- кстати, а после термической обработки 100% никаких остаточных не остается? а то курочку люблю... и уточку..
потому что они не контактировали ни с домашней птицей, ни с человеком - в малонаселенных местах были
Может наталкивался на историю об вымершей экспедиции, занимавшейся исследованием перелетных птиц, точнее как раз путей миграций их..? Слышала с чьих-то слов.. а меньше всего люблю такие "черные истории", либо факты - либо договоримся не сеять панику... жить-то всем хочется, а как почитаешь:
считайте как хотите но мои мысли такие что это будет самым большим мором за всю историю человечества
- кстати, а после термической обработки 100% никаких остаточных не остается? а то курочку люблю... и уточку.
нет. сей вирус хорошо переност холод, но очень плохо жару (5 мин при 70-80 градусах хватит для дезинфекции) - тока руками дотрагиваться к сырой особо не надо. Конечно это стоит учитывать, если только пойдет широкая эпидемия
но закрывать уши тоже глупо
Именно. Если существует вероятность, то ее просто нужно принимать во внимание
нет. сей вирус хорошо переност холод, но очень плохо жару
- А сколько времени может жить без хозяина? Вон, споры сиб.язвы натуральной что-то под 70 или сколько-то могут оставаться жизнеспособными, из-за чего раскапывать захоронения таких опасно. Искусственная - что-то 5 лет или в этом роде (опять же, если склероз не обманывает).
А вот ентот сколько может?
Именно. Если существует вероятность, то ее просто нужно принимать во внимание
- Угу. согласен, принимать обязательно надо, только панику разводить не стоит
[12-03-2005 15:44] Вьетнамские врачи предполагают, что произошле уже второй случай заражения "птичьим гриппом" медсестры от пациента. Она госпитализирована. Всего на севере Вьетнама от этой болезни умерли 46 человек. По мнению специалистов, если вирус "птичьего гриппа" в результате мутации будет легко передаваться людям, в мире разразиться пандемия этой болезни, что может повлечь за собой миллионы жертв. Добавлено в 23:14 Во Вьетнаме у медсестры подозревают "птичий грипп"
Во Вьетнаме с подозрением на "птичий грипп" госпитализирована медсестра. Она ухаживала за пациентом, которому поставлен этот диагноз. Как сообщают западные СМИ со ссылкой на санитарные власти страны, окончательные результаты тестов 41-летней женщины должны стать известны на следующей неделе. Если диагноз подтвердится, то это будет уже второй случай заражения "птичьим гриппом" среди медперсонала. Ранее на этой неделе в больницу в Ханое доставили 26-летнего медбрата, который в феврале ухаживал в клинике на севере страны за пациентом с этим заболеванием. Власти тогда заявили, что о передаче вируса от человека человеку речь, судя по всему, не идет. Специалисты предупреждают, что если вирус мутирует и начнет передаваться от человека человеку, это может привести к эпидемии, способной унести жизни миллионов жителей планеты.
Вирус птичьего гриппа начал мутировать уже в человеческой популяции, сообщается на официальном сайте Всемирной организации здравоохранения (World Health Organization). К такому выводу пришли эксперты после изучения последних случаев инфекции по Вьетнаме.
Передача вируса медицинским работникам, которые ухаживают за больными птичьим гриппом, указывает на то, что вирус начал изменять свои свойства уже непосредственно в человеческой популяции. Таким образом, угроза пандемии становится все более реальной и более близкой по возможным срокам развития. Свиньи, люди и собаки стали болеть одним и тем же
Птичий грипп в прошлом году никто не предсказал. И атипичную пневмонию в позапрошлом - тоже
Эксперты ВОЗ считают необходимым скорейшее эпидемиологическое расследование каждого нового случая и принятие всех мер по недопущению распространения заболевания среди людей.
Напомним, что первые случаи инфекции у человека, вызванный вирусом H5N1, были зарегистрирован в январе 2004 года во Вьетнаме и Таиланде. Всего за это время было зафиксировано три вспышки заболевания: с января по март (35 случаев, из них 24 смертельных), с августа по октябрь (9 случаев, из них 8 смертельных) и с декабря 2004 по настоящее время (на 11 марта - 25 случаев, из них 14 смертельных).
Основной удар инфекции пришелся на Вьетнам, который объявил о своей неспособности справиться с эпидемией и обратился к мировому сообществу за технической и финансовой помощью.
ССЫЛКИ ПО ТЕМЕ Avian influenza – situation in Viet Nam - update 11 - World Health Organization, 11.03.2005 В лабораториях Вьетнама пропустили семь случаев птичьего гриппа - Mednovosti.ru, 09.03.2005 Птичий грипп в Азии унес 47-ю жизнь - Mednovosti.ru, 28.02.2005 Вирус птичьего гриппа оказался более опасным, чем считалось - Mednovosti.ru, 17.02.2005 На российских птичницах проведут эксперимент - Mednovosti.ru, 03.02.2005
PS - Итак, остается от нескольких недель или пары месяцев, до полугода (т.е. осенью), в лучшем случае, на подготовку.
PPS - в принципе, для окончательной мутации, которая даст возможность вирусу куриного гриппа легкопроникать в человеческий организм (а не как сейчас, когда нужна огромная доза вирусов сразу, чтобы хоть частьпроникла), необходимо, чтобы человек заболевший причьим гриппом, одновременно с этим заразился и обычным человечьим - тогда вирус птььего приппа сможет обменяться генами с обычным гриппом, и найдет способы легкого проникновения в организм.
True Toll of Avian Flu Remains a Mystery By LAWRENCE K. ALTMAN, M.D.
Published: March 15, 2005
While early reports of the deadliness of human avian influenza suggested that about 90 percent of the victims died, there are growing signs that the disease's true death rate is much lower - although still high enough to kill many millions of people if the worst fears about its spread come to fruition.
Few acute infectious diseases have death rates exceeding 5 or 10 percent. Exceptions are rabies, which is nearly always fatal, and Ebola and Lassa fever, with reported death rates ranging from 25 to 90 percent. The death rate for garden-variety flu for children, the elderly or the immuno-compromised is less than 1 percent in developed countries. At least 20 million people worldwide died in the 1918 influenza pandemic, with an estimated death rate of 2 percent.
As of yesterday, the death rate from A(H5N1) avian influenza in Southeast Asia was 67 percent: 46 deaths among 69 confirmed cases reported from Cambodia (1), Thailand (17) and Vietnam (51), according to the World Health Organization.
The death rate forbird flu is dwindling because it is easier to count people who die than those who may become infected and have minor symptoms, or none at all. This phenomenon of subclinical disease - a mild case of thebird flu, as it were - seems to be occurring with more frequency than previously appreciated.
For instance, the virus was detected in a healthy 81-year-old man in Vietnam and in a few others who barely knew they had been ill. If mild or symptomless cases are missed, the death rate will be skewed to falsely high levels.
On the grimmer side, other findings indicate that human bird flu infections may be more widespread than initially suspected and possibly transmitted by feces. The virus was found in a child with severe diarrhea and encephalitis, but no respiratory symptoms, leading health officials to ask doctors to consider testing feces for A(H5N1) virus more often.
The bottom line is that more human bird flu may be around than once suspected, but fewer people who get it become gravely ill and die than initially predicted.
That, however, is an oversimplification. Establishing a death rate for a disease like bird flu is a moving target for medical detectives.
Obtaining an accurate death rate depends on many factors, including the ability of people to get health care and the quality of the laboratory testing forthe A(H5N1) virus.
Each step in the process must go right to get an accurate death rate, and that is difficult enough to attain in the United States. The problems are multiplied in poor countries with too few trained technicians and inadequate laboratory facilities.
Also, a true death rate depends on governments' honesty to overcome fears about losses from decreased tourism and trade to report all cases. Health officials credit aggressive journalists in Vietnam for reporting more and timelier information aboutbird flu than the government.
Medical history teaches that high death rates first reported in outbreaks of newly recognized infectious agents usually drop as epidemiologists interview contacts and test for mild infection. Until that is done, death rates usually are limited to people who get to a hospital, who are often the sickest and may not receive treatment in time.
Even the start of determining death rates is difficult. As doctors examine patients with respiratory symptoms, they must overcome practical hurdles like having enough swabs and other standard equipment to take samples from patients' noses. They must also know how to obtain the specimens properly.
Few laboratories in developing countries can test forthe virus. Also, sending specimens to laboratories can be nearly impossible because of the lack of good roads and express mail systems. Specimens must be packed to stay cold forabout 12 hours to preserve any virus present. But dry ice, widely available in developed countries, is nonexistent in some affected countries.
Under the microscope: preparedness forbird flu outbreak
PM - Wednesday, 16 March , 2005 18:29:35 Reporter: David Mark
PAUL LOCKYER: Is Australia prepared for an outbreak of bird flu? A disease so deadly that the World Health Organisation has warned that millions of people may be at risk.
Greens Senator Bob Brown wants a parliamentary inquiry held into Australia's ability to control an outbreak, but the Health Minister Tony Abbot said today it was unnecessary.
Today in the second part of a two-part series, we take a look at how Australian agencies and health carers would respond to a flu pandemic, and how order and calm could be maintained in the face of public panic.
David Mark reports.
DAVID MARK: It could happen so easily.
A plane arrives from say Bangkok and on board is someone who unknowingly has caught a mutated version of the virus which the World Health Organisation believes could kill 100 million people.
Thus far, the avian influenza, or bird flu, has only been transmitted from diseased poultry in south-east Asia.
The fear is that the virus may mix with another so that it may be transmitted from human-to-human.
After that, the job of keeping the virus out of Australia becomes infinitely more difficult, and it's for this reason the Federal Government has put together an Australian Action Plan for Pandemic Influenza.
So back to our person on the plane.
Australia's Chief Medical Officer, Dr John Horvath, explains what may happen when that person gets sick.
JOHN HORVATH: The next line of defence is to quarantine that person, then we have an immediate response by various public health units.
DAVID MARK: The problem arises when someone slips through the net, as Dr Alan Hampson from the World Health Organisation explains.
ALAN HAMPSON: Maybe the taxi driver who drives somebody from the airport to their hotel, maybe people in the hotel.
DAVID MARK: Retired molecular biologist, Professor Graham Laver, says Australia could be in the grips of a pandemic within weeks.
GRAHAM LAVER: If it's really transmissible, in other words if one person in a supermarket can infect another 100 people, and each of those people go and infect another 100 somewhere, I mean it just explodes.
DAVID MARK: So how well prepared is Australia?
The Federal Health Minister, Tony Abbott, was asked that very question in Parliament today.
TONY ABBOTT: Mr Speaker, I can say that thanks largely to the good work of federal and state health officials, Mr Speaker, Australia is far better prepared than any… than ever before, and certainly, in the judgement of the World Health Organisation, as well prepared as any country in the world.
AILLEN PLANT: In our worst-case scenario we'd look at really up to 25 per cent of thepopulation being infected.
DAVID MARK: Aileen Plant is the Professor of International Health at the Australian Biosecurity Co-operative Research Centre at Curtin University and a member of the National Influenza Pandemic Action Committee.
AILEEN PLANT: I think some time within the next couple of years we will see a pandemic of flu. The real question is whether it will have mutated so that it's more mild.
DAVID MARK: In terms of the mildness of the pandemic, at the moment the mortality rate of those people who have been hospitalised with the disease is around 75 per cent. Is it likely that that sort of mortality rate would continue if the virus does mutate such that it's transmissible from human-to-human?
AILEEN PLANT: No idea. Who can tell which way the mutations will go? I mean, even a mild pandemic still has a huge impact.
DAVID MARK: That's a terrifying prospect. You're saying in your worst-case scenario a quarter of thepopulation might catch the virus. That means millions of Australians could die.
AILEEN PLANT: Absolutely.
DAVID MARK: The pandemic action plan has identified a million people involved in essential services who will receive the first protection in the event of an outbreak in theform of antiviral drugs.
AILEEN PLANT: And they start from the border, so there's about 3,000 people who work on the border who are likely to come into contact with people who may be infected, and it goes to doctors and nurses who are actually seeing patients.
DAVID MARK: You say there's about a million essential service workers. Does that mean that there are enough antiviral drugs stockpiled already in Australia to cover those one million people?
AILEEN PLANT: Well the exact amount of stockpile isn't really publicly known, but my understanding is that there is enough for those people for some weeks. So we've certainly got an opportunity to start controlling the outbreak early.
DAVID MARK: The problem according to Graham Laver is that a limited number of antivirals could lead to panic.
GRAHAM LAVER: If a pandemic (inaudible) was killing people, and people realised that these drugs were available for some people and not for others, there would be panic. And people will be desperate to get their hands on them.
JOHN HOVARTH: There is a risk of panic. People will be frightened, and we have got to ensure that we are doing the best to minimise thechances of the virus coming to this country, delaying it for as long as possible till a vaccine is manufactured, and then acting the most prudently to limit the effect on the community.
DAVID MARK: Australia's Chief Medical Officer, Dr John Horvath.
Then there's Australia's medical system.
Are hospitals and GP's prepared for a major pandemic?
Professor Ailleen Plant.
AILEEN PLANT: Probably not as well prepared as they need to be. I certainly think that as far as general practitioners, pharmacists, nurse practitioners, hospital preparedness, we've still got a fair way to go.
DAVID MARK: What are the deficiencies?
AILEEN PLANT: Knowledge, preparedness to implement what'll really be quite draconian infection control measures. It'll be extremely difficult to do that.
DAVID MARK: So you're saying essentially the problem is one of education?
AILEEN PLANT: Education is a major problem.
PAUL LOCKYER: Professor Aileen Plant from Curtin University in Perth, and in a further report tomorrow, David Mark will look at the crucial search for a bird flu vaccine.
WHO urges world governments to prepare forbird flu pandemic
Officials of the World Health Organization (WHO) are urging world governments to begin making preparations for a flu pandemic that could come as early as next year. A strain of avian flu in Asia has killed at least 40 people in Asia so far this year, and the WHO fears that the virus could soon mutate into a form that spreads easily between humans.
Last Update: Friday, March 18, 2005. 12:31pm (AEDT)
WHO fears bird flu could jump to epidemic proportions. (File photo) (Reuters)
Bird flu: can Australian medical resources cope?
By by David Mark for PM
The World Health Organisation (WHO) believes avian influenza is a ticking time bomb capable of killing millions.
So far the virus has made the species jump - obviously between birds and people - it has killed 46 people in South-East Asia. But if it makes the next jump to epidemic proportions, an estimated five million Australians could catch the disease.
The resulting death rate would be devastating, with the old, the very young, and those with compromised immune systems in the frontline.
Australia is said to havethe most antiviral medication per capita of any country, but the Federal Government does not want you to know exactly how much.
Do we have enough to stave off the initial wave of the virus? And how long would it take to produce a safe vaccine and deliver it to all Australians?
Thus far 69 people have been hospitalised with the virus and 46 people have died.
All those who died after contracting the deadly flu in South-East Asia caught the virus from poultry, but the fear is that the virus could mutate and so pass easily from person to person.
Peter Collignon is a professor in infectious diseases and microbiology at the Canberra Hospital.
He says one of the issues is whether the organism or this type of flu will develop and spread from person to person readily.
"But the main issue with preparation - particularly if a large number of people might be exposed - is first of all having adequate medical facilities and drugs that may stop the initial, both people getting very sick from it, but also the staff and people who care forthem," he said. Plan
Under the national Pandemic Action Plan one million essential services workers such as quarantine staff, police, doctors and nurses, wouldhave access to antiviral drugs which help stop the virus.
Aileen Plant is the Professor of International Health at the Australian Biosecurity Cooperative Research Centre at Curtin University.
She says there would be enough drugs for a few weeks.
"There's two antivirals - there's one called Tamiflu, that's the tradename, and the other main one is Relenza - they have different methods of administration," she said.
But the worst-case scenario outlined in the national influenza action plan is that five million Australians could catch the disease. So wouldthere be enough drugs if the disease spread?
"Initially there would be because we wouldn't be rolling out you know, enough drugs for a million workers in the first day - that's not how it would work," Professor Plant said.
"I think if the epidemic went on and on, we would hope that we would be able to get them, and it depends of course on the availability, competing demands on those drugs around the world."
The Australian public may believe they have a right to know how many antivirals have been stockpiled, but the actual number will remain a secret.
Australia's Chief Medical Officer Dr John Horvath says that is because it is a part of the national security arrangements which is a decision of government, that at this particular time, is not appropriate.
Retired molecular biologist Professor Graham Laver says the number needed would be whatever it takes to treat all 20 million Australians, and he says pharmacists should be the frontline.
"As soon as you feel the symptoms coming on you go to the chemist you take a dose of Tamiflu the infection will be curtailed you'll get better," he said.
"And in addition, you'll now be immunised against that virus forthe rest of the season."
Dr Horvath disagrees.
"This is a debate that has been going on for some little time. The real concern that some of the authorities have, is that these drugs are in very short supply worldwide, and you may well end up using it for a whole lot of people who havethe common cold," he said.
"At the moment there is no easy diagnostic test forthe flu. Therefore, there are concerns that a whole lot of antivirals would be wasted."
But for Professor Collignon antivirals are a side issue.
"The real issue if we have to do something about this, is to readily and fairly effectively, come up with a vaccine that is both safe and will work at stopping other people from getting the infections, so that it doesn't continue to spread from person to person and those people who are vaccinated are then protected," he said. Vaccine
Professor Collignon says realistically it may take six months before you can actually produce the vaccine, make sure it works and that it is safe, and then have sufficient number produced so that you can distribute it widely.
Another issue that arises then, is that in a worst-case scenario, there may be millions of Australians who are infected. So how will the Government produce enough vaccine and distribute it so that those people can all get it in time?
"Well I think that's very difficult. We are fortunate in Australia in that we stillhave an influenza manufacturing plant in Australia, in Melbourne, which was part of the old government-owned CSL laboratories," Professor Collignon said.
"But again how quickly one can ramp that up and produce a vaccine is dependent on a lot of factors. I mean, we've also got to make sure what we give is safe, and that it works."
For now the world is watching, waiting and preparing as best it can.
Thebird flu may never mutate and remain a problem for a relatively small number of people in South-East Asia. But most experts say an influenza epidemic is overdue, the question is how bad will it be.
Dr Horvath is keen to reassure Australians, but even he says we will not know what will happen until it is over.
"Recently the WHO, at a meeting, said Australia is the best prepared of any country at the present time for a flu pandemic. The answer to your question, regrettably, we won't know until after the event occurs," he said.
"Have we done enough? Can't tell you that." In other developments: The World Health Organisation says avian influenza, or bird flu, could be the world's next pandemic and could kill up to one million people. (Full Story) The World Health Organisation fears bird flu could be the world's next great pandemic and could kill 100 million people. (Full Story)
Wednesday, March 16, 2005 Commentary | Home Flu pandemic could kill one billion people around the world, say experts
A Russian scientist has alarmingly announced that one billion people stand to die from the coming global flu pandemic. In the United States alone, as many as 700,000 people are expected to die in as little as six months following the outbreak.
Are these figures for real? They may be on the high side, but even the World Health Organization now says the next global pandemic is overdue. Furthermore (and perhaps even more importantly), the world is not at all prepared to manufacture and distribute enough vaccines to protect the global population from the coming pandemic. Health officials can't even get flu shots distributed without creating a near-panic in thepopulation. Imagine the fear and confusion that would be created by a killer virus: a flu pandemic.
So what kind of viral strain is expected to strike the world next? Probably a variation of thebird flu (see related ebook on bird flu) virus, or a particular strain known as H5N1, which right now exists in other species but is expected to make the cross-species jump and end up in humans very soon.
You can expect the mass media to severely distort this story as it unfolds in order to avert a public panic. People will be told there is no pandemic even while tens of thousands are dying from it. Vaccines will simply not be available on a widespread basis. But the people in the know will have long since prepared forthe pandemic with their own anti-viral herbs and immune-boosting nutritional strategies.
In fact, surviving the next flu pandemic will probably be relatively easy if you have a strong immune system. The key is knowing how to make it strong (and having the discpline to actually do it before the flu strikes).
Experts blame inaccurate tests and an inability to fight the virus
By CHARLES PILLER Los Angeles Times
RESOURCES BIRD FLU
Scientists are watching the spread of bird flu in Asia with concern, fearing the incidence of the disease is underreported.
HO CHI MINH CITY, VIETNAM - After more than a year of watching patients sicken and die of bird flu, Dr. Tran Tinh Hien of the Hospital for Tropical Diseases here thought he understood the illness.
Then last month, he learned of an unsettling study. Japanese researchers retested samples from 30 Vietnamese patients whose lab tests showed no signs of the disease. They discovered that seven had actually been infected.
"We are especially worried because it may mean we missed some patients," said Tran, the hospital's deputy director.
Tran is part of a growing consensus that the extent of human bird-flu infection in Southeast Asia may have been significantly underestimated.
In the last few months, scientists have begun to think that the inaccuracy of laboratory tests, the wide variation of symptoms and the inability of public health agencies to combat the disease may have created the erroneous perception that bird flu is still rare among humans.
The number of infections is key. The more there are, the greater thechancethe virus will mutate into a form that can easily be passed between people, who wouldhave little immunity to the new disease. Scientists think nearly all infections so far have been caused by contact with sick or dead poultry.
Officially, the tally doesn't sound alarming. But doctors and public health officials point to a glaring oddity in the statistics that underscores the belief that the case count is too low to be true.
Vietnam and Thailand have reported the overwhelming majority of recent cases. Yet Laos, which is sandwiched between the countries, has reported no cases among people or birds this year.
Cambodia, which is also flanked by Vietnam and Thailand, has confirmed only a single human case.
"People are not trying to cover it up, but given how widespread the infection is in poultry in Southeast Asia, it's hard to believe people have gotten ill in only (three) countries," said Jeremy Farrar, a University of Oxford flu researcher at the Hospital for Tropical Diseases.
Philippe Buchy, head of virology at thePasteurInstitute, the only testing center in Cambodia, added, "The best way not to find something is not to look for it."
The current bird flu, a variety formally known as H5N1, was first detected in Hong Kong in 1997.
After the slaughter of millions of chickens and ducks throughout Southeast Asia, public health officials thought the disease was under control.
But since December, the virus has seen a resurgence in birds in the region.
Some public health officials now think the disease is ingrained in wild birds and would be virtually impossible to wipe out.
Forthe most part, doctors searching for infected humans looked for classic pneumonia-like symptoms such as coughing, lung damage and often death.
But theJapanese study and several other recent scientific papers suggest that doctors haven't been looking for all the right clues.
Therecent discovery of mild cases debunks the widely accepted idea that bird flu kills about 70 percent of its victims, which would make it one of the most lethal infectious diseases.
But that seemingly good news has a disturbing implication. "In global health terms, people who don't die can be more of a problem," Farrar said, because they provide havens forthe virus and may help it circulate in their communities and beyond.
Limited antiviral drugs in flu pandemic could pose Solomon-like dilemmas
Sun Mar 20, 4:43 PM ET
TORONTO (CP) - Little known and rarely used in North America, antiviral drugs will be the first line of defence when the next influenza pandemic strikes, in the months before a vaccine can be made available.
But with a national stockpile sufficient to treat only a fraction of Canada's population, deciding how to ration and distribute antivirals in the first wave of a pandemic poses King Solomon-like dilemmas for public health officials.
A number from acrossthe country will meet in Winnipeg on Tuesday and Wednesday to try to get a better handle on the drugs - how they are used and what their use may achieve as part of federal, provincial and municipal pandemic preparedness plans.
The idea behind the meeting is to ensure that care-givers and policy makers "have got state-of-the-art information on antivirals," says Dr. Arlene King, director of respiratory illnesses in the new Public Health Agency of Canada.
Officials of Health Canada, and later the public health agency, have been labouring for years on the federal plan, considered one of the most advanced in the world. Its evolving recommendations on who should have priority access to antiviral drugs are the result of wrenching deliberations of a committee comprised of public health experts and medical ethicists.
"All I can say is they're difficult," committee chair Dr. Susan Tamblyn says of the group's ongoing debates.
"I think the whole situation is difficult. And I guess when drugs or anything else are in short supply and we try and figure out how they can best be used, you look at persons who fall within groups that are more likely to have complications and try and deal with it that way.
"But we acknowledge it's going to be difficult in individual situations and for individual (health-care) practitioners."
Dr. Allison McGeer, an infectious diseases expert at Toronto's Mount Sinai Hospital, agrees it won't be easy for those who will face public demand forthe precious drugs in what could be panic-filled times.
"If it's not a bad pandemic, then there are lots of people out there who don't believe in taking medication when they're sick. So if it's a 1957-58 variety, it's not going to be that difficult to persuade healthy adults that they don't need to be treated," says McGeer, referring to the relatively mild Asian flu pandemic of the late '50s, one of three in the last century.
"If it's anything more serious than that, it may not be quite so easy."
Currently, the most effective drug in the antiviral arsenal is oseltamivir, sold under the brand name Tamiflu. It can be used as treatment, to soften the blow of the illness, and to prevent infection, which is called prophylaxis.
At roughly $60 (retail) for a single treatment course of 10 pills, the drug is costly and in limited supply globally. That's because heightened fears of a pandemic brought on by the ongoing avian influenza crisis in southeast Asia have spurred governments of several developed countries to purchase large stockpiles.
As Canada's pandemic plan notes, these drugs have to be purchased in advance. When the last major pandemic scare occurred in Hong Kong in 1997, "antiviral drugs rapidly became virtually unavailable for purchase worldwide."
By the end of this month, Canada will have roughly 20 million oseltamivir pills stockpiled.
Dr. David Butler-Jones, head of the public health agency, says he hopes to eventually lay in about 30 million pills. The drugs will be used primarily for treatment of the ill, but some will be set aside for prophylaxis of front-line health-care workers in a bid to keep hospitals functioning.
Treatment takes two pills a day for five days while prophylaxis requires a single pill a day forthe entire period during which protection is needed. For instance, protecting an intensive care nurse for six weeks would take 42 pills, or just over four treatment courses.
Simple math suggests hard choices will have to be made.
"At three million (treatment) doses, you're going to have to draw the line somewhere," McGeer notes. "You're going to be drawing lines about who's eligible and who's not eligible. 'Your chronic disease is not severe enough for me to be able to treat you.' That's going to be very difficult."
The most recentversion of pandemic priority groupings would give first crack at the drugs to people hospitalized for influenza - if they are admitted within the first 48 hours of their illness, King explains. (To be effective, antiviral drugs must be taken within 24 to 48 hours of illness onset).
A large group of essential workers are second on the priority list. The idea is that at the first sign of illness, designated workers will be given a course of treatment on an outpatient basis. The tricky issue of getting the drugs to those workers must be worked out at local levels.
The term essential worker catches a large group of people including: health-care professionals, fire and police officers, key elected officials, employees needed to maintain gas, water, electricity and communications networks, funeral home staff, those involved in the transport of essential goods such as food and medicines and prison guards.
"We're actually going through the pain of defining all these people," says King, who adds that it will be important for authorities from all levels of government to speak the same language when it comes to designating essential workers.
Third priority will be the prophylaxis of front-line health-care workers and key decision makers. Next comes treatment of people who have medical conditions that put them at high-risk of complications from flu. Fifth on the priority list are high-risk residents of health institutions.
Supplies in the national stockpile will be divided up among provinces and territories on a per capita basis, King added. Добавлено в 10:43 ЗЫ - поинтересовался на днях, как обстоит дело с наличием того же Тамифлю (антивирусный препарат против гриппа - ингибитор нейроминидазы (препятсвует высвобождению расплодившихся вирусов в зараженной клетке), наиболее эффективный (40%) из существующих, хотя полностью эффективных пока еще не придумали). В Крыму про такое вообще не слыхивали. В Москве на данный момент всего полторы сотни пачек на весь город - http://www.medlux.ru/dsearch/ddb.cgi?patte...EB%FE&allds=yes
LONDON (AFP) - Hundreds of thousands of people may die and one quarter of the work force could be absent if Britain were hit by a bird flu pandemic, a senior government official said.
"It may be somewhere between 20,000 and 750,000 extra deaths and it may be 25 percent of thepopulation off work," the government's chief medical officer Liam Donaldson told a conference in London.
"That is the shape of the event we are going to have to deal with," Donaldson said.
Britain's population is nearly 60 million people, with 28 million working, according to government figures.
Contingency plans already announced by the Department of Health include the stockpiling of the anti-viral drug Tamiflu at a cost of 200 million pounds (380 million dollars, 290 million euros), he said.
He has also outlined measures to reduce the spread of the virus, including closing down schools and cancelling football matches and other events.
His comments to an international forum at Chatham House came days after one of the country's leading scientists warned that the government had been "optimistic" in its assumptions on the potential problem.
Professor Hugh Pennington, president of the Society for General Microbiology, said he believed up to two million Britons could perish from a mutated form of the H5N1 virus.
He has criticised current planning for an outbreak, warning that a strain affecting humans will be "here before we know it."
Though the government has ordered 14.6 million vaccine doses for Britain they will take up to two years to arrive, sparking fears that thepopulation will be at risk in the interim.
Since last January, some 46 people southeast Asia, most of them in Vietnam, have died after contracting a type of the disease as a result of contact with sick or dead birds.
Medical experts have warned that if the virus develops the ability to pass from human to human, the consequences would be devastating. Добавлено в 07:03 Monday, March 21, 2005
Get healthy now to prepare your immune system forbird flu outbreak
When taking a look at the potential threat of thebird flu virus, it's difficult to get an accurate perspective. For many people in the United States, Canada or the UK, thebird flu virus is just some other strange disease in Asia that's killing pigs or birds, and the implications don't really hit home. But then there's the World Health Organization, which is raising the alarm over thebird flu virus and becoming increasingly concerned with each passing week. And there's the CDC, which has called thebird flu virus the single greatest threat to humanity. That's a serious statement. And that goes right along with the World Health Organization's advice that countries should literally stockpile vaccines forthe virus.
And yet, the vaccines aren't even out of the testing phase yet. So how do you stockpile a vaccine when it hasn't been safety tested or approved? Right now, the only thing that countries can stockpile is antiviral drugs such as Tamiflu. And, by the way, Tamiflu is anti-viral, but even it is not nearly as strong as the combination of antiviral herbs and various nutritional supplements as outlined in my free downloadable book called "How To Beat TheBird Flu Virus." So even though these countries are stockpiling Tamiflu, people would actually be far better protected by acquiring potent antiviral herbs, minerals and supplements as a protection against thebird flu virus.
But knowing the way most people think, few will actually prepare for this. And frankly, they might get away with it. There is a real possibility that thebird flu virus could be a bust. Maybe it will never become a pandemic. But history has taught us that the minute we get too comfortable thinking that all the pandemics are over or that we as modern scientists have conquered nature, then nature will turn around and slap us in the face with a hard lesson that wipes out tens of millions of people around the world. Historically, we've seen this scenario return like clockwork. These pandemics occur on a regular, predictable basis. Thebird flu virus is well positioned to be the next chapter in that saga of global epidemics.
A lot of people ask me, "So what should I do to prepare forthebird flu pandemic? What's reasonable versus overreacting?" To answer that, let's take a look at the behavior of the general population. Most people will do nothing to prepare until it becomes a problem in their local area. When USA Today or CNN starts warning people aboutthe virus and people start seeing their friends or coworkers die from it, then they will suddenly realize that they need to take some action. At that point, of course, it will be too late. At that time, the vaccines will be depleted; supplies will be severely restricted and there simply won't be enough to go around.
The World Health Organization has already warned countries aboutthe coming vaccine shortages. By the time people really need the vaccine, it won't be there forthem. That means if you're going to prepare forthebird flu pandemic, you have to do so ahead of time. One of the smartest things you can do to prepare is to improve your health right now. A strong immune system will help defend against thebird flu virus. And if you want a strong immune system, you've got to stop poisoning your body right now through foods, prescription drugs, environmental toxins and chronic stress.
If you wait forthe virus to hit, it's going to be too late. You can't reform your immune system in 24 hours. You can't just change your diet one day and expect to be healthier the next day or the next week or even the next month. It takes many months of healthy eating and wise lifestyle choices to make strong, lasting changes in your health and immune system function. You'd better start now if you want to be in peak health by the time thebird flu virus comes around. And, in the worst case, if you were wrong, if you prepared for nothing, then you will at least have a healthy immune system even if there's no bird flu virus.
And that could just save you from plenty of other diseases like cancer.
Come to think of it, if thebird flu virus really becomes a pandemic, it could turn out to be a selective killer of millions. With organized medicine basically sidelined by the virus, the people most likely to survive will be those who lead healthy lifestyles to begin with. Let's face it: people who live day to day in an immunosupressed state are basically just asking to be infected or killed by this virus. When a person eats junk food, avoids taking nutritional supplements, refuses to exercise, and keeps popping over-the-counter medications and prescription drugs, they are just as culpable as thebird flu virus itself, in my opinion. I'm tired of hearing people whine about being victims when they won't lift a finger to do a single healthy thing forthemselves.
In 1918, during the last major pandemic, at least people had an excuse for being unhealthy. Many lived in extreme poverty. Healthy foods weren't available. Nutrition (see related ebook on nutrition) was poorly understood. But today, it's different: nearly everyone in industrialized nations has access to healthy, nutritious foods and medicinal herbs. And yet many people refuse to make healthy decisions, leaving them no better off than the malnourished victims of 1918. Remember: most Americans today are malnourished -- even as they are obese and diabetic from consuming empty calories. The malnourished, I believe, are going to have a very tough time surviving thebird flu virus if it goes global.
And conventional medicine? Helpless against thebird flu. When the hospital beds fill up, the message to everyone else will be, "Go home and die."
The first human trials of a vaccine against H5N1 bird flu are likely to be a waste of time and money.
Theformulations that the US plans to test are thought likely to be ineffective - and even if they do work it will take far too long to manufacture enough doses to prevent a pandemic strain wreaking havoc. Other countries are following more promising approaches, but they are not ready to start trials.
Fears that the H5N1 virus might mutate into a form capable of triggering a human pandemic have persuaded several countries to change strategy. Instead of waiting for a pandemic strain to emerge, health authorities are creating human vaccines against the current strain. Although these vaccines might not be perfect, the hope is that they will make the difference between life and death.
The sooner prototype vaccines are tested, the sooner vaccine makers can prepare to manufacture the vast quantities that might be needed. But so far the US is the only country to have ordered enough prototype vaccine to do clinical trials - and there are two major problems with its formulations. No immunising effect
The key ingredient in any flu vaccine is the viral protein haemagglutinin, or HA. Vaccines against ordinary flu contain 15 micrograms each of three varieties of HA. The clinical trials planned by the US National Institute of Allergy and Infectious Diseases will test doses of 15 and 45 micrograms of H5 - the HA of the H5N1 virus killing people in Vietnam. The aim is to make the vaccine as similar to ordinary flu vaccines as possible, to ease approval by the FDA.
But several studies have shown that with HAs that people have not been exposed to before, such as H5, even doses higher than 15 micrograms have little or no immunising effect. "I predict they won't get much immune response at all," says Tony Colegate of the vaccine company Chiron in the UK, head of the industry's pandemic task force.
For this reason, other countries planning to test prototype vaccines - like Japan, Canada and Australia - will all add a chemical such as alum to boost the immune system reaction. This adjuvant is used in many childhood vaccines.
Another important benefit of adding an adjuvant is that far less HA will be needed in each dose. That is crucial because vaccine production capacity is limited. Worldwide capacity
The single flu vaccine factory in the US would take six months to produce 180 million doses of 15 micrograms of H5, according to calculations by flu expert David Fedson in the latest issue of the Journal of Public Health Policy. And since past studies suggest people need two shots three weeks apart to develop immunity to novel strains, that is enough for only 90 million people. All vaccine plants worldwide could produce only enough for450 million people.
In 2001, however, scientists in the UK found that with an adjuvant, two doses of just 7.5 micrograms of H5 were enough to induce immunity in previously unexposed people. And last year scientists at GlaxoSmithKline Biologicals found that two doses each of 1.9 micrograms of another novel HA were enough.
If a vaccine could be made with just 1.9 micrograms per dose, the world's vaccine plants could churn out 7.2 billion doses in six months, enough for 3.6 billion people, Fedson says. "That's probably more than the world's combined healthcare services can vaccinate."
Bruce Gellin, head of the US National Vaccine Programme Office, says thetrials now being planned "are only the first in a long series". Last week his department asked for proposals to find ways to make vaccines stretch farther, he says. "We are taking this very seriously."
Journal reference: Journal of Public Health Policy
Mortuaries and emergency services are to be put on alert and told to prepare for up to three-quarters of a million deaths from a bird flu pandemic, The Independent on Sunday can reveal.
Emergency planners have begun to look for sites for special mortuaries, each capable of storing 1,000 bodies, and the Home Office is to hold an exercise this summer to practise coping with mass fatalities. The instruction, to go out from theCivil Contingencies Secretariat, the Cabinet Office body in charge of emergencies, explodes the Government's public position that the pandemic could be expected to kill only "around 50,000" people in Britain.
It shows that its true expectation is closer to the prediction made by Professor Hugh Pennington, the president of the Society for General Microbiology, in The Independent on Sunday two weeks ago that up to two million Britons could perish. The Secretariat also believes that a quarter of the country's workforce could fall ill, paralysing economic life.
A senior government official told a private seminar in London last week: "It may be somewhere between 20,000 and 750,000 extra deaths and it may be 25 per cent of thepopulation off work. That is the shape of the event we are going to have to deal with."
He added that plans had been drawn up to confirm that emergency services and coroners had the staff and equipment to cope with such a crisis. Senior emergency planners said last week that they received official instructions at the end of last year to prepare for mass mortuaries to cope with a flu pandemic or a biological terrorism attack.
They said that most police authority areas normally had emergency mortuaries to hold 100 to 200 bodies, but they had now been asked to make provision for up to 1,000.
The authorities were now identifying greenfield sites and beginning to enter into contracts with firms to provide marquees and buildings to put on them. The planners said that these would be cooled to aboutthe same temperature as household refrigerators, to store bodies.
The scale of the preparation suggests that the Government fears that the 14.6 million doses of anti-viral drugs it has ordered may not arrive before a pandemic. Even in a year's time, less than half of the order will have been met. The drugs have been delayed partly because ministers waited for months before making the order.
Last November an official flu exercise involving health bodies, emergency services and government - Exercise Icarus - identified the lack of anti-viral drugs as a key concern. The order was placed this month.
Dr John Simpson, of the Health Protection Agency's emergency response division, said the Government was planning more exercises, including preventing public gatherings, to stop the disease spreading.
Senior officials at the World Health Organisation (WHO) told the IoS that they predict the flu virus could circle the globe within two months.
Краткая выжимка из статей на этой странице 1. Лекарств, которые могут реально помочь при птичьем гриппе, очень мало как таковых и они дороги и их производиться в мире ограниченное количество. Одним из таких является озельтамивир (он же Тамифлю), но его одна упаковка (на курс) стоит около 50-60$. До конца этого месяца Канада запасется примерно 20 млн. таблеток (примерно на 2 млн. чел.), но так как этого очень мало, то они решили вывделять лекарство в зависимости от важности соц. группы, к которой принадлежит человек.
--Примечание: речь идет не о симптоматических средствах, которые обычно применяются при гриппе, и которые лишь несколько облегчают состояние больного во время болезни, а именно о лекарствах, которые непосредственно влияют на вирус (о вакцинах позже упомяну). Таковых действительно мало - это такие как ремантадин (ухудшает условия дляпроникновения вируса в клетку) и рассматриваемый в статье Тамифлю (ухудшает условия для вирусов, расплодившихся и высвобождающихся из зараженной клетки). Ремантадин сейчас довольно малоэффективен - из-за его широкого применения вирусы так или иначе довольно быстро учатся обходить это препятсвие (хотя возможно на вирусы птичьего гриппа поначалу он будет влиять сильнее чем на обычный). Тамифлю в этом отношении пока заметно более эффективен, но при широком применении возможно повторит судьбу ремантадина (т.е. эффективность его снизиться в несколько раз). Дороговизна и малодоступность Тамифлю вероятно и объясняется желанием обеспечить его эффективность - тогда минимальна вероятность возникновения штаммов вируса, на которых Тамифлю не будет действовать.
2. Официальные прогнозы по количеству погибших британцев - до 750 000 чел. Но проф. Пеннингтон прогнозирует 2 млн. погибших британцев. На закупку Тамифлю выделяется 380 млн. баксов.
3. Статья о необходимости подготовки своей имунной системы к возможной пандемии, так какдля выживания важен будет каждый доп. фактор - ну в общем типичный набор: здоровый образ жизни и натурпродукты, отсутствие стрессов и т.п. Надеятся на обычное медобслуживание не стоит - когда больницы и госпитали будут переполненны заболевшими, там тебя скорее всего встретят словами: "Иди домой и умри!" :-)
4. Проходящие сейчас испытания вакцина от птичьего гриппа могут оказаться напрасными - стандартное количество одной дозы в 15 мкг может оказаться недостаточно, чтобы имунная система распознала вирус и выработался иммунитет. Поэтому тестироваться будут и дозы в 45 мкг. Однако даже если 15 мкг на дозу хватит, все равно все имеющиеся в мире предприятия смогут выработать за полгода вакцины только для450 млн. чел. В связи с этим, планируюстя также испытания вакцины в самой минимальной дозировке в 1,9 мкг при одновременном стимулировании имунной системы другими препаратами - тогда возможно такой дозировки и хватит для выработки имунного ответа. При дозе 1,9 мкг производственных мощностей в мире за полгода хватит на 3,6 млдр. чел. --Примечание: неэффективность вакцины может быть быть не только из-за малой дозировки - сам вирус птичьего гриппа меняется очень быстро, и скорее всего вакцина будет быстро устаревать. Какой-то толк от нее конечно будет, но вопрос какой.
5. Опять обсуждается возможные количества тех, кто погибнет в Британии от птичьего гриппа (оценки 50 или 750 тыс. - официальные, 2 млн. - неофициальные). В связи с планируемым очень большим количеством смертей обсуждаетсяпроблема размещения и утилизации трупов - в официальной инструкции говорится о необходимости специально подготовить к концу года морги для такого количества.
Российские ученые разработали модель распространения вируса "птичьего" гриппа и продемострировали на примере Гонконга. 29 марта 2005 года, 13:01 Текст: Эльвира Кошкина
Математическая модель распространения вируса "птичьего гриппа" была разработана в институте эпидемиологии и микробиологии имени Н.Ф. Гамалеи. В качестве примера ученые использовали гипотетическую ситуацию с возможностью распространения "птичьего" гриппа в Гонконге (около семи миллионов жителей). Модель демонстрирует, что если такая эпидемия произойдет, она продлится четыре месяца и может охватить до двух миллионов человек. На 78-й день, в пик эпидемии, число заболевших может достичь 365000 человек, а количество заражавшихся ежедневно составляло бы 118000 жителей города. Сделать прогнозы относительно возможной смертности "в рамках модели" среди заразившихся вирусом "птичьего" гриппа микробиологи затруднились.
Пока вирус "птичьего" гриппа не передается от человека к человеку, сообщает РИА "Новости". Веротяность его мутации существует, но этого может никогда не произойти. Как сообщил глава лаборатории эпидемиологической кибернетики института Борис Боев, за последние несколько лет в Таиланде, Вьетнаме и Китае было зарегистрировано несколько десятков случаев заражения людей этим видом гриппа непосредственно от домашней птицы. Умерли в этих случаях около 60% заболевших.
Всемирная организация здравоохранения (ВОЗ) прогнозирует вероятность возникновения пандемии гриппа в 2005 году. Как сообщает Медновости.Ру, об этом заявил накануне академик, вице-президент РАН Рем Петров.
«Неделю назад ВОЗ сообщила, что в предстоящем эпидсезоне существует вероятность возникновения гриппа, который вызовет пандемию», — сказал Петров. Он уточнил, что речь идет о новом типе гриппа — так называемом «птичьем гриппе».
Петров отметил, что вообще вирус гриппа является самым «неприятным» из всех видов ОРЗ, поскольку он легко передается воздушно-капельным путем, вызывая эпидемии, а также обладает очень высокой генетической изменчивостью. Так, в нынешнем году, по словам Петрова, в Россию придет новый штамм гриппа, отличный от того, который был в 2004 году. «По сообщению ВОЗ, сейчас движется штамм «Калифорния», — сказал академик.
По данным ВОЗ, каждый взрослый человек болеет ОРЗ в среднем два раза в год. В России ежегодно фиксируется более семи миллионов случаев заболевания гриппом. Причем эпидемии данного заболевания нередко приводят к серьезным осложнениям. Так, на долю гриппа приходится до 6 процентов летальных исходов.
Петров сообщил, что в текущем сезоне основная эпидемия гриппа закончена, а ОРЗ идет на убыль. «Однако при такой весне ОРЗ могут еще затянуться», — заключил академик.
Напомним, что в связи с возможной пандемией гриппа Главный государственный санитарный врач России уже объявлял санэпидслужбам готовность номер один.