Saturday, December 29, 2007

December 28 Flu Update

annnnnnndddddd, we're back.

Two new human cases of bird flu in Egypt.

WHO finds one case of h2h transmission, but no mutation in the virus. Correctly, they state:

"There is no suggestion that the virus has changed into a form that poses a broader risk," WHO spokesman John Rainford told AFP. "If that had been the case, we would have witnessed more cases of human transmission."

CIDRAP on a new confirmed death in Vietnam, and the Egypt cases.

There is also a new avian outbreak in Myanmar.

Revere with an interesting post, defending the right of people to interpret data as they see fit, but not question the veracity of professionals risking their own safety in the field.

Time Magazine says a bird flu vaccine is a Top 10 medical breakthrough for 2007.

In Vietnam, they held an airport drill to prepare for further outbreaks.

Avian outbreak in Bangladesh, commence culling.

Bahrain has mapped out a plan to fight bird flu.

Philippines announces new steps to fight bird flu.

A bird flu workshop is planned for North Carolina.


At 8:06 PM, Blogger Wulfgang said...


Welcome back. I find the WHO statement rather curiously worded, as well as their news releases in general, concerning the recent Pakistan cluster of nine individuals. The statement you posted, almost sounds like it was Indonesian in origin: “ if that had been the case (i.e. mutation towards higher transmission), we would have witnessed more cases of human transmission”. The question is therefore, how many case indicate increased transmissibility – 25 or perhaps subjectively even 50 or 75 ?

I believe also there is a valid question of “false negative” testing involved in the Pakistan cluster, especially since the testing of samples was done well after the patients were administered Tamiflu, including the 30+ direct contacts involved. If this were to be the case in Pakistan, then one really has to question the validity of test results and suspected gaps in other places, like Indonesia, China and Egypt. One would have to certainly question the CFR rate statistics themselves. In my view, the recent cluster in Pakistan is concerning, but not necessarily alarming, because we will need to see a much larger infected population, in more countries, to raise the pandemic level and sound the alert.

I certainly buy Revere’s comment about “defending the right of people to interpret data as they see fit, but not question the veracity of professionals risking their own safety in the field”. HOWEVER, I think the WHO is starting to dance on the pin a little with their explanations. We are in fact seeing a sharp and noticeable increase in human infections once more, especially in Egypt, Pakistan, Indonesia which are most likely clusters that are increasing in some limited form – calling the outbreaks “no evidence of sustained or community human-to-human transmission” - seems to be the new spin statement framed to down play or defuse this upward trend in human infections and international concern we are seeing. India, nearly all the countries in the Middle East, China and Asia, all are on high stages of influenza alert, and have emergency Tamiflu stockpiles and full fledged hospital action plans in place. This means they are very worried in my book. We also have another disturbing phenomenon going on: the epizootic of HPAI is spreading unabated in Vietnam, Russia, Saudi Arabia, Indonesia, Iran (yes, contrary to their denials), Egypt, and most probably in Europe and central Africa. Poultry inoculations on the most massive scale known to mankind, do not seem to be effective.

I guess what is really troubling me is that we never hear of any dissent by the WHO scientists in their assessments. Their senior spokesmen always seem to have news releases that are dismissive in tone, and they are starting to seem too carefully crafted, so as not to upset the political or economic equations anywhere. I understand they have to perform a careful balancing act on an H5N1 tightrope: any false alarm or if they pull the trigger prematurely, they instantly and permanently lose credibility; and if they miss the “call” completely, the game starts and they forfeit and pay the stiffest of penalties.

Could the WHO actually be falling into the terrible trap by under estimating their risk assessments by their own field scientists and investigators ? I really am wondering here, because I have seen first hand, some monumental mistakes made by stellar organizations who just simply didn’t listen to the internal warnings and risk assessments of their own brilliant internal scientists, physicians and engineers – that is, until disaster struck – then hindsight becomes twenty-twenty, and the finger pointing, fact finding teams and culpability starts.

The overall macro rising trend we are actually seeing with increased human clusters and repeated widespread epizootics in countries, is simply not being reflected in their well orchestrated news releases, at least in my view.



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