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Bird-Flu Papers, Recently Deemed Too Dangerous, Are Freed for Publication
By Josh Fischman
A U.S. biosecurity panel recommended the publication of two revised papers on the bird-flu virus. One of the authors, Yoshihiro Kawaoka, a virologist at the University of Wisconsin at Madison, said his paper still contains the data and methods that caused concern in the first place, with some elaboration about safety issues.
The papers show that a few mutations in the H5N1 avian influenza virus could make it transmissible through the air among mammals, including human beings. The wild form of the virus now mainly infects birds. The lead authors of each paper, Mr. Kawaoka and Ron Fouchier, a virologist at the Erasmus Medical Center, in the Netherlands, were set to publish them in the prominent journals Nature and Science, respectively.
Then the National Science Advisory Board for Biosecurity, a panel of scientists that was asked to review the papers by the National Institutes of Health, threw a roadblock in the way. It said the list of mutations should be removed from the papers before they were published because the virus had an estimated human fatality rate of 50 to 60 percent, and many labs experimenting with the mutated form would raise the chances of an accidental escape or even give terrorists the chance to use it.
The advisory board's action was an unprecedented form of censorship, and it set off a storm of controversy, with the authors and scientists like Mr. Racaniello arguing that studying those very mutations was the best way to watch for a threatening outbreak of the disease, and to develop ways to combat it. Journal editors decried the interference with communication among scientists.
But some infectious-disease experts like D.A. Henderson, the scientist who led the worldwide effort to eradicate smallpox and is now a distinguished scholar at the Center for Biosecurity of the University of Pittsburgh Medical Center, said the censorship was a good idea because the risks of publishing outweighed the benefits. Improving Surveillance
After meeting on Thursday and Friday morning in Washington, D.C., the board decided that the benefits now outweigh the risks. "The data described in the revised manuscripts do not appear to provide information that would immediately enable misuse of the research in ways that would endanger public health or national security," the board said in a statement. In addition, it said, "new evidence has emerged that underscores the fact that understanding specific mutations may improve international surveillance."
Part of that evidence, Mr. Kawaoka wrote in an e-mail, is contained in his revisions, which "provided a more in-depth explanation of the significance of the findings to public health and a description of the laboratory biosafety and biosecurity." His paper, he added, would contain descriptions of all the mutations that enhanced transmission of the virus, the very data that initially concerned the board.
Mr. Racaniello said that arguments made since the board's initial decision might have swayed its members. "All of these mutations have already been seen in circulating strains of H5N1," he said. With the papers, "we now know they contribute to transmissibility. So if you start seeing one of them, or more than one, you should increase surveillance in that geographic region." The board also changed its position, Mr. Kawaoka suggested, "because the meeting helped everyone to better understand not only the research, but the precautions taken to conduct these studies." The board did not focus on claims that the flu's lethality was exaggerated, though outside scientists repeatedly argued over that point. Dueling papers were published recently about the fatality rate, some asserting that it is lower than the official estimate and that the risk is overstated, and others arguing that those papers are miscalculations.
Dr. Henderson, who stands by the official H5N1 fatality estimates, which come from the World Health Organization, appeared disappointed by the decision to publish the papers. The fatality rate is higher than that of smallpox, he said, "and this virus can spread better and faster than anything else we have." However, he agreed with Mr. Kawaoka that people better understood the safety issues now, and he said that was important. "There's been an educational process going on here that I'm very pleased about. The risk will be reduced because labs that work with this virus won't treat it casually, but as something that's very dangerous."

American Experience: Influenza 1918
In March 1918, scores of fit young soldiers poured into an Army hospital in Kansas. Their complaints of fever, sore throat and headache marked the first signs of a flu epidemic that would quickly ravage the nation. By year's end, the flu would kill nearly 700,000 Americans -- more than all U.S. combat deaths in that century combined. Interviews with survivors shed light on this horrifying and strangely forgotten chapter in history.

Follow on Twitter @FluGov Washington D.C. http://www.Flu.gov One-stop access to U.S. Government H1N1, avian and pandemic flu information.

Beat Swine Flu Symptoms with Vitamin D3

5000 Units of the Sunshine Vitamin Daily Increases H1N1 Immunity

Vitamin D (technically not a vitamin) is also known as: Vitamin D2; Vitamin D3; Calcidiol; Calcifidiol; Calcitriol calcitriol, is actually a secosteroid hormone that targets over 2000 genes (about 10% of the human genome) in the human body.
Vitamin D3 - cholecalciferol (pronounced koh·luh·kal·sif·uh·rawl)
Formal name: 25-hydroxy-vitamin D; 1,25 dihydroxy-vitamin D; 25-hydroxycholecalciferol

Michael Holick PhD MD
Professor of Medicine, Physiology, and Biophysics Director, General Clinical Research Center Director, Vitamin D, Skin, and Bone Research Laboratory - Director, Biologic Effects of Light Research Center
Boston University Medical Center
Boston University School of Medicine
715 Albany Street M-1013 Boston, MA 02118, USA Phone:
[p] 1.617.638.4545 [f]1.617.638.8882
[e] mfholick@bu.edu PubMed: Holick MF - Google Scholar

Professor and Doctor Michael Holick from the Boston University School of Medicine author of The Vitamin D Solution: A 3-Step Strategy to Cure our Most Common Health Care Problem, has won the Linus Pauling Institute for Health Research Award for his work in understanding the vital role that vitamin D plays in the body's immune system.
Dr. Michael Holick, also maintains that patients are often misdiagnosed by their physicians. The classic signs of vitamin D deficiency present as aches in the muscles and bones, which doctors mistake for fibromyalgia or chronic fatigue syndrome or depression. The only sure way of knowing if a person is deficient in vitamin D is to take a blood test to check the serum levels. Known as the 25-OH vitamin D test, it measures the amount of vitamin D in the body. how much vitamin D should you take?

 

 

How Much Should You Take? - from the Vitamin D Council
Supplement with at least 5,000 units (IU) of vitamin D3 daily.
Purchase the 1000 IU/day vitamin D3 cholecalciferol pills
that are available over-the-counter in North America or a 5,000 IU capsule.
Take an average of 5,000 IU a day, year-round, if you have some sun exposure. If you have little, or no, sun exposure you will need to take at least 5,000 IU per day. How much more depends on your latitude of residence, skin pigmentation, and body weight. Generally speaking, the further you live away from the equator, the darker your skin, and/or the more you weigh, the more you will have to take to maintain healthy blood levels.
Vitamin D is viewed as a hormone, a steroid hormone, not a vitamin. Steroid hormone-vitamin D dose needs to be individualized, enough to raise your blood level of 25-hydroxy vitamin D to normal. (We aim for a normal level of 60-70 ng/ml.)

TEST - There's only one way to individualize your need for vitamin D and thereby determine your dose: Measure a blood level.

All test kits sold on VirginiaHopkinsTestKits.com include the cost of the results. A blood test is about $65.00 or this one
This test acknowldeges it made mistakes 25-hydroxyvitamin D test


Dosage and Use

Adjust your dosage so that blood levels are between 50–80ng/mL
(or 125–200 nM/L) year-round.

Nobody can gauge your vitamin D need by looking at you, by your skin color, size, or other simple measurement like weight or body fat. A vitamin D blood level needs to be measured specifically─period.

Be sure to eat spinach with your vitamin D.
Take one capsule daily with a fat-based, low fiber meal. To work properly, vitamin D needs magnesium, vitamin K, zinc, and probably boron. Even if a complete vitamin D3 supplement with all these co-factors becomes available, you can save some money by just eating spinach every day.

Caution
Individuals consuming more than 2,000 IU/day of vitamin D (from diet and supplements) should periodically obtain a serum 25-hydroxy vitamin D measurement. Toxicity is very unlikely in healthy individuals at a dose of less than 10,000 IU/day. Vitamin D can store in your body and can be toxic so do not over supplement. Excessive vitamin D will increase the calcium in your blood & be toxic to your kidneys.*

"Bird Flu"
"Swine Flu"

 

 

LEAD & MANAGE MY SCHOOL H1N1 Flu Information

Swine Flu -- H1N1 Cr Rapidly; Predominantly Affects Young

SiloBreaker - Find the Most Recent Birdflu AnnouncementsLiteracy
and Health
Download educational Materials
Avian Flu,
Bird Flu,
H5N1,
Avian Influenza


GET VACCINATED
U.S. FLU SHOT FINDER

The ethnic minority communities we work in are among the highest risk for Avian or "Bird" Flu. Yet, as you know, they are least likely to have access to accurate information about the disease. The threat of a potential Avian Flu pandemic prompts us to inform ethnic groups about some preventive measures their communities can take.

Do the children in your school classroom come from families whose home language is different from standard english? Second Language Learners ESL need information in their language.

FREE AVIAN FLU EDUCATIONAL MATERIAL AVAILABLE FOR IMMEDIATE USE

More than just millions of wild and domestic flocks will die if this flu begins to spread among humans. Dr. Dianne Mathews (MD, MPH), an SIL member serving in Asia; and Dr. Indarto, the Indonesian veterinarian in charge of communicable animal diseases for Papua Province, both understand the threat of Avian Flu.Following the suggestion of SIL's Asia Area Director, Dr. Larry Jones, they collaborated to research the topic. Assisted by SIL technicians, Larry Mathews and Dennis Conroy, they have developed some informative material on Avian Flu for ethnic groups in Indonesia. The materials could be easily adapted to other contexts.
A booklet and audio version provides basic risk and prevention information in story form, a means that many ethnic groups use to transmit information.
The master copy of the booklet is diglot (English and Indonesian). The story text could be translated into other languages. Two sets of illustrations for the Avian Flu booklet reflect Papuan and Asian cultures.
However, the line drawings are generic enough to be used "as is" or modified as needed for African or other ethnic groups. In other words, this booklet is a "shellbook " and easily adapted.

Category 5 Pandemic - U.S. Issues Guidelines in Case of Flu Pandemic February 1, 2007 Cities should close schools for up to three months in the event of a severe flu outbreak.

Ball games and movies should be canceled and working hours staggered so subways and buses are less crowded, the federal government advised today in issuing new pandemic flu guidelines to states and cities. We have to be prepared for a Category 5 pandemic, said Dr. Martin Cetron, director of global migration and quarantine for the Centers for Disease Control and Prevention, in releasing the guidelines. The new guidelines also advocate having sick people and all their families even apparently healthy members stay home for 7 to 10 days.
No ones arguing that by closing all the schools, you're going to prevent the spread, Dr. Markel added. But if you can cut cases by 10 or 20 or 30 percent and its your family thats spared, thats a big deal.School closures can be very controversial, and picking the right moment is hard, because it must be done before cases soar.

AVIAN FLU RISK & PREVENTION BOOKLET
For communities at highest risk to lose flocks and family during an outbreak. They need information in a language they understand to prompt them to take preventative action.

ENGLISH TITLE: Terpen Village Avoids Avian Influenza
BAHASA INDONESIAN TITLE: Desa Terpen Terhindar Dari Penyakit Flu Burung

AVIAN FLU RISK & PREVENTION BOOKLET - COMPLETE SHELLS OR MODELS
(Available http://www.sil.org/literacy or on the W&D CD Rom)

ENGLISH- INDONESIAN VERSION, ENGLISH AND INDONESIAN ON SAME PAGE,
PAPUAN ILLUSTRATIONS
Publisher 2003 file (1.9 MB)
Publisher 2000 file (8.5 MB)
PDF file (1 MB)

ENGLISH- INDONESIAN VERSION, ENGLISH AND INDONESIAN ON SAME PAGE,
ASIAN ILLUSTRATIONS
Publisher 2003 file (1.9 MB)
Publisher 2000 file (7.9 MB)
PDF file (1 MB)

BAHASA INDONESIAN VERSION, ENGLISH IN BACK OF BOOK, ASIAN
ILLUSTRATIONS
Publisher 2003 file (1.8 MB)
Publisher 2000 file (7.9 MB)
PDF fle (963 KB)

ENGLISH ONLY VERSION, ASIAN ILLUSTRATIONS
Publisher 2003 file (1.8 MB)
Publisher 2000 file (7.9 MB)
PDF file (1.1 MB)

ENGLISH ONLY VERSION, PAPUAN ILLUSTRATIONS
Publisher 2003 file (2.7 MB)
Publisher 2000 file (15.7 MB)
PDF file (1.5 MB)

INDIVIDUAL PARTS
**PERMISSION AND FRONT MATTER **
English, Front Matter & Forward (MS Word, 24 KB)
English, Permission Statement (MS Word, 20 KB)

STORY TEXT
** English (MS Word, 39 KB) **
Indonesian (MS Word, 48 KB)
Spanish Available soon

ILLUSTRATIONS (35 DRAWINGS)
Sequence of illustrations and text (MS Word, 45 KB)
Asian illustrations (zipped tif files, 4.9 MB)
Papuan illustrations (zipped tif files, 4.8 MB)

AUDIO VERSION
English text audio Available soon

AVIAN FLU POSTER
English Available soon

AVIAN FLU LEAFLET
** English, How to Avoid Bird Flu at Home (MS Word, 302 KB) **

AVIAN FLU FACT SHEET FOR COMMUNITY FIELD WORKERS
English fact sheet (MS Word, 23 KB)

Avian Flu Risk & Prevention Booklet (various versions in PDF, Publisher, and Word)

Pandemic Preparedness Plan

Current Outbreaks / Trends / Geographic Areas / Research

Pennsylvania Avian Flu Pandemic Flu  Pandemic Preparedness Plan

U.S. Issues Guidelines in Case of Flu Pandemic
http://www.nytimes.com/2007/02/01/health/01cnd-flu.html

By DONALD G. McNEIL Jr. February 1, 2007
Cities should close schools for up to three months in the event of a severe flu outbreak, ball games and movies should be canceled and working hours staggered so subways and buses are less crowded, the federal government advised today in issuing new pandemic flu guidelines to states and cities. Health officials acknowledged that such measures would hugely disrupt public life, but they argued that these measure would buy the time needed to produce vaccines and would save lives because flu viruses attack in waves lasting about two months. We have to be prepared for a Category 5 pandemic, said Dr. Martin Cetron, director of global migration and quarantine for the Centers for Disease Control and Prevention, in releasing the guidelines. Its not easy. The only thing thats harder is facing the consequences. That will be intolerable. In an innovation, the new guidelines are modeled on the five levels of hurricanes, but ranked by lethality instead of wind speed. Category 1, which assumes 90,000 Americans would die, is equivalent to a bad year for seasonal flu, Glen Nowak, a C.D.C. spokesman, said. (About 36,000 Americans die of flu in an average year.) Category 5, which assumes 1.8 million dead, is the equivalent of the 1918 Spanish flu pandemic. (That flu killed about 2 percent of those infected; the H5N1 flu now circulating in Asia has killed more than 50 percent but is not easily transmitted.)
The new guidelines also advocate having sick people and all their families even apparently healthy members stay home for 7 to 10 days.They advise against closing state borders or airports because crucial deliveries, including food, would stop. They did not offer guidance on wearing masks, but Dr. Cetron said the C.D.C. would issue advice on this soon. The guidelines are only advisory, since authority for measures like  closing schools rests with state and city officials; but many local officials had asked for guidance, Dr. Cetron said.
The federal government has taken primary responsibility for developing and stockpiling vaccines and antiviral drugs, as well as masks and some other supplies. Todays guidelines are partly based on a recent study of how 44 cities fared in the 1918 epidemic conducted jointly by the C.D.C. and the University of Michigans medical school. Historians and epidemiologists pored over hospital records and newspaper clippings, trying to determine what factors partly spared some cities and doomed others.
While a few tiny towns escaped the epidemic entirely by cutting off all contact with outside, most cities took less drastic measures. These included isolating the sick and quarantining homes and rooming houses, closing schools, churches, bars and other gathering places, canceling parades, ball games, theaters and other public events, staggering factory hours, barring door-to-door sales, discouraging the use of public transport and encouraging the use of face masks.
The most effective measure seemed to be moving early and quickly. For example, said Dr. Howard Markel, a medical historian and one of the studys leaders, Philadelphia, the worst-hit city, had nearly three times as many sick and dead per capita as St. Louis, which had was hit weeks later by the virus moving inland from the Eastern Seaboard and had time to react as soon as flu cases rose above averages.No matter how you set up the model, Dr. Markel said, the cities that acted earlier and with more layered protective measures fared better. Any pandemic is expected to move faster than a new vaccine can be produced; current experimental vaccines against H5N1 avian flu are in short supply and based on strains isolated in 2004 or 2005. Although the government is creating a $4 billion stockpile of the antiviral drug Tamiflu, it is only useful when taken within the first 48 hours, and Tamiflu-resistant flu strains have already been found in Vietnam and Egypt. No ones arguing that by closing all the schools, you're going to prevent the spread, Dr. Markel added. But if you can cut cases by 10 or 20 or 30  % and its your family thats spared, thats a big deal.
School closures can be very controversial, and picking the right moment is hard, because it must be done before cases soar. Jeffrey Levi, executive director of the Trust for Americas Health, a health policy organization, noted that in poor city neighborhoods, 30 to 60 percent of all children get breakfasts or lunches crucial to their nutrition at school. What are you going to do about that? he asked. Dr. Markel said it might be possible to keep the cafeterias open and transport food to points where parents could pick it up, a move that would also keep cafeteria workers and bus drivers employed. Several public health experts praised the C.D.C. guidelines, although there were some quibbles with aspects of them.Dr. Michael T. Osterholm, director of the University of Minnesotas Center for Infectious Disease Research and Policy, said he saw no point in fretting over exactly when to close schools, because his experience in meningitis outbreaks convinced him that terrified parents would keep their children at home anyway. I don't think well have to pull that trigger, he said. The hard part is  going to be unpulling it. How do the principals know when schools should  open again? Other experts pointed out that children out of school often behave in  ways that are nearly as contagious. Youngsters are sent to day care  centers, and teenagers gather in malls or at each others houses. Well be facing the same problem, but without the teaching, said Dr.  Irwin Redlener, director of the National Center for Disaster  Preparedness at Columbia Universitys Mailman School of Public Health.  They might as well be in class.
Also, he noted, many employed people cannot afford to stay at home and the financial stress from not working could increase domestic violence. And he said most states and cities lacked the money to carry out the suggested guidelines or to stage drills of them.
Dr. Cetron argued that caring for children in groups of six or fewer cut transmission risks. He also argued that parents would keep many children from gathering. My kids arent going to be going to the mall, he said.
The historian John Barry, author of The Great Influenza, a history of the 1918 flu, questioned an idea underpinning the studys conclusions. There is evidence, he said, that some cities with low sickness and death rates in 1918, including St. Louis and Cincinnati, were hit by a milder spring wave of the virus. That would have, in effect, inoculated their citizens against the more severe fall wave and might have been more important than their public health measures.
The guidelines did not suggest using the military to enforce quarantines, as President Bush said he might do when he first mentioned avian flu in 2005.Dr. Levi said that using the National Guard to set up temporary clinics or move pharmaceutical supplies might make sense.But they're not there, he said. The people who know how to run field  hospitals are in Iraq.Copyright 2007 The New York Times Company

Financial services firms face flu pandemic -- on paper 2007
What may be the largest pandemic planning exercise ever conducted in the U.S. is set to begin next month. The dry run will force financial services firms to operate with shrinking numbers of employees -- on paper, at least.More than 1,800 organizations have signed up to participate in the three-week simulation, which is being sponsored by the U.S. Department of the Treasury and the Securities Industry and Financial Markets Association. The exercise will also cover telecommunications issues. Participants will gather in conference rooms and assess how their businesses would be affected if a bird flu outbreak or other pandemic resulted in major reductions in the number of available employees. The U.K. simulation Report used employee absenteeism levels that began at 15% at the onset of the pandemic and then reached as high as 60% in some business units.

USINFOlistmgr@STATE.GOV Date Thu, 20 Mar 2008
Subject: Internet Latest Tool in Emerging Infectious Disease Surveillance
Atlanta -- In an era of pandemics like HIV/AIDS and emerging diseases like highly pathogenic avian influenza and multidrug-resistant tuberculosis, disease surveillance is critical to early detection and response. Until the early 1990s, such surveillance -- systematic data collection and analysis -- consisted largely of manual recordkeeping and official reporting of disease outbreaks to the World Health Organization (WHO) by
member-state ministries of health. Today, a growing number of informal Internet-based organizations contribute to emerging infectious disease surveillance by receiving information from subscribers or collecting it online from electronic media, discussion
groups and other Web sites 24 hours a day, and sending alerts out by e-mail. According to a statement on the WHO Web site, more than 60 percent of its initial outbreak reports now come from unofficial, informal sources.
Even Google.org, the philanthropic arm of the company behind the world's most popular search engine, has launched a Predict and Prevent  Initiative, led by epidemiologist Dr. Larry Brilliant, to "use information and technology," a Google press release said, "to empower communities to predict and prevent emerging threats before they become local,  regional or global crises."

DIGITAL DETECTION
The Program for Monitoring Emerging Diseases (ProMED)-mail, part of the International Society for Infectious Diseases, began as an experimental system in 1993 and is the oldest of the global electronic reporting  systems for emerging infectious diseases and toxins.Subscription is free and open to all sources; ProMED is approaching 45,000 subscribers worldwide and reports in seven languages. All reports are screened by a panel of expert moderators before the reports are posted.
Writing in Global Infectious Disease Surveillance and Detection:  Assessing the Challenges, Finding Solutions, a 2007 workshop summary, Dr. Stephen Morse of Columbia University said ProMED was among the first to report the 1995 Ebola outbreak in Kikwit, Democratic Republic of the Congo; the 1999 West Nile virus outbreak in New York State; and the 2003 severe acute respiratory syndrome outbreak in China.
"What lessons have we learned?" asked ProMED's Dr. Marjorie Pollack during a presentation at the 2008 International Conference on Emerging  Infectious Diseases (ICEID), held March 16-19 in Atlanta. "We live in a global village. No single institution has the complete capacity to address all needs and cover all bases with respect to disease surveillance."
ProMED, Morse said, has encouraged the development of more digital detection networks, including Canada's Global Public Health Information Network and WHO's Global Outbreak Alert and Response Network (See  "Updated Rules Offer New Framework for Health Security
Other networks include the European Commission's Medical Intelligence System (MedISys), a real-time news alert system on medical topics that reviews more than 20,000 articles daily from 800 Web sources and categorizes articles in 25 languages; and WHO alerts. The network then organizes and displays the information in real time as graphic maps.
HealthMap, a free automated network that gathers information on infectious outbreaks from news wires, RSS feeds, ProMED mailing lists, a product of the Harvard-MIT Division of Health Sciences and Technology, was created by Clark Freifeld, a research software  developer at the Children's Hospital Informatics Program, and John Brownstein, an assistant professor of pediatrics at Harvard Medical School.
Project Argus is a U.S. government global biological event-detection and tracking system that provides early warning alerts, according to Dr.  James Wilson in Advances in Disease Surveillance 2007. Multilingual analysts cover global sources in 34 languages. Argus manages up to 3,300 biological event case files and, during the 2007 flu season, issued nearly 3,000 event reports across 128 countries and in 27 languages.

EARLY WARNING
The Google.org Predict and Prevent Initiative will focus on emerging infectious diseases, which are on the rise because of climate change, urbanization, growing international travel and trade and closer contact between people and animals. Most of the world's emerging diseases are zoonoses -- animal diseases thatspread to people See Emerging Infectious Diseases Focus of International Meeting. The effort supports two related pathways from prediction to prevention, Brilliant said during a presentation at ICEID 2008. The first is vulnerability mapping -- establishing which populations have minimal or no access to health care and may live with and depend on animals for their
livelihood -- and identifying "hot spots" where diseases are most likely to arise. The second path involves creating systems for better detection of  threats by using innovative methods to find threats quickly wherever they occur, confirming outbreaks and identifying their cause, and alerting key involved parties, from villagers to global health authorities.

Other resources

 

Swine Flu News Per Death Ratio and the Media HYPE

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