Thursday, February 08, 2007

February 7 Flu Update

A second vet in UK is being tested for bird flu symptoms.

An MP says Britain should provide some of its Tamiflu stock to poultry workers in Suffolk (note incorrect use of the word vaccine.)

The cull in Britain is fingers are crossed that the virus did not spread.

There is now an outbreak in Pakistan, but the government says it is nothing to worry about.

ProMed on the outbreak in Pakistan.

The US Embassy in Indonesia has warned US Citizens to stay away from cats because they can carry H5N1. This is an unusual warning that could portend that there is something going on that has been underplayed.

Yesterday's controversy was over the Indonesian samples. Indonesia is refusing to share samples gathered in its countries--and for some solid reasons. There was also dispute over whether the country had an exclusive deal with Baxter to use the samples. Helen Branswell today says the company says No.

Under the memorandum of understanding, Indonesia will provide strains of the H5N1 virus circulating in the country and Baxter will offer technical expertise to produce the vaccine, said Indonesia's Health Minister Siti Fadilah Supari.

Experts in this story say Indonesia's actions could slow efforts for a vaccine.

Effect Measure blog this story, noting the good arguments on both sides. Here's a potential solution.

What's the solution? Here's one suggestion. Influenza vaccine is too important to be in private hands. This episode is a good example of what happens. WHO should set up a dozen or so geographically distributed international vaccine institutes whose task it is to manufacture and provide at cost seasonal and pandemic vaccines for their regions. The vaccine would be distributed according to need to countries in the region of the institute.

ProMed on two new cases in Indonesia, noting that one is exceptional because the woman reportedly caught the disease from a wild bird.

The new US budget has pandemic prep in it, but cuts biosecurity.

ProMed on the new case in Egypt.

FAO is confident Britain can handle bird flu outbreak.

GSK says it will begin human vaccine trials in the second quarter.

Nigerian citizens are educated on how to stay safe from bird flu. We have no idea what challenges are entailed in these issues, across cultures.

ARE you one of those who drink fresh eggs? If your answer is yes, you had better desist from doing so until further notice to prevent getting infected with the dreaded bird flu virus.

New Zealand said yesterday it's pandemic prep was best in the world. Not so fast, say some. What about a Command Centre.

Forbes reminds people of the obvious--bird flu has not gone away.

UNICEF is spending money to fight the bird flu in Kazakhstan.

More on the CIDRAP business summit. The key question is, how do you prepare for something when you don't know--and we really mean DON'T KNOW--what could happen and what you might have to prepare for.

He took his "fog of pandemic preparedness" concept from the theory of the "fog of war," a state of ambiguity soldiers can find themselves in when they doubt their own capabilities and feel unsure of their adversary's capabilities and intentions.

Pandemic planning can produce its own haze as planners grapple with issues like ensuring their supply chain or determining government's role. "We talk about what we might do or can do, but we really don't know," Osterholm said. "There are so many uncertainties."


Shining some light into the pandemic cloud, however, is the recent document on community mitigation measures by the US Department of Health and Human Services (see links below). "You don't want to have a [pandemic planning] policy inconsistent with this document," Osterholm said.

Consumer Reports answers bird flu questions.


At 11:22 AM, Anonymous Lisa said...

Given the concerns about some countries being less than forthright in their disclosure of bird flu incidents, I'm wondering if you are aware of any sources "on the ground" who can get word out of these countries more quickly and reliably than a state-run media, should there be any signficant H2H outbreaks. Any thoughts?

At 5:36 PM, Anonymous mpb said...

re: your remark about culture affecting bird flu-- There has been a bit of cultural awareness in the H5N1 bird flu folks on-line, more than the US state and federal governmental agencies, but I think much more needs to be examined.

Certainly cultural factors (as in culture as a human adaptation) will probably be most significant set in a pandemic because most of what we think of as biological factors are mediated or even created as a result of culture (biocultural adaptation Biocultural Dimensions of Environment and Health).

A lot of this information is already known, although scattered in the literature and collected for reasons other than pandemic epidemiology and preparedness.

Unfortunately, the way the CDC and other funding sources operate, there's no way that grassroots scientists, indigent or not, can contribute the needed knowledge. Too bad there aren't support mechanisms from the private donor world that could overcome the government and academic establishment reluctance.

At 7:42 PM, Blogger Wulfgang said...


A couple of quick comments on your articles.

Then I would like to respond to reader Lisa’s question.

When one reads the Daily Times article about Pakistan, and their government says, “there’s nothing to worry about”, the precautionary amber light immediately snaps on. What I mean precisely is Dr. Afzal’s uncomforting statement that, “no case of bird flu had so far been reported either in commercial layer or broiler poultry from anywhere in the country”. What this really means is… no other cases have been reported where the birds are actually dying in any provinces, in third world lingo (i.e. this is their third world version of adequate bird flu surveillance, which is unlike ours). These are two different statements with two different meanings, which are so common these days from these countries.

I agree with you Orange, the US Embassy warning to stay far away from stray cats is a clear indicator of some inside information, not publicly acknowledged yet. Not my personal opinion saying this, - professional judgment kicking in here. As I have openly stated before, always watch the information and communique’s from the US State Department carefully. The are the most powerful, independent and insightful arms of the US government.

I have been following all the 2007 Orlando Pandemic Influenza Summit news very closely, for a hint of anything said out-of-script. The CIDRAP article summarizes Dr. Osterholm’s remarks and continuous warning’s pretty well, but there is one particular area discussed that I am in total disagreement with his comment. Dr. Osterholm believes that, “some executives may see pandemic planning as no longer important… and they have to plan around pandemic fatigue”. The fact is: some executives are tuned in to the process, granted, but most never got fully engaged in the first place, which I call the Kenneth Lay ala Enron approach. Most, so far, only view avian influenza as a nebulous threat, something akin to Y2K, a hurricane, or a poor earnings event. It’s not on their radar screens. So… the issue is not one of fatigue, but how to get these captains of industry realistically energized and focused.

Finally Lisa’s question. Here’s my take on things.

She is essentially asking the same question, that I have seen time and time again, by others, in different form, on many of the good blog sites, and that is – what’s the best source for learning that a pandemic is emerging, and how will we know. My answer is not surprisingly, right here on the internet, for a couple of reasons: worldwide information is nearly instantaneous, from nearly every country of the world twenty four hours a day, and these internet sites are “populated” by so many people from such diverse backgrounds, that it would be nearly impossible to stifle critical information such as a high pathogenic emerging deadly outbreak of H5N1, coupled with a high mortality rate, anyplace in the world. Always remember, official government websites offer only guidance and pandemic planning information, but blog sites, like yours (and quite a few others), give important information on almost a “real-time” basis. When and if, something transpires, any reasonably alert person will have enough advance notice from these sources I mentioned. If you wait to see the news on your favorite national TV news network, which usually lags by several days – you will be behind the “power curve” from the get-go.

Because I personally have spent much time with extremely knowledgeable people on this subject, I offer the following general common sense advice, to take or leave as you wish:

• Have a personal preparation plan in place for your family which provides for two weeks and up to two months.

• Assume in a pandemic that your movement and transportation will be severely constrained.

• Assume if a pandemic emerges, what ever food, supplies and medicines you have on hand could be it for quite a while.

• Assume that sending your children to school is out of the question, for obvious reasons.

• Have the means to transport your family out of your area in an emergency situation.

• Assume that your work will take a back seat to your family’s safety for an indeterminable period of time.

• Have basic emergency communications handy (basic two way radios, etc)

• Have some minimal means in an emergency situation to protect your family from harm – this is a very controversial topic, but it must be considered, because law enforcement officers will get sick also.

• Get your personal affairs in order.

All these considerations I have mentioned, simply cannot be prepared for in a day or two, at the last minute.

PS - MPB - very interesting comment you have on the cultural aspects of the pandemic situation.
Generally, I guess I would agree with your observations.



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