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Concerns arise over symptomless Egypt bird flu cases

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  • #61
    Re: Concerns arise over symptomless Egypt bird flu cases


    Warnings of the flu virus mutated prion infects poultry fortified .. والمنتجون يهددون بالإضراب The producers are threatening to strike

    4/12/2009 11:03:00 AM
    CAIRO - Editor Masrawy - The press reports that the fortifications against influenza virus, bird flu has become to no avail.
    The newspaper quoted the source as veterinary confirmed casualties in the heavily fortified poultry traditional appeals, which have not changed since three years.
    He pointed out that the current three types of immunizations, a "HP 5, 7, 9," dealing with some kind of virus is no longer in Egypt, and the government has refused to contact the companies that produce vaccines, for the manufacture of a new vaccine based on the analysis of samples from dead poultry.
    He stressed that all countries in the world every three months to examine samples of dead poultry by international companies specialized in the production of new vaccines developed in accordance with the mutated virus.


    القاهرة - محرر مصراوي - حذرت تقارير صحفية من ان تحصينات الطيور ضد فيروس انفلونزا الطيور أصبحت دون جدوي.
    ونقلت صحيفة الوفد عن مصدر الطب البيطري تأكيده وقوع اصابات في الدواجن المحصنة بالطعون التقليدية، والتي لم تتغير منذ ثلاث سنوات.
    واشار إلى أن أنواع التحصينات الحالية الثلاثة وهي "إتش 5، 7 ، 9" تعالج نوعا من الفيروس لم يعد موجودا في مصر، وان الحكومة رفضت الاتصال بشركات إنتاج الأمصال، لصناعة مصل جديد بناءً علي تحليل عينات من الدواجن النافقة.
    وأكد أن جميع دول العالم تقوم كل ثلاثة أشهر بفحص عينات من الدواجن النافقة عن طريق الشركات العالمية المتخصصة في انتاج لقاحات جديدة مطورة طبقا لتحور الفيروس.

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    • #62
      Re: Concerns arise over symptomless Egypt bird flu cases

      From post # 49 -

      "...Professor Robert Webster, of St Jude Children's Research Hospital in Memphis, Tennessee – who is the world's leading authority on the disease – told The Independent on Sunday that, while he himself had not seen firm data, the WHO in Egypt was raising "a very, very important issue" which should receive "maximum attention". He added: "I hope to hell they are wrong. If this **** thing becomes less pathogenic, it will become more transmissible.'..."

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      • #63
        Re: Concerns arise over symptomless Egypt bird flu cases

        So how worried, should we be by this news....?

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        • #64
          Re: Concerns arise over symptomless Egypt bird flu cases

          Originally posted by vinny View Post
          So how worried, should we be by this news....?
          Silent spread of mild H5N1 is cause for concern. Once H5N1 gets into the human population, the dice rolling significantly accelerates.

          Comment


          • #65
            Re: Concerns arise over symptomless Egypt bird flu cases

            Originally posted by Florida1 View Post
            From post # 49 -

            "...Professor Robert Webster, of St Jude Children's Research Hospital in Memphis, Tennessee ? who is the world's leading authority on the disease ? told The Independent on Sunday that, while he himself had not seen firm data, the WHO in Egypt was raising "a very, very important issue" which should receive "maximum attention". He added: "I hope to hell they are wrong. If this **** thing becomes less pathogenic, it will become more transmissible.'..."
            If -- then -- else --- or -- ??

            An earlier report by Reuters citing J. Jabbour said that WHO would have back additional studies about sero-prevalence of H5N1 antibodies in Egypt.

            In future...

            If H5N1 is spreading unnoticed in Egypt or elsewhere even with professor Webster should admit that we haven't longer time to await these surveys results.

            We are waiting for Turkey, Vietnam, Indonesia and more other places surveys for years...

            Is it time to call for more honesty or not?

            I admit I am very, very tired when hearing experts media interviewes.

            They have had ten years for doing these antibodies prevalence studies and we are now here in first quarter of 2009 and we are repeating the same exact words told six or more years ago.

            Further, ''less pathogenicity -- more transmissibility''... oh very good science...!

            If H5N1 kills people, it's worrying; if H5N1 doesn't kill people it's worrying; if H5N1 doesn't transmit well, it will do tomorrow...

            The question to submit to experts is: why are we not prepared after six (or ten years) after emersion of H5N1 virus?

            Because, time is running fast and after all those IFs it will remain nothing other to see people fall ill.

            My personal opinion doesn't imply any kind of this website endorsement and represents only my point of view.

            Comment


            • #66
              Re: Concerns arise over symptomless Egypt bird flu cases

              AVIAN INFLUENZA, HUMAN (72): EGYPT, VIRULENCE
              *********************************************
              A ProMED-mail post
              <http://www.promedmail.org>
              ProMED-mail is a program of the
              International Society for Infectious Diseases
              <http://www.isid.org>

              Date: Sun 12 Apr 2009
              Source: The Independent online [edited]
              <http://www.independent.co.uk/news/science/new-bird-flu-cases-suggest-the-danger-of-pandemic-is-rising-1667526.html>

              Infections in Egypt raise scientists' fears that the virus will be
              spread by humans. This paradox -- emerging from Egypt, the most
              recent epicentre of the disease -- threatens to increase the
              disease's ability to spread from person to person by helping it
              achieve the crucial mutation in the virus which could turn it into
              the greatest plague to hit Britain since the Black Death. Last year
              [2009], the government identified the bird-flu virus H5N1 as the
              biggest threat facing the country, with the potential to kill up to
              750 000 Britons.

              The World Health Organization (WHO) is to back an investigation into
              a change in the pattern of the disease in Egypt, the most seriously
              affected country outside Asia. Although infections have been on the
              rise this year [2009], with 3 more reported last week, they have
              almost all been in children under the age of 3, while 12 months ago,
              it was mainly adults and older children who were affected. And the
              infections have been much milder than usual; the disease normally
              kills more than half of those affected; all of the 11 Egyptians so
              far infected this year are still alive.

              Experts say that these developments make it more likely that the
              virus will spread. Ironically, its very virulence has provided an
              important safeguard. It did not get much chance to infect other
              people when it killed its victims swiftly, but now it has much more
              of a chance to mutate and be passed on. The WHO fears that this
              year's [2009] rise in infections among small children, without
              similar cases being seen in older people, raises questions about
              whether adults are being infected but not falling ill, so acting as
              symptomless carriers of the disease. Its investigation, due to start
              this summer, will see whether this is happening by testing the blood
              of people who may have been in contact with infected birds but who
              have not themselves become sick.

              John Jabbour, who works with WHO in Cairo, told Reuters last week:
              "There is something strange happening in Egypt. Why in children now
              and not in adults? We need to see if there are sub-clinical cases in
              the community." He added that if the research did find such cases,
              they would be the 1st to be discovered anywhere in the world. Though
              he stressed that there was still no evidence of the disease passing
              from person to person, other experts are also becoming alarmed.
              Professor Robert Webster, of St Jude Children's Research Hospital in
              Memphis, Tennessee -- who is the world's leading authority on the
              disease -- told The Independent on Sunday [12 Apr 2009] that, while
              he himself had not seen firm data, the WHO in Egypt was raising "a
              very, very important issue" which should receive "maximum attention."
              He added: "I hope to hell they are wrong. If this **** thing becomes
              less pathogenic, it will become more transmissible." And Professor
              John Oxford, of Queen Mary, University of London, said that any
              evidence that H5N1 was becoming less deadly would be serious, as the
              greatest cause for concern was the disease's ability to spread. Even
              a much less virulent strain of the virus could result in a
              devastating pandemic. Studies show that an outbreak that killed as
              few as 5 percent of those it infected could still cause hundreds of
              millions of deaths around the world.

              [Byline: Geoffrey Lean]

              --
              Communicated by:
              Dr.med Martin Dirksen-Fischer
              Hamburg, Germany
              <MartinDirksenFischer@gmx.de>

              [As of 5 Apr 2009, it remained true that there had been no deaths
              among patients in Egypt with confirmed avian H5N1 influenza virus
              infections since the resurgence of the illness in Egypt in late 2008.
              11 of these 13 patients have been children 6 years of age or younger.
              These data do indeed suggest that there may have been a reduction in
              the virulence of the outbreak strain, and there is a perceived risk
              of progression of the virus to less a virulent but more transmissible
              form.

              On the other hand, all the patients had exposure to diseased or dead
              poultry, and they likely contracted infection from that source and
              not from human carriers. Furthermore, there has been no evidence of
              onward transmission of infection to family members.

              Several of the children are still in critical condition, and all may
              not survive. Another relevant factor in evaluation of the Egyptian
              situation is the immediate resort to treatment with the influenza
              virus neuraminidase inhibitor Tamiflu.

              The proposed WHO study is an important initiative in attempts to
              define properties of avian influenza virus that may convert it into a
              human pathogen. - Mod.CP]

              [see also;
              Avian influenza, human (71): Egypt, Viet Nam, WHO 20090408.1359
              Avian influenza, human (70): Egypt (QL), 63rd case 20090406.1336
              Avian influenza, human (69): Egypt (BH) 62nd case 20090404.1299
              Avian influenza, human (66): Egypt (BH) 20090402.1271
              Avian influenza, human (59): Viet Nam (ST) NOT 20090325.1162
              Avian influenza, human (56): Viet Nam (DT) NOT, (ST) susp. 20090321.1128
              Avian influenza, human (55): Egypt (AT), Viet Nam (DT) 20090320.1118
              2006
              ----
              Avian influenza (208): NS1 virulence determinant 20061106.3183]
              .................................................. ....cp/msp/jw

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              • #67
                Re: Concerns arise over symptomless Egypt bird flu cases

                Originally posted by niman View Post
                AVIAN INFLUENZA, HUMAN (72): EGYPT, VIRULENCE
                *********************************************

                Several of the children are still in critical condition, and all may
                not survive.
                - Mod.CP]
                Once again CP simply makes up data to support his poisition that H5N1 is not dangerous and only infects humans that are genetically predisposed. There have been NO reports of "several children...still in critical condition...and all may not survive." This statement is a figment of CP's imagination.

                The only recent case that was in critical condition was the most recent case, and local media reports indicated that patient has stabilized and was improving.

                Government reports have indicated only three patients were still hospitalized, and those three patients are almost certainly the three patients who were confirmed last week. Two of the three were cousins who were described as being in "good general condition" and there was no indication that they were ever in critical condition, developed pneumonia, were on a ventilator, or "may not survive".

                The comments of CP on H5N1, which regularly distort the actual data, should cease.

                Comment


                • #68
                  Re: Concerns arise over symptomless Egypt bird flu cases

                  I have not seen any reports that any of the recently hospitalized toddlers have been, or are in, critical condition.

                  Comment


                  • #69
                    Re: Concerns arise over symptomless Egypt bird flu cases

                    Originally posted by Florida1 View Post
                    I have not seen any reports that any of the recently hospitalized toddlers have been, or are in, critical condition.
                    The latest case (6M) was initially in critical condition. However, recent reports have said he improved.

                    The case hospitalized on March 1 was also in critical condition, but has almost certainly been discharged.

                    Currently there are only 3 H5N1 confirmed cases still hospitalized, and the three are almost certainly the three cases confrmed last week (and there are no reports indicating they are or ever were in critical condition).

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                    • #70
                      Re: Concerns arise over symptomless Egypt bird flu cases

                      Commentary

                      Comment


                      • #71
                        Re: Concerns arise over symptomless Egypt bird flu cases

                        Commentary

                        Curious ProMED Comments on Mild H5N1 In Egypt

                        Recombinomics Commentary 06:50
                        April 13, 2009

                        On the other hand, all the patients had exposure to diseased or dead poultry, and they likely contracted infection from that source and not from human carriers. Furthermore, there has been no evidence of
                        onward transmission of infection to family members.

                        Several of the children are still in critical condition, and all may not survive.

                        The above comments at ProMED are curious. They are made in association with another English language report raising concerns associated with the H5N1 cases in Egypt. The concerns center on the concentration of confirmed cases in toddlers, between the ages of 1 ? and 2 ?, as well as the mild nature of the cases. None of the confirmed cases in 2009 have died and 10/12 cases are toddlers. Moreover, the cases not only recover, but the courses are mild.

                        Only one of the 10 toddler cases was in critical condition, and that case along with nine other toddlers has been discharged. The three cases that are currently hospitalized include two toddlers, and both have been characterized as being in "good general condition". There was no indication that these two cases or any of the seven other cases were ever in critical condition or had developed pneumonia or had been placed on a respirator. Moreover, the most recent case, who was not a toddler, was said to be improving, reducing the likelihood of death. Thus, it is clear that there is little likelihood that any of the confirmed H5N1 cases in toddlers will die, and survival is in question for only one of the 12 confirmed cases.

                        This low case fatality rate is similar to the cases in the spring of 2007. Those cases were generally older and were large children between the ages of 3 and 10. Among this group, 16/17 survived and again the cases were mild and few developed pneumonia or were placed on a respirator. There was little evidence to suggest this low case fatality rate was tied to prompt oseltamivir treatment because the 10 cases prior to the mild cases in 2007 were fatal and the cases between the mild cases in 2007 and the mild case in 2009 involved patients in critical condition and most of those cases also died.

                        Thus, the mild cases involving children in 2007 and toddlers in 2009 has raised concerns that H5N1 has been spreading via mild cases and this spread has produced protective immunity in older cases, resulting in a high concentration of toddler cases in 2009.

                        This concern has been increased by the lack of testing of patients that have symptoms but no connection to dead and dying poultry, as well as the high number of patients hospitalized with symptoms and poultry contact. Less than 1% of these patients are PCR positive, raising concerns of a high number of false negatives among these hospitalized patients.

                        Similarly, the detection of H5N1 in two cousins who were next door neighbors and developed symptoms four days apart raise additional concerns that there was onward transmission to a relative, linkages to dead or dying poultry notwithstanding. There have been no H5N1 confirmed poultry deaths reported near the Beheira households of the cousins (see updated map) and these has also been no confirmed poultry deaths in Qena (see updated map), the location of H5N1 infected toddler confirmed prior to the Behiera cousins. The lack of reports of confirmed poultry deaths near these recent confirmed cases has raised concerns further.

                        Therefore the comments in ProMED, which extend the number of commentaries denying human to human transmission of H5N1, continue to be hazardous to the world's health.


                        .
                        "The next major advancement in the health of American people will be determined by what the individual is willing to do for himself"-- John Knowles, Former President of the Rockefeller Foundation

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                        • #72
                          Re: Concerns arise over symptomless Egypt bird flu cases

                          Originally posted by Florida1 View Post
                          I have not seen any reports that any of the recently hospitalized toddlers have been, or are in, critical condition.
                          Since WHO and other official health agency continue to not provide follow-up reports about clinical courses of human cases of avian influenza virus H5N1 infection in Egypt and elsewhere, it should be taken into account the chance that some of the statement ''about pediatric patients in good conditions'' could be influenced by propaganda aimed at minimizing public opinion impact of H5N1 poultry epizootics uncontrolled spread.

                          Another discrepancy: J. Jabbour suggested mild H5N1 human cases but his referent agency (WHO) states ''children with poultry contacts'' in Egytpian updates.

                          There is the chance that both statement of J.J. and WHO may contain inaccuracies and the entire picture of Egyptian events could result too foggy to draw firm conclusions.

                          In other words, since ''mild'' pediatric H5N1 infections is continuing to occur from early this year, how many people could have contract the virus?

                          Egypt is a crowded place. There are several touristic resorts. Borders are porous with neighboring Gaza Strip (with the consequences that one may imagine, as the unhygienic situation of local population).

                          A readily transmissible infectious disease may have infected thousands of people.

                          We in Italy are continuing to receive thousands of migrants by sea and air, from Lybia, Tunisia and - in great number - from Alexandria and other coastal ports.

                          No pneumonia of unknown cause among them. No spread of atypical ailments in the tiny island of Lampedusa, main destination of migrants.

                          More facts and follow-up reports are needed.

                          This post presents only my opinions and doesn't imply this website endorsement of any of my conclusions.

                          Comment


                          • #73
                            Re: Concerns arise over symptomless Egypt bird flu cases

                            Referring to post #57:

                            A:
                            The current system of phases does not include severity of disease.

                            Might the above fact be the reason for the following…

                            B:

                            …..tested in Vietnam and produced a significant number of positives (the actual data was never released).

                            …..the CDC in Atlanta, and more positives were found (the actual data was never released).

                            …..meeting in Manila (May 5, 2005), and discussion of the 1000 serum samples was never released

                            …..Japan claimed the samples were negative, but again the data was never released.
                            Give A, plus multiple Bs, it’s not surprising to see an outcome such as…..

                            The Manila meeting did discuss raising the pandemic level, but it was decided to wait and see
                            AKA.....The WHO pandemic system of phases is unworkable.

                            .
                            "The next major advancement in the health of American people will be determined by what the individual is willing to do for himself"-- John Knowles, Former President of the Rockefeller Foundation

                            Comment


                            • #74
                              Re: Concerns arise over symptomless Egypt bird flu cases

                              Originally posted by ironorehopper View Post
                              Since WHO and other official health agency continue to not provide follow-up reports about clinical courses of human cases of avian influenza virus H5N1 infection in Egypt and elsewhere, it should be taken into account the chance that some of the statement ''about pediatric patients in good conditions'' could be influenced by propaganda aimed at minimizing public opinion impact of H5N1 poultry epizootics uncontrolled spread.

                              Another discrepancy: J. Jabbour suggested mild H5N1 human cases but his referent agency (WHO) states ''children with poultry contacts'' in Egytpian updates.

                              There is the chance that both statement of J.J. and WHO may contain inaccuracies and the entire picture of Egyptian events could result too foggy to draw firm conclusions.

                              In other words, since ''mild'' pediatric H5N1 infections is continuing to occur from early this year, how many people could have contract the virus?

                              Egypt is a crowded place. There are several touristic resorts. Borders are porous with neighboring Gaza Strip (with the consequences that one may imagine, as the unhygienic situation of local population).

                              A readily transmissible infectious disease may have infected thousands of people.

                              We in Italy are continuing to receive thousands of migrants by sea and air, from Lybia, Tunisia and - in great number - from Alexandria and other coastal ports.

                              No pneumonia of unknown cause among them. No spread of atypical ailments in the tiny island of Lampedusa, main destination of migrants.

                              More facts and follow-up reports are needed.

                              This post presents only my opinions and doesn't imply this website endorsement of any of my conclusions.
                              WHO does provide data on fatalities, and none have been reported in 2009. There is no evidence to support critical cases in 2009 (other than the two describe). The only three confirmed cases still hospitalized (as of last week) are the three cases confirmed in the prior week.

                              Comment


                              • #75
                                Re: Concerns arise over symptomless Egypt bird flu cases

                                WHO backs investigation into Bird Flu situation in Egypt

                                <!-- begin content --> Submitted by Continuity Forum on Mon, 2009-04-13 09:50.News
                                Category Business Continuity Pandemic and Research
                                <hr> Is Bird Flu threat changing?
                                <hr> Following an increase in infection rates and what appears to be a change in the pattern in Egypt the World Health Organisation is backing more detailed investigation
                                In Egypt the World Health Organisation is backing further examination and investigation as the numbers contracting the disease rise and and the pattern of infection change. At first sight the changes appear to be good news with all of those infected in the country have survived pointing to a reduction in the virulence of the H5N1, but clinically this change could be bad news.
                                This possible change in the nature of the virus may be the precursor of a more substantial evolutionary stage. Clinically, the virulence of a virus imposes a factor that limits transmission rates and the time available for further mutation; as virulence decreases, the potential for a much increased rate of infection increases.
                                As the virulence drops, it can mean more potential for individual infections although fewer die overall in percentage terms. In Egypt this year all 12 cases survived, in China where 7 cases have been reported the mortality rate was 57% and Vietnam 100%. Most experience shows this is one of the precursor conditions for a Pandemic to occur.
                                Last week, a WHO organisation spokesman reported that investigations were to centre on a search for Sub-clinical cases in H5N1 infection and other factors that may mean the virus is changing. Sub-clinical cases are milder infections which provide a primary breeding ground for virus mutation.
                                Whilst the lower mortality rate does look like at first sight like good news, it is all to easy to misinterpret this a diminished risk. The real risk is that as infection rates rise numerically and the Case Fatality Rate falls the total number at risk of infection can start to rise rapidly. Although there is no suggestion yet of human to human infection the increased number of cases in Egypt poses the question is this first stage in the creation of the conditions needed for the jump.
                                Professor Robert Webster, of St Jude Children's Research Hospital in the US commented ?that WHO in Egypt was raising a very, very important issue which should receive maximum attention. He added: "I hope to hell they are wrong. If this thing becomes less pathogenic, it will become more transmissible."
                                Professor John Oxford, of Queen Mary, University of London, a leading international expert concurred saying ?that any evidence that H5N1 was becoming less deadly would be serious, as the greatest cause for concern was the disease's ability to spread.?
                                Pandemic Flu tops the National Risk Register and for those planning serious consideration needs to be given to the organisations ability to cope with its impact
                                All organisations in the public and private should have created plans to curb the effects and mitigate the impact of the disruption caused by a Pandemic yet our study shows 73% do not have proper plans to protect the business or its employees.
                                This stark finding comes after the National Risk Register produced by the Cabinet Office highlighted the threat of a pandemic as the most serious threat to the UK.
                                With over 90% of organisations not calculating the possible financial impact of a pandemic on their operations few realise how expensive it could be and falsely judge the risks to the organisations as being not relevant or unmanageable.
                                Even those who had developed plans confessed to a lack of confidence in over two thirds of respondents with many stating a lack of executive support as the main issue (75%).
                                The threat of a pandemic is real, yet our finding show that most businesses are ignoring the threat, often considering it to be vastly overhyped despite the evidence from the last century when three pandemics killed tens of millions.
                                More information on pandemic research


                                The Continuity Forum is the leading body supporting Business Continuity, Security and Risk Manangement sectors for the Public and Private sectors.

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