Monday, May 30, 2005

May 30 Flu Update

New Zealand press talks about Chinese underestimation of bird flu problems.

South Australia is simulating the response to its bird flu problem.

Congress looks at a flu pandemic. Among the topics--where will the health care workers come from.

In South Africa, they are expecting the pandemic to hit hard.

Recombinomics says that WHO should be pushing harder for answers in China.

Recombinomics writes about the GAO report on the US pandemic plan--and how it falls short. Recombinomics then tracks the situation point by point, showing where our government should acted.

The US has wasted a year. H5N1 has not.

Here's the GAO report.

Effect Measure on the false claims of drug companies that there is no money in vaccines.

Effect Measure on the Chinese giving up their vaccine plans.

May 29 Flu Update

Vietnam has abandoned its plans for a human flu vaccine....

Roche has Tamiflu production problems...opening second facility in second half of the year.

Bird flu scare in Fiji.

Recombinomics notes that both ends of the fowl flyway have suspicious health cases.

Saturday, May 28, 2005

May 28 Flu Update

ProMed says WHO has talked with Chinese officials, who said reports of human cases are unfounded. Luckily, the Chinese have always been straight forward in the past.

Scotsmen on the bird flu cover-up in China.

Vietnam is giving up on unilateral plans for bird flu vaccine

Slate looks at the bird flu from the perspective of the birds....

Recombinomics on the 1,000 dead birds in China.

Recombinomics says that flu should be on the interational "must report" list.

All Things Considered Reports on regulations to do just that.

Recombinomisc notes that ProMed is skeptical about the birds in China being killed by flu because of how "exceptional" it would be for a flu virus to be that pathogenic. Recombinomics isn't swayed...

Recombinomics joins the crowd questioning the Chinese claims of 100% efficacy of their vaccine.

Effect Measure covers the same topic.

Friday, May 27, 2005

May 27 Flu Update

Readers note: I just finished reading the Nature articles today, and they are excellent. Many are nothing new to close observers of the flu scene, but the future blog is very good. Anyone wishing to understand the flu can start with the Nature articles.

The Chinese say the bird flu threat has been stemmed.

China is also admitting to some under-reporting.

PBS jumps in on the China story, with this interview which contains audio links.

China is also denying any human bird flu deaths.

Recombinomics says the key questions is what killed 121 people in Qinghai?--note...given the unconfirmed nature of the report, the first question might be "were there 121 deaths?"

Recombinomics says that the 1,000 bird deaths is unprecedented.

Effect Measure on what we know and don't know in China.

Here's an update from Effect Measure that may shed light on the "blackout" characertization.

Update, 2:35 EST pm, 5/27/05: From China Daily (reporting press conference held by Jia Youling, director general of the Veterinary Bureau of the Ministry of Agriculture):
Qinghai Province, has been sealed off right after death of some migratory birds was found. He said there had been no precedent in the world to prevent and control avian influenza among migratory birds, and China's measures are all aimed at preventing the virus from spreading to domestic animals and human beings.

Up to May 26, more than 1,000 migratory birds including bar-headed geese and great black-headed gulls were killed by bird flu virus in northwest China's Qinghai Province. No tourists and irrelevant persons had been allowed to get into the habitats of migratory birds and the infected areas since the outbreak, he said."Sealing off the province" might be the source of the "blackout" rumors and also the suspicion something dire was happening there. We will keep watching developments.

The Pulitzer Prize Winning (Toledo) Blade weighed in with an anti-flu editorial today.

Even so, this Bump in the Beltway dude thinks its dopey.

CIDRAP on the Nature article.

CIDRAP on the Indonesia and the China situations.

The Standard of Hong Kong notes that the flu season isn't ending there.

Here's an estimate of 207,000 bird flu deaths in US...which as you know is on the low side of the estimates.

Euopreans are planning to fight a flu pandemic.

WebMD notes criticism of US pandemic preparation.

Effect Measure notes that the US pandemic plan should be done by the end of the summer. Not that there is any reason to hurry.

Effect Measure throws up his hands at high public officials who are concerned about our lack of flu planning--and it was their job in the first place.

ProMed on Chinese claims of a 100% effective flu vaccine.

May 26 Flu Update

More follow up on the Chinese flu situation. Nothing is clear, and this may all be nothing, but, as you will below, there are clear calls for the Chinese to come forth with information that settles the question. If these are true, it is the biggest known outbreak to date.

Recombinomics has been all over this story, here citing local info that a news blackout is being enforced in China.

Recombinomics on the China situation signalling Phase 6--infections are out of control.

Recombinomics calls for the Chinese to release retails, not carefully worded denials.

Recombinomics looks at the 60% fatality rate (is it possible?) in Qinghai.

Recombinomics demands answers.

Effect Measure cites New Scientist and discusses China's record of open reporting and the self-defeating nature of lying.

Late last night, Effect Measure noted this update. Comment #3 in this link is a translation of the original, unverified report, with some skepticism. Remember, we are relying on unverified, essentially indigenous and possibly anonymous sources for this news, which ALSO happens to coincide nicely with the dead geese. Confirmation is needed.

China again denies human flu in their country.

ProMed on the Chinese denial, lack of real information.

Articles says experts say time is running out.

From Reuters, US still unprepared for bird flu.

A modest proposal...New Zealand Columnist calls for Minister of Agriculture Shock Troops

National Geographic on the world's lack of preperation.

The Globe and Mail on the need for vaccine production.

Thursday, May 26, 2005

May 25 Flu Update

Late last night, Recombinomics posted this bombshell--reports that the bird flu MAY have taken 121 cases in China where the geese died.

Effect Measure weighs in as well.

Here's the raw link.

If true, then our perception of the whole situation has to change. Check back tonight for more news.

Wednesday, May 25, 2005

May 25 Flu Update

Today's lead story was dug up by Recomibinomics. Unconfirmed reports say there have been human cases of bird flu in the areas of China where the fowl died over the past month or so. If so, this would be big news.

Here's the ProMed source report.

China denies human cases.

Reuters answers the question, "what is bird flu."

In Hawaii, they are planning to screen air travellers at the airport for flu.

The United Arab Emiratse says its flu-safe.

In New Zealand, they are concerned about palm kernals bringing bird flu, and critical of national biosecurity plans. on the WHO bird flu pronouncements

National Geographic on the WHO bird flu threat

Experts say China is "dismally" unprepared for bird flu.

CIDRAP says there were multiple species of birds dead in China.

Nature magazine has an entire issue devoted to the avian flu...subscription required.

Here's the cover....

Effect Measure on the Nature issue.

There are confirmations of flu in swine in Indonesia...Recombinomics tells.

Recombinomics on genetic recombination and some recent data released.

Recombinomics wondering whether a death from eating wild boar could be Influenza A.

Tuesday, May 24, 2005

May 24 Flu Update

China says that bird flu outbreak is isolated.

Recombinomics says that Qinghai is the crossing point for two major bird "flyways," which is obvious potential consequence to the spread of flu via migratory bird.

Recombinomics says that bird flu evolution is evident in Qinghai.

The Phillipines have culled 500 parrots.

WHO praises Thailand for its flu program.

Canada has issued a travel advisory for Asia.

Effect Measure lauds pandemic planning in New York City...if you can stop it there, you can stop it anywhere.

CDC updates its avian flu fact sheet.

Monday, May 23, 2005

May 23 Flu Update

Time Magazine on the bird flu "picking a genetic lock."

Malaysia says its bird flu free.

Australian Green says nation not ready for flu pandemic.

CIDRAP writes on the new death in Vietnam, and infected geese in China.

Effect Measure on bird flu inaction...

If this were intelligence regarding a possible terrorist action we would be on Red Alert. Yet there is still no visible action from the US CDC or most state health authorities. This must now be counted a national scandal.

Recombinomics says the only question left is whether the pandemic is stage 5 or the final state 6.

Recombinomics has tracked the dead Chinese geese back to India, where he says that a meningitis outbreak in early May might be flu related, and signal a spreading flu pandemic.

Recombinomics on the mixing of migratory birds in Asia.

Recombinomics talks about reports of additional large numbers of dead geese.

ProMed Mail on the Chinese situation.

Sunday, May 22, 2005

May 22 Flu Update

Here's today's only real news. The China geese that had the bird flu were migratory, and originated in India. Recombinomics says that we don't know where the flu has been.

ProMed Mail on the Chinese fowl...

There are two new cases in Vietnam.

Baltimore Sun editorial on "preparing for the worst."

ProMed mail on the WHO report from last week"

May 21 Flu Update

Bird Flu in China, new protective measures are being taken.

Kansas City Star on the lack of a vaccine, and the threat of a pandemic.

Recombinomics on the China case, the need for more information, and where those birds might have come from. (Note, previously the public was told bird flu was ruled out in these cases.

Effect Measure surveys the web's flu sites, including this one (Thank you!).

Yesterday we ran a story on health activists and their doubts about the bird flu pandemic. Effect Measure says he understands why they don't trust the authorities, but this time, there is a real threat.

Friday, May 20, 2005

May 20 Flu Update

Another flu death in Vietnam.

WebMd on bird flu and noting the tamiflu resistant case.

Equal time department. These folks feel that the bird flu is part of US-inspired paranoia over global terrorism.

Vaccine work in Canada....

Recombinomics on the lack of genetic data available from 2005, and what they feel it will show.

May 19 Flu Update

The WHO report detailing the human-human transmission, pandemic potential and the clearly distinct virus types in Vietnam reverberated around the world yesterday, links to which we are not going to reproduce, since most were boilerplate wire stories. Suffice it to say this: it was big flu news in the MSM and the blogosphere.

The Draft WHO report on pandemic preparedness.

CIDRAP comments on the WHO report.

Calling avian flu "the most serious known health threat the world is facing today," Lee Jong-wook, MD, MPH, noted the importance of the window of time between hints of a pandemic and its actual occurrence.

That's a great phrase that's come out in a couple of different contexts. The hints will be there before we know for sure its happening.

Further monitoring in Vietnam has caused WHO to up its case count--CIDRAP writes.

Official WHO Release

45 eggs in China found to have bird flu

Recombinomics asks whether there is human-human transmission in Thailand.

Recombinomics says that the WHO information on 2005 isolates is proof that the shifting and drifting theories are wrong, and the recombination is the key.

Recombinomics has questions based on WHO's answers.

CDC updates the Asia portion of its flu guidance.

Effect Measure has been busy. Here's a story about public health officials keeping their flu plan secret to foil Al Qaeda.

CIDRAP on nursese emigrating to the US from Asian countries, and how that will effect flu response in the old country.

Effect Measure comments on yesterday's flu news.

Effect Measure on the transformation of preperation-or lack thereof--into damage control in the flu arena.

Secretary Leavitt comments in Geneva.

Wednesday, May 18, 2005

May 18 Flu Update

Leading today's Flu news, WHO is telling a conference that evidence shows a mutating flu virus, and a strong pandemic possibility. Greater human-human transmission is also noted. Here, CIDRAP writes.

Bloomberg has a media report on WHO

ProMed Mail has its take on the WHO report.

After an inconclusive test, Indonesia wants to test a worker for flu. It would be the first Indonesian case, at least since 12/04.

Recombinomics on what this means.

Gridlock on Parliament Hill has left the flu vaccine tests victim to budget wars---can Belinda Stronach really fix this?

Europeans looking into early warning sign for bird flu.

Recombinomics on evidence of, you guessed it, recombination among H5N1 viruses, and a plea for more public data.

Recombinomics with today's analytic piece. In it, Niman writes about the tamiflu containment strategy. Under that concept, if the flu hits, tamiflu, an antiviral that effects the N part of H5N1, would be rushed to the site to limit the spread before the disease gets too many branches and is unstoppable.

Others have wondered about this approach. In this article, Recombinomics poses the idea that there could be evidence that the virus easily mutates to be tamiflu resistant.

This is a significant idea. Check these pages, and you will see that tamiflu is a central part of every nation's defense to the pandemic. Tamiflu is being stockpiled in many places. A tamiflu-resistant flu would be signficiantly bad news.

Thus, media reports suggest that significant changes are occurring in HA and NA. NA is targeted by the only available H5N1 antiviral, Tamiflu. The above report suggests that an H5N1 Tamiflu-resistant strain has evolved. Widespread use of Tamiflu will generate selection pressure for resistance. The comments above imply that such resistance is relatively easy for H5N1, since the number of H5N1 confirmed patients treated with Tamiflu has been exceedingly low. Tamiflu is the antiviral drug being stockpiled by many countries.

Effect Measure on the latest situation in Vietnam.

Tuesday, May 17, 2005

May 17 Flu Update

There's a world health assembly going on, and they are talking flu...

Its a vaccine story...

CIDRAP on the second case in Vietnam. I am sure others will notice the presence of a false negative test.

Recombinomics on the lack of 2005 isolates in the GenBank.

A pertinent article excerpt:

...WHO is looking for reassortment with human genes, which has never been reported for H5N1 in spite of 4 distinct human outbreaks in 1997, 2003, 2004, 2005. WHO still believes the evolving H5N1 genetic changes are from random mutations instead of elegant evolution via recombination.

Recombinomics on the asymptomatic pigs.

ProMed on the second Vietnemese case.

May 16 Flu Update

Indoensia testing more pigs for bird flu.

Here's a genetic story for you vaccine junkies.

Here's a WHO release on the assessments of flu done in Manila in early May.

Monday, May 16, 2005

May 15 Flu Update

A second case in Vietnam.

More on the big health meeting in Geneva.

ProMed on the Indonesian flu alert.

FAO update on flu situation.

Here's one I missed, as WHO writes about the dilemma governments are in given the unpredictable nature of the flu, and how that dilemma effects resource allocation.

Saturday, May 14, 2005

May 14 Flu Update

Vietnam retorts that it shares bird flu info with WHO.

Another story of bird flu in Indonesian Pigs.

Widespead bird flu among greyhounds in Florida, says Recombinomics.

ProMed on the bird flu in Indonesian pigs.

May 13 Flu Update--The Virus works on, the Bureaucrats work on

A Cambodian is suspected of having bird flu, in hospital, stable condition

Recombinomics on this woman's survival, and how it could signal a changing virus.

A man in Vietnam has tested positive for bird flu--and just when the Vietnemese were claiming they had it licked.

CIDRAP has the further info on this....note the use of the phrase "well entrenched."

ProMed Mail on the Vietnam case AND the Cambodian case."

In Asia, they're discussing a continent-wide approach to bird flu.

Indonesia is heightening bird flu surveillance.

Recombinomics on the Indonesia case. Flu has been found in swine, and H5N1 isn't the only type spreading around, creating a mixing bowl in the fourth most populous country in the world.

ProMed Mail on the Indonesian Pigs.

International meetings in Vietnam are designed to give WHO new way to prevent global spread.

WHO denies that the bird flu samples are being hoarded--it would appear there is some dissension in WHO on this point.

WHO official press release.

Effect Measure analyzes the WHO "denial" in typically trenchent fashion.

Recomibinomics on bird flu (not H5N1) in greyhounds in US, discusses recombination possibilities.

Recomibinomics again reminds us that in 1918 bird flu didn't always look like flu, and often looked like meningitis--and there's an outbreak of that in India.

ProMed on an Indian inquiry into the three poultry workers found carrying H5N1.

Thursday, May 12, 2005

May 12 Flu Update

The Indian government is looking into reports of bird flu in 3 samples.

News that bird flu samples weren't being shared has resulted in news that bird flu samples are being shared.

Australia sets up bird flu vaccine center.

World Health Assembly to open in Geneva, discuss bird flu.

Today's lead story comes from Effect Measure, previewing a story in Nature today that says WHO has received no samples from bird in eight months.

Knowledge of the genetic make-up of circulating virus provides a critical warning sign regarding an impending pandemic. The countries involved have resource and facility limitations but also may wish to control information because of impact on trade and tourism. We recently posted on the testing problem and suggested pressure or incentives be applied to increase cooperation.

Nature reports Vietnam may ship a large number of samples to the WHO flu center at CDC sometime soon. It's a start but it hasn't happened yet. The situation is urgent. WHO needs to get it in gear.

Several of the six H5N1 isolates contain a mutated form of the virus, but with so few samples to work on, it is impossible to judge how worried to be, says Klaus Stöhr, coordinator of the WHO's flu programme. "It's as if you hear a noise in your car engine, but you keep driving, not knowing whether it's serious."

Memo to Klaus: It's serious.

Here's a mainstream link on this story.

Here's the Nature link, subscription required.

Recombinomics weighs in...

Finally, don't miss the comments on Effect Measure.

Here's an article about "uncomfortable" flu 25 years ago.

Recombinomics explains yesterday's story about the bad flu tests, and why a simple test can't be solely relied on in definite determination of flu victims.

Yesterday, we reported on flu found in Indian poultry workers. Recombinomics discusses the significance of this news. Samples were drawn in 2002, and at that time, this flu was thought to have only been in Hong Kong.

CDC has updated its bird flu fact sheet.

Wednesday, May 11, 2005

May 10 Flu Update

Genetic signatures of the bird flu have been found in Indian poultry workers--samples drawn in 2002.

Toronto prepares for pandemic, as reported in Globe and Mail.

Commercial press release on new flu test.

Recombinomics on WHO statement that Korean pig flu is not a risk.

CDC Asia update.

Tuesday, May 10, 2005

May 9 Flu Update

They are testing human vaccines in Vietnam. Does this somehow seem haphazard to anyone else?

China says geese didn't die of bird flu.

Recombinomics is not reassured by this.

Dynavax says its new vaccine approach looks good in preclinicals. This approach does not require matching specific genetic sequences.

Here's another company with another approach to a universal flu vaccine.

Effect Measure reviews an article critical of Thai flu prevention efforts, than suggests those same criticisms could be applied to the US government.

ProMed Mail on the Canadian flu test SNAFU.

Monday, May 09, 2005

May 9 Flu Update--back in the saddle

Recombinomics with the seminal question on recombination and mutation.

Such concern was easy to understand. Increased efficiency in human-to-human transmission of a recombinant virus that produces milder disease is the formula for a pandemic. It creates more hosts for more dual infections and more recombinants. H5N1 in humans offers more chances of a human being infected with H5N1 and H3N2, which could undergo a recombination similar to the one described earlier. However, this time the human receptor binding domain in H3N2 could be acquired. The recombinant H5N1 could achieve the type of efficiency seen in human flu viruses, which are almost impossible to control.

These changes of course set the stage for more recombination, when more humans are infected, and the H5N1 that has a 100% case fatality rate in southern Vietnam and Cambodia is still circulating. The greater the number of dual infections, the greater the chance of more recombination.

This leads to a greater chance of a recombinant with efficient transmission combined with a high case fatality rate to create a pandemic rivaling 1918.

Recombinomics on WHO hinting that pandemic may have begun.

Flu detection test in Vietnam and Canada may be out of date, resulting in false negatives.

Excellent Houston Chronicle story on the potential pandemic and where is stands.

Fine Houston Chronicle graphic on the flu.

Recombinomics on the "scandalous" underreporting of the swine flu.

This outstanding link is courtesy of Bill+. New England Journal of Medicine publishes article saying that world not ready for flu pandemic.

CIDRAP on the NEJoM story.

Effect Measure on the NEJoM story (must read)

Vietnam to vaccinate 600,000 chickens.

CIDRAP on Vietnam declaring victory over bird flu.

New bird flu death in Cambodia.

The Globe and Mail--one of the leading flu coverage sources, on the lack of antivirals at the point of infection in Asia.

USA Today on the battle to save the world from the SE Asia.

Korean DMZ is reportedly bird flu free.

China says US CDC results (long awaited) say that there is no mutation to the bird flu virus.

Do greyhounds in Rhode Island have bird flu. Recombinomics on the case.

Wednesday, May 04, 2005

May 3 Flu update

Please Note:

We're leaving town for the East Coast today, and this blog will be updated again on Monday, May 9th.

Rural farmers in Vietnam are ignoring the ban, making things worse.

Some chickens are getting some shots in Vietnam.

The Phillipines remain on high alert.

CDC says its destroyed all H2N2 samples.

Tuesday, May 03, 2005

May 2 Flu Update

Some news is finally breaking out. Strong comments from recombinomics, and an excellent post by Effect Measure. The blogosphere, as usual, is working away.

The news has been quiet lately, but Effect Measure summarizes two recent stories that may indicate subtle increases in concern at WHO and CDC. Note his invitation to Recombimomics to weigh in on the shifting/drifting virus.

Globe and Mail story referenced in the Effect Measure Post.

Independent article we ran yesterday, referenced in Effect Measure.

Recombinomics strongly comments on his views that the mutation theory is discredited, and that reassortment is the vehicle for the virus to change.

Note this:

H5N1 is evolving via recombination, not reassortment or mutation. It is time for some of the WHO consultants to turn in their membership cards in the "Flat Earth Society", and move on to a true understanding of how influenza evolves.

Australians said not ready for bird flu.

Story on St. Jude doc who identified H5.

Column from Milwaukee on the looming bird flu pandemic.

Sunday, May 01, 2005

May 1 Mayday Flu Update

Independent in Britain on the flu pandemic and human-human transmission in Asia.

Working off thes story listed above, Recombinomics draws parallels between 1918 and 2005. Note the confirmation of the 7 clusters, note WHO calling in unprecedented, and note the 33 flu in Korea opening a second front and unparalleled chance for infection.

My commentary here. A while ago we had a story on the government running computer simulations to plot strategies on containment. Nature is constantly moving, testing limits, finding openings without looking for them. This is proof that simulating is probably folly, and right only by luck. A deadly pandemic, if it occurs, will come only by the confluence of events which could never have been predicted, as all "accidents" are.

Recombiomics on 33 flu and bioterrorism.