Tuesday, March 04, 2008

March 3 Flu Update

Post of the day. Revere looks at some research that tested blood of poultry farmers in Thailand. The conclusion is that there do not appear to be large amounts of minor, undetected cases of bird flu. "The tip of the iceberg is the iceberg." Given the virulence of the disease (and the implication that the case fatality rate we see is, more or less the real case fatality rate), we should hope it stays that way.

There is a suspected human case in Thailand.

Tamiflu appears to be doing better in aiding the survival of H5N1 patients.

(Effect Measure blogs this as well....)

Two more provinces hit in Vietnam.

Pakistan is looking to register all poultry farms.

CIDRAP on the new case in Eygpt.

ProMed also summarizes recent cases in Egypt.

A suspected case in Hong Kong is negative.

Interstingly, the new flu vaccine apparently is more protective of Asians than Caucasians. (Take that Indonesia).

Indonesian NGO is taking its bird flu program into new areas.

After that the center introduced the use of special nets to contain the movement of chickens and ducks in backyard farms.

"We recommended they develop healthy backyard farming by installing the special net around the farm to minimize direct contact between human and fowls."


At 6:17 PM, Blogger Wulfgang said...


Before everyone jumps up and down ecstatically about the seroprevalence study in Thailand which appears to provide more proof of extremely limited or nonexistent mild H5N1 infections – note that the study is 4-5 years old. That's pretty old stuff in my book. Now, I’m not a an expert like Revere, but it does seem to me that this data might be a little outdated (or maybe not). The bottom line is that many of us simple people would like to see more current information, perhaps in the 12-18 months timeframe, to quell the anxiety factor.

Same kind of critical comment regarding the efficacy of Tamiflu: it works reasonably well within the first 24-48 hours after onset of illness, after that however, the odds of survival seem to be a little on the dismal side. The real underlying message I see in the Roche generated report, is twofold: (1) the US and Canada had better damn well have an extremely rapid distribution network greased and ready to roll out at a moments notice, if H5N1 becomes highly transmissible – otherwise, the fatality rate due to late medication delivery will explode dimensionally; (2) with rapidly increasing viral resistance to Oseltamivir becoming evident in H1 and H5, it seems (to me at least) pretty risky for nations to put all of their eggs in one antiviral basket – I would think they all would want to really start accelerating a candidate H5N1 type vaccine (fast track the trials) and have it on “standby-off-the-shelf” for extremely rapid production and distribution in a world-wide emergency situation. This kind of (I’m talking serious here, not just “fill the square”) approach would provide some practical minimal assurance level of military, medical, emergency responder and other “essential personnel” availability.

Last, I would like to know how GlaxoSmithKline arrived at the conclusion that “Asians respond better than Caucasians to their bird flu vaccine” in their trial studies. I saw in the article 1,200 people in Thailand, Taiwan, Hong Kong and Singapore were mentioned, but unless the “Caucasians” were already embedded in these countries – where else were the Caucasians and in what countries did they reside ? Europe perhaps ? Inquiring minds need to know…

I also noticed that apparently Indonesia did not participate in the trials. That’s too bad, because once again, due to Ms. Supari’s belligerence and weirdness, I truly believe they missed out on a real opportunity to participate in a world wide cooperative solution, at least a vaccine trial approach that would have benefited her citizens.

Instead, they are still stuck in the mud without any real health or mitigation strategies to curtail their endemic bird flu problems. Maybe President Susilo Bambang Yudhoyono, will add two and two together soon and dump her out on the “back forty” soon.



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