Dirt 5 Release Date, PC System Requirements, Gameplay, Review, and More

first_imgdirt 5 codemasters site weather dirt_5_codemasters_website_weatherDirt 5’s dynamic weather system makes for gorgeous racing backdropsPhoto Credit: CodemastersDirt 5 PC system requirementsHere are the minimum and recommended requirements for Dirt 5 on PC, detailed on the game’s Steam page:- Advertisement – Dirt 5 is out this week as the eighth instalment in the franchise from Codemasters. Dirt 5 focuses completely on off-road racing with a plethora of gorgeous tracks and fun modes to choose from. For gamers looking beyond arcade races, Dirt 5 also offers a story-based Career mode where the player will step into the shoes of a budding racer trying to make his mark in the gritty world of off-road rallies. You will be mentored by veteran racer Alex Janiček, voiced by none other than Troy Baker of The Last of Us fame. You will be pitted against the cold, calculated champion Bruno Durand, played by yet another voice-acting legend, Nolan North (Uncharted, Assassin’s Creed). From release date to system requirements, here’s everything you need to know about Dirt 5.Dirt 5 release dateDirt 5 is set to release on Friday, November 6, on PC, PlayStation 4, and Xbox One. Next-gen releases will kick off on November 10, when the title will be available for Xbox Series S/X owners. The game will be available on PlayStation 5 on November 12. Its worth noting that users who have already purchased the title on PlayStation 4 will get a free upgrade to PlayStation 5. No announcement has yet been made regarding a free upgrade for Xbox consoles.- Advertisement – Apart from Career, Dirt 5 gamers will get to choose from several more modes such as Arcade, Time Trial, online Multiplayer, and local co-op split-screen for up to four players. Dirt 5 also brings in the Playgrounds mode that allows gamers to design, create, edit, and race in custom arenas. Every single creation will come with a global leaderboard to help you see how well you fare with gamers from around the world.Speaking of car classes, Dirt 5 goes all out with 13 different categories of vehicles, each with its own playing style and challenges. You can choose to go for a vintage racing experience with classes such as Classic Rally, 80s Rally, and 90s Rally. Or if you’re looking for an instant adrenaline rush, you can choose from classes such as Sprint, Super Lites, Formula Off Road, or our favourite, Rock Bouncers marked by crazy big wheels and even crazier suspension.Dirt 5 reviewDirt 5 early reviews have already started pouring in. On Metacritic, the game scores 77 percent for PC, 82 percent for PS4, and 84 percent for Xbox One.In its review, PC Gamer drew comparison between Dirt 5 and the recently launched Project CARS 3. The publication wrote, “Dirt 5 isn’t a bad game, then. It’s not a Project CARS 3. The two make interesting points of comparison, though. Both take the bizarre decision to distance their IPs from sim racing at a time when it has never been more popular, and possibly never will again, yes. But whereas Slightly Mad’s game seems to be jutting out its chin and actively daring you to find something of the franchise’s prior identity which you liked among its new mess of utterly characterless racing, Dirt 5 is guilty of the opposite.”Top Gear, in its review, wrote, “Dirt 5 is unashamedly an arcade racer, with more in common with the classic Sega Rally series than its sim stablemate. The dynamic weather is hugely atmospheric, the course design is uniformly excellent and races tend to be exactly the right sort of chaotic.”Dirt 5 priceAvailable for pre-order on all platforms, Dirt 5 offers a pre-order bonus of Ford F-150 Raptor PreRunner by Deberti Design with the standard edition.You can also opt for Dirt 5 Amplified Edition that brings in add-ons such as three exclusive vehicles — Ariel Nomad Tactical, Audi TT Safari, and VW Beetle Rallycross — along with three exclusive player sponsors as well with new objectives, rewards, and liveries. Apart from some extra currency and XP boosts, the Amplified Edition also offers three-day early access for Xbox One, PlayStation 4, and Steam users, starting November 3. You will also get automatic access to all post-launch additions to the title.The standard edition is priced at Rs. 3,999 in India/ $59.99 in the US on PlayStation Store and at Rs. 3,799 in India/ $59.99 in the US for Xbox users. On Steam, the title is available for Rs. 1,299 in India/ $59.99 in the US.The Amplified Edition is priced at Rs. 7,493 in India/ $79.99 in the US for PlayStation and at Rs. 4,899 in India/ $79.99 in the US for Xbox. PC gamers can get the Amplified Edition for Rs. 1,699 in India/ $79.99 in the US on Steam.Will Xbox Series S, PS5 Digital Edition fail in India? We discussed this on Orbital, our weekly technology podcast, which you can subscribe to via Apple Podcasts, Google Podcasts, or RSS, download the episode, or just hit the play button below.Affiliate links may be automatically generated – see our ethics statement for details. – Advertisement – Common specifications include 64-Bit Windows 10 (Build 18632), DirectX 12, broadband internet, 60GB of available storage space, and a DirectX compatible sound card. For Dolby Atmos playback, PC audio solution containing Atmos patch is required.Dirt 5 PC minimum system requirementsProcessor: Intel Core i3 2130 / AMD FX 4300Memory: 8 GB RAMGraphics: NVIDIA GTX 970 / AMD RX 480 (DirectX12 Graphics Card)Dirt 5 PC recommended system requirementsProcessor: Intel Core i5 9600K / AMD Ryzen 5 3600Memory: 16 GB RAMGraphics: NVIDIA GTX 1070 Ti / AMD Vega 64 (DirectX12 Graphics Card)Dirt 5 gameplay- Advertisement –last_img read more

‘Explosive situation’: German minister fears a constitutional crisis in the U.S.

first_imgWith incumbent President Trump already claiming victory with millions of U.S. election votes uncounted, a top German official warned of an “explosive situation.”- Advertisement –last_img

Young Americans came out in droves to cast first-time votes—and it’s having quite the impact

first_img“As a first-generation American, I’ve been reminded of the sacrifices my parents faced to get to the U.S. throughout my life. Despite the imposter syndrome I’ve faced, I know that I have earned every opportunity that has come my way. Voting in this election was especially important to me because I am actively shaping the future of our country,” Ashley Ramcharan, an Indian-American from Upstate New York, told Daily Kos.“This year, I was fortunate to intern for Congressman Paul Tonko (NY-20). This experience has given me an inside look into a campaign and allowed me to build connections. I’ve faced criticism from conservative family members, but I think that only fueled my determination,” she added.ImagefromiOS.jpgAshley Ramcharan xNEW – YOUTH VOTING STATE BY STATE: We’ve got data on how young people voted in 30+ states. In nearly every state, they supported Joe Biden, often by big double-digit margins. And in two states (GA and VA) youth made up more than 20% of all votes cast! https://t.co/BkVQDVmfXJ— CIRCLE (@CivicYouth) November 4, 2020The narrative that young people do not care is long over. Young people are turning out in high numbers and are expecting change. Don’t believe me? Head to Twitter and see for yourself. Young people are not only sharing why they voted but encouraging others to do so, too.  Lucky for you, we gathered some posts below from both the #youthvote and #firsttimevoters hashtags. – Advertisement – xYoung people are turning out to vote by the MILLIONS, and we haven’t even had Election Day yet. We’re seizing our power and making our voices heard. Thank you for staying in this fight with us. If you haven’t already, don’t miss this moment, VOTE before polls close tomorrow! pic.twitter.com/sZAavcUAYD— NextGen America 🗳✨ (@NextGenAmerica) November 3, 2020 More than a week before the election, data showed that at least 7 million voters between the ages of 18-29 already voted, compared to 1.9 million in the age group who voted in 2016. “With a week of early voting (when the data was collected) and Election Day still to come, in Texas, Florida, North Carolina, Georgia, Arizona, and Montana, young people have already cast at least half as many votes as they did total votes in the last presidential election,” Tufts University’s Center for Information & Research on Civic Learning and Engagement (CIRCLE) reported.First-time voters have increased significantly this year. According to NBC News Decision Desk and TargetSmart, more than 20% of early voters nationwide are people who didn’t, or couldn’t, vote in 2016. “While early vote turnout has shattered all records, the most meaningful statistic is the number of ballots cast by voters who didn’t turn out in 2016,” Tom Bonier, TargetSmart CEO, told NBC News. “These are the voters who will determine how the 2020 electorate differs from Trump’s winning coalition in 2016.” He added that these new voters are not only younger and more diverse, but more likely to vote Democratic— and he was right data compiled by CIRCLE found that in more than 30 states young people supported Biden in majority double-digit margins. – Advertisement – xMy cousin who is the daughter of immigrants is voting for her first time! She’s only 18 years old and is casting her vote keeping her parents, tíos, and cousins like me who can’t vote yet and I’m totally weeping 😭😭🥺#alientovotes cc:@AlientoAZ pic.twitter.com/p8QiqzKbK0— Reyna Can’t Vote | VOTE 🗳 (@ReynaEMontoya) October 12, 2020- Advertisement – x“…to all people regardless of their birth, the right to live, to work, to be themselves, and to become whatever their visions can combine to make them. This is the promise of America!” ~The American Adventure 🇺🇲#FirstTimeVoter #VOTE pic.twitter.com/jYuGqvfDWN— Gabe’s Imagination (@Disneyman2021) November 3, 2020 7AADA7BE-9C9D-474B-84A8-59A270F1E34F.JPGHarris Khan“As our nation has learned that every vote matters from our previous election, I exercised my right to vote to assure my voice is heard and for the betterment of this nation’s future,” Harris Khan, a Pakistani-American from New Jersey, told Daily Kos. With the millions of young folks voting before and during the election, there are a lot more stories to share. Head to Twitter and see for yourself the overwhelming number of young Americans who are hoping for change and a better future. – Advertisement –last_img read more

How Do You Advertise a Town Ravaged by Hurricanes?

first_imgComing AttractionsNow, back at the satellite office, Ms. Duncan and her team are working on budgeting for the next fiscal year, trying to come up with a plan to sell Lake Charles again. It’s about rebuilding, but rebuilding better, and taking advantage of the new things that might come out of this dark period of the city’s history.“There may be new restaurants, and new attractions that come from this,” she said. “There’s sort of this unfortunate beauty that might come from this. Maybe the inside of one of our attractions is gutted, and that sucks, but maybe they have an opportunity to reinvent themselves.”Seeing how Lake Charles has come together in the wake of two hurricanes has only made the decision easier. “It’s more fulfilling now, to be sure,” she said. “It validates why I choose to stay here. Yes, everyone’s lives are in chaos right now. But we’re still checking in on each other, making sure we’re OK. We worry about our neighbors, even in the midst of our own struggles.”Something about the fact that there are many obstacles ahead makes Ms. Duncan more dedicated to the place. “If I were to leave, I would be a different environment and all that,” she said. “But by staying, I’m constantly challenging myself. It’s that constant, daily challenge of thinking, what can I do better? How can I make this place better? How can I leave it better for the next generation?” It has Ms. Duncan questioning how she will continue to do the job of promoting the place she loves.“The reality is, what product do we have to pitch?” she said. “What event? What’s open? We know that all of our hotels are going to be filled till the end of the year with utility workers and first responders. And then, sooner or later, with families who have been displaced.” “We were still pitching stories during Covid-19,” she said, “but we couldn’t host anyone, because we really just can’t do that safely.” When Hurricane Laura hit, though, her bosses “mainly cared about our well-being and our health.” It has also shifted her thinking about her own future. (Lake Charles is not located on the coast, but it is still affected by frequent storms, a changing coast line and sea level rise.)“You start thinking, what does your house look like?” Ms. Duncan said. “What does your job look like? What is everything that I do for a living, promote for a living, going to look like?”Hurricanes One and TwoBefore the storms, Ms. Duncan’s job was to pitch stories to out-of-state writers and reporters about Lake Charles and Southwest Louisiana, including about the Creole Nature Trail, a scenic byway that lets visitors walk through Louisiana tall grasses and alligator habitats, and Adventure Point, an attraction along the trail where kids can don real-life hunting gear and smell spices used in Louisiana cooking.- Advertisement – – Advertisement – As a 24-year-old public relations representative for her city, Kathryn Shea Duncan eats, sleeps and breathes Lake Charles, La.The working-class town, home to about 80,000 people and just inland from the Gulf of Mexico, is the big city she grew up visiting, and where she spent Thanksgiving with family. She rented her first home in Lake Charles. She met her boyfriend, Ryan Beeson, at the Panorama Music House downtown. She can tell you the best place to get a po’ boy, hold a baby alligator or crab off dry land.- Advertisement – It made Ms. Duncan reconsider her frustration. “I was kind of like, OK, maybe I need to chill out, and stay here a little longer,” she said, adding she felt that there was a reason she was here. Then, in October, Hurricane Delta made a turn for Lake Charles. Ms. Duncan boarded up her house once again, storing her television in her laundry room along with framed photographs of her deceased father.center_img On Aug. 25, the night Laura made landfall, Mr. Beeson and Ms. Duncan were at Ms. Duncan’s mother’s house in Crowley, La., a town about a quarter of the size of Lake Charles, and about an hour away by car. A Changing StateMs. Duncan’s family has lived in this region of Louisiana for generations, and have roots going back to the original group of Cajuns who were exiled from Acadia, in Canada, by the British in the 1700s.Physically, the state has changed a lot since then. In 2014, the map was redrawn to account for a shrinking coastline, and storms are more frequent — and more deadly — than ever. But Ms. Duncan is committed to riding it out.“We can make it better,” she said. “Through economic development and improving our infrastructure, and having a cleaner environment, and better transportation. You can’t do all of those big things if you don’t stay and work at it day by day.”“I’m a very future-oriented person,” Ms. Duncan said, sitting in her den in Lake Charles, under a framed, hand-drawn map of the state of Louisiana. “I’m always planning the next five years.” – Advertisement – It stands to reason that Ms. Duncan might eventually want to move to a different city. But Lake Charles is her home, she said. And leaving never felt as alluring as staying put.“If I were to move somewhere with a million people, it would be almost meaningless to try and make a difference,” she said. “But if I stay here, and am resilient, living in a city of 80,000, where mostly all of them think and act the same, and I’m a millennial who probably does not have the same thoughts and experiences as those around me, I can make a difference.”“If I leave,” she added, “then who is going to stay? Who is going to be that person?”October was a different story. With Hurricane Delta baring down on Lake Charles, she and Mr. Beeson evacuated once again, this time to San Antonio to stay with friends. With traffic, the normally five-hour drive took them 12. “To be completely honest with you, I wanted to move,” Ms. Duncan said. “I was frustrated. I was angry that this kept happening.”But after the storm, Ms. Duncan was overwhelmed with emotion seeing the work her community did together to rebuild. It’s exciting, she said, to be a part of that. There’s a Facebook group for her neighborhood, where people check in on one another, making sure they all have what they need.“Even our mail lady is in the group,” Ms. Duncan said, “and two days after Laura, she posted that she was on her way home, and that she was going to drop off the mail when she got there.” Mr. Beeson woke Ms. Duncan in the middle of the night. “I know you don’t want to see this, but I think you should know what’s going on,” he said, handing Ms. Duncan his phone. It revealed a photograph of the Panorama Music House, completely destroyed.“Literally, it had just fallen,” Ms. Duncan said. “Like a waterfall.”The owners had been in the process of building a small museum on the top floor dedicated to the musical history of Lake Charles, which Ms. Duncan was excited to recommend to visitors. (The country musician Lucinda Williams, for example, was born and raised nearby and named one of her most famous songs after the town.)“I just sat there, sobbing,” Ms. Duncan said. “Grieving for what might be lost.”That hurricane, a category four storm, ended up displacing more than 6,000 Lake Charles residents. Wind damage left small buildings and big box stores, like Best Buy and Hobby Lobby, in pieces, and tens of thousands of people were without electricity for weeks.Ms. Duncan’s home survived with minimal damage, but her office had to be gutted. Her neighbor had it much worse. “She had ceiling damage, so they’re gutting her side out,” she said. “She can’t live there. And she’s a nurse.” But Ms. Duncan’s resolve to stay in the city has been shaken by the series of hurricanes that have devastated the place and much of the surrounding area this year. Thousands of residents remain displaced, and aid — in the form of charitable giving and volunteers — has been hard to come by with the whole country struggling with coronavirus outbreaks and distracted by politics. (The mayor, Nic Hunter, has worked to spread awareness of the state of his city, appearing on CNN, Fox News and NPR, where he told listeners, “I am begging, I am pleading for Americans not to forget about Lake Charles.”)last_img read more

Amazfit GTS 2 bezel-free smartwatch offers complete health and fitness tracking » Gadget Flow

first_imgMany watches these days do more than tell the time, and the Amazfit GTS 2 bezel-free smartwatch is no exception. This beautiful watch blends style and health by providing you with all the fitness tracking insights you need. Its 3D curved bezel-less design makes it stand out from the pack as a gorgeous—not just techy—accessory. Plus, this AMOLED screen has a 341 ppi pixel density for super clear and lifelike colors as well as easily readable text. Furthermore, the edge-to-edge display has both scratch-and wear-resistant coating that enhances its durability. Choose from Desert Gold, Urban Gray, and Midnight Black options and then personalize the watch face to your liking. With the Amazfit GTS 2, you’ll get a BioTracker 2 PPG high-precision sensor that measures blood-oxygen levels, heart rate, stress, sleep quality, and more. – Advertisement –last_img read more

Pregnant Stassi Schroeder, Beau Clark’s Daughter’s Nursery: Pics

first_imgGetting her room ready! Pregnant Stassi Schroeder and Beau Clark have been preparing for their daughter’s arrival with a “fairy tale” nursery.The Vanderpump Rules alum, 32, gave her followers the first glimpse of the space in October when she showed a framed photo of a heart.- Advertisement – Clark revealed in an October “Give Them Lala … With Randall” podcast episode that he and Schroeder conceived their little one on Easter.“We weren’t planning for it, obviously,” the dad-to-be said at the time. “We just weren’t being careful like we normally were.”While the pair were initially supposed to tie the knot in September in Italy, they chose a different location due to the coronavirus pandemic, posting footage via Instagram from their September surprise backyard wedding in October.“Today would’ve been our wedding day,” the bride captioned a video at the time. “We went and did it anyway. Married Sept 2020. Hopefully Italian dream wedding Oct 2021. I am so proud to be your wife.”Keep scrolling to see their baby-to-be’s sweet space ahead of her birth. “My favorite part of her nursery,” the Next Level Basic author wrote on her Instagram Story at the time. “After I bought this, we discovered she has a hole in her heart, and it was the worst week of our lives waiting to find out just how serious it was. After a week of actual hell on earth, the doctors said it’s incredibly small and should heal on its own.”The former reality star concluded that the piece of artwork now “means so much more” to her and the commercial casting director.Later that same month, the Louisiana native showed the Harry Potter accents in the nursery, including a book-themed mobile.- Advertisement – “OK but how magical is my baby’s mini Harry Potter OOTD mirror?!” the former “Straight Up With Stassi” podcast host wrote on her October Instagram Story. “Fairy tale vibes.”Us Weekly broke the news in June that Schroeder was pregnant with her and Clark’s first child. Later that same month, the couple confirmed the news with a baby bump photo and announced that they have a girl on the way.- Advertisement – – Advertisement –last_img read more

UK reports H5 flu outbreak in turkeys

first_imgNov 12, 2007 (CIDRAP News) – Veterinary officials in England today announced an avian influenza outbreak in turkeys at a farm in Norfolk, after initial tests showed that the birds were positive for an H5 strain of the virus.Officials are awaiting full test results to determine if the turkeys have the highly pathogenic H5N1 strain of the virus, according to a press release from England’s Department for Environment, Food and Rural Affairs (DEFRA). Fred Landeg, acting chief veterinary officer, told BBC News today that he expects test results in the next 24 hours.To date, the deadly H5N1 strain has been identified in British poultry just once, at a turkey farm in February of this year.The site of the new outbreak is a farm 107 miles northeast of London, near the town of Diss, that also has ducks and geese, DEFRA said. All of the birds will be slaughtered. The number of birds slated for culling is about 5,000, according to the BBC report.Authorities have established a 3-km protection zone around the farm, along with a 10-km surveillance zone. “We are also urgently considering with ornithological and other experts what wider measures may be needed,” DEFRA said.Landeg said the disease was discovered yesterday when a veterinarian noted an increasing number of turkey deaths in one of the farm’s five barns, according to the BBC report. He said the affected birds had access to the outdoors and may have been at increased risk of contracting the disease from wild birds, which migrate in autumn.A few weeks ago, the chief veterinarian for the United Nations Food and Agriculture Organization warned that apparently healthy geese and ducks in Europe could be harboring the H5N1 virus. He advised authorities in regions that have significant duck and geese production to reinforce their monitoring and surveillance systems.In the UK’s February outbreak, the lethal H5N1 virus was found at the Bernard Matthews turkey operation in Suffolk, about 70 miles northeast of London. The source of the virus, which led to the culling of 152,000 birds, was never conclusively identified, but authorities said it was probably contaminated turkey meat imported from Hungary.The UK had an outbreak of a different avian flu type in March. In that case, a low-pathogenic H7N2 virus was detected at two small farms, one in northern Wales and one in northwest England. The outbreaks were linked to a handful of mild cases in humans.The lethal H5N1 virus has turned up in wild birds in Britain once, in a swan found dead on the coast of Scotland in March 2006. Also, the virus was identified in October 2005 in a parrot that had been imported from Suriname and quarantined in Essex with birds imported from Taiwan.See also:Feb 5 CIDRAP News story “England reports first H5N1 poultry outbreak”May 29 CIDRAP News story “Welsh officials announce four H7N2 flu cases, suspect human-to-human transmission”Oct 26 CIDRAP News story “FAO warns H5N1 may be lurking in Europe”Apr 6, 2006, CIDRAP News story “Avian flu reaches Scotland as FAO reports progress”last_img read more

GAO cites barriers to antiviral, vaccine roles in pandemic

first_imgJan 23, 2008 (CIDRAP News) – Antiviral medications and vaccines are two tools that many government and health officials hope will stall the spread of an influenza pandemic, but each strategy has daunting challenges, according to a new report from Congress’s Government Accountability Office (GAO).The report, Influenza Pandemic: Efforts Under Way to Address Constraints on Using Antivirals and Vaccines to Forestall a Pandemic, was requested by four members of Congress who head various health and homeland security committees. It was released this week on the GAO’s Web site.In its report, the GAO acknowledges that national governments and international organizations are working with pharmaceutical manufacturers to expand global production of antivirals and vaccines. However, it cites a US Department of Health and Human Services (HHS) caveat that a pandemic vaccine might play little role in the early phases of a pandemic, because it will take 20 to 23 weeks to develop and produce a targeted vaccine. Also, the GAO says it would be difficult to quickly expand antiviral production, because of the need to build new facilities, obtain production materials, and gain regulatory approval.Weaknesses in international surveillance systems are hampering the detection of influenza outbreaks, which the GAO says could limit the ability to promptly administer or develop antivirals or vaccines.”WHO has noted that to increase the likelihood of successfully forestalling the onset of a pandemic, surveillance in affected countries needs to improve, particularly concerning the capacity to detect clusters of cases closely related in time and place,” the report states. “If early signals are not identified, the opportunity for preemptive action will be missed.”Indonesia’s reluctance to share human H5N1 samples with the international community, because of its concerns that the country will not have access to the resulting pandemic vaccines, has further weakened global surveillance efforts in humans, the GAO authors write.Likewise, surveillance of influenza in animals also has shortcomings, the GAO reports. For example, outbreak definitions and reporting methods vary by country, and some countries, such as Djibouti and Uganda, lack the capacity to collect, transport, or identify animal influenza samples.The GAO notes that the WHO’s revised International Health Regulations, which for most countries took effect in June 2007, are aimed at improving global surveillance. The regulations spell out basic public health capacities countries must have and set a June 2012 deadline for nations to develop them. Also, the GAO lauds the US National Institutes of Health (NIH) for its support of influenza research and surveillance and highlights the Centers for Disease Control and Prevention’s (CDC’s) role in characterizing and tracking the global spread of the H5N1 virus.Nonexistent or poor distribution networks in many countries will hamper the release of antiviral or vaccine stockpiles, the GAO warns, citing one of its earlier investigations that found 10 of 17 countries reviewed didn’t have plans for mobilizing medical countermeasure stockpiles. A lack of distribution networks is particularly an obstacle to antiviral utilization, because experts recommend that the drugs be taken within 48 hours of symptom onset, the GAO says.To best utilize antivirals and vaccines, health officials need a reliable, fast diagnostic test to identify patients who have H5N1 infections, the report states. Though the CDC awarded four companies $11.4 million to develop new diagnostic tests, the agency estimates that approval and commercialization of the devices will take 2 or 3 years.More international support for clinical trials is needed to spur the development and evaluation of antivirals and vaccines, the GAO says. The report notes that most of the support for these studies comes from only four countries: the United States, Australia, Japan, and the United Kingdom.Health officials have hoped that establishing greater global demand for seasonal influenza vaccines could help build greater vaccine production capacity, but the GAO says some countries are too overwhelmed to participate.”Seasonal influenza programs compete with many other public health priorities for limited budgets in developing countries,” the report states. “Citing Vietnam as an example, NIH officials told us that countries may have been too overwhelmed with H5N1 outbreaks to accept offers of assistance to develop vaccine production infrastructure.”The WHO, HHS, and the US State Department were asked to review the GAO report in draft form. The GAO said the WHO commented in an e-mail that the report was “comprehensive and useful.” HHS, in a letter accompanying the GAO report, emphasized that vaccines and antivirals are only one part of the government’s pandemic response plan. The State Department and HHS both questioned the GAO’s use of the term “forestall” when referring to using antivirals and vaccines during a pandemic.”While preventing a pandemic from occurring is the goal that all strive for, whether it can actually be achieved is not known,” wrote Vincent J. Ventimiglia, assistant secretary for legislation at HHS, in a letter accompanying the report.However, the GAO said its use of the word “forestall” is consistent with the WHO’s usage of the term.See also: January 2008 GAO reporthttp://www.gao.gov/new.items/d0892.pdfCIDRAP News article series published in 2007: “THE PANDEMIC VACCINE PUZZLE”last_img read more

CDC rejects report of mutant H1N1 strain in Brazil

first_imgJun 17, 2009 (CIDRAP News) – The Centers for Disease Control and Prevention (CDC) and other experts have rejected a report that a new strain of the novel H1N1 influenza virus has been identified in a Brazilian patient.Scientists at Adolfo Lutz Bacteriological Institute in Sao Paolo said they found the new strain in a local patient who has recovered, according to a Medical News Today (MNT) report, which was based on information from the institute and Agence France-Presse.The story said the scientists found “a number of discrete alterations in nucleotide and amino acid sequences” in the isolate’s hemagglutinin (HA) gene. They also analyzed the matrix-protein (MP) gene and found no changes.But CDC spokesman Joe Quimby in Atlanta discounted the report that the isolate is a new strain. “Our scientists have no knowledge of a new strain of novel A H1N1 influenza,” he said.”It’s the same strain, it’s not a new strain,” Quimby added.The Brazilian researchers labeled the isolate A/Sao/Paolo/1454/H1N1. They deposited the nucleotide sequences for the HA and MP genes in GenBank under accession numbers GQ247724 and GQ250156, the MNT report said.Vincent Racaniello, PhD, a Columbia University virologist who writes Virology Blog, also dismissed the claim of a new strain.”Comparison of the amino acid sequence of the HA protein of A/Sao Paulo/1454/H1N1 with those of other isolates of the current pandemic strain reveals no alterations in the HA protein which would allow the virus to infect new hosts,” Racaniello wrote in his blog. “The HA protein of this virus and many other 2009 H1N1 isolates are identical. The few amino acid differences with other 2009 H1N1 isolates are in areas that would not be expected to influence antigenicity or host range.”The MNT report said the virus came from a 26-year-old Sao Paolo man who fell ill shortly after returning from a trip to Mexico. He was hospitalized on Apr 24 and later recovered.last_img read more

Novel H1N1 flu can cause severe respiratory illness

first_imgJun 29, 2009 (CIDRAP News) – Novel H1N1 influenza can cause severe respiratory illness, profound lung damage, and death even in patients with no underlying conditions to make them vulnerable, a team of physicians from Mexico report in a rush article published online today by the New England Journal of Medicine (NEJM).The analysis of 18 patients hospitalized with H1N1 (swine) flu at the National Institute of Respiratory Diseases (INER) in Mexico during the pandemic’s earliest days reveals that fewer than half had underlying medical conditions, but more than half needed mechanical ventilation within a day of admission. Seven of the 18 died.In a companion article, also published in advance online today, a multi-national team from Mexico and the United States document the age distribution of the first month of the H1N1 pandemic in Mexico, where the disease appears to have struck first, and confirm its unusual pattern of severe pneumonia among younger patients. Matching the pattern to those of earlier pandemics, the team speculates on the “biologic plausibility of partial protection” in older people exposed to mid-20th century strains of seasonal flu.The case series of 18 patients, written by researchers from INER, the Mexican Secretariat of Health and BIRMEX, Mexico’s state-owned vaccine-production laboratories, documents the severe illness of the first patients admitted with lab-confirmed H1N1 infection and x-ray–confirmed bilateral pneumonia during the pandemic’s first wave.The 18, of whom 7 died, are a subset of 98 patients hospitalized at the institute with pneumonia or influenza-like illness between March 24, the presumed onset date of the first known case, and April 24. Those 98 were a subset of 214 patients who came to the institute’s emergency room with influenza-like illness or severe respiratory distress.The 18 patients were evenly divided by gender but ranged widely in age, from 9 months to 61 years, with a median age of 38. They were all at least moderately ill, with fever of at least 38°C (100.4°F), cough, and difficulty breathing; 4 of the 5 children had diarrhea.Most had bloodwork findings that indicated acute viral infections, inflammation and cardiac distress. Half had low blood pressure that persisted after emergency treatment, and 10 of the 18 needed to be put on ventilators within 24 hours of arrival at the hospital.Eight of the 10—5 of the 11 survivors and 3 of the 7 who died—had a pre-existing medical condition: asthma, sleep apnea, diabetes, or high blood pressure. (In the United States, “The vast majority of the fatalities … do occur in people with underlying conditions,” Dr. Anne Schuchat of the Centers for Disease Control and Prevention said in a press briefing Friday. “It’s not 100%.  It’s more on the on order of three-fourths.”)”We did not find a factor that, before the onset of illness, predicted a worse outcome or death among our patients,” the researchers said.In a finding that is likely to fuel an ongoing debate, the researchers found that none of the 18 patients had concomitant bacterial pneumonia, a finding that has been replicated in the United States and that differs from cases recorded during the 1918 pandemic. However, 9 of the survivors and 4 of the deceased received antibiotics during outpatient visits before they reached the institute, and 17 were given antibiotics after admission there, making it unlikely that any bacterial infection would be discovered.Fourteen of the 18 received the antiviral drug oseltamivir (Tamiflu), either at admission or within a few days of being admitted—in all cases, many days after the 2-day window when flu antivirals are most likely to have an effect.The patients had a difficult course, with renal failure in 1 survivor and 5 of the deceased and multi-organ failure in all 7 of the dead. Pathological examination of the lungs of one of the dead patients showed severe damage to lung tissue, but, with no bacterial infection evident, the researchers ascribed it to the primary viral pneumonia caused by the new flu. No evidence was found of co-infection with any other virus.And as evidence of the way the novel H1N1 took Mexico and the world by surprise, the researchers found that the 18 patients passed the flu to their families, with 82 people potentially exposed and 20 ill. Four required hospital treatment, and 1 died. Plus, 22 of the 190 healthcare workers who came in contact with the first 3 patients admitted to the institute also came down with the novel flu, but were sent home with oseltamivir and were only mildly ill.Like the first set of patients, the healthcare workers and family members who fell ill in the second generation of cases were primarily younger, a situation mirrored in the second paper published today in NEJM. The analysis is by scientists from Arizona State University, the University of California, Berkeley, and the US National Institutes of Health, along with the Mexican Ministry of Health and National Institute of Public Health.They found that, out of 2,155 reported cases of severe pneumonia and 2,582 lab-confirmed samples of the new flu submitted in Mexico during the pandemic’s first month, 71% of severe pneumonias and 87% of deaths occurred in those between the ages of 5 and 59. That pattern is unlike any observed during seasonal flu in Mexico but matches records from the three pandemics of the 20th century, they said.Perez-Padilla R, de la Rosa-Zamboni D, Ponce de Leon S et al. Pneumonia and respiratory failure from swine-origin influenza A (H1N1) in Mexico. N Engl J Med 2009 (published online Jun 29) [Full text]Chowell D, Bertozzi S, Arantxa Colchero M et al. Severe respiratory disease concurrent with the circulation of H1N1 influenza. 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