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Avian Influenza Daily Digest
September 15, 2008 14:00 GMT
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Article Summaries ...
Quid Novi
OIE: Laos, Immediate Notification
Regional Reporting and Surveillance
EC holds avian influenza prevention workshop in Cebu
9/15/08 Philappine News--International experts on avian influenza prevention are in Cebu City to conduct the five-day training workshop on the prevention of Highly Pathogenic Avian Influenza (HPAI) in the Philippines from September 15 to 19.
Regional Reporting and Surveillance
TOGO: Officials to slaughter more poultry to fight bird flu spread
9/15/08 IRIN--Officials have quarantined Agbata village in southern Togo, and plan to cull all poultry within a three kilometre radius, as they await lab confirmation of which avian flu virus killed 3,000 birds there on 09 September.
Regional Reporting and Surveillance
Science and Technology
Vaxin gets grant for poultry vaccine
9/15/08 Montgomery Advertiser--Birmingham-based Vaxin Inc. has received a nearly $1 million grant from the National Institutes of Health to proceed with experiments on the biotechnology company's bird flu vaccine. Chief Executive Bill Enright said the $995,000 grant will be used to expedite development of a poultry vaccine to prevent the spread of avian influenza to people. Vaxin's plan calls for chickens to be vaccinated while still in their eggs. Enright said the grant resulted from milestones the company met under a $100,000 grant to study the safety and effectiveness of the vaccine on poultry.
Vaccines
Pathogenicity of Chinese H5N1 highly pathogenic avian influenza viruses in pigeons
9/13/08 Archives of Virology--[abstract] It has long been thought that pigeons are resistant against H5 highly pathogenic avian influenza (HPAI) viruses. Recently, however, highly pathogenic H5N1 avian influenza viruses have demonstrated distinct biological properties that may be capable of causing disease in pigeons. To examine the susceptibility of domestic pigeons to recent H5N1 viruses, we inoculated pigeons using H5N1 viruses isolated in China from 2002 to 2004. Within 21 days following inoculation, all pigeons had survived and fully recovered from temporary clinical signs. However, seroconversion assays demonstrated that several viruses did in fact establish infection in pigeons and caused a certain amount of viral shedding in the oropharynx and cloaca. There was not, however, a definitive relationship between viral shedding and viral origin. Viruses were also inconsistently isolated from various organs of pigeons in infected groups. Pathological examination revealed that the infection had started as respiratory inflammation and caused the most severe lesions in the brain in later stages. These results indicate that pigeons are susceptible to the more recent Asian H5N1 HPAI and could be a source of infection to other animals, including humans.
AI Research
Health officials watching whether flu viruses are becoming resistant to drug
9/15/08 Edmonton Sun/Branswell--As flu season approaches, public health authorities will be keeping an anxious eye on one family of flu viruses to see if an unwelcome phenomenon that cropped up last winter will stage a repeat performance.
Science and Technology
New AI vaccine developed
9/15/08 World Poultry.Net--Vaxin has now developed a vaccine that can be rapidly produced and mass administered. This vaccine was recently featured at the Immunotherapeutics & Vaccine Summit in Boston.
Vaccines
St. Louis University to use 500 volunteers in avian-flu vaccine tests
9/15/08 St. Louis Dispatch-- In the ongoing search for an effective vaccine, researchers at St. Louis University School of Medicine will help test new combinations of vaccines in 500 people to see if the body can build resistance to the dangerous virus that has claimed hundreds of lives worldwide.
Vaccines
Pandemic Preparedness
WHO Says Flu Fatigue Poses Public Health Threat
9/15/08 Bloomberg--Apathy toward the pandemic risk posed by bird flu is one of the greatest threats to public health and may undermine efforts to improve disease detection and control systems in developing countries, a World Health Organization official said.
Pandemic Preparedness
Full Text of Articles follow ...
Vaccines
Vaxin gets grant for poultry vaccine
9/15/08 Montgomery Advertiser--Birmingham-based Vaxin Inc. has received a nearly $1 million grant from the National Institutes of Health to proceed with experiments on the biotechnology company's bird flu vaccine. Chief Executive Bill Enright said the $995,000 grant will be used to expedite development of a poultry vaccine to prevent the spread of avian influenza to people.
Vaxin's plan calls for chickens to be vaccinated while still in their eggs. Enright said the grant resulted from milestones the company met under a $100,000 grant to study the safety and effectiveness of the vaccine on poultry.
AI Research
Pathogenicity of Chinese H5N1 highly pathogenic avian influenza viruses in pigeons
9/13/08 Archives of Virology--[abstract]--Beibei Jia1, Jianzhong Shi1, Yanbing Li1, Kyoko Shinya2, 3, Yukiko Muramoto4, Xianying Zeng1, Guobin Tian1, Yoshihiro Kawaoka4, 5 and Hualan Chen1 Contact Information
(1) Animal Influenza Laboratory of the Ministry of Agriculture and National Key Laboratory of Veterinary Biotechnology, Harbin Veterinary Research Institute, Chinese Academy of Agricultural Sciences, 427 Maduan Street, 150001 Harbin, People?s Republic of China
(2) The International Center for Medical Research and Treatment, Kobe University, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
(3) Faculty of Agriculture, Tottori University, Tottori 680-8553, Japan
(4) Institute of Medical Sciences, University of Tokyo, Tokyo 108-8639, Japan
(5) Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI 53706, USA
Received: 18 June 2008 Accepted: 30 July 2008 Published online: 9 September 2008
Abstract It has long been thought that pigeons are resistant against H5 highly pathogenic avian influenza (HPAI) viruses. Recently, however, highly pathogenic H5N1 avian influenza viruses have demonstrated distinct biological properties that may be capable of causing disease in pigeons. To examine the susceptibility of domestic pigeons to recent H5N1 viruses, we inoculated pigeons using H5N1 viruses isolated in China from 2002 to 2004. Within 21 days following inoculation, all pigeons had survived and fully recovered from temporary clinical signs. However, seroconversion assays demonstrated that several viruses did in fact establish infection in pigeons and caused a certain amount of viral shedding in the oropharynx and cloaca. There was not, however, a definitive relationship between viral shedding and viral origin. Viruses were also inconsistently isolated from various organs of pigeons in infected groups. Pathological examination revealed that the infection had started as respiratory inflammation and caused the most severe lesions in the brain in later stages. These results indicate that pigeons are susceptible to the more recent Asian H5N1 HPAI and could be a source of infection to other animals, including humans.
Quid Novi
OIE: Laos, Immediate Notification
Highly pathogenic avian influenza,
Laos
Information received on 14/09/2008 from Dr Khambounheuang Bounkhouang , Directeur Général, Département de l'Elevage et des Pêches , Ministère de l'Agriculture et des Forêts , Vientiane, Laos
Summary
Report type Immediate notification
Start date 27/08/2008
Date of first confirmation of the event 04/09/2008
Report date 14/09/2008
Date submitted to OIE 14/09/2008
Reason for notification Reoccurrence of a listed disease
Date of previous occurrence 02/2008
Causal agent Highly pathogenic avian influenza virus
Serotype H5N1
Nature of diagnosis Laboratory (basic), Laboratory (advanced)
This event pertains to the whole country
New outbreaks
Outbreak 1 Nalae village, Nalae village, Xay, OUDOMXAY
Date of start of the outbreak 01/09/2008
Outbreak status Continuing (or date resolved not provided)
Epidemiological unit Village
Affected animals
Species Susceptible Cases Deaths Destroyed Slaughtered
Birds 1170 23 23
Affected population The positive flock was discovered due to back tracing from Nambak outbreak. A surveillance zone of 5-Km-radius was drawn around the suspected farm in Oudomxay, from where the positive ducklings in Nambak originated, even though no positive animals were found on that farm. Very low daily mortality (2%) was reported during disease investigation in one flock in Nalae village. This flock also originated from the same farm. Animals originated from the same farm as infected Nambak flock.
Outbreak 2 Fa village, Fa village, Nambak, LUANGPRABANG
Date of start of the outbreak 27/08/2008
Outbreak status Continuing (or date resolved not provided)
Epidemiological unit Village
Affected animals
Species Susceptible Cases Deaths Destroyed Slaughtered
Birds 5422 247 197 5225 0
Affected population Ducklings in a small commercial unit within a village with backyard poultry. They were purchased on 20 August 2008 and started to die on 27 August 2008 (about 4% and then increasing to 10% per day). Farmer reported it to the district officer on 1 September. Samples were confirmed to be positive for HPAI H5N1 on 4 September 2008. The declaration of the CVO and the provincial governor was made on 5 September 2008. The infected flock was culled on 4 September 2008 and culling within the 1-Km-radius zone around the control zone started on 5 September 2008. Culling was presumably completed on 12 September 2008 (backyard poultry). Legal purchase and movement from a farm in other province where illegal import is suspected. Investigation on that farm is on-going.
Summary of outbreaks Total outbreaks: 2
Total animals affected
Species Susceptible Cases Deaths Destroyed Slaughtered
Birds 6592 270 220 5225 0
Outbreak statistics
Species Apparent morbidity rate Apparent mortality rate Apparent case fatality rate Proportion susceptible animals lost*
Birds 4.10% 3.34% 81.48% **
* Removed from the susceptible population through death, destruction and/or slaughter
** Not calculated because of missing information
Epidemiology
Source of the outbreak(s) or origin of infection
* Introduction of new live animals
* Legal movement of animals
* Illegal movement of animals
Control measures
Measures applied
* Stamping out
* Movement control inside the country
* Screening
* Disinfection of infected premises/establishment(s)
* Vaccination prohibited
* No treatment of affected animals
Measures to be applied
* No other measures
Diagnostic test results
Laboratory name and type National Animal Health Centre, Avian Influenza Laboratory (National laboratory)
Tests and results
Species Test Test date Result
Birds real-time PCR 11/09/2008 Positive
Birds reverse transcription ? polymerase chain reaction (RT-PCR) 04/09/2008 Positive
Future Reporting
The event is continuing. Weekly follow-up reports will be submitted.
Science and Technology
Health officials watching whether flu viruses are becoming resistant to drug
9/15/08 Edmonton Sun/Branswell--As flu season approaches, public health authorities will be keeping an anxious eye on one family of flu viruses to see if an unwelcome phenomenon that cropped up last winter will stage a repeat performance.
To the surprise and dismay of scientists and governments, H1N1 viruses that were resistant to Tamiflu suddenly appeared in high numbers in Northern Europe.
Testing elsewhere has since shown viruses resistant to the key drug ? whose generic name is oseltamivir ? have spread to North and South America, the Caribbean, Africa, parts of Asia, Australia and New Zealand.
North American officials say they will quickly test for resistance once the northern hemisphere flu season begins and H1N1 viruses start to spread.
And in the U.S. at least, authorities are entertaining the possibility they may have to tweak the advice they give doctors on which flu drugs to use should ? as most expect ? the problem recur.
?We are thinking about the various sorts of scenarios that might occur,? says Dr. Tony Fiori, who develops antiviral drug and vaccine policy in the influenza division of the U.S. Centers for Disease Control in Atlanta, Ga.
?It?s hard to imagine we?d be at a point of telling people not to use oseltamivir. We might look at possibilities like pushing people towards using zanamivir when they can, since there hasn?t been resistance seen to that.?
Zanamivir is the generic name for GlaxoSmithKline?s Relenza, which, like Tamiflu, belongs to a class of drugs called neuraminidase inhibitors.
Both drugs block the ability of flu viruses to spread from infected cells to healthy ones, making symptoms less severe and speeding recovery.
Tamiflu producer Hoffman-La Roche intends to get into the surveillance effort, mounting a multi-country study to figure out how much resistance is out there, whether the resistant viruses cause milder disease and what happens clinically to people infected with the resistant viruses who take Tamiflu.
?So in a very short space of time we hope to get a picture on the frequency, if the strain does re-emerge in the northern hemisphere,? says Dr. David Reddy, Roche?s pandemic influenza task force leader.
?We don?t know what the northern hemisphere will bring,? he said, expressing an optimism not supported by the resistance pattern seen in H1N1 viruses during the southern hemisphere flu season.
Canada too will be testing early so it can inform the medical community of which kinds of flu viruses are causing the most disease and whether they are resistant to Tamiflu.
But the Public Health Agency of Canada is unlikely to issue across-the-board recommendations, because the drug still works against two other types of flu viruses ? the other influenza A subtype, H3N2 as well as influenza B viruses ? and because it?s unlikely there will be one single pattern of illness across the entire country.
?This season?s going to be a little bit more complicated than previous seasons. And I think one is going to have to . . . at the local and provincial level take more of a risk-assessment, risk-management approach based on what strains of flu are circulating,? says Dr. John Spika, acting director general of the centre for immunization and respiratory infectious diseases.
?Are they H1N1 predominantly or are they H3N2? And, based on the available information, then decide whether or not it is appropriate to use the oseltamivir or potentially adamantane drugs. And how zanamivir fits in with that as well.?
The adamantane drugs are older flu drugs that have their own resistance problem.
In early 2006 both the CDC and the Public Health Agency told doctors not to use the drugs when it was found over 90 per cent of H3N2 viruses were resistant to them.
As for Tamiflu and Relenza, neither drug has done remarkably well in the seasonal flu market except in Japan, where Tamiflu is widely used.
So in some ways, the resistance problem isn?t likely to have a huge impact on how doctors treat their patients who contract influenza ? so long as resistance doesn?t also emerge in either or both of H3N2 and influenza B viruses, experts say.
?That?s what everybody?s holding their breath on,? says Dr. Allison McGeer, an influenza expert at Toronto?s Mount Sinai Hospital.
?If we see H3N2 resistance at significant levels, that?s the catastrophic bridge.?
But Roche has sold vast quantities of Tamiflu to governments and corporations for pandemic influenza stockpiles.
Discovering the vulnerability of the main drug weapon in pandemic arsenals has unsettled governments, public health officials and flu researchers.
?The bigger issue is loss of confidence overall and how it will shape the stockpiling,? says McGeer, who says governments may be less willing to lay in stockpiles when the next generation of flu drugs hit the market for fear the Tamiflu phenomenon will repeat itself.
It is a fact of nature that bacteria and viruses will eventually evolve to become resistant to drugs.
But research had suggested that the changes flu viruses would have to undergo to become resistant to Tamiflu would so weaken them that they would lose the capacity to spread from person to person.
Last winter nature delivered a double whammy: Not only had resistance emerged ? and emerged in places where it was clear misuse wasn?t responsible ? but the resistant viruses spread easily.
That demolished the theory that resistant viruses were less biologically fit viruses, at least so far as H1N1 viruses are concerned.
?I am really staggered that this H1N1 virus has been able to spread as it has,? says Jennifer McKimm-Breschkin, a flu antiviral expert at Australia?s Commonwealth Scientific and Industrial Research Organization and a member of the team that developed Relenza.
McKimm-Breschkin, who receives no royalties from sales of the drug, thinks in light of the resistance problem, public health agencies should be telling doctors to use Relenza this flu season.
?The drugs are expensive. So if you have one drug that you know is effective against all (flu) strains, surely the logical prescribing pattern is to prescribe that drug.?
But she thinks officials would be reluctant to issue that kind of recommendation, because of the lion?s share position Tamiflu holds in most pandemic drug stockpiles.
?It is a politically sensitive issue because of the stockpiling. And governments don?t want to alarm people that the stockpiles may not be useful because the bird flu still remains sensitive,? McKimm-Breschkin says, referring to the dangerous H5N1 strain killing poultry and occasionally people in parts of Asia and Africa.
Other experts say the Tamiflu situation doesn?t merit the same response as the adamantane drug resistance problem did.
For one thing, at least in North America, the Tamiflu resistance rates were lower last winter ? 26 per cent in Canada, and 11 per cent in the U.S.
And for another thing, H1N1 viruses generally cause milder flu than H3N2 viruses.
Fiori says there is another important distinction between the two situations.
?I think what makes it somewhat different from the adamantane situation of a couple of years ago is that we had a good drug ? perhaps even a better drug ? in reserve at that point,? he says, referring to Tamiflu.
?And we don?t at this point. We don?t really have that sort of option here.?
Regional Reporting and Surveillance
EC holds avian influenza prevention workshop in Cebu
9/15/08 Philappine News--International experts on avian influenza prevention are in Cebu City to conduct the five-day training workshop on the prevention of Highly Pathogenic Avian Influenza (HPAI) in the Philippines from September 15 to 19.
Dr. David John Hadrill and Andrew Almond, international experts on avian influenza prevention have been commissioned by the European Commission (EC) to conduct the training course in the country where Cebu is the venue for the Visayas workshop.
A total of 20 representatives that are Regional Avian Influenza coordinators, provincial and city veterinarians from Regions 6,7,8 and 9 comprised the participants of the activity.
This is the first training activity on avian influenza prevention that is funded by the EC where three workshops are slated, each in Luzon, Visayas and Mindanao. The workshops are organized in cooperation with the Department of Agriculture particularly the Bureau of Animal Industry.
The Philippine remains one of the three countries in Southeast Asia which to date has not had any detected HPAI cases. The presence of the disease in neighboring countries and the high rate of spread of the disease following an initial infection necessitated the continued vigilance and training of staff working in animal health and disease.
A high awareness of the disease by the veterinary staff and management of outbreak response strategies in order to be capable of identifying signs of the disease and how to respond if and when the virus gets into the country is critical.
The technical assistance forms part of the EC's international commitment to combat avian influenza and prepare for a possible human pandemic within the context of the Better Training for Safer Food program's focus areas of food and feed safety, animal health and animal welfare. Thus, the EC has stepped up preventive measures in response to the threat of animal diseases such as the HPAI caused y the virus strain H5N1.
Before Cebu, a similar activity was held in Angeles City for the participants coming from Regions I, II, III, IV and V. A final workshop is slated in Cagayan de Oro on September 22 until 26 for participants from Regions X, XI XII and the CARAGA and ARMM Regions. (PIA-Cebu/FCR)
Vaccines
New AI vaccine developed
9/15/08 World Poultry.Net--Vaxin has now developed a vaccine that can be rapidly produced and mass administered. This vaccine was recently featured at the Immunotherapeutics & Vaccine Summit in Boston.
Kent Van Kampen, Vaxin's COO and an authority on vaccine development: "Our vaccine uses a neutered cold virus to carry a tiny snippet of influenza DNA, rather than the entire influenza virus," Van Kampen said. "When the immune system responds, it actually learns how to be immune to the target disease - avian influenza in this case."
This vaccine has been shown to provide excellent protection when administered to poultry before hatching. Vaxin has utilised these advances to develop a version of the vaccine that will soon be tested in humans.
Regional Reporting and Surveillance
TOGO: Officials to slaughter more poultry to fight bird flu spread
9/15/08 IRIN--Officials have quarantined Agbata village in southern Togo, and plan to cull all poultry within a three kilometre radius, as they await lab confirmation of which avian flu virus killed 3,000 birds there on 09 September.
Authorities have already slaughtered about 1,500 birds that survived this week's bird flu epidemic in three poultry farms in Agbata, 10 km from the capital, Lome.
Togo?s government is awaiting lab confirmation to learn if it was the H5N1 virus, which was first discovered in Togo in June 2007.
The country?s livestock director, Komla Batasse Batawui, told IRIN that officials reacted as quickly as possible and are prepared to do more. ?We deplore the fact that these farms lost 80 percent of their poultry. Seven rapid flu tests came back positive and we are waiting lab confirmation. Within the next three weeks, we will slaughter birds within three kilometres of this affected village.?
Batawui said farmers will be compensated for their losses, without specifying how much. The Ministry of Agriculture, Livestock and Fish has launched an appeal for international assistance to fight and prevent the spread of bird flu in Togo.
The West African pandemic advisor for the UN Office for the Coordination of Humanitarian Affairs, Liviu Vedrasco, says while compensation schemes are important, it is critical countries put in place good national pandemic response systems.
Though the virus has been mostly contained to poultry, the World Health Organization has estimated about 200 people worldwide have died from poultry-to-human H5N1 infections in the last five years.
Some experts say the unpredictable H5N1 virus, or still undiscovered viruses, may mutate and potentially spread among humans.
?This most recent outbreak [in Togo] keeps governments alert about the need to have a good human pandemic disaster plan in place [in case of person-to-person H5N1 infections] ? It is important governments do not become complacent and think nothing needs to be done. This does not take money [per se], but rather it involves one government ministry talking to another,? said Vedrasco.
Several West African countries have reported similar cases of bird flu in poultry, with only Nigeria reporting one human bird flu death, according to the UN.
Vaccines
St. Louis University to use 500 volunteers in avian-flu vaccine tests
9/15/08 St. Louis Dispatch-- In the ongoing search for an effective vaccine, researchers at St. Louis University School of Medicine will help test new combinations of vaccines in 500 people to see if the body can build resistance to the dangerous virus that has claimed hundreds of lives worldwide.
"We don't know what strain will emerge as the next pandemic and we don't know when that will happen, but we all believe that will happen sometime," said Dr. Robert Belshe, director of the school's Center for Vaccine Development and the study's principal investigator.
"This is preparation for making a vaccine that will be effective in preventing serious illness or death in the event of a bird flu epidemic."
The U.S. government developed an avian flu vaccine in 2004, but the strains of bird flu now circulating have mutated.
The researchers want to learn if the 6 million doses of stockpiled vaccine from 2004 are still worthwhile, particularly if given along with a booster shot of a newly developed vaccine.
Vaccines stimulate the creation of antibodies that help people to fight infections. Participants in the clinical trial will get one or both of the vaccines to see how well they work alone and in combination with eachother.
They'll also be tested for differences if the shots are given one, two or four weeks apart.
Although bird flu does not spread easily among people, as of June there have been 385 human cases and 243 deaths, with the majority occurring in Indonesia, Vietnam and China, according to the World Health Organization.
The vaccine study is funded by the National Institute of Allergy and Infectious Diseases.
The 500 participants will be recruited by research centers in the cities of St. Louis, Atlanta and Seattle.
Pandemic Preparedness
WHO Says Flu Fatigue Poses Public Health Threat
9/15/08 Bloomberg--Apathy toward the pandemic risk posed by bird flu is one of the greatest threats to public health and may undermine efforts to improve disease detection and control systems in developing countries, a World Health Organization official said.
Health authorities have been monitoring the H5N1 strain of avian influenza for more than a decade for any sign that it is becoming as contagious as seasonal flu. While millions of birds have been infected, fewer than 400 people are reported to have contracted the illness, including 36 this year.
``The threat of a pandemic, of a virus jumping from animals into humans, is still there, but the biggest threat that we have now is `flu fatigue','' Dr. Julie Hall, deputy regional adviser on communicable disease surveillance and response with the WHO's Western Pacific region, told reporters in Sydney today.
Misconceptions that the pandemic threat is ``a storm in a teacup'' may sap investment in surveillance for bird flu as well as other infectious diseases, particularly in parts of Asia, where systems are ``very weak,'' Hall said. Donor governments and organizations such as the World Bank have pledged more than $2 billion the past three years to help poorer nations stem bird flu's spread and prepare for any pandemic it spawns.
``These systems are useful for many different things -- from naturally occurring diseases through to manmade and bioterrorism threats,'' Hall said in a telephone interview. ``It should be seen as a long-term investment for multiple purposes that one day will most definitely be needed.''
More money to fund global preparedness programs will be sought next month, when Egypt hosts an international ministerial conference on avian and pandemic influenza.
Growing Threat
The world is closer to another influenza pandemic than at any time since 1968, when the last of the previous century's three pandemics occurred, according to the Geneva-based WHO. The H5N1 virus has spread to more than 60 countries and caused at least 6,500 poultry outbreaks since 2003.
``There has been a lot of hype about pandemic influenza and a fair amount of investment into strengthening surveillance and response systems, but I believe now this new disease called flu fatigue is setting in,'' Hall told a meeting hosted by the Australian Science Media Centre.
``We haven't seen a pandemic, but the H5 virus and all the other influenza viruses are still out there,'' she said. ``Nipah virus is there causing problems and changing. Dengue is on the rise.''
Population density, increasing poultry production, natural disasters and global warming may spur the emergence of undiscovered diseases in Asia as more people move or are displaced and have closer contact with animals, she said.
An outbreak of nipah virus in Malaysian pigs in 1998 that killed 105 people is one of the most significant epidemics to have occurred anywhere in the world during the past 15 years, according to the Centers for Disease Control and Prevention.
