Vietnam to Vaccinate Chickens, Ducks against

19 July (Reuters Health)—Vietnam will use >400 million batches of vaccine to inoculate its chickens and ducks against the deadly bird flu that has killed 40 people in the country, half of them since December.

Agriculture Deputy Minister Bui Ba Bong said in a plan that the government would use 415 million doses of Dutch and Chinese vaccines in a program starting in 2 provinces from 1 August.

Other provinces facing high risk of infection would follow between 1 October and 10 November, before the arrival of the winter when the deadly virus seems to thrive best.

Vietnam has an estimated 210 million poultry.

The Chinese vaccine against the H5N1 virus, which international health officials fear could mutate into a form which might trigger a human pandemic, would be used on ducks.

A Dutch vaccine against the H5N2 virus, a less virulent strain which is not widespread in Vietnam, will be used on chickens.

“The vaccine against the H5N2 virus works well against the H5N1 virus as it functions against the H5 subtype,” Dau Ngoc Hao, deputy head of the Agriculture Ministry's Animal Health Department, told Reuters.

Vietnam decided on the Dutch vaccine because it had been used elsewhere, while a vaccine against the H5N1 virus had been developed in China only early this year, he said.

More than 140 million chickens have been slaughtered in the region in a bid to halt the disease, but experts say it is now endemic in several countries, including Vietnam.

Tests Show Promise for Human Avian Influenza Vaccine

8 August (Reuters Health [Lisa Richwine])—Human tests of an experimental vaccine show it is effective at stimulating the immune system to fight the avian H5N1 strain that experts worry could spur a worldwide pandemic, a top government scientist said.

The findings are a step forward, but do not overcome the major hurdle of producing enough vaccine to meet demand in the event of a flu pandemic, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. The vaccine is grown in chicken eggs and production can take months.

Dr. Fauci said early analysis of tests in healthy adults <65 years of age showed the vaccine, which is made by French company Sanofi-Aventis, produced a strong immune response.

Government scientists tested the Sanofi-Aventis vaccine in ∼450 healthy adults <65 years of age and had analyzed data on ∼113 of them, Dr. Fauci said. The results showed the doses needed to produce an immune response that would be expected to be protective were higher than what is usually given in an annual flu shot, he said.

Further tests in people ⩾65 years of age should begin within a month or so, Dr. Fauci said. If those go well, additional tests are expected in children.

The US government has ordered 2 million doses of the vaccine from Sanofi-Aventis for a national stockpile and is negotiating with the company to order more, Dr. Fauci said.

PowderMed Claims It Could Quickly Produce Pandemic Flu Vaccine

1 August (Agence de Presse Medicale for Reuters Health [Richard Woodman])—UK vaccine company, PowderMed, claimed on Monday its DNA vaccine technology would enable it to quickly produce large quantities of vaccine in the event of a influenza pandemic.

In a statement, it said it had produced an H5N1 vaccine by cloning the H5 gene from the current circulating avian flu strain into a DNA vaccine, which had completed preclinical development and should enter clinical trials by the middle of 2006.

Dr. Clive Dix, CEO, said, “A PowderMed manufacturing facility will be capable of delivering the vaccine requirements of an entire country within 3 months. This is not possible for other technologies.”

Just 1.2 kg of vaccine DNA would be enough to vaccinate the population of the US twice—an initial dose and a booster dose. A detailed study, carried out with contract manufacturing partners, showed that 150 million influenza vaccine doses could be made in 3 months.

The avian flu vaccine uses the same standard DNA vaccine backbone as PowderMed's annual flu vaccine, which is on track to begin phase IIb trials in 2006.

UK's Acambis Says Developing Universal Flu Vaccine

4 August (Reuters Health [Ben Hirschler])—Britain's Acambis Plc. said it was developing a potentially breakthrough new shot that could offer permanent protection against all types of flu.

The Cambridge-based vaccine specialist believes its product, which should enter human trials in the coming months, may also offer protection against a flu pandemic, such as the one which some scientists fear might be triggered by bird flu.

Current flu vaccines have to be given every year. But Acambis hopes to generate a universal vaccine that would protect against both A and B strains of influenza and would not require annual changes to the formulation.

The idea is to include in the vaccine elements of a protein which is found in all types of flu.

Existing flu shots are manufactured laboriously in chicken eggs, while Acambis's product will use high-tech recombinant bacterial fermentation technology.

The experimental product is still a long way from the market—it will require many years of clinical studies before winning approval.

Angola Marburg Outbreak Near End, Vigilance Urged

19 July (Reuters Health [Karen Iley])—Angola has not seen a new case of Marburg hemorrhagic fever for >2 weeks, officials said, suggesting the outbreak that killed >300 people is petering out—but they still urge caution.

With the last confirmed case on 9 July, emergency teams have been leaving Uige, the northern province which bore the brunt of the disease. But they say the outbreak in the southern African country will not be officially over until 42 days after the last case, twice the maximum incubation period.

“We really are moving towards the end,” Fatoumata Binta Dialla, Angola representative for the United Nations World Health Organization, told Reuters. “But we cannot say the outbreak is over until we have finished tracking down all the people who came into contact with the victims.”

Health officials launched a vast effort to spread awareness and track down cases, but often arrived too late to do more than recover the bodies. There is no cure or vaccine.

The disease devastated the local hospital, killing most of the pediatric nurses and an Italian doctor. Prices in the region soared as drivers refused to deliver supplies there from the capital Luanda.

After a careful review of cases in Uige province, Angolan officials said they had revised the total death toll down to 312 dead out of 351 total cases.

Another 6 died outside Uige, although all cases stemmed from the area, where the international medical effort is winding down. Medical charity Medicins Sans Frontieres said it had withdrawn its 250-strong emergency medical team.

Editor's comment. And so as with other outbreaks of infection due to Marburg virus and Ebola virus, this outbreak is subsiding with no hints as to where it originated or where the infecting agent resides between outbreaks.

AIDS in Asia Spread from Myanmar, Study Says

19 July (Reuters Health [Evelyn Leopold])—Heroin users and prostitutes in Myanmar have spread HIV through large parts of Asia, according to a Council on Foreign Relations study.

The use of so-called genetic fingerprinting now allows scientists to identify changes in the evolution of the virus and thereby dispute accusations, such as the one Libya made against Bulgarian nurses, that one group or another was spreading the virus.

“With the exception of one serious outbreak in China, virtually all the strains of HIV now circulating in Asia—from Manipur, India, all the way to Vietnam, from mid-China all the way down to Indonesia, come from a single country,” Laurie Garrett, author of the 67-page report, told a news conference.

“Several research teams have proven that these various HIV strains can be tracked along 4 major routes, all originating in Burma,” she said, referring to Myanmar's former name.

The highest infection rates are among prostitutes and heroin users in Myanmar, ranked as the world's top opium producer until 2003 when Afghanistan moved to first place.

Garrett said the new technology, known as molecular epidemiology, could counter accusations of who spread the epidemic. For example, a year ago, India charged that “promiscuous Pakistanis” spread HIV in Kashmir.

More serious is Libya's jailing in 1999 of 5 Bulgarian nurses and a Palestinian doctor, accused of deliberately infecting 426 children with HIV. Bulgaria countered that Libya failed to screen its blood transfusion supplies.

“Were the Libyan government willing to comply, a study of the HIV strains found in the 426 infected children might offer proof of their origin,” Garrett's report said.

Using genetic techniques, researchers have also proved that the rapidly growing HIV epidemic in the former Soviet Union—Russia, Ukraine, and the Baltic states—appears to stem from 1 strain spread by drug users nearly a decade ago.

“Nearly all of the HIV viruses circulating in that region...closely match one another genetically, were introduced into the area in 1996–1997, and are being spread through injection by drug users,” Garrett wrote.