Flu Stories

by DemFromCT

Over at Daily Kos, regular TNH contributor Plutonium Page has summarized one of a series of stories in Nature fictionalizing the flu pandemic of the winter of 2006. Interestingly, the well-respected magazine chose the form of a 'blog' to get the word out.

26 December 2005 It's an emergency -- official

President George Bush has just addressed the press in the East Room of the White House. Here's the transcript: "At this hour, the World Health Organization has declared a full-scale pandemic influenza alert, with person-to-person spread lasting more than two weeks in Cambodia and Vietnam. During previous influenza pandemics in the United States, large numbers of people were ill, sought medical care, were hospitalized and died. On my orders, the Department of Homeland Security and the Department of Health and Human Services have today implemented the nation's draft Pandemic Influenza Response and Preparedness Plan. It will serve as our road map, on how we as a nation, and as a member of the global health community, respond to the pandemic. We are ready. Thank you, and may God bless America."

Ready, my ass! I've reported on avian flu for almost a decade. The first thing I did on hearing Bush's address was to get on my cellphone to my husband, Jonathan. I told him to pack some bags and get ready to take the kids to my mother's house in Florida. "Remember all that stuff I told you about how a bird flu pandemic might hit the United States? Well, I think it's about to happen."

A review of the technique is here from the blog WorldChanging:

The current (26 May 2005) issue of Nature focuses on avian flu and the possibility of a pandemic. They've chosen to illustrate how a flu pandemic might play out with a future scenario in the form of a blog. While WorldChanging has written before about both the hype and reality of a possible pandemic, the Nature piece is worth reading -- especially as an example of how scenarios and blogs as narrative vehicles continue to trickle up through traditional media.

In the meantime, the following is not fiction (as we traditionally define it, anyway):

What Is Really Going On In China?

We don't yet know.  But read this collection of links.  Here is the most worrying excerpt:

Reports coming out of Qinghai suggest H5N1 infections in humans and birds are out of control, with birds distributing H5N1 to the north and west, while people are being cremated and told to keep quiet.

Reports from Chinese language papers detail over 200 suspected infections in over two dozen locations in Qinghai Province.  In the most affected 18 regions, there are 121 deaths, generating a case fatality rate above 60%.

Even if only a small fraction of the deaths are H5N1 linked, the cases would move the bird flu pandemic stage from 5 to the final stage 6, representing sustained human-to-human transmission of H5N1.

The high case fatality rate suggests the H5N1 in Qinghai has achieved efficient human transmission while retaining a high case fatality rate.  If confirmed, these data would have major pandemic preparedness implications.  These cases began almost a month ago and are now spreading via people who have previously entered the high risk area.

In one sense, a less virulent death rate, coupled with increased infectivity would be the worst combination. China also claims to be developing a vaccine, which, along with everything else we read, is impossible to objectively verify.

For more Q&A on bird flu see the New Yorker. One example:

        How does SARS fit into this story? For a while, it inspired something like panic, and yet the concern seems to have died down.       

When sars emerged, nobody knew what caused it or how deadly it would be. Officials monitoring the first reports assumed it was a flu pandemic—and they were actually relieved to find out that it was not. But the fear is not hard to understand: some people were afraid that sars would be as deadly as H.I.V. was when it first began to spread, in the nineteen-eighties, but also as easy to contract as the flu. It turned out to be a new virus—a distant cousin to the common-cold virus—and it is neither very easy to get nor, usually, deadly. But new diseases with no known causes or cures are always frightening.

Unfortunately, there'll be more to come on this. The Nature issue is very thorough, and worth an entire read.

      

Comments

[DemFromCT]

WHO is trying to do the right thing. See (or rather, listen to) All Things Considered:

All Things Considered, May 27, 2005 · International law requires nations to report outbreaks of only three diseases: cholera, plague and yellow fever. That's changing under sweeping new regulations approved this week that require nations to tell the World Health Organization about any outbreak with the potential to spread across borders.

[DemFromCT]

some more: U.S. Criticized Over Bird Flu Plans

[Fred in Vermont]

>China also claims to be developing a vaccine, which, along with everything else we read, is impossible to objectively verify.<

The claims of a human to human contagion with hundreds of victims are also hard to verify.  One cite I saw that gave raw automatic translations of some of the uncensored blogs out of the area gave accounts which seemed to some readers to suggest that this might just be an attempt to use the admitted large kill of wild geese in the area to push for better health care systems in a very remote and impoverished area.

But valid or not, a claim like this just can not be ignored.  It shows how important it is that there be international transparency is such situations.  There needs to be some sort on international framework that would assure that independent teams could fully explore all such claims that have any plausibility.

The idea of rapid human to human transmission coupled with a very high death rate is the sort of "perfect storm" of viral evolution that makes epidemiologists come down with cold sweats. We need international structures that will ensure quick objective evaluation of such potential threats.  They have happened before and they will happen again and in many ways the modern world is more vulnerable than in earlier centuries.

[DemFromCT]

Thanks, Fred in Vermont, for your links and for payin' attention.

[DemFromCT]

by the way

Roche faces Tamiflu production bottleneck following WHO bird flu warning

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