Saturday, November 19, 2005

November 19 Flu Update--More Flu in China

China reports two flu outbreaks, hundreds of miles apart (Courtesy an anonymous commenter from yesterday).

Excellent AP story on why we get so little help from studying the history of flu pandemics.

Studies of past pandemics don't reveal how the switchover from bird virus to human scourge will happen in the next one. Instead, they illustrate there are two routes. The virus can make the genetic changes on its own. Or it can pick up genes from a human flu virus, perhaps in a person who became infected simultaneously with the bird and human viruses. This gene-swapping process is called reassortment.

Taubenberger, who is studying the genetic makeup of the 1918 pandemic virus, said that germ appears to have mutated on its own. In contrast, the viruses behind the other two pandemics of the 20th Century were apparently products of reassortment, he said.
The APEC summit has concluded, with a resolution that includes progress and ambition on the bird flu.

APEC preparation includes a simulation to test the plan.

FWIW, the full text of the APEC "Busan Declaration."

ProMed reports on two new outbreaks in Vietnam, and about Chinese pledges of cooperation with APEC.

Geoffrey York of the Globe and Mail weighs in with a must read on the question of transparency in China. His conclusion is that any lack of transparency is as much at the local and regional level as part of a national strategy.

Beijing is desperately trying to educate its local officials and health officers about the realities of the disease, but the first instinct of many Chinese bureaucrats is to conceal and cover up. The greatest danger is that those same bureaucrats might even conceal a case of human-to-human transmission, the potential trigger of a global bird-flu epidemic that could kill millions of people.

After repeated denials, China finally confirmed its first human cases of bird flu this week, including two deaths where bird flu is confirmed or strongly suspected.

Evidence of a cover-up has already emerged in at least two regions of China. In Hunan province, reporters were arrested when they tried to investigate rumours of a bird-flu outbreak. Officials declared last month that the case was "closed," and then were forced to admit this week that the outbreak was indeed caused by bird flu.

In Liaoning province, where three bird-flu outbreaks have erupted, it was revealed this week that a bureaucrat has been arrested for trying to cover up the illnesses of chickens at local farms.

Zhao Yonghe, head of veterinary services in a village in Liaoning, was allegedly giving certificates to local farmers to verify that their chickens were healthy, though he knew they had contracted the bird-flu virus.

Onto this emerging stage steps Helen Branswell, who writes that China is hesitant to share actual viruses, even though they are sharing viral sequences--again, for reasons which may not be based on a national strategy.

Lubroth says China's slowness to share viruses reflects a concern there that the country's researchers do not receive adequate credit for their scientific contribution.

Brown can understand that point of view, saying scientists the world over hoard their data in order to ensure they get credit for their findings, which is key to ensuring ongoing research funding.

"You don't give away your data because the big labs will take it, they'll take the credit and you're sitting there writing a grant application without having the work published by yourself," he says.

Effect Measure notes that these reasons are plausible from the viewpoint of a practicing researcher.

Effect Measure also has insights into whether H2H is happening in Indonesia, asking whether the only acceptable proof of H2H is when it is already happening on a large scale.

ProMed with the news angle to the same story (along with reports on the China debate cited above.

Firstly, although the majority (but not all) of the human cases can be related to contact with diseased poultry, the number of human cases of illness must be a very small proportion of all contacts between humans and diseased poultry. Other as-yet-unrecognized factors must be involved.

Secondly, nucleotide sequence analysis is useful in unravelling the epidemiology of separate outbreaks. But sequence variation has to be correlated with biological experiments to make predictions about the imminence of changes in transmissibility and virus virulence. Mutations tend to be deleterious unless there is some external selective pressure favouring survival of a particular phenotype.
The Philippines says it should be a model for fighting the bird flu.

The BBC was in Vietnam, where officials voice optimism at beating the bird flu, but the reporter leaves skeptical of their ability to win.

From the White House, here is a "fact sheet" on US leadership in Avian Influenza.

Duck in British Columbia is bird flu positive, though the exact strain has not been determined yet. Quarantining is taking place.

Recombinomics comments on why we don't know yet if this is HPAI.

The BBC reports on the US clearing Tamiflu.

In Australia, they are training students to give flu shots.

China has agreed to supply India with shikimic acid, the rare and secret ingredient in Tamiflu.

Recombinomics reports there is a low pathogen mode of H5N1 in Manitoba.

Crofsblogs chimes in with a late Branswell article confirming what Recombiomics published on this.

Recombinomics with more on Canada--results appear to point to LPAI.

Recombinomics passes along boxun reports that there are 77 human fatalities in Liaoning, China, from H5N1.

ProMed on the safety of Tamiflu.


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