June 23 Flu UpdateIn the big flu news for the day, WHO has announced that the virus did mutate in the family cluster in Indonesia. There are strong statements that the mutation DID NOT make it more able to pass from human to human (what would you expect?) Still, its the first evidence we have seen of a mutation of that kind...and, (my view), no one really knows what the virus needs to do to flip the switch. Here, we link to Helen Branswell.
"As far as we know they don't correlate with any particular functional changes about the virus," Dr. Keiji Fukuda, co-ordinator of the WHO's global influenza program, said in an interview from Jakarta. "It doesn't confer any greater transmissibility or any greater pathogenicity."
Tracking single cases or small clusters is like watching sparks. Each one might trigger a fire - but to date WHO sees no signals that's happening, Fukuda said.
Here's a wire story on the same topic. US experts say that it is "noteworthy" but not enough to change the pandemic phase. Note also, the wonder at being able to do this kind of detection in a remote Indonesian village...(my note) can we really not say that technology and connectivity is giving us a significant advantage over past pandemics?
Promed on the cluster story. Note mod comment (CP) that says asks, first, what initiated the cluster, and second, what made this family so susceptible?
Finally, CIDRAP covers this story.
The other big news from yesterday was the Chinese scientists writing a letter to NEJM that said China had H5N1 two years earlier than they had ever admitted. Then, the scientists (or some) tried to withdraw the letter. Branswell again.
The story gets stranger. The researcher in whose name the retraction email was sent says he didn't send it...making you wonder who did?
On Wednesday, the journal said it had received an e-mail signed with the researcher's name that requested the letter reporting the case be withdrawn from publication. Wu has since telephoned the journal's editors and sent a fax denying he had made any such request.
WHO has asked China to clarify the facts around this case.
Effect Measure writes on the twists and turns in this story.
Helen Branswell is back one more time, with a story on the Chinese flu vaccine which is showing some results.
A Chinese-made H5N1 flu vaccine has been shown to provoke good immune responses at significantly lower doses than those made by most western vaccine manufacturers - an early finding that could help other companies learn to stretch the limited global vaccine supply in the case of a flu pandemic.
But the formula used by the Chinese company - vaccine made using whole viruses, rather than viruses broken into particles - is no longer commonly made by western flu vaccine manufacturers.
And they appear hesitant to shift gears on their year-to-year vaccine manufacturing processes to improve their output for a pandemic - an extraordinary event the timing and severity of which cannot be predicted.
"Companies that have been making split-virus vaccines are reluctant to test whole-virus vaccines because this would require them to get new regulatory approval for their process and this would cost them a great deal of money . . . for a specific product that they may never market," said Dr. David Fedson, a retired academic and flu vaccine industry expert who lives in France.
Bird flu panic has hit Zambia, and like everywhere else, chicken consumption is down.
Indonesia is upgrading a bird flu lab to meet WHO standards.
Burma is going to restock areas hit by bird flu culling.
The European Food Safety Authority has determined that there is no evidence of bird flu being transmitted through the normal consumption of chicken and eggs.
More on wild bird surveillance in Oregon.
CIDRAP has this report from a study that says that mass vaccination programs make it hard to detect human cases, and that when you have areas with low human cases and high vaccination, you should interpret results carefully. Report also notes that there have been strong warnings that bad vaccination programs are dangerous.
Surveillance for H5N1 cases in humans," the authors write, "is becoming harder where poultry immunization is widely but imperfectly implemented, because the marker of local poultry deaths for human case detection is being lost.
"Declines in the number of sporadic human cases in countries with poultry vaccination programs should therefore be interpreted cautiously."
Letter to editor in Chattanooga says that we should vaccinate for bird flu with what we have now--what could it hurt.
Promed on OIE reports from Hungary--more bird outbreaks of H5.
ProMed reports the June 2 Danish case was H5N2.
Recent sequences released show evidence of recombination--from Recombinomics.