Flu Stories: UK Deals With H5N1 Outbreak; US Plans For Graded Response

So it's official as of this AM:

Officials confirmed Saturday that the H5N1 strain of bird flu had been found in turkeys on a commercial farm _ Britain's first mass outbreak of the disease that has ravaged Asia's poultry stocks and killed more than 160 people worldwide. The virus strain that killed about 2,500 turkeys on the British poultry farm was identified as the highly pathogenic Asian strain, similar to a virus found in Hungary in January, the Department for Environment, Food and Rural Affairs said.

As i wrote on today's open thread, according to the BBC, Prof. John Oxford is speculating that perhaps a small bird came through a ventilation shaft. The extent of virus in the smaller bird population beyond ducks and geese is unknown. But the idea that poultry in developed countries can be infected remains relevant. BTW, cooking birds kills the virus, and the likelihood of a resultant human case is small. These birds were too young to get into the food supply in any case. Still, it's a problem that has not gone away (and because it's the UK there will be a flurry of news - it took them by surprise).

This all follows the release of the CDC's Community Mitigation Strategy on Thursday, which is a remarkable document that lays out a variable approach to pandemics based on severity. It treats pandemics like hurricanes, assigning a category score from 1-5. A cat 4/5 pandemic would require severe measures such as closing the schools for up to 3 months (the social disruption would be justified by the desire to save lives) whereas milder cat 1 or cat 2 pandemics would require simpler measures.

The idea of the more extreme social distancing measures would be to reduce the number of deaths and delay the onset of morbidity and mortality so as to better allow existing facilities (i.e., hospitals and health care workers) to cope.

While I have been critical of CDC in the past, I must give them credit for pulling together an extremely sophisticated plan while trying to coordinate the differing needs of a host of federal agencies from the Department of Education to the Department of Homeland Security. Even more remarkable is the level of consultation with various stakeholders, including the public, that took place prior to the release of these guidelines. But the difficult task of implementing these recommendations both at state and local level, figuring out how to even track unlicensed day care, work with colleges and health care workers, etc. has only begun.

As long as there's time, some or most of these measures can be implemented, and some or most of the hurdles can be surmounted. The unanswerable question is "how much time do we have?" That's where the UK story comes in to remind us that while there's no evidence of an imminent pandemic, the known unknowns and the unknown unknowns make any predictions extremely chancy. This H5N1 is one nasty virus and the work to implement the community mitigation strategies needs to be done in parallel with the work on a pandemic vaccine (and that's merely the complete rebuilding and restructuring of how vaccines are made, distributed and administered... all without knowing if H5N1 or some other virus is the pandemic strain. Hopefully, the vaccine work is completed before the non-pharmaceutical mitigation in necessary.

Pandemic interest by the public waxes and wanes. But rebuilding public health infrastructure is something that needs to be supported whether incidents like the UK H5N1 outbreak are in the news or not. if attention begats support, funds and political will, so be it. This outbreak in turkeys is going to cost the UK some dollar equivalents, but it's a wake-up call for the kind of work that needs to be done.

Comments

[emptypockets]

is there routine monitoring on poultry farms or was this only picked up after a couple thousand birds dropped dead?

I see that all birds from that farm were then incinerated. does the gov't compensate the farmer in any way for that?

as with mad cow, my impression is that UK & Canadian farmers are more responsible about reporting diseased animals than US farmers -- who prefer a "see no evil" approach, avoiding monitoring so they won't have to kill their herds (or flocks). is that characterization accurate?

do any groups sell bird flu insurance, like hurricane insurance, that might lower the bar for altruism on the part of the farmer expected to report an infection? should they?

[DemFromCT]

don't know the answers to these good questions. it does seem that the first birds died (70 or so) and the next day, more and then the 3rd day in the hundreds, so it was only then they were reported. This was not picked up by routine surveillance.

he first signs of the virus emerged last Tuesday, when 71 chicks died. A further 186 died the following day, 860 on Thursday and 1,500 on Friday. Yesterday hundreds of white-feathered birds were being pushed into an open-topped container by a tractor with a giant blue shovel. They were covered with a tarpaulin cover and taken away for incineration shortly before 1pm.

Bernard Matthews informed the Department for Environment, Food and Rural Affairs about the dead birds on Thursday night. Preliminary tests late on Friday confirmed bird flu, but it was only yesterday that further tests revealed the H5N1 strain. It is the first case on a UK commercial farm of H5N1, which has killed 164 people - most in south-east Asia - since 2003. The virus cannot pass from human to human at present.

There was criticism yesterday that Matthews's firm was too slow to act. Lillian Foreman, 43, a local resident, said: 'If turkeys started dying on the Tuesday, why wasn't Defra notified then?'

link

As for compensation, i don't know if that happens. The birds die if they're not killed.... high path avian influenza is pretty efficient. So, again, it's not a 'better approach'.

[DemFromCT]

Oh, and note the flu wiki link at the bottom of the Guardian story.

[emptypockets]

they die if they're not killed -- if they're infected. the WaPo story you link to, up top, says that all 159,000 birds from the farm were incinerated even though the virus was only found in 1 of the farm's 22 turkey sheds.

the other choice the farmer had was to try to cover up the infection and gamble that the one shed might die off but that the infection would not spread to the rest of the farm -- given 22 sheds, figure that's a savings of up to 95% of the farm's stock. that's a strong incentive.

it's remarkable to me that the farmer was honest enough to report it, even if it did take him two days to do so. I can certainly imagine a US farm trying to cover it up altogether.

[romunov]

Indonesia has recorded the virus in cats, too.

[kim]

I found this news to be quite alarming, other than an occasional dead migratory bird I'd seen H5N1 as a relatively distant threat to "the west" (US/CANADA/UK, IMO).

I immediately thought of DemFromCT when I read this story, and knew/hoped I'd find a new post on TheNextHurrah.

[sheds]

So if you have multiple bird sheds, how easily is H5N1 spread? Do the birds have to come into direct contact with each other or can it be spread airborne or through contact with the same food/materials?

TonyinAus