Bird flu in Vietnam

The following two articles are quite interesting for their up close look at life in Vietnam in the bird flu era.

Vietnam was initially the most hard hit country. Until recently passed by Indonesia, it had the most deaths from avian flu of any country in the world.

Yet it has successfully turned that around. In the past year, there've been no chicken flu cases found in people and only a few in birds.

It stands in stark contrast to Indonesia, where governments efforts to control the spread of bird flu are much weaker. And even to Thailand, which until recently also seemed to have the disease under control. But that country has had a small resurgence corresponding to political turmoil.

It's politically correst to say that Vietnam has been successful not because it's an authoritarian, socialist regime . . . but because they've attained consensus at every level.

They've achieved consensus at every level because it's an authoritarian, socialist regime.

That doesn't mean that ordinary people want bird flu back again, just that they know they must follow the government's lead.

bird flu prevention in Vietnam

bird flu and Vietnamese culture

The latest page added to my site on bird flu is:

bird flu complications -- encephalitis

Bird Flu in Vietnam
Bird Flu in Vietnam

Bird flu case in Iraq

Considering the number of people in Iraq, especially Baghdad and the Sunni triangle, dying from bombings by terrorists and from private militias and death squads, bird flu probably doesn't seem like a major threat.

However, Iraqi authorities have now learned that a boy who had respiratory problems earlier this year, and fortunately recovered, was infected with bird flu.

bird flu in Iraq

If chickens or other bird were infected with the H5N1 virus earlier this year, where did it go?

Given the security risks in the four out of fourteen Iraqi provinces where remaining Bathist followers of deposed Saddam Hussein and foreign terrorists are still active (the mass media is not telling you the violence is bad but contained - most of Iraq is reasonably peaceful and under government control.), it seems unlikely that the government could mount an effective response to H5N1 infections in chickens and people.



Bird Flu in Iraq
Bird Flu in Iraq

Bird flu in Bali pigs

One thing that has puzzled me about the spread of bird flu is the absence of researchers finding the disease in pigs.

That's good news, but now that's changed.

bird flu in pigs

The reason the lack of news about avian flu in pigs is good news itself is that pigs can catch both human and avian influenzas. Many influenza experts have feared the potential of pigs to act as genetic mixing bowls where ordinary seasonal human flu viruses interact with the H5N1 bird flu virus to create new genetic combinations . . .

. . . which could include a strain of virus with the strength and lethality of bird flu and the ability to easily pass from human to human of ordinary seasonal flu.

Through much of Asia, small farmers keep both chickens and pigs, often in the same building.

So far, a pandemic influenza has not emerged from some pig in Asia, but the potential is still there, as the above article shows.

We may be thankful that the country currently with the most widespread bird flu infections is mostly Muslim. So far as I know, most Indonesians do not keep pigs, because it is forbidden by their religion.

However, the people of Bali are mostly Hindus. They would not raise cattle for food, but are not forbidden to keep pigs.

Let's hope that the pigs of Bali do not breed a pandemic.


a bird flu complication -- encephalitis



Bird Flu in Pigs
Bird Flu in Pigs

Bird flu virus resisting Tamiflu in Thailand

The link is not currently working, so I'm not including, but I recently read an interesting article that appeared in The Bangkok Post.

A research study in Thailand found signs that the H5N1 bird flu virus was developing resistance to Tamiflu (oseltamivir).

This is bad news for everyone in the established medical system who is pinning all their hopes of defeating this disease on that drug.

The team allegedly found actual changes in the neuraminidase protein (which is how the virus breaks out of infected cells to infect more cells). Tamiflu works by inhibiting the function of neuraminidase. If the virus cannot break out of the infected cells, they cannot infect news ones.

The study will soon be published in the Emerging Infectious
Diseases Journal and Journal of Virological Methods.

Previously, resistance to Tamiflu was found in some H5N1 samples taken from Vietnamese victims in 2005.

There's been no known human to human transmission of Tamiflu-resistant bird flu, but such strains could still infect chickens and ducks.

Whenever anyone is diagnosed with avian flu, everybody around them, all family, friends and neighbors, are also being given treatments of Tamiflu.

This wholesale use of the drug is likely encouraging the H5N1 virus to develop into resistant strains.

The widespread use of Tamiflu to treat flu victims has also contributed to the finding that the human flu H3N2 virus also also developed resistance to Tamiflu.



Resistance to Tamiflu Discovered
Resistance to Tamiflu Discovered

New bird flu case in Eygpt

Bird flu seems to be able to go through periods where it's dormant, and authorities think they have it under control -- and then it pops up again.

A woman in Eygpt is the latest victim. But she is the first human avian flu patient since May.

Eygptian woman latest bird flu case

The avian bird flu virus was first found in Egypt in February 2006, and it spread from around March to May. But the government did act quickly to cull chickens, and by the end of May seemed to have it under control.

Plus, in Egypt almost all commercially raised chickens have been vaccinated, and about 20% of "backyard" chickens.

But recently they found an outbreak of the disease in some chickens.

Then this woman found some of the ducks she kept sick and dying. She killed them and plucked their feathers, thus exposing herself to the H5N1 bird flu virus.

So far, Egypt is the country with the most number of bird flu cases outside Asia.


High Fever -- a bird flu complication





New Bird Flu Case
New Bird Flu Case

Qinghai Lake bird flu virus samples sent to U.S.

In the spring of 2005, a major die off of migratory birds around Qing Hai Lake in China signalled the emergence of a new strain of bird flu, now known as Qinghai Lake strain.

It's considered scientifically important because it is genetically different from the strains of bird flu going around SouthEast Asia -- Thailand, Vietnam and Indonesia.

The Qinghai Lake strain spread to the Middle East and Africa, presumably via migratory birds, because Qinghai Lake is a major resting place for migrating birds in Asia.

Because it's the dominant strain in Africa, understanding it may be important to fighting the disease in that country, where resources are much scarcer than in even the poor parts of rural Asia.

However, China has not released the genetic information on Qinghai Lake, until recently.

On September 28, samples taken from dead birds found around Qinghai Lake in early 2005 have been sent to the U.S., so the Center for Disease Control CDC can run sophisticated genetic sequencing analysis on them.

This should enable scientists around the world to learn more about how the H5N1 virus has developed and mutated and therefore how this subtype may mutate in the future.



China shares Qinghai Lake bird flu isolates





Qinghai Lake Bird Flu
Qinghai Lake Bird Flu

Up to 25% bird flu in Indonesia back yard poultry

Here's a good overview of some of the problems we face in controlling the spread of the H5N1 avian influenza virus, particularly in Indonesia.

A survey found the H5N1 virus in 27% of chickens in flocks and caged, in some of Indonesia's most densely populated areas. The methodology of the survey is given, so we don't really know how widespread the problem really is, but I suggest that if even a mediocre survey can find 27% H5N1 infection in chickens anywhere in the country, that country's got a big problem.

Yes, given Indonesia's weird and widespread geography, there're probably plenty of provinces of that country where avian flu is nowhere to be found at all.

But we know from the hospital admissions of bird flu patients that the virus is spreading to people in ever-greater numbers in highly populated areas.

And of course, highly populated areas with bird flu are what we should fear the most. Because if the virus starts spreading from person to person and mutates into a strain that expedites that contagion, it will happen fastest the more victims it can easily find close by.

Therefore, pandemic influenza likes population density of victims.

And the more the virus spreads, whether in chickens or people, the greater the likelihood that it will eventually mutate into a highly contagious but still lethal strain.



Bird flu in up to 25% of Indonesian back yard poultry


Bird Flu Complications -- Encephalitis


Indonesia Bird Flu
Indonesia Bird Flu

Indonesia bird flu case number 69

The victim is a 21 year old woman from the province of East Java. She is still hospitalized after being admitted September 25.

Avian flu takes time to cure and get over, even when you're in the hospital.

She is the older sister of an 11 year old boy who died on September 18, and since they were living in the same household, it's most likely that she caught the disease from the same source -- sick chickens. Chickens in their household have died both before and after this boy's death.

Out of 69 known bird flu cases in Indonesia, 52 have died, so the mortality rate in that country is running well ahead of the overall 55% mortality rate for Asian flu patients.



Bird flu Case 69 in Indonesia





Indonesia Bird Flu
Indonesia Bird Flu

New Chinese bird flu outbreak

About 1000 chickens died from bird flu in northern China, in Henan New Village in Yinchuan. Another 72,930 have been slaughtered to control the bird flu H5N1 virus.

Supposedly, this new outbreak is now under control.

If you have to wonder -- where is the H5N1 virus while all outbreaks are "under control?" If they're really "under control," then where do new outbreaks come from?


New bird flu outbreak in China


Complications of bird flu -- high fever



China Bird Flu
China Bird Flu

Bird flu medical research

This is an interesting article on a research study of bird flu.

It concludes that one reason the H5N1 avian influenza virus is so deadly to people, is that it replicates much more than ordinary seasonal flu. Plus, the virus apparently gets into the bloodstream of victims, which doesn't happen with seasonal influenza.

This increase in viral load in the lungs and throughout the body is what triggers the extreme inflammatory response from the body -- the cytokine storm which can be as fatal as the infection itself.


bird flu replication helps account for extreme virulence


Bird Flu Research
Bird Flu Research

official WHO bird flu case definitions

Here's the expert medical guidelines for diagnosing avian influenza. Here's hoping that this gets out to every doctor and nurse in every bush clinic in the Eastern Hemisphere. Too many possible bird flu cases are never tested, even when they're in children who're siblings of known bird flu victims!

One thing I spotted that makes me wonder -- they mention looking for respiratory problems and high fever, which makes sense -- but ignore possible encephalitis cases. That could be caused by an H5N1 infection.

Also of concern is that the guidelines include close contact with either a sick person or chickens. If H5N1 does mutate into a highly contagious form, it could quickly spread to people who don't know they have had contact with people with bird flu.

That is, just as with any influenza, you can catch avian bird flu from shaking hands with someone who is also infected but doesn't even know or show it themselves, because they're still in asymptomatic.

So a doctor going strictly by these guidelines would not suspect you had bird flu, not test you for it, and just think you had ordinary seasonal flu or something else -- and let you go spread it to other people.

WHO avian influenza case definitions and guidelines


How you can protect yourself from bird flu related pneumonia



WHO Bird Flu Case Definitions
WHO Bird Flu Case Definitions

Global Initiative on Sharing Avian Influenza Data (GISAID)

This is a great new development. Veterinary virologist Ilaria Capua has emerged as the latest hero in the fight against bird flu.

Genetic sequences of samples of H5N1 taken from infected people and chickens have been keep private, so that researchers would be sure to get credit for their work. The only way to access many sequences has been restricted to the 15 flu laboratories working with the United Nations World Health Organisation WHO.

This is understandable, and they should get credit. However, keeping these sequences locked up has prevented anybody from getting a full, big picture of how the virus is changing over time . . . which could indicate where and when it's on the verge of becoming highly infectious.

Ms. Capua of the Vialle dell'Universita in Padova, Italy started rebelling against this in March this year -- she began posted flu sequences to GenBank, where it's publicly available.

Thanks to her example and pressure on the rest of the research community, many leading avian influenza scientists have tentatively agreed to share data. They have agreed to set up the Global Initiative on Sharing Avian Influenza Data (GISAID). The letter outlining the agreement is signed by 70 scientists and health officials, including six Nobel laureates.

They'll all still get credit for their contributions, as they obviously should, but we'll all benefit by this sharing of H5N1 genetic sequences.

bird flu genetic database will be set up





Bird Flu Genetic Database
Bird Flu Genetic Database

more suspected bird flu cases in Indonesia

There're 3 new suspected cases of bird flu in Indonesia -- in a new area, the province of Central Sulawesi.

Two toddlers and a 21 year old housewife (mother of the children?) have been hospitalized in the Undata Hospital, in the capital of the province, Paludue.

They all live in the Kamonji district where authorities recently found chickens dead of avian influenza.

It'll take time before these cases are confirmed or not as chicken flu from the H5N1 virus. Still, they illustrate that Indonesia is not getting the situation under control. One day they're going to wake up and realize they've got a full-fledged emergency on their hands. It seems that the government is not going to take all-out effective action until they wangle more money from wealthier countries.

more suspected bird flu cases in a new province of Indonesia


What are the Symptoms of Bird Flu


Bird Flu in Indonesia
Bird Flu in Indonesia

low pathogenic bird flu in North American swans

For any of you still worried . . . the variety of H5N1 found in those mute swans in Michigan not long ago is NOT the high pathogenic avian influenza HPAI we call bird flu. It's low pathogenic avian influenza, which means it's the North American strain of H5N1.

It's not new, and it's not dangerous. Not to the swans and not to us. It's been found in this hemisphere before.

low pathogenic avian flu in North American mute swans





Bird Flu in US
Bird Flu in US

Finally, bird flu genetic info from Indonesia

Here's welcome news -- Indonesia is making genetic sequences of bird flu virus isolates available to the public. This means that scientists around the world can study and map the information, to determine what is happening to the virus in that country.

The bird flu virus will be both from those infecting human patients and those found in chickens. This is important because there's a suspicion that the virus is going from person to person more than WHO is acknowledging, rather than everybody catching it from chickens.

So scientists wants to see if the isolates found in human patients matches or not isolates found in nearby infected chickens.

Indonesia sent 91 avian flu viruses to the Geelong Laboratory in Australia. That's a reference laboratory for the United Nations Food and Agriculture Organization FAO.
Information from the CDC was transferred to the U.S. Department of Energy's Los Alamos National Laboratory. And also Genbank.
Another laboratory, at the University of Hong Kong and run by influenza expert Dr. Malik Peiris has also transferred work to Los Alamos.

Indonesia makes genetic bird flu isolates open to public



What is the Definition of H5N1


Bird Flu Genetics
Bird Flu Genetics

bird flu in cats in Iraq

People are not the only mammals that the H5N1 bird flu virus infects -- there've also been reports of cats infected with the disease, from Germany to tigers in the Bangkok Zoo, and reports from Indonesia.

Now it appears that some cats in Iraq caught the virus from eating dead chickens. The strain of the H5N1 appears to be the same as the one that infected a person in Iraq not long ago.

This is the strain of H5N1 called Clade II, also called the Qinghai strain because it was first found in dead migratory birds around Qinghai Lake in 2005.

Fortunately, the cats were in the northern, Kurdish area of Iraq. I say that because I'm assuming this area has relatively few American soldiers, because the Kurds are keeping their area of Iraq free of terrorist violence (the problems are almost all in the Sunni triangle area -- NOT the entire country). Otherwise there's the possibility, although remote, of American soldiers catching bird flu from infected cats.

bird flu infects cats in Iraq





Bird Flu in Cats
Bird Flu in Cats

More on Tamiflu and bird test results

Here's some more information about how taking Tamiflu or oseltamivir (generic) can interfere with test results and give false negative results in bird flu patients.

When bird flu in an area is suspected, oseltamivir or some equivalent is being given to anybody who might have had contact with a known victim or the dead chickens. If they later become sick, the oseltamivir may be inhibiting the H5N1 virus from replicating.

That means that there's not enough virus in their throats to detect using the standard throat swab.

Yet we know that treating somebody with an antiviral drug should begin within 48 hours of the onset of symptoms. And that's pushing it. The sooner, the better.

So you can't wait for test results before beginning the treatment, if they appear to have the flu. Laboratory testing takes days.

If the person took Tamiflu 2 to 3 days before the test, they could have avian flu but come up negative on the test.

Seems to me this is a good thing for the individual patient, but epidemiologists who're concerned with tracking the disease are concerned.

Tamiflu interferes with bird flu test results


What is the Difference Between Bird Flu and Ordinary Seasonal Flu


Bird Flu and Tamiflu
Bird Flu and Tamiflu