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If bird flu virus becomes pandemic, high death rates possible: WHO report

christian

Valued Member
New H5N1 strain could start wave of bird flu outbreaks
Reuters Alertnet - 30 Oct 2006 21:01:57 GMT

By Tan Ee Lyn
HONG KONG, Oct 31 (Reuters) - Scientists in Hong Kong and the United States have detected a new strain of H5N1 bird flu virus in China and warned it might have started another wave of outbreaks in poultry in Southeast Asia and move deeper into Eurasia.

The strain, called the "Fujian-like virus" because it was first isolated in China's southern Fujian province in March 2005, has increasingly been detected since Oct. 2005 in poultry in six provinces in China, displacing other H5N1 strains.

The strain might also have become resistant to vaccines, which China began using on a large scale from Sept. 2005 to protect poultry from H5N1, said the scientists.


The researchers are from the University of Hong Kong, including virologists Guan Yi and Malik Peiris, and Rob Webster of St Jude Children's Research Hospital in the United States.

"The predominance of this Fujian-like virus appears to be responsible for the increased prevalence of H5N1 in poultry since Oct. 2005 and recent human infection cases in China," they said in an article published in the U.S.-based Proceedings of the National Academy of Sciences (www.pnas.org).

"It has already caused poultry outbreaks in Laos, Malaysia and Thailand, and human disease in Thailand. It is likely that this variant has already initiated a third wave of transmission throughout Southeast Asia and may spread further in Eurasia."

The first wave of H5N1 outbreaks occurred in late 2003 and 2004 in many parts of Asia. The second wave started in China's Qinghai Lake in May 2005 and that strain has since been found in parts of Europe, Africa and the Middle East.

The virus has killed more than 150 people since late 2003 and remains largely a disease among birds. But experts fear it could trigger a flu pandemic and kill millions of people if it mutates into a strain that can pass from human to human.

SUPER STRAIN
The researchers collected 53,220 fecal samples from chickens, geese and ducks in poultry markets in six Chinese provinces between July 2005 and June 2006. Of these, 1,294 tested positive for H5N1.

But genetic sequencing of viruses collected from Oct. 2005 onwards showed the Fujian strain was clearly becoming predominant over other H5N1 strains. Between April and June this year, 103 out of 108 H5N1-positive samples were of the Fujian type.

"That's pretty conclusive proof that this new variant is predominant," said Gavin Smith, one of the researchers in the Hong Kong team.

To test how well vaccinated poultry could stand up to various strains of H5N1, the researchers collected 1,113 blood samples from chickens from Nov. 2005 to April 2006.

Only 180 samples, or 16 percent, tested positive for H5N1 antibodies. They were exposed to 3 strains of H5N1 -- namely the Yunnan, Guiyang and Fujian-like strains.

The antibodies managed to neutralise the Yunnan and Guiyang strains, but had little or no effect on the Fujian virus.

"The market poultry, many of them don't have antibodies against H5 virus and those that do are not well protected against the Fujian virus, which is why we think the Fujian-like virus has been able to grow because other (strains) have been suppressed," Smith told Reuters in an interview.

"What happens with vaccines is that you basically introduce something that kills off most of the viruses, but there are always going to be some viruses that can escape from it."
 
Re: New H5N1 strain could start wave of bird flu outbreaks

Re: New H5N1 strain could start wave of bird flu outbreaks

This story is on the new sequences (out a bit before the embargo end, which is at 5 PM EST). There will be quite a few reports on this.
 
Re: New H5N1 strain could start wave of bird flu outbreaks

Re: New H5N1 strain could start wave of bird flu outbreaks

Recombinomics Commentary
April 5, 2006

A report from the Ministry of Health from the People's Republic of China contains some additional genetic information on H5N1 isolates in China. Recently China released the HA sequences from three H5N1 patients in China. All three were closely related to a Fujian duck isolate, A/DK/Fujian/1734/05(H5N1) and had the same HA cleavage site, RERRRKR, which was missing a lysine. The recent report describes three additional human isolates, A/Jiangxi/1/2005(H5N1), A/Hunan/1/2005(H5N1), and A/Sichuan/1/2006(H5N1). These isolates would appear to be from the index cases for each of those provinces. All three cases were fatal (age, gender, date of death 35M, Dec4; 41F, Dec 21, 35F, Jan 11, respectively).

Amino acid homology was available for the two most recent 2005 cases and like the first three cases, all were greater than 99% homologous to A/DK/Fujian/1734/05(H5N1) and all three had the same HA cleavage site (RERRRKR). These data indicate all six reported human cases in China are closely related to the Fujian strain as are the recent isolates from Malaysia and Laos. In China, there were human cases in five provinces (Anhui, Guangxi, Jiangxi, Fujian, Sichuan) indicating the Fujian strain is widespread.

The report also showed that all of the human cases as well as two chicken sequences (A/CK/Hunan/21/05 and A/CK/Lianoning/23/05) had sequences indicating they would be sensitive to M2 ion channel blockers (Amantadine and Rimantidine) and neuraminidase inhibitors (Tamiflu and Relenza). However, the sequence homology for the Liaoning isolate was markedly lower (96.9% with the Fujian duck). The H5N1 outbreak in Liaoning was difficult to control and several vaccines were used, which was probably related to the lack of sequence homology. Sequence data fro the human Liaoning case was not included.

The report also showed that the two most recent H5N1 human cases also had PB2 E627K, which is associated with a poor prognosis and is in all Qinghai strains. The report also had data on the isolate from the index case in Turkey, A/Turkey/12/06(H5N1). The report listed the HA S227N, but also indicated that the cleavage site was RERRRKKR, which if true would be unusual, because the cleavage site for the Qinghai strain was usually GERRRKKR (the report however may have been in error because the cleavage site for a bar headed goose isolate was listed as RERRRKKR, but the deposited sequence is GERRRKKR.
 
Re: New H5N1 strain could start wave of bird flu outbreaks

Re: New H5N1 strain could start wave of bird flu outbreaks

christian said:
........ with vaccines is that you basically introduce something that kills off most of the viruses, but there are always going to be some viruses that can escape from it."

Looks like a reporter who thinks a VAX works like an antibiotic. Maybe they don't understand vaccination-driven mutation.

.
 
If bird flu virus becomes pandemic, high death rates possible: WHO report

-Admins-please feel free to remove this from Breaking News if you deem appropriate. I felt it was a watershed moment, when TPTB acknowledge that a strain may not attentuate when jumping to H2H.

-------------------------------------------------------------------------------

Thursday, Nov 02, 2006



(CP) - There's no guarantee the H5N1 avian flu virus would become less deadly to people if it triggers a pandemic, a new report from the World Health Organization warns.
A group of eminent influenza scientists gathered by the WHO last month concluded there is no reason to believe that the virus, which kills roughly 60 per cent of people who become infected, would become any milder if it evolves to become a pandemic strain.

The report, based on that meeting, cautions governments against spending a lot of money to stockpile existing H5N1 vaccines. It also reveals that a low level of H5N1 viruses found in wild and domestic birds appear to be naturally resistant to oseltamivir, the main flu drug being stockpiled against a future pandemic.

The WHO scientist who convened the meeting cautioned, however, that the question of how lethal an H5N1 pandemic might be is the scientific equivalent of a black hole.




Modern science has never seen a flu virus as nasty as H5N1, and there is no way of knowing if the virus can become easily transmissible among people or what an H5N1 pandemic would look like.

"It's one of those things that you hate to conjecture," said Michael Perdue, an avian influenza expert and scientist with the WHO's global influenza program.

"We just don't know enough about this virus, a whole new subtype for humans. . . . If a new H5 enters, it could be more lethal than anything we've ever seen in history. (But) who knows?"





"I think it's anybody's opinion because it's just so completely unknown."

The report noted some modelling studies suggest a highly lethal virus could not spark a pandemic, because people who fall gravely ill aren't walking about transmitting flu to others. "All such matters remain difficult to predict," the report concludes.

It also questions the wisdom of stockpiling current versions of H5N1 vaccine for later use, saying there is little evidence that a vaccine against one variant of the virus will induce a good immune response against even other currently circulating H5N1 viruses, let alone future ones.

"We still don't have the data that would say that a pre-pandemic vaccine based on one H5N1 strain would completely protect against another," Perdue said from Geneva.

"Although one would hope it would mitigate the effects some, we don't have the data to show it."

The United States and Switzerland are stockpiling current H5N1 vaccines. And several other countries - Singapore and Britain among them - are reported to be in negotiations with vaccine maker GlaxoSmithKline to buy bulk lots of its H5N1 vaccine for stockpiling purposes.



© The Canadian Press, 2006



http://www.canadaeast.com/cp/health/article2.php?articleID=62442
 
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Re: If bird flu virus becomes pandemic, high death rates possible: WHO report

<big><big>Commentary</big></big>
[FONT=Arial,Helvetica].[/FONT]
H5N1 Case Fatality Rate

Recombinomics Commentary
Novermber 29, 2004



>>A few analysts have suggested that the death toll could be considerably higher. Henry L. Niman, a medical researcher in Pittsburgh, who tends toward gloomy predictions and is a strong critic of W.H.O. for being too conservative, said that with more than 70 percent of the human victims of the disease dying so far, the death toll could in theory exceed a billion people if the disease were to spread rapidly among people with little if any reduction in current mortality rates.

"That estimate is unscientific unjustified, and an inaccurate extrapolation from the current situation," Dr. Stöhr, the W.H.O. expert, said.<<

Under the current situation, there is no pandemic in people (less than 50 reported cases worldwide). However, WHO had estimated that a pandemic could lead to the infection of 1/3 to 1/4 of the world's population, which would be 1.5 to 2 billion infected people. With a case fatality rate of 70%, that would generate over 1 billion deaths.

Efficient human to human transmission is still the key event and recombination can place a human receptor binding sequence on an avian H5 background and achieve human to human transmission without changing the rest of the avian genes, which are producing the 70% case fatality rate.
 
Re: If bird flu virus becomes pandemic, high death rates possible: WHO report

I'm not sure about this source, I don't know how reliable this information is.
MHSC


http://www.theregister.co.uk/2006/11/03/bird_flu_warning/
WHO issues bird flu warning, warns on Tamiflu research

By Lucy Sherriff


<SMALL>Published Friday 3rd November 2006 11:36 GMT

</SMALL>
The World Health Organisation has warned that there is no guarantee that a pandemic strain of the H5N1 virus will be less deadly to people. The report, published this week, contains the findings of a meeting of flu experts held last month.


The method of change will determine how deadly the virus is, the report says. If the virus changes by exchanging genes with a human flu virus, a process called reassortment, a pandemic might not be too deadly. However, straightforward adaptive mutation would leave the virulence of the disease unchanged, the scientists warned.

It also cautioned against regarding the anti-viral drug Tamiflu as a magic bullet, highlighting that some H5N1 viruses seem to already be naturally resistant to the effects of the drug.


The report comes less than two weeks after the Centre for Ecology and Hydrology (CEH) in the UK issued a warning about the possible environmental effects of large scale use of Tamiflu.


Dr Andrew Singer of the CEH said: "An antiviral drug has never been widely used before, so we need to determine what might happen. During a flu pandemic, millions of people will all take Tamiflu at the same time. Over just eight or nine weeks, massive amounts of the drug will be expelled in sewage and find its way into the rivers. It could have huge effects on the fish and other wildlife."

A build up of the drug in rivers could cause the avian version of the virus to become resistant to it, which could lead to a new, resistant strain emerging in humans, Singer argues.


He is calling for research into ways to safely break the anti-viral down once it is in the sewage system but before it reaches the public waterways. ®
 
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