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.
Early this year the CDC (Centers for Disease Control and Prevention) developed and published a way to judge pandemics, in the pre-pandemic planning stage, by severity, assigning categories reminiscent of hurricane strength classifications.
The model assumes that 30% of the overall population will get the pandemic strain of the virus, although different age groups and population centers may experience significant differences in the percentages, both overall and in the specific age groups.
One of the world's foremost influenza researchers (who shall remain nameless) told me about a year ago, "I can't promise to have the answers though, you will be surprised at how little we actually know." It was both refreshing and chilling to hear one of the world's most quoted and respected clinical researchers give that candid assessment.
It also points out how fragile our understanding of flu really is. And while we make certain assumptions about the virus, we also realize that when we get one answer, we wind up with a thousand new questions.
Two poultry farms in Thanphyuzayat on July 24 reported chickens dying abnormally and after a series of testing for days, it was identified with H5N1, said Myanmar's Livestock Breeding and Veterinary Department (LBVD) on July 29.
I think this is a great step in educating our people. My three guys are all out of high school now, but anything that brings a discussion of a pandemic is a good thing. One of my sons is going to be a teacher.... he still has an open mind and is okay w/ me talking to him about a flu pandemic. Another is serving in the Coast Guard, in health services, and is stationed at the Academy in CT......We chitchat about medical stuff and he'd let me know if something was up. Although he thinks I'm a little "crazy" about the flu. .
Thanks again for keeping us updated. Your work is truly appreciated. .
A doctor in Ha Tay province said there were no bird flu outbreaks in the area where the latest victim lived.
"It made us difficult to pin down how she became infected," he said. "Earlier she bought a chicken leg of unknown origin for a meal in the family but nobody else got sick."
Ten people who came into contact with the woman have been monitored for any symptom and given anti-viral Tamiflu as a preventive measure while her house was disinfected, the doctor from the provincial Preventive Medicine Centre told Reuters.
Pregnant women in their second and third trimesters are known to be at increased risk for influenza complications, and health officials and pandemic planners worry about how to prevent and treat pandemic influenza in this group. Mortality rates in pregnant women during the 1918-19 pandemic ranged around 50%, compared to about 33% for the general population, according to a report in the May issue of Obstetrics & Gynecology.
At least two other pregnant women are among the WHO's confirmed H5N1 cases. One was a Chinese woman who was 4 months pregnant when she died in November 2005 after intensive supportive care failed, according to a report in a March 2006 issue of the New England Journal of Medicine (NEJM).The other was a 22-year-old Indonesian woman, reported by the country as its 76th H5N1 fatality, who was 4 months pregnant when she died in May.
"We're very conscious that this is a precedent-setting meeting, as are most of the delegations," said Dr. David Heymann, head of communicable diseases for the World Health Organization, under whose auspices the five-day meeting is taking place.
That's because the talks could change the conditions under which biological materials are provided to the WHO for global surveillance of and research on influenza viruses.
Depending on what is decided, the consequences could ripple far beyond the science of flu, experts say, conceivably affecting, for example, the pharmaceutical industry's ability to make and update an eventual HIV vaccine or limiting how quickly the world could respond to the next SARS-like disease outbreak.
Myanmar has detected its second outbreak of bird flu in less than a month, this time on a poultry farm in the central region of Bago, health officials said Wednesday.
The finding came just days after Myanmar reported outbreaks on two poultry farms in Mon state, about 300 kilometers (180 miles) south of Yangon.
India
The scope of the culling operations has had to be broadened.
Incredible that they have screened thousands of people so far.
Nearly 200,000 poultry have been culled in Manipur in the drive against bird flu and authorities have decided to begin a second round. Health officials on Wednesday said over 300 people are under special medical supervision though no human has contracted the disease so far.
Health officials said there were no reports of humans contracting the virus although a massive surveillance campaign was on to ensure safety of the locals. Over 200,000 people have gone through health checkups so far.
Warden Messages from the US Consulate Office in Kolkata, India
From Effect Measure with permission of the editors.
The Editors of Effect Measure are senior public health scientists and practitioners. Paul Revere was a member of the first local Board of Health in the United States (Boston, 1799). The Editors sign their posts "Revere" to recognize the public service of a professional forerunner better known for other things.
The intellectual property issues surrounding H5N1 and pandemic influenza in general continue to deepen and ramify into uncharted territory. Currently the usual suspects are meeting in Singapore to try to resolve issues that have arisen when some developing countries, led by Indonesia, have upset the international flu applecart by refusing to provide viral isolates to the WHO laboratory network, asserting that the practice of supplying "their" isolates to pharmaceutical companies who then make vaccines the originating country can't afford was inequitable and intolerable. I have waded into this morass a number of times... and been notably unsympathetic to Indonesia. I am no more sympathetic now, but I am also losing patience with Indon's opponents, scientists, drug companies and the rich governments. They are also getting nervous:
With little fanfare or public attention, representatives of 24 countries began Tuesday to try to resolve a virus-sharing impasse that is undermining the world's ability to chart the pandemic threat posed by H5N1 avian flu.
But rather than hailing the meeting as a way to break the troubling logjam, some scientists and public health officials are watching with trepidation, worrying the process may hinder the way research into influenza and other infectious diseases is conducted.
"We're very conscious that this is a precedent-setting meeting, as are most of the delegations," said Dr. David Heymann, head of communicable diseases for the World Health Organization, under whose auspices the five-day meeting is taking place.
That's because the talks could change the conditions under which biological materials are provided to the WHO for global surveillance of and research on influenza viruses.
Depending on what is decided, the consequences could ripple far beyond the science of flu, experts say, conceivably affecting, for example, the pharmaceutical industry's ability to make and update an eventual HIV vaccine or limiting how quickly the world could respond to the next SARS-like disease outbreak. (Helen Branswell, Cnadian Press via Medbroadcast)
It's no secret there is unprecedented activity on the patenting and licensing front for vaccine technology directly pertinent to pandemic influenza. It seems to us that too much attention has been directed on how the activities of developing countries affect scientific progress and the possibility of producing a successful vaccine and not enough on the various machinations and scheming of these would-be patent holders and the scientists who enable them.
So here's our suggestion. We cut the intellectual property Gordian Knot by proclaiming all applications of a technology to combating or preventing an influenza pandemic a patent and license free zone. That's right. No patents or licenses will be valid for any technology involved with preventing a global catastrophe from a pandemic strain of influenza A. This is very limited in scope. It is not meant to apply to all patents at all times for all reasons. You can still make money making a good product. Research and development costs can be underwritten as most are now through public funding (research grants), in exchange for which all discoveries regarding influenza have a public license or be placed in the public domain. This has been done already with a process for making Tamiflu quickly and cheaply...
My colleagues in the scientific community are part of the problem. Stop allowing your work to be patented. Refuse to do it. Issue it with a public license. Most of us are scientists because we want to make the world a better place or just to find out how the world works. We don't need this patent and biotech nonsense.
More importantly, in this context, it's wrong.
Commentary on the Singapore meeting from Scott Mcpherson's blog. Scott was the CIO of the
Florida House of Representatives. I believe that he still is.
These new positives provide additional evidence for endemic H5N1 in Germany. Once again the positives are during the summer, which long range migration is minimal, and the new positives expand the geographical range and H5N1 positives in the summer. The H5N1 in multiple locations (in four states) in Germany, as well as multiple locations in the Czech Republic and France, indicate H5N1 in Europe is widespread.
This is a very disturbing study done on Tamiflu resistance particularly in
Indonesian viruses. Tamiflu is used extensively to blanket human populations in areas where new poultry cases of H5N1 have occurred. If there are any human infections, then for sure everyone in the area is tested and treated prophylactically. The implications of Tamiflu resistance are enormous. This is our first line drug.
Reduced Sensitivity of Influenza A (H5N1) to Oseltamivir
The NAs from all the clade 2 2005 Indonesian viruses demonstrated a 15- to 30-fold decrease in sensitivity specifically to oseltamivir compared with clade 1 viruses (Table 1, Figure, panel B). Govorkova et al. (5) also recently showed that the A/Turkey/15/2006 clade 2 virus was almost 60-fold less sensitive to oseltamivir in a plaque reduction assay than was the clade 1 A/Vietnam/1203/2004 virus.
The specific decrease in sensitivity to oseltamivir of both 2005 Cambodian clade 1 and especially the Indonesian clade 2 influenza (H5N1) isolates is disturbing, especially since they maintain their pathogenicity and transmissibility in birds and are clearly pathogenic in humans, since Indonesia has the highest death rate from influenza (H5N1) infections of any country. This finding is in contrast to recent observations that mutations conferring zanamivir resistance in human strains have poor viability and are not genetically stable (12). Such a decrease in oseltamivir sensitivity could lead to suboptimal drug dosing in treating persons infected with these isolates, which is thought to facilitate selection of viruses with a high level of resistance
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indigo girl
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From Sophia Zoe's blog,
Basics: Pandemic Severity
http://birdflujourney.typepad.com/a_journey_through_the_wor/2007/07/basics-pandemic.html