Avian Flu Pandemic?

[Adrian]

I have just begun to go through the data surrounding H5N1. Does anyone know any more about the specific rates of cross-species transfer? The numbers from WHO do not seem to justify the great hype surrounding the "impending doom". Here are the WHO mortality numbers:


26.12.03-10.03.04: 35 cases, 24 deaths
19.07.04-08.10.04: 9 cases, 8 deaths
16.12.04-to date: 72 cases, 28 deaths
TOTAL: 116 cases, 60 deaths

(Source: WHO, Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO, Sep 2005)

The numbers just seem to warrant such a large focus. Much of the deaths have been because of people handing dying and diseased birds, or people cleaning bird droppings. The WHO paper on the topic ("Assessment of risk to human health associated with outbreaks of highly pathogenic H5N1 avian influenza in poultry", WHO 2004) states that the high risk areas tend to be open-air markets in low income areas. It doesn't seem that it would be that difficult to spend a few million to ensure more sanitary conditions, but I have been hearing estimates of spending over 60 million dollars in US alone. I guess they are worried about a mutation, but WHO's own recommendations seem a little overkill: "Rapid destruction – within three days – of Hong Kong’s entire poultry population, estimated at around 1.5 million birds" (Avian influenza, WHO 2004).

Does anyone have any more data on the subject?

[TobiasTheViking]

If they didn't make statements like that(which they do all the time, remember SARS?) then you would never hear about them.

And nothing would be done. It is a game of "Cry Wolf" where you need to do it to get any funding to work with the problems that are real(and just general funding to run the program). And you have to "Cry Wolf" to get the funding, in the end, it will probably bite them, but that is what they are doing.


What is that i'm hearing, uh, a branch broke THERE IS A WOLF.
Oh, i guess not anyways, just a deer.
What is that i'm hearing, uh, a branch broke THERE IS A WOLF.
oh, i guess not anyways, just a cow.

etc.

Of course, i may be pesimistic.

[drkitten]

Originally Posted by Adrian

I have just begun to go through the data surrounding H5N1. Does anyone know any more about the specific rates of cross-species transfer? The numbers from WHO do not seem to justify the great hype surrounding the "impending doom". Here are the WHO mortality numbers:

The numbers just seem to warrant such a large focus.

Yes, it's a mutation that they are worried about.

Specifically, they're worried about a mutation that will enable human-to-human transfer. So far, (almost) all cases in humans have been incurred directly from birds. I think there are like three cases of human to human transfer on record, and no recorded cases of a human-to-human-to-human transfer.

However, influenza, in general, is one of the most infectious diseases out there, which is why it's so easy to catch (from other humans). The influenza virus is also known to swap genes between subtypes. As soon as the H5N1 virus acquires the ability to be transferred easily from human to human -- and it's a question of when, not if -- we're quite possibly going to see a billion cases wordwide, as people in Hong Kong pick it up and carry it via airplane literally all over the world. With a 50% mortality rate, that could kill 500 million people.

Basically, it's a time bomb, and the pathologists can hear it ticking.

[Adrian]

Originally Posted by drkitten

Yes, it's a mutation that they are worried about.
However, influenza, in general, is one of the most infectious diseases out there, which is why it's so easy to catch (from other humans). The influenza virus is also known to swap genes between subtypes. As soon as the H5N1 virus acquires the ability to be transferred easily from human to human -- and it's a question of when, not if -- we're quite possibly going to see a billion cases wordwide, as people in Hong Kong pick it up and carry it via airplane literally all over the world. With a 50% mortality rate, that could kill 500 million people.

I just don't get the logical jump from 110 cases to a billion? There have been human cases of H5N1 even before 1997 and it has not yet mutated into a human-to-human disease. It is true that this variant has a propensity to mutate quite often, but there are quite a few diseases that share this propensity that have not become global pandemics. High mutation rates do not necessarily mean global pandemic and such "end of times" outcomes.

[Kevin_Lowe]

I do not imagine anyone has a scientifically based idea on exactly how likely it is for H5N1 to mutate into a pandemic killer, owing to the lack of data on such things.

We do know that the possibility is real, however, and the consequences would be disastrous.

[Dymanic]

Quote:

Adrian:
It is true that this variant has a propensity to mutate quite often, but there are quite a few diseases that share this propensity that have not become global pandemics.

It doesn't have to be a mutation. The big concern is that H5N1 will gain the capability for human-to-human transmission through recombination with another strain.
http://www.recombinomics.com/News/10...Confirmed.html

You are right that H5N1 isn't the only pathogen capable of producing a global pandemic; it's just the one to watch right now. It is also true that until the new strain emerges, we can't acurately predict what the attack rate will be, but it is not unreasonable to expect something like 15% to 35%. Let's hope the death rate is closer to the 1% or 2% seen in typical flu strains than to the over 50% we're seeing in the current strain.

It may not be possible to be completely prepared for such an event, but that doesn't mean we have to be as completely unprepared as we are at present.

Quote:

Kevin_Lowe:
I do not imagine anyone has a scientifically based idea on exactly how likely it is for H5N1 to mutate into a pandemic killer, owing to the lack of data on such things.

Perhaps not exactly how likely, but it is reasonable to say -- approximately -- that it is very likely.

Two types of molecules project from the surface of a virus: a hemagglutinin and a neuraminidase (hence, "H5N1", etc). The hemagglutinin binds to carbohydrate on the glycoproteins of the epithelial cells of the host; the neuraminidase facilitates the budding of fresh virus from the plasma membrane. To survive, the virus must (because of the strong antibody response by the host's immune system) constantly change the epitopes on the hemagglutinin molecule. It's called antigenic shift, and it's what flu viruses do.

--------------------------
"The differences between 2004 H5N1 from Vietnam and 2005 H5N1 from Qinghai Lake are 18 amino acids in HA and 13 amino acids in NA. Thus, the number of differences between H5N1 in 2004 in Vietnam and 2005 in Qinghai Lake is almost as great as the number of differences between 1997 and 2004, which covers 7 years."
--------------------------
http://www.recombinomics.com/News/08...Evolution.html

[Badly Shaved Monkey]

The unspoken assumption in the doomsday scenarios is that it acquires human-human transmissibility and retains its high pathogenicity. I don't know what the odds are and I've not seen it discussed.

[Bowser]

The current mortality rate isn't 50%. That is the rate of the sickest people who landed in the Asian health facilities. It doesn't account for those who never really manifested any symptoms or recovered on their own.

One of the issues is, being bird flu, it will be very difficult to produce much vaccine, and it will take a while to produce any. If h5n1 hits here this winter, we won't have any vaccine. Meanwhile, China's "husbandry" practices are ensuring that h5n1 will become increasingly resistant to the few available pharma anti-virals. The one that has been most highly lauded, Tamiflu, is in seriously short supply. At least for those of us in the U.S. since the major national order is on long backorder.

Another issue is that this isn't ordinary flu. It is a superflu that can kill otherwise healthy individuals (young adults) by cytokine storm.

To the extent the 1918 Spanish Flu was "doomsday", it had a relatively low mortality rate, but spread quickly and killed very quickly. Flu doesn't need a high mortality rate to be very disruptive.

[Badly Shaved Monkey]

Originally Posted by Bowser

The current mortality rate isn't 50%. That is the rate of the sickest people who landed in the Asian health facilities. It doesn't account for those who never really manifested any symptoms or recovered on their own.

One of the issues is, being bird flu, it will be very difficult to produce much vaccine, and it will take a while to produce any. If h5n1 hits here this winter, we won't have any vaccine. Meanwhile, China's "husbandry" practices are ensuring that h5n1 will become increasingly resistant to the few available pharma anti-virals. The one that has been most highly lauded, Tamiflu, is in seriously short supply. At least for those of us in the U.S. since the major national order is on long backorder.

Another issue is that this isn't ordinary flu. It is a superflu that can kill otherwise healthy individuals (young adults) by cytokine storm.

To the extent the 1918 Spanish Flu was "doomsday", it had a relatively low mortality rate, but spread quickly and killed very quickly. Flu doesn't need a high mortality rate to be very disruptive.

Congratulations. Intelligent and interesting

[Dymanic]

Originally Posted by Badly Shaved Monkey

The unspoken assumption in the doomsday scenarios is that it acquires human-human transmissibility and retains its high pathogenicity. I don't know what the odds are and I've not seen it discussed.

I don't see those as unspoken assumptions; if you haven't seen this discussed explicitly, you may simply not have looked in the right places. The question would seem to be: are those reasonable assumptions?

The human population has no known natural immunity to H5N1 because it is genetically distinct from the three flu strains currently circulating in humans (H1N1, H1N2, and H3N2). Because of this, high pathogenicity is pretty much a slam dunk for the virus once it attains human-to-human transmissibility; maybe not 55%, but still, high.

As for the liklihood of the virus aquiring the capability for human-to-human transmissibility, it's worth keeping in mind that the influenza virus genome has remarkable plasticity because of a high mutation rate and its segmentation into 8 separate RNA molecules. This segmentation allows frequent genetic exchange by segment reassortment in hosts co-infected with 2 different influenza viruses. It's really just a matter of time.

[Badly Shaved Monkey]

Originally Posted by Dymanic

I don't see those as unspoken assumptions; if you haven't seen this discussed explicitly, you may simply not have looked in the right places. The question would seem to be: are those reasonable assumptions?

The human population has no known natural immunity to H5N1 because it is genetically distinct from the three flu strains currently circulating in humans (H1N1, H1N2, and H3N2). Because of this, high pathogenicity is pretty much a slam dunk for the virus once it attains human-to-human transmissibility; maybe not 55%, but still, high.

As for the liklihood of the virus aquiring the capability for human-to-human transmissibility, it's worth keeping in mind that the influenza virus genome has remarkable plasticity because of a high mutation rate and its segmentation into 8 separate RNA molecules. This segmentation allows frequent genetic exchange by segment reassortment in hosts co-infected with 2 different influenza viruses. It's really just a matter of time.

OK, not discussed where I have read about it, but your answer still hasn't answered my conundrum. Are human-human transmissibility virulence factors indpendent of pathogenicity?

[Capsid]

Originally Posted by Badly Shaved Monkey

OK, not discussed where I have read about it, but your answer still hasn't answered my conundrum. Are human-human transmissibility virulence factors indpendent of pathogenicity?

I think it is not known. Nothing about the sequence of the 1918 Spanish flu virus indicated that it was pathogenic.

[Badly Shaved Monkey]

Originally Posted by Capsid

I think it is not known. Nothing about the sequence of the 1918 Spanish flu virus indicated that it was pathogenic.

Your definitive lack of definitiveness seems more reasonable to me than the simplistic predictions.

[Dymanic]

Originally Posted by Badly Shaved Monkey

Are human-human transmissibility virulence factors indpendent of pathogenicity?

Well, since "virulent" and "pathogenic" may be regarded as synonymous, what you are asking is whether human-human transmissibility is independent of virulence/pathogenicity.

The answer (which may not help much) is: yes and no, and (as Capsid has pointed out) we don't know. Does the incomplete nature of our ability to predict the course and strength of an approaching hurricane render any attempts to do so 'simplistic'? We can't know exactly what changes are required to facilitate sustained human-human transmission, nor predict what other changes might accompany such a change. It is of course possible that in aquiring genes from another strain, H5N1 might lose enough of its virulence as to be no worse than a typical flu strain. A category 5 hurricane might also lose much of its strength before making landfall, but counting on that may not be the best bet either. Whatever is not clear, one thing that is is that the world is far less prepared to deal with a major pandemic of any type than was New Orleans to deal with Katrina.

[Badly Shaved Monkey]

Originally Posted by Dymanic

Well, since "virulent" and "pathogenic" may be regarded as synonymous, what you are asking is whether human-human transmissibility is independent of virulence/pathogenicity.

The answer (which may not help much) is: yes and no, and (as Capsid has pointed out) we don't know. Does the incomplete nature of our ability to predict the course and strength of an approaching hurricane render any attempts to do so 'simplistic'? We can't know exactly what changes are required to facilitate sustained human-human transmission, nor predict what other changes might accompany such a change. It is of course possible that in aquiring genes from another strain, H5N1 might lose enough of its virulence as to be no worse than a typical flu strain. A category 5 hurricane might also lose much of its strength before making landfall, but counting on that may not be the best bet either. Whatever is not clear, one thing that is is that the world is far less prepared to deal with a major pandemic of any type than was New Orleans to deal with Katrina.

Small point, when I did microbiology, virulence factors and pathogenicity were different, hence my usage. Virulence factor is a more global term that includes transmissibility whereas pathogenicity specifically refers to the amount of damage done to the host.

[Nobody]

Has it been possible for the authorities to make a rough guess of when this virus will actually spread and cause a pandemic ? Earlier in the year I heard that it was expected to arrive round about now and that there would be a severe shortage of vaccine and anti-virals.

Has a vaccine against H5N1 been developed yet ? If this is the case, is it expected that enough will be ready to avoid spread of the disease to pandemic proportions ? Assuming pharmaceutical companies market Oseltamivir/Zanamivir at as fast a rate as possible, is it expected that there will be enough of these drugs available to treat/prevent infection in unvaccinated or already ill individuals ?

[TobiasTheViking]

Originally Posted by Nobody

Has it been possible for the authorities to make a rough guess of when this virus will actually spread and cause a pandemic ?

I don't think anyone have ever made a prediction like that, or rather, i don't think one have ever come true.

Please provide me with sources if i'm wrong.

[Nobody]

Originally Posted by TobiasTheCommie

I don't think anyone have ever made a prediction like that, or rather, i don't think one have ever come true.

Please provide me with sources if i'm wrong.

It might just have been a rumour. I was just wondering if the virology experts had enough information yet to determine when the pandemic is likely to emerge and hence if there will be enough vaccine and anti-virals available to avert a massive scale disaster.

[TobiasTheViking]

Originally Posted by Nobody

It might just have been a rumour. I was just wondering if the virology experts had enough information yet to determine when the pandemic is likely to emerge and hence if there will be enough vaccine and anti-virals available to avert a massive scale disaster.

oh, theyve made many predictions, based on the information they have, and some made up numbers.

Just like you can prove with the same equation that.
1) there are thousands of other alien races living in our galaxy
2) we are most likely the only race in our galaxy.

We can do that because we don't know the numbers, so we guess. Well, they guess.

But i am eager to be proven wrong, since this is very pesimistic.

[Dymanic]

Originally Posted by Nobody

Has it been possible for the authorities to make a rough guess of when this virus will actually spread and cause a pandemic?

A rough guess? Sure: "Maybe soon".

Quote:

Earlier in the year I heard that it was expected to arrive round about now and that there would be a severe shortage of vaccine and anti-virals.

The regular flu season in the northern hemisphere typically starts anywhere between now and a month or so from now, but as for avian flu, I don't know who would have been willing to stick their neck out far enough to make a specific prediction like that.

Quote:

Has a vaccine against H5N1 been developed yet?

No. There's a bit of a problem with that. It has to do with economics. Drug companies operate on a for-profit basis, and developing and testing vaccines gets expensive. The fact that flu virus is genetically a moving target creates a real possibility that a manufacturer could get stuck holding large quanitites of useless product. The success of each year's flu vaccine is dependent on a mix of educated guesswork and luck, and that's with strains already in the human population. Without the support of public money, commercial enterprises couldn't afford to attempt development of a vaccine.

The NIH has paid Sanofi Pasteur and Chiron, a manufacturer based in Emeryville, California, to make prototype vaccines against H5N1, with the hope that these vaccines would confer at least some resistance against the new strain. They have reported some successful results against current strains of H5N1, but using dosages much higher than the 15 micrograms typical for flu vaccines. The U.S. awarded them a $100 million contract on Thursday, and they expect to report results on low-dosage tests by December.

Quote:

If this is the case, is it expected that enough will be ready to avoid spread of the disease to pandemic proportions?

No. Once the new stain emerges, we're looking at probably six months to develop a vaccine (unless Sanofi Pasteur gets lucky). And even then, worldwide capacity for flu-vaccine production is currently only about 300 million doses per year (depending on whom you talk to, and what constitutes a 'dose').

Quote:

is it expected that there will be enough of these drugs available to treat/prevent infection in unvaccinated or already ill individuals?

Treating and preventing are two very different things. A lot depends on how early an outbreak is identified, on how quickly authorities respond (and on just how much authority they are given) as well as on the availability of resources. If an outbreak was identified early enough, ill individuals could be treated with antivirals, but if it was already rolling, it might make better sense to use 'Draconian quarantine' of those already infected, allocating antivirals first to prophylactic treatment of emergency and health-care workers, etc. The trick is whatever works best to keep the 'R-naught' (or R0) number down; the average number of new infections that one infected person will cause.

[-42-]

Originally Posted by TobiasTheCommie

If they didn't make statements like that(which they do all the time, remember SARS?) then you would never hear about them.

And nothing would be done. It is a game of "Cry Wolf" where you need to do it to get any funding to work with the problems that are real(and just general funding to run the program). And you have to "Cry Wolf" to get the funding, in the end, it will probably bite them, but that is what they are doing.


What is that i'm hearing, uh, a branch broke THERE IS A WOLF.
Oh, i guess not anyways, just a deer.
What is that i'm hearing, uh, a branch broke THERE IS A WOLF.
oh, i guess not anyways, just a cow.

etc.

Of course, i may be pesimistic.

Contractable Disease:
300,000,000+ - Smallpox (20th Century)
200,000,000 - Black Death (worldwide, 1300s)
100,000,000 - Plague of Justinian (Europe 540-590) (disputed)
10,000,000 - 100,000,000 - deaths from diseases in Europe (millions) and the Americas (tens of millions) from diseases exchanged between continents after 1492
50,000,000 - Spanish Flu (worldwide, 1918 - 1919)
19,000,000 - AIDS (worldwide, 1981 - )
10,000,000 - Bubonic Plague (China, 1892 - 1896)
5,000,000 - Antonine Plague Roman Empire 165 - 180
4,000,000 - Asian Flu pandemic (worldwide, 1957)
1,000,000 - Hong Kong Flu pandemic (worldwide, 1968)
130,000 - North American smallpox epidemic (1775 - 1782)
60,000 - Great Plague of London (1665)
775 - Severe Acute Respiratory Syndrome (SARS) (Mostly East Asia, few cases in Europe, Canada and United States, 2002-2003)
677 - West Nile Virus outbreak (North America, 1999 - 2004)


Honestly, as far as contractable diseases go, I think really prefer a 'cry wolf' as opposed to the alternative. As far as the fear tactics, well... I suppose there are worse things to make people afraid of...

[Badly Shaved Monkey]

Originally Posted by Dymanic

A rough guess? Sure: "Maybe soon".


The regular flu season in the northern hemisphere typically starts anywhere between now and a month or so from now, but as for avian flu, I don't know who would have been willing to stick their neck out far enough to make a specific prediction like that.

What would be your comment if I suggest that the lack of reliable human-human transmission now, in mid-October 2005, means that we are likely to have ducked the bullet for this year?

If we have, then, accepting your valid points about the economics and practicalities of vaccine and antiviral production, the likely horizon has been pushed back significantly and we have more time to sort ourselves out.

[TobiasTheViking]

Originally Posted by -42-

Contractable Disease:
300,000,000+ - Smallpox (20th Century)
200,000,000 - Black Death (worldwide, 1300s)
100,000,000 - Plague of Justinian (Europe 540-590) (disputed)
10,000,000 - 100,000,000 - deaths from diseases in Europe (millions) and the Americas (tens of millions) from diseases exchanged between continents after 1492
50,000,000 - Spanish Flu (worldwide, 1918 - 1919)
19,000,000 - AIDS (worldwide, 1981 - )
10,000,000 - Bubonic Plague (China, 1892 - 1896)
5,000,000 - Antonine Plague Roman Empire 165 - 180
4,000,000 - Asian Flu pandemic (worldwide, 1957)
1,000,000 - Hong Kong Flu pandemic (worldwide, 1968)
130,000 - North American smallpox epidemic (1775 - 1782)
60,000 - Great Plague of London (1665)
775 - Severe Acute Respiratory Syndrome (SARS) (Mostly East Asia, few cases in Europe, Canada and United States, 2002-2003)
677 - West Nile Virus outbreak (North America, 1999 - 2004)


Honestly, as far as contractable diseases go, I think really prefer a 'cry wolf' as opposed to the alternative. As far as the fear tactics, well... I suppose there are worse things to make people afraid of...

Ehm, he asked predictions, how many of those were predicted?

And while we are at that SARS was not a pandemic, nor was West Nile Virus.

Of course vaccinations are a good thing, i'm not saying it isn't. I just don't think that we can properly predict it, and i am not convinced that the money is well spent there.

I also don't think they should stop their work, but i do think they should stop their hype.

[Corpse Cruncher]

I maybe wrong; but I thought more people have died of pneumonia this year than the Avian flu?

Perhaps I am missing the point here. How is this flu any worse than the normal stains of flu? Is this one a man-made variant?

[Capsid]

Originally Posted by Corpse Cruncher

I maybe wrong; but I thought more people have died of pneumonia this year than the Avian flu?

Perhaps I am missing the point here. How is this flu any worse than the normal stains of flu? Is this one a man-made variant?

Around 60 people have died in SE Asia so far from this strain (H5N1). It's worse than other flu strains because of its pathogenicity, i.e it kills more numbers of birds/humans than others.

It's not a man made variant, perhaps you are thinking of the reconstructed Spanish flu virus that was reported recently.

[Corpse Cruncher]

Perhaps I was. I just wondered why this Avian flu had the same 'panic' attached to it.

[casebro]

Originally Posted by -42-

Contractable Disease:
300,000,000+ - Smallpox (20th Century)
200,000,000 - Black Death (worldwide, 1300s)
100,000,000 - Plague of Justinian (Europe 540-590) (disputed)
10,000,000 - 100,000,000 - deaths from diseases in Europe (millions) and the Americas (tens of millions) from diseases exchanged between continents after 1492
50,000,000 - Spanish Flu (worldwide, 1918 - 1919)
19,000,000 - AIDS (worldwide, 1981 - )
10,000,000 - Bubonic Plague (China, 1892 - 1896)
5,000,000 - Antonine Plague Roman Empire 165 - 180
4,000,000 - Asian Flu pandemic (worldwide, 1957)
1,000,000 - Hong Kong Flu pandemic (worldwide, 1968)
130,000 - North American smallpox epidemic (1775 - 1782)
60,000 - Great Plague of London (1665)
775 - Severe Acute Respiratory Syndrome (SARS) (Mostly East Asia, few cases in Europe, Canada and United States, 2002-2003)
677 - West Nile Virus outbreak (North America, 1999 - 2004)


Honestly, as far as contractable diseases go, I think really prefer a 'cry wolf' as opposed to the alternative. As far as the fear tactics, well... I suppose there are worse things to make people afraid of...

To which I might add some things that were "Crying Wolf", remember:

Swine Flu?
Ebola?
SARS ?
AIDS? (still a life style disease, NOT in the general population, in First World counties, maybe 3rd world too)
Legionairres?

I think I see a lot of "Let's keep the people scared, they will then pay us to lead them to safety". Don't we see a lot of 're-defining' of diseases to raise 'awareness'? Now GUNS are a 'disease' too?

Can someone re-organise the upper list by date? Seems we just don't have Plagues lately. Isn't confidence in modern health care appropriate?

But then, I am a cynic as well as a skeptic.

[Dymanic]

Originally Posted by Badly Shaved Monkey

What would be your comment if I suggest that the lack of reliable human-human transmission now, in mid-October 2005, means that we are likely to have ducked the bullet for this year?

The optimist in me is happy to agree, noting that my very presence here is in defiance of enormous odds already. The pessimist notes that worldwide surveillance for H5N1 has not really reached an optimum, and laboratory testing to confirm human infection is technically difficult, with some tests producing inconclusive or unreliable results. I think it would be prudent to proceed on the assumption that a pandemic could begin at any time.

Quote:

If we have, then, accepting your valid points about the economics and practicalities of vaccine and antiviral production, the likely horizon has been pushed back significantly and we have more time to sort ourselves out.

However much time we have, I hope we use it well. I hope the lesson from Katrina will inspire large numbers of people to take a pro-active stance; to give thought to what preparations they personally need to make to deal with potential threats to their personal safety, rather than rely on government or anyone else to protect them or rescue them. If you don't work in a hospital, or hold an important government position, or drive an ambulance or a fire truck, you probably aren't one of the people likely to get an issue of antiviral or vaccine, but there may be other things you can do to increase your chances of being among the two-thirds or so of the population that won't become infected with the virus.

I also hope the Chinese don't use the time to breed resistance to Tamiflu into the bug by using it to treat chickens, and I also hope some of the gas station owners who charged twenty bucks a gallon for gas during the recent evacuations won't think of hoarding quantities of it in anticipation of peddling it on the streets for hundreds of dollars per dose once the pandemic starts.

[Capsid]

Originally Posted by Dymanic

If you don't work in a hospital, or hold an important government position, or drive an ambulance or a fire truck, you probably aren't one of the people likely to get an issue of antiviral or vaccine....

The current vaccine is unlikely to protect you against H5N1 anyway.

[Iamme]

On the Robert Scott Bell talk radio show...when I happened to stumble across this show that I never heard before... he was talking about this very flu. He thinks that it is not most likely going to happen, and he spoke on this. Unfortunately, now I can't remember what he said as I was too interested in trying to remember his name while driving and what to say about him when I got here to post. You can call the radio show now if you want and talk to Bell, AND his guest by phone from Kiev, Ukraine...Kevin Trudeau, by calling 1-800-449-TALK. Or, maybe you could find some interesting reading on his website at rsbell.com.

[Iamme]

Originally Posted by casebro

To which I might add some things that were "Crying Wolf", remember:

Swine Flu?
Ebola?
SARS ?
AIDS? (still a life style disease, NOT in the general population, in First World counties, maybe 3rd world too)
Legionairres?

I think I see a lot of "Let's keep the people scared, they will then pay us to lead them to safety". Don't we see a lot of 're-defining' of diseases to raise 'awareness'? Now GUNS are a 'disease' too?

Can someone re-organise the upper list by date? Seems we just don't have Plagues lately. Isn't confidence in modern health care appropriate?

But then, I am a cynic as well as a skeptic.

NOW I remember; Bell brought up the same thing...about SARS, for comparison.

Let's just pray? and hope, that Bell and you are correct in your assertions. I never could figure out why a creator who had the power to create us and all things would allow either a pest or a disease to overwhelm us. Remember..I am not some wacked out fundamentalist, and I ponder these issues as any skeptic would. It sounds so unreasonable to believe that everything under the sun just so happened just because it just so happened. Yet, at the same time, when you hear of the recent Pakistan earthquake, Katrina, the tsunami, 9-11, Black death...etc., one really wonders exactly what this god is that we are dealing with..if there is one. Or, could this be the Bible speaking the truth of this vindictive God that doesn't appreciate the way we are treating the earth and behaving on the earth, and we are in the prophesized 'end days'? If you want to get into this further, there are the apropriate threads, of which I am a part, over in the religion and philosophy forum.

[luchog]

Originally Posted by casebro

To which I might add some things that were "Crying Wolf", remember:

SARS ?

SARS was identified early, and major efforts were made to isolate and quarantine any outbreaks; including stepping up hospital safety and disease identification procedures in areas with a significant number of Asian immigrants and travellers. Without that reaction, it could have been far, far worse. I had aquaintances working in Vancouver, BC hospitals during the outbreak; and they were really coming down hard on safety procedures.
[/quote]

Quote:

AIDS? (still a life style disease, NOT in the general population, in First World counties, maybe 3rd world too)

AIDS is not a "lifestyle" disease. And it is becoming a major problem in the Third World; not exclusively from sexual contact, but through other avenues, such as poor safety procedures in hospitals. Plus, the lack of testing availble makes it more likely that the disease will be passed on before it is detected. The highest infection rate is currently in adult heterosexual females.

The only reason that it hasn't become the sort of pandemic that various Flu strains have is it's extremely low transmissibility. It can only be transmitted through direct, significant exchange of bodily fluids, and the virus cannot survive for more than brief periods outside the human body or a similarly hospitable environment. Influenza virii are highly transmissible, in several different modes, including airborne; and can survive for significant periods outside the body or similar host environment.

Quote:

I think I see a lot of "Let's keep the people scared, they will then pay us to lead them to safety". Don't we see a lot of 're-defining' of diseases to raise 'awareness'? Now GUNS are a 'disease' too?

There's a huge difference between the two. Guns as a "disease" is a meaningless semantical construct, and is created purely for propaganda purposes; the actual problem is cultural and in no way analogous to a true disease. It is, at best, junk science. Influenza viruses, however, are a true disease, by the accepted medical definition; and carry a well-documented and quantifiable risk. The "scare tactics" are based on a scientific evaluation of that risk. It is not an exact science, and there is still a lot that we do not know, and cannot possibly predict with a high degree of accuracy (being based on random natural processes). However, we do know enough to be able to calculate probabilities with a reasonable amount of accuracy, and base our responses on those probabilities.

[Dymanic]

Originally Posted by Iamme

On the Robert Scott Bell talk radio show...when I happened to stumble across this show that I never heard before... he was talking about this very flu. He thinks that it is not most likely going to happen, and he spoke on this.

LMAO!

Good one.

[RandFan]

Originally Posted by luchog

AIDS is not a "lifestyle" disease.

...

It can only be transmitted through direct, significant exchange of bodily fluids, and the virus cannot survive for more than brief periods outside the human body or a similarly hospitable environment.

I personally would not call it a lifestyle disease but I'm curious, what percentage of aids is transmitted via sexual intercourse?

[casebro]

Originally Posted by luchog

The highest infection rate is currently in adult heterosexual females.

I think you have that wrong- I believe it goes "The group with the fastest rate of increase is heterosexual females". And that statistic may be out of date, it could have leveled off by now. Isn't the overall rate in the US something like 1:5,000? With a prety stable number now? Does the word "Epidemic" even apply?

I guess any infectious disease could mutate and spread like wildfire through what has become a world wide mono-culture of humans. Tuberculosis, pneumonia, chicken pox, mumps, could all mutate. And each kills more people today than Avian flu, or Ebola, or SARS, or "Flesh Eating Bacteria"....Whats to get head up about with the disease o'the day?

[Badly Shaved Monkey]

Originally Posted by casebro

Whats to get head up about with the disease o'the day?

(I don't normally bother with grammar errors, but you might genuinely be interested that the word "head" in that sentence should be "het", if I am grasping your meaning correctly)

[Bowser]

h5n1 is most certainly not part of this year's vaccine, and I doubt it will be part of next year's either. The limited h5n1 vaccine eventually available will be a two-shot series and unlikely to be combined with anything else.

h5n1 is endemic in the wild bird population. It has caused major dieoffs among the wild populations, and it is being spread via migration. Domestic fowl are vulnerable to exposure to wild birds, for instance from droppings. It does not appear possible to isolate h5n1, so we have to hope that the strains are not nearly so virulent.

Even if h5n1 becomes viable this year, its success may not be a good indicator of what happens in future winters. The 1918 flu started off slowly; it was not a major killer until at least the second year.

[drkitten]

Originally Posted by Adrian

I just don't get the logical jump from 110 cases to a billion? There have been human cases of H5N1 even before 1997 and it has not yet mutated into a human-to-human disease.

Yes, that's exactly why there haven't been a billion cases yet.

At the risk of indulging in a bit of hyperbole -- either the virus is capable of being transmitted easily from human to human, or it isn't. Mutations either happen or they don't, but you never get 2/3 or a mutation. In the case of the influenza virus, we know more or less what a typical transmission pattern looks like -- and H5N1 doesn't display it. Yet.

One way of looking at it that may help. We know of a plausible scenario where H5N1 causes a few dozen cases per year -- that's basically the current situation. We also know of a plausible scenario where H5N1 causes a billion cases per year -- that's the scenario where H5N1 acquires a more typical influenza-like transmission pattern (which it could easily do via it's high mutation rate, or via gene-swapping with other strains of flu). I can't come up with a plausible situation where H5N1 causes 10,000 cases per year. For H5N1 to increase in transmissibility enough to cause 10,000 cases would almost require easy human-to-human transmission capacity, but as soon as you get that, you're back to the billion case scenario.

Normally a billion cases of flu a year aren't a problem -- they're typical. But the death rate from "normal" strains of flu isn't anywhere near 50%. That's the problem. H5N1 is different from normal flu in two major ways -- it doesn't transmit from human to human well, and it kills a hell of a lot of its victims. When those two ways drop to one.... well, that will be a problem.

[geni]

Originally Posted by casebro

I think you have that wrong- I believe it goes "The group with the fastest rate of increase is heterosexual females". And that statistic may be out of date, it could have leveled off by now. Isn't the overall rate in the US something like 1:5,000? With a prety stable number now? Does the word "Epidemic" even apply?

The US is a pretty small percentage of the world population. Looking at international rate it appears that the word Epidemic does apply.

Quote:

Tuberculosis, pneumonia, chicken pox, mumps, could all mutate.

They all have a pretty low mutation rate.

[alfaniner]

Why is this one so much worse than the regular flu?