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probegallo
Вообще, интервью весьма занимательное:

"...когда мы передали ВОЗ 100 доз нашего иммуноглобулина против лихорадки Эбола, то в дальнейшем, по нашей информации, этот препарат попал не в Африку, где ежегодно фиксируются сотни случаев этого абсолютно смертельного заболевания, а в Форт-Детрик - институт инфекционных заболеваний армии США. Негативных публикаций в научной прессе тоже не было, хотя американцы не преминули бы это сделать, если бы доказали, что наш препарат чем-то не хорош.

- Отмечает ли Родина работу военных микробиологов боевыми наградами?

- Широкий общественный резонанс имело создание единственного в мире иммуноглобулина для профилактики лихорадки Эбола. За эту работу бывший начальник Вирусологического центра генерал-майор медицинской службы Александр Махлай был удостоен в 1995 году звания Героя России. А летом 1999 года нашим специалистам снова пришлось расшифровывать истинную природу неизвестной инфекции, вспыхнувшей в станице Обливской Ростовской области и в Ставропольском крае - никто из гражданских врачей не мог поставить точный диагноз, зато возникло предположение насчет распространения лихорадки Эбола среди местного населения. Не исключалась даже возможность введения карантина в Ростове-на-Дону, что привело бы к полному перекрытию транспортных потоков на Северный Кавказ и обратно и к организации массы санпропускников, пунктов питания - в общем, огромным финансовым затратам для страны. И только бригада наших специалистов, срочно прилетевшая в Старый Оскол (для этого у нас есть своя эскадрилья в войсках РХБЗ), провела необходимые диагностические исследования и в течение суток установила, что это не лихорадка Эбола, а Конго-Крымская геморрагическая лихорадка, возбудители которой не так опасны при передаче от человека к человеку. Все сразу облегченно вздохнули, нужда в карантине отпала, хотя наши специалисты были готовы на неподготовленной базе и при минимальных средствах защиты не только оказать помощь выявленным контактным лицам (прилетели с определенным запасом иммуноглобулина), но и локализовать очаг заражения."
probegallo
Снова о маленьком пушЫстом северном зверьке:

http://www.recombinomics.com/News/04110502...0_HCM_City.html

1000's of Children in Ho Chi Minh City with Bird Flu Symptoms

Recombinomics Commentary
April 11, 2005

>>Hospitals in Ho Chi Minh City have been filled with thousands of children who have caught respiratory and digestive illnesses due to the hot weather.

Pediatric Hospital I reported that it had examined nearly 4,000 children patients a day with some 85 per cent of them suffering from respiratory problems, said a hospital doctor.

Meanwhile, more than 3,000 children were brought into Pediatric Hospital II on Monday. One-third of the children had respiratory problems and 300 others had digestive problems.

Besides, many children have been hospitalized for brain diseases caused by the entero virus.

The major reason behind the illnesses is that children are sleeping all night with fans on due to the hot weather in recent days.<<


The deafening dearth of data in Vietnam may have ended.

The number of children alone would be cause for concern, but large numbers of patients with respiratory and digestive illness and "brain diseases". in Vietnam ring alarm bells very loudly.

Serious H5N1 testing is indicated, although results from Quang Binh, Haiphong, and Quang Ninh have not been reported.

Bird flu monitoring in Vietnam is well beyond scandalous.


Добавлено в [mergetime]1113255827[/mergetime]
рекомендую посмотреть
http://discuss.agonist.org/yabbse/index.php?board=6
probegallo
Bird flu looking more like a pandemic

http://washingtontimes.com/upi-breaking/20...72843-3205r.htm

Hanoi, Vietnam, Apr. 23 (UPI) -- Public health officials in Vietnam fear the South Asian outbreak of bird flu is becoming less virulent and, thus, more likely to spawn a pandemic.

The new fear stems, ironically, from the declining mortality rates of infected humans, the Washington Post reported Saturday.

About a year ago some two-thirds of human victims in Vietnam died, but recently that figure has plunged by nearly half.

If that trend continues, it raises the likelihood that infected humans' greater longevity will result in more people contracting avian influenza -- and thus increasing the chances it will become a global problem.

"The virus could be adapting to humans," said Peter Horby, an epidemiologist with the World Health Organization in Hanoi, the Vietnamese capital. "There's a number of indications it could be moving toward a more dangerous virus."

By way of comparison, the 1918 Spanish flu pandemic that killed some 40 million people worldwide, had a 5 percent mortality rate. The comparable rate for bird flu has fallen from nearly 70 percent to 35 percent this year.

Also worrying health officials is the emergence of asymptomatic bird flu in poultry
Добавлено в [mergetime]1114262697[/mergetime]
Dark side to good news on bird flu

As virus becomes less lethal, it could gain mobility

By Alan Sipress
The Washington Post
Updated: 11:16 p.m. ET April 22, 2005


HANOI - Nguyen Sy Tuan can barely talk. His wasted frame is tucked beneath a thin white sheet on the hospital cot. His cheeks are sunken and his bulging eyes stare blankly at the ceiling. But the young man has begun to eat rice again and can finally breathe without a mechanical ventilator, a dramatic turnaround for a bird flu patient whose doctors had assumed would die.

More than a year after avian influenza emerged in East Asia, killing more than two-thirds of the people with confirmed cases, Vietnamese doctors are reporting that the mortality rate in their country has dropped substantially.

An ominous turn
But while this is good news for survivors, it could mean the outbreak of bird flu in Southeast Asia is taking an ominous turn. If a disease quickly kills almost everyone it infects, it has little chance of spreading very far, according to international health experts. The less lethal bird flu becomes, they say, the more likely it is to develop into the global pandemic they fear, potentially killing tens of millions of people.

"The virus could be adapting to humans," said Peter Horby, an epidemiologist with the World Health Organization in Hanoi, the Vietnamese capital. "There's a number of indications it could be moving toward a more dangerous virus."

The mortality rate for bird flu in Vietnam this year is about 35 percent, almost exactly half that of last year, according to Health Ministry statistics. The mortality rate of the 1918 Spanish flu pandemic, by comparison, was less than 5 percent, but the outbreak killed an estimated 40 million people worldwide.

Officials said the drop in the bird flu mortality rate was more marked in northern Vietnam than in the south. While the virus in southern Vietnam is still killing at the same pace as last year, the rate in the area around Hanoi and elsewhere in the north has dropped from that level to as low as 20 percent. Vietnamese health experts said their suspicion that the disease is shifting is further supported by preliminary research showing a genetic change in the virus in the north resulting in the production of a protein with one fewer amino acids than in the south.

A virus on the move?
Health researchers believe that nearly all the 52 people known to have died of bird flu in Southeast Asia caught the virus from infected poultry. But with more clusters of cases among families reported in Vietnam this year — including that of Tuan, his sister and their grandfather — experts say they are growing increasingly suspicious that the disease has begun passing from one human to another.

Also worrying is the discovery of at least five cases, including that of Tuan's grandfather, in which people tested positive for bird flu but showed no symptoms. This could make it more difficult to contain an epidemic because people could transmit the disease without anyone realizing it.

Last year, U.S. researchers reported that ducks in Southeast Asia had begun carrying the bird flu virus without showing symptoms. Now, scientists in Vietnam have found numerous asymptomatic cases in the country's vast chicken population, according to Nguyen Tran Hien, director of the National Institute of Hygiene and Epidemiology.

"It seems that the virus may adapt in humans and in poultry a little bit. Therefore, the symptoms are not as severe as before," Hien said. "Also, the transmission may be faster and easier."

Moreover, the existing virus strain is not the only threat. Each human case also presents a chance for the bird flu virus to swap genetic material with an ordinary flu bug — if the person becomes infected with both strains at the same time — potentially creating a new hybrid that is highly lethal and even easier to catch.

"We are concerned that if the virus is changing, maybe a new virus is coming in the future," Hien said.


Two survivors
Tuan, 21, left his home among the glistening paddies of northern Vietnam's rice-growing region more than a year ago for Haiphong, on the coast, where he worked harvesting seaweed for use in local cuisine. In early February, he returned to his family's simple brick house to celebrate the Tet New Year holiday.

According to his doctors, Tuan slaughtered a chicken for a festival meal, cutting its neck while his 14-year-old sister clutched the wings and legs. The bird was likely infected, and soon the siblings were, too.

Tuan started running a high fever about four days later, his wizened father recounted between puffs on a traditional bowl pipe in the family's one-room home.

When Tuan started coughing and had trouble breathing, he was taken to the local health center in Thai Thuy district. X-rays showed a white smudge on his left lung. Tuan was transferred after less than a day to a larger hospital in the provincial capital. There, the doctors concluded he had contracted the H5N1 strain of avian influenza and immediately rushed him to the tropical disease institute at Hanoi's Bach Mai Hospital.

By the time he arrived, X-rays showed, the white smudge had clouded the entire lung. Soon it took over the other one as well. "From one day to the next day, it spread very quickly," recalled Nguyen Thi Tuong Van, deputy director of the Bach Mai intensive care unit.

After 10 days, with his breathing failing, the doctors inserted a tube in Tuan's throat and put him on a ventilator. The infection spread to his kidneys and liver.

"We thought it was very likely the bird flu would kill him," Van said. "Then, when it seemed the situation couldn't get much worse, it started to get better. Two weeks later, when he didn't die, I thought maybe we could cure him."

Tuan's sister, Nguyen Thi Ngoan, a tall, mischievous 14-year-old with large black eyes, fell sick several days after her brother and also recovered.

At the district health center, X-rays revealed her lungs were clear, but a subsequent blood test was positive for bird flu. She was transferred to the Hanoi hospital, where she lay in the cot beside her brother and her temperature soared to 105 degrees.

But the fever broke after four days and returned to normal within two weeks, her doctors said. Ngoan went back to school in late March as a local celebrity, teased by her peers as "Miss H5."

A vital question
Vietnamese and international health officials say they are confident that the mortality rate has dropped but are not sure by how much. Better screening and wider public awareness of bird flu could mean health workers are catching and recovering from milder cases that would have gone unreported a year ago. WHO officials have complained, however, that Vietnam is reluctant to provide detailed information about human cases. Senior Health Ministry officials respond that reports are provided in accord with national regulations.

The question now is whether bird flu in Vietnam has begun passing among humans.

If it has, Nguyen Duc Tinh, a nurse who treated Tuan at the Thai Thuy district health center and fell sick with bird flu soon after, would be a likely instance. Tinh, 26, said he had no contact with poultry for a month beforehand despite government accounts attributing his illness to infected chickens.

Tinh said he was the hospital staff member who had the closest contact with Tuan during his brief stay at the health center, taking his blood pressure and temperature, giving him injections and helping him walk. Within a week, Tinh had developed muscle aches and a high fever, symptoms of what he believed was a common flu. But when the fever subsided and then returned two days later, he grew alarmed.

"Then I suspected I had bird flu," he recalled, his brown eyes widening. "I was really, really afraid of dying."

But just two weeks after joining Tuan in the Hanoi hospital, Tinh was discharged and went back to his village.

"I had lost hope when the fever came a second time," he said. "When I returned to my home town, I felt as if I were born again."

© 2005 The Washington Post Company
© 2005 MSNBC.com

URL: http://www.msnbc.msn.com/id/7593132/
LandWarrior
Интересная ссылка:
Rumata
да да да, форум не дает возможности постить ссылки если менее 10 постов.
probegallo
кстати, напоминаю ссылку, где публикуются свежие новости по проблеме и их профессиональное обсуждение - http://discuss.agonist.org/yabbse/index.php?board=6

probegallo
10 мая, 09:14

Феодосии угрожает «птичий грипп»?

Последние три недели в Феодосийскую ветлечебницу общества защиты животных горожане приносят больных голубей с одинаковыми симптомами: нарушение координации и глотания.

По словам ветеринара Елены Филипповой, эти симптомы очень похожи на проявление энцефалопатии - отека головного мозга. Некоторые болезни передаются человеку от птиц, но в этом случае людям вряд ли что-то угрожает.

«Все голуби, которых мне приносили, умирали. Недавно ко мне пришел молодой человек, который принес голубя с теми же симптомами. Сейчас он сам смотрит за птицей, пытается ее вылечить. Теща этого парня - патологоанатом, если голубь умрет, она сможет провести вскрытие, и мне сообщат о результатах», - рассказала Елена Филиппова, передает «Обком».

Филиппова также сообщила, что многие болезни передаются человеку от птиц, особенно от голубей. Но голуби ее не заразили, поэтому Елена Владимировна считает, что болезнь для человека не опасна.

По словам заведующей инфекционным отделением феодосийской городской больницы №1 Лидии Демешиной, есть такое заболевание «орнитоз», которое передается человеку от птиц, в основном голубей.

«Проявление клинического орнитоза - пневмония, - сказала она. - Я не думаю, что сейчас голуби болеют именно этой инфекцией. За 19 лет моей работы в Феодосии, я ни разу не сталкивалась с подобными случаями».

http://www.for-ua.com/news/2005/05/10/091448.html
probegallo
Commentary

Tamiflu Resistant H5N1 in Vietnam?

Recombinomics Commentary
May 17, 2005

>> The genetic changes they have seen in the northern Vietnam viruses are in the gene that codes for the spike, a molecule called haemaglutinin, in a part that controls how well the spike fits into the receptor…….

One final surprise too. One recent sample from Vietnam proved to be, in part, resistant to the drug mainly used to treat victims of H5N1.

Chances are it's a one-off - the patient was being treated with the drug - but the WHO scientists warn that if further samples are found, it would have serious implications indeed. <<

The above comments on changes in HA suggest that the protein that is missing one amino acid is HA, and the missing amino acid is in the poly-basic cleavage site. If so, it is likely that the missing amino acid matches the missing amino acid in H5N1 found in Shanghai and other provinces in eastern China. These data suggest that the new H5N1 in northern Vietnam is indeed a recombinant between the H5N1 in Vietnam and the H5N1 in China.

The data also suggests that H5N1 in China is being under-reported, adding to the misinformation provided by the poor surveillance of H5N1. China, like all Asian countries that had H5N1 last year or this year, has not submitted any publicly available 2005 H5N1 sequences to GenBank. The sequences held by WHO consultants, but not shared with the rest of the scientific community, may indeed provide clues that WHO appears to have trouble interpreting beyond a funny noise in a car.

Thus, media reports suggest that significant changes are occurring in HA and NA. NA is targeted by the only available H5N1 antiviral, Tamiflu. The above report suggests that an H5N1 Tamiflu-resistant strain has evolved. Widespread use of Tamiflu will generate selection pressure for resistance. The comments above imply that such resistance is relatively easy for H5N1, since the number of H5N1 confirmed patients treated with Tamiflu has been exceedingly low. Tamiflu is the antiviral drug being stockpiled by many countries.

However, because surveillance of H5N1 in mild cases in northern Vietnam has been virtually absent, the possibility of Tamiflu treatment of mild human cases is quite real, since the drug has been approved for treatment and prevention of influenza. Widespread treatment with Tamiflu will likely generate widespread resistance.

http://www.recombinomics.com/News/05170503...Resistance.html

Добавлено в [mergetime]1116401548[/mergetime]
Bird flu 'may pass to humans'

http://www.channel4.com/news/special-repor...¶sStartAt=1
Published: 17 May 2005

By: Julian Rush

Scientists are warning that the virus which causes bird flu could soon be able to pass between humans.

New evidence seen by Channel 4 News points to an increased risk of a global flu outbreak because of the way the virus has started to mutate.

It has killed 52 people in Asia in the last two years, and despite the slaughter of millions of birds has not stopped spreading. Now we've seen a report by World Health Organisation scientists which warns that the risk of a global flu outbreak is increasing.

These are the first signs the bird flu virus H5N1 is evolving and evolving in ways that make a global pandemic more likely.

Deep in northern Vietnam, scientists have noticed localised changes in the patterns of infection.

In the lab, they have seen genetic changes too that suggest the virus in northern Vietnam is different: changes that may affect how the disease will spread.

Scientists at the World Health Organisation monitoring avian flu in South East Asia say they are seeing what they call a "worrisome development".

Recent cases have started appearing in clusters and the disease is getting a little milder - signs, they say, the virus may be adapting to humans: changing genetically to transmit more easily between people at the cost of losing a little of its virulence.

Professor Maria Zambon from the Health Protection Agency, told Channel 4 News: If you have a virus which is more virulent for humans it may be less transmissable. But if the virus is better able to transmit within humans it may be less virulent.

Even a weakened H5N1 virus will still be very dangerous. A flu virus infects human cells when a protein spike on the virus binds with a receptor on the cell surface.

The genetic changes they have seen in the northern Vietnam viruses are in the gene that codes for the spike, a molecule called haemaglutinin, in a part that controls how well the spike fits into the receptor.

The report we've seen recommends immediate steps should be taken to step up surveillance in countries where H5N1 is present and they say there's an urgent need for up-to-date information on the genetics of the virus.

Constant monitoring of virus from new victims is the key: the WHO denies reports south-east Asian countries have failed to provide samples - Vietnam alone has supplied over a hundred - but it does admit it's been hard to extract virus from many of them, hampering research.

H5N1 is proving to be a virus full of surprises. The original jump from wild ducks - where it doesn't cause illness - to domestic chickens where it kills - was a genetic leap akin to a jump from a cat to a horse. The leap from chickens to humans was even bigger.

The nastiest surprise would be what's called reassortment - if a completely new virus emerged after H5N1 got into someone already infected with conventional human flu.

So news today three pigs in Indonesia have tested positive for H5N1 is a warning. There aren't many pigs in this largely Muslim country, but as a precaution pigs are being quarantined and tested before they're slaughtered.

And the news there are signs of genetic shifts in the virus in northern Vietnam could affect the plans of some governments to control a pandemic with vaccines.

Many that are now being stockpiled are based on British research that took a virus from Vietnam last year and genetically engineered to make it safe. The man who did it admits genetic shifts since then could make the stockpiles redundant.

One final surprise too. One recent sample from Vietnam proved to be, in part, resistant to the drug mainly used to treat victims of H5N1.

Chances are it's a one-off - the patient was being treated with the drug - but the WHO scientists warn that if further samples are found, it would have serious implications indeed.
probegallo
WHO report charts disturbing changes in avian flu virus, urges preparations

http://www.canada.com/health/story.html?id...0a89fe70&page=2

WHO report charts disturbing changes in avian flu virus, urges preparations

Helen Branswell
Canadian Press

Wednesday, May 18, 2005

TORONTO (CP) - The World Health Organization urged countries to make full haste with pandemic influenza preparations Wednesday as it released a report outlining disturbing changes to the H5N1 virus circulating in Asia.

Among the recent findings is evidence the virus's genetic makeup appears to be altering in a way that may make H5N1 better adapted for spread among people.

As well the report documents a case where the virus showed partial resistance to the main drug the wealthy countries of the world are stockpiling to combat it, oseltamivir.

While experts cautioned that finding is not necessarily surprising, it does raise questions about whether an oseltamivir-resistant strain of the virus could propagate and spread. The report notes that scenario, if it were to occur, would have "significant implications for . . . H5N1 prevention and control."

A leading infectious disease expert said the evidence in the report is limited, but paints a worrisome picture of a changing pattern of infection and disease in northern Vietnam.

"I think it tells us that everything about H5N1 is headed in the direction that none of us would like to see it go," said Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

"Do I say that that's going to mean there's an impending pandemic? I don't know that. Does it tell me that . . . there's a growing concern about it? Absolutely."

Evidence in the report was drawn from a recent WHO fact-finding mission to Vietnam and from a meeting of influenza experts in Manila last week.

The WHO admits the implications of the changes in both disease patterns and viral makeup are not fully clear, but suggests the viruses "pose a continuing and potentially growing pandemic threat."

"Based on these concerns and findings, it would be prudent to . . . implement or complete pandemic preparatory actions as soon as possible, even if current H5N1 outbreaks in Asia cease or diminish during the summer," it states.

In recent weeks flu experts have been sounding the alarm about the changing pattern of infection in northern Vietnam.

This spring there has appeared to be more clusters of cases, possibly the result of more limited human-to-human spread, and a greater age range of cases. As well the case fatality rate has dropped - something experts had anticipated would have to happen if H5N1 were to become a pandemic strain.

The report combines information about those changes with disturbing laboratory findings. Some viruses are showing genetic changes near what's known as the "receptor binding site" - the point where the invading virus attaches to the cell walls of a host.

Flu viruses made entirely of avian influenza genes don't tend to bind well to human receptor binding sites. But these changes may indicate the virus is evolving to be a better fit.

Science is not currently capable of predicting what, if anything, these changes mean, especially with the limited data that has emerged so far, said Dr. Earl Brown, a virologist at the University of Ottawa who specializes in flu evolution.

"It's incomplete science," he said.

More evidence may emerge in coming weeks.

Canada's National Microbiology Laboratory has sent a team of three scientists to Hanoi to help scientists there analyse blood samples from contacts of H5N1 cases. The goal is to try to get a sense how many have developed antibodies to the virus - a sign they were infected, possibly by human-to-human spread.

"It will help a lot in, I think, clarifying the extent of infection," said Dr. Frank Plummer, scientific director of the national lab. The team, led by Dr. Yan Li, chief of the influenza laboratory, left for Hanoi on Wednesday.

WHO: flu pandemic threat may be growing

May 18, 2005 (CIDRAP News) – The H5N1 avian influenza virus is evolving and poses "a continuing and potentially growing pandemic threat," say experts who were convened recently by the World Health Organization (WHO) to study the pathogen.

Changing patterns of cases, particularly in northern Vietnam, may indicate the virus is becoming more infectious for humans, the WHO said in a report on an international meeting of experts held May 6 and 7 in Manila. In addition, genetic analysis indicates that H5N1 viruses are becoming more antigenically diverse.

The report cites several differences between epidemiologic features of human cases this year in northern Vietnam and those in southern Vietnam this year and overall last year:

* Northern Vietnam has had eight case clusters this year, versus only two in the south.
* Case clusters in northern Vietnam this year have lasted longer than did clusters last year.
* The average age of infected people in northern Vietnam rose from 17 to about 31 years between 2004 and 2005, but it stayed about the same in southern Vietnam (15 to 18 years).
* The case-fatality rate has dropped to 34% this year in the north but is 83% in the south.

In addition, the report says the recent discovery of three asymptomatic cases in Vietnam suggests that milder infections are occurring. A few asymptomatic cases also were found in Japan and Thailand in the past year, and others were discovered in Hong Kong after the H5N1 outbreak in 1997.

The report says the longer duration of recent clusters may signal a growing number of ways in which people contract the virus, including exposure to sick birds, environmental infection, lengthy exposure to asymptomatic birds that are shedding virus, and person-to-person transmission.

The avian virus had already vaulted to the top of the pandemic threat list because it had developed the ability to sicken and kill humans. The virus's inability to cause efficient, ongoing human-to-human transmission is the last barrier to a pandemic. Now experts appear worried that the barrier is crumbling.

"Investigators were not able to prove that human-to-human transmission had occurred. However, they expressed concerns, which were shared by local clinicians, that the pattern of disease appeared to have changed in a manner consistent with this possibility," the assessment states.

At the same time, it says that in places where the disease in poultry has been controlled or eliminated, human cases have stopped. And thus far, the first case in most of the human clusters in Vietnam followed the person's exposure to infected poultry.

For now, "Prevention of H5N1 avian influenza in humans is best achieved by controlling infection in poultry," the document states. "As already recommended by FAO and OIE [the United Nations Food and Agriculture Organization and the World Organization for Animal Health], control strategies for this disease should consider vaccination of poultry, which has been used successfully before."

A team of WHO expert consultants studied Vietnam's outbreak at that country's request from Apr 15 through 25, the report says. That study showed H5N1 could be changing more in the northern region, which prompted a second expert consultation.

This second meeting was held May 6 and 7 at the WHO regional office in Manila. Representatives from Vietnam, Cambodia, and Thailand presented details about the epidemiologic, clinical, and virologic findings regarding H5N1 in people and poultry. Other data were included from the WHO Global Influenza Network and other countries.

The experts make a number of recommendations, including increasing efforts to improve risk assessment, to boost the ability of affected countries to address outbreaks, and to speed the pace of pandemic planning.

The 14 recommendations include the following:

* WHO should convene its Pandemic Task Force to meet regularly, assess the data, and determine the risk for pandemic flu.
* All nations should move as quickly as possible to complete "practical operational pandemic preparedness plans."
* WHO should explore "all possible mechanisms" to make H5N1 vaccine available to the Asian countries affected before a pandemic. It should bring together technical experts, countries, manufacturers and possible donors to find ways to boost global H5N1 vaccine production.
* Coordination of animal and human surveillance and viral information must be improved from the ground level to the national and international level, and data must be exchanged quickly.
* The WHO should complete a handbook on how to investigate possible H5N1 clusters.
* The WHO should explore building a stockpile of antiviral drugs that could be used to respond to early signs of a potential pandemic.
* Countries needing funding and agencies that may provide funding must coordinate their efforts to avoid redundancy and eliminate gaps

As the experts call for greater international effort to address the escalating threat, they also acknowledge the difficulties of preparing for a possible pandemic:

"Evolution of a pandemic strain of virus may be preceded by numerous small steps, none of which is sufficient to signal clearly that a pandemic is about to start. This poses a difficult public health dilemma. If public health authorities move too soon, then unnecessary and costly actions may be taken. However, if action is delayed until there is unmistakable evidence that the virus has become sufficiently transmissible among people to allow a pandemic to develop, then it most likely will be too late to implement effective . . . responses."

http://www.cidrap.umn.edu/cidrap/content/i...may1805who.html
probegallo
ВОЗ: Птичий грипп может передаваться от человека к человеку
Корреспондент.net

19 Мая 2005, 16:04

Последние исследования подтвердили возможность передачи вируса птичьего гриппа от человека к человеку. Об этом в четверг, 19 мая, в Женеве, Швейцария, объявила Всемирная организация здравоохранения (ВОЗ).

Ранее эксперты уже выражались обеспокоенность по поводу возможной мутации вируса птичьего гриппа, из-за чего он в ближайшем будущем будет легко передаваться от человека к человеку, что неминуемо обернется миллионами жертв.

До последнего времени считалось, что смертельно опасный вирус не передается подобным образом, однако последние исследования, проведенные во Вьетнаме, доказали обратное, заявила сегодня ВОЗ.

Эксперты организации уже выразили опасения по поводу возможной пандемии птичьего гриппа.

"Мы считаем, что будет пандемия, но не знаем когда", - заявил в четверг глава отдела по надзору за инфекционными заболеваниями ВОЗ Геналь Родье.

С конца 2003 года опасный для человека штамм вируса птичьего гриппа H5N1 уже унес жизни более 50 человек в Юго-Восточной Азии. Наибольшее количество погибших зарегистрировано во Вьетнаме – 37. Кроме того, 12 человек погибли в Таиланде и 4 – в Камбодже.

По материалам Associated Press
probegallo
WHO warns of bird flu mutation

http://www.health24.com/medical/Condition_...-1700,31197.asp

WHO warns of bird flu mutation
The World Health Organisation has been warning for several months now that the avian influenza virus could combine with a human flu strain – making it resistant to any existing human flu vaccine and creating a worldwide human flu pandemic.

Now, clusters of human bird flu cases indicate the deadly virus may have mutated into a germ more easily passed between people.

Last week, a Vietnamese female nurse who cared for her bird flu patients was hospitalised with bird flu symptoms despite having no known contact with fowl and other birds, according to wire service reports. Although tests haven't confirmed this diagnosis yet, a 26-year-old nurse, who cared for the same patients, has already tested positive for bird flu.

Red alert
No one can say with certainty that an H5N1 flu pandemic is on the cards. But there are several warning lights flickering: the virus keeps popping up in different areas despite vigorous efforts to contain it; certain animals with which humans have frequent contact have become hosts; and it looks like H5N1 is becoming more aggressive.

Experts reckon that, with global travelling being what it is, an outbreak could spread around the world within a month. And, as the avian H5N1 strain seems to be extremely infective, a large-scale outbreak of the virus could be a lot more serious than the Sars pandemic of 2003.

Situation carefully monitored
Despite these reports, "South Africans have no need to panic at the moment," says virologist Dr Gert van Zyl from the Department of Medical Virology, University of Stellenbosch.

To date, no cases of human-to-human transmission of bird flu have occurred in Africa.

And "The World Health Organisation is monitoring the situation in the East carefully," Van Zyl says. If the H5N1 virus should ever spread to South Africa, our government would work closely with the WHO to contain the virus.

In the past, flu pandemics have hit so fast, that scientists didn't have a chance to keep up with them. But surveillance of the virus has become good enough to enable health officials to come up with a vaccine fast enough to limit a pandemic's path of destruction.

Get your flu shot
At this stage, South Africans should make it a priority to get their annual flu shots. Note, however, that these injections protect only against the influenza viruses A and B. Vaccines that protect against H5N1 are only in the early stages of development.

The WHO and the National Health Authority this winter recommend vaccination against the A/Wellington (H3N2)-, A/New Caledonia (H1N1)- and B/Shanghai-like strains for South Africa.

Although "there is no indication that this year's strains are more aggressive than previous ones," Van Zyl still recommends that people should go for a shot at the end of March or early April – especially if you fall into a risk group:

Risk groups include:

People of all ages with chronic debilitating disease, especially those with chronic cardiac, pulmonary, renal and metabolic disorders.
People over 65 years of age.
People receiving immunosuppressive therapy.
Women who would be in the second or third trimester of pregnancy during the flu season. Pregnant women with medical conditions which place them at risk for flu complications should be immunised at any stage of pregnancy.
Medical and nursing staff responsible for the care of high-risk cases.
Children on long-term aspirin therapy.
The first flu outbreaks usually start occurring late in April. – (Health24)
probegallo
Nature 435, 400-402 (26 May 2005) | doi: 10.1038/435400a

Avian flu special: The flu pandemic: were we ready?
Top of pageAbstractWelcome to my weblog. I'm Sally O'Reilly, a freelance journalist based in Washington DC. I've been researching a book on pandemic preparedness. But now the time for preparation has run out.

26 December 2005 It's an emergency — official
President George Bush has just addressed the press in the East Room of the White House. Here's the transcript: "At this hour, the World Health Organization has declared a full-scale pandemic influenza alert, with person-to-person spread lasting more than two weeks in Cambodia and Vietnam. During previous influenza pandemics in the United States, large numbers of people were ill, sought medical care, were hospitalized and died. On my orders, the Department of Homeland Security and the Department of Health and Human Services have today implemented the nation's draft Pandemic Influenza Response and Preparedness Plan. It will serve as our road map, on how we as a nation, and as a member of the global health community, respond to the pandemic. We are ready. Thank you, and may God bless America."


PORNCHAI KITTIWONGSAKUL/AFP/GETTY IMAGES/KIN CHEUNG/REUTERS/CORBIS
Ready, my ass! I've reported on avian flu for almost a decade. The first thing I did on hearing Bush's address was to get on my cellphone to my husband, Jonathan. I told him to pack some bags and get ready to take the kids to my mother's house in Florida. "Remember all that stuff I told you about how a bird flu pandemic might hit the United States? Well, I think it's about to happen."

28 December 2005 Journey to the source
Hanoi, Vietnam. I'm exhausted, and I can still taste the disinfectant they sprayed inside the Doctors Without Borders plane. I'm at the Bach Mai Hospital. It was here, three weeks ago, that what they're calling the 'Hanoi index case' fell sick. A Malaysian on business, he was transferred to a hospital in Hong Kong, where he died. Samples sent to labs in the WHO Global Influenza Surveillance Network showed he was infected with an H5N1 avian flu virus, but one that differed from earlier isolates. It had mutated.

But he won't have been the first patient with this mutated strain. As early as October there were hundreds of human H5N1 cases in the countryside south of here, but only a handful got picked up. Most went unnoticed by health authorities. Surveillance for human cases of flu in Vietnam has been patchy, and DNA diagnostic tests unreliable. WHO calls for more international funding were ignored. Now the virus has had three months to spread, pick up mutations and get better and better at jumping between humans.

What's weirdest is that there weren't any declared outbreaks of bird flu in chickens here recently. Farmers weren't exactly queuing up to declare cases, though. There'd been talk of setting up a global fund to help them cope with eradicating avian flu, to compensate them for lost trade. But it came to nothing. Then again, perhaps the virus came from ducks, which can be infected without showing symptoms.

29 December 2005 Life behind the mask
Today, I hooked up with the 15-person international team from the WHO's Global Outbreak Alert and Response Network. They're like the cast in that movie Outbreak, about some monkey virus.

We've got epidemiologists from the CDC — the US Centers for Disease Control and Prevention — along with mathematical modellers from Imperial and Emory, and virus hunters from the Pasteur Institute in Paris and the Robert Koch Institute in Germany. They're here to help hospitals control infection, and strengthen surveillance for human cases. Another team is doing the same in Cambodia. Across the world, health authorities are ramping up surveillance, trying to spot and isolate any exported cases as quickly as possible. They've grounded all commercial flights to and from the region. The chaos is way worse than with SARS.

Second evening here. The N95 face masks, which the WHO has advised us to wear, are the worst part. Your glasses steam up and you feel half-suffocated. I only take mine off to eat and drink. The team has a web video conference via a high-bandwidth satellite connection with WHO headquarters in Geneva. Its Department of Communicable Disease Surveillance and Response is coordinating the international response. Poor guys, there's just a handful of them.

They run through the latest stats. Here we go: 1,800 cases in Cambodia, 1,100 in Vietnam. Uh, oh ... six suspect cases in Tokyo and Johannesburg. So much for the flight bans. Overall, the mortality rate is 9%. That's nasty — worse than 1918. But it'll come down, as there's probably loads of asymptomatic cases.

The labs have finished sequencing the virus and we now have a template for an H5N1 vaccine. But it won't be ready for months. So for now, the WHO is trying a long shot, known as targeted antiviral prophylaxis.

Basically, the idea is to blanket bomb all index cases, their households and people in the immediate vicinities with antiviral drugs such as Tamiflu. Computer models predict that if we do this, we might just stop the pandemic in its tracks. But there hasn't been enough modelling, and now we're doing the experiment for real.

Continued modelling will be vital, though, to work out how to deploy the limited supplies of Tamiflu we've got, and how long we need to treat people for the drug to work. Geneva informs us that the WHO international stockpile contains just 120,000 pills. WHO officials have been on the phone today with countries that have national stockpiles.

The politicians know that stopping the pandemic at source would be the best solution. But they're reluctant to donate drugs, as they'll have less for their own citizens if this approach fails. No point asking the United States — they've only got enough pills for 1% of the population. Britain and France have enough for a quarter of their populations. Will they spare us any? Will they hell.

30 December 2005 Getting to know the enemy
Geneva announces that the latest epidemiological studies say that the virus seems to have a 'basic reproductive number', or R0, of between 1.4 and 2.0. This means that one case on average infects only one or two people. So if we can detect cases quickly and treat them and their contacts, the models suggest we could contain the virus most of the time. At the least, that might slow the pandemic and corral it in that region for a few months. That would win time to get a vaccine.

But we know there is a very short window. As time goes by, this virus will get better and better at transmitting between humans, and the R0 will increase. If it goes above 3, there's no way we'll contain it.

The latest news from Cambodia cheers us up. There's a slowdown in new cases. Control efforts seem to be keeping the lid on the virus there. But here it's a different story: the team is having difficulties finding and isolating contacts of patients in this crowded city.

This flu moves much faster than SARS because its incubation period is just two days. People are spreading the virus the day before they get sick, and asymptomatic patients without even being visibly ill. Tamiflu needs to be administered within two days of anyone showing symptoms.

As I wandered through the streets this afternoon, it wasn't looking good. People are walking around Hanoi coughing and spluttering. They've closed the schools, which is the right thing to do, but what are all the kids doing? Hanging out downtown enjoying the unexpected holiday.

31 December 2005 Six months to a vaccine!
Vaccine teleconference. There are 125 people — companies, regulators, scientists — hooked in, each with their own agenda. It's impossible. There's a lot of talk on whether the six-month delay before there is any vaccine can be shortened. Scientists had been working on methods of growing virus for the vaccine in large vats of cultured animal cells instead of eggs. That could cut the delay to maybe three months. But progress had been held up by US Food and Drug Administration concerns over the safety of the cell lines. In any case, it would probably take at least two years before the existing factories could be switched over.

So we're stuck with eggs. A fast-track FDA approval for an H5N1 vaccine is under way. Fortunately, the US Department of Health and Human Services last year funded Sanofi-Pasteur to test a 'mock' H5N1 vaccine, using antigens from an earlier strain. So we don't need to start the approval procedure from scratch for the pandemic strain. We've gained some time.

But US production capacity — one factory — is only enough to cover up to 90 million people. The situation is better in the European Union: it can probably produce enough to cover 30% of its 450 million people. The predictable news is that every vaccine-producing nation has just nationalized its supply to serve its own citizens first. The 'have-not' countries aren't going to get any vaccine.

There's a lot of hindsight and recrimination at this meeting. The United States only tested vaccines at standard doses. Testing a vaccine containing an immune-boosting adjuvant might have allowed it to be diluted eightfold. Even with existing world production capacity, that would have let us produce 7.2 billion shots, enough to treat half the world's population. Now it's too late.

25 January 2006 Escaping from hell
Apologies for the long delay in posting. The past few weeks have been chaos. I was out with WHO teams from dawn to dusk as they tried in vain to stamp out the outbreak with drugs. People fell sick all over Hanoi and 1 in 50 of them died. Many of the worst affected felt fine in the morning, but were dead by lunchtime — blue in the face, gasping for air. At the overcrowded hospital, I saw victims collapsing, suffocating in their own lung fluid, blood streaming from their noses and gums. Others had longer ordeals, tortured by encephalitis as the virus ate into their brains, or overwhelmed by multiple organ failure. Panicky authorities transported corpses out to the fields by truck and burnt them on open pyres.


P. BRONSTEIN/GETTY IMAGES
In a desperate last attempt to quell the outbreak, the WHO took what drugs it had left here and blindly treated whole sections of the city where transmission was most severe. The army was supposed to enforce quarantine, but many of them were sick as well, or had joined the exodus from the city. The fleeing people inevitably spread the disease to the countryside.

In a few days' time, the Vietnamese are supposed to celebrate Tet, the lunar new year festival. It's traditional to eat chicken — but not this year. My plane leaves tonight. I feel like I'm escaping from hell.

2 February 2006 The virus spreads
Today, I was at a press conference at the National Institutes of Health in Bethesda. A guy from the CDC pointed to a giant screen, a map of the world dotted with red pixels. He said that they'd reckoned the virus might hit in two or more waves up to eight months apart, as in past epidemics. They'd hoped the first pandemic strain of H5N1 might be poorly contagious, and come back again with a vengeance after it had picked up more infectivity. By that time we might have had a vaccine. That was just a hunch, though. And it was wrong.

The mild pandemic in 1968 took almost a year to cross the globe. This one probably started around October. So we're now almost four months in. Look at that map! With the huge increase in passengers travelling by air, it's already lodged in 38 cities around the globe. The outline of Asia is barely visible beneath the swarm of red pixels.

Now the virus is in coastal cities on both sides of South America. It hit Europe two weeks ago, ripping through Paris in just 11 days. In the French capital alone, there were 2.5 million cases and 50,000 dead. That's par for the course — infection rate 25% and mortality 2%, similar to the 1918 pandemic. Extrapolate these numbers, and we're going to have over 30 million dead worldwide. In poor and densely populated countries like India, it could be worse.

Where's next, I asked. Based on passenger data — which had to be prised from the airlines — one epidemiologist was willing to make a guess. "Within two weeks, there." He traced his finger from San Diego to Los Angeles, up to San Francisco. Within another three to four weeks, it'll be the turn of the conurbations along the eastern seaboard.

18 February 2006 This can't be happening
The United States is battened down before the storm. The government has outlawed all gatherings in public places. In past pandemics that never worked. But epidemiologists say that if we do it early on, it might slow the spread. Modelling also suggests that closing schools and universities is especially important as teenagers and young adults are among the worst hit. We just need to stop them from hanging out elsewhere. Stay at home, is the message blaring from every TV screen.

On CNN it's now round-the-clock coverage, with a red 'Pandemic' banner running across the bottom of the screen. "We're in the twenty-first century, and they're telling us about how to wash our hands properly, and practise 'respiratory etiquette'," exclaims Jonathan. "Why aren't there drugs? And I can't believe there's no vaccine. This can't be happening in America."

20 February 2006 America shuts down
The Commissioned Corps of the US Public Health Service, the nation's uniformed force of health professionals, has just been mobilized. The US Northern Command is in charge of the military response. Soldiers are setting up triage centres, anticipating overflowing emergency rooms and morgues. Images are coming in of tent cities being erected in New York's Central Park. Wards are being installed in schools and churches. Troops are on the streets. "There's going to be civil unrest," a general informed me on the phone this morning.


J. S. APPLEWHITE/AP
The CDC is in charge of national influenza surveillance, but it's a nightmare now. This is the peak season for ordinary flu, sparking false alarms and panic. Scant supplies of Tamiflu are being reserved for medical first responders, and essential services. (Stocking cash machines is an essential service, we learn.)

There's a lot of looting going on in pharmacies, but to no avail. The drugs are being distributed in convoys, with military jeeps in front and behind. Masks costing a dollar are being sold on street corners for $20. E-mailed ads for counterfeit drugs are filling up my inbox.

27 February 2006 Everyone for themselves
I watch the scenes of a society descending into chaos from the relative security of my mother's isolated home. Red tail lights snake to the horizon as people pour out of the cities. Half the doctors haven't turned up for work; many are either ill, or caring for loved ones.

Who should get the few mechanical respirators that can mean the difference between life and death? The youngest, or those with the best chances of pulling through? "Our leadership must be prepared to make calculated decisions that will force raw prioritization of life-saving resources," explains a colonel on CNN.

17 MAY 2006 The dust settles
The pandemic was declared over today. H5N1 will be back next year, or before that, as it replaces the existing seasonal flu strains. But by then, those who have recovered from this bout will have immunity, and we will have a vaccine. Pandemics move faster than governments or international bureaucracies, and the cost is hundreds of billions of dollars more than it would have been had we tackled avian flu in Asia in the first place, and invested in flu research. For millions of families, the cost isn't measured in dollars.

Watching all that military hardware on the streets made me think. We imagined we could encourage pharmaceutical companies to develop innovative vaccines and drugs by offering 'incentives' or modest subsidies. When the military knows it needs a fighter aircraft, it doesn't offer incentives to Lockheed Martin or Boeing. It pays them through procurement to develop the weapon to the specifications it wants.

Were we ready? Ready, my ass!

Sally O'Reilly's blog was written by Declan Butler, Nature's senior reporter in Paris.
probegallo
"Who's saying anyone should panic? Prepare, don't panic."

http://discuss.agonist.org/yabbse/index.ph...;threadid=21562
probegallo
Возможно, уже начинается 6-я фаза - т.е. уже фактически реальное начало пандемии по классификации ВОЗ...

Boxun Human Bird Flu Cases in Gangcha County Qinghai China

Recombinomics Commentary
June 1, 2005

>> China reported last week that a couple of hundred wild geese had died of avian flu in China's remote Qinghai province, north of Tibet. Niman didn't just speculate about the implications. He went to a Chinese-language news source and used Babelfish, an online translation service, to get more about the story.

What he got was not just a couple of hundred dead geese, but a thousand wild birds from five different species. And he obtained reports of 121 human deaths in 18 villages near the site of the bird deaths. Coupled with reports of 200 unusual illnesses, this began to look to Niman like human-to-human transmission of avian flu, with a catastrophic 60 percent case mortality rate. <<

A few clarifications on the commentary on the commentaries are in order. The information on the over than 1000 dead birds near Qinghai Lake comes from many sources. Initial wire service reports described the deaths of 178 bar headed geese. These initial reports clearly indicated that the deaths were not linked to bird flu.

Follow-up reports indicated dead birds had tested positive for H5N1, although the number and relationship to the 178 previously reported deaths was unclear. Clarification came from the initial report filed by China to the OIE, which described 519 dead birds representing 5 species in Gangcha Province, Qingahia Province. These deaths were laboratory confirmed. In the weekly OIE report the 519 were again listed but the report indicated that the virus isolated from the birds was H5N1 and was highly pathogenic in laboratory infected chickens.

The official report was followed by a news conference, which was widely reported. At the news conference the deaths of over 1000 birds were reported and one media report indicated most were in Qinghai Province, suggesting the bird deaths might be widespread.

For the human cases, the initial report came from Promed, who had translated the Abundant News story. That reported indicated six tourists had died. Four were named and three of the four were from Chengdu, Sichuan Province (about 400 miles southeast of Qinghai Lake). The clustering of three deaths of three tourists from the same location would be cause for concern. These initial reports were followed by a report of 121 deaths in 18 communities in Gangcha Province, along with 79 infections generating a case fatality rate of over 60%.

Follow-up reports included a smaller number of cases in more distant communities as well as a news blackout, checks of computer, difficulties connecting to the Internet, and related issues centered on limiting news.

All of the reports linked to the human cases come from the same source and have not been independently verified. However, these reports are quite specific and the severity of the reported events is quite clear and not lost in translation. If verified, these reports would dwarf prior reports on human H5N1 cases and move the 2005 flu pandemic from phase 5, which involve an increase in human-to-human transmission, to the final phase 6, which is sustained and widespread human-to-human transmission.

Although not verified, the reports via Abundant News are quite specific and consistent. The disease described is somewhat atypical, involving fever and vomiting, but not respiratory illness. The specifics in the series of reports are not adequately addressed with blanket denials by official sources in China.

http://www.recombinomics.com/News/06010502...ha_Qinghai.html
probegallo
PS - если даже подтвердиться реальное наступление 6й фазы, то все равно, до осени распространение вируса будет сильно сдерживаться жарой...
probegallo
Итак, обстановка похоже накаляется, но в этой теме опубликовано очень много материалов на англицкой мове. Переводить или даже давать выжимки времени у меня нет. Но есть хорошый сервис с переводом с English-Russian (сегодня обнаружил) -

http://babelfish.altavista.com/babelfish/tr

Там можно переводить как текстовый блок, так и сразу страницу (вставив url в нижнюю строку). В броузере надо принудительно выставить кодировку Unicode UTF-8
probegallo
Хм, утверждают, что ниже - фотографии массовой гибели птиц в Китае на острове Boxun. В принципе, возможно - в воздухе нет ни одной (хотя на фото вечер или утро), на второй фотографии (видно с сильныи телеобъективом) видно всего 2 или 3 птицы, держащиеся на ногах

user posted image

user posted image

Подробнее см... http://discuss.agonist.org/yabbse/index.ph...;threadid=21603
probegallo
Новые фото из тех мест

user posted image

user posted image

Сцылка (перевод с китайского на инглиш)

http://babelfish.altavista.com/babelfish/t....shtml&lp=zh_en
probegallo
новая фота из тех мест

user posted image

А вот так это выглядело ранее

user posted image


коммент - http://www.recombinomics.com/News/06050503...hird_Photo.html
probegallo
Итак, темой будущей (весьма вероятно) пандемии avian flu заинтересовались в Foreign Affairs и собираются все лето публиковать материалы. Если кто не знает, Foreign Affairs - самое крутое аналитическое издание в США, которым руководствуются в Белом доме.

http://www.foreignaffairs.org/background/pandemic/

The Next Pandemic?

Preview of a special section coming in the July/August issue of Foreign Affairs.

Editor's Note

International health officials are warning that a deadly avian influenza virus may soon spread rapidly, overwhelming unprepared health systems in rich and poor countries alike. If the virus mutates to become easily transmittable among humans, the death toll of the resulting global pandemic could number in the millions.

As a call to action, the July/August issue of Foreign Affairs will be publishing a special set of articles written by Laurie Garrett of the Council on Foreign Relations, Dr. Michael Osterholm of the University of Minnesota and the Department of Homeland Security, and Drs. William Karesh and Robert Cook of the Wildlife Conservation Society. Special condensed versions of the essays by Garrett and Osterholm, along with a Web-only Q & A with Garrett, are available on the Foreign Affairs website today.

Nature magazine is providing additional information on the medical and scientific aspects of the H5N1 virus. The coverage of both magazines is being coordinated to assist efforts of the Royal Institution World Science Assembly to spur preparations by governments and international organizations.

Probable Cause - сцылка
by Laurie Garrett

Since it first emerged in 1997, avian influenza has become deadlier and more resilient. It has infected 109 people and killed 59 of them. If the virus becomes capable of human-to-human transmission and retains its extraordinary potency, humanity could face a pandemic unlike any ever witnessed.

Preparing for the Next Pandemic - сцылка
by Michael T. Osterholm

If an influenza pandemic struck today, borders would close, the global economy would shut down, international vaccine supplies and health-care systems would be overwhelmed, and panic would reign. To limit the fallout, the industrialized world must create a detailed response strategy involving the public and private sectors.

Q&A with Laurie Garrett - сцылка

Laurie Garrett is Senior Fellow for Global Health at the Council on Foreign Relations. She has won the Pulitzer, Polk, and Peabody prizes for her journalism and is the author of The Coming Plague: Newly Emerging Diseases in a World Out of Balance and Betrayal of Trust: The Collapse of Global Public Health. Here she answers questions relating to her current research on the danger of an avian flu pandemic.

Coming in the July/August issue
The Human-Animal Link
by William B. Karesh and Robert A. Cook

Recent outbreaks of avian flu, SARS, the Ebola virus, and mad cow disease wreaked havoc on global trade and transport. They also all originated in animals. Humanity today is acutely vulnerable to diseases that start off in other species, yet our health care remains dangerously blinkered. It is time for a new, global approach.

Coming in the July/August issue
The Lessons of HIV/AIDS
by Laurie Garrett

To get a sense of the broader damage a new pandemic might do, it helps to consider the one the world is currently enduring: HIV/AIDS. Because this deadly scourge moves slowly, many of its social, political, and economic effects have yet to be understood. But the impact is hard to overstate. And it is growing.
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