Wild Birds Could Spread Avian Flu

Wild ducks that are immune to the effects of H5N1 avian influenza could be spreading the virus far and wide, U.S. government researchers said on Monday.

Satellite tracking of migrating northern pintail ducks showed they flew from a bird flu-infected marsh in Japan to nesting areas in Russia, said the scientists from the U.S. Geological Survey and the University of Tokyo said.

The study does not prove the pintails carried the virus, but the species can be infected with H5N1 with no ill effects.

H5N1 bird flu has been circulating in Asia and the Middle East, with occasional outbreaks in Europe, since 2003. It rarely infects people but when it does it is deadly: the World Health Organization has documented 493 cases and 292 deaths.

It wipes out chickens, who have no immunity, and some other bird species and can seriously damage poultry farms. Experts fear it has the potential to cause a human flu pandemic that would be much worse than the H1N1 swine flu pandemic.

Experts have argued about whether wild birds, spread the virus, or the poultry trade, or both.

Writing in the journal Ibis, the researchers described how they attached satellite transmitters to 92 northern pintail ducks several months before the H5N1 virus was discovered in dead and dying whooper swans in a wetlands in Japan.

Twelve percent of marked pintails used the same wetlands as infected swans. Then some of them migrated more than 2,000 miles to nesting areas in eastern Russia.

Birds can spread flu viruses orally and in their droppings.

“Consequently, infected wild birds that do not become ill, or birds that shed the virus before they become ill, may contribute to the spread of H5N1,” said Jerry Hupp of the USGS.

USGS scientists have been testing birds in Alaska, considered a potential place where H5N1 could enter the Americas from Asia. So far, no case of highly pathogenic H5N1 has been found in either birds or people in the Americas.

Two cases with rapid development of drug-resistant 2009 H1N1 influenza reported

Scientists have reported two cases in which people with compromised immune systems who became ill with 2009 H1N1 influenza developed drug-resistant strains of virus after less than two weeks on therapy.

Doctors from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, have said that medics, who treat prolonged influenza infection should be aware that even a short course of antiviral treatment may lead to drug-resistant virus.

They also said that the authors, and clinicians should take into mind this possibility while developing initial treatment strategies for their patients who have impaired immune function.

Both patients in the new report developed resistance to the key influenza drug oseltamivir (Tamiflu), and one also demonstrated clinical resistance to another antiviral agent, now in experimental testing, intravenous peramivir, said senior authors Dr. Matthew J. Memoli and Dr. Jeffery K. Taubenberger.

This is the first reported case of clinically significant peramivir-resistant 2009 H1N1 illness, say the scientists.

The people in the current case report had immune limitations due to blood stem cell transplants that occurred several years previously. Both recovered from their influenza infections.

“While the emergence of drug-resistant influenza virus is not in itself surprising, these cases demonstrate that resistant strains can emerge after only a brief period of drug therapy. We have a limited number of drugs available for treating influenza and these findings provide additional urgency to efforts to develop antivirals that attack influenza virus in novel ways,” said NIAID Director Anthony S. Fauci.

The 2009 H1N1 influenza virus is susceptible to just one of the two available classes of anti-influenza drugs, the neuraminidase inhibitors. Besides oseltamivir, other neuraminidase inhibitors are zanamivir (Relenza), which is inhaled, and the intravenously administered investigational drug peramivir.

It was shown that some strains contained a genetic mutation (the H275Y mutation) that makes the virus less susceptible to some neuraminidase inhibitors.

The two people in the current case study had pre-existing medical conditions that impaired their immune system function before contracting 2009 H1N1 flu.

In the newly described cases, the mutation appeared after 14 days in one individual and after nine days in the second.

Protection from influenza virus

A University of Alberta-led research team has discovered the genetic detector that allows ducks to live, unharmed, as the host of influenza.

The duck’s virus detector gene, called retinoic acid inducible gene-I, or RIG-I, enables a duck’s immune system to contain the virus, which typically spreads from ducks to chickens, where it mutates and can evolve to be a human threat like the H5N1 influenza virus.

The first human H5N1 cases were in Hong Kong in 1997. Eighteen people with close contact to chickens became infected and six died.

The research by Katharine Magor, a U of A associate professor of biology, shows that chickens do not have a RIG-I gene.

A healthy chicken can die within 18 hours after infection, but researchers have successfully transferred the RIG-I gene from ducks to chicken cells.

The chicken’s defenses against influenza were augmented and RIG-I reduced viral replication by half.

One potential application of this research could affect the worldwide poultry industry by production of an influenza-resistant chicken created by transgenesis.

The study appears in the online, early edition of Proceedings from the National Academy of Sciences .

WHO to decide new flu vaccine formula

Flu vaccine makers anxiously await the decision, scheduled to be announced at 5 a.m. EST/1000 GMT, because they need this guidance to start formulating vaccines for the Northern Hemisphere’s fall vaccine mix.

The decision is more complicated this year because of the pandemic of H1N1 swine flu. Although the pandemic is on the wane, the virus is still infecting and killing people.

Other strains of flu are still circulating but at far lower levels than usually seen in February.

Here are some possible outcomes of the WHO meeting:

SWINE FLU REPLACES H1N1 IN VACCINE

The pandemic strain of H1N1 could simply replace the older H1N1 component of the vaccine. Influenza vaccines are trivalent, meaning they contain three different strains. They are an H1N1 strain, and H3N2 strain and an influenza B strain.

Every year these strains “drift” slightly and the vaccine is reformulated when one drifts enough to justify changing it. Because flu viruses constantly mutate, monitoring these changes is an ongoing process. The WHO advisers could potentially vote to have the pandemic H1N1 strain substitute for the current H1N1 seasonal strain.

This would be good news for vaccine makers and governments that have made and stockpiled doses of H1N1 vaccine that have not been used and could become part of the seasonal flu vaccine mix.

ADD H1N1 TO THE SEASONAL VACCINE

Advisers may be reluctant to completely replace the H1N1 component with the pandemic strain. Although there is not yet much seasonal H1N1 circulating, during the 2008-2009 season it became resistant to the antiviral drug oseltamivir, Roche AG’s Tamiflu.

Flu experts have been debating whether it is possible to have a quadrivalent seasonal flu vaccine — one with four components instead of three. There could be two H1N1 strains in such a vaccine — seasonal and pandemic.

KEEP TWO SEPARATE VACCINES

The advisers may decide to keep the trivalent formula for seasonal flu vaccine and also continue to recommend the pandemic H1N1 swine flu vaccine as a separate immunization.

The H1N1 swine flu vaccine will not be dropped. “The current pandemic virus, the H1N1 virus, is by far, the most common virus being isolated for influenza viruses around the world,” WHO’s Dr. Keiji Fukuda told reporters last week.

“It shows no signs of disappearing and … that there is a very good bet that we will expect to see this virus around for quite a while.”

U.S. health officials said H1N1 swine flu has killed as many as 17,000 Americans, including 1,800 children. Globally, 15,000 deaths have been officially reported but WHO says it will take years to get the true, much higher, toll.

Tamiflu sales boost Roche profits

Swiss drugs firm Roche has reported an 8% rise in annual sales, helped by sales of swine flu drug Tamiflu and cancer treatments, such as Herceptin.

The rate of growth is twice the industry average and operating profits were up by 14% to 15bn Swiss francs ($14.2bn, £8.89bn).

However, overall net income for the year fell 22% to 8.5bn Swiss francs as a result of takeover costs.

Last year, Roche bought US pharmaceutical giant Genentech.

It says that this deal is already proving profitable.

Although sales of Tamiflu soared last year, they are expected to fall sharply in 2010, to 1.2bn Swiss francs from 3.2bn Swiss francs in 2009.

Will Tamiflu Shortage Drive U.S. To India’s Version?

With demand for the swine flu vaccine outpacing supply, the Centers for Disease Control and Prevention says it is open to considering importing a generic flu drug from India. There’s just one problem: Tamiflu, the brand-name drug, is still under U.S. patent.

Flu-related hospitalizations and deaths are still on the rise in the United States. But there’s a shortage of Tamiflu, the anti-viral medication that can protect against complications caused by the illness.

To deal with the shortage, the CDC has ordered more Tamiflu from Roche, its Swiss manufacturer — but it is not expected to arrive until January.

Antiflu, a generic version of Tamiflu, is made by the Indian company Cipla — despite the fact that Tamiflu’s patent is protected under U.S. law until 2016. The Cipla version costs 20 to 30 percent less than the brand-name drug.

Dr. Yusuf Hamied, chairman of Cipla, says he is eager to provide the U.S. market with his generic version of the drug.

“We would keep our factories open night and day, because this is an emergency,” he told NPR’s Steve Inskeep.

“We would certainly cooperate in whatever way possible.”

The U.S. government has already released its last 200,000-some doses of the oral liquid version of Tamiflu for children. The highest hospitalization rate for swine flu is in children age 4 and under.

A recent poll from the Harvard School of Public Health found that only about a third of adults who have tried to get a swine flu vaccine have been able to get it.
Hamied says Antiflu is an exact clone of Tamiflu. It has been approved by the World Health Organization and is already for sale in India.

In 2001, Cipla tried to import its generic version of the antibiotic Cipro — which was stockpiled after the anthrax attacks in 2001.

“The drug was covered under patent,” Hamied said.

“And I think what happened — the American government stockpiled Ciprofloxacin and probably made a deal with Bayer [the manufacturer] at a much lower price than what was the prevailing market price at the time.”

Hamied said his new plan to export Cipla’s version of Tamiflu to the United States faces similar problems.

To import Antiflu before 2016, the U.S. government would have to override patent law, which it would likely only do in a real emergency. And Cipla’s drug does not yet have Food and Drug Administration approval.

India is the largest and fastest-growing producer of generic medicines; Hamied’s company has a long history of producing generic drugs to sell at cheap prices in the developing world.

The most famous of these is Cipla’s generic anti-retroviral drug. It is considered to be lifesaving for HIV-positive people in Africa, because it is available for a fraction of the cost of brand-name anti-retrovirals.

In developed countries, anti-retrovirals cost around $6,000 per patient per year; the Indian generic version is available in the developing world for $800.

Influenza A/H1N1 continues to spread in Asia

The number of influenza A/H1N1 confirmed cases continued to rise in most of Asia countries on Friday.

New Zealand now reported 216 confirms cases. Meanwhile, it was moving to a “manage it” phase as part of its response to the Influenza A/H1N1 outbreak. The shift in phase reflected the increased spread of the virus, rather than a change in the severity of the illness, said Health Minister Tony Ryall.

“We’re remaining in code yellow we are not moving to code red, this is a reflection of the spread, not the severity, of the flu,” he said.

“Our focus is now moving to helping those people in the community that have the illness.”

Finance Minister Bill English said influenza A/H1N1 represents “one more bend in the road to recovery,” but the economy faces significantly larger challenges.

Westpac Bank is estimating that influenza A/H1N1 could cut 1 percent to 2 percent from New Zealand’s economic growth over the next year which may lengthen the recession by another two of quarters.

Malaysia declared four more imported cases of A/H1N1 flu on Thursday, bringing up the total number of the patients to 27, according to local media on Friday.

So far, 12 of the 27 patients had fully recovered and the other15 still remained in quarantine and treatment in hospital, the ministry said.

The ministry also said that 10 of the 27 patients were foreigners, and currently a total of 160 close contacts of these patients were under quarantine in the country.

Malaysia has introduced ten new measures to prevent A/H1N1 flu from spreading in the country.

Malaysian Deputy Prime Minister Muhyiddin Yassin said that one of the measures was compulsory health declaration form by all travelers arriving in the country, which would be gazetted next week.

Other measures included sending health officers on board flights to scan body temperatures of passengers coming from the United States, Melbourne of Australia and Manila of the Philippines.

Also, Malaysia would give A/H1N1 flu vaccines to high-risk groups to reduce infection risks.

Thailand’s Public Health Ministry on Friday announced 71 more patients, who are confirmed to have caught the A/H1N1 flu virus, bringing the country’s total number to 589.

The Japanese government relaxed its guidelines for dealing with the new A/H1N1 influenza Friday although the total infection tally is still on the rise.

Under the revised guidelines, the government basically allows every medical institution in the country to see new-flu patients and for people with mild symptoms to recuperate at home.

The government will also stop counting all individual infections and focus instead more on early detection of group infections.

The health Ministry also decided the same day to start producing a vaccine against the new flu in mid-July, which would allow for inoculations to start as early as October, by stopping output of seasonal flu vaccine.

The tally of infections in Japan approached 750 as of Friday morning after the first cases were confirmed May 9. But symptoms are milder than initially feared and no one died due to the disease.

In Australia, Health Minister Nicola Roxon issued a statement on Friday night after a man confirmed with the virus died, saying that A/H1N1 flu remains mild in Australia and most people infected make a rapid and full recovery.

“While swine flu (A/H1N1 flu) is mild in most, severe in some and moderate overall, those with existing conditions are more vulnerable to the severe effects of the disease,” Roxon said.

Roxon said that during the protect phase of the pandemic, the government remained focused on identifying, targeting and treating people who are most vulnerable to severe complications from A/H1N1flu.

In Bangladesh, the first A/H1N1 flu case was detected on Thursday, the health ministry said in press statement on Friday.

Singapore has confirmed another 26 new cases of influenza A/H1N1 cases, bringing the total number of confirmed cases here to 103, the country’s Health Ministry said on Friday night.

Singapore reported its first confirmed case of Influenza A/H1N1on May 27. So far, 29 patients have been discharged. The remaining74 patients are still in the hospital and their conditions remain stable.

In China’s Hong Kong, a study done by local experts showed that the magnitude of influenza A’s summer peak has become higher in recent years in Hong Kong.

The Chinese University of Hong Kong and the Hong Kong Observatory jointly studied the relationship between weather and influenza activity in Hong Kong.

The study analyzed the information of the laboratory-confirmed influenza A and B cases admitted to the Prince of Wales Hospital and the Observatory’s weather data from 1997 to 2006.

The study found that, in general, there were more influenza A than influenza B-associated admissions in Hong Kong. The two types of influenza showed a different relationship with weather conditions.

As the new strain disease, influenza A/H1N1, which is spreading among different countries and regions, belongs to the influenza A type, Chan expected the magnitude of the new virus will become stronger during June and July.

Hong Kong health authorities announced Friday 16 new cases of influenza A/H1N1 were confirmed, bring to 237 the total number of influenza A/H1N1 cases in the city.

On the same day, the Education Bureau of the HKSAR government announced that classes of four schools would be suspended for 14 days between June 20 and July 3.

Macao reported an A/H1N1 influenza suspect case on Friday involving a Macao resident who tested positive for the virus in preliminary tests.

Despite the climbing number of A/H1N1 influenza cases in neighboring regions, the Special Administrative Region (SAR) just reported its first confirmed case Thursday.

Better data needed’ on swine flu

The government must map the spread of swine flu more accurately in order to predict the number of people who are likely to die from it, scientists say.

Researchers at Imperial College say data is vital to ensure the country is “best prepared to fight the pandemic”.

They predict that one in 200 people who get swine flu badly enough to need medical help could go on to die.

Meanwhile, the BBC understands that vaccines may not be ready until later than the government had predicted.

Medical correspondent Fergus Walsh said World Health Organisation officials expected the first stocks to be available in September or October, not August as ministers had said.

Chief medical officer Liam Donaldson also told the BBC that to cope with “the height of the pandemic”, the government was considering changing the rules to speed up the death certification process for swine flu victims.

“We want to try and reduce as much as possible the burden of work on doctors and we are considering all sorts of things which will help will that,” he said.

“That’s one of the options that’s being looked at.”

Margin of error

Accurate predictions about the number of deaths likely to occur from swine flu are not yet available.
Current estimates suggest it is about as virulent as some types of seasonal flu, but far less deadly than some previous flu pandemics.

The BBC’s science editor Susan Watts said in a good year a thousand people die of seasonal flu, but in a bad year it can be 30,000.

Any estimates about swine flu are subject to a wide margin of error, not least because not everyone who catches it develops symptoms.

But despite the difficulties, the Imperial College scientists – who are advising the government on its swine flu strategy – say more accurate mapping of the spread of the virus must be carried out if it is to be effectively managed.

Dr Tini Garske said: “If we fail to get an accurate prediction of severity, we will not be providing healthcare planners, doctors and nurses, with the information that they need to ensure they are best prepared to fight the pandemic as we head into the flu season this autumn.”

She said data must be collected “according to well designed study protocols and analysed in a more sophisticated way than is frequently being performed at present”.

‘Only an estimate’

Not everyone who is infected with swine flu will become ill enough to report their case to a doctor.

Of the proportion who do, scientists predict that 0.5% of them – one in 200 – could go on to die.

Health Secretary Andy Burnham has said there could be 100,000 new cases of swine flu a day later in the year.

If that prediction and the Imperial College figures are both correct, that could mean 500 people dying every day.

There need to be plans for hospitals to share workloads across areas
Prof Steve Field
Royal College of GPs

The chief medical officer told the BBC that was “only an estimate”.

“There are higher and lower estimates, we can’t be absolutely sure at this stage where the mortality will fall,” Sir Liam said.

“Our own estimates show a much broader range than that and a lower figure, but the truth of the matter is it’s far too early to say.”

There have so far been 17 swine flu-related deaths in the UK.

On Tuesday, a post-mortem examination ruled that a GP who died after contracting it was not killed by the virus.

Prof Steve Field, from the Royal College of GPs, said plans to manage the outbreak were on schedule.

“What we’re learning is this is happening in hotspots around the country… so there need to be plans for individual hospitals and for hospitals to share workloads across areas,” he said.

Tiny Med Island Finally Succumbs To Swine Flu

The last country in the European Union to be infected with the swine influenza virus is Malta! This tiny Mediterranean island with a population of 400,000 people managed to hold out until the beginning of July despite hundreds of thousands of tourists arriving by plane and sea.
Tiny Med Island Finally Succumbs To Swine Flu

The Director of Health for the island Mr. Ray Busuttil explained that in line with correct procedure the infected individuals had been given the antiviral medication Tamiflu and members of their family and other people they had been in contact with had also been given the drug.

As is often the case in small confined places like Malta news of the swine flu infections spread rapidly and in some cases caused undue panic. Many people decided not to go to work with or canceled holidays abroad because they were frightened of coming into contact with people who were infected. The number of cases in Malta currently stands at 39 confirmed.

However the Maltese government said that they were keeping a close eye on the situation and that other then following simple hygiene practices such as washing hands, people should continue with their lives as normal. The government said that avoiding crowded gatherings was also a good idea however this will be hard to enact especially as there are so many summer parties and gatherings on the beach at this time of year. Some health experts predict that with the huge Isle of MTV concert coming up on Wednesday evening the virus could spread significantly more.

In line with the World Health Organisation recommendations the Maltese government has a stock of Tamiflu which will enable 25% of its population to be treated and more medicine has been ordered from its manufacturer Roche. The Maltese government has also invested in 10,000 courses of the other effective influenza medication Relenza.

Tamiflu knocked at No.1

Everybody complains about getting Viagra spam at some point but over the last few days Viagra has been knocked off the top spot and is no longer the most spammed drug in the world after the influenza medication Tamiflu became the no.1 inbox-clogger all over the globe. According to Mr. David Pruce from the Royal Pharmaceutical Society the sudden hike in the number of spam emails which contain the words Tamiflu is incredible and is obviously directly linked to the scare surrounding the swine influenza pandemic.

Tamiflu medication are almost certainly selling a fake version of it that is likely to be completely ineffective or dangerous. Tamiflu is also a prescription drug and therefore it is illegal to promote it in this way.

While many people may perceive sending out Viagra spam as a harmless activity which could only lead to disappointed men, the act of sending out Tamiflu spam to make people buy a dud medication which is supposed to be a lifesaver is almost tantamount to murder. In 3rd world countries tens of thousands of people die every year from using fake medications which don’t do what they are supposed to and now the criminal manufacturers of these products are trying to cash in on the fears of people living in the United Kingdom by sending out these evil spam emails.

If you receive Tamiflu spam you should delete it immediately and whatever you do don’t be stupid enough to buy anything from the website it links you to. Never take chances with influenza medication!