Thursday, January 17, 2008

January 16 Flu Update

Very important story. This report says that bird flu has been misdiagnosed in cases in Asia, much as it often was early in the 1918 pandemic. This has delayed treatment, possibly exaggerating the lethality of the virus. It also effects the quick response required for the world's containment strategy.

``There are substantial challenges to a rapid diagnosis,'' said Frederick Hayden, a doctor with World Health Organization's Global Influenza Program in Geneva and one of the study's 11 authors. ``We don't have right now an efficient, highly predictive and sensitive point-of-care diagnostic test for H5.''

Furthermore, lethality could be effected by the different variants of the disease that are circulating.

It reports that ongoing examination of the genetic structure of viruses shows they have evolved widely, currently breaking out into 10 separate families or clades.

Additionally, CIDRAP reports that a study shows that infection sources are unclear in 25% of cases. This is a must read, as it summarizes Tamiflu resistance, the cytokine storm, etc.

Link to the full report, for those interested.

Along these lines, there is some thought the virus might be kicked up in dust or stick to surfaces to infect people.

The OIE chief clarifies, but does not entirely retract his controversial comments from the other day.

Revere jumps in to say that the OIE chief didn't quite make it safely home with his new statement.

Iran says it has an avian breakout among free range chickens.

A fourth swan tests positive in the UK.

Culling has stopped in West Bengal while additional testing is done.

This article says the outbreak in India is the worst the country has seen

There's also an outbreak in another part of India.

India says Bangladesh caused the most recent outbreak.

Apparently, there is talk of vaccinating all free range poultry in the UK. Here is a debate over whether that will help.

Revere has new data on whether dogs and cats can be involved in avian flu. Note that, as always, we need more data.

1 Comments:

At 6:57 PM, Blogger Wulfgang said...

Orange;

I believe after combing through your articles today your very first observation hits the nail squarely on the head: we are seeing an abundance of misdiagnosed bird flu cases, much as it often was early in the 1918 pandemic. Very observant on your part – and I happen to agree with you on this key point. I do also think there are some other dangerous phenomena occurring, namely…because of the pervasive spread of the virus throughout the world, and the inability to diagnose or test accurately and timely, the WHO is clearly unable at this time to ascertain or assemble any real logic or predictions as to what progressive stage this virus has really achieved. The smartest WHO and OIE scientists literally cannot predict with any certainty what this virus is going to really do, if anything, or when. Another thing is becoming readily apparent – this is a virus that has truly become a worldwide problem – economically it has the potential to decimate the entire poultry industry in most third world countries. If it were to mutate further and advance into the human population, it could easily and credibly be devastating in its destruction of humans and their societies. Final comments on your first three articles: H5N1 is showing eerie similarities to 1918 every step of the way, from the large number of misdiagnosed people and symptoms, to the propensity of it to inordinately strike the young, to the pneumonia-like syndrome it exhibits, and to the scientific confusion about exposure mediums or sources of infections. It does at least SEEM that history is about ready to repeat itself.

Notice specifically in the CIDRAP article that the WHO will not endorse any prepandemic vaccination at this time in order to prime the human population. I believe this is unfortunate, because in my view, they need to strongly start considering the possibly and likelihood that a novel avian influenza pandemic could spontaneously erupt, without warning, rendering a large portion of the world without any defense, except for Oseltamivir. And Tamiflu may not prove to be effective. If they fail to develop a clearly articulated prepandemic vaccination recommendation and criteria in advance, the nations of the world will decide on their own.

Your article about Iran finally reporting its H5N1 bird flu outbreak (30 days after it occurred), when most all of us had seen numerous local reports of this event back in December 2007, really highlights the transparency and political problems the WHO and OIE is battling. What’s more, what India is reporting in your MSM articles and what is actually being reported in their local newspapers, is quite different: their bird flu outbreak is far from over and they are battling one of the biggest outbreaks ever. Many thousands of infected chickens were sold once they were suspected of being ill, removed to other places, hidden, or even eaten, to avoid the culling and quarantine efforts of the Indian government. This has no doubt resulted in a very large number of infected poultry being moved to infect other locations, making the disease nearly impossible to eradicate, regardless of the government spin and hype. The real lesson in India is that with over one billion people at risk, strong and swift and decisive government action is required – and they need to discard their “village voluntary compliance” approach when it comes to bird flu.

India can blame the source of the infection in its poultry in West Bengal, on Bangladesh all it wants, but its spread within its own districts is clearly due to their lack of communication, surveillance and control procedures within its own country.

Your news today is not all that encouraging to us bunch of neurotics out here.

Wulfgang

 

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