Avian Flu

[sarongsong]

"Avian flu poses the single biggest threat to the world right now...The "high season" for the avian flu was just starting in Asia...The U.S. government contracted with two companies...to make an avian flu vaccine, which will begin testing in people later this year..."
Reuters

[beskeptical]

Told ya so. :P Warning, don't read my post if you are the worrying type.



















Actually you don't have to lock the doors yet but it wouldn't hurt to check those food supplies should you decide to hold up inside while it rages around the community.

Think I'm making fun of woowoos? I'm not.

Here's a fun fact that wasn't in the news summaries. The European vaccine manufacturers met last year to assess the WORLD capacity to make flu vaccine should a new deadly strain emerge. They calculated there is capacity to make enough vaccine for only 5% of the world's population and even that might be 2-3 years from now.

Past flu pandemics have tended to emerge rather suddenly so even though we are closely monitoring the situation, from detection of the start of human to human sustained transmission until it was out of control and worldwide could be as short as only a few months.

Just last month two cases of fatal H5N1 flu, (the bad one we are watching), were found in two kids who died of brain infections, not respiratory infections. They were siblings so it isn't yet known if the virus was the reason or the kids' genetics were the reason their disease was different. And, it isn't yet known how many, if any, other previously unrecognized cases there might be since no one was looking for flu in non-respiratory infection fatalities.

So what do you all think? Should we join the woowoos this time?

I'm also curious how GLPers are discussing this flu. Do you think they are going to miss the real hazard while they are busy watching the imagined ones?

[W.F. Tomba]

I wonder how our government would respond if it were announced that a deadly strain of avian flu was spreading rapidly from person to person in Asia. On Sept. 11, 2001 we discovered that there were dangerous, stealthy killers on the loose who could wipe out large numbers of people in our country, and who were probably coming by airplane. So all flights to anywhere in the U.S. were grounded. This was a sensible measure given the threat. A new catastrophic flu would be a dangerous, stealthy killer capable of wiping out even more people in our country, and which would probably come by airplane, ship, car, and foot. Closing our borders altogether would therefore be a sensible measure. Do you think they would do it?

[sarongsong]

Told ya so. :P

Yes, beskeptical; I nearly put you in the opening

...Just last month two cases of fatal H5N1 flu, (the bad one we are watching)...

"...Scientists now know that the H5N1 virus had been undergoing rapid evolution during the [Hong Kong 1997] incident...in 2001, Yoshihi Kawaoko discovered that a single chemical base change in the PB2 gene permitted the virus to infect people...in a pandemic, public health officials may need to turn to manufacturing systems that don't depend on eggs---cultivating the suspect virus in tissues or using recombinant DNA techniques, which replace lethal stretches of the genome with benign parts..."
Secret Agents: The Menace of Emerging Infections, Chapter 5---Madeline Drexler

[Candy]

Dumb question, what are the symptoms?

I haven't been sick for 4 years, and I got a whammy this last week.
Chills, fever, chills, fever, stuffy nose.

[beskeptical]

I wonder how our government would respond if it were announced that a deadly strain of avian flu was spreading rapidly from person to person in Asia. On Sept. 11, 2001 we discovered that there were dangerous, stealthy killers on the loose who could wipe out large numbers of people in our country, and who were probably coming by airplane. So all flights to anywhere in the U.S. were grounded. This was a sensible measure given the threat. A new catastrophic flu would be a dangerous, stealthy killer capable of wiping out even more people in our country, and which would probably come by airplane, ship, car, and foot. Closing our borders altogether would therefore be a sensible measure. Do you think they would do it?

Unlikely scenario since it will be here before it's bad enough for the non-medical government agents to realize how bad it is. IE CDC knows but Congress and the Pres won't get the seriousness of it until the epidemic is quite far along.

[Candy]

I wonder how our government would respond if it were announced that a deadly strain of avian flu was spreading rapidly from person to person in Asia. On Sept. 11, 2001 we discovered that there were dangerous, stealthy killers on the loose who could wipe out large numbers of people in our country, and who were probably coming by airplane. So all flights to anywhere in the U.S. were grounded. This was a sensible measure given the threat. A new catastrophic flu would be a dangerous, stealthy killer capable of wiping out even more people in our country, and which would probably come by airplane, ship, car, and foot. Closing our borders altogether would therefore be a sensible measure. Do you think they would do it?

Unlikely scenario since it will be here before it's bad enough for the non-medical government agents to realize how bad it is. IE CDC knows but Congress and the Pres won't get the seriousness of it until the epidemic is quite far along.

So chances of US citizens getting it? The doctor kept asking me if I had traveled lately. I had a double whammy rash, too. I figured out the rash... rosea... ????

[beskeptical]

Told ya so. :P

Yes, beskeptical; I nearly put you in the opening

...Just last month two cases of fatal H5N1 flu, (the bad one we are watching)...

"...Scientists now know that the H5N1 virus had been undergoing rapid evolution during the [Hong Kong 1997] incident...in 2001, Yoshihi Kawaoko discovered that a single chemical base change in the PB2 gene permitted the virus to infect people...in a pandemic, public health officials may need to turn to manufacturing systems that don't depend on eggs---cultivating the suspect virus in tissues or using recombinant DNA techniques, which replace lethal stretches of the genome with benign parts..."
Secret Agents: The Menace of Emerging Infections, Chapter 5---Madeline Drexler

The WHO has already sent vaccine virus 'stocks' to the vaccine companies to make vaccine for human trials. They are hoping the viruses they have chosen will be protective but they can't be sure what the pandemic virus will actually end up as. I believe they are using vaccine virus that does match part of the new virus but isn't lethal to the chicken eggs. So the plan is to use existing vaccine production methods.

Any new vaccine production method such as recombinant vaccine is several years away at the earliest and there is no capacity in place for mass production.

[beskeptical]

So chances of US citizens getting it? The doctor kept asking me if I had traveled lately. I had a double whammy rash, too. I figured out the rash... rosea... ????

Unless you've been eating raw duck blood or handling live chickens in Asia you don't have it.

We have been on alert for both Avian flu and SARS since the SARS outbreak. It means you have a good doctor if they are asking for travel history.

There's no rash associated with this.

Symptoms of influenza:

Fairly sudden onset, fever >101 F , muscle aches, general malaise, no appetite. By day two you have coughing and the usual but severe respiratory symptoms.

But don't get too worried if you have these symptoms, the flu is peaking right now in the US and Europe and there is a lot of it going around. It isn't the bad one.

You will know there is a problem within days of it breaking out in Asia so there is nothing to worry about as far as if you are sick now. Think of the lottery, someone has to be first but there's no way it's going to be one of us. The WHO is actually doing an incredible job monitoring the situation considering the part of the world they are dealing with.

Rosea? Did you mean Pityriasis Rosea? That's a pretty harmless disease.

[mickal555]

UH no.... Asia is just below us.... I hope I don't get this

[W.F. Tomba]

I wonder how our government would respond if it were announced that a deadly strain of avian flu was spreading rapidly from person to person in Asia. On Sept. 11, 2001 we discovered that there were dangerous, stealthy killers on the loose who could wipe out large numbers of people in our country, and who were probably coming by airplane. So all flights to anywhere in the U.S. were grounded. This was a sensible measure given the threat. A new catastrophic flu would be a dangerous, stealthy killer capable of wiping out even more people in our country, and which would probably come by airplane, ship, car, and foot. Closing our borders altogether would therefore be a sensible measure. Do you think they would do it?

Unlikely scenario since it will be here before it's bad enough for the non-medical government agents to realize how bad it is. IE CDC knows but Congress and the Pres won't get the seriousness of it until the epidemic is quite far along.

Yeah, I was afraid you'd say that. I'd say the same. But that really bothers me. If you and I understand how serious this is before it's even happened, and the health officials have been raising the alarm for quite a while now, why can't the message get through to Washington? Why aren't these things seen as a security issue? Personally, I am far more worried about being attacked by a virus than by another human being.

[Candy]

Rosea? Did you mean Pityriasis Rosea? That's a pretty harmless disease.

Yeah, freaky rash to get, though. I hear it's not common.

[beskeptical]

UH no.... Asia is just below us.... I hope I don't get this

It won't matter where you are, if it's bad it will be worldwide in weeks.

In 1918, there was a wave of disease that sort of died out then resurfaced as a major outbreak that circled the globe in 4 months.

This disease first surfaced in 1997. It's the same disease labeled Hong Kong Avian flu back then if you recall they had to kill all or practically all the chickens in Hong Kong. Well they just didn't quite snuff it out and it really flared up last year and is still getting worse. But it isn't a danger to humans just yet and no one is absolutely positive it will ever be one. It does though sure look like it's heading that way.

The bottom line is start thinking about it but don't start worrying yet. Just watch the news for changes in the situation.

It's expensive but you can buy a few months worth of Tamiflu. For the moment it is the only drug that works for this virus. You need a prescription but most doctors would write one if you asked. Problem is 3 months worth for one person is $400 in Canada and twice that in the US. There will be some of this drug available and if we use it wisely it will save a lot of people. Problem is stock piles of Tamiflu won't be enough either. Canada recently decided or is thinking about buying 25 million dollars worth of Tamiflu to be prepared. My HMO has so far decided not to get extra but they are getting my feedback. I am keeping my doctor up to date on the situation and he in turn is in touch with their infectious disease department head. I hope to convince them to spend at least some dollars on the drug.

[beskeptical]

Rosea? Did you mean Pityriasis Rosea? That's a pretty harmless disease.

Yeah, freaky rash to get, though. I hear it's not common.

Actually it is pretty common, for you young college kids. :wink:

I had it. Some of my friends have had it. I've seen lots of cases.

[beskeptical]

Yeah, I was afraid you'd say that. I'd say the same. But that really bothers me. If you and I understand how serious this is before it's even happened, and the health officials have been raising the alarm for quite a while now, why can't the message get through to Washington? Why aren't these things seen as a security issue? Personally, I am far more worried about being attacked by a virus than by another human being.

Well 1918 was long enough ago people just think it can't happen today. They have this impression modern medicine has infectious disease under control.

[mickal555]

beskeptical,

You are the calmest person in the world.... if you are telling me to stock up on really expensive stuff- ........ -

[beskeptical]

beskeptical,

You are the calmest person in the world.... if you are telling me to stock up on really expensive stuff- ........ -

I debated if I should have said it because there really is no medical standard to recommend such a thing. Truth is though, I bought what I hope is enough for me and my son. I figured it cost me the same as 1&1/2 months of health insurance.

Unfortunately I have this picture of that twilight zone show where the family goes in their bomb shelter and the neighbors freak out trying to get in then it turns out to be a false alarm. 8-[

The flu vaccine shortage this year was an eye opener. Even though I got my vaccine supply before the problems started, for those who hadn't got theirs the public health took the rest to control who got it and also mandated by law who we could vaccinate. I don't want to have no control over whether or not I can get a life saving drug. I also asked my HMO if they had a plan on how to allocate such drugs should a worse case scenario occur and they essentially said they had their head in the sand. They just plan to defer to the public health to tell them how to allocate it.

Well the public health is a bit of an unwieldy agency. They go by the book. Should the flu start killing young people, the PHD conceivable could use the same vaccine allocation plan, people >65 etc., until some major time consuming re-evaluation and decision making process takes place.

I can't really recommend anyone buy an expensive drug for a hazard that hasn't really manifested itself yet. But I don't want to deny the fact I bought some.

[mickal555]

OK..... I was more worried than anything as I don't want to die of the cold

[W.F. Tomba]

I can't really recommend anyone buy an expensive drug for a hazard that hasn't really manifested itself yet. But I don't want to deny the fact I bought some.

What's the shelf life on that stuff?

[beskeptical]

There is a compromise here on the Tamiflu. You really only need 10 which is about $45 in Canada and 70 something here.

The PHD currently recommends not taking it daily which is the preventative dose, but rather taking it if you are exposed or actually get infected. The tricky part is, you have to take it on day one of your symptoms. By the second or third day it isn't going to work. It means you have to know the difference between the flu and other illnesses, but that is manageable.

[jofg]

This is one of the more realistic - and I think scarier - woowoo-type possibilities out there!

Are there any good, informative sites out there where I could go to track this and stay up-to-dated? I'd hate to be "behind the curve" on this one if it happens to gets bad. But i also don't want to have to track it on GLP

[Swift]

Yeah, I was afraid you'd say that. I'd say the same. But that really bothers me. If you and I understand how serious this is before it's even happened, and the health officials have been raising the alarm for quite a while now, why can't the message get through to Washington? Why aren't these things seen as a security issue? Personally, I am far more worried about being attacked by a virus than by another human being.

Well 1918 was long enough ago people just think it can't happen today. They have this impression modern medicine has infectious disease under control.

Just to make 1918 a little more current, my grandmother (my father's mother) died in 1918 when my dad was three; we suspect it was from the flu (my dad wasn't sure and there are no living relatives to get details from).

American Scientist had an interesting piece about the bird flu about a year ago. Here is a link to the article, but it is for subscribers only. Here is the abstract

In 1997 the world came perilously close to a global epidemic of the "flu." If this particular virus had attained the ability to spread from person to person, the pandemic might have taken the lives of a third of the human population. As it was, only six people died—and all of them had contracted the virus from chickens sold in Hong Kong poultry markets. The only thing that saved us was the quick thinking of scientists who convinced health authorities to slaughter more than a million domesticated fowl in the city's markets. The avian virus turned out to be a new strain—one that the human population had never seen before. Webster, one of the scientists who consulted Hong Kong authorities in 1997, and Walker tell a horrific tale: These new, deadly strains arise a few times every century, and the next one is around the corner.

It was the March/April 2003 issue.

[TriangleMan]

Hopefully the SARS problem in 2002-2003 has led to some changes in detection and quarantine procedures (as well as increased funding) to help stop the spread of potentially epidemic disease. Unfortunately with air travel it would not take much to spread a contagious disease world-wide in a matter of weeks.

If Bird Flu has found a way to mutate such that it can easily travel from person to person it will be a real crisis. I remember back in the 80s one doctor was grateful that AIDS couldn't spread easily, noting that if it could spread as easily as a cold it would be "goodbye human race".

[mike alexander]

Scientific American recently had an article on the 1918 influenza (sorry, can't give the exact issue, but it was the last few months) that is a very helpful introduction to the subject.

[Hutch]

I can heartily recommend The Great Influenza, by John M. Barry. http://www.amazon.com/exec/obidos/AS...036051-4857476

Compelling read, how medical science tried to fight it, and just how frightenly fast in moved...and killed.

And like the book says, we can vaccinate against flu these days..but we still cannot cure it.

[W.F. Tomba]

The H5N1 flu is showing extremely high death rates, but isn't it very possible that there are a lot of milder, unrecognized cases? Given the type of communities this thing is spreading in, it seems unlikely that everyone who gets it will go to a doctor if they're not extremely sick.

I just keep thinking of ways we could be doing much, much more to stop this problem. For example, what if the First World nations got together and agreed to compensate the Asian poultry farmers for the slaughter of all the poultry in the affected areas? Sure, it would cost a lot of money, but more than being hit with a major flu pandemic?

It's excusable to be caught off guard by something that really is a surprise, like a tsunami or an asteroid impact. But how can we be so unprepared for a threat that prompted emergency action in 1997? Forgive me for adapting a tired old cliche, but if we could get men to the moon in ten years, why can't we ramp up vaccine production in seven?

How can we just stand by and put millions of lives at risk through inaction?

[Doodler]

And like the book says, we can vaccinate against flu these days..but we still cannot cure it.

Same with any virus, unfortunately.

[TriangleMan]

It's not just chickens though. I believe turkeys, ducks and other waterfowl can have it as well. I'm not sure whether other Avians can harbour the virus, if so then we'd need to eliminate other birds as well.

[W.F. Tomba]

It's not just chickens though. I believe turkeys, ducks and other waterfowl can have it as well. I'm not sure whether other Avians can harbour the virus, if so then we'd need to eliminate other birds as well.

I meant poultry in the sense of all domesticated fowl. The purpose wouldn't be to wipe out the virus entirely, but to destroy its path from birds to humans. I realize it would be only a temporary fix to buy time. I guess that would only be valuable if we used the time well, though. #-o

Edit: Another idea---if we can make a vaccine, why can't we make one to use on birds?

[beskeptical]

This is one of the more realistic - and I think scarier - woowoo-type possibilities out there!

Are there any good, informative sites out there where I could go to track this and stay up-to-dated? I'd hate to be "behind the curve" on this one if it happens to gets bad. But i also don't want to have to track it on GLP

Main Pro Med is the best site for daily reports of outbreaks of animal and human infectious diseases around the world.

Couple of cautions, don't get alarmed about any of the reports when they say "unknown cause" or things like that. This site monitors news sources and prints the story as is. Often there is a very rational comment about the article added by the moderator.

An example was a recent article of 25 pigs a day dying of "pig flu" in a town in India. Of course the first thought is H5N1 has spread but the moderator adds,

[Infectious diseases, particularly zoonoses, should be ruled out. In
case an investigation takes place, we shall be grateful for an
update. - Mod.AS]

IE calm down folks we get these reports all the time and shouldn't jump to conclusions.

And it is true, only a few of the reports end up about real problems like SARS. I will say though, SARS was reported on here long before any agency started to notice. If you go back through the SARS archives it is a very interesting chronology of reports.

The second caution is don't sign up for the list serve. Their mailing list has been infected with viruses more times than I can count. I e-mailed them several; times asking them to post something about it but they never have. For an infectious disease site, oh the irony of it. :roll:

They have posted 2 of my e-mails though. If you have an important point it gets noticed. There is no chit chat nor "gee that's interesting" so e-mails have to be specifically about monitoring outbreaks. They do an excellent job of keeping to that in a strict way.


For general information about flu and avian flu go to CDC flu page and WHO home page sites. CDC has an Emerging Infectious Disease Journal. It is very technical and not a daily report but there are plenty of interesting articles. It's a monthly publication and there is no subscription needed. WHO also has daily reports on worldwide outbreaks. The WHO site on flu is good but they changes their flu monitoring report site and it is confusing to navigate now.