Sunday, December 16, 2007

December 15 Flu Update

The Pakistan situation continues to evolve. There now appear to be 8 human cases, which is the most we have seen emerge in one place. We don't know if this is it, but we haven't seen something like this before, and it must have some significance.

From the Canadian Press story....note WHO comment.

The WHO said confirmatory testing must still be done. And a spokesperson for the agency said investigations are underway to try to determine how the various people became infected, but noted some human-to-human spread may have occurred.

"We can't rule it out," Gregory Hartl said from Geneva.

"There are other plausible explanations.... We don't know enough at this point. And in some of these cases, one never will know enough."

My note: Even if another plausible explanation emerges, it is still something which has not happened before.

Note2: There are many, many stories on the Pakistan situation, which are essentially all the same story and not listed here.

ProMed covers the Pakistan situation.

Revere notes that his site isn't for breaking news, and neither is this one. However, he cites some places to go for updated flu info.

IHT reports on recent flu developments.

Effect Measure provides context to Myanmar and Pakistan. Must read.

There's an avian outbreak in Germany.

But hey! Armenia is safe.

More culling in Saudi Arabia.

Myanmar stresses flu prevention.


At 7:35 PM, Blogger Wulfgang said...


A couple of quick thoughts about your news today – I will avoid a discussion of the specifics in Pakistan, since nobody knows the details yet – and it may be many weeks until the real facts (if that is possible) are known.

First, I buy the WHO pooh-pooh comment that, “experts who study H5N1 have come to expect this kind of upswing in viral activity at this time of year, both in poultry and in people”. However, I am sure those passengers on the Titanic had the same false sense of comfort and security, as the ship first started listing. It is very apparent due to the lapsed time in the reported human infections by Pakistan, China and Myanmar (Burma), if these reported incidences were the actual start of an authentic pandemic, the WHO would be so far behind the power curve, that they probably shouldn’t waste the travel fare investigating. Just make sure the Tamiflu is pumped into the populations.

Secondly, people are so concerned about the micro aspects of individual infected head counts in Pakistan, they are really missing the broader implications of the suspected human-to-human transmission, and what it represents. The much larger concern in my view is the proximity of these bubbling human infections: in the entire Indo-China, Asia and the Middle Eastern areas, which are all densely concentrated with humans. In fact, China (1.4B), Pakistan (165M), India (1.1B), Indonesia (246M), Vietnam (84M), Myanmar (47M), Egypt (79M) and Nigeria (132M), where H5N1 is endemic, added together, comprise approximately 50% of the entire worlds population of 6.6 Billion people. Infections of both poultry and people in these countries, represents a huge risk to the rest of the world.

And I suppose there is a third observation that needs noting in the present Pakistan situation: how porous our borders really are, and how simple it is for any infected individual with any communicable disease, to board a plane and travel cross-continent. All they need is a ticket.

Yes, I will wait like everyone else until the WHO and CDC folks get done flailing around in Pakistan and fill up their notebooks with detailed timelines and interviews and provide their assessments of this series of incidents and infections. However, that is all what I consider CYA, cleanup and damage control. We will never hear how close we dodged the bullet, nor will we know how many hundreds if not thousands, of individuals were stuffed to Tamiflu to avoid a massive epidemic.

Orange, have you ever seen one official report from the WHO, or any country for that matter, which reveals for these outbreak locations, the quantities of Tamiflu tablets that had to be dispensed, in order to preclude additional human infections ? I haven’t.

If we knew this information, it might be a truer indicator of just how severe these human cases really are becoming.



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