We know that PBF is only a mutation or two away and could literally explode at any time. If it retains anywhere near its current lethality the Spanish Flu will look like the world just had a bad cold.
I came across this earlier today:
Grain stockpiles at lowest for 25 years http://www.ft.com/cms/s/0c021878-5a16-11db-8f16-0000779e2340.html
We know that BF is killing a gadzillion birds and birds eat a lot of bugs. What is that going to do to the world’s grain supplies in coming years?
Then there is XDR TB and all the other exotic diseases that seem to be springing up.
All we need now is an earth crossing comet called “Wormwood.”
Am I connecting the dots correctly, revealing a perfect storm brewing, or am I just reading too much of all this doom and gloom stuff?
“Am I connecting the dots correctly, revealing a perfect storm brewing, or am I just reading too much of all this doom and gloom stuff?”
pfwag. I honestly think that if all of us are given enough time…we will go full circle and convince ourselves that a pandemic is not going to happen…and that is probably about the time when your the pandemic will start.
Yes, I have to agree with you. This is the perfect storm that is brewing.
For starters, this is the first pandemic where two major animal food sources could be knocked out when humans start spreading the disease into pig and chicken barns…
…and now we find out that our wheat reserves are thin as well…who invented this just in time strategy anyway.
I will describe the one thing that proved to me that this was a virus unlike any other in human history…
…cats are that one thing…we knew the 1918 virus affected dogs as well as pigs…but there are no influenza viruses in cats…up until now they have been immune to influenza viruses…and yet, it seems that soon we will be able to count the animals not susceptible to this virus easier than the ones that are susceptible…
…this is a gobsmacker with no precedent in history, believe me.
Cats therefore, are the reason that a perfect storm is brewing…
…it would take me ten thousand words to give the long version of the answer and it would make for a pretty long post.
Is it passing from C2C though TomDVM? Does immunity mean absolute immunity? I understand what you are saying, but have you considered this?
Hi Patch. I really hope you are right about the pandemic and I am completely wrong…time will tell.
I don’t quite understand your post above…The point I was trying to make was that in a pandemic the zoonosis will work in reverse…we are going to knock out a lot of pig and poultry farms by infectious farm workers passing H5N1 to the farm animals…
…and we had better hope that cattle and sheep and goats don’t become susceptible.
What I’m saying is….unless I’ve missed something in the news, efficient transmission has only occurred within a species. Jumping species is still somewhat rare and efficient transmission, in a “jumped species” has yet to occur.
Is this correct?
Patch As far as immunity in chickens goes…they don’t stay alive long enough to develop immunity. Each subsequent crop into the barn is a blank slate with no immunity…
…so Asian governments must revaccinate each subsequent generation in the poultry barns…won’t work.
Let me “restate” this, with one clarification:
What I’m saying is….unless I’ve missed something in the news, efficient transmission has only occurred within a species (Birds). Jumping species is still somewhat rare and efficient transmission, in a “jumped species” has yet to occur.
Patch. I guess you are right to a point…
…in a pandemic, we will be infectious to animals…in 1918 H1N1 was very infectious from humans to pigs and dogs…and I base my assumptions on that…
…but I suppose we could have a pandemic where we cannot pass it on.
Just something to think about TomDVM. Thanks for the discussion.
I do respect your opinion. I get nervous when you start jumping on Dick and the WHO. But I respect your opinion.
Thanks Patch. I really respect your opinion as well…and I sincerely hope I turn out to be wrong about all this.
…as far as Dick goes…he deserves everything I am giving him and if he doesn’t like it…he can come on flu wiki and discuss things with me in a professional manner…
…I will treat him much better on flu wiki than he treated one of my hero’s…Dr. David Nabarro.
As far as the World Health Organization goes…they no longer are an issue because they have proven themselves irrelevant in the matters at hand.
Of grain, a few months ago the world had a 57-day supply - on the low side. Apparently it must be less than that now. I was hoping the article would indicate the grain supply in days. And yes, if birds are hit en masse, we are going to have an onslaught of insects, and they are going munch in our gardens and fields. There will be more mosquitoes and more mosquito-borne diseases. Maybe the snakes can keep populations of rats and mice down; they will love the cover our overgrown lawns provide ;→.
Inky ~
I am late for school, so I didn’t have time to read all of this, so someone has already mentioned this, forgive me. Look into the ‘Sparrow War’ in China when war was declared on all the sparrows and what happened to the crops. They killed most of birds and there were no birds left to eat the bugs and they experienced massive crop failure.
Yes, and if you spray insecticide to kill the plague of insects, you kill the bees that pollinate your crops, so you’ve done yourself in all over again. We really need to be thinking this through, but I’m not sure what the solutions are.
Yes, and if you spray insecticide to kill the plague of insects, you kill the bees that pollinate your crops, so you’ve done yourself in all over again. We really need to be thinking this through, but I’m not sure what the solutions are.
I was under the impression it was mostly water birds that were under threat from bird flu? Surely most of these are vegitarian? Not saying there won’t be knock on effects but let’s not find too many things to worry about. Please?
Tom, I have a vet related question for you and I realize you might not know the answer, but thought I’d ask.
30 years ago I met my current vet at our church & have managed to use him for all my cats since then, except for a period of about 3 years and even then I’d call and ask him if what the “other” vet said sounded right to him!
When we met, he was making house calls which made it easy for ME. When he moved away he started working as a relief worker for other vets in Birmingham, AL (I’d call to see which clinic he was going to work any day I needed to take a cat in for treatment & go where he was scheduled to work) until he started his own vet business. So I’ve known him to work in a variety of ways in a variety of locations.
I remember asking him if he was still doing housecalls and he said something about his license not letting him practice except in the clinic. Now I know that vets go to ranches and farms to treat large animals.
Do you know enough about USA law to know whether there are different licenses for large and small animals?
If there’s not, then maybe in an emergency my vet could go back to doing housecalls so I wouldn’t have to take my cats in to his clinic, unless it was an emergency. I’ve seen 3 of my furbabies die in the last year, the last one was quite a shock, and I just can’t bear to think of endangering the remaining babes unless it was life threatening.
Do you know what the chances are that laws might be considered “flexible” during an emergency?
Tom DVM --- who invented this just in time strategy anyway.
Corporate America. It’s all about profits and the bottom line…Less inventory, bigger profit, creating higher demand, creating even higher profit.
uk bird - I cannot fault you for not wanting more to worry about.
uk bird – at 08:50 --- Surely most of these are vegitarian?
I agree with you about not looking for more things to worry about. However, most of the water-fowl I’ve seen or heard of eat bugs in the dirt around lakes, rivers and swamps.
Hmmmm…does that make a tomato-worm a vegetable?
Bronco Bill. It’s really good to see you back…thanks.
I’m workin on it. There has been a move in veterinary medicine over the past few decades to develop house call veterinarians who visit your pets in your home…I assume this trend has also occured in the United States.
Each State has it’s own self-regulating association for veterinarians. If you search under your state name, contact information should be avaliable…
…If you phone of e mail them, they should be able to provide you with a list of veterinarians who provide this service in your area.
I have a great deal of respect for farm animal veterinarians and you may have a mixed animal veterinarian in your area that does both. He/She might have a unique odor but I’m sure they will be friendly, competent and will really enjoy the cup of coffee and cookies afterwards.
I’m sorry to hear about your cats. I had only really had contact with one cat before I became a veterinarian; my sister had brought a mean wild cat home, so I was worried that I might not be able to work with them…
…In the end, I think I preferred them over dogs…but don’t tell anybody…its a secret!! /:0)
I was on a little roadtrip midweek and heard on the radio yesterday (national broadcast, hourly news) that U.S. government foodstuffs for the giveaway programs are getting short. The program administrators of these programs are having to ration their supplies. There is much less there in the strategic national supply of foodstuffs than there was even a couple of years ago. They gave no reason as to why that has occurred.
So that 3 or 4 days per capita of cheese, dried milk etc. that was reported some time back is now even less than that, another piece of the perfect storm.
If you go to http://www.fas.usda.gov/grain/circular/2006/09-06/grain0906.pdf, you will find the latest US Department of Agriculture report on the world grain situation. World rice stocks are near normal at ~80 million tons. World wheat stocks averaged 143 million tons in 2003–05 and are now 126 million tons, with world consumption of 616 million tons. The biggest shortfall is in coarse grains (corn and sorghum mainly)with current stocks of only 125.8 million tons against a previous three-year average of 164 million tons and consumption of 1,010 million tons. Coarse grains are mainly used for animal feed and if many of them died from flu, some could be switched to other animals or, in a pinch, people. Since it “costs” 2–4 pounds of grain to create a pound of meat, moving to a less animal-intensive diet would actually free up the grains.
On the bird die-off causing a food shortage due to increased insect damage, the birds that are massively dying are not (so far) mainly the ones that eat most of the bugs on grains. Most of the shortages, as in Australia, are more weather related.
I think what uk bird was asking is that AI has not been found in passerines (perching birds-sparrows, crows, thrush ect) at this time. And yes water birds eat meat-slugs, mollucks, clams ect.
I think what uk bird was asking is that AI has not been found in passerines (perching birds-sparrows, crows, thrush ect) at this time. And yes water birds eat meat-slugs, mollucks, clams ect.
Tom DVM – at 09:43 thanks! I’ll follow your advice & do some research — I tried to ask my vet about bird flu months ago, and his reply was that it wasn’t a worry here. The stories of the cats dying of the virus was just breaking I guess. Anyway, he wasn’t worried then.
I know what you mean about getting fond of cats…..my husband was like you until he lived the last 13 years with my cats! We took 3 healthy cats in for dental cleaning & brought them home fine except for what I’d call a panic attack from the smallest. Then that one started drooling which we thought was just from the dental work & in an hour or two he had labored breathing so we rushed him to the emergency vet and they did xrays of this cat we thought had been healthy and saw fluid around his lungs & a mass (I’d been there only a couple of months before with my 22 year old who was dying with fluid & a lung tumor). Treatment was aggressive to at least bring his symptoms under control, but it never helped. By dawn we had to put him to sleep.
10 years ago we found him on the side of the road with a punctured lung and paralysed leg (which returned to normal eventually) so he already had scar tissue that was lifting his lungs up off the rib cage but there was fluid that they drew off, then there was the “mass”.
When in doubt about causes, I let my vet do a post mortems so that he’s assured his diagnosis was “nailed”. During this one he found that there was no “mass” like they usually mean, but a rather large series of “bubbles” filled with fluid in the lungs. The way my vet described them I pictured large water balloons causing an unknown problem.
He took a ton of slides and sent them to a more specialized pathologist to study rather than the usual guy, because he knew the slides would be handled right & we’d find out what those things were instead of risking them being destroyed by someone else preparing the slides for the regular pathologist.
We’re still awaiting news. These rascals get under your skin and into your hearts in such a big way. To be loved by a cat is truly being loved.
This cat would rarely play with toy mice or balls because we were his toys and he and my husband were very close. The house is very empty with them gone even though we still have 4 (one is new - he came inside just before my 22 year old died with fluid on her lungs too and a real tumor in the lungs). 3 of the 4 are ‘seniors’ or ‘geriatric’ age & I just am terrified that taking them to the clinic would endanger their health once BF hits — so I’m over-mothering them now — they’re loving it. I worry.
Avian influenza is just one more good reason for making sure that our bat populations are healthy.
I know, a little of topic, but its like prepping using the redundancy theory … always have a back up.
There are tons of plans on the internet for building bat houses and bat habitats. This might prove to be a useful exercise for those with a little time on their hands … or for a kids’ project.
TomDVM - “it would take me ten thousand words to give the long version of the answer and it would make for a pretty long post.” That would be a post I would love to read. You have a way of conveying complicated theories in understandable (to me) and easy to read language. I, for one, would really look forward to every single word of the 10,000! So if you do feel compelled to begin that potentially long post, this reader would surely appreciate it! And many others here would too, I know.
/:0)
uk Bird and katherine: Yes, H5N1 has been found in tree sparrows in China and in pigeons there as well.
uk Bird and katherine: Yes, H5N1 has been found in tree sparrows in China and in pigeons there as well.
Still wondering though…
In H5N1 we have a very dangerous virus that appears to be easily transmissable in birds. It has demonstrated an ability to infect across species lines but has (of yet anyway) not deomonstrated the ability to become efficiently transmissable to any of these “cross species”.
Could someone tell me why it hasn’t become a epidemic or pandemic in ANY species other than birds (to my knowledge). Cause I’m not sure an answer of, “Well it could happen”, is good enough to convince anybody I know to start preparing.
I see a lot of things going on in this world, that could easily be the makings of the “Perfect Storm”. And that storm’s fronts are not limited to the disease.
Again, this monster appears so far anyway, to be limiting itself to our feathered friends, even after demonstrating it’s ability to jump party lines. Isn’t that correct?
Pixie – at 12:43 sparrows,
I posted something yesterday about something happening to sparrows in Hungary (millions?) but I could not get a good translation. I could not tell if the birds were having problems or if the birds where the problem. the Hungarian article is here:
http://tinyurl.com/tt9xt can anyone translate?
Sorry…I wish we could edit these posts. I need to proof read…but no time :-)
What I mean to say is, I don’t see how H5N1 has become efficiently transmissible WITHIN ANY cross species that it has infected. This includes, Dogs, cats, tigers and humans, for example. So far, thankfully, there appears to be a species barrier. Not just for humans, but all species. H5N1 infected chickens have been living along side pigs in Asia for nearly 10 years now.
On rare occasions it’s infected several other mammals, but in none of those species, has it become efficiently transmissible.
Again…a simple “not yet” is an answer, but not a very good one.
It’s no better than the “It hasn’t happened yet, so it won’t” argument. I’m looking for a better answer.
Patch. I certainly agree with the overall message in your post…but…and there is always a but…
…the species barrier was crossed once and for all in 1997 and several times in several species since then…
…but you are right in the sense that efficient intraspecies (between members of the same species) has not occurred other than in chickens…
…If you remember last winter…the two most respected expert virologists said the same thing within a week of each other. Dr. Webster said that two more mutations and H5N1 would gain pandemic potential (transmissibility) and then Dr. Nabarro made the same statement which Dr. Osterhaus confirmed was an off the record comment that came directly from him…
…Do you think it was just a fluke that both men made the same statement at the same time…an absolute statement like that is kind of a funny one to have to retract later…kind of like saying we had rain last week…no maybe it was a sprinkle.
H5N1 has not acquired pandemic potential but look at how far it has come or gone in the last twelve months let alone how far it has come in the last nine years…
…when you say it is endemic in Asia, what you are saying is that there is no way that we can escape the consequences whether through mutation, recombination or reassortment…and there is Karo with its confirmed H-H-H.
It would be nice if we could freeze it now and prevent further development but nature does not work that way…
…in my opinion, the drums of was are beating…they may not be loud enough for us but a lot of experts and regulators and governments around the world are hearing the sound of footsteps.
Tom DVM – at 20:37 When you speak of a perfect storm throw in the fact that TPTB will NOT shut down air travel. It will shut down but only when pilots refuse to fly or passengers refuse to be cooped up in an airplane for extended periods of time. The reason is that a large (about 10%) of the US economy depends on the travel industry. Money talks Bird Flu walks.
Everything clearly shows that IF this goes pandemic, it is going to burn fast and hot, however the good news may be that it will only burn for about 6 to 12 weeks. (That is if it does not mutate during the burn and starts all over again (waves)).
Anon 451.
I think H5N1 is such a ‘freak’ that we will have to do what we have done for nine years…
…shake our heads and expect the unexpected.
anin_541
and this is a possibility? About how long could the waves last?
Tom DVM – at 21:23 Yeah the thing that has me is the possibility that we may have 2 or 3 different strains all burning at the same time. Just get over one strain and get hit with a different one and you could be down for the count. Add to that the H7 and H9 that is trying to spin up. What a mess.
sounds more like the perfect virus, which something I had wondered about. Is it possible, say for two different viruses to infect the same person at the same time? If so, could those two viruses mutate into one virus while in the human? Sounds science fiction.
Anon 451.
In the 1918 pandemic the mild first wave produced short-term immunity against the virulent second wave…therefore, limiting losses.
What scares me most is that nature never does the same thing twice in a row. What if this time we have the virulent first wave with no induced immunity as in 1918.
It honestly seems that it doesn’t matter from what angle we look at this…we lose big time.
cottontop – at 21:32 If they are both flu virus like H5N1 and H7N7 the answer is yes. And now we would have three floating around.
Patch – at 15:48
What I mean to say is, I don’t see how H5N1 has become efficiently transmissible WITHIN ANY cross species that it has infected. This includes, Dogs, cats, tigers and humans, for example. So far, thankfully, there appears to be a species barrier. Not just for humans, but all species. H5N1 infected chickens have been living along side pigs in Asia for nearly 10 years now.
On rare occasions it’s infected several other mammals, but in none of those species, has it become efficiently transmissible.
Again…a simple “not yet” is an answer, but not a very good one.
It’s no better than the “It hasn’t happened yet, so it won’t” argument. I’m looking for a better answer.
Maybe this page Graph Of Cluster Size And Frequency Over Time is the answer you are looking for. Take your time and consider the significance of the apparent increase in no as well as size of clusters.
DennisC: From the rough online translation, it sounds like the birds are a “pest” and they are trying to get rid of them. The birds seem to be very much alive, as it says they are trying to frighten them away to no avail. They seem to be innundated with sparrows, more than at any other time since they’ve been keeping track, and think maybe it is because of the warm weather. It sounds like they do not think the problem will end until cooler autumn weather arrives.
Anon_22 - The cluster graph is interesting. But it merely states clusters and does not confirm H2H. My point is, if we had that chart for every species except chickens, it would probably look similar. Cross species infections are rare, considering there are millions of chickens coming into contact with different species every day. And when it does cross over, it does not appear to transmit efficiently in ANY species, others than chickens. It’s had a lot of opportunity to do so.
And I’m not convinced that increased human infections are the result of mutations making it more readily transmissible. I think maybe, the increased human infections are simply a product of increased bird infections, as this thing gets bigger. Eventually, it will burn out.
Like everyone here, I’m hoping it burns out before it finds the right keys. And it looks to me, like the keys are hard to find.
Pixie – at 22:41 Thanks, I was thinking that may be what it was about.
“Like everyone here, I’m hoping it burns out before it finds the right keys. And it looks to me, like the keys are hard to find.”
Patch. I agree. The keys are hard to find and therefore, despite a soup of seasonal influenza’s in humans and low and high virulence influenza in birds, we only have three pandemics per century.
Two of the world’s foremost experts said last winter at the relatively exact same time that it would only two more mutations were required. Why do you think they made the statements?
I hope you are right in the end but you are assuming that H5N1 is the only candidate for the next pandemic. We have 3 or 4 pandemic potential influenzas circulating right now in various parts of the world and other viruses like SARS and Nipah that are not flu’s but could also cause a pandemic…
…and we are presently in a flash flood of mutating pathogens of all kinds…
…seems to me that the fact that we are now pushing the upper outlier of 40 yrs. which is the longest inter-pandemic period in history coupled with the variety of pandemic potential viruses being pushed along by hidden environmental forces means that the odds are stacked against us.
…There are two kinds of luck and we are garaunteed to get equal amounts of both…we can only stay lucky for so long and we have let H5N1 play with us for too long a period already.
Patch, I share your ambivalence over whether H5N1 will ever be able to spread efficiently, outside of certain bird species. I’ve always had a healthy sceptisism over whether or not this could happen. When I first started following this over two years ago, I looked at the risk/consequences of a severe pandemic caused by H5N1. Back then, I felt that the risk was low, but the outcome would be so catastrophic that if one didn’t prepare, one would be a fool to ignore the warning signs. Let’s face it: there is no hard evidence that H5N1 will cause the next pandemic. However, I was greatly agitated by those on the other side saying that since H5N1 has had so many opportunities to go pandemic and hasn’t, that it will never happen (I know you’re not one of these, by the way). There are still too many questions to be answered, questions that we have only skimmed the surface. For example, Tom brings up that Nabarro, Webster and other heavy-weights claimed that the virus only needed a couple of changes to go pandemic. But you have heavy-weights on the other side (Taubenberger) who are saying that its not that easy. Then you have folks saying that it is endemic in Indonesia. Let’s not forget that Indonesia is a warm-weather clime, and the virus doesn’t survive very long in warm temperatures. I too am worried about Indonesia, but the big question there is what effect are the Tamiflu blankets having in suppressing a pandemic strain? Another more global question is: Why are outbreaks in humans still preceded by returning migratory fowl? Asked another way: If there are strains that only affect birds and those that only affect humans, as evidenced by the new sequence releases, why then does it take returning migratory fowl to create another outbreak in places like Egypt and China? And speaking of new sequence releases, why hasn’t Dr. Niman or anyone else made any more predictions, such as the S227N prediction in the Turkey outbreaks? It seems a bit quiet, doesn’t it? We were all waiting for the Chinese sequence releases, and nobody has come out and said that particular recent polymorphisms bring us any closer to a pandemic strain (aside from clarifying that the so-called mammalian strains don’t match the avian ones). I agree with Tom DVM on a lot of this as well. Tom said awhile back that a vet depends on certain zoontic diseases to stay in certain species and not to spread (I believe he said something to the effect that vets bet their lives on this principle). So I give a lot of weight to Tom’s “hunches”, because these same hunches have saved his life in many instances, I would imagine. I just have a lot of questions like you do, Patch, so I can understand your ambivalence.
anon_22 – at 21:48 - I haven’t said much in weeks, but those graphs look like a trend toward a tight, tall cluster of spikes between December until March as a recurrent theme. Tom’s perfect storm seems likely to be a “Nor’easter”, a winter hurricane, if that trend holds. I haven’t posted the completed summary from the NJ meeting the end of September, but the official position seemed to think we had more time, because the tone was one of “let’s make plans and get to work while we still have time” and “no one panic”. During the time since I had my own personal “perfect storm” that killed any chance of prepping.
Unless I’m really lucky, you guys remember the things I’ve said about keeping up the grid and learning the mechanics of how things work so you can restart it after the burns pass. If I get lucky I’ll pop up out of a rabbit hole somewhere that I was able to bolt to in the last few minutes, but I’m no longer counting on it. Of course, once on accepts the inevitability of death, it is a lot less scary, and a lot easier to function without fear.
Tom at 23:32 brought up the matter of luck, and I will expand on that theme. Our civilization has had an extraordinarily favorable run of good luck since the end of World War II. Sure there were (and are) wars of containment and nasty surprises like The Twin Towers and others. And Pol Pot did his work In Cambodia and Mao had his genocidal campaigns to stroke his ego, and the Gulags in the Soviet Union did some heavy lifting, but, all in all, compared to the first half of the 20th century it has been a walk in the park. And prosperity has flouished as never before, even in The Third World.
And there was that week in October 1962 when the Cuban Missile Crisis left the Soviet Union blinking, more or less.
The complexity and hyperdensity of our current civilization does not lend itself to the perpetual kind of tranquillity that the Pharaohs engineered (except for a dynastic hiccup or two). Too many balls are in the air, and too much time has elapsed, and too many bullets have been dodged.
We are due, no, we are overdue.
Patch, the point about the clusters, and in epidemiology in general, is not about absolute proof. It’s a bit like trying to read chicken entrails (bad joke!) to tell the future. But epidemiology does work to a certain degree.
Having given this a bit of thought recently, I believe one mistake of this forum has been to focus too much on the molecular biology for prediction. Remember that predictions always need prior data and a good-enough model to work. Whether you are predicting pandemics, the weather, or how successful a student will be in relation to their SAT points, you can’t make good predictions unless you have accumulated a critical threshold of consistent data. I think our understanding of the molecular biology (or virology) is still too crude to give us reliable tools for prediction. It is only good enough to for us begin asking important questions that might uncover keys to our understanding eg pathogenesis or evolutionary pressure. We still need loads and loads of data eg massive amounts of whole genome sequencing from many species, for us to have enough of a background understanding to begin to do prediction.
Epidemiology, however, approaches this from a different point of view, that disease outbreaks often (but not always) conform to certain rough patterns. As far as H5N1 is concerned, it has acted pretty consistently for the past few years, and always in one direction, ie increasing number of cases, increasing frequency of clusters, and is not irratic at all! That was the reason why I showed that chart. If the data is correct, and we are seeing increasing proportion of cases that are part of a cluster, as well as increasing cluster size, and we are seeing the closing of the gaps where in previous years there would be no cases during certain months, etc etc, if all this is accurate, then this is very consistent with a new emerging infectious disease, and there is every reason to expect that it is more likely to break out than not. This expectation, as far as I am concerned, will only be reversed if we see a reversing trend, eg decreasing cases, decreasing clusters etc. Until then, I personally am going to act as if it is going to happen, we just don’t know when, and my pandemic prep efforts will continue until the trends reverse significantly and persistently!
Was on the road most of this week. One of my stops: CA Pandemic Flu Preparedness Symposium. It was a tremendous effort, however the 2 scenarios presented for planning were 1957/68 and 1918. Sigh…
But I did get John Barry’s autograph, although I did not get to question him as I wanted to.
Patch,
Like everyone here, I’m hoping it burns out before it finds the right keys. And it looks to me, like the keys are hard to find.
When it burns out, I will happily close up shop and go home. :-)
Until then, there’s a job to be done!
One addendum to my previous post. I am convinced that we are feeling what a few were sensing in August 1914. Except that this time I expect the wars to follow the panflu. And that the wars will be diffuse and widespread, a new Hundred Year’s War gone global.
If panflu comes, Pax Americana will be finished, and it will be every region to sort things out for themselves.
Predictions….. hmmm.
It seems like I recall the hurricane forcasters at the beginning of the year say we would have about 15 hurricanes this year.
Enza-John Berry’s autograph? Way cool!
To divert my mind from flu-overload I picked up “A history of the End of the World” which is about how the book of Revelation has influenced culture and Western Thought through out the ages. Imagine my surprise when I find (on the back cover) a blurb written by, yes you guessed it Mr. John Berry.
Sometimes I feel like I just can’t get away from the flu…….
Hi Medical Maven, why do you think that we’ll have widespread wars, because of the disruptions of political infrastructures and the scarcity of necessary resources? Sorry, I don’t mean to put words in your mouth… please, go on…
Also, what is Pax Americana?
We had a young new weatherman in our area. He had passed his weather exams with flying colors, but he couldn’t predict the weather right in our area. He said we would have rain but the sun would shine and he said the sun would shine but we’d get rain. The thing was, our area didn’t go by the “rules” of weather and experienced weather forecasters knew that and based their predictions on what had happened in the past when the weather patterns were similar. When the young new weatherman realizied this, he bagan to study the past weather in our area and soon his predictions became more accurate. Now I’m not saying throw out the science books but the nature of nature is based on the past. If it were not, there would be no instinct in animals. We too are animals and even though we have intelligence to figure out the science of things, we also have the instinct to tell us to look at the past. When I look at the past, I don’t see how hard it is for that damn bug to mutate, all I can see is that it DOES and we had better get ready for it.
Anon_22 - Point well taken.
Oremus - I was thinking the same thing recently. Nature is unpredictable.
TRay75 at 00:02 - I’m hoping that you find a nice, safe rabbit hole to weather the storm:-)
Bill Nye “the Science Guy” was on Fox News the other day. Neil Cavuto asked him why the “knucklehead” forecasters got the hurricane prediction wrong this year. Neil said that some prominent forecasters even said there would be 1–2 Katrina-like hurricanes that would hit this year but didn’t. Nye said without even batting an eye, “But there WILL be another Katrina-like hurricane within the next thirty years!” There are two things wrong with this logic. The first thing is that nobody can say with 100% certainty that something WILL happen without a magical crystal ball. The second thing is that it is very hard to hold the prognosticator accountable when the action could take place so far into the future. I once heard that the closer you get to entering a black hole that time seems to stretch out. The event horizon seems to get farther away from you. I’ve seen several people make prognostications and then seem to lengthen them. Dr. Webster comes to mind. At first this thing was imminent, and now it could be in 5 years, maybe never. I don’t want to sound like someone else we all know who is hung up on probabilities. I’m not. I’m just saying you might lose a little credibility when you jump out on the thin reed of insufficient data to come to certain conclusions. At the beginning of this discussion a couple of years ago, I think we all came to the agreement that (1) we have insufficient evidence and (2) because of this, we just don’t know for sure. I ask you, what has changed? Are you saying we now have sufficient evidence to come to some sure conclusions? As this issue relates to structure of the virus, I’m sure there are military bioterrorism experts who could look at a potential pathogen under an electron microscope and tell you exactly what an organism could do. Ken Alibek comes to mind.
That’s Just Ducky-Yes, you have it pegged, political disruption and scarcity of resources, but also Man’s damn proclivity to become highly destructive when a long-established equilibrium has been blown away. And then an almost impossible process of reining in those tendencies and establishing a new equilibrium evolves out of the chaos.
Pax Americana is a updating of the old phrase Pax Romona. Instead of Rome being the world superpower and keeping the mayhem tamped down and commerce flowing it is now America (The United States) that has that role. Prior to America it was Britain that had that role. Wars happen as a matter of choice or design during these periods, but they are little wars, wars to fine-tune global interests.
What is to be greatly feared is to have no “Big Dog” on the block and so a widespread, intercountry free-for-all ensues on a regional basis with no overall restraining authority such as Pax Americana now provides.
Damn early morning eyes-Pax Romana
“I was thinking the same thing recently. Nature is unpredictable.”
Patch and Oremus. I would disagree slightly with your hypothesis. Nature is not unpredictable. Nature is predictably unpredictable. What I mean by that is that nature repeats itself but it never does the same thing twice…it is highly intricate with patterns overlaying other patterns…you can only extrapolate the future by seeing cleary the complicated interaction of the ‘thousand veils’.
De jure. Your post at 9:03 is a beautiful piece of writing: clear, concise and complete…but that doesn’t stop me from also slightly disagreeing.
To explain myself, we must go back a thousand years to Plato and the philosophical foundation of scientific principle…and therefore scientific method.
Flu wiki is in essence a scientifc discussion by like-minded scientists of diffuse expertise from around the world.
My point is that I am not here to convince you of anything and that was never my purpose…I have nothing to win or lose by convincing anyone of anything.
I am here to tell the truth governed by scientific ethics and principles. I am here to add my voice to yours so that what pops out in the end might be the truth but more importantly might help humanity in many ways that can’t be known to us.
This scientific problem is not different then hundreds of others that are dealt with each day…we start with nothing but questions and then we start to answer or bite off a few here and a few there…but through it all the frustration is the foundation question is still there.
……………………………………………………………..
If I could I would ask you to visualize something for me. A female or a male is standing somewhere outside on Christmas Day 2004. You can pick the location that best suits your visualization…
…The person is calmly saying that he/she has been examining patterns in nature and has come to a conclusion that a tsunami in the Indian Ocean is imminent and his/her intuition is saying, for reasons that he/she does not understand, that it could be very soon.
You have known that person for many years and they are quite often right but not always…and that is the point in these discussions…nothing is perfect.
The analogy between the Asian tsunami on Boxing Day 2004 with associated history and an influenza pandemic with associated history are the perfect match.
…………………………………………………………….
The philosophical point here is that we listen to our colleagues and keep and open mind while considering the issues at hand. If we disagree with the opinion of our colleague we have an obligation to put forth effort to return a well thought out reasoning as to why they are incorrect in their thinking…both you and your colleague have an obligation to be above personal insults etc. because you are not discussing whether a sports team is going to win a championship…but whether a significant number of children will die and the world as we know it will probably come to an end.
Thanks for listening to the diffuse argument.
Comments as always are welcome on all sides of the argument. /:0)
The foundation question is….WHEN?
Tom DVM at 10:32: “…The person is calmly saying that he/she has been examining patterns in nature and has come to a conclusion that a tsunami in the Indian Ocean is imminent and his/her intuition is saying, for reasons that he/she does not understand, that it could be very soon.” Tom, I’d also like you to visualize something. The time is December 31, 1999 at 10:00 p.m. The person is warmly-bundled, hunkered down in an old fashioned bomb shelter somewhere in the middle of Wyoming (no, it’s not Dick Cheney). This person, a computer programmer by profession, feels he has the inside story on what is going to happen in 2 hours. He has quit his job, moved his family from across two states and has cashed in his entire life’s savings to buy provisions for the coming apocolypse. He has fenced off his ranch with razor wire, purchased .50 caliber guns (and plenty of ammunition) and has booby-trapped all of the ingress and egress points to the property. This is an extreme example, but I saw lesser versions of this play out in my community. Tom, I appreciate your patience, courage, honesty and experience so evident in your posts. I’m afraid, however, that at times we don’t allow for alternative outcomes to this issue. I’m not saying that the H5N1 will decrease in virulence, burn out, etc., but as you have so often shrewdly observed, H5N1 has made liars out of all of the experts (by the way, I consider you an expert on this issue ;-) ). I’m hoping that H5N1 puts you in the same category as all of the other experts, but I’m preparing as if what you are saying will happen. However, I think when we say that it WILL happen, regardless, we are at the very least missing some steps in the process to reach that conclusion, steps which might tell us how to fine tweak our preparations, whether or not to move to Wyoming, etc., etc. Thanks for keeping an open mind, and thanks again for the benefit of your experiences in weighing in on this.
“However, I think when we say that it WILL happen, regardless, we are at the very least missing some steps in the process to reach that conclusion…”
De jure.
You and I can only go with the data as presented to us from which to ‘witch’ our interpretation of future events. If the background data is incorrect, there isn’t much we can do…
…the point I would make is that there are some absolutes that can be determined by existing irrefutable evidence…
…The longest inter-pandemic period in the history of mankind is approx. 40 yrs. and we are now at approx. the 40 yr mark.
…at the same time there can be three pandemics occur within 15 years and in the twentieth century there were two distinct pandemics in 1957 and 1968.
…and last but not least…from 1950 until 1997 there were two identified cases of avian influenza in humans…both of which lived…
…since 1997 we have had several subtypes of high virulence avian influenza making humans sick…
…H3N8 a subtype of influenza that remained stable and ‘dormant’ in horses for decades or hundreds of years has, in the 1997 time period, jumped the species barrier successfully and is now ‘killing significant numbers’ of dogs while making many others seriously ill…which is a parallel to the 1918 pandemic, only in an animal species other than humans.
1) the ground is shifting fast (in respect to the mutation rate of pathogens)
2) The question is not if…we have had recurrent patterns of worldwide pandemics for as long as humans have been on this planet…and there have been more frequent influenza pandemics in the human species then any other mammalian species or in birds for that matter…humans are a highly susceptible to ‘drive by pandemics’.
3)The question is when and all the trend-line point to sooner rather than later even if we only consider the data from the last year. …………………………………………………………….
It would be interesting to put together a list of parameters that would seem to indicate that the pandemic would be later (decades etc.) rather than earlier (years)…so that we could discuss it.
Thanks.
De jure at 10:58-Tom is telling us what he believes based on his experience. That experience includes the intuitive. There are always “missing steps” when engaging in the intuitive. Scientists even now are investigating the mystery of intuition. Intuition may never be able to be defined or broken down into a formula.
So we have to take Tom’s two cents for what it is worth based on our extensive readings of this thoughts and experiences over these many months.
It is “buyer beware” for all of us, but most critically for any just-arriving newbies. You have to get to know us regulars and to take our measure.
But we must all remember that Man is the motely sum of his extremes. We are not a balanced creature. We are an admixture of the incompatible and the contradictory. Balance is a faint hope. But suvival of the self as a living entity so that one can project oneself into the future, now that is a goal that can be striven for and accomplished. And if one goes a little overboard in striving for that goal, the harm is minimal in comparison to being unprepared for the alternative.
And for those that go way overboard, well, they would have probably exercised that option in some other manner if bird flu had not come along. The prospect of avian flu was there at the right time to capture their rising mania for whatever reason.
There are worse tragedies that bumping up the GDP, moving cross-country, and losing your job. You can always get another job, but once you’re dead, that’s it.
Medical Maven – at 11:38; De jure at 10:58
To support what MM was saying, and why I really do trust Tom’s intuition. Many years ago my DW had moved some furniture and was having a hard time breathing. I took her to the hospital (military on base) and the young doctors were all trying to figure out what was wrong (no X-ray yet), An SF medic, that I had known for years walked in and from 4 feet away said “She has a partial collapse of the left lung, but you will need an X-ray to confirm.” He walked out and we did not see him for a week, a half hour later the “Doctors” decided to get X-Rays for her sprained shoulder. X-Ray revealed a partial collapse of the left lung.
When we saw our friend again I asked him how he knew, he said just the way she was breathing was what his intuition was telling him to look for. I said I don’t understand and he said neither do I but if my my gut tells me to look for something, normally that’s what it is.
You now understand why I really do trust Tom’s “gut feelings” over some “Doctors” facts.
Tom, I’m not arguing with you on the issue that a pandemic is inevitable. I think we can safely say that one is inevitable. The problem that I am having is over the word “imminent”. I believe Dr. Nabarro, perhaps Dr. Webster, would have already said (or could have been interpreted as having said) that we would be in the midst of a pandemic by now. Then there is the prominent Russian scientist who called it (two years ago). I agree that we are facing a catastrophic event, but you know how the mass media pick the juiciest lines to run with. Why is that important? This is not a Y2K event. You and I both know that if it doesn’t happen this year, it will happen within the next several years. But most people will remember a quote out of the newspaper that it was “imminent”, meaning this year, and when that doesn’t happen, they will say “ah, I told you so. Just like I told you so on Jan.1, 2000. When will you ever learn?” Then the giant wave will come and take them out to sea. Some folks would say, “served ‘em right. They should have listened.” I argue that they just might have listened if someone had been a bit more circumspect in their prediction. You say it will happen Fall ‘06 - Spring ‘07. What if it happens Fall ‘07 - Spring ‘08? I know it seems like splitting hairs to us, the folks who have been following it for awhile. But what about the new ones? The ones who still have the Y2K mindset? I have an open mind on when this thing could happen. I hope others do as well.
De jure – at 12:26
I agree with you absolutely.
It’s one thing to trust our own intuition, and everyone does that to a certain degree, but it is quite another to rely on that for risk communication and to convince others…
De jure, Medical Maven, Anon 451.
Thanks. It continues to be an engaging and intriguing conversation.
De jure. I am glad for the ‘path forward’ that we are following when we question and comment and further explain and by doing so reach deeper and deeper levels of the issue…not sure where it will all end up but it continues to be intellectually stimulating to discuss things with exceptional minds.
Imminent. Yep, it’s imminent. We don’t know the equation to convert imminent in ‘nature time’ to human time. I don’t like being put on hold for more than thirty seconds…mother nature may have no problem with being on hold for thirty months or thirty years.
You brought up an interesting additional point, If I lined up Dr. Webster, Dr. Osterhaus, Dr. Nabarro, the Russian virologist you mentioned and I could go on if my mind wasn’t a sieve…
…all of these experts, the foremost experts in the world, at one time or another in the past twelve months, have looked at the issue and groaned saying basically….we are screwed.
Normally we couldn’t get two scientists to agree on anything and yet we have an amazing anonymity…
…not one of them would make any comment without due and serious consideration because they know the weight of their words…
…honestly, we really should concentrate and try at some point on a thread to reverse argue this thing…I believe this came from Plato…test your hypothesis by coming at it from the oppositie direction.
At the moment, to provide data that it is not going to happen…soon…it might be a short discussion because other than the blanket assurance by a few without a shred of evidence to back their statement up…I can’t think of one indicator that it is not going to ‘flash-over’ on us.
The fact that in nine years it hasn’t means nothing in isolation because it could only be the perception between our time and her time as I mentioned.
The vast array of circumstancial evidence is like a stadium full of people pointing north.
it’s almost like a timed sequence that has “woken up” in these viruses. Kind of like it’s programmed in their genetic makeup to “wake up and mutate” It seems to be happening more and more with these viruses.
Hi anon 22.
Our posts crossed…same thing goes for you in the first comment of my post.
I think the point I would make is…that if it was just intuition speaking I wouldn’t be on flu wiki commenting in the first place…I would be doing other things.
I think the real discussion we should be having is…what is the real value of circumstancial evidence…
…I believe that it is equivalent en masse to hard evidence…I think many on flu wiki might not believe this is the case.
In my experience, if I as a practising veterinarian ever waited for the concrete information to act…I would be looking at a bunch or carcasses laying on the ground and a farmer scratching his head. /:0)
To me…science is all about…interpreting the circumstantial evidence and being proven right later with hard evidence…
…for example, observing the phenotypic expression of a pathogen (disease) later confirmed with serology or genotype (sequencing) etc.
…and I know you are an intuitive too.
I remember having a talk with a veterinarian friend before I graduated from veterinary college. She said that uterine torsions and prolapsed uteruses etc. occurred much more often on full moons and she hated being on call during a full moon.
I told her that she was nuts…and then graduated and started being on call during full moons and observed the increase in frequency of certain things including births.
I also noted many other disease outbreaks being controlled by weather changes including pneumonia and scours outbreaks on many farms triggered at the same time.
The viruses gentoype didn’t wake up…it is not telling the virus to mutate in my opinion…
…I think it is environmental pressors coming to bare on all pathogens whether viruses, bacteria, fungi or parasites…
…it could be global warming, sunspot activity or from a million and one other unseen factors…our six senses are not going to allow us to identify the causative agent…but we can in our parallel universe observe through the looking glass its expression which unfortunately is going to be disease in our fragile species that in the larger scheme of things…really is non-essential.
Yes, it will happen and the big question is When. But a bigger question is how bad. Will be a event that fills the hospitals and dr. offices but not much else? or will it be the civiliation killer that some have suggested.
Yes, it will happen and the big question is When. But a bigger question is how bad. Will be a event that fills the hospitals and dr. offices but not much else? or will it be the civiliation killer that some have suggested.
If 40% of the people get sick and cannot work, we may have see civilization crumble even if the CFR is low.
Great series of posts Tom. You do a great job of going over old ground and then adding bits of “new” that illuminate the whole in a different, refracting light.
You beat me to the punch while I was elsewhere on the net in regards to the FACT that there is not much left to intuit.
And I think anon_22 would have to agree that it may take years of developments in the field of virology in order for us to have more definitive indicators as to how this is going to go AT THIS POINT IN TIME.
So if you can’t persuade somebody that we have a serious, time-crucial situation on our hands with the facts such as they are, well then, they will stay unpersuaded until H5N1 slaps them up the side of their head. And I won’t be laughing.
Medical Maven – at 10:13 Thanks for your reply, and yes, I agree that we have much to fear in regards to warring in the wake of a collapse of civilization.
That is actually the main reason I am hoping to relocate to a secluded, sparsely populated area of the US at the first sign of sustained, efficient transmission. If I could do it sooner, realistically, I would. I could probably SIP in the city for the entire period of the pandemic, if necessary, even if it lasted two years. I could probably remain safe from infection and subsist on stored supplies. Providing I escaped whatever the resulting social disruption wrought. I’m not so sure about how well I would fare in the city on an idefinite basis amid a collapsed infrastructure. If you throw in widespread regional warring into the mix, I am quite sure that survival in the cities would be quite challenging, to say the very least.
doug baker. I agree with the importance of how bad…the circumstancial evidence all points to bad…but we will never know until the pandemic virus arrives as there is a full template of possbilities due to mutation, reassortment or recombintation.
LMWatBullRun. I agree but I think CFR may not be the best way to measure the ferocity of the virus…what if a virus destroyed the lungs of 50% of the persons who get sick, leaving them permanently with air exchange compromised but not killing them.
In that case the CFR may be low and the Incapacity Rate may be far higher also affecting civilizaton as we know it.
I continue to be amazed that we have had no long-term studies of the quality of life and ongoing medical problems of those who survived an H5N1 infection. You would think they would collect and release this type of information for the purposes of planning the expected requirements in the immediate post-pandemic period.
TomDVM
I do not profess to know really anything about pathogens, or anything of the kind. These are very ancient pathogens with a “mind of their own.” It surely isn’t to feasible to say that sequencencing or genetic makeup, doesn’t contain soemthing of that kind, and yes, I agree with you that enviroment, ect.
I adore science to a point, but have found scientist minded people also very stubbon to accept what is not ration, or tangable. There’s always something more going on than what meets the eye.
Medical Maven Thanks.
“There’s always something more going on than what meets the eye.”
Cottontop. Where I come from, they call what you just hit…a home run!!
Exactly. That is what has kept my interest. Just when you think you have Mother Nature figured out…boom…you get a two by four up the side of the head.
Thanks.
anonymous – at 15:10
I think everyone agrees that we will have social disruption as a result of a pandemic.
The *extent* of social disruption we will have will be in direct correlation to the severity of the case attack rate - the percentage of the population that gets infected - and sick or otherwise indisposed, e.g. caring for sick, afraid to go out of their houses, or dead.
If social disruption persists long enough, we will have infrastructure collapse. The duration of the infrastructure collapse would be a direct correlation to the severity of the case fatality rate. An infrastructure collapes of sufficient duration would result in the collapse of the civilization.
Tom DVM – at 15:33
You know, you’re right, I really haven’t seen that discussed, and that is a good point. One more variable to add to the soup.
We *may* be able to *roughly* guage the case attack rate and case fatality rate once there is clear evidence of uncontained, sustained, efficient third (or greater) generation human transmission. Even if there is an attempt to contain the spread of the news of the extent of the disease outbreak, the spread of the outbreak of disease will be quite evident. We will see hospitals flooded with the desperately sick, healthcare workers will be among the patients in great number, and there will be large numbers of people dying in a very short period of time. There will be a small window of time between the evidence of uncontained local/regional epidemic and full blown pandemic sweeping the world.
Tom DVM, I don’t disagree with you on the value of circumstantial evidence in assessing a situation. The Lacy Peterson case in California comes to mind. Every bit of evidence that the jury looked at was circumstantial…and yet it was enough for them to render a death penalty verdict against Scott Peterson (and well-rendered, I might add). But I’m sure that you will agree that circumstantial evidence is best-suited for answering certain and not necessarily all questions.
Would I look at circumstantial evidence to answer such questions as “Who?”, “What?”, “Where?”, and “How?” Certainly. Would I use it to answer “When?” Maybe not. Because circumstantial evidence is retrospective. It doesn’t lend itself to prospective answers. Here’s an example. Would you consider a 2 degree F. increase in the Gulf of Mexico ocean temperature as circumstantial in assessing a weather pattern? No, because it is direct evidence. How about a shift in the jet stream to the north? Also direct evidence. Add in some additional direct evidence concerning North American fronts and storms forming off the coast of Africa, and someone with a little talent might be able to accurately predict a hurricane. That’s why I think it is so important for someone with a little talent to look at the latest sequences coming out of China, Indonesia, etc. This to me is like a shifting jet stream, increase in ocean temperature, etc. It is a main variable. If the forecaster is wrong, he could say, “I did the best that I could with the data.” What about someone who bases everything on circumstantial evidence? Yes, I think we can answer the question, “will there be another pandemic?” with circumstantial evidence. We could even answer the question (I believe) regarding its severity. But can we answer the question “when will it be?” Well, exactly how are we going to do that? Again, I think we need some additional direct evidence to answer that question.
By the way, I should make one point, and that is that I may be in the same boat as everyone else living in the city. I am counting on bugging out to my dad’s house in the remote countryside. I’m just making him aware of the H5N1 threat, as all he knew about it was the pap he has seen on the news over the last couple of years. If I’m not successful in this endeavor, I will be riding it out in the city also. Sigh.
De jure. I agree with every comment you have made but I think you are putting too much stock in the sequences…they don’t know what the sequences mean…they don’t know where the virulence is, where the transmissibility is, they don’t know where the when is in the sequence…
…the state of influenza research is kind of …deplorable…
…we aren’t alot further ahead then they were in 1918…and Dr. Welch commented at the end of 1918 how they knew no more than they did in 1890.
Influenza is the great disease queston mark…and like the cure for cancer, the answers with influenza may prove evasive long into the future.
The point is that we may not like it but circumstancial evidence and pohentoypic expression may be all we have to go on.
Tom DVM at 16:24: Hmmm. So using my weather analogy, what you are saying is that we don’t have forecasters with the right talent, even though we may be able to collect the direct evidence? Well, that’s a scary thought, and you might be right about that. I’ve suspected that there may not be a Max Mayfield out there in the field of virology (due to the relatively deafening silence in the press notwithstanding the recent sequence releases from China.) I hope that your wrong, Tom. I really do, because I remember reading about one of the great scientists from the Spanish flu era saying that if the flu had lasted a week or two longer, civilization might have failed (can’t remember which one said it, but it was referenced in John Barry’s book).
Yes, Tom DMV at 16:24, I think you hit the nail on the head in your last sentence. I’ve come to the conclusion for myself that the debates over recombination vs. reassortment and random mutation are probably moot points. Because I don’t think there will be enough time to manufacture enough (any) of a vaccine that might come of all the research, get it distributed and get it into people fast enough to prevent the inevitable. Maybe circumstantial evidence and gut instinct will be all we’re left with, and maybe we will have to hope it will be enough. I think the participants on FW are instrumental in working out how to ascertain what that circumstantial evidence is, how to recognise it, and how to evaluate it.
De jure at 16:18-“someone with a little talent to look at the latest sequences”.
There is “talent” out there, but the trouble is they don’t know what they are looking at (OR where to look OR the significance of what they are seeing), such is the undeveloped state of virology.
Nature isn’t a court of law and with the possible fate of mankind at stake, “circumstantial evidence” used prospectively in regards to the timing of the next pandemic will have to do.
And to my untrained mind I have enough to convict, (panflu is coming around the corner, five years maximum, but more likely by the end of next year).
In my observations, I find the Wikie Motto highly appropreiate. “It’s not what the say,but what they do.” TPTB appear to be moving (slowly) in the direction of a pandemic. States and comunnities are just now starting to “get it”. Why? Remember this needs to be balanced with TPTB rule of “No Panic” due to JITD. Fact: People will die due to TPTB lack of getting people to prepare in time. These same people wear blinders while shopping. They do not see the cans of tuna on the end of the isle. They also do not see the windup multiband radio/flashlight at the registar just before checking out and at least wonder why. Why are people still clueless? TPTB “No Panic” rule. Lack of media coverage. Let’s not forget the people who will always refuse to face reality. This is likely to cause more collateral deaths than deaths from the flu.
Watch and be alert to what is going on around you. This virus has yet to suprize or disappoint me. This virus is on it’s own timeline. Forget about that timeline matching ours.
Fact: The outcome of this situation has become our resposibility! gina
Tom & De jure, I think the issue is the level of proof needed to come to certain conclusions and/or for action depends on what you are trying to do. If it is for your own personal risk assessment, or if you are trying to make a case to convince others, then the level of proof will be very different.
On the issue of sequences, I think they are important on specific issues such as whether we are using the right primers for PCR tests or whether there is an unknown host. But I don’t think they will be as important in providing the kind of direct evidence that De jure is looking for to answer the ‘when’ question. THAT is most likely going to be dependent on meticulous epidemiological work.
Does anyone know if Tamiflu would be covered by most health Ins. companies? I have scripts for it but not sure if my Ins. will pay for them?
“Medical Maven – at 00:40…. I am convinced that we are feeling what a few were sensing in August 1914. Except that this time I expect the wars to follow the panflu.”
Or happen at the same time. I was listening to NPR the other day and was thinking we were on the edge of another World War. Put that with global warming, pan flu, other emerging diseases, and overpopulation… famine will add just the right icing on the cake. Yipes!
oh, it just hit me…..Europe is on the edge of a big problem with drug resistant TB and polio and other “old” diseases are reemerging. It’s just the Coming Plague thing. For the last century humanity has lived in a fantasy world where disease seemed conquered and we could do anything. I guess it’s just back to reality for us!
I think you’d be lucky to be able to GET tamiflu at the moment, even with an Rx. If I had an Rx, I’d go buy the maximum, even if I had to do it on the credit card.
Here’s what I don’t get. We understand that H5N1 has the alpha receptor that works on human lungs and we are worried that it will acquire the alpha receptor that allows it to enter nasal and throat lining cells — so what is the mechanism that applies when humans/cats/dogs eat a chicken that has died from H5N1 and subsequently get ill themselves with the virus. Is the virus entering stomach lining cells?
I just finished reading John Barry’s The Great Influenza. Maybe reading the account of the Spanish Flu put me in the Perfect Storm Mindset. The accounts of the Spanish Flu in some of the large cities was horrific. And that was with “only” a 5% death rate.
After reading his book I note that the death rate was probably higher than officially reported but regardless there were also a lot of follow-on complications in the survivors, most notably “encephalits lethargia.”
Also, while the Spanish Flu hit in three waves over 1918 and 1919, the following year “1920 would see either (sources differ) the second or third most deaths from influenza and pneumonia in the twentiteth century.” While I have seen references that H5N1 will be with us for a long time, I had never heard that before believing that Spanish Flu went away after the third wave and “normal flu” returned.
With the H5N1 mutations over this year, any change in the death rate? What are the odds that it will drop to “only 5%” with the last few mutations before going pandemic? Is there a bad storm or rainbow over the horizon?
“What are the odds that it will drop to “only 5%” with the last few mutations before going pandemic?”
It has to drop some or it won’t be able to spread enough to go pandemic. I’d say it’s a crap shot on when and how bad!
I don’t get this argument that CFR has to drop in order for H5N1 to go pandemic. People are contagious before they are sick and sick for a number of days before they succumb, so the conclusion is illogical. Many people can be infected before a victim dies. Where does that idea of dropping CFR come from? What scientific or historical basis is there for it? I would love to have a reason to think that the CFR will drop, but I’m still in search of a sound one.
Isn’t there an African virus (Ebola?) that has been around for decades and occasionally flares up and wipes out some village with a similar CFR? Wouldn’t the more species that harbor H5N1, especially ones that are just carriers, make that a plausible scenario too with the difference being that the bird carriers can spread it all over the world?
Isn’t there an African virus (Ebola?) that has been around for decades and occasionally flares up and wipes out some village with a similar CFR? Wouldn’t the more species that harbor H5N1, especially ones that are just carriers, make that a plausible scenario too with the difference being that the bird carriers can spread it all over the world?
InKy – at 20:38
Your argument is actually the one that defies influenza virus logic and that’s the logic that counts here. It’s just the way the virus works. It causes higher mortality now because it infects deeper in the lungs (amoung other reasons). But, that also makes it harder for it to spread from human to human. Once it infects in the throat, etc… (upper respiratory) the mortality rate will fall, but the ability of the virus to infect quickly and efficiently will go up.
If that still doesn’t make sense to you search the archives of this site for more info in laymens language or go to http://www.pubmed.gov and read the professional journals yourself.
MLBIT - Thanks for giving me some direction. I’ll need to do some further research to understand, I know, since I don’t immediately see why an upper respiratory infection can be predicted to preclude or replace a deadly one deeper in the lungs. I’ll head to pubmed.gov.
with the emergence of newcastle disease, I have become curious about it. Now there are some of you, or all of you who think this is nothing that should even be discussed. Maybe.
there has been on out break of newcastle disease in east lothian, scotland, of more than 17,000 grey partridges at a holding in fenton barns in derm. has been confirmed friday, 13, 2006. In april of this year, the potentially fatal H5N1 strain of bird flu was confirmed in a dead swan found in fife.
august of this year, bulgaria’s first suspected bird flu case confirmed as newcastle disease, a low pathogenic form of bird flu, not related to the potentially lethal H5 or H7 viruses. the isolated strain was 99.7% compatable with that found in Greece in 2005. bulgaria’s first bird flu outbreak was reported at the end of july of this year. LATER, BULGARIAN AND EUROPEAN LABS BELIEVED THE DISEASE WAS A COMBINATION OF NEWCASLE DISEASE AND A LOW-PATHOGENIC AVIAN FLU. in feb, four cases of the potentially deadly H5N1 bird flu viruses were regerstered in wild swans in the north of the country.
it seems that newcastle is following avian. “there is no danger to humans eating meat from a chicken affected by this disease.” and “there is no threat from newcasele disease to humans.” isn’t this exactly what they said about avian bird flu in the begining? could newcastle be gaining some ground, just like avian bird flu started out? could the two viruses mix? or stay parallel to each other and reak havoic? the only difference between these two viruses is the family; newcastle diasease is paramyxovirdae, avian bird flu H5N1 is orthomyxoviriade. how big or small of the difference, I don’t know.
TomDVM- what do you think? (that I’m nuts?)
MLBIT, there is actually no scientific support to the notion that the CFR has to drop if H5N1 goes pandemic. Read the following excerpt from this paper H5N1 Outbreaks and Enzootic Influenza, by Robert Webster, Malik Peiris,Honglin Chen,and Yi Guan
This question was discussed in great depth on this thread
pfwag – at 20:50 Isn’t there an African virus (Ebola?) that has been around for decades and occasionally flares up and wipes out some village with a similar CFR? Wouldn’t the more species that harbor H5N1, especially ones that are just carriers, make that a plausible scenario too with the difference being that the bird carriers can spread it all over the world?
The difference between Ebola and flu is that the latter is contagious before symptoms and transmits mainly via the respiratory route.
cottontop. Given the current set of circumstances we find ourselves in with respect to the broad geographical distribution of H5N1, the reports of infection in a previously unheard of number or animal species and the fact that in some of these species the disease may be asymptomatic…you raise and point out emerging concerns with your post.
Influenza has a set on non-specific clinical signs, both in animals and humans. In fact, they believe that approx. ninety percent of reported influenza cases in North America each year are actualy food posionings. What we commonly call the flu, is actually caused by cold viruses.
As I’m sure you know, in humans, even back in 1918, influenza was confused with Dengue fever. A year ago there was not the concern with disease outbreaks around the world like we are seeing today…and I think that is a reflection of where the virus is at in the eyes of experts and regulators around the world.
In animals, the main disease that is confused with avian influenza is Newcastle disease. I am not all that knowledgable with avian diseases but I believe Newcastle disease is very similar to avian influenza with an immunosuppresive component such that you could potentially get dual infections.
I think the bottom line is that one other evolutionary strategy and reason that influenza is probably the most successful pathogen in human history is that it is insidious in its behavior and the phentoypic expression (disease) is hard to distinguish from a multitude of other diseases.
The World Health Organization invented the containment strategy after Q Lake and just before Indonesia and Karo last year, in my opinion, as a public relation exercise…
…anyone at this point on flu wiki could tell them that for the reasons mentioned above, it will be gone around the world before they realize and can confirm it is there in the first place…
…I hope it makes the World Health Organization feel better to apin and mislead on every issue related to H5N1…because all it does for the rest of us is put another chink in what they mistakenly believe is impenetrable armour.
anon_22 – at 07:07
You may be correct, but I think the jury is still out in the scientific community.
An example: Nature. 2006 Mar 23;440(7083):435–6. Avian flu: influenza virus receptors in the human airway. · Shinya K, · Ebina M, · Yamada S, · Ono M, · Kasai N, · Kawaoka Y. Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA. Although more than 100 people have been infected by H5N1 influenza A viruses, human-to-human transmission is rare. What are the molecular barriers limiting human-to-human transmission? Here we demonstrate an anatomical difference in the distribution in the human airway of the different binding molecules preferred by the avian and human influenza viruses. The respective molecules are sialic acid linked to galactose by an alpha-2,3 linkage (SAalpha2,3Gal) and by an alpha-2,6 linkage (SAalpha2,6Gal). Our findings may provide a rational explanation for why H5N1 viruses at present rarely infect and spread between humans although they can replicate efficiently in the lungs. PMID: 16554799 [PubMed - indexed for MEDLINE]
There are other examples from the professional papers, but I am sure you how to find them.
MLBIT – at 14:46
This issue of receptor binding has been discussed many times as you said on this forum. That particular paper only attempted to suggest a reason why H5N1 in its current incarnation may find it hard to spread between humans.
A fuller explanation is given in the first post on this thread H5N1 Receptor Binding.
The issue of receptor binding and the molecular mechanisms required to achieve that is very complex, as discussed in the rest of that thread and also here. Also check this out for the issue of species barrier . Whether H5N1 is able to achieve a change in receptor binding preference, and whether that change is sufficient to cause efficient transmission, as you said, the jury is out.
But I don’t think there is any disagreement about the general concept that influenza viruses when they acquire the ability to transmit efficiently between humans, are primarily respiratory viruses, whereas Ebola, even when ‘highly contagious’, tend to be primarily spread by contact.
Need an answer: Is it correct to characterize the h5n1 we are currently seeing in Indo as a human virus? a bird virus? or in transition?
It’s an avian virus isolated from humans.
(-a virus that seems to be much better at getting into mammals than previous avian influenzas?)
“why H5N1 in its current incarnation may find it hard to spread between humans”
may be more to do with which humans have gotten sick ; ones who were not taking long crowded bus, train, or airplane rides with other travelers, who probably would have made much larger clusters in the time people are contagious before symptoms, and during the symptoms, if they had been in the wrong place for us, and the perfect place to disperse a variant that had been through a person or two already. Some too-intimate tourist might unknowingly pick something up from someone who is just having a family member fall sick but does not know they themselves are contagious, and then, the tourist would fly a half a planeful of it into the travel web.
Dr.Nabarro said in an interview back in Dec.2005,
“… The biology colleagues that I speak with tell me that if the pathogenic characteristics of H5N1 were to be taken forward as it mutates into having a human-to-human transmission capacity, then we would have a virus with high pathogenicity.
So, we really have to hope that if it’s a mutant of H5N1 that causes the next pandemic, it sheds some of the pathogenicity that this current virus has during its mutation.”…
(We know Hope is not enough, when dealing with Nature’s consequences.)
Thsnks anon-22 and crfullmoon. That explains why I am hearing from some corners the glib response of “oh, it’s not a human virus yet; we don’t have to worry yet.” They are technically correct but…
I think may be some conflation of two separate issues here. The first is where the virus is good a binding, and the second is how the infection proceeds. See this paper which compares virulence of two “avian receptor” variants and found that HA and NA segments were insufficient to increase virulence, but PB1, PB2 and PA in combination were.
While receptor binding may affect transmissibilty in humans, it may be completely irrelevant to ultimate virulence during infection.
Long thread closed and continued here
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