Wednesday, March 29, 2006

March 29 Flu Update

The New England Journal of Medicine drops today's bombshell. There's certainly limited optimism in the blogosphere for the flu vaccine, but this data (covered in NYT) suggests the situation is worse than feared.

A dose 12 times the amount used in a standard flu shot protected just 54 percent of the people in a study being described Thursday in The New England Journal of Medicine.

That level of effectiveness is "poor to moderate at best," in the opinion of Dr. Gregory A. Poland of the Mayo Clinic, who wrote an editorial accompanying the report.

Our other bombshell--or bombshells--are coming from the pens of Revere and Marc Siegel. An alert reader pointed me to their rather bombastic fight. You are aware, no doubt, that Marc Siegel is someone who thinks too much is being made of the bird flu, and you are probably aware that Revere doesn't think much of Siegel's views. Finally, Siegel is on a book tour, and his links have been on our site the last couple of days. Suffice it to say he's toeing the same line he always has.

So, Revere blogged. Here is but a sample.

I suggest he read the Nature paper before commenting on it (or he can read the Effect Measure post on it if reading the paper itself is too arduous). I would love it if he would explain the meaning of a "large mutation" and a "small mutation" and where in the article it says that we are two of each away from the next pandemic virus. I have just re-read it and it says no such thing. I would love it if he would explain where it says the virus attaches deep in the lungs of birds, since only human tissues were used in the study. I would love it if he would tell me where the paper says we can't transmit the virus to each other.
Siegel reacted rather strongly, via comments on the Effect Measure site...also emailing the comments to Revere with the subject line "coward." Here's a taste.

i dare you to allow me to answer your posts in print or to engage me in an open debate. your distortions of what i write are childish and extremely unprofessional.
you are discrediting yourself as a physician and as a public health expert.
FYI - i have received many congratulatory letters on my latest articles from scientists all over the country.

Later, Revere responded again. No excerpt here, but suffice it to say that "pipsqueak" was used.

There's a second death in Egypt, and three more confirmed cases. WHO reports.

Article acknowledges that bird flu would be a disaster in the Congo, yet there are clear and present problems which must be addressed more urgently now.

Indian vets say that bad blood samples are hampering the nation's ability to fight bird flu in poultry.

Dr. Fauci with a dose of reality....bird flu is likely to arrive in US on an airplane.

In Alaska, they will test pond and river water for traces of bird flu (does this mean they are testing wild water?)

Vietnam has vaccinated 6 million fowl against the bird flu...the national poultry population is 220 million.

The EU will fund 50% of any aid given to the poultry sector to compensate for reduced demand during pandemics and their scares.

Toronto says SARS helped them prepare. Here's something I haven't seen before.

Ontario’s influenza plan aims to free up overwhelmed hospitals by providing telephone and Internet home care to less vulnerable patients.
Official with the Chinese Medical Association says country needs better education on the bird flu. Last two people who died waited too long for treatment.

The Leavitt Flu Tour was in Utah.

An AI task force member from the Asian Development Bank is lauding Indian response to the bird flu.
Morgantown, WV, is making its bird flu plans.

HealthCanada warns Canadians against fradulent claims.

Roche has licensed another Chinese company to make Tamiflu.

CIDRAP on a dead Egyptian human and a sick Swedish mink.

FDA approves Relenza to prevent (not treat) flu...

A scientific meeting in Geneva will cover Tamiflu and Relenza, and include a careful analysis of the date to make sure we are going in the right direction. Revere notes here that some people think Relenza may have been overlooked.

CIDRAP gives us the staight scoop....

Four large, placebo-controlled studies have shown the effectiveness of Relenza for preventing flu, the FDA reported. In two trials, the incidence of flu in households whose members received the drug was 4.1%, versus 19.0% in households where people received a placebo.

ProMed on Cambodia and Egypt. The Cambodian story says that a young girl who died was from a village where no birds with flu can be found.


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