Daniels has what the World Health O. dubbed as XDR-TB, or extremely drug resistant tuberculosis , which is virtually untreatable using current anti-TB drugs. Daniels was considered “uncooperative and a danger to the public” and was ordered locked up because he did not take precautions to avoid infecting others or even to wear a mask in public. Although currently rare in the US, XDR-TB broke out in Africa last year with an alarmingly high mortality rate. XDR-TB is transmitted the same as other forms of tuberculosis – by aerosol droplets expelled by an infection person with a cough, sneeze, kiss, spit, or sharing of utensils.

Now, though TB is a bacterial infection (and technically not a “concern” of this blog), INFLUENZA has the potential of becoming drug-resistant** as well.

In the face of increasing use (and misuse) of flu drugs, the potential of developing drug-resistant flu viruses, the problem of containing H5N1 across much of Asia, and likened to the days when the world dealt with smallpox and leprosy, once again we face the the issue of dealing with infected persons with untreatable symptoms.

Putting people and whole villages quarantined have been in practice and found highly effective. But as H5N1 spreads to less isolated cities and across nations, it is getting much harder to control the transmission of flu viruses.

Now, I have no answers to the issues/questions below, but I pose them because I myself am looking for more concrete solutions to the global health threat of a drug-resistant influenza/bird flu/pandemic flu/ virus.

1. Should uncooperative contagious persons (as Daniels was charged) be locked up?

2. What needs to be done about infected persons wishing to travel? Do airlines or cruise ships have the right to refuse a sick person from boarding? Should there be an international law to govern the travel of contagious persons sick with life-threatening diseases?

3. How long should a quarantine (or shelter-in-place) last? A survey last year posed that Americans will only stay home 7 days at the most in the event of a flu pandemic. The need to work is the top reason for not staying home. Will this number of days be enough?

4. What kind of regulations should there be in place to prevent the overuse of drugs that may cause resistance?

Certainly, there are more questions than the above, but if you have answers or ideas or more questions, feel free to fill the comment and begin a discussion.

**The U.S. Centers for Disease Control reported last year that 92% of influenza A (H3N2) viruses isolated from patients demonstrated an amino acid change that confers resistance to adamantanes. Two of eight type A flu viruses were in fact resistant. Canadian authorities report the same mutations in isolates recently tested. These findings prompted the CDC to recommend against the use of amantadanes for flu treatment last season. In addition, a small study of Japanese children treated with oseltamivir also reported a high frequency of resistant viruses. However, no transmission of neuraminidase inhibitor-resistant viruses in humans has been documented to date.

[Source: MSNBC; image]

Tags: drug-resistance, XDR-TB, tuberculosis, influenza, bird flu, pandemic, oseltamivir, adamantanes, world health, virus, viral disease, viral illness

Post from: Blisstree

Drug-resistant TB patient quarantined for life… and what this means for bird flu

That’s the number of people anticipated to become infected in a pandemic , and the US Department of Health and Human Services (DHHS) wants states to purchase enough antivirals to treat this many number of people. The Bush administration plans to purchase enough drugs to treat 44 million people nationwide, or about 15 percent of each state’s population, but states will have to use their own funds to pay for the remaining courses of drugs, although the federal government will also subsidize a quarter of the cost.

California is allocating enough resources to buy antivirals and treat 25 percent of its population. To date, it is one of only 13 states to order the medications. Some states are hesitant to stock up because the antivirals have never been tested to protect against bird flu and they want more evidence the drugs actually will work.

Even if there’s enough to treat 25% nationwide, there’s still the three quarters left untreated. Who gets to decide who’s going to get treated? The DHHS’ recommendations for top priority go to:

The rationale for the list is in this DHHS pandemic flu plan page.

[Source: pandemicflu.gov; DHHS pandemic flu plan]

Tags: avian flu, health, Health and Human Services, health care workers, pandemic flu, public awareness and prevention, Tamiflu, Relenza

Post from: Blisstree

In a flu pandemic, who gets the antiviral drugs?

Vaccines containing inactivated influenza virus have been available for 50 years to prevent flu and its complications, according to background information in the article. Immune responses decrease with age, however, and currently available flu vaccines are not always effective in the elderly. Recommended vaccines contain 15 micrograms (mcg) of inactivated virus per strain.

Wendy A. Keitel, MD, Baylor College of Medicine, Houston, and colleagues studied the response to vaccines containing 15, 30 and 60 mcg of virus among 202 individuals age 65 years and older (average age 72.4) in 2002. The 60-mcg level was selected as the highest dosage because manufacturers would reasonably be able to produce that type of vaccine.

Participants were randomly assigned to receive one of the three vaccines or a placebo injection and then were monitored daily for one week afterward. They were also examined 30 minutes, two days and 28 days after the vaccine and were contacted six months later to inquire about serious adverse events or side effects. Blood was drawn before the immunization and one month after.

On average, individuals who received higher dosages of vaccine had higher concentrations of antibodies against the flu virus in their blood one month later. In addition, a larger percentage of those who received the higher-dose vaccines had what physicians believe is a sufficient immune response to protect them from developing the flu if they were exposed to the virus.

With all of the focus currently on the bird flu, it is easy to overlook the regular old seasonal flu. In the Southern Hemisphere flu season is just starting. People of all ages need to be sure to get vaccinated against the seasonal flu.

High-Dose Flu Vaccines Appear to Safely Boost Immunity in Elderly

Post from: Blisstree

FLu Vaccines For The Elderly – The Stronger The Better

At the same time, many villagers have become convinced that the fatalities were not from the bird flu. “They are convinced black magic is at work, that ghosts now haunt their quiet Christian community of about 1,500 people.”

As their neighbors started dying, confusion and mistrust prompted villagers to stop cooperating with officials. Many refused to give blood samples, fearing they would later fall ill and suffer the fate of their neighbors.

The case has been a powerful lesson for WHO officials in understanding the importance of early communication and education.

“We’re seeing what problems we’re going to run into on the ground,” WHO spokesman Dick Thompson said. “We’re learning with every step.”

Jules Pieters, manager of WHO’s rapid response and containment group in Geneva, said it is clear that people familiar with the culture, language and customs of this area should have been involved earlier to help villagers understand what was happening, how to protect themselves and the importance of allowing treatment if they develop symptoms.

Some neighbors insist, however, that bird flu is not to blame. They are convinced black magic is at work, that ghosts now haunt their quiet Christian community of about 1,500 people.

Many are too scared to even pass by the family’s houses, and some who live nearby are awakened by nightmares that they will be the next to die.

“We are so afraid just to step into that house,” said a 37-year-old woman who identified herself only as Sembining. “We can’t tell what we’re afraid of — we’re just afraid.”

She lived near the victims and said the first woman who died was like a daughter to her. She recalled feeding and caring for her friend as she lay burning with fever before bird flu was ever suspected. Sembining can’t understand why she, too, didn’t fall ill.

“I think the family was cursed,” she said. “It must be, because if it’s bird flu, why only their family? Their blood?”

This is the largest cluster in a handful of cases involving bird flu passing from human to human, but scientists think it has always done so between blood relatives — not spouses. That has led some to theorize there may be a genetic susceptibility to the disease, but there is no evidence yet to support that.

Tests found no trace of the H5N1 virus in the village’s poultry, and dozens of hens, roosters and chicks run freely in backyards. Pigs, cows, buffalo, dogs and barefoot children roam along the rutted road and across fields of chilies, oranges and limes.

Indonesian villagers blame magic, not flu

Post from: Blisstree

WHO Learns Powerful Lesson In Indonesia & Black Magic

A bird flu vaccine piggybacked onto a widely used vaccine against another bird virus could be a quick and easy way to protect poultry against the H5N1 avian influenza virus, researchers said on Monday.

Two separate teams of researchers came up with a combination that is easy to make, protects chickens well and could be sprayed onto flocks.

Plus the vaccines are formulated in a way that answers the concerns that a bird flu vaccine could actually mask an outbreak, or could make trade in poultry products from vaccinated flocks more difficult, the researchers wrote in reports published in the Proceedings of the National Academy of Sciences.

Read the full story from CNN.com

Post from: Blisstree

New bird flu vaccine easier to apply to poultry – CNN.com

The five companies to which the contracts have been awarded are Britain’s GlaxoSmithKline PLC, MedImmune Inc., Swiss firm Novartis Vaccines and Diagnostics, DynPort Vaccine Co. and Solvay Pharmaceuticals of Belgium.

“The announcement came a day after the White House released an action plan to counter any avian flu pandemic, amid fears that an outbreak could kill as many as two million Americans and cause economic havoc.”
Yahoo News

US awards one billion dollar bird flu vaccine contracts

Five Drug Companies Get Flu Vaccine Funding

Five drugmakers win US contracts for flu vaccine

Post from: Blisstree

Five Drug Companies Receive Over One Billion Dollars For Bird Flu Vaccine Research

It is feared that bird flu (H5N1) could mutate into a form that could be passed directy between humans, thereby igniting a global pandemic. The movie plays that notion up to the fullest.

One of the movies executive producers has stated, “We call this a plausible, worst-case scenario. This could actually happen. It may not be this bad but it could be this bad. The reason to portray it this way is to kind of give a wake-up call to everyone and this is something we shouldn’t ignore and we should be as prepared as we should be.”

While realtistically portraying goods and services shortages, as well as some of the panic that might be expected, this is still a dramatization. Some experts fear that it will do the country a disservice by blurring the lines between reality and entertainment.

My concern is that it will blow things way out of proportion. The bird flu is a very real threat that we all need to be aware of prepare for. At the same time, sensationalizing it for Hollywood may be doing us all a disservice by ratcheting up the panic factor.

Remember, this is a movie, not a documentary. Watch the movie but stay calm. Let’s not react the way the country did after Orson Wells did the radio play, “The War of the Worlds”.

Bird Flu Hitting TV Screens May 9

Post from: Blisstree

Fatal Contact: Bird Flu in America, Airs on ABC May 9

Quoting the Effect Measure site:

“Effect Measure is a forum for progressive public health discussion and argument as well as a source of public health information from around the web that interests the Editor(s).

In epidemiology an effect is the endpoint of a causal mechanism. An effect measure is an estimate of the influence of a particular factor on a population’s health. The Editors of Effect Measure are senior public health scientists and practitioners. Their names would be immediately recognizable to many in the public health community. They prefer to keep their online and public lives separate to allow maximum freedom of expression. Paul Revere was a member of the first local Board of Health in the United States (Boston, 1799). The Editors sign their posts “Revere” to recognize the public service of a professional forerunner better known for other things.

I recommend their site highly for additional information regarding Avian Flu. Check out the left collumn for links to all the posting they have done regarding this growing threat.

Effect Measure

Post from: Blisstree

Another Great Site For Bird Flu Information and More

The model shows that fast treatment and isolation of everyone infected as well as the people they have been in contact with would be the most important aspect in controlling any type of flu outbreak.

The researchers have also recommended stockpiling flu vaccine even if the effectivness is minimal.

The article goes on to say: “But health-care workers will be key to beating back any outbreak, said Dr. David L. Katz, an associate professor of public health and director of the Prevention Research Center at Yale University School of Medicine. “Almost all of the potentially effective flu containment strategies require coordination among first responder agencies, clear messages, rapid and reliable communication, unambiguous chains of command, and efficient distribution of resource materials,” he said.”

Computers Predict Bird Flu Pandemic’s Course

Post from: Blisstree

Researchers Use Computers To Help Plan For Pandemic

There is an enormous amount of information here you. One of the biggest surprises is “Poultry imports and smuggling will probably bring H5N1 to North America [much more quickly] than wild bird migration.”

Check out Baldilocks for the answers to many of your questions.

Birds in Your Hands

Post from: Blisstree

Bird Flu Questions? Don’t Panic, Here Are Answers For You