Anybody worried about the Bird Flu creeping towards Ireland?

Zaph0d

psi wrote:

Likewise, you can't class bird flu as a threat to humans, because it doesn't currently have the capability to cause a pandemic. *IF* (and its a big big if) it did jump species it would be a threat, but it hasn't and due to the specific nature required for such an event to occur, its far more likely it won't happen than will happen. So can you really call it a threat?

When you make a risk assessment it's always relative to other risks. A typical person reading this thread may be a 20 year old Irish person, your chances of reaching your 26th birthday are around 998/1000. Despite these odds, the various fatal risks are still taken seriously and mitigating actions are considered sensible (seatbelts, lifejackets, anti-depressants). The question is whether the product of the probability of a pandemic flu occurring in the next 6 years multiplied by the number of people it would kill during that time is comparable with the existing remote risks of death. If the risk is not negligible then the next question is whether any cost effective measures can be taken to mitigate the effects of a possible pandemic.

By comparison they were cave men back then. For example, mankind successfully wiped out one of the most contagious and devistating viruses it has ever known. No other creature has the ability to do such a thing.

What has changed? Hygiene? Containment?

GuanYin

Zaph0d wrote:

If the risk is not negligible then the next question is whether any cost effective measures can be taken to mitigate the effects of a possible pandemic.

You're missing my point. There are is a chance of quite literally hundreds of different abian influenza strains becoming a threat to mankind. H5N1 is indeed a particularly nasty strain, but aside from that the only thing that stands it apart from other strains is the news coverage.

I mean we don't even know how virulent it would be in humans. Even if it does become human-human transmissible, we don't actually know if the changes will effect its pathogenicity. There are so many unknown variables that the risk of H5N1 is most likely negligible.

Now as I've said before, I'm all for taking a global flu pandemic strategy into being. But doing this over time, in a calm and logical way is the smart thing to do. Stockpiling drugs that will probably be ineffective, at great cost to the taxpayers and causing a mild state of panic, is not the way to do this.

What has changed? Hygiene? Containment?

Yes and yes but the most important factor is communication. We know have global monitoring agencies and better communication facilities. Because of this, if something REALLY nasty did emerge and it was found that an infectee had boarded a flight from hong kong to london, we would have the flight time to dicover the fact and prepare. We've never had this kind of luxury in dealing with a global threat disease before.

An in any case, who is to say we haven't already met the next emerging flu pandemic and controlled it? 50 years ago SARS might have reashed a death toll of hundreds of thousands....

bonkey

psi wrote:

For instance (analogy time), if the IRA acquired a nuclear device, it would be seen as a nuclear threat.

Yes, because there is a chance of them using the nuclear decide they acquired.

Were they looking for one, there would be a chance of them acquiring one, and thus there would be the threat of them becoming nuclear-capable.

But the IRA would never be classed anywhere as a nuclear threat.
Likewise, you can't class bird flu as a threat to humans,

But you can classify the threat that bird-flu will mutate to human-human transmissible, and therefore become human-threatening.

Well look. There are plenty of animal diseases that could jump species and wreck havoc with humans, they just don't have as much PR.

Its nothing to do with PR.

H5N1 is remarkably similar to the strain more commonly known as Spanish flu. It is also a strain of a virus which is well known for its mutative capability, as well as an identified non-negligible probability of mutating to a point capable of species jump.

Thus, we have a situation where there is what appears to be a strain of a flu known for mutation to human/human transmission capability, which also shares many facets of what has been identified as the most lethal recorded flu strain in the wild.

This is not PR. This is a situation where only one factor - human/human transmissability - is missing before we have a lethal combination. GOing back to your IRA analagy, its like they have all the parts of a nuclear bomb except one. If they acquire that part, they are nuclear capable. If they don't, they ain't.

So if the IRA had all parts of a nuclear bomb bar one...would you be insisting that it didn't constitute anything threatening except in PR terms?

If you still insist, incidentally, that there's plenty of similar viral threats out there - where only one of the lethal-to-human, highly-contagious, human-transmissible, highly-mutatable, no-effective-countermeasure-for-pandemic points is not covered.....care to name some?

Worst case scenarios are being plotted and really, thats all it is. A scenario.

And if the IRA had their hands on a nuke, it would only be a scenario that they would set it off. Thats what threats are - undesireable scenarios that have a non-zero probability of arising. Scenarios.

We're actually long overdue a pandemic if you listen to some "experts" but what all this forgets to take into account is the MASSIVE advances in medicine, medical response and disease control world wide since we lats had a flu pandemic.

Actually, medically we're pretty-much nowhere when it comes to dealing with the flu, except when its a variant that falls inside certain known brackets - typically those which make it generally non-lethal.

Also, the notion of a probability being "overdue" is statistically nonsensical, given that future probabilities are not based on past. If the likelihood of a pandemic arising in any given year is 5%, it doesn't matter whether there's been one two years ago, or none in the last hundred. The likelihood of one occurring next year is still only 5%.

Also note that while pandemics do (statistically) occur preiodically, these statistics say nothing about the lethality of the strain which will cause it. Even if we want to suggest we're overdue a pandemic, this doesn't mean that we're overdue a lethal pandemic.

For example, mankind successfully wiped out one of the most contagious and devistating viruses it has ever known.

Which one?

Now, I'm not suggesting we get cocky or not take the threat of disease seriously, but I don't think we should be devoting time and resources to worrying about the next great disease that *might* come along, when there are plenty of terrible diseases doing damage here already.

True, but this is where the cynic in me will point out that there are very few diseases threatening the rich, and very few poor who can give the rich incentive enough to make them the drugs to tackle the existant terrible diseases.

One very valid point which was raised about the threat of a super-flu pandemic is the fact that Tamiflu (the only drug at the time believed to be in any way effective) took almost a year to prepare, and was done so using a massively inefficient and outdated technology. Simply put, if H5N1 did mutate to h/h tranmissability and retained its lethality....we don't have the capability to tackle it medically on a large scale.

Thus, a new flu strain, just as SARS etc, grabs the headlines because it threatens the rich and the developed nations, and not just those who can't afford what medicine can already tackle. Captain Trips could kill Bill Gates as readily as it would kill a destitute person living on the streets of Calcutta. That makes it newsworthy, unfortunately.

GuanYin

bonkey wrote:

Were they looking for one, there would be a chance of them acquiring one, and thus there would be the threat of them becoming nuclear-capable.

But you can classify the threat that bird-flu will mutate to human-human transmissible, and therefore become human-threatening.

Thats grasping a bit bonkey. There are plenty of 2-step instances in life wher eyou can say X happens Y becomes a threat.

Its nothing to do with PR.

H5N1 is remarkably similar to the strain more commonly known as Spanish flu. It is also a strain of a virus which is well known for its mutative capability, as well as an identified non-negligible probability of mutating to a point capable of species jump.

Thus, we have a situation where there is what appears to be a strain of a flu known for mutation to human/human transmission capability, which also shares many facets of what has been identified as the most lethal recorded flu strain in the wild.


This is not PR. This is a situation where only one factor - human/human transmissability - is missing before we have a lethal combination. GOing back to your IRA analagy, its like they have all the parts of a nuclear bomb except one. If they acquire that part, they are nuclear capable. If they don't, they ain't.

So if the IRA had all parts of a nuclear bomb bar one...would you be insisting that it didn't constitute anything threatening except in PR terms?

That an oversimplification bonkey.


It is true that there is similarity between H5N1 and "spanish flu" but then all flu viruses are limited to a mere 8 gene segments. There are strong similarities between seasonal influenza (infecting humans) and avian flus too. But in fairness the similarities between the egentic code is roughly 98%. But considering the genetic code between humans and chimpanzees is only 96% its worth noting that its the remaining 2% that matters, the differences, rather than the similarities.

There are about 4,400 amino acids in avian flu viruses and of these around 30 would have to mutate in a specific way to lead to a virus comparable to Spanish flu.

But like I said before, we don't know what any of these changes would do. Virulence facors are often strongly linked to other non-virulent factors in a virus.

So for any given step that avian flu makes in becoming similar to spanish flu, it may cause a knock-on effect that reduced the simularity or virulence in another way.

All these changes have been occuring for half a century, given the range of genetic mutations across the board, there is no reason more reaosn to think that if avian flu does become human-human transmissible, the virus may either be unable to cause lethal pathogenisis in human, or may require further adaption in the new host before becoming so capable. It may even already have happened. In this case, it is most likely we'll adapt either immunologically or medically before it mutates again.

Of course, all this is speculation, but then again, so is theidea that avian flu will be a threat to humans.

If you still insist, incidentally, that there's plenty of similar viral threats out there - where only one of the lethal-to-human, highly-contagious, human-transmissible, highly-mutatable, no-effective-countermeasure-for-pandemic points is not covered.....care to name some?

Well what you ask there doesn't apply to H5N1 either. At least I don't think so, can you rephrase that in a less muddled way? (sorry, I am trying to answer, I just can't quite get that sentance structure clear in my head and I want to answer the right question).

And if the IRA had their hands on a nuke, it would only be a scenario that they would set it off. Thats what threats are - undesireable scenarios that have a non-zero probability of arising. Scenarios.

I didn't intend for you to try and drag out this analogy, mainly because apart from my simplified version, its not a very good one. But if we wante dto carry it on, it would be more analagous to suggest that the IRA had their parts to a bomb and it could be any type of bomb with a weak bomb being most likely but a small small chance of being a nuclear bomb. It would also be a case where 1-2% of the bomb was assembled randomly by "a blind bombmaker".

Actually, medically we're pretty-much nowhere when it comes to dealing with the flu, except when its a variant that falls inside certain known brackets - typically those which make it generally non-lethal.

Well its true there are about 40,000 deaths worldwide a year due to flu, but the big thing to remember is that "contagion protocols" have improved. Ok the incubation period and often asymptomatic nature of influenza are a problem, but then this will depend specifically on the natue of avian flu should it become human transmissible.

Estimates for 1918 spanish flu outbreak suggest each infectee managed to infect 20-30 others. However, the most recent studies suggest that the average number of transmissions from an infectee for flu is 4 people (Nature, Dec 05). This suggests that an outbreak may be more likely to be contained locally.

Also, the notion of a probability being "overdue" is statistically nonsensical, given that future probabilities are not based on past. If the likelihood of a pandemic arising in any given year is 5%, it doesn't matter whether there's been one two years ago, or none in the last hundred. The likelihood of one occurring next year is still only 5%.

I agree, it is much the same as overdue meteorites etc etc. But again, the 5% figure is based on previous encounters, which may or may not imply anything in future cases.

Also note that while pandemics do (statistically) occur preiodically, these statistics say nothing about the lethality of the strain which will cause it. Even if we want to suggest we're overdue a pandemic, this doesn't mean that we're overdue a lethal pandemic.

Actually, I believe the current media blurb is referring to lethal pandemics.

Which one?

Smallpox.

True, but this is where the cynic in me will point out that there are very few diseases threatening the rich, and very few poor who can give the rich incentive enough to make them the drugs to tackle the existant terrible diseases.

The ironic thing is, it is the current mortality rate for h5n1 inhumans that is causing many alarm bells to ring. But like so many things, the so called facts depend on how you examine the figures.

It is true that approx 55% of those diagnosed with bird flu have died. This, on the surface makes it the most human-pathogenic flu known. However, the key word is diagnosed.
Most ofthe recent studies point to the fact that there have most likely been far far more infections than those diagnosed, especially in rural areas - where human-poultry contact is almost constant. These infections may never get reported, they may not even by symptomatic infections, its quite likely that many of these people already have a strong anti-avian flu immune system in place.

When you also consider, it is usually the most sick and disabled that go to hospitals with illness - that is, those infectees that are most sick, then the credibility of the H5N1 pathogenicity estimates deminish rapidly.

One very valid point which was raised about the threat of a super-flu pandemic is the fact that Tamiflu (the only drug at the time believed to be in any way effective) took almost a year to prepare, and was done so using a massively inefficient and outdated technology. Simply put, if H5N1 did mutate to h/h tranmissability and retained its lethality....we don't have the capability to tackle it medically on a large scale.

Actually GSKB have Relenza, an inhaled antivrial drug that seems to be effective against avian flu. Its also much less used, which means that the chance of human strains having resistances to is is much decreased.

Peramivir is also (last I heard) at end stage of animal trials and it is much cheaper and easier to produce than tamiflu. An FDA waiver may be required if they wanted quick large quantities, but the truth is, tehre are other options.

Thus, a new flu strain, just as SARS etc, grabs the headlines because it threatens the rich and the developed nations, and not just those who can't afford what medicine can already tackle. Captain Trips could kill Bill Gates as readily as it would kill a destitute person living on the streets of Calcutta. That makes it newsworthy, unfortunately.

Well Emory university's biostatistician Ira Longini has put together scenarios involving an outbreak across a 3500 mile-squared area containing 500,000 people (modelling Thailand). The estimates are promising, suggesting that we would have up to 4 weeks to intervene with antivirals if a human outbreak occured.

Unfortunately with all the hype and countries like Ireland panic-stockpiling such drugs, instead of 500,000 to a million courses being put on standby for shipment to the source of an outbreak, we're doing ourselves more harm than good.

leannan

boardy wrote:

It is not the actual Bird Flu (which will hit Ireland very soon) that I am worried about but the supposed pandemic that will follow if the flu crosses into a human-to-human transmission.

Will it be our Armageddon?
As it is a constantly mutating virus, will it be worse than the great flu pandemic of 1918–1919, which caused an estimated 40 to 50 million deaths worldwide?

From http://www.who.int/csr/don/2004_01_15/en/:Laboratory studies have demonstrated that isolates from this virus have a high pathogenicity and can cause severe disease in humans.

I am not one to worry too much about impending doom, but this is kind of scary.

More info at:
http://www.cdc.gov/flu/avian/

I heard on television that if/when the flu mutates and begins to spread person to person, we should all have about 6 weeks of food and water stored at home. This is so we won't have to leave home and risk contamination when the flu sweeps through our region. I can't say I am nearly prepared, but here in the Pacific NW we are also being told to prepare for an earthquake. Apparently, there is a big one headed our way. Enough to make one a bit nervous, no?
Hmmm, that reminds me, I need to go to the grocery store...

GuanYin

leannan wrote:

I heard on television that if/when the flu mutates and begins to spread person to person, we should all have about 6 weeks of food and water stored at home. This is so we won't have to leave home and risk contamination when the flu sweeps through our region. I can't say I am nearly prepared, but here in the Pacific NW we are also being told to prepare for an earthquake. Apparently, there is a big one headed our way. Enough to make one a bit nervous, no?
Hmmm, that reminds me, I need to go to the grocery store...

Are you sure you should go out at all? What if we're hit by a meteorite while you're on the way to the store :rolleyes:

Seriously though, I'm not going to tell you it isn't a threat, because it is. I heard that its coming to get you - specifically - just you

leannan

psi wrote:

Are you sure you should go out at all? What if we're hit by a meteorite while you're on the way to the store :rolleyes:

Seriously though, I'm not going to tell you it isn't a threat, because it is. I heard that its coming to get you - specifically - just you

lol lol lol
This is just what I heard, so it seems reasonable to have some kind of back up plan in case we need one. I don't want to be the one who ends up having nothing prepared and find myself in an earthquake without any food or water for a week. Just like you should have candles and flashlights and such for power outages. Basic precaution. Nothing drastic. lol