bird flu
revere | June 12, 2007An extremely interesting article is slated to appear in the American Journal of Epidemiology later this month. I haven't seen it yet but Nature News carried a short piece about it. It comes from a team of experts in seasonal flu patterns at NIH's Fogarty International Center (FIC).
The notion that flu epidemics start in areas of high population density and spread outwards may not hold true for the tropics, hints a study from Brazil.
In that country, new research reveals, flu starts in the less densely populated north and moves towards cities in the south. The result indicates that climate,…
revere | June 11, 2007Two Associated Press articles over the weekend suggest to me the US poultry industry is getting ready for avian flu, in earnest. One story reports how news of bird flu in US poultry would affect consumer habits. One reports on the practical problem of having to kill hundreds of thousands of birds quickly and efficiently -- kill the, that is, for purposes other than sating our appetites. Here's the essence of the first story, about consumer attitudes. The results are about what consumers would do in a hypothetical instance and are always subject to how events actually unfold. They also have…
revere | June 8, 2007CDC is bowing to reality and grudgingly giving their blessing to civilian use of over-the-counter respirators ("masks" in common parlance) should there be an influenza pandemic. I've repeatedly called attention to the lack of evidence that wearing a respirator would be effective to protect people from influenza virus. Many readers here (mistakenly) believe I am against masks. I am not. Nor am I for them. If this is a pandemic Pascal's wager -- it can't hurt and maybe it will help -- that's fine. As long as the premise -- that it can't hurt -- is true. That's my main reason for wanting some…
revere | June 8, 2007We've written here about China's failure to share viral isolates, but we hope we've also made clear that many Chinese scientists have been forthcoming in sharing much other scientific information with colleagues in other countries about their experience with bird flu. A good example of interesting and valuable information has just appeared (published Ahead of Print in CDC's journal Emerging Infectious Diseases). The paper has details on six H5N1 cases that occurred in China between October 2005 and October 2006. The cases were all in urban areas and had no known exposure to sick poultry or…
revere | June 7, 2007A survey of doctors specializing in the infectious diseases of children attending a conference showed over half weren't very worried about a bird flu pandemic. I guess they know something I don't. Or maybe I've been reading the wrong things. Things like this:
The H5N1 bird flu virus in Indonesia may have undergone a mutation that allows it to jump more easily from poultry to humans, the head of the country's commission on bird flu control said on Wednesday.
[snip]
"In the past it took exposure of high intensity and density to the virus to get infected. There are now suspicions, early…
revere | June 6, 2007I don't usually do movie reviews here, much less reviews of movie reviews. But since I was pretty hard on Marc Siegel a year or two ago (I won't link to the posts since that would be just criticizing him all over again; they are on the old site), I'll take the time to say his movie review of Pandemic on the Hallmark channel didn't offend me. I wouldn't have written it that way, but there were some good things in it. What I liked about it was the balanced way he evaluated the veracity and plausibility of the facts portrayed in the movie. Dramatic presentations like this are a mode of public…
revere | June 6, 2007Last November a WHO study "stated" there was evidence a genetic factor was at work in the susceptibility to H5N1 because it appeared an abnormally high number of reported clusters involved only blood relatives. At the time I expressed some polite skepticism (Not All in Our Genes). Whether the observed data actually had more blood relative cases than would be expected bdepends on what one would expect. What you "expect" is the so-called null-distribution, which in turn depends on a plausible underlying probability model. Now a doctoral student working with Marc Lipsitch and his collaborators…
revere | June 5, 2007I'm just about done with the TB incident. I've said what I had to say (here, here, here and here) about the incident itself and TB on a plane in general. The one thing left is the significance for pandemic flu prevention.
I don't think there is any significance for pandemic prevention because at the moment we have no way to prevent a pandemic. We don't know what will make a pandemic happen or not happen, but if the biology will let it happen and a strain arises with easy transmissibility between people, then that's the ball game. Even if it burns out in one place it will happen again. And…
revere | June 4, 2007Most influenza subtypes are said to be diseases of birds, so it is somewhat surprising there hasn't been more study of poultry workers or veterinarians exposed to infected birds in the course of their work. A study by Gregory Gray and his team at , an epidemiologist at the Center for Emerging Infectious Diseases, at the University of Iowa's College of Public Health has just been published. The results cast into doubt the mantra that transmission of avian influenza virus to humans is difficult and uncommon.
Graduate student Kendall Myers in Gray's team studied the blood sera obtained from…
revere | June 1, 2007The world's five decade influenza surveillance system can be added as more collateral damage to George W. Bush's Global War on Everybody he Doesn't Like:
Anti-US sentiment contributed to Indonesia's success in leading developing countries to push the U.N. health body into agreeing to change a 50-year-old influenza virus-sharing system, the health minister said.
Iran, Iraq, Cuba, North Korea, Bolivia and Myanmar were among the 23 countries supporting Indonesia's argument that the existing system of unconditional sample-sharing was unfair to poorer nations, because they could not afford…
revere | May 31, 2007Readers here who try to get their neighbors to prep and run into a stone wall aren't alone.
It's tough to convince people they need to be prepared for disasters. It's even harder when they don't believe that the scenario you envision will ever happen.
Nevertheless, local governments in Hall County and throughout Georgia are putting together plans for dealing with an influenza pandemic.
They don't have a choice. (Gainesville Times)
This Gainesville is the one in Georgia, not Florida, and they have no choice because Georgia's Governor, one Sonny Perdue, told them they had to. Governor Perdue is…
revere | May 27, 2007Just this month three prominent members of the flu science establishment warned their colleagues that predicting an influenza pandemic was not really possible (Taubenberger, Morens and Fauci, JAMA. 2007 May 9;297(18):2025-7). Not just the time frame is unpredictable, but also the subtype. H5N1 is the bogeyman, and rightly given its horrific case fatality rate (60%), but influenza is primarily a disease of birds. There is therefore a huge reservoir and other subtypes can cause trouble. As if to add an exclamation mark to a well timed warning, this week saw an outbreak of H7N2 in a poultry…
revere | May 26, 2007After saying yesterday morning that China has not shared any of its human viral isolates, along comes an Associated Press report that two isolates were just sent and will shortly arrive at a WHO reference lab in the US. I'd love to say this demonstrates the power of Effect Measure, but . . . Anyway:
The sample updates of the H5N1 virus from China's Health Ministry are awaiting customs clearance, said Joanna Brent, a spokeswoman for WHO's Beijing office.
They include specimens from a 2006 case in Xinjiang in China's far west, and a case in the southern province of Fujian in 2007, Brent said. (…
revere | May 25, 2007A couple of days ago the World Organization for Animal Health (OIE) suggested we may have turned a corner in the bird flu fight. Whenever I see something like that it sends a chill down my spine, because invariably within a few days things happen to put the lie to this eternally springing hope, and this was no exception. We've got bird flu appearing in Vietnam (including the first confirmed human case since November 2005), China, Nigeria, Bangladesh, Ghana, etc. Thirty countries so far this year (out of a total of 59 that have ever reported outbreaks). Yet another human case in Indonesia (…
revere | May 24, 2007Reuters Health has a short note on a survey of 169 nurses, doctors and other health care workers (HCWs in the jargon) about whether they would report for duty during a pandemic. It was done by Dr. Charlene Irvin of St. John Hospital and Medical Center in Detroit, Michigan. I don't know where it was published or what its methods were, so it is hard to say how representative of all HCWs the results are. But it probably isn't very far off. Remember, though, I'm an epidemiologist. We are infamous for blithely acting as if numbers like 84 and 86 are the same. Some of you may remember a sign along…
revere | May 23, 2007A new experiment in flu communications was noted yesterday by my wiki partner and fellow blogger (The Next Hurrah) DemFromCT over at the mega-blog, DailyKos:
Recognizing the need for people to take pandemic flu preparations more seriously, and recognizing that blogging is a powerful and effective two-way communications tool, Health and Human Services Secretary Mike Leavitt is hosting a Pandemic Flu Leadership Conference in Washington DC on June 13, to which I've been invited (based on work done at Flu Wiki and here). And as part of the effort to reach as many people as possible, a blog has…
revere | May 22, 2007Sometimes it's good to have a "coordinated message" and sometimes it isn't. The UN agencies dealing with bird flu certainly don't have a coordinated message and that's just fine with me. I don't trust anybody to have the right "message" and we're better served by each agency calling it as they see it. Even if the way the see it seems, well, distinctly odd:
Avian Flu Virus May Be Nearing End as Fewer Birds Die, OIE Says
The avian flu virus that threatens to spark the first pandemic in almost four decades may be nearing the end of its natural cycle after it killed fewer wild and migratory…
revere | May 21, 2007One of the enduring scientific mysteries about influenza is what causes its marked seasonal pattern. A new paper in the Journal of Virology provides a useful mini-review of the many theories. [PubMed says its free online, but it seems to be behind a subscription firewall; maybe that will change. Here's the cite: Lofgren E, Fefferman NH, Naumov YN, Gorski J, Naumova EN., "Influenza seasonality: underlying causes and modeling theories", J Virol. 2007 Jun;81(11):5429-36. I have a print copy only.] The most surprising thing to most people who don't follow this is that this is still a mystery. We'…
revere | May 18, 2007One difference between city dwellers in bird flu afflicted areas like Indonesia and southeast asia and the US is that many of the former keep poultry as companion animals (aka, pets) or sources of protein (eggs, meat). But some people in the US think it sounds like a pretty good idea:
Last year, two parents living in the city of Madison, Wisconsin decided it was time to get their kids a pet. But they didn't want a cat. Not a dog, either. Not even a rabbit. They wanted a chicken. Twenty-five chickens, actually. All were shipped at one day old, and arrived in a tiny, cheeping package delivered…
revere | May 18, 2007WHO's Director General is talking tough, but is she talking tough to the right people? We don't know, but we can keep our eye open for results:
Addressing concerns raised by developing countries such as Indonesia, Chan said she was committed to finding ways of distributing potentially life-saving vaccines in the event of a human influenza pandemic.
"WHO recognises the concern of many developing countries and I am fully behind you. That's why we are taking a series of actions to make sure that developing countries have equitable access to affordable pandemic vaccines," she said.
Chan also…