Tuesday, December 20, 2005

December 20 Flu Update

More on the debate over whether China is open or not. The NIH says that the Chinese are being completely open and sharing data with them.

"There is a definite willingness to be completely cooperative, be completely transparent and to exchange samples with the WHO and with other partners so we can track the genetic changes," he told a news conference in Beijing.

"I think it is remarkable as compared to the situation before SARS, where transparency and cooperation was less than optimal," he said. "At the time, we had a real difficulty in collaborating, getting samples and explanations."

ProMed on China sharing samples, which are different from the flu in Vietnam. Not suprising, says the mod comment, since it is RNA, and not itself proof of H2H.

More openness, the WHO regional director for Western Asia is going to make a trip to China.

Apparently, the first mainland Chinese death--from early October--is now lab confirmed.

Vietnam says flu remains in 12 provinces.

A province in the Philippines is organizing its flu program.

In the middle of January, there will be a "pledging conference" in China where nations will come and...well...make pledges to help fight the bird flu.

Dr. Nabarro is in India, talking to that country about what each nation should do to help monitor for bird flu and stamp it out where it occurs.

Recombinomics says a Hunan H5N1 has a "novel" cleavage site, which indicates a virus which continues to evolve.

As the fight in Europe continues over farm subsidy payments, the EU has agreed to higher payments to poultry farmers for preparing to fight the bird flu.

In the UK, Christmas turkey sales are not effected by bird flu fears.

Indonesia will now go door to door in its capital to do bird flu surveillance.

Tests on dead and sick birds in Ethiopia are negative for bird flu.

The UN wants to help the Ukraine fight bird flu.

And down the stretch they come! Piegon racing is back in the UK.

186 swans killed by bird flu in Kalmikia, Russia.

Medscape says that by combining flu control measures, they strongest part of a pandemic could be blunted. This is a must read. Note the basic strategy is the same: hang on until a vaccine shows up.

Because of the specter posed by avian influenza and the devastation caused by the 1918 influenza pandemic, experts have wanted to know if control measures would be of any benefit. Such measures include restricting travel in affected areas; "smart" vaccines that target avian influenza specifically, rather than the typical trivalent vaccines; and using antivirals only in people who have actually been infected.

"Such measures could delay the arrival of epidemic waves so that vaccines could be available in time," said principal investigator Antoine Flahault, MD, PhD, during a presentation. Dr. Flahault, a professor of epidemiology at the University of Pierre and Marie Curie in Paris, France, noted that this synergistic use of control measures would reduce the effect of a pandemic.

The investigators developed a model to assess both the global geographic and temporal spread of pandemic influenza and the potential effect of control measures. The system takes into account disease spread at the city level by considering both population in and air traffic among 52 of the world's major cities according to air traffic data from 2000. The system also allows for assessing the effect of 4 control measures: isolating infected individuals, reducing air transportation into and out of infected areas, strategic use of antivirals, and vaccination.

The system draws on data from a more recent influenza pandemic, the Hong Kong pandemic of 1968-1969. In affected areas, the average rate of infection was 26%, with a range of 6% to 33%, and the fatality rate in infected individuals was 2.6%. Using these data, in the absence of control measures, with the air traffic common to contemporary life, 500 million people could be infected in 5 months and 4 million infected people would die, according to Dr. Flahault. The projected mortality rate is less than was seen in the Hong Kong influenza pandemic because of the availability of antiviral medication. Dr. Flahault commented that even without a pandemic, 250,000 to 500,000 people die annually from typical outbreaks of influenza.

Is it generic or is it fake?---US FDA testing alleged Tamiflu.

If you have stockpiled Tamiflu for your family, ABC news wants to interview you.


ProMed on Vietnam, Romania and the Ukraine.

Finally, Crofsblog reports this from Declan Butler of Nature. Robert Webster of St. Jude's and others write about the state of play in the flu evolution...comparing to a flu pandemic as a global tsunami. Must read. Here is crofsblogs post.

Here is the full article.

We cannot wait and allow nature to take its course. SARS was interrupted by early case detection and isolation, but influenza is transmissible early in the course of the disease and cannot be controlled by similar means. Just 1 year before the catastrophic tsunami of December 2004, Asian leaders rejected a proposed tsunami warning system for the Indian Ocean because it was too expensive and the risk was too remote. This mistake must not be repeated in relation to an H5N1 avian influenza pandemic.

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