Sunday, April 06, 2008

April 6 Flu Update

ProMed on death in Egypt (reported earlier) and a new death in Indonesia.

Swans in France have H5N1.

Human-Human transmission is reported in Pakistan.

According to Dr Mukhtiar Zaman Afridi, head of the isolation ward for avian flu patients at Khyber Teaching Hospital in Peshawar, a poultry worker in Peshawar apparently passed the disease on to members of his family.

Vietnam is going to declare itself bird flu free, which virtually ensures an outbreak next week.

Third possible outbreak in South Korea.

More bird flu in India.

Indonesia is criticized in editorial in The Blade.


At 6:25 PM, Blogger Wulfgang said...


Two things concern me about the human-to-human bird flu transmission episode in Pakistan. First, is the obvious time lapse between the initial outbreak back in late October and November last year, and the 3-4 months it took for the WHO to confirm it was authentic “limited human-to-human transmission”. This is way too long. This time lapse tells me that the WHO, unfortunately, primarily views its primary role as little more than investigative and confirmation, rather than early warning surveillance. They are not on a war footing. If it takes 3-4 actual months for the WHO bureaucrats to confirm a real emergence of a deadly highly contagious pandemic, or hot spot region, then we are all pretty much SOL, in my view. The second aspect of this Pakistani cluster event that is concerning is that it all involved brothers of the same family, therefore, the infection transmission was very unlikely to have involved intimate close contact (i.e. unlike with small children, etc) with each other. Transmission via intimate contact is understandable, but acquiring the disease from just being in close proximity is rather worrisome (think airborne here).

A couple of other general observations I would like to make about your news articles are the following: the declaration “bird flu free”, has become rather meaningless these days, because of the widespread footprint and reoccurrence cycles of the virus. Countries like Germany, India and Vietnam (as well as others) who declare themselves free of bird flu, but are surrounded by outbreaks in neighboring countries, are deluding themselves. It seems as if any of these countries raise ducks, or have migrating wild birds flying overhead (like cranes, swans, etc), then they will have a repeat outbreak – it’s just a matter of time. Moreover, it also seems as if many countries of the world are now conspicuously entering final stages of vaccine preparation, in consonance with the continued expansion of H5N1 around the globe: more and more countries, like Vietnam, China, the US, Russia, Great Britain, Japan and many others, have recently announced completion of “human vaccine trials”, and are clearly preparing to stockpile massive amounts of emergency pandemic vaccine by year end.

I would call this, the “final stage” of preparation before the second great influenza pandemic. Many of the third world countries that have showed lack of surveillance, lack of adequate containment and preparation thus far, and indifference due to government incompetence, cultural or religious reasons, or economic impacts – like Indonesia and Egypt - had better be prepared to pay a much larger price in human terms for the consequences of their inaction.

One dose of a human H5N1 vaccine during a pandemic, will make the price of a barrel of oil, or an ounce of gold, seems like chump change.



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