bird flu
revere | March 2, 2007If the number of emails I've gotten about the new "market" in pandemic risk were buy orders, I'd be doing very well. A market in pandemic risk? Of course. Is this a great country, or what?
Is a bird flu pandemic coming? Health experts say there is no way to know, and especially no way to know when.
But someone does know, or, rather, the combined experience of a lot of someones -- doctors and nurses treating the odd human patient, microbiologists studying virus samples and virus experts studying disease patterns.
A new "market" launched on Thursday aims to take advantage of this combined…
revere | March 1, 2007In the 1918 pandemic deaths occurred either from the usual secondary bacterial infections or the rapidly advancing acute respiratory distress syndrome. The latter, at least, seems also characteristic of the current human cases of H5N1, and in both the 1918 virus and the contemporary H5N1 there is strong evidence that a dysregulated immune system resulting in a "cytokine storm" may be involved (see our brief description of cytokine storm at The Flu Wiki). But what are the details of a cytokine storm and how does the virus cause it? A new paper in the Journal of Virology on an entirely…
revere | February 28, 2007Sometimes my flu obsessed readers think no one is paying attention but it isn't true. Beneath the surface of a spasmodically and superficially interested mainstream media, various institutions are worrying and grappling with the enormity of the consequences of a pandemic. Colleges and universities have the special problem of large and dense communities of mobile and active young adults, the ones in the cross-hairs of the current pandemic candidate, influenza A/H5N1. Many, probably most, colleges and universities have not done much. But a significant number have. The University of Minnesota is…
revere | February 27, 2007The bird flu news hasn't been that good this week. New outbreaks in Afghanistan, Kuwait, Vietnam's previously quiet north, continuing infestations in Russia, and human cases in Egypt and Laos (although confusion over the Egyptian case) (see rundown in CEDRAP News here and here). How about some good news? Like, tests have shown the experimental vaccine now being considered for licensing by the FDA is safe. Of course there is also other news about the vaccine:
The federal government is weighing approval of a bird flu vaccine that is even less effective than previously thought.
Sanofi Aventis SA…
revere | February 26, 2007An official at the new Stockholm-based European Centre for Disease Prevention and Control (ECDC) is complaining about the flood of information about emerging diseases produced by the internet:
"A few years ago people were predicting that the internet and new technologies such as automated media scanning would make this task easier," said Denis Coulombier, head of the ECDC's Preparedness and Response unit, in a statement.
"In fact, almost the reverse has happened," he added.
"Epidemic intelligence officers in Europe are often so flooded with information that the 'spam' and 'background noise'…
revere | February 25, 2007Table top exercises are supposed to be realistic. I've taken part in them and I can tell you they are. So it's not surprising this realism, often including simulated notices and documents, can combine with the speed of information dissemination of the internet in ways that are, well, not surprising:
UNICEF and the Maldivian government are today reassuring people that reports of a bird flu outbreak in the Maldives are untrue.
The reports were spread after documents forming part of a UNICEF simulation training exercise were doctored and leaked by a third party. A document detailing the…
revere | February 24, 2007The American Public Health Association is the organizational voice of American public health. I've been a member for almost 40 years and served on its Governing Council and on one of its top policy boards. Admittedly I've not been very active for the last number of years, especially as APHA has become neutered and politically marginalized. But I have a soft spot in my heart for it and its tens of thousands of members, mostly dedicated, hardworking and underpaid public sector professionals. So it pains me to say their just announced pandemic flu "prescription" is a prescription for an obsolete…
revere | February 23, 2007In August of 2005, Dr. Oleg Kiselyov bravely predicted that a bird flu outbreak in Russia would fade away in two weeks:
A senior World Health Organization official said the bird flu epidemic in Russia will "die down completely in 10 to 15 days," and that bird flu vaccine for humans will start being tested in September and might come into use in October.
"Anti-epidemic measures have localized the [bird flu] outbreak," and recent weather changes will help localize the disease, Oleg Kiselyov, head of the WHO National Influenza Center, told a news conference in St. Petersburg. (Interfax, our…
revere | February 22, 2007It is easy to lose track of the various outbreaks of bird flu in poultry since the first of the year, but WHO has a nice map to remind you:
Since it's a bit small in this format, I'll read it off for you: UK, Russia (various places), Hungary, Turkey, Pakistan, South Korea, Japan, Laos, Thailand, Vietnam, Egypt, Nigeria, Indonesia. A large format version can be seen here. We need to add Afghanistan, China/Hong Kong (not shown on the map).
Here is a bar chart listing the countries that have had poultry or wild bird cases and the number of outbreaks in each:
Source: World Organization for…
revere | February 21, 2007Good idea, but is it new? When I read (hat tip easyhiker) that computer scientists at the University of Maryland were suggesting logging onto a social networking site as a useful adjunct to official information in the event of a pandemic, I thought this was not a new idea. The grandaddy/mama of sites like this, The Flu Wiki, has been up since June of 2005. It regularly logs thousands of daily visitors sharing information and tips on pandemic prepping. Other sites, in bulletin board format, have also been up for a long time. Flublogia is already well-populated.
But an examination of their…
revere | February 20, 2007It is now clear someone will be punished for the bird flu debacle at Bernard Matthews turkey farm in the UK. Several hundred factory workers:
Around 130 workers at a Bernard Matthews site face being laid off in the wake of the bird flu outbreak, a union has reported.
The employees at Great Witchingham, near Norwich, will be stood down for 20 days from Tuesday, according to the Transport and General Workers' Union.
The firm is preparing to lay off a total of 500 workers, the TGWU claimed.
Environment Secretary David Miliband is expected to make a Commons statement on bird flu later this…
revere | February 19, 2007Here is another dispatch from our continuing series, Notes from a Parallel Universe (parts I and II here and here). In this universe there is a confirmed H5N1 outbreak near Moscow.
In The Parallel Universe this is impossible:
MOSCOW. Feb 18 (Interfax) - Experts from Rosptitsesoyuz, Russia's poultry producers association, say poultry farms in the Moscow region are immune to the bird flu virus.
"All poultry farms in the Moscow region, and in the rest of Russia, have been working under a tight closed regime since August 2005, which rules out the spread of the bird flu virus to…
revere | February 18, 2007The mess up at the Bernard Matthews H5N1 infected turkey farm just gets worse by the day.
Health officials are urgently investigating fears that the disposal of contaminated waste from the Bernard Matthews plant at the centre of the bird flu outbreak may have allowed the virus to spread to other parts of the country.
Experts fear that meat and packaging contaminated with the deadly H5N1 bird flu virus from the Bernard Matthews processing plant at Holton, Suffolk, may have found its way on to landfill sites, where wild birds might become infected. Meat carrying the virus could also have been…
revere | February 17, 2007One thing at which WHO is spectacularly successful -- sending mixed messages. In October avian influenza was a major public health threat and the world needed to do more.
While the deadly bird flu virus has not spread as widely as feared in Africa, vigilance is still needed across the world to counter its advance and deal with its impact on humans, the United Nations coordinator for the disease said today, expressing in particular "very great concern" over Indonesia, where practically the whole country has been affected. (UN's David Nabarro, October 2006)
Now we are on the verge of having an…
revere | February 16, 2007I rarely plumb Effect Measure's archives except when I think the material has some point for today. And today we are treated almost daily to reports of bird flu outside of asia: Turkey, the UK, Nigeria, Hungary, Egypt. What's going on?
Sometimes it's useful to look back. Here's our post from one year ago today.
Lots of places plus Indonesia
The reports of H5N1 infectedwild birds (mainly swans) in new countries are coming almost too fast to keep track of. Denmark is the latest (confirmation pending), but we can add Hungary and Dagestan (Russian Federation north of the Caucasus), too.…
revere | February 15, 2007Health Care Renewal is an excellent blog with a special interest in medical conflict of interest issues. Last week one of the HCR bloggers, Roy Poses, posted about "The Threat of Pseudoevidence-Based Medicine." The occasion was a article by Smith in the UK journal Clinical Governance (2007; 12: 42-52), which I don't have access to, but there is enough in the excerpts and commentary at HCR to get the basic idea.
We hear a lot about Evidence Based Medicine (EBM), using the best available evidence to inform clinical practice. The gold standard for evidence is a randomized clinical trial,…
revere | February 14, 2007A new paper has just appeared in PLoS Medicine on an old topic: whether seasonal influenza vaccines might also cause enough cross-reactivity to protect against H5N1. The basic idea is simple. The immune system "sees" the surface proteins on the flu virus and makes protective antibodies against them. The major stimulant for this is the hemagglutinin protein (HA), the H part of H5N1. There are 16 different immunological flavors of HA that cross-react very little. Since the human population has never had widespread infection with a flu virus that has the H5 subtype (we have had H1, H2 and H3…
revere | February 13, 2007An influenza pandemic will have many casualties, but truthfully, it never occurred to me YouTube might be one of them:
Many companies and government agencies are counting on legions of teleworkers to keep their operations running in the event of an influenza pandemic. But those plans may quickly run aground as millions of people turn to the Internet for news and even entertainment, potentially producing a bandwidth-choking surge in online traffic.
Such a surge would almost certainly prompt calls to restrict or prioritize traffic, such as blocking video transmissions wherever possible,…
revere | February 12, 2007The Hungarians are miffed because the UK is trying to pin the blame on them for the recent bird flu outbreak. They think blaming Hungary for the virus is the easy way out. It isn't. What it implicates is that the vaunted biosecurity firewall for developed country poultry producers is porous. Whether it finally turns out that the virus came from Hungary or not, the possibility is there. We checked to see what the US industry had to say on their website, http://www.avianinfluenzainfo.com/:
Asian bird flu is H5N1 highly pathogenic avian influenza (AI) - a disease of birds that has occurred…
revere | February 11, 2007A paper that appeared a week ago seems to have made its way to the wires. I had intended to post on it but didn't get around to it. But I guess the time has come.
Two medical geographers have written a letter to CDC's journal, Emerging Infectious Diseases, about what many have already observed: 90% of the WHO cases of H5N1 in humans are under the age of 40 years old. Using information on 169 of the current 271 cases, Matthew Smallman-Raynor and Andrew D. Cliff, medical geographers at the Universities of Nottingham and Cambridge in the UK find:
Subject to multiple selection biases in the…