Tuesday, May 29, 2007

May 29 Flu Update

A soldier in China has H5N1.

The USA Today joins the chorus....don't forget H7 when you watch for a pandemic. (Check the comments from yesterday from a good comment from Wulfgang.)

CIDRAP weighs in as well. Human to human is suspected.

ProMed has this story. Note that their expert says human-human not happening.

Larger news thread on Welsh bird flu.

A Chinese woman was released from the hospital after three months of bird flu treatment. China says she was treated with serum from a survivor.

CIDRAP also reports on the two news stories from China.

Another duck farms was hit in Vietnam, with more than 2,000 birds dead.

A dead bird in Hong Kong was tested for bird flu.

China donated about $1M to Indonesia to help with bird flu fight.

A new spectrometer will help hospital diagnose 92 types of flu.


At 6:20 PM, Blogger Wulfgang said...


My comment today is on one of your most unlikely (and unglamorous) articles: the duck farms of Vietnam.

I believe Vietnam may prove to be the ultimate transparent litmus test for whether vaccination of poultry is successful or not – and whether it is actually is making the H5N1 situation worse in the long run.

Vietnam is entering a very desperate time, in my view. The H5N1 epidemic there is about to spread on a much larger scale.

Recall, Vietnam was one of the worst hit countries back in 2003, with 42 fatalities in 24 months. As a result, they carried out mass multi-year poultry vaccination programs, in phases, in the years 2004 and 2005 – using vaccines brought in from France (Merial) and Holland. In 2006, they started using bird flu vaccine from China, and not one poultry outbreak was reported for the entire year – that was good news. In 2007, Vietnam actually reverted to a domestically produced bird flu vaccine, and has vaccinated more than 121 million poultry in 99% of its provinces so far this year. As a result of these hundreds of millions of doses dispensed over the last three and one half years, Vietnam was duly lauded as the poster child for bird flu control.

Now they are becoming desperate, as bird flu in the last thirty day’s, appears to be re-emerging with a vengeance. They are currently resorting to one more compulsory mass vaccination, as they are on the brink of another epidemic. In fact, when the virus should be slowing down at the beginning of their summer, due to warmer weather, it has not skipped a beat. And I don’t buy Vietnam’s simple explanation that all infections in 2007 thus far have been those birds that were left out of the nationwide program.

Why is this happening ?

I believe what is going on are a couple of things: primarily they are using very poor or mismatched vaccines, like in Indonesia and in China. They were forced in the beginning to essentially use the vaccines that were only commercially available at the time – experimental vaccines. I am also speculating that their current outbreak is caused by their intensive cumulative mass inoculation campaigns over the last three years, which have inadvertently caused the H5N1 to silently spread further amongst the vaccinated birds. Improperly vaccinated poultry evade detection and forces novel selection pressures and produces further new mutated strains. This vicious cycle which they have created, coupled with the mass inoculations of ducks, which harbor hidden infections since they are natural host’s of H5N1 and shed the viruses undetected, has further exacerbated the problem.

Poultry vaccines should follow the same rigorous process as human influenza: the dominant circulating strains should be accurately identified; each virus strain should be produced separately and later combined to make one vaccine; purification and testing should occur to determine proper amount and yield of the virus to ensure concentrate is adequate for immunization of poultry; proper doses should be filled into vials and containers; they should be distributed by reputable firms; and vaccination procedures should be consistently applied. Unfortunately, there has been no regulation, control or consistent uniform procedures for poultry vaccines anywhere in the world – most of all, in China, Indonesia, Vietnam, Thailand, Egypt or Nigeria.

Now Vietnam is stuck, just like China and Indonesia, in a situation of “unpredictable viral evolution” – if they cease to mass vaccinate, then the infestation becomes permanent, whether it’s chickens, ducks or pigs, and the problem becomes endemic and uncontrollable. All this “experimentation” with vaccines has created a very “Kafkaesque” situation, which has wrongly been attributed to migratory birds and illegal poultry trade.

Where this all culminates, is anybody’s guess, but I predict it won’t be pleasant.

I hate to use the trite and over-used phrase, “it’s not a matter of if, but when” a pandemic occurs, but I truly believe with every massive multi-phase poultry inoculation program these countries perform, we are one gigantic step closer to all hell breaking loose.

Just my usual opinion, from the sidelines…



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