Saturday, August 19, 2006

August 18 Flu Update

Another woman has died in Indonesia, as cluster concerns continue to grow.

Indonesia is continuing to investigate the cluster. My note: in this one, the people don't all live in the same house, so it if is a cluster, it would seem to indicate a higher level of contagiousness.

As both men developed symptoms on the same day, epidemiologists assume that they acquired their infection from a shared environmental source, the WHO said.

``The currently recognized incubation period for H5N1 infection of 2 to 8 days makes human-human transmission between the two highly improbable,'' it said.

Effect Measure notes this, and how confusing it is to sort out the exact situation with media reports. Revere is waiting for the dust to settle.

ProMed on the Indonesian cases. Note the mod comment:

The 2 young men could have acquired their infection from a shared environmental source. The currently recognized incubation period for H5N1 infection of 2 to 8 days made human-human transmission between the 2 highly improbable.

Recombinomics has a local translated report on another potential new case.

A Thai scientist says that bird flu in that country is not closer to human transmission.

The UN has warned that bird flu in endemic in Asia, and this compounds the problem with the disease in people.

To wit: more outbreaks in birds in Cambodia.

Some have said that vaccine makers are using too many old versions of the bird flu virus in developing their vaccines. There is evidence that the virus is diversifying in real time. WHO has now joined this chorus--of course, with a caveat not to be alarmed about the diversification, but plan for it when developing better vaccines.

CIDRAP has this story as well, which may be the most significant of the day.

Michael T. Osterholm, PhD, MPH, a leading pandemic preparedness expert, said recognition of the three subclades demonstrates how diverse the virus is and how dynamically it is evolving. He said the WHO notice is more important for the questions it raises than for the vaccine guidance it contains. "Does that mean H5N1 is closer to becoming an agent that can readily transmit human-to-human? That's the billion dollar question," he told CIDRAP News. Osterholm is director of the University of Minnesota's Center for Infectious Disease Research and Policy, publisher of the CIDRAP Web site.

Many experts who follow the ongoing analysis of the H5N1 virus sequences are alarmed at how fast the virus is evolving into an increasingly more complex network of clades and subclades, Osterholm said. The evolving nature of the virus complicates vaccine planning. He said if an avian influenza pandemic emerges, a strain-specific vaccine will need to be developed to treat the disease.

Effect Measure weighs in on this, as well.

Effect Measure says we need to understand the full range of animals who can get and transmit bird flu. He wonders what effect dogs, cats, rats, etc, might play in the transmission of the disease.

Of course H5N1 could be infecting many other animal species (cats, rats, etc.) but they still might not be important sources of human infection if the virus is not easily transmitted from them to humans. But some of them might be important, depending on the various modes and pathways of infection. Moreover, a virus which currently is not easily transmitted from some non-poultry source could become so as it adapts to its new biological and ecological environment. More information on viral survival in the environment, transmissibility by other routes than inhalation, and a broader consideration of affected species is urgently needed. Efforts might usefully be concentrated on animal species commensal with humans, such as companion animals and domesticated livestock and small rodents that live in human settlements.

Interesting: Thailand has noted that screening a healthcare facilities is not effective, because some working class people go straight to the pharmacy. So, pharmacies are being enlisted to screen for bird flu and other infectious diseases.

An article in Nature says that if you are going to vaccinate a flock, you should at least vaccinate 95% of them to be effective.

An article by two Chinese scientists in the British Medical Journal attempts to draw lessons from SARS and apply them to bird flu.

Zimbabwe has banned poultry imports from outside the Southern Africa Development Community.

The Chairman of the Gordon County Board of Health (GA) has warned local people that bird flu would be a big problem in US.

Lee County FL is preparing its bird flu plan.

"I still believe in a place called Hope" Arkansas is doing bird flu planning.

Training is underway in Piggot, AR, too.

Vietnam is tightening its bird flu quarantines as it desperately tries to remain bird flu free.

IBM and South Florida are looking for $18M to develop a supercomputer to help fight the bird flu.

The supercomputer would be used to study bird flu and other infectious diseases. Eventually, it could help to transform the city into a research mecca with a university-affiliated Center for Emerging Infectious Diseases at its hub, attracting scientific and technological talent and businesses who want access to the King Kong computer.

Vietnam is banning the internal transport of poultry on public vehicles.


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