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News Reports for January 25, 2012

by: NewsDiary

Sat Jan 21, 2012 at 23:27:53 PM EST


Reminder: Please do not post whole articles, just snippets and links, and do not post articles from the Las Vegas Review-Journal. Thanks!

Bulgaria
•  Flu epidemics in some Bulgarian districts (Link)

China
•  WHO report on human H5N1 case (fatal) (Link)

Egypt
•  H5N1 case reported in Fayoum (Link)

India
•  Poultry deaths trigger bird flu panic (Link)

Indonesia
•  Avian flu threatens to claim additional life (Link)
•  Two RS Kandow Caring Suspect Bird Flu (translated) (Link)
•  Again, Bird Flu Patient Dies (translated)(Link)

Japan
•  Flu spreading in Japan, doubling number of cases per hospital (Link)

United States
•  Experts Warn People about Unpredictable Flu Virus (Link)

Research
•  Helen Branswell: Researcher at heart of bird flu studies controversy reveals details of his findings (Link)
•  Nature: H5N1: Flu transmission work is urgent (Link)
•  Pandemic 2009 H1N1 virus gives wings to avian flu (Link)
•  Declan Butler: Nature - Caution urged for mutant flu work (Link)

General
•  Should we fear avian H5N1 influenza? (Link)

Commentary
•  Recombinomics: Fatal Suspect H5N1 Case In Tangerang Indonesia (Link)
•  Recombinomics: Fatal Suspect H5N1 Case In Cengkareng Indonesia (Link)


•  H (Link)

NewsDiary :: News Reports for January 25, 2012

News for January 24, 2012 is here.


Thanks to all of the newshounds!
Special thanks to the newshound volunteers who translate international stories - thanks for keeping us all informed!

Other useful links:
WHO A(H1N1) Site
WHO H5N1 human case totals, last updated January 24, 2012
Charts and Graphs on H5N1 from WHO
Google Flu Trends
CDC Weekly Influenza Summary
Map of seasonal influenza in the U.S.
CIDPC (Canada) Weekly FluWatch
UK RCGP Weekly Data on Communicable and Respiratory Diseases
Flu Wiki Main Page

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Flu epidemics in some Bulgarian districts
A flu epidemic will be declared in Pazardzhik municipality on January 25 2012 after one was declared in Samokov on January 23 (Snip) Stara Zagora, Haskovo and Sofia were expected to follow.

For now, no schools would be closed, the Health Ministry said. But the Education Ministry said the opposite, that schools would be closed where epidemics were declared. (Snip) decisions on closing schools were up to regional inspectorates of education.

(Snip) this year there was no evidence of the AH1N1 "swine flu" virus in Bulgaria. http://www.sofiaecho.com/2012/...

(Note: It would have been helpful if they had told us the most active type, H3N2 or B.)

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

     


China: WHO report on human H5N1 case (fatal)
http://www.who.int/csr/don/201...

Avian influenza - situation in China - update

24 January 2012 - The Ministry of Health of China has notified WHO of a human case of avian influenza A (H5N1) virus infection.‬‪

The case is a 39 year-old male from Guiyan City, Guizhou Province. He developed symptoms on 6 January 2012 and was admitted to hospital but was in critical condition and died on 22 January 2012.‬‪

The case was laboratory diagnosed by Guizhou CDC and confirmed by China CDC on 22 January 2012. Investigation into the source of infection is ongoing. Close contacts of the case are being monitored and to date all remain well.‬‪  


Flu spreading in Japan, doubling number of cases per hospital
TOKYO (Kyodo) -- An influenza epidemic is spreading in Japan, doubling the number of cases per hospital (Snip) Over 90 percent of the cases this flu season are due to the Hong Kong influenza A virus subtype H3N2, marking the first epidemic in five years of the seasonal flu virus that can cause encephalitis in infants and gravely affect elderly people (Snip)

Data collected on a regular basis from around 5,000 medical institutions across Japan show that the average number of cases stood at 7.33 in the week through Jan. 15, up from 3.76 a week earlier. The number of cases, which increased in all 47 prefectures, has since continued to grow, the institute added, referring to data from around 6,700 drugstores.

People aged 70 and older accounted for an estimated 6 percent of the cases, up from around 2 percent in normal years (Snip) http://mdn.mainichi.jp/mdnnews...

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

     


Suspected Avian Flu Patient Dies in Tangerang
January 25, 2012
http://www.thejakartapost.com/...
Tangerang, Indonesia:  MR, 18, a patient who was suspected of having contracted the H5N1 virus died on Wednesday at Tangerang General Hospital after being treated for five days in an isolation room at the city-run hospital.
"The patient died at about 12:30 p.m. rom respiratory failure," said hospital spokesman Achmad Muchlis.
Muchlis said that the patient was a resident of Mekarsari village in Panongan, Tangerang.
"As of today, we can not officially confirm that his death was related to the avian flu virus," he said, adding that laboratory tests on the patient were negative.
When The Jakarta Post arrived at the hospital, the isolation room where MR had been treated was locked.  According to Muchlis, the remains of the patient had been brought home by his family.  MR suffered a high fever for six days. He was treated at the private Sari hospital in Karawaci last Wednesday.  As his condition worsened, the hospital referred him to Tangerang General Hospital on Saturday.  

"I am opposed to any form of tyranny over the mind of man."  Thomas Jefferson

Fatal Suspect H5N1 Case In Tangerang Indonesia
Recombinomics Commentary

Patient suspect bird flu, Rohmat (18), resident of RT 09/03, Ciodeng Village, Village Blooms Jaya, District Panongan, Tangerang regency, died after being treated for five days in critical condition in RSU Tangerang District, on Wednesday.

Previously the patient's condition was critical since it first entered isolation space bird flu," said Public Relations RSU Tangerang Regency Ahmad Muchlis when confirmed on her cell phone. According Muchlis, until now is still not clear whether Rohmat died from bird flu or not. "There is no certainty. But the results of observations in the home environment Rohmat by the Health Department yesterday was negative bird flu," he said. He added that the next will Rohmat shrouded corpse in the mortuary. Chances are, he said, Rohmat not take home to his family home. "The possibility is not taken home, but immediately buried," explained Muchlis.

The above translation describes the death of a suspect H5N1 case (18M) in Tangerang, Indonesia, which is on the northwest side of Jakarta.  The death follows a confirmed H5N1 cluster in North Jakarta, as well as suspect fatal cases in Cengkareng, which is adjacent to Tangerang, as well as Bekasi, which is on the east sided of Jakarta.  

Although the three most recent cases have not been H5N1 confirmed, the second case (5F)  in the North Jakarta cluster tested negative multiple times before H5N1 confirmation at autopsy, raising concerns about the sensitivity of the H5N1 (test) for the bird flu currently circulating in Indonesia.

False negatives in Indonesia are common because patients are tested after the start of Tamiflu treatment (Snip).  Patient who recover continue to test negative and are not reported as confirmed cases, while those who die have increasing H5N1 RNA levels, which eventually test positive.  This testing procedure accounts in part for the high case fatality rate (Snip) 80% in Indonesia since the first confirmed cases were reported in 2005.

However, at least two (of) the three cases adjacent to Jakarta have tested negative, even though the patients have died with H5N1 symptoms, and have been quickly buried, per protocol for confirmed H5N1 cases. These recent fatalities and the failure to link the cases to infected poultry, has raised concerns that the H5N1 in Indonesia is being transmitted more efficiently, as seen in the confirmed cluster in North Jakarta as well as the Bali cluster.

Sequences from the Bali cluster included receptor binding domain changes (D187N, A188G, R193M), as well a clear examples of recombination.  Moreover, these changes are likely to lead to immunological escape. (Snip) http://www.recombinomics.com/N...

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

     


India: Poultry deaths trigger bird flu panic (Odisha)
BERHAMPUR: Death of poultry in Raikia block has spread bird flu panic among the residents. The deaths were reported from two SHGs. (Snip) a SHG in Gamandi village had procured 600 chicks with financial assistance from a bank on (Snip) on January 6. (Snip) the members found 10 chicks dead the following day. And so far, 180 have perished.

Another SHG at Barepanga village too saw death of 50 chicks. http://ibnlive.in.com/news/pou...

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

     


Fatal Suspect H5N1 Case In Cengkareng Indonesia
Recombinomics Commentary

Now, allegations of similar cases are also found in West Jakarta, where a boy aged three years initials RV, a resident of RT 15/07 Cengkarengtimur Village, District Cengkareng , died on Monday (23 / 1) around 06.00 after previous intensive care at Friendship Hospital, East Jakarta.

Regarding the victim's body is covered a coffin and not allowed to open, say Parwathi, it was according to the procedure as a form of anticipation of the hospital for suspected cases of bird flu. Despite the negative results of bird flu, disclosed Parwathi,

The above translation describes the death of a suspect H5N1 case (3M) in Cengkareng, Indonesia, which is adjacent to Tangerang, where another suspect H5N1 case (18M) also died after testing negative for H5N1.  These two cases had bird flu symptoms and were buried in a sealed coffin, which is customary for H5N1 cases.

The failure to detect H5N1 in these two fatal cases in adjacent areas on the west side of Jakarta is in addition to the suspect case in Bekasi, on the east side of Jakarta, as well as the confirmed cluster in North Jakarta (Snip)

These five cases in the Jakarta area raise concerns that H5N1 is being more efficiently transmitted as it evolves away from the sequences being used in the H5N1 PCR test.
http://www.recombinomics.com/N...

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

     


Indonesia: Avian flu threatens to claim additional life
Multa Fidrus and Elly Burhaini Faizal, The Jakarta Post, Tangerang/Jakarta | Wed, 01/25/2012 8:35 AM

An 18-year-old man thought to be infected with avian flu was in critical condition at the Tangerang General Hospital as of Tuesday.

"The patient is still in isolation," hospital spokesman Achmad Muchlis said. "He is exhibiting the symptoms of avian flu, but the team of doctors is still waiting for confirmation from laboratory results."

The patient, a resident from Me-karsari village in Tangerang regency, suffered from a high fever for six days after which time he was taken to the private Sari Asih Hospital in Karawaci last Wednesday, when he developed respiratory problems.

As his condition worsened, the hospital transferred him to Tangerang General Hospital on Saturday.

According to the hospital's president director, Mamahit, the family informed doctors that before the patient fell sick, one of the ducks he had raised had died.

"Referring to the case history and the symptoms he was suffering from, we treated him as a bird flu patient," he told reporters.

A team from the Tangerang Health Agency conducted a survey around the patient's neighborhood.

"We haven't as yet found any infected fowl ... We also checked all [the patient's] family members and neighbors, but none of them were sick," agency head Naniek Isnaeni said. "We are still waiting for the patient's laboratory results to know what to do next."

Within the part two weeks, there have been two confirmed deaths from avian flu in Jakarta alone.

Health Minister Endang Rahayu Sedyaningsih said Tuesday that health care facilities in Indonesia had sufficient capacity to properly diagnose avian influenza; however, more efforts were needed to expand the country's bird flu laboratory capacity, which would allow more sensitive detection of the disease.

"We are conducting polymerase chain reaction [PCR] swab tests on mucus taken from the nose and throat to detect whether it contains the H5N1 virus. The test can produce results in quite a short period of time, but we may need a further test involving virus sequencing in order to get a more accurate result on whether a patient is positive for H5N1. However, not all labs have these facilities," she said.

Lab testing is one of the areas of expertise the government aims to develop in tackling the disease.

"We are improving 42 labs assigned as diagnostic centers for avian influenza," said Endang.

Endang said cross-sector collaboration played a key role in tackling the highly pathogenic avian influenza virus. The Health Ministry is collaborating with other institutions, including the agriculture and trade ministries, to combat outbreaks.

The ministry has also distributed anti-influenza drugs called Oseltamivir to health care facilities, including both hospitals and community health centers, free of charge. "We have sufficient stocks of Oseltamivir to last until next year," Endang said, adding that the government had reserve stocks of more than 1.4 million Oseltamivir tablets ready to distribute if needed.

Tjandra Yoga Aditama, the director general of Disease Control and Environmental Health (P2PL), said that bird flu patients undergoing Oseltamivir therapy would experience a higher chance of recovery compared with those who did not.

"Eighty-eight people, or 47 percent of 188 patients with bird flu infections, who received Oseltamivir therapy recovered from the illness, while only 7 people, or 12 percent of 56 patients, who did not receive the therapy survived," he said, referring to a research study conducted in six countries including Indonesia.

http://www.thejakartapost.com/...

United we stand: Divided we fall
www.flunewsnetwork.com


Should we fear avian H5N1 influenza?
To know the fatality rate of avian H5N1 influenza virus in humans, we need to divide the number of fatalities by the number of infections. We do not know that last number - but there are hints that it could be quite large.

http://www.virology.ws/2012/01...


I have a wild theory
that H9N2 confers some protection against H5N1. I think it was that virus that was supposed to make H5N1 invisible in birds and it might be the same for people. However, while people who regularly raise and slaughter their own chickens may have had an H9N2 infection, the vast majority of the rest of us would have no protection at all.

Of course that is still a wild theory.


[ Parent ]
Might they also have had exposure to LPAI H5N1? n/t


[ Parent ]
Hi off_leash
I have always believed there are many cases that go uncounted, especially in Indonesia and some of the other countries in Asia and in Africa too. I think a lot of those are relative mild cases that would drastically lower the CFR. However, even if the true CFR is only 5% to 10% and I think it is a higher than that, deaths in an H5N1 pandemic would be horrific. So yes, we should definitely fear H5N1. Thanks for posting the article.... it was a good one.

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

     


[ Parent ]
real CFR
I pray that the real CFR is indeed lower, but I'm prepared in case it is not. If it works out that there are many unreported mild cases that's great. If there are cases of LPAI that are providing some protection (as cow pox did for smallpox) that's great too. Unfortunately I'm not knowledgeable enough to say for sure.

[ Parent ]
What are the author's leanings?
Not to say the study cited wasn't accurate: from reading the abstract, it seems 9% of the population sample from rural Thailand did have antibodies to HPAI H5N1. However this conclusion by the author of the article -

Until we know how many individuals are infected with avian influenza H5N1, we must refrain from making dire conclusions about the pathogenicity of the virus. Doing so has only lead us down a dangerous path of fearing that H5N1 influenza virus might be used as a weapon of bioterrorism, and restricting the publication of scientific papers on the virus.

seems a little biased in favor of publishing the research papers on the genetically altered H5N1. I think this requires some scrutiny, especially when the researchers who have developed the weapons grade H5N1 in ferrets themselves tout H5N1 as the deadliest virus they have ever seen, based on their own studies.  I don't think that the enhanced transmissability they have genetically created in the virus has enhanced its virulence, right?

So if it is, as the author claims this Thailand study shows,  naturally a fairly mild virus with a low CFR, why would the genetic engineers say it was so deadly?

Always have a plan B.


[ Parent ]
Your comments....
"Unfortunately I'm not knowledgeable enough to say for sure." Unfortunately, none of us are. Flu viruses are so unpredictable that even the top scientist/virologist don't know so we are in good company.

You're prepared and that makes you better off than 99% of the world's population!  

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

     


[ Parent ]
Egypt: H5N1 case reported in Fayoum
By Ashraf Sadek - The Egyptian Gazette
Sunday, January 22, 2012 03:42:51 PM

FAYOUM - A 30-year-old man from the governorate of Fayoum, some 100km south of Cairo, has been diagnosed as having contracted the deadly H5N1 bird flu virus, the Health Ministry announced.

The man, identified only as A. H., had been admitted to el-Fayoum General Hospital on Thursday night with a high temperature before being transferred to el-Umraniya Chest Hospital in Giza for further treatment, the Ministry said.
He became the first case of the virus reported in Egypt this year since the first outbreak was announced in February 2006.

Women and children had borne the brunt of the virus due to their role in taking care of domestic fowl in Egypt.
The Ministry said the man showed symptoms including a high temperature after coming into contact with domestic poultry.

However, the patient is in a stable condition in hospital and being treated with the necessary medicine, the Ministry said.
While the H5N1 virus only rarely infects people, experts fear it could mutate into a form that humans could easily pass to one another, sparking a pandemic that could kill millions.

"Preventive measures have been taken and samples were taken from poultry raised at the man's home before the birds were killed. The house and chicken coops were disinfected," the Ministry said.

Egypt " the Arab world's most populous state " is on a major route for migratory birds and has seen the third highest number of H5N1 cases after Indonesia and China six years ago.

http://213.158.162.45/~egyptia...

United we stand: Divided we fall
www.flunewsnetwork.com


Researcher at heart of bird flu studies controversy reveals details of his findings
Helen Branswell via the Winnipeg Free Press:
TORONTO - A scientist at the centre of a raging controversy over bird flu transmission studies has broken his silence, in the process revealing information about his study that has not been made public previously.

In a commentary in the journal Nature, flu virologist Yoshihiro Kawaoka argued the work he and other high level influenza scientists do to try to puzzle out why some flu viruses spread in humans while others don't is too important to be shelved.

"Our work remains urgent - we cannot give it up," wrote Kawaoka, who up until now has made no comment on the controversy that is pitting flu scientists against the community of biosecurity experts...



I sure hope he doesn't come to regret that decision!!


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

     


[ Parent ]
Nature: H5N1: Flu transmission work is urgent
This is the Nature article that prompted Branswell's piece above.
Highly pathogenic avian H5N1 influenza viruses first proved lethal in humans in 1997 in Hong Kong. Since 2003, 578 confirmed infections have resulted in 340 deaths (go.nature.com/epb7ts). Now widespread in parts of southeast Asia and the Middle East, H5N1 viruses have killed or led to the culling of hundreds of millions of birds.

To date, H5N1 viruses have not been transmitted between humans. Some experts have argued that it is impossible. But given the potential consequences of a global outbreak, it is crucial to know whether these viruses can ever become transmissible. Work by my group (accepted by Nature) and an independent study (accepted by Science) led by Ron Fouchier of the Erasmus Medical Center in Rotterdam, the Netherlands, suggest that H5N1 viruses have the potential to spread between mammals. As the risks of such research and its publication are debated by the community, I argue that we should pursue transmission studies of highly pathogenic avian influenza viruses with urgency.


Hattip to Michael Coston at Avian Flu Diary.

On the other hand
http://news.sciencemag.org/sci...

...virologist Ron Fouchier of Erasmus Medical Center calmly explains why his team created what he says is "probably one of the most dangerous viruses you can make"-
SNIP
"I can't think of another pathogenic organism that is as scary as this one," adds Keim, who has worked on anthrax for many years. "I don't think anthrax is scary at all compared to this."
SNIP
Fouchier.... passed the virus from one ferret to another multiple times, a low-tech and time-honored method of making a pathogen adapt to a new host.
After 10 generations, the virus had become "airborne": Healthy ferrets became infected simply by being housed in a cage next to a sick one.
SNIP
The real case-fatality rate is probably lower because an unknown number of milder cases are never diagnosed and reported, but scientists agree that the virus is vicious. Based on Fouchier's talk in Malta, New Scientist reported that the strain created by the Rotterdam team is just as lethal to ferrets as the original one.


Always have a plan B.

[ Parent ]
US: Experts Warn People about Unpredictable Flu Virus
Cases of flu have been down in the United States this year but experts still warn people about the unpredictable state of the virus. Tom Skinner of the US Centers for Disease Control and Prevention said that they observed low activity around the United States.

He maintained that the flu season peaks in the first few months of the year. They expect cases of flu to increases as February nears. Health-care providers concurred with the observations. Both the East and West Coasts show low activity of the flu virus. But they said that the season might arrive later than the usual.

The CDC said that by the end of the first week of January, the flu virus had a slight increase in activity but it was still considered minimal across 48 states. Colorado and New Hampshire had higher rates of flu than other states but by just a slight margin. Continued: http://www.healthaim.com/exper...

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

     


Pandemic 2009 H1N1 virus gives wings to avian flu
Has the 2009 H1N1 flu pandemic increased the risk that the H5N1 avian flu virus could evolve to create a human pandemic?

That's a possibility raised by the work of Yoshihiro Kawaoka of the University of Wisconsin, Madison, the main conclusions of which - but not the details - are revealed in a Comment article in Nature today. His team created a virus that has the H5 haemagglutinin (HA) surface protein from the H5N1 virus, with all the remaining genes coming from the 2009 pandemic H1N1 virus. The resulting virus proved to be highly transmissible in ferrets, and is therefore likely to have the same behaviour in other mammals, including humans.

What's intriguing is that before the 2009 pandemic, several research groups had tried the same experiment, using the garden-variety seasonal H1N1 flu, but without success

. The difference is that the 2009 pandemic H1N1 virus, which is a triple reassortant of pig, avian and human viruses, contains the triple reassortant gene (TRIG) cassette, which is believed to make it far easier for a flu virus to swap genes with those from other species. This suggests that H5N1 may find it much easier to reassort with pandemic 2009 H1N1 virus circulating in the wild to create a pandemic virus, whereas it had coexisted with seasonal flu since 1997 without evolving into a pandemic strain, explains Bruno Lina, a virologist and flu researcher at the CNRS, France's basic-research agency, who works at the University of Claude Bernard Lyon-1.
Continued: http://blogs.nature.com/news/2...

(Note: That is  what we all thought when the H1N1 swine flu broke out in 2009. We have been concerned all along the two would swap genes and take the H5N1 virus to the final step of becoming airborne.)

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

     


Two RS Kandow Caring Suspect Bird Flu
http://www.metrotvnews.com/rea...
January 25, 2012
Manado, Indonesia:  Two people are now in intensive care at the Hospital Professor Kandow in Manado, North Sulawesi.  The patients, who originate from Bolaang Mongondow and Minahasa, North Sulawesi, were allegedly exposed to bird flu.  Both residents are AP, an 81 year old resident of Bintauna, Bolmon District, and RP, a four-year-old resident of Kanonang, Minahasa Regency.  When taken to the hospital, the patients experienced high fever and shortness of breath accompanied by flu.  Previouslly each of the two patients were treated in area clinics.



"I am opposed to any form of tyranny over the mind of man."  Thomas Jefferson


There is also a video at the above link
showing the two patients. Manado is the capital of the North Sulawesi province.

Map link: http://maps.google.com/maps?hl...

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

     


[ Parent ]
Thanks, Carol.


"I am opposed to any form of tyranny over the mind of man."  Thomas Jefferson

[ Parent ]
Again, Bird Flu Patient Dies
January 25, 2012
http://metro.vivanews.com/news...
Tangerang, Indonesia:  After being treated five days in bird flu isolation space, RO, an 18 year old man indicated as a bird flu suspect, died at 12:30 PM in the Bird Flu Isolation Room Tangerang District Hospital.

"The patient died at 12:30 PM, due to respiratory failure," said Head of Public Relations Tangerang District Hospital, Achmad Muchlis to VIVAnews.com, Wednesday, January 25, 2012.

He said that since entering the isolation room, the patient's condition was critically ill and there was no progress until finally he died of respiratory failure.

"Until now there has been no correct official information related to whether the patient was infected with bird flu," he said.

While VIVAnews.com monitored the isolation room, which is also adjacent to the mortuary that was closed to the public, the gate, both from within and outside the hospital was locked with a padlock.

"Because of fears that the bird flu virus can spread and cause infection," he said.

Previously RO entered the isolation room five days ago, Saturday, January 21, 2012.  RO was indicated as a bird flu suspect after he was treated at Mercy Hospital Sari Karawaci, Tangerang, since Friday, January 20, 2012.
(more)

"I am opposed to any form of tyranny over the mind of man."  Thomas Jefferson


Nature: Caution urged for mutant flu work
This time it's Declan Butler in Nature:
Why would scientists deliberately create a form of the H5N1 avian influenza virus that is probably highly transmissible in humans? In the growing debate about research that has done precisely that1, a key question is whether the public-health benefits of the work outweigh the risks of a potential pandemic if the virus escaped from the lab.

For the scientists who have created the mutated strains of the H5N1 virus, the justifications are clear. Surveillance of flu viruses could, they argue, allow health organizations to monitor birds and other animals for the mutations that would provide an early warning of a pandemic and enable authorities to act quickly to contain the virus.

That claim is meeting with scepticism, however. More than a dozen flu experts contacted by Nature say they believe that the work opens up important vistas in basic research, and that it sends a valuable warning about the potential for the virus to spark a human pandemic. But they caution that virus surveillance systems are ill-equipped to detect such mutations arising in flu viruses. As such, work on the viruses is unlikely to offer significant, immediate public-health benefits, they say.



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