Bird Flu Mutations Likely To Trigger Pandemic Identified

Fox News ^ | 11-16-2006 | Daniel J DeNoon

[blam]

Bird Flu Mutations Likely to Trigger Pandemic Identified

Thursday, November 16, 2006

By Daniel J. DeNoon

Either of two simple bird flu virus mutations could trigger a deadly pandemic, Japanese scientists warn.

Both mutations already have popped up in humans infected with the H5N1 bird flu virus.

They've been seen in bird flu viruses isolated from two people in Azerbaijan and from one person in Iraq, according to the Japanese scientists. Neither mutation has been seen among the more than 600 H5N1 viruses isolated from birds.

The two human mutations give the bird flu virus the ability to attach to human cells. It's the kind of mutation seen early in the 1918, 1957, and 1968 flu pandemics, warn Shinya Yamada of the University of Tokyo and colleagues.

Fortunately, the H5N1 viruses carrying these mutations do not appear to have caused any outbreaks of human-to-human transmission.

But these mutants seem capable of replicating in humans -- "an essential indicator of pandemic potential," the researchers report.

Flu viruses attach to receptor molecules on the outside of cells that line the airway.

[little jeremiah]

Check this out if you haven't yet. It took me quite a while since the traffic there must be pretty heavy.

http://www.fluwikie2.com/pmwiki.php?n=Forum.Checkmate

[little jeremiah]

Even if the lethality lowers a lot it'll only be as bad as the 1918 flu, then.

[blam]

" It took me quite a while since the traffic there must be pretty heavy."

Thanks. I'll try later. I can't even get in right now.

[little jeremiah]

Basically it's an account from a poster whose friend works for the state government and attended a meeting today. Her (I guess a she) friend recounted the points made a the meeting, the topic being flu pandemic. Apparently the fedgov is directing the stategovs to be in line with fed, and announcements will be forthcoming. There is quite a bit of detail, all highly interesting. I wish I'd copied it, I can't get there either. Maybe in the middle of the night.

It does seem as though "they" are assuming that the CFR will reduce to even less than 1918.

[ARealMothersSonForever]

Is this the same bird flu that has been killing millions since J F'n K said we were not doing enough about it in 2004? Cholera, typhoid, diphtheria, and malaria do kill millions. Bird flu is a shakedown scam that has killed hundreds in Asia. A place that one might note keeps live poultry and hogs inside their homes. There is a good reason that flu vaccines are developed by swabbing hog snouts in Asia to determine the prevalent strains and mutations.

[blam]

"It does seem as though "they" are assuming that the CFR will reduce to even less than 1918."

What is CFR? I keep seeing this and don't know what it means.

[little jeremiah]

Sorry - I've been spending a lot of time on FluWiki and CurEvents the last few days.

CFR is Case Fatality Rate, the percentage of deaths of those who contract a disease. There is another term for what percentage of the population contracts a disease, can't remember that term.

Many people are assuming that the CFR will reduce tremendously if/when H5N1 is easily transmissable H2H, but others disagree. It's all pretty much either informed or ill-informed speculation from what I can tell. But I'm an uneducated less than layman.

I'd rather not get it than hope that I'll be one of the ones that doesn't die. And even the survivors of the 1918 flu often suffered from all kinds of health problems afterwards.

Another detail I just remembered is that apparently the attendees were told that Tamiflu does jack.

[little jeremiah]

Have you done much reading about this?

If not, I would suggest for your sake that you do.

Ever read about the 1918 flu?

[blam]

"CFR is Case Fatality Rate, the percentage of deaths of those who contract a disease. There is another term for what percentage of the population contracts a disease, can't remember that term. "

Okay. Thanks.

[little jeremiah]

I just got FW. Here's the relevent comments and the link again: (the format of FW is "funny" right now; also, there are other very informative comments on the thread. I'm just copying the ones that kind of hit me over the head.)

http://www.fluwikie2.com/pmwiki.php?n=Forum.Checkmate

Anon in NH – at 16:31
I am waiting for a call from a friend who is at a high level of state government. He is going to debrief me as to a meeting his department had today. His wife, who did not have tons of details, told me that, “Things are not good, and there is going to be an announcement in the next 10 days.”

Whether that announcement will be made by our state’s leadership or at the federal or international level, I do not know.

I have no further information at this time, and I must be away from the computer for the next hour or two.

I will post more as I learn it, probably later tonight.

Anon in NH – at 18:18
okcinder – at 17:57 I may have missed something earlier on. Do we have any reason to believe that Anon in NH’s friend’s information is bird flu or disaster related?

It is. Sorry. I just assumed that was obvious given the thread I’m posting to. There has been a lot of activity at the state level per this friend. Essential workers in his dept. signed up two days ago on a hush-hush list to receive packages containing antibiotics for themselves and family members. That same day, the meeting to which I referred earlier was announced for today. The meeting was held. The five-second summary, “It’s not good, and there will be an announcement in the next 10 days” is a direct quote from my contact’s immediate family member. As I said before, I’ll post after I hear from him directly. I have no idea what type of announcement or at what level/from what direction it is to come.

It just dawned on me that this information meshes with something posted last week I believe (by Nann?) that her relatives who work at Boston hospitals were told there would be an announcement in the coming days. Can’t remember what thread at this point.

Stay tuned.


Anon in NH – at 20:32
Hi, All,

Spoke with my contact, and the long and short of it is this: The federal government is apparently going to announce updated pandemic management recommendations in the next week or two in a coordinated announcement to the public and states. States will be expected to bring their pandemic plans into compliance with the federal recommendations. The recommendations sound like a sweeping endorsement of the IOM recommendations (discussed at length in threads here a couple of weeks ago courtesy of anon_22).

The specific recommendations my friend mentioned that are being endorsed by the feds are:

1. Early school closure

2. No international travel

3. Cancel public events

4. Prophylactic treatment with antivirals (see note below) of household members of the sick

5. Social distancing

6. Voluntary quarantining

7. Leaning away from directing strategic stockpiles of antivirals to health care workers and first responders

Other highlights of the meeting include…

Goal: The goal of adopting the above recommendations is to decompress the peak and hopefully allow a degree of more managed chaos in health care and other infrastructure. The downside is it means people are going to need be ready (and I quote) “to hunker down” for a longer period of time than if the peak were short and steep.

Antivirals: As far as using antivirals prophylactically, that recommendation is in direct contradiction to another announcement that was made at the meeting stating that Tamiflu is not effective against H5N1. According to my contact, the meeting attendees were told Relenza “may” be effective. (Of course, we here all know there’s even less Relenza availability than there is Tamiflu, so that’s a moot point.)

Vaccine Development: Apparently, H5N1 is supposedly killing the embryos in which the vaccines are to be cultured rendering that method of vaccine development ineffective. I don’t know enough about this to make heads or tails of this info or to tell if what he was saying was totally off the mark. I did confirm with him in no uncertain terms that the meeting attendees were explicitly told that there would be no vaccine available. I know there have been comments on the wiki relating to the fact that testing for H5N1 cannot be done effectively using poultry embryos, but I haven’t paid close enough attention to that topic and didn’t have any insightful questions to ask him to get more detail. Sorry.

Planning Assumptions: As near as I can tell from what my friend told me, the planning assumptions are ridiculously low. My contact stated 1% CFR. I told him that was crazy. He responded by citing the mantra, “Will swap virulence for efficiency.” He knows I don’t buy that, but I didn’t want to push him on it and risk alienating him. (For anyone in NH, the good news is that only 4,000 are going to die. Phew!)

Mask Use: Heavy emphasis on use of N95 masks, or, in a pinch, surgical masks with pantyhose over them. Supposedly this has been shown to be as effective as N95s. As you all know, that’s not exactly a claim to fame.

Duration: Those in attendance were told to expect multiple waves that could last up to three years. That number startled me. I pressed him on this point to clarify whether he meant that subsequent seasonal flu seasons would be especially bad in the years immediately following the pandemic. He was firm that he was told the pandemic could last up to three years with time to restock between waves.

Trigger: Here’s the rub, folks. All of these measures will hinge on WHO announcing efficient H2H. I think we all agree a pandemic could be halfway around the world—literally—before that happens. For that reason, let me reiterate the critical point that NS1 made at 19:36… The only way we will know that PF51 has started will be when R0 rises, and the only way we’ll know that number is in retrospect from watching the size of clusters and the deaths of HCW (post-facto). Information control will be the norm, so our back channels like FluWiki lookout posts will be the only hope of having advance notice.

nd that, folks, is all she wrote. Hope this helps.

[redlegplanner]

Current mortality runing > 50% from Avian Influenza - i.e. the disease that is caught from close contact with birds. Avian Influenza is currently difficult to catch. If it mutates through genetic resortment or antigen drift, it has the potential to become easily transmittable from human to human. Current planning estimate is that the mortality rate will range from .2% to 2%. However, the World Health Organization (WHO) recently reported that a conference of subject matter experts reported that this assumption may be in error and the mortality could run much higher.

[blam]

Thanks for the post. Doesn't sound good.

[ARealMothersSonForever]

Thank you, I have done extensive reading on this subject. In 1918, the flu was most rampant in military barracks, ships, and other areas where humans were in very close proximity. Asymptomatic individuals died within 24 hours. Personal hygiene was atrocious by current standards. The most effective containment method was quarantine.
I do remember the "Swine Flu" pandemic. Many people from the NIH, including Richard Krause, have studied this and written extensively on the subject. Here is an excerpt, and an applicable link:
"The 1918 influenza pandemic has shaped research and public health for nearly a century. In 1976, the specter of 1918 loomed large when a pandemic threatened the country again. Public health officials initiated a mass vaccination campaign, but the anticipated pandemic failed to occur. An examination of the available data in 1976 and the decision to vaccinate, as well as lessons learned from the HIV/AIDS epidemic in the early 1980s, may help shape an appropriate public health response to future threats from avian influenza or other infectious diseases."

http://www.cdc.gov/ncidod/EID/vol12no01/05-1132.htm

It is worth noting that this was published in 1998.

[little jeremiah]

It certainly doesn't sound good at all.

The Aesop's fable of the grasshopper and the ant comes to mind.

[little jeremiah]

Then you must be aware that there is no vaccine for H5N1 in humans.

[little jeremiah]

Check out comment 50, you might want to ping your list.

[ARealMothersSonForever]

But there IS a vaccine for the primary carriers (birds). It does have a lethality rate that would be economically unacceptable in US or European poultry flocks. Even Asian nations did not quibble about killing off hundreds of thousands of birds. Human vaccine development may not become necessary in the event that the primary carriers are vaccinated. Reference rabies. The point being that Asian nations must develop hygiene, healthcare, and basic sanitary conditions. Or risk becoming quarantined nations. In case nobody noticed, we shut down all international travel one day in September, 2001. It would be very possible to isolate specific countries or origination points, and exterminate the bulk of the primary carriers. The Chinese are showing little restraint with respect to dogs and rabies this very day.

[Smokin' Joe]

Ping to comment 50....Thanks, little jeremiah!

[metmom]

Looks that way to me.

[metmom]

Wasn't the one in 68 the Hong Kong flu? That was pretty bad whether or not. It went through our family and I was sick for a week and that was considered lucky, but my dad was out for a couple. He was really sick.