Turning the corner on bird flu?

Revere. A wonderful piece of writing. Thanks.

I'll believe it when I (don't) see it.

But I also think we need to be cautious not to be so invested in being 'right' for blaring the scare-trumpets that we start denying if the threat has passed.

If the panzootic in wild birds dies out naturally and we control the domestic bird outbreaks, then the risk that H5N1 will be the next flu pandemic really *will* become minescule and we'll be facing some other flu instead of what we've expected. It remains possible that this will happen.

Revere -

short, sweet, and right on point !

I agree that we might as well remove the China cases from this for the sake of accurracy, because the three cases from Hong Kong / Fujian during February 2003 are not included in graph.

It must also be recognized that there is no panzootic in wild birds - there is only a panzootic in domesticated poultry ...

ZoKun

Off topic.

Looks like we have a new surgeon general, Kentucky physician James Holsinger.

Don't know anything about him.

See http://www.reutershealth.com/archive/2007/05/25/eline/links/20070525eli…

bc: Thanks for the heads up. OK, you Bluegrass State folks. What's the scoop on the new SG?

Here's a brief bio:

James W. Holsinger, Jr., M.D., Ph.D. is Chairman of the Good Samaritan Foundation Board of Trustees. Dr. Holsinger was elected to the Board in 2000, Vice Chair in 2002 and Chairman July 1, 2003. He is Chancellor Emeritus of the Albert B. Chandler Medical Center at the University of Kentucky.
Dr. Holsinger served for 26 years in the Department of Veterans Affairs and culminated his career in an appointment by the President of the United States as Chief Medical Director of the Veterans Health Administration in 1990. He is a former Undersecretary for Health Department of Veterans Affairs and was reassigned as the Director of the VA Medical Center in Lexington in 1993. He served 31 years in the United States Army Reserve retiring as a Major General in 1993.
Dr. Holsinger served as Chancellor of the Albert B. Chandler Medical Center at the University of Kentucky from July 1, 1994 until July 1, 2003. Dr. Holsinger is Professor of Medicine, Surgery, Anatomy and Health Care Administration and is a Commonwealth Professor in the Health Sciences at the University of Kentucky.

Lisa - RIGHT! Good post. Thanks!

So, is he going to get on tv and say,
despite not really wanting to bother you during the first couple years of the warning period, in hopes it would go away,
we Are in a Pandemic Influenza Year Alert; one could start any time, and one thing the public is going to need is a deep pandemic pantry at home, and some willingness to make better choices and learn new things?

Someone invite the new SG over to HHS's Blog:
"PandemicFlu Leadership" is currently an oxymoron.

Someone in MA said it was Homeland Security that had swayed public health or local planners into taking an "all-hazards" (being equal) approach, (rather than actually believing pandemic is our biggest threat). I'm sure there's plenty of blame to go around, but no one has wanted to tell Massachusetts that during a pandemic there won't be federal, state, nor mutual aid, nor vaccine, nor effective treatment, so, form local PPCC's and get preparing to take care of themselves.

Surgeon General could say it, once a week; I'm sure he could find the time, if he wanted to.
(I'd prefer Dr.Nabarro, but I know he has too much on his shoulders right now. Use his quotes.)
At least the SG can say, "I'm your US SG ! Here's what H5N1 has done so far, in which nations, and, we have it in the US too; in wild waterfowl. There are plenty of plans of paper, but now, we have to tell you public what you need to live through these plans; let's talk. I hope we haven't left this too late.")
None of public health or the SG's other goals will matter if pandemic with high cfr is not addressed; all other concerns will come to naught, like the tsunami communities' and New Orleans'. (Or the native nations did after Columbus and European animals and diseases came to this continent.)

There is no way Indonesian govt and population is going to get things under control!
No will, no way!

We aren't much better; no one wants to be the one to warn about something so bad; in fact, they've kept everyone so calm they mistook "not being warned" for "not being in danger"!

More on Holsinger:

from the Louisville Courier Journal
http://www.courier-journal.com/apps/pbcs.dll/article?AID=/20070525/NEWS…

"Sheila Schuster, executive director of the Kentucky Mental Health Coalition, said Holsinger was an "excellent" head of the cabinet and she is pleased with the appointment.

"He was such a people person and he really threw himself into all of the issues," said Schuster, who lobbies the administration on health care. "He was a quick learner and he really wanted to understand what the implications of the services were."
"Holsinger didn't seem to be wedded to any political ideology, she said.

"I think his faith is very strong and part of who he is, but I never felt like that dictated policy," she said.

[snip]

Holsinger, a graduate of the Duke University School of Medicine, also has a doctorate from Duke, a master's degree from the University of South Carolina, a bachelor's degree from UK and a master's degree from Asbury Theological Seminary in Wilmore, Ky.

[snip]

He is treasurer of the World Methodist Council and is president of the Judicial Council of the United Methodist Church, his wife said. "

There is a new bird flu case in China in a 19 year old soldier, and what's interesting about it is they are seeking people who had contact with him. Usually they look for birds, but this time the are looking for people.

"The case has received high attention from China's cabinet and military leaders, who have urged authorities to keep a close eye on people who had close contact with Cheng."

Lisa the GP: "[Perhaps] we'll be facing some other flu instead of what we've expected. It remains possible that this will happen."

So true! Triggered by new postings at Recombinomics, I've spent the afternoon researching H7N2. This has culminated in my setting up a Pubmed Search Inquiry -- H7N2 and H5N1 recombination and transmission in and between humans

[h]ttp://www.ncbi.nlm.nih.gov/entrez/cubby.fcgi?call=09twqtsiFdXYXUB3PgO7mpfdT9y…

Hey, I could indeed be barking up the wrong tree. But it sure pays to cover all bases... So, if any folk out there write on topic I'll know in realtime!

Jonny-You danged skippy bubba about that barking up the wrong tree with Lisa. The fact is that four people are symptomatic with something that isnt supposed to be too very contagious is not a good sign. A one off case might be one thing, but four? Remember, they said not to panic.... I feel all better now. DEFRA has everything under control and they have their next bailout package for B. Matthews in hand.

USDA has tons of money set aside for BF bailouts when it hits here to protect an industry. You know how many chicken mcnuggets we eat, or buckets of Kentucky Fried? Everyone gets a 9/11 bailout and it will inflate the economies. They need on both sides of the Atlantic to shuck this program and let them take the hits. Maybe then they will start doing something about BF before its really too late. Dont forget H9.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&li…

I just thought that, given their expressed opinions of Dr. Gerberding, the Reveres would be tickled by the casting for the head of the CDC. And yes I'm watching this bit of fluff as I type, having come in for the second hour after watching Earthstorm, a movie in which one of the Baldwin brothers plays a demolitions expert drafted to be an astronaut on a mission to keep the moon from spontaneously exploding.

I guess you see my taste in comedies...

http://www.mcall.com/entertainment/tv/all-tune0526.5866516may26,0,38379…

May 26, 2007
'Pandemic': a thriller with gasps, giggles
By Kevin McDonough United Feature Syndicate

Bird flu is no laughing matter, but ''Pandemic'' (Hallmark Channel at 8, TV-PG, L-V) is a hoot. It may be filled with scenes of death and disease plaguing man, bird and beast, but you won't be able to take your eyes off the cast.

This is, after all, a film starring Tiffani Thiessen as Dr. Kayla Martin, an elite doctor in charge of the Centers for Disease Control and Prevention. The former star of ''Beverly Hills 90210'' and ''Two Guys, A Girl and A Pizza Place'' has to deliver a lot of very bad news when an airliner from Australia lands in Los Angeles carrying a dead surfer who appears to have died from bird flu.

etc...

Lisa: I guess I should be laughing. But I have no idea who Tiffani Thiessen is. Does the tight sweater reveal any anatomical details? Like a backbone?

Urp... Make that 11 confirmed H7 cases now. Does that mean that Tiff Thiesen will be coming to take care of me in a tight sweater if I start to run a fever.... Maybe I'll cough a bit and really run that fever up. I am really mad at her too Lisa, she never calls anymore....

Howdy all,

Australia's National Nine News site has an incredibly well written AP article updating the (highly likely) combined B2H/H2H H7 outbreak in North Wales, U.K.

Ninemsn.com -- More showing signs of bird flu in UK
Sunday May 27 06:44 AEST
http://news.ninemsn.com.au/article.aspx?id=94939

Excerpt: "Those affected either had direct contact with the affected poultry or with farm workers, said Chris Lines, a spokesman for [The Health Protection Agency, an independent non-governmental body].

The H7 subtype of bird flu is believed to be less virulent than H5, but it has in the past caused human cases, and was responsible for a large outbreak which led to one death in the Netherlands in 2003.

The mortality rates of H7 viruses are far lower than H5N1, which experts say causes death in around half of cases..."

As mentioned in a previous posting, the Recombinomics Commentary (May 25), "Efficient H7N2 Transmission To Bird Flu Patients in England" highlights the pandemic trigger dangers posed by a geographic co-circulation of H7 and H5 -- Henry Niman: "The co-circulation of H7 and Qinghai H5N1 is cause for concern because of the ability of H5N1 to acquire sequences [eg. M230I]that increase the efficiency of human to human transmission..."

So, this is the state of play at the moment -- where the frack are my ol' skippy drinking buddies when you really need them! Back in the 90s, we used to enjoy watching Tiffani Thiessen on Beverly Hills, 90210. A naive time (those early to mid 90s) so utterly remote from our contemporary existence. I sincerely hope I won't be drinking alone when one of the three Aussie commercial TV networks unleash that CDC gal in a tight sweater, Tiffani Thiessen as Dr. Kayla Martin!?!

The number of human cases in Wales, England is likely to grow markedly

http://www.recombinomics.com/News/05270701/H7N2_Efficient_11.html

It is also noteworthy that this H7N2 outbreak, like the H7N3 outbreak in England in 2006, was not picked up by Defra prior to the outbreaks on the farms.

Both H5N1 and H7 are widespread in wild birds in western Europe, but detection is very poor.

The recent ahead of the press paper of Qinghai H5N1 in a healthy teal in the Nile Delta in December, 2005,

http://www.cdc.gov/eid/content/13/7/pdfs/06-1222.pdf

and its virtual identity with Qinghai H5N1 in Germany, Austria, Slovenia, Italy, Czech Republic, and Ukraine adds addditional evidence for the surviellance failure.

In December, 2005, no country in western Europe, the Middle East, or Africa had (ever) reported the Qinghai strain of H5N1.

Biosecurity advice is to isolate new incoming stock from the rest of the flock/herd to prevent introducing pathogens.

I don't know if this was followed in the Welsh outbreak but of the 15 Rhode Island Reds that were imported from a local market all 15 died from H7N2. Can someone explain in simple terms why 100% fatality would still be called 'Low Path' please?

I made comments earlier today, but once again the post vanished into the ether.

Henry: Sorry. Thesystem again. It tends to do this whenever there are several links in the comment because it thinks it might be spam. I have to go back and restore them and I occasionally miss some, especially on weekends.