revere | June 27, 2006The first half of 2006 is coming to an end. So far it was the world's worst for avian influenza, as the disease spread to birds across Asia, Europe and Africa, with new human cases being reported every couple of days.Since January, at least 54 people have died from the H5N1 avian influenza strain in Azerbaijan, Cambodia, China, Djibouti, Egypt, Indonesia, Iraq and Turkey, according to the World Health Organization. That compares with 19 fatalities in Vietnam and Cambodia in the first six months of 2005. Human cases create opportunity for the virus to mutate into a lethal pandemic form.
[snip…
revere | June 27, 2006The fact seven people in Azerbaijan contracted bird flu from wild birds has been assumed for some time and now has been officially confirmed by researchers in Germany:
Four people have died after catching avian flu from infected swans, in the first confirmed cases of the disease being passed from wild birds, scientists have revealed.
The victims, from a village in Azerbaijan, are believed to have caught the lethal H5N1 virus earlier this year when they plucked the feathers from dead birds to sell for pillows. Three other people were infected by the swans but survived.
Andreas Gilsdorf, an…
revere | June 27, 2006Better not have a "sudden event" in China. Or rather, you can have one, but don't tell anyone about it.
What's a "sudden event"?While state media did not offer a definition of "sudden events," in the past they have included natural disasters, major accidents, public health or social safety incidents. (New York Times; h/t Easy Hiker)
What will happen to you if you tell?
Chinese media outlets will be fined up to $12,500 each time they report on "sudden events" without prior authorization from government officials, according to a draft law under review by the Communist Party-controlled…
revere | June 26, 2006Beltway journalists in traditional media outlets like the New York Times must find it tiresome to take dictation for the Bush administration day after day. Concurring Opinions blogmeister Daniel Solove has taken pity on them and crafted a template (or stationery, in word processing terms) for use by journalists like NYT's stenographers to write their stories about the latest government snooping activity.
Here it is:
Under a top secret program initiated by the Bush Administration after the Sept. 11 attacks, the [insert name of agency (FBI, CIA, NSA, etc.)] have been gathering a vast database…
revere | June 26, 2006Mount Sinai School of Medicine has just entered into "a territory limited license agreement with Avimex Animal Health" to produce a new biological that combines an H5 flu vaccine combined with portion of another important disease virus for commercial poultry, Newcastle Disease.The privately owned world-leader in the avian influenza H5 emulsified vaccine market will use Mount Sinai's patented live recombinant Newcastle disease technology that contains an insertion of the H5 gene, for use in Brazil, India, Japan, Mexico, and Taiwan.
Inventors, Peter Palese, PhD, Chairman and Professor,…
revere | June 25, 2006The war in Iraq is going down as history's most dangerous for journalists. War correspondents have some idea what they are getting into, however. Reporters covering local funerals of bird flu victims and poultry culling operations are usually general beat reporters and didn't sign up for ultra hazardous duty. Now the Indonesian press corps is starting to worry.
''I really feel strongly that the issue of health and safety of reporters covering avian flu must be addressed by the management of news organizations,'' said Daenk Haryono of the North Sumatra-based 'Harian Global' daily.
''Many…
revere | June 25, 2006A quiet Sunday in America. Here's something on being quiet from Richard Cohen in the Washington Post:
Pope Benedict XVI went late last month to that place where 1.5 million people, mostly Jews, were murdered -- that memorial to the very worst in mankind, that factory whose sole product was death, and this is what he said: "In a place like this, words fail. In the end, there can only be a dread silence -- a silence which is itself a heartfelt cry to God. Why, Lord, did you remain silent? How could you tolerate all this?"
Others have asked how the Vatican under Pope Pius XII could have remained…
revere | June 24, 2006Helen Branswell, whose sources and reporting are the best, has a fascinating follow-up to the Chinese report in the New England Journal of Medicine the other day giving clinical details of a human case of bird flu in China that occurred a full two years before China officially reported any cases and a month prior to any reports in the current outbreak, thought to have started in Vietnam in late 2003.
Shortly before the paper was officially published in the Correspondence section of the journal but after it had gone out to subscribers by First Class mail, the editors received multiple…
revere | June 24, 2006In August of last year we wrote a post, Festering wounds of Iraq. It was about an antibiotic resistant organism, Acinetobacter baumannii, proving very troublesome in wound infections in soldiers. A. baumannii resides in the soil and is a problem world-wide, not just an Iraqi problem. But it is also a problem specifically related to the war in Iraq. Wound infections with this organism are more likely to occur at the time of injury under battle conditions or to be acquired in emergency treatment settings. Preventing this infection in stateside hospitals has also been a challenge. Without the…
revere | June 23, 2006Indonesia registered its 51st official case and 39th death this week, a 13 year Jakarta boy who had helped his grandfather slaughter sick chickens, took sick a week later and was dead less than a week after that. There's more discouraging news from this benighted bird flu hotspot.
The Indonesian Ministry of Health says the people in the village where the large family cluster with human to human transmission have refused to be tested or have their chickens tested. WHO has been saying repeatedly that there is no evidence of infection beyond blood relations in this cluster (Jakarta Post). If…
revere | June 23, 2006If you live in Europe, you probably like to complain about your national health care system. I have no doubt you have a lot to complain about. But you could live in the US, be over 65 and have to contend with the new government sponsored (but privately administered) prescription drug plan.
Anne and her husband Dixie, both in their 70s, got frazzled trying to work their way through the maddening maze of George W's new prescription drug program, which compels seniors to choose among 1,400 competing drug-insurance schemes offered by 80 corporations. Each plan in this baffling "marketplace"…
revere | June 22, 2006Getting crank letters (or comments) goes with the territory on a blog. But what Sri Lanka's UN Ambassador Prasad Kariyawasam is getting seems a bit excessive. 100,000 letters from Americans complaining a UN Conference on illegal small arms trade is taking place on -- imagine this -- July 4, that sacred global holiday, American Independence Day. The crank letters use wording kindly provided by the National Rifle Association. Not that it matters, but the letter writers are in error. The June 26 - July 7 conference is at the UN headquarters in New York which will be closed on July 4.
The…
revere | June 22, 2006The latest chapter in the Chinese Disease Cover-up Follies involves a just published report in the New England Journal of Medicine by eight Chinese doctors reporting the genetic sequences of an H5N1 case that occurred in November of 2003. Old news. Except China didn't officially report its first case until two years later, November 2005. Just as the first issues of the journal were reaching NEJM's subscribers, were notified that one or more of the authors wished to withdraw the paper. Too bad. Too late.
Meanwhile, the World Health Organization is expressing shock at the reporting lapse and…
revere | June 22, 2006The Center for Infectious Disease Research and Policy (CIDRAP) is a resource for all manner of information on infectious diseases and especially avian influenza. At their website one can find a technical overview which compiles a lot of bird flu information scattered over many sources. But it is a technical overview (although not overly specialized). Some of the entries may not be self evident even to physicians. We've selected one example because it interests us and we think it might interest others. It's just a couple of sentences but will seem counterintuitive to many.
Laboratory tests do…
revere | June 21, 2006I once read the restaurant industry in the US (and probably elsewhere) is one of the highest mortality businesses around. About half of new restaurants don't make it through the first year. It is a tough business, long hours, low wages for most. Immigrant labor is common.
Some restaurants do very well for their owners, but most don't. The industry is always looking over its shoulder at the next problem and their are many. In the US, immigration reform, paying (or trying to avoid paying) health insurance for workers, fending off legislative attempts to force them to pay even half a living…
revere | June 21, 2006Old soldiers -- and young ones, too -- do die, but if there's a flu pandemic with a lot of absenteeism in the workforce, the VA has plans to let them just fade away. Or something like that.Families of veterans who die during a bird flu outbreak shouldn't count on burying their loved ones in any of the 120 national cemeteries. The Department of Veterans Affairs foresees closing the military graveyards in a pandemic because of staffing problems.
The VA buries more than 250 veterans and eligible family members a day -- about 93,000 a year. Itoperates cemeteries in 39 states and Puerto Rico.…
revere | June 20, 2006There is currently no vaccine for a pandemic strain of H5N1 avian influenza, and if a pandemic strain does emerge it will take at least 6 months to get the first batches of one. Currently the productive capacity for influenza vaccines is so overmatched by the needs of a global population, only a tiny fraction of those that will need it could be immunized.
The current experimental (and relatively ineffectual) vaccines for H5N1 are not for a pandemic strain but for a strain current in southeast asia that is still poorly transmissible from person to person. It is thought an easily transmissible…
revere | June 20, 2006As you read this a meeting of more than three dozen avian flu experts should be convening in Jakarta to discuss the disastrous state of public health in that country. Many poor countries have disastrous public health systems, but Indonesia has something else: a huge population of people living in close contact with a huge population of poultry infected with an influenza A subtype (the H5N1 subtype) that has crossed the bird/human species line. Influenza A is a major killer of human beings worldwide, but the global population has substantial (at least partial) immunity to the circulating…
revere | June 19, 2006One of the distinctive things about influenza outbreaks in humans is its seasonality. That's why we call "ordinary" influenza seasonal influenza. Interestingly, we don't know what controls that seasonality, nor do we know if it also is a factor in pandemic strains. Pandemic strains are different in many ways and perhaps seasonality will be one of them. The second wave of 1918 started in August.
The question is even muddier when it comes to avian influenza, as WHO is acknowledging.
"We do know that the bird flu virus can survive for a time in colder weather, but it's really not clear at this…
revere | June 19, 2006I've spent some time here (old site, here, here, here, here and here) explaining WHO's place in the international system. It explains certain things I thought important to understand.
An important part of the international "system" (Westphalian-style) is there is no official authority over sovereign nation states. That means that power politics operates, sometimes quietly, sometimes nakedly. WHO is not immune. A shocking case in point relates to some highly questionable decisions made by the late WHO Director General, Dr. Lee Jong-wook. It is awkward to bring this up in the wake of his…