Friday, January 04, 2008

January 3 Flu Update

ProMed reports on two potential new cases in Egypt, though identities may be confused. Also looks at possible wild bird infection in Vietnam. Note mod comment below:

It is not unreasonable to assume in the absence of demonstrable H5N1 virus infection in domestic poultry that infection could have been introduced into the household via the carcasses of wild birds. However the evidence is no more than circumstantial as there has been no confirmation (in this case or any other case to my knowledge) that H5N1 virus has been contracted by humans from wild birds, dead or alive. Furthermore it has not been confirmed that the wild birds involved actually carried the virus. If transmission had occurred it would imply that the young child was genetically susceptible to infection whereas the family members who hunted and exhibited no
illness were not.

People have been asking for proof that the genetic structure--and not just the circumstantial evidence--shows no evidence of mutation in Pakistan. Apparently, that has now been provided.

CIDRAP has this story as well.

Bird flu found in chickens at a kindergarten in Israel.

CIDRAP looks at outbreaks around the world.

Egypt says its a not a pandemic in that country.

UK story on universal flu vaccine developed by Cambridge firm.

Indonesia says it will certify farms as bird flu free, based on sound practices.

There's another outbreak in Vietnam.

Editorial in Bangladesh urges country to protect the poultry sector.

If you are interested in that sort of thing, I can tell you that over on Effect Measure, there has been a raging debate over Revere's post defending WHO field workers. Today, he continues by running an email from the man he criticized, specifically. To his credit, the answer is non-defensive, rational, and demonstrates that poor reporting might be the cause. Note, the kicker, which is the final portion of his statement.


At 3:42 PM, Blogger Wulfgang said...


I suppose I take exception to the mod comment in your first ProMed report which states, “If transmission had occurred (i.e. from wild birds) it would imply that the Vietnamese young child was genetically susceptible to infection whereas the family members who hunted and exhibited no illness were not”. There are several well documented research studies of fowl hunters and veterinarians in the US who have handled “wild birds”, who have turned up sero- positive with H5N1 (assumed to be LPAI) antibodies in their bloodstream, indicating prior exposure or possible infection. As you can tell, I don’t buy into bird flu “genetic susceptibility theories” at all, that is, until they are proven. On a more positive note, notice that the cumulative CFR’s of Egypt and Vietnam are nearly identical: Egypt is running ~ 43% and Vietnam is hovering at ~ 47%, which implies consistent and adequate surveillance and reporting.

Sorry Orange, I’m not one of those conspiracy bottom dwellers, but I truly believe Henry Niman has called the WHO testing of the Pakistan situation correctly – flawed. Even the WHO themselves admit that samples could have deteriorated by the time they reached the London lab. The degradation of specimen samples, as well as the likelihood of prior anti-viral interference, could easily have resulted in corrupted receptor test results and negative identification of H5N1 in the PCR tests. Note also the following glowering disparity: Pakistan NIH tests initially resulted in positives in the other family members, while WHO tests only verified one. Whether the mistakes are false negatives or false positives, to me is immaterial – what we really have here is Dr. Hayden shooting from the hip and asserting “no worrisome genetic changes”, over a weekend and deflecting the miscommunication to “bad reporting”. Truth be told however, we’ll never know now.

Regarding the article about Indonesia certifying their commercial poultry farms to be “bird flu free”, if they turn out negative in testing…. Just one question – why ? What is this going to accomplish ? To my knowledge and understanding, commercial poultry operations are not the problem in Indonesia and never has been. The problem has been free ranging and back yard subsistence poultry, and in fact I am not aware of one large commercial poultry operation that has ever reported an H5N1 problem or outbreak in their facilities. I am really either extremely dense or I’m missing something vital when it comes to their veterinary and agricultural surveillance program. In my view, this is another example of where they “just don’t get it”.

I don’t mean to always sound like I’m constantly down on the WHO and their spokes persons, but people need to understand that they are a world wide health organization, which is first and foremost politically motivated and driven. Contrary to popular belief, they are not impartial and transparent on most issues and definitely have their own agendas which they steadfastly adhere to. If they tick off too many benefactors and contributors, and raise undue bird flu alarm, then their funding dries up. Would I trust their leaders judgment and veracity at this time to provide actual timely pandemic warning of an imminent influenza pandemic ?

Probably not. I am inclined to believe like many others on the side lines that they will wait until they have an iron-clad clearly identifiable out-of-control obvious health crisis involving many hundreds of thousands of deaths attributable to H5/H7/H9 (?) infection spread across multiple countries, before they raise any international alarm bells or warnings. I believe their new “sustained community” description is just another news talking point, meant to dispel rumors.

They are going to wait until the first fighter actually hits the mat, before they declare the fight is on.



Post a Comment

Links to this post:

Create a Link

<< Home