children

By NOBUYA SAWA / Staff Writer

Face masks are being seen everywhere in Japan at the peak of flu season, as the number of patients is increasing at the fastest pace in 10 years.

The number of patients who sought treatment at medical institutions subject to a survey stood at 42.62 on average in the latest week from Jan. 30 to Feb. 5. That was the highest at this time of the year since 2002.

The total number of flu patients in Japan is estimated to be about 2.11 million.

Starting this month, the number of patients who have contracted different types of flu strains is also increasing.

This influenza season features the spread of a Type A Hong Kong flu for the first time in five seasons. About 90 percent of patients were contracting that type of virus until January. From this month, however, patients that are suffering from a Type B influenza are also increasing in some areas.

“Antibodies that were gained as a result of infection are maintained for certain periods. As time passes, however, their effects wane. As a Type A Hong Kong flu is spreading after a long interval, people may have lost their immunities,” said Hideki Hasegawa, director of the Department of Pathology at National Institute of Infectious Diseases (NIID).

Because of the various types of strains, there is a growing fear that the current flu season will be a long-lasting one.

In the Tokyo metropolitan area, until mid-January, the number of patients was relatively small. In recent weeks, however, it has increased sharply there. In addition, the number of patients has been hovering at high levels in the Tokai and Shikoku regions since early January.

According to an announcement from the NIID, the number of patients per medical institution stood at 35.95 on a national average in the previous week from Jan. 23-29.

In the latest week, however, the figure jumped to 50.94 in Saitama Prefecture, 50.84 in Chiba Prefecture, 45.20 in Tokyo and 48.86 in Kanagawa Prefecture.

In the Kinki region, the corresponding figures were hovering around 40 in the latest week, almost the same as that in the previous week. For example, it stood at 44.81 in Osaka Prefecture and 42.46 in Hyogo Prefecture.

In the previous week, prefectures with the largest numbers of patients per medical institution were Fukui, Kochi and Aichi. In all of the three prefectures, their figures dropped to 64.41, 54.21 and 47.38 respectively in the latest week. However, the figures were still at high levels.

In Chugoku and Kyushu regions, high levels also continued in the latest week with the number of patients at 51.64 in Yamaguchi Prefecture, 55.36 in Miyazaki Prefecture and 45.67 in Oita Prefecture.

The number of flu patients is also increasing in areas affected by the Great East Japan Earthquake. In Iwate Prefecture, the number increased from 45.52 in the previous week to 58.98 in the latest week, the second highest in Japan following Fukui Prefecture.

http://ajw.asahi.com/article/behind_news/social_affairs/AJ201202110005

Recombinomics Commentary 05:00
January 5, 2012 More recently, investigation of a case in West Virginia has identified a possible outbreak, with 23 out of 70 contacts of the case reporting ILI; all have recovered.

The above comments are in the California Department of Public Health December 15 H3N2v advisory.  The West Virginia cluster was described in the CDC early release MMWR, but the 23 ILI cases were not mentioned.  Instead the report said there were several contacts of the index case, A/West Virginia/06/2011, which initially tested as negative.  trH3N2 was isolated from a contact, A/West Virginia/07/2011, which initially tested as inconclusive and was reported as an influenza A case.  The partial sequence of HA and NA were virtually identical to the index case, and both had a novel N2 that was easily distinguished from the first 10 cases in 2011 (H3N2pdm11).

Thus, the vast majority of cases at the day care center were not reported, and the two confirmed cases had serious testing issues.  The numbers cited in the California advisory indicate the attack rate was high, and the transmission was sustained for almost a month, but the CDC maintains that there is no sustained or community transmission of H3N2v.  None of the cluster members have reported contact with swine.

A pediatric case in Napa County, California has also tested positive for trH3N2 and is under investigation.  Anecdotal reports indicate ILI is widespread in pediatric cases in northern California, but most are mild and not tested.  As seen in the West Virginia cluster, testing is a serious issue, allowing the trH3n2 to silently spread.

An explosion of cases and clusters is expected this month.

CDC confirms two human infections with novel influenza viruses

December 9, 2011 -- CDC has confirmed two cases of human infection with two different novel influenza A viruses in different states. Both patients have fully recovered. While the viruses infecting both patients have been found in U.S. swine and some of the prior human infections with these viruses have been associated with direct or close swine contact, there are no reports of direct or close contact with swine prior to illness onset in either of these cases. Laboratory testing at CDC has confirmed that both novel viruses are susceptible to the antiviral medications oseltamivir (Tamiflu®) and zanamivir (Relenza®).

West Virginia
One case of human infection with a novel influenza virus was reported by West Virginia and involves infection of a child with the novel influenza A (H3N2) virus with genes from swine, human, and avian lineages with the M gene from the 2009 H1N1 virus that was first identified in August 2011. Ten prior human infections with this virus in four other states have been confirmed. These occurred in Indiana (2), Pennsylvania (3), Maine (2), and Iowa (3).

These novel influenza A (H3N2) viruses are substantially different from currently circulating seasonal (human) influenza A (H3N2) viruses, but are distantly related to human influenza viruses that circulated among people in the 1990s. For that reason, some adults may have some residual immunity against this virus. This might help explain why 10 of the 11 cases that have been detected have occurred in children.

Most human infections with viruses that circulate in swine (but not humans) have been associated with swine exposure, but limited human-to-human transmission associated with these viruses is thought to have occurred as well, most recently in Iowa. While an investigation is ongoing in West Virginia, no direct or indirect contact with swine has been reported, implying that limited human-to-human transmission of this virus may have occurred again.

No ongoing community transmission of this virus has been detected in the United States. However, CDC is taking this situation very seriously. Surveillance surrounding reported cases is being further enhanced and, as a precaution, a vaccine virus has been developed and provided to manufacturers for them to begin vaccine production should that become necessary.

Minnesota
The other case of novel influenza A virus infection was reported by Minnesota, and is associated with a different influenza virus; an influenza A (H1N2) virus that circulates in swine  in the United States, but does not normally infect or cause illness in humans. This case also was in a child. This is only the second case of human infection with this novel influenza A (H1N2) virus reported to CDC since novel influenza virus infections became nationally notifiable in 2007. The first such case was identified in Michigan in 2007. By some characteristics, this H1N2 virus is close to human influenza A (H1N1) viruses called “A/New Caledonia /20/99-like,” which circulated and caused illness among people as recently as 2007. As a result, people who were exposed to A/New Caledonia/20/99-like viruses may have some existing immune protection against the virus detected in Minnesota. Again, no direct or indirect contact with swine has been reported with this case, implying that limited human-to-human transmission may have occurred in this instance as well.

Detection of Swine Influenza Infections in Humans
Human infections with novel influenza A viruses normally found in swine are rare events. Recently, however, the frequency of such detections has increased. This could be occurring for a number of reasons, including one or more of the following factors: First, laboratory methods for testing for these viruses in the United States were improved following the 2009 H1N1 pandemic. These improvements may be resulting in viruses being identified now that would have gone undetected previously. Second, this could be due to increased surveillance in the United States for influenza at this time of year. CDC has requested that states analyze, and then send, their first influenza virus specimens of the season for seasonal influenza surveillance purposes. This practice, coupled with very low levels of seasonal flu activity at this time, could mean that sporadic novel influenza infections are more likely to be tested. Third, it is possible that the increased frequency of detection of novel influenza viruses with swine origins identified by CDC represents a true increase in the number of such cases, possibly occurring from exposure to infected swine  or through subsequent, limited human-to-human transmission.

The novel influenza A (H1N2) virus identified in Minnesota is known to circulate in U.S. swine herds. While the prevalence of the novel influenza A H3N2 virus with the 2009 H1N1 M gene in swine is unknown, the virus has been detected in U.S. swine through the United States Department of Agriculture’s swine influenza surveillance program.

In response to recent human infections with novel influenza viruses, CDC would like to convey the following information:

1. 1. CDC recommends an annual seasonal flu vaccine to protect against seasonal influenza viruses; however, a seasonal flu vaccine is unlikely to protect against flu viruses that normally circulate in swine.
2. There are two FDA–cleared drugs that are expected to be effective in treating illness associated with these viruses. The antiviral drugs oseltamivir and zanamivir – which are used to treat infection with human seasonal influenza viruses – also have shown activity against influenza viruses from swine. (For more information about influenza antiviral medications, please see www.cdc.gov/flu/antivirals/whatyoushould.htm )
3. Influenza has not been shown to be transmissible to people through eating properly handled and prepared pork (pig meat) or other products derived from pigs. For more information about the proper handling and preparation of pork, visit the USDA website fact sheet “Fresh Pork From Farm to Table.”

At this time, CDC recommends the following:

1. People who experience flu symptoms following direct or close contact with swine and who require medical attention (see below) should mention this exposure to their doctor or health care provider. (A list of flu symptoms is available at www.cdc.gov/flu/about/disease/symptoms.htm.)
2. For people who have NOT had exposure to swine and develop ILI, CDC’s recommendations for seeking treatment are the same as they are for seasonal influenza.
   1. If you have symptoms of flu and are very sick or worried about your illness contact your health care provider.
   2. Certain people are at greater risk of serious flu-related complications (including young children, elderly persons, pregnant women and people with certain long-term medical conditions) and this is true both for seasonal flu and novel  flu virus infections. (For a full list of people at higher risk of flu related complications, see www.cdc.gov/flu/about/disease/high_risk.htm.) 
   3. If these people develop ILI, it’s best for them to contact their doctor. (The majority of recent novel influenza A (H3N2) cases have been in children.)
   4. Your doctor may prescribe antiviral drugs that can treat the flu. These drugs work better for treatment the sooner they are started.

More information about swine influenza and links to all previous reports related cases of novel influenza A (H3N2) viruses infections are available on the CDC swine influenza website at www.cdc.gov/flu/swineflu/index.htm.

Source: http://www.cdc.gov/media/haveyouheard/stories/novel_influenza.html

Samawa - Shaker Alaaajipa
A source at the Department of Health Muthanna, the death of two children of one family suspected Basapthma bird flu, also pointed to the existence of four goals with the symptoms themselves under observation and intensive care.
The source said in a hospital in Samawah (morning): The «two girls of one family in the area of Al Bogerad of the hand Suer who died as a result of disease suspected bird flu ».
He noted that the Health Department Muthanna did not confirm they got sick himself, but expressed reservations on the subject, noting that the state of the two girls discovered after the spread of the disease completely in over their bodies .
The source explained »The first child was suffering from high temperatures and deficits in the kidneys, which led to her death after a washing process renal her two hours ago.
The source «to a death in the same area in terms of Suer ten days ago due to similar symptoms, as said her sister also suffer these symptoms lying in a hospital birth, and children in Samawa, in addition to another child of the same family also suffer from high temperatures but stable condition, to some extent ».
and said: «We got information from the region have the field of poultry in the vicinity of homes of those families witnessed the deaths of more than fifty chickens at the same time ».
For his part, said Nawaf Almhklari, Director of Health Information Muthanna (morning): «operation room was established under the guidance and supervision of the Director General of Health Muthanna for this purpose at a time when taking a sample of deceased and sent to the Central Health Laboratory in Baghdad to make sure the cause of death.
He said that the first child died after suffering from acute renal failure as initial diagnosis, while suffered the second case of high temperatures, which led to her death within 24 hours, confirming the presence of four cases under the viewing and intensive care and it's stable.

originaly Posted by Commonground .

http://pandemicinformationnews.blogspot.com/2011/11/iraq-h5n1-suspected-human-cases.html

The death of two girls in Muthanna suspected bird flu and
كتبها aliraqnews3 By aliraqnews3
الأربعاء, 23 نوفمبر 2011 14:55 Wednesday, November 23, 2011 14:55

المثنى - شبكة اخبار العراق - كشف مصدر في دائرة صحة المثنى عن وفاة طفلتين من عائلة واحدة يشتبه بإصابتهما بمرض انفلونزا الطيور كما اشار إلى وجود اربع اصابات تحمل الاعراض نفسها تحت المشاهدة والعناية المركزة. Muthanna - Iraq News Network - A source in Al Muthanna Health Department for the deaths of two children of one family Basapthma suspected bird flu, also pointed to the existence of four goals with the same symptoms under observation and intensive care.

وقال مصدر صحي في مستشفى السماوة ان طفلتين من عائلة واحدة في منطقة آل بوجراد التابعة لناحية السوير توفيتا نتيجة الإصابة بمرض يشتبه إنه انفلونزا الطيور.وأشار إلى أن دائرة صحة المثنى لم تؤكد اصابتهما بالمرض نفسه، لكنها تحفظت على الموضوع.
He said a healthy source of Samawa in the hospital that the two children of one family in every area of ​​the hand Bogerad Suer who died as a result of disease suspected bird flu. He pointed out that Muthanna Health Department did not confirm they got sick himself, but expressed reservations on the subject.

مبينا أن حالة الفتاتين اكتشفت بعد انتشار المرض بشكل كامل في أنحاء جسديهما.واوضح المصدران الطفلة الاولى كانت تعاني من ارتفاع درجات الحرارة وعجز حاد في الكليتين ما أدى الى وفاتها بعد اجراء عملية الغسل الكلوي لها بساعتين تقريباً.وأشار الى حدوث حالة وفاة بالمنطقة نفسها في ناحية السوير قبل عشرة ايام نتيجة لأعراض مشابهة، كما ان شقيقتها تعاني أيضا هذه الاعراض وهي ترقد بمستشفى الولادة والاطفال في السماوة اضافة الى طفلة اخرى من العائلة نفسها تعاني ايضا من ارتفاع درجات الحرارة لكن حالتها مستقرة الى حد ما.وبين أن صحة السماوة حصلت معلومات من المنطقة بوجود حقل دواجن على مقربة من بيوت تلك العوائل شهد نفوق اكثر من خمسين دجاجة في آن واحد

Indicating that the state of the two girls discovered after the spread of the disease completely in over their bodies. He sources first child was suffering from high temperatures and deficits in the kidneys, which led to her death after a washing process renal her two hours ago. He pointed to a death in the same area in terms of Suer ten days ago due to similar symptoms, and that her sister also suffer these symptoms lying in a hospital birth, and children in Samawa, in addition to another child of the same family also suffer from high temperatures but stable condition, to some extent. and that the health of Samawa, obtained information from the region the existence of a field in the vicinity of poultry houses that families saw the deaths of more than fifty chickens at the same


التعليقات (1) Comments (1)
المثنى - السماوة Muthanna - Samawa
أرسلت بواسطة سجاد السماوي, نوفمبر 23, 2011 Posted by Sajjad heavenly, November 23, 2011

المرض ليس أنفلاونزا الطيور ولكن يشك أن يكون الحمى النزفيّه Disease is not Onfelonzha birds, but doubted that the hemorrhagic fever

An outbreak of an usually mild form of pneumonia has been reported among school-age children in Shelby County, southeast of Indianapolis.

Several of the children, primarily in elementary and middle schools, have been hospitalized, the Shelby County Health Department reports.

"At least 20 students have shown a similar chest x-ray pattern, and several have required hospital admission and treatment with intravenous antibiotics," said a news release from Shelby County health officials. "The affected students are distributed throughout Shelby County, and thus the disease is not associated with any one school or other specific location or activity."

The exact cause is unknown, but it is believed to be a type of "walking pneumonia," which comes from specific bacteria that does not respond to drug treatments including penicillin and cephalexin. The bacteria can be fought with drugs including erythromycin (also known as Z-Pak), fluoroquinolones (also known as Cipro, Levaquin), and tetracyclines.

Typical symptoms include fever, cough, bronchitis, sore throat, headache and tiredness, according to the Indiana State Department of Health's epidemiology resource center, which said walking pneumonia usually is mild and rarely requires hospitalization. Infections of the middle ear

also can result.

Symptoms may persist for a few days to more than a month, according to the state center. Symptoms begin 15 to 25 days after exposure and generally develop slowly, over a period of two to four days.

The State Department of Health provided local physicians with testing kits for the bacteria mycoplasma to help determine if it is the cause of the ailment, Shelby County authorities said. The bacteria are transmitted via droplets from coughs or other contact with saliva.

There are no vaccines to prevent mycoplasma pneumonia, the state reports.

Children with the ailment should stay home from school, the health department said.

"If your children have a cough and any of the symptoms above, please keep them home from school and seek evaluation from your primary care physician," the release said. "As always, cough into your sleeve, wash your hands frequently or use antibiotic hand gel, and dispose of tissues properly."

http://www.indystar.com/article/20111108/LIVING01/111080396/Pneumonia-breaks-out-among-Shelby-County-children?odyssey=mod|newswell|text|IndyStar.com|s

Atypical Pneumonia in Indiana Children Raise trH3N2 Concerns
Recombinomics Commentary 19:45
November 8, 2011
"Every time it went away it would always come back, and it was 102," said parent Kim Dickmann.

Her son Luke, 6, has pneumonia.

"When you start seeing chest X-rays with infiltrates, fluid in the lungs, you know this is more than just your typical illness," said Dr. Paula Gustafson, a Shelby county pediatrician.

Gustafson said she saw 15 possible cases of pneumonia last week and upward of five possible cases on Monday.

"We've had some of them complain about intense cough, tightness in their chest, they've been on a couple rounds of antibiotics, and they aren't getting better," she said.

The above comments describe an atypical pneumonia in elementary and middle school students spreading throughout Shelby County, Indiana.  The Shelby County health department is treating the outbreak as Mycoplasma, but as seen above, cases have a high temperature and are not responding to antibiotics and there has been no lab confirmations reported.  Moreover, at least five of the more than 25 symptomatic students have been hospitalized.

The age demographic matches that of most confirmed trH3N2 cases this year (six of the seven were 9 years of age or younger), of which two were in Indiana.  Media reports do not suggest these patients have been tested for influenza.

More information on testing would be useful.

Recombinomics Commentary 17:30
October 24, 2011

"The acquisition of the M gene likely occurred as a result of swine being co–infected with the swine influenza A (H3N2) virus and the human 2009 H1N1 virus".

The above comments are from the latest CDC “Have You Heard” which discusses the most recently reported trH3N2 cases (8M), A/Maine/06/2011.  This isolate increases the overwhelming evidence for the transmission of trH3N2 in humans, yet the CDC continues to cite swine involvement, which is not supported by data.

The sequence data provides compelling evidence for human transmission, and the evidence was initially made public in November, 2010 when the CDC released the sequence data on trH3N2 cases. The sequences were released just after the WHO issued a pager alter on two trH3N2 patients and the sequences (A/Wisconsin/12/2010 and A/Pennsylvania/14/2010) raised concerns. Many of the internal genes from cases were clustering phylogenetically, signaling adaptation to humans. However, the CDC put out its first “Have You Heard” on trH3N2, which suggested the two cases did not represent human transmission because of differences between the two sets of sequences.

Shortly after these assurances were given, another case was reported.  This case was in Minnesota and the sequences, A/Minnesota/11/2010, were closely related to the Wisconsin case, providing more evidence for human transmission.  This sequence data was strengthened by 2011 reports on additional 2010 cases.

The first data set came from the report of a second Pennsylvania case, A/Pennsylvania/40/2010, who developed symptoms less than a week prior to the Wisconsin case.  However, the sample was initially classified as seasonal H3N2, and additional analysis / reporting was delayed because of technical difficulties in growing the virus.  In week 4 of 2011 the case was reported as another trH3N2 case, and the sequence was closely related to the Wisconsin case, demonstrating clear clustering of sequences from human trH3N2.

The concern that this clustering signaled human transmission was confirmed in week 21, when the daughter of the Minnesota case was confirmed to have also been trH3N2 infected, even though she had no swine contract.  The CDC then acknowledged limited human transmission (additional family members were also symptomatic, but trH3N2 confirmations were reported as “inconclusive), and selected the isolate from the father as a pandemic H3N2 vaccine target.

However, the sequence data for human transmission was significantly strengthened, when sequences from the first 2011 trH3N2 case (2M), A/Indiana/08/2011, were released at GISAID without comment, other than a note mentioning the presence of an M gene segment from pandemic H1N1 (H1N1pdm09). The acquisition of the M gene was a concern because an independent reported cited the M gene as being critical for the jump of H1N1pdm09 from swine to humans.  Therefore, this acquisition could drive the jump of trH3N2 from swine to humans.  The sequences of the other genes also increased concerns.  5 gene segments (PB2, PA, HA, NP, NS) including H3 matched the most common 2010 human trH3N2 sequences, while the NA was closely related to the second Pennsylvania isolate (PA/14/2010) and the PB1 was related to two other human cases, A/Ohio/01/2007 and A/Ohio/02/2007, linked to the Huron County outbreak.  This, all seven of the trH3N2 gene segments matched prior human isolates, adding to the evidence of human adaptation.

The release of the Indiana sequence was followed by an early release MMWR which described the Indiana case (2M) as well as a 2011 case (2F), A/Pennsylvania/09/2011, who was from Schuylkill County in eastern Pennsylvania, but attended the Washington County agricultural fair in western Pennsylvania.  The Indiana case had no swine contact, but his caretaker contact with swine was cited as a potential trH3N2 source leading to limited human to human contact.  However, the caretaker and associated swine were asymptomatic, so no true link was established.  Similarly, the Schuylkill resident attended an agricultural fair, but no symptomatic swine was identified.  The MMWR also cited sequence differences between the Indiana and Pennsylvania cases, suggesting the infections did not come from a common source.  However, both sets of sequences had the same constellation of genes, including the M gene from H1N1pdm09, as well as matches for all 7 trH3N2 gene segments.

The early release MMWR was followed by another “Have You Heard” which described two addition cases (both 9F), A/Pennsylvania/10/2011 and A/Pennsylvania/11/2011, which had the identical set of gene segments.  These three cases from the same county fair represented the largest number of trH3N2 isolates from a single location.  However, the investigation, which the CDC characterized as “intensive”, failed to identify a source for any of the 2011 cases.

The release of the sequences from the 2011 trH3N2 cases in Pennsylvania strongly supported human transmission.  Although the sequences from PA/09/2011 signaled a different source, the sequences from the other two cases, PA/10/2011 and PA/11/2011, were virtually identical to each other as well as IN/08/2011, even though the Indiana case was a month earlier and at a location 100’s of miles away.  The sequence identity between these three cases, which were not epidemiologically linked, strongly supported sustained transmission, and the identical constellation of genes in the third Pennsylvania case strong supported human adaptation.

The support was increased with the report of the 5th trH3N2 case (8M), A/Maine/06/2011, which also had the M gene from H1N1pdm09.  The sequences confirmed that the identical constellation of genes was involved, although several gene segments began evolving away from the 2010 human trH3N2 sequences at an earlier data, strongly suggesting that this novel trH3N2 represented a new human contagion, and represented sustained transmission.

The CDC has denied sustained transmission based on epidemiological data, which was generated using the same approach that failed to identify a source for any of the 5 2011 trH3N2 cases.  The linkage to swine was based solely on the pseudo linkages, which led to trH3N2 testing, which is only done by the CDC and is limited to samples received, which are flagged due to pseudo linkage to swine, including the Indiana case which had no direct linkage, and the other four cases who had attended fairs where asymptomatic swine were exhibited.

However, no symptomatic swine have been identified at these fairs, and no swine have been identified with the constellation of genes found in all five human cases from three states (Indiana, Pennsylvania, and Maine).

Thus, in spite of this lack of any real data linking human trH3N2 to trH3N2 infected swine, the CDC continues to statements such as the one quoted above, which are based on hopes and dreams, and lack any real data.

Virus Involved in Cuban Dissident’s Death Is Spreading

HAVANA – Cuban health authorities warned Saturday that two flu viruses are spreading on the island that particularly affect the elderly and babies, one of which struck Laura Pollan, leader of the Ladies in White, who died a week ago.

"At the moment the flu viruses that are spreading are the H3N2 that chiefly affects the adult population, and respiratory syncytial virus that affects children of less that a year old, causing bronchial complaints in some babies," the official daily Granma said Saturday in an article about seasonal flu.

"That does not exclude either of these pathogenic agents from afflicting people of any age," the report adds, without ever mentioning the case of Pollan.

Last Oct. 14 the leader of the Ladies in White dissident group, Laura Pollan, 63, died after suffering respiratory failure and diabetic decompensation combined with respiratory syncytial virus, a type of dengue and her chronic diabetes, members of her family said at the time.

An official government "blog" mentioned Pollan's death, citing the head of the intensive care unit where the dissident was hospitalized for a week, saying that the diagnosis was "pneumonia from respiratory syncytial virus, a bacterial respiratory infection and acute respiratory failure."

This past week, dissidents have expressed their doubts and suspicions about Laura Pollan's death, among them her companion and Ladies in White spokeswoman Berta Soler.

Several days ago, Soler told foreign media that during Pollan's hospitalization there was some confusion about whether or not she had dengue, and said that the test results took longer than expected.

In the article published Saturday, the public is advised to take preventive and hygienic measures to ward off flu, to see a doctor when the first symptoms appear and to remember that children and those older than 65, as well as people with chronic ailments, are the groups most at risk of possible complications, above all those derived from pneumonia.

Granma, the official organ of the Communist Party of Cuba, said that an anti-flu vaccine will soon be administered to the groups that are most vulnerable.

http://www.laht.com/article.asp?ArticleId=435385&CategoryId=14510

108CSR.com - The bird flu virus has claimed three victims in Bali, Wayan brothers Ari Aldiawan and Nengah Rica, along with their mother, Ni Wayan Purnami. All three are citizens of the Village Jehem, Bangli regency, Bali.


But the Governor of Bali, Made Mangku Pastika, not too worried about the bird flu virus will develop into a plague. According to him, Bali has been experienced to handle the bird flu virus. "We are very experienced. All appropriate SOPs already set standards. Living community participation needs to be improved to prevent the spread of the deadly virus," said Pastika in Bali Parliament House on Friday (21/10).

Pastika said the Provincial Government of Bali has been attempts to localize the birds and make the vaccine. "I appealed to the district government is also doing the same thing," he said. During this time, continued Pastika, has never been any protest from the central government and relevant international world of bird flu in Bali, because of all SOPs handling of bird flu has been conducted properly.

Meanwhile, the rapid test (rapid test) has shown, that the 62 villages in Bali have been infected. Rapid test were retested several times in a number of laboratories, and the result is the same, namely 62 birds in the area of bird flu positive.

http://www.108csr.com/home/news.php?id=2651

Recombinomics Commentary 23:15
October 21, 2011

CDC has confirmed the fifth case of human infection with a swine–origin influenza A (H3N2) virus that carries the M gene from the 2009 H1N1 virus. This virus was first detected in a child in Indiana in July. Subsequently three additional cases of human infection with swine–origin influenza A (H3N2) viruses carrying the same genetic change were detected in Pennsylvania. Though rare, human infections with swine–origin influenza viruses can occur, usually after close contact with infected swine.

While we know the M gene plays a role in influenza virus infection, assembly and replication, the significance of this change in these swine–origin influenza A (H3N2) viruses is unknown at this time. CDC continues to investigate the implications of this genetic change.

The above comments are from the latest “have you heard” put out by the CDC.  The statements represent an agency in the state of denial with regard to the human transmission of trH3N2.  They confuse reported trH3N2 with actual trH3N2 infections.  The association with swine is directly linked to the CDC trH3N2 testing which is largely limited cases with some kind of pseudo-link to swine.

The report acknowledges that the 5 trH3N2 in 2011 all involve the same trH3N2 virus which has an M gene from pandemic H1N1, but ignores the data indicating the M gene of pandemic H1N1 is critical for human transmission.

The CDC has yet to provide any direct evidence for human trH3N2 infections from swine in 2011.  The first case (from Indiana) has no known swine contact, and the CDC has acknowledged likely human to human transmission, which has also been acknowledged for the two most recent 2010 trH3N2 cases (father and daughter from Minnesota represent by A/Minnesota/11/2010 isolated from the father).

For the four most recent trH3N2 cases (in Pennsylvania and Maine) no link has been established between SOIV infected swine and the four cases.  The three Pennsylvania cases attended an agricultural fair (which is why they were tested for trH3N2), but no swine with symptoms or trH3N2 swine infections have been identified.  The same is true for the Maine fair in Cumberland County.  Moreover, no swine anywhere at any time have been identified with the human constellation, even though swine surveillance in 2010 and 2011 has been dramatically increased in the US.

Similarly, the CDC has failed to demonstrate that trH3N2 is rare in recent human H3N2 cases.  They have released sequences from 15 US H3N2 cases infected since July, and 5 of the 15 were trH3N2.

Thus, the CDC is relying solely on its heavily biased testing to claim the swine linkage.

Distribution of trH3N2 PCR kits to state labs is long overdue. 

Such state testing will determine the true extent and transmission of trH3N2 in humans in the US in the 2011/2012 season.

PORTLAND, Maine (AP) — An unusual strain of swine flu has infected five young children in Maine, Pennsylvania and Indiana, health officials said Friday.

A young boy of 7 or 8 from Cumberland County, Maine became the latest case when he came down with flu symptoms in early October, not long after being exposed to pigs at an agricultural fair, the Maine Center for Disease Control and Prevention said. He and the other four children have recovered, health officials said.

The H3N2 swine-origin strain was confirmed by the U.S. Centers for Disease Control as the same strain identified earlier in three cases in Pennsylvania and one case in Indiana, according to Maine's state epidemiologist Stephen Sears.

The three infected children in Pennsylvania had all attended an agricultural fair in August where pigs were exhibited, the CDC said. The Indiana child had not been exposed to pigs, but is thought to have been infected in late August by another person who had recently been exposed to pigs, but who did not have flu symptoms.

Unusual strains of influenza pop up virtually every year, health officials said, and there's nothing to suggest that this H3N2 strain is being widely transmitted from person to person. The infected boy in Maine was treated by a family doctor and is back up and playing, Sears said.

"We're taking a prudent public health approach to this," Sears said. "This is an unusual virus, but it doesn't appear to be spreading in people, so we don't think it's a major issue."

The first case of H3N2 was reported to the federal CDC in late August after a boy under 5 from Indiana experienced a fever, cough, shortness of breath, diarrhea and a sore throat. The boy was hospitalized for treatment and has since recovered.

Like humans, pigs can become infected with influenza viruses and suffer the same symptoms people do. Pigs can become infected not only with swine flu viruses, but with human and avian influenza viruses as well, the CDC says. On rare occasions, humans can become infected with swine flu viruses; the CDC says fewer than two dozen cases have been documented in the last five years.

The H3N2 virus contains a gene picked up from H1N1 swine flu virus that resulted in global pandemic in 2009, the first combination virus to turn up in people since the pandemic, according to the CDC. It is a hybrid of viruses that have infected pigs over the last decade.

Influenza viruses are constantly changing and picking up genes from other viruses, and the H3N2 strain represents a step in the evolutionary process of a virus taking on new genetic properties, said federal CDC spokesman Tom Skinner.

"Right now we don't see any widespread person-to-person transmission and that's the key when it comes to influenza cases," Skinner said.

Meanwhile, seasonal influenza activity remains low around the country with the arrival of seasonal flu season, the CDC says. The agency said earlier that this year's vaccine, the same as last year's, likely would not protect against the new swine strain.

http://www.southbendtribune.com/news/sbt-new-swine-flu-virus-sickens-5-children-in-3-states-20111021,0,3133475.story

Recombinomics Commentary 02:20
October 17, 2011
Wayan Aldiawan, 10, and his 5-year-old sister Nengah Rika Ani died Sunday after being treated for two days, Sanglah hospital official Elzarita Arbain said.

'Throat swabs and blood samples came back positive for H5N1,' he said, referring to the deadliest strain of bird flu.

The chief of the hospital's bird flu ward, Ken Wirasandi, said the children had contact with dead fowl in their neighbourhood in Bangli district.

The above comments describe a fatal H5N1 cluster in the Bangli district on the island of Bali in Indonesia. Although these fatalities have not yet been confirmed by the Indonesian Ministry of Health or WHO, confirmation of fatal cases is far more common than suspect cases that survive, including those confirmed locally.

This cluster is of concern because of reports indicating the mother of the above children has been hospitalized with symptoms, including a low platelet count, which is characteristic of H5N1 infections.  More detail on the mother and other symptomatic contacts would be useful.