The Coming Influenza Pandemic?

February 25 Flu Update

Earlier on Saturday, Xinhua reported that two new human cases of bird flu had been diagnosed in the east of the country.

A Chinese girl in eastern Zhejiang province and a woman farmer in neighbouring Anhui province were currently in critical condition, Xinhua cited the Ministry of Health as saying.

PETER CAVE: Are you seeing mutations in the virus in Indonesia?

ANDREW JEREMIJENKO: Yes, that's a good question. We are seeing mutations in the human virus. We are not seeing that same mutation in the bird virus. And that's of great concern.

Basically, when you do an investigation of a bird flu case, you should try to find the virus from the human and match it up with the virus from the bird and find the cause.

Now, in Indonesia, the investigations have been sub-optimal, and they have not been able to match the human virus to the poultry virus, so we really do not know where that virus is coming from in most of these human cases.

PETER CAVE: Does it suggest it's going through an intermediary before it's infecting humans?

PETER CAVE: It's a possibility that we can't rule out. I think they really need to do a lot more investigations. So far the closest match we have to the human virus is from a cat virus. So the cat could be an intermediate. We really don't know what's happening yet. They need to do more studies, they need to get better investigators on the ground to work out what is happening in Indonesia, and it needs to be done urgently.

PETER CAVE: Can Indonesia do this on its own?

ANDREW JEREMIJENKO: I think they need international assistance. So far the investigations have been unable to match the viruses. It is poor communication between the Department of Health and the Department of Agriculture. There are many reasons, but they don't seem to be able to match the viruses from the human case to the animal case, and that is putting the world at threat.

Dr. Scott Dowell of the U.S. Centers for Disease Control and Prevention said it's difficult to predict the spread of the disease in the next few months, because public health officials have little experience tracking a disease spread by migratory birds.

"I'm not an expert on migratory birds carrying human pathogens. I don't know who is. We're going beyond our experience," said Dowell who heads CDC's global disease detection program.

The closest analogy he could think of is West Nile virus, a bird-associated illness that began in Africa and landed on the East Coast of the United States in 1999. Within four years, it had spread to the West Coast.

As to where the virus has the best chance of morphing into a more serious human threat, Nigeria, where many people live close to their chickens, poses a particular threat. Its 800 federal veterinarians lack the support they need to combat the disease, said Dr. Peter Cowen, former director of a WHO coordinating center in veterinary public health.

posted by Orange @ 8:31 AM