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Avian Influenza Daily Digest
December 8, 2008 17:15 GMT
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60-Day HPAI H5N1 Outbreak Map
2008 WHO Confirmed Human Cases HPAI H5N1
AI Daily Digest Archive
Article Summaries ...
Quid Novi
India: Reuters video report, culling in Assam India
India: Bird Flu Alert in Tripura?and Mizoram
Indonesia: chicken die-off repoerted in West Sumatra
Regional Reporting and Surveillance
Nigeria: Director of Livestock denies report of HPAI in Gombe
12/8/08 RSOE EDIS--The Director of Livestock and Pest Control in Nigeria?s Federal Ministry of Agriculture and Water Resources, Dr Junaid Maina, has refuted a report that unidentified dangerous strain of Avian Influenza (Bird flu), much deadlier than HN51, was discovered in Gombe in northern Nigeria. ?As far as I know, there has been no outbreak in the country since July,? Maina told journalists on Friday in Abuja. ?We?ve contacted all the relevant agencies from the National Veterinary Research Institute (NVRI) in Vom, near Jos as the diagnostic confirmatory body and it said no sample was diagnosed by the laboratory. ?The Gombe State director of veterinary medicine and all the zonal offices and the desk officer who was claimed to have confirmed the diagnoses refuted such claims,?? he said. Maina said that it was only his office as the national chief veterinary officer that could make such pronouncements through the office of the Minister for Agriculture and Water Resources after all confirmation with relevant agencies. He said the report could be referring to the last outbreak in July 2008 after a random bird sample collection from various markets in Gombe showed a positive but non-deadly result in one duck. He said that since the confirmation of the Highly Pathogenic Avian Influenza (HPAI) in February 2006, the Nigerian government had demonstrated a high political will by instituting various measures directed towards the various strata of the society in the control and eradication of the disease.
Regional Reporting and Surveillance
India likely to ask Bangladesh to contain bird flu
12/8/08 Financial Express--New DelhiIndia is likely to ask Bangladesh to help contain the spread of bird flu in the region. This deadly disease related to poultry birds recently occurred in Assam, which borders Bangladesh. Indian authorities feel that the deadly virus has entered the country from Bangladesh
Regional Reporting and Surveillance
India: Ban on poultry transportation in Assam as bird flu spreads
12/8/08 Farming UK--With bird flu spreading to at least three districts since it was first detected in a village in Hajo block in Kamrup (Rural) district in November, authorities in Assam have imposed a ban on inter-district transportation of poultry.
Regional Reporting and Surveillance
India: Transmitters to unravel avian migration mystery
12/8/08 Express Buzz--BHUBANESWAR: For the first time, migratory routes of birds that throng the Chilika lagoon would be determined through satellite telemetry.
Regional Reporting and Surveillance
(Op/Ed) Indonesia's bird flu warrior takes on the world
12/8/08 Macau Daily--Sliding with short steps onto the stage in front of a crowd of students, academics and supporters, Indonesia's Health Minister Siti Fadilah Supari is in her element. Her hair swept up into the voluminous bouffant favoured by Indonesia's wealthy ladies, the bespectacled 57-year-old delivers her scalding critique of global injustice in soft, rounded Javanese vowels that frequently trail into a whisper.
Regional Reporting and Surveillance
Launch of West African Viral Surveillance Network
12/8/08 Tropika.net--Source Article: : International Consortium on Anti-Virals (see original article)--A new surveillance network has been launched that will facilitate collaboration in the fight against viral diseases across West Africa.
Regional Reporting and Surveillance
Indonesia: Sanglah hospital launches bird flu treatment ward
12/5/08 Jakarta Post--The island's largest hospital, RSUP Sanglah, now has a dedicated and fully equipped ward for treating patients with bird flu, opened Thursday with a modest pemlaspas (purification) ceremony.
Regional Reporting and Surveillance
New-strain influenza (Op/Ed)
12/5/08 Asahi--The government's basic stance on combating an outbreak of potentially disastrous influenza caused by a new strain of virus is about to undergo a major overhaul.
Regional Reporting and Surveillance
The G-7 promises to improve the systems of rapid alert of pandemics and bioterrorism
12/5/08 Europa Press, contributed by email--The ministers of Health of the countries of the G-7 (The United States, Japan, Canada, Germany, United Kingdom, France and Italy) and of Mexico promised today to improve the international systems of early alert and of response to the threats of the chemical, biological terrorism and radionuclear and to the pandemic influenza. They agreed besides the fact that the closing border is not the best method to stop the spread and contagion of a pandemic and that enclosed might aggravate the situation.
Regional Reporting and Surveillance
India: India corn end lower as bird flu hits demand
12/5/08 Reuters--Indian corn futures ended weak on Friday as an outbreak of bird flu in the north eastern state of Assam hit demand, analysts said.
Regional Reporting and Surveillance
ECDC Influenza News
12/5/08 ECDC--ECDC Influenza news for week 49 (November 4th) are now published on the ECDC website. Epidemiological updates * Seasonal Influenza * Influenza activity in Europe continues to be low - Week 47, Week 48 will be posted on December...
Regional Reporting and Surveillance
Bhutan: Imposes Partial Ban on Poultry Products from West Bengal and Assam Provinces in India
12/5/08 ARGUS--Bhutan?s department of livestock has banned the import of frozen chicken and eggs from Assam and West Bengal provinces in neighboring India, due to the H5N1 avian influenza (AI) or ?bird flu? outbreak in those regions on 27 November. The import of day-old-poultry birds used for breeding was also banned, as it was passing through Guwahati [Assam, India]. According to an official at the livestock department, they have not imposed a ?blanket ban? on all Indian poultry products, but have increased precautionary measures.
Regional Reporting and Surveillance
Science and Technology
Antibodies still protect 1918 flu survivors-study
12/8/08 Today Zaman--Antibodies from survivors of the 1918 flu pandemic, the worst in human memory, still protect against the highly deadly virus, researchers reported on Sunday.The findings by a team of influenza and immune system experts suggest new and better ways to fight viruses -- especially new pandemic strains that emerge and spread before a vaccine can be formulated.
AI Research
Lithuania: Lithuanians get experimental bird flu vaccine
12/8/08 Baltic-course--Almost one hundred residents of Lithuania have been given an experimental vaccine for fighting bird flu, Radio Vilnius/ELTA informed. According to Lithuanian scientists, all of the participants of the medical test were volunteers. Medical professionals, involved in the research in Lithuania said that they cannot yet reveal much information about the results of the experiment. It was said that the vaccine came from Austria. The volunteers received two injections of the vaccine and later made notes on the way they felt and symptoms in a special journal. The test is to last for eight months. Even though it started only a few weeks ago, medical professionals claim they have enough volunteers. The virus, which originated in Asia, reached Europe in this decade. Over three hundred people have already died from it.
Vaccines
In the context of reporting on a bird die-off in Bafwasende, an international source reported that the provincial inspector of agriculture and livestock indicated that preliminary symptoms of the bird die-off do not appear to be Newcastle disease. Accordi
12/5/08 CDC/EID--[full text pdf]Human infection with the highly pathogenic avian influenza A virus (H5N1) was discovered in Hong Kong Special Administrative Region, People?s Republic of China, in 1997 (1?3). It has since been identified in other countries, primarily in Southeast Asia. Among 100 confirmed infected patients, 46 have died in Vietnam since 2003 (4,5). Severe viral pneumonia accompanied by diffuse alveolar damage develops in patients infected with influenza virus (H5N1) (6). High viral load causes intense cytokine reactions and inflammation (7). Clinical factors that might be associated with severity include age, delayed consultation, lower respiratory tract lesions, and leukopenia (4,8?10). However, few cases have reported which factors, including patient management, affect outcomes. Our study reviews the clinical courses of patients treated in Hanoi, Vietnam, and investigates the association between clinical findings and survival.
AI Research
Vaccine Makers Urge Speedy Accord on Pandemic Plan
12/5/08 ABC News--Drugmakers Urge End to 'Pandemic Fatigue' on Government's Part Governments need to overcome their "pandemic fatigue" and act quickly to finalize a response plan to potential flu threats, leading drugmakers said on Thursday. The pharmaceutical industry is "very close to ready" to respond to a potential outbreak by shifting seasonal flu vaccine production to more targeted pandemic ones, said Stephen Gardner of GSK Biologics.
Vaccines
Emerging infections: a perpetual challenge
12/5/08 Lancet--[request full text pdf] David M Morens, Gregory K Folkers, Anthony S Fauci Introduction: Emerging and re-emerging infectious diseases, and their determinants, have recently attracted substantial scientifi c and popular attention. HIV/AIDS, severe acute respiratory syndrome, H5N1 avian influenza, and many other emerging diseases have either proved fatal or caused international alarm. Common and interactive co-determinants of disease emergence, including population growth, travel, and environmental disruption, have been increasingly documented and studied. Are emerging infections a new phenomenon related to modern life, or do more basic determinants, transcending time, place, and human progress, govern disease generation? By examining a number of historically notable epidemics, we suggest that emerging diseases, similar in their novelty, impact, and elicitation of control responses, have occurred throughout recorded history. Fundamental determinants, typically acting in concert, seem to underlie their emergence, and infections such as these are likely to continue to remain challenges to human survival.
Science and Technology
Pandemic Preparedness
EU Hosts Global Health Security Initiative Talks
12/5/08 Market Watch--Meeting in Brussels today for the Global Health Security Initiative (GHSI), health ministers from the G7 countries agreed to further strengthen collaboration on the development and deployment of medical countermeasures to global health threats. Hosted by the European Commission, ministers from the United States, Britain, Canada, Germany, France, Italy, Japan plus Mexico agreed to continue to make a concerted effort to share best practices in border management, improve crisis communications, and further cooperate on drugs and vaccines development which would include virus sample sharing for influenza pandemic preparedness.
Pandemic Preparedness
HHS: PlanFirst Webcast
12/5/08 HHS--Join us on Wednesday, December 17th at 2 p.m. ET for the next PlanFirst Webcast. The focus of this Webcast will be a discussion of HHS guidance on antiviral drug use and stockpiling to be released later this month.
Pandemic Preparedness
Full Text of Articles follow ...
Regional Reporting and Surveillance
Nigeria: Director of Livestock denies report of HPAI in Gombe
12/8/08 RSOE EDIS--The Director of Livestock and Pest Control in Nigeria?s Federal Ministry of Agriculture and Water Resources, Dr Junaid Maina, has refuted a report that unidentified dangerous strain of Avian Influenza (Bird flu), much deadlier than HN51, was discovered in Gombe in northern Nigeria. ?As far as I know, there has been no outbreak in the country since July,? Maina told journalists on Friday in Abuja. ?We?ve contacted all the relevant agencies from the National Veterinary Research Institute (NVRI) in Vom, near Jos as the diagnostic confirmatory body and it said no sample was diagnosed by the laboratory. ?The Gombe State director of veterinary medicine and all the zonal offices and the desk officer who was claimed to have confirmed the diagnoses refuted such claims,?? he said. Maina said that it was only his office as the national chief veterinary officer that could make such pronouncements through the office of the Minister for Agriculture and Water Resources after all confirmation with relevant agencies. He said the report could be referring to the last outbreak in July 2008 after a random bird sample collection from various markets in Gombe showed a positive but non-deadly result in one duck. He said that since the confirmation of the Highly Pathogenic Avian Influenza (HPAI) in February 2006, the Nigerian government had demonstrated a high political will by instituting various measures directed towards the various strata of the society in the control and eradication of the disease.
He said that part of the strategy was the strengthening of the epidemio-surveillance network and bio-security on farms and border posts, massive sensitisation and creating awareness, fumigation of the bird markets and obtaining of US$50 million credit under the World Bank emergency funds for the implementation of the Avian Influenza Control Project (AICP). He said that as a result of that, substantial improvements were recorded in strengthening epidemio-surveillance, transport of specimen samples and capacity for laboratory diagnostic services at NVRI and veterinary teaching hospitals. He said that the Nigerian government was also collaborating with the Poultry Farmers Association (PAN) in the institutionalisation of best farming practices in poultry production with focus on bio-security and movement management of poultry through various border and interstate control posts. Maina said all the improvements recorded led to the selection of NVRI as a regional laboratory for Avian Influenza and other trans-boundary animal diseases for West and Central Africa. He reiterated that consumption of poultry products in Nigeria was safe.)
Quid Novi
India: Reuters video report, culling in Assam India
12/8/08 Reuters Video--Thousands of chickens are being slaughtered after bird flu is confirmed in poultry in Assam state.
The cull has been ordered after laboratory tests confirmed the cases of H5N1 virus but some reports suggest the outbreak has already spread to several districts.
Paul Chapman reports.
Regional Reporting and Surveillance
India likely to ask Bangladesh to contain bird flu
12/8/08 Financial Express--New DelhiIndia is likely to ask Bangladesh to help contain the spread of bird flu in the region. This deadly disease related to poultry birds recently occurred in Assam, which borders Bangladesh. Indian authorities feel that the deadly virus has entered the country from Bangladesh
Bird flu has spread to Barpeta, Nalabari and Kamrup districts in Assam leading to culling of over 1,00,000 birds. The worst hit area and the epicentre is Palasbari circle. The neigbouring states like Tripura and Mizoram have sounded a high alert. Bird Flu has been occurring in the country since 2006 and has severely affected the poultry industry and exports. The last incidence of bird flu was reported in West Bengal in February, 2008 and after extensive culling operations and control measures, the world animal health organisation ? OIE ? declared the country as bird flu-free in mid-November, this year. But before some importing countries could lift the ban on Indian exports, the tragedy visited again in the first week of December.
Earlier, there were incidences of bird flu in northeastern India and authorities had maintained that the virus spread from Bangladesh.
The matter was taken up in the forum of South Asian Association for Regional Cooperation (SAARC). ?We have asked the ministry of external affairs to take up the issue with Bangladesh for containing the spread of the deadly virus. We are members of the eight-nation body SAARC and the region has to be free of bird flu virus and the cooperation of Bangladesh is absolutely necessary,? said a senior official in the department of animal husbandry.
Regional Reporting and Surveillance
India: Ban on poultry transportation in Assam as bird flu spreads
12/8/08 Farming UK--With bird flu spreading to at least three districts since it was first detected in a village in Hajo block in Kamrup (Rural) district in November, authorities in Assam have imposed a ban on inter-district transportation of poultry.
?We have so far culled over one lakh chicks in different villages in Kamrup, Nalbari and Barpeta districts, while authorities in different districts have banned entry of poultry from other districts in order to prevent further spread of the disease,? Aswini Kataky, Director of Veterinary and Animal Husbandry said here on Sunday.
It was on November 27 that the authorities first detected the dreaded disease in Rajabazar village under Hajo revenue circle in Kamrup (Rural) district and atleast 25,000 birds were culled in a 3-km radius of Rajabazar. Four days later bird flu was detected and confirmed at Patgaon village under Rani block as well as in Sarpara village under Rampur block, both in Kamrup district. Bird flu was subsequently reported and confirmed in Gobardhana block in Barpeta district and in Paschim Nalbari block in the last three days. Rapid reaction teams have already culled about 50,000 birds in these two blocks in the last two days, Kataky said.
The Assam government has sounded a general alert against the spread of bird flu apart from the ban on inter-district transportation of poultry. ?There have been some reports of people trying to shift the birds from infected areas to other places with the intention of disposing them off in the markets instead of taking the government compensation,? Kataky said.
Meanwhile, authorities in the three Barak Valley districts of southern Assam have banned the entry of poultry from neighbouring Manipur, Meghalaya and Mizoram in view of the bird flu reported from different parts of the state. A sizeable number of poultry is regularly smuggled into the Barak Valley from Bangladesh and it was from such smuggled poultry that Tripura had suffered a massive outbreak of bird flu last year.
Quid Novi
India: Bird Flu Alert in Tripura?and Mizoram
12/8/08 Khaleej Times--The northeastern states of Tripura and Mizoram on Sunday sounded a bird flu alert after the spread of the virus in adjoining Assam, officials said.
More than 100,000 poultry were culled in Assam during the past 10 days after a bird flu outbreak in the state.?
?The Mizoram government has asked traders not to import poultry and poultry products from Assam and asked its officials to maintain a close vigil along the border,? Director of Animal Husbandry and Veterinary C. Sangnghina said.?
He said: ?There are no reports of avian flu attack in Mizoram, but we cannot remain complacent.?
The Tripura government also issued a similar bird flu alert.?
?More than 80 Rapid Response Teams (RRT) are ready to act in case of an outbreak of bird flu in Tripura,? said Sisir Paul, deputy director of the state?s animal resource department.
AI Research
Antibodies still protect 1918 flu survivors-study
12/8/08 Today Zaman--Antibodies from survivors of the 1918 flu pandemic, the worst in human memory, still protect against the highly deadly virus, researchers reported on Sunday.The findings by a team of influenza and immune system experts suggest new and better ways to fight viruses -- especially new pandemic strains that emerge and spread before a vaccine can be formulated.
These survivors, now aged 91 to 101, all lived through the pandemic as children.
Their immune systems still carry a memory of that virus and can produce proteins called antibodies that kill the 1918 flu strain with surprising efficiency, the researchers report in the journal Nature.
It was very surprising that these subjects would still have cells floating in their blood so long afterward, said Dr. James Crowe of Vanderbilt University in Tennessee, who helped lead the study.
The antibodies also protected mice from the 1918 virus, which swept around the world at the end of World War One killing between 50 million and 100 million people, Crowe's team reports in the journal Nature.
The antibodies that we isolated are remarkable antibodies. They grab onto the virus very tightly and they virtually never fall off, Crowe said in a telephone interview.
That allows them to kill the 1918 virus with extreme potency, meaning it takes a very small amount of antibody.
The human body has two systems for fighting off bacterial and viral invaders. One system uses so-called T-cells while the other employs B-cells, made in the bone marrow, which in turn make antibodies to both flag and directly attack the targets.
Resurrected virus
Dr. Christopher Basler and colleagues at the Mount Sinai School of Medicine in New York tested the 1918 survivors and found that in most of them, the B-cells made antibodies highly attuned to the 1918 flu strain.
Dr. Terrence Tumpey at the U.S. Centers for Disease Control and Prevention had worked on a team that resurrected the 1918 virus taken from buried victims of the epidemic and tested this virus in mice. Mice given the antibodies from the elderly survivors lived, while those given placebos died.
Crowe said it will now be important to test other people who have had influenza to see if their immune responses are as strong. The thought is the first influenza that you see during life is the one that you have the best immunity to, he said.
If we can learn the rules about how these antibodies work we may be able to design antibodies to lots of other viruses.
The 1918 flu was an H1N1 strain that apparently came straight from birds. This study tells us that human beings can make long lasting immune responses to bird influenza, Crowe said.
Crowe said his team is working to get antibodies from people vaccinated with experimental shots for the H5N1 avian influenza now circulating in Asia, Europe, the Middle East and Africa. H5N1 mostly affects birds but it has infected 385 people since 2003, killing 243.
Experts fear that, like the H1N1 virus did in 1918, H5N1 will mutate into a form that passes easily among people and spark another pandemic. No one knows if the vaccines being made now would protect against whatever form of H5N1 might emerge.
Crowe said antibodies from survivors might make a good interim treatment while a vaccine is formulated, manufactured and distributed -- a process that would take months.
Regional Reporting and Surveillance
India: Transmitters to unravel avian migration mystery
12/8/08 Express Buzz--BHUBANESWAR: For the first time, migratory routes of birds that throng the Chilika lagoon would be determined through satellite telemetry.
An initiative that will throw light on the path that the avian visitors take to during their intercontinental migration, which has remained more or less shrouded in mystery, would see 35 birds of five species fitted with satellite transmitters.
A team from the United State Geological Survey (USGS) would impart technical training to the local wildlife as well as veterinary staffers as well as to members of Bombay Natural History Society (BNHS) which will play a major role in this satellite telemetry project along with the Food and Agriculture Organisation.
Chilika, sub-continent?s largest birding site attracts over 7 lakh migratory birds including species from various parts of the globe. Of the 226 species recorded at the wetland during the winter, 95 species are inter- continental.
A similar satellite telemetry project was implemented on the Siberian cranes of Bharatpur Wildlife Sanctuary in Rajasthan a few years back.
But this project promises to be big. ??It?s for the first time in India that multiple species are being fitted with such transmitters,?? Chief Executive, Chilika Development Authority (CDA), Sudarshan Panda said. Necessary clearance from Chief Wildlife Warden B.K.Patnaik has been secured for the programme.
Orissa, earlier, had witnessed satellite telemetry programme experimented on Olive Ridley turtles.
The amphibians were fitted with transmitters which were bigger in size than the ones to be attached to the birds.
??This initiative is likely to give us vital information on the migratory behaviour of birds,?? Panda said.
Besides, CDA is gearing up to carry out an extensive disease surveillance in the lagoon in wake of the avian influenza threat. The exercise would start on December 9 and conclude on December 17 during which teams would collect blood samples of the birds. The samples would be examined for presence of the H5N1 virus.
It is being carried out jointly by FAO, Ministry of Environment and Forests,Ministry of Agriculture, Wetland International, Directorate of Veterinary and Animal Husbandry besides BNHS, USGS and CDA.
Regional Reporting and Surveillance
(Op/Ed) Indonesia's bird flu warrior takes on the world
12/8/08 Macau Daily--Sliding with short steps onto the stage in front of a crowd of students, academics and supporters, Indonesia's Health Minister Siti Fadilah Supari is in her element.
Her hair swept up into the voluminous bouffant favoured by Indonesia's wealthy ladies, the bespectacled 57-year-old delivers her scalding critique of global injustice in soft, rounded Javanese vowels that frequently trail into a whisper.
The venue is a university discussion of her memoir-cum-manifesto, "It's Time for the World to Change: Divine Hands Behind Avian Influenza," and the audience bursts into applause as she issues her broadsides.
Supari is in charge of the response to bird flu in the country most heavily hit by the virus. With 112 dead and counting, Indonesia accounts for nearly half of all human deaths from the disease.
If the H5N1 virus mutates into a form easily transmissible between humans, setting off a worldwide pandemic that could kill millions, it will likely happen here.
But while most governments have set about tracking the spread and development of the bug, Supari has turned the fight against avian influenza into a broader struggle over the soul of globalisation.
Since late 2006 Supari has refused to share all but a handful of Indonesia's virus samples with the World Health Organisation (WHO), saying Indonesia will only resume if the system is changed to give poor countries control over where their viruses go, and a share of any profits from vaccines.
Addressing the crowd, Supari accused rich countries and the WHO of a conspiracy to trick poor nations into giving away virus samples, which she says are passed on to drug companies for their own profit.
"Then the virus is turned into vaccines (that are sent to) Indonesia and Indonesia has to buy them and if they don't buy them, they have to go into debt and it turns and turns again, and in the end developed countries make new viruses which are then sent to developing countries," she said.
"The conspiracy between superpower nations and global organisations is a reality. It isn't a theory, isn't rhetoric, but it's something I've experienced myself," she tells the enthralled audience.
The claims are part of a list of accusations -- which include raising the possibility that a US lab could use Indonesian virus strains to create biological weapons -- that have turned Supari into one of the most polarising figures in global health.
While Supari's stand has earned her hero status among many Indonesians for taking on powerful vested interests, critics say keeping virus samples from the world's scientists leaves humanity more exposed to a nightmare pandemic.
'Indonesia is saving humankind'
A cardiologist before being handpicked in 2004 by President Susilo Bambang Yudhoyono to fill a quota of four women in his cabinet, Supari is not a member of any political party, and is aloof from much of the jockeying of Indonesian politics.
She also says she did not start in her job spoiling for a fight with the West. Rather, she says she was shocked after being offered vaccines containing Southeast Asian H5N1 strains taken without their home countries' permission.
Supari claimed vindication in early 2007 after Australian drug company CSL came forward with a trial vaccine containing Indonesian bird flu strains.
CSL freely admits to using Indonesian strains but says under current WHO rules it is under no obligation to compensate Indonesia or guarantee access, company spokeswoman Rachel David says.
"The concerns that were raised by the Indonesia health minister (in 2007) were legitimate, and of course she was concerned about the access of Indonesia to pandemic vaccines, but it was essentially not something CSL was in a position to help with," she says.
Supari herself appears immune to criticism that she is endangering world health.
The real fear, Supari argues, is that if a pandemic does break out developing countries will be unable to protect their own people.
"(Stopping virus sharing) is important so our voice can be heard by the WHO and we want to change the global virus sharing mechanism to be fair, transparent and equitable," Supari says at her ministerial offices.
"What we mean by fair is that any virus sharing should be accompanied by benefits derived from the shared virus, and these benefits should be coming from the vaccine producing countries," she says.
"What Indonesia has been doing so far is to save humankind, and Indonesia is of the view that (under) the current system, which is unfair, untransparent and not equitable, the danger is much more than the pandemic itself."
Supari's basic complaint against the world system has received its fair share of support, with developing countries rallying behind Indonesia's efforts to push changes at WHO talks at the end of this year.
"She wants to have a transparent mechanism and I think it's not a bad idea. It's good for everybody," says Makarim Wibisono, a senior Indonesian diplomat pushing Indonesia's case at the WHO in Geneva.
"I don't think it's alarming to humanity, I don't think it's alarming for the future of the world."
Supari does appear to be vindicated by a flood of patents being lodged on the samples of H5N1 that have made it out of Indonesia, with companies in developed countries claiming ownership over viral DNA taken from sick Indonesians.
According to US-based influenza blog Immunocompetent, 83 patent applications mentioning H5N1 have been lodged since the start of 2007, the vast majority of them from rich nations.
Supari's fight taps into one of the hot-button issues of globalisation: biopiracy, which refers to the corporate exploitation of indigenous knowledge.
But while countries from Africa to South America fight against attempts by multinationals to patent, for example, chemical compounds in medicinal plants that have been used for generations, Indonesia's claim to virus samples is higher stakes -- and much more emotive.
'The nuttiest idea I've ever heard'
Even some who sympathise with Supari's charge that corporations rig the global health system think she is playing a dangerous game.
Keeping samples away from international scientists leaves the world dangerously uninformed about the virus and potentially unaware of an emerging pandemic, says Kartono Mohamad, former head of Indonesia's doctor's association.
"If something happens then maybe Indonesia is to blame if we cannot help the world contain the virus," he says.
"She has a point, but she's gambling. She's not only gambling with the virus but the safety and security of the Indonesian people as well."
Supari's confrontational style and bellicose language has also helped turn a bland issue of intellectual property and health bureaucracy into a matter of religious and national pride in Indonesia, and frustration abroad.
The minister's suggestion in her book that a US lab could use bird flu to create biological weapons was denounced by US Defence Secretary Robert Gates on a February visit to Jakarta as "the nuttiest idea I've ever heard".
Aware of her image problem abroad, Supari insists she is not anti-Western. "I love the US government, I love the US, but what I oppose is a mechanism that isn't fair and harms humanity," she says, referring to WHO's virus-sharing system.
Supari also says she has never labelled the current health system a "conspiracy" by developed countries and drug companies, despite using the term in the book and in numerous public statements.
Supari also says she had not argued US labs are using virus samples to make biological weapons, but that the non-transparent system is open to abuse: "I don't know if my virus is going to be used as material for a vaccine or as material for a biological weapon."
"I didn't say that developed countries are making new viruses to be spread in developing countries, but actually I was talking about the dependency of developing countries on developed nations, which is going to get bigger if the current system continues," she says.
The minister has put her Islamic faith at the front and centre of her fight, claiming divine guidance.
She is a member of the moderate Islamic mass movement Muhammadiyah, but has also reportedly cosied up to radicals such as the Islamist Hizbut Tahrir group, which believes in replacing Indonesia's secular government with a Muslim caliphate.
"She has kind of become giddy because many people, especially the Islamic organisations, see her as a hero, a new hero in this country because she is fighting the United States," former top doctor Kartono Mohamad says.
"Her motives I do not know. I think she wants to be a hero fighting against the giants, the David fighting against the Goliath."
Some of those who support her initial stand over virus sharing say Supari's turn into conspiracy theories has taken on a momentum of its own, getting in the way of the bird flu fight.
"I disagree with her approach, with the way she is talking to other parties and actually that approach puts us in a difficult position. For example, I have lost some friends, research fellows," says the head of the expert panel of Indonesia's bird flu committee, Amin Subandrio.
Despite her anti-Western rhetoric, Supari has also frozen most Indonesian scientists out of access to virus samples, Subandrio said.
"Some of the statements in her book are not based on evidence but probably only based on information from some person, I don't know who is giving her information," Subandrio says.
For Subandrio, who shares some of the responsibility for combating the virus, there is not so much fear of a pandemic as exasperation.
Bird flu is endemic in poultry in all but two of Indonesia's 33 provinces and while the number of human cases is dropping, they far outstrip anywhere else in the world, according to health ministry figures.
"I don't think she is gambling but I'm afraid she's looking at the problem not from a scientific point of view but another, probably popularity or something like that," Subandrio says.
Vaccines
Lithuania: Lithuanians get experimental bird flu vaccine
12/8/08 Baltic-course--Almost one hundred residents of Lithuania have been given an experimental vaccine for fighting bird flu, Radio Vilnius/ELTA informed. According to Lithuanian scientists, all of the participants of the medical test were volunteers. Medical professionals, involved in the research in Lithuania said that they cannot yet reveal much information about the results of the experiment. It was said that the vaccine came from Austria. The volunteers received two injections of the vaccine and later made notes on the way they felt and symptoms in a special journal. The test is to last for eight months. Even though it started only a few weeks ago, medical professionals claim they have enough volunteers. The virus, which originated in Asia, reached Europe in this decade. Over three hundred people have already died from it.
Regional Reporting and Surveillance
Launch of West African Viral Surveillance Network
12/8/08 Tropika.net--Source Article: : International Consortium on Anti-Virals (see original article)--A new surveillance network has been launched that will facilitate collaboration in the fight against viral diseases across West Africa.
The launch took place in November during the 7th International Symposium, of the International Consortium on Anti-Virals (ICAV), held in Beijing where representatives of institutions and government agencies from West Africa, Europe, Australia, China and Canada signed a memorandum of understanding inaugurating the West African Viral Surveillance Network (WAVS). WAVS builds on discussions that took place at the Abuja, Nigeria ICAV Symposium of May 2007 and subsequent roundtable discussions with stakeholders.
?WAVS will help us fill the gaps in our surveillance infrastructure?, said Dr Mike Ochoga, who coordinates Nigeria?s Avian Influenza Rapid Response Team.
Viral diseases infect about five million people a year in West Africa, impeding poverty reduction and sustainable development. The eradication of high-burden viral disease is integral to the achievement of the Millennium Development Goals of the United Nations. Viral surveillance capacity in West Africa ? the key to reducing prevalence of viral infection ? remains weak. In addition to ongoing polio, Lassa, and West Nile epidemics, the highly pathogenic avian influenza virus H5N1 has recently become endemic in many countries in the region.
The UN has, therefore, identified West Africa as a priority region for surveillance strengthening. Increased surveillance provides information essential to rapid and effective disease management and control, the implementation of effective prevention, treatment, prophylaxis and vaccine deployment strategies, and design of new therapeutic leads.
ICAV?s Africa Regional Director, Dr Oyekanmi Nash said, ?The surveillance gaps that the network had identified include those on sample collection and referral systems, viral identification and analysis, and collaboration and coordination. WAVS addresses these gaps through focused activities with the identified regional and international collaborative scientists, institutions and organizations.?
Professor Bamidele Solomon, Director-General of the National Biotechnology Development Agency of the Nigerian Federal Government, hailed the establishment of WAVS as, ?A big step forward in strengthening existing linkages both inside and outside the country for something of great importance.?
The WAVS Network will bridge the gap between existing surveillance systems in the region. ?The existing polio surveillance network is very effective?, according to Professor Festus Adu of the WHO Polio Laboratory at the University of Ibadan in Nigeria: ?WAVS will aid in the transition of such networks to other diseases once we have reached our goal of polio eradication.?
The International Consortium on Anti-Virals (ICAV)
ICAV is at the centre of pandemic preparedness and global public health, developing urgently needed, low-cost anti-virals. A not-for-profit drug development organization, ICAV accelerates the discovery, development and delivery of novel anti-viral therapies for neglected and emerging diseases through the international collaboration of scientists, government and industry. ICAV harvests promising drug candidates for pre-clinical and clinical development from its international network of over 250 scientists from 24 countries. ICAV ensures global availability of anti-virals by offering therapies at cost or free in lower- and middle-income countries.
The ICAV 7th International Symposium ?Challenging Pandemics: Science, Policy Preparedness?
Organized in conjunction with the Institute of Microbiology of the Chinese Academy of Sciences, the symposium gathered over 100 scientists, public health experts, industry representatives, and policymakers to advance the development of safe, affordable and effective anti-viral therapeutics for infectious diseases. The key objectives of the symposium are to identify promising new anti-viral development candidates and to foster new collaborations to accelerate the development of new therapeutics. The symposium featured sessions on avian influenza, hepatitis, dengue, enteroviruses, and traditional strategies for drug development.
Regional Reporting and Surveillance
Indonesia: Sanglah hospital launches bird flu treatment ward
12/5/08 Jakarta Post--The island's largest hospital, RSUP Sanglah, now has a dedicated and fully equipped ward for treating patients with bird flu, opened Thursday with a modest pemlaspas (purification) ceremony.
The ceremony, which Balinese Hindus believe is necessary for any new building before it can be used, was organized by the hospital and the Bali Health Agency. The ward lies in the hospital's Nusa Indah wing, which is dedicated to the treatment of tropical diseases.
"The building is part of an effort to improve the island's preparedness to cope with avian influenza and other communicable diseases," Bali Health Agency head Dewa Made Oka said.
Oka said the establishment of the bird flu ward underlined the Bali administration's commitment to fighting any future epidemic. Bird flu outbreaks hit Bali in 2004 and 2007, claiming two lives.
The last reported case of bird flu on the island was in March, when the veterinary agency found five infected chickens in Karangasem regency.
"Since then we have not found any new cases nor detected any indication of the disease's presence. Hopefully, we will not find any case in the future," he said.
The two-story, fully air-conditioned ward has 27 beds. The first floor hosts four intensive care chambers and a large room with six beds to treat patients suspected of having contracted avian influenza.
The ward is equipped with a sophisticated air regulation and filtering system. The physicians and paramedics assigned to the ward are obliged to wear additional personal safety equipment.
The construction of the ward started in 1997, and has cost the Bali administration nearly Rp 2.7 billion (US$222,680).
Secretary of the Sanglah Avian Influenza Mitigation Team, Ken Wirasandhi MD, said the building's design was based on the standard set by the World Health Organization. Sanglah is the second hospital in the country to have a dedicated bird flu treatment ward.
"The ward can also be used to treat patients who contract other communicable diseases, such as SARS (Severe Acute Respiratory Syndrome) and rabies," he said.
He said that with the ward in full operation, the hospital would be able to offer high-quality treatment for patients.
"The existence of the ward will also enable us to convince foreign tourists not to be afraid to visit Bali even when the island is facing an epidemic," he said.
AI Research
In the context of reporting on a bird die-off in Bafwasende, an international source reported that the provincial inspector of agriculture and livestock indicated that preliminary symptoms of the bird die-off do not appear to be Newcastle disease. Accordi
12/5/08 CDC/EID--[full text pdf]Human infection with the highly pathogenic avian influenza A virus (H5N1) was discovered in Hong Kong Special Administrative Region, People?s Republic of China, in 1997 (1?3). It has since been identified in other countries, primarily in Southeast Asia. Among 100 confirmed infected patients, 46 have died in Vietnam since 2003 (4,5). Severe viral pneumonia accompanied by diffuse alveolar damage develops in patients infected with influenza virus (H5N1) (6). High viral load causes intense cytokine reactions and inflammation (7). Clinical factors that might be associated with severity include age, delayed consultation, lower respiratory tract lesions, and leukopenia (4,8?10). However, few cases have reported which factors, including patient management, affect outcomes. Our study reviews the clinical courses of patients treated in Hanoi, Vietnam, and investigates the association between clinical findings and survival.
Regional Reporting and Surveillance
New-strain influenza (Op/Ed)
12/5/08 Asahi--The government's basic stance on combating an outbreak of potentially disastrous influenza caused by a new strain of virus is about to undergo a major overhaul.
A panel representing the various ministries concerned completed drafting revisions to the government's existing action plan last week. The revised plan, which will be finalized early next year after input from the public, acknowledges that an overseas outbreak of a new-strain flu pandemic would inevitably reach Japan. Thus, the focus of the revisions is to prevent an outbreak from developing into a pandemic.
The current action plan is centered on trying to keep flu out of the nation and isolating infected people quickly. Facilities for such purposes have been set up, but the plan is still lacking in proactive measures to deal with a pandemic.
Many advanced nations already have measures in place to deal with a pandemic, having concluded that containing one would be impossible in densely populated urban areas. We must say our government's proposed change in policy was long overdue.
The panel also drafted guidelines on infection prevention and improvement of medical services, among other things. However, some of these guidelines are still based on past policies and lack coherence. The panel should review them thoroughly and put together effective measures without delay.
Any new-strain flu can quickly spread out of control because people have no immunity.
According to estimates by the Ministry of Health, Labor and Welfare, one in four residents would be infected; 2 million people would be hospitalized; and, in a worst-case scenario, 640,000 people would die. Hospitals and clinics are simply incapable of dealing with so many patients. The same would hold true even if this nation had a fully functional health care system.
The panel guidelines offer two different sets of flu-containment measures by drawing a distinction between the early stages of a pandemic when infections are at their lowest and the more advanced stages of widespread infection.
In the early stages, all patients would be hospitalized, and those who have been in contact with these flu-carriers would be urged to take Tamiflu or other anti-virus drugs for prevention. In the advanced stages, all but the gravely ill would be urged to recuperate at home, and Tamiflu would be dispensed only for treatment, not for prevention.
But who decides when the early stages have evolved into something more ominous? The public must be informed in advance. It is necessary to establish systems, such as the one for delivery of flu drugs, to support people who are recuperating at home. Otherwise, hordes of people will rush to hospitals and clinics. We can't overstate the confusion that would follow.
The panel has proposed setting up a dedicated "outpatient section for those running a fever" at each hospital to prevent infection to other patients. But even experts are divided on whether such a measure would prevent the spread of infection.
The panel also calls for across-the-prefecture closure of all schools when even just one student has come down with flu. If this happens, it would likely result in increased numbers of parents and guardians taking days off from work, which in turn could lead to staff shortages at medical and other facilities where anti-flu services are provided.
Local governments are now faced with the major challenge of planning and implementing specific measures of their own. Each community must ascertain what to do if a crisis arises. It is the responsibility of the central government to support these local efforts.
And now, each one of us should also start thinking about what to do if a pandemic occurs.
Regional Reporting and Surveillance
The G-7 promises to improve the systems of rapid alert of pandemics and bioterrorism
12/5/08 Europa Press, contributed by email--The ministers of Health of the countries of the G-7 (The United States, Japan, Canada, Germany, United Kingdom, France and Italy) and of Mexico promised today to improve the international systems of early alert and of response to the threats of the chemical, biological terrorism and radionuclear and to the pandemic influenza. They agreed besides the fact that the closing border is not the best method to stop the spread and contagion of a pandemic and that enclosed might aggravate the situation.
These were the principal conclusions of the ninth ministerial meeting of the Global Initiative called for the Sanitary Security. The Initiative was created initially in 2001 as response to the terrorist attempts of September 11 and the later sending of letters with anthrax in the United States, and it gets together once a year at the ministerial level.
The meeting of this year of the Initiative, which was received by the European Commission, centred on three topics: research and drug development and vaccines against the sanitary risks; measurements and allotment of samples of virus to give a response to the pandemic influenza; and finally, mechanisms of communication of crisis among the members.
"It is vital to collaborate narrowly with our associates to improve the global systems of rapid alert and of response to the threats related to chemical, biological agents and radionuclear, the pandemic influenza or more wide questions of health as the security of the food chain and the security of the products", said the commissioner responsible for Health, Androulla Vassiliou.
The community Executive invited to the countries of the G-7 to take part in an exercise of preparation opposite to a sanitary international simulated crisis that Brussels has foreseen to organize in 2010. It is a question of testing the systems of communication of the risk. The exercise will include questions as the political ones of communication to the citizens, as well as the management of the events in real time or how the information is shared, made clear the police station.
Vassiliou announced that the community Executive is studying to present a legislative offer on health threats.
For what it refers to the closing border in case of pandemic, the minister of French Health, Roselyne Bachelot, affirmed that this type of measurement would be very difficult to apply in the EU. "All the countries have expressed their desire not to close the borders in case of pandemic", underlined Bachelot, which was alert of that "the decision to close the borders might be counter-productive and aggravate the situation".
Finally, the ministers of Health of the G-7 and Mexico agreed to reinforce the international cooperation in the research on medical answers to this type of threats with the aim to guarantee the availability of vaccines, medicines and all kinds of interventions in case of a situation of sanitary crisis.
Regional Reporting and Surveillance
India: India corn end lower as bird flu hits demand
12/5/08 Reuters--Indian corn futures ended weak on Friday as an outbreak of bird flu in the north eastern state of Assam hit demand, analysts said.
Corn is mainly used as poultry feed.
People are now a little cautious, so demand is likely to remain weak for some more days, said Mehul Agrawal, an analyst with Sharekhan Commodities Pvt Ltd.
January corn NMZF9 fell 0.6 percent to end at 825.50 rupees per 100 kg on the National Commodity and Derivatives Exchange. (Reporting Debiprasad Nayak; Editing by Harish Nambiar)
Pandemic Preparedness
EU Hosts Global Health Security Initiative Talks
12/5/08 Market Watch--Meeting in Brussels today for the Global Health Security Initiative (GHSI), health ministers from the G7 countries agreed to further strengthen collaboration on the development and deployment of medical countermeasures to global health threats. Hosted by the European Commission, ministers from the United States, Britain, Canada, Germany, France, Italy, Japan plus Mexico agreed to continue to make a concerted effort to share best practices in border management, improve crisis communications, and further cooperate on drugs and vaccines development which would include virus sample sharing for influenza pandemic preparedness.
"The European Commission is committed to building a stronger global collaboration to address common health security challenges," said European Health Commissioner, Androulla Vassiliou, who chaired the meeting. "In an ever more interdependent world, it is vital to collaborate closely with our partners to improve global rapid alerting and response systems on threats related to chemical, biological and radio-nuclear agents, pandemic influenza or wider health issues such as safety of the food chain and product safety (...) I have today invited all GHSI partners to participate in a preparedness exercise which the Commission plans to organize in 2010."
Established in 2001 as a response to September 11th terrorist attacks and the subsequent release of anthrax letters in the US, the GHSI seeks to forge stronger global collaboration on health security by addressing health threats from chemical, biological and radio/nuclear agents and by developing preparedness and response to pandemic influenza.
A joint communique was issued at the end of the meeting:
http://ec.europa.eu/health/index_en.htm
More information on the EU work on health security can be found at:
http://ec.europa.eu/health/ph_threats/health_security/health_security_en.htm
More information on the GHSI can be found at:
http://www.ghsi.ca/english/index.asp
Vaccines
Vaccine Makers Urge Speedy Accord on Pandemic Plan
12/5/08 ABC News--Drugmakers Urge End to 'Pandemic Fatigue' on Government's Part
Governments need to overcome their "pandemic fatigue" and act quickly to finalize a response plan to potential flu threats, leading drugmakers said on Thursday. The pharmaceutical industry is "very close to ready" to respond to a potential outbreak by shifting seasonal flu vaccine production to more targeted pandemic ones, said Stephen Gardner of GSK Biologics.
But Gardner told a news briefing that countries needed to stop stalling and craft an accord on sharing samples of virus strains with pandemic potential for tests that accelerate efforts to formulate effective vaccines.
"We don't have time to negotiate a new agreement when a pandemic arises. We need to get on with manufacturing quickly," he said. "Time is of the essence to ensure good vaccine supply."
The World Health Organization (WHO) will host an inter-governmental meeting next week where the United Nations agency's member states will discuss sensitive questions about virus sample sharing and access to vaccines in case of a flu pandemic.
Regional Reporting and Surveillance
ECDC Influenza News
12/5/08 ECDC--ECDC Influenza news for week 49 (November 4th) are now published on the ECDC website.
Epidemiological updates
* Seasonal Influenza
* Influenza activity in Europe continues to be low - Week 47, Week 48 will be posted on December 5th
* Oseltamivir resistance in seasonal influenza virus
* Avian influenza
* Human health ? no new human cases of avian influenza A(H5N1) reported by WHO since 10th September 2008
* Animal health - new case of highly pathogenic avian influenza in poultry reported by OIE in a small village in India. Investigations are ongoing and measures have been implemented, no illness in humans has been reported in the region.
Scientific Advances ? Pandemic Influenza
* What its like working in hospital with personal protective equipment (PPE) report of a simulation During a UK simulation exercise that tested the protective equipment in a pandemic influenza infection, the patients and staff found uncomfortable wearing a surgical mask for longer periods of time and despite the pre-training for the exercise the staff were unsecure using infection control measures.
Public Health Developments
* Intergovernmental meeting on pandemic preparedness and virus sharing 8-13 December 2008, Geneva WHO is organising next week the 3rd Intergovernmental Meeting on Virus Sharing and Benefit Sharing. There is a new ECDC page and EU briefing on this available on the ECDC web-site . The EU briefing is available specifically as a full document and in the form of the Executive summary only.
Meetings and workshops
* International symposium on viral respiratory disease surveillance. Seville, Spain 25-27th March 2009.
Regional Reporting and Surveillance
Bhutan: Imposes Partial Ban on Poultry Products from West Bengal and Assam Provinces in India
12/5/08 ARGUS--Bhutan?s department of livestock has banned the import of frozen chicken and eggs from Assam and West Bengal provinces in neighboring India, due to the H5N1 avian influenza (AI) or ?bird flu? outbreak in those regions on 27 November. The import of day-old-poultry birds used for breeding was also banned, as it was passing through Guwahati [Assam, India]. According to an official at the livestock department, they have not imposed a ?blanket ban? on all Indian poultry products, but have increased precautionary measures.
The source notes that poultry products from identified sources in India will be allowed to enter Bhutan through Phuentsholing gate in Chukha district, and any movement of poultry along the Assam border will only take place through a lateral highway. The department has also engaged the veterinary vigilance team (VVT) along the southern border districts of Sarpang and Samdrup Jongkhar to carry out laboratory and clinical surveillance. Other precautionary quarantine and regulatory measures, such as disinfecting vehicles and high risk goods, have also been placed along the border.
Article URL(s)
http://www.kuenselonline.com/modules.php?name=News&file=article&sid=11568
Quid Novi
Indonesia: chicken die-off repoerted in West Sumatra
12/5/08 ARGUS--300 chickens died suddenly in Malakopak village (Pagai Utara district, Kepulauan Mentawai regency, Sumatera Barat [West Sumatera province]). An official from the local livestock agency suspected Newcastle disease, while residents believed that these chickens were infected with avian influenza. Authorities have neither investigated these bird die-offs nor tested the chicken samples. The source noted that residents in the area often consume the meat of livestock that had died a few days prior.
Article URL(s)
http://www.posmetropadang.com/content/view/9809/2498/
Pandemic Preparedness
HHS: PlanFirst Webcast
12/5/08 HHS--Join us on Wednesday, December 17th at 2 p.m. ET for the next PlanFirst Webcast. The focus of this Webcast will be a discussion of HHS guidance on antiviral drug use and stockpiling to be released later this month.
Antiviral drugs will be an important part of a multi-faceted response to an influenza pandemic. They will be used to contain an initial pandemic outbreak, slow the spread of infection, and treat those who have pandemic illness.
No registration is required. Email your questions for the Webcast panelists before and/or during the program to hhsstudio@hhs.gov. Please include your first name, state and town.
Science and Technology
Emerging infections: a perpetual challenge
12/5/08 Lancet--[request full text pdf]
David M Morens, Gregory K Folkers, Anthony S Fauci
Introduction: Emerging and re-emerging infectious diseases, and their determinants, have recently attracted substantial scientifi c and popular attention. HIV/AIDS, severe acute respiratory syndrome, H5N1 avian influenza, and many other emerging diseases have either proved fatal or caused international alarm. Common and interactive co-determinants of disease emergence, including population growth, travel, and environmental disruption, have been increasingly documented and studied. Are emerging infections a new phenomenon related to modern life, or do more basic determinants, transcending time, place, and human progress, govern disease generation? By examining a number of historically notable epidemics, we suggest that emerging diseases, similar in their novelty, impact, and elicitation of control responses, have occurred throughout recorded history. Fundamental determinants, typically acting in concert, seem to underlie their emergence, and infections such as these are likely to continue to remain challenges to human survival.
