Penumbra Pandemia

"Doctor treated for bird flu in Indonesia
Web posted at: 3/31/2007 9:18:12
REUTERS
JAKARTA
A doctor who had been treating a 15-year-old boy who died from bird flu is being treated in an isolation ward after developing symptoms of the disease, a hospital official said on yesterday.
The doctor had treated the boy, from Indramayu in West Java, at a hospital in Bandung. The boy died on March 25 from the H5N1 virus, the official said.
'He is in an isolation room, doing fine. He has been suffering from a sore throat, fever and some respiratory problems. However, he wore a complete protection suit when dealing with a bird flu patient last week,' Doctor Yusuf Hadi, the head of the bird flu department at Hasan Sadikin hospital in Bandung, said by telephone.
'Two or three days after having contact with the boy, he suffered from fever. But now, he is OK, he does not have fever anymore. He has been treated as a bird flu suspect together with a woman and two children.'
************
Were the woman and two children the doctor's family?

China Reports 15th Human H5N1 Death
30 March 2007
"The Occupational Health and Safety
www.ohsonline.com
The World Health Organization yesterday said China's Ministry of Health had reported a new fatal case of human infection with the H5N1 avian influenza virus. Confirmed by the national laboratory, the case involved a 16-year-old male from Anhui province who developed fever and pneumonia-like symptoms on March 17 and was hospitalized March 20. He died March 27.
'There is no initial indication to suggest he had contact with sick birds prior to becoming unwell and investigations to identify the source of his exposure are ongoing,' WHO said. 'Close contacts have been placed under medical observation and all remain well.' The report said 24 cases have been confirmed to date in China, 15 of them fatal.

Egypt's Ministry of Health and Population also announced two new human cases of H5N1 infection this week and said both have been confirmed by the Egyptian Central Public Health Laboratory and by the U.S. Naval Medical Research Unit No. 3 (NAMRU-3). One is a 6-year-old girl hospitalized March 25 with symptoms, the other a 5-year-old boy hospitalized the same day. Both children were exposed to sick birds, WHO said, which said 13 of the 29 confirmed cases to date in Egypt have been fatal."

'Sick' flight is held at Newark airport
Avian flu ruled out on jet from Hong Kong
Tuesday, March 27, 2007
BY MARK MUELLER AND MARY JO PATTERSON
Star-Ledger Staff
"A Continental flight loaded with 272 passengers from Hong Kong -- some of them sick -- was kept on the tarmac at Newark Liberty International Airport yesterday until health officials ruled out avian flu as the source of their illness.
The culprit was most likely 'seasonal flu,' said Shelly Diaz, a spokeswoman for the U.S. Centers for Disease Control and Prevention in Atlanta, which dispatched a medical crew to Newark. Initial reports put the number of sick passengers at seven.
Flight 98 arrived at 2:05 p.m., but no one was allowed to disembark until about 4 p.m., said Mary Clark, a spokeswoman for Continental Airlines. She said the flight crew noticed 'a number of' passengers who appeared ill upon boarding in Hong Kong and contacted authorities.
They were members of a large tour group returning to Quebec, Canada, from a Chinese river cruise, she said. Their final destination was Montreal.
Officials with the CDC's Global Migration and Quarantine office at LaGuardia Airport dispatched an emergency medical services crew, who boarded the plane and interviewed everyone on board, Diaz of the CDC said.
'They asked (them) about their symptoms, and whether they had been exposed to any sick or dead poultry or birds,' she said.
Passengers interviewed after leaving the plane said the sick travelers had been on a 21-day excursion to China. Traveling together in seven buses, the group had visited the Great Wall of China, Tiananmen Square, Shanghai and other cities in China, and took a four-day cruise along the Yangtze River, they said.
Lise Lortie, 58, of Montreal said a number of people began sneezing and coughing in Beijing, where the weather was unexpectedly chilly.
'It was cold there, and many of us caught colds,' said Lortie, who was not sick.
Though she heard coughing on the flight, she thought nothing of it until the pilot announced a health official would be brought on board to check on sick passengers."

CDC releases pandemic flu preparedness plans
Worse-case scenarios for virus spread were analyzed; plans drawn from historic outbreaks in the United States.
by Kirsten H. Ellis
IDN Staff Writer
The Infectious Disease News
"Officials said pre-planning is the best way to minimize morbidity and mortality in the wake of pandemic flu because a vaccine to match a strain would likely be unavailable for at least six weeks after the virus outset. ---"

"Archive Number 20070317.0938
Published Date 17-MAR-2007
Subject PRO/AH/EDR> Avian influenza (54): Egypt, Nigeria, China (Jiangsu): RFI
AVIAN INFLUENZA (54): EGYPT, NIGERIA, CHINA (JIANGSU): REQUEST FOR INFROMATION

A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases
---
[3] China (Jiangsu) - request for information
Date: Wed 14 March 14, 2007
From: Dan Silver
Source: 21food.cn [trans. by submitter, edited]
Market prices for corn in the Jiangsu area are stable to slightly
rising. A large local feed producer says that after the Spring
Festival, there are rumors of avian influenza outbreak[s] in this
area with high death rates for poultry. Breeders are panic-stricken
and do not dare casually stock up. Breeding demand has fallen,
dragging down feed demand. But because incoming market volumes [corn
feed supply] are low, prices quoted by traders rose. Actual
purchasing requirements are comparatively weak.
--
ProMED-mail
[Any available information pertaining to the rumors above about avian
influenza in the Jiangsu area will be appreciated. - Mod.AS]

The province of Jiangsu in eastern China can be located on the map at http://www.lib.utexas.edu/maps/middle_east_and_asia/china_pol01.jpg.
- CopyEd.MJ]"

Beijing to Reduce Spitting for Olympics With Education Campaign
Wing-Gar Cheng
Bloomberg
14 March 2007, 06:45 EDT
"Beijing will distribute a booklet on spitting to try to stamp out the habit, and complete a rating of restaurants this year to improve food standards for the Olympics.
The city government identified 45 potential public health outbreaks such as bird flu and the spread of waterborne or intestinal diseases, which might disrupt the Summer Games and Paralympics in 2008, Jin Dapeng, director of the Beijing Public Health Bureau, said at a regular briefing today. About 35,000 restaurants will be rated from 'A' to 'D', based on how well these outlets meet food safety standards, he said.
The city government last month started a campaign to promote manners ahead of the 2008 Olympic Games by introducing monthly 'queuing days' to encourage people to stand in line, and raising the number of covered bins for disposing of spit. The booklet and queuing day, set for the 11th of every month, are part of a wider plan to improve etiquette in time for the 17-day sports event.
'Very soon, you'll see action and moves to prevent and forbid spitting,' Jin said. 'Spitting is just uncivilized and it endangers public health.'
Spitting has become less common in China in the past decade because of growing concerns about health.
The Chinese capital will tighten enforcement of the 50 yuan ($6.45) maximum fine for littering and spitting in public places, as well as starting a campaign to educate citizens on using tissues to dispose of spit in covered bins, Zhang Huiguang, head of Beijing's Capital Ethic Development Office, said last month. The government will place more bins around the city, she said.
The city wants to step up education to explain the causes and harmful effects of spitting, Jin said. The city had previous success in programs to get residents to wash their hands and avoid spitting in public places during the 2003 outbreak of severe acute respiratory syndrome, or SARS, he said.
Manners are already improving, according to the bureau's index on 'civilized behavior,' run by Renmin University. The index increased to 69.06 percent last year from 65.21 percent in 2005 as people spit and littered less, Zhang said.
Beijing also wants to create no-smoking zones in the city, including Olympic venues during the Games, Jin said.
To contact the reporter on this story: Wing-Gar Cheng in Beijing at wgcheng@bloomberg.net"
*****
Imagine, Beijing has a Capital Ethic Development Office
:)

Theresa42
13 Mar 2007 on 02:33 PM
"Radiological findings of three cases of human H5N1 avian influenza
The Ministry of Health has taken the step of publicizing here on its web site, the detailed but anonymised radiological findings of three cases of human H5N1 avian influenza. We do so in the hope that this will improve National and International understanding of this emerging disease. The close monitoring of these 3 cases especially demonstrates how subtle the early radiological findings can be and the value of epidemiological data in assisting clinical interpretation. We again pay our deepest respects to the few families who suffered such tragic losses and acknowledge the professionalism of epidemiologists, veterinologists, doctors, nurses, laboratory and radiological staff at village, district and central level in their efforts to recognize and control this challenging disease.

These three cases were all laboratory confirmed. The detailed epidemiology has been described in the WHO publication Weekly epidemiological record (Human avian influenza in Azerbaijan, February-March 2006. Wkly Epidemiol Rec. 5 MAY 2006:81(18):183-8 http://www.who.int/wer/2006/wer8118.pdf) and in the journal Eurosurveillance (Euro Surveill 2006;11(5):122-6 http://www.eurosurveillance.org/eq/...006_122-126.pdf)

A detailed clinical description is being prepared for publication and the clinical, laboratory and epidemiological databases have been shared among our National experts and with the WHO.

X-ray presentations
Case 1: http://www.health.gov.az/article.php?h5n1_case1_en
Case 2: http://www.health.gov.az/article.php?h5n1_case2_en
Case 3: http://www.health.gov.az/article.php?h5n1_case3_en

Information to accompany the images
Case 1
This 16 year old male was started on Oseltamivir on the 4th day of illness. In spite of intense supportive therapy he died on the 10th day of illness.
Cases 2 and 3
Both cases had low grade fever (<37.5C) for 2 days. They were observed and immediately started on oseltamivir. The low grade fever settled in both cases within 1.5 to 2.5 days and oseltamivir was discontinued after 4 days when they were discharged back to community surveillance, with no symptoms and after examination and laboratory testing remained normal. They both subsequently developed high fever (>38C). The families agreed to their re-hospitalization where they received supportive therapy (which included oxygen sometimes at high flow rates according to oxygen saturation findings), and recommencement of oseltamivir. Because of uncertainty including that surrounding potential exposure or even re-exposure , the day of onset is described here as both the day from second onset of fever followed in parentheses by the day from initial onset of the transient low grade fever. These cases became apyrexial during day 12 or 13 (19or20). Both cases survived and their convalescent films are included here.

http://www.health.gov.az/article.php?h5n1_en
http://www.euro.who.int/flu/situation/20061201_1

WHO: "Recommended composition of influenza virus vaccines for use in the 2007-2008 northern hemisphere influenza season

It is recommended that vaccines to be used in the 2007-8 season (northern hemisphere winter) contain the following:

— an A/Solomon Islands/3/2006 (H1N1)-like virus;
— an A/Wisconsin/67/2005 (H3N2)-like virusa ;
— a B/Malaysia/2506/2004-like virus

Candidate vaccine viruses include:
a A/Wisconsin/67/2005 (H3N2) and A/Hiroshima/52/2005

For more information
Recommended composition of influenza virus vaccines for use in the 2007–2008 influenza season [pdf 92kb]"
*****
WHO says that the world is still on stage three.

"Kuwait reports no new bird flu cases for 3rd day
KUWAIT, March 11 (KUNA) -- No new bird flu cases have been reported from Kuwaiti provinces and areas for the third day in succession, a spokesman said here Sunday.
Tests for 506 bird samples over the last 24 hours were all negative for the fatal bird flu virus, said Ahmad Al-Shatti, spokesman for the joint committee for combating bird flu.
The killer bird flu disease has been contained to a large extent in Kuwait thanks to intensive precautionary measures by the Public Authority for Agriculture and Fish Resources and people's favorable cooperation with all relevant instructions, Al-Shatti added.
Meanwhile, labs of the Kuwaiti Ministry of Health said all samples of 311 people who had contact with birds were all negative for bird flu virus, which bespeaks that Kuwait is free of bird flu human cases. ---"

"Kuwait tests 308 human samples for bird flu
KUWAIT, March 10 (KUNA) -- A total of 308 human samples were taken for the bird flu virus in Kuwait on Saturday, a Kuwaiti anti-bird flu committee said.
Of the 308 human samples, tests for 280 people who had contact with birds came negative, Ahmad Al-Shatti, spokesman for the Joint Committee for Combating Bird Flue Disease said.
No new bird flu cases have been reported on Saturday, he said, quoting the daily report of the Kuwaiti Public Authority for Agriculture and Fish Resources.
He urged hawk hunters in particular to keep away from hunting by any means this season with a view to reducing the opportunities of contact with migrant birds that could be carriers of the killer bird flu virus.
However, the Kuwaiti official thanked people for cooperating with over 45 field teams of the authority, who were carrying out a scheduled farm disinfection process at the areas of Wafra, Al-Abdali, Kabad and Al-Sulaibia."

Eritrea: Regional Workshop On Coordinated Fight Against Avian Flu in Africa Conducted Here
March 5, 2007
Shabait.com (Asmara)
"A regional workshop on the coordinated fight against avian flu in Africa was conducted on March 2 at Hotel Intercontinental Asmara in which representatives of animal health protection from 40 African countries took part.
The participants held in-depth discussions on making due contribution to the on-going efforts to combat bird flu through mapping out coordinated plans and strategies, as well as the exchange of timely information among each country, and using the information for joint action.
They also adopted resolutions including intensive training for animal health professionals, fully equipping laboratories, specifying the role of partners and sponsors and the active participation of government and private institutions, as well as for member states to chart programs and actively cooperate with partners.
Speaking on the occasion, the Director of Animal Resource Department in the African Union, Dr. Traore, said that research work on domestic and wild animals at regional and international levels is relevant in order to combat bird flu which is posing a major challenge globally. He further called on member states to exchange up-to-date information so as to cope with it.
---
It is to be noted that Eritrea has set up a committee that supervises the movement of birds as it lies in their route of migration."

CSIRO workers exposed to bird flu
Daniel Breen
07Mar07
Geelong's CSIRO [Australia]
THREE scientists have been exposed to bird flu in a safety suit bungle at Geelong's animal health laboratory.
The CSIRO scientists had infected live ducks with the H5N1 strain of bird flu before killing them to assess the impact of the virus about 1pm Monday.
But the experiment went pear shaped about 1pm Monday when the scientists released that they had failed to reactivate air filters in their specially designed suits, increasing their risk of exposure to the deadly virus.
The trio were immediately removed from the laboratory and taken away for testing and treatment.
---
'They had been doing some testing on ducks ---. They were taken to Geelong Hospital and they were discharged after an hour.', [CSIRO media liaison manager Ms Chalkley said.]
---
The trio will continue anti-viral treatment as a precaution, with two of the workers set to spend the next seven days at home. The third member has been completely cleared of infection and is not required to remain in isolation.
---
Most human cases have resulted from contact with diseased poultry."
*****
Just wondering how come one of the workers could have been completely cleared of infection and how could the workers be discharged after only one hour.

Greenfield graves for the bird-flu dead.
The Times Online
Valerie Elliott, Consumer Editor
March 05, 2007
"Greenfield land would be turned into burial grounds for thousands of victims in the event of an avian flu pandemic, under emergency plans being considered by the Government.
A nationwide shortage of cemetery space means that room would be needed to bury as many as 400,000 victims. A search is now under way to find greenfield sites on the edge of cities. Mass burial pits for the dead have been ruled out. Instead the plan is to create dignified, landscaped cemeteries that could become a memorial for victims.
Local government chiefs have been ordered to secure additional burial space as a priority after last month’s two-day exercise Operation Winter Willow, which tested Britain’s preparations for the grim reality of managing the dead and the sick and keeping the nation open for business.
It was the biggest emergency planning exercise since the end of the Cold War and involved 8,000 organisations and companies. One of the shortcomings identified was the lack of cemetery space. Councils must now agree contracts with companies supplying mechanical diggers so that individual burial plots may swiftly be prepared.
Should an epidemic hit, normal planning rules for the construction of public graveyards are to be scrapped.
---
A draft avian influenza contingency plan is to be published by the Department of Health this month and a final report completed by the summer.
---
The Times has learnt that families of the dead would still be able to choose between a burial or a cremation, but that lengthy funeral services are ruled out. Faith leaders have been asked to devise short religious services for the dispatch of the dead and to delay memorial services until the wave of disease is over.
In areas where the flu strain is rampant, schools would close and parents are to keep younger children under what amounts to house arrest. Emergency planning chiefs anticipate that the disease would spread more quickly among children as they have more physical contact with each other. Scientific experts have warned that a two-metre gap is required between individuals to stop the virus spreading through droplets.
---
Supermarkets have agreed to move in vast quantities of key supplies such as bottled water, cleaning and disinfecting materials and flu remedies if the disease takes hold. ---"
*****
I hope other countries in Europe and around globe study the Winter Willow as a lesson to pandemic preparation. Hopefully we'll hear soon of other countries' rehearsals.
Read more:
Part two
Part one

Bird flu confirmed in NWFP
The International News
Sunday, March 04, 2007, Safar 14, 1428 A.H.
PESHAWAR
"The National Reference Laboratory for Poultry Diseases, Islamabad, has confirmed the presence of Avian Influenza H5N1 virus in the birds found dead in Peshawar, Naushera and Charsadda districts.
Well-informed sources in Veterinary Research Institute NWFP said the Islamabad lab confirmed presence of the virus in black Partridge and dead crows. The lab is also processing the serum samples from Desi layers it received.
The NWFP government, the sources said, is yet to take precautionary measures. They said the Directorate of Livestock and Dairy Development Department had received the report on February 28 from Islamabad but the department has not yet checked the poultry farms and quarantined them. The Islamabad lab had recommended culling of all birds in the premises and disinfecting farms as per standard protocol, the sources informed."

‘Bird flu’ smuggling attempt is revealed
Feb 28, 2007
Irish News
http://www.irishnews.com/images/28022007/frontpage.pdf
ATTEMPTS were made to smuggle more than 17 tonnes of illegal poultry from China into Belfast at the height of an avian flu outbreak.
The consignment was seized by department of agriculture officials at Belfast Port in August 2005 but details have only just emerged.
At the time the far east was in the grip of the rampant H5N1 strain of avian flu and the world was watching with horror as the deadly virus was beginning to be contracted by humans.
China, one of the countries at the centre of the outbreak, is banned from exporting poultry meat into the EU.
The entire consignment of 17,380kg was destroyed by rendering [heat treatment].
Legal action against the importers is being brought by the Food Standards Agency.
Penalties for illegally importing meat, animal products or plants are fines of up to £5,000 and up to two years’ imprisonment.
The seizure was one of 138 made in the north in last financial year and 773 over five years.
These included meat products, fish products, dairy products, fruit and vegetables.
The poultry seizure was the first of such magnitude and [as far as is known] the only illegal non-EU commercial import in that period.
China is widely thought to be the source of the deadly H5N1 strain of bird flu – which was first reported among members of a Hong Kong family that had travelled to the mainland. One person recovered, the other died.
Earlier this month the virus was found at a Bernard Matthews turkey farm at Suffolk in England.
There is speculation that it came via meat imports from the company’s plant in Hungary where an almost identical strain has been found.
Three cases against people found to have imported illegal meat into Northern Ireland have been prepared for prosecution in the past five years.
To date just one case – brought just this month – has resulted in a conviction.
It concerned the seizure of a consignment of raw meat and fish from the Philippines at George Best Belfast City Airport.
The importer was given a conditional discharge and ordered to pay court costs.
The produce was destroyed by incineration or deep burial at an approved site.
Department of Agriculture inspectors patrol Belfast City and International airports and the ports of Belfast, Larne and Warrenpoint.
Seizures of illegal food imports at the north’s airports have risen sharply in recent years. Current legislation makes it illegal to bring back meat and milkbased products for personal use into Northern Ireland from countries outside the EU."

The use of antibodies back in 1918
influenza.sph.unimelb.edu.au/data/S0001/chapters/P1_chap_3.pdf
p. 95
Dr. Huff-Hewitt reported four cases of successful antisera treatment in the British Medical Journal for May
10th, 1919, page 575.
Dr. Huff-Hewitt's method consisted in obtaining blood by the syringeful
from a patient recently convalescent from a moderately severe
attack of the disease, allowing it to clot and then injecting the resultant serum subcutaneously into the patient who is severely ill.
"In his case it was a convalescent mother who thus gave
her serum to her child, and the latter though extremely ill at
the time, forthwith improved and made a good recovery.
The same result ensued in three other very serious cases treated in
the same way, and one admires the resourcefulness of the
practitioner who carried out this treatment without any laboratory to help him.
It was not until the epidemic was over that one saw his publication, and one did not test the treatment oneself, but the possible value of making use of serum from convalescent individuals in the treatment of other patients still acutely ill seems clear, and one would advocate further use of the method in any future epidemic in the hope that thereby some more or less specific remedy will have been discovered for that which throughout the epidemic of 1918-19 baffled all other
forms of treatment when once the 'pneumonic' type of the
disease had obtained a strong hold upon the patient.[citating 'Dutchie']"

"Successful treatment of avian influenza with convalescent plasma.
http://www.hkam.org.hk/publications...km0612p489a.pdf
Hong Kong Med J Vol 12 No 6 December 2006 489

LETTER TO THE EDITOR
To the Editor—According to the WHO Epidemic and Pandemic
Alert and Response (EPR), 19 cases of human infection with avian
influenza A/H5N1, including 12 deaths had been confirmed in China
by 26 July 2006, giving it a mortality rate of 63%.
We would like to report recovery in a patient with confirmed
H5N1 avian influenza and signs of multiple organ failure who was
treated with some innovative technologies, including transfusion of autologous convalescent plasma. This male patient had been to a
local live poultry market several times before developing symptoms
of fever and pneumonia on 3 June 2006. When admitted to hospital
9 days later, he was critically ill with lung and heart failure, renal
failure, toxic hepatitis, bleeding from his upper gastrointestinal tract,
and disseminated intravascular coagulation.
Moreover, his lungs were infected by several drug-resistant bacteria such as Pseudomonas aeruginosa.
His immune system was clearly weakened.
A woman who had recovered from avian influenza (diagnosed
on 11 February) donated her convalescent plasma (group O). Based upon our past experience using plasma collection from a convalescing
patient for passive immune therapy during the SARS outbreak in 2003,
1 we used a protocol of MCS+ and 995E/LDPLP to obtain 500 mL plasma. The plasma was divided into five bags and was tested to ensure it was free of infectious agents. The patient received five transfusions of 100 mL convalescent plasma at intervals of between 5 and 10 hours from day 3 of his hospital admission. This, combined
with several other medical methods, arrested his clinical decline. Between the 7th and the 16th days of treatment with passive immunotherapy, the virus became undetectable in his serum and
specific antibodies to H5N1 appeared. Eventually the patient was taken
off the ventilator, was able to eat and was discharged from hospital on
2 August.
During the SARS outbreak several reports indicated that use of
passive immune therapy was an effective treatment for acute cases
of that disease.
2 However, up to now there have been no reports of
the use of convalescent plasma to manage avian influenza. Although
we cannot prove that the recovery of this patient was solely due
to infusion of convalescent plasma, it was indeed critical. If a
combination of two techniques, viral inactivation and plasmapheresis, is used to treat this new communicable disease, a therapeutic chain of
transfusion can be established between convalescent patients and newly infected patients if necessary.

LK Kong, MS
(e-mail: klk001@msn.com)
BP Zhou, MD
Institute of Transfusion Medicine, Shenzhen Blood Center
Shenzhen 518035, China

References
1. LK Kong. Letter to the Editor. Transfusion and apheresis sciences 2003;(29):
101.
2. Wong VW, Dai D, Wu AK, Sung JJ. Treatment of severe acute respiratory
syndrome with convalescent plasma. Hong Kong Med J 2003;9:199-201.
Successful treatment of avian influenza with convalescent plasma"

Farmer cured of bird flu donates serum for treatment of new human infection
People's Daily Online
16:04, March 03, 2007
"The farmer from East China's Anhui Province, who contracted the deadly H5N1 strain of bird flu last December but was later cured of the avian disease, was called in to donate his serum for treatment of another rural Chinese woman who was confirmed last month to have been infected of the same virus.
Xu Longshan, spokesman and chief of the Fujian Provincial Professional Panel for Prevention and Control of Human Infection of Bird Flu, told Xinhua Saturday health workers from Anhui Province Thursday escorted the farmer, identified by his surname as Li, to Fuzhou, capital of Fujian Province, where experts from the blood center affiliated to the Fujian Provincial Bureau of Health got serum from him the second day.
---
'The serum was brought to Jian'ou on the same day, and so far, medical workers have carried out the first round of injection on the woman who was just confirmed of being infected of the lethal strain of the avian disease,' said Xu.
'The method is new but is for sure to be of some effect in improving the woman's capability of fighting against new rounds of infection,' said Xu, who admitted it would take some time before the woman could develop immunity of her own against the avian disease.
Li from Fujian, 44, is a native of Damiao Village, a marketplace in the mountainous township of Xiaosong. The woman, who kept five chickens at her home, developed symptoms including fever on Feb. 18. She had visited village clinics and township hospitals before being hospitalized on Feb. 24 in the Jian'ou City hospital.
She was confirmed to be infected with the virus by the Chinese Center for Disease Control and Prevention on Feb. 27.
---
According to Xu, the woman patient was found with inflammation on her left lung when she came to the hospital on Feb. 24, but her pneumonia symptoms developed quickly and she went into a coma the next day. A chest X-ray on Feb. 25 shows large shadows on her lungs.
As of Thursday evening, Li's body temperature and pulse had returned to normal, and her lungs and breathing appeared to be functioning better but she was still breathing with the help of a respirator, Xu said.
Doctors say Li is still in a critical condition and they are trying to boost her immunity to prevent further organic infection.
Over ten doctors and medical experts from local hospitals, and Beijing-based Chaoyang Hospital and Ditan Hospital are trying to work out a detailed treatment plan to save Li, said Xu Yongxi, head of the hospital.
Policemen and hospital staff have been seen guarding the ward where the patient is staying and doctors are wearing thick, disinfected suits.
The patient's husband is with her in the hospital, and her 13-year-old son, who now stays in her four-storey house with his grand-mother, looked saddened, and said he hoped his mother could recover soon.
Li from Fujian is the country's first human case of bird flu in seven weeks since China reported on Jan. 10 that the other Li from Anhui, 37, had contracted bird flu last December but had recovered.
---
Source: Xinhua"

Are Some People Immune To Avian Flu?
Public Library of Science
via Science Daily
February 28, 2007
"New results from Richard Webby at St. Jude Children's Research Hospital and colleagues published in the international open-access medical journal PLoS Medicine suggest that the answer might be yes.
The H5N1 avian flu virus is quite different from the seasonal H1N1 and H3N2 flu viruses most humans have been exposed to, which is why many scientists believe that H5N1 could start a new pandemic. (The H and N refer to two virus components, the proteins hemagglutinin and neuraminidase, each of which exists in several varieties identified by a number following the letter.)
Webby and colleagues wondered whether immunity to the human type 1 neuraminidase (huN1) in H1N1 influenza virus strains (and vaccines made to protect against them) could provide protection against avian H5N1 influenza virus, which contains the closely related avian type 1 neuraminidase (avN1). In the new study, they investigated this possibility in mice and in a small group of humans.
The researchers immunized mice with DNA that caused their cells to make the neuraminidase from an H1N1 virus found in human outbreaks. They then examined the immune response of the mice to this huN1 and to avN1 from an avian H5N1 virus isolated from a human patient (A/Vietnam/1203/04). Most of the mice responded to the DNA vaccine by making antibodies that recognized huN1; a few also made antibodies against avN1. (Antibodies are proteins circulating in the body that recognize and stick to some specific part of a foreign agent such as a virus.) All the vaccinated mice survived infection with a man-made flu virus containing huN1, and half also survived infection with low doses of A/Vietnam/1203/04 or of a man-made virus containing avN1.
The researchers then tested blood samples from 38 human volunteers for their ability to inactivate neuraminidase from an H1N1 virus and two H5N1 viruses. Most of the samples were active against the protein from the H1N1 virus; and 8 or 9 also inhibited the protein from both H5N1 viruses.
The results indicate that a vaccine containing huN1 makes mice produce antibodies that partly protect them against avian H5N1 infection. In addition, the human data suggest that a proportion of people have low titer antibodies against H5N1 influenza because of prior exposure to H1N1 viruses or routine influenza vaccination.
As Laura Gillim-Ross and Kanta Subbarao (US National Institute of Allergy and Infectious Diseases) write in an accompanying Perspective article, these results provide a tantalizing suggestion but fall short of demonstrating that there is actual protection in humans against avian flu. Further work is needed to investigate this important question, and Gillim-Ross and Subbarao discuss the challenges and opportunities for such research.
Citation: Sandbulte MR, Jimenez GS, Boon ACM, Smith LR, Treanor JJ, et al. (2007) Cross-reactive neuraminidase antibodies afford partial protection against H5N1 in mice and are present in unexposed humans. PLoS Med 4(2): e59. (http://dx.doi.org/10.1371/journal.pmed.0040059)