Re: Pandemic Flu - Thread II

Originally Posted by indigo girl

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. It is because it has the POTENTIAL to kill millions.

Exactly, it has the POTENTIAL to kill millions. Yet the word pandemic is thrown around as if it's a sure thing. And yes it is mutating, although I wouldn't describe it as "rapidly"...not moreso than various other viruses. Show me conclusive proof of antigenic shift and then I'll be concerned...but you keep citing people such as Dr. Niman who hasn't published a peer-reviewed paper since the mid-1990s. Which credible and non-biased source has validated these claims? Not to mention Dr. Niman owns Recombinomics Inc...any guess as to what they are filing patents for? This makes me wonder what Dr. Niman's motives are in all of this. Especially when:

-Again, no peer reveiwed paper since the mid 90s
-Klaus Stöhr who is a bird flu expert at the WHO, calls Niman leads "far-fetched,"
-The journal Science has debunked Niman's last human-human transmission theory involving swine (via antigenic shift).
-Dr. Martin Williams, who also covers H5N1, has stated his direct quote about Dr. Niman : "Niman pours forth a veritable stream-of-consciousness series of commentaries, taking news tidbits from here and there and concocting some truths, and a generous helping of pure baloney." "He's just prolific, It's just scaremongering. People like to read it and get excited."


Frankly, Dr. Niman's motives and credibility are questionable at best. And more importantly, all I am saying here is we must be careful with sensationalized statements that equate to fear-mongering. Sure every time a human is infected, it offers the potential for an adaptation allowing to the increased ability to infect humans...but exactly how often does such a situation occur? We're running with 'possibility' instead of 'probability' here.

Originally Posted by indigo girl

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.

I agree fully, when it does occur I too will be concerned. *when* it occurs.

Originally Posted by indigo girl

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.

No surprise, just a question posed to validate claims. And yes, actually you can can argue with lab analysis. This is like statistics, where "facts" can be strewn to make points. For example, they proved that "human to human" occured, and that "analysis of viral sequences" provied it. Fine, nice use of ambiguous terms there...but I'd need a bit more information on the scope of the project, some details/clarifications...the controls maybe. That is why "facts or facts" doesn't quite hold up, and the "facts" change for many areas every decade or so. Remember when it was better to place a baby on it's tummy instead of it's back? That was based on facts...

Originally Posted by indigo girl

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.

Please make no mistake, I take this potential very seriously. However, I like to remind myself that I am absolutely in love with a field based in science. Because of this, I am fond of approaching issues in a scientific manner and keeping everything in perspective. Fact is, this is such a big issue because the media has made it one...while ignoring issues such as in my past post concerning our exacerbating the problem with bacteria.

I commend your efforts in tracking this issue. If this does break out into a pandemic, I'll tout you as a true hero. And hey it is an issue and it is dangerous, it DOES warrent coverage. So please understand that I am not trying to be critical of you or your efforts here. I am merely offering the other side here, making sure people are informed enough to honestly make decisions for themselves. I'd imagine with your impressive experience as a nurse that you've seen plenty of people who would take one side of the story and run with it...I'm just trying to make people stop for a moment and think a bit before taking off

Take care and good luck with your research.

Re: Pandemic Flu - Thread II

Originally Posted by Cosper123

Exactly, it has the POTENTIAL to kill millions. Yet the word pandemic is thrown around as if it's a sure thing. And yes it is mutating, although I wouldn't describe it as "rapidly"...not moreso than various other viruses. Show me conclusive proof of antigenic shift and then I'll be concerned...but you keep citing people such as Dr. Niman who hasn't published a peer-reviewed paper since the mid-1990s. Which credible and non-biased source has validated these claims? Not to mention Dr. Niman owns Recombinomics Inc...any guess as to what they are filing patents for? This makes me wonder what Dr. Niman's motives are in all of this. Especially when:

-Again, no peer reveiwed paper since the mid 90s
-Klaus Stöhr who is a bird flu expert at the WHO, calls Niman leads "far-fetched,"
-The journal Science has debunked Niman's last human-human transmission theory involving swine (via antigenic shift).
-Dr. Martin Williams, who also covers H5N1, has stated his direct quote about Dr. Niman : "Niman pours forth a veritable stream-of-consciousness series of commentaries, taking news tidbits from here and there and concocting some truths, and a generous helping of pure baloney." "He's just prolific, It's just scaremongering. People like to read it and get excited."


Frankly, Dr. Niman's motives and credibility are questionable at best. And more importantly, all I am saying here is we must be careful with sensationalized statements that equate to fear-mongering. Sure every time a human is infected, it offers the potential for an adaptation allowing to the increased ability to infect humans...but exactly how often does such a situation occur? We're running with 'possibility' instead of 'probability' here.



I agree fully, when it does occur I too will be concerned. *when* it occurs.


No surprise, just a question posed to validate claims. And yes, actually you can can argue with lab analysis. This is like statistics, where "facts" can be strewn to make points. For example, they proved that "human to human" occured, and that "analysis of viral sequences" provied it. Fine, nice use of ambiguous terms there...but I'd need a bit more information on the scope of the project, some details/clarifications...the controls maybe. That is why "facts or facts" doesn't quite hold up, and the "facts" change for many areas every decade or so. Remember when it was better to place a baby on it's tummy instead of it's back? That was based on facts...



Please make no mistake, I take this potential very seriously. However, I like to remind myself that I am absolutely in love with a field based in science. Because of this, I am fond of approaching issues in a scientific manner and keeping everything in perspective. Fact is, this is such a big issue because the media has made it one...while ignoring issues such as in my past post concerning our exacerbating the problem with bacteria.

I commend your efforts in tracking this issue. If this does break out into a pandemic, I'll tout you as a true hero. And hey it is an issue and it is dangerous, it DOES warrent coverage. So please understand that I am not trying to be critical of you or your efforts here. I am merely offering the other side here, making sure people are informed enough to honestly make decisions for themselves. I'd imagine with your impressive experience as a nurse that you've seen plenty of people who would take one side of the story and run with it...I'm just trying to make people stop for a moment and think a bit before taking off

Take care and good luck with your research.

Dr. Niman's view about recombination being the principle driving force for viral evolution is controversial. I would not argue that point. That his work with viral sequencing is aimed toward predicting vaccines in no way diminishes his contributions to the ungoing research and discussions regarding avian flu. Personally, I believe he is correct. He appears to be interested in patents not publishing. But, this is not really about Niman anyway. He is just one scientist. He does not need me to defend him. There are links to many other sources provided in the two pandemic flu threads regarding viral mutation. How often does the opportunity for mutation have to occur? It just has to occur once in a sustainable form.

Dr. Martin Williams, the ornithologist, and conservationist that you mention, is himself somewhat controversial in that not every scientist would agree with his conclusions about H5N1 and wild birds. He could be considered to have an agenda. I thought his conclusions were interesting, but at odds with what other scientists were saying about H5N1. Does this make him wrong not necessarily about everything. I am very sympathetic to what he is saying because I am a birder. In his own way, he is just as fixated in his view of things as Niman is. Moral of the story, scientists can be proven wrong about some things, but be right about other things. So I would not negate him nor Niman. Time will tell, just as it will with Niman's predictions some of which have already proven to be correct. I have been unable to locate any peer reviewed papers that Dr. Williams has published. On his site, he says he has published articles in some magazines. I thought I had read a paper by him, but have not been able to locate anything. BTW, again on his site, he makes disparaging remarks about Dr. Webster of St. Judes, Dr. Nabarro at the UN, etc. also. I thought that this article that he wrote was of interest but it's not not in a peer reviewed journal: Farm fish fed dead chickens a risk for H5N1 influenza in Indonesia?

Scientists like nurses frequently disagree. I think that adds to the discussion. They also sling mud at each other.

This is what Klaus Stohr, at the WHO, the other scientist that you mentioned, is saying about the threat estimate which in reality is what I am interested in:
Dr. Klaus Stohr | "A Ticking Time Bomb in Your Backyard"

Your statement that this is a big issue because the media has made it one, is your perception, and not necessarily invalid. This risk communicator addresses the downplaying of risk by reporters. My own experience has been that large sectors of the public have no knowledge about risk at all. But, that is my perception.
Peter Sandman Column: Pandemic Influenza Risk Communication: The Teachable Moment

Originally Posted by //www.psandman.com/col/pandemic.htm#no-1

Despite the numbers game, H5N1 experts are doing their best to sound the alarm. But other information sources seem to be muting the alarm. This includes some stunning examples from government health agencies, medical newsletters, and others who ought to know better. And it includes some examples from journalists, who might have been expected to err on the sensationalist side instead. It’s as if these other communicators can’t quite believe what the experts are telling them, and keep toning it down to something they consider less “panic-provoking” and more “responsible.” We’re not sure if this toning down is conscious or unconscious, intentional or naive. But it is common.

If CIDRAP, CDC, and the WHO believe two generations of human to human transmission have occurred, I have no reason not to believe it. They don't have to explain the lab experiment or testing to me. To make such a statement, would have taken a lot of verification of the results because it is such a major admission for them to make. I am certain that they would not have done so unless they were positive. I believe that they are being extremely careful about anything they say.

If the US government is telling people to have some food, water, and supplies put away for a "potential" pandemic, I think that they mean it. When they say you are responsible for your own preparations, I believe them. Self reliance is a really good idea. I can think of many reasons to do this anyway, and no reason not to. We did discuss this in thread one. Who would want to be in line at a store after any kind of emergency was announced? If nothing happens you are ready for flood, hurricane, blizzard, whatever.

BTW, I agree with you about the bacteria, but I just don't have any spare time left to study any thing else. I think longingly of dengue fever...I would just like to add that it would be helpful in the future if you could provide links to your sources of discussion. And, be careful about personal remarks like the "hero" reference. I'm not going to take it personally, but some people might. Good luck to you too, Cosper123. I have enjoyed our discussion. I hope that you and yours stay well.

Re: Pandemic Flu - Thread II

H5N1 in India in Feb 2006
http://timesofindia.indiatimes.com/a...59,curpg-1.cms

Originally Posted by //timesofindia.indiatimes.com/articleshow/msid-223059,curpg-1.cms[/url

... the virus that hit India, ... had mutated and undergone a re-assortment in Turkey.
...the virus, which had originated in Qinghai...was carried to Turkey by migratory birds. Here, the virus mutated and mixed with the Vietnamese strain. The mixed strain was then brought to India by migratory birds. This phenomenon of being hit by a re-assorted virus has not been reported from any other country over the past four years.

Re: Pandemic Flu - Thread II

A Public Heath Director in Arizona Gets Point Across Via Newspaper Article:
http://www.zwire.com/site/news.cfm?n...d=222077&rfi=6
-------------------------------------------------------------------------------------
Influenza Virus - Science Background I - from Effect Measure:
http://scienceblogs.com/effectmeasur...kgr_4.php#more
-------------------------------------------------------------------------------------
An example of scientists disagreeing with each other about what the research is showing:
http://bodyandhealth.canada.com/chan...id=1020&rot=11

Re: Pandemic Flu - Thread II

The Egyptian woman admitted to the hospital on Oct 4th has died despite treatment
with Tamiflu and advanced medical care:
http://www.alertnet.org/thenews/newsdesk/L3068642.htm
There is another suspected new case in the same region, and reports are saying
five cases are possible.
Bloomberg subscription service is reporting this.
http://www.gom.net.eg/gom1/gom.shtml
Human Bird Flu Case Reported in North Egypt, Al Ghomhuria Says
2006-10-30 02:42 (New York)

Originally Posted by ://www.gom.net.eg/gom1/gom.shtml

Oct. 30 (Bloomberg) -- A suspected case of human bird flu has been reported in the northern Egyptian governorate of Gharbiyah, raising the number of possible infected humans in
the area to five, al-Ghomhuria reported, citing a local hospital.
A 23-year-old woman in the city of Tanta was suspected of having symptoms of avian flu and was transported to a local hospital, the Cairo-based newspaper reported......

Re: Pandemic Flu - Thread II

This article makes several interesting points, not the least of which is that we do
not know, how we are going to tell if we are close to a pandemic situation.
http://www.latimes.com/news/printedi...news-a_section

Originally Posted by //www.latimes.com/news/printedition/asection/la-sci-birdflu31oct31,1,2393002.story?coll=la-news-a_section

The researchers ... said the vaccine administered to birds in China was ineffective against the strain and may have facilitated its proliferation ... by eliminating weaker flu strains.

"... they're basically driving the evolution" of H5N1, said Henry Niman, president of a virus and vaccine research company in Pittsburgh called Recombinomics Inc. who was not involved with the study.

"There seems to be a lot more of the virus around in 2006 than in 2005," ...a dominant strain is also more likely to spread widely. That has happened twice since H5N1 was first identified in China in 1996.
The first wave of outbreaks were limited to Asia, but the second wave traveled from western China's Qinghai Lake in 2005 to Europe and Africa — and continues to spread. "Now", said lead author Dr. Yi Guan,..."we believe it is likely a third wave has already started."

Vaccinating poultry against H5N1 amounts to "a huge natural experiment," said Dr. Scott P. Layne, an epidemiologist at the UCLA School of Public Health. "By vaccinating we're manipulating the virus' evolution....

David Nabarro, who coordinates the United Nations' efforts against human and avian influenza, said the new data were a reminder that H5N1 was constantly evolving.
"I don't think it's a sign that we're getting any closer to pandemic flu," Nabarro said. "Frankly, I don't know how we're going to know when pandemic flu gets close. We're just going to get hit by it."

Another article: http://www.ajc.com/news/content/shar...COX_W6947.html

Originally Posted by //www.ajc.com/news/content/shared/news/stories/2006/10/PANDEMIC31_COX_W6947.html[/url

Frederick Hayden, a University of Virginia virologist ...with the World Health Organization's pandemic preparedness program, said the genetic changes described by Webster and his colleagues "appear to be unprecedented, and we don't know what's driving that."

Re: Pandemic Flu - Thread II

Influenza Virus - Science Background II - from Effect Measure:
http://scienceblogs.com/effectmeasur...kgr_1.php#more

http://scienceblogs.com/effectmeasur...me_stories.php

Re: Pandemic Flu - Thread II

I have been following this issue for about a year and may be able to contribute to the discussion.

There is an excellent website called the www.FluWikie.com which allows anyone to collaborate of this challenge. There are links to clinical studies of H5N1, science of influenza, online classes, videos, preparedness information, infection control, foreign language resources, hundreds of pages from many authorities. It really is the central non-governmental source of pandemic information. I hope that you visit the site and participate by contributing your experience to the pages there. For example if you know about treating Fever then simply go to that page click Edit and type your info then click Save. You will need to note a summary of what you added and a username like here. Spam is removed daily. I find using the Index and the Site Map are easy ways to navigate the site.


I put together many useful files onto a cd which is a great way to share a lot of information. This can help reduce the learning curve for thouse new to the subject. The cd can be downloaded from the website or you can contact me for a copy. Some of the info is copyrighted (WHO, CDC, etc) so I do not sell the discs. See www.pandemicreferenceguides.com It is not fancy and suggestions are always welcomed. There is also a 200 page file that is made of several documents which would be useful to have available printed for reference.

Regarding the herbal treatment of influenza, I would only bet my life on supplements which have proven efficacy. The link to the Master Flu Tonic on CurEvents is not based on scientific research. The first issue is that the H5N1 virus replicates very fast, can hit the ON button for immune response creating a cytokine storm and possibly Acute Respiratory Distress Syndrome. Shannon of CurEvents posted a good summary of her research is here. I also plan to take supplements for anti-influenza properties. References from studies in PubMed are cited here.

For ARDS some patients are given OXEPA. The nearest non-prescription equivalent might be Fish Oil and Borage Oil. There is also a evidence that statins may improve outcomes but there is no silver bullet when it comes to ARDS.

Keep up the good work! We need all the help we can get.

Here is the About section of the FluWiki...
The purpose of the Flu Wiki is to help local communities prepare for and perhaps cope with a possible influenza pandemic. This is a task previously ceded to local, state and national governmental public health agencies. Our goal is to be:

• a reliable source of information, as neutral as possible, about important facts useful for a public health approach to pandemic influenza
• a venue for anticipating the vast range of problems that may arise if a pandemic does occur
• a venue for thinking about implementable solutions to foreseeable problems

No one, in any health department or government agency, knows all the things needed to cope with an influenza pandemic. But it is likely someone knows something about some aspect of each of them and if we can pool and share our knowledge we can advance preparation for and the ability to cope with events. This is not meant to be a substitute for planning, preparation and implemntation by civil authorities, but a parallel effort that complements, supports and extends those efforts.

Re: Pandemic Flu - Thread II

Hello Fredness,
I am glad that you have posted here. I am very much aware of Fluwiki, and the other sites, and have no hesitation recommending them to those who are interested.
We do have to be very careful about recommendations regarding any herbal remedies. Everyone on this site knows that we are not allowed to give medical advice as per the TOS.
So anything other than medical care is not a substitute for what your doctor may give you. That said, I agree that herbals, statins, and I would add homeopathic information should be made available also, and that you should go to Fluwiki or Flutrackers to get that information. Realistically, Tamiflu may not be available for everyone, and may not be effective for everyone. I think that out of necessity, you may need other information, and that is why you should know where to find it.
My own personal choices are a little different from Fredness, but the thinking behind it is much the same. Anyone should feel free to PM to discuss this at any time.

Re: Pandemic Flu - Thread II

I am not a physician and did not intend to offer medical advice. Simply sharing time I spent reading studies in PubMed and personal conclusions.

Watching the Update on AntiViral Drugs and Strategies For Their Use from the University of Washington Regional Pandemic Influenza Conference, I was suprised to see the spike in amantadine resistance of the H3N2 strain go from 20%-90% in 2003. Bad news. Just as HIV treatments may include multiple antivirals we may need to consider the same for H5N1. Some of the studies cited describe how some plants increased the efficacy of amantadine/rimantadine.

I am reading parts of The Great Influenza by John Barry. There are more than a few alarming pages in that book. p. 348 says "in some areas the mortality rate reached 30%". I understand the avg was 2% but apparently that was not the case everywhere. We need all the help we can get.

A big discussion on the FluWiki now is the role of Public Health Officials in educating the public. I don't see the gov't website www.pandemicflu.gov advertised to the degree that you would expect considering the gravity of the message that it conveys. There appears to be a great chasm between the scientists and the media attention. There are pages and pages of plans from various departments but how much is being put into the hands of the public? It is rare to find an official to publicly advise people to prep for 3 months of possible isolation but that seems to be a minimum consensus based on experience and models. The Institute of Medicine held a workshop on the The Role of Community-Based Mitigation Strategies During an Influenza Pandemic

Non pharmaceutical intervention is a big part. (We know that pharmaceutical interventions will be insufficient.) They concluded early school closure could reduce the peak which also reduce the strain on healthcare providers. Determining the trigger of when to is the hard part. One presenter estimates is that if a pandemic on the scale of 1918 happened today we would lose as many childen as die from all causes in 20 years.