Pandemic Flu from Europe

European recomendations on Non Pharmaceutical Interventions

2006-11-08T09:12:00.000Z

On 2006-10-12, the European Centre of Diseases Control has published "Personal (non-Pharmaceutical) Public Health Measures for Reducing Transmission of Human Influenza - Interim ECDC Recommendations". (The US has a similar document, called "Interim Guidance on Planning for the Use of Surgical Masks and Respirators in Health Care Settings during an Influenza Pandemic".)

It makes a reference to two documents by the World Health Organisation (one on National and Community Measures and another on International Measures). My short summary: local measures will work to a certain extent and we should prepare for them, but international measures probably won't do much. Of course, don't take my word for it: go read the reports.

The ECDC document doesn't yet acknowledge the publication of very important data on "modeling community containment" by the Institute of Medicine (US).

A number of things are pretty obvious:

There won't be a vaccine for the first many months after the beginning of a pandemic. Antivirals will be available to some and not to others. So we need to explore "non pharmaceutical interventions" (NPI) and get used to that term.
Closing schools will mean less exposure to children, a flattening of the curve for all, and possibly less cases overall.
Adding other "social distance" measures will provide aditional benefit. (There seems to be no substitute for closing schools early.)
For it to work, school closure and other measures must be carried out really early in the pandemic, which means proactively. (If the pandemic is bad enough, schools will close reactively anyway. Accept it and get over it: schools will close, now what?.)
Proactive things are acceptable if teachers and parents and employeers talk about it openly, now.
For these measures to work, there's some preparation that needs to be carried out on many levels: how do communities (and businesses and essential services and families) deal with absentee rates due to parents taking care of children at home? Who needs to cross-train (how many people at your office can fix a computer problem)? Who needs to stock-up on food, water and other essential items?

Tell your family, friends, colleagues and citizens about it:

Schools will close.
It's better to close them proactively.
They may be closed for more than two months.
If things are bad we will need to add more "social distance" layers (closing schools will be the right thing to do but may not be enough).
What will be the effects in our community?
What should we do to prepare?
Why wait, really?

It's not the antivirals that matter in a bad pandemic

2006-06-26T00:02:00.000+01:00

Here a GP is reported to request that electricity continues to power his practice.

A flu pandemic across the UK could result in "1,000 September 11ths" and preparations are "woefully inadequate", a doctor warned today.

Dr Steve Hajioff will tell doctors at the British Medical Association's annual conference on Tuesday that a flu pandemic would have "enormous" implications. He believes stockpiling anti-virals is less important than getting transport, fuel and water companies to make adequate plans.
[...]

Dr Hajioff said the Government had taken action but stocking anti-viral drugs was the "icing not the cake".
He added: "It's not anti-virals that are important, it's how we keep going, keep functioning as a country and keep the flu from spreading. I'm a GP and I can prepare my surgery, but if the electricity company that supplies my power has not prepared, then I am not going to be able to treat patients.

It looks like the "bad pandemic" scenario is starting to sink in.

A "not bad" pandemic would disrupt health-care services. Just do the numbers: no surge capacity, and many people simultaneously ill. Yes, that means health-care providers too.

The magic word is ... simultaneously.

Simultaneously in your hometown and mine. Simultaneously all over the country. Simultaneously all over Europe. Simultaneously all over the world.

Now, add the length of time it takes for a pandemic wave to unfold. What would that be? 4 to 8 weeks? A simultaneous, long-lasting mess.

Ah, yes, but there's bound to be a period of calm after that, right?

Wrong! It will be a period of calm before the second wave. So, no matter if the first wave is mild or not, people will remember 1918. (I certainly will remember it.) They will remeber the second wave was much worse.

And they'll stockpile. In a rush. And of course, again, simultaneously.

Do you really think a "now that there's no pandemic going on" buying panic would hurt us? Well, then, I suggest you multiply that by whatever amount you chose, and that's what the real thing would be like.

Look: we don't know when there will be a pandemic. But even with a "not so bad" one there will be panic buying. Lots of it. So better start now and build things up slowly (fast!). Doesn't it make sense?

EU says H5 virus found in Hungary

2006-06-10T10:55:00.000+01:00

The European Commission said Friday that a H5 highly pathogenic strain of bird flu had been found in a domestic flock of geese in Hungary.

Samples will be sent to the European Union (EU)'s reference laboratory for avian flu in Weybridge, near London, for further tests to determine whether it is the deadly H5N1 strain, the commission said in a statement.

The Hungarian authorities found the infected flock in Bacs- Kiskun in southern Hungary. Cases of highly pathogenic bird flu were detected in wild birds earlier this year in this county.

All 2,300 geese in the flock were immediately culled upon suspicion of the virus. All poultry in the 1 km radius around the outbreak are also being culled Friday, the commission said.

If confirmed, it would be the fifth outbreak of high pathogenic H5N1 avian flu in domestic poultry in a EU member state, following outbreaks in domestic poultry in France, Sweden, Germany and Denmark.

Source: People's Daily Online from Xinhua: EU says H5 virus found in Hungary

Technorati Tags: Avian flu | Bird Flu | Community | Europe | H5N1 | WHO | influenza | poultry

Ghana: Aftermath of bird flu Poultry farmers saddled with bank loans

2006-06-09T20:58:00.000+01:00

Although poultry farmers were compelled to drop the prices of their produce by 30% to 40% during the peak of the bird flu scare the measure has done little to save the industry from collapse. The result is the huge debts hanging on the necks of poultry farmers.

Mr. Kofi Agyei-Henaku the Executive Secretary of the Ghana National Association of Poultry Farmers said the measures have eroded the capital base and cash inflows of many poultry farms, especially farmers with large operations that are indebted to financial institutions.

Speaking at the National Bird Flu briefing programme in Accra on Tuesday, Agyei-Henaku observed that during the peak of the bird flu scare hatcheries had to destroy a large number of day old chicks and gave example of how a reputable hatchery in the Greater Accra region destroyed 49,760 day old chicks within six weeks because prospective customers failed to collect them leading to a loss of more than ¢358 million.

Source: Ghana web: Aftermath of bird flu Poultry farmers saddled with bank loans

Technorati Tags: Avian flu | Bird Flu | Community | H5N1 | influenza | poultry

China plagued by bird-flu coverups

2006-06-09T20:52:00.000+01:00

Qiao Songju, a resident of Gaoyou county in Jiangsu province, attained a brief heroic reputation for informing authorities of a massive bird-flu outbreak in Anhui province in October 2005. Tipped by Qiao, the Ministry of Agriculture confirmed the outbreak of the deadly H5N1 bird flu among geese and chicken in Liangying village of Chuzhou city.

Qiao gained overnight fame as the first informer of a bird-flu outbreak. But his joy did not last long. One month later, Gaoyou police paid a midnight visit to Qiao’s home and “invited” him to the station for a “chat”, which turned out to be the prologue to detention. The next day, Qiao was arrested on suspected fraud and blackmail activities. His arrest happened 2 days after he attempted to report another bird flu outbreak — this time in his own hometown. His arrest made headlines.

Observers pointed out that the timing of Qiao’s arrest suggested it was hardly coincidental. Many believed he was being framed. The Guangzhou-based and often outspoken South Metropolis News pointed out Qiao’s arrest took place when he was preparing to expose the bird flu outbreak in Gaoyou.

Qiao was tried on 21 and 26 Apr 2006. The court has yet to hand down a verdict. In China, it is rare for such a case to be tried twice without a court ruling. Analysts said it was likely that the central government intervened, so the case now seems to be moving to Qiao’s advantage.

Near the Jiangsu provincial capital Nanjing, Gaoyou abounds in geese and ducks. Poultry and eggs provide almost the entire gross domestic product (GDP) to Gaoyou. For the locals, an outbreak of bird flu there could mean the end of the world.

To the local farmers, Qiao was just a “bad guy”. Because of his tip-off, the government decided to destroy all reared poultry in the neighborhood, but the state compensation did not suffice to cover the colossal loss.

Source: Asia Times Online: China plagued by bird-flu coverups

Technorati Tags: Avian flu | Bird Flu | Chicken | Community | H5N1 | influenza | Knowledge | poultry

EU: Bird flu incidence in wild birds falling

2006-06-09T20:47:00.000+01:00

The survey found that between February 2006 and 21 May 2006, 741 cases of highly pathogenic avian influenza , most of them confirmed as the deadly H5N1 strain, have been detected in wild birds in 13 member states – Greece, Italy, Slovenia, Hungary, Austria, Germany, France, Slovakia, Sweden, Poland, Denmark, Czech Republic and UK.

There have been four outbreaks of H5N1 avian influenza in poultry in the EU, and all of these were swiftly eradicated following detection. No human case of the H5N1 virus has occurred in the EU.

There is considerable variation in the number of cases of highly pathogenic avian influenza in wild birds, ranging from 326 in Germany to one found in the UK.

The peak in terms of the number of cases in wild birds was reached in March with 362 cases, compared to 200 in February, with cases declining to 162 in April and 17 in May.

The most commonly affected wild birds have been swans, representing 62.8 per cent of the total, followed by ducks (16.3 per cent), geese (4.5 per cent), birds of prey (3.9 per cent) and others (13 per cent).

Source: Food production daily: Bird flu incidence in wild birds falling in EU

Technorati Tags: Avian flu | Bird Flu | Europe | H5N1 | influenza | Knowledge | poultry

2 months of food: $1,200; Emergency-prepared pantry: Priceless

2006-06-09T20:42:00.000+01:00

Outstanding article. Nice picture of pandemic preps. Includes meal by meal list with prices. Way to go Ms. Price!

LOVELAND - In a cool, dry basement room, shelves full of canned food and hulking bags of flour and other staples act as Suzy Price’s insurance policy.

It’s a policy against a blizzard, flood, pandemic flu, even job loss.

As federal, state and local health officials urge America to stockpile two weeks’ to two months’ worth of food, medical supplies and emergency items in case of a flu pandemic, perhaps one caused by the H5N1 strain of bird flu, experts say the public can learn from people like Price.

She didn’t outfit herself and her family in a day or a week or a month. She amassed what she estimates to be at least a year and a half of food supply over the course of years, buying 10 cans of cream of mushroom soup when it was on sale or a couple extra jars of peanut butter when the price was too good to pass up.

She buys only items her family eats anyway - tuna, peanut butter, canned peaches, cereal - and uses the oldest ones before they go bad, then replaces those with fresher products.

The government’s Web site urges families to stock two weeks of emergency items. Others, including Larimer County’s chief health official, suggest two months of supplies.

China says it contains bird flu outbreak

2006-06-09T16:54:00.000+01:00

"China has contained a newly discovered outbreak of the H5N1 bird flu virus in its far western region of Xinjiang by culling more than 17 100 poultry, the official Xinhua news agency said on Friday.

The Ministry of Agriculture revealed on Wednesday that poultry on a farm in Xinjiang's Hetian County had died from the bird flu virus.

Experts and veterinarians killed birds and disinfected the area to prevent possible new outbreaks, and no new suspected case has been discovered near the infected area, the ministry said on Friday. It did not specify how many birds had been infected."

Source: IOL from Xinhua: China says it contains bird flu outbreak

Technorati Tags: Avian flu | Bird Flu | Chicken | H5N1 | influenza | poultry

Hungary: H5 Virus Found in Poultry Farm

2006-06-09T16:40:00.000+01:00

"The H5 virus has been found in a poultry farm in Hungary, but it is unclear yet whether it is the H5N1 bird flu strain, which is dangerous to humans, AFP reported citing a statement of the European Commission. The Hungarian authorities confirmed the information."

Source: Focus English News: H5 Virus Found in Poultry Farm in Hungary

Technorati Tags: Avian flu | Bird Flu | Community | Europe | H5N1 | influenza | poultry

Russia: Bird Flu Still Not Eliminated In Six Locations

2006-06-09T16:34:00.000+01:00

"Bird flu still has not been eliminated in six locations in Russia - four locations in the Omsk region and two locations in the Altai region, the federal veterinary watchdog Rosselkhoznadzor reported Thursday.

Altogether this year bird flu was reported in 90 locations in 11 districts of the Southern Russia and three districts in Siberia."

Source: Dow Jones Newswires: Bird Flu Still Not Eliminated In Six Locations In Russia

Technorati Tags: Avian flu | Bird Flu | Community | H5N1 | influenza

Malta gearing up to combat flu pandemic

2006-06-09T09:00:00.000+01:00

"New equipment installed at St Luke's Hospital will enable health authorities to know whether the influenza virus causing the dreaded pandemic has arrived.

Within three hours of taking a sample from a sick person, the health authorities would know if the virus is the same as that identified by the World Health Organisation as causing a world-wide pandemic, which flu experts have long been saying is overdue.

'An influenza pandemic can come at any time and we need to be prepared by joining forces and coming up with the best plan for Malta,' the Principal Permanent Secretary, Godwin Grima, who is chairing the multi-ministerial pandemic preparedness committee, said."

Source: The Times & The Sunday Times: Malta gearing up to combat flu pandemic

Technorati Tags: Avian flu | Bird Flu | Community | H5N1 |influenza | pandemic | prepare

WHO lab indicates Indonesian girl did not die of bird flu

2006-06-09T08:54:00.000+01:00

"A lab approved by the World Health Organization said a seven-year-old Indonesian girl who tested positive locally for bird flu did not have the virus, a senior Health Ministry official said Friday.

The girl, from Pamulang on the outskirts of Jakarta, died June 1 after apparently coming into contact with sick poultry, said Nyoman Kandun. Her 10-year-old brother died three days earlier with similar flu-like symptoms but no samples were taken.

'This is the first time local tests came back positive and Hong Kong laboratory tests negative,'' said Kandun, adding WHO needs to carry out new tests to reconfirm its findings."

Source: National Post: WHO lab indicates Indonesian girl did not die of bird flu

Technorati Tags: Avian flu | Bird Flu | Chicken | H5N1 | WHO | influenza | poultry

Indonesia: Medan bird flu patient recovering

2006-06-09T08:51:00.000+01:00

"A man being treated for bird flu at Adam Malik Hospital in Medan may soon be released after doctors determined he had fully recovered from the illness.

The patient is part of a large family cluster of bird flu cases that emerged in Karo, North Sumatra. Seven of the man's relatives died of the disease."

Source: The Jakarta Post: Medan bird flu patient recovering

Technorati Tags: Avian flu | Bird Flu | Community | H5N1 | influenza

UK: Bird flu hits holiday sales at Thomas Cook

2006-06-09T08:47:00.000+01:00

"The number of British holidaymakers using Thomas Cook has fallen by almost 25,000, or 2.8%, as fears over avian flu in Turkey, one of the most popular destinations for Britons, hit the German group's sales.

Europe's second-largest tour operator said weak UK sales were 'more or less in line with market levels'. There have been several deaths in Turkey linked to the H5N1 virus."

Source: Guardian Unlimited: Bird flu hits holiday sales at Thomas Cook

Technorati Tags: Avian flu | Bird Flu | fear | Europe | H5N1 | influenza

Indonesia: Bird sellers say bird flu does not exist

2006-06-09T00:27:00.000+01:00

"Bird sellers in Jakarta said Thursday they did not believe that bird flu really existed, although it has killed at least 37 people in the country, 13 of whom were from the capital.

'I do not believe that bird flu really exists. There is no bird trader here infected with the disease,' Santoso, 30, a bird trader at Pramuka bird market in Central Jakarta was quoted by Antara news agency as saying.

"If there is bird flu, all the birds in the market would have already died," he added."

Source: The Jakarta Post from Antara: Bird sellers say bird flu does not exist

Technorati Tags: Avian flu | Bird Flu | H5N1 | influenza | Knowledge

Russia govt assigns large funds for bird flu fight

2006-06-09T00:12:00.000+01:00

"The Russian government decided to pay a fee of up to three million dollars in the multi-donor trust fund of the World Bank for the fight against flu, including bird flu, in 2006-2008, the governmental press service said Thursday with reference to a governmental decree issued on June 5."

Source: ITAR-TASS: Russia govt assigns large funds for bird flu fight

Technorati Tags: Avian flu | Bird Flu | Europe | H5N1 | influenza

Tanzania announces total ban on poultry imports

2006-06-08T22:28:00.000+01:00

"The Tanzanian government has announced a total ban on imports of poultry and poultry products to help check against the threat of bird flu.

The ban had to be exercised following reports that the disease had already been spotted in Sudan and Djibouti, according to Tanzanian Livestock Development Minister Shukuru Kawambwa."

Source: People's Daily Online from Xinhua: Tanzania announces total ban on poultry imports

Technorati Tags: Avian flu | Bird Flu | H5N1 | influenza | Knowledge | prepare

Chinese ambassador calls for int'l cooperation for bird flu prevention

2006-06-08T17:55:00.000+01:00

"China supported the setting up of a multilateral cooperation system for bird flu prevention and control, Chinese ambassador to the Vienna Office of the United Nations and other international organizations said on Wednesday.

'The International community should set up a global monitoring and forewarning system against avian influenza and other infectious diseases.' Ambassador Tang Guoqiang told a senior official meeting on bird flu issues.

He appealed for improved education and instruction on systems of prevention and control of the epidemic for developing countries.

'Moreover, the international community should also develop joint scientific research as soon as possible, in order to make a breakthrough in the fundamental scientific research on avian influenza,' he added.

The Chinese ambassador also called on relevant countries and international organizations to honor their commitments of contributions and donations as soon as possible, so as to provide sufficient funds to the countries hit by the avian influenza in time."

Source: People's Daily Online from Xinhua: Chinese ambassador calls for int'l cooperation for bird flu prevention

Science: CDC: States Should Aim to Contain Bird Flu

2006-06-08T17:44:00.000+01:00

"States preparing for a possible bird flu outbreak should focus on how to contain the virus because a vaccine will be unavailable for several months, the head of the Centers for Disease Control and Prevention said Wednesday.

The preparation could help medical centers, which are likely to experience shortages in staffs, supplies, beds and medicine in the event of a pandemic, Dr. Julie Gerberding said.

'Out of the starting gate there won't be any vaccine, it'll take some time,' Gerberding told The Associated Press. 'So we've got to look at old-fashioned ways of slowing the virus down.'"

Source: 620 ktar.com: CDC: States Should Aim to Contain Bird Flu

Technorati Tags: Avian flu | Bird Flu | Community | H5N1 | influenza | Knowledge | pandemic | prepare | Vaccine

Indonesia launches bird flu awareness campaign

2006-06-08T17:36:00.000+01:00

"Indonesia launched a bird flu awareness campaign on Wednesday in a bid to stop the rapid increasing of bird flu cases in the country.

The Health Minister Siti Fadilah Supari asked the people to watch out for the avian influenza (AI) virus by avoiding direct contact with poultry and keeping poultry out of their homes.

'The number of bird flu patients has increased rapidly in Indonesia, and in Medan, the largest bird flu patient cluster has been found recently. Laboratory-check results show that they were infected with the avian influenza virus from poultry. Therefore, poultry must be kept separate from human being,' said the minister.

She cited Vietnam as an example, saying that Vietnam had been able to stop the spread of bird flu virus infection after the country freed its areas from poultry for six months."

Source: People's Daily Online from Xinhua: Indonesia launches bird flu awareness campaign

Technorati Tags: Avian flu | Bird Flu | Community | H5N1 | WHO | influenza | Knowledge

China reports new bird flu case

2006-06-08T17:22:00.000+01:00

"China has discovered a new H5N1 bird flu case in poultry in the western Xinjiang Uygur Autonomous Region, the Ministry of Agriculture (MOA) said on Wednesday.

Epidemic prevention workers prepare to put killed poultry on trucks in Hetian of northwest China's Xinjiang Uygur Autonomous Region, Nov. 15, 2005. Highly pathogenic bird flu epidemic was reported in Hetian City of the Xinjiang Uygur Autonomous Region, the Chinese Ministry of Agriculture said on Thursday.

The case was identified after domestic poultry at a farm in Xinjiang's Hetian County died of an unclear illness.

The dead poultry were confirmed to have been infected with the bird flu virus on Wednesday after testing at the national bird flu laboratory"

Source: China Daily: China reports new bird flu case

Technorati Tags: Avian flu | Bird Flu | Chicken | H5N1 | influenza | poultry

Hungary: Fresh doubts over flu vaccine

2006-06-08T17:16:00.000+01:00

"HUNGARY'S vaccine for bird flu came under yet more criticism last week, days before the EU extended its ban on neighboring Romania's live poultry and poultry products across the country.

The Hungarian vaccine against H5N1 (the virulent strain of avian influenza), was accused of being 'nothing but a bluff,' according to daily Népszabadság, reporting on an article published by the Bloomsberg news agency.

Bloomsberg raised doubts over the vaccine, saying no scientific evidence to corroborate its effectiveness had been presented in the seven months following the announcement of its development.

The Hungarian government and Omninvest Kft, the private company that developed the vaccine, had last spoken of its effectiveness and, in a publicity drive, the vaccine was taken by the Health Minister."

Source: The Budapest Sun Online: Fresh doubts over flu vaccine

Technorati Tags: Avian flu | Bird Flu | Europe | H5N1 | influenza | Knowledge | Vaccine

Africa needs $760 mln to fight bird flu-report

2006-06-08T17:12:00.000+01:00

"Africa needs $760 million to fight bird flu over the next three years, about three times as much as donors pencilled into their $1.9 billion pledge made in January, the African Union and aid organisations said Wednesday.

The pledge made at a donors conference in Beijing did not assume bird flu would break out in Africa, according to a study by the AU, the Food and Agriculture Organisation (FAO) and the World Organisation for Animal Health (OIE) presented in Vienna.

But eight African countries have reported the virus since February, and OIE Director General Bernard Vallat told Reuters on the sidelines of a Vienna conference of bird flu coordinators that this increased the funds needed significantly.

'During the Beijing conference, Africa was not yet infected,' Vallat said in an interview. 'In Beijing the cost was calculated only for prevention. But when a country is infected, the cost is multiplied by at least three or four.'"

Source: Reuters: Africa needs $760 mln to fight bird flu-report

Technorati Tags: Action | Avian flu | Bird Flu | H5N1 | WHO | influenza

Indonesia Is Running Out of Ideas on Bird Flu, Supari Says

2006-06-08T16:53:00.000+01:00

"Indonesia's Health Minister Siti Fadilah Supari said she is struggling to warn of the danger of bird flu, which has killed three of every four people it has infected in the world's fourth-most-populous nation.

``I am running out of ideas how to make the public aware,'' Supari told reporters in Jakarta today. Yesterday the health ministry confirmed the 49th human avian influenza case. The H5N1 strain has infected people in more than half of Indonesia's 33 provinces since July."

Source: Bloomberg: Indonesia Is Running Out of Ideas on Bird Flu, Supari Says

Technorati Tags: Avian flu | Bird Flu | Community | H5N1 | influenza | Knowledge

Zambia: More resources needed to counter avian flu

2006-06-08T16:34:00.000+01:00

"Zambia has repeatedly said it lacks the technical expertise, personnel and funds to tackle a possible outbreak of H5N1 bird flu, but recent donations will help to remedy this situation.

The European Union contributed $200,000, while the UN Food and Agricultural Organisation (FAO) this week donated US$89,000 worth of test kits and other equipment to counter the deadly virus.

Richard Chizyuka, permanent secretary in the Ministry of Agriculture and Cooperatives, said a lack of resources had stalled many of the government's prevention initiatives - despite a national response plan and a budget - but the protective gear from FAO would help step up active surveillance.

Zambian officials have time and again underlined a lack of capacity to handle a possible outbreak. Earlier this year, the cabinet approved a $4.8 million budget to tackle avian influenza, with the emphasis on prevention."

Source: IRIN: ZAMBIA: More resources needed to counter avian flu

Technorati Tags: Avian flu | Bird Flu | H5N1 | influenza | Knowledge | pandemic | prepare