Avian Flu Surveillance Project

A couple of 'grabs' from Drudge:

Mammals at greater risk as BF mutates:

http://www.guardian.co.uk/international/story/0,3604,1641765,00.html

....and a few questions about the side effects of Tamiflu:

http://articles.news.aol.com/news/article.adp?id=20051111212209990004

Saudi Arabia Hosts Int'l Conf. on Bird Flu

Saudi fears intensify with the approach of Hajj season.

By Fawaz Mohammad, IOL Correspondent

RIYADH, November 14, 2005 (IslamOnline.net) – Saudi Arabia is planning to host an international conference on November 21-22 to discuss ways of preventing an outbreak of the bird flu during the Muslim hajj.

"The conference will discuss means of vaccination against the approaching danger of the avian flu," said Zayad bin Ahmed Memish, director of the Gulf Center for anti-bodies Saturday, November 12.

The two-day conference will bring together more than 300 health experts and specialists from around the globe in addition to Saudi officials to discuss means of protection against the deadly virus.

"The conference will also probe ways to gain more information about the nature of the virus as well as means of diagnosis and protection," added Memish, who is also head of the conference's organizing committee.

Executive director of the National Guards' health affairs department Dr. Abdullah bin Abdul Aziz highlighted importance of the conference in fighting the avian flu.

"It comes at a time world countries are racing time to gain more information about the deadly virus to prevent its outbreak."

Fears of bird Flu coming to the Arab world were highlighted when the Paris-based World Organization for Animal Health said 3,673 wild waterfowl had died in Iran.

Saudi fears intensify with the approach of Hajj season, where millions of Muslims from the four corners of the globe head for the Kingdom for the annual spiritual journey.

Official figures put the total number of pilgrims performing last year's Hajj at 1,892,710, with 1,419,706 from abroad and 473,004 Saudis and other Muslim residents of the kingdom.

Every able-bodied adult Muslim who can financially afford the trip must perform hajj, one of the five pillars of Islam, once in their lifetime.

Hajj consists of several ceremonies, meant to symbolize the essential concepts of the Islamic faith, and to commemorate the trials of Prophet Abraham and his family.

Fears

Fears of a bird flu outbreak have been high in Saudi Arabia since reports that chickens perished in a farm in the Kingdom.

Fears of a bird flu outbreak have been high in the oil-rich kingdom since reports on November 6, that chickens perished in a farm in southeastern Saudi Arabia.

The owner of the farm in Surat Obaida, south of Khamis Mushayt in the Asir region said he had told the Saudi authorities that the poultry “started to cough, faint and then die” within three days.

But Saudi officials denied an outbreak of the avian virus in the region, saying tests on the perished birds showed no sign of the flu.

Saudi Arabia has stepped up measures to prevent any outbreak of virus in the country.

On Saturday, Saudi Arabia said that it was banning all bird imports from neighboring countries amid heightened regional concerns about bird flu, according to Agence France Presse (AFP).

"A royal decree was sent to the customs and all entry points forbidding the entry of all bird species coming from countries bordering the kingdom," the official SPA agency said.

The decision comes a day after Kuwait announced a bird stricken with avian flu in the country carried the deadly H5N1 strain, in the first case of its kind in the Gulf region.

Another bird was found to have the milder H5N2 strain.

On October 25, the kingdom banned live bird imports from Asian countries, Romania and Turkey where the deadly strain of H5N1 avian flu has been detected.

Scientists fear if the bird flu virus, which originated in Asia, were to pass on any large scale from birds to humans it could mutate into a variety that could spread between humans. In a virulent form, they say, this could kill millions worldwide.

Anti-bird Flu Drug

In a related development, China said Sunday it has developed what it calls the equivalent of the anti-bird flu drug Tamiflu in preparation for a feared pandemic if the virus begins spreading among humans.

Zhong Nanshan, director of the Guangzhou Institute of Respiratory Diseases, was quoted in the Information Times newspaper as saying the drug would be effective in treating the virus, Reuters said.

The Information Times report did not say when the drug might be available or say how it compared with the antiviral Tamiflu, made by Swiss drug giant Roche Holding AG.

In the absence of a vaccine for bird flu, the World Health Organization recommends that governments stockpile Tamiflu, which does not cure the disease but can reduce its severity and might slow the spread of a pandemic.

China has reported a total of eight outbreaks of the deadly H5N1 strain of bird flu in poultry since the start of October.

The latest outbreak occurred in Jingshan county in Hubei province. Local authorities have culled more than 31,000 poultry within a radius of 3 km (2 miles).

The H5N1 strain first emerged in Hong Kong in 1997, when it caused the death or destruction of 1.5 million birds. Eighteen people fell ill, of whom six died.

It re-emerged in 2003 in South Korea and has spread to China, Vietnam, Thailand, Laos and Indonesia. H5N1 has infected 117 people in four countries and killed 60, according to the WHO.

Bird flu 'mutated into more dangerous form'
09:40am 14th November 2005
http://www.dailymail.co.uk/pages/live/articles/health/healthmain.html?in_article_id=368562&in_page_id=1774&in_a_source=reuters

Study shows bird flu is mutating

Bird flu has mutated into a more dangerous form which could breed in humans, according to scientists.
The Vietnamese research has shown the bug is adapting to infect humans in the biggest study of its kind.

The respected Ho Chi Minh Pasteur Institute in Vietnam said it had decoded 24 samples of the H5N1 virus taken from poultry and humans.

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Join the debate » The results showed a significant variation of antigen - any foreign substance that stimulates the body's immune system to produce antibodies.

"The H5N1 type that infected people and waterfowl in early 2005 has several mutations focusing in the important functional parts of the surface proteins," the institute said on its website.

"There has been a mutation allowing the virus to breed effectively on mammal tissue and become highly virulent," it said.

Virus could breed in humans

The study also found a mutation of the PB2 gene in a virus sample from a patient who died in the southern Dong Thap province earlier this year.

Small changes in this gene can make it much easier for the virus to breed in humans making it more deadly.

An Agriculture Ministry report said the H5N1 virus had now hit 10 of Vietnam's 64 provinces since returning in early October. Vietnam's death toll since the virus first arrived in late 2003 is 42.

The latest affected area is the northern port of Haiphong where 1,000 ducks and chickens died in four farms last week.

Bui Quang Anh, head of the ministry's animal health department, has warned provincial authorities that improper quarantine of infected poultry was helping the disease to spread.

Poultry rearing to be banned in Vietnam

Vietnam is gearing up its battle against bird flu with Hanoi and Ho Chi Minh City officials spreading the word about a November 15 deadline from when poultry raising will be banned in those cities.

The Hanoi's People Committee said live poultry will be destroyed from Thursday if found in the capital.

Last week, Agriculture Minister Cao Duc Phat said police and soldiers would be used to quarantine farms, destroy sick poultry and man checkpoints to control poultry transportation better.

Bird flu has killed at least 64 people in Asia since it arrived in 2003 and became endemic in several countries.

Thirteen people are known to have died of bird flu in Thailand, five in Indonesia and four in Cambodia.

Thanks for all the posts sorry I have been absent so long. I have been busy with vocational and family issues

I imagine that you have been very busy as of late.

Are you working on the flu currently?

This MUST have already been posted on FR somewhere:

Over 50 birds die in British quarantine from bird flu

http://www.breitbart.com/news/2005/11/15/051115145036.wxhdj7hl.html

In a related development, China said Sunday it has developed what it calls the equivalent of the anti-bird flu drug Tamiflu in preparation for a feared pandemic if the virus begins spreading among humans.

Sadly for western animal lovers, it's made from Panda testicles.

Thanks for posting.

My guess is that we will miss the main event this flu season. But it is so widespread in birds, and in pigs as well (though not as widespread), that it seems certain we will see something major in the 2006/07 flu season.

If so, I certainly hope someone comes up with something REALLY innovative in the next 12 months...

"I imagine that you have been very busy as of late.

Are you working on the flu currently?"

Yes very busy and yes it is my sole role the field of influenza. I work as part of the sentinel system

U.K. Says Flu Failed to Spread From Infected Birds (Update2)

Nov. 15 (Bloomberg) -- The strain of avian influenza capable of infecting people didn't spread between species in a quarantine center in the U.K. after killing as many as 53 birds from Taiwan, government scientists said...

(snip)

Smugglers?

Taiwan responded to the U.K. report by saying there is a ``good possibility that profit-driven traders smuggled mesias from China to Taiwan, using our avian flu-free country as a front from which they laundered these birds to the UK and other countries,'' the British Broadcasting Corp. reported. Taiwan has asked if it can send a team to the U.K. to discuss the findings with British officials, BBC said.

http://www.bloomberg.com/apps/news?pid=10000102&sid=a_oHg4orzc_0&refer=uk

Ping to post # 2,110.

Here's a new one from TCS. http://www.techcentralstation.com/111705C.html

The Flu the Next Time
Duane D. Freese

President Bush's plan to combat the threat of avian flu is borne of fears that the H5N1 viral strain closely resembles the 1918 flu strain that had leapt from birds to humans, killing 500,000 Americans and 20 million people worldwide. A report by the Department of Health and Human Services after the unveiling of Bush's plan warned that as many as 1.9 million Americans could be killed in a new pandemic with a third of the population becoming infected.

As protection, the administration's plan proposes spending $1.2 billion to vaccinate 20 million Americans with the current strain of avian flu. The idea is to give key emergency personnel some limited immunity to a mutated pandemic strain while a vaccine is prepared for the actual strain. To increase the ability to create enough of that kind of vaccine, the Bush plan would invest $2.8 billion in research and development of a cell-based (versus egg-based) vaccine, making it possible to inoculate everyone within six months of an outbreak.

That new technology, though, won't be ready until 2010 at the earliest. In the interim, and even after it's available, the first line of defense will be antivirals for most people. Antivirals given within 48 hours of onset of flu symptoms can in many cases relieve the worst of those symptoms, which in the case of the avian flu means it can prevent a lot of deaths.

The Bush plan calls for buying enough to treat about 44 million Americans, about 15% of the population, and expects states and local governments to kick in and buy enough to cover another 10% or so.

What antiviral to buy? The primary one, though not the only one needed, would be Tamiflu. This drug from California-based inventor Gilead Sciences is licensed for production by the Swiss pharmaceutical firm Hoffmann-La Roche. Tamiflu has been shown to reduce mortality in the avian flu strain that is of concern, at least in mouse models; and it can be made in a form that is easy to take and has a long shelf live.

Roche began expanding its supply chain after contacts with the Department of Health and Human Services in 2003, and the Food and Drug Administration recently approved a new U.S. manufacturing site.

That said, Roche doesn't have the capacity and won't have the capacity to produce enough to meet the administration's goals for some time.

New York Sen. Charles Schumer recently criticized President Bush's pandemic plan flu for failing to provide antiviral medicine for enough Americans soon enough. Schumer wants the country to follow the lead of some European countries that are seeking to acquire enough to cover 40% of their populations, a level that health experts believe would be safer yet.

All indications are that if you want to really keep a pandemic from getting out of hand and killing hundreds of thousands of people, you're going to need a lot of antiviral at the ready. That's because pandemics run in waves. They can come in two or three over several months. And antivirals only work as long as your taking them, unlike vaccines that offer longer range immunity.

Further, Tamiflu is a rather complicated formula to make, according to Roche. It requires a 10-step production process that can take six to eight months to complete once all materials are on hand. And one key ingredient, shikimic acid, from the star anise plant, is in limited supply.

So, it isn't like you can simply churn out enough additional antiviral really quickly to meet the needs of a nation of 300 million. You have to have it on hand so people can take the full regimen when they need it. If you take less than the prescribed full course, as with anything with drugs, you can encourage mutation into resistant strains.

While Sen. Schumer's concerns are understandable, he proposed the wrong solution to resolve the problem. He threatened Roche with legislation requiring compulsory licensing -- essentially breaking their patent rights. He drew back from that threat when Roche then met with a key New York state generic drugmaker, Barr, to discuss licensing production of Tamiflu here.

With numerous generic drug makers' offices and facilities in his state, Schumer's actions are nothing unexpected - it's a typical political sop to constituents at the expense of others. He made the same threat of legislation against the German pharmaceutical giant Bayer over the anti-anthrax drug Cipro at the height of the post 9/11 anthrax scare. And the Bush administration went along, too. It threatened Bayer until Bayer agreed to cut a deal for cut-rate prices.

The Cipro episode created a field day for anti-pharmaceutical industry zealots, such as Jamie Love of the Consumer Project on Technology, a Naderite group, who told the San Francisco Chronicle: "The Cipro thing was timely. When the US did not like the price of a medicine, we were very fast to say we might override patent rights."

In the current imbroglio with Roche, Love is beating the drums again: "I think it is pretty clear that Roche intends to suppress generic production as much as it can get away with. A failure to issue compulsory licenses liberally will result in a slower response by the generic industry to the capacity and supply problem, and much higher prices, and smaller stockpiles. The private market is likely to be particularly important for those who cannot realistically depend upon governments to protect them." There is nothing Love and the others would like more than to break the current reluctance of developed nations to force licensing of patented medicines to generics manufacturers.

But a failure by the Bush administration and the wealthy western countries to protect property rights for life-saving medicines would be disastrous.

As Bill Gates, whose foundation is providing billions for health programs worldwide, recently noted: "When you think about developing world health, the price of drugs is not the key issue. It's the drugs that aren't being invented, and part of the reason they aren't being invented is that [if] the pharmaceutical companies work in these areas, then they're expected to give the drugs away."

In a new study Avian Flu: What Should Be Done, economist Tyler Cowen argues that respect for property rights and paying fair prices for drugs are especially important if new drugs are to be available for future pandemics, whether the long lasting AIDS pandemic or of the shorter duration but equally kind an avian flu pandemic might pose.

"Confiscating property rights would reduce the incentive for innovation the next time around," Cowen argues. "Moralizing aside," he goes on, "the future supply of antivirals and other drugs still will depend on expected profits. … If we eliminate or reduce such profits, we can expect less innovation in the future."

So, Sen. Schumer's reaching immediately for the compulsory licensing threat was not good -- not for the United States or for defeating the pandemic.

The good news, though, is that Roche has agreed to work with the administration to meet its stockpile needs, and has settled its dispute with Gilead, which can now become one of the partners it needs in an appropriate expansion of the production of the drug.

But governments must make sure appropriate incentives are in place so that will happen. As Cowen points out, stockpiles of any particular anti-viral is no solution to a pandemic. It is more important to decentralize supplies and provide timely distribution of any drugs that might be helpful in battling the disease. In short, don't count on any drug being a silver bullet. It is ridiculous that governments worldwide focused so much attention on getting cheap drugs that they failed to promote the invention, development and distribution of those medicines needed to meet a deadly outbreak of avian flu.

Either way, the tough Love approach of whipping drug makers into releasing one drug, and in the process discouraging the production of better ones -- or drugs for the next potential pandemic, whatever it may be -- is no solution.

Ya hear about this?

Hi Raygun

Yes I have been aware of these incidents, it's too early to say what has happened. 12 cases is not really enough of a study group, there needs to be a report based on a wider and more inclusive sample group

I work as part of the sentinel system

Interesting. Let us know if the "bug" makes the jump.

Check this out:

http://www.freerepublic.com/focus/f-news/1524497/posts
China: Avian Flu Death Count Uncovered... 310 Dead (5,554 in Quarantine)

Posted on 11/18/2005 6:43:39 AM PST by TigerLikesRooster

China: Avian Flu Death Count Uncovered.... 310 Dead (5,554 in Quarantine)

/begin my translation

Avian Flu Death Count Uncovered.... 310 Dead

| 2005·11·18 10:14 |

Avian Flu Statistic Published by Boxun (boxun.com)
Statistic on Avian Flu, which is spreading in many parts of China, including the actual number of the infected and the dead, were published on Nov. 14 at Boxun.com, a China-related news site.

According to their expose, the number of fatalities in this year up to Nov 12, totals 310 from 13 different provinces, and the number of the quarantined people is 5,554 in total, contrary to the official announcement from Chinese authorities.

Moreover, the numbers in the statistics are lower than the actual ones. These numbers were 'approved' by the Cabinet. The data were provided by an high-level official of Chinese Health Ministry, and it was not revealed the manner in which they came to receive this statistic.

According to the source, since 2004, deadly epidemics are breaking out in many parts of China, including Avian Flu. Since 2005, military was put in charge of epidemic control, leading to tightened information blackout. This kept the accurate report on epidemic situation from coming out to the international community.

The source also said that, the announcement by Chinese Health Ministry is also masking the real situation by resorting to 'technical treatment' or 'unique academic modification and interpretation.' Even when they allow foreign experts or international organizations into China for inspection, they can do it only under Chinese authorities' supervision, which made it almost impossible to uncover the real truth.

Right now, the spread of Avian Flu has become the serious situation in many places of China, and each provincial government is given clear instruction on handling the crisis and keeping out the information.

Currently, Chinese Cabinet and Supreme Military Command issued an instruction, "Anyone suspected to be infected by Avian Flu, or really infected ones should be all confined to designated medical facilities and its report be made to higher government immediately. It is strictly prohibited to reveal information on (Avian Flu) infection without approval of the Cabinet. Any violators will be disciplined and fired or held accountable by further means."

The source also mentioned another authorities' instruction, which says, "If a patient dies (of Avian Flu), you cannot record Avian Flu or H5N1 as a cause of death. A patient suffering infectious respiratory disease, but who did not get treatment at designated medical facilities will not receive assistance such as health insurance. The medical facility which treated this patient will also receive stiff sanction.

/end my translation

Ping to the above post. Thanks for the line little jeremiah!

Thanks to Tiger - longtime freeper, and translator! We appreciate your work.

I believe Boxun.

This is shocking, except that knowing China, it isn't.

Thanks, Tiger, lj, red...

2ndrecon, see post 2116...

If possible, it would be nice to get total deaths or total infections as a sequence as a function of time. I.e. number of cumulative deaths (or infections, either will do just fine) for several different dates. That way I can calculate the growth rate.

I don't particularly care whether the data are accurate, per se. What is important, is that if they are biased (i.e. undereported), they are consistently biased.

I can't read Chineese, and I cannot decipher what the infection/death rate is. The post only provided the net total now.

Thanks