Sunday, November 20, 2005

November 20 Flu Update--Human Death toll continues to rise

A 35M died in Indonesia yesterday of what local test results indicate is the bird flu. More tests from Hong Kong are expected for final confirmation.

The Australian PM says there was calm determination, not panic, over flu at APEC.

The Chinese Health Minister says bird flu is contained and under control.

Could be a translation thing...this story quotes the minister as saying it is 'controllable.'

A WHO official stressed the importance of global surveillance on Meet the Press today. Note the last sentence...encapsulating what used to be the computer model driven containment strategy in "small possibility."

`We need to know when this pandemic virus emerges and we need to know quickly,'' which may be difficult because some Asian nations have weak disease-surveillance systems, said Mike Ryan, the World Health Organization's director of epidemic and pandemic alert and response. ``There's a small possibility we may be able to throw a fire blanket on this virus as it emerges,'' he said.
Here's the full Meet the Press transcript. Included is Dr. Fauci with this on the current state of the vaccine--its production, but he seems unconcerned about the virus mutating since the strain was identified 18 months ago.

MR. RUSSERT: ...but there is no vaccine to deal with the bird flu, correct?

DR. FAUCI: That's--in some respects, correct, but in others not. We do have a vaccine that was developed from a virus that was isolated from a Vietnamese patient about a year and a half ago. At the NIH, we've been in clinical trials with this H5N1 vaccine. It has been shown to be safe and it has been shown to be able to induce an immune response that would be predictive of being protective. We're doing the studies in individuals who are healthy. We're moving to elderly. The critical issue, and this is the constraining issue, is that we don't have the vaccine production capacity at this time to make enough vaccine for the people who might need it. That's really the problem.


The early warning system is interesting...it looks at the routes of migrating birds and where they rest. It should be operational....in six months.

From Australia, the current flu plan is viewed as strong on chilling predictions, but weak on a single, unified surveillance system.

Delaware is putting its pandemic plan into test mode.

Scotland estimates a pandemic pricetag at 26B pounds in two years.

Excellent (Toledo) Blade article on the paths of migrating birds, the most likely pathways into North America and Ohio.

The European Medicines Agency is watching Tamiflu.

Roche tries to protect its "golden ticket" by protecting patents and increasing production. Part of doing so is trying to tamp down concern by referring to avian flu as an "animal welfare" issue in its current state. Note this:

But John Oxford, a professor of virology at Queen Mary's University of London, who said he would receive a fee for speaking at the Roche briefing, insisted much of the burden rested with Tamiflu.

"We need plans and ammunition and Tamiflu is at least half of our ammunition," Oxford said, adding there was a clear relationship between the current H5N1 strain and the deadly Spanish flu virus of 1918-1919. "Without Tamiflu, we would be going into this naked."

He also warned that bird flu was "like the Scarlet Pimpernel: You never know where it's going to appear. And it's got a greater spectrum of variety than any other flu virus we've ever seen before."


The South Coast Times (MASS), is taking flu seriously, and hopes the current vaccine might be partially effective.

ProMed with reports of birds and all manner of other living fish and mammals comingling in Vietnam, Taiwan's accusation that the birds that died in quarantine in Britain were Chinese birds smuggled through Taiwan, and an answer to how the Kuwaiti flamingo got the flu (migratory bird droppings).

Crofsblogs notes this from the New York Times--an editorial on the inadequate Bush Flu plan. Apparently, Secretary Leavitt made big news today saying the US was "unprepared" for the pandemic. It is surprising that this is news....he has said it over and over again.

Crofsblog also found this--the IHT notes that the ambitious Chinese efforts to vaccinate 14B poultry could actually make the disease worse by tracking the virus from farm to farm with the vaccination team.

He then pulls out a word I didn't know existed for something I have long been fascinated with--injuries caused by efforts to heal. I have called it dying from the cure--the actual word is iatrogenic.

Finally, Crofsblog says enterpising readers sent him this transcript of an 11/16 pandemic confernece sponsored by the Council of Foreign Relations, led by Laurie Garrett, one of our favorites here. I'm going to peruse it tonight, but here's the link for your own use.

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