Pandemic News/Awareness. - page 9

I had to close the other panflu thread as it was way too long, and becoming unreadable. I am starting this one with info on the agenda of this meeting tomorrow in Congress. I am linking to... Read More

  1. by   Laidback Al
    tracking clusters of human h5n1 cases is important because it can tell is if human h5n1 infection is spreading. the specific links provided by indigo girl are somewhat confusing regarding clusters. in the first link nonlocality discusses his/her previous model of stages of a pandemic based on the number of human clusters. nonlocality states "in my opinion what is happening right now in indonesia is an explosion of what i call stage 3 events - small, short duration h5n1 illness clusters."

    in the second link nonlocality states "since late 2006 the number of simultaneous clusters has grown significantly, particularly in indonesia but also simultaneous with clusters in other countries (laos, egypt, etc.). . . i believe the average number of h2h transmissions within a cluster continues to increase."

    but this is mostly speculation and in a later post, notbornyesterday asks "let's have the case count which you find indicative, nonlocality."

    in the third link above, monotreme provide a link to his summary of clusters, but doesn't address whether or not nonlocality assertions are correct.

    so i will provide a concise summary and discussion of h5n1 human clusters.

    the first human cluster of h5n1 actually occurred in 1997. since 1997 there have been a total 47 human h5n1 clusters using monotreme's cluster definition. a graph of the number of clusters by year through 2006 can be found at:
    http://www.flutrackers.com/forum/sho...19&postcount=4

    so far in 2007, there have only been 2 human clusters that meet montreme's definition. in spite of nonlocality's belief, there has not been an explosion of small, short duration h5n1 illness clusters recently. what there has been is an explosion of reporting of suspected cases and suspected clusters, not just in indonesia, but also in egypt. these suspected cases are just that, suspected, until confirmed. there is no data yet to suggest that the number of human h5n1 clusters is increasing this year over last year.

    more importantly, however, is the fact that the cluster size, the average number of infected individuals in each cluster, is not growing over time. the overall range of the number of individual per cluster per year remains between 2.33 and 3.14 individuals. so far, the cluster size of h5n1 infected individuals is not increasing and indicates that h5n1 is not yet easily transmissible between humans.
  2. by   moh_sir
    Quote from indigo girl
    The following essay addresses an issue that many are not aware of, but need to know. Whenever you read about a positive avian flu test result, you almost always hear that the victim had contact with poultry. What you are unlikely to be told however, is that the viral sequences of the humans does not match the viral sequences of the poultry. What does this mean? It could mean that there is good chance that there is a hidden mammalian reservoir for H5N1.

    In Indonesia, the virus in the people most closely resembled the virus in a cat. This has important ramifications for preventing disease, particularly in countries where felines are pets (not the case in Indonesia), and are allowed access to the outdoors with the possibility of catching wildbirds.

    http://afludiary.blogspot.com/2007/0...-bird-flu.html

    http://crofsblogs.typepad.com/h5n1/2...ep_cats_a.html
  3. by   moh_sir
    The situation in England regarding the finding of H5N1 avian flu in the Bernard Matthews turkey sheds is very confusing. The story keeps changing, and not for the better. I am going to post a few links to show you just how crazy this is getting. I am having a difficult time understanding all of this, so if you find it so, don't be surprised...

    First, I'll let the Reveres at Effect Measure have their say:
    http://scienceblogs.com/effectmeasur...on_th.php#more

    Then, let's look at what the UK gov't is saying:
    http://www.flutrackers.com/forum/sho...80&postcount=1

    Unfortunately, this study does not seem to agree with their assessment about transmissibility thru the GI tract, and it should be pointed out that some victims (since deceased) have had the consumption of contaminated food as their only risk factor.
    http://www.flutrackers.com/forum/sho...81&postcount=2

    Last, but not least, there is this story of a worker, who participated in the cull. He was bitten by a turkey, and his wound was cleaned with ALCOHOL?
    He was not given Tamiflu until after his mother's doctor in Portugal insisted that he go to the hospital. By this time, he has flu s/s according to this post:
    http://www.flutrackers.com/forum/sho...87&postcount=1

  4. by   indigo girl
    Quote from laidback al
    in the third link above, monotreme provide a link to his summary of clusters, but doesn't address whether or not nonlocality assertions are correct.

    so i will provide a concise summary and discussion of h5n1 human clusters.

    the first human cluster of h5n1 actually occurred in 1997. since 1997 there have been a total 47 human h5n1 clusters using monotreme's cluster definition. a graph of the number of clusters by year through 2006 can be found at:
    http://www.flutrackers.com/forum/sho...19&postcount=4

    so far in 2007, there have only been 2 human clusters that meet montreme's definition. in spite of nonlocality's belief, there has not been an explosion of small, short duration h5n1 illness clusters recently. what there has been is an explosion of reporting of suspected cases and suspected clusters, not just in indonesia, but also in egypt. these suspected cases are just that, suspected, until confirmed. there is no data yet to suggest that the number of human h5n1 clusters is increasing this year over last year.

    more importantly, however, is the fact that the cluster size, the average number of infected individuals in each cluster, is not growing over time. the overall range of the number of individual per cluster per year remains between 2.33 and 3.14 individuals. so far, the cluster size of h5n1 infected individuals is not increasing and indicates that h5n1 is not yet easily transmissible between humans.
    thank you for clarifying. i found the subject of clusters interesting, and i was open to nonlocality's interpretation, but do not necessarily agree with it. my first question however, would be this. we know that suspect cases are being given tamiflu. what are the chances that at least some of these cases are really positive? are they really testing everyone before treating with tamiflu? my guess is that we will never know. the information coming out of indonesia at present is scant since their disagreement about sharing isolates.

    i believe monotreme also interpreted the info as possibly meaning people were being infected from a common source.
  5. by   indigo girl
    Quote from moh_sir
    Quote:
    Quote from indigo girl
    The following essay addresses an issue that many are not aware of, but need to know. Whenever you read about a positive avian flu test result, you almost always hear that the victim had contact with poultry. What you are unlikely to be told however, is that the viral sequences of the humans does not match the viral sequences of the poultry. What does this mean? It could mean that there is good chance that there is a hidden mammalian reservoir for H5N1.

    In Indonesia, the virus in the people most closely resembled the virus in a cat. This has important ramifications for preventing disease, particularly in countries where felines are pets (not the case in Indonesia), and are allowed access to the outdoors with the possibility of catching wildbirds.

    http://afludiary.blogspot.com/2007/0...-bird-flu.html

    http://crofsblogs.typepad.com/h5n1/2...ep_cats_a.html

    Hello moh sir,

    You highlighted this post to ask for clarification? It is a good pick. I am glad that you pointed this out because I recently asked Dr. Niman of Recombinomics about this, and whether or not the situation had changed.

    Here is the question. Are people in Indonesia now being infected by their poultry? Some of us did not think so previously because the sequences from the people and the poultry did not match. As noted above, the human sequences most closely matched a cat in the area. But, things have changed. I hope that this clarifies this for you, if not ask again.

    http://www.curevents.com/vb/showpost...6&postcount=11
    Last edit by indigo girl on Jun 21, '10
  6. by   indigo girl
    Quote from moh_sir
    The situation in England regarding the finding of H5N1 avian flu in the Bernard Matthews turkey sheds is very confusing. The story keeps changing, and not for the better. I am going to post a few links to show you just how crazy this is getting. I am having a difficult time understanding all of this, so if you find it so, don't be surprised...

    First, I'll let the Reveres at Effect Measure have their say:
    http://scienceblogs.com/effectmeasur...on_th.php#more

    Then, let's look at what the UK gov't is saying:
    http://www.flutrackers.com/forum/sho...80&postcount=1

    Unfortunately, this study does not seem to agree with their assessment about transmissibility thru the GI tract, and it should be pointed out that some victims (since deceased) have had the consumption of contaminated food as their only risk factor.
    http://www.flutrackers.com/forum/sho...81&postcount=2

    Last, but not least, there is this story of a worker, who participated in the cull. He was bitten by a turkey, and his wound was cleaned with ALCOHOL?
    He was not given Tamiflu until after his mother's doctor in Portugal insisted that he go to the hospital. By this time, he has flu s/s according to this post:
    http://www.flutrackers.com/forum/sho...87&postcount=1

    The only section here that I would comment on is the last one about the culler. We never heard any more about this culler from Portugal so it is likely, he was probably never infected.

    What was your question?
  7. by   Laidback Al
    Quote from indigo girl
    Thank you for clarifying. I found the subject of clusters interesting, and I was open to nonlocality's interpretation, but do not necessarily agree with it. My first question however, would be this. We know that suspect cases are being given Tamiflu. What are the chances that at least some of these cases are really positive? Are they really testing everyone before treating with Tamiflu? My guess is that we will never know. The information coming out of Indonesia at present is scant since their disagreement about sharing isolates.

    I believe Monotreme also interpreted the info as possibly meaning people were being infected from a common source.
    Monotreme's definition (which I use as well) simply identifies groups of individuals who are all infected within a short time span in localized geographic area. The source of the infection of these individuals is still an open question for me and probably for Monotreme. It is often assumed that most of these human infections result from a common exposure to poultry, but there appears to be at least several clusters where human-to-human (H2H) transmission has occurred. Alternatively, as Niman, Monotreme, and others have suggested, the source of human infection could be also be a common mammalian reservoir such as cats.

    Your question about the treatment protocols for Tamiflu is a good one. We do not have the information to know how and when individuals are selected for treatment with Tamiflu. It seems clear that Tamiflu can affect the quick-test results, i.e. there can be false negatives. Without follow-up antibody testing, we will not know if any of the individuals with influenza-like symptoms that were administered Tamiflu were actually infected with the H5N1 virus and recovered.
  8. by   indigo girl
    Quote from Laidback Al
    We do not have the information to know how and when individuals are selected for treatment with Tamiflu. It seems clear that Tamiflu can affect the quick-test results, i.e. there can be false negatives. Without follow-up antibody testing, we will not know if any of the individuals with influenza-like symptoms that were administered Tamiflu were actually infected with the H5N1 virus and recovered.
    What is troublesome is that so many people were treated with Tamiflu in Indonesia. We don't have the information so we really do not know. I was remembering this article. Unfortunately the Fluwiki link does not seem to work so I am using the curevents.com link.


    http://www.curevents.com/vb/showpost...5&postcount=79
  9. by   indigo girl
    Another positive case in Indonesia in a 20 yr old woman:
    http://afludiary.blogspot.com/2007/0...-new-case.html

    And what about those many other cases that we never hear any follow up on?

    The Avian Flu Story Graveyard:
    http://afludiary.blogspot.com/2007/0...graveyard.html
  10. by   indigo girl
  11. by   indigo girl
    You have to read this. Lots to think about , and much commentary from different sources. The area of concern, relates to comments from the Egyptians that indicate, they are worried that H5N1 is becoming more virulent. Keep in mind, this virus may present in different ways. It may not look like a respiratory virus at all in some cases. We are all still learning about what it is capable of.

    You can listen to the BBC broadcast if the link is still working.

    Many thanks to Theresa42 for her tireless efforts in translation, and for all of the info that she provides. And, FlaMedic, thanks for letting me use your essays. I could never write nearly as well as you do.
    http://afludiary.blogspot.com/2007/0...s-mutated.html
    Last edit by indigo girl on Mar 14, '07
  12. by   indigo girl
    A 10 year old Egyptian girl has tested positive for H5N1. So far this season, we have had 4 and 5 year old kids that survived, and another 4 year old still in the hospital. I am concerned that this is a school age child. The younger kids did well. I hope that it will not matter what her age is, and that she will recover and go home to her family.
    http://www.flutrackers.com/forum/sho...11&postcount=2
  13. by   indigo girl
    The Fight Over Vaccines Gets Ugly - Commentary Avian Flu Diary

    Well, it was bound to, wasn't it? When you have such a critically important commodity, in miniscule supply, and a great need, it will get uglier still.

    Personally, I am not going to count on it because I do not expect that it will be available in time. How could it be?

    It looks like most of us will be relying on what worked in the past or researching alternative remedies when there is nothing else available.


    http://afludiary.blogspot.com/2007/0...gets-ugly.html

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