bird flu
revere | February 10, 2007There is no bird flu in the UK. The biosecurity is too good for that to happen. OK. There is bird flu in the UK but it is well confined. It must have gotten there from wild birds. Biosecurity is too good for anything else. OK. It might have gotten to the UK on a truck from Hungary where there is bird flu in poultry. But it's well confined. OK. It's not well confined, but just affects turkeys in one small shed on one farm. OK. It somehow got out of that shed and infected birds in three other sheds on that farm. But it's confined to that farm. OK. It's possible it got loose into wild animals.…
revere | February 9, 2007Cats again (see here, here, here, here, here, here, here and here). Now the UN's Food and Agriculture Organization (FAO) is warning that cats are susceptible to H5N1:
The United Nations Food and Agriculture Organization (FAO) said today that cats should be monitored for signs of bird flu or avian influenza.
They said that cats, like humans, can become infected with the deadly strain of the H5N1 virus that causes avian flu, possibly from eating infected birds, or from being in very close contact with infected birds or their feces. But they emphasize there is no evidence of a sustained cat to…
revere | February 8, 2007I sympathize with the Indonesians up to a point. Their outrage over what they perceive as the plundering by vaccine makers of their natural resources (in this case a lethal virus isolated from Indonesian bird flu cases) is understandable -- barely. Their subsequent actions to stop sharing samples of the virus with WHO and their attempt to justify it by blaming WHO is not understandable. Nor is it intelligent. But then very little in the way of effective and intelligent bird flu policies has come out of Indonesia anyway. This is part of the package, alas.
The complaint of the Indonesian…
revere | February 7, 2007This was an incident waiting to happen. Indonesia has signed a preliminary agreement with vaccine maker Baxter international an arrangement to supply with with viral vaccine seed in exchange for an unknown compensation. It is unclear whether the arrangement is exclusive to Baxter or not (see today's New York Times, says not). Until the deal is completed they will not continue to send viral isolates to other scientists for research or other purposes. Sharing of sequence data is said to be unaffected. The deal with Big Pharma Baxter International puts viral seed strains from the world's…
revere | February 6, 2007The public may not have bird flu on the front burner but there is action elsewhere. New vaccine technologies are being worked on and so are antivirals. One ready to be used clinically is peramivir, made by BioCryst. Peramivir is another neuraminidase inhibitor like oseltamivir (Tamiflu) and zanamivir (Relenza) although it has to be given intravenously or by intramuscular injection.
Tamiflu and Relenza are chemically similar, looking like the natural cell surface receptor (sialic acid) the virus latches on to to initiate infection and which it needs to be released from when the replicated…
revere | February 5, 2007No vaccine, antivirals in short supply, what to do if bird flu strikes? Wash your hands, seems to be a favorite. While its efficacy is unproven, it's not a bad thing to do anyway. Dry skin is the only plausible side effect. Dry skin and hand sanitizer abuse. It's 70% ethyl alcohol:
The 49-year-old Maryland inmate seemed seriously sick after he drank from a gallon-container of hand sanitizer. Described as "loony," "red-eyed" and "combative," he was whisked by officials to a nearby Baltimore hospital for treatment.
But they quickly discovered he wasn't ill -- just very, very drunk on Purell.…
revere | February 5, 2007The big news is that the UK has its first large outbreak of H5N1 in commercial poultry, a turkey farm in Suffolk. Retailers there are already moving to reassure the public. Although this is the UK's largest turkey farm, large chains have been quick to say they do not sell its birds. The Talking Points have been ready for some time. You have nothing to fear but fear itself. It is perfectly safe to eat an infected bird if you cook it properly.
The US poultry industry is also ready, although they have assured us they are safe because they have excellent biosecurity. Just like the UK farms…
revere | February 4, 2007Friday CDC released its guidelines for communities to respond to pandemic flu. It adopts a hurricane warning analogy (Category 1 to Category 5 pandemic). The Categories are keyed to case fatality ratio, with the lowest category being roughly the experience of seasonal influenza (less then 0.1% CFR and illness rates of 5 - 20%), Cat 2 being the experience of the 1957 and 1968 pandemics (CFR of less than .5%) ratcheting up to Cat 5, the experience of the 1918 spanish Flu, whose CFR has been roughly estimated to be around 2 - 3%. By these measures, if H5N1 went pandemic at its current CFR of 60…
revere | February 3, 2007It's official. Bird flu has come to poultry in the UK, with the death of 1000 turkeys in Suffolk. The Department of Environment, Food and Rural Affairs (Defra) just announced confirmation that the H5 virus is indeed H5N1 (via BBChat tip Peter McG.). This is the second confirmed appearance of the virus in Europe this year and the second appearance in the UK in the last 12 months (previously chickens in Norfolk in April 2006). Most people expect there to be more instances elsewhere in Europe.
The virus is out there. Gone from the headlines doesn't mean it's gone from the world.
revere | February 3, 2007CDC held a full scale bird flu drill yesterday and allowed reporters to watch (h/t ch). After some reported what they saw, one wonders if they will do it again. Not that they finished the drill, which was stopped halfway because Atlanta had an ice storm. I hope this doesn't happen during a real emergency. An emergency like this one:
⢠A 22-year-old Georgetown University student who visited his family in Indonesia returned to the United States. He became seriously ill the next day and went to a Washington, D.C. hospital. Lab tests confirmed he had the bird flu that's been killing people in…
revere | February 2, 2007I'm sure you've read about this on other blogs (what? you read other blogs?), but it is just too juicy and too emblematic not to comment on here. Well, I won't actually comment on it. It is self-parodying:
Indonesia claimed a major victory in the fight against bird flu Thursday, saying the heart of the capital had been cleared of backyard fowl and that residents elsewhere were handing in chickens for slaughter.
But poultry could still be seen roaming freely in suburban neighborhoods and some people hid pet birds in their homes, raising doubts the campaign would prevent further human deaths in…
revere | February 2, 2007If H5N1 is going to "go pandemic" it has to be transmissible from person to person. This occurs, but rarely. Why? The 1918 virus was not only lethal but easily transmissible. What's the difference between the 1918 pandemic strain and all the H5N1 strains we've seen so far?
One of the theories was that H5N1 didn't transmit readily because it didn't infect readily, and the explanation for that was that the avian versions hooked on to cellular receptors that are readily accessible in birds but not in humans. We've discussed the underlying science frequently (here [first in five part series, with…
revere | February 1, 2007It's flu season. Human flu, that is. Also, it seems, flu in poultry. So if someone comes down with high fever, aches and pains and a cough in an area where there is H5N1 in poultry, is it likely to be bird flu? The answer, so far, is "No." The reason is fairly straightforward, although this is counter-intuitive for many. First, the empirical evidence (from Thailand), then the explanation.
Nearly half of the patients on the bird-flu watch list have, in fact, caught human influenza, the Medical Sciences Department (MSD) disclosed yesterday.
Since bird-flu infections among fowls were detected…
revere | January 31, 2007Our Wiki partner DemFromCT has this post at DailyKos this morning about a CDC media phone conference/advisory tomorrow on its new Public Service Announcements (PSA) on pandemic flu and its guidelines on community measures that can be taken in the absence of a vaccine. This is the kind of ratcheting up some will see as a new an ominous development, but that's not my view. Instead I see it as the kind of thing that should to be done well in advance of anything happening, whether it happens or not. It is just good, routine public health practice.
We still need to see what these PSAs and…
revere | January 31, 2007Exploration with new vaccine technologies is moving forward rapidly, although given the usual pace of the science and then necessary tests for safety and efficacy it isn't likely we will have a bird flu vaccine sooner than two or three years from now. Maybe that's enough time. Maybe it isn't. It would have been good if we'd have started earlier, but we didn't. Anyway, here's the latest entry, a skin patch vaccination (TransDermalImmunization, TDI). Naturally the news comes to us not through a scientific publication but through a press release. How else do you raise money these days? (That's a…
revere | January 29, 2007Having taken on the American Chemical Society the other day, why stop there. Let's talk about the American Chemistry Council, the ACC (neé the Manufacturing Chemists' Association, then the Chemical Manufacturers Association and now ACC). And bird flu. Yes, bird flu. The ACC is a trade association of the largest chemical companies and has a division called the Chlorine Chemistry Division which has just launched a website "dedicated to educating the public on flu prevention and recovery." If you believe that I've got a 1995 Volvo with low mileage (for a Volvo) just for you. Only driven at the…
revere | January 28, 2007Yesterday we took note of the mirror image of absenteeism, presenteeism. The concern here is that people will show up to work sick and if they are infectious, spread influenza or whatever else is going around. As we noted people have various reasons for working sick, not the least of which is that they cannot afford to "waste" a sick day in case they need the few they have for family emergencies (like a sick child) or simply because they don't have paid sick leave and need the money. Almost half of US workers are in that position. So various proposals have been made to require paid sick leave…
revere | January 27, 2007Whenever the topic of sick leave comes up, employers are quick to raise the specter of malingering to get out of work. But a recent report on CNN suggests that showing up when sick may be costing plenty, too. "Presenteeism" is not just a financial problem but a public health one particularly germane to influenza:
Practically every workplace has one - the employee who comes to the job aching, coughing and sneezing.
So-called "presenteeism," or going to work when sick, is a persistent problem at more than half of U.S. workplaces and costs U.S. business a whopping $180 billion a year, research…
revere | January 26, 2007It seems like just yesterday the UN's Food and Agriculture Organization was saying that the current resurgence of bird flu is not as bad as last year when it burst out of Asia and extended itself into 40 countries or so. It wasn't yesterday. It was Monday. Enough time for that judgment to look a wee bit premature.
In fairness, FAO cautioned everyone not to let down their guard. Good advice, especially as the first poultry outbreak in Europe this season has now been confirmed in Hungary and the virus has returned to Japan for the first time in three years. We aren't even mentioning China and…
revere | January 25, 2007We spend a lot of time on bird flu here because, as I have explained, it is a useful lens through which to look at the void in public health leadership as well as preparedness issues of the system that allegedly protects us from bird flu and much else. We don't spend all this time on bird flu because we believe it is the most important public health problem in the world. It could become so, but it isn't now. Our view is that if it ever does, we should be ready for it, and it takes leadership for that to happen. But there are other gigantic problems, too, and we want to highlight one of them…