I rarely plumb Effect Measure's archives except when I think the material has some point for today. And today we are treated almost daily to reports of bird flu outside of asia: Turkey, the UK, Nigeria, Hungary, Egypt. What's going on?
Sometimes it's useful to look back. Here's our post from one year ago today.
The reports of H5N1 infectedwild birds (mainly swans) in new countries are coming almost too fast to keep track of. Denmark is the latest (confirmation pending), but we can add Hungary and Dagestan (Russian Federation north of the Caucasus), too.
Meanwhile the Iraqis are desperately trying to cordon off poultry traffic in Maysan province, using the military for the purpose (as if they don't have anything else to do).
Dr. Ibtisam Aziz Ali, spokeswoman of a government committee dealing with the bird flu crisis, said Health Minister Abdel Mutalib Mohammed declared the alert after birds suspected of having avian influenza were discovered in at least five of parts of Maysan province, which borders Iran and lies on a major trade route between Basra and Baghdad.
Maysan includes some of Iraq's famous marshlands, and U.S. and United Nations officials fear that the deadly disease could spread rapidly if it reaches the area rich in bird life.
Late Tuesday, Mohammed met in Amarah, 290 kilometres southeast of Baghdad, with local health authorities and tribal sheiks to brief them on the bird flu threat and government measures to combat it.
The minister said he has to "totally close" Maysan using Iraqi soldiers and police and carry out culling of poultry."The disease has apparently spread among local birds, not migratory birds," said Mohammed. "I have seen five centres where infections have been detected by rapid laboratory testing. Now we have declared a state of health alert." (cnews)
The Europeans are quaking in their boots, too, locking up or planning to lock up their chickens in an effort to keep them away from migratory birds they fear carry the virus (Reuters). The poultry industry has already taken a hit, with sales plummeting. The European Commission's Standing Committee on the Food and Chain and Animal Heath met yesterday and today to discuss coordination of national measures (Reuters).
But the place I find most worrisome is Indonesia. Human disease continues to bubble away there, and the bubbles are coming faster and are more numerous now.
Humans are contracting the deadly H5N1 strain of the virus at a faster pace, causing more deaths, Agriculture Minister Anton Apriantono told reporters in Jakarta before attending a cabinet meeting on bird flu, without elaborating."We will step up preventive efforts, be more proactive,'' Apriantono said. "We will do checking even on areas that haven't seen any cases of dead poultry. Information dissemination about bird flu will be stepped up.''
Indonesia has the second-highest number of bird flu cases among humans in the world. The H5N1 virus has killed at least 18 people of the 25 people it has infected in the Southeast Asian nation. Health authorities say they are concerned the virus will mutate into a form easily transmitted among humans, causing a deadly global pandemic. The country's suspected sixth cluster of human infections, in two adults and their two-year-old daughter, has heightened concerns.
The government plans to start searching Jakarta homes starting next week, Apriantono said. The government will cull diseased poultry in a 1 kilometer (0.6 mile) radius and vaccinate fowl within a 3 kilometer radius.
"We have the highest cluster of the disease in the world'' among humans, said Health Minister Siti Fadilah Supari. "And the higher the cluster the higher possibility of human-to- human'' infection. (Bloomberg)
Indonesia is the fourth most populous country in the world. Many people live close to poultry in their back yards. The birds are a source of protein but also highly prized as pets and companion animals. H5N1 is now endemic in Indonesian poultry and perhaps swine.
I'm not in the guessing game here. Too many things we don't understand about this virus.
But if I were going to guess (which I'm not), this is where I'd say it will start.
The more things change . . .
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Revere(s). Thanks for the last year...thanks for the explanations and stuff that had not been presented by others...and thanks for giving the speechless a voice, both here and at flu wiki.
...It is about this 'high impact, low probability' event that has become the norm for Dr. Sandman and Dick and the gang and the World Health Organizationand by extension, the Public Health Agency of Canada, the Government of Canada and all the others.
I cannot believe anyone could look at the current situation and conclude other than this is a high probability event.
I would like to challenge Dr. Sandman to provide some collected scientific evidence or observations and present them here on Effect Measure for the world to see...because as all would know, he and the others haven't presented any...yet.
In the spirit of the event, I will present one of my own...
...The longest interpandemic period in recorded history is I believe 42 years...we are presently at 39 yrs. and counting...
...just how lucky do you feel?
Thanks again
/:0)
Tom,
I know of few (if any) public health officials that say that a pandemic is a "low probability". I agree, that some have said (at least in the past), that an H5N1 pandemic is a low probability. But without fail, every health official's words, written or spoken, have indicated a pandemic is a high probability. What no one knows (including you) is the form in which it comes.
I appreciate all the work all organizations are doing to avoid a pandemic (or lessen it's severity). With the millions of birds culled, think of the billions of mutations that did NOT happen, due to their action. Perhaps we've already avoided a pandemic?
I haven't reviewed any charts recently, but it seems that H5N1 cases haven't been any more numerous year to date, then they were last year. I know Tom that you've stated that March 2007 was your estimate for the beginning of a Pandemic. As that time draws near, are you finding yourself more concerned because of recent events? Or just frustrated with the progress?
"Perhaps we've already avoided a pandemic?"
Subtle messaging Patch...very good...is this not zero probability?
"Tom that you've stated that March 2007 was your estimate for the beginning of a Pandemic. As that time draws near, are you finding yourself more concerned because of recent events? Tom that you've stated that March 2007 was your estimate for the beginning of a Pandemic. As that time draws near, are you finding yourself more concerned because of recent events? Or just frustrated with the progress?
Well Thanks for remembering Patch. Actually, the truth is that, after looking at the WHO's estimate of 2-7 million mortality only, I decided to examine the potentials for myself...
...and I estimated two years ago that the pandemic would start in the 2006-2007 flu season which doesn't end in March.
"Or just frustrated with the progress?
I am not sure whether you are asking me if I am disappointed that my prediction has not come true or if I am disappointed by the progress in preparations.
I do not expect to make it through a pandemic so I guess the answer to your question is no, I am glad to still be alive...what's next...the old 'fear-mongerer' charge?
Am I disappointed by the response of the World Health Organization...yes, as I said before...if the World Health Organization had a brain...they would eat it!!
The fact is and the fact was two years ago that antivirals don't and won't work...which part of 18% resistance with seasonal influenza in Japan and 100% to amantadines do they not understand. Secondly, when was the last time you saw a kid with influenza decide to go flying? There are serious side-effects.
The vaccination promise is a joke...you know it, I know it...my dog clover knows it.
What I would have liked instead of the repeated (you seem to have missed it?) claim that this is a low probability-high impact event...would be one world leader willing to make a difference...to stand before the TV cameras and say...we have a major problem here...
...this is a real threat and here is what we are going to do...first, we are going to have a package avaliable for every familly to use when not if the pandemic occurs...it is going to include antibioitics, prednisolone tablets, oral electrolyte powders and anti-fever medication. In addition, we will have healthcare workers for telephone and computer advice as the hospitals will be overwhelmed or closed within the first few weeks of the pandemic...
...and we are working to insulate infrastructure including talking to our farmers so that they can assist with food supplies (3 day food supply or less in all major cities).
I would also like to state that a pademic is bad for business and particularly bad for the pharmaceutical industry...I would have thought that it would be in the corporations interest to make sure that there was billions of influenza vaccines avaliable to ensure that there will be customers in the future.
Like I said...just how lucky do you feel?
First, you've misinterpretted my comments. I did NOT mean that you were frustrated that a pandemic has not occurred. Rather, that you were frustrated at the progress we've made to PREPARE. Sorry..I wasn't clear.
I might disagree with you from time to time Tom, but I assure you, I don't think your the type of person who "fear mongers" or who would wish for bad things to happen.
You are convinced that H5N1 is going pandemic and you are further convinced, that it's impact can not be mitigated by antivirals or vaccines. You could be right on both counts.
I like your idea of giving people "prep kits", with those medications and instructions. But is that any better than stocking tamiflu, if we don't know what we are dealing with yet? Certainly, regional or local call centers make sense in any emergency.
Good thoughts!
Oh..but one thing Tom. I remember distinctly, you saying March 2007 in one post or another (on FW). I put stock in what you say and I remembered that!
I don't mean to say that you are afraid of being wrong. I assume you still believe that this flu season will be the jumping point. And therefore, wondered if that has you more concerned.
Frankly...I hope you are wrong and I'm sure you do too!
The Free Guide to Pandemic Bird Flu Preparedness is available at: http://www.pandemicinfosite.com
"What I would have liked instead..."
Great suggestions, Tom. And furthermore I would like to know if the government is doing or funding any studies to conclusively determine how effective protective masks will be in a pandemic - and exactly which models, if any have real value and will not just provide false security, are best. We shouldn't have to wait for Consumer Reports to study the matter.
Plus they could follow up on studies like the ones on Vitamin D reported on at http://www.lef.org/magazine/mag2007/feb2007_report_vitamind_01.htm to determine if Vitamin D or other substance supplementation does in fact increase resistance to influenza or would help alleviate its effects.
I wonder how many things like this, which the governments of the world could be doing, are actually being done. And with the Health-Agency-Pharmaceutical-Industry (HAPI) complex, you have to wonder if the billions that are being spent on things like stocking Tamiflu are solely motivated by a desire to preserve public health.