Saturday, June 16, 2007

June 16th Flu Update

For the first time since 2005, a human has died of bird flu in Vietnam (given the widespread avian outbreaks, this was a matter of time)

His family raised fighting cocks and ducks, state media said.

ProMed reports a new human case in Indonesia.

Malaysia is looking to get a flu-free designation.

GSK is joining the parade to donate flu vaccine, and sell more at a preferential price to developing countries.


At 7:15 PM, Blogger Wulfgang said...


News is thin on any Sunday, but your article on the 20 year old who died in northern Ha Tay province in Vietnam, has a couple of interesting twists to it. He is only one of five individuals in the last month to come down with the virus. These one’sies and two’sies are not that significant in an epidemiology sense.

First, the fact that his family raised fighting cocks and ducks, is somewhat important – a double whammy "risk" factor, which is especially dangerous these days.

What is significant is that the risk of pandemic hasn’t gone away one iota. In fact it’s greater than it has ever been – especially since Prime Minister Nguyen Tan Dung ordered all 70 million ducks to be vaccinated immediately.

It is my belief and opinion that, once again, this mass vaccination being undertaken is going to contribute to further alarming genetic changes in the virus, similar to Indonesia and China. I’ll beat my “anti-mass-poultry-vaccination drum” once again, today: instead of massive culling of the suspect fowls, vaccinating such large numbers of domestic birds in the environment (in the billions), is driving the epizootic and viral evolution of avian virus in unknown and unpredictable ways – which has never before seen in human history. With known human CFR rates approaching 60-80%, the danger is becoming astronomical.

Vaccinating such huge numbers of poultry with these countries actually increases the likelihood for antigenic drift of viruses circulating in these fowl. Even if vaccination expected to reduce or eliminate infection in the animals, which will coincidentally reduce the risk of virus transmission from animals to humans, there are starting to appear very undesirable repercussions: it is accelerating the rate of evolutionary change of antigenic properties for the virus and causing the evolution (mutations) to proceed much faster than otherwise might have been expected. Mass vaccinations are also suspected of enabling the rate of evolutionary diversification of the virus into a greater number of subclades.

This, in turn, will make it more extremely complex to predict pre-pandemic vaccines, and it also increases the risk that none among the advance pre-pandemic vaccines will fit the actual pandemic virus when the pandemic starts.

Releasing of millions of their vaccinated ducks in their rice paddies ensures that the process will eventually mature into multiple pandemic strains, in my opinion. The only way they can beat the spread of H5N1 is evolve their production in large contain bio-secure farm factories, and rid poultry completely from back yard farms and the open environment.

I believe the WHO suspects this process I have described above, is true and is happening in most of these countries, but they cannot verify it due to lack of current strain samples. They are in a position, therefore, where they believe they can beat the pandemic clock with the use of Tamiflu, building increased world wide human vaccine manufacturing surge capacity, and increased surveillance.

I hope they are correct, but I suspect the odds are 50/50. When HHS Michael Leavitt gets on national TV to warn of an imminent novel avian influenza pandemic, we will all know that “time is up”.



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