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News Reports for November 29, 2012

by: NewsDiary

Sat Nov 24, 2012 at 15:13:39 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!

• Change in disease pattern poses fresh challenges (Link)

United States
• ProMED:  Influenza (107): USA (FL) (Link)
• Flu Lands in Unpredictable Places; Cold Weather Not Cause (Link)
• TN: Flu season may be starting early in East (Link)

• Lighting Up Chickens to Prevent Bird Flu Pandemics (Link)

• Recombinomics: Novel Beta Coronavirus Mecca Linkage Raises Concerns (Link)
• Recombinomics: Qatar Novel Beta Coronavirus Case In Mecca for Umrah Week (Link)
• Recombinomics: Widespread Novel Beta Coronavirus Alerts Issued (Link)
• Recombinomics: Massive H5N1 Wild Bird Outbreak In Krasnodar (Russia) (Link)

• H(Link)

NewsDiary :: News Reports for November 29, 2012

News for November 28, 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 August 10, 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

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ProMED: Influenza (107): USA (FL)
Flu cases are spiking in Central Florida and across the state, and doctors say they are seeing them in numbers they typically don't see until January. In the past week, 250 confirmed cases have been reported at Centra Care urgent care's 21 locations. That is double from just a week ago.

"Normally, we don't see flu ramp up at this rate until about January, so we are a couple of months early," Centra Care's Dr. Tim Hendrix said. Most people who have been diagnosed with the flu did not previously receive a flu shot, Hendrix said. After flu symptoms develop -- fever, body aches, sometimes a cough -- it will be too late for the vaccine. However, doctors urge those people to take Tamiflu, which will cut down on the life span of the flu [virus].


Is this another early warning of an impending outbreak of influenza virus infection in the northern hemisphere following the similar report from Georgia a week ago? The most recent World Health Organisation (WHO) Global Update concluded that there was no evidence of this as yet: see ProMED-mail post: Influenza (106): WHO update 20121123.1422001. Unfortunately, neither report has been backed up with precise diagnostic data. The WHO and ECDC weekly updates continue to report only limited influenza virus activity globally. More precise diagnostic information is awaited from these 2 southern states. http://www.promedmail.org/dire...

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


Flu Lands in Unpredictable Places; Cold Weather Not Cause
Although most children grow up hearing that they'll catch the flu if they play in the snow without a scarf, weather has very little to do with which regions get more flu, doctors say.

"It's actually not that predicable," said Dr. Jon Abramson, who specializes in pediatric infectious diseases at Wake Forest Baptist Health in North Carolina.

Mississippi has had the most reported cases of influenza-like illness in the United States so far this season, according to the Centers for Disease Control and Prevention. Even though Mississippi had an average temperature of 53.3 degrees this month, it is the only state in the country with a flu-like activity level of "high." Louisiana and Alabama are right behind it with moderate activity levels. Most other states -- with colder climates -- have had lower levels.

Abramson said the flu season tends to start in October and last through April, mostly coinciding with the school year rather than the temperature. He said studies have shown that the flu spreads mostly from school-age children, who often have poorer hygiene and catch the virus because they are in close contact with one another. Then, they pass it along to adults.

Weather becomes a contributing factor mostly because it forces children indoors, where they mix together and spread germs, said Allison Aiello, a professor and epidemiologist at the University of Michigan's School of Public Health.


Since Sept. 30, about 2,400 influenza cases have been reported to the Centers for Disease Control and Prevention, including 28 cases of H1N1. Despite its tropical temperatures, even Hawaii has reported flu cases this season.

Abramson said his North Carolina hospital has already had 25 influenza cases this season. In contrast, by the same time last year, the same hospital didn't have a single case. "This is the South. It's fairly warm, so you wouldn't expect it this early," he said. "It doesn't seem to behave exactly by the coldness."

The flu can spread any time of year, Abramson said, citing this summer's swine flu outbreak. The H3N2V strain jumped from 29 to 145 cases in less than a week in August of this year, with most of them in Indiana and Ohio.

(Snip) http://abcnews.go.com/Health/f...

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


Lighting Up Chickens to Prevent Bird Flu Pandemics
(Large Snip)

The bird flu virus is lethal when it infects humans, but fortunately it does not spread very well. In contrast, the swine flu virus is incredibly efficient at moving from person to person, but its fatality rate is low. Virologist and epidemiologists fear hybrid viruses, such as a deadly avian virus with improved transmissibility. Such a hybrid virus has been formed before and will most likely occur again. We know that when two different influenza viruses inhabit the same cell they can exchange gene segments, and completely new hybrid viruses can be formed. This increases the chance of a virus evolving in leaps and bounds. For example, both human and avian viruses can infect pigs, and if they both infect the same cell in the pig, they can swop gene fragments, thereby creating an avian flu virus that is capable of infecting humans.

Ron Fouchier, a virologist at the Erasmus Medical Center in Rotterdam, Holland, and Yoshihiro Kawaoka of the School of Veterinary Medicine at the University of Wisconsin in the United States have shown that it takes only five mutations to transform the bird flu virus into a form that is transmissible from mammal to mammal by coughs and sneezes. Two of the five mutations have already been found in wild birds -- which means that some avian virsuses are just three mutations away from becoming transmissible between mammals.

The bird flu virus acts differently in humans than in its native host. In birds it infects the gastrointestinal tract and not the lungs. As a consequence, bird droppings can harbor significant amounts of the avian virus and they can contaminate lakes and ponds. In 1996, a new influenza virus was found in domestic geese in China's Guangdong province. Since then, the same avian virus has become endemic to bird populations of six countries and has been found in 57 other countries. Very occasionally, some of them have made the transition from birds to individuals working on chicken farms. The cross species jump is rare and the only victims have been people with extensive contact with infected poultry. So far this year, only 30 people have been infected by the bird flu virus, but 19 of them have died.

According to Peter Palese, a virologist at Mount Sinai School of Medicine in New York, "Infection and disease are not directly proportional to exposure. Ninety-nine point nine percent of the people who are massively exposed don't have [the] disease, and don't have antibodies in their blood. But in people who get sick, the virus replicates like crazy."

Imagine if this deadly virus started moving from person to person. Controlling avian flu in wild birds is an impossible task, however limiting its spread amongst domesticated ducks and chickens -- the most who are the most common bridges to human infections -- may soon be possible. This is due to a project Laurence Tiley, a molecular biologist at the University of Cambridge, and Helen Sang, an expert in genetically modifying chickens at the Roslin Institute in Scotland, are working on such research. They have created genetically modified chickens that limit the transferal of the avian flu virus between chickens. Right now, this is just a proof of concept experiment. Tiley has no intentions of selling his transgenic chickens to poultry farms in the next few years. If he can improve his technique so that the transgenic chickens cannot transmit a single virus or be immune to infection, then transgenic poultry may be ready for the market. He says, "We have more ambitious objectives in terms of getting full flu resistance before we would propose to put these chickens into true production."

The transgenic chickens created in this research may have the best chance of any genetically modified organisms at being used to combat a disease. This is because chickens bred in the poultry industry are isolated from wild chickens and birds, and there is little chance that the genetic modifications will enter free-range chickens. Transgenic chickens are much more isolated than genetically modified plants, whose pollen freely blows in the wind. Additionally, the consequences of a bird flu pandemic are so severe that they might justify the widespread adoption of genetically modified chickens.

The flu has created an interesting dilemma for us. The pressure our civilization is placing on nature and the way we are changing to mega-farms is increasing the likelihood of an influenza outbreak. However, to reduce the probability of an influenza pandemic, we can either reduce our population and our meat consumption, or we can tinker with nature by creating genetically modified poultry. Soon we might have to decide whether we are willing to accept genetically organisms as our allies in the fight against diseases such as the flu. http://www.huffingtonpost.com/...

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


Crazy - and self-serving
That's propaganda for some scientist who wants to see his frankenchicken make him millions! ;-[ It's a false  premise thus false conclusion - we "have to have" mega farms so someday we "have to have" genetically modified chicken! That kind of talking scares the heck out of me - let's pile complexity on top of complexity, as if the whole system isn't spiraling out of control as it is! Thanks for finding this!

[ Parent ]
Are we still supposed to eat these chickens?
Relating to an organism whose genome has been altered by the transfer of a gene or genes from another species or breed. Transgenic organisms are used in research to help determine the function of the inserted gene, while in industry they are used to produce a desired substance.


Are there other animals involved, or only virus?  Details are sketchy in the articles I've found.  

What precautions have been taken to prevent the DNA from the GM chickens getting into the food chain (before appropriate approval has been granted)?
   There is no possibility of DNA from these GM chickens getting into the food chain, unless by some illegal or malicious intent. The chickens carry a marker that would be very easily detected if such an event occurred.

Is the "marker" the green glow mentioned in this article from January 2011?  http://arstechnica.com/science...  

[snip]The researchers say that although large-scale distribution of the genetically modified (GM) birds will one day be feasible, their study is meant only to show proof-of-concept of the technique.

"We have more ambitious objectives in terms of getting full flu resistance before we would propose to put these chickens into true production," says Laurence Tiley, a molecular virologist at the University of Cambridge, UK, and lead investigator for the study. His team is now working on further genetic tweaks that would inhibit the virus in different ways. "It would be a bit like combination drug therapy for HIV," he says.

Other experts point out that even if the GM chickens carried full resistance to influenza, there are political and economic hurdles to their widespread commercial use - not least the public's aversion to GM food. [my bolding]

"It's the beginning of something which will require a certain number of years to see whether it is accepted by the public," says Ilaria Capua, head of virology at the Experimental Animal Health Care Institute of Venice in Legnaro, Italy. [snip]


Other transgenic chickens have been developed, but possibly only used for research.  This Wall Street Journal article is about India:

[snip]Transgenic chickens have already been developed in the U.S., Canada, the U.K. and China, he said.

"These chickens can enhance productivity and give a huge quantity of flesh," Mr. Bhattacharya said, adding that transgenic birds can produce up to 300 eggs over 72 weeks, more than twice the number of eggs produced by normal varieties of chickens.[snip]


Genetic modification may not be harmless.  There's been a big increase in food allergies and food intolerance in recent years.  Among other likely causes, wheat has been modified to contain more protein and even to be resistant to herbicides.  

(New book "Wheat Belly" describes the changes in genetics of wheat:  http://www.youtube.com/watch?v...  Thousands of years ago wheat had 14 chromosomes [einkorn]; then 28 chromosomes [emmer]; then spelt, kamut, and one other, [missed it] chromosomes.  In 1950, 42 chromosomes.  1960s, there was a population explosion, and after much research they boosted yields of wheat by 8 or 10 times with a "high-yielding semi-dwarf strain".  I haven't watched the rest of the video yet.)  

Probably we should be cautious about new genetic developments....

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

[ Parent ]
Novel Beta Coronavirus Mecca Linkage Raises Concerns
Recombinomics Commentary

He was a previously well 49 year-old man who developed a mild undiagnosed respiratory illness while visiting Saudi Arabia during August 2012, which fully resolved. He subsequently presented to a physician in Qatar on 3 September, with cough, myalgia and arthralgia, and was prescribed oral antibiotics. Five days later, he was admitted to a Qatari hospital with fever (38.4 °C) and hypoxia, with oxygen saturation of 91% on room air. A chest X-ray showed bilateral lower zone consolidation. He was treated with ceftriaxone, azithromycin and oseltamivir. After 48 hours, he required intubation and ventilation and was transferred by air ambulance to London. During transfer, he was clinically unstable, requiring manual ventilation.

Mounts says when the first two infections with this virus were spotted, in June and then September, both men had been in Mecca, Saudia Arabia, before they got sick. As such the chance existed that the source of infection - which is currently unknown - was only found there.

But the newest infections show that isn't possible. Some of the Saudi cases had not been to Mecca before they got sick. They live in and fell ill in Riyadh, the capital. And the most recent case from Qatar lives in Doha and had not recently travelled outside the country.

The above comments raise questions about a Mecca source for the novel betacornavirus reported in the past few months.  The first set of comments (Snip) is from a Eurosuveillance report on the first confirmed case (49M) from Qatar.  Although the patient developed a severe illness more than 10 days after returning from a visit to Saudi Arabia, a mild respiratory illness developed while in Saudi Arabia, raising concerns that the coronavirus isolated after transfer to London caused the mild disease in Saudi Arabia and then caused the more severe symptoms when the patient relapsed.

The second set of comments (Snip) cite a WHO technical representative, who notes that both of the initial confirmed cases had traveled to Mecca prior to symptoms, raising concerns that these initial cases were linked to infections in Mecca that were linked to preparations for the Hajj which includes visits to Mecca and Medina by pilgrims who journey to Saudi Arabia from many countries outside of the Middle East including Indonesia, Pakistan, and India.  The brother of the surviving case 49F indicated his brother went to Mecca for Umrah week.

This linkage of the Qatar case to the Hajj may have precipitated the curious comments in an October 22 ProMed report by Dr Ziad Memish who is the Deputy Minister of Public Health for the Kingdom of Saudi Arabia (KSA) as well as Director for WHO Collaborating Center for Mass Gatherings.  (Snip).

The third case was hospitalized in Riyadh and was recovering, but no age, gender, or dates were released.  The same was true for the fourth case, which was also in Riyadh and media reports indicated the KSA MoH noted the cases had no serious consequences, yet two relatives of the fourth case had died after renal failure.  Renal failure was also reported for the first two confirmed cases as well as about 5% of SARS cases in 2003.  Most of the SARS CoV cases with renal failure died.

Similarly, WHO described the recent cases from Saudi Arabia as well as the second case from Qatar, while withholding age, gender, and dates.  The WHO report did indicate that two of the confirmed cases were epidemiologically linked to each other as well as two additional symptomatic family members.  The untested family member (70M) died after developing renal failure as did his son, who tested positive for the novel betacornavirus.  The fourth family member was symptomatic, but tested negative.  Some media reports suggest he may be retested.  Media reports also indicted the son was hospitalized after his father died, suggest a gap in disease onset dates signaling human to human transmission.  Media reports also indicate the cluster was in October, but not reported until November 23.  The height of Hajj activities were in October, which is also when the second Qatar case was infected, although he did not travel outside of Doha prior to his illness.

(Snip) all six confirmed cases and the two probable cases were male, which may have affected testing or may have been related to religious ceremonies which limit interactions between genders.  The linkage of the first two confirmed cases to Mecca raises concerns that the novel coronavirus may have spread among Hajj attendees, who subsequently spread the virus to other locations, including Riyadh and Doha.

(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


Qatar Novel Beta Coronavirus Case In Mecca for Umrah Week
Recombinomics Commentary

Pointing out that the flight details sick to his brother began after returning from Umrah week where began to feel shortness of breath and cough

The above translation of comments by the brother of the first novel beta coronavirus case (49M) in Qatar indicates the brother traveled to Saudi Arabia for Umrah week.  Media reports cited his visit to Mecca prior to more severe symptoms that developed in Doha, Qatar prior to air ambulance transfer to London, (Snip).

The above case developed renal failure and was hospitalized for several months, but survived. Symptoms, including renal failure matched SARS CoV from 2003 as well as the first confirmed case fatally infected with the recent novel coronavirus.  Renal failure was also reported for the two members of the Riyadh cluster, who died.  The son was nCoV confirmed, while tests on his father (70M) are pending.  The gap in dates of death suggest human to human transmission.

(Snip) The similarities of these severe cases with the 2003 SARS CoV outbreak raise concerns that the cases with renal failure represent the severe cases in the spectrum of presentations.  For the 2003 SARS CoV outbreak, about 5% developed renal failure and most with renal failure died.  These similarities raise concerns that most infections with the novel coronavirus are milder than the fatal cases or those with renal failure, and the milder cases are largely untested.

WHO has recommended wider testing, but the linkage of the initial cases to Mecca, including a trip during Umrah week, raises concerns that the novel coronavirus has spread well beyond Saudi Arabia and Qatar.  Large numbers of pilgrims from Indonesia, India, and Pakistan visited Saudi Arabia for the Hajj, and the return of those pilgrims to their counties or origin has increased concerns. 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


Widespread Novel Beta Coronavirus Alerts Issued
Recombinomics Commentary

What is known is that this virus is different from any other that has been found to date in humans and animals. Symptoms may include fever, coughing and difficulty breathing.

The above comments are from a novel betacoronavirus alert by Public Health Agency of Canada which was similar to alerts issued by agencies in multiple countries including Hong Kong and Brunei.  

These alerts followed the November 23 WHO update which increased the number of confirmed cases to six and cited two additional probable cases.  The two probable cases and two of the confirmed cases were from the same family from Riyadh, Saudi Arabia.  Two of the family members died including a father (70M) and son.  Both died after developing renal failure and the son was hospitalized after his father died suggesting he was infected by his father.  However, the disease onset dates for the family members has not been released, but confirmation of the two probable cases is expected this week.  (Snip)  All four family members had similar symptoms, but the two fatal cases were more severe and developed renal failure or multi-organ failure.

The first two cases also developed renal failure.  The first case (60M) died, while the second case (49M) has been hospitalized for almost 3 months.  The three deaths and prolonged hospitalization for the four cases with renal failure is similar to SARS CoV cases in 2003, where about 5% of lab confirmed cases developed renal failure and the vast majority died.  However, about 90% of the confirmed SARS CoV cases survived, suggesting that milder cases due to the current novel coronavirus have not been reported.

The milder cases may be widespread.  The initial cases had visited Mecca and one had done so during Umrah week, raising concerns that pilgrims from the Hajj have spread the virus well beyond Saudi Arabia and Qatar (Snip).

WHO has recommended wider testing and expects additional positives.  As noted above, the novel coronavirus has not been detected in any animal species in spite of aggressive testing of multiple species, especially bats, following the 2003 SARS CoV outbreak. 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


Massive H5N1 Wild Bird Outbreak In Krasnodar
Recombinomics Commentary

On the coasts of the Black and Azov seas, local residents discovered near the village in Veselovka in Temryuk district of the Krasnodar Territory and the area of the resort of Anapa coastline estuaries Kiziltash, Bugaz and spit naked thousands of dead birds, including gulls, coots, cormorants, swans and ducks.

The above translation describes a massive H5N1 outbreak in wild birds in western Krasnodar.  Multiple stories in Russian media describe the outbreak with estimates ranging from 600 to 1000's of dead birds.  H5 has been confirmed and it is likely that the deaths are due to clade (Fujian strain) which is now widespread in wild birds in eastern Asian countries including China, Japan, and South Korea.

The number of dead birds is similar to prior reports of clade 2.2 (Qinghai) outbreaks in China, Russia, Mongolia, and Kazakhstan in 2005 and 2006.  The last large outbreak of H5N1 in Krasnodar was in 2006 and was due to clade 2.2.

However, clade (Fujian) has largely replaced clade 2.2 (Qinghai) in wild birds in Asia and clade has been reported in Europe previously.  However, this outbreaks appears to be significantly larger and likely signals a serious spread of this sub-clade to Europe, the Middle East, and Africa.

In Egypt, clade 2.2.1 is endemic and also appears in Israel at a lower frequency.  The sub-clade with the 3 BP deletion has become dominant in Egypt and accounts for all human cases since 2009.  The movement of clade into the Middle East and northern Africa could lead to rapid H5N1 evolution via recombination and reassortment. Continued: http://www.recombinomics.com/N...

(Note: Krasnodar Territory is in Russia.)

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


India: Change in disease pattern poses fresh challenges
Infections typical of hot and humid weather, such as dengue, malaria, encephalitis, meningitis and chikungunya, have tended to persist despite the onset of winter reflecting a changing weather pattern. Normally, diseases that break out during the rainy season tend to fade away on the withdrawal of the monsoon. That hasn't happened this year posing a new challenge for public health authorities. Cold-weather maladies, like various types of influenza, including the dreaded swine flu and bird flu, have surfaced, adding to the woes. Delhi alone has recorded more than 1,800 cases of dengue causing scores of deaths. Mumbai, too, has seen over 700 cases of dengue, including some deaths, the most famed victim being filmmaker Yash Chopra. The situation in other cities and villages is no different.


Bird flu and swine flu infections, which spread through air and not through vectors, are known to respond to some of the available prophylactic and curative medicines, including Tamiflu, which need to be stocked and made available to the public at affordable prices. Given the magnitude of the challenge, this is no mean task. Public health authorities need to play a more pro-active role. To be effective, the combat against these diseases needs to be carried out on many fronts. http://newindianexpress.com/ed...

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


US: Flu season may be starting early in East Tennessee
KNOXVILLE (WATE) - If you're feeling under the weather, you're not alone. Health experts say this flu season is coming a little earlier than usual.

According to the CDC, the southeast is experiencing "elevated levels" of flu activity. Right now, reports in Tennessee are sporadic, but several surrounding states, including Alabama, Georgia, North Carolina and especially Mississippi, are seeing flu-like viruses spread quickly.

"We're seeing a lot of flu as well as bad upper respiratory infections and sinus infections," said Dr. John Wilkinson. "Last winter was not too bad from an infectious disease standpoint. We had some flu. It certainly seems like we're having more flu this season than we did last season."

The flu normally peaks here in February.

"We are just a little bit early because I've been seeing a rise since the end of October. All through November we have steadily seen an increase," said Connie Cronley, epidemiology nurse for the Knox Count Health Department. Continued: http://www.wate.com/story/2022...

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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