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Avian Influenza (Bird Flu)
(Released July 2007)

 
  by Sujata Suri  

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  1. Avian flu: the creation of expectations in the interplay between science and the media

    Brigitte Nerlich and Christopher Halliday.

    Sociology of health & illness, Vol. 29, No. 1, Jan 2007, pp. 46-65.

    This paper examines the emerging cultural patterns and interpretative repertoires in reports of an impending pandemic of avian flu in the UK mass media and scientific journals at the beginning of 2005, paying particular attention to metaphors, pragmatic markers ('risk signals'), symbolic dates and scare statistics used by scientists and the media to create expectations and elicit actions. This study complements other work on the metaphorical framing of infectious disease, such as foot and mouth disease and SARS, tries to link it to developments in the sociology of expectations and applies insights from pragmatics both to the sociology of metaphor and the sociology of expectations.

  2. Avian influenza A (H5N1) infection: targets and strategies for chemotherapeutic intervention

    Erik De Clercq and Johan Neyts.

    Trends in.pharmacological sciences, Vol. 28, No. 6, Jun 2007, pp. 280-285.

    In an avian flu pandemic, which drugs could be used to treat or prevent infection with influenza A (H5N1) virus? Foremost are the viral neuraminidase inhibitors oseltamivir and zanamivir, which have already been used to treat human influenza A (H1N1 and H3N2) and B virus infections. The use of the M2 ion channel blockers amantadine and rimantadine is compounded by the rapid development of drug resistance. Although formally approved for other indications (i.e. treatment of hepatitis C), ribavirin and pegylated interferon might also be useful for controlling avian flu. Combined use of the currently available drugs should be taken into account and attempts should be made to develop new strategies directed at unexplored targets such as the viral proteins hemagglutinin, the viral polymerase (and endonuclease) and the non-structural protein NS1. As has been shown for other viral infections, RNA interference could be a powerful means with which to suppress the replication of avian H5N1.

  3. Graphical Representation and Numerical Characterization of H5N1 Avian Flu Neuraminidase Gene Sequence

    Ashesh Nandy, Subhash C. Basak and Brian D. Gute.

    Journal of chemical information and modeling, Vol. 47, No. 3, May-Jun 2007, pp. 945-951.

    The high degree of virulence and potential for development of a pandemic strain of the H5N1 avian flu has resulted in wide interest in characterization of the various genes of the H5N1 virus genome. We have considered for our analysis all 173 available complete sequences, as of February 2006, of the neuraminidase gene, which is the target of the most effective treatment regimen comprising the inhibitors oseltamivir and zanamivir. We have used a 2D graphical representation of the neuraminidase RNA sequences of H5N1 strains to identify a few distinct structural motifs. The H5N1 strains were split into two main classes: strains that were benign to human beings in the years up to 1996 and the period 1999-2002 and strains that were highly pathogenic to humans in the periods 1997 and 2003 to present. Comparisons with earlier H1N1 pandemic and epidemic strains have also been made to understand the current status of the gene. Our findings indicate that the base composition and distribution patterns are significantly different in the two periods, and this may be of interest in studying mutational changes in such viral genes.

  4. Radiological and clinical course of pneumonia in patients with avian influenza H5N1

    Ali Bay, Omer Etlik, A. Faik Oner, et al.

    European Journal of Radiology, Vol. 61, No. 2, Feb 2007, pp. 245-250.

    INTRODUCTION: We evaluated chest X-ray and clinical findings of patients with lower respiratory tract infection due to influenza H5N1 and presented the radiological findings and clinical course of the infection. MATERIALS AND METHODS: Between December 2005 and February 2006, eight hospitalized patients (median age 10, 5-15 years) with avian-flu were evaluated in this study. All patients were evaluated with chest X-ray and four of them with CT scan. Post mortem pathological characterization were also available for three of the patients. RESULTS: A rapidly progressive pneumonia with high mortality rate was observed especially for cases with late admission. The major radiologic abnormalities were extensive pneumonic infiltration with segmental and multifocal distribution, mostly located in lower zones of the lung. No pleural effusion and hilar lymphadenopathy was noted. CONCLUSION: Avian flu may be presented as rapidly progressive pneumonia. The chest radiography has an important role in diagnosis and should be obtained daily because of rapid change of the findings that may necessitate prompt action.

  5. Analyzing disaster risks and plans: An avian flu example

    Baruch Fischhoff, Waendi Bruine Bruin, Uemit Guevenc, Denise Caruso and Larry Brilliant.

    Journal of Risk and Uncertainty, Vol. 33, No. 1-2, Sep 2006, pp. 131-149.

    Narrative approaches to analyzing risks seek to identify the variables critical to creating and controlling a risk, then to instantiate them in terms of coherent themes (e.g., organizational failure, strategic surprise). Computational approaches to analyzing risks seek to identify the same critical variables, then to instantiate them in terms of their probability. Disaster risk analysis faces complex, novel processes that strain the capabilities of both approaches. We propose an approach that integrates elements of each, relying on what we call structured scenarios and computable models. It is illustrated by framing the analysis of plans for a possible avian flu pandemic.

  6. Avian Flu: Multiple introductions of H5N1 in Nigeria

    M. F. Ducatez, C. M. Olinger, A. A. Owoade, et al.

    Nature, Vol. 442, No. 7098, 6 Jul 2006, pp. 37.

    As the avian influenza virus H5N1 swept from Asia across Russia to Europe, Nigeria was the first country in Africa to report the emergence of this highly pathogenic virus. Here we analyse H5N1 sequences in poultry from two different farms in Lagos state and find that three H5N1 lineages were independently introduced through routes that coincide with the flight paths of migratory birds, although independent trade imports cannot be excluded.

  7. Avian flu: the wrath of birdzilla or Polly got the sniffles?

    Tiffany Musick, Holly Cymet and Tyler Childs Cymet.

    Comprehensive therapy, Vol. 32, No. 2, Summer 2006, pp. 90-93.

    The potential damage from an avian flu epidemic is huge, but unlikely. Currently, the virus affects birds and humans who handle dead birds. Only one case of suspected human-to-human transmission exists. If human-to-human transmission can occur with a new strain of the virus, we are susceptible to a pandemic. The many subtypes of influenza act and develop differently. The inflammatory response generated by the virus accounts for the illness. Vaccines are being developed, but the difficulties are real, and the time to success cannot be confidently stated. Lymphopenia, thrombocytopenia, and elevated liver enzymes are common. Treatment has to take into account societal issues as well as the individual health of every patient.

  8. Avian Influenza: An Ecological and Evolutionary Perspective for Waterbird Scientists

    Sabir Bin Muzaffar, Ronald C. Ydenberg and Ian L. Jones.

    Waterbirds, Vol. 29, No. 3, 243-257, Sep 2006, pp. 243-257.

    Highly pathogenic avian influenza (HPAI) type A of the subtype H5N1 has recently spread widely and rapidly across Eurasia, and even to Africa, with deaths of both wild and domestic birds recorded. There are fears that it may soon spread to the Americas. Media accounts, communications from international bodies and national governments, and even some of the professional research literature attributes the spread, in part, to movements of HP strains by migratory birds. The origin of highly pathogenic strains is attributed to mutations, or to reassortment of virus genes from different host species. In this paper we review these hypotheses in light of knowledge about the ecology and evolution of avian influenza, looked at from the viewpoint of its natural reservoir - waterbirds. Our purpose here is to alert waterbird biologists that they have much to contribute to the science of this globally-important issue. New technologies have revealed that the genome of avian influenza contains much variation beyond that recognizable by classical antibody techniques, and have established avian influenza as a rapidly evolving and diversifying lineage. The extensive genetic variability in the viral genome and extensive reassortment within host species suggests that high pathogenicity could repeatedly and independently evolve from low pathogenic ancestors under appropriate selection pressures, such as those in poultry production systems. This makes infection of wild birds by HPAI lineages evolved in poultry a more likely occurrence than the reverse. The available evidence largely fits this model. We make recommendations that will help reduce the incursion of domestically-evolved avian influenza strains into wild populations of birds.

  9. Can cats spread avian flu?

    D. Butler.

    Nature, Vol. 440, No. 7081, Mar 2006, pp. 135.

  10. Epidemiology and control of SARS in Singapore

    Kee-Tai Goh, Jeffery Cutter, Bee-Hoon Heng, et al.

    Annals of the Academy of Medicine, Singapore, Vol. 35, No. 5, May 2006, pp. 301-316.

    Severe acute respiratory syndrome (SARS) was imported into Singapore in late February 2003 by a local resident who returned from a holiday in Hong Kong and started an outbreak in the hospital where she was admitted on 1 March 2003. The disease subsequently spread to 4 other healthcare institutions and a vegetable wholesale centre. During the period between March and May 2003, 238 probable SARS cases, including 8 imported cases and 33 deaths, were reported. Transmission within the healthcare and household settings accounted for more than 90% of the cases. Factors contributing to the spread of infection included the failure to recognise the high infectivity of this novel infection, resulting in a delay in isolating initial cases and contacts and the implementation of personal protective measures in healthcare institutions; and the super-spreading events by 5 index cases, including 3 with co-morbid conditions presenting with atypical clinical manifestations of SARS. Key public health measures were directed at prevention and control within the community and hospitals, and the prevention of imported and exported cases. An isolated laboratory-acquired case of SARS was reported on 8 September 2003. Based on the lessons learnt, Singapore has further strengthened its operational readiness and laboratory safety to respond to SARS, avian flu and other emerging diseases.

  11. Genomic Analysis of Influenza A Viruses, including Avian Flu (H5N1) Strains

    Insung Ahn, Byeong-Jin Jeong, Se-Eun Bae, Jin Jung and Hyeon S. Son.

    European journal of epidemiology, Vol. 21, No. 7, Jul 2006, pp. 511-519.

    This study was designed to conduct genomic analysis in two steps, such as the overall relative synonymous codon usage (RSCU) analysis of the five virus species in the orthomyxoviridae family, and more intensive pattern analysis of the four subtypes of influenza A virus (H1N1, H2N2, H3N2, and H5N1) which were isolated from human population. All the subtypes were categorized by their isolated regions, including Asia, Europe, and Africa, and most of the synonymous codon usage patterns were analyzed by correspondence analysis (CA). As a result, influenza A virus showed the lowest synonymous codon usage bias among the virus species of the orthomyxoviridae family, and influenza B and influenza C virus were followed, while suggesting that influenza A virus might have an advantage in transmitting across the species barrier due to their low codon usage bias. The ENC values of the host-specific HA and NA genes represented their different HA and NA types very well, and this reveals that each influenza A virus subtype uses different codon usage patterns as well as the amino acid compositions. In NP, PA and PB2 genes, most of the virus subtypes showed similar RSCU patterns except for H5N1 and H3N2 (A/HK/1774/1999) subtypes which were suspected to be transmitted across the species barrier, from avian and porcine species to human beings, respectively. This distinguishable synonymous codon usage patterns in non-human origin viruses might be useful in determining the origin of influenza A viruses in genomic levels as well as the serological tests. In this study, all the process, including extracting sequences from GenBank flat file and calculating codon usage values, was conducted by Java codes, and these bioinformatics-related methods may be useful in predicting the evolutionary patterns of pandemic viruses.

  12. Key strategies for reducing spread of avian influenza among commercial poultry holdings: lessons for transmission to humans

    Arnaud Le Menach, Elisabeta Vergu, Rebecca F. Grais, David L. Smith and Antoine Flahault.

    Proceedings.Biological sciences / The Royal Society, Vol. 273, No. 1600, Oct 7 2006, pp. 2467-2475.

    Recent avian flu epidemics (A/H5N1) in Southeast Asia and case reports from around the world have led to fears of a human pandemic. Control of these outbreaks in birds would probably lead to reduced transmission of the avian virus to humans. This study presents a mathematical model based on stochastic farm-to-farm transmission that incorporates flock size and spatial contacts to evaluate the impact of control strategies. Fit to data from the recent epidemic in the Netherlands, we evaluate the efficacy of control strategies and forecast avian influenza dynamics. Our results identify high-risk areas of spread by mapping of the farm level reproductive number. Results suggest that an immediate depopulation of infected flocks following an accurate and quick diagnosis would have a greater impact than simply depopulating surrounding flocks. Understanding the relative importance of different control measures is essential for response planning.

  13. Migratory birds and avian flu

    Rob Fergus, Michael Fry, William B. Karesh, Peter P. Marra, Scott Newman and Ellen Paul.

    Science (Washington D C), Vol. 312, No. 5775, 2006, pp. 845-846.

  14. The potential for a pandemic? What the renal professional and patient need to know about avian flu

    Benjamin G. Barlow.

    Nephrology news & issues, Vol. 20, No. 9, Aug 2006, pp. 42-46.

  15. Preparing for avian flu

    Center for Healthcare Environmental Management.

    Healthcare hazard management monitor : HHMM : the newsletter of the Center for Healthcare Environmental Management, Vol. 19, No. 12, Aug 2006, pp. 1-8.

  16. Regional collaboration in the Middle East to deal with H5N1 avian flu

    Alex Leventhal, Assad Ramlawi, Adel Belbiesi and Ran D. Balicer.

    BMJ (Clinical research ed.), Vol. 333, No. 7573, Oct 21 2006, pp. 856-858.

  17. SARS revisited: managing "outbreaks" with "communications"

    K. U. Menon.

    Annals of the Academy of Medicine, Singapore, Vol. 35, No. 5, May 2006, pp. 361-367.

    "Risk communications" has acquired some importance in the wake of our experience of SARS. Handled well, it helps to build mutual respect between a government or an organisation and the target groups with which it is communicating. It helps nurture public trust and confidence in getting over the crisis. The World Health Organization (WHO) has also come to recognise its importance after SARS and organised the first Expert Consultation on Outbreak Communications conference in Singapore in September 2004. This article assesses the context and the key features which worked to Singapore's advantage. Looking at the data now widely available on the Internet of the experience of SARS-infected countries like China, Taiwan, Canada, the article identifies the key areas of strategic communications in which Singapore fared particularly well. Another issue discussed is whether Singapore's experience has universal applicability or whether it is limited because of Singapore's unique cultural, historical and geographical circumstances. Finally, the article also looks at some of the post-SARS enhancements that have been put in place following the lessons learnt from SARS and the need to confront new infectious outbreaks like avian flu.

  18. Strategic analysis on responding human avian flu and flu pandemic in China

    Guang Zeng.

    Biomedical and environmental sciences : BES, Vol. 19, No. 2, Apr 2006, pp. 158-161.

  19. Understanding the Risk of an Avian Flu Pandemic: Rational Waiting or Precautionary Failure?

    Marcello Basili and Maurizio Franzini.

    Risk Analysis, Vol. 26, No. 3, Jun 2006, pp. 617-630.

    The precautionary principle (PP) has been proposed as the proper guide for the decision-making criteria to be adopted in the face of the new catastrophic risks that have arisen in the last decades. This article puts forward a workable definition of the PP based on the so-called alpha -maximin expected utility approach, applying it to the possible outbreak of the avian flu disease among humans. Moreover, it shows how the shortage and-or lack of effective drugs against the infection of the virus A(H5N1) among humans can be considered a precautionary failure.

  20. Will the next human influenza pandemic be caused by the virus of the avian flu A/H5N1? Arguments pro and counter

    H. W. Doerr, Domenica Varwig, Regina Allwinn and J. Cinatl.

    Medical microbiology and immunology, Vol. 195, No. 2, Jun 2006, pp. 45-47.

    In 1997, the avian influenza A subtype H5N1 that caused big outbreaks of fowl pest in mass poultry farming had emerged in Hong Kong. Its spread throughout Eurasia had given rise to concerns in terms of the possible imminence of the next human influenza pandemic. In this article, epidemiological and virological arguments supporting or declining this fear are outlined and discussed with regard to viral infectivity and pathogenicity.