As if we don't have enough problems......

[saltydawg]

H5N1 influenza strain raises concern about a pandemic

If the virus mutates and can efficiently transmit from person to person, it could cause a deadly pandemic.

by Marie Rosenthal
Editor in Chief, Infectious Disease News

September 2005

WASHINGTON — The human avian H5N1 influenza cases occurring in Asia bring the threat of an influenza pandemic ever closer to our shores, said Benjamin Schwartz, MD, at a press conference sponsored here by the National Foundation for Infectious Diseases.

So far, there has been no confirmed person-to-person transmission, but if the strain mutates and develops that transmission capability, it could cause a deadly pandemic.

The Trust for America’s Health (TFAH) released state-by-state projections that found more than 500,000 Americans could die and more than 2.3 million could be hospitalized if a moderately severe strain of a pandemic influenza virus hit this country. Based on its estimates, 67 million Americans are at risk of contracting the pandemic influenza strain. A pandemic with the H5N1 strain could be worse though, according to Schwartz. The mortality rate so far is higher than 50%.


A possible pandemic

One would be hard pressed to find a public health official or infectious disease specialist who does not believe a pandemic is possible and probable, and that this H5N1 strain increases the likelihood of it being sooner rather than later. “I think [H5N1] has all of us not only fascinated, but anxious. I did not think that it would spread that quickly,” William Schaffner, MD, told Infectious Disease News.

“Influenza pandemics occur when a new influenza strain to which most or all of the population is susceptible spreads among people. This new strain can develop by the sharing of genetic material between avian and human influenza virus strains, either in a coinfected animal such as a pig or in humans, or possibly by mutation of an avian influenza strain,” explained Schwartz, who is senior service advisor, National Vaccine Program Office at the Department of Health and Human Services (HHS), and who is working on the national pandemic plan.

The chance of a recombination depends on the viral strain and how widespread it is among humans and animals. This is why the current H5N1 strain in Asia represents a major pandemic threat. Its scope is unprecedented, Schwartz said. H5N1, which can be asymptomatic, infects domestic poultry and wild waterfowl. Infected migrating birds can carry the virus long distances as well.

People with H5N1 infection generally have severe disease, Schwartz said. “Unlike the flu that occurs in the United States each year, which most often causes mild disease, reported H5N1 cases usually progress to pneumonia, frequently progress to respiratory failure and accompanying multiorgan system failure and, in more than half of all cases, death occurs.”

A normal flu season tends to kill the most vulnerable populations: the elderly, infants and those with chronic conditions. Most of the H5N1 deaths have occurred in young and previously healthy individuals, Schwartz added.

The ongoing disease in domestic and wild poultry and the evolution of the H5N1 virus, which appears to be adapting to spread among mammals, point to a growing threat. “However, it is unclear whether this strain of H5N1 will ever acquire the ability for efficient and sustained transmission among people,” he said.

So, public health officials prepare for a pandemic with an eye on H5N1, but a realization that the threat could be lurking somewhere else. The influenza pandemic of 1918 probably started in the middle of the United States, although it is difficult to pinpoint exactly where.

Many steps must be taken to prepare for a pandemic. Surveillance must be enhanced. The production capacity of influenza vaccines and antiviral drugs must be increased, and the capabilities of the health care systems to respond must be improved to reduce death and severe illness among those who contract the disease.

“Early detection of influenza among animals and people is critical,” Schwartz said, but many countries affected by avian influenza lack good surveillance systems, as well as the necessary laboratory, epidemiologic and veterinarian staff.

The NIH and WHO have provided money and manpower to improve the surveillance infrastructure of Asian countries, to strengthen detection and response capabilities, and to improve data management and information sharing.


From detection to protection

Vaccination will be the primary prevention strategy in a pandemic. “However, we face substantial challenges in developing and producing pandemic vaccine. Developing a vaccine to a new influenza strain may take up to six months,” Schwartz said, which makes early detection even more critical.

Even if there is a vaccine, the need will exceed production capacity. “Unlike annual influenza, where we focus our efforts on only part of the population, in a pandemic, everyone will be susceptible and vaccination most likely will be recommended universally,” he said. “And because every country, not just the United States, will be experiencing the pandemic, we assume that only vaccine manufactured within the United States will be available for our population, despite preexisting contractual agreements.”

[Dawgbitten]

World has slim chance to stop flu pandemic
Sep 20 1:48 AM US/Eastern


By Michael Perry

NOUMEA, New Caledonia (Reuters) - The initial outbreak of what could explode into a bird flu pandemic may affect only a few people, but the world will have just weeks to contain the deadly virus before it spreads and kills millions.

Chances of containment are limited because the potentially catastrophic infection may not be detected until it has already spread to several countries, like the SARS virus in 2003. Avian flu vaccines developed in advance will have little impact on the pandemic virus.

It will take scientists four to six months to develop a vaccine that protects against the pandemic virus, by which time thousands could have died. There is little likelihood a vaccine will even reach the country where the pandemic starts.

That is the scenario outlined on Tuesday by Dr Hitoshi Oshitani, the man who was on the frontline in the battle against SARS and now leads the fight against avian flu in Asia.

"SARS in retrospect was an easy virus to contain," said Oshitani, the World Health Organization's Asian communicable diseases expert.

"The pandemic virus is much more difficult, maybe impossible, to contain once it starts," he told Reuters at a WHO conference in Noumea, capital of the French Pacific territory of New Caledonia. "The geographic spread is historically unprecedented."

Oshitani said nobody knew when a pandemic would occur, it could be within weeks or years, but all the conditions were in place, save one -- a virus that transmitted from human to human.

The contagious H5N1 virus, which has killed 64 people in four Asian countries since it was first detected in 2003, might not be the one to trigger the pandemic, he said. Instead a genetically different strain could develop that passes between humans.

While bird flu cases continued to spread throughout Asia, with Indonesia this week placed on alert after reporting four deaths, Oshitani said the winter months of December, January and February would see an acceleration in cases, and the more human cases the greater risk that the virus would mutate.

Vietnam, Indonesia and Cambodia were most vulnerable due to the large domestic poultry populations, he said.

MASSIVE, RAPID CAMPAIGN

When a pandemic is first detected, health authorities will need to carry out a massive anti-viral inoculation campaign within two to three weeks to have any chance of containment, said Oshitani.

"Theoretically it is possible to contain the virus if we have early signs of a pandemic detected at the source," he said.

Scientists estimate that between 300,000 and one million people will immediately need anti-virals, but there are only limited stocks. WHO will receive one million doses by the end of 2005 and a further two million by mid-2006.

Even when an avian flu vaccine is fully developed, production limitations will mean there will not be enough vaccine.

"Right now we have a timeframe of four to six months to develop and produce a certain quantity of vaccine and that may not be fast enough," said Oshitani.

Last week French drug maker Sanofi-Aventis won a $100 million contract to supply the United States a vaccine against H5N1. The United States has also awarded a $2.8 million contract to Britain's GlaxoSmithKline for 84,300 courses of an antiviral. The purchases are part of a U.S. plan to buy vaccine for 20 million people and antivirals for another 20 million.

Oshitani said the early vaccines were unlikely to protect against the pandemic virus. "The vaccine should match the pandemic strain. So a vaccine developed for the virus in Vietnam now may not protect you from another virus," he said.

But Oshitani fears that once a pandemic occurs, the world's rich nations may dominate vaccine supply.

"The distribution of a vaccine will be a major issue when a pandemic starts. There is no mechanism for distribution," he said. Asked whether poorer Asian nations such as Cambodia and Vietnam would get a vaccine, Oshitani said "probably not."

Avian flu has moved west from Asia and into Russia, with many fearing migratory wild birds will spread the virus to Europe and possibly the United States via Alaska.

But Oshitani casts doubt on the impact migratory birds are having on the spread of avian flu, saying different sub-types of the H5N1 virus are in Asia and Russia.

"There are so many uncertainties about the pandemic. We don't know how it will start. We don't know exactly how it is spreading," he said.

Oshitani said that the successful containment measures used against SARS, such as quarantining those infected and cross-border checks, would fail against an avian pandemic, as people spreading bird flu may not show early symptoms.

"The pandemic is likely to be like the seasonal influenza, which is much more infectious than the SARS virus," he said.

[saltydawg]

The latest issue of National Geographic has a major story on the danger of the H5N1 virus. If you get a chance, take a look.

I'm in the process of stockpiling 6 months worth of food and water as well as other essential items.

[dawg80]

It's the end of the world!



Good thing I am saved!

[Dirtydawg]

It's the end of the world!



Good thing I am saved!

I think I read somewhere that these viruses are getting stronger due to global warming.

[Dawgbitten]

I hope you guys aren't making light of this situation. I know I am not. I am currently reading The Great Influenza by John Barry (Same guy who wrote Rising Tide). It is about the Influenza epidemic of 1918. You might want to read it.

Don't think for a minute that this SARS thing can't flare back up stronger than it was and come visit the US as well.


China sets blueprint for fighting flu pandemic
Sep 28 10:00 AM US/Eastern



BEIJING (Reuters) - China announced color-coded emergency measures on Wednesday to avert or handle an influenza pandemic amid fears that a deadly strain of bird flu could mutate and infect millions of people around the world.

Millions of Chinese catch flu every winter, while avian influenza, including the deadly H5N1 strain that has killed 65 people in Asia, is believed endemic among the country's bird population.

The Health Ministry, widely criticized three years ago for its handling of a deadly SARS outbreak, is to set up a national anti-influenza leadership group and stockpile vaccines. It has urged regional governments to coordinate monitoring efforts.

Four levels of alert -- blue, yellow, orange and red -- will indicate the seriousness of the outbreak.

"The most serious level, red, will be announced in case of a consistent and rapid spread of new sub-type flu virus among the people, or if the World Health Organization announces the outbreak of a flu pandemic," the ministry said.

Experts say southern China could be ground zero for such a pandemic because many there live in close proximity to livestock, allowing animal diseases such as bird flu to jump to humans.

"If a person is infected with a human influenza and also contracts avian influenza ... the two kinds of influenza could mix and re-assort themselves into a more dangerous strain that could cause easy human-to-human transmission," Aphaluck Bhatiasevi, a WHO spokeswoman in Beijing, told Reuters.

"And that would be the pandemic."

China's plan focused on preventing and handling infections of human influenza and did not specifically mention bird flu, but it was also geared to handle such an outbreak, Bhatiasevi said.

The government would subsidize and encourage research and production of flu vaccines and medicines while beefing up national stockpiles, the ministry scheme says.

"We have to admit our vaccine production capabilities and medicine stores are weak points," National Influenza Center director Shu Yuelong was quoted as saying.

The Outlook Weekly magazine quoted Shu as adding that China, with a population of 1.3 billion, had only nine flu vaccine makers with total annual production capacity of 10 million doses.

In the plan, the Health Ministry also pledges to compile weekly reports analyzing information from the nationwide influenza monitoring system and to share data with the WHO.

"China has learned from the SARS experience and has been more open and more willing to respond to disease outbreaks," Bhatiasevi said.

Beijing was widely criticized for initially trying to cover up the outbreak of SARS (Severe Acute Respiratory Syndrome), which emerged in southern China and spread globally in 2003, infecting 8,000 people and killing 800.

[Cool Hand Clyde]

Ronald Reagan invented SARS to get rid of Asians.

Oh wait, that was aids and blacks?

Or was it crack and blacks?

I can't remember exactly what Jessie/Sharpton/Farakan said.

[saltydawg]

It's the end of the world!



Good thing I am saved!

You will undoubtedly be identified as the person with the big smile on his face.