The H5N1 strain of influenza - often referred to as bird flu - is first known to have jumped from chickens to humans in 1997. Since 2004 it has ripped through poultry and wild bird populations across Eurasia, and had a 53% mortality rate in the first 147 people it is known to have infected. Health authorities fear this strain, or its descendent, could cause a lethal new flu pandemic in people with the potential to kill billions.
Flu has been a regular scourge of humanity for thousands of years. Flu viruses each possess a mere 10 genes encoded in RNA. All of the 16 known genetic subgroups originate in water birds, and especially in ducks.The virus is well adapted to their immune systems, and does not usually make them sick. This leaves the animals free to move around and spread the virus - just what it needs to persist.
But sometimes a bird flu virus jumps to an animal whose immune system it is not adapted to.
In 2004, researchers in Kyoto, Japan determined that blowflies could carry the AI virus internally, and there has always been the suspicion that flies could carry infected material from place to place as mechanical vectors. Simply put, a fly lands on infected poultry droppings, and then buzzes off with a viral payload attached to its feet.
Options include two possible routes to producing vaccine in quantity, and the use of statins to mitigate the effects of a cytokine storm.
Follow the full link and check out the interview noted above in the commentary.
This is a very useful paper which hopefully will produce some needed results.
The fundamental reason why most of the world's people will remain vulnerable to an imminent pandemic is the lack of global industrial capacity that will allow us to quickly produce adequate supplies of affordable inactivated vaccines and antiviral agents. None of the current efforts to develop vaccines and antivirals addresses this fundamental need. Thus, it is not surprising that initiatives for pandemic preparedness concentrate on community mitigation and nonpharmaceutical interventions.5
Three new approaches could help us better confront an imminent pandemic. Two involve vaccines, one that is already licensed for seasonal use and another that could be licensed within one year. The third approach involves a generic medication that is widely available and inexpensive. It is not clear whether time will show these three approaches to be the best ways to confront a pandemic; other promising interventions in early stages of development may eventually prove to be better. Nonetheless, all three of these interventions share one unique and fundamental advantage: the industrial capacity already exists to produce them quickly in sufficient supply to meet global demand. What is lacking is the social imagination and political will to demonstrate that they are efficacious and ensure they can be produced.
... until 2003, the world leader in avian influenza outbreaks among domestic poultry was -- drum roll, please -- the United States of America. As written in Dr. Michael Greger's excellent tome "Bird Flu: A Virus of Our Own Hatching," Greger presents a compelling argument that it might be the Delmarva Peninsula within the Delaware, Virginia and Maryland triangle, and not Guangdong, China or Jakarta, Indonesia, where a pandemic launches.
"...Thus far, there is no evidence the virus is actually present in the samples collected. The testing detected only antibodies, which indicate possible past exposure to the virus."
Allow me to translate this obviously encoded message. What he means is not "possible,' but "likely" exposure to the H5N1 virus, even if low-path. Turkeys do not get hatched with H5N1 in their veins. This means that a flock of 54,000 turkeys -- destined for the dinner tables of America and elsewhere -- had exposure to H5N1 enough to have produced antibodies. This means that very, very recently ...there was H5N1 on that farm. And the turkeys were exposed to it.
... sometime in the past 12 weeks to a year, low-path H5N1 was present in significant volume on the farm in question. And it got past the breeders and the State and Federal authorities. So it is possible that a low-pathogenic H5N1 could have entered this unnamed Virginia farm, circulated among the 54,000 birds, and its progeny could have been high-path H5N1. Now that is a sobering thought, that surveillance in the US missed this important development.
Oh, so it was H5N1 then. I was wondering what H5 virus they were going to find.
North Carolina State University reports that H5N1 can remain active in the stomachs of common houseflies for up to three hours. This study cited a 1985 study of housefly infestations with avian influenza stemming from 1983's huge H5N2 outbreak in Lancaster County, Pennsylvania. That study showed that more than a third of the houseflies trapped during the H5N2 outbreak had bird flu virus in their guts. Following a Kyoto, Japan outbreak of "bad" H5N1 in 2004, more evidence was collected to support the flies-as-vectors theory.
Nonetheless, nothing of consequence has been done to reduce or eliminate houseflies as a serious vector of avian influenza within the poultry industry.
The Elephant in the Room is the question of the samples the Indonesian government finally gave up to the WHO, following their little spat over vaccine rights and first dibs. What precious time was lost in isolating changes in the virus? And what are those changes? They are apparently enough to cause the Indonesian government to begin rush production of a prepandemic vaccine while ignoring WHO entreaties to stockpile rather than inject. The Indonesian government has decided to "stockpile vaccine in people, not buildings," which was the rallying cry of the Ford Administration's Swine Flu decision in 1976. And the Indonesian government has one heckuva lot more evidence to support its decision than Ford did in 76.
...the highest risk is from birds that have passed through the Czech Republic, Germany and France. Last month there were three outbreaks of the flu strain in the Czech Republic, and three cases in southern Germany. There was also an outbreak in France this month and experts expect more cases.
The greatest threat is believed to be from the blackheaded gull, which returns to Britain from the area around the Baltic Sea. About 50,000 to 100,000 pairs of these gulls breed in the Czech Republic before leaving for other parts of Western Europe, including Britain. These birds could appear this month.
The other imminent threat is from the mallard, which will start returning to Britain next month. Mallards breed in large numbers throughout Europe, with 25,000 to 45,000 pairs in the Czech Republic and 200,000 to 400,000 pairs in Germany.
New research suggests successful treatment of the H5N1 avian flu virus requires targeting the virus, not the overwhelming immune response it triggers.
The study, done in mice genetically engineered to lack critical immune system chemicals called cytokines, found these mice were as likely to die from H5N1 infection as mice armed with an intact immune system.
That suggests the activity of the virus, not the immune response it induces, is the main driver of the disease process, said the authors, from St. Jude Children's Research Hospital in Memphis, Tenn.
As such, it is evidence that a phenomenon known as a "cytokine storm" - a massive and cascading production of immune system chemicals that actually damages the host it is meant to protect - is not responsible for the astonishing death rates seen in H5N1 infections.
FROM THE WHITE HOUSE, THEIR OWN REPORT CARD ON THE NATIONAL PLAN FOR PANDEMIC FLU PREPARATION
The White House had a press conference on 7/17/07 during which they addressed the media about the national effort to prepare the country for an anticipated pandemic event as well as any other biological catastrophic event. What they had to say, will effect your local community at some point in time.
There are many govt agencies involved in this national plan. And, the
national plan involves of necessity interacting with other countries,
and international agencies.
I find it difficult to digest anything government puts out. Maybe you do too.
I think the best way to look at their information is to break it apart into smaller,
more digestible pieces. That is what I am attempting to do here.
The full conference is at the link below. I am only going to pull out parts of
Dr. Rajeev Venkayya, Special Assistant to the President for Biodefense
Ambassador John Lange, State Department Special Representative on Avian and Pandemic Influenza
Dr. John Clifford, USDA Chief Veterinarian
Admiral John Agwunobi, Assistant Secretary of Health
Dr. Jeff Runge, DHS Chief Medical Officer on Pandemic Preparedness
These quotes are from Dr. Venkayya, Special Assistant to the President for Biodefense:
As I think many of you are aware, we began back in 2005 with a recognition that this new influenza virus had been documented in about 16 countries globally. Since that time, the number of countries with documented bird infections of H5N1 has increased to 60.
And so this outbreak in birds does not show any sign of abating, but more concerning -- of greater concern is the fact that we know that this virus can infect humans. And although it hasn't infected many humans, to our knowledge -- right around 300 individuals worldwide -- the mortality in those that it has infected is right around 60 percent.
Now, why is this important? Well, we've faced three pandemics in the last century; we face influenza pandemics on a regular basis, about three every century for the past several. And the most serious of those in the 20th century killed about 20 to 40 million individuals worldwide, and that was with a mortality rate of 1 to 2 percent.
We don't know what's going to happen with this particular influenza virus, but if it's not H5N1, we can be certain that some other influenza virus at some point in the future will lead to a pandemic. More importantly, if it's not an influenza pandemic in the next 10 years, we know -- we can almost be certain that some other biological threat will come upon us and we will need to be prepared for that.
Now, the media's attention has waned a bit, and the public's attention has waned a bit to this threat, and there are understandable reasons for that. But it's important for governments and officials at the federal, state and local level, as well as those who are in charge of companies, non-governmental organizations, churches, other faith-based organizations, and individuals to keep this in mind, because this preparedness effort that we've undertaken is not done.
... we've embarked on a moon-shot approach to reestablishing vaccine production capacity and new technologies such as adjuvants to stretch the effectiveness or the number of individuals we could vaccinate with a single dose of vaccine.Admiral Agwunobi will speak more about that.He will also speak about the community mitigation guidance that was released by Dr. Gerberding in February, which essentially provides a road map, an essential road map, we think, for communities, in light of the hard, cold facts, and that is that we are almost certainly not going to have sufficient health and medical capacity to take care of the large numbers of individuals that would be presented by a severe pandemic.
The reality is that there are tremendous challenges to sealing our borders to begin with.Secondly, we believe, and scientists concur, that if a pandemic virus emerges anywhere on the globe, it is inevitable that it will arrive here in the U.S., irrespective of the actions that we take at the borders.
And so our planning approach is to plan to limit the arrival of individuals who might be affected with a pandemic virus, those who might be affected to place them -- to give public health -- implement public health measures to limit onward transmission, but to do what we can to also simultaneously preserve the flow of goods and people.
In the setting of insufficient vaccine, who should get vaccine first? The reality is that there's not going to be a single answer. It will depend upon the characteristics of the pandemic -- the population, the age group that the pandemic virus seems to favor, as well as our supply, as well as the overall impact we anticipate on our national infrastructure. And so the Department of Health and Human Services and Homeland Security have worked with public groups, professional societies and others to develop a draft of that prioritization guidance that you can anticipate seeing in the coming weeks for public comment.
We continue to have a great deal of difficulty in determining when outbreaks of infection occur in animals and in humans overseas.Just to be brutally honest,we have a lot of trouble determining when we have an outbreak of infectious disease in a community here in the United States. We have limited surveillance capability here in the U.S.
... we need to have uniform biosurveillance capability, we believe, to prepare us not only for a pandemic but any outbreak of infectious disease. We need to further enhance our mass casualty care capabilities in communities,referencing back to the point that I made about insufficient bed space and public health capacity. We need to implement the community mitigation road map that's been laid out by the CDC. And then finally we need to attend to a concern that's been highlighted for us by countries that don't have access to vaccine or don't have much hope of having access to vaccine in the near future, and that is the issue of global vaccine access and a more equitable distribution of the life-saving countermeasures to the international community. And we are committed to working with the WHO and our international partners to address that.
Dr. Rajeev Venkayya, Special Assistant to the President for Biodefense
Ambassador John Lange, State Department Special Representative on Avian and Pandemic Influenza
Dr. John Clifford, USDA Chief Veterinarian
Admiral John Agwunobi, Assistant Secretary of Health
Dr. Jeff Runge, DHS Chief Medical Officer on Pandemic Preparedness
The following quote is from Ambassador John Lange, State Department Special Representative on Avian and Pandemic Influenza:
...to prepare for the possibility of a human pandemic is a large-scale global engagement that has unfolded since the seriousness of the threat became apparent a few years ago -- specifically ongoing efforts by governments, international organizations, and the private sector.
In September 2005, President Bush announced the International Partnership on Avian and Pandemic Influenza. And the goals of the international partnership are to elevate avian and pandemic influenza on national agendas in governments around the world; to coordinate efforts among donors and affected nations; to mobilize and leverage resources; to increase transparency in disease reporting and improving surveillance, a point that Dr. Venkayya made about the importance of surveillance; and to build local capacity to identify, contain and respond to an influenza pandemic.
...donor governments and the multilateral development banks and international financial institutions have really stepped forward, and the total pledges, as of last December, the last pledging conference, were $2.3 billion. The United States has made the largest pledge of any country, totaling $434 million, by the end of last year, and we anticipate further commitments will be forthcoming this year.
In sum, the world has been engaged and continues to be engaged on avian and pandemic influenza. This global engagement involves a really enormous, multi-faceted effort.
...the Department of State coordinates the U.S. government's international efforts, along the lines of the three pillars that are in the National Implementation Plan that was released in May of last year: preparedness and communication, surveillance and detection, and response and containment.
These international efforts, while coordinated by the Department of State, are really an interagency enterprise, including the agencies that are up here with me today. It involves not only the State Department but the Department of Agriculture, the Department of Health and Human Services, the Department of Homeland Security, Department of Defense, our major international assistance through the U.S. Agency for International Development, and various other federal entities all working internationally.
In terms of international organizations, we have cooperated very closely with the United Nations System Influenza Coordinator, Dr. David Nabarro, and with the institutions internationally who are very focused on programmatic activities in line with the concerns -- the Food and Agriculture Organization of the United Nations, and the World Organization for Animal Health, known as OIE by its French initials, are focusing on the animal health side; the World Health Organization on the human health side. And then there's the World Bank and many other multilateral institutions.
The United States is supporting preparedness efforts in more than 65 countries, working in collaboration with WHO, FAO, OIE and other partners. We've deployed scientists, veterinarians, public health experts, physicians, emergency response teams, all to either affected or high-risk countries, to assist in the development and implementation of emergency preparedness plans relevant to both avian influenza and to pandemic influenza.
With our neighbors Canada and Mexico, we're finalizing an avian and pandemic influenza plan that will be issued next month as part of the Security and Prosperity Partnership of North America. And this plan will lay out a sound, coordinated trilateral approach to prepare for and respond to the possibility of the arrival on this continent of highly pathogenic avian influenza, possibly in migratory birds or in poultry, or a human influenza pandemic.
We're supporting activities in more than 50 countries to generate public awareness about the threat of avian influenza and to promote behaviors that reduce the risk of disease transmission from poultry to people.
We're also providing up-to-date information on avian and pandemic influenza to the majority of over 2 million Americans registered with our embassies and consulates abroad by using websites, town hall meetings hosted by our embassies and consulates, publications and other means.
We've supported efforts to expand and enhance animal and human disease surveillance systems, and we're working with partners to improve capacity for detection and laboratory diagnoses, as well as early warning networks in 75 countries.
...we've supported the training of more than 129,000 animal health workers and 17,000 human health workers in surveillance and response.
Dr. Rajeev Venkayya, Special Assistant to the President for Biodefense
Ambassador John Lange, State Department Special Representative on Avian and Pandemic Influenza
Dr. John Clifford, USDA Chief Veterinarian
Admiral John Agwunobi, Assistant Secretary of Health
Dr. Jeff Runge, DHS Chief Medical Officer on Pandemic Preparedness
The following are quotes from Dr. John Clifford, USDA Chief Veterinarian
...a tremendous commitment by many people, both within Animal and Plant Health Inspection Service, where I work, and throughout USDA, from the Foreign Agriculture Service to our colleagues from Agricultural Research Service to Food Safety Inspection Service. I will certainly not attempt to review all of the areas in which we've made progress, but I would like to share just a few of them with you today.
APHIS's emergency coordinators have participated in more than 50 state and county level tabletop exercises to ensure that we are ready, not only at the federal government level, but that we are working closely with our state and local officials to ensure well coordinated response.
We've expanded the national veterinary stockpile to attain another 40 million doses of avian influenza vaccine for birds. This brings our total supply to 140 million doses of kill vaccine to protect older birds.We also have a contract in place that will quickly give us access to another 500 million doses of live pox recombinant H5N1 vaccine to protect younger birds.
I should mention that it is impractical to attempt to vaccinate all poultry, as we've seen in other countries. In the event of a highly pathogenic AI detection, vaccines can be used to protect healthy birds outside the perimeter of the outbreak.
We have contracts in place and are continuing to test them to ensure delivery within 24 hours of the supplies we would need to respond to an outbreak. These include such things as personal protective gear, antivirals, AI field test kits, portable satellite communication equipment, portable vaccine shipment and storage containers, disinfectants, depopulation, decontamination and disposal service contracts.
We've tried to anticipate and address potential problems that might slow our ability to respond to an outbreak. For example, we recognize that in some instances, states have expressed a concern regarding the use of veterinarians working in an emergency response who are not licensed in their state.We are working to develop an emergency management assistance compact that would allow us to use veterinarians from neighboring states to work in the event of an outbreak.
...with...Department of Interior and state wildlife agencies, we continue our comprehensive surveillance of wild birds in every North America fly zone, to ensure we have a strong early warning system in place... Since April of this year, we've already tested more than 5,000 wild birds and 400 fecal samples. All wild bird and environmental samples have been negative for highly pathogenic H5N1.
We are also monitoring wild birds in Russia, Greenland and Mexicoas early warning if the virus approaches the U.S. in these species.
To meet the demands of 45 laboratories in the National Animal Health Laboratory Network and all 50 state wildlife agencies, APHIS conducted six avian influenza workshops to increase communication between all parties involved in wild bird surveillance. The workshops reviewed laboratory and communication protocols to ensure an effective and efficient response to high-path AI detection in wild birds. Our hope is that our international efforts will help to ensure that high-path H5N1 never reaches our borders.
USDA personnel are part of rapid assessment and rapid response teams that are working in more than 30 countries worldwide.
There are about 130 volunteers available for international deployments, either through the FAO or bilaterally between the infected country and the U.S.
We also have a system in place to rapidly deploy USDA assets when needed internationally, without compromising U.S. domestic response capabilities.
We've worked in more than 50 countries to help deliver and disseminate educational materials to prevent the spread of high-path H5N1.
We have helped train more than 100,000 people in other countries, ranging from animal health workers and wildlife biologists to government policy makers.
We have worked with international health organizations to ensure all priority countries have established early warning networks...They all have or are working on response plans, and all priority countries also have access to our training.
We have delivered rapid detection kits to 26 countries and have worked with international partners to ensure all priority countries have access to lab diagnostic services. In other words, every priority country has lab testing services available, either from the U.S. or an accredited lab in another region of the world.
... USDA has two decades of experience responding to AI, including both low-path and high-path forms of the virus.
A detection of H5N1 high-path AI in birds does not signal the start of a human pandemic. USDA has clear aggressive action plans to eradicate the virus if it is detected in domestic poultry and backyard birds. We have much more advanced protection and response plans than existing countries where the virus has moved from birds to humans.
In the event of an outbreak, we have a plan in place to prevent affected poultry from entering the food supply. Having said that, it's important to mention that fully cooking poultry kills the AI virus, so it is safe to eat properly prepared poultry.
Many of us who work in the animal health worry that the detection of a low-path H5N1, which we refer to at a North American strain of H5N1, would spark panic stories about the dangerous bird flu arriving in the U.S.
Nothing could be further from reality. We've now had several detections of low-path H5N1 in both wild and domestic birds.Instead of sparking panic, the stories sounded the all-clear by presenting factual information when low-path AI is not a concern.
I know that reporters are under tremendous pressure to turn stories quickly, and I want to express our appreciation for the way you've handled reporting on AI.
indigo girl
5,173 Posts
Other vectors, like houseflies:
http://afludiary.blogspot.com/2007/07/houseflies-revisited.html