Thursday, April 12, 2007

April 12 Flu Update

11 people are being tested for bird flu in Lagos, Nigeria.

ProMed on confirmed deaths in Egypt and Cambodia. Note that in the Cairo death, Tamiflu was administered but did not save the teenager.

India has earmarked 1.3 billion rupees to fight bird flu.

Vietnam reports poultry vaccinations are behind schedule.

The World Bank is giving Vietnam $38 million to fight the bird flu.

Yet another in an unending series of press releases from the Philippines on how it is fighting avian flu.

CIDRAP on whether insects could be used to make flu vaccines instead of eggs.

Revere says this is "pretty interesting" too.

The Health Department in New Canaan is preparing to fight bird flu.


At 6:11 PM, Blogger Wulfgang said...


There is indeed a lot of controversy surrounding the report out of Lagos, Nigeria, regarding the 11 people who are being tested for suspected bird flu. How in the world do individuals get infected with H5N1, literally 2 months after exposure to someone else who died from it ? Lots of good questions need answered on this, if that’s even possible. Most of though, aren’t surprised, and are expecting a lot more illnesses out of Nigeria and other areas of sub Sahara Africa.

After reading the ProMed report about the two young female fatalities out of Egypt and Cambodia, where even Tamiflu was of little efficacy, I concluded that there will unfortunately be a lot more of this gender who succumb in these places, before all is said and done.

I like to work the numbers which are embedded in your articles, to see what message they convey. Here’s a quick take from my knot hole:

• India has earmarked 1.3 B rupees to fight bird flu over three years – sounds like a huge of money, until you convert the Rupees into dollars. Then, it amounts to only approximately $ 31.6 M, or about $ 10M per year to spend in a country of 1B population, for preparation, control and containment of bird flu. Nah, that ain’t gonna get it.

• Vietnam reports poultry vaccinations are behind schedule. Only 6 of 34 total provinces have successfully completed vaccinations. That’s a dismal 18% success rate. Nah, again.

• Vietnam receives $ 38 M from the World Bank to fight the bird flu. These numbers are almost identical to the Indian outlay above. This also results in a dismal $ 12-13M annual expenditure to contain a potential pandemic. Triple nah.

Not surprisingly, both your CIDRAP and Effective Measure article about insect-cell-based vaccine, via cell-culture technology, were quite fascinating. There are some obvious pro’s and con’s to the story, that are apparent, when one slowly wades through it.

The big pro’s are that it would shave a little off the production time for a pandemic H5 type novel vaccine, and it represents a whole new modern DNA type approach, which seems to result in a vaccine that performs equal to, or better than conventional vaccines.

The drawbacks are significant: the entire development and production process associated with this new approach, would require nearly a decade lead time, because of its complexities and quality control assurance requirements. We don’t have this luxury. Like Revere says, this is not the silver bullet, which would “save us at the last minute, a la the movie Outbreak”.

Plus, quite honestly, there’s just something about an “insect based flu vaccine”, that makes a person downright nervous about it – especially after having watched the movie, “The Fly”, with Jeff Goldblum. None of us wants to end up looking like an big ugly fly insect, even if we end up with superpowers, like Spiderman.

I found your New Canaan, Connecticut Health Department article, a little too optimistic in its content. If I didn’t know any better, I really wouldn’t be concerned about much, if I just read about the subject the way it was explained, for the first time. For example, it says – “The Tamiflu dosage has been worked out, we were told a course of treatment consists of one pill a day for 10 consecutive days”; it says later, “custom –made vaccines will then be distributed as quickly as possible to breakout hot spots”; “plans for vaccinating call for two shots thirty days apart”, and the best of all – “ new technology has come on line… and various vaccines made via egg-less technology are being field tested right now”.

I really think the New Canaan Pandemic Preparedness Committee ought to be more realistic and stop with the fluffy puppy approach.

As even Revere admits… there is no real silver bullet which will act as savior for a pandemic (yet). Far from it.



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