Thursday, August 16, 2007

August 16 Flu Update

Yet another death in Indonesia. This is a 17 year old girl from just west of Jakarta. They are "working" to figure out how she was exposed.

Glaxo Smith Kline is selling more vaccine to US, and is planning clinical trials in the US. The stockpile is now just above 27 million doses. CIDRAP reports.

Baxter has a contract to supply the UK with vaccine if there is a pandemic.

Toronto researchers say they have discovered how the body reacts to SARS--and that info could be a clue for an influenza pandemic.

The Lancet has a study on an oil/water emulsion being used as an adjuvant.

There is a move for a uniform naming nomenclature for HPAI.

1 Comments:

At 6:10 PM, Blogger Wulfgang said...

Orange;

Have you started to notice the very short 4-5 day timelines (i.e. first reported sick – hospitalization – death) in these Indonesian bird flu fatalities lately ? This is becoming eerily similar to 1918.

Your CIDRAP article about more US and UK H5N1 vaccine orders from manufacturer GSK, and the announcement of clinical phase I/II and III trials, is kind of intriguing. Two totally separate pre-pandemic vaccine approaches between the US and UK are involved here. In my view, if a country doesn’t have a pre-pandemic vaccine reserve established in advance, sitting in a strategic reserve stockpile ready to deploy at the onset of a pandemic – they are hosed.

There simply, in my opinion, will not be enough time to manufacture a “tailored” H5N1 vaccine (and get it delivered) to do the UK any good, once a pandemic is declared by the WHO. We are probably talking 6-12 months for the delivery of any custom vaccine – which would be no doubt long after the primary effects of a pandemic would be felt. That’s pretty risky in my book.

Much better to have a strategic reserve of doses all ready in place, inoculate the citizens, and take the initial calculated risks, up front. I would think this would be the optimal approach.

What is most interesting about your article which discusses revision of the H5N1 nomenclature, is that it appears to makes a whole lot of sense: if done correctly, it would quickly illustrate the complexity and the large magnitude of reassortments which have taken place. It would provide a visualization of how the patterns of transmissibility are maturing and progressing, by the phylogenetic branches. From what I understand about influenza virus mutations – if you track the evolution and mutations of the HA protein in H5N1, you are essentially going to be able to establish patterns of transformation and predict its eventual transmissibility to humans (mathematical models and timelines). You might even be able to predict a flash point, probability, and geographical region.

However, the bad news for the day is (at lease it seems to me): this revised phylogenetic approach is completely contingent/dependent upon the receipt of current and timely received sample strains. Without these up-to-date strains to “label”, the trees and branches, the process will be always be a significant “percentage incomplete”.

This is another reason why we need countries like Indonesia and China to stop talking, and force them to “step up to the plate”. Sadly though, both countries are more concerned with the economics of tourism (for example, the 2008 Olympics and Bali), and are obfuscating or down right refusing to reveal the true factual situations go on. We are only getting a small part of the story.

As a result of these misguided political and economic priorities, this is why China’s domestic pig population is currently collapsing under their very noses with PRRS, and why Indonesia feels it must start pre-pandemic H5N1 vaccination on its citizens in September.

Just my opinion, of course. (keep in mind it has taken me many years to cultivate my keen neurosis).

Wulfgang

 

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