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The Editors of Effect Measure are senior public health scientists and practitioners. Paul Revere was a member of the first local Board of Health in the United States (Boston, 1799). The Editors sign their posts "Revere" to recognize the public service of a professional forerunner better known for other things.

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Good bird flu primer

Category: Bird flubiology
Posted on: March 5, 2008 7:52 AM, by revere

Every once in a while we run across introductory presentations of basic bird flu-ology we think are particularly good. This is one. If you follow this area you won't learn anything new, but I think you'll be impressed by how concise and well chosen this material is. I have a few quibbles with the material but on the whole it is accurate and informative. If you are new to the subject of flu science, this is a very quick and efficient starter kit. You can find more detailed explanations in a number of our posts (here, here, here, here, here):

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1

my three and four year-old sons watched the whole thing and now have a better understanding of why they get vaccinations.

thanks!

Posted by: oigocosas | March 5, 2008 12:55 PM

2

I knew all that (I'd probably forgotten about Type B and C influenzas only infecting humans), but it was still nice to have it laid out like that. Thanks.

Interesting artistic choice to have the person exposed to the virus be a double amputee...

Posted by: caia | March 5, 2008 2:58 PM

3

I'm a little disappointed/confused by the next video in this series: Avian Flu (2): Threat of a pandemic

They said antigenic shift happened when a human influenza virus reassorted with an avian virus. They mentioned this could happen in either pigs or humans, but emphasized pigs, and said all three pandemics of the last hundred years emerged this way.

I'm confused because:
1) Do we really know there was reassortment in pigs for all three? I thought there was controversy even about 1918.

2) Would H5N1 (or another novel avian virus) have to reassort with a human virus to produce a pandemic virus? I thought simple mutations (antigenic shift?) in H5N1 et al. could be enough. After all...

3) Isn't that how H5N1 acquired the ability to (rarely) infect humans already?

Posted by: caia | March 5, 2008 3:16 PM

4

To clarify, the video stated that antigenic shift=reassortment was necessary for a human pandemic.

Posted by: caia | March 5, 2008 3:19 PM

5

caia: One of the reasons I didn't include it was that I didn't think it was quite right. Even the one I showed I had a quibble or two with (the carpet of spikes isn't exactly right) but I thought overall it was pretty good for a primer. And while humans get type C it really isn't pathogenic in most instances.

Posted by: revere | March 5, 2008 4:52 PM

6

Ok, good. I'd hate to think I'd been following avian flu for three years and was totally wrong. Thanks.

Posted by: caia | March 5, 2008 7:51 PM

7

Following transcript excerpt (positioned near end of video presentation) relating specifically to the process of human immune system creation of H5N1 viral antibodies seems, to me, just a wee bit odd vis a vis the "cytokine storm":

Vetstoria.com, "Unfortunately, this process takes time. If it is the first time you get infected by the virus [transgenic pathogen H5N1], your immune system may take too long to start acting and you will suffer the full effects of the infection."

Revere, "I have a few quibbles with the material but on the whole it is accurate and informative..."

I agree with Revere -- the info is accurate relative to conventional viruses, but H5N1 aint "conventional" and overstimulates the immune system into a "cytokine storm". I've been under the impression that this is what ends up killing people, irrespective of H5 viral load!?!

Posted by: Jonathon Singleton | March 6, 2008 12:25 AM

8

Jon: This video is not about pathogenesis but about the virus. It is meant to explain immunity with respect to vaccination. Cytokine storm is not usually what kills people with influenza (or this virus), but it is one of the ways the infection can play out. We don't understand cytokine storm mechanisms, when it happens or doesn't happen or what exactly it involves. It is more of an impressionistic term, like sepsis, which it resembles. This video is not about the disease but the virus.

Posted by: revere | March 6, 2008 7:35 AM

9

Revere, thanks for the response...

I watched the video twice plus the bit I transcribed multiple times. Hey, I'm really trying my best here, Revere. Been researching this planet altering issue (educated by a double major arts degree, not medical) in an incredibly hostile sociopolitical climate -- I was targeted by homophobic medicolegal folk in Perth, WA, hometown of actor Heath Ledger (see below) due to publically voicing my vocationally trained abilities in "pattern recognition"! Due to the undisputed fact OUT queers in OZ are despised by government employees (yeah, go figure when public servants are themselves gay or lesbian), I've had zero legal closure on the violent events of 1997/8. For example, a few years ago when seeking access to original uncensored legal docs, the male staff at Perth FOI pretty much told me to 'fuck off and die faggot' -- typical response for Australian goverment employed sociopaths!

But back to topic, my impression of the Vetstoria.com video. Revere: "This video is not about pathogenesis but about the virus. It is meant to explain immunity with respect to vaccination." If that indeed was the video's intent, then obviously I got confused due to the phrasing used in the excerpt -- vaccines operate much differently on the immune system compared to an environmental viral infection. That's exactly what I thought they were talking 'bout -- raw H5N1 infection with a pathogenic strain! My mistake...

My mistake, cos I've been following and operating in the view (see below) raw environmental H5N1 infection creates an immune system dysregulation -- and this is what ultimately causes mortality, not the replication of the virus itself."

Now, if only Heath Ledger's fellow citizens could get their acts together and grant me legal closure, maybe then this would give me the peace of mind, body and soul to return to Aussie uni and (((LEARN)))!?!

Cheers:*)

Genomed Press Release -- "Cytokine Storm" Paper Confirms GenoMed's Approach to Avian Flu

By David W. Moskowitz MD CEO, GenoMed (November 14, 2005)

GenoMed (OTC Pink Sheets GMED), a Next Generation Disease Management company whose business is public health, announced today that its approach to avian influenza was confirmed last week by a Hong Kong research group who found that the avian influenza virus induces a "cytokine storm" in human lung cells grown in tissue culture.

Dr. J.S.M. Peiris and colleagues published last week in Respiratory Research that avian influenza (H5N1) viruses isolated from dead patients cause lung cells to produce many more pro-inflammatory molecules, called "cytokines," than regular influenza A viral strains. This research confirms GenoMed's hypothesis that the host's immune response to the virus is what causes death, not the replication of the virus itself."

EffectMeasure -- "Cytokine storm revisited" By revere (July 18, 2007)

http://scienceblogs.com/effectmeasure/2007/07/cytokine_storm_revisited.php

Excerpt: "[We] think it is premature to write off the cytokine system as a target for treating patients who, for reasons we still don't understand, might have been catapulted into a disastrous dysregulation of their immune systems. By the time this happens it is no longer a question of preventing viral replication. That window is closed..."

Genomed Press Release -- CNBC Story on GenoMed's Press Release About Heath Ledger

By David W. Moskowitz MD CEO, GenoMed (January 26, 2008)

The "cytokine storm" is a hard concept to get, especially when the flu is supposed to be so benign. Lord knows the infectious disease community is still divided about its importance.

But misunderstanding sure beats not noticing at all. It's a first step. Our science, I'm confident, will carry the day. Greater recognition will mean more patients in our trials, and the chance to prove our hypothesis, once and for all. We need a clear answer: either we have something that will transform the care of viral and other infectious diseases, or we don't, and it's back to the drawing board..."

Posted by: Jonathon Singleton | March 7, 2008 2:29 AM

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