Thursday, June 21, 2007

June 21 Flu Update

A second person in Vietnam is dead of bird flu.

ProMed on Vietnam's second recent death--note the family raised chickens.

There is a third outbreak in Ghana.

The outbreak in the Czech Republic is H5N1 (CIDRAP).

ProMed on the Czech Republic.

Perhaps accounting for the higher fatality rate, a researcher says flu in Indonesia is less susceptible to Tamiflu.

In counterpoint, a Canadian doctor says that Tamiflu could cut bird flu deaths in half if administered correctly.

We blogged recently on the new antiviral being investigated. Revere asks, what about old drugs? In our search for new drugs, are we missing obvious solutions, like statins.

This will get the blogosphere fired up. Report says US leads world pandemic efforts.

Experts are concerned that as public pressure on the bird flu drops, funds will dry up (from CIDRAP conference).

"Freedom from infection has not been sustained in the region," she said. "There has been a recurrence of cases in most of the affected countries, with some countries having continuing outbreaks. The virus may be endemic in some countries."

CIDRAP on the vets/bird flu story.

This CBC story covers something we blogged on a little while ago....the religious community in Canada in preparing for its role during a pandemic.

Malaysia is going to help "poorer" countries gear up for bird flu.

In India, Punjab is preparing for bird flu, too.


At 9:51 PM, Blogger Wulfgang said...


Interesting set of articles.

If I were a member of the Trades Union Congress in Great Britain, I would be wondering how really prepared the government is. The way the article reads, it would appear as if the threat of bird flu just suddenly surfaced yesterday and employer’s should start working on policies for sick leave and remote work locations. (These basic things should have been completed a year ago, so the article was a little surprising to me).

In the group of SE Asian nations who met to discuss infectious diseases – did you notice two country’s names noticeably absent ? (answer: China and Indonesia). I hate say it, but Vietnam appears to be the real emerging SE Asian leader in regards to international bird flu cooperation.

No thanks on the membership application to the HHS “Biodefense Advisory Board” – I already belong to too many figure head organizations or Boards of Director’s, that can’t quite seem to figure out what their real charter or responsibilities are. (other than advising… hmmm)

Regarding Revere’s commentary and ensuing discussion about the “Options for the Control of Inflenza VI Conference” in Toronto – he makes a very interesting speculation once again (twice in the same week) about the future – wondering if the meeting will actually take place again in three years. Most interesting and clever, because he doesn’t quite come out and say a pandemic is imminent, but infers it. He makes it very clear in his discussion, that unknown biological mechanics is driving the avian viruses, and this makes the calculation of a pandemic probability, almost incalculable and uncertain. I agree with his assessment.

One way to better assess the odds, or probability of a pandemic, is to simply consider it in terms of “increasing possibility”, or “increased likelihood”, as a result of the passage of time, and the spread of the viruses throughout the world. This is really what’s happening. More outbreaks are being reported each week now, regardless of seasons, in countries on nearly every continent.

The most alarming statement in the Revere discussion, is buried in the blog comments: Henry Niman’s statement that “the latest outbreak in the Czech Republic STRONGLY suggests H7N2 and H5N1 are co-circulating in Europe, providing the recombination opportunity for the H7 ease of transmission getting together with the H5N1 high CFR”.

This kind of situation is extremely disconcerting and would really make a “bad day” for all of us: a 60+ % documented and undisputed CFR average, worldwide for H5N1. This is thirty times the CFR of 1918.

It would take a massive response on a world scale, heretofore unknown to mankind, to deal with such devastation.


At 10:40 PM, Anonymous Nick said...

This was recently released and is full of valuable information.

GAO (Government Accountability Office). Influenza pandemic: Efforts to forestall onset are under way; identifying countries at greatest risk entails challenges. GAO-07-604. Jun 20, 2007

At 6:37 PM, Blogger Wulfgang said...


Your articles today do not contain good news, anyway you slice-and-dice it:

1. Viruses from Indonesia are showing 20-30 times less susceptibility (resistance) to Tamiflu. (news from Australian researcher – most likely accurate).

2. The deadly H5N1 virus strain is “mutating unpredictably” at a rapid pace and is very unstable and changeable (news from Asia Pacific health ministers in Sidney, Australia and the WHO).

3. The H5N1 virus is continuing to evade detection and control efforts and is changing as it moves to new ecosystems (CIDRAP)

4. We are moving towards virus “endemicity” and poultry vaccinations are reducing birds clinical symptoms – decreasing viral shedding, slowing disease transmission, but does not block infections entirely – potentially allowing the virus to spread silently.

5. A worldwide influenza pandemic could descend on the entire world within weeks: no country in the world has the antiviral stockpiles to fend off the first wave of a pandemic by covering anywhere near 65% of its population.

Couple this with the following factual information – pre-pandemic H5N1 type vaccines being stockpiled, or currently under development (like Indonesia is doing) – might not provide any adequate protection against the final pandemic strain, or S-T-R-A-I-N-S.

A reasonable person could conclude after reading your articles today, that we might all be on the verge of being royally and globally screwed: It would take six months minimum, and probably much longer (since manufacturer’s get sick just like the rest of us), for the countries of the world to develop and manufacture enough pandemic vaccine to have any effect on a pandemic.

The dilemma I see in all this is that is most we will be “on our own”, for quite a long time, to fend for ourselves, with little or no assistance. The collective information that we are starting to see in the news regarding the mutation, resistance building, and re-spread of the H5 and H7 viruses across the globe – indicates that the novel viruses are becoming “non-novel”. They are slowing developing themselves into potentially deadlier pathogens.

The internal threat assessments of our national security, economy, social infrastructure and safety, being conducted within the agencies of the federal government, will never be publicized Orange, because of the terrible implications. It could easily be far worse than any of your articles have indicated. While every effort is being made to prepare and inform the public about the potential disruptive effects of a pandemic, all agency heads and their staffs and families, have also made silent preparations for emergency refuge, to function in remote isolated locations (safe havens). This is a fact that none of you are being told publicly. I have said this before: the government is preparing for and planning for, a worst case set of events.

This information should tell you all how serious and encompassing the threat of a pandemic actually is: the leaders are covering their own asses – under the guise of “COOP planning”, which are general survivability plans for unlikely natural disasters and terrorist disruptions.

How many times have the leaders warned, “you are on your own essentially” ?

Logically, does this statement make sense for a “mild” pandemic ? Nope – any way you slice and dice it.



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