Avian Flu Preparedness Project

Freepers. ^ | July 29, 2005 | various FReepers

[Judith Anne]

This thread is for specific questions and answers about preparing for Avian Flu in the US. News articles and discussion about the Avian Flu can be found here:

http://www.freerepublic.com/focus/f-news/1399613/posts

Everyone who was on the Avian Flu Surveillance Project ping list will be on this ping list. If you want on or off this list, please let me or Dog Gone know. Thanks.

[MD_Willington_1976]

How do we go about getting private stock of Tamiflu and avian flu vaccine...

I can see most of the purchased vaccines going to the government, healthcare workers and the military, while the peons scurry about with the carts...

ashes ashes we all fall down...think that's funny...I don't.

[txhurl]

bttt

[bitt]

Deadly avian flu keeps N.J. on edge

Friday, September 16, 2005

By BOB GROVES
STAFF WRITER
http://www.northjersey.com/page.php?qstr=eXJpcnk3ZjczN2Y3dnFlZUVFeXkzJmZnYmVsN2Y3dnFlZUVFeXk2NzY5NzgwJnlyaXJ5N2Y3MTdmN3ZxZWVFRXl5Mg==


There's flu, and then there's Flu.

This year, doctors are on the lookout not just for seasonal influenza, but also for the possible arrival, later on, of a lethal and highly contagious strain of avian flu from Southeast Asia.


"Basically, bird flu has the same symptoms as regular flu, except you don't get better," said Dr. Barry Prystowsky, a pediatrician in Nutley. Prystowski is one of about two-dozen doctors in New Jersey designated by the state as "sentinel physicians," who keep a watchful eye for signs of pending epidemics.

"You quickly dehydrate and get pneumonia at the same time. You would need hospitalization within a few days, then end up on a respirator and probably die," Prystowsky said.

It's a dire diagnosis, but New Jersey health officials believe the state is ready.

Sentinel physicians are one component of a comprehensive early detection and response system outlined in a draft of the state's 2005 Influenza Pandemic Plan. An updated version of the plan, first conceived in 2002, is posted online. It will be revised to keep up with emerging infectious diseases, officials said.

A pandemic is an epidemic that can spread across a country and to other parts of the world. Bird flu, which emerged last year in Vietnam and Thailand and moved recently to Russia, has killed more than 50 people, mainly poultry workers. What has not happened, but what health officials fear, is that the avian flu virus - known as H5N1 - will be spread further by migratory birds.

The even bigger fear is that the virus will combine genetically with a human viral strain that can be transmitted person to person.

That new strain would be highly contagious and deadly, scientists say.

Some experts have predicted darkly that, if such a strain develops, the world could face a pandemic like the so-called Spanish flu of 1918 that killed more than 20 million people. There is no way to say if and when bird flu will hit the United States, but European officials worried this summer that they will have to deal with it sooner rather than later. One British scientist told reporters bird flu presents "a national emergency. ... Many people are threatened by a virus that can decimate a country."

As it is, New Jersey health officials estimate that an eight-week pandemic would cause 1.5 million outpatient visits and nearly 41,000 hospital admissions, including 9,553 patients in intensive care and 4,775 on respirators. There would be 8,141 deaths, they estimate.

Across the United States, officials predict that a pandemic could kill upward of 207,000 and hospitalize 733,000, compared with 36,000 deaths and 114,000 hospitalizations in an average flu season.

Sentinel doctors

Sentinel physicians such as Prystowsky are on the outlook for increasing numbers of patients with symptoms such as sore throat, fever and cough. The doctors file a weekly report with New Jersey's Local Information Network and Communication System and state health officials analyze the data for spikes in the numbers.

If a suspicious illness appears, the sentinel physician may send a sample to the state labs in Trenton to be tested and forwarded to the federal Centers for Disease Control and Prevention, which oversees the sentinel program.

New Jersey's Pandemic Plan is a "generic" defense against any invading microbe, said Dr. Eddy Bresnitz, the state epidemiologist.

"The approach would be the same whether for bird flu or other flu," Bresnitz said. "This is flu. We're going to test it. When we do surveillance, we don't presuppose for what. If we knew what strain it was, we wouldn't have to test for it."

New Jersey will also monitor any "influenza-like illness" reported by hospitals, nursing homes and elementary schools, as well as the amount of over-the-counter drugs sold by pharmacies, as possible early indicators of flu.

Also, six cities - Paterson, Jersey City, Elizabeth, Newark, Trenton and Camden - are among 120 cities nationally that will tell the CDC each week how many death certificates involved pneumonia and influenza.

New Jersey's response to a flu pandemic would include informing the public about supplies of vaccine and antiviral medication - such as Tamiflu, an effective prescription flu treatment if used shortly after symptoms appear - school and business closings, suspended public meetings, travel restrictions and quarantines. More than 3,000 crisis counselors would be deployed.

The state is a lot better prepared since Sept. 11 and the subsequent anthrax and bioterrorism scares, Bresnitz said. "We've really improved all our capabilities of responding to emerging infections," he said.

In months to come, New Jersey will stage a flu-pandemic exercise similar to the simulated bio-terrorism attack drills held at hospitals in the spring, Bresnitz said. The state Department of Agriculture also has an avian-flu detection and response plan, including the culling of infected poultry flocks if necessary.

Flu is airborne

Bresnitz said there is more than just a whimsical distinction between sentinel physicians who gather information, and the so-called sentinel chickens used by health officials in years past to detect the presence of West Nile virus-infected mosquitoes.

But surveillance is only a tool for early detection and might not stop a pandemic, Bresnitz said.

"Influenza is an airborne disease spread very efficiently, with a short incubation, so we'd have to depend on other things," he said. This includes common sense personal hygiene such as hand washing and covering coughs and sneezes.

Seasonal influenza and flu pandemics have many similar public health issues, such as potential vaccine shortages, Bresnitz said. Federal scientists, for example, announced this month they had successfully tested a potentially effective bird-flu vaccine in people, but are unsure whether they can produce enough of it in time.

"But a pandemic is a different beast," Bresnitz cautioned. "A novel virus strain that nobody is experienced with has higher mortality and greater number of people infected."

New Jersey will also encourage hospitals statewide to develop "surge capacity" guidelines, similar to ones issued during last year's flu-vaccine shortage, to accommodate the anticipated crush of thousands of pandemic patients. They will have to decide whom to admit and whom to send home.

"I think they're all as prepared as they can be," Aline Holmes said of the New Jersey Hospital Association's 105 members.

"Everyone has their plans in place to work closely with the Health Department," said Holmes, a nurse and the association's flu liaison with the state.

Prystowsky, the Nutley sentinel physician, is less sanguine.

If bird flu combines with a human viral strain and begins to spread, he said, "I think it's going to be devastating."

"I think thousands of people are going to die, especially the fragile, the elderly, the very young, the babies. I don't think we'll have the vaccine supply because they won't be able to produce it. If it hits, hopefully we'll have enough Tamiflu to save some of us."
~~~~~~~~~~~~~~~~~~~~~~~~~
http://abclocal.go.com/wtvd/story?section=triangle&id=3450239

Worries Mount over Bird Flu Tim Nelson
(09/16/05 -- RALEIGH) - Health experts say a deadly, new strain of the flu virus could pose a far greater threat than smallpox, AIDS or anthrax.

ABC News obtained a government draft report predicts as many as 200,000 Americans could die within a few months if the killer strain made its way to the United States. The avian flu, or bird flu, comes from Asia. It had never been seen in humans until recently. About half of the people it infected have died.
The strain started in birds, which transmitted the virus to people. Doctors fear that the virus could mutate.

"It would move rapidly through the population, if it had adapted to the point that it can move from human to human," said Dr. Leah Devlin, the state's health director.


She says local, state and federal officials are preparing for a worst-case scenario. At this point, neither the state nor the country has an adequate vaccine supply against the bird flu. The U.S. agreed yesterday to purchase about $100 million of inoculations, possibly enough for $2 million.

Devlin says the state is as prepared as it can be.

"We have strong laws in N.C. about reporting communicable diseases," she said. "We also have strong laws about quarantine and isolation. So, we are in good shape in N.C. We are as prepared as we can be, given we don't have enough vaccine for everyone."

Devlin says everyone should get their normal flu shorts to protect against a regular flu virus, but adds the normal vaccine would not prevent bird flu.
~~~~~~~~~~~~~~~~~~~~~

http://www.thejakartapost.com/detaillatestnews.asp?fileid=20050917173215&irec=1
Indonesia promises tough action to counter spread of bird flu

JAKARTA (AFP): Indonesia promised tough action Saturday to counter the spread of bird flu and urged people to remain calm after the country confirmed a fourth death from the virus.

The death last week of a 37-year-old Jakarta woman from bird flu brought Indonesia's toll level with that of Cambodia, while 43 deaths have been recorded in Vietnam and 12 in Thailand.

"We appeal to the public to help us by remaining calm. We will work very hard to minimize this disease so that it will not spread further," Health Minister Siti Fadillah Supari told AFP.

I Nyoman Kandun, the ministry's director general of disease control, said Saturday that a six-year-old girl was also being treated in Jakarta as a "suspected case" of bird flu.

Commenting on mounting international concern that bird flu could mutate into a major killer, Nyoman said Indonesia would carry out "comprehensive efforts" to stop further outbreaks.

Birds would be vaccinated, people visiting infected areas would be monitored, hospitals would be told how to cope with bird flu patients and an information campaign on the virus would be launched, he said.

Jakarta launched a massive vaccination drive against the disease after a man and his two daughters died in suburban Jakarta in July, but has been criticized for carrying out only limited culls.

The World Health Organization (WHO) requires that poultry within a radius of three kilometers (1.9 miles) from any bird flu outbreak be killed.

Health experts have warned that the bird flu virus could spark a global pandemic if it developed the ability to spread quickly among humans. (**)
~~~~~~~~~~~~~~

http://news.xinhuanet.com/english/2005-09/17/content_3502821.htm

Thai gov't to ask US assistance in fighting bird flu

www.chinaview.cn 2005-09-17 13:18:19

BANGKOK, Sept. 17 (Xinhuanet) -- Thailand will seek help from the United States in strengthening its ability to combat bird flu, an official from the Livestock Development has said.

The department will ask the United States to help develop its laboratory work and capacity-building for epidemiologists, the key part for fighting avian influenza, Nirundorn Aungtragoolsuk, head of the disease control and veterinary services bureau was quoted by Bangkok Post newspaper as saying Saturday.

To date, Thailand have all together eight laboratories to conduct bird flu test and no more than 10 epidemiologists working to detect and contain the epidemic. .......

~~~
http://www.chinadaily.com.cn/english/doc/2005-09/17/content_478729.htm

WHO warns of a world wide bird flu epedemic
(IHT.com)
Updated: 2005-09-17 15:16

As World Health Organization officials repeated warnings about the potential for a deadly bird flu pandemic and President George W. Bush proposed an "international partnership" to combat the disease, wealthier countries around the world are redoubling efforts to purchase an experimental vaccine and antiviral drugs in the hopes of protecting their own citizens from infection.

"We cannot afford to face the pandemic unprepared," said Lee Jong Wook, director of the WHO, at the United Nations on Thursday.

The UN agency and the European Union have been urging countries for months to prepare for the possibility of a future human pandemic caused by the bird flu virus, even as they have acknowledged that there is no current risk: The virus, A(H5N1), which has killed millions of birds, only rarely infects humans and does not normally spread from person to person - a basic requirement for human epidemics.

But scientists are worried that it could someday acquire that ability through one of several biological processes. Faced with the unprecedented damage caused by Hurricane Katrina, calls for better disaster planning against disease seem to have taken on new urgency.

This week, the United States announced that it had placed an order for $100 million worth of a promising but still technically unlicensed vaccine that is under development by the French drug maker Sanofi-Aventis.

Italy announced that it had contracted to order 35 million doses of vaccine and other medicines.

Roche Pharmaceuticals was struggling to fill huge recent orders from 30 jurisdictions for antiviral drugs, said Martina Rupp, a spokeswoman for the company, based in Basel, Switzerland. These include Australia, France, England, Singapore and South Korea, as well as Hong Kong..............

~~~~~~~~~~~~
http://www.taipeitimes.com/News/world/archives/2005/09/17/2003272035

Indonesia confirms bird flu death

DON'T PANIC, YET: The country confirmed its fourth human death from H5N1, Asia's 63rd, as a WHO official warned yet again on the threat of a deadly pandemic

AP , JAKARTA
Saturday, Sep 17, 2005,Page 5

An Indonesian man carries chickens on his motorbike at a farm in Jakarta yesterday. Indonesian health authorities announced yesterday its fourth human death from bird flu after tests confirmed that the woman who died late last week was infected by the deadly virus.
PHOTO: EPA

Indonesia yesterday confirmed its fourth human death from the bird flu virus, taking the death toll in Asia to 63, and said it was investigating whether a neighbor of the victim was also sickened by the disease.

Tests from a Hong Kong laboratory showed that a 37-year-old woman who died last week had contracted the H5N1 bird flu virus, said I Nyoman Kandun, the health ministry's director general for illness control and environmental health.

The health ministry also said that a neighbor of the woman had been hospitalized with symptoms consistent with bird flu. But authorities said they were still awaiting lab results before confirming she had been sickened by the virus.

Kandun warned that Indonesia would continue to report cases because the virus was rife in poultry farms across the country.

"It will be like in Vietnam and Thailand," he told reporters.

The virus has swept through poultry populations in large swathes of Asia since 2003, resulting in the deaths of tens of millions of birds -- and 63 people, most of them in Vietnam and Thailand.

"Be alert, but do not be alarmed."

I Nyoman Kandun, the Indonesian health ministry's director general for illness control and environmental health

Indonesia recorded its first human fatalities from bird flu in July when a father and his two daughters died after contracting the virus. Officials have linked those deaths to droppings from an infected bird.

Kandun said the source of the latest infection was not yet known.

He said surveillance of poultry needed to be stepped up, but urged the country's 210 million people not to panic.

"Be alert, but do not be alarmed," he said.

Officials have carried out limited vaccinations of some of the estimated 2 billion birds in the country, but say they lack funds to carry out culls of flocks in areas where the virus is prevalent.

The virus has been recorded in 22 of Indonesia's 32 provinces since 2003.

Most of the human deaths from bird flu have been linked to contact with sick birds. But the World Health Organization has warned that the virus could mutate into a form which is more easily transmitted from human to human, possibly triggering a pandemic that could kill millions worldwide.

Indonesia confirmed its fourth human death from bird flu on Friday and said another person was suspected of having the virus as global alarm grew that the disease would mutate and become a pandemic.

Speaking in New York on Thursday, World Health Organization chief Lee Jong-wook said the virus was moving toward becoming transmissible by humans and that the international community had no time to waste to prevent a pandemic.

The highly pathogenic H5N1 strain of the virus has killed 64 people in four Asian countries since late 2003 and also spread to Russia and Europe.

Indonesian health officials said tests had shown bird flu killed a woman who died last week in a Jakarta hospital after she was admitted suffering from pneumonia and flu-like respiratory problems.

"It's positive for H5N1," I Nyoman Kandun, director-general of disease control at the Health Ministry, told reporters.

[bitt]

http://www.nytimes.com/2005/09/19/health/19flu.html
By ELISABETH ROSENTHAL
Published: September 19, 2005
International Herald Tribune

ROME, Sept. 18 - As World Health Organization officials repeat warnings about the potential for a deadly bird flu pandemic, wealthier countries are redoubling efforts to buy an experimental vaccine and antiviral drugs in the hopes of protecting their citizens from infection.

At the United Nations on Wednesday, President Bush proposed an "international partnership" to combat the disease, and the United States announced last week that it had placed orders for $100 million worth of a promising but technically unlicensed vaccine that is under development by the French drug maker Sanofi-Aventis.

"We cannot afford to face the pandemic unprepared," Lee Jong Wook, the director of the World Health Organization, said Thursday at the United Nations.

The health agency and the European Union have been urging countries for months to prepare for the possibility of a human pandemic caused by the bird flu virus, even as they have acknowledged that there is no current risk. The virus, A(H5N1), which has killed millions of birds, only rarely infects humans and does not normally spread from person to person - a basic requirement for human epidemics.

But scientists are worried that it could someday acquire that ability through one of several biological processes. In the wake of the unprecedented damage caused by Hurricane Katrina, calls for better disaster planning against disease seem to have taken on new urgency.

Roche Pharmaceuticals was struggling to fill huge recent orders from 30 countries for antiviral drugs, placed as part of disaster planning, said Martina Rupp, a spokeswoman for the company. Those countries include Australia, France, England, Singapore and South Korea.

"We have learned in the past weeks that bad things can happen very fast," said Michael O. Leavitt, the secretary of health and human services, as he explained the need for the new partnership to fight bird flu.

Specialists say planning for the possibility of a worldwide pandemic is difficult because the vaccines are novel and the drugs have not been used in this capacity before.

But as countries spend tens of millions of dollars to prepare for bird flu, they are investing in uncertain and untested strategies, WHO officials acknowledge.

The basic problem is that the A(H5N1) virus has not changed in a way that would allow for widespread human infection. What is more, health officials said they would not know precisely how to combat the virus until after it mutated, when they would be able to study its composition and how deadly it was.

"We know we're overdue for an influenza pandemic strain, and we know it will occur, but we don't know when or even exactly what virus will cause it," said Dick Thompson, a WHO spokesman. "It is possible that the virus won't be H5N1 at all or that this virus will change in a way so that the vaccine under development doesn't work against it."

He said the health agency would not comment on whether it was rational for countries to spend so much on medicine orders. But, he added, "We think it is wise because it encourages the companies to do the research and development on this very difficult problem."

The bird flu virus has two characteristics that make it capable of igniting a pandemic. It is a new virus, so humans have no defenses against it. It produces severe disease, killing about half of those infected, almost all through contact with sick birds.

"H5N1 has pandemic potential but it is not a pandemic virus," Mr. Thompson said, because it does not spread easily among humans.

But flu viruses are prone to mutation and exchanging genetic material when they infect an animal together. So one big fear is that an ordinary human flu virus and the bird flu virus could mix genes, creating a new type of lethal human bird flu virus............

[unseen]

The author of the above article is doing a major disservice to her readers. It is clear that she does not believe in H5N1 causing a pandemic. Her writing confesses this 100%. she thinks it is a waste of money and is only happening due to Katrina. She uses the lowest numbers for the number of potential deaths and writes that "someday" this may become a problem. I see this article in the NYTIMES as a major roadblock in getting people prepared for what is to come. IMO. Even if it does not come the knowledge and experience gained preparing for it will help in numerous ways. Including possible bioterror attacks, disaster response, genetic technologies, and possible better vaccine manufacturing. In short the money is well spent even if nothing happens which I doubt.

[bitt]

agreed.

for all interested, check latest at
http://www.freerepublic.com/focus/f-news/1399613/posts?page=1473#1473

[unseen]

Time to think about closing off countries access to US.

http://www.recombinomics.com/News/09200504/H5N1_Casual_Phase_5.html

This looks bad, very very bad.

The growing familial and geographic clustering of cases in a relatively small area are cause for concern and suggest the pandemic has moved to phase 5, which is characterized by growing clusters of cases. The lack of close contact with suspect sources of H5N1 infections raise concerns that the clusters will continue to grow, signaling a significant increase in efficient human transmission. The transmission is cause for concern is Jakarta is a major metropolitan city with an International Airport. More testing and sequence data would be useful to see if the virus is novel and is a recombinant. Testing to see if the H5N1 is the same in the zoo employees and the Tangerang neighbors would be useful, as would the sensitivity to the amantadines.

[M. Espinola]

Some updates:

AFX Indonesia faces bird flu epidemic - health minister (Forbes/9-21-05)

(JAKARTA (AFX) - Indonesia is facing a bird flu epidemic as another possible victim died after showing signs of infection, Health Minister Siti Fadilah Supari said.)

World experts head to Indonesia as bird flu spreads (ABC-News 9-21-05)

(JAKARTA (Reuters/ABC) - Health experts from around the world are converging on Indonesia, fearing a deadly bird flu outbreak in the world's fourth-most-populous country could spark a pandemic, a U.N. health official said on Wednesday.)

Indonesian girl dies of suspected bird flu (The Jakarta Post 9-21-05)

(JAKARTA (Antara): A five-year girl thought to have bird flu died at the Sulianti Saroso Hospital in North Jakarta on Wednesday morning, Minister of Health Fadilah Supari said.)

US exec warns of bird flu pandemic (Philippine Daily Inquirer 9-21-05)

(PACIFIC RIM countries are bracing for an economically devastating bird flu pandemic by researching the disease and strengthening their capabilities to deal with problems that could follow, a senior United States official said yesterday.

Michael Michalak, the US representative to Asia Pacific Economic Cooperation, said the 21 members of APEC plan to unveil an action plan outlining strategies to battle avian flu, which he described as the "next possible disaster," during their annual summit in South Korea in November.)

[bitt]

ping to update

[redgolum]

How? If the bug is in the geese, it is already here.

With the massive concentrations of people in shelters due to the hurricanes, we have a heck of a petri dish set up. Just think what will happen when all those folks in the domes stat getting the flu, even regular flu.

Some theories say the reason the 1918 pandemic took off was all the military forts set up for WWI. With all this hurricane evacuees, we have a similar situation only in a smaller scale.

[M. Espinola]

"Some theories say the reason the 1918 pandemic took off was all the military forts set up for WWI. With all this hurricane evacuees, we have a similar situation only in a smaller scale."

Very good point.

The 'Spanish' influenza may, however, have originated in March 1918 among U.S. soldiers in Kansas; about 500 men there were infected, among whom 48 were listed as having died of "pneumonia".

Those who survived the illness may have carried the disease to Europe, where in the summer and fall of 1918 over one and one-half million U.S. soldiers were sent to fight in World War One.

On September 28th, 1918 a "4th Liberty Loan Drive" parade in Philadelphia was attended by 200,000 people. Since influenza is a respiratory illness spread by breathing, within days of the parade 635 new cases of influenza were reported; and on 6 October, 289 people died.

In the midst of the epidemic the acting Surgeon General of the Army noted the unusual character of this epidemic: whereas influenza normally was a mild disease that killed only the very young and the very old, this influenza was most dangerous to people 21 to 29 years of age. This influenza took the strong and spared the weak.

Source

[Lazamataz]

This is seriously scaring the sh*t outta me.

[redgolum]

I read that book also. Part of the reason the last German offensive failed in WWI was that most of the troops got sick. The guns of France didn't save Paris, a flu bug did.

Will another Cat 5 heading to Houston, and the resulting dislocation of people to shelters, if one of those large groups gets the flu..

Well, that is usually the part of the movie I start eating popcorn. Bad things.

[Lazamataz]

The thing that's got me effed-up is, everyone's talking about a 50% mortality rate. That's not an illness, that's more like a natural bioweapon.

[redgolum]

That's not an illness, that's more like a natural bioweapon

I suspect that it will not have the 50% mortality, and I doubt it does now. Remember, many who get the flu don't go to the doctor they just plow through it, so there are cases that haven't caused death and were not reported.

That being said, for a 50% mortality rate on reported cases suggests a very high mortality on overall cases. The 1918 was under 5%, and caused world wide panic. Once the hospitals get tapped out, if we are looking at something like that it will be devastating.

[Lazamataz]

The present, unmutated virus kills at 50%. If you get it from a bird, you've got a 50/50 chance. Then again, you are right, that's reported cases -- if it is severe enough to go to the doctor, 50% of the time you are going to die.

Now, again, you are right: If it mutates, the lethality might go up or down. We might end up with a 90% killer bug, or another 1918 5% killer bug. A 90%-er would have us wearing bearskins and carrying clubs in 3 generations, and a 5%-er would really collapse a lot of economy.

[SamiGirl]

Please add me to your ping list. Thanks.

[SamiGirl]

I asked my doctor to give me 3-month prescriptions and got them filled at the pharmacy. Hope that helps.

[M. Espinola]

"This is seriously scaring the sh*t outta me."

Like myself, that reaction is a clear understanding you have grasped the seriousness of the current situation overseas, and are not treating the potential of a transcontinental infection as something else to invent jokes about, as so many unfortunately are doing on FR, including people living in nations with actual 'Bird Flu' cases, as was shown on a PBS TV news show last night.

It was my own doctor & dentist who woke me up. They both stated have a sufficient amount of 'Tamiflu' on hand & buy it now just in case.

[Lazamataz]

IOW, you aren't saying "Oh, it's not that bad."

What you are saying is, "It's way worse than that, pal."