bird flu
revere | January 1, 2007The Reveres get a lot of emails from folks who think their issue is worthy of mention on Effect Measure. For the most part, they are right, and the only reason for not mentioning them is the time and attention span of The Reveres. One of the privileges of blogging is the blogger gets to set the agenda. Periodically I get emails from someone who feels very passionately about the harm being done to military personnel by mandatory anthrax vaccination. I've even blogged about it on occasion (on the old site, here, here, here and here), and I think there are some serious public health issues…
revere | December 31, 2006What looked like probable human H5N1 in Vietnam with four cases in one family (a mother and three children), may not be, although the circumstances are sufficiently suspicious we prefer to suspend judgment a bit longer before concluding that this was a false alarm. False negatives and false positives occur. In some senses, though it doesn't matter much. The virus continues to be found in poultry in more and more places in Vietnam, with 73% of poultry samples in the central province of Qung Nam reported positive. These developments are probably a combination of endemic virus, infected poultry…
revere | December 30, 2006Indonesia and Nigeria have a couple of things in common. One is bird flu.
So far, both countries have a stubborn endemic infestation of the virus in their poultry, and neither has been successful in bringing it under control. Indonesia also has the distinction of more human fatalities from bird flu than any other nation, by far: 57 deaths. The closest runner-up is Vietnam with 42.
Not to worry. Indonesia will have this dire situation under control by this time next year:
Indonesia, which has the world's highest bird flu death toll, plans to ramp up its fight against the virus and hopes to…
revere | December 29, 2006The third of the recently diagnosed H5N1 cases in Egypt has now died, bringing that country's total to 18 cases with 10 deaths, the largest outside asia, southeast asia or Indonesia. The case count for 2006 now shows more cases (114) and more deaths (79) than any previous year. And the virus was more deadly, at last measured by a case fatality ratio (deaths divided by total confirmed cases). Indeed the number of deaths in 2006 exceeded the total of deaths for 2003, 2004 and 2005 combined (79 versus 78), although the number of cases exceeded last year's by only 18%, compared to an 88% increase…
revere | December 28, 2006Like Indonesia, the Philippines is an archipelago, comprising some 7000 islands of varying size. It is also close to Indonesia, which lies just to the south across the Sulu Sea. Indonesia has more bird flu deaths than any country in the world and the disease is endemic in poultry all over that huge country. But so far, The Philippines has reported no H5N1 in poultry or humans. The fact that The Philippines has reported no bird flu is remarkable. Maybe too remarkable.
Here's the map indicating the human cases in Indonesia, as kept up to date by a cadre of dedicated FluWikians, here. The…
revere | December 27, 2006Somethings you don't have to keep saying and others bear repeating. This is one that bears repeating because most of us would rather believe we are making progress on combatting avian influenza.
The exemplar in the fight was Vietnam, the country still with the most confirmed human cases (Indonesia has the most deaths), but also a country that registered no new cases, human or poultry, since a year ago November (some isolated cases of stork infection were reported in August). Vietnam's supposed success was attributed to a vigorous program of vaccinating birds and banning live markets in Hanoi…
revere | December 26, 2006It is an unconscious assumption of many public health officials, experts and most health educators that The Truth Shall Make you Free. We know it won't, not even in something as simple as understanding what to do and not do about bird flu. A paper this month in CDC's scientific journal, Emerging Infectious Diseases, is a case in point. Public health workers at the Pasteur Institute in Cambodia, the London School of Hygiene, the Cambodian Ministry of Agriculture and the UN's FAO undertook a survey about the knowledge, attitudes and practices among rural villagers in Cambodia, a southeast asian…
revere | December 25, 2006The trouble with the influenza A/H5N1 virus is that it's a virus and doesn't know it's Christmas and time to take a break. It doesn't know anything because it doesn't think or know or believe or want anything. It just makes copies of itself and that can be done anytime it and a suitable copy machine (aka a competent host) are in the same place. Apparently they were in the same place in Egypt over the last week or so.
Egypt has detected a third new case of the H5N1 bird flu virus, just hours after confirming two new cases in a brother and sister, a World Health Organisation official said…
revere | December 23, 2006The newswires are humming again with another story of the estimated toll a flu pandemic might exact, if it were as bad as 1918. This time the occasion is a paper just published (.pdf) in the British medical journal, The Lancet, which attempts the most careful estimate yet of the toll of the 1918 epidemic. As often happens, the headlines, and in some cases the contents of the articles are all over the place. Some examples: "Bird Flu Can Kill 62 Million People", "New flu pandemic could kill 81 million", and "Study Finds Much Bird Flu Planning is Misplaced." We took a look at The Lancet article…
revere | December 22, 2006If you were wondering what happened to bird flu, you can ask the people in Vietnam, South Korea and Nigeria. The virus doesn't care if you know where it is or not. It just keeps going about its business, making copies of itself, using whatever hosts are around whose genetic and protein copy machines it can hijack for its own use. With all the talk about "where's bird flu?" it is useful to remind ourselves it's still around. And flu season is just starting:
Nigeria:
Bird flu reached every region of Nigeria, Africa's most populous nation, after government inspectors found infections in three…
revere | December 21, 2006This week President Bush signed the Pandemic and All-Hazards Preparedness Act (S. 3678). It has generally gotten favorable reviews from public health professionals concerned with preparedness, including the Clinicians Biosecurity Network and The Trust for America's Health. We've taken a look, too, and find much to like, but whether this will indeed be useful will depend on how it's implemented. We have a few observations of our own, as well.
The law has four Titles, each dealing with a separate but related topic. Title I. pertains to " National Preparedness and Response, Leadership,…
revere | December 20, 2006Vietnam is once again reporting bird flu in chickens and ducks after no reports in poultry or humans since November of last year. I have not posted what I have been thinking during this lull, because I had no evidence to support it. But in truth I have suspected the virus has been quietly percolating away there beneath the radar screen. No reported outbreaks or cases doesn't necessarily mean the virus is absent.
I still have no evidence. But the virus has poked its head above water again:
At a conference held Tuesday by the National Steering Committee on Bird Flu Control, Cao Duc Phat,…
revere | December 19, 2006I've debated (with myself) whether to post anything about disgraced columnist Michael Fumento's rantings that bird flu was a "Chicken Little" story (literally: it's entitled, "Chicken Littles were Wrong"). It was published in the far right rag, Weekly Standard, where Science is a dimunutive figure in the far distance, but now it's been picked up by Yahoo and other outlets, so I guess I'll have to bite the bullet and say something about this sleaze.
Why am I attacking him instead of what he wrote? I'll get to that in a minute, but first let me continue my egregious ad hominem ways. Fumento is…
revere | December 18, 2006I like stories like this. If there is a pandemic, while some places will do very badly, many places will find a way. I say "if there is a pandemic," but if you are poultry producer in southeast asia the pandemic has already happened, where it is a panzootic, a pandemic in animals (in this case birds). Thailand has one of the largest poultry export sectors in the world. When H5N1 hit Thailand, its sixth largest poultry producer, Sun Group was in trouble. Twenty-five countries in the EU, almost its sole market, put a ban on fresh chicken imports from Thailand, leaving it without customers and…
revere | December 17, 2006We continue our summary of the Institute of Medicine "Letter Report" on non-drug non-vaccine measures to slow or contain the spread of an influenza pandemic of a severity similar or worse than that of 1918 (see previous post on models here). The IOM report examined several analyses of historical data from 1918 to see if it was possible to obtain information on the effectiveness interventions on the pattern of outbreaks in various cities in the US. It is well known that both timing and severity varied a great deal in that pandemic. The goal was to see if differences in morbidity and mortality…
revere | December 16, 2006On December 11, The Institute of Medicine, one of the four constituent parts of the National Academies of Science, released a "letter report" reviewing the scant information on effects from non-drug measures to slow or contain spread of an influenza pandemic (available as a free download here). The report was produced after a special workshop on October 25 in which the panel participants heard from a variety of experts, with subsequent deliberations that produced the summary letter report and its recommendations.
"Letter Reports" are mini-versions of the full IOM treatment where a specially…
revere | December 15, 2006There are many local stories about pandemic flu planning and they all sound pretty much the same. Local officials saying they are making good progress but there's still much left to do and if a pandemic struck they'd be in trouble. Yawn. But every once in a while you read one where you say to yourself, "Some of this has sunk in. They're asking the right questions." Not often, or at least not often enough, but when we started talking about this no one was asking questions like this:
Meals on Wheels delivers 850 meals a day in Rockingham County [New Hampshire], relying on 35-40 drivers and…
revere | December 14, 2006Last week we posted on the Canadians realizing that if a a pandemic hit, even a moderate one, their hospital system would be in deep feces. This week it's the US's turn. Not that this is news, exactly, but it bears repeating. Again. And again. And again. So here's the message. Again:
Half of all U.S. states would run out of hospital beds within the first two weeks of a moderate flu pandemic and 47 states would run out if a bad one hit, according to a report issued on Tuesday.
The report from the Trust for America's Health shows the United States is still poorly prepared for a pandemic,…
revere | December 13, 2006New scientific information travels in various ways. The internet is the lastest. Sometimes it's the quickest, too, but often the old ways also work. The oldest method of communication between scientists used to be correspondence. Leibniz was famous for his extensive letter writing to other scientists during the scientific revolution of the 18th century. Even before the appearance of scientific journals, there were local or regional meetings, where scientist would gather periodically and exchange ideas and information through presentations, debate and discussion. These meetings are still…
revere | December 13, 2006Again, H5N1 is rewriting the book. Influenza A is usually thought of as an intestinal disease of birds. Surveillance and monitoring, therefore, has been carried out by sampling bird feces and cloacal (rectal) swabs. In a meeting in Singapore, however, the dean of flu virologists, Robert Webster of St. Jude's Children's Hospital in Memphis, is now reporting there are much higher H5N1 viral loads in the upper respiratory tract of birds than in the intestines. This is work done jointly with Albert Osterhaus in The Netherlands. It has led to changes in recommendations for detecting the virus in…