I have a new article up today at Slate, examining the emergent H7N9 avian influenzas, and a bit of a review of "bird flu" in general:
While we were carefully watching H5N1 in Asia and Europe, another influenza virus—2009 H1N1—appeared seemingly out of nowhere. Ultimately traced back to swine, this virus was easily spread between people, but unlike H5N1, it wasn’t any more deadly than our normal yearly influenza viruses (which, it should be noted, still kill on the order of 36,000 Americans each year). And now, while we’re still working on understanding how H5N1 and H1N1 have jumped between…
bird flu
There is a new outbreak of a bird flu in eastern China, referred to as H7N9. The first thing you need to know is that human populations have not been previously exposed (to any degree) to H7 or N9 type virus, so if this virus were to mutate in such as way as to spread human to human, the result could be very serious. Moreover, the "H" component of the virus is thought to have a genetic sequence that is known to readily mutate into form that would be target (bind to) human rather than bird cells.
The virus has been found in chickens, pigeons, and ducks in markets where live birds are sold…
I'm an epidemiologist, not an immunologist or a virologist but I like reading immunology and virology. It's interesting, in some ways for me it's more interesting than reading epidemiology. In an epidemiological paper I can see pretty quickly where things are going (or going wrong) and there isn't much mystery. But the sheer number of moving parts in a cellular system is amazing and confounding. Navigating through the myriad bits and pieces that appear every week in the scientific literature is tough for experts and even tougher for the rest of us who aren't experts. Vincent Racaniello over…
We continue to learn a great deal about influenza infection as researchers harvest information from the recent swine flu pandemic. The pork producers don't like to call it "swine flu" but it may well be that its long sojourn in that animal since 1918 (did we give Spanish flu to pigs or did pigs give it us?) may hold an important clue to why older people suffered less than younger ones. It seemed fairly likely that the difference was related to immunity, but since H1N1 came back in 1977 after being absent since 1957, it wasn't clear why younger people born after 1977 would be as immune as…
The blogosphere (DemFromCT at DailyKos) and the main stream media (Alan Sipress at the Washington Post) brought us the two faces of the current flu pandemic. Like Janus, one took lessons from the present and past, the other looked worriedly to the future.
Dem's piece on flu at DailyKos (a regular feature of the world's biggest political blog) is superb. Most everyone who regularly reads about flu in the blogosphere (and it is a huge readership) knows that DemFromCT is the blog handle of an expert who has been writing about pandemic flu for years (as long or longer than we have and we are…
A couple of days ago Dr. Marion Koopmans, chief of virology in the infectious diseases laboratory of the National Institute of Public Health, The Netherlands, notified the infectious disease community through the website/email list ProMed that two of their swine flu isolates showed a particular genetic change in one of the virus's eight genetic segments. Even though this virus has been described as relatively stable genetically, individual viruses, even within the same patient, often have small differences in the thousands of letters that make up their genetic code. Influenza A virus is a…
People infected with the bird flu virus - influenza A subtype H5N1 - go through the usual symptoms of fever, aching muscles and cough. The virus is so virulent that 60% of infected humans have died. But according to a study in mice, the infection could also take a more inconspicuous toll on the brain, causing the sorts of damage that could increase the risk of diseases like Parkinson's and Alzheimer's many years after the virus has been cleared.
The link between influenza and Parkinson's disease is hardly old but certainly controversial. Previous studies have found no traces of flu genetic…
In June 2005 a reader over at the old site suggested we put up some of our flu related material on Wikipedia. That sounded like a great idea to me. Even better, why not start a special purpose wiki -- a flu wiki -- to harvest the vast knowledge of the hivemind? Many, if not most, of the problems that would plague us in a pandemic weren't medical or even scientific in nature. They were things like, how do you prepare your small business for the possibility that the one person who knows how to unjam the fax machine is out sick for 4 weeks? Two other bloggers were also doing flu stuff at that…
Late yesterday afternoon a Morbidity and Mortality Weekly Report (MMWR) Dispatch appeared on CDC's website that is unique in my experience. MMWR is usually heavily vetted and edited and nothing gets out of there fast. Indeed, in recent years, nothing at all got out of CDC very fast. And yet here is this Dispatch, with text referring to the same day of issue (April 21), reporting on two young patients with febrile respiratory illnesses, one of whose cases CDC only learned about on April 13, 8 days earlier. April 17 CDC determined that the two children, both from the San Diego, California area…
Every day, it seems, we find out that what we thought we knew about flu isn't the case. As one noted flu expert said to me once, "I knew much more about flu 20 years ago than I do now." So it's good to remember that we are also finding out a lot about flu that we never knew or even thought we knew. A case in point is an extremely important new paper in PLoS Medicine ( Khurana S, Suguitan AL Jr., Rivera Y, Simmons CP, Lanzavecchia A, et al.(2009) Antigenic Fingerprinting of H5N1 Avian Influenza Using Convalescent Sera and Monoclonal Antibodies Reveals Potential Vaccine and Diagnostic Targets.…
The news of a new antiviral comes at a Press Conference. That could either mean a blockbuster breakthrough or an unwarranted device to get attention for some otherwise decent but not blockbuster science. Unfortunately, the news that "Experts Identify Compound That May Fight Bird Flu" is of the second type:
Scientists in Hong Kong and the United States have identified a synthetic compound which appears to be able to stop the replication of influenza viruses, including the H5N1 bird flu virus.
The search for such new "inhibitors" has grown more urgent in recent years as drugs, like oseltamivir…
A tantalizing Reuters story yesterday called attention to the uptick in human bird flu cases in Egypt, the African country with more cases than any other (although far behind Asian countries like Indonesia). The observation prompting renewed expressions of concern are that new cases seem to be in the very young (toddlers) but adult cases have almost disappeared. So where are these toddlers picking up the virus? A possibility that is consistent with the observations is that adults are giving it to the toddlers but are themselves symptomless carriers. It's not impossible, because we know that…
If you had a prowler at your house you'd call the police. You'd want them to come. But what if they sent a SWAT Team, surrounded the house and blasted it from all sides. Not good. That seems to be something like the scenario for a response to a class of virulent influenza viruses. They trip the alarm and the army descends and levels the house. The prowler is taken care of. So are you. The phenomenon has acquired the name "cytokine storm," although a better description might be immune system dysregulation. Your immune system has a lot of powerful weapons to protect you, but like a police force…
"The Stupid. It Burns!" I don't know where this Simpson-esque phrase comes from, but The Stupid burns pretty bright in the brains of Republican Governors Mark Sanford and Bobby Jindal who are refusing stimulus money for unemployment compensation even though their states have some of the highest unemployment rates in the nation. That's stupid. Like refusing help with avian influenza even if you have more cases of the disease than anywhere in the world. The Stupid isn't just an American disease.
Take Indonesian Health Minister Siti Fadillah Supari. Please.
Source: plognark
Indonesian Health…
There is an attitude toward the prospects of an influenza pandemic and what, or what not, to do about it that I have little patience with. We saw examples a couple of years ago with the writings of Wendy Orent and Marc Siegel and now it is surfacing again from Philip Alcabes, in an op ed in the Washington Post over the weekend. All three are smart and well informed -- but that doesn't prevent them from being wrong headed. The Alcabes piece, ironically entitled "5 Myths About Pandemic Panic" is either built on myths or strawmen, take your pick. Here is my commentary on the "5 Myths":…
Flu season is in full swing and cases of bird flu seem to follow the same kind of seasonal pattern as "ordinary" flu. Last year more than half the reported human bird flu cases were in Indoesia. But the Indonesian health minister has already warned the world she was only going to tell us what was happening with human bird flu in her country when she felt like it, and apparently she doesn't feel like telling anyone. In December of 2007 (last flu season) Indonesia officially reported 4 cases of bird flu and the following month, January 2008, 9 more. February 2008 brought another 3. This flu…
There is as yet no pandemic bird flu vaccine but there are a lot of potential vaccines. The recent fiasco involving Baxter International (here, here) involved one in development. There are many more. They employ old and new technologies and are in various stages, a few in early clinical trials. Many more are in the pre-clinical (animal or test tube) phase, although they are frequently reported in the news because the company developing it wants to attract support or publicity. I often don't pay attention to announcements of "breakthroughs" that are successful in mice. Many vaccines work in…
In a post the other day on some kind of flu vaccine mishap in Austria we called it a colossal screw-up. It turns out we may have understated the case. Maybe. Because while more details are leaking out, the company responsible for it, Baxter International, isn't saying exactly what happened on the grounds that it is confidential business information. You almost have to admire that kind of arrogance. Almost. Meanwhile Helen Branswell brings us more details:
The company that released contaminated flu virus material from a plant in Austria confirmed Friday that the experimental product contained…
As I write this the story is still hazy [see Addendum] but it sounds like the kind of colossal screw-up we had four years ago when the American College of Pathology sent a pandemic flu strain (H2N2) to thousands of clinical and hospital laboratories as part of routine competency testing (see here, here, here). That was inattention by CDC, whose Director was mesmerized by the bioterrorism phantom and couldn't see beyond them. This time it's a vaccine maker and the cock-up sounds pretty horrendous, although it is hard to figure out exactly what has happened given the incomplete descriptions and…
A just released report on world wide vaccine production capacity says . . . if you don't have access to the report (and I don't, as yet), what it says depends on which news source you want to read. For example you can read Reuters (the glass half full wire service stroy) or Agence France Presse (the glass half empty wire service study). Here are the ledes in each:
Reuters:
Drug companies have increased their capacity to make bird flu vaccines by 300% in the past two years but will still need four years to meet global demand in the event of a pandemic, a study says.
It also said doses of…