Friday, January 25, 2008

January 25 Flu Update

WHO confirms deaths in Vietnam and Indonesia.

The Bird Flu is said to be getting worse in Bangladesh.

Thailand has a new avian outbreak.

W. Bengal, India, says it did not delay fighting bird flu (my note: this will just underscore that the usual petty bickering will continue to be a feature of a pandemic).

Authorities are fervently trying to prevent bird flu from reaching Calcutta.

ProMed looks at news from Indonesia and Vietnam, and also looks at the possibility of swallows as flu vectors.

The UN says bird flu remains a global threat at global conference.

CIDRAP has this as well...noting that the virus continues to have pandemic potential.

Effect Measure blogs this as well. Note that no one claims to know the answers, but Revere wonders why we wouldn't take action based on those who say a pandemic could happen.

Some mutual aid between states is designed to help fight the bird flu in India.

Raising the spectre of viral resistance, docs in US are continuing to prescribe old antivirals against standards. (CIDRAP)

China confirms father-son flu transmission.

Earlier this week we learned that WHO was tracking flu viruses. Note here via ProMed is a link to the resulting document.


At 9:48 PM, Blogger Wulfgang said...


Unfortunately, from the news articles I am reading, I am getting the very strong impression that the WHO, FAO, and OIE are acting more in the administrative role as a “clearing house” for world wide bird flu dissemination of the latest information, rather than the proactive facilitative agencies of behavioral change and emergency coordination management, they should be. Notice the headline titles in your articles: “WHO confirms H5N1 deaths in Vietnam, Indonesia”; “UN says bird flu remains a global threat”; and “FAO: spate of H5N1 outbreaks warrants stronger controls”. Just an observation here.

The bird flu situation in India and in Bangladesh, is out of control at the current time. India was totally unprepared for the massive infestation of H5N1 in West Bengal, and Bangladesh is close to throwing in the towel. India will soon have to declare a nationwide health emergency and recruit their military and perhaps other outside nations, to stop the spread of this disease in their poultry population. India also has to stop their internal bickering and finger pointing (blame game), as this acts as an impediment to any chance of success: as you so aptly point out, Orange – bickering seems to be one of the common features associated with a pre-pandemic situation.

In my view, things are so bad in India at the current time (without raising the specter of infected and dying goats and the likelihood of misdiagnosing huge numbers of mild H5N1 infections in people) that they do not even know or acknowledge that the virus is already prevalent in Calcutta. Setting up quarantines and border checkpoints this late in the game, will turn out ineffective and probably useless. The only redeeming “success” that I am aware of so far in this near pandemonium by their government bureaucracy, is that they have been very efficient in dispensing Tamiflu by the truckload to the cullers and to the suspect infected cases in villages, thereby setting up an efficient smothering blanket, in order to avoid massive testing and the possibility of reporting any suspect H5N1 infections externally. However, because of this approach, the number of individuals running around West Bengal and Bangladesh at the present time who have been exposed to the H5N1 virus and would test positive for antibodies, must be huge.

The saddest sequel to the story will be that once all the poultry will have died or been culled in West Bengal, the WHO (by their criteria), will declare the crisis over – all without one human infection being reported or documented. We call this the “Vietnam War Syndrome: declare victory and withdraw”.

Regarding your posted EM Revere article: this is probably one of the few times I don’t have any strong opinion. Only time (and history) will tell whether Dr. Webster is right, or whether Dr. Palese was correct. But Revere is absolutely on the money when he says, “… the only rapid response in India is panic”, and “we should act as if Rob Webster is right”. We must continue to make preparations as if a human pandemic were imminent, for if we fail to do this, countries like India, Bangladesh, Indonesia, Pakistan and Egypt, could face the nightmare of having to provide emergency health care to hundreds of millions of sick people. This, as we all know, would be an impossible task. The human panic scenario alone in these countries would be unmanageable, without major government and military intervention.

Which brings to mind where the bottom line really would be if this occurred: once the Tamiflu blanket stops being effective or we exhaust our supply of antivirals, major unvaccinated portions of the world human population are about as vulnerable as we were back in the 1350’s, when the Black Plague killed about 60% of the European population.

Not a pleasant thought before the weekend.



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