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EINet Alert ~ Mar 09, 2007


*****A free service of the APEC Emerging Infections Network*****
APEC EINet News Briefs offers the latest news, journal articles, and notifications for emerging infections affecting the APEC member economies. It was created to foster transparency, communication, and collaboration in emerging infectious diseases among health professionals, international business and commerce leaders, and policy makers in the Asia-Pacific region.
In this edition:
- Global: Cumulative number of human cases of avian influenza H5N1
- Global: Glaxo H5N1 vaccine may work against multiple strains
- Afghanistan (Nangarhar, Kunar): 2 suspected human cases of avian influenza H5N1 infection
- Afghanistan (Nangarhar, Kunar, Kabul): Avian influenza H5N1 found in 6 more areas
- Iran (Tehran): Suspected avian influenza deaths in birds
- Kuwait (Jahra, Farwaniya): 2 cases of avian influenza H5N1 reported in chickens
- China (Tibet): Avian influenza H5N1 deaths in Tibet Poultry
- China: Officials rejects research findings of Guangdong origin of avian influenza H5N1
- Hong Kong: New avian case of avian influenza H5N1 infection; risk from bird trade
- Indonesia: Study to investigate avian influenza H5N1 link to cats
- Laos (Vientiane): First fatal case of avian influenza H5N1 infection
- Malaysia: Avian influenza prevention & control policy
- Pakistan (Northwest Frontier Province): Outbreak of avian influenza H5N1 in poultry
- South Korea (Anseong): Outbreak of avian influenza H5N1 in ducks
- Viet Nam (Hanoi): Avian influenza H5N1 confirmed in chickens near capital

1. Updates
- Avian/Pandemic influenza updates
- Seasonal Influenza

2. Articles
- A statistical phylogeography of influenza A H5N1
- Influenza vaccination coverage among children with asthma--United States, 2004--05 influenza season
- H5N1 Viruses and Vaccines
- Spanish Influenza in Japanese Armed Forces, 1918–1920
- Movements of birds and avian influenza from Asia into Alaska
- Use of Prediction Markets to Forecast Infectious Disease Activity

3. Notifications
- Pandemic Influenza Conference, Barbados, May 2007


Global
Global: Cumulative number of human cases of avian influenza H5N1
Economy / Cases (Deaths)

2003
Viet Nam / 3 (3)
Total / 3 (3)

2004
Thailand / 17 (12)
Viet Nam / 29 (20)
Total / 46 (32)

2005
Cambodia / 4 (4)
China / 8 (5)
Indonesia / 17 (11)
Thailand / 5 (2)
Viet Nam / 61 (19)
Total / 95 (41)

2006
Azerbaijan / 8 (5)
Cambodia / 2 (2)
China / 13 (8)
Djibouti / 1 (0)
Egypt / 18 (10)
Indonesia / 56 (46)
Iraq / 3 (2)
Thailand / 3 (3)
Turkey / 12 (4)
Total / 116 (80)

2007
China / 1 (0)
Egypt / 5 (3)
Indonesia / 6 (5)
Laos / 1 (1)
Nigeria / 1 (1)
Total / 14 (10)

Total no. of confirmed human cases of avian influenza A/(H5N1), Dec 2003 to present: 277 (168).
(WHO 3/8/07 http://www.who.int/csr/disease/avianinfluenza/en/ )

Avian influenza age & sex distribution data from WHO/WPRO: http://www.wpro.who.int/sites/csr/data/data_Graphs.htm.
(WHO/WPRO 2/27/07)

WHO's maps showing world's areas reporting confirmed cases of H5N1 avian influenza in humans, poultry and wild birds (last updated 3/7/07): http://gamapserver.who.int/mapLibrary/

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Global: Glaxo H5N1 vaccine may work against multiple strains
The British pharmaceutical company GlaxoSmithKline (GSK) unveiled new findings suggesting that its inactivated H5N1 influenza vaccine may protect humans from more than one strain of the virus, which may build a stronger case for prepandemic vaccination and spur more countries to consider stockpiling. Researchers from GSK detailed recent findings from two studies at a symposium in Hong Kong, the company said Mar 5. The company has not yet published any clinical trials in peer-reviewed medical journals. GSK's vaccine, based on an H5N1 virus collected in Vietnam in 2004, contains a proprietary adjuvant (an immune-stimulating chemical). Adjuvants enable vaccine makers to produce more doses from a limited supply of antigen. In November, WHO cautioned governments against stockpiling prepandemic vaccines, because many fundamental questions about H5N1 vaccines remained, such as whether vaccines would work against more than one strain of the virus. However, vaccines that are effective against more than one strain could strengthen the case for building prepandemic vaccine stockpiles. In 2006, the US Department of Health and Human Services awarded GSK a $40 million contract for a supply of its H5N1 antigen in bulk form, and in January it granted the company $63.3 million to develop antigen-sparing H5N1 influenza vaccines.
(CIDRAP 3/6/07. www.cidrap.umn.edu )

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Europe/Near East
Afghanistan (Nangarhar, Kunar): 2 suspected human cases of avian influenza H5N1 infection
2 people have been hospitalized in Afghanistan with possible bird flu symptoms, and their blood is being analyzed to confirm whether they have the virus. Afghanistan has not had any human cases of the H5N1 version of bird flu, but has confirmed outbreaks of the virus in chickens and turkeys in the provinces of Nangarhar and Kunar. The 2 patients have been hospitalized in Kunar. Authorities in Kunar and Nangarhar are slaughtering birds and disinfecting areas where the outbreaks were confirmed. Officials said that around 4000 birds are being vaccinated each day.
(ProMED, 3/2/07. http://promedmail.org )

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Afghanistan (Nangarhar, Kunar, Kabul): Avian influenza H5N1 found in 6 more areas
The H5N1 bird flu virus has been confirmed in 6 additional areas in eastern Afghanistan and the country's capital, the UN said Mar 8, 2007. The U.N. Food and Agriculture Organization said samples collected from home-raised poultry tested positive in a laboratory. It confirmed H5N1 outbreaks in the Khogiani, Rodat and Bati Kot districts of Nangarhar province, Khas Kunar and Kuz Kunar in Kunar province, and in the Shah Shahid area of Kabul. The government immediately began disinfecting and quarantining affected areas and slaughtering nearby poultry, FAO said. FAO had confirmed outbreaks of H5N1 in the eastern city of Jalalabad Feb 20 and in the Sawki district of Kunar Feb 24, 2007. Afghanistan reported its first cases of H5N1 Mar and Apr 2006 in Kabul and in the provinces of Kapisa, Logar and Nangarhar. There have been no reported infections of humans.
(ProMED, 3/8/07, http://promedmail.org )

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Iran (Tehran): Suspected avian influenza deaths in birds
Suspicious poultry deaths have been reported in Tehran's Pardisan Park, purportedly attributed to an outbreak of avian flu. Reacting to the yet unconfirmed report, chairman of the environmental NGO Avay-e Sabz (Green Song) Society called on citizens, especially children, to avoid visiting the park. Results of laboratory examinations on carcasses of 24 saker falcons, 1 kestrel and a number of owls are pending. Reportedly, one of the dead birds has in fact tested positive for avian influenza. Officials decided that the whole bird population in the park would be culled Mar 6, but the measure was postponed until the final results are announced. This is the first report of avian flu in domestic fowl in Iran; the country reported flu in wild swans in 2006.
(ProMED, 3/8/07 http://promedmail.org )

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Kuwait (Jahra, Farwaniya): 2 cases of avian influenza H5N1 reported in chickens
Kuwait said Mar 3, 2007 that it had found 2 new cases of the H5N1 strain of bird flu in chickens, then announced Mar 6 that it had detected 2 new cases involving a falcon and a chicken found in Jahra and Farwaniya respectively, said a spokesman for the Ministry of Health. With this, the total number of H5N1 cases discovered in the country now stands at 52. The new cases were traced to the bird market in the al-Rai area, reported Health Ministry officials. Since the outbreak of the disease, 25 000 birds have been slaughtered, and fumigation campaign is being conducted in poultry farms across the country. Blood samples of 50 bird handlers tested negative for the H5N1 strain and that 65 teams are actively involved in containing the outbreak. The bird market and Kuwait's zoo are shut down while poultry shops in residential areas are being closed for 3 months. Soon after the discovery of the avian flu virus, Kuwait banned the import of all poultry products, and the ban will continue until the disease is eradicated. Meanwhile, a team of experts from the World Organisation for Animal Health (OIE) arrived in Kuwait. The official reiterated that no case of bird flu in humans has been found so far after testing 268 samples for people who had been in contact with the infected birds. Kuwait has stocked some 10 million capsules of the drug Tamiflu, which are sufficient to treat about 40 percent of the population of 3 million. Kuwaiti officials were unable to say whether the bird flu cases have affected poultry consumption or sales prices.
(ProMED, 3/4/07, 3/7/07. http://promedmail.org )

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Asia
China (Tibet): Avian influenza H5N1 deaths in Tibet Poultry
China has suffered an outbreak of H5N1 avian flu among poultry in Tibet, while the virus also struck down thousands of wild birds in the region, state media and animal health monitors reported Mar 6, 2007. China's chief veterinary officer, Jia Youling, said the poultry died of H5N1. 680 fowl died in the outbreak in Chengguan Village near Lhasa, the capital of Tibet, and nearly 7000 other birds there were culled, according to the OIE. The report did not specify what kinds of birds were infected. The government has closed the market and is also monitoring the health of wild birds. Jia also reported 3 separate outbreaks of H5N1 among wild birds in Tibet, including one that killed 28 migratory birds near Lhasa and 2 others that killed 2579 and 57 wild birds elsewhere in the region. The wild species infected included bar-headed geese, crows and hawks, according to the OIE. Qinghai is a known transit point for migratory birds, and the virus killed thousands of bar-headed geese at a nature reserve in the province in mid-2005, raising fears that the virus was on the move, jumping among hosts in the wild. The current disease event seems to be indicative of the reemergence of the disease in China, though virus circulation might have been masked by the mass vaccinations, preventing its clinical manifestation.
(ProMED, 3/7/06. http://promedmail.org )

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China: Officials rejects research findings of Guangdong origin of avian influenza H5N1
Chinese officials have rejected the findings of an American study that pointed to China's southern province of Guangdong as the source of multiple H5N1 virus strains that spread internationally, according to a report on the China Daily Web site. The report used genetic and geographic data on the H5N1 virus to chart its history over the past decade. From analyzing 192 samples obtained across Asia and Europe, researchers concluded that several strains of the virus originated in Guangdong province, and they claim to have identified bird migration routes that facilitated the regional and international spread of the virus. He Xia, a spokesperson for the Guangdong Provincial Agricultural Department, said the researchers' conclusions are flawed and the study lacks credibility. "Actually, Guangong did not witness any bird flu cases in 1996. As a result, the findings are not based on facts," He said. China's reaction to the report was reminiscent of an episode in Nov 2006, when another report in PNAS drew criticism from Chinese officials. In that case, US scientists said that a new H5N1 subtype, which they labeled Fujian-like, had become predominant in southern China in the previous year and had been found in human cases. The Chinese agriculture ministry denied that any new strain had emerged.
(CIDRAP, 3/8/07. http://www.cidrap.umn.edu )

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Hong Kong: New avian case of avian influenza H5N1 infection; risk from bird trade
Another bird in Hong Kong has tested positive for the H5N1 bird flu virus, authorities said 9 Mar 2007. A long-tailed shrike [Lanius schach] found dead 3 Mar 2007 in the densely populated Hung Hom district was confirmed with the disease by the government's agriculture, fisheries and conservation department. Biologists believe local species of wild birds found dead with the virus could have picked it up from contact with infected flocks in mainland China. The discovery of a thirteenth bird infected with H5N1 in Hong Kong this year has prompted the Hong Kong Bird Watching Society to urge the Hong Kong government to ban the trade in wild birds. Mike Kilburn, the vice-chairman of the Society, noted that 70% of the infected birds have been found within 3 km of the Mong Kok bird market, and that all infected birds found in 2006-2007 were either birds such as the scaly-breasted munia (Lonchura punctata) and silver-eared mesia (Leiothrix argentaurus), which are sold for religious release; or urban scavengers or predators such as magpies and goshawks which feed on sick or dead birds. "It's the confinement of traded birds in unhygienic and stressful conditions, and not concentrations of migratory birds, which represents the real risk of infection to the public," Kilburn said. He further noted that thousands of wild birds have been tested for H5N1 at Mai Po refuge in the past 2 years, and none of the free-flying wild birds has tested positive for H5N1. It is estimated that between 450,000 and 700,000 birds are imported each year into Hong Kong, and except for 40,000 to 80,000 that are checked, the majority are unregulated.
(Promed 3/9/07 http://promedmail.org ; USGS 3/8/07 http://www.nwhc.usgs.gov/disease_information/avian_influenza/index.jsp )

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Indonesia: Study to investigate avian influenza H5N1 link to cats
Domestic and stray cats that prey on birds in Southeast Asia may play a critical role in transforming avian influenza into a global pandemic, virus-tracking scientists say. To investigate, researchers will begin Apr 2007 the world's largest examination of bird flu in stray cats in Indonesia, where a survey found one in 5 felines carry the lethal H5N1 virus in some areas. Cats, because of their close interactions with humans, may provide a conduit for the transmission of the flu between birds and people. Scientists led by the United Nations' Food and Agriculture Organization will examine feline habits and collect blood samples to test for exposure to the H5N1 virus. Disease trackers aim to collect data during the next 3 months, with preliminary results collated soon after, said John Weaver, a senior adviser with the agency in Jakarta."The prevalence of the virus is quite high" judging from preliminary tests on swabs of the cats' upper airways, C.A. Nidom, a scientist at Airlangga University in Surabaya, said. Nidom found H5N1 in 98 of 500 cats living near poultry markets in high-risk areas on the island of Java and in Lampung province on southern Sumatra island.
(ProMED, 3/8/07, http://promedmail.org )

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Laos (Vientiane): First fatal case of avian influenza H5N1 infection
A 15-year-old Lao girl has died from bird flu, the Health Ministry said Mar 8, 2007, the country's first confirmed death from the H5N1 virus. She died Mar 7 in a hospital in neighboring Thailand, the ministry said. A 42-year-old Lao woman died of suspected bird flu Mar 4, but tests have not yet confirmed she had contracted H5N1 virus infection.
(ProMED, 3/4/07, 3/8/07, http://promedmail.org, WHO, 3/8/07 http://who.int/en )

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Malaysia: Avian influenza prevention & control policy
Malaysia ruled out resorting to vaccine to contain the H5N1 virus in poultry and asserted it will keep on culling infected birds as the better option. Malaysia, unlike its neighbors, Vietnam and Indonesia, is still culling poultry and compensating farmers due to the small number of infected birds in the nation. Malaysia is also constantly observing the situation and is carrying out awareness campaigns aimed at villagers regarding the disease, and this has proved effective in curbing its spread, officials said.
(ProMED, 3/4/06. http://promedmail.org )

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Pakistan (Northwest Frontier Province): Outbreak of avian influenza H5N1 in poultry
The National Reference Laboratory for Poultry Diseases, Islamabad, has confirmed the presence of avian influenza H5N1 virus in the birds found dead in Peshawar, Naushera and Charsadda districts. The Islamabad lab confirmed presence of the virus in a black partridge and dead crows. The lab is also processing the serum samples from Desi [local, South-Asian breeds] layers it received. The government has yet to take precautionary measures. The Islamabad lab had recommended culling of all birds in the premises and disinfecting farms as per standard protocol, the sources said.
(ProMED, 3/4/06. http://promedmail.org )

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South Korea (Anseong): Outbreak of avian influenza H5N1 in ducks
A fresh case of highly virulent bird flu was discovered at a poultry farm Mar 8, 2007. It is the seventh bird flu case since Nov 2006, when the first outbreak in 3 years was reported on a poultry farm in Iksan, about 230 km south of Seoul. The most recent outbreak was reported Feb 10, 2007, in Anseong, about 15 km north of Cheonan, where a similar bird flu case was also detected Jan 2007. Authorities started an investigation into the newest case when a farmer reported that about 30 ducks at the farm died of an unknown cause. The remaining 13 000 on the farm will be slaughtered. An official said the quarantine authorities were to cordon off an area within a 3-km radius of the duck farm and destroy 55000 chickens and ducks there. In 2003 and 2004, South Korea destroyed more than 5 million poultry to curb the spread of the disease.
(ProMED, 3/8/07, http://promedmail.org )

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Viet Nam (Hanoi): Avian influenza H5N1 confirmed in chickens near capital
Bird flu has killed more than 1000 chickens at 2 farms on the outskirts of Hanoi, the country's animal health authority said Mar 7. Health workers slaughtered scores of chickens at the farms in Dong Anh district after tests confirmed that the H5N1 virus had killed a total of 1150 birds. Viet Nam has had no human cases of bird flu since Nov 2005, but the virus, which first arrived late 2003, returned to poultry in the south late 2006. More infections were detected in ducks in the southern province of Vinh Long and in chickens in the northern provinces of Hai Duong and Ha Tay in the past 3 weeks. Agriculture Minister Cao Duc Phat said the H5N1 virus existed throughout Viet Nam, even though poultry vaccination had helped prevent its spread. Viet Nam is expected to start its next phase of vaccinating poultry in the second half of Mar 2007 and will allow the resumption of raising and hatching waterfowl from 15 Mar 2007.
(ProMED 3/7/07, http://promedmail.org )

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1. Updates
Avian/Pandemic influenza updates
- UN: http://influenza.un.org/. UN response to avian influenza and the pandemic threat. Also, http://www.irinnews.org/Birdflu.asp provides information on avian influenza in order to help the humanitarian community.
- WHO: http://www.who.int/csr/disease/avian_influenza/en/index.html.
- UN FAO: http://www.fao.org/ag/againfo/subjects/en/health/diseases-cards/special_avian.html.
- OIE: http://www.oie.int/eng/en_index.htm. Link to upcoming avian influenza conferences.
- US CDC: http://www.cdc.gov/flu/avian/index.htm. Bird embargo updates.
- The US government’s web site for pandemic/avian flu: http://www.pandemicflu.gov/.
- Health Canada: information on pandemic influenza: http://www.influenza.gc.ca/index_e.html.
- CIDRAP: http://www.cidrap.umn.edu/. Frequently updated news and journal articles.
- PAHO: http://www.paho.org/English/AD/DPC/CD/influenza.htm.
- US Geological Survey, National Wildlife Health Center Avian Influenza Information: http://www.nwhc.usgs.gov/disease_information/avian_influenza/index.jsp. Global updates.
(UN; WHO; FAO, OIE; CDC; Health Canada; CIDRAP; PAHO; USGS)

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Seasonal Influenza
Chinese Taipei
Based on the sentinel surveillance system in Taiwan, during the eighth epidemiological week (Feb 18 to 24, 2007), the percentage of outpatient visits to sentinel physicians for influenza-like illness (ILI) has decreased by 0.2% compared with last week but is 3.8% higher than the same period in 2006. In recent 4 weeks (week 5 to 8, 2007), the respective ILI consultation rates (per 100 outpatient visits) were 5.02, 4.58, 4.06 and 4.05. Comparing to last week, all 6 regions reported a decreased trend. The dominant respiratory virus identified by National Influenza Center and CDC Collaborating Labs for week 5 to 8, 2007 was influenza A (H3) virus, followed by B virus. The other main respiratory viruses were Adenovirus and HSV (Herpes simplex virus). To date, 43 clusters have been reported this influenza season. Based on reporting dates, 8 additional severe influenza cases were reported during week 7 to 8. Based on onset dates, 126 severe cases have been reported cumulatively in the 2006-2007 epidemic season. Among these, 27 were confirmed, 88 were excluded, and 11 are still pending. So far this season (weeks 26, 2006 to week 8, 2007), 5 deaths have been reported.
(Taiwan IHR Focal Point 3/9/07)

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2. Articles
A statistical phylogeography of influenza A H5N1
Robert G. Wallace et al. Proceedings of the National Academy of Sciences of the USA (PNAS), 104(11) 4473-8 (online edition).
Abstract : The geographic diffusion of highly pathogenic influenza A H5N1 has largely been traced from the perspective of the virus's victims. Birds of a variety of avian orders have been sampled across localities, and their infection has been identified by a general genetic test. Another approach tracks the migration from the perspective of the virus alone, by way of a phylogeography of H5N1 genetic sequences. Although several phylogenies in the literature have labeled H5N1 clades by geographic region, none has analytically inferred the history of the virus's migration. With a statistical phylogeography of 192 hemagglutinin and neuraminidase isolates, we show that the Chinese province of Guangdong is the source of multiple H5N1 strains spreading at both regional and international scales. In contrast, Indochina appears to be a regional sink, at the same time demonstrating bidirectional dispersal among localities within the region. An evolutionary trace of HA1 across the phylogeography suggests a mechanism by which H5N1 is able to infect repeated cycles of host species across localities, regardless of the host species first infected in each locale. The trace also hypothesizes amino acid replacements that preceded the 1st recorded outbreak of pathogenic H5N1 in Hong Kong, 1997.
(ProMED, 3/8/07. http://promedmail.org )

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Influenza vaccination coverage among children with asthma--United States, 2004--05 influenza season
(references removed)
“In 2005, approximately 8.9% (6.5 million) of U.S. children aged <18 years were reported to have current asthma. Children with asthma are at high risk for complications from influenza, and influenza vaccination has been determined to safely and effectively reduce rates of influenza in these children. Since its establishment in 1964, the Advisory Committee on Immunization Practices (ACIP) has recommended that all children with asthma aged >6 months receive vaccination with inactivated influenza vaccine during each influenza season; however, national influenza vaccination coverage rates specifically for children with asthma have not been determined. Previous studies have assessed influenza vaccination rates in children with asthma at the local level using health maintenance organization and clinician group-practice information, with estimates ranging from 10% to 43% for various influenza seasons. Another study used Behavioral Risk Factor Surveillance System (BRFSS) data to estimate influenza vaccination coverage in children aged 2--17 years with one or more conditions putting them at high risk for complications from influenza (including asthma, although asthma was not assessed separately); in that study, the national rate was estimated at 34.8% for the 2004--05 influenza season (based on a sample size of 685, which included all states and the District of Columbia [DC]). To estimate national influenza vaccination coverage rates among children aged 2--17 years with current asthma,CDC analyzed data from the 2005 National Health Interview Survey (NHIS). This report describes the results of that analysis and provides the first national estimates of influenza vaccination coverage among children with asthma. The findings indicated that although children with current asthma were more likely to receive influenza vaccination than children without current asthma, the vaccination coverage rate among children with asthma was low, at 29.0% (95% confidence interval [CI] = 24.5--33.9). These findings underscore the need to increase influenza vaccination coverage in children with asthma aged 2--17 years by identifying and overcoming barriers to vaccination.”
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5609a2.htm
(MMWR, March 9, 2007. 56(09);193-196)

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H5N1 Viruses and Vaccines
Subbarao, K and Luke, C. PLoS Pathog 3(3): e40 doi:10.1371/journal.ppat.0030040. Published: March 2, 2007.
http://pathogens.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.ppat.0030040
“The establishment and spread of highly pathogenic avian influenza (HPAI) viruses of the H5N1 subtype in birds and coincident infections in humans since 2003 have raised concerns that we may be facing an influenza pandemic caused by an H5N1 influenza virus. In this brief Opinion piece, we consider the pandemic threat posed by H5N1 viruses and review the published data on the evaluation of H5N1 vaccines in preclinical and clinical studies. . .Although there is no evidence that H5N1 viruses have yet acquired pandemic potential, the consequences of such an event are serious enough that preparation for a possible pandemic is essential.”

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Spanish Influenza in Japanese Armed Forces, 1918–1920
Akihiko Kawana et al. EID. Volume 13, Number 4–April 2007
http://www.cdc.gov/eid/content/13/4/590.htm
Abstract: “With the recent outbreaks of avian influenza A (H5N1), the risk for the next influenza pandemic has increased. For effective countermeasures against the next pandemic, investigation of past pandemics is necessary. We selected cases diagnosed as influenza from medical records and hospitalization registries of Japanese army hospitals during 1918–1920, the Spanish influenza era, and investigated clinical features and circumstances of outbreaks. Admission lists showed a sudden increase in the number of inpatients with influenza in November 1918 and showed the effect of the first wave of this pandemic in Tokyo. The death rate was high (6%–8%) even though patients were otherwise healthy male adults.”

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Movements of birds and avian influenza from Asia into Alaska
Winker K et al. EID. Volume 13, Number 4–April 2007
http://www.cdc.gov/EID/content/13/4/06-1072.htm
Abstract: “Asian-origin avian influenza (AI) viruses are spread in part by migratory birds. In Alaska, diverse avian hosts from Asia and the Americas overlap in a region of intercontinental avifaunal mixing. This region is hypothesized to be a zone of Asia-to-America virus transfer because birds there can mingle in waters contaminated by wild-bird–origin AI viruses. Our 7 years of AI virus surveillance among waterfowl and shorebirds in this region (1998–2004; 8,254 samples) showed remarkably low infection rates (0.06%). Our findings suggest an Arctic effect on viral ecology, caused perhaps by low ecosystem productivity and low host densities relative to available water. Combined with a synthesis of avian diversity and abundance, intercontinental host movements, and genetic analyses, our results suggest that the risk and probably the frequency of intercontinental virus transfer in this region are relatively low.”

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Use of Prediction Markets to Forecast Infectious Disease Activity
Philip M. Polgreen et al. Clin Infect Dis. 2007 Jan 15;44(2):272-9. Epub 2006 Dec 14.
http://www.journals.uchicago.edu/CID/journal/issues/v44n2/40364/brief/40364.abstract.html
Abstract: “Prediction markets have accurately forecasted the outcomes of a wide range of future events, including sales of computer printers, elections, and the Federal Reserve's decisions about interest rates. We propose that prediction markets may be useful for tracking and forecasting emerging infectious diseases, such as severe acute respiratory syndrome and avian influenza, by aggregating expert opinion quickly, accurately, and inexpensively. Data from a pilot study in the state of Iowa suggest that these markets can accurately predict statewide seasonal influenza activity 2–4 weeks in advance by using clinical data volunteered from participating health care workers. Information revealed by prediction markets may help to inform treatment, prevention, and policy decisions. Also, these markets could help to refine existing surveillance systems.”
***See CIDRAP article on this study: http://www.cidrap.umn.edu/cidrap/content/influenza/panflu/news/mar0707market.html

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3. Notifications
Pandemic Influenza Conference, Barbados, May 2007
Global Conferencing and Education Inc. invites you to the International Pandemic Influenza conference (H5N1 Bird Flu), to be held at the Hilton Hotel, in Bridgetown, Barbados, from 7 to 9 May 2007. To register for this conference, please visit the website at http://www.gblconf.com. Availability of spaces will become limited for this international event. Who should attend: All health care providers, including doctors, veterinary and poultry experts, virologists, and emergency and disaster planners.

Confirmed speakers include:
Right Honorable Dr Jerome Walcott MP, Minister of Health, Government of Barbados; Dr Mark Loeb, professor, Departments of Pathology and Molecular Medicine, Clinical Epidemiology and Biostatistics, McMaster University; Dr Indira J. Ekanayake, senior agriculturist, Sustainable Development (LCSSD) - Latin America & Caribbean, The World Bank; Dr Juergen Stech, research scientist, Institute of Virology, University Hospital Germany; Dr Lance C. Jennings, clinical virologist, Microbiology Department, New Zealand; Dr Sardikin Giriputro, head of Suliantom Saroso Hospital, Indonesia; Dr Eluemuno Blyden, head, Department of Biological Sciences Department, Njala University, Sierra Leone; Dr Phillip Nieburg, senior associate and co-chair, Prevention Committee, HIV/AIDS Task Force, USA; Dr David Heyman, director and senior fellow, Homeland Security Programme, Center for Strategy and International Security, USA; Surgeon Commodore Lionel J Jarvis QHS FRCR Royal Navy, director of Medical Policy, UK Ministry of Defense; Professor Jon Bragi Bjarnason, PhD professor of Biochemistry, Science Institute, University of Iceland; Hazel A. Todd, manager, Crisis Preparedness, Response, and Recovery, United Way of America; Dr Lloyd Webb, deputy director of Public Health, Pan American Health Organisation PAHO), World Health Organization (WHO); Dr Austin Denby, Scientist, Centers for Disease Control and Prevention, Atlanta, USA; Dr Richard Coker, reader in Public Health in the Department of Public Health and Policy, the London School of Hygiene and Tropical Medicine; Professor William Stanhope, Institute of Biosecurity, St Louis University School of Public Health, USA; Dr Douglas Fleming OBE, director, Royal College of General Practitioners, Flu Unit, Birmingham, UK; Professor Ronald Eccles, director, Common Cold Centre and Healthcare Clinical Trials, Cardiff School of Biosciences, Cardiff University, Wales, UK; Professor John Oxford, professor of Virology, Queen Mary's College and Scientific Director of Retroscreen Ltd, UK; Dr Joseph Bryant, research scientist, Institute of Human Virology University of Maryland, USA.
(ProMED, 3/6/06. http://promedmail.org )

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