Posted on 05/09/2005 10:18:08 AM PDT by Dog Gone
Some folks suggested that we begin a thread similar to the Marsburg Surveillance Project for monitoring developments regarding Avian Flu.
The purpose is to have an extended thread where those interested can post articles and comments as this story unfolds.
If we're lucky, the story and this thread will fade away.
That's a good question but one I am not qualified to answer. Perhaps Mother Abigail can?
I do, however, remember this same question came up a few months ago and was answered by 'Kelly_2000' - who is apparently knowledgeable (BTW, I haven't seen her here for quite a while and this is her specialty so she is undoubtedly very busy). As I recall, she replied protection would not be perfect but might provide some protection, perhaps up to 70%.
Now, 70% is a long, long way to the good from the natural 'zero' immunity we now have. So, with a killer like this I will gladly take that any day as opposed to nothing at all while we await a newer vaccine based on the actual raging virus.
But as I say, perhaps somebody more knowledgeable than I can respond in greater detail?
marking spot
Daily Bird Flu News Updates:
http://www.thepoultrysite.com/LatestNews/?AREA=LatestNews&Display=6187
Reuters via SMH - 17th October 2005
Tackle bird flu at its source, vet urges
Building up South-East Asia's defences against bird flu could take 10 years, but fighting the virus at its source would be cheaper and a more effective way to stop a human pandemic, a top animal health official says.
Alejandro Thiermann, of the World Organisation for Animal Health, said too much attention was being paid to stockpiling scarce antiviral drugs and developing a vaccine, and "not enough on birds".
China remains worrisome. Hmmm.
thanks for the update
best posts award. did you ping the whole list?
Thanks bitt, yep I pinged the list you gave me.
Among other things, the film followed one family who had eaten a chicken that had died of illness. I believe this was in Viet Nam. The 22-year-old son was devastatingly ill. His little 10(?) year old sister fell ill also, but seemed to do better and recover quite well. The young man was near death for some time, and when he recovered he looked like a skeleton. They said he could have permanent weakened lungs. They tested the whole family for the virus, and the 80-year-old grandfather also tested positive but was completely symptom-free.
Next they showed a man who had been the constant nurse in the hospital for the young man above. He fell very ill with the virus, but he too recovered. They interviewed him, and he said that he lives in the city, not near any poultry, and never eats poultry or birds. But he cared for the sick man for weeks. That has to be human-to-human.
Near the end of the film, they showed a silhouette of a sick man lying in a private room and said that it was a physician who had been caring for patients with bird flu.
This virus is obviously transmittable human to human.
Yes it is, just not easily transmissable, yet.
The story about the Vietnamese family is on the BBC site, btw. I read it the other day.
http://www.freerepublic.com/focus/f-news/1504369/posts
As Alarm Over Flu Grows, Agency Tries to Quiet Fears
nytimes ^ | 10/18/05 | LAWRENCE K. ALTMAN
Posted on 10/18/2005 1:01:51 AM EDT by bitt
Trying to calm worldwide alarm about the spread of an avian influenza virus to Europe from Asia, an official of the World Health Organization cautioned yesterday that there were still no signs of an influenza pandemic in humans.
But the A(H5N1) avian strain is expected to spread to additional countries, and the agency remains concerned about the longer-term potential for the virus to mutate or combine with a human influenza virus to create a new one that could cause a human pandemic, the official, Dr. Mike Ryan, said. A pandemic is an epidemic that is prevalent across a wide area.
~~~~~~~~~~~~~
http://www.freerepublic.com/focus/f-news/1503902/posts
Litigation, regulation, price controls, and the avian flu. [This reminds me of Atlas Shrugged]
National Review ^ | October 17, 2005 | Sally Pipes
Posted on 10/17/2005 10:23:08 AM EDT by grundle
http://www.nationalreview.com/comment/pipes200510170828.asp
October 17, 2005, 8:28 a.m.
Red Tape Choking Us
Litigation, regulation, price controls, and the avian flu.
By Sally Pipes
"We are not prepared for a pandemic,” Health and Human Services Secretary Michael Leavitt said earlier this month. We do, however, face a significant risk of being hit by one. A new strain of the avian flu, known as H5N1, has killed at least 60 people in Asia since 2003. So far, humans cannot pass it to one another — virtually everyone infected caught the virus from a diseased bird.
The risk to people is nevertheless grave. The 1918 Spanish flu epidemic, blamed for 50 million deaths, also started among birds, but it mutated and spread to humans. Scientists fear the same thing could happen now. As an expert epidemiologist recently told the Wall Street Journal, “It’s not a question of if, but when.” The Centers for Disease Control (CDC) estimates that an avian-flu pandemic could kill between 89,000 and 207,000 Americans. There is no publicly available vaccine for the new strain.
~~~~~~~~~~~~~~
http://theedge.bostonherald.com/healthNews/view.bg?articleid=107564
Flu shots no help against avian strain
By Jessica Heslam
Tuesday, October 18, 2005
As avian flu fears continue to heighten, some confused Bay Staters have been asking their doctors whether this season's flu shot would protect them against the deadly bird flu.
It won't.
``This flu shot will not protect against avian flu. There's no vaccine available to protect people against avian flu,'' said Dr. Alfred DeMaria of the state Department of Public Health. ``People are confused about a pandemic flu, avian flu and ordinary flu.''
Nearly 430,000 doses of flu vaccine were delivered to state health officials Friday, part of the 728,000 that are expected.
People who are most vulnerable, such as those older than 65 or who have chronic health conditions, are being urged to get a flu shot. After Oct. 24, anyone can get a flu shot, officials said.
Last year at this time, the Bay State had a shortage of flu vaccine after a supplier was shut down because of contamination concerns. Half the U.S. supply was lost.
``We were very uncertain at this time last year,'' DeMaria said. ``Things look pretty good now.''
So far, 117 people in Asia – mostly poultry farmers – have caught the H5N1 strain, also known as avian flu. Nearly all infections have been traced to direct contact with infected birds.
Officials fear avian flu will eventually spread from human to human. A worldwide flu outbreak occurs every 20 to 50 years, experts say, and the last one occurred in 1968.
The World Health Organization said yesterday that avian flu can be expected to spread to other countries, but the biggest threat of it mutating into a human virus remains in Asia. The disease was recently found in Romania and Turkey. No cases have been reported in the United States.
Study shows 15 clusters of avian flu cases; some likely human-to-human spread
10-18-05 | Helen Branswell
Posted on 10/18/2005 8:04:21 AM EDT by Mother Abigail
Study shows 15 clusters of avian flu cases; some likely human-to-human spread
Helen BranswellCanadian Press
Tuesday, October 18, 2005
Clustering of human cases of H5N1 avian flu infections has occurred on at least 15 occasions since late 2003 and limited human-to-human transmission of the virus may have occurred in several of these groupings, researchers will report in an upcoming issue of the scientific journal Emerging Infectious Diseases.
But key information on several of the clusters - the most recent documented in the paper occurred in early July - is still outstanding, illustrating some of the problems international health authorities will likely face if they try to put into action a plan to extinguish an emerging pandemic at source.
The lead author admitted that the rate at which information about human cases has emerged from affected countries raises worries about how clear a picture international authorities have when such events occur.
"Part of the reason to highlight this is to suggest any cluster should be viewed as a worrisome event and should be thoroughly worked up so that we can ascertain if it's person-to-person (spread) or rule it out," said Sonja Olsen, acting director of the U.S. Centers for Disease Control's International Emerging Infections Program, which is based in Bangkok.
"I'm sure some of these are just clear that there was no person to person and some to me seem less clear from the data that we have. But I think it raises the issue of: Do we have enough data on each of these?" Mathematical modelling work published in August suggests an emerging pandemic strain could be snuffed out at source.
But success was predicated on rapid identification of clustering of cases and likely human-to-human spread so that contacts of infected people could be quickly placed on antiviral drugs. Measures would also have to be taken to cordon off an affected area to ensure infected people didn't flee and spread the disease.
The authors combed published reports and consulted regional contacts looking for clusters of cases within families that occurred from January 2004 to July 2005. Since their report was submitted another family cluster occurred in Indonesia involving a woman and her young nephew, both of whom tested positive for H5N1 virus.
Their report will appear in the November issue of the journal, which is published by the CDC.
A cluster was considered two or more cases, where at least one member tested positive for the virus and other members of the cluster experienced severe pneumonia or death from respiratory disease.
Olsen said where human-to-human transmission may have taken place, the dates of onset of illness suggest transmission stopping after one generation. In other words, if a person passed the disease on to someone else, the newly infected individual did not appear to have spread it further.
"It's not to say there weren't tertiary cases, but we're not clearly seeing that in these data," she said from Bangkok.
Daily Bird Flu News Updates:
http://www.thepoultrysite.com/LatestNews/?AREA=LatestNews&Display=6187
KAZINFORM - 18th October 2005
Russia confirms bird flu in two eastern regions
MOSCOW - Bird flu cases have been confirmed in two more districts in the eastern Russian province of Kurgan and 22 others are suspected to be outbreak sites, the Russian Agriculture Ministry said in a press release Monday. "Quarantine was lifted from two previously suspected districts in the Novosibirsk region (Siberia) and 17 districts remain under suspicion. In the Altai Region (Siberia), two districts are under suspicion," the ministry reported, Kazinform refers to RIA Novosti.
She had additional comments expanding on the article. The actual thread is here:
Mother Abigail thread on Avian Flu clusters
In my view, the H5N1 Surveillance Project thread (i.e., THIS one) is the best single source for archived news on H5N1. Personally, I would like to see it kept continually up to date.
So... Many thanks to ALL who have been keeping this thread current.
TechCentralStation has posted a few good articles recently about this issue. Here's the most recent:
http://www.techcentralstation.com/101705B.html
Preparing for the Pandemic
Henry I. Miller, MD
I have a long and intimate relationship with influenza virus. More than 30 years ago, I was the co-discoverer of one of the viral enzymes that are essential for the virus to duplicate and proliferate. Later, my medical training taught me respect for this pathogen. Real influenza -- as opposed to a garden-variety cold -- is a serious illness. Its victims don't soon forget the fever, headache, muscle aches and profound weakness, and in an average year -- in spite of vaccines that are usually at least moderately effective -- it kills tens of thousands in this country.
Now it appears that the flu virus is poised to repeat its several-times-a-century metamorphosis into something much worse.
First, some background. The exterior of the flu virus consists of a lipid envelope from which project two surface proteins, hemagglutinin (H) and neuraminidase (N). The virus constantly mutates, which may cause significant alterations in either or both of these, enabling the virus to elude detection and neutralization by humans' immune system. A minor change is called genetic drift; a major one, genetic shift. The former is the reason that flu vaccines need to be updated from year to year; an example of the latter was the change in subtype from H1N1 to H2N2 that gave rise to the 1957 pandemic. This new variant was sufficiently distinct that people had little immunity to it: The rate of infection of symptomatic flu that year exceeded 50 percent in urban populations, and 70,000 died from it in the United States alone.
In the 1957 outbreak the mortality rate (the fraction of infected persons who die) was low, but we appear to be on the verge of another, much worse pandemic.
During the past several years, an especially virulent strain of avian flu, designated H5N1, has ravaged flocks of domesticated poultry in Asia and spread to migratory birds and (rarely) to humans. Now found from Russia and Japan to Indonesia, it is moving inexorably toward Europe. Since 2003, more than 60 human deaths have been attributed to H5N1. Public health experts and virologists are concerned about the potential of this strain because it already has two of the three characteristics needed to cause a pandemic: It can jump from birds to human, and can produce a severe and often fatal illness. If additional genetic evolution makes H5N1 highly transmissible among humans -- the third characteristic of a pandemic strain -- a devastating world-wide outbreak could become a reality.
Moreover, this is an extraordinarily deadly variant: The mortality rate for persons infected with the existing H5N1 appears to be around 50 percent, whereas the usual annual flu bug kills fewer than one percent.
We are ill-prepared for a flu pandemic. Reserve capacity is grossly inadequate for vaccines, drugs and hospital beds. The best and most cost-effective intervention -- prevention with a vaccine -- presents many obstacles, technological, economic and logistical.
Anti-flu drugs exist but are not a panacea. Unlike vaccines, which confer long-term immunity after one or two doses, drugs need to be taken for long periods. The only drug that has been shown to prevent the flu is Tamiflu, the prophylactic dose of which is one tablet a day, the effect lasting only as long as one takes the drug. (The other major anti-flu medicine, Relenza, has only been shown to be effective to treat, but not prevent, flu.)
Historically, flu pandemics have come in two or three waves, lasting a total of 13-23 months. In other words, the need to take Tamiflu -- by first responders, health care workers and ordinary citizens -- could go on for months and months, or even years. U.S. public health officials have said they plan to buy 20 million doses of Tamiflu, but that would be enough to treat only 200,000 people (fewer than the number who would attend a seven-game World Series) for 100 days. And the retail price per pill is around $8, so the expense to treat that small number of people for that amount of time would be $160 million.
According to various models, in the absence of sufficient amounts of an effective vaccine -- which is not yet within reach -- to blunt a pandemic we would need to treat perhaps a third to a half of the population with Tamiflu. Do the math: 100 million people for 100 days equals 10 billion doses, at a retail cost of $80 billion, in order to blunt the pandemic's first wave.
Although President Bush and HHS Secretary Leavitt are saying some of the right things about the need to prepare for the pandemic, if they or their staffs have done this sort of calculation, they give no sign of it.
We need push-pull incentives to forming public-private partnerships. Public policy must reward both inputs on R&D (via grants, tax credits and the waiver of regulatory registration fees) and outputs of products (with guaranteed purchases, payments for the regulatory approval of new drugs or vaccines, and indemnification from liability claims). Part of this effort should be R&D on various new technologies and approaches to making flu vaccine, to boosting the immune response to vaccines, and to creating greater reserve capacity for the production of drugs like Tamiflu and Relenza.
Preparation for pandemic flu involves many thorny issues of science, technology and medicine, but also much more. It requires contingency plans for the "social" aspects of a deadly pandemic -- when to shut our borders to travelers from infected regions, close schools, restrict public gatherings, and enforce quarantines, as well as a designated chain of command to implement those decisions.
Like the WWII Manhattan Project to develop the atomic bomb, preparation for a flu pandemic involves scientific uncertainties, strategic decisions that span many specialties and government departments, and prodigious resources. To oversee all this, we'll need a Flu-Pandemic Czar -- someone analogous to Army General Leslie Groves, who headed the Manhattan Project: a plenipotentiary with broad powers and discretion.
There is no time to waste.
Henry I. Miller, a physician and fellow at the Hoover Institution, was the founding director of the Office of Biotechnology at the FDA, 1989-1993. Barron's selected his latest book, "The Frankenfood Myth..." as one of the 25 Best Books of 2004.
Thanks for an outstanding post.
I know a lot of people are following this that I did not ping. Sorry if I left someone off (I don't have a ping list).
Concise, informative, scary. Thanks for posting.
I do not think that there will be an H5N1 Manhattan project. I'm not very hopeful about a benign outcome of antigenic shift with the virus, either.
I find I have less and less to say about this...guess I've said everything a hundred times already.
bump
China Reports 2,600 Birds Dead of Bird Flu in North, EU Suspects Disease in Macedonia
http://ap.tbo.com/ap/breaking/MGBWW36HZEE.html
Published: Oct 19, 2005
BEIJING (AP) - Some 2,600 birds have been found dead of bird flu in northern China's grasslands, the government said Wednesday.
In Brussels, a European Union official said there is a suspicion of bird flu in Macedonia. The disease has already affected birds in at least two other European countries; Romania and Greece.
In Russia, hundreds of birds have died suddenly in a region south of Moscow, local media reported on Wednesday, raising fears of a new outbreak of bird flu there. If confirmed, the discovery in the Tula region, about 125 miles south of Moscow, would mark the first time that the deadly virus has appeared in European Russia, west of the Ural Mountains.
The dead birds in China were found in a breeding facility in Tengjiaying, a village near Hohhot, the capital of the Inner Mongolia region, the official Xinhua news agency reported. They were infected by the deadly H5N1 strain of the virus, Xinhua said. It did not give any further details.
"The epidemic is under control," Xinhua said.
European Union officials said they were preparing to extend a ban on imports of pet birds and feathers from Siberia because of the bird flu.
EU spokesman Philip Tod also said the EU executive would send experts to Greece to help identify bird the bird flu strain there. Health officials said they will also hold a simulation exercise of a flu pandemic by end of year to improve preparedness.
AP-ES-10-19-05 0639EDT
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