Monday, May 14, 2007

May 13--Mother's Day Flu Update

There's a bird flu death in Indonesia--all but lab confirmed. She was 26, 4 months pregnant.

ProMed has this story as well.

The World Health Assembly is coming up. Helen Branswell is here with her usual indispensable analysis. Avian flu will be the big topic--and here is the problem. This throws cold water on the idea of a pre-pandemic vaccine.

Simply put, scientists can't be certain how much vaccine is needed to protect people against novel influenza viruses such as H5N1 avian flu, because they don't know what the immune system of a person protected against a new flu strain would look like.

Sure, they can observe whether immunization with H5N1 vaccine produces certain antibodies and to what levels the antibodies rise, but they have no way of gauging how much protection those antibodies will provide if the person is exposed to the virus.

"We can't get the answer to that until the pandemic comes. There's just no way," admits Dr. Robert Webster, the renown flu researcher from St. Jude Children's Hospital in Memphis, Tenn.

Of course, virus sharing is also on the agenda at the Assembly.

Bangladesh still struggles with bird flu.

ProMed on Bangladesh and Vietnam.

Surveillance is being stepped up in Volta.

African publication says bird flu deadlier than HIV.


At 7:49 PM, Blogger Wulfgang said...


The Helen Branswell’s article is without doubt one of her best, and written in her usual clarity and with the prescience of the facts and issues surrounding a pandemic vaccine.

In a nutshell, her summary also points out the dire situation the world faces, when the pandemic planning dots start getting connected. For example, reading between the lines, says the following:

• There is no sure-fire pre-pandemic or pandemic vaccine at this point, and there isn’t going to be a likely candidate, until the pandemic emerges in full force, and only then will the antibody protection factor can be gauged and deemed potent and acceptable. To think otherwise is wishful thinking at this point.

• Once the pandemic starts its world-wide transmission, by definition, it will be fairly obvious that Tamiflu may prove to be of limited value and efficacy. Acquiring it within 24 hours of exposure to any novel virus is a pipedream on a drawing board for about 99% of the population.

• Issues with Indonesia and other countries, for example China, over their refusal to share virus samples, will eventually become moot – there will be literally millions of samples of the deceased, from which to draw live samples at that point.

• The predicted 4-6 month time estimate for developing a pandemic vaccine for the major of the populations will finally be recognized as unobtainable, it will in reality be revised to the realistic 12-18 month timeframe, even under the best of conditions.

• The demands that will be placed on state and federal resources will be overwhelming – 5,000 cities or 500 hotspot regions cannot be supported simultaneously by the largest military force on earth – this is an impossible logistics challenge.

• The larger and densest populated metropolitan areas are most likely to get limited crisis support first, the rural and isolated areas will receive it last. Governments respond to “numbers” during a crisis, not necessary actual need.

• National Guard and Reserve support most likely will be overwhelmed, and will be doing well, just to hold their own – the true lack of supplies, equipment and manpower which has been consumed by Iraq will quickly become evident.

• The “wealthiest” world nations economic and delivery chain engines, run on electricity and fuel. Once both become unavailable, the entire interrelated and interdependent system breaks down. Hospitals have no power, homes, the internet, communications, delivery trucks, grocery stores, taxis, buses, airlines and pharmaceuticals – none of them work, move or are delivered.

• I submit that even if a pandemic is declared, a very large number of citizenry will still not make adequate preparations. It is not the nature or inclination of most individuals in developed countries to prepare in advance for disasters. Nearly fifty million Americans currently do not have health insurance and the vast majority of people have no means for retirement. Preparation for a pandemic is not in their cognitive process.

So far, the good news has been that the Tamiflu “blanket approach” to stem the tide of a pandemic, has been quite successful. However, at time passes, more and more densely populated third world countries are becoming overwhelmed with the virus, giving it exponential opportunities to mutate further. The really bad news is the following: vaccination of poultry and swine (the chief protagonists) have proven to be largely unsuccessful, because of inconsistent approaches and quality of vaccines; and certain cultures and types of governments (even religious customs) are not effective in controlling the virus.

We are on borrowed time, in my view. As long as countries in the world like China and Indonesia exist, who refuse to share virus samples, for what ever reason (it doesn’t matter) and who largely allow further mutations of influenza and all other deadly viruses – the world is under a pandemic watch.

Geographically, socially, politically, population-wise and culturally, both countries are world disasters waiting to happen.



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