Bird flu: some things bear repeating

Somethings you don't have to keep saying and others bear repeating. This is one that bears repeating because most of us would rather believe we are making progress on combatting avian influenza.

The exemplar in the fight was Vietnam, the country still with the most confirmed human cases (Indonesia has the most deaths), but also a country that registered no new cases, human or poultry, since a year ago November (some isolated cases of stork infection were reported in August). Vietnam's supposed success was attributed to a vigorous program of vaccinating birds and banning live markets in Hanoi. But now the virus is back in Vietnamese poultry and is spreading in two southern provinces:

Additional cases of the deadly H5N1 virus were detected in Ca Mau and Bac Lieu provinces in the Mekong delta, with nearly 8,400 poultry dead or culled, the national animal health department said on its website.

The two provinces were the first to report major outbreaks of bird flu in the communist nation in the past year. (TerraNet)

Vietnam and the UN are launching an "awareness program" on TV and radio. It will likely be successful in reinforcing awareness, as was a similar program in Cambodia. Unfortunately the Cambodian program didn't alter risky poultry handling practices, and the Vietnamese one probably won't either. Most people expect more cases:

The campaign comes as the trade and transport of poultry are expected to increase ahead of the traditional new year festival known as Tet, in mid-February.

The new outbreaks highlight "that the risk of recurrence of avian influenza remains," said Andrew Speedy, the UN Food and Agriculture Organisation's representative in Vietnam.

"With increased demand for poultry leading up to Tet, we need to be highly vigilant, particularly with respect to poultry raised and marketed illegally," he said.

The World Health Organisation also urged authorities to enhance "surveillance for possible human cases, alerting healthcare facilities and strengthening health messaging to affected communities".

National authorities in Vietnam are blaming the locals, but all this will do is make it more likely outbreaks will be covered up. The virus has been there the whole time and is making its seasonal appearance. At least the outbreak is once again raising the index of suspicion regarding human cases, making it more likely any true cases will be detected and reported.

This virus is thoroughly entrenched in asia, southeast asia and probably parts of Africa. It isn't going away, regardless of whether the news agencies are interested in it or not or whether it is reported or not reported or whether it is detected or not detected.

It's still out there and it will be out there for the foreseeable future. That's what bears repeating.

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Amazing little country Vietnam. They singlehandedly stopped bird flu last year without money, doctors, medicines to do it. They vaccinated with shitty vaccine that they made and big surprise its back. Did they stop it last year? All depends if almost overnight you stop calling it H5N1 and then start calling it just pneumonia.

Overnight they stopped it by calling it just plain pneumonia because in a Com country the state is always right and you cant buy guns and ammo if you have bird flu floating around. Hope against hope, then direct poultry handling practices be changed, smack the UN for money that immediately gets redirected into Swiss accounts. Indict some low level government employees and blame them for the new outbreaks and jail them. See! Its easy to stamp out bird flu.

By M. Randolph Kruger (not verified) on 27 Dec 2006 #permalink

For some reason, the WHO seems to have acted, with what can only be termed as blinding speed, in accepting H5N1 virus as the cause of death, for the three human fatalities in Egypt.

See http://www.who.int/csr/don/2006_12_27a/en/

From our past experience, right about at this time, the tissue samples from the victims would be just about to start on their way, to some far away laboratory or the other.

Way to go Dr Chan!

JM Tom

The-Best-Bird-Flu-Blogs-team.

MRK - If that were true, why wouldn't these Vietnam cases remain hidden or masked by the govt? Your argument is fraught with holes.

I don't doubt this virus is entrenched, to some level. But as I understand it, migratory birds and smuggling/illegal importation are the prime vehicles for transmission. It stands to reason, that Vietnam (and the world) must remain vigilant. But it doesn't necessarily mean that everywhere it goes, it stays. Does it? France is one example that comes to mind.

I dunno, patch; MRK's argument might have been fraught with holes, but it made me LMAO. If it's not totally true, I'll bet there is some truth in it. Maybe there were just small outbreaks here and there, easy enough to cover or call something else. But with the cooler weather, the simmering cases suddenly explode and there are way too many for the govt to hide any more, so they announce that it's back. Come on, it's not that holey. And as for France...the season isn't over yet.

By mary in hawaii (not verified) on 27 Dec 2006 #permalink

Sure Mary, you could look at it that way. Maybe it has been simmering for the last year and has now exploded into two cases. I mean it would be impossible for any govt to hide the explosion of two whole cases, wouldn't it?

OK, sorry. I'm being a bit satirical. But then again, maybe it's as it appears. Maybe it was brought in my some unvaccinated smuggled birds.

Either way, me thinks MRK's argument is more funny than accurate.

As for France. If you are waiting for the season to pass before acquiescing, then I doubt you could say it's "entrenched" there. Wouldn't you agree, that in stands to reason, that any outbreak there, would come from an outside source, at this point? If not, we'd certainly be seeing vast outbreaks, with the large population of commercial poultry farms.

No way Patch it was in the Vietnamese newspapers about the head of the flu program buying cars, building houses in Thailand and Swiss accounts.

Then there is the thing from the Tropical Diseases hospital. Suddenly they were getting 1500 cases of "pnuemonia" a week. I sent an email to Menno de Jong there and said, "WHAT"? 1500 CASES A WEEK? " and bird flu just simply melted away. Havent heard a word outta there since.... Like I said, very amazing little country.

Hey but I could be wrong Patch, but my mom was in PR for 40 years and I know BS. when it starts to stink. This one has a good odor too it if not the hard smell under the blanket. Prior to this it was like 300 or so per week for pneumonia and then 1500. You can call it Revere's all planetary too goddamn many people equalizer, pneumonia or H5N1 it doesnt matter once it breaks. You have to read the articles these countries put out and look at every provocative statement and determine what are the reporters really trying to say. I doubt seriously that they ever did stop it. Funny Patch? Its pathetic.

By M. Randolph Kruger (not verified) on 27 Dec 2006 #permalink

Patch: "explosion of two whole cases"????
I was referring to the outbreaks in two provinces involving 8400 birds. not two birds. ("cases") I would say 8400 dead birds are hard to overlook, yes. And re France, how many dead birds were ever discovered there in its outbreak? If only a handful, then probably not entrenched, no. But the comparing the conditions in France with those in Vietnam is way beyond apples and oranges, IMHO. Climate, culture, income level....

Now, onto a totally different arena.

Revere: Need some of your expertise, please. This article surfaced yesterday regarding a study by Replikin ltd which claims their analyses demonstrates that H5N1s affinity for humans is growing. I put this on fluwikie, asking what experts there thought, and Susan C (anon 22) who is of course a very knowledgeable person said it was essentially a crock. I am not arguing with her expertise, but would really like a second opinion, since this claim is really alarming and important news. Here's the link.

http://orange.advfn.com/news_Human-H5N1-Virus-Replikin-Count-Overtakes-…

By mary in hawaii (not verified) on 28 Dec 2006 #permalink

MiH: I've looked several times for the science behind the Replikin method and so far haven't found it. Maybe someone has a cite? They've been issuing regular press releases but I don't see any publications that can be evaluated. So I have no idea if this is hype, hope, the real thing or bullshit. This isn't new with them, though. It's been going on for a while. I just ignore them until they publish or display their data and analyses publicly, with argument and documentation. As I do with some others.

http://www.replikins.com/

They also have an interesting new study re the role of shrimp in carrying these "replikins" of H5N1 to birds.

By mary in hawaii (not verified) on 28 Dec 2006 #permalink

What's a replikin? I read the website and I can't figure out what it is. Can anyone explain?

Thanks

By Repli-wha?? (not verified) on 28 Dec 2006 #permalink

tmbuktu: See my response to Mary in Hawaii a few comments above. This is vapor ware as far as I can see. Replikins don't appear in the scientific literature. I am ignoring these press releases of theirs as I did the many similar ones they floated in the past until they publish in the scientific literature or put their data and analysis out there for all to see.

Well said Revere. they need to publish in the peer-reviewed literature to have credibility.

Revere, whats your read on the "miracle" vaccine that has been cranked up?

"SCIENTISTS are on the verge of producing a revolutionary flu vaccine that works against all major types of the disease. Described as the "holy grail" of flu protection, it would fight off all strains of influenza A, the virus behind both bird flu and the nastiest outbreaks of winter flu.Two injections could give long-lasting immunity, unlike the current vaccine which has to be administered every year.The jab, which will be tested on humans for the first time in the next few months, would also be quicker and easier to make, meaning vast quantities could be stockpiled against a global outbreak of bird flu. "

Story relates to British firm Accambis. Sounds like, well the flu shots that dont work any better than they do now and it wont give you 100% protection. Two hits a year too. Are we chinese poultry all of a sudden where we would find that hey it didnt work and we just go down one day like a chicken flock? If we were geting vaccinated every six months with updated vaccine wouldnt that give rise eventually to a superbug, not that this one isnt so super?

By M. Randolph Kruger (not verified) on 29 Dec 2006 #permalink

Revere: regarding this issue about publishing in peer reviewed literature...Once a company like replikins has patented their scientific discovery, theories, research data etc their rights to it would be protected, would they not? So there is no compelling reason at that point not to publish their data and results in legitimate peer reviewed literature, right? Just trying to clarify this issue in my own mind. I certainly do know and understand that all legit science needs to be reviewed and tested by peers to verify that it is replicable and valid. It's a keystone of science. But I also understand that there are potential fortunes to be made in this arena, and so discoverers of new procedures etc might want to protect their financial interests. So, my question above.

By mary in hawaii (not verified) on 30 Dec 2006 #permalink

MiH: Once a patent or license is granted, their rights are protected. But in this area, I have no particular respect for people who, if they truly have vital information as these people say they do, with hold them. It makes with holding sequences seem like nothing. If we complain about that, we should complain much more about this. But this stuff is probably bullshit.

The main reason to publish is so that we can see whether we want to believe anything they say. I am guessing they are just trying to attract investors with these phony press releases.

Randy: Regarding the "miracle" vaccine, there is a lot of work being done on vaccine technology and M2 vaccines aren't new. They have had a variety of difficulties and I had a post up about them on the old site. Of the things under development, it may be that some will turn out to be genuine advances, but we are very, very far from having the benefits at the moment. No one knows if this will work in people, how broad spectrum it will be and many other things. It's all about timing.

Hi, sorry for the extremely late comment. I found this webpage because I was Googling replikins to find out what they are.

It IS possible to stop bird flu in domestic chicken flocks (of course wild birds are another story) by fairly aggressive quarantining and culling around outbreak areas. You don't need high technology or lots of money but you do need a government that can bring down the hammer regardless of how many farmers are complaining. I don't know what the veterinary authority is like in Vietnam, but Communist country theoretically should have that level of control. My country, Malaysia, had a couple of H5N1 HPAI outbreaks in chickens, but they were controlled and we had no human deaths.

Regarding Replikins, the company's website smells fishy to me and overall I think it's a big fraud - at least, the part about replikins. According to the website, they're some sort of amino acid motif, but since the units on the y-axes in their graphs are "replikins per 100 amino acids", they must be very short indeed. And it's very strange that these replikins occur across viruses from different families, and even parasites like malaria and trypanosomes.

The pages where they talk about predicting SARS coronavirus (CoV) are just plain ridiculous. They said since we don't have any SARS CoV sequences before 2003, they just analysed all the other CoV sequences and "discovered" a spike in replikins in 2003. The reason this is silly is because this analysis doesn't include the CoV which was responsible for the SARS epidemic, and the viruses which supposedly showed this spike didn't cause epidemics!

The valid but extremely non-revolutionary part of their work is doing sequence alignments to find which parts of viral proteins are conserved (that is, similar across multiple isolates or strains) and synthesizing peptides (short chunks of protein) based on that to use as vaccines. This is not any new concept or technology, and furthermore it's very expensive to make synthetic peptides rather than growing vaccine viruses the old-fashioned way. This is the basis for their ONLY peer-reviewed paper on replikins listed on PubMed, which was published in Avian Diseases.

Xenoblogista: I agree with your assessment of Replikins which is why I never write about them even though they aggressively put out press releases. The biosecurity for poultry flocks is theoretically possible and plausible but has been spotty in practice. It isn't a question of how authoritarian the government is but its actual reach. China has a terrible problem with compliance because the central authority doesn't reach the provinces which are in the control of local fiefdoms. So biosecurity can be done but even in the best of circumstances isn't fool proof and often doesn't work.