Pakistan Has Eight Suspected Human Cases of Bird Flu

Dec. 16 (Bloomberg)—Five members of a family in Pakistan are among eight people who may be the country’s first human cases of bird flu, the World Health Organization said. At least one brother died.

Pakistan’s national laboratory found the lethal H5N1 avian flu strain caused the infections in three brothers and two cousins from the same family, according to information from a Dec. 15 WHO statement and Gregory Hartl, a WHO spokesman in Geneva. Another brother from the U.S., who attended a funeral for one of the victims, and his son tested negative for the virus at a hospital in Nassau County, New York, Hartl said.

Medical teams have been sent to Pakistan to assist local authorities in investigating the cases, in which two people had only mild symptoms, Hartl said. Doctors are monitoring for signs avian flu may be adapting to humans by killing fewer people, fostering its spread.

``It’s too early to make any definitive conclusions’’ about the outbreak, Hartl said in a Dec. 15 telephone interview. ``We are still in the middle of it.’’

The remaining suspected cases in Pakistan include a man and his niece, and a male who worked on a nearby farm.

Doctors from the WHO in Geneva and Cairo, and from the U.S. Navy Medical Research Unit No. 3 in Cairo will arrive in Pakistan during the next two days to track and stem the disease’s spread, and to analyze specimens for any genetic mutations in the virus.

It is too early to determine whether the cases were caused by an animal source or through limited person-to-person spread, he said. Some of the infected people also kept chickens and quails and it is unclear what personal protective equipment was used during culling operations, Hartl said.

Pakistan authorities sent Tamiflu to the affected area to treat cases and prevent further infection, Hartl said.

``Pakistan has been doing everything right’’ in terms of tracing people at risk of infection and preventing its spread, Hartl said.

The infections probably began late October in an agriculture ministry official involved in culling diseased poultry on a farm at Abbottabad in North-West Frontier Province, which borders Afghanistan, Hartl said.

The man fell ill and was cared for by two of his brothers, who also became unwell. One of the brothers died about a month ago and was buried before specimens could be taken for a diagnosis. The other died on Nov. 29 and was positive for H5N1 in preliminary tests, Hartl said. Antibody screening on the first man, who recovered, found he’d been infected with H5N1.

Two cousins, at least one of who is a woman, were positive for H5N1, although they developed only mild symptoms, he said. A man and his niece, who were also involved in culling poultry on either the same or a neighboring farm, have tested positive, Hartl said. The eighth case is a male farm-worker from Mansehra, about 20 kilometers (12 miles) from the other cases, he said.

The suspected Pakistan cases occurred in the Peshawar area of the country and were detected following a series of culling operations in response to outbreaks of H5N1 in poultry, according to the WHO statement. Samples from the cases are being sent to a WHO reference laboratory in Cairo for confirmation and further analysis.

Avian influenza story source: Bloomberg

Posted by on 12/16 at 03:10 PM

H5N1 avian flu: Spread by drinking water into small clusters:
Human to human and contact transmission of influenza occur - but are overvalued immense. In the course of Influenza epidemics in Germany recognized clusters are rarely (9% of the cases in the season 2005).
In temperate climates the lethal H5N1 avian flu virus will be transferred to humans strong seasonal in the cold via cold drinking water, as with the birds feb/mar 2006.
Recent research must worry: So far the virus had to reach the bronchi and the lungs in order to infect humans. Now it infects the upper respiratory system (mucous membranes of the throat e.g. when drinking and mucous membranes of the nose and probably also the conjunctiva of the eyes as well as the eardrum e.g. at showering). In a few cases (Viet Nam, Thailand) stomach and intestine by the H5N1 virus were stricken but not the bronchi and the lungs. The virus might been orally taken up, e.g. when drinking contaminated water.
The performance to eliminate viruses of the drinking water processing plants in Germany regularly does not meet the requirements of the WHO and the USA/USEPA. Conventional disinfection procedures are poor, because microorganisms in the water are not in suspension, but embedded in particles. Even ground water used for drinking water is not free from viruses.
In temperate climates the strong seasonal waterborne infections like norovirus, rotavirus, salmonellae, campylobacter and - differing from the usual dogma - influenza are mainly triggered by drinking water dependent on the drinking water temperature (in Germany minimum feb/mar – maximum august). There is no evidence that influenza primary is transmitted by saliva droplets. In temperate climates the strong interdependence between influenza infections and environmental temperatures can’t be explained with the primary biotic transmission by saliva droplets from human to human with temperatures of 37.5°C. There must be an abiotic vehicle like cold drinking water. There is no other appropriate abiotic vehicle. In Germany about 98% of inhabitants have a central public water supply with older and better protected water. Therefore in Germany cold water is decisive to virulence of viruses.
In hot climates/tropics the flood-related influenza is typical after extreme weather and natural after floods. Virulence of Influenza virus depends on temperature and time. If young and fresh H5N1 contaminated water from low local wells, cisterns, tanks, rain barrels or rice fields is used for water supply water temperature for infection may be higher as in temperate climates.

Dipl.-Ing. Wilfried Soddemann
eMail soddemann-aachen@t-online.de
http://www.dugi-ev.de/information.html
Epidemiological Analysis: http://www.dugi-ev.de/TW_INFEKTIONEN_H5N1_20071019.pdf

Posted by Dipl.-Ing. Wilfried Soddemann  on  12/17  at  01:12 AM
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