Thursday, December 20, 2007

December 19 Flu Update

WHO has told Pakistani authorities that the cluster in Pakistan was due to a combination of common infection sources and some H2H from very close contact. With what we know, this is plausible. There have been other H2H transmissions from close contact. It would be interesting to see if the onset dates match the theory. Finally, the ultimate point is to find out if the virus itself was any different.

CIDRAP has this from FAO.....avian outbreaks were down for 2007, despite a recent spike.

Voice of America has this from David Nabarro:

Bird flu is a problem that will likely be with us for some years to come, according to David Nabarro, senior coordinator for avian and human influenza at the United Nations. But citing data on the spread of the H5N1 virus from 146 nations, Nabarro emphasized the positive. "The first thing to say is that the situation has changed, between 2004 and 2007, the rate at which new countries are being affected by H5N1 has reduced, we've got a bit of a plateauing [leveling out], the number of human cases, which act as a sentinel, has slightly decreased, and the human deaths have also decreased." He said that broad epidemiological evidence suggests that the H5N1 virus situation is not quite so serious.

Declan Butler of Nature interviews the Indonesian Health Minister about its view on sharing virus samples.

We are willing to share viruses for research purposes but if a commercial company wants to create a vaccine from those samples, then it must negotiate with Indonesia, which has rights over the samples.

But the key outstanding concession Indonesia demands is that all shared virus samples be subject to a material transfer agreement clearly setting out such rights. We already share our virus-sequence data with the Global Initiative on Sharing Avian Influenza Data (GISAID), a body created last year. I consider GISAID has established a fair and transparent mechanism for regulating genetic-sequencing databases because it includes a material transfer agreement.

The current US budget has slashed pandemic funds from $870M to $76M.

The US State Department is running a series of articles on bird flu preparedness, featuring Vietnam here. Interesting point: they say that preparing for bird flu has strengthened the country's overall capacity to fight disease.....does Revere write for the State Department.

Speaking of Revere, he does write on Effect Measure. Here, he blogs yesterday's news that Indonesia looks back at some past cases to see if they were bird flu. He notes how differently this is explained in different media outlets.

A University in Pakistan is trying to raise awareness.

Article details bird flu preparedness challenge in East Java, Indonesia.

“I’ve never been frightened of bird flu,” Maryati, a chicken-seller, told IRIN, while cutting up a bird. “I’ve also heard about cases of human avian flu but I’m not worried.”

Canadian experts say masks don't protect against flu.

The world association of Chief Risk Officers has released a position paper on bird flu.

Virginia is well prepared for a pandemic.


At 3:37 PM, Blogger Wulfgang said...


I see in one of your first articles that the FAO reports a downturn in H5N1 outbreaks for 2007. Sounds plausible, except when you read the article carefully, a couple of sentences really poke out at you. One is, “Also, wild bird deaths were reported in Hong Kong, but not in mainland China, the second poke-out is, “The only Middle Eastern country reporting an H5N1 outbreak so far this year has been Saudi Arabia”. Do these sentences sound plausible – nah, both very unlikely, in view of the shoddy and misrepresentative reporting we are actually seeing. In fact, a father and H5N1 infected son (confirmed) were just quarantined at the Kuwait airport this week – but no report of infected birds anywhere in Kuwait. This scenario is just like in China, people get infected from H5N1, they die, and no infected poultry reports. Then the government officials act all dumbed down and report no direct infection with poultry. If you believe this crapola, I still have some more land in Florida available for sale folks.

I started reading the Declan Butler interview with that idiot, Siti Fadilah Supari, until I got to the second paragraph, where she asserts that western rich nations actually create diseases and infect poor countries, I guess like in Indonesia. Then I stopped and thought, what’s the use? She actually is severely mentally challenged. She reminds me of that that New Orleans mayor, Ray Nagin, who was totally oblivious to the category V hurricane bearing down on his city twenty four hours before it hit and ignored evacuation advice. He then alleged that all the New Orleans problems associated with Katrina were the result of racism and failure on the part of the federal government to act quickly enough. He accepted no responsibility, kind of like Supari. He was too busy entertaining his guests from out of town to even be slightly concerned about his constituents. Both Supari and Nagin are incompetent individuals who are still in positions of power, who have no business doing anything, except housekeeping or driving a cement truck. But they are both still in office, and so I suppose we still have some surprises in store – they still both represent a danger to the public.

Your saga about Congress cutting the 2008 HHS budget is because they didn’t spend all of their 2007 budget by Sept 31st. They still had not managed to spend a whopping $ 1.2B of their 2007 appropriations. I could have helped them – I have ideas. The rule in government is: if you fail to spend your budget, it will get cut the subsequent year by Congress, who will interpret your failure to spend, as “not needed”.

Regarding your State Department article about Vietnam, which describes the close cooperation of USAID, HHS, CDC, USDA, FAO and the World Bank, and their financial and technical support to help build their public and animal health infrastructure – this seems to be in total contrast to belligerent Indonesia. I do believe that the Vietnamese government is acting, reporting, controlling and using their resources for the public good and in good faith. In Indonesia, the plethora of poultry wet markets, lack of education, government and religious corruption, and inept public health leadership, tells me that it’s an avian sinkhole just waiting to collapse.

Finally, I read your World Association of Risk Officers position paper article. Actually, these pencil pushers and green-eyeshade types have nailed the bird flu situation fairly accurately, which is not surprising to me. According to their analysis, based on the facts and circumstances of 1918, they “expect the excess mortality to be significantly lower if a pandemic as severe as that experienced in 1918 were to occur again today”. I don’t doubt that for a moment. HOWEVER, based on the fatality rates we are seeing today with H5N1, Ebola, SARS, XRTB – the likelihood of modern day pandemic staying within the 1918 epidemiological parameters, is very questionable.

I wouldn’t bet money on the next pandemic being in the 1918, 1957 or 1968 neighborhood as far as infectiousness and mortality rates. I believe we are going to see the next pandemic as an uptown version, a novel avian virus on steroids, driving in a Hummer, with the Rap music turned way up.



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