Wednesday, April 30, 2008

April 29 Flu Update

A three-year old boy has died of bird flu.

Several chickens had suddenly died in the neighbourhood where the boy lived, Sulistyowati said, adding the boy had had contact with the birds.

Human behavior meets infectious disease...poll shows that people in Egypt are keeping their poultry, despite warnings.

There's a new outbreak in South Korea.

North Korea has formed an office to fight bird flu.

CIDRAP news round up.

CIDRAP on Sanofi getting contract to add clade 2.2 to the US vaccine stockpile.

Sanofi called the strain "particularly troubling because it is the first to be identified in an outbreak of migratory birds, which have the potential to spread the virus across continents."

Robinson told CIDRAP News the national stockpile already contains supplies of vaccine based on three other H5N1 variants: clade 1, clade 2.1, and clade 2.3. HHS has sought to diversify the stockpile out of concern that a vaccine based on one strain won't work well against a pandemic virus stemming from a different strain.

ProMed on Japanese outbreak, and on H7 in Denmark.

The Philippines are concerned about people smuggling in Peking Ducks.

Check out what the Dominican Republic had to do to be certified bird flu free.

Tanzania is alert to the risks of bird flu.

Health forums in Kansas discuss bird flu among other public health topics.

New Health Director in Washington state says....

When and if it changes, then we'll worry about having a pandemic influenza. Pandemic influenza would be the kind that happened in 1918; there are a lot of people who get very ill. Unfortunately, a lot of people die from this kind of thing.

Toronto is stockpiling antivirals for city workers, the first Canadian City to do so. CIDRAP reports.


At 6:33 PM, Blogger Wulfgang said...


Interesting group of articles today.

I believe with the H5N1 CFR creeping slowly higher in Indonesia at 81% (i.e. 381 reported cases, and 240 deaths, including the little 3 year old boy just reported), and a 63% average CFR worldwide, it would be really nice if the entire North American federal and state governments, and major cities like Toronto, Chicago, and Los Angeles – at minimum publicize what their precise priorities are for dispensing the anti-virals and the vaccines. They should also make public what their stockpile and intents are. To date we seem to have limited and inconsistent stockpiles of both drugs being squirreled away (“treated like state secrets”), and very little if any actual communication to the public about who is identified to receive them, or in what priority order during a national pandemic emergency. This is clearly a prescription for disaster, chaos, panic and violence, at least in my view.

According to your CIDRAP article, amazingly, while Los Angeles has managed to acquire 100% of its federal subsidy of antivirals, and Chicago 67%, New York City, has only managed to acquire 30 courses. Let’s see: NYC is really the core of the “East Coast Megalopolis” isn’t it (?) – a gigantic 55+ million people “mega-city or metropolitan area” composed of New Hampshire, Rhode Island, Boston, NYC, Newark, Philadelphia, Connecticut, Washington DC, Baltimore, Virginia, West Virginia, if I remember my geography of the East Coast correctly. NYC also receives about 20 million visitors a year – more than any other city in the world. And they have only bought 40 courses of Tamiflu for its stockpile? How many course of antivirals has the state of New York purchased ?

One would think that a far better antiviral and vaccine strategy to employ across North America, would be for the USA, Canada and Mexico, to form an international alliance that is totally integrated to make sure adequate stockpiles of both vaccines and antivirals are available for all of their very large metropolitan areas first (where the highest density of the populations are), with rural areas following close behind. Then, prioritization and preventative treatment (prophylactic use) of medications and non-pharmaceutical interventions could be agreed upon and publicized.

If the plan is to provide existing H5N1 vaccines and antivirals to “critical personnel” in the early stages of a pandemic – lets identify who these individuals are, get adequate stockpiles, pre-disperse and position the medicines to storage locations throughout the large metropolitan and rural areas, and publish the “rules of engagement”. Toronto seems to understand this – New York City even after 9/11, does not. Failure to have a true integrated strategic North American pandemic battle plan is inviting a catastrophe.



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