Saturday, May 16, 2009

Japan confirms 16 new swine flu cases

2:29PM Sunday May 17, 2009

TOKYO - Japan's health ministry says 16 more cases of swine flu have been confirmed. The country's tally is now at 21.

The Health and Welfare Ministry says the 16 are teenagers at several high schools in the western prefectures of Hyogo and Osaka.

The ministry said ON Sunday that the patients all tested positive for the H1N1 virus the day before and are recovering at local hospitals,

Japan on Saturday confirmed its first domestic case of swine flu. Japan's first four cases were contracted outside the country.

Threats from illegally-imported chicken legs, pig entrails

17:08' 14/05/2009 (GMT+7)

VietNamNet Bridge – Grilled chicken legs are the favourite cuisine of many people, who don’t know that they could lose their lives to food poisoning.

Hanoi police have seized a dozen tonnes of illegal-imported chickens and pig entrails so far this year.

The Hanoi Market Control Agency has detected many cases of illegally-imported chicken legs and pig entrails, which were addled or very mouldy, being transported from Vietnam-China border provinces to Hanoi.

If they had not been seized, these things would have been processed into aromatic and eye-catching cuisine at restaurants in Hanoi.

Grilled chicken legs, chicken wings and pig stomach are favoured by many people. But anybody who saw how the food is processed would never dare approach these items again.

A reporter of Cong An Nhan Dan witnessed the processing procedures at a restaurant selling grilled chicken legs and wings in Hanoi. Mouldy, leaden chicken legs and wings were taken from nylon bags and washed in a big basin with some kinds of chemicals.

It is said that these chemicals make meat look fresh immediately after being washed, even though it might have been mouldy before.

They were then mixed with spices for flavour and grilled. The restaurant sold a chicken leg for VND2,000 and a wing for VND10,000. A restaurant like this sells grilled chicken legs and wings with non-origin chili sauce.

Besides chicken parts, grilled brisket and pig entrail soup are also very popular and these cuisines are processed from unsafe pig entrails imported illegally from China.

On May 12, Hanoi authorities seized a truck from the northern border province of Lang Son which was transporting 40kg of pig brisket and 576kg of pig entrails. The driver confessed that this batch of goods was illegally imported from China via the border gate in Lang Son. These things were very smelly and mouldy.

Previously, Hanoi police discovered some similar cases, seizing a dozen tonnes of illegal-imported chickens and pig entrails.

Traders not only import chicken legs and wings, but also old chickens from China. This kind of chicken is rejected by Chinese breeders since they cannot lay eggs and are sold to Vietnamese traders at very low prices. By the time they are seized, many chickens have died already.

Swine Flu: The View From a Brooklyn ER

by Trudy Whitman (edit@broVisits Increase, But Most Have Only Mild Symptoms

By Trudy Whitman
Brooklyn Daily Eagle

COBBLE HILL — On the average, the Long Island College Hospital Emergency Department logs in 170 patients daily. But on Monday, April 27, after a weekend of media blitz about the swine flu outbreak, or what health officials are now referring to as the H1N1 virus, the LICH Emergency Department examined 231 patients.

And the numbers topped 200 for the remainder of the week, according to Dr. Tucker Woods, who heads this LICH department.

Contrary to city, state, and federal Health Department recommendations, most of these patients visited the E.D. with only mild flu-like symptoms; health authorities are telling people with minor coughs and sore throats to just remain at home. Others represented a group the health experts are calling the “worried well.”

Only patients with severe symptoms are being swabbed at LICH for swine flu testing, following again following recommendations, said Dr. Woods. But these practices could change overnight.

“This is an ever-changing situation,” Dr. Woods explained. “The Department of Health puts out recommendations pretty regularly, and what might be true today isn’t necessarily true tomorrow. We’ve been very aggressive emailing staff to give them the latest updates.”

In addition to e-mail updates from health agencies, Woods participates in conference calls initiated by the Department of Health every afternoon at 4:30. On these calls, the city’s key emergency department personnel receive the latest news and up-to-the-minute policy procedures regarding flu treatment.

On the morning of April 27, the LICH Emergency Department organized a meeting where staff members were debriefed about the situation and told what LICH would be doing to handle it.

“We already had policies in place for any pandemic-type outbreak,” Dr. Woods noted, “but we assembled a team to review these and to make sure that everyone knew what to do if there is a pandemic.”

Preventive Measures

Among the measures taken by LICH are the posting of signs in all the waiting rooms in multiple languages about hand hygiene and the provision of hand sanitizer pumps prominently displayed in the hospital. The hospital has also assembled a large supply of masks, should they be needed in the coming weeks. In addition, Dr. Woods has met with pharmacy personnel to ensure that there are plentiful supplies of the antiviral medications Tamiflu and Relenza.

LICH’s stockpile of antivirals is impressive, Dr. Woods stressed: “The hospital is always thinking ahead and worrying about worse-case scenarios.”

Asked why the virus appears to be more virulent in Mexico than in the United States, Dr. Woods replied that experts don’t know yet. “But that is a big question,” he agreed. “I expect that we will see more severe cases in the U.S.” (News stories this past weekend suggested that Mexicans may not be getting as sick as initially reported.)

Dr. Woods said that he is “not too worried” about a possible pandemic and that “people shouldn’t be alarmed.” “What’s reassuring to me is that back in 1918, they didn’t have the medications to treat viruses. I feel encouraged that it [the swine flu] is sensitive to these medications, and I also feel encouraged that we haven’t seen a high number of deaths so far.”

“I think we’re going to be O.K.,” Dr. Woods concluded.

Swine flu facts can be obtained from the New York City Health Department at www.nyc.gov/html/doh/html/cd/cdinflu.shtml and from the Centers for Disease Control and Prevention at www.cdc.gov/swineflu/general_info.htm.

oklyneagle.net), published online 05-04-2009

INFLUENZA A (H1N1) - WORLDWIDE (29)

A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

[1] Swine H1N1 clarification
[2] WHO decline to assign severity scale
[3] Reproductive rate estimate


******
[1] Swine H1N1 clarification
Date: Thu 14 May 2009
From: Ian Brown
<i.h.brown@vla.defra.gsi.gov.uk>


re: Pathogenesis of swine influenza virus reported as part [2] of Influenza
A (H1N1) - worldwide (26), archived as 20090514.1798.
--------------------------------------------------------------
The above post quotes a study with H1N1 in pigs conducted by Sreta D,
Kedkovid R, Tuamsang S, Kitikoon P,Thanawongnuwech R. Pathogenesis of swine
influenza virus (Thai isolates) in weanling pigs: an experimental trial.

It should be clarified that the H1N1 virus used in this study is a local
strain from 2005 with a haemagglutinin gene derived from classical swine
H1N1 virus. Therefore whilst there may be some genetic characteristics in
this virus, with some similarity to the current emergent influenza (A) H1N1
human virus, it is not the same. The study whilst of interest does confirm
symptoms and pathology consistent with numerous other published studies
using this virus subtype in pigs.


--
Ian Brown
Veterinary Laboratories Agency (VLA)
Weybridge, UK

[ProMED-mail thanks Ian Brown for this clarification. - Mod.CP]

******
[2] WHO declines to assign severity scale
Date: Wed 13 May 2009

Source: Medscape Infectious Diseases [edited]
<http://www.medscape.com/viewarticle/702773?src=rss> [membership required]


WHO declines to assign severity scale
-------------------------------------
The World Health Organization (WHO) said today that it is unable to assign
a severity scale to the influenza A (H1N1) epidemic for the reason that
disease characteristics and responses of countries vary. Dr Sylvie Briand,
with the WHO Global Influenza Programme, spoke today [13 May 2009] at a
media briefing in Geneva. According to Dr Briand, the WHO pandemic alert
level phases are mainly based on the transmission of the virus and its
geographical spread, while "the severity itself is assessed by other
means." Currently, the pandemic alert level has remained at level 5 out of
6, indicating community-based outbreaks in a single WHO region
.

The severity of a potential pandemic is based on 3 factors: "the
[characteristics of the] virus, the vulnerability of the population, and
the intervention we can put in place to reduce the impact of severe
disease,"
Dr Briand said. Assessing severity is important for helping
countries determine their response to an outbreak, but at a global level, a
severity index is "not very helpful" because "severity will vary from place
to place," she said. Dr Briand pointed out that while wealthier countries
may have the resources to mount a more effective response to an outbreak
,
some developing parts of the world such as West Africa are already used to
coping with epidemics and may be at an advantage due to having healthcare
systems in place. This is referred to as the "resilience" of a country, she
said.

Dr Briand also emphasized that oseltamivir and zanamivir are effective
against this novel H1N1 strain, which is in contrast to the seasonal
influenza strain, which is resistant to these antiviral drugs.

News reports are circulating regarding a claim by an eminent Australian
influenza researcher that human error may have been involved in creating
this strain. Adrian Gibbs, 75, said in an interview that he intends to
publish a report suggesting the new strain may have accidentally evolved in
eggs that scientists use to grow viruses and drugmakers use to make
vaccines. WHO spokesperson Gregory Hartl said the WHO is looking into
evidence regarding these claims, but "it is way too soon to say anything."
He added that the WHO's main task is to assess the current risk level and
to "help member states to be prepared to respond."

Yesterday CDC issued a dispatch in the Morbidity and Mortality Weekly
Report on novel influenza A (H1N1) virus infections in pregnant women. As
of 10 May 2009, 20 probable or confirmed cases had been reported in
pregnant women. Of the women, 3 have been hospitalized and 1 woman died.
The CDC is recommending that pregnant women with confirmed, probable, or
suspected novel influenza A (H1N1) virus infection should receive antiviral
treatment for 5 days. Interim guidance on issues specific to pregnant women
and the novel influenza A (H1N1) virus is available at

<http://www.cdc.gov/h1n1flu/clinician_pregnant.htm>.

[byline: Emma Hitt]

--
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ProMED-mail
<promed@promedmail.org>

******
[3] Reproductive rate estimate
Date: Thu 14 May 2009 [edited]
Source: Eurosurveillance, Vol. 14, Issue 19 [edited]
<http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19205>


A preliminary estimation of the reproduction ratio for new influenza
A(H1N1) from the outbreak in in Mexico, March-April 2009

----------------------------------------------------------------------------
As of 12 May 2009, 5251 cases of the new influenza A(H1N1) have been
officially reported to the World Health Organization (WHO) from 30
countries, with most of the identified cases exported from Mexico where a
local epidemic has been going on for the last 2 months. Sustained
human-to-human transmission is necessary to trigger influenza pandemic and
estimating the reproduction ratio (average number of secondary cases per
primary case) is necessary for forecasting the spread of infection. We use
2 methods to estimate the reproduction ratio from the epidemic curve in
Mexico using 3 plausible generation intervals (the time between primary and
secondary case infection). As expected, the reproduction ratio estimates
were highly sensitive to assumptions regarding the generation interval,
which remains to be estimated for the current epidemic. Here, we suggest
that the reproduction ratio was less than 2.2 ­ 3.1 in Mexico, depending on
the generation interval. Monitoring and updating the reproduction ratio
estimate as the epidemic spreads outside Mexico into different settings
should remain a priority for assessing the situation and helping to plan
public health interventions.

Introduction
------------
As of 12 May 2009, 5251 cases of the new influenza A(H1N1) have been
officially reported to WHO from 30 countries [1,2]. 2 parameters must be
estimated for this new virus using mathematical and computational models:
the reproduction ratio (R), which measures the average number of secondary
cases per primary case; and the generation interval, which measures the
average time between infection in a primary case and its secondary cases.
The larger the reproduction ratio, the higher the required efficacy of
public health interventions [3]. Here we use 2 different methods to provide
preliminary estimates of R for the outbreak in Mexico.

Methods
-------
We used the daily incidence data from 11 March to 2 May 2009 as reported by
the Mexican health authorities [4]
(<http://portal.salud.gob.mx/descargas/pdf/influenza/situacion_actual_de_la_epidemia_080509.pdf>).
The data consisted in 1364 confirmed cases given as daily counts.

2 different approaches were used to estimate R:
(1) M1 - intrinsic growth rate [5]: the growth rate of the epidemic is
estimated by Poisson regression over a given time interval and transformed
to R using Laplace transform of the generation interval distribution. The
assumptions are the exponential growth of the epidemic and known generation
interval. After visual inspection of the epidemic curve, all periods
starting before 20 Apr 2009 and ending after this date, more than 5 days
long, were explored. Goodness of fit of the exponential model was judged by
the deviance R­squared measure.
(2) M2 - real time estimation [6]: a daily reproduction ratio R(t) is
determined by averaging the number of secondary cases over all possible
chains of transmissions compatible with the epidemic curve. This approach
assumes no imported cases, equiprobability of all chains of transmission
compatible with the data and known generation interval. The 2 methods
require full specification of the generation interval distribution.

As no information regarding the actual generation interval in Mexico is
available, we used 3 plausible candidate values of the generation interval
(denoted GI) derived from different approaches: one (denoted as PAN)
obtained from household studies from the 1957 and 1968 pandemics [7], one
derived from viral excretion in experimental influenza infection (denoted
as VIR) [8], and a hypothetical distribution introduced in Elveback
(denoted ELV) [9]. Their values with mean standard deviation (SD) were the
following: PAN = 3.1 +/- 1.9 days; VIR = 2.6 +/- 1 day; ELV = 4.6 +/- 1.5 days.

Results
--------
When using M1, the period starting on 9 Apr 2009 and ending on 24 Apr 2009
yielded the best fit for exponential growth, with daily rate r = 0.30 [CI95
per cent 0.28-0.34]. [The Epidemic curve of the outbreak of new influenza
A(H1N1) in Mexico and fitted exponential growth over the period 9 to 24 Apr
2009 is illustrated as a figure in the original text]. The corresponding R
was 2.2 [2.1, 2.4] for the PAN GI; 2.6 [2.4, 2.8] for the VIR GI; and 3.1
[2.9, 3.5] for the ELV GI. Overall, the differences in goodness of fit were
small. The reproduction ratio decreased as the duration of the period used
to estimate the growth rate increased: for the PAN GI, the maximum was 2.7
(8 days) and the minimum 2.0 (17 days).

With method M2, all 3 generation intervals led to similar profiles of R(t)
with time: R(t) was around 1 up to 8 Apr 2009 then increased rapidly during
the 2 following weeks. [Estimates of the daily reproduction ratio R(t) in
the outbreak of new influenza A(H1N1) in Mexico is illustrated in the text
by a figure]. The magnitude of R depended on the generation interval: the
maximum value was 2.1 (18 April) for the PAN GI; 4.0 (11 April) for the VIR
GI; and 3.2 (17 April) for the ELV GI.

[The epidemic growth rates estimated for the new influenza A(H1N1) epidemic
in Mexico and corresponding reproduction ratio estimates calculated with
method M1 are presented as a table in the original text.]

Discussion
----------
Obtaining timely estimates of the reproduction ratio is crucial for
deciding on public health interventions in case of a pandemic. In this
respect, our analysis suggests that the maximum reproduction ratio was <
2.2 (for PAN GI); < 2.6 (for VIR GI) and < 3.1 (for ELV GI) during the
outbreak in Mexico, subject to the following limitations.

Firstly, the epidemic curve was obtained by retrospective testing of
samples, so that new cases may still be added. Indeed, for the same period
(11 Mar 2009 to 26 Apr 2009), there were 97 confirmed cases in the report
published on 1 May 2009, 682 in the 5 May 2009 report, and 803 in the 8 May
2009 report. With each new version of the epidemic curve, the reproduction
ratio estimates grew smaller. The increase in the epidemic curve coincided
with the setup of enhanced surveillance (starting from 16 Apr 2009),
suggesting improved case-finding with time. This notification/surveillance
bias leads to overestimation of the reproduction ratio, as a larger number
of late cases would be attributed to fewer earlier cases; on the other
hand, however, the effect of public health interventions (closure of
schools, restaurants and other public places, etc.) may affect the results
in the opposite direction.

The assumptions required to estimate the reproduction ratio must also be
taken into account. As already mentioned, the generation interval is
unknown for the outbreak in Mexico, but of major importance for
quantitative estimates. This illustrates the importance of estimating as
soon as possible the generation time distribution to calibrate estimates of
R [6]. As expected, longer generation time generally led to larger
estimated R [3]. We believe the PAN GI should be favoured in the
interpretation of the results, as it was determined from household data
during past influenza pandemics.

A 2nd limitation arises from arbitrary deciding which part of the epidemic
curve displayed exponential growth, namely a minimum duration (5 days), a
starting and ending date. Stochastic variations, especially in small time
series, may cause large uncertainties in the estimates [10]. Observing that
the real time reproduction ratio M2, which does not rely on the exponential
growth assumption, yielded smaller reproduction ratio estimates, suggests
that method M1 yielded upper bound estimates.

A comprehensive analysis of all available data has independently led to the
range 1.4-1.6 for the reproduction ratio [11]. At least 2 factors
contribute to this substantially lower estimate: underreporting was
explicitly taken into account and reduced the reproduction ratio, and the
generation interval, estimated from the actual epidemic, seems to have been
much shorter than considered here (mean 1.9 days).

Although sensitive to all uncertainties discussed above, our early
estimates show that the reproduction ratio in Mexico was in a range similar
to that of past influenza pandemics [12,13].

References
----------
1. WHO. Influenza A(H1N1) - update 25. 12 May 2009. Available from:
<http://www.who.int/csr/don/2009_05_12/en/index.html>
2. European Centre for Disease Prevention and Control. ECDC Situation
Report. Influenza A(H1N1) infection. 12 May 2009. Available from:
<http://www.ecdc.europa.eu/en/files/pdf/Health_topics/Situation_Report_090512_0800hrs.pdf>

3. Ferguson NM, Cummings DA, Fraser C, Cajka JC, Cooley PC, Burke DS.
Strategies for mitigating an influenza pandemic. Nature 2006; 442(7101):
448-52.
4. Ministry of Health of Mexico. Situación actual de la epidemia [Current
epidemic situation]. 8 May 2009. Available from:
<http://portal.salud.gob.mx/descargas/pdf/influenza/situacion_actual_de_la_epidemia_080509.pdf>
[at the time of posting (15 May 2009) this URL is unavailable, but a
current bulletin can be accessed
<http://portal.salud.gob.mx/descargas/pdf/influenza/situacion_actual_epidemia_150509.pdf>]
5. Wallinga J, Lipsitch M. How generation intervals shape the relationship
between growth rates and reproductive numbers. Proc Biol Sci 2007;
274(1609): 599-604.
6. Cauchemez S, Boelle PY, Donnelly CA, Ferguson NM, Thomas G, Leung GM, et
al. Real-time estimates in early detection of SARS. Emerg Infect Dis 2006;
12(1): 10-3.
7. Ansart S, Boelle PY, Cauchemez S, Legrand J, Carrat F, Ferguson N, et
al. Generation interval and reproduction number for influenza: a review.
Technical report. Universite Pierre et Marie Curie: Paris; 24 April 2009.
8. Carrat F, Vergu E, Ferguson NM, Lemaitre M, Cauchemez S, Leach S, et al.
Time lines of infection and disease in human influenza: a review of
volunteer challenge studies. Am J Epidemiol 2008; 167(7): 775-85.
9. Elveback LR, Fox JP, Ackerman E, Langworthy A, Boyd M, Gatewood L. An
influenza simulation model for immunization studies. Am J Epidemiol 1976;
103(2): 152-65.
10. Chowell G, Nishiura H, Bettencourt LM. Comparative estimation of the
reproduction number for pandemic influenza from daily case notification
data. J R Soc Interface 2007; 4(12): 155-66.
11. Fraser C, Donnelly CA, Cauchelmes S, Hanage WP, Van Kerkhove MD,
Hollingsworth TD, et al. Pandemic potential of a strain of influenza A
(H1N1): early findings. Published 11 May 2009 on Science Express. DOI:
10.1126/science.1176062. Available from:
<http://www.sciencemag.org/cgi/content/abstract/1176062>
12. Mills CE, Robins JM, Lipsitch M. Transmissibility of 1918 pandemic
influenza. Nature 2004; 432(7019): 904-6.
13. Gani R, Hughes H, Fleming D, Griffin T, Medlock J, Leach S. Potential
impact of antiviral drug use during influenza pandemic. Emerg Infect Dis
2005; 11(9): 1355-62.

[byline: P Y Boelle1,2, P Bernillon3, J C Desenclos3, At:
1) INSERM, Institut national de la sante et de la recherche medicale
(National Institute of Health and Medical Research), U707, Paris, France
2) Universite Pierre et Marie Curie - Paris 6, UMR S 707, Paris, France
3) Institut National de Veille Sanitaire (Institute for Public Health
Surveillance, InVS), Saint-Maurice, France
<http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19205>]

--
communicated by:
ProMED-mail
<promed@promedmail.org>

[The estimate of the reproduction ratio arrived at by Boelle and colleagues
is somewhat higher than that of Fraser and colleagues reported previously
in ProMED-mail (see: part [1] of Influenza A (H1N1) - worldwide (23)
archived as 20090511.1764), but is in line with that observed in past
influenza virus pandemics. Further refinement of these analyses is
essential and must remain a priority for assessing the epidemic situation
and helping to plan public health interventions

Japan confirms 1st swine flu caught inside country

May 16, 2009 04:08 EDT

TOKYO (AP) -- Japan is ordering schools closed in a port city after confirming its first case of swine flu caught inside the country.

Officials say a high school student in the port city of Kobe has tested positive for the virus. He had not traveled abroad recently. Preliminary tests show two other students at the school may also have tested positive.


All Kobe schools are being closed for seven days in an effort to prevent further spreading.

The confirmed case is Japan's fifth. The first four were students and a teacher who recently returned from a school trip to Canada.

Malaysia is also reporting another case of swine flu, in a woman who recently returned from the United States. It's Malaysia's second confirmed case.

And in the U.S., authorities in Texas are reporting the fifth U.S. death linked to the virus.

Influenza A: 'Virus will spread far and wide'

2009/05/16
Influenza A: 'Virus will spread far and wide'


GENEVA: The World Health Organisation said yesterday research suggests the influenza A virus was so contagious, it would probably spread to new, unaffected regions.

Acting WHO assistant director-general Keiji Fukuda said studies by experts indicated a "significant number of people" had been infected but remained undetected or unconfirmed by laboratory tests.

"Their work also suggests that the virus is transmissible enough that we will expect to see continued community level outbreaks and regional spread.

Appear HPAI in Vinh Long

Update 02:31 on 17-05-2009

Xuất hiện dịch cúm gia cầm tại Vĩnh Long Appear HPAI in Vinh Long


ND- Theo Cục Thú y, ngày 14-5, dịch cúm gia cầm đã phát sinh trên đàn vịt của hộ gia đình ở xã Nguyễn Văn Thảnh, huyện Bình Tân (Vĩnh Long). Per-ND Department of Animal Health, on 14-5, HPAI has arisen on the ducks out of the household in Nguyen Van Thanh, Tan Binh district (Vinh Long).

Tổng số vịt bị ốm, chết là 250 con trong tổng đàn 1.100 con. Total ducks are sick, 250 children died in the 1100 Forum. Chi cục Thú y đang tiến hành các biện pháp chống dịch theo quy định. Animal Health Department are conducting anti-disease measures as prescribed. Hiện cả nước có hai tỉnh Ðồng Tháp và Vĩnh Long có dịch cúm gia cầm chưa qua 21 ngày. Presently there are two provinces Dong Thap and Vinh Long HPAI not last 21 days.

Emerging antiviral targets for influenza A virus.

Medline Abstract
Robert M Krug and James M Aramini
Trends Pharmacol Sci, May 8, 2009; .
Institute for Cellular and Molecular Biology, Section of Molecular Genetics and Microbiology, University of Texas at Austin, Austin, TX 78712, USA.

The potential threat of a pandemic caused by H5N1 influenza A viruses has stimulated increased research on developing new antivirals against influenza A viruses. Current antivirals are directed against the M2 protein (named adamantanes) and the neuraminidase (named zanamivir and oseltamivir). However, both seasonal and H5N1 influenza A viruses have developed resistance to adamantanes and oseltamivir. Accordingly, new antivirals directed at the M2 and neuraminidase proteins, and against the hemagglutinin protein, are being developed. In addition, elucidation of the structural basis for several crucial functions of other viral proteins (specifically the non-structural NS1A protein, the nucleoprotein and the viral polymerase) has identified novel targets for the development of new antivirals. Here, we describe how functional and structural studies led to the discovery of these novel targets and also how structural information is facilitating the rational design of new drugs against previously identified targets.

PMID: 19428126

Vaccination against human influenza A/H3N2 virus prevents the induction of heterosubtypic immunity against lethal infection with avian influenza A/H5N

Medline Abstract

R Bodewes, JH Kreijtz, C Baas, MM Geelhoed-Mieras, G de Mutsert, G van Amerongen, JM van den Brand, RA Fouchier, AD Osterhaus, and GF Rimmelzwaan
PLoS ONE, January 1, 2009; 4(5): e5538.
Department of Virology, Erasmus Medical Center, Rotterdam, The Netherlands.

Annual vaccination against seasonal influenza viruses is recommended for certain individuals that have a high risk for complications resulting from infection with these viruses. Recently it was recommended in a number of countries including the USA to vaccinate all healthy children between 6 and 59 months of age as well. However, vaccination of immunologically naïve subjects against seasonal influenza may prevent the induction of heterosubtypic immunity against potentially pandemic strains of an alternative subtype, otherwise induced by infection with the seasonal strains. Here we show in a mouse model that the induction of protective heterosubtypic immunity by infection with a human A/H3N2 influenza virus is prevented by effective vaccination against the A/H3N2 strain. Consequently, vaccinated mice were no longer protected against a lethal infection with an avian A/H5N1 influenza virus. As a result H3N2-vaccinated mice continued to loose body weight after A/H5N1 infection, had 100-fold higher lung virus titers on day 7 post infection and more severe histopathological changes than mice that were not protected by vaccination against A/H3N2 influenza. The lack of protection correlated with reduced virus-specific CD8+ T cell responses after A/H5N1 virus challenge infection. These findings may have implications for the general recommendation to vaccinate all healthy children against seasonal influenza in the light of the current pandemic threat caused by highly pathogenic avian A/H5N1 influenza viruses.

Taiwan to donate flu medicine to WHO

05/16/2009 (Taiwan News)

Taiwan will donate US$5 million worth of vaccines or medicine to the World Health Organization (WHO) this year to help it fight the swine flu outbreak, the nation's top health official said yesterday.

Yeh Ching-chuan, minister of the Department of Health, made the remarks prior to his departure later in the day for Geneva, where he will attend the annual meeting of the World Health Assembly (WHA), scheduled for Monday to Friday.

The WHA is the highest decision-making body of the WHO.

Yeh said Premier Liu Chao-shiuan has directed local authorities to donate US$5 million worth of vaccines or medicines to help the WHO fight against the new flu, which in principle will be purchased in Taiwan.

But Yeh said Taiwan has yet to coordinate with the WHO Secretariat on the specifics of the donation and how it will be given to the WHO.

Liu also directed that Taiwan donate US$5 million a year in principle, Yeh said, adding that the DOH will also discuss the use of the annual donation with the WHO Secretariat.

Yeh will lead a 15-member delegation comprised of health officials and experts to attend the WHA meeting, marking the first time that the country has been allowed to participate in a meeting or activity of United Nations agencies since losing its U.N. membership to China in 1971.

This is also the first time Taiwan will be allowed to take part in the WHA as an observer after 12 failed attempts.

He said the government's stance on serving as an observer will be "give and take."

On the one hand, the government will donate US$5 million worth of vaccines or medicines to the WHO, but on the other hand, it will ask the WHO to reciprocate by assisting Taiwan in fighting swine flu, accredit the flu laboratory of the DOH's Centers for Disease Control, and help Taiwan's flu vaccine and pharmaceutical plants to meet WHO criteria.

No. 71 transfer of infection to hospital under police guard

Saturday, May 16, 2009 - 19:52

Were the result of the sample taken from the child, Ahmed Abdel Hadi Abdo Bayadp Foreign Bhmyat positive Mahala died of bird flu, bringing the number of people infected with the disease to the case 71 and case No. 7 meeting Sunday attended by the village of Mit Allit Hashim Mahallah Center, and his mother went to the hospital to detect fevers Mahallah what was taken from the sample in the outpatient clinic and denied his mother at the beginning of the matter is that Mkhalt of the birds and their acknowledgment in writing that they themselves do not have any domestic birds.


وعندما جاءت نتيجة العينة إيجابية قامت لجنة من مديرية الصحة بمستشفى حميات المحلة بالانتقال لمنزل الطفل واعترضهم والده بشدة وقاموا باستدعاء شرطة مركز المحلة، وتم أخذ عينة أخرى بعد أن رفض والده بشدة الإجراءات وجاءت العينة الثانية إيجابية وتم استدعاء شرطة مركز المحلة لإحضار الطفل لمستشفى حميات المحلة لنقله للمستشفى، وبعد ذلك تم استدعاء مباحث قسم ثان المحلة لتأمين خروج سيارة الإسعاف التى نقلت الطفل لمستشفى منشية البكرى بالقاهرة.

When the sample was positive by the Commission from the Directorate of Health Hospital fevers Mahallah move to the child's home and challenged his father, who strongly call Mahalla police station, another sample was taken after he refused his father's actions were strongly second sample was called positive Mahalla police station to bring the child to the hospital admitted him for Mahala to the hospital, and then was summoned a second Mahallah Investigation Section to ensure the exit of the ambulance, which was quoted by the child to hospital in the capital Cairo.


قامت مديرية الصحة بأخذ عينات من والدته وأبية وشقيقة وجدتة وتم إرسال العينات إلى المعامل المركزية بوزارة الصحة لبيان مدى إصابتهم بالمرض من عدمه، حيث إنهم مخالطون لطيور منزلية ويربونها داخل منزلهم برغم كتابتهم إقراراً على أنفسهم لعدم تربيتهم للطيور داخل المنزل.

The Directorate of Health took samples from his mother and father and sister and I found the samples were sent to labs central Ministry of Health with the extent of illness or not, as they Mkhataiwn birds within the home and keep their home despite the writing on the recognition of themselves for not raising them for the birds inside the house.


تم فرض كردون أمنى حول المنزل وإعدام الطيور المنزلية المجاورة وهدم العشش وأخذ عينات من الأهالى لبيان مدى إصابتهم بالمرض من عدمه ووضعت مديرية الصحة بالغربية فى حالة تأهب قصوى، حيث إنها الحالة رقم 7 إيجابية بالمحافظة.

Kerdoun security has been imposed around the house and execution of domestic birds and the destruction of neighboring nests and the taking of samples from people with the extent of illness, whether or not to have been meeting Sunday attended by the health department on high alert, as it was the No. 7 to maintain a positive.


حيث سبق أن توفى 4 حالات منهم 3 من أسرة واحدة وممرضة من مركز زفتى وسيدة من مركز سمنود وشفاء حالتين وهذه هى الحالة السابعة داخل محافظة الغربية منذ ظهور المرض

Having already died, including 3 of 4 of one family and a nurse from the Center for Zvty and a woman from the Center for Healing and Smonod two and this is the case in the seventh province of the West since the outbreak of the disease

Due to avian flu and swine .... Lake plans to close the schools ..

Saturday, May 16, 2009 - 20:44
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Transformation of avian and swine to the nightmare matter of everyone B

Bookmark and Share أصبح الحديث عن تحول مرض أنفلونزا الطيور والخنازير إلى وباء سريع الانتشار بين البشر كابوساً يؤرق الكثيرين وبدأ المسئولون يتحدثون عن ضرورة منع التجمعات أياً كانت، فمثلاً هناك حديث عن تأثر موسم الحج والعمرة هذا العام سلباً وأيضاً والمدارس والجامعات

Has become the talk about bird flu and swine flu epidemic to spread rapidly among humans nightmare haunts many officials began talking about the need to prevent any gatherings were, for example, there is talk about the vulnerability of the Hajj and Umrah season this year and also negatively, schools and universities


ففى البحيرة مثلاً أعلن اللواء محمد شعراوى محافظ البحيرة أنه فى حالة تحول مرض أنفلونزا الطيور إلى وباء، فإن خطة المحافظة تتضمن إغلاق جميع المدارس التى ظهرت بها أية حالات إصابة، وكذلك إغلاق المدارس فى المناطق المصابة وتحويل بعض المدارس إلى مستشفيات وفتح فترات مسائية ببعض المدارس لاستيعاب طلاب المدارس الأخرى بجميع المراحل التعليمية مع سرعة عزل الطلبة المشتبه فى إصابتهم لنقلهم إلى المستشفيات بسيارات الإسعاف المجهزة.

In the lake, for example, said the governor, Major General Mohammed Sharawi lake that in the case of avian bird flu pandemic, the plan includes maintaining the closure of all schools that have emerged out of any cases of infection, as well as the closure of schools in the affected areas and the conversion of some schools to hospitals and the opening evening at some schools to accommodate the students of other schools of all levels of education with the rapid isolation of students suspected of transporting the injured to hospitals equipped ambulances.


القليوبية Kalyobiya
ومن جانبه أكد د.حسام العطار رئيس جامعة بنها أن اتخاذ إجراءات حاسمة تحسباً لظهور المرض أمر لابد منه، ولذلك وافق المجلس الأعلى للجامعات برئاسة د.هانى هلال وزير التعليم العالى والدولة للبحث العلمى على، رفع حالة التأهب كإجراء وقائى لمواجهة فيروس أنفلونزا الخنازير.

For his part, he said. Hissam-Attar, Head of the University of Banha to take decisive action in anticipation of the emergence of the disease is imperative, therefore, agreed with the Supreme Council of Universities, headed by Dr.. Hany Helal Minister of Higher Education and Scientific Research, to raise the alert as a precautionary measure to meet the swine flu virus.


ومن الإجراءات التى تم اتخاذها فى هذا الشأن تقليل أعداد الطلاب فى المدرجات، وذلك بتقسيمهم إلى مجموعات لا يزيد عدد المجموعة عن 200 طالب مع إعادة تقديم المحاضرات عدة مرات لاستيعاب الطلاب، مشيراً أنه تم وضع خطة طوارئ بالمستشفيات الجامعية ببنها.

It is the actions that have been taken in this regard to reduce the number of students in the stands, in Ptksimanm to groups of no more than the group of 200 students with the lectures several times to accommodate the students, noting that it was an emergency plan Bpinha university hospital.


أما بالنسبة للامتحانات فقد تقرر عقدها فى موعدها، ما دام المرض لم يدخل مصر، فكلما عقدت الامتحانات فى وقت مبكر، كان الأمر أفضل من تأجيلها فى ظل احتمال ظهور المرض فى أية لحظة مشيراً أن إجراءها فى هذا الوقت هو عين الصواب، وأوضح أن مرض أنفلونزا الطيور أصبح من الأمراض المتوطنة فى مصر مما لا يستدعى معه تأجيل الامتحانات.

As for the examinations have been scheduled to be held in time, as long as the disease did not enter Egypt, the more examinations were held at an early date, it is better than delayed in view of the likelihood of the emergence of the disease at any moment, adding that the conduct at this time is the right thing to do, and pointed out that the bird flu influenza disease has become endemic in Egypt, which requires him not to postpone the examinations.


ورفض سعيد شلبى وكيل وزارة التربية والتعليم، مبدأ تأجيل امتحانات نهاية العام أو عقدها فى أماكن مفتوحة تفادياً لانتشار مرض أنفلونزا الخنازير بين الطلاب فى حالة ظهوره بمصر.

Said Chalabi refused to Undersecretary of the Ministry of Education, the principle of postponement of examinations or the end of the year held in the open in order to avoid the spread of swine flu among the students in the event of his appearance in Egypt.


وأكد شلبى أن امتحانات النقل والشهادات والثانوية العامة والتى بدأت منذ أسبوع بمدارس المحافظة تعقد فى أماكنها المحددة مسبقاً طبقاً للجداول المعلنة بكل مدرسة، وأن أعداد الطلاب داخل اللجان مناسبة ولا تتجاوز الـ20 طالباً، كما أن اللجان التى حددتها المديرية جيدة التهوية ومزودة بفرق الإشراف الصحى من الأطباء والزائرات الصحيات بالمدارس، مما يعنى أنه لا داعى لنقل الامتحانات إلى أماكن مفتوحة طالما لم يظهر المرض.

Chalabi said that the examinations and certificates and the transfer and secondary, which began a week ago, the complexity of maintaining schools in their pre-defined according to the stated school schedules, and the number of students within the appropriate committees in excess of 20 students, and the commissions set by the Directorate with a good ventilation and supervision of the health teams of doctors health visitors and school, which means it does not need to move to places of examinations are open as long as no apparent disease.


الإسكندرية Alexandria
وأكد د.سعيد عبده نافع نائب رئيس جامعة الإسكندرية (فرع دمنهور) أنه لا نية لتأجيل الامتحانات هذا العام وأن الجامعة اتخذت إجراءات للحفاظ على سلامة أبنائها الطلاب من خلال منع التكدسات فى الأماكن المغلقة ومراعاة إقامة الامتحانات فى أماكن جيدة التهوية يراعى فيها السلامة الصحية, كما قامت الجامعة بإغلاق جميع الأماكن المغلقة (سيئة التهوية).

He said. Abdo Said Nafie, Vice-President of the University of Alexandria (Damanhour Branch) had no intention to postpone the examinations this year and the university has taken action to preserve the safety of their children by preventing students from populations in closed areas, taking into account the administration of examinations at places of good ventilation to take into account the health and safety, as The university closed the closure of all places (poor ventilation).


كما حرصت الجامعة على وجود فريق طبى مدرب داخل الكليات لاكتشاف أية حالة يشتبه فى إصابتها بأنفلونزا الطيور وذلك لتحويلها على الفور لمستشفى الجامعة.

As the university has a medical team trained in the colleges for the detection of any suspected case of bird flu in order to transfer immediately to University Hospital.


مضيفاً أن الجامعة تقوم بدور فعال فى التوعية بمخاطر المرض

من خلال عقد عدة ندوات ومؤتمرات بالمشاركة مع الجانب اليابانى, وكذلك لشرح كل ما يتعلق بموضوع أنفلونزا الخنازير.


He said, adding that the University has taken an active role in raising awareness of the dangers of the disease through the holding of several conferences and seminars in partnership with the Japanese side, as well as to explain what the subject of swine flu.


الدقهلية Dakahlia
أكد أحمد الصاوى وكيل مديرية التربية والتعليم بالدقهلية، أنه لا يوجد أى تأجيل للامتحانات سواء الشهادات أو النقل، وستتم كلها فى موعدها ولا يوجد أى تأجيل لها نتيجة وجود مرض أنفلونزا الطيور، حيث إننا أكدنا على أهمية وجود التهوية فى قاعات الامتحان وأن الأبواب والشبابيك يجب أن تكون مفتوحة كما أن عدد الطلاب يتراوح بين 16 إلى 20 طالباً كما أننا بدأنا الامتحانات منذ يوم 9 مايو ولم تظهر أية حالات إصابة بين تلامييذ المحافظة كما أن لدى كل لجنة مشرفة صحية لكشف أية حالة مرضية وسط التلاميذ.

Ahmed El-Sawy and the Under-Directorate of Education Badakkhlip, there was no postponement of the examinations, whether or not transportation, and all will be on time and there is no postponement as a result of the presence of bird flu, as we emphasized the importance of the presence of ventilation in the examination rooms and doors and windows must be be open and the number of students ranges from 16 to 20 students and we have begun examination since May 9 did not show any cases Tlamiiv also maintain that the supervisor of each of the health to detect any case of a satisfactory compromise students.


وأشار الدكتور عبد الكريم على السيد أن كل شىء يسير بطريقة طبيعية إلا أننا أخذنا وسائل التوعية للمواطنين ونعقد الندوات التى تنمى من التوعية لدى المواطنين لتجنب الأماكن المزدحمة وركزنا على عمل ندوات للجمعيات الزراعية حضرها ما يزيد عن 600 مواطن.

He pointed to Mr. Abdul Karim everything that is the only natural way means we are raising awareness of citizens and hold seminars to develop awareness among the citizens to avoid crowded places, and focus on the work of associations of agricultural seminars attended by more than 600 people.


وعلمت اليوم السابع من مصادر داخل جامعة المنصورة، أنه تم إلغاء خيمة الامتحانات الخاصة بكلية الحقوق والتى تسع لأكثر من خمسة آلاف طالب لأداء الامتحانات وتم توزيع اللجان على قاعات الدراسة الصغيرة، كما تم الشديد على النظافة وتطهير تلك اللجان أثناء الامتحانات.

Learned that the seventh day from sources within the University of Mansoura, a tent had been the abolition of examinations for the Faculty of Law, and that nine of the more than five thousand students to sit for examinations have been distributed to the small classroom, were also strong on the hygiene and cleansing of these committees during the examinations.


المنيا Menya
على الصعيد نفسه أكد د.ماهر جابر رئيس جامعة المنيا أنه تم رفع حاله الطوارئ باللجان استعداداً لامتحانات آخر العام حرصاً وخوفاً على سلامة الطلاب، مؤكداً أنه إذا تم تأجيل الامتحانات أو إلغاؤها ولم يتم القضاء على فيروس أنفلونزا الخنازير فسوف ندخل فى حسبة برمة وتضيع السنة الدراسية هباءً ويضيع كل المجهود المبذول، كما حذر الطلاب بعدم استخدام السلوكيات السيئة، وخاصة عملية التقبيل فى السلام وخاصة بعد عودة الطلاب من فترة غياب طويلة عن الجامعة.

On the same level, he said. Maher Jaber, President of the University of Minya has been the lifting of the emergency committees in preparation for the examinations last year, the interest and concern for the safety of students, saying that if the exams were postponed or canceled has not been the elimination of swine flu virus will enter the calculation in the screw and lost school year lost in vain, and every effort, and also warned students not to use bad behavior, especially the kissing in the peace process, especially after students return from a long absence from the university.


وأكد أن هناك إجراءات وقائية كثيرة منها أداء الامتحانات فى أماكن مفتوحة ووجود مسافات بين الطلاب وبعضهم بعضاً أما عبد الكريم وكيل وزارة التربية والتعليم فقد أكد أن المديرية استعدت استعداداً كاملاً لمواجهة أية مفاجآت أثناء أداء الامتحانات والتأكيد على ضرورة وجود الزائرات الصحيات بجميع مدارس المحافظة ولن تقبل المديرية أى أعذار من أى زائرة صحية.

He emphasized that there are many preventive measures, including the performance of examinations in the presence of open spaces and distances between students and each other, Abdel-Karim and Undersecretary of the Ministry of Education has confirmed that the Directorate has prepared fully prepared to face any surprises in the performance of examinations and to emphasize the need for health visitors to maintain all the schools will not accept Directorate no excuses from any health visitor.


كفر الشيخ Kafr El-Sheikh
قال د.فوزى تركى رئيس جامعة كفر الشيخ إن الجامعة قامت بنسخ ( البريشورات) وتم توزيعها على الأساتذة والطلاب بكليات الجامعة الثمان لتحذيرهم من مخاطر الإصابة بأنفلونزا الطيور وكيفية الوقاية منها، وسوف يتم توزيع أعداد أخرى على الطلاب أثناء دخول الامتحانات لمزيد من التوعية.

D said. Fozie Turkish president of the University of Kafr el-Sheikh that the University has copies (Albraichorat) have been distributed to teachers and students of the eight faculties of the university to warn them of the risk of bird flu and how to prevent them, and the numbers will be distributed to other students during the entrance exams for more awareness.


طالب رئيس الجامعة خلال اجتماعه مع عمداء الكليات بضرورة تقديم الوعى العملى والنظرى للطلاب لتعريفهم بالمرض حتى يكونوا حريصين على وقاية أنفسهم وأسرهم بنقل أساليب التوعية والوقاية إليهم.

Chairman of the University during a meeting with deans of colleges need to provide practical and conceptual awareness for students to familiarize them with the disease so they had to be careful to protect themselves and their families to transfer the methods of prevention and awareness to them.


أضاف تركى أن الجامعة لا تنوى تأجيل موعد الامتحانات النظرية التى ستبدأ يوم 23 مايو القادم إلا أنها اتخذت عددا من الاستعدادات لعدم حدوث أيه إصابات بين الطلاب والعاملين بالجامعة.

Turk added that the university does not intend to postpone the date of the theory examinations, which will begin on May 23 next, it has taken a number of preparations for the lack of any injuries among the students and university workers.


أوضح د.إبراهيم أمان نائب رئيس جامعة كفر الشيخ أن استعدادت الجامعة للامتحانات لهذا العام أكثر حرصاً، خاصة مع ظهور حالات للأنفلونزا الطيور بالمحافظة، وكان أهمها زيادة وسائل التوعية باللجان وأماكن الامتحانات وتقليل أعداد الطلاب باللجان حتى تكون هناك تهوية مناسبة وتوزيع المياه المثلجة على الطلاب فى أكواب بلاستيكية تستخدم مرة واحدة يتم إعدامها فوراً حتى لا تنتقل أية عدوى التوعية للطالب باستخدام مناديل عند العطس حتى لا تنتشر العدوى من خلال الرذاذ بالإضافة إلى الإجراءات الوقائية وحث الطلاب على النظافة العامة مع وجود أطباء باللجان منهم طبيب حميات وممرض وسيارة إسعاف مجهزة خاصة بالجامعة لنقل أية حالات طارئة إلى المستشفى.

He added. Ibrahim Aman, the deputy president of the University of Kafr el-Sheikh that the preparations for the examinations to the university this year, more careful, especially with the emergence of cases of bird flu, the government, was the most important means of increasing awareness and places of examination committees and commissions to reduce the number of students so that there is adequate ventilation and chilled water distribution to students in plastic cups are used once to be executed immediately so as not to move any student awareness of the infection using tissues when sneezing so as not to spread the infection through droplets in addition to preventive action and urged the students to hygiene, with the commissions, including doctors and nurses administering doctor and an ambulance equipped with a special university for the transfer of any emergencies to the hospital.


قال محمد الأمين وكيل وزارة التربية والتعليم بكفر الشيخ إننا بدأنا امتحانات النقل وسط أجواء طبيعية ولم تسجل أية حالات اشتباه وسوف نقوم باستكمال الامتحانات فى مواعيدها ونقوم بتحذير أولياء الأمور والطلاب من ارتفاعات درجة الحرارة للكشف حتى لا تكون هناك أية إصابات بالأنفلونزا، ونحرص على أن تتم أعمال نظافة على درجة عالية حتى لا تكون هناك أوبئة تنقل المرض.

Mohammed said the Under-Secretary of the Ministry of Education in Kafr Sheikh examinations we have a natural transportation center of the airspace has not registered any cases of suspicion and we will complete the examination in time and we are warning parents and students of the temperature rises to detect so that there would be any flu cases, and we are keen to be the work of the high degree of cleanliness so that there are no epidemics of transmitting the disease.

Japan confirms first domestic A/H1NA flu case, Malaysia confirms 2nd new flu patient

2009-05-16 23:39:28

HONG KONG, May 16 (Xinhua) -- Japan confirmed on Saturday its first domestic case of Influenza A/H1N1, while Malaysia confirmed a Malaysian women was infected with the new flu, the second in the country.

The Japanese Ministry of Health, Labor and Welfare said on Saturday a 17-year-old male high school student in Kobe city, Hyogo Prefecture, who has no record of overseas travel, was confirmed to be infected with the H1N1 strain of influenza A virus.

The student's family members have shown no sign of symptoms of A/H1N1 flu infection.

It is the first confirmed case in the country after four patients were found infected at an airport after returning from the United States on May 8.

Two other senior high school students from the city -- one male and one female also with no record of overseas travel -- have also tested positive for the new flu in local laboratory tests, the Kobe municipal government said.

The government's health watchdog is analyzing the specimens taken from them at the National Institute of Infectious Diseases in Tokyo.

Malaysian Health Ministry's deputy director-general Ramlee Rahmat said on Saturday that a second Malaysian has been confirmed to be infected with the A /H1N1 flu virus at the Penang Hospital in northern Penang state.

The patient, a woman, was admitted to the Penang Hospital on Friday and the results were confirmed on Saturday morning, he said.

She was a friend of the first patient who was confirmed with the virus at the Sungai Buloh Hospital in central Selangor state on Friday, Ramlee said.

She was on the same flight with the first confirmed patient, a 21-year-old male student, who flew on Malaysia Airlines flight MH091 from New Jersey, the United States, to the Kuala Lumpur International Airport (KLIA) via Stockholm in Sweden.

Ramlee said the woman's family, as well as two other friends of the two infected, were put under home quarantine.

Both of them are now in stable condition, he said.

Australian Health Minister Nicola Roxon announced on Saturday there were 28 people in Australia awaiting test results for A/H1N1flu.

"We do currently have a number of people, including a family, who have tested positive to influenza A," Roxon told reporters in Melbourne.

"We're likely to have the results of those (tests) either late tonight or first thing tomorrow morning," Australian Associated Press quoted the minister as saying.

In Singapore, the Health Ministry announced on Saturday that home quarantine order (HQO) was lifted for travelers to Singapore with a recent Mexican travel history.

The ministry said that it has reviewed the imposition of the HQO in light of new information on the Influenza A/H1N1 outbreak situation.

"The outbreak in Mexico appears to be cooling off with a fall in the number of new confirmed cases. The number of exported cases from Mexico has also fallen significantly," it said.

But the ministry said that HQO will still be issued to any person who is a known or suspected close contact of a probable or confirmed case of Influenza A/H1N1, adding that the country will continue with temperature screening for passengers entering Singapore at all land, sea and air checkpoints.

There are currently no Influenza A/H1N1 cases reported in Singapore.

Queens Assistant Principal Mitchell Wiener, near death from swine flu, shows improvement - family Read more: http://www.nydailynews.com/ny_local/2009

Saturday, May 16th 2009, 10:48 AM

A Queens assistant principal who nearly died from the swine flu showed "slight improvement" overnight as his tormented family maintained a vigil at his hospital bedside.

"Nothing has gotten worse," Adam Wiener, 23, the eldest son of beloved teacher Mitchell Wiener said Saturday. "There is reason to hope."

Mitchell Wiener, a 31-year teaching veteran assigned to Intermediate School 238 in Queens, remained unconscious for a third day at Flushing Hospital.

Wiener, who became incoherent after his fever spiked, arrived at the facility Wednesday morning.

His wife, Bonnie, along with twin sons Farrell and Jordan, stayed with the 55-year-old all night in his room, according to Adam Wiener.

The family was forced to wear full-body protective suits to avoid contamination by the virus.

IS 238 is one of a half-dozen city school shut down Thursday and Friday over concerns of the spreading swine flu, although city officials stressed the outbreaks were isolated.

Five of the schools were in Queens: IS 238 in Hollis, IS 5 in Elmhurst, Public School 16 in Corona, Junior High School 74 in Bayside and PS 107 in Flushing.

The sixth, IS 318, is in Williamsburg, Brooklyn.

The Wiener family, along with parents and elected officials, questioned whether the city was responding quickly enough to flu clusters in their schools.

Mayor Bloomberg said the closings were handled on a school by school basis.

More schools could close before Monday, said teachers union president Randi Weingarten. Her staff received reports from 21 schools - including the three closed Friday - of a high number of student absences.

hat-tip thebes

WHO chief warns against false security about flu

[Interesting in the fact that she mentioned it.]



Last Updated: 2009-05-15 9:00:25 -0400 (Reuters Health)

* Warns newly-discovered strain may have global implications

* Parts of Southeast Asia seen at particular threat

By Stephanie Nebehay

GENEVA (Reuters) - The World Health Organisation warned on Friday against a false sense of security from waning and apparently mild outbreaks of H1N1 flu, saying the worst may not be over.

WHO Director-General Margaret Chan, who raised the United Nations agency's pandemic alert to the second-highest level, said there remained "great uncertainty" about the strain that could pose particular threats in Southeast Asia.

"We are meeting at a time of crisis that could have global implications," she told an intergovernmental meeting on pandemic preparedness at the WHO's Geneva headquarters.

The meeting is tackling the sensitive question of virus sharing, in which countries provide biological specimens to the international community for use by pharmaceutical companies and vaccine makers who are formulating jab ingredients.

At the height of fears about bird flu, Indonesia had refused to share H5N1 virus samples without guarantees that any vaccines developed from them would be made available to poorer countries at an affordable price.

GlaxoSmithKline, Sanofi-Aventis, Novartis, Baxter International and other pharmaceutical companies others are awaiting WHO guidance about whether to start mass-producing vaccines to fight H1N1, which may force them to cut production of seasonal flu shots.

Chan said she would make a recommendation soon about the appropriate balance between the types of jabs.

"We are moving on two tracks to ensure some security for seasonal vaccine and at the same time kick-starting early scientific work for pandemic vaccine," she told the session.

MILD SYMPTOMS

The WHO chief commended countries with H1N1 infections for their "timely sharing of samples for risk assessment and making seed vaccine," saying that starting point for larger production of jabs could be ready by the end of this month.

And another top official, acting WHO director-general Keiji Fukuda, said there had been "rapid, widespread sharing of specimens" to date.

Participants in the two-day WHO meeting are seeking to reach agreement on standards for transparency, trust, and sovereignty related to virus sample sharing, an issue that is also expected to dominate next week's annual World Health Assembly in Geneva.

"I hope the end result is something really balanced that we can use for a long time," Fukuda said.

-snip-
But Chan stressed that important risks remain.

She said the WHO is closely watching parts of Southeast Asia that saw large outbreaks of H5N1 avian flu -- a virus that can be deadly when it passes from birds to humans, but has not spread easily between people to date.

A mixture of H5N1 and H1N1 viruses could have a big impact, she said, while stressing: "I am not saying it will happen."

Health Organization: the high incidence and mortality of new influenza

Saturday, May 16

ZURICH (Reuters) - World Health Organization said on Saturday that the number of confirmed human cases (H 1 to 1) new 8451 jumped to 66 wounded, including the case of the death.

The organization said that the States that have declared the emergence of cases of HIV infections is widely known as the swine flu rose to 36 after the state confirmed that Ecuador and Peru, the first cases in each.

Showed the vast majority of cases in Mexico and the United States.


And the payment of the spread of the disease to the WHO announcement that the epidemic has become imminent.

The organization raised in the 29 April state of alert in anticipation of the spread of the epidemic to the fifth grade on a scale of 6 degrees.


Said Margaret Chan, Director-General of the World Health Organization on Friday said there was "considerable uncertainty" about the new strain continued to proliferate may constitute a particular risk in South-East Asia.


Then, U.S. health officials said later they were down they have adopted warnings against travel to Mexico.


And follow the behavior of the new virus strains of seasonal flu, which spread rapidly causing symptoms slightly sick people and most severe at the other.



Cause seasonal flu in the death of 500 thousand people annually, mostly the elderly and those suffering from respiratory problems such as asthma.



The organization reported that Mexico had declared 2895 as the emergence of the virus confirmed cases including 60 deaths.


The United States has about 4714 injured, including four deaths.

Canada confirmed a case of 496 in addition to the nine cases in Costa Rica and in the event of the death of each.

من سانجيف ميلجاني By Sanjeev Migani

Turkey reports 1st 2 cases

May 16, 2009
Virus detected in travellers from the United States

ISTANBUL - TURKEY identified its first two cases of the H1N1 flu in a married couple travelling to Iraq from the United States, health officials and local media said on Saturday.

A 26-year-old American man, travelling from the US via Amsterdam, was found to be suffering from the H1N1 virus after arriving at Istanbul's Ataturk Airport en route to Iraq on Friday, Turkish Health Minister Recep Akdag said at a press conference that was broadcast live.

Authorities later determined the man's wife was also infected with the H1N1 virus, the NTV television channel said, without saying how it obtained the information. The husband and wife had been quarantined along with other family members and were under observation at a Turkish research hospital, where they were being given anti-viral medication, Mr Akdag said.

Turkey, a major tourist destination, becomes at least the 37th country in the world to report an incident of swine flu. The World Health Organisation (WHO) said on Saturday that 72 people have died from the disease or its complications.

The Iraqi-American family was travelling on a KLM aircraft to Istanbul that was carrying 163 passengers, most of whom are now being monitored for signs of the flu, said Mr Akdag.

The patients' family would be held in isolation at Istanbul's Haseki Hospital until May 21 to determine whether they too are suffering from swine flu, because the virus takes up to a week to manifest itself, Mr Akdag said.

'We know of the existence of a few (passengers) whom we've been unable to contact,' he added. 'They need to be alert so that they can be given preventative medicine and in order to protect others.'

Thermal cameras set up at the Istanbul airport had detected the man had a high fever, and tests at the national laboratory revealed he was carrying the H1N1 virus, Mr Akdag said.

His wife's infection was discovered after she submitted to testing at the hospital, NTV reported.

'Everything is under control,' Prime Minister Tayyip Erdogan told reporters when asked about the diagnosis of the country's first H1N1 case. 'Everything is being monitored closely.' -- REUTERS

New flu strain spreads to Turkey and India

Sat May 16, 2009

By Ayla Jean Yackley

ISTANBUL (Reuters) - Turkey and India confirmed their first cases of H1N1 flu on Saturday, all involving air passengers arriving from the United States.

Thirty-eight countries have now confirmed cases of the new flu strain, a mix of swine, human and avian viruses, which last month prompted the World Heath Organisation to raise its global pandemic alert level to 5 on a 6-point scale.

The western Japanese city of Kobe said it would close some public schools for a week after eight people were confirmed as being infected with the new H1N1 influenza, commonly known as swine flu.

Three of the eight were teenage students from the same school -- the first confirmed cases in Japan involving people who had not been overseas. The other five were from another school, Kyodo news agency said.

The WHO, whose data lags national tallies, had earlier put the number of confirmed worldwide cases at 8,451, with 72 deaths.

The vast majority of deaths -- 66 -- have been in Mexico, where the outbreak started. The United States has reported four, and Canada and Costa Rica one each.

FAMILY QUARANTINE

Turkey identified its first two cases in a married couple travelling to Iraq from the United States, health officials and local media said. Continued...

Swine flu suspect discharged from hospital

05/16/09 22:27

Bandung (ANTARA News) - After being confirmed as not carrying the swine flu H1N1 virus, ES (39), an airline co-pilot, was on Saturday discharged from Hasan Sadikin Hospital where he had been treated as a suspected swine flu sufferer.


"Based on the results of examinations by the Central Health Research and Development Agency, ES has been declared as suffering only from the common flu, not from swine flu that is caused by the Type A H1N1 virus. So today he has been allowed to return home," the chief of the team of doctors in charge of special infectious diseases at the hospital, Dr Hadi Jusuf, told ANTARA here on Saturday.

Hadi said to monitor ES`s health condition, the hospital had asked his family to continue watching over his health.

ES was referred to the hospital by a doctor at the local Husein Sastranegara airport on Tuesday, the team`s spokesman, Dr Primal Soedjana, said.

He said before being admitted to the hospital with suspected swine flu symptoms, ES had often traveled abroad , including to Singapore and Malaysia.

"His activities were marked by high mobility. He often traveled overseas and once had direct contact with a flu patient at one of the foreign airports," he said.

When he was examined he showed such symptoms as headache, running nose, sore throat, high fever and a quick heart beat, he said.(*)

9 injured in suspected cases of bird flu and Sohag lake

Saturday, May 16, 2009 - 16:05

قامت مستشفيات حميات دمنهور والإسكندرية باحتجاز 3 أشخاص، للاشتباه فى إصابتهم بمرض أنفلونزا الطيور بعد ظهور أعراض عليهم تتشابه مع أعراض مرض أنفلونزا الطيور عليها.

The hospital admitted the detention of Damanhour and Alexandria, 3 persons, suspected of having bird flu after an outbreak of symptoms were similar to the symptoms of bird flu it.


كان اللواء مجدى أبو قمر مدير أمن البحيرة قد تلقى إخطاراً من مستشفى حميات الإسكندرية باحتجاز فاطمة إبراهيم بيومى (5 سنوات) مقيمة بقرية العزة بأبو المطامير وطارق فتحى يوسف (19 شهراً) مقيم بكفر الدوار.

The General Director Majdi Abu Amar security lake has received notification from the hospital admitted the detention of Alexandria Fatima Ibrahim Bayoumi (5 years) resident village pride and Almtamir Abu Tarek Fathi Yusuf (19 months) residing in Kafr Dawar.


كما قامت مستشفى حميات دمنهور باحتجاز محمد أحمد الغلبان (21 سنة – عامل زراعى) ومقيم بإيتاى البارود، وذلك بعد الاشتباه فى إصابتهم بمرض أنفلونزا الطيور، حيث ظهرت عليهم أعراض ارتفاع شديد فى درجة الحرارة والتهاب بالحلق وضيق بالتنفس وآلام بالعظام، وتم أخذ عينة دم من المصاب لفحصها معملياً.

The hospital has admitted the detention of Mohamed Ahmed Damanhour Ghalban (21 years - a working farm) and a resident Biitay powder, after suspected bird flu patients, where they showed severe symptoms of high fever and throat infection and lack of breathing and the pain of the bones, blood samples were taken from infected laboratory for examination.


وعلى الفور تم التنسيق مع مديرية الطب الوقائى والإدارة الصحية والطب البيطرى، حيث تم عمل حملة لمنازلهم حيث تم تطهير المنازل والمنازل المحيطة وكذا المخالطين لهم، وتم أخذ عينة من الدواجن الموجودة بالمنزل لفحصها معملياً.

And immediately was coordination with the Directorate of Preventive Medicine and Department of health and veterinary medicine, where they were the work of a campaign to clean up their homes with the surrounding houses and homes, as well as their contacts, and was taking a sample of the existing poultry house laboratory for examination.


هذا كما احتجزت مستشفى حميات سوهاج خمس حالات جديدة بعد ظهور أعراض المرض عليهم من ارتفاع فى درجة الحرارة ورشح وإعياء وهم عطيات إسماعيل احمد (29 عاماً) ربة منزل ومقيمة بأخميم وسناء رجب السيد (32 عاماً) ربة منزل ونجلتها فريال نصر على عطية (3 أعوام) ومقيمين بندر طهطا وزهراء هراس فضيل (عامان)، وهاجر شكرى عبد الله (5 أعوام) ومقيمين ببندر أخميم وأوفا صبرة محمد (30 عاماً) ونجفة محمد أحمد (32 عاماً).

This also held hospital fevers Souhag after five new cases reported symptoms of fever, fatigue, and they nominated Attiyat Ismail Ahmad (29 years) and a housewife and resident Bokhmim Mr. Recep Sana (32 years) and housewife Ngeltha Feryal insist Attia (3 years ) and the residents of Bandar Tahtah and Zahra Fidail bike (two years), and emigrated Shukri Abdullah (5 years) and residents Bbandar Okhmim Sabrah Ofa and Mohammed (30 years) and Najafp Mohamed Ahmed (32 years).


تم أخذ عينات من المشتبه فى إصابتهم وإرسالها إلى المعامل المركزية بالوزارة لبيان مدى إصابتهم بالمرض من عدامه. Sampling of suspected infection and sent to the central laboratories of the ministry's statement of the extent of the illness, Aadamh.

Deporting Palestinians suspected child afflicted swine flu

Saturday, May 16, 2009 - 18:34

Egyptian security authorities decided to deport a child named Mohammed Nassar (12 years) to the Gaza Strip today after entering the Rafah crossing, on suspicion of being infected with swine flu.

وقال مصدر طبى بشمال سيناء إن الطفل ظهرت علية أعراض الأنفلونزا خلال دخوله من المعبر وهو ما استوجب احتجازه فى مستشفى الحميات لإجراء الفحوصات والتأكد من إصابته بأنفلونزا الخنازير من عدمها، إلا أن تعليمات أمنية صدرت بترحيل الطفل مباشرة إلى قطاع غزة ومنع أية حالات أخرى مشابهة من الدخول لمصر.

A medical source said that the northern Sinai, the child developed symptoms of influenza during the entry of the crossing, which necessitated detention in hospital for a fever and tests to make sure flu from pigs or not, but the security instructions issued to deport the child directly to the Gaza Strip and prevent any other cases similar entry to Egypt.


يذكر أن الطفل دخل إلى مصر من أجل إجراء عملية جراحية بعد أن فشلت أسرته فى علاجه بإسرائيل.

States that the child came to Egypt to undergo surgery after his family failed in the treatment of Israel.

Egypt Suspected Cases as of May 16th

This is a list of suspected cases in Egypt's northern Governorates. This list only goes back as far as May 14th.

Gharbiyah Gov.

Mahallah

Post #95: May 3rd:
He also met with hospital fevers Mahallah Magda Saleh Ahmed, 30, and Magda Abdel Shafi 32 years old, dead from the village of Habib Smonod Center,

Post #102: May 7th:
While detained fevers Nada Abdallah Ghazi al-Mahalla (6 years) from the village of Kafr El-Mahalla Dkhamis Center, and Norhan Sameh (3 and a half years) from the village of Mahala dead Sarraj Center, and Alaeddin Sameh (two years) Mahallat cane Mahallah Center, Abdullah Hussam Shahawi (two years) of the Village Center Jabriya place.

Post #106: May 9th:
Detained hospital admitted Tanta area and 4 new cases of suspected infected with bird flu, after the sense of high temperature and lack of breathing and severe bone pain, fevers, where the detention Mahallah Huda Abdul Rahim (27 years) from the village of Kafr Hegazy Center area and Mahmoud Mohamed Sabry two and a half from the village of monks Smonod Center.

Post #127: May 13th:
The Mahalla and Tanta fevers, the detention of three new cases of suspected bird flu, with fevers held Mahala, Safiya Mohamed Suleiman (32 years old housewife),

Post #142: May 15th:
Fathi El-Mahalla made Abdalmqsod (61 years)

Post #143: May 15th: (confirmed) #71
3 yo
Village: Mahalla

Post #144: May 6th (posted May 15th)
34 yo
Tanta District, Gharbia Covernorate (confirmed) #68

Post #149: May 16th
Mus'ad Ibrahim Nasr (9 years) from the village of Mahala Abshit Center
Ahmed Mukhtar Abdelkhaliq stones (3 years) from the village of Shubra Babil Center area
Amr Mahmoud Manna (5 years) from Kafr El-Mahalla Irtunp Center
Yusuf Sayed Ahmed (57 years) Specialist analysis of medical Ibcoay Almlq Qtor Center.

Post #176 May 16th
[listed as in both Mahallah & Tanta]
Fathi Abdel-Maksoud, «61 years» Awad, and
Manal Ismail «28 years»




Tanta

Post #133 May 14th
Mustafa Mokhtar Abdel Wahab (23 years), village of Alqrchip Center Alsentp
Nagwa Ibrahim Mansour (23 years) Tanta,
Reza Ahmed Ramadan fine (40 years) Kara Tlapt of Caesar Center Tanta
Mohammed Abdulghaffar Ghurab 45 years of Berma.

Post #142 May 15th
Reza Mohammed Ahmed (40 years) of Caesar Tlapt,
Mohamed Ibrahim Abdulghaffar (45 years) of Berma.

Post #149 May 16th
Muhammad Abdel-Al (40 years) Btnta
India Ngeltha Ahmed (20 years) from the scene Btnta.



Kafr Ash Shaykh Gov.
Kafr El-Sheikh



Post #134 May 14th
Mohamed Radwan Hawwari (3 years) and friend
Nasser Rowan (7 months) and
Abdel Rahman Musa Rida (8 months) and
Munira Reza Abdul Samad (7 years) and
Ahmad Reza Abdul Samad (two), and brother
Faris Abdul Samad Reza (3 years ),
Magdi Abdel-Al Hendawi (39 years) and
Mona Ciny mouse (27 years) and the immortality of
Mohamed Abdel Fattah (20 years) and
Aziza Hassanein Junaidi (21 years) and
Raja Mohammed Saleh (49 years).

Ash Sharqiyah Gov.
Zagazig

Post #140 May 15th
Mahmoud Ali El-Shafei (4 1/2) from Kafr Saqr, confirmed #70

Post #141 May 15th
detained four suspected human cases of bird flu


Menoufia [Minufiyah] Gov.
Shibin

Post #134 May 14th
Salwa Baha'eddin Afify (47 years), Bhmyat Shebin,
Samar and Ruslan Abdul forces (5 years) and her brother
Abdul Rahman (one year and two months), Hdzhma Bhmyat al Naoura,

Post #141 May 15th
Salwa Afifi (45F) Kom Bcpin resident





Menya
Post #140 May 15th
Jamal Abdulmohsen (4), from the village of Taha columns
Saadiya Abu-Zeid and
Abdel Aal (56) the village of el-Amarna East


Al Buhayrah Gov.

Damanhour
Post #141 May 15th
Mai Mohamed Zaki "4 years"
Mahmudiya Mohamed Ibrahim Ghoneim (23) of Obouhms Tamer
Mohamed Ahmed "5 months"


Dakahlia [Daqahliyah] Gov.

Mansurah

Post #140 May 15th
Mustafa Muawwad (33) and
Sakina Saad Naeem (33) from the village need Ratiba,
Ibrahim Ismail (63) from the village of stone Ooic Center Mansoura,
Mahmoud Attia marina (40) of Belkas,
Hoda Hamdi Mahmoud, (2 1/2) of the Arab village of Kafr center line.

Post #177 May 16th
Fathi made Abdalmqsod (59)
Ibrahim Awad Ibrahim (30)
Shehata Reda Gomaa(55)
Alasal (52)
Mas'ada Hassanin (55)

Egypt

Click on map:

The transfer of 250 doctors from the General Hospital, Kafr El-Sheikh

[Older article - May 7th]

Thursday, May 7, 2009 - 13:17
Maj. Gen. Ahmed Abdeen, the governor of Kafr El-Sheikh for the seventh day, that plan has been prepared in collaboration with Dr. أسامة فريد وكيل وزارة الصحة بكفر الشيخ لنقل 250 طبيبا، من بين 491 طبيبا متواجدين بمستشفى كفر الشيخ العام فوق حاجة العملية الطبية بالمستشفى، وتوزيعهم على المستشفيات المركزية لنقل عدد منهم، وندب آخرين للوحدات الصحية القروية، وذلك على دفعات من أجل إعادة التوزيع العادل بالمستشفيات، ووصول الخدمة الطبية للفلاح بقريته.

Osama Farid Deputy Minister of Health Sheikh kaafirs for the transfer of 250 doctors, 491 doctors of the present General Hospital, Kafr El-Sheikh over the need for the hospital medical process, and distribution in the central hospitals to transfer a number of them, and the assignment of other rural health units, and the payments for the restoration of an equitable distribution of hospital, and the arrival of medical service for farmers in his village.


يأتى ذلك القرار، بعد الاعتراض الذى أعلنه أطباء كفر الشيخ لنقل 21 طبيبا من مستشفى كفر الشيخ العام الى المستشفيات المركزية بمختلف أرجاء المحافظة، خلال الجمعية العمومية الطارئة بنقابة الأطباء الفرعية أول أمس، الثلاثاء، برئاسة د.

That decision came after an objection by the doctors of Kafr el-Sheikh for the transfer of 21 doctors from the General Hospital of Kafr el-Sheikh to the central hospitals across the province, through the General Association of public emergency the first Subcommittee on doctors, on Tuesday, headed by Dr..
محمد فؤاد نقيب أطباء كفر الشيخ. Mohamed Fouad Al Doctors Syndicate.

Including three children .. الاشتباه فى إصابة 6 حالات بأنفلونزا الطيور بالغربية 6 injured in suspected cases of bird flu meeting Sunday attended by

Saturday, May 16, 2009 - 13:05
Detained hospital admitted Tanta and Mahala 6 new cases of suspected bird flu patients after feeling symptoms of the disease.

حيث احتجزت حميات المحلة مسعد نصر إبراهيم (9 سنوات) من قرية لابشيط مركز المحلة وأحمد عبدالخالق مختار الكريمة (3 سنوات) من قرية شبرا بابل مركز المحلة وعمرو مناع محمود (5 سنوات) من كفر إرطنة مركز المحلة ويوسف سيد أحمد (57 سنة) أخصائى تحاليل طبية من إبشواى الملق مركز قطور.

Where she was detained fevers Mahallah Mus'ad Ibrahim Nasr (9 years) from the village of Mahala Abshit Center and Ahmed Mukhtar Abdelkhaliq stones (3 years) from the village of Shubra Babil Center area and Amr Mahmoud Manna (5 years) from Kafr El-Mahalla Irtunp Center and Yusuf Sayed Ahmed (57 years) Specialist analysis of medical Ibcoay Almlq Qtor Center.


فيما احتجزت حميات طنطا كلاً من سحر محمد عبد العال (40 سنة) ونجلتها هند أحمد (20 سنة) من منطقة الساحة بطنطا.
Tanta fevers held in both the magic of Muhammad Abdel-Al (40 years) and India Ngeltha Ahmed (20 years) from the scene Btnta.


وتم أخذ عينة دم من المرضى ومسحة حلق وإرسالها للمعامل المركزية بوزارة الصحة للتأكد من إصابتهم بالمرض من عدمه، كما تم إعطاؤهم عقار التايمفلو لحين وصول نتيجة العينات المأخوذة منهم.
Blood samples were taken from patients and melancholy hours, and sent to labs central Ministry of Health to make sure whether the disease has also been given the drug Altaymflo until the arrival of the result of samples taken from them.