bird flu

Everyone seems to have an opinion about whether bird flu will be the next terrible global pandemic. In current parlance "bird flu" means human infection with the highly pathogenic avian influenza/A subtype H5N1. There is no doubt that this is the 800 pound gorilla in the global health room at the moment, but not because it is more likely to become a pandemic (NB: pandemic by definition is a globally dispersed sudden increase in infection among humans; the same situation for animals is called a panzootic, and it is plausible to say we have an H5N1 panzootic for birds now). On the basis of…
After spending more time than I wished "defending" WHO against what I considered a particular kind of scurrilous attack (it also seemed to raise the hackles of some unintended as targets, but the dialog with them was at least rational) -- after all that, I now have to turn around and complain about WHO (again). Let me be constructive and offer their spokesperson, John Rainford (or whoever writes the statements he mouths), a little biology lesson. A mutation of a virus is a technical term that describes a replicable change in the sequence of bases that constitute the virus's genetic blueprint…
Former Pakistani Prime Minister Benazir Bhutto, despite a bevy of bodyguards, was assassinated yesterday. Pakistan is a dangerous place, especially for pro-American politicians or those thought to be pro-Western officials. It's something to think about when you read that WHO and the US reference laboratory NAMRU-3 each sent teams to the politically unstable and hostile-to-the-West northern regions of Pakistan to gather information about the recent cluster of bird flu cases. WHO's team was in Peshawar, north of Islamabad. Here's what Middle East expert Juan Cole said about Peshawar the other…
Bird flu is still flu and one expects an uptick of cases during "flu season" which usually gets underway in earnest in December. So from that perspective it isn't a surprise that December has seen human fatalities from bird flu in six countries: Pakistan, China, Vietnam, Egypt, Burma and, of course, Indonesia. Once the Pakistani cases are officially confirmed and added to the December tally for this flu season it will make it the worst December yet, but we shouldn't read too much into this. Flu seasons are notoriously variable and the numbers bounce around a lot from year to year. But . . .…
The Toronto Sun has another one of the "such and such a city/state/country isn't prepared for a pandemic" stories. The judgment comes from the 2007 Auditor General of Ontario's annual report. Yawn. Like it's so easy to know what to do, right? Maybe not. So the Report has some recommendations: The report says the ministry "does not have assurance that all members of the health system knew what to do in planning for and during a pandemic." As a result, the report lists recommendations that would serve to help prepare Ontario for such a catastrophic flu bug. The recommendations include, among…
In my Christmas stocking this morning I found a Season's greeting from the excellent down-under medical/public health blog impactEDnurse. Here's the card and the link to the little present that goes with it: I offer you up a nurses public service video on the best way to detect avian influenza: http://impactednurse.com/?p=428 Merry Christmas. And Gesundheit.
The recent report of a novel influenza virus in pigs, the H2N3 subtype, has been raised some alarm in certain quarters. I just read the paper itself (doi: 10.1073/pnas.0710286104) and then the account in CIDRAP News, which is both accurate and complete. I recommend it highly as a summary of this work. I have a bit to add, but first their concise summary of events leading to the investigation: The discovery of the new virus began with an illness outbreak in pigs at a Missouri swine nursery in September 2006, according to the report. The pigs' lungs showed obvious signs of pneumonia, and tests…
WHO [World Health Organization] is now saying that human to human (H2H) transmission has not been ruled out in China or Pakistan: China: The World Health Organization said Friday it was impossible to say whether a case of bird flu in China involving a 52- year-old man was due to human-to-human transmission - but, even if it was, it was down to very close contact between the victims. The Assistant Director-General for Health Security at WHO, Dr David Heymann, said the only proven transmission of this nature so far, in Indonesia and Thailand, had been as a result of very 'close contact' in a '…
It's been less than a week since the first reports out of Pakistan that cases of bird flu were appearing there. At the time we warned that the coming of flu season meant these kinds of reports were to be expected, but by the weekend concern increased as a family cluster appeared. As common in the early days of an outbreak news reports were contradictory and confusing. We elected to wait. By Sunday, some excellent reporting by Helen Branswell and diligent combing of the news by flusites allowed us to make a preliminary summary. We fully expected more surprises. The biggest surprise so far is…
Nature's senior correspondent, Declan Butler, was one of the first to raise the profile of a pandemic threat in the scientific community and has had done some superb reporting since, including several stories on sharing gene sequences. The problematic actors in his earlier stories were respected scientists and the business-as-usual way they were approaching release of genetic sequences even as the world worried that the virus they were studying, influenza A, was inexorably searching for the right recipe to enhance its own raison d'etre, to make still more copies of itself, potentially with…
We have occasion to comment often here about how the same bird flu story is spun different ways. A case in point is reporting on statements made by the head of Indonesia's National Avian Influenza Committee, Bayu Krisnamurthi and the two different directions Agence France Presse and Reuters took the story. Here's AFP: Indonesian bird flu officials said Tuesday they were investigating several recent avian influenza deaths where the victims were believed to have not come into contact with infected poultry. "In the last three to four months, we have had four cases where the poultry in the…
I don't know much about the West African state of Benin, but the newswires have made sure to alert me to the fact it is the home of ritual Voodoo sacrifice. Which, it turns out, is relevant to bird flu because Benin is having a poultry outbreak with H5N1. This is not much of a surprise, as it is surrounded by neighbors that already have reported infected poultry: Nigeria, Togo, Niger and Burkina Faso. A bit farther afield but still in the region are Ghana, Ivory Coast and Cameroon, all with reported poultry outbreaks. Nigeria has also had a human fatality. But back to Voodoo. In the US we…
With everyone on tenterhooks over the confusing outbreak of human bird flu cases in Pakistan and the first reported case in Burma (aka Myanmar), WHO is taking the opportunity to give its member nations a pep talk about swift reporting. Since there is evidence the reporting might not have been so terribly swift in that case, one must assume they consider this a "teachable moment" rather than an exemplar: The World Health Organisation (WHO) on Sunday praised Asian countries for swiftly reporting the latest bird flu cases after Pakistan and Myanmar were hit by a resurgence of the disease. Asia-…
If I knew for sure what was going on with the reported human bird flu outbreak in Pakistan's northwest border region I'd tell you. At this point it appears no one knows for sure -- not WHO, not CDC, not even the Pakistani authorities. The region where the cases are reported is near the Afghan border and is not under firm government control. The unsettled political situation merely adds to the usual confusion inevitable in the early days of any outbreak. We are all looking for a pandemic signal embedded in a lot of noise, difficult enough, but we don't even know what the signal sounds or looks…
Since this is not a breaking news site, I am waiting to see what is going on in Pakistan. I'll likely sum up tomorrow afternoon what I find by then (I hope with some value added). Here are some places you can keep checking for breaking news. They are the usual suspects: Helen Branswell's reports (natch). Latest here.Flu Wiki ForumCrof's BlogAvian Flu DiaryScott McPhersonSophia ZoeFlu TrackersCurEventsRecombinomics There are plenty of others, most accessible from one of the above sites. I'll be checking along with you.
As noted yesterday, it's flu season. That includes bird flu. So we are seeing cases pop up. Yet another in Indonesia and the father-son cases in China. Then reports out of Pakistan of the first human cases on the Indian sub-continent. Those case are as yet unconfirmed. Now WHO is confirming cases in Burma (aka Myanmar), the first in that military dictatorship not known for being open about what goes on there: The World Health Organisation (WHO) announced Myanmar's first human case of bird flu, the victim a seven-year-old girl who survived the disease. The girl, from the northeastern Shan…
China tries to close the door on a possible H2H while Pakistan opens the door to human bird flu cases on the Indian sub-continent. First China. Two recent cases, a fatal case of a 24 year old male followed after a period of some days by the infection of his father raised the issue whether the son passed the H5N1 infection to the father. No one wants this to be the case and the Chinese, who are hosting the summer Olympics in Beijing have a lot at stake. The spin on this, though, is incomprehensible: China's health authorities said here on Monday that no human-to-human transmission had been…
The medical site WebScape has a service that caters to physicians called MedPulse. In about 20 specialty areas it surveys a dozen or two scientific journal and alerts subscribers to interesting or pertinent papers. I subscribe to the Public Health and Prevention topic and the other day got the list of the "most read" articles by subscribers in the last year. There is always something curiously fascinating about "top ten" lists and this was no exception. So what do you think preventive medicine types were reading on MedPulse newsletters the last year? At the top of the list was a paper from…
The dramatic infectious agents like MRSA, Ebola and bird flu get the headlines but there are a lot of others out there, some of them capable of being just as nasty. Consider the new variant of adenovirus serotype 14, for example: Infectious-disease expert David N. Gilbert was making rounds at the Providence Portland Medical Center in Oregon in April when he realized that an unusual number of patients, including young, vigorous adults, were being hit by a frightening pneumonia. "What was so striking was to see patients who were otherwise healthy be just devastated," Gilbert said. Within a day…
Concern about cutting down the rain forests is not just a conservationists hobby horse. As more and more trees are cut down for their wood and the land cleared for agricultural use the unplanned consequence is that more an more mobile and traveling humans come in contact with animals for the first time. These animal populations are reservoirs for many viruses, some, like Ebola and AIDS, make their way into new homes, human bodies. The rain forest is no more than an incubation period's travel from major cities. But this isn't the only way animals and humans are thrown together in intimate and…