Trying to put bird fu on the "no fly" list?

There are a lot of industries that will suffer mightily if there were an influenza pandemic so it's hard to single out any one that will be hit harder. But among the most vulnerable certainly must be the travel industry. At the height of a pandemic the problem is probably moot. By that time even the people in the travel industry will have other things to think about. But a pandemic doesn't start in an instant. It starts somewhere and depending upon surveillance systems we will have more or less time to react depending upon where we are. There will also likely be a period of uncertainty when we don't know exactly what's going on. Is a half dozen small clusters in Indonesia the start of something big or just better recognition of what was going on before? Is a cluster of a dozen in Vietnam the signal? (these are both hypotheticals, just so it's clear). In that uncertain period lots of decisions about travel by individual countries might be taken that are or aren't warranted. Indeed, most people who have studied this doubt travel restrictions will do much at all, if anything, to slow a pandemic that is underway. That won't stop people from trying, though. So the travel industry is trying to arrive early:

Director-General of Civil Aviation Norman Lo has called for a regional push to curb the spread of avian flu and cut its impact on air travel, due to its potential to spark a human pandemic.

Opening the two-day Co-operative Arrangement for Preventing the Spread of Communicable Diseases through Air Travel First Steering Committee Meeting today, Mr Lo said the International Civil Aviation Organisation has initiated the arrangement to co-ordinate the co-operative arrangements among participating jurisdictions and airports to reduce the risk of spreading avian influenza and similar illnesses via air travel. (Hong Kong official news outlet)

This little conclave, then, is ostensibly to plan for international measures for preventing the spread of infectious disease through air travel by identifying effective measures. Since there aren't any obvious such measures for influenza, my guess as to what this is really about is to reach some tacit understandings about what countries won't do (like isolating a region or a country), while deciding on some visible measures of "pandemic preparedness theater," like automatic fever sensors to reassure the traveling public they are "safe."

Here's my contribution. Make all passengers take off their shoes before passing through security.

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Well, they are just gathering. Let's see what they come up with after the meeting. This is the usual "let's look like we're doing something" stuff that happens when big bucks are at stake. I see that the WHO is present. Let's see what they say afterwards.

Rapid: Doesn't sound too much like Ebola but I usually prefer to wait until there is more info. Ebola is not very contagious and this seems to be fairly contagious. Ebola doesn't affect chickens or pigs (that I know of, anyway) but maybe someone will correct me on this. I am on the road without access to reference materials.

Revere,

I got a real kick out of your comment about "Make all passengers take off their shoes before passing through security." Yes that always makes me feel real... safe, especially when I am taking the shoes off of my 82 year old mother-in-law when she is in a wheel chair.

rapid heartbeat...re does hemorrhagic fever attack pigs and chickens? No. Per WHO's own latest research article on the subject, the only other animal besides primates it's been found in is a bat. Crof suggests that the infection of pigs and chickens may be coincidental; ie, they were infected with some other disease and this one now attacking their human cohabitants actually is ebola or marburg. Problem: if it's hemorrhagic fever serious enough to kill over 100 people, why aren't any of them hemorrhaging? Second thing is , the reported symptoms are almost identical to a mystery illness currently attacking hundreds of residents of a small island off Sumatra. Which of course isn't bf either. All of which has my heart beating a little more rapidly as well.

By maryinhawaii (not verified) on 01 Sep 2007 #permalink

With regard to airline procedures to contain a nascent pandemic, two things are virtually certain.

First, those procedures will be delayed and resisted by the executives of the airlines until such time as the cat (and the pandemic) is well and truly out of the bag. A look behind the scenes will reveal that the industry even now, today, under normal conditions, routinely dispatches aircraft with potentially serious outstanding maintenance problems, being flown by fatigued flight crews. If safety is subordinate to revenue now, do not expect that attitude to change when conditions do.

Second, the procedures will do little or nothing to restrain the operations of what is currently an explosively growing parallel industry of private jet aviation, operating not from the passenger terminal but from FBO quarters, often at smaller regional airports. A pandemic need not spread via transport in economy class aboard a big Boeing or Airbus. It can also do so in the luxurious surroundings of someone's Gulfstream V, and it will be less likely to be caught by screening on arrival.

--

Working in Pandemic Preparedness and knowing what is being done behind the scene, the airline industry is highly regulated by the government and will be directed during a pandemic to isolate certain destinations. In other words, there will be no flights from areas with pandemic influenza accepted into the United States period. The airlines will comply because their flights will be turned away and they will not want to lose money on flying to destinations that they can't arrive into the United States. The same holds true for private aircraft and charter aircraft, they will be denied landing rights and will be turned away.

The airlines are in agreement with this already and understand that it is the best way to protect the nation from a pandemic.

eagle3: "The airlines are in agreement with this already and understand that it is the best way to protect the nation from a pandemic."

I agree with you they will have no choice but I don't agree it will do a thing. Once this gets underway there is no way to protect a country from a pandemic, or even slow it much (or at all), at least that's what the models show and I have no reason to think they are wrong. That's why I called this pandemic theater.

Eagle-Revere is right. It might slow it for a couple of days, maybe a month or two but they have to have ships port and planes land eventually. They cant isolate a city/country for more than a couple of days or it starts to die. E.g. the world food supply is pegged at 40 days and its unevenly distributed. If they make port, the rats and mice will have it and goddman if its unloading poultry product they aint gonna check every friggin' fryer in the frozen containers. Thats how we will get it. Someone will make a payoff to get a couple of hundred sick birds into a processing plant. The workers of course will get sick and they will have shipped their little load of death on out into the world. Someone, someplace will buy it and get blood on their hands, cut it up themselves and atomize the stuff into the air. Or they'll toss the fat or skin into the doggie bowl and next thing you know your two year old will have it. He will get sick and infect you or the wife or bro and sis and they will go to school and infect by contact and honking into the air.

It will cut us all down like knives. Even if we dont die, its so debilitating the survivors helping others out idea is kind of only a company line thing. You could die from not being able to eat, you could also die if the power goes out. Once it gets out of control they pretty much will have to just keep the infrastructure going to minimize the effects. Certainly two weeks into it I doubt it would do any good to go to a doctor or show at the hospital if its high path.

Mary-do a search on "ebola flu" and see what you pull up. China 2.5 years ago.

By M. Randolph Kruger (not verified) on 04 Sep 2007 #permalink

The way it is going to arrive is by a person crossing the border illegally. Ships that arrive at port will already be screened. They have transit times. Any ill persons on board have to be declared by the master of the vessel (the captain) before arrival and the Coast Guard will hold the vessel out of port in quarantine until there is no illness on board. There are no imported live foul for consumption coming into the country, they all come in frozen and they are no risk. All fowl that come in as pets (alive) have to go into quarantine. There are smuggled birds, but there are vigilant officers watching for that and stiff fines and when a pandemic starts, there will be jail time added. Land border travelers will be screened for illness and turned awayed if they are at any risk for exposure or illness.

I agree, these measures will only slow down the fact that it will eventually arrive in the United States and we will all be in deep trouble. You had better have an emergency survival kit at home because things will not operate on a normal basis for awhile.

Don't expect that we will have a vaccine available for this either. Current anti-virals may not be very effective either. Good hygeine and social distancing will help and of course PPE.

Good luck.

Eagle3: It will arrive on a human being, all right, but not crossing the border illegally. People are infectious with this disease before showing symptoms so it will cross with the millions of travelers that normally cross borders. We will then export it to Central and Soutrh America. They will get it from us.

Eagle-I dont want to break the news to you but Fedex is one one of the largest bird transporters in the world. Their FDA inspection is not much more than a handwave and thei for sure aint sticking their heads in there to see if there is something wrong.

About 50,000 live ones a month into Memphis alone. Did I mention the large ratites that I help them with?

As for the ships, Nyet. If they are not visibly sick or running a fever, out into the population they go.

By M. Randolph Kruger (not verified) on 05 Sep 2007 #permalink

Mr. Kruger,

Ships have transit times. If a crewman on a ship was exposed to the flu, if he showed no signs of illness when he arrived, he does not have the flu. Why, because he has been on the ocean for at least 8-13 days and would have come down with the flu if he had exposure at the start of his journey. So if no crewmembers onboard a vessel arriving in the U.S. are ill, then the entire vessel can be presumed to be influenza free.

You might have 50,000 birds transiting through Memphis, but by law, they have to go to a quarantine facility before they can go to the new owner. That is a U.S. Fish and Wildlife law, not a FDA regulation or law.

What are large ratites?

Revere,

You could be right in your assumption. We have speculated on that. Screening methods will try to capture persons that may have been exposed and are potentially infected and they will be sent to quarantine. NO system is 100% effective however. That is why our modeling indicates that an illegal crossing will bring it in first.

You are correct that it will also spread out of the U.S. to other areas as it spreads here, immigrants from Central and South America will want to flee back to their home countrries and will spread the disease. People will most likely not spread it to Europe if it has not affected that region yet, as they have similar safeguards.

Once it is worldwide, all bets are off and who would want to be traveling anyways?

Mr. Kruger,

Ships have transit times. If a crewman on a ship was exposed to the flu, if he showed no signs of illness when he arrived, he does not have the flu. Why, because he has been on the ocean for at least 8-13 days and would have come down with the flu if he had exposure at the start of his journey. So if no crewmembers onboard a vessel arriving in the U.S. are ill, then the entire vessel can be presumed to be influenza free.

You might have 50,000 birds transiting through Memphis, but by law, they have to go to a quarantine facility before they can go to the new owner. That is a U.S. Fish and Wildlife law, not a FDA regulation or law.

What are large ratites?

Revere,

You could be right in your assumption. We have speculated on that. Screening methods will try to capture persons that may have been exposed and are potentially infected and they will be sent to quarantine. NO system is 100% effective however. That is why our modeling indicates that an illegal crossing will bring it in first.

You are correct that it will also spread out of the U.S. to other areas as it spreads here, immigrants from Central and South America will want to flee back to their home countrries and will spread the disease. People will most likely not spread it to Europe if it has not affected that region yet, as they have similar safeguards.

Once it is worldwide, all bets are off and who would want to be traveling anyways?

Eagle-FDA controls the handling of bio-birds. E.g. those that are planned to be used in research. Ratites are emu's, ostriches, rhea's. They are cheap so they go too. When birds are in transit they are just that, in transit. There are no regulations from USFW for transiting birds. Once they get into a country they go to a pen or hen house for quarantine.

As for ships porting, they do container ships about every three days up and down the coasts of the US. If you may recall there was a suspected case of H5N1 in Estonia last year that we never heard the outcome of. It was from a German ship that was porting up with "fresh" chicken. He only had to go two days to get that one. I dont though discount your 8-13 days scenario. But think of what happens if it say got onto a supertanker or something like it and everyone bagged it. We could have ships loose at sea, we could also have ships that are not allowed to port, or aircraft that are bio-bombs. There just might not be enough bio protection to go around to isolate/quarantine more than about 1000 properly in the US at any given time.

Lots to think about.

By M. Randolph Kruger (not verified) on 11 Sep 2007 #permalink

Eagle-BTW its the APHIS division of USDA and not USFW that has control. Each state has different regulations for importation of animals. USFW has those animals in the US that are listed in their sphere of control.

Wouldnt matter anyway though if it breaks, it will likely go and come from every direction H2H, transgenic animal to human, human to animal, feces, toilets atomize human feces when they flush. Airplanes might be able to filter some of the stuff, but I wouldnt want to be leaving a country where I knew they had it with the vents blowing in my face.

Revere-You have any comments on Chan/Chen/Cheng or my favorite Auntie Margaret's comments that H5N1 will set off the next pandemic? Thats just three days after they commented that it indeed was human to human in Indon two years ago. Is it possible that they refuse to send out isolates, samples and the data because they know it will prove they have it?

By M. Randolph Kruger (not verified) on 11 Sep 2007 #permalink

Hey MRK, are these two any of the stories you're asking the R's about? If you want the links just say so.

WHO warns over complacency on bird flu
JEJU ISLAND, South Korea (AFP)
The World Health Organisation warned Monday against complacency in the fight against bird flu, saying another human influenza pandemic is inevitable sooner or later.

"I am often asked if the effort invested in pandemic preparedness is a waste of resources," director general Margaret Chan told a regional meeting of the world organisation.

"Has public health cried wolf too often and too loudly?" she said in a speech.

"Not at all. Pandemics are recurring events. We do not know whether the H5N1 (avian influenza) virus will cause the next pandemic. But we do know this: the world will experience another influenza pandemic sooner or later."

And this interesting bit of news:

NORTHCOM hosts Canada, Mexico at Pandemic Influenza Conference
By Sgt. 1st Class Gail Braymen, Public Affairs Office of North American Aerospace Defense Command and U.S. Northern Command
Sep 9, 2007
Blackanthem Military News
PETERSON AIR FORCE BASE, Colo. - Representatives from American, Canadian and Mexican military and government agencies came to U.S. Northern Command headquarters here this week to discuss their plans and preparedness for a possible influenza pandemic.

About 80 officials are attending NORTHCOM's first Tri-National Pandemic Influenza Conference.

"Pandemic influenza does not respect borders," said Francisco Averhoff, chief of quarantine and border health services at the Centers for Disease Control and Prevention. "It's clear that it's necessary, when you talk about this disease, that we need to have a continental strategy and work together with our partners in Canada and Mexico to make sure that we can best deal with this."

Health officials cannot predict if or when a pandemic influenza will develop, but a particularly dangerous strain of avian flu known as H5N1 is being closely monitored around the world for signs it may be spreading from human to human.

Lea-Yup, one of them was in the Pandung Post. I had to get the translator out and then a translator for the translation...Tks Tan06.

Its becoming apparent at least to me that the deal about releasing the isolates, samples and information is not so much about vaccine but more like clearly H2H transmission. Supari isnt stupid and it would do their tourism trade completely.

By M. Randolph Kruger (not verified) on 12 Sep 2007 #permalink