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Avian Influenza Daily Digest
October 17, 2008 14:00 GMT
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Article Summaries ...
Quid Novi
Indonesia: poultry die-off reported in Karanganyar District, Central Java
Germany: 3 Cases of H5N3 Detected at Zoo
Responses to Avian Influenza and State of Pandemic Readiness Fourth Global Progress Report
Regional Reporting and Surveillance
Workshop on Avian Influenza Organized in Qalqilyah
10/17/08 ARGUS--A local source reported that Jerusalem Open University, in cooperation with WHO, Qalqilyah Health Department, the Education District, and the Students? Union, has organized a workshop on Avian Influenza (AI) in Qalqilyah. The Head of the School Health and Health Education Section gave a presentation on modes of AI transmission and its prevention, stressing that no cases of AI have been reported in Gaza and the West Bank. He also indicated that the initiative is cooperating with WHO to control the disease and prevent its spread.
Regional Reporting and Surveillance
UNICEF: Raising awareness of bird flu in Myanmar
10/17/08 UNICEF--[link to short video on story] More than 60 health and livestock professionals are now ready to implement their communication workplan on avian influenza, which was drafted during a recent three-day training session held in Nyaung Shwe Township, Shan State.
Regional Reporting and Surveillance
African Countries Covenene to Determine Effectiveness of Preventive Measures against AI Epidemic
10/17/08 ARGUS--A multinational source reports that [unspecified] members of the African economic and monetary community commenced a 3-day meeting on 15 October in Douala, Cameroon to take preventive measures against an AI ?epidemic". Reportedly, the meeting will reinforce national capabilities and establish rapid response and coordinated mechanisms in the event of an AI outbreak. Participants also aim to address prevention methods against infections of highly pathogenic avian influenza (HPAI) and promote the importance of a cross-border fight against the disease. According to the source the FAO also recommended that the member countries test the effectiveness of their national plans before an actual outbreak occurred.
Regional Reporting and Surveillance
Pakistan: Butchers play havoc with public health
http://thepost.com.pk/IsbNewsT.aspx?dtlid=187799&catid=17
Regional Reporting and Surveillance
Indonesia: Ag Ministry outlines poultry plans
10/17/08 Jakarta Post--Jakarta will clear out smaller-scale poultry industries by 2010 as part of its efforts to prevent more deaths from bird flu, agricultural authorities said Tuesday.
Regional Reporting and Surveillance
Science and Technology
Modeling the Economic Impact of Pandemic Influenza: A Case Study in Turkey
10/2008 Springerlink--[pdf full text]--Influenza pandemics have occurred intermittently throughout the 20th century and killed millions of people worldwide. It is expected that influenza pandemics will continue to occur in the near future. Huge number of deaths and cases is the most troublesome aspect of the influenza pandemics, but the other important trouble is the economic impact of the influenza pandemics to the countries. In this study, we try to detect the cost of a possible influenza pandemic under different scenarios and attack rates. We include the vaccination and antiviral treatment cost for direct cost and we add the work absenteeism cost to the calculations for indirect cost of influenza pandemics. As a case study, we calculate the economic impact of pandemic influenza for Turkey under three different scenarios and three different attack rates. Our optimistic estimation shows that the economic impact of pandemic influenza will be between 1.364 billion dollars and 2.687 billions dollars to Turkish economy depending on the vaccination strategies.
AI Research
MedImmune Licenses Reverse Genetics Technology to Hungary´s Omninvest
10/17/08 Network Medica--MedImmune announced that it has licensed its reverse genetics technology to Omninvest, a Hungarian research and manufacturing company, to support the development and construction of new vaccine strains to produce non-live human influenza vaccines.
Vaccines
USGS Q & A
10/17/08 USGS Website-- Question: Where are the most likely routes that H5N1 could enter the United States through migratory birds?
Science and Technology
Funds to Study How AI Evades Antiviral Responses
10/17/08 The Poultry Site--The National Institute of Allergy and Infectious Diseases (NIAID), one of the National Institutes of Health, has awarded a contract to the University of Washington (UW) to use systems biology approaches to comprehensively analyze and model the virus-host interactions and cellular response networks that are induced or altered during the course of acute respiratory virus infection.
AI Research
Supplement Launched At Successful Influenza Conference: Milestone Influenza Publication By Elsevier Journal Vaccine
10/17/08 Medical News Today--Last month during an influenza conference organized by the European Scientific Working Group on influenza (ESWI), the Elsevier journal Vaccine released a supplement dedicated to influenza vaccines (http://www.sciencedirect.com/science/journal/0264410X). This publication provides a comprehensive, state-of-the-art overview on influenza vaccines and was supported by the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA).
AI Research
Pandemic Preparedness
UN System Influenza Coordinator warns of gaps in flu readiness
10/18/08 Pharma Marketletter--Although most countries surveyed by the UN System Influenza Coordinator, David Nabarro, are making progress in controlling avian influenza, many Asia-Pacific nations are lagging in terms of coping with the economic and social consequences of a human pandemic. Speaking to the UN's IRIN news network, Dr Nabarro said: "in general, the situation is that countries are getting much more on top of the bird flu. I'm impressed with progress, but I am saying a lot more needs to be done, particularly on multi-sectoral pandemic preparedness."
Pandemic Preparedness
China-Japan-South Korea joint exercise to deal with influenza
10/17/08 Xinhua--On October 16 and 17, China, Japan and South Korea will hold a joint influenza pandemic contingency desktop exercise in Seoul, capital of South Korea.
Pandemic Preparedness
Pandemic Flu Models Improve Food, Quarantine Strategies
10/18/08 Medical News Today--The 1918 flu pandemic killed more than 40 million people worldwide and affected persons of all age groups. While it is difficult to predict when the next influenza pandemic will occur or how severe it will be, researchers at the Georgia Institute of Technology have developed models to help organizations like the American Red Cross and Georgia Department of Education prepare emergency response plans.
Pandemic Preparedness
Flu Pandemic May Cost World Economy Up to $3 Trillion (Update3)
10/18/08 Bloomberg--A flu pandemic could kill 71 million people worldwide and push the global economy into a ``major global recession'' costing more than $3 trillion, according to raised estimates by the World Bank of a worst-case scenario.
Pandemic Preparedness
Insurers must prepare for worldwide pandemic threat
10/17/08 Insurance Times/UK--Insurers must prepare for a worldwide pandemic such as avian flu, Lloyd?s emerging risks teams has warned. A worldwide pandemic has historic recurrence rates of between 30 and 50 years and another catastrophe is likely to occur sometime in the future, the report says.
Pandemic Preparedness
Full Text of Articles follow ...
Regional Reporting and Surveillance
Workshop on Avian Influenza Organized in Qalqilyah
10/17/08 ARGUS--A local source reported that Jerusalem Open University, in cooperation with WHO, Qalqilyah Health Department, the Education District, and the Students? Union, has organized a workshop on Avian Influenza (AI) in Qalqilyah. The Head of the School Health and Health Education Section gave a presentation on modes of AI transmission and its prevention, stressing that no cases of AI have been reported in Gaza and the West Bank. He also indicated that the initiative is cooperating with WHO to control the disease and prevent its spread.
AI Research
Modeling the Economic Impact of Pandemic Influenza: A Case Study in Turkey
10/2008 Springerlink--[pdf full text]--Elcin Yoldascan1 Contact Information, Behice Kurtaran2, Melik Koyuncu3 and Esra Koyuncu3
(1) Faculty of Medicine, Department of Public Health, Cukurova University, 01330 Adana, Turkey
(2) Faculty of Medicine, Department of Clinical Bacteriology, Cukurova University, 01330 Adana, Turkey
(3) Faculty of Engineering and Architecture, Department of Industrial Engineering, Cukurova University, 01330 Adana, Turkey
Received: 28 August 2008 Accepted: 26 September 2008 Published online: 14 October 2008
Abstract Influenza pandemics have occurred intermittently throughout the 20th century and killed millions of people worldwide. It is expected that influenza pandemics will continue to occur in the near future. Huge number of deaths and cases is the most troublesome aspect of the influenza pandemics, but the other important trouble is the economic impact of the influenza pandemics to the countries. In this study, we try to detect the cost of a possible influenza pandemic under different scenarios and attack rates. We include the vaccination and antiviral treatment cost for direct cost and we add the work absenteeism cost to the calculations for indirect cost of influenza pandemics. As a case study, we calculate the economic impact of pandemic influenza for Turkey under three different scenarios and three different attack rates. Our optimistic estimation shows that the economic impact of pandemic influenza will be between 1.364 billion dollars and 2.687 billions dollars to Turkish economy depending on the vaccination strategies.
Quid Novi
Indonesia: poultry die-off reported in Karanganyar District, Central Java
10/17/08 ARGUS--A local source reported that an unspecified number of chickens died suddenly in Manggung village (Cangakan sub-district, Karanganyar district, Karanganyar regency, Central Java province). Rapid testing confirmed the presence of avian influenza. Local authorities are going to vaccinate poultry and monitor the area for any sign of illness among residents. The head of the local livestock agency also noted there is inadequate funding from the regional government to handle avian influenza cases, which required them to work with the private sector. The source did not mention culling procedures.
Vaccines
MedImmune Licenses Reverse Genetics Technology to Hungary´s Omninvest
10/17/08 Network Medica--MedImmune announced that it has licensed its reverse genetics technology to Omninvest, a Hungarian research and manufacturing company, to support the development and construction of new vaccine strains to produce non-live human influenza vaccines.
Reverse genetics is a method by which viruses such as influenza can be generated from segments of DNA.
For potential pandemic influenza vaccines, reverse genetics is useful technology because the process does not require manufacturers to work directly with potentially highly infectious pandemic strains, such as H5N1, only with segments of the virus's genome.
This is the second agreement of this kind that MedImmune signs in the third quarter of 2008. No financial details of the agreement were reported.
Science and Technology
USGS Q & A
10/17/08 USGS Website--
Question: Where are the most likely routes that H5N1 could enter the United States through migratory birds?
Answer: Migratory birds usually travel the same routes in their annual migrations. In the Northern Hemisphere, birds begin moving south during August and September of each year. North American migratory birds that over-winter in Asia may come into contact with potentially infected domestic or wild birds during the winter months. In spring, migratory birds will migrate north to their breeding grounds in eastern Russia, Alaska, and Canada. Migratory birds infected with the HPAI H5N1 returning from Asia can potentially interact with other North American wild birds as they co-mingle on the breeding grounds.
Source of this FAQ:
http://www.nwhc.usgs.gov/disease_information/avian_influenza/index.jsp
Quid Novi
Germany: 3 Cases of H5N3 Detected at Zoo
10/17/08 ARGUS--Regional media report 3 cases of H5N3 avian influenza at a zoo in Leipzig. According to Sachsen?s Ministry for Social Affairs, 2 ducks and 1 goose were diagnosed with the virus during a routine check-up. The zoo?s administration announced that the affected animals were culled on the recommendation of the district veterinarian. Since wild birds are the presumed source of contamination, all of the zoo?s birds must remain in their cages. A spokesperson for the zoo stated that the birds in question probably contracted the virus at a nearby pond. Results of testing conducted on all of the zoo?s other birds were negative for avian influenza. According to the zoo?s administration, a second round of testing will take place within the next few days.
Article URL(s)
http://www.lvz-online.de/aktuell/content/76007.html
Quid Novi
Responses to Avian Influenza and State of Pandemic Readiness Fourth Global Progress Report
10/2008 UN [download full text pdf]--It is now nearly five years since H5N1 highly pathogenic avian influenza (HPAI) spread across Southeast Asia and then to the rest of Asia, Europe and Africa. The rapid spread, significant socioeconomic losses, numerous human deaths, and the potential threat of a human pandemic influenza triggered concerted global action to control the disease and prepare for the next influenza pandemic.
Since then around US$2.7 billion has been pledged and US$1.5 billion disbursed globally by the donor
community to fight against HPAI and to aid pandemic preparedness. In addition, proportionately enormous
funding and human resources have been expended by countries affected and at?risk of HPAI and in preparing for a pandemic. The threat posed over the last 5 years has mobilized an unprecedented coming together of the animal health, human health, disaster preparedness and communication sectors to work in a cross discipline, cross sector and cross boundary way. At the last International Ministerial Conference on Avian and Pandemic Influenza held in New Delhi (4?6 December 2007) it was acknowledged that significant progress made towards eliminating HPAI in many infected countries, but serious concerns remained.
In response to requests from participants at the New Delhi Conference, the United Nations System Influenza
Coordinator (UNSIC) and the World Bank have produced this Fourth Global Progress Report on Responses to Avian Influenza and Pandemic Readiness. The report i) describes international financial assistance provided to date; ii) assesses national capacities to respond to HPAI and prepared for the next influenza pandemic; iii) analyses implications of this progress for animal and human health and iv) recommends some key next steps. It focuses on progress with responses to avian influenza and with pandemic preparedness between June 2007 and June 2008, but also looks back over the last three years.
Information was provided by national authorities from 148 countries that responded to an UNSIC survey questionnaire supplemented by with case studies, interviews and reports from UN system bodies and other partners. The information on donor pledges, commitments and disbursements has been collected by the World Bank via a donor polling exercise. A global analysis of the situation now in mid to late 2008 indicates fewer outbreaks in poultry, fewer newly infected countries, fewer human cases and fewer deaths compared to the same period in 2006 and 2007. Over 50 of the 61 countries that have experience an H5N1 outbreak, have successfully eliminated the disease.
However, the virus remains entrenched in several countries and the threat of further outbreaks of HPAI in
poultry (and sporadic cases in humans) persists. The threat of an influenza pandemic remains unchanged. While
these findings suggest that HPAI strategies are successful when properly implemented, they also highlight that
sustained vigilance and continued investment is needed in both surveillance and capacity to respond to HPAI.
Significant progress has been made during the last year, and there is now near global awareness of the issue
and the need to enable nations and communities to prevent, prepare and be able to respond to HPAI and
pandemic influenza. Surveillance capacities have improved significantly over the past 3 years and there is now
greater awareness and more incentives for reporting. Significant efforts are still needed in biosecurity and
fundamental behavior change by poultry owners/ producers remains a long term objective. There is still the
need for high political commitment to improve and invest in animal and public health systems. Many countries
have made substantial progress for their national pandemic preparedness; in some regions sophisticated
advancements continue to be made in deepening and developing preparations. However, many of the plans
have not yet been fully endorsed or made operational ? in particular at the local level and preparations in
sectors beyond health need to be strengthened. Whilst the threat remains, it can be concluded that the world
is significantly better prepared to respond to HPAI and to mitigate the impacts of the next influenza pandemic.
Need remains for continued advocacy, support and monitoring of preparations to ensure the capacity to
respond to the threat of HPAI (and in many cases other zoonosis) is strengthened and made sustainable. In
addition, it is essential to review, adapt and update pandemic preparations which will not only be of benefit in
the event of pandemic but for the general resilience of a country against other emergencies.
With the threat of HPAI came an increased awareness of health threats at the animal?human?interface, and of
the importance of a multi?sectoral response. This better understanding needs to be sustained and advanced:
During 2009, the world?s nations should agree on ways to better prevent, prepare and respond to the health,
social, economic and political impacts of pandemics and emerging infectious diseases at the at the animalhuman?
ecosystem?interface.
9
Regional Reporting and Surveillance
UNICEF: Raising awareness of bird flu in Myanmar
10/17/08 UNICEF--[link to short video on story] More than 60 health and livestock professionals are now ready to implement their communication workplan on avian influenza, which was drafted during a recent three-day training session held in Nyaung Shwe Township, Shan State.
The plan aims to make a significance contribution towards combating the threat of bird flu here in an area that is at high risk for a potential outbreak. Nyaung Shwe is close to a wetland wildlife sanctuary located on a major north-south migration path for birds.
Improving communication skills
The training was organized in collaboration with the Ministry of Livestock and Fisheries, the Ministry of Health, local authorities and UNICEF to equip front frontline communicators with skills in disseminating avian influenza messages to families and community members.
UNICEF has been designated as UN focal point for avian influenza risk communication, and the Government of Japan has provided financial support of $1.9 million for this communication effort.
In March 2006, the Ministry of Livestock and Fisheries reported the first outbreak of the disease among chickens in central Myanmar. On 18 November 2007, the country saw its first reported human case in a seven-year-old girl.
?Preventive messages?
?This training is very important, because I learned a lot on communication approaches that I was not aware of before,? said one of the participants, livestock official Than Naing Soe, adding that he already had technical knowledge about avian influenza but did not have expertise in communications.
?The training gives us the opportunity for the best combination of our professional and communication skill, which will result in delivering preventive messages effectively to the community,? he noted.
At the training session, participants learned essential communication skills through active group discussion and role playing.
Access to information
Following the training, an awareness-raising presentation on prevention of avian and pandemic influenza was held at the heart of the Inle wetland. More than 400 people attended.
Such public talks significantly enhance the dissemination of prevention messages to communities. Posters in local ethnic languages, pamphlets, booklets for children, and TV and radio spots on key messages have also been produced and distributed to help prevent bird flu in Myanmar.
The need for such measures is clear: According to a 2006 study on poultry rearing and other practices pertaining to avian influenza, 65 per cent of respondents in Myanmar lacked access to information about the disease and how to prevent it.
Pandemic Preparedness
UN System Influenza Coordinator warns of gaps in flu readiness
10/18/08 Pharma Marketletter--Although most countries surveyed by the UN System Influenza Coordinator, David Nabarro, are making progress in controlling avian influenza, many Asia-Pacific nations are lagging in terms of coping with the economic and social consequences of a human pandemic. Speaking to the UN's IRIN news network, Dr Nabarro said: "in general, the situation is that countries are getting much more on top of the bird flu. I'm impressed with progress, but I am saying a lot more needs to be done, particularly on multi-sectoral pandemic preparedness."
One major issue identified in the course of simulations aimed at testing the readiness of national government agencies, has been that health service planning, for coping with high absenteeism rates among hospital personnel, has not taken into account likely disruption to other emergency services or to the economy as a whole.
The UNSIC in the Asia-Pacific region, working with the Thailand-based Asian Disaster Preparedness Center and Kenan Institute Asia, has produced a book, titled: Simulation exercises on influenza pandemic responses in the Asia-Pacific region, to be distributed at the Sixth International Ministerial Conference on Avian and Pandemic Influenza in Egypt, in late October. Dr Nabarro explained that it is designed to encourage national authorities to test their pandemic preparedness through simulations.
Japan builds 48B yen vaccine stockpile
Japan recently expanded its Ministry of Health, Labor and Welfare budget to include 70.5 billion yen ($699.2 million) for measures against infectious diseases, including a new strain of influenza (Marketletter 15 September). Of this, 48.2 billion yen was allocated to creating a stockpile of oral anti-influenza products such as Swiss drug major Roche's Tamiflu (oseltamivir), UK-headquartered pharmaceutical giant GlaxoSmithKline and Australian drug development firm Biota Holdings' Relenza (zanamivir) and a pre-pandemic vaccine, as well as the promotion of R&D on new therapies.
Possible advanced immunization with MF59
One issue is the optimal vaccination of the population in the event of an outbreak of human-to-human transmitted avian flu. In the event that millions of people become infected, inoculating emergency services personnel is unlikely to be sufficient. Research presented at the Third European Influenza Conference in Portugal indicates that individuals immunized six years earlier with an MF59-adjuvanted H5N3 vaccine responded quicker to an H5N1 (clade 1) vaccine containing the same proprietary ingredient. The study's lead investigator, Iain Stephenson of Leicester University, UK, said this would allow a proactive approach of part-immunizing the public (Marketletter September 29). The MF59 adjuvant was developed by Switzerland's Novartis.
Regional Reporting and Surveillance
African Countries Covenene to Determine Effectiveness of Preventive Measures against AI Epidemic
10/17/08 ARGUS--A multinational source reports that [unspecified] members of the African economic and monetary community commenced a 3-day meeting on 15 October in Douala, Cameroon to take preventive measures against an AI ?epidemic". Reportedly, the meeting will reinforce national capabilities and establish rapid response and coordinated mechanisms in the event of an AI outbreak. Participants also aim to address prevention methods against infections of highly pathogenic avian influenza (HPAI) and promote the importance of a cross-border fight against the disease. According to the source the FAO also recommended that the member countries test the effectiveness of their national plans before an actual outbreak occurred.
Article URL(s)
http://gaboneco.com/show_article.php?IDActu=10534
Regional Reporting and Surveillance
Pakistan: Butchers play havoc with public health
http://thepost.com.pk/IsbNewsT.aspx?dtlid=187799&catid=17
"The butchers also melt the fat of animals in their shops, and the emerging smell is so acrid as cannot be expressed in words. The butchers at these meat shops, usually in half-naked attires, are abusive towards the residents whenever they dare to complain," said Mohammad Alam, a resident.
Mohammad Sarwar, a flat renter in the market says: "The ground floor of their building is occupied by many meat-sellers, who slaughter the animals inside their shops. The blood and other animal waste are disposed through the sewer lines, causing frequent choking of the sewers. Consequently, the filthy water and blood overflows in the compound posing sheer health hazard to the residents, particularly the children."
"The blood and filth accumulated underground becomes a source of breeding rats and other insects, as a result of which the building foundations are deteriorating fast besides creating sanitary problems," said another tenant Murtaza Hussain.
At times, the building presents the look of an animal farm as the butchers load and unload animals from the trucks inside the compound and tie them with the pillars, he added.
"The butchers have virtually turned their shops into slaughterhouses in connivance with the authorities concerned. The hygiene conditions at these shops are too poor," said Abdul Haq, a civil servant residing in the locality.
Furqan Asghar, a businessman, said huge quantities of mutton and beef are sold at the Peshawar Morr market. As the meat remains hanging outside the butcher shops till late into night it is impossible for mutton or beef to stay fresh for that long and that too in the open, he added.
"We apply our forefathers' methods; do not wash it and the meat will never stink and remain fresh for 24 hours. Though many butchers keep deep freezers for storing meat; however, usually what remains unsold is purchased by the marriage halls and restaurants," said one butcher Rana Ramzan. Like meat sellers, poultry sellers are also playing their role in debasing the area environment. The poultry stock, mainly live chicken, is stored in bulk without meeting the required hygiene standards.
"The respective farms, governing bodies and the city administration must ensure that the poultry stock being marketed is hygienic and germ-free. The government should arrange random sample tests to see if it is free of SARS or bird flu viruses," said Mohammad Hafeez, a shopkeeper. Atif Manzoor, a resident, said the CDA functionaries should conduct a surprise visit to the market and see the butchers' highhandedness themselves and take the necessary measures to ensure observance of the sanitary and hygiene standards.
Pandemic Preparedness
China-Japan-South Korea joint exercise to deal with influenza
10/17/08 Xinhua--On October 16 and 17, China, Japan and South Korea will hold a joint influenza pandemic contingency desktop exercise in Seoul, capital of South Korea.
Participants include experts from the Center for Disease Control and Prevention of the three countries as well as observers from the World Health Organization headquarters and countries of Western Pacific regions, according to Beijing Times' report.
China, Japan and South Korea are neighbors with frequent trade contacts. Outbreaks of epidemic diseases could easily spread cross borders. As a result, to deal with pandemic influenza in the area, it is essential for the three countries to strengthen coordination and cooperation.
AI Research
Funds to Study How AI Evades Antiviral Responses
10/17/08 The Poultry Site--The National Institute of Allergy and Infectious Diseases (NIAID), one of the National Institutes of Health, has awarded a contract to the University of Washington (UW) to use systems biology approaches to comprehensively analyze and model the virus-host interactions and cellular response networks that are induced or altered during the course of acute respiratory virus infection.
This new research program will be led by Dr. Michael Katze, UW professor of microbiology and associate director of the Washington National Primate Research Center. Katze will head a multidisciplinary team of researchers from the UW, University of Wisconsin-Madison, University of North Carolina, Oregon Health & Science University, and Pacific Northwest National Laboratory in Richland, Washington.
The team will receive about $17 million over five years for the development of computational models of the host response to H5N1 avian influenza virus ("bird flu") and severe acute respiratory syndrome (SARS) associated coronavirus, two highly pathogenic respiratory viruses that represent significant threats to human health and the global economy. These models will be premised on the acquisition of large datasets through high-throughput genomic, proteomic, and metabolomic technologies, using samples from a variety of biological model systems.
The goal is to generate predictive models that can be experimentally validated in an in vivo setting and which will reveal whether influenza and SARS viruses use common strategies to regulate cellular signaling circuitry and evade antiviral defenses. In addition, these large datasets, as well as the modeled interpretations, will be made freely available to the research community via the Internet, thus providing powerful resources for other scientists exploring viral diseases.
Systems biology provides global views, or models, of the vast numbers of molecular components and interactions that make up complex functions inside living things. The UW research program is unusual in that, in addition to the traditional simple cell culture models, it will also use mouse and nonhuman primate infection models. These animal models will allow researchers to study disease-relevant complexities, Such information is likely to help translate findings into new clinical initiatives, including new targets for therapeutic intervention. Understanding the initial, innate, antiviral response also has potential in developing alternative vaccine strategies, where such early signals are exploited to induce more robust adaptive immune outcomes.
"This program is distinctive in its comparison of different respiratory viruses and the incorporation of animal models," said Katze. "There are few antiviral drugs available and none that work against diverse types of viruses. It would be extremely beneficial to have information that could lead to the rational design of a drug that could be used against a range of different viruses."
Pandemic Preparedness
Pandemic Flu Models Improve Food, Quarantine Strategies
10/18/08 Medical News Today--The 1918 flu pandemic killed more than 40 million people worldwide and affected persons of all age groups. While it is difficult to predict when the next influenza pandemic will occur or how severe it will be, researchers at the Georgia Institute of Technology have developed models to help organizations like the American Red Cross and Georgia Department of Education prepare emergency response plans.
"The models are flexible so that multiple scenarios can be investigated to see which options meet a certain goal," said Pinar Keskinocak, an associate professor in Georgia Tech's H. Milton Stewart School of Industrial and Systems Engineering (ISyE). "This goal can be different for various groups, such as serving the most people given the availability of limited resources or minimizing the number of people infected while not negatively affecting businesses."
Details of the models, developed with ISyE associate professor Julie Swann and graduate student Ali Ekici, will be presented on October 12 at the Institute for Operations Research and the Management Sciences Annual Meeting.
Knowing how many people will need food, how many food distribution facilities will be necessary, where the facilities should be located and how the resources should be allocated among the facilities is very important, according to Marilyn Self, who is the manager of disaster readiness for the Metropolitan Atlanta Chapter of the American Red Cross. Self has been collaborating with Georgia Tech researchers on this project.
"These models have provided solid food distribution data that has helped us formulate the questions we have to ask and the decisions that we have to make about food distribution during a pandemic on a local and statewide level," said Self.
The Georgia Department of Education is using Georgia Tech's models to investigate whether or not schools should be closed during a pandemic.
"Closing schools affects both families and businesses because parents will have to stay home and take care of children," said Garry McGiboney, associate state superintendent at the Georgia Department of Education. "We have to worry about important emergency workers like hospital staff members and law enforcement officers not being able to work because they have to tend to their children because schools are closed."
To estimate the number of meals required for a given area or determine if closing schools would be beneficial, the researchers first needed to determine how many people and/or households would be infected. To do this, they constructed a generic disease spread model, which described how the influenza disease would spread among individuals.
The researchers used U.S. Census Bureau tract data - including household statistics, work flow data, classroom sizes and age statistics - to test the model. Crowded areas, including Atlanta and its suburbs, were always affected around the same time regardless of where the disease initiated. However, the time required for the disease to spread to rural areas depended on where the disease started.
With this information, the Georgia Tech researchers used the disease spread model as a forecasting tool to calculate the number of meals that would be required in metropolitan Atlanta during a flu pandemic. They tested three major scenarios: feeding every household with an infected individual (someone symptomatic or hospitalized), every household with an infected adult, or every household with all adults infected.
The simulations showed that the 15 counties surrounding Atlanta would require approximately 2.2 million, 1.4 million or 150,000 meals per day for the respective scenarios during the peak infection period. For the entire pandemic, the number of meals would reach 62, 38 or 3.8 million for the three scenarios respectively.
The researchers also determined the number of meals that would be necessary if only those households that fell below a certain income level were fed. The results showed that 200,000; 120,000 or 14,000 meals per day would be required for the respective scenarios during the peak infection period in that case.
Interventions such as voluntary quarantine or school closures could also affect food distribution by changing the number of infected individuals.
"Voluntary quarantine means that if an individual is sick in a household, everyone in that household should stay home," explained Keskinocak. "However, we realize that not everyone will follow this rule, so the model assumes that only a certain percentage of infected individuals will stay home."
The researchers investigated the effects of voluntary quarantine on disease spread, as well as the best time to begin the quarantine and how long it should last.
The results showed that the number of people infected at the peak time and the total number of individuals infected decreased as the length of the quarantine was extended, but there was a diminishing rate of return. The researchers determined that an eight-week quarantine was the most effective in terms of reducing the number of individuals infected during the peak time if it was implemented at the beginning of the fourth week.
"These results are important because during a pandemic, communities have limited resources, including food and volunteers to distribute the food," noted Swann. "If fewer people require the resources, especially during the peak time period, organizations like the American Red Cross can meet the needs of more people."
The researchers also compared the two interventions - quarantine and school closure. The results showed that closing schools reduced the number of people infected with the virus. However, a four-week voluntary quarantine was found to be at least as effective as a six-week school closure for reducing the percentage of the population infected with the virus and the number of people infected at the peak time.
The Georgia Department of Education and the Metropolitan Atlanta Chapter of the American Red Cross have used the models to gain insight into the best ways for their organizations to respond to a flu pandemic.
"Running all of these different scenarios has helped us realize that we will have a lot more people to feed in metropolitan Atlanta during a pandemic flu than we imagined. The models have provided us with a realistic idea of where we'll need to locate community food distribution facilities and how many we might need to have given certain assumptions and decisions," said Self.
The researchers plan to conduct future work in two areas - developing models for other states and extending the model to also include vaccine distribution. The model may also be useful for other purposes such as estimating hospital capacity needs, according to Keskinocak.
"While we hope that a pandemic never occurs, our models will help Georgia and other states across the United States prepare response plans for the potential," added Keskinocak.
AI Research
Supplement Launched At Successful Influenza Conference: Milestone Influenza Publication By Elsevier Journal Vaccine
10/17/08 Medical News Today--Last month during an influenza conference organized by the European Scientific Working Group on influenza (ESWI), the Elsevier journal Vaccine released a supplement dedicated to influenza vaccines (http://www.sciencedirect.com/science/journal/0264410X). This publication provides a comprehensive, state-of-the-art overview on influenza vaccines and was supported by the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA).
Influenza, commonly known as (the) Flu, continues to be a major cause of mortality, and vaccination remains the mainstay of efforts to prevent and control the disease. Flu spreads around the world in seasonal epidemics, killing millions of people in pandemic and hundreds of thousands in non-pandemic years.
In their editorial in the supplement, Marie Paule Kieny and Keiji Fukuda of the World Health Organization (WHO) specifically address the pandemic influenza vaccine challenge and stress: "that an efficient response at the outset of an influenza pandemic will depend on the robust global surveillance systems implemented by the WHO's Global Influenza Surveillance Network".
The Vaccine supplement focuses entirely on new developments in the area of human influenza vaccines, by bringing together key experts from many of the relevant disciplines in this field. "It is a highly valuable and very timely publication and I am convinced that it will be well-read across the world" stated Co-Guest Editor Gregory Poland, from the Mayo Clinic College of Medicine in Rochester, USA.
The 3rd European Influenza Conference in Portugal was organized by ESWI and had a scientific program including every aspect of influenza prevention, control and treatment. Beyond the science, the conference also offered sessions and workshops for governmental representatives and opinion leaders in healthcare. ESWI President and Co-Guest Editor of the Vaccine supplement Ab Osterhaus, from the Erasmus Medical Centre in Rotterdam, the Netherlands, considered the meeting a great success and said: "Communication and cooperation between scientists, policy makers and healthcare professionals is key to significantly reducing the burden of influenza, and the conference facilitated that process perfectly".
Regional Reporting and Surveillance
Indonesia: Ag Ministry outlines poultry plans
10/17/08 Jakarta Post--Jakarta will clear out smaller-scale poultry industries by 2010 as part of its efforts to prevent more deaths from bird flu, agricultural authorities said Tuesday.
Muhammad Azhar, the Agriculture Ministry's coordinator for bird-flu control, said only six poultry-processing plants located on Jakarta's outskirts would be eligible to distribute chicken meat to traditional markets. Two years ago the city issued a poultry-restriction bylaw to enable such efforts.
"We hope by 2010 no live chickens will be sold at traditional markets. It's not an easy job for Jakarta, with its huge population and high density, to get rid of poultry industries, since these small-scale enterprises are the main income for many people. But this challenging target has to be met."
The planned restructuring of chicken farms and processing plants in the capital is apparently in line with key points in the 2007 much-praised bylaw on poultry restriction. Critics have only pointed out the government's inattention to enforcing the law.
Azhar, however, was not clear whether the city would provide compensation or alternative ventures for current chicken processing business owners who will be forced to close down their businesses.
The Jakarta Husbandry and Fisheries Agency estimated in 2007 about 700 commercial poultry farms were raising and slaughtering chickens in the city. Two-thirds of them were located in Central and East Jakarta.
Azhar said the 2010 target was part of Jakarta's long-term plans to prevent the spread of bird flu in the capital. Out of 112 confirmed deaths from the bird-flu virus crossing over to the human population, more than 20 occurred in Jakarta.
The city also plans to work closely with neighboring cities like Tangerang in Banten and Bekasi in West Java. Both supply large quantities of live chickens and meat to Jakarta.
"Chicken consumption in Jakarta is quite high. It's around 700,000 chickens every day and most are raised outside Jakarta," he said.
Azhar offered his comments during a workshop for journalists receiving grants from the Food and Agriculture Organization to work on news stories about bird flu.
Separately on Tuesday, delegates from Tajikistan -- jointly hosted by the United Nations Children's Fund and John Hopkins University -- visited two Banten schools in Serang and Pandeglang to take a look at how teachers discussed avian influenza in their classrooms.
Basil A. Safi from John Hopkins said the study excursion was aimed at looking at Indonesian experiences with handling bird flu during the last three years.
"Learning about experiences here can help Tajikistan better prepare for the future," said Safi.
"Tajikistan itself has yet to have a case of avian influenza, either in birds or humans. But, since many birds migrate from Asia to Africa, the country is considered to be at high risk," he said, adding they had led a similar tour in Egypt in June.
The delegates visited a state elementary school, SDN Cipocok Jaya 1, in Serang and an Islamic boarding school, Pesantren Daar el-Falaah, in Pandeglang.
They watched how teachers explained the lesson on how to prevent avian influenza to their students in a fun way.
The teachers conveyed essential prevention practices. Children learned to wash their hands before meals and to report any dead poultry immediately to neighborhood community leaders.
Pandemic Preparedness
Flu Pandemic May Cost World Economy Up to $3 Trillion (Update3)
10/18/08 Bloomberg--A flu pandemic could kill 71 million people worldwide and push the global economy into a ``major global recession'' costing more than $3 trillion, according to raised estimates by the World Bank of a worst-case scenario.
A slump in tourism, transportation and retail sales, as well as workplace absenteeism and lower productivity caused by a ``severe'' outbreak, may cut global gross domestic product by 4.8 percent, the Washington-based bank said in an internal report updated last month and obtained by Bloomberg News today. Economic modeling by the bank in June 2006 estimated GDP would drop by 3.1 percent, or about $2 trillion.
The spread of the H5N1 avian-influenza strain across Asia, Africa and Europe prompted the development of vaccines and the slaughter of poultry from Indonesia to the U.K. Measures to avoid infection would generate most of the costs, said the report, which used simulations to underline the importance of global preparations for a pandemic sparked by bird flu. Human cases of H5N1 infection have fallen by half this year as controls of outbreaks in poultry improve.
``Even with such efforts, an eventual human pandemic at some unknown point in the future is virtually inevitable,'' Andrew Burns, Dominique van der Mensbrugghe and Hans Timmer, economists at the bank, wrote in the report.
Pandemic Threat
The threat of a flu pandemic, raised by the World Health Organization in 2003, persists because the H5N1 virus is entrenched in parts of Asia and Africa, the World Bank said. Such a contagion would start when a novel influenza A-type virus, to which almost no one has natural immunity, emerges and begins spreading. Experts believe that the so-called 1918 Spanish Flu pandemic, which may have killed as many as 50 million people, began when an avian flu virus jumped to people.
``Because such a pandemic would spread very quickly, substantial efforts need to be put into place to develop effective strategies and contingency plans that could be enacted at short notice,'' the economists said. ``Much more research and coordination at the global level are required.''
The World Bank, which funds projects to alleviate poverty, is working with developing countries to improve hospitals and laboratories, enabling better surveillance and management of avian flu, and to prepare for a possible pandemic.
At least 387 people in 15 countries have been infected with the H5N1 virus since 2003, according to the World Health Organization. Almost two of every three cases were fatal. So far this year, 36 cases have been reported, down from 74 in the first 10 months of 2007.
Eliminating Disease
More than 50 of the 61 countries that have experienced an H5N1 outbreak in poultry in the past five years have successfully eliminated the disease, according to the United Nations.
In Vietnam, one in eight domestic fowl died from the disease or were culled to prevent its spread in 2004. If the virus were to become as entrenched in poultry flocks globally, it would trim 0.1 percent from global GDP and as much as 0.7 percent in Latin America and the Caribbean, according to the World Bank report.
World leaders will be asked to donate about $500 million -- the amount required annually to fund bird flu control efforts and prepare for a pandemic -- when they meet Oct. 24 to 26 in Sharm El-Sheikh, Egypt, for the Sixth International Ministerial Conference on Avian and Pandemic Influenza, a UN official said.
`Massive' Cost
``The potential cost of a human pandemic is massive compared with the quite modest sums required to ensure pandemic preparedness,'' said David Nabarro, UN senior coordinator for avian and pandemic influenza, in a telephone interview from Geneva today. The funds ``must be coupled with political commitment to ensure that all parts of government, civil society and the private sector are prepared to keep functioning in the event of a pandemic.''
A ``mild'' pandemic, similar to the Hong Kong flu of 1968- 69, could kill about 1.4 million people and cut global GDP by 0.7 percent in the first year, according to the World Bank's latest estimates.
Seasonal flu epidemics result in 250,000 to 500,000 deaths annually, mostly among those older than 65 years, according to the World Health Organization.
A ``moderate'' pandemic characteristic of the 1957 Asian flu could kill 14.2 million people and shave 2 percent from the global economy in the first year, the bank said. Some forecasts have estimated deaths during a ``severe'' pandemic at as high as 180 million to 260 million, the report said.
Changed Behavior
Changed behavior by individuals in the face of a pandemic, such as reduced air travel in order to avoid infection in the enclosed space of a plane, avoiding travel to infected destinations and spurning restaurants and mass transport, could account for 60 percent of costs during a pandemic, the bank said.
``People's efforts to avoid infection are five times more important than mortality and more than twice as important as illness'' in terms of economic impact, the authors said. In the worst-case, they assumed that air travel would slump by 20 percent for the whole year, and that tourism, restaurant meals, and use of mass transportation would decline by the same amount.
``Given the tremendous uncertainties surrounding the possibility and eventual nature of a pandemic inflation, these simulations must be viewed as purely illustrative,'' the report said. ``They provide a sense of the overall magnitude of potential costs. Actual costs, both in terms of human lives and economic losses, may be very different.''
Pandemic Preparedness
Insurers must prepare for worldwide pandemic threat
10/17/08 Insurance Times/UK--Insurers must prepare for a worldwide pandemic such as avian flu, Lloyd?s emerging risks teams has warned. A worldwide pandemic has historic recurrence rates of between 30 and 50 years and another catastrophe is likely to occur sometime in the future, the report says.
Trevor Maynard, emerging risks manager, said: ?In some respects business leaders have to ensure that they are not the odd one out, particularly given the large volume of information that is available to help with planning.
?You do not want to be the one business that has not taken adequate steps to prepare contingency plans in the case of a pandemic and see your business perform worse than your peers.?
The report, called ?Pandemic ? Potential Insurance Impacts?, claims a worldwide pandemic could devastate the global GDP by up to 10 per cent ? leaving insurers facing heavy losses.
The most devastating pandemic in modern history was the Spanish Flu, between 1918 and 1920, which killed up to 100million people, mostly fit and healthy people.
He added: ?The significant message is that society should not optimise to one particular scenario as a worst case. Much has been said of the 1918 Spanish Flu epidemic, which is said to have killed up to 100 million people worldwide.
?While Avian Flu is seen as the most likely next pandemic, we have to ensure we are prepared for other types of pandemics that may require different responses and pose different challenges ?some of which may well have higher rates of mortality than flu.?
