Helen Branswell latest articles (June 2006)

[Snowy Owl]

Hospital bloc plans for pandemic
Thu, June 1, 2006
​

Hospitals decide protecting staff beats waiting for outbreak.

By HELEN BRANSWELL, CP

http://lfpress.ca/newsstand/CityandRegion/2006/06/01/1609190-sun.html

TORONTO -- A bloc of Canada's largest and most influential teaching hospitals has decided to buy enough of the antiviral drug Tamiflu to protect all of their employees from becoming ill during a pandemic -- a decision that will require huge and costly reserves of the drug.

The policy runs counter to the current federal, provincial and territorial thinking, which suggests saving limited stores of Tamiflu for the treatment of people who become sick rather than trying to stave off illness, a drug-intensive process called prophylaxis.

The move could place significant pressure on other hospitals and public health officials to follow suit; health-care unions elsewhere could demand the same level of protection in exchange for assurances their members will show up for work during a pandemic.

"I think there's really no reason why unions wouldn't say 'This is what we want' following that example," Dr. Perry Kendall, chief medical officer of health for British Columbia said of the announcement from the Toronto Academic Health Services Network, which comprises 12 hospitals, including the Hospital for Sick Children and St. Michael's Hospital.

Kendall and others suggested the decision reflects the high level of trauma that haunts health-care workers in Toronto as a result of the city's devastating SARS outbreak in the spring of 2003. That disease spread largely in hospitals and it took an extraordinary toll on health-care workers and their families.

The committee that took the decision to use Tamiflu to protect all staff countered that SARS did play a role, but not the role their critics contend. The decision was not fuelled by post-traumatic stress, they argued, but by the understanding that the only way to keep hospitals functioning during a pandemic will be to stop staff from getting sick.

"It was sufficiently clear to us that this was the best thing to do for our hospitals and for the patients we need to be taking care of; that what other people were going to think about it (the decision) or what external implications it was going to have just wasn't relevant," said Dr. Allison McGeer, head of infection control at Toronto's Mount Sinai Hospital.

"This is not a decision that was taken on an emotional basis . . . This was a decision that was taken on cold, hard facts."

The decision involves buying enough drug to protect 55,000 employees for 56 days -- the rough estimate of what it might take for the first wave of a pandemic to move through the community. (The belief is Canada's pandemic vaccine manufacturer, GlaxoSmithKline, will have vaccine ready in time to protect against a second wave of illness.)

That's more than three million Tamiflu pills, at a cost of $7.2 million dollars.
​

 

[Mingus]

Re: Helen Branswell latest articles (June 2006)

The last article talk about (post #2)
Dr. Malik Peiris's article abstract at
http://www.h5n1experts.org/forum/showthread.php?t=482&highlight=Differential+expression

 

[Snowy Owl]

Unprepared for a pandemic

Unprepared for a pandemic

Unprepared for a pandemic

Report says Canadian businesses are worried about avian flu, but doing little to plan for it

By Helen Branswell
The Canadian Press

Canadian businesses are worried about a possible influenza pandemic but appear to be doing little to prepare themselves to weather one, a report by the Conference Board of Canada suggests.
A survey of member businesses conducted in February revealed executives of nearly 80 per cent of businesses that responded were concerned about the impact a pandemic would have on their operations.
But only 4 per cent of responding companies reported having a pandemic business continuity plan completed.
While 71 per cent of businesses said they were working on a pandemic plan, a quarter said they don't have one and aren't working on one.
More than half of respondents who haven't completed a plan said pandemic planning isn't a priority for them. Even the vast majority of businesses that identified themselves as providing "essential services" don't yet have completed pandemic plans.
"In short, if the H5N1 (avian flu) virus mutated into a pandemic strain in the near future, most of the respondents who claim to provide essential services, including organizations responsible for utilities and key transportation and communications networks, would not have a strategy in place to deal with this emergency," a report from the conference board said.
Conference Board vice-president Prem Benimadhu suggested the findings were "a bit surprising," especially given only 28 per cent of the businesses asked to respond to the survey even bothered to answer.
"The surprise is the gap between concern and execution," he said.
Benimadhu said businesses seem to be operating with a "full plate mentality," dealing with the issues immediately before them and assuming that if a pandemic were to begin they could address their business needs at that point.
"This thing, the pandemic, being what it is, if it hits if you are not prepared that's the end of your business, frankly. You won't have time to prepare."



http://www.hamiltonspectator.com/NA...2&call_pageid=1020420665036&col=1112101662835

 

[Snowy Owl]

Bird flu found in P.E.I. goose

Bird flu found in P.E.I. goose

Bird flu found in P.E.I. goose
Virus unlikely to be strain found in Asia, expert says
By HELEN BRANSWELL The Canadian Press

A domestic goose that died in western Prince Edward Island this week tested positive for an H5 avian influenza virus, the Canadian Food Inspection Agency confirmed Friday.


Samples are being sent to the CFIA?s National Centre for Foreign Animal Diseases in Winnipeg so that confirmatory tests can be run and the neuraminidase (the N in a flu virus?s name) can be determined.


Results of those tests aren?t expected until Monday or Tuesday at the earliest, said Dr. Jim Clark, the CFIA?s director of animal health. But Clark said there are already clues this avian flu virus isn?t likely the highly pathogenic H5N1 virus that has decimated chicken flocks in parts of Asia.


That?s because the goose was part of a small, free-range flock of chickens, geese and ducks. And while four of 11 geese in the flock died, none of the chickens fell ill.


"If this is a highly pathogenic virus ? or it was ? then it should have been causing some difficulty for the chickens," Clark said in an interview from Ottawa.


"So we?re relatively confident that the virus has low pathogenicity. But we won?t be able to say that definitely until the lab in Winnipeg finishes analyzing the samples."


Clark said there?s actually no evidence at this point that avian flu played a role in the death of the geese.


"Just because these birds have died, we mustn?t jump to the conclusion it was an influenza virus that killed them," he cautioned.


A post-mortem examination of the bird will be done to determine the cause of death. The other birds in the flock ? killed as a precautionary measure ? will also be examined for presence of the virus.


A spokeswoman for the Public Health Agency of Canada said at the request of provincial authorities, the agency is sending three epidemiologists to Prince Edward Island to help in the investigation and to help monitor the health of people who came in contact with the flock.


"Based on the information that we have at this point in time . . . there is no new threat to human health," said Aggie Adamczyk.


"But while we wait for the results of further testing . . . precautions are being taken to protect the health of those who have been in close contact with birds."


Dr. Lamont Sweet, P.E.I.?s chief medical officer, said people in the vicinity will be monitored for flu-like symptoms or eye infections.


Although H5N1 causes severe infection and often death in humans, most avian flu viruses induce no human disease or at worst conjunctivitis.
The owner of the birds, who was raising them for personal consumption, told authorities he noticed four of his geese were "walking funny" on Sunday.


"Monday morning, he came out (and) the four birds that were walking funny were dead," Clark said.


The geese were purchased about six weeks ago from a local co-operative. Clark said a trace-back is underway to see where the birds came from.

http://thechronicleherald.ca/Canada/510719.html

 

[KC]

Re: Helen Branswell latest articles (June 2006)

"If this is a highly pathogenic virus ? or it was ? then it should have been causing some difficulty for the chickens," Clark said in an interview from Ottawa.

"So we?re relatively confident that the virus has low pathogenicity. But we won?t be able to say that definitely until the lab in Winnipeg finishes analyzing the samples."

Tell that to the Goose that died. It resulted in death.

Assumptions that "sentinel chickens" will be able to predict spread, or pathogenicity in humans are false. See West Nile Virus research and observations on how "sentinel flocks" may indicate "presence" but not accurately reflect how a disease is spreading or evolving, or how the primary (avian) or other species (human) versions are spreading.

 

[Snowy Owl]

Indonesia seeks expert help with bird flu problem, but faces major challenge

Indonesia seeks expert help with bird flu problem, but faces major challenge

Indonesia seeks expert help with bird flu problem, but faces major challenge
18:23:57 EDT Jun 18, 2006

HELEN BRANSWELL

http://www.cbc.ca/cp/health/060618/x061806.html

(CP) - Some of the world's leading influenza experts will gather in Jakarta this week to assess the worrisome avian flu situation in Indonesia, where human cases of H5N1 infection have mounted at a disturbing rate over the past year. <!-- CPPara1End--> <!-- CPPara2-->Observers say the expert consultation, taking place at the request of the Indonesian government, is a welcome sign of that country's concern about the threat H5N1 poses both for its citizens and the global community. <!-- CPPara2End-->
<!-- CPPara3-->"I think calling this meeting is a step towards recognizing that they have got a problem and they do have a responsibility to the rest of the world in terms of trying to deal with it," says Lance Jennings, a virologist and epidemiologist at Christchurch Hospital in New Zealand. <!-- CPPara3End-->
"I think it's a positive move and will lead to improved understanding," adds Jennings, who last year participated in a similar World Health Organization-led assessment of the H5N1 problem in Vietnam.
Indonesia's National Committee for Avian Influenza Control and Pandemic Influenza Preparedness asked the WHO and its animal health counterpart, the Food and Agriculture Organization, to bring a variety of experts to Indonesia to study the scope of the problem and make recommendations on how best to attack it.
Leading experts such as Dr. Keiji Fukuda, co-ordinator of WHO's global flu program, Dr. Nancy Cox, head of the influenza branch at the U.S. Centers for Disease Control in Atlanta, and Dr. Malik Peiris of Hong Kong University will take part in the three-day review, which begins Wednesday.
Since Indonesia began reporting human cases of H5N1 last July, infections have been occurring at a rapid and unsettling clip - virtually one a week on average.
"There are special concerns about Indonesia," admits WHO spokesperson Dick Thompson.
"First, that these cases are turning up across this vast region - that's a huge country. And secondly, there's a number of clusters - more clusters than we've seen elsewhere."
Of the 49 confirmed cases, 37 have died. A number of other people are strongly suspected of having had the virus, but they died and were buried or cremated before samples could be taken to look for proof of infection.
Of the 10 countries that have recorded human cases of H5N1, Indonesia to date has had the second highest number of cases. Only Vietnam's tally exceeds that of Indonesia. But the former's efforts to combat the virus in poultry flocks appear to have paid off; Vietnam has not reported a human case of H5N1 since last November.
Many of the Indonesian cases have occurred in clusters of two or three, although last month the largest cluster of cases seen to date - eight members of a single family - had health authorities around the world on edge. The WHO said that cluster likely involved human-to-human-to-human spread, the first time such prolonged transmission is thought to have occurred.
Also concerning is the fact that many of the human cases in Indonesia have occurred in areas where no outbreaks of the virus have been reported in poultry. Experts say that points to gaping holes in the country's veterinary surveillance capacity.
Dr. Angus Nicoll, who heads influenza activities at the European Centre for Disease Control and Prevention in Stockholm, heard Indonesia's assessment of its avian flu problem at a recent meeting in Vienna of countries that are funding the fight against avian influenza.
Nicoll says control over veterinary services has been devolved to local authorities, hamstringing efforts to mount the type of co-ordinated attack needed to bring the virus under control.
"What the people from Indonesia were saying (in Vienna) was good in one way in that they were being open but worrying the other way because they've clearly got into a very substantial mess," Nicoll says.
"Their veterinary services in particular were very much weakened by decisions to distribute . . . responsibility down to the local level."
Nicoll is heartened the country has asked for help. But he's also worried it may be outside Indonesia's capacity to act on the recommendations the experts will make - or wish to make.


"It's a positive sign. But the caveat there would be we have to wait and see whether the Indonesians are able to implement the recommendations.


"I think what's concerning is if the answer is 'You need to change your devolved veterinary services,' that's a big tanker to turn around," he says bluntly.


"That might not be a terribly easy or welcome piece of advice for them to get."


<center>? The Canadian Press, 2006</center>​

 

[Snowy Owl]

China fudged bird flu facts: report

China fudged bird flu facts: report

China fudged bird flu facts: report
By HELEN BRANSWELL, CANADIAN PRESS
http://winnipegsun.com/News/World/2006/06/22/1646703-sun.html

In an extraordinary turn of events, Chinese researchers have contradicted Beijing's official version of the country's H5N1 human infection timeline, revealing a Chinese man died of H5N1 avian flu fully two years before China reported its first human case to the World Health Organization in November 2005.


The eight researchers reported in a letter in today's New England Journal of Medicine -- a letter they attempted to withdraw yesterday -- on the genetic blueprint of H5N1 virus isolated from the man, who died in November 2003.
Influenza experts outside China have long believed the country has hidden or missed human cases of H5N1.


​

 

[sharon sanders]

Re: Helen Branswell latest articles (June 2006)

Mystery thickens around report of early Chinese bird flu case
16:14:27 EDT Jun 23, 2006

HELEN BRANSWELL




<!-- CPPara1-->(CP) - The mystery surrounding a report by Chinese researchers that contradicts Beijing's official line on how long China has been having human cases of H5N1 avian flu took a twist Friday that suggests someone may have tried to block the report's publication in a prestigious medical journal. <!-- CPPara1End-->
<!-- CPPara2-->Hours before the official release of this week's issue of New England Journal of Medicine, editors at the journal received a series of e-mails from someone purporting to be Dr. Wu-Chun Cao, one of the authors of the report which had been submitted by eight Chinese scientists. <!-- CPPara2End-->
<!-- CPPara3-->But on Friday, editors at the journal spoke by phone with someone they believe to be Cao. He categorically denied having sent the e-mails and told the journal he and his co-authors stand behind their report. <!-- CPPara3End-->
Cao, of the State Key Laboratory of Pathogens and Biosecurity, later faxed the journal a letter reaffirming those claims.
"He has not requested withdrawal of the report, and so it stands as published in the issue of June 22," Dr. Jeffrey Drazen, editor-in-chief, said in a statement.
"We are continuing to investigate."
The eight researchers reported on the molecular characteristics of an H5N1 virus isolated from a Chinese man who died in November 2003.
The report has stirred up intense interest in the scientific world because that was two full years before Beijing first reported a human H5N1 case to the World Health Organization, in November 2005.
The authors made no reference to the discrepancy between their report and China's official H5N1 timeline. Nor did they indicate whether the testing that discovered H5N1 virus in the dead man's lung was actually done around the time of death or more recently.
When the report was published the WHO's China office formally requested that the Chinese Ministry of Health explain the discrepancy and provide information about the case.
On Friday, a WHO spokesperson in Geneva declined to comment on the latest development.
Influenza experts outside China have long believed the country has hidden or missed human cases of H5N1, but they hadn't anticipated seeing proof in the pages of one of the world's most prestigious medical journals. China has officially reported 19 cases and 12 deaths.
A spokesperson for the New England Journal of Medicine said the journal had received "multiple" e-mails asking to withdraw the report. From the e-mail addresses, some seemed to be from Cao; others claimed to be from all eight authors.
"It seemed very clear that they were coming from Dr. Cao and/or that institution," Karen Pedersen said from Boston. Copies of the e-mails were also faxed to the journal.
But editors could not immediately reach Cao to explore why he wanted the report pulled and to explain it was too late - the journal had been printed and mailed to subscribers days earlier.
On Friday someone identifying himself as Cao called the journal and said he hadn't made the request and didn't want to withdraw the report. Pedersen said the journal editors believe that call was legitimate. The editors asked Cao to submit a letter reaffirming that the report should stand, and they received that letter. Pedersen said the journal was in the process Friday of getting the remaining seven researchers to sign similar letters.

http://www.cbc.ca/cp/health/060623/x062320.html