Avian Flu Update: limited human-to-human transmission

If you haven't already heard, it's being reported that members of the same family in Indonesia are infected with H5N1. 7 family members have been infected and 6 have died so far. The WHO is trying to find the bird source of the virus but haven't been able to do so as of yet. This cluster is the largest we've seen since H5N1 has been in the population and signals limited human-to-human contact.

Experts are watching and waiting to see if infection spreads outside of this family cluster. So far it hasn't, and so far the virus isolated from the family members has not mutated to what we believe would cause a pandemic.

Keep all of this in mind as you listen to reports from the MSM, as they have a tendency to misreport and leave out important information.

Maybe cooking it doesn't kill the virus? They all seemed to get sick within a few days of each other, but so far no spreading. :shrug:

Hopefully the one family member who hasn't died will recover and be able to recall details. They were all within close proximity of each other so it seems human-to-human transmission is what occurred.

or one or more of them dragged the virus into the house after working with birds.

The WHO hasn't been able to verify that any of them were in contact with birds - apparently they don't have any livestock of their own.

(including on the CDC website) that some of the avian flu deaths have occurred from consumption of uncooked duck's blood, which is considered a delicacy in that part of the world, so I wonder if that is a factor in these cases.

The CDC also recommends that uncooked poultry or poultry products, including blood, should not be consumed, so I'm thinking that maybe cooking poultry does kill the virus.

But then, this is just one of those "known unknowns". I don't think WHO and the CDC really know the answers themselves.

if you wore gloves and a mask while preparing the infected bird then thoroughly disinfected the kitchen.
A dead infected chicken is not something I want to touch. The virus can live for a long time at freezing temps.

In any case, I suspect they've already ruled out an obvious contact like duck's blood soup x( but there was one woman several months back believed to have been infected by inhaling particles of dried bird droppings after sweeping the yard. Another victim washed a piece of fruit in water later believed to have been contaminated with droppings. Perhaps one or more members of this family had a similar contact?

Months ago I was really freaked out about bird flu, but now I tend to agree with what some other DUers have said all along - that common sense and paying attention to hygiene is a good defense, and not to believe all the hype.

You know, basic hygiene, hand washing, cooking meat thoroughly, not letting raw meat tough surfaces that cooked food later touches, without proper cleaning in between.........the things they aren't teaching in school anymore.

virologist community? If they expect to see "x" change (predicted mutation), and are looking for that, will they notice a much subtler "y" change (not predicted mutation)?

Are there any virologists out there who can answer this?

There are very specific markers that indicate mutations within the current virus and mutations that would indicated a species jump. Virologists know them and probably dream about them. :hi:

http://www.alertnet.org/thenews/newsdesk/JAK153112.htm

No bird flu virus mutation seen in Indonesia

24 May 2006 13:35:23 GMT

Source: Reuters

JAKARTA, May 24 (Reuters) - Limited human-to-human transmission of bird flu might have occurred in an Indonesian family and health experts are tracing anyone who might have had contact with them, the World Health Organisation said.

But a senior WHO official said in Jakarta this was not the first time the world was seeing a family cluster and said that fresh scientific evidence has shown the virus in Indonesia has not mutated to one that can spread easily among people.

WHO said on Wednesday it had no immediate plans to call a meeting of experts to discuss raising its global bird flu alert. snip

WHO and Indonesian health officials are baffled over the source of the infection but genetic sequencing has shown the H5N1 bird flu virus has not mutated, the U.N. agency said on its Web site (http://www.who.int) on Tuesday.

"All confirmed cases in the cluster can be directly linked to close and prolonged exposure to a patient during a phase of severe illness. Although human-to-human transmission cannot be ruled out, the search for a possible alternative source of exposure is continuing."

- snip -

"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).

The human viruses from this cluster are genetically similar to viruses isolated from poultry in North Sumatra during a previous outbreak."


http://www.who.int/csr/don/2006_05_23/en/index.html

That is what your headline says.

Don

"All confirmed cases in the cluster can be directly linked to close and prolonged exposure to a patient during a phase of severe illness."

Highly unlikely all seven family members contracted the virus directly from birds. Maybe one of them did, but then it was passed to other family members.

"All confirmed cases in the cluster can be directly linked to close and prolonged exposure to a patient during a phase of severe illness. Although human-to-human transmission cannot be ruled out, the search for a possible alternative source of exposure is continuing."

Highly unlikely or not the WHO is not confirming what you are presenting as fact. The only thing they say they are sure of is that the virus has not mutated.

Don

you are correct that the WHO is not definitively stating human-to-human transmission, because they haven't ruled out another source yet. However, following infection patterns of other cases and those in this particular family cluster where no contact with birds has been identified, there is really no other explanation. The family members were in close contact with each other during phases of severe illness.

Those I've talked with in the Infectious Diseases community are saying that family members contracted the virus from each other. I can't prove it of course, and the experts in the field may not be able to do so either.

and they know the likelyhood of such a mutation is more a matter of when than it is of "if" such a mutation will occur. The best course of action as individuals is just to prepare to wait it out in your homes if and when it occurs to just let it run its course and save yourselves and your families by preventing any exposure...it is like the new hurricane advice..be prepared yourselves, because in the end that is the only thing that will save you. So, just stock up on enough canned food and water to live in your home for a month or two...and if and when it starts, dont leave your home and dont let your children leave the home until it is over. If it never happens, u can still eat the stored food. It is just one of those easy better safe than sorry actions that you can take.

so yes; they are all over it, especially since they haven't identified a source as of yet. Knowing what I know, it is a matter of "when" and your advice is sound. :hi:

before it reaches here. Once it does, all hope is lost.

and it doesn't appear to be significantly different from other versions that transmit only between birds and humans directly.

" 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).

The human viruses from this cluster are genetically similar to viruses isolated from poultry in North Sumatra during a previous outbreak."

It must be said that the current virus can be transmitted person to person, but the droplets have to go deep inside the lungs of the patient to infect them. That requirement means that the virus does not spread easily between people, but it does mean that in some very special circumstances it can happen.

It still remains to be seen how these individuals were infected.

No sign of bird flu mutation in Indonesia case: WHO

May 24, 2006 — By Diyan Jari

JAKARTA (Reuters) - Limited human-to-human transmission of bird flu might have occurred in an Indonesian family but there is no evidence the virus has mutated to allow it to pass easily among people, the World Health Organization said.

Seven members of the family from a village in north Sumatra died this month and the WHO and Indonesian health officials are baffled over the source of the H5N1 avian flu virus.

But they say there is no evidence the virus has passed to anyone else outside the initial cluster of up to eight people.

(snip)
The agency said such close contact was considered a possible source of infection. However, genetic sequencing of the virus — which would enable scientists to tell if it has mutated — showed nothing unusual.


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WHO expresses concern about bird flu cluster

GENEVA (AP) - A family of eight people infected with bird flu in Indonesia may have passed the disease among themselves rather than individually catching it from poultry, but the World Health Organization is leaving its pandemic alert level unchanged, the agency said Wednesday.

"All confirmed cases in the cluster can be directly linked to close and prolonged exposure to a patient during a phase of severe illness," said a WHO statement. "Although human-to-human transmission cannot be ruled out, the search for a possible alternative source of exposure is continuing."

The agency's alert level remained Wednesday at 3, where it has been for months. That means there is "no or very limited human-to-human transmission."

WHO spokeswoman Maria Cheng said it was unlikely the agency would raise the alert level in the immediate future.

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From the WHO, itself:

Avian influenza – situation in Indonesia – update 14

23 May 2006

The Ministry of Health in Indonesia has confirmed an additional case of human infection with the H5N1 avian influenza virus. The case occurred in a 32-year-old man. He developed symptoms on 15 May and died on 22 May.

(snip)
Analysis of viruses

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).

The human viruses from this cluster are genetically similar to viruses isolated from poultry in North Sumatra during a previous outbreak.
more