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Monday, November 21, 2005

Possible under reporting of bird flu infections in China and other Southeast Asian countries may be promoting an illusory sense that human infections are very limited. Common press reports only describe fewer than 130 people as infected with H5N1 avian flu and that fewer than 70 have died worldwide. Yet, there are enormous problems getting accurate data, especially in a country like China with a population of more than a billion.

“Reporting a suspected bird flu infection in bird or humans is a very unlikely event,” said Dr. Shoshana Zimmerman of the eHealth Institute. She is also a founder of www.birdflubeacon.com, a site dedicated to bird flu issues. “There are very few incentives to report, and lots of reasons to refrain from reporting. From the viewpoint of local rural small farmers, there is little to be gained and much to be lost by reporting an infection. The worse threat is that their flocks could be killed, leaving them destitute.”

There are many factors which mitigate against reporting bird or human infections of bird flu.

• The deaths of chickens, ducks, and birds are common events for farmer. Even when a large number die at one time they may see no purpose in reporting the deaths.

• When a human dies in locations with little or no medical services, the rural farmer’s priority for discerning the cause of death may be low.

• In rural areas most people are not taken to hospitals when they are sick.

• Bird flu symptoms are not widely known. If the symptoms are not known, they will not be recognized and reports of possible bird or human infections can not be made.

• The expenses required for detection are those of proper collection and shipment of samples to one of approximately 200 laboratories worldwide, as well as the testing procedure that requires a two week period of waiting before results are obtained.

• The lack of incentive for countries to report large scale outbreaks as it may lead to widespread panic and economic loss, as occurred with SARS. These factors can be seen at work in the way that the first bird flu death was reported in China,” Dr. Zimmerman stated.

A young woman, Zhou Maoya, died after returning home to the village of Yantan in Annui province to prepare for her wedding. Her family has stated that they did not take her to the hospital because they thought it would not do any good. Officials also note rural Chinese also often cite relatively expensive medical costs as a reason for not seeking treatment when sick.

Although initially authorities attributed her death to pneumonia the resulting political pressure prompted China to invite the World Health Organization to send experts to investigate. The authorities then rescinded the previous position and attributed her death to bird flu based on the similarity of the symptoms that she was reported to exhibit with those of bird flu. The village was quarantined and journalists were denied access. It is not known how many others might be infected in the village. Official announcements were made of plans to vaccinate and cull birds.

A local government official, Fan Qian, told AFP that it was believed Zhou was infected while she was outside of the province.

Fan Tan, a local official, told AFP news that 1,000 birds in Yantan had been culled (killed). Plans were announced to vaccinate 2 million poultry in the area, a huge and difficult task.

Zhang, another official, said authorities had met with all villagers to give them flu vaccinations and to tell them how to protect themselves against the bird flu virus, including not consuming poultry products. It is known that flu vaccinations do not protect against bird flu.

Villagers and local officials minimized the threat. In outlying areas of Yantan, residents said that they did not know of any new outbreaks. Other possible infections have been attributed to similar common causes but there have not been any tests performed validating those attributions.

Fan Litan, a peasant woman from Fantu village, about 2 miles from Yantan, lost many of her ducks, and chickens and also a dog; she has attributed these deaths to the acts of hooligans. She said her family had been extremely frightened when her animals suddenly died. “We were scared to death,” said Fan, standing next to a red sign posted on the outside wall of her home that said: “Prevention and control by the masses is basic for people.” Fan said ducks and chickens are all healthy but she admitted that she had stopped eating poultry. No testing of these birds has been reported yet.

According to a recent AFP report from Liuchang, 59 miles south of Yantan, the obstacles to identifying infections are enormous.

Like many, one Liuchang villager named Wang Hemin said he was concerned and would keep a closer eye on his ducks and chickens, but felt no immediacy since the infection was not in his province. He learned about bird flu on TV, and is aware that officials have come to his village of 2,700 people to warn residents about the virus. They offered guidelines: they told people that poultry which die suddenly could have contracted bird flu and should not be eaten or sold and that such an incident should also immediately be reported. However, the symptoms of H5N1 bird flu were not directly described.

Residents have not yet been fully informed of what symptoms to look for in ill poultry–they are fever, diarrhea, teary eyes and swelling in the legs of the birds. Though a pledge was made earlier in the week to vaccinate 2 million birds immediately, no bird vaccinations in this area have been reported yet.

In another nearby village, Nazahuang, chickens scuttle in and out of houses. One resident, Fan Jiexu, 73, said no officials had yet warned her village to take precautions. Throughout rural areas, it is customary for chickens to scuttle in and out of homes. Ducks and bird often die and are eaten by villagers when it is believed safe to do so.

China has reported 17 avian flu outbreaks as of this week. Despite the Chinese government issued high alerts, critical information is not being adequately communicated to some rural villages. The size of the poultry population, the common and normal occurrence of poultry death on farms, and status of roughly 70% of the poultry population as being kept in backyards are factors complicating infection control.

The head of World Health Organization’s China office, Henk Bekedam, is aware that slow reaction to bird flu threats and difficulty monitoring poultry in the world’s most populous country makes control of its spread challenging.

Testing is required to confirm H5N1 virus, and positive test results lead to the killing of nearby flocks. The incentive for many villagers, officials, and governments to minimize reports of H5N1 virus infections and severe medical and economic complications for making confirmations of infection are obstacles opposing complete and full reporting of the spread and infection rates of the virus.

Wednesday, January 31, 2007

A woman, one of three people who recently died of flu like symptoms, in Lagos, Nigeria, has tested positive for the H5N1 strain of Avian influenza.

It is the first bird flu in Nigeria since the strain arrived in Nigeria a year ago. H5N1 was confirmed in blood samples tested in Rome and London from the three recent deaths.

The Food and Agriculture Organization of the United Nations stated that while the threat from avian flu has decreased from last year, there still remains flare-ups around the world, urging countries to “remain vigilant and fully cooperate with international organizations”.

Bird flu is spread by wild birds for whom the virus is a stomach disease and, generally, not fatal.

Although the disease has killed 164 people, it has only been out of 269 cases, this gives the disease around a 60% fatality rate compared to the 1918 ‘Spanish flu’ pandemic which had a mortality rate of around 5%.

The outer coat of the virus particle is characterised by two types of glyco-proteins, neurominidase and haemagglutinin, both of which interact with sialic acid.

Haemagglutinin has sixteen forms, H1 to H16, and binds to sialic acid on the target cell, facilitating the entry of the virus.

Neurominidase is found in nine forms, N1 to N9, this protein allows the progeny viri to escape the infected cell by cleaving sialic acid.

The two main drugs against bird flu currently on the market, Tamiflu^® and Relenza^®, both target the sialic acid binding pocket of neurominidase. Neither of these drugs will cure the disease, but will stop its spread through the body. As such they have to be administered within 48 hours of symptoms appearing. In all 9 sub types of neurominidase, the structure of the target area for the drugs is the same. There is also a flu vaccine but the current flu vaccine does not protect against H5N1.

Human to human transmission is very rare, at the moment bird flu can only be caught from prolonged exposure to infected birds, specifically their droppings from which the bird flu virus has been crystallized and parts of the structure solved.

Unlike diseases such as smallpox and measles, for which their are effectively protecting vaccines, the flu virus constantly mutates. Each year the virus is slightly different from the last, this is the genetic drift of the virus – small point mutations on the surface, causing an evasion of our immune system. Many of the problems arise when there is a major shift of the surface proteins, for instance when a different subtype appears, such as H5.

There are three strains of human influenza circulating around the globe; H1N1 first isolated in 1933, H2N2 first isolated in 1957 and H3N2 first isolated in 1968. Other than humans; pigs, seals and horses have various strains of influenza, however only wild birds have all the known subtypes of haemagglutinin and neurominidase. Of the 144 combinations of N(1-9) and H(1-16) we have had three.

Thursday, October 18, 2007

It can be difficult to be John Reed.

Christopher Hitchens called him a “Bin Ladenist” and Cathy Young editorialized in The Boston Globe that he “blames the victims of terrorism” when he puts out a novel like Snowball’s Chance, a biting send-up of George Orwell‘s Animal Farm which he was inspired to write after the terrorist attacks on September 11. “The clear references to 9/11 in the apocalyptic ending can only bring Orwell’s name into disrepute in the U.S.,” wrote William Hamilton, the British literary executor of the Orwell estate. That process had already begun: it was revealed Orwell gave the British Foreign Office a list of people he suspected of being “crypto-Communists and fellow travelers,” labeling some of them as Jews and homosexuals. “I really wanted to explode that book,” Reed told The New York Times. “I wanted to completely undermine it.”

Is this man who wants to blow up the classic literary canon taught to children in schools a menace, or a messiah? David Shankbone went to interview him for Wikinews and found that, as often is the case, the answer lies somewhere in the middle.

Reed is electrified by the changes that surround him that channel through a lens of inspiration wrought by his children. “The kids have made me a better writer,” Reed said. In his new untitled work, which he calls a “new play by William Shakespeare,” he takes lines from The Bard‘s classics to form an original tragedy. He began it in 2003, but only with the birth of his children could he finish it. “I didn’t understand the characters who had children. I didn’t really understand them. And once I had had kids, I could approach them differently.”

Taking the old to make it new is a theme in his work and in his world view. Reed foresees new narrative forms being born, Biblical epics that will be played out across print and electronic mediums. He is pulled forward by revolutions of the past, a search for a spiritual sensibility, and a desire to locate himself in the process.

Below is David Shankbone’s conversation with novelist John Reed.

Thursday, February 24, 2005

A paste containing synthetic tooth enamel can seal small cavities without drilling. Kazue Yamagishi and colleagues at the FAP Dental Institute in Tokyo say that the paste can repair small cavities in 15 minutes.

Currently, fillers don’t stick to such small cavities so dentists must drill bigger holes. Hydroxyapatite crystals, of which natural enamel is made, bond with teeth to repair tiny areas of damage.

Yamagishi and colleagues have tested their paste on a lower premolar tooth that showed early signs of decay. They found that the synthetic enamel merged with the natural enamel. The synthetic enamel also appears to make teeth stronger which will improve resistance to future decay. As with drilling, however, there is still the potential for pain: The paste is strongly acidic to encourage crystal growth and causes inflammation if it touches the gums.

The paste is reported in the journal Nature.

Wednesday, January 1, 2020

On Sunday, the state of emergency begun on November 15 over a measles outbreak ended in Samoa. The island nation’s cabinet unanimously voted to lift it on Saturday afternoon, and the National Emergency Operation Centre (NEOC) announced the decision that night. NEOC reported a 95% immunization rate on December 24, and the last measles-related death during the state of emergency on December 26.

Restrictions on public gathering and travel were to be lifted, and schools to reopen. The Health Emergency Operation Center were to take over the relief efforts centralized under the National Emergency Operation Centre. The Ministry of Health and the Ministry of Foreign Affairs were tasked to produce a recovery plan within two weeks for consideration by the cabinet.

As of Sunday, the Disease Surveillance Team reported a total of 5667 cases during the outbreak. Out these, 1846 persons were hospitalized and 1720 had already been discharged, while 81 had lost their lives. The December 6 National Measles Response and Recovery Appeal identified children under 5 years of age as having the highest mortality, corresponding with the relative shortfall of vaccination in the age group.

Tupua Tamasese Meaole Hospital returned to normal operation on Sunday, joining Faleolo District Hospital and Leulumoega District Hospital, which returned to normal on Friday. During the peak of the outbreak, Tupua Tamasese Meaole’s Acute Primary Care Clinic and Leulumoega District hospital were made measles wards, and Leulumoega District Hospital was designated to deal with patients without measles, in an effort to quarantine infected individuals. The Australian medical mission’s fifth rotation is to remain on the islands until January 4 to help facilitate the transition. On Sunday teams had already begun to disassemble the tents erected to deal with the large number of admissions.

The state of emergency was expected to end on December 15, but on December 14 it was extended by two weeks to allow the immunization campaign to continue. At the time, the prime minister called for a 100% immunization rate, and stated 92% had been reached. As of Sunday, the rate had reached 95% according to NEOC data. Aid agencies say populations with sufficiently high vaccination rates have enough herd immunity to prevent any further infections from spreading out of control, meaning an infected person is not likely to come into contact with enough unvaccinated people to cause a chain reaction.

UNICEF reported they had delivered over 105 thousand doses of vaccine to Samoa by November 22. The national vaccination campaign started on November 20. A government order made vaccination mandatory and free of charge for children between six months and 19 years of age and for women between 20 and 35, considered childbearing age. On December 5 and 6, the government of Samoa executed a planned shutdown of public services and the private sector to leave room for a nationwide door-to-door immunization drive. The government said 128 vaccination teams participated.

To curb the spread of disease, the government prohibited inter-island travel for those under 19, schools were closed, and authorities recommended residents avoid public gatherings and medical facilities unless they were in need of medical attention. Unvaccinated pregnant women were prohibited from going to their workplaces.

The outbreak was first confirmed by the government on October 16, after the Victorian Infectious Disease Reference Laboratory in Melbourne tested 7 out of 20 suspected cases positive for measles.

In 2019 in the Pacific region, outbreaks of measles were declared in parts of the Philippines first on February 6, Tonga on October 22, Fiji on November 7, and American Samoa on December 8. The D8 strain, which caused a New Zealand outbreak, has been identified in Samoa and Fiji. New Zealand serves as a travel hub for small Pacific nations. According to data from the World Health Organisation, in 2018 there were approximately 10 million cases of measles and 140 thousand related deaths worldwide.

Tuesday, June 16, 2009

An Oklahoma police officer is on paid administrative leave, following an altercation with ambulance personnel while they were transporting a patient to the hospital. Trooper Daniel Martin, a member of the Oklahoma Highway Patrol (OHP), was caught on video by his police vehicle’s dashboard-camera in a physical struggle with paramedic Maurice White, Jr. after Martin pulled the ambulance over. Martin had previously passed the ambulance while en route to another call, but came back and pulled over the ambulance. The incident occurred on May 24, and footage from the police dash-cam was released following a tort claim filed by paramedic White.

It has also been suggested that the previous call had in-fact been to pick up his wife from a police station who was then present in the car during the incident between Martin and the ambulance.

Footage by the OHP released Friday shows the ambulance personnel repeatedly informing Trooper Martin that they have a patient in the back of the ambulance that they are in the midst of transporting to the hospital. Martin yells at the ambulance driver for making what he claims was an obscene gesture – the ambulance driver asserts he raised both hands signalling confusion at the police officer’s actions. Trooper Martin can be heard telling the ambulance driver “I’m going to give you a ticket for failure to yield, and when I go by you saying ‘What’s going on?’ you don’t need to give me no hand gestures now, I ain’t going to put up with that [expletive], do you understand me?”

The video from the police dash-cam is eight minutes long, and paramedic White can be seen twice being pushed up against his ambulance by Trooper Martin. In one instance, Martin shoves White up against the ambulance while gripping his neck tightly with his other hand. In a written statement, paramedic White described the hold placed on him by the Trooper, stating “he engaged my trachea in a claw-like grip digging his nail into my neck while partially shutting off my air supply.”

The sister of the patient in the ambulance, Clara Harper, was following the ambulance and witnessed the incident. Harper later viewed the footage from the police dash-cam, and she stated to Tulsa World paramedic White “never once became aggressive to that trooper.” She asserted that “He did nothing wrong.” After the ambulance was allowed to continue transporting the patient to the hospital, Harper got into the ambulance to be with her sister. “She was scared, and I was trying to calm her down and telling her everything was going to be all right,” said Harper.

Paramedic White was interviewed by KOKI-TV, and recounted his thoughts as the incident was taking place. He stated his main concern was for his ambulance patient: “It was surrealistic because I’ve never had such an experience. My biggest concern was for the patient. If there’s any nightmare from this, it’s because of what that mother, that patient, had to go through.” White’s attorney told KOKI-TV that if White deemed the arrest to be unlawful, he had the right to resist it. White is a paramedic for Creek Nation Emergency Medical Services in Oklahoma. He told FOX News he was surprised at the actions of the police trooper. “He’s taken an oath, just as I have, to protect and serve. I could not believe that this was happening,” said White.

The Oklahoma Department of Public Safety decided to release the police dash-cam video publicly after amateur video of the incident was posted to the video-sharing website YouTube. Captain Chris West, spokesman for the OHP, explained why the video was not released earlier. “We’ve been well aware of the fact that this incident has drawn enormous attention, but made the decision to protect the integrity of the investigation, any and all relevant evidence, as well as the rights of the department employees,” said West. Prior to the release of the dash-cam video, a relative of the patient had posted video of the incident to YouTube. The son of the ambulance patient can be seen in a video stating to the camera “Highway patrolman pulled over my mom’s ambulance because he’s mad we didn’t pull over, and he tried to arrest … the EMT from taking my mother to the hospital.”

Richard O’Carroll, the lawyer for paramedic White, said that Trooper Martin abused his authority as a police officer. “Everything on this needs to relate back to why are we here? One man is there protecting a patient and one man is there abusing his authority and throwing his weight around,” said O’Carroll. White’s attorney filed a tort claim on behalf of his client in order to get the video of the police vehicle’s dash-cam released. Trooper Martin’s lawyer says he did not realize a patient was in the ambulance at the time of the incident.

O’Carroll explained the decision of paramedic White not to use sirens while transporting his patient to the hospital: “There was a reason he wasn’t running sirens. There was a suggestion of chest pains and a heart condition and sirens aggravate these conditions by increasing the blood pressure.” However the attorney for Trooper Martin, Gary James, said that the ambulance was not exempt from regulations because it did not have its sirens on. “If they’re not running their sirens or lights, they don’t get afforded any emergency vehicle exemptions,” said James. The OHP chief is handling an internal review into the incident. As of June 1, Trooper Martin has been on paid administrative leave.

Saturday, May 14, 2005

Myrtle Beach, South Carolina —This weekend is the kick-off for two motorcycle rallies held annually in the U.S. eastern seacoast town of Myrtle Beach. Enthusiasts this year are expected to meet or exceed the 170,000 bikers that arrived last year in droves to the small resort town of 23,000. Festivities span two weeks, and extend again this year into the Memorial Day.

Leading off is the week-long Harley rally, followed by the next week’s BikeFest. In and around town, both day and night are punctured by the sounds of bike engines gunned and revved at stop lights and in parking lots. Groups of cycle riders dominate the streets.

“By Friday night, the front parking lot will be a full line of motorcycles to the corner.” said motel owner Ranjan Patel. The Super 8 motel takes up half a block at its location in the heart of the downtown motel strip. “Both sides [of Ocean Blvd] are nothing but bikes.” Both she and her co-owner husband agree, the influx of bikers dwarf in size the numbers of tourists who visit during regular summer months for ocean-side and family amusement park attractions.

The highly accesorised bikes, decked with chrome and polished to show it, flashed the townscape. Choppers made a showing, but road hogs dominated the ridership, often going twosome. Many rally goers arrived on the scene with SUV’s or big pickup trucks towing cargo trailers loaded with cycles.

Growth in the sheer size of the two rallies led police to make changes in the handling of traffic flow. During BikeFest last year, the mostly black crowd that came in on the heels of the largely white Harley rally the week earlier, were faced with confusion when the two-lane Ocean Blvd was made one-way.

A branch of the NAACP in Conway, the next town over from Myrtle Beach, alleged discrimination by Horry County and Myrtle Beach Police. They claimed authorities and police used an overwhelming and aggressive police presence, combined with a restrictive one-way traffic pattern, to intimidate and discourage the participants in the rally.

An injunction was issued earlier this week by U.S. District Judge Terry Wooten, who ruled that bikers at both rallies be treated the same. Myrtle Beach city lawyers immediately filed an appeal to the ruling at the Fourth U.S. Circuit Court of Appeals, saying “the trial court erroneously determined that the plaintiffs would likely succeed on the merits; that is, that the city of Myrtle Beach intentionally treats Memorial Day weekend tourists differently from others similarly situated because of their race.”

A plan to submit an opposition to the notice has already been announced by Michael Navarre, an attorney for Steptoe & Johnson, who represents the NAACP civil rights group. “We certainly don’t think the judge has ruled erroneously,” Navarre said, according to The Sun News.

Traffic control and safety measures were in full swing Friday morning on US-17. Both directions of the 4-lane divided highway south of Myrtle Beach had traffic cones and parking barriers set up to control traffic. Large flashing road signs on each side of the highway warned cars to use the passing lane. The warning sign flashed a message that the right lane was for motorcycle use only. Police monitored the pull-offs near a Harley dealer’s lot where popular attractions were set-up in the immediate vicinity.