http://www.nytimes.com/2006/06/16/world/as...r=1&oref=slogin
Another Death in Indonesia Deepens Fears of Bird Flu's Spread
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By DONALD G. McNEIL Jr.
Published: June 16, 2006
The death of a 38th person from avian flu in Indonesia was confirmed yesterday by the World Health Organization and the situation in that country continued to worsen.
Indonesia is now in second place, after Vietnam, which has had 42 deaths, but none this year, while Indonesia's caseload is climbing rapidly and striking many family clusters.
The World Bank said Monday that Indonesia's response to the flu was disorganized and underfinanced. On Tuesday, the World Animal Health Organization said Indonesia was no longer even counting most poultry outbreaks. In the last year, it has officially reported the deaths of only 800 chickens, while there have been news reports of the deaths of thousands of birds from 29 of the country's 33 provinces.
Indonesia, the world's fourth-most-populous nation, has 242 million inhabitants and an estimated 1.3 billion chickens spread across 18,000 islands.
On Monday The Jakarta Post quoted several local health experts as saying that the government was not disclosing how widespread the disease was or how many times human-to-human transmission might have occurred. And last week Indonesia's health minister, Siti Fadilah Supari, said she was "running out of ideas for how to make the public aware" of the threat and get them to kill sick chickens instead of eating them.
Yesterday the Indonesian Health Ministry said the death of a 7-year-old girl in Banten Province on June 1 was the country's 38th from avian flu. The girl's 10-year-old brother died May 29, but he was buried before specimens were taken, so he was not included in the count. Chickens in the family's household had died earlier.
According to news agency reports quoting health officials, the 7-year-old had tested negative for avian flu in nose and throat swabs taken when she was alive, but then tested positive when lung tissue was taken after her death.
Nose and throat swabs — the routine way of diagnosing regular flu — may give false negatives because the bird flu virus attaches to cells deep in the lungs, not to the upper respiratory tract. In January, according to the World Health Organization, the same error caused the first human cases in Turkey's outbreak to be misdiagnosed.
Dr. Henry L. Niman, a biochemist who has questioned many of the health organization's official counts, argued that flu cases were underestimated because of that error and because blood tests could also produce false negatives if the blood was drawn before detectable antibodies had built up. Victims can die before that happens, and the outbreak in Indonesia has a very high death rate: of the 50 known cases, 38 have died.
An Indonesian newspaper, The Tempo, reported yesterday that one of its reporters who covered the extermination of infected poultry and the funeral of a flu victim near Jakarta had been hospitalized with flu symptoms; the newspaper did not report any test results.
Dick Thompson, a World Health Organization spokesman, said he knew nothing about the reporter who fell ill, but he said the agency was drafting safety guidelines for journalists. "Some of them are getting pretty close to cases," he said.
There have been several reports of Indonesian nurses' falling sick after tending avian flu victims, which could indicate that the virus was spreading more easily between humans. On June 6, the World Health Organization reported that tests on four such nurses had convincingly ruled out A(H5N1), the avian flu, and indicated that one had a seasonal flu, A(H1N1), instead.
Dr. Niman said convincing evidence could be obtained only from blood tests.
Mr. Thompson, who recently returned from Indonesia, said that he did not know how the nurses had been tested, but that he thought that Indonesian health authorities "are really on top of the human cases, investigating them aggressively," even though animal cases were spiraling out of control.
Full Version: Pandemic Flu
http://today.reuters.com/news/newsarticle....&src=rss&rpc=22
Canada quarantines second poultry flock for bird flu
Sun Jun 18, 2006 6:26pm ET
By Marcy Nicholson
WINNIPEG, Manitoba (Reuters) - Canada is investigating a second backyard poultry flock for bird flu, although all birds remain healthy, authorities said on Sunday.
"A quarantine has been instituted at that premise and it's because there's been contact either with live birds or through foot traffic and potential contamination with the original infected farm," said Canadian Food Inspection Agency veterinarian Jim Clark.
The CFIA announced on Friday it had detected a case of H5 avian flu in a gosling from a backyard poultry flock after four goslings died, in the eastern province of Prince Edward Island.
Test results are expected on Tuesday, to confirm if the virus is a North American or Asian strain. If there is enough virus present, the CFIA will be able to determine whether it is a high or low pathogen strain.
"There's no direct evidence that the influenza virus was the cause of the problem in the four birds that died," Clark added.
All birds on the second farm, adjacent to the original farm, remain healthy and the CFIA has taken some swab samples to determine if the virus exists on that farm.
The noncommercial flock of 35 to 40 ducks, geese and chickens on the original farm were euthanized by the CFIA on Friday.
Clark said he was not aware of any human illness linked to the virus.
The CFIA has said there is no evidence the case involves the high-pathogen H5N1 strain that has spread to 48 countries since 2003. H5N1 has not been discovered in the Americas.
© Reuters 2006. All Rights Reserved.
Canada quarantines second poultry flock for bird flu
Sun Jun 18, 2006 6:26pm ET
By Marcy Nicholson
WINNIPEG, Manitoba (Reuters) - Canada is investigating a second backyard poultry flock for bird flu, although all birds remain healthy, authorities said on Sunday.
"A quarantine has been instituted at that premise and it's because there's been contact either with live birds or through foot traffic and potential contamination with the original infected farm," said Canadian Food Inspection Agency veterinarian Jim Clark.
The CFIA announced on Friday it had detected a case of H5 avian flu in a gosling from a backyard poultry flock after four goslings died, in the eastern province of Prince Edward Island.
Test results are expected on Tuesday, to confirm if the virus is a North American or Asian strain. If there is enough virus present, the CFIA will be able to determine whether it is a high or low pathogen strain.
"There's no direct evidence that the influenza virus was the cause of the problem in the four birds that died," Clark added.
All birds on the second farm, adjacent to the original farm, remain healthy and the CFIA has taken some swab samples to determine if the virus exists on that farm.
The noncommercial flock of 35 to 40 ducks, geese and chickens on the original farm were euthanized by the CFIA on Friday.
Clark said he was not aware of any human illness linked to the virus.
The CFIA has said there is no evidence the case involves the high-pathogen H5N1 strain that has spread to 48 countries since 2003. H5N1 has not been discovered in the Americas.
© Reuters 2006. All Rights Reserved.
http://today.reuters.com/news/newsArticle....IRDFLU-CASE.xml
Bird flu may have been mistaken for SARS
Thu Jun 22, 2006 1:46 AM ET
By Maggie Fox, Health and Science Correspondent
WASHINGTON (Reuters) - A Chinese man who died of pneumonia in 2003 and was at first classified as a SARS victim might have in fact died of avian influenza, Chinese researchers reported on Wednesday.
But in a confusing development, at least one of the researchers asked that the letter reporting the case be withdrawn from publication in the New England Journal of Medicine. Editors of the medical journal said they were trying to find out why.
The letter was available to journalists before its withdrawal, and describes the case of a 24-year-old man who died from pneumonia and respiratory distress in November 2003.
"Because the clinical manifestations were consistent with those of the severe acute respiratory syndrome (SARS) and occurred when sporadic cases of SARS were described in southern China, serum and lung tissue from the patient, as well as fluid aspirated from his chest, were examined for SARS coronavirus," the researchers wrote. "All tests were negative for SARS."
The World Health Organization said it was asking China's Ministry of Health for clarification.
"This has been signed by eight scientists from very prestigious institutions. It certainly adds weight to the information," said Roy Wadia, WHO spokesman in China.
SARS first broke out in China's southern Guangdong province in 2002 and spread as far afield as Canada before it was brought under control in 2003. It killed close to 800 people out of the 8,000 known to have been infected.
Ironically, experts at the time assumed the then-mysterious illness making people sick in China was H5N1 avian influenza, which broke out in Hong Kong in 1997 and then disappeared.
NOT SURPRISING
Wadia said: "It reinforces what we have known for a very long time which is that the H5N1 virus has been in the environment of this part of the world for a while and it's therefore not surprising that you would have these sort of cases."
"This (case) was the same time that the virus had started taking human lives in some other countries, Vietnam, Thailand."
"In fact, WHO said in February 2004, when China was awash in poultry outbreaks at the time, that it would not be inconceivable that there could be sporadic human cases on the Chinese mainland that may not have been tracked or confirmed."
Influenza experts say flu viruses rarely just disappear and had been waiting for its return, which was reported in 2003.
In the case of the Chinese man, tests of his tissue were positive for influenza virus and genetic sequencing later showed it to be H5N1 avian influenza.
It genetically resembled samples of viruses taken from Chinese chickens in various provinces in 2004, the letter says. Parts of the virus also resembled Japanese samples.
The eight researchers who signed the letter include Dr. Wu-Chun Cao of the State Key Laboratory of Pathogens and Biosecurity, Dr. Qing-Yu Zhu of the State Key Laboratory of the Beijing Institute of Microbiology and Epidemiology, and Dr. Wei Wang of the 309th Hospital of the People's Liberation Army.
They said the virus infecting the man had mixed lineages and that their findings were important for developing an eventual bird flu vaccine.
"The genetic distance between the isolate reported and the strain currently proposed for vaccine development implies that viruses from different regions may need to be considered in the development of an effective vaccine against influenza A virus," they wrote.
The H5N1 avian flu virus has swept across most of Asia, into parts of Europe and Africa. While it is mainly a disease of birds, it occasionally infects people and has killed 130.
(Additional reporting by Tan Ee Lyn in Hong Kong)
--------------------------------------------------------------------------------
© Reuters 2006. All rights reserved. Republication or redistribution of Reuters content, including by caching, framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.
Bird flu may have been mistaken for SARS
Thu Jun 22, 2006 1:46 AM ET
By Maggie Fox, Health and Science Correspondent
WASHINGTON (Reuters) - A Chinese man who died of pneumonia in 2003 and was at first classified as a SARS victim might have in fact died of avian influenza, Chinese researchers reported on Wednesday.
But in a confusing development, at least one of the researchers asked that the letter reporting the case be withdrawn from publication in the New England Journal of Medicine. Editors of the medical journal said they were trying to find out why.
The letter was available to journalists before its withdrawal, and describes the case of a 24-year-old man who died from pneumonia and respiratory distress in November 2003.
"Because the clinical manifestations were consistent with those of the severe acute respiratory syndrome (SARS) and occurred when sporadic cases of SARS were described in southern China, serum and lung tissue from the patient, as well as fluid aspirated from his chest, were examined for SARS coronavirus," the researchers wrote. "All tests were negative for SARS."
The World Health Organization said it was asking China's Ministry of Health for clarification.
"This has been signed by eight scientists from very prestigious institutions. It certainly adds weight to the information," said Roy Wadia, WHO spokesman in China.
SARS first broke out in China's southern Guangdong province in 2002 and spread as far afield as Canada before it was brought under control in 2003. It killed close to 800 people out of the 8,000 known to have been infected.
Ironically, experts at the time assumed the then-mysterious illness making people sick in China was H5N1 avian influenza, which broke out in Hong Kong in 1997 and then disappeared.
NOT SURPRISING
Wadia said: "It reinforces what we have known for a very long time which is that the H5N1 virus has been in the environment of this part of the world for a while and it's therefore not surprising that you would have these sort of cases."
"This (case) was the same time that the virus had started taking human lives in some other countries, Vietnam, Thailand."
"In fact, WHO said in February 2004, when China was awash in poultry outbreaks at the time, that it would not be inconceivable that there could be sporadic human cases on the Chinese mainland that may not have been tracked or confirmed."
Influenza experts say flu viruses rarely just disappear and had been waiting for its return, which was reported in 2003.
In the case of the Chinese man, tests of his tissue were positive for influenza virus and genetic sequencing later showed it to be H5N1 avian influenza.
It genetically resembled samples of viruses taken from Chinese chickens in various provinces in 2004, the letter says. Parts of the virus also resembled Japanese samples.
The eight researchers who signed the letter include Dr. Wu-Chun Cao of the State Key Laboratory of Pathogens and Biosecurity, Dr. Qing-Yu Zhu of the State Key Laboratory of the Beijing Institute of Microbiology and Epidemiology, and Dr. Wei Wang of the 309th Hospital of the People's Liberation Army.
They said the virus infecting the man had mixed lineages and that their findings were important for developing an eventual bird flu vaccine.
"The genetic distance between the isolate reported and the strain currently proposed for vaccine development implies that viruses from different regions may need to be considered in the development of an effective vaccine against influenza A virus," they wrote.
The H5N1 avian flu virus has swept across most of Asia, into parts of Europe and Africa. While it is mainly a disease of birds, it occasionally infects people and has killed 130.
(Additional reporting by Tan Ee Lyn in Hong Kong)
--------------------------------------------------------------------------------
© Reuters 2006. All rights reserved. Republication or redistribution of Reuters content, including by caching, framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.
http://www.nytimes.com/aponline/world/AP-Bird-Flu.html
WHO Says Bird Flu Virus Mutated
By THE ASSOCIATED PRESS
Published: June 23, 2006
Filed at 12:24 p.m. ET
JAKARTA, Indonesia (AP) -- A World Health Organization investigation showed that the H5N1 virus mutated slightly in an Indonesian family cluster on Sumatra island, but bird flu experts insisted Friday it did not increase the possibility of a human pandemic.
The virus that infected eight members of a family last month -- killing seven of them -- appears to have slightly mutated in a 10-year-old boy, who is then suspected of passing the virus to his father, the WHO investigative report said.
It is the first evidence indicating that a person caught the virus from a human and then passed it on to another person, said Tim Uyeki, an epidemiologist from the U.S. Centers for Disease Control and Prevention. He said the H5N1 virus died with the father and did not pass outside the family.
''It stopped. It was dead end at that point,'' he said, stressing that viruses are always slightly changing and there was no reason to raise alarm.
Dr. William Schaffner, a bird flu expert at the Vanderbilt University, called the mutation ''noteworthy but not worrisome.'' Generally it takes a series of mutations in a bird flu virus to raise the danger of a pandemic in humans, he said in a telephone interview.
Schaffner said it is remarkable that scientists were able to discover a mutation that occurred in a remote village in Indonesia. That's the result of intense surveillance linked with ''21st-century laboratory virology,'' he said. ''That's awesome.''
The findings appeared in a report obtained by The Associated Press that was distributed at a closed meeting in Jakarta attended by some of the world's top bird flu experts.
The three-day session that wrapped up Friday was convened after Indonesia asked for international help. The country has experienced an explosion of human bird flu cases this year and is on pace to become the world's hardest-hit nation with 39 deaths.
The government said it needed $900 million over the next three years to fight the virus, which is ravaging poultry stocks across the archipelago. Health experts urged full implementation and funding of its national bird flu plan.
''Human cases and clusters are expected to continue to occur in Indonesia as long as avian influenza in poultry persists,'' said Bayu Krisnamurthi, Indonesia's national bird flu coordinator.
But Welfare Minister Aburizal Bakrie said the virus has shown no sign of changing in any way that would allow it to spread easily among people, potentially sparking a pandemic.
So far, the H5N1 virus remains hard for people to catch, and most human cases have been traced to contact with infected birds.
WHO concluded in its report that human-to-human transmission likely occurred among seven relatives infected with the H5N1 virus. An eighth family member who was buried before specimens could be taken is believed to have been infected by poultry, the report said.
Despite the virus' slight mutation, Uyeki insisted that an analysis suggested there was ''nothing remarkable about these viruses.''
Bird flu has killed at least 130 people worldwide since it began ravaging Asian poultry stocks in late 2003. Indonesia trails on Vietnam, where 42 people have died, in human bird flu deaths.
WHO and others continue to investigate a report that a Beijing man originally thought to have SARS actually died of bird flu in November 2003 -- two years before the Chinese reported any human H5N1 flu infections from the mainland.
Eight Beijing scientists detailed the case in Thursday's New England Journal of Medicine. At the last minute, the lead author without explanation asked to have the report withdrawn, but that was not possible because it was already printed. The journal has been unable to reach the scientists to see whether they want to retract the report.
WHO had been unaware of the case.
''We have asked the Ministry of Health via a formal letter (our usual protocol) to clarify the report,'' said Roy Wadia, a spokesman in WHO's China office. ''The ministry says they are investigating this report, and will get back to us soon.''
Efforts to reach the scientists for comment have been unsuccessful.
------
Associated Press reporter Zakki Hakim in Jakarta, Medical Writer Marilynn Marchione in Milwaukee and Science Writer Malcolm Ritter in New York contributed to this report.
WHO Says Bird Flu Virus Mutated
By THE ASSOCIATED PRESS
Published: June 23, 2006
Filed at 12:24 p.m. ET
JAKARTA, Indonesia (AP) -- A World Health Organization investigation showed that the H5N1 virus mutated slightly in an Indonesian family cluster on Sumatra island, but bird flu experts insisted Friday it did not increase the possibility of a human pandemic.
The virus that infected eight members of a family last month -- killing seven of them -- appears to have slightly mutated in a 10-year-old boy, who is then suspected of passing the virus to his father, the WHO investigative report said.
It is the first evidence indicating that a person caught the virus from a human and then passed it on to another person, said Tim Uyeki, an epidemiologist from the U.S. Centers for Disease Control and Prevention. He said the H5N1 virus died with the father and did not pass outside the family.
''It stopped. It was dead end at that point,'' he said, stressing that viruses are always slightly changing and there was no reason to raise alarm.
Dr. William Schaffner, a bird flu expert at the Vanderbilt University, called the mutation ''noteworthy but not worrisome.'' Generally it takes a series of mutations in a bird flu virus to raise the danger of a pandemic in humans, he said in a telephone interview.
Schaffner said it is remarkable that scientists were able to discover a mutation that occurred in a remote village in Indonesia. That's the result of intense surveillance linked with ''21st-century laboratory virology,'' he said. ''That's awesome.''
The findings appeared in a report obtained by The Associated Press that was distributed at a closed meeting in Jakarta attended by some of the world's top bird flu experts.
The three-day session that wrapped up Friday was convened after Indonesia asked for international help. The country has experienced an explosion of human bird flu cases this year and is on pace to become the world's hardest-hit nation with 39 deaths.
The government said it needed $900 million over the next three years to fight the virus, which is ravaging poultry stocks across the archipelago. Health experts urged full implementation and funding of its national bird flu plan.
''Human cases and clusters are expected to continue to occur in Indonesia as long as avian influenza in poultry persists,'' said Bayu Krisnamurthi, Indonesia's national bird flu coordinator.
But Welfare Minister Aburizal Bakrie said the virus has shown no sign of changing in any way that would allow it to spread easily among people, potentially sparking a pandemic.
So far, the H5N1 virus remains hard for people to catch, and most human cases have been traced to contact with infected birds.
WHO concluded in its report that human-to-human transmission likely occurred among seven relatives infected with the H5N1 virus. An eighth family member who was buried before specimens could be taken is believed to have been infected by poultry, the report said.
Despite the virus' slight mutation, Uyeki insisted that an analysis suggested there was ''nothing remarkable about these viruses.''
Bird flu has killed at least 130 people worldwide since it began ravaging Asian poultry stocks in late 2003. Indonesia trails on Vietnam, where 42 people have died, in human bird flu deaths.
WHO and others continue to investigate a report that a Beijing man originally thought to have SARS actually died of bird flu in November 2003 -- two years before the Chinese reported any human H5N1 flu infections from the mainland.
Eight Beijing scientists detailed the case in Thursday's New England Journal of Medicine. At the last minute, the lead author without explanation asked to have the report withdrawn, but that was not possible because it was already printed. The journal has been unable to reach the scientists to see whether they want to retract the report.
WHO had been unaware of the case.
''We have asked the Ministry of Health via a formal letter (our usual protocol) to clarify the report,'' said Roy Wadia, a spokesman in WHO's China office. ''The ministry says they are investigating this report, and will get back to us soon.''
Efforts to reach the scientists for comment have been unsuccessful.
------
Associated Press reporter Zakki Hakim in Jakarta, Medical Writer Marilynn Marchione in Milwaukee and Science Writer Malcolm Ritter in New York contributed to this report.
http://www.guardian.co.uk/international/st...1805813,00.html
First cases found of avian flu caught from wild
· Four Azeris died after plucking swan feathers
· Virus spread by humans in Indonesia, WHO confirms
David Adam and James Meikle
Monday June 26, 2006
The Guardian
Four people have died after catching avian flu from infected swans, in the first confirmed cases of the disease being passed from wild birds, scientists have revealed.
The victims, from a village in Azerbaijan, are believed to have caught the lethal H5N1 virus earlier this year when they plucked the feathers from dead birds to sell for pillows. Three other people were infected by the swans but survived.
Andreas Gilsdorf, an epidemiologist at the Robert Koch Institute in Berlin, who led the team that made the discovery, said: "As far as we know this is the first transmission from a wild bird, but it was a very intensive contact. We know that the virus is carried by swans and we know that you can catch the virus if you have close contact, so it doesn't change anything, it's just the first time it has been reported."
Some ornithologists and conservation experts have tried to play down the role that wild birds could play in spreading the disease. The UN's Convention on Migratory Species organised a "world migratory bird day" in April, which it said came "at a time when migratory birds are being unfairly portrayed solely as the harbingers of death and disease".
Almost all of the 220 other confirmed human cases of bird flu, including 130 deaths, have been linked to infected domestic poultry. A handful are believed to have caught the disease directly from infected humans.
The cluster of cases in the Salyan district of Azerbaijan, 90 miles south-east of Baku, was first reported in March. Six of the seven, all aged between 10 and 20, were from the same family. Relatives initially denied any contact - hunting and trading wild birds and their products there is illegal - but eventually admitted that the victims had plucked the feathers from dead swans among a huge number of the birds to have died in February.
Only one wild bird has been found with H5N1 in Britain in recent years, the dead swan floating off Fife in April. But surveillance of migratory birds returning this autumn is likely to be far greater and more targeted on specific species of ducks, geese and swans than it was this winter and spring. Checks are being carried out this summer on the black headed gull and lesser black back gull, which might have travelled from North Africa. Nigeria suffered a big outbreak in poultry this year.
Andy Evans, head of terrestrial research for the RSPB, said: "You have to get extremely close to an infected bird. Most cases are associated with poultry and preparing poultry for the pot. This is essentially the same process. If you have extremely close contact with an infected carcass, it is possibly to contract the disease, but it remains difficult."
The Health Protection Agency said: "Our advice remains the same, if you see a dead bird, don't pick it up." Defra said its scientific advisers regarded the risk of bird flu transmitting to humans from wild birds as small.
Separately, the World Health Organisation has confirmed fears that a cluster of cases in Indonesia was caused by the virus passing directly from person to person. Seven people died, but officials insisted there was no risk of wider transmission. Scientists found that the virus had mutated slightly, but not into a form that could be passed on easily.
First cases found of avian flu caught from wild
· Four Azeris died after plucking swan feathers
· Virus spread by humans in Indonesia, WHO confirms
David Adam and James Meikle
Monday June 26, 2006
The Guardian
Four people have died after catching avian flu from infected swans, in the first confirmed cases of the disease being passed from wild birds, scientists have revealed.
The victims, from a village in Azerbaijan, are believed to have caught the lethal H5N1 virus earlier this year when they plucked the feathers from dead birds to sell for pillows. Three other people were infected by the swans but survived.
Andreas Gilsdorf, an epidemiologist at the Robert Koch Institute in Berlin, who led the team that made the discovery, said: "As far as we know this is the first transmission from a wild bird, but it was a very intensive contact. We know that the virus is carried by swans and we know that you can catch the virus if you have close contact, so it doesn't change anything, it's just the first time it has been reported."
Some ornithologists and conservation experts have tried to play down the role that wild birds could play in spreading the disease. The UN's Convention on Migratory Species organised a "world migratory bird day" in April, which it said came "at a time when migratory birds are being unfairly portrayed solely as the harbingers of death and disease".
Almost all of the 220 other confirmed human cases of bird flu, including 130 deaths, have been linked to infected domestic poultry. A handful are believed to have caught the disease directly from infected humans.
The cluster of cases in the Salyan district of Azerbaijan, 90 miles south-east of Baku, was first reported in March. Six of the seven, all aged between 10 and 20, were from the same family. Relatives initially denied any contact - hunting and trading wild birds and their products there is illegal - but eventually admitted that the victims had plucked the feathers from dead swans among a huge number of the birds to have died in February.
Only one wild bird has been found with H5N1 in Britain in recent years, the dead swan floating off Fife in April. But surveillance of migratory birds returning this autumn is likely to be far greater and more targeted on specific species of ducks, geese and swans than it was this winter and spring. Checks are being carried out this summer on the black headed gull and lesser black back gull, which might have travelled from North Africa. Nigeria suffered a big outbreak in poultry this year.
Andy Evans, head of terrestrial research for the RSPB, said: "You have to get extremely close to an infected bird. Most cases are associated with poultry and preparing poultry for the pot. This is essentially the same process. If you have extremely close contact with an infected carcass, it is possibly to contract the disease, but it remains difficult."
The Health Protection Agency said: "Our advice remains the same, if you see a dead bird, don't pick it up." Defra said its scientific advisers regarded the risk of bird flu transmitting to humans from wild birds as small.
Separately, the World Health Organisation has confirmed fears that a cluster of cases in Indonesia was caused by the virus passing directly from person to person. Seven people died, but officials insisted there was no risk of wider transmission. Scientists found that the virus had mutated slightly, but not into a form that could be passed on easily.
On April 18, 2006, the Lowell Pandemic Influenza Public Discussion was held at the Tsongas Arena in Lowell, MA. The Lowell event was the first of a possible series of public discussion sessions being held across the state as part of the Massachusetts Pandemic Flu Public Participation Project.
The Lowell Pandemic Influenza Public Discussion was a follow-up effort to two related events. First, at the state and national level, the event was an effort to continue the involvement of the public in pandemic planning that was initiated through the Pandemic Flu Vaccination Priorities Public Engagement Pilot Project. Massachusetts was one of three states to participate in the pilot project. As part of the pilot project, in September 2005, Massachusetts held a meeting with 40 people from around the state to discuss priority groups for influenza vaccine during a pandemic.
Secondly, at the city and regional level, this event followed the "Avian Influenza Pandemic Conference" of the Program on Homeland Security at Middlesex Community College, which was held in Lowell on December 6, 2005. The conference attracted 200 attendees from five states, representing eighty-five institutions and agencies from higher education, health care,federal, state and local government, organized labor and private companies.
To download a pdf of the full summary report of the public discussion, a facilitated small-group focus group process, go here.
The Lowell Pandemic Influenza Public Discussion was a follow-up effort to two related events. First, at the state and national level, the event was an effort to continue the involvement of the public in pandemic planning that was initiated through the Pandemic Flu Vaccination Priorities Public Engagement Pilot Project. Massachusetts was one of three states to participate in the pilot project. As part of the pilot project, in September 2005, Massachusetts held a meeting with 40 people from around the state to discuss priority groups for influenza vaccine during a pandemic.
Secondly, at the city and regional level, this event followed the "Avian Influenza Pandemic Conference" of the Program on Homeland Security at Middlesex Community College, which was held in Lowell on December 6, 2005. The conference attracted 200 attendees from five states, representing eighty-five institutions and agencies from higher education, health care,federal, state and local government, organized labor and private companies.
To download a pdf of the full summary report of the public discussion, a facilitated small-group focus group process, go here.
http://news.monstersandcritics.com/health/...test_H5N1_death
Indonesia stuck with bird flu as US confirms latest H5N1 death
Jul 14, 2006, 13:06 GMT
Jakarta - A senior health official conceded Friday that Indonesia will be unable to bring bird flu under control in the near future, as a US laboratory confirmed the country's 41st death from the H5N1 virus.
Nyoman Kandun, director general of Indonesia's Health Ministry, said a sample sent to the US Centers for Disease Control in Atlanta confirmed that a 3-year-old toddler who died in hospital in Jakarta last week had bird flu.
Vietnam has recorded 42 bird-flu deaths, the most of any nation, but has not had a single case this year. Indonesia, however, has had 30 deaths alone in 2006 and a 75-per-cent death rate overall from the virus.
The Jakarta Post on Friday, citing leading veterinarians, reported that Indonesia will continue to be plagued by bird flu because the government's vaccination, early detection, research, eradication and public-awareness campaigns were not being conducted simultaneously.
Indonesia has been criticized for its slow reaction and subsequent attempts to contain the virus after it was first detected in the country's poultry population in 2004.
'Incidental culling in one area and vaccination in another would not ensure the virus would be gone,' Rangga Tabu, an animal expert from Gadjah Mada University in Yogyakarta, told a national veterinarian congress on Thursday, the Post reported.
Kandun agreed that as long as Indonesia was unable to stop birds from passing along the virus to humans, infections would continue among both the poultry and human populations.
'The risk factors are there,' he told Deutsche Presse Agentur dpa. 'As long as you cannot manage the upstream (of the disease) to people, you will be examining the cases all the time.'
International scientists and health officials have warned the H5N1 virus could mutate and cause human-to-human transmission, sparking a pandemic that could kill millions.
© 2006 dpa - Deutsche Presse-Agentur
Indonesia stuck with bird flu as US confirms latest H5N1 death
Jul 14, 2006, 13:06 GMT
Jakarta - A senior health official conceded Friday that Indonesia will be unable to bring bird flu under control in the near future, as a US laboratory confirmed the country's 41st death from the H5N1 virus.
Nyoman Kandun, director general of Indonesia's Health Ministry, said a sample sent to the US Centers for Disease Control in Atlanta confirmed that a 3-year-old toddler who died in hospital in Jakarta last week had bird flu.
Vietnam has recorded 42 bird-flu deaths, the most of any nation, but has not had a single case this year. Indonesia, however, has had 30 deaths alone in 2006 and a 75-per-cent death rate overall from the virus.
The Jakarta Post on Friday, citing leading veterinarians, reported that Indonesia will continue to be plagued by bird flu because the government's vaccination, early detection, research, eradication and public-awareness campaigns were not being conducted simultaneously.
Indonesia has been criticized for its slow reaction and subsequent attempts to contain the virus after it was first detected in the country's poultry population in 2004.
'Incidental culling in one area and vaccination in another would not ensure the virus would be gone,' Rangga Tabu, an animal expert from Gadjah Mada University in Yogyakarta, told a national veterinarian congress on Thursday, the Post reported.
Kandun agreed that as long as Indonesia was unable to stop birds from passing along the virus to humans, infections would continue among both the poultry and human populations.
'The risk factors are there,' he told Deutsche Presse Agentur dpa. 'As long as you cannot manage the upstream (of the disease) to people, you will be examining the cases all the time.'
International scientists and health officials have warned the H5N1 virus could mutate and cause human-to-human transmission, sparking a pandemic that could kill millions.
© 2006 dpa - Deutsche Presse-Agentur
There was a recent article seems to have been missed about a new vaccine made using less,and being up to date with the latest version of the virus, meaning 100s of millions of shots could be made rather quickly, as it would take less in each one and the first round of testing went so well they are already gearing it up to test and get it into production.
Anyone have the articles on this?
Was a long one in the NY Times
Anyone have the articles on this?
Was a long one in the NY Times
Gee, where have I heard this before?
-- -- --
http://www.bangkokpost.com/News/12Sep2006_news26.php
Tuesday September 12, 2006
FOCUS / AVIAN INFLUENZA
Instant treatment vital for bird flu cases, says study
By DONALD G MCNEIL JR
Avian flu kills in much the same way the global flu pandemic of 1918 did, by drowning victims in fluid produced in their own lungs, a new study has found. The study also suggests that immediate treatment with antiviral drugs is crucial, because the virus reproduces so quickly that, if not suppressed within the first 48 hours, it tends to push victims into a rapid decline to death. ''The paradigm 'hit hard and hit early' probably is very true for H5N1 influenza,'' said Dr Menno D de Jong, an Oxford University virologist and the study's lead author. However, he added, because the body's own immune response does part of the damage, doctors should consider giving anti-inflammatory drugs along with antivirals like Tamiflu.
Although the results of the relatively small study are precisely what flu experts had predicted from laboratory work, Dr Anne Moscona, a professor of pediatrics and immunology at the Weill Cornell Medical College, called it a ''major advance'' because so little clinical information had previously been gleaned from the 241 known cases of the disease.
Many of those cases have been in rural villages in Asia, where victims pick it up from backyard chickens and are buried or cremated before the virus that killed them is even identified.
This study, which appears in the October issue of Nature Medicine, was led by an Oxford research team in Ho Chi Minh City, Vietnam, and compared 18 people with the A(H5N1) avian flu in 2004 and 2005 to eight people infected with seasonal human flus.
It found that the avian flu patients, and particularly the 13 who died from it, had unusually high levels of the virus in their bodies. Consequently, they also had high levels of the chemicals, known as cytokines and chemokines, that trigger the immune system's inflammatory response.
Those chemicals, some of which are produced in cells lining the narrowest passages in the lungs, draw in white blood cells to attack invaders. But doing so too vigorously can flood the lungs, causing deadly pneumonia.
The effect, known as the ''Cytokine Storm'', is the leading theory as to why so many young, previously healthy people died in the 1918-19 pandemic, known as the Spanish flu, which killed tens of millions of people. Seasonal flus tend to kill the very old and very young, who usually die from bacterial infections that develop days after the milder flu virus has irritated their lung tissue.
The avian flu virus was easier to detect in throat swabs than in nasal swabs, Dr de Jong said, which is the opposite of how seasonal flu is detected, and useful for doctors doing flu tests. And the virus was found in rectal swabs, which is important for hospitals to know because it means diarrhoea, common among flu patients, can also spread the disease.
Flu experts were surprised that such high concentrations of the virus were found in nose and throat swabs. Earlier studies had suggested that the avian flu is not easily transmitted between humans because, unlike seasonal flu, it attaches primarily to receptors found deep in the lungs.
Dr de Jong said there could be several explanations: The throat swabs could have picked up virus coughed up from the lungs. Different receptors are spread up and down the breathing tract. And it is possible _ though unproved _ that some people may simply be born with receptors more amenable to the virus. That theory has been offered by epidemiologists who note that, even in villages where all the chickens are sick, human outbreaks tend to cluster in families.
The study also showed that some of the flu strains isolated in Vietnam had particular genetic changes that virologists have been watching for, fearing that these changes would make them more lethal.
But those changes appeared in only some patients, and in those who died as well as those who lived, ''so I wouldn't make too much of it,'' Dr Moscona said.
Henry L Niman, a Pittsburgh biochemist who has been tracking viral changes and raised earlier alarms about E627K, agreed.
''Lethality in the virus may rely on several changes,'' he said. ''But it's got several different paths to the same end. That's what makes it so efficient.'' NYT
-- -- --
http://www.pharmatimes.com/news/9519-H5N1-...aspx?src=PTWeek
World News | New findings could guide H5N1 drug development - 11/09/2006
The hunt for new treatments against H5N1 avian flu must focus on drugs that prevent the massive inflammation the virus causes, experts say.
The warning follows details from the first-ever controlled clinical study of the virus's immunological effects.
Vietnamese doctors who treated 18 victims of H5N1 infection in 2004/5 have documented in the latest issue of Nature Medicine how their patients' immune systems became stoked up to an extraordinary degree.
Their comparison of the patients, 13 of whom died, with eight others suffering normal H3N2 or H1H1 human influenza, revealed the extent of immune-dysfunction.
Most strikingly, they observed a massive release of inflammatory cytokines and chemokines, chemicals that rev-up the immune system, causing huge inflammation and tissue damage. Some of these substances were present at levels hundreds or thousands of times higher than in patients with ordinary influenza.
These observations explain how H5N1 infection typically kills patients through pneumonia and multi-organ failure, the researchers say.
The focus of new drug development and clinical management "must be in preventing this intense cytokine response," said the lead investigator Dr Meno de Jong of the Oxford University Clinical Research Unit at the Hospital for Tropical Diseases in Ho Chi Minh City, Vietnam.
His team reported in Nature Medicine that the patients who died from H5N1 had the highest levels of cytokines - and the highest levels of virus - circulating in their bodies. The results also underlined the need to provide anti-viral drugs very quickly, he said. Once the cytokine burst had started it was usually too late to alter the course of the disease.
Another important discovery was that, conversely, one component of the immune system, the T-cell response, was fatally weakened by H5N1 infection, thereby allowing viral replication to increase.
Dr Wendy Barclay, a virologist at Reading University who studies the effects flu viruses on the immune system, said: "The research suggests that stopping the virus replicating early on infection with antivirals in the key to treatment."
She noted that treating patients with anti-inflammatory drugs, as some doctors have suggested, "might do more harm than good". "Immunomodulatory drugs are blunt instruments. The last thing you want to do is weaken parts of the immune system needed to fight the virus."
-- -- --
http://www.bangkokpost.com/News/12Sep2006_news26.php
Tuesday September 12, 2006
FOCUS / AVIAN INFLUENZA
Instant treatment vital for bird flu cases, says study
By DONALD G MCNEIL JR
Avian flu kills in much the same way the global flu pandemic of 1918 did, by drowning victims in fluid produced in their own lungs, a new study has found. The study also suggests that immediate treatment with antiviral drugs is crucial, because the virus reproduces so quickly that, if not suppressed within the first 48 hours, it tends to push victims into a rapid decline to death. ''The paradigm 'hit hard and hit early' probably is very true for H5N1 influenza,'' said Dr Menno D de Jong, an Oxford University virologist and the study's lead author. However, he added, because the body's own immune response does part of the damage, doctors should consider giving anti-inflammatory drugs along with antivirals like Tamiflu.
Although the results of the relatively small study are precisely what flu experts had predicted from laboratory work, Dr Anne Moscona, a professor of pediatrics and immunology at the Weill Cornell Medical College, called it a ''major advance'' because so little clinical information had previously been gleaned from the 241 known cases of the disease.
Many of those cases have been in rural villages in Asia, where victims pick it up from backyard chickens and are buried or cremated before the virus that killed them is even identified.
This study, which appears in the October issue of Nature Medicine, was led by an Oxford research team in Ho Chi Minh City, Vietnam, and compared 18 people with the A(H5N1) avian flu in 2004 and 2005 to eight people infected with seasonal human flus.
It found that the avian flu patients, and particularly the 13 who died from it, had unusually high levels of the virus in their bodies. Consequently, they also had high levels of the chemicals, known as cytokines and chemokines, that trigger the immune system's inflammatory response.
Those chemicals, some of which are produced in cells lining the narrowest passages in the lungs, draw in white blood cells to attack invaders. But doing so too vigorously can flood the lungs, causing deadly pneumonia.
The effect, known as the ''Cytokine Storm'', is the leading theory as to why so many young, previously healthy people died in the 1918-19 pandemic, known as the Spanish flu, which killed tens of millions of people. Seasonal flus tend to kill the very old and very young, who usually die from bacterial infections that develop days after the milder flu virus has irritated their lung tissue.
The avian flu virus was easier to detect in throat swabs than in nasal swabs, Dr de Jong said, which is the opposite of how seasonal flu is detected, and useful for doctors doing flu tests. And the virus was found in rectal swabs, which is important for hospitals to know because it means diarrhoea, common among flu patients, can also spread the disease.
Flu experts were surprised that such high concentrations of the virus were found in nose and throat swabs. Earlier studies had suggested that the avian flu is not easily transmitted between humans because, unlike seasonal flu, it attaches primarily to receptors found deep in the lungs.
Dr de Jong said there could be several explanations: The throat swabs could have picked up virus coughed up from the lungs. Different receptors are spread up and down the breathing tract. And it is possible _ though unproved _ that some people may simply be born with receptors more amenable to the virus. That theory has been offered by epidemiologists who note that, even in villages where all the chickens are sick, human outbreaks tend to cluster in families.
The study also showed that some of the flu strains isolated in Vietnam had particular genetic changes that virologists have been watching for, fearing that these changes would make them more lethal.
But those changes appeared in only some patients, and in those who died as well as those who lived, ''so I wouldn't make too much of it,'' Dr Moscona said.
Henry L Niman, a Pittsburgh biochemist who has been tracking viral changes and raised earlier alarms about E627K, agreed.
''Lethality in the virus may rely on several changes,'' he said. ''But it's got several different paths to the same end. That's what makes it so efficient.'' NYT
-- -- --
http://www.pharmatimes.com/news/9519-H5N1-...aspx?src=PTWeek
World News | New findings could guide H5N1 drug development - 11/09/2006
The hunt for new treatments against H5N1 avian flu must focus on drugs that prevent the massive inflammation the virus causes, experts say.
The warning follows details from the first-ever controlled clinical study of the virus's immunological effects.
Vietnamese doctors who treated 18 victims of H5N1 infection in 2004/5 have documented in the latest issue of Nature Medicine how their patients' immune systems became stoked up to an extraordinary degree.
Their comparison of the patients, 13 of whom died, with eight others suffering normal H3N2 or H1H1 human influenza, revealed the extent of immune-dysfunction.
Most strikingly, they observed a massive release of inflammatory cytokines and chemokines, chemicals that rev-up the immune system, causing huge inflammation and tissue damage. Some of these substances were present at levels hundreds or thousands of times higher than in patients with ordinary influenza.
These observations explain how H5N1 infection typically kills patients through pneumonia and multi-organ failure, the researchers say.
The focus of new drug development and clinical management "must be in preventing this intense cytokine response," said the lead investigator Dr Meno de Jong of the Oxford University Clinical Research Unit at the Hospital for Tropical Diseases in Ho Chi Minh City, Vietnam.
His team reported in Nature Medicine that the patients who died from H5N1 had the highest levels of cytokines - and the highest levels of virus - circulating in their bodies. The results also underlined the need to provide anti-viral drugs very quickly, he said. Once the cytokine burst had started it was usually too late to alter the course of the disease.
Another important discovery was that, conversely, one component of the immune system, the T-cell response, was fatally weakened by H5N1 infection, thereby allowing viral replication to increase.
Dr Wendy Barclay, a virologist at Reading University who studies the effects flu viruses on the immune system, said: "The research suggests that stopping the virus replicating early on infection with antivirals in the key to treatment."
She noted that treating patients with anti-inflammatory drugs, as some doctors have suggested, "might do more harm than good". "Immunomodulatory drugs are blunt instruments. The last thing you want to do is weaken parts of the immune system needed to fight the virus."
A clove of garlic a day. 
It beats the devil off.
It beats the devil off.
If bird flu virus becomes pandemic, high death rates possible: WHO report
Provided by: Canadian Press
Written by: HELEN BRANSWELL, The Canadian Press
Nov. 2, 2006
http://bodyandhealth.canada.com/channel_he..._id=1020&rot=11
(CP) - There is no guarantee the H5N1 avian flu virus will become less deadly to people if it evolves to the point where it is able to trigger a pandemic, warns a report released Thursday by the World Health Organization.
The report also questions the wisdom of governments stockpiling existing H5N1 vaccines. And it reveals that a low level of H5N1 viruses found in wild and domestic birds appear to be naturally resistant to oseltamivir, or Tamiflu, the drug many companies, corporations and individuals are stockpiling against a future pandemic.
The report is the product of a meeting of international influenza experts hosted last month by the WHO.
It concludes that if H5N1 were to become a pandemic virus by swapping genes with human flu viruses - a process called reassortment - the ensuing pandemic might not be too onerous. But if it reaches pandemic status by a gradual series of genetic changes - called adaptive mutation - it may retain its extraordinary severity.
"You cannot assume that adaptation to human-to-human transmission automatically will lead to lower virulence," said Dr. Malik Peiris, a microbiologist from the University of Hong Kong who attended the meeting.
"If the avian virus essentially crosses over lock, stock and barrel, by adaptive mutation, then there is really no reason to believe that you will lose a lot of the severity of disease that you see now."
Since the virus erupted in Asia in late 2003, the virus has killed nearly 60 per cent of people known to have been infected. As of Oct. 31, the virus had infected 256 people in 10 countries, killing 152, according to the WHO.
It is often assumed that H5N1 - like many other pathogens - probably causes a range of disease from virtually symptomless to the life-threatening, but that only the most severely ill cases come to the attention of authorities when they seek medical help.
If that's true, the current case count is probably only the tip of the iceberg - which would mean that the death rate is exaggerated.
But a review of the studies done so far looking for mild infection in people exposed to H5N1-infected chickens or human cases of the disease suggest remarkably few cases seem to go undetected - a fact that surprised some attending the expert meeting, the report notes.
The WHO scientist who organized the meeting cautioned Thursday that the question of how lethal an H5N1 pandemic might be is the scientific equivalent of a black hole.
Modern science has never seen a flu virus as nasty as H5N1. There is no way of knowing if the virus can adapt to easily transmit from person to person or what kind of disease it would cause if it did.
"It's one of those things that you hate to conjecture," said Dr. Michael Perdue, an avian influenza expert and scientist with the WHO's global influenza program.
"We just don't know enough about this virus, a whole new subtype for humans. . . . If a new H5 enters, it could be more lethal than anything we've ever seen in history. (But) who knows?"
"I think it's anybody's opinion because it's just so completely unknown."
Still, the uncertainty demands that countries prepare, said Dr. Michael Osterholm, an infectious diseases expert who did not attend the meeting.
"This report should be another sober reminder of why pandemic preparedness fatigue is not acceptable," said Osterholm, director of the Center for Infectious Diseases Research and Policy at the University of Minnesota.
The report noted some modelling studies suggest a highly lethal virus could not spark a pandemic, because people who fall gravely ill aren't walking about spreading the virus. "All such matters remain difficult to predict," the report concludes.
On the issue of stockpiling current H5N1 vaccines for later use, the report says there is little evidence that a vaccine against one variant of the virus will protect a person against other currently circulating H5N1 viruses, let alone future versions.
"We still don't have the data that would say that a pre-pandemic vaccine based on one H5N1 strain would completely protect against another," Perdue said from Geneva.
"Although one would hope it would mitigate the effects some, we don't have the data to show it."
Osterholm called that an important message, given that governments are already announcing intentions to add H5N1 vaccine to their pandemic stockpiles.
"I think the report does a very good job in detailing why there should be a real pause in our rush to buy vaccine as a way of getting any one country ready for a pandemic," he said.
The United States and Switzerland are putting aside current H5N1 vaccines. And several other countries - Singapore and Britain among them - are reported to be in negotiations with vaccine maker GlaxoSmithKline to buy its H5N1 vaccine for stockpiling purposes.
The report also reveals that unnamed researchers have discovered that a small portion of H5N1 viruses isolated from birds - it does not say where - carried mutations that make them naturally resistant to Tamiflu.
Peiris, who knew about the work, didn't want to talk about the unpublished findings, saying they were "very preliminary."
View more infection news
Provided by: Canadian Press
Written by: HELEN BRANSWELL, The Canadian Press
Nov. 2, 2006
http://bodyandhealth.canada.com/channel_he..._id=1020&rot=11
(CP) - There is no guarantee the H5N1 avian flu virus will become less deadly to people if it evolves to the point where it is able to trigger a pandemic, warns a report released Thursday by the World Health Organization.
The report also questions the wisdom of governments stockpiling existing H5N1 vaccines. And it reveals that a low level of H5N1 viruses found in wild and domestic birds appear to be naturally resistant to oseltamivir, or Tamiflu, the drug many companies, corporations and individuals are stockpiling against a future pandemic.
The report is the product of a meeting of international influenza experts hosted last month by the WHO.
It concludes that if H5N1 were to become a pandemic virus by swapping genes with human flu viruses - a process called reassortment - the ensuing pandemic might not be too onerous. But if it reaches pandemic status by a gradual series of genetic changes - called adaptive mutation - it may retain its extraordinary severity.
"You cannot assume that adaptation to human-to-human transmission automatically will lead to lower virulence," said Dr. Malik Peiris, a microbiologist from the University of Hong Kong who attended the meeting.
"If the avian virus essentially crosses over lock, stock and barrel, by adaptive mutation, then there is really no reason to believe that you will lose a lot of the severity of disease that you see now."
Since the virus erupted in Asia in late 2003, the virus has killed nearly 60 per cent of people known to have been infected. As of Oct. 31, the virus had infected 256 people in 10 countries, killing 152, according to the WHO.
It is often assumed that H5N1 - like many other pathogens - probably causes a range of disease from virtually symptomless to the life-threatening, but that only the most severely ill cases come to the attention of authorities when they seek medical help.
If that's true, the current case count is probably only the tip of the iceberg - which would mean that the death rate is exaggerated.
But a review of the studies done so far looking for mild infection in people exposed to H5N1-infected chickens or human cases of the disease suggest remarkably few cases seem to go undetected - a fact that surprised some attending the expert meeting, the report notes.
The WHO scientist who organized the meeting cautioned Thursday that the question of how lethal an H5N1 pandemic might be is the scientific equivalent of a black hole.
Modern science has never seen a flu virus as nasty as H5N1. There is no way of knowing if the virus can adapt to easily transmit from person to person or what kind of disease it would cause if it did.
"It's one of those things that you hate to conjecture," said Dr. Michael Perdue, an avian influenza expert and scientist with the WHO's global influenza program.
"We just don't know enough about this virus, a whole new subtype for humans. . . . If a new H5 enters, it could be more lethal than anything we've ever seen in history. (But) who knows?"
"I think it's anybody's opinion because it's just so completely unknown."
Still, the uncertainty demands that countries prepare, said Dr. Michael Osterholm, an infectious diseases expert who did not attend the meeting.
"This report should be another sober reminder of why pandemic preparedness fatigue is not acceptable," said Osterholm, director of the Center for Infectious Diseases Research and Policy at the University of Minnesota.
The report noted some modelling studies suggest a highly lethal virus could not spark a pandemic, because people who fall gravely ill aren't walking about spreading the virus. "All such matters remain difficult to predict," the report concludes.
On the issue of stockpiling current H5N1 vaccines for later use, the report says there is little evidence that a vaccine against one variant of the virus will protect a person against other currently circulating H5N1 viruses, let alone future versions.
"We still don't have the data that would say that a pre-pandemic vaccine based on one H5N1 strain would completely protect against another," Perdue said from Geneva.
"Although one would hope it would mitigate the effects some, we don't have the data to show it."
Osterholm called that an important message, given that governments are already announcing intentions to add H5N1 vaccine to their pandemic stockpiles.
"I think the report does a very good job in detailing why there should be a real pause in our rush to buy vaccine as a way of getting any one country ready for a pandemic," he said.
The United States and Switzerland are putting aside current H5N1 vaccines. And several other countries - Singapore and Britain among them - are reported to be in negotiations with vaccine maker GlaxoSmithKline to buy its H5N1 vaccine for stockpiling purposes.
The report also reveals that unnamed researchers have discovered that a small portion of H5N1 viruses isolated from birds - it does not say where - carried mutations that make them naturally resistant to Tamiflu.
Peiris, who knew about the work, didn't want to talk about the unpublished findings, saying they were "very preliminary."
View more infection news
http://www.bloomberg.com/apps/news?pid=206...oDWYS8&refer=us
-- --
Roche's Tamiflu to Add Warning on Psychiatric Risks (Update1)
By Catherine Larkin
Nov. 13 (Bloomberg) -- Roche Holding AG's Tamiflu flu treatment must carry information warning of potential risks of psychiatric side effects, U.S. regulators said.
The Food and Drug Administration approved a labeling revision to include information on those risks after reports of self-injury and mutilation among Japanese patients using the drug, the agency said today in an e-mailed statement. Most of these side effects were reported in children.
The new label will urge doctors to monitor patients with influenza for signs of abnormal behavior immediately after they begin taking Tamiflu. While the ``relative contribution of the drug to these events is not known,'' the regulators said the labeling revision is intended to mitigate the potential risks.
Roche, based in Basel, Switzerland, said in a statement that it is committed to working with regulators to ensure that the drug's labeling accurately reflects reports of adverse events.
To contact the reporter on this story: Catherine Larkin in Washington at clarkin4@bloomberg.net .
Last Updated: November 13, 2006 17:37 EST
-- --
http://www.marketwatch.com/news/story/stor...FF2417855B8E%7D
--
FDA staff calls for Tamiflu to carry behavior warning
Last Update: 4:51 PM ET Nov 13, 2006
WASHINGTON (MarketWatch) -- Food and Drug Administration staff recommend that the label for Roche Holding AG's (RHHBY) flu drug Tamiflu be updated to include a precaution related to possible psychiatric problems in patients who take it.
The staff's recommendation, posted on the FDA's Web site Monday, follows a 10-month review that found 103 cases of "neuropsychiatric adverse events," including the death of a 14-year-old boy who fell after climbing on his condominium balcony railing.
From the 103 cases, 67% are pediatric patients and 95% occurred outside the U.S., mostly in Japan.
Two other related deaths by people who took Tamiflu were reported, including an adult who left a suicide note. There have been other reports of people who had jumped or fallen, but they survived the injuries, the FDA staff said.
The officials still don't know if the new cases, reported from August 2005 to July this year, are linked to the drug, to the flu virus, or both.
The staff's recommendation on label changes is to be discussed Thursday by FDA's pediatric advisory committee. Although the agency isn't required to follow the panel's suggestions, it usually does.
Last year, both the committee and the panel said Tamiflu was safe for use in children and said there was no link to reports of 12 deaths in children taking the drug in Japan.
A previous review by the FDA staff covering 1999 to August 2005 found 126 cases of neuropsychiatric adverse events from people who took Tamiflu.
In Japan, Tamiflu's label already carries information on such events, and the FDA staff said "it would be prudent to update the U.S. labeling to be similar in scope."
"In particular, we want to alert the clinician, patient and patient's guardian to closely monitor the patient in order to abort any attempt at unsafe behavior," the staff said in a 23-page report.
-Contact: 201-938-5400
-- --
Roche's Tamiflu to Add Warning on Psychiatric Risks (Update1)
By Catherine Larkin
Nov. 13 (Bloomberg) -- Roche Holding AG's Tamiflu flu treatment must carry information warning of potential risks of psychiatric side effects, U.S. regulators said.
The Food and Drug Administration approved a labeling revision to include information on those risks after reports of self-injury and mutilation among Japanese patients using the drug, the agency said today in an e-mailed statement. Most of these side effects were reported in children.
The new label will urge doctors to monitor patients with influenza for signs of abnormal behavior immediately after they begin taking Tamiflu. While the ``relative contribution of the drug to these events is not known,'' the regulators said the labeling revision is intended to mitigate the potential risks.
Roche, based in Basel, Switzerland, said in a statement that it is committed to working with regulators to ensure that the drug's labeling accurately reflects reports of adverse events.
To contact the reporter on this story: Catherine Larkin in Washington at clarkin4@bloomberg.net .
Last Updated: November 13, 2006 17:37 EST
-- --
http://www.marketwatch.com/news/story/stor...FF2417855B8E%7D
--
FDA staff calls for Tamiflu to carry behavior warning
Last Update: 4:51 PM ET Nov 13, 2006
WASHINGTON (MarketWatch) -- Food and Drug Administration staff recommend that the label for Roche Holding AG's (RHHBY) flu drug Tamiflu be updated to include a precaution related to possible psychiatric problems in patients who take it.
The staff's recommendation, posted on the FDA's Web site Monday, follows a 10-month review that found 103 cases of "neuropsychiatric adverse events," including the death of a 14-year-old boy who fell after climbing on his condominium balcony railing.
From the 103 cases, 67% are pediatric patients and 95% occurred outside the U.S., mostly in Japan.
Two other related deaths by people who took Tamiflu were reported, including an adult who left a suicide note. There have been other reports of people who had jumped or fallen, but they survived the injuries, the FDA staff said.
The officials still don't know if the new cases, reported from August 2005 to July this year, are linked to the drug, to the flu virus, or both.
The staff's recommendation on label changes is to be discussed Thursday by FDA's pediatric advisory committee. Although the agency isn't required to follow the panel's suggestions, it usually does.
Last year, both the committee and the panel said Tamiflu was safe for use in children and said there was no link to reports of 12 deaths in children taking the drug in Japan.
A previous review by the FDA staff covering 1999 to August 2005 found 126 cases of neuropsychiatric adverse events from people who took Tamiflu.
In Japan, Tamiflu's label already carries information on such events, and the FDA staff said "it would be prudent to update the U.S. labeling to be similar in scope."
"In particular, we want to alert the clinician, patient and patient's guardian to closely monitor the patient in order to abort any attempt at unsafe behavior," the staff said in a 23-page report.
-Contact: 201-938-5400
http://content.nejm.org/cgi/content/full/355/21/2174
-- --
FOCUS ON RESEARCH
Volume 355:2174-2177 November 23, 2006 Number 21
H5N1 Influenza — Continuing Evolution and Spread
Robert G. Webster, Ph.D., and Elena A. Govorkova, M.D., Ph.D.
There is no question that there will be another influenza pandemic someday. We simply don't know when it will occur or whether it will be caused by the H5N1 avian influenza virus. But given the number of cases of H5N1 influenza that have occurred in humans to date (251 as of late September 2006) and the rate of death of more than 50%, it would be prudent to develop robust plans for dealing with such a pandemic.
The epicenters of both the Asian influenza pandemic of 1957 and the Hong Kong influenza pandemic of 1968 were in Southeast Asia, and it is in this region that multiple clades of H5N1 influenza virus have already emerged. The Asian H5N1 virus was first detected in Guangdong Province, China, in 1996, when it killed some geese, but it received little attention until it spread through live-poultry markets in Hong Kong to humans in May 1997, killing 6 of 18 infected persons (see map and time line). The culling of all poultry in Hong Kong ended the first wave of H5N1, but the virus continued to circulate among apparently healthy ducks in the coastal provinces of China.
--
The Spread of H5N1 Influenza Virus and Time Line Showing Its Emergence.
see enlargeable map/graphic at original link above...
The shaded area across southern China is the hypothetical epicenter for the emergence of H5N1 clades and subclades. The H5N1 viruses are being perpetuated in the domestic birds of the region, despite the use of universal vaccination of all domestic poultry. The red dot in the time line denotes the occurrence of the first human case, followed by the number of confirmed human cases in that country. The green and blue solid bars represent documented H5N1 infection in domestic poultry and wild birds, and dashed bars indicate that H5N1 in the avian population is suspected. These limited surveillance data are adapted from the World Health Organization and the U.N. Food and Agriculture Organization (www.fao.org). HA denotes hemagglutinin.
From 1997 to May 2005, H5N1 viruses were largely confined to Southeast Asia, but after they had infected wild birds in Qinghai Lake, China, they rapidly spread westward. The deaths of swans and geese marked H5N1's spread into Europe, India, and Africa. Infections with highly pathogenic H5N1 viruses were confirmed in poultry in Turkey in mid-October 2005, and the first confirmed human cases in Turkey occurred in early January 2006. Thus, H5N1 influenza viruses continue to emerge from the epicenter.
The H5N1 viruses can be divided into clade 1 and clade 2; the latter can be further subdivided into three subclades. The bad news is that these clades and subclades probably differ sufficiently in their antigenic structure to warrant the preparation of different vaccines. Studies in ferrets suggest that vaccine against one clade will not protect against infection with another clade, though it will protect against influenza-associated death.1 Thus, the available information supports the notion that a vaccine against H5N1 is worth stockpiling as a "prepandemic" vaccine, since very few persons have been immunologically exposed to H5 antigens and priming with one clade may be beneficial.
Another key question is whether these clades and subclades vary in sensitivity to available anti-influenza drugs. The majority of H5N1 clade 1 viruses (e.g., A/Vietnam/1203/2004) are resistant to the adamantanes (amantadine and rimantadine), but the majority of clade 2 viruses (e.g., A/Indonesia/5/2005) are sensitive. All H5N1 viruses that have been tested are sensitive to the neuraminidase inhibitors; these drugs may be effective when used prophylactically, but the window for effective treatment will probably be limited to 1 to 2 days after initial infection. Kandun et al. make clear in their report in this issue of the Journal (pages 2186–2194) on three clusters of patients with H5N1 infection in Indonesia that the difficulty with the use of a neuraminidase inhibitor (oseltamivir) in those cases was that treatment began 5 to 7 days after initial infection. Such delayed administration of the drug limits its value in decreasing the viral load and might lead to the selection of resistant strains.
The use of rapid diagnostics for H5N1 virus infection can permit specific antiviral treatments to be initiated early. Oner et al. report in this issue of the Journal (pages 2179–2185) that in a human outbreak of H5N1 in Turkey, it was difficult to detect H5N1 virus infection with standard techniques; the authors found that a real-time polymerase-chain-reaction assay performed on nasopharyngeal specimens had the best diagnostic value.
The continuing evolution of H5N1 viruses and the clusters of human infections in Indonesia and Turkey raise important questions. First, can the source of H5N1 be eliminated? And second, is the increasing number of clusters of human infection an indicator of evolution toward consistent human-to-human transmission?
Controlling H5N1 influenza by eradicating it at the source in domestic poultry has worked for some wealthy countries: in 2003, Japan and South Korea eradicated H5N1 through a strategy of quarantine and culling of poultry and implementation of improved biosecurity measures for poultry facilities. In Thailand, however, the same strategy resulted in only a temporary respite; after nearly a year with no H5N1 activity, new cases in humans in July 2006 heralded the resurgence of H5N1 in domestic poultry.
An alternative strategy adopted by China, Indonesia, and Vietnam has been to vaccinate uninfected poultry in conjunction with the quarantine and culling of infected birds. This approach has failed, however, and its critics explain that poultry vaccines are largely of poor quality, do not provide sterilizing immunity, and promote antigenic drift. Yet vaccines against H5N1 influenza virus have been used successfully since 2004 on all poultry sold in Hong Kong, where no H5N1 virus has been isolated from fowl in live-bird markets despite extensive prospective surveillance.
Perhaps the most important experiment in controlling H5N1 is one that is ongoing in Vietnam. Since the country adopted a strategy of vaccinating all poultry with inactivated, oil-emulsion H5N1 vaccine, there have been no additional cases in humans and no reported H5N1 infections in chickens. But in September 2006, H5N1 was reported to have reemerged in ducks and geese in Vietnam. Thus, H5N1 influenza vaccine seems to protect chickens and, indirectly, humans, but probably not waterfowl.
Given that the vaccine predominantly used in Vietnam is prepared in China, where the policy is to vaccinate all poultry, some have questioned why H5N1 is not under control in China. The problem may be the lack of protection in waterfowl. Ducks may be the stealth carriers (the Trojan horses of H5N1 influenza), for wild mallard ducks do not always show signs of disease when infected with any of a range of highly pathogenic H5N1 viruses.2 Our knowledge about the efficacy of H5N1 influenza vaccines in domestic waterfowl is limited, and highly pathogenic H5N1 viruses continue to be isolated from waterfowl in the epicenter of the epidemic. If the reservoir of highly pathogenic H5N1 virus is domestic waterfowl, the virus should theoretically be eradicable, but eliminating it would require improved vaccines for waterfowl and draconian prospective surveillance and culling.
Meanwhile, the number of infections in humans continues to increase. By mid-August, 97 humans had been infected in 2006 — the same number as in all of 2005. Perhaps the most surprising thing about highly pathogenic H5N1 is that although more than 230 million domestic birds have died or been killed, only 251 humans have become ill from H5N1 infection, and there has been little or no evidence of subclinical infection in humans. The current H5N1 virus is apparently not well "fitted" to replication in humans, although the genetic makeup of a small proportion of humans supports attachment and replication of the virus, if not its transmission. The specific receptor for the current avian influenza virus (2-3 sialic acid) is found deep in the respiratory tract of humans,3 but it seems likely that only a minority of people have receptors for avian influenza viruses in their upper respiratory tracts. Moreover, receptor specificity is only one of the requirements for human infection; the virus must also find compatible enzyme systems in the infected human cells if the viral polymerase complex is to function. Currently, these conditions are apparently met in only a few persons. But the virus is always changing, and mutations that make it more compatible with human transmission may occur at any time.
The seasonality of H5N1 influenza seems similar to that of human influenza: the virus has apparently been more transmissible among chickens, and consequently to humans, during the cooler months. The cases in humans in Turkey, Iraq, and Egypt occurred during the cooler months and coincided with explosive outbreaks of the disease in wild and domestic poultry. In the tropical areas of Asia, there have been two resurgences of H5N1 during the warmer months of the year — a pattern that resembles that followed by human influenza in the tropics, with its multiple peaks of activity. With winter approaching in the northern hemisphere, H5N1 may spread further. Will it cross from Eurasia to the Americas? Will wild migratory birds carry it from their breeding sites in northern Europe and Siberia to commercial poultry in Europe, Africa, and America? If it is endemic in wild migratory birds that are not rapidly killed by it, then spread to domestic backyard poultry is inevitable. The intermittent spread to humans will continue, and the virus will continue to evolve.
Clearly, we must prepare for the possibility of an influenza pandemic. If H5N1 influenza achieves pandemic status in humans — and we have no way to know whether it will — the results could be catastrophic.
--
Drs. Webster and Govorkova report receiving research funding from Hoffmann–La Roche and BioCryst Pharmaceuticals. Dr. Webster reports receiving consulting fees from GlaxoSmithKline; and Dr. Govorkova, consulting fees from BioCryst Pharmaceuticals. No other potential conflict of interest relevant to this article was reported.
Source Information
Dr. Webster is a professor and Dr. Govorkova a senior scientist in the Department of Infectious Diseases, Division of Virology, St. Jude Children's Research Hospital, Memphis, TN.
References
Govorkova EA, Webby RJ, Humberd J, Seiler JP, Webster RG. Immunization with reverse-genetics-produced H5N1 influenza vaccine protects ferrets against homologous and heterologous challenge. J Infect Dis 2006;194:159-167. [CrossRef][ISI][Medline]
Hulse-Post DJ, Sturm-Ramirez KM, Humberd J, et al. Role of domestic ducks in the propagation and biological evolution of highly pathogenic H5N1 influenza viruses in Asia. Proc Natl Acad Sci U S A 2005;102:10682-10687. [Abstract/Full Text]
Shinya K, Ebina M, Yamada S, Ono M, Kasai N, Kawaoka Y. Avian flu: influenza virus receptors in the human airway. Nature 2006;440:435-436. [CrossRef][ISI][Medline]
This article has been cited by other articles:
(2006). Avian Flu: Deadly, and Difficult to Diagnose. Journal Watch (General) 2006: 1-1 [Full Text]
The New England Journal of Medicine is owned, published, and copyrighted © 2006 Massachusetts Medical Society. All rights reserved.
-- --
FOCUS ON RESEARCH
Volume 355:2174-2177 November 23, 2006 Number 21
H5N1 Influenza — Continuing Evolution and Spread
Robert G. Webster, Ph.D., and Elena A. Govorkova, M.D., Ph.D.
There is no question that there will be another influenza pandemic someday. We simply don't know when it will occur or whether it will be caused by the H5N1 avian influenza virus. But given the number of cases of H5N1 influenza that have occurred in humans to date (251 as of late September 2006) and the rate of death of more than 50%, it would be prudent to develop robust plans for dealing with such a pandemic.
The epicenters of both the Asian influenza pandemic of 1957 and the Hong Kong influenza pandemic of 1968 were in Southeast Asia, and it is in this region that multiple clades of H5N1 influenza virus have already emerged. The Asian H5N1 virus was first detected in Guangdong Province, China, in 1996, when it killed some geese, but it received little attention until it spread through live-poultry markets in Hong Kong to humans in May 1997, killing 6 of 18 infected persons (see map and time line). The culling of all poultry in Hong Kong ended the first wave of H5N1, but the virus continued to circulate among apparently healthy ducks in the coastal provinces of China.
--
The Spread of H5N1 Influenza Virus and Time Line Showing Its Emergence.
see enlargeable map/graphic at original link above...
The shaded area across southern China is the hypothetical epicenter for the emergence of H5N1 clades and subclades. The H5N1 viruses are being perpetuated in the domestic birds of the region, despite the use of universal vaccination of all domestic poultry. The red dot in the time line denotes the occurrence of the first human case, followed by the number of confirmed human cases in that country. The green and blue solid bars represent documented H5N1 infection in domestic poultry and wild birds, and dashed bars indicate that H5N1 in the avian population is suspected. These limited surveillance data are adapted from the World Health Organization and the U.N. Food and Agriculture Organization (www.fao.org). HA denotes hemagglutinin.
From 1997 to May 2005, H5N1 viruses were largely confined to Southeast Asia, but after they had infected wild birds in Qinghai Lake, China, they rapidly spread westward. The deaths of swans and geese marked H5N1's spread into Europe, India, and Africa. Infections with highly pathogenic H5N1 viruses were confirmed in poultry in Turkey in mid-October 2005, and the first confirmed human cases in Turkey occurred in early January 2006. Thus, H5N1 influenza viruses continue to emerge from the epicenter.
The H5N1 viruses can be divided into clade 1 and clade 2; the latter can be further subdivided into three subclades. The bad news is that these clades and subclades probably differ sufficiently in their antigenic structure to warrant the preparation of different vaccines. Studies in ferrets suggest that vaccine against one clade will not protect against infection with another clade, though it will protect against influenza-associated death.1 Thus, the available information supports the notion that a vaccine against H5N1 is worth stockpiling as a "prepandemic" vaccine, since very few persons have been immunologically exposed to H5 antigens and priming with one clade may be beneficial.
Another key question is whether these clades and subclades vary in sensitivity to available anti-influenza drugs. The majority of H5N1 clade 1 viruses (e.g., A/Vietnam/1203/2004) are resistant to the adamantanes (amantadine and rimantadine), but the majority of clade 2 viruses (e.g., A/Indonesia/5/2005) are sensitive. All H5N1 viruses that have been tested are sensitive to the neuraminidase inhibitors; these drugs may be effective when used prophylactically, but the window for effective treatment will probably be limited to 1 to 2 days after initial infection. Kandun et al. make clear in their report in this issue of the Journal (pages 2186–2194) on three clusters of patients with H5N1 infection in Indonesia that the difficulty with the use of a neuraminidase inhibitor (oseltamivir) in those cases was that treatment began 5 to 7 days after initial infection. Such delayed administration of the drug limits its value in decreasing the viral load and might lead to the selection of resistant strains.
The use of rapid diagnostics for H5N1 virus infection can permit specific antiviral treatments to be initiated early. Oner et al. report in this issue of the Journal (pages 2179–2185) that in a human outbreak of H5N1 in Turkey, it was difficult to detect H5N1 virus infection with standard techniques; the authors found that a real-time polymerase-chain-reaction assay performed on nasopharyngeal specimens had the best diagnostic value.
The continuing evolution of H5N1 viruses and the clusters of human infections in Indonesia and Turkey raise important questions. First, can the source of H5N1 be eliminated? And second, is the increasing number of clusters of human infection an indicator of evolution toward consistent human-to-human transmission?
Controlling H5N1 influenza by eradicating it at the source in domestic poultry has worked for some wealthy countries: in 2003, Japan and South Korea eradicated H5N1 through a strategy of quarantine and culling of poultry and implementation of improved biosecurity measures for poultry facilities. In Thailand, however, the same strategy resulted in only a temporary respite; after nearly a year with no H5N1 activity, new cases in humans in July 2006 heralded the resurgence of H5N1 in domestic poultry.
An alternative strategy adopted by China, Indonesia, and Vietnam has been to vaccinate uninfected poultry in conjunction with the quarantine and culling of infected birds. This approach has failed, however, and its critics explain that poultry vaccines are largely of poor quality, do not provide sterilizing immunity, and promote antigenic drift. Yet vaccines against H5N1 influenza virus have been used successfully since 2004 on all poultry sold in Hong Kong, where no H5N1 virus has been isolated from fowl in live-bird markets despite extensive prospective surveillance.
Perhaps the most important experiment in controlling H5N1 is one that is ongoing in Vietnam. Since the country adopted a strategy of vaccinating all poultry with inactivated, oil-emulsion H5N1 vaccine, there have been no additional cases in humans and no reported H5N1 infections in chickens. But in September 2006, H5N1 was reported to have reemerged in ducks and geese in Vietnam. Thus, H5N1 influenza vaccine seems to protect chickens and, indirectly, humans, but probably not waterfowl.
Given that the vaccine predominantly used in Vietnam is prepared in China, where the policy is to vaccinate all poultry, some have questioned why H5N1 is not under control in China. The problem may be the lack of protection in waterfowl. Ducks may be the stealth carriers (the Trojan horses of H5N1 influenza), for wild mallard ducks do not always show signs of disease when infected with any of a range of highly pathogenic H5N1 viruses.2 Our knowledge about the efficacy of H5N1 influenza vaccines in domestic waterfowl is limited, and highly pathogenic H5N1 viruses continue to be isolated from waterfowl in the epicenter of the epidemic. If the reservoir of highly pathogenic H5N1 virus is domestic waterfowl, the virus should theoretically be eradicable, but eliminating it would require improved vaccines for waterfowl and draconian prospective surveillance and culling.
Meanwhile, the number of infections in humans continues to increase. By mid-August, 97 humans had been infected in 2006 — the same number as in all of 2005. Perhaps the most surprising thing about highly pathogenic H5N1 is that although more than 230 million domestic birds have died or been killed, only 251 humans have become ill from H5N1 infection, and there has been little or no evidence of subclinical infection in humans. The current H5N1 virus is apparently not well "fitted" to replication in humans, although the genetic makeup of a small proportion of humans supports attachment and replication of the virus, if not its transmission. The specific receptor for the current avian influenza virus (2-3 sialic acid) is found deep in the respiratory tract of humans,3 but it seems likely that only a minority of people have receptors for avian influenza viruses in their upper respiratory tracts. Moreover, receptor specificity is only one of the requirements for human infection; the virus must also find compatible enzyme systems in the infected human cells if the viral polymerase complex is to function. Currently, these conditions are apparently met in only a few persons. But the virus is always changing, and mutations that make it more compatible with human transmission may occur at any time.
The seasonality of H5N1 influenza seems similar to that of human influenza: the virus has apparently been more transmissible among chickens, and consequently to humans, during the cooler months. The cases in humans in Turkey, Iraq, and Egypt occurred during the cooler months and coincided with explosive outbreaks of the disease in wild and domestic poultry. In the tropical areas of Asia, there have been two resurgences of H5N1 during the warmer months of the year — a pattern that resembles that followed by human influenza in the tropics, with its multiple peaks of activity. With winter approaching in the northern hemisphere, H5N1 may spread further. Will it cross from Eurasia to the Americas? Will wild migratory birds carry it from their breeding sites in northern Europe and Siberia to commercial poultry in Europe, Africa, and America? If it is endemic in wild migratory birds that are not rapidly killed by it, then spread to domestic backyard poultry is inevitable. The intermittent spread to humans will continue, and the virus will continue to evolve.
Clearly, we must prepare for the possibility of an influenza pandemic. If H5N1 influenza achieves pandemic status in humans — and we have no way to know whether it will — the results could be catastrophic.
--
Drs. Webster and Govorkova report receiving research funding from Hoffmann–La Roche and BioCryst Pharmaceuticals. Dr. Webster reports receiving consulting fees from GlaxoSmithKline; and Dr. Govorkova, consulting fees from BioCryst Pharmaceuticals. No other potential conflict of interest relevant to this article was reported.
Source Information
Dr. Webster is a professor and Dr. Govorkova a senior scientist in the Department of Infectious Diseases, Division of Virology, St. Jude Children's Research Hospital, Memphis, TN.
References
Govorkova EA, Webby RJ, Humberd J, Seiler JP, Webster RG. Immunization with reverse-genetics-produced H5N1 influenza vaccine protects ferrets against homologous and heterologous challenge. J Infect Dis 2006;194:159-167. [CrossRef][ISI][Medline]
Hulse-Post DJ, Sturm-Ramirez KM, Humberd J, et al. Role of domestic ducks in the propagation and biological evolution of highly pathogenic H5N1 influenza viruses in Asia. Proc Natl Acad Sci U S A 2005;102:10682-10687. [Abstract/Full Text]
Shinya K, Ebina M, Yamada S, Ono M, Kasai N, Kawaoka Y. Avian flu: influenza virus receptors in the human airway. Nature 2006;440:435-436. [CrossRef][ISI][Medline]
This article has been cited by other articles:
(2006). Avian Flu: Deadly, and Difficult to Diagnose. Journal Watch (General) 2006: 1-1 [Full Text]
The New England Journal of Medicine is owned, published, and copyrighted © 2006 Massachusetts Medical Society. All rights reserved.
http://www.nrc.gov/reading-rm/doc-collecti...006/06-147.html
-- --
NRC RELEASES PLAN FOR CONTINUED “MISSION-ESSENTIAL” OPERATIONS
DURING AN AVIAN FLU PANDEMIC
The U.S. Nuclear Regulatory Commission has released its 90-page plan outlining how the agency would maintain mission-essential and supporting functions during a possible flu pandemic that may cause staff absenteeism of 40 percent or more. The plan says the NRC would systematically “shed” lower priority work and take certain action ahead of time to better support staff during a pandemic, including enhanced telecommunications and stocking of hygiene supplies.
The pandemic plan complements the agency’s existing Continuity of Operations Plan and reflects considerations provided by the Department of Homeland Security pandemic planning guidelines.
“This is a plan that we hope we never have to implement,” said NRC Commissioner Jeffrey Merrifield, who is taking a lead role in the review of the planning effort. “But it is prudent to plan ahead and anticipate what actions might be needed and what prioritization of activities must be done in order for the NRC to maintain its essential, core mission of protecting public health and safety.”
The federal government planning assumptions for the pandemic include absenteeism as high as 40 percent for periods of weeks in the course of a 12- to 18-month period. The nuclear power industry is creating its own business continuity planning and site-specific options, and is discussing its efforts and potential needs with the NRC.
Among other items, the plan includes a three-stage implementation process of initiation, execution and reconstitution, and designated lines of succession for agency leadership. Identified “pandemic priority functions” include incident response, threat assessment and dissemination, external communications, critical licensing activities, enforcement and administrative support. Some routine licensing, exercises and inspections may be deferred, delayed or cancelled depending on the availability of staff. However, the NRC will not allow operational safety or security to be jeopardized regardless of the pandemic situation. The plan will be updated annually with new planning assumptions.
The public portion of the pandemic plan will be available on the NRC Web site at: http://www.nrc.gov/reading-rm/doc-collecti...attachment2.pdf.
-- --
NRC RELEASES PLAN FOR CONTINUED “MISSION-ESSENTIAL” OPERATIONS
DURING AN AVIAN FLU PANDEMIC
The U.S. Nuclear Regulatory Commission has released its 90-page plan outlining how the agency would maintain mission-essential and supporting functions during a possible flu pandemic that may cause staff absenteeism of 40 percent or more. The plan says the NRC would systematically “shed” lower priority work and take certain action ahead of time to better support staff during a pandemic, including enhanced telecommunications and stocking of hygiene supplies.
The pandemic plan complements the agency’s existing Continuity of Operations Plan and reflects considerations provided by the Department of Homeland Security pandemic planning guidelines.
“This is a plan that we hope we never have to implement,” said NRC Commissioner Jeffrey Merrifield, who is taking a lead role in the review of the planning effort. “But it is prudent to plan ahead and anticipate what actions might be needed and what prioritization of activities must be done in order for the NRC to maintain its essential, core mission of protecting public health and safety.”
The federal government planning assumptions for the pandemic include absenteeism as high as 40 percent for periods of weeks in the course of a 12- to 18-month period. The nuclear power industry is creating its own business continuity planning and site-specific options, and is discussing its efforts and potential needs with the NRC.
Among other items, the plan includes a three-stage implementation process of initiation, execution and reconstitution, and designated lines of succession for agency leadership. Identified “pandemic priority functions” include incident response, threat assessment and dissemination, external communications, critical licensing activities, enforcement and administrative support. Some routine licensing, exercises and inspections may be deferred, delayed or cancelled depending on the availability of staff. However, the NRC will not allow operational safety or security to be jeopardized regardless of the pandemic situation. The plan will be updated annually with new planning assumptions.
The public portion of the pandemic plan will be available on the NRC Web site at: http://www.nrc.gov/reading-rm/doc-collecti...attachment2.pdf.
http://www.computerworld.com/action/articl...rticleId=275619
-- --
IT Caught Off Guard by Flu Pandemic Warning
Call to make quarantine preparations a priority is ‘eye-opener’ for execs
Patrick Thibodeau
December 04, 2006 (Computerworld) -- LAS VEGAS --
Gartner Inc. is recommending that businesses complete planning by the second quarter of next year for a possible avian influenza pandemic and in particular stock up on supplies that would be needed by data center workers who might be quarantined together.
Among the suggestions offered last week by Gartner analyst Ken McGee at the consulting firm’s annual data center conference here: Store 42 gallons of water per data center employee — enough for a six-week quarantine — and don’t forget about food, medical care, cooking facilities, sanitation and electricity.
In a quarantined environment, “you are not going anywhere,” McGee said.
McGee’s presentation caught the attention of John Stingl, chief technology officer at Russell Investment Group. During the session, Stingl said later, he sent a note on his handheld to his administrative assistant asking that a meeting about Russell Investment’s pandemic-specific planning be arranged back at the company’s Tacoma, Wash., office.
Stingl said the investment firm has a good disaster recovery and business continuity plan. But after hearing McGee’s stark warning, Stingl said he wants to know more about the company’s plans for a pandemic. “It was an eye-opener,” Stingl said of the presentation.
Brad Kowal, associate director of Shands HealthCare’s data center, said the Gainesville, Fla.-based medical center has had its hands full dealing with business continuity planning aimed at protecting against hurricanes. “And then you throw this in [and are told to] get it done by the second quarter. It’s literally stun and shock for me,” he said.
A Shared Responsibility
McGee said pandemic planning costs should total no more than 5% of an IT budget, but he stressed that the burden shouldn’t be absorbed by the IT budget alone — it should be shared throughout a company.
Among the things companies should do, McGee said, is decide whether they intend to keep their data centers operating during a pandemic. And then, if they do plan to keep IT operations going, they should consider preparing for up to a 12-week quarantine.
Gartner recommends that companies conduct educational sessions with employees so they know how to prepare their own households for a pandemic. In the office, one person should be made responsible for planning, and business continuity plans will have to be adapted for a pandemic, McGee said. He added that IT should oversee installation of broadband services to the homes of its most critical employees but also assume that there may be failures in public networks.
One person in attendance, who said he works at a Fortune 100 insurance company but requested anonymity, said his company has taken pandemic planning seriously.
“We have almost 30,000 employees, and fully a third of them in the next six months will be able to work remotely,” he said.
In addition to ensuring that their own operations would be able to continue during a pandemic, IT managers should also review the contingency plans of their vendors, McGee said.
He added that vendor contracts should include service guarantees and “extraordinarily harsh terms if that vendor does not come through” in the event of a pandemic.
McGee didn’t tell attendees that a pandemic is in the offing. But pandemics have been regular occurrences in human history. And although it is unknown whether avian influenza will explode into a global pandemic, the number of deaths related to it are creeping up — and more appear possible as the disease spreads. Since 2003, 153 of the 258 people diagnosed with avian flu have died.
“The point is [that] the degree of transmission seems to be increasing from human to human,” McGee said.
Toward the end of McGee’s presentation, an electronic survey asked attendees whether they believe a bird flu pandemic will take place within three years. Fifty-eight percent said yes, 25% said no, and 17% said they weren’t sure.
-- --
IT Caught Off Guard by Flu Pandemic Warning
Call to make quarantine preparations a priority is ‘eye-opener’ for execs
Patrick Thibodeau
December 04, 2006 (Computerworld) -- LAS VEGAS --
Gartner Inc. is recommending that businesses complete planning by the second quarter of next year for a possible avian influenza pandemic and in particular stock up on supplies that would be needed by data center workers who might be quarantined together.
Among the suggestions offered last week by Gartner analyst Ken McGee at the consulting firm’s annual data center conference here: Store 42 gallons of water per data center employee — enough for a six-week quarantine — and don’t forget about food, medical care, cooking facilities, sanitation and electricity.
In a quarantined environment, “you are not going anywhere,” McGee said.
McGee’s presentation caught the attention of John Stingl, chief technology officer at Russell Investment Group. During the session, Stingl said later, he sent a note on his handheld to his administrative assistant asking that a meeting about Russell Investment’s pandemic-specific planning be arranged back at the company’s Tacoma, Wash., office.
Stingl said the investment firm has a good disaster recovery and business continuity plan. But after hearing McGee’s stark warning, Stingl said he wants to know more about the company’s plans for a pandemic. “It was an eye-opener,” Stingl said of the presentation.
Brad Kowal, associate director of Shands HealthCare’s data center, said the Gainesville, Fla.-based medical center has had its hands full dealing with business continuity planning aimed at protecting against hurricanes. “And then you throw this in [and are told to] get it done by the second quarter. It’s literally stun and shock for me,” he said.
A Shared Responsibility
McGee said pandemic planning costs should total no more than 5% of an IT budget, but he stressed that the burden shouldn’t be absorbed by the IT budget alone — it should be shared throughout a company.
Among the things companies should do, McGee said, is decide whether they intend to keep their data centers operating during a pandemic. And then, if they do plan to keep IT operations going, they should consider preparing for up to a 12-week quarantine.
Gartner recommends that companies conduct educational sessions with employees so they know how to prepare their own households for a pandemic. In the office, one person should be made responsible for planning, and business continuity plans will have to be adapted for a pandemic, McGee said. He added that IT should oversee installation of broadband services to the homes of its most critical employees but also assume that there may be failures in public networks.
One person in attendance, who said he works at a Fortune 100 insurance company but requested anonymity, said his company has taken pandemic planning seriously.
“We have almost 30,000 employees, and fully a third of them in the next six months will be able to work remotely,” he said.
In addition to ensuring that their own operations would be able to continue during a pandemic, IT managers should also review the contingency plans of their vendors, McGee said.
He added that vendor contracts should include service guarantees and “extraordinarily harsh terms if that vendor does not come through” in the event of a pandemic.
McGee didn’t tell attendees that a pandemic is in the offing. But pandemics have been regular occurrences in human history. And although it is unknown whether avian influenza will explode into a global pandemic, the number of deaths related to it are creeping up — and more appear possible as the disease spreads. Since 2003, 153 of the 258 people diagnosed with avian flu have died.
“The point is [that] the degree of transmission seems to be increasing from human to human,” McGee said.
Toward the end of McGee’s presentation, an electronic survey asked attendees whether they believe a bird flu pandemic will take place within three years. Fifty-eight percent said yes, 25% said no, and 17% said they weren’t sure.
February 1, 2007
U.S. Issues Guidelines in Case of Flu Pandemic
By DONALD G. McNEIL Jr.
http://www.nytimes.com/2007/02/01/health/0...agewanted=print
ATLANTA, Feb. 1 — Cities should close schools for up to three months in the event of a severe flu outbreak, ball games and movies should be canceled and working hours staggered so subways and buses are less crowded, the federal government advised today in issuing new pandemic flu guidelines to states and cities.
Health officials acknowledged that such measures would hugely disrupt public life, but they argued that these measure would buy the time needed to produce vaccines and would save lives because flu viruses attack in waves lasting about two months.
“We have to be prepared for a Category 5 pandemic,” said Dr. Martin Cetron, director of global migration and quarantine for the Centers for Disease Control and Prevention, in releasing the guidelines. “It’s not easy. The only thing that’s harder is facing the consequences. That will be intolerable.”
In an innovation, the new guidelines are modeled on the five levels of hurricanes, but ranked by lethality instead of wind speed. Category 1, which assumes 90,000 Americans would die, is equivalent to a bad year for seasonal flu, Glen Nowak, a C.D.C. spokesman, said. (About 36,000 Americans die of flu in an average year.) Category 5, which assumes 1.8 million dead, is the equivalent of the 1918 Spanish flu pandemic. (That flu killed about 2 percent of those infected; the H5N1 flu now circulating in Asia has killed more than 50 percent but is not easily transmitted.)
The new guidelines also advocate having sick people and all their families even apparently healthy members stay home for 7 to 10 days.
They advise against closing state borders or airports because crucial deliveries, including food, would stop. They did not offer guidance on wearing masks, but Dr. Cetron said the C.D.C. would issue advice on this soon.
The guidelines are only advisory, since authority for measures like closing schools rests with state and city officials; but many local officials had asked for guidance, Dr. Cetron said.
The federal government has taken primary responsibility for developing and stockpiling vaccines and antiviral drugs, as well as masks and some other supplies.
Today’s guidelines are partly based on a recent study of how 44 cities fared in the 1918 epidemic conducted jointly by the C.D.C. and the University of Michigan’s medical school. Historians and epidemiologists pored over hospital records and newspaper clippings, trying to determine what factors partly spared some cities and doomed others.
While a few tiny towns escaped the epidemic entirely by cutting off all contact with outside, most cities took less drastic measures. These included isolating the sick and quarantining homes and rooming houses, closing schools, churches, bars and other gathering places, canceling parades, ball games, theaters and other public events, staggering factory hours, barring door-to-door sales, discouraging the use of public transport and encouraging the use of face masks.
The most effective measure seemed to be moving early and quickly. For example, said Dr. Howard Markel, a medical historian and one of the study’s leaders, Philadelphia, the worst-hit city, had nearly three times as many sick and dead per capita as St. Louis, which had was hit weeks later by the virus moving inland from the Eastern Seaboard and had time to react as soon as flu cases rose above averages.
“No matter how you set up the model,” Dr. Markel said, “the cities that acted earlier and with more layered protective measures fared better.”
Any pandemic is expected to move faster than a new vaccine can be produced; current experimental vaccines against H5N1 avian flu are in short supply and based on strains isolated in 2004 or 2005. Although the government is creating a $4 billion stockpile of the antiviral drug Tamiflu, it is only useful when taken within the first 48 hours, and Tamiflu-resistant flu strains have already been found in Vietnam and Egypt.
“No one’s arguing that by closing all the schools, you’re going to prevent the spread,” Dr. Markel added. “But if you can cut cases by 10 or 20 or 30 percent and it’s your family that’s spared, that’s a big deal.”
School closures can be very controversial, and picking the right moment is hard, because it must be done before cases soar.
Jeffrey Levi, executive director of the Trust for America’s Health, a health policy organization, noted that in poor city neighborhoods, 30 to 60 percent of all children get breakfasts or lunches crucial to their nutrition at school.
“What are you going to do about that?” he asked.
Dr. Markel said it might be possible to keep the cafeterias open and transport food to points where parents could pick it up, a move that would also keep cafeteria workers and bus drivers employed.
Several public health experts praised the C.D.C. guidelines, although there were some quibbles with aspects of them.
Dr. Michael T. Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy, said he saw no point in fretting over exactly when to close schools, because his experience in meningitis outbreaks convinced him that terrified parents would keep their children at home anyway.
“I don’t think we’ll have to pull that trigger,” he said. “The hard part is going to be unpulling it. How do the principals know when schools should open again?”
Other experts pointed out that children out of school often behave in ways that are nearly as contagious. Youngsters are sent to day care centers, and teenagers gather in malls or at each others’ houses.
“We’ll be facing the same problem, but without the teaching,” said Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University’s Mailman School of Public Health. “They might as well be in class.”
Also, he noted, many employed people cannot afford to stay at home and the financial stress from not working could increase domestic violence. And he said most states and cities lacked the money to carry out the suggested guidelines or to stage drills of them.
Dr. Cetron argued that caring for children in groups of six or fewer cut transmission risks. He also argued that parents would keep many children from gathering.
“My kids aren’t going to be going to the mall,” he said.
The historian John Barry, author of “The Great Influenza,” a history of the 1918 flu, questioned an idea underpinning the study’s conclusions. There is evidence, he said, that some cities with low sickness and death rates in 1918, including St. Louis and Cincinnati, were hit by a milder spring wave of the virus. That would have, in effect, inoculated their citizens against the more severe fall wave and might have been more important than their public health measures.
The guidelines did not suggest using the military to enforce quarantines, as President Bush said he might do when he first mentioned avian flu in 2005.
Dr. Levi said that using the National Guard to set up temporary clinics or move pharmaceutical supplies might make sense.
“But they’re not there,” he said. “The people who know how to run field hospitals are in Iraq.”
Home
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Copyright 2007 The New York Times Company
U.S. Issues Guidelines in Case of Flu Pandemic
By DONALD G. McNEIL Jr.
http://www.nytimes.com/2007/02/01/health/0...agewanted=print
ATLANTA, Feb. 1 — Cities should close schools for up to three months in the event of a severe flu outbreak, ball games and movies should be canceled and working hours staggered so subways and buses are less crowded, the federal government advised today in issuing new pandemic flu guidelines to states and cities.
Health officials acknowledged that such measures would hugely disrupt public life, but they argued that these measure would buy the time needed to produce vaccines and would save lives because flu viruses attack in waves lasting about two months.
“We have to be prepared for a Category 5 pandemic,” said Dr. Martin Cetron, director of global migration and quarantine for the Centers for Disease Control and Prevention, in releasing the guidelines. “It’s not easy. The only thing that’s harder is facing the consequences. That will be intolerable.”
In an innovation, the new guidelines are modeled on the five levels of hurricanes, but ranked by lethality instead of wind speed. Category 1, which assumes 90,000 Americans would die, is equivalent to a bad year for seasonal flu, Glen Nowak, a C.D.C. spokesman, said. (About 36,000 Americans die of flu in an average year.) Category 5, which assumes 1.8 million dead, is the equivalent of the 1918 Spanish flu pandemic. (That flu killed about 2 percent of those infected; the H5N1 flu now circulating in Asia has killed more than 50 percent but is not easily transmitted.)
The new guidelines also advocate having sick people and all their families even apparently healthy members stay home for 7 to 10 days.
They advise against closing state borders or airports because crucial deliveries, including food, would stop. They did not offer guidance on wearing masks, but Dr. Cetron said the C.D.C. would issue advice on this soon.
The guidelines are only advisory, since authority for measures like closing schools rests with state and city officials; but many local officials had asked for guidance, Dr. Cetron said.
The federal government has taken primary responsibility for developing and stockpiling vaccines and antiviral drugs, as well as masks and some other supplies.
Today’s guidelines are partly based on a recent study of how 44 cities fared in the 1918 epidemic conducted jointly by the C.D.C. and the University of Michigan’s medical school. Historians and epidemiologists pored over hospital records and newspaper clippings, trying to determine what factors partly spared some cities and doomed others.
While a few tiny towns escaped the epidemic entirely by cutting off all contact with outside, most cities took less drastic measures. These included isolating the sick and quarantining homes and rooming houses, closing schools, churches, bars and other gathering places, canceling parades, ball games, theaters and other public events, staggering factory hours, barring door-to-door sales, discouraging the use of public transport and encouraging the use of face masks.
The most effective measure seemed to be moving early and quickly. For example, said Dr. Howard Markel, a medical historian and one of the study’s leaders, Philadelphia, the worst-hit city, had nearly three times as many sick and dead per capita as St. Louis, which had was hit weeks later by the virus moving inland from the Eastern Seaboard and had time to react as soon as flu cases rose above averages.
“No matter how you set up the model,” Dr. Markel said, “the cities that acted earlier and with more layered protective measures fared better.”
Any pandemic is expected to move faster than a new vaccine can be produced; current experimental vaccines against H5N1 avian flu are in short supply and based on strains isolated in 2004 or 2005. Although the government is creating a $4 billion stockpile of the antiviral drug Tamiflu, it is only useful when taken within the first 48 hours, and Tamiflu-resistant flu strains have already been found in Vietnam and Egypt.
“No one’s arguing that by closing all the schools, you’re going to prevent the spread,” Dr. Markel added. “But if you can cut cases by 10 or 20 or 30 percent and it’s your family that’s spared, that’s a big deal.”
School closures can be very controversial, and picking the right moment is hard, because it must be done before cases soar.
Jeffrey Levi, executive director of the Trust for America’s Health, a health policy organization, noted that in poor city neighborhoods, 30 to 60 percent of all children get breakfasts or lunches crucial to their nutrition at school.
“What are you going to do about that?” he asked.
Dr. Markel said it might be possible to keep the cafeterias open and transport food to points where parents could pick it up, a move that would also keep cafeteria workers and bus drivers employed.
Several public health experts praised the C.D.C. guidelines, although there were some quibbles with aspects of them.
Dr. Michael T. Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy, said he saw no point in fretting over exactly when to close schools, because his experience in meningitis outbreaks convinced him that terrified parents would keep their children at home anyway.
“I don’t think we’ll have to pull that trigger,” he said. “The hard part is going to be unpulling it. How do the principals know when schools should open again?”
Other experts pointed out that children out of school often behave in ways that are nearly as contagious. Youngsters are sent to day care centers, and teenagers gather in malls or at each others’ houses.
“We’ll be facing the same problem, but without the teaching,” said Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University’s Mailman School of Public Health. “They might as well be in class.”
Also, he noted, many employed people cannot afford to stay at home and the financial stress from not working could increase domestic violence. And he said most states and cities lacked the money to carry out the suggested guidelines or to stage drills of them.
Dr. Cetron argued that caring for children in groups of six or fewer cut transmission risks. He also argued that parents would keep many children from gathering.
“My kids aren’t going to be going to the mall,” he said.
The historian John Barry, author of “The Great Influenza,” a history of the 1918 flu, questioned an idea underpinning the study’s conclusions. There is evidence, he said, that some cities with low sickness and death rates in 1918, including St. Louis and Cincinnati, were hit by a milder spring wave of the virus. That would have, in effect, inoculated their citizens against the more severe fall wave and might have been more important than their public health measures.
The guidelines did not suggest using the military to enforce quarantines, as President Bush said he might do when he first mentioned avian flu in 2005.
Dr. Levi said that using the National Guard to set up temporary clinics or move pharmaceutical supplies might make sense.
“But they’re not there,” he said. “The people who know how to run field hospitals are in Iraq.”
Home
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Copyright 2007 The New York Times Company
http://news.aol.com/topnews/articles/_a/he...201203309990002
-- --
Updated:2007-02-01 21:10:38
Health Officials Practice for the 'Big One'
By MIKE STOBBE
AP
ATLANTA (Feb. 1) - This was the Big One, a deadly flu epidemic. But fortunately it was a fake. So when U.S. health officials made some missteps in their largest-ever drill to prepare for a national outbreak of a deadly new flu, no one died.
Some information was wrong because people misstated facts as they passed them on - like a game of telephone gone slightly awry. Some information was classified, so some key public health experts didn't have all the facts.
And there was an ice storm - for real - that hit the Atlanta area and caused the U.S. Centers for Disease Control to stop the exercise early so employees wouldn't be caught in the weather.
Disaster planning has become a common concept in government, but it's relatively new at the CDC. "We haven't had a tradition in public health" of doing such drills, said Glen Nowak, a CDC spokesman.
The drill involved close to 300 CDC employees and was designed to run over a 24-hour period, from Wednesday to Thursday. Most of the action was at CDC's emergency operations center - the agency's equivalent to NASA's Mission Control in Houston.
An Associated Press reporter and three other journalists were allowed to observe - an unusual step for the CDC, but an effort to better work with the media and improve communication should a real pandemic occur.
The drill was designed and run by MPRI, an Atlanta consulting company led by retired military officers. The CDC is paying the company $7 million for its work on the drill, future exercises and some planning work.
It started with CDC Director Dr. Julie Gerberding and her top infectious disease staff meeting Wednesday morning to confront the hypothetical disaster - we repeat, this is a fake scenario:
A 22-year-old Georgetown University student who visited his family in Indonesia returned to the United States. He became seriously ill the next day and went to a Washington, D.C. hospital. Lab tests confirmed he had the bird flu that's been killing people in Asia.
In reality, this kind of influenza - scientists call it H5N1 - has not been spread efficiently from person to person. But in the drill, CDC officials got information that it spread among the student's family back in Indonesia and might be a contagion threat here.
More bad news...
The student lived in a dormitory, and some of his housemates were reporting flu-like illness.
He was a member of the Georgetown swim team and may have infected several members before they went to New York for a swim meet.
He was on three different flights on his way from Jakarta to Washington, exposing hundreds of other passengers who scattered to at least 16 U.S. cities. One was a 55-year-old man who had since died in Chicago from a respiratory illness that might be bird-flu related.
The student died. Later that day, it became clear that eight people had cases of H5N1, including the Chicago man, and tests on others were pending.
At the time the exercise was cut short, the government was facing some big decisions. One was whether to start shipping from federal stockpiles more than 21 million doses of Tamiflu, and antiviral medication. Should it all go out at once, or just to states that had confirmed cases?
Another was whether to send all flights from Indonesian airports with sick patients only to certain U.S. airports - a measure that could jack up public concern and cause serious economic fallout.
Throughout the day, there were moments of miscommunication. In a late-morning briefing with a consulting company staffer playing the U.S. Secretary of Health and Human Services, Gerberding repeatedly said the student was in Baltimore (not Washington, D.C.). CDC officials at various times said they had passenger manifestos from two of the flights the student had been on, then they seemed to say they had the information on all, then they seemed to backtrack.
Slips were expected in a novel experience like this, but it's important to note that the facts of the case were straight at the crucial points. "We actually had all the correct information at the time decisions were made," said Dr. Stephen Redd, the CDC official who was the flu pandemic expert advising the exercise's incident commander.
A pretend press conference held by Gerberding in the afternoon, in which CDC staffer played reporters, caused the real reporters to mutter among themselves that the outcome probably would have lead to a confusing variety of reports about whether there was a pandemic or not.
"This is really hard. This is a really hard communication," Gerberding said.
More disturbing to CDC employees was how much information Gerberding and some other key officials held back, because not everyone in the room had the necessary security clearance. At one briefing, it became clear that some of the agency's top viral experts were in the dark about some potentially important details.
"What we learned from this is we have to practice," said Dr. Richard Besser, director of the CDC's Coordinating Office for Terrorism Preparedness and Emergency Response.
Copyright 2007 The Associated Press
- - - - - - - - - - - - -
http://news.aol.com/topnews/articles/_a/fe...201161309990001
Updated:2007-02-01 17:50:43
Feds Introduce Flu Severity Scale
By LAURAN NEERGAARD
AP
WASHINGTON (Feb. 1) - The government will grade the severity of the next flu pandemic just like forecasters grade hurricane strength - with a ranking system unveiled Thursday to help states determine when they should take increasingly strong steps to combat flu's spread.
At issue are old-fashioned infection-control measures that may help slow the spread of the next worldwide outbreak of a super-flu until vaccines become available, steps that range from home quarantine to closing schools and postponing sporting events.
But those measures can increase a pandemic's economic fallout, and even have unintended consequences. Closing schools, for example, can keep adults home from work to care for children. And it doesn't help if older kids go sneeze on each other at the mall.
The new guidelines, from the federal Centers for Disease Control and Prevention, don't tell states what infection-control steps to take - and make clear that rushing to implement them could do more harm than good.
Instead, the new "pandemic severity index" suggests when a super-flu's threat becomes great enough to justify gradually escalating those strategies.
The top example: Just as coastal communities don't evacuate for a Category 1 hurricane, schools shouldn't close for a Category 1 flu pandemic. But if the next pandemic appears to be a super-lethal Category 5, the guidelines recommend states close schools for up to three months.
"Not all pandemics are equally severe," Dr. Julie Gerberding, the CDC's director, said Thursday in unveiling the new guidelines.
The CDC deliberately copied the nation's hurricane ranking system to help the general public immediately recognize what to expect once a pandemic strikes, and thus help communities make what Gerberding called "real tough decisions" about when and how to curtail normal activities.
"Everyone knows what a Category 1 hurricane is, everyone knows what a Category 4 or 5 hurricane is and ... the different harm that could come from these kinds of different scenarios," she explained.
It is advice that states, grappling with exactly how drastic their pandemic preparations should be, have been awaiting anxiously, said Dr. Robert Stroube, Virginia's health commissioner and president of the Association of State and Territorial Health Officials.
"You kind of plan for the worst, but the odds are it won't be," Stroube said.
Even adjoining states often have been unable to agree on best policies.
With the guidelines, "we're coming out with consensus so we don't have to reinvent it in every state throughout the country," he added.
Influenza pandemics can strike when the easy-to-mutate flu virus shifts to a strain that people never have experienced. Scientists cannot predict when the next pandemic will arrive, although concern is rising that the Asian bird flu might trigger one if it starts spreading easily from person to person.
Most planning until now has focused on the worst-case scenario of an outbreak as severe as in 1918, when 50 million people worldwide died. But the 20th century's other two pandemics, in 1957 and 1968, were far less severe, claiming 2 million and 1 million lives, respectively.
There's no way to tell how bad the next one will be until it begins. But once the next pandemic strain begins circulating, gene testing and how fast it spreads will let scientists predict its lethality fairly quickly, said Dr. Pascal James Imperato, a former New York City health commissioner who now directs public health at the State University of New York-Downstate Medical Center.
Federal officials are "concerned about pulling the trigger too fast" on drastic infection-control measures, added Jeff Levi of the Trust for America's Health.
That's where the CDC's new hurricane-style ranking system comes in.
If the CDC decides a new flu strain will be the least severe, with the potential of killing no more than 90,000 people, states would be urged to just isolate the sick, mostly at home, minimizing visitors who might catch the virus.
With a more moderate 1957- or 1968-like strain - 90,000 to 450,000 potential deaths - states might consider closing schools, but CDC doesn't recommend it and says any closures should be less than a month.
If more than 900,000 deaths are predicted, a Category 4 or 1918-like Category 5 pandemic, then CDC does recommend closing schools, from one month to three months, depending on each community's level of illness. Other steps are recommended too, including avoiding crowded gatherings and encouraging people to work from home.
States also should consider having everyone in the household of a sick patient voluntarily stay home for seven days, in case they are silently incubating the virus, in all but the least severe pandemics. And if states have enough anti-flu medication, they should consider giving family members doses during quarantine to ward off infection.
But with the rankings come stern warnings. In a recent Harvard study, one in four adults said there was no one to care for them at home if they got sick, another one in four couldn't afford to miss work for even a week, and one in five said their bosses would insist they come to work even if they were sick and contagious.
The guidelines lay out that kind of fallout, and urge communities to figure out ways to minimize it.
"This is the start of that discussion, not the end," cautioned Levi, the public health advocate.
Copyright 2007 The Associated Press.
-- --
Updated:2007-02-01 21:10:38
Health Officials Practice for the 'Big One'
By MIKE STOBBE
AP
ATLANTA (Feb. 1) - This was the Big One, a deadly flu epidemic. But fortunately it was a fake. So when U.S. health officials made some missteps in their largest-ever drill to prepare for a national outbreak of a deadly new flu, no one died.
Some information was wrong because people misstated facts as they passed them on - like a game of telephone gone slightly awry. Some information was classified, so some key public health experts didn't have all the facts.
And there was an ice storm - for real - that hit the Atlanta area and caused the U.S. Centers for Disease Control to stop the exercise early so employees wouldn't be caught in the weather.
Disaster planning has become a common concept in government, but it's relatively new at the CDC. "We haven't had a tradition in public health" of doing such drills, said Glen Nowak, a CDC spokesman.
The drill involved close to 300 CDC employees and was designed to run over a 24-hour period, from Wednesday to Thursday. Most of the action was at CDC's emergency operations center - the agency's equivalent to NASA's Mission Control in Houston.
An Associated Press reporter and three other journalists were allowed to observe - an unusual step for the CDC, but an effort to better work with the media and improve communication should a real pandemic occur.
The drill was designed and run by MPRI, an Atlanta consulting company led by retired military officers. The CDC is paying the company $7 million for its work on the drill, future exercises and some planning work.
It started with CDC Director Dr. Julie Gerberding and her top infectious disease staff meeting Wednesday morning to confront the hypothetical disaster - we repeat, this is a fake scenario:
A 22-year-old Georgetown University student who visited his family in Indonesia returned to the United States. He became seriously ill the next day and went to a Washington, D.C. hospital. Lab tests confirmed he had the bird flu that's been killing people in Asia.
In reality, this kind of influenza - scientists call it H5N1 - has not been spread efficiently from person to person. But in the drill, CDC officials got information that it spread among the student's family back in Indonesia and might be a contagion threat here.
More bad news...
The student lived in a dormitory, and some of his housemates were reporting flu-like illness.
He was a member of the Georgetown swim team and may have infected several members before they went to New York for a swim meet.
He was on three different flights on his way from Jakarta to Washington, exposing hundreds of other passengers who scattered to at least 16 U.S. cities. One was a 55-year-old man who had since died in Chicago from a respiratory illness that might be bird-flu related.
The student died. Later that day, it became clear that eight people had cases of H5N1, including the Chicago man, and tests on others were pending.
At the time the exercise was cut short, the government was facing some big decisions. One was whether to start shipping from federal stockpiles more than 21 million doses of Tamiflu, and antiviral medication. Should it all go out at once, or just to states that had confirmed cases?
Another was whether to send all flights from Indonesian airports with sick patients only to certain U.S. airports - a measure that could jack up public concern and cause serious economic fallout.
Throughout the day, there were moments of miscommunication. In a late-morning briefing with a consulting company staffer playing the U.S. Secretary of Health and Human Services, Gerberding repeatedly said the student was in Baltimore (not Washington, D.C.). CDC officials at various times said they had passenger manifestos from two of the flights the student had been on, then they seemed to say they had the information on all, then they seemed to backtrack.
Slips were expected in a novel experience like this, but it's important to note that the facts of the case were straight at the crucial points. "We actually had all the correct information at the time decisions were made," said Dr. Stephen Redd, the CDC official who was the flu pandemic expert advising the exercise's incident commander.
A pretend press conference held by Gerberding in the afternoon, in which CDC staffer played reporters, caused the real reporters to mutter among themselves that the outcome probably would have lead to a confusing variety of reports about whether there was a pandemic or not.
"This is really hard. This is a really hard communication," Gerberding said.
More disturbing to CDC employees was how much information Gerberding and some other key officials held back, because not everyone in the room had the necessary security clearance. At one briefing, it became clear that some of the agency's top viral experts were in the dark about some potentially important details.
"What we learned from this is we have to practice," said Dr. Richard Besser, director of the CDC's Coordinating Office for Terrorism Preparedness and Emergency Response.
Copyright 2007 The Associated Press
- - - - - - - - - - - - -
http://news.aol.com/topnews/articles/_a/fe...201161309990001
Updated:2007-02-01 17:50:43
Feds Introduce Flu Severity Scale
By LAURAN NEERGAARD
AP
WASHINGTON (Feb. 1) - The government will grade the severity of the next flu pandemic just like forecasters grade hurricane strength - with a ranking system unveiled Thursday to help states determine when they should take increasingly strong steps to combat flu's spread.
At issue are old-fashioned infection-control measures that may help slow the spread of the next worldwide outbreak of a super-flu until vaccines become available, steps that range from home quarantine to closing schools and postponing sporting events.
But those measures can increase a pandemic's economic fallout, and even have unintended consequences. Closing schools, for example, can keep adults home from work to care for children. And it doesn't help if older kids go sneeze on each other at the mall.
The new guidelines, from the federal Centers for Disease Control and Prevention, don't tell states what infection-control steps to take - and make clear that rushing to implement them could do more harm than good.
Instead, the new "pandemic severity index" suggests when a super-flu's threat becomes great enough to justify gradually escalating those strategies.
The top example: Just as coastal communities don't evacuate for a Category 1 hurricane, schools shouldn't close for a Category 1 flu pandemic. But if the next pandemic appears to be a super-lethal Category 5, the guidelines recommend states close schools for up to three months.
"Not all pandemics are equally severe," Dr. Julie Gerberding, the CDC's director, said Thursday in unveiling the new guidelines.
The CDC deliberately copied the nation's hurricane ranking system to help the general public immediately recognize what to expect once a pandemic strikes, and thus help communities make what Gerberding called "real tough decisions" about when and how to curtail normal activities.
"Everyone knows what a Category 1 hurricane is, everyone knows what a Category 4 or 5 hurricane is and ... the different harm that could come from these kinds of different scenarios," she explained.
It is advice that states, grappling with exactly how drastic their pandemic preparations should be, have been awaiting anxiously, said Dr. Robert Stroube, Virginia's health commissioner and president of the Association of State and Territorial Health Officials.
"You kind of plan for the worst, but the odds are it won't be," Stroube said.
Even adjoining states often have been unable to agree on best policies.
With the guidelines, "we're coming out with consensus so we don't have to reinvent it in every state throughout the country," he added.
Influenza pandemics can strike when the easy-to-mutate flu virus shifts to a strain that people never have experienced. Scientists cannot predict when the next pandemic will arrive, although concern is rising that the Asian bird flu might trigger one if it starts spreading easily from person to person.
Most planning until now has focused on the worst-case scenario of an outbreak as severe as in 1918, when 50 million people worldwide died. But the 20th century's other two pandemics, in 1957 and 1968, were far less severe, claiming 2 million and 1 million lives, respectively.
There's no way to tell how bad the next one will be until it begins. But once the next pandemic strain begins circulating, gene testing and how fast it spreads will let scientists predict its lethality fairly quickly, said Dr. Pascal James Imperato, a former New York City health commissioner who now directs public health at the State University of New York-Downstate Medical Center.
Federal officials are "concerned about pulling the trigger too fast" on drastic infection-control measures, added Jeff Levi of the Trust for America's Health.
That's where the CDC's new hurricane-style ranking system comes in.
If the CDC decides a new flu strain will be the least severe, with the potential of killing no more than 90,000 people, states would be urged to just isolate the sick, mostly at home, minimizing visitors who might catch the virus.
With a more moderate 1957- or 1968-like strain - 90,000 to 450,000 potential deaths - states might consider closing schools, but CDC doesn't recommend it and says any closures should be less than a month.
If more than 900,000 deaths are predicted, a Category 4 or 1918-like Category 5 pandemic, then CDC does recommend closing schools, from one month to three months, depending on each community's level of illness. Other steps are recommended too, including avoiding crowded gatherings and encouraging people to work from home.
States also should consider having everyone in the household of a sick patient voluntarily stay home for seven days, in case they are silently incubating the virus, in all but the least severe pandemics. And if states have enough anti-flu medication, they should consider giving family members doses during quarantine to ward off infection.
But with the rankings come stern warnings. In a recent Harvard study, one in four adults said there was no one to care for them at home if they got sick, another one in four couldn't afford to miss work for even a week, and one in five said their bosses would insist they come to work even if they were sick and contagious.
The guidelines lay out that kind of fallout, and urge communities to figure out ways to minimize it.
"This is the start of that discussion, not the end," cautioned Levi, the public health advocate.
Copyright 2007 The Associated Press.
I received this email from my cousin in Colorado who follows a lot of this and thought I would share it with you as a heads up to a possible warning. I can't vouch for the accuracy, but I can say its scary if its true.
1. Emerging Killer Virus Starts Like a Cold, But Kills Many 2. Avian Flu Has
Already Been Weaponized (Rima E. Laibow, MD)
_________________________________
Emerging Killer Virus Starts Like a Cold, But Kills Many
Saturday, July 19, 2008 by: David Gutierrez
http://www.naturalnews.com/023659.html
(NaturalNews) A newly discovered and highly lethal virus strain begins with
symptoms similar to that of a cold but can quickly lead to severe
respiratory crisis.
"This virus has the capability of causing severe respiratory illness in
people of all ages, regardless of their medical condition," said John Su, of
the Centers for Disease Control and Prevention.
The virus was discovered by infectious-disease expert David N.
Gilbert, who noticed that otherwise healthy patients were being stricken by
pneumonia so severe that they would die without oxygen treatment. The
dangerous symptoms developed within only one or two days of initial cough
and fever symptoms.
Since Gilbert's discovery of the virus in Portland, Oregon, outbreaks have
been identified at military bases in Washington, Texas and South Carolina.
The disease is a variety of adenovirus, the family that includes 51
infectious agents responsible for diseases such as colds, pink eye,
bronchitis and the stomach flu. A mutation has apparently occurred in a
virus called adenovirus 14, making it much more lethal. In the first
outbreak examined by Gilbert, seven of 30 hospitalized patients died.
"That's an incredibly high mortality rate," Gilbert said.
One of the patients who survived was 18-year-old Joseph Spencer. After
experiencing severe, flu-like symptoms including chills, fever and vomiting,
Spencer went to the hospital, where he was placed in intensive care and
treated for 18 days.
"We told the family we didn't think he was going to survive," Gilbert said.
Spencer was eventually discharged, but says he still feels weak and short of
breath, and has had problems with his memory.
Tests have determined that more 50 percent of adenovirus infections in
Oregon are now caused by the new strain of adenovirus 14.
"That's shocking," said Paul Lewis, an Oregon health investigator. "It went
from being imperceptible to being the majority."
Health officials caution that while the vast majority of cold-like
infections are harmless, patients whose symptoms continue getting worse
should see a doctor.
_________________________________________________
Dr.Laibow's Blog and Video Report on the Avian Flu Threat:
http://www.healthfreedomusa.org/index.php?p=742
***
Avian Flu Has Already Been Weaponized
www.HealthFreedomUSA.org
I'll give you the bottom line first: based on Gen. Stubblebine's careful
analysis of the existing evidence, Avian Flu has already been turned into a
pandemic virus with a lot of sophisticated help from people who are not your
friends, but who are very good at weaponizing organisms, like the previously
innocuous bird flu virus, H5N1.
There is a basic virological fact you need to know to make sense of what
comes next: it is impossible to make a vaccine against a virus that does not
yet exist. Public relations efforts to the contrary, IF a vaccine is being
made against the Avian Flu virus in its pandemic form, that means that the
pandemic virus already exists. Period. End of discussion. So that fact
that the Avian Flu vaccine is already being manufactured in China by
Sanofi-Pasteur, a wholly-owned subsidiary of the French arm of the
Rockefeller oil cartel (Total
Petroleum) is confirmation of what you are about to read. If you
allow it to be introduced into your body, there is no reason to imagine it
will be anything but an unmitigated disaster for your immune system and for
you. We believe it's planned to be that way.
I do not know A. True Ott, PhD, but he was kind enough to send me a PDF file
recently in which he puts a lot of the pieces together that I have been
finding in my own research. Some of his conclusions I have serious
difficulty with, but parts of his chronology are used here with
appreciation.
Let's start with the basics: H5N1 is a benign, commonplace virus which most
birds carry with no harm to themselves or humans. Humans also have viruses
we have no problem with: these viral companions keep our immune systems
healthy and humming. Only under the stimulus of novel and dangerous toxins
which your body has no way to get rid of (detoxify), and stress which
overwhelms your coping capacity, does an innocuous virus mutate and become
something that can make you sick or kill you.
All human cases of H5N1 have occurred in areas of sick birds in large
concentrations such as factory farms where handlers come into contact with
stressed and sick birds in toxic surroundings where toxic residues are
concentrated at high levels.
For example, in Vietnam, where thousands of gallons of Monsanto chemicals
such as Agent Orange were dumped in huge amounts following the Vietnam war
outbreaks of Avian Flu are not uncommon. These outbreaks occurred in highly
toxic environments, where crowded, sick factory farm chickens have been
inoculated [supposedly] against Avian Flu.
It will also become deadly, of course, when labs are employed to alter it so
that it becomes an efficient weapon of mass destruction. The US has had a
program to accomplish exactly that for over a century now, astounding as
that may seem!
Our best intelligence estimate is that pandemic Avian Flu already exists.
It appears to have been turned into a massive viral threat through
bioengineering by the United States, fusing the deadly genome of the 1918
Pandemic, mis-named the "Spanish Flu", with the DNA of the
H5N1 virus in a growth medium of human kidney cells to make sure that the
virus recognizes human cells and knows how to invade them.
Please re-read that paragraph again and consider the threat that poses to
you and your family.
The Spanish Pandemic Rides Again
The genome of the 1918 pandemic so-called "Spanish Flu" was recently
intentionally resurrected. Because of that ressurection, the Avian Flu, and
its vaccine, are now a US government-instigated threat to life - your life.
The Spanish Flu, which was not Spanish at all, was created in the US through
an early bioweapons program and injected into healthy young men (i.e.,
'soliders') as the first mandatory vaccination in the military during WWI
(also known as the "War to End Wars" and the "Great War"). The "Spanish
Flu", which originated in Kansas on US Military bases, killed a minimum of
50 million Americans. It was one of the deadliest pandemics in modern
history. It was also one of the most successful biological weapons ever
created.
Time Line To Disaster
This may be one of the most important chronologies you will ever read:
April 6, 1917:
* US declares war on Austria-Hungary, Bulgaria, Germany, and the Ottoman
Empire.
* America swings into full production of War material.
* American men are drafted into military service and deployed for training
in Spain
* ALL NEW RECRUITS ARE GIVEN MANDATORY VACCINATIONS --- One of which is a
"broad-spectrum" live virus influenza vaccination
* Rockefeller makes millions in vaccine sales while consolidating Standard
Oil contracts worldwide
* The first British soldiers committed to World War I are deployed to Iraq
to protect American oil interests there
* Following mass vaccine injections, U.S. soldiers are crowded into troop
ships and sent to "train" in Spain. Seasick, stressed soldiers aged 18-34
exhibit influenza symptoms on the voyage
* Immediately after arriving in Spain, U.S. soldiers are "trained", that is,
exposed to, the various forms of gas they will experience in the trenches in
France
* Exposure to these highly toxic gasses causes the live-virus influenza
organisms to mutate into an extremely lethal, and highly communicable, form
of virus
* Millions of young, healthy men and women aged 18-34 die worldwide as a
result of vaccinations combined with novel and highly toxic chemicals
November 11, 1918
*
Armastice with Germany and its Allies
*
*
Following the end of "The Great War" - The heads of the various
multi-national banks met in conference at San Remo in 1924 to assess war
reparations for Germany.
* John D. Rockefeller and the Rothschilds have consolidated and vastly
increased their wealth through actively funding both sides of the war
March 28, 1924
* Rockefeller formes a French oil conglomerate calling it "Total", the
"French Company of Petroleums" aka CFP
* TOTAL is awarded a controlling interest via Deutsche Bank's stock in the
Turkish Petroleum Company in Baghdad which was eventually renamed the Iraq
Petroleum Company
* The Iraq Petroleum Company was confiscated and nationalized by Saddam
Hussein in 1990.
* TOTAL Inc. is a true multi-national mega-corporation which operates in
more than 130 countries and has over 110,000 employees.
Now the Avian Flu - Oil - China - US - WMD connection starts to get
interesting.
Here's the Play: Oil to Drugs to Death
Two of TOTAL's prime, wholly-owned subsidiaries are the pharmaceutical
giants Sanofi-Aventis, and Sanofi-Pasteur. Both are world-leaders in the
development and testing of experimental vaccines, which are manufactured
primarily in China. On March 23, 2005, NIH, through the National Institute
of Allergy and Infectious Disease, announces the initiation of a program to
develop a vaccine for Avian Flu, asserting that although there have only
been less than a handfull of cases, Avian Flu poses a vast public health
menace.
http://www3.niaid.nih.gov/news/newsrelease...avianfluvax.htm
And it is clearly true that a weaponized virus does present a massive threat
to public health. That's the whole point of weaponizing it, isn't it? For a
look at Sanofi-Pasteur's plans for its profit (and perhaps your death). You
can confirm their plans here:
www.sanofi-aventis.com/Images/060706_IR_en_tcm23-13319.pdf
But please come back when you finish reading. The information below is
critically important to you.
As a side note, the Chinese factories of these two pharmacetuical mammoths
are (unlike Sanofi-Pasteur's Swiftwater, PA, factory, according to
dissidents such as Harry Wu, et. al.) staffed in part or entirely by
poltical and other prisoners working under brutal slave labor conditions.
China has a long history of Western Pharmaceutical manufacture, according to
Wikipedia.
Bear in mind that most influenza strains and their hosts adapt to each other
after roughtly two years, so that the same strain of flu no longer causes
symptoms. Of course, once a strain has been weaponized, there is little
reason to think that it will revert as natural strains do. It, or the
vaccine it seems to legitimize, will go on killing and killing and killing.
Or is the word "culling"?
To date, there have only been around 385 human cases identified worldwide
(if those identifications are trustworthy, of course), with only 243 deaths.
To put the absurdity of this effort into perspective, Sudden Cardiac Death
(SCD), which researchers believe is heavily associated with aspartame
consumption, is a leading cause of death which, according to the CDC, for
example, killed 460,000 Americans in
1999 and the numbers keep rising
(http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5106a3.htm). but Aspartame is
not under the gun. Instead, Avian Flu is.
To quote Dr. Ott, "There are 6.7 Billion humans on planet earth. This
equates to a statistical infection rate of .000000004215 percent. In other
words, statistically speaking, you are over 100,000 times more likely to be
hit by lightning in your home than to contract the "Bird Flu."
Given the shockingly obvious lack of a real threat from an unweaponized H5N1
virus, how can we explain the Bush Administration spending billions of
dollars preparing each of the 50 States for what it drums into us is the
"inevitable Bird Flu pandemic" anticipated to kill half or more of all
Americans and similar numbers of people around the globe?
Back to the Time Line
March 1997:
* Zero confirmed "H5N1" human cases exist anywhere in the word
* The U.S. Armed Forces Institute of Pathology, Ft. Detrick, Rockville,
Maryland, the US research center for biological weaponry, commissions Dr.
Jeffery Taubenberger to lead a research team to ISOLATE the 1918 Flu Virus'
genetic code, the most lethal pathogen in history
Aug. 24, 1997:
* Brevig, Alaska. Research Team member Johan Hultin sends well-preserved
1918 flu virus specimens (from a frozen body killed by the 1918 flu) to Dr.
Taubenberger's lab in Maryland.
* Days later, Taubenberger detects the genetic fragments for which he has
been searching.
* The 1918 virus' RNA-based gene fragments are analyzed by computer
sequencing in order to reveal its complete genetic code. Even with a
super-computer, this code sequencing will take years to complete.
October, 2003:
* Taubenberger's team finally deciphers the deadly 1918 flu virus'
entire genetic code - completing a 6 year project.
* Taubenberger's colleague, R.G. Webster, publishes article in American
Scientist Magazine declaring: "The world is teetering on the edge of a flu
pandemic that could kill a large fraction of the human population".
October, 2004
* Dmtry Lvov, head of the Russian Virology Institute declares that up to one
billion people around the world could die during the next pandemic.
June, 2005:
* At Mount Sinai School of Medicine in New York (alleged to be Rockefeller
controlled), Taubenberger,Peter Palese and Adolfo Garcia-Sastro create
plasmids, or DNA rings, from the 1918 killer virus, permanently
"stabilizing" its genetic material for use as a biological weapon
* This is the final step in revitalizing the deadly pathogen but the press
is told tit will only to be used as a "vaccination tool" - even though the
disease is currently non-existent.
August, 2005:
* Taugenberger's team inserts plasmids into human kidney cells which then
transfers human DNA into the virus making it "human specific"
* The 1918 virus, responsible for the death of millions around the world is
now ready for use by humans
Sept. 9, 2005:
* The UN in New York City issues a world-wide press release introducing
David Nabarro as the "UN System Senior Coordinator for Avian, Human
Influenza".
Sept. 29, 2005:
* Nabarro issues an "Official U.N. Warning" that "an outbreak of 'avian
influenza' would kill between 5 million and 150 million people on each
continent."
Oct. 2005:
* Pres. Bush's newly appointed secretary of Health and Human Services (HHS,
the parent organization of both the CDC and the FDA), former Utah Governor
Mike O. Leavitt, intensifies multibillion Pandemic Bird Flu preparations
Dec. 2005:
* Bush solicits Congress for $7.1 Billion to fund "preparations" ---
$3.3 billion is immediately allocated to Leavitt's HHS
January 24, 2006
* Department of Homeland Security awards KBR, a Halliburton subsidiary, a
$385 million contract for US detention centers
Jan. 2006:
* Leavitt launches website - www.pandemicflu.gov - on which he says:
"Let me be clear. It is only a matter of time before we discover H5N1 in
America. The migration patterns of the wild fowl that carry the virus makes
it appearance here almost inevitable!"
* China hosts the "International Pledging Conference on Avian and Human
Influenza" in Beijing and is promised massive sums of money from the west
--- Leavitt alone commits $334 million in funds to aid China's research into
"vaccine development".
* Leavitt has a long history of fostering Chinese trade activities as Utah's
Governor
March 2006:
* Breaking new ground, Leavitt's HHS allocates funds to a private television
network to produce a "made-for-TV" movie about the "bird flu"
* Leavitt jokes that he wants "the handsomest actor" to play his character
* Leavitt declares on HHS website (exactly as John D. Rockefeller declared
in 1916): "The best defense against influenza is VACCINATION."
* Leavitt further declares: "The current U.S. capacity for manufacturing
egg-based vaccines is not sufficient to supply our entire population. HHS is
supporting research into [human kidney] cell-based vaccine manufacture of
producing vaccine domestically
April, 2006:
* HHS announces a $97 million contract for the development of cell-based flu
vaccine.
* Leavitt declares: "The FDA can use its Emergency Use Authorization
authority to permit the use of unapproved products if there's a reasonable
belief the products may be effective."
* 32 states pass laws which make resisting inocculation once ordered by the
governor a felony.
* These laws join Patriot Act I, II, BARDA, BIOSHIELD I, II in making drug
treatment and innoculation mandatory once a Pandemic is called.
* Unlimited quarantine without review is mandated under these laws for those
who resist innoculation under Pandemic conditions.
* Fully staffed, empty detention centers exist all over North America.
The largest, in Alasks, is roumored to have a 2.5 million person capacity.
December, 2006
* New York Times reports Gulf War Syndrome positively linked to vaccination
of Veterans.
* More than 100,000 vets contracted the syndrome during the 1991 Desert
Storm Operation.
* More than 20,000 vets have died to date from this syndrom believed to be
triggered by squalene, a vaccine "adjuvant."
* All modern vaccines contain squalene
April 17, 2007:
* The Food and Drug Adminstration (FDA) branch of HHS utilizes its Emergency
Use Authorization authority and awards a license to produce
H5N1 "Bird Flu" vaccines to Sanofi-Pasteur.
* FDA Bird Flu approval letter states:
"We have approved your Biologics License Application (BLA) for Influenza
Virus Vaccine, H5N1, effective this date. You are hereby authorized to
introduce or deliver for introduction into interstate commerce, Influenza
Virus Vaccine, H5N1, under your existing Department of Health and Human
Services U.S. License No. 1725; however, we acknowledge your statement
provided in your submission of April 5, 2007, that Sanofi Pasteur Inc. does
not intend to license this product for commercial distribution, since it was
produced under contract to the U.S. Department of Health and Human Services
as part of national pandemic preparedness initiatives. Influenza Virus
Vaccine, H5N1, is indicated for active immunization of persons 18 through 64
years of age at increased risk of exposure to the H5N1 influenza virus
subtype contained in the vaccine."
* Among the required post-market studies on this untested vaccine are;
Protocol submission: Study DMID 04-077: "A randomized, double-blinded, phase
I/II, study of the safety, reactogenicity, and immunogenicity of
intramuscular inactivated influenza A/H5N1 vaccine in healthy children aged
2 years through 9 years."
Final study report submission: September 30, 2008.Study DMID 04-076:
"A randomized double-blinded, placebo-controlled, phase I/II, dose-ranging
study of the safety, reactogenicity, and immunogenicity of intramuscular
inactivated influenza A/H5N1 vaccine in healthy elderly adults."
Study DMID 05-0043: "Revaccination of healthy subjects with intramuscular
inactivated subunit influenza A/Vietnam/1203/2004 (H5N1) vaccine
representing a drifted variant.
"Study DMID 05-0090: "Evaluation of a booster dose of
A/Vietnam/1203/04 (H5N1) vaccine administered at 6 months to healthy adult
subjects after a two dose schedule at 0 and 1 month."
Study DMID 05-0129: "Open label evaluation of H5N1 vaccine at vaccine
manufacturing facilities."
Study DMID 05-0130: "A single center, open label, phase I/II study of the
safety and immunogenicity of two 90 µg doses of intramuscular inactivated
influenza A/H5N1 vaccine in healthy adult subjects."
Nov. 26, 2007:
* Leavitt's HHS orders 100 million H5N1 "vaccines [doses]" from
Sanofi-Pasteur. Expected delivery date, August, 2008.
* Sanofi-Pasteur issues a press release announcing their lucrative HHS
contract (100 million vaccines @ $15 USD each) and declares that the
cell-based vaccine will be mass produced in the company's CHINA facility -
then shipped to Stillwater, PA for hypodermic syringe-friendly packaging.
* Approval and contract have all been consumated in the absence of offical
human testing.
Jan. 2008:
* Covert 'human trials' of Sanofi-Pasteur H5N1 vaccine is conducted on 350
homeless vagrants in Poland.
* According to London Telegraph
(http://www.telegraph.co.uk/news/worldnews/...676/Homeless-pe
ople-die-after-bird-flu-vaccine-trial-in-Poland.html)
and Examininer articles, this results in 21 "instant" deaths and over 200
severely incapacitated or hospitalized." Development and sales of
H5N1 vaccine continues.
February 14, 2008
* U.S. Air Force Gen. Gene Renuart, commander of North American Aerospace
Defense Command and U.S. Northern Command, and Canadian Air Force Lt.-Gen.
Marc Dumais, commander of Canada Command, sign a Civil Assistance Plan that
allows the military from one nation to support the armed forces of the other
nation during a civil emergency.
* "Our commands were created by our respective governments to respond to the
defense and security challenges of the twenty-first century, and we both
realize that these and other challenges are best met through cooperation
between friends....
The plan facilitates the military-to-military support of civil authorities
once government authorities have agreed on an appropriate response."
*
Avian Flu response is a part of NorthCom's mission, and according to Gen.
Stubblebine's analysis, appears to be the primary element in its
mission: http://www.northcom.mil/Avian%20Flu/index.html
June 17, 2008
.AOLWebSuite .AOLPicturesFullSizeLink { height: 1px; width: 1px; overflow: hidden; } .AOLWebSuite a {color:blue; text-decoration: underline; cursor: pointer}
1. Emerging Killer Virus Starts Like a Cold, But Kills Many 2. Avian Flu Has
Already Been Weaponized (Rima E. Laibow, MD)
_________________________________
Emerging Killer Virus Starts Like a Cold, But Kills Many
Saturday, July 19, 2008 by: David Gutierrez
http://www.naturalnews.com/023659.html
(NaturalNews) A newly discovered and highly lethal virus strain begins with
symptoms similar to that of a cold but can quickly lead to severe
respiratory crisis.
"This virus has the capability of causing severe respiratory illness in
people of all ages, regardless of their medical condition," said John Su, of
the Centers for Disease Control and Prevention.
The virus was discovered by infectious-disease expert David N.
Gilbert, who noticed that otherwise healthy patients were being stricken by
pneumonia so severe that they would die without oxygen treatment. The
dangerous symptoms developed within only one or two days of initial cough
and fever symptoms.
Since Gilbert's discovery of the virus in Portland, Oregon, outbreaks have
been identified at military bases in Washington, Texas and South Carolina.
The disease is a variety of adenovirus, the family that includes 51
infectious agents responsible for diseases such as colds, pink eye,
bronchitis and the stomach flu. A mutation has apparently occurred in a
virus called adenovirus 14, making it much more lethal. In the first
outbreak examined by Gilbert, seven of 30 hospitalized patients died.
"That's an incredibly high mortality rate," Gilbert said.
One of the patients who survived was 18-year-old Joseph Spencer. After
experiencing severe, flu-like symptoms including chills, fever and vomiting,
Spencer went to the hospital, where he was placed in intensive care and
treated for 18 days.
"We told the family we didn't think he was going to survive," Gilbert said.
Spencer was eventually discharged, but says he still feels weak and short of
breath, and has had problems with his memory.
Tests have determined that more 50 percent of adenovirus infections in
Oregon are now caused by the new strain of adenovirus 14.
"That's shocking," said Paul Lewis, an Oregon health investigator. "It went
from being imperceptible to being the majority."
Health officials caution that while the vast majority of cold-like
infections are harmless, patients whose symptoms continue getting worse
should see a doctor.
_________________________________________________
Dr.Laibow's Blog and Video Report on the Avian Flu Threat:
http://www.healthfreedomusa.org/index.php?p=742
***
Avian Flu Has Already Been Weaponized
www.HealthFreedomUSA.org
I'll give you the bottom line first: based on Gen. Stubblebine's careful
analysis of the existing evidence, Avian Flu has already been turned into a
pandemic virus with a lot of sophisticated help from people who are not your
friends, but who are very good at weaponizing organisms, like the previously
innocuous bird flu virus, H5N1.
There is a basic virological fact you need to know to make sense of what
comes next: it is impossible to make a vaccine against a virus that does not
yet exist. Public relations efforts to the contrary, IF a vaccine is being
made against the Avian Flu virus in its pandemic form, that means that the
pandemic virus already exists. Period. End of discussion. So that fact
that the Avian Flu vaccine is already being manufactured in China by
Sanofi-Pasteur, a wholly-owned subsidiary of the French arm of the
Rockefeller oil cartel (Total
Petroleum) is confirmation of what you are about to read. If you
allow it to be introduced into your body, there is no reason to imagine it
will be anything but an unmitigated disaster for your immune system and for
you. We believe it's planned to be that way.
I do not know A. True Ott, PhD, but he was kind enough to send me a PDF file
recently in which he puts a lot of the pieces together that I have been
finding in my own research. Some of his conclusions I have serious
difficulty with, but parts of his chronology are used here with
appreciation.
Let's start with the basics: H5N1 is a benign, commonplace virus which most
birds carry with no harm to themselves or humans. Humans also have viruses
we have no problem with: these viral companions keep our immune systems
healthy and humming. Only under the stimulus of novel and dangerous toxins
which your body has no way to get rid of (detoxify), and stress which
overwhelms your coping capacity, does an innocuous virus mutate and become
something that can make you sick or kill you.
All human cases of H5N1 have occurred in areas of sick birds in large
concentrations such as factory farms where handlers come into contact with
stressed and sick birds in toxic surroundings where toxic residues are
concentrated at high levels.
For example, in Vietnam, where thousands of gallons of Monsanto chemicals
such as Agent Orange were dumped in huge amounts following the Vietnam war
outbreaks of Avian Flu are not uncommon. These outbreaks occurred in highly
toxic environments, where crowded, sick factory farm chickens have been
inoculated [supposedly] against Avian Flu.
It will also become deadly, of course, when labs are employed to alter it so
that it becomes an efficient weapon of mass destruction. The US has had a
program to accomplish exactly that for over a century now, astounding as
that may seem!
Our best intelligence estimate is that pandemic Avian Flu already exists.
It appears to have been turned into a massive viral threat through
bioengineering by the United States, fusing the deadly genome of the 1918
Pandemic, mis-named the "Spanish Flu", with the DNA of the
H5N1 virus in a growth medium of human kidney cells to make sure that the
virus recognizes human cells and knows how to invade them.
Please re-read that paragraph again and consider the threat that poses to
you and your family.
The Spanish Pandemic Rides Again
The genome of the 1918 pandemic so-called "Spanish Flu" was recently
intentionally resurrected. Because of that ressurection, the Avian Flu, and
its vaccine, are now a US government-instigated threat to life - your life.
The Spanish Flu, which was not Spanish at all, was created in the US through
an early bioweapons program and injected into healthy young men (i.e.,
'soliders') as the first mandatory vaccination in the military during WWI
(also known as the "War to End Wars" and the "Great War"). The "Spanish
Flu", which originated in Kansas on US Military bases, killed a minimum of
50 million Americans. It was one of the deadliest pandemics in modern
history. It was also one of the most successful biological weapons ever
created.
Time Line To Disaster
This may be one of the most important chronologies you will ever read:
April 6, 1917:
* US declares war on Austria-Hungary, Bulgaria, Germany, and the Ottoman
Empire.
* America swings into full production of War material.
* American men are drafted into military service and deployed for training
in Spain
* ALL NEW RECRUITS ARE GIVEN MANDATORY VACCINATIONS --- One of which is a
"broad-spectrum" live virus influenza vaccination
* Rockefeller makes millions in vaccine sales while consolidating Standard
Oil contracts worldwide
* The first British soldiers committed to World War I are deployed to Iraq
to protect American oil interests there
* Following mass vaccine injections, U.S. soldiers are crowded into troop
ships and sent to "train" in Spain. Seasick, stressed soldiers aged 18-34
exhibit influenza symptoms on the voyage
* Immediately after arriving in Spain, U.S. soldiers are "trained", that is,
exposed to, the various forms of gas they will experience in the trenches in
France
* Exposure to these highly toxic gasses causes the live-virus influenza
organisms to mutate into an extremely lethal, and highly communicable, form
of virus
* Millions of young, healthy men and women aged 18-34 die worldwide as a
result of vaccinations combined with novel and highly toxic chemicals
November 11, 1918
*
Armastice with Germany and its Allies
*
*
Following the end of "The Great War" - The heads of the various
multi-national banks met in conference at San Remo in 1924 to assess war
reparations for Germany.
* John D. Rockefeller and the Rothschilds have consolidated and vastly
increased their wealth through actively funding both sides of the war
March 28, 1924
* Rockefeller formes a French oil conglomerate calling it "Total", the
"French Company of Petroleums" aka CFP
* TOTAL is awarded a controlling interest via Deutsche Bank's stock in the
Turkish Petroleum Company in Baghdad which was eventually renamed the Iraq
Petroleum Company
* The Iraq Petroleum Company was confiscated and nationalized by Saddam
Hussein in 1990.
* TOTAL Inc. is a true multi-national mega-corporation which operates in
more than 130 countries and has over 110,000 employees.
Now the Avian Flu - Oil - China - US - WMD connection starts to get
interesting.
Here's the Play: Oil to Drugs to Death
Two of TOTAL's prime, wholly-owned subsidiaries are the pharmaceutical
giants Sanofi-Aventis, and Sanofi-Pasteur. Both are world-leaders in the
development and testing of experimental vaccines, which are manufactured
primarily in China. On March 23, 2005, NIH, through the National Institute
of Allergy and Infectious Disease, announces the initiation of a program to
develop a vaccine for Avian Flu, asserting that although there have only
been less than a handfull of cases, Avian Flu poses a vast public health
menace.
http://www3.niaid.nih.gov/news/newsrelease...avianfluvax.htm
And it is clearly true that a weaponized virus does present a massive threat
to public health. That's the whole point of weaponizing it, isn't it? For a
look at Sanofi-Pasteur's plans for its profit (and perhaps your death). You
can confirm their plans here:
www.sanofi-aventis.com/Images/060706_IR_en_tcm23-13319.pdf
But please come back when you finish reading. The information below is
critically important to you.
As a side note, the Chinese factories of these two pharmacetuical mammoths
are (unlike Sanofi-Pasteur's Swiftwater, PA, factory, according to
dissidents such as Harry Wu, et. al.) staffed in part or entirely by
poltical and other prisoners working under brutal slave labor conditions.
China has a long history of Western Pharmaceutical manufacture, according to
Wikipedia.
Bear in mind that most influenza strains and their hosts adapt to each other
after roughtly two years, so that the same strain of flu no longer causes
symptoms. Of course, once a strain has been weaponized, there is little
reason to think that it will revert as natural strains do. It, or the
vaccine it seems to legitimize, will go on killing and killing and killing.
Or is the word "culling"?
To date, there have only been around 385 human cases identified worldwide
(if those identifications are trustworthy, of course), with only 243 deaths.
To put the absurdity of this effort into perspective, Sudden Cardiac Death
(SCD), which researchers believe is heavily associated with aspartame
consumption, is a leading cause of death which, according to the CDC, for
example, killed 460,000 Americans in
1999 and the numbers keep rising
(http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5106a3.htm). but Aspartame is
not under the gun. Instead, Avian Flu is.
To quote Dr. Ott, "There are 6.7 Billion humans on planet earth. This
equates to a statistical infection rate of .000000004215 percent. In other
words, statistically speaking, you are over 100,000 times more likely to be
hit by lightning in your home than to contract the "Bird Flu."
Given the shockingly obvious lack of a real threat from an unweaponized H5N1
virus, how can we explain the Bush Administration spending billions of
dollars preparing each of the 50 States for what it drums into us is the
"inevitable Bird Flu pandemic" anticipated to kill half or more of all
Americans and similar numbers of people around the globe?
Back to the Time Line
March 1997:
* Zero confirmed "H5N1" human cases exist anywhere in the word
* The U.S. Armed Forces Institute of Pathology, Ft. Detrick, Rockville,
Maryland, the US research center for biological weaponry, commissions Dr.
Jeffery Taubenberger to lead a research team to ISOLATE the 1918 Flu Virus'
genetic code, the most lethal pathogen in history
Aug. 24, 1997:
* Brevig, Alaska. Research Team member Johan Hultin sends well-preserved
1918 flu virus specimens (from a frozen body killed by the 1918 flu) to Dr.
Taubenberger's lab in Maryland.
* Days later, Taubenberger detects the genetic fragments for which he has
been searching.
* The 1918 virus' RNA-based gene fragments are analyzed by computer
sequencing in order to reveal its complete genetic code. Even with a
super-computer, this code sequencing will take years to complete.
October, 2003:
* Taubenberger's team finally deciphers the deadly 1918 flu virus'
entire genetic code - completing a 6 year project.
* Taubenberger's colleague, R.G. Webster, publishes article in American
Scientist Magazine declaring: "The world is teetering on the edge of a flu
pandemic that could kill a large fraction of the human population".
October, 2004
* Dmtry Lvov, head of the Russian Virology Institute declares that up to one
billion people around the world could die during the next pandemic.
June, 2005:
* At Mount Sinai School of Medicine in New York (alleged to be Rockefeller
controlled), Taubenberger,Peter Palese and Adolfo Garcia-Sastro create
plasmids, or DNA rings, from the 1918 killer virus, permanently
"stabilizing" its genetic material for use as a biological weapon
* This is the final step in revitalizing the deadly pathogen but the press
is told tit will only to be used as a "vaccination tool" - even though the
disease is currently non-existent.
August, 2005:
* Taugenberger's team inserts plasmids into human kidney cells which then
transfers human DNA into the virus making it "human specific"
* The 1918 virus, responsible for the death of millions around the world is
now ready for use by humans
Sept. 9, 2005:
* The UN in New York City issues a world-wide press release introducing
David Nabarro as the "UN System Senior Coordinator for Avian, Human
Influenza".
Sept. 29, 2005:
* Nabarro issues an "Official U.N. Warning" that "an outbreak of 'avian
influenza' would kill between 5 million and 150 million people on each
continent."
Oct. 2005:
* Pres. Bush's newly appointed secretary of Health and Human Services (HHS,
the parent organization of both the CDC and the FDA), former Utah Governor
Mike O. Leavitt, intensifies multibillion Pandemic Bird Flu preparations
Dec. 2005:
* Bush solicits Congress for $7.1 Billion to fund "preparations" ---
$3.3 billion is immediately allocated to Leavitt's HHS
January 24, 2006
* Department of Homeland Security awards KBR, a Halliburton subsidiary, a
$385 million contract for US detention centers
Jan. 2006:
* Leavitt launches website - www.pandemicflu.gov - on which he says:
"Let me be clear. It is only a matter of time before we discover H5N1 in
America. The migration patterns of the wild fowl that carry the virus makes
it appearance here almost inevitable!"
* China hosts the "International Pledging Conference on Avian and Human
Influenza" in Beijing and is promised massive sums of money from the west
--- Leavitt alone commits $334 million in funds to aid China's research into
"vaccine development".
* Leavitt has a long history of fostering Chinese trade activities as Utah's
Governor
March 2006:
* Breaking new ground, Leavitt's HHS allocates funds to a private television
network to produce a "made-for-TV" movie about the "bird flu"
* Leavitt jokes that he wants "the handsomest actor" to play his character
* Leavitt declares on HHS website (exactly as John D. Rockefeller declared
in 1916): "The best defense against influenza is VACCINATION."
* Leavitt further declares: "The current U.S. capacity for manufacturing
egg-based vaccines is not sufficient to supply our entire population. HHS is
supporting research into [human kidney] cell-based vaccine manufacture of
producing vaccine domestically
April, 2006:
* HHS announces a $97 million contract for the development of cell-based flu
vaccine.
* Leavitt declares: "The FDA can use its Emergency Use Authorization
authority to permit the use of unapproved products if there's a reasonable
belief the products may be effective."
* 32 states pass laws which make resisting inocculation once ordered by the
governor a felony.
* These laws join Patriot Act I, II, BARDA, BIOSHIELD I, II in making drug
treatment and innoculation mandatory once a Pandemic is called.
* Unlimited quarantine without review is mandated under these laws for those
who resist innoculation under Pandemic conditions.
* Fully staffed, empty detention centers exist all over North America.
The largest, in Alasks, is roumored to have a 2.5 million person capacity.
December, 2006
* New York Times reports Gulf War Syndrome positively linked to vaccination
of Veterans.
* More than 100,000 vets contracted the syndrome during the 1991 Desert
Storm Operation.
* More than 20,000 vets have died to date from this syndrom believed to be
triggered by squalene, a vaccine "adjuvant."
* All modern vaccines contain squalene
April 17, 2007:
* The Food and Drug Adminstration (FDA) branch of HHS utilizes its Emergency
Use Authorization authority and awards a license to produce
H5N1 "Bird Flu" vaccines to Sanofi-Pasteur.
* FDA Bird Flu approval letter states:
"We have approved your Biologics License Application (BLA) for Influenza
Virus Vaccine, H5N1, effective this date. You are hereby authorized to
introduce or deliver for introduction into interstate commerce, Influenza
Virus Vaccine, H5N1, under your existing Department of Health and Human
Services U.S. License No. 1725; however, we acknowledge your statement
provided in your submission of April 5, 2007, that Sanofi Pasteur Inc. does
not intend to license this product for commercial distribution, since it was
produced under contract to the U.S. Department of Health and Human Services
as part of national pandemic preparedness initiatives. Influenza Virus
Vaccine, H5N1, is indicated for active immunization of persons 18 through 64
years of age at increased risk of exposure to the H5N1 influenza virus
subtype contained in the vaccine."
* Among the required post-market studies on this untested vaccine are;
Protocol submission: Study DMID 04-077: "A randomized, double-blinded, phase
I/II, study of the safety, reactogenicity, and immunogenicity of
intramuscular inactivated influenza A/H5N1 vaccine in healthy children aged
2 years through 9 years."
Final study report submission: September 30, 2008.Study DMID 04-076:
"A randomized double-blinded, placebo-controlled, phase I/II, dose-ranging
study of the safety, reactogenicity, and immunogenicity of intramuscular
inactivated influenza A/H5N1 vaccine in healthy elderly adults."
Study DMID 05-0043: "Revaccination of healthy subjects with intramuscular
inactivated subunit influenza A/Vietnam/1203/2004 (H5N1) vaccine
representing a drifted variant.
"Study DMID 05-0090: "Evaluation of a booster dose of
A/Vietnam/1203/04 (H5N1) vaccine administered at 6 months to healthy adult
subjects after a two dose schedule at 0 and 1 month."
Study DMID 05-0129: "Open label evaluation of H5N1 vaccine at vaccine
manufacturing facilities."
Study DMID 05-0130: "A single center, open label, phase I/II study of the
safety and immunogenicity of two 90 µg doses of intramuscular inactivated
influenza A/H5N1 vaccine in healthy adult subjects."
Nov. 26, 2007:
* Leavitt's HHS orders 100 million H5N1 "vaccines [doses]" from
Sanofi-Pasteur. Expected delivery date, August, 2008.
* Sanofi-Pasteur issues a press release announcing their lucrative HHS
contract (100 million vaccines @ $15 USD each) and declares that the
cell-based vaccine will be mass produced in the company's CHINA facility -
then shipped to Stillwater, PA for hypodermic syringe-friendly packaging.
* Approval and contract have all been consumated in the absence of offical
human testing.
Jan. 2008:
* Covert 'human trials' of Sanofi-Pasteur H5N1 vaccine is conducted on 350
homeless vagrants in Poland.
* According to London Telegraph
(http://www.telegraph.co.uk/news/worldnews/...676/Homeless-pe
ople-die-after-bird-flu-vaccine-trial-in-Poland.html)
and Examininer articles, this results in 21 "instant" deaths and over 200
severely incapacitated or hospitalized." Development and sales of
H5N1 vaccine continues.
February 14, 2008
* U.S. Air Force Gen. Gene Renuart, commander of North American Aerospace
Defense Command and U.S. Northern Command, and Canadian Air Force Lt.-Gen.
Marc Dumais, commander of Canada Command, sign a Civil Assistance Plan that
allows the military from one nation to support the armed forces of the other
nation during a civil emergency.
* "Our commands were created by our respective governments to respond to the
defense and security challenges of the twenty-first century, and we both
realize that these and other challenges are best met through cooperation
between friends....
The plan facilitates the military-to-military support of civil authorities
once government authorities have agreed on an appropriate response."
*
Avian Flu response is a part of NorthCom's mission, and according to Gen.
Stubblebine's analysis, appears to be the primary element in its
mission: http://www.northcom.mil/Avian%20Flu/index.html
June 17, 2008
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