Posted on 05/09/2005 10:18:08 AM PDT by Dog Gone
Some folks suggested that we begin a thread similar to the Marsburg Surveillance Project for monitoring developments regarding Avian Flu.
The purpose is to have an extended thread where those interested can post articles and comments as this story unfolds.
If we're lucky, the story and this thread will fade away.
There is a lot of interest in, and news on, avian flu. Looking like it may get here in the US this fall (maybe).
Thanks for the ping. I want to stay informed.
I read, and I often understand, but I'm not sufficiently knowledgable to post on either this or the Marburg thread. Thank you to those FReepers with expertise in associated fields who keep the rest of us up to date.
Does anyone here know how far along researchers are in developing a vaccine for avian flu? Perhaps Kelly_2000 can help us here? Are sufficient resources being allocated, or is this something about which our government reps need to be better informed?
Since this thread is new today, perhaps some posted background basics -- why the worry, what's being done, etc. -- would be appropriate for later referral. Or maybe a post with collected links to earlier flu threads, like was done for Marburg.
Just suggestions from a layman.
On the contrary, your suggestions about background information and articles being posted here are excellent. It certainly slipped my mind.
I'm not sure who has a list of background articles, or if anyone does...
I'll go look up a couple, probably from WHO and the CDC and post links here shortly.
Here's a link to an article from the New England Journal of Medicine, entitled "Preparing for the Next Pandemic" dated May 5, 2005:
http://content.nejm.org/cgi/content/full/352/18/1839
This is a really excellent overview of the situation, in my opinion.
Beyond research and development, we need a public health approach that includes far more than drafting of general plans, as several countries and states have done. We need a detailed operational blueprint of the best way to get through 12 to 24 months of a pandemic.
What if the next pandemic were to start tonight? If it were determined that several cities in Vietnam had major outbreaks of H5N1 infection associated with high mortality, there would be a scramble to stop the virus from entering other countries by greatly reducing or even prohibiting foreign travel and trade. The global economy would come to a halt, and since we could not expect appropriate vaccines to be available for many months and we have very limited stockpiles of antiviral drugs, we would be facing a 1918-like scenario.
Production of a vaccine would take a minimum of six months after isolation of the circulating strain, and given the capacity of all the current international vaccine manufacturers, supplies during those next six months would be limited to fewer than a billion monovalent doses. Since two doses may be required for protection, we could vaccinate fewer than 500 million people — approximately 14 percent of the world's population. And owing to our global "just-in-time delivery" economy, we would have no surge capacity for health care, food supplies, and many other products and services. For example, in the United States today, we have only 105,000 mechanical ventilators, 75,000 to 80,000 of which are in use at any given time for everyday medical care; during a garden-variety influenza season, more than 100,000 are required. In a pandemic, most patients with influenza who needed ventilation would not have access to it
Good Deal (bump)
Thanks.
I want on this ping list too, please.
I haven't seen a single story about how the vaccine companies are addressing this situation and what their capabilities will be.
If a pandemic is probable or even possible, what exactly are we doing about it? I don't think it's an unreasonable question.
According to my copy of the list from Dog Gone, you're on it. Did you get pinged, earlier?
Well, DG, the problem is we don't know enough about the virus to make a vaccine yet. In fact, the test for the current group of avian flu cases depends on identification from the virus circulating in fall, of 2004.
It's thought that the virus has changed enough that there are false negatives, leading to a whole host of difficulties. In fact, it's fairly certain that there are an unknown number of false negatives, and that we cannot currently identify avian flu from the tests we presently have.
I'll post a commentary from Recombinomics here in a second.
Pandemic Flu False Negatives in Vietnam and Korea
Recombinomics Commentary
May 8, 2005
>>Genetic sequences from more recent versions of H5N1 are needed to produce more up-to-date test components, called primers.
Primers are tiny strands of synthetic nucleic acid used in PCR or polymerase chain reaction testing. If they are a perfect match for the influenza strain, primers used in flu tests should bind to the RNA of the virus.
Kobasa and lab technician Laura Hart spent several weeks at the National Institute for Hygiene and Epidemiology in Hanoi, sharing diagnostic expertise and helping Vietnamese scientists assess their testing proficiency.
That is when the problem with the primers came to light.
"There've been enough changes in the viruses between last year and this year that we found some of our PCR primers did not work that well," says Kobasa, a researcher in the division of respiratory viruses.
<<
The comments above offer some explanation for the false negatives in southern Vietnam. Earlier this year, tests from the National Institute for Infectious Diseases (NIID) in Tokyo found that several samples that tested negative at the Pasteur Institute in Ho Chi Minh City tested positive in Tokyo. The number of false negatives was initially reported as 7 of 30. The number was raised to 11 of 30 in follow-up NY Times report.
These numbers indicated that approximately 80% of the H5N1 positive cases in southern Vietnam were being missed. Recent reports indicated a missing amino acid has been detected in isolates in northern Vietnam, suggesting those isolates were recombinants between isolates from Vietnam and isolates from China. It seems likely that there have been primer problems in northern Vietnam also, which may explain why northern Vietnam sent 1000 samples to CDC for testing.
The lowered sensitivity for tests in the south may be do in part to an evolving H5N1, which continues to recombine with the many versions of the virus in Vietnam and new versions brought into the area by migratory birds. This primer related sensitivity problem may also explain why Thailand failed to identify any human cases this season when H5N1 was detected throughout the country in a wide variety of domestic and wild birds. Human Influenza A cases were testing negative for H5N1. The testing was almost certainly also based on the 2004 sequences, which had changed in 2005.
For Vietnam and Thailand, new probes relied in part on new sequences. However, primer issues may have also played a role in the WHO's failure to find WSN/33 sequences in swine in Korea. However, for the Korean sequences, the 2004 sequences were known in 2004 and had been deposited at GenBank in 2004. However animal quarantine in Korea as well as consultants to the WHO failed to confirm the data. In 2005 they did find H1N2 sequences in Korean swine, but these sequences had been reported previously in swine from the United States and Korea. They were quite different from the human WSN/33 sequences, or the original WSN/33 sequences or the closely related sequences found in swine.
The WHO had written up a release that described these 27 isolates from 2 farms in Korea. Although a draft was distributed to media, it remains unclear if the release ever went out to a larger audience. A small number of these isolates were sequenced and no WSN/33 was found in the limited number of sequences generated. However, it remains unclear if the primers used to generate the H1N2 sequences would have detected WSN/33 sequences.
Thus, the lack of primer specificity may have generated false negatives in Vietnam and Korea. The inability of the WHO to monitor H5N1 and WSN/33 seriously impacts any intervention strategy. The results from the 1000 samples from northern Vietnam have not been released. It remains unclear as to how much sample collection has been done from patients with flu-like symptoms. In northern Vietnam the case fatality rate has fallen to 20%. Many of the recovered patients are H5N1 positive, but have a relatively short hospital stay, which suggests a large number of milder cases may not be seen by physicians or hospitals.
Similarly, it is not clear where the WSN/33 sequences are in Korea, or how the 1933 human lab virus made its way into swine in Korea. Since Korea imports pigs from the United States and H1N2 was detected in the United States prior to being detected in Korea, the H1N2 and WSN/33 infections could date back to 2001 or earlier.
Strategies based on control of H5N1 bird flu or WSN/33 pandemic flu dependent on early detection have limited chance of success if the presence of the virus is largely unknown.
http://www.recombinomics.com/News/05080501/False_Negatives_Vietnam_Korea.html
bttt
Then we're screwed. I'm not willing to accept that yet without an admission from the pharmaceutical companies.
If it takes six months to manufacture and distribute a vaccine, and if they don't have one already in the works for avian flu, the earliest we could see one is in November if they start tomorrow, and that's too late.
The only hope we'd have then is that it somehow doesn't spread very fast in Asia and doesn't hop continents.
"If we're lucky, the story and this thread will fade away."
And if we're not the peregrines will fly it intercontinent.
"Biothreats" thread"
The threat matrix threads have been incorporating all bio hazard info along with chem and nuclear as it appears on the net.
http://www.freerepublic.com/focus/f-news/1383919/posts
I think I did. I'm running two ping lists, and am currently overwhelmed!
:-)
That's all right, idle mind/devil's workshop and all that.
I posted this on the Marburg thread but was told this is a good place to post it also.
To those that wish to form a Bird Flu surveillance project thread...This story should scare you.....Marburg is scary but at the moment it pales to what is going on in Asia.
HONG KONG: More than 10,000 people, mostly children, have been suffereing from flu symptoms during an outbreak in southern China during the weeklong Labor Day holiday according to media reports.
The victims had symptoms including runny noses, cough and fever.
More than half of the 10,000 people who contracted the virus were children, the report said, adding that a hospital in the city of Shenzhen had to set up temporary beds to accommodate nearly 700 children admitted daily during last week's holiday.
A man surnamed Shen who answered the phone at Shenzhen's health department said he didn't have information on the outbreak.
Asian countries are vigilant about flu outbreaks amid warnings that bird flu could mutate and become easily transmissible among humans, sparking a pandemic that could kill millions.
Bird flu has killed 52 people in Vietnam, Thailand and Cambodia since it began ravaging poultry farms across Asia in late 2003, but there have been no signs of human-to-human transmission so far.
http://timesofindia.indiatimes.com/articleshow/1102486.cms
I like the last paragraph the best. When have you heard of 10,000 people getting the flu in the same week? The case for human-to-human transmission is made in this article and the MSM ignore the facts and just report what the government says. Just proves that reporters are among the dumbest people on the earth.
and a second post..
The above is dated 05-08-05 but if that isn't enough look at this posted 04-11-05.
Hospitals in Ho Chi Minh City have been filled with thousands of children who have caught respiratory and digestive illnesses due to the hot weather.
Pediatric Hospital I reported that it had examined nearly 4,000 children patients a day with some 85 per cent of them suffering from respiratory problems, said a hospital doctor.
Meanwhile, more than 3,000 children were brought into Pediatric Hospital II on Monday. One-third of the children had respiratory problems and 300 others had digestive problems.
Besides, many children have been hospitalized for brain diseases caused by the entero virus.
The major reason behind the illnesses is that children are sleeping all night with fans on due to the hot weather in recent days.
April and May are probably the hottest months of the year in the South of Vietnam.
Thus, the children have lost a lot of water from their skins and are easily immune to respiratory illnesses, said Dr. Nguyen Duy Tien from Pediatric Hospital I.
http://www.thanhniennews.com/healthy/?catid=8&newsid=6087
But you know mass infections of thousands of children happen every day. Right? There is no human-to-human transmission of a flu strain that humans have no immunity going through South Asia like wildfire is there? So the question is this, Do you trust the media and government to tell you the truth and facts? If you do I have a bridge you maybe interested in buying....they would rather you know about the runaway bride or Jackson
One final note. What do you think would happen to this Economy if tens of thousands of people could not go to work at the same time in the same city. If parents had to call off to stay with sick kids. If schools were canceled to prevent spreading of infection. In this just in time inventory system that America runs on it could be a nightmare. p.s. I can just imagine the law suits being filed if an infected person died in a gym because there wasn't enough beds in the hospital.
I wonder why he is promoting protein inhibitors over and above vaccination? protein inhibitors such as this are only effective if taken prior to the onset of symptoms, they also retard the replication of the virus not relieve symptoms, in the case of influenza high risk groups are still at risk of succumbing to symptoms that impair and impact the respiratory system (ARDS chiefly). The most effective proactive measures against a pandemic of this nature would be timely and relevant vaccination as well as symptomatic relief for infected high risk groups. The majority of the mortality statistic is made up from the elderly (65+), infants under 2 years old, people with weakened immune systems, caregivers and people with chronic conditions such as asthma, diabetes, heart or lung disease. If this is undertaken then most patients will recover, remember that influenza for instance is not attributed with a high mortality statistic it kills the high risk in the main, even in pandemic years.
the government only becomes aware of the danger of pandemic when it is too late, once the filed reports are coming in, there is not much that can be achieved only reactionary measures. It is far more likely that a proactive strategy will result in less fatalities globally.
Nice thread Judith well done :-)
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