Wednesday, December 27, 2006

December 27 Flu Update--Happy Birthday to the Coming Influenza Pandemic?

Photo Courtesy Cassidy Norvell on Flickr.

It was two years ago today that I decided to blog the flu. Nearly every day since then I've posted the latest news on the avian flu. This is, in fact, my 693rd post, amazingly enough. Some days it takes a few minutes, and in busy seasons it can take hours. I've enjoyed it a lot, gotten nice feedback from people who read, and built a small following which is about 100 times more than I ever thought I would get.

The first post was on the discovery of AI in Japan.

For what it is worth, when I started I believed a pandemic could hit any minute. It wasn't that close then, but its closer now than it was two years ago. The question is whether we have used our time to prepare ourselves for strategic, society-level solutions.

I did it because I was interested in keeping up on the topic, and as I begin the third year, I still am. So, thanks for reading. Thanks for commenting. I hope you find it useful.

A third member of an extended family in Egypt has died. He was in the hospital for 10 days, for those trying to calculate exposure sequences. Could he be the index case? (Ducks were being slaughtered for a wedding celebration).

CIDRAP on the Egypt cases.

Recombinomics also on the Egypt cases.

Official WHO statement, strong on the exposure to sick poultry.

Now that the flu is back, Vietnam is warning that it could be widespread in the country before it finally goes away.

Effect Measure on the recent cases in Vietnam, the inevitable casting of blame, and the real story: the flu is entrenched and not going anywhere.

For those who say the bird flu is going away...deaths this year outpaced the last year years combined.

Flu reports in Asia has spawned a more watchful atmosphere at the airport in Manila.

Stars and Stripes says that a recent bird flu outbreak in South Korea isn't a threat to military forces.

Canadian Rx industry puts $1M into flu programs.

Canadian scientists say they have identified a new fact about how flu replicates

The study revealed novel characteristics of a protein, called NS1, that activates a key pathway in the virus's reproduction. This information will help the researchers learn how to create harmless influenza viruses that can be used as live vaccines.

The pathway can be thought of as an assembly line with a switch to turn it on, says Zhou. "If the switch is turned on, the pathway enables efficient production of more viruses. But only the NS1 protein can turn on the switch."



At 11:55 AM, Blogger Wulfgang said...


And a good day to you once again. Whether you know it or not, with your blog site, you are indeed providing an invaluable service to many around the globe. I found your motivation statement for starting the blog rather interesting, but not surprising. Many people expected an actual avian influenza pandemic to be the scourge of the world headlines in 2005 and 2006, and it hasn’t been. But no matter at this point, it’s immaterial, since I believe the virus is firmly entrenched throughout Asia, the Middle East and Africa, and we will see continual resurgences and predictable further emergent evolution in 2007 and 2008.

The most insightful article of your lot today, is again, by revere, in Effective Measure. Their article highlights the biggest problem the world faces today – false information, which leads to apathy and complacency. Their comment points out the skepticism of Vietnam being really “bird flu free” and concludes by saying the virus is thoroughly entrenched in the continents, regardless of whether governments report cases of occurrence, news medias are interested, or whether even it is detected. This is a very accurate observation and summary of what is going on in many third world countries today where H5N1 is endemic – victory is declared, cases are misreported (as pneumonia and other maladies), or not reported at all, the people surreptitiously continue with their dangerous poultry handling practices, farming and cultural habits, and the virus continues to percolate. Name any country in the news where H5N1 is reported – China, Vietnam, Indonesia, Cambodia, Thailand, Nigeria, Egypt, Iran, and this is predominately the case. Lack of adequate surveillance and reporting is rampant. This is all a vicious cycle of ignorance and folly, in my view – continual feeding of one of the apocalyptic four horses.

If anyone thinks all is well, well… then they are sadly mistaken. This period of false H5N1 quiescence is the most dangerous. It is very misleading. It is almost like the people who believe H5N1 is most lethal with a current fatality rate of 60-100% - when in fact it is actually not, because it is so confined and isolated within small family clusters. It is actually when the virus becomes more transmissible at lower CFR rates that it becomes really lethal to large numbers of people and it obviously hasn’t reached this point yet, but it slowly arriving there through efficiency. When it does reach this stage, my prediction is that we will see CFR rates all over the world board – differences over time, across different countries and continents, and across different age groups, before it finally stabilizes into true epidemic form. We're already starting to see this - think about it logically.

At that point, precision containment and quick control measures as well as intervention, will be the only way to thwart an actual pandemic. How many countries (or local state areas) in the world, realistically, in 2007 are fully prepared to automically implement these crucial procedures ? Not many in my view, when it actually comes down to it – lots of tough talk, but there’s very little hard core action in those plans when it comes down to it.



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