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Indonesia H2H Cover-up?

H

HenryN

Retired
Word is leaking out that human sequences from Indonesia are being withheld because they contain novel cleavage site (RESRRKKR), which is not found in bird H5N1 sequences including the recent avian submissions to GenBank

<TABLE cellSpacing=5 cellPadding=5 width="90%" border=0><TBODY><TR><TD align=middle colSpan=2>Nucleotide Sequences</TD></TR><TR><TD width="20%">DQ497642.1</TD><TD width="80%">Influenza A virus (A/chicken/Malang/BBVet-IV/2004(H5N1)) hemagglutinin (HA) gene, partial cds
</TD></TR><TR><TD width="20%">DQ497643.1</TD><TD width="80%">Influenza A virus (A/chicken/Magetan/BBVW/2005(H5N1)) hemagglutinin (HA) gene, partial cds
</TD></TR><TR><TD width="20%">DQ497644.1</TD><TD width="80%">Influenza A virus (A/chicken/Ngawi/BPPV4/2004(H5N1)) hemagglutinin (HA) gene, partial cds
</TD></TR><TR><TD width="20%">DQ497645.1</TD><TD width="80%">Influenza A virus (A/chicken/Pekalongan/BPPV4/2003(H5N1)) hemagglutinin (HA) gene, partial cds
</TD></TR><TR><TD width="20%">DQ497646.1</TD><TD width="80%">Influenza A virus (A/chicken/Sragen/BPPV4/2003(H5N1)) hemagglutinin (HA) gene, partial cds
</TD></TR><TR><TD width="20%">DQ497647.1</TD><TD width="80%">Influenza A virus (A/quail/Boyolali/BPPV4/2004(H5N1)) hemagglutinin (HA) gene, partial cds
</TD></TR><TR><TD width="20%">DQ497648.1</TD><TD width="80%">Influenza A virus (A/chicken/Purworejo/BBVW/2005(H5N1)) hemagglutinin (HA) gene, partial cds
</TD></TR><TR><TD width="20%">DQ497649.1</TD><TD width="80%">Influenza A virus (A/quail/Yogjakarta/BBVet-IX/2004(H5N1)) hemagglutinin (HA) gene, partial cds
</TD></TR><TR><TD width="20%">DQ497650.1</TD><TD width="80%">Influenza A virus (A/chicken/Kulon Progo/BBVet-XII-2/2004(H5N1)) hemagglutinin (HA) gene, partial cds
</TD></TR><TR><TD width="20%">DQ497651.1</TD><TD width="80%">Influenza A virus (A/chicken/Gunung Kidal/BBVW/2005(H5N1)) hemagglutinin (HA) gene, partial cds
</TD></TR><TR><TD width="20%">DQ497652.1</TD><TD width="80%">Influenza A virus (A/chicken/Kulon Progo/BBVW/2005(H5N1)) hemagglutinin (HA) gene, partial cds
</TD></TR><TR><TD width="20%">DQ497653.1</TD><TD width="80%">Influenza A virus (A/chicken/Purwakarta/BBVet-IV/2004(H5N1)) hemagglutinin (HA) gene, partial cds
</TD></TR><TR><TD width="20%">DQ497654.1</TD><TD width="80%">Influenza A virus (A/quail/Tasikmalaya/BPPV4/2004(H5N1)) hemagglutinin (HA) gene, partial cds
</TD></TR><TR><TD width="20%">DQ497655.1</TD><TD width="80%">Influenza A virus (A/chicken/Bangli Bali/BBPV6-1/2004(H5N1)) hemagglutinin (HA) gene, partial cds
</TD></TR><TR><TD width="20%">DQ497656.1</TD><TD width="80%">Influenza A virus (A/chicken/Bangli Bali/BPPV6-2/2004(H5N1)) hemagglutinin (HA) gene, partial cds
</TD></TR><TR><TD width="20%">DQ497657.1</TD><TD width="80%">Influenza A virus (A/chicken/Jembrana/BPPV6/2004(H5N1)) hemagglutinin (HA) gene, partial cds
</TD></TR><TR><TD width="20%">DQ497658.1</TD><TD width="80%">Influenza A virus (A/chicken/Mangarai-NTT/BPPV6/2004(H5N1)) hemagglutinin (HA) gene, partial cds
</TD></TR><TR><TD width="20%">DQ497659.1</TD><TD width="80%">Influenza A virus (A/duck/Parepare/BBVM/2005(H5N1)) hemagglutinin (HA) gene, partial cds
</TD></TR><TR><TD width="20%">DQ497660.1</TD><TD width="80%">Influenza A virus (A/chicken/Kupang-2-NTT/BPPV6/2004(H5N1)) hemagglutinin (HA) gene, partial cds
</TD></TR><TR><TD width="20%">DQ497661.1</TD><TD width="80%">Influenza A virus (A/chicken/Kupang-3-NTT/BPPV6/2004(H5N1)) hemagglutinin (HA) gene, partial cds
</TD></TR><TR><TD width="20%">DQ497662.1</TD><TD width="80%">Influenza A virus (A/chicken/Kupang-1-NTT/BPPV6/2004(H5N1)) hemagglutinin (HA) gene, partial cds
</TD></TR><TR><TD width="20%">DQ497663.1</TD><TD width="80%">Influenza A virus (A/chicken/Pangkalpinang/BPPV3/2004(H5N1)) hemagglutinin (HA) gene, partial cds
</TD></TR><TR><TD width="20%">DQ497664.1</TD><TD width="80%">Influenza A virus (A/turkey/Kedaton/BPPV3/2004(H5N1)) hemagglutinin (HA) gene, partial cds
</TD></TR><TR><TD width="20%">DQ497665.1</TD><TD width="80%">Influenza A virus (A/chicken/Simalanggang/BPPVI/2005(H5N1)) hemagglutinin (HA) gene, partial cds
</TD></TR><TR><TD width="20%">DQ497666.1</TD><TD width="80%">Influenza A virus (A/chicken/Tebing Tinggi/BPPVI/2005(H5N1)) hemagglutinin (HA) gene, partial cds
</TD></TR><TR><TD width="20%">DQ497667.1</TD><TD width="80%">Influenza A virus (A/chicken/Dairi/BPPVI/2005(H5N1)) hemagglutinin (HA) gene, partial cds
</TD></TR><TR><TD width="20%">DQ497668.1</TD><TD width="80%">Influenza A virus (A/chicken/Deli Serdang/BPPVI/2005(H5N1)) hemagglutinin (HA) gene, partial cds
</TD></TR><TR><TD width="20%">DQ497669.1</TD><TD width="80%">Influenza A virus (A/chicken/Tarutung/BPPVI/2005(H5N1)) hemagglutinin (HA) gene, partial cds
</TD></TR></TBODY></TABLE>
 
Re: Indonesia H2H Cover-up?

Henry - Do you have a source for this "cover-up" info? Or can you say why you believe this?
 
Re: Indonesia H2H Cover-up?

There has only been one human HA H5N1 sequence released (from index cluster in July 2005). The cleavage site is not in any bird H5N1 from Indonesia including those listed in first post and below. In fact the RESRRKKR cleavage site is not in any H5N1 at Genbank. Rumor has it that it is common in mammalian sequences from Indonesia, suggesting the birds are not the source for the human infections.

<TABLE cellSpacing=5 cellPadding=5 width="90%" border=0><TBODY><TR><TD align=middle colSpan=2>Nucleotide Sequences</TD></TR><TR><TD width="20%">AY651320.1</TD><TD width="80%">Influenza A virus (A/Ck/Indonesia/PA/2003(H5N1)) hemagglutinin (HA) gene, partial cds

</TD></TR><TR><TD width="20%">AY651321.1</TD><TD width="80%">Influenza A virus (A/Ck/Indonesia/BL/2003(H5N1)) hemagglutinin (HA) gene, partial cds

</TD></TR><TR><TD width="20%">AY651322.1</TD><TD width="80%">Influenza A virus (A/Dk/Indonesia/MS/2004(H5N1)) hemagglutinin (HA) gene, partial cds

</TD></TR><TR><TD width="20%">AY651323.1</TD><TD width="80%">Influenza A virus (A/Ck/Indonesia/2A/2003(H5N1)) hemagglutinin (HA) gene, partial cds

</TD></TR><TR><TD width="20%">AY651324.1</TD><TD width="80%">Influenza A virus (A/Ck/Indonesia/4/2004(H5N1)) hemagglutinin (HA) gene, partial cds

</TD></TR><TR><TD width="20%">AY651325.1</TD><TD width="80%">Influenza A virus (A/Ck/Indonesia/5/2004(H5N1)) hemagglutinin (HA) gene, partial cds

</TD></TR></TBODY></TABLE>
 
Re: Indonesia H2H Cover-up?

I'll buy the birds are not the source, but could the source be mammalian, insectivore or actually limited h2h?
 
Re: Indonesia H2H Cover-up?

WHO is playing dumb? As long as the bomb went off within a family, it doesn't matter if H5N1 got the right fuse.

Graham Tallis, a WHO epidemiologist who traveled to the family's village to investigate the cases, said that while health officials were on alert for cases of fever and there are a lot of health-care workers in the area, "there's no evidence of spread beyond the family group."


Here is Dr. Niman's comment:

The latest cluster in Indonesia again raises the question of human-to-human (H2H) transmission. As in most familial clusters, there is a 5?10 day gap between the disease onset date (April 27) of the index case, and other family members (May 3?4). In addition, the family members were at an April 29 BBQ, suggesting they were infected there by the index case. The number of clusters in Indonesia remains high. In addition to the familial clusters, there is a geographical cluster in Bekasi.
 
Re: Indonesia H2H Cover-up?

Yes, they all dead, most of them, but if someone can find out what the vector is, maybe we can stop it, from starting up again.
The geographical cluster in Bekasi is even more disturbing. Now Dr Niman is saying 30 confirmed, is that in total, or in this instance?
 
Re: Indonesia H2H Cover-up?

How do we as a community voice our opposition to the with-holding of the sequences?

-Hawkeye
 
Re: Indonesia H2H Cover-up?

WHO officials consider this right at this moment.

See that tread.
WHO May Open Its Private Bird Flu Database
http://www.flutrackers.com/forum/showthread.php?t=2899&highlight=database

The main issue for WHO may be to keep access to the Chinese data.

For the Indonesian issue, a novel cleavage site unique for human sequences is a strong evidence and a concerning one.

This is a Quote from the last "Weekly epidemiological record" of WHO
at http://www.who.int/wer

Avian influenza, Indonesia- Update

...

An investigation to determine the source of his infection is continuing. He lived in close proximity to pens where animals, including poultry, were kept.

...
Click to expand...

The sentence is write in a way to let think the animals where more important as an infection source than poultry.
This is even more obvious in the French version on the document.

The other relevent info is "An investigation ... is continuing".

Maybe we are very near of a major announcement and the rumors Dr.Niman talking about is just an other clue pointing toward this whole picture.
 
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Re: Indonesia H2H Cover-up?

It seems the only way to get something done is through the media. If some intrepid journalist with the right backing had the courage to stand up and let people know how important it is that these sequences be shared than maybe something could happen.

Don't bother writing to your senators or congressman as that will accomplish nothing.

The media is the only way to go.
 
Re: Indonesia H2H Cover-up?

We could stop paying taxes, the WHO (not the band) is financed by governments. :D

DB is right " The media is the only way to go."
 
Re: Indonesia H2H Cover-up?

http://www.recombinomics.com/News/05170605/H5N1_Indonesia_Novel.html
Commentary

Novel Human H5N1in Indonesia Raises Pandemic Concerns
Recombinomics Commentary
May 17, 2006

The recent large cluster in Indonesia has refocused attention on human-to-human transmission and the novel cleavage site in human HA H5N1. Although cleavage sites can change, there has been no evidence for a species specific change.
The first H5N1 isolated in Asia in 1996 in the Guangdong goose had the highly pathogenic sequences of RERRRKKR. That sequence has found in the human cases in 1997 as well as most human and animal isolates in Asia. In 2005 milder cases in northern Vietnam had been noted and those cases had lost an R in the cleavage site, which was then RERRKKR. Recently, China released human sequence data and those sequences were closely related to a Fujian strain, which was missing a K, giving the sequence RERRRKR. However, that cleavage site had been found in a duck in Fujian province and had been in bird H5N1 sequences dating back to 2003. The Qinghai strain of H5N1 has a unique sequence of GERRRKKR, which is found in virtually all of the Qinghai isolates, including human isolates from Iraq and Egypt.
Thus, although the cleavage can change, the change is typically found in both mammals and birds. The bird H5N1 sequences from Indonesia have the common sequence of RERRRKKR and the recent sequences from Indonesia span isolates from 2003 to 2005. However, the human isolate from 2005 has the novel sequence RESRRKKR. This sequence is not found in any of the avian H5N1 Indonesian sequences or any other H5N1 sequence at GenBank. However, the one sequence is not definitive because there are some novel sequences that have not become widespread and may lack significance.
However, a report that a cat sequence from Indonesia has the same change is cause for concern, as is the comment that many additional human sequences from Indonesia also have the same change. A large number of human isolates with RESRRKKR, in the absence of any avian sequences with RESRRKKR, would indicate that birds were not a source of the human H5N1 infections.
These data raise concerns that the human sequences are due to infection by H5N1 from other humans or other mammals. Since there have been over 30 confirmed cases of human H5N1 in Indonesia, the WHO private database would have the answer to the frequency of human H5N1 with the novel cleavage site.
If that data validates the comment that several human and cats sequences have the novel site, then the claims that the human cases were due to poultry infections would be suspect and the limited testing, which requires association with dying poultry should be expanded to those who have bird flu symptoms, but lack a poultry connection.
 
Re: Indonesia H2H Cover-up?

Well we keep coming back to cats. Though as I understand it they are mainly feral. Did this family have a pet cat?
 
Re: Indonesia H2H Cover-up?

<!-- / icon and title --><!-- message -->
Bird flu human-to-human infection feared

18 May 2006 <TABLE cellSpacing=0 cellPadding=0 width=5 border=0><TBODY><TR><TD height=5>
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</TD></TR></TBODY></TABLE>
[FONT=Verdana, Arial, Helvetica, MS Sans Serif]JAKARTA: The World Health Organisation confirmed six more human cases of bird flu infections in Indonesia, including five members of a family whose case has triggered fears of human-to-human transmission.[/FONT]

[FONT=Verdana, Arial, Helvetica, MS Sans Serif]"There are six confirmations. One from Surabaya and five from Medan. One from Medan is still alive," said Sari Setiogi, the WHO's Indonesia spokeswoman. [/FONT]
[FONT=Verdana, Arial, Helvetica, MS Sans Serif]An outbreak of H5N1 bird flu involving up to eight members of a family at Medan in North Sumatra province has worried health agencies around the world but a Health Ministry official said on Wednesday it was not a case of human-to-human transmission. [/FONT]
[FONT=Verdana, Arial, Helvetica, MS Sans Serif]"The spread was through risk factors from poultry or other animals. There is no proof of human to human," Nyoman Kandun, director-general of disease control, said. [/FONT]
[FONT=Verdana, Arial, Helvetica, MS Sans Serif]"The world is watching us. We are not being hasty," he added. [/FONT]
[FONT=Verdana, Arial, Helvetica, MS Sans Serif]Four of the five family members have died and samples from a further three people believed to be part of the family cluster of infections are still being tested. [/FONT]
[FONT=Verdana, Arial, Helvetica, MS Sans Serif]The WHO has sent a team to the area near Medan. The agency said it was on alert for signs the virus is mutating into one that can be easily transmitted between people, a development that could signal the start of a pandemic in which millions could die. [/FONT]
[FONT=Verdana, Arial, Helvetica, MS Sans Serif]
[/FONT]
[FONT=Verdana, Arial, Helvetica, MS Sans Serif]Such a mutation could occur anywhere there is bird flu, the WHO says. [/FONT]
[FONT=Verdana, Arial, Helvetica, MS Sans Serif]Kandun said authorities were still trying to identify the source of the virus in the cluster case in Kubu Simbelang village in Karo regency, about 50km (30 miles) south of Medan. [/FONT]
[FONT=Verdana, Arial, Helvetica, MS Sans Serif]But an Indonesian agriculture official who declined to be named told Reuters tests had shed no light on the case. [/FONT]
[FONT=Verdana, Arial, Helvetica, MS Sans Serif]"There is a big question mark. Blood samples from all kinds of animals from chickens, ducks, geese, birds, pigs, cats and dogs turned out negative so far. Manure has also been checked. The result is negative," the Jakarta-based official said. [/FONT]
[FONT=Verdana, Arial, Helvetica, MS Sans Serif]Some reports have suggested chicken manure used as fertiliser might be the link. Infected birds can excrete large amounts of the H5N1 virus and this can be one way it can spread to birds, and people. [/FONT]
[FONT=Verdana, Arial, Helvetica, MS Sans Serif]The sixth of the cases confirmed on Wednesday was a 38-year-old catering businesswoman from Surabaya who had dealt with live pigs and pork meat before she died last week. [/FONT]
[FONT=Verdana, Arial, Helvetica, MS Sans Serif]The latest deaths bring the number of Indonesians who have died from bird flu to 30, by far the highest death rate in the world this year from the disease. [/FONT]
[FONT=Verdana, Arial, Helvetica, MS Sans Serif]Bird flu has killed 115 people worldwide, the majority in east Asia, since reappearing in 2003. Virtually all the victims caught the disease from poultry. [/FONT]
[FONT=Verdana, Arial, Helvetica, MS Sans Serif]The H5N1 virus is endemic in much of Indonesia. On Tuesday a senior Agriculture Ministry official said H5N1 had been detected for the first time in poultry in remote eastern Papua province.
http://www.stuff.co.nz/stuff/0,2106,3671206a12,00.html
[/FONT]
<!-- / message --><!-- controls -->
 
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Re: Indonesia H2H Cover-up?

<!--StartFragment --> You can?t tell the players without a scorecard and the comments and actions have been quite bizzare. Although Dr Jeremijenko suggested there was a problem because the Vet and Med groups don?t talk, he was being kind and creating some lines to read between.


The HA cleavage site is the first thing sequenced in most animal labs, so the difference between the cleavage sites must be well known. However, Hong Kong has data for both, and certainly knows that RESRRKKR is novel.

Indonesia sends its human samples to Hong Kong (YI Guan and Maelik Perez) for confirmation. They have a huge sequencing lab and have commented in the past that the human Indonesian sequences were like the Indonesian poultry sequences, so they definitely have the human sequences.


However, it is Hong Kong that has published ALL of the Indonesian bird sequences (one small set in 2004 when the first H5N1 sequences came out, and again in 2006 in assocaition with their recent publication on H5N1 saying that there were regional diffeences, and then again more recntly in the absense of publication. The recent sequences were bird isolates from Indonesia and both bird and human isolates from Vietnam. Hong Kong has also released prior to publication, 2006 bird sequences from Malaysia and Laos (showing that they were like the Fujian strain infecting people in China).


Thus, Hong Kong has started releasing sequences prior to publication, has released many Indonesian bird sequences, and has released ZERO human sequences from Indonesia (the lone human sequence was released by the CDC).


Yi Guan knows there is H2H in Vietnam and Indonesia. When WHO put out the nonsense on duck blood pudding for the cluster in early 2005, Yi Guan said it was not possible to develop symptoms 17 days after exposure, but WHO not only held onto their fairy tale, they actually used the 17 days in their new guidlines, saying that symptoms could occur 17 days after exposure, which was and is utter nosnense, but that?s how they denied H2H in that cluster.


Now Yi Guan is again saying that the spread between the disease onset date of the index case in Indonesia and the family members is also too long for a common source, again implying H2H.


Thus, Yi Guan knowns how many human sequneces have the novel cleavage site, knows there is H2H, yet is holding the human sequences.

Clearly WHO or Indonesia or both don?t want that info released. When asked about earlier relase a few months ago, Yi Guan said they would reconsider if WHO changed its policy, implying the hold was linked to WHO. Hong Kong has now released many animal sequences, but the human sequences remain locked up, so it sounds like it is WHO or Indonesia or both, and I suspect it is BOTH that hold the key.
 
Re: Indonesia H2H Cover-up?

Thank you Dr. Niman for providing some clarity on the situation.
 
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