Friday, June 08, 2007

June 8 Flu Update

The bird flu marches on. A 10 year old girl in Egypt has the flu, and she is "very critical."

CIDRAP on Egypt.

5 Malaysians are hospitalized with bird flu symptoms.

A magpie in Hong Kong is also sick.

Indonesia says that H5N1 now has an 80% mortality rate.

There are now avian outbreaks in 17 provinces in Vietnam.

Australia says 48,000 people would die in a pandemic.

Revere blogs an interesting study from China. Six people had died there who had no exposure to poultry. Study appears to point to wet markets as a significant risk factor.

Canada is beginning its wild bird surveillance.

APEC meeting ends with the right words--countries will share samples.

CIDRAP has the story on human antibodies protecting against the bird flu.

"In theory it makes obvious sense—it's an extension of the immunization process," said Osterholm, director of the University of Minnesota Center for Infectious Disease Research and Policy, which publishes CIDRAP News.

The main question on the scientific side is whether the antibody treatment would have broad enough activity to be effective against an emerging pandemic strain of H5N1, which could differ from the strain used in producing the antibodies, he said.

But on a practical level, Osterholm said, "Once a pandemic hits, there won't be time or materials to obtain and stockpile large volumes of this. What in theory is ideal, is in practice maybe a nightmare. I don't see how the plasmapharesis community is going to be able to quickly gear up to actually make lots of this antibody and then move it into the clinical setting in a timely way to have much impact. . . . The idea of trying to create millions of immunotherapy treatments is a stretch."

Australian publication says the vaccine shortage is a global threat.

Excellent Revere post on CDC mask guidance. Revere blogs that evidence is light that masks help, and if you were wearing a mask and thought you were safe, you might do some things you wouldn't otherwise--perhaps making you less safe.

The Catholic News Services mentions that one of its nuns is posting on the HHS blog.

Long-term strategies are being considered in Bangladesh.


At 10:51 AM, Blogger Wulfgang said...


Your two CIDRAP and Canberra Times articles really point out the current dilemma we face, concerning the ability to field a viable pandemic vaccine in large enough quantities to satisfy the world’s needs. While the CIDRAP article is quite intriguing, it ends up disappointing, due to the fact it can’t replace vaccines and it is not really viable to develop monoclonal antibodies in large enough quantities (for a novel virus) to make any impact.

Which leaves us where we are presently and will remain for a long time: first, the inability to acquire up to date H5N1 strains on a timely basis from specific countries, like China and Indonesia; and second, we face the situation of limited world wide production capacity, which prevents us from producing the necessary pandemic vaccines in sufficient quantity.

Both situations combined represent a huge global threat to mankind, which doesn’t seem to disturb either of them.

Without any doubt, the nine countries who presently possess the majority of the capacity to produce pandemic vaccines, will give the highest priority to themselves in a catastrophic situation. Regardless of any multinational agreements about an “international stockpile of vaccines” – the western countries will continue to hunker down further – especially, without China’s and Indonesia’s cooperation (which we haven’t seen in approximately a year).

If a real pandemic were to immerge in the next six months, I wouldn’t be too concerned with who is “inflamed in the rich-poor divide”. At the rate things are going, very few individuals in the entire world will end up getting vaccinated with a pandemic vaccine, so I’m not even too concerned about that either.

We are all in the pandemic boat together. When it sinks, it all depends on who gets the vaccine lifeboats.

What really concerns me is the following, and I have been harping on this many times now: assume that we do indeed over the next several years establish manufacturing capability and the capacity for these third world countries to inoculate their own citizens sufficiently…. Is there going to be any assurance of quality control on the entire strain selection and production process ? In some of these desperate countries the answer is a qualified yes, but in most of them, no.

The WHO has established an excellent oversight process over the last 50 years to assure that the most likely seasonal influenza strains are collected, analyzed and selected. With all these third world underdeveloped countries (mostly with weak or incompetent leadership, corrupt governments, and inadequate health care systems) attempting to replicate pandemic vaccine manufacturing and production, with primitive technology and insufficient data and analysis – we may be placing the world at greater risk than ever before. This is my view.

My main point is: does anybody have any confidence that China, Indonesia, Vietnam, or any of these countries, are even currently employing the correct strains when they inoculate their millions and billions of poultry several times a year ? So far, we’ve heard reports and rumors, that several have not and have exacerbated the problem, providing perfect opportunities for the virus to mutate further and spread to other countries.

The western world might be better off pooling our money, and simply supplying countries like Indonesia with 240 millions doses of H5N1 vaccine, on an annual basis, at no cost, rather then have them noodling around and experimenting with inferior home-grown pandemic vaccines on their human population and jeopardizing the entire world.

It might be far cheaper and safer in the long run.

That’s my point.



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