Wednesday, March 14, 2007

MArch 13 Flu update

As reported earlier, the standoff between Indonesia and WHO continues. NO sample sharing until Indonesia is assured in writing that the strains will not be used in an "unaffordable" vaccine.

CIDRAP with what might be today's most far-reaching news. A review of studies says that influenza is generally not airborne, but is transmitted at close quarters. This is contrary to a great deal of research, which the study finds to be faulty. The research team supports more robust research and prophalytic anti-virals.

Dr. Osterholm has doubts:

Michael T. Osterholm, PhD, MPH, director of the University of Minnesota Center for Infectious Disease Research and Policy, publisher of CIDRAP News, expressed skepticism about the authors' conclusion that airborne transmission is unlikely to be a major factor in spreading flu. He said that view doesn't fit well with the seasonal flu's typical pattern of erupting nearly simultaneously in widely separated places.

"From my 30 years of experience I've always been impressed with how seasonal flu functions on a community basis as an aerosol-transmitted disease," he said. "We can see outbreaks in areas separated by hundreds of miles; that's much more consistent with an aerosol-transmitted pathogen—though that doesn't prove aerosol transmission. Pandemics have marched around the world in weeks to months in eras before we had jet planes. That smacks much more of an agent that's transmitted by the aerosol route."

We wondered here why the US was moving ahead with a pretty blah Sanofi vaccine, when Canada appears to have a better one that uses an adjuvant. Apparently, the US is now considering mixing the two approaches.

New avian cases have emerged in Myanmar.

India has banned the import of live poultry--pigs, and pig meat--from flu stricken nations. Inclusion of swine is interesting.

I have said here often that what fascinates me about the flu is how it finds the weak points in how we live...without fail, like water finding a leak. Here is a story in that vein...the cultural practices of rural villages in Egypt and how they contribute to the bird flu.

Also from Egypt, bird flu has emerged in flocks that had supposedly been vaccinated. It is unclear if the vaccine didn't work, if the strain is different, or people lied about their flocks being vaccinated.

24 penguins died at SeaWorld in Australia. Bird flu is ruled out.

Counties in Idaho are working on their pandemic prep.

Brazil says it has found an effective adjuvant.

Via an alert reader, Scottsdale AZ is also doing flu planning--before the issue hits the front page.


At 8:21 PM, Blogger Wulfgang said...


Good selection of interesting articles today.

I don’t know about anyone else, but I was once pretty sympathetic for Indonesia and its intransigence regarding the release of their virus strains to the WHO, but now I’m getting a little annoyed, and the situation appears to me to be slipping into the good old “entitlement mentality” syndrome. If adjacent countries like China, India, Thailand and Vietnam are taking steps to ensure that they have their own vaccines available through acceptable channels and means, why can’t Indonesia stop whining every week, and do the same ? I do have a Wulfgang type solution though, very unique, as always.

Margie Chen, should butch up and go ahead and provide Indonesia with an iron clad legally binding agreement, so Indonesia can start shipping their virus strains, as has been the accepted procedure for the last 50 years. Then the WHO ought to immediately make the strain available to the entire world virus manufacturing community. Then Indonesian can sue the entire world for breach of contract, and take everybody to some court, say in the Hague, for redress and compensatory damages. The final step is to then litigate the case for the next century. If the WHO doesn’t take a firm stand on this, at the rate they’re going, they’ll be paying Indonesia millions of dollars in reparations for the deceased H5N1 Indonesian people also.

If Indonesia doesn’t have the means to produce its own vaccine and even take minimal preventative action within its borders to stop the spread of H5N1, then it certainly doesn’t have the deep pockets and financial resources to litigate in any court for a hundred years. So, problem solved. The rest of the world gets what they need, and if we’re nice about it, we may just ship some vaccine to them when the pandemic emerges out of control there. If they aren’t nice to us, well, we clean the place up, build some nice Hiltons and casinos and have a whole bunch of recreational islands for spring break vacationers.

The CIDRAP article is obviously very controversial and the debate of whether influenza transmission is highly “aerosoled” has been going on for years. This is why anybody with a few synapses, has a adequate supply of both respirators and masks. I do. I’m not waiting around until these noodle heads with 195-245 IQ’s end their debate. I’m clearly with Dr. Osterholm on this subject – the research doesn’t make a whole lot of sense. Viruses are just like the game of horseshoes and throwing hand grenades in my view… all you have to do is get close and you’re “tagged”. I also hate reports that have no practical solutions or recommendations embedded somewhere – we call these kind of reports, “feces droppers”, where I work.

The Bloomberg article on the US considering purchase of the superior GSK vaccine to “blend” with its Sanofi stockpile, is quite a novel approach to stretch our supply dilemma. Still, the most worrisome aspect of this great idea, is the whether or not the FDA drags its feet in the process, as usual and becomes the long death pole in the tent. In addition, it looks like an excellent recovery strategy, in order to cover someone’s hasty decision.

You are right Orange, the New Delhi article banning the import of pigs and pig meat products from countries that have experienced bird flu outbreaks, is quite interesting. I believe many more countries ought to pay attention to this conservative Indian approach, especially in view of situation in mainland China, who has experienced massive numbers of unexplained swine and swine farmer deaths, over the last two years and kept it silent. This is a very wise move on the part of India.

Your comment on the rampant H5N1 situation in Egypt, and how their cultural practices contribute towards the spread of the bird flu, is right on the mark. In order to reverse this trend in that country, both the government and religious Imam’s there need to butch up too, to make sure simple surveillance and preventative procedures, like responsible vaccinating poultry and disposal practices, are followed precisely. Up to now though, we have heard from many different religious denominations throughout the world, concerning their bird flu preparations and advisement to their followers, but not a solid peep on the subject from the Imam’s (yeah, oooh I’m scared to say this, come and get me).

Responsibility educates.



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