Monday, March 31, 2008

March 30 Flu Update

Temperature goes up, bird flu goes down in Bangladesh.

Vietnam is importing bird flu (avian) vaccine from China.

Interview with flu expert who has been saying the bird flu can be stopped with good surveillance.

Revere blogs this article in an excellent post. Key words: "Trust is not transitive."

Yi Guan is a genuine expert in the virology of H5N1 and an expert in the Art of Surveillance as we now practice it. Surveillance is of supreme importance in global preparation to face a potential pandemic with a very dangerous virus. But just because it is his opinion that the hammer he wields will hit all the nails on the head doesn't mean that a good hammer is even close to being a sufficient tool even under the best of circumstances.

In Vietnam, they're calling on district leaders to get tougher on poultry smuggling.


At 6:20 PM, Blogger Wulfgang said...


Seems to me that Bangladesh said nearly the same thing about 12 months ago… the weather was turning warmer and “bird flu was under control”. I have a sneaking suspicion this isn’t the end of their problems. Vietnam was also optimistic a year ago when they thought they had beat down the virus in their poultry by inoculating hundreds of millions of ducks and chickens, and look at where they are right now – having to accelerate the delivery of their poultry vaccine purchase from China, so things don’t spiral out of control.

Regarding your two articles about the Hong Kong microbiologist, Yi Guan, no doubt like Revere points out, this guy has put in time in riding a laboratory desk looking up birds butts, but probably falls a little short in credibility with his utopian-like statements about “proper surveillance”. I have a similar problem with Guan’s viewpoint, but a little different than Revere’s “trust isn’t transitive” take on things.

The problem I have with bird flu surveillance as we know it across the world, is that it is a broken system, and totally inconsistent and unreliable – as is the present system for reporting of human illnesses. Unlike, Yi Guan, I believe we have only averted an influenza pandemic not because of current “surveillance and detection” (which I believe is slipshod), but simply due to the tons of Tamiflu we dispensed to people in third world countries, and because of the billions of poultry we have vaccinated against H5N1 in the Asian and Middle Eastern countries.

Does anybody on this planet really believe that there have absolutely no human H5N1 infection cases in India or Pakistan ? How about China – anybody believe their numbers of bird flu outbreaks or reported human cases over the last three years are totally accurate? Indonesia notoriously botches its diagnoses of human bird flu infections and mistaking identifies them as common “pneumonia” or Dengue fever, even when it is documented that multiple members of the same family die of mysterious similar causes, and when health care workers themselves fall ill from treating suspected bird flu human cases in hospitals. Indonesia and the WHO don’t even acknowledge the familial H5N1 clusters which seem to be popping up every other week. In my view, the sanguine surveillance and government sanctioned news reports from all of these countries have only turned out to be a self serving means to carefully preserve civil calm and maintain economic stability - they are not reports that are based on any scientific reliability or medical soundness.

The most recent reliable assessment of where we are at with H5N1, comes from Dmitry Lvov, Director of the Ivanovsky Research Insistute of Virology at the Russian Academy of Medical Sciences, who says, “the danger of mutations, Lvov warns is considerable, and the situation is potentially highly alarming”. He also states, “Nobody can change the evolution of the flu virus or prevent a pandemic now”.

The Russians are known for their pragmatic and realistic assessment of all things: I would recommend that everyone pay attention to what this top Russki dude is saying.



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