Bird Flu and Taiwan

[Belgian_Pie]

I was just reading the Belgian newspapers and the news about the bird flu wasn’t that good.

The strain H5N1 found in Vietnam is probably resistant for ‘Tamiflu’, so if you get a shot or not … makes no difference to this strain … you’ll die probably … this strain can jump from person to person … :s

[MaPoSquid]

“Tamiflu” is not a vaccine. It is a drug that interferes with viral reproduction so that you can get rid of the flu faster.

The current problem with the H5N1 bird flu is that influenza vaccine is manufactured by injecting the virus into fertilized chicken eggs, letting the growing chick get the flu and develop antibodies, and then filtering out the antibodies for injection into humans.

Unfortunately, H5N1 bird flu kills the embryos, which results in nothing useful for vaccine production. So, no vaccine.

Disclaimer: the above is my understanding from general news articles and may be incorrect.

[Shiner]

I just heard that in case of an Outbreak the WTO (or Roche) only supply flu medizine for 100k people. They said supply in Taiwan is already short in hospitals with one month waiting time.

Is anybody considering buying the medicine in advance for a potential outbreak?

[seeker4]

Conveniently, I just did some reading on this avian or bird flu lately:

• There are several bird flus circulating. The one causing all of the stir is H5N1 because it is widespread in Asia (and moving beyond) and has had an extraordinarily high fatality rate, around 60% once infected.

• A vaccine does exist, but not in commercial quantities.

• Whereas a vaccine would be taken in advance to prevent the illness, as MaPoSquid said, Tamiflu is not a vaccine but is an anti-viral drug

[MaPoSquid]

The Wall Street Journal has a long editorial regarding bird flu:
opinionjournal.com/editorial … =110007416

Reasons to Be Fearful
We are ill-prepared for a flu pandemic.

BY HENRY I. MILLER
Monday, October 17, 2005 12:01 a.m.

During the past several years, an especially virulent strain of avian flu has ravaged flocks of domesticated poultry in Asia and spread to migratory birds. Fortunately, only rarely has it been transmitted from bird to human, and probably not at all between humans . . . yet. But flu virus mutates readily, and virologists expect that sooner or later it will acquire the ability to spread from person to person.

This is potentially catastrophic. The avian flu strain H5N1 already has two of the three characteristics needed to cause a pandemic: It can (1) jump from bird to human and (2) produce an often fatal illness; more than 60 deaths have been attributed to H5N1. If additional genetic evolution makes the virus highly transmissible among humans–the third characteristic of a pandemic strain–a worldwide outbreak could become reality. (The operative term here is highly transmissible; a flu virus that spreads as readily as the common cold would spell real trouble, but one that spreads less readily would be more manageable.)

H5N1 is an extraordinarily deadly variant: The mortality rate for persons infected with the existing H5N1 appears to be around 50%, whereas the garden-variety annual flu kills less than 1%. This gives us plenty to worry about. The acquisition of the genetic change(s) needed to become transmissible from human to human is stochastic–i.e., essentially random, therefore unpredictable. The more viruses there are, the greater the chances that one will acquire the “open-sesame” genetic changes, either by mutation or by exchanging genes during simultaneous infection of a person or animal with H5N1 and another flu virus. And there is more H5N1 around every day: In recent months it has spread over much of Asia and into Russia. Only last week, it was discovered in birds in Turkey.

More at the link.

[seeker4]

@MaPoSquid

The Wall Street Journal has a long editorial regarding bird flu:
opinionjournal.com/editorial … =110007416

Too bad the link requires registration.

My only comment is that the author’s comment regarding lethality is misleading. He makes it seem as if this particular strain is far more lethal than those in the past (50% vs. 1%). I already explained that in my post above; info that came from experts in that field. In short, there is every reason to believe that this virus will follow the path of others in the past with regards to normal lethality.

@The Medicinenet.com article above

The H5N1 bird flu bug has been particularly deadly for people unlucky enough to catch it from poultry. But if the bug learns to spread among humans, it almost certainly won’t be as deadly as it is now, says Ira Longini, PhD, professor of biostatistics at Emory University’s Rollins School of Public Health.

“Avian H5N1 looks like a 70% case fatality in humans. But this has never been true of any human strain,” Longini told WebMD last December. “There has never been any human influenza virus that has behaved that way in recorded or even unrecorded history. The case fatality of even highly virulent flu strains are a couple of deaths per 10,000 people.”

[sandman]

In Britain, they’re expecting 70,000 deaths when the outbreak occurs. The normal rate of flu deaths there is just 12,000 per year.

[NeonNoodle]

Here is my rough estimate for 1918.

world population (W) = 1.6 billion people
total influenza deaths (TD) = 50 milliion people
fatality rate (FR) (@ 100% population infected) = TD/W x 100 = 3.125%
FR (@ 50% pop. infected) = 6.25%
FR (@ 25% pop. infected) = 12.5%

Some have claimed there were as many as 100 million deaths so all those statistics would be doubled. Given the state of the world (WWI, Russian Revolution) at that time I’m sure more people would have lived. But I’m still curious where the 1% figure came from. Or did I miss something?

[seeker4]

Sandman: That normal rate of 12% info comes from where?

In your comment about Britain expecting 70K fatalities, which countries are you including?

NN: I don’t know the exact answer to your question. My info is coming from that quotation that I posted from the guy who studies this as a profession (and teaches it as a professor). My guess would be that the missing link that makes the math come out right is “time”. We are missing some time factor.

In other words, the normal 1% figure is 1% over some period of time, probably one year. The cumulative figure for a pandemic, which is likely to stretch over a longer period, would be higher. For example, the 1918 pandemic started in 1918, but it may not have ended in 1918. I may be completely incorrect, but that’s my best guess. If I find the answer, I’ll post it.

[sandman]

@seeker4

Sandman: That normal rate of 12% info comes from where?

In your comment about Britain expecting 70K fatalities, which countries are you including?

Not 12%, 12,000. The figure is for UK. I just read it today, but the link here gives 50,000, not 70,000.

[MaPoSquid]

@seeker4

@MaPoSquid

The Wall Street Journal has a long editorial regarding bird flu:
opinionjournal.com/editorial … =110007416

Too bad the link requires registration.

If it’s “today’s featured article”, it requires that you put in some email address. “x@x.com” works. It won’t even require that after noon tomorrow.

My only comment is that the author’s comment regarding lethality is misleading. He makes it seem as if this particular strain is far more lethal than those in the past (50% vs. 1%). I already explained that in my post above; info that came from experts in that field. In short, there is every reason to believe that this virus will follow the path of others in the past with regards to normal lethality.

That depends on luck. The current cases are roughly 50% mortality. “Plan for the worst, hope for the best.”

Remember SARS? 10% mortality, but that was with major treatment including putting patients on ventilators. If it had spread as easily as the common cold, it would have overwhelmed every nation’s medical resources; there just aren’t that many ventilators available, and they take time to build. (Of course, if it had hit the U.S., it would’ve been all Bush’s fault. )

[seeker4]

According to a Stanford University website on the 1918 Pandemic, the following is true:

• It was the worst pandemic in recorded history, killing more people that the Black Death / Bubonic Plague.

• The deaths occurred in a single year on a global scale

• “The influenza virus had a profound virulence, with a mortality rate at 2.5% compared to the previous influenza epidemics, which were less than 0.1%.”

stanford.edu/group/virus/uda/

=================================

NeonNoodle: Using your world population figure of 1.6 billion for 1918, if we assume 40 million deaths, that would exactly equal the 2.5% mortality rate mentioned on that website.

@sandman

Not 12%, 12,000. The figure is for UK. I just read it today, but the link here gives 50,000, not 70,000.

Sorry, you’re right. Getting bleary-eyed. Time for bed.

[MaPoSquid]

news.yahoo.com/s/ap/bird_flu_us&printer=1

Official: Preventing Pandemic Impossible

By MARGIE MASON, AP Medical WriterSat Oct 15, 4:12 PM ET

After wandering amid cages of birds and rabbits at an open-air market in Hanoi, after watching the gutting of a freshly slaughtered chicken, and after visiting a Haiphong family sickened by bird flu, the United States’ top health official came to a grim conclusion: Preventing the start of a global flu outbreak is just about impossible.

U.S. Health and Human Services Secretary Mike Leavitt was wrapping up a fact-finding mission Saturday in the region hardest-hit by bird flu. He said his tour of Thailand, Cambodia, Laos and Vietnam has painted a clearer picture of just how daunting it would be to identify and contain an outbreak if the virus mutates to a form easily spread among people. It could skip across borders and oceans, killing millions and crippling entire nations.

“Can we create a network of surveillance sufficient enough to find the spark when it happens, to get there fast enough?” he said. “The chances of that happening are not good.”

Leavitt, who is expected in Indonesia on Sunday, told reporters the trip has given him a realistic view of the challenges in Asia where people and animals living closely together is rooted in the culture.

“I was at a market in Cambodia and talked with a pig vendor who traveled 600 kilometers (373 miles) the night before to sell her pigs,” he said. “She had carried them on the top of a bus in a box next to a load of chickens, and I was sitting next to her … with several other baskets of geese and several baskets of turkeys and ducks and then right next to pigs.”

…

The HHS secretary - who was accompanied by the disease chief of the National Institutes of Health and the head of the Centers for Disease Control and Prevention, among others - said he would use information gleaned from his trip to work on U.S. preparedness and to start asking questions of Americans. Health officials have said a quarantine is the best approach if a flu pandemic is unleashed, but Leavitt said Americans are not ready.

“People have not exercised adequate personal preparedness to last more than three or four days in their normal environment without going to the store,” he said. “What’s the responsibility of communities? What’s the responsibility of families? Is it important that the mayor of a small town be thinking about a decision between Tamiflu and a swimming pool?”

This ties in to some comments I made in the thread about Hurricane Katrina – keeping a few days of supplies around is important.

In the case of a lethal pandemic, it wouldn’t be a bad idea to have a couple of months of supplies on hand. I followed the Mormon model back in Seattle; I wouldn’t have had much of a varied diet but I could have survived for a year, as long as I had electricity and tap water. Here, maybe two weeks at best. It’s a problem. . . .

[MaPoSquid]

@seeker4

According to a Stanford University website on the 1918 Pandemic, the following is true:

• It was the worst pandemic in recorded history, killing more people that the Black Death / Bubonic Plague.

• The deaths occurred in a single year on a global scale

• “The influenza virus had a profound virulence, with a mortality rate at 2.5% compared to the previous influenza epidemics, which were less than 0.1%.”

stanford.edu/group/virus/uda/

Except that they aren’t comparing percentages, they’re comparing totals. “2.5% of 1.6 billion” is more than “33% of a hundred million” (or whatever the Black Plague was) – the Plague was a more localized disease than influenza. Plague hit areas with poor sanitation and lots of rats, in pockets, and limited by geographic boundaries. Influenza, by contrast, spread worldwide by trade and IIRC also by birds.

If you read Guns, Germs, and Steel by Jared Diamond, early travelers brought new diseases into lands where entire native populations had no immunity; the diseases frequently wiped out said native populations with nearly 100% lethality. This was not always the old chestnut about “smallpox blankets”; in some cases, it was simple contact with no intent to harm. (My copy is currently on loan, else I’d cite a few pages.)

[Dragonbones]

@seeker4

When a virus changes forms, for example when one adapts from an animal virus into a human virus, its lethality lessens considerably, from the current 60% to far less than 1%.

Can anyone explain why this is, or why this claim is made? I don’t find this to be a logical necessity. I do understand that an excessively rapidly lethal pathogen may limit its own spread, as by killing hosts too rapidly it prevents their transmitting it to many others. But given an adequate period of incubation and communicability, that’s not a given, either. Furthermore, the figure of ‘far less than 1%’ doesn’t match the mortality rates of some of the historical plagues which did make the animal-human leap. Or did I miss something??? :eh:

[dearpeter]

Here is a really scary “opinion piece” by some syndicated columnist I’ve never heard of (but that’s not surprising). Or at least, it tries to be really scary. I hope it’s hyperbole. This guy says the publishing of the 1918 flu genetic sequence will basically lead to some terrorist group producing the virus for nefarious reasons. Damn, 12 Monkeys was a scary movie.

Here’s the link.

Full quote:

Charles Krauthammer / Syndicated columnist

A deadly race with bird flu

WASHINGTON ? While official Washington has been poring over Harriet Miers’ long-ago doings on the Dallas City Council and parsing the Byzantine comings and goings of the Fitzgerald grand jury, relatively unnoticed was perhaps the most momentous event of our lifetime ? what is left of it, as I shall explain. It was announced last week that American scientists have just created a living, killing copy of the 1918 “Spanish” flu.

This is big. Very big.

First, it is a scientific achievement of staggering proportions. The Spanish flu has not been seen on this blue planet for 85 years. Its re-creation is a story of enterprise, ingenuity, serendipity, hard work and sheer brilliance. It involves finding deep in the bowels of a military hospital in Washington a couple of tissue samples from the lungs of soldiers who died in 1918 (in an autopsy collection first ordered into existence by Abraham Lincoln), and the disinterment of an Alaskan Eskimo who died of the flu and whose remains had been preserved by the permafrost.

Then, using slicing and dicing techniques only Michael Crichton could imagine, they pulled off a microbiological Jurassic Park: the first ever resurrection of an ancient pathogen. And not just any ancient pathogen, explained virologist Eddie Holmes, but “the agent of the most important disease pandemic in human history.”

Which brings us to the second element of this story: Beyond the brilliance lies the sheer terror. We have quite literally brought back to life an agent of near-biblical destruction. It killed more people in six months than were killed in the four years of the First World War. It killed more humans than any other disease of similar duration in the history of the world, says Alfred W. Crosby, who wrote a history of the 1918 pandemic. And, notes The New Scientist, when the re-created virus was given to mice in heavily quarantined laboratories in Atlanta, it killed the mice more quickly than any other flu virus ever tested.

Now that I have your attention, consider, with appropriate trepidation, the third element of this story: What to do with this knowledge? Not only has the virus been physically re-created. But its entire genome has now been published for the whole world, good people and very bad, to see.

The decision to publish was a very close and terrifying call.

On the one hand, we need the knowledge disseminated. We’ve learned from this research that the 1918 flu was bird flu, “the most bird-like of all mammalian flu viruses,” says Jeffery Taubenberger, lead researcher in unraveling the genome. There is a bird flu epidemic right now in Asia that has infected 117 people and killed 60. It has already developed a few of the genomic changes that permit transmission to humans. Therefore, you want to put out the knowledge of the structure of the 1918 flu, which made the full jump from birds to humans, so that every researcher in the world can start looking for ways to anticipate, monitor, prevent and counteract similar changes in today’s bird flu.

We are essentially in a life-and-death race with the bird flu. Can we figure out how to pre-empt it before it figures out how to evolve into a transmittable form with 1918 lethality that will decimate humanity? To run that race we need the genetic sequence universally known ? not just to inform and guide but to galvanize new research.

On the other hand, resurrection of the virus and publication of its structure opens the gates of hell. Anybody, bad guys included, can now create it. Biological knowledge is far easier to acquire for Osama and friends than nuclear knowledge. And if you can’t make this stuff yourself, you can simply order up DNA sequences from commercial laboratories around the world that will make it and ship it to you on demand. Taubenberger himself admits that “the technology is available.”

And if the bad guys can’t make the flu themselves, they could try to steal it. That’s not easy. But the incentive to do so from a secure facility could not be greater. Nature, which published the full genome sequence, cites Rutgers bacteriologist Richard Ebright as warning that there is a significant risk “verging on inevitability” of accidental release into the human population or of theft by a “disgruntled, disturbed or extremist laboratory employee.”

One batch of 1918 flu has the capacity for mass destruction that no Bond villain could ever dream of. Why try to steal loose nukes in Russia? A nuke can only destroy a city. The flu virus, properly evolved, is potentially a destroyer of civilizations.

We might have just given it to our enemies.

Have a nice day.

[NeonNoodle]

Following on what dearpeter’s link had to say, this is what Ray Kurzweil and Bill Joy have to say about the publishing of the 1918 flu genome.

AFTER a decade of painstaking research, federal and university scientists have reconstructed the 1918 influenza virus that killed 50 million people worldwide. Like the flu viruses now raising alarm bells in Asia, the 1918 virus was a bird flu that jumped directly to humans, the scientists reported. To shed light on how the virus evolved, the United States Department of Health and Human Services published the full genome of the 1918 influenza virus on the Internet in the GenBank database.

This is extremely foolish. The genome is essentially the design of a weapon of mass destruction. No responsible scientist would advocate publishing precise designs for an atomic bomb, and in two ways revealing the sequence for the flu virus is even more dangerous.

First, it would be easier to create and release this highly destructive virus from the genetic data than it would be to build and detonate an atomic bomb given only its design, as you don’t need rare raw materials like plutonium or enriched uranium. Synthesizing the virus from scratch would be difficult, but far from impossible. An easier approach would be to modify a conventional flu virus with the eight unique and now published genes of the 1918 killer virus.

Opinion | Recipe for Destruction (Published 2005)

[seeker4]

Sorry, been tied up.

Let

[nivek]

@seeker4

• A vaccine does exist, but not in commercial quantities.

I believe there is no vaccine available to date because there is no specific strain ie: we need a human strain of the virus so this needs to come first before they can create an anti-virus/vaccine.

At this point in time there are no recorded cases of human to human transmission. If/when this happens we then have the chance of the pandemic with this specific strain. All current cases are transmission from infected animal to human. You see high levels of infections from workers in infected chicken farms or those in the 3rd world who live in close proximity to their animals.

Tamiflu was swept off the shelves of stores last year, so I think it is hard to get your hands on any. Most countries are ordering supplies for approx 10% of population, but as it takes 12mths to manufacture supply is v.slow… I think TW ordered enough for just 2 million treatments.

[Stray_Dog]

Just popped out of the Pets forum to give my point of view:

Doesn’t it tell you something that the deadliest viruses of late have originated from animals kept in inhumane conditions?

SARS came from civet cats kept many to a cage in inhumane conditions at market.

Bird flu comes from birds kept in cramped, squallid conditions while awaiting slaughter.

Mad cow diease from factory-farmed cows, fed cow brains amongst other meat parts despite being herbivores.

Am I forgetting any?

Anyway, is this a sign that humans are not meant to abuse nature?

Hmm …