Thursday, August 14, 2008

August 14 Flu Update

Study on Indonesia shows that 80% of cases are fatal. Oddly, it reaffirms that every anti-virals help, but notes that goal is rarely achieved.

Would GPs show up for work during a pandemic? Australia thinks they may not.

Of course, the if pandemic flu broke out in China during the Olympics, it would have huge pandemic potential because everyone would scatter to the four corners of the Earth after the Olympics were over. Here, a reporter from Edmonton looks at that very situation.

Researchers continue to make comments about H9 causing a pandemic, here on CIDRAP.

ProMed has an interesting story on bird flu in swans which they say merits a close read.

I suspect that they demonstrate why adult swans are found dead. The question is how far can a sick swan fly -- 'sick' is a variable term -- and survive, if it even wished to fly while convalescing from this infection; to appreciate risk this should be recalculated as the prevalence rate of infected flying swans.

Developments in Nigeria (new strain) have Ghana worried.

Nature blog has the raspberries for British press, which gives more attention to a quck flu testing machine than it does to a new strain in Nigeria.

Here's a story on the flu testing machine.

Bird flu testing has a higher priority in Nigeria.

Laos has a new law that will reform veterinary service.

Cleveland Plain Dealer runs bird flu primer.

N. Sulawesi has distributed poultry vaccines, but there isn't enough for all the chickens.

Chinese researchers are testing a combination of statins and caffeine to fight bird flu.

Interesting reader comments from Indonesia when there was a suspected cluster of 13 people.


At 6:10 PM, Blogger Wulfgang said...


Your lead story about the atrocious 80% bird flu death rate in Indonesia (due primarily to misdiagnosis, late admission to hospitals and late administering of Oseltamivir), has very ominous implications and lessons-to-be-learned for all countries. That is, if indeed H5N1 in its present virulent form were the cause of the next pandemic, we had better be prepared to make antiviral’s easily accessible to the masses.

Specifically, we need to anticipate and implement the following three things: (1) North America better have a realistic influenza pandemic “early warning system” in place; (2) the US, Canada and Mexico must on short notice be able to distribute (or even pre-distribute) our SNS stockpile’s of antivirals to local distribution points so citizenry can have immediate access; and (3) we must have a viable pre-pandemic vaccine on standby, ready for immediate inoculation of our emergency responders, health care and military personnel. In my view, the key to effective control of an influenza pandemic caused by H5N1 or something similar, will require an extremely rapid response, driven by HHS, CDC, FEMA leadership, as well as state EOC’s and local health departments kicking into high gear.

As your Australian article (GP’s might take flight in bird flu crisis) points out, it is very likely that a significant number of physicians and health care workers may not report for duty during a pandemic. People should not be surprised at all and this has to be factored into emergency planning. During many of the natural catastrophe’s that have occurred in India, Indonesia, Africa and even the US, many health care workers and physicians (and their families) fled, along with everyone else. This has been a well documented occurrence. During hurricanes Katrina and Rita here in the US, I personally observed many of my own neighbors who were physicians, nurses, even law enforcement officers – flee the Gulf Coast area. As the article points out, “there is no ethical obligation on doctors to put themselves in harms way while doing their job”. Anybody who thinks the government can “force” or coerce emergency responders and health workers to endanger themselves and their families during a pandemic, is smoking dope. Pre-priming this important population segment with closely matched vaccine, along with their entire immediate families, would no doubt help resolve the problem.

A world wide influenza pandemic displaying the 80+% death rate (similar to what is actually occurring in Indonesia), would cause sheer pandemonium everywhere. It would be a silent killer and stalker, since it would be airborne, over a long period of time. It would be unstoppable. It would make SARS, HIV, XRTB, Ebola, Dengue and West Nile seem like a hang nail in comparison.

Shoot man, anybody who would report to work and walk amongst the public during those deadly conditions without sufficient protection, would face a possible death sentence and would need their head examined.



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