Saturday, April 01, 2006

April 1 Flu Update

In addition to the dead girl in Indonesia (yesterday), note that another man is confirmed ill with H5N1 there as well.

David Nabarro holds press conference, declares flu "scare" over. Marc Siegel made WHO Director-General.

Recombinomics with the story of possible H5N1 in penguins in Antartica.

A dead swan 160Km of Prague is the nation's fourth H5N1 bird.

They think they are very prepared for the flu in Portsmouth, NH.

Russia is preparing for human trials on its bird flu vaccine.

The US--Canada--and Mexico (North America) have pledged joint flu action.

The Andean nations have hammered out joint bird flu plans, too.

Somebody tried to smuggle 16,000 chickens from India to Bangladesh, but Bangladesh caught them.

Local story on same issue.

The Times of London says that bird flu victims could end up in "plague pits." (No joke here...burial is a legit issue.)

A confidential Home Office report says as many as 320,000 people could die from the H5N1 strain of the virus if it mutates into a form that can readily be passed between humans. It says the emergency services may have to enforce mass burial. “Common [mass] burial stirs up images of the burial pits used in the great plague of 1665 — where in London 70,000 people died,” it adds.

The report, Managing Excess Deaths in an Influenza Pandemic, dated March 22, says vaccines against bird flu should not be seen as a “silver bullet” solution and “will not be available in the first wave of a pandemic [possibly longer]”.

Vical has a DNA vaccine with postive preclinical results.

Speaking of vaccines, more on the NEJM report, effectively halving the available vaccine supply.

Here's Helen Branswell on the Vaccine story.

With current worldwide flu vaccine production capacity, a dosing regime of two shots of 90 mcgs apiece would mean approximately 75 million people around the world - or just over one per cent of the global population - could be vaccinated in the first year of a pandemic.

The director of the U.S. National Institute of Allergy and Infectious Diseases, which is funding a series of clinical trials into an H5N1 vaccine, suggested the dosing requirements were "sobering news."

And Dr. Anthony Fauci said more research is underway to try to find ways to lower the amount of antigen needed to protect against the H5N1 flu strain, through the use of chemicals known as adjuvants that boost the immune response to vaccine

Effect Measure weighs in on the Branswell story.

So in addition, GSK plans to test a novel adjuvant, which they will not identify except to say it is not their proprietary adjuvant, MPL (monophosphoryl lipid A). That raises safety and licensing questions. There is always a risk that the added benefits for immunogenicity provided by an adjuvant will be balanced by some adverse reaction. The most likely would be increased frequency of pain and tenderness at the injection site, granulomas or sterile abscesses there. (A granuloma is a non-specific inflamatory reaction appearing as a reddened, raised bump. They are usually not serious.) Malaise, fever and other systemic reactions are also seen and not uncommon. However, the immune system is complicated and sometimes reacts in unexpected ways. Phase I and II clinical trials are mainly designed to test the safety of a vaccine, with or without adjuvants.

ProMed on a sick fourth bird in Switzerland.

ProMed confirmation on Indonesia, Jordan, and a new suspected case in Azerbaijan


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