Avian Flu - What we need to know

H5 infections in Ibaraki, Japan

Antibody tests showed Tuesday that chickens at seven more farms in Ibaraki Prefecture may have been infected with a bird flu virus of the H5 strain in the past, the prefectural government said.

Chickens at two farms near the seven in the town of Ogawa have already tested positive for antibodies to the virus.

The prefectural government imposed a ban on transferring chickens and eggs from an area surrounding the seven farms to places outside.

It will also decide whether to cull the chickens at the farms after hearing from an expert panel of the Ministry of Agriculture, Forestry and Fisheries.

The prefectural government has confirmed that chickens at 14 farms were infected with the avian influenza.

The story comes from Kyodo News.

Vaccination program starts in Hanoi

A trial poultry vaccination programme began in the Vietnamese capital in a bid to combat bird flu, which has caused 42 deaths in the communist nation.

"After the pilot program, which started Monday, a mass vaccination campaign will be launched in Hanoi between September 15 and 30," Dao Duy Tam, deputy director of Hanoi's agriculture and rural development department, told AFP.

[...] The government, which earlier planned to begin vaccinating 80 percent of its more than 200 million chickens and ducks in October, decided to bring the start forward to September.

Vietnam wants to complete the mass vaccination before winter, which is believed to be the prime time for the virus to spread.

Source.

More airport quarantine stations in the US

The government plans to more than triple the number of quarantine stations at airports around the country and hire scores of health officers as part of a broad plan to try to stop deadly infectious diseases from entering the United States.

Ten new stations, at airports stretching from Alaska to Puerto Rico, are already open or nearing completion, and about 50 new health officers are undergoing training. The Centers for Disease Control and Prevention plans to build an additional seven stations as soon as it can get the money. Eight stations that have existed for years are gaining staff, so that when the plan is complete, the country will be blanketed by a network of 25 centers designed as a first-line of defense against a global disease pandemic.

[...] If a global pandemic looms, though, the plan calls for the centers to play a key role in setting up a firebreak that would try to keep the disease out of the United States. The stations would help coordinate broad programs under which thousands of air travelers might be subject to medical evaluation, or offered medical pamphlets and advice, before being allowed to enter the country. Federal experts emphasized that passengers would be quarantined only if there is strong reason to suspect they have been exposed to a serious disease, and then only long enough rule out that possibility or get them into medical-isolation wards at hospitals.

The Washington Post has the entire story.

Bird flu in Finland

Health officials believe that a number of sick seagulls found in the Finnish city of Oulu were carriers avian influenza, or bird flu virus.

The Helsinki laboratory of the National Veterinary and Food Research Institute of Finland (EELA) published the results of its study on Friday. Final confirmation is expected in three weeks once the EU’s Reference Laboratory in Britain has examined the samples.

The Ministry of Agriculture and Forestry says that the sick gulls were found in connection with an intensified monitoring programme aimed at preparing for the possible spread of bird flu.

A member of the public saw the birds, concluded that they might be sick, and alerted the Oulu laboratory of EELA. About ten seagulls were found, and about half of them were already dead.

Officials say that the virus in question is probably a weak low-pathogen version, which does not spread as easily as the more dangerous variation.

[...] Finland has prepared for a possible bird flu pandemic by acquiring 1.3 million doses of an anti-viral medicine.

The virus found in Finland is not H5N1. Read the full story here.

H5N1 found in Vietnamese civets

"One mother and two children of the endangered Owston's palm civets died in the same cage in June with a confirmation of H5N1 infection by a laboratory in Hong Kong," said Hoang Van Than, deputy director of the Cuc Phuong National Park in northern Ninh Binh province, 90 kilometres (55 miles) south of Hanoi.

Some chickens raised by farmers nearby had also succumbed to the virus while only three of the more than 20 civets raised in the park were infected, Than said.

Here is the story. Civets were suspected at one point to be the source of SARS in China.

Russia continues to struggle with flu

Russia is stepping up measures to contain the spread of the deadly bird flu virus amid signs the outbreak is stabilizing, Reuters reported Thursday quoting Russia’s chief epidemiologist, but Kazakhstan said it was probing possible new cases.

“Deaths of wild fowl continue to occur, although less intensively,” Gennady Onishchenko, head of Russia’s state consumer rights watchdog and top epidemiologist, told reporters.

Read the entire article here. One of the latest measures taken by the government is to ban bird hunting.

The spread of bird flu to Europe

According to UN officials the Balkans may be the gateway for bird flu in Europe:

Millions of birds migrate each year to Black Sea neighbours Romania and Bulgaria for the milder winter climate, making the area a potential gateway to central Europe for the bird flu virus, which has already swept into Russia from southeast Asia.

[...] "Knowing the flyways and the bird species that use them, there is a high likelihood that the virus will continue to spread as it has so far," Jutzi, Director of the Animal and Production and Health Division of the U.N.'s Food and Agriculture Organisation, told Reuters.

"Particularly in the southeastern part of the Balkans, given that these flyways go down there ... It is quite probable in the future and is a major concern for us."

WHO receives Tamiflu donation from Roche

The World Health Organization (WHO) began on Wednesday to build a first line of defense against a feared global bird flu pandemic with a major drug donation from a leading Swiss firm.

The United Nations agency said a donation by Swiss drug maker Roche of enough of its Tamiflu antiviral to treat 3 million people could slow the spread of the outbreak among humans, especially in countries too poor to afford their own stockpile.

The Reuters story is encouraging, but the much more needs to be done if the drugs are to be effective as a "blanket" to slow the virus within an initial outbreak area. Early detection is essential.

How long do the negative consequences of flu epidemics last?

There has been a recent study of the 1918-1919 flu.  It turns out that the pandemic affected health outcomes for many decades to follow.  Here is the abstract:

In the 1960-1980 Decennial U.S. Census data, cohorts in utero during the height of the Pandemic typically display reduced educational attainment, increased rates of physical disability, lower income, lower socioeconomic status, as well as accelerated adult mortality compared with other birth cohorts. In addition, persons born in states with more severe exposure to the Pandemic experienced worse outcomes than those born in states with less severe Pandemic exposures. These results demonstrate that investments aimed at improving fetal health can have substantial long-term effects on subsequent health and economic outcomes.

Thanks to Alex Tabarrok for the pointer, his post contains a lengthier and interesting discussion of the 1918-1919 pandemic.

FT coverage of bird flu

Today the Financial Times features a number of bird flu articles, starting with a front page story on the latest measures taken by European countries. In another article we learn that there is considerable divergence of opinion in the EU on how big of a threat bird flu is:

The Netherlands yesterday ordered farmers to keep poultry inside to prevent bird flu spreading into the country.

However, the UK played down the threat posed to domestic fowl from migratory birds. The Department for Environment, Food and Rural Affairs said it was not planning any measures to keep poultry indoors.

In Europe, the Netherlands has most experience in dealing with the bird flu:

The spread of the virus two years ago among its nearly 2,000 poultry farmers led to the slaughter of 30m animals at a cost of hundreds of millions of euros.

“Poultry farmers are very afraid that this strain will arrive in western Europe. In 2003 many farmers were hit hard by what happened and it took a lot of time for them to get going again. Nobody wants this to happen ever again,” said Klass Johan Osinga, of the LTO Dutch farmers’ union.

The Netherlands last year exported almost €500m worth of eggs, making it the seventh largest producer among the EU’s then 15 countries. In 2003 it produced nearly 600,000 tonnes of poultry meat.

A separate FT article covers the latest vaccine developments:

GlaxoSmithKline is gearing up to file for preliminary European regulatory approv- al by the end of this year for a pandemic flu vaccine that could be used to tackle the future spread of the lethal H5N1 virus.

The move marks an early attempt by one of the world's largest vaccine manufacturers to prepare for high-volume production in accordance with European Union regulations on pandemic flu passed in 2004.

[...] GSK is in the final stages of compiling all the necessary documentation designed to show the European Medicines Agency its technical skills and production methods in order to make subsequent authorisation of a specific vaccine easier.

The company has already run clinical trials showing successful treatment of other flu strains using its flu vaccines in combination with a common “adjuvant” designed to help further boost the response of the human immune system.

The move comes ahead of its planned launch of clinical trials early next year with a potential H5N1 flu vaccine in combination with a proprietary adjuvant, from its “AS” range, which it believes will provide it with a substantial edge over its competitors.

GlaxoSmithKline currently manufactures the antiviral medicine Relenza, also reviewed in an article from today's FT.

Read the entire batch of articles in the FT, hat tip to the New Economist for the links.