Pakistan: Human H5N1 Cluster December 2007

HenryN · Dec 15, 2007

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

<TABLE class=lan18 cellSpacing=0 cellPadding=0 width="97%" align=center border=0><TBODY><TR><TD class=hei22 vAlign=bottom height=25>2 Pakistanis die of bird flu
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2007-12-15 20:41:04 </TD><TD class=hui12 align=middle width="26%"> </TD><TD class=hui12 align=middle width="12%">

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ISLAMABAD, Dec. 15 (Xinhua) -- Pakistani National Institute of Health on Saturday confirmed that two people died of bird flu in northwestern Pakistan.
The two cases were registered in North West Frontier Province (NWFP), local TV channel DAWN NEWS reported. The administration of Khyber Teaching Hospital (KTH) on Thursday said that two brothers Mohammad Ilyas and Tariq, who were brought to the hospital from Mansehra in NWFP on suspicion of carrying H5N1 virus, died of bird flu at last, according to local newspaper The News. "The two brothers have been confirmed as bird flu victims and are the first human sufferers of the disease in our country," Dr Siddiqur Rahman, Acting Chief Executive of the KTH, was quoted by The News as saying.

http://news.xinhuanet.com/english/2007-12/15/content_7256463.htm

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HenryN · Dec 15, 2007

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Pakistan confirms first bird flu death
Posted: 15 December 2007 2059 hrs
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ISLAMABAD : Pakistan on Saturday confirmed that a man who worked on a poultry farm with infected birds has become the country's first death from the bird flu virus.

One of the man's brothers also died but he was not tested for the virus, the health ministry said in a statement.

It did not say why the second man was not tested.

Six people were confirmed to have been infected with the H5N1 strain of avian influenza, all of them in North West Frontier Province, which borders Afghanistan, the ministry said.

"Five of them have fully recovered. One of the confirmed cases died in hospital while his brother, who could not be tested, has also died," the statement said.

A spokesman told AFP that the confirmed victim, Muhammad Tariq, had been involved in a cull of birds at an infected poultry farm in late October.

Three of his brothers were also admitted to hospital and one, named Mohammad Illyas, also died.

"We are not certain how Illyas died because we could not conduct his testing," the spokesman said.

Hospital officials in the provincial capital of Peshawar told AFP that Tariq died late last month, a few days before his brother, who was admitted with similar symptoms but was not tested for the virus.

The virus is usually transmitted to humans from infected birds but scientists fear it could mutate into a form easily transmissible between humans, sparking a global pandemic that could kill millions. - CNA/ch

http://www.channelnewsasia.com/stories/afp_asiapacific/view/317593/1/.html

HenryN · Dec 15, 2007

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Bird flu kills man in Pakistan

13 minutes ago
Six people in northern Pakistan were infected with H5N1 bird flu last month and at least one person has died of the disease, the government said.
It was not immediately clear if the World Health Organisation also had identified the bird flu virus as the deadly H5N1 strain.
Of the six people who tested positive, "Five of them have fully recovered. One of the confirmed cases died in hospital, while his brother who could not be tested has also died," the Health Ministry said in a statement.

http://ukpress.google.com/article/ALeqM5j4PzFI2gVU43AO2L6VmgbhDeEWkg

HenryN · Dec 15, 2007

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Last Modified: 15 Dec 2007
Source: PA News

Six people in northern Pakistan were infected with H5N1 bird flu last month and at least one person has died of the disease, the government said.
<!--p class="mpujump">article continues below...</p>

</a-->It was not immediately clear if the World Health Organisation also had identified the bird flu virus as the deadly H5N1 strain.
<!--p class="mpujump"><a href="#fold">article continues below...</p>

</a-->Of the six people who tested positive, "Five of them have fully recovered. One of the confirmed cases died in hospital, while his brother who could not be tested has also died," the Health Ministry said in a statement.

<A href="http://www.channel4.com/news/articles/world/bird+flu+kills+man+in+pakistan/1188852">http://www.channel4.com/news/articles/world/bird+flu+kills+man+in+pakistan/1188852
<!--p class="mpujump">article continues below...</p>

HenryN · Dec 15, 2007

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

[FONT=Georgia, Times New Roman, Times, serif]6 Pakistanis infected, one fatally, with H5N1 bird flu, government says[/FONT]

2007-12-15 14:30:38 -

ISLAMABAD, Pakistan (AP) - Six people caught H5N1 bird flu in northern Pakistan last month and at least one person with the disease has died, the government said Saturday.
The World Health Organization confirmed the H5N1 strain was found in the six cases, but said a second round of tests were being carried out to make sure.
If confirmed, the infections would be the first in humans in Pakistan.
The Health Ministry said it had tested several patients and others they had been in contact with in late October. The results for six people from the Abbottabad and Mansehra districts of North West Frontier Province were positive, it said in a statement.
?Five of them have fully recovered. One of the confirmed cases died in hospital, while his brother who could not be tested has also died,? the Health Ministry said in a statement.
To prevent the disease spreading, the ministry said it was treating people who had been in contact with those infected, setting up isolation wards in hospitals and procuring drugs for treatment and protective clothing for health workers.
Khalif Bile, the WHO representative in Pakistan, said preliminary tests had been carried out. He said the WHO was encouraging the government to carry out confirmation tests and the results should be available by Tuesday. 

http://www.pr-inside.com/print349834.htm

Commonground · Dec 15, 2007

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Dr. Niman, after reading all these posts, I am thinking that Muhammad Tariq was the Index Case. He was involved in a cull in late October. Worked on a poultry farm. Died late last month. A few days before his brother Illyas was admitted.

HenryN · Dec 15, 2007

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Commentary at

http://www.recombinomics.com/News/12150702/H5N1_Pakistan_Confirmed_H2H2H.html

yielddude · Dec 15, 2007

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Pakistan Reports One Death From Bird Flu Virus; Six Infected

By Khaleeq Ahmed

Dec. 15 (Bloomberg) -- Pakistan reported its first death from the lethal H5N1 strain of avian influenza, with three others quarantined after showing symptoms of the disease.

``One man died from bird flu on Nov. 25 in the northwestern city of Peshawar, three recovered and were sent home and another three are in quarantine and being looked after,'' Federal Health Secretary Khushnood Lashari said in a phone interview from the capital, Islamabad, today.

The health ministry can't confirm whether two brothers who died last week had also been infected with the lethal H5N1 strain because they were buried before specimens were collected, Lashari said.

The new cases show the H5N1 flu strain is continuing to spread, putting people at risk of the disease and creating opportunities for the virus to become adept at infecting humans. The World Health Organization says millions could die if the virus becomes as contagious as seasonal flu and touches of a global pandemic.

At least 340 people in 13 countries have contracted the virus since 2003. Three of every five cases were fatal and most were caused by contact with infected poultry, such as children playing with them or adults butchering them or plucking feathers, according to the Geneva-based WHO.

Including the five most recent cases, nine people are reported to have been infected with H5N1 so far this month, the most since June. There were five recorded cases in December 2006.

Four cases of infection were recorded in Indonesia, China and Myanmar this month.

Poultry Outbreaks

Pakistan has reported 44 H5N1 outbreaks in poultry to the World Organization for Animal Health since early 2006. The most recent occurred on Nov. 27 and 28 in the states of Punjab and North-West Frontier Province, killing almost 20,000 chickens.

Suspected H5N1 fatalities in Pakistan were reported by the News yesterday. Two brothers died Dec. 10 at Khyber Teaching Hospital in Peshawar after contracting the virus, possibly at the poultry farm on which they worked in Mansehra, the daily national newspaper reported, citing Siddiqur Rahman, the hospital's acting chief executive. Mansehra is in North-West Frontier Province, which borders Afghanistan.

Of those who have tested positive for the virus, three have been hospitalized in Mansehra, said Lashari at the health ministry. The most recent infection was diagnosed Dec. 5, he said. The other cases are in the provincial capital, Peshawar, one of whom has recovered and was discharged from the hospital.

Those still infected have been quarantined and authorities from the Ministry of Food, Agriculture and Livestock are checking whether the disease has spread further among poultry flocks. Supplies of Roche Holding AG's antiviral medicine, Tamiflu, have been dispatched to affected districts.

Myanmar Case

Myanmar, formerly known as Burma, confirmed its first human H5N1 infection in a 7-year-old girl from the township of Kyaing Tone in eastern Shan state, WHO said in a statement yesterday. The case was detected through routine surveillance following an outbreak of H5N1 in poultry in the area in mid-November, the agency said.

The girl developed fever and a headache on Nov. 21 and was hospitalized six days later. She has now recovered, WHO said. The National Health Laboratory in Yangon and the National Institute of Health in Thailand made the initial diagnosis, which was confirmed at the WHO Collaborating Centre for Reference and Research on Influenza in Tokyo, the agency said.

To contact the reporter on this story: Khaleeq Ahmed in Islamabad on paknews@bloomberg.net

Last Updated: December 15, 2007 09:10 EST

http://www.bloomberg.com/apps/news?pid=20601091&sid=a1ENfQg82MGE&refer=india

HenryN · Dec 15, 2007

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Commonground said:
Dr. Niman, after reading all these posts, I am thinking that Muhammad Tariq was the Index Case. He was involved in a cull in late October. Worked on a poultry farm. Died late last month. A few days before his brother Illyas was admitted.

The vet was the index case. This is H2H2H or H2H2H2H, depending on when the fourth brother developed symptoms.

HenryN · Dec 15, 2007

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

One dead, six infected with bird flu in Pakistan

Sat Dec 15, 2007 7:55pm IST

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ISLAMABAD (Reuters) - Pakistan has recorded its first human death from bird flu and six other people have been infected with the deadly H5N1 virus over the last two months, a senior Health Ministry official said on Saturday.
"Seven in total. One died and six other people were infected with the H5N1 virus," Federal Health Secretary Khushnood Akhtar Lashari told Reuters. "It was confirmed by blood tests."
The cases were reported in the North West Frontier Province, Lashari said.
Two people have recovered and four are in quarantine.
While Pakistan has registered cases of bird flu in poultry this is the first time it has been reported in humans, Lashari said. The first poultry case appeared in early 2006.
Lashari said no more poultry or human cases had been detected in the last two weeks. A World Health Organisation (WHO) team will arrive in Pakistan in the next few days.
It has so far appeared difficult for humans to contract H5N1, which is mainly an animal disease. But experts fear the strain could spark a global pandemic and kill millions if it mutates to spread more easily.
WHO spokesman Gregory Hartl said that as many as eight people were suspected to have contracted the virus in the North West Frontier Province, though investigations were continuing.
The first known human infection was in a man who had worked as a poultry culler, who died.
Two of that man's brothers had also fallen ill, one of whom also subsequently died. It has not been confirmed whether the second death occurred as a result of the man caring for his brother or from exposure to infected birds kept in their home, Hartl said.
"The details are not 100 percent clear ... The virus has not been characterised yet," Hartl said, referring to analysis on whether the bird flu strain had mutated. "There are several cases within one family. We don't know how the family members contracted the virus."
The WHO is expected to give more details later on Saturday.
The Pakistani cases would bring to nearly 350 the number of people worldwide who are known to have contracted the H5N1 virus, which has killed more than 200 people since 2003.
Indonesia has had the heaviest toll, with 115 human cases including 92 deaths, followed by Vietnam with 100 cases and 46 deaths, according to WHO figures.

http://in.reuters.com/article/topNe...15?pageNumber=2&virtualBrandChannel=0&sp=true

sharon sanders · Dec 15, 2007

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

From Resident Dark Horse at PFI this morning:

"Sorry, Cactus, I had lots of work to do yesterday and didn't have time to watch the boards. Woke up to all this news this morning.<o

></o

>
<o

> </o

>
I just contacted Tom Skinner, CDC spokesman, and asked him about this New York City event last weekend. He said that the NY State Health Dept. has chapter and verse on the whole thing. Skinner said that the man was tested and did not have H5N1 even though his siblings reportedly did. At this point, he showed no antibodies.<o

></o

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<o

> </o

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I have to run now and don't have time to call the NY State Health Dept, but I'll try later this afternoon.<o

></o

>
<o

> </o

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[FONT=&quot]Why don't you folks here put together a list of questions for me to ask?"

Further corroboration.

[/FONT]

Farmer · Dec 15, 2007

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

More details from WHO and CDC, Helen Braswell reporting:

http://www.ctv.ca/servlet/ArticleNe...1215/avian_flu_071215/20071215?hub=TopStories

Pakistan H5N1 cases may involve human transmission
Updated Sat. Dec. 15 2007 10:12 AM ET

Helen Branswell, medical reporter, The Canadian Press

Authorities in Pakistan have announced that country's first reported cases of H5N1 avian flu in a cluster of family members which may have involved human-to-human transmission.

There was some confusion Saturday about how many people had tested positive for the virus, with Pakistan announcing six cases but an official of the World Health Organization suggesting as many as nine people may have tested positive for the virus in that country.
The WHO spokesperson said investigations are still underway to try to determine how the various people became infected, but some human-to-human spread is possible.

"We can't rule it out,'' WHO spokesperson Gregory Hartl said from Geneva.

"There are other plausible explanations.... We don't know enough at this point. And in some of these cases, one never will know enough.''

The cluster of cases involved four brothers and two cousins living in the country's North West Frontier Province. Two of the brothers died, one without having been tested.

A doctor who treated members of the family also has tested positive for H5N1, Hartl said. But she was not tested with the standard diagnostic assay used to detect H5N1 infection and further testing is needed to determine if she is indeed a case.

Three people who are unrelated to the family but who were involved in culling H5N1-infected poultry in the same area have also tested positive.

Meanwhile, U.S. health officials have confirmed they conducted H5N1 testing on a man who had recently visited Pakistan and was complaining of mild respiratory symptoms. The man is believed to be another brother from the affected family.

A spokesperson for the U.S. Centers for Disease Control confirmed Saturday that the CDC sent its plane to Albany last Saturday to collect specimens taken from the man, who lives in Nassau County.

Tests done in the state lab and confirmed at the CDC in Atlanta showed the man was not infected with the virus.

The initial infection dates back to Oct. 25, when a livestock official -- a brother in the family -- fell ill. It appears that it was only after two of the man's brothers fell ill and died that testing was done looking for H5N1 infection. It is believed the first positive test was received in late November.

The WHO was officially alerted on Dec. 12, Hartl said.

"We feel that the Pakistanis have done everything right in terms of their response,'' he said, noting the country has done a "huge'' amount of work to strengthen infection control and increase surveillance.

"(But) yes, they could have alerted us earlier.''

The statement from Pakistan's health ministry announced six infections, with five people having recovered. It was unclear who the country was counting as cases in that report.

But that figure would not include the brother who died without being tested. While his symptoms and his exposure history are highly suggestive of H5N1 infection, he cannot be added to the official case count.

A lab team from the U.S. Naval Medical Research Unit in Cairo is travelling to Pakistan to conduct confirmatory testing. And WHO is sending a team of two doctors with experience treating H5N1 patients as well as an epidemiologist to help with the investigation of cases.

Pakistan is the 14th country to announce human infections with the H5N1 virus. If these cases are confirmed, they will bring the global case count since late 2003 to nearly 350 human cases and 209 deaths.

On Friday, the WHO announced that Myanmar had reported its first human case in a seven-year-old girl who fell ill in late November. She has since recovered.

sharon sanders · Dec 15, 2007

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

"..Meanwhile, U.S. health officials have confirmed they conducted H5N1 testing on a man who had recently visited Pakistan and was complaining of mild respiratory symptoms. The man is believed to be another brother from the affected family.

A spokesperson for the U.S. Centers for Disease Control confirmed Saturday that the CDC sent its plane to Albany last Saturday to collect specimens taken from the man, who lives in Nassau County.

Tests done in the state lab and confirmed at the CDC in Atlanta showed the man was not infected with the virus..."

A 2nd corroboration. Thank you.

Giuseppe · Dec 15, 2007

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

-=From World Health Organization:=-

Avian influenza ? situation in Pakistan
15 December 2007

The Ministry of Health in Pakistan has informed WHO of 8 suspected human cases of H5N1 avian influenza infection in the Peshawar area of the country. These cases were detected following a series of culling operations in response to outbreaks of H5N1 in poultry. One of the cases has now recovered and a further two suspected cases have since died.

Samples taken from the suspected cases have tested positive for H5N1 in the national laboratory and are being forwarded to a WHO H5 Reference Laboratory for confirmation and further analysis. The MoH is taking steps to investigate and contain this event, including case isolation and contact tracing and monitoring, detailed epidemiological investigations, providing oseltamivir for case management and prophylaxis, reviewing hospital infection control measures and enhancing health care-based and community-based surveillance for acute respiratory infections.

WHO is providing technical support to the MoH in epidemiological investigations, reviewing the surveillance, prevention and control measures that have been implemented and carrying out viral sequencing of avian and human isolates.

Multiple poultry outbreaks of H5N1 influenza have been occurring in Pakistan since 2006. In 2007, there have also been outbreaks in wild birds. A majority of the outbreaks discovered have been in the ?poultry belt? of North-West Frontier Province, particularly in the Abbottabad and Mansehra area and cases of infection in wild birds have been identified in the Islamabad Capital Territory.
-
http://www.who.int/csr/don/2007_12_15/en/index.html
------

sharon sanders · Dec 15, 2007

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

I am now adjusting our ticker tape to reflect this latest corroboration.

Thank you to everyone who supported FluTrackers.

Commonground · Dec 15, 2007

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

The Ministry of Health in Pakistan has informed WHO of 8 suspected human cases of H5N1 avian influenza infection in the Peshawar area of the country. These cases were detected following a series of culling operations in response to outbreaks of H5N1 in poultry. One of the cases has now recovered and a further two suspected cases have since died.

O.K., now what about the confirmed?

Theresa42 · Dec 15, 2007

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Farmer said:
A doctor who treated members of the family also has tested positive for H5N1, Hartl said.

Another indication of possible (probable?) H2H infection.

(THANK YOU, HELEN BRANSWELL!!!)

Theresa42 · Dec 15, 2007

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

CDC notice:

Avian influenza - Situation in Pakistan

December 15, 2007

The Ministry of Health in Pakistan has informed the World Health Organization (WHO) of 8 suspected human cases of H5N1 avian influenza infection in the Peshawar area of the country. If confirmed, these would be the first reported human cases in Pakistan. For more information, see the WHO update from December, 15, 2007. There are no reports of animal or human avian influenza A (H5N1) infections in the United States.

http://www.cdc.gov/flu/avian/updates/pakistan15dec07.htm

HenryN · Dec 15, 2007

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Commentary at

http://www.recombinomics.com/News/12150703/H5N1_Pakistan_Cluster_HCW.html

HenryN · Dec 15, 2007

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

<table id="ss" cellspacing="0"><tbody><tr id="ss-navigation"><td id="ss-zoom-single" colspan="3"></td></tr><tr><td colspan="3">

</td></tr><tr><td id="ss-caption" colspan="3">Pakistani brothers Mohammed Ishtiaq, right, and Mohammed Tariq, left, who were treated for suspected H5N1 bird flu, come out from their house in Sukur village near Peshawar, Pakistan on Saturday, Dec. 15, 2007. Six people caught H5N1 bird flu in northern Pakistan last month and at least one person with the disease has died, the government said Saturday. The U.N. World Health Organization confirmed the deadly H5N1 strain was found in the six cases, but said a second round of tests were being carried out to make sure. (AP Photo/Mohammad Zubair)
http://ap.google.com/article/ALeqM5ilbnTDTey5W_baRqkBnsmWGHIiDwD8TI1NE00

6 Pakistanis Infected With H5N1 Bird Flu

19 minutes ago
ISLAMABAD, Pakistan (AP) — Six people caught the deadly strain of bird flu in northern Pakistan last month and at least one person with the disease has died, the government said Saturday.
The World Health Organization confirmed that all six cases were positive for the H5N1 strain of the virus in preliminary testing, but said a second round of analysis was being conducted to make sure.
If confirmed, the infections would be the first in humans in South Asia.
Pakistan's Health Ministry said it had tested several patients and others with whom they had come into contact in late October. The results for six people from the Abbottabad and Mansehra districts of North West Frontier Province were positive, it said in a statement.
The ministry said five people had fully recovered, one died in a hospital and his brother, who could not be tested, also died. It did not explain why the brother could not be tested.
The virus has killed more than 200 people worldwide since it began ravaging Asian poultry stocks in late 2003, according to the WHO.
Most of the human cases of H5N1 bird flu have been reported in Indonesia and Vietnam. On Friday, the WHO confirmed the first case in Myanmar, where a 7-year-old girl was infected but recovered.

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Pakistan: Human H5N1 Cluster December 2007

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