Tuesday, October 11, 2005

October 11 Flu Update

The Swiss are downplaying the news about flu in Romania and Turkey. Sensibly, they are afraid of crying wolf, and losing the ability to motivate their population later.

Reuters has an article on no quick fixes for bird flu--and no real answers if it happens before a vaccine is ready.

"To believe that you can contain this locally is to believe in fairy tales," said Mike Osterholm, an infectious disease specialist at the University of Minnesota who has advised the U.S. government on avian flu and warned of the danger of a flu pandemic for years.
WTOL-TV details local flu preparations in Toledo, Ohio.

Secretary Leavitt is in Cambodia, pledging to help that nation improve its surveillance ability.

The British have enlisted their bird-watchers in the bird surveillance effort. The government has a number where people should report large numbers of dead birds, but not, "any old dead pigeon."

We've had some reader comments that Roche should create generic tamiflu to allow production to ramp up. This story indicates this has broken into an international debate....

Two perspectives:

But the company and some outside experts say the production of Tamiflu is so complex and time-consuming that even generic makers could not quickly expand global supplies.

and...

But the head of WHO's global influenza program, Klaus Stohr, said generic manufacture of Tamiflu could not happen quickly . "There will be no way in the next two years a company would be able to produce generic Tamiflu," he said.

This article says Roche is ready to ramp up.

Columbia has some "low pathogenicity" bird flu....they swear they know its not HPAI.

Bloomberg on WHO-lab confirmation of a fifth Indonesian case.

Turkish press says no human cases of bird flu.

Hungary appears to have stumbled onto a new flu trial method that will yield vaccine results sometime in the next two weeks.

A cull ordered in Turkey.

WHO's David Nabarro has established a priority--shortening flu proudction times.

The Kansas City Star reviews flu plans in Missouri and Kansas.

WHO warns of Coming Influenza Pandemic.

The Houston Chronicle draws a link many people have made--ranging from Revere to Secretary Leavitt--that of Hurricane response and flu response.

The North Texas Understater (OK, its really the North Texas Daily) says bird flu could be a problem.

CIDRAP has a fascinating review that details a NEJM article that compares avian flu and typical human flu. Here are some findings.

The new report says the virus may incubate longer than other human flu viruses before causing symptoms. Incubation periods in ordinary flu range from 1 to 4 days, with an average of 2 days, according to the Centers for Disease Control and Prevention (CDC). In H5N1 cases, the incubation time has mostly been from 2 to 4 days but has stretched to 8 days, the WHO report says. In household clusters of cases, the time between cases has generally ranged from 2 to 5 days but sometimes has been as long as 17 days.

Initial symptoms are more likely to include diarrhea in avian flu than in ordinary flu, the report says. The problem can appear up to a week before any respiratory symptoms. That feature, combined with the detection of viral RNA in stool samples, suggests that the virus grows in the gastrointestinal tract.

Lower respiratory tract symptoms such as shortness of breath appear early in the course of the illness, whereas upper respiratory symptoms such as runny nose are less common, the article says. Also, unlike in ordinary flu cases, the virus may be found in larger amounts in the throat than in the nose.


Lots of good stuff here. I'm no scientist, but it seems as if a longer incubation period would, if it survived adaptation to H2H, make it much easier for the disease to spread.

The virus being in the GI tract is also interesting--could that be an effect of the number of people who got the disease from eating infected chicken?

Blood tests of people in contact with H5N1 patients in Vietnam and Thailand have shown no evidence of asymptomatic infections. However, surveillance involving polymerase chain reaction (PCR) tests has revealed mild cases, more infections in older adults, and an increase in family clusters of cases in northern Vietnam—"findings suggesting that the local virus strains may be adapting to humans," the article says. (The WHO first reported these findings in May; see link to more information below.)

In Australia, they are looking for a regional approach.

CBS in Chicago has a good one--bird flu is a one flight away.

Nice Effect Measure post on remembering our own poultry workers, and how they feel about bird flu.

The latest NZ phone book has what to do in case of a bird flu pandemic....interesting approach (via Effect Measure).

Excellent Effect Measure post. Yesterday, we linked the latest Peter Sandman article on flu communications. Revere looks at it, noting that Sandman chides us for not welcoming new--and perhaps less enlightened people--to our cause. Revere is OK with this to a point, but when it includes President Bush, its a different story.

Recombinomics says a patient was transferred from one level of hospital care to another only 20 minutes before death, calling into question the ability of the Indonesians to monitor disease in its midst.

The Bulgarians have broken the news of confirmed flu in Turkey (recombinomics).

ProMed has the EU supporting a poultry ban in Turkey, but not Romania, based not on politics, but on flu being confirmed in Turkey and suspected in Romania.

ProMed on a corruption scandal in Indonesia regarding flu tests.

ProMed has text of an offical report from Turkey.

H5N1 has this from the BBC--farmers in the effected Turkish community are not happy.

H5N1 on American exceptionalism, and whether it lies inside the heart of the American Right's response to bird flu.

H5N1 has this from Jakarta...a new case, and the zoo is open again.

1 Comments:

At 2:06 PM, Anonymous Anonymous said...

Good to hear that the Taiwanese are looking into reverse engineering Tamiflu. The ethical dilemma concerning IP should be dismissed at this point: Saving millions of lives is much more important (and more ethical) than IP and the choice should always be towards saving lives.

Even if Roche says it's difficult to make Tamiflu (and it probably is) that doesn't mean that we shouldn't start setting up more factories to produce it. If (as they say) it will take 2 years for new facilities to be able to produce quantities of Tamiflu, that just means we'd better get to work on it right away.

 

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