Monday, June 23, 2008

June 22 Flu Update

Here's an article right out of the flu playbook. One of the cardinal ideas about bird flu is that it will often be mis-diagnosed, just as it was in 1918. And this report indicates that may be happening now....if nothing else, it cuts a hole in the containment strategy.

Another great article from Helen Branswell. Is the lack of a consistent measurement tool hampering the ability to calibrate the flu vaccine correctly?

Differences in the sensitivity of the tests mean companies could be underestimating or overestimating the power of their vaccines as they try to work out what is the smallest protective dose, experts admit.

As things stand now, there is no way to usefully compare the results of one company's clinical trials for their vaccine with a competitor's findings.

Revere blogs this article as well, saying that its clear from the noise in the vaccine space that commercial interests still believe a pandemic is possible, even as the headlines quiet.

A flu meeting in November will discuss whether WHO should stockpile more pre-pandemic vaccines.

Bird flu, or the fear thereof has caused a cull in Pakistan.

Interesting article from the Times of London. Bernard Matthews, the major poultry producer in Britain who experienced an outbreak last year is shooting back....either giving quality data, or trying to use the situation to blame wild birds and scare people away from free-range turkeys. You can decide.


At 6:27 PM, Blogger Wulfgang said...


I agree with you on your first comment, “right out of the flu playbook” and the uncanny “mis-diagnoses” similarity to 1918. Other observations I would like to point out about the situation in Indonesia (according to the Tehran Times article), are the following: (1) from their experience with H5N1 human illnesses, according to Sardikin Giriputro, they have had best results if Tamiflu is administered less than 2 days after the onset of symptoms of infection. This effectively means that the US should begin a thorough re-evaluation of its SNS stockpile policy of anti-virals now: consideration should be given to distribute the Oseltamivir to commercial pharmacies and/or state dispensaries throughout the nation and keep a minimal reserve at the national level; and (2) Mr. Giriputro stated very succinctly that rapid diagnostic test kits were being used to diagnose the in disease in “animals” (reservoirs) – what animals is he referring to and just how pervasive has the virus spread throughout the animal population there?; and (3) Mr. Giriputro states that due to “weak viral loading”, numerous human test results for bird flu are resulting in false negatives. This begs the natural question: since many infected humans are being misdiagnosed as dengue fever and typhoid, and many are false negatives…the number of actual H5N1infected Indonesians (and deaths) could be far higher than anybody ever imagined… except Madame Supari, she knows darn well and isn’t saying. I’ve always said that her antics were just a smoke-screen.

One can presume, since Sardikin Girirputro is Director of the Suliant Sarose Infectious Disease Hospital, and not a government health deparment minion, he is in an independent position to know the full story, and can speak authoritatively.

Regarding the Helen Branswell and Revere articles about H5N1 vaccine test variability and accurately testing and comparing their effectiveness, I may be a minority, but I don’t worry so much about Sanofi Pasteur, Baxter and GSK vaccines. I really do have gas pains when I think about all the third world countries like China, Vietnam, Thailand, Indonesia, India and Pakistan noodling around in the developmental R&D side and pumping out a macabre Frankenstein version that has dramatic harmful side effects, or is just plain ineffective. My basis for concern – simply due to the fact that their poultry vaccines have apparently not been all that effective - so how could one conclude that they would be any better at human vaccines ?

Finally, I see from your last article about the WHO re-considering the need to increase their pre-pandemic vaccine stockpile for third world countries. In my view, they will need to dramatically alter their stance on the subject, to include the possibility that it may prove to be more cost effective and superior epidemiologically to pre-prime the populations of certain endemic countries, rather than wait until the poo-poo hits the proverbial fan. Why not build up some immunity in populations like the Japanese approach ? How in the world does anyone plan on ensuring that primary first responders and critical infrastructure personnel are protected (wait six to nine months – that ain’t gonna work to well in my opinion)?

Why wait the extra six to twelve months until the entire world is in a panic and in danger of chaos and near collapse – just because virologists want the “perfect pandemic vaccine match” ? It just doesn’t seem to be a very prudent approach.



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