Tuesday, June 26, 2007

June 26 Flu Update

A new human case is reported in Vietnam.

Among birds in Vietnam, a new outbreak in one province, while four other provinces are declared clean.

ProMed on Egypt and Indonesian human cases from yesterday.

A second avian outbreak has occurred in Germany.

ProMed on this outbreak in Germany. Note especially this mod comment:

The distance between Leipzig and Nurnberg exceeds 200 km [124 miles]. Confirmation from the OIE reference laboratory in Riems is anticipated, as well as molecular data on the interrelationship between the recent isolates from Germany, Czech Republic, Hungary, England (as well as the recent Siberian isolates from wild duck?!). - Mod.AS

ProMed on the previous outbreak in Germany.

Meanwhile, Malaysia claims it is bird flu free.

The BBC on the international bird flu meeting being held in Scotland.

CIDRAP--could diluting the flu vaccine protect more people in a pandemic? (Note: This is curious to me, since the vaccines have had trouble stimulating immune response at low doses).

For example, in one scenario, the model showed that if 20 million of the United States' 300 million residents were given two 10-mcg doses of one vaccine, the attack rate would drop from 73.2% to 69.5%, and if the same amount of vaccine antigen were spread out over 80 million with two 2.5-mcg doses, the attack rate would drop to 67.7%.

Another scenario envisioned dividing the planned US vaccine stockpile among 160 million people instead of the targeted 20 million. That approach would lower the overall attack rate from 67.6% to 58.7%, according to the model.

Did more healthcare workers take a seasonal flu jab last year--and was it because of bird flu?

Nova Scotia has rolled out its pandemic plan.

Revere blogs on the GAO report on the USDA pandemic plan. He notes that H5N1 has a lot of uncertainty as it relates to humans, but much less as it relates to animals. So, a veterinary organization should be farther ahead than this.

ProMed/OIE report from Togo.


At 6:24 PM, Blogger Wulfgang said...


Easy and comical things first – Revere sure hit the nail on the head in his commentary about the GAO report on the USDA and DHS. I’m still chuckling about his observation about the DHS being the most incompetent and dysfunctional agency in the US government. He’s got that nailed – except for the Coast Guard and Secret Service elements - the rest of them (INS, Border Protection, Customs, FEMA, and Transportation) are pretty much wasted spending, dysfunctional and a misuse of precious oxygen in my view. It’s got more advisory panels and committees than all the worlds churches and Fortune 500, combined. Leadership, strategy, and reliability is totally lacking in this gigantic paper-pushing behemoth of a bureaucracy. As far as the USDA, I believe they will come through with flying colors if H5N1 ever comes to North America, A-N-D, the DHS gets out of the way.

The CIDRAP article was pretty disappointing. This definitely would be a last ditch effort and not the preferred way to proceed. If it comes down to diluting pre-pandemic vaccines, where only “half are able to neutralize target flu antigens”, and the attack rate is only reduced by minus 15-20% (from 73%), with no data on the efficacy or immunogenecity of such low doses … we all would be pretty much screwed and tattooed, Orange.

I’d rather take my chances on eating rhubarb or cabbage, than hold out false hopes of immunity vis-à-vis a diluted vaccine, at the front end of a pandemic. As they used to say during Vietnam, “I’m right behind you Lieutenant”. (yeah, I was in that fiasco, luckily my name’s not on the wall)

I see also in your BBC article which covers the meeting in Scotland, that the scientists “have been astonished at the rate with which in the past two years, H5N1 has spread to Western Europe: from the Far East”. And they are going to see “if we can build a better surveillance system”. My comment- too many conferences, not enough action. In Germany, the scientists there appear to be bringing up the rear, by trying to establish if the virus is connected to outbreaks in Czechoslovakia, and Hungary. I wonder if they’ve ever heard of wild birds ?

It appears that Europe has a critical immediate need to increase their surveillance efforts by about 100 fold and concentrate more on early detection. Indonesia, Egypt and Nigeria aren’t the only hot spots around the world. Europe needs to stop taking the attitude that it has eliminated or controlled the H5N1 virus – the facts are proving other wise.

Early detection, coupled with rapid responses, are the only solutions for controlling an emerging infectious disease on a global scale and keeping a pandemic threat minimized.

It appears (to me) that Europe is really very poorly prepared at this point, contrary to conventional wisdom.



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