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1918-19, "Spanish flu," [A (H1N1)], caused the highest number of known influenza deaths: more than 500,000 people died in the United States, and up to 50 million people may have died worldwide. Many people died within the first few days after infection, and others died of complications later. Nearly half of those who died were young, healthy adults. Influenza A (H1N1) viruses still circulate today after being introduced again into the human population in the 1970s.

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Interpandemic period

Phase 1: No new influenza virus subtypes have been detected in humans. An influenza virus subtype that has caused human infection may be present in animals. If present in animals, the risk of human infection or disease is considered to be low.

Phase 2: No new influenza virus subtypes have been detected in humans. However, a circulating animal influenza virus subtype poses a substantial risk of human disease.

Pandemic alert period

Phase 3: Human infection(s) with a new subtype, but no human-to-human spread, or at most rare instances of spread to a close contact.

Phase 4: Small cluster(s) with limited human-to-human transmission but spread is highly localized, suggesting that the virus is not well adapted to humans.

Phase 5: Larger cluster(s) but human-to-human spread still localized, suggesting that the virus is becoming increasingly better adapted to humans, but may not yet be fully transmissible (substantial pandemic risk).

Pandemic period

Phase 6: Pandemic: increased and sustained transmission in general population.

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Some people who felt well in the morning became sick by noon, and were dead by nightfall.

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Findings pointing to an altered role for domestic ducks join other recent evidence that the H5N1 virus circulating in parts of Asia has increased its pathogenicity in chickens and mice (a laboratory model for mammals), and has expanded its host range to include mammals, such as felines, not previously considered susceptible to infection.

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In the past, pandemics have announced themselves with a sudden explosion of cases which took the world by surprise. This time, we have been given a clear warning. During 2004, large parts of Asia experienced unprecedented outbreaks of highly pathogenic avian influenza, caused by the H5N1 virus, in poultry. The virus crossed the species barrier to infect humans, with a high rate of mortality. Monitoring of the evolving situation, coordinated by WHO, has produced many signs that a pandemic may be imminent.

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As yet another feature, the genetic content of these viruses is neatly segmented into eight genes. This facilitates the most greatly feared event: the swapping of gene segments during coinfection with human and avian influenza viruses, creating a new virus subtype that will be entirely or largely unfamiliar to the human immune system. If this new “hybrid� virus contains the right mix of genes, causing severe disease and allowing easy and sustainable human-to-human transmission, it will ignite a pandemic. This strategy, known as antigenic shift, works well as a long-term survival tactic: immunologically, a new virus subtype starts from scratch and is guaranteed a very large population of susceptible hosts.

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As a virus from the H5 subtype will be foreign to the immune system of everyone alive today, vulnerability to an H5N1-like pandemic virus would be universal.

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Although the second wave of outbreaks has been far less conspicuous in the numbers of humans and animals affected, it has demonstrated several unusual features. These features, confirmed by findings from recent epidemiological and laboratory studies, suggest that the virus may be evolving in ways that increasingly favour the start of a pandemic. Evidence strongly indicates that H5N1 is now endemic in parts of Asia, having established a permanent ecological niche in poultry. The risk of further human cases will continue, as will opportunities for a pandemic virus to emerge. Studies comparing virus samples over time show that H5N1 has become progressively more pathogenic in poultry and in the mammalian mouse model, and is now hardier than in the past, surviving several days longer in the environment. Evidence further suggests that H5N1 is expanding its mammalian host range. For example, the virus has recently been shown to cause severe disease and deaths in species, including experimentally infected domestic cats and naturally infected captive tigers, not previously considered susceptible to disease caused by any influenza A virus. The outbreak in tigers, which began on 11 October in Thailand, had a second disturbing feature. Altogether, 147 tigers in a population of 418 developed high fevers, usually progressing to severe pneumonia, as a result of H5N1 infection. Preliminary investigation found no evidence of tiger-to-tiger transmission. As infection was linked to the feeding of chicken carcasses, the amount of infected chicken moving in the food supply must have been great to have caused disease in so many large animals.

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All these are from the same WHO pdf file as above.

[ May 26, 2005, 04:56 AM: Message edited by: Tatiana ]
 

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Posted by Tatiana (Member # 6776) on :
 
That pdf file is awesome, btw. I'm reading the whole thing. It's clear, complete, and factual. It tells the whole story, what you really need to know. I highly recommend it for anyone for some good bedtime reading.

I stay up at night thinking about these things, worrying about the human species, heh.
 

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Posted by Tatiana (Member # 6776) on :
 
You know what? I'd be very careful with birds of any sort, anywhere in the world. Once they're properly cooked they don't transmit disease, but when you're cleaing raw chickens or ducks preparatory to cooking them, it's probably wise to be extremely careful. Wear protective gloves especially if you have any cuts or scrapes on your hands. Those tigers got it from eating raw chicken carcasses, so the transmission risk must not decrease very rapidly after the bird is dead. Certainly anyone who slaughters live birds or handles newly killed birds is at risk.

I'm really glad I'm vegetarian nowadays. However, once the virus changes to become easily transmissable between humans, nobody anywhere in the world will be safe from it.

[ May 26, 2005, 05:34 AM: Message edited by: Tatiana ]
 

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Posted by quidscribis (Member # 5124) on :
 
Tatiana, in the country, yes. In my neighborhood, no. In other words, I'm never exposed to live chickens or birds of any description. Oh, but we do have some birds that land on our balcony or stair railing or that sort of thing, but I'm never withing five or ten feet of them.
 

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Posted by Tatiana (Member # 6776) on :
 
Okay that's good. You're probably about as safe as any of us, in that case.

Pandemics always spread very rapidly to all parts of the world. With international travel and shipping nowadays, once the virus becomes readily transmissable between humans, there will probably be no more than a few months difference in when you're exposed no matter where you live.

For the moment, though, it's all about direct contact with infected birds.
 

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Posted by Tatiana (Member # 6776) on :
 
In my reading of this excellent World Health Organization pdf file, I came across the recommendations for handling raw poultry and eggs. Though we may have seen this many times, it bears repeating in context of this highly deadly disease.

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WHO advice on the preparation of poultry for consumption

1. Avoid contamination
Separate raw meat from cooked or ready-to-eat foods. Do not use the same chopping board or the same knife for preparing raw meat and cooked or ready-to-eat foods. Do not handle both raw and cooked foods without washing your hands in between and do not place cooked meat back on the same plate or surface it was on before it was cooked.
2. Cook thoroughly
Thorough cooking will inactivate influenza viruses. Either ensure that the poultry meat reaches 70 degrees C (160 degrees F) or that the meat is not pink and there are no pink juices.
3. Be careful with eggs
Eggs, too, may carry pathogens, such as the birdflu virus inside or on their shells. Care must be taken in handling raw eggs and shells. Wash shells in soapy water and wash hands afterwards. Egg yolks should not be runny or liquid. Do not use raw or soft-boiled eggs in foods that will not be cooked.
4. Keep clean
After handling raw or thawed raw poultry or eggs, wash your hands and all surfaces and utensils thoroughly with soap and water.

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I'm not trying to get people alarmed, I'm trying to figure out how we should prepare, and to spread knowledge that might serve to keep more people alive

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Why not do that? Too expensive? I'm not sure.

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Needles
 

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Posted by Annie (Member # 295) on :
 

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3. What can we do to personally prepare? Should we attempt to obtain anti-virals in advance for our families? Or possibly antibiotics in case we survive the initial flu and get secondary pneumonia? Should we keep Gatorade and Pedialyte on hand? Death comes very quickly from multiple organ failure to many, but supposing we survive that phase, what drugs/supplies would we need?

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Originally posted by Tatiana:
The last really bad influenza pandemic was in 1918 when something like fifty million people died worldwide, more than in all the combat in the 20th century, I read. Now the very deadly avian influenza in Southeast Asia is likely to mutate into a form that can be transmitted easily person to person. When that happens we're likely to see worldwide some very high death rates. They are trying to figure out what we can do that might make things better but even the most optimistic scenarios are pretty awful.

Because of the way the flu virus behaves, it's not so much a matter of "if" as "when". But we have no idea how much time we have. And we just don't have the capacity to generate enough doses of vaccine to be very effective (witness the debacle over the ordinary flu shots this last year).

Does the human species need to invest in more pharmaceutical manufacturing facilities for vaccines? Even ten times as much as we now have? What should we do? And what would the world be like if 1/3 of the people died next year? I haven't read Pepys. What is it like living in plague times? Would the normal social fabric strain to the breaking point?

I'm interested in the deeper questions behind this, too.

1. What do we personally do in a situation where 2/3 of the population comes down sick with the flu and half of those die? Are we personally prepared? Should we do what we can to look after the sick or stay as far away as possible in an effort to reduce our exposure?

2. Health care workers get the most exposure so they usually take a bigger hit than other professions. So we will be coping with a crisis with fewer doctors and hospital staff members than our usual number, meanwhile the number of patients will be off the charts.

3. What can we do to personally prepare? Should we attempt to obtain anti-virals in advance for our families? Or possibly antibiotics in case we survive the initial flu and get secondary pneumonia? Should we keep Gatorade and Pedialyte on hand? Death comes very quickly from multiple organ failure to many, but supposing we survive that phase, what drugs/supplies would we need?

4. Should we go to the hospital in the event we become sick during a pandemic, or would it be safer to stay at home?

I just want to know the right answers to these questions in advance, so that I don't have to waste time pondering alternatives when the time comes.

It's possible that in the course of mutating into a form that is easily transmissable between humans the virus will become much less deadly, but we don't know that for certain. It makes sense to know ahead of time what is the right thing to do in any event.

The mortality rates are chilling. Over half the people who get sick die within days.

Regardless of the specifics of the pathogen, plagues are a fact of nature. They've occurred again and again throughout history, and if our ability to cope has improved some, the increase in population density worldwide coupled with the rapid speed of travel nowadays has eaten up those gains and them some. It's really not a matter of "if" but "when" a plague (whether of influenza or some other pathogen) will occur. So what would you do? Doesn't it make sense to spend at least a little time deciding now?

Will the fabric of society break down? How do we strengthen it to prevent that?

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I thought about widespread advance vaccination against any chosen H5N1 strain, that it would greatly decrease the severity of any outbreak even if the particular strain was rather different. They do say the reason the mortality is so high and the resistance so low is because the immune systems in humans alive today have never had any challenges from H5 viruses. Why not do that? Too expensive? I'm not sure.

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I suspect that the reason why a plan to immunize the general public against H5N1 would fail is twofold--first, it would be expensive. Not as expensive as doing nothing will eventually be, but most governments are pretty short sighted, and are going to focus on the pain of immediate expense over long term expense. Second, it's guaranteed that a certain percentage of the people immunized would die as a result of the immunization. That percentage would be a fraction of the number killed if H5N1 were to sweep through the population unobstructed, but again, the cost would have to be paid now, rather than later.

Combine these two things, both of which basically boil down to short sightedness, with the fact that a relatively small percentage of the population is aware that there might be a problem on the horizon, and the fact that of those that are aware of it it seems more like a possibility than a certainty, and I think you have your answer.
 

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Posted by Sopwith (Member # 4640) on :
 
And don't keep a huge number of birds in small cages right in the middle of high population areas.

I know it has been a major problem in Hong Kong, Beijing and other large Asian cities where there are humongous livestock markets. And most recent flu outbreaks have been traced to those places...
 

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Posted by Tatiana (Member # 6776) on :
 
Annie, flu shots act by strenghtening the immune system, though. I think they are good things, along with all the other things you mentioned.

According to my doctor, aspirin and advil and such drugs do not compromise the immune system's ability to fight infections, though being healthy in all ways, nutrition, exercise, sleep, and cleanliness can certainly help a great deal.

One of the problems with pandemics as opposed to the normal yearly flu epidemics is they sometimes target the young and healthy preferentially over the old and sick, for some reason. The 1918 flu did that and bird flu so far seems to be doing it as well.

kai, if everyone else gets the vaccine, you don't have to. And maybe it could be the under-the-skin type like tuberculosis, that you don't have to be impaled on a long thin spike to receive. Do you dislike the air pressure gun type injections too? Or are those okay?
 

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Posted by Bob the Lawyer (Member # 3278) on :
 

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Annie, flu shots act by strenghtening the immune system, though. I think they are good things, along with all the other things you mentioned.

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Regulatory agencies have established procedures for advance approval of a “mock-up� vaccine and subsequent fasttrack marketing authorization once a pandemic is declared.

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Tuesday, March 15, 2005
Merial Launches New H5N1 Avian Influenza Vaccine
GLOBAL - Merial today announced the introduction of a new inactivated vaccine, GALLIMUNE(R) Flu H5N9, developed and shown to be effective specifically for use against the highly pathogenic avian influenza virus H5N1 that has caused devastating economic losses in the poultry industry in Asia, and which has been linked to the deaths of over 29 humans.


Once vaccinated by GALLIMUNE Flu H5N9, chickens can be readily differentiated from infected birds through the use of the DIVA (differentiating infected from vaccinated animals) serological diagnostic test, which detects a non-pathogenic influenza strain contained in the vaccine.

GALLIMUNE Flu H5N9, an inactivated vaccine, joins TROVAC(R) AIV H5 as Merial's second major introduction of avian influenza vaccines. Recently conducted experiments with TROVAC AIV have shown the efficacy of this fowlpox vector avian influenza vaccine against the pathogenic Asian H5N1 virus. Tests conducted at government laboratories in the United States and Australia demonstrated significant levels of protection against viruses isolated in Korea and Vietnam. The vaccine was also able to reduce or eliminate the shedding of the virulent virus from the vaccinated chickens.

TROVAC AIV H5 is the only USDA licensed avian influenza vaccine for administration to chickens at one day of age. More than one billion doses of the TROVAC AIV H5 vaccine have been sold in Mexico and Central America since 1998.

TROVAC data is also being evaluated by international agencies and experts for inclusion in international guidelines for controlling and preventing avian influenza outbreaks.

Merial is a world-leading, innovation-driven animal health company, providing a comprehensive range of products to enhance the health, well-being and performance of a wide range of animals. Merial employs approximately 6,000 people and operates in more than 150 countries worldwide. Its 2004 sales were in excess of $1.8 billion. Merial Limited is a joint venture between Merck & Co., Inc. and sanofi-aventis.

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Monday, March 14, 2005
Bird Flu Clusters May Signal Virus Change

THAILAND - A cluster of human bird flu cases among relatives and possibly health workers in Vietnam may show the virus is changing into a form that can be passed on by humans, the World Health Organization said. The WHO is worried that bird flu, which has killed 47 people in Asia, could mutate into an easily spread form that sparks the next influenza pandemic, killing millions.

"Such cases can provide the first signal that the virus is altering its behavior in human populations and thus alert authorities to the need to intervene quickly," the WHO said in a statement seen on Monday.

The main concern of the WHO was a series of cases of the deadly H5N1 bird flu virus in a family in the northern Vietnam province of Thai Binh and the possible infection of two nurses who cared for one of the patients.

It also said it had received confirmation of an additional 10 cases of human infections from Vietnam's Health Ministry.

"Full information on new cases, including those that may be closely related in time and place, is critical to ongoing assessment of the pandemic risk posed by the H5N1 virus," the U.N health agency said in a statement.

The new cases were detected in early March or through re-examination of older cases, some of which dated back to late January and three of which had been fatal, the WHO said.

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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.

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Clinical, epidemiologic, and laboratory evidence suggests that a pandemic caused by the current H5N1 strain would be more likely to mimic the 1918 pandemic than those that occurred more recently.5 If we translate the rate of death associated with the 1918 influenzavirus to that in the current population, there could be 1.7 million deaths in the United States and 180 million to 360 million deaths globally. We have an extremely limited armamentarium with which to handle millions of cases of ARDS (respiratory distress syndrome) — one not much different from that available to the front-line medical corps in 1918.

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More than a year after avian influenza emerged in East Asia, killing more than two-thirds of the people with confirmed cases, Vietnamese doctors are reporting that the mortality rate in their country has dropped substantially.

Nguyen Sy Tuan lies in bed at Hanoi's Bach Mai Hospital as he recuperates from bird flu. Experts say dropping death rates could signal a wider outbreak.

But while this is good news for survivors, it could mean the outbreak of bird flu in Southeast Asia is taking an ominous turn. If a disease quickly kills almost everyone it infects, it has little chance of spreading very far, according to international health experts. The less lethal bird flu becomes, they say, the more likely it is to develop into the global pandemic they fear, potentially killing tens of millions of people

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Also worrying is the discovery of at least five cases, including that of Tuan's grandfather, in which people tested positive for bird flu but showed no symptoms. This could make it more difficult to contain an epidemic because people could transmit the disease without anyone realizing it.

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Peter Horby, the WHO medical epidemiologist in Hanoi, said that while the mortality rate from H5N1 infections was falling, the virus appeared to be adapting to human hosts, which was taken to be an indication that transmission between humans would become easier.

"The fact that it's been around for a year and we haven't seen a pandemic is no reason to be complacent," he said.

"I'm more concerned than I was a year ago." He estimated the probability of a pandemic at "more than 50 per cent".

Dr Klaus Stohr, the WHO global influenza programme chief, reported an increase in the number of cluster cases reported recently, with the biggest a family of five cases.

There have been seven cluster cases in Vietnam, all within single families, most recently in the northern province of Haiphong.

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"We at WHO believe that the world is now in the gravest possible danger of a pandemic," says Shigeru Omi, Western Pacific regional leader for the World Health Organization. Those words echo Julie Gerberding, director of the federal Centers for Disease Control and Prevention, who called the current situation "a very high threat."

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Officials are also grappling with how to handle the economic and social disruption that pandemics cause. Pandemics last much longer than a hurricane or other natural disaster and typically hit in waves, with a first wave of infections followed by a second wave some three to 12 months later. If children fall ill, parents will have to stay home from work to take care of them, and business will suffer. Ditto if schools are closed to reduce the risk of infection. "We're talking about reducing morbidity and mortality, and maintaining social order," says Matt Cartter, epidemiology program coordinator for the Connecticut Department of Health.

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"We've never suffered an event of such magnitude that it shuts down the global economy," says infectious-disease specialist Osterholm. "In 1918 we were much more self-sufficient."

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Research suggests nearly 4000 New Zealanders would die within eight weeks of the virus getting here. A further one million would seek medical attention and 20,000 would be hospitalised, placing huge strains on the health system.

Auckland Regional Public Health Service communicable diseases expert Dr Will Paterson said in the event of a pandemic it was desirable to limit the effect on health services by slowing the disease's spread, even if that meant prolonging its duration.

To do that it would be necessary to impose emergency restrictions, including stopping travel across Cook Strait if people in only one island were infected and closing events where large numbers gathered.

If the virus did mutate into a more infectious form and a plane load of "barmy army" Lions supporters arrived after an Asian stopover, cancelling attendance at rugby matches would have to be considered, Paterson said.

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Repeated warnings about the international community's failure to respond to the pandemic threat have fallen on deaf ears.

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Originally posted by Phanto:
All this makes me really wonder -- why don't all people have a few weeks worth of water and food stockpiled? Gah.

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If you live in hurricane country this time of year, you do.
 

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Posted by Tatiana (Member # 6776) on :
 
It seems to be endemic now in Indonesia pigs, which is more very bad news. Pigs can get both bird and human influenza viruses, and serve as an excellent mixing vessel for the two.

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Concerns over the presence of a dangerous strain of avian flu virus in Indonesia's pigs are growing, as government tests confirm the existence of infection. In some areas, the H5N1 virus could be infecting up to half of the pig population, without causing any signs of disease.

The initial discovery was made earlier this year by an independent researcher working outside national and international surveillance systems. Chairul Nidom, a virologist at Airlangga University's tropical-disease centre in Surabaya, Java, found the H5N1 virus in five of ten pigs tested from Banten in western Java.

The presence of the virus in pigs is a particular worry because the animals can harbour both bird and human flu viruses, and act as a 'mixing vessel' for the emergence of a strain of avian flu that can easily infect humans. There are now signs that the virus could be spreading unchecked through the pig population.

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This flu moves much faster than SARS because its incubation period is just two days. People are spreading the virus the day before they get sick, and asymptomatic patients without even being visibly ill. Tamiflu needs to be administered within two days of anyone showing symptoms.

As I wandered through the streets this afternoon, it wasn't looking good. People are walking around Hanoi coughing and spluttering. They've closed the schools, which is the right thing to do, but what are all the kids doing? Hanging out downtown enjoying the unexpected holiday.

...

On CNN it's now round-the-clock coverage, with a red 'Pandemic' banner running across the bottom of the screen. "We're in the twenty-first century, and they're telling us about how to wash our hands properly, and practise 'respiratory etiquette'," exclaims Jonathan. "Why aren't there drugs? And I can't believe there's no vaccine. This can't be happening in America."

...

There's a lot of looting going on in pharmacies, but to no avail. The drugs are being distributed in convoys, with military jeeps in front and behind. Masks costing a dollar are being sold on street corners for $20. E-mailed ads for counterfeit drugs are filling up my inbox.

...

Who should get the few mechanical respirators that can mean the difference between life and death? The youngest, or those with the best chances of pulling through? "Our leadership must be prepared to make calculated decisions that will force raw prioritization of life-saving resources," explains a colonel on CNN.

...

17 MAY 2006 The dust settles
The pandemic was declared over today. H5N1 will be back next year, or before that, as it replaces the existing seasonal flu strains. But by then, those who have recovered from this bout will have immunity, and we will have a vaccine. Pandemics move faster than governments or international bureaucracies, and the cost is hundreds of billions of dollars more than it would have been had we tackled avian flu in Asia in the first place, and invested in flu research. For millions of families, the cost isn't measured in dollars.

Watching all that military hardware on the streets made me think. We imagined we could encourage pharmaceutical companies to develop innovative vaccines and drugs by offering 'incentives' or modest subsidies. When the military knows it needs a fighter aircraft, it doesn't offer incentives to Lockheed Martin or Boeing. It pays them through procurement to develop the weapon to the specifications it wants.

Were we ready? Ready, my ass!

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Posted by Tatiana (Member # 6776) on :
 
People, this may be one of the most significant events in human history that any of us experience. How will we respond as individuals, in our neighborhoods, our families, our societies, our countries, and our species? Will we tear at one another, grabbing what we need for ourselves, laying blame for poor preparation on leaders or on others, ignoring the plight of those around us, keeping supplies and drugs for ourselves and our families, viewing all others as enemies?

Or will we realize that here in a tiny microbe, something too small even to see, we have a common enemy to all humans, birds, pigs, and other species. Will we begin personal preparation now, and call for our leaders at every level to do whatever can be done to prepare on a local, national, and global level? During the weeks when the plague is at its height will we pull together, joining in a spirit of generosity, brotherhood, and deep connection with everyone around us, or will we show only hostility, indifference, self-preservation?

I issue this profound moral challange to all of hatrack. Some of us will not survive. Decide right now how you are planning to act when this thing hits and then measure your actions daily against that yardstick. Each person's actions serve as a model for those around them. What spirit will you model? In what spirit will you live or, if needs be, die?

The human species has an opportunity, in the severe challenge which this virus will bring us, either to sink to its lowest depths, or to rise above, to find a new spirit, to realize what matters in life, to pull together with one heart. It's our choice. Which will we choose?
 

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Posted by Jenny Gardener (Member # 903) on :
 
Tatiana, I admire you so much for bringing this up!

My family has a retreat of sorts. We're building our own home on a 10-acre lot. We'll heat with wood from our forest. We can grow some of our own food. We can hunt deer, if necessary. And we can stay away from people. I think we'd likely draw away from others, in order to preserve our lives. And then, in the rebuilding, share what resources we have.

I personally know nothing or have little that would help other people in a medical emergency. I'd be willing to take in children to keep them from the hotbeds of infection. I know how to work with them.

But adults in crisis scare me. I don't trust humanity in general to act sanely.

I've long desired to know how to live off the land. I'm likely to research herbalism in a crisis like a pandemic, and become somewhat of a witch. I guess I'd be glad to share what herbal knowledge I had. But I'm not likely to head into the cities when I already live in the country.
 

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Posted by Theca (Member # 1629) on :
 
I doubt I'll need to worry about survival. There really isn't any point in me stocking up supplies. I think I'd probably just scatter cat food everywhere in the apartment, fill all the sinks and tubs with water, and head to work and hope the cat survives. I could always stock up on tamiflu for me and the nurses. That's a possibility. But I think modern civilization would truly end if it became a pandemic so I don't think it truly would matter what preparations I make.
 

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Posted by Tatiana (Member # 6776) on :
 
Theca, I do think you and your nurses should take what Tamiflu there is. That's the way to leverage the least drugs into the most lives saved, if all health care professionals take it. There are likely to be several waves of contagion, and the later ones are usually more deadly. By all means it's good for everyone to keep going as long as possible. Survivors of the first waves can do the most good during the later ones.

The fabric of society will certainly be strained, but I have faith that it will hold. People do pull together in emergencies. Survivors will emerge and then society will go on, as it has after past scourges.

I'm planning to do the same thing with cat food and water in my home, leaving many bowls around. I may open a window to let them have a chance to get outside too. Since I don't know if I can take care of them, it seems like I should give them every chance to take care of themselves. On the other hand, the racoons will come in and eat their food if I do that, so I'm not sure if I should.

One thing that struck me today is this. It's surprising that people who work in poultry processing plants in Asia haven't come down with it as expected. I wonder if they have developed antibodies, as they've discovered several people who never got sick have done (the grandfather of one of the family clusters, and some people who worked decontaminating farms, and so on). What if it's possible to get immunity through contact with minute amounts of virus over long periods of time, as opposed to those who were hit with a large amount of virus at once (people who slaughtered infected birds at home without any eye or skin protection from the blood, for instance.) I don't really know how that can be helpful but it's something that struck me this morning with the force of an important insight.
 

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Posted by Belle (Member # 2314) on :
 

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What about police and fire and garbage and other essential services if half the workforce is out sick?

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To me all these considerations have much more weight to them, have a deeper ring of truth, than your facile dismissal based on a single experience with some entirely different organism.

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That seems to bear paying attention to, particularly since there are many things we can do to be better prepared than we are.

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I issue this profound moral challange to all of hatrack. Some of us will not survive. Decide right now how you are planning to act when this thing hits and then measure your actions daily against that yardstick. Each person's actions serve as a model for those around them. What spirit will you model? In what spirit will you live or, if needs be, die?

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I would far rather wake up every morning as if it were the first morning of my life than wake up every morning as if it were the last. Even though I would live it no differently.
 

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Posted by Kwea (Member # 2199) on :
 
ak, they aren't saying anything new, that was my point.


Also, USAMRIID was the inital training point for both the WHO and the CDC. USAMRIID developed teh protocols they refer to when dealing with these situations, and conducts cross training for both those orginizations.


They aren't saying that this IS going to happen, if you reread those papers, they are saying it is possible. They really have no idea how likely it is to EVER happen, and they can't make any sort of real predicitions regarding the spread of this, or any other, possible pandemic.


In the past 10 years I have heard cery similar situations described about at least 10 different pathogins, and none of the estimate or predicitions were correct.


I am not saying ignore the problem, but I am saying that blowing it out of proportion cause panic, and that panic leads people to act in an irrational manner.


The whole point of the chicken little parallel is that when you come to a conclusion based on indaequate facts (and anyone claiming to be able to predict the future path/progress of a possible pandemic variety disease is doing so, IMO) you can cause a panic that is worse than the possible disease.


They were wrong about Ebola, but that doesn't mean we should stop looking at what caused it. Same thing that goes for Hantavirus, and Rift Valley Fever, and Lassa, and on and on and on....all of those at one point were candidates for a pandemic outbreak, but the "experts" were wrong about them too.


It could happen, but then again a black hole could swallow us all tomorrow too.


Kwea
 

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Posted by Shigosei (Member # 3831) on :
 
I'd just like to take this opportunity to inform everyone that, according to the ad at the bottom of this screen, vampires are real. Everyone go buy silver and garlic!

Seriously, though, I suspect that sooner or later, we will have a pandemic of some kind. I'd prefer to see an increase in the production of Tamiflu or other antivirals known to protect against avian flu. I also hope that some research will go into better means of vaccine production, so that if a pandemic does hit, we can develop new vaccines quickly. However, I'm not sure that we all personally can do much more than try to stay healthy, and make sure that we have adequate supplies of food and clean water. General disaster preparedness never hurts.
 

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Posted by Ryuko (Member # 5125) on :
 
Part of me wishes for a pandemic, becauseI know that our population needs to be cut down. With this many people, the possibility for illness is so high that it's an inevitability rather than a possibility.

Even saying something like this, I know that with my weak lungs, any illness that traveled through the air would kill me very quickly. But I guess when and if this happens, I'll have to be sacrificed for the good of the gene pool. But that won't keep me from trying to live.
 

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Posted by Shigosei (Member # 3831) on :
 
Letting you die won't necessarily improve the gene pool. It will only select for people who have high resistance to influenza, or healthy immune systems. Not to mention that "good genes" is somewhat subjective. What if the pandemic kills off a higher proportion of altruistic people because they get infected while helping others?

Also, I'd much rather see the population controlled through the use of contraception. Massive die-offs may be natural, but that doesn't make them the preferred method for preventing the overpopulation of humans.
 

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Posted by Morbo (Member # 5309) on :
 

quote:

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Would doctors know how to go about buying antiviral drugs [elsewhere Tatiana mentions stockpiling antibiotics as well--Morbo] to keep on hand? That seems really wise and useful to encourage everyone to do, and yet I think they are not available without a prescription. Is there some process we can initiate to change that? Or some way to work within the current laws but still allow this to happen? Pharmacists or doctors, do you know?

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quote:

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Kwea, I respect your experience but I still feel that the World Health Organization, the Centers for Disease Control and Prevention, the Department of Health and Human Services, Scientific American magazine, and Nature Magazine combined (they are all in agreement) are more authoritative than your experiences with other organisms. All the world's influenza experts are joined in saying this has a very high risk of being as bad as 1918 or worse.

---

But what is that risk? Less than 1%? Far less? I think the main thing your quoted sources agree on is a possibility of a pandemic, not that it's more likely than not.

People and governments are strapped for cash, and cannot prepare against every possible risk--it's impossible.
 

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Posted by Morbo (Member # 5309) on :
 
As far as helping friends and neighbors in a pandemic: I would help friends and family, at some risk to myself which I would try to minimize.

My neighbors would be on their own.
 

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Posted by Theca (Member # 1629) on :
 
Good points, Morbo.

I was just thinking, maybe I should start plotting out which mormon family lives closest to me, with their year supply of foodstuffs stored away.
 

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Posted by Morbo (Member # 5309) on :
 

quote:

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Originally posted by Theca:
I was just thinking, maybe I should start plotting out which mormon family lives closest to me, with their year supply of foodstuffs stored away.

---

LOL, I was thinking the same thing. In an emergency, I would convert in a flash if they have pop-tarts and peanut butter.
 

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Posted by Kwea (Member # 2199) on :
 
: :
 

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Posted by Tatiana (Member # 6776) on :
 
The head of the WHO recently said the risk of pandemic is risen to 50%. The mortality guesses range from 20 million to 1 billion. They are all guesses, yet they are informed guesses.

I thought like you, "why worry about it before it happens?" until I read the information about 1918, and the genetic information about the influenza virus and how it behaves. I challenge everyone on hatrack to read the WHO pdf file that's linked above (and again here for ease of reference). It's excellent.

There's no scare mongering going on, if anything, the warnings are too muted for fear of seeming alarmist. It's definitely serious, and the warnings are falling on mostly deaf ears.

After the fact, then people will pay attention. Then there will be a 9/11 type commission asking who knew what and when they knew it, and why they didn't do more. Britain and France have enough Tamiflu for 25% of their populations. We (the US) have enough for 1% of ours. Why were our leaders so shortsighted? Because we elect the sort of leaders who reflect our own level of unwillingness to conceive of new events that seem so impossible beforehand, maybe?

After the fact, people will pay attention, the sad thing is that we're already after the fact in one sense. We lived through 1918, we should have learned from it. Must everything happen in each generation before we believe in it? Another challenge: read a journal of someone who was an adult in 1918 to learn what it was like. Or ask someone old if they remember their parents' stories about it.

Again, I'm not saying to people "be mortally afraid but do nothing". What I'm saying is "prepare yourselves and your families, and call loudly for more preparedness from our leaders". When we are prepared as much as we can be, then we will be at peace. When everyone knows the right thing to do in advance, then there will not be panic when the time comes. Instead we will all pull together and the overall losses will be made much less than if we are caught totally off guard, and everyone panics in the clutch.

[ May 31, 2005, 02:23 PM: Message edited by: Tatiana ]
 

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Posted by Tatiana (Member # 6776) on :
 
My mother takes this seriously because she heard about it from her mother who was a young adult in 1918.

When the tsunami hit in Southeast Asia there was a group of 500 or so primitive fisherfolk living on two remote islands whom the Indonesian government had feared would be totally wiped out. Weeks later when they got around to sending a helicopter to check on them, they threw spears at it. They had all survived. They said their parents and grandparents had taught them when the earth shakes, to move to high ground. All 500 of them picked up their reed baskets and ran to the hills when they felt the quake. There's something funny about the fact that we in our culture of instant global communication were caught so off guard while these stone age people had it totally covered.

Maybe the difference is that they, in their small group, realize they have to exercise their own judgement, and be proactive about interacting with their environment. We in our vast network of care come to feel that everything that matters will be handled by someone else, and is not our responsibility or concern. But how loudly we yell when "they" turned out to have dropped the ball, weren't prepared, didn't protect us.

I think some time in the last ten years the responsibility for everyone's safety and the health and well being of the whole planet became mine personally. Unfortunately when that happens, you become like a parent saying "son, watch out for this danger, it's wise to do this and this to stay safe," and the world is like your recalcitrant teenager saying "oh moooooom, you're such a downer! Leave me be, I know what I'm dooooooooing!"

So then what do you say? "Your choices are your own, but they have consequences"?

It wasn't the iceberg that sank the Titanic so much as everyone's belief that it was unsinkable, you know?

[ May 31, 2005, 02:38 PM: Message edited by: Tatiana ]
 

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Posted by Tatiana (Member # 6776) on :
 

quote:

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Indeed, the potential for social unrest is a major concern for those laying pandemic plans. And demand for Tamiflu could exacerbate the problem. Who will, and who will not, be treated with this scarce but valuable resource? "It's not easy — we know there won't be enough for everyone," says Theresa Tam of the Public Health Agency of Canada. Britain, which is among the best-prepared countries, has ordered enough for about 25% of its population; Canada has stocks for just over 5% of its people; the United States currently cannot even cover 1%.

In practice, a significant proportion of supplies might be used for prophylaxis of health-care workers — for up to two months as the influenza wave passes through — leaving less for treating the sick. "It is not a happy situation," says Klaus Stöhr, the WHO's chief influenza expert. Canada, wary of the potential for a public backlash if health workers were perceived to be saving their own skins, included an ethicist on its Pandemic Influenza Committee.

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quote:

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Originally posted by Theca:

I was just thinking, maybe I should start plotting out which mormon family lives closest to me, with their year supply of foodstuffs stored away.

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I know what you mean! I've been LDS for 4 years now, and have seen myself starting to change in many ways, but I still totally feel like a grasshopper among ants. Mormons are so prepared!
 

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Posted by TomDavidson (Member # 124) on :
 
"I think some time in the last ten years the responsibility for everyone's safety and the health and well being of the whole planet became mine personally."

Does this make you popular at parties?
 

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Posted by Tatiana (Member # 6776) on :
 
Oh, thank you, Noemon! I am copying the text of all the articles posted online, so I guess I can print those out for a hard copy. Still, the picture of the Asian chick with the skull and crossbones facemask on the cover is just so cool! Maybe if there are any leftovers, it'll be possible to buy it as a back issue.
 

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Posted by Tatiana (Member # 6776) on :
 

quote:

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Originally posted by TomDavidson:
Does this make you popular at parties?

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Tom, about as much as here at hatrack.
 

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Posted by Noemon (Member # 1115) on :
 
Looks like Tamiflu protects against both A and B strains of influenza, Feyd, so while it's possible that the virus could evolve in such a way as to render Tamiflu useless against it, it isn't all that likely. As you pointed out though, it would be a good idea not to be dismissive of the possibility.

So what is the shelf life of Tamiflu, anyway? How long would a stockpile of it be good for? Also, how long do its effects remain in people who take it?
 

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Posted by Kwea (Member # 2199) on :
 

quote:

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Originally posted by Tatiana:

quote:

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Originally posted by TomDavidson:
Does this make you popular at parties?

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Tom, about as much as here at hatrack.

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Then I guess you are doing fine then.
 

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Posted by Noemon (Member # 1115) on :
 
Sure Anne Kate! I was hoping to be able to pick up a copy for you on my way home from work tonight. Another possibility for actually getting your hands on a copy would be to see if any of the science departments on campus (assuming there is a college near you, of course) have a departmental copy floating around that they'd be willing to part with after everyone has had a chance to look at it.

You know, I could *swear* that I've seen a copy of Nature at Books and Company. I'm not utterly sure that the guy I talked to knew what he was talking about.
 

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Posted by TomDavidson (Member # 124) on :
 
You do know that you're not responsible for preserving all life on the planet, right?

I absolve you of any responsibility whatsoever for my continued existence, for example.
 

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Posted by aspectre (Member # 2222) on :
 
If I remember the Nature articles correctly, Noeman, Tamiflu has a shelf-life of 10years. However, the manufacturor's 2003 statement of shelf-life was 4years for Tamiflu capsules, and 18months for TamifluOralSuspension powder.

May have to do with the assumed different methods between pharmacist storage vs government storage,
and/or an impressive re-engineering of inert ingredients&capsule and/or of the drug itself.

[ May 31, 2005, 03:21 PM: Message edited by: aspectre ]
 

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Posted by Ryuko (Member # 5125) on :
 

quote:

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Originally posted by Shigosei:
Letting you die won't necessarily improve the gene pool. It will only select for people who have high resistance to influenza, or healthy immune systems. Not to mention that "good genes" is somewhat subjective. What if the pandemic kills off a higher proportion of altruistic people because they get infected while helping others?

Also, I'd much rather see the population controlled through the use of contraception. Massive die-offs may be natural, but that doesn't make them the preferred method for preventing the overpopulation of humans.

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quote:

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The recommended oral dose of TAMIFLU for treatment of influenza in adults and adolescents 13 years and older is 75 mg twice daily for 5 days. Treatment should begin within 2 days of onset of symptoms of influenza.

The recommended oral dose of TAMIFLU for prophylaxis of influenza in adults and adolescents 13 years and older following close contact with an infected individual is 75 mg once daily for at least 7 days. Therapy should begin within 2 days of exposure. The recommended dose for prophylaxis during a community outbreak of influenza is 75 mg once daily. Safety and efficacy have been demonstrated for up to 6 weeks. The duration of protection lasts for as long as dosing is continued.

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Posted by Noemon (Member # 1115) on :
 
Okay, so it pretty much has to be taken constantly to provide protection. I see why the injectable antiviral is a better choice for prophylactic purposes. I think that in the long term it would be a good idea for the government to fund research into something like Tamiflu--long shelf life, available in pill and powder forms--that provided protection for a longer period of time. If we had something like that, it could be extremely useful. Supplies of it could be cached in various area in the third world hotspots where this flu might emerge, and be distributed to the population there at the first sign of an outbreak. There would still be distribution problems, of course, but as long as the medicine could be stored for long periods of time at room temperature I think it would be possible to overcome them.
 

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Posted by Tatiana (Member # 6776) on :
 
Yes, I agree that if we could find a drug that needed to be taken less often, we'd be better off. I think all the drugs we do have now are useful in different ways. I understand that it is believed that resistance to Tamiflu will be the most difficult for the virus to develop, or else render it mostly harmless in the process.

Also during the height of an outbreak health care professionals are likely to be incredibly overburdened, so an oral form might be far better than injections just because it's so much easier for people to self-administer.

In addition Tamiflu shows the least tendency to cause side effects of any of the flu anti-virals. Particularly when giving drugs prophylactically to prevent illness rather than to treat an existing illness, it's important to choose those drugs with lowest incidence of side effects.

Lastly, it does have a shelf life of 10 years, according to the information I've read.

I believe for all those reasons Tamiflu is the preferred drug for stockpiling against the threat of a pandemic. However, we should also have more weapons than one in our arsenal, in case resistance does develop. One approach they're discussing to prevent resistance is a multi-drug treatment regime, similar to what they are doing now against HIV. Vaccines and the other antiviral drugs that have been shown to be effective against influenza should certainly not be neglected.
 

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Posted by aspectre (Member # 2222) on :
 
Yeah, that's what I thought I'd read in Nature. However, Roche's 7Jan2004TamifluFactSheet states that the shelf life is 48months for the capsule and 18months for the oral suspension.
But then 13months previously, Roche announced a Tamiflu shelf life of 3years for the capsule and 1year for the oral suspension.

Assuming a trend, the 2005 Roche FactSheet may contain a shelf life higher than 4years: there are many nonRoche websites claiming that Tamiflu has a 5year shelf life.

[ June 02, 2005, 06:58 AM: Message edited by: aspectre ]
 

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Posted by mothertree (Member # 4999) on :
 
I found This to be an interesting read. Having read it a few years ago, I guess this latest news is less shocking. I don't watch news often, but I caught the piece on News Hour about this last week. There is also a Nova episode about it, I believe. Or maybe I just got visuals of it in my head as I was reading the Gina Kolada book. I mean, how can you not read a book by Gina Kolad?
 

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Posted by Noemon (Member # 1115) on :
 
New Scientist has an article up today that talks about the possibility of H5N1 developing resistance to Tamiflu.
 

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Posted by Tatiana (Member # 6776) on :
 
Interesting article! I had not heard that about China giving amantadine to chickens. All we know about China is that they haven't told the truth in the past about SARS or about H5N1 outbreaks in birds. It's hard to have faith in anything at all that they say now. They claim no human cases but I don't think anyone believes that.

Lying governments really annoy me. We should all go online and tell the truth always so as to train all our governments not to lie, that they will always be found out and look far worse than if they'd just told the truth up front. In whose best interest are lies? Rarely does it protect the people. Usually the only thing to be protected is the pride of those in power. How many times has "national security" been misused as a reason for secrecy?

Still looks like Tamiflu is the best bet. Two years backorder is really bad news, though. I wonder if pharmacies are able still to fill prescriptions for it from their current stocks? I wonder, too, if any peramivir is available directly from BioCyst. They're right here in town.

The governments of the world seem so incompetent in this so far. All these snafus!

1) Human vaccines are still grown in chicken embryos taking months to develop (because of regulatory delays and weak financial incentives) while animal vaccines are grown in cell cultures which can be developed more quickly and manufactured in huge quantities.

2) There are only a few factories in the world that can make vaccines. Changing them over to faster manufacturing methods will take two years.

3) The WHO is desperately underfunded hampering their efforts at monitoring.

4) Lying by Asian governments and possessiveness by rich countries might take away our only shot at stopping the first outbreaks and buying ourselves time, perhaps the weeks or months needed to develop and deploy vaccines.

It's vitally crucially important for every human in the world to work together against this common enemy. Who was it said "We must hang together or we will most assuredly hang separately"? Sounds like Churchill.
 

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Posted by aspectre (Member # 2222) on :
 
BenjaminFranklin.
The main thing that stockpiling Tamiflu will accomplish is provide cheap Tamiflu for farmers to add to their livestock feed: making the viruses mutate faster, incidentally creating Tamiflu-resistant strains faster.

[ June 02, 2005, 02:03 PM: Message edited by: aspectre ]
 

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Posted by Tatiana (Member # 6776) on :
 
More bad news, this time from China.

quote:

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Officials in China have denied reports, published on the Internet, that 200 people have contracted bird flu in Qinghai province and that 121 have died from the infection.

The reports originated from the US-based Chinese news agency Boxun News and were repeated by ProMED—mail, an online reporting system that warns of outbreaks of infectious diseases.

In 2003, ProMed—mail broke the news of China's outbreak of SARS (severe acute respiratory syndrome) after it was reported by Boxun News. At the time, China had yet to report the outbreak.

Denying Boxun's claim that bird flu had claimed human lives in China, the official Xinhua news agency added that hospitals in Gangca county, where the bird flu cases were reported had opened a separate department for patients with fever.

The World Health Organization says it has no reason not to believe the Chinese authorities' denial of human cases of bird flu.

---

From the journal Nature as reported by SciDev.net here.

Because the officials are denying it, we have no way to know for sure if these people all got it from birds, or if human to human transmission is more likely. I tend to believe the Boxun News, who told the truth about SARS, as opposed to the Chinese government, who we know lied about SARS. The number of cases is highly suggestive of direct human to human infection, isn't it? Though we can't know for sure unless the Chinese government becomes more open about what's going on, and allows WHO investigators in, it sure does seem like this thing is starting.
 

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Posted by Tatiana (Member # 6776) on :
 
More on the Northern Vietnam strains from Science magazine May 27th issue here.

quote:

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New genetic analyses of samples from recent human H5N1 avian influenza patients reinforce epidemiological evidence suggesting that new strains of the virus may be emerging in northern Vietnam. But an expert report detailing the genetic analyses, posted on the Web site of the World Health Organization (WHO) last week, cautions that data are too limited to draw firm conclusions. Even so, the report urges heightened surveillance, increased preparedness, and further research, warning that H5N1 poses "a continuing and potentially growing pandemic threat."

At a meeting to review data at the request of WHO, held in Manila on 6 and 7 May, scientists also concluded that human-to-human transmission of the virus may be more common than previously thought. The meeting--attended by 40 or so epidemiologists, virologists, public and animal health experts, and representatives from Cambodia, Thailand, and Vietnam--came on the heels of a visit by a three-person WHO team to Vietnam in late April.

Lance Jennings, a clinical virologist for the Canterbury District Health Board in New Zealand and a member of the WHO team, says epidemiological evidence, some of it previously reported (Science, 22 April, p. 477), indicates a changing virus: Clusters of infection are larger and more numerous than seen previously, and there is often a time lag between the onset of symptoms in the first case and subsequent cases within clusters. Among those infected were three infants, ruling out poultry tending as a route of infection in those cases. And in a few other cases, exposure to poultry could not be traced. Although these findings suggest that human-to-human transmission is occurring, Jennings adds that "there are other possible explanations." The virus could have acquired the ability to persist longer in the environment, or perhaps resistant poultry are now shedding the virus without signs of sickness.

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quote:

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I just think personal first person accounts of that period would be really interesting to hear.

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Wow AK, you are really into this flu pandemic thing.

For a fictional account of the Black Death in England, you could read Connie Willis' The Domesday Book , about a time-traveller who goes back to document the plague.

It's well-written and -researched but a real downer...
 

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Posted by Marek (Member # 5404) on :
 
I recall a first person account by a prince from the time of the red death.
 

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Posted by Tammy (Member # 4119) on :
 
I'm feeling a lot less proud of the two new bird feeders I put up this morning.


 

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Posted by skillery (Member # 6209) on :
 
Is there a way to keep pigs from eating goose poop?
 

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Posted by Sharpie (Member # 482) on :
 
I couldn't keep a black lab from eating goose poop. And pigs are a bit smarter than labs.
 

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Posted by Tatiana (Member # 6776) on :
 
I'm specifically interested in the influenza pandemic of 1918. That seems to be the closest model we have for what a bird flu pandemic might be like.
 

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Posted by Tatiana (Member # 6776) on :
 
Tammy, I too feed the birds beside my house. Depending on the amount of illegal bird smuggling that goes on, there's probably as much chance that they will catch it from us as vice versa. Also the main species they have seen die in Asia seem to be geese, ducks, and chickens so far. That doesn't mean other species don't get it, though, for sure. Populations of songbirds are already way down across the western hemisphere. I really do hope this doesn't put another big dent in those.

One thing about which I'm not worried. Bird flu alone will not make the human species extinct. The only way it could trigger that is if we, in madness at our losses, decide to blame someone else besides ourselves for it and start wars with them.

During the 1918 influenza pandemic some people in the U.S. said the Germans were responsible --- and I don't know but some German people may have thought it was from the Jews or the Allies or someone. People don't tend to act too rationally when their family members are all dying and stuff. They want someone to blame, be it God or The Government, or The Enemy (whomever they perceive that to be).

Hopefully since we've all been reading the warnings for months, such rumors won't have much power. Certainly everyone with intelligence, among whom I count all of hatrack, will know better.

The social unrest is likely to be a factor we all need to take into account. People, even if they are dismissive of warnings beforehand, are likely to be angry after the fact that they weren't protected, given drugs, treated at the hospital, given vaccines, etc. There are likely to be lots of bitter feelings, human nature being what it is. Will that explode into riots or looting? Let's hope it won't.
 

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Posted by Tatiana (Member # 6776) on :
 
Yay, I found one such first person account! This was from a doctor in an army hospital in the U.S.

quote:

---

Camp Devens, Mass.
Surgical Ward No 16
29 September 1918
(Base Hospital)

My dear Burt-
It is more than likely that you would be interested in the news of this place, for there is a possibility that you will be assigned here for duty, so having a minute between rounds I will try to tell you a little about the situation here as I have seen it in the last week.
As you know I have not seen much Pneumonia in the last few years in Detroit, so when I came here I was somewhat behind in the niceties of the Army way of intricate Diagnosis. Also to make it good, I have had for the last week an exacerbation of my old "Ear Rot" as Artie Ogle calls it, and could not use a Stethoscope at all, but had to get by on my ability to "spot" ' em thru my general knowledge of Pneumonias. I did well enough, and finally found an old Phonendoscope that I pieced together, and from then on was all right. You know the Army regulations require very close locations etc.

Camp Devens is near Boston, and has about 50,000 men, or did have before this epidemic broke loose. It also has the Base Hospital for the Div. of the N. East. This epidemic started about four weeks ago, and has developed so rapidly that the camp is demoralized and all ordinary work is held up till it has passed. All assembleges of soldiers taboo.
These men start with what appears to be an ordinary attack of LaGrippe or Influenza, and when brought to the Hosp. they very rapidly develop the most viscous type of Pneumonia that has ever been seen. Two hours after admission they have the Mahogany spots over the cheek bones, and a few hours later you can begin to see the Cyanosis extending from their ears and spreading all over the face, until it is hard to distinguish the coloured men from the white. It is only a matter of a few hours then until death comes, and it is simply a struggle for air until they suffocate. It is horrible. One can stand it to see one, two or twenty men die, but to see these poor devils dropping like flies sort of gets on your nerves. We have been averaging about 100 deaths per day, and still keeping it up. There is no doubt in my mind that there is a new mixed infection here, but what I dont know. My total time is taken up hunting Rales, rales dry or moist, sibilant or crepitant or any other of the hundred things that one may find in the chest, they all mean but one thing here -Pneumonia-and that means in about all cases death.

The normal number of resident Drs. here is about 25 and that has been increased to over 250, all of whom (of course excepting me) have temporary orders-"Return to your proper Station on completion of work". Mine says "Permanent Duty", but I have been in the Army just long enough to learn that it doesnt always mean what it says. So I dont know what will happen to me at the end of this.
We have lost an outrageous number of Nurses and Drs., and the little town of Ayer is a sight. It takes Special trains to carry away the dead. For several days there were no coffins and the bodies piled up something fierce, we used to go down to the morgue (which is just back of my ward) and look at the boys laid out in long rows. It beats any sight they ever had in France after a battle. An extra long barracks has been vacated for the use of the Morgue, and it would make any man sit up and take notice to walk down the long lines of dead soldiers all dressed and laid out in double rows. We have no relief here, you get up in the morning at 5 .30 and work steady till about 9.30 P.M., sleep, then go at it again. Some of the men of course have been here all the time, and they are TIRED.

If this letter seems somewhat disconnected overlook it, for I have been called away from it a dozen times the last time just now by the Officer of the Day, who came in to tell me that they have not as yet found at any of the autopsies any case beyond the Red. Hepatitis. stage. It kills them before they get that far.

I dont wish you any hard luck Old Man but I do wish you were here for a while at least. Its more comfortable when one has a friend about. The men here are all good fellows, but I get so damned sick o Pneumonia that when I go to eat I want to find some fellow who will not "Talk Shop" but there aint none nohow. We eat it live it, sleep it, and dream it, to say nothing of breathing it 16 hours a day. I would be very grateful indeed if you would drop me a line or two once in a while, and I will promise you that if you ever get into a fix like this, I will do the same for you.

Each man here gets a ward with about 150 beds, (Mine has 168) and has an Asst. Chief to boss him, and you can imagine what the paper work alone is - fierce,-- and the Govt. demands all paper work be kept up in good shape. I have only four day nurses and five night nurses (female) a ward-master, and four orderlies. So you can see that we are busy. I write this in piecemeal fashion. It may be a long time before I can get another letter to you, but will try.

This letter will give you an idea of the monthly report which has to be in Monday. I have mine most ready now. My Boss was in just now and gave me a lot more work to do so I will have to close this.

Good By old Pal,
"God be with you till we meet again"
Keep the Bouells open.
(Sgd) Roy.

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quote:

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China finds bird flu in Xinjiang
China has announced details of a second outbreak of bird flu, this time in the western region of Xinjiang.
The Ministry of Agriculture said more than 400 geese had died at a farm in Tacheng, and a further 13,000 birds had been culled as a precaution.

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quote:

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HANOI, Vietnam (AP) - Vietnam has recorded six new cases of bird flu in the past week, state-controlled media and officials said Wednesday.

The six people, all from northern provinces, had been admitted to a hospital in Hanoi over the past week, the Pioneer newspaper said. Five of them were in stable condition, it added.

Officials at the Ministry of Health declined to comment Wednesday.

Nguyen Tran Hien, director of the National Institute of Hygiene and Epidemiology said those who had contracted bird flu since the last outbreak in December last year showed less severe symptoms of high fever, coughing and breathing difficulties.

He said the institute was researching whether the virus had evolved to allow for faster transfer, while becoming less virulent.

---

quote:

---

Bird flu found in Indonesian man
Indonesia has confirmed its first case of bird flu in humans.
A farm worker in South Sulawesi has tested positive for the H5N1 strain of the virus, although he has shown no outward symptoms of the disease.

---

quote:

---

Vietnam reports five more new bird flu cases

HANOI, Vietnam (AP) - Vietnam reported Friday that five more people have contracted the bird flu virus as the country struggles to contain the disease, officials said.

Bird flu has ravaged poultry farms throughout Asia and jumped to humans, killing 54 people in three countries. Vietnam has been the hardest hit with 38 deaths so far.

The five latest cases bring the total of people infected with the virus to 11 over the past week, said Tran Quy, director of Bach Mai hospital in Hanoi.

The patients, all from northern provinces, are being treated at the hospital and are in stable condition, he said.

Quy said separately that a male doctor at the hospital who helped take samples from the patients initially tested positive for the disease, but a second test turned up negative.

---

quote:

---

A Vietnamese doctor in Hanoi, who treated bird flu patients, has contracted the disease himself, leaders of the Bach Mai hospital reported Friday. The male doctor had been taking samples from carriers of the H5N1 virus, officials said, adding that his condition was stable.

---

quote:

---

>> The institute is treating a total of 23 local people with bird flu symptoms, of whom 11 have been confirmed to have contracted bird flu virus strain H5N1 by the hospital's officials, said the paper. The bird flu patients, all from northern localities, are instable health condition. <<

---

quote:

---

On Friday [17 Jun 2005], a senior health official said a number of suspected human-to-human cases of H5N1 had been detected by the National Institute of Hygiene and Epidemiology (in Vietnam).

"We have got a number of suspected cases of human-to-human transmission of bird flu, including a doctor from Bach Mai hospital", Nguyen Tran Hien, the director of the institute, told Deutsche Presse-Agentur. "We will need to do more research before coming to any conclusion".

---

quote:

---

China reported a new outbreak of H5N1 in its far western Xinjiang region this week, the third time the virus has been found among birds in remote western China in recent months.

"It looks like the virus is still very active," Mona said.

---

From Reuters of June 22.

Everyone's all excited the last few days about China using amantadine on chickens and causing resistance, and the government has even admitted it now after many previous flat denials (I love how China does <laughs>) but scientists have known that for months from examining the viruses themselves. They developed specific resistance to amantadine which means they have to have been exposed to amantadine, and all the geographical evidence pointed toward China.

<digression> It's so funny how a newspaper can make something "a big story" as though it's breaking news, when it's something we've all known for months. But I'm glad they did it! China's government needs to take responsibility for the stuff they do, and maybe if they get caught lying often enough they'll even consider telling the truth from time to time. That would be awesome!

All governments should tell the truth always. That would make the world a much better place. It surprises me that we the people (who are the ultimate rulers) allow them to lie to us and we accept it. I wonder why it should be considered okay for governments to do anything it's not okay for people to do? </digression>
 

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Posted by Tatiana (Member # 6776) on :
 
In other news, the CDC updated their advice to travellers to Southeast Asia. I will give you just the high points.

quote:

---

According to a 15 Jun 2005 World Health Organization (WHO) report, the Ministry of Health of Viet Nam has confirmed 4 new human cases of avian influenza A (H5N1) virus infection. All 4 patients are alive. 2 are from the northern city of Hanoi, the 3rd from the nearby province of Hai Duong, and the 4th from the central province of Nghe An. These are the latest in a series of sporadic human cases of H5N1 human infection reported in Viet Nam since December 2004. Also since December 2004, there have been 4 cases reported from Cambodia. As of 17 Jun 2005, there have been 107 human cases of avian influenza A (H5N1) reported in Viet Nam (86), Thailand (17), and Cambodia (4), resulting in 54 deaths [and
one in Indonesia - Mod.CP].

It is thought that a few cases of person to person spread of H5N1 viruses have occurred. For example, one instance of probable person to person transmission associated with close contact between an ill child and her mother is thought to have occurred in Thailand in September 2004. More recently, possible person to person transmission of H5N1 viruses is being investigated in several clusters of human cases in Vietnam. So far, spread of H5N1 virus from one ill person to another has been very rare and transmission has not continued any further beyond one person.

---

quote:

---

During travel: Avoid all direct contact with poultry, including touching well-appearing, sick, or dead chickens and ducks. Avoid places such as poultry farms and bird markets where live poultry are raised or kept, and avoid handling surfaces contaminated with poultry feces or excretions.

As with other infectious illnesses, one of the most important preventive practices is careful and frequent handwashing. Cleaning your hands often, using soap and water (or waterless alcohol-based hand rubs when soap is not available and hands are not visibly soiled), removes potentially infectious material from your skin and helps prevent disease transmission. Influenza viruses are destroyed by heat; therefore, as a precaution, all foods from poultry, including eggs and poultry blood, should be thoroughly cooked.

---

 

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Posted by Tatiana (Member # 6776) on :
 
No news of new human cases, however, in the last few days there have been bird cases detected in Japan, prompting large culls, (I believe in vaccination rather than culling), but it's H5N2, a strain that has shown no tendency to jump to humans, so it's not worrying.

No news is definitely good news!
 

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Posted by aspectre (Member # 2222) on :
 
Vaccination hides new cases.
 

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Posted by Tatiana (Member # 6776) on :
 
How does it hide new cases? I thought the idea was to prevent them. How about human vaccination, after we have effective human vaccines? Does that hide new cases too?

Also, culling kills the very birds who might have developed immunity, or be genetically less susciptible, leaving flocks just as vulnerable as ever, right?

Obviously now that the virus is endemic among wild waterfowl, and because of cases detected in ducks and pigs who don't even appear sick, the hope of eradicating the virus altogether is past. This would seem to indicate to me that culling is a failed strategy and we should vaccinate instead.

Also, the people love their birds, and their livlihood in many cases depends on their birds. So in any case it would seem preferable to save as many birds as possible, and culling can only be justified if there's some reasonable chance of stamping out the virus altogether.

[ June 28, 2005, 09:20 PM: Message edited by: Tatiana ]
 

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Posted by Tatiana (Member # 6776) on :
 

quote:

---

A nagging question about avian (H5N1) influenza virus infection of humans in Viet Nam is whether there is considerably more mild, clinically undetected or inapparent infection than accounted for by only considering the most seriously ill cases admitted to hospital. Since the most seriously ill are the tip of the iceberg in most human viral diseases, this is a plausible concern. Its significance would be that there is more transmission of the virus -- either from poultry to humans or from human to human -- than has been conceded at present. Equivocal evidence to suggest this has apparently been obtained by a joint Vietnamese-Canadian research team working in Hanoi.

Using a method called western blotting, the researchers tested hundreds of stored blood samples to see if these showed evidence of antibodies to H5N1 virus. Rumors are that: "scores of samples came back positive." As a consequence the Vietnamese authorities have asked for international assistance.

A team of international influenza experts is in Hanoi, at the invitation of the Vietnamese government, to investigate worrisome signs that avian H5N1 influenza virus may be adapting in ways that may make it more likely to spark an influenza pandemic, the World Health Organization has confirmed. The group of about a half-dozen virologists and epidemiologists from the United States, Britain, Japan and Hong Kong will be following up concerns raised at a special WHO avian influenza summit held last month in Manila, spokespersons for the organization said on Thu 23 Jun 2005. The team will also be analysing some potentially disturbing but hard-to-assess test results that could suggest a significant number of additional human infections have occurred but went undetected.

see the Canadian Press report via Yahoo News, Thu 24 Jun 2005: here.

That's what we know at this point..... but Dick Thompson, director of communications for the WHO's communicable diseases branch in Geneva, stated that: "These are highly questionable results, difficult to evaluate at the moment".

The official explanation for this diffidence is the possibility the western blotting is not sufficiently specific to rule out [the possibility that] it is detecting antibodies to other influenza strains [serotypes] than H5N1, although for other viruses "westerns" are used as confirmatory tests because they are more specific than the conventional ELISA tests.

---

quote:

---

GENEVA, June 30 (Reuters) - Tests have yielded no evidence so far that the bird flu virus is mutating and becoming easier to transmit between humans, the World Health Organisation said on Thursday.

In May the WHO warned that the virus in Vietnam, the country with the highest number of cases, could be changing and becoming easier to pass on.

Such a mutation could herald the start of a long-predicted international flu pandemic capable of killing millions of people around the world.

But the Geneva-based body said in a brief statement that laboratory and epidemiological examinations of recent Vietnamese cases, carried out by an international team, had revealed no change to the virus.

"We did not find evidence to substantiate what was suggested in Manila," said WHO spokeswoman Maria Cheng, referring to the meeting in the Philippines where the concerns first surfaced.

---

They then go on to say more tests are needed to know for sure, etc. But so far, at least, it's looking good.

This is from reuters here.

<delighted to have some good news to report, for a change>
 

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Posted by Morbo (Member # 5309) on :
 

quote:

---

UN experts urge action on threat of bird flu
By Evelyn Rusli International Herald Tribune

TUESDAY, JULY 5, 2005
KUALA LUMPUR UN health experts warned at a conference here on Monday that the world had a limited time and opportunity to contain the avian flu virus before it could potentially become a global pandemic.

The UN conference was convened this week because of the concern among experts from around the world that the bird flu virus was in danger of spreading out of control, the health officials said.

"We are at a tipping point," the Western Pacific regional director for the UN's World Health Organization, Shigeru Omi, said in an interview on Monday. "Either we can reverse this situation or things will get out of hand."
[SKIPPED SECTION]

The case is also particularly troubling because highly mobile carriers, such as migratory birds, could rapidly spread the virus to unaffected regions.

But Indonesia and China, the two most populous countries so far affected, are also major areas of concern, Domenech said.

China has not reported any human cases yet, but health experts are worried that lethal, more resistant strains could soon emerge because of renegade pharmaceutical labs in the country that have dispensed antiviral treatments to poultry farmers.

"By using the wrong drugs, it'll only make the virus stronger," Omi said.

It will be difficult to understand the extent of this problem because UN officials and the Chinese government do not know which labs are producing the antiviral treatments or how popular the treatments are, he added.

---

Exerpts, see link for the whole article.
http://www.iht.com/articles/2005/07/04/news/flu.php

This is one thing I am worried about (I posted about it earlier in the thread), that enthusiastic measures taken to fight avian flu will make the virus more drug-resistant, harder to treat, and more lethal.

[ July 04, 2005, 05:00 PM: Message edited by: Morbo ]
 

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Posted by Tatiana (Member # 6776) on :
 
The whole "renegade" thing is highly suspect. Other sources report the government for years encouraged farmers to use amantadine on poultry. We need to save human flu drugs for human use, for sure. But which humans get them is problematic.

Any use of antivirals whatsoever could possibly contribute to the development of resistance. That's just how evolution works. So while there's no sense in indiscriminate use, neither is there any sense in holding off and not using them at all. The most effective use, if the human species wants to be reasonable and smart, is to detect outbreaks of human to human (H-H) transmission very early and saturate the area with antivirals. That, combined with pre-vaccination, actually works to quell outbreaks, buying time (months or even years) before the next time the virus mutates to allow H-H transmission.

If such a strain should break out and spread past any chance of containment, though, the best use of antivirals would be for health care workers only. We probably don't have enough drug to cover all the doctors, nurses, and medical techs in the world so there's no sense in trying to cover anyone else. Perhaps heads of state, to prevent the chaos that would ensue if 1/3 of the world's governments changed hands simultaneously at the height of the pandemic, say. If we start trying to cover all essential workers, it's hopeless. Who isn't essential? Power plants? Garbage pickup? Water works? Police? Phones? Everyone is essential! I guess what everyone would hope is that nobody at all uses the drug except themselves. That way the drug retains maximum effectiveness.

There was just a big conference in Malaysia in which the WHO came up with a ten year plan for fighting the virus. They need $102 million to fund it, and so far only have $30 million. We should pony-up the money. That's a tiny fraction of what one day of pandemic will cost our economy.

The virus is now endemic in wild waterfowl in Asia so it is only a matter of time before it travels via migrating birds to all of the eastern hemisphere. More culling seems foolish at this point, since it is hopeless now to try to eradicate the virus altogether. Vaccination, along with breeding the birds who survive the scourges would seem to be the best method of protecting flocks. People's livelihoods depend on these birds. The fact that this strategy allows for immune avian carriers is something we have to accept. We've already seen that domestic ducks and pigs are immune carriers, as well as possibly some humans. Attempted eradication was a good strategy back in 1997 when H5N1 first appeared. It's no longer a useful method of combatting the virus. We need to switch to wide scale vaccination of bird (three options now for vaccines) and human (no options yet but we MUST rush this) populations.

There are no new chains of human cases being reported from northern Vietnam, which is very good news. If this outbreak isn't taking hold then it certainly buys us a little more time.
 

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Posted by Lyrhawn (Member # 7039) on :
 
I read yesterday that scientists are expecting it to spread to Europe, Australia, Oceania and maybe Africa by the end of next year.
 

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Posted by Tatiana (Member # 6776) on :
 
Reuters 7/13/2005: VIETNAM - Bird flu has killed another Vietnamese and infected three more... Thirteen others were suspected of being infected with the the virus.

Not good news. No definitive answers on if it's H2H transmission or not, but worrying. Also I fear that if it's happening in Vietnam, it may be happening too in China, but we aren't hearing about it.
 

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Posted by Tatiana (Member # 6776) on :
 
More bad news on several fronts:

From the BBC 15 JUL 2005:

quote:

---

Bird flu is suspected in the deaths of three people in Indonesia, the country's health minister has said.
If confirmed, the victims - a man and his two young daughters - would be Indonesia's first human fatalities from the disease.
...
Ms Supari said she was concerned the three victims could have contracted the disease via human-to-human transmission, because they had no known contact with poultry.

---

quote:

---

In the Isle of Grain after the Armistice, therefore, I had to readjust my ideas considerably, and readjust them to the fact that there was a strange stuff called fun to be got out of life. Whatever capricious Fate decides the course of one's life was careful in my case to see that the transition to fun didn't come too suddenly, because my introduction to the merrry new world opening before me was by way of a series of funerals. At that time there was a terrible epidemic of influenza ravaging the country, and men and women were dying of it all over England. Deaths in the army became so numerous that my battalion was ordered to provide a permanent funeral party to tour round Kent with a gun carriage and a dozen specially drilled men to conduct military funerals.

---

quote:

---

Current flu vaccines work by giving immunity to two proteins called haemagglutinin and neuraminidase, which are found on the surface of flu viruses.


We aim to avoid the need for annual re-engineering and manufacture of the new product
Dr Thomas Monath, chief scientific officer at Acambis

However, these proteins keep mutating which means doctors have to keep making new vaccines to keep up.

Scientists at Acambis' laboratory in the US, together with Belgian researchers at Flanders Interuniversity Institute for Biotechnology, are focusing their efforts on a different protein, called M2, which does not mutate, as well as other technology that they cannot disclose yet for commercial reasons.

...

Professor Karl Nicholson, professor of infectious diseases at Leicester University, said: "It would be enormously helpful to mankind to have just the one vaccine but sadly I think it is a long way off."

He said it might be 10 years before any such product could be ready for widespread use in humans.

---

quote:

---

...the science behind all the worry is questionable. It rests on the unproven claim that the avian flu will develop exactly like the strain that caused the flu pandemic of 1918.

....The current bird flu, however, has a different molecular structure than the 1918 bug. And though it has infected millions of birds, there is no direct evidence that it is about to mutate into a form that would transmit from human to human.

---

quote:

---

Even if the worst-case scenario does occur and the virus mutates, there is no current indication that it will spread the way the Spanish flu did in 1918. That disease incubated in the World War I trenches before it spread across the world, infecting soldiers who were exhausted, packed together in trenches, and lacked access to hygiene. These conditions were an essential breeding ground for the virus. Today, there is no way a huge number of people would be packed together in WWI-like conditions.

---

• Canada, Australia, and Japan have pledged unspecified amounts for vaccine trials
• France has pledged to buy enough vaccine for its population
• The UK has asked companies to tender bids
• Germany has pledged 20 million euros for vaccine trials
• Italy has announced it will spend 50 million euros on vaccines, and has announced purchasing contracts with three differrent companies

[ September 16, 2005, 02:57 PM: Message edited by: Noemon ]
 

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Posted by Kwea (Member # 2199) on :
 
I think the reason they considered that fact that there could have been more people contracting it a bad thing is because it could invalidate tehir ideas of what the mortality rate is...it could be higher, or lower, the problem is that they don't know.


I doubt it will be a problem, really, for many reason, but that is why they were wondering.
 

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Posted by Noemon (Member # 1115) on :
 
Kwea, I'm not sure what you're responding to. I assume it's one of the articles that's been linked to in this thread, but could you quote it or reference it? It may just be that I'm tired, but I'm puzzled.
 

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Posted by Samarkand (Member # 8379) on :
 
Um, the way you avoid disease is to quarantine like crazy. Anyone remember the SARS outbreak? Shut down the airports, cordon off neighborhoods, forbid people to leave their houses, put armed guards at exits and entrances. And yes, I definitely think the government would do this is we were looking at a Pandemic.

The book many of you may be remembering is Connie Willis' Doomsday Book. Oh Connie, how I love thee.

How to prepare? Get your yearly flu shots, that resistance rolls over, stay in general good health, and if an outbreak occurs stay away from other people.

As far as a vaccine: Flu vaccine is very specific. Each year the WHO and the CDC and whoever guess what the nest year's flu virus will look like. They sequence it and then it takes several months to produce. Sometimes they guess wrong and the vaccine isn't for the right virus. In the event of a Pandemic, it would be some time before our scientists would be able to produce a vaccine. Then there would be issues of manufacturing and ditribution, not to mention dead or dying scientists, workers, etc.

In order to prevent the outbreak, China and the rest of the Asian countries where bird flu has popped up need to get real about the danger and let the WHO in to do their work. And continue quarantines and mass bird slaughter .
 

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Posted by Tatiana (Member # 6776) on :
 
Noemon, that's an awesome article in New Scientist. I'm so glad to hear that something is finally being done. I only hope it's in time.

Samarkand, quarantine is shown in computer models to be effective only in very early phases of outbreaks of human-to-human (H2H) transmissible strains. Once the virus gains a decent foothold in a population, it's inevitable that it will travel around the globe within weeks to months. However, pre-vaccination of the whole population, plus quarantine in those places where H2H outbreaks first occur (if caught very early) is shown to be effective at supressing outbreaks.

Mass slaughter of infected bird populations has waned in effectiveness as a containment tool. The virus is endemic now in wild bird populations, and is found in asymptomatic pigs and domestic ducks. Basically, we're past the stage where mass slaughter can help much. Focus has changed to mass vaccination of domestic birds.
 

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Posted by Tatiana (Member # 6776) on :
 
17 People have bird flu in Indonesia right now, but as far as they can tell, they all got it from birds in the zoo. They claim there's still no good evidence for much human to human transmission, for which I am grateful. I would feel we'd collectively dodged a bullet if it doesn't happen some time this winter, though. Pray that it does not.
 

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Posted by Noemon (Member # 1115) on :
 
Yeah, I read about the people in Indonesia. ::winces::

Any particular reason for the winter timeframe for an outbreak, or is it just a feeling? I don't have much of a feel at all for when it'll happen.
 

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Posted by Shigosei (Member # 3831) on :
 
I've been wondering what will happen if the outbreak occurs while I'm still at college, living in the dorm. This is a building with maybe 300 people, and the air is circulated from room to room. If someone gets the flu, we will all get it. I guess that the school would probably shut down, and maybe I can stay at a friend's house until my parents can come to get me (taking a plane home would probably be a bad idea).
 

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Posted by andi330 (Member # 8572) on :
 

quote:

---

Originally posted by Noemon:
More good news! Well, part of this is just an expansion of the last article I linked to, but still, it's heartening stuff!

Low-Dose Bird Flu Vaccine Tested on Humans

To sum up the good news:

A vaccine consisting of killed virus combined with an immune system stimulator is being tested, with the results expected in December. If successful, the world's vaccine producing capabilities would essentially quadruple.

In addition to the US order for $100 million worth of vaccine:

• Canada, Australia, and Japan have pledged unspecified amounts for vaccine trials
• France has pledged to buy enough vaccine for its population
• The UK has asked companies to tender bids
• Germany has pledged 20 million euros for vaccine trials
• Italy has announced it will spend 50 million euros on vaccines, and has announced purchasing contracts with three differrent companies

---

On the other hand, no flu virus is capable of keeping everyone from catching the flu. Many people actually catch the flu from the vaccines (my father quit taking them once he got out of the military because they always made him sick). Since the virus also randomly mutates once inside humans, the people that do catch it could still spread it, even to people who may have had the vaccines.

Even if the vaccine worked perfectly, there would still be problems, because the government would have a hard time forcing people to get the vaccine. It's not like with kids before they go to school, (and because of freedom of religion laws some people can get around required school immunizations) they can't just show up and require you to take medication. Which means, no matter how much they encourage it, there will be people who refuse to go. It's been long enough since the last pandemic that there hasn't been one in my lifetime. Many young people won't think that it's as big a problem as it could be, and unless the government offers free flu shots there are many who cannot afford them.
 

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Posted by Theaca (Member # 8325) on :
 
If it is a killed virus vaccine then you can't catch the flu from it. Because it is DEAD. I'm not quite sure what your point is about mutations.
 

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Posted by Kwea (Member # 2199) on :
 
. . .
 

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Posted by Tatiana (Member # 6776) on :
 
Flu season is in the wintertime in the Northern Hemisphere. I don't think anyone knows for sure why. There are various theories.
 

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Posted by Noemon (Member # 1115) on :
 
You know those infected birds in Turkey? It's definitely H5N1 that they've got.
 

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Posted by Tatiana (Member # 6776) on :
 
Oh, that's bad news.
 

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Posted by pH (Member # 1350) on :
 
I'm scared.

So, is it worth my time to go get the flu vaccine they're offering at the drugstores around here, or will that do no good at all?

I never even bothered with flu vaccines until I started living in a dorm.

-pH
 

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Posted by Noemon (Member # 1115) on :
 
Well, it'll help you to avoid getting sick from the flu that it's designed to prevent against. If you were living in an area where birds carrying H5N1 were present it would be a good idea to get the shot, as you would be doing something to remove yourself as an incubation ground in which a human to human transmissible flu could swap genes with H5N1.

But in terms of protecting you from a human to human transmissible H5N1 variant? Nah, won't do you much good.
 

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Posted by Samarkand (Member # 8379) on :
 
So I was watching the news and they showed pictures of birds in Turkey with the virus, and the birds were turkeys . . . and then I didn't know if it was found in Turkey the country or turkey the bird, or maybe both. It was traumatizing.
 

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Posted by Tatiana (Member # 6776) on :
 

quote:

---

Originally posted by Samarkand:
So I was watching the news and they showed pictures of birds in Turkey with the virus, and the birds were turkeys . . . and then I didn't know if it was found in Turkey the country or turkey the bird, or maybe both. It was traumatizing.

---

That was awesome!

Scientific American's new issue (November) has an article "Preparing for a Pandemic, Are we ready?" It's not up online yet, and I don't know if it will be available to the public when it is, but I thought I would quote some interesting bits.

"The lethargic, poorly coordinated and undersized response [to Katrina] raises concerns about how nations would cope with a much larger and more lethal kind of natural disaster that scientists warn will occur, possibly soon: a pandemic of influenza. The threat of a flu pandemic is more ominous, and its parallels to Katrina more apt, than it might first seem. The routine seasonal upsurges of flu and of hurricanes engender a familiarity that easily leads to complacency and inadequate preparations for the "big one" that experts admonish is sure to come."
 

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Posted by Tatiana (Member # 6776) on :
 
"Epidemiologists have warned that the next pandemic could sicken one in every three people on the planet, hospitalize many of those, and kill tens to hundreds of millions. The disease would spare no nation, race or income group. There would be no certain way to avoid infection."

"Flu shots matched to the new virus will arrive too late to prevent or slow the early stages of a pandemic, but rapid response with antiviral drugs might contain an emerging flu strain at its source temporarily, buying time for international preparations."

"In many places, drug supplies and other health resources will be overwhelmed."
 

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Posted by Tatiana (Member # 6776) on :
 
"The experts recommended surgical masks for flu patients and health workers exposed to those patients. For the healthy, hand washing offers more protection than wearing masks in public, because poeple can be exposed to the virus at home, at work and by touching contraminated surfaces, including the surface of a mask."

Sounds like to me that masks AND frequent handwashing are both good ideas during a pandemic, since 1) we don't know who is infected and contagious but not showing symptoms yet, and 2) if it's a good idea for health workers exposed to patients then it must be a good idea for anyone potentially exposed to anyone sick, in other words, anyone in public during an outbreak.
 

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Posted by Tatiana (Member # 6776) on :
 
"Because no one would have immunity to a new strain, they expect 50 percent of the population to be infected by the virus. Depending on its virulence, between one third and two thirds of those people will become sick, yielding a clinical attack rate of 15 to 35 percent of the whole population."

"No government is ready now. In the US ... Trust for America's Health (TFAH) esitmates that a severe pandemic virus ... could translate into 4.7 million Americans needing hospitalizations. ... The country currently has fewer than one million staffed hospital beds."

"Many of the most severe illnesses and deaths from H5N1 infection have been among previously healthy young adults and children."
 

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Posted by Tatiana (Member # 6776) on :
 
"Nothing about the H5N1 virus in its current form offers reason to hope that it would produce a wimpy pandemic, according to Frederick G. Hayden, a University of Virginia virologist who is advising WHO on treating avian flu victims. "Unless this virus changes dramatically in pathogenicity," he asserts, "we will be confronted with a very lethal strain.""

"Fatality rates in diagnosed H5N1 victims are running about 50 percent. Even if that fell to 5 percent as the virus traded virulence for transmissibility among people, Hayden warns, "It would still represent a death rate double [that of] 1918, and that's despite modern technologies like antibiotics and ventilators.""

""We have only one enemy," CDC director Gerberding has said repeatedly, "and that is complacency.""
 

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Posted by Noemon (Member # 1115) on :
 
Tamiflu Resistant H5N1

The good news is that the mutation makes the flu less able to spread. The bad news is obvious.
 

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Posted by Tatiana (Member # 6776) on :
 
Yikes!
 

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Posted by Noemon (Member # 1115) on :
 
Taiwan to ignore flu drug patent

This strikes me as a sensible move on Taiwan's part.
 

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Posted by fugu13 (Member # 2859) on :
 
It is, but it'll likely get them some stiff fines. Countries which ignore patents are generally frowned upon in groups like the WTO.

I suspect, though, that this isn't so much an objection to the practice, but an objection to the lack of clarity in such a practice. The uncertainty it introduces into markets is significant for anyone who makes a drug treating even moderately serious illnesses. I think it could be transformed into a more acceptable action by the adoption of well-defined guidelines for doing so.
 

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Posted by aspectre (Member # 2222) on :
 
Actually, there is an internationally recognized exception to drug patent monopolies for the case of a national health emergency.
 

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Posted by fugu13 (Member # 2859) on :
 
Yes, and no national health emergency has been declared in Taiwan.
 

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Posted by aspectre (Member # 2222) on :
 
And Hoffman-LaRoche is already in negotiations with various drug companies around the world inregards to royalty payments in exchange for use of their patent.
Considering that it takes ~6months for a batch of Tamiflu to be processed from start-to-finish -- even with machinery, proper manufacturing&separation techniques, and experienced technicians already in place -- there should be more than enough time for the Taiwanese to secure a royalty agreement before it is even possible for their first pills to be sold. I'd be surprised if the entirety of the manufacturing machinery could be properly assembled&tested in 6months.

[ October 23, 2005, 03:59 PM: Message edited by: aspectre ]
 

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Posted by Tatiana (Member # 6776) on :
 
I agree that it's a good idea. I wish every pharmacy company in the US would do the same. Then there might be a chance we would have enough. Seriously, Roche should invoke some extraordinary circumstances in this case and waive their patent rights.

Imagine being the CEO or other executive who could have made that choice, after about 100 million people have died because you didn't. That would suck.
 

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Posted by aspectre (Member # 2222) on :
 
It was Hoffman-LaRoche's idea to share their patent, with good reasons.
They can't produce enough of Tamiflu to meet demand. And can't meet the deadline for new manufacturing plant capacity in a morally timely manner to fulfill current demand. Nor can they economicly justify the risk of building new manufacturing facilities based on projecting the unprecedented current demand into the future.

By creating Tamiflu manufacturing partnerships, Hoffman-LaRoche can reasonably expect to be able to meet current demand within the near future, while minimizing their own financial exposure. And incidentally, dodge the political lynching sure to come should H5N1 start killing large numbers of people before there is an abundant supply of their drug available.

[ November 21, 2005, 07:01 AM: Message edited by: aspectre ]
 

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Posted by Elizabeth (Member # 5218) on :
 
Yikes.

http://news.yahoo.com/fc/Health/Bird_Flu

I am trying not to get extremely panicky about this, so if anyone has some good "calm down, silly" advice, I am all for it!
 

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Posted by aspectre (Member # 2222) on :
 
Calm down, silly. One is as likely to die of a newly virulent strain of Ebola as of BirdFlu. And even more likely to die of a flu that hasn't been seen yet. And yet even more likely to die of a flu that "A lot of that has been going around." already.

Personally, I expect to be taken out by an SUV driver who hates bicyclists for not wasting enough gasoline.
 

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Posted by Elizabeth (Member # 5218) on :
 
Thanks, aspectre, but keep in mind that I contracted a disease that about one in ten million people get, so the odds aren;t going to work!

And it seems like they are saying the odds would be one out of three?
 

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Posted by aspectre (Member # 2222) on :
 
Actually, the odds of dying are closer to 1 out of 1. Eventually.
I'm still gonna try to beat the odds though.

The problem is that I haven't seen anything even vaguely scientific which makes H5N1 more than marginally more likely to mutate into human-to-human infectivity which would lead to an especially deadly pandemic than other diseases known.
Or unknown, like SARS popping up in China from outta nowhere.

[ October 23, 2005, 03:51 PM: Message edited by: aspectre ]
 

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Posted by Elizabeth (Member # 5218) on :
 
Do you mean the odds of dying from it once you get it, or the odds of getting it? Or, dare i ask...both?

My husband has been freaking me out with info lately. One of the things "they" are saying is that it will cause a major depression, as no one will go to work, etc.
 

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Posted by Ryuko (Member # 5125) on :
 
I'm not going to bother worrying about this... It'll just make me sick. I'll try not to get sick, but if I do get sick, I'll die no matter what.. so there's really no reason to get all stressed out.. Either I die or I don't. That's how it is all the time anyway.
 

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Posted by Elizabeth (Member # 5218) on :
 
"Either I die or I don't. That's how it is all the time anyway.

Except it isn't really as easy as all that, Ryuko, though you might want it to be.

Almost dying is not very fun, and it makes you realize that dying is not so hot itself. Add to that the fact that, in the case of a pandemic, you would most likely watch your children die(if you have them) and everyone else you know, and it is not as easily discounted(to me) as regular old "everyone dies eventually" kind of dying.
 

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Posted by Tatiana (Member # 6776) on :
 

quote:

---

The problem is that I haven't seen anything even vaguely scientific which makes H5N1 more than marginally more likely to mutate into human-to-human infectivity which would lead to an especially deadly pandemic than other diseases known.
Or unknown, like SARS popping up in China from outta nowhere.

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quote:

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5,600 citizens

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quote:

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Originally posted by Elizabeth:
"Either I die or I don't. That's how it is all the time anyway.

Except it isn't really as easy as all that, Ryuko, though you might want it to be.

Almost dying is not very fun, and it makes you realize that dying is not so hot itself. Add to that the fact that, in the case of a pandemic, you would most likely watch your children die(if you have them) and everyone else you know, and it is not as easily discounted(to me) as regular old "everyone dies eventually" kind of dying.

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quote:

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Apparently the appropriate people in the white house have already secured a sufficient supply for the people they feel need it most (read: the politicians and their families). Bush's entire administration is scared out of their minds over the very real, very serious possibility that H5N1 will become transmittable from human to human.

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quote:

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I already looked for tamiflu a month ago and was told it wasn't available yet this year.

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I'm sorry to say that whoever told you this was sadly misinformed, since I obtained mine almost exactly a month ago from Target. And if you already recognize the danger posed by H5N1, why are you being so trivial about this?

Actually, don't bother answering, I'm ignoring your posts in this thread because it's taking a lot of my willpower (and backspacing) to keep from saying something nasty.
 

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Posted by Theaca (Member # 8325) on :
 
Go right ahead and say something nastier. If you can read the minds of the entire Bush administration you can probably read my mind too. And tamiflu is one of those seasonal drugs that not all pharmacies carry in the summertime so I'm not surprised you found it and I didn't.
 

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Posted by Tstorm (Member # 1871) on :
 
Buying a drug that might help sounds comforting, but I haven't heard or seen any evidence it actually helps. In fact, the news articles always seem to state that. Does anyone here know if it helps or not? I'll put my trust in Hatrack over the news guys any day.

What I've read: It might help, if taken during the first onset of symptoms.
 

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Posted by Shigosei (Member # 3831) on :
 
I halfway expect the flu to be resistant by the time I get it. I'm going to try not to catch it at all, and if I fail at that, I'm hoping my immune system will take care of it.
 

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Posted by Tstorm (Member # 1871) on :
 
I just spent some time reading about Tamiflu. If this is the big savior, I'm not encouraged. I sure can't go asking for a flu vaccine, because even in a normal season, it's reserved for the elderly and people with chronic conditions. I'm a healthy young male in his 20s. I've read reports that historically, the worst pandemics disproportionately affected my age group: the healthy adult people who usually don't get sick. My mother read a book about flu pandemics and has told me this as well. Of course, every flu virus is a little different. I can always hope.

All I can do at this point is NOT worry about it, and just hope it's not as bad as the experts predict. If the pandemic does happen, I can maintain my healthy habits, wash my hands with paranoid obsession, and maybe wear a mask.
 

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Posted by Shigosei (Member # 3831) on :
 
Yeah, I'm in the age group for getting very sick as well. Of course, our age group was sitting around in trenches last time there was a horrible pandemic. I don't know how much of a factor that was. Were young people disproportionally affected in the milder pandemics mid-century?

I also find encouraging the fact that in 1918, a lot of people still had diseases such as tuberculosis, things which are no longer as widespread. Of course, HIV will probably make people much more susceptible. And I suspect that the third world will be hit very hard.

A regular flu vaccine won't protect you from H5N1--there's no vaccine for that publicly available at this time.

Chances are you won't die from the flu. You might want to start stocking some food and water, though, because services might get disrupted.
 

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Posted by Tstorm (Member # 1871) on :
 
Yeah, I was just thinking through a possible preparation list. Basic, obvious stuff. Water, like you said. But my water is from the tap, I think. What if the water treatment plant has problems due to staffing or supply disruptions? Yeah, water, might be useful. Food, obviously, because the grocery store depends on nightly deliveries.

A computer game, because if my workplace closes, I'll need my solitary entertainment.

Yeah, worrying won't help, all I can do is plan.
 

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Posted by Noemon (Member # 1115) on :
 
The US government has launched Pandemicflu.gov.

Also, as I'm sure everyone is aware, Bush has unveiled the US's bird flu action plan
 

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Posted by Tatiana (Member # 6776) on :
 
Scientific American has a great new article out. This one can be read online.
 

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Posted by ElJay (Member # 6358) on :
 
Three children in Turkey have died in suspected bird flu cases.

Two have already been confirmed, the third is being sent for testing, and there's a fourth in the hospital. They are all from the same family, and were playing with a head from a dead chicken like a ball, so seems unlikely to be person-to-person spread yet, but they're testing for that, too.
 

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Posted by sweetbaboo (Member # 8845) on :
 
MSN homepage had this article that puts the flu hitting the US in as few as six months to a year. I haven't read this whole thread (it's so large and full of information) but skimmed most of it. Here's the link

http://www.msnbc.msn.com/id/11741441/

A friend of mine said that the government suggested having a 6 month store of food and water (of course she couldn't remember her source). In cursory searches, I couldn't find anywhere the government suggests that but maybe someone here, who is more informed, knows?

Personally, I don't think it ever hurts to be prepared and I'd rather err on the side of doing what I can in advance for my family in case of any emergency.
 

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Posted by sweetbaboo (Member # 8845) on :
 
Tatiana, a few pages ago, you said that you have information written up that you'd be willing to share for an enrichment meeting. We are having a food storage and emergency preparedness enrichment meeting in April and I would love a condensed version (5 mins) to share. My email is in my profile. Thanks.
 

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Posted by Tatiana (Member # 6776) on :
 
Okay, great! Let me look it up! I'll try to email it to you by this weekend latest!

I'm so glad you're going to do this. I talked to the enrichment people at my ward and they were like <blank look>.

I really wish there was some way to email the church leadership in Salt Lake and ask them if they've considered a special message about bird flu preparedness.
 

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Posted by Tatiana (Member # 6776) on :
 
Interesting stuff, ElJay and sweetaboo! I didn't see those before. Doesn't it warm your heart to hear Michael Chertoff tell us it's all under control? Just like in New Orleans with Katrina, yep. I'm sure they'll take gooooood care of us.

It's going to make people a lot more aware if birds begin to get it in this country in six months, but the real danger is after it mutates to a form that's easily transmisslble from human to human. There are reasons for believing it might easily pick up the genes to do that, but of course nobody is sure. But if that happens, no matter where in the world it starts (and it probably will start in Asia), there won't be anywhere in the world that's safe. The human-transmissible form will be able to sweep the whole world within a month or two. Even people in remote Alaskan villages got it (the flu pandemic then) from the postman in 1918.

So, in a way, if it comes here to the U.S. it will be better because people may begin to take it more seriously. The risk is just as severe either way, but maybe if birds start dying here, then people will pay more attention and begin to prepare themselves, mentally as well as physically.

Having six month or a year supply of food and water is a very good idea for disaster planning in any event, sweetaboo. It comes in handy in a number of circumstances, such as periods of unemployment, as well as various infrastructure breakdowns and natural disasters. It is a form of savings that's sort of the ultimate cash, food. Of course, you have to learn a lot of ways to prepare dried beans, since you need to rotate it out for it to stay good. I have about nine months supply of dried beans and rice saved up now, and probably six months of water at a gallon a day a person. It takes a while to build up a good store. I usually just toss a bag or two of beans and rice in my cart each time I go to the store, and every gatorade, soda, or bottled water bottle I empty gets filled from the tap and put in the basement. Start now and you will have a decent sized store built up fairly soon.
 

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Posted by Noemon (Member # 1115) on :
 
This is incredibly good news. Elias Corey deserves high praise for both his work and his decision not to patent it.
 

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Posted by JonnyNotSoBravo (Member # 5715) on :
 
Government website:

quote:

---

“This means that individual actions are perhaps the most important element of our preparedness and response activities,” Townsend said. The homeland security expert said the plan will rely on individuals exercising some common sense if illness begins to take hold in their towns – avoiding trips to shopping malls or canceling vacations, for instance.

---

While this is VERY true, I can't help but think this is partly the administration preparing us because FEMA doesn't have the funds, management, or planning in place to deal with this.

Noemon, while it's great that it hasn't been patented yet, I'm afraid some pharmaceutical company will swoop in and try to patent the process the same way that Microsoft patented the Apple drop down menu that Apple "borrowed" from Xerox. That patent became part of Windows which made Gates and Allen two of the richest men in the world.

[ May 04, 2006, 04:02 PM: Message edited by: JonnyNotSoBravo ]
 

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Posted by Noemon (Member # 1115) on :
 
Yeah, that occurred to me too, JNSB. Not sure how to combat that.

Everything I've read suggests that measures like the ones Homeland Security is recommending will be unlikely to do much of anything to help contain the spread of the virus. Quarantine is useful in preventing or containing epidemic only at an illness's point of origin; I imagine that a half-hearted "try not to go out so much approach wouldn't do a thing.
 

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Posted by Tatiana (Member # 6776) on :
 
Noemon, that's great news about the new process for making Tamiflu! I hope it gets cranked up in time.

sweetbaboo, I never emailed you that information! I got busy and forgot. I'm so sorry! If you can still use it, I will gather it together and send. All the information and the links are in this thread, particularly on the first page. But I had put it into the form of notes for a talk, and I can get that into electronic form for people to use, if there's a need.

My talk was basically in five parts.

1. Ask about family stories, journals, or anything else people might know about the 1918 flu, as a way to introduce flu pandemics. Tell a little about the 1918 pandemic, or fill in information gaps left by what people in the group relate.

2. Sketch why it's a danger, why scientists are sure there will be another flu pandemic sometime, and why conditions make it look very imminent now.

3. Tell why the health care infrastructure will be totally overwhelmed and unable to help at all. Tell how crucial services, power, water, food, etc. might be impacted during peak times.

4. Tell how we can prepare to help ourselves. Basically, food storage, water storage, storage of sick-foods, Tamiflu, face masks, medicines for survivors, limiting public contact during high risk times, networks of contacts for emergency supplies. Planning who will check on grandma, and so on.

5. Open floor for questions.

That's more than a five minute talk, right there. If you only have 5 minutes, perhaps just cover items 4 and 5, get email addresses, and email links to people who want more information.
 

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Posted by Tatiana (Member # 6776) on :
 
Well, it's time to bump this thread, and the latest news is not at all good.

There are a zillion sites that sell Tamiflu on the web, but I have no reason at all to believe any of them are real. I expect they sell counterfeit drug that has no effectiveness. Can anyone come up with any evidence otherwise? Or does anyone know of a reliable source?
 

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Posted by Noemon (Member # 1115) on :
 
I assumed that you were going to be posting information about that Indonesian family where family members caught bird flu from each other. At least one strain of it is now human to human transmissible, although apparently still not *easily* transmissible.
 

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Posted by Tatiana (Member # 6776) on :
 
The Poultry Page is an excellent source of bird flu information! They surpass the others in that they are always factual, informative, and clear.

My assessment is that this is simply a confirmation of what we've strongly suspected from other cases, that human to human transmission is occurring in isolated cases. This is the stage below a full pandemic alert. So long as clusters are self-limiting, it shows we still have some time, though it could be months, or it could be years.

One thing I find encouraging is that reassortment does not seem to be the mechanism by which pandemic strains are formed. At least, the 1918 strain was shown to have formed by mutation rather than reassortment, and it's been confirmed by genetic testing of all the H5N1 strains that are out there now, that none of them have formed by reassortment. Reassortment must not be as easy as it seems at first look. That means it may take mutation, probably several mutations, before a pandemic strain could come about.

Let's hope and pray that the crucial mutations necessary to make H5N1 easily transmissible person to person are a long time coming, or never do. Or if they do, that they are accompanied by a huge decrease in mortality. It's certainly not comforting that 6 out of 7 people in this cluster died.
 

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Posted by Tatiana (Member # 6776) on :
 
Here's the compilation page. That last link was the story of the latest cluster.
 

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Posted by Tatiana (Member # 6776) on :
 
For ease of reference, the U.S. Government's page.

The W.H.O. page on avian flu.
 

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Posted by Tatiana (Member # 6776) on :
 
So far we are still at level 3 on the pandemic alert scale, which is good news, but some people feel we are tipping over into level 4.
 

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Posted by Tatiana (Member # 6776) on :
 
Here is a good family planning checklist. None of it should be unfamiliar to LDS families, who should have all that stuff on hand already. But it's always a good idea to doublecheck the list to be sure you've thought of everything, and improve any deficiences you might have.

When people keep everything they need on hand always, it helps prevent any runs on supplies at times of crisis.
 

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Posted by Tatiana (Member # 6776) on :
 
<bumps>
 

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Posted by Primal Curve (Member # 3587) on :
 
I'm preparing by scheduling a trip to a public place for every night in the next year where I will be sure to share drinks, food, and sloppy kisses with every person in the room.
 

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Posted by Tatiana (Member # 6776) on :
 

 

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Posted by Tatiana (Member # 6776) on :
 
Some encouaging news lately.

"Bird Flu Virus May Need Significant Mutation for Human Pandemic

July 31 (Bloomberg) -- Scientists failed in multiple attempts to make a more contagious form of the H5N1 bird flu, suggesting the virus may have to undergo massive change to cause a human pandemic.

After mixing genes from human and bird influenzas in a way researchers have projected might lead to a pandemic, the virus remained hard to spread said researchers led by Taronna Maines, a U.S. Centers for Disease Control and Prevention scientist. The study was conducted on ferrets, which are at least as susceptible to flu as people, the scientists said in a report released today. "

From Bloomberg.com here.
 

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Posted by Kwea (Member # 2199) on :
 
Who would have guessed.


Wait....I did.


Good news all around.
 

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Posted by Tatiana (Member # 6776) on :
 
Please don't congratulate yourself yet and tempt fate. It's one encouraging thing in the midst of many. Still, I'm delighted. We may have time to actually be ready now.
 

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Posted by Kwea (Member # 2199) on :
 
It is very hard for a virus to mutate to the point where the species barrier collapses. Thank God.

I never said it wouldn't, but I did say it was less of a probability than was being suggested. I am sure they are working hard on it in case it turns out to be the exception rather than the rule.
 

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Posted by Shigosei (Member # 3831) on :
 
I still say we need better flu vaccine production methods. Pandemics have happened before, and they will almost certainly happen again. It doesn't matter if we dodged a bullet this time...eventually, something's gonna jump the barrier. Besides, even the seasonal flu is reason enough to work on better vaccines. Remember how there was a shortage a few years ago because a large batch of vaccine got spoiled and there wasn't enough time before flu season to make more? If we can produce it faster, that wouldn't be such an issue. Also, it would be great to have a broader vaccine so we wouldn't have to guess every year which ones to put in the vaccine.
 

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Posted by Tatiana (Member # 6776) on :
 
We totally haven't dodged the bullet yet, just have a bit of encouraging news is all. Influenza has jumped the species barrier again and again throughout human history. A few times a century is normal, and last century there were 3. We were very lucky that the last two of those were not as deadly as most new flus are.
 

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Posted by Shigosei (Member # 3831) on :
 
I did say if. Don't worry, I'm still worried.
 

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Posted by Tatiana (Member # 6776) on :
 
Some good news!

"A bird flu vaccine cultured in laboratory-grown cells and not chicken eggs like traditional vaccines is being tested at the University of Maryland School of Medicine.

The new method allows for the production of larger quantities of vaccine because drug companies would not be limited by the supply of specialized chicken eggs used for the manufacture of traditional flu vaccines."

Check it out!
 

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Posted by Noemon (Member # 1115) on :
 
Woot!
 

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Posted by Shigosei (Member # 3831) on :
 
Excellent. I hope this production method will also be used someday for regular flu vaccine. As I've said, this will help prevent shortages if vaccine batches become spoiled somehow.
 

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Posted by Tatiana (Member # 6776) on :
 
It's flu season again! I will be relieved and excited if we go another winter with no pandemic.
 

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Posted by Kwea (Member # 2199) on :
 

 

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Posted by Noemon (Member # 1115) on :
 
Interesting.
 

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Posted by Shigosei (Member # 3831) on :
 
I'm not sure that pandemic flu is limited to the typical flu season. My understanding is that it could hit any time of the year.
 

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Posted by Tatiana (Member # 6776) on :
 
More encouraging news! An article in USA Today says an experimental vaccine has proved effective against more than one strain of H5N1. Now if we could just get the world's population vaccinated with it before the pandemic hits!
 

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Posted by Tatiana (Member # 6776) on :
 
http://www.alertnet.org/thenews/newsdesk/KLR30946.htm
 

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Posted by Tatiana (Member # 6776) on :
 
http://www.iht.com/articles/ap/2007/06/23/europe/EU-GEN-Germany-Bird-Flu.php

Sorry I've been slacking on keeping everyone informed. There are several new cases in Germany.

[ June 23, 2007, 04:23 PM: Message edited by: Tatiana ]
 

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Posted by Kwea (Member # 2199) on :
 
What a pandemic.


I am very glad it spreading so slowly. Last I heard it is not considered a high threat at all, although it bears watching.


I hope the new vaccinations are effective, and really make it easier to mass produce vaccinations.
 

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Posted by Tatiana (Member # 6776) on :
 
Yes, so far we've been quite lucky that it's not become a pandemic. Not considered a high threat? I only wish! Yes it's still a very big threat. The CDC, the WHO, and every medical body I know of considers it a huge threat still. The amount we don't know about how the genetic changes arise that lead to a form that's easily transmissible human to human is enormous, though. So there's certainly room to hope we continue to dodge the bullet for a few more years.

Here's an interesting flu wiki that's getting started.

Here's the U.S. Government's pandemic flu site. There is a lot of good info here too.
World Health Organization's avian flu site with additional information. There's a great timeline here that came out this month Basically, the virus has spread in wild and domestic birds as far as Western Europe, and human cases have occurred in Africa, the Middle East, and Eastern Europe. So far human to human transmission is still rare and limited.

Basically we're in phase 3 of the pandemic scale, meaning limited human-to-human transmission. We've been very lucky in having this time (so far) to prepare. If we can get pre-vaccinations through clinical trials, overcome the production hurdles, and actually pre-vaccinate a significant portion of the human species before the virus mutates or reassorts to gain easy human-to-human transmissibility, then we can consider ourselves out of major danger from this pathogen. That's a big if, and our efforts don't need to be relaxed.

Thinking something is safe because so far it hasn't caused big problems is an idea that needs a pithy name. I know that the Soviet nuclear industry had this feeling pre-Chernobyl, NASA had this feeling pre-Challenger, and Davis-Besse nuclear plant felt this way about their boric acid deposits before they discovered the football sized hole in their reactor head in 2002. It's something we're specifically taught as a mental fallacy in our accident analysis courses.

It's also inapplicable in this case, (that no big problems have happened yet), where we have the history of pandemic flu in 1918 and before to refer to. Indeed, throughout recorded history, pandemic flu has struck with severity every century or so. In this time of widespread literacy and written records, disasters should not have to happen in every generation to be taken seriously.
 

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Posted by Tatiana (Member # 6776) on :
 
Small human-to-human cluster of H5N1 cases. Not a good sign.
 

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Posted by Kwea (Member # 2199) on :
 
Huge threat?

Not really, although it is something to work on to be sure.


Comparing this to 1918 isn't really accurate, either. We have better treatments, better production facilities, and a better medical understanding of how things work.


It is far more rare for something to mutate and become dangerous than it is for it to fail to do so. There is always a risk, of course, but the species barrior isn't tissue thin, thank God.

It is a threat, and one that needs to be watched, but it is hardly the level of threat you seem to think it is.


That doesn't mean we can't prepare, though. I hope they continue to press on with the necessary research. Even if this threat nevers matures, research done to prevent it might increase our over all knowledge base, which is never a bad thing.
 

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Posted by Tatiana (Member # 6776) on :
 
"...but it is hardly the level of threat you seem to think it is. "

Not me. The CDC, WHO, and every other medical body in the world.
 

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Posted by DeathofBees (Member # 3862) on :
 
I hope this link isn't a repost of anything earlier in the thread...

Smithsonian magazine did a feature back in January 2006 on Robert Webster, a leading scientist in the field and "the one who discovered that birds were likely responsible for past flu pandemics," according to the article. Not that Smithsonian is the final authority on scientific information, but considering Webster's level of involvement in the research currently taking place, I find it difficult to disregard his warnings.

I'm not going to hide in the ground because of this threat, but I will stock flu medicines with my other emergency preparations and keep my ears tuned to the news.
 

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Posted by Shigosei (Member # 3831) on :
 
The 1918 flu managed to jump the species barrier. Genetic studies seem to indicate that it also came from birds. Additionally, flu pandemics really aren't a rare event. Historically, there have been several -- there was also a pandemic in 1890 -- and there were milder pandemics (such as the one in 1957). It has happened before, and it will happen again. It might not be now, and it might not be H5N1, but it will happen eventually.

Additionally, our advanced medicine probably won't save us. Our health care system is already stretched pretty thin. We don't have extra resources, and we won't be able to care for all the people who get sick. The only way modern technology will help us is if we get a vaccine made and stockpiled before the pandemic hits. Otherwise, I suspect we will be on our own.

Which is not to say that I think we should be panicking. You should have food and water to last a few months, but it's a good idea to have that around anyway. Wash your hands and practice good hygiene -- again, good to do in any case. And yes, I think we need to be putting pressure on the government and our communities to be ready for something like this. Dwelling on it, however, isn't going to help.
 

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Posted by Kwea (Member # 2199) on :
 
Amen.
 

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Posted by Tatiana (Member # 6776) on :
 
I thought this was a very cool article and I'm glad things like this are happening.
 

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Posted by Kwea (Member # 2199) on :
 
For the record, that article is bunk. Not only is this NOT the most deadly disease in the world, it isn't even close. I can name at least 3 with a mortality rate of over 90% easily.


Or I could if I wanted USAMRIID to be very unhappy with me again.


I agree that this type of program is good, but the obvious bias in reporting makes me cringe.


I think an agenda just smacked me in the face........hard.
 

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Posted by Tatiana (Member # 6776) on :
 
DeathofBees, that Smithsonian article was great!

quote:

---

Webster says the world is teetering on the edge of a knife blade. He thinks that H5N1 poses the most serious public health threat since the Spanish flu pandemic of 1918, which killed an estimated 40 million to 100 million people worldwide. Though the H5N1 strain has so far shown no signs that it will acquire the ability to transmit easily from person to person—all evidence is that flu victims in Vietnam and Thailand acquired the virus from direct contact with infected poultry—that has provided Webster no comfort. It’s only a matter of time before this virus, as he puts it, “goes off.” He has been saying this for several years. The world is finally taking notice. Elaborate plans are now being created in dozens of countries to deal with a pandemic. In November, President Bush requested that $7.1 billion be set aside to prepare for one, with hundreds of millions of dollars to be spent on further developing a new vaccine that was recently hatched in Webster’s lab.

---

 

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Posted by Kwea (Member # 2199) on :
 
Great. Even if this peters out, I think the money spent on research is well spent. It will pay off if we ever need it for anything else as well, and we are long overdue for a system to be developed in our country.
 

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Posted by Shigosei (Member # 3831) on :
 
Agreed, Kwea. H5N1 isn't the only possibly dangerous pathogen out there, and it certainly isn't the most deadly by either death toll or mortality rate. Much of what we can do to protect ourselves against bird flu is also useful for protecting ourselves in general, and I highly support those measures. We need our health infrastructure to be in better condition. I also think that we could do well by having a better system for making flu vaccine. After all, a faster means of production will be useful not just in a pandemic, but also when something happens to the annual stockpiles of flu vaccine.
 

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Posted by Kwea (Member # 2199) on :
 
GET....OUT....OF.....MY....HEAD!!!!
 

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Posted by Tatiana (Member # 6776) on :
 
More deaths reported but no definite evidence for human to human transmission. (I'm going to abbreviate as H2H from now on, okay?)
 

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Posted by Tatiana (Member # 6776) on :
 
A cluster of 8 cases of H2H transmission. Not a good sign.

quote:

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Should a strain of avian flu acquire the ability to cause sustained human-to-human transmission, the results could be catastrophic, Longini said. "If not contained, the outbreak could spread worldwide through the global transportation network faster than the appropriate vaccine supply could be made available. That's why it's so important to ascertain whether human-to-human transmission is happening as well as the virulence of the strain." The researchers estimated the secondary-attack rate of the virus in Indonesia — the risk of one infected person passing it to another — to be 29 percent, a level of infectiousness similar to statistical estimates for seasonal influenza A in the United States.

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Posted by Noemon (Member # 1115) on :
 
The universal flu vaccine's development appears to be continuing to come along nicely
 

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Posted by Kwea (Member # 2199) on :
 
That is really cool! I hope it pans out....and not just because of the implications for Avian Flu, but because of the value of the technique used in making this. What other types of vaccinations will be possible soon.....
 

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Posted by Tatiana (Member # 6776) on :
 
Wow that is so awesome! I want to get that vaccination. I don't want to have the flu ever again.
 

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