Saturday, March 25, 2006

March 24 Flu Update

Two more deaths in Asia. The Shanghai death we reported earlier has been confirmed, as has one in Cambodia, the first there in nearly one year.

In response, Shanghai is ratcheting up its alert level.

WHO reports on Shanghai. She was a migrant worker, but there are no reported bird cases in Shanghai.

CIDRAP on China--42 people are under observation.

WHO on Cambodia, a 3 year old girl who is said to have played with chickens.

ProMed on Cambodia and China.

Poland confirms H5N1 in another bird (a hawk).

This report says the bird flu has been found in Jordan, but no human cases.

The Palestinian Authority will begin culling chickens in Gaza.

Has bird flu reached Gaililee, nothern Israel?

CIDRAP on the middle east cases.

ProMed on the Middle East, and on a UN report that says bird flu might present a threat to endandgerd mammals.

Greyhound Canada is going to stop transporting birds.

China is employing RFID to fight the bird flu.

Azerbaijan warns that spring will bring fresh outbreaks.

Bird flu spectre haunts the poultry industry in Pakistan.

Argentina has purchased 5 million courses of Tamiflu.

For those scoring at home, this one scores against the migratory bird theory. Or, at least, the migratory bird ONLY theory. An outbreak on a French turkey farm is said to be not explainable by migratory birds.

ProMed on this report as well. Note mod comment. If you're looking for a simple answer, its probably not there.

Escondido, California will hold public bird flu forums.

Vietnam says it has synthesized the main ingredient in Tamiflu.

An Insurance Industry trade paper looks at Tamiflu risk adjustment in Alaska.

Effect Measure jumps in on the "deep lung" issue, with a kind word for the article we unearthed when the story came out. (As always, thanks for reading). Here's his conclusion, which follows must read scientific analysis.

At this point we don't know. The investigators speculate (in the news stories more than the papers themselves) that the reason bird flu is not as "catchable" as ordinary flu is that its residence deep in the lungs makes its transmission more difficult. There is no mucus in the gas exchange units so coughing and sneezing is less likely to create a virus-containing aerosol. Or so it would seem. In truth, however, we don't know the main routes of transmission. Gas from the alveoli (the deep air sacs) is certainly expelled on exhalation, likely contains virus, and once outside the humidified environs of the respiratory tract would rapidly dessicate (dry up) and could form droplet micronuclei. The assumption that virus deep in the lungs is less transmissible might be correct but it has not been shown. Other factors might be involved. Neither paper tested the transmissibility question, which remains pure speculation (although not implausible). The Japanese paper also points out that if the virus were to develop the ability to dock with α-2, 6 cells, either in addition to or instead of α-2, 3, we could have a nasty actor on our hands. One isolate from Hong Kong in 2003 seems to have this ambidextrous character, although most H5N1s do not.

Today, we link to this article from Recombinomics. He looks at the Shanghai case, and calls again for more open disclosure of data.

It was important to link to him today, because he also received a moment in the sun, as Dr. Niman was profiled in the Wall Street Journal courtesy of Nick Zamiska. He's much maligned and often criticized (even in comments posted to this blog), and occasionally out front of things, but he is also educated and informed with a valid perspective. Further, when this blog started in December 2004, he was often the only source reporting flu news anywhere. Cheers, Dr. Niman.


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