December 26 Flu Update--one year anniversary
December 27, 2006 represents the one year anniversary of The Coming Influenza Pandemic. We started with a post like like you see above. Since then, we've received tons of great feedback and encouragement, along with nearly 97,000 page impressions, and being featured on Yahoo! as site of the day on October 17.
I started the blog because I was planning on following the pandemic more closely. I got the Gina Kolata book for Christmas that year, and had it read in a day, after having earlier read the Malcolm Gladwell and New York Times magazine articles. I found and find the flu fascinating for its ability to be a perfect tracker for our human behavior, exposing our weaknesses with an elegant brutality. So, I thought as long as I was following it, I would throw some links up for others.
My goal was to put the facts into the blog, with some comments thrown in to keep it interesting...kind of like "The Note" for flu junkies. I try not to step over what I know, leaving the science to the experts. I do, however, have a layman's perspective, only with an upgraded self-education.
Thanks to everyone who reads and to those who comment and email. It is very gratifying. On to year 2!Although that town in Australia was subsequently cleared of flu, fear is keeping tourism down.Good story from the Boston Globe, which says that the US poultry industry is living in fear of a flu pandemic. They are increasing security measures, because they know what a panic would cost them---not to mention the culling.
Similarly, in Taiwan the EPA is putting into place protective measures.
Placing the chick on the ground, he checked automated food and temperature controls in the cavernous henhouse west of Modesto, then returned to his truck and unzipped his full-body biosecurity suit.
Instinctively, Carlson reached for a bottle in the door pocket, squirted a dollop of clear gel into his calloused hand and rubbed it in.
''Farmers using hand sanitizers," he said. ''Crazy, huh?"
In the age of bird flu, the ideal poultry or egg farm would be more controlled than a prison, more sanitary than a hospital, and more remote than a desert island.
Reality is not far off. The new tools of the trade are locked gates, visitor logs, and antiviral truck washes. Failure to wear biosecurity gear is a firing offense.
Up until now, Taiwan has taken the work of defending against bird flu seriously, stockpiling Tamiflu as well as ingredients to produce Tamiflu, requesting "coercive authorization" to produce Tamiflu, tightening up defenses against bird smuggling, providing funds for farmers to put up wire fencing, increasing sampling of migratory birds for the HN virus family, holding conferences to increase the flow of information and holding large-scale drills. A local health official in Japan details his region's plans for fighting the pandemic.More sick birds in Romania, and the culling goes on.Here's a perspective on a debate you often hear--can technology and science deliver us from a pandemic? A Chinese offical says that China should insist that it do so.
The Chinese have a new live vaccine for birds, as reported earlier. It is remarkably versatile--it can be injected or used as a nasal spray.ProMed has various reports on this as well...note the very faint note of skepticism in the mod comment.
Provided the vaccine has been found safe (for the vaccinated birds as well as for the vaccinators) and efficacious, as should have been convincingly manifested in the laboratory and in controlled experimental vaccinations in the field, this has the potential to become a significant step forward in the combat against avian influenza. Applying the oral (drinking water), nasal or aerosol routes for mass-vaccination is a time and labor saving application mode that might enable achieving China's ambitious undertaking to vaccinate its 14 billion domestic poultry.The Anti-Influenza Task Force in The Philippines says migratory birds have arrived, been sampled, and do not have bird flu.Charleston SC paper tells readers not to ask for Tamifu if they aren't sick.
Hopefully, careful testing has preceded the official go-ahead approval announced on 23 Dec 2005.
Crofsblog points us to this Chinese blog that says Chinese media have no evidence of a cover up and takes strong shots at Boxun.
December 21 Flu Update--New England Journal of Medicine reports Tamiflu resistant flu is costing lives.
Today's big story...New England Journal of Medicine says two people died in Vietnam recently of flu because the disease resisted the Tamiflu. Note that this reflects statements from a local physician we ran a few weeks ago. It goes without saying that, if it continues to be true, this blows a major hole in containment strategies.
"Improper use of personal stockpiles of oseltamivir [the medical name for Tamiflu] may promote resistance, thereby lessening the usefulness of our frontline defense against influenza, and should be strongly discouraged," wrote Moscona, a medical professor at Weill Medical College of Cornell University in New York who specializes in pediatrics, microbiology and immunology.
Roche disputes the report:
Earlier today, Roche held a news briefing to respond to the findings on Tamiflu-resistant avian flu. Dr. David Reddy, influenza pandemic task force leader for Roche, said the case reports confirmed that Tamiflu is effective against the virus, because four of the eight treated patients experienced a drop in their viral levels in response to Tamiflu, and they survived. The virus progressed in the other four patients who received Tamiflu, and they later died.
Finally, here's the prescription:
"We need to work on a variety of countermeasures — not just Tamiflu — in the hope that some, and ideally many, will indeed be effective," said Bittner, chief of infectious diseases at the VA Medical Center in Omaha, Neb.
For a broader approach, he suggested widespread dispensing of pneumonia vaccines to prevent a common complication of the flu; urging smokers to quit to help them have the healthiest possible lungs and hearts; developing new ways to manufacture the flu vaccine; testing new theories to slow the spread of infection; and formulating plans to keep essential services, such as emergency medical care, running.
The Journal reports indicated that a similar drug, Relenza, might not be prone to the same problems, although there is little evidence to confirm that at this point.
Recombinomics agrees on the combination approach, and also says that the Tamiflu resistant H5N1 seems quite "fit," a bad development.Helen Branswell has her usual outstanding piece on this situation. Two key pieces:
Reuters says Turkey sales actually down for Christmas in Britain. The Ag Secretary (AgSec) is asking Congress to approve bird flu funding.A journey of a million miles....they've started human trials on a bird flu vaccine in China, with six volunteers.North Korea, of all places, says it has developed a way to detect bird flu.New Zealand details potential cost to the nation in a pandemic.Romania finds bird flu East of Bucharest, in the 22nd village since October.Effect Measure says that WHO has a handbook for journalists in covering the bird flu, but in his view is misleads them on the question of a vaccine.ProMed has reports on surveys of migratory birds in Denmark.Sussex County, NJ has been declared ready for a pandemic.The UN says that Indonesia needs to be better prepared for a pandemic.
Research studies are currently being set up in Southeast Asia to try to determine whether higher doses, for longer periods, are needed to treat H5N1 infections.
Should that prove to be the case, governments would face the unwelcome realization that national stockpiles of oseltamivir, or Tamiflu, will not protect as many people as they had anticipated.
Dr. Keiji Fukuda, an influenza expert with the World Health Organization, listed some of the questions posed by the findings, published Thursday in the New England Journal of Medicine.
“How frequently will we see resistance arise? What is going to be the full impact of that? Is that just going to be on individual patients who are under treatment or is it going to escalate and become a larger problem for other people who may get infected by antiviral-resistant viruses?” asked Dr. Fukuda, who was not involved in the research.
“I think these are all open questions.”
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.
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.
"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."
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.Is it generic or is it fake?---US FDA testing alleged Tamiflu.
"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.
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.
December 19 Flu Update--UN Says Battle with Bird Flu being lost
David Nabarro, of WHO, says the world is "losing the battle" against bird flu. One thing about Nabarro is clear--he knows how to make a headline to draw attention to what he is trying to do.
"This H5N1 virus is slowly changing though genetic re-assortment or mutation. The change is slow, but if this virus undergoes the change that leads to sustained human-to-human transmission, then we have a major problem. Then we probably will have the next human pandemic influenza. This is (a) serious risk.
"Virologists who study these things say do not get complacent. It is quite feasible that H5N1 could mutate. The fact that it has taken some years should not lead you to believe that we are through the worst.
"We believe that it is starting to spread into Africa. I do hope that the Malawi case is not H5N1. If they are, then it's very serious."
Recombinomics on why H5N1 in Malawi is likely, in his view.There's another death in Indonesia. An eight year old boy died there, local lab confirmed H5N1, WHO tests not in yet.ProMed notes that actually there are reports of two deaths in Indonesia, but one may be a duplicate.More bird flu outbreaks in Romania.A new flu detection test has been cleared by the FDA.Korea reiterates: no pathogenic bird flu.ProMed has a news collection on Korea.
How do poultry farmers make our after the cull? Nice story about a Chinese farmer who took his settlement, bought date trees, and now sells them.Kirin shares up on yesterday's news (see below) about a flu antibody.Vietnam says seven more provinces have bird flu under control.Kuwait received its first Tamiflu shipment.The US House approved pandemic funding at only a little over half what the President requested. CIDRAP reports.
Effect Measure has his take on the Congress and what actually happened. Apparently, liability remains a big issue. I don't know how you get vaccine production ramped up without some liability protections.Effect Measure also has an interesting post on the possibility of intradermal injection of flu vaccine to help boost immune response.Finally, for all the talk of the bird flu hurting business, The (Toledo) Blade has this on a business gaining--sauerkraut. Reports from Korea that pickled cabbage can fight the flu can be seen in sales results. Read on...
After reports reached the United States in October that scientists at Seoul National University in South Korea had fed an extract of kimchi, a spicy variation of sauerkraut, to 13 chickens infected with avian flu and 11 of them started to recover, sales of sauerkraut have jumped.
The family-run Fremont Co. in Sandusky County, which sells fermented white cabbage under the Frank's and Snowfloss brands, has been a prime beneficiary of rising demand.
December 17 Flu Update--Is the NIH considering a live virus vaccine, US Market Says 65 Percent chance of someone IN US catching bird flu by March 2006
You may be familiar with INTRADE, a website where people can "bet" on upcoming events. Its a sort of futures market that has successfully predicted several items during 2006. Well, they say there is a 65% chance that someone in the US will have bird flu by March.On the vaccine front, NIH is studying a nasal vaccine for flu that uses live virus.
As the flu continues to break out in the Ukraine, they are considering stepping up flu controls.Meanwhile, Romania had its 18th outbreak.12 more dead Swane were found in Astrakhan, Russia.Want to see the private sector get involved in fighting the flu? About 60 food companies, including Tysons, McDonald's, and Yum were in Thailand to help share their expertise on food safety. Their goal, protect their business by stemming the tide of bird flu.
And if it works, this new vaccine frontier may not just protect against the bird flu strain, called H5N1, considered today's top health threat. It offers the potential for rapid, off-the-shelf protection against whatever novel variation of the constantly evolving influenza virus shows up next _ through a library of live-virus nasal sprays that the National Institutes of Health plans to freeze.
"It's high-risk, high-reward" research, said Dr. Brian Murphy, who heads the NIH laboratory where Dr. Kanta Subbarao is brewing the nasal sprays _ including one for a different bird-flu strain that appeared safe during the first crucial human testing last summer.
“The McDonald’s people and people from Cargill and others are very focused in response to all of us from the U. N. and government people saying we would like to work with you,” David Nabarro, the U. N. ’s New York-based avian flu coordinator, said in an interview Thursday from Bangkok, where he addressed the meeting. There is cooperation from companies which “have a vested interest in responding better to avian influenza and preparing properly for the pandemic.”
Food companies have a financial interest in curbing the disease’s spread. A nationwide survey of 1, 007 U. S. adults on Oct. 14 by Opinion Research Corp. for the Center for Consumer Freedom found nearly half of Americans mistakenly believe that they can contract bird flu by eating chicken.
Vietnam says the number of communes hit by bird flu has been cut in half.
Fake Tamiflu was seized at customs in San Francisco.
A reader sent me this link to the Lac Du Bonnet Leader, of Lac Du Bonnet, Manitoba. They're doing the hard planning work there now, but, like most people, struggle with where bird flu falls on any specific model of Federalism.
Finally, a must read from Helen Branswell, who writes one of those 2005 year in review pieces.
The world seemed unimpressed. That is until a vicious tempest named Katrina taught a humbled American administration how little it could do to mitigate the crushing impact of Mother Nature's wrath.
Suddenly the experts' warning – there's no greater potential natural disaster than a bad flu pandemic – began to resonate with frightening clarity.
And just about then, migratory birds began to die on the fringes of Europe, stricken by the same virus that had sickened nearly 120 people in four Asian countries, killing roughly half those who fell ill. A month later, the world's most populous country, China, admitted it had joined the list of nations – now numbering five – with confirmed human cases of H5N1 infection.
A backburner issue was white-hot news.
December 16 Flu Update--Vaccine News May Not be as good as reported
The New Scientist reports on the vaccine news from Sanofi, and their take is not as positive as the official reports earlier in the week.
Scientists had hoped that very low doses of vaccine virus would make humans immune if injected along with an immune-stimulating chemical called an adjuvant. Helen Branswell, as usual, gets it right, saying that results are disappointing to anyone hoping for a "fish and loaves type miracle."I think most people wonder what's going on in that virus. Is it moving toward H2H, or is it stuck? Is it a sudden movement, or will it be gradual. David Nabarro of WHO says that people should not be complacent, that the virus has made mutations already that could tend to point to H2h.
But on Thursday, French vaccine company Sanofi pasteur announced that in tests on 300 people in France, they did not. “The prospects for adequate global supplies of an effective pandemic vaccine of any kind are dimmer now than they were last week,” David Fedson, founder of the vaccine industry’s pandemic task force, told New Scientist.
WHO officially confirms the sixth human case in China. CIDRAP on the Chinese case.Human death reported in Indonesia. ProMed on China and Indonesia.
"There are some subtle changes in the genetic makeup of H5N1 which suggest that it is making some of the mutations that would enable it to have a higher likelihood of being able to become a human-to-human transmitted virus," said David Nabarro.
"Virologists who study these things say do not get complacent. It is quite feasible that H5N1 could mutate. The fact that it has taken some years should not lead you to believe that we are through the worst."
ProMed on Taiwan and Romania, as well.
There are also more suspected outbreaks in Romania.Reuters on the most recent human cases.More Ukranian villages have been hit.Health experts warn Tamiflu is not a panacea
Clinical data supports Tamiflu's success against H5N1. Not all human victims of avian flu have been treated with Tamiflu - it has to be taken within 48 hours of the onset of symptoms to be effective - but most who have taken it survived.
Some research also indicates that in controlled environments, people who take sustained treatments of Tamiflu may be protected against avian flu. Coupled with the drug's ability to stop the spread of the H5N1 virus within the body, experts say it will prove critical in saving lives during the early stages of a pandemic.
"These antivirals are tremendously effective in a pandemic," said Dr. Kathleen Neuzil, head of the pandemic influenza task force at the Infectious Diseases Society of America.An interesting step forward...Indonesia and Thailand are essentially going to pool their Tamiflu stocks...giving each a greater rapid response capability.Australia is ordering $60M worth of Relenza, another antiviral.
Biota boss Peter Cook welcomed the deal, saying it proved the company had an "excellent" product - superior to the rival Roche drug Tamiflu, which has also been stockpiled by the Government.Indonesia says it will have human vaccine in one year.The Chinese vice-premier says that despite initial success in fighting bird flu, it remains a long-term task.
"Relenza has not demonstrated the resistance that Tamiflu has and appears to be efficacious in conditions where Tamiflu is not," he said.
A similar message from Vietnam, where the Deputy PM said that the fights goes on, and people have to remain vigilant.The UN's David Nabarro is in Cambodia, where he told people that the flu pandemic could start anywhere.The British House of Lords has told the government it should being doing more on an international basis to fight the flu.Businesses in British Columbia have been told to make a plan and check it twice....Thousands of dead birds were found in Malawi, and AI tests are being done. Note the mod comment calling for caution.
December 15 Flu Update--New Case In China
The Chinese have confirmed their sixth case of bird flu. It is in new area for human infection--but is adjacent to an area with known problems. He is a peddler. The news from the vaccine front is good, says Reuters. Note, its still a two-dose deal, though the doses are each 1/3 as large as the ones tested without an ajuvant.
A 30 microgram dose with an adjuvant -- an additive that boosts the immune response -- in a two-dose regimen showed an immune response consistent with the requirements of regulators to approve seasonal influenza vaccine, Sanofi Pasteur said.Effect Measure picks up on this story, noting ongoing uncertainty, and that the vaccine is still four time weaker than the seasonal flu vaccine.
The Esteemed Helen Branswell has her take on this story as well. As always, this is the best read available.
That dosing regime would be a political and public health nightmare, reducing the combined global output to enough vaccine to protect 75 million people in the first year of a pandemic. At two doses of 30 micrograms, the combined output would be enough to protect 225 million people in the first year.
"It's a lot better than two doses of 90," said British vaccine expert Dr. Iain Stephenson said of the Sanofi findings. "(But) it's still pretty worrying, isn't it?"
CIDRAP on the vaccine story as well
Yesterday, we quoted a Russian doctor telling people in that country they had nothing to fear for the bird flu for two years. Effect Measure notes that his track record is not too good.
16 ASEAN countries pledge to overcome the bird flu.
Interesting story. Expert says "frenzy" of unilateral national efforts is hurting the overall attempts to fight the flu.
"It's fragmenting the ability to create a global strategy for the purposes of protection and response," Fidler told a teleconference organized by the American Society of International Law.
Chicago Tribune covers story we ran earlier--Ukraine confirmation of H5N1 in Crimea.
USDA is working to protect US birds, including testing migratory birds on the West Coast.
Romania is seeing the bird flu spreading...to Bulgaria.
New Zealand is setting up flu clinics--primarily to keep their stock of GPs healthy themselves.
About half of Australian pharmacists surveyed feel the nation will be ready for bird flu.
Vancouver WA says its not ready for the bird flu.
The EU says Tamiflu safe in kids...
and it doesn't need special warning labels.
Montreal looks back on 2005...and the bird flu.
December 14 Flu Update--nearly 7 Billion birds in China vaccinated.
Holy Poultry! China says it has vaccinated 6.85 Billion birds. ProMed says that initial tests of people around the 5 year old boy who caught H5N1 recently have "cooled fears of human to human transmission."WHO Situation update on the death in Indonesia. Note especially the length of time since his death.
He developed symptoms of fever, cough and breathing difficulty on 6 November, was hospitalized on 9 November, and died on 19 November. Indonesia is promising to cooperate with WHO to stamp out the bird flu.ASEAN nations adopted an eight point plan for fighting pandemic flu, reviewable here.The Kaiser Family Foundation did this webcast on the intersection between the avian flu pandemic and HIV/AIDS. You can view it here.A Gaithersburg MD paper interviews local businesses on their preperation for the flu, than wonders if it isn't just an overhyped threat from bureaucrats protecting their funding.In the US, CIDRAP has the story of the first of 50 planning meetings--one in each state--across the US. The first was in Minnesota.
Family members and close contacts were placed under observation and tested for possible infection. No evidence of additional cases has been detected.
Investigations have been undertaken to determine the source of the man’s exposure. While he did not keep poultry in his household, chickens and other birds were found in his neighbourhood. Samples from these birds have been taken and are undergoing tests to determine whether they may have been the source of infection.
The general theme of the half-day conference was that much, if not most, of the real work of preparing for a pandemic must be done at the local and state levels.
An audience that nearly packed the auditorium at the Minnesota History Center in St. Paul heard that pandemic preparedness consists of much more than a plan on paper or an intention to stockpile antiviral drugs.
"Hope is not a plan," said Minnesota Gov. Tim Pawlenty.
Health and Human Services (HHS ) Secretary Michael O. Leavitt said, "A plan represents our aspiration; being prepared is what we've demonstrated in the context of an exercise."
The Reuters report is a little more alarming about the state of preperation in Minnesota.
Minnesota only has 10 percent of the hospital beds it would need if a flu pandemic broke out and has nowhere near enough drugs or ventilators to treat the sickest patients, Minnesota Commissioner of Health Dianne Mandernach said on Wednesday. And her state is being praised as one of the most prepared for a pandemic or other emergency.Washington County, Wisconsin is also preparing for a pandemic while it prepares for season flu.11 Flu outbreaks in the Ukraine.Two countries have banned poultry imports from the Ukraine.Meanwhile, Europe announces it will be ready for the bird flu by 2007.Meanwhile, a Russian expert says a flu pandemic will come within two years.
Still meanwhile, as migration end, Europe restricts bird flu measures.
Here's an AP story with a new chapter in the "China: Open or not Open" debate.
Health workers arrived 30 minutes after Qin Zhijun reported finding dead chickens. Within 11 hours, tests confirmed it was bird flu and his flock of 7,000 birds was destroyed. Taiwan finds bird flu near the capital, but its not H5N1.ProMed on China and Taiwan--including an extensive story about the state of flu regulations in China, and the coming lunar new year.A local health authority in Alberta is preparing for the pandemic.They are discouraging the prescribing of Tamiflu in Arkansas.Pregnant women and babies in Singapore are being advised to stay away from Tamiflu.Effect Measure has this on FDA warnings to sham flu cures.Effect Measure also has this--Burlington ON will have a community meeting tomorrow to simulate a flu pandemic and get everyone in the community talking.In this press release, Alnylam says it will begin to study using RNA Interference to fight pandemic flu.
Then China's normally slow, secretive government did something even more unusual. Instead of imposing an information blackout, it flew foreign reporters to the northern region of Inner Mongolia to meet Qin and see his farm.
RNA interference, or RNAi, is a naturally occurring mechanism within cells for selectively silencing and regulating specific genes. Since many diseases are caused by the inappropriate activity of specific genes, the ability to silence genes selectively through RNAi could provide a new way to treat a wide range of human diseases. RNAi is induced by small, double-stranded RNA molecules. One method to activate RNAi is with chemically synthesized small interfering RNAs, or siRNAs, which are double-stranded RNAs that are targeted to a specific disease-associated gene. The siRNA molecules are used by the natural RNAi machinery in cells to cause highly targeted gene silencing.
December 9 Flu Update--Death in Thailand, and a leading virologist says China is hiding bird flu
A five-year old boy has died of bird flu in Thailand.Part V of the debate over whether China is hiding bird flu. Guan Yi, a leading expert on bird fu says that the bird flu is in all parts of China. Note: he does not specifically address the issue of human cases, at least in this article.
Recently, there's been some debate as to how much Tamiflu helps. A doctor from Vietnam said it didn't help at all. WHO is beginning to study whether the recommended dose--designed for a respiratory flu--is insufficient for a systemic flu.
"I don't know if they are brave enough to admit that they have the virus in every corner of the country," said Guan Yi, a virologist at the University of Hong Kong who has analyzed nearly 100,000 bird-flu-virus samples from across China.
"Quite honestly, some provinces have the virus and they still haven't announced any outbreak. I can show direct evidence, even though China is still trying very hard to block my research. The government doesn't do any surveillance studies, but they say there is no outbreak."
``This virus may be causing them more systemic infection so the usual recommended dose of antiviral is based on our experience on usual human influenza infections which only causes respiratory infection,'' he said.
Under the planned schedule for the Tamiflu trial, 150 milligrams of the medicine would be given twice a day for five days, Horby said. That compares with the recommended dose of 75 milligrams twice a day for five days, he said.
CNN reports that the bird flu vaccine is akin to putting "all your eggs in one basket."Meanwhile, Sen. Frist urges his colleagues to support the $7.1B administration request, using, apparently, an argument he thought they would listen to....that the bird flu would be bad for the economy.Yesterday, Sen. Schumer said Roche was talking about increasing Tamiflu production. Today, Roche confirmed those talks.There are fears that the bird flu is spreading across the Crimea.With the passing of the Autumn migration, Belgium is going Holland and Germany is relaxing its bird flu measures.Greece urges EU cooperation on bird flu.This article from South Africa is urging the nation to prepare for bird flu now, rather than wait. It cites many pandemic preperation efforts around the world.Here's a high quality article from Gaithersburg, MD, where people are thinking through what they would do....telecommuting, drive through banking...you get the idea.Here's an update from Bhutan on the bird flu prep.Brunei is attending a bird flu meeting in China.CIDRAP on HHS urging businesses to think about the bird flu.CIDRAP on the news from China and Thailand.Yesterday, we ran ProMed with a report that said that research which showed widespread immunity to H5N1 in China was unfounded. Effect Measure follows up with an analysis of this report.