Study: Ferrets, H1N1 and Pneumonia

 

 

 

# 4392

 

 

While the pandemic of 2009 certainly appears to have been less severe than the 1957 Asian flu, its true impact has not been determined.  

 

It may take months, or perhaps years, before we have a really good handle on the severity of this virus.

 

Despite attempts by some to paint this virus as `no worse than seasonal flu’, we continue to see evidence that novel H1N1 differed from seasonal flu in terms of severity and the profile of patients hardest hit.

 

In a normal flu season, it is those over the age of 65 who make up 90% of the flu-related fatalities.  During the past 10 months, those under 65 have borne the brunt of this virus.

 

While the vast majority of those infected by this virus only suffered mild to moderate illness, a significant number number of people suffered serious complications.   In many cases, those victims developed severe, life threatening pneumonias.

 

Over the past eight months we’ve seen a steady parade of reports showing that there is something fundamentally different about the way the novel H1N1 virus attacks humans.   

 

A few blogs on that subject include:

 

Canada: H1N1 Sent More To ICU Than Seasonal Flu

I Only Have Eyes For Flu

Cytokine Storm Warnings

NIH: Post Mortem Studies Of H1N1

Pathology Of Fatal H1N1 Lung Infections

 

Today we’ve another study, this time out of the Department of Virology, Erasmus Medical Centre and ViroClinics Biosciences BV, Rotterdam, The Netherlands  which uses a ferret model to test the pathogenicity of the novel H1N1 virus against seasonal and bird flu.

 

Ferrets are often used in influenza studies due to their high susceptibility to the virus.

 

The entire study is a pay-per-view in the latest edition of The Journal of Infectious Diseases, so I only have access to the abstract.  

 

If this study sounds familiar, there’s a reason.

 

This appears to be a follow up to research widely reported last summer (see The ECDC On The Ferret Pathogenicity Study, and Ferreting Out The Severity Of A Flu Virus) on the pathogenesis of novel H1N1 in ferrets.

 

The upshot, once again, seems to indicate that the novel H1N1 virus produces more severe pneumonia (in ferrets) than seasonal flu, although less severe than what is seen from the H5N1 virus.

 

The abstract follows:

 

Severity of Pneumonia Due to New H1N1 Influenza Virus in Ferrets Is Intermediate between That Due to Seasonal H1N1 Virus and Highly Pathogenic Avian Influenza H5N1 Virus

Judith M. A. van den Brand,Koert J. Stittelaar, Geert van Amerongen,Guus F. Rimmelzwaan, James Simon, Emmie de Wit, Vincent Munster,Theo Bestebroer, Ron A. M. Fouchier, Thijs Kuiken, and Albert D. M. E. Osterhaus

 

Background.

The newly emerged influenza A(H1N1) virus (new H1N1 virus) is causing the first influenza pandemic of this century. Three influenza pandemics of the previous century caused variable mortality, which largely depended on the development of severe pneumonia. However, the ability of the new H1N1 virus to cause pneumonia is poorly understood.

 

Methods.

The new H1N1 virus was inoculated intratracheally into ferrets. Its ability to cause pneumonia was compared with that of seasonal influenza H1N1 virus and highly pathogenic avian influenza (HPAI) H5N1 virus by using clinical, virological, and pathological analyses.

 

Results.

Our results showed that the new H1N1 virus causes pneumonia in ferrets intermediate in severity between that caused by seasonal H1N1 virus and by HPAI H5N1 virus. The new H1N1 virus replicated well throughout the lower respiratory tract and more extensively than did both seasonal H1N1 virus (which replicated mainly in the bronchi) and HPAI H5N1 virus (which replicated mainly in the alveoli). High loads of new H1N1 virus in lung tissue were associated with diffuse alveolar damage and mortality.

 

Conclusions.

The new H1N1 virus may be intrinsically more pathogenic for humans than is seasonal H1N1 virus.

Roundup Of Flublogia

 

 

# 4391

 

 

It’s been several weeks since my last recap of stories from in and around Flublogia (along with other science blogs), so this quiet Sunday morning seems an ideal time to catch up.

 

As always, this is a subjective list of things that I found of interest, and by no means mentions every worthy blog post out there.

 

With influenza on the decline in North America and around the world, much of the focus of Flublogia has shifted away from `breaking news’ to a review of what we’ve learned, or are learning, from this pandemic.

 

You’ll also find a rise in coverage of other EIDs (Emerging Infectious Diseases).

 

My apologies for the good stories I may miss.  So, with that said, in no particularly order . . .

 

 

CIDRAP has a long history of providing in depth coverage of EIDs and other pathogenic threats.   Their frequently updated Novel H1N1 Influenza (Swine Flu) overview is a resource I use on a regular basis.

 

CIDRAP News coverage is second to none, with terrific reporting by editor Robert Roos, staff writer Lisa Schnirring, and contributing writer Maryn McKenna.  

 

A few recent examples include:

 

Hong Kong reports swine-pandemic flu reassortant 

Emergency departments see rise in flu-like illness

Study yields highly pathogenic avian, human flu virus mix

Updated review questions benefits of flu vaccine in elderly

 

If CIDRAP News isn’t among your daily internet stops (they update weekdays - usually late afternoon/early evening EST), it should be.

 

While H1N1 may be declining, H5N1 bird flu reports have been on the rise, with both human and poultry infections reported in places like Indonesia, Vietnam, and Egypt.  

 

Often, we get our first glimpse of these cases from the flu forum newshounds who work diligently each and every day, combing through foreign language media for these sorts of reports. 

 

This is exacting (and sometimes exhausting) work, and it requires both dedication and skill.   You’ll find a tribute to these volunteers in my essay: Newshounds: They Cover The Pandemic Front.

 

I won’t attempt to name them all, but the four whose names seem to be showing up the most in this blog over the past few weeks are; Ironorehopper, Dutchy, Ida at BFIC, and Commonground of Pandemic Information News.

 

My thanks to them, and to all of the other newshounds.

 

Sharon Sanders, editor of FluTrackers conducted another in her series of high profile radio interviews last week, this time with Gregory Härtl, spokesperson for the World Health Organization.  

 

If you missed the broadcast, the show is archived here.

 

My buddy Scott McPherson doesn’t blog as often as most of us would like, but when he does it is invariably an informative, and always entertaining, read.   You’ll find three new blogs this month on his website.

 

The countdown to the release of Maryn McKenna’s new book  SUPERBUG: The Fatal Menace of MRSA continues, with the big day just over 3 weeks away. 

 

Meanwhile, Maryn continues to update us on emerging antibiotic resistant pathogens via her Superbug blog, with several stories that showcased the reports from CBS Evening News with Katie Couric on the use of antibiotics on the farm.

 

CBS antibiotics and farming package, day one

CBS antibiotics and farming, day 2 - and more on the Danish experience

Antibiotics and farming — CBS follow-up video

 

Revere at Effect Measure is drowning writing a grant proposal, but still manages to come up for air on occasion.  Recently Revere looked at the issue of pre-existing conditions and pandemic influenza in Bad flu and underlying medical conditions.

 

Crof over at Crofsblog, is using his Spanish language skills to track emerging infectious diseases in Central and South America, along with his usual terrific coverage of influenza.  You’ll find some of the best coverage of Dengue, Malaria, and other diseases on his blog.

 

Ian York on his Mystery Rays blog continues to fascinate with his historical look back at disease outbreaks of the past, including his recent look at yellow fever (The deadliest, most awe-inspiring of the Plagues ).

 

Prior to that Ian looked at the complex issues of virulence and transmission in an intriguing look at Rabbits, virulence, history, and connections .

 

On the flu front, York `did the math’ and came up with a reasonable approximation on the level of herd immunity we likely have in the United States to novel H1N1 in How many Americans are immune to H1N1?

 

Paul over at Chen Qi continues to publish – in newspaper format – a terrific daily roundup of disease and disaster news. 

 

Vincent Racaniello at the Virology Blog continues with his series of college virology lectures (#10 is now posted), along with his TWiV and TWiP podcasts.  

 

And of course, the flu forums (I visit Flu Wiki and FluTrackers on a daily basis) continue to provide a font of information.

 

 

A sampling of some of my own offerings would include:

 

Influenza B Rising

Assessing A New Antiviral

PNAS: H3N2 And H5N1 Reassortment

Norovirus: The Gift That Keeps On Giving

An H1N1 Seroprevalence Study

TCAD: A Triple Play Combination

H9N2: The Other Bird Flu Threat

 

 

Hopefully this roundup will point you towards an article, or perhaps a resource, you may have missed in the past.

Vietnam:`Animal Disease’ Warning

 

 

 

# 4390

 

 

Many of the common illnesses we think of as `human’ diseases actually began in other species, and only later migrated to humans.

 

Influenza, as most of you know, is native to aquatic birds – but jumped species thousands of years ago and many strains have adapted to humans.

 

Babesiosis, Borrelia (Lyme), Nipah, Hendra, Malaria, Hantavirus, ebola,Leptospirosis, Q-Fever, bird flu  . . .  the list of zoonotic diseases is extensive and growing. 

 

The age of emerging infectious diseases in humans really began in earnest about 10,000 years ago when man began to domesticate – and live in close proximity to – other animals.   

 

The scourge of Tuberculosis, which now infects 1/3rd of humanity, probably jumped to humans when man began to coral and raise its traditional hosts; goats and cattle.  Measles appears to have evolved from canine distemper and/or the Rinderpest virus of cattle.  

 

Michael Greger in his Bird Flu: A Virus of Our Own Hatching video, goes into considerable detail on the evolution of zoonotic diseases.  The video is terrific, as is his book (available free online).

 

Swine flu (A/H1N1/2009) , which emerged nearly a year ago, was just the latest example of a species jump, this time from pigs to man.   Fortunately, novel H1N1 has not turned out to be the highly virulent virus that some feared.

 

The same cannot be said for bird flu, which has killed roughly half of those known to be infected. While the H5N1 virus has yet to adapt well enough to humans to pose an epidemic threat, each new human infection is another opportunity for it to learn.

 

In the wake of yesterday’s report of Vietnam’s first bird flu death of 2010, we get this warning that residents should be on the alert for `animal diseases’ that may erupt in that country over the coming months.

 

After a truly horrendous 2004-2005, Vietnam managed to largely curtail the spread of H5N1 in 2006 and the first half of 2007.  For about 18 months they were viewed as the model of successful containment.

 

Since mid-2007, however, bird flu has been making a comeback in Vietnam, and there are fears that if steps aren’t taken, they could see large outbreaks in poultry.

 

 

 

Animal disease warning issued as bird flu kills Mekong resident

The Vietnamese Ministry of Health reported the first human bird flu death this year on Friday, prompting an animal health official to warn that animal health diseases could sweep the country in 2010.

 

The 38-year-old victim from the Mekong Delta Tien Giang Province was killed February 23, soon before Pasteur Institute in Ho Chi Minh City confirmed she had tested positive with the H5N1 virus. The victim’s name has not been released.

 

She had killed and processed sick chicken before getting sick on February 13.

 

The victim was hospitalized eight days after that at Sa Dec Hospital in the nearby Dong Thap Province when her condition became worse. She was diagnosed with severe viral pneumonia.

 

Also on Friday, Hoang Van Nam, acting head of the Animal Health Department at the Ministry of Agriculture and Rural Development, said bird flu outbreaks have been reported in Nam Dinh and Dien Bien Provinces in the north, Khanh Hoa in the central region, and Ca Mau and Soc Trang in the Mekong Delta.

 

Khanh Hoa was added last to the list after 770 chickens in Ninh Hoa District and 6,000 quails in Van Ninh District got sick.

 

Chicken in Ca Mau were detected with the H5N1 virus in late January and nearly 200 ducks have contracted the virus recently.

 

“There’s very high risk bird flu will spread to other areas around the country, especially the Mekong Delta,” Nam said.

 

Delta farmers are harvesting their winter-spring crop and letting their ducks roam free to clean spilling rice seeds.

 

Nam said that can easily lead to outbreaks of bird flu.

 

(Continue . . .)

Getting Out While The Getting’s Good

 

 

# 4389

 

 

Evacuations of low lying coastal areas have been called for in Hawaii, and no doubt, have (or will be) issued in other regions of the Pacific as the scope of today’s Tsunami becomes better defined.    

 

Whether it be due to a Tsunami, earthquake, flash flood, hurricane, or fire . . . sometimes you need to get out of Dodge in a hurry. And being prepared for that contingency can make all of the difference in the world.

 

Ready.gov has long advocated that everyone be ready with a bugout bag, emergency supplies for sheltering in place, and most importantly . . . an emergency plan.

 

 

Last year FEMA declared 59 major disasters in the United States. 

 

In 2008, there were 75.  Hurricanes, ice storms, blizzards, wild fires, floods, severe storms, earthquakes . . . you name it . . . we live on a dangerous planet.

 

All of which points out the need to be prepared for emergencies, no matter what the cause.

 

Disasters happen.

 

And so you need to have adequate emergency supplies (including a good first aid kit), to care for your family for at least the first 72 hours following a natural disaster.

Other good places to get preparedness information include:

 

FEMA http://www.fema.gov/index.shtm

AMERICAN RED CROSS http://www.redcross.org/

 

As a former paramedic, I can’t stress enough the importance of having a good first aid kit at home, and in your car.  And just as important, learning how to properly use one.

 

 

Taking a first-aid course, and CPR training, are both investments that could pay off big someday, for you, and for your loved ones. 

 

I’ve written on the necessity to have a `to go’, or bug out bag (BOB), several times in the past, including a tour of my own bag.

 

Inside My Bug Out Bag

What About BOB?

 

For a complete description, follow the link to Inside My Bug Out Bag, but here are a few pictures of what I keep at the ready 24/7.

 

 

 

The next disaster may strike with little or no notice.  You and your family may have only seconds to react.   Being ready means you can go on with life without worrying obsessively about those things you cannot predict or control.

 

As I tell people:

 

Preparing is easy.  Worrying is hard.

Tsunami Warning For The Pacific

 

 

 

# 4388

 

In the early hours of this morning a massive 8.8 magnitude quake struck southern Chile, causing what early reports suggest is extensive damage, and generating a Tsunami.

 

This Tsunami – or rather, series of Tsunamis – are traveling across the Pacific at roughly the speed of an airliner.   Their impacts won’t be felt in places like Hawaii, New Zealand, and Indonesia for hours.

 

It is impossible to forecast with any accuracy how large these tsunami waves will be when they reach these locations, but we can estimate the arrival time.

 

The first of these Tsunamis is expect to strike the Hawaiian islands a little after 11am, HST.

 

 

 

Huge earthquake batters Chile, 78 dead

SANTIAGO, Chile (Reuters) - A massive magnitude-8.8 earthquake struck south-central Chile early on Saturday, killing at least 78 people, knocking down buildings and triggering a tsunami.

 

President Michelle Bachelet said there were 78 confirmed deaths and that more were possible. Telephone and power lines were down, making it difficult to make an early assessment of the damage, but serious damage was reported in two southern cities.

 

"Never in my life have I experienced a quake like this, it's like the end of the world," one man told local television from the city of Temuco, where the quake damaged buildings and forced staff to evacuate the regional hospital.

 

The U.S. Geological Survey said the earthquake struck 56 miles northeast of the city of Concepcion at a depth of 22 miles at 3:34 a.m. (1:34 a.m. ET).

(Continue . . . )

 

 

Early reports, such as the number of deaths, amount of damage, and size of tsunamis generated are all subject to revision.

  

The latest Tsunami bulletins are available by clicking the graphic below.

 

BULLETIN
TSUNAMI MESSAGE NUMBER   7
NWS PACIFIC TSUNAMI WARNING CENTER EWA BEACH HI
148 AM HST SAT FEB 27 2010

TO - CIVIL DEFENSE IN THE STATE OF HAWAII

SUBJECT - TSUNAMI WARNING SUPPLEMENT

A TSUNAMI WARNING CONTINUES IN EFFECT FOR THE STATE OF HAWAII.

AN EARTHQUAKE HAS OCCURRED WITH THESE PRELIMINARY PARAMETERS

   ORIGIN TIME - 0834 PM HST 26 FEB 2010
   COORDINATES - 36.1 SOUTH   72.6 WEST
   LOCATION    - NEAR COAST OF CENTRAL CHILE
   MAGNITUDE   - 8.8  MOMENT

EVALUATION

A TSUNAMI HAS BEEN GENERATED THAT COULD CAUSE DAMAGE ALONG  COASTLINES OF ALL ISLANDS IN THE STATE OF HAWAII. URGENT ACTION  SHOULD BE TAKEN TO PROTECT LIVES AND PROPERTY.

 

A TSUNAMI IS A SERIES OF LONG OCEAN WAVES. EACH INDIVIDUAL WAVE  CREST CAN LAST 5 TO 15 MINUTES OR MORE AND EXTENSIVELY FLOOD  COASTAL AREAS. THE DANGER CAN CONTINUE FOR MANY HOURS AFTER THE  INITIAL WAVE AS SUBSEQUENT WAVES ARRIVE. TSUNAMI WAVE HEIGHTS  CANNOT BE PREDICTED AND THE FIRST WAVE MAY NOT BE THE LARGEST.

 

TSUNAMI WAVES EFFICIENTLY WRAP AROUND ISLANDS. ALL SHORES ARE AT RISK NO MATTER WHICH DIRECTION THEY FACE. THE TROUGH OF A TSUNAMI  WAVE MAY TEMPORARILY EXPOSE THE SEAFLOOR BUT THE AREA WILL  QUICKLY FLOOD AGAIN. EXTREMELY STRONG AND UNUSUAL NEARSHORE  CURRENTS CAN ACCOMPANY A TSUNAMI. DEBRIS PICKED UP AND CARRIED  BY A TSUNAMI AMPLIFIES ITS DESTRUCTIVE POWER.
SIMULTANEOUS HIGH TIDES OR HIGH SURF CAN SIGNIFICANTLY INCREASE THE TSUNAMI HAZARD.

 

THE ESTIMATED ARRIVAL TIME IN HAWAII OF THE FIRST TSUNAMI WAVE IS

         1119 AM HST SAT 27 FEB 2010

MESSAGES WILL BE ISSUED HOURLY OR SOONER AS CONDITIONS WARRANT.

Hong Kong: Swine Flu Reassortment

 

 

# 4387

 

 

From Ironorehopper via his blog and FluTrackers we get this press release from the Hong Kong government about the discovery of a reassorted swine flu virus discovered last month in a pig from mainland China.

 

First the press release, then some discussion.

 

 

Swine Influenza Virus reassorted with Pandemic H1N1 

February 26, 2010
Issued at HKT 22:37

The University of Hong Kong (HKU) had found in its regular influenza virus surveillance programme that one sample taken from a pig at the Sheung Shui Slaughterhouse on January 7 contained a virus which was essentially a swine influenza virus but had picked up a pandemic H1N1 gene by genetic reassortment. There is no cause for alarm for public health and pork remains safe for consumption. Government is closely monitoring developments and shall continue to keep the public informed.

 

This is the first time that reassortment of swine influenza virus with the pandemic H1N1 virus was found in the surveillance programme.

 

Prof Malik Peiris, the HKU expert in charge of the surveillance programme, considered that the findings of reassortment between the pandemic H1N1 virus and swine influenza virus was not totally unexpected. These events were likely occurring worldwide and its detection in Hong Kong was purely the consequence of intensive surveillance.  Further tests are being conducted by HKU to determine if there are any particular  characteristics of this strain.

 

A spokesman for the Centre for Food Safety (CFS) reaffirmed that the World Health Organization, World Organisation for Animal Health and Food and Agriculture Organization of the United Nations had stated that pork and pork products which were handled properly and thoroughly cooked were safe for human consumption.  It is safe to eat pork and pork products that are cooked to an internal temperature of 70 degrees Celsius or above.

 

A spokesman for the Centre for Health Protection also said: “Laboratory surveillance on human specimens by the Department of Health (DH) has not detected similar viruses in humans.

 

“There is no sign that the virus is present in Hong Kong population at this time.  The DH will maintain intensive surveillance of influenza in humans.

 

“Preliminary findings also show that the virus is sensitive to antiviral drug, oseltamivir. ”

 

The CFS spokesman said:“The sample was taken from a pig imported from the Mainland. We have informed the Mainland authorities so that they can further step up the monitoring and inspection of the registered farms supplying live pigs to Hong Kong.”

(Continue . . . )

 

 

We talk about the reassortment of flu viruses in these pages with some regularity.  Essentially, it occurs when two different flu viruses infect the same cell in a host at the same time, and swap gene segments.

 

The host can be a human, a bird, a pig, or any other mammal capable of being infected by multiple influenza viruses.   How often this happens is unknown, but only rarely does it result in a new, viable virus that threatens humans.

 

 

 

 

Hong Kong is perhaps the most diligent region on earth for monitoring and examining flu viruses.  Located adjacent to what many consider to be the `cradle of influenza’, mainland China, they are often the first to identify new and exotic strains.

 

We will eagerly await further details on exactly what swine virus, and what H1N1 gene segments, were involved.  And what, if any, changes in pathogenicity or transmissibility may have occurred

 

For now this discovery of a reassorted virus is more of a scientific curiosity than a public health threat. There are no reports of any further spread of the virus at this time. 

 

This is, however, an important reminder that the only constant with influenza viruses is that they constantly change.  Whether it be via antigenic drift (small mutations) or antigenic shift (reassortment), virologists are quick to remind us.

Shift happens.

 

While the recent drop in influenza activity around the globe has been a welcome respite, we shouldn’t allow ourselves to be lulled into complacency.  

 

There are no guarantees that we’ll have another 40 years before the next pandemic virus emerges.

Influenza B Rising

 

 

 

# 4386

 

 

While pandemic H1N1 continues to be reported in many areas of the world, the levels being seen today are far lower than what was reported a couple of months ago.  The other seasonal strains (H1N1 and H3N2) are being reported only sporadically around the world.

 

The question on everyone’s mind is; what (if anything) will rise to fill the void?

 

Over the past few weeks, reports of influenza B infections have been steadily increasing, particularly out of Hong Kong and China.   The short course on influenza B from the CDC reads:

 

Influenza Type B

Influenza B viruses are usually found only in humans. Unlike influenza A viruses, these viruses are not classified according to subtype. Influenza B viruses can cause morbidity and mortality among humans, but in general are associated with less severe epidemics than influenza A viruses. Although influenza type B viruses can cause human epidemics, they have not caused pandemics.

 

The chart(s) below show that of the 2076 samples recently tested by FluNet that proved positive for influenza (week of Feb 6-13), more than 50% were Influenza B.

What this portends for the future is unknown, since the start of the flu season in the southern hemisphere is still several weeks away.  Will H1N1 make a comeback? 

We’ll have to wait and see.

 

 

(blow up of last 3 months)

Here then is the latest influenza virological surveillance report from the World Health Organization.   You’ll find additional information in Pandemic (H1N1) 2009 - update 89.

 

 

Weekly virological surveillance update

26 February 2010 -- Pandemic influenza A(H1N1) 2009 infections have continued to decrease in most countries of the Northern Hemisphere in recent weeks. Little activity has been reported in the Southern Hemisphere in 2010 to date. In nearly all countries where human influenza infection is reported, the pandemic influenza A (H1N1) continues to be the predominant subtype among all influenza A viruses subtyped (87.3% in North America region, AMR, 94% in EUR and 90% global). Seasonal A(H1N1) viruses continue to be detected very sporadically. Sporadic influenza A(H3N2) activity has been reported from some countries in recent weeks. Influenza B activity continued to increase in China and Hong Kong SAR China.

 

Based on FluNet reporting for the week from 6-13 February 2010*, the total number of specimens reportedly positive for influenza viruses by NIC laboratories was 2,076. Of these, 1,003/2,076 (48.3%) were typed as influenza A and 1,073 (51.7%) as influenza B. Of all sub-typed influenza A viruses, 90% (781/866) were pandemic A(H1N1) 2009. Hong Kong SAR China has reported increased influenza B activity in recent weeks accounting for 56.1% of all influenza detections in the reporting week, while in China it accounted for 83.5%.

(Continue . . . )

Vietnam: Reported Bird Flu Fatality

 

 

# 4386

 

 

Commonground posting on her website and on FluTrackers has several reports this morning on the first H5N1 fatality out of Vietnam for the year.   The case involves a 38-year-old woman from Tien Giang Province who died on Feb 23rd.

 

 

 

Map from wikipedia

 

Confirmed the first case of death due to influenza A (H5N1) in 2010

Director of Department of Preventive Health and Environment

 

(Ministry of Health) Nguyen Huy Nga has confirmed a female patient, 38 years old, residing in An Thai Trung commune, Cai Be district, Tien Giang province died from influenza A ( H5N1). This is the first case of death due to influenza A (H5N1) in 2010.

 

Patients with disease onset date of February 13, had own treatment at home and to commune health treatment but did not help. As of February 21, patients more tired, chest pain, difficulty breathing, was taken to the treatment at the Hospital Sa Dec, Dong Thap province. Here, the patient was diagnosed: Pneumonia due to severe virus - severe shock infection. Although the resuscitation, treatment of positive, but the evolutions severe disease, patients die on February 23 at 09h00.

 

Epidemiological investigation showed that patients with a history of slaughtering and processing aquatic birds sick. On February 23, Pasteur Institute Ho. Ho Chi Minh answered test results positive for influenza A virus (H5N1). So this is the first fatality due to influenza A (H5N1) in 2010.

(Continue . . . )

Assessing A New Antiviral

 

 

 

# 4385

 

 

 

Five years ago we had four antiviral drugs that worked pretty well against nearly all of the influenza viruses in circulation.  We had the old standbys of Amantadine and Rimantadine, which had been around nearly 50 years, along with the relatively new drugs Tamiflu and Relenza.

 

But by late 2005 it became apparent that the H3N2 seasonal flu virus was becoming resistant to the older class of drugs.   The cause was suspected by many to stem from the illegal and indiscriminate use of Amantadine as an additive to chicken feed in China.

 

While still effective against the H1N1 seasonal virus, in January of 2006 the CDC recommended that drugs of the Amantadine class no longer be used against influenza.    Tamiflu (oseltamivir) was the new `go to’ drug, with Relenza (zanamivir) as a backup.

 

With the prospects of a pandemic on the horizon, many nations invested heavily in Tamiflu, stockpiling hundreds of millions of capsules.  

 

Then . . . in 2008, we began to see signs of resistance forming to Tamiflu as well.   This time in seasonal H1N1.   Within a year, nearly all seasonal H1N1 viruses were resistant.

 

While still effective against the H3N2 viruses, novel H1N1, and most of the avian strains there are concerns that the `life’ of Tamiflu may be limited.  Victories against viruses and bacteria sometimes prove to be short-lived.

 

Therefore, new antivirals are a hot research field right now.

 

One of the brighter prospects undergoing testing is CS-8958, or laninamivir, being developed by Daiichi Sankyo Co Ltd. 

 

PLoS Pathogens has a study revealing promising test results in its latest edition entitled:

 

Efficacy of the New Neuraminidase Inhibitor CS-8958 against H5N1 Influenza Viruses

Maki Kiso, Shuku Kubo, Makoto Ozawa, Quynh Mai Le, Chairul A. Nidom, Makoto Yamashita, Yoshihiro Kawaoka

 

At least two of the authors listed above should be familiar names to readers of this blog;  Yoshihiro Kawaoka and C. A. Nidom.

 

A few choice excerpts from the abstract, followed by Maggie Fox’s story from Reuters.

 

ABSTRACT

CS-8958 functions as a long-acting NA inhibitor in vivo (mice) and is efficacious against seasonal influenza strains following a single intranasal dose. Here, we tested the efficacy of this compound against H5N1 influenza viruses, which have spread across several continents and caused epidemics with high morbidity and mortality.

 

We demonstrated that R-125489 interferes with the NA activity of H5N1 viruses, including oseltamivir-resistant and different clade strains. A single dose of CS-8958 (1,500 µg/kg) given to mice 2 h post-infection with H5N1 influenza viruses produced a higher survival rate than did continuous five-day administration of oseltamivir (50 mg/kg twice daily).

 

Virus titers in lungs and brain were substantially lower in infected mice treated with a single dose of CS-8958 than in those treated with the five-day course of oseltamivir. CS-8958 was also highly efficacious against highly pathogenic H5N1 influenza virus and oseltamivir-resistant variants. 

 

These results stem from a mouse model, and one must always be mindful that what works in mice doesn’t always work in humans. 

 

Still, the big news is that one dose of this inhaled antiviral works as well as a five day regimen of Tamiflu (in mice), and that it is effective against antiviral resistant strains of H5N1.  

 

The manufacturer hopes to bring this new drug to market next year.

Maggie Fox picks up the story for us.

 

New inhaled drug protects from flu in single dose

By Maggie Fox, Health and Science Editor

WASHINGTON (Reuters) – A single dose of an experimental influenza drug saves more mice from H5N1 avian influenza than the preferred drug Tamiflu, researchers reported on Thursday, and can also protect against infection.

 

The tests of Daiichi Sankyo Co Ltd's CS 8958 or laninamivir show one inhaled dose worked better than Tamiflu to keep mice alive when infected with a normally deadly dose.

 

The report in the Public Library of Science Journal PLoS Pathogens covers one of the dozens of ongoing studies of a new batch of influenza drugs being developed by a variety of companies.

 

"Importantly, a single dose of CS-8958 conferred a more potent and long-lasting protective effect to mice against H5N1 influenza viruses than that of oseltamivir phosphate," Yoshihiro Kawaoka of the University of Wisconsin and colleagues wrote in their report.

(Continue . . . )

ACIP Recommends Near `Universal’ Flu Vaccinations

 

 

# 4384

 

 

ACIP, the Advisory Committee on Immunization Practices, yesterday came forth with a long anticipated recommendation that just about all Americans over the age of 6 months should receive a yearly flu vaccination.

 

 

Maggie Fox, science and health editor for Reuters, brings us the details in her story.

 

UPDATE 1-Everyone in US should get flu vaccine - experts

Thu Feb 25, 2010 1:44am GMT

(Updates with vote on flu vaccine)

* 97 million H1N1 vaccines administered in U.S.

* Deaths could exceed normal seasonal flu year

* Obese and children at highest risk

By Maggie Fox, Health and Science Editor

WASHINGTON, Feb 24 (Reuters) - Everyone in the United States over the age of six months should get seasonal influenza vaccines every year, federal vaccine advisers said on Wednesday.

 

The Advisory Committee on Immunization Practices made the long-awaited vote to recommend virtually universal flu vaccination -- something public health experts have long recommended.

 

"The new recommendation seeks to remove barriers to influenza immunization and signals the importance of preventing influenza across the entire population," the U.S. Centers for Disease Control and Prevention said in a statement.

 

Earlier, experts told the committee that people who were morbidly obese and school-aged children were much more likely to become seriously ill or to die from H1N1 swine flu, as opposed to seasonal flu, which mostly kills the frail elderly.

(Continue . . .)

 

 

Two additional points are  brought out in this article.

 

First, Maggie reports that H3N2 is on the rise in China, accounting now for about 6% of their influenza cases.  This suggests that reports of seasonal flu’s demise may yet be premature.

 

Second is that the pandemic death toll in the United States – now estimated at near 17,000 – may be revised upward over the coming months and may exceed the 36,000 deaths we `expect’ from an average flu season.

 

(36K deaths is the CDC’s yearly estimate of flu deaths.  Not a count)

 

While many have been quick to latch onto early numbers and jump to conclusions regarding the impact and severity of this pandemic, the simple truth is that it will take months – likely years – before we can analyze most of the data.

 

Until then, pronouncements regarding this pandemic need to be viewed as preliminary at best.

CDC Q&A On H1N1 And Underlying Conditions

 

 

# 4383

 

 

The CDC has maintained, and refined over time, a list of those underlying medical conditions they believe predispose some people to more serious complications from the H1N1 pandemic virus.  

 

Here is their list as of early December:

 

People at High Risk for Developing Flu-Related Complications

• Children younger than 5, but especially children younger than 2 years old
• Adults 65 years of age and older
• Pregnant women
• People who have medical conditions including:
  • Asthma
  • Neurological and neurodevelopmental conditions [including disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy, epilepsy (seizure disorders), stroke, intellectual disability (mental retardation), moderate to severe developmental delay, muscular dystrophy, or spinal cord injury].
  • Chronic lung disease (such as chronic obstructive pulmonary disease [COPD] and cystic fibrosis
  • Heart disease (such as congenital heart disease, congestive heart failure and coronary artery disease)
  • Blood disorders (such as sickle cell disease)
  • Endocrine disorders (such as diabetes mellitus)
  • Kidney disorders
  • Liver disorders
  • Metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders)
  • Weakened immune system due to disease or medication (such as people with HIV or AIDs, or cancer, or those on chronic steroids)
  • People younger than 19 years of age who are receiving long-term aspirin therapy

 

Tuesday night the CDC posted an overview and Q&A on the most commonly seen underlying conditions in patients hospitalized from the H1N1 flu over the past 10 months.   

 

This  update reflects data gather from roughly 60 counties, and 13 metro areas around the country, and is covers the time span April 15, 2009 – February 16, 2010. I’ll not post the whole thing, since you can follow this link to read it in its entirety. 

 

Since very early in this pandemic it has been apparent that people with certain types of underlying conditions were being hospitalized with serious complications.    Pregnancy and Asthma were both identified very early as potential complicating factors.

 

According to EIP data collected from April 2009 to February 16, 2010, 85% of hospitalized adults and 58% of hospitalized children with 2009 H1N1 virus infections have had one or more medical conditions. 

 

The two charts below show the most commonly reported underlying conditions in adults and children.  For both cohorts, Asthma was the number one complicating factor, showing up in more than 30% of each group.

 

After that, developmental and neurological disorders weighed heavily among children, and chronic metabolic, cardiac, and pulmonary disorders impacted adults the greatest.

 

 

 

 

 

Other blogs that have dealt with this subject in the past few months include:

 

CMAJ: Asthma As A Pandemic Risk Factor In Children

Australian Study: H1N1 Hospitalized Patients

Study: H1N1 Hospitalization Profiles

Study: H1N1 A Threat To All Age Groups

Indonesia: Four Bird Flu Suspects Hospitalized

 

 

# 4382

 

 

Ida at The Bird Flu Information Corner tonight has a report out of Pangkalpinang, Indonesia regarding four kids from Kecamatan Simpangkatis who are being treated in a special unit for bird flu patients.

 

These are suspect cases, based on clinical symptoms and their proximity to recent poultry deaths.   Laboratory results are not expected for several days.

 

 

Pangkalpinang, Bangka-Belitung ::: Four bird flu suspect kids

Pangkalpinang – Four kids from Kecamatan Simpangkatis are treated in Depati Hamzah regional hospital, Pangkalpinang. Patients are placed in special unit for bird flu patients.

 

They were suspected of contracting bird flu infection as they exhibited continuous fever, said Supriyadi, Health Service official of Bangka Tengah. Patients’ family confirmed that they experienced many chicken deaths not long before.

 

The suspected kids were found during field investigation on people, which is routinely done by Simpangkatis public health centre officers when birds in the area reported to have suddenly died.

 

To anticipate any possibility of bird flu transmission to human, public health officers referred the four kids of Kecamatan Simpangkatis to Depati Hamzah regional hospital. Medical team of the hospital had collected their blood sample for bird flu test. Laboratory confirmation expected to be issued within a week.

 

Kecamatan Simpangkatis is one of sub-districts under observation of regional health service because of large bird flu H5N1 outbreak in chickens.

Source: Indonesia local newspaper, Bangka Pos.

CIDRAP: Watching Rates Of ILI’s Around The Country

 

 

# 4381

 

 

 

Lisa Schnirring, in a feature for CIDRAP News tonight, tracks down some anecdotal reports of recent increases in ILIs (Influenza-like Illnesses) being reported in emergency departments around the country.

 

She also brings us word of the first increase in flu-like illnesses on US college campuses since late November, as reported by the ACHA (American College Health Association).

 

At this time, it is unknown whether these reports reflect an increase in pandemic H1N1 cases, or whether some other respiratory viruses may be to blame.  

 

The overall rates of ILI, while increasing in some regions, remain low.   I’ve just reproduced the opening paragraphs to Lisa’s report, follow the link to read it in its entirety.

 

 

 

Emergency departments see rise in flu-like illness

Lisa Schnirring Staff Writer

Feb 24, 2010 (CIDRAP News) – Some of the nation's emergency departments are noting increases in flu-like illness cases that appear to be pandemic H1N1, and colleges are reporting the first increase in flu-like illness since the end of November, but it's not clear if these are early signs of a third pandemic flu wave.

 

The American College of Emergency Physicians (ACEP) said today in a Twitter post that some of its members were anecdotally reporting a new wave of pandemic H1N1 patients coming to emergency departments and asked if other physicians were seeing similar patterns.

 

Carl Schultz, MD, professor of emergency medicine at the University of California at Irvine, told CIDRAP News that the increase in the number of influenza-like illnesses appears to be real, but he cautioned that many of the cases have not been confirmed as the pandemic H1N1 strain, because many departments stopped specifically testing for it because of low flu activity. Schultz chairs ACEP's disaster preparedness and response committee.

(Continue . . . )

Egyptian Media: Bird Flu Case #103

 

 

# 4380

 

 

Commonground, posting both on her Pandemic Information News website and on FluTrackers, has picked up media reports of yet another H5N1 case in Egypt. 

 

This time of a 14 month-old reportedly in stable condition at the Banha Fever Hospital.

 

This makes the 13th H5N1 case out of Egypt since the beginning of the year.   You’ll find a thread on FluTrackers with several other translated reports of this case.

 

 

Aged 14 months and his condition is stable

Last Update: 24/02/2010 18:29 timing of Cairo

Ministry of Health announced Wednesday in the Egyptian case was found 103 bird flu for a child one year old and two months of milk Qalubia.

The history of the illness of the situation that the onset of symptoms was on February 22 and entered the Banha Fever Hospital in the next day suffering from a high temperature and cough, runny nose and shortness of breath, and after being exposed to birds suspected of being infected with bird flu.

 

Have been given Tamiflu, the child immediately in a stable condition.

 

 

It is said that families in rural areas continue to retain the custom of raising poultry at home, leading to mixing for children and women, the Government is making strenuous efforts to contain the deadly virus and limit its spread, and calls through the media to avoid mixing with any birds, but a final After the adoption of precautionary measures.

 

 

Meanwhile, in Menoufia, residents are `panicked’ over the sudden deaths of chickens, according to this report (also posted by Commonground) on FluTrackers.

 

 

Panic among people fearing an outbreak of avian influenza Menoufia

---

Wednesday, February 24th, 2010 - 20:54

Seen some of the villages and the villages of central Quesna Menouf Menofia, the case of mass deaths among domestic birds in the past three days, began the emergence of symptoms peculiar to the presence of chicken blue color known as the chicken and turn to black, followed by the death of birds.

Serious threat is the people's dumping dead chickens in large quantities in the vicinity of their homes, and on the edge of canals, putting children at risk of bird flu.

 
Dr. Ahmed Fouad, General Manager of Veterinary Medicine Menoufia, it was a medical team to go to the villages which have had cases mortality, to ensure the quality of the disease, whether it is bird flu or not, and in if you are sure will be culling all domestic birds in houses and cleared and then bury the dead them in safe places Sahara, appealing to citizens of the need for the immediate reporting of mortality until they are disposed so as not to return again after the disease have been eliminated.

A Classic Photo Op

 

# 4379

 

 

 

Guangdong Province, which lies adjacent to Hong Kong, has long been the site of suspected bird flu activity – although rarely do we get official acknowledgment of the fact.  

 

Last year, you may recall, hundreds of dead (and H5N1 infected) chickens were found washed up on the beaches around Hong Kong, after having floated down the Pearl river from mainland China.

 

For an overview, see More On The Chinese Bird Flu Mystery and for warnings from a leading Chinese scientist that vaccines may mask H5N1 symptoms, see  Zhong Nanshan On Asymptomatic Poultry. 

 

 

And every year migratory birds arrive in Hong Kong from the mainland, and they too sometimes carry the H5N1 virus.

 

Since Hong Kong imports considerable poultry, and other food items, from Guangdong Province there are naturally concerns about the safety of those goods.   Recent food safety scandals coming out of China over the past year or two haven’t helped matters much, either.

 

So this reassuring Xinhua news article, and accompanying photo – showing a single terrified chicken undergoing scrutiny by no less than 3 hazmat suited inspectors – caught my eye this morning. 

 

No doubt this level of inspection goes on for each and every chicken headed to the live markets of Hong Kong.  And, doubtless, inspectors can detect asymptomatic H5N1 in poultry, just by looking at them.   

 

(Actually, they appear to be reading a toe tag.  Probably reads `Inspected by Number 14’  in Cantonese).

Pardon my snark. 

 

My thanks to Sharon Sanders on FluTrackers for posting this picture which is simply too good not to share.

 

 

 

China - Officials Inspect Poultry Before Shipment from Guangdong Province to Hong Kong

---

Guangdong to ensure the safety of fresh agricultural products to Hong Kong

2010-2-24

Figure: inspection and quarantine officers fresh agricultural products to Hong Kong to strengthen inspection to ensure safety

(Newspaper photo)

show on the 23rd Guangzhou, Xinhua Reporters from the Guangdong Entry-Exit Inspection and Quarantine Bureau was informed that, during the Spring Festival in Guangdong for Hong Kong fresh agricultural products, both to ensure the quality and safety of food, but also ensure rapid clearance, customs clearance and smooth.

 

During the Spring Festival, Guangdong Board for Hong Kong and Macao from the 1555 batch, 62476; 216 batches of chicken, 29109; food aquatic animals 2156 batch, 173.4 tons; 1000 batch of vegetables, 7300 tons; milk 20 batches of 224 tons.

 

Guangdong, Hong Kong and Macao fresh agricultural products, a major source of food every day, 450 trucks and ships more than 10 types of fresh agricultural products will be continuously transported to Hong Kong.

HAI: Hospital Acquired Infections

 

 

 

# 4378

 

 

Although the media tends to focus primarily on dramatic events - like pandemics, earthquakes, and terrorist attacks – there are many far-more-common-yet-deadly health threats out there that put us at risk every day.

 

Nosocomial, or Hospital Acquired Infections (HAIs) are a prime example.  

 

According to a new study, just published in the Archives of Internal Medicine, just two of these infections (HAI sepsis and pneumonia) claim nearly 50,000 lives a year in the US alone.

 

The cost goes beyond the tragic loss of life, of course.  There is pain and suffering, and an enormous economic cost as well.   HAIs – many of which are preventable – take a terrible toll each year.

 

This has been one of the main subjects covered by Maryn McKenna on her terrific Superbug Blog.  Her eagerly anticipated book on MRSA is due out late next month. 

 

First a few excerpts from the abstract of this study, then on to a press release with more details.

 

Clinical and Economic Outcomes Attributable to Health Care–Associated Sepsis and Pneumonia

Michael R. Eber, BSE; Ramanan Laxminarayan, PhD, MPH; Eli N. Perencevich, MD, MS; Anup Malani, PhD, JD

Arch Intern Med. 2010;170(4):347-353.

Methods Hospital discharge records from the Nationwide Inpatient Sample database were used to identify sepsis and pneumonia cases among 69 million discharges from hospitals in 40 US states between 1998 and 2006. Community-acquired infections were excluded using criteria adapted from previous studies. Because these criteria may not exclude all community-acquired infections, outcomes were examined separately for cases associated with invasive procedures, which were unlikely to result from preexisting infections.

 

<SNIP>

Results In cases associated with invasive surgery, attributable mean length of stay was 10.9 days, costs were $32 900, and mortality was 19.5% for sepsis; corresponding values for pneumonia were 14.0 days, $46 400, and 11.4%, respectively (P < .001). In cases not associated with invasive surgery, attributable mean length of stay, costs, and mortality were estimated to be 1.9 to 6.0 days, $5800 to $12 700, and 11.7% to 16.0% for sepsis and 3.7 to 9.7 days, $11 100 to $22 300, and 4.6% to 10.3% for pneumonia (P < .001).
 

 

 

The press release for this study is below, with more detail.  You can also find more information on the Extending The Cure website.

 

New study shows sepsis and pneumonia caused by hospital-acquired infections kill 48,000 patients

Cost $8.1 billion to treat

Washington D.C. – Two common conditions caused by hospital-acquired infections (HAIs) killed 48,000 people and ramped up health care costs by $8.1 billion in 2006 alone, according to a study released today in the Archives of Internal Medicine.

 

This is the largest nationally representative study to date of the toll taken by sepsis and pneumonia, two conditions often caused by deadly microbes, including the antibiotic-resistant bacteria MRSA. Such infections can lead to longer hospital stays, serious complications and even death.

 

"In many cases, these conditions could have been avoided with better infection control in hospitals," said Ramanan Laxminarayan, Ph.D., principal investigator for Extending the Cure, a project examining antibiotic resistance based at the Washington, D.C. think-tank Resources for the Future.

 

"Infections that are acquired during the course of a hospital stay cost the United States a staggering amount in terms of lives lost and health care costs," he said. "Hospitals and other health care providers must act now to protect patients from this growing menace."

 

(Continue . . . )

WHO Statement On Pandemic Status

 

 

# 4376

 

 

Trying to second guess the course of a pandemic, particularly when our understanding of how the influenza virus works is (to put it kindly) incomplete, is a quick way to get egg on your face.  

 

While levels of novel H1N1 influenza in North America and Europe have declined dramatically over the past couple of months, and it looks like the pandemic of 2009 may have run its course, we’ve been fooled before.

 

NEJM 2009

 

The 1957 pandemic, for example, appeared to have run out of steam by the spring the following year - but roared back to life two years later, and then again 3 years after that.

Influenza is often full of surprises.

 

So one can understand why the WHO (World Health Organization) isn’t particularly anxious to declare the pandemic of 2009 as being over.  

 

With rising levels of immunity in the developed world (from exposure and/or vaccination), it would be a bit surprising to see another major wave of illness in North America or Europe.   

 

Surprising, but not impossible.

 

And many parts of the world have no access to vaccine, and immunity levels remain relatively low. 

 

There also remains the possibility that the virus will pick up antigenic changes that would allow it to evade existing immunity – something that could spark a new round of illness.

 

So one can understand the reluctance of scientists to declare that this pandemic has peaked.

 

Although the WHO telegraphed their intentions not to roll back the pandemic phase last night, this morning they’ve released an official statement.     

 

They will revisit the issue again in a few weeks.

 

 

24 February 2010

Director-General statement following the seventh meeting of the Emergency Committee

The Emergency Committee held its seventh meeting by teleconference on 23 February 2010. The Director-General sought the Committee's views on the determination of the pandemic status.

 

A detailed update was provided to the Committee on the global pandemic situation. After asking additional questions and reviewing the evidence and holding extensive discussion, the Committee was of the view that there was mixed evidence showing declining or low pandemic activity in many countries, but new community level transmission activity in West Africa. Moreover, they expressed concern that the winter months of the Southern Hemisphere had not yet started and there was uncertainty whether additional generalized waves of activity might occur and the need to not undermine preparations. The Committee advised that it was premature to conclude that all parts of the world have experienced peak transmission of the H1N1 pandemic influenza and that additional time and information was needed to provide expert advice on the status of the pandemic. The Committee accordingly suggested that the Committee be re-convened in a few weeks to review intervening developments and related epidemiological information.

 

Having considered these views, the current epidemiological evidence and other relevant information, the Director-General determined that there had been no change in the pandemic phase, and decided to continue to monitor the situation and developments closely and to convene the Committee again within the next several weeks.

 

The WHO Director-General asked the Committee for their views on continuance of the three current temporary IHR recommendations issued for the public health emergency of international concern. The consensus view of the Committee was in favor of continuation but to update the second recommendation by replacing "Intensify" with "Maintain" in recognition of the increased pandemic surveillance already implemented by countries and the need to maintain this activity. Having considered the views of the Emergency Committee, and the ongoing pandemic situation, the Director-General determined to continue the three temporary recommendations, as modified, namely:

• countries should not close borders or restrict international traffic and trade;
• maintain surveillance of unusual flu-like illness & severe pneumonia;
• if ill, it is prudent to delay travel.

Clipping Dengue’s Wings

 

 

 

# 4375

 

 

While I’m mindful of the the Law of Unintended Consequences, which always seems positioned to remind mankind that it’s not nice to fool with Mother Nature, scientists have come up with a unique way – they believe – will help control mosquito borne Dengue fever.

 

Essentially, they plan to release genetically altered male Aedes Aegypti mosquitoes that would produce flightless female offspring, a trait not carried forward by the males.

 

Since female mosquitoes are the ones that bite and transmit Dengue, grounding them would go a long way towards reducing the disease.  

 

Whether this sparks protests from `mosquito’s rights’ advocacy groups remains to be seen. 

 

This report from the BBC.

 

 

'Lame' mosquitoes to stop dengue

The dengue virus is spread by infected female Aedes aegypti mosquitoes

Scientists are breeding a genetically altered strain of mosquito in an effort to curb the spread of dengue fever.

 

The dengue virus is spread by the bite of infected female mosquitoes and there is no vaccine or treatment.

 

Experts say the illness affects up to 100 million people a year and threatens over a third of the world's population.

 

Scientists hope their genetically altered males will mate with females to create female offspring that will inherit a gene limiting wing growth.

 

The study is published in Proceedings of the National Academy of Sciences.

The scientists say their approach offers a safe, efficient alternative to harmful insecticides and could be used to stop other diseases spread by mosquitoes, like malaria.

 

They estimate that if released, the new breed could sustainably suppress the native mosquito population in six to nine months.

(Continue . . . )

 

 

For those who would like more than the BBC condensed version, here is the PNAS abstract, and a link to the entire open access article.

 

 

 

Female-specific flightless phenotype for mosquito control

Guoliang Fu Rosemary S. Lees  Derric Nimmo Diane Aw Li Jin  Pam Gray Thomas U. Berendonk Helen White-Cooper Sarah Scaife Hoang Kim Phuc Osvaldo Marinotti Nijole Jasinskiene Anthony A. James Luke Alphey

Abstract

Dengue and dengue hemorrhagic fever are increasing public health problems with an estimated 50–100 million new infections each year. Aedes aegypti is the major vector of dengue viruses in its range and control of this mosquito would reduce significantly human morbidity and mortality. Present mosquito control methods are not sufficiently effective and new approaches are needed urgently.

 

A “sterile-male-release” strategy based on the release of mosquitoes carrying a conditional dominant lethal gene is an attractive new control methodology. Transgenic strains of Aedes aegypti were engineered to have a repressible female-specific flightless phenotype using either two separate transgenes or a single transgene, based on the use of a female-specific indirect flight muscle promoter from the Aedes aegypti Actin-4 gene.

 

These strains eliminate the need for sterilization by irradiation, permit male-only release (“genetic sexing”), and enable the release of eggs instead of adults. Furthermore, these strains are expected to facilitate area-wide control or elimination of dengue if adopted as part of an integrated pest management strategy.

Two Suspect H5N1 Cases In Indonesia

 

(Updated)

 

# 4374

 

Meanwhile, in Indonesia  . . .

 

Ida at The Bird Flu Information Corner – a joint endeavor between Kobe University, in Japan and the Institute of Tropical Disease, Airlangga University, Indonesia – has a translation of a local TV news report on two suspect H5N1 cases in the central Java town of Megelang.

 

 

 

 

 

 

Magelang, Central Java ::: Two bird flu suspect patients

Magelang – A 36-year-old woman, named Sururi, and a 16-month-old boy, named Rizki Putrawan, were treated at Unit G, Tidar Hospital in Magelang, Central Java as they suspected of contracting bird flu virus H5N1. Sururi is a resident of Desa Balarejo, while Rizki is a resident of Desa Madurekso, which both places are the name of villages in Kecamatan (sub-district) Kaliangkrik.

 

The boy’s mother said that her son had high fever of unknown cause. Rizki had been brought to public health center nearby his house before been transferred to Tidar hospital to get intensive treatment. Afterward, he had been recovered and discharged from hospital.

 

In mean time, the hospital is still treating the other suspect patient woman, Sururi.

 

Source: Indonesia regional TV, TATV.

 

 

Updated: 7:40 EST

As I posted the above translation the details seemed a bit familiar to me, but a quick search of my blog didn’t turn up a similar report.  

A few minutes ago, Commonground contacted me and let me know that Dutchy had a series of earlier reports on these cases going back to the 17th, and had posted it on FluTrackers.

 

My thanks to Commonground, Dutchy, Ida and the rest of the flu forum newshounds – without whose considerable efforts, this blog would be impossible to maintain.