A killer race
It's in the news. People are dying from a relative of the 1918 Influenza virus half a world away, and scientists fear it may be the next pandemic. Sounds like science fiction, or the latest box-office smash, right? Unfortunately, it's real, and is happening right now.
chickens: (Photo courtesy Laura Hadden)
In Southeast Asia, a virus known as avian influenza or avian flu has the potential to spread and kill humans with terrifying speed. Avian flu is also known as H5N1 for the proteins that bind, infect, and destroy its host cell to thrive. Chickens can die within hours of exposure, swollen and hemorrhaging, but it is just as lethal to mammals from lab mice to tigers. The virus has decimated bird flocks in 11 countries mostly in Asia, and has killed 62 people (half the known cases) to date, with highest fatalities occurring in Vietnam, Cambodia, and Thailand. So far, nearly all people infected contracted the sickness directly from infected poultry and at this point there is no confirmed evidence of efficient human-to-human transmission. However, health authorities fear that the H5N1 strain will likely mutate into a pathogen easily passed between humans if it continues to persist in the environment. If that happens, and authorities believe it's only a matter of time, the world could face a catastrophic pandemic.
Many health organizations and governments are stockpiling a drug (Tamiflu) to protect against this potential pandemic, but scientists are reporting that a strain of H5N1 avian flu virus is showing resistance to the antiviral drug. Scientists are working to avoid this disaster by detecting changes in the evolving H5N1 virus. As a first step, scientists have rebuilt the 1918 flu-a disease that killed as many as 50 million people-from pieces of genetic material retrieved from the lungs of people who died 87 years ago. Gene-swapping experiments are starting to give scientists some clues in the lab. When small substitutions were made, the reconstructed virus could no longer replicate in the lungs of mice, kill animals, or attach itself to human lung cells.
So far H5N1 has not yet learned the trick of racing from person to person like the ordinary flu and maybe never will. Nevertheless, experts fear that the risk could materialize and are urging the world to prepare for the worst.
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Outbreaks of disease in poultry flocks in Turkey and Romania have experts fearing that H5N1 bird flu has reached Europe. But scientists don't yet know for sure whether or not the disease in these two outbreaks is, in fact, even avian flu, much less the strain that everyone is worried about.
Aside from the obvious threat to domestic poultry flocks, virologists are afraid that the H5N1 flu will mutate from its current form, in which the virus is transmitted from birds to people, to a new, scary form in which the virus jumps from person to person directly.
I dont want to DIE!!
The outbreaks of avian flu in Romania and Turkey were caused by avian flu, and new cases have been found in Greece.
Some countries are starting to stockpile Tamiflu, the antiviral drug that may help people infected with the flu. But at least one human case of the bird flu has proved resistant to Tamiflu. Another drug that may be useful is an antiviral called Relenza.
Antivirals aren't vaccines; they don't keep people from getting sick in the first place, but they can help keep the virus from replicating itself so explosively. Antivirals will be useful in the early stages of any outbreak, as it will take time to create and distribute a vaccine and for people to develop immunity.
A drug manufacturer in India has announced that it will be making a generic version of Tamiflu, in spite of the fact that the drug is still protected by a patent. (The Indian generic drug will not be sold in the West.)
The US FDA is discussing the safety of Tamiflu use by children after reports of 12 deaths in Japan. (Tamiflu has been widely prescribed and used in Japan for influenza cases.)
The FDA notes, however, that they don't have enough information to prove that Tamiflu caused the deaths. The fatalities could have been caused by encephalopathy, a complication of influenza itself.
Preliminary tests detected the H5N1 strain of bird flu in samples from an area south of Moscow where hundreds of birds died suddenly.
The Chinese government reports that 2,600 birds have been found dead of the same strain of bird flu in the Inner Mongolia region.
Officials also said that they fear an outbreak in Macedonia, where a large number of birds have died.
And the risk of bird flu spreading to the Middle East and Africa, carried by migratory birds, has grown with the confirmation of the Turkish and Romanian outbreaks.
Despite the bird deaths, the European Center for Disease Prevention and Control is downplaying fears of the H5N1 flu spreading to humans. They told people not to touch dead birds, and to only eat well-cooked eggs or poultry. Zsuzsanna Jakob, head of the agency, said:
Officials at the agency are planning to hold a simulation exercise of a flu pandemic by the end of the year to improve their preparedness.
And the World Health Organization is recommending that governments stockpile enough antiviral drugs to treat 25% of their populations.
Scientists fear that migrating birds from Europe and Asia carrying the H5N1 virus will arrive in Africa's Rift Valley (Ethiopia, Kenya, and Tanzania) between December and early spring.
Because of the lack of money and scientific infrastructure in those countries, the virus could easily become widespread in the environment and on farms before it's detected. And because people in this area live in close proximity with animals, there's a very real possibility that the human influenza virus and the avian flu could mix, perhaps giving the avian virus the ability to spread easily from person to person.
Once outbreaks of avian flu were discovered in Asia and Europe, authorities killed millions of birds in attempts to stop the spread of the disease. But in Africa, a family's chickens often aren't a commercial product but a crucial source of protein. Officials warn that poor farmers may not report dead birds for fear of losing their chickens. Or they might slaughter birds (to eat them or to sell them in local markets) before public health workers can examine them. (Eating cooked birds isn't dangerous, but touching infected birds before they're cooked could infect humans.) And, of course, taking sick birds or their bodies to markets could infect other birds, spreading the animal disease and making a human one more likely.
The United Nations says it will help countries in Africa step up their surveillance to try and prevent epidemiologists' worst-case scenario.
China reported four more bird flu outbreaks in Liaoning province in the last two weeks. Experts fear that counterfeit vaccines are being sold in the province, and that millions of birds haven't been properly protected against the virus. (Yes, a vaccine is available for birds. Why isn't a vaccine available yet for people? Read this.)
Bird flu is real, and a potential catastrophe. But will it be a worldwide pandemic? At least one doctor says no.
Dr. Patrick Cunningham, an Assistant Professor of Medicine at the University of Chicago, argues "there will never be another 1918." Many factors contributed to the mass fatalaties of that outbreak--poor sanitation, crowded living conditions, generally poorer health and nutrition, etc. These factors have been greatly reduced, at least in the West.
Make no mistake--bird flu is a serious threat, especially in underdeveloped parts of the world. But Dr. Cunningham believes it is unlikely to match the flu of 1918, at least here in the US.
The conditions for a serious flu outbreak still exist in many parts of the world where a pandemic is most likely to originate. I find shrugging off the potential seriousness of this strain of virus because it may infect and possibly kill fewer people in the US than in the rest of the world to be a bit ruthless. Are our lives more valuable than those in other countries?
I don't believe Dr. Cunningham is shrugging off anything. He recognizes the serious threat posed by avian flu. However, that threat is not equal in all parts of the world. We in the US probably have less to worry about. (Note: that's less to worry about, not nothing to worry about.) Working the public into a panic is not a good thing. Focusing attention and resources on places that are more vulnerable, is.
It is true that the fatality rate would be much less in America than undeveloped areas of the world. According to Mike Osterhome, disease researcher, we could loose 1-2% of our population (still in millions). While that death rate is nothing to snuff at, the major problem will be in how the population reacts w/ mass hysteria and our country shutting down to the point where basic services are threatened. That is why it is so important to plan now!
Cunningham says,
But the aspect of the 1918 flu that many doctors and scientists found so puzzling and scary was that the virus hit the very young and the very old, as expected, but also took out a surprising number of healthy adults in their prime. (The mortality plot of the 1918 flu looks like a "W", with peaks at the ends and in the middle.)
He's probably right, in some ways. Some virologists think that the 1918 outbreak began in the giant, crowded camps set up to train soldiers for World War II, and traveled around the world with the soldiers. There isn't a mass mobilization of that scale anywhere in the world today. Many people who didn't die of viral pneumonia later developed bacterial pneumonia; in 1918 there were no antibiotics, but obviously we have very good ones today. And SOME people probably are less crowded, better nourished, and have better access to medicine. But not everyone. And, as is the case with many infectious diseases, the threat to the least fortunate is a threat to all of us.
I've been reading John M. Barry's The Great Influenza: The Epic Story of the Deadliest Plague in History. This passage (from page 239) addressed part of my discomfort with Gene/Cunningham's position:
So the next question is WHY did the 1918 flu kill so many young and healthy people? Read on...
WHY did the 1918 flu kill so many young and healthy people?
Again, I'm relying on John M. Barry's The Great Influenza: The Epic Story of the Deadliest Plague in History, this time from pages 246 and 247:
Enzymes in saliva that destroy some microbes are the body's first defense. Any pathogens that the enzymes don't destroy have to get past nasal hairs that filter out large particles, and mucus that lines breathing passageways and traps organisms and irritants. Cells underneath the mucus layer have cilia--little fans, beating 1,000 to 1,500 times a minute--that sweep microbes up into the larynx. And if a microbe does manage to gain a foothold, the body tries to flush it out with fluids--a runny nose--or with coughs and sneezes.
Two kinds of white blood cells patrol the respiratory system, seeking and destroying all invaders. More enzymes directly attack bacteria and viruses or block them from attaching to tissue beneath the mucus. White blood cells also produce interferon, which can help to block infection by viruses.
From page 250:
Early results suggest that the H5N1 avian flu also causes people's immune systems to overreact.
If the H5N1 avian flu is really as deadly in humans as it seems to be right now, it's because the virus triggers a massive immune response that can damage the lungs and cause death. (These findings are based on a study of 26 patients in Viet Nam--18 victims of H5N1 avian flu and 8 victims of regular influenza.)
Mice infected with the reconstructed 1918 flu virus experience "an overblown inflammatory response" that can cause serious lung damage and death.
Scary news, yes, but it also offers a new avenue for research: if scientist can target the patient's immune response to the virus, as well as the virus itself, they'll have two weapons against pandemic flu.
More evidence that 1918 flu and H5N1 avian influenza cause an overblown immune response...
Was an overactive immune response the only killer?
Nope.
The battle between the virus and the immune system destroyed the cells under the mucus with the cilia. Without the sweeping action of the cilia,
(Barry, page 251)
But modern drugs have leveled the playing field, right?
Hard to say, actually.
A 1957 flu pandemic
(Barry, p. 252)
Not exactly reassuring.
What about antivirals?
There are two that could work against the avian flu. Tamiflu, the first-line drug, is being stockpiled all around the world. But it takes a while to make and right now there isn't enough of it to treat the victims that epidemiologists predict should the avian flu make the jump to human-to-human transmission. Also, there's evidence that a strain of the H5N1 avian flu virus is showing resistance to Tamiflu. A second antiviral drug, Relenza, is also being produced.
A new study shows that none of the treatments used for SARS patients did much good, and some of them might actually have been harmful. (Those treatments included most of the retroviral drugs, including the ones being stockpiled for use against a possible H5N1 avian flu pandemic.) SARS, or Sudden Acute Respiratory Syndrome, is caused by a coronavirus that hadn't been previously seen in people; it may have made a species jump via live exotic animals sold for food. It spread quickly via airline travel and within hospitals.
The study gives a clear picture of how tough it is to be on the front lines of the battle against newly emerging infectious diseases...
As of October 21, the H5N1 virus has killed 67 people; 44 in Vietnam, 13 in Thailand, six in Indonesia and four in Cambodia. Almost all of the victims had close contact with birds or had eaten improperly cooked poultry or eggs. There are a few cases where epidemiologists aren't sure how the victims got sick.
In Thailand, a mother died of the H5N1 virus last year after caring for her dying daughter, who also had the disease. And this week possible cases of avian flu among family members in Indonesia sparked fears that the virus had developed a much-feared mutation that would allow it to spread easily from person to person.
But the World Health Organization says "not so fast!" The virus may, in fact, just be spreading via the close contact normal in families.
Stay tuned...
WHO officials discovered that the victims of avian flu in Indonesia all had exposure to infected poultry, and they're ruling out human-to-human transmission for now.
China has reported at least one confirmed human death due to avian flu--a 24-year-old farmer from the eastern province of Anhui.
In Hunan province, a 9-year-old boy has recovered from H5N1 flu. His 12-year-old sister, who died in October, is suspected of having had the virus, but samples aren't available to prove it.
MSNBSC has a cool slideshow called "Bird Flu Around the World".
The virus that's currently circulating--the one that we can study and make a vaccine against--infects humans by way of birds. It won't cause a pandemic in people. To do that, it will have to mutate. And any vaccine made against the bird virus might not work against the new human one. Still, a few drug companies are tackling the problem, hoping that a vaccine against the current virus will provide at least partial protection if and when the virus mutates.
Read this transcript of NPR's Health Editor, Joe Neel, talking about the status of influenza treatments and vaccines.
Scientists in China are trying to use H5N1 antibodies from horses to treat avian influenza in people. (This method of illness-prevention is called passive immunotherapy.)
Vaccines are in development, but they're all experimental, and don't yet target a human H5N1 virus. And there are only a few drug treatments for people who catch avian influenza.
But antibodies from horses protected lab mice known to be vulnerable to the avian flu. The scientists say their treatment,
Though this is definitely good news, it's not quite as rosy as it sounds. The experiments were done on dog kidney cells and lab mice, and there's a lot more work to do before anyone can say this treatment is safe and effective in people. Also, the horse antibodies can cause a strong immune response called "serum sickness" in people treated with them. But careful purification of the antibodies can help reduce the risk.
Could you use the chicken vaccine on people?
That's what New York Times reporter Donald G. McNeil asked in his article, "Turning to Chickens in Fight with Bird Flu."
The answer, in short, is either "no" or "only in the direst of situations."
Why?
The chicken and human vaccines start out the same way--workers inject the virus into fertilized eggs to multiply as the embryo grows. After being extracted from the egg, the virus is killed (often with ultraviolet light), then concentrated and mixed with an agent that causes a heightened immune response.
But the chicken vaccine isn't filtered and purified to remove bits of bacteria or other viruses. And they usually contain the whole virus, not just the part needed to prime the body's immune system. And the purification part is the expensive part.
The "booster" agent in chicken vaccines is mineral oil, which does cause a strong immune reaction, but can also cause inflammation and abcesses. Chicken vaccines are weaker--chickens are small, and market chickens only need to be protected for 6 weeks.
Chicken vaccines may not work in people at all. And they may cause nasty side effects.
So, in the event of a pandemic, doctors will have to weigh the risks of using the chicken vaccines against the risk of doing nothing at all.
Avian influenza is a concern, but the sky isn't falling.
Here's Newsweek's take on why avian flu shouldn't be compared to the 1918 virus.
I think that this attement is copletly right! It is a disease, we all know, but it isn't the end of the world!
Dr. Abigail Zuger wrote an editorial for The New York Times suggesting that our collective freaking out about distant and hypothetical health risks (like avian flu) frees us from having to worry about our immediate and real ones--risks caused by our unwillingness to face reality or change our behavior.
An article in the November issue of Scientific American thoroughly covered the possible implications of an influenza pandemic.
Check out the BBC's "flu tracker."
Know what those letters and numbers (H5N1) mean?
Influenza strains are classified according to two proteins on the surface of the virus--hemagglutinin and neuraminidase. (Hemagglutinin allows the virus to bond to the cell that's being infected. Neuraminidase allows newly created viruses to escape from infected cells.) Our immune systems make antibodies against these two proteins, or antigens.
There are 16 subtypes of hemagglutinin proteins, three (H1, H2, H3) associated with epidemics in people. And there are nine subtypes of neuraminidase proteins, two (N1, N2) associated with epidemics in people.
The influenza virus experiences antigenic shift--where the virus gradually mutates over time to evade the immune system--and antigenic drift--where two different strains of influenza combine to form a new subtype with a mixture of the surface antigens of the two original viral strains.
Huh? Say that part about the antigenic shift again?
When two different strains of influenza infect the same cell at the same time, their protein capsids and lipid envelopes are removed, exposing their RNA, which is then transcribed to DNA. The infected cell then produces new viruses that combine antigens; for example, H3N2 and H5N1 can form H5N2 this way. Because our immune systems have trouble recognizing new influenza strains, they can be highly dangerous. Influenza viruses that "shifted" caused the Asian Flu pandemic of 1957, the Hong Kong Flu pandemic of 1968, and the Swine Flu scare of 1976, and the infamous Spanish Flu outbreak of 1918 that killed millions of people worldwide.
The vast majority of human avian flu victims are people who had close contact with poultry. And scientists have found the virus in bird droppings, blood, etc., so that makes sense. The bigger mystery, though, is why some people get sick and others don't. Lots and lots of people work in the bird markets of Asia, surrounded by secretions that could be contaminated with the flu virus, and only a very small number of those folks have become ill.
Scientists in Japan and the Netherlands published part of the answer in today's issue of Nature and this week's Science. Their research shows that the cells that the avian flu virus binds to are clustered deep in human lungs, while the cells that human flu binds to are in our upper respiratory tracts. That means that avian flu is unlikely to spread by coughs and sneezes, and in order to become a pandemic strain,the virus may have to undergo more mutations than previously thought.
A recent news item about an avian flu outbreak in Canada got me thinking: is avian flu here in Minnesota?
Turns out that birds in North America, especially turkeys and waterfowl, experience some strain of avian flu almost every year. And Minnesota, which is the nation's top producer of turkeys, has had some cases of avian flu every year since 1979 (except for 1997). The outbreaks have involved 1,100 flocks of turkeys.
But Minnesota has an avian flu monitoring and control program, and past bouts of bird flu have convinced most poultry producers to move their turkeys and chickens indoors, where they're protected from diseases spread by migratory birds.
None of the Minnesota outbreaks has involved the H5N1 strain of avian influenza that has been headline news lately. Officials in Canada are testing sick ducks and should know which strain of avian influenza they're dealing with as early as today.
Here's more about how the US poultry industry is dealing with the threat of H5N1 avian flu.
Scientists at Seoul National University in South Korea gave an extract of kimchi, a spicy Korean version of sauerkraut, to 13 chickens infected with avian influenza. A week later, 11 of the chickens started to recover.
Is sauerkraut a magic bullet against the disease? Who knows? A sample of 13 chickens isn't much to work with, and a lot more research needs to be done before a claim like that can be substantiated.
But several TV and radio stations have picked up the story, and one major sauerkraut distributor has seen an 850% spike in sales!
Should sauerkraut have any preventative effect, and should a pandemic develop, Twin Citians will be in good shape: there are at least 115,000 tons of the stuff in Wisconsin alone.
Here's more on the sauerkraut story...
Anyone have any thoughts about how fears of an avian flu pandemic compare to the 1976 swine flu scare?
Here's an interesting paper on the swine flu scare by Joel Warner: "The Sky is Falling: An Analysis of the Swine Flu Affair of 1976." He looks at whether or not the measures taken by scientists and politicians were justified, and why the vaccination program was a failure.
Another swine flu site: "1976: Fear of a great plague"
Richard Krause, of the National Institutes of Health, wrote, "The Swine Flu Episode and the Fog of Epidemics."
Washington Post staff writer David Brown wrote: A Shot in the Dark: Swine Flu's Vaccine Lessons."
Bird flu in Vietnam is mutating.
Researchers at the Ho Chi Minh Pasteur Institute looked at 24 samples of the H5N1 virus, from both poultry and humans, and saw significant variations in the antigens on the viruses' surfaces. (Antigens are the foreign substances on the virus's envelope that stimulate the body's immune system to produce antibodies.) The changes suggest that the virus is adapting to new hosts. A post on the Institute's website says:
British researchers are trying to create a genetically modified line of chickens that will be able to resist all strains of avian influenza.
The UK has been largely anti-GMOs (genetically modified organisms) in the past. But with the alternative being the wholesale slaughter of poultry flocks and a possible human pandemic, people might change their minds...
In a bizarre and somewhat alarming move, Indonesia's National Institute of Health for Research and Development ordered that the biggest, most experienced and best-equipped avian influenza laboratory in the country be shut down at the end of this year. See the letter announcing the decision here.
The lab, called NAMRU-2, is run by the United States Navy in Jakarta, and participates in with the World Health Organization's surveillance for emerging diseases in Indonesia. Closing the lab could hamper detection of an outbreak of influenza. Given that a rapid response to the detection of a local influenza outbreak is key to averting a global outbreak, and given the cases of avian flu already diagnosed in Indonesia, I hope that the US and Indonesia can resolve their issues to keep this lab open.
Bird flu is really deadly!
It looks that way right now, but a closer look might reveal a different truth.
Right now, the cases that governments are reporting, and that make the news, are the ones associated with a severe illness or death. But it's possible that a lot of people have been exposed and didn't get critically ill, or even sick at all. To know for sure, you'd have to test large numbers of people for antibodies to the H5N1 virus.
Several such studies have been done in Asian countries, but the results haven't been published yet.
At least one study suggests that mild flu-like symptoms are pretty common among people who work closely with poultry. According to a MedPageToday article,
Scientists are still trying to figure out just how dangerous and deadly this flu really is.
this sounds like another one of those 'killer bees' threats. so im not so sure about it. im not trying to be ignorant but yeah that's what it sounds like. i mean, look at the health care we have these days.
Yes, health care has certainly improved.
And maybe the scientific establishment is overreacting, on the theory that it's better to be safe than sorry.
But read the posts near the top of this thread about exactly HOW the 1918 flu killed so many people. And read, too, the disaster preparedness plans that apply to avian flu. Sure, we have better equipment and better drugs, but those won't help us if we don't have enough respirators to breathe for all the people who need them, or the virus mutates faster than we can develop new antivirals and other drugs.
The best weapon against avian flu might be quarantine, but that's never a popular option, and it doesn't work so well if there's a period when an infected person is symptomless but still able to pass on the virus.
MedPage Today has put together a special end-of-year report, analyzing 2005's avian flu coverage. Pretty interesting.
what if your a vegetarian??? could you still get from other products.. not including meat???
All the health agencies say that if the meat is properly cooked and handled, there is no risk of catching avian flu by eating poultry.
If you're a vegetarian, and you avoid contact with both domestic and wild birds (scientists think the virus is shed in their secretions), you should have no risk at all for the current avian flu.
But if the virus mutates, so that it's transmissible from person to person, then avoiding meat won't confer any protection at all.
When do scientists suspect bird flu will come to the u.s.?
Scientists say it's possible that the H5N1 virus could spread to Alaska or western Canada as early as this spring. The US is expanding efforts to test migrating wild birds in an attempt to detect the virus's arrival here.
Listen to a story NPR did on this subject.
Government officials are operating under the assumption that someone will find an infected bird in the US by the fall. But as long as it's a bird disease, it's not a cause for panic.
Another story on looking for avian flu in Alaska.
What caused the bird flu?
i think even if you are a veggie only eater you would be at the same level of risk for a strain of flu that was passed from person to person. if it comes to that.
I do think the Avian bird flu will become an epidemic but with the new technology and new resources that we will find a cure or vaccine in the near future
On February 15 NPR's Health Editor, Joe Neel, answered listener questions about the potential for a flu pandemic and the status of vaccines and treatments. Want to read the transcript?
Scientists are testing a vaccine against H5N1 avian flu right now. (This New York Times graphic shows how it works.) But it's a vaccine against the current avian flu. To become pandemic flu, the H5N1 virus will have to mutate, and the vaccine in development right now won't work against it.
On Monday, March 13, Health and Human Services Secretary Mike Leavitt said it will take at least six months to produce a vaccine against bird flu that has mutated to allow human-to-human transmission. Until that vaccine is available, communities will have to rely on traditional public health measures to stop the flu's spread.
probably
now that i learned more about it im not so worried about it anymore. but in a way i am!
Ebeneezer Scrooge's thoughts\r\n\r\ni think the avian flu is something that everyone should know about. i am doing it for a science project
The H5N1 bird flu virus has spread to Africa and has been confirmed in north-central Nigeria.
What exactly IS the bird flu? How do you catch it, and how do you cure it?
Here's the Wikipedia entry on avian flu, and the Center for Disease Control's Avian Influenza fact sheet, although there are lots of other resources already linked in the previous posts.
Scientists don't know how you catch it, although they think it may require direct contact with the virus-laden secretions of infected birds. (That may be why doctors are seeing cases among people who work with poultry, although the big mystery is why some people get sick when so many others don't.)
We also don't know how to cure it. There are two antiviral drugs that may help, if they're taken in time, but influenza is a viral disease, and those mostly just have to run their course.
this isn't the only flu outbreak. there was the pig flu somes years back. we live in a fear base world. they want to sell you something based on your fear. study shows that people buy and consume more when they are scared. world govn't are increasing their gnp as we speak.
It's true that this isn't the only flu outbreak since 1918. Read some above posts for more information on the swine flu scare of 1976.
I'm not a conspiracy theorist. I think that someone stands to gain, somehow, from just about any event, but that doesn't mean that the concern of scientists and policy makers over the H5N1 strain of avian flu is some trumped up nonsense to get people scared and buying things.
If we're lucky, the avian flu scare will end up like the swine flu scare, and we'll be able to look back and see where we were wrong and where we overreacted. But, given their incomplete understanding right now, I think that scientists are genuinely concerned.
Avian flu hit Turkey hard, with at least 20 infections and 4 deaths (including three children from one family) as of January 20th. Thousands of birds have been slaughtered in an attempt to contain the virus. But amidst all that chaos, scientists also see opportunities to study the H5N1 virus.
The Turkish government has been very receptive to proposed avian flu research, and scientists are considering:
Why Turkey?
Well, Turkish doctors seem to take more elaborate patient histories than those in East Asia, and good case histories are important to understanding viral exposure.
Scientists are also particularly interested in the Turkish outbreak because the country experienced a large number of human cases in a short period of time. Is that because it's winter and people brought their animals inside when the weather turned bad? (In rural Turkey, lots of people live in one-room houses with their animals.) Is it because of a genetic mutation in the virus, seen also in China and Vietnam, that allows it to bind more easily to human cells?
And the disease seems to be milder in Turkey than in East Asia. (The death rate of about 25% is half that seen so far in East Asia, and there have been five mild or completely asymptomatic cases.) Are milder cases happening elsewhere and just not being recorded? Or is it because worried Turkish parents, well-versed in the symptoms of avian flu, are taking their children to hospitals right away and getting them antiviral drugs early in the course of the disease? Or are some of these milder cases actually false positives?
Researchers are hoping to tease out the answers to all of these questions.
New cases of avian flu (in birds, not people) have been reported in:
Scientists are also testing dead birds found in Bosnia for the H5N1 virus.
That's the bad news.
The good news is that an Australian company, CSL Ltd., has tested small doses of avian flu vaccine in healthy adults and achieved "encouraging" results.
The H5N1 flu has spread to 13 new countries in the last three weeks (including those listed in the above post), and a human case popped up in Malaysia, which had been avian flu-free for about a year.
The Washington Post says that wild birds may be getting a bad rap when they're blamed for the spread of the H5N1 virus to Nigeria. Some scientists think it's far more likely that the virus arrived in poultry and poultry products--chickens living in giant commercial flocks, not little backyard ones. (Nigeria imports more than a million chicks each year from countries such as Turkey and China.)
It has now arrived in Europe - Germany, France, etc. - via wild bird migrations from Africa. Be worried? Who knows...
I hope it doesn't hit the U.S.!
The guards at the Tower of London are caring for the fortress' fabled ravens inside in an attempt to keep them safe from H5N1 flu spread by wild birds. Legend says that should the ravens ever leave the Tower, the centuries-old castle--and the British monarchy with it--will crumble.
Swedish authorities have reported cases of H5N1 flu in wild ducks.
The US Center for Disease Control maintains a website ("Avian Influenza: Current Situation") which is frequently updated and lists all the countries with human cases and all the countries with animal cases.
In late February, scientists discovered H5N1 virus in a dead cat in Germany. (Read Joe's blog post about the discovery.) It was the first mammalian case of H5N1 flu in Europe. (Later stories said that three domestic cats had been found infected with the virus.)
On March 2, scientists found H5N1 virus in a weasel-like animal called a stone marten. The stone marten was found alive, but obviously ill, on the same German island as the dead cats. Researchers think the stone marten got sick the same way the cats did: by eating infected birds.
Eight other mammal species (in addition to humans, domestic cats, and stone martens) are known to be susceptible to H5N1 avian flu:
These incidents don't necessarily mean an increased risk of pandemic flu, but scientists are investigating the virus's potential to adapt to mammals (including humans).
Ian Wilson and other scientists at The Scripps Research Institute in La Jolla, California, have identified some of the mutations the H5N1 avian flu virus will need if it's to cause a human pandemic. Specifically, they looked at a structure on the surface of all influenza viruses called hemagglutinin (the "H" in H5N1--see the previous post for more).
The researchers dissected and imaged a sample of the virus that killed a 10-year-old Vietnamese boy in 2004. This virus looks a lot like the virus that caused the 1918 epidemic. And it looks less similar to H5N1 virus taken from a duck in Singapore.
The change in the hemagglutinin structure seems to make the virus more able to bind to mammal cells, but it doesn't seem to have full virulence.
A previous study, though, suggested that only two mutations are necessary to change the bird virus into one that sickens people.
The scientists suggest that the test they used, called a glycan array, might be useful in monitoring the virus in birds and as it infects people, letting epidemiologists recognize viral mutations early on and alerting public health officials to the potential for a pandemic.
See this post (above) -- scientists have figured out why the avian flu isn't spread easily by coughing or sneezing.
will the bird flu ever reach the united states?\r\n\r\n\r\n\r\nTori Johnson\r\n\r\nMinnestoa
the "bird flu" i think will be a problem, but with all of our new medical advances, i think it will be taken care of and i dont think it will get too out of control.
Should we really be worried about getting the epedemic?
Today's New York Times science and health news feed is all stories about avian flu.
"Q&A: How Serious is the Risk?"
"On the Front: A Pandemic is Worrisome but 'Unlikely'"
"At the UN: This Virus Has an Expert 'Quite Scared'"
"Making a Ferret Sneeze for Hints to the Transmission of Bird Flu"
"From the Chickens' Perspective, the Sky Really is Falling"
Well I think the human race should wipe it off the face of the earth and save the birds and humans being killed by it right now. or at least find a cure for it. SAVE THE BIRDS AND HUMANS!!!!!\r\n\r\nSarah Johnson Made this Comment!!!!\r\n\r\nGo CURE \r\n\r\nBoo Bird Flu.
I have a question for you guys. If the bird flu gets to the United States, which it probably will. How will the people of the U.S. deal with this problom.
The Associated Press just put out an article addressing key aspects of the US pandemic plan.
More on the US pandemic disaster plan...
The difficulty of making Tamiflu from shikimic acid limited the amount of competition Roche was likely to face from other companies. That may now have changed. Two articles today explain:
NewScientist
Chemical and Engineering News.
i hope that the bird flu doesnt happen!!!
the bird flu is bad
How realistic was the TV movie "Fatal Contact: Bird Flu in America"? C. Ed Hsu, professor of public and community health at the University of Maryland and expert in public health emergency preparedness for disease and bioterrorism, answers that question.
why do we have to know about bird flu its getting me scared
the bird flu may be deadly, but it has been told that it will be a long time before it comes. also it has been told that it will come soon too. these people must be confusing the bird flu with the comon flu. i think it will be total chaos when it comes
we will not be prepared for it no matter how many warnings we are given now. It's the American way unfortunately. Iwould like to know how to prepare or prevent this - what canwe do??
I think the flu that is going around is very scary they should take extra percautions so I don't get it cuz i really don't want it cuz I want to live forever! ahhhhhh i don't wanna die!!!!!!!!!!.........from the birds that are my favorite animals!
Sydnee duh i totally agree with you because i dont wanna die either lol.
I think that they should make a injections -shot- to help people recover from the illness, or prevent it from getting to a person. Just think, a bird can get it, then your pet, then you. Think of how helpful that injection would be. Like the chicken pox. If u take the shot you have a really good chance that u wont get the chicken pox.
-Makenzie-
Hi, Makenzie.
I think that scientists the world over would be happy if they could develop and produce a vaccine against the avian flu, just as you suggest. There *is* a vaccine for chickens. But it doesn't work in people. (See this post and this one for explanations why not.)
However, there's been some encouraging news on the vaccine front in the last few days.
Experts agree that the best way to prevent a bird flu pandemic in people is to contain the virus in birds.
Poultry flocks are also hit hard by the Newcastle virus (which doesn't infect humans). To protect chickens, farmers use a vaccine that is made by many companies, cheap to manufacture, and easy to administer. Dr. Peter Palese, of the Mount Sinai School of Medicine in New York, told Reuters:
Two separate teams of researchers--Palese's team in New York and another in Germany--have discovered that they can graft some of the proteins from the H5N1 virus onto the Newcastle virus used in the chicken vaccine. And it protects 92% of the chickens.
Even better, this formulation eases fears that some have about avian influenza chicken vaccines:
Even better, the vaccine can be made very, very quickly. Angela Romer-Oberdorfer, of the German team, said:
On these points, the two teams of researchers agree.
However, the German team thinks the technique could be used in humans. The New York team disagrees.
The findings from both research groups appear in this week's issue of the Procedings of the National Academy of Sciences.
I think that the birds with this flu should all be kill and any people who keep there birds that have the flu should be put in a different place then the other birds who doe not have the flu.
Yesterday scientists in Alaska started testing migratory birds for signs of the H5N1 avian flu.
Possible human-to-human transmission? That's what officials from the World Health Organization (WHO) are trying to figure out.
They're concerned about a cluster of 7 bird flu cases (resulting in 7 deaths) in a family in Sumatra, Indonesia.
So far, scientists haven't been able to track down an animal source of their illness. But they also know, from tests, that the virus hasn't mutated.
So it's possible that the virus infected the family members through close human contact. (There have been a few other cases of suspected human-to-human transmission, always through close and prolonged contact within families with active disease.)
Bad as that might be, epidemiologists don't worry as much about clustered cases like this. Instead, they're watching closely for the appearance of a bird flu virus that can spread easily from person to person through CASUAL contact--like regular, seasonal influenza. And so far, they haven't seen any cases like that.
The H5N1 avian flu virus has infected people in 10 countries, causing a reported 218 illnesses (and 124 deaths).
WHO posts "disease outbreak news" on its website, including avian influenza updates. This cluster is the subject of the most recent reports. WHO is also running a full feature on avian influenza.
According to the WHO, Indonesian health experts are tracing anyone who might have had contact with the family that recently died of bird flu. WHO officials are emphasizing that this is not the first family cluster and that tests on the virus isolated from the family show that it had not mutated.
Still, the lack of sick animals in the village has WHO worried, and they consider this incident a significant development.
If we are so worried about people contracting the flu i think that even tho we try to make antiviral substances that we should keep the experementing to a low. With having resistances to all these flus it also allows the virus to become stronger which initially will hurt us in the long run. with common day virus being faught by all differnt types of medication it makes the virus stronger which will affect us with a more serious outcome
how can we prevent it?
There are many types of avian (bird) flu in the world. Birds have flu seasons just like people do. There are different types of avian flu in the US now, and there hae been for a long, long time. The type of bird flu that is in the news today is just one type. It may or may not come to the US.
I think that that is really sad that so many people are dieing from the bird flu and I would never want to get the bird flu, and I feel bad for the family that had some one they new and loved that died from the bird flu
yiiiiiiikkkkkkeeesss!
its not a matter of if it will happen, but when it will happen.
this really stinks, is there anyway that we can stop it? this has the ability to destroy everything that we have worked so hard to get. we need to spend less money on finding out what it can do in the future, but on how we can kill it
Indonesia has just confirmed its 38th death from avian flu, a seven-year-old girl who died on June 1. Her ten-year-old brother died two days earlier, but was buried before samples could be obtained for testing.
who cares abouut the bird flue its just a sickness?
Well that is true, but there is a small problem regarding its ability to transfer onto humans gives it the potential to kill millions of people. But yeah it is just a sickness.
So this is just imformation about the bird flu! Geesh, Who knew before reading this article it's called avian flu. (weird scientific name...)
So what exactly can we do about the "bird flu" or Avian Influenza, in matters of preventing it. Since it is thought to be the new pandemic? Do you think that people are going to over-react or are the acting in the best manner possible and coming up with vaccines that they know will help the society?
i think we should do nothing
wow thats crazy i never knew that i hope it never transfers to humans
We should not panic about bird flu. During the last pandemic in 1918 critical care was in its infancy and there were few antivirals. In addition, santitary conditions were poor at best among the general population. There is not likely to be any major threat to the majority of us.
I think we are worrying a little too much about this. True, it could be a bad thing, but I think it's too much hysteria and not enough logical thinking. That is my opinion.
why do people find this illness so frightening when the human flu kills 15 million a year in the u.s. alone? sure the concept is scary, but we have many more illnesses of our own that people hardly pay attention to....
just one more step on the road to rapture...
this is a very good web site. it is good that you are teaching us but make sure that you do not scare some of the kids becaouse this may sound frightning!
Question: Why is the scientific community concerned about the avian flu mutating and becomming transferable by way of human-to-human contact? I guess A.I.D.S did the species leap some how and that isn't even an air born disease. So do I think we need to worry about it? I would say no the lay person dosen't but once "they" come out with a vaccination of some sort it would be wise to do some research on the vaccination and make sure it is safe and even necessary. This county, I believe, is vaccinating crazy, soon our bodies will not be able to handel a common cold. Such as the chicken pox vaccination, the reacation some children can have to the shot far exceeds the risk as compared to the actual disease, in my opinion ofcourse.
Simply put, scientists are worried that the H5N1 strain of avian flu might mutate to allow human-to-human transmission because there is now evidence that the 1918 flu strain, which killed millions of people worldwide, was a similar strain of avian flu that mutated to allow for human-to-human transmission.
It's always wise to do some research on any medical treatment or procedure before agreeing to it. A bird flu vaccine would be no exception. And IF a vaccine is developed, it wouldn't be offered unless a true pandemic (or epidemic) situation develops and experts deem the risk of the disease far worse than the cost and distribution of the vaccine.
I personally disagree strongly with you in your assessment of the value and risk of vaccines. There is a lot of bad vaccine information out there. And a lot of people agree with you, not me. Check out the comments associated with this Buzz poll about whether or not pediatricians should drop patients who refuse vaccines. And this post about a polio outbreak in Minnesota also generated a lot of discussion about vaccines.
If you really think about it, just try to remember how fascinating this virus is. The Avian Flu (or bird flu) as of now is just poultry-human transformations. But scientists fear that the virus will mutate and it'll be passed through human-human, along with poultry-human. You have to admit, that is pretty amazing. Small things in the world, like viruses, bacteria, etc have the power not only to mutate and grow into something more powerful, but they can also kill off entire species and groups of living creatures.
In a way, we're not on the top of the foodchain anymore.
Avian Influenza is a scary thing. And we should be ready for the worst. But we are much better off than we were in 1918. Not just because of treatment, because of knowledge.
In 1918, they weren't sure of origin/cause, or what influenza truly is. Now they understand what causes it (a virus), and how we can treat it and hopefully stop the spread.
Also remember that this strain is different than the strain from 1918. This could very well mean different implications. For better or worse, we cannot yet say.
Hopefully, though, we'll find a sure way to halt the spread.
i think that the bird flu is really scary, and that people should get some more knowledge about it. what if it happens around where they live? if they know what it is, they can know how to prevent it!!!
Laos has just started a poultry cull, hoping to contain a recent outbreak of H5N1 bird flu. (Laos has experienced isolated cases, in poultry, of the bird flu, but this is the first full-fledged outbreak since 2004.
Laos has not reported any human deaths due to the virus, but neighboring Thailand reported its 15th last month. Laos is bordered by Thailand, China, and Vietnam, all of which have reported large-scale outbreaks in poultry and experienced human deaths in the last few years.
With everyone talking about the bird flu it is scaring a lot people away from eating chickens. If there was any kind of danger in the United States they would have to inform us of it.
As long as it's properly cooked, you can eat chickens and other poultry with little fear of the bird flu. The virus is passed, scientists think, through bodily secretions, and the people who have become ill with H5N1 virus have all had close and prolonged contact with infected poultry or a person who has had such contact.
You're right: right now, avian influenza isn't a big worry in the US. Unless the virus mutates to allow efficient person-to-person transmission, it will likely never be a big problem here. But note that Minnesota is one of the biggest sources of turkeys, and a poultry outbreak here, perhaps spread by wild birds, would have an impact. (Poultry growers in the state have already taken steps to isolate their flocks from contact with wild birds.)
The bird flu is never coming here. Remember a couple years ago those 'Africanized' killer bees were supposed to come up into the U.S. through Mexico? They never came. There are tons of stories like that that you can read about. The only reason everyone is so scared is because of the media. The media is the stuff that is scaring America. It is a way for them to get attention and watch their shows and broadcasts. Even if it does make it here against all odds a private company just developed an experimental vaccine that works on 'lab rats' (i don't believe they tested on too many rats though). Sanitary conditions in hospitals should be sufficient to Quarantine the virus.
To answer the original question of the blog though, the government would not necessarily have to informus about it. They may very well try to keep everything hush, hush, about it so don't count on anyone being required to tell us.
The virus that causes bird flu is much less limited by the environment than are Africanized bees. So, this analogy seems pretty lame.
I thimk it's awful how bird flu will affect this generation. I hope a cure is found fast
what caused the bird flu
As soon as the Drug companies release vaccines to the mass public, I'm sure we'll see a huge fatal outbreak of the 1918 virus, or "bird flu" as it were. then big pharamcy can cash in on all the hype. the scare of the outbreak will result in more people getting the vaccination, thus exposing themselves to a disease they would normally have no contact with or chance of receiving. The big hoax here is that there have only been 62 deaths. That number hasnt been increasing by more than a death or two a month.. thousands of times that number are dying every day from real diseases.
I don't think that we're likely to see drug companies releasing vaccines to the general public any time in the near future. That's not generally how vaccines are distributed, first. And second, almost all manufacturing capacity is being used to create vaccine for stockpile by governments in the event of a pandemic.
If the CDC makes a recommendation for the general public to be vaccinated, it will be because a) the H5N1 virus is already here, in the US, b) it has mutated to allow for efficient human-to-human transmission, and c) it has already caused an alarming number of illnesses or deaths.
Getting the vaccine at such a point will not "expose [people] to a disease they would normally have no contact with or chance of receiving."
There are some posts near the top of this thread that explain how the 1918 flu killed, and how it affected the world. Wanting to avoid a replay of that situation has sometimes led scientists and politicians to recommend comprehensive vaccination programs before a real risk has been demonstrated. (The 1976 swine flu scare is a good example. You can read about it earlier in this thread.) But remember, too, that the 1976 scare happened before we were able to do rapid genetic testing to understand precisely what flu strain we're dealing with. And, of course, there were no antiviral drugs.
As for your assertion that, "...The big hoax here is that there have only been 62 deaths," I must correct your facts. According to the BBC's flu tracker, there have been 236 reported cases and 138 deaths. Now, it may be that incomplete data produces a misleading picture of the lethality of the disease, but I don't like those odds!
However, you are completely right when you say that thousands of times that number are dying every day from other diseases. And many of those diseases, such as malaria, are preventable with the right funding and leadership. (Note: new feature on malaria and other vector-borne diseases coming soon!) Still, H5N1 avian flu has the potential to become a fast-moving worldwide killer, and it IS worthy of scientific and political attention.
The New York Times has reported that researchers at the University of Colorado have developed a new influenza test ("FluChip") that takes less than 12 hours. This great news for field epidemiologists studying the H5N1 avian flu.
Right now, figuring out whether a not an outbreak of flu is caused by the H5N1 strain requires that a researcher obtain a sample, freeze it, ship it to a highly secure lab (usually in a major city like Atlanta or Hong Kong), and wait while the virus is grown in eggs, isolated, and analyzed genetically. The whole process takes 4 or 5 days, not counting shipping time, and risks samples thawing and being ruined during shipping. That makes it tough for public health officials in remote villages to decide quickly whether or not to kill thousands of potentially infected birds or to treat hundreds of potentially exposed people with expensive drugs. (Not to mention the problem of drug resistance...)
But now, a microchip covered with bits of genetic material from many different flu strains cuts the time needed to diagnose a particular type of flu from a week to less than a day. Samples don't have to be frozen, and they need only be shipped to labs that can amplify bits of genetic material--many countries have labs like this in provincial or national capitals. And because parts rather than whole viruses are being amplified, the work can be done in labs with lower biosecurity levels.
Kathy L. Rowlen, the professor who led the team that developed FluChip, says that a version of the test may be ready for use in the field within two years.
Researchers at the US Navy's Bureau of Medicine and Surgery, reporting in Annals of Internal Medicine, suggest that a therapy used to combat the 1918 flu might also work today, should the H5N1 avian flu become a human pandemic.
The scientists did an analysis of 8 reports of treatments involving 1703 people in which doctors used serum from recovering patients to try and combat the flu-related pneumonia killing other victims.
According to the MedPageToday teaching brief,
This is encouraging because one recovering patient could, in theory, provide enough plasma to treat several victims of H5N1 influenza. However, there were limitations of the original studies.
Further,
Still, the Navy scientists suggest that new clinical trials should test the idea.
Making a vaccine against H5N1 avian influenza has been tough for a few reasons:
But there's some good news, too. Researchers at the National Institutes of Allergy and Infectious Diseases discovered that a nasal spray containing weakened, but live, H5N1 virus completely protected lab animals against the disease after two doses, and prevented death due to the flu after a single one. Better still, the virus in the nasal spray cross-reacts with other strains of the virus, conferring some immunity no matter which strain an animal is exposed to.
So now scientists are cautiously testing the technique in people.
Did you hear that air travel plays a role in the spread of influenza?
Scientists at Children's Hospital in Boston published their findings on this topic in the online journal PLoS Medicine (www.plosmedicine.org). They found that domestic airline travel volume in Novermeber predicts the rate of influenza spread and international airline travel influences the timing of influenza mortality. "The flight ban in the US after the terrorist attack on 9/11 and the depression of the air travel market provided a natural experiment of the evaluation of flight restrictions; the decrease in air travel was associated with a delayed and prolonged influenza season."
If there was a pandemic looming should the government restrict or limit airline travel?
Yes, it is only common sense to prevent or limit a large scale outbreak and confine it as much as possible.
The World Health Organization (WHO) has reported a strange case of the bird flu. In May of 2006, a 27 year old Indonesian man spent 6 days caring for his younger sister who was infected with the H5N1 avian influenza virus. Soon after, he developed a cough and abdominal pain, but quickly recovered. Initially he tested negative for the H5N1 virus. In August, he was tested again and he tested positive. The man claimed he had no direct contact with poultry. The WHO could not rule out human-to-human transmission as the cause of his infection. Is this the start of the bird flu outbreak?
At some point all disease will be transmitted human to human, they simply need to find the right sequence of transportation.
Scientists are using tiny transmitters and GPS technology to track the migration of wild birds. The theory is that wild birds are helping to spread H5N1 avian flu; knowing where the birds go will help scientists understand their role in transmitting the virus.
Okay, that's kinda creepy.
I mean, I have chickens. They're my best friends! And I have asthma, so since this is a lung thing it would affect be more easily, right?
My mom too!
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