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Pakistan: Human H5N1 Cluster December 2007

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

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

aROUND 10 DAYS AD

On the edge, not exponential yet

Seldomly but accuratly said in the past as you have witness from so,
not too bad, not too bad

I WILL NOT REPEAT THAT WITHOUT THE PRESENCE OF MY LAWYERS

????????????????????

a HUGE BIG THANK TO UNITED STATES
 
Re: Pakistan: Bird Flu claims 2 lives; more suspects

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

All thanks to Snowhound

PESHAWAR: Inquiry ordered into bird flu death


<center> By Ashfaq Yusufzai</center>
PESHAWAR, Dec 16: The federal government has expressed concern over the death of a person from bird flu virus in the NWFP and directed the provincial health department to hold an inquiry into the matter, sources said.

In a letter to the NWFP health department, the government expressed dissatisfaction over the measures being taken by the department to control the spread of bird flu virus. The health ministry had directed the provincial government to take concrete measures to prevent transmission of the virus to human, the source added.

The letter said the government had been imparting technical training to the officials concerned on modern lines for the last three years but non-existence of a surveillance system had strengthened fears about the threat posed by bird flu.

The provincial government had also been asked to explain why the health department had failed to develop a referral system to apply brakes to the disease.

According to the sources, the provincial government, on its part, had started holding meetings to fix the responsibility on officials for showing laxity in anti-flu effort.

Health secretary Abdul Samad Khan said that the provincial government had created special wards for suspected bird flu cases in 14 districts of the province. He said: ?The blood samples of the two patients, reportedly died of bird flu, had not been received yet.?

He said that an emergency meeting, which took place under the health minister on Friday, issued warning to concerned departments to be alert to cope with the threats posed by the bird flu. The health and livestock departments had decided to develop a surveillance system to monitor the suspected cases, he added

The secretary said that a state of emergency had been declared in the hospitals of various cities, including Mansehra, Abbottabad, Mardan, Charsadda and Nowshera, besides keeping constant monitoring of poultry farms. He said that trained doctors and health workers would examine the patients.

Mr Khan said that guidelines regarding the culling of poultry suspected of carrying virus had already been provided to the people associated with the poultry industry. He said that availability of diagnostic facilities would also help detect the disease.

http://www.dawn.com/2007/12/17/local8.htm
 
Re: Pakistan: Bird Flu claims 2 lives; more suspects

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

Everyone is watching Pakistan and Myanmar.

WHO to investigate bird flu cases in Pakistan, Myanmar

BEIJING, Dec. 17 (Xinhuanet) -- The World Health Organisation (WHO) has sent experts to help investigate the cause of first bird flu cases in people in Pakistan and Myanmar and find out if the virus was transmitted through human contact, according to media reports Sunday.

WHO meanwhile praised Pakistan and Myanmar for their swiftly reporting the cases after the outbreak.

Two brothers Mohammad Ilyas and Tariq, who were brought to a hospital from Mansehra in North West Frontier Province on suspicion of carrying H5N1 virus, died of bird flu in Pakistan Thursday.

"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 Khyber Teaching Hospital in Pakistan.

In Myanmar, the first human infection of bird flu was known to the public on Saturday. A 7-year old girl, Ma Nan Kham Tha, was found infected with bird flu virus among four suspected of carrying the virus last month and was kept in quarantine and given a dosage of timiflu pills since Nov. 27 until her discharge on Dec. 12.

Specimens of the four suspected were first sent to a lab in Yangon which confirmed on Nov. 26 the girl's infection. The human samples of the four were also sent to a lab in Bangkok as well as the WHO lab in Tokyo and those laboratory tests further confirmed the status.

Khalif Bile, WHO representative in Pakistan, said preliminary tests had been carried out, adding the organization was encouraging the governments to carry out confirmation tests and the results should be available by Tuesday.

The H5N1 virus has killed at least 208 people worldwide since it began ravaging Asian poultry stocks in late 2003. So far, most human cases have been linked to contact with sick birds.
 
Re: Pakistan: Bird Flu claims 2 lives; more suspects

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

Frontier seriously considering closing poultry business
By Mushtaq Yusufzai

PESHAWAR: The Caretaker NWFP Health Minister Syed Kamal Shah expressed his dismay over the ?continuous reluctance? of the National Institute of Health (NIH) in providing the provincial government with reports regarding the bird flu victims.

Setting a 24-hour deadline to the NIH for releasing the report, he said that the institute?s denial or delay would be taken as they were hiding the report for vested interests. Besides, Syed Kamal said that the NWFP government was seriously considering closing down the poultry business in the Frontier province.

The minister said 70 per cent of Pakistan?s poultry industry was based in the two districts of the NWFP, including Abbottabad and Mansehra, which he felt had been posing serious threat to the lives of the local population.

It may be recalled that after the painful deaths of two young brothers, Muhammad Idrees and Muhammad Ilyas, at the Khyber Teaching Hospital (KTH) in Peshawar on October 19 and 29 respectively mainly because of the sheer negligence of the hospital administration as well as by the unresponsive attitude of the NIH authorities, three more patients suffering from bird flu virus were admitted to hospitals in Abbottabad and Peshawar.

In Ayub Medical Complex (AMC), Abbottabad, where two patients, Omar, 38, and a 10-year-old girl were admitted, doctors said their condition was stable and they were sent home.

Medical Superintendent AMC Dr Iftikhar, when reached on telephone, told ?The News? one of them Omar was working at a poultry farm in Abbottabad while the girl was living in the vicinity of the farm.

?Their blood samples had been sent to the NIH but the report is awaited,? he said. Another patient Riaz Hussain, who belongs to the nearby Palosai town, was admitted to the KTH.

Dr Mukhtiar Zaman Afridi, who is a noted chest physician and in charge of Pulmonology ward of the hospital, when contacted on telephone said the patient was in a stable condition and his blood samples had been sent to the NIH. Also, he said the report was expected to be made available to them today (Monday).

He said the patient had been kept in an isolation room and was under his personal observation. However, during a visit to the hospital (KTH) on Sunday, a number of doctors and health workers complained to this correspondent that there was a mechanism to keep them safe from the virus but the ventilator of the isolation room where the patient had been kept was open and the virus could spread around in the entire hospital through air.

Also, this scribe found Dr Mukhtiar Zaman Afridi was removing fears from the mind of his staff created after the death of two brothers under their observation. Majority of doctors, paramedics and nurses were reluctant to go into the isolation room to attend the patient.

However, Dr Mukhtiar?s lecture persuaded his staff to continue attending this altogether different patient. Despite being a public holiday, Dr Mukhtiar was seen present in the hospital from early morning to the evening where he regularly examined the patient.

It was dismal to note that the two isolation rooms where the two brothers were kept and later died were found locked by the hospital administration. Also, despite the passage of two weeks, the KTH administration has failed to ensure sterilisation of equipment used in attending the two brothers.
 
Re: Pakistan: Bird Flu claims 2 lives; more suspects

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

AVIAN INFLUENZA, HUMAN (167): PAKISTAN*****************************************A ProMED-mail post<http://www.promedmail.org>ProMED-mail is a program of theInternational Society for Infectious Diseases<http://www.isid.org>
Date: Sun 16 Dec 20007Source: The Nation (Pakistan), Agence France Presse (AFP) report [edited]<http://www.nation.com.pk/daily/dec-2007/16/index11.php>The Health Ministry on Saturday [15 Dec 2007] confirmed that a manwho died after culling infected birds at a poultry farm was thecountry's 1st fatality from the bird flu virus. One of the man'sbrothers who took part in the cull also died, but he was not testedfor the virus, a Ministry spokesman told AFP. It was not immediatelyknown why the 2nd man was not tested [Previously, it was reportedthat he had been buried before samples could be taken. - Mod.CP].The spokesman ruled out any case of human-to-human transmission, adevelopment that could have signaled a mutation of the virus with thepossibility to kill millions around the world. 6 people wereconfirmed to have been infected with the H5N1 strain of avianinfluenza, all of them in the North Western Frontier Province (NWFP),the Ministry said in a statement. "5 of them have fully recovered.One of the confirmed cases died in hospital, while his brother, whocould not be tested, has also died," it said.Ministry spokesman Mazhar Nisar said the confirmed victim, the brother who died, and 2 other brothers who were infected but survived all worked on the same cull of infected birds. "We are not certain how (the brother) diedbecause we could not conduct his testing," Nisar said.Hospital officials in Peshawar [NWFP] told AFP that the confirmedvictim died late last month [November 2007], a few days before hisbrother, who was admitted with similar symptoms but was not tested.Nisar said there had been no human transmission in this case.--
Communicated by:ProMED-mail Rapporteur Mary Marshall
[This report provides a new twist to the story, contradicting somepreviously reported statements from the Ministry. In this version, the number of confirmed cases is 6, 5 of whom have recovered. Two of 4 brotherstested H5N1-positive, while a 3rd died but was not tested. Three ofthese 4 brothers, including the 2 fatal cases and one of the 2surviving brothers, were employed in poultry culling. (Elsewhere itis recorded that the 4th was a visitor now returned to the USA andfound to be H5N1-negative there). If this version of the story iscorrect, it is likely that the brothers were infected from the samesource in the course of their employment and that human-to-humantransmission has not occurred. Further clarification and verificationof the diagnoses by an independent source are awaited. - Mod.CP]
[see also:
Avian influenza, human (166): Pakistan, WHO 20071215.4038
Avian influenza, human (165): Pakistan 20071214.4023
Avian influenza, human (163): Pakistan 1st report 20071213.4008]
.....................................cp/msp/jw
</PRE>
 
Re: Pakistan: Bird Flu claims 2 lives; more suspects

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

AVIAN INFLUENZA, HUMAN (167): PAKISTAN
[This report provides a new twist to the story, contradicting somepreviously reported statements from the Ministry. In this version, the number of confirmed cases is 6, 5 of whom have recovered. Two of 4 brotherstested H5N1-positive, while a 3rd died but was not tested. Three of these 4 brothers, including the 2 fatal cases and one of the 2 surviving brothers, were employed in poultry culling. (Elsewhere itis recorded that the 4th was a visitor now returned to the USA andfound to be H5N1-negative there). If this version of the story iscorrect, it is likely that the brothers were infected from the same source in the course of their employment and that human-to-humantransmission has not occurred. Further clarification and verificationof the diagnoses by an independent source are awaited. - Mod.CP]


</PRE>
Considering the current date and the overwhelming data supporting H2H, calling the above commentary citing a "common source" pure propadanda is not bashing. It is a VERY well documented fact.
 
Re: Pakistan: Bird Flu claims 2 lives; more suspects

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

WHO warns countries to be vigilant as bird flu flares in Asia

By MARGIE MASON
AP Medical Writer

HANOI, Vietnam (AP) -- The World Health Organization warned Monday that countries should be on alert for bird flu because it is again on the move, with Pakistan reporting new infections and Myanmar logging its first human case.

"The key to the public health response is surveillance," said Peter Cordingley, spokesman for the WHO Western Pacific region in Manila. "If we do actually get to the cases with antivirals early on, the health outcome is a lot better."

WHO experts were arriving in Pakistan to try to sort out cases reported there, South Asia's first human infections.

Four brothers and two cousins fell ill last month in Abbotabad, a small city north of Islamabad, while three others who slaughtered poultry in the same area and a nearby town tested positive for the H5N1 bird flu virus earlier this month.

Two of the brothers died, but specimens were collected from only one.

The cases were positive for H5N1 in initial government testing, but WHO will conduct further analysis to confirm the results.

WHO spokesman Gregory Hartl in Geneva said Sunday human-to-human transmission had not been ruled out, but added that poultry outbreaks had earlier been reported in the area and it was unclear whether all the patients were exposed to sick birds.

A doctor who cared for the brothers also experienced mild flu-like symptoms, but more testing needs to be carried out to determine if she was infected, Hartl said.

With fresh poultry outbreaks reported in a number of countries, including Germany over the weekend, WHO urged nations to be vigilant in identifying and reporting cases in both birds and humans.

Myanmar's first human case was reported Friday in a 7-year-old girl who fell ill last month and survived, while Indonesia, the country hardest hit by the virus, has announced its 93rd death from the virus.

Two human cases were also recently confirmed in China, one of whom died.

The H5N1 virus often flares during the winter months. In some countries, like Indonesia, poultry outbreaks and human cases are reported year round, but many countries experience a flurry of activity when temperatures drop.

"It starts to pop at this time of the year, not just in this region where it's endemic, but it starts to appear in the West," Cordingley said. "Between now and April is a very dangerous time of the year."

At least 208 people have died from the virus, which began plaguing Asian poultry stocks in late 2003. It remains hard for people to catch, but scientists worry it could mutate into a form that spreads easily among people, potentially sparking a pandemic.

Most human cases have been linked to sick birds, but experts suspect limited transmission may have occurred in a few cases involving blood relatives.

http://hosted.ap.org/dynamic/storie...ME&TEMPLATE=DEFAULT&CTIME=2007-12-17-01-47-11
 
Re: Pakistan: Bird Flu claims 2 lives; more suspects

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

<TABLE cellSpacing=0 cellPadding=1 width="99%" align=center border=0><TBODY><TR><TD>[FONT=Verdana, Arial, Helvetica, sans-serif]WHO team arrives in Pakistan to investigate bird flu outbreak [/FONT]</TD></TR><TR><TD><TABLE cellSpacing=0 cellPadding=0 width="100%" border=0><TBODY><TR><TD width="83%">[FONT=Verdana, Arial, Helvetica, sans-serif]Posted on : 2007-12-17 | Author : DPA
News Category : Asia
[/FONT][FONT=Verdana, Arial, Helvetica, sans-serif][/FONT]</TD><TD vAlign=bottom width="17%">[FONT=Verdana, Arial, Helvetica, sans-serif][/FONT]</TD></TR></TBODY></TABLE></TD></TR><TR><TD>[FONT=Verdana, Arial, Helvetica, sans-serif]
[/FONT]<TABLE cellSpacing=2 cellPadding=0 width="100%" border=0><TBODY><TR vAlign=top><TD>[FONT=Verdana, Arial, Helvetica, sans-serif]Islamabad - A medical team from the World Health Organization (WHO) arrived in Pakistan on Monday to investigate a possible human-to-human transmission of the bird flu virus in the country's north-west region. The team, which arrived from Geneva, was due to travel to the North-West Frontier Province to join other WHO staff in the towns of Manshera and Abbotabad, site of the country's first-ever human cases of the H5N1 avian influenza virus, according to WHO officials in Islamabad.
At least two people have died and a total of eight were infected, including a number of blood relatives, prompting Pakistan's Ministry of Health to request the WHO investigate a possible human-to-human transmission, which are extremely rare but have occurred among family members in Indonesia, Cambodia and Vietnam.
Globally, bird flu has killed at least 210 people worldwide since 2003. Most human cases of H5N1 are linked to contact with infected birds, but experts fear the virus might mutate into a form that spreads easily among humans, potentially sparking a pandemic that could kill millions of people.
[/FONT]
</TD></TR></TBODY></TABLE>
</TD></TR></TBODY></TABLE>
http://www.earthtimes.org/articles/show/159896.html#
 
Re: Pakistan: Bird Flu claims 2 lives; more suspects

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

check out the scrolling text in the red banner and the timeliness of the information here http://www.nih.org.pk/ Great way to run a communications campaign. NOT!:( :( :(
 
Re: Pakistan: Bird Flu claims 2 lives; more suspects

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

Great way to expand the petri dish. :(

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

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

check out the scrolling text in the red banner and the timeliness of the information here http://www.nih.org.pk/ Great way to run a communications campaign. NOT!:( :( :(
The H2H cluster began in OCTOBER. Transparency is NOT Pakistan's strong suit.
 
Re: Pakistan: Bird Flu claims 2 lives; more suspects

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

WHO team arrives to probe Pakistan bird flu cases

17 Dec 2007


ISLAMABAD, Dec 17 (Reuters) - A World Health Organization team headed for Pakistan's North West Frontier Province on Monday to investigate how eight people were infected with bird flu, after the country reported its first human death from the virus.

Health officials confirmed at the weekend that eight people had tested positive for H5N1 in the province since late October, of which one person, who worked in a poultry farm, died.

A brother of the dead person, who had not been tested, also died. It was not yet clear if he was a victim of bird flu.

"The team will investigate whom the affected people were in contact with, whether they visited poultry farms or affected persons," Health Secretary Khushnood Akhtar Lashari told Reuters.

"The other people tested positive were not from the poultry farm. Five of them have recovered while two were still being treated."

No more new cases have been reported in the last two weeks.

Humans rarely contract H5N1, which is mainly an animal disease. But experts fear the strain could spark a global pandemic and kill millions of it mutates to a form that spreads more easily.

The three-member WHO team, joined by officials from the Pakistan National Institute of Health, will visit Peshawar, where patients were treated, and Abbottabad, where authorities reported the last H5N1 virus case in wild birds on Nov. 30.

Bird flu first appeared in Pakistan in early 2006, and several outbreaks of H5N1 were reported this year.

http://www.alertnet.org/thenews/newsdesk/ISL93978.htm
 
Re: Pakistan: Bird Flu claims 2 lives; more suspects

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

WHO team arrives to probe Pakistan bird flu cases

17 Dec 2007


ISLAMABAD, Dec 17 (Reuters) - Health officials confirmed at the weekend that eight people had tested positive for H5N1 in the province since late October, of which one person, who worked in a poultry farm, died.

http://www.alertnet.org/thenews/newsdesk/ISL93978.htm
Media myth extended (there has been no credible data indicating the two dead brothers were poultry workers - their surviving brother has been quoted as saying they were students).
 
Re: Pakistan: Bird Flu claims 2 lives; more suspects

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

I post an update about LPAI H5 / H7 poultry epizootics in Italy. I think some of this thread contributors may be interested in details about phylogenetic and genetic relations between viruses detected since June 2007. The post is in European Union wild birds / poultry epizootics update thread I initiated.
 
Re: Pakistan: Bird Flu claims 2 lives; more suspects

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

In post #198 (Bloomberg article), note the reference to quail...

It is too early to determine whether the cases were caused by an animal source or through limited person-to-person spread, he said. Some of the infected people also kept chickens and quails and it is unclear what personal protective equipment was used during culling operations, Hartl said....

Remember that quail have both a2,3 and a2,6 galactose receptors!

So did they catch H5N1 from their chickens or their quail?

See: "Quail carry sialic acid receptors compatible with binding of avian and human influenza viruses" at http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&uid=16325879&cmd=showdetailview&indexed=google

Last sentence....
.....Together with previous observations, these results are consistent with the notion that quail could provide an environment for the spread of reassortants between avian and human influenza viruses, thus acting as a potential intermediate host.
.
 
Re: Pakistan: Bird Flu claims 2 lives; more suspects

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

M.M., APMw.: "... Four brothers and two cousins fell ill last month in Abbotabad, a small city north of Islamabad, while three others who slaughtered poultry in the same area and a nearby town tested positive for the H5N1 bird flu virus earlier this month.
Reuters: No more new cases have been reported in the last two weeks.

After 2 weeks without new infections - another "WHO stage 3" family cluster (?)
 
Re: Pakistan: Bird Flu claims 2 lives; more suspects

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

WHO is now saying 4 brothers and a cousin were +ve in preliminary tests, not 3 bros and 2 cousines, FYI
 
Re: Pakistan: Bird Flu claims 2 lives; more suspects

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

WHO is now saying 4 brothers and a cousin were +ve in preliminary tests, not 3 bros and 2 cousines, FYI
This is in addition to the untested fatal case (or has his sample been "found")?
 
Re: Pakistan: Bird Flu claims 2 lives; more suspects

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

No, they are still talking about 8 preliminary +vs, just that a man thought to be a cousin turned out to be a brother.
 
Re: Pakistan: Bird Flu claims 2 lives; more suspects

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

http://www.thefrontierpost.com/News.aspx?ncat=hn&nid=640

Pakistan has eight suspected human cases of Bird Flu

ISLAMABAD (PPI): Five members of a family in Pakistan are among eight people who may be the country's first human cases of bird flu, World Health Organization said. At least one brother died. The laboratory found lethal H5N1 avian flu strain caused infections in three brothers and two cousins from same family, according to information from Dec. 15 WHO statement and Gregory Hartl, a WHO spokesman in Geneva. Another brother from United States, who attended a funeral for one of victims, and his son tested negative for virus at a hospital in Nassau County, New York. Medical teams have been sent to Pakistan to assist local authorities in investigating cases, in which two people had only mild symptoms, Hartl said. Doctors are monitoring for signs avian flu may be adapting to humans by killing fewer people, fostering its spread. “It's too early to make any definitive conclusions'' about outbreak, he said. ``We are still in middle of it.'' New York State health officials were informed Dec. 7 that a man from Nassau County who had returned from Pakistan told his doctor he might have been exposed to avian flu, said Claudia Hutton, director of public affairs for state department of health. The man went into voluntary quarantine at home, Hutton said. Then his son began developing flu-like symptoms. Samples from both man and his son were tested at state laboratories and at U.S. Centers for Disease Control and Prevention in Atlanta. CDC sent an airplane to Albany to pick up samples. The samples came back negative for H5N1 avian flu this week, and man and his son are no longer in quarantine, he said. He said there were erroneous reports on Internet that another brother of H5N1-infected family members in Pakistan returned to the U.S. and tested positive. The remaining suspected cases in Pakistan include a man and his niece, and a male who worked on a nearby farm. Doctors from WHO in Geneva & Cairo, and from U.S. Navy Medical Research Unit No. 3 in Cairo will arrive in Pakistan in next two days to track and stem disease's spread, and analyze specimens for any genetic mutations in virus. Pakistan reported 44 H5N1 outbreaks in poultry to World Organization for Animal Health since early 2006. Most recent occurred on Nov. 27 and Nov. 28 in Punjab and NWFP, killing almost 20,000 chickens. The frequent outbreaks in Pakistan and high density of people meant it was ``not surprising'' that human cases eventually occurred in that country, Hartl said. It is too early to determine whether cases were caused by animal source or through limited person-to-person spread. Some of infected people also kept chickens and quails and it is unclear what personal protective equipment was used during culling operations, Hartl said. Pakistan authorities sent Tamiflu to affected area to treat cases and prevent further infection. `Pakistan has been doing everything right'' in terms of tracing people at risk of infection and preventing its spread, he said. The infections probably began late October in agriculture ministry official involved in culling diseased poultry on a farm at Abbottabad, Hartl said. The man fell ill and was cared for by two of his brothers, who also became unwell. One of brothers died about a month ago and was buried before specimens could be taken for a diagnosis. Other died on Nov. 29 and was positive for H5N1 in preliminary tests, Hartl said. Antibody screening on first man, who recovered, found he'd been infected with H5N1. The suspected cases occurred in Peshawar and detected following a series of culling operations in response to outbreaks of H5N1 in poultry, WHO said. Samples from cases are being sent to WHO reference laboratory for confirmation and further analysis.
 
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