Saturday, September 01, 2007

The Truth About Bird Flu In Bali

Taboo-Breaking Revelations About H5N1 Crossing Over Into Dogs, Pigs, Cats


In Bali, you don't talk about bird flu. And if you do talk about it, you say it's no big deal, poses no threat and nobody should be too worried about it.

Outbreaks of bird flu, particularly human deaths (of which there has been two, possibly three, in August) related to H5N1 infection, have a nasty habit of impacting on the tourist trade. And tourism is the lifeblood of Bali today.

As the Jakarta Post points out, in this revelatory article, "it is very rare to hear someone talk frankly about the threat of bird flu on the island".

The person doing the talking, below, is Denpasar virologist Udayana University Ngurah Mahardika, who was the first to speak out about the possibility of human bird flu deaths in Bali, two years ago, long before they became a nerve-fraying reality :

In his research he came across the daunting discovery that the virus in Bali had crossed over to mammals, such as pigs, dogs and cats.

He became somewhat unpopular on the island, which at the time had just begun to recover from the aftermath of the terrorist bombings of 2002 and 2005.

Bali's government officials and politicians not only dismissed Mahardika's findings, but also criticized the validity of his research.

Despite his skeptics' doubts, and claims that his lab did not comply with bio-security standards, Mahardika was confident with his findings.

Some six months after issuing his warning, a bird flu outbreak in poultry spread across the island -- from Bali's southern Jembrana regency, to west Klungkung regency and the capital city, Denpasar.

Bali's first human victim of the bird flu virus died on Aug. 12, with a second death on Aug. 21, increasing the nation's death toll to 83 out of 105 cases -- the highest fatality rate from H5N1 in humans in the world.

"There was political apathy," he said. "This is the social cost of our ignorance".

He said as a Balinese-Hindu, he believes there is "Atma" (an essential divinity) within all humans. "In my study of molecular biology, I have often asked myself if god put Atma in DNA."

He became aware of the avian influenza virus in 2003 -- when the virus was first detected in Bali and had taken Indonesia's first H5N1 victim in Tangerang, Banten.

"I started to follow the development of the virus and had the chance to do extensive research in 2005," he said.

The island of Bali -- an area of only 5,000 square kilometers and inhabited by 3.2 million humans, who live alongside approximately 12 million fowl and 900,000 pigs -- is a potential breeding ground for the virus.

"It might seem an exhausted thing to say, but public participation is the only way we can fight this virus," he said.

With NGO experience under his belt, Mahardika set up a model program for bird flu awareness.

"My students and I held an educational campaign in Sedang village, in Denpasar. For a period of three months, we conducted campaigns aimed at educating elementary school children and villagers on the bird flu virus. It worked. When there was a bird flu outbreak in the village, they managed to contain it to only nine households," he said.

"There should be an ongoing campaign to combat this virus. Poultry should not be allowed to roam freely in neighborhood areas anymore. All chickens should be fenced in and separated from pigs. The public markets (where they are sold) should be reorganized ... live fowl should no longer be sold there."

Mahardika said the possibility of a pandemic was no longer a question of if, but when.

"Now is the only time humans have the chance to prevent a pandemic," he said.

"We didn't have a chance with AIDS because it spread quietly and unseen, but bird flu is different -- we have the chance to contain it.

"It is in our hands -- we can either do something about it or remain in denial."

1 comment:

Dipl.-Ing. Wilfried Soddemann said...

Another one whistleblower:

Influenza: Initial introduction of influenza viruses to the population via abiotic water supply versus biotic human viral respirated droplet shedding

The primary, initial transmission of the human influenza epidemics by the biotic droplet infection is not proven (BRANKSTON et al. 2007) and extremely improbably as influenza epidemics

• appear only in 9% of the cases (season 2004/2005 in Germany) together with recognized clusters.
• appear virologically locally singularly (influenza-subtypes and precision typing).
• appear geographically locally singularly.
• are not proven with priority in large cities and densely populated areas.
• appear predominantly in the colder regions of Germany.
• regularly reach their maxima in certain districts/cities.
• in temperate climates strictly run parallel to the course of the sum of coldness during the winter.
• can hardly spread via saliva droplets. Saliva contains far less Influenza viruses than the - heavier - droplets from throat and nose.


The facts

Influenza epidemics in Germany rarely appear together with recognized clusters (9% of the cases in the season 2004/2005) (RKI 2006).

Influenza epidemics appear virologically locally singularly (influenza-subtypes and precision typing) (AGI 2007).

Influenza epidemics also run geographically locally singularly. They are not proven with priority in large cities and densely populated areas. They arise predominantly in the colder regions of Germany (in the east with cold continental climate in the winter, southeast, altitudes) (RKI 2007). They reach their maxima regularly in certain districts/cities (RKI 2007).

In temperate climates Influenza epidemics run strictly parallel to the course of the sum of coldness during winter.

In hot climates/tropics the flood-related influenza is typical after extreme weather and natural after a flood. Virulence of influenza virus depends on temperature and time. If young and fresh contaminated water from a local low well, a cistern, tank, rain barrel or rice field is used water temperature may be higher. In the tropics there are often outdoor cisterns, tanks, rain barrels, rice fields or local low wells for water supply. In Germany about 98% inhabitants have a central public water supply with older and better protected water. In Germany therefore coldness is decisive as to virulence of influenza viruses in drinking water.

Influenza epidemics can hardly spread by saliva droplets. Saliva contains far less influenza viruses than the substantially heavier droplets from throat and nose (ANONYMOUS 2003) (GOLDMANN 2001).

Human influenza viruses could be proven in the excretions of mammals such as pigs (faecal and oronasal), wild boar (faecal and oronasal), cattle and goats, so that the transmission path from the environment over waters and the drinking water in principle is possible (BROWN 2004) (GRAVES et al. 1975) (KADEN et al. 2001) (KAWAOKA et al. 1986) (LANDOLT et al. 2003) (MARKOWSKA DANIEL et al. 1999) (RKI 1999) (VICENTE et al. 2002) (WEBSTER 1998) (ZHOU et al. 1996) (CARPENTER 2001). With considerable certainty further animal species that are infected with influenza A will be discovered in the future (WEBSTER 1998).


Elimination and inactivating of viruses during the drinking water treatment

Drinking water is often not or only roughly filtered in Germany. The very small viruses are not definitely removed thereby. For groundwater treatment fast speed filtration plants for the elimination of iron and manganese do not possess any effect regarding the elimination of viruses (WHO 2004). Even the plants in Germany which are known to be particularly efficient regarding the flocculation and filtration can not reach the elimination and inactivating goals demanded from the WHO (WHO 2004); not even under the consideration of the common disinfection procedures, whose efficiency decreases with sinking water temperature [Chlorine and ozone treatment] and that are only of limited efficiency when microorganisms are embedded in particles or in biofilm [Chlorine, ozone treatment and UV irradiation].


"Cooling chain of the public water supply"

Coldness is by far the most important parameter for the preservation of virulent influenza viruses in water. The temperature minimum of the dam water in Germany values in January and February 3-4°C. Every year, river water has its temperature minimum also in January and February. Close to the surface ground water in Germany has its temperature minimum - similar to the soil in 100 cm depth - at the ground water surface of about 3°C in February and March. Ground water taken from wells of larger depth can also be colder than the deeper ground water due to the affection of surface water that infiltrates in the case of unsatisfactory sealing between the fountain and the surrounding rock. River water draining away and reaching wells on short ways can have the same effect. Bank filtrate from wells, which was drilled near the bank from surface water, adopts the temperature of the cold surface water. The same applies to wells, from which ground water enriched with surface water is pumped. The soil temperatures in a meter of depth correspond to the temperatures of the drinking water pipelines that are laid frost-protected in the soils. The temperature minima of the soil temperatures in a 100 cm depth value in Germany during the months February and March 3-5°C (DWD 2007). The temperatures of the drinking water pipelines and the drinking water transported in them adapt themselves to the soil temperatures. In the winter cold raw water remains cold in the drinking water treatment plants and after the treatment to drinking water in the water tanks and water pipelines until the connection to the consumers. The temperature minimum of the drinking water when connecting to the consumers follows in particular the run of the wintry cold sum in the soil and in the water pipelines. It arises in the months February/March. The cold drinking water is first mixed in the dwellings at the taps with warm water from the house installation. Thus the continuous "cooling chain of the public water supply" is described from the water winning up to the consumers with a drinking water temperature of about 4-5°C in the months February/March. Cold, young, freshly by Influenzaviruses contaminated drinking water, taken out from surface water and badly protected surface near ground water as well as out of the ground water from karst can be the abiotic vehicle, which conserves virulent Influenzaviruses in the winter at 4-5°C and transports them over the "cooling chain of the public water supply" to humans.


Transmission paths of the drinking water

Infections by drinking water will not be transmitted alone by drinking the water. Further transmission paths are the inhalation of aerosols and the contact with the drinking water. Access for humans are the conjunctiva, the nose mucous membrane, the mouth mucous membrane, the eardrum, wounds and by catheters affected other mucous membranes.


Conclusions

The primary transmission of the influenza by the biotic “warm” droplet infection from human to human is, already because of the strict dependence on environmental temperatures in temperate climates, extremely improbable. The influenza must be triggered by an abiotic vehicle, which is increasingly efficient regarding the spread of infections with increasingly cold environmental temperatures. Therefore it has to be searched for abiotic vehicles dependent on cold environmental temperatures for the transmission of the influenza in temperate climates. Drinking water is such an abiotic vehicle.

The stated references and indications show that cold drinking water can be that abiotic vehicle, by which virulent human Influenza viruses from the reservoirs reach humans and triggers predominantly the seasonal influenza epidemics.

That applies in particular also to the extremely lethal H5N1 bird flu, whose faecal transmission is indisputable.


References

AGI (2007): Arbeitsgemeinschaft Influenza http://influenza.rki.de/agi
ANONYM (2003): Understanding Sars and other Respiratory Infections May 2003.
http://www.ifh-homehygiene.org/2003/2downloadabledoc/SARS.pdf
BRANKSTON et al. (2007): Transmission of influenza A in human beings. Lancet Infect Dis. 2007 Apr;7 (4):257-65. http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17376383&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
BROWN (2004): Influenza Virus Infections of Pigs, Part 1: swine, avian & human influenza viruses. http://www.pighealth.com/influenza.htm ; Part 2: Transmission between pigs and other species. Veterinary Laboratories Agency, UK.
http://www.pighealth.com/influenzaB.htm
DWD (2007): Deutscher Wetterdienst (DWD), Wetterstation Erfurt-Bindersleben, Erdbodentemperaturen aus 100 cm Tiefe
GOLDMANN (2001): Epidemiology and Prevention of Pediatric Viral Respiratory Infections in Health-Care Institutions, Children’s Hospital and Harvard Medical School, Boston, Massachusetts, USA, Emerging Infectious Diseases, Special Issue.
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GRAVES et al. (1975): Human viruses in animals in West Bengal: An ecological analysis, Human Ecology, Volume 3, Number 2 / April, 1975, 105-130.
http://www.springerlink.com/content/u5408wx5t622ll82/
KADEN et al. (2001): Gefährliche Verwandtschaft. Schwarzwild - ein natürliches Reservoir für Infektionserreger und Ansteckungsquelle für Hausschweine? Bundes-forschungsanstalt für Viruskrankheiten der Tiere: Forschungsreport 1/2001: 24-28.
http://ticker-grosstiere.animal-health-online.de/20010902-00002/
KAWAOKA et al. (1986): Intestinal replication of influenza A viruses in two mammalian species, Archives of Virology, Volume 93, Numbers 3-4 / December, 1987, 303-308.
http://www.springerlink.com/content/g352726672xj5703/
LANDOLT et al. (2003): Comparison of the Pathogenesis of Two Genetically Different H3N2 Influenza A Viruses in Pigs, J Clin Microbiol. 2003 May; 41(5): 1936–1941.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstract&artid=154671
MARKOWSKA-DANIEL et al. (1999): Seroprevalence of influenza virus among wild boars in Poland. National Veterinary Research Institute, Swine Diseases Departement, Pulawy, Poland. http://www.medwet.lublin.pl/Year%201999/vol99-05/art222-98.htm
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WEBSTER (1998): Influenza: An Emerging Disease. Emerging Infectious Diseases 4(3). http://www.cdc.gov/ncidod/eid/vol4no3/webster.htm
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Contact:
Bauassessor Dipl.-Ing. Wilfried Soddemann
eMail: soddemann-aachen@t-online.de