Bird Flu - Is it Time for Vaccines?

[Berislav]

This really scared me:

http://www.agi.it/english/news.pl?doc=200509121413-1097-RT1-CRO-0-NF11&page=0&id=agionline-eng.oggitalia

What do you think? Is it going to be really that dreadful? Or is this just their way of making people realize the gravity of the situation?

Italy is a rich country and it will probably have enough vaccine to prevent a death toll of that magnitude, but what about countries which don't have the facilities to produce new vaccines post haste if the strain mutates?

I don't want to die!

Especially being killed by the bird flu! How lame! I mean, really, bird flu. Avian influenza sounds cooler, though.

P.S.
It would be great if one of PF's resident biologists would comment on this disease.

 

[SOS2008]

This really scared me:

http://www.agi.it/english/news.pl?doc=200509121413-1097-RT1-CRO-0-NF11&page=0&id=agionline-eng.oggitalia

What do you think? Is it going to be really that dreadful? Or is this just their way of making people realize the gravity of the situation?

Italy is a rich country and it will probably have enough vaccine to prevent a death toll of that magnitude, but what about countries which don't have the facilities to produce new vaccines post haste if the strain mutates?

I don't want to die!

Especially being killed by the bird flu! How lame! I mean, really, bird flu. Avian influenza sounds cooler, though.

P.S.
It would be great if one of PF's resident biologists would comment on this disease.

I started a thread on this, and mad cow disease, etc. I think in the Biology section. Even if you don't eat meat it doesn't mean disease can't be passed from one species to another (like AIDS). I think it should be of concern, and we need to change the way we produce food--now.

 

[Skyhunter]

I started a thread on this, and mad cow disease, etc. I think in the Biology section. Even if you don't eat meat it doesn't mean disease can't be passed from one species to another (like AIDS). I think it should be of concern, and we need to change the way we produce food--now.

Almost everyday I hear or know of someone getting sick from the food they eat.

My advice, go Vegan.

 

[Berislav]

I started a thread on this, and mad cow disease, etc. I think in the Biology section. Even if you don't eat meat it doesn't mean disease can't be passed from one species to another (like AIDS). I think it should be of concern, and we need to change the way we produce food--now.

Yes, I think that every country should build improvised laboratories for mass-production of vaccine, as well.
I mean, even a poor government could afford such a facility, right? Or maybe private contractors?

 

[loseyourname]

I have a hard time being sympathetic to these predictions, given the frequent 'cry wolf' scenarios we've seen. For all the fuss about mad cow, how many people actually got infected? There was a huge scare here in California about killer bees ten years ago, and they haven't done jack. More recently, there was a huge scare about west nile. I caught west nile. Don't get me wrong - I could barely move and felt like my brain had liquefied, but it only lasted three days. It kills only a miniscule percentage of those who catch it - something like three deaths so far over four years or so. Then again, for all I know, this might be a legitimate threat and I'm so turned off to fear-mongering at this point that I'm going to completely ignore it.

 

[SOS2008]

Yes, I think that every country should build improvised laboratories for mass-production of vaccine, as well. I mean, even a poor government could afford such a facility, right? Or maybe private contractors?

Unfortunately private pharmaceutical companies invest R&D in drugs like Viagra because of the larger profit margins.

I have a hard time being sympathetic to these predictions, given the frequent 'cry wolf' scenarios we've seen. For all the fuss about mad cow, how many people actually got infected? There was a huge scare here in California about killer bees ten years ago, and they haven't done jack. More recently, there was a huge scare about west nile. I caught west nile. Don't get me wrong - I could barely move and felt like my brain had liquefied, but it only lasted three days. It kills only a miniscule percentage of those who catch it - something like three deaths so far over four years or so. Then again, for all I know, this might be a legitimate threat and I'm so turned off to fear-mongering at this point that I'm going to completely ignore it.

Though the problem has not escalated to pandemic proportions...yet...my concern is with the unsanitary methods used for mass production of these animals. This requires antibiotics, which are passed on to those who eat the meat, only for the animals to become immune, etc., etc., etc. These conditions are perfect for the creation of viruses like HIV, that then morph and spread beyond human control.

 

[Skyhunter]

I have a hard time being sympathetic to these predictions, given the frequent 'cry wolf' scenarios we've seen. For all the fuss about mad cow, how many people actually got infected?

Here is an interesting study.

Given the new research showing that infected beef may be responsible for some (classical) CJD, thousands of Americans may already be dying because of mad cow disease every year,"

http://agobservatory.org/madcow/index.cfm?id=19041

 

[Dissident Dan]

I have a hard time being sympathetic to these predictions, given the frequent 'cry wolf' scenarios we've seen. For all the fuss about mad cow, how many people actually got infected?

There is speculation there are a lot of cases of mad cow that have been misdiagnosed as Alzheimer's Disease:

http://chemistry.about.com/cs/medical/a/aamadconc.htm

It is believed that many of the cases assumed to be Alzheimer’s Disease may be the human form of BSE, Creutzfeldt-Jakob Disease (CJD), which is difficult to distinguish from Alzheimer’s (27). The most common misdiagnosis of CJD is Alzheimer's disease. (53) Hidden cases of 1 to 13% are CJD. Laura Manuelidis, section chief of surgery in the neuropathology department at Yale University, conducted a 1989 study that found 13 percent of Alzheimer's patients actually had CJD. That percentage could add up to 120,000 or more CJD victims a year going undetected and not included in official statistics, instead of the 250 reported (53). And since the disease could occur at any time up to 40 years, the number of people affected in future years could be astronomical.

 

[loseyourname]

This requires antibiotics, which are passed on to those who eat the meat, only for the animals to become immune, etc., etc., etc. These conditions are perfect for the creation of viruses like HIV, that then morph and spread beyond human control.

It's just a technicality, but antiobiotic resistance will not ease the spread of viral diseases. Also, I think what you meant is that the bacteria become immune (resistant is a better word), not the animals.

About the mad cow thing, if there really do prove to be undiagnosed cases in significant numbers, then I'll take back what I said, specific to that claim. That doesn't change the fact that we've seen hundreds of false alarms in just the past decade and I still have no sympathy for John Stossel-esque muckrakers that want us to believe ever other thing we touch can kill us.

 

[Skyhunter]

About the mad cow thing, if there really do prove to be undiagnosed cases in significant numbers, then I'll take back what I said, specific to that claim. That doesn't change the fact that we've seen hundreds of false alarms in just the past decade and I still have no sympathy for John Stossel-esque muckrakers that want us to believe ever other thing we touch can kill us.

I understand that and to a large degree I feel the same way.

But then I have also been profoundly disillusioned in my life. Part of the reason that west nile doesn't spread quickly is:

1. People wear repellent.

2. The government takes positive steps to reduce the threat, through abatement.

3. The mosquitoes that carry it (at least in CA) don't normally travel far from where they hatch and are shy, and only feed while the victim is sleeping or sedentary.

I just wanted to show you the results of some more recent study. This study is significant because what they discovered is that random prion diseases may not be random at all.

 

[Astronuc]

http://news.yahoo.com/s/nm/20051023/wl_nm/birdflu_britain_dc_1;_ylt=AiXW.zPdSyjWZnuV.ZCuNxeTvyIi;_ylu=X3oDMTBiMW04NW9mBHNlYwMlJVRPUCUl

LONDON - A parrot that died in quarantine in Britain has been found to have the lethal H5N1 strain of bird flu, the agriculture ministry said on Sunday. A ministry spokeswoman confirmed that scientists had found "the highly pathogenic H5N1 virus" in the parrot. "The closest match is to a strain found in ducks in China earlier this year," she said. The parrot, imported from Suriname, South America, was part of a mixed consignment of 148 birds that arrived on September 16, the ministry said. They were held with another consignment of 216 birds from Taiwan.

This seems to confirm a potential pandemic of bird flu. It is showing up in several cases in Europe, particularly poultry populations in Russia and Romania, far from the cases reported in China and E Asia.

The H5N1 strain has killed more than 60 people in four Asian countries since breaking out in late 2003 in South Korea.

H5N1 does not infect people easily, but the concern is that in a matter of time, H5N1 may mutate to a more virulent form.

 

[Gokul43201]

Will somebody please keep Mr. Manson away from those chickens ?!

Seriously though, what kind of stimulus does it take to create the necessary kind of mutation ? Or is it just a matter of time and chance ?

 

[Moonbear]

Unfortunately private pharmaceutical companies invest R&D in drugs like Viagra because of the larger profit margins.

The technology is available to make vaccines, but the problem is that it takes time to produce them. They are not just grown up in a reactor overnight (and many are produced using chicken eggs...isn't that irony for you?) With most flu vaccines, they guess ahead of time what the most likely strains are going to be for the flu season and produce vaccines for them...that's what the annual flu shot is each year. If it turns out that a different strain is loose than predicted, the flu season is pretty much over by the time a new vaccine can be produced in sufficient quantities to protect the public. With the avian flu, until an outbreak begins, there is no way to start producing a vaccine. Although some vaccines are in development against current strains, it's no guarantee they would be effective against a strain that gains the ability to be transmitted among humans. Also keep in mind that the profits from drugs like Viagra help pay the R&D bills on the less profitable drugs, so don't discount one for the other.

Though the problem has not escalated to pandemic proportions...yet...my concern is with the unsanitary methods used for mass production of these animals. This requires antibiotics, which are passed on to those who eat the meat, only for the animals to become immune, etc., etc., etc. These conditions are perfect for the creation of viruses like HIV, that then morph and spread beyond human control.

First, it is a misconception that the mass production of animals is unsanitary. If anything, the more intensive agricultural practices are more sanitary than the free-range conditions where animals are left to eat from the same ground where their wastes are deposited with no possibility of disinfecting the area (some pathogens can survive a decade or more in soil). Most cases of transmission of bird flu to humans are in areas where there is a lot of small, backyard farming, not intensive agriculture. Second, antibiotics have nothing to do with viruses. Third, the conditions that promote spread of viruses have more to do with populations of animals and humans intermingling than with animals essentially quarantined in large production facilities. Fourth, the spread of a virus from animals to humans is based on the chance of the virus mutating to something that does infect humans, it is not "induced" or "caused" by any of the agricultural practices. If the mutated virus has the ability to be transmitted from human to human, then it can spread quickly among populations of humans.

Here is a report on the European use of antibiotics in animals that gives some insight both regarding the actual contribution of animal agriculture to antibiotic resistant bacteria (again, nothing to do with viruses) relative to clinical uses of antibiotics in humans (by far a larger contributor to antibiotic resistance in humans), and to the sanitation of facilities for intensive agriculture.
http://www.agbioforum.org/v3n23/v3n23a13-follet.htm

With regard to food safety in the US, here is information put out by the University of Minnesota extension office that addresses many of the concerns raised about animals in general:
http://www.extension.umn.edu/distribution/nutrition/DJ5513.html

And a fact sheet specifically about chickens (since the topic here is birds) put out by the USDA:
http://www.fsis.usda.gov/Fact_Sheets/Chicken_Food_Safety_Focus/index.asp

Again, keep in mind that the antibiotic use has nothing to do with flu, which is a virus not bacteria, but since it was raised in this thread, I wanted to address it.

Regarding avian flu, the best source of information is the CDC site:
http://www.cdc.gov/flu/avian/

Right now, person-to-person transmission seems to be very rare, if at all (in an agricultural community where many people are exposed to the infected birds, it can be hard to tell if they were infected by contact with birds/surface contaminants or other people). A pandemic would require sustained person-to-person transmission. Right now, it's more a matter of being prepared to respond quickly should clear indications of sustained human-to-human transmission appear (such as in health-care workers treating infected patients) in order to prevent a pandemic from happening rather than that a pandemic is likely.

The World Health Organization's FAQs are also helpful in explaining many of these issues.
http://www.who.int/csr/disease/avian_influenza/avian_faqs/en/index.html

 

[Evo]

To do a quick summary of what Moonbear said: (for those that don't read much)

What I had read (last week) is that the bird flu is not transmitted human to human currently, although a case is being investigated about possible transmission within a family, but I guess it's also possible that they both came into contact with infected birds.

The fear is that if enough humans are infected that the virus could mutate into a strain that can be transmitted human to human. That is not currently the case.

Did I get that right MB?

 

[SOS2008]

With the avian flu, until an outbreak begins, there is no way to start producing a vaccine. Although some vaccines are in development against current strains, it's no guarantee they would be effective against a strain that gains the ability to be transmitted among humans. Also keep in mind that the profits from drugs like Viagra help pay the R&D bills on the less profitable drugs, so don't discount one for the other.

First, it is a misconception that the mass production of animals is unsanitary. If anything, the more intensive agricultural practices are more sanitary than the free-range conditions where animals are left to eat from the same ground where their wastes are deposited with no possibility of disinfecting the area (some pathogens can survive a decade or more in soil). Most cases of transmission of bird flu to humans are in areas where there is a lot of small, backyard farming, not intensive agriculture.

Second, antibiotics have nothing to do with viruses. Third, the conditions that promote spread of viruses have more to do with populations of animals and humans intermingling than with animals essentially quarantined in large production facilities. Fourth, the spread of a virus from animals to humans is based on the chance of the virus mutating to something that does infect humans, it is not "induced" or "caused" by any of the agricultural practices. If the mutated virus has the ability to be transmitted from human to human, then it can spread quickly among populations of humans.

Thanks for the great information (as always--and why I originally posted something on this in the biology section, but more about food production in general). This was an old thread, and as the topic of avian flu has become more important to the public, I have seen various reports and programs covering this kind of information--such as the complexity and time frame required to make vaccinations, and in the case of avian flu, the outdoor birds being at a much higher risk (due to migration, etc.).

The cramped conditions may apply more to cattle, and loseyourname clarified the point about the use of antibiotics and diminishing effectiveness against disease—which is probably more the case for dairies. A report was done some time back about how more and more cattlemen were reverting to free range, even if it resulted in a little higher cost to the consumer. But I haven’t seen any updates on this. My brother-in-law is a rancher who has always used the free-range method, and the profit is very small.

There have also been problems with pigs (oh no!).

 

[Astronuc]

There have also been problems with pigs (oh no!).

Yet.

The concern is that H5N1 is highly pathogenic, and if it gets into the swine population and mutates to a form more easily transmissible to humans, then we would have some serious trouble.

Many are concerned about the recurrence of situation like the Spanish Flu in 1918, which was caused by deadly strain of avian influenza, a variant of H1N1, which is one of the Orthomyxoviridae family of RNA viruses which infect vertebrates. I believe H5N1 is one of these, at least according to article on Wikipedia - http://en.wikipedia.org/wiki/Orthomyxoviridae

I think the problem is that in some countries, avian and swine populations mix intimately with each other and with people, particularly in parts of Asia, and then people (tourists and business people) travel abroad, much more readily than in the past. Not to mention migratory fowl.

 

[Moonbear]

Thanks for the great information (as always--and why I originally posted something on this in the biology section, but more about food production in general). This was an old thread, and as the topic of avian flu has become more important to the public, I have seen various reports and programs covering this kind of information--such as the complexity and time frame required to make vaccinations, and in the case of avian flu, the outdoor birds being at a much higher risk (due to migration, etc.).

Yes, the concern is more with the wild birds in terms of avian flu, mainly because it doesn't make them sick, so they can carry it and spread it without showing any ill symptoms. That will make controlling it much more difficult, assuming any strain that can be transmitted from human-to-human remains infectious of wild birds.

The cramped conditions may apply more to cattle, and loseyourname clarified the point about the use of antibiotics and diminishing effectiveness against disease—which is probably more the case for dairies.

Well, antibiotic use is even more limited in dairies than in poultry production. In poultry production, they'll treat the whole flock if a few come down ill, but in dairies, they'll treat individual cattle only for an actual infection because the milk from any cow being treated with antibiotics has to be discarded; it's not permitted to be sold for human consumption. If antibiotic residues are detected in a tank of milk, not only will the farmer lose his profits on his milk, but will have to pay for all the other farmers' milk that was mixed into the same tank. Cramped conditions are generally avoided, because the stress of overcrowding can negatively impact fertility. This is even more the case for pigs, which seem especially susceptible to overcrowding. There's a definite financial incentive to not overcrowd animals.

A report was done some time back about how more and more cattlemen were reverting to free range, even if it resulted in a little higher cost to the consumer. But I haven’t seen any updates on this. My brother-in-law is a rancher who has always used the free-range method, and the profit is very small.

Free-range conditions are common with beef cattle, but wouldn't be used for dairy cattle (you need to bring in the dairy cows 2 to 3 times a day for milking, depending on how much milk they produce, so you don't want to keep them very far from the milking shed). Moving beef cattle into more intensive feedlot type operations is more a way to bring them quickly up to market weight.

There have also been problems with pigs (oh no!).

With regard to flu viruses, you mean? Yes, pigs seem to have enough in common with human physiology to make them a common route of transmission of viruses from animals to humans. This is nothing new.

 

[Moonbear]

The concern is that H5N1 is highly pathogenic, and if it gets into the swine population and mutates to a form more easily transmissible to humans, then we would have some serious trouble.

Considering it is already infecting humans without jumping to pigs first, I'm not sure if pigs are/will be significant in the transmission of this disease in humans.

According to the CDC site I linked above, the concern is with this particular H5N1 strain because it has been deadly in a majority of the people it has infected, and the others required hospitalization. There are a few other strains of avian flu that have jumped to humans, but they have had very mild effects, so are not of as much concern (symptoms ranged from typical mild seasonal flu symptoms to conjunctival infections - that's an eye infection).

 

[devil-fire]

part of the hype about this is due to the news media's has attention deficit disorder. if it wasn't the world ending from bird flu it would be the closest commit to Earth that might tear us out of orbit and kill us all or maybe something totally new that no one has ever thought about getting their neighborhood ruined by

 

[russ_watters]

Even if you don't eat meat it doesn't mean disease can't be passed from one species to another (like AIDS). I think it should be of concern, and we need to change the way we produce food--now.

Don't those two sentences contradict each other?

 

[Astronuc]

Considering it is already infecting humans without jumping to pigs first, I'm not sure if pigs are/will be significant in the transmission of this disease in humans.

According to the CDC site I linked above, the concern is with this particular H5N1 strain because it has been deadly in a majority of the people it has infected, and the others required hospitalization.

I recognize my statement was a bit awkward.

I am certainly not an expert in disease, but I see two factors with regard to the disease - transmissibility (the ability to spread) and virulence (I don't know if that's the correct term).

I thought that swine flus were more easily transmitted to humans (i.e. more contagious) then bird flus. And then there is the seriousness of the illness - i.e. is it more deadly than other flus.

I suppose one should try to stay healthy and observe good hygiene - e.g. wash hands periodically, especially when in public places. Perhaps get a flu shot. Stay away from people who have strong coughs and who do not cover their mouths when coughing.

 

[The Smoking Man]

In my research on the topic, I came across a statistic on the http://www.who.int/mediacentre/factsheets/2003/fs211/en/" showing that EVERY YEAR 250,000 to 500,000 people die of flu.

So far, in the years when SARS hit, we have seen a total mortality rate of about 800.

Now, I'm living in China and I know that population control here is comparable to herding cats. Why didn't whole communities die out here?

We hear of these warnings of pandemic and yet nobody has explained to me why the pandemic didn't already happen when we were less prepared than we are now.

I hate to say this and be branded a 'conspiracy theorist' but just how much of the controversy has to do with marketing the product http://www.tamiflu.com/consumer_recognizing.asp" ?

Take a look at the link above which will take you to the Tamiflu 'diagnosis site'. Use the wheel and take a look at the difference between how they diagnose the difference between flu and cold symptoms.

Now, remember, this product is only effective if used within the first two days of symptoms appearing.

All symptoms are common to both illnesses except 'exhaustion' and ... anyone who has stayed up all night with a cough can argue the point.

It also discusses symptoms that manifest for 2 to 3 weeks ... on a medicine that must be administered within 2 days!?

Can anyone tell me the name of a doctor who would risk NOT prescribing this drug and the potential for malpractice for misdiagnosis.

Tamiflu is the only product that has thus far given relief to SARS sufferers.

When this was first discovered, the people researching SARS advised against the use of Tamiflu because of the danger of developing resistant strains.

Roche has been unable to keep the shelves stocked with this product.

Roche in fact suggests on its http://www.tamiflu.com/consumer_prevention.asp" that it can be taken as a preventative i.e before symptoms manifest.

I know of several companes here in China who have ordered cases of this stuff for their employees.

SARS is now http://search.yahoo.com/search?p=tamiflu+resistant&ei=UTF-8&fr=slv5-&b=11"

It is at times like this I feel like Mendelson in Confessions of a Medical Heretic when he describes Valium and its use.

 

[pattylou]

Yay! You're back!

:D

 

[pattylou]

To do a quick summary of what Moonbear said: (for those that don't read much)
What I had read (last week) is that the bird flu is not transmitted human to human currently, although a case is being investigated about possible transmission within a family, but I guess it's also possible that they both came into contact with infected birds.
The fear is that if enough humans are infected that the virus could mutate into a strain that can be transmitted human to human. That is not currently the case.
Did I get that right MB?

There have been a couple cases of human-human H5N1 transmissions.

The secondary human in each case has (typically) not developed the disease as profoundly as the index case, although in at least one case, has died (in addition to the index case.) Exposure to birds has been largely ruled out in these cases.

http://www.recombinomics.com/News/03100503/H5N1_Secondary_Female.html

 

[Smurf]

TSM IS BACK! WOOOOOTT!

*sending out chain PM*

Hey dude, even evo said she missed you.

 

[The Smoking Man]

TSM IS BACK! WOOOOOTT!
*sending out chain PM*
Hey dude, even evo said she missed you.

It appears the line between 'a$$hole and infamous' is as thin as the one between 'genius and madness'.

Sold any T-shirts?

 

[loseyourname]

In my research on the topic, I came across a statistic on the http://www.who.int/mediacentre/factsheets/2003/fs211/en/" showing that EVERY YEAR 250,000 to 500,000 people die of flu.

How on Earth is that possible? I've had pneumonia twice in the last four years and West Nile once and I was never anywhere near death. Is this just killing the elderly and very young, or what?

I hate to say this and be branded a 'conspiracy theorist' but just how much of the controversy has to do with marketing the product http://www.tamiflu.com/consumer_recognizing.asp" ?

Take a look at the link above which will take you to the Tamiflu 'diagnosis site'. Use the wheel and take a look at the difference between how they diagnose the difference between flu and cold symptoms.

A possible reason for the 'fear mongering' that I keep talking about? Or should we seriously be as concerned as the talking heads want us to be?

 

[The Smoking Man]

How on Earth is that possible? I've had pneumonia twice in the last four years and West Nile once and I was never anywhere near death. Is this just killing the elderly and very young, or what?
A possible reason for the 'fear mongering' that I keep talking about? Or should we seriously be as concerned as the talking heads want us to be?

I have the same questions as you.
The last incident which happened in Canada was traced to a patient 0 that traveled there on a plane. From what I understand, there were only about 10 people infected on the flight which was presumably a 777 or something equally large. http://www.cbc.ca/news/background/sars/".
This was during the first outbreak.
Since then

On April 20, an interim report by Ontario Justice Archie Campbell's inquiry offered 53 recommendations including the establishment of a provincial centre for disease control. Campbell observed that Ontario's health system had been unable to manage the crisis because it was "broken." The province's medical infrastructure was pushed to its limits and the region's hospitality industry was also paralyzed by of the outbreak.
A day after that report, an independent expert panel on SARS presented another 50 suggestions. The panel observed that local officials, who are the first to observe an infectious outbreak and are best poised to contain it, had the least resources available to them.

Here is a http://www.cbc.ca/news/background/sars/timeline.html" of the whole SARS incident on a day to day basis.
From what I am seeing, in a totally defenseless system, the world coped.
Now we are aware and prepared better than the first time.
Any new illness will be a different mutation however and things that worked the last time may not work this time.
In short ...

 

[devil-fire]

Any new illness will be a different mutation however and things that worked the last time may not work this time.
In short ...

vaccines won't work with difference viruses but i think the idea behind a lot of this pandemic awareness/preparedness has to do with contagious viruses in general. maybe giving authority to health officials in an emergency situation could be an example of a new measure being introduced (i don't actually have a clue what they are up to).

 

[Skyhunter]

http://www.tamiflu.com/consumer_recognizing.asp"[/PLAIN] ?

I don't mind being labeled a conspiracy theorist.

So here is an interesting link to a possible conspirator.

http://www.mercola.com/2005/oct/25/rumsfeld_to_profit_from_avian_flu_hoax.htm#