News Reports for July 31

Power outage in Utah

http://tinyurl.com/3...

Power outage taught lessons

Few of us would actively seek out what we call learning experiences. That's because learning experiences, by their very nature, can range from unpleasant to painful. However, for those willing to let the lessons sink in, they can be a valuable source of wisdom and improvement. Time will tell whether the power outage two weeks ago throughout Washington County was just such a learning experience.

When a wildfire near Dammeron Valley took out the power countywide, it came as a mild surprise to most residents who found themselves without air conditioning, refrigeration and Internet access. But as the outage dragged on for four long hours, many folks began to fray around the edges.

There was a run on water and ice at area grocery stores, gas pumps stopped working and some motorists actually ran out of gas alongside the road. Hotel rooms were quickly snapped up in Mesquite, and in Cedar City, and traffic along the infamous bottlenecks throughout St. George was at a virtual standstill. Without electricity, credit and debit card transactions could not be completed and the stifling heat added another level of intensity.

City and county officials enacted their contingency plans to ensure emergency services and communications remained functional, but they, too, found that the outage was a learning experience that revealed room for improvement. To their credit, they had a plan for such an occurrence already in place.

Hopefully the experience brought just enough discomfort to Washington County residents to impress upon them the need for personal preparation. If nothing else, it certainly provided a clear picture of specific deficiencies in people's individual readiness. Simple measures, like having extra cases of bottled water, shelf stable foods, auxiliary light sources and an alternate means of cooking one's supper, would have allayed much of the uncertainty many residents felt that day.

Perhaps some folks now see wisdom in keeping their vehicle's fuel tank topped off, having a store of water and a good pair of walking shoes in their vehicle should travel prove difficult.
The difference between the prepared and the unprepared is that when such circumstances arise, the prepared have the peace of mind of knowing they have already provided the basics they'll need.

Now is the time, if you were one of those caught unprepared, to evaluate what constituted the greatest concerns you experienced during the outage. Seriously, ponder those areas where you recognized your vulnerability and then write them down and take the steps to address those concerns today - not sometime in the near future.

It's remarkable when something unexpected occurs and you realize that you have the tools, the skills and the supplies to meet the challenge. You may even be tempted to feel a bit smug. That's better than feeling powerless.

Bryan Hyde is an evening radio talk show host on KSUB 590 AM

 

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by: Quilter.1 @ Mon Jul 30, 2007 at 23:21:58 PM CDT

Avian flu - A real threat

Monday July 30 2007--Dr. Gilbert Morris, writing for Caribbean Net News speaks of the "Coming catastrophe - Avian flu", and although his commentary might not cause immediate wholesale panic, it will bring to everyone's attention the seriousness of such an issue, (Snip)

With so many Caribbean states surviving off world travel then it is easy to see the grave concerns which will be indeed compounded by the general lack of super-organised and effectively equipped medical facilities in most of the region.

Many of us might have taken Avian flu lightly, perhaps thinking it will stay around Asia and its environs. The sad news is that there is this possibility that a situation like a country's Carnival celebrations or some other festival could easily land Avian flu in our laps and then the trouble would have begun. Dr. Morris' piece is more than just food for thought but a call to action on the part of world leaders including those of the Caribbean. To not prepare could be detrimental to the world and Morris offers blunt insight into the problem at this stage.

"Health and illness - or sickness beyond being generally unwell - will be the main issue of our new millennium. And in a manner of speaking, we are off to a good start. The Avian (Bird) flu (H5N1) threatens to repeat the 1918 global pandemic that killed 40 million people. In today's numbers, based on global population, that would mean between 80 to 200 million people; depending on geographical area and population density.
(Snip)
Dr. Morris continues by saying "Sadly, the impact of the H5N1 strain is that it spreads in the body very quickly; beyond the respiratory tract which is the flu virus' normal habitat. This suggests, generally, that the infection and death follow on far too quickly for medical intervention. And that means mass deaths in the case of a pandemic.
Continued....http://sunstkitts.co...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Mon Jul 30, 2007 at 23:23:57 PM CDT

CDC July 2007 Pandemic Flu Update

Didn't see this issue posted anywhere previously.  This is a PanFlu update that CDC sends to its employees each month.  See http://www.immunize.....  It says it is for CDC use only ["The monthly Pandemic Influenza Update is prepared by CDC's Priority Communication System and is intended for INTERNAL USE ONLY."], but it's posted on the immunize.org website, which is available to all.

It mentions the Pandemic Flu Leadership Summit in June.

It says:  IF YOU ARE ASKED...."Should I stockpile food, water, medications? How long should a stockpile be designed to last? What are the Government's recommendations for personal and family stockpiles?"

In the newsletter it doesn't actually provide a time frame; it says you need to be able to meet your needs until outside assistance is available, then adds, "Given that the main purpose of a stockpile is really to allow the owner the time needed to reconnect to support from the outside world, it does not need to be aimed at assuring self sufficiency for prolonged periods of time. Even in the most extreme emergency circumstances the need for prolonged periods of self-sufficiency is very unlikely." It then links to the www.pandemicflu.gov website recommending 2 weeks of food and water.

Worth taking a look at to see the "official" CDC information being given to their own employees.

Also mentions the 2007 HHS Public Health Emergency Medical
Countermeasures Enterprise Workshop, July 31 - August 2, meeting in Washington DC.  See http://www.hhs.gov/a... for more info.  The plenary sessions will be webcast (not live) after the meeting at the website.

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by: big critter @ Mon Jul 30, 2007 at 23:31:14 PM CDT

P.S. you can also view some prior issues, if interested,

at this website
http://www.immunize....

The comment about "internal use only" is included only on the July 2007 issue; no prior issues say that.

I'm not sure all the issues are linked here.  I'm pretty sure there were some other 2007 issues that were forwarded to me by email.

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by: big critter @ Mon Jul 30, 2007 at 23:42:26 PM CDT

[ Parent ]

Admiral Agwunobi's remarks in this newsletter

are nearly identical to those he posted at the DHHS blog on the same subject, and which we suspected were canned (perhaps they were, destined for this newsletter). 

Regardless of what he may have discovered as far as new information as a result of participating in the DHHS blog, he repeats here in this new CDC internal newsletter the same information that got him so excoriated at the DHHS blog.

"Even in the most extreme emergency circumstances the need for prolonged periods of self-sufficiency is very unlikely."

The "vibrant" interaction with flublogia apparently had little affect on Admiral Agwunobi.  He did note at the DHHS blog our vociferous disagreement with this view. Nevertheless, he has not been moved to change that view.  So now, officially, when CDC employees are asked by civilians about preparing for pandemic flu, the words of Agwunobi, which we so objected to, have now become official agency policy. 

I realize that the pdf does link to the pandemicflu.gov site which advises "at least two weeks."  My concern, though, is that the overall tone of the message of this pandemic flu update newsletter is one that minimizes the risks to CDC employees. There is substantial emphasis on vaccine progress too.  (And we wonder where local PH gets these ideas). 

SIP is recommended only in terms of "stay at home if you're sick."  I believe that this is now firm official policy too, and no further advice to SIP as a preventative will be vocalized.  I  believe that urging SIP for well individuals is seen as contrary to the stated goal to "lessen the overall impact..to society."

There is a chart on the last page of the newsletter entitled "Who Infects Whom?"  If one does not stop to really examine it closely and ask some questions about its assumptions (which are not stated), it may give an incorrect impression about which age groups may be most at risk from a panflu, certainly if it is H5N1-related and where the demographics currently clearly skew towards the young. 

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by: Pixie @ Tue Jul 31, 2007 at 04:54:04 AM CDT

[ Parent ]

VIETNAM - On the newest patient from Vietnam

The patient's initials...

Macine-tanslated from Vietnamese:

Add a patient contract flu A H5N1
July 31,2007

30/7, Health Ministry say:  across supervise circumstances pneumonia heavy nature level suspect contract flu A H5N1 because of courtyard epidemic hygiene t? central accomplish, discovered add a patient obtain diagnose is positive with virus flu A H5N1.

Here is female patient ?.T.H., 22 year-old do shallow craftsmanship in Cao Phong, (Thanh Oai - Ha Tay), join courtyard in active treat faculty, hospital Bach Mai with diagnose is pneumonia heavy nature level.  Now, patient ?.T.H. ing in situation suy respiratory and must th? machine.

http://www2.vietnamn...

Proud FAF-er.

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by: Theresa42 @ Mon Jul 30, 2007 at 23:46:09 PM CDT

That's...

...D.T.H.

Proud FAF-er.

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by: Theresa42 @ Mon Jul 30, 2007 at 23:46:40 PM CDT

[ Parent ]

Bird flu kills pregnant woman in Vietnam, country's 3rd death this year

Jul 31, 4:19 AM EDT
http://hosted.ap.org...

HANOI, Vietnam (AP) -- Bird flu has killed a pregnant woman in Vietnam, marking the country's third death this year as the virus continues to hit poultry farms, an official said Tuesday.

The 22-year-old woman from northern Ha Tay province died Saturday at Bach Mai Hospital in Hanoi. Test results confirmed she was infected with the H5N1 bird flu virus, said hospital director Tran Thuy Hanh.

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by: Pixie @ Tue Jul 31, 2007 at 04:11:32 AM CDT

Third bird flu death in Vietnam in less than two months

Posted: 31 July 2007 1649 hrs
http://www.channelne...

HANOI - A 22-year-old pregnant woman has died of bird flu in Vietnam, medical sources said Tuesday, bringing the death toll in the country to three in less than two months.

The woman, who lived in Ha Tay province outside the capital Hanoi, died Saturday after being admitted a week before for treatment, said a source at a Hanoi hospital who asked not to be named.

"Tests were positive for the H5N1 virus," the source said.

Her death brings to 45 the number of people who have died of bird flu in Vietnam. Two people -- a 20-year-old man and a 28-year-old woman -- died in June of avian influenza, the first fatalities announced since November 2005.

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by: Pixie @ Tue Jul 31, 2007 at 04:17:49 AM CDT

Bird flu has killed a Vietnamese woman who was seven months pregnant.

Last Updated 31/07/2007, 21:08:33 Select text size:

woman, aged 22 has been confirmed to have contracted the H-5-N-1 virus by laboratory tests in Vietnam.

She died in the Bach Mai hospital in Hanoi after being admitted from a farm in the northern province of Ha Tay, the largest poultry supplier to the country's capital.

A doctor in Ha Tay province says there are no bird flu outbreaks in the area where she lived.

Ten people who came into contact with the woman are being monitored for any symptoms and have been given anti-viral medicine as a preventive measure.

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by: Pixie @ Tue Jul 31, 2007 at 07:04:30 AM CDT

"A chicken leg of unknown origin..."

Good grief.  I thought I'd heard all the bf excuses already....

Hat-tip, AnneZ!

Pregnant Vietnamese woman dies of bird flu
31 Jul 2007 09:15:48 GMT
Source: Reuters

By Ho Binh Minh

HANOI, July 31 (Reuters) - A Vietnamese woman who was seven months pregnant has died of bird flu, the country's third human death from the virus this year, doctors said on Tuesday.

"She died on Saturday," said Doctor Tran Thuy Hanh, chief of the Bach Mai hospital where the 22-year-old woman was taken last week from a farm in the northern province of Ha Tay, the largest poultry supplier to Hanoi.

Hanh gave no further details of the woman, who had been confirmed to have contracted the H5N1 virus by laboratory tests in Vietnam.

The World Health Organisation (WHO) has not confirmed she had bird flu, which killed a 28-year-old woman from northern Vietnam last month.

A doctor in Ha Tay province said there were no bird flu outbreaks in the area where the latest victim lived.

"It made us difficult to pin down how she became infected," he said. "Earlier she bought a chicken leg of unknown origin for a meal in the family but nobody else got sick."

Ten people who came into contact with the woman have been monitored for any symptom and given anti-viral Tamiflu as a preventive measure while her house was disinfected, the doctor from the provincial Preventive Medicine Centre told Reuters.

(...)

http://www.alertnet....

Proud FAF-er.

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by: Theresa42 @ Tue Jul 31, 2007 at 11:09:01 AM CDT

[ Parent ]

If she bought a chicken leg while living in Ha Tay, touted as...

the largest poultry supplier to Hanoi, chances are it was a local bird,not imported IMO.

There are no bf outbreaks in the area, but have there been in the past?  If not - and no other humans around are sick - it's time to start looking for asymptomatic carriers - human, bird, cat, dog, pig and other.

Always have a plan B.

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by: maryinhawaii @ Tue Jul 31, 2007 at 15:59:32 PM CDT

[ Parent ]

A 20 yr.old male living in Ha Tay died on June 10, 2007

He was hospitalized on June 8 and tested positive for H5N1.

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Tue Jul 31, 2007 at 17:30:55 PM CDT

[ Parent ]

So we have 2 human cases in area, but no poultry outbreaks? n/t

Always have a plan B.

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by: maryinhawaii @ Tue Jul 31, 2007 at 22:56:43 PM CDT

[ Parent ]

20 yr old was from a different district in Ha Tay

Just a note that the 20 yr old who died back in June was from Ba Vi district, while the most recent victim was from Thanh Oai district (the lower of the two districts outlined on the map) which is just outside of Hanoi:

http://www.mypicshar...

Proud FAF-er.

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by: Theresa42 @ Tue Jul 31, 2007 at 23:26:06 PM CDT

[ Parent ]

VIETNAM - DTH admitted to Bach Mai hosp on July 26 (last Thurs)

She was admitted to Bach Mai Hospital in Hanoi this past Thursday, July 26 -- she might've been in another, regional hospital beforehand.  This article doesn't report on her death.

Machine-translated from Vietnamese:

First circumstances contract flu A/H5N1 is a thai father [pregnant]
July 31, 2007

Circumstances patient contract flu A/H5N1 treating in hospital Bach Mai obtained Health Ministry assert is first case contract flu A/H5N1 when carrying thai [pregnant].

Day 31/7, TS Nguyen Huy Nga - director medical bureau prevention Vietnam (Health Ministry) say, patient is she D.T.H. (22 year-old, in Cao Vien, Thanh Oai, Ha Tay), carrying thai [pregnant] month seventh.

She D.T.H did autumn craftsmanship club together (to present a gift to sb.) phan chicken to breed fish, join [admitted to] hospital Bach Mai from day 26/7 [last Thursday] with diagnose pneumonia heavy nature level.

Appear patient obtaining treat in active treat faculty (hospital Bach Mai) in situation suy respiratory heavy and must th? machine.

Against circumstances carrying thai contract flu A/H5N1, TS Nguyen write in - director hospital father san central say, Vietnam and World not yet has study which about her circumstances mother carry thai contracted virus H5N1 foetus then has contract this disease well no.

Nevertheless, many health possibility of foetus will very bad for when people mother being suy respiratory foetus then also being fewed oxy.  If obtain give birth to in moment at present, small grandchildren also will meet problem about respiratory because of body not yet has substance do surface prop up phe nang lung, this substance help lung complete activity when small born.

The same day, Mr. Nguyen Khac Hien - director medical office Ha Tay say office received obtain official dispatch of Health Ministry announcement about circumstances contract flu H5N1 of she D.T.H.

Obtain know, she H. no contact with disease poultry or kill cut open meat whose only buy partly child chicken about processing. All home together eat but only has she H. has disease performance.

http://www2.vietnamn...

Proud FAF-er.

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by: Theresa42 @ Tue Jul 31, 2007 at 11:39:08 AM CDT

[ Parent ]

Any idea what this means?

"She D.T.H did autumn craftsmanship club together (to present a gift to sb.) phan chicken to breed fish,"

It sounds like she was a participant in some crafts making group to make gifts to sb...whoever that is. Maybe she was making things for the baby. But what does 'phan chicken to breed fish" mean? And I wonder if they have tested other people who participated in the craftsmanship club...if it is indeed a group thing. Would they be the 10 being tested and given tamiflu?

Always have a plan B.

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by: maryinhawaii @ Tue Jul 31, 2007 at 16:04:50 PM CDT

[ Parent ]

Vietnamese woman worked collecting chicken excrement(?)

Thanks for asking, Mary!  First of all -- I wouldn't take the translations from that Vietnamese machine-translator too literally -- it's extremely useful, but still seems to be very much a BETA program (total vocabulary = 26,528 words).

So, I looked up the words of that sentence in a Vietnamese-English dictionary, and I got this:

She D.T.H. is profession collect/obtain collect/gather excrements chicken keep feed/breed fish....

So, it sounds like she works collecting chicken excrement to feed fish.  Why on earth are they wondering how she got bf?!

BTW -- it looks as though there's also a machine-translator at this dictionary site -- I'll be giving it a try to see how it works!:
http://vdict.com/?au...

Proud FAF-er.

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by: Theresa42 @ Tue Jul 31, 2007 at 22:39:31 PM CDT

[ Parent ]

I'll never complain about my job again!! ;o] n/t

Always have a plan B.

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by: maryinhawaii @ Tue Jul 31, 2007 at 23:01:56 PM CDT

[ Parent ]

a second thought just occured to me....if they feed chicken excrement to fish

have they tested the fish to see if the virus remains alive in them? (I am presuming these are aqua-farmed food fish they are feeding.) hmmmm.  Fish is one of those things people tend to cook very lightly (if at all...sashimi here is a very common and well loved dish!)

Always have a plan B.

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by: maryinhawaii @ Tue Jul 31, 2007 at 23:05:28 PM CDT

[ Parent ]

Yeah...

...I meant to say (should've said) farmed fish.  It doesn't say so in the article (as far as I can tell!), but I'm guessing this is one of those installations where they're farming poultry and fish in tandem and (Mmmmm!) feeding the chicken poo to the fish.  In some cases, they've got the fish ponds placed directly under the chicken coops.

Bleh!  Yeah -- NOT a nice job, huh?  :-/

Proud FAF-er.

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by: Theresa42 @ Tue Jul 31, 2007 at 23:14:55 PM CDT

[ Parent ]

You gals we're right. That's

exactly what she did, according to this morning's article.
I certainly hope these farm raised fish are not intended for export. I'm guessing they are for local consumption.

United we stand: Divided we fall

http://cottontopssandbox.wordp...

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by: cottontop @ Wed Aug 01, 2007 at 05:50:26 AM CDT

[ Parent ]

I wouldn't be so sure...

In my local market, I can buy Tiger shrimps from Thailand (never mind all the chicken products from Thailand sold in the UK and France!), so who knows where Vietnamese fish might wind up.  :-/

Proud FAF-er.

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by: Theresa42 @ Wed Aug 01, 2007 at 23:42:40 PM CDT

[ Parent ]

Vietnamese fish exports to the EU

Here you go...

Fish export to EU sees 74% growth (5/18)
July 23(?), 2007

Fish export turnover to the EU market from the beginning of this year has reached US$28 million, 74% above last year's same period. Key products exported includes catfish and mackerel.

According to the Vietnam Association of Seafood Exporters and Producers (VASEP), European consumers now prefer ready-made seafood.

Additionally, the EU's expansion not only improves Vietnam's seafood export turnover to this market but also creates a new market for low-cost seafood. Eastern EU is  also a potential market for fresh water fishes.

Last year, Vietnam's fish export turnover to the EU market was US$110 million, tripling the previous year and representing a half of seafood export turnover to this market. Vietnam's fish export turnover to the EU market exceeded that to Japan (US$66 million), only stayed behind that to the US (US$141 million), and accounted for 20% of the country's fish export turnover (US$141 million).

http://www.vietrade....

Proud FAF-er.

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by: Theresa42 @ Wed Aug 01, 2007 at 23:49:37 PM CDT

[ Parent ]

Official, French swans H5N1 positive

The French Ministry of Agriculture has confirmed that the two dead swans found in the Moselle Department on Sunday 29 July 2007 were positive for HPAI H5N1.

Link in French: http://tinyurl.com/2...

Let me be blind to wicked text, deaf to wicked words, mute to wicked comments.

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by: FrenchieGirl @ Tue Jul 31, 2007 at 08:22:59 AM CDT

Russia'- Bird flu outbreaks possible in Chelyabinsk

YEKATERINBURG, July 31 (Itar-Tass) - Outbreaks of bird flu are not ruled out in Russia's Chelyabinsk region in August, the press service of the emergencies ministry's regional department told Itar-Tass on Tuesday.

"In 2005, three of seven bird flu outbreaks were registered in August," the press service said. An increase in rabies among domestic and wild animals is also forecasted in the region in August.

According to Rospotrebnadzor consumer rights watchdog, in 2006 bird flu was registered in ten Russian regions, killing 1.3 million poultry. This year the epidemic has moved to densely populated central regions of Russia. Bird flu cases have been registered in Moscow's southeastern district, the Moscow and Kaluga regions, the Republic of Adygeya and the southern Krasnodar region.

http://www.itar-tass...

Be Prepared

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by: DennisC @ Tue Jul 31, 2007 at 09:17:33 AM CDT

Research - Detecting Human-to-Human Transmission of H5N1

Report on previous clusters and how future clusters might be monitored

http://www.cdc.gov/e...

Highly pathogenic avian influenza A (HPAI) subtype H5N1 has caused family case clusters, mostly in
Southeast Asia, that could be due to human-to-human transmission. Should this virus, or another
zoonotic influenza virus, gain the ability of sustained human-to-human transmission, an influenza
pandemic could result. We used statistical methods to test whether observed clusters of HPAI (H5N1)
illnesses in families in northern Sumatra, Indonesia, and eastern Turkey were due to human-to-human
transmission. Given that human-to-human transmission occurs, we estimate the infection secondary
attack rates (SARs) and the local basic reproductive number, R0. We find statistical evidence of humanto-
human transmission (p = 0.009) in Sumatra but not in Turkey (p = 0.114). For Sumatra, the estimated
household SAR was 29% (95% confidence interval [CI] 15-51). The estimated lower limit on the local R0
was 1.14 (95% CI 0.61-2.14). Effective HPAI (H5N1) surveillance, containment response, and field
evaluation are essential to monitor and contain potential pandemic strains.

cont.

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by: UK - Bird @ Tue Jul 31, 2007 at 12:10:18 PM CDT

Karo: 54 survivors given tamiflu prophylactically.

page 3
As an intervention, 54 surviving relatives and close contacts were identified and placed under voluntary quarantine (7). All of these persons, except for pregnant women and infants, received oseltamivir prophylactically.

page 7
We have presented statistical evidence that the strain of HPAI (H5N1) that caused the family cluster of human cases in northern Sumatra was spread from human to human and that the
household SAR was 29%. This household SAR is similar to statistical estimates for interpandemic influenza A in the United States (12.7%-30.6%) (18,19). The mean incubation
period of this strain appears to have been ?5 days, nearly twice as long as for past pandemic strains and current interpandemic strains of influenza. The CI for the estimated lower bound for the local R0 covers 1. Therefore, even though we determined that human-to-human transmission probably occurred, whether the virus was capable of sustained human-to-human transmission is not clear. This virus may have required very close human contact to be transmitted. Even with no intervention, the finding that R0 = 1.14 indicates that the chance that a single introduction would result in any further spread is ?12%. In addition, the reported prophylactic use of oseltamivir may have played some role in limiting further spread.

Computer simulations have shown that the targeted use of influenza antiviral agents could be effective in containing a potential pandemic strain of influenza at the source (21,22), if initiated within 3 weeks of the initial case in the community, and if the R0 is <1.8.

If the last paragraph is true, then as long as the virus does not gain Tamiflu resistance AND R0 < 1.8, the chance of containing it is fairly good.  If I understand correctly, R0>=1.8 should be considered very efficient. Are references 21, 22 the reason why TPTB do not show enough signs of urgency? Are these computer simulations credible?

How often do we see Tamiflu blankets applied in Indonesia? If there continues to be humanly transmitted strain, what is the R0?

You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.

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by: anon.yyz @ Tue Jul 31, 2007 at 16:04:05 PM CDT

[ Parent ]

29% Attack rate near high end of seasonal flu attack rate.

This household SAR is similar to statistical estimates for interpandemic influenza A in the United States (12.7%-30.6%) (18,19).

The lack of more generations at this AR seems counter intuitive to our experience with seasonal flu.

Was this attack rate only applicable to close contacts?

Was there a barrier of transmission or was this really contained by Tamiflu?

You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.

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by: anon.yyz @ Tue Jul 31, 2007 at 16:25:07 PM CDT

[ Parent ]

Sounds like good news, bad news to me.

The good news is the RO last year in Sumatra was less than that required to start and sustain a pandemic. The bad news is that may have been at least in part due to the application of tamiflu blanketing. It wasn't clear to me (although it might be in the actual scientific paper) to what degree they adjusted their computations to account for the prophylactic use of tamiflu in the RO.

The good news is that tamiflu blanketing is an apparently effective way to contain a potential pandemic at its source. The bad news is there is a limited supply, and people do not always come forth for treatment until the symptoms are dire: should one of these infected carriers happen to meantime attend a large gathering, particularly of an international nature, it might be hard to track down all the people exposed in time to give them tamiflu prophylactically. Also, some strains of the virus have already become more resistant to these antivirals since the Sumatra incident, which was I believe the first time Tamiflu was applied on such a large scale and as a preventative measure.

One other question comes to mind: The fact that the mean incubation period of 5 days is twice as long as the usual incubation period for influenza and pandemic influenza...is that a good thing or a bad thing? On one hand, it seems like health officials would have a better chance of stopping its spread with antiviral blankets if this strain of bf takes a bit longer to become symptomatic. But on the other hand, I seem to recall that a person infected with H5N1 can pass the virus on to others before they themselves show any symptoms. So having a 5+ day runway in which a carrier can infect people before anyone knows they are sick seems like it could potentially increase the chances of H2H spread.

Always have a plan B.

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by: maryinhawaii @ Tue Jul 31, 2007 at 16:25:49 PM CDT

[ Parent ]

Longer incubation may not lengthen infectious period.

The pre-symptomatic infectious period is usually described in just that way (approx 24 hours before symptoms), which would seem to indicate that until the virus had become sufficiently entrenched to be close to causing symptoms it was not yet infectious. 

Even though the range of incubation period for some of the earlier cases extended from 2-8 days, (http://content.nejm.... (Table 3))
infectiousness always seems to be described based on onset of symptoms.  The incubation period in the last couple of years has seemed to have settled towards the bottom of that range, but anytime you are trying to do statistical analysis with a universe of under 300 cases with this many different strains, the analysis itself can become a bit strained.

I keep wishing the more recent data had been made available to the public, not placed behind the restrictive walls of proprietary journals as we find here:

http://www.ajicjourn...

It has been over 4 months since the The Second WHO Consultation on Clinical Aspects of Human Infection with Avian Influenza A (H5N1) Virus and all we have to show for it is this lousy summary:

http://www.who.int/c...

I would really like to have something like the 2005 NEJM article to compare aspects that were evidently discussed at the March 2007 meeting in Turkey

http://www.who.int/c...

The meeting is expected to

Summarize the current understanding about important features of H5N1 infection, including incubation period, clinical course, and duration of viral shedding.

Summarize current understanding about the pathology and clinical manifestations of influenza A (H5N1) virus infection in humans.

Improve understanding of responses to currently used treatments, including antivirals.

(>:^? Not letting go yet:
http://www.newfluwik...)

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

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by: Into The Woods @ Tue Jul 31, 2007 at 17:23:20 PM CDT

[ Parent ]

We often hear about AR of 35% for a pandemic strain.

29% is not that far off.

What I don't understand is that if they were able to contain a 29% AR then, why 35% AR during a pandemic is not containable.  Whether the barrier was genetic or man made (tamiflu blanket), the outbreak didn't go beyond the third generation.

Let's assume that the AR goes up to 70%, what difference would it make if a tamiflu blanket can stop it?  The remaining risk is if a pandemic strain starts in an area with no access to tamiflu blanket and the generation time is so short that there are too many 'escapees'.

You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.

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by: anon.yyz @ Tue Jul 31, 2007 at 18:46:59 PM CDT

[ Parent ]

Secondary Attack Rate different from Attack Rate though?

I am clearly confused. 

I thought the Attack Rate (percentage of total population who become ill) was different from the term they are talking about as a Secondary Attack Rate. 

This is one reason I get frustrated with this kind of probability study - highly defined terminology might work for the mathematical probability priesthood  but not so much for us common parishioners.

What do they mean when they are saying Secondary Attack Rate:

Model of Probability of Transmission
We define p1 as the probability that an infectious household member infects another household member in 1 day. If the distribution of the infectious period is known, we can obtain the household secondary attack rate (SAR1) from p1, defined as the probability that an infectious household member infects another household member over his or her infectious period.
...
We have presented statistical evidence that the strain of HPAI (H5N1) that caused the family cluster of human cases in northern Sumatra was spread from human to human and that the household SAR was 29%. This household SAR is similar to statistical estimates for interpandemic influenza A in the United States (12.7%-30.6%) (18,19).

And how does the term Secondary Attack Rate relate to the commonly used Attack Rate ? 

 

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

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by: Into The Woods @ Tue Jul 31, 2007 at 19:13:12 PM CDT

[ Parent ]

Is the AR a cumulative percentage over the duration of a wave? n/t

You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.

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by: anon.yyz @ Tue Jul 31, 2007 at 19:16:03 PM CDT

[ Parent ]

Secondary may mean other than index case (from poultry)

I think it is the same as AR, except the authors limited it to one household for both Karo and a U.S. seasonal flu situation.

You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.

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by: anon.yyz @ Tue Jul 31, 2007 at 19:35:27 PM CDT

[ Parent ]

I don't find that 29% SAR comforting

What it tells me is that, in close contact situations, this virus has a pretty high ability to transfer from human to human....3 out of 10 if I understand the data correctly.

  We have been repeatedly assured that H5N1's ability to infect humans is very very low, and until/unless that changes there will be no pandemic. This assurance has been based on the fact that out of the millions of poultry that have sickened and died of HPAI over the past few years, only 300 known cases of humans have been infected. That makes it sound like a b2h attack rate  of ?? (I hate to show my stupidity...I'm thinking like 1 in a million: would that be an AR of .0001%?)

Anyway, the point is that in this case the human to human attack rate was much much higher than the seeming attack rate from bird to human. If so, then why? That's the big question. Once it attacks a human, is it changed in some way that makes SAR h2h more effective?

Always have a plan B.

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by: maryinhawaii @ Tue Jul 31, 2007 at 23:19:07 PM CDT

[ Parent ]

The factor I'm more concerned with

is CFR.  If the attack rate is 30% vs 40% it won't matter if 60+% are still dying.  Plus given the "fuzziness" of the data I don't think we're really know until there are more h2h cases. 

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by: LauraB @ Tue Jul 31, 2007 at 18:52:14 PM CDT

[ Parent ]

I am more concerned about unmitigated AR than CFR.

A pandemic starts when you can no longer contain H2H, not before, no matter how high the CFR is.

Sure it is terrible for Indonesia to be coping with CFR in the  80% range, but their society hasn't collapsed. If AR gets out of hand, it would be a different story altogether.

You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.

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by: anon.yyz @ Tue Jul 31, 2007 at 19:11:08 PM CDT

[ Parent ]

LauraB, I agree with you.

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Tue Jul 31, 2007 at 19:17:14 PM CDT

[ Parent ]

Not that I am unconcerned about high CFR.

Once it turns pandemic, it doesn't take a super high CFR to be disastrous. CFR higher than single digits become almost moot.

You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.

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by: anon.yyz @ Tue Jul 31, 2007 at 19:46:29 PM CDT

[ Parent ]

Longer incubation period

allows the carrier to get farther away from the point of infection. 

In an isolated, rural setting without a lot of travel, the longer incubation period may be good because it gives more time to apply a Tamiflu blanket.  OTOH, in an urban/mobile setting, it makes it much harder to track down and catch up with possible carriers.

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by: AlohaOR @ Tue Jul 31, 2007 at 23:55:02 PM CDT

[ Parent ]

Blood relation status not considered?

It seems that in both their analysis and in the data identified in the appendix that is used for the statistical analysis that while the blood relations of the Sumatra (Karo) cluster was mentioned, it was an aspect not really considered in calculating the SARs.

The 'finding' that according to their analysis the household secondary attack rate (number of other people each infected person infects) in Karo was .29 seems weakened by this omission. 

If I remember correctly, only blood relatives became infected (in-laws were exposed but not infected).  There was much speculation at that time (and after) that the virus strain that infected the folks in Karo may have gained additional infectiousness, but that it was constrained in some way to be more infectious only to individuals uniquely suseptible (from some genetic characteristic present in those blood relatives).

If this was the case, it would then seem to follow that removal of that blood-line limitation would result in a significantly increased Secondary Attack Rate - that might not be as containable as projected in this study.

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

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by: Into The Woods @ Tue Jul 31, 2007 at 16:52:26 PM CDT

[ Parent ]

Has anyone studied whether

seasonal flu hits genetic barriers - has this ever been observed for the other flus?  Or are they just postulating this for H5N1?  Seems like too small a statistical sample to really work with and derive a definitive answer from in the case of the Karo cluster.

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by: Pixie @ Tue Jul 31, 2007 at 19:38:23 PM CDT

[ Parent ]

Genetic barrier or Tamiflu blanket saved the day?

Last year, there was this argument that the Karo outbreak wasn't efficient because it needed genetic pre-disposition. Put another way, it was a special case of a genetic short coming that made that family more vulnerable. This was of course touted as the good news if it could be proven.

In this paper, neither genetic barrier nor Tamilflu blankets were not ruled out a factor of a limited transmission.

If Tamiflu blanket was indeed the only factor, then it was a proof that containment is not unachievable at a SAR of 29% which in my view is good news, subject to the usual caution.

If Tamiflu blanket wasn't the factor, and genetic barrier was, then we don't know what will really happen if the genetic barrier is breached.  We don't know whether a Tamiflu blanket would necessarily contain a future outbreak from another mutation.

Further, if genetic barrier was a factor, we don't know whether it was a factor for AR, for CFR, or for both.

I have previously questioned why a country such as the Philipines with similar socio economic conditions to Indonesia does not have the same problem. The Karo Batak is listed as "Indigenous People of the World":

http://www.peoplesof...

As for R0, it is a measure after the fact i.e. good for hind sight or for historians, and it is meaningless in predicting future outcome.

You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.

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by: anon.yyz @ Wed Aug 01, 2007 at 12:06:02 PM CDT

[ Parent ]

Correction, sorry.

In this paper, neither genetic barrier nor Tamilflu blankets were not ruled out a factor of a limited transmission.

Please replace were not ruled out a factor with was ruled out as a factor

You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.

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by: anon.yyz @ Wed Aug 01, 2007 at 12:23:15 PM CDT

[ Parent ]

Genetic pre-disposition discussion

from previous comments:

http://www.newfluwik...

http://www.newfluwik...

If "rare genetic traits" correlate with "close marriages", then the genetic pre-disposition argument in the Karo outbreak cannot be ruled out.

You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.

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by: anon.yyz @ Thu Aug 02, 2007 at 22:19:19 PM CDT

[ Parent ]

Grand Jury declines homicide charges against Dr. Anna Pou - who stayed during Katrina

I don't remember seeing this reported here, but its importance to standards of care and ethical issues during disaster situations is well recognized. 

Good for her.

http://www.wwltv.com...

A grand jury refused Tuesday to indict a surgeon accused of murdering four seriously ill patients with high doses of painkillers in a putrid hospital in the desperate days after Hurricane Katrina, apparently closing the books on the only criminal mercy-killing case to emerge from the storm.

Dr. Anna Pou and two nurses were arrested last summer after Attorney General Charles Foti's investigation concluded they gave four patients a "lethal cocktail" at Memorial Medical Center amid the chaotic conditions that followed the August 2005 storm.
...

Rather than a triumph, Pou said she felt the decision was a memorial to all who had died after Hurricane Katrina. "We need to remember the magnitude of human suffering following the storm," she said.

Pou said afterward she would stay in a hospital on duty if another hurricane threatened. She urged officials to require evacuation of hospitals for storms stronger than Category 2.
...

On Tuesday, Pou, who said she hoped to resume her practice as quickly as possible, refused to answer questions about what happened at the hospital because of civil cases still pending. Four lawsuits have been filed by families of three patients.

Charges against the nurses, Lori Budo and Cheri Landry, were dropped after they were compelled to testify last month before the grand jury under legal guidelines that kept their testimony from being used against them.

Budo's attorney, Eddie Castaing, called the grand jury's decision proof that none of the three should ever have been arrested.

Assistant District Attorney Michael Morales had asked the grand jurors to return one charge of second-degree murder and nine of murder conspiracy against Pou.

She believes her ordeal will keep other medical professionals from remaining during storms.

"I think it will make it difficult for clinicians to deliver care," Pou said. "Especially for patients that are not theirs."
...
When the levees broke in New Orleans following the hurricane's landfall, 80 percent of the city flooded. The lower level Memorial Medical Center was under 10 feet of water, and electricity was out across the city. Inside the hospital, the temperature topped 100 degrees.

At least 34 people died at Memorial, many from dehydration during the four-day wait for rescuers to evacuate them. In the "60 Minutes" interview, Pou acknowledged administering drugs to relieve pain but stressed: "Anytime you provide pain medicine to anybody, there is a risk. But as I said, my role is to help them through the pain."

Other doctors who were there described the situation as resembling a MASH unit during wartime rather than an urban American hospital.

"It was stifling. We were hoisting patients floor to floor on the backs of strong young men. It was as bad as you can imagine," Dr. Gregory Vorhoff, who stayed throughout the storm and eventually hitched a ride on a boat to seek help, told The Associated Press after Pou was arrested.

The grand jurors, on behalf of the rest of us, recognized that responsibility cannot be laid on the shoulders of those that stay and continue to do their best to fight when the rest of society is in uncontrolled retreat. 

It is a test we will face again on a much larger scale if a severe or moderate pandemic reaches our shores.

ITW(Joel J)
Courage is resistance to fear, mastery of fear - not absence of fear.
- Mark Twain
 

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by: Into The Woods @ Tue Jul 31, 2007 at 14:18:20 PM CDT

Good for the Grand Jury!

Thanks for posting this, Joel.  I haven't been following this story closely, but I remember when I heard that they were thinking of charging her I thought, give me a break!  Under those circumstances -- being cut off from practically all resources?!  I'm sure she and all the staff there did the best they could until they could do no more.

Proud FAF-er.

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by: Theresa42 @ Tue Jul 31, 2007 at 23:19:56 PM CDT

[ Parent ]

Suspected Bird Flu (in chickens) - Papua New Guinea

Bird flu fears heighten at border after chicken deaths

THE mysterious deaths of chickens in the Tapsie area of Telefomin district in West Sepik Province has resulted in a medical team, animal doctors and quarantine officers rushing to the area last week.
The team from Vanimo went to investigate the situation and will be returning on Friday.
A medical team from Port Moresby is also in Yapsie following discussions with the provincial administration.
An officer with the quarantine office in Vanimo, Francis Oken confirmed the trip to Yapsie by the investigation team. He said however that he could not give any details until the team returns with an accurate report.
Provincial health authorities also said it was too early to say if the deaths were caused by the dreaded avian flu.
A similar case of dead chickens was reported earlier in the same area but villagers buried the chickens before experts could investigate.

http://www.postcouri...

Comment:  I still check the two PNG news sites almost every day.  Most of the news is politics related due to the recent elections.  Much violence and turmoil is occuring related to the politics.  In my opinion PNG is still one of the most likely locations for a mutation and breakout of a pandemic flu virus.  There are many extremely isolated locations in the highlands and the dominant meat animals are pigs and chickens.  Almost non-existant medical care and media/communications.  My concern has been for some time that the first we will hear of a pandemic beginning is when it boils out of the highlands of PNG.

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by: Okieman @ Tue Jul 31, 2007 at 16:16:10 PM CDT

And there, they have no tamiflu blankets to contain it, do they? n/t

Always have a plan B.

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by: maryinhawaii @ Tue Jul 31, 2007 at 16:29:55 PM CDT

[ Parent ]

Thanks, Okieman!

There's confirmed bf in poultry in neighboring Papua Province, Indonesia, as well:

http://www.newfluwik...

Proud FAF-er.

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by: Theresa42 @ Tue Jul 31, 2007 at 23:04:24 PM CDT

[ Parent ]

Simulation Tourism Vs. Avian Flu Defences

...With an estimated 10 million people travelling abroad at any given time and many more within their own countries, UNWTO keeps a close watch on health risks generally and AHI specifically. While there has been no change in the level of AHI alerts issued by the World Health Organization, the Tourism sector is already taking action to be fully aware of the potential dangers and to prepare effectively.

The simulation helped to identify possible gaps in response systems and to understand the pressures and dynamics in a real-world situation....

http://www.scoop.co....

Be Prepared

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by: DennisC @ Tue Jul 31, 2007 at 18:37:28 PM CDT

we have a tourism diary

http://newfluwiki2.c...

so I've copied this piece of news over there for further comments there.

Good catch, DennisC!

You arm yourself to the teeth just in case.  You don't leave the gun near the baby's hand.

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by: lugon @ Wed Aug 01, 2007 at 05:51:48 AM CDT

[ Parent ]

Nova Science Now- on now, H5N1- poss. repeat n/t

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by: bird-dog @ Tue Jul 31, 2007 at 19:33:29 PM CDT

link to Nova Science Now on PBS...

http://www.pbs.org/w...

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by: bird-dog @ Tue Jul 31, 2007 at 19:37:29 PM CDT

[ Parent ]

Could a deadly disease be headed to the Gulf Coast?

"(MOBILE, Ala.) July 31 -- Health experts said it's only a matter of time before there's a world-wide outbreak of a deadly disease. It's a disease that we have little or no immunity to and have no vaccination for. Many health experts from the World Health Organization and the Centers for Disease Control say the next outbreak or pandemic could be the H5N1 virus, commonly called the bird flu. NBC15's Andrea Ramey tells us how our local agencies are already preparing for this global outbreak...

http://www.nbc15onli...
27b92b2c-9530-435b-af24-93b0307e6d69

... State and local health officials estimate more than 14,000 hospital beds would be needed for an outbreak -- we currently have 5,000 and 2,700 people would die from this disease just in Mobile County alone -- that's more than half the county's population."

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by: K from Mi @ Tue Jul 31, 2007 at 19:53:41 PM CDT

nbc15online link is broken

Try this link:
http://www.nbc15onli...

You know...what would be really cool is if NBC15 in Mobile, Alabama would broadcast this story over the air, and expand a bit on how bad the 1918 flu was there. I'm sure there must be historical archives for that area...

If folks aren't gonna listen to common sense, then puttin' the fear of Gawd in 'em might do the trick!

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by: Bronco Bill @ Tue Jul 31, 2007 at 20:21:37 PM CDT

[ Parent ]

link correction

http://www.nbc15onli...
27b92b2c-9530-435b-af24-93b0307e6d69

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by: K from Mi @ Tue Jul 31, 2007 at 19:55:57 PM CDT

one-piece link

http://www.nbc15onli...

"The truth does not change according to our ability to stomach it."  Flannery O'Connor

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by: Jane @ Tue Jul 31, 2007 at 20:02:32 PM CDT

[ Parent ]

Would be nice if the papers would pick this up.

"Would we close the schools, close churches, malls, Wal-Mart? I mean what's going to be closed? What's going to be open? How are we going to get food? There's just so many things we've got to plan out," Tucker said.

She said most of the essential businesses like banks and Alabama Power already have a bird flu operating plan, but many still do not.

"They want to put their head in the sand and not even prepare for it. There's a couple agencies like that," Tucker said

"The truth does not change according to our ability to stomach it."  Flannery O'Connor

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by: Jane @ Tue Jul 31, 2007 at 20:09:33 PM CDT

[ Parent ]

Ontario Pandemic Plan incorporates Community Mitigation Guidance

Not sure if this is the first Canadian Province or U.S. State to formally adopt CMG. The latest version of the Ontario Health Plan for Influenza Pandemic incorporates Community Mitigation Guidance.

http://www.health.go...

Pandemic is to be rated as mild, moderate or severe based on CFR:

? <0.1% case fatality rate = a mild pandemic
? from 0.1% to <1.0% case fatality rate = a moderate pandemic
? 1.0% or higher case fatality rate = a severe pandemic.

OHPIP's plan for public health measures is based on the assumption that, by the time the pandemic arrives in Ontario, we will have information about its severity.  Figure 6.1 illustrates a severity-based approach where the type and extent of public health measures varies depending on the severity of the pandemic.

Figure 6.1 is on page 8 of the PDF file.

You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.

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by: anon.yyz @ Tue Jul 31, 2007 at 21:05:16 PM CDT

my God, this is the most gratifying thing

to read for a long time.

There is a difference between having that CMG adopted in the US, and actually seeing it being quoted as authoritative source in support of policy in another country!

Well done, CDC, and the whole CMG writing team!  ;-)


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

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by: SusanC @ Tue Jul 31, 2007 at 23:40:02 PM CDT

[ Parent ]

Ontario incorporates Precautionary Principle in Occupational Health and Safety.

Most notable is even under Emergency Powers, the Occupational Health & Safety Act cannot be overruled.

Chapter 7 of the new Ontario Health Plan for Influenza Pandemic

http://www.health.go...

Occupational health and safety measures and infection prevention and control measures can help protect health care workers and patients from exposure to the influenza virus in health care settings. This chapter was developed in collaboration with the Ministry of Labour and describes:
the regulatory framework and legislated requirements, roles and responsibilities for workplace health and safety; the risks of influenza transmission in the workplace; the importance of education; the hierarchy of control measures that can reduce the spread of influenza in health care settings; and recommended infection prevention and control measures. Recommendations are based on the precautionary principle as set out by Justice Campbell in the final report of the SARS Commission (Spring of Fear, December 2006) which stated: "We cannot wait for scientific certainty before we take reasonable steps to reduce risk."

page 3
iv. Emergency Management and Civil Protection Act

The Emergency Management and Civil Protection Act gives the Lieutenant Governor in Council and the Premier special powers to deal with declared emergencies inOntario. Under this Act, orders can be issued authorizing persons to provide services during an emergency.

Note: Although the Emergency Management and Civil Protection Act provides special powers, the Occupational Health & Safety Act cannot be overruled in any emergency because worker safety is paramount. All roles, responsibilities, duties, and authority outlined in the OHSA remain intact during an emergency, and the OHSA prevails to the extent of any conflict with the Emergency Management and Civil Protection Act.


You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.

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by: anon.yyz @ Tue Jul 31, 2007 at 21:17:16 PM CDT

What else are new in the Ontario Pandemic Plan?

A Cancer Care chapter and a Pediatric Services chapter.

This Pandemic Planner Newsletter is special edition to describe it:

http://www.health.go...

and the page where you can find all the chapters of the plan:

http://www.health.go...

You want perspective. I want perspective. Let's talk. We don't have to agree on every thing. If we do, one of us is redundant.

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by: anon.yyz @ Tue Jul 31, 2007 at 21:22:09 PM CDT

GAO report on DHS/FEMA efforts to prepare/respond to disasters

"Observations on DHS and FEMA Efforts to Prepare for and Respond to Major and Catastrophic Disasters and Address Related Recommendations and Legislation"

http://www.gao.gov/n...

Pandemic flu is mentioned specifically in several sections.

I haven't had time to read it.

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by: big critter @ Tue Jul 31, 2007 at 22:39:06 PM CDT

Please post new articles to the August 1 News diary

News Reports for August 1

Thank you!

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by: Nimbus @ Tue Jul 31, 2007 at 23:45:55 PM CDT

Thanks for the link

I didn't see the video until you posted the link for the article.  It's worth watching -

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by: K from Mi @ Wed Aug 01, 2007 at 08:29:06 AM CDT

Info on Vietnamese fish

In Vietnam, there are household production systems that use farms, livestock and fish ponds. Livestock excrement is deposited in the fish ponds and eaten directly or indirectly (algae growth) by the fish. These are mainly in the north and central parts of the country and supply small amounts of fish to local markets. The export operations are mainly in the south, especially the Mekong Delta, where commercial feed or crops are used to feed fish and shrimp. There have been problems with antibiotic residues in the shrimp and some have been rejected by importing countries. There have been fewer problems with the fish, which are raised in cages in the Mekong River. There is almost no chance that the tra or basa fish imported are subject to any chicken viruses. Chickens do not like moisture and ducks are the main livestock bird of choice in the Mekong Delta.

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by: INFOMASS @ Wed Aug 01, 2007 at 23:51:46 PM CDT

Thanks, Infomass!

Learn something new everyday.  :-)

I do remember reading somewhere at some point about poultry (I think chicken) + fish farms where the fish were kept directly below the poulty -- to facilitate the feeding of the fish, obviously.  If/when I get a chance, I'll try to re-find what I read (it was some time ago now -- but it left an impression on me 'cause I just thought, yuck!).

Proud FAF-er.

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by: Theresa42 @ Thu Aug 02, 2007 at 00:22:50 AM CDT

[ Parent ]

Integrated fish/poultry farming

Here's what I remember reading -- from the FAO.  Don't know if and/or where these practices are undertaken (maybe not Vietnam) -- these demonstration models were construced in Bangladesh:

Demonstration of semi-intensive polyculture and integrated fish-poultry farming in Bangladesh

Manuring [of the fish pond]:

Besides base manuring during pond preparation, no additional manure was applied to ponds throughout the culture period as the purpose of regular continuous manuring was done by the poultry birds (chicken and ducks) housed above the pond water....

Poultry house:

Chicken houses were built above the pond water in all the 4 places....

http://www.fao.org/d...

Proud FAF-er.

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by: Theresa42 @ Thu Aug 02, 2007 at 00:42:35 AM CDT

[ Parent ]