Friday, April 25, 2008

April 24 Flu Update

Indonesia has begun a major flu exercise.

It would begin with the isolation of a village where a field hospital would be set up to treat people with flu-like symptoms. At the closing on Sunday, officials will try to prevent ``infected'' travelers from leaving the international airport and spreading the virus to other countries.

A University of Pittsburgh team published a study that says that a vaccine is the best way to stop a pandemic (this is what I believe as well).

The team reviewed more than 150 scientific studies on bird flu and identified three main categories of potential vaccines. Treating infected people with antiviral drugs is not very effective and tests to diagnose infection need to be updated as the virus mutates, the researchers said.

India blames Bangladesh for spread of bird flu.

An Australian team claims to be close to a super-vaccine.

The new vaccine uses a natural plant sugar to trigger signals within the immune system, forcing it to produce more antibodies in response to the vaccine's antigen.

Revere wraps up the series on the cellular workings of bird flu with this post, where he explains the significance.

The bottom line here seems to be that Acute Lung Injury (ALI) with resulting ARDS is the result of oxidative stress coupled to the machinery of the innate immune system through one pathway leading out of TLR4.

1 Comments:

At 5:26 PM, Blogger Wulfgang said...

Orange;

Regardless of the media news hype out of Indonesia, the sensationalized “1,000 person three-day first-of-a-kind bird flu simulation” on the topical tourist destination of Bali – will largely miss the mark. In my view, the exercise is being mainly confined (by Supari’s design) to the Bali tourist island three tiny districts, the local Ngurah Rai airport, and the nearby Sanglah General Hospital in Denpasar, and is being too choreographed as a public relations event.

Actually, Jakarta and the city of Tangerang in Banten Province, Southeast Sumatra, Mojokerto in East Java, West Java, Semarang and Makassar, and Surbaya, are the worst effected areas, based on their own reports and independent model simulations. These key areas are not being included in this touted bird flu exercise. Neither is Sulianti Saroso in North Jakarta, the country’s main bird flu treatment center. This weekend exercise does not constitute part of a national pandemic emergency planning response or system, simply because one doesn’t exist in the first place, and it will not equip them for much of anything in the event of real pandemic.

Orange, I agree with your comment that “a vaccine is the best way to stop a pandemic”. The problem as we all know it, is that current manufacturing capacity is severely limited to 700 million doses per year under the best of circumstances, and it will be a decade before we could even begin to reach the 8 billion people surge requirement. (note: even our military capability to produce bullets for training and for the ridiculous war in Iraq is limited to 500 million per year). This leaves us with only two viable options: dependence on massive use of Tamiflu with the hope and prayer that it might work, or pre-prime our populations with a semi-matched H5N1 or similar vaccine, like Japan is preparing to initiate. My vote swings to the latter approach – I see no other viable way to protect people from a pandemic scourge. The massive logistics necessary to target significant geographical regions of the world population within the 48 hour requirement that it would take to make Tamiflu effective, does not exist. Nor does the capability exist anywhere to produce enough perfectly matched pandemic influenza vaccine for the majority of the world’s population, within a year – in fact it would take SEVERAL years to produce enough to make a difference. And that is too long to be of any value.

Time for a reality check: the Japanese are on the right track with their plan to inoculate 20 million citizens before their H5N1 vaccines expire. I believe more countries will follow suit shortly. Countries like India will always try to deflect their government’s ineptness by blaming Bangladesh for their bird flu worries and Indonesia will try to deflect their sorry endemic disease situation by refusing to provide virus samples, or by accusing the US of developing bio-weapons with their strains. But when it comes down to it, we are talking about the likelihood of a catastrophic pandemic (which is growing as time passes), a small change (key mutation) in one of the factors affecting an entire influenza system, which will lead to a larger critical genetic change, resulting in an explosive onset of disease across the world. The Japanese also know the reverse will occur when the balance of susceptible and immune individuals shifts from the proportion required to sustain an epidemic, to a marginally smaller proportion where the probability of transmission of an infectious agent to a susceptible host falls below the critical level required to sustain the epidemic. This is why Japan has made the decision to inoculate their citizens en masse. They are hedging their bets.

Some world governments like India and Indonesia just don’t quite “get it” yet – they just can’t seem to get beyond blaming others for their bird flu woes and refuse to take responsibility for their own national health care and survival.

Wulfgang

 

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