Wednesday, July 30, 2008

July 29 Flu Update

Thai paper looks at recent reports (US and UK) of poor pandemic planning.

Meanwhile, Thailand is said to have four potential new cases, though this appears sketchy.

ProMed on the South Korean cat and the outbreak in Nigeria.

CIDRAP reports on the GAO report that states are looking for more guidance from the federal government on flu planning

Helen Branswell on Canadian research that will look at remote and isolated rural tribes to study how flu spreads. The thinking is that they are a better example because there are few contacts outside the tribe.

The government in West Bengal says it is taking steps to combat bird flu.


At 5:20 PM, Anonymous Anonymous said...

On a pedantic note--
"tribe" in the US has a legal meaning, one of the forms of government. The Canadian equivalent is "First Nations", I believe. The Hutterites are a Euro-American religious group and not a "tribe". It is the latter which will be studied.

I do wish we would examine our region (Yukon-Kuskokwim Delta of western Alaska) similarly. We have small populations (less than 100 to 800 residents, not counting Bethel the hub) that are relatively isolated from each other (no roads) and 400 miles from the nearest Wal-Mart. However, I suspect that we have far more travel between villages and between the Delta and the big City Anchorage than most people. I've suggested only half in jest that if H5N1 comes, it will be through Ted Stevens Airport in Anchorage and not the reverse, from the migrating waterfowl. We have a lot of respiratory infections it seems.

Our communities are recognized "tribes", mostly Eskimo villages but also some Indian.

At 6:33 PM, Blogger Wulfgang said...


I always find it absolutely amazing that it takes an independent organization like the GAO to step in, do the leg-work, and provide details and critical information about gaps on important national security activities like pandemic preparation. Overall, even with the turbulent and catastrophic lessons-learned from Katrina, it seems very doubtful that the DHS and FEMA are even remotely prepared for a national health care emergency with the implications and risk that a pandemic poses (both the DHS and FEMA seem to be totally fixated on the Bush Administration’s “terrorism agenda”, and localized natural disasters such as storms and fires, which have an entirely different set of support and operations criteria).

In my view, mass vaccination and anti-viral distribution, seems to be a no-brainer to implement (the HHS, CDC in cooperation with the states emergency operations centers should be easily able to handle this) – the fundamentally hard questions, like massive fatality management, hospital surge capacity, school closures and public containment, triage, border protection, adequate protective equipment and how to handle major critical infrastructure issues like electricity, water, gasoline and fuel supplies, emergency services, preserving social law-and-order, and supply chain continuity – now these are things one would think Michael Chertoff himself would be making absolutely sure are pre-coordinated across the nation and planned in advance. As pointed out by the GAO report, and your Thailand article, neither the US not Britain are really ready or rehearsed for an influenza pandemic on the scale of 1918, let alone something far worse.

Your articles from Phicit, Thailand about possible human H5N1 clusters, and the poultry deaths in at least four distant Nigerian states, indicates to me that H5N1 virus is still a very serious public health threat and continuing to spread relentlessly around the globe.

It is becoming very apparent that if a pandemic occurs, every country throughout the world will have to “hunker down” and “suck it up”, and may have to depend solely on what limited resources and procedures are internally available at that time. Anybody expecting anything out of the WHO (other than an innocuous and superfluous report and a pandemic index discussion) in the way of leadership, will be sadly mistaken, in my opinion. I do not fully believe as the British House of Lord report states, “they are a dysfunctional organization”, but certainly the WHO organization is definitely not structured or staffed to provide any kind of world wide cross-country pandemic coordination, response or leadership on a large scale. (e.g. they can't even get Siti Supari under control)

The only forewarning anybody is going to get when a deadly influenza pandemic starts is: unsubstantiated internet, financial and MSM reports of massive numbers of sick and dying people in some locale. Kind of like what could easily be starting to happen in Indonesia, Thailand, China (during the Olympic games), Egypt (think Hajj) or Nigeria, right under our very noses. The real question is exactly where will H5N1 mutate and become a human disease first.

My bet, as always, is that it will start in China or Indonesia or one of the Asian countries.


At 10:22 PM, Blogger Orange said...

MPB, thank you for commenting and the information/corrections. I certainly apologize if I mis-represented the situation. Thanks for your contribution.


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