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"Given the evidence that pigs can support the reassortment of influenza viruses from humans and other species, it is prudent that we enhance surveillance for atypical influenza viruses in pigs as part of overall pandemic preparedness efforts," the researchers said.

I don't understand, it already is, this is not any new discovery. The WHO and CDC also monitor type A,B and C influenza strains. An absurd statement...

someone who is fiscally conservative and socially liberal

Not a very good definition IMO

stem cells harvested from carcinomas???

teratocarcinomas, still immoral IMO, but you can do a google and you will find a lot of white papers on the subject. :-)

which would then make an insurance model fail once there is no one NOT using them? Which would seem inevitable especially as the population 'greys'?

Most of the presentations I have seen, mention a subscription service, with segmentation for various levels of investment from the consumer. i doubt the premiums are on a parity with insurance models. More likely they are similar in nature to an amortized subscription service based on estimated or projected future demand. With the subscription offering affordability on a quarterly pay plan and a discount over time. rather than paying on demand for instance, which i assume would be the luxury of the high end customer.

Hi Fyre:-)

aren't all migratory wildfowl potential vectors for avian flu?

influenza is a zoonosis, avian populations are the reservoir for the Type A strain of influenza

Til then wouldn't culling waterfowl be premature?

No because the risk is actually in the two porcine and avian populations exchanging influenza genome, while in the environment that is common to both species. marshland, wetlands and lakes etc. Biological transfer and mechanical transfer mechanisms result in porcine hosts acting as recombination hosts for both strains to exchange code

If your doctor has done a lot of research into H5N1 and thinks that modern medicine will prevent it being "bad" in the US, you owe it to yourself to do your own research. With the internet that is an easy task. Find some good websites (there may be some on this thread) and spend several days' worth of hours reading. I think you'll change your mind.

if "modern health-care" could deal with a pandemic flu event, why do the FEMA and CDC have a multi billion dollar budget and plan for disaster management in the very same worse case scenario?

I am astounded that any clinician would give a patient this kind of advice. Influenza always presents high morbidity how could a health-care infrastructure cope with the clinical care burden? even if the CFR and mortality rate where not so high?

sometimes as a virologist i get so angry when clinicians that should know better give such advice to patients. this attitude of "lets not get people alarmed" will likely have a counter effect. and create a population that is not prepared and requires far more support from emergency and federal services.

OK rant over for now :-)

Hi Judith, it's great to talk with you too :-)

I have been very busy with a dissertation lately and will be for some more time to come.

Nice to see this topic in the forum making people aware and talking on it.

Pandemic flu is the Russian roulette of the virology domain. As you say, the risk isnt going away, it never does, it's omnipresent. Influenza is patient, it can wait several decades, but it will always take the perfect molecular combination, interactions between flora and fauna, and the perfect geological / demographic landscape. On a backdrop of socio-political chaos that is our world in conflict (world war 1) then it will seize the moment. And how.....

For the benefit of the thread, acquiring mammalian polymorphisms or antigenic variance or recombination events can all lead to a human to human strain of H5N1. I hope this clears up the misunderstanding

Tamiflu? Nothing.

Relenza? Nothing.

You would not expect these protein inhibitors to have any effect on patient recovery while a patient is symptomatic, at that point it would be too ate to use protein inhibitors such as tamiflu. Protein inhibitors such as these are effective at retarding the virus ability to bind to cell structures and replicate. They must be used at early onset prior to becoming symptomatic, they are not used to reduce infectivity of the virus.

I agree with your comments concerning patients with acute symptoms that succumb to ARDS or pneumonia, many have died despite clinical care, that is worrying.

AND REMAINS OTHERWISE UNCHANGED"

strictly speaking that's not really accurate, it only requires that the subtype remains highly pathogenic and virulent, "unchanged" when discussing single strand RNA virus and in particular influenza shows a little naivety concerning the nature of antigenic variance and the innate instability of spontaneous replication without the need for polymerase enzymes and the errors that are frequent and predictable. Basically the influenza genome is dynamic and anything but "UNCHANGED"

:-) Thanks for the post L

Another 1918 type outbreak is the kind of thing that makes epidemioligists wake up in a cold sweat. Let's hope we never see it again. Not bloody likely, but we can hope. L

unfortunately it's a statistical certainty :-(

Okay, some facts: "The influenza virus had a profound virulence, with a mortality rate at 2.5%

Yes this is significant in the annual flu season we observe a mortality statistic of around 0.04%

But I fear you are missing the point, it's the morbidity statistic alongside the mortality statistic that make pandemic flu unique.

Are you so 'rigidly' extrapolating into the future based on past results that you have overlooked the gains made in containing those contagions that at one time absolutely ravaged mankind?"

Let's be clear here, there are NO cures for ANY of the VIRAL diseases on this planet. You cannot cure a cold, you cannot cure influenza, you cannot cure viral pneumonia, you cannot cure, polio or AIDS.

You can treat symptoms and offer symptomatic relief, you can also introduce preventative measures such as vaccination programs, BUT THERE ARE NO CURES.

Influenza kills around 1-2 million people globally per flu season (September to August) with 40,000 of these cases in the USA alone, these are mostly patients from high risk groups. However during a pandemic season this changes to those outside of the high risk groups. Vaccinations cannot be offered if they do not exist, they also take time to reach maximum efficacy and provide the so called herd immunity statistic that would prevent mortality statistics seen in the 1818 pandemic.

Modern technology and advances would likely work against society if a pandemic occurred from a subtype of influenza as virulent as the 1918 subtype. Travel would accelerate disease cluster and distribution, the mortality statistics would likely be increased by the trend of allergic and asthmatic infants that are a result of modern pollutants. health care professionals would likely come in contact with the pathogen first as a result of seeing patients with conditions such as ARDS and pneumonia that would not immediately be linked with influenza, these same health care professionals would help spread the disease amongst the healthy population and prevent the needy being treated when they become too sick to work themselves.

Is this a doom and gloom scenario? It certainly is a possibility, no one can predict the efficacy of the current vaccines or the cross immune benefit that would be derived. Nor can we predict with any certainty how virulent will the pandemic strain become over the coming years. However of the 40,000,000 people that died within the last century i doubt any of those living during those times would ever call influenza anything but catastrophic.

I agree, it's far more precise to cite the type of cell being discussed such as totipotent, pluripotent, or multipotent. The origins of that cell will also help with the understanding in any debate, embryonic or adult is bandied around in many conversations, however some of the research it is linked with sometimes uses cells harvested from carcinoma for instance.

Hmmmm...well if not a mass market paradigm then what paradigm IS this

I am glad you ask, but I must clarify this point, and create a common definition as there is a danger of miscommunication.

"mass market" in my opinion refers to applications that are able to be positioned to a larger target user group, or consumers. It also implies a market landscape that is broad perhaps horizontal rather than vertical, yes? This would be the opposite of niche or specialist market positioning, Yes?

It does not in my opinion, also imply a "one size fits all" product segmentation. It could contain also entry level, mid range and high end segments. In the case of our discussion, mass market in pharmaceutical applications is certainly a single product position targeting a large or largest possible target consumer group.

However stem cell research is not only going to produce pharma applications, far from it.

Stem cell research will provide applications such as organ synthesis, bone marrow, tissue and platelet farms. these are applications that will be largely prohibitive in cost to the consumer because, of the requirement to customize his product for HIM. There is a mass market appeal for the kind of service or product, as everyone will want it or desire it. There is no small or niche market community or target user group interested in such a product. However there is no generic protocol for it's production it cannot be "mass produced" NOT "mass market" the wrong term is being bandied about in this debate in my opinion.

Mass production however is a constraint that will be overcome not via production efficiency or any other technological development. However it will be overcome by financial services innovations. At the moment startups are recruiting even at my university to compel doctoral and graduate students to join companies at the forefront of this research. It is happening with a higher and higher frequency. The sales spiel is very good they are very slick. The revenue model will be based on an "insurance" premium payed by a client, that provides organ repositories / banks, or platelet farms or whatever the application, to be prepared in advance to the paying customer, should he need to avail himself of the services he is subscribing to. It's going to lead to ethical dilemmas in the future, some of which have been portrayed in visionary science fiction novels and movies.

So... What business models and revenue stream would make fetal stem cells a better choice than adult cells? Why the push for fetal?

Your preaching to the choir :-) I am a catholic, in any event religious beliefs or not, I would never be able to reconcile my conscience with the immoral harvesting of stem cells from fetal donors. Any potential benefit would not be worth the loss of human life.

Concerning the utilization of fetal stem cells? A significant dollar spend on R&D has been made by many investors and private as well as public companies. Making a positive ROI on that investment is the main cause of the push with fetal stem cell research. In other cases scientists believe their particular application requires fetal stem cells. From what I have read, each case can only be judged on a case by case basis, or on the merits of the empirical data supporting one or the other white paper in this domain. There is no "blanket statement" that promotes fetal stem cells, adult stem cells or synthesized stem cells (see research in India and Taiwan in August 2005 NEJM for that one)over one another. Much as I would like that to be the case. It is important to look at the overview objectively without emotive or cognitive bias. it's hard to do that when science is murdering unborn children, however the battle will be won by reasoning in peer review, sadly it's doubtful that any ethical oversight will prevent utilization of human fetal stem cells in the future.

The ONLY reason fetal stem cells are being pushed is to enable mass marketing of a stem cell solution.

I'm surprised you don't see this...

I am a microbiologist and I am afraid I see alternative business models and revenue streams proposed, for future treatment regimes and protocols you are apparently unaware of. revenue models are not dependent on generic protocol. Many existing models exist in areas of medicine that disagree with your opinion.

You cant do that if the treatment has to be customized for each patient.

In the traditional pharmacological sectors and markets this is true, but you are describing stem cell therapies that are NOT based on traditonal paradigms. Nor are they limited to current mass market paradigms. Growing new organs for patients from totopotent cells THEY posses would not be "mass market" viable either. Yet this emerging industry and technique is coming. You seem to be starting your hypothesis on a flawed premise and making several erroneous assumptions.

I broke the code, and have been saying this for years. Follow the money...

It would still cost money to have this kind of treatment, regardless of whether the treatment protocol / product was patented or not. this is not the crux the of the matter at all.

woo hoo :-)

*hi fives Cindy*

this one is a keeper lol