World Health Organisation scientist Hitoshi Oshitani spends his days planning for a nightmare scenario -- a bird flu pandemic among humans that would kill millions and bring nations to their knees. . There is much that experts still don not know aboutthe deadly H5N1 strain of avian influenza -- exactly how humans contract it from infected poultry, and why so many of its victims are healthy youngsters. . But Oshitani says they do know vulnerable countries are ill-prepared and that if the virus mutates and erupts among humans in one of Asia's crowded mega-cities, it will be impossible to prevent it from becoming a pandemic. . "If a pandemic starts we cannot do anything to stop it. What we can do, once a pandemic starts, is just to reduce the negative impact by being better prepared," said the Manila-based WHO policy-maker. . "It's probably just a matter of time. Every 30 to 40 years we have had a pandemic," he told AFP on the sidelines of an international conference on bird flu held this week in the Malaysian capital. . After working on the front line of the SARS crisis, which struck terror into the region and beyond in 2003, he says the deadly pneumonia was in retrospect an "easy disease to control" because it was only spread by people who had fevers. . "Usually for influenza, it's almost impossible to control. That's why we have huge outbreaks every year." . To date, most bird flu victims have caught the disease from animals, but the fear is it will mutate into a form that can spread easily among humans, triggering a contagion that could kill tens of millions of people. . Oshitani, who specializes in communicable disease surveillance and response, says WHO experts are working on models to prevent a pandemic if an outbreak of the mutated virus was detected in time, but figuring out how to contain such a virulent disease is baffling them. . "It's not simple and we don't have any experience. (With) polio control or measles control we have a lot of experience ... but for this particular case it's extremely difficult to come up with a good plan," he says. . Measures being contemplated are to treat infected people and surrounding communities with antiviral drugs, and restrict their movement to prevent others from the disease. . But if a deadly flu virus was being spread by people with no symptoms, whose movements were not able to be controlled, in a country that could not afford expensive medicines, halting an outbreak would be almost impossible, he says. . Oshitani says the WHO has a stockpile of 60,000-70,000 doses of antiviral drugs in its Manila regional office, but the logistics of getting them to a remote community in time to stop the disease would be difficult. . "Our window of opportunity will be just two or three weeks," he says. After that the virus would almost certainly have moved on. . And in teeming cities like the Thai capital Bangkok or Vietnam's Ho Chi Minh City, the sheer mass and movement of people would mean the virus would have to be allowed to run its course through thepopulation. . "There are no other alternative tools to stop the spread," Oshitani said. . What would happen then is the stuff of nightmares. . Water and electricity supplies could be disrupted because utility workers are too sick to maintain them, the public transportation system could be abandoned for fear of infection, and those who cannot afford drugs would succumb in huge numbers. . "If more than 20 percent of thepopulation is affected, it could affect a whole range of social activities," Oshitani said, adding the crisis would no longer be just a health issue, but one which could damage entire economies. . "People do not want to get infected in a bus or the train. People may not want to go to the supermarket. So how to maintain that social life is a big challenge, particularly in urban areas." . Oshitani said there were worrying signs a mutation is looming. Growing numbers of people are being infected with bird flu -- 64 cases have emerged in Asia so far this year, compared with 44 forthe whole of 2004. . The disease is still circulating widely in the region, and the virus has continued to change and mutate since jumping to humans in 1997, when it killed six people in Hong Kong. . Since resurfacing in 2003, it has killed 55 people in Asia including 39 in Vietnam, 12 in Thailand and four in Cambodia. . "These are all bad indicators in terms of the risk of a pandemic," he said. . Experts from the World Organisation for Animal Health and the United Nations' Food and Agriculture Organisation this week unveiled a 100 million dollar plan to rein in bird flu within a decade. . But as a backup measure, the WHO is urging countries to prepare by stockpiling antiviral drugs and readying hospitals to deal with large numbers of sick people. . While some developing countries have started to work on a strategy, others with less resources such as Cambodia and Laos have barely begun, Oshitani said. . "If you start thinking of what you should do after a pandemic starts, it will be too late," he warned. — AFP
Добавлено в 07:26 H5N1 in Russia Kazakhstan and Mongolia?
The global economy could be profoundly disrupted as tens of millions of people die
The avian influenza spreading throughout Asia has so far confined its economic harm largely to farmers, who have had to slaughter tens of millions of their chickens and ducks.
But scientists and economists fear that if the virus were to mutate in such a way as to spread easily among humans, the global economy could be profoundly disrupted as tens of millions of people die.
Even if the deaths were largely limited to Asia, U.S. companies, particularly airlines, could suffer, said economist Eric Graber, president of the National Economists Club, which held a meeting Thursday to explore the financial ramifications of global epidemics.
In Asian countries, massive deaths would reduce productivity and slash output, he said. Even worse, "the fear factor" could spread up the globalized supply chain of manufactured goods, he said.
"People here could become afraid of buying products originating in those countries," he said. That could harm major importers such as Wal-Mart Stores Inc. "And people will be afraid of traveling in those countries," hurting U.S. airlines, he said.
A far bigger concern may be that Americans will continue to travel to Asia, and inadvertently bring back the deadly flu, said another meeting participant, Martin Apple, president of the Council of Scientific Society Presidents, an organization of the leaders of about 60 scientific federations and societies.
Apple said that in a "worst-case scenario," in which bird flu was easily passed from human to human, millions of Americans could die. World Health Organization officials have said the global death toll could reach 100 million. In a typical year, 36,000 Americans die from regular flu, according to the Centers for Disease Control and Prevention.
So far, bird flu, caused by a strain calledtheH5N1 avian influenza virus, has spread to at least eight countries in Asia, killing about 55 people. But those deaths appear to have been caused by direct contact with infected fowl.
"Once we have human-to-human transmission, which is apparently just beginning, it becomes an extremely serious issue, unless it's contained," Apple said.
The virus is not yet out of control, he noted. "If we took a lot of concerted action in the next 100 days, we could have a big impact," he said. "If we fail to act in the next 180 days, I think we will pay the consequences."
Even if the virus never mutates, it could have a devastating economic impact if it were to reach this country and begin killing masses of animals, he said. This virus "has the potential for eliminating, at least for some period of time, the American poultry industry" as well as the pork industry, he said.
This week, scientists reported in the journals Nature and Science that, despite efforts to cull domesticated flocks of fowl, migratory geese that can fly far beyond China may be spreading bird flu.
The epidemic of severe acute respiratory syndrome in Asia in 2002- 03 was limited in economic impact, said Maureen Lewis, senior fellow at the Center for Global Development. Even so, SARS did serious harm to certain economic sectors.
According to Lewis' study, over the course of the crisis, scheduled flight arrivals declined by about two-thirds in Southeast Asia, causing a sharp drop in business at hotels, restaurants and stores.
In Hong Kong, retail sales fell 50 percent. At the peak of the epidemic, the number of visitors and tourists dropped 80 percent in Taiwan and nearly as much in Singapore.
Monday, Jul. 11, 2005 Shortly after health experts met last week in Kuala Lumpur to craft a plan to control avian flu, Dr. Shigeru Omi, Regional Director forthe World Health Organization's (WHO) Western Pacific region, spoke with TIME's Bryan Walsh aboutthe challenge of fighting a highly unpredictable virus, the need to harness international resources, and the terrible toll a human pandemic would take.
Are we closer to a flu pandemic than ever before?
The virus is already entrenched in this part of the world, number one. Second, the number of human cases is on the rise, particularly in Vietnam. And third, the virus continues to be unpredictable and unstable. That's why we have to remain constantly on alert.
Do we havethe ability to prevent a pandemic?
This is not an easy battle. The virus is everywhere and very changeable. We are dealing with billions of animals, not just human beings. But I still believe there is a window of opportunity. That's why we should implement all the necessary strategies—cleaning up backyard farms, improving surveillance—not just on a piecemeal basis but comprehensively and thoroughly. There is no single panacea.
Are developed countries providing sufficient aid to carry out these measures?
The international community has already provided a lot of support, and I'm very grateful. But we need an additional $250 million altogether. This sounds like a big figure, but this is a lot less than the magnitude of theeconomic loss that a pandemic would cause.
Studies published last week showed that the virus is now circulating in migratory birds in western China. Could these birds spread the virus?
The findings certainly confirm that the virus is very unstable. Migratory birds used to be regarded as reasonably resistant to the virus, but now we find that's not the case. We cannot rule out the possibility that these birds will carry it to other areas. The most important thing is to test more samples from animals and humans in the area, so that we know how far the virus has spread.
Are you happy with the cooperation you've received from Beijing?
Overall, I am quite happy. We found they had aggressively culled poultry, and had restricted the movement of poultry and people. That's good, but we strongly recommend that the Chinese government get more samples from humans and animals. We need to know whether the virus is spreading among asymptomatic birds and humans.
How do you respond to charges that Chinese farmers have been using the flu drug Amantadine on their chickens?
The Chinese government has officially told the WHO that the government has never encouraged [use of] this drug for prevention purposes. We're waiting formore information. It's a very serious blow to our fight against this virus if amantadine has been used in an inappropriate manner, because this drug would normally play an important role in treating influenza.
Does the WHO support Vietnam's efforts to develop its own bird-flu vaccine?
We understand why Vietnam wants to produce its own vaccine—because there may not be enough vaccine from the West for developing countries. [But] if the vaccine quality is not well controlled, the vaccine will cause more problems than it solves. Our job is not to stop the Vietnamese but to make sure the vaccine produced will be safe and effective.
Vietnam has seen rising case numbers with a lower mortality rate. What does this mean forthe virus?
Our investigations have concluded that, so far, there's no evidence of efficient human-to-human transmission there. But given the unpredictable nature of the virus, the longer the current situation persists, themore chance the virus will achieve efficient human-to-human transmission.
Are there any genetic changes in the virus?
TheH5N1 virus has undergone significant genetic changes over the past several years, but there's no evidence so far of a specific change that makes the virus more transmissible to humans.
You've said that 100 million people could die in a worst-case pandemic. Do you still believe that?
If [a pandemic] happens, the consequences could be very serious, and the magnitude of human casualties could be in the order of millions of deaths. One hundred million is just one of so many possible figures. What's important is to understand the serious potential consequences and prepare forthem.
From the Jul. 18, 2005 issue of TIME Asia Magazine
Headlines: Influenza News June 10, 2005, CIDRAP Foreign Affairs Magazine to Feature "The Next Pandemic" Excerpt from the article:
The influential journal Foreign Affairs is adding its voice to the warnings about a potential influenza pandemic by publishing a special section on pandemics in its forthcoming July/August issue. Titled "The Next Pandemic," the section includes four articles by a panel of experts. They focus on the evidence that theH5N1 flu virus may spark a pandemic, the challenges of preparing for a pandemic, the need to integrate disease-control efforts for people and animals, and the lessons of the HIV/AIDS pandemic. Foreign Affairs is the second well-known journal in less than three weeks to publish a sizable collection of articles on the threat of a pandemic.
Foreign Affairs is the second well-known journal in less than three weeks to publish a sizable collection of articles on the threat of a pandemic. The British journal Nature published 10 articles on the subject in its May 26 issue.
Foreign Affairs has also scheduled a special press briefing on the pandemic issue for Jun 16 in Washington, DC. The briefing will feature two of the article authors, Laurie Garrett and Michael T. Osterholm, along with Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, and James F. Hoge Jr., editor of the journal.
Following are summaries of theForeign Affairs articles.
'The next pandemic?'
TheH5N1 flu virus is showing potential to cause the next flu pandemic. It is impossible to predict when a pandemic might hit—the swine flu of 1976, which failed to materialize, is a notable example of the risks of such predictions—but author Laurie Garrett is certain that the world is currently unready to address such a threat. Garrett is a senior fellow for global health at the Council on Foreign Relations.
The imbalance of wealth, the weakness of public health systems in countries worldwide, and the numerous hurdles to fast, efficient vaccine production are just a few of the issues that will affect how the world copes with a pandemic, Garrett says. She recommends that national policymakers prepare now "for worst-case scenarios involving quarantines, weakened armed services, dwindling hospital space and vaccine supplie." Further, it is in every government's interest to bolster the funding and authority of the World Health Organization and theFood and Agriculture Organization so they can offer timely, impartial assessments of an epidemic's progress.
People engaged in policy and security worldwide "cannot afford to ignore the warning" of a possible pandemic, Garrett writes.
'Preparing forthe Next Pandemic'
The next flu pandemic could well cause hundreds of millions of deaths around the world and bring the global economy to a standstill, writes Michael T. Osterholm, PhD, MPH, director of the University of Minnesota Center for Infectious Disease Research and Policy, publisher of this Web site.
Recent evidence suggests that theH5N1 strain of influenza A could trigger a pandemic like that of 1918-19, which probably killed between 50 million and 100 million people, Osterholm writes. In today's world, that could mean up to 360 million deaths. The SARS (severe acute respiratory syndrome) epidemic gave a hint of the kind of economic disruption a pandemic could cause. Though only about 8,000 of SARS cases occurred, the disease cost the Asia-Pacific region an estimated $40 billion.
If a major pandemic began today, the global economy would shut down, Osterholm predicts. The disease would trigger shortages of food and other essential commodities. No vaccine would be available in the first several months, and in the first year the world could produce only enough vaccine forabout 14% of thepopulation. The antiviral drug oseltamivir could help countries that have stockpiled it, but in most of the world it would be unavailable. Other medical supplies such as masks and ventilators would be in short supply.
As he has done in other recent writings, Osterholm calls for detailed operational planning to get through a pandemic. He also advocates an international project to develop the ability to produce a vaccine forthe entire world population within several months of the start of a pandemic. If there isn't enough vaccine to go around, economic disaster will overtake all countries, regardless of their vaccine supplies. "No one can truly be isolated from a pandemic," he writes.
'One World, One Health'
Many diseases that have scared the public and disrupted global commerce in recent years have been zoonoses — diseases that originated in animals and crossed into humans. The emergence of diseases like avian flu, SARS, and Ebola tell us that it's time to knock down the walls between the agencies and groups that deal with diseases in humans, domestic animals, and wildlife, according to William B. Karesh and Robert A. Cook. Karesh directs the field veterinary program at the Wildlife Conservation Society (WCS) and co-chairs the World Conservation Union's veterinary specialist group; Cook is vice-president of the WCS and its chief veterinarian.
Burgeoning international travel, population growth, the global trade in animals and animal products, and a growing dependence on intensified livestock production have made humanity more vulnerable to cross-species diseases, Karesh and Cook write. But "no government agency or multilateral organization today focuses on the numerous diseases that threaten people, domestic animals, and wildlife alike."
The authors observe that the eradication of smallpox — the only major infectious disease that has been eradicated — was possible largely because smallpox, at least under natural conditions, affects only humans. When a pathogen can infect a range of hosts, controlling it becomes far more difficult and requires an integrated approach, they write.
They call for a number of steps to integrate efforts to deal with human and animal diseases. Examples include better surveillance of wildlife diseases, requiring animal traders to pay more of the cost of preventing and controlling outbreaks, and inducing governments to improve the regulation of trade in animals.
"Bridges must be built between different scientific disciplines, and trade in wildlife must be dramatically reduced and, like the livestock industry, properly regulated," Karesh and Cook argue.
'The lessons of HIV/AIDS'
To understand the impact of a potential avian flu pandemic, author Laurie Garrett suggests, one should first examine a slower-moving global pandemic: HIV/AIDS. Garrett details the massive destabilization of countries acrossthe world as soldiers, teachers, and political leaders die and countless children are orphaned.
Donor states should spend heavily on HIV/AIDS prevention, care, and treatment, but also emphasize development to usher thepoorest countries into the global economy, Garrett contends. Donor states also should step up international programs that prevent high-risk sex and drug use while providing condoms and sterile needles, she adds. Thesurvival of some developing countries may rest on risking tension over unequal treatment to provide antiretroviral therapy to important people and workers in key sectors of society.
In addition, science and global security interests must recognize the importance of developing more sophisticated methods to identify and track specific strains of HIV and factors, such as drug smuggling, that contribute to the spread of the disease.
Formore information, seethe links to the three articles in Foreign Affairs.
Interview was with Laurie Garrett, a senior fellow forthe council of foreign relations, plague expert. She authored article on H5N1 in "Foreign Affairs", saying "This is 'doom may loom'".
She said that the scientific community believes pandemic influenza has switched from a possibility to a probability.
She doesn't feel we are prepared to deal with pandemic. "If it comes this fall, there's not a heck of a lot we can do", she said.
She refers to foreign policy concerns brought about by a maximum of 300M doses of vaccine worldwide, leaving many countries without, IF a vaccine could be made.
She raised the problem that flu vaccine is grown on chicken eggs, and this virus is 100 percent lethal to chickens, so growing the virus on chicken eggs is really tough.
She said that this virus continues to mutate, and to do so in alarming ways.
She was asked if this were an alarmist position, and said no. Said in 1918, before travel this easy, the flu circumnavigated the globe three times in 18 months.
Nothing said that those of us here don't know - a hell of a lot said that the majority of people either don't know or don't want to accept. Interview too short, too shallow, but the important thing of note is that it happened at all.
"If it comes this fall, there's not a heck of a lot we can do",
(тут мой вольный перевод) "когда эта напасть обрушиться на нас - обратить ее нам не в силах"
А в двух словах.. их исследовательское сообщество убеждено, что проблема медленно (для вселенских мерок) но верно из возможной превращается в весьма ивесьма правдоподобную. Ну и еще один малоприятный акцент, что сейчас вакцина производится на основе куриных яиц, а поскольку вирус смертоносен для самих кур, то сам процесс усложняется, сами понимаете.. (Яйца нести некому) Примерно так. ну и оканчивает свою речь на "оптимистичной" ноте, мол ОНО уже пришло... И мутирует, мутирует...
Flu coming to Guymon: Training exercise planned this fall
"One-fifth of thepopulation is expected to die."
That was the grim warning Monday from Tammie Miller, a Registered Nurse from the Oklahoma State Department of Health.
She was speaking to the Guymon Chamber of Commerce members regarding the potential for avian flu to be transmitted to human hosts.
"It's not a matter of if it going to happen, it's when it is going to happen," she said.
Miller pointed out that the flu, once believed to be contained only by thebird family, has now been found in swine and there is one case under investigation involving a human host.
"This isn't going to be an illness that will come and go. It will go on for weeks and even months. You will see schools and businesses closed." Much of the problem stems from the current inability to produce a vaccine against avian flu. "Antivirals will help but there are not enough and they are costly," she pointed out.
Because of such an epidemic possibility, the state is planning an exercise designed to train local government officials and the general public in dealing with an outbreak.
In Guymon, the exercise is scheduled this fall and is expected to involve several thousand people.
Guymon is one of 35 cities in the state that will be going through such an exercise which is funded through the federal government through the anti-terrorism legislation.
Miller said the program is a two-day event that will start with the Oklahoma Highway Patrol being notified that an outbreak has occurred and vaccine is needed. "The OHP will be in charge of delivering the medication and will provide security," she said.
On day two of the exercise, the vaccinations will be given with local officials in charge of everything from traffic control to ensuring sufficient supplies of water and even electricity.
She pointed out the exercise will include real immunizations that will be given to local residents. That vaccine is the type given annually to counter the flu virus.
"We expect 2,500 to 3,000 people to be vaccinated during this exercise," she said. "Because of the number, we are going to need some volunteer help, including nurses, translators and emergency medical service personnel.
"This is a lot of work but it is also a lot of fun," Miller told the chamber members.
More information aboutthe exercise will be provided whenthe actual date is set.
Re:2 Indonesians die from suspected bird flu « Reply #4 on: Today at 06:43:18am » Reply with quote
Seems the board is down at the moment. That is why I will past it here. Boxun reports now that China confirms Boxun report on the fact that theH5N1 is different from the 'previous H5N1'. Basically they refer to the Nature and Science papers, now they are out, they might as well state that the Quinhai situation is serious.
(July 13, 2,005) Today (July 13), China officially claimed that bird flu in Qinghai is not H5N1, but a new type. "It is much moredangerous than H5N1", according to this official report released today. In an unconfirmed news on May 25 2005, released by Boxun, it stated that thebird flu in Qinghai is a new form of virus rather than H5N1, "its symptom is slightly different from H5N1, but it can resist high temprature, faster to show symptoms and more likely to transfer".
In a series of reports (released but not unconfirmed by Boxun), it claimed to have people dead of this virus, but this claim has been denied by the government. (boxun.com)
Chinese Communist Party confirmed the abundant news sends the Qinghai birds and beasts flu epidemic situation the authenticity (Abundant news on July 13, 2005) According to the abundant news on May 25, 2005 reported that, "stated according to the insider, at present may understand is this birds and beasts flu certainly is not pure H5N1, but is H5N1 ties the synthesis with other infectious virus the new infection virus, but in the symptom only has the small difference with H5N1, has the ambush in particular under the high temperature, manifests suddenly the time to be quicker, but has the infection." Yesterday Sina published the news "the Lake Qinghai birds and beasts flu really ominously to find out the new H5N1 virus to kill the migratory bird". The news called "one kind killed" the migratory bird after the reorganization new H5N1 virus "." "In this Lake Qinghai epidemic situation, the scientist from the dead bird's pharynx and larynx, 泄殖腔 in the secretion separated the virus, and carried on the entire gene group to 4 virus isolations sample to examine. The result discovered, they and known H5N1 virus type all quite same not less than. In other words, virus's gene group possibly passed through the rearrangement." "This kind of new H5N1 virus harm is enormous, its toxicity has gone far beyond previously the similar aquatic birdbirds and beasts flu virus which discovered north part of China."
The Chinese Communist Party news already confirmed the abundant news disclosed Qinghai birds and beasts flu epidemic situation authenticity. (Abundant news boxun.com)
Human to Human Transmission of H5N1Bird Flu in Asia
Recombinomics Commentary July 15, 2005
The victims, a 38-year-old man and his two girls, ages nine and one, would be the country's first human fatalities linked to the virus. They lived in a suburb of Jakarta and all died in the last week and a half, Health Minister Siti Fadilah Supari said.
But Dr. Georg Petersen, a WHO representative, said that while the three Indonesian family members had no known contact with poultry, a more thorough investigation could turn up evidence to the contrary.
"In other countries, this is often the case," he said.
The comments above by yet another WHO representative misrepresenting the data on human-to-human transmission of H5N1bird flu in Asia is unfortunate, but not unexpected. Today's Science has a figure showing that WHO places the flu pandemic at stage 3, which was also stated last week in a Nature news story on the Qinghai sequences. Clearly WHO is misrepresenting the stage of the current flu pandemic.
Stage four of the pandemic is represented by small dead end human-to human transmission. There have been over a dozen of such clusters beginning in early 2004 in Vietnam. These clusters are characterized by a bimodal distribution, which is present in virtually every familial cluster in Vietnam, Thailand, and Cambodia. This is true in the current cluster in Indonesia. Both the husband and one-year-old sister developed symptoms after the index case was hospitalized last month. The two secondary transmissions were hospitalized on July 7. This 5-10 day gap between the index case and subsequent infections in family members is the hall mark of familial human-to-human transmission of H5N1 and has been laboratory confirmed in Vietnam, Thailand, and Cambodia.
WHO disregards the fact that virtually all familial clusters have been bimodal and instead tries to find alternative explanations, which make little sense epidemiologically, but are fed to the media and even the top peer reviewed scientific journals, which then faithfully publish the data, misrepresenting the true stage of the 2005 flu pandemic.
One bimodal distribution within a family is highly suggestive of human-to-human transmission. Two such clusters move human-to-human transmission to near certainty, and over a dozen leave little doubt, yet WHO has told the media that the pandemic is at stage 3, whenthe familial clusters are clear examples of limited human-to-human transmission, which is the definition of stage 4.
The expansion of these clusters has happened in northern Vietnam, signaling stage 5 and if reports out of Qinghai are accurate, then the stage has already moved to phase 6, the final stage..
The listing of the pandemic stage at 3 in today's Science is beyond scandalous. It is a clear misrepresentation of the facts, and such misrepresentations by WHO encourage countries to issue misleading information, as happened once again in Indonesia.
The latest misrepresentations extend the commission by omission statements throughout Asia, including the lack of2005 OIE reports on H5N1 in China, which were demonstrated by sequence data from 2005 isolates in Fujian, Shantou, Hunan, and Yunnan provinces.
The human-to-human transmission in Indonesia now represents the fourth country with reported human-to-human transmission of H5N1. Vietnam and Thailand reported such clusters in 2004 Vietnam and Cambodia had clusters in 2005. Third party reports indicate China had much larger clusters in 2005
The real question of stages is if the true level is 5 or 6.
Добавлено в [mergetime]1121438303[/mergetime] UPDATE: 2005.07.15
Canada asleep at the wheel
Canada, like many other countries, has failed to stockpile sufficient anti-viral drugs like Tamiflu in preparation for a (bird) flu pandemic. The government simply has not been paying attention until recently, and it is too late now: the sole manufacturer of Tamiflu has worldwide orders for at least 40 million doses, and nowhere near the capacity to make them anytime soon.
The federal authorities responsible have neglected to do the jobs they were hired for. Canada has Tamiflu in stock for maybe 7% of its population, the US less than 1%. European countries like Britain and France are reported to be close to 40%.
The Ottawa Citizen yesterday cited Ontario's chief medical officer of health, Dr. Sheela Basrur, and Dr. Carolyn Bennett, the federal minister responsible for public health.
So what is the "solution" the government in Ottawa sees to essentially cover up its own failure? They tell people it is bad to ask their doctors for Tamiflu, because that would not fit in with the government plans. The few doses that are available in the country should now go to the frail, the elderly and "the essential".
Dr. Basrur says that without an adequate supply of medication, federal and provincial government efforts to reduce anticipated deaths could be jeopardized. Yes, we understand that. So why is there no adequate supply of medication? How are the people to blame who ask their doctor for it?
If I were a journalist, my first question forthese officials would be whether theyseethemselves as "essential". If the answer were affirmative, as I suspect it would be, that would be the last question I would ever haveforthem. But I would love to be proven wrong.
Dr. Bennett claims that people do not really understand that it will be the nursing homes and the frail elderly and the people with the compromised immune systems that will need this. I think people understand that quite well. But that is not the story. Dr. Michael Osterholm put it best when he said that as a health practitioner he prefers to let the government decide who should get the drugs during a pandemic, but as a husband, a father and a friend, he thinks stockpiling Tamiflu is something people should absolutely consider.
All in all, though I understand it is a hard situation, I resent the fact that officials try to put the blame fortheir mistakes on the very people they are supposed to represent and help.
Another item from the Ottawa Citizen article is numbers. Dr. Basrur puts worst-case scenario anticipated deaths at 58.000 in Canada. This is the kind of thing that makes me curious and suspicious, and glad I have a back of an envelope at hand.
The last large flu pandemic was the Spanish flu of 1918. Some 40 million people died worldwide from that (estimates range from 20 to 100 million). The world population in 1918 was about 1.8 billion people. In 2005, that number has risen to 6.5 billion, or roughly 3,5 times more. 40 million times 3,5 is 140 million deaths worldwide. This is a conservative number. Dr. Osterholm puts it at between 180 and 360 million. Remember, we are talking about a worst-case scenario.
Canada has about 0.5% of the world population. 0.5% of the death toll of 140 million is 700.000. But we can presume the pandemic will hit harder in Asia than it does here. To allow for that, divide the number by 2. That leaves 350.000 deaths in Canada. And this is without taking into account the hugely increased mobility in the world, which is sure to be a factor in spreading a virus.
So where does the 58.000 number come from? No idea. A government report in the UK puts worst-case numbers there at around 700.000. Someone is not making sense.
One last thing: the Spanish flu pandemic killed mainly healthy young adults, 20-40 years old, and not the frail elderly. Dr. Osterholm says that is because strong immune systems are likely to turn against their own bodies in the case of avian flu, in what he calls a cytokine storm. Answering the question of who should get the medication is not as clear-cut as you might think. Posted by RoelMeijer 2005.07.15 // H5N1 tamiflu Canada government // #
Roche Laboratories Inc., Nutley, N.J., is being awarded a maximum $58,000,000 firm fixed price contract for Army, Navy, Air Force, and Marine Corps for Oseltamivir Phosphate Capsules. This is a requirements contract with a base year and one option period. Performance completion date is Feb. 28, 2006. Contract funds will not expire at the end of the current fiscal year. There were two proposals solicited and one responded. The contracting activity is the Defense Supply Center Philadelphia, Philadelphia, Pa. (SP0200-05-D-0009).
« Reply #76 on: Yesterday at 10:04:32am » Reply with quote
I havethe feeling that when h2h is achived, we are going to see WAY more deaths than what has been projected. Most mortaliy tables are based on 20-30% infection rates world wide with a paltry 3-10% death rate.
Really now, I don't know what the infection percentage would be, but lets say 40% of thepopulation (world wide) = 6.5 billion x .40 = 2.6 BILLION infected only.
Now comes the hard part. H5N1 has historically registered 50-80% death rate!
Do the math...2.6 Billion x avg death rate of 65% = 1.69 BILLION.
Evolving Catastrophic H5N1Bird Flu Pandemic in 2005
Recombinomics Commentary July 17, 2005
The latest boxun report describes 10 strains of H5N1 circulating in China. Eight of the ten have some evidence for human infections, but there is no direct independent confirmation of the data. The data suggest that the 2005 pandemic is well underway and a wide range of catastrophic events will continue to make news. The report also suggests H5N1 in China is diverse and evolving, expanding a trend that will likely culminate in an event that may make the 1918 flu pandemic look tame.
Although the specifics of the report are not directly confirmed by third parties, the actions of China and the sequences of theH5N1 emerging from China, strongly support the descriptions of the strains in the boxun reports.
China's statements and actions support many of the details in the boxun story. WhenH5N1 exploded throughout Asia, and affected countries adjacent to China, the role of China as a breeding grounds forH5N1 was suspected. There had been many reports of H5N1 in Hong Kong and most of the poultry in Hong Kong's live markets comes from China. TheH5N1 deaths of members of a Hong Kong family that had visited Fujian province in 2003 were a signal that China had H5N1 that could infect humans.
In 2004, whenH5N1 infections were being reported throughout Asia, China also admitted to having H5N1 outbreaks in poultry. Only Vietnam and Thailand reported human cases, although most of theH5N1 detected in 2004 was the Z genotype, and more closely related to other Z genotype isolates than the 2003 isolates from the family that had visited Fujian province.
In 2005 the reported outbreaks had taken on a somewhat different distribution, but evidence began to mount suggesting that the differences were more related to reporting than actual changes. Human cases were limited to Vietnam and Cambodia, but recent sequence data on 2005 isolates demonstrates considerable genetic diversity, yet there were human cases in the north and south. In the north there were two versions of H5N1 that lacked an ARG residue in the HA cleavage site. This missing ARG had been seen earlier in isolates from China. In the Manila report some additional information was presented. The isolates in Vietnam were segregating into two groups. Northern Vietnam isolates resembled 2005 isolates from Thailand, while southern Vietnam isolates were more like isolates from Cambodia.
In 2005 Cambodia reported human H5N1 cases, but Thailand did not. The lack of human cases in Thailand was suspect because of numerous H5N1 outbreaks in birds in 2005, as well as human and wild cat outbreaks in 2004 in Thailand. Similarly, the lack of human cases in Indonesia became suspect whenH5N1 antibodies were found in a poultry worker and H5N1virus was found in swine. Now there appears to be human-to-human transmission of fatal H5N1 in Indonesia.
The 2005 sequences in Indonesia and Vietnam have similarities with 2004 Yunnan H5N1 sequences. Although China has not reported any H5N1 outbreaks in 2005 prior to the May outbreak in Qinghai, the Nature paper described 2005 H5N1 isolates from four provinces in China, Fujian, Hunan, Yunnan. And Guangdong. The 2005 isolates from Hunan, Yunnan, and Guangdong (Shantou), were similar to isolates from 2003 or 2004.
Thus, as the number of diverse H5N1 isolates from people in northern and southern Vietnam as well as Cambodia and Indonesia increase, the likelihood of human cases in China also increases, yet China has never reported a human H5N1 case.
The boxun report describes eight strains of H5N1 than have been linked to human cases. The strain of greatest virulence, RK7, appears to be the same as the eight isolates described in Nature and Science. It is quite lethal in experimental chickens and mice and boxun report indicating it is lethal in humans. Supporting the human lethality is the present of the PB2 polymorphism E627K, which is associated with H5N1 virulence in mammals.
E627K is found in all human isolates, but the only H5N1 isolates with the change are from mammals that had a poor outcome. Prior to Qinghai Lake, all birdH5N1 isolates had the E at position 627. Thus, finding E627K in all 8 Qinghai isolates is unprecedented, as is the large number of dead migratory birds with H5N1.
The boxun reports are indirectly supported by the Nature and Science reports, as well as sequences in human cases in countries adjacent to China. There is much more reason to doubt statements by China on the lack of human infections in China or statement by WHO on the lack of mild H5N1 cases in northern Vietnam.
The data in the boxun report is considerably more believable and the data suggests a catastrophic pandemic will expand, as birds migrate away from Qinghi Lake and summer nesting sites and return to Europe, India, and southeast Asia to spread a variety of new and old H5N1 strains capable of causing lethal infections in humans and a variety of other species.
The latest in vivo data on use of Tamiflu to treat H5N1bird flu suggests pandemic use may be limited, especially at the recommended dose and duration. When mice were treated at the recommended dose for 5 days, 50% died. This outcome was not unexpected base on prior in vitro data, but discouraging with regard to pandemic containment because the mice had treatment started before infection. Most patients would not be treated until after symptoms developed, which is usually 2-4 after infection. The mice did fare somewhat better if treated for 8 days, but 20% still died and more may have had H5N1 brain infections since the strain used is neurotropic, as are many of themore lethal strains of H5N1.
The most recent confirmed human H5N1 fatalities have been in Vietnam, Cambodia, and Thailand. All public H5N1 sequences from Vietnam and Thailand since 2004 have two resistance markers in the MP gene, precluding the use of amantadine. Thus, pandemic preparedness plans have focused on Tamiflu, but most plans do not consider the likelihood that the recommend dose of Tamiflu will be ineffective if the pandemic is cause by H5N1 closely related to the isolates from Vietnam and Thailand.
However, recent boxun reports describe several H5N1 strains in China that can infect humans and most strains in China are amantadine sensitive, based on wild type polymorphisms at positions 26 and 31 of their M2 protein. The most virulent strain is RK7, which appears to correspond to therecent isolates from Qinghai Lake. These isolates have been described in recent Nature and Science reports and there was no mention of amantadine resistance markers. The Qingahi MP gene is most closely related to a chicken isolate from Shantou, which is amantadine sensitive. The other parental sequence, from a peregrine falcon in Hong Kong, is also amantadine sensitive.
Recent reports from Indonesia suggest that the fatalities of three family members may be due to H5N1, which may be transmissible human-to-human and lethal in all three family members. The family lives near H5N1 positive swine. Isolates from the swine are similar to Yunnan isolates, and all Yunnan H5N1 sequences at GenBank are amantadine sensitive.
As the number of reported H5N1 cases outside of Vietnam, Thailand, and Cambodia grow, the likelihood that an exported H5N1 will be amantadine sensitive also grows,
Amantadine is approved for prophylactic treatment of adult influenza infections. It is less expensive and more available than Tamiflu and may soon be stockpiled also.
Министерство здравоохранения Индонезии подтвердило, что смерть трех жителей Джакарты была вызвана птичьим гриппом. Результаты исследования лаборатории в Гонконге подтвердили, что 38-летний мужчина и две его дочери - в возрасте одного года и девяти лет - умерли от вируса H5N1.
Врачи опасаются, что они могут иметь дело с распространением вируса от человека к человеку, так как ни отец, ни его дочери не имели прямого контакта с домашней птицей. Представители Всемирной организации здравоохранения (ВОЗ), однако, считают, что делать подобные выводы рано; необходимы более глубокие исследования обстоятельств смерти семьи. 300 человек, которые имели в последнее время контакт с семьей, проживавшей на окраине Джакарты, находятся под пристальным вниманием врачей.
С января 2004 года от птичьего гриппа умерли более 50 человек в Камбодже, Вьетнаме и Таиланде. Кроме того, в азиатских странах, правительства которых пытаются остановить распространение болезни, были умерщвлены миллионы птиц.
В Индонезии случае птичьего гриппа среди домашней птицы возникали уже несколько раз в различных провинциях страны. Недавно стало известно, что вирусом птичьего гриппа заразился один из работников фермы. Однако члены семьи из Джакарты - первые жертвы болезни за все это время.
Ученые опасаются, что если вирус приобретет способность распространятся от человека к человеку, это может привести к глобальной эпидемии с миллионными жертвами.
Widespread Human H5N1Bird Flu Infections in China?
Recombinomics Commentary July 20, 2005
Patient's infection source is the chicken which edible includes thevirus, the duck, the goose and its the egg product or the above living specimen contact. The patient after the infection internal heat birds and beasts flu, thevirus meets the ambush, the usual incubation period is 15 days, crosses the patient after the incubation period to be able to appear the blood to be hot, the hands and feet department massively sheds skin, has the red spot phenomenon, the patient lungs can appear the high fever which continues, causes cough which the patient appears suppresses with difficulty, and has the discontinuity to have a poor appetite, dizziness, the body becomes emaciated and so on the symptom, the partial partners havethe flu symptom, the partial crowds havethe immunity to this type virus, this virus at present treats unusual complex, belongs to the stubborn disease, at present China's many places merely list as this disease the simple chronic pneumonia, the chronic bronchitis, virulent flu, Chinese medicine rebirth all kinds
The above machine translated boxun report suggests that large inflows of patients in China, including Guandong province, are due to H5N1bird flu. Many of the infections originate in various forms of food (probably uncooked or undercooked) and have a long incubation period of about two weeks.
The infections are misdiagnosed, which is similar to reports of 1918 flu pandemic. This latest boxun report, in conjunction with earlier reports of 10 different H5N1 strains in China is cause for concern. Eight of the ten strains were found in humans and the range of symptoms was broad, including those with mild flu-like conditions. The most virulent human strain was RK7, which would appear to be the virulent Qinghai Lake strain recently described in Nature and Science. This strain could cause a catastrophic pandemic because of transport by migratory birds. The Qinghai outbreak was quickly followed by deaths of ducks and geese on farms in Xinjiang and China has not responded to a WHO request for an on site visit to the Xinjiang areas. There have also been reports of pneumonia clusters in Tacheng, site of on soutbreak and boxun reports have provided detail on fatal H5N1 human cases in Qinghai.
These data strongly suggest that the pandemic stage is at five or six, although WHO maintains that it is at three indicating all of the familial clusters, including the latest in Indonesia, are mere coincidences and not due to human-to-human transmission (stage four is defined by small dead end human-to-human transmission clusters).
WHO's position is not scientifically valid and encourages under-reporting, which appears to be rampant in China, where a raging stage six flu pandemic may be happening.
Authorities also haven't responded to a WHO request to be allowed to visit the Xinjiang region in China's northwest, where there have been reports of a bird flu outbreak alongthe border with Kazakhstan, said Roy Wadia, a spokesman for WHO's Beijing office.
Chinese authorities have yet to release samples gathered in the western province of Qinghai, where at least 6,000 migratory birds have died, Wadia said.
"It would be useful if information on thevirus was shared with the international agencies concerning bird flu, or if it were deposited at gene banks as per the usual procedures in these cases," Wadia said.
China's Ministry of Agriculture didn't immediately respond Wednesday to requests for comment.
China's failure to respond to foreign appeals for cooperation has prompted fears that the outbreak might be bigger and moredangerous than reported.
The above comments add considerable weight to concerns that there is a raging human pandemic in China. China has been the epicenter of the unprecedented H5N1 outbreak in 2004. H5N1 was reported throughout China and most adjacent countries. The reported human cases were in Vietnam and Thailand. In 2005 the human cases were initially concentrated in Vietnam and Cambodia.
However, the demographics of the outbreak in Vietnam suggested a less lethal but more transmissible variant was affecting northern Vietnam. Although these cases had been laboratory confirmed, WHO refused to acknowledge the widespread human-to-human transmission. The first sequences of 2005 were recently made public, and these new sequences clearly show a China connection, with sequences found in Guangdong and Yunnan province. Today fatal human H5N1 was confirmed in Indonesia in suburban Jakarta, where H5N1 was also detected in asymptomatic swine. The swine sequences also pointed toward a Yunnan origin.
The sequences of theH5N1 provide valuable clues on the origin of infections. A large database was generated using 2004 isolates and additional 2005 isolates have been deposited at GenBank, although two weeks after publication, GenBank has still not released these sequences.
The description of the sequences however, has been published and they also show links to earlier sequences from Shantou and Hong Kong. The Nature paper also described 2005 H5N1 sequences from Yunnan, Hunan, and Fujian Province in addition to Shantou in Guangdong Provicince. The Qinghai sequences also have a polymorphism in PB2 (E627K), which had previously been limited to human flu isolates. The presence in H5N1 was limited to brain isolates from experimental mice, or severe, usually fatal, cases in humans, dating back to the 1997 outbreak.
TheH5N1 in Qinghai is unusually severe in migratory birds, which is why it is critical to obtain additional sequence information on thebirds before they disperse throughout Asia and Europe. These sequences can help identify the genetic changes, which are required to produce more specific probes for detecting H5N1 and designingmore specific vaccines.
Boxun reports indicate thebirds at Qinghai Lake are infected with several versions of H5N1, which leads to new reassortants and recombinants. The Qinghai isolates are already reassortants, with three genes related to Shantou isolates and five related to a Hong Kong isolate. The E627K indicates they are also recombinants and dual infections will generate new recombinants.
The withholding of the sequence data is an ominous sign. Boxun reports indicate China has an active avian influenza program and will certainly collect samples and sequences from Qinghai lake, in addition to the sequences from the Xinjiang outbreaks. Failure to share this information adds to speculation of a widespread cover-up of human cases. Boxun reports detailed human cases in Qinghai and the description of the 10 strains indicates 8 infect humans.
China has never reported a human H5N1 case although fatal human cases in Vietnam, Thailand, Cambodia, and Indonesia all have genetic links to China.
It appears increasingly likely that an unreported flu pandemic is well underway in China.
Published Thursday 21st July 2005 01:02 GMT Now is the time to train as a nurse, join the army or make yourself indispensable to the government in some other way. The government has confirmed that it is to stockpile two million shots of the vaccine against theH5N1 strain of bird flu.
It plans to use the drug to protect emergency and medical workers against a global outbreak of thevirus, after Indonesian officials confirmed three human fatalities earlier this week, the BBC reports. The cases have prompted concern that thevirus can now spread from human to human.
Always ready with a cheery statistic, the World Heath Organisation says that a pandemic of thevirus is "inevitable" (т.е. утверждают, что неизбежна, пандемия-то ), and says that attempts to contain thevirus in Asia have not been successful. A pandemic could cause as many as 50,000 deaths in the UK.
Health Secretary, Patricia Hewitt said in a statement: "I have decided it would be prudent to purchase a limited quantity of H5N1 vaccine which could be used to help protect those that need it most, such as NHS workers. This, alongside the purchase of 14.6 million doses of antivirals and the other public health measures we have in place, will help ensure that the UK continues to be at theforefront of international preparedness for a possible flu pandemic."
She added that the UK would also carry out clinical studies of how the vaccine works against thevirus, and how effective it could be.
The government has invited manufacturers of the vaccine to tender for a contract to supply two million doses.
Птичий грипп достиг России Под Новосибирском зарегистрирован птичий грипп, сообщается в МЧС России.
«Большое количество птиц погибло... и исследование показало присутствие вируса птичьего гриппа типа H5,"- заявил представитель МЧС Виктор Бельцов, передает «Газета.ru».
Как сообщил источник в МЧС, «в 11.00 мск поступило сообщение о огромном падеже птицы в селе Суздалка. В общей сложности погибли 200 гусей и 100 кур».
В настоящее время к работе приступили специалисты управления ветеринарии области, территориального управления федеральной службы Роспотребнадзора по Новосибирской области, а также департамента здравоохранения.
PS. Если кто внимательно читал предыдущие посты, то должен был заметить, что Генри Ниман утверждал, что реальное начало пандемии может начаться в августе, когда прилетевшие на лето на север Китая птицы начнут возвращаться обратно (в том числе и через юг Сибири - в Европу). Именно на севере Китая была зарегистрирована мощнейшая вспышка H5N1, с уже мутировавшими генами, облегчающими заражение млекопитающий, в т.ч. людей.
Итак, уже не только ак. Львов озвучивает предполагаемую цифру потерь среди населения примерно в 1 млрд. чел., а и британские медицинские официальные лица (ранее Остерхольм, один из американских высокопоставленных медиков, давал прогноз на 360 млн.)
Bird Flu More Worrisome Than Terrorism, Says UK Health Expert
'The human mortality with H5N1bird flu could be 30 percent and an epidemic could infect 50 percent of the world's population. I am much more concerned about this than terrorist threats,' said a UK respiratory disease expert. Two million doses of bird-flu vaccine are to be stockpiled in Britain, the government announced yesterday, as a leading expert said he was more concerned aboutthevirus than terrorist attacks. The vaccines will be given to key workers to form "the first line of defense" in any outbreak.
Doctors have already warned a pandemic of bird flu is inevitable and could kill up to 50,000 people in Scotland.
In March, ministers announced plans to cope with such an outbreak, including setting aside GBP 14.6 million worth of anti-viral drugs to treat the flu. Now Indonesia has reported its first human death linked to bird flu -- known as theH5N1virus -- taking the death toll in southeast Asia to 57.
Mortality Could Be 30 Percent
At the moment, bird flu appears to pose a limited threat to humans because it cannot be spread easily from person to person.
But the outbreak in Asia has led to concern among scientists.
Peter Openshaw, the head of the respiratory infections section at the national heart and lung institute, Imperial College, London, said: "It's difficult to know if a major outbreak is about to happen, but mutated H5N1bird flu that spreads between people would be much harder to control than SARS or smallpox.
"The human mortality with H5N1bird flu could be 30 percent and an epidemic could infect 50 percent of the world's population. I am much more concerned about this than terrorist threats." a d v e r t i s e m e n t [AD]
Patricia Hewitt, the health secretary, announced yesterday that manufacturers are to be invited to tender for a contract to supply theH5N1 vaccine.
She said: "I have decided it would be prudent to purchase a limited quantity of H5N1 vaccine which could be used to help protect those that need it most, such as NHS workers. We will also be able to carry out further research so that we can find out how the vaccine can be used most effectively."
Vaccine May Not Be Effective
Because the vaccine plans are for a national emergency, rather than for regular health care, they cover the whole of the UK.
However, the health service in Scotland will have separate plans to allow for differences in policy, and health agencies acrossthe UK will be involved in monitoring any outbreak.
Jim McMenamin, a consultant epidemiologist with Health Protection Scotland (HPS), said bird flu was a risk to Scotland and it was the responsibility of health workers across Britain to be prepared.
"Theyhave been looking at this for some time on the available evidence that there continues to be a threat of avian influenza in southeast Asia. In response to that threat, this is a welcome development."
If a pandemic does occur, a vaccine could be used in a number of ways.
If the flu affects a particular sector of thepopulation, such as young children or the elderly, it could be given to them. Or, if a certain part of the country is affected, it could be given to the surrounding population. Most commonly, it could be given to key workers, particularly those in hospitals, to ensure that public services are maintained.
However, given thevirus constantly changes, the vaccine will not necessarily be effective against the threat.
HPS, along with the Health Protection Agency in England, will assist in any research to find out how the vaccine works and how effective it can be.
Под Новосибирском зарегистрирован птичий грипп, сообщается в МЧС России.
- Тож хотел сообщить, но опоздал По ТВ профессор успокаивал, что у нас вЫроятность заразиться меньшая, бо у нас традиционно покупать мороженую (а хначит, заранее ощипанную и выпотрошенную) птицу, а не убитую прямо при тебе, как там.. Успокаивал, что заразившихся людей нету.. пока.. (прим.моё)
предполагаемую цифру потерь среди населения примерно в 1 млрд. чел.,
- Если учесть, что половина населения шарика (1,7 + 1,2 + 0,7млрд) сосредоточена в ЮВА (если по пунктам - китай, индия, индонезия, насколько помню), то весьма вероятно... Не хочется заниматься конспирологией, но поскольку прецеденты уже были (напр, колорадский жук, внезапно с 1949 начавший приплывать в ящиках на побережье балтики, пр.) возникает мысля, настолько ли естественна причина возникновения данной мутации вируса.... Как тогда надо было опустить черезсельхоз главного конкурента, так и теперь..