Friday, November 24, 2006

November 24 Flu Update

A new antiviral is out--Peramivir. Note: it must be injected.

Peramivir has two important advantages over the other therapies. Tamiflu, which is taken orally, and Relenza, which is inhaled, are difficult to administer to unconscious patients. Peramivir does not have this problem because it is injected, and the first human studies have shown that it also reaches the bloodstream in higher concentrations and remains active for longer.

The new drug would also provide a valuable alternative if a pandemic strain were to evolve resistance to Tamiflu, the front-line treatment that has been stockpiled by many countries, including Britain. Some H5N1 viruses have already shown resistance to Tamiflu, and if such a strain became dominant the drug would become useless. This week, a report from the Royal Society urged the Government not to rely on it exclusively.

ProMed reports that the reported avian case in Sudan was negative. Note the mod comment that they warned us to be careful on this one in the first place, and then the mod takes a shot at the media.

ProMed on the South Korea situation.

More on the NEJM studies...quick tests for bird flu are often inaccurate.

ProMed posts on the NEJM articles as well.

To date, surveillance in Ohio has revealed no bird flu.

Canada has added to its bird flu drug stockpile with more Relenza.

A researcher from Mass. went to Alaska to held in the surveillance effort and he spoke to the Pembroke Watershed Association.

A similar story from a woman on faculty at Central Michigan University.

Brunei and Malaysia continue to fight the bird flu.

South Korea says its bird flu was low path.

Revere writes on the international readership of flu blogs...noting that his readership has a strong Northern Europe contingent. He even ran a cool map.

A cranky professor asks if taking a "chicken little" approach to bird flu was right. (Perhaps the professor should acquaint himself with the work of Peter Sandman.)

We all saw the infamous "shelter in place" warning the US embassy sent to US Nationals living abroad...telling them to be prepared to survive on their own for 12 weeks in a pandemic. Rachel is a 26 year old living in Belgrade, and here is her reaction to the email.


At 9:38 PM, Blogger Wulfgang said...


I just had to shake my head in disbelief when I read the article "Pustolovina: adventure in Serbian". If I were Rachel's parents, I would have a talk with her about the threat of a possible pandemic. But I doubt they will. Most parents, and tourists naively believe that if they run into a jam overseas, the U.S. government is going to bail them out, free gratus. Similar to Lebanon. During a pandemic, nothing could be farther from the truth. As the State Dept warning clearly says, "... prepare to shelter-in-place at least two, and up to twelve weeks". It also warns succinctly, " ...airlines may cease operations" and "travel restrictions may impede people from returning to the U.S. or fleeing to other countries". I don't have any trouble understanding the message. Rachel sounds like a student and is totally clueless as to what might happen and how she may be treated in Serbia, if avian influenza evolves into epidemic mode. I have a better chance of flying with fabricated wings, than she does knowing how to acquire potable water. Too bad, so sad.

Having lived overseas a number of years myself, and having gained first hand knowledge of how typical Americans (living in other countries) react to a crisis, a pandemic will be a personal disaster of monumental proportion to nearly all of these individuals and their families. One of the cardinal rules one follows whenever living in a foreign country is to always, always, always, have one or two escape options available, where ever you live. And I don't mean a commercial airline ticket or a taxi.

The State Dept issued this warning several weeks ago for a specific reason, based upon many sources of information it believes to be accurate. One doesn't need to be a neurosurgeon to understand the warning and its implications.

Rachel dear girl, if you thought the e-mail distribution list warning you got from the U.S. Embassy in Belgrade was "horrifying", you ain't seen nothin' yet. Do you honestly think our government would send out this warning just to scare people, without any basis ? The cavalry isn't coming to rescue you Rachel - that's the real message.


At 9:49 AM, Blogger Orange said...

I guess my reaction was a little less strong. I think that while the State Department's advice could be prudent, it is extreme to the point where people will have a hard time taking it seriously. No doubt, in an absolute worst case, a person would be glad they had done each one. Problem is, as Sandman has written, if you paint the absolute worst case, people instinctively decide that it isn't very likely to occur. It is simply how people process risk.

I have corresponded with people living overseas, and I understand how alone and vulnerable people would feel. At the same time, a traveler in Slovakia told me that the sense of community was so strong in his area that he felt safer than he would have felt at home.

At 10:34 AM, Blogger Wulfgang said...


Sorry for what appears to be a strong reaction. I am one of the few people who have actually worked several years in our embassies overseas. Generally, when a crisis erupts, U.S. citizens flock to them and demand that they be assisted, and depending upon the situation, it may not be possible. Or, in the case of vacationers or students, the relatives, friends and parents make unrealistic demands. During a pandemic situation, it will not be possible for many weeks or months to assist anyone. We may be truly in a state of national and world-wide emergency.

I saw first hand many situations where the State Dept could not provide any assistance. For example, when tourists got involved in illegal activity, or fell gravely ill. Those individuals were pretty much left up to their own resources to sort out the situation, unfortunately. And finally, to complicate things, most travelers are not fluent in foreign languages, so they are at a tremendous disadvantage even communicating their needs and situation. The saddest cases I saw were actually "missionaries" and their family who had no clear idea of the hardships they would be exposed to, once they started living in a foreign third world country. They usually had few resources to get back to the U.S. and their churches pretty much abandoned them. Embassies usually have very limited funds to help individuals in these situations.

I can easily see during a pandemic situation where people could be in for the shock of their lives. People like Rachel better beware.



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