World Vision is reporting many, until now, unreported deaths from Bird Flu in Indonesia. The full story is at the link below.
From http://crofsblogs.typepad.com/h5n1/2006/02/from_an_ngo_in_.html
The cases of bird flu infections in Indonesia are only smaller than Vietnam. The World Health Organization, as of February 18, confirmed that 19 Indonesians have been killed by the bird flu virus. Out of these number, eight people died in the last 50 days alone – the highest rate of deaths in the world. The last victim, Purnomo (23) who died at a Jakarta hospital last week, was suspected as being infected while trading chicken at a marketplace in East Jakarta.
Scores of patients with bird flu symptoms are currently under intensive treatment in Jakarta, Bandung and other cities. There have been reports of deaths with bird flu symptoms in several smaller cities, such as in Subang, West Java. In most cases, their families buried the bodies without prior inspection of the real cause of their deaths.
Is there a WHO presence in Indonesia or are we reliant on local media and official statements to get coverage? This NGO has gone out on a limb to publish this sort of data.
Thanks Clark. This article well demonstrates the disconnect between official statements and experience in the field.
Could we have a link to the original World Vision page this came from? I cant find it anywhere.
Indonesia is the height of my ‘worry zone’, followed closely by China. However, previous rumors about Indonesia turned out not to be as dire as advertised.
This really calls for investigation. I hope they’ve sent the report to WHO, CDC, ECDC etc and not just the blogs.
World Vision is not a creditable reporter. Treat these as rumors until confirmed. Crof’s a good guy, but he isn’t a scientist and isn’t in position to judge these stories.
Tom DVM, you’re making some major assumptions ahead of data. is this seasonal flu? Something else?
How many times do we need to read rumors on the web that turn out not to be true before a hint of skepticism seeps in? I understand that it could be true. That doesn’t make it true - yet.
…”In most cases, their families buried the bodies without prior inspection of the real cause of their deaths.”…
Can’t they get enough international help to get out there on the ground and keep track of this, and educate the public?
http://www.who.int/csr/don/2006_02_13/en/index.html …”update 3, 13 February 2006…The newly confirmed cases bring the total in Indonesia to 25. Of these, 18 were fatal”
(Website hadn’t posted past Feb. 13 yet.)
DemFromCT. Point well taken. I have found crofsblog to be a reputable source of information. He seems to double check sources before they are released on his website. He states that the report is from “World Vision International’s Indonesia Office” and I assume he checked directly with them…but you are right, any of us can slip up once in a while but with crofsblog track record, I don’t think so.
They’re only as good as their source here.
DemFromCT. Sorry, I don’t understand you’re point at 19.42. I have found World Vision and Crofsblog to be reputable sources. That influences the credibility in my eyes. We have had newspaper articles noted without questioning the credibility of the reporter (quoting experts in proper context).
DemFromCT. I ask for your qualification because I have learned much from you and Melanie….and while I’m at it, I don’t know how you find the time to do this but I am truly thankful for your effort and investment.
Crofsblog’s reporter status is not in question. I don’t know who World Vision used as their source. There’s no data about how they came by the info in the short article. To me, this is rumor, and just because crofsblog publishes rumor, that doesn’t make it so. Do they do their own testing? How do they know?
I think this is an excellent topic to add to the rumors page.
Here’s the rumors link. we should add to this as we get reports.
DemFromCT. I understand you’re point but crofsblog doesn’t have reporters and I assume this report came directly from World Visions Office in Indonesia. I assumed it was an official report. I don’t think it would be on crofsblog unless it was confirmed as an official report.
Tom DVM – at 19:54
I am not assuming that. There’s no link. I will add to the rumors page if and when we find exactly what it is.
In the meantime, I appreciate your previous (and all of) your comments.
DemFromCt. One additional thought. Under the parameters and from an ethical perspective..would that mean that anything not printed in a peer reviewed journal should go on the rumours page.
Anyway, the report is troubling if it turns out to be proven correct.
Rumor or not, the above is definitely how the next pandemic will begin. And by the time, it gets verified, it will have traveled to a nearby airport. Previews of things to come, next year or five years from now (and maybe not even H5N1).
World Vision is a Christian humanitarian NGO with no expertise in medical matters.
Medical Maven. You are right. The flu in North America that jumped from horses to dogs is really troubling.
Let’s consider stratifying the classifications of information here a bit more. I wonder if just dumping anything not vetted by WHO into the rumour crapper is a valid method. We are dealing with gradients of information, all massaged, that are unbelievably poor at the moment. If we were to consider and develop a few more bins for information that is from a typically reliable source, but not yet validated, then we’ll have made progress and will have created a more complete data set for evaluation. Fuzzy logic and dirty data won’t answer all our questions or make our predictions perfect, but they will allow us a modicum of practicality in this information poor environment.
Recall that many great discoveries are made by chasing the outliers on the graphs . . . “oops, how did that happen” sort of epiphany. If we can view the data, regardless of santification by official sources, then the brainpower here will make insights and potentially discoveries.
Any suggestions on categories?
NSI. My grandmother always told me when you talk too much, nobody listens but I had to comment on your post. I have always found that the trends, the patterns and often the answer is found in the ‘outliers’.
NS1 , go to the rumors page and organize it any way you want. As you’ll see there are few entries, stratified by time and source.
It’s a wiki. It’s hands on. Jump right in. ;-)
bumpwed for viewing. an important topic to discuss. How would you like to handle rumors?
How do we define “rumor”? We all have a point of view. Anything that doesn’t mesh withour personal point of view is classified “rumor” or “speculation”. I’ve seen this happen on every side of every discussion. Human nature. The problem is that as soon as a line of reasoning goes into the speculation or rumor area, it is branded as untrue. maybe or maybe not.
What I find notable is the number of scientist who speculate and rumor monger, and use their titles to bluster their way through. This virus is constantly surprising me.
I agree with clark. To have everything classified as rumors except pronouncements from official mouthpieces and articles/studies in scientific/medical journals is way too limiting. Hearsay with no documentation of any sort is rumor.
The crofsblog piece was rumor material only because it did not have sources that somebody could check. How did the reporter come across or verify the information? And if it isn’t verified yet, but suspected, when and how will it be verified? And if the cases are being ignored or shoved into the background, what entity is behind that?
Well, maybe so. In the absence of standards, I’ll just do it my way .;-)
To me, it’s like love or pornography - I can’t define it, but i know it when I see it. For example, a rumor is a major human outbreak unreported or poorly reported in the press or by reliable sources. I have used that criterion to build the rumors page. As is said there:
This Indonesian report by World Vision certainly qualifies as a rumor. As soon as we get some corroboration, it’ll be moved into ‘report’ or ‘fact’ or whatever you wish to call it.
This article from crofs starts with “Here’s a welcome report from World Vision International’s Indonesia office:”
The way that it is presented suggests that the person posting it is making a direct quote from something written by World Vision International’s Indonesia’s Office.’ I would not consider this a rumour because anyone can contact World Vision’s office and verify with them. The fact that there is no mention of whether such verification was done does not take away the fact that this source, a well known and well established international NGO, is very specifically and obviously cited.
Someone writing that ‘world vision said xyz happened’ is different from someone writing ‘I heard that xyz happened’, or, worse, ‘xyz happened’. The last 2 are rumours, the first is information that may or may not be correct.
If I am able to go to a source and ask ‘ did you say this? How did you know? What is your evidence?’ and have a reasonable degree of confidence in the party’s ability to give credible answers, then this to me is a useful bit of supportive information. It may not carry as much weight as if Reuters or AP has gone and done the checking before reporting it. But it is not a rumour and would carry more weight than rumours.
Medical Maven, I don’t agree with your presumption of guilt about ‘entities’ behind this or that, but I do agree with you on this:
Hearsay with no documentation of any sort is rumor.
My presumption is that if there’s something behind it, someone will document it; someone else will corroborate it. The World Vision report won’t stay rumor if others can corroborate it. But folks can be ill with ‘flu-like’ illness and not have H5N1. Surely you agree with that. So the current report is rumor unless someone’s reporting positive testing.
anon_22, no that’s not right. Find a link to World Vision (I’ve found the home page, but not the report). Or post a copy of the report. Find some documentation. Until then, it’s a rumor.
Dem & Melanie,
With all respect, I don’t know if it is just me or do I detect a rising degree of defensiveness in moderators such that rather than commenting on the problem under discussion, more and more time is spent on debating whether forum members’ posts are valid? Can we not relax a bit and let the collective intelligence of the community work on the different bits of information? I believe that a lot if not most of the forum regulars are able to make sensible judgements about the validity of certain types of information, so that the discussions can move to a more productive and/or creative level.
Dem, does it have to be posted on a website to mean anything? What if it was a locally circulated newsletter that we do not have access to immediately? My point is that it is possible to confirm it eg by emailing them. Do you have to see every single bit of information to process it?
Noltice that I am not saying that you should believe it. I am saying that we can keep that in mind, as a small bit of side information.
Anon_22: The lack of detail in the report just sort of crumbled its credibility in my opinion. You made a good point, but from a secondary news source the reporters must try harder to flesh out the story with more facts.
I went to World Vision’s site and couldn’t find any news regarding Indonesia that was newer than Nov 2005.
I did a search looking for “world vision international indonesia” trying to find the Indonesia office for World Vision, but came up empty handed.
I usually like to believe what Crofford posts, but I wish he would put in a link for this one.
I don’t have any problem with World Vision’s credibility, but am having some “credibility” issues with this item.
anon_22 – at 21:55
I’m not challenging anyone’s post. I’m delighted it’s been posted and I’m delighted to have this conversation). But i also recall chasing down rumors about dozens of ill Iraqis, Turkish, Chinese and possibly Indonesian citizzens since the wiki was started. many of the reports turned out to be untrue. The Crimean reports preserved on the rumors page also were untrue. Some of these things at first pass might well have been true. But experience is an excellent teacher, and I’d hate to reinvent the wheel every time.
At the same time, new bits and pieces of info pop up… some will turn out to be very useful (given the topic, i hate to use canary in the coal mine, but you know what I’m getting at).
With the number of posters we have perusing the news, we can do the due diligence. And we can do it with a suspension of belief while we gather the information.
I don’t think that’s defensive at all. I think it’s prudent.
Just to clarify: I am actually not advocating whether world vision has or has not credibility issues. I personally am neutral with regards to whether I believe that what is written is correct. I am just saying that there are rumours and there are information that may or may not be correct, and then there are the regular sources that we have more confidence in.
At this point when a pandemic seems very likely to come out of Indonesia more than anywhere else, and where official sources may be slow or non-transparent or too dependent on inadequate scientific data to provide useful timely information, to rely solely on completely trusted sources is a worthy goal that may not serve us too well.
Dem, I appreciate your fine work. Truely I do. Only I’m afraid that all of us have our work cut out chasing information that often turn out to be wrong. But I would rather use this community to chase such information than set them aside too quickly. Because when you put something under ‘rumours’ believe me it will not get the follow up needed for us to figure out whether there is some truth in it. And one of these days we will miss something that was highly significant that had been sitting in the ‘rumour’ thread the whole time with nobody chasing it down.
anon_22 – at 22:08
I see your point. But at the same time, jumping at every piece of news is difficult to do. That’s why, I think, some corroborating evidence is worthwhile to ask for (lab data is great, an AP report is good, a blog report is okay, a phone call from my brother-in-law needs to be checked out). Hey, someone’s got the be the skeptic. Might as well be me.
Keep being the the reasonable skeptic Dem. You are my beacon of reason in all the haze!
I have visited west Java, but I no longer have the contact friend from Java. Not too many Westeners show up there judging from the reaction of the people. The countryside is primitive, like an old National Geographic scene. I can believe this can happen there, where the news is hard to determine, even by the capital city, Jakarta. The rural area is so backward and isolated. What you see, other news media looking for a scoop, also see. If nothing more comes of it, by tomorrow, it’s probably not right.
Couldn’t we just ask Mr. Kilian to provide the source of information from World Vision (newsletter, website or whatever) rather than debating whether its a rumor or not? If someone at World Vision really has information about this, let’s get them to comment directly. Let’s try to get specific information.
Patch – at 22:29
Thanks… it could still turn out to be true. I wrote CK to ask what they’ve got. And I actually completely agree with anon_22, Tom DVM and everyone else in the sense that I’m not dismissing it, I’m asking for everyone to keep their eyes open for more info on this.
If there are linkable sources, I’ll put it on the rumors page here so everyone can find it. The next link might come on some other thread, like a current news thread.
I can’t believe a big outbreak will stay hidden. If it’s true, we’ll find out soon enough.
Just sat down and started following the debate. One thing is for certain, if/when a pandemic begins the rumour mill will be beyound comprehension. This issue does need to be addressed. My suggestion is to have a thread titled “Information Needing Verification - <subject>” Once it has been established as rumour, dump it in the rumour bin. If verified as valid, place it in a thread indicating so.
To me, rumors are “Information Needing Verification ”, hence the rumors page. I agree, Okieman, we can play a role here.
BTW, I’ve also written the Indonesian World Vision Director for help in sorting this out. But just because I write people doesn’t mean they write me back. ;-)
“I see your point. But at the same time, jumping at every piece of news is difficult to do.”
DemFromCT/Melanie, I’ve made this point several times previously but there are those on the board that want a mountain of proof to validate any news that would be considered good but those same individuals seem very quick to validate any news that would seem bad. With that being the case, I want to thank-you for your efforts to keep things balanced and while maintaining intellectual honesty on the board.
Tram, your jumping in like that, gave me a good laugh. And it was in a good way. Your character and mode of conducting yourself is predictable (as we all are), and you, too, are a formidable counterbalance. : )
You disagree with my statement?
Nah. He’s telling you that you’re growing on him. ;-)
Not totally. Everybody has their bias, even you. You are a good guy just trying to keep us on the straight and narrow. But I believe we will disagree from time to time. : )
We all have our biases, absolutely. But wikis are about the wisdom of crowds.
M-M,
The flu scientists agree on very little. Why should we?
“At this point when a pandemic seems very likely to come out of Indonesia more than anywhere else, and where official sources may be slow or non-transparent or too dependent on inadequate scientific data to provide useful timely information, to rely solely on completely trusted sources is a worthy goal that may not serve us too well.”
http://www.thejakartapost.com/detailnational.asp?fileid=20060222.D02&irec=2
I believe that all of us are looking outside of the Wiki for the pieces of the puzzle that will allow us to pull in the welcome mat, close the shades and be grateful that we have done the prep.
Tram, as prepared as I am, and I imagine the same for many others, in no way shape or form would I celebrate the onset of a pandemic. I do not desire to “be right,” and I will weep pray for all peoples because I care about humanity at large. Already I loose sleep over those whose lives will forever be ruined and possibly lost because of H5N1.
Melanie and Dem: Please reread Anon_22 at 22:08 and 22:12, then Okieman at 22:50. I agree with both their comments. If information is too quickly shuttled to what I call the archives, then debate and communication are cut off.
Until this thread and then a bit of searching, I didn’t know that World Vision has a radio news program (news magazine format, search for World Vision Radio). They have done a report on bird flu. I can’t find the source of Crof’s info, but I’m glad the thread continued. Reporters chase rumors/information all the time. If the rumor/information isn’t discounted too quickly and moved to the archives, we posters/reporters have a chance to help track it down. I don’t frequently read the rumor archive very often, but I do follow the discussion forum.
“You are a good guy just trying to keep us on the straight and narrow. But I believe we will disagree from time to time. : )”
Thanks for the nice compliment…and you seem to be equally “good”. I have to admit that providing balance is a bit of a challenge though as you always seem to be ganging up on me….LOL ;0)
It wasn’t too long ago that parts of Indonesia were decimated because of the tsunami. I am under the impression that there has been and still remains quite a large group of volunteer/aid groups there. It seems odd to me that there hasn’t been any info. from that direction? Unless the tsunami-hit areas are too far north from where the BF is being reported? Maybe some volunteer organizations have info. on their websites. I just thought of that so I haven’t followed up on the idea myself but I think I will—tomorrow :) I’m doing crash prep for teaching three different cooking classes tomorrow but couldn’t resist checking out the action tonight at the wiki!
I meant to add to my post at 1:35 that the rumor thread in the discussion forum, by its very title, sounds like it is for information that already has been discounted. For me, it could be the difference between the technical, dictionary definition and the colloquial use of the term.
Melanie at 20:02 said “World Vision is a Christian humanitarian NGO with no expertise in medical matters.”
Take a look at: http://tinyurl.com/fncyd
It seems that much of what they actually do is healthcare related.
Nightowl – at 02:18
There is a tendency of Forum posters to not use the rest of the wiki. The wiki is actually the ‘active’ part. The rumors page, like every other part of the wiki, is meant for constant updating. Those Forum users who never look elsewhere are really missing out. It’s not a ‘dump’ for used and discarded news or ideas.
Nor at any time did I mean to imply that showing up on the ‘rumors’ page cuts off debate here. Nor does being skeptical shut off debate. Pleae reread the blurb at 21:47 and on the rumors page itself. Some rumors are true, and it’s not a pejorative term. It’s a classification (‘needs corroboration’).
In any case, I received two emails back. CK, at H5N1, is also trying to confirm. The original piece is from a news release by someone describing themselves as a local ‘communication manager’ for World Vision. The hot paragraph,
has no other citation. CK, the original poster, is looking for other sources as we are.
I also wrote the Regional Communications Director for World Vision, James East, whose name I found on the web site. His reply was that they are aware of the report,they ‘have reqested futher sourcing on this story from WV Indonesia’ as they want to verify what they can.’
I have to wonder if they had the story, didn’t want to release it without verification, and it was released anyway through ‘unconventional channels’. [That doesn’t make it true or false, it makes it a rumor. ;-)]
In any case, reading that ‘hot’ paragraph I can see how Java and rural areas might have cases uncounted, but Jakarta and the cities with scores of unreported patients? I have my doubts.
It sounds suspect to me. If they wanted to release it through unconventional channels, so their institution wasn’t associated with the info, why issue a press release, even one sourced to a “local communications manager”? If they wanted to get the info out anonymously, they could leak it to major media. And if they wanted to send out a press release, why wasn’t the release spread around more? I’ve looked everywhere and can find no other reference to this.
I’m not ruling out the idea that the information might have a kernel of truth in it. But I do think skepticism is in order. With desktop publishing, anyone can put out a “press release” and attribute it to anyone they want. Legit press releases have a name and contact number for reporters to call for more information, and don’t quote anonymous sources.
It sounds more like a news tip for follow-up reporting than actual news at this point.
James East eas clear: please bear with them; the speculation is e=tirely mine.
I guess I leapt to conclusions! One question: Did James East know that his own organization had issued the press release, or know that a press release had been issued by someone calling themselves the local WV communications manager?
Sorry to be such a hair-splitter …
Worried Well - I concur that measured skepticism is appropriate, but we must not loose site of 2 facts: First, much of the world where H5N1 has now been confirmed are underdeveloped, abject poor, where “In most cases, their families buried the bodies without prior inspection of the real cause of their deaths,” is totally plausible. There is NO surveillance there. This is true in the bush area of Africa, the tsunami ravaged and war torn areas of India, and most of Indonesia. We now have a situation where millions of people may be exposed to infected birds living in close proximity to humans, thereby increasing the chance for H2H mutation. http://www.tucsoncitizen.com/news/national/022206b2_birdflu
Secondarily, we have to remember the “stigma” of being “THE” country where the pandemic starts. That will plaque the country economically, socially, etc. for ions. The impact on us (Wiki readers) is trying to read between the lines. gather the pieces and complete the puzzle, and know when it is appropriate to roll up the sidewalk and pull the shades. For me, I prefer to error on the side of conservative. I don’t believe any of us have gone to all the expense and trouble to prep, just to wait until we are standing in line in our local grocery to have someone standing next to us tell us how sick their child is.
The effect a story of this nature has on me is to ask, “is this plausable,” and can I confirm with other sources over the next couple of days. It is likely that it will already be wide spread H2H by the time we hear about it in our mainstream media because of the things I have identified above. Again, no one wants to be “right,” more than they want to be safe. I hope our collective wisdom will keep us informed and able to make the best decisions that are ours to make.
The effect a story of this nature has on me is to ask, “is this plausable,” and can I confirm with other sources over the next couple of days.
I couldn’t agree more. When the communications officer is unwilling to reaffirm what the report says, I figure it’s best to do what you suggest. WV may be that confirming source… let’s see what they say.
NP Mom, I totally agree about having to read between the lines. Given the time lag between symptoms, even death, and official announcement of a new case, I think reading between the lines is the only way anyone will know when to roll up the sidewalks.
And I also recognize the fact that there are huge gaps in surveillance. One doesn’t have to know much about Africa and southeast Asia to know that a semi-truck could be driven sideways through surveillance gaps there. Surveillance isn’t gap-free in the developed world, either.
It’s the ex-newpaper reporter in me questioning the sources of this information. The language in that “hot paragraph” makes me skeptical. Call it news judgment or intuition or whatever. It just does not ring true to me.
Also … I don’t trust officials any more than the next cynical reporter does. It’s the official types who care about the stigma of being the country where the pandemic starts. The media doesn’t. I’m not saying that the media will catch it quickly — there’s so little on-the-ground international reporting these days, that’s unlikely — only that the media has no vested interest in keeping anything quiet.
One last thing and I’ll stop blabbing: If I trusted the mainstream media to get me the panflu info I need, then I wouldn’t haunt the wiki so obsessively! Seriously, I’m thankful that this place collects any and all info and throws it out for discussion.
I remember our ‘discussions’ when the rumours page was first established, and one point, which I cannot seem to find above, was that often what comes out as rumours, until discounted, may well be our early signal system of what is actually happening. As already discussed, until verified, all such stories are, by definition, rumours.
In Turkey, we were getting so many ‘rumours’ and we relied on Wiki contributors from within Turkey to help us through. Although these were kept in the discussion forum, in hindsight, we should have perhaps made greater use of the rumours segment.
There are several reasons why I think such stories should be in the rumours page - they get prominence (not lost in a discussion thread), they get followed up for verification, and they give us a signalling system as outlined above. Putting things in the rumours page does not ‘discount’ them - it says ‘let’s get some focus on this thing’.
AnnieB – at 14:25
Thank you. That’s exactly the way I see it. Turkey was so active, lively, focused and ‘happening’ that we never got the chance (or had the need) to use the rumors page. Now, there are so many reports from diffuse geographical places, I think a rumors page has value.
Dem and Annie, I take your point. May I suggest then calling it ‘unverified reports’ as ‘rumors’ have too many different meanings to different people. Better yet, call it ‘New Unverified Reports’ with a date to mirror the ‘New Reports’ thread, how about that?
Rumors and Unverified Reports? How about that? We can’t make two forum threads (no one can tell what’s what) but we can rename the rumors page.
Or, if we were in the advertising world, we would rename it “help verify these reports” - that would get some attention - and give the intention of the page as well.
I second AnnieB’s recommendation—”help verify these reports”. That way it is not a File 13, it is a call to action. Perfect.
How about lies and conspiracies….?
….Just kidding :0)
Ah Tram, you are getting into the swing of things!
I added —”help verify these reports” to the rumors page.
Good thought!!
And the wiki continues to improve. Excellent ideas coming forth.
BTW, Dem, please don’t assume that just because a poster is honest enough to say they rarely use one place in the wiki, it doesn’t mean they haven’t used and continue to use other places. I do appreciate what you all have done. I have referred countless people to this site and have told them to be sure and read all of the incredible information and resources (one-stop shopping for information). Thank you to all.
Nightowl, I have noted there are (without question) Forum users who never use the rest of the wiki - any of thw wiki. They bookmark the Forum and don’t even use the front page! That’s fine, but they are missing out.
I just don’t want the rest of the wiki to be considered secondary. They are two parts of a whiole.
I’ve printed basic guides for my friends. the package is Woodson’d monograph, fluwiki front page and H5N1 front(current when printed), as well as Effect Measure. I’ve highlighted links here and on Crawford w brief descriptions.
It’s been 24 hours now since tha last post, and 36 since the first. At least three different groups (email correspondents) are checking into this. So far no further word. What does that mean?
Given Jakarta’s size and access, I’d say it means no news is no news. OTOH, the rural areas can not be so easily dismissed.
We still need to wait, but I can’t find corroboration from anyone as of this moment, including the original source.
DemFromCT. Thanks for staying on the issue. If I could I would like to give my interpretation of this article in relation to H5N1 and Asia. The specifics of any report by the WHO or World Vision, newspaper reports etc. carries the same weight with me because it is not the specifics but the trend line that is important. None of us can confirm the specifics of any report, Government, United Nations or otherwise. I would question the accuracy of many official reports as well.
Many countries in Asia have not reported anything at all. That means that Hong Kong, Vietnam, Indonesia etc. that are reporting represent the tip of a iceburg with most hidden beneath the surface. We must extrapolate what is going on in the rest from circumstancial evidence.
The news from Vietnam is good at the moment. There has not been a reported case for three months. Hong Kong has reported that H5N1 is now endemic; the strain is an old one that was in Korea and China in 2004…and then there is Indonesia. Whether a number of people are in intensive care or not, is not important. The pandemic has not started. There are definitely clusters but no sustained H-H. However, there have been a number of reports in the past two weeks from Indonesia that are troubling, both from unofficial and official sources. When you put all of these reports together, removing the specifics of any one report, the trend line is not good. If one would want to intepret the findings in Vietnam as a victory, the conclusion in my opinion would be very premature. However, Vietnam deserves all the credit in the world for interrupting the dissemination when other more advanced countries couldn’t.
Asia, the epicenter and a place that the virus has been playing in for nine years is, in my opinion, far more important then the ripples in the Middle East, Africa, and Europe. Different strains of H5N1 are now freely circulating. The number of animal and bird species that the virus is circulating through is steadily increasing. The virus can circulate and multiply within some species such as birds and pigs etc. without causing disease…a reservoir of infection while at the same time maintaining of increasing mortality rates (given the lack of serological evidence otherwise).
I think at this point we have no idea who is spinning us and who is not. Who is reporting accurately and who is not….but you can take the specifics out and watch the trends.
DemFromCT, thanks for taking the time to verify that this story is likely another wild rumor (ie primary source for Niman). These type of “stories” add nothing to our monitoring, except hype & hysteria. Again, your efforts to maintain sanity here are to be commended.
Niman has nothing to do with this one. Tom’s points about Indonesia and SE Asia are well taken. But its’ worth taking time.
BTW, Tram, I wrote Dr. Butcher inviting him to comment but never got a response.It means nothing, but just saying. maybe he read the thread.
Tram at 10:56
‘DemFromCT, thanks for taking the time to verify that this story is likely another wild rumor (ie primary source for Niman). These type of “stories” add nothing to our monitoring, except hype & hysteria. Again, your efforts to maintain sanity here are to be commended.’
Ditto Tram.
Tram, Dem,
I too, have written Dr. Butcher and when he responded, he noted he would be traveling extensively in the next several weeks. I have every reason to believe he would respond, if able. I suspect if/when things cool down a bit, that he will post here and elsewhere. I’m sure he’s busy at the moment. I’m guessing that many countries/governments are seeking his advice about replacing the hundreds of thousands (millions) of chickens that have been culled and seeking suggestions to better maintain disease free flocks.
Also like to apologize. I didn’t mean to suggest Niman had something to do with this one.
Tram and Patch: I may be starting to waver over to your side, but if you look at your seeming stance, I don’t believe you have been sufficiently sobered by the science of this phenomenon. Read the recently posted “Webster et al paper” (as Monotreme described it) on the “Bird flu likely to burst out again and again” thread. And what I am referring to is not the study that originated this thread.
And I have seen very little hysteria here, maybe a little hype. We are too sane. informed, and prepared to be hysterical.
DemFromCT, if you have a question\questions for Dr. Butcher, send him another email. As far as participating in a thread, I don’t want to speak for him but I’m not sure he has an interest in that. I just received an email reply from him yesterday. He was not able to access email the last (2) weeks as he was in remote poultry farming areas in Russia.
By the way his opinion of H5N1 becoming H2H has not changed (ie very unlikely).
I know Niman had nothing to do with this one. When reviewing his site, however, this story is exactly the type of rumor that he usually uses to build his case….
“Tram and Patch: I may be starting to waver over to your side, but if you look at your seeming stance, I don’t believe you have been sufficiently sobered by the science of this phenomenon.”
MM, I’m a professional with a scientific/engineering background. I’ve followed this story very closely for some time now and have carefully evaluated arguments/evidence (on boths sides) for how this thing is/might be playing out. When stripped down to the facts as I know them, I’m pretty optimistic. I’d be very optimistic if Indonesia would finally get serious and clean up their sandbox.
The key for me is to strip out the hype/hysteria generated by the storytellers and deal with just the available facts. IMHO reports like those that Niman runs with, do nothing but cloud the facts and do damage by adding hype/hysteria to the picture…..
Tram and Patch. I agree with most of what both of you are saying in respect to unsubstantiated rumours and the speculation that results. However, there are trends and I think you might agree that the trends are not good at the moment. I may have taken World Vision as a reputable source mistakenly…as both Melanie and DemFromCT, you and Patch have pointed out.
But one of the other rumours was Quangyi Lake (sp) from May 2005. Boxun reports made some claims that may or may not have been false…but if one looks at trends rather than specifics, I think we would agree that the event was pivotal in a change in the virus that allowed it to escape containment in Asia. Since we don’t know what is spin and what is truth…and with the current lack of science, I think we should look at pronouncements by the WHO and so called rumours with equal skepticism.
Dr. Butcher’s viewpoint is esssential to coming to objective scientific conclusions. I understand he is a ‘field’ rather than a ‘theoretical’ scientist and therefore doesn’t tend to produce papers for publication. I would be really interested in his opinions as to the reason why, he doesn’t think this thing is going to become a pandemic…and as Tram has pointed out my objective conclusion (not hype) is that it is going to be very bad. As I have stated before, I would like to be proven wrong. With that in mind, maybe Tram or Patch could ask him to put his thoughts on paper so that we could examine them…or if someone could tell me how to directly contact him, I would be happy to do so.
“Tram and Patch. I agree with most of what both of you are saying in respect to unsubstantiated rumours and the speculation that results. However, there are trends and I think you might agree that the trends are not good at the moment.”
TomDVM, I’m not asking anyone to agree with me and I’m not intersted in “winning an argument”. I’m simply interested in stripping the b.s. from the big story and letting the facts speak. As far as the “trends” go, other than seeing H5N1 now circulate in wild birds, the story hasn’t really changed. Sequence data has show the virus to be pretty stable since 1997 and furthermore it’s increased affinity towards wild birds would suggest that it’s evolving in the right direction. Do we see “explosions” of postive cases in the middle east as Niman wanted us to believe? No. Do we see explosions of positive cases in India? No (no positve cases). Although detection may be more difficult, we’ve seen no explosions of cases in Africa either. In all of these places, people live with their chickens….and are in daily contact with their waste, blood, etc yet infections are very rare. The fact is that H5N1 infections remain difficult for humans to get and I see no trends that should concern me.
Tram: “I’d be very optimistic if Indonesia would finally get serious and clean up their sandbox” But how likely is that? And doesn’t it seem virtually certain that H5N1 will become endemic in Africa where there is no reasonable hope of a “clean up”? And magpies and other common birds are still dropping dead in Hong Kong.
So reading between the lines with what is possible and probable I would guess that you will never be more than simply optimistic until the passage of time gives more experience and spread to the virus. You can label me as “slightly pessimistic”. Time will tell. Let us remember this dialogue come the fall of 2007.
Tram. I agree that the fact is that H5N1 infections remain difficult for humans to get. I disagree and the evidence indicates that the virus has not been stable since 1997 but has been found to be highly mutable. As you know, I have some problems with Dr. Niman. I also would like to strip the B. S. from the big story but we don’t have the science (including paired accurate serology) to do so. That’s where Dr. Butcher comes in….to prove my conclusions are dead wrong.
“Tram: “I’d be very optimistic if Indonesia would finally get serious and clean up their sandbox” But how likely is that? And doesn’t it seem virtually certain that H5N1 will become endemic in Africa where there is no reasonable hope of a “clean up”? And magpies and other common birds are still dropping dead in Hong Kong.”
Speaking of Indonesia, I’m pretty confident that they’ll clean up thier mess. There will be too much international pressure for them not to. I recently posted an article about the clean up of Vietnam. The situation there last year was arguably worse than things are right now in Indonesia. In fact Niman (FWIW) had Vietnam at pandemic stage 6 last June. Things look great there now…they finally got serious about cleaning it up. This is not to say that they’ll never see it again. It will require ongoing maintenance.
Tram: I will be willing to concede a lot to you, if we reach late Fall 2007 unscathed.
“I disagree and the evidence indicates that the virus has not been stable since 1997 but has been found to be highly mutable.”
Tom, Dr. Taubenberger has described the mutations of H5N1 being small compared to the 1918 virus (assuming it’s even evolving in a parallel fashion).
“But whereas the 1918 virus may have had 30 changes, the H5 viruses that we see have no more than a small handful of these changes. Luckily, if this is the process that is going on, we are seeing a very early development. We are at a very early stage.” - Dr. Taubenberger late-2005
His statement is supported by the fact that the virus is behaving essentially the same as it always has, in terms of human infections.
That’s the good news (and there is good news). The Webster paper, otoh, discussing the endemic nature of H5N1 is also worth considering. Webster suggests better poultry vaccines (not the Chinese varienty from c. 1997) are the way to go. That’s what I’d love to have Dr. Butcher’s opinion on. The EU can’t decide, partly because the effect such a move would have on exports. But is there a better alternative?
As to Indonesia, I think it safe to say that there are rumors, there will always be rumors, and skepticism mixed with attention is the way to go in future. My question is:
How can Flu Wiki help? Neither a Butcher basher nor a Niman nay-sayer, we. We need to weigh all the available evidence and help collate, inform and - yes - teach.
Tram. I think the point many experts make is that since there is little in the way of science on the subject (previous to the fall of 2005, recombination etc. was thought to be the only way for an avian virus to gain pandemic potential…1918 - pure avian virus)and given the unique characteristics of H5N1, we are presently in the dark and any conclusions at this point are speculation based on intuition. In my opinion, qualification is a good measure of objectivity.
DemFromCT/Melanie, as long as Flu Wiki maintains an environment that encourages the free flow of ideas it will remain the best flu site on the web.
Tram. Sorry, in addition a virus that can mutate in the middle of what appeared to be successful treatment with antivirals, and then kill the patient 2–4 days later, would have to be classified as highly mutagenic. I have never heard of a similar case with any other disease, bacterial or viral.
Tram,
Thanks. That’s sorta the point of the whole exercise, to harness “the wisdom of crowds.”