Penumbra Pandemia

"More H5N1 Mis-matches in Indonesia
Recombinomics Commentary
November 29, 2007
The bird flu vaccine for Medan for example, could not be compared with giving of the vaccine that was same in Java. Giving of the wrong vaccine, said NIDOM, even could change the vaccine into the trigger increasing the strength of the bird flu virus.
Along with the NIDOM explanation, [Audio ounce Demand]. NIDOM said that must be attention now and no longer to the poultry that was regarded as the virus bearer. But must think about how the pattern of the spread of the bird flu virus to humankind.
With the Tropical Diseases Centre Universitas Airlangga Team, NIDOM was researching anywhere the bird flu virus could spread after from the poultry, the cat and the pig.

The above translation notes that H5N1 is rapidly evolving in Indonesia, and the reservoir remains uncertain. Although the H5N1 in Indonesia is clade 2.1, many sub-clades have evolved, and the new subclades are frequently not well represented in bird isolates.
These match failures were seen shortly after the first human isolates were sequenced. Most were from Java and did not match poultry isolates. The isolates had a novel cleavage site and the first related sequences were found in a cat from Indramyu.
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New human H5N1 sequences have not been released since early January, and the most recent sequences again form a new branch not well represented by the avian sequence.
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These match failures again suggests that many of the human infections are linked to reservoirs not well represented by current isolates, and more extensive testing of other sources, including wild birds is warranted.
The H5N1 is evolving into multiple sub-clades, which are also not well represented in current vaccines. Vaccine mis-matches can also drive H5N1 evolution. Therefore a broader testing of potential H5N1 reservoirs and release of recent human H5N1 samples would be useful."

H5N1 in Riyadh Saudi Arabia (11/20/07)
Recombinomics Commentary
November 18, 2007
"'The emergence of these results coincided with the disclosure of cases of death of poultry birds inside the home in the Jerusalem district, which is located in north-eastern part of Riyadh, has not yet been identified causes that led to the death of the chickens.
Al-Watan newspaper carried photographs of an agriculture ministry team in masks and white coats in the Aziziya market south of Riyadh, saying bird flu cases had been found there.
The discovery comes just a few weeks before nearly 2 million faithful arrive for the annual haj pilgrimage season in Mecca.'

Earlier, Egypt reported H5N1 in backyard farms in Minya, and Yemen has reported poultry deaths which have not been tested because of a lack of funds.
At this time of the year migratory birds pass through the area. In December, 2005 H5N1 was detected in a healthy teal in the Nile Delta. However, most of the H5N1 in the nregion is detected in poultry farms which include large commercial farms as well as small backyard farms.
Although human cases have not been recently reported, cases were detected in Egypt in 2006 as well as 2007, suggesting additional cases will be reported soon.
As noted above, the recent reports of H5N1 in the region come shortly before the upcoming Haj."

"Fifth bird flu cull launched
BBC
Wednesday, 21 November 2007, 17:28 GMT
Poultry on a fifth farm near the Norfolk-Suffolk border are to be culled in a bid to control the current outbreak of bird flu, officials say.
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the deadly H5N1 strain was first suspected on 15 November.
Acting Chief Veterinary Officer Fred Landeg said the move is based on new information about an exposure risk.
He stressed that all poultry keepers must report any signs of the disease."

Bird flu: second H5N1 case confirmed
ITN/Channel 4 News
19 Nov 2007
A second case of the deadly H5N1 bird flu virus has been confirmed at a poultry farm on the Norfolk/Suffolk border.
Nine thousand turkeys at the site have already been slaughtered.
The site of the new infection, Hill Meadow Farm, Knettishall, is outside the original 3km protection zone set up around Redgrave Park farm, but inside the wider restricted area which covers Suffolk and much of Norfolk.
The premises were identified as having 'dangerous contact' with the initial outbreak last week because staff for Redgrave Poultry, the operator of all five sites where culls have taken place, moved between the farms.
Defra said the birds appeared healthy when they were first inspected, but a precautionary cull was completed on Saturday.
Acting chief veterinary officer Fred Landeg said: 'The laboratory test results today highlight the importance of poultry keepers in the area being extremely vigilant.'
He added: 'It is essential they practise the highest levels of biosecurity and report any suspicions of disease to their local animal health office.'
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Officials are still awaiting results following culls at two other farms in Norfolk: Stone House in West Harling, and Bridge Farm, Pulham."

"Bird flu detected at poulty farm in Saudi
ABCNews/AFP
14 Nov 2007
The lethal H5N1 strain of bird flu has been detected at a poulty farm in Saudi Arabia and 50,000 birds have been culled, the agriculture ministry said.
It said tests were carried out after 1,500 birds died in a farm of the Al-Kharj region, 150 kilometres south of Riyadh.
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It said no human case has been found and an investigation was taking place to determine the origin of the illness.
The kingdom banned all live poulty imports after bird flu was last detected in Saudi Arabia in March.
In April, neighbouring Kuwait culled 1.7 million birds after the strain was found, but there no reports of human cases. ---"

"Dead Riau Health Care Worker H5N1 Confirmed
Recombinomics Commentary
November 9, 2007
'A hospital employee suspected of having bird flu died on Tuesday evening in Pekanbaru, Riau province [Indonesia] after being treated for only a few minutes at Arifin Achmad Hospital.
The 31-year-old man, identified as MN, was employed on the administrative staff of Permata Hati Hospital in Duri district and was initially treated at that hospital.
Three days before checking into Permata Hati, MN came down with a high fever, dry cough and diarrhea.
His condition had been improving when fever returned together with seizures and the transfer to Arifin Ahmad was ordered.
Arifin Achmad spokesperson said upon arrival the patient was already in 'terminal' condition. 'We prepared the isolation ward for him ... and tried our best ....'
An uncle said he did not believe bird flu was the cause. He said MN had no poultry at his house. 'He also had no contact with poultry recently.'
The patient who died in the Derah Public Hospital (RSUD) Arifin Achmad Pekanbaru, Muhammad Nabi (31), that was reconciliation from one of the clinics in the Thorn, Kabupaten Bengkalis, Riau, was stated by Balitbangkes Department of Health positive was infected by the bird flu virus.
Results of the sample research wiped off nose mucus and the throat as well as the patient's blood that were sent to Balitbangkes Department of Health menunjukan positive avian influenza, said Tim Doctor Penanggulangan Chairman of RSUD Arifin Achmad Bird Flu, Azizman Saad, in Pekanbaru, on Friday.'

The above media report and translation confirm that the hospital employee who died this week was H5N1 positive. As noted in the earlier report, the victim had no recent contact with poultry and was on the administrative staff at the hospital in Duri, where he and his neighbor were initially treated.
Confirmation of H5N1 in a health care worker is cause for concern because such infections signal a more efficient transmission and may signal more unreported cases at the Duri hospital.
WHO and the Department of Health begin an investigation tomorrow amid media reports of a cover-up of cases.
More details on the reported deaths of patients and health care workers would be useful."

"H5N1 Cluster in Tangerang Indonesia
Recombinomics Commentary
November 3, 2007
A 30-year-old Indonesian woman died of suspected bird flu on Saturday, the country's health ministry said here.
The woman from Tanggerang town on the outskirts of Jakarta died on Saturday in a designated bird flu hospital of Persahabatan in east Jakarta, said Harris Subiantro, an official of the anti-bird flu center of the ministry.
One of two laboratories' tests, which needed for confirmation, indicated that she was positive of avian influenza, said the official.
'She was dead today. One of laboratory tests has showed positive,' he told Xinhua.
The above comments describe the fourth laboratory confirmed H5N1 in Tangerang in the past few weeks. Three of the four have been confirmed twice and are official WHO cases. Two of the earlier cases were neighbors. One (5F) died October 22, while the neighbor (3M) has returned home. Confirmed mild cases of H5N1 are rare, and the vast majority are contacts of confirmed cases, because patients with mild symptoms are not generally tested. Testing is done at infectious disease hospitals, and most suspect H5N1 are admitted after failing to respond to treatment at primary care facilities.
The geographical cluster in Tangerang, which is adjacent to Jakarta is cause for concern. The most recent public human H5N1 was made public in early January. Therefore the genetic evolution of H5N1 from patients in Indonesia is unclear. Although most of the patients have some linkage to poultry, the concentration of cases in space and time indicates the H5N1 is being transferred to humans more efficiently.
The other hot spot for human H5N1 in Indonesia is on the island of Sumatra in Riau. In addition to confirmed cases in September and October, there was a suspect family cluster. Although initial media reports indicated the niece (10F) was positive, subsequent reports indicated confirmatory test were negative. However, the death of her aunt (17F) 11 days earlier, keeps suspicions high since both had bird flu symptoms.
The increase in geographic clusters in Indonesia remains a cause for concern."
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Not a good-looking picture.

22 ill in school flu outbreak
CHP logo (Eng version) via Crofsblogs' H5N1
The Centre for Health Protection is investigating an outbreak of influenza-like illness affecting 22 boys at a Central primary school.
The students, aged six to 11, have come down with fever, cough and sore throat since October 27. Twenty-one consulted general practitioners or outpatient clinics. One was admitted to a private hospital and is stable.
The centre has taken a sample from the respiratory tract of a patient and is waiting for laboratory test results.
The centre is monitoring the school and its staff have received health instructions. ---"
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If the quick tests were negative, then why would they inform the lab tests like this? Or were the H5N1 quick tests positive?