Thursday, December 14, 2006

December 14 Flu Update

The New England Journal of Medicine is prepared to report that vaccines for bird flu do not need to be a perfect match in order to be effective.

Suzanne Ohmit of the University of Michigan School of Public Health and her colleagues found that in the fall of 2004, Sanofi-Pasteur's FluZone vaccine was 77 percent effective and MedImmune Inc.'s Flumist worked in 57 percent of the cases even though the flu strain making the rounds that year was not selected for the vaccine.

Experts speaking in Indonesia urged the world to "beef up" its bird flu protection systems. The quote listed below gets to the nitty gritty of planning that people usually miss...

Drugmakers told the conference they were trying to get around simple but daunting logistical problems in developing H5N1 vaccines for humans. "Syringes and needles will be in short supply in the event of a pandemic," said James Young, president of research and development at MedImmune Inc, which markets a nasal spray vaccine that fights the common flu. "We are looking at changeable tips -- after spraying into the nose of one person, you can change the tip and go to the next person," he said.

Here Reuters recounts the ravages of past epidemics as a sidebar to the story above.

CIDRAP with an interesting story...the Institute of Medicine studied whether community interventions (covering your mouth, quarantine, etc) would help in a pandemic. The answer: maybe a little.

North Korea claims to have a vaccine for birds.

Myanmar continues to monitor bird flu.

The US has issued a warning that the bird flu could still mutate and cause a human pandemic.

The stories are trickling in from the Truth for America's Health Report on state preparedness. Here is Florida's.

Effect Measure on the report on the nation's preparedness.

Recombinomics notes that the Qinghai sequence has been found in the South Korean birds. He asserts that this demonstrates that the disease is being spread by wild birds.

An avian influenza committee ("The Akwa Ibom public enlightenment committee for mass awareness on Avian Influenza") is "taking off"

In China, the Vice Premier has urged the state to increase its efforts in bird flu prevention.

Korea Air reports people still selecting chicken for their inflight meal.

Harvard held a discussion group on the overall public health system, following along a common theme from Effect Measure....

The global response to bioterrorism and AIDS is increasing health system capacity in a way also useful if avian flu strikes, according to experts attending an interdisciplinary conference on Asian flus.

The bad news, however, is that vast disparities in health care systems still persist and, despite the expanding capacity in recent years, bird flu could still have a devastating impact.

For the fluwonks, I suppose this document might be interesting Illinois Schools guide to what to do during a pandemic.

Here's the actual document.


At 1:35 PM, Blogger Wulfgang said...


Of all the articles you published on your daily update today, the CIDRAP summary of the IOM Committee report, "IOM says community measures may help in a pandemic", really got my blood pressure thumping my temples.

You see, I'm used to bureaucractic committee's and reports. I have served in the federal service for nearly four decades, so, I feel like a real pro on the subject. Let me start by saying: if you want the lowest common demoninator, establish a "committee" to develop some findings. Another way to summarize committees, is that they are "a consensus for lack of leadership". This report prepared by a 13-member committee, chaired by Adel Mahmoud, MD, PHD, former president of Merck Vaccines, seemed to me to be pretty, well, useless.

I quote one of their apparent major findings - "It is almost impossible to say that any of the community interventions have been proven ineffective... However, it is also almost impossible to say that the interventions, either individually or in combination, will be effective in mitigating an influenza pandemic". Question: what does this double-speak mean ?

I quote another one of their key findings - "The committee's conclusion on the key question of community restrictions, such as closing schools and limiting public gatherings, is that they have a role, but the evidence does not permit any predictions about the effects of specific types of restricttions or the comparative effects of voluntary versus mandatory restrictions". Question: what kind of fecal statement is this ?

Out of the 11 recommendations offered by this report, only one is noteworthy and outstanding: one calls for the "development of 'decision-aid models that can be readily linked to surveillance data to provide real-time feedback' during a pandemic". The remainder of the IOM recommendations is the usual academic, pointless, noncommittal, bureaucratic, sensitivity derived, drivel.

Oddly enough, the IOM Committee didn't pick up on Dr. Howard Markel's (U of Mich), or Dr. Marc Lipsitch's, prelimary results, which indicated that " early interventions were significantly associated with lower peak rates and that early school closures were most closedly linked with lower peaks", and "evidence shows tht the more restrictions were used, and the longer they were in place, the milder the pandemic". These findings and statements sound pretty clear to ol' Wulfgang. So, two people managed to figure it out, through common sense, and the eleven person IOM Committer never left the runway.

And the Harvard University "interdisciplinary conference on Asian flu" looked to me like a waste of oxygen, also. As the School of Public health Dean Barry Bloom, said, "We're doing what a university does best... Not putting out fires, but sitting back and reflecting". Boy, this is some real high-powered action. Get a clue genious. The world needs firefighters more than it needs reflectors or philosopher's. At least in my opinion.

What the world needs is less "philosophy" about a pandemic, and more common sense, concrete specific recommendations, grounded in reality. Some results that people can use.

All you esteemed scholars out there studying pandemics, remember what was said two thousand years ago, still stands true today: "Certum est quia impossibile est" (translation - It is certain because it is impossible).



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