Study: Vitamin D And The Innate Immune System

 

 

 

# 6306

 

 

The theory that reduced levels of Vitamin D might lead to an increased likelihood of contracting viral infections – while not proven or universally accepted – has seen a fair amount of support in the medical field over the past few years.

 

While I don’t actively promote Vitamin D in this column, I have blogged on several flu-related Vitamin D studies over the years, Including:

 

Study: Vitamin D And Flu-Like Illnesses

Scientists To Study Vitamin D And The Flu

Vitamin D To Ward Off Flu?

 

Although intriguing, these studies have yet to settle the debate over Vitamin D’s benefits in warding off viral infections.  

 

 

In 2010, the IOM released a 999 page report on Vitamin D (see IOM Report On Vitamin D) finding - that while essential for promoting good bone health - insufficient evidence for its effects on other disease processes exists at this time.

 

The IOM granted that further studies were warranted, but found that those to date they have yielded conflicting and mixed results.

 

Which brings us to a new study, published in the May edition of the Journal of Leukocyte Biology that suggests that lower levels of Vitamin D – particularly in the elderly – may lead to autoimmune diseases and viral infections.

 

What these researchers found was a decrease in serum 25-hydroxy vitamin D in healthy adults as they aged, and a negative correlation between serum 25OHD levels and MFI (mean fluorescence intensity) expression of TLR7 on B cells, T cells, and monocytes.

 

TLR7 is one of a number of toll-like receptors, which are proteins that play an integral role in the innate (or non-specific) immune system. 

 

Our innate immune system  not only fights infections, it also buys time for our Adaptive Immune System to learn to recognize and fight specific pathogens.

 

First some excerpts from the press release, then a link to the abstract.

 

Vitamin D supplements may protect against viral infections during the winter

New research published in the Journal of Leukocyte Biology suggests that the older population could benefit from vitamin D supplementation in autumn and winter to protect against viral infections

Vitamin D may be known as the sunshine vitamin, but a new research report appearing in the Journal of Leukocyte Biology shows that it is more than that. According to the report, insufficient levels of vitamin D are related to a deficiency in our innate immune defenses that protect us from infections, neoplasias or autoimmune diseases. Since vitamin D levels decrease during autumn and winter when days are shorter and sunlight is relatively weak, this may explain why people are more prone to viral infection during these times. It also suggests that vitamin D supplementation, especially in older populations, could strengthen people's innate immunity against viral infections.

(Continue . . . )

Age and low levels of circulating vitamin D are associated with impaired innate immune function

Lorena Alvarez-Rodriguez, Marcos Lopez-Hoyos, Maite Garcia-Unzueta, Jose Antonio Amado, Pedro Muñoz Cacho and Victor Manuel Martinez-Taboada

 

 

This study adds incrementally to our knowledge, and suggests a mechanism by which low Vitamin D levels might impair immunity.

 

Not exactly proof that Vitamin D is protective against viral infections.

 

But it is another piece of data to consider.

ECDC: Status & Importance Of Invasive Mosquito Breeds In Europe

 

# 6365

 

While once thought of as something only a problem to tropical or semi-tropical regions, mosquito borne diseases like Malaria, Dengue, and Chikungunya increasingly pose a threat to parts of Europe as well.

 

A few recent examples:

 

• Last year the CDC issued a travel announcement for Greece regarding a few cases of autochthonous P. Vivax malaria transmission that had been reported over the previous months (see ECDC: Local Malaria Acquisition In Greece).

 

• In 2011 the HPA (Health Protection Agency) reported on the rapidly increasing number of imported Dengue cases into the UK (see Dengue fever cases double among UK travellers).

 

• In 2007, a traveler returning from India imported Chikungunya into Northern Italy, resulting in the infection of nearly 300 residents (for details see It's A Smaller World After All).

 

 

The list of mosquito-borne diseases that could in the future (or already do) threaten parts of Europe go beyond the three mentioned above, and includes West Nile Virus, Zika Virus, Yellow Fever, Ockelbo virus, and even Rift Valley Fever.

 

In 2010 the journal Eurosurveillance devoted an entire issue to The Threat Of Vector Borne Diseases, with perhaps the biggest threat outlined in Yellow fever and dengue: a threat to Europe? by P Reiter.

 

Complicating matters, as global climate change occurs, and as mosquito species are spread inadvertently through the movement of trade goods, ships, and airplanes, new – potentially invasive – mosquito species are being introduced into Europe.

 

Accordingly, it was announced last year that in 2012 the ECDC will produce guidelines to assist Member States in implementing invasive mosquito vector surveillance.

 

Today, as part of that ongoing process,  the ECDC has released a review of the public health ramifications of invasive mosquitoes in Europe.

 

 

Review of status and public health importance of invasive mosquitoes in Europe

30 Apr 2012

ECDC

Invasive mosquito species in Europe present a potential public health threat and their surveillance and control are essential, concludes an article published this week in the journal ‘Vector-borne and zoonotic diseases’, funded and co-authored by ECDC.

 

The article provides a review of the current geographic spread (pathways for importation and onward dissemination), public health risks related to disease transmission, biology and climatic conditions and control methods of the invasive mosquitoes in Europe.

 

In the recent years six  non-European Aedes mosquitoes (Aedes albopictus, Aedes aegypti, Aedes japonicus, Aedes atropalpus, Aedes koreicus, Aedes triseriatus) have been imported in Europe through the international trade and some of these species are established and spread in Europe.

 

The invasive mosquito species present a public health risk, as they can be vectors for a number of pathogens. While there is no proof that they could all transmit diseases, there is a potential risk linked to the presence of such mosquito species in Europe, concludes the article. Recent outbreaks of mosquito-borne disease - the chikungunya fever in Italy in 2007 and subsequent autochthonous cases of dengue fever in France and Croatia in 2010 - confirms this threat . This risk can increase in the future, state the authors, due to geographical establishment of the mosquito species in Europe, more frequent travel, and more favourable climatic conditions.

 

That is why, surveillance and control of the exotic mosquito species in Europe are essential. ECDC through VBORNET (a network of European medical entomologists and public health experts) (link to VBORNET) generates updated quarterly maps of the current distribution status of the exotic mosquito species in Europe (link to maps) - based on a compilation of existing data from various sources. Information exchange between medical entomologists, public health professionals responsible for managing disease outbreaks and policymakers is needed to improve preparedness for vector-borne diseases.

 

ECDC will produce in 2012 guidelines to assist the Member States to implement invasive mosquito vector surveillance (link to Mosquito guidelines page) and improve coverage and harmonization of data collection within the EU.

 

Read the article – published in Vector-borne and zoonotic diseases and openly accessible:

A Review of the Invasive Mosquitoes in Europe: Ecology, Public Health Risks, and Control Options, Jolyon M. Medlock, Kayleigh M. Hansford, Francis Schaffner,  Veerle Versteirt, Guy Hendrickx, Herve Zeller, and Wim Van Bortel5, Vector-borne and zoonotic diseases, Volume 12, Number XX, 2012

Read more:
Aedes aegypti
Aedes albopictus
Aedes japonicus
Mosquito guidelines
Vector-borne diseases
Emerging and Vector-borne Diseases Programme

 

 

 

While today’s report focuses on Europe, the problem of new invasive mosquito species – and the spread of vector-borne diseases into new territories – is of global concern.

A few of my blogs on the threats to North America include:

 

EID Journal:Vector-Borne Infections

Florida: Locally Acquired Malaria Case Suspected

ASTMH: Dengue and Insect-Borne EIDs In The US

MMWR: Dengue Fever In Key West

Eastern Equine Encephalitis (EEE)

National Academies Webcast On H5N1 Research: May 1st

 

 

# 6304

 

On Tuesday, May 1st, the National Academies will host a day long workshop on the far reaching implications of life sciences research and associated technologies. These issues have recently come to the forefront during the public debate over H5N1 research.

 

The workshop, put together by the National Research Council and the Institute of Medicine, will be webcast starting at 8:30 a.m.  EDT and running to 5:15 p.m. EDT on May 1st, and may be accessed from the National Academies' homepage (www.nationalacademies.org).

 

 

Below you’ll find the press release, and a link to further details on the National Academies webpage.

 

National Academy of Sciences

Lessons learned from the H5N1 research controversy -- May 1 workshop

Recent debate about whether to publish research findings on more easily transmitted strains of the H5N1 avian influenza virus has sparked an international discussion about the appropriateness of this type of research and the ways that research risks are assessed. At this National Research Council-Institute of Medicine workshop, scientists, policymakers, and the public will examine the implications of advances in the life sciences and associated technologies on assessments of risk and benefits; research-related decisions and social responsibility; current measures for minimizing research risks to individuals and the larger public; and whether additional measures may be necessary to deal with new risks raised by new scientific capabilities.

 

The workshop will take place from 8:30 a.m. to 5:15 p.m. EDT at the 20 F Conference Center, 20 F St., N.W., Washington D.C. Seating is limited; reporters who wish to attend should contact the Office of News and Public Information; 202-334-2138 or e-mail news@nas.edu. Registration for the meeting and an agenda are available at http://www.nationalacademies.org/stl. Those who cannot attend may watch a live video webcast at http://www.nationalacademies.org.

 

For more information, or to register to attend in person, visit:

 

Issues Raised, Lessons Learned, and Paths Forward for Dual-Use Research in the Life Sciences: The H5N1 Research Controversy - A Workshop

Four Million Fears, BC

 

 

# 6303

 

 

One of the recurring themes in this blog is that disasters can strike anytime, and just about anywhere. For most people, that remains an abstract concept and hard to accept possibility.

 

Which is why it is useful to identify local hazards and point them out to the residents. Here in Florida, talk of hurricane preparedness begins every year several weeks before the season starts.

 

Fellow blogger Crawford Kilian (aka Crof) has a nice feature in The Tyee today, that looks at five disasters that – given enough time – are likely to impact the roughly four million residents of British Columbia.

 

 

Five Disasters to Befall BC

TYEE LIST #12: Earthquakes, pandemics, solar flares; a calamitous pall hangs over our province.

By Crawford Kilian, Today, TheTyee.ca

Natural disasters are exciting when they happen to other people, but we'd rather not think about undergoing them ourselves. As Woody Allen famously observed, "I'm not afraid of death; I just don't want to be there when it happens."

Still, we should make our wills even when we're in our prime, and we should bear in mind that some events are so extensive that we will indeed be there when they happen. So let us consider five certain disasters B.C. will face at some point in the future.

(Continue . . . )

 

 

As always, Crof provides an interesting and informative read.

 

As if to drive home the point, in the overnight hours the island of Vancouver has experienced no fewer than three  4.0+ magnitude quakes.  Not enough to do any real damage – but a not so gentle reminder that millions of us stand on shaky ground.

 

For another take on all of this - last year in Just A Matter Of Time - I took a long look at the devastating potential of a Vancouver earthquake – tsunami combination.

Bali Closes Live Market After Suspected Bird Flu Fatality

 

 

 

# 6302

 

Although we continue to see conflicting reports come out of Indonesia regarding the 8 year-old from Bali who is suspected to have died from an H5N1 infection earlier this week (see Bali: Suspected Bird Flu Fatality), today the Jakarta Globe is reporting that a local live market has been closed after the detection of bird flu.

 

Tainted Market Closed After Bird Flu Death in Bali

Made Arya Kencana | April 28, 2012

Denpasar. Authorities in Bali closed down the Satria Poultry Market in Denpasar on Friday after several chickens there tested positive for bird flu, days after the resort island recorded the country’s seventh human death this year from the infectious disease.

Anak Agung Gede Bayu Bramasta, the head of the Denpasar livestock agency, said the market would remain closed for at least three weeks.

(Continue . . . )

 

 

Bali, a popular international tourist destination, has seen more than a half dozen high profile H5N1 cases over the past several years. In order to protect the island’s economy, in 2005 it was decreed that only locally raised chickens could be sold on the island.

 

But as this story indicates, those rules are routinely flouted and poultry are imported from East Java on a daily basis.

 

If this week’s fatality is eventually confirmed to have been due to the H5N1 virus, it will mark the second bird flu fatality on the island (see WHO Update Mar 1, 2012) this year.  Last fall, a 29-year old mother, and her two children, from Bali died of the virus as well (see WHO Indonesia Update #8 2011).

 

Although we continue to see isolated human infections around the world, and the virus continues to evolve (see H5N1: An Increasingly Complex Family Tree), for now H5N1 is primarily a threat to poultry.

The concern, of course, is that over time that could change.

 

And so the world remains at Pre-pandemic Phase III on the H5N1 virus, and we continue to watch for signs that the virus is adapting better to humans.

Turn In Your Old Rx Drugs Today

 

 

# 6301

 

Millions of medicine cabinets around the country are filled with unused, expired, and potentially dangerous prescription drugs that – for a variety of reasons – never get taken by the person for whom they were intended.

 

Often a doctor changes a prescription, or a patient doesn’t finish their meds.  Sometimes a patient dies with a medicine cabinet full of pills.

 

Whatever the reason, these drugs pose a serious threat, both to people, and to the environment. 

 

 

Too often, they end up flushed down the drain, or tossed into the trash, only to end up in rivers and streams. Or worse, they can end up in the hands of the wrong persons, and are used recreationally – particularly by teenagers.

 

For many, the dilemma is how to properly dispose of these pills. To this end, the National Take Back Initiative was created by the DEA, in conjunction local law enforcement agencies, to provide a safe – no question’s asked - place to take these drugs.

 

Today (April 28th), there will be thousands of drop-off points set up around the country where you can take these drugs.

 

 

You’ll find handy links for a search engine that will provide you with local drop off locations around the country.

 

NATIONAL TAKE-BACK INITIATIVE

April 28, 2012
10:00 AM - 2:00 PM

The Drug Enforcement Administration (DEA) has scheduled another National Prescription Drug Take-Back Day which will take place on Saturday, April 28, 2012, from 10:00 a.m. to 2:00 p.m.  This is a great opportunity for those who missed the previous events, or who have subsequently accumulated unwanted, unused prescription drugs, to safely dispose of those medications.

Americans that participated in the DEA’s third National Prescription Drug Take-Back Day on October 29, 2011, turned in more than 377,086 pounds (188.5 tons) of unwanted or expired medications for safe and proper disposal at the 5,327 take-back sites that were available in all 50 states and U.S. territories. When the results of the three prior Take-Back Days are combined, the DEA, and its state, local, and tribal law-enforcement and community partners have removed 995,185 pounds (498.5 tons) of medication from circulation in the past 13 months.

“The amount of prescription drugs turned in by the American public during the past three Take-Back Day events speaks volumes about the need to develop a convenient way to rid homes of unwanted or expired prescription drugs,” said DEA Administrator Michele M. Leonhart. “DEA remains hard at work to establish just such a drug disposal process, and will continue to offer take-back opportunities until the proper regulations are in place.”

“With the continued support and hard work of our more than 3,945 state, local, and tribal law enforcement and community partners, these three events have dramatically reduced the risk of prescription drug diversion and abuse, and increased awareness of this critical public health issue,” said Leonhart.

Collection Site Locator:

Find a collection site near you. Check back frequently as collection sites are continuously being added.

Dutch Govt. Grants Fouchier Export License For H5N1 Research

 

 

# 6300

 

Four days after holding hearings in the Netherlands, the Dutch government today announced the granting of an export license to Ron Fouchier which clears the way for the publication of his research on transmissible strains of the H5N1 virus.

 

The decision was announced today in a letter of authorization posted on the Dutch Ministry for Agriculture and Foreign Trade website.

 

 

Letter authorization for export manuscripts on bird flu research

Letter authorization for export manuscripts on bird flu research

Page | 1 page | 31 KB

Unknown type | 27/04/2012 | EL & I

Letter from Secretary Bleacher (EL & I) about the status of the license for the export of manuscripts with detailed information about the modified avian flu virus (H5N1). The Secretary of State has decided to grant the license.

Bali: Suspected Bird Flu Fatality

 

# 6299

 

Several news outlets overnight are reporting on the death of an 8 year-old  child on the Indonesian island of Bali, ostensibly from the H5N1 virus.

 

While some of these media reports vaguely indicate a positive lab finding for H5N1, others suggest that the girl’s diagnosis was based on clinical signs and symptoms. Until the Indonesian Ministry of Health confirms this case, it remains `suspected’.

 

 

Gert van der Hoek on FluTrackers   has picked up and translated a couple of media reports on this case (another has been added by Shiloh) on this thread.

 

A translated excerpt from Antara news reads:

 

Patient Died With Clinical Condition for Bird Flu

Wednesday, in April 25 2012
Denpasar (Antara Bali) - A Patient was suspected bird flu, with initial P (8) died when undergoing the maintenance in the central Public Hospital, Denpasar, clinically showed the condition was attacked by this deadly illness.

 

"We indeed treated the patient that clinically his direction to bird flu, afterwards was based on the laboratory inspection simply in RSUD Bangli also showed the picture" of the "virus infection," said the Secretary of the Penanggulangan Committee of the Flu Burung Rumah Sakit Umum Pusat Illness (RSUP) Sanglah, Dr IGB Ken Wirasandhi, on Wednesday.

 

He said, so as the patient of the female child from Kintamani, Kabupaten Bangli, that was at once treated in Nusa space as isolation space for the bird flu sufferer, since his arrival on Tuesday afternoon (24/4) around struck 17,00 Wita.

(Continue . . . )

 

If confirmed, this case would make the 7th known H5N1 case on the island of Bali.

 

 

The H5N1 virus remains poorly adapted to human physiology, and so far remains primarily a threat to poultry and wild birds.

 

That could change of course, as the dozens of strains and clades around the world continue to mutate and evolve. So we watch these cases with great interest, looking for any signs that the threat has changed.

TEDx UMN: Rethinking Influenza Vaccines

 

 

# 6298

 

Constant readers are aware that I am an unabashed fan of TED Talks, and have featured a number of them in this blog.  TED stands for Technology, Entertainment, Design, and participants are invited to `give the 18 minute talk of their lives’ before a live audience.

 

I was first turned onto the TED Talks when a friend sent me a link to the winner of 2006’s TED Prize, Dr. Larry Brilliant's presentation on his dream of a new global system that can identify and contain pandemics before they spread. If you’ve never seen this speech, I urge you to watch it now.

 

There are now over 1100 TED talks on a myriad of subjects, freely available for viewing on the TED Website, and you could spend weeks exploring the site. You can also subscribe to them on itunes or view them on Youtube.

 

So popular have the official TED TALKS become that local, independently organized versions of them (called TEDx) have sprung up around the world. 

 

TEXx describes their mission as:

 

Created in the spirit of TED’s mission, “ideas worth spreading,” the TEDx program is designed to give communities, organizations and individuals the opportunity to stimulate dialogue through TED-like experiences at the local level. TEDx events are fully planned and coordinated independently, on a community-by-community basis

 

And now there are hundreds of local TEDx events held around the world every month. Their website provides information on upcoming events.

 

Last weekend the University of Minnesota held a day-long TEDx event (TEDxUMN) , which was live-streamed on the internet, and those videos are now online.

 

While I would invite you to view all of the talks, I wanted to call attention to one in particular, delivered by Nick Kelley -  preparedness program coordinator at CIDRAP – on Rethinking Influenza Vaccines.

 

The TEDxUMN talks are archived in two videos on this page, and you’ll find Nick’s in the second (bottom) video, at time stamp 2:16:35. 

 

 

Nick’s message is that influenza vaccines – while providing modest (59%) protection in healthy adults (under 65) – are in dire need of improvement. Worse, our inability to produce vaccines quickly seriously limits their value in a pandemic.

 

Despite these deficits, today’s flu vaccine remain our best weapon against influenza.

 

Nick argues that our acceptance of today’s vaccine technology as being `good enough’ serves as a psychological barrier to investing in, and developing, better vaccine technologies.

 

I’ll not give away the rest of his talk.

 

Follow this link to watch Nick’s entire presentation, and while you are at it, take a look at some of the other dozen plus TEDxUMN presentations.

 

 

Personal Note:  I’ll be away from my desk for much of the next three days, and while I’ll have my laptop with me, blogging and updates to this site may be light until Friday.

As always, Crofsblog, Arkanoid Legent, FluTrackers, the Flu Wiki  and Maryn McKenna’s Superbug Blog are terrific resources in Flublogia. 

Taiwan: Three Poultry Workers Show H5N2 Antibodies

 

Photo Credit – FAO

# 6297

 

 

There are several variations of this news report floating across the wires this morning, but in the end, it may turn out that there is less to this story than at first appears.

 

The gist of the story is that three poultry workers and/or animal quarantine officers who worked at a farm where the H5N2 virus was recently discovered have tested positive for antibodies to the H5N2 virus.

 

H5N2, while an avian influenza virus, is currently considered a far less dangerous pathogen than its infamous cousin, H5N1.

 

But all H5 viruses (along with H7s) are reportable to the OIE because of their potential to evolve into more dangerous viruses, particularly when they are allowed to proliferate in large flocks of poultry.

 

First a link to the Taiwan story, then I’ll return with more:

 

3 poultry workers, quarantine officers show antibodies for H5N2

2012/04/22 21:05:42

Taipei, April 22 (CNA) The Centers for Disease Control (CDC) confirmed Sunday that three poultry workers and officials working in animal quarantine have tested positive for antibodies for the H5N2 strain of avian influenza.

However, all three people are healthy and none have developed any flu symptoms, CDC Deputy Director-General Chou Jih-haw said, adding that there is no public health risk of human-to-human transmission.

(Continue . . .)

 

While antibodies to the H5N2 virus have been detected a few times in humans in the past, the virus has never been shown to cause illness in human hosts. 

 

A couple of studies in the past include:

 

J Epidemiol. 2008;18(4):160-6. Epub 2008 Jul 7.

Human H5N2 avian influenza infection in Japan and the factors associated with high H5N2-neutralizing antibody titer.

Ogata T, Yamazaki Y, Okabe N, Nakamura Y, Tashiro M, Nagata N, Itamura S, Yasui Y, Nakashima K, Doi M, Izumi Y, Fujieda T, Yamato S, Kawada Y.

Arch Virol. 2009;154(3):421-7. Epub 2009 Feb 3.

 

Serological survey of avian H5N2-subtype influenza virus infections in human populations.

Yamazaki Y, Doy M, Okabe N, Yasui Y, Nakashima K, Fujieda T, Yamato S, Kawata Y, Ogata T.

 

 

While suggestive of prior H5N2 infection, there is precious little evidence to link any significant or serious human illness to the H5N2 virus.

 

Complicating the story out of Taiwan is the fact that, starting in 2010, Taiwan began offering soon-to-expire H5N1 vaccine to high risk members of their population, including poultry workers and animal quarantine officers. 

 

See Focus Taiwan article from Sept 1st, 2010 titled CDC begins national bird flu vaccination program for details.

 

 

So while it is possible that these three workers acquired H5N2 antibodies from direct exposure to infected poultry, it may simply be that their tests are showing cross-reactivity to H5N1 antibodies created by the bird flu vaccine they received.

 

It has also been suggested that a history of seasonal influenza vaccinations could produce H5N2-neutralizing antibody positivity as well.

 

Which leaves us with an intriguing story, but one with a lot of possible holes in it.

 

For more on the H5N2 virus in Taiwan, you may wish to revisit:

 

WHO: Human Risk From H5N2 Is Low

Taiwan: H5N2 At Poultry Farm

Fouchier Research To be Debated In The Netherlands This Week

BSL-4 Lab Worker - Photo Credit –USAMRIID

 

# 6296

 

Although the United States has officially withdrawn its objections to the publication of Ron Fouchier’s H5N1 ferret research study (see The Biosecurity Debate On H5N1 Research for background on this issue), there remains another bureaucratic obstacle to publication in the form of an export license from the Dutch government.

 

According to a Radio Netherlands report, the debate will be taken up tomorrow, and there remains considerable opposition to the publication. 

 

A hat tip to Pathfinder on FluTrackers for this link.

 

Publication ban on virus research: security or censorship?

Published on : 21 April 2012 - 6:41pm | By Willemien Groot

On Monday, Dutch experts will debate whether or not Dr Ron Fouchier should be allowed to publish the results of his research, which has created a potentially dangerous strain of the H5N1 bird flu virus. The United States biosecurity watchdog has withdrawn its objections to publication. Dutch Deputy Minister for Innovation Henk Bleker, on the other hand, still fears the research could be used by terrorists. Fouchier rejects any ban on publication of his work. A row is in the making.

(Continue . . . )

 

 

Fouchier has reportedly not applied for an export license, and has stated that he intends to publish his research with – or without – the sanctioning of his government.

 

According to a report by CIDRAP NEWS last week (see Fouchier plans to flout Dutch export law, publish H5N1 study),  Fouchier could conceivably find himself facing criminal charges if he attempts to publish his data without government permission.

 

While the U.S. has withdrawn its objections to the publication of Fouchier’s research (and Professor Yoshihiro Kawaoka’s in Wisconsin), and has recently issued new regulations regarding oversight of Dual Use Research of Concern (see U.S. Issues New DURC Oversight Rules), there remain many unresolved bio-security issues surrounding the life sciences and bioengineering fields.

 

Among them:

• How are we to handle this brave new world of life sciences, where new viruses and other life forms can be created in the laboratory?
• Who is to decide on what is appropriate, or safe research?
• Who decides what should be published, and who should have access to redacted information?
• What laboratory protocols and protections are necessary for working the the H5N1 virus, and other virulent pathogens?

 

Regardless of what the Dutch government decides in the near term on the publication of Fouchier’s research, the problem of what to do about future DURC research projects are not going away.

 

These are serious biosecurity concerns that must be faced, debated, and agreed upon internationally, not just by individual countries.

And better sooner, rather than later. 

FEMA/NOAA/NWS: Severe Weather Preparedness Week April 22nd-30th

 

# 6295

 

April of 2011 saw the largest number of tornadoes for a single month on record, with 758 twisters that claimed 364 lives.  The following May, there were 326 tornadoes that killed an additional 178 people around the nation.

 

In fact, 2011 saw a record breaking 14 Billion-dollar-plus weather related disasters (see Weathering Heights: A Year For The Record Books) across the United States. 

 

And that, despite relatively few hurricane strikes.

 

Weather-related disasters are on the rise around the world, partially due to climate change, and partially due to the fact that as our populations increase there are more of us sprawled out  in harm’s way.

 

While many states have promoted a severe weather awareness week for years (and NOAA promotes their Hurricane Preparedness Week in May of each year), this year will mark the first national Severe Weather Preparedness Week.

Credit FEMA NWS 

 

Admittedly, I may be more keenly aware of the weather than most, having spent the bulk of my 58 years under the red splotch (see above map) over Florida that indicates the greatest number of thunderstorm days in the United States.

 

And 15 of those years were spent afloat, aboard sailboats with large lightning rods (we called them masts), pointed skyward.

 

While they may see fewer days with thunderstorms, people who live in the Midwestern and Southern states are actually at greater risk of seeing severe hail and large tornadoes.

 

Lightning (something Florida is also famous for) claims another 30 to 50 lives each year.

 

 

Add in floods, heat waves (one in the early 1980s claimed thousands of lives), droughts, hurricanes, blizzards and ice storms, and a variety of weather-related accidents – and the yearly toll from severe or adverse weather grows even larger.

 

Of all of the potential disasters you and your family are apt to face during your lifetime, the most likely are due to severe weather.

 

NOAA’s National Weather Service has put together a new web presence called Weather Ready Nation, which provides abundant information on preparing for severe weather, and a number of toolkits for spreading the word.

 

 

You can also connect with Weather Ready Nation and the National Weather Service via a number of social media outlets:

 

WRN Social Media

NOAA Youtube
NOAA's Facebook
NOAA Twitter Feed

---

NWS Facebook
NWS Youtube
NWS Twitter Feed

 

Essentially NOAA and FEMA are urging everyone:

 

To “be a force of nature,” NOAA and FEMA encourage citizens to prepare for extreme weather by following these guidelines:

• Know your risk: The first step to becoming weather-ready is to understand the type of hazardous weather that can affect where you live and work, and how the weather could impact you and your family. Check the weather forecast regularly and sign up for alerts from your local emergency management officials. Severe weather comes in many forms and your shelter plan should include all types of local hazards.

• Take action: Pledge to develop an emergency plan based on your local weather hazards and practice how and where to take shelter. Create or refresh an emergency kit for needed food, supplies and medication. Post your plan where visitors can see it. Learn what you can do to strengthen your home or business against severe weather. Obtain a NOAA Weather Radio. Download FEMA’s mobile app so you can access important safety tips on what to do before and during severe weather. Understand the weather warning system and become a certified storm spotter through the National Weather Service.

• Be a force of nature: Once you have taken action, tell your family, friends, school staff and co-workers about how they can prepare. Share the resources and alert systems you discovered with your social media network. Studies show individuals need to receive messages a number of ways before acting – and you can be one of those sources. When you go to shelter during a warning, send a text, tweet or post a status update so your friends and family know. You might just save their lives, too. For more information on how you can participate, visit www.ready.gov/severe-weather

 

 

While many people today seem to be obsessing about some unlikely 2012 doomsday event, the real day-to-day threat to your family’s safety come from more localized and likely disasters, such as earthquakes, floods, and severe weather.

 

And finally,  a few of my preparedness blogs you might wish to revisit include:

 

When 72 Hours Isn’t Enough

In An Emergency, Who Has Your Back?

An Appropriate Level Of Preparedness

The Gift Of Preparedness 2011

CDC Streaming Health: Influenza Videos

 

 

# 6294

 

The CDC, along with other government agencies, increasingly are using social media to inform and educate the public. In addition to their traditional web presence, we are seeing agencies use twitter chats and updates, stream live webinars and press conferences, and many of these agencies maintain Youtube Channels with updated selections of videos.

As an example, the CDC’s Streaming Health video channel features 300 videos, on a wide variety of health topics. 

 

Over the past week, they have uploaded 7 videos on influenza, which run anywhere from 2 to 10 minutes in length.

 

 

   10:27

Misconceptions about Flu and the Flu Vaccine

 

    3:06

Flu: Medicine Safety and Children

    2:45

Flu Warning Signs That Need Medical Care Right Away

 

      8:55

Answers to Common Questions about Flu Vaccine Safety

 

   6:27

Flu Vaccine Information for Pregnant Women and Children

 

    5:44

Answers to Common Questions about the Flu Vaccine

 

   2:22

How to Know if You Have the Flu: Flu Symptoms

 

 

 

For convenience, you’ll find the videos arranged by topic in 18 playlists, including: Influenza, Emergency Preparedness, Novel H1N1 Influenza, Cancer, PSAs, and videos en Español.

 

 

In another social media venue, next Monday the CDC will conduct a `twitter chat’ on STD’s.  Here’s the announcement.

 

Join us! We will be talking more about STD prevention and young people during our live Twitter chat with CDC Director Dr. Tom Frieden (@DrFriedenCDC) on April 23 at 1 pm EDT. #CDCChat

Popocatepetl Webcam

 

 

# 6293

 

The stratovolcano Popocatepetl - located just 43 miles southeast of Mexico City - has been increasingly restless over the past week, forcing authorities to raise the alert level. 

 

As reported by the Associated Press a short while ago, the volcano is spewing smoke and throwing rocks high into the air and a red glow is visible near the crater.

 

There is a webcam trained at the northern flank of the 17,802 foot volcano, which refreshes every 60 seconds.

You can view the activity at this link.

 

The alert is currently at level 5 (yellow) of 7.  Should the alert be raised to level 6 (red), evacuations may be ordered of nearby residents. 

 

`Popo’ has been erupting intermittently since 1994, with a very large eruption in December of 2000.

Flu Strain Identified in CT. Veterans Home

 

 

# 6292

 

 

Earlier this week a number of news stories emerged regarding two dozen elderly residents of a Rocky Hills, CT veterans home who were hospitalized for influenza (see More Influenza Cases At Rocky Hill Veterans’ Home).

 

As all of these patients reportedly had received the seasonal flu vaccine early in the fall, there were some concerns expressed in the media that a variant strain of flu, not covered by the current vaccine, might be the cause.

 

Today, The Hartford Courant is reporting that the culprit – based on laboratory tests conducted by the state health department – has been determined to be regular seasonal H3N2. 

 

The same strain contained in the flu shot.

 

First the report, then I’ll return with more on why this isn’t a particularly surprising event.

 

State Officials ID Strain Of Flu That Caused Outbreak At Rocky Hill Vets Home

H3N2, A Strain Targeted By This Season's Vaccine, Is The Culprit

BY WILLIAM WEIR, bweir@courant.com The Hartford Courant

4:00 p.m. EDT, April 19, 2012

The strain of flu that sent 24 veterans living at a Rocky Hill residential home to the hospital has been identified as one that was targeted by this year's influenza vaccine.

(Continue . . .)

 

 

 

This veteran’s residence is home to 478 vets, nearly all male, and their average age is said to be 80-85. The 2 dozen residents hospitalized make up only about 5% of the facility’s population.

 

While influenza can strike people of any age, it is the elderly who experience the greatest health burden from the illness. Those over 65 are more likely to be hospitalized, or die, as a result of the flu.

 

(Credit NFID )

 

The immune system of those over 65 is often  less robust than their younger counterparts, and they are often dealing with underlying chronic conditions such as heart disease, COPD, and diabetes that further increase their risks.

 

Complicating matters, the influenza vaccine is generally less effective in the elderly as well (see Study: Flu Vaccines And The Elderly, Flu Shots For The Elderly May Have Limited Benefits).

 

Last year NFID (National Foundation for Infectious Diseases) convened a panel of experts to address the issues of influenza and the elderly that included such familiar names in public health as Arnold Monto, MD; Kristin Nichol, MD, MPH; H. Keipp Talbot, MD, MPH; and William Schaffner, MD.

 

From that panel a 5-page brief has emerged, called: Understanding the Challenges and Opportunities in Protecting Older Adults from Influenza.

 

Although the elderly generally see less protection from the flu vaccine, older individuals may still mount a robust immune response. In populations 65 and older, the brief points out that:

• Hospitalization rates for influenza and pneumonia are lower in community-dwelling adults who received the seasonal influenza vaccine.
• Immunization is associated with reduced hospitalization of older patients for cardiac, respiratory, and cerebrovascular diseases.

 

While the goal of vaccinating the younger population is to prevent infection, the authors point out that:

 

. . . the goal in older adults is to prevent severe illness, including exacerbation of underlying conditions, hospitalization, and mortality.

 

In other words, even if the vaccine doesn’t always prevent infection in the elderly, studies suggest that the vaccine may blunt the seriousness of the illness in those over 65.

 

And since (so far) none of these veterans has died, and that only about 5% of the residents have been seriously sickened by the virus, this vaccine would appear to have afforded these residents at least some degree of protection. 

 

It is no secret that the flu vaccine could stand improvement, particularly for those with weakened immune responses.

 

In 2010 a new high-dose flu vaccine containing 4 times the normal amount of antigen; 60 µg of each of the three recommended strains, instead of the normal  15 µg, was approved (see MMWR On High Dose Flu Vaccine For Seniors).

 

But this shot is too new to know how much better it works in the elderly.  We should get answers to that question in the next year or so.

 

In the meantime, better (and faster) vaccine technologies are needed. To improve not only the efficiency of the vaccine, but the availability in the event of a pandemic, as well.

 

For more on all of this, NFID has a resource rich website with information fact sheets on a variety of infectious diseases, continuing medical education (CME) links, information on conferences and courses, and publications.

H5N1 Seroprevalence Among Jiangsu Province Poultry Workers

 

Study location Jiangsu Province – Credit Wikipedia

 

# 6291

 

 

We’ve a new study that adds incrementally to our knowledge base on human infection by the H5N1 bird flu virus that appeared in BMC Infectious Diseases yesterday. The results of which, I suspect, will end up being used by both sides of the The Great CFR Divide.

 

 

Researchers interviewed and took blood samples from 306 poultry workers from three counties in Jiangsu Province, China between July 1st and August 15th, 2010. None of the workers reported serious respiratory illness in the past, and all dealt with un-vaccinated poultry on routine basis.

 

The open access study may be viewed at:

 

Seroprevalence of avian influenza A (H5N1) virus among poultry workers in Jiangsu Province, China: an observational study

Xiang Huo, Rongqiang Zu, Xian Qi, Yuanfang Qin, Liang Li, Fenyang Tang, Zhibin Hu and Fengcai Zhu

BMC Infectious Diseases 2012, 12:93 doi:10.1186/1471-2334-12-93

Published: 18 April 2012

Abstract (provisional)

Background

Since 2003 to 06 Jan 2012, the number of laboratory confirmed human cases of infection with avian influenza in China was 41 and 27 were fatal. However, the official estimate of the H5N1 case-fatality rate has been described by some as an over estimation since there may be numerous undetected asymptomatic/mild cases of H5N1 infection. This study was conducted to better understand the real infection rate and evaluate the potential risk factors for the zoonotic spread of H5N1 viruses to humans.

Methods

A seroepidemiological survey was conducted in poultry workers, a group expected to have the highest level of exposure to H5N1-infected birds, from 3 counties with habitat lakes of wildfowl in Jiangsu province, China. Serum specimens were collected from 306 participants for H5N1 serological test. All participants were interviewed to collect information about poultry exposures.

Results

The overall seropositive rate was 2.61% for H5N1 antibodies. The poultry number was found associated with a 2.39-fold significantly increased subclinical infection risk after adjusted with age and gender.

Conclusions

Avian-to -human transmission of avian H5N1 virus remained low. Workers associated with raising larger poultry flocks have a higher risk on seroconversion.

 

 

 

The researchers used two different H5N1 reference antigen strains for the seroprevalence analysis; one from 2010 A/Hubei/1/10 (clade 2.3.2)  and an older one from 2005 A/Anhui/1/05 (clade 2.3.4).

 

While the total seropositive rate was 2.61% (95%CI, 1.14%–5.09%), it turned out that none of the blood samples tested positive for the newer (A/Hubei/1/10) strain.

 

Only antibodies to the older A/Anhui/1/05 strain were detected.

 

And of the three locations tested (Gaochun, Jianhu and Gaoyou counties) the percentage of workers testing positive ranged from zero (Gaochun) to 5.38% (95%CI, 2.19%–10.78%) in Gaoyou.

 

In their discussion, the authors state:

 

Several serological studies have been conducted to assess the transmission of H5N1 virus in poultry workers. The reported seropositive rates vary from 0 to 10% [9-11]. In the present study, the overall positive rate we found was 2.61% and in different sampling districts the rates varied from 0 to 5.38%.

 

Many factors could be responsible for the variability, such as the H5N1 infection rate and vaccination rate of the poultry, the precautions and job duties of the workers. In our study, poultry number was identified as a novel risk factor associated with human infection with avian H5N1 virus, which could be accounted for the distinction of seropositive rate among districts and studies.

<SNIP>

Conclusions

Avian-to –human transmission of avian H5N1 virus remained low. Workers associated with raising larger poultry flocks have a higher risk of seropositivity.

 

 

This is a small sampling - a little over three hundred blood tests conducted across three counties in Northern China – so one must be careful in extrapolating these numbers across a wider population.

 

But the lack of seropositivity among poultry workers in Gaochun county suggests a good deal of variability, even among high risk populations.

 

Which means you can’t simply multiply the population of endemic regions by 2.61% in order to come up with a reasonable estimate of the number infected.

 

And there’s a lot we don’t know about the road to achieving seropositivity, including viral load required, mode of infection (or exposure), and differences in the pathogenicity and transmissibility of various clades of the virus.

 

Earlier this week in Differences In Virulence Between Closely Related H5N1 Strains, we looked at two closely related H5N1 strains which produced decidedly different pathogenesis in mice and ducks.

 

With at least 20 clades of the virus identified, and a good deal of genetic variation within each clade, it makes it very difficult to make any general statement about the virulence or transmissibility of the H5N1 virus.

 

Today’s study shows that low levels of H5N1 seropositivity among some poultry workers in China exists.

 

But it is neither uniform nor is it universal. 

 

It’s another data set to consider, along with the handful of other studies we’ve seen. But does not provide a definitive answer, one way or the other, on the transmissibility of the H5N1 virus.

 

For more on H5N1 seroprevalence studies, and the controversy over the Case Fatality Rate of the H5N1 virus, you may wish to revisit:

 

mBio: Mammalian-Transmissible H5N1 Influenza: Facts and Perspective

Science: Peter Palese On The CFR of H5N1

Study: Subclinical H5 & H9 Infections In Humans

The Thailand Serological Study

China Reporting H5N1 In Poultry

 

Map Credit Wikipedia

# 6290

 

 

Via the China Daily we’ve a report (that has also been echoed in Chinese Language news reports overnight) that a large outbreak of H5N1 has been detected in Northwestern China.

 

The big news here isn’t so much that Chinese poultry have been discovered to be infected by the H5N1 virus (something that many observers suspect happens more often than we are told), but that in this case, it is being publically acknowledged.

 

Here is the report from China Daily.

 

H5N1 bird flu reported in NW China

Updated: 2012-04-18 20:30

(Xinhua)

BEIJING - China's Northwestern Ningxia Hui autonomous region has reported an outbreak of the highly epidemic H5N1 bird flu virus in poultry, the Ministry of Agriculture (MOA) announced Wednesday.

 

More than 23,000 chickens at several farms in a village of Touying town in the city of Guyuan in Ningxia showed symptoms of suspected avian flu Friday and the National Avian Influenza Reference Laboratory confirmed the epidemic was a H5N1 bird flu case after testing samples collected at those sites, according to the MOA.

 

The body said in a statement that a total of 95,000 chickens have been culled after the H5N1 bird flu case was confirmed.

 

"The epidemic is under control now," it said, as a team was dispatched to the quarantined area to guide epidemic prevention.

USGS: New Real-Time Earthquake Map

 

New Real-Time USGS Earthquake Map

 

# 6289

 

 

The USGS has introduced an impressive real-time earthquake map on their Earthquakes Hazards Webpage, that allows the user to customize how the data is delivered. 

 

The control panel (see below) allows the user to filter out quakes based on minimum display parameters.

 

 

And the map has the ability to pan and zoom, allowing the user to drill down to the local level (including information on cities, streets, and fault lines).

Close up View of seismic activity around Tokyo, Japan

 

The global map display lists the most recent earthquakes (based on your criteria), and you can click on each event to get more information.

 

 

 

For more on the unveiling of this new tool, we have the following press release from the USGS.

 

Enhanced Real-time Earthquake Information Now Online

Released: 4/17/2012 1:53:48 PM

 

New U.S. Geological Survey webpages featuring more robust, real-time earthquake information are now available.  Whether the earthquake is minor or major, earthquake.usgs.gov visitors will see a unique, interactive earthquake map that regularly updates, can be individually tailored, and provides saved settings for future map visits.

 

In 2011, the website logged almost 48 million unique visitors and nearly 468 million pageviews.

 

"For all citizens of 'Earthquake Country,' whether they reside in our Nation's Capital or near a major global tectonic plate boundary, the new USGS earthquake webpages supply increased functionality to provide more real-time information tailored to the viewer's specific needs," said USGS Director Marcia McNutt. "When the ground shakes and time is of the essence, our goal is to ensure that the most timely information is at the fingertips of those who need to know."

 

From the website, users can access Latest Earthquakes  to zoom into and pan the world map to select different basemaps, as well as overlays such as plate boundaries, faults, and earthquake hazards. Information can be fine-tuned to display earthquakes on the map by time window, magnitude, depth, and maximum recorded intensity.  A list below the map updates for the current map view and settings and is sortable by any data column. Users can also download earthquake lists into other map interfaces like GoogleEarth (KML format) and Excel (CSV).

 

The event page when an earthquake is selected has also been upgraded and it provides interactive features and more information, including downloadable data files in various formats for each earthquake product, such as ShakeMap, Did You Feel It?, etc. This new event-centric view allows the visitor to see all the information associated with each earthquake without having to jump around the website to view each related product.

 

A future product in development will utilize the same user interface to search a comprehensive earthquake catalog populated with all existing USGS earthquake data, presenting a seamless view of recorded world-wide earthquakes current and historic.  It is anticipated that this product will be released in beta later this year.

NIAID Video: Antigenic Drift

 

 

# 6288

 

 

NIAID, part of the NIH, has just released a short (3 minute) video that nicely illustrates how flu viruses change antigenically over time, and eventually mutate so that the current flu vaccine no long is effective.

 

 

 

As the seasonal H3N2 virus that has been covered in the flu vaccine over the past 3 years has begun to accumulate changes like the ones discussed in this video, in the fall a new H3N2 strain will be incorporated in the flu shot.

 

There are currently 18 videos on the NIAID Youtube site, and links to others on other channels.

Well worth taking a look.