Thursday, January 09, 2014

Part 16 - A Bioforming Pandemic - H5N1 Claims its First Victim in North America with Fatality in Canada


By Aaron Hermann

The H5N1 variant of "Bird Flu" has officially arrived in North America claiming its first victim. The still unidentified adult from Alberta, Canada died earlier this week from a fatal infection later identified as the H5N1 virus. This incident is getting some decent coverage by most mainstream and alternative media outlets in regards to volume, but no one seems to be asking some very important questions.

The official story leaves me with more questions than answers and I am simply not buying what the "officials" are selling. We are being told that this person from Canada traveled to Beijing, where we were told the bird flu was not present, and came back feeling feverish and unwell and was then dead a few days later.

We are continually being told that the H5N1 virus is not transmissable between people and is only contracted through direct contact with infected poultry. If that is true, the story they are presenting us is that this person travels to a region in China where we are told there is no bird flu and supposedly has direct contact with an infected bird in a region where there are no infected birds and then comes back home and dies a few days later, yet we have nothing to worry about.

Does anyone else have a hard time believing this story? I hope so!

Apparently we are supposed to take comfort in the fact that the family of this individual and others they had close contact with upon their return are asymptomatic and being treated prophylactically with anti-viral medication while under supervision for the next 10 days, which is double the time the H5N1 takes to normally incubate and become symptomatic.

Another interesting twist to this story is the fact that the victim did not display the usual respiratory signs associated with the H5N1 virus. The victim had swelling in the brain and intestinal symptoms as opposed to the more prevalent coughing, trouble breathing, etc.

This just in...we're being taken for suckers and dupes! All of this is theater, but this is the only thing we have to go on so we go with it. We depend upon the Holy Spirit to guide us and show us what is true and to give us insight into what is really taking place in the fallen world we live in. The H5N1 making its way into North America is a big deal, regardless of what we are being told in the media.

Lord willing, I will be building off of this post in the days ahead and tying in some very relevant and pressing issues that are happening concurrently with the developments in Canada, such as the presence of clusters of drug resistant H1N1, "Swine Flu", in Japan and the Southern United States, and a "nightmare bacteria" in Illinois that appears to be a carbapenem-resistant intestinal illness, and the presence of a mobile app for apple and android that involves gameplay that encourages people to create a plague that will wipe out the planet.

With that being said, I felt it was important to present a compendium of the reports, articles, and statements made about the development relating to the H5N1 virus on North American soil and allow those who are inspired to take the time and put in the effort to go through the material.

The folks at the POTR blog have an interesting take on the development that I will present here. I am not sure I agree with their assessment, but it is one worth taking a look at. Also included in this presentation are statements from the CDC, the WHO, and articles from CIDRAP and other online publications.

Posting from POTR blog:

Much has been made of the report that the Canadian H5N1 bird flu victim had little to no respiratory involvement, ie no coughing etc. In birds, the bird flu is mostly intestinal; It appears that the case may be the same with both H5N1 and H7N9 bird flu in humans.

So far we have not seen any reports that the Canadian victim had diarrhea or vomiting, but we expect that she probably did have these symptoms. And given such intestinal symptoms, an aircraft toilet is the perfect place to spread the disease via both surface contamination and aerosolized flush related contamination.

In that regard, it would not surprise us if there were additional H5N1 cases related to the Canadian incident. However, we would expect those cases to be self limiting, and likely undetectable as no one is going to be looking for H5N1 as a cause of death in any case not directly tied to China.

But we will add one Caveat, there have been rumors of the Chinese engaging in Gain of Function (GOF) research with H5N1; that situation would change the ball game and the risk profile of this Canadian detection. Given, the woman's supposed lack of contact with poultry in Beijing, one might surmise something unusual is occurring, but she could just as easily come in contact with infected pigeon droppings.

In the mean time, the real take away from this case is that from an epidemiological perspective it is much easier for H7N9 to jump on board an aircraft than it is for H5N1. Given that the Canadian victim was infectious for 12 days before the authorities understood what was happening, and that the infection time is roughly 3 days from exposure; it is clear that North America has little chance of putting the Genie back in the bottle once it gets on the runs.


An Airplane Toilet Is A PRIME Place To Spread Bird Flu

A report from Yahoo News:

Canada announced Wednesday the first H5N1 avian flu death in North America, of a patient who had just returned from China, and said it was urgently contacting airline passengers on the victim's flights.

It was also the first known instance of someone in North America contracting the illness, Canada Health Minister Rona Ambrose told a press conference, stressing it was an "isolated case."

The victim, who had recently returned from a trip to Beijing and had been otherwise completely healthy, was from the western plains province of Alberta, officials said, adding they were withholding the person's gender and other identifying details to protect the family's privacy.

"I am here to confirm North America's first human case of H5N1, also known as avian flu," Ambrose said, confirming the patient died on January 3.

"I want to reassure the public this is an isolated case and the risk of H5N1 to Canadians is very low. There is no evidence of sustained human-to-human transmission," the minister added.

The virus is contracted directly from birds, mainly poultry. The illness it causes in humans is severe and 60 percent of human cases are fatal.

The victim began to feel ill during the December 27 flight home to Alberta province, developing a fever and headache. They were admitted to hospital on January 1 when the symptoms worsened suddenly and they began falling in and out of conciousness.

The patient died two days later.

The federal microbiology laboratory in Winnipeg, Manitoba, identified the H5N1 virus overnight from a specimen that had been taken while the victim was still alive.

Doctors said the deceased had traveled with two companions who are not sick but will be kept under observation as a precaution for 10 days -- double the usual time it takes for the virus to manifest itself.

"The patient's family is not showing any sign of illness. There is no evidence of human-to-human transmission on airplanes. All evidence indicates this is one isolated case in an individual who is infected following exposure in China," said Alberta Chief Medical Officer James Talbot.

"Although we don't know at this time how the individual contracted the virus," he added.

Talbot said the victim had not traveled outside Beijing to the regions of China, and had not visited a farm, nor a public market.

Canadian officials have notified China and the World Health Organization, but said they are at a loss to explain where or how the person caught the illness. Beijing had been believed to be free of the bird flu virus.

Search for airline passengers

Authorities have also secured passenger lists and were contacting others on the same flights as the victim to reassure them of the "extremely low" chance of contagion.

The victim flew from Beijing to Vancouver on Air Canada flight 030 on December 27, then went on to Edmonton, Alberta, aboard Air Canada flight 244.

The person's final destination was not revealed, again for privacy reasons, but he or she was treated at an Edmonton hospital.

Other recent fatal cases have been reported in Indonesia and Cambodia, in November.

Avian flu viruses have been around for a long time in wild birds but do not generally cause disease in humans, though in rare cases they mutate and jump species.

Strains of the H5, H7 and H9 avian influenza subtypes have caused human infections, mainly following direct contact with infected poultry. None of the strains have yet mutated to become easily transmissible from person to person -- the epidemiologists nightmare.

The H5N1 virus is the best-known of the strains, having caused 633 confirmed flu cases in humans in 15 countries from 2003 to July this year, of whom 377 died.


Canada reports first H5N1 bird flu death in North America

CIDRAP REPORTS:

It remained unclear today how the victim of the first H5N1 avian influenza infection in North America, a Canadian who visited China in December, was exposed to the virus, as health authorities stressed the case's uniqueness and continued to describe the risk of further transmission as very low.

The victim, an Alberta resident, became ill while flying from Beijing to Vancouver, B.C., and on to Edmonton, Alta., on Dec 27, and died on Jan 3, Canadian officials reported yesterday. They have not released any identifying information about the person.

Canadian health officials at a press conference yesterday said the person did not leave Beijing during the China visit and did not visit any high-risk sites such as poultry markets. And the World Health Organization (WHO) said today that the person had no reported contact with poultry, animals, or sick people. The WHO also revealed that he or she was in Beijing from Dec 6 to 27.

China has not reported any human H5N1 cases since February 2013, and the country's latest confirmed H5N1 poultry outbreak was reported a week ago in Guizhou province in southwestern China, a long way from Beijing.

The last two human H5N1 cases reported in China also occurred in Guizhou province, in February 2013. Reports at the time said the two patients had no history of exposure to poultry.

Multiple firsts

Meanwhile, the US Centers for Disease Control and Prevention (CDC), in a statement posted late yesterday, commented on the uniqueness of the Canadian case.

"This is the first detected case of human infection with avian influenza A H5N1 virus in North or South America. It also is the first case of H5N1 infection ever imported by a traveler into a country where this virus is not present in poultry," the agency said.

Officials said yesterday that no symptoms have been reported in any contacts of the victim, including two traveling companions. Contacts are receiving preventive antiviral treatment, according to the WHO, which said the victim had just one traveling companion.

The CDC called the health risk posed by the case very low and is not recommending any special actions by the public in response to it. Nonetheless, the agency said it would send clinicians a reminder about when and how to test for H5N1.

"The detection of one isolated case of H5N1 virus infection in a returned traveler does not change the current risk assessment for an H5N1 pandemic," the CDC said. "A pandemic would only result if the H5N1 virus were to gain the ability to spread efficiently from person-to-person and there is no indication that this has occurred."

ECDC says risk unchanged
The European Centre for Disease Prevention and Control (ECDC) reached a similar conclusion, saying today that its last H5N1 risk assessment, issued a year ago, is still valid.

"The risk of secondary and co-primary cases among the close contacts of this case is considered to be very low for the following reasons: more than 10 days has passed since onset of the disease, transmission of A(H5N1) on board aircrafts has never been documented, and there is no evidence of sustained human-to-human transmission of A(H5N1) ever occurring," the ECDC said.

"The risk of health care associated transmission in Canada is considered very low for the same reasons."

Canada's deputy chief public health officer, Gregory Taylor, MD, recommended yesterday that travelers to places where avian flu circulates should avoid high-risk areas such as poultry farms and live-animal markets, avoid unnecessary contact with birds, avoid surfaces that have droppings on them, and make sure that all poultry dishes are well-cooked.

With the new case, the WHO's tally of confirmed H5N1 cases since 2003 stands at 649, with 385 deaths, for a case-fatality rate of 59%. Most patients had exposure to poultry, but human-to-human transmission is regarded as probable in a few cases that involved prolonged close contact between family members.

As reported previously, the Canadian patient's presentation was somewhat unusual, though not unprecedented, in that there were no respiratory symptoms, officials said. James Talbot, MD, PhD, Alberta's chief medical officer of health, said the patient's diagnosis at the time of death was meningoencephalitis, or inflammation of the brain and the lining around it, according to a report in the Edmonton Journal.

"That is one of the ways H5N1 patients die," Talbot said.


Exposure source in Canadian H5N1 case a mystery


Canadian officials announced today that an Alberta resident who traveled to Beijing in December has died of H5N1 avian influenza, marking the first human H5N1 case reported in North America.

The victim, who was not identified, was admitted to an Alberta hospital on Jan 1 and died Jan 3, the government of Alberta said in a statement.

At an afternoon press conference, Canadian officials said the victim flew on Dec 27 from Beijing to Vancouver and then to Edmonton. They described the risk of transmission of the virus to fellow airline passengers or other contacts of the person as very low.

"This is a very rare and isolated case," Dr. James Talbot, Alberta's chief medical officer of health, said in the Alberta statement. "Avian influenza is not easily transmitted from person to person. It is not the same virus that is currently present in seasonal influenza in Alberta.

"Public health has followed up with all close contacts of this individual and offered Tamiflu [oseltamivir] as a precaution. None of them have symptoms and the risk of developing symptoms is extremely low. Precautions for health care staff were also taken as part of this individual's hospital treatment.

"I expect that with the rarity of transmission and the additional precautions taken, there will be no more cases in Alberta," Talbot said.

H5N1 infection is usually traced to contact with diseased poultry, but a few cases of probable human-to-human transmission have been reported in connection with prolonged close contact.

Officials said it was unclear how the person caught the virus, but there is no evidence of person-to-person transmission, according to a Canadian Press (CP) report.

Seeking to protect the victim's identity, the government gave no information on the patient's age, gender, or occupation, nor did it disclose where he or she was hospitalized.

The World Health Organization (WHO) lists a total of 648 human H5N1 cases as of Dec 20, 2013, including 384 deaths. China had two cases in 2013, both fatal, according to the WHO.

Officials at the press conference said the victim traveled with two companions, who are being monitored for signs of illness.

They said the person flew on Air Canada flight 030 from Beijing to Vancouver and, after a few hours' layover, on Air Canada flight 244 from Vancouver to Edmonton. Passengers on those flights will be contacted, mainly to reassure them that their risk is low, but also to advise them to contact local medical officials if they experience symptoms, health officials said.

The person's first symptoms developed during the trip from Beijing to Vancouver, CBC News reported.

Canadian officials described the person's symptoms as fever, malaise, and headache—an unusual presentation that suggested central nervous system involvement. One official said the signs were "more consistent with a subset of H5 cases which don't start with a primary respiratory presentation."

The patient was previously healthy, officials said. In investigating the case, they found that the person was co-infected with a common type of coronavirus—not the SARS (severe acute respiratory syndrome) coronavirus. (They didn't mention the Middle East respiratory syndrome coronavirus, which has been confined to the Middle East and to a few European and north African countries.)

One official said it was initially thought that the combination of two viruses might explain the severe illness, but because H5N1 infections are often severe, they concluded that that's not very likely.

Commenting on the case today, infectious disease expert Michael T. Osterholm, PhD, MPH, said he is surprised that more H5N1 cases have not been exported from areas where the virus is endemic to other parts of the world.

He voiced agreement that the risk of transmission to others is probably very low. "This doesn't fundamentally change the risk picture for H5N1 around the world," he said.

Osterholm is director of the University of Minnesota's Center for Infectious Disease Research and Policy, which publishes CIDRAP News.


Fatal H5N1 case in Canada is North America's first


CDC REPORT:

January 8, 2014 – Canada has reported the first case of human infection with avian influenza A (H5N1) virus ever detected in the Americas. The case occurred in a traveler who had recently returned from China. H5N1 virus infections are rare and these viruses do not spread easily from person to person. Most of the 648 human cases of H5N1 infections that have been detected since 2003 have occurred in people with direct or close contact with poultry. The Centers for Disease Control and Prevention (CDC) considers that the health risk to people in the Americas posed by the detection of this one case is very low. CDC is not recommending that the public take any special actions regarding H5N1 virus in response to this case. For people traveling to China, CDC recommends that people take the same protective actions against H5N1 as recommended to protect against H7N9 or other avian influenza A viruses. This information is available on the CDC website at Travelers Health: Avian Flu (Bird Flu).

According to Canadian health officials, the patient, who died on January 3, 2014, recently traveled to Beijing, China, where avian influenza A H5N1 is endemic among poultry. This is the first detected case of human infection with avian influenza A H5N1 virus in North or South America. It also is the first case of H5N1 infection ever imported by a traveler into a country where this virus is not present in poultry. No such H5N1 viruses have been detected in people or in animals in the United States.

While human infection is rare, it often results in serious illness with very high mortality (60%). CDC has recommended enhanced surveillance measures to detect possible cases of H5N1 in this country since 2003. In 2007, “novel influenza A infections” such as H5N1, became nationally notifiable diseases in the United States. Novel influenza A virus infections include all human infections with influenza A viruses that are different from currently circulating human seasonal influenza H1 and H3 viruses. Rapid reporting of human infections with novel influenza A viruses facilitates prompt detection and characterization of influenza A viruses and accelerates the implementation of effective public health responses.

While the current risk from H5N1 viruses is very low and CDC believes it unlikely that cases of H5N1 have occurred in the United States, CDC will send out a reminder to clinicians in this country about when and how to test for H5N1 infection. The recommendations for testing for H5N1 are similar to those for H7N9 and include recent travel (within 10 days) to a country with H5N1 virus infections in birds or people. The guidance for H7N9 is posted on the CDC website at Human Infections with Novel Influenza A (H7N9) Viruses.

According to CDC, more concerning for Americans right now is seasonal flu, which is widespread in much of the country. The agency urges people who have not gotten their seasonal flu vaccine this season to get vaccinated now. A seasonal vaccine will protect you against seasonal flu viruses.

As mentioned previously, avian influenza A H5N1 is endemic in poultry in China. Since 2003, 45 cases of human infection with H5N1 have been reported in China and 30 (67%) have died. Affected persons have ranged in age from 2 years to 62 years, with an average age of 26 years. Most of the reported cases have had poultry exposure.

The detection of one isolated case of H5N1 virus infection in a returned traveler does not change the current risk assessment for an H5N1 pandemic. A pandemic would only result if the H5N1 virus were to gain the ability to spread efficiently from person-to-person and there is no indication that this has occurred.

CDC is in close contact with Canadian public health partners and has offered laboratory and other support as needed. The agency will continue to monitor this situation closely and work with public health partners to rapidly test any incoming specimens and advise local and state authorities regarding control measures if needed. Long-term preparedness measures against H5N1 include the existence of a stockpile of H5N1 vaccine in the Strategic National Stockpile.

Background

H5N1 is a virus that occurs mainly in birds, is highly contagious among birds, and can be deadly to them, especially domestic poultry. Since December 2003, highly pathogenic avian influenza A (H5N1) virus infections in birds have been reported in Asia, Africa, and Europe. H5N1 viruses are considered endemic (ever present) in poultry in at least six countries (alphabetically: Bangladesh, China, Egypt, India, Indonesia and Vietnam) with sporadic detection in wild birds and poultry outbreaks occurring in other countries. The virus also is circulating widely in other countries in those regions. From 2003 through December 10, 2013, 648 laboratory-confirmed human cases with H5N1 virus infection have been officially reported to WHO from 15 countries. Of these cases, 384 died (60%). At the current time, there is no ongoing transmission of any avian influenza A viruses in humans, including

However, the H5N1 epizootic poses an important public health threat since influenza viruses evolve and swap genes frequently. If H5N1 viruses were to gain the ability for efficient and sustained transmission among humans, an influenza pandemic could result, with potentially high rates of illness and death worldwide. The Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO) and Food and Agriculture Organization of the United Nations (FAO) conduct routine surveillance to monitor influenza viruses, including H5N1 viruses, for changes that may have implications for animal and public health.


First Human Avian Influenza A (H5N1) Virus Infection Reported in Americas

WHO Report presented on the Avian Flu Diary blog:

Just about 24 hours after the news broke of North America’s first imported case of H5N1 (see Alberta Canada Reports Fatal (Imported) H5N1 Infection) the World Health Organization has published an update on their GAR (Global Alert & Response) page.

While this update doesn’t add a whole lot we didn’t already know, it does confirm that close contacts, including healthcare workers, are receiving PEP (Post Exposure Prophylaxis) antivirals, and to date, all contacts remain asymptomatic.

The idea behind PEP is that once someone is identified as having a novel influenza virus, that those people who have been exposed to the patient are given a 10-day prophylactic course of antiviral medications. PEP is also often used to protect poultry cullers who may be exposed when disposing of infected birds.

For more on how antivirals like oseltamivir can be used to prevent infection after exposure, you wish to revisit my 2008 blog Pandemic PEP Talk.

Human infection with avian influenza A(H5N1) virus - update

Disease outbreak news

9 January 2014 - WHO has been informed by Canada of a laboratory-confirmed case of human infection with avian influenza A(H5N1) virus in a previously healthy adult, who was first symptomatic on 27 December 2013 and died 3 January 2014.

The person visited Beijing, China, from 6 to 27 December 2013 and returned to Canada on 27 December 2013. The individual was symptomatic during travel with malaise and feeling feverish. The person travelled with one other individual who is well.

Laboratory test was conducted at the Alberta Provincial Lab and confirmed by Canada's National Microbiology Laboratory.

The person had no known exposure to poultry or other animals, nor to ill individuals.

Close contacts, including household contacts and health care workers, are under observation and have received antiviral post-exposure prophylaxis. All contacts have been asymptomatic to date. Follow-up of the airline passengers is also ongoing.

This is the first case of human infection with avian influenza A(H5N1) virus reported in Canada and the first confirmed human case in the Americas Region.

Globally there have been a total of 649 cases and 385 deaths reported, including this latest case.

WHO does not advise special screening at points of entry with regard to this event, nor does it recommend any travel or trade restrictions.


WHO GAR Update on Canadian H5N1 Fatality (From AFD)

More to come, Lord willing!


By Aaron Hermann

Please feel free to contact me through my Gmail account. (theultimateplan@)

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