Wednesday, September 21, 2005

September 21 Flu this it?

Big, big news day. Be sure to read all the way to the end...some of the biggest stories from today where not from Indonesia.

Early today, the Indonesian Health Minister said bird flu an epidemic in her country.

"This can be described as an epidemic. These (cases) will happen again as long as we cannot determine the source," Supari told reporters, but she insisted it would be wrong to label it a "frightening epidemic".
She later retracted that statement, saying if things worsened it would be an epidemic.

Helen Branswell of CP says WHO is trying to "dial back" concern.

Despite reports of a number of suspect cases, there are currently no plans to convene the meeting of experts that would be needed before the organization could declare the world had moved one step closer to a flu pandemic, Dick Thompson said from Geneva.

"We're not anywhere close to that. We see no relationship between any of these ... suspect cases," said Thompson, communications director for the agency's communicable diseases branch.

"The level of anxiety is higher in Indonesia. It is not in Geneva."


Thompson also moved to dispel reports the WHO was getting ready to deploy a supply of antiviral drugs to Indonesia.

The WHO has been promised a stockpile of three million treatment courses of the drug oseltamivir or Tamiflu to be used as a pandemic fire blanket. The agency has committed itself to trying to stop or slow a pandemic once a strain emerges that seems to have the capacity to spread in sustained fashion from person to person.

Thompson said a small number of treatment courses were sent to Indonesia in July when a cluster of what were thought to be three cases in one family was identified. But there are currently no plans to draw down the stockpile for Indonesia, he insisted.

"No, definitely not."

Indonesia will cull where the bird flu is most intense.

Lost in all this is another bird flu death, a young girl.

ABC News has the story on the Indonesian crisis.

ABC News also has this--is it cause for alarm?

CIDRAP on the fears in Indonesia.

Effect Measure on whether Indonesia is boiling, or simmering.

Effect Measure on international experts converging on Indonesia.

Recombinomics has this concern on a false positive.

Recombinomics on three new admissions in Indonesia.

Not surprisingly, Recombinomics says the events in Indonesia are due to recombination.

Recombinomics says that a young girl was denied admission to the hospital in Jakarta, based on a machine translation.

ProMed on the Indonesian situation.

More from ProMed on Indonesia.

From Australia, the question over whether this is the start of pandemic.

Two of our favorites, Michael Osterholm and Helen Branswell, did a symposium last night at the Wilson Center in Washington. Here's the audio link, here's the video link, and here's the .ppt.

Here's a news story from VOA on the event. Every word is a must read.

Osterholm said:

In general terms, we are not much better able to handle acute respiratory distress syndrome, in any number of cases today, than we were in 1918," he said. "So, do not go back and say, well, it is different today, it is not 1918. Unfortunately, folks, it is 1918 all over again, even from a clinical response standpoint.

Outside Jakarta, the Irish decided to test their culling prowess by taking out 10,000 birds.

Malaysia says it is flu-free, despite being a neighbor of Indonesia.

Annals of Internal Medicine has this editorial, which is a reasonable assessment, if a little conservative. They note at the end that the recommendation is enough Tamiflu for 50% of the US population.

This might be the most important article today. For those who think (or whose friends tell you) that the vaccine is on the way, the New York Times has this from the vaccine front. Two studies in The Lancet point out the weaknesses of the approach.

Even so, the research is alarming because it demonstrates how quickly and unexpectedly flu viruses can become impervious to medicines once they are put into common use, as they would be in the case of a pandemic. Also, at their best, antiviral medicines do not cure influenza. They cut down on transmission of the disease and reduce somewhat the symptoms and complications in those already infected, including the high rate of associated pneumonias.

Called for comment, a spokesman for the World Health Organization, Dick Thompson, said that the group could neither support nor deny the findings of the analysis of vaccine studies at this point, noting only that some experts criticized the researchers for "not including some important past studies" in their sample.

Helen Branswell has her take on the same story.

Reuters on bird flu fact sheet.

The Houston Chronicle says that the Bush bird flu speech was for the birds.

Effect Measure has a Nature article from Declan Butler that says the US doesn't live up to the sharing of data called for in the Bush UN Address.


At 11:05 PM, Anonymous Anonymous said...

This comment has been removed by a blog administrator.

At 2:56 PM, Blogger jerseycityjoan said...

Thank you for your continued efforts to keep up to date on the latest flu news.

With a second hideously strong hurricane about to hit the Gulf Coast in less than a month, I can't help but wonder how much better the emergency response will be. I suspect some things will improve but not others.

I still can't imagine how we'd (i.e., certainly people from first world countries, and many from the less-developed world too) cope with a multi-wave Spanish Flu-type epidemic, stretched out out over many months.

We been brought up to think such disasters are a thing of the past. We don't have the same kind of unquestioning faith in God that so many in those earlier, more difficult days, or the resignation that came from a lifetime of seeing many more people die before they were old.

In short, the double-whammy Katrina-Rita punch will be giving us more warnings, but I'm afraid most of us won't be listening. We'll be just as surprised when the pandemic hits as the people in New Orleans were when the levees gave way.

At 7:39 PM, Anonymous Matt said...

It seems like there is so much h5n1 activity going on lately. Makes me wonder if it has mutated for better human to human transmission. Just seems so strange that so many people are getting sick in such a short period of time. The next few weeks will be very interesting.


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