Wednesday, February 15, 2006

February 15 Flu Update

"Something is very wrong." (Dr. Bob Gleeson)

The news just keeps expanding, it seems. Flu cases cropping up all around the world, big news from CIDRAP. Hopefully, I've been able to order this in a way that makes sense, but its increasingly hard.

WaPo on yesterday's flu news, including Iran and Italy.

The bird flu has entered Hungary--swans, again.

ProMed report says that the swans are H5 only, but it wouldn't surprise anyone if H5N1 was confirmed once it gets back from the all night lab in England.

Two birds died in Niger, which borders on Nigeria. Given the track record, virtually certain H5N1 diagnosis. Mod says it sounds like poultry, not wild birds.

There is well justified concern in Indonesia, where the human infection rate is picking up. The country is pledging to more carefully monitor even areas with no record of infection.

Note this on clusters:
The country's suspected sixth cluster of human infections, in two adults and their two-year-old daughter, has heightened concerns.

CP, the highly skeptical ProMed mod says that the clusters are not necessarily going to lead to H2H any sooner.

The Swiss have elevated their bird flu threat level. Poultry are not to be kept outdoors.

New York Times also writes on what is being done in Europe to protect poultry.

The Lowry Institute of Australia has issued a new report which attempts to project the "worst case" of the flu. How about 142M deaths, and a $4.4 trillion economic impact--equal to the entire Japanese economy.

Here's a link to the full report.

Key FAO official calls for better coordination, and better compensation for culled birds.

There's an official bird flu alert in Southern Iraq.

There's a massive new outbreak among birds in southern Russia.

Nigeria says its testing poultry farm workers for note--do these tests ever turn up asymptomatic cases?

ProMed on suspected bird outbreak in Denmark (a virual certainty), panic bird selling in Nigeria making the situation at work, Greek update and more on a massive Russian outbreak.

Recombinomics notes that Poland may have an outbreak, too.

Here's something that could become far too prevalent--major slaughter conducted in Zambia based on a false alarm.

In Nothern Thailand, another set of cases is said to be negative.

The EC is preparing to introduce protective measures in Germany, where an H5N1 bird was reported yesterday.

Here is an EU press release on the co-funding of surveillance plans and on a ban on certain types of poultry.

Reuters is at the CIDRAP Business Pandemic conference, and their writer seems to have the idea down. Here's the lead today. Peter Sandman makes an appearence, too

When burying a body in the backyard, don't put it too close to the septic system. That was one piece of advice offered on Wednesday to a business conference on preparing for a potentially lethal bird flu andemic.

Preparations for a global flu pandemic, which many experts believe is overdue, have begun but the grisly details are horrific and the number of sick could quickly overwhelm the health care system.

Here's CIDRAP's write up on its event. I suspect every syllable of the CIDRAP stuff in must read, though I have only skimmed. Will print out for some bedtime reading tonight.

Osterholm sought to background the audience on the science of pandemics in an hour-long talk he called "Influenza 101." A major theme was that recent research has uncovered chilling similarities between the H5N1 avian influenza virus now circulating in Asia and the H1N1 flu virus that took the world by storm in 1918.

Researchers recently have concluded that the 1918 virus jumped directly from birds to humans, which bears comparison with the way the H5N1 avian virus is infecting some humans, though it has not spread from person to person. Further, certain mutations seen in the 1918 virus have also been found in H5N1 viruses, Osterholm said.

"I can't come to any other conclusion than that H5N1 and the 1918 H1N1 [viruses] are kissing cousins of the highest order," he said.

He warned that modern medicine won't offer a great deal of protection in the first several months of a pandemic flu, if ever. Given the time it takes to develop and produce a vaccine for a new flu strain, "Don't count on a vaccine to get us out of this, at least in the first stage," he said.

The flu drug oseltamivir (Tamiflu) also has its limitations, he said. "The way we use Tamiflu now may not work for H5N1—it's likely to be needed at a much higher dosage for a much longer time period."

CIDRAP also polled their attendees, and found only 18% had a pandemic plan.

Helen Branswell was in Minneapolis for the CIDRAP conference (where else?) As usual, she finds unique insights. Such a pandemic, the easy answer is to telecommute, isn't it? Are the servers ready for that? What if power loses take ATMs down? Cash Panic? More...

"There's lots of movement in the highest levels of corporate America," Falvey said. "They're taking it very seriously."

For her part, Cooper wasn't convinced much of the business sector has recognized that mass human illness would have unanticipated consequences outside of the health-care sector.

"I do not believe that businesses are prepared. I certainly don't believe the infrastructure is prepared," she said, referring to the vast network of services -- garbage removal, electricity, water systems -- that keep society functioning.

CIDRAP also did a section on the impact on infrastructure...

and on routine health services.

They held a similar seminar in Thailand.

Ghana is about an hour from Nigeria, and today their media took a shot at explaining the bird flu to the country.

A Canadian company has developed generic Tamiflu, and is preparing to ask the Canadian government for permission to export it to developing countries.

Interesting article from Hong Kong, noting that the flu causes lots of problems, including counterfeit drugs.

Bulgaria tells its citizens that it has five different tests for bird flu--as well as enough medicine in case things get bad. Of course, on these questions, time will tell.

Effect Measure on the migratory bird debate. Apparently, reports today in Nature and Science say the question is still open. Revere asks why it can't be both.

Crofsblog has this from Nigeria, as WHO officals were discouraged from travelling to flu sites.

Dr. Gleeson says he is getting increasingly nervous, "for a normally calm guy." Don't look to Europe where people don't live with their chickens--look to Africa, Asia and the Middle East.

Something is very wrong. The next move is up to H5N1--whether it wants to stay B2B with rare B2H or go H2H, now is the time. The next few weeks will be crucial.


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