Wednesday, March 30, 2005

March 30 Flu Update

WHO report on N. Korean flu outbreak.

Meanwhile, the UN has sent thier Flu expert to North Korea to investigate the situation.

ProMed on the North Korean report.

Recombinomics on the UN sending test kits to North Korea.

Reuters has four new cases in Vietnam.

Official Vietnam has chosen to brag on a new flu-free province.

WHO says that there is "no evidence" of easy human transmission of bird flu, but they are watching carefully...especially the Haiphong Five/Eight.

ProMed on the WHO's report.

Recombinomics analyzes this news, asserting that the Haiphong Five/Eight is the first family cluster of a virulent disease (prior transmission appeared to be a milder version. If true, this represents a serious danger.

Vietnam goes on to say that the flu situation is "complicated." Of course, of this there is no doubt. They rely on the popular hypothesis that the virus appears more virulent than it is due to the poor rural health conditions.

Reader Bill has pointed us to this article on low pathogenic bird flu in Mexico. May not be H5N1.

Tuesday, March 29, 2005

March 29 Flu Update

WHO Update 12 summarizes situation in Vietnam and Cambodia.

CIDRAP weighs in on the WHO report.

Oregon crafting bird flu response--as part of change, Oregon University Ducks will change their nickname to the Terrible Tamiflu.

Cambodia reports second human case of bird flu.

Add three neighbors to the Haiphong Five. Recombinomics discusses what we know and don't know.

Recombinomics on what surely LOOKS like efficient transportation.

South Korea newsapaper editorializes for North Korea to tell the truth on bird flu.

China shows willingness to step in and assist with bird flu in North Korea.

Add three neighbors to the Haiphong Five. Recombinomics discusses what we know and don't know.

A Canadian scientist has an interesting perspective...says the real challenge isn't the number who will die, but how the sick will be cared for...decries the escalating doom projections.

More from Canada, as it plays out the scenario.

ProMed on the hope of cooperation on the Korean peninsula.

ProMed on the WHO Haiphong Five report.

Indonesian Quail dying of bird flu.

Effect Measure with its normal very strong analysis of what is going on. A couple key quotes:

What is clear is that H5N1 infection is entrenched in local poultry, has not been eliminated and continues to be transmitted to humans. Whether this witch's brew is simmering or starting to boil over is not obvious. One could defensibly see it either way. But it is indefensible to act as if it is not boiling over. The costs of an error are too great. But that is what we continue to do.


Read the last three sentences again. You can sum up today's situation in those 29 words.

These are pretty good, too--on North Korea.

This is just one more example of the complex interaction between politics, social conditions and the natural environment. Fortunately most of the time the stars don't line up just right. But sometimes they do.

Monday, March 28, 2005

March 28 Flu Update

A new bird flu case in North Vietnam.

Recombinomics on what is now the Haiphong Six.



Wisely, South Korea is ready to help North Korea stem the bird flu tide. Question remains as to whether the North will accept.

The Governor in Jakarta is advising people to stay away from bird with flu symptoms--probably forgotten advise following today's earthquake.

From Salt Lake City, an editorial calling for preperation for the pandemic.

ProMed with updated info from the CDC.

ProMed with an update from Cambodia.

Easter Sunday Flu Update

First, I want to re-recommend these two articles to you...on the ground, and very dramatic and solid overviews of what is going on.

London Observer with well-written first a in series of two story on the bird flu.

Reader Bill+ pointed us here. London Observer with well-written second a in series of two story on the bird flu.

Here is your quoe of the day...

If H5N1 was like SARS then at least 10 of my staff ought to be dead by now. They're not ... That isn't to say that the disease isn't dangerous. It is ... But the main reason we are continuing to see so many deaths is the delay in referring people to hospital."

Jeremy Farrar, director of the Oxford University Clinical Research Institute at the Hospital for Tropical Diseases, Hanoi


Second, this from N. Korea, where they
stunned the world by admitting to bird flu in their nation.

The Herald Sun from Australia analyzes this development,noting that North Korea has long been feared as the worst possible place for a pandemic to start. Note, the flu meets politics again!

Recombinomics on the flu and N. Korea.


ProMed on the N. Korea situation.

Here is the (Toledo) Blade's Micheal Woods on flu being the next bad thing....or not. Cites the swine flu precedent as why the scientific community cannot afford to be wrong again.

They're talking mass quarantine in Britain again.

Effect Measure reviews a US News and World report article on the flu. Excellent point among many here is that while we decry lack of media attention, stories like this still don't outshout Terry Schiavo.

Here's the direct link to the first article.

US News and World report on the vaccine...noting correctly that not only do you have to get the genetics right, but you also have to produce it.

Easter Sunday Flu Update

First, I want to re-recommend these two articles to you...on the ground, and very dramatic and solid overviews of what is going on.

London Observer with well-written first a in series of two story on the bird flu.

Reader Bill+ pointed us here. London Observer with well-written second a in series of two story on the bird flu.

Here is your quoe of the day...

If H5N1 was like SARS then at least 10 of my staff ought to be dead by now. They're not ... That isn't to say that the disease isn't dangerous. It is ... But the main reason we are continuing to see so many deaths is the delay in referring people to hospital."

Jeremy Farrar, director of the Oxford University Clinical Research Institute at the Hospital for Tropical Diseases, Hanoi


Second, this from N. Korea, where they
stunned the world by admitting to bird flu in their nation.

The Herald Sun from Australia analyzes this development,noting that North Korea has long been feared as the worst possible place for a pandemic to start. Note, the flu meets politics again!

Recombinomics on the flu and N. Korea.

Here is the (Toledo) Blade's Micheal Woods on flu being the next bad thing....or not. Cites the swine flu precedent as why the scientific community cannot afford to be wrong again.

They're talking mass quarantine in Britain again.

Effect Measure reviews a US News and World report article on the flu. Excellent point among many here is that while we decry lack of media attention, stories like this still don't outshout Terry Schiavo.

Here's the direct link to the first article.

US News and World report on the vaccine...noting correctly that not only do you have to get the genetics right, but you also have to produce it.

Saturday, March 26, 2005

March 26 Flu Update

OK, this time they're serious. Vietnam mounting a campaign to fight bird flu.

Bird Flu outbreak in Cambodia.

Sweeden sets aside funds to protect 500,000 sweedes.

Here's part 2 of the excellent series started yesterday from the Observer.

Recombinomics on the Haiphong Five and previous repors of sick birds in their area.

Bloomberg on the ground in Quan Binh on on the reports of a cluster there.

Effect Measure talks about the uncertainty around this cluster.

March 25 Good Friday Flu Update

Vietnam and Cambodia both confirm flu deaths.

Recombinomics on whether a family cluster of five signals pandemic.

CIDRAP notes that one of these cases had no known exposure to infected poultry.

Two more suspected Quang Binh cases.

CIDRAP here on good vaccine news. We have reported earlier here that a journal article said that experiments with mice showed that a non-exact match could still help against bird flu. This study also cites a study with ducks. Could this be a luck break for humanity?

Not likely, says the New Scientist. Little immunizing effect is expected from the style of vaccine being tested, based on an expert from Chiron. Alum could be added. Production difficulties are also cited.

Reader Bill+ pointed us here. London Observer with well-written first a in series of two story on the bird flu.

Bird Flu rages in Indonesia...Recombinomics.

ProMed on developments in Vietnam and Cambodia. Note claims that the virus doesn't pass easily between bird and human.

ProMed on the Cambodian death.

Thursday, March 24, 2005

March 24 Flu Update

Leading today's news is a second Cambodian dying of flu.

ProMed Mail has the news on the 195 cases. It appears to be largely a combination of psychological panic and ordinary flu, and not the massive outbreak originally reported.

The Recombnomics angle...

Effect Measure on the deeply confusing reports from Quang Binh.

Indonesia reports widespread bird flu, but no human cases--its only a matter of time.

New Hampshire figures about 1,000 deaths of bird flu sounds right...

If you have access, Science Magazine has a flu article. Best use of the word confounding...

Canada sending experts to SE Asia to see what can be done to help.

Looking ahead, the Canadians recognize that antivirals will be vital in early days of the pandemic. Yet, Doctors and nurses have litte experience with them. Article suggests a little practice now might help that.

Recombinomics on the emerging clusters and what they mean.

In today's sleeper story, scientists are saying cell cultures could speed up emergency flu preperation.

Wednesday, March 23, 2005

March 23 Flu Update

For those of you looking for vaccine into, CIDRAP tells us that clinical trials are starting soon.

NIAID press release on clincial trials....

and the University of Rochester weighs in.

The Quang Bihn mystery continues and Recombinomics is on the case, as always.

ProMed on the new case.

CDC trying again to mix genes to try and predict what new combinations might show...Recombinomics again.

ISDA representatives say that the nation is unprepared for the bird flu.

Here's a study on the economic costs of bird flu so far. Imagine what it would do to our economy.

Washington Post on the Cambodians fighting the flu with no dough.

Myanmar says no bird flu in Burma. Turns out yesterdays report on Burma was from an opposition group based in Norway.

Hong Kong may ban travellers from Vietnam.

Today's star post from Effect Measure---if you, like me, are interested in how the flu will expose the weak points of our society, not our immune system. Teaser question: Will there be enough respirators?

Effect Measure on dopey bureaucratic plans.

Tuesday, March 22, 2005

March 22 Flu Update

A Press Association story from Scotland on bird flu death projections in that country...

Governor of West Java says bird flu plans are overblown.

CDC expert (from New York Times magazine article) says that there must be milder cases of the flu, so counts are low.

USA Today reports on the same speech...noting that bird flu pandemic would strain even the US healthcare system.

Recombinomics takes a critical look at the CDC story.

Recombinomics on the evolving knowledge of the 195 bird flu cases in Quang Binh Hue.

Effect Measure on the initial reports of little disease in Quang Binh.

ProMed Mail on the Quang Binh case.

Here's a journal abstract on mice testing of a vaccine produced through reverse genetics. Seems to indicate that even a perfect match provides some protection.

Recombinomics notes that a recent case presentation indicates a possible genetic shift in the flu away from strictly respiratory to dengue-like symptoms...

Recombinomics notes that a recent case presentation indicates a possible genetic shift in the flu away from strictly respiratory to dengue-like symptoms...

Recombinomics says the Angola situation was Marburg virus.

Monday, March 21, 2005

March 21 Flu2 Update

Vietnemese girls marks death #14 since December 2004.

Thousands of chickens die in what may signal bird flu outbreak in Burma--thanks to commenter Bill.

Bird flu preperations in Oregon.

Canada.com on the potential ethical decisions behind rationing antivirals.

Effect Measure on the 159.

March 21 BREAKING NEWS!

Bill has pointed out media reports today showing that authorities in Vietnam learned of yesterday's blockbuster 195 potential cases from the media. Note the use of quarantines.

Recombinomics weighs in here, and here.

Note the second article carefully. Reference to common flu raises questions.

Sunday, March 20, 2005

March 20--Bombshell?

195 people in South Vietnam village have bird flu symptoms--if so, this is a new day.

Recombinomics on this new development...

ProMed on the 195 new cases. Note the editor's comments, which say the event does NOT confirm human-human transmission, and a single source remains a possibility.

Effect Measure on the 195 case. He notes, correctly, that if it starts, this is one way it would look.

Recombinomics on the WHO excluding clear-cut cases, and his view that human-human transmission is occurring.

LA Times writer says scientists fear flu is understated.

ProMed says has more news of a North Korean denial of bird flu.

Saturday, March 19, 2005

March 19 Flu Update--Slow Day on the flu news front

Recombinomics gamely attempts to sort out cluster details, but without the correct details, its conjecture and mystery.

Recombinomics looks at a disease killing children in Angola, and makes the case that it looks like Vietnam in December 2003.

March 18 flu update

Indonesia claims it has isolated the bird flu

CDC travel guidelines issued...that once in a lifetime tour of Vietnemese Poultry Farms should probably be postponed.

Cambodia and WHO teaming up...

N. Korea says no bird flu here.

The official Vietnemese news agency reports much success over bird flu.

Recombinomics continues to search for flu presenting itself as something like another disease, as it did in 1918.

Recombinomics on the Quang-Binh cluster.

CIDRAP has a flu summary.

Effect Measure on bird flu as a health and safety measure in the poultry industry, and how it effects labor organization.

Thursday, March 17, 2005

St. Patty's Flu Update

According to this, Australia has the biggest per capital antiviral stockpile in the world...and worries it may not be enough.

Very interesting story on how bird flu interfaces with VERY rural Vietnam farming practices...

New bird flu case in Vietnam.

Recombinomics has the 411 on this new case. It appears to be mild. In the North, the fatalite rate is 20%.

Bird Flu enters trade debate in Scotland.

Recombinomics says under reporting of cases goes on throughout the region.

Effect Measure on flu miscellany..nice chance to catch up.

Wednesday, March 16, 2005

March 16 Flu Update

Here at The Coming Influenza Pandemic?, we pride ourselves on equal time. So, Bill has commented with this article that says that the flu is being overblown by health bureaucrats trying to inflate their budgets. Read and decide for yourself...

And, for the record, note the "?" in the title of this blog.

The LA Times on leading health experts who say the flu is badly understated.

This article is about what a nightmare flu would be in N. Korea, echoing thoughts many of us probably had when the news broke. Another example of how the flu virus is as good a sociological marker as we have.

Bird Flu --not culling--kills 25,000 birds in Indonesia.

Recombinomics says the WHO should be warning families about the family clusters being found.

Recombinomics on more false negatives...the more we learn the less we know.

Recombinomics on the sick birds in Indonesia, pointing out that there is also dengue fever there, and flu testing is indeed even with atypical symptoms.

ProMed has the chicken story.

ProMed has Dr. Frankel of the VA in Virginia calling for debate on treating a symptomatic flu patients with an antiviral. Read on...

Effect measure with Part II of a commentary on tamiflu...

And finally, the exciting conclusion from Effect measure, Part III.

Tuesday, March 15, 2005

Ides of March Flu Update

Cry Havoc, and let loose the dogs of flu!

ProMed Mail has Dr. Lawrence Altman from the New York Times on death rates for flu. He notes that they always start high because you only find the really serious cases and then the rates come down. Its important to note that the 1918 flu had a death rate of 2 or 2.5%. The editor also notes that the health status of the population factors in as well...the virus does not work in a vaccuum.

ProMed mail on the N. Korean cases.

Recombinomics on a death in South Vietnam.

Effect Measure reader Dylan posted long and insightful comments on Tamiflu, which Revere is raising from the comments section and running as a serialized article.

South Korea tells North Korea to keep its sick chickens.

Singapore preparing for the flu.

Recombinomics says that 78 percent of cases are false negative, and comments on what that means to WHO's rapid response plans.

Monday, March 14, 2005

March 14 Flu Update

Reports leak out of North Korea of a bird flu outbreak.

Recombinomics on the North Korea outbreak...might not be H5N1

Recombinomics says that clusters indicate slow drift toward efficient human-human transmission, and that the decreased fatality rate increases pandemic possibilities (by not killing the host as quickly).

ProMed Mail on a journal detailing a single source for the virus

Vietnam says the now famous "second nurse" did not have the flu. If true, it takes the tension down a notch.

Man in Vietnam may have died over the weekend from flu. Samples to the lab...

WHO says bird flu clusters signal possible mutation.

On ProMed Mail, Horby clarifies his comment that asymptomatic patients do not pose a risk of transmission.

Effect Measure with a rather intense debate on Tamiflu storage (note the comments)...if you like that sort of thing.

March 13 Flu Update

Sorry we're a little late today.

Recombinomics reports WHO noting clusters indicating changes in the virus.

Recombinomics on the Thai Binh cluster.

Vietnam says the nurse case that has caused so much attention is not bird flu, but Recombinomics notes that a shifting virus might not react to the normal tests.

Recombinomics on the virus extending its species profile.

Ken Livingstone, Mayor of London, criticizes anti-terror laws, saying the flu is a bigger threat.

Cambodia details cash problems fighting bird flu.

Recombinomics on transparency and surveillance hampering pandemic preperations. If time is of the essence in stopping a pandemic, than we need a more rapid response

Saturday, March 12, 2005

March 12 Flu Update--Alarming New Case--does it signal efficient human-human transmission

Effect Measure has our first take on this. Experts are now calling into question the veracity of the officials in Vietnam, and whether WHO is exercising wishful thinking.

Note this quote: Given these concerns, it is hard to understand why WHO continues to reassure the world, when in fact it is still in the dark about the situation.

Reuters with a straight news read.

Recombinomics on the same issue, noting "more efficient" human-human transmission.

Recombinomics notes persuasively why the transmission was probably nurse-nurse. He also brings up a point others have mentioned, which is that it is possible that the genetic shift/drift that allowed human-human transmission could also make the virus less virulent, which could be the case here.

On the home front, Virginia has stepped up flu surveillance.

National Post (Canada) pooh-poohs the whole thing.

Canada.com writes on the new info from Vietnam, breaking logjam.

Friday, March 11, 2005

March 11 Flu Update

Latest WHO flu update

WHO official says that no flu cases are due to human-human transmission

Flu data called into question

Thailand stockpiling antivirals, considering generics...

Finland stockpiling tamiflu as well...

Iowa State Health Lab preparing to join flu fight

Johns Hopkins newsletter on flu...basic, but note the comments section, where readers chide them for re-broadcasting WHO's human-human transmission assertion...they even cite recombinomics

Recombinomics disputes WHO assertion that the virus has mutated little and that vaccine standards are reliable.

Recombinomics writes that a case in a family cluster in Vietnam is a dual infection, and its implications. Strap your science hat on for this one...

Recombinomics notes a tendency toward females being infected on a secondary basis

ProMed summarizes the WHO news

CIDRAP on the current state of play.

Thursday, March 10, 2005

March 10 Update

New Zealand newspaper does the grim math on the potential flu in New Zealand.

Canada.com on expert fears that the virus has mutated. We all complain about media coverage of the flu, but canada.com has a story almost every day.

Here, a WHO expert says asymptomatic cases are nothing to worry about, and that those people are probably not very contagious.

Vietnamese communities think they are unprepared for bird flu

Recombinomics says that the unreported cases add 8 deaths.

Effect Measure with a fantastic essay on how tamiflu works.

Wednesday, March 09, 2005

March 9 Flu Update--yesterday's news reverberates

False positives, asymptomatic patients. Is this a slow drift (or shift) toward pandemic.

But we'll start with ProMed, which carries stories on the asymptomatic cases. But the interesting story is the first one, with a WHO official saying the current virus has mutated little since last year, and this year's vaccine recommendation still holds.

CanWest writes on similarities to the 1918 flu.

Norway stockpiling antivirals... This appears to the government's action of (last?) resort.

Hong Kong does the same...

United Nations hurriedly gathering data on yesterday's four cases

Chicago Tribune provides rare US mass media coverage of yesterday's events

From the Nero Bureau--Thailand says that bird flu under control...

...and Vietnam says two more provinces bird flu free

If this is what you're into, a publisher has natural antiviral herbs/vitamins list

Recombinomics on what is obvious now. The bird flu has spread much farther than anyone thought, and is complex and varied in its presentation.

Recombinomics on a new cluster in Vietnam.

Effect Measure with an excellent essay on the wishful thinking and avoidance going on right now. We are not 'connecting the dots'

Tuesday, March 08, 2005

March 8 Flu Update

Hong kong plans to spend $254 on antiviral stockpiling.

You can't spend $254 million in cabbage, can you? Korean paper reports that kimchi effective in treating bird flu.

Vietnamese officials are studying whether the "health care" case is a human transmission.

Health official says that flu could cover the globe in 30 days.

Canada says that flu pandemic is imminent, also notes bioterror fear.

New York Times on the 4 new cases.

Thailand agrees to test bird flu vaccine on humans.

Recombinomics notes that 1918 flu and 2005 similar in that early cases misdiagnosed.

Recombinomics writes that atypical cases in clusters point to greater human-human transmission than previously suspected. Still, shouldn't it have spread much faster and more more lethally than before?

New from CDC...fact sheet on history of pandemics, notes "medium" pandemic death tolls. Makes good point on shortages of healthcare workers due to flu and carrying for their own family. I often wonder if this will stretch the binds of our compact.

CDC flu facts...

ProMed has commentary on bird flu vaccines, including from a Texas vet with similar experience..he sounds a cautionary tale on the misuse of vaccine testing.

Monday, March 07, 2005

March 7 Flu Update--is Human-human transmission here?

Hiatus over. We're back, and its good to be back.

WHO welcomes us home with a new avian flu update, citing four new cases in Vietnam, the first after a lull.

Recombinomics dissects this report, focusing on a nurse who could have caught flu from a relatively brief exposure....or from infected poultry. Still, he points on the clusters begin to look more and more like efficient human-human transmission.

More Recomibomics on the same topic.

Bloomberg on the sick health care worker

CIDRAP notes also that there have now been retrospective flu IDs. This could call some of the comfort level in the public health community into question.