# Avian flu - not if but when



## used to be jwoodget (Aug 22, 2002)

The latest data from Vietnam points to there being a 50% chance of the current isolated outbreaks of avian flu that have been occurring over the past year breaking out into a worldwide epidemic. The problem is that the H5N1 virus seems to be persisting and humans keep getting infected. The human to human transmission rate is currently low, but if a person with a common influenza virus was infected with the avian variety, the genomes would recombine and likely result in transferance of the virulence genes of the common influenza virus to the deadly avian virus. This commonly occurs and is one reason why flu viruses are so difficult to vaccinate against as they continually shuffle and mutate their DNA. Conservative death estimates for a pandemic are in the low millions but it could be worse than the Spanish flu of 1918 that killed 50 million.

Regardless of the ultimate severity in terms of human lives lost, the epidemic will cause massive trade and economic disruption, triggering worldwide recessions. If the death toll is in the tens of millions range, then there will be significant impact on society worldwide.

We keep hearing about the tiniest probabilities of an asteroid impact but I'd think that a 50:50 chance of a pandemic of avian flu should be grabbing a bit more attention. The scary thing is that in the scientific communities, it is. But little seems to be getting through to the public. Perhaps this is because there seems little we can do without causing similar disruption to that that would be caused by a real outbreak. Why take the risk? That's the attitude that was a major reason for the SARS spread but this is a completely different ballgame.

See todays news.....

It's difficult to know whether the news is alarmist (the Real Chicken Little!) or truly worrying. However, Australia does seem to be taking preventative action. Moreover, the problem is getting worse, not better. That should be ringing alarm bells. If you are interested in monitoring the situation then here are some web sites:

CDC information
CBC backgrounder


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## MacDoc (Nov 3, 2001)

The Side B factor to this......I agree with not IF BTW is the mortality rate is 60%+ ...with all of modern medicine applied. 

It looks like the world dodged the Marberg bullet this time but "it's not over" entirely.

JW you would know better than me but I guess it's the combinatorial unknowns that prevent any real action on a vaccine. It would be a guess at this point which strains hook up.


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## Dr.G. (Aug 4, 2001)

Jim, if you were put in a position of total authority, with absolute power, and thus organizations such as WHO and CDC had to follow your dictates, what might you do starting Monday to help prepare us for this literal "flip of the coin"?


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## MacNutt (Jan 16, 2002)

I'm guessing that the only real way to deal with or truly contain an outbreak of something like this would be to completely isolate whatever area that it is first detected in. For however long it takes to run it's course.

Pretty drastic. And none too popular either. Especially for the (most likely) emerging nation that suffers from this total isolation. And, unless draconian measures like martial law were strictly enforced, then _someone_ with the infection would still be able to get out. And it would spread to a larger area. Fast.

Then...we are sunk. Or sixty percent of those who catch it are. And worldwide economies would take a helluva wallop, no doubt. This means that even people who never get the virus would be affected. To say the least.

Not good.


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## MacDoc (Nov 3, 2001)

BC an emerging nation is it......????

While the situation in BC is better NOW....avian flu can jump anywhere



> B.C. minister says avian flu 'not under control'
> Last Updated Thu, 15 Apr 2004 20:21:20
> VANCOUVER - B.C. Agriculture Minister John van Dongen says the avian flu in the Fraser Valley is still out of control after new figures show 29 poultry farms are now infected with the virus.
> 
> ...





> Review says B.C. avian flu outbreak well handled but improvement needed	Jan. 17, 2005
> Written by: STEVE MERTL
> 
> VANCOUVER (CP) - An avian flu outbreak last year in British Columbia could have easily spread east beyond the Fraser Valley, says a poultry industry representative who reviewed the handling of the epidemic.
> ...


Maybe time to apply to the world bank 'n all being a "third world nation"

I would suspect a first world nation might be most resisting of forced quarantine. Gotta do that biz, take that vacation et al.

.........little bigotry showing??....not the first time.


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## MacNutt (Jan 16, 2002)

Oh, put a sock in it, David.

The avian flu I was talking about is the sort that has already infected humans. This is most likely to appear in an Asian country. Already has, in fact.

Maybe it's time to stop sniping away at me and park your jealousy long enough to really deal with the predicted pandemic. Everyone's talking about it these days...and pretty much everyone seems to think that it will come from one of the poorer nations. Most likely in eastern Asia.

And, because of air travel and extensive trade, it will likely spread like wildfire unless we take some truly harsh measures to stop it. As I said earlier, these methods will NOT be popular. With anyone. No matter where they are put into place.

Wonder what Jim Woodgett has to say about this? He is our resident expert on these things.

Is immediate and complete isolation of the infected area the answer? Or...is there some other solution?


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## MacDoc (Nov 3, 2001)

jealousy??..... :clap:....a new height of the absurd.

What you think there something speical about avian flu in BC that it stops evolving??
It'll jump where ever and whenever the right conditions arise.

Our first world focus on "hygiene" has already made us more susceptible to a variety of ailments and asthma and diabetes are on incredible upward curves in the first world.

We're just building up a nice pool of immune suppressed fodder for the bug that jumps.


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## MacNutt (Jan 16, 2002)

Odd...I don't recall Jim having even mentioned the bird-only avian flu that was discovered in BC last year. There is NO evidence at all that it was even a widespread phenomemon. But they killed off almost every sort of domesticated bird for miles around anyway. And we've heard nothing more about it, ever since.

Woodgett DID, however, mention VietNam. Which is where avian flu has been spotted rather recently. And it is also the only place where we have heard about the strain leaping to a human host. It's in the souteast asian countries where birds (ducks and chickens) are usually kept alongside pigs. And the combination of the two (pigs being very close to human at a cellular level) that usually gives rise to most of the more viruent strains of influenza. Ones that travel here on airplanes along with their infected human hosts, BTW.

So park your jealousy and put up with the smog and the crumbling infrastructure and the smog and the crime and the smog and the traffic and the smog. And try to ignore that shiny new Apple store in your area. While watching the best and brightest moving away to the west coast, every single day. Try not to think about the dying manufacturing sector, either. It'll just give you indigestion. (especially if your beloved Liberals ever manage to implement Kyoto!)

Say...did I mention the smog? Or the highest environmental lead levels on all the continent? Or the smog? "The Smog that KILLS!?!"

But let's leave that for another thread. And lets get back on track to debate what the best approach to an Asian avian flu outbreak might be. Okay?

Isolation of the infected area? Or is there another solution?


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## Gerbill (Jul 1, 2003)

MacNutt said:


> Oh, put a sock in it, David.
> 
> The avian flu I was talking about is the sort that has already infected humans. This is most likely to appear in an Asian country. Already has, in fact.
> 
> Maybe it's time to stop sniping away at me and park your jealousy long enough.......


Sounds like Conrad ("Lord Tubby of Fleet") Black - anyone who doesn't like him must be jealous of his wealth, urbanity, etc.


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## MacNutt (Jan 16, 2002)

And maybe...just MAYBE..it's time to deal with the actual problem of an avian flu pandemic. And discuss it a bit? Talk about what might be actually DONE about it? Especially since so many medical professionals seem to think that it's just over the horizon.

Or...we can listen to macdoc whine on and snipe away about how horrible BC is, while he quaffs down double doses of antihistamines just to be able to breathe the smoggy air in his own chosen paradise.  

Personally, I think we should talk about the avian flu. The type of avian flu that may affect humans. Not the type that killed a few chickens last year in BC. And that NEVER infected a single human being.

Want to talk about a looming epidemic that has already spread from animal to human in southeast asia? That may be spreading from human to human, as we speak? And that may threaten ALL of us in the very near future?

Then I'm listening!

Want to turn his thread into a forum for an elder Ontarian to bash away at BC whilst gagging out his last breaths from inside a cloud of choking smog??

Then FORGET IT! I have better things to do with my time.

Sooo....Let the informed discussions begin!

(or NOT)...Your choice.


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## used to be jwoodget (Aug 22, 2002)

Dr. G., 

If I was "in power" which is certainly not the same as being head of the public health agency since they are not empowered to act without higher-up assent, then this is my initial plan and its based on relative risk.

First a foreword. The most conservative scientific estimates of consequences of a pandemic flu outbreak pin the cost at tens of billions - to Canada!! I would use this as the argument to prepare in a significant manner insofar as basically almost anything we spend is reasonable and these costs will include personal liberties. No, I've not turned into a Nazi. This is being responsible.

A. Monitor all incoming flights from affected areas effective September 1, 2005. The following procedures would be publicised and will likely reduce travel and cause economic pain. Monitoring means examining every passenger from South East Asia including China for evidence of fever. A quarantine facility (basically a rented hotel) would be used to monitor anyone with a fever for 10 days.

B. All hospitals and primary physicians will be sent daily updates on status fromt he National Nicrobiology Labb (closest we've got to CDC for the time being) including information on symptoms. All patients diagnosed with flu will have to be reported (much like TB). Hospitals and primary care-givers will be supplied with N95 masks. All metropolitan hospitals will be supplied with containment gear.

C. Conversion of a exisiting facilities in each province into negative pressue isolation units. These would either be disused government buildings or hotel-like buildings. Funding would be entirely federal.

D. Contracting vaccine production capacity with Canadian companies (Aventis Pasteur labs and the one in BC). There are some partially effective vaccines. These would be a start. There are also otheranti-viral drugs.

E. Public education. This has to be scaled. It's important to communicate that the actions being taken are precautionary and that inconvenience is minimal compared to the possible outcome.

F. Set aside $2 billion per year for the measures, effective immediately. While these measures are aimed avian flu, they will be applicable to other communicative diseases.

All of these measures assume a pandemic doesn't occur and are simply preparations. If there was evidence of a highly infectious variant, then the next stage is far more draconian and will mean cessation of all travel to initially affected areas - recognizing that this will become global within 3 months. The Canadian afgencies will know this and will use the tiny amount of time available to massively scale up containment efforts. If a pandemic strikes, up to one in 10 adult Canadians will be involved in some sort of activity associated with the pandemic. 

Doing nothing burns time we do not have enough of. Perhaps if Canada was more visible in its activities, then the rest of the world might wake up. There ARE things we can do right now and they are proportionate to the risk.

Obviously, even if we did everything right, then if other countries do not and there is a pandemic, our lives will change in ways that are currently unimaginable. Doing nothing is an option, but it is irresponsible and will ultimately cost us much more.

So lets cut the crap and discuss this intelligently. Some professional people I know are taking quite drastic action right now (stockpiling masks, liquidating investments). I don't think that is a particularly good idea as it would precipitate a fiscal emergency all by itself, but it indicates how concerned some people who are in the know feel.


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## MacDoc (Nov 3, 2001)

Put a cork in it Gerry cuz you CLEARLY haven't a clue about the subject.

There are 15 or so strains of avian flu identified, ANY of them can jump to humans under the right conditions anywhere in the world that humans and birds mix. Pointing to the third world as a "cause" is bull**** and bigoted AND not based on either science or reality.......typical nonsense from the tequila fumed SSI hermit.

It HAS jumped in BC.



> Avian influenza that infects poultry in close proximity to humans is a concern because of its pandemic potential. In 2004, an outbreak of highly pathogenic avian influenza H7N3 occurred in poultry in British Columbia, Canada. *Surveillance identified two persons with confirmed avian influenza infection. Symptoms included conjunctivitis and mild influenzalike illness.*
> 
> Influenza is the most diversified in birds, particularly in wild waterfowl (1). Concern exists that outbreaks of avian influenza in domestic poultry could, through a process of genetic reassortment, mutation, or both, introduce new influenza subtypes into the human population. In the context of widespread susceptibility, such an event could be the precursor of a pandemic (2,3)
> 
> ...


One reason it's so hard to prepare for is influenzas ability to evolve quickly and there are numerous human strains as well so the possible combinations are enormous......some could be almost harmless - might even be beneficial in preparing our immune systems for a more potent variant.

Canada got a wake up call with SARS. A pandemic is a true, real, immediate threat requiring resources and the kind of preparedness Jim outlines......not wasting money on "terrorist behind dumpsters" and missile defence stupity.

Pandemic preparedness and getting off fossil fuels - dealing with carbon and warming are the twin issues that demand the very greatest of government and citizen effort and zeal to deal with.

No one on the planet is free from these twin threats...........

'Course there are always those who are ill informed, blind or just plain incapable of understanding what IS a "real and present danger".

Somebody setup a recommended reading list....... 

••

Jim thanks for the "to do list"........ okay now a list of WHO's to do it.


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## Paul O'Keefe (Jun 3, 2005)

I'm not worried about this pademic flu stuff. If I get it and survive, I 'll be happy. If I get it and I die, I won't care.. I'll be dead.

Seriously though, some times it pays to be on a remote sparesly populated island!

I just sold my VHS copy of Dawn of the Dead (original) at a yardsale we had today. Zombies is what I'm worried about, not avian flu.


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## MacDoc (Nov 3, 2001)

Healthy approach :clap: ..........hmm not quite the best choice of phrase perhaps 

I'm of two minds, while I deplore the suffering it would bring, Gaia has a tad too many on the bus these days.


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## MacNutt (Jan 16, 2002)

Good post JWoodgett. That's what we were all looking for. A list of just what we would be facing and how a top medical professional suggests that we deal with it.

Pretty harsh stuff. But about what I expected. And I doubt if most of it would go over very well with the buying public...but the situation will progress rapidly beyond our ability to control it if we DON'T do all of this. And more! 

Scary times, indeed.

Oh...and macdoc..perhaps you'd like to toss the oxygen mask and get off the meds long enough to really READ Jims last post. In detail.

Then, you might be able to rejoin this important discussion without spending so much of your time on silly diversions.

Just a thought....


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## used to be jwoodget (Aug 22, 2002)

Worldwide surveillance is critical. Avian to human transfer can happen anywhere. However, it is more likely to happen in an area with endemic avian flu (such as Vietnam where they've killed over 4 million chickens). However, it could happen in a poultry plant in Saskatoon. But wherever the derivation of the virulent strain occurs, we'll have only weeks to contain it. That's why debating what to do in the meantime seems akin to Nero's fiddling.


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## MacDoc (Nov 3, 2001)

Yes Gerry - at least I UNDERSTAND what I read......what did you do, get some religion about staying on topic during your "sabbatical".??

Anytime, anywhere and the resources need to be in place BEFORE not wasted on testosterone toys........or left to the "market" to deal with.
Some issues REQUIRE collective effort. This is one.

and by and large WHO and other organizations have done an admirable multilateral job in identifying risk and reacting to what HAS occurred.
There WILL be a next time.

Threats require realistic assessment and resources and allocating those against other threats that exist at the same time. Identifying what SHOULD NOT have resources allocated to chimerical threats is part of the discussion. 
Mechanisms of protection and prophylactic measures still more important.

As long as we want cheap "industrial" meat - we risk the consequences of cross species pandemics. It IS a choice after all.
Not many threatening grains tho ergot can get pretty trippy 
Just ask those wacky witches in Salem.


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## MacNutt (Jan 16, 2002)

Most of the focus and most of the cases of human/avian transfer seem to be coming from southeast asia. A point I tried to make in one of my very first posts.

Doesn't mean it couldn't or wouldn't happen here...but we need to look closely at where it is most likely to occur, and then plan for the very worst case scenario.

This will likely mean some sort of draconian isolation measures. And will almost certainly mean the instantaneous cessation of all trade and travel to and from the infected area. At least until the disease has run it's course and can be controlled by some new vaccines or meds.

Nobody is going to like what we have to do. It will be vastly unpopular. But the alternative is too horrible to think about.

I agree with JWoodgett. We need to get ON this right now! We need to prepare ourselves mentally, and we also need to stockpile resources. Waiting until the outbreak is upon us will be too late.

And...what really freaks me out a bit is this:

Canada is already critically short of medical professionals. If we do get an outbreak (and this looks to be almost inevitable) then these people will be on the front lines. And, like in the recent SARS outbreak in Ontario, I suspect that a fair number of them may end up being exposed to the disease. Probably early on. Perhaps even before we are completely aware that there IS an outbreak.  

What happens then?

Already overcrowded Canadian hospitals suddenly stuffed to the rafters with hordes of new patients suffering from a highly communicable disease. One that mutates when exposed to other similar diseases. Doctors and nurses who's numbers have been reduced because some of THEM have already contracted the pestilence as well.

YIKES.  

JWoodgett is right. Surveillance is critical. So is the ability and the will to react to the very first signs of an outbreak, wherever it may occur. Let's hope and pray that our leaders don't "dither" on this one. We may not get a second chance.


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## PosterBoy (Jan 22, 2002)

I'd like to take this opportunity to invite MacDoc and MacNutt to take their little pissing match outside. Neither of you are really contributing to this thread anymore, you're just yelling at one another.

We've already established that avian flu can transfer to humans pretty much anywhere, anytime. The fact that it has happened more in Asia than here doesn't mean that it couldn't, or wouldn't happen here.

If I'm not mistaken, the biggest problem isn't that some people might get avian flu, it's that avian flu might meet an existing influenza strain in a person and they might mutate themselves into something much, much worse.


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## Dr.G. (Aug 4, 2001)

PB, I think that epidemiologists might concur with your concern that "...the biggest problem isn't that some people might get avian flu, it's that avian flu might meet an existing influenza strain in a person and they might mutate themselves into something much, much worse." This is probably the "worse case" scenario, but it is still a possibility.


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## used to be jwoodget (Aug 22, 2002)

More than a possibility. It happens all the time with viruses. The issue here is that most viruses are either very deadly or very infectious, not both. It's when a virus gains attributes of both by recombination within a dually infected cell that you get the chimaeras. This isn't science fiction. It's how all pandemic agents are started.


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## MacNutt (Jan 16, 2002)

PosterBoy said:


> I'd like to take this opportunity to invite MacDoc and MacNutt to take their little pissing match outside. Neither of you are really contributing to this thread anymore, you're just yelling at one another.
> 
> We've already established that avian flu can transfer to humans pretty much anywhere, anytime. The fact that it has happened more in Asia than here doesn't mean that it couldn't, or wouldn't happen here.
> 
> If I'm not mistaken, the biggest problem isn't that some people might get avian flu, it's that avian flu might meet an existing influenza strain in a person and they might mutate themselves into something much, much worse.


Take a moment to actually read and absorb all of what I've written so far PB.

This "pissing match", as you put it, was instigated by macdoc and I have attempted to shut it down and re-direct the discussion back to the important subject at hand at every turn. I have no time for his petty jealousies.

I have spent about ten per cent of my time on this thread dealing with macdocs smog-related coughing and wheezing while he snipes away at BC. I've spent the other ninety per cent of my reply time trying to get a clearer picture of how to deal with the upcoming pandemic. Mostly by asking Jim Woodgett about the subject. He being the most informed expert we have around here when it comes to medical matters.

A mutated strain of the avian flu that is transmitted to humans...and then is contagious from human to human is a VERY scary prospect.

And, the fact that it could (and probably will) happen here does not lessen or diminish the fact that it _ALREADY HAS_ happened in southeast Asia. And the fact that we Canadians have already shown that we are quite well equipped to deal quickly and decisively with the problem...while many of the smaller Asian countries are not...should point out to you where the focus of our concern should lie.

We need to have a clear set of procedures in place and be ready to deal with this at a moment's notice. No matter WHERE it happens. And we also need to have some fairly specialised gear in many of our hospitals as well. We need to do this NOW...before the inevitable happens.

Long-term "studies" and dithering by our leaders, or overly "political correct" behavior by some of our population, is NOT going to get the job done.

We need to start planning and preparing for this NOW.


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## MacDoc (Nov 3, 2001)

PB you just can never resist being third man in so I'll invite you in your own terms to "piss off".
Every post was salient to the topic and despite your penchant for jumping in you are NOT a moderator.
And Gerry just because YOU fail to connect smog, population densities both human and animal, immune system vulnerability and pandemics is only indicative of your lack of understanding.
••••

One the issues that leads to crossover opportunities is lack of biodiversity in human food supplies/meat animals under factory/high density conditions.

One choice of society is reduce the use of meat as an everyday protein source - tofu is unlikely to do the kind of harm an avian flu crossover might.

Reducing the breeding pool for influenzas, reducing population densities overall both human and animal is a better long term solution in my mind as opposed to trying to set into place permanent defences against a very agile foe.

Programs to kill the breeding sites for mosquitos work better than defending against the impact after they are in the environment.

No question outbreak defence that is coordinated internationally is critical given the population and meat consumption patterns.

Yet I would hazard that much of the demand leading to high densities of food animals is first world driven.
Approachs like use of wide spectrum antibiotics in feed lots just go to breed the super bugs that look at US as prime fodder......and the high levels of hygiene in first world societies makes us even more vulnerable.

The law of unintended consequences on a number of fronts.
Anyone follow "Regenesis"?..........there have been some interesting scenarios regarding bacterial and viral mutuations........engineered or evolved.

Set in Toronto it makes the threat very real.....the one showing a bus with a high infectious very deadly virus aboard was gripping.

I'm sure I'm not alone in not realizing how deadly SARs was as it was occuring and how much greater the potential was for deaths in the larger Ontario population. 
I get reminded tho each time I hit the diabetes clinic at the the hospital. 

JW... how is MARS tied into pandemic defence or analysis - I have not heard much on the facility lately??


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## PosterBoy (Jan 22, 2002)

MacNutt: Whether it was instaigated by MacDoc or not, it takes two to tango and you're a more than willing partner.

MacDoc: Talking about avian flu is salient to the discussion; calling MacNutt a drunk and yelling about his level of comprehension is not. 

I may not be a moderator, but that doesn't mean I'm the only one who's tired of you two yelling at each other.


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## MacNutt (Jan 16, 2002)

Just read your last post quite thoroughly, macdoc (see...it DOES happen! Once in a while) 

What I gather you think our response should be to this looming pandemic is that we should all become more vegetarian. Rely upon tofu a lot more...and on farmed mass produced meat a lot less? Thereby lessening the opportunity for these bird/pig/human viruses to get started in the first place?

Is that correct?

Sounds GREAT! A brilliant solution! Pure GENIUS!!  

Now...tell me how you plan to do it.  

(this oughta be good)


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## MacDoc (Nov 3, 2001)

As a matter of fact it's a critical aspect. 

I see you are drifting back to your original world is rosy mankind uber alle viewpoint
http://www.ehmac.ca/showthread.php?t=25872&page=2&pp=10&highlight=world



> We can already deal with all sorts of natural and man made disasters. I expect that we will be able to handle anything short of a supernova, sometime down the road.
> 
> Of course...SOME people around here would have you believe that the sky is ALWAYS just about to fall in. Doom and gloom is their stock in trade. This is what drives their ongoing daily angst. And keeps their doctors rich.
> 
> Yaaawwwnn.


and now all of a sudden 



> A mutated strain of the avian flu that is transmitted to humans...and then is contagious from human to human* is a VERY scary prospect.*


Pardon me if I take this new found concern with a large dose of skepticism.

Part of the solution is as easy as voting with wallets - cut back on the amount of meat and open up the diversity of the protein products, support biodiversity and most of all getting the population to a level that rereduces the risk of this kind of pandemic.

It is no short course to undertake and no one thing will be a magic bullet. An enormous part of the equation is the nature of the populace's immune system - a mild world wide outbreak may actually turn out to be very beneficial. It's the luck of the draw and we are overdue for a large virulent outbreak. Immunities to a variety of strains have been reduced in the population.

As with forest fires too stringent an interdiction can create conditions for massive problems later.

Getting at the underlying causes of pandemics is ALSO critical.

Be sarcastic all you like Gerry.....it just shows how limited your understanding is.

Bryanc wrote this on your last bit of sarcasm about pandemics



> Bryanc wrote
> 
> Yep, all them scientists are just chicken-littles...
> 
> ...


Does this new found concern mean YOU will listen............???? Little evidence so far.


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## MacNutt (Jan 16, 2002)

HEY...I'm Listening!!

I'm even listening to YOU for a change, macdoc. That's how serious I'm taking this.  

And, while you may have a point that we _SHOULD_ attempt to reduce the dependance on mass farmed meat products...I have NO idea how you could possibly persuade most of the world's population to actually Do it. 

Not in any sort of a reasonable time frame.

Meanwhile, the pandemic is looming just over the horizon. Pretty much all of the experts are telling us that it is a certainty that this thing will hit us. And rather soon, too.

So, what say we all sit down and put our heads together and think really really HARD about how we will handle this pandemic if it hits in the next few months. Or even in the next couple of years.

While we are doing that...we can pluck away at the guitar string of "More tofu and Less meat" for the masses. Someday they'll pick up the tune and begin to dance along with us. Meanwhile...let's deal with the upcoming crisis in a timely fashion. And plan for it.

Fair enough?


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## used to be jwoodget (Aug 22, 2002)

I guess this little scuffle demonstrates what happens in political circles when possibilities of catastrophic developments are discussed. It's always easier to discuss agendas you are comfortable with rather than dealing with the problem.

With respect to the dependence on bulk farming, I'd point out that the cases in Vietnam are coming from free-range poultry that are raised by families. There the problem is the close contact between the animals and the humans. Insense farming can increase risk but because the farms are more isolated and the animal to human ratio is much higher, virus infection problems are more containable (note, bacterial infection is much worse - however).

Macdoc, I think you are proposing to deal with the threat in a long term manner by removing the dependency on low efficiency meat in our diets. While this might allieviate the problem, it is unrealistic. Morover, we don't have time.


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## MacDoc (Nov 3, 2001)

JW it's not REMOVING........ it's REDUCING dependency on meat and also altering the nature of the meat production to reduce the risk.

Indeed we don't have time and it's not a panacea but it's one aspect in reducing risk.
There IS going to be 40-50% more people in the next 30 years - after that it drifts down - hopefully not due to sweeping pandemics.

The breeding ground for bubonic plague and others were resolved not by cures but by breaking the link with rats and fleas and hygiene.

Reducing the source of the potential pandemics in my mind must be a factor in the dealing with the issue in the long term. Changing habits, just as with smoking have a role to play.

Of course in the short term deal with the WHEN to reduce the impact and contain outbreaks when to do occur is paramount.

Cross species transmission is not the only down side of the meat binge..there are many others.

Canny these virii. Barely alive by any definition......monstrously destructive nonetheless.

Ma Nature's ultimate contraceptive. 

I'm encouraged by this trend



> Worldwatch Paper #163: Home Grown: The Case For Local Food In A Global Market
> Brian Halweil
> 
> Everyone, everywhere depends increasingly on long-distance food. Encouraged by food processing innovations, cheap oil, and subsidies, since 1961 the value of global trade in food has tripled and the tonnage of food shipped between nations has grown fourfold, while population has only doubled. In the United States, food typically travels between 1,500 and 2,500 miles from farm to plate, as much as 25 percent farther than in 1980. For some, the long-distance food system offers unparalleled choice. But it often runs roughshod over local cuisines, varieties, and agriculture, while consuming staggering amounts of fuel, generating greenhouse gases, eroding the pleasures of face-to-face interactions around food, and compromising food security. Fortunately, the long-distance food habit is beginning to weaken under the influence of a young, but surging, local foods movement. From peanut butter makers in Zimbabwe to pork producers in Germany and rooftop gardeners in Vancouver, entrepreneurial farmers, start-up food businesses, restaurants, supermarkets, and concerned consumers are propelling a revolution that can help restore rural areas, enrich poor nations, and return fresh, delicious and wholesome food to cities


other articles
http://www.brown.edu/Administration/George_Street_Journal/vol29/29GSJ02b.html

It does much to reduce the trans-species risk pool of mono-culture "factory food" and increases bio-diversity which also is important in the long run ( just ask French wine makers ).

an excellent but long article on the consequences and risks of a high meat regime diet in humans

*Eating Meat: Evolution, Patterns and Consequences. *

http://72.14.207.104/search?q=cache...03.pdf+meat+dependence+risk+of+pandemic&hl=en

One relevant clip



> Conversely, there is no scientifically defensible reason for the extraor-
> dinarily meaty diets now prevailing in most Western countries. These diets
> do not make people healthier and do not prolong their lives. Instead, to
> recapitulate, they have undesirable environmental impacts as they gener-
> ...


With our high planetary population EVERY person can reduce the epizootic risks with some small changes in habits, both consumption and looking at the source of foods.

We must depend on frontline response WHEN it happens but we can individually reduce the risk on small ways that add up globally.

Awareness is a start.

•••


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## MacNutt (Jan 16, 2002)

used to be jwoodget said:


> With respect to the dependence on bulk farming, I'd point out that the cases in Vietnam are coming from free-range poultry that are raised by families. There the problem is the close contact between the animals and the humans. Insense farming can increase risk but because the farms are more isolated and the animal to human ratio is much higher, virus infection problems are more containable (note, bacterial infection is much worse - however).
> 
> Macdoc, I think you are proposing to deal with the threat in a long term manner by removing the dependency on low efficiency meat in our diets. While this might allieviate the problem, it is unrealistic. Morover, we don't have time.


Good ideas that MIGHT work in the long term. IF you can find some way to implement them, macdoc.

But it's a pretty big stretch, if you ask me...

Meanwhile, we live in the here and now. And this pandemic is probably just around the next corner. We need to start planning for the inevitable right NOW!

Later on...when we have the spare time...we can work on readjusting the gravitational constant of the whole universe. Right now, we need to get to work on the problem at hand.

Get the picture macdoc?


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## PosterBoy (Jan 22, 2002)

It's worth pointing out that depending where the whole avian flu thing happens, a big part of the equation deciding how big a pandemic it ends up being could be the local government.

SARS, for example, probably wouldn't have spread as far as it did if China hadn't 
suppressed all information about it.

It all depends on the word getting out, and getting out as fast as possible.


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## MacNutt (Jan 16, 2002)

We might note here than the WHO seems to think that BC did a bang-up job in dealing with the avian flu.

Nobody died. Nobody even got _SICK!_.

They aren't quite so kind with regards to the recent SARS outbreak in Ontario. And several people died in that one, BTW. It was badly handled. By all accounts.

And some of the smaller asian countries haven't exactly scored high on the prevention meter, either. Especially when faced with a very real threat. Or an actual outbreak.

JWoodgett says we need to do some serious survellance on this. While actively getting prepared for the very worst case scenario.

I tend to agree with him on this.


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## PosterBoy (Jan 22, 2002)

SARS was bad, but considering that if China had told everyone what was going on in the first place probably fewer people would have died, I'd say the fault was not entirely T.O.'s own.

It's one thing to call for surveillance, but it's hard to implement when another government is actively suppressing information.


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## used to be jwoodget (Aug 22, 2002)

MacNutt, I thought you'd put the Ontario vs BC thing to rest? But you seem to want to continue to parry with macdoc.  Let's move on. Personally, I think BC was incredibly lucky with SARS. I don't think anyone should be depending on luck when the avian flu strikes.


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## MacDoc (Nov 3, 2001)

Yeah geez the point is that an outbreak can occur anywhere and get transmitted elsewhere very quickly.

China certainly was negligent in not revealing the full extent ( is SARs not still present there ??) of the problem.

JW how quickly once a strain is indentified can a vaccine be spun up??

My sense is the potential is so large that any uncontained outbreak = big time problems world wide or is it still feasible to put up walls regionally??


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## used to be jwoodget (Aug 22, 2002)

Macdoc, do you want the bad news or the really bad news?

It typically takes 8-9 months to prepare a batch of new flu vaccine using fertilized chicken eggs. There are other methods in development (some vaccines are made using Vero cells) but it'll be at least 2007 before there is an option other than eggs. In an emergency, a couple of months could be shaved off (along with safety testing).

The really bad news is that current vaccine egg production is only sufficient to cover 25% of the western world or 5% of the entire world. Moreover, the choices for the 2006 winter flu season were finalized in February 2005 by the WHO. Are you feeling lucky?


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## MacDoc (Nov 3, 2001)

Have to be. 

So rapid identification and containment is the ONLY way to avoid a mandatory world population adjustment 

OR it's a relatively impotent combo 

OR one that our current vaccines HAPPEN to help with assuming we have had our flu shots

We know the beast in the east is very potent.
We know the one that jumped in BC was not.

What ARE the odds????......... I guess the permutations and combinations are enormous. 

Eat drink and be merry........ for tomorrow......urk urk....


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## used to be jwoodget (Aug 22, 2002)

Chiron, one of the largest producers of vaccine has just announced a much reduced capacity to ship vaccines over the next 6-12 months. They are the company that owns a facility in Liverpool, UK that was shut down last year for purifiy/contamination fears causing a shortage of flu vaccine. Canada gets most of its vaccine from IDT (BC) and Aventis-Pasteur.

As Jobs said in his Stanford Commencement speech - life can be short - make the most of it!


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## MacDoc (Nov 3, 2001)

So tactics.

Getting a flu shot for the year has how much % of ameliorating the BIG ONE?

Are there masks that one can purchase ahead of time that are effective?

Do anti virals have any impact........what is the availability?

Does The Big One qualify for Business Interruption Insurance? 

oh yeah what insurance company could possibly pay out on a 30% of the population dies rate.


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## used to be jwoodget (Aug 22, 2002)

N95 masks are the most effective in preventing aerosol transmission. But, these cost $3-4 apiece and are what the medical staff used during SARS. They can only be used once, however, and then must be trashed. There was a shortage during the SARS crisis. 

No idea what protection is afforded with the flu shot (last years or what will be released in October/November, 2005) but it makes sense to get it, even if you have to pay for it. If it saves you one bout of traditional flu, its paid for itself 20 fold.

Some anti-virals may be effective if given at the first sign of symptoms. I am not sure if any are available without a prescription (I doubt it). If you Google avian flu, you'll see various companies selling anti-influenza drugs but most of these are untested. Are these quacks? Some may be. Ask your MD. I have no idea whether any of these drugs are being stockpiled by governments.

Insurance? If its really bad, it'll be a waste of time. There is no way to avoid the financial consequences in such circumstances. Be happy that you can try to avoid the medical consequences.

But the most important thing is to stay aware of what's happening. I think there will be some warning and most people will not appreciate this (and think its scare-mongering).


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## MacDoc (Nov 3, 2001)

> N95 masks are the most effective in preventing aerosol transmission. But, these cost $3-4 apiece and are what the medical staff used during SARS. They can only be used once, however, and then must be trashed. There was a shortage during the SARS crisis.


How many would be needed for a household of 3 to carry through an outbreak??
Would they need to be worn only when out??
Are there more sophiscated masks that are reusuable.??



> No idea what protection is afforded with the flu shot (last years or what will be released in October/November, 2005) but it makes sense to get it, even if you have to pay for it. If it saves you one bout of traditional flu, its paid for itself 20 fold.


If the yearly shot happens to contain protection against the jump over strain willthat help?? Do the yearly shots contain multiple strain protection??



> Some anti-virals may be effective if given at the first sign of symptoms. I am not sure if any are available without a prescription (I doubt it). If you Google avian flu, you'll see various companies selling anti-influenza drugs but most of these are untested. Are these quacks? Some may be. Ask your MD. I have no idea whether any of these drugs are being stockpiled by governments.[/quot]
> I'll do some looking.
> 
> 
> ...


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## used to be jwoodget (Aug 22, 2002)

If there is an outbreak, it'll last 6-8 months, there will be a lull and then a second spread will occur for 6-8 months after that (based on previous pandemic behaviours). Staying indoors, at home, as long as no one is infected (obviously) should not require use of a mask. Sharing an elevator, public transit, talking to a parking attendant, flying, going to a cinema, theatre or ball game..... all no-no's but there won't be any flights and the cinemas, theatres, sports arenas and restaurants will likely close down. 

All flu vaccines contain multiple strain epitopes - 3 or 4. None of these are guarenteed to block the strain they represent due to drift. Sometimes there is cross-protection to another strain that wasn't present in the innoculum. The WHO scientists basically make informed guesses.

The May 26 issue of Nature magazine had a series of extremely good articles on the avian flu. PM me if you want to read them. They include a hypothetical retrospective calendar of the outbreak as well as information on current interventions, etc.


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## Dr.G. (Aug 4, 2001)

Jim, is sounds like the regular flu vaccine that is being produced now for the basic flu shot next fall/winter will most likely not be the strain of flu on the go during flu season. Thus, how are these predictions actually made as to what strain to focus upon for a flu season five months away?


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## MacDoc (Nov 3, 2001)

Why don't I see Nature at Chapters 

So we have maybe a 25% chance that any given year the flu shot gives some protection ( figuring there are 15 known strains ) against a recombinant monster.

6 months - figure 1-2 trips out a week minimum 100 masks minimum for 3 people.

Then one could be a speculator and buy say 400. 

Do they keep 

•••

completely off topic did you happen to catch the latest SciAm on *Inconstant Constants*// 
http://www.sciam.com/article.cfm?articleID=0005BFE6-2965-128A-A96583414B7F0000

I'm usually "okay" with most articles but that one stretched the brain tissues.

This one comment stood out 


> Like all galaxies, our Milky Way is about a million times denser than the cosmic average,* so it is not expanding along with the universe.* In 2003 Barrow and David F. Mota of Cambridge calculated that may behave differently within the galaxy than inside emptier regions of space.


such a tiny spec in the scheme of things our world is.......

Now back to our regularly scheduled broadcast


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## used to be jwoodget (Aug 22, 2002)

I'm not sure of the process for predicting which strains to cover. I think its a combination of tracking the sequences of the known antigens (capsid proteins) that are hyper-variable and projecting the most likely variants for the most common strains. The ultimate effectiveness is not possible to determine prior to the actual flu season as there are too many variables. However, the track record shows that the vaccine is effective a significant proportion of the time. There is also the fact that people are immunized against variants in the past inoculi that haven't been found in the wild but may appear. Thus, building up a T cell memory against a catalogue of flu viruses, both real and hypothetical, may be of real value. Countering that is the concern expressed by some that by these weak vaccine challenges, only a weak response will be mounted to the real thing and that one might be better off without any vaccination. However, the evidence for that is not compelling in my mind.

Yes, the masks last for several years and most pharmacies sell them (at least they do in the GTA).


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## martman (May 5, 2005)

The sky is falling! The sky is falling!
It's been a good three years now that the media has been hyping the "upcomming pandemic". It is all fear mongering. Yes there will be another pandemic but will it be this year? Or next? Either way it is a great way to sell newspapers and keep people in fear.

As for flu vaccines I have seen no real studdies on the effecacy of these vaccines especially when the wrong strain is in the vaccine (pretty much allways the case).

We should develop a strategy for dealing whith the eventuallity of a pandemic but we should not lose sleep over this. We have (mostly) all survived the last pandemic and many of us got sick and are still around to talk about it. 
Less doom and gloom please.
Thanks,


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## MacDoc (Nov 3, 2001)

> We have (mostly) all survived the last pandemic


The last one did not have 60% plus mortality rate........the particular worrisome one in East Asia does even with all the advances of current treatments.

So it's okay to spend billions on "terrorism lunacy" but la de da on something that IS overdue and if it's a bad strain WILL kill millions??

Odd sort of reasoning.
Awareness will save lives and maybe whole communities if it's a bad strain that hits.

Do you have a smoke detector - of course, it's mandated.......yet the potential for fire death is miniscule compared to this.

This is not IF.......it's WHEN.....and HOW BAD. If the one in east Asia gets loose........REAL BAD.


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## used to be jwoodget (Aug 22, 2002)

martman isn't alone. It's a lot cheaper in the short run to do precisely nothing, hence the current pathetic state of readiness. Look at the tsunami fiasco on the west coast this week. Most people hadn't a clue what to do despit the loss of 200,000 lives just 6 months ago in Indonesia. 

I see these preventative measures as insurance. I don't expect the majority of people to lift a finger and that's their choice - as long as its informed. Unfortunately, the vast majority of people are truly ignorant of this threat despite high quality information. Perhaps its a natural fatalism?

As for SARS, did you know that the MDs in Guangdong province had established care and containment guidelines 6 weeks before the Hong Kong outbreak but were suppressed in their ability to communicate that knowledge - even to other Chinese provinces? If the flu doesn't get us, incompetent politicians will.


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## MacDoc (Nov 3, 2001)

> If the flu doesn't get us, incompetent politicians will.


a fate WORSE than death.......err well..... 

BTW I was a healthy outdoors type, my wife was a hospital technician and a long distane runnr and kayaker - we both got that last pandemic and I was never so sick in my life - we lived in an isolated farmhouse and after ten days of deteriorating health we literally staggered out the long laneway ( 1/3 mile ) to the car and into a doctors office looking like death warmed over.

It was AWFUL and I'm frankly not sure I would survive that level of illness today without being in a hospital.
Nothing since has come close.

I've only ever been in hospital for tonsils out so generally healthy and I tell you I can still clearly remember how awful that was and it's nowhere close to the 1918 Pandemic or the SE Asian avian strain. I was a fit 20 year old and never ever want to be that sick again.



> DURING THE FLU EPIDEMIC of 1918, according to medical lore, victims were struck down almost in midstride. *Four women in a bridge group played cards together until 11 o'clock in the evening. By the next morning three of them were dead.* One man got on a streetcar feeling well enough to go to work, rode six blocks and died. During the single month of October, influenza killed 196,000 people in this country_ more than twice as many as would die of AIDS during the first 10 years of that epidemic. By the end of the winter of 1918-19, two billion people around the world had come down with influenza, and between 20 million and 40 million had died
> 
> The 1918 influenza pandemic killed as many people in a single year as died in the four-year Black Death, the bubonic plague that ravaged Europe from 1347 to 1351.


 

The sky fell once within my fathers lifetime ( he's still alive ). There's a crack in celestial bowl showing in Asia.


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## martman (May 5, 2005)

Yes but the 1918 pandemic occured durring wwi when malnitrition was also a pandemic.
Yes the current avian flu outbreak is highly fatal if caught but that is the point isn't it? IF CAUGHT. It is not exactly easy to catch this flu and if this changes the mortality rate is also likely to decrease. A successful disease does not usually kill the host.

I am not against those in the disease buisness doing their jobs (ie formulating strategies to deal with pandemics) but this constant hype in the papers is counter productive and will lead to the boy who called wolf syndrome.


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## MacDoc (Nov 3, 2001)

Four women playing bridge and 3 die within 24 hours does not result from malnutrion issues - it was a killer period.
OUR immune systems are stressed from a lot more environmental factors than were present in 1918 and there are far more older people.

The SE Asian strain just is not YET easily transmissible. We've been lucky.

••

THIS is a "cry wolf" situation

*Obesity: An Overblown Epidemic?*
A growing number of dissenting researchers accuse government and medical authorities--as well as the media--of misleading the public about the health consequences of rising body weights

http://www.sciam.com/article.cfm?chanID=sa006&colID=1&articleID=000E5065-2345-128A-9E1583414B7F0000

and that's SciAm going to bat. 
Deserves it's own thread.


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## martman (May 5, 2005)

No one said it wasn't a killer and no one is saying the next pandemic will be as bad as 1918.

You still have not given me any reason the hype in the newspapers is helping.


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## MacDoc (Nov 3, 2001)

Awareness - resources allocated - rather this hype which is justified than the "terrorists behind every dustbin nonsense" and look what resources THAT foolishly sucks up.

The GTA took a hammer hit from SARs which was a pinprick compared to a major pandemic.
Even getting people to get their regular flu shots saves lives and might ameliorate the impact of a nasty strain.

That Marburg outbreak came near to getting loose as well.
With the population growth over the next 20 years a pandemic is THE major threat for widespread death and is only overshadowed in the larger framework by global climate change.

In my mind these are two credible large scale threats and neither are getting the resources they deserve tho the climate situation has a very high awareness.

But the latter is slow change - the pandemic???  If it's a bad one it will rewrite the demographics just as AIDs as done in some parts of Africa......in much much shorter time period.

The NOVA special on Population that has been running this week is amazing.


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## used to be jwoodget (Aug 22, 2002)

martman, forget the newspapers. Read the scientific articles. They are factual and they don't sell papers. 

The projections for a contagious version of the avian flu are just that - projections. These include estimates that are significantly worse than the Spanish flu toll. But you are also forgetting that the 1918 flu was not in a world of massive trade and globalization and travel. The financial impact of a pandemic that killed a million people (which is a very low end estimate) would be devastating to the worlds economy.

As for crying wolf, anyone can choose to personally ignore the information but politicians should not as they have a responsibility to protect their citizens.


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## used to be jwoodget (Aug 22, 2002)

You'd think some people actually want a pandemic! Chinese farmers have been dosing poultry with an anti-viral drug that is one of only two that is partially effective against flu infections after initial symptoms!

From this weeks Science: Vol 308, Issue 5730, 1849-1851 , 24 June 2005

INFECTIOUS DISEASES:
Lapses Worry Bird Flu Experts
Dennis Normile and Martin Enserink*

Global health experts trying to stave off a deadly pandemic of avian flu are alarmed by recent actions they see as counterproductive and even dangerous. Vietnam has been slow to report 10 new human cases, and farmers in China have reportedly been giving an antiviral drug to chickens that may have made the virus resistant to one of the few drugs available to fight human flu. If confirmed, China's actions would be "very, very dangerous," says Ilaria Capua of the Istituto Zooprofilattico Sperimentale della Venezie in Legnaro, Italy.

Vietnam has found another possible case of human-to-human transmission of the H5N1 virus among a total of 10 new cases it reported in a 1-week period--6 weeks or more after they were originally detected. The Ministry of Health officially notified the World Health Organization (WHO) of three new human H5N1 cases on 8 June, but the most recent of those had been detected on 26 April. On 14 June, Vietnam reported three more human cases that had turned up during the last 2 weeks of May. And on 17 June, the ministry reported four additional cases that had emerged between 1 and 17 June.

Peter Horby, an epidemiologist in WHO's Hanoi office, says Vietnamese officials have quickly asked for help when there were obvious changes in the virus's behavior, as when numerous mild cases of the disease emerged this spring. But he says it has been frustrating that these same officials have been less forthcoming in reporting the details of what they apparently see as more routine cases.

Some bird flu experts are equally alarmed by China's veterinary use of the human antiviral drug amantadine, as reported in the 18 June Washington Post. According to the article, drugmakers and other sources in China admitted that the drug has been sold cheaply to farmers and given to poultry both as a treatment and a prophylactic since the late 1990s.

Most of the H5N1 strains isolated in the current outbreak in Asia are resistant to amantadine, but establishing a firm link with China's use of the drug would require extensive data on where, when, and how much of the drug was used, notes Klaus Stöhr, WHO's global influenza coordinator. K. Y. Yuen, a virologist at the University of Hong Kong, says the misuse of antivirals, such as amantadine, does raise the risk of fostering resistance. But he says the genetic mutation associated with amantadine resistance has been reported in viruses not exposed to the drug, which suggests that other factors might be at work as well.

Still, given the threat of a pandemic and the dearth of flu drugs--the only alternative to amantadine and a cousin is oseltamivir, or Tamiflu, which is more expensive and harder to produce--antivirals should probably not be used for animal flu infection at all, Stöhr says. They aren't licensed for use in poultry and would do little to contain the virus anyway if not accompanied by strict biosecurity measures, adds Capua.

Xu Shixing, a Chinese Ministry of Agriculture official, says the ministry never approved the use of amantadine for poultry, as was claimed in the Post article.

In yet another reminder of the virus's expanding geographical grip, Indonesia confirmed its first human case of H5N1 infection last week, the fourth country to do so.


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## MacDoc (Nov 3, 2001)

I caught the CBC Radio special on the pandemic issue ......very well done.

Many resources here. http://crofsblogs.typepad.com/h5n1/2005/06/books_on_flu.html

Then there is this........



> Ethics of stockpiling flu drugs for doctors' relatives questioned
> Last Updated Fri, 24 Jun 2005 21:33:06 EDT
> CBC News
> Some Canadian doctors are quietly building personal stockpiles of an antiviral flu drug for their families in case of a pandemic, but the practice may be viewed as unethical.
> ...


http://www.cbc.ca/story/science/national/2005/06/24/flu-drugs050624.html


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## Dr.G. (Aug 4, 2001)

Macdoc, I had an interesting chat with my pharmacist re Tamiflu. He said, off the record, that they have been having prescriptions filled by some doctors, and numerous other people who have the money to buy $35 a week doses (which is not covered by health insurance) for 6-12 months!!! I used mental math to figure out that that was over $1800 ($1820 to be exact) per person. He said that they have filled special orders of 6-12 month supplies for various people. I thought "Where would I be able to come up with $5460 for myself, and my wife and son?" Guess we are either going to have to sell the doxies, or go without.

Still, I cannot see the Federal government supplying these doses for this length of time to anyone but politicians, doctors, health care workers, and other "essential persons". As a university professor, I fear that I am very low on the "essential person" scale.


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## MacDoc (Nov 3, 2001)

Well Dr. G there is the get out of town scenario as well or the turn into a hermit.

3-4 months supply of food lets you sit it out at home or in isolation. Unlike some pandemics where say rats or fleas can be carriers or mosquitoes for others ( malaria/West Nile ) quarantine as was done with SARS IS an option if there is preparation.

My guess is tho that people will tend to take chances and play roulette with it being a killer strain.

Anyone have a 3 month list of foodstuffs to get by on??

I would certainly want all the antivirals to go to essential service people especially the larger infrastructure water/electricity and of course medical.

The economic results tho would be difficult and would certainly require almost a war footing ( that's what it is- war with a virus ) where in some senses certain parts of the economy would or should be suspended.

ie what form could a "stay home" order take?? Would institutions such as banks etc accept a "stasis" situation due to a national emergency.

For instance could a family declare itself in quarantine - stay home so as not to contribute to the problem yet not suffer from employment or financial consequences.

Could a business do the same.??

This would be a societal effort and if SARS had a silver lining it was a wake up call but I wonder what kind of "put on hold" methods to halt the spread actually exists.

I for one would isolate my family for the duration whatever the economic consequences if it was a severe pandemic.

Anyone got a basic "get by" food list??


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## used to be jwoodget (Aug 22, 2002)

Gilead, the company that developed Tamiflu, is trying to regain control of it since Roche has the distribution rights. It costs $5 a pill. The problem is that it is only effective at the earliest stages of infection - i.e.e there is little time to react and start the dose. But it isn't viral strain specific either (unlike vaccines) which is why our government could and should stockpile it now. 

As for hunkering down, people would need to avoid other people and wearing masks would help. The obvious places to avoid would be waiting rooms and public transport. Hardly an option for the GTA.... As for the ethics of physician stockpiling, its tricky. It's essentially a form of private healthcare (as its not covered). Thus, those without the financial wherewithall will not have access. I would favour providing it to those who ask (say 100 day supply per person). If the flu strikes, the cost of protecting people will have been recouped 1000X over versus the aftermath of a widespread outbreak.

The pills only have a shelf life of 5 years...


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## Dr.G. (Aug 4, 2001)

MacDoc, your suggestion that "... there is the get out of town scenario as well or the turn into a hermit" option does not sound very likely for many of us. This will turn into a uniquely ethical situation, much like the scenarios we discussed back in the 60's when many were building bomb shelters.


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## used to be jwoodget (Aug 22, 2002)

Here's a source of information for medical professionals about how Ontario is planning for the pandemic. I'm quite impressed. The issue is whether it's enough given the relative risk and whether it is all talk and no action but at least someone is taking it seriously. Hopefully, other provinces are doing similar things.


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## MacDoc (Nov 3, 2001)

> get out of town scenario as well or the turn into a hermit" option does not sound very likely for many of us.


Why??
If it's a bad epidemic that's exactly what is needed - ONLY medical and key infrastructure in the population should be active on a daily basis.

People were quarantined during SARs and most were voluntary.
The way to help stop the spread is to reduce contact.

Concentrating defensive drugs on key segments such as food supply medical and emergency staff, power providers.
The first world is far better equipped to take this course of action than those less well off.

What does 3 months of basic food stuffs consist of??


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## MacDoc (Nov 3, 2001)

> *WHO urges `all-out war' on bird flu
> Experts call for mass vaccinations of poultry in Asia
> 
> Outbreak `at the tipping point,' conference told *
> ...


Nasty.....


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## Dr.G. (Aug 4, 2001)

NEW YORK (AP) -- An outbreak of bird flu among migratory waterfowl in China suggests the disease -- which could trigger a dangerous flu among people -- may be poised to spread to India, Australia, New Zealand and eventually Europe, scientists warn.

If the migrating birds carry the H5N1 flu virus beyond its current stronghold in southeast Asia, it could devastate poultry farms and raise the risk of a deadly flu pandemic in people, experts said.


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## MacDoc (Nov 3, 2001)

Can I get a 30-60 days of food shopping list....PLEASE....surely there are SOME survivalists here. ??????


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## Dr.G. (Aug 4, 2001)

Good luck, my friend. Think "dehydrated" as well as getting clean water to make this "treat".


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## MacDoc (Nov 3, 2001)

Canned and other staples including frozen are quite straightforward and water is not an issue. It's just to avoid going out to buy food - not a mountain climb.


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## martman (May 5, 2005)

MacDoc said:


> Can I get a 30-60 days of food shopping list....PLEASE....surely there are SOME survivalists here. ??????


No joke....
Mormons have a a tennet of their religion that they must keep a two year supply of food in their homes at all times. Maybe a "friendly" Mormon would be willing to help you with that.
Again: No Joke


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## MacDoc (Nov 3, 2001)

I'm serious as well. I'd like to know a good 30/60 day mix of food to keep around as a "just in case".

The ehMac Flu survival plan.


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## MacDoc (Nov 3, 2001)

tick.......



> *Mystery disease kills 17 in southwest China*
> Sun Jul 24, 2005 11:06 PM ET
> 
> BEIJING (Reuters) - Authorities in southwest China are investigating a mysterious disease that has killed 17 farm workers and left at least 12 critically ill after they handled sick or dead livestock, the official China Daily said Monday.
> ...


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## Dr.G. (Aug 4, 2001)

MacDoc, are you the "Doctor of Doom".......................or the prophet who is foretelling our doom if we don't take this problem seriously???


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## Vexel (Jan 30, 2005)

Great outline of the whole thing pandemic and your best defenses:

http://www.newstarget.com/z002366.html

Preparing your Basic Survival Stash (at your request MacDoc  ):

http://www.survival-center.com/guide/food.htm


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## MacDoc (Nov 3, 2001)

Dr. G I'm attempting - under the waving flag of warning from JW - to keep people focused on REAL threats not boogie men under the bed.
Millions spent on "security" are in most part being "misspent".

The Grim Reaper chuckles and sharpens his viral sword while society at large looks another direction.


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## MacDoc (Nov 3, 2001)

From the Economist



> *Containing a pandemic*
> Aug 4th 2005
> 
> Two studies suggest it may be possible to prevent a global outbreak of deadly influenza by using anti-viral drugs
> ...


JW - your thoughts and where are WE in Ontario on this program.?


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## used to be jwoodget (Aug 22, 2002)

I read the two papers. They state that a pandemic could be contained if (freaking huge "if") there was a massive response to the early detection of a cluster of less than 30 people by isolating/quarantining and treating (Tamiflu or vaccine) 100-200,000 people in the region of the outbreak. This assumes the outbreak is not in an urban centre and there has been no contact of infected inividuals with outsiders. In addition, the outbreak must not be transmitted by a migrating bird only domestic animals. To me, the papers simply demonstrate that it will not be practical to contain an outbreak unless there is enormous luck.

As to where we are, the Federal government is stockpiling some drugs and has monthly (or possibly weekly) meetings between designated provincial individuals across the nation. The good news is that there are signs of an effective vaccine and this will go into mass production by September. However, vaccines are static whereas viruses are not. The virus may mutate and avoid the immune cells primed for its antigens. In which case, drugs like Tamiflu may still be effective if taken early enough after infection.

I think we will get some warning of an actual outbreak although action would have to be taken very rapidly once an outbreak is confirmed. The question is how seriously the warning will be taken, and what practical options will be available. I'd expect there to be enough vaccine to treat only emergency workers and front-line healthcare professionals in the first instance with reserves held to saturate initial outbreaks.


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## used to be jwoodget (Aug 22, 2002)

Birds infected with the avian flu are moving East across Russia. This was predictable and not something that could have averted (except by massive culls of both wild birds and domesticated birds) due to the high infectivity of the virus among birds (though not in humans yet).


----------



## MacDoc (Nov 3, 2001)

> By GRAEME SMITH
> Saturday, August 20, 2005 Updated at 2:03 AM EDT
> From Saturday's Globe and Mail
> 
> ...


----------



## Snapple Quaffer (Sep 2, 2003)

http://news.bbc.co.uk/1/hi/health/4165732.stm

Click … whirr … "There is no cause for alarm …" Click … whirr … "There is no cause for alarm …" Click … whirr … "There is no cause for alarm …" Click … whirr … "There is no cause for alarm …"


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## MacDoc (Nov 3, 2001)

Yeah - *"On Beach"*......avian flu version. It's the damn mortality rate that is really the scary aspect.



> *Bird flu's 'huge potential risk'*
> 
> By Alex Kirby
> BBC News Online environment correspondent
> ...


It killed 40 million in 1918 when world population was about a billion people. We have 6x the population now and somewhere between 15 to 30 times the fatality rate and that's despite modern medical care for those who have been infected.
Hopefully in the jump the virulence will soften. Evolution at work.......with prime supply.


----------



## MacDoc (Nov 3, 2001)

> *GTA firms join forces to fight flu pandemic*
> Business leaders form advisory group
> Examine methods for vaccine delivery
> TYLER HAMILTON
> ...


I'm curious as to what people thnk the appropriate "suspension of economic activity" might be composed of.

Should there be a declared state of emergency should things like banking be frozen as well for the duration ... ie without pay cheques flowing etc people could be in default very quickly and banks in particular should not benefit from a widespread health emergency.

SARs was miniscule compared to this and still was devastating to certain industries.

HAs anyone taken steps.
I'd REALLY like a 30 day emergency food "don't leave the house" list. Any survivalists????


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## SINC (Feb 16, 2001)

Try this site for some information MacDoc:

http://www.aaoobfoods.com/30daysurvival.htm


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## used to be jwoodget (Aug 22, 2002)

At least there seems to be some action in the GTA. I hope other metropolis's are taking similar action. Note the concern about "morgue capacity"... If we only spent 1% of what we're spending on terrorism and security, we'd be in a much better shape to prevent tens of thousands of deaths.


> Toronto Star 26 Aug 2005 GTA gets ready for flu pandemic
> If one million people ill, outbreak could cripple the region
> Health officials will meet next month to discuss their plans
> RITA DALY
> ...


----------



## martman (May 5, 2005)

SINC said:


> Try this site for some information MacDoc:
> 
> http://www.aaoobfoods.com/30daysurvival.htm


Nice link. I wonder if any Canadian companies are doing this. I bet shipping is a killer. 

I again point you to the Mormons (no I am not kidding) as survivalism is a tennet of their religion. I'm sure many Mormans would be happy to talk to you about keeping canned food and how much you need for how much time you plan to hide out. They are told to keep 6 months supply at all times and learn about rotating the supply so it remains eddible.


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## Dr.G. (Aug 4, 2001)

My wife laughed at my Y2K "stash", as she called it back then. However, while we quickly used all of the canned provisions, over the many months that followed, we never had to wonder about various basic necessities, such as toilet paper and toothpaste. As well, I store water not just for drinking (which I use each week or so to water the indoor and outdoor plants when I rotate the supply), but also for the toilet. My wife thinks that this is crazy, but I tell her that without water in the tank, due to a situation like a water main break, one needs water to flush.


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## used to be jwoodget (Aug 22, 2002)

Thar's money in them thar flu vaccines.... Vancouver ID Biomedical has just been bought by GlaxoSmithKline for $1.4 billion. Shareholders must be happy..... (30% over 20 day average share price which had been on the rise over the past year). Chiron is being chased by Novartis.


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## Dr.G. (Aug 4, 2001)

Jim, but will the consolidation of these sorts of companies actually make for a more efficient and cost-effective result for the patients who need these sorts of medicines?


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## used to be jwoodget (Aug 22, 2002)

I don't know Dr. G. The Chiron mess at the plant in the UK is certainly an example of what can happen if standards aren't met and the big boys tend to be very careful about their plants (since they can't afford a bad rap). Whether or not this consolidation has a demonstrable effect on vaccine development and distribution is anyones guess. The take-home though, is that flu vaccines are now seen as a major product (with major profits).


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## MacDoc (Nov 3, 2001)

I'd like to keep this current and has anyone heard of anything really nasty arising from Katrina.

That is a real mess there - I know 3 have died from the water.


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## used to be jwoodget (Aug 22, 2002)

Katrina has caused diarrhea and vomiting but there have been no reports from the CDC of anything nastier (yet). Quite remarkable given the garbage and "organics" in the water. Of course, sanitation conditions are awful and the very best thing to do is for people to get out and leave the toxic cleanup to the guys in the white suits....

The salt water does act to reduce some of the noxious organisms but I wouldn't go swimming in the lake.....


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## used to be jwoodget (Aug 22, 2002)

Latest news is that the US government is in talks with Roche, the makers of Tamiflu, for a billion dollar order. Next thing you know, Haliburton will be contracted to make the stuff. Still, as we saw with Katrina, a $billion now will save a bunch later (lives!).


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## MacDoc (Nov 3, 2001)

> Flu vaccine
> 
> *Preparing for a pandemic*
> Sep 22nd 2005
> ...


....more here

remainder of article 

...some progress, more awareness. :clap:

BTW when IS flu season.....'bout now????
I better get my shot sooner than later.


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## used to be jwoodget (Aug 22, 2002)

Immunizations will start in the next month for regular flu shots, and run through the beginning of 2006. This shot does not protect against the avian flu virus but getting it will reduce the "noise" if there is a pandemic. For example, if you showed symptoms of "regular" flu during a period of high anxiety of a pandemic, then you'll probably be home-quarantined. This is what happened during SARS and affected many more people than were actually infected with SARS.

There is going to be an international conference on bird flu in October in Ottawa. That should raise awareness. In the meantime, this Canada Public Health Agency website is a good source of information pertinent to Canadians.


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## Dr.G. (Aug 4, 2001)

Jim, the flu shots next month will reflect a "coverage" over which strains of flu from this past year?


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## used to be jwoodget (Aug 22, 2002)

According to the WHO recommendations that were set in February 2005 to allow the vaccine makers time to produce the material, this years vaccine should cover: 
an A/New Caledonia/20/99(H1N1)-like virus
an A/California/7/2004(H3N2)-like virus
a B/Shanghai/361/2002-like virus

If you want to track previous compositions, you can check here. It's a glorified bet...... are you feeling lucky?


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## Dr.G. (Aug 4, 2001)

Jim, sounds like "Russian Roulette", but I see that you cannot suddenly create a vaccine that takes into account the situation last week.


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## MacDoc (Nov 3, 2001)

Catching the trifector in the 9th so to speak...

I will "self quarantine" sick or not.

Question if anyone knows........are there guidelines in states of emergencies for how things like mortgages, bill payments, wages etc are handled by financial institutions and employers etc.

I would think the disaster in Louisiana would bring up many situations like that but say in a declared pandemic ARE there any rules or guidelines??

Personal experience????, educated guesses ?????


----------



## used to be jwoodget (Aug 22, 2002)

Dr.G. said:


> Jim, sounds like "Russian Roulette", but I see that you cannot suddenly create a vaccine that takes into account the situation last week.


Unlike Hollywood......

macdoc, it's anyone's guess but it's complicated by any impact on international commerce (unlike local natural disasters). Assets in place will remain but there are many instances where the value of property, for example, plummets placing many people under water for their mortgages. If there is a true pandemic killing, say, 1-5% of the Canadian polulation, then it would be similar to a declared war. Government typically declares a war act which limits liabilities and abilities to pay but also severely limits cash flow and "liquidation" of assets. In essence, the economy is slowed down to allow responses and reduce financial hardship. Hard to know to what degree this would be effective.

During SARS, personal financial loss during quarantine was quite severe for some people (loss of income, cancelled holidays, etc) but the length of the quarantine was only about 3 weeks and the percentage affected was miniscule. Health workers were paid if they were quarantined - but that case was not universal.


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## MacDoc (Nov 3, 2001)

Hmmmm maybe time to review my "business interruption" insurance.


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## MacDoc (Nov 3, 2001)

This sounds promising - caught an analysis in this month's Discover. The 3 month lead time is very good news as is the storage and delivery method improvement.












> *PowderMed Manufactures a Vaccine Against H5N1 (Avian Influenza) for Clinical Development*
> Monday August 1, 4:00 am ET
> 
> OXFORD, England--(BUSINESS WIRE)--Aug. 1, 2005--PowderMed, the immunotherapeutics company focused on the development and manufacture of DNA-based vaccines for viral diseases and cancer, has announced that it has progressed its H5N1 Avian Influenza Vaccine programme into the final stages of preclinical development. PowderMed has produced an H5N1 vaccine by cloning the H5 gene from the current circulating avian flu strain ("the gene cassette") into the company's proprietary DNA vaccine backbone and the vaccine is now ready for development. Manufacturing and toxicology studies are now in progress, and *it is anticipated that this vaccine will enter clinical trials by the middle of 2006.*
> ...


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## used to be jwoodget (Aug 22, 2002)

Here's hoping macdoc, but DNA vaccines have been hyped for several years and you'll note that press release does not talk about efficacy. There is a *lot* of money at stake for anyone who can generate an effective vaccine and the big boys are investing heavily (after a decade where vaccine development was a dirty word). Whether DNA vaccines will be efficacious against avian flu is unclear but anything that cuts down the response time could be a life-saver - literally.


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## used to be jwoodget (Aug 22, 2002)

Not to be cast as Debbie Downer but: Flu pandemic's toll inestimable, WHO says.

Talking of the WHO, met Hazel Macallion this morning. It was very clear she know's who's WHO since Mississauga has a program that collaborates with the organization.


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## Dr.G. (Aug 4, 2001)

Jim, when I read this G&M article I immediately thought of you...........and our resident doomsayer, MacDoc. It is as if we know the train is coming, but we are still standing on the tracks. At least with MacDoc's hurricanes, there is little we can do to stop it from coming.


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## used to be jwoodget (Aug 22, 2002)

It's a real conundrum. The enemy is out there but we don't know what precise form it will take. We know what it looks like, but we don't know how if its a search party or a battalion. We know it is armed, but we don't know if it has pistols or tactical nukes.

There are people doing something about preparations, but it is a fine line between crying wolf and being irresponsible and there is huge variance in projections - among the people best positioned to make estimations. To be fatalist, this thing will hit. We will have some warning. Don't believe anything else as its all guess work.


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## Dr.G. (Aug 4, 2001)

It would be interesting to know what measures certain provinces are taking. NL could close its borders, but then we would be soon running out of food. We are still being told that "Washing your hands" is the best line of defense, but while I do this anyway, I feel that this is just a bland PR statement.


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## MacDoc (Nov 3, 2001)

Gaia being devious to get the **** saps population down.


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## Dr.G. (Aug 4, 2001)

HONG KONG, China (Reuters) -- "A strain of the H5N1 bird flu virus that may unleash the next global flu pandemic is showing resistance to Tamiflu, the antiviral drug that countries around the world are now stockpiling to fend off the looming threat."

I know of a doctor who has stockpiled enough for his family that is NOT going to like this news.


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## MacDoc (Nov 3, 2001)

This month's National Geo - cover story ;(

http://www7.nationalgeographic.com/ngm/0510/feature1/

Suggested reading...

EDIT: Added URL. Please post URLs for articles for attribution.

[edit ehMax] *Please* just link to stories that are copyrighted, and not paste in their entirety.


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## used to be jwoodget (Aug 22, 2002)

I heard from a colleague today that in China, in several cases, the avian flu caused the death of the person (often a child) without evidence of respiratory distress. The child exhibited symptoms of diarrhea and a temperature but no coughing. The victim died within days of exhibiting symptoms due to viral infection of the brain. This pathology reduces the infectivity of the virus (since it cannot spread from person to person) but explains the extraordinarily high mortality rate. There is very little information getting out about this disease. 

The good news (for us) is that such infection requires very close contact to the infected animal.


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## MacDoc (Nov 3, 2001)

Don't kiss a duck.......sorry graveyard humour mood.

•••

What's with this 



> Wednesday, October 5, 2005 Posted at 8:23 PM EDT
> Canadian Press
> 
> Toronto — A deadly outbreak of a respiratory illness at a Toronto seniors' home has claimed six more lives, raising the death toll to 16, health officials said Wednesday.
> ...


http://www.theglobeandmail.com/servlet/story/RTGAM.20051005.wsenoirs1005/BNStory/National/

Completely unknown??.....that's seriously scary given the mortality and obvious ability to spread.


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## used to be jwoodget (Aug 22, 2002)

You'd be surprised how common this is. It occurs every year in retirement homes. The infectious agent gets a hold in the weak and vulnerable and then spread to healthier people (who typically recover). There are many such viruses and bacteria and we'll never keep them all at bay in people who are immunocompromised.

The latest news is that researchers have recreated the 1918 Spanish flu strain and shown it to be a derivative of an avian flu. Deja flu?


----------



## Dr.G. (Aug 4, 2001)

"Deja flu?" Yes, all over again. One wonders what will happen if one of those viles of this strain of flu ever gets stolen. An extremest infects him/herself, and then wanders around New York City, London, Paris, etc, infected those nearby. It is the ultimate in biological warfare, terrorist-style.


----------



## used to be jwoodget (Aug 22, 2002)

Unlikely (as in "ain't gonna happen). The material is under level 4 security and containment. They've learned a huge amount of information as well as performing an historic reconstruction. It isn't trivial to regenerate a virus like this and although someone could try to mutate a common flu virus to contain the particular antigens/spike proteins of this strain, it is far, far more tricky to get it to actually work (thank goodness). Makes for good fiction though.

Maybe I spoke too soon.....


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## MacDoc (Nov 3, 2001)

> Looking for the next outbreak
> FluWatch a national system to detect early signs
> 
> `Sentinel' doctors, epidemiologists work together
> ...


http://www.thestar.com/NASApp/cs/Co...ageid=968332188492&col=968793972154&t=TS_Home

Sentinel physicians.......excellent :clap:

••••

Dr. G - is a "vile of flu" like a "gaggle of geese".......an intriguing Freudian slip and most appropo.


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## MacDoc (Nov 3, 2001)

knock knock.....



> *Deadly bird flu strain found in Turkey*
> CONSTANT BRAND
> ASSOCIATED PRESS
> 
> ...


http://www.thestar.com/NASApp/cs/Co...54&t=TS_Home&DPL=IvsNDS/7ChAX&tacodalogin=yes


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## used to be jwoodget (Aug 22, 2002)

The National is running a special on the bird flu threat next week. Finally, its getting into the mainstream. There is still time to deal with this (or at least prepare people for the possibilities).


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## MacDoc (Nov 3, 2001)

I actually eyed a few cases of Kraft dinner and a good deal on ham and bean soup for a just in case stash.

How useful are the masks and what do they typically cost.
I still need to get my flu shot.


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## SINC (Feb 16, 2001)

Have the stash, and have for some time.

Masks should and can be reasonably priced.

My flu shot is happening next week.


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## used to be jwoodget (Aug 22, 2002)

N95 masks are quite expensive but are the onbly ones that have suffiecient filtration capacity to be protective from aerosol infections. They are typically around $2-3 apiece. Look around in drugstores. You may find some bargains but ensure they are new and also to standard.


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## MacDoc (Nov 3, 2001)

$2-3 each - how long are they good for??


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## used to be jwoodget (Aug 22, 2002)

They are single use.... at least if used as instructed. The point being that if they are contaminated on the outside from exposure (and you'd never know), then they must be trashed. Suppliers are making a killing. The prices have doubled. You can get them at Home Depot and Rona at better prices than drugstores. Simple face masks are perhaps good enough for low risk situations. Note, N95 masks do not protect your eyes and it is possible to be infected through your conjunctival membranes.


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## Dr.G. (Aug 4, 2001)

Not to make light of the notion of wearing masks, but I found this to be an interesting picture.

http://www.kodakgallery.com/PhotoView.jsp?&collid=412522935203&photoid=773542559203

Seriously, I have been reading on CNN that there is now a case of avian flu that is resistant to any sort of protection provided by Tamiflu. My pharmacist told me that it is in short supply here in NL anyway, much of it having been bought up by doctors in the province. Our provincial government has yet to provide the people with some sense of their policy for dealing with this sort of outbreak.


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## MacDoc (Nov 3, 2001)

Ohhhh JW you are making me feel so warm and safe....NOT......


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## Dr.G. (Aug 4, 2001)

MacDoc, at least Jim is presenting the situation in a realistic manner, with none of the hype and fear-mongering that I have heard, and totally none of the "xenophobia" that shall soon start coming about from Asia being the prime location for this outbreak. We shall see.


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## MacDoc (Nov 3, 2001)

I'm just teasing him - JWs a sane voice indeed :clap:
That said a little hype to kickstart the concern would not be misplaced. The fact that such a high percentage die despite best treatment efforts by modern medicine is most worrisome.
I won't go the TamiFlu route - other critical care and workers need it more.

I do think self quarantine will be my choice if something untoward gets loose. Just thought I'd find out about the masks - maybe get a few for an unexpected trip out.
Time to look for the canned good bargain bin.

Never know - the mayor might have to call the army in for a snow storm or such.... 

••••
Y'know those GoogleAds......... 



> Avian Flu News
> Entertaining & Inspiring Articles
> & Reviews on Canada's Health Issues


Entertaining ????!!!!!


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## MacDoc (Nov 3, 2001)

> *Bird flu reaches Europe*
> Saturday, October 15, 2005 Posted at 2:58 PM EDT
> Associated Press
> 
> ...


----------



## MACSPECTRUM (Oct 31, 2002)

MacDoc said:


> Never know - the mayor might have to call the army in for a snow storm or such....


Bono shovels snow?
I know he shovels bull$hit, but...

Oh, wrong mayor.


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## used to be jwoodget (Aug 22, 2002)

FWIW, I found a pack of 20 N95 masks at Rona today for about $30. There are two types. The ones with exhale valves are about twice as expensive. You can wear them longer but for most uses, the cheaper masks are fine. During the SARS outbreak, Health Canada listed some useful mask guidelines. Note, these masks will not necessarily protect you - they are a first step. During SARS, these masks shot up 5X in price and people were being ripped off.

As macdoc suggests, if the flu pandemic does hit Canada, the best protection will be to isolate yourself and avoid public contact with other people. However, that simply won't be an option for millions of people and would bring the country to its knees.


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## used to be jwoodget (Aug 22, 2002)

Here's a report in the Scotsman on the potential impact in Scotland of a pandemic. The population is around 5 million so they are predicting 1 in 100 will die. Gulp.


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## MacDoc (Nov 3, 2001)

> Oct. 17, 2005. 06:42 AM
> 
> *Romanian fowl killed to curb bird flu*
> ALEXANDRU ALEXE
> ...


http://www.thestar.com/NASApp/cs/Co...129499412435&DPL=IvsNDS/7ChAX&tacodalogin=yes

a step further west


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## MacDoc (Nov 3, 2001)

Graveyard humour courtesy the Star


----------



## used to be jwoodget (Aug 22, 2002)

I thought the cartoon in the Globe and Mail was a truly scary metaphor.....


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## gastonbuffet (Sep 23, 2004)

Couple of people died last week in China due to these. 
My plan: I'm going to KFC and Popeye's, get my fill on bird, and then it's cold turkey for the rest of my life.


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## Dr.G. (Aug 4, 2001)

Jim, we can only speculate what shall happen when that "egg" hatches. I still don't feel as if we here in Canada are prepared. However, in all fairness, how could one really prepare fully for this sort of situation?


----------



## MacDoc (Nov 3, 2001)

> Two Turkish children killed by bird flu
> Jan. 6, 2006. 10:52 AM
> ASSOCIATED PRESS
> 
> ...


http://www.thestar.com/NASApp/cs/Co...6&call_pageid=1130234746907&col=1130234746922



Tick.........


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## Dr.G. (Aug 4, 2001)

"ANKARA, Turkey (CNN) -- An 11-year-old girl died of bird flu in Turkey on Friday, the country's third death from the virus, officials said."

Tick......tock........


----------



## SINC (Feb 16, 2001)

As I was watching TV last night, a commercial for an upcoming special on the spread of viruses worldwide came on for a series of programs all next week.

I think it was the Discovery Channel, but I will watch for it again and make note of it for this thread.


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## MacDoc (Nov 3, 2001)

> *Five more human cases of bird flu found in Turkey*
> Saturday, January 7, 2006 Posted at 8:55 PM EST
> Associated Press
> 
> ...


http://www.theglobeandmail.com/servlet/story/RTGAM.20060108.wturkey0108/BNStory/International/ 

I have a question......if you've had the flu for the year is it worthwhile to still get a flu shot late in the season???


----------



## MacDoc (Nov 3, 2001)

Make that 23  



> Experts worried bird flu spreading among humans
> Updated Sat. Jan. 7 2006 7:07 AM ET
> 
> CTV.ca News
> ...


http://www.ctv.ca/servlet/ArticleNe...06/bird_flu_turkey_060106/20060107?hub=Health


----------



## MacDoc (Nov 3, 2001)

> Turkey takes fright as bird flu heads towards Europe
> Jan 9th 2006
> From The Economist Global Agenda
> 
> ...


massive sounds of dice rolling 







..far too fast and loud for my comfort.....


----------



## martman (May 5, 2005)

Here is a different perspective on the bird flu. Which I again state for the record is not the pandemic but is a sad excuse to sell more newspapers.

http://www.globalresearch.ca/PrintArticle.php?articleId=1148


> Who Owns the Rights on Tamiflu: Rumsfeld To Profit From Bird Flu Hoax
> 
> By Dr. Joseph Mercola
> 
> ...


----------



## MacDoc (Nov 3, 2001)

What a crock of conspiracy nonsense. WHO is in no way influenced by corporate shenanigans



> *Altogether, more than half of the laboratory-confirmed cases have been fatal.* H5N1 avian influenza in humans is still *a rare disease, but a severe one that must be closely watched and studied, particularly because of the potential this virus to evolve in ways that could start a pandemic.*


I'll take the assessment of the World Helath Organization over a conspiracy theory. It's a very dangerous strain.

http://www.who.int/csr/disease/avian_influenza/avianinfluenza_factsheetJan2006/en/index.html

It IS a pandemic in birds and a rare one.



> *Prior to the present situation, outbreaks of highly pathogenic avian influenza in poultry were considered rare.* Excluding the current outbreaks caused by the H5N1 virus, only 24 outbreaks of highly pathogenic avian influenza have been recorded worldwide since 1959. Of these, 14 occurred in the past decade. The majority have shown limited geographical spread, a few remained confined to a single farm or flock, and only one spread internationally. All of the larger outbreaks were costly for the agricultural sector and difficult to control


This is rare strain and highly fatal one even for birds. Even the WHO admits Tamiflu treatment is of unknown efficacy.

The only good news is that there seems to be some weakening of the strain.
I had not realized the 1918 strain is still circulating in the world but has little or no impact.

Ma Nature MAY have a hit a foul ball on this one to reduce the human pests on her planet but damn it's too close to the line and still in the air.


----------



## Beej (Sep 10, 2005)

I actually agree with MacDoc, even though he refuses to hug me. This is another example of condemnation by connect-the-dots. Let's talk moon landing...


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## martman (May 5, 2005)

I still say it is WAY overhypped.
Yes it is killing a lot of birds but it is not killing many people and the indications are that most of those infected are never diagnosed so the death rate is WAY lower than usually reported in the media. 

Call it a wacky conspiracy theory but h5n1 is not going to be the next major pandemic and the media has been irresponsible in its pushing and hying of this theory at the expense of the truth. There are many diseases that are communicable and that have killed WAY more people than h5n1 (hell most flus kill more people than h5n1)but still the press keeps hyping this like they wish it would be the pandemic. Frankly I'm disgusted.

As for my article yes it is a little wierd but so is the fact that Cheney has his hands in every money grab going on in the US.


----------



## Beej (Sep 10, 2005)

martman said:


> I still say it is WAY overhypped.
> ...
> As for my article yes it is a little wierd but so is the fact that Cheney has his hands in every money grab going on in the US.


The first statement is, in my opinion, very reasonable, especially considering media leanings, and may foster some interesting discussion. No conspiracy, just 'if it bleeds it leads'. I don't agree, but there is some rationale behind it.

The second statement is what it is: A humorous overstatement. He worries me far more than Bush (because he's no fool), but 'every money grab' is just rhetoric. How about 'a number of money grabs'?


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## MacDoc (Nov 3, 2001)

Who scientists are very frustrated as their efforts to get attention to the danger are too often falling on deaf ears and only now is the issue getting the funding it needs.

Millions of birds are being destroyed ( an economic hardship in itself ) and human infection closely monitored as it is such a virulent strain of influenza.
This level of warning is not the norm for WHO and we ignore it at our massive peril.

What's frustrating for the health organizations is they may have already prevented a cross over by their efforts to date and then get told " look see nothing happened".

It needs to remain on high alert and all the funding to make sure that " look see nothing happened" continues.

There was not one nuclear exchange for all the trillions spent on "defence".

Yet this strain has the potential of doing more damage to humans than a nuclear exchange other than all out nuclear war.

We are overdue. Humans develop immunity by exposure - 50% fatality even with the best of modern medicine means a nasty beastie is loose and evolving.
SOME indications are it's weakening but it's still uncertain

The 1918 version could kill healthy young adults in 48 hours yet leave young and old untouched. If EVER money was well spent on "defence" - this is one time.
I truly do hope we can say a few years out....."look see nothing happened".
And I'll give WHO full credit for guarding the gate well.

Until then it needs to be front and centre.

Cheney and conspiracy theories are unneeded and in some sense dangerous distractions as they appear to blunt the real threat level...... implying it's manufactured fear like "terrorists behind every dumpster" and WMDs in Iraq.

If anything, as with global climate change, there is not enough awareness in the media......tho on both accounts it's getting there.
The more REAL information in circulation the better people can appreciate the effort of WHO and others and encourage support for those efforts.

You have to know that if doctors personally are stockpiling Tamiflu............it's no idle threat. 50% fatality on something that can and has in the past jumped to a human spreadable disease form is scary. 

Yes Victoria there just MIGHT be a monster under the bed


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## martman (May 5, 2005)

The mortality rate is FAR from 50%. Keep feeding the fear.

I am not saying CDC and like organisations should ignore h5n1, I am saying the press is irresponsible. As proof I point to your mistaken belief that 50% of cases end in death.


http://deseretnews.com/dn/view/0,1249,635175149,00.html


> Study calls bird flu not so deadly
> By Lindsey Tanner
> Associated Press
> CHICAGO — As bird-flu cases rise at a disturbing pace in Turkey, new research offers a bit of hope — it's likely that many people who get it don't become seriously ill and quickly recover.
> ...


So I again say that this is just hyperbole designed to sell newspapers. Notice how this started up after it was realised that West Nile virus was no where near as severe as the press wanted us all to believe. The press seems to believe they have a vested interest in keeping us scared so it is always a new disease to hype. Again the number of deaths attributed to h5n1 are small in comparisson to other diseases.

I'm not saying CDC should ignore h5n1 buit I am saying that the media hype is wrong and that we are suckers for buying into it. As for Doctors stashing tamiflu? So what my sister-in law is a doctor and she stashed all kinds of drugs. what is your point?


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## used to be jwoodget (Aug 22, 2002)

Martman, you are absolutely correct to be critical of anything you read but, respectfully, you are also a fool if you think pandemic flu is over-hyped. In the history of humankind, the longest period between pandemic outbreaks was 36 years. We are now at 40 years. Yes, millions die of malnutrition and millions die of other communicable diseases such as malaria, HIV and TB. Many of these are preventable and curable. That they are not being treated is a tragedy and speaks volumes of our lack of compassion as a modern society. However, none of these facts are relevant to flu. The fact that people are making money from Tamiflu is irrelevant. Ditto for HIV drugs. Indeed, there's one heck of a lot more money to be made from Herceptin or Avastin. As for the mortality rate, you might note that the study in question did NOT identify the people as being infected with the H5N1 strain (it was conjecture since there are 15 other avian flu strains). In CONFIRMED cases of H5N1 infection, the mortality rate is around 50%. Ever noticed that there are differing variants of human flu? Finally, treatment of people with Tamiflu, if it is effective against avian flu (it will likely be somewhat effective but the degree to which it is is currently unknown), is unlikely to lead to resistant strains given that the dosage rate of Tamiflu will be so low (Canada has the highest per capita stocks and it is not even enough to cover "essential workers").

Is there hype? You betcha. Should there be hype? You betcha! It would be incredibly more irresponsible to deny the threat and then have half a million Canadians die than to prepare for and try to mitigate an epidemic. It looks like we may have dodged the bullet this flu season, but a pandemic is inevitable over the next few years. Live in denial if you wish, or do whatever you can to prepare for it. Fortunately for all of us, the medical profession does not gamble with lives and neither does it react in a knee-jerk fashion to the press. It has its own data.


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## MacDoc (Nov 3, 2001)

And the scary part is that these are young healthy people with full modern medical care succumbing.
Early on the mortality rate was over 60% so treatment has been learned and as I mentioned there is some indication the strain is weakening which also reduces mortality. That is some good news.
The die roll is how it combines - it could be combine and come out a very tame variation that is positive and gives ongoing immunity to similar strains.
It come out a monster like 1918 which would see 500 million dead or more with today's population..and the horrible part of that was it people in their prime 20s and 30s.

I want WHO reporting on this and every paper reporting on the progress just as if it were a hot war ..which is exactly what it is.


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## martman (May 5, 2005)

Or it could turn out (most likely senerio) that H5N1 is NOT the next pandemic.

I'm not saying we shouldn't prepare for the next pandemic. But what I am saying is this: 
1) the media hype helps no one. It is just SARS all over again.
2) H5N1 is not the next pandemic and I doubt it ever will be
3) Most cases of human H5N1 never get reported so the 50% figgure is way off
4) The constantly crying wolf helps no one in any disease senario.
5) The is little to no benefit to the public to be constantly kept in fear of the latest disease trend other than to sell newspaper / tv advertising.
6) Thoses whose jobs it is to monitor disease should certainly be keeping an eye on this and all possible threats but should not hype BS to the media.
7) There is little "average joe" can do to "prepare " for a pandemic situation anyway. 


I do not buy you the hype is good message. Look at the effect it has had on me. I think this kind of fear mongering would be better put to use durring an emergency rather than every time someting slightly communicable comes around. 
Remember SARS / West Nile? Too much hype around bogus (or possible) threats is COUNTER PRODUCTIVE.


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## MacDoc (Nov 3, 2001)

> Or it could turn out (most likely senerio) that H5N1 is NOT the next pandemic.
> 
> I'm not saying we shouldn't prepare for the next pandemic. But what I am saying is this:
> 1) the media hype helps no one. It is just SARS all over again.
> ...


1. SARS did not get ENOUGH media coverage early enough. Were it not for some pretty significant heroics SARS could be endemic.

2. H5N1 is already a very serious pandemic - an historic one in the avian population and it has already shown signs of evolving and while there are no "confirmed" human to human there are a number of suspicious situations.



> 3) Most cases of human H5N1 never get reported so the 50% figgure is way off


 and how can you possibly put your "speculation" up against WHOs actual figures. In this case it's you doing the nonsense without basis.

4/5 Awareness means being alert to the dangers and planning ahead - I have, others have - it also means political initiatives to support the funding for the effort. Without awareness public officials are not held to account over preparedness issues.

6. It's NOT hype, it's a strong warning of an overdue cycle of influenza whose likely source is particularly virulent.
Just as scientists had a hard time getting attention to global climate change so it's been difficult getting awareness of the scale of the danger here, that it's overdue and that the current "jump to humans" threat strain is extremely virulent.
There WILL be a major earthquake in LA, or Japan..there WILL be more tsunami's.
When there are large scale threats..as this is.......awareness is critical and support for those on the frontlines also critical.

HYPE is "crime wave in Toronto".

7) Planning for a potential pandemic is no different and likely more important than planning for a house fire with your kids. I have a few masks, A few more supplies in place while the threat is high.

SARS taught us much and if anything not to underestimate the impact.

West Nile is a fact of life and some people will die from it. It's no where near the virulent threat that a major influenza outbreak could be but it's also a wise idea to be careful around mosquitos.

The only one having an effect on you is YOU. If you can't determine real threat from HYPE........ma nature may well have you in her sights for "end of gene line" treatment.


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## used to be jwoodget (Aug 22, 2002)

Let's see.... if avian flu wasn't in the news, just how much effort do you think would be being put into a vaccine or, indeed, into ramping up Tamiflu production? H5N1 is currently the best bet for a pandemic flu given the past natural history of influenza viruses. It doesn't mean it will become pandemic, but its the most likely in terms of current situations. I assume you do not believe in life/car/travel insurance either.....

No one wants to cry wolf. But there is a specific and real threat. People have died and more will die. The virus is spreading through the avian population, devastating domestic birds by the millions. It is not a false nightmare. It's currently a bad dream and let's hope it'll stay that way.


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## Beej (Sep 10, 2005)

used to be jwoodget said:


> Let's see.... if avian flu wasn't in the news, just how much effort do you think would be being put into a vaccine or, indeed, into ramping up Tamiflu production?


From my experience, the call to action for pandemic planning (any pandemic) is a big benefit. Utilities aren't ready to handle losing a large chunk of their workforce. We got a glimpse of this in New Orleans, but they still had help from nearby states. 

If a pandemic hits, and plans aren't in place, our water, gas and power grids could go down. If this happened in winter (less likely? not sure about the medical rationale) our country would be seriously compromised, and it wouldn't be the flu killing people. So, in the sense that it has upgraded this issue in the minds of government and business leaders, it has been helpful. 

What happens if 20% of the workforce just doesn't show up? How about 30% or 40%? They may be sick, or afraid to mill about in public. These are real questions being asked now. It may turn out to be infeasible to plan for this, but I'm not sure there has been a widespread effort to even try to figure this out in recent memory.

Either way, will our infrastructure work and for how long? Even if it is unlikely, these kind of things should be planned for a 1 in 10,000 type probability (not an exact number, just picking one), sort of like building design (any engineers care to add real numbers to this?). People got really cheesed at losing power in August...that was an inconvenience relative to losing it and gas in winter.


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## Dr.G. (Aug 4, 2001)

Beej, we just came back from the vet with our pups, and he said the same thing as you ("If a pandemic hits, and plans aren't in place, our water, gas and power grids could go down. If this happened in winter (less likely? not sure about the medical rationale) our country would be seriously compromised, and it wouldn't be the flu killing people.") We got to talking about dogs not being able to be cared for anymore by people who were sick, and how packs of dogs could resort back to their "pack mentality" once again.


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## Beej (Sep 10, 2005)

You have an advantage if you have food stored up: animals convert food into heat (and poop, which may be combustible too  ). 

Didn't the pack thing happen in New Orleans? Infrastructure security agencies should be pouring over the NO experience. It was not the same as a pandemic, but it was the closest example we've had recently. Is the army corp. of engineers adequate or even trained to fill in? Are infrastructure systems designed to be run by skeleton staff for an extended period? Hopefully these issues are being examined.

A really complex issue is that in a normal outage, you may set up plans to centrally gather people to minimise their utility needs and keep track of them. Relatively straight-forward: local churches, arenas etc. get to be designated recovery areas, while grid-connections to households are disabled to conserve.

In a pandemic, gathering people together is likely the last thing you'd want, so utility demand couldn't be controlled very well.


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## MacDoc (Nov 3, 2001)

more dice tumbling



> *Bird flu emerges in Africa*
> Feb. 8, 2006. 07:19 PM
> CANADIAN PRESS
> 
> ...


http://www.thestar.com/NASApp/cs/Co...ageid=968332188492&col=968793972154&t=TS_Home

on a very vulnerable populace.


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## MacDoc (Nov 3, 2001)

Info sites

http://www.health.gov.on.ca/english/public/program/pubhealth/flu/flu_03/flu_cold_sars.html

http://www.phac-aspc.gc.ca/fluwatch/

http://www.cdc.gov/flu/


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## Beej (Sep 10, 2005)

Alternative perspective. Sorry, but I think the article is locked.
http://www.theglobeandmail.com/servlet/story/RTGAM.20060320.wxcoflu20/BNStory/specialComment/home

...
A human influenza pandemic is likely to occur some time in the next 40 years. There is no reliable scientific basis for predicting its timing, severity or the precise virus likely to trigger it. We should make prudent but limited preparations for this pandemic by enhancing our capacity to produce influenza vaccine and improving our surveillance for new strains of influenza virus. Ontario hospitals need those 300 nurses more than they need the Tamiflu stockpile.

And we should calm down, stop chasing phantoms and spend our efforts tackling the myriad of real problems that we actually do face.

Richard Schabas, Ontario's chief medical officer of health from 1987 to 1997, is currently chief of staff at York Central Hospital in Richmond Hill, Ont.
...


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## MacDoc (Nov 3, 2001)

> *Bird flu toll rises past 100-mark*
> 
> Millions of birds have been culled in an effort to curb the virus
> The world's human death toll from bird flu has reached 103 since late 2003, the World Health Organization has said.
> ...


http://news.bbc.co.uk/2/hi/europe/4830046.stm

One grain of wheat on the chessboard, two grains of wheat on the chessboard,..........


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## used to be jwoodget (Aug 22, 2002)

The Schabas article has been widely discussed. He's saying people are crying Wolf. I would say that they are being responsible. The risk to the global economy of a pandemic form of avian flu with a mortality rate of 10% (which is far below the current virus's kill rate of 45% - but lets be conservative) would be in the multiple billions of dollars, casting aside the human tragedy. We are spending a few million. So if the relative risk is 1 in a 100 of H5N1 going pandemic, we're underspending by a factor of at least 100.

300 extra nurses for Ontario would be great. But who is saying that the money that is currently going into preparedness for a pandemic would instead go to hiring nurses? 

Let's all hope that it doesn't become infectious for humans. The meagre amounts being spent to mitigate the risk are trivial and if there is no pandemic, its hardly a waste (since Tamiflu, for example, is effective against regular flu). Schabas's arguement is akin to asking why anyone bothers investing in a tsunami alert system or buys insurance.


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## RevMatt (Sep 10, 2005)

Why it isn't spreading in humans.

A brief respite. The possibility of mutation still lurks, but at least we finally understand why the current strain isn't overly contagious in humans, or other mammals. It lodges to far in to be spread by coughs and the like.


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## Dr.G. (Aug 4, 2001)

RevMatt, a virus has a way of evolving to the extent that it will survive. Thus, it is only a matter of time before a virus is able to be spread via the air. We shall see.


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## MacDoc (Nov 3, 2001)

Yep the 1918 virus is still with us and circulating but survival and threat do not equate. There is evidence that the H51n is weakening in virulency but that's no guarantee for any human form that might develop.

Still even for the sake of the bird populations and the agony to low income poultry farmers the sooner this one fades to impotency the better.
It's a current example of evolution in action I could do without.
The bird populations are unwillingly being culled - those that resist the virus pass their genes on.

Let's hope the human gene pool's number for pruning does not come up.

After all the few who are immune to AIDs owe that immunity the Black Death culling. Evolution takes odd paths.

There is an interesting article in SciAm about new understanding of viruses as a fourth order of life and how crtical a mechanism they are in evolution going right back to life origins.



> *A new branch in the Tree of Life*
> February 17, 2006 3:57 PM PST
> 
> A monstrous discovery suggests that viruses, long regarded as lowly evolutionary latecomers, may have been the precursors of all life on Earth. "We haven't even begun to scratch the surface. The numbers are mind-boggling. If you put every virus particle on Earth together in a row, they would form a line 10 million light-years long. People, even most biologists, don't have a clue. The general public thinks genetic diversity is us and birds and plants and animals and that viruses are just HIV and the flu. But most of the genetic material on this planet is viruses. No question about it. They and their ability to interact with organisms and move genetic material around are the major players in driving speciation, in determining how organisms even become what they are.
> ...


and you thought having a primate as an ancestor was odd....

say hello to mom......err dad......err 









http://www.overmatter.com/2006/02/mimivirus.html



> "If this is true," Forterre has said of the viral-nucleus hypothesis, "then we are all basically descended from viruses..


......maybe Ma Nature wants a new batch of sourdough to work with


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## MacDoc (Nov 3, 2001)

Wow this could be an incredible breakthrough :clap:
There's a Nobel prize in the making if this makes it to wide spread use. Brilliant bit of science.....two decades of work !!



> *Treatment 'to neutralise all flu'*
> 
> There are fears of flu pandemic
> Scientists say they are developing an entirely new way of providing instant protection against flu.
> ...


http://news.bbc.co.uk/2/hi/health/5404184.stm


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## MacDoc (Nov 3, 2001)

Hear that bullet zing by......this ain't over by a long shot...



> *Study confirms human-human spread of bird flu*
> Updated Wed. Aug. 29 2007 10:43 AM ET
> 
> CTV.ca News Staff
> ...


CTV.ca | Study confirms human-human spread of bird flu


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## used to be jwoodget (Aug 22, 2002)

Interesting movie coming up (filmed in Guelph) called Blindness about a virus infection that destroys sight - based on the book by José Saramago (Don McKellar wrote the screenplay). 

As for avoiding viruses, they are, by their very nature almost indefinable. Fortunately, our immune systems are also pretty cool and eliminate most infections (you just don't realise it unless one gets through). Like a lot of things on this planet, viruses go with the territory. The fact is that technology cannot protect us from everything and prevention in the case of infections is a damn sight better than cure. 

Back to my little hole....


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## BigDL (Apr 16, 2003)

used to be jwoodget said:


> Interesting movie coming up (filmed in Guelph) called Blindness about a virus infection that destroys sight - based on the book by José Saramago (Don McKellar wrote the screenplay).
> 
> As for avoiding viruses, they are, by their very nature almost indefinable. Fortunately, our immune systems are also pretty cool and eliminate most infections (you just don't realise it unless one gets through). Like a lot of things on this planet, viruses go with the territory. The fact is that technology cannot protect us from everything and prevention in the case of infections is a damn sight better than cure.
> 
> Back to my little hole....


Welcome back. Nice to see your return to this board, don't be such a stranger, I'm a strangerbut that's a whole nother issue.


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## Kosh (May 27, 2002)

Interesting thread. Avian Flu really hasn't been in the news this year. I wonder how far it's spread by now? Did it ever make it to Canada - even in birds? There was a scare there once, but I think it turned out to be a different strain of the bird flu. Good to see the royal swans were let out into the river in Ottawa to stretch their wings.


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## used to be jwoodget (Aug 22, 2002)

There's been lots of developing news on avian flu, but none of the intensity and pandemic paranoia of last year. Unfortunately, its still around, quietly mutating and incubating in various bird populations. Part of the problem is suppression of information in certain countries due to the potential for export blockades, etc. Just like BSE which has just "disappeared". Sure.... 

Like the crumbling infrastructure in Quebec, the clock is ticking but old age, lightning or a million other things could getcha before a pandemic.


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## MacDoc (Nov 3, 2001)

Get your flu shot.
Wash your hands.



> Bird flu virus becoming more dangerous: study
> Updated Fri. Oct. 5 2007 11:27 AM ET
> 
> CTV.ca News Staff
> ...


CTV.ca | Bird flu virus becoming more dangerous: study


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