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Centers for Disease Control Prevention

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European Centre for Disease Prevention and Control

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Center for Infectious Disease Research and Policy CIDRAP

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Pandemics


Bird Flu Pandemic - Fågelvirusinfluensa - and other pandemics


The Butterfly Defect:
the shocks to the global supply chain brought about in 2011 by the earthquake and tsunami in Japan and flooding in Thailand,
and the threat of pandemic posed by illnesses such as severe acute respiratory syndrome earlier this century.
How Globalization Creates Systemic Risks, and What to do About It
by Ian Goldin and Mike Mariathasan
Review by Shawn Donnan, FT, July 20, 2014

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Deadliest, Rarest Form of Plague Contracted Near Denver
an airborne version that can be spread through coughing and sneezing.
He may have contracted the illness from his dog
Bloomberg, July 11, 2014 5:09 PM GMT+0200

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www.cdc.gov/plague/


Ebola utom kontroll i Västafrika

Spridningen av den fruktade epidemin ebola är nu "utom kontroll" i Västafrika, med fler än 60 områden som är drabbade enligt organisationen Läkare utan gränser (MSF).

Nu varnar MSF för att viruset sprids på nya platser i Guinea, Sierra Leone och Liberia, med risk för ytterligare spridning.
-Epidemin är nu utom kontroll, säger Bart Janssen som leder MSF:s insatser.

"Omfattningen på den nuvarande ebolaepidemin är ojämförbar mot tidigare fall när det gäller antal döda" skriver MSF i ett uttalande.

142 SVT Text Måndag 23 jun 2014


The Ebola outbreak ravaging West Africa is “totally out of control,”
according to a senior official for Médecins Sans Frontières (MSF), who says the medical group is stretched to the limit in responding.
www.msf.org/

Ebola outbreak in west Africa ‘out of control’, warns aid group
Javier Blas, Africa Editor, Financial Times June 23, 2014


Ebola virus disease (EVD) now i Monrovia, capital of Liberia.
Symptoms include high fever, bleeding and central nervous system damage. Fatality rate can reach 90%.
Incubation period is two to 21 days. There is no vaccine or cure.
BBC 18 June 2014


H7N9
The "danger zones" in Asia which are vulnerable to a deadly bird flu have been mapped by scientists.
The H7N9 virus spread from birds to people and was first detected in March 2013 in China.
BBC 17 June 2014

New viruses are always a concern because of their unknown potential to spread round the world as a deadly pandemic.

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Five years after the 2009 H1N1 influenza virus emerged,
the world's ability to cope with a flu pandemic is a bit better than it was in April 2009, but there's still a long way to go,
says Harvey Fineberg, MD, PhD, who chaired the international committee that was assigned by the World Health Organization (WHO) to evaluate the global response to the pandemic.
The Center for Infectious Disease Research and Policy (CIDRAP; "SID-wrap"), 9 April 2014

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The number of people believed to have been killed by the Ebola virus in Guinea has passed 100,
the UN World Health Organization says.
It was "one of the most challenging Ebola outbreaks we have ever dealt with"

and could take another four months to contain, the WHO said.
BBC 8 April 2014

Full text at BBC

Lägesrapport hos WHO


Ebola outbreak in Guinea 'limited geographically' - WHO
BBC 1 April 2014

Outbreak of Ebola in Guinea and Liberia
CDC 30 March 2014

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On a spring morning in 1918 Private Albert Gitchell, a cook in the U.S. Army, woke up feeling unwell.
His throat was sore, his bones ached and he had a fever.
By midday, over one hundred other soldiers reported symptoms matching Gitchell's.
These were, it is claimed, the first recorded cases of the 1918 flu pandemic, or "Spanish Flu".
When it was over, up to 50 million people around the world had died from the disease
.
CNBC, 5 Feb 2014

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Svininfluensan går nu in i sin värsta fas. Minst tre personer har dött i Sverige. Fyra i Finland.
– Det är bara toppen av isberget. De flesta testas inte, så vi vet inte hur många som drabbats,
säger Hélène Englund, epidemiolog på Folkhälsomyndigheten.
Aftonbladet 13 februari 2014

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H10N8
New strain of 'deadly' bird flu
Scientists told The Lancet the potential for it to become a pandemic "should not be underestimated"
BBC 5 February 2014

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Antibiotics have transformed human health and saved millions of lives.
Now, as a result of overuse, they are no longer working.
The golden age of medicine has come to an end
Daily Telegraph 2014

Antibiotics are no longer effective. The drugs that have transformed life and longevity and saved countless millions since penicillin was discovered by Sir Alexander Fleming in 1928 now saturate every corner of our environment. We stuff them into ourselves and our animals; we spray them on crops, dump them in rivers, and even – as emerged at a meeting of science ministers from the G8 last year - paint them on the hulls of boats to keep off barnacles.

NATIONAL RISK REGISTER



The government’s list of the greatest threats facing the country.
Adding antibiotic resistance is being actively considered

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Despite progress, the world is still unprepared for a new pandemic disease
The risk of such an outbreak turning into a pandemic is low, but the danger, if it does, is huge:
in 1918 50m-100m people were killed by Spanish flu,
compared with 16m in the first world war and 30m so far from AIDS

The Economist print, April 20th 2013

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Första Världskriget


Influensarapporterna sammanfattar läget i Sverige och omvärlden.
De publiceras varje torsdag under influensasäsongen.
Folkhälsomyndigheten


Fågelinfluensa sprids åter i Kina
Totalt har omkring 250 fall av fågelinfluensa H7N9 rapporterats från Kina, varav 56 personer har avlidit.
Samtidigt rapporteras det om två fall av typen H10N8 som tidigare aldrig smittat människor.
Folkhälsomyndigheten 30 januari 2014

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Hong Kong has reported its first confirmed human infection of H7N9 avian influenza,
the strain of the virus that has killed 45 people in China this year.

Bloomberg, Dec 2, 2013 8:46 PM GMT+0100

The victim is a 36-year-old Indonesian domestic helper, who had traveled to the neighboring mainland Chinese city of Shenzhen, where she bought and slaughtered a chicken, Hong Kong’s government said yesterday in statement.
The woman is in critical condition in Hong Kong’s Queen Mary Hospital and her home contacts will be admitted to Princess Margaret Hospital for isolation and testing, Secretary for Food and Health Ko Wing-man said in the statement.

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There is no Plan Bee for when we run out of pollinators
Dave Goulson, FT, November 8, 2013

The writer is professor of biology at Sussex university and author of
A Sting in the Tale

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The deadly coronavirus that emerged last year does not currently
appear to be infectious enough to pose a global threat, researchers say.
BBC, July 5, 2013

Their analysis of 55 cases of Middle East respiratory-syndrome coronavirus, published in the Lancet, indicated the virus struggled to spread in people. But the virus may be mutating, which means it could become a much greater threat.
It is similar to viruses that cause Sars and the common cold.

The study indicated each patient would, on average, infect 0.69 others. So three infected patients would pass the virus on to just two people.

Prof Arnaud Fontanet told the BBC: "The virus as it currently stands is not able to start an epidemic.

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"Pandemic 2 is the sequel to the morbidly fun original Pandemic,
a game in which your goal is to eradicate the human race with the perfect disease."

Read about it here


Influensa slår mot landet – men toppen är inte nådd
Smittskyddsinstitutet (SMI) gör en egen webbmätning. Den pekar också spikrakt uppåt.
Som det ser ut nu kommer influensaaktiviteterna att öka och nå sin topp någon gång de närmaste veckorna,
säger epidemiologen Hélène Englund
Metro 7 februari 2013

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New AIDS-like Disease Emerges As Ebola Ravages Uganda, DR Congo
Guardian 25 August 2012

Indeed, outbreaks of Ebola haemorrhagic fever in Uganda and Democratic Republic of Congo has led to deaths of at least 27 persons and maimed others, while researchers have identified a mysterious new disease that has left scores of people in Asia and some in the United States of America with AIDS-like symptoms, even though they are not infected with HIV.

According to the study on new AIDS-like disease published Thursday in New England Journal of Medicine, the patients’ immune systems become damaged, leaving them unable to fend off germs as healthy people do. What triggers this is not known, but the disease does not seem to be contagious.

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Surveillance and outbreak reports
Using an outbreak to study the sensitivity of the surveillance of enterohaemorrhagic Escherichia coli and other enteropathic Escherichia coli in Bavaria, Germany, January to October 2011
H Englund, W Hautmann
Eurosurveillance, Volume 17, Issue 34, 23 August 2012

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Hong Kong is culling 17,000 chickens after three birds were confirmed to have died from
the deadly H5N1 bird flu strain in the past week.
BBC, 21 December 2011

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News


Bird flu fear as mutant strain hits China and Vietnam
BBC 29 August 2011

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News


Resistent tuberkulos sprids snabbt i Europa
Ekot 14 september 2011

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Början på sidan

Nyheter


"Contagion".
An action-thriller centered on the threat posed by a deadly disease and an international team of doctors contracted by the CDC to deal with the outbreak.
Click


SARS


Ett stort utbrott av fågelinfluensan, en pandemi, går inte att undvika.
Det sa FN:s samordnare för fågelinfluensa i Davos.
Ekot 31/1 2006

Hélène Englund
Master's thesis, KI:
Development of a serological diagnostic method for avian influenza




Regulators want big, complex banks to hold larger buffers of capital to protect the financial system.
Big banks argue this is unnecessary because risk is diversified across their larger balance sheets.
Who is right? Natural sciences – especially epidemiology, ecology and genetics – provide clues.
The writers are executive director for financial stability at the Bank of England,
and a professor of zoology at Oxford University and former British chief scientific adviser

FT February 20 2011

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Four pilgrims have died of swine flu as they take part in this year's annual Mecca pilgrimage, Saudi officials say.
The latest figures from the World Health Organization show the virus has so far killed 6,750 people worldwide.
BBC 21 November 2009

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See also CNN

Kommentar från en sakkunnig person:
Med anledning av den nya influensan utfärdade Saudiarabien reserekommendationer i ett försök att begränsa smittspridningen.
Mer om detta finns på WHO:s hemsida: http://www.who.int


It is feared viruses will spread quickly in the huge crowds at the Hajj
Two million Muslims converge on Mecca each year for the Hajj pilgrimage.
BBC 15 September 2009

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On April 25, Rod Daniels, the deputy director of the World Influenza Centre in London...
"I got back to the lab, and as soon as we saw a sequence of the hemagglutinin, we looked at the receptor binding site and found indications of an alpha-2,6 binding specificity,"
Daniels, 54, recalls. "I knew then — we have a problem."
Time, Aug. 11, 2009

On April 25, Rod Daniels, the deputy director of the World Influenza Centre in London, was at a meeting in Germany when he received a call from a co-worker: an influenza outbreak had been reported in Mexico and the first samples of the virus were on their way to London for examination. A virologist who has studied flu for more than 30 years, Daniels knew exactly what he was looking for. Influenza A viruses — the type that can cause pandemics — use a protein called hemagglutinin to bind to the cells of their animal hosts. When a virus jumps from animals to humans, its contagiousness is largely determined by what is called the "binding specificity" of this protein. An alpha-2,3 binding specificity means the virus is well suited to the cells in an animal respiratory tract but probably not human cells. An alpha-2,6 binding specificity, on the other hand, means the virus can easily bind to human cells.

"Right now this pandemic would appear to be a mild one," says the center's director, Alan Hay, 65. "But influenza viruses can change quite suddenly. And there's no reason another, more dangerous virus couldn't emerge with pandemic potential. It's crucial that we keep our eye on the ball."

Hay's team is also on the lookout for changes in the virus that might make it resistant to the antiviral drug Tamiflu, which has been shown to reduce the severity of the disease caused by many flu viruses. Tamiflu works by inhibiting the neuraminidase enzyme (that's the N in H1N1) and preventing it from doing its job of helping the virus replicate once inside a human cell. But certain amino-acid changes in the neuraminidase can render Tamiflu ineffective

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Swine flu:
How serious a threat?
PROFESSOR NEIL FERGUSON, WORLD HEALTH ORGANIZATION:
We might expect up to 30-40% of the population to become ill in the next six months if this truly turns into a pandemic
BBC 28/4 2009


WHO höjer, för första gången, pandemivarningsnivån från fas 3 till fas 4
Världens länder bör därmed övergå från förberedelser till genomförandet av beredskapsplaner.
Viruset har redan spridits så snabbt och långt att det inte helt kan slås ut
SvD 28 april 2009

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Swine Flu: 5 Things You Need to Know About the Outbreak
Time 27/4 2009

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Outbreak in Mexico, and so on
The World Health Organization has confirmed that at least some of the cases are a never-before-seen version of the H1N1 strain of influenza type A.
H1N1 is the same strain which causes seasonal outbreaks of flu in humans on a regular basis.
But this latest version of H1N1 is different: it contains genetic material that is typically found in strains of the virus that affect humans, birds and swine.
Flu viruses have the ability to swap genetic components with each other, and it seems likely that the new version of H1N1 resulted from a mixing of different versions of the virus, which may usually affect different species, in the same animal host.

BBC 26/4 2009

U.S. prepares for possible swine flu epidemic as global cases rise
CNN 27/4 2009

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A most unfortunate logo...


Fågelinfluensa av den fruktade virustypen H5N1 har påträffats hos fåglar i Brandenburg utanför Berlin.
Saudiarabiens jordbruksdepartement har beordrat att 13.500 strutsar ska avlivas efter ett nytt utbrott av fågelinfluensa i kungadömet.
TT-AFP/DN 2007-12-16

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Some 24,000 birds on four premises are being culled as a precaution
after the virulent H5N1 strain of bird flu was found in turkeys on a Suffolk farm.
BBC 2007-11-14


Outbreak
Nearly 160,000 turkeys will have been gassed to contain the outbreak
The H5N1 strain was similar to a case in geese in Hungary in January.
BBC 5/1 2007

There are suggestions the most likely way for the virus to have been spread by wild birds. But BBC environment correspondent Sarah Mukherjee said migration does not take place at this time of year and there were no indications of an EU outbreak from monitoring programmes.

Full text with links

Similar at CNN

Början på sidan - Top of page


ECB warns of hedge funds risk to stability
in the same category as a possible bird flu pandemic
Financial Times 2/6 2006

Hedge funds have created a “major risk” to global financial stability for which there are no obvious remedies, the European Central Bank warned on Thursday in one of the bluntest official statements yet on the rapidly growing sector.

In a clear hint of rising official nervousness about the multi-billion-dollar industry, the ECB ranked an “idiosyncratic collapse of a key hedge fund or a cluster of smaller funds” in the same category as a possible bird flu pandemic as the types of shocks that could trigger fresh disruption in financial markets.

The comments came in the Frankfurt-based central bank’s latest “financial stability review”, which for the first time included a special section on hedge funds.
The review highlighted an increasing tendency by funds to mimic strategies followed by others. It noted that the correlation of hedge fund returns had “surpassed levels seen just before the near-collapse of Long Term Capital Management in 1998”.

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Hedge Funds

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Avian influenza – situation in Indonesia – update 14
WHO 23 May 2006

Full genetic sequencing of two viruses isolated from cases in this cluster has been completed by WHO H5 reference laboratories in Hong Kong and the USA. Sequencing of all eight gene segments found no evidence of genetic reassortment with human or pig influenza viruses and no evidence of significant mutations. The viruses showed no mutations associated with resistance to the neuraminidase inhibitors, including oseltamivir (Tamiflu).

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Början på sidan


UN: Bird flu has spread in Burma with more than 100 outbreaks
The situation was "more serious than we imagined".
BBC 10/4 2006

He said the outbreaks were mainly in the central district of Mandalay and the northern district of Sagaing.

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Början på sidan


Den aggressiva varianten av fågelinfluensan, H5N1, fortsätter att sprida sig i Afrika.
I Burkina Faso i närheten av huvudstaden Ouagadougou.
Ekot 4/4 2006

I Burkina Faso har tre fall konstaterats på en fjäderfäfarm i närheten av huvudstaden Ouagadougou. Burkina Faso är det femte afrikanska landet som drabbas. Tidigare har smittan hittats i Nigeria, Niger, Egypten och Kamerun.

Att smittan sprider sig i Afrika oroar experterna, eftersom länderna där är dåligt rustade för att vidta skyddsåtgärder.

Burkina Faso

Ouagadougou


Den farliga formen av fågelinfluensan H5N1 uppstod med största sannolikhet i södra Kina.
Samma område har också störst potential i hela världen att starta en helt ny influensaepidemi bland människor, en så kallad pandemi.
Karin Bojs, DN 3/3 2006

Genom att jämföra små skillnader i virusets arvsmassa har forskarna kunnat bygga släktträd och rekonstruera H5N1:s historia. Det började för cirka tio år sedan i södra Kina.

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Början på sidan


"Nu besannas forskarnas skräckscenario. Den farliga formen av viruset H5N1 sprider sig som en löpeld över världens fattigaste kontinent Afrika"
Karin Bojs, DN 27/2 2006

- Nu besannas forskarnas skräckscenario. Den farliga formen av viruset H5N1 sprider sig som en löpeld över världens fattigaste kontinent Afrika. Niger är extremt fattigt även med afrikanska mått. Här finns mycket små möjligheter att begränsa en smitta. Ända sedan smittan upptäcktes bland vildfåglar i Sibirien och Ryssland i somras har forskarna våndats och sagt: "bara den inte sprids till Afrika".

Och vad är problemet?
- För det första att smittan nu är omöjlig att begränsa. Den kommer att spridas både av vilda fåglar och av tamfåglar som folk transporterar till olika platser.

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Början på sidan


"We have absolutely no control over the introduction of the virus by migratory birds that are about to start returning from Africa to Siberia, Scandinavia and Greenland," said French food safety agency panelist Jean Hars.
"It is unavoidable," he told AFP.

Health commissioner Marko Kyprianou, attending the two days of talks with health experts from EU member states, underlined that there is unlikely to be an early end to the cases of bird flu. "Given that the spring migration will begin soon we will review again the situation to see if there's need for additional methods ... We shouldn't be surprised if we have more migratory wild birds with this virus," he said. "There's no need to panic," he warned.

Europe urges calm as bird flu spreads further


New vaccine offers hope against H5N1
Herald Tribune 2/2 2006

Scientists said they have produced a vaccine against the H5N1 strain of bird flu that has protected mice, using a genetic engineering technique that can be easily scaled up for stockpiling the drug to prepare for a pandemic.

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Scientists console us that, while the virus has mutated since the first Asian cases of 2003, there is no evidence that it has mutated into something that can be transmitted by human-to-human contact. But this is true only in a sense.
To the scientist, the important issue is whether the flu can break free of its avian origins and reproduce itself with purely human hosts.
Christopher Caldwell, Financial Times, January 14 2006

Rationality and irrationality are not synonyms for moderation and overreaction. People have a difficult time imagining themselves felled as random victims of natural processes. So calm, cool and collected people may irrationally underestimate the possibility of bad things happening.

Fear can be reasonable, which is to say measured and protective. Or it can take the form of panic – misguided, embarrassing and even dangerous. Everyone would like to promote the former kind over the latter. The problem is that no philosopher, politician or scientist has ever come up with a reliable way to tell rational and irrational fears apart.

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Global bank HSBC believes that as many as half its staff could be knocked out of action by a bird flu pandemic.
BBC 10/1 2006

HSBC has 253,000 staff worldwide and operates in 77 countries. Its business in Asia was affected by the outbreak of the Sars virus in 2003.

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Sverige ska starta egen produktion av vaccin.
Morgan Johansson: Vi vet att om vi skulle få en pandemi sprids den väldigt snabbt.
Ekot 13/12 2005

Därom rådde politisk enighet när folkhälso- och socialtjänstminister Morgan Johansson bjöd in samtliga riksdagspartier för en diskussion om den svenska beredskapen vid en eventuell global epidemi av till exempel fågelinfluensa.

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Lennart Nilsson pictures of The Virus H5N1
Dagens Nyheter kan nu som första tidning visa hans bilder.
DN 6/11 2005

Pernilla Petersson, som är biomedicinsk analytiker, har odlat viruset i Smittskyddsinstitutets säkerhetslaboratorium. Därefter har hon avdödat viruset och gett preparaten till Lennart Nilsson.

Han har kämpat i många dagar vid sitt svepelektronmikroskop - djupt nere i en källare på Karolinska institutet.

Just detta virus har smittat och dödat inte bara tiotusentals fåglar, utan också två människor: en far och hans dotter. De dog för två år sedan.

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CNN takes in-depth look at bird flu
In an insightful special program hosted by Stan Grant, "Bird Flu, Preventing a Pandemic," CNN International correspondents report from Asia, Europe and America on the threats, fears and potential cures around the virus
November 3, 5 and 6, 2005

EUROPE/MIDDLE EAST/AFRICA (GMT)
Thursday, November 3: 1400 & 1800
Saturday, November 5: 1800
Sunday, November 6: 2200

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President Bush announced Tuesday that he would ask Congress for $7.1 billion in emergency funding to prepare the country for a possible flu pandemic.
"A pandemic is a lot like a forest fire," Bush said. "If caught early, it might be extinguished with limited damage; if allowed to smolder undetected, it can grow to an inferno that spreads quickly beyond our ability to control it."
"En gnista kan tända en präriebrand"
CNN 2/11 2005

The administration's plan provides funding for early detection, containment and treatment of an outbreak. It also calls for improving the process of creating flu vaccines and stockpiling antiviral drugs.

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En enda gnista kan tända en präriebrand
Valda Verk av Mao Tse-tung, Band I
Klicka här

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UN says avian flu may hit Africa next
Governments and farmers in these parts of the world, particularly in East Africa, are unprepared, lacking both the money and scientific infrastructure to control outbreaks of the virus
The next stops on bird migratory pathways are not in western Europe, but in the Middle East, North Africa and East Africa, UN officials said.
Elisabeth Rosenthal International Herald Tribune 20/10 2005

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On Thursday October 20th, Indonesia's health minister, Siti Fadillah Supari, expressed concern over clusters of possible bird flu within human families that had been detected in the country in recent days.
She said such clusters, if confirmed, could mean that the virus's transformation into a form more threatening to humans may now have happened.
The Economist, Thursday October 20 2005

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Quarantines work well at controlling the spread of some types of disease. But there isn't any quarantine that would help stop pandemic flu.
Wendy Orent, Author, Plague: "The Mysterious Past and Terrifying Future of the World's Most Dangerous Disease"
Washington Post 16/8 2005

The very term quarantine can be misunderstood (not to mention the military's role). Did the president mean gathering those exposed to flu in a single location and forcing them to stay there? Did he mean isolating them in their homes? Cordoning off whole communities where cases crop up? Not all quarantines are alike; each carries its own risks and benefits.

It is hard to imagine how the military would oversee a quarantined area. If a health worker, drug addict or teenager attempted to break the quarantine, what would soldiers do? Shoot on sight? Teenagers and health workers were the people who most often violated quarantine rules in Toronto during the severe acute respiratory syndrome (SARS) scare in 2003. Moreover, the use of a quarantine to control a flu pandemic isn't only a potential threat to life and civil liberties; it's also a waste of money, resources and time. The reason: There isn't any kind of quarantine that will do any good - at least not for a pandemic influenza.

Quarantine, from the Italian "quarantina," which means "space of 40 days," dates from 15th-century regulations devised in certain Italian cities to control the spread of plague by sequestering those thought to have been exposed to the disease. Along with isolation -- secluding those who are clearly sick -- it can be an effective tool for controlling outbreaks of certain types of disease.

Influenza is entirely different. The virus spreads explosively. Coughing, sneezing, or even speaking launches flu particles in an aerosol cloud of tiny droplets, which can drift in the air for some distance. Physician and flu researcher Edwin Kilbourne, who worked with flu patients during the pandemic of 1957-58, points out that people with flu may shed the virus even before they know they're sick -- not much, but enough to transmit the disease. Worse, some 10 to 20 percent of flu patients have subclinical infections; they never look sick at all. Yet they can still spread infection. Faced with a flu pandemic, you'd hardly know where the disease was coming from.
How can you quarantine a disease like that? According to Kilbourne, you can't.

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Plague: "The Mysterious Past and Terrifying Future of the World's Most Dangerous Disease"

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Många fruktansvärt hemska saker kan drabba Sverige. Terrorister kan slå till med kärnvapen. En pandemi kan dra in över landet. En komet kan slå ner.
Pandemier kan uppenbarligen vara oerhört farliga.
Men hur stor är egentligen risken att vi drabbas?
SvD-ledare 15/10 2005


Sir Liam Donaldson, the chief medical officer:
A bird flu pandemic will hit Britain, it would probably kill about 50,000 people in the UK
and a death toll of 750,000 was "not impossible".
BBC 16/10 2005

A bird flu pandemic will hit Britain - but not necessarily this winter, the chief medical officer has said.
Sir Liam Donaldson said a deadly outbreak would come when a strain of bird flu mutated with human flu.
He told the BBC's Sunday AM show it would probably kill about 50,000 people in the UK, but the epicentre of any new strain was likely to be in East Asia.

"We can't make this pandemic go away, because it is a natural phenomenon, it will come," he said.

"But what we can do is to limit its impact."

If a new strain did hit the UK before a vaccine was created, Sir Liam said an extra 50,000 would probably die - and a death toll of 750,000 was "not impossible".

Sir Liam said flu pandemics were things which came in "natural cycles" every 10 to 40 years, with the last taking place in 1968/69.

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Anders Tegnell, enhetschef på Socialstyrelsens smittskyddsenhet: Svenskarna prioriteras efter en plan
Inte ens alla i regeringen kan vara säkra på att få medicin.
- Fem ministrar räcker för att regeringen ska kunna fatta beslut
Aftonbladet 15/10 2005

Svenskarna prioriteras efter en plan som Krisberedskapsmyndigheten och Socialstyrelsen har utarbetat. Förutom gamla och sjuka kommer 325 000 svenskar med nyckelpositioner i samhället att få medicin.
-I vår grundplan ska fem procent av personalen på de aktuella arbetsplatserna ingå. Det ska täcka en minimibemanning som kan klara grunden i verksamheten, säger Anders Tegnell.

Kolla, finns du med på listan?

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Många fruktansvärt hemska saker kan drabba Sverige. Terrorister kan slå till med kärnvapen. En pandemi kan dra in över landet. En komet kan slå ner.
Pandemier kan uppenbarligen vara oerhört farliga.
Men hur stor är egentligen risken att vi drabbas?
SvD-ledare 15/10 2005



Europe is not properly prepared for a flu pandemic and has inadequate supplies of vaccines and antiviral drugs, says an internal European Commission document obtained by the Financial Times.
FT 15/10 2005

The internal EU document says 16 of the 25 members have informed Brussels about their supplies of antiviral drugs, to be used if avian flu jumps to humans. There are 10m doses in the EU and European Economic Area (Norway, Iceland and Liechtenstein), and a further 36m to be delivered by the end of 2007 enough for about 10 per cent of the EU population, against World Health Organisation recommendations for 25 per cent coverage.

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From Washington and Brussels to Hong Kong and Bangkok, governments have belatedly woken up to the global threat presented by the H5N1 strain of avian influenza now endemic in poultry across much of Asia.
Financial Times editorial 10/10 2005

By far the most important step governments can take is to improve surveillance of bird and human populations to enable doctors to stamp out any human outbreak of the disease before it spreads. Health experts believe a combination of quarantine, antiviral drugs and vaccination could stall an incipient epidemic - but only if an outbreak is swiftly identified.


A plan developed by the Bush administration to deal with any possible outbreak of pandemic flu shows that the United States is woefully unprepared for what could become the worst disaster in the nation's history.
A draft of the final plan, which has been years in the making and is expected to be released later this month, says a large outbreak that began in Asia would be likely, because of modern travel patterns, to reach the United States within "a few months or even weeks."
New York Times 8/10 2005

If such an outbreak occurred, hospitals would become overwhelmed, riots would engulf vaccination clinics, and even power and food would be in short supply, according to the plan, which was obtained by The New York Times.If such an outbreak occurred, hospitals would become overwhelmed, riots would engulf vaccination clinics, and even power and food would be in short supply, according to the plan, which was obtained by The New York Times.

The 381-page plan calls for quarantine and travel restrictions but concedes that such measures "are unlikely to delay introduction of pandemic disease into the U.S. by more than a month or two."

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America's top health official says the world is "woefully unprepared" to respond to a pandemic, a problem made more urgent by concerns that the current avian flu virus could spread into a global health crisis.
CNN 6/10 2005

"The world is woefully unprepared," Mike Leavitt, the U.S. secretary of health and human services, told CNN Thursday.

Leavitt, who is hosting the event along with U.S. Global Affairs Undersecretary Paula Dobriansky, said officials were trying to devise a comprehensive surveillance plan so that the virus could be monitored closely, allowing for a quick response if it was seen to be spreading.

That way, he said, "if it happens in Thailand or Laos or Cambodia, the rest of the world can go there and help them contain it. Containment is our first strategy."

President George W. Bush has said aggressive action would be needed to prevent a potentially disastrous U.S. outbreak of the disease. But his call for Congress to give him the power to use the military in law enforcement roles in the event of a bird flu pandemic has been criticized as akin to introducing martial law.

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Spanska sjukan var fågelinfluensa
Amerikanska forskare har återskapat det virus som orsakade spanska sjukan – influensaepidemin som dödade omkring 50 miljoner människor 1918.
DN Karin Bojs 5/10 2005

För åtta år sedan for den svenskfödde, då sjuttiotreårige läkaren Johan Hultin till Alaska och grävde i den ständigt frusna jorden efter en massgrav från 1918.

Johan Hultin gav vävnadsprovet till molekylärbiologen Jeffrey Taubenberger och hans medarbetare vid amerikanska arméns patologiska institut. De har sedan lyckats kartlägga virusets gener, in i minsta beståndsdel. Hittills har Taubenberger publicerat information om fem gener. I dagens nummer av tidskriften Nature beskriver forskargruppen de återstående tre generna

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President Bush on the possibility of an avian flu pandemic
"I'm concerned about what an avian flu outbreak could mean for the United States and the world,"
- Such an deadly event would raise difficult questions, such as how a quarantine might be enforced, he said.

"One option is the use of a military that's able to plan and move," he said. "So that's why I put it on the table. I think it's an important debate for Congress to have."
CNN 5/10 2005

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U.N. backs off 150m flu deaths
World Health Organization said it was impossible to estimate how many people could die from a possible new pandemic triggered by bird flu.
On Thursday, Dr. David Nabarro said a pandemic could come at any time and claim anywhere between 5 million and 150 million lives depending on the world's response to bird flu.
CNN 30/9 2005

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A girl with symptoms of bird flu died in a Jakarta hospital on Wednesday as the Indonesian government announced it would carry out mass culling of poultry in high-risk areas
A US government fact-finding team from the Centers for Disease Control and Protection and other agencies arrived in Jakarta on Sunday.
Financial Times 21/9 2005

Blood samples of the five-year girl, who was suspected of having the disease, would be sent to Hong Kong for tests, a process which could take weeks.

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The most lethal human epidemics - including the three great flu pandemics of the 20th century - have all involved germs crossing the species barrier from birds and animals to people. Many microbiologists say a combination of four factors makes influenza potentially the most dangerous of all known viruses:
It crosses the species barrier readily, it can be very virulent, killing a high proportion of those infected, it is highly contagious, spreading rapidly between people, and it mutates fast into more dangerous strains.
Financial Times Briefing 23/8 2005

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Financial Times Bird Flu page

Perhaps I have influenced the Financial Times?
The next few months will be critical for the battle to avoid
what could be a cataclysmic flu pandemic

Financial Times editorial 5/8 2005
See also: Cataclysm

The next few months will be critical for the battle to avoid what could be a cataclysmic flu pandemic, killing millions of young people and costing hundreds of billions of dollars in economic disruption. The autumn migration of wild birds is expected to spread the lethal H5N1 strain of avian flu, which scientists see as the most likely cause of a pandemic, from Asia to regions where wildlife has not been infected. Then the winter flu season will make people more susceptible to infection.

The autumn migration of wild birds is expected to spread the lethal H5N1 strain of avian flu, which scientists see as the most likely cause of a pandemic, from Asia to regions where wildlife has not been infected. Then the winter flu season will make people more susceptible to infection.

No one knows what the chances are that avian flu will go human this year, next year - or indeed ever. But virologists say the risk is great enough to be worth giving the WHO substantially more resources for a flu rapid reaction force.

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The most important development this year is the establishment of bird flu infection among wild birds - waterfowl in particular. This increases the risk that avian migrations will carry the virus around the world.
The more widely it spreads, the greater the chance of it mutating somewhere to a form that transmits easily between people
FT’s science editor, Clive Cookson 31/8 2005

For FT.com’s special report on bird flu click here

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The Next Pandemic?
A special section in the July/August 2005 issue of
Foreign Affairs.


H5N1 avian influenza – first steps towards development of a human vaccine
WHO 12 August 2005

On 6 August, government scientists at the US National Institute of Allergy and Infectious Diseases announced results from initial clinical trials of a vaccine being developed to protect humans against infection with H5N1 avian influenza. Preliminary data indicate that the experimental vaccine evoked an immune response in a small group of healthy adults.

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Roche Gives WHO 3M Doses of Bird Flu Drug
The antiviral oseltamivir, known commercially as Tamiflu, is the only treatment proven to be effective in humans against bird flu.
Washington Post/AP, August 24, 2005

Tamiflu could help reduce illness and death and could potentially contain an emerging pandemic virus or slow its spread when combined with other measures, WHO said.

The longer the H5N1 bird flu strain circulates, the greater the risk that the virus will mutate into a form that can be spread between people and trigger a pandemic, WHO said. If that happens, slowing the pandemic's spread would critical to allowing medical authorities time to produce vaccines against the virus and introduce other emergency measures.

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Fågelinfluensan närmar sig Europa.
Vår beredskap mot en sådan pandemi är god, påstår regeringen.
Folkhälsominister Morgan Johansson har lovat att alla ska få ett fullgott skydd. Det är än så länge ett tunt löfte.
Aftonbladet-ledare 25/8 2005

Först när ett nytt virus uppstår kan färdiga vaccin tas fram.

Ytterligare ett problem är landstingens oförmåga att klara den panik som kan uppstå. Stora rubriker om SARS räckte för att smittskyddsläkarna skulle bli nedringda, trots att sjukdomen aldrig kom till Sverige. Vid en pandemi skulle trycket bli betydligt störr

Sverige måste ha en beredskap för en situation där den tidiga begränsningen av smittan har misslyckats.

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Renate Kunast, consumer protection minister, said: "We are preparing for a worst-case scenario."
German farmers could be ordered to keep flocks of poultry in pens to prevent contact with wild migratory birds arriving from central Asia, expected in mid-September.
Ms Kunast warned against panic, but called for preventive action across the European Union.
Financial Times 20/8 2005

As revealed in the Financial Times on Friday, British doctors are to be schooled on how to handle an outbreak of bird flu if it spreads to humans, as experts fear is possible. Doctors will be issued with a 50-page pamphlet detailing the steps they should take to contain any outbreak.

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A pair of dice, rolled again and again, will eventually produce two sixes.
Similarly, the virus that causes influenza is constantly changing at random and, one day, will mutate in a way that will enable it to infect billions of people, and to kill millions
The Economist, editorial, 4/8 2005

Some suggest that SARS was a useful warning. And yet it has left many with the unfortunate impression that, even after a bit of bungling, a new disease can be easily contained. But flu is a far bigger danger than SARS because it moves so much faster. So, too, must the world's governments if they are to prevent death on a massive scale.

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A global pandemic of bird flu claiming millions of lives could be stopped if governments work together, say experts.
UK and US teams used computer models to work out the possible scenarios if the virus H5N1 mutated and became capable of spreading from human to human. The result could be deaths on the scale of the 1918 Spanish flu which claimed between 20 and 40 million lives.
BBC 3/8 2005

Two key conditions would have to be met to limit an outbreak of human-transmissible bird flu to fewer than 200 cases.
Firstly, the virus would have to be identified while confined to about 30 people, they told Nature.
In addition, antiviral drugs would have to be distributed rapidly to the 20,000 individuals nearest those infected.

Full text with links to Nature and Science


HANOI, Vietnam (AP) -- Bird flu has killed two more people in Vietnam
CNN July 29, 2005 with good links

Last week, Indonesia reported its first bird flu deaths after a 38-year-old man and his two young daughters tested positive for the disease.

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Flu viruses can swap many genes rapidly to make new resistant strains, US researchers have found.
BBC 26/7 2005

Scientists previously believed that gene swapping progressed gradually from season to season.
The National Institutes of Health team found instead, influenza A exchanged several genes at once, causing sudden and major changes to the virus.

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Could the outbreak of the H5N1 strain spiral into a human flu pandemic, a global cataclysm that could kill millions in a matter of months and shake societies to their core?
By mixing H5N1 and human flu viruses in the lab, scientists can find out how likely this is, and how dangerous a hybrid it would be.
An accidental release—not so far-fetched a scenario given that the severe acute respiratory syndrome (SARS) virus managed to escape from three Asian labs in the past year—could lead to global disaster.
Lim Li Lin and Chee Yoke Heong, 31/7 2004

There is a way to find out, flu scientists say — but it’s controversial. Leaving nature to take its course, a pandemic could be ignited if avian and human influenza strains recombine—say, in the lungs of an Asian farmer infected with both—producing a brand-new hybrid no human is immune to. By mixing H5N1 and human flu viruses in the lab, scientists can find out how likely this is, and how dangerous a hybrid it would be.
Such experiments can give the world a better handle on the risks, but they could also create dangerous new viruses that would have to be destroyed or locked up forever in a scientific high-security prison.

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"Is it a bird, is it a plane?"
Fears mount over China bird flu
H5N1 outbreak at Lake Qinghai was particularly worrying because it affected migratory birds, including gulls.
BBC 28/6 2005

WHO China representative Henk Bekedam said the H5N1 outbreak at Lake Qinghai was particularly worrying because it affected migratory birds, including gulls.

"The biggest concern I would have is that we have many birds that are asymptomatic and they can fly from here to 1,000km (621 miles) further up. That's troublesome," he said, the AFP news agency reported.


The Japanese government Friday confirmed the country's first outbreak of a high-risk bird flu in three years,
though it stressed that there was no evidence the disease had spread beyond chickens.
The report came two weeks after Hong Kong reported the first human case there since 2003
Wall Street Journal 3/12, 2010, 3:57 P.M. ET

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Jonathan Livingston Seagull

He recovered to level flight and was quiet for a time before he spoke. "Very well," he said, "who are you?"
"We're from your Flock, Jonathan. We are your brothers." The words were strong and calm. "We've come to take you higher, to take you home."
"Home I have none. Flock I have none. I am Outcast And we fly now at the peak of the Great Mountain Wind Beyond a few hundred feet, I can lift this old body no higher."
"But you can, Jonathan. For you have learned. One school is finished, and the time has come to another to begin."
As it had shined across him all his life, so understanding lighted that moment for Jonathan Seagull. they were right. He could fly higher, and it was time to go home.
He gave one last long look across the sky, across that magnificent silver land where he had learned so much.
"I'm ready," he said at last.
And Jonathan Livingston Seagull rose with the two starbright gulls to disappear into a perfect dark sky.

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Pic from ashampoo