Saturday, January 26, 2008

January 25 Flu Update

Today's most significant story, from the flu conference. CIDRAP reports that there is evidence of subclinical disease in Cambodia. This would have huge implications for H5N1--both its transmissibility (higher than thought) and its lethality (lower than thought).

Revere blogs this, noting that it is a positive development.

Not all H5N1 cases are serious or fatal disease.

ProMed also has this story. Note mod comment from the ever-skeptical CP:

This is an interesting observation, but difficult to interpret in the absence of
quantitative data. The analysis is limited by the fact that there have been few human cases of H5N1 avian influenza in Cambodia (since the beginning of 2005 only 7 and all fatal). The study would have been more productive if conducted in a country with greater exposure to the disease. The 100 percent fatality rate in Cambodia and the occurrence of a low frequency of inapparent infection in children is compatible with some degree of inherent resistance of the majority of the population to the H5N1 virus.

Two more districts in West Bengal are reporting flu outbreaks.

A total of 11 districts have been hit.

Low compensation is part of the problem in India, as noted previously.

State is calling for "all possible help" for flu.

Seasonal rains are hitting India, and they hope it helps with bird flu spread.

Nepal is afraid that bird smuggling will bring bird flu over from India.

Interesting stuff on CIDRAP. You will recall the recent study that said non-drug interventions saved lives in 1918. A debate between John Barry, who wrote "The Book" on the pandemic and the authors has erupted over whether New York City used quarantines has emerged.

Kaiser is testing a genetically engineered vaccine.

Along the lines of what has been mentioned before, Crucell has developed ideas on how to use blood from infected people to develop antibodies.

No new cases noted in the UK.

A Phase I test of a universal flu vaccine has been completed.

Story on vaccine testing site in Halifax.

Finland has picked Glaxo to supply its pandemic vaccine.

There's a parrot joke in here. Belarus killed some parrots on fear they had bird flu.


At 6:42 PM, Blogger Wulfgang said...


Your most significant story of the day is quite intriguing – for example, why the two year lapse in revealing the results of the Cambodian study ? One would think this important study and seroprevalence survey data supporting the suggestion that there be a large number of mild human cases escaping detection, is significant enough that it would be released immediately. I wonder also if the WHO, FAO or OIE geniuses were even aware of it, and if so, why embargo it for two years ? A number of other good questions come to mind also: if these organizations were aware of this study, wouldn’t they deem it prudent to follow up immediately with similar antibody checks in other places, like West Bengal, Egypt and Bangladesh, perhaps to check for asymptomatic H5N1 cases ? Also, does the fact that Tamiflu is being massively dispensed to large populations, actually camouflage or mask the human illness, thereby corrupting or distorting the H5N1 tests results? Assuming the Cambodian research data is accurate, it does seem to indicate and support the contention that H5N1 is not a very human transmissible virus (deadly, yes). Too soon to tell in my mind.

The raw data would account for Reveres main theme that “this is good news”, however, it doesn’t answer critical questions such as does environment or different immunological play a large role in their mild infections. Logic dictates that there probably are many human infections we are missing (I have always believed this), but it is too soon to arrive any conclusion that the virus has an unbelievably low 1% transmission rate, or that CFR is actually an astounding 60-80%. The true answer lies somewhere in between - the virus is going to eventually stabilize at some unknown CAR and CFR when a pandemic occurs, and only then will we know the exact numbers.

Your article about the universal flu vaccine Phase I trials being conducted by Acambis sounds absolutely astounding, if it works. Talk about a miracle cure – anything that would provide life long protection against any influenza A strains, quite honestly would be an astounding modern scientific breakthrough. On the other hand, the thought of devising genetically engineering blood vis-à-vis human monoclonal antibodies, as a possible H5N1 antidote, just creeps me out for some reason. With my luck, I would end up the only human on the planet that probably would receive a dose of contaminated blood from an HIV-MDRTB-Dengue-Ebola-infected street person. Nah… I’ll pass on the engineered blood until that’s the only option left on the planet.

While everyone seems to be fretting about what’s going on in India these days, we had a close call right here in the US, in our backyard. Check out this news link Orange (it doesn’t seem be newsworthy enough for national news):



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