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H5N1 migrated through the Middle East and into Africa in the fall and winter. Although a number of countries in Africa (Egypt, Nigeria, Niger, Burkina Faso) and the Middle East (Turkey, Azerbaijan, Iraq, Iran, Israel, Jordan) have confirmed H5N1, many others have not.
The countries failing to identify H5N1 reveal severe deficiencies in monitoring. Many of these countries report hundreds or thousands of negative tests results, but the countries fail to detect low pathogenic bird flu, which is common in migratory birds world wide. These false negatives highlight monitoring shortfalls, which are not being addressed.
January 2006. The World Health Organization (WHO) ...document summarizes the course of bird flu in its two-year spread across Eurasia. In regard to the human cases that have appeared in six nations, the fact sheet points out some puzzling unknown factors. Human cases of disease have not appeared in commercial poultry enterprises or culling operations, as might be expected. Instead, the majority of cases have stricken previously healthy children and young adults exposed to small flocks kept in domestic settings. ...The document also describes physicians’ observations about the “unusually aggressive clinical course” of the disease in humans.
In poultry, the viruses cause two distinctly different forms of disease - one common and mild, the other rare and highly lethal. In the mild form, signs of illness may be expressed only as ...mild effects on the respiratory system. Outbreaks can be so mild they escape detection unless regular testing for viruses is in place. ...highly pathogenic avian influenza is characterized by sudden onset of severe disease, rapid contagion, and a mortality rate that can approach 100% within 48 hours. In this form of the disease, the virus not only affects the respiratory tract, as in the mild form, but also invades multiple organs and tissues. The resulting massive internal haemorrhaging has earned it the lay name of “chicken Ebola”.
THE DISEASE IN HUMANS ...To date, not all human cases have arisen from exposure to dead or visibly ill domestic birds. ...In many patients, the disease caused by the H5N1 virus follows an unusually aggressive clinical course, with rapid deterioration and high fatality. Like most emerging disease, H5N1 influenza in humans is poorly understood. ...the current picture could change given the propensity of this virus to mutate rapidly and unpredictably.
The incubation period for H5N1 avian influenza may be longer than that for normal seasonal influenza, which is around 2 to 3 days. Current data for H5N1 infection indicate an incubation period ranging from 2 to 8 days and possibly as long as 17 days. However, the possibility of multiple exposure to the virus makes it difficult to define the incubation period precisely. WHO currently recommends that an incubation period of 7 days be used for field investigations and the monitoring of patient contacts.
Initial symptoms include a high fever, usually with a temperature higher than 38oC, and influenza-like symptoms. Diarrhoea, vomiting, abdominal pain, chest pain, and bleeding from the nose and gums have also been reported as early symptoms in some patients. ...Watery diarrhoea without blood appears to be more common in H5N1 avian influenza than in normal seasonal influenza. The spectrum of clinical symptoms may, however, be broader, and not all confirmed patients have presented with respiratory symptoms.
The World Health Organization (WHO) has officially certified that the disease known as influenza A type H5N1 now is endemic among birds and animals in Asia.
Conclusion ...If nothing else, we hope to raise the consciousness of citizens around the world in an effort to support the urgent endeavours of the public health and medical professionals. Governments must take the lead in providing funding to all regions of the world, particularly the poorest nations of Asia. In today's world, the economy is borderless and so are public health and terrorism risks. Forget the "each man for himself" psychology of protectionist and anti-globalization rhetoric. Like it or not, we are all in this together, and we are all dragged downward by the weakest links.
TOM CLARK: There's a new warning tonight about the dangers of avian flu but it's not coming from doctors. It's from bankers. Financial experts are urging Canadian businesses to work with governments to prevent its spread. They say that if bird flu blows into a pandemic, it could mean financial catastrophe. CTV's medical specialist Avis Favaro explains.
AVIS FAVARO (Reporter): The avian flu spreading through Russia and China is not only a health concern, it poses a financial threat. In what's thought to be the first of its kind comes this report, an investors' guide to avian flu. If bird flu becomes a contagious human disease, how that could hit Canadian businesses and the investor portfolios.
SHERRY COOPER (BMO Nesbitt Burns): I'm not trying to assess the probability of a pandemic, but it's out there and it's frightening.
FAVARO: Sherry Cooper and a team from BMO Nesbitt Burns projects that if a pandemic happened, the world economy would slow dramatically, stock prices would plunge, there would be travel restrictions, many employees would stay hope, that is if they still have one.
COOPER: Housing prices would collapse, partly because there will be individuals who can't work, aren't subsidized by large corporations, therefore wouldn't have income, wouldn't be able to make their mortgage payments.
FAVARO: According to the report, those who have hoarded cash could then buy property cheaply. That's why it suggests Canadians invest conservatively and reduce debt.
COOPER: Stop buying things that you can't afford to buy. Pay down your debt.
• Plans to deal with an influenza pandemic need to be founded on widely held ethical values, so that people understand in advance the kinds of choices that will have to be made. Decision makers and the public need to be engaged in the discussions about ethical choices, so plans reflect what most people will accept as fair, and good for public health.
• The Pandemic Influenza Working Group at the University of Toronto Joint Centre for Bioethics (JCB) has developed a 15-point ethical guide for planning and decision-making for a pandemic.
• The JCB Working Group has identified four key ethical issues that need to be addressed in pandemic planning, and made specific recommendations for each. The four major issues are:
1. health workers’ duty to provide care during a communicable disease outbreak;
2. restricting liberty in the interest of public health by measures such as quarantine;
3. priority setting, including the allocation of scarce resources such as vaccines and antiviral medicines; and
4. global governance implications, such as travel advisories.
• The JCB Working Group recommends that all pandemic plans have an ethical component, and offers the ethical guide contained in this paper for use in Ethical considerations in preparedness planning for pandemic influenza developing such a component.
When an influenza pandemic strikes the world many people, ranging from government and medical leaders to health care workers, will face a host of difficult decisions that will affect people's freedoms and their chances of survival. There will be choices about the level of risk health care workers should face while caring for the sick, the imposition of restrictive measures such as quarantines, the allocation of limited resources such as medicines, and the use of travel restrictions and other measures to contain the spread of disease.
Governments and health care leaders have been working on pandemic plans in many parts of the world. However, most of their communication to the public has focussed on technical issues, such how to obtain, stockpile and distribute medicines, and the assignment of duties.
Planners have not generally communicated the ethical underpinnings of their choices in a clear manner. But ethical issues have surfaced in public debates, often in the news media. Should people purchase their own stockpiles of antiviral drugs such as Tamiflu, or should they accept governments’ decisions on how to allocate such medications? When medications are distributed, should children come before or after health care and emergency services workers, or decision makers such politicians?
Government and health care leaders need to make the values behind their decisions public. They should discuss the values with people who could be affected, ranging from health care workers, who will find themselves on the front lines, to government officials, who are making decisions about the allocation of limited resources, to the public at large, because people will be affected in many ways. They need to do this in advance of a health crisis, not when people are lining up at emergency ward doors.
Openly discussing the choices and confirming that they are based on ethical values that are shared by members of a society brings important benefits. If ethics are clearly built into pandemic plans in an open and transparent manner, and with buy-in from multiple sectors of society, the plans carry greater trust, authority and legitimacy. Advance discussions of such issues can help to address fears of the unknown. People will be more likely to cooperate, and accept difficult decisions made by their leaders for the common good. It is a goal of this paper to provide guidance and to spur a broad public discussion of the
often difficult ethical issues underlying decisions.
The inaction and lackluster response of government officials and planning has made this planet a potential powder keg of death. Poverty, exploitation, corruption, partisan politics, bureaucracy, profit…these are just some of the words to describe what humans have done to combat the most deadly disease known to man. Scientists and researchers have been saying for years that this was around the corner. In fact a corner that was well known to hit about every 30 years.
April 18, 2006 - On Tuesday, May 9 (8:00-10:00 p.m., ET), ABC will bring to television a two-hour original movie. "Fatal Contact: Bird Flu in America" follows an outbreak of an Avian Flu from its origins in a Hong Kong market through its mutation into a virus transmittable from human to human around the world.
The meticulously researched film stars Joely Richardson ("Nip/Tuck"), Stacy Keach ("Prison Break," "Blackbeard"), Ann Cusack ("Grey's Anatomy," "Ghost Whisperer"), Justina Machado ("Six Feet Under"), Scott Cohen ("Street Time," "Law & Order: Trial by Jury") and David Ramsey ("All of Us").
...The film deals with the current threat of the Avian Flu virus (H5N1). Scientists continue to debate the degree to which the virus can mutate and be easily passed among human beings.
Originally posted by soficrow
Mauddib - I collect information and I think. I don't say I know "the truth."
I simply state the obvious, with a qualifier like "it seems" or "apparently."
I am not clear where your problem lies. ...
In what appears to be a reversal of previous policy, the head of the US Centers for Disease Control (CDC) Julie Gerberding, says that "there is no evidence that it will be the next pandemic, commenting about avian flu. This article in the Tacoma News Tribune says that the remarks were made during a pandemic flu conference that drew 1,200 people from across the state, mostly health department officials and others involved in emergency planning.
... Gerberding noted that, though the disease has killed “gazillions of birds,” it has killed about 100 people out of about 200 sickened worldwide. The victims were in intense, daily contact with sick flocks, often sharing the same living space. Two people have become infected from person-to-person contact.
She did not say what had changed the thinking of health care officials about bird flu, but said that, at this point, there is “no reason to think it ever will” pass easily between people."
Originally posted by dgtempe
In a very strange twist in events, here is the latest for all of you to ponder:
CDC Says Bird Flu Not Serious Threat to Humans!!!!!
Is this woman a liar? Why would she LIE to emergency management?
The first cases of bird flu in the United States could show up in the next few weeks with the spring bird migration.
In preparation the Bush administration has drafted a plan that spells out in detail how the government would respond to a pandemic that could claim close to two million American lives and possibly overwhelm the U.S. health care system.
REPORT - Bird flu plans unaffordable, US hospital heads say
WASHINGTON, April 18 (Reuters) - The U.S. government may be urging local officials and hospitals to get ready for a bird flu pandemic, but top hospital executives said on Tuesday they cannot do everything that is being called for. ..."If the federal government doesn't help run this, it really isn't going to go well," Dr. Frank Peacock, who heads emergency preparedness at the Cleveland Clinic in Ohio, told a conference.
"We don't know when it would come. But we do know that we are overdue and underprepared," U.S. Health and Human Services Secretary Mike Leavitt told the emergency preparedness conference sponsored by U.S. News & World Report magazine. ...Experts say the United States and other countries have too few drugs, supplies such as latex gloves, or even equipment such as ventilators to deal with a pandemic of a respiratory virus.
As he has been doing for months, Leavitt said people need to be prepared on an individual and local level and cannot expect much immediate help from the federal government. ...Preparedness could come down to more than having the medical equipment. ..."We may not have the staff needed to run those ventilators adequately," said Vicki Running, who heads disaster planning at Stanford University Medical Center in California. ...Day-to-day business is already overwhelming hospitals, according to Running. "We are operating at capacity," she said. ...And the for-profit health care industry allows no fat.
"Those patients are going to get some morphine and get sat in a corner. That is the definition of a disaster -- need exceeds resources," Peacock said. ...Then health workers will turn to patients who are more easily helped, and the very sickest may have to be allowed to die as comfortably as possible, he said.
Fear of damage to the economy, and precipitation of a national and possibly global recession. It is widely predicted the BF in birds will reach the US anytime very soon – weeks – if it has not arrived already.
In each country where BF has been confirmed in birds, the poultry industry has gone to a state of near collapse, or has in fact collapsed. In itself, the knock on effects to both the local economy, and thereby the international economy are very severe. Chicken is a major source of protein in most of Asia, Africa, India etc – and prices of other meat sources have increased in some cases by as much as 100% and more. This is having knock on effects on every economical aspect - from reduced amounts of disposable income in local economies (= less exports from the US) to reduced tourism etc and populations anger at govt. measures taken for containment and control. It is proving to be very politically destabilising in some countries, especially where the population just does not understand why all their birds are being taken from them and killed with no or very little compensation, and in most of these countries every family has a few chickens.
Now the prevailing consideration in both the US and the EU will be to stop similar economic consequences in their domestic markets. Italy and Germany have seen its poultry industry collapse already as consumers have reacted by avoiding chicken products and eggs.
If the US govt stops telling people in the US to stockpile 6 weeks supply of food and meds for general preparedness planning (and some states are suggesting 3 months worth) then it is more likely that there is something afoot within the virus that means that they perceive a lower risk from it than previously. ‘Watch what they do, not what they say’ is a good philosophy here. As yet, this advice in US state pandemic preparedness plans is still very much there, as is the advice on the HHS website. There is also increasing govt led activity with infrastructure organisations such as water supply, electricity, food movement and the like in both the EU and the US. This does not suggest that they perceive a lower risk. Increased monies have also been made available for IV bags, drips etc used by hospitals so that supplies can be built up.
Originally posted by dgtempe
But, this has NOT jumped from human to human....
I still think its fear mongering for the most part.
While Dr. Marc Siegel provocatively highlights the vexing uncertainties surrounding the bird flu, his perspective is a narrow one. The potential public health menace posed by pandemic influenza encompasses far more than the H5N1 bird flu.
In addition to the multiple H5N1 bird flu strains presently of concern, many other forms of influenza viruses exist, and the next human pandemic could spring from any of them. The overwhelming expert consensus remains that whether or not it happens that a H5N1 bird flu strain sparks it, an influenza pandemic is inevitable. If bird flu is suppressed somehow or fortuitously fades away, it is imperative to recognize that the underlying danger of pandemic influenza does not depart with this virus.
The perverse quandary is that even an unexpected and welcome quick exit of the H5N1 virus, an event that could offer the much-needed breathing room to bolster our defenses, might actually prove perilous if it leads the public to the erroneous conclusion that all threat has passed. ...In that event, H5N1 bird flu could claim its most significant and ultimately tragic casualties: political support and financial wherewithal for emerging global programs to combat the permanent menace of pandemic influenza.
Microbes are becoming resistant to antibiotics due to environmental pollution, overuse of antibiotics, and antibacterial agents.
Mechanisms of spread of antibiotic resistance
Antibiotics do not, in themselves, cause resistance. Instead, they allow naturally resistant variants within a population to survive and reproduce while those individuals without the resistance factor die. Once in a bacterial population, antibiotic resistance can spread rapidly. Even unrelated bacteria can gain resistance from their neighbors in a phenomenon called horizontal gene transfer. Resistance to antibiotics is encoded in DNA, the genetic blueprint for life. Bacteria are able to exchange DNA, especially in the form of plasmids (small, self-replicating circles of DNA) and pass resistance very rapidly.
Conjugation. Bacteria can fuse and exchange plasmids and sometimes chromosome fragments. Increase in mobilizing plasmids has been associated with use of antibiotics in swine husbandry. These plasmids have a broad host range and are able to cross genus lines during transfer.
Transfection. Viruses can infect bacteria and fungi, passing along genes from one infected organism to the next. These genes sometimes encode resistance factors. The use of antibiotic growth promoters in animal husbandry may increase the amount of free phage in intestines and may contribute to the spread of antibiotic resistance.
Transformation. When a bacterium lyses in its environment, any other actively-growing bacteria in that vicinity can pick up its DNA. This is another mechanism of resistance spread, since plasmids (including resistance or R plasmids) are more easily used by the recipient bacterium than chromosomal material.
According to the Center for Disease Control (CDC), approximately 70 percent of infections that people get while hospitalized are now resistant to at least one antibiotic. Resistance to antibiotics is rapidly outpacing our ability to synthesize new drugs.
Environment Literacy Council provides basic information about antibiotic resistance with several notable links to learn more about the problem.
Overview of the issue by the Union of Concerned Scientists, with links to useful information such as the consumer's guide to antibiotic-free meat.
Microbiology portal. Microbes.info is a good starting point for finding information concerning microbiology.
"Antimicrobial resistance issues in animal agriculture" pdf.
This extensive paper has contributors within the USDA including Animal & Plant Health Inspection Service, Veterinary Services, Centers for Epidemiology & Animal Health, and Center for Emerging Issues. It evaluates available data on the use of antibiotics in animal husbandry both in the US and overseas. There is also a discussion of the Swedish ban on the use of antibiotic growth promoters in animal. (USDA-APHIS, December 1999).
"Emergence of a debate: Antibiotic growth promoters and public health". An article by A. Bezoen, W. Van Haren, and J. C. Hanekamp (1998). Part I introduces the issue and assessing the risk, and explores the use of antibiotics and resistance mechanisms. Part II discusses bacterial antibiotic resistance and human health and prevalence of bacteria resistant to antibiotics.
"The rise of antibiotic-resistant infections" An article by Ricki Lewis, Ph.D. in the US Food and Drug Administration (USFDA) Consumer Magazine from 1995 reviewing the problem of antibiotic resistance and the mechanisms by which bacteria become resistant to antibiotics and other environmental chemicals.
The Middle East is shaping up for the Third World War per Richard Mayberry's prediction some years ago if we invaded Baghdad, reflecting eighty-eight separate tribal factions guaranteeing a civil war that would in time engulf the region... highlighted by the fall of America's puppet House Of Saud and knighting of thousands of martyrdom warriors into the fray (Ben Ladin might be spilling family blood on this front right now judging by oil production sabotage).
But world war pales in comparison to my continuing monitoring of H5N1. Out of a universe of over 2,500 bird flu genomes identified and mapped to date only two contain the extra protein tag that makes slaughter of human beings, viral strains H1N1 with its 5% kill rate in 1918 and 'kissing cousin' H5N1 with its best case scenario, ameliorated 50% kill rate. Gold will explode but it won't count for much if H5N1 comes to town because in 2-7 days the pandemic will be on every continent and there aren't and won't be any vaccines. Ergo the reason behind all the media silence. What's the point?
"It is clear that the H5N1 problem originated from outbreaks in poultry and that the outbreaks and their geographical spread probably cannot be stopped without implementation of proper control measures in the global poultry industry," Fouchier's team wrote.
"Poultry trade and mechanical movement of infected materials are likely modes for spreading highly pathogenic avian influenza in general," they added. ..."It is most likely that the H5N1 virus has circulated continuously in domestic birds in Southeast Asia since 1997 and, as a consequence, has evolved substantially," they wrote.
Something must have changed, experts agree. H5N1 has been around in birds since 1959 and a 1997 outbreak in Hong Kong, in which 18 people became infected, was quickly stopped with merciless culling and disinfection of bird markets. ...But it re-emerged in 2003 and has accelerated its spread.
The experts suggested that the spring migration may not spread the virus much. Water fowl seem most susceptible to infection when they are young, and they cited studies showing that the viruses are more common in birds in the autumn and less common in the spring.
No need to cull wild birds to stop birdflu: expert
...China made several commitments, including an agreement to drop a mad cow disease-related ban on imports of U.S. beef.
State health officials are ready to air a media campaign upon the first reports of avian flu in New York to extinguish any flare-up of public panic.
Officials said the ads stress that the appearance of a bird infected with the H5N1 virus does not mean an outbreak in humans is looming.
The campaign, which includes print, radio and TV spots, will run in the late summer or early fall as a precursor to the regular flu season regardless of whether avian flu surfaces in the state. The ads will run sooner if reports of avian flu surface before then.
Homeland Security Council member Ron Dolin did not mince words when he told members of the New Mexico Press Women's Association, "We only get one chance to get this right," that "our health, economy, society and government are all at risk" and "this looming catastrophe does not come with a reset button." ...Dolin said it is not certain that the flu will make the jump from human to human but is quite likely. ...Right now, there is no vaccine to prevent the disease.
He explained that during the pandemic, the role of the federal government would be to provide continuity of government. ...When it hits American shores, Dolin said the government would not address the pandemic at the local level but rather concentrate its efforts on maintaining the country's infrastructure. ..."The number one critical infrastructure on line is the Internet," Dolin said. "Our nation is tied globally to Internet, as is communication and commerce." ...Retired federal employees might be summoned back to work, he said adding that the National Guard would have to be used to squelch "insurrection." ...The Department of Homeland Security has the overall authority, however, Dolin said the president is the person in charge. ...In addressing why there would be an insurrection, he explained that individuals would choose to take care of themselves and their families and would not want to risk exposure to the flu in order to keep law and order.
...containment of the flu will merely postpone the inevitable; 40 percent of the U.S. workforce can be expected to be out during a pandemic, he said. Members of the workforce will be sick or dead, others depressed, caring for loved ones or staying at home to prevent spread of the virus. ...The incubation for bird flu is one-four days with an average of two days. Viral shedding and the risk of transmission will be greatest during the first two days of illness, he said. ...Outbreaks will last some six-eight weeks in each community. Multiple waves may occur with each wave of illness lasting two-three months.
The return of warmer weather to the northern hemisphere is unlikely to bring a let-up in the deadly H5N1 virus since it is already endemic in poultry flocks in several parts of Asia, experts say. ...Scientists previously found the bird flu virus to be most active from October to March when temperatures are cooler or below 20 Celsius (68 Fahrenheit), but now they are warning against any complacency with the return of summer.
"I don't think it will go away in the summer months, it will continue to be in poultry," said Hong Kong microbiologist Malik Peiris, who has studied the virus since 1997, when it made its first known jump to humans in Hong Kong, killing six people. ..."The virus has been persisting in quite diverse climates, such as Indonesia, where it is hot ... to a large extent it has been maintained in poultry flocks."
Although the number of human infections from birds is low at 204 cases, 113 have died and some experts say just a few mutations are needed for the virus to transmit among people, triggering a pandemic. ...the lower rates do not mean the virus has attenuated. ..."In most places in Asia, it is only those which are severely ill that get picked up for investigation. Those with mild flu-like disease are not. You don't see the milder cases of H5N1, that skews your rate of severity and mortality," Peiris said.
Originally posted by loam
Mil d form of bird flu found in New Jersey...
Thus it begins....
Authorities have discovered a mild form of avian influenza at a live bird market in New Jersey, but it is not the deadly H5N1 strain governments around the world are trying to contain, the state's agriculture department said.