Tuesday, August 30, 2005

August 30 Flu Update

Nature's Power...

CIDRAP says bird flu confirmed in Mongolia, ruled out in Finland.

Recombinomics isn't convinced on Finland, yet, noting that similarity between the dead birds there and the dead birds elsewhere.

In Poland, the government is calling on the EU to support the Russian bird flu efforts.

US officials are in Alaska, checking migratory birds for signs of bird flu...thinking that geographically, that could be this continent's point of entry.

There is a new region hit by bird flu in the Urals.

Vietnam confirms that the three civets died of bird flu.

VOA says that the US is continuing the race against the virus.

Nervous UK farmers continue to seek reassurance that the government won't implement strong bird regulations, as in Holland.

France has been strengthening the bird flu defenses, sound alarm for others.

Recombinomics notes additional evidence of recombination in the results from Mongolia.

You will have noted our ongoing debates from ProMed on the migratory bird theory. Recombinomics talks about the evidence of the migratory birds spreading the flu.

ProMed on the reports from Russia about the spread of the bird flu.

ProMed on Finland and LPAI.

Avian Flu blog has some information on a bird vaccination program starting in Vietnam.

Monday, August 29, 2005

August 29 Flu Update

Man, its the slowest weekday in a long, long time.

Ulster has 100,000 doses of Tamiflu coming shortly.

Also in Ulster, farmers are meeting with the government to discuss bird flu restrictions.

The Russians are implementing bird flu guidelines.

Also in Russia, they say the cost of bird flu has been 38 million rubles.

The CDC plans to seek public comment on its flu pandemic plan.

The Marin Independent Journal in California has this on the potential pandemic.

Utah is preparing for a pandemic.

Effect Measure is asking where the Democrats are on the pandemic.

Crofsblogs has the reports from Finland, which continue to confirm LPAI....or exhaustion.

Sunday, August 28, 2005

August 27-28 Flu Update

Point one. A civet is not a cat. My apologies.

The Chicago Tribune has the civet story today.

The Finnish Gulls are suspected to have bird flu, although the Finns continue to say it was LPAI.

The Financial Times of London has the skinny on what stocks can be expected to do if the bird flu hits--hint: sell your airline and travel stocks.

The Sunday Times points out--as we did here some time ago--that elites in theUK government are slated to get scarce Tamiflu.

The Sunday Times has another story--nothing new--laying out the nearly inevitable steps.

The Independent has a couple of interesting bird flu stories. The first compares flu to BSE, which caused a massive upheaval in the nation. The article criticizes what it sees as the government's repeating of the "false reassurance" policy from BSE. In the second, an on-the-scene reporter says there isn't enough petrol to burn the birds in Siberia.

The United Arab Emiates is certainly on the ball.

Italy is clamping down on its borders to attempt to keep the bird flu out. (Stage One of the Osterholm scenario....see "We're Screwed."

The Sunday Herald (Glasgow) has an intelligent, must-read on the vaccine situation, and how the US vaccine will be difficult to ship around the world. Among the reasons are (emphasis added):

US scientists are genetically modifying H5N1 to “remove the lethal features” and then injecting it into embryos to extract antigens. Tests have been carried out on humans and the drug appears to provide immunity. However, all this scientific endeavour could be futile. If H5N1 mutates when it starts to pass between humans directly, the American vaccine will be useless . Even if the new vaccine did work against human-to-human bird flu, the WHO warns it will still take “ possibly years” before it is available to patients. Also, until the USA stockpiles enough of the drug to protect its own population, America is unlikely to distribute the drug to the rest of the world. That’s not inhumanity on the part of the US, says the WHO any country on earth would do the same.

The USA could pass the science behind the new vaccine to the rest of the world ... but every country in receipt of the technology would have to first master it, develop the drug, test it, regulate it and license it – and that will take a very long time. Also, the quantity of antigens being produced for the new vaccine is very low. For every dose of this new vaccine, doctors need up to 12 times the amount of antigens that are required for regular flu vaccines. Two jabs are also needed, rather than one. “We are really talking about years before Joe Smith in New York can go to his health clinic and get a shot for avian flu,”says a WHO spokesperson.

On a similar point, ProMed has this on a recent study released by the WHO on the genetics of the flu. Note the following mod comment (Emphasis added):

Perhaps one of the most significant aspects of this analysis is the finding that antigenic drift is occurring and that some recent isolates are distinguishable from virus isolates that were chosen as the candidate vaccine antigens. This identifies a need for continued surveillance of poultry for the appearance of antigenic variants which may compromise the effectiveness of the current vaccine under development. A rolling program of vaccine development may be required to take account of possible changes in the antigenicity of the virus.

The Sunday Herald (Glasgow) also warns that crossing fingers won't help.

Flu gets a little ink in Galveston.

Recombinomics on the situation in Finland and in Bulgaria.

Effect Measure on Finland.

Effect Measure on the civets--look closely, I think he said they were cats!

You will recall the challenge on Promed which said that dead birds don't migrate, and the charge to find one sick bird actually migrating. Some responses are here.

ProMed notes that the Finnish claim of LPAI does have some merit to it.

Another farm in Japan is H5N1 positive. (ProMed)

Crofsblog has a story on nine unexplained deaths in Nepal, consistent with Spanish Flu symptoms.

Crofsblog has this on WAPO saying that the US is tripling quarantine at the borders, and then notes an inherent problem with this approach.

Crofsblog has an NPR interview with Margaret Chan on WHO.

Russia is saying that it could have caught the bird flu earlier, with more money.

Recombinomics has the story of concerns about two types of flu circulating in Europe, and the chances of them combining.

Recombinomics says the pandemic is looming, and notes that the reservoir of flu in healthy birds could be a problem for years to come.

No real link, but in conclusion, Crofsblog has pointed us to the coverage of the hurricane in New Orleans, which I have watched all evening. Let's watch how a society provides food and water in the midst of a crisis.

Saturday, August 27, 2005

August 26 flu Update

The EU has its conclusions on the bird flu meetings. This is the kind of document that can be really painful later.

It considers that taking into account the existing knowledge on the migratory routes of the species of birds proceeding from central and western Asia and that might pose a risk of spreading the H5N1 avian influenza virus into the EU, the immediate risk of introduction of AI via these birds is probably remote or low (this also depends on the different areas of the EU).

As if in counterpoint, Finland is reporting it might have a dead seagull from bird flu, though they say its LPAI.

Recombinomics on the Finland story.

ProMed praises Finland for rapid response and surveillance.

Germans say they have a flu test that gives results in hours.

In China, officials are now saying that bird flu is more dangerous than SARS.

The Asian Development Bank has approved US$38M to Vietnam for fighting the bird flu.

The EU is looking into whether the Dutch flu moves (keeping chickens inside) violated EU regulations, since, apparently, animal health is an EU matter. Also, there was problems with using the "free range" label.

A nice editorial on the flu from UAE--this guy is ahead of many prominent MSM observers.

Here's a transcript of a radio show in Australia talking about the bird flu in Europe. Note, as always, the confidence of the government bureaucrat.

Manchester is preparing for the flu.

Meanwhile, health officials in Manchester are urging people to ignore "scare tactics" about drug shortages during a flu pandemic, and not to buy Tamiflu over the Internet.

As if in counterpoint, here's a very interesting story about Australian Nobel Laureate Peter Doherty. He has a new book called "the Beginners Guide to Winning the Nobel Prize." He says he is asked often about the bird flu. Here is his answer, emphasis added:

The question he is most asked now is whether bird flu is going to cross over to humans and become the killer pandemic many scientists fear.

Here science fails. It's a roll of the dice, he admits. He quotes figures estimating that 70 million lives could be at risk if the virus does mutate to allow rampant human to human transmission — a circumstance many of his peers fear is inevitable.

The toll was at least 40 million when the last flu pandemic struck in 1918, when the world population was about a third of its present size and did not have aircraft to help its spread.

He suggests people should consider asking their doctor for a script for the antiviral flu medication Tamiflu — the drug governments around the world are stockpiling against a catastrophic influenza outbreak.

He always has his vial of Tamiflu — his $56 "insurance policy" — on hand. Should everyone be hoarding a stash? "It depends how scared you are. But if the flu epidemic hits, the Tamiflu will run out fast."

Hong Kong is viewed as crucial to containing bird flu by this expert.

A month late, a Thai paper is informing its readers that major journals say the flu can be contained.

The Mirror on the bird flu---"Are our lives in Danger?"

The Telegraph (UK) has a Q&A on the bird flu.

CIDRAP on the civets, from yesterday. Civets are cats, and it represents a jump to mammals, though not the first.

ProMed on the civets--"interesting, but not surprising."

WHO experts are going to Mongolia to study bird flu there. Recombinomics covers it.

ProMed has another of a series of what seem to be regular updates from Russia. If only China was this transparent.

Via Crofsblogs, we have an analysis for a flu pandemic on European economies.

Friday, August 26, 2005

August 25 Flu Update

EU Veterinary Experts are meeting, and they are split over the necessity of Dutch plans to keep birds indoors.

The Head of the British Veterinary Association says that it is inevitable that migratory birds will bring bird flu to Britain.

A UN expert paints a scenario where the Balkans are the gateway where bird flu comes to Europe.

Birds heading south for the winter from Siberia may carry a deadly strain of avian flu to the Balkan peninsula and mingle with other flocks from northern Europe, experts said on Thursday.

Millions of birds migrate each year to Black Sea neighbors Romania and Bulgaria for the milder winter climate, making the area a potential gateway to central Europe for the bird flu virus, which has already swept into Russia from southeast Asia.

The Russian agriculture minister says bird flu is under control there.

Russia says there have been 91 villages effected by the bird flu.

In France, Chirac says France will spare no expense to protect its people from the pandemic.

In Australia, a government minister says hunting fowl is safe.

New Scientist has bird flu knock-knock-knocking on Europe's door.

Indiana has released its bird flu plan.

The Ft. Wayne paper has the Indiana story, too.

There were lots of stories today about WHO getting the Tamiflu from Roche, which I am not repeating here. But, Helen Branswell is a different case. Her story we run. And she lays bear the internal conflict on the "containment" strategy.

Here's the WHO perspective.

"We want to nip a pandemic in the bud - if we can do it," Dr. Margaret Chan, the agency's special representative for influenza said at a news conference in Geneva.

"Even knowing we may not be successful, we need to try. Because the potential damage of a pandemic of influenza is so devastating not to try it we would be failing the world. And that's the sentiment of many of us who are working in this area."

Here's Dr. Osterholm's perspective.

"More than anything, I want to stop this in its tracks. But you know what? Feeling good and facing reality sometimes just don't mesh," said Dr. Michael Osterholm, a leading proponent of pandemic preparedness who fears a containment strategy will create a false sense of security that will undermine preparedness efforts.

"I fear desperately by the mere presence of this activity it will give many others excuses to say: 'Don't worry. We'll stop it in its tracks. We don't need to prepare for a pandemic,' " said Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

Here's the Branswell analysis:

Despite the widespread skepticism - even within WHO - over whether containment could work, the agency may have had no choice but to commit to such an effort after the publication earlier this month of two mathematical modelling studies that suggest an emerging pandemic could be snuffed out.

Here's a more official report about what went on in Brussels.

Here's a Q&A from Brussels on what the EU is up to with bird flu.

Here's a timeline of EU actions.

CIDRAP says Europe is relatively dismissive of the threat from birds. They feel protective measures such as in Holland are "disproportionate."

ProMed has this same take.

Recombinomics on the Swedish decision to also load up on cheaper Amantadine as well as the more expensive N-inhibitors.

CIDRAP has this very interesting story on efforts to develop a universal, perennial flu vaccine by targetting the M2 protein, which shifts less than the H and the N parts. The article refers to it as the "Holy Grail" of flu protection.

A scientists from Mayo College said this:

"We need a proof of principle at this point," he said. "There are a number of entities trying to develop a similar vaccine. I do think it's theoretically possible. From an immunologic point of view, the key will be choosing the right antigen [viral protein] and knowing that the antigen is displayed early in the infection, so that an immune response can be generated early enough to abort the infection. My concern is if you find antigens that are displayed late in the infection, you may generate an immune response too late to do much good."
Effect Measures notes that WHO continues to say that while the disease spreads (despite killing 100s of millions of birds), there is no evidence of human transmission. Revere isn't too sure, noting a tendency among pandemics for their to be a smoldering effect.

ProMed has this from Russia, where officials say the sick bird in Altai was the only one (?). ProMed's mods continue to ask for evidence of disease in healthy birds.

Avian flu kills civets in captivity in Vietnam, via crofsblog.

Wednesday, August 24, 2005

August 24 Flu Update

Today's biggest news--and most shocking news--is the revelation that the Department of Homeland Security will lead the bird flu fight in the US, and not HHS.

Effect Measure expresses dismay on this better than I can.

Roche has donated enough Tamiflu for 3 million people, and will form the cornerstone of WHO's modelling-based containment strategy.

CIDRAP has this story as well.

Reports on the ground in Russia say that the bird flu is present in 45 villages with unclear reports from 75 others.

FAO says that the spread of bird flu West shows that the International Community must step forward with more support of bird flu containment efforts.

The UK continues to examine options, including pigs this time.

There's another part of Siberia with confirmed wild bird flu.

The Altai Territory in Siberia begins vaccination regime for birds.

Recombinomics has Altai as well.

The Financial Times pokes holes in any "fortress England" mentality that might exist.

Still, even if Europe’s poultry industry emerges relatively unscathed in the months ahead and no human cases are detected, Europeans can ill afford complacency. As long as the virus remains entrenched in Asia and circulates through other regions with poor public health systems, the risk remains that the virus will trigger a human pandemic, which some estimate would reach across the globe within four months.

Although only a handful of new human bird flu cases have been reported in Asia in recent months, the WHO expects an upturn in the numbers as the weather cools.

IHT on Europe alert for flu.

VOA says WHO is stepping up bird flu preperations.

New Hampshire public radio has this on a legislative briefing in that state on bird flu prep.

The Government of India has announced bird flu protection measures.

Recombinomics on the ongoing reporting from Russia and the vicinity.

Effect Measure on planning in the EU...and the US.

Recombinomics on the scandal of poor surveillance in Asia over the last year.

ProMed gathers the news on EU planning.

A couple of days we linked to a ProMed comment that called for data, saying that "dead birds don't migrate." The poster challenged anyone to find a healthy wild bird shedding virus. Here, the thread continues in support of that proposition.

August 23 Flu Update

Bird flu was confirmed in seven nothern Kazakh villages and threatens the western part of the nation, according to a health expert there.

Recombinomics comments on this story.

Reuters says projections show no windfall profits for flu vaccine makers. Why?

Industry analysts believe production constraints and laborious manufacturing procedures will curtail revenues for the foreseeable future.
It sounds like financial analysts are ahead of many in the MSM.

In Britain, famers are meeting with the government to urge that the decision not to adopt Dutch protections be maintained in the future.

The Financial Times has the same story.

On the other hand, the EU is meeting to look over the Dutch requirements and see if they have merit for the continent.

Russian regions are kicking up the bird flu fight.

The European Commission says Russia has the situation under control, and there risk of spread to other countries is considerably low.

Additional bird flu deaths among birds are reported in Russia.

There starting human trials in Hungary.

WaPo has Robert Webster, the "hero" of the new vaccine, who it says is the man who developed the theory that flu came from birds.

The Salt Lake Tribune profiles Margaret Chan, who is the new leader of the fight against pandemic influenza at WHO.

Austria has a story on the bird flu spread.

Reuters has this on Dutch and Swiss researchers who say mallards carry several kinds of avian flu, and could be used to track the disease.

Recombinomics notes, for those who think the situation on the ground is stabilized in Russia, that migratory bird season is coming.

Recombinomics on a machine translation of a bird flu report in Sverdlovsk, and what it might mean if true.

Crofsblog has this from the Detroit News. He notes it is basically nothing new, though it says, unsourced, that British researchers found avian flu in the spinal column of a young boy from Vietnam, which is interesting.

Excellent find by Avian Flu: What we need to know. The journal article studies the health effects of people who were in utero during the Spanish Flu, and its not good. The ultimate question is, when is a pandemic really over.

Here's a post on the new study, with more information.

The (Toledo) Blade ran this editorial, perhaps pushing the limits of MSM vaccine enthusiasm. Check this:

Americans owe huge appreciation to Dr. Fauci, his staff, and associates. They have done a fantastic job in creating a successful vaccine we may all depend on and in setting out steps leading to its distribution. They show American science at its best.
I found this on a map blog, purely by chance. Its a map which places the spread of influenza against areas of dense bird and pig production. Interesting, though not easy to digest.

Monday, August 22, 2005

August 22 Flu Update

While scientists in Britain are urging careful consideration of bird flu measures taken in Holland, the government is staying the course.

Reuters has this story on US safeguards against the bird flu, which could be a little overconfident.

"I think biosecurity has been ratcheted up to a high level. It is very hard to get on farms these days," said Richard Lobb, spokesman for the National Chicken Council.

Does this count a dome to keep migratory fowl out?

Bird flu was found on another Japanese farm.

ProMed on the Japanese report, noting the new outbreak is 44 miles from the previous outbreak.

The EU says it thinks the risk from migratory fowl is low.

Russia reports no registered human cases of bird flu.

More bad economic news...in UAE, pet shops are suffering.

Meanwhile, a UAE medical study says bird flu is a risk.

Klaus Stohr was in Bangkok, where he delivered a stark and bleak assessment of the world's preperation for the bird flu.

Taiwan is preparing to fight the bird flu.

Ongoing news about imminent (not long-range) shortages of Tamiflu, whose sales are skyrocketing.

"We are on a collision course to panic," warns Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

"I think that what's going to happen is . . . that this drug - which has yet to really be demonstrated to have any clinical impact on H5N1 infection - is now going to become the 'I can't get product, therefore I must have it right away product.'

"The reality is going to come through that there is only so much available."

Financial Times--rapidly gaining in the MSM flu rankings--has the tale of two drugs, Tamiflu and Relenza.

CIDRAP has the growing news that wild bird flu is gaining a foothold (or a clawhold) in Mongolia.

Recombinomics asks if the bird flu is being covered up in India.

Recombinomics on confirmed wild bird flu in Russia.

ProMed on more reports from Siberia that still don't answer the questions. The final anonymous mod question is good. All of the sampling is of dead birds, which do not migrate. It asks if anyone has found a healthy, migrating bird that is capable of shedding HPAI?

Sunday, August 21, 2005

August 21 Flu Update

In Switzerland, they are preparing to educate poultry farmers.

In a related story, poultry farmers are just beginning to dig out in Thailand.

The "hero" of the new flu virus is a man named Robert Webster of St. Jude's.

The Staunton News Leader of Virginia has this op-ed piece on what bird flu could do...and its written by a Doctor.

Here's an op-ed from Jamaica, on bird flu and HIV and all kinds of things.

The New York Times says that public health officials in NY have been meeting since February to plan for the pandemic. This is a must read, with excepts below. I ask my more learned readers this: they are working on the assumption there is no drug answer. They are preparing for that eventuality. Is this the kind of planning everyone should be doing?

If a pandemic similar to the one of 1918 occurred today, as many as 2.8 million New York City residents could be infected within months, sending more than 200,000 to the hospital and clogging the morgues with 400 deaths a day during the peak infection period.

With a vaccine for the strain of influenza referred to as avian flu A(H5N1) many months away from final testing and production, most of New York's planning is being done on the assumption that there will be no vaccine available to prevent illness and only limited drugs to treat patients and help protect essential workers.

Still, it is not clear how effective any drug will be against a mutated strain. Therefore, the response plans will set a framework for dealing with some of the more delicate issues that would have to be addressed in event of pandemic flu, such as when and where to establish quarantines and how to deal with sick people entering the region by airplane. Health officials are also thinking through the risks and benefits of measures like canceling public gatherings, ordering businesses shuttered and closing schools. The challenges are as basic as getting people to cover their mouths when they sneeze and as complex as increasing the capacity of laboratories to do testing.

Additionally, engineers are studying the ventilation systems in many hospitals to see if it is possible to create isolated sections so that an already difficult situation is not made worse by having the entire facility contaminated.

"The real issue is trying to control transmission," Ms. Waltman said.

Many hospitals have recently redesigned their emergency room entrances so that the acutely ill can enter without coming into contact with others in the building, she said.

The Lancet recommendation of Relenza has been good for shareholders of the company that makes it.

Yesterday, we had a report of wild bird flu on a commercial farm in Russia. Recombinomics has his take.

As does ProMed...

This is interesting. ProMed summarizes a journal article that looks at wild fowl, the natural reservoir of bird flu. By looking at the range of virus within the birds, the authors suggest that by studying wild fowl proactively, you might be able to anticipate the range of the virus, and develop vaccine coverage.

August 20 Flu Update

Reuters has the news from Siberia that the bird flu has struck a large commercial poultry farm. The article claims that previous outbreaks were at subsistence farms, and not part of the national food supply network.

In Australia, they are prepared to close all ports if the flu strikes.

The Airport in Rome is beginning to examine travellers from flu-afflicted countries. Hint to travellers: don't cough.

The Atlanta Journal-Constitution has a strong warning in an editorial to move on the bird flu.

Nature gives no warning to many of the natural disasters that kill and injure thousands of people worldwide every year. The tsunami that last December killed 175,000 to 225,000 people showed up only hours before as a rumbling on the ocean floor. Even a killer virus like the one that causes AIDS comes to infect humans only rarely.

With influenza, science experts, public health officials and the world's leaders get months, sometimes years of warning that death is lurking among this most common of microbes. We should heed the warning we have been given.

The Financial Times of Bombay says bird flu is a crisis waiting to explode.

The Telegraph (UK) has this on the approaching flu pandemic. (thanks to Crofsblog).

Yesterday, we noted the WHO raining on the vaccine parade. Here's the actual document in .pdf.

Saturday, August 20, 2005

August 19 Flu Update

Our lead story today comes from WHO. You have read in this space and others that the ballooons and confetti that accompanied the announcement of the early success in clinical trials was unwarranted, if only because of severe production difficulties. WHO has now come out and agreed with that position. (via Forbes)

The World Health Organisation has warned that the global capacity to manufacture anti-flu vaccines would not be flexible or large enough to counter a threatened pandemic that could rapidly kill millions of people around the world.

'Current global manufacturing capacity ... is inadequate to meet the expected global needs during a pandemic and cannot be rapidly augmented,' the WHO said in a weekly bulletin on disease outbreaks and threats.

The WHO's epidemiological bulletin welcomed the announcement earlier this month of successful first clinical trials of a vaccine to protect humans from the H5N1 strain of bird flu.

But it also highlighted a number of drawbacks in the production and distribution chain that could hamper the new vaccine's practical effectiveness.

The WHO bulletin also highlighted problems with the formulation of the H5N1 vaccine tested by French vaccine company Sanofi Pasteur and scientists in the US.

It contains a higher dose of antigens than common flu vaccines while antigen supplies are limited. The WHO said preliminary results of tests on formulations that could use less antigens would be available in three months.

Here's more coverage of the flu regulations in Germany and Holland we wrote on yesterday.

Reuters on the German preperations.

Gps (Family Docs) in Britain were briefed on the flu.

Reuters on the British docs...

Japan is surveying farms for the bird flu

A bird expert in Russia says bird flu could reach Moscow as early as this Fall.

The Financial Times says its near a Tamiflu deal with WHO.

Alaska--the most like US entry point for bird flu from Siberia, is watching for the bird flu.

My readers will like this story--its about a health official in Virginia who raised the alarm on the flu at a regional conference.

Lots of flu news from Malta. Here, they inform their public they have ordered enough Tamiflu.

Delawere is preparing for the bird flu.

Recombinomics has this on dead birds in Mongolia, indicating a three part spread of the bird flu--East, south and West to Europe.

Wild Bird flu is confirmed in Mongolia, via Recombinomics, who also notes there will be more migration as the weather gets cold.

ProMed on the Mongolia reports: note the mod comment on what the increased geographic range could say about how the virus has mutated.

Recombinomics on the lab confirmed wild bird flu in Kazakhstan.

Recombinomics on machine translation of wild bird flu in European Russia.

ProMed has the news of an early bird hunting season in Russia, hoping to help cull the birds.

Crofsblogs has the pandemic plans from British Columbia.

Thursday, August 18, 2005

August 18 Flu Update

Bird flu has now been found in fowl in Japan, though it may be a mild version.

Recombinomics on the Japan Report.

AVCLUB Eddie sent me this link to last night's NBC Nightly News, which did a bird flu story.

WHO is asking Russia and Kazakhstan to monitor for bird flu, including patients presenting with respiratory difficulties.

The LA Times has this on wary farmers in China.

Germany is preparing as if the worst is happening....isn't that a novel concept. Even so, what they can do is very limited.

Vietnam is intensifying the bird vaccination program.

The latest WHO update is out. Its titled "Geographical spread of H5N1 avian influenza in birds," if that gives you an idea where it is going.

WHO fully agrees with FAO and OIE that control of avian influenza infection in wild bird populations is not feasible and should not be attempted....

The expanding geographical presence of the virus is of concern as it creates further opportunities for human exposure. Each additional human case increases opportunities for the virus to improve its transmissibility, through either adaptive mutation or reassortment. The emergence of an H5N1 strain that is readily transmitted among humans would mark the start of a pandemic.

In Malta, pharmacies are complaining at being left out of bird flu planning...

though they also say they have enough medicine.

CIDRAP writes on Japan and the WHO report.

Helen Branswell, Fluitzer nominee, writes on yesterday's WHO report (see Canary in the Mine) that called for stockpiling drugs for their staff.

Recombinomics has a report of wild bird flu in Mongolia.

Recombinomics also has news of flu near the Caspian Sea.

Recombinomics notes that China is offering to share its isolate data. He goes on to point out that the rapid spread of this disease is a rare opportunity to study the virus in action. Also, he has this to say:

The data should make it abundantly clear that a serious vaccine effort is required, and targeting a single isolate with limited resources is hazardous to the world's health.

Effect Measure has today's must read on the spread of the disease into Europe. If you want a critical summary of public statements and what the news of recent days could really mean, read on.

ProMed has this report from Russia that says the bird die-off cited by Effect Measure was actually saline poisioning.

ProMed on the continuing spread in Russia.

Silviu at H5N1 has this about a recent report on vaccine development. It raises a key point. If you want to have capacity, you have to promise to buy the vaccines no matter what.

Wednesday, August 17, 2005

August 17 Flu Update

Russia continues slaughter program to try and fight bird flu.

As Recombinomics speculated yesterday, media reports in Russia say flu has spread to the Urals.

WaPo on bird flu...interviewing experts. Here are some snippets.

"Will this make its way to Western Europe? I think most of us have no doubt," said Michael Osterholm, an expert on bird flu and director of the Center for Infectious Disease Research and Policy at the University of Minnesota in the United States.

"Theoretically, because it's going to be stopped in its tracks, it's not going to infect humans because of the quick detection, and therefore it would have less of a chance to become adapted to humans," Lubroth said.

However, Osterholm noted that each time the virus passes from one bird to another presents another opportunity for it to mutate.

"This is genetic roulette," he said. "Every bit of spread just adds that much more potential for a mutation to occur that results in a strain that would be more readily transmitted between humans."

In Russia, experts are calling for a federal flu program.

The Washington Times (WaTi??) on the spread in Russia.

Stepping up the pace of bird vaccinations in Vietnam.

In what could still be an optimistic assessment, the Russians say bird flu won't be contained until October.

In Altai (Russia), hunting waterfowl is banned.

Mother Jones asks if time has already run out for the pandemic (good articles).

The new U.S. Health and Human Services Secretary Mike Leavitt told the Associated Press in early August that an influenza pandemic was now an "absolute certainty,"
Here's a canary in the mine...WHO is urging regional offices to have drugs stockpiled for staff.

CIDRAP on the Russians ratcheting up their flu efforts.

CIDRAP says the pig outbreak in China appears spent, and that WHO says all signs continue to point to a pig bacteria.

Russia thinks it would take a year to develop a flu vacccine.

A local task force is formed as part of comprehensive plans to fight flu in the Phillipines.

In New Zealand, they are downplaying the dangers of flu coming in via migratory birds.

Recombinomics says bird flu is confirmed in another part of Kazhakstan.

ProMed has the same story.

Crofsblogs finds this from Znet on the coming flu pandemic. Author is Mike Davis, who has a book coming out soon on the global flu threat.

Crofsblogs pointed us yesterday to a Canadian financial analysis that said a flu pandemic could cause a global depression. Here's a link to a .pdf of the report, also courtesy of Crofsblog.

Tuesday, August 16, 2005

August 16 Flu Update

EU watching bird flu move West, but said to be "unfazed."

There's 100 dead birds in Kazahkstan
, and a cull in the Urals.

Recombinomics comments....

In Kazahkstan, they're seeking international help to fight the bird flu.

The Australian government insists its ready for the bird flu.

The mysterious Chinese pig bacteria has taken 39 lives.

Russia's Chief Medical Officer has undertaken new protective measures.

As we noted yesterday, the flu is in six Russian regions.

Here's a new one. Dutch farmers are being urged to keep their poultry indoors to fight the spread of the flu.

Here's a company which consults on the business and economic implications of bird flu.

There's a local study of the pandemic going on in Columbia, MD.

while in Taiwan they have already concluded that they must be prepared.

This might be considered a little shocking. President Bush has taken the Barry book on the Great Flu Pandemic on vacation with him to read.

The Indy Star on the pandemic potential of the bird flu.

In Canada, ID Biomedical is close to a deal to provide flu trials to the government.

The US has placed an order for a record number of eggs...for making vaccine.

Recombinomics cites reports that say that the bird flu has arrived at the Caspian Sea much ahead of schedule.

Effect Measure on a hospital's efforts to require flu shots for nurses.

ProMed on the situation in Siberia, looking for data.

Crofsblog found this, which says that a Canadian brokerage is saying that the bird flu may trigger a Global Depression.

Crofsblog also notes that InstaPundit is continuing to cover bird flu.

Yesterday, we noted quizically the ProMed note on the role of "genetic susceptibility" in the spread of the flu. Silviu at Avianflu notes that it may have more to do with the handling and preperation of birds.

Silviu also has news of Germany stockpiling Relenza.

Monday, August 15, 2005

August 15 Flu Update

News from Moscow tracks the spread of flu west in Russia into a sixth region, now in the Ural mountains.

The Russians also say the sick journalist actually had a common respiratory infection.

CIDRAP writes on Russia as well.

A Russian physician says that migratory patterns of birds would predict flu spreading to the Black Sea and the Caspian Sea by Fall.

Nepal is mobilizing bird flu detection and prevention experts.

The Financial Times says Chiron is calling for immediate deployment of a "promising" flu vaccine.

The Lancet says its in favor of contingency plans. Also recommends stockpiling Relenza along with Tamiflu, says its cheaper and less likely to become resistant.

A DHHS official is in Vietnam to strengthen bird flu cooperation.

Roche says that the recommendation to use Relenza will not effect is financial position.

Yesterday we covered the "Manhattan Project" speech from Senator Frist. Recombinomics reviews the speech.
Recombinomics on the further spread in Russia.

The Philadelphia Inquirer has an editorial that refers to the US response to the flu as "passive." Effect Measure comments.

The comments on Effect Measure are good as always.

Interesting post from ProMed. It has an on-the-ground report from Jakarta that ProMed says "closes" the case of how the family of three was infected there. The quesion is if it was bird droppings, why did only three people get sick? The hypothesis is that there is varied genetic susceptibility among people, and shared in the Jakarta family that got ill. The post also claims that an increased susceptibility among Vietnemese people is "apparent."

ProMed with a summary on the Russia news.

Crofsblogs has this that says that the China pig story (remember that!) has conflicting news on whether the disease is a pig bacteria or not.

Sunday, August 14, 2005

August 14 Flu Update

The government in Ireland has ordered 200,000 doses of the as-of-yet unfinished flu vaccine for their front line medical workers.

Switzerland is now banning poultry imports from 13 countries.

In Tacoma, public health workers scan emergency room records everyday to look for the footprints of infectious disease. They say that avian flu is only a plane ride away.

Indonesian estimates show that bird flu "scares" have cost the bird influstry there RP600 billion.

Senator Frist, who I disagree with often yet often respect, had this summary published in the Seattle PI on the need for a Manhattan project against infectious disease.

The article is taken from a speech at the Harvard Medical school, captured here in full text.

Henry Niman, of Recombinomics, was interviewed at the Dallas Morning News, and responded with his normal crisp, blunt oratory. Note especially what he says about the "vaccine" and whether this is Y2K all over again.

ProMed with an official report from China that includes data on the spread into Tibet.

Crofsblogs on the Modesto Bee story that has California public health officials watching for signs of the flu. Note their nervous feelings about the lack of bird deaths--and whether it might mean the virus has evolved in the birds to a less virulent, more contagious form.

Tyler at Avian Flu has this on Russian poultry farmers hiding their birds from the authorities. (This has to be very common across Asia.)

The Economist weighed in on the bird flu in this week's edition. The articles focus on the containment model, and its implications. The magazine gives a bit too much weight to the models, but has the gravity of the situation right in this leader (editorial) subscription required.

Here's the straight news story, again subscription required. The actual article in the print edition is laden with caveats.

Saturday, August 13, 2005

August 14 Flu Update--Back from vacation edition

You go away, nothing changes. China is claiming a flu outbreak is under control (this time in Tibet).

A Russian journalist downplays the flu that may have been caught covering the pandemic.

They are preparing in Nepal.

Some companies are being advised to stock up on antivirals.

CIDRAP on the Asian flu conference. Osterholm notes here that supply problems hinder the effective use of any drug-based response.

Osterholm, director of CIDRAP, publisher of this Web site, continued, "What we need to do right now is focus on what will get us through a pandemic without counting on drugs. We just don't have a supply chain that can manufacture enough vaccine and antivirals to make a meaningful dent in what we'd need if the pandemic hits in the next 2 or 3 years. We need to think about things like food supplies, healthcare workers and facilities, essential services. We're wasting time."

Helen Branswell, of CP, perhaps the leading MSM source on the flu, writes about tests on a flu vaccine being conducted with people who received a 1997 Hong Kong H5 vaccine trial.

By giving this group a single shot of a newly developed H5N1 vaccine, researchers hope to start puzzling out answers to two key questions: How long can the immune system remember novel strains of avian influenza? And can priming the body's protective force to fight a previously unseen flu virus arm it to later battle a related pandemic strain?

Recombinomics says the bird flu is racing across Russia.

Recombinomics on the further spread of the disease across Russia.

Recombinomics notes again that recombination is at work in Russia.

Recombinomics also says that tests show the H5N1 is being tracked in birds to Mongolia.

ProMed has the same report from Mongolia.

The CDC has updated its travel advice on bird flu, through ProMed.

ProMed on a follow up report from Kazhakstan.

ProMed has data which solidifies earlier report from Siberia.

This is comforting, Crofsblogs has this on the Russians testing their own flu vaccine.

Crofsblogs also has news of pandemic planning in New England via the web.

Friday, August 05, 2005


The Coming Influenza Pandemic will on on hiatus until August 14, 2005. Look forward to being back with you then....

Thursday, August 04, 2005

August 4 Flu Update

CIDRAP has the news of two NIH funded studies that analyze containment strategies for the flu. The plan is to "nip it in the bud" with highly focused resources.

Michael Osterholm, Director of CIDRAP, had this to say in comment:

"I want these strategies to work," infectious disease expert Michael Osterholm, PhD, MPH, told CIDRAP News. "But in all my years in public health, I have yet to see mathematical models that have driven public health actions in meaningful ways." Osterholm used HIV and bovine spongiform encephalopathy (BSE) as examples of diseases for which there have been what he calls a "pandemic of modeling studies."

"My concern is that papers like these suggest more direction for planning than is warranted and may placate policymakers who believe the planning puzzle has clear solutions. . . . The issue of antiviral treatment, for example, has to be looked at against the whole system of disease occurrence and transmission. How well can we detect the disease when it starts occurring? How can we make sure travelers who appear healthy aren't unknowingly spreading the virus?" Osterholm, who is director of the Center for Infectious Disease Research and Policy at the University of Minnesota, publisher of this Web site, used as illustration the example of SARS' fast jump from the Far East to Canada in 2003.

Osterholm also made the point that since a flu pandemic will very likely be caused by a mutation of the H5N1 virus currently spreading among birds in Asia, we will be facing a "reloading" problem at the source—that since birds are a reservoir that is constantly replenished, "We are dealing with a moving target, not a static population like humans. . . . Culling [the birds] won't work. It's like throwing fresh wood on a fire."

Here's an NIH link to the study.

Here's a WHO link.

The Daily Mail in the UK has its take on this...something along the lines of scientists say it can be "stopped in its tracks."

WaPo is a little more reasonable, on the order of a theory.

The Times of London notes, correctly, that the key is "decisive action" would be required under the plan.

Effect Measure drops the bomb on these studies, despite that he respects the people who did them. Note these quotes:

...it must be said again: once this virus gains the capability of being transmitted from person to person like other influenza subtypes that circulate in human populations, there will be no way to prevent its global spread.


So I hate to disagree with Elizabeth Halloran of Emory, an infectious disease epidemiologist of note and a genuine expert. In her view, as reported by the BBC,
"Our findings indicate that we have reason to be somewhat hopeful.

"If - or, more likely, when - an outbreak occurs in humans, there is a chance of containing it and preventing a pandemic."
There is no reason at all to be hopeful.

As always, the comments are excellent on Effect Measure.

Tyler Cowen on Avian Flu has a nice post, too.

Note that Thailand, or similar places, has not had the past facility to stop malaria, or even to provide clean drinking water to its rural populations. Measures of these kinds will limit deaths, and should be taken, but they are highly unlikely to stop a pandemic from spreading, should one get started.

Here is a Reuters timeline that spells out the march of the bird flu through Asia.

Reuters bird flu fact sheet.

Roche is in discussions to donate a substantial amount of Tamiflu to WHO.

In Vietnam, there were three news human cases in July.

From Russia, flu threatens European Russia.

Fiji is on the case to fight the pandemic.

Vietnam is vaccinating poultry.

Recombinomics on the spread of bird flu in Russia.

Staggering....Recombinomics says 70% of waterfowl in Mekong Delta are bird flu positive.

Crofsblogs points us to the disease section on boxun.

Wednesday, August 03, 2005

August 3 Flu Update

WaPo is rapidly picking up the bird flu story. This is on the spread to a new area of Siberia.

Here's the TASS story on the same topic.

Russia is having war games, and this report says its soliders are going to get flu shots (??) for bird flu. Check the well photo-shopped image out in this story.

Russia is looking at a $1B tab for the bird flu to farmers alone.

The cull is on in Siberia.

CIDRAP with a story on the cull.

There's a new case of human bird flu in Vietnam.

Recombinomics on the new case. He reminds us that there are two H5N1 in Vietnam--a milder version in the north, where this case is, and a more deadly version in the south, and discusses the implications of this genetic variability running around.

The HHS Secretary says they may use the US Postal Service to deliver flu meds (Tamiflu, I guess) to homes during a pandemic.

(Two thoughts. First, if the mail carriers get the flu, we're in real trouble. And, if they think I'm taking an injection from my mail carrier, they have another thing coming.)

The Rutgers College of Nursing is during an infectious disease seminar in October. Keynote speaker will be Gina Kolata of the New York Times, who wrote an outstanding flu book I read last December.

The EU Communications Commission is working on a green paper on pandemic preparedness.

Recombinomics looks ath the situation in China, which is, for lack of a better phrase, a bacterial and viral cluster-f**k. Niman combines on-the-ground, unconfirmed reports with other media accounts in this commentary.

Recombinomics cites a machine translation here showing bird flu in Tyumen, a heavy poultry district in Russia.

Wikipedia on Tyumen, which is in Siberia

Recombinomics on the spread of the flu toward Europe.

More Recombinomics and the spread to Asia.

Recombinomics notes that the isolate heading to Europe is not resistant to Amantadine and Rimantadine, which could increase demand for these drugs.

Recombinomics has a machine translation which points to four new human cases in Kazhakstan.

Recombinomics has this boxun report about villages being razed in China based on the riots reported last week due to quarantines. Unconfirmed, but not implausible.

The above translation of a boxun report suggest that three villages were razed in response to unrest linked to a forced bird flu quarantine in Yushu in northwestern Qinghai in China. China has imposed news blackouts and arrested reporters in the past, so verifiable news from the area is difficult to obtain.
Croflogs identified this, based on Declan Butler on Connotea, which is a Singapore news site on bird flu.

Tuesday, August 02, 2005

August 2 Flu Update

Here is a Russian source saying scientists have confirmed that the bird flu in Siberia came from Southeast Asia.

The same source calls for a Russian program against the bird flu.

The regional Governor in Russia is ordering a massive culling of birds.

Moscow Times has this story as well.

India is growing increasingly nervous about bird flu , and is making plans.

A British company says it has the answer for a human vaccine--quick, adaptable, and scaleable.

From Kazakhstan, more news on sick birds.

HHS Secretary Leavitt was on CBS Early Show yesterday, where he struck a reassuring tone.

Indonesia thinks bird flu won't hurt tourism.

At a National Consultation meeting in India, they are talking surveillance.

CIDRAP on the confounding disease outbreak in China, citing experts who doubt the official story. The Chinese claim they have sequenced the infection source.

Official WHO press release cited in CIDRAP story.

Recombinomics says Chinese stonewalling is exporting the flu pandemic.
Recombinomics tracks the March of the flu through Russia.

Effect Measure critques a story on a public health planning session in Northern Colorado. It isn't pretty.

ProMed sorts out confusion over whether there had ever been bird flu in Russia before.

ProMed with more on Siberia. Note the mod comment that there has been no official confirmation of the N5N1 in Siberia.

Crofsblogs has this link, to a manual on preparing for the pandemic. Its called the "Coming Pandemic"

Slate did an article on bird flu blogs, spurred by the WaPo story. Its cited in yesterday's comments as well.

Crofsblogs has a commentary on the whole subject, which is worth a read.

This has made me reflect on something I learned in US Army basic training 42 years ago: The recruit who's a day ahead of you thinks your ignorance makes you a total jerk, and the recruit who's two weeks ahead of both of you knows you're both jerks.

But in the army you could abuse the newbies with a clear conscience. Those of us who are a week or two further along in our pandemic education can't afford to put on airs. We just need to bring the Instapundits up to speed as fast as possible: "Thank God you're here! Here's the situation—what can you do to help?"
The Guardian with the effect of the bird flu in local areas.

Monday, August 01, 2005

August 1

August begins with bird flu crossing into Kazakhstan with a human case.

Recombinomics on the Kazakhstan story--and what it might say about China.

Effect Measure on Kazakhstan, and what it means for Europe.

ProMed on Kazakhstan. Note this:

From an unofficial source in the vicinity of Golubovka, we have been
informed that 300 ducks and geese died there by Fri 29 Jul 2005, while
diagnosis was pending.


If confirmed, this will signal a dramatic extension of the range of avian
influenza virus capable of infecting humans. All previous human cases of
avian influenza have been reported from East and South Asia -- Cambodia,
Indonesia, Thailand and Viet Nam -- countries remote from the Pavlodar
region of Kazakhstan.

The Chicago Tribune on Siberia.

The Washington Post did this story on a potential pandemic that was picked up around the country. Its nothing new to anyone following the flu news.

Effect Measure with a nice critique built off the WaPo story. As many have written, once the pandemic happens, we'll have congressional hearings on top of congressional hearings to find out why we didn't do anything.

Indonesia was ready to say it was bird flu free a few weeks ago--not they only hope to reach that by 2007.

Vietnam is beginning again to vaccinate birds.

Australia continues to be justifiably nervous.

I have said before that the flu virus finds our weaknesses. Its if a World War that puts people in crowded trains, so be it. If its a withering public health system, as noted here in California, the flu will expose it.

The Rocky Mountain News editorializes on the pandemic.

Effect Measure on mixed messags coming from Indonesia.

Via Crofsblogs, the Chinese are confident of defeating their swine bacteria problem.

Also via Crofslblog, the Chinese have banned journalists from the site of the "swine bacteria."

Crofsblog has surveyed the landscape and found a shortage of MSM news on bird flu.

Instapundit (also via crofsblog, who was busy yesterday) notes the WaPo article and urges concern, though I think he mistakes the fact that 1918 flu was aggrevated by TB.