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PETER CAVE: Victorian and New South Wales health authorities are warning people to protect themselves against mosquitoes following detection of the rare but potentially deadly virus, Murray Valley encephalitis.

The mosquito borne disease has been detected in flocks of chickens in southern and western regions of New South Wales.

Rachel Carbonell reports.

RACHEL CARBONELL: Murray Valley encephalitis has been detected in specially placed chicken flocks designed to act as early warning system for the virus in western and southern New South Wales, including on the Murray River border town of Moama, which is just across from the Victorian town of Echuca.

It has prompted health authorities in both states to warn people to take extra precautions against mosquitoes and watch out for the symptoms of the disease which include severe headache, fever, neck stiffness, drowsiness and confusion.

Dr Jeremy McAnulty is the director for the Centre for Health Protection at NSW Health.

JEREMY MCANULTY: Murray Valley encephalitis or MVE is a rare infection of humans in New South Wales. It's carried by mosquitoes, it's a virus and really appears or is evident in New South Wales only every couple of decades or so when there have been outbreaks historically and between those outbreaks we rarely see it.

When it does occur it's carried by mosquitoes and is primarily a virus of birds, so mosquitoes transmit it between birds and occasionally people get in the way of that so that a mosquito will bite a person and then can infect a person if that person happens to be carrying it.

Most of the time, in fact perhaps 99 per cent or more of the time, an infected person will remain totally well and not get any symptoms but in a small proportion of people who are infected will get an illness that ranges from being fairly mild to very severe and fatal.

RACHEL CARBONELL: There's been no cases of Murray Valley encephalitis reported in Victoria since the early to mid 1970s, what's the situation in New South Wales.

JEREMY MCANULTY: In New South Wales there was - and in other parts of Australia - there was outbreak in the 1970s where there were, in the order of 60-80 cases of MVE in people. Since then we've seen very little activity although we have seen the occasional human case over the last few years, most recently in the last summer when we saw two people with the infection, one of whom didn't have symptoms was found by testing and one whom did have symptoms and recovered.

RACHEL CARBONELL: You've said it's a very rare disease but what's the likely prognosis if you are diagnosed with it and with a version of the virus that is presenting with symptoms.

JEREMY MCANULTY: Well first of all most people don't get symptoms but if you do get symptoms then they can range from being relatively mild - so a fever, headache, nausea, vomiting and then that lasting several days and recovering. To much more severe and it causing an encephalitis or brain infection or meningitis infection of the lining of the brain and that's much more serious and can lead to things like neck stiffness, headache, feeling tired, feeling really crook, confusing, even fitting and coma and in about a third of people who get the symptoms it can be fatal and in about another third they can have long-term ongoing neurological problems.

So it can be a nasty disease if you get it.

RACHEL CARBONELL: Health authorities say risks for other non fatal mosquito-borne diseases such as Ross River fever and Barmah forest virus also remain.

PETER CAVE: Rachel Carbonell reporting.

13 January 2012 Last updated at 01:28 ET

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Bird flu empties South Africa's ostrich farms
By Pumza Fihlani BBC News, Oudtshoorn

Ostriches on a farm in Oudtshoorn in the Western Cape South Africa's population of more than 200,000 ostriches is the world's largest


South Africa's ostrich farmers are struggling to cope after thousands of their birds were culled during one of the country's worst outbreaks of bird flu.

Exports to Europe - the biggest market for South Africa's ostrich meat - have crashed since the EU banned the import of the low-cholesterol meat to stop the virus spreading.

Some farmers have been able to salvage their business through exporting ostrich feathers to South America - they are used in the colourful Rio Carnival.

Oudtshoorn, a town about 450km (279 miles) from Cape Town, is the heartland of the country's ostrich industry.

Highgate Ostrich Show Farm is empty, apart from a few workers cleaning the yard there is no-one else in sight.
Continue reading the main story
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Our first priority now is to get birds back on the farm so I can bring back all my employees and we go back to earning a living”

Arenhold Hooper Ostrich farmer

This is uncharacteristic of the popular tourist farm which is always abuzz with activity.

Hundreds of local and international visitors would normally be queuing to ride trained ostriches, buy luxury ostrich products such as leather and feathers or simply to spend time feeding the birds.

But for the first time in its 80 years, there are no ostriches for visitors to see - they have all been culled.

"When the virus was discovered on our farm a few months ago the authorities came and took away all our birds," Arenhold Hooper tells me.

His ostriches were among 40,000 ostriches killed in the area, believed to either have the virus or have come into contact with infected birds.

All the meat was thrown away.

Mr Hooper is a fifth-generation ostrich farmer. He says he had to fire all his 38 employees and close the farm - he and his workers are now unemployed.
Dancer at the Rio Carnival (file photo) Ostrich feathers are often used to make costumes for the Rio Carnival

The Highgate farm workers have more than 130 dependants between them and they are desperate to earn a salary again.

"It all happened so fast we didn't even have time to prepare our staff for what was happening," he says.

The ostrich industry in this area is responsible for the direct employment of 20,000 people.

"It has been a frustrating time for all of us. Our first priority now is to get birds back on the farm so I can bring back all my employees and we go back to earning a living," says Mr Hooper.

But that will not be for some months.

He has been barred from re-populating his farm until the ban is lifted even though he is not a meat exporter.

Officials cannot say if the virus poses a threat to humans but they are not taking any risks - so for now all birds are considered potentially dangerous.
Feather fashion
Continue reading the main story
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Our ostrich feathers are incredibly popular in South America where they are used in costumes for the Rio Carnival, haute couture, clothing and feather dusters”

Zackie Jonker Ostrich Products South Africa

Across town, I met Zackie Jonker, the head of Ostrich Products South Africa - one of the largest ostrich product exporters in the area - and discussed his plight over lunch.

All the food orders from the tables around me featured ostrich in some form.

I seemed to be the only one anxious about my food - it would be my very first ostrich steak.

It was soft and full of flavour, just as Mr Jonker had assured me.

It is this taste that has made it popular in places like Europe, which consumes 90% of the low-cholesterol beef-like meat, according to the South African Ostrich Business Chamber, a group regulating trade in this industry.

Mr Jonker breeds thousands of ostriches on a number of farms in Oudtshoorn and has lost 6,000 ostriches because of the bird flu.

But he is trying to recoup some profits by exporting ostrich leather and feathers to South America, the US, Europe, China, Korea and Japan.

His company generates 60% of its export income from feathers and leather and 40% from meat.

"Our ostrich feathers are incredibly popular in South America where they are used in costumes for the Rio Carnival, haute couture, clothing and feather dusters. We have fortunately been able to retain some revenue through that," explains Mr Jonker.

But not a lot of farmers have access to this luxury market - so being able to export meat again is a priority.
Vendors in Oudtshoorn in the Western Cape Vendors in the Western Cape use ostrich feathers to make dusters
To slaughter or not to slaughter?

South Africa's ostriches are bred mainly in two provinces - the Western Cape and the Eastern Cape.

In Oudtshoorn alone 150,000 birds are reared in an area measuring over 20,000 sq km (7,722 sq miles).
Continue reading the main story
SOUTH AFRICA'S OSTRICHES

More than 40,000 ostriches have been killed since June
About 150,000 ostriches in the Western Cape alone
South Africa exports ostrich feathers to South America where they are used in the Rio Carnival
Ostrich leather is sought after for its soft texture
Contrary to popular belief, ostriches do not bury their heads in the sand
They are omnivores+, eating whatever is available from plants to insects and lizards

Source: Department of Agriculture, South Africa Ostrich Business Chamber

With each passing month the industry is losing 108m rand ($13m; £8.2m).

The Western Cape Department of Agriculture and Rural Development says the disease seems be under control for now.

But it adds that more tests are being done on the thousands of ostriches in this region.

"We need to continue running tests until none of the ostriches test positive and we need to maintain this for three months, only then will the ban be lifted and the markets opened again," the department's Wouter Kriel told the BBC.

In the meantime, farmers have been offered some money as compensation for their loss but all involved agree that the money is not enough to cushion the blow to their business.

But those who still have healthy ostriches are urged to slaughter them for the domestic market, to try and prevent the disease from spreading.

"It is not as good as the money they would make if they were exporting their meat but it is better than nothing," explains Mr Kriel.

Although the farmers are against this idea, with the costs of caring for the birds piling up this seems likely to be the only option for the 300 or so farmers for now.

But experts say even if the ban on meat exports is lifted in the next few months and the region declared "clean" - it will take up to four years for the industry to recover from the effects of the outbreak.

India reports new TB strain resistant to all drugs

Mon, Jan 16, 2012



Indian doctors have reported the country's first cases of "totally drug-resistant tuberculosis," a long-feared and virtually untreatable form of the killer lung disease.

It's not the first time highly resistant cases like this have been seen. Since 2003, patients have been documented in Italy and Iran. It has mostly been limited to impoverished areas, and has not spread widely. But experts believe there could be many undocumented cases.

No one expects the Indian TB strains to rapidly spread elsewhere. The airborne disease is mainly transmitted through close personal contact and isn't nearly as contagious as the flu. Indeed, most of the cases of this kind of TB were not from person-to-person infection but were mutations that occurred in poorly treated patients.

What's more, there's a debate within the public health community about whether to even label TB infections as totally drug resistant. The World Health Organization hasn't accepted the term and still considers the cases to be what's now called extensively drug-resistant TB, or XDR. However, Dr. Paul Nunn, a coordinator at the WHO's Stop TB Department in Geneva, said there is ample proof that these virtually untreatable cases do exist.

The Indian hospital that saw the initial cases tested a dozen medicines and none of them worked, a pretty comprehensive assessment. A TB expert at the U.S. Centers for Disease Control and Prevention said they do appear to be totally resistant to available drugs.

"It is concerning," said Dr. Kenneth Castro, director of the CDC's Division of Tuberculosis Elimination. "Anytime we see something like this, we better get on top of it before it becomes a more widespread problem."

Ordinary TB is easily cured by taking antibiotics for six to nine months. However, if that treatment is interrupted or the dose is cut down, the stubborn bacteria battle back and mutate into a tougher strain that can no longer be killed by standard drugs. The disease becomes harder and more expensive to treat.

In India, doctors in Mumbai have reported a total of 12 patients who failed initial treatment and also didn't respond to the medicines tried next over an average of two to three years. Three have died. None of the others have been successfully treated.

The doctors detailed the first four cases in a letter to a U.S. medical journal last month, blaming private doctors for prescribing inappropriate drug plans that sparked greater resistance in three of those four patients.

"These three patients had received erratic, unsupervised second-line drugs, added individually and often in incorrect doses, from multiple private practitioners," wrote the doctors from P.D. Hinduja National Hospital and Medical Research Center in the journal Clinical Infectious Diseases.

One of the doctors, Zarir Udwadia, in a phone interview, said there is little hope for the surviving nine patients, all poor slum dwellers living in the community. He said he has detected one case of a mother passing the strain to a daughter living in close quarters. One of the patients was also infected with HIV, which typically results in faster death.

Udwadia criticized the testing and treatment methods of the Indian government's TB program, which he says forces patients to turn to private doctors, many of whom do not understand how to properly treat TB or the risks of increasing drug resistance by prescribing the wrong drugs.

"It was a given that this would happen," Udwadia said. "They have had no help from the Indian TB system. They are the untouchables, so no one is making a fuss. They don't have the power to vocalize. There's going to be more family contacts. It's going to spread for sure."

India's Health Ministry did not respond to phone calls and written requests for comment Monday and last week.

Similar highly resistant cases have been noted before. In 2003, two Italian women died and there were 15 cases reported from Iran in 2009. That same year, The Associated Press reported on a case of a Peruvian teenager who was infected at home but diagnosed while visiting Florida. He was successfully treated for a year and a half with experimental high doses of medicines not typically used for TB, costing about $500,000.

Those resources are unthinkable in the developing world, where TB remains a menacing killer and where few hospitals can perform tests to find out which antibiotics might work.

"For there to be another report coming out from India is no surprise at all. Indeed, in a sense, it's surprising it's taken so long," said WHO's Nunn. This is "yet another alarm call for countries and others engaged in TB control to do their jobs properly."

Tuberculosis is an age-old scourge that lies dormant in an estimated 1 in 3 people. About 10 percent of those people eventually develop active TB, which kills roughly 2 million a year, according to WHO. Each victim infects an average of 10 to 15 others every year, typically through sneezing or coughing.

If a TB case is found to be resistant to the two most powerful anti-TB drugs, the patient is classified as having multi drug-resistant TB (MDR). An even worse classification of TB — one the WHO accepts — is extensively drug-resistant TB (XDR), a form of the disease that was first reported in 2006 and is virtually resistant to all drugs.

An estimated 20 percent of the world's multi-drug-resistant cases are found in India, which is home to a quarter of all types of tuberculosis cases worldwide.

___

AP writers Mike Stobbe in Atlanta and Muneeza Naqvi in New Delhi contributed to this report.

so now , as the report comes from India ..we will soon have announced a wonder drug produced in an Indian laboratory that counters all TB ... seen it all before

Now that the BBC is ALSO carrying this news item, perhaps you'll read it for what this truly represents: A pressing and news worthy article.

17 January 2012 Last updated at 06:02 ET
http://www.bbc.co.uk/news/health-16592199

Indian TB cases 'can't be cured'

Tuberculosis drugs Some strains are becoming resistant to antibiotics


Plan to tackle drug-resistant TB
TB vaccine provides 'double hit'
'First ever' fall in global TB

Tuberculosis which appears to be totally resistant to antibiotic treatment has been reported for the first time by Indian doctors.

Concern over drug-resistant strains of TB is growing, with similar 'incurable' TB emerging in Italy and Iran.

Doctors in Mumbai said 12 patients had a "totally drug resistant" form of the infection, and three have died.

The Indian Health Ministry is investigating the cases and has sent a team of doctors to Mumbai.

TB is one of the world's biggest killers, second only to HIV among infectious diseases.

Normally a patient with TB is given a six to nine month course of antibiotics to eradicate it.

However, new strains of the bacterium have developed which are increasingly resistant to the antibiotics most commonly used to treat it.

Partially drug-resistant TB can now found in countries across the world, and "multi-drug resistant" strains affect countries such as Russia and China.

'Serious threat'

The Indian reports will fuel concerns over the ability of doctors to contain the disease in years to come.

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Anytime we see something like this, we better get on top of it before it becomes a more widespread problem”

Dr Kenneth Castro Centers for Disease Control

The doctors at the Hinduja National Hospital in Mumbai who discovered it said they had treated patients for up to two years with a battery of drugs, to no avail.

The patients came from slum areas of the city, they said, where close contact between people meant further spread was likely.

The American Centers for Disease Control (CDC) confirmed that the Indian strain did appear to be completely resistant.

Dr Kenneth Castro, director of its Division of Tuberculosis Elimination, said: "Anytime we see something like this, we better get on top of it before it becomes a more widespread problem."

Patients who do not finish their lengthy course of treatment also present the bacterium with the perfect environment for developing further resistance.

However, there have been repeated calls for the pharmaceutical industry to make more efforts to develop fresh antibiotics.

TB

Tuberculosis is an infectious disease that usually affects the lungs
It is transmitted via droplets from the lungs of people with the active form of the disease
Symptoms of TB include coughing, chest pains, weakness, weight loss, fever and night sweats
Tuberculosis is usually treatable with a course of antibiotics

Dr Ruth Mcnerney, a senior lecturer at the London School of Hygiene and Tropical Medicine and a trustee of charity TB Alert, said the new cases represented a "serious threat" to global efforts to control TB.

"What we're seeing is probably just the tip of the iceberg. We don't know how widespread this is because so few people are tested for drug resistance."

She said the high prevalence of TB in India, coupled with high population density within its cities, meant that the new type of TB could be a bigger problem than previous "totally resistant" strains.

"It's going to take a massive effort and change in political will to get to grips with this - not just from the Indian government but from everyone else.This is a global problem, not just an Indian one."