[CanadaSue]

Things remain fairly quiet in Europe, the US & Canada. The European report first:

http://dev.eiss.org/cgi-files/bulletin_v2.cgi?display=1&code=130&bulletin=130

Flu remains below baseline levels for most reporting nations. The one exception is Northern Ireland where it would appear flu is really taking off - well the season has got to start somewhere...

54 positives were collected & types during the week. 10 were B strain & the remainder A. 10 of those were subtyped 2 were H1N1 & 8 were N3 - only onw of these was subtyped further to H3N2. No surprises yet & the 2 A/Wellington variant speciments from Switzerland, (A/Shantou), are very close to A/Wellington. A/Wellington is already in the southern hemisphere reccomendation for their vax.

So far this year, H3N2 is again dominant but it's darned early to tell. 1/3 of samples are H1N1. Europe is predicting that the flu season is just now about to start. Makes sense - many schools finished term today & travel will pick up with lots of mixing & matching throughout Europe. I expect to see the % of positive tests really ramp up in about 2 weeks.

RSV may have peaked in France & the UK but is increasing elsewhere in Europse. No funnies there.

[CanadaSue]

http://www.cdc.gov/flu/weekly/

New York is the only state reporting widespread activity. Kentucky & Florida are reporting regional activity. I'll have to check county maps for Florida but I'd not be surprised to find a relation between counties experiencing relatively high levels of flu & those hit heard by any of the hurricanes.

Overall in the last reporting weeks, US flu levels remain low. Only 3.1% of tested samples are positive for flu. Most of those are A strain & of those subtyped, all are H3N2. There's no H1N1 or H2N1 here at all yet. The 11 B strain smaples match the vax formulation.

During that week, 6.1& of deaths nation wide are reported due to respiratory. Flu isn't segregated out, (flu complications rather), but that total remains below this week's baseline of 7.6%. NO children have died due to flu or related problems & hospitalizations of kids for same remains low. I noted on their table comparing the last several season that the hospitalization of kids remained very low until mid January most years that sharply ramped up as flu season hit its stride. The exception was last year & if this season were to be as last year, that number would be up considerably within the next 2 weeks. My personal bet is that we won't see anything 'interesting' at any level until the report dated January 14th - everyone's been back at school/work 2 weeks by then & the reports are usually a week behind actual case loads - that then, would represent more accuratekly results up to January 7th.

Fewer people than normal are calling their doctors because of flu - well below seaosnabl again.

So far so good.

One comment - with some states & regions within them having flu vax left & little demand - go for it if you'tre inclined. You've got time to do that & be protected against the 3 vax strains by the time the season really lits in mid to late January. So far, nothing outside those strains is being seen in the US.

[GrayBear]

My wife and I followed your flu reports closely last year and followed you over here. We are considered to be in the vulnerable group, me from age (73) and her from a "permenent" abdominal pain as yet not formally diagnosed in spite of exploratory operations plus testing by UC Med and Stanford as well as our local physicians and labs. Strong pain meds also seem to have depressed her immune system so she catches everything that comes along.

She got the flu shot about a month ago, they came up with vaccine for me several days ago.

When "The Flu Season" hits we sort of hole-up in our semi-isolated little foothill community and try to avoid people. We read your reports for our version of an "All Clear."

Thanks,

GrayBear

[CanadaSue]

http://www.phac-aspc.gc.ca/fluwatch/04-05/w50_04/index.html

In the last reporting week, 1.3% of visits to doctors involved respiratory illness complaints. 82 samples were tested & 79 were A/Fujian like & 2() were B'Shanghai. Quebec had by far the highest flu cases with 37. Ontario, (universal free vax with about 50% uptake so far), only had 8 cases. Alberta is running second with 24 cases, 9 in BC & 3 in Saskatchewan. None in the east coast provinces.

It's easrly here too & I expect that will ramp up in the next few weeks. School ended today save for those few university kids who have exams left & judging by the highway near my place, the exodus to grandma's house has started.

Here in Ontario, I expect cases to ramp up in Toronto first - with 5+ million people & a busy international airport, that's a given. Quebec will continue to see more cases & it will spread across the country.

Other respiratories - RSV, parainfluenza & adenoviruses are also up across most of the country.

[Arubi]

Florida A&M seeks to create flu vaccine lab, production plant


Associated Press

TALLAHASSEE, Fla. - Officials at Florida A&M University want to create a flu vaccine lab and production plant that could help avoid shortages of the vaccine like the country is seeing this year.

University and local government officials are pushing the idea, but need nearly $40 million in state money and would have to get federal officials to sign off on the program.

Backers of the plan say they're aiming to have the program going by the 2008 flu season.

Henry Lewis, former head of FAMU's pharmacy school, who is leading the effort to start the vaccine lab, said FAMU and Florida State University could join a national drug company in research and production at a lab in Tallahassee. The pharmacy school has drafted a $39.9 million budget request, covering everything from a feasibility study to equipping the facility.

Along with being able to add to the nation's flu vaccine stockpile, officials here see it as a potential economic boost to the state's capital city.

"I see this institute, at build-out, generating about 500 new jobs," Lewis said. More jobs could follow in a cluster of businesses that would complement the lab, from research to farming the chickens used in the vaccine creation.

"As the state government continues to downsize, we're going to have to find other ways in which we can bring economic engines to our city," Lewis said. "This we see as an excellent way to create new jobs, solve a critical health problem for the nation and the state of Florida as well."

State Reps. Dave Coley, R-Marianna, and Curtis Richardson, D-Tallahassee, said they will try to tap into the state's economic-development reserve fund for the startup costs.

Currently, there's only one company manufacturing flu vaccine in the United States, Lewis said.

Federal officials might be particularly receptive to the idea this year because of the national shortage of vaccine. In October, 48 million doses of flu vaccine, roughly half the anticipated U.S. supply, was unexpectedly withdrawn from the market because of bacterial contamination at the British company that makes it.

---

Information from: Tallahassee Democrat, http://www.tdo.com

[Arubi]

www.news8austin.com


New flu vaccine undergoes test

Updated: 12/17/2004 5:00:00 AM
By: CNN
After trying for weeks to get a flu shot, Graham Ball finally found a place he could get one – a clinical trial.

The vaccine's maker, Glaxo Smith Kline, announced last week it would donate up to 4 million doses to help Americans who can't get a vaccine this year.

But since this particular vaccine is not officially approved by the FDA, it's considered an investigational new drug or an IND.

"We are confident that the Glaxo Smith Kline vaccine is safe and effective. For use under an IND this vaccine has been licensed for use in more than 30 different countries," Health and Human Services Secretary Tommy Thompson said.

To help it get complete U.S. approval, the government has asked the University of Maryland School of Medicine in Baltimore to test the vaccine.

"The purpose for our trial is to test the vaccine in American volunteers in order to provide the appropriate data to the Food and Drug Administration," Dr. James Campbell said.

The trial will be done in January. If the FDA approves it, Glaxo Smith Kline can then gear up production to make millions more doses for next year.

http://www.news8austin.com/content/living/health_beat/?ArID=127225&SecID=169

[Roger Thornhill]

Why would the exposure in February not show up until December?



Five People in Japan May Have Bird Flu Virus - Kyodo

Friday, December 17, 2004 9:17:46 PM ET

TOKYO (Reuters) - Five people in Japan may have been infected with the bird flu virus after an outbreak among chickens in western Japan in February, Kyodo news agency said, adding that none was in serious condition.

If confirmed the cases would mark the first human infections of bird flu in Japan, which reported several cases of bird flu earlier this year.

All of the cases reported in Japan have been identified as the H5N1 virus, the strain that has hit other countries in Asia and has been blamed for human deaths in Vietnam and Thailand.

"An antibody to the bird flu virus has been detected but the virus itself was not found in blood serum samples taken from the people," Kyodo said in the report, quoting sources familiar with the case.

"They all had fever but none of them was in serious condition, according to the sources," Kyodo said.

Four of those possibly infected were workers at a farm in the town of Tamba in Kyoto prefecture, western Japan, Kyodo said.

The other person had helped disinfect the farm after a bird flu outbreak among chickens in February, it added.

Other Japanese media including major dailies carried similar reports. Health Ministry officials were unavailable for comment.

After the February outbreak some 240,000 chickens and 20 million eggs were disposed of at the Kyoto farm and another one nearby to prevent the infection from spreading, the agency said.


http://www.metronews.ca/reuters_int...al.asp?id=46649

[CanadaSue]

I've been reading that article over & over & from what I'm seeing - it's looking more like sloppy writing on the part of the reporter. If I may show what I mean, bit by bit:

***Five people in Japan may have been infected with the bird flu virus after an outbreak among chickens in western Japan in February.***

It would seem they were infected or found to be infected just after they had their avian outbreaks in February.

***"An antibody to the bird flu virus has been detected but the virus itself was not found in blood serum samples taken from the people," Kyodo said in the report, quoting sources familiar with the case.

"They all had fever but none of them was in serious condition, according to the sources," Kyodo said.***

This is more confusing. No matter when they had the flu - as long as they didn't get sick within the last few days, the H5N1 antibodies are there for life. And they HAD fever, (part tense) none 'was in'... could be today? After 48 hours of ibnfection it's rare to find detectable levels of virus - it's cleared that fast from the body.

The fact that 4 were farm workers & 1 helped in disinfection after the birds were killed also suggests we're talking about no later than very early last March.

Remember that Japan, while a developed nation also can keep things pretty close hold. They, (government), may simply have chosen not to reveal these cases & I'm going to guess here as to why. Japan was ashamed of these outbreaks - they felt it reflected poorly on their poultry farmning practices - no such thing as they are right up there with the best in the world. There WAS a great deal of concern about potential human cases & Japan is another crowded nation. Citizens of that nation were horrified at the prosepcts - must as they were during SARS.

It's possible the government thought it best - as the illness does appear to have been self limiting - to simply keep this very close hold. They performed very strict agricultural quarantines & darned near personally escorted every vehicle going near the exclusion zones so may have felt the illnesses meant sloppiness on the part of those who became ill - why worry the general public for that?

Okay, now that we all feel better - let me run the other way. Let's say these cases are breaking now, (highly unlikely but let's run with that); what does or could it mean?

It's also flu season in Japan & I wish to God I read Japanese & could access their press first hand - gonna check a few other sources. What if these are current cases? We're talking 4 poultry workers & one who had cleaned after. It makes no sense with that one case, but let me get back to that one in a bit. If the first four are CURRENTLY ill & still work on poultry farms, we may have a strain that's subclinical in poultry & able to sicken humans - that's an interesting combination of genetic changes I'd never really considered - sounded too firghteningly perfect for pandemic purposes.

Either we have that or somehow, these 5 workers picked it up in the ENVIRONMENT near their workplace. So why have the poultry not become ill? nless there's another point of commonality among them...??? Argh!

The third, really woo woo possibility is that the wretched virus remained LATENT within them for these... 9/10 months? Flu DOES NOT DO THAT! Please by all that's holy, let's not go there. It would mean they would have been infected by the virus which somehow remained in their systems undetected all this time & only manifested now? Now that would be so revolutionary with flu virus we'd damned near have to throw out everything we know about H5N1.

Let's take that one step further. It's such an unlikely combination of mutations it would not have cropped up everywhere but MIGHT have originated wherever the strain affecting Japan did - that did match Vietnam's I think - I WILL check, believe me. Okay whatever, for now. What it means, (if this unthinkable thing happened), is that possibly in Japan & perhaps Vietnam, people who were exposed to H5N1 still have it in their systems - latent & what happens when it begins to manifest? Hoe many could possibly be harbouring this virus in this way & when would they 'break' with it? If you get a lot of such cases at once - that's a lot of potential human interaction & possibility of human to human.

Please understand - I'm typing as I try to think this through & each possibility strikes me as more bizarre than the last. The last couple are unmentionable, almost.

Look if either the last 2 have occured - we may be truly up creek, no paddle.

But to say this is highly speculative is understating it to the point of ridiculousness. In all likelhood, it's very late reporting of human cases from last winter.

But believe me - Sue is going ahunting - NOW!

[CanadaSue]

http://asia.news.yahoo.com/041217/kyodo/d871fpe00.html

The article is almost word for word but with at least one very interesting addition:

***Before taking part in the operations, the fifth person took the flu drug oseltamivir phosphate, known by its product name Tamiflu, and wore a protective suit with a hood, as well as goggles and a mask, they said.

One of the sources said it would be necessary to verify whether the person wore the gear properly.***


Whether or not he wore the gear properly - he took Tamiflu & still devloped a case of H5N1.

This one also leads me to think we're talking about last winter.

[Shadowfane]

Let's not ALSO assume that he took it in the correct dosages, and that it failed.....

He may hve taken it as a prophy, but not long enough or in the correct dosages...

oseltamivir has shown efficacy against both H1N1 and H5N1, per the brits (i think, or one of the Scandinavians....)