The H5N1/H1N1 Combo mix warning thread

[Treyfish]

Re: The H5N1/H1N1 Combo mix warning thread

WHO: H1N1 swine flu pandemic will stick around for another year
By Michael Krebs.
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<ABBR title="Dec 29, 2009 at 6:22PM EST">Dec 29, 2009</ABBR> by ■
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The World Health Organization warned government health authorities to remain vigilant on the H1N1 swine flu pandemic, saying the virus could mutate before vaccines can help it dissipate.

The World Health Organization is confident that the H1N1 swine flu pandemic will be under control in a year's time - however, WHO officials warned global governments to remain vigilant for any mutations in the troublesome bug.
The warning was given with a wary eye on the considerably more dangerous H5N1 virus - commonly referred to as bird flu. WHO officials remain concerned over the bird flu's recurring appearances in China and India in domestic and wild avian species.
"It is still premature and too early for us to say we have come to an end of the pandemic influenza worldwide. It would be prudent and appropriate ... to continue to monitor the evolution of this pandemic for the next six to 12 months," WHO Director-General Margaret Chan said at a news conference.
Last week, the World Health Organization attributed nearly 12,000 deaths worldwide to the H1N1 swine flu pandemic.
While Chan admitted the world was not prepared for a more brutal influenza pandemic of the kind associated with the H5N1 bird flu, she sought to retain a positive position on the current H1N1 challenge.
"The fact that the long overdue influenza pandemic is so moderate in its impact is probably the best health news of the decade," Chan said.http://www.digitaljournal.com/article/284675

[Treyfish]

Re: The H5N1/H1N1 Combo mix warning thread

100 Million Chinese Migrate, Concern H1N1 Will Spike

By Xiong Bin & Lin Li
New Tang Dynasty Television Created: Dec 30, 2009
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PANDEMIC: College students' body temperatures are checked at a military training camp in Beijing on Oct. 29, following the death of a student from H1N1 at the Beihang University in Beijing. (AFP/AFP/Getty Images)



Migrant workers returning to their homes for holidays in January and February will trigger another spike in the H1N1 epidemic in mainland China, according to U.S. virologist, Dr. Lin Xiaoxu.

Almost half of the 225 million migrants are expected to return home by the Chinese New Year at the beginning of February, according to China's National Bureau of Statistics.
The tide of workers mostly comes from southern China, the most highly concentrated region of migrants. Of those returning home, a quarter will set out from Guangdong Province, the factory hub of China.

With a potential virus mutation looming and more wintry weather, Lin said it will become even more difficult to control the H1N1 epidemic.

?People are worried that the avian flu (H5N1) will recombine with H1N1 or have another lethal mutation that strengthens the infectiousness,? Lin said. ?Southern China has always been easy prey to outbreaks of epidemics.?

The concern is that H1N1 will recombine with H5N1 avian flu, to create a superflu. H5N1 has a mortality rate as high as 60 percent. Professor Su Ih-jen, former director of Centre for Disease Control in Taiwan, said the H1N1 flu has low mortality but high infectiousness, while the H5N1 bird flu has low infectiousness but high mortality.

?We are more concerned that H1N1 will recombine with seasonal flu,? Su told Sound of Hope radio. He said a lack of effective systems to report H1N1 infections in China means the true numbers are expected to be much higher than those published.

Lin said that if China?s health department cannot monitor the trend of the virus? mutation, vaccination will be a daunting task.

?Some areas have already had serious outbreaks of avian flu, swine flu, blue-ear pig disease, and hand-foot-mouth disease. I think these areas need to be monitored more carefully,? Lin said.

Doctors have received notices throughout China?s municipal and provincial hospitals not to diagnose H1N1 for patients, according to research conducted by New Tang Dynasty Television (NTDTV).

Instead, doctors have been told to diagnose patients with ?seasonal flu? or ?pneumonia,? with only the severely ill patients selected to undertake an H1N1 confirmation test. Those with mild symptoms are sent home, according to doctors.

Recent interviews by The Epoch Times have revealed that doctors, school staff, experts, and ordinary Chinese people are all painting the same picture?of a swiftly moving pandemic that is being covered up, based on instruction from the communist regime?s leadership.

A senior doctor from Chaoyang County in northeast China?s Liaoning Province told NTDTV that the regime has abdicated responsibility for treatment of H1N1 cases, and that cadres at all levels are covering up the pandemic to save their political careers.

?Now, we don?t report [H1N1], we just say that it is a flu,? the doctor said on condition of anonymity. ?The government does not care ? There are plenty of regulations?if 10 people die, you cannot report all 10, you can only report one. Now, there are only lies.? http://www.theepochtimes.com/n2/content/view/27256/

[Twall]

Re: The H5N1/H1N1 Combo mix warning thread

Mountain is expected to increase mortality of swine influenza
القاهرة ـ من حسام زايد: Cairo, Hossam Zayed:


توقع الدكتور حاتم الجبلي وزير الصحة وفاة نحو مائتي مصاب بإنفلونزا الخنازير خلال شهر يناير الحالي, علي أن تبدأ تلك الأعداد في الانخفاض خلال شهري فبراير ومارس المقبلين. Expected, Dr. Hatem el-Minister of Health and killed nearly two hundred infected with swine flu during the month of January instant, I have to start those numbers to decline during the months of February and March next.


وأكد وزير الصحة أن أعداد المتوفين في مصر بالمرض ـ التي وصلت إلي159 حالة حتي أمس ـ لا تدل علي وجود مشكلة حقيقية نظرا لأنه لم يكن هناك حصر بأعداد المتوفين بالإنفلونزا الموسمية من قبل, وأوضح أن تلك هي المرة الأولي التي يتم فيها ذلك, مشيرا إلي أن العام الحالي سوف يشكل القاعدة المعلوماتية التي يقاس عليها فيما بعد بمرض الإنفلونزا. The Minister of Health that the death toll in Egypt, the disease, which reached to 159 cases so yesterday do not indicate a real problem because there was no inventory numbers of the deceased by seasonal influenza, and explained that this was the first time that the so, adding that this year will be an information base which is measured by the later of influenza illness. وشدد الدكتور حاتم الجبلي علي أن سياسة التطعيم التي تنتهجها وزارة الصحة متمثلة في حملة تطعيم طلبة المدارس ـ التي بدأت منذ أيام ـ سوف يترتب عليها الإسراع بكسر موجة إنفلونزا الخنازير الحالية خلال أسبوعين أو ثلاثة, حيث يتوقع أن تنحسر تلك الموجة بنهاية شهر يناير الحالي. In addition, Dr Hatem mountain that the vaccination policy pursued by the Ministry of Health represented by the school vaccination campaign, which began days ago will result in accelerated fracture wave swine influenza during the current two or three weeks, which is expected to recede by the end of the wave of current January . وأشار إلي أن كل الجهود التي بدأت في مصر من أجل الوقاية من الإصابة بالمرض يجب أن تستمر, حيث إن مصر لديها عامل خطورة لتحور الفيروس نتيجة توطن فيروس إنفلونزا الطيور بها, وبالتالي لابد من الاستمرار في تنفيذ الإجراءات الوقائية. He pointed out that all the efforts that began in Egypt for the prevention of the disease must continue, as Egypt has a risk factor for the mutation of the virus as a result of endemic avian influenza virus, and therefore must continue to implement preventive measures.

[Treyfish]

Re: The H5N1/H1N1 Combo mix warning thread

SEAsia to crack down on poultry smuggling to fight H5N1

HONG KONG
Fri Jan 15, 2010 5:34am EST




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<script type="text/javascript"> <!-- Exception rendering module on server --> </script> HONG KONG (Reuters) - Disease experts in Southeast Asia will map out key poultry smuggling routes, especially along Cambodia's long border with Thailand and Vietnam, in a move to prevent the spread of the H5N1 bird flu virus in the region.
Swine Flu
Researchers from China, Cambodia, Indonesia, Thailand and Vietnam met in the Chinese city of Kunming to discuss ways to control the spread of the virus, which kills 60 percent of the people it infects.
Even though H5N1 transmission between people is weak, experts say it continues to pose a risk especially if it gets mixed with the now dominant H1N1 swine flu virus. Such a hybrid may then be both deadly and easily transmissible among people.


"In Cambodia, illegal or informal trade occurs along its long border with Thailand and Vietnam. There is that informal trade, not just in birds, but eggs and other poultry products, smuggling," said Khieu Borin, director of Cambodia's Center for Livestock and Agriculture Department.
"It can be in small or large numbers ... but because poultry has (can be infected by) H5N1, so smuggling of fighting cocks or chickens can carry H5N1, there will be some risk," he told Reuters in a telephone interview.
While scarce media attention has been paid in the last year to H5N1, there have been outbreaks of the disease in birds and it has killed people in China, Egypt, Indonesia and Vietnam.
Experts also discussed the role of wild migratory birds in the spread of the H5N1.
"Our China colleagues found that bar-headed geese fly from China to India and found records of outbreaks in poultry along the flyway. This suggests the role of these birds in spreading the virus along the flyway," said Witthawat Wiriyarat, a veterinarian and virologist with Thailand's Mahidol University.
"There are opportunities to meet other birds along the pathway like in paddy fields and wetlands. If one bird can release the virus into the environment, other animals can get it and spread it to poultry," Wiriyarat told Reuters.
One worry often cited by experts is Indonesia's insistence on not sharing virus samples. Researchers need to study the virus to track its molecular changes, which can influence its behavior.
Friday, Indonesia's health minister Endang Sedyaningsih said the country will continue to hold back samples until it secured guarantees from richer nations and drugmakers that poor countries get access to affordable vaccines derived from their samples.
http://www.reuters.com/article/idUSTRE60E1KH20100115

[Treyfish]

Re: The H5N1/H1N1 Combo mix warning thread

A flow prevention and control strategies to adjust Weina Ban?
Release Date: 2010-01-31 | Author: Xiang-Zheng
http://www.stdaily.com 2010 Nian 01 Yue 31 日 来源: Science and Technology Daily Author: Xiang-Zheng

Reporter Xiang Zheng

The decision-making perspective

Mainland of China since May 11 has been found in the first case of the patient, so far, millions of people are infected. China's prevention and control measures from the initial strong containment, isolation of patients to medical treatment is to increase strength, mild special treatment without the need to rest at home. China's prevention and control strategies through which to adjust? Why should we continue to be adjusted? A stream of our country's prevention and control of the Government's "overreaction", "wasting disease prevention and control of resources" argument, China's prevention and control department's attitude? To this end, an interview with Chinese Center for Disease Control and Prevention Influenza A H1N1 influenza prevention and control of emergency response director of the office FENG Zi-jian.

Of new infectious diseases can not be taken lightly

Because the vaccine, antibiotics, widely used in the last century the seventies and eighties the incidence of infectious diseases dropped to its lowest level since the founding of new China, a number of infectious diseases or even eliminated, our existing health care means strong enough to control of infectious diseases optimism enveloped the industry. But in recent years, with the avian flu, mad cow disease, the emergence of new infectious diseases, hand, foot and mouth, tuberculosis and other infectious diseases have begun to gain the original trend, people suddenly discovered that infectious diseases continue to threaten human health. FENG Zi-jian told reporters that the emergence of avian influenza H5N1 virus infection, especially of people, the countries took a new influenza pandemic, the growing concern.
H1N1 strikes suddenly caught off guard by various countries, the initial understanding in it too little, although whether it is pathogenic or infectious, the performance of Influenza A H1N1 was relatively mild, but because of China's geographical location of biological environment is important to wild birds migration route. If the highly pathogenic avian influenza H5N1 virus and influenza A H1N1 reassortant influenza virus occurred, it may bring serious consequences. WHO has stressed the importance of prevention. In order to take preventive measures, China's disease control department worked day and night to prevent a pandemic. In the early strict port entry-exit inspection and quarantine, has taken strong measures for containment, isolation and treatment of patients, for persons in close contact with a 7-day medical observation.

"We are infectious diseases prevention and control knowledge, the measures are derived from historical experience, while changes in the environment and is established under the prevention and control measures", FENG Zi-jian told reporters after the world had appeared three times an influenza pandemic, the 1918 Spanish flu There have been three peaks, the other two, there were two peaks of influenza. Among them, the second wave of virus destruction and the death rate is higher than the first wave of serious, and a third also show a more serious destruction on him. "The reason why we attach so much importance to prevent the first wave, because if a virus in the population to take root, it will be easier to variation."

Stringent control measures for the early fight for Disease Control and Prevention valuable time in the ensuing hot season, we have strengthened the medical care, disease surveillance, drug stocks, vaccine research and development work for the autumn and winter of the second wave of influenza Crest made adequate preparation.

A deal with the core objective of stream

As early as Influenza A H1N1 influenza was introduced into China mainland ago, the Chinese Government has identified 18 prevention and control principle in a stream, namely, "a high degree of attention and positive response, joint prevention and control, according to scientific treatment." As the epidemic changes and the deepening of understanding of the disease at different stages of the prevention and control of a stream of constantly changing priorities. A flow prevention and control has two key objectives, namely, the effective prevention and control of large-scale outbreaks and clusters of outbreaks, maintaining the smooth functioning of the socio-economic, security and stability of the normal life of ordinary people; to strengthen the work of clinical treatment, early identification, diagnosis and treatment of clinical critically ill patients, emerged as little as possible cases, early treatment to reduce the deaths occurred.

FENG Zi-jian introduction, Ministry of Health, the current prevention and control strategy is to block input, non-proliferation, reducing harm. If the virus does not mutate virulence remain at current levels, is still "more moderate", it will not adopt an impact on the socio-economic activities, national initiatives focused on isolation of patients is only used under certain circumstances, the Ministry of Health will no longer be closely follow the patient, medical observation, the focus will be placed on a stream of severe identification and discovery are no longer for all acute febrile respiratory tract infection for laboratory diagnosis.

CDC Emergency Response Office of the core of the current goal is to "Let A peak flow is more popular later as much as possible to a flow peak held down some, affecting public health and economic and social order, some as small as possible."

The current focus on prevention and control guidance to the public for personal prevention, do a good job agencies to prevent and control outbreaks, community prevention and control guidance. When necessary, local area implementation of the "pressure peak load reduction," "slow epidemic peak pressure" measures, intensity and clinical severity of epidemic monitoring, virological surveillance, as well as the variation of the virus found.

Chinese Center for Disease Control and Prevention Office of the core task of emergency response, monitoring and situation analysis to determine, medical institutions do a good job surge in patient preparation, the peak prevalence down to ease the medical load to ensure that key social services running, antiviral distribution and use of reserves , vaccinations, information dissemination and risk communication.

"Right now we have a stream of prevention and control measures and abroad there is no essential difference, but a difference in terminology resources of the countries," FENG Zi-jian stressed that the epidemic disease control system is to strengthen the monitoring, assessment of disease trends, assess the situation changes, close observation of the virus variation do a good job massive surge in the clinical treatment and patient preparation, and accelerate vaccine production, distribution and vaccination at the same time do a good job of public information and education and communication.

FENG Zi-jian stressed that the influenza A H1N1 influenza virus for the future of performance seems to rely on existing technology can not predict its future can only rely on time to verify. Enhanced virulence of the future in case the virus is still likely to enhance the prevention and control efforts, it is possible to reduce the assembly, restricting non-essential travel, etc. to reduce disease transmission.

A flow is a protracted war prevention and control of

A stream will be in China for how long? Will the variation? The public health threat be? There is no clear-cut explanation. However, from the traditional disease, development, and popular laws of perspective, a new virus appears, in general there are three development directions, one is its condition gradually worsened gradually increased hazard, resulting in widespread dissemination of epidemic, or even result in higher case fatality rate. The second is its virulence gradually weaker and weaker, or even eliminate. Another possibility is that gradually turned into advantages of strain to replace the traditional seasonal influenza, become a major epidemic strains, but virulence is not increased too much.

In general, both influenza A H1N1 influenza or influenza B influenza tradition, once at the community level to take root, it will not go away anytime soon, it may be accompanied by human Aioi. Therefore, the prevention and control of influenza A H1N1 influenza will be an ongoing battle.

In this case, the public health is not only doctors, disease control agency workers do, the public are also important participants.

FENG Zi-jian an interview with reporters, stressed that "At present most needed to prevent a flow of communication to the public health knowledge, if everyone protect themselves and their families, public health would not be a big trouble."

He said, "For the vast majority of people, the influenza A H1N1 influenza is a very mild disease, the course is not long, can be recovered without special treatment. A stream of cases even though there is also no need to panic. As long as we strictly enforce the the relevant provisions, pay attention to personal hygiene, washing hands frequently, to develop good respiratory hygiene practices, strengthen self-protection, to develop good personal hygiene and habits, while timely diagnosis and treatment of symptoms, a stream will not cause more damage, " .http://www.stdaily.com/kjrb/content/...ent_151928.htm

[Treyfish]

Re: The H5N1/H1N1 Combo mix warning thread

<table width="100%" border="0" cellpadding="0" cellspacing="0"><tbody><tr><td class="newsBlackHeading01" style="padding-left: 20px; padding-top: 5px;" valign="top" bgcolor="#f2f3f4">Flu pandemic: what lies ahead
Thursday 11 February 2010</td> </tr> <tr> <td style="padding-left: 20px; padding-top: 5px;" bgcolor="#f2f3f4"></td> </tr> <tr> <td bgcolor="#f2f3f4"> <table width="96%" align="center" border="0" cellpadding="6" cellspacing="0"> <tbody> <tr> <td colspan="2" height="25" valign="middle" align="left">
</td> </tr> <tr> <td colspan="2" height="25" valign="middle" align="left"> Pandemic is heading for ?post-peak? period, WHO says amid lingering concerns over unpredictable future </td> </tr> <tr> <td class="gText" colspan="2" valign="middle" align="left"></td> </tr> <tr> <td class="gText" valign="top" width="1" align="left"> <table width="100%" border="0" cellpadding="0" cellspacing="0"> <tbody> <tr> <td></td> </tr> <tr> <td class="gTextSmall">Source: CDC/Jim Gathany</td> </tr> </tbody> </table> </td> <td class="gText" valign="top" align="left"> The 2009 pandemic is waning in most parts of the world, but recently Senegal has reported the first 14 cases of ?swine flu? to be associated with community transmission of the virus in West Africa, the World Health Organization (WHO) said today.

?There is a scientific judgment that the worst on a global level may be over,? said Keiji Fukuda, Special Adviser on Pandemic Influenza to the Director-General, at a news conference. ??However it?s also very clear that the virus has not disappeared. We can anticipate significant local upsurges.?

This pattern of activity for the new virus is different from patterns documented a few months ago, explained Fukuda, and could mean that the pandemic has entered a period of transition into ?regular? flu activity dubbed the ?post-peak? period in the WHO pandemic guidance document. But a formal assessment of this will be made later this month in the 7th meeting of an advisory body, the International Health Regulations (IHR) Emergency Committee.

In a different meeting to be held on 18 February, the WHO will decide which virus strains to recommend for companies making the vaccine that will be distributed in the northern hemisphere in the next flu season. Seasonal flu viruses have not disappeared, said Fukuda, but the swine-origin H1N1 strain is now dominating. ?I don?t want to second guess what the expert advisers will recommend; but it is fair to point out that the current pandemic virus is by far the most common being isolated.?

Juergen Richt, from Kansas State University in the USA, is worried about the far-reaching spread of this highly transmissible virus. As it becomse the dominant strain, it is more likely to circulate in the same areas that harbour the H5N1 bird-flu strain. If this happens, ?it could be big trouble?, he says.

Although the swine-flu virus has not been found to infect chickens, where the H5N1 strain is commonly found, both viruses could infect humans at the same time ? a window of opportunity to re-assort. Because the new H1N1 virus spreads more easily than the seasonal H1N1 and H3N2 strains, Richt believes that the chances of the two virus subtypes swapping genetic material in this way are higher than they were before the pandemic strain emerged.

A transformation of the H5N1 virus ?could be only a couple of mutations away?, says Richt. Swapping genes with the new H1N1 virus might allow it to transmit more efficiently, creating a very different pandemic scenario.

Fukuda said today that all the pandemic-H1N1 strains analysed so far look very similar, so this virus subtype appears to be very stable.

But in a world of fickle flu viruses the H5N1 strain appears especially unstable. According to results from an influenza-A genome-mapping project published this month in PLoS ONE, H5N1 viruses appear to swap genetic material with other virus subtypes often, but fail to accumulate enough mutations to allow efficient spread between people. The authors say that this suggests a low pandemic risk for this strain ?in its current form?.

Raul Rabadan from Columbia University in New York, USA, cautions that ?although we are learning more about these viruses, we still do not have a complete understanding of all factors that could contribute to the efficient propagation of influenza viruses in humans.?
?Viruses are so flexible?, says Richt. One never knows what might be around the corner, he points out, so keeping surveillance efforts going is essential.

http://www.eht-forum.org/news.html?fileId=news100211064350&from=home&id=0</td></tr></tbody></table>
</td></tr></tbody></table>

[Twall]

Re: The H5N1/H1N1 Combo mix warning thread

Infectious Disease Expert Spells Out Top Influenza Concerns
By Bruce Jancin
Elsevier Global Medical News
February 11, 2010

KEYSTONE, Colorado (EGMN) – Where has all the seasonal influenza gone?

That’s one of the questions preoccupying flu watchers during this unprecedented 2009-2010 influenza season. Other key questions they’re pondering include: Will we see a third wave of the influenza A(H1N1) pandemic? And what’s going to happen if – or more likely, when – the extremely deadly avian influenza A(H5N1) virus reassorts with H1N1?

Seasonal flu in the United States ordinarily follows a predictable pattern. It arrives in force in January, peaks in February, and then tails off in March. This year, seasonal flu didn’t show up anywhere in the United States in January, aside from a few sporadic cases of no epidemiologic significance, Dr. Gwen Huitt said at a meeting on allergy and respiratory disease.

Instead, the Centers for Disease Control and Prevention’s Outpatient Influenza-Like Illness Surveillance Network reported a huge peak in October, 4 months earlier than usual and was the crest of the second wave of the H1N1 pandemic. The first wave came in June ’09.

“That was a paradigm shift. It was far different than anything seen in recent history,” recalled Dr. Huitt of the department of medicine at the University of Colorado, who is also an infectious disease specialist at National Jewish Health, both in Denver.

“We’re treading uncharted territory right now, but the thing we’re all concerned about is whether or not we’ll have a third wave. The 1918 Spanish flu H1N1 pandemic had three waves. The second was the worst, and the third was almost as bad. So we’re just waiting to see what happens,” Dr. Huitt said at the meeting sponsored by National Jewish Health.

The CDC has reported 59 documented cases of oseltamivir-resistant H1N1 through January of this year. A third wave of the pandemic could turn oseltamivir resistance into a major problem. Availability of another oral drug in addition to oseltamivir and zanamivir would be most welcome. Unfortunately, the only anti-influenza drug in phase-III testing is intravenous peramivir, although it does look promising.

Seasonal influenza A isn’t being seen on a significant scale anywhere in the world right now. However, an upsurge in seasonal influenza B is underway in China.

“Fortunately, it’s a strain included in our seasonal influenza vaccine, so I think our population should be fairly well covered if that virus starts appearing in North America,” she said.

The biggest concern now, Dr. Huitt said, is the prospect of genetic reassortment between avian influenza and the H1N1 virus. The avian H5N1 virus has an extremely high mortality rate – around 50&#37; – but poor human-to-human transmissibility. The H1N1 virus has a much lower death rate – certainly less than 10% – but is highly transmissible.

Egypt and Indonesia are the hotbeds of H5N1 activity right now, with large outbreaks in both poultry and humans. Workers from the CDC and the World Health Organization are on the scene, trying to figure out the next move.
Pigs are susceptible to both avian influenza and H1N1 and are thought to be a frequent source of new human viral strains. And, in underdeveloped areas of the world, pigs and flocks of poultry often live underneath or in human dwellings.

“All it takes is two gene reassortments. One has already taken place. So we’re waiting for the other shoe to drop, and if that occurs, then you’ve got a supervirus that’s quite lethal. ... and easily transmissible from human to human,” the physician said.

Dr. Huitt reported having no relevant financial interests.

[Vibrant62]

Re: The H5N1/H1N1 Combo mix warning thread

Chinese researchers have published a paper on H5N1 reassortment potential here http://www.plosone.org/article/info%...l.pone.0009167
but just in case, attached too.

The paper appears to confirm that there is potential for reassortment, but some limitations too.

[Vibrant62]

Re: The H5N1/H1N1 Combo mix warning thread

[URL="http://www.thelancet.com/H1N1-flu/egmn/0c03e3e6"]
The biggest concern now, Dr. Huitt said, is the prospect of genetic reassortment between avian influenza and the H1N1 virus. The avian H5N1 virus has an extremely high mortality rate – around 50&#37; – but poor human-to-human transmissibility. The H1N1 virus has a much lower death rate – certainly less than 10% – but is highly transmissible.

Egypt and Indonesia are the hotbeds of H5N1 activity right now, with large outbreaks in both poultry and humans. Workers from the CDC and the World Health Organization are on the scene, trying to figure out the next move.
Pigs are susceptible to both avian influenza and H1N1 and are thought to be a frequent source of new human viral strains. And, in underdeveloped areas of the world, pigs and flocks of poultry often live underneath or in human dwellings.

“All it takes is two gene reassortments. One has already taken place. So we’re waiting for the other shoe to drop, and if that occurs, then you’ve got a supervirus that’s quite lethal. ... and easily transmissible from human to human,” the physician said.

Dr. Huitt reported having no relevant financial interests.

Does anyone have further information on what he means here? the implication is that H5N1 has already picked up an H1N1 gene - have we seen this anywhere on a published sequence?

[sharon sanders]

Re: The H5N1/H1N1 Combo mix warning thread

The last H5N1 sequence deposited at GISAID for Egypt was from a sample June 6, 2009.

The latest H5N1 sequence deposited at GISAID for Indonesia was from a sample in 2008.

Maybe some can check GenBank.

My understanding is that most experts are still worried about H5N1 and the genetic exchange potential with H1N1.

This is why we are following H5N1 so closely at FT.

Egypt has experienced 2.5 times the amount of confirmed H5N1 human cases as of this time last year:

http://www.flutrackers.com/forum/showpost.ph?p=342272&postcount=1

2009: Jan-Feb = 5 cases, 0 deaths

2010: Jan-Feb = 12 cases, 3 deaths

And the age distribution is much older.

Indonesia has 2 confirmed human cases this year with 1 death. In the case that survived the symptoms were MILD and the H5N1 diagnosis came AFTER a ROUTINE surveillance program picked it up. A prudent person has to ask how many undiagnosed mild cases are being missed in Indonesia.

[Treyfish]

Re: The H5N1/H1N1 Combo mix warning thread

After H1N1, Researchers Warn of a Potential New Superbug

By Bryan Walsh Monday, Feb. 22, 2010

<script type="text/javascript"> adFactory.getCmAd(146, 40, "article", "tout").write(); </script><script type="text/javascript" src="http://ad.doubleclick.net/adj/cm.tim/healthsci;aid=1967118;ch=scihealth;ptype=content;c type=article;sz=146x40;path=time;path=health;path= article;dcove=d;cmpos=article;cmtyp=tout;pgurl=1;r host=www.newsnow.co.uk;tile=5;ord=556664314372?"></script>


Indonesian health officials destroy fowl suspected of carrying the avian flu virus in a neighborhood in Badung, Indonesia
Made Nagi / EPA / Corbis




When the 2009 H1N1 flu virus emerged last April, it triggered the first new pandemic in more than 40 years, producing endless headlines and panic. But, now, some 10 months into the pandemic, the public's fear has subsided. H1N1 turned out to be relatively weak, and action by global and national health officials has helped blunt the damage caused by the virus; by mid-February, more than 16,000 people worldwide had died from the new flu, according to the World Health Organization (WHO), but that figure is in line with mortality in a normal flu year.
On Tuesday the WHO will convene a special panel that could begin the process of declaring an official end to the pandemic. "We hope that the worst is behind us and the overall trend will be going down," said Dr. Keiji Fukuda, the WHO's special adviser to the director-general for pandemic influenza, in a Feb. 18 press conference. (See what you need to know about the H1N1 vaccine.)
But the close of the H1N1 pandemic does not eliminate the long-term threat from influenza. Another pandemic could arise at any time, and a new paper published in the Feb. 22 Proceedings of the National Academy of Sciences (PNAS) demonstrates that it could even come from an existing flu virus that many of us have forgotten about: the H5N1 bird flu, which has infected 478 people in 15 countries since 2003, with 286 deaths ? a fatality rate higher than 50%.
A team of scientists from the U.S., Indonesia and Japan, led by virologist Yoshihiro Kawaoka at the University of Wisconsin ? Madison, combined a strain of the deadly H5N1 avian virus with strains of H3N2 human seasonal flu, creating 254 new, mutated viruses. By injecting them in lab mice, researchers found that some of the hybrid viruses were both deadly (like bird flu) and transmissible (like seasonal human flu) ? the kind of genetically mutated superflu viruses that experts have been warning about for decades.
The reason H5N1, which first cropped up in humans in 1997, has never given rise to a pandemic is that the virus does not appear to spread easily among people. It has been transmitted between humans only in rare cases, usually among family members in close conditions. But the fear has long been that if bird flu genetically mixed with human flu ? in a process called reassortment, in which two flu viruses swap genes in an infected cell ? it could create a new strain that is both deadly and transmissible, as illustrated by the new PNAS study. That's how many past pandemic viruses, including 2009 H1N1, were created, leading to new strains to which humans have no natural immunity.
In 2008 scientists from the Centers for Disease Control and Prevention generated artificially combined H5N1 and H3N2 viruses in a lab, but the resulting hybrids were all less deadly than the original bird flu strain. That led to hopes that the H5N1 virus simply lacked the ability to be a true pandemic killer and that to become more transmissible, it would necessarily have to become less dangerous.
But the PNAS study undermines that hope. The key difference in this study was the presence of a single gene from the H3N2 human virus: the PB2 protein, which gave the hybrid viruses the ability to spread easily among the lab mice. Scientists think the protein may allow hybrid viruses to grow more efficiently in the lower temperatures of the upper respiratory tract, from which the virus can more easily spread to others. (The H5N1 virus tends to infect the lower respiratory tract in humans, where it can't easily get out and spread.)
Nevertheless, in the real world, H5N1 has not yet mutated into a more contagious form, despite having had plenty of chances to mix with human flu viruses. That could mean bird flu will remain a dead end, infecting the occasional unlucky person but never turning into a full-blown pandemic. But the PNAS study suggests that the potential exists, and it gives health officials a surveillance target in the form of the PB2 protein in each human H5N1 infection. Global health experts must always be ready: while the 2009 H1N1 pandemic may be winding down, the next flu war has already been brewing.
http://www.time.com/time/health/arti...lth+Stories%29

[Kavoom]

Reassortment between avian H5N1 and human H3N2

http://www.pnas.org/content/early/2010/02/18/0912807107.abstract

"The spread of avian H5N1 influenza viruses around the globe has become a worldwide public health concern. To evaluate the pathogenic potential of reassortant viruses between currently cocirculating avian H5N1 and human H3N2 influenza viruses, we generated all the 254 combinations of reassortant viruses between A/chicken/South Kalimantan/UT6028/06 (SK06, H5N1) and A/Tokyo/Ut-Sk-1/07 (Tok07, H3N2) influenza viruses by reverse genetics. We found that the presence of Tok07 PB2 protein in the ribonucleoprotein (RNP) complex allowed efficient viral RNA transcription in a minigenome assay and that RNP activity played an essential role in the viability and replicative ability of the reassortant viruses. When the pathogenicity of 75 reassortant H5 viruses was tested in mice, 22 were more pathogenic than the parental SK06 virus, and three were extremely virulent."

[Laidback Al]

Re: The H5N1/H1N1 Combo mix warning thread

Virus hybridization could create pandemic bird flu

February 22, 2010

Genetic interactions between avian H5N1 influenza and human seasonal influenza viruses have the potential to create hybrid strains combining the virulence of bird flu with the pandemic ability of H1N1, according to a new study.

In laboratory experiments in mice, a single gene segment from a human seasonal flu virus, H3N2, was able to convert the avian H5N1 virus into a highly pathogenic form. The findings are reported the week of Feb. 22 in the online early edition of the Proceedings of the National Academy of Sciences.
"Some hybrids between H5N1 virus and seasonal influenza viruses were more pathogenic than the original H5N1 viruses. That is worrisome," says Yoshihiro Kawaoka, a virologist at the University of Wisconsin-Madison and senior author of the new study.
The H5N1 bird flu virus has spread worldwide through bird populations and has caused 442 confirmed human cases and 262 deaths, according to the World Health Organization. To date, however, bird flu has not been able to spread effectively between people.
"H5N1 virus has never acquired the ability to transmit among humans, which is why we haven't had a pandemic. The worry is that the pandemic H1N1 virus may provide that nature in the background of this highly pathogenic H5N1 virus," says Kawaoka, a professor of pathobiological sciences at the UW-Madison School of Veterinary Medicine.
Two viruses infecting a single host cell can swap genetic material, or reassort, creating hybrid strains with characteristics of each parent virus.
Before the current study, hybrid viruses generated in lab studies had always been less virulent than parent strains. However, the new findings raise concerns that H5N1 and pandemic H1N1 viruses could reassort in individuals exposed to both viruses and generate an influenza strain that is both highly virulent and contagious.
The increased virulence seen in the new study seems to arise from one of the eight genes in the viral genome, called PB2, which is known to affect how well the virus grows in mammalian hosts, including humans. When tested in mice, the human virus version of PB2 swapped into H5N1 converted the avian virus to a highly pathogenic form.
The researchers say surveillance of viral populations is critical to monitor the potential emergence of highly pathogenic viral variants due to reassortment of avian and human influenza viruses. Their results, including identification of the PB2 segment as a key to enhanced virulence, offer information likely to be useful in the event of a pandemic caused by a hybrid avian-human influenza virus.
"With the new pandemic H1N1 virus, people sort of forgot about H5N1 avian influenza. But the reality is that H5N1 avian virus is still out there," Kawaoka says. "Our data suggests that it is possible there may be reassortment between H5 and pandemic H1N1 that can create a more pathogenic H5N1."

Provided by University of Wisconsin-Madison

http://www.physorg.com/news186071749.html

[Treyfish]

Re: The H5N1/H1N1 Combo mix warning thread

A flow of a pandemic "may not" occur
2010-03-05 03:00:00 Source: Jinyang Wang - New Express (Guangzhou)

Zhong Nanshan: Southern from February to June a high incidence of influenza, the most worried about human transmission of new variant of

New Express News (Reporter YIN GUO Xiao-yan CHEN Qi-tin Liuzheng Xu Cao Jingjing Liao Ying-yi) Yesterday, the National People's Congress, Chinese Academy of Engineering academician Zhong Nanshan, told reporters sounded "alarm bells": influenza in southern China is the high season of February to 6 months, there are other mutations found in H3N2 influenza viruses are most worried about mixing the virus to generate new variants.

Zhong Nanshan said that the recent two months, the mainland accounted for influenza A flow ratio gradually decrease, A flow of a pandemic "may not" happen.

He said that last year, Hong Kong and the Mainland, was found in pigs in a stream of individual variants, and some are also resistant to Tamiflu, even in the end of last year also found that individual H5N1 (avian influenza); the same time, in southern China, including Hong Kong, In the February to June for the influenza season, the medical estimates of the A stream that currently the predominant influenza outbreak is unlikely, but there may be other influenza viruses mix, so this time should not relax their vigilance.
He said that although the show you will be seeing the virus variant does not pose any outbreak, but medical authorities most fear is the virus through the mixture to produce a new variant, with resistance, both human transmission characteristics, "This is the most afraid of. " http://news.163.com/10/0305/03/60VT6APJ000146BB.html

[Commonground]

Re: The H5N1/H1N1 Combo mix warning thread

Post #74 (out of China):

Southern from February to June a high incidence of influenza, the most worried about human transmission of new variant of

This is out of Vietnam:

March 3, 2010
excerpt

""Previous years, avian influenza appears in winter, cold weather. Also this year, avian influenza appears to prolonged hot and dry season. This suggests that influenza A/H5N1 virus strain variations, complicated development. Concern that avian influenza outbreaks occur in the former."

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