Sunday, December 31, 2006

December 30 Flu Update

The initial news was that four people were under suspicion of bird flu in Vietnam. This report from the Vietnamese press says there are actually six. They are in the same family, and are reported to have all eaten sick chickens.

More on the news from Vietnam.

ProMed on Vietnam.

Note that Tamiflu has been employed with these patients.

The Agriculture Minister in Vietnam is calling for stronger action against the bird flu.

ProMed is clarifying the actual number of cases due to confusion over reports from Egypt.

Some local efforts to combat the bird flu in India.

The government of Indonesia says that bird flu remains a threat to the nation in 2007.

Revere blogs this news....

The Federal Government in Nigeria is compensating farmers for culled birds.

Helen Branswell says that we should add emergency preparedness to our 2007 Resolutions.

Tech Blog on how the image at the front of this blog was developed, and how it could be used (hint: its a flu virus).

Saturday, December 30, 2006

Breaking News--Four suspected cases in Vietnam

All four people from the same family....

Friday, December 29, 2006

December 29 Flu Update

Situation in Egypt is called "grim."

On the current bird flu situation in Egypt, Egyptian Health Ministry spokesman Abdel Rahman Shahine told Xinhua that the situation seems to be dangerous but it is under control, specially as people start to recognize how dangerous the virus is and directly inform the authorities of any suspected cases.

The US government says it has met 90% of its objectives for bird flu prep from six months ago.

Michael T. Osterholm, PhD, MPH, director of the University of Minnesota Center for Infectious Disease Research and Policy (CIDRAP), publisher of the CIDRAP Web site, said he applauds the Bush administration for issuing a progress report on pandemic preparedness. "But we really have to ask ourselves the hard question 'What does it mean to be prepared?', and right now, I don't think we have a clue," he said.
Here's a link to the actual report.

ProMed on Vietnam...strong efforts with internal checkpoints to help stamp out the bird flu.

Jordan says it is still vigilant against the bird flu.

Researchers in South Korea say that travelers are not likely to catch the bird flu.

Indonesia has allocated $61M for bird flu prevention in 2007 to chase their goal of no human cases.

Amador County, CA, is preparing for a pandemic.

An official from a travel insurance company says that bird flu deaths could be reduced by immunizing against secondary diseases that come in after the flu.

From Budapest, the new flu risk is complacency.

The University of Maryland is testing a cell-based vaccine in clinical trials.

Businesses in the Research Triangle, NC, are preparing for pandemics.

Effect Measure evokes a earthquake zone building code metaphor to look at what case fatality trends mean for the bird flu.

Letter to the Editor in Salem OR calls for poultry to be removed from residential neighborhoods due to risk of bird flu.

December 28 Flu Update

A third province in the Mekong Delta is reporting bird flu outbreaks among birds.

In response, Vietnam continues to preach awareness.

Effect Measure on claims from the Philippines that there is no bird flu in that country. Post shows a map that would suggest that if there isn't bird flu in the Philippines, there should be...then doubts the efficacy of recent security measures.

From The Daily Mail (UK)...claiming British scientists are on the verge of a universal Influenza A vaccine that would last for years (This will have some credibility when the BBC picks it up).

Azerbaijan is continuing bird flu surveillance, though they say there are no cases among birds recently.

A Christian Journal in France reminds its readers that Churches might have to close if the bird flu strikes.

The Deputy-Director of Bangkok Health says the disease is now local--the government has the ability to contain it if there is an outbreak.

Interesting, honest article from Saudi Arabia--people are aware of the bird flu, but losing vigilance as the threat is perceived to fade.

Globe and Mail on Christmas tree disposal notes that pine trees can be used to make Tamiflu.

Leading indicator of more flu? Indonesia is investigating 22 mysterious fever-related deaths over the last two months. Watching and waiting advised...

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."


Tuesday, December 26, 2006

December 26 Flu Update

OK, we're back in the saddle. Nice holiday, enjoying some time off.

The big news during the break was that two people have died of bird flu in Egypt. A 30-year woman died Christmas Eve and then her niece died the next day. Obviously, that pattern will get people's attention.

Effect Measure with another excellent post. Knowledge--or, put another way, ignorance--isn't holding people back in Cambodia from proper flu control measures, and they probably aren't elsewhere, either. It revolves around a lack of adequate compensation. In a way, education is taking the easy way out.

Australian paper lists bird flu among predictions that did not come through in 2006.

Promed with a posting on recombinants found in nation's recently, including a correction.

ProMed on OIE report from Vietnam--not discrepancy between number of birds reported infected and number of birds reported culled.

ProMed says live poultry markets in China have been closed permanently.

Vietnam continues to scramble with its latest flu outbreak.

Saturday, December 23, 2006

December 22 Flu Update--Christmas Edition

Readers, this will be the last update of this blog until December 26, the day before we will have a little second birthday party for the blog. In the meantime, we're going to have a Merry Christmas at our house, and I hope your house enjoys the season's blessings as well.

There is a new bird outbreak in Indonesia.

The most serious bird flu problem today might be in Nigeria.

More on the report that 62 million could die in a 1918 style pandemic.

Helen Branswell (back on the flu beat) writes on this report.

A U.S. infectious diseases expert challenged the paper’s suggestion that the developed world would get off relatively lightly from a 1918-like pandemic, saying the study and an accompanying editorial underestimate the effect of globalization on supply of essential goods and overestimate the capacity of developed world medical systems to cope with a crush of gravely ill people.

"The paper and the editorial have no sense at all of a modern global just-in-time economy, where the kind of drugs and medical services that they assume will be available in a modern world just won’t be there," said Dr. Michael Osterholm, director of the Center for Infectious Diseases Research and Policy at the University of Minnesota.

Effect Measure has its usual high quality thoughtful post on this report...essential to understanding this report in the context of December 2006. (Update: see Wulfgang's comments...I just read this article in depth, and it is fascinating and a must read.)

This paper reinforces what we already "know" but often refuse to acknowledge. Whatever the analysis, the bottom line seems to be that the best way to protect ourselves is to have a robust and resilient society with an intact, effective and functioning public health and social services infrastructure. It is highly likely that the variable per capita income is a surrogate for the benefits those things bring to a community's health.

How many death's will it take before we know, that too many people have died?

CIDRAP (where Dr. Osterholm is Director) also has this story.

South Korea has continued reports on culling.

The bird flu is back in Vietnam, and the government says vaccination is the key to stamping it out.

Wire story on how Asians are scrambling to stamp out this latest re-emergence of the flu.

Effect Measure also looks around the world and notes that the virus does not care if we believe it is present or not.

ProMed has an EU report on the state of the virus...heavy emphasis on the animal nature of the disease and improving veterinary services.

Nice story from New Jersey that details how bird flu might hit a local community.

Surveillance is ongoing for bird flu in South Carolina.

CIDRAP on the battles on multiple continents as 2006 comes to an end.

Cameroon has put money into the bird flu fight.

A massive bird registry has been created in Britain.

Experts on VOA say that the world made progress in 2006 on a number of diseases, including bird flu.

Friday, December 22, 2006

December 21 Flu Update

South Korea reports a fourth outbreak of flu among birds.

HHS has asked the public to contribute comments on how to allocate scare vaccine during a pandemic.

We blogged earlier in the week on President Bush signing a hazard preparedness law, and we wondered out loud what some of the blogosphere's wonks would think of it. Revere weighs in here.

There are some good things here. It is still just enabling legislation and has no money attached to it and lots of blank spaces that need to be filled in. Getting the public health responses out of Homeland Security and into DHHS is a good move. For the rest, we'll just have to wait and see. This administration has a poor track record.

ProMed covers flu stories from around the world.

There is a new projected/estimated bird flu death toll....62 million.

The geese in the St. Petersburg Zoo did not die of bird flu.

Residents in Utah are urged to stop feeding ducks and geese.

Indonesia says it is having success with bird flu, noting reduced cases.

I swear I am not making this up. Click it and see. The Northern Ireland Pigeon Association had its December meeting and discussed bird flu.

Thursday, December 21, 2006

December 20 Flu Update

Vietnam has confirmed the bird flu outbreaks and that the virus is H5N1, high path.

Effect Measure comments on this point. As Revere notes, people have suspected that the bird flu was still in Vietnam, even though there were no officially reported cases. In a complicated situation where information is hard to come by, there is no doubt that this makes sense. However, I do think it is fair to assert that Vietnam has gone from having the worst bird flu situation to the world to having, well, NOT the worst, and that seems like an accomplishment to me. Revere also discusses the difficulty in diagnosing cases that present as pneumonia.

ProMed on Vietnam and South Korea.

CIDRAP on Vietnam and other news, including mass bird die-offs that are NOT from H5N1.

There is a fresh outbreak of bird flu in Nigeria, which is said to be more widespread that first thought.

Recombinomics on Nigeria.

Dr. Bob Gleeson spoke about the bird flu as the next pandemic.

Experts in Thailand say it is still too early to stockpile bird flu vaccine.

Marin County, CA, sent home notes with 40,000 schoolchildren about the bird flu.

Editorial in Fort Wayne reminds people that the bird flu has not gone away--and that even if there is no pandemic, our prep time is not wasted.

Laramine WY is spending about 84K on pandemic prep.

The American Public Health Association has developed its pandemic guidelines in the form of a policy statement.

Thailand says it is carefully monitoring the development of bird flu in that country.

Florida thinks hurricanes are good practice for a pandemic.

Tuesday, December 19, 2006

December 19 Flu Update

After a year without flu, Vietnam is reporting avian cases in two provinces in the Mekong Delta.

Bird flu is rejected in France as the cause of death for birds.

The White House reports on its progress preparing for the bird flu, saying it has met "most of its early goals."

The focus of the federal government's efforts to combat a pandemic is on vaccination, and Townsend said, "There are a number of barriers that will prevent us from having large amounts of vaccine quickly during a pandemic."

Who is the world's largest chicken exporter? Brazil...and they are rallying from the bird flu issues earlier this year.

CIDRAP on the state by state analysis...keyword "slow"

The pandemic strategy for Prince Edward Island has been released.

Column talks about "straight talk"for bird flu....answering hard questions about who gets treated, civil liberties, etc.

Bird flu has been found in 44 local government areas in Nigeria.

We ran the article from Michael Furmento of Weekly Standard recently about the "Chicken Littles" being wrong about the flu. Revere responds.

Kazakh scientists say they have a vaccine for birds.

ProMed is back with this story on a team of scientists doing surveillance in South Korea.

Bird smugglers foiled in Buffalo.

USAID has provided 4,500 flu testing kits to Pakistan.

Bush signed three health related laws, including one dealing with pandemic flu.

News for librarians--plans in Dallas say you may have to be phone operators if they do not report for work during a pandemic.

December 18 Flu Update

Is this the re-emergence of flu in Europe? Birds in the zoo died in St. Petersburg....

and France is testing birds at a site where 4,000 birds died.

Indonesia is preparing to produce flu vaccines for people.

Fascinating post from example of a resourceful Thai poultry country could teach us all something.

Slow news? ProMed has had only four posts on AI in December. There have been days with that many.

Cell-culture vaccine work is being conducted at the University of Maryland.

A Philippine Department gave the local media a briefing on bird flu. In theory, this is a good idea that could improve public awareness. In reality, it all depends on who does the briefing.

This Year In Review article from Hungary cites bird flu....

The top chemistry advancements includes the ability to synthesize the key ingredient in Tamiflu.

More state prep updates....Colorado concedes gaps but is happy with progress...

and Wisconsin reports basically the same...

and Oklahoma isn't much different.

The state of Washington is using its bird flu $$ to help prepare for disaster in general.

Federal Computer Week notes the the bird flu contributed to a focus on continuity planning this year.

A little holiday fun...test your readiness quotient.

Monday, December 18, 2006

December 17 Flu Update...

is canceled. Will post tonight. Root canal...

Sunday, December 17, 2006

December 16 Flu Update

A bunch of ducks have died in Idaho!! But it was not bird flu (no surprise there), but rather it was moldy grain.

The authors of the Flu Pandemic and You are interviewed in the Globe and Mail (Canada).

Effect Measure blogs on the Institute of Medicine report "interesting and useful."

Surveillance efforts are ongoing in Delaware.

More on state preparation--from New York.

Report on the state of play in Oklahoma, where the waving wheat sure smells sweet.

New Jersey's report is in....

so is North Carolina's...

and Alaska's

and Nebraska's.

Saturday, December 16, 2006

December 15 Flu Update

South Korea confirms that its flu cases are the Qinghai strain.

European regulators have approved a Glaxo pre-pandemic virus.

But it would only be used once a pandemic has officially been declared and would not be stockpiled in its current form, since it will have to be adapted to include the exact pandemic virus strain.

Congress passed a health preparedness bill...I'm wondering what some of our public policy wonks think.

Another "whatever happened to the bird flu" article.

Effect Measure on pandemic planning, asking whether anyone really gets it all. Cites another example of something people don't think about--like Wheeled Meals in a pandemic.

Indonesia still has the highest number of current cases.

Cumberland County PA held a flu summit.

There was a lecture in Sayre, PA.

They were also discussing the flu in North Carolina.

An official of the Georgia Cooperative Extension is out to correct "untrue rumors" about the bird flu.

From the Weekly Standard...."The Chicken Littles were wrong."

Texas Company announces portable, inflatable hospital facilities for surges.

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.

Wednesday, December 13, 2006

December 13 Flu Update

Effect Measure on recent research that shows that the bird flu does not stay exclusively in the digestive track of waterfowl, as previously thought. There are now recommendations to swab the respiratory track as well---a lot more difficult than just check feces. Another curveball from H5N1.

Revere also blogs the article about not giving up on flu patients who present later in the course of the disease. Also interesting--it still emphasizes the need for quicker flu detection tests. Revere notes that a lot of work is being done, and it needs to get online as soon as possible.

Declan Butler of Nature has the latest version of his Google Earth bird flu tracker out. Very cool.

WaPo on the report to CDC that tried to learn the lessons of 1918 and apply them to 2006-7.

A conference is held in Charlottesville, VA, on the "when not if" theme.

A tabletop simulation was held in Ontario.

Additional simulation news from Ontario.

Could this happen in the US? New Zealand passes law giving sweeping powers to government during a pandemic.

A new model in Britain projects 26 million people infected.

Hospital shortages are identified as a flu risk in Delaware.

Paper in Los Alamos reports on flu presentation that said pandemic could be like "many Katrinas."

While admitting their own friendly disagreements and the uncertainties of their disciplines, a team of scientists stopped short of saying, "you're on your own," but implied that might yet be the case.

Here's a link to the Trust for America's Health report on crisis preparedness in the US.

An Indonesian Youth Forum is doing flu education as a project.

Some wild bird surveillance in India is reported to be negative.

The Columbus Dispatch runs a story on whether Ohio is ready for a crisis--including a pandemic.

Here's the analysis, for those who are curious.

Tuesday, December 12, 2006

December 12 Flu Update

It is truly remarkable. Vietnam is bird flu free for a year, but their guard stays up.

A doctor in Vietnam says not to give up on late stage bird flu cases, they can be saved.

The medical community believes anti-virals such as Tamiflu are only effective in fighting the H5N1 bird flu virus if they are administered within 48 hours of the onset of symptoms. But virologist Menno de Jong said this assumption might only hold true for human flu viruses. H5N1 behaves differently from human flu viruses and has been observed to be replicating in its human hosts even on the seventh or eighth day, he said. "In my experience, there is a clear suggestion that there was still virus replication (when we made) a late start in treatment. In four of my patients, there was very rapid clearance of the virus from the throat and all 4 survived," he told Reuters on the sidelines of a conference on avian flu and other infectious diseases in Singapore.
CIDRAP has this story as well.

Effect Measure on a report on bird flu in the acturial industry. They seem to think that they will be able to handle it....or settle it in court.

Federal poultry officials held a meeting to warn the poultry industry not to let their guard down against bird flu.

Fecal samples from Utah birds are being tested as part of routine surveillance.

Tests in California surveillance were also negative.

South Alabama businesses are warned to be ready for the bird flu.

The public health department in Guam has created a pandemic flu committee.

In Bangladesh, they are preparing to do bird flu surveillance.

From Swazi: how does bird flu affect birds.

December 11 Flu Update

Dr. Webster and other experts were in Indonesia, and they had interesting things to say. First, the number of cases goes up each year, and second, vaccines are needed for all bird flu strains.

The H5N1 bird flu virus has undergone many changes since making its first known jump into humans in 1997 and vaccines must be manufactured to fight its major strains, experts said on Monday. While the virus remains largely a bird disease and does not infect people easily, the scientists at a conference on avian flu and other infectious diseases in Singapore warned against any complacency.

"What's worrying is there were more (human) cases in 2006 than 2004 and 2005. The problem is still with us," Robert Webster of the St Jude Children's Research Hospital in the United States told Reuters on the sidelines of the conference. "It's (H5N1) continuing to evolve and there are multiple lineages of this virus still out there. What cross-protection is there between these clades (strains) and sub-clades?"

Different report, same event...expect winter to bring more cases in Asia.

In counterpoint, China has announced no cases yet this winter.

Effect Measure on the story about the "weak point" of the flu virus that is all over the news. Revere points out that as you learn more, things don't always get clearer....

ProMed on a couple different things....first, the reports in South Korea, and second, the idea that the flu virus is slowing least in animals. Note mod comment that says we will find out during the winter if the slowdown in animals is seasonal or perhaps a slowing of the panzootic.

US State Department website reports $434M pledge to bird flu effort by US.

The Republic of Ireland is buying 11.3 million Euros worth of Relenza.

Effect Measure on the article we ran yesterday on "What ever happened to bird flu" which ran on AP. Revere notes the many different headlines the story ran under, all of which underplayed the real warnings in the story.

Chicken sales fell in South Korea late last month on bird flu fears--but they are rebounding.

The bird flu in Quail is confirmed (South Korea).

CIDRAP on the "accord" about naming flu viruses.

A US university is joining with an Indian university to do bird flu research.

Sunday, December 10, 2006

December 10 Flu Update

AP story on the "disappearance" of the bird flu.

Bird flu has hit quails in South Korea, according to a published report. I am not sure if the disease has infected this species before, but perhaps others will know.

Effect Measure on the spat over the name of the Fujian-like flu virus.

So WHO now wants to take another look at the international conventions for naming influenza viruses (for an explanation of the current system, see your entry for at The Flu Wiki), prompted by this episode.

Bloomberg on vaccine companies racing to find a vaccine for the bird flu.

The Swiss are happy with their bird flu vaccination program.

Fla_Medic reviews Tamiflu, walking through the many sticky issues related to its use in a pandemic.

Tracking bird flu in Nigeria remains a challenge.

Bird flu gets Tabloid treatment in Britain--no, it was not brought here by space aliens!!

December 9 Flu Update

Effect Measure with a thoughtful post. If there has been a consistent theme to Revere's posts, it has been that any measures that build up the public health infrastructure would help society--even if a pandemic never occurs. Merge that idea with the article this week about the wide range of emerging animal diseases, and you get an interesting and provoking post.

Useful Reuters fact boxes, first on the worldwide spread of the flu, and second on 2006 chronology.

A company in Singapore says it has an herbal extract from elderberries that is more effective than Tamiflu.

This article says the US is building flu fighting capacity overseas.

Interesting blog that says it is an average person's attempt to understand the bird flu. In this post, the author reacts to a recent study that showed the virus could mutate in a single pass in mice. Here's a section from the blog.

The paper closed with this line:

Urgent measures to deal with a possible pandemic, such as the development and application of effective vaccines and the stockpiling of anti-influenza drugs, are needed.


Seems I may not be the only one who had their world rocked.

Saturday, December 09, 2006

December 8 Flu Update

At the Mali conference, $475M more has been pledged for the bird flu fight, though it is still a fraction of the need (they had hoped for $1B).

Also from Mali, it is acknowledged that no one agency will be able to fight bird flu---it will take many different agencies.

In Mali, an important point is made. Many scientists feel that the bird flu is only one animal virus that threatens humans, and results from a number of factors including farming practices.

OIE is happy with the Mali conference.

CIDRAP on Mali.

The Northern Region of Vietnam has made it through what ordinarily its first flu cycle.

Apparently, the dispute between China and Hong Kong from a few weeks ago that centered on the presence of a specific strain of flu is actually the result of a "stigmatizing" name.

Short but interesting article on the hajj pilgrimage and how it could present a bird flu risk. (And, in fact, it is exactly the kind of event that could, though the number of opportunities for the disease to spread are too many to count).

Cities in Quebec are completing mutual aid pacts in case of the bird flu.

Effect Measure blogs an article in the Globe and Mail that talks about a study done on hospital capacity in Toronto, and what it would be like during a pandemic.

Thursday, December 07, 2006

December 7 Flu Update

From Nature, a weakness in the virus has been identified that could open the door to new therapies.

The CDC is hosting a two day meeting next week on how to minimize the impact of a pandemic.

Efforts are still underway to turn around the bird flu situation in Africa.

"This continent is affected by quite a number of development and humanitarian challenges, some of which are very well known, including malaria and HIV," David Nabarro said ahead of a global summit on bird flu in Mali, West Africa, starting on Wednesday. "I think African heads of state would be forgiven for saying 'Well, thanks for coming and telling us about this challenge -- we will add it to our list'," Nabarro said.
The Swiss say that their vaccinations in the zoo were successful.

Ministers at the Global Health Security Initiative are saying that the outbreak in S. Korea proves that bird flu has not gone away.

Poultry producers in Ivory Coast say that the government has invented or overplayed the bird flu threat in order to manipulate poultry prices.

A city in China has increased bird flu surveillance at its borders.

Rumors of an outbreak among birds in Azeri. are said to be proven false.

Revere finds a recent article in the Journal of Immunology disturbing. I'll let him explain why.

The Cox inhibitors are among the most used for the symptoms of cold and flu. This means that when you start to feel lousy and fill yourself up with aspirin or ibuprofen, you could also be interfering with this "recall response" of your immune system. In effect, you would be canceling or at least diminishing your immunity.

CBS News blog writes that the bird flu has left the media's radar--but not the author's.

Fla_Medic blogs on this same topic.

A new report in London's bemoans the lack of preparation among business for bird flu.

Recombinomics on recent Chinese sequences which do not include the Quinhai sequences.

One of the major issues with the flu--how will a pandemic effect cultural this case, in Africa.

They are prepared and reassured in Concord, MA.

Wednesday, December 06, 2006

December 6 Flu Update

The Mali conference is open, with complacency about the flu as big an enemy as the flu.

"Technical experts are sometimes accused of having overestimated the risks from this disease, or of exaggerating its potential threat," said Modibo Traore, head of the African Union's InterAfrican Bureau for Animal Resources. "The rampant demotivation that has resulted seems to have affected the main players in the struggle on all continents, and notably the donor community," Traore told the opening session.

Along the same theme, Dr. Webster refers to the flu as "smoldering."

WHO officials discusses the debate on pre-pandemic vaccines--even if not perfect you might get some protection, or you might immunize for something that never happens.

The NRC starts to answer the question..."how do you run a nuclear power plant with 40% absenteeism.

People in Beaver County, PA, are told that the bird flu would swamp available healthcare resources.

In North Carolina, they are preparing with mobile hospital tents.

This article says the US fights bird flu in Asia (including with $$) so we don't have to fight it here (with more $$ and misery).

USAID is holding a seminar on how to correctly and safely use PPE when working with potentially inflected flu birds.

Effect Measure on the state of play in Nigeria--officially there is no bird flu, but no one really knows.

The Buckeye Ag Radio Network has nominated Avian Influenza as story of the year in ag. (I'd like to hear the acceptance speech).

Tuesday, December 05, 2006

December 5 Flu Update

CIDRAP says poultry are more likely to bring bird flu then wildfowl.

Popular Mechanics on an air purifier that fights the bird flu.

Nigeria makes a shocking admission...poor surveillance means they don't know their bird flu status.

Meanwhile, the Nigerians are being warned not to vaccinate their poultry.

Another US surveillance story, this time from the Salton Sea in California.

National Geographic on looking for flu in all the wrong places...employs regrettable "wild goose chase" metaphor.

Effect Measure on this story, as well.

The other issue is the relative importance of wild bird migration versus poultry movements. Some feel the speed and distance of the spread can only ber explained by long distance travel of wild birds. This is certainly a plausible scenario. But substantial work has been done by mathematicians on the pattern and speed of spread on netowrks of various topologies (patterns of connection). We now know that some linkage patterns (e.g., small world or scale free topologies) can appear as rapid and wide spreads without requiring major jumps or infrequent long jumps. Most of the spread is local, with the occasional midrange or longer jump.

Recombinomics has an extensive review of this issue as well.

They had a flu scare in Zanzibar based on some illegal imports.

The story of Central America's fight against bird flu.

The VP of the Asian Development Bank says innovative approaches to bird flu are needed.

Scientists from Los Alamos National Lab are giving a talk on bird flu next week.

The Swiss have laid out their pandemic plan.

Tennessee is considering the purchase of $8M in Tamiflu.

Florida Medic blogs on the US government's bargain basement flu fighting plan.

Monday, December 04, 2006

December 4 Flu Update

Scientists say the US flu surveillance program is off base--flu is most likely to come to the US through Latin America.

A medical journal says that a dog died of bird flu in Thailand.

CDC is contracting for the development of rapid flu tests, with a goal of 30 minutes.

Effect Measure writes on one of the mysteries of the bird kills much younger people than seasonal flu does. There are cool charts included, too. I have always assumed that robust young immune systems are at fault, but others may have their own ideas.

WHO's Nabarro says bird flu is still an imminent threat and could cost $750M per year.

Outbreaks of the lethal H5N1 avian flu virus, which is constantly changing and may mutate to be easily transmissible between humans, could spark the next flu pandemic, David Nabarro, the UN's pandemic-flu coordinator, said in an e-mail.

Recombinomics says that there is a large bird die off in Azerbaijan, leading to the idea that surveillance there might be weak.

Winter diligence is detailed in Vietnam.

South Korea is providing full compensation to bird flu victims.

This story, optimistically, says we could wait four months for a vaccine during a pandemic.

A British company has a release on a biocleansing gel that is said to be effective against bird flu.

CIDRAP on the US buying "fast" bird flu tests.

CIDRAP with more on the World Bank estimates of the cost of fighting the bird flu.

Sunday, December 03, 2006

December 3 Flu Update

The UK is planning a massive bird flu exercise, involving thousands of people working on the assumption that the country is "closed off" due to the flu.

At the Mali bird flu meeting next week, a major outcome will be to seek more $$--and to ID Africa as the weak link in flu prep.

The Cull in South Korea is up to 771,000 birds.

Now the Irish are concerned about the shelf life of their pre-pandemic vaccine stockpile.

Israel is helping Palestinian vets fight the bird flu.

The World Bank has a good insight--if you are going to fight the bird flu, farmers need to know they will get prompt and fair payments.

Though we feel helpless before the uncontrollable power of the influenza virus, we are far ahead of where our forefathers were in 1918. Revere comments.

Guam is conducting bird flu surveillance.

Interesting blog post from a student midwife. Apparently, a physician's group had adopted a position that hospital births were the best way to go. A number of groups objected, some citing pandemic flu as a reason. I had never thought of this, but for a routine birth, a hospital in a pandemic is the last place you would want to be.

Finally, we are distressed that this statement is published at a time when the public health system is preparing for pandemic influenza. The National Pandemic Flu Plan calls for hospitals to develop ‘surge capacity’ plans to maximize their capability to care for seriously ill patients, and create alternative care sites for routine care. Specifically, the plan calls for health systems to explore ways of “increasing the role of home care, and developing off-site care facilities.” It seems likely that in an influenza pandemic, a hospital bed – in short supply and in close proximity to those ill with a virulent virus – may not be the safest place for healthy women to give birth.
Bird flu and its blogging effort was written up on the DailyKos, too.

Saturday, December 02, 2006

December 2 Flu Update

President Bush's special assistant for biodefense gave a speech in Ravenna, OH.

"The best thing you can do is have a close, well-matched vaccine," Venkayya told those who attended. "It's the closest thing to a silver bullet."

China has promised the new WHO director that it will share samples in a quicker fashion. This dynamic will be interesting. On one hand, China will probably remain secretive. On the other, how much do they want to embarrass the woman who represents their first venture onto the UN stage.

The MA legislature is "mulling" bird flu $$.

The "When, not if" message is delivered in Chapel Hill, NC. Of course, that's the simplest question. There's a ton of uncertainty on when it will happen, and what it will entail.

Recombinomics claims that the two people who died in Indonesia had strains of bird flu that are different from those known to be carried in birds.

December 1 Flu Update

In Thailand, officials are considering whether to take the controversial step of vaccinating poultry against the flu.

Canada has issued a warning about Tamiflu, blogged here by Revere. Note MSM screwing up vaccine/anti-viral distinction in headlines, and Revere's own practice on Tamiflu (which matches mine).

The EU has extended its ban on importing birds for 3 additional months.

South Korea says it dealt well with bird flu...but North Korea would be another story.

ProMed on WHO guidelines for diagnosing bird flu. Mod comment says that the guidelines are in response to concerns raised in those NEJM articles on missed cases.

Excellent article on vaccine labs gearing up to fight the bird flu.

The animal husbandry industry lost $2B due to bird flu, according to a report.

CIDRAP on the Canadian triage plan to allocate ventilators.

The inclusion criteria identify patients who may benefit from critical care treatment, focusing on respiratory failure.

Exclusion criteria place patients in three different categories: those who have a poor prognosis despite critical care, those whose care demands resources that can't be provided during a pandemic, and those who have underlying advanced medical conditions such as malignant cancer or end-stage organ failure that complicates their critical influenza status.

The authors write that they struggled with the decision to put an age cutoff in the plan's exclusion criteria. They did not include one in their original protocol draft because they claim age may not strongly predict critical care outcomes. "However, we received strong and consistent feedback from both expert and stakeholder consultations that an age criterion should be included," they wrote. Age above 85 is listed among the exclusion criteria, but the authors suggest that the topic of age cutoff requires more research and community input.

The "minimum qualifications for survival" component attempts to place a limit on the resources used for any one patient. "This is a concept foreign to many medical systems in developed countries but one that has been used in war zones and refugee camps," the authors write. In the triage protocol, patients are reassessed at 48 and 120 hours to identify early those who are improving and those likely to have a poor outcome.

Lame Duck Governor (flu humor) Bob Taft held a pandemic exercise in Ohio.

Stars and Stripes says to be aware, not worried.

Nice story from the Central Michigan student paper--A professor and student are studying water, sediment and feces in migratory pathways for bird flu.

There is now a website that has information on wild bird surveillance.

Officials in North Dakota are conducting bird flu surveillance.

The American Public Health Association has a seasonal flu blog...and in this post they answer the question of whether the flu shot will protect against bird flu.

A UN map on the bird flu.