Tuesday, December 04, 2007

December 3 Flu Update

Bird flu outbreak in Romania.

CIDRAP on the Chinese man who died of bird flu.

Must read Revere post on Chinese case. Everyone agrees there probably are more cases there than we know about, but the route of exposure is not apparent in the cases we do know about. If you believe China's numbers, than transmissibility is low, and that's good. Except, it means that the case fatality rate really is as high as it appears now.

CIDRAP on Poland and Bangladesh. Note additional information about H5N1 turkeys being in the human food supply.

More on IT prep for a pandemic, as they continue to test scenarios. (One thing these guys seem to get is that when you test your system for a pandemic, you learn about your system in ways you can use even if there never is a pandemic).

Saudi Arabia says WHO is monitoring its bird flu response.

India asked the world to look for "low cost" means of fighting bird flu.

Also from India, education is identified as key to fighting bird flu.

The Oklahoma legislature is looking at the state's pandemic prep.

GPs in Ireland say that pandemic would have a "huge impact."


At 7:17 PM, Blogger Wulfgang said...


I see the Revere clan is just as baffled by the Chinese bird flu death reporting methodology and lack of supporting documentation, as the rest of us. In my view, and as you so aptly point out, IF YOU BELIEVE CHINA’S NUMBERS, then it’s logical that transmissibility is low and the case fatality rate is as REALLY high as it appears.

However…I don’t believe their numbers at all, and never have. Speculation of “wet markets”, not withstanding, I believe what is occurring is that the total reported number of H5N1 infected people in China is being vastly understated and/or misreported for political, economic, public health and social reasons. I also believe this is exactly the case with Indonesia. What is consistent between the two countries is that they are both massive reservoirs of HPAI bird flu infection and do not want the extent of the infestation made public. However…

If individuals are becoming infected with H5N1 in China and Indonesia, and they had absolutely no contact with sick poultry or processed wet market poultry, then one can only conclude that the government officials are not being truthful, or other unknown vectors or reservoirs are involved. Furthermore, one can also conclude that if the situation is that atrocious in both countries, then H5N1 tainted poultry meat has been, or is being, distributed to their citizens – similar to what just happened in Poland. In other wards, I am describing a situation in both countries so bad, that they are only attempting to “contain” the infestation through massive poultry inoculations, and they are finding that they cannot eradicate it.

As China and Indonesia have both found out, and which India is about to learn, there are no “low-cost options” for fighting bird flu once it has infested a large segment of a poultry population in a country. The continuous life-and-death-cycle of avian viruses are set into motion, much like the proverbial “perpetual motion” machine, and they become unstoppable by any known scientific means, so far. Either you destroy the entire industry and start over, or you vaccinate the birds as a stop-gap measure – and neither method works.

Now comes the most amazing part of the story in the avian evolutionary process: we have several virus models to look at in Africa, with the Ebola and HIV. The Ebola virus situation in Uganda is rapidly devolving into an extremely bad situation. It could be are next pandemic, and not an avian virus. The Ebola virus has apparently suddenly mutated from a previously unknown type of Ebola, making it the fifth strain, and is currently running rampant in Uganda and parts of the Congo. The similarity to the evolution of H5N1 is startling, and it appears to be going through a similar internal gene “restructuring” which is allowing it to become more widespread in exchange for a reduction in lethality. The current mutation may have produced a mutation that is less deadly, but is more easily transmitted – this seems to be the phenomenon we are seeing, and it is the most grave of conditions – it could allow an epidemic of the mutated Ebola virus to reoccur in vast pandemic proportions. It also has a wide range of known reservoirs which makes it hard to spot. Even though there are no known instances that I know, of a virus changing from a bloodborne or bodily fluid route of transmission to a respiratory one, it is entirely possible that what we are seeing is a mutated airborne “capable” Ebola virus, in process.

The HIV virus has a similar evolution history of spiraling out of control. Sequencing studies prove that in the mid-1970’s, zoonosis or some other unknown significant mutational event occurred, which caused the virus to subdivide into at least ten different clades. Although the primary route of transmission is still by blood products or bodily fluids, the number of humans who succumb to infection on an annual basis, easily numbers in the millions. It already qualifies as a pandemic virus.

Final question: are we seeing the H5N1 evolve into a pandemic virus in China and Indonesia right before our very eyes, similar to the HIV and Ebola mutations which have occurred in Africa ? I find the analogy and similarities rather startling.



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