bird flu
revere | April 4, 2008One of the least talked about problems in pandemic preparedness planning is that even if there is flu all around us and the health care system is struggling (and almost certainly failing) to handle the resulting demand of patients, people will still be getting sick from the usual things (heart attacks, strokes, etc.), having accidents, and yes, getting pregnant.
There is pretty good reason to think that getting the flu when pregnant is even worse than getting the flu otherwise. A pregnant woman's immune system reacts differently because of the special circumstance of accommodating the…
revere | April 3, 2008The index case was a 5 year old Miniature Schnauzer with 5 days of nasal discharge and sneezing. The dog recovered but the next case, a 3 year old Cocker Spaniel wasn't so lucky, nor were the 2 Korean hunting dogs (Jindos) or a 3 year old Yorkshire terrier. Then 13 dogs in a shelter started to show signs of nasal discharge, cough and high fever. Antibody studies showed that they had all been suffering from influenza infection, subtype H3N2. These cases happened in the spring and summer of 2007 (NB: this is not flu season). H3N2 is the most common subtype involved in human seasonal influenza.…
revere | April 2, 2008If a worker refused to report for work because it was a demonstrably dangerous workplace they would be within their rights, with a few exceptions. One of the exceptions in some states seems to be health care workers (HCW) who refuse to work during a pandemic. A HCW, like any other worker, might not report for work for a variety of reasons: fear for their own safety, fear for the safety of their families should they bring home an infectious disease like influenza, need to care for their family if one is sick or has not caretaker (say, because the schools are closed). In at least two states,…
revere | March 31, 2008Trust is not transitive, as someone recently pointed out, when reporting on the airline pilot who carried a gun into the cockpit and then accidentally or negligently discharged it and blew a hole in the plane. We had every reason to trust the pilot to be able to fly a 747, but not necessarily to handle a firearm properly. Trust isn't transitive.
There is no doubt that Yi Guan, a professor at the University of Hong Kong, is an expert on H5N1 virus, its genetic lineages and surveillance for the virus in wild birds. He has reportedly screened, via cloacal swabs and fecal specimens, more than…
revere | March 28, 2008Hard on the heels of my semi-facetious prediction that bird flu would return to Germany because Germany had declared itself bird flu free, the Swiss announced an infected wild duck on the shores of Lake Sempach. Since this duck didn't have a passport on him I am sure he never strayed over the nearby border with Germany. We don't know what kind of duck this was [see update, below], a question that is of surprising interest in light of a new paper.
Bird flu is avian influenza, i.e., an infection of birds by the influenza virus. The role of wild migratory birds versus human caused movement of…
revere | March 27, 2008Bird flu is a viral disease but its effects go beyond viral infection. An obvious but important fact. Consider Egypt.
The first poultry cases in Egypt were only a little over two years ago, but the virus quickly took root there. The poultry infections were a harbinger of human infections, 18 that year (2006), 25 the next year, 4 so far this yar. Egypt now has more human cases of the disease than any other country outside of Asia (47 cases, 20 deaths). Like other countries with bird flu problems they also have a large population who lives in close contact with birds. Many people keep poultry…
revere | March 26, 2008Germany has been free of bird flu in poultry for three months. I predict they are about to have another outbreak. How do I know? Because every time I see something like this it's like a signal to whatever fickle gods control these things:
The German government declared on Tuesday the country is free of bird flu, with no cases of deadly H5N1 avian influenza discovered in wild birds or domestic poultry for the past three months.
According to German Agriculture Ministry, the last outbreak of bird flu was in poultry in rural areas west of Berlin in December.
Germany had its first brush with bird…
revere | March 25, 2008We've covered the Indonesian refusal to cooperate with international influenza surveillance system to a fare thee well (see posts posts here, here, here, here, here, here, here, here, here, here, here, here, here and links therein), so this is just an update with some additional observations how Indonesia's deplorable behavior isn't that different than the US's deplorable behavior in the Middle East. First, Indonesia. When last we checked in Indonesia had sent off half a dozen flu specimens from the period after the end of January 2007 when it started its boycott. The hope was that the…
revere | March 21, 2008While we are all waiting for the other shoe to drop and a nasty, rip roaring flu pandemic to come rushing down the tracks at us, lots of companies have jumped into the pandemic vaccine sweepstakes. Reuters reports that at least 16 companies are testing flu vaccines and probably even more are involved in some technical aspect of vaccine production. That's good, although whether it will make any significant difference except around the margins remains to be seen. Timing is everything.
Meanwhile, though, work is going forward on many vaccine fronts. The one to hit the PR wires today is a report…
revere | March 20, 2008I rarely report about suspected bird flu cases here, preferring to wait a couple of days to let things sort out. In the early years of this blog I did report about them in the course of time, experience and some reflection we have come to our present position. Besides, it's not necessary. There are plenty of reputable, reliable and thorough places in flublogia to get up to the minute news. Given all that, it isn't surprising we didn't say anything here about a couple of suspect imported cases in Toronto. In fact, like crof, I hadn't heard about them. Now, thanks the the denials streaming out…
revere | March 19, 2008The chief veterinary officer of the UN's Food and Agriculture Organization (FAO) reaffirmed what everyone paying attention already knows: the bird flu situation in Indonesia is critical. The archipelago nation is the fourth most populous country in the world fragmented geographically on 17,000 islands and politically by a disastrously decentralized government. Of its 31 provinces, FAO says 31 have reported infected poultry, and on some of the largest -- Java, Sumatra, Bali and southern Sulawesi -- it is endemic and solidly entrenched. There are an estimated 30 million poultry smallholdings in…
revere | March 18, 2008Last week The US Department of Health and Human Services (HHS) released a comprehensive pandemic flu guidance document for states, accompanying it with a web presentation, the first of three. I haven't seen the Web Seminar and only quickly perused the document, so I am commenting on the basis of a description in CIDRAP News, a reliable source. You can find the Web presentation and document at pandemicflu.gov. It is always best to see the original, so this is my take from a second hand source. Even so, I don't think our take is likely to be wildly off kilter (assuming you don't think we are…
revere | March 17, 2008There are all sorts of ways to prepare for an emergency. One is to simulate it inside a computer (a computer model). But you don't have to simulate inside a computer. You can also do it in "meatspace" (aka, the real world). Dungeons and Dragons using books is one example of this. Another is to do a pandemic version of D&D. It's called a table top exercise, although the size of the table can be pretty big. Recently our wiki partner, DemFromCT (if you can call someone a partner who does all the work), observed a CDC exercise which he has described in detail over at the FluWiki Forum (here,…
revere | March 16, 2008The headline seemed to say it all: "Funding Issues Stymie Pandemic Preparation." Right, I thought. All the money is going in to procurement, too little into shoring up a failing public health system. Little did I know:
The fear of bioterrorism and avian flu are driving a healthy new interest by biotech firms in developing products in the field of infectious diseases. "Even though we were developing a smallpox vaccine in 2000, there is no doubt that 9/11 was the moment that biodefense suddenly came up the funding ladder in the U.S.," said Clement Lewin, Ph.D., vp of marketing policy and…
revere | March 14, 2008There are a lot of rats in this world and they have meat on them. I always wondered why they weren't more commonly used as a human food source. Bird flu has taken care of that. Enjoy:
revere | March 13, 2008Few of us had heard of palm civets before SARS. Then these small nocturnal animals came under suspicion as the source of the human SARS virus. Civet cats were a wild animal delicacy in the area where SARS broke out and it was discovered that they were infected with the same virus as humans. Did humans give it to the civet or the other way around? Or is their some third source? Bats have been discussed for SARS.
Now Vietnam is reporting, for the second time, the deaths of civets from H5N1:
Four Owston's palm civets, a catlike carnivorous species that the International Union for the…
revere | March 11, 2008I'm an advocate of using computer models to help us think about what might or could happen during various pandemic flu scenarios, but it is a technique with drawbacks. For one, it can suggest that some things might be possible that are either very difficult to do or aren't feasible. This happened in 2005 when some models were published in Science and Nature that suggested a pandemic could be nipped in the bud before it started. Most people thought that what was required was unrealistic but it put WHO in a bind. They had to marshal their resources to show they were willing to try or go down…
revere | March 7, 2008There are a lot of open questions about the influenza antiviral drug oseltamivir ("Tamiflu"), among them whether it works at all for bird flu (highly pathogenic influenza A/H5N1), and if it does, whether resistance will develop making it ineffective. But all the questions have a common assumption: that the patient is actually taking Tamiflu. How would you know if you were or not? Because the bottle says so? Not necessarily. In December 2005 U.S. Customs and Border Protection (CBP) Officers seized 51 shipments they said were counterfeit Tamiflu pills at their air mail facility in San Francisco…
revere | March 6, 2008If you look at the bar chart below you will see that this year's bird flu season is shaping up to look pretty much like last year. In the first two months of the year there are a few more cases but essentially the picture looks much the same. If that is indeed true, then also expect a spike of cases this month (March) since you can also see that is the past pattern. Already cases are being reported in Egypt, and of course, Indonesia. The countries involved this season have been Vietnam, China, Egypt and Indonesia, just like last year. Whether you consider that reassuring or worrying probably…
revere | March 5, 2008Every once in a while we run across introductory presentations of basic bird flu-ology we think are particularly good. This is one. If you follow this area you won't learn anything new, but I think you'll be impressed by how concise and well chosen this material is. I have a few quibbles with the material but on the whole it is accurate and informative. If you are new to the subject of flu science, this is a very quick and efficient starter kit. You can find more detailed explanations in a number of our posts (here, here, here, here, here):