Tuesday, November 15, 2005

November 15 Flu Update--China confirms its first human case, and says it will vaccinate 14B poultry,

China is going to vaccinate 14B poultry for bird flu. You read that right.

CIDRAP on this ambitious plan.

ProMed has this on the first confirmed human case in China.

The 10th and 11th flu outbreaks in China have been announced.

5o birds being imported to Britain from Taiwan died of bird flu in quarantine.

In Indonesia, they are planning to use volunteers and soliders to go door-to-door checking for sick birds.

The regular seasonal flu is getting slighted by the bird flu.

APEC has a plan to finance the bird flu fight.

Reuters updates its bird flu Q&A.

A local task force in Bellingham, WA, is planning for the pandemic.

Occasionally, we refer to Avian Flu, What we need to know, a flu blog. The author has developed a 40-page policy analysis on bird flu. You can get it here. (I have not read it.)

Here is the executive summary:

To combat a possible avian flu pandemic, we should consider the following:

1. The single most important thing we can do for a pandemic—whether avian flu or not—is to have well-prepared local health care systems. We should prepare for pandemics in ways that are politically sustainable and remain useful even if an avian flu pandemic does not occur.

2. Prepare social norms and emergency procedures which would limit or delay the spread of a pandemic. Regular hand washing, and other beneficial public customs, may save more lives than a Tamiflu stockpile.

3. Decentralize our supplies of anti-virals and treat timely distribution as more important than simply creating a stockpile.

4. Institute prizes for effective vaccines and relax liability laws for vaccine makers. Our government has been discouraging what it should be encouraging.

5. Respect intellectual property by buying the relevant drugs and vaccines at fair prices. Confiscating property rights would reduce the incentive for innovation the next time around.

6. Make economic preparations to ensure the continuity of food and power supplies. The relevant “choke points” may include the check clearing system and the use of mass transit to deliver food supply workers to their jobs.

7. Realize that the federal government will be largely powerless in the worst stages of a pandemic and make appropriate local plans.

8. Encourage the formation of prediction markets in an avian flu pandemic. This will give us a better idea of the probability of widespread human-to-human transmission.

9. Provide incentives for Asian countries to improve their surveillance. Tie foreign aid to the receipt of useful information about the progress of avian flu.

10. Reform the World Health Organization and give it greater autonomy from its government funders.

We should not do the following:

1. Tamiflu and vaccine stockpiling have their roles but they should not form the centerpiece of a plan. In addition to the medical limitations of these investments, institutional factors will restrict our ability to allocate these supplies promptly to their proper uses.

2. We should not rely on quarantines and mass isolations. Both tend to be counterproductive and could spread rather than limit a pandemic.

3. We should not expect the Army or Armed Forces to be part of a useful response plan.

4. We should not expect to choke off a pandemic in its country of origin. Once a pandemic has started abroad, we should shut schools and many public places immediately.

5. We should not obsess over avian flu at the expense of other medical issues. The next pandemic or public health crisis could come from any number of sources. By focusing on local preparedness and decentralized responses, this plan is robust to surprise and will also prove useful for responding to terrorism or natural catastrophes.

Company announces partnership with NIH to evaluate the Universal Viral Inactivation Method.

US Rep Nita Lowey writes about the need to plan in The Hill.

The historical society in Lexington, VA, is going to do a presentation on the 1918/19 flu.

Via Crofsblogs, Vietnemese investigators are testing flu vaccines on themselves.

Also via Crofsblogs, a nice Jakarta Post story on the hospital there where the flu patients end up.

In Grande Prairie, Alberta agree vaccinating birds can help prevent the disease from spreading.

Colorado also has a statewide bird flu task force.

Here's a news release on the poultry industry website on avian flu.

Here's a link to the website.

UK story about bird flu not interfering with Christmas turkeys.

CIDRAP on a lack of funds hampering bird flu efforts in Asia. (I can understand some of the countries, but does China really not have any money?)

BBC on the question of Tamiflu-related suicides in Japan.

Qatar is going to regulate the sale of Tamiflu to prevent panic buying.

If you're wondering why personal stockpiling of Tamiflu doesn't make sense, check out this WSJ article syndicated in the Pittsburgh Post Gazette.

But there are several reasons why it is impractical for individuals to stock up on flu drugs. First, we don't yet know what an adequate dose is. While 10 pills of Tamiflu -- two pills a day for five days -- is typically enough to battle regular flu, rodent studies suggest we might need more than that to battle H5N1. In August, the Journal of Infectious Diseases reported that the standard five-day dose protected only 50 percent of mice infected with H5N1. Eight days of treatment boosted survival to 80 percent.

In addition, the flu drugs protect you only as long as you are taking them. If you are the only one in your neighborhood taking Tamiflu during an outbreak, it isn't going to do you much good because you will be as vulnerable as everyone else the moment you stop taking the drug.

"You can't keep on using Tamiflu forever," says Suresh Mittal, a virology professor at Purdue University in West Lafayette, Ind. "It's not a vaccine. As soon as someone stops the drug, they are equally capable of getting the infection."

Taiwan will begin producing Tamiflu in March.

A British expert warns his government that its order should be 20X bigger for flu vaccine.


At 2:36 AM, Anonymous Anonymous said...

I live in an apartment. I remember during SARS about an apartment complex having people being infected with SARS because they live in the same building, but not having direct contact. Not sure what the outcome of that was. I wish that someone could post an article about apartment living during an outbreak and what can be done to not become infected by your neighbors. Thanks.


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