Bird flu is spreading in poultry in Bangladesh. And Kuwait has had bird flu in its poultry but is hoping its cull of 1.7 million birds has stopped it. But not until four Bangladeshis working on the cull were hospitalized with possible bird flu infection. Isolation was undertaken because of blood tests. The Kuwaiti cullers are said to have received prophylactic Tamiflu and these workers were not reporting symptoms, but "preliminary tests" were positive (via crof's blog). More definitive tests are to come:
Preliminary tests for bird flu were positive on four Bangladeshi workers who had been culling infected chickens in Kuwait, a medical source said on Wednesday, but they have not been officially confirmed.This would be the first cases of bird flu affecting humans in Arab nations of the Gulf.
"The first test on the four men was positive," the source told AFP, requesting anonymity. "We have taken blood samples for a second test to reconfirm the initial results. We expect the outcome within hours.
"If the outcome is reconfirmed as positive, we will have to send blood samples to the World Health Organisation (WHO) laboratory in Cairo for a final confirmation," the source said. (AFP via Turkish Press)
Clinical specimens have been sent to a WHO reference lab in Cairo (presumably NAMRU3) for confirmation, results expected today.
Average Kuwaitis don't seem concerned. They are wealthy enough to make up the difference in domestic chicken and eggs with higher priced imported supplies.
More than a month after bird flu was detected, chicken and eggs are still on the menu in Kuwait, with imports assuring supply after two thirds of the Gulf Arab state's egg-laying hens were culled.
Kuwait has confirmed 106 cases of the deadly H5N1 strain in birds and banned the import of live birds. Poultry shops have been closed since the end of February and four Asian workers were hospitalised with suspected avian influenza on Tuesday.
But restaurateurs, scientists and poultry industry sources said that while poultry prices had risen, demand was being met with increased imports of frozen chicken from countries such as Brazil, India and France.
"There are no problems with supplies. People are still ordering eggs and chickens," said Rana al-Omani, who runs a fast food restaurant in downtown Kuwait City.
She said the price of fresh chicken breasts had risen by 50 percent and eggs by 20 percent in the last three weeks, but many consumers had not changed their eating habits. "I still eat chicken. I am not afraid of bird flu," said Kuwaiti engineer Badr, who was eating shawarma, a popular sandwich in the Middle East filled with grilled meat or chicken. (Reuters via Khaleej Times)
While Kuwait is more wealthy than most countries, the same pattern seems repeated elsewhere. The first brush with bird flu causes great public alarm. After that, it's a yawn.
Someone once told me their grandmother said you can get used to anything, "even a stone in your shoe." This seems true, most of the time. Of course, when the stone becomes the size of the Rock of Gibralter . . .
Update, 4/5/07, 11:50 am EDST: AFP now reporting four Bangladeshis do not have bird flu after failure to confirm by the WHO reference lab in Egypt. There seem to be conflicting reports as to whether they had flu-like symptoms or were asymptomatic. In any event, they are now declared as non-cases.
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Am I understanding this correctly..that they tested positive for H5N1, but are asymptomatic? In other words, it appears the Tamiflu is working prophylatically?
Patch: All we know at this juncture is that on the basis of a "blood sample" they were considered potentially infected, with more definitive confirmation pending. I don't know what this means, so will await clarification with the rest of you. The implication was that Tamiflu was used prophylactically and they are asymptomatic. Whether those two facts are related we don't know, either.
Patch
It was never going to work. The writing was on the wall a long time ago...
...its just that it was the expedient thing for our friends at the World Health Organization to do.
...and by the way, I believe some of those asymptomatic patients have been intubated.
Tom: Got a link? I haven't seen this info and it is clearly important.
Tom: Just updated. AFP says these are not H5N1 cases (link in the update). That's what I know at this point. If you have further or other information, please post in a comment.
Revere I'd be glad to if I had any idea how to do a link. /:0)
Go to Pandemic Flu Information and check the News Thread. I think Rick has some pictures.
Revere. The pictures are in a post at 2:13 on Apr. 4 News - pge three at Pandemic Flu Information Forum.
Tom - you need a little code to make a link show up as text, but all you really need is to copy and past the URL (web address) from the address bar on your browser. Here's a link to Effect Measure as an example:
http://scienceblogs.com/effectmeasure/
Long URLs may take more than one line, and so not be "active", but we can still copy and paste them into our own address bars, as long as the entire link appears.
Thanks caia.
I am 'computer challenged'.
Tom,
First, what do you mean, "It was never going to work?" I'm not sure how you can say that with such confidence? I can believe that Tamiflu may not continue to work forever, but never?
Can you refute the update posted by Revere? Intubated verses asymptomatic (or negative) is quite a contradiction! Somebody is getting bad information.
There are hundreds of Pandemic Flu Information forums. Which one are you referring to?
Thank you.
OK Tom, I think I found what you were looking at..was it this?
http://tinyurl.com/2hfosu (first page of the post)
I didn't take time to get too involved in the site or this particular post, but the first question that comes to mind is...what makes anyone thing that the pictures that they show are actually associated with these particular cases? Perhaps they are "file photos".
In either case, I'm not sure any of this is confirmed.
Patch
It is Pandemic Flu Information Forum.
In my opinion, we are now in the era of 'faith-based' science...we are to accept on faith whatever authorities decide to give us.
You accept what you want to accept and I will do the same...after all, this time it won't be a localized catastrophe like a hurricane...your extended family and mine will be affected.
The scientific facts are, in my opinion, that there was significant levels of Tamiflu resistance demonstrated to seasonal influenza before H5N1 showed up on the radar.
The scientific fact is that the odds of producing a vaccine involving chickens and eggs during a pandemic of avian influenza are close to zero. If you want to wait the eighteen months for that ship to come in...be my guest.
Since many of us are going to be directly involved in treating the sick...it is basically 'pick you poison'. I would rather depend on the sterile method than pharmaceutical preventatives.
Revere, I believe the initial tests were positive after they became "ill". Then they were given Tamiflu or as it was happening. Then they came back negative. My question, wouldnt Tamiflu reduce the viral load to the point that it might not be detectible in the blood or the airway(s)?
Roger that Tom. I have enough equipment for 20 people, estimating a filter per week in highly infectious environments and about two months before I see a resupply. They dont show with filters I will be heading home for the last decon of great pandemic.
Randy: I believe the workers were given Tamiflu prophylactically starting before their exposure. I have no way to know what that did or didn't do regarding whether they got sick or not. As far as we know, they were never infected with H5N1.
As I understand it, Revere is correct. The Tamiflu was administered as a prophylactic to workers who would be culling H5N1 infected poultry.
Randy, I'd be interested to know where you got your information that they became ill and THEN were given Tamiflu.
I've been away from the news, but the last I heard was they were H5N1 negative. Has that changed? Certainly, if they were H5N1 positive and the Tamiflu was ineffective, they'd be in serious condition and we'd be hearing about it.
Tom, I'm all about Faith. I'm a devoted, Christian man. Perhaps you are putting your "Faith" in the wrong authority? :-) OK, I won't go there.
On Tamiflu....I don't view Tamiflu as "a cure". But maybe a way to reduce symptoms to a survivable level.
On vaccine development, during a pandemic...I agree. Developing egg based vaccines will be of little help. Honestly, I think the whole thing will be over, before they get a vaccine developed with egg based technology. If they can get the cell thing going...then we might have a chance for some limited vaccine.
However, there may be something to PARTIAL immunity with existing vaccines or even some type of immunity through previous exposure to N1. So we can't throw existing vaccines our vaccine technology out entirely.
Effect Measure is the only BF site I frequent any more. I applaud their well balanced approach. I thank you very much.
I am continually concerned when people read too much into something. The official word is not always a conspiracy.
I know some of you hear the fat lady singing....I'm still enjoying the show.
The 4 workers who tested positive were reported asymptomatic in some news reports. Culling 1.7 mil birds takes many workers and Kuwait says all workers had blood samples screened, regardless of symptoms. The results now appear to be false positives, but MPs in Kuwait took it as a wake up call and - in light of growing discontent among scientists with current preventive measures - are organizing to consider more effective action (http://www.kuwaittimes.net/read_news.php?newsid=MTIwNDM1Njk5MA==). Because of culling, etc, Kuwait now imports most of it's chicken and eggs, and only the poor suffer for the slightly higher prices, so they can ban factory farming in favor of free-range production and so kill two birds (groan) with one stone.
Patch-Initial tests were positive and they took them down (its above). Then they took the blood apparently and then I guess went for the PCR/RT. I dont know the process but I have read that Tamiflu inhibits that particular test because it reduces the viral load. I dont know that to be fact but it would explain a lot of postive-negative-then positives again.
I havent read that any of them did turn flamingly symptomatic afterwards either. Tamiflu might indeed reduce the CFR's but I am sure if someone gets it they'll feel like they took a ride to the gates of Hell.
Patch
http://today.reuters.co.uk/news/CrisesArticle.aspx?storyId=DHA111101