bird flu
revere | October 18, 2006There's a lot of good regional reporting around that most of us don't get to see. Consider the Sun Herald in gulfport, Mississippi. We think of Gulfport as Katrina country these days, but like the rest of the world in 1918 it was pandemic flu territory. Local reporter Kat Bergeron looked back nine decades to that other catastrophe and concluded there are still a lot of missing puzzle pieces.
Nearly nine decades after the 1918-1919 influenza pandemic swept across the Mississippi Coast - and every country in the world - researchers and health officials continue to study and revise death tolls.…
revere | October 18, 2006A paper has just been published that is a real wake up call. I am stunned more of us didn't think about this sooner.
We all remember the Tamiflu frenzy that ensued in 2004 when people first realized the bird flu train might be coming down the tracks. There was a great deal of talk about how Tamiflu (oseltamivir) was the only antiviral capable of saving someone from the virus and it was in short supply. So many people started to stock up:
Fears of an outbreak of bird flu led Americans to hoard the anti-viral medicine Tamiflu in 2005, with prescriptions spiking most sharply when media coverage…
revere | October 17, 2006Bird flu has claimed 55 people in Indonesia, with the death of a 67 year old woman. The world's fourth most populous nation (after China, India and the U.S.), Indonesia has had 72 cases since June 2005 and the most deaths (WHO). Only Vietnam has registered more cases (93 cases), but fewer deaths (42) (WHO).
A look at this bar chart shows how the epicenter of human bird flu has shifted from Vietnam (clade 1, Vietnam southeast asia, magenta color) to Indonesia (clade 2, Indonesia, yellow color). You can also clearly see the start of the new flu season. The chart does not include the three most…
revere | October 16, 2006This story ("Scientists close to neutralizing all flu types") continues to circulate and frankly, I don't understand why.
British scientists believe they are close to finding a way to stop all flu viruses --including the deadly H5N1 virus, known as the bird flu.
Researchers at Warwick University say they have found a way to turn the flu virus against itself.
Although the research is still in its preliminary stage, the results are a source of optimism for the medical community concerned about the global spread of bird flu.
"We're very close. The lab data are as good as they can be. It works…
revere | October 13, 2006A paper to be presented today at the annual meetings of the Infectious Disease Society of America, but following a familiar pattern the results have been presented in a press release. The news is modestly good, but the emphasis should be on modestly.
The paper reports work that took advantage of a group of people who were vaccinated with two doses of an experimental bird flu vaccine in 1998, shortly after the first human cases in Hong Kong. The viral strain of H5N1 used then was of a lineage (or "clade") different than the ones used in the recent spate of vaccine trials from a lineage…
revere | October 12, 2006The Federal government's flu plan is in it final stages of recapitulation -- sorry, I mean, the final stages of preparation. The headline of the AP news story says it all: U.S. Pandemic Flu Plan: Hole up at Home. Jeez.
The federal Centers for Disease Control and Prevention is pitching the plan at medical meetings and aims to send it out for review by the end of the year. State and local governments have asked for unusually detailed and specific advice on such matters as closing schools and canceling public events, one CDC official said.
This week, CDC awarded $5.2 million in grants related…
revere | October 11, 2006Here's a cautionary tale. Many readers know that H5N1 infection is capable of causing a sudden over activity of the immune system, manifested in a so-called cytokine storm. Over active immune systems have been implicated in many other diseases, as well, although the type of "over activity" isn't the same. Autoimmune diseases, like rheumatoid arthritis or lupus erythematosus are caused by the body making antibodies to its own tissues. As in cytokine storm, an immune system that normally functions to protect us, makes us sick. To damp down the inappropriate activity, drugs like steroids are…
revere | October 11, 2006Bird flu popped up in poultry in Egypt in February of this year and within months the north African country registered more human cases (14) than any other outside of Asia. The last human case was in May and with the warm summer months detections in poultry waned as well. Then at the end of September birds again were shown infected in a village near Aswan, at the southern end of the Nile Valley.
WHO spokesman Hassan el-Bushra told IRIN that the infected animals, raised in the backyard of a house in the town of Edfu, have now been culled. Ministry of Health officials have "instigated the WHO-…
revere | October 10, 2006Pandemic Flu Awareness Week registers its first success. The Onion Radio News (audio clip) provides evidence bird flu awareness has reached the average American.
revere | October 9, 2006Today marks the second Pandemic Flu Awareness Week, launched by my colleagues over at The Flu Wiki. The good news is that in the year since the first effort to raise the awareness of the blogosphere, much has happened in the way of increased recognition of the pandemic threat. Communities around the world have started to plan for the possibility of a pandemic and the planning process will pay dividends. More good news is that a pandemic strain of H5N1, the leading candidate for a disastrous flu pandemic, has yet to come into the open. The bad news is that there is much, much more that needs…
revere | October 7, 2006Today The Jakarta Post is saying a study by the Indonesian Environment Information Center (PILI) in Yogyakarta has shown feral cats have become infected with H5N1 through "contact" with infected poultry at markets. There is no additional information on the nature of the contact, although eating the bird would seem likely but not the only possibility. PILI is also concluding the literature shows migratory birds are not vectors, blaming the poultry trade for movement of the virus. PILI is currently studying the migratory bird problem in Indonesia.
The statement about cats was made during a…
revere | October 6, 2006I'm still trying to figure out if the statement by Ambassador John Lange, the US State Department's special representative on avian and pandemic influenza, that this country is close to "state-of-the-art" in its preparations for a pandemic of H5N1 and its biosecurity measures is some kind of dark humor about state-of-the-art in general or just an amazingly clueless assessment of where we are. I'm aware that a sense of humor doesn't usually characterize the official prnouncements of this administration, although some of them do produce hysterical laughter. I'm pretty sure he is either clueless…
revere | October 3, 2006Here's a solicitation for reader input.
A medical conference in the UK last week was told that the Government's faith in antivirals as the key to combatting a pandemic is misplaced. There was the usual handwringing about the havoc that a pandemic would bring and dueling views as to whether British society could cope with it without breaking down. I'll put my bets on British society. And American society. And French society. And, etc.
But I'm not a betting man, so some real planning and preparation is obviously in order. We've known this all along, said it all along and even done some of it,…
revere | September 30, 2006There are reasonable and plausible suggestions that there may be other reservoirs for H5N1 than poultry. We have discussed it here numerous times, but we don't know although I certainly wouldn't rule it out. But the poultry reservoir is gigantic and probably the source of most human contact with the virus. Consider Indonesia, with its estimated 300 million poultry:
Bird flu may have infected a quarter of backyard fowl in some of Indonesia's most densely populated areas, the country's top veterinary official said, risking human lives and increasing the threat of a pandemic.
Random tests…
revere | September 30, 2006The Rockefeller Foundation's conference center in Bellagio, Italy on Lake Como is a lovely place (digression: so I'm told by people I know who have spent time there. I haven't -- yet. This is a big hint to the Foundation that I am available to take a week there and tell you what I think. Or you can find out for nothing here. But I'd rather tell you in person.).
In June Ruth Faden, a bioethicist at Johns Hopkins convened a group of experts there to talk about ways to soften the impact of a flu pandemic on the world's most vulnerable:
"Within countries rich and poor, the burden will be felt…
revere | September 29, 2006We've now had a chance to take a look at a new paper in Nature (advance online publication 27 September 2006 | doi:10.1038/nature05181) on increased host immune and cell death responses in mice infected with the reconstructed 1918 virus compared to other viruses with only some of the 1918 gene segments. It is a very interesting paper.
The authors (Kash et al.) infected mice intranasally (through the nose) with four viruses, one a currently circulating human H1N1 virus, A/Texas/36/91, dubbed Tx91 for short, and three others, two produced by replacing first two of the eight gene segments of…
revere | September 27, 2006When we first began to cover the bird flu problem -- back in 2004 -- it wasn't being discussed much anywhere, including the blogs. We started talking about it for two main reasons. First, it seemed to us, as it seemed to many informed public health scientists, that this was a possible freight train coming down the tracks. We didn't know then (nor we know now) how far the train was, whether it would get all the way to us or how fast it would be going if it did get to us. But we could feel the vibrations on the tracks and we knew enough about train wrecks of the past to worry. That was the…
revere | September 26, 2006The City of Boston is now soliciting volunteers for a new Boston Medical Reserve Corps Program, designed to help the city prepare for disasters:
"I want everyone in Boston to consider joining the Boston Medical Reserve Corps; people in our medical, health and business communities, our residents, our college students, retirees -- anyone who wants to help," said Mayor Menino in announcing the recruitment drive. "We're looking for everyday heroes to help make Boston safer and more prepared."
Following many disasters, large numbers of people often come forward to help. Many of those well-…
revere | September 26, 2006Many readers here know that WHO has a pandemic phasing arrangement, and there has been much confusion and consternation about why they have or have not "called" phase 4. In a characteristically informative article, Helen Branswell of Canadian Press gives some of the details, including the names of some of those who will advise WHO on whether to change the warning level.
In short, WHO has established a committee of experts to help them determine the phasing. Branswell says the committee has about 20 experts, including some stalwarts of the influenza science establishment:
The list of 20 or so…
revere | September 20, 2006Nick Zamiska had an interesting piece in yesterday's Wall Street Journal about the difficulty WHO is having encouraging a sense of urgency about a possible pandemic of avian influenza and the many other programs and problems with which they are daily engaged in a (literally) life and death struggle in many places in the world most of us have never heard of. The problem is made more difficult because of the roulette-wheel like nature of an emerging pandemic. We don't know when or if our number will come up or how much we should invest in the event it does. So far it hasn't happened, which is a…