- Why annual recommendations for influenza vaccine composition are necessary
Circulating influenza viruses in humans are subject to permanent antigenic changes which require annual adaptation of the influenza vaccine formulation. Updates in influenza vaccine composition should ensure the closest possible match between the influenza vaccine strains and the circulating influenza strains; ensuring this match is one of the foundations for influenza vaccine efficacy.

How they are made
Information on circulating strains and epidemiological trends is gathered by the WHO Global Influenza Surveillance Network administered by WHO since 1948, the year of WHO’s inception. The Global Influenza Surveillance Network currently consists of 112 national influenza centres in 83 countries and four WHO Collaborating Centres for Reference and Research on Influenza located in Atlanta, United States; London, United Kingdom; Melbourne, Australia; and Tokyo, Japan.
---
Twice a year, WHO organizes a consultation with the Directors of the WHO Collaborating Centres and representatives of key national laboratories to review the results of these laboratory and clinical studies and make recommendations on the composition of the influenza vaccine (February: northern hemisphere; September: southern hemisphere). Immediately after this consultation WHO informs representatives of pharmaceutical companies on its decisions which are published in the press and the WHO Weekly Epidemiological Record. WHO collaborates with key national licensing agencies on the provision of viruses for vaccine production as well as vaccine potency testing reagents. More than 250 million vaccine doses are produced annually based on the WHO recommendations. Since 1972 WHO has recommended 39 changes in the influenza vaccine formulation."
*****
WHO Recommendations for Influenza Vaccine Composition
www.who.int web page
Thu 25 Jan 2007

1. Northern hemisphere: 2006-2007
2. Southern hemisphere: 2006
3. Northern hemisphere: 2005-2006
4. Southern hemisphere: 2005
5. Northern hemisphere: 2004-2005
6. Southern hemisphere: 2004
7. Northern hemisphere: 2003-2004
8. Southern hemisphere: 2003
9. Northern hemisphere: 2002-2003
10. Southern hemisphere: 2002
11. Northern hemisphere: 2001-2002
12. Southern hemisphere: May-October 2001
13. Northern hemisphere: 2000-2001
14. Southern hemisphere: May-October 2000
15. Northern hemisphere: November 1999 to April 2000
16. Southern hemisphere 1999
17. Northern hemisphere November 1998-April 1999

Southern hemisphere 2007 (WHO Weekly Epidemiological Record, 13 Oct 2006, p. 390)
It is recommended that vaccines to be used in the 2007 season (southern hemisphere winter) contain the following:
— an A/New Caledonia/20/99(H1N1)-like virus;
— an A/Wisconsin/67/2005 (H3N2)-like virusa;
— a B/Malaysia/2506/2004-like virus

"Bird Flu Found In Texas
Highly Contagious Strain Found At San Antonio Chicken Farm
CBS News
Feb. 23, 2004
(AP) A strain of avian influenza found on a Texas chicken farm is highly contagious and far more dangerous to chickens than originally thought, and it has spread to live bird markets in Houston, federal officials said Monday.
However, the flu is not the same strain that has killed at least 22 people in Asia, said Dr. Ron DeHaven of the U.S. Department of Agriculture.
The strain, found in Gonzales County in South Texas, poses little threat to people, said Dr. Nancy Cox of the federal Centers for Disease Control and Prevention.
'Nonetheless, as we move forward in this particular situation, we have to keep an open mind,' Cox said.
On Friday, state officials said the outbreak was a low-pathogenic version of bird flu, meaning it posed little risk to humans and only low risk to chickens.
However, it was reclassified as high-pathogenic after genetic testing during the weekend, DeHaven said.
It is the first time since 1983-84 that high-pathogenic avian flu has been found in the United States, DeHaven said.
The name and location of the chicken farm wasn't revealed.
The farm's flock was destroyed during the weekend but birds from that flock already had been sent to two live bird markets in Houston, DeHaven said.
Preliminary testing showed that the disease was found in the live-bird markets, DeHaven said. Chickens at one of those markets also were destroyed, and the same process had been started at the other market, he said.
Two other strains of bird flu have turned up in recent weeks in the eastern United States. One was detected at a farm in central Pennsylvania, and the other was found at two farms in Delaware and at live bird markets in New Jersey. None of those strains resembles the H5N1 virus that has jumped to humans in Asia."
*****
Why was it determined low pathogenic at first? It didn't kill the birds, but genetically was deadly for people? Has the strain been in USA all the time?

"Cat owners at greater risk of bird flu, finds boffin
London, Jan. 25 (ANI)
---
[Dr. Albert Osterhaus of Erasmus University in Rotterdam] also advised that all pets should be kept indoors and tested immediately for the bird flu virus if they became ill.
For the study, Dr Chiarul Anwar Nidom of Airlangga University took blood samples from 500 cats living near poultry markets in four areas of the island of Java, which had recently bore the brunt of H5N1 outbreaks in poultry and people. He found that one in five cats had been infected with the virus at some point, probably through eating infected birds.
He said that many other infected cats would have died from the virus, meaning that many more than 20 per cent may have picked up the infection, which shows that cats could catch the virus from each other too.
'I am quite taken aback by the results,' he told New Scientist magazine. (ANI)"

Chief vet confirms bird flu suspicion in S, swine fever in N Hungary
Budapest, January 23 (MTI)
Hungary's veterinary authorities have reported geese showing symptoms of bird flu from a poultry farm near Szentes, S Hungary, chief veterinary officer Miklos Suth told the press on Tuesday.
Suth confirmed earlier reports that some 40 birds with symptoms of the disease had been found at a farm of 3,300 geese on Sunday.
Meanwhile, swine fever in three wild boar has also been detected near Hungary's border with Slovakia, Suth said. Veterinary authorities have begun taking protective action and reported both cases to EU authorities, Suth added."

Rapid diagnosis of H5N1 avian influenza virus infection by newly developed influenza H5 hemagglutinin gene-specific loop-mediated isothermal amplification method.
Imai M, Ninomiya A, Minekawa H, Notomi T, Ishizaki T, Van Tu P, Tien NT, Tashiro M, Odagiri T.
Laboratory of Influenza Viruses, Department of Virology 3, National Institute of Infectious Diseases, Gakuen 4-7-1, Musashi-Murayama, Tokyo 208-0011, Japan.
J Virol Methods. 2007 Jan 9; [Epub ahead of print]
Reverse transcriptase loop-mediated isothermal amplification (RT-LAMP) is a unique gene amplification method that can be completed within 35min at 62.5 degrees C. In the present study, RT-LAMP was used to develop a rapid and sensitive laboratory diagnostic system for the H5N1 highly pathogenic avian influenza (HPAI). The sensitivity of the system was 0.1-0.01 plaque-forming units per reaction for HPAI-H5N1 viruses belonging to the genetically and antigenically distinct clade 1, represented by A/Vietnam/JP1203/2004, and clade 2, represented by A/Indonesia/JP283/2006. This RT-LAMP sensitivity is 10-fold higher than the sensitivity of standard one-step RT-PCR. By using viral RNAs extracted from avian influenza viruses of H1-H15 hemagglutinin (HA) subtypes and human pathogenic respiratory viruses, it was confirmed that the RT-LAMP system amplifies specifically RNA of the H5 subtype virus. The system detected H5-HA genes in throat swabs collected from humans as well as from wild birds. These results suggest that the present RT-LAMP system is a useful diagnostic tool for surveillance of recent outbreaks of the HPAI-H5N1 virus.
PMID: 17218021 [PubMed - as supplied by publisher]"

Official Chinese bird flu deaths could be 'tip of iceberg'
NewScientist.com news service
Debora MacKenzie
Updated 11:00 28 November 2005
A respected Japanese scientist, who works with the World Health Organization, has told New Scientist he fears that China’s official tally of laboratory-confirmed human bird flu fatalities – just three – is only the tip of the iceberg.
Masato Tashiro, head of virology at Tokyo’s National Institute of Infectious Disease – a WHO-collaborating centre for bird flu – showed a slide at a meeting of virologists in Marburg, Germany, on 19 November [2005] listing 'several dozen' outbreaks in people, nearly 300 deaths, 3000 people placed in isolation, and seven human-to-human transmissions. The meeting was reported in the German newspaper Frankfurter Allgemeine Zeitung.
Tashiro has now told New Scientist that the figures were examples of the 'unauthorised information' circulating in China, where he was helping to investigate recent outbreaks.
Earlier reports suggested that Tashiro believed 300 to be the true death toll from bird flu in China. 'I do not know whether the numbers were based on any evidence,' he says.
But the message is that 'we do not know how many cases actually occurred in China', due to poor disease surveillance. 'If surveillance is done more extensively, more cases may be detected.' He says the international community should assist China with monitoring. He describes the situation as an 'iceberg phenomenon' – with most cases unreported.

Severe restrictions
---
The potential problem of underreporting may not only be technical. There are also claims that Chinese medical personnel have been arrested for trying to report cases. China enforced severe restrictions on the investigation and reporting of suspected cases of bird flu in June 2005.
But the WHO says it does not believe China is deliberately hiding cases as it did during the SARS outbreak in 2003. 'There are many countries where surveillance is weak and needs to be strengthened, I think that's true in certain parts of China as well,' says Roy Wadia, a WHO spokesman based in Beijing. 'We're getting lots of information in a timely way about the outbreaks and we're asked to be part of the ongoing investigations. I think that speaks for itself.'
Virologists consider the relative absence of human cases of bird flu in China unusual, given its widespread infection in birds. China has reported 22 poultry outbreaks in 10 provinces all across the country since mid-October 2005, the latest being on Friday.
The WHO told the official Chinese news agency Xinhua last week that the virus that caused the outbreak in Hunan is the same as the H5N1 flu in Vietnam and Thailand, where it has caused 113 confirmed human cases and 55 deaths so far."

Pandemic business piece of advice:
"During a pandemic there will be a very important pool of workers who contract the disease but survive and become immune. Keeping a database of these individuals would make staffing front-line public areas easier."

"Bird flu comes back? Many are quarantined in Guangzhou
Boxun
Jan 20, 2007 at 10:41:25 AM
Source said dozens of people quarantined in the 8th Hospital in Guangzhou - capital city of Guangdong Province. Many people are also quarantined too in one army hospital in this city. It is believed to be bird flu.

Update at 11pm Jan. 20 NY Time: Latest information shows the patients are more likey to be SARS. One person from 8th Hospital told reporter that they have some SARS patients, this is not an official annoucement by hospital, thus more information is needed to come to a conclusion."

Disaster zones declared
Poultry movements banned in all 16 districts as mass bird cull gets underway
By Sunthorn Pongpao Apiradee Treerutkuarkul
The Bangkok Post 21 Jan 2007
All 16 districts in this central province have been declared disaster zones to help public health authorities with the mass culling of poultry in bird flu-prone areas.
A ban on fowl movements throughout the province, especially free-range ducks from other provinces, has also been enforced.
Provincial Governor Cherdpan na Songkhla, who issued the order yesterday, said areas where bird flu had previously been confirmed, such as Bang Pahan, Phak Hai and Bang Pa-in districts, were still at risk because the virus remained dormant in water resources and residential areas.
Provincial health official Rattanachai Chullanet said the latest laboratory tests showed that Boonlert Chuenruedee, 43, a free-range duck raiser, was not infected with bird flu virus after he helped bury dead ducks and later developed a high fever and sore throat.
Deputy permanent secretary for agriculture Yukol Limlamthong said Thailand should be on alert for a possible outbreak spreading into the kingdom from neighbouring countries.
To prevent a possible new outbreak of the deadly H5N1 virus, the Agriculture and Cooperatives Ministry has sought cooperation from the Customs Department to monitor and ban the import of poultry and breeding equipment from neighbouring countries hit by avian influenza.
As the Agriculture and Cooperatives Ministry steps up its guard against bird flu, public health authorities are considering a new partner in China to jointly develop influenza vaccines.
Public Health Minister Mongkol na Songkhla and senior health officials decided to look for a new Chinese biotechnology firm which could provide better technology and a larger production capacity than Sinovac Biotech, a Chinese firm previously targeted for the job.
'We would like to make sure that we get the best technology for research and development of a vaccine. We need to think thoroughly before making a decision to sign a contract with any firm,' Dr Mongkol said after returning from China last week.
The Public Health Ministry previously planned to work with Sinovac Biotechnology, which has the potential to transfer technological know-how which could help vaccine development.
The company planned to construct a vaccine manufacturing plant in Saraburi or a Livestock Development Department plant in Nakhon Ratchasima capable of producing up to two million doses of human flu vaccine a year by 2009.
The minister said any cooperation with the Chinese biotechnology firm regarding vaccine development would be carried out under a government-to-government framework which needed final approval from the prime minister.
However, he accepted that the decision to find a new partner could set back preparations for a possible flu pandemic as it could take up to four years to finalise the blueprint for a plant after signing a contract with a firm.
He was worried that delays to plans to manufacture millions of doses of the vaccine could hamper Thailand's opportunity to receive international funding for bird flu research and development from the World Health Organisation (WHO).
The WHO will choose which country to grant the budget to on Feb 14. The health agency last month sent a proposal to request grants from the WHO-organised Pledging Fund, contributed to by richer nations such as the United States and Japan. If approved, Thailand could receive up to 80 million baht for developing the flu vaccine plant. Six countries _ Thailand, Brazil, India, Indonesia, Mexico and Vietnam _ have been shortlisted for the programme.
Dr Mongkol in October called for a rethink of plans to vaccinate animals developed after the country faced a series of avian flu outbreaks since 2004. He said the virus had mutated and it was difficult to diagnose the symptoms in new human fatalities.
The bird flu policy committee, chaired by Deputy Prime Minister Kosit Panpiemras, will make a decision on limited vaccine use in bird flu-plagued areas on Jan 29.
However, virologist Prasert Thongcharoen said a thorough study on the effectiveness of animal vaccines used in neighbouring countries such as Vietnam and Indonesia was essential before undertaking the measure here.
Such a study was necessary to find out if the vaccine could reduce the transmission of the virus from both animals to animals and animals to humans, he said.
Bird flu was still rife in Vietnam and Indonesia despite their animal vaccination policies, he said."

"Five Suspect H5N1 Cases in Egypt
Recombinomics Commentary
January 19, 2007
Another five persons were suspected of having been infected with bird flu virus in Egypt, an Egyptian Health Ministry official said on Friday.
Three women had already been sent to a fever hospital in downtown Cairo after being suspected of having been infected with the deadly disease, the official was quoted by Egyptian TV as saying.
Due to the same reason, another lady and a child have also been sent to a hospital in Fayyum governorate, 85 km south to Cairo, the official added.

The above comments on five suspect bird flu cases in Egypt are cause for concern. Although suspect cases are frequently cited in the local media, transfer to the fever hospital in Cairo and verification by the Health Ministry increases the likelihood that cases will be confirmed.
Human cases in Egypt have developed early this season. Last season, the first case was confirmed in mid-March. This season the first case was confirmed in October, followed by a cluster of three in December and a fifth case this month. All five of these cases have died, and the two sequences from the cluster had the Tamiflu resistance marker N294S. ---"

Niman at www.curevents.com
10:27 AM 19 Jan 2007
"The N274S in Egypt is unrealted to the Tamiflu treatment. The patients were treated with the standard 2 X 75 mg. Two days after the start of treatment, samples were collected. Sequencing was directly from the clinical sample. The was no hint of any wild type sequence at position 294 and no hint of H274Y, the common Tamiflu resistance marker in H5N1. Sequences from both patients gave the same results (at two inpendent labs).
The only other case that had N294S was a patient in Vietnam. However, she had considerably more H274Y than N294S.
The N294S in Egypt was from the birds, not the Tamiflu."

"N294S Tamiflu Resistance in Gharbiya Cluster
Recombinomics Commentary
January 18, 2007

The health organization emphasized that it was too early to tell whether the resistant strain had developed independently in the two patients, who were both under treatment with the drug, or whether they had picked it up from birds or from each other. The resistant strain did not spread to anyone else, including a third family member who also had avian flu.

'Given the information we have, we don’t see any broad public health implications,' said Dick Thompson, a spokesman for the organization.

The above comments acknowledge the Tamiflu resistance in two members of the Gharbiya cluster, however, circumstantial data strongly suggests that the change, N294S, developed prior to treatment of the cluster members with Tamiflu.
---
The samples were collected within 48 hours of treatment, so it is unlikely that all four sequences (two from each patient) became so dominant so shortly after the start of treatment in both patients.
---
the data to date suggests these changes were present prior to the start of treatment. There is no data in the literature indicating N294S lacks fitness."

Bird flu cases surge in Jakarta
Jan 16, 2007
tvnz.co.nz
One of two hospitals designated to treat bird flu cases in the Indonesian capital has been overwhelmed with patients with symptoms of the disease, a doctor said on Tuesday. --"
*****
No Bloomberg nor other agency reports about the possibility that the Rothschilds' or other money lords of the World would be in any way interested in the threat of bird flu. Maybe it was just a news bubble waiting for a burst and to be revealed to contain only clean air, after all.

Anyways, has any of you actually seen H5N1 dead birds live (not on TV or internet)? Or heard straight from friends or acquaintances that they would have seen birds or people falling with H5N1 - live and really? Or is it just media hype created for other purposes? Certainly the stocks have gone up and down.

It has been rumoured at the bird flu sites (flutrackers, curevents, fluwikie) that the famous money family Rothschilds' would have promised to give money for the poor nations to struggle against bird flu. The timetable nor the decicion of the sum has not yet been confirmed. The news is waited to be published first via Bloomberg.
If you readers' have any new information or rumours about the case, please inform us at Penumbra of Pandemia blog about it.

UNDIAGNOSED DISEASE, PORCINE - CHINA: UPDATE
Archive Number 20070114.0185
Published Date 14-JAN-2007
Subject PRO/AH/EDR> Undiagnosed disease, porcine - China: update
A ProMED-mail post of International Society for Infectious Diseases
[3]
Date: Thu 21 Dec 2006
From: Dan Silver
Source: Shandong Animal Husbandry Net via Chinabreed.com [trans. from
Chinese by sender, edited]

Week 50 Shandong Pig Market Climbs Again
11-15 Dec 2006: "Swine High Fever Disease continues in some areas, and a few areas also have swine influenza. Hopefully, those associated with pig farming will carefully manage winter breeding, carefully calculate breeding costs, and avoid losses."
Dan Silver

[An interactive administrative map of China is available at
http://en.wikipedia.org/wiki/Image:China_administrative.png.
Subscribers are referred to China's report, dated 14 Sep 2006, to the
OIE on 'Swine High Fever Disease,' included in ProMED-mail's posting
20060924.2732 with Mod.PC's comprehensive commentary.
---
The said report mentioned the following provinces, affected since the start of the disease 'at the end of June 2006:' Hunan, Jiangxi, Anhui, Jiangsu, Zhejiang and Hubei.
The Chinese report to the OIE mentioned also a similar swine disease, which has been seen during the last few years in some southern provinces of China. However, it was seasonal, restricted to hot summers, and affected certain areas along the Yangtze River, mainly in the provinces of Hunan, Hubei, Jangxi, Anhui and Jiagsu. They claimed that if there is any new detection of the disease, it will be notified to the OIE immediately.
According to the current internet-derived information (for which Dan Silver is gratefully acknowledged), 'Swine High Fever Disease' has been recently recorded also in the provinces Shandong and Shaanxi and is thus still there. As suggested by Mod. PC (see 20060924.2732), we will continue to refer to this disease as "undiagnosed" rather than 'high fever' disease until a more definitive diagnosis is established, either as a syndrome resulting from mixed infections with particular agents or when a definite single agent is identified.

We shall update subscribers if and when new epidemiological or diagnostic developments regarding this hitherto undiagnosed disease unfold. - Mod.AS]
[see also: 2006 ---
Undiagnosed disease, porcine - China (04) 20061129.3387
Undiagnosed disease, porcine - China (03): OIE 20060924.2732
Undiagnosed disease, porcine - China (02): RFI 20060908.2549
Undiagnosed disease, porcine - China (South), RFI 20060903.2508]
................arn/msp/mpp"

Archive Number 20070113.0183
Published Date 13-JAN-2007
Subject PRO> Norovirus - USA (multistate)(02)
NOROVIRUS - USA (MULTISTATE) (02)
********************************
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Fri, 12 Jan 2007 21:22:33 +0100
From: Marion Koopmans
I would like to respond to the posting [Norovirus - USA (multistate)
20070112.0145] in which the moderator wonders if the attention for
noroviruses is reflecting media hype or something else. I would like
to remind the moderator (and the readers) of a posting from December
2006 (Norovirus, increased activity - Europe 20061214.8255).
This was a report from our European norovirus research and
surveillance network in the December issue of Eurosurveillance. Here
we reported increased activity of norovirus associated with emergence
of a new variant of GGII4. This genotype is the most common norovirus
found in institutional outbreaks, and evolves quite fast.
We have seen 3 pandemics of GGII4 new variants in the past 10 years,
and probably are witnessing the 4th one. Reasons for this rapid
evolution are not clear, but suggest selective advantage of the new
viruses, possibly immune escape. This is currently under
investigation in our network.
The new variants first were detected in the spring of 2006, when
several cruise ships sailing across Europe reported norovirus
outbreaks. Contacts with groups in HongKong and Australia confirmed
their presence in those parts of the world as well. The European CDC,
following the report of the investigation, called an expert meeting
to discuss the situation. A report is available on the ECDC website
( dated 12 Sep 2006.
Virologists across the world can access the rapid genotyping tool on
our website to check if the viruses that they have identified match
with the new variant strains. (see ; go to
foodborne viruses in Europe, choose quicktyping tool). We have sent
CDC US this information. We have not seen any sequence data from the
US, but my guess would be that they are looking at the same variant.
I hope this helps to put things into context."
*****
The norovirus pandemic landed in Finland officially on 31 Jul 2006. So it took about three or four months of a noro pandemic that spreads a lot like influenza to immigrate our country.

Details from Jakarta
via Crofsblogs
January 13, 2007 at 09:51 AM
"-- * In front of where AA lived there are houses, and beyond them is a small, open chicken slaughterhouse where some 30-40 chickens are killed each day. It's an open field, also used as the community garbage dump. The local people dump their garbage there; the landowner, who also owns the slaughterhouse, burns the garbage every afternoon. Slaughtering takes place every morning. I saw several coops filled with chickens. Some seemed ill: they were losing feathers and couldn't move their feet. --"

Britain's Bird flu 'buddies' plan
Jo Revill, health editor
Sunday January 14, 2007
The Observer
Everyone in Britain will be asked to name a friend or relative who would be willing to bring them life-saving medication in the event of a flu pandemic.
Under a national pandemic plan being unveiled this week, patients who fall ill with symptoms of a highly virulent form will rely on their 'bird flu buddies' to bring them emergency Tamiflu tablets, rather than a doctor or nurse.
Government planners believe the NHS would soon be overwhelmed if healthcare staff had to see every sick person before handing out packets of the antiviral medication that can lessen the complications of pandemic flu.
Read the rest

Toivottavasti Suomen suunnitelmissa ei ole turvauduttu pelkkään viranomaiskratiaan.

via CurEvents
Mojo
12 Jan 2007
"from flu wiki
*[new] HCW and 7 family members!
And this from Liputan (possible first HCW and her family)
1-13-07 http://www.liputan6....

Liputan6.com, Jakarta: the Resident who was reconciled because of suffering the sign similar to bird flu continued to improve for the length of Friday (12/1).
In the afternoon till tonight had six patients from a family that entered the Friendship Hospital, Jakarta East.
This family came the Sukaragam Village, Serang Just, Bekasi, West Java [read: the Patient Bird Flu improved].
They still children and aged between six and 12 years.
Last Monday, they ate the chicken was sick property of the neighbour.
The next day this family was endless immediately suffered hot and vomited.
Worried was attacked avian influenza, they then took medicine to the Bekasi regional Public Hospital before being reconciled to RS the Friendship.
The nurse RS the Friendship evidently also there are those that felt the sign similar to bird flu after one of his kept poultries died suddenly.
This nurse was named Komarahmi.
Not only that.
The family's seven Komarahmi members took part in feeling the sign to be similar.
The official of the Health of the Depok City, West Java, of the Service immediately checked the female family.
This family planned to undergo the blood inspection in the Komarahmi place worked.
Early of this year already three patients RS the Friendship that was stated positive terjangkit bird flu, two including dying.
Up to now ten patients are still being treated in this hospital.
Entered the rainy season, the community was asked for increasingly guarded against this deadly illness. Because this deadly illness could develop faster in the cold temperature."

"Legionelloosia Thaimaan Phuketiin matkustaneilla
9. tammikuuta 2007
Päivitetty tiedote 11.1.2007
9.1. 2007 päivättyyn tiedotteeseen ei ole tullut muutoksia. Kansanterveyslaitos seuraa tilannetta koko ajan.
Kaksi ruotsalaista, yksi suomalainen ja yksi norjalainen matkailija on sairastunut legionellabakteerin aiheuttamaan keuhkokuumeeseen. He kaikki ovat olleet sairaalahoidossa tai toipumassa. Sairastuneet ovat majoittuneet Thaimaassa Phuketin Patong Beach:lla sijaitsevassa Phuket Grand Tropicana -hotellissa 20.11.2006 jälkeen.
Hotellia käyttävälle suomalaiselle matkanjärjestäjälle (Aurinkomatkat) on suositeltu asiakkaiden siirtämistä pois kyseisestä hotellista mahdollisimman pian. Tämän jälkeen matkanjärjestäjä ei käytä hotellia ennen kuin hotelli on korjannut vesi- ja ilmastointijärjestelmät ja siitä on saatu asianmukainen varmistus. Myös kansainvälinen matkatoimistojen yhteistyöelin, WHO ja Euroopan tautikeskus (ECDC) ovat tietoisia asiasta.
Kyseisessä hotellissa 20.11.2006 jälkeen majoittuneita, jotka ovat sairastuneet matkalla tai sen jälkeen 14 päivän kuluessa yli 38 ºC kuumeeseen, kehotetaan hakeutumaan mahdollisimman nopeasti lääkäriin tilanteen arvioimiseksi. Lääkäriin ei ole tarpeen hakeutua, mikäli oireet ovat jo hävinneet.
Legionellabakteeri aiheuttaa antibiooteilla hoidettavan keuhkokuumeen, jonka oireina ovat yleinen sairauden tunne ja kuume. Tartuntalähteenä toimii tavallisesti legionellabakteeria sisältävä vesi päästessään hengitysteihin. Itämisaika tartunnalle altistumisesta ensimmäisiin oireisiin on 2─14 päivää. Infektio ei tartu henkilöstä toiseen. Epäiltäessä legionellakeuhkokuumetta, tauti todetaan virtsan antigeenitestillä, hengitystie-eritteiden viljelyllä ja veren vasta-ainetutkimuksilla.
Lisätietoja legionellabakteerista ja sen aiheuttamasta taudista löytyy Kansanterveyslaitoksen www-palvelussa osoitteessa http://www.ktl.fi/portal/12096 Euroopan matkailuun liittyvien legionellainfektioiden seurantajärjestelmästä osoitteessa www.ewgli.org/index.htm.
Lisätietoja antavat:
Kansanterveyslaitos, infektioepidemiologian osasto, Puh. (09) 47 441 (Terveydenhuolto ja tiedotusvälineet)
Aurinkomatkat, puhelinmyynti, 010 446 446 (Matkoja koskevat kyselyt)"

The Unicef has created an online centre for avian and pandemic influenza related communication resources.
The site has been developed under the aegis of the UN System Influenza Coordinator (UNSIC) as a joint initiative of the Food and Agriculture Organization (FAO), United Nations Development Programme (UNDP), United Nations Children's Fund (UNICEF), World Food Programme (WFP) and the World Health Organization (WHO). This site has been made possible through financial assistance from the Government of Japan.
The Resource Centre aims to provide users with strategic communication products, information and tools developed around the globe to prevent, contain and respond to outbreaks of highly pathogenic avian influenza virus.

"--- Kahden Grand Tropicana -hotellissa asuneen suomalaisturistin tiedetään saaneen legionellabakteeritartunnan. Toinen sairastuneista on edelleen sairaalahoidossa.
Aurinkomatkat lähettää parhaillaan Phuketista Suomeen palanneille asiakkailleen kirjeitä, joissa kehotetaan ottamaan yhteyttä lääkäriin, jos lomailijalla on Phuketista palattuaan ollut influenssaoireita tai yli 38 asteen kuume. Kirjeen saavat kaikki 20. marraskuuta jälkeen Grand Tropicana-hotellissa asuneet.
Lääkäriin ei tarvitse ottaa yhteyttä, jos mahdolliset oireet ovat jo kadonneet.
---
Legionella-tartuntaepäilyjen kohdistuminen thaimaalaishotelliin saatiin selville eurooppalaisen taudinseurantaverkoston avulla. Jo vuosi sitten samaisessa Phuket Grand Tropicana-hotellissa asunut suomalainen sairastui legionellabakteerista. Yksittäistä tapausta ei silloin tutkittu tarkemmin.
---"
*****
Briefly in English:
"--- Two Finnish tourists who lived in the hotel Grand Tropicana have got an infection of Legionella pneumophila bacteria. Another one of the patients is still in hospital treatment. [The Finnish travel agency] Aurinkomatkat is presently sending letters to its customers who have flew back to Finland from Phuket. In the letters the travel agency advise to contact a doctor if the holiday-maker has had influenza symptoms or fever over 38 degrees Celsius after coming back from Phuket. The letter is sent to all travel agency customers who have stayed in the Grand Tropicana hotel after Nov 20 2006.
The contact to doctor is not required if the possible symptms have already disappeared.

[Edited 11 Jan, 2007 20:46 p.m.] YLE television news at 20:30 p.m. reports that about 1500 Finnish travellers are being sent the above mentioned warning letter.
---
The common source for Legionella infections was found to be the Thai hotel by the European contagious disease follow-up network. Already a year ago one Finn, who had stayed in the same hotel Phuket Grand Tropicana, was infected and ill with Legionella pneumophila. As being a single case it wasn't then investigated any more careful. ---"
*****
Just a couple of questions:
- How was the disease identified? By what kind of lab tests?
- Why wasn't this reported in English by the Finnish national news agency YLE?
- Why are the symptoms of influenza stressed in the letters? Why not symptoms of pneumonia and a common cold, for example?

New Nature article: H5N1 tropism doesn't explain increased severity
via Mojo at Flu Wiki Forum
Wed Jan 10, 2007 at 19:26:47 PM EET
"In conclusion, our understanding that H5N1 virus infects nasopharyngeal and oropharyngeal epithelia implies that the inefficiency of the avian-to-human or human-to-human transmission of the H5N1 virus may not be explained by the inability of the virus to replicate at these sites. Virus infection of cells that apparently do not express SAa2-3Gal.1-3GalNAc implies that there may be other binding sites on the epithelium that mediate virus entry. Furthermore, because human H1N1 and avian H5N1 viruses do not differ in their ability to replicate in the alveolar epithelium, we also conclude that the increased severity of human H5N1 influenza cannot be explained purely on the basis of a differential tropism of H5N1 to the lower respiratory tract."

Undiagnosed respiratory illness in school pupils in Shanxi, China
"A ProMED-mail post
Archive Number 20070109.0088
09-JAN-2007
---
Date: Mon 8 Jan 2007
From: Dan Silver
Source: Shanxi Evening News, Xinhua Shanxi report [translated by
submitter; edited]
Between 26 Dec and 31 Dec 2006, 86 students were hospitalized for
fever and cough in Wenxi County's Chengguan Middle School. After
treatment, sick students and teachers were all discharged from
hospital on Tue 2 Jan 2007. The exact cause of their illness awaits
evaluation by appropriate national agencies.
Xinan Zhao, Party Secretary of Wenxi People's Hospital, stated that a
total of 86 students (Note: the preceding reports mention 2 sick
teachers] were hospitalized [during the course of] the outbreak). The
hospital provided thorough symptomatic treatment and prompt
preventive care. There were no serious cases. Blood samples from
Chengguan students have been sent to appropriate national labs. To
prevent recurrence of disease, Chengguan Middle School has taken
instruction from city and county disease prevention and control
experts, and conducted thorough cleaning of each classroom and
dormitories in the school to ensure that students can return to class
as normal after New Year.
[Byline: Jia He and Xiaofeng Cao]
--
Dan Silver
[The number of pupils and teachers affected by the outbreak has risen
from the 74 recorded on 29 Dec 2006 to the 86 recorded on 31 Dec
2006. All those affected have now been discharged from hospital. The
short duration of the outbreak and the absence of severe outcomes
suggest a mild seasonal respiratory virus infection. A final
diagnosis is awaited. --"

"Flu Claims Life of 10-Year-Old
Posted by: Sally Durwald, Producer
Created: 1/9/2007 10:49:29 AM
Updated: 1/9/2007 10:51:17 AM
SYRACUSE, N.Y. (AP) -- Health officials in the Syracuse area say a ten-year-old boy has died from complications of the flu.
That determination was made after officials received the results of preliminary lab tests performed by the Onondaga County Health
Department. Follow-up tests are being conducted.
County Health Commissioner Doctor Cynthia Morrow says the boy's death could be the first pediatric flu-related death in New York
state this season.
Pediatric flu deaths are rare, with only 35 across the country last year.
Authorities aren't releasing the boy's name.
The health department has advised those who came in contact with the boy to see their doctors.
Flu outbreaks typically peak in February. Last year's flu season ran through April."

Between 10 and 20 Bogor inhabitants were sick similar to Bird Flu
JABOTABEK » Bogor
On Tuesday, January 09 2007 21:08 WIB
"Bogor -- MIOL: Between 10 and 20 residents in the Village of Blok Asem the Sukaresmi District, the Sareal Land Subdistrict, the Bogor City, suffered was sick that his sign was similar to bird flu.
Ironically, till Tuesday (9/1), they were not yet handled seriously by the local health service.
Already three today, the resident of the Village of the acid Bloc, RT 3/RW2, restless resulting from the death of dozens of tails of the chicken suddenly dilokasi this.
Moreover up to now, the chicken belonging to the resident still there are those that died.
Idris, 30, the local resident had claimed to be his 15 kept chickens since Idul Adha till Tuesday, died suddenly.
The death of his chickens, did not show the sign was sick beforehand.
Concerned if spreading the illness, Idris at once burnt his chicken carcass.
The chairman RT 3, Muhtar, 40 said from the report that acceptance, there were 66 chickens that died belonging to several of his residents.
The resident's concern increasingly improved, after being found had as many as 11 residents that generally children suffered the high fever was accompanied breathless was similar to the sign of bird flu.
According to muhtar, this sign happened the discovery hose of dozens of tails of the chicken that died suddenly.
Moreover two children Muhtar, that is Rifki, 3, and Rafiz, 8, suffered the sign like that.
Apart from two children Muhtar, the other resident who was sick two children Sukarji, 40, that is Sulistyowati, 12, and Mediastuti, 2,5.
Sulistyowati was sick since the last seven days.He the high fever and never recovered. Whereas Mediastuti just yesterday was sick.
In the meantime, the similar matter was also experienced by the other Nur Gozali child, 3.
The child from Heni already three days experienced was sick the fever and breathless.
Up to now the resident that terjangkit the illness was similar to this bird flu was not yet handled intensively in the hospital.
They still was in his house was their respective, because of the lack of the medical treatment cost. In fact this case has been reported to the local district side.
In the meantime, when it was confirmed this problem, the Head of Sector the Prevention of the Eradication of the Illness and the Health of the Environment (P3KL) the Health Service of the Bogor City, Sri Pinantari Hanum said did not yet receive the report and immediately will do the checking.
'I the cheque previously. Earlier I outside and continued to be in a meeting.
Tonight I at once dropped the team off to check. Please by me earlier contacted his community health centre side but did not yet have the report.'
Let us hope not this misdirected.
But results will later be informed by me again, he said.
For the first time, said Sri, must be seen first clinical him.
Quite clinical him showed like the sign of bird flu or not.
Moreover was also true the amount of how many people that experienced was sick like that.
According to Sri, if clinical him only showed the common fever or dengue fever, tomorrow will be evaluated with did surveylen.
But if menunjukan the sign of bird flu, namely the fever was accompanied with crowded, immediately was brought to the hospital. 'That a matter protap available.'"

"Thousands of birds fall from sky
By Amanda O'Brien
January 10, 2007 01:00am
THOUSANDS of birds have fallen from the skies over Esperance and no one knows why.
Is it an illness, toxins or a natural phenomenon? A string of autopsies in Perth have shed no light on the mystery.
All the residents of flood-devastated Esperance know is that their 'dawn chorus' of singing birds is missing.
The main casualties are wattle birds, yellow-throated miners, new holland honeyeaters and singing honeyeaters, although some dead crows, hawks and pigeons have also been found.
Wildlife officers are baffled by the 'catastrophic' event, which the Department of Environment and Conservation said began well before last week's freak storm.
On Monday, Esperance, 725km southeast of Perth, was declared a natural disaster zone.
District nature conservation co-ordinator Mike Fitzgerald said the first reports of birds dropping dead in people's yards came in three weeks ago. More than 500 deaths had since been notified. But the calls stopped suddenly last week, reportedly because no birds were left.
'It's very substantial. We estimate several thousand birds are dead, although we don't have a clear number because of the large areas of bushland,' Mr Fitzgerald said.
Birds Australia, the nation's main bird conservation group, said it had not heard of a similar occurrence. 'Not on that scale, and all at the same time, and also the fact that it's several different species,' chief executive Graeme Hamilton said. 'You'd have to call that a most unusual event and one that we'd all have to be concerned about.'
He expected birds would return to the area once the problem - natural or man-made phenomenon - was fixed but said it was vital the cause was identified.
The Department of Agriculture and Food, which conducted the autopsies, has almost ruled out an infectious process.
Acting chief veterinary officer Fiona Sunderman said toxins were the most likely cause but the deaths could be due to anything from toxic algae to chemicals and pesticides.
Dr Sunderman said there were no leads yet on which of potentially hundreds of toxins might be responsible. Some birds were seen convulsing as they died.
Michelle Crisp was one of the first to contact the DEC after finding dozens of dead birds on her property one morning.
She told The Australian she normally had hundreds of birds in her yard, but that she and a neighbour counted 80 dead birds in one day.
'It went to the point where we had nothing, not a bird,' she said.
'It was like a moonscape, just horrible. But the frightening thing for us, we didn't find any more birds after that. We literally didn't have any birds left to die.'"

http://www.sarscommission.ca/report/index.html
via crofsblogs via C-Health by Helen Branswell:
January 09, 2007
"--- The final report of a commission into Toronto's SARS crisis says those involved in the response failed to ensure the safety of health-care workers, who continued to become infected throughout the four months the virus plagued Ontario hospitals.
The report by Justice Archie Campbell suggests the Ontario Ministry of Labour play a lead role in the response to future infectious disease outbreaks in hospitals to ensure that workplace safety is given the highest priority.
The 1,204-page report said the Labour Ministry was effectively sidelined during SARS, which claimed 44 lives during the outbreak in the spring of 2003. And it suggested health-care workers would have been better protected if occupational health experts were involved.
---
The report recommended dozens of changes to hospital practices, disease surveillance and provincial public health and emergency legislation.
Forty-five per cent of Ontario's 375 SARS cases were health-care workers, and two nurses and a doctor died from SARS.
The report said hospitals are as dangerous a place to work as mines and factories. But Ontario hospital workers don't enjoy the same level of workplace protection as workers in those other sectors. ---"

Flu Patients Crowd Israel's Hospitals
22:05 Jan 08, '07 / 18 Tevet 5767
www.israelnationalnews.com
(IsraelNN.com)
"Hospitals across Israel are reporting overcrowding due to the increasing number of people suffering from influenza-based illnesses. The elderly and children are the most vulnerable at this time.
Prof. Manfred Green, director of the Center for Disease Control at the Health Ministry, said Monday that it's not too late to get inoculated. He added that a couple of new strains of the flu virus expected to appear in Israel this winter but the vaccine protects against them as well."

Poultry workers to get flu vaccination
Monday, 8 January 2007, 12:36 GMT
BBC
"Poultry workers in England are to be offered seasonal flu jabs as a way to minimise any threat from bird flu.
Experts say offering them protection against human flu will cut the already small risk that they might catch human and bird flu at the same time.
[Dr David Salisbury], the Department of Health's director of immunisation,[said]:'This is a prudent and precautionary step to take as part of our contingency planning in protecting the population against the risk of pandemic flu.'
Information packs are being sent to all keepers of poultry who are required to be registered and approved slaughterhouses in England.
Primary care trusts throughout England will be given the appropriate amount of seasonal flu vaccine and extra resources to cater for the expected additional uptake.
It is estimated that more than 60,000 poultry workers may be eligible for the flu vaccine.
At a briefing to announce the plans, Fred Landeg, the government's chief veterinary officer, warned that very cold weather would increase the risk of bird flu coming to the UK this year. He said a cold snap could mean that wild birds headed west towards the UK."

11:20 a.m. EST, January 8, 2007
"Dead birds prompt Austin downtown shutdown
AUSTIN, Texas (AP) -- Police shut down 10 blocks of businesses in the heart of downtown Austin early Monday after dozens of birds were found dead.
Emergency workers donned yellow hazardous-material suits, and dozens of fire trucks and ambulances were parked nearby, as they began testing for any sort of environmental contaminant or gas or chlorine leaks that might have cause the bird deaths.
There were no reports of any people harmed. A 10-block stretch of the main north-south route through downtown was blocked off as were several side streets and all buildings in the area. They were expected to remain off-limits until about noon, said police spokeswoman Toni Chovanetz.
'There is no credible intelligence to suggest an imminent threat to the homeland or Austin at this time,' said Department of Homeland Security spokesman Russ Knocke.
Homeland Security, the Department of Health and Human Services and state authorities are monitoring the situation, he said.
The bird carcasses were found overnight along Congress Avenue between Sixth and Eighth streets.
The street closure Monday morning stretched from the front of the state Capitol to a section of the Colorado River known as Town Lake. The Capitol opened on schedule Monday, the day before the legislative session was to begin."

Quang Ninh rehearses to fight bird flu in humans
Jan 8, 2007
"(SGT-QUANG NINH) Around 700 employees of the 185 wards and communes in Quang Ninh Province and health officials yesterday joined a rehearsal of fighting bird flu in humans in the province’s Cam Pha District.
The rehearsal was aimed at improving the public knowledge and experience in fighting the deadly disease.
Quang Ninh has basically completed the vaccination against the epidemic on its poultry flocks . The provincial Bureau of Animal Health will complete the vaccination this month, and supply 1.3 tons of chemicals and equipment for fighting the highly contagious disease."

*****
It looks strikingly authentic in the picture. Almost as if they were treating a real H5N1 patient.

UK bird flu exercise shows financial service risks
Thu Jan 4, 2007 7:31am ET21
LONDON (Reuters) - A bird-flu pandemic would force waves of retail bank branch closures in Britain and sharp cutbacks in investment banks' trading activity, UK financial regulators said on Thursday.
The regulators published the findings in a report on the results of a bird-flu pandemic exercise they ran over a six week period in October and November last year.
'The exercise presented them (the financial services firms) with a genuine challenge which has already prompted many of them to make adjustments to their business continuity plans,' the regulators said.
---
'Although no overall cash shortage emerged during the exercise, there were bottlenecks,' they said. 'In addition, growing staff shortages forced the high street banks to close an increasing number of branches.'
---
'Proprietary activity was sharply cut back as firms concentrated their resources on fulfilling customer-driven business.'
As a result, some of the banks are now keen to discuss practical and operational difficulties they faced during the exercise in relation to credit and liquidity risks.
---
Some 70 financial services organizations and around 3,500 people took part in the simulation that ran from October 13 to November 24.
The Financial Services Authority, the Bank of England and the Treasury, which organized the exercise, now plan to hold a series of workshops and seminars this year on issues raised by the simulation, including coordination of cross-border regulatory responses.
These three routinely cooperate on business continuity planning for incidents that could cause major disruptions to the City of London financial services industry.
---"

Why is the world so poorly prepared for a pandemic of hypervirulent avian influenza?

Authors: Olav Albert Christophersen; Anna Haug a
Affiliation: a Norwegian University of Life Sciences. Ås. Norway
Published in: Microbial Ecology in Health and Disease, Volume 18, Issue 3 & 4 December 2006, pages 113 - 132

Abstract
The world is now extremely poorly prepared to counter a possible pandemic of hypervirulent H5N1 influenza. Most countries are planning for nothing worse than the Spanish flu pandemic. It may be possible that this can in large measure be explained as a consequence of an epidemic of wishful thinking, which may already have infected the health authorities (and parts of the scientific community as well) in most countries in the world. However, it may also be possible that it can have happened as a consequence of too little contact between medical scientists and more general biologists (natural scientists) from disciplines such as ornithology, ecology and evolutionary biology.
This may have led to a lack of proper understanding among medical scientists (and health bureaucrats) of the nature of evolutionary processes affecting influenza viruses, as regards the evolution of host species adaptation, infectivity and virulence properties, and also a lack of appreciation of the ways in which such forms of evolutionary adaptation depend on ecological boundary conditions that have radically changed, comparing the world in 2006 to the world in 1918.
While the Spanish flu virus possibly might be compared to a one-headed monster, it may be possible that highly virulent varieties of H5N1 virus might better be compared to a three-headed one - because there is evidence of at least three independent virulence factors connected with three different genes.
It is highly unlikely that all of the high-virulence alleles will simultaneously mutate and disappear if and when the haemagglutinin gene changes so as to make the haemagglutinin molecule better adapted for the human-type (alpha-2,6-linked) receptor (which is a necessary prerequisite in order that a pandemic with H5N1 virus may start).
It is more probable that evolutionary adaptation of the haemagglutinin of H5N1 viruses to the human-type receptor will happen without any simultaneous change in those other genetic properties that now are important for explaining the exceptionally high virulence of certain strains of avian-adapted H5N1 influenza virus.
The change of the haemagglutinin molecule from avian adaptation to human adaptation must be expected to act as an additional virulence factor because it will enhance the total number of cells that can be infected (per host organism), increase the total rate of virus replication and potentiate the effects of the other virulence factors already present. The monster will then have four heads, not three, and case fatality rates must be expected to become even higher than they have been until now, perhaps reaching as high as 98-99% (at least in poor countries with less than optimal nutrition).

http://www.informaworld.com/smpp/content~content=a768149644~db=all~order=page

Suspected flu outbreak sends 60 students to hospital in north China
China Economic Net
Last Updated(Beijing Time):2006-12-29 15:05
"Sixty children and a teacher at a middle school in north China have been hospitalized after a suspected flu outbreak, local sources said on Thursday. ---
'Twenty infected students, who are seriously ill, are being treated in hospital,' said Li Wenyuan, director of the center. ---
The center suspected it was a flu outbreak after conducting sample tests.
Other students in the same classes were ordered to stay in school under observation, while the rest of the students in the school were sent home to study until further notice, said local education authorities."

China: Undiagnosed fever affects 60 in a Middle School in Shanxi province
Archive Number 20070101.0006
Published Date 01-JAN-2007
Subject PRO/EDR> Undiagnosed respiratory illness, school pupils - China (Shanxi): RFI
The Shanxi Youth Daily reports that at 10:00 a.m. on 27 Dec 2006, the director of 7th grade Class 137 at Shanxi's Wenxi County Chengguan Middle
School, Teacher Zhang, found that some students had developed fever and cough. After the school sought guidance from the Wenxi County Education
Bureau, it sent ill students to the hospital for treatment. Afterward,
students continued to be admitted to hospital for fever. Between 10:00 a.m.
on 27 Dec 2006 and 12:00 noon on 28 Dec 2006, 59 students and one teacher
had been admitted to the Infectious Disease Department of Wenxi County
People's Hospital.
Chengguan Middle School Principal Zhang was found at the entrance to Wenxi County People's Hospital's Infectious Disease Department. He stated that
after the 2nd period on the morning of 27 Dec 2006, the director of 7th
grade Class 137, Teacher Zhang, found that some students were coughing and
had fever. Teacher Zhang immediately informed the school administration of
the situation. The school quickly reported to the Wenxi Education Bureau.
Then, the 1st 36 students showing symptoms were rushed to Wenxi County
People's Hospital. Teacher Zhang, who was the 1st to notice the fever [in
students], was also admitted to the hospital for fever on the afternoon of
27 Dec 2006.
Yesterday [28 Dec 2006] morning, special guards were seen posted at the
entrance to the Wenxi County People's Hospital Infectious Disease
Department. All personnel must wear cotton masks and must have permission
from the hospital administration to enter. Medical personnel wear isolation
gowns. Inside, more than 20 students in relatively serious condition receive IV [intravenous] therapy in the ward. Others students in less serious condition sit in a room near the department entrance and are on oral medication. All students in the department wear masks as required.
Yesterday [28 Dec 2006] at noon, the Wenxi County government stated that, within a day after students came down with fever, the number of patients had increased to 60, affecting 6 classes in grade 7 and grade 8 at Chengguan Middle School.
Of 60 patients, there are 39 males and 21 females. Five are between 11 and
13 years old, 2 are 14 years old, and one is 40 years old. 29 have fever
accompanied by cough. Three have temperatures above 39 C, 17 between 38-39
C, and 9 between 37-38 C. Another 31 have temperatures around 37 C.
This incident has attracted concern from countless parents in Wenxi.
Yesterday [28 Dec 2006] morning, several dozen parents anxiously waited in
the cold wind outside the hospital's Infectious Disease Department for the
diagnosis.
---
On the afternoon of 27 Dec 2006, infectious disease specialists and
epidemiologists from the Yuncheng City Medical Rescue Group rushed to
Wenxi, quickly starting treatment of students and opening an
epidemiological investigation.
Yesterday [28 Dec 2006] at about 2:00 p.m., a female doctor from the Infectious Disease Department of Wenxi County People's Hospital told reporters that chest radiographs of 20 patients showed inflammatory changes, and some had abnormal blood counts. Based on symptoms, preliminary diagnosis is pulmonary infection. But the specific disease cannot be confirmed until expert diagnosis is made.
Yesterday [28 Dec 2006] at 4:00 p.m., the Wenxi People's Government stated
that 8 of 60 patients had shown obvious improvement after symptomatic treatment. The hospital is now implementing "consolidation treatment" of
these 8 patients.
As late as 5:00 p.m. yesterday [28 Dec 2006], ongoing treatment of sick
students and teachers was continuing."