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EINet Alert ~ Aug 01, 2008
*****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:
1. Influenza News
- Global: Cumulative number of human cases of avian influenza A/(H5N1)
- UK: Bernard Matthews halts sale of foreign-raised turkeys
- Indonesia (Medan): ASEAN states to test readiness on H5N1 avian influenza
- South Korea (North Jeolla): Cat becomes country's first mammal to die of H5N1 avian influenza
- Thailand (Phichit): Four suspected cases of H5N1 avian influenza test negative
- Canada: Pandemic research receives $1.6 million funding boost
- USA (Washington): Comic book to spread word on influenza to immigrants, youth
- Nigeria: Fresh H5N1 avian influenza outbreak in poultry
- Avian/Pandemic Influenza
- Consumer Knowledge and Risk Perceptions of Avian Influenza
- Environmental Contamination during Influenza A Virus (H5N1) Outbreaks, Cambodia, 2006
- Highly Pathogenic Avian Influenza Virus (H5N1) in Experimentally Infected Adult Mute Swans
- Contact structures in the poultry industry in Great Britain: Exploring
- Laboratory Investigation of the First Suspected Human Cases of Infection with Avian Influenza A(H5N1) Virus in Bulgaria
- Experimental infections of herring gulls (Larus argentatus) with H5N1 highly pathogenic avian influenza viruses by intranasal inoculation of virus and ingestion of virus-infected chicken meat
- Efficacy of disinfectants and hand sanitizers against avian respiratory viruses
- Ethics in the Worst of Times: Rationing to Protect the Public's Health during a Severe Influenza Pandemic
- No Ordinary Flu: Preparedness comic book in multiple languages
- PHI2008--Envisioning Options for Integrated Public Health Information Systems for Low Resource Settings: Components, Connections, Partners, Strategies
1. Influenza News
Global: Cumulative number of human cases of avian influenza A/(H5N1)
Economy / Cases (Deaths)
***For data on human cases of avian influenza prior to 2008, go to: http://depts.washington.edu/einet/humanh5n1.html
Total no. of confirmed human cases of avian influenza A/(H5N1), Dec 2003 to present: 385 (243).
Avian influenza age distribution data from WHO/WPRO: http://www.wpro.who.int/sites/csr/data/data_Graphs.htm.
WHO's maps showing world's areas affected by H5N1 avian influenza (last updated 6.19.08): http://gamapserver.who.int/mapLibrary/
WHO’s timeline of important H5N1-related events (last updated 7.14.08): http://www.who.int/csr/disease/avian_influenza/ai_timeline/en/index.html
UK: Bernard Matthews halts sale of foreign-raised turkeys
Bernard Matthews Foods is to stop selling turkeys raised outside the UK, a move designed to address concerns that its outbreak of bird flu two years ago may have been caused by infected birds imported from sub-contractors in Hungary. Jeremy Hall, who coordinated the company's response, said "many learned people had their doubts" that the virus was imported in carcasses or equipment traveling from Hungary to its plants in East Anglia, but the move "removes any potential risk."
The decision, which affects less than two percent of the birds sold by the company, is one of a number of initiatives taken in response to the H5N1 outbreak that triggered widespread culling and damaged Bernard Matthews' sales and reputation. Mr. Hall, who recently gave a presentation on the subject to the food industry, warned that bird flu in animals could become an annual event in Europe. He called on policymakers to strengthen cross-border exchange of information. He said reduced purchases of imported meat could help cut the risk of infection, but argued there was evidence the virus spread through wild migratory birds. In spite of recent improvements, he said it could take two months before European Union countries identifying a bird flu outbreak provided the information to a central database available to industry. He argued that following infection reports elsewhere in Europe, the Department for Environment, Food and Rural Affairs (DEFRA) should be more willing than it is now to announce "housing orders," which allow poultry breeders to bring birds indoors for several weeks to keep them safe without losing the right to label them free range. Mr. Hall said DEFRA remained reluctant to make such orders unless there were infections in the UK, France or the Netherlands, and was skeptical it would unveil any change in policy ahead of Christmas. He said officials had refused to allow workers culling birds at Bernard Matthews' plant to wear full face masks, encouraging them to switch to less practical goggles in spite of written instructions to the contrary.
Indonesia (Medan): ASEAN states to test readiness on H5N1 avian influenza
Bird flu chiefs from across Southeast Asia have agreed to assess the ability of their governments to respond to a deadly human pandemic of the virus, an Indonesian official said on 23 Jul 2008. A three-day meeting of representatives from members of the Association of Southeast Asian Nations (ASEAN) agreed countries must be better organized to tackle a human-to-human outbreak of H5N1, Bayu Krisnamurthi said.
Many of the 10 states had little organized bureaucracy or infrastructure to tackle a pandemic, which could kill millions if it mutates into a more easily transmissible form, Krisnamurthi said. "Indonesia, Thailand, Vietnam, have experienced human cases. Others have not. That's the main difference between countries," the official, who heads Indonesia's bird flu committee, said after the meeting in Medan. "First we would like an assessment of ASEAN countries on pandemic preparedness. . .if pandemic influenza happened in one of the (ASEAN) countries, the reach and the impact would be on a regional scale," he said. Countries are expected to finish assessing their preparedness by January or February 2009, Krisnamurthi said. Health ministers from the 10 ASEAN states will also meet in the Philippines capital Manila in October 2008 to discuss preparedness and the need to develop a "common language" to deal with the threat, he said.
South Korea (North Jeolla): Cat becomes country's first mammal to die of H5N1 avian influenza
The College of Veterinary Medicine at Chungnam National University asked the national quarantine service to verify the exact cause of death. The Ministry said unlike poultry, cats do not transfer the highly pathogenic strain to humans. The virus found in the cat was the same strain that killed thousands of poultry in April 2008. Joo Yi-Seok, head of the Department of Animal Disease Control at the NVRQS said, "Because cats do not have a strong enough system to reproduce the bird flu virus in their bodies, there is no risk of cats spreading the virus. There is no known case around the world of humans being infected with the virus by cats."
Thailand (Phichit): Four suspected cases of H5N1 avian influenza test negative
The four people tested included a six-year-old child, a 10-year-old child, and two women aged 62 and 70. They all remain under observation in Phichit's Sam Ngam Hospital. The six-year-old does not have the flu. The four reported they had come into contact with dead chickens in their village before falling ill. Three days later, they had a high fever, and it was feared they had been infected with the H5N1 strain.
Paijit has asked healthcare volunteers in Sam Ngam district to monitor the symptoms of the relatives of the three patients with seasonal flu for the next 12 days. If any suspicious symptoms are found, they will also be sent to hospital immediately. He also urged villagers to avoid cooking food using chickens or ducks that have died suspiciously. Villagers should incinerate any such poultry in order to minimize the risk of the H5N1 virus spreading to other areas, he said.
Canada: Pandemic research receives $1.6 million funding boost
Densely populated cities and increased air travel can be factors which create and spread pandemic disease. But a McMaster University researcher is working with isolated Hutterite communities to understand the transmission of pandemic diseases like influenza. Dr. Mark Loeb and his research team have received $1.6 million in funding to carry out the research from the Rx&D Health Research Foundation (HRF), the Canadian Institutes of Health Research (CIHR) and the Canadian Food Inspection Agency (CFIA).
Dr. Loeb will work with Hutterite communities in western Canada to examine the transmission of flu viruses from person to person and from pigs to humans. Dr. Loeb is an internationally-recognized expert in infectious disease epidemiology, and has studied SARS (as founding director of the Canadian SARS Research Network), West Nile Virus, and antibiotic use and resistance. His team's new research will detect influenza viruses in humans and pigs in Hutterite communities, and use computer modeling to analyze the transmission of the virus. "Hutterite communities are uniquely well-suited to this sort of research, because they are active swine farmers and because they live in isolation from mainstream society," says Loeb. "We hope to use this research grant to learn important lessons about how disease spreads and how to prevent it."
"The SARS outbreak taught us that there are no national boundaries when it comes to infectious diseases," said Dr. Bhagirath Singh, Scientific Director of the CIHR Institute of Infection and Immunity. "Through this partnership, Dr. Loeb and his team will receive the critical support needed to further advance knowledge in the area of pandemic preparedness and influenza outbreaks."
USA (Washington): Comic book to spread word on influenza to immigrants, youth
The comic took six months to produce and cost $75,000 — which was paid for by the National Association of County & City Health Officials (NACCHO). The state Department of Health is hoping to distribute more than 300,000 copies of the comic at schools statewide. King County officials plan to hand out 78,000 additional copies, while NACCHO has ordered 160,000 copies for national distribution.
The concept and story were created by Meredith Li-Vollmer of Public Health – Seattle & King County and Matthew French, a public health graduate student at the University of Washington and research assistant with APEC EINet. The comic book was drawn by Seattle artist, David Lasky. Li-Vollmer said the idea of the comic is to reach low-literacy folks through an easily accessible medium. She said most experts believe it's not a case of "if" another outbreak strikes — but a matter of "when." "The main message is that it can potentially be catastrophic, and everyone needs to be prepared," Li-Vollmer said.
Nigeria: Fresh H5N1 avian influenza outbreak in poultry
An outbreak of the H5N1 bird flu virus has been found in two Nigerian poultry markets, the first discovery in almost 10 months in Africa's most populous nation, the agriculture ministry said on 28 Jul 2008. Junaidu Maina, agriculture director for the livestock department, said the infected chickens and ducks were located last week in the northern cities of Kano and Katsina. "Immediate actions have already been taken to control the outbreak. The affected farms are being depopulated and disinfected," he said. The virus was first discovered in Nigeria in February 2006 and infected poultry in 25 states before being contained. The last Nigerian outbreak was in October 2007.
- UN: http://www.undp.org/mdtf/influenza/overview.shtml UNDP recently launched a new web site for information on fund management and administrative services and includes the website of the Central Fund for Influenza Action. This site also includes a list of useful links to governments, international agencies, NGOs, and scientific organizations.
- WHO: http://www.who.int/csr/disease/avian_influenza/en/index.html The Influenza Virus Tracking System is now live and can be accessed by the public at: www.who.int/fluvirus_tracker.
- UN FAO: http://www.fao.org/avianflu/en/maps.html. View the latest cumulative highly pathogenic avian influenza outbreak maps.
- OIE: http://www.oie.int/eng/info_ev/en_AI_avianinfluenza.htm. Link to the Communication Portal gives latest facts, updates, timeline, and more.
- US CDC: http://www.cdc.gov/flu/avian/index.htm. Visit "Pandemic Influenza Preparedness Tools for Professionals" at: http://www.cdc.gov/flu/pandemic/preparednesstools.htm. This site contains resources to help hospital administrators and state and local health officials prepare for the next influenza pandemic.
- The US government’s website for pandemic/avian flu: http://www.pandemicflu.gov/. View the factsheet "Control of Pandemic Flu Virus on Environmental Surfaces in Homes and Public Places" at: http://www.pandemicflu.gov/plan/individual/panfacts.html
- CIDRAP: http://www.cidrap.umn.edu/ See "Promising Practices: Pandemic Preparedness Tools:" Find more than 130 peer-reviewed practices from 22 states and 33 counties aimed at furthering pandemic preparedness.
- PAHO: http://www.paho.org/English/AD/DPC/CD/influenza.htm Link to the Avian Influenza Portal at: http://influenza.bvsalud.org/php/level.php?lang=en&component=19&item=1. The Portal is a developing project for the operation of product networks and information services, for specialists, authorities and the general public.
- US Geological Survey, National Wildlife Health Center Avian Influenza Information: http://www.nwhc.usgs.gov/disease_information/avian_influenza/index.jsp Read about the latest news on H5N1 in wild birds and poultry.
(UN; WHO; FAO, OIE; CDC; CIDRAP; PAHO; USGS)
Consumer Knowledge and Risk Perceptions of Avian Influenza
Hsu JL, et al. Poultry Science. 2008;87:1526-1534 http://ps.fass.org/cgi/content/abstract/87/8/1526
Environmental Contamination during Influenza A Virus (H5N1) Outbreaks, Cambodia, 2006
Highly Pathogenic Avian Influenza Virus (H5N1) in Experimentally Infected Adult Mute Swans
Contact structures in the poultry industry in Great Britain: Exploring
Laboratory Investigation of the First Suspected Human Cases of Infection with Avian Influenza A(H5N1) Virus in Bulgaria
Experimental infections of herring gulls (Larus argentatus) with H5N1 highly pathogenic avian influenza viruses by intranasal inoculation of virus and ingestion of virus-infected chicken meat
Efficacy of disinfectants and hand sanitizers against avian respiratory viruses
Ethics in the Worst of Times: Rationing to Protect the Public's Health during a Severe Influenza Pandemic
Who should be first to receive scarce health-related resources in a severe pandemic? How should scarce resources like antivirals, masks, vaccines, and ventilators be rationed? How will you communicate a public health perspective to your community, supporting rationing strategies to further our common good? How will you educate them and enlist their support of a state-wide plan to ration these resources in ways intended to save the most lives, preserve public safety and order, and be fair?
Ethicists in Minnesota have worked with state and local public health agencies and a diverse community panel to develop an ethical framework to guide the Minnesota Department of Health's decisions in the midst of a severe pandemic, for the statewide rationing of a range of critical health-related resources for prevention, treatment and personal protection. In this session, they presented their ethical framework, consisting of principles, goals, and strategies. They engaged participants in the vexing ethical issues associated with deciding which groups should be prioritized to receive these vital resources when everyone is, in varying ways and to varying extents, at risk.
Click below for videos from 5 June 2008
No Ordinary Flu: Preparedness comic book in multiple languages
To promote pandemic flu preparedness, Public Health - Seattle & King County has developed a 12-page comic book on pandemic flu. Targeting readers of all ages, this story tells the tale of a family’s experience of the 1918 influenza pandemic. It also explains the threat of pandemic flu today, illustrates what to expect during a pandemic (such as school closures), and offers tips to help households prepare. You can order copies (or download) all 12 language versions of the comic (PDF format) at the above link.
PHI2008--Envisioning Options for Integrated Public Health Information Systems for Low Resource Settings: Components, Connections, Partners, Strategies
Dates: 18-19 September 2008
PHI2008 will be hosted by Global Partners in Public Health Informatics (GPPHI) at the Center for Public Health Informatics (CPHI) at the University of Washington, Seattle, WA, USA. The idea of creating a partnership of governmental and non-governmental organizations, academic institutions and companies to define and develop a vision for addressing health challenges in low-resource settings through information and communications technologies was first articulated at PHI2007: Building a Global Partnership in Public Health Informatics. PHI2007 brought together nearly 200 individuals from across the globe who created the impetus for the Global Partners in PHI.
The Rockefeller Foundation recently funded the UW Center for Public Health Informatics to begin the planning process for the Global Partners organization. That process will take place over the coming year through an invitational meeting on Public Health Informatics at the Rockefeller Foundation conference center in Bellagio, Italy as well as at the second annual GPPHI meeting -- PHI2008 -- to be held in September 18-19, 2008 at the Bell Harbor Conference Center, Seattle, Washington, USA. The theme for the PHI2008 meeting is "Envisioning Options for Integrated Public Health Information Systems for Low Resource Settings: Components, Connections, Partners, Strategies."