Influenza Virus Mashup

(Mon, 30 Jan 2012 19:46:00 +0000)

BSL-4 Lab Worker - Photo Credit –USAMRIID

# 6110

We are now 10 days into the self-imposed 60 day moratorium on the conducting (and publication) of controversial H5N1 research, and the meeting to discuss the future direction of such work in Geneva is still more than a couple of weeks away.

Meanwhile, the war of words - and the battle for the hearts and minds of the public - continues full throttle with advocates on both sides of this issue making their case in the media.

Today PBS Newshour has posted responses from three experts to a series of questions about this debate.

Richard H. Ebright - a molecular biologist at Rutgers

Vincent Racaniello - a microbiologist at Columbia, and author of the Virology Blog

Carl Zimmer, a journalist, author, and blogger

As you might imagine, there is a considerable difference of opinion over what should be done. Follow the link below to read:

SCIENCE — January 30, 2012 at 11:54 AM EDT

Experts Weigh in on Bird Flu Research

By: David Pelcyger

For earlier coverage of this story, you may wish to revisit:

Nature: Yoshihiro Kawaoka Talks About His H5N1 Research

WHO: Will Host H5N1 Talks In Geneva

ScienceMag: Ron Fouchier Interview On The H5N1 Research Moratorium

Science Magazine: Public Health, Biosecurity, and H5N1

There’s an old saying that Academic infighting is so vicious, because the stakes are so low. But in this case, both sides view the stakes here as being enormously high.

Biosecurity and concerns over public safety versus revered and well established principles of Scientific Freedom.

Given the tenor of some of the discussions I’ve seen over the past couple of weeks, the gulf between these two sides doesn’t seem to be getting any narrower.

Via Antara News: Bird flu in Bogor still restricted to chickens. Excerpt:

Bogor city health authorities have ascertained that no people in a ward where a number of chickens have been dying suddenly since Thursday (Jan 9) have contracted Avian Influenza (AI). 

"We have made on-the-spot checks and taken data and we can say that so far nobody in the neighborhood has been infected with the H5N1 virus," Dwi Susanto, a member of the Bogor City Health Office`s surveillance team, said on Saturday. 

Two people in Kampung Kayu Manis in Bogor city's Tanah Sareal ward where the chickens died were found to be sick but a medical check showed them to be suffering from the common flu, he said.

Mike Coston at Avian Flu Diary has an excellent post today: Surviving A Different Kind Of Aftershock. Excerpt (but read the whole thing):

The recent earthquakes in Haiti and in Fukushima, Japan – along with  Hurricane Katrina in New Orleans – have shown how communities can be forever changed by a disaster.   

With our short attention span, and the news media’s proclivity for moving on to the next big disaster or story, we often forget that the struggle to rebuild devastated communities can take years.   

And sometimes, for some of the people caught in harm’s way, there is no going back to the way things used to be.

(Mon, 30 Jan 2012 13:57:00 +0000)

# 6109

FEMA and Ready.gov, along with organizations like the American Red Cross (and indeed, this blog), spend a great deal of time trying to convince individuals, families, businesses and communities to prepare for emergencies and disasters.

The standardized advice is that everyone needs to be prepared to deal with a disaster for at least 3 days (meaning having a first aid kit, emergency supplies, and a plan) before help arrives.

Sure . . .  they’d like you to be prepared for longer . . .  but few enough Americans can be bothered to prepare for even 72 hours.

 

I personally advocate a minimum of a week’s worth of supplies (two would be better), but then I live in the heart of hurricane country, and am admittedly a bit of a belt-and-suspenders kind of guy (see NPM11: Living The Prepared Life).

There are some post-disaster aftershocks, however, that even two weeks of supplies won’t prepare you for.

The recent earthquakes in Haiti and in Fukushima, Japan – along with  Hurricane Katrina in New Orleans – have shown how communities can be forever changed by a disaster.

With our short attention span, and the news media’s proclivity for moving on to the next big disaster or story, we often forget that the struggle to rebuild devastated communities can take years.

And sometimes, for some of the people caught in harm’s way, there is no going back to the way things used to be.

Today, in a sobering news story by ABC (Australian Brocasting Corp), we learn that the first of what may eventually become 5,000 homes are to be demolished in the wake of their recent series of earthquakes near Christchurch, NZ.

The land they were built on experienced significant liquefaction during the September 2010 and February 2011 earthquakes, and so homes will not be rebuilt on these lots.

NZ begins demolishing Christchurch suburbs

By New Zealand correspondent Dominique Schwartz

Updated January 30, 2012 18:50:35

As this story indicates, that despite some compensation offered by the government, many residents have lost tens (or even hundreds) of thousands of dollars and say they have `no way of moving forward’.

With tremors continuing (see map above), those who escaped with only minor or moderate damage get nerve-wracking daily reminders that the ground beneath their feet could move violently again at any time.

And for those who would like to move away and start anew, the reality is that there are few buyers willing to purchase a home or a business in an area where the ground continues to shake.

Not all of the aftershocks of a disaster are seismic in nature. Some are economic, while others can be psychological.

While often hidden from view, the psychological impact of a disaster can be enormous and ongoing. Last year in Post Disaster Stress & Suicide Rates we looked at the impact of disaster-related PTSD (Post Traumatic Stress Disorder).

Although a good disaster plan and emergency kit are imperative to get you through the opening hours and days of a disaster, knowing how to help friends, family, and neighbors deal with the psychological effects of a disaster can be equally important.

Luckily, there are things that can be done - even by the layperson - to help reduce the psychological impact of a disaster. 

A few resources you may wish to revisit:

In Psychological First Aid: The WHO Guide For Field Workers we looked a simple guidebook anyone can use to help others in emotional distress.

The CDC also provides a website which contains a number of resources devoted to coping with disasters.

Coping With a Disaster or Traumatic Event

Trauma and Disaster Mental Health Resources

The effects of a disaster, terrorist attack, or other public health emergency can be long-lasting, and the resulting trauma can reverberate even with those not directly affected by the disaster. This page provides general strategies for promoting mental health and resilience. These strategies were developed by various organizations based on experiences in prior disasters.

As does the National Center For PTSD - including videos - on how to provide Psychological First Aid.

Psychological First Aid: Field Operations Guide

For Disaster Responders

Developed jointly with the National Child Traumatic Stress Network, PFA is an evidence-informed modular approach for assisting people in the immediate aftermath of disaster and terrorism: to reduce initial distress, and to foster short and long-term adaptive functioning.

A small reminder that not all wounds are readily visible to the naked eye, and that the proper bandage for them may not always reside inside your first aid kit.

Thanks to Emmy Fitri for tweeting me the link to this story in The Jakarta Globe: Bird Flu Fears in Indonesia: Flap Over Jakarta Pet Market Move. Excerpt:

Despite lingering fears about the spread of bird flu in the country with the world’s highest number of fatalities from the deadly avian influenza virus, Indonesia’s largest pet market has survived several attempts to relocate it. 

Located in East Jakarta, Pasar Pramuka is one of the 23 pet markets in Jakarta that sell birds. It boasts no fewer than 152 stores selling anything from various pigeon breeds and ducks to ornamental chickens. 

The market, which is popular with many Jakarta shoppers, sits just 5m from the densely populated Pal Meriam residential area — a clear challenge to municipal laws that ban poultry from being reared within 25m of residential areas. 

While the laws specifically refer to farmed poultry and slaughterhouses, it is clear that pet birds would pose similar risks of spreading bird flu to humans. 

But the people living near Pasar Pramuka are not worried. 

“The pet market has been around for 30 years. We haven’t had anyone here catching bird flu,” Evaldi, 46, who lives about 20m from the market, said as his six-year-old son Razaq Gumanti, played with his pet bird. 

His neighbor Damiri, too, told The Straits Times: “They have been keeping Pasar Pramuka market very clean, probably the cleanest market in the country. As long as they keep up with that hygiene work, we should not be worried.” 

It is the kind of response that frustrates Ipih Ruyani, Jakarta’s top bureaucrat overseeing the culling of sick poultry and checking on whether poultry handlers keep to the rules. 

“Their typical argument is: We have been living with live poultry for years. If there were bird flu, we would have caught it a long time ago,” she said, sighing. 

Jakarta’s municipal government has been trying to move Pasar Pramuka for the past four years but has been facing delays from a combination of protests from stallholders and the public, as well as slow bureaucracy. 

The first attempt was made in 2007, the year 37 people died from bird flu in Indonesia. The country accounts for almost half of human bird flu fatalities, and saw 45 people die in 2006.

Via ABC News, a slightly confusing report: Crackdown on avian influenza in Victoria. Excerpt:

Victorian authorities are tracing all poultry movements from two duck farms where avian influenza has been found. 

The low pathogenic strain of the disease was discovered on Friday afternoon and 10,000 ducks have already been destroyed. 

The two farms are north west of Melbourne and under one ownership. 

Veterinarian Dr Peter Scott, who advises the egg industry, says this is not bird flu, but is a local disease carried by wild waterfowl.

The Chief Vet of Victoria, Dr Andrew Cameron, says it is not as contagious or harmful as the H5N1 strain that is affecting poultry and people in Asia. 

He says there is no risk to human health from this outbreak.

So it's avian influenza but it's not bird flu, and it's "not as contagious or harmful as the H5N1 strain." What are we dealing with here? 

The February issue of Emerging Infectious Diseases is now online, and this article caught my eye: Pathogenic Responses among Young Adults during the 1918 Influenza Pandemic. The abstract, re-paragraphed:

Of the unexplained characteristics of the 1918–19 influenza pandemic, the extreme mortality rate among young adults (W-shaped mortality curve) is the foremost. Lack of a coherent explanation of this and other epidemiologic and clinical manifestations of the pandemic contributes to uncertainty in preparing for future pandemics. 

Contemporaneous records suggest that immunopathologic responses were a critical determinant of the high mortality rate among young adults and other high-risk subgroups. 

Historical records and findings from laboratory animal studies suggest that persons who were exposed to influenza once before 1918 (e.g., A/H3Nx 1890 pandemic strain) were likely to have dysregulated, pathologic cellular immune responses to infections with the A/H1N1 1918 pandemic strain. The immunopathologic effects transiently increased susceptibility to ultimately lethal secondary bacterial pneumonia. 

The extreme mortality rate associated with the 1918–19 pandemic is unlikely to recur naturally. However, T-cell–mediated immunopathologic effects should be carefully monitored in developing and using universal influenza vaccines.

(Sun, 29 Jan 2012 17:42:00 +0000)

# 6108

When I saw the reports on Friday about India’s Health Ministry’s attempts to downplay reports of totally drug resistant tuberculosis, I was immediately reminded of the old joke about the doctor who couldn’t cure you, but for a small fee he’d touch up your X-rays.

Today, Maryn McKenna takes a closer look at India’s denials (which are similar to the official reaction we saw last year over NDM-1)  in her Superbug Blog.

Follow the link to read:

TDR-TB: The Indian Government Denies It

• By Maryn McKenna
• January 29, 2012 

An update to the news two weeks ago of totally drug-resistant tuberculosis, TDR-TB, being identified in India (and earlier in Italy and Iran): The Indian government has announced that it doesn’t exist, and is putting pressure on the physicians who identified it to say they made a mistake.

(Continue . . . )

Mike Coston at Avian Flu Diary has a fascinating post on The Kolkata Crow Mystery, reporting that the city authorities are finally looking into local crow deaths.

The New York Times has published an editorial: The Missing Bird Flu Report. The NYT supports redaction of the reports before they're published.