Re: Pandemic Flu - Thread II

Originally Posted by fusster

Well I'm just worried about if there's an outbreak and it becomes contained, is there still a risk of getting the bird flu days/weeks/months later by touching something the patient may have come into contact with? The fact that it can be in the water is really scary as well.

I would think infection controls measures such as wiping down door knobs, and discarding soiled linen the way we do now is going to help. Bleach should be stored. My concern would be large numbers of patients in a health care facility. Will there be enough clean linen? Meds? Food? Picture that hospital in Katrina with no power, no supplies. I have seen plans in one facility for establishing an on site morgue. They believe this is respiratory, but I would be careful with anything infected.


Drinking water will become a problem if many are sick and the treatment plants can not do their job. That is why storing bottled water or your current tap water is advised.

They do say, however, if pandemic occurs it will be in waves, months apart.
The model they base this on of course is the 1918 pandemic.

Re: Pandemic Flu - Thread II

75 deaths worldwide in 16 years since this strain has been around. to put that into perspective we have 550,270 deaths to cancer every year according to the CDC...in the USA alone.

However, that number has steadily increased in the last 5 years or so, but again, lets put that into perspective. Where has this increase been? Oh yes, in countries where people have a tendancy to live amongst their animals and have poor sanitation systems/habits.

In addition comments such as this do not help - "Human to Human to Human spread of H5N1 was observed in Karo, Indonesia, earlier this year."

As some may have noticed, no source was sited here. And for such a ground-breaking revelation as human to human transmission...I hate to be a stickler for the details...but I'd like a credible source. I ask this not just to be difficult, but as I said this is a serious claim to be throwing around so lightly just to make a point. Lets discuss this serious matter on the merits of truth, not propaganda and scare tactics. In the spirit of such a discussion, I offer this tidbit -

The failure of the twenty human isolates to match the 50 avian isolates suggests birds are not the source of H5N1 in most of the human cases in Indonesia. - courtesy of the World Health Organisation

Please take the time to consider that this merely says that in the situation in Karo, Indonesia...that transfer between the 50 isolates from the birds they had, didn't match the cases that the human isolates were derived from. This doesn't mean it was human to human, as this statement does not take a lot into consideration. And this my friend, was the closest thing I could find to validate your 'sky is falling' claim that it is transmittable between humans.

At the very best at this point, we can assume/deduct that some guy with pidgeon feces on him shook hands with another guy who then got it as well. That sounds like more of a fomite situation to me, not human to human trasmission. And until we've approached this with a rational assessment of what really happened (like maybe, say...along the lines of the scientific method?) then we really have no place making such grand accusations of human to human transmission.


Yeah last great flu pandemics were in...1901 and 1918...we're due. And with greater populated cities, public transportation, etc. we are prime for a big whopper. But also take into consideration we don't live as in close proximation with livestock as we once did...and those who do in rural areas are still heavily isolated to rural areas. Yes there are migratory birds that come well into the cities and such...but when is the last time YOU got bombed by a passing pidgeon or had to scrape up duck feces in the park. So your biggest risk by far will be that fellow nurse who lives on a ranch somewhere on the outskirts of the city. Just avoid them if they don't look like they bathe often...there, pandemic solved

In the end it's a flu...do what you'd do to prevent any flu. Eat well, take your vitamins, get plenty of sleep, etc. If you believe the cytokine dysregulation information then eat nothing but candy bars and take up smoking (not really a good idea boys and girls, remember the flu is a respiratory infection...you should probably just drink heavily )

Most importantly....wash your hands, wear a mask around someone coughing and sneezing without covering themselves properly, and if you have a habit of frequently putting your hands in your mouth or eyes then stop

All in all IMO you people need to be much more concerned with bacteria

Yes the bird flu should be taken seriously, but not moreso than many other things as I see it. I mean what can we really do against this flu anyhow? Not like vaccines are gonna help, they are after all a shot in the dark and completely useless if it does become transmitable between humans...because it would have undergone either antigenic shift or antigenic drift at that point. Your biggest precautions are the ones I listed above...avoid sickly people (again, wear a mask if they aren't covering up their sneezes and coughs properly), wash your hands, practice good hygiene in general, and avoid touching your mouth and eyes unless you have just washed your eyes.

Bacteria on the other hand...the medical field and patients are actually helping that problem.

So yeah, if anything is going to keep me up at night...it's the impending doom of the suped up bacteria strains.

Re: Pandemic Flu - Thread II

Dr. Niman's commentary on the recent USDA report on birds tested in Michigan: http://www.recombinomics.com/News/10...gan_Again.html

Originally Posted by /www.recombinomics.com/News/10270603/H5N1_Michigan_Again.html

The USDA site suggests the isolation failures were due to a lack of viable H5N1, but viability is dependent on isolation procedures and each test has a detection limit, and results indicate the sensitivity of the isolation procedure is lower than the PCR test. This detection limit may also be impacted by handling, shipping, and pooling of samples.

Dual infections may also limit isolation and dual infections are common in wild birds as indicated by the isolation of H5N3 and H6N2 from H5N1 positive samples.

An alternative approach for detecting high path H5N1 involves sequence analysis. Recombination is common between H5N1 and low path serotypes, including H5.

Re: Pandemic Flu - Thread II

UN holds avian flu meeting in Iran:
http://birdflubreakingnews.com/templ...1847135506.htm
------------------------------------------
WHO to report on ethical issues in pandemic planning:
http://www.cidrap.umn.edu/cidrap/con...ct2706who.html

Originally Posted by www.cidrap.umn.edu/cidrap/content/influenza/panflu/news/oct2706who.html

...the discussions focused on four main topics: equitable access to therapeutic and prophylactic measures; ethical aspects of interventions such as quarantine and social distancing; what healthcare workers should be expected to do during an outbreak and what obligations are owed them; and issues that arise between governments when developing a multilateral response to a pandemic...

"The recognition that emerged very strongly [at the meetings] was that it was going to be essential to have public engagement in all aspects of planning and a frank and candid recognition that the questions of the pandemic are going to be not just technical questions, but also ethical questions," Capron said.

In response to a question about vaccine rationing, Capron said, "One of the things that emerged very strongly is the necessity for good ethics to rest on good facts." Some at the meeting challenged the assumption that children and elderly people will be at greatest risk, and suggested, he said, that health agencies may need "contingency plans depending on what the virus turns out to be like, how it behaves."

Re: Pandemic Flu - Thread II

http://www.curevents.com/vb/showpost...06&postcount=1

I took a class in Herbal Medicine years ago, sponsored by the Sisters of the Medical Mission. They were missonary nuns, who were also registered nurses. I think this is the formula that they used for colds. I was very happy to find this. Will it help for flu? I really don't know, but in the absence of Tamiflu or if it doesn't work, at least this is safe for children as you can see by the ingredients. Getting them to take it, on the other hand...

I should mention, however, that it looks like health care workers and their families as well as emergency personel (police, fireman), and water treatment workers, etc., will be given Tamiflu if it is available. This is not a substitute for whatever your doctor would give you. It is a mixture of herbs that people already commonly eat, and therefore safe unless of course, you have an allergy.

This would be antiviral due to the garlic and onion. Probiotic due to the type of vinegar used. And, will bring up phlegm, useful to prevent pneumonia.

Wear gloves, and glasses if you make this. The peppers are hot. Someone on the blog I found this on, said their daughter mixes some with chocolate and puts it on ice cream. Actually, it's not a bad idea if you like that type of thing.

Re: Pandemic Flu - Thread II

I did not notice your post until this AM hence the delay in responding. I don't mind having a dialogue with you about this topic. And, I think that actually, you are somewhat concerned about this. You should have some reasonable concern but, the sky is not falling.

Originally Posted by Cosper123

75 deaths worldwide in 16 years since this strain has been around. to put that into perspective we have 550,270 deaths to cancer every year according to the CDC...in the USA alone.
However, that number has steadily increased in the last 5 years or so, but again, lets put that into perspective. Where has this increase been? Oh yes, in countries where people have a tendancy to live amongst their animals and have poor sanitation systems/habits.

Yes, indeed the cases are occurring there. I assume that you mean it is irrelevant to the rest of the world because we don't live like that. But, if
you think that, you have missed the point. And, here it is:

http://www.cidrap.umn.edu/cidrap/con...ts/panflu.html

Originally Posted by www.cidrap.umn.edu/cidrap/content/influenza/panflu/biofacts/panflu.html

Inefficient transmission of current H5N1 strains may be related to lack of appropriate avian virus cell receptors in the upper respiratory tracts of humans and the inability of H5N1 strains to recognize human cell receptors (see References: Shinya 2006). A mutation allowing H5N1 avian influenza virus to recognize human cell receptors could enhance person-to-person transmission owing to the potential for greater viral replication in the upper respiratory tract.

The fact is that this virus is mutating rapidly. Check out all of the posts quoting Dr. Niman referring to this. Every time a human is infected, it offers another opportunity for adaptation allowing for the increased ability to infect humans. This is why milions and millions of dollars are being spent all over the world on this problem. It is because it has the POTENTIAL to kill millions. And, it does not matter that it is way over there in a poor country like Indonesia, where the people live with their chickens under unsanitary conditions. Those are, however, the ideal conditions for a mutation to occur. Where and how they live is an irrelevant point, with regard to dismissing the risk to the rest of the world.
Migrating birds may not bring this virus here, but people certainly will if it does become as transmissible as any other flu. Keep in mind, you are contagious before you even know you have it. One patient who got on a plane infected many, many others with SARS. SARS is not as contagious as influenza, BTW.

Originally Posted by www.cidrap.umn.edu/cidrap/content/influenza/panflu/biofacts/panflu.html

Public health officials are closely monitoring the ongoing occurrence of H5N1 avian influenza in humans and watching for the emergence of a strain capable of causing sustained human-to-human transmission.

The fact that it is occurring in Indonesia is not influencing the amount of concern. They are watching for "sustained" transmission. If that occurs, then we do not know what will happen, but it will be great cause for concern.

Originally Posted by Cosper123

In addition comments such as this do not help - "Human to Human to Human spread of H5N1 was observed in Karo, Indonesia, earlier this year."
As some may have noticed, no source was sited here. And for such a ground-breaking revelation as human to human transmission...I hate to be a stickler for the details...but I'd like a credible source. I ask this not just to be difficult, but as I said this is a serious claim to be throwing around so lightly just to make a point. Lets discuss this serious matter on the merits of truth, not propaganda and scare tactics.

If you had been following all the information on both threads, this would not have been a surprise. But, there is an awful lot of information, so you could have missed it. They say "sustained" person to person has not happened yet. They don't deny that human to human has occurred.
Or that human to human to human has occurred. How do they know this?
In the Karo cluster, which is the Indonesian cluster, referred to here, it was proven in the lab with analysis of viral sequences. You can't argue with lab analysis. Facts are facts.

Originally Posted by [url

www.cidrap.umn.edu/cidrap/content/influenza/panflu/biofacts/panflu.html][/url]
The high case-fatality rate suggests that the pathogenicity of H5N1 may be similar to the 1918 H1N1 pandemic strain. Researchers have hypothesized that cytokine storm (ie, overproduction of cytokines) may have played an important role in the pathogenesis of the 1918 pandemic strain. A laboratory-based study involving H5N1 strains taken from ill humans in Asia (during 1997 and 2004) and an ordinary current H1N1 strain (circulating in Asia in 1998) found that all the H5N1 viruses caused human alveolar cells and bronchial epithelial cells to secrete significantly higher levels of various cytokines and chemokines than did the ordinary virus (see References: Chan 2005). Another recent study demonstrated a strong induction of chemokines and their receptors in macrophages infected by H5N1 and H9N2 avian influenza viruses (see References: Zhou 2006). Finally, a recent case series reported from Vietnam involving patients with H5N1 influenza showed that high viral load and high chemokine and cytokine levels are central to the pathogenesis of H5N1 influenza (see References: de Jong 2006). These findings support the role of cytokine storm in the pathogenesis of H5N1.

I hope this helpful to you. You can PM me anytime for any suggestions or questions if you feel the need. I do realize that with all the other diseases with higher numbers of fatalities at this time, it is very difficult to take this seriously.

Stay healthy,

indigo

Re: Pandemic Flu * Thread II

1918 * The enemy within:

http://www.historynet.com/magazines/...featured=y&c=y

Re: Pandemic Flu - Thread II

Pregnancy and Influenza Planning, commentary from Effect Measure on the serious need to address this issue in any planning:

http://scienceblogs.com/effectmeasur...nni_1.php#more

Re: Pandemic Flu - Thread II

CIDRAP - Just released on Oct 27 2006, a report on avian influenza and implications for human disease:
http://www.cidrap.umn.edu/cidrap/con...flu_human.html

Originally Posted by www.cidrap.umn.edu/cidrap/content/influenza/avianflu/biofacts/avflu_human.html

Outbreaks of influenza have been recognized in domestic poultry (chickens and turkeys) for many years. Avian influenza strains in domestic chickens and turkeys are classified according to disease severity, with two recognized forms: highly pathogenic avian influenza (HPAI), also known as fowl plague, and low-pathogenic avian influenza (LPAI). Avian influenza viruses that cause HPAI are highly virulent, and mortality rates in infected flocks often approach 100%. LPAI viruses are generally of lower virulence, but these viruses can serve as progenitors to HPAI viruses. All HPAI strains identified to date have involved H5 and H7 subtypes.
Human infections caused by avian strains have been associated with both HPAI and LPAI strains (H5, H7, and H9) (see References: HHS 2005: Pandemic influenza plan).
Evidence that HPAI strains arise from LPAI strains has led the World Organization for Animal Health (OIE) to classify all H5 or H7 strains as notifiable (see References: Alexander 2003, Capua 2004, OIE 2005).


If H5N1 continues to circulate widely among poultry, the potential for emergence of a pandemic strain remains high. For example, H5N1 viruses have been found in pigs in southern China in 2001 and 2003 (see References: Cyranoski 2004), and human H3N2 influenza viruses are endemic in pigs in that area. H5N1 has been reported in pigs in Indonesia as well (see Oct 10, 2006, CIDRAP News Story and see References: Cyranoski 2005). Thus, the conditions exist for exchange of genetic material between the different viruses in the pig host (see References: Li 2004; WHO: Avian influenza: update: implications of H5N1 infections in pigs in China).

Some scientists believe that reassortment between an avian and a human strain could occur in the human population without an intermediary host; if this proves true, as more humans become exposed and infected, the potential for reassortment with a human strain may also increase. It is also possible that a pandemic strain could emerge following a more gradual process of adaptive mutation in humans, which is likely what happened with the 1918 H1N1 pandemic strain (see References: Taubenberger 2005; WHO: Influenza pandemic preparedness and response 2005).

To date, sustained person-to-person transmission has not been recognized, although probable person-to-person spread was identified in Thailand involving transmission from an ill child to her mother and aunt (see References: Ungchusak 2005) and several other familial clusters have been recognized (see References: Olsen 2005: Family clustering of avian influenza A [H5N1]). In May 2006, WHO reported an H5N1 influenza cluster in Indonesia involving seven cases of person-to-person transmission; one of the cases involved two generations of transmission (see References: WHO: Avian influenza: Situation in Indonesia: Update 14 and see May 24, 2006, CIDRAP News story).

Inefficient transmission of current H5N1 strains may be related to lack of appropriate avian virus cell receptors in the upper respiratory tracts of humans and the inability of H5N1 strains to recognize human cell receptors (see References: Shinya 2006). A mutation allowing H5N1 avian influenza virus to recognize human cell receptors could enhance person-to-person transmission owing to the potential for greater viral replication in the upper respiratory tract.

Intensified surveillance in northern Vietnam suggests that the local strains are adapting to humans. These efforts have identified less severe cases, more infections in older adults, and a few family clusters that suggest person-to-person spread (see References: WHO Writing Committee of the WHO Consultation on Human Influenza A/H5 2005).

Re: Pandemic Flu - Thread II

Originally Posted by fusster

Well I'm just worried about if there's an outbreak and it becomes contained, is there still a risk of getting the bird flu days/weeks/months later by touching something the patient may have come into contact with? The fact that it can be in the water is really scary as well.

I just wanted to update this because I just read the following report today that does address your concerns more directly:
http://www.cidrap.umn.edu/cidrap/con...flu_human.html

Originally Posted by www.cidrap.umn.edu/cidrap/content/influenza/avianflu/biofacts/avflu_human.html

Physical characteristics of influenza A viruses
Viruses remain infectious after 24 to 48 hours on nonporous environmental surfaces and less than 12 hours on porous surfaces (see References: Bean 1982). (Note: The importance of fomites in disease transmission has not been determined.)
Influenza A viruses can persist for extended periods of time in water (see References: WHO: Review of latest available evidence on risks to human health through potential transmission of avian influenza [H5N1] through water and sewage). One study of subtype H3N6 found that virus resuspended in Mississippi River water was detected for up to 32 days at 4°C and was undetectable after 4 days at 22°C (see References: Webster 1978). Another study found that several avian influenza viruses persisted in distilled water for 207 days at 17°C and 102 days at 28°C (see References: Stallknecht 1990).
Recent data from studies of H5N1 in domestic ducks have shown that H5N1 can survive in the environment for 6 days at 37ºC (see References: WHO: Laboratory study of H5N1 viruses in domestic ducks).
Inactivation of the virus occurs under the following conditions (see References: OIE 2002, PHS): temperatures of 56ºC for 3 hours or 60ºC or more for 30 minutes; acidic pH conditions; presence of oxidizing agents such as sodium dodecyl sulfate, lipid solvents, and B-propiolactone; and exposure to disinfectants such as formalin and iodine compounds.