Thursday, August 04, 2005

August 4 Flu Update

CIDRAP has the news of two NIH funded studies that analyze containment strategies for the flu. The plan is to "nip it in the bud" with highly focused resources.

Michael Osterholm, Director of CIDRAP, had this to say in comment:

"I want these strategies to work," infectious disease expert Michael Osterholm, PhD, MPH, told CIDRAP News. "But in all my years in public health, I have yet to see mathematical models that have driven public health actions in meaningful ways." Osterholm used HIV and bovine spongiform encephalopathy (BSE) as examples of diseases for which there have been what he calls a "pandemic of modeling studies."

"My concern is that papers like these suggest more direction for planning than is warranted and may placate policymakers who believe the planning puzzle has clear solutions. . . . The issue of antiviral treatment, for example, has to be looked at against the whole system of disease occurrence and transmission. How well can we detect the disease when it starts occurring? How can we make sure travelers who appear healthy aren't unknowingly spreading the virus?" Osterholm, who is director of the Center for Infectious Disease Research and Policy at the University of Minnesota, publisher of this Web site, used as illustration the example of SARS' fast jump from the Far East to Canada in 2003.

Osterholm also made the point that since a flu pandemic will very likely be caused by a mutation of the H5N1 virus currently spreading among birds in Asia, we will be facing a "reloading" problem at the source—that since birds are a reservoir that is constantly replenished, "We are dealing with a moving target, not a static population like humans. . . . Culling [the birds] won't work. It's like throwing fresh wood on a fire."

Here's an NIH link to the study.

Here's a WHO link.

The Daily Mail in the UK has its take on this...something along the lines of scientists say it can be "stopped in its tracks."

WaPo is a little more reasonable, on the order of a theory.

The Times of London notes, correctly, that the key is "decisive action" would be required under the plan.

Effect Measure drops the bomb on these studies, despite that he respects the people who did them. Note these quotes: must be said again: once this virus gains the capability of being transmitted from person to person like other influenza subtypes that circulate in human populations, there will be no way to prevent its global spread.


So I hate to disagree with Elizabeth Halloran of Emory, an infectious disease epidemiologist of note and a genuine expert. In her view, as reported by the BBC,
"Our findings indicate that we have reason to be somewhat hopeful.

"If - or, more likely, when - an outbreak occurs in humans, there is a chance of containing it and preventing a pandemic."
There is no reason at all to be hopeful.

As always, the comments are excellent on Effect Measure.

Tyler Cowen on Avian Flu has a nice post, too.

Note that Thailand, or similar places, has not had the past facility to stop malaria, or even to provide clean drinking water to its rural populations. Measures of these kinds will limit deaths, and should be taken, but they are highly unlikely to stop a pandemic from spreading, should one get started.

Here is a Reuters timeline that spells out the march of the bird flu through Asia.

Reuters bird flu fact sheet.

Roche is in discussions to donate a substantial amount of Tamiflu to WHO.

In Vietnam, there were three news human cases in July.

From Russia, flu threatens European Russia.

Fiji is on the case to fight the pandemic.

Vietnam is vaccinating poultry.

Recombinomics on the spread of bird flu in Russia.

Staggering....Recombinomics says 70% of waterfowl in Mekong Delta are bird flu positive.

Crofsblogs points us to the disease section on boxun.


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