Today's round-up is meant to highlight a few things. Firstly, the NY Times health section has an extended focus on bird flu today, with six different stories on the topic. Of interest (well, they all are) is the Q&A about the likelihood of pandemic. I especially note:
Q. Is the government prepared for a bird flu pandemic?
A. No. The nation does not have an approved flu vaccine for people or enough antiviral drugs or respirators for all who would need them. The best protection in any flu pandemic will come from a vaccine, but scientists cannot tell ahead of time what strain the vaccine should protect against.
Q. If there is an epidemic of flu in humans, how can I protect myself?
A. If there is a vaccine available, that would be the best option. But if there is no vaccine it may be hard to avoid being infected. Flu pandemics spread quickly, even to isolated regions. The 1918 flu reached Alaskan villages where the only way visitors could arrive was by dog sled.
Some health officials have recommended stockpiling two to three months’ worth of food, fuel and water in case a pandemic interferes with food distribution or staffing levels at public utilities, or people are advised to stay home.
Regular readers will be familiar with both answers.
Also of note is a few web-based wiki articles. One is an extended interview (48 minutes) I have to an IT guy at theory. is the reason on Flu Wiki, wherein I talk about the nexus between health and politicial blogging.
Also, here's a (partial) list of the 33 best wikis on the web by nomination (in progress), various subjects.
Wikis are of interest to technology people and library science folks above and beyond content. Always interesting to be reminded of that when I get email from unexpected sources.
Finally, there have been some important papers recently about viral receptors in the human lung in Science and Nature. Effect Measure summarizes:
Finally we come to the question of what it means. My answer may be disappointing. At this point we don't know. The investigators speculate (in the news stories more than the papers themselves) that the reason bird flu is not as "catchable" as ordinary flu is that its residence deep in the lungs makes its transmission more difficult. There is no mucus in the gas exchange units so coughing and sneezing is less likely to create a virus-containing aerosol. Or so it would seem. In truth, however, we don't know the main routes of transmission. Gas from the alveoli (the deep air sacs) is certainly expelled on exhalation, likely contains virus, and once outside the humidified environs of the respiratory tract would rapidly dessicate (dry up) and could form droplet micronuclei. The assumption that virus deep in the lungs is less transmissible might be correct but it has not been shown. Other factors might be involved. Neither paper tested the transmissibility question, which remains pure speculation (although not implausible). The Japanese paper also points out that if the virus were to develop the ability to dock with α-2, 6 cells, either in addition to or instead of α-2, 3, we could have a nasty actor on our hands. One isolate from Hong Kong in 2003 seems to have this ambidextrous character, although most H5N1s do not.
That's my initial read of these two fascinating papers. They are a step forward but leave much to be discovered. Contrary to the more optimistic interpretations, it is too early to conclude that H5N1 is not likely to be easily transmissible from person to person soley on account of its location deep in the lungs. The papers do not show this nor do they conclude this.
This is exciting science, but also urgent science. Much, much more to learn.
Hard to disagree with that.