The Coming Influenza Pandemic?: May 2008

Saturday, May 31, 2008

We're gone, no post today

Friday, May 30, 2008

May 29 Flu Update

CIDRAP reports on a study on a school closure in North Carolina. It had minimal effect on families...but they still went to large gatherings, so the overall point of closing the schools is not clear.

County in West Virginia hears bird flu briefing.

ProMed on the WHO confirmation in Bangladesh.

Bird flu exercise held in Qatar.

Thursday, May 29, 2008

May 28 Flu Update

The WHO has confirmed the case in Bangladesh.

Bhutan holds flu awareness meeting (hint: there's ART)

There is a threat of bird flu, but the stupid swans of Dorset continue to breed.

The Philippines had banned poultry imports from Saskatchewan.

CIDRAP on the evolution of human-like H7 viruses.

Revere blogs on this study as well. As always, this is the perfect piece for understanding this report. One thing is that the whole flu world is not H5N1. The other is below--this little RNA clump remains a mystery to us, a humbling moment in our know-it-all world.

What I get from this study is that we are still some way from understanding the underlying biology of transmissibility and its relation to receptor configurations and related matters. At this point we cannot simply look at the virus's genetic sequence to see what is going to happen. We don't yet understand the connection between the sequence and the biology. Maybe some day we will, but today isn't that day.

Wednesday, May 28, 2008

May 27 Flu Update

CIDRAP reports....Indonesia claims that 112 countries support its virus sharing stance.

Scientists at Los Alamos have developed a mathematical model to study how H5N1 evolves, hopefully providing real time tracking of the progress to human transmissibility.

“What we wanted to create was a mathematically rigorous way to account for changes in transmissibility,” said Bettencourt. “We now have a tool that will tell us in the very short term what is happening based on anomaly detection. What this method won’t tell you is what’s going to happen five years from now.”

EU research helps develop more knowledge on how the flu virus hijacks cells.

Nepal has banned bird sacrifices at Hindi temples, according to this report.

Helen Branswell has the story on H7 viruses coming closer to adapting for humans. More of a warning...the virus is constantly evolving. (Also, this virus is more common here in North America.

China grants patent to yield enhancing technology for vaccines.

Has Australia excluded general practice physicians from its pandemic planning.

Producing flu vaccine is seen as big economic opportunity.

Tuesday, May 27, 2008

No blog today, maybe tomorrow

Monday, May 26, 2008

May 25 Flu Update

UNICEF is educating the media in Africa about how to write about bird flu.

Vietnam says some poultry producers are keeping bird flu at bay. (I have no idea what the cooling system has to do with anything).

many big chicken farms in Mekong Delta provinces are still safe from the scourge due to their self-contained chicken raising process and the automatic system of cooling.

Interesting article on poultry news in Asia. Note deep in the article that the live poultry trade will be banned in Jakarta...in 2010.

ProMed has the story from Bangladesh.

The new information is that the infection was contracted in January 2008, and independent confirmation of the local diagnosis was not available until late May 2008. The affected child has since recovered, but the nature of his exposure remains unexplained.

Sunday, May 25, 2008

May 24 Flu Update

Bangladeshi toddler is termed "mystery." How did he get bird flu?

Champaign IL is told that the bird flu is a matter of time.

Saturday, May 24, 2008

May 23 Flu Update

The story of the Bangladeshi toddler is all over the news, but we won't repeat them here.

CIDRAP reports on links between bird flu in South Korea and Japan, and on suspicious bird deaths in Sumatra.

ProMed has the same stories...

Here's a report on the impact of the sick toddler on the poultry industry in Bangladesh.

Revere notes that it is HIGHLY unlikely that this is the first human case in Bangladesh.

South Korea is upgrading the bird flu fight.

Azerbaijan dutifully reports no bird flu in the nation.

Will farmers be able to buy avian flu insurance soon?

Friday, May 23, 2008

May 22 Flu Update

A toddler in Bangladesh has bird flu, the country's first case. He is said to have recovered, and lived near no poultry, but in the slums.

CIDRAP on the Bangladesh case.

Albany GA had a bird flu seminar.

Thursday, May 22, 2008

May 21 Flu Update

Indian officials optimistically believe they are "mopping up" bird flu in Darjeeling.

Here (search for "flu") we get the encouraging news that bird flu has allowed Israeli and Palestinian officials to cooperate.

Indonesia is now requiring that people get permission before they take their animals to travel.

A Minnesota Regional Medical Office has held a bird flu summit.

South Koreans are urged to fight flu by washing their hands.

In Japan, firefighters are doing pandemic drills.

Flu Primer for Shelbyville, TN

PETA blames filthy farms for bird flu.

Alumni magazine looks at graduate who is working on bird flu. Look for the name Eric Blum.

Wednesday, May 21, 2008

May 20 Flu Update

Good thing there is no fish flu....South Koreans are turning to seafood in the bird flu scare

Good flu primer for Tennessee audience.

Continuing flu education is urged in Kenya.

WHO DG Dr. Chan ranks bird flu right up there with climate change and the food shortage.

Article urges Malaysian readers not to be desensitized to bird flu

Bird flu planning is also underway in the Philippines.

Tuesday, May 20, 2008

May 19 Flu Update

More on drug resistance in the flu. Excellent story, and really kind of chilling. This virus is very agile.

Birds in Siberia have bird flu antibodies.

State officials in Colorado are making plans for business continuity in a pandemic.

Experts welcome Indonesia's latest pledge to share data--CIDRAP reports.

CIDRAP also has the news of the prepandemic vaccine in Europe.

Expert says natural viruses like flu are more dangerous than bioterror.

More on business impact of agri-disease in South Korea.

Monday, May 19, 2008

May 18 Flu Update

For the second time, South Korea has mobilized troops to help in the culling of poultry.

More on ongoing culling in South Korea.

Chicken restaurants are suffering serious problems from bird flu scare in South Korea.

Quang Nam in Vietnam says it is bird flu free.

Helen Branswell on EU approval of H5N1 pre-pandemic vaccine--Prepandrix!

Usual high quality post from Revere on the mantra that all human cases have bird exposure....they don't, and we may be missing H2H because we are so quick to explain away infections. Note this...

This case is mysterious in other ways, too. It was originally reported that the teenage girl's 15 year old brother was also a bird flu victim, but the story now goes that the brother died of typhoid fever 10 days before his sister. Had it been bird flu this would have been looked on as a likely person to person transmission. It seems a bit convenient -- but still possible, I suppose -- that the brother died of another fatal infectious disease within exactly one incubation period of his sister. Since it sounds like the brother died before the diagnosis of bird flu was suspected and the diagnosis is based on an unnamed blood test rather than PCR you have to wonder. Of even more interest is the report that a family member of the two, a 24 year old, is being treated at another hospital with bird flu like symptoms.

Don't know we have heard much from Nepal, but this report says its neighboring states are nervous.

Sunday, May 18, 2008

May 17 Flu Update

Now India is putting conditions on how it will share flu viruses.

The Netherlands and France are about to get permission to vaccinate poultry flocks, and the EU is approving it.

Human volunteers in Vietnam have gotten their second dose of flu vaccine.

If you travel away from the United Arab Emirates, don't try to bring eggs back.

Saturday, May 17, 2008

May 16 Flu Update

More on the new outbreaks in India. Commence Culling.

South Korea claims that the strain of bird flu it had has never caused a human infection.

CIDRAP on the lack of a worldwide vaccine stockpile, one year after WHO called for it.

This report says the US is going to study the blood of flu victims in Vietnam.

People in Nepal are urged to be alert about bird flu.

Political pressure in Pakistan on the slow progress of Ag programs, including bird flu....

and calls in India for the resignation of the ag minister.

Pakistani poultry producers also want subsidy for bird vaccine they have to import.

BBC on the revelation that more than one anti-viral is needed in any national stockpile. Seems like I saw this on the blogosphere some time ago....

Hey, and GSK thinks its prudent to stockpile the drug it makes.

Dr. Osterholm delivers a speech in Minnesota with a consistent message--imagine the chaos during a pandemic.

The Indonesian financial sector will have an emergency drill.

Friday, May 16, 2008

May 15 Flu Update

More bird flu in South Korea.

An additional confirmation of bird flu in India as well.

ProMed on South Korea and India. Note reference to a "slow" response in India.

There's going to be an online database with influenza virus information on it. Indonesia says it will participate.

"It think it's wonderful," said Peter Palese, who studies influenza viruses at Mount Sinai School of Medicine in New York, adding that it will help researchers make sure the virus isn't mutating to a form that spreads more easily between people, with the potential to kill millions worldwide.
"It goes in the direction of creating a global health conscience."
The free, online site launched Thursday, 18 months after strategic adviser Peter Bogner and 77 influential scientists and health experts wrote a letter to Nature magazine calling for information about bird flu to be shared more quickly and openly, and creating the Global Initiative on Sharing Avian Influenza Data, or GISAID.

Nature's report on Tamiflu resistance is all over the place. Here, an Australian paper notes that a lot of eggs were put in the Tamiflu basket. Note that Relenza appears to perform well...

And this article explains why, in actual scientific terms.

More on the reaction in Australia...given the Tamiflu-reliant flu strategies in nearly every country, any country could really have written this.

CIDRAP has this as well. Note emphasis on anti-viral mix.

Good Revere post on the issue of scientific ethics and the sharing of flu viruses. He has empathy for the feeling that something belongs to you when you made it workable through your own hard work, and that might work for most research, but not for an emerging issue like the flu where time is of the essence.

A Filipino city changes its bird flu program.

Thursday, May 15, 2008

Sorry Folks......

Park's Closed! Moose out front should have told you.

Back online tomorrow.

Wednesday, May 14, 2008

May 13 Flu Update

CIDRAP on a critical care panel discussing how to handle scarce medical resources during a surge.

More on endemic bird flu in South Korea.

Farmers are being "sensitized" to bird flu in Sierra Leone.

This report says Yemen is stopping Saudi poultry imports, but I am not aware of any recent outbreaks there. Perhaps this is a "ghost" story.

Tuesday, May 13, 2008

May 12 Flu Update

After a second outbreak of bird flu in Seoul, the authorities have killed the entire poultry population in the city. All of them.

CIDRAP on South Korea as well. Note spread to farms in the Seoul metro area.

In fact, bird flu may be endemic in South Korea.

North Korea is casting a wary eye on South Korea.

A new locality in Vietnam has found bird flu.

Australia, on the other hand, still says its bird flu risk is low.

Indonesia's state pharma firm is saying it will have human flu vaccine...by 2011.

OSHA is looking for insight on the stockpiling of respirators in the event of a pandemic.

Monday, May 12, 2008

May 11 Flu Update

Vietnam reports good results from its human bird flu vaccine.

Thailand has apparently prevented the smuggling of bird flu vaccine from China.

Australia held a second pandemic influenza conference.

A common theme. Bird flu containment efforts are hampered by poor compensation for farmers.

Sunday, May 11, 2008

May 10th Flu Update

A swan in northern Japan is bird flu positive, and fear of spread among wild birds is increasing.

More bird flu in India, as a new region is hit.

South Korea is upping its Tamiflu stockpile as bird flu continues to spread in the country. Note this revealing phrase:

The decision came after South Korean President Lee Myung-Bak on Saturday told his cabinet to increase stockpiles of anti-viral drugs to ease public fears about bird flu.
"The people are increasingly concerned about human infection of avian influenza," Lee was quoted as saying at a meeting of cabinet ministers by Yonhap news agency.

ProMed with good round up of all the news from Asia.

Story on companies in Canada and their disaster prep, including bird flu.

An alert reader had sent this along. A woman in Canada died on a cross country train. The train was quarantined and no one was allowed off. Helen Branswell writes about this new world. And, the woman had a heart attack. Just project that to a fully engaged pandemic.

Saturday, May 10, 2008

No Update Today

Posting will resume tomorrow.

Friday, May 09, 2008

May 8 Flu Update

The Safe America Foundation is going to train corporate leaders on planning for natural disasters like a pandemic.

Local churches in Carthage, MO talk to a pandemic planning committee.

Wednesday, May 07, 2008

May 7 Flu Update

Hospitals in Seoul are on "high alert."

Lloyd's of London has an interview with its Director of Emerging Risks which serves as a pretty good primer about a potential bird flu pandemic.

Bird flu is reported back in Southern Vietnam.

Bird flu drill held in Alaska.

PETA renews argument that factory farms cause or encourage bird flu.

This is cool....Maria Merziotis, of Ottawa, Canada, won a national biotechnology contest with bird flu implications. That's the world's future, right there!

A 17-year-old Ottawa high school student has won a national student biotechnology competition by making a molecule that flu viruses stick to, which could potentially be used to diagnose or eventually prevent flu infections.

Official WHO release on Geneva meetings.

"New concepts and tools including the International Health Regulations 2005, the global pandemic influenza action plan, antiviral and H5N1 vaccine stockpiles, pandemic severity scale and a rapid containment protocol have emerged since the last revision in 2005," said Dr Keiji Fukuda, Coordinator of the WHO Global Influenza Programme. "Experience gained through dealing with H5N1 outbreaks, and through active preparedness by many countries makes this review a crucial exercise."

Abilene TX hosts bird flu drill.

Worcester, MD has opted not to buy anti-virals, after a presentation.

May 6 Flu Update

A WHO conference is starting in Geneva about bird flu. Very interesting. Here is the salient point:

The risk of a human influenza pandemic remains real and is probably growing as the bird flu virus becomes entrenched in poultry in more countries, health officials warned on Tuesday.

CIDRAP has this story as well. The statement below should get the ball rolling....

"We are concerned that the spread through migratory birds hasn't stopped. Once the virus is established in birds it is difficult to get rid of the virus and the risk (to humans) remains unless countries develop good control of transmission in birds," he told Reuters.

CIDRAP's story includes a look back at what WHO issued the last time it gave flu guidance in 2005. Note emphasis on the containment strategy.

The World Health Organization has published a new pandemic influenza preparedness plan that puts increased emphasis on the possibility of delaying a flu pandemic to buy time for improving the world's defenses against it.

There has been a bird flu outbreak in Seoul.

No PEOPLE in Seoul have bird flu, based on this report....

but it hasn't stopped people from flocking (sorry) to their doctors.

Supari continues to talk in Indonesia, emphasizing cultural issues at heart of dispute with US.

Bill Gates will go to Indonesia to talk influenza vaccine.

Officials in York, PA are urged to have a pandemic plan.

Massachusetts schools have a plan to close during a pandemic.

A pandemic flu outbreak could force the schools to close for up to four weeks, or more if 30 percent of the district’s students and teachers become ill.
Weymouth High School would become a secondary hospital to receive patients who are seriously ill if South Shore Hospital is inundated during a pandemic.
“When you get to a 30 percent absenteeism rate, it will be time to close the schools down,” said Elaine Pisciottoli, a coordinator for the school district’s emergency crisis response management during a recent school committee meeting.

Trent University is looking at the need for better anti-virals, especially as Tamiflu resistance grows.

Tuesday, May 06, 2008

May 5 Flu Update

CIDRAP on ongoing flu problems in South Korea and Japan.

A veterinary is going to look at how the environment, human, and animal health are inter-related.

North Korea is inoculating poultry after outbreak in South Korea.

Here is where the pandemic rubber hits the road. A group of medical experts is looking at ventilator allocation. Remember, in a pandemic, the US would be sorely short of ventilators. Remember, also, that bird flu won't be the only thing drawing on that supply. So, what did the experts find?

To prepare, hospitals should designate a triage team with the Godlike task of deciding who will and who won't get lifesaving care, the task force wrote. Those out of luck are the people at high risk of death and a slim chance of long-term survival. But the recommendations get much more specific, and include:

People older than 85.
Those with severe trauma, which could include critical injuries from car crashes and shootings.
Severely burned patients older than 60.
Those with severe mental impairment, which could include advanced Alzheimer's disease.
Those with a severe chronic disease, such as advanced heart failure, lung disease or poorly controlled diabetes.

Revere blogs this topic as well, seeing a start on some progress, but in a sense, a misguided effort. And, of course, the whole thing feels like the lifeboat exercise we used to do in school when the teacher forgot to do her lesson plans.

But as some point out, the shortened list might even be a violation of federal law prohibiting discrimination by age or disability or income. If the task force report provokes discussion and argument, that's a good thing. But it doesn't provide a way to settle the issue, so it isn't necessarily progress.
Maybe instead of arguing who will go in the lifeboats if the ship sails into an iceberg we should be building safer boats with more lifeboats. Of course it's not a question of one or the other. We can do both. Unfortunately we are only doing one.

The Pacific Island Health Officer Association has discussed bird flu at a meeting.

Australia used tamiflu during seasonal flu, and now is looking at a diminished pandemic stockpile.

CIDRAP reviews best planning practices, this time with interactive kiosks in North Carolina.

Monday, May 05, 2008

No Update today

See you tomorrow.....

Sunday, May 04, 2008

May 3 Flu Update

Pandemic danger is discussed in Alabama.

ProMed on continuing problems in South Korea.

Saturday, May 03, 2008

May 2 Flu Update

Outbreaks in South Korea continue.

Bird flu problems continue in Bengal.

Thailand says it is bird flu free.

More of the Navy Lab in Indonesia that is said to be used for spying.

CIDRAP on the new technique that can make antibodies fast.

CIDRAP with more on a vaccine technique that uses cells and is faster than egg based techniques.

This story from the US Geologic survey talks about how an online tool will allow global spread of disease to be tracked.

Here's a link to the map.

Hawaiian legislator says that Governor needs emergency pandemic powers.

Friday, May 02, 2008

May 1 Flu Update

Excellent CIDRAP article on what would happen during a pandemic with school closures. HHS held a webinar...think about daycare and children who get significant nutrition from the lunch at school....for starters.

More on a suspected outbreak in South Korea.

A state in India is prepping for bird flu after it hits a neighboring state.

WHO denies it advised travelers for the Olympics to bring Tamiflu.

Beverly, MA is considering a flu committee.

A flu exercise will also be held in Micronesia....which sounds like something from Gulliver's Travels, but isn't.

The Coming Influenza Pandemic?

Is a global influenza pandemic on the way that could kill millions of people? Are we going to relive the horror of 1918? If it happens, are we even remotely prepared to save ourselves? Scientists from around the world are concerned about bird flu...since 2004 our site has tracked news of H5N1 influenza from around the world.

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FluWiki online.
Wikipedia on Influenza
CDC Flu Page
WHO Flu Page
CDC Avian Influenza
New Yorker's Malcolm Gladwell on the search for the flu in permafrost
New Yorker's Malcolm Gladwell on Flu as our most deadly contagion
The Planning and Politics behind the flu from Greenhammer
Preparing for the Next Pandemic
Michael T. Osterholm, Ph.D., M.P.H.
New England Journal of Medicine, May 5, 2005
Is there anything we can do to avoid this course? The answer is a qualified yes that depends on how everyone, from world leaders to local elected officials, decides to respond. We need bold and timely leadership at the highest levels of the governments in the developed world; these governments must recognize the economic, security, and health threats posed by the next influenza pandemic and invest accordingly. The resources needed must be considered in the light of the eventual costs of failing to invest in such an effort. The loss of human life even in a mild pandemic will be devastating, and the cost of a world economy in shambles for several years can only be imagined.
ABC Primetime, September 2005
"Right now in human beings, it kills 55 percent of the people it infects," says Laurie Garrett, a senior fellow on global health policy at the Council on Foreign Relations. "That makes it the most lethal flu we know of that has ever been on planet Earth affecting human beings."
Dr. Robert Webster
Society just can't accept the idea that 50 percent of the population could die. And I think we have to face that possibility," Webster said. "I'm sorry if I'm making people a little frightened, but I feel it's my role.
Dr. Robert Fedson
"There is nothing in Darwinian evolution that says that our DNA has to survive compared to say the DNA of an earthworm. I mean Darwinian evolution is completely indifferent to which DNA happens to persist. We are not necessarily unique as a species as far as evolution is concerned and we can disappear like other species have already disappeared."

The Coming Influenza Pandemic?