Monday, February 05, 2007

February 5 Flu Update

Chock full of info in this story. 12-year old girl died of bird flu in Egypt. Her initial tests were (wait for it) negative, so she may not have received Tamiflu...and her strain might or might not be resistant anyway.

Bird flu in British Turkeys leads to lower share prices for American chickens. Go figure.

Russia has banned the import of poultry from the UK.

Conversely, Brits are still eating turkey.

Of course, the ultimate question...where did it come from.

ProMed: Britain spawns precautions in Norway and the Netherlands, and a possible new outbreak in Russia.

CIDRAP rounds around the world, including a new outbreak in Japan.

ABC News reports that US hospitals are unprepared for a pandemic surge (personal note: of all the unknowns in this field, this is something I am sure of)

With a 60% fatality rate, physicians are looking to new options, trying to find something that will stem the tide of death.

Local op-ed piece on bird flu in Nigeria.

Malaysia says that the it does not restrict travel from countries stricken with bird flu.

Japan is conducting exercises to deal with human bird flu.

In Ireland, the Derry City Council is being trained to bury dead bodies in a pandemic.

New Zealand says its pandemic prep is among the best in the world.

The Welsh say their bird flu plan is ready, too.

CIDRAP reports on its business summit...says businesses are becoming more aware of bird flu threat.

Revere...eating undercooked poultry can lead to salmonella....or H5N1. Yet, people still get salmonella. Draw your own conclusions.


At 6:30 PM, Blogger Wulfgang said...


I read your suite of articles today with my usual independent jaundiced eye towards what the real “messages” are that they were sending, and found some interesting ones.

First, the rather alarming news out of Egypt that yet another individual has died from H5N1, and this is appears to be both the first and last announcement of the fact. It dismays me that so many third world countries have now slipped into the “non-disclosure mode”, so as to protect their internal poultry industry and not panic their citizens. This 1918-like, “sweep the bad news under the run” type behavior, will only make things worse. The fact that we have so many nations, including China, now hiding valuable information and data about the disease, only defeats the surveillance line-of-defense being implemented by the WHO.

Secondly, are the interesting degrees of preparedness being portrayed for a pandemic, contained in your news articles from Japan, Ireland, New Zealand and in the ABC news report about US hospitals. Right now, one would have to say, no matter what the best plans and exercises are being broadcasted, major failures and deaths are inevitable in anything greater than a Category 1-2 pandemic. I submit that no government or health care system is as ready now as they should be for what will happen. As presently being proven in nearly all the Asian countries, Egypt, Nigeria, and Europe, surveillance of H5N1 is not reliable enough to spot a nascent pandemic in time. It currently takes weeks of sophisticated diagnoses during a normal epidemic, to determine if a co-infected person is suffering from, or has deceased from, an H1 or H3 type virus, versus an H5 virus. Therefore, once a pandemic starts because of the inability to see it coming, it will be unstoppable, until it runs its natural course. What’s worse, because most people will have had no prior exposure or immunity to the particular pandemic strain, everyone will need multiple doses of a vaccine that cannot be produced in sufficient quantities, until 6-12 months after the first influenza wave. At the rate the current H5N1 virus is mutating its resistance to anti-virals, people will also need multiple doses of Tamiflu, which is also in very limited supply.

Some countries like Ireland, as explained in your Belfast article, have already realistically assessed the potential for an astounding number of deaths, and are factoring this risk information into action – by making provisions now to deal with high numbers of mortalities. I applaud them for this action. Granted, nobody knows what the casualty numbers and human toll will be eventually, until the pandemic actual starts, but it could end up to be ultra-cataclysmic. Stopping a lightning fast H5N1 type pandemic through intervention procedures will be impossible, and isolation or social distancing procedures, only delays the inevitable scourge. The complacency being seen by the majority of corporate leaders (ref: your CIDRAP article) in the US only makes a bad situation worse, because their tactic of “hoping” that a problem goes away, is not a viable planning tool. It is nothing at all. Unfortunately, we live in a western environment with short attention spans, and the reality is – the more mistakes you make, the more you ultimately lose.

If anyone reading this believes I am being overly pessimistic, then consider the following information carefully and place it in the right context in your mind as it might affect you personally:

Most government agencies anticipate a clinical attack rate of say, 15 to 40 percent of the population in any particular affected country during a moderate pandemic. It is then very reasonable to assume only an average estimate of 25 percent of any entire nation to fall ill and start flooding the emergency rooms. Fatality rates in currently diagnosed H5N1 patients exceed 50 percent, and there is no indication they are lessening– but, say even for illustration purposes if that rate does in fact fall to a measly 5 percent as the virus does the tradeoff from virulence to transmissibility, it would still represent a death rate double that of 1918. It would mean between 3-4 million deaths in the US alone, despite the heavy dependence on modern medicines and medical technology available. We could easily accelerate beyond the starting point of what the CDC calls a “Cat 5 type pandemic”. This is a "life altering" situation.

Despite the numerous countries declaring themselves “ready for a pandemic”, it is high doubtful in my opinion that they really are. The world surveillance, readily available vaccines, containment procedures, access to medical care, and determination to adequately prepare, is just not there yet.



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