Posted on 05/09/2005 10:18:08 AM PDT by Dog Gone
The two reports I linked here do NOT mean H5N1 is definitely here, but they ARE an example of what I would expect the first indication to look like. When H5N1 eventually shows up, I suspect the first warning is likely to be something like these two articles.
Here's one piece of info: 5 employees and 68 residents of a nursing home in Toronto, Canada, have become ill with a flu like respiratory illness. 15 of them have been hospitalized, and 4 have died. It is NOT known what it is, but the Canadian authorities report it is NOT H5N1. Details of how they excluded H5N1 so quickly are not reported. The nursing home article is here:
The same nursing home was also mentioned in an article yesterday, although there were fewer hospitalized people at that time. Yesterday's article also mentioned a second hospital with two similar patients from a different source. All these patients have unknown respiratory ailments similar to flu.
Yesterday's article also mentioned 30 dead birds found at a local golf course. The birds have been sent for testing, but the results are not yet known.
An article on the dead birds is here:
Obviously, this does not mean H5N1 has come to North America. However, as some may remember from the SARS epidemic, Toronto has a high Asian population, and was the only city in the Western hemisphere hit to any significant degree by SARS. If/when H5N1 gets to North America, Toronto is one of the cities that could be hit early.
NOTE: I'm NOT saying H5N1 has made it to North America. But I DO think Toronto bears watching.
I agree. There is NO indication that the Toronto flu is Avian.
But I also think this is how it will arrive and announce itself, although I think it will be a school or college, not a nursing home.
Actually, since a nursing home is likely to have a disproportionate number of frail people, it might show up there before showing up at a college or school.
The key question would be how the residents got exposed. Presumably, one of the employees would be exposed elsewhere. Once he became contagious, the entire population of the nursing home would be exposed in short order. A group of frail people, all exposed at the same time, could become sick in a hurry and pretty much all at the same time.
The key question is: What is it? Once you figure out what it is then you can take steps to figure out how it came into the house and then how to fight it. It could be a visiting relative. A young son or a grandson just back from a game of Golf where he noticed 60 birds that had died on the golf course.
I understand your point about a disproportionate number of frail people in a nursing home.
But the Avian flu hasn't so far affected very many elderly, mostly children and young adults, iirc.
And the 1918 flu went for the young and healthy, that was my reasoning here.
A local history book I own has a chapter about the 1918 Flu epidemic. It tells about the older people surviving and the theory was the oldsters had been exposed to more germs in their lifetime.
The author of the story didn't say a Dr provided this info, so take it for what it's worth.
I'm debating whether to try to get ahold of some tamiflu. Just in case...but would hate to shell out a few hundred dollars (for the whole family) and have it be ineffective...
Daily Bird Flu News Updates:
The Times - 3rd October 2005
http://www.timesonline.co.uk/article/0,,2-1805397,00.html
British flu pandemic 'will kill 50,000'
UK - A British flu pandemic is inevitable and will put the lives of tens of thousands of people at risk, according to the country’s top medical officer. Sir Liam Donaldson said today that it was a "biological inevitability" that when the pandemic arrives, it would have a "serious impact". The Chief Medical Officer for England said that the government’s contingency plans were looking at 50,000 deaths in the UK from the pandemic. He added that a pandemic could arrive at any time and that it was impossible to state that Britain was ready to cope.
Kingdom Prepares to Fight Bird Flu Epidemic Threat
Maha Akeel, Arab News
JEDDAH, 3 October 2005 — As Saudi Arabia prepares to welcome Muslims from around the world who want to spend Ramadan in the holy cities and then the millions who come for Haj, concerns are high about the possible arrival of bird flu in the Kingdom. Many of those who come for Umrah and Haj are from areas in Asia where the virus has spread among humans with deadly effect.
Excerpted - more at link:
Thanks for the article and the link. Very interesting...Saudi Arabia and other ME countries stockpiling Tamiflu and Relenza...
There's just not going to be enough to go around....
But I thought it wasn't spreading human to human? (/sarcasm)
Ping, please.
Ping, please.
Tuesday, October 04, 2005
Another Indonesian suspected of bird flu, condition stable
INDONESIA - A young Indonesian man is suspected of having bird flu after a local test result showed positive, and health officials said on Tuesday a specimen would be sent to a Hong Kong laboratory for further testings.
Bird flu has killed more than 60 people in four Asian nations since late 2003 and has been found in birds in Russia and Europe.
Experts' greatest fear is that the H5N1 bird flu virus, which has the power to kill one out of every two people it infects, could set off a pandemic if it gains the ability to be passed easily among people.
I Nyoman Kandun, head of disease control at Indonesia's health ministry, said the young man's condition was stable and he was being cared for at a hospital in Bandar Lampung on Sumatra island designated to treat people with bird flu symptoms.
"Although the local test shows that he is positive, we don't want to reach any conclusion yet as we are awaiting results from Hong Kong," Kandun told Reuters.
Common symptoms of the disease, such as pneumonia, can have other causes, while local testing has not always squared with results from the Hong Kong laboratory recognised by the World Health Organisation (WHO).
Indonesia officials have said five people are believed to have died in the country from the H5N1 virus strain. The World Health Organisation puts the number of dead at three, based on Hong Kong tests, and says there is a fourth case of a boy who has the disease but is alive and in stable condition.
"We have received patients with similar symptoms, but they proved to be from other causes," Kandun said.
Separately, Agriculture Minister Anton Apriyantono said authorities have found infected fowl in the neighbourhoods of the victims.
"There is a link between human victims with (infected) fowl in the surrounding area. However, we are not certain if (they) were exposed from the neighbourhoods," Apriyantono told reporters.
Officials have said suspected human cases have come from nine provinces out of 33 across Indonesia's sprawling archipelago. The virus has spread to 22 provinces and more than 10 million fowl have been culled since late 2003.
I have to agree with her. One letter written to my nephew in Iraq at the time was an apology for my generation screwing things up so badly, being so stupid, and having the wrong focus on the most important of world events, events materializing in the ME at the time. It seems my generations' focus was on the USSR, even though we had warning signs, from as early as I recall, the 1970's and the Carter mess.
[Date: 2005-10-05]
Experts in Hong Kong have warned that the human H5N1 strain of avian flu that surfaced in northern Vietnam this year is proving resistant to Tamiflu, the commercial brand of oseltamivir, a powerful antiviral drug widely considered the best chance of protecting the population.
Dr William Chui, an associate professor at Queen Mary Hospital in Hong Kong, has said that health authorities could no longer rely on Tamiflu. 'There are now resistant H5N1 strains appearing and we can't totally rely on one drug,' reports Reuters. Mr Chui also claimed that general viral resistance to Tamiflu is growing in Japan, where doctors routinely prescribe this drug to fight common human influenza.
Public health experts have urged drug manufacturers to make more effective versions of Relenza (zanamivir), an alternative antiviral that is also known to be effective in battling the feared H5N1. Relenza is inhaled. 'Manufacturers should think about producing an injectable form of Relenza because resistance to Tamiflu has been seen in Japan and Vietnam,' Mr Chui said. 'Also with injections, high doses can be given where necessary and onset time is a lot faster.'
A small Japanese independent study published last August already suggested that influenza viruses were becoming resistant to Tamiflu, and that the resistance may be more common than thought. In this study, 18 per cent of the child patients had Tamiflu-resistant influenza, said lead researcher Yoshihiro Kawaoka, a professor of virology, microbiology, and immunology at the University of Tokyo.
A Swiss manufacturer Roche Holdings AG spokesperson said that its own research had pointed to resistance being much lower in both children and adults. Roche also pointed out that this study included several children under one year old (Tamiflu is not approved for use in this age group), and that the Japanese patients 'may not have received an adequate dose of Tamiflu'.
Two further reports published recently in The Lancet medical journal also state that resistance to anti-flu drugs is growing worldwide. In places such as China, drug resistance has exceeded 70 per cent, suggesting that drugs such as amantadine and rimantadine will probably no longer be effective for treatment or as a preventive, reports The Times.
News of the virus's presence advancing towards Europe has prompted the EU to begin stockpiling antiviral drugs. Tamiflu was being stockpiled by countries as part of 'preparedness strategies'. However, the UK now believes that, due to the speed with which the flu virus mutates, the most effective medication would not been known until a pandemic arrived. Tamiflu is however still considered to be an effective option. On BBC Radio, Sir Liam Donaldson, Chief Medical Officer for England, said that contingency plans for the UK had not changed.
The Australian federal government has also stockpiled about four million doses of Tamiflu, rather than the alternative anti-viral drug, Relenza, based on medical advice. The US federal government has stockpiled Tamiflu for one million people.
Finland has informed pharmaceutical labs across Europe that it is seeking 5.2 million doses of a vaccine against the deadly bird flu, allowing it to protect its entire population. The Finnish government has asked its parliament to free 21 million euro for the purchase of stockpiles of the vaccine. Although Finland aims to stockpile enough vaccines to protect all Finns, authorities are not planning to start vaccinating the population until an epidemic has been declared. Finland experienced its first bird flu scare last month, when gulls appeared to show signs of the virus. The strain was later found to be harmless to humans.
Fears about the latest strain of bird flu triggering a new pandemic are real in spite of the fact that there is no evidence of human-to-human transmission of the avian flu H5N1 strain. So far, it has mainly infected humans who were in close contact with infected birds. But the virus needs to be under permanent monitoring in order to establish whether there are any genetic changes that could make it become more lethal and spread more rapidly.
In recent weeks, several countries have joined forces to coordinate preparation. The United States announced a new International Partnership on Avian and Pandemic Influenza at a World Summit in New York. On 7 and 8 November the World Health Organisation will host a meeting of all partners to coordinate the funding needed.
http://dbs.cordis.lu/cgi-bin/srchidadb?CALLER=NHP_EN_NEWS&ACTION=D&SESSION=&RCN=EN_RCN_ID:24551
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