Re: Pandemic Awareness/Preparation

When a recession and a pandemic collide

http://www.scottmcpherson.net/journa...c-collide.html

Scott McPherson is the CIO (Chief Information Officer) of the Florida House of Representatives. He blogs on pandemic preparation in his spare time. He make a few points here. First, that Tamiflu is not the only antiviral that govt should be stockpiling for pandemic preparation especially given that one of our seasonal influenzas is now immune to it and that this could happen with bird flu. Next, he reminds us of the increasing importance of computer data, and that this is part of critical infrastructure.

Originally Posted by www.scottmcpherson.net

In Britain, even though its government is also dutifully doling out billions of pounds Sterling to banks and other institutions, its government has declared it is doubling its stockplie of antivirals -- and (wisely) increasing its reliance on the inhalant Relenza/zanamivir for prophylactic use by first responders and law enforcement/military.

What do the Brits know that we don't know?

I read the federal government's recent assessment of the fifty states' preparedness for a flu pandemic, and I am sorry, but I don't believe a word of it. It's not that I think anyone is lying, but I refuse to believe any state is truly, look-in-the-mirror-prepared for a killer pandemic with a mortality rate close to 1918's.

Why? I do not see any state moving beyond the 25% antiviral purchase goal. I see many states meeting their share of that 25% goal, but none really exceeding it.

Why? I see no state embracing innovative solutions, such as the co-administration of probenecid to effectively double the supply of Tamiflu.

Why? I don't think the feds can plan their way out of a wet paper bag.

Why? There is no emphasis on information technology data center and network professionals as among the first to need antivirals, particularly those in the public sector's own front lines of defense -- namely social services, law enforcement and unemployment assistance. Nowhere, in any federal pandemic document, do I see anything other than a cursory reference to "critical infrastructure" as even acknowledging the essential role that government data center and application developer and system engineer and network engineer and cybersecurity professional employees will play in a pandemic.

Computers will route the information that is needed for people to make decisions and move resources. Computers will tell us who is sick and where (look at the Google plan to match search expressions with geography and, in their plan, be able to predict where a pandemic has broken out). Computers will tell us how much of something is left and how much to ration. If data center people get sick (and because they work in enclosed spaces, they work in very close physical proximity to one another and they WILL get sick in disproportionate numbers to the general population), you will have staffing problems and you will have maintenance postponements and database reorgs gone undone and then you will have system failures. Big system failures.

Re: Pandemic Awareness/Preparation

Chinese expert issues new bird flu warning

http://news.xinhuanet.com/english/20...t_10775326.htm

I am behind on the bird flu news lately due to other obligations and illness. Meanwhile there are stories coming out of China, Indonesia, Vietnam, and Egypt. H5N1 is busy this time of year.

First a look at China which is not admitting to much viral activity but some news is leaking out as in this story from one of China's top scientists famous for his role in the SARS epidemic. Dr. Zhong knows the score.

Originally Posted by news.xinhuanet.com

A leading Chinese expert on respiratory diseases has warned the public to be aware that poultry can be infected with the bird flu virus but show no symptoms.

"Special attention should be paid to such animals, including those that have been vaccinated," said Zhong Nanshan.

"The existing vaccines can only reduce the amount of virus, rather than totally inactivating it," he said.

Zhong, an academician at the Chinese Academy of Engineering, is one of the scientists who helped control the spread of the Severe Acute Respiratory Syndrome, or SARS, in China in 2003.

His warning comes after eight human cases of the H5N1 strain of avian influenza have been reported across the country since January.

Zhong said he had noticed that more than half of those infected had no direct contact with birds and nor did they live in the areas where infected fowl with symptoms were reported.

China defends bird flu vaccination plan despite deaths

http://news.yahoo.com/s/nm/20090206/..._birdflu_china

As China defends its vaccination policy, claiming no outbreaks in poultry, dead birds positive for H5N1 are washing up on the shores of Hong Kong.

Originally Posted by news.yahoo.com

Apart from the discovery of a case during routine sampling in eastern China's Jiangsu province in December, Chinese testing has not detected any bird flu since June.

Meanwhile, two ducks and a goose found in Hong Kong have tested positive for H5N1, the strain of bird flu that can infect humans. Hong Kong closed its Mai Po nature preserve as a precaution for 21 days from Friday, after a dead grey heron found there also tested positive for bird flu.

Hong Kong authorities are still testing 14 other dead birds found last week on Lantau Island.
"We're checking water currents" to see if the birds were washed ashore from mainland China, a government spokeswoman said.

Dead fowl found in NW China's Xinjiang test positive for H5N1 virus

http://afludiary.blogspot.com/2009/0...-outbreak.html

But wait one, the Chinese do admit that a SMALL outbreak occurred though they don't explain how this happened given that they have this vaccination program in place.

Originally Posted by news.xinhuanet.com

China's Ministry of Agriculture announced Tuesday that dead fowl found in the northwestern Xinjiang Uygur Autonomous Region were confirmed as H5N1 positive in tests by the national laboratory.

The ministry said 519 fowl died of bird flu...

China's Health Ministry: Victims Had Contact With Poultry

http://afludiary.blogspot.com/2009/0...ctims-had.html

And, now the Chinese change the story yet again about the recent human victims of bird flu saying that these people did have contact with poultry even while they still say that there has not been any poultry deaths except for the one small outbreak in Xinjiang. Yes, it's confusing alright, and very hard to take anything that they report at face value particularly when they try to reassure everyone that there has been no mutation in the H5N1 virus that would allow human to human transmission. Of course there has been human to human transmission, but it's not been efficient nor often officially admitted to...

Re: Pandemic Awareness/Preparation

What Do the Japanese Know That We Don't Know?


http://www.bloomberg.com/apps/news?p...fer=technology

Why Panasonic made this decision is open to interpretation.

Originally Posted by www.bloomberg.com

The company in December instructed staff assigned to parts of Asia, Africa, eastern Europe and South America to repatriate their families by September, Akira Kadota, a spokesman for Osaka- based Panasonic, said by telephone today. He declined to comment on the number of employees or households affected.

Panasonic may be the first major company to order families home on concern people wouldn’t receive needed health care in case of a widespread flu outbreak. A pandemic could kill 71 million people worldwide and lead to a “major global recession” costing $3 trillion, according to a worst-case scenario outlined by the World Bank in October.

Honda Motor Corp., Japan’s second-biggest carmaker, considered bringing home families of expatriates in China after a woman in Beijing infected with bird flu died on Jan. 5, said Hideto Maekawa, a spokesman for the company. The carmaker has advised employees to cut down on “unnecessary and non-urgent” business trips, he said.

http://pandemicchronicle.com/2009/02...mic-influenza/

Originally Posted by pandemicchronicle.com

This action by Panasonic is rife for speculation; unfortunately, there is just not enough information in the news blurb to puzzle out anything beyond the fact that this is a precautionary measure in anticipation of a possibility.

All of this is worth noting, it’s also worth further monitoring to see if any other companies follow suit. On the purely speculative front: Panasonic has a presence in China. If something is going on in China, and many believe there is a significant likelihood there is, then Panasonic is in a position to know more than I do sitting at my computer in Charleston, SC.

Panasonic's pandemic-related move fuels questions, concern

http://www.cidrap.umn.edu/cidrap/con...asonic-br.html

Originally Posted by www.cidrap.umn.edu

Bloomberg News published its initial story on Panasonic's request to its foreign employees last night, citing a Nikkei news story that did not quote any Panasonic sources. That prompted a handful of editors from prominent pandemic flu blogs, such as Avian Flu Diary and A Pandemic Chronicle, to swing into action, said Sharon Sanders, editor-in-chief of FluTrackers, a well-known Web message board that focuses on avian flu developments.

The editors met online late last night to coordinate their coverage of the story and ask their contributors to translate foreign-language information on the Panasonic development, Sanders told CIDRAP News. She said she connected with Panasonic's spokesman in Japan last night to flesh out some of the facts, which Bloomberg obtained and reported in today's updates of its stories.

Re: Pandemic Awareness/Preparation

Egypt

http://www.recombinomics.com/News/02...Toddler_2.html

This is the second toddler recently diagnosed with bird flu in Egypt. The first child recovered.

Egypt vaccinates its poultry but, as we are seeing in China and Vietnam as well, the virus is still present and can infect people even if the birds do not appear sick. This link is pointing out that the strain of virus present in Egypt appears to be vaccine resistant. The Egyptians are no longer filing reports of outbreaks in poultry as they occur now that the disease is endemic in their country. Supposedly they are doing this on a 6 month basis, sending all the information at once so if there is an increase in the number of outbreaks, we are not going to be aware of it in real time except by translations if the local media comments on it. The Egyptian government also censors its news media.

Originally Posted by www.recombinomics.com

The translation describes a bird exposure, but external monitoring H5N1 in poultry is somewhat compromised by Egypt’s announcement that H5N1 was endemic, leading to OIE reports at 6 month intervals. H5N1 in Egypt has been a concern because of the emergence of a vaccine resistant strain a year ago. This H5N1 was isolated from vaccinated flocks and was widespread in Egypt, and also detected in Israel.

Vietnam

http://www.flutrackers.com/forum/sho...604#post208497

This is a horrific picture of what is happening in Vietnam. Bird flu outbreaks are occurring in seven different provinces. Some of the people are rioting and trying to save their poultry while the govt attempts to cull the birds to stop the virus. Poultry is an important source of cheap protein in that country. You have to wonder just how bad things are when the people choose to eat infected birds or do without. Poverty is helping to drive the epidemic.

Meanwhile a young woman is dying. She is the second human case this month.

Originally Posted by www.flutrackers.com

Ly Tai Mui, from northern Quang Ninh Province, is seriously ill with pneumonia, having tested positive for human avian flu. The 23-year-old was hospitalised with fever and breathing difficulties in January after eating a sick chicken.
Nguyen Huy Nga, head of the Preventative Health and Environment Agency, told IRIN the woman had shown "no improvement despite continuous positive treatment".

Nga said no other family members had shown signs of the virus even though they had also eaten infected poultry.
Vaccination efforts have become lax because Vietnam had, until recently, considered itself bird flu-free. Farmers have also delayed reporting outbreaks. In one case a crowd tried to prevent authorities from culling birds that were being transported to the capital and lacked proper health certificates.

"Hundreds of people were trying to grab the chickens," said Nguyen Huy Dang, a senior official with Hanoi's Animal Health Department. "They jumped into the pit where we were burning the [live] birds, even after we told them they had been sprayed with chemicals."

Animal health officials and market workers were unable to stop the crowds, which eventually made off with nearly all 1,500 birds. Police arrested nine people for trying to stop the cull.
"We never expected anything like that to happen," said Dang. "It's never happened before so we didn't have the personnel to prevent it."

Indonesia

http://afludiary.blogspot.com/2009/0...t-goes-on.html

Indonesia continues to be a hotspot for bird flu activity. We have to rely on reports from the media now that their govt is no longer reporting outbreaks. They do however, still have a relationship with the WHO and have asked for assistance at times.

For those planning a vacation in Bali, perhaps you should consider another option...

Originally Posted by afludiary.blogspot.com

Our first stop this morning is Bali, where some birds have been culled after birds in a backyard flock died mysteriously. Additionally, a 19 year-old (gender uncertain) is receiving Tamiflu, but is not hospitalized.

Anyplace else in Indonesia, 15 dead chickens would not raise much concern. But Bali is a major tourist/vacation destination for much of Australia, New Zealand, and Asia.

An outbreak of Bird Flu there, even a minor one, could have major economic repercussions for the tourist industry.

...in South Sulawesi - six villages are isolated due to an outbreak of the virus in poultry. The exact details of how these villages are `isolated' are not provided.

This may simply indicate restrictions on the transportation of poultry and eggs out of these villages, or it might signify a tighter cordon. It's impossible to tell from this report.

And in East Java, multiple outbreaks of bird flu are still being reported among poultry.

Re: Pandemic Awareness/Preparation

http://afludiary.blogspot.com/2009/0...und-noise.html

Lots of strange information lately regarding bird flu. Of course, this is the time of year that there are many outbreaks in bird populations, and reports of human cases. This is not unexpected. But, none the less, there is some rather puzzling information being reported. I think that you have to look at the overall picture to see where this could be leading.

http://www.scottmcpherson.net/journa...-portents.html

The following link is also of note. Tamiflu resistance has developed in the US and most other countries in one of our seasonal influenzas, H1N1. If this seasonal flu infects someone who is also infected with bird flu, there is potential for serious concern. These viruses could recombine genetic material, resulting in bird flu becoming Tamiflu resistant as well. The Japanese are researching this. Their govt as well as a major Japanese corporation have made some announcements lately that would indicate that they are have been taking more serious precautions with regards to pandemic influenza preparations.

http://www.yomiuri.co.jp/dy/national...14TDY02309.htm

Re: Pandemic Awareness/Preparation

The Hidden Outbreak

http://www.forbes.com/2009/02/13/chi...3_asia_05.html

Forbes article regarding the possibility that the Chinese are hiding information on bird flu.

If I lived in Hong Kong, I'd be a little concerned. Note the comments following the article on the Forbes site.

Originally Posted by www.forbes.com

China slaughtered more than 13,218 fowl in its northwestern Xinjiang Uighur autonomous region after 519 dead birds were confirmed to have contracted the H5N1 strain of bird flu, the state news agency Xinhua quietly disclosed on Tuesday night.

Measures were taken, birds were killed, and the epidemic had been brought under control, Beijing's official mouthpiece said in a 75-word article. But is that it? The report, citing the Ministry of Agriculture, provided no details on when, where and how the virus had spread.

http://tinyurl.com/c2h3hp

Originally Posted by media.wildcat.arizona.edu

More than 400 UA students from various colleges will participate in a pandemic flu exercise today at the Arizona Health Sciences Center in order to be more prepared if such a outbreak were to occur.

Students from the Colleges of Medicine, Pharmacy, Nursing, Law and the UA Mel and Enid Zuckerman College of Public Health will discuss various disaster scenarios and also learn how to handle the outcomes of a flu pandemic hitting Tucson.

They'll learn about the consequences of limited resources, the safety of healthcare workers, the role of the private sector, healthcare for non-citizens and also the role of media in informing the public about an outbreak, Strich said.

Re: Pandemic Awareness/Preparation

Second Bird to Bird Outbreak in Bali

http://crofsblogs.typepad.com/h5n1/2...eak-in-10-days

Bird flu is endemic in Indonesia and that includes the beautiful island of Bali. They will do their best to control it but it is not ever going to be completely eradicated.

Vietnam - 10th Province Reporting Outbreaks

http://crofsblogs.typepad.com/h5n1/2...have-h5n1.html

Vietnam Reports 3rd Human Case for this Year

http://www.chinapost.com.tw/asia/vie...am-reports.htm

Meanwhile in Vietnam, the spread continues which is not so unusual this time of year except for the fact that they have a poultry vaccination program which appears to have failed. And, another human case is found.

Originally Posted by www.chinapost.com.tw

The 35-year-old man from northern Ninh Binh province, some 60 miles (100
kilometers ) south of Hanoi, developed a high fever on Feb. 5 after slaughtering and eating several ducks his family had raised, said Vu Van Can, deputy director of the provincial health department.

Nepal Reporting Bird Flu Is Back

http://crofsblogs.typepad.com/h5n1/2...-in-jhapa.html

Once it is in the environment, it always seems to come back. No doubt this will be a continual battle.

Laos Reporting Outbreak in Birds

http://afludiary.blogspot.com/2009/0...tbreak-in.html

Another country in the area under attack, and you have to wonder about what the silent nations are not saying. Birds and the H5N1 virus do not respect borders.

Re: Pandemic Awareness/Preparation

Vietnam Reports Bird Flu Fatality

http://afludiary.blogspot.com/2009/0...-fatality.html

This is the young woman mentioned in the post from 2/11/09. She never recovered. She was 23 years old, and appears to have had good medical care.

The 1918 Spanish flu had a case fatality ratio of just 2%, but killed 50 million people world wide. The CFR of H5N1 is 63%.

Originally Posted by english.vietnamnet.vn

She died after 18 days of medical treatments under the thorough care and close supervision round the clock by three shifts of provincial doctors and experts from the National Tropical Disease Medical Institute and the Bach Mai Hospital.

Her treatments, including the most modern breathing apparatus, blood screening and blood transmission all the time and dialysis, cost an estimated 20 million VND a day, according to the provincial hospital.

Re: Pandemic Awareness/Preparation

Thank you for the continued updates, indigo girl. We appreciate all your hard work to keep allnurses.com informed.

Re: Pandemic Awareness/Preparation

Pandemic Flu - Children at Risk

http://readymoms.org/

I would be remiss if I did not point people towards what can be done to prepare for a catastrophic situation such as a severe pandemic. One of the best educational links that will help you most easily is the Readymom material. Yes, it was started by mothers with kids. Why? Because just telling you the ongoing history of influenza and bird flu in particular is not going to help you protect your family. You need practical and simple to implement advice.

Maybe you think that all of this information is a waste of time because none of this has happened yet. A pandemic sparked by bird flu, H5N1 is only a possibility, you say. But, what if you are wrong, and you have children? Please open the link below the description of who the readymoms are. If you read nothing else on this page, open the fluwiki link to the pamphlet on kids at risk. Hopefully you'll come to understand our concern about the well being of the kids in this country.

Look at the numbers. Think about what they represent, and take some steps to protect your family.

Originally Posted by readymoms.org

ReadyMoms Alliance is a U.S. nonprofit and the collaborative work of volunteers including parents, physicians, and emergency management professionals. We encourage citizen engagement in planning and preparedness. Our volunteers work directly with the public and through local governments, organizations, and businesses to present information on pandemic influenza, its impact on families and communities, and ways to prepare for a pandemic and other disasters. We invite professionals and informed volunteers in every community to download our materials and use them to help foster preparedness that will save lives and enhance community resilience in the next pandemic or any other emergency.

http://newfluwiki2.com/upload/Childr...out%202009.pdf

Originally Posted by Children%20at%20risk%20handout%202009.pdf

Scientists speculate that H5N1 may become less lethal should it cause the next pandemic. However, even a much-weakened H5N1 will cause decades of child and adolescent deaths in one season.

I have added another link only to point out that the insurance industry is taking this threat very seriously, and that it is not just kids that are at risk. Comparing the case fatality ratio of the 1918 pandemic which was 2% with the H5N1 CFR of over 60%, this is what they had to say, and has been reformatted to read more easily.

The term H2H means human to human transmission.

http://www.soa.org/files/pdf/resrch-li-rep-pan-life.pdf

Originally Posted by www.soa.org

Just as in catastrophe modeling there are 100-year and 500-year events, there
is a possibility of another pandemic exceeding the boundaries of the 1918 event.

There is certainly historical precedent for this. Each period of globalization has
opened up populations to new public health perils. As urbanized Europeans
spread out to new lands, they brought diseases with them to populations that
had no immunity.

Some populations they encountered experienced mortality rates as high as 99
percent with diseases such as smallpox. While society has developed “herd
immunity” to certain diseases, the H5 subtype has not previously been recorded
in the human population; there is, in fact, no precedent for what might
occur if sustained H2H transmission of H5N1 were to occur.

The cumulative mortality rate for confirmed cases of H5N1 has been hovering
at 60 percent, although it is likely that mild cases and some deaths go
unreported. Based on a 2007 WHO study of cases with onset dates between
2004 and 2006, 89 percent of the patients were younger than 40. The
disease has demonstrated evidence of “cytokine storm,” an immune system
response gone fatally awry resulting in Acute Respiratory Distress Syndrome
(ARDS). These characteristics are similar to some of the most disturbing
aspects of the 1918 pandemic, which showed an affinity for young, healthy lungs.