bird flu
revere | May 16, 2007"Promise them anything, but give them Arpege" was a famous perfume ad campaign of the 1960s. Indonesia is free with promises, but what it is actually handing out doesn't smell like Arpege. After promising (for at least the third time since January) to resume sharing of viral isolates, we find only three clinical specimens, not isolates, have arrived in Japan but the provision of specimens or isolates from another 12 known and confirmed cases from Indonesia is unclear.
After refusing to share H5N1 avian flu viruses with the World Health Organization since the start of the year, Indonesian…
revere | May 16, 2007The squabble about viral isolates originating within the borders of Indonesia notwithstanding, the simple fact is that if there were a pandemic there is only a fraction of the needed productive vaccine capacity necessary globally. What fraction? Good question.
The earth is home to 6 billion people, give or take a few hundred million. And a few hundred million doses is our global vaccine capacity in the event of a pandemic. The annual capacity is estimated around 300 - 400 million, possibly 500 million if pushed. That's annual production. If we had to ramp up a specific pandemic strain from…
revere | May 11, 2007The US military didn't plan for the aftermath of Iraq. You know, controlling the civilian population? So they've learned their lesson. You gotta plan for it:
The US military has begun to plan for a possible avian flu pandemic that could kill as many as three million people in the United States in as little as six weeks, a Pentagon planning document said.
The Defense Department's "Implementation Plan for Pandemic Influenza," which was posted Wednesday on a Pentagon website, lays out guidelines and planning assumptions for US military services and combatant commands.
Possible scenarios include…
revere | May 10, 2007The stand-off between Indonesia and the rest of the world over sharing of viral isolates obtained within its borders continues. Indonesia has identified a problem, but in our opinion, has no standing to impose its proffered unworkable solution. Everyone tends to see this from their own particular perspective, so we'll give you ours. We aren't WHO (and have had no contact with them on this matter) and we aren't citizens of Indonesia or any other developing country. We are citizens of a rich, developed country. But we are also long time, committed public health professionals. I think we have…
revere | May 9, 2007Last week another mathematical modeling paper made the newswires. If you wonder how this happens, the answer is that universities and companies have PR departments that put out press releases. Services like ScienceDaily aggregate and package these press releases for journalists and others (like us). Since a mathematical paper in a specialized journal (in this case it is PLoS Computational Biology) is not likely to be read by a reporter, especially a reporter on deadline, it isn't surprising the news stories follow the press release rather than the paper. In this case, I am sorry to say, the…
revere | May 8, 2007Two news items from Indonesia, one about a new case of bird flu, one about the competency and responsibility of the Indonesian authorities. I take that back. The competence and responsibility of the Indonesian authorities are not in doubt. They have neither.
First, the new case:
Bird flu has killed a woman in Indonesia, taking the death toll in the country worst hit by the deadly virus to 75, a health ministry official said on Monday.
Two series of tests confirmed that the 29-year-old woman was infected with the deadly H5N1 strain of the virus, said Suhardaningrum, from the national bird flu…
revere | May 7, 2007Thursday CDC issued some "Interim Guidance Issued For The Use Of Facemasks And Respirators In Public Settings During An Influenza Pandemic" and of course there were many news stories. It would seem the guidance wasn't exactly clear, at least judging from what headline writers took away from exactly the same story:
CDC recommends masks in pandemic
Masks Might Not Block the Super-Flu
CDC offers tips on using masks against flu
Scientists can't mask their opinion
US Government Issues Facemask Advice For Flu Pandemic
Consider using masks if flu strikes
CDC: Masks Not Much Help In Flu Pandemic…
revere | May 5, 2007It may seem to have nothing to do flyways for avian influenza virus, but bear with me. In 1962 there was another flyway that revealed Soviet missiles in Cuba:
It was 0737 in the morning of Sunday 14 October 1962 when Major Richard Heyser began the crossing of Cuba in his U-2. He flew almost due north-on a course some 60 miles to the west of Havana and passed over the northerly beaches six minutes later. In that brief timespan be took 928 pictures, which covered a swath 75 miles wide. The resolution of his best shots was a matter of three feet.
Once past the target, he headed for McCoy Air…
revere | May 4, 2007What do you say when you really don't know the answer to the question, "Should I wear a mask to protect me against bird flu if it becomes pandemic?" Here's the CDC answer:
If a super-flu strikes, face masks may not protect you. Even so, the government says people should consider wearing them in certain situations, just in case. The consumer advice issued Thursday reflects the fact that the science behind it is unclear. Whether widespread use of masks will help, or harm, during the next worldwide flu outbreak is a question that researchers are studying furiously. (AP)
I'm not sure exactly how…
revere | May 2, 2007China has now agreed to send WHO bird flu isolates, but Indonesia, after first agreeing to do so, won't. Or is it the other way around? It's easy to get mixed up because China has made this promise before (posts here, here and here) and so has Indonesia. Whatever.
Indonesia's health minister has accused the World Health Organization of breaking its promise to assure that the country's bird flu samples would not be used commercially, dragging out a dispute about equal access to a future vaccine.
Siti Fadilah Supari said late Monday Indonesia was ready to resume the supply of specimens, but had…
revere | May 1, 2007Last week we talked about "mash-ups," the combination of online resources from disparate sources, and pointed out that Google Maps and Google Earth were favorite substrates for this. Declan Butler, senior correspondent at Nature, is the first we know of to construct a Google Earth mashup for bird flu. Now there is a very sophisticated version from scientists at the University of Colorado and Ohio State University:
The research team has tracked the spread avian flu around the globe over time by specific host groups of birds, mammals and insects. (Credit: CU-Boulder, Ohio State University)
A…
revere | April 30, 2007"China" was one of the founding members of the United Nations. Whatever you mean by "China," anyway. When the UN was formed in 1945 there was only one China. After the Revolution of 1949 the losing side retreated to Taiwan and claimed the title of Republic of China. The US and its allies stupidly continued to recognize them as "China" to keep another communist country from the Security Council, but by 1971 the absurdity of denying mot Chinese a seat in the UN was patently obvious and the People's Republic of China took the place of the ROC. At the time I was strongly in favor of this and I…
revere | April 27, 2007It was inevitable. Roche is now planning to cut production of its antiviral Tamiflu because, they say, supply is exceeding demand:
Swiss pharmaceutical group Roche said Thursday it would trim production of the frontline bird flu drug Tamiflu unless demand picked up, but warned that the world was still not ready for a pandemic.
Manufacturing capacity for the antiviral treatment has reached 400 million treatment courses a year and is outstripping demand, William Burns, the chief executive of the group's pharmaceuticals division told journalists.
Roche has received orders for 215 million…
revere | April 26, 2007The wound opened by Indonesia's balk on supplying H5N1 viral isolates to WHO for vaccine surveillance (see here and here) has now been fixed -- with a band-aid:
Indonesia and other five countries are being awarded grants by the World Health Organization to establish in-country manufacturing capacity for influenza vaccine, according to Indonesian branch of WHO.
As part of a concerted effort to ensure more equitable access to a potential pandemic influenza vaccine, up to 2.5 million U.S. dollars sponsored by the governments of Japan and the United States will go towards Brazil, India, Mexico,…
revere | April 25, 2007The stuff you read in the newspapers. Jeez. First a story about Des Moines, Iowa officials looking for someplace to quarantine people in the event of a bird flu outbreak. Yes, that's right. Quarantine. Lots of times when you read that they really mean, isolation, the segregation of sick people. Quarantine is the segregation of possibly exposed people who aren't sick. And in Des Moines they really mean "quarantine":
One of the toughest challenges would be to quarantine people who were exposed to the virus but weren't showing symptoms. Most would be asked to stay home for about a week. Those…
revere | April 24, 2007The Bernard Matthews company, Europe's largest turkey (producer), had a nasty brush with bird flu and had to kill 160,000 birds, amidst many questions about its biosecurity measures (or not). But the company didn't suffer. It will get £600,000 compensation, courtesy UK taxpayers. The 250 workers the company laid off aren't so lucky. They get squat.
The Department for Environment, Food and Rural Affairs said the compensation system was designed to encourage farmers to report potentially deadly outbreaks.
"Early reporting is essential to preventing disease spread, which would result in a far…
revere | April 23, 2007If you travel at all, and I have to travel a fair amount, you know how brittle the air traffic system is. Last week I did an out-and-back one day affair of around 500 miles each way. Weather was good and I made it to my destination on time. The meeting went from 10 am to 1:45 pm. Then a dash to the airport for a 2:35 pm flight home. Except that higher than usual winds at my destination set in motion a cascade of air traffic delays as the number of available runways shrank and I was 3 hours late. Not terrible, but just a measure of how sensitive the system is to the slightest upset.
The…
revere | April 20, 2007Bird flu clinicians -- the handful of doctors that have actually treated human cases of bird flu -- met in Turkey last month, and upon comparing notes made new recommendations. Among them, don't use steroids:
Doctors caring for H5N1 patients should not treat them with corticosteroids, the World Health Organization said Thursday, noting the drugs don't help and sometimes harm patients trying to battle the often severe infection.
Corticosteroids should only be used on patients with persistent septic shock, a condition in which blood pressure drops to dangerous levels because of an infection in…
revere | April 19, 2007An excellent article on the CIDRAP site by Maryn McKenna (late of the Atlanta Journal Constitution where she had the CDC beat) won't be news to readers here, but it is news that it is news. The subject is efforts by non public health types in preparing for pandemic influenza. McKenna notes that recent reports by two different but highly regarded groups has noted that governmental planners are not making full use of grass roots groups outside of professional boundaries. In fact they aren't making use of them at all. Communication with the public is one way.
The first report, "Community…