March 22 Non-Update
No update today. Events have conspired against me. I hope to have an update up tonight.
MArch 13 Flu update
As reported earlier, the standoff between Indonesia and WHO continues. NO sample sharing until Indonesia is assured in writing that the strains will not be used in an "unaffordable" vaccine.CIDRAP with what might be today's most far-reaching news. A review of studies says that influenza is generally not airborne, but is transmitted at close quarters. This is contrary to a great deal of research, which the study finds to be faulty. The research team supports more robust research and prophalytic anti-virals.
Dr. Osterholm has doubts:
Michael T. Osterholm, PhD, MPH, director of the University of Minnesota Center for Infectious Disease Research and Policy, publisher of CIDRAP News, expressed skepticism about the authors' conclusion that airborne transmission is unlikely to be a major factor in spreading flu. He said that view doesn't fit well with the seasonal flu's typical pattern of erupting nearly simultaneously in widely separated places.
"From my 30 years of experience I've always been impressed with how seasonal flu functions on a community basis as an aerosol-transmitted disease," he said. "We can see outbreaks in areas separated by hundreds of miles; that's much more consistent with an aerosol-transmitted pathogen—though that doesn't prove aerosol transmission. Pandemics have marched around the world in weeks to months in eras before we had jet planes. That smacks much more of an agent that's transmitted by the aerosol route."
We wondered here why the US was moving ahead with a pretty blah Sanofi vaccine, when Canada appears to have a better one that uses an adjuvant. Apparently, the US is now considering mixing the two approaches.New avian cases have emerged in Myanmar.India has banned the import of live poultry--pigs, and pig meat--from flu stricken nations. Inclusion of swine is interesting.I have said here often that what fascinates me about the flu is how it finds the weak points in how we live...without fail, like water finding a leak. Here is a story in that vein...the cultural practices of rural villages in Egypt and how they contribute to the bird flu.Also from Egypt, bird flu has emerged in flocks that had supposedly been vaccinated. It is unclear if the vaccine didn't work, if the strain is different, or people lied about their flocks being vaccinated.24 penguins died at SeaWorld in Australia. Bird flu is ruled out.Counties in Idaho are working on their pandemic prep.Brazil says it has found an effective adjuvant.Via an alert reader, Scottsdale AZ is also doing flu planning--before the issue hits the front page.
March 7 Flu Update
The bird flu has reached Hanoi (avian outbreaks).Bird flu continues to break out in Kuwait. (I don't think we are aware of a country with this kind of avian presence that has not had a human case.)China says it is not the source of the bird flu virus.
Effect Measure blogs the paper that started all this, ending up frustrated by the quality of the writing and the way the ideas were presented.ProMed has the news from a number of countries, and also mentions this article based on the press release from the University. Note even their mod says he/she is withholding comment until the actual article is available.China claims a mass cull has taken care of the flu problem in Tibet.CIDRAP on the Iowa Flu Market. Dr. Osterholm thinks it is a bad idea.
"The findings, which say Guangdong is the source of the multiple avian flu virus strains spreading both regionally and internationally, are the wrong conclusion to the evidence and lack credibility," the China Daily quoted He Xia, a Guangdong agricultural official, as saying.
It did not elaborate.
Not everyone thinks the AFM is a good idea. "It really compounds uncertainty," said Michael T. Osterholm, PhD, MPH, director of the University of Minnesota Center for Infectious Disease Research and Policy, publisher of CIDRAP News.
"Right now the world's best experts can't tell you what's going to happen, so having 100 people predict what they don't know doesn't add any more precision or intelligence to the issue," Osterholm said. "It's maybe not quite a gimmick, but it doesn't give me any more reason to think we'll be more informed about the next pandemic."
He added, "Whether you have a market or not, you still need good disease surveillance. This just seems like a glitzy way of doing disease surveillance."
This article from the Globe and Mail (Canada) is excellent. Talks about British NHS plans to have people help their neighbors during a pandemic (picking up meds, etc). Question is this...sure you're a good neighbor. But would you be in a pandemic?Japan is spending money to prepare for a bird flu pandemic.Novavax of Pennsylvania is a late entrant into the vaccine war, but they have spunk.
March 5 Flu Update
Helen Branswell on the big vaccine news, that GSK says it has a vaccine that protects against multiple strains of bird flu.
The GSK vaccine is made with an adjuvant, a chemical that significantly enhances the activity of the vaccine. Earlier work by the company showed it could trigger what is thought to be a protective response with two small doses of vaccine, at 3.8 micrograms apiece.
An unadjuvanted vaccine made by Sanofi Pasteur required more than 23 times as much antigen - two doses of 90 micrograms - and even then fewer than half of volunteers generated antibody levels thought to be protective.
(Given this, can someone with a better background explain to me why the US is using the Sanofi vaccine?) Revere blogs on the Sanofi vaccine being "better than nothing."China is the source of H5N1, according to this analysis. More specifically, Guangdong.\
And Guangdong appears to be the source of renewed waves of the H5N1 strain, which has killed or forced the destruction of hundreds of millions of birds, the team at the University of California Irvine reported. "We show that the Chinese province of Guangdong is the source of multiple H5N1 strains spreading at both regional and international scales," the researchers wrote...
Russia says that new cases have stopped emerging in birds.
China is gearing up to fight the flu, including required immunization of all domestic poultry.There were dead birds in Myanmar, but they do not have H5N1, according to reports.There are now 50 avian cases of flu in Kuwait.25,000 birds have been culled in Kuwait.Reports from Laos continue to indicate that the country had its first bird flu death.WHO concurs, via CIDRAP.Africans are reminded that bird flu remains a threat.Business Week on the leverage Indonesia has won for poor countries in the struggle to allocate flu resources.A Canadian professor outlines the threats of bird flu for a Romanian publication.A table top exercise will be held in Saipan.A couple of days ago, we ran a story about a vaccine solution proposed in Hong Kong. This is a profile of the researcher, who is using techniques he learned fighting AIDS.A Health Region in Alberta is holding a pandemic seminar.Malaysia says it is sharing its experience in diagnosing flu with other countries, since they are bird flu free and all.The UAE is stockpiling Tamiflu to prepare for a bird flu pandemic.
February 28 Flu Non-Update
I'm traveling today and won't be able to update the blog. Next update will be Thursday evening (maybe), or Friday (for sure).