The Coming Influenza Pandemic?

October 31 Flu Update--is bird flu in Canada?

posted by Orange @ 10:23 PM 0 comments

October 30 Flu Update--what makes some people sick and others not...and a preview of US bird flu plan.

Farrar said it's possible some people could have a pre-existing immunity protecting them, but there has been no research to prove that. He also said the type of contact between people and poultry could play a role.

The Bush administration's long-awaited plan on how to fight the next superflu probably will include beefed-up attempts to spot human infections early, both here and abroad, and how to isolate the sick.

"Understand that a lot of the things we need to do to prepare are not related to magic bullets," said Michael Osterholm of the University of Minnesota, an infectious-disease specialist who has advised the government on preparations for the next worldwide flu outbreak but has not seen the final version of the plan.

How to provide food supplies, everyday medical care for people who do not have the superflu, basic utilities and even security must be part of the plan, Osterholm and others have counseled the Bush administration.

"In this day and age of a global economy, with just-in-time delivery and no surge capacity and international supply chains -- those things are very difficult to do for a week, let alone for 12 to 18 months of what will be a very tough time," he said.

"You didn't want to be up, you had such a terrible headache," she said. "I stayed in bed. You didn't care for food. When you're ill like that you don't care. You don't care if you live or die."

100 companies have contacted Roche to ask about a Tamiflu license...

and WHO is backing the Vietnemese request to make bird Tamiflu.

Effect Measure notes what may become a typical International bird flu transaction. Columbia is forthcoming on some LPAI, and other countries are critical for damaging poultry sales on the continet. As Effect Measure says, "just watch."

posted by Orange @ 10:07 PM 0 comments

October 29 Flu Update...Mask sales skyrocket in US

posted by Orange @ 7:29 AM 0 comments

October 28 Flu Update--Two new deaths in Vietnam?

It's very, very clear that all the critical symptoms pointed to bird flu," Dr Nguyen Ngoc Tai, the director of the Vietnam-Cuba Hospital in Dong Hoi, central Vietnam, told Reuters.

"After SARS they know they should really provide timely information about what is going on," WHO spokeswoman Fadela Chaib told a news briefing in Geneva.

"Recent investigations have indicated that H5 haemagglutinins (HA) genes of viruses from birds in China, Indonesia, Japan, Mongolia, Russia, South Korea and Turkey, and 3 viruses from humans in Indonesia are genetically distinguishable from the prototype strains selected last year for influenza pandemic vaccine development," the WHO said. "There is also evidence of antigenic variation among the HA of recent viruses. However, their geographical spread and pathogenicity in human populations remain unclear."

The WHO said it does not recommend changing the H5N1 prototype strains chosen previously for vaccine development. But the agency said its "H5 Reference Laboratory Network" has begun developing H5N1 vaccine prototype strains from the recent viruses.

There is no guarantee that the experimental H5N1 vaccines now under development would work in the event of a pandemic, since the virus is likely to evolve further before that happens. But experts hope that the vaccines would be close enough to the pandemic strain to provide at least some cross-protection. The viral changes reported by the WHO seem to suggest that the vaccines now in development would be less likely to work well, though the WHO didn't say that.

posted by Orange @ 8:14 AM 0 comments

October 27 Flu Update--test results on sick Chinese girl are in

"You don't have export poultry industries in Africa near the scale of what you see in Asia," Morrison said. South Africa is the main exception, he added.

The vaccine will be a "pre-pandemic" formulation that Chiron and other companies have been working on for more than a year now, Chiron said. Doctors and health officials hope it will be useful as a "priming dose" that would help jumpstart an immune response to be fine-tuned by a second vaccine.

Indonesia's human bird flu outbreak is puzzling experts because several victims do not work or live around poultry, prompting an investigation into whether other animal hosts, perhaps cats, are to blame for the disease's spread.

posted by Orange @ 10:39 PM 1 comments

October 26 Flu Update--Hong Kong Paper reports girl dies in Chinese village known to have bird flu

The possibility of instructing poultry farmers to bring free range chickens indoors is being urgently discussed by ministers with the industry and a register of commercial poultry producers will be established, Environment Secretary Margaret Beckett said.

posted by Orange @ 10:50 PM 0 comments

October 25 Flu Update--HHS Secretary Says Flu Could Hit US Next Year

Dr. Walter Boyce, is the director of the Wildlife Health Center at the University of California, Davis. He says the migrating birds in the Pacific flyway on the west coast of the United States often began their journey as far away as Siberia.

"Clearly bird flu is on the move. Our concern is wild birds as they migrate, might carry the bird flu with them. Our goal is to detect what viruses they are carrying and basically have an early warning that something might be getting ready to happen"

Relenza - the trade name for the drug zanamivir - is sold by GlaxoSmithKline. Some antiviral experts believe the drug may be better for some people, including pregnant women, than Tamiflu because it goes directly to the site of infection and less drug is absorbed into the blood stream.

posted by Orange @ 10:20 PM 1 comments

October 24 Flu Update--the Flu marches on with new deaths in Thailand and Indonesia.

The threat of a flu pandemic is more ominous, and its parallels to Katrina more apt, than it might first seem. The routine seasonal upsurges of flu and of hurricanes engender a familiarity that easily leads to complacency and inadequate preparations for the "big one" that experts admonish is sure to come.

We have a lovely synthetic-flu virus that will probably make a fine vaccine. Scandalously, we've had it since June 2004, yet only one vaccine company has manufactured it in enough quantity to do substantial tests in humans. And even those tests wasted time on a formulation that didn't work very well -- as scientists had actually predicted. Other companies and countries are only starting now.

...

First, governments are reluctant to prepare, expensively, for a disaster when scientists can't say exactly when or how it will happen. But it's companies that make drugs and vaccines. So the preparations have been left largely to the private sector. What happened then is what economists call "market failure."

No corporate interest can pay to test a vaccine if it can't tell its shareholders there is sure to be a market for it. Nor can it relinquish patent control, or scale up to make billions of the pills it can barely give away in a normal flu year. Not unless governments pay.

...

In a globalized economy, disease anywhere hurts everywhere.

posted by Orange @ 10:47 PM 1 comments

October 23 Flu Update--English Parrot is H5N1

With avian influenza now diagnosed among birds in two-thirds of the country's provinces, Indonesia must begin the immediate culling of poultry in infected areas and revamp its campaign to vaccinate fowl against the virus, according to officials from the U.N. Food and Agriculture Organization.

posted by Orange @ 10:20 PM 1 comments

October 22 Flu Update

"Substantial loss of life would obviously lead to a decline in economic output but we believe fear of infection, leading to drastically altered behavior, would result in the greatest economic damage," said Rob Carnell, economist at ING bank. "We cannot begin to quantify the potential damage in terms of gross domestic product, but a realistic scenario might be GDP declines in the tens of percent," said Carnell. "In the case of slower growing economies such as Europe or Japan, a decade's economic growth could be wiped out."

It is inevitable that these kinds of restrictions will come into play if a pandemic is starting. It is just as inevitable they will be costly and will fail. It isn't even sure they will slow things up much. This is apparently an obligatory response that can't be stopped. But it shouldn't also prevent us from beginning the kind of community mobilization that will really make a difference in managing the consequences of a pandemic, should one come.

posted by Orange @ 10:54 AM 0 comments

October 21 Flu Update

posted by Orange @ 10:38 PM 0 comments

October 20 Flu Update

When people living in the remote Danube Delta villages of Ceamurlia de Jos and Maliuc heard last week that their chickens and ducks would have to be destroyed to help prevent the spread of the Avian flu virus, they reacted in different ways. Some wept and prayed as they handed over their birds; others tried to hide them. Said Ceamurlia resident Gina Braileanu, "My uncle was caught hiding a hen close to his chest. He had to give it up."

Others immediately slaughtered their flocks, stuffing them into freezers for later consumption. But in the end there was no hiding place...

91,000 birds (corrected) were culled in China after the latest outbreak.

The Economist has a long bird flu story that is probably nothing new to long-time flu observers, though it appears to be accurate and realistic.

A teleconference is being held on the economic reaction to the flu pandemic--before it even begins.

Dr. Elizabeth Whalen, of the American college of Science and Health is beginning a national tour to discuss "the nature of a potential outbreak of avian influenza, the shortage of anti-viral medicines such as Tamiflu and the lack of an effective vaccine."

EU Health ministers held another meeting on the bird flu.

Here's the official WHO update on the situation in Thailand.

Helen Branswell is back again, with this article quoting a Canadian Health Official as saying that sharing knowledge helps everyone--based on the SARS situation.

A UK unit is coordinating an EU bird flu exercise.

A local official in Atlanta comments on pandemic response in that area.

Roche is continung to back down--agreeing to meet with potential generic producers of Tamiflu.

Since the patent is still pending in India, they might be able to start now.

Bosnia and Herzegovina is allocating $ for Tamiflu.

A company willing to produce copious amount of generic Tamiflu has jumped into the fray.

Report from Wales say bird flu drug stockpile will be ready in one year.

Flu brings Israel and Jordan together to fight----the flu.

Effect Measure wonders if all this news is really more news, or just a lower bar to get into the paper...or whether all this news is only the tip of the iceberg.

Recombinomics looks at OIE data and says the case is closed---H5N1 is in Romania.

Recombinomics has translation data of two familial clusters admitted to the hospital on the same day in Jakarta.

ProMed on Taiwan's import issue.

ProMed on Thailand, and Indonesia, including the new potential clusters.

ProMed on Thailand.

posted by Orange @ 10:36 PM 2 comments

October 19 Flu Update

The vast new geographical expansion of the dangerous H5N1 virus has avian influenza experts worried a bird version of the Stealth Bomber may be at play.

And they readily admit that finding the asymptomatic culprit or culprits from among thousands of species of birds may be a herculean challenge.

"If this is a . . . virus that seems to have fixed itself in some species and we don't know which species it is -- but maybe it's not showing any clinical sign in this particular species -- how do we find this guy?" Michael Perdue, avian influenza expert with the World Health Organization, asks with evident anxiety in his voice.

The realization that some mystery migratory birds are spreading the Asian virus suggests future unwanted appearances in Europe cannot be ruled out.

Most of the drugs have never been used to control outbreaks, and it is not even clear how well they would work against the dreaded H5N1 virus if it should jump from birds to humans. It is also unclear whether a vaccine currently under production would have any effect against an emergent pandemic strain, even its manufacturer, Sanofi Pasteur, admits.

There is huge uncertainty about how best to prepare for such a pandemic, and fundamental questions remain unanswered. If, for example, governments were to treat 20 percent to 40 percent of their populations with antiviral medicines - the strategy outlined by many European countries - the virus could quickly become resistant to available drugs, making it even more dangerous.

The most effective step the world could take is to establish a comprehensive global surveillance system capable of swiftly detecting and reacting to a human outbreak....That will require the pocketbook of rich nations, which can best afford to create a surveillance system, and the cooperation of poor nations, where a bird flu outbreak is most likely to occur.

Hungary's health minister Jenö Rácz was among several dozen Hungarians who underwent tests of the trial H5N1 vaccine.

He said: "The results are preliminary but I can say with 99.9% certainty that the vaccine works."

"It's being sold right now as almost the Cipro of post-9/11," said Osterholm, referring to mass purchases of the antibiotic ciprofloxacin, after mailed anthrax attacks killed 5 people in the United States in the fall of 2001.

posted by Orange @ 11:48 PM 0 comments

October 18 Flu Update

In a few potential scenarios, the world gets lucky and officials act quickly to vaccinate populations and distribute lifesaving antiviral drugs. The damage, while enormous, is limited and economies recover after a few months.

But health experts are unusually united in warning that if H5N1 makes the jump from birds to people in the next two years, it will cause an unprecedented disaster.

"I want to emphasize the certainty that a pandemic will occur," Dr. Gregory Poland of the Mayo Clinic Medical School in Rochester, Minnesota, who represents the Infectious Diseases Society of America, told a briefing last week of Congressional staffers and lobbyists.

"When this happens, time will be described, for those left living, as before and after the pandemic."

Officials at the Centers for Disease Control and Prevention have been handling numerous fearful phone calls from the public and the media, fielding such questions as "Is it safe to have a bird feeder in my yard?" and "Is it still OK to have turkey at Thanksgiving?"

“It’s been insane,” said Dave Daigle, a spokesman for the CDC, which has been getting an average of 447,000 hits a day on its avian flu information Web page.

"Short of obtaining [antiviral] drugs, there’s not really much we can do to prepare," says Webby. "My expectation is that [bird flu] would spread within community, like a normal human flu. The transmission of that virus, the mechanism, would be similar, so normal precautions would be the same."

That means regular hand washing and staying home if you feel ill. Beyond that, about all someone can do is to get vaccinated for the regular flu.

The vaccine for the upcoming flu season wouldn't offer protection against bird flu. But protecting people against conventional flu could make them stronger against a new illness, some health experts say.

posted by Orange @ 6:31 PM 2 comments

October 17 Flu Update

posted by Orange @ 7:21 AM 4 comments