Summary from Indonesia Outbreak as at 24 October 2006
| Cases Discussed | Jun-06 | Jul-06 | Aug-06 | Sep-06 | Oct-06 | Total |
|---|---|---|---|---|---|---|
| Died, no tests | 2 | 2 | 4 | 3 | 4 | 15 |
| Died, tested positive | 4 | 3 | 2 | 3 | 3 | 15 |
| Other tested positive | 0 | 1 | 3 | 1 | 0 | 5 |
| Suspected symptoms | 4 | 2 | 46 | 38 | 26 | 116 |
| Tested negative | 0 | 6 | 26 | 19 | 7 | 58 |
| Totals | 10 | 14 | 81 | 64 | 40 | 209 |
(Please see the thread Volunteers Needed as Lookouts Worldwide if you want to help)
(From WHO as at 16 Oct - latest update) Total human cases worldwide 256, deaths 151 (2006 – 109 with 73 deaths)
(If you want the links to open in a new window, hold down the shift key and then click on the link)
India
Indonesia
Nigeria
Russia
United Kingdom
United States of America
Zanzibar
General
Link to news thread for 24 October (link News Reports for October 24 )
(Usual disclaimer about may not have captured everything. Feel free to add your own where omissions have occurred.)
Please note that I copy the links directly from the thread so if they don’t work you may need to re-visit the Thread.
S. Korea to implement tough bird flu prevention measures beginning November
SEOUL, Oct. 25 (Yonhap) — South Korea plans to implement a series of tough measures aimed at preventing bird flu from hitting the country during the winter months, the Ministry of Agriculture and Forestry said Wednesday. The plan, which will run from November through February, calls for the government to step up quarantine and monitoring efforts to stem the flu from coming into the country through imports of infected birds and poultry. The measures also come as there are increased concerns that migrating birds which travel south in the winter season may bring the deadly bird flu virus into the country.
The ministry said imports of poultry and live birds from China and Thailand are banned since both have reported cases of the disease, while authorities said they will tighten the monitoring of products from other countries that run high risks. South Koreans travelling abroad will also be advised not to bring in poultry from countries that run high risks. Agricultural quarantine officers will be placed in all international airports and sea terminals to enforce these rules.
Domestically, authorities said they will step up the monitoring of duck and chicken farms and take immediate action if a case is discovered. If a bird flu case is reported, the government plans to quarantine an area up to 3 kilometers from the suspected site and destroy all birds that could have contracted the disease. Movement of birds from the region and the surrounding area will be forbidden for at least 30 days.
more … link http://tinyurl.com/yafw6w
(USA - Maryland) County hospitals brace for flu pandemic As locals plan for potential outbreak, state officials to monitor Maryland’s poultry industry Wednesday, Oct. 25, 2006
by Anju S. Bawa Special to The Gazette (link http://tinyurl.com/ucpzb)
No one knows when or where a pandemic flu will strike or how bad it will be, but five county hospitals have a plan to alert medical care workers, and officials are monitoring Maryland’s poultry industry for signs of an avian flu outbreak.
Montgomery’s hospitals have been participating in a 24-hour program that collects electronic data from the community, such as emergency room visits, drug sales and school absenteeism. The data are then analyzed by computer for unusual patterns.
‘‘It gives a picture of what is going on in the community in terms of health,” said Kathy Wood, manager of emergency planning at the county Department of Health and Human Services. The system was piloted in Montgomery County four years ago and has expanded to the Washington, D.C., area, Wood said.
<snip>
The hospitals also have emergency plans for operating with only half of their employees and a surge of patients.
Seasonal flu is caused by human influenza viruses .. <snip> .. However, a pandemic, or global outbreak, can occur if a type of virus emerges that can spread easily from human to human, travel around the world, and cause serious illness and death in people who have little natural immunity to it.
<snip>
‘‘The avian flu is not an epidemic or a pandemic yet,” said Mimi Cameron, a doctor and infectious disease specialist from Kaiser Permanente who spoke last week at the Holy Cross Hospital roundtable. Notably, all of the cases of infection were from poultry. ‘‘Poultry is big in Maryland,” Cameron said, referring to the industry centered on the Eastern Shore.
There are protocols in place for community farmers. If avian flu is detected on a farm, all the animals will be killed and composted on site. Regulations for maintaining poultry require farmers to shelter and test the birds regularly, but this may not be the case for organic farming, Cameron said.
Cameron said she eats organic chicken and eggs, but if a case of avian flu occurred, she would stop consumption all together.
Marilyn Bassford, coordinator of the National Animal Identification System and Poultry Registration for the Maryland Department of Agriculture, is worried about ‘‘backyard flocks” that are open to contact by wild birds, which increases the possibility of flu transmission. Many households raise chickens, ducks or other birds on their property.
Bassford estimated there are 50 backyard flocks in Montgomery County, and encouraged registration to increase protection. ‘‘We need a working knowledge of these flocks to quickly test them in case of a problem,” she said by telephone Friday.
<snip>
‘‘We have had a state of laissez-faire about emergency preparedness because people feel that nothing bad happens here,” said Amy Waye, communications manager at Suburban Hospital in Bethesda.
Quarantine lifted in bird flu-hit area of Inner Mongolia
The quarantine imposed on an area in north China’s Inner Mongolia Autonomous Region, which was hit by an outbreak of bird flu last month, has been lifted, local authorities announced on Wednesday.
A ceremony was held to mark the lifting of the quarantine in Jiuyuan District of Baotou city on Wednesday morning.
Experts with the regional headquarters for the prevention of major animal-related epidemics said that no new outbreak of bird flu had been reported since the last poultry was culled 21 days ago.
Nearly 1,000 chickens and ducks were reported to have died suddenly on a poultry farm in Xincheng Village of Jiuyuan District in Baotou City on September 27. The national avian influenza laboratory later confirmed that the H5N1 virus was found in samples of the dead poultry. About 30,000 fowls within three kilometers of the farm were subsequently slaughtered. No human infections were found.
more at http://tinyurl.com/yl8n29
«!ACHTUNG!»
http://news.xinhuanet.com/english/2006-10/25/content_5245020.htm
Possible vectors for North America.
I couldn’t see that this had been put up.
!!
Ta Blue. This story is about the wood duck and laughing gull being very susceptible to HPAI viruses. It was first posted here on Monday if memory serves me - no guarantee on the memory doing anything really ;-)
Slow-ish news day I see. Oh well, little news is good news.
Bird flu leads to drop in exports from Maryland www.worldpoultry.comm click on news
Vietnamese Village chief dismissed for embezzling bird flu funds www.iht.com click on regions
Fears of bird flu appear over blown www.pjstar.com/services/redirects/methodist.html
(can’t find the story on the methodist hosp link), but I’d reckon community preparations for “human pandemic influenza” are much “under”-blown
Heads Up Hunters: http://tinyurl.com/wnwqf
Monday, October 23, 2006
Snippet from Pro Med Mail
Low pathogenic avian influenza commonly occurs in wild birds. It typically causes only minor sickness or no noticeable signs in birds. These strains of the virus include LPAI H5N1, commonly referred to as “North American” H5N1, which is very different from the more severe HPAI H5N1 circulating overseas.There is no known health risk to hunters or hunting dogs from contact with low-pathogenic forms of avian influenza virus. Nevertheless, hunters are always encouraged to use common-sense sanitation practices, such as hand washing and thorough cooking, when handling or preparing wildlife of any kind. DOI has issued guidelines for safe handling and preparation of wild game.For more information about USDA’s efforts and research related to avian influenza, go to <http://www.usda.gov/birdflu>.For more information about Interior’s efforts and hunter education program, go to <http://www.doi.gov/issues/avianflu.html>.For information about the federal government’s overall efforts related to avian influenza and human pandemic preparedness, go to <http://www.avianflu.gov/>.
crfullmoon @ 06:41
sorry about that. my link won’t let me acess that link for some reason. will try later to get that.
Comments….I couldn’t get the link to Methodist either and would really like to see the story.The headline makes me very disappointed tho.I did alot of work on spreading the preparedness message this last winter and spring thru my methodist church with the help of our pastor.I hate to see backsliding.
New York Times / Face Facts http://tinyurl.com/yelmoe
Anonymous - at 9:21:
I read that op-ed yesterday. Most of it is good information, but the author does state that respirators can be reused because the virus does not live on the material they are made with for long (?).
Also, the author is not a medical authority or a scientist, but a professor at the Stanford Business School.
sorry folk, but that link has disappered. however, I found a couple of links dealing with churches /families preparing. Is it o.k. to post these?
Bird Flu May Return to Europe in Coming Weeks, UN Agency Says from Bloomberg
Bird flu may return to Europe in the coming weeks, spread by wild ducks, swans and geese carrying the lethal virus south from their Arctic mating grounds…[more]
Bird flu warning prevents world pandemic from Asia News (Italy)
UN official says early warning on possible virus mutation generated right response in governments, preventing an immediate pandemic. He makes an appeal for Indonesia and Africa…Although the number of H5N1 virus-related deaths is rising, the United Nations is satisfied that a quick response by governments last year prevented a pandemic, said David Nabarro, a senior UN health coordinator..Many experts also believe it will take five to 10 years to change poultry rearing practices, especially in countries where poultry is plentiful and birds are kept in the backyard…
I can’t quite equate the mood that we have evaded a bird flu pandemic with the increasingly prescriptive plans for social distancing and masks etc.
Pandemic Flu Patients Should Stay Home, U.S. Officials May Say
Oct. 24 (Bloomberg) — Health officials may propose a plan to prevent the spread of pandemic flu in the U.S. that includes treating sick patients at home, rather than in hospitals.
The home therapy option is based on computer models showing that limiting personal contact may slow growth of a pandemic. Advisers to the U.S. Institute of Medicine are meeting tomorrow in Washington to determine if scientific estimates are strong enough to make health policy decisions affecting the lives millions of Americans in a deadly flu outbreak.
etc.
Hi uk bird. I made a few comments about this article yesterday but will add a few here as well.
In day to day life, we deal with two kinds of knowledgable experts…there are those on the ground whether they are mothers, teachers, nurses, grocery store clerks, truck drivers, farmers etc…
…since they are on the front line, the interface, all the time they are continually monitoring input from the particular environment they are emersed in…
…and then there are the supervisors…they are at arms length from the public and from feedback systems that are operating instantaneously in all environments.
So in this case, supervisors were asked to come up with a solution for the problem of a complete lack of surge capacity in hospitals. They thought for a moment and then said, I know, we will treat everyone at home…
…even higher supervisors, even more removed from the public are thrilled with the conclusion and this is the first attempt at preconditioning the public to this eventuallity.
However, they and the American (Canadian) Medical Assocs. have failed to also inform the public that they will not only not have hospitals but will not have any twentieth century treatments for secondary infections from influenza.
In a pandemic, the demand for broad spectrum antibiotics is going to rise, I would expect by thousands or millions of times. It would take years for pharmaceutical companies to ramp up production…and they will be lucky if production doesn’t go down significantly due to a significant percentage of pharmaceutical workers being away from work or dead.
I have done some calculations and I believe for 60 dollars, every child could have not only medications but also adequate food supplies if the pandemic comes to pass.
It seems to me that 60$/young person is a pretty good investment.
So, the bottom line is that we are to get sick at home, recieve no treatment or food deliveries at home and to die at home…and we are to accept this happening to our children because some supervisor…
…who has never been on the front line, expects us to?
In Canada in 2003, friendly supervisors from the World Health Organization, Health Canada and local hospitals and health units, suggested that all the protection nurses and doctors needed was surgical masks…
…the supervisors did not have to serve on the interface with the public in hospital emergency departments…too bad!!
Tom DVM and/or Dr. Woodson
question … I accept that the primary treatment will be at home. Assuming that situation, if one comes down with Pandemic BF, assuming one is treated with or without Anti-virals (tamiflu, relenza, etc.), and survives the virus … next potential issue may be pneumonia?
I assume that is the point of Tom’s statement of need for broad spectrum antibiotics. I understand that antibiotics are not for viral infections.
How, and at what point would a layman caregiver (such as myself) be able to recognize (and differentiate) the symptoms of bacterial based pneumonia (if it set in) that would require the use of antibiotics?
Is there a simple symptoms guide/flow chart to help a layamn diagnose? What tools and/or eperience required? I read Dr. Woodson’s book - I did not see this discussion or distinction mentioned.
Please correct any (and all) of my mistatements - I not a doc or RN - but may make the difference for my family.
thanks!
Annonx2: Have you considered getting a pneumonia vaccine now so that this will not be as likely of a problem?
A question to go with the Annonx2′s questions, what are broad spectrum antibiotics and which ones should we be stocking up with?
Old thread: Which Medications should I stock?
Seek medical advice (if you can get it) -depends on what you might need, and, if you’re allergic to anything. (Are you up on your traveller’s shots?) Are you thinking pandemic, or other illness, or, infected-wound-need-for-antibiotics?
Back to News Reports…”which is already in progress”…
Comment - I don’t recall seeing this story, so if it’s a repeat, I apologize.
Boston, Massachusetts, USA
Advance Warning of H5N1 Influenza Outbreaks May Be Found in Shrimp Virus Reservoirs
BOSTON, Oct 25, 2006 /PRNewswire via COMTEX/ — Researchers at Replikins, Ltd.[1] have discovered that the shrimp viruses White Spot Syndrome virus (WSSV) and Taura Syndrome virus (TSV) - global lethal pathogens for shrimp - may be reservoirs for the peptide building blocks of H5N1, or bird flu virus…..
I wished they would have explained how this could or would be of concern to us humans. Would eating shrimp make us sick? what’s the connection between poultry/humans/shrimp? Birds eat shrimp, do they get sick?
cottontop - 15:54
Shrimp are bottom feeders, so they would be exposed to contaminated feces waste from infected chickens or any other animal that waters where they feed. Once again, the party line is if you cook your food properly, you will not become sick.
I found it interesting in the view that it seems to me that all viral activity ramps up right before a pandemic. We’re getting the reports of polio, dengue fever, rabies, meningitis, cholera, etc. outbreaks from all over the world. Someone said that following H5N1 was like watching a viral storm. To me, this story just reaffirms that everything is nature is interconnected in ways that we still don’t understand yet. The question that remains is how high of a price will we have to pay before we begin to understand?
The U.S. imports quite a lot of tiger shrimp from Indonesia. Japan is the largest importer of Indonesian shrimp.
Blue Ridge Mountain Mom-
I would hate to give up my shrimp! I’ve notice this same thing with the viruses. thought it was just me. “…how high of a price will we have to pay before we begin to understand?” I’m afraid the price will be very high. Humans do not learn lessons well or easily. As long as we place ourselves as reigning superiors over every other creature on earth, we’ll never get it. Humans are not intelligent creatures. We can’t even live in harmony each other, let alone the earth.
Janet Annonx2 anonymous (please pick a name any name thanks)
Okay, by may moniker, you would know that I am a veterinarian. JV has done some excellent work on medications, which ones to take etc. If you go to the ‘Ask the Moderators’ thread, Pogge or DemFromCt or BroncoBill can direct you to the archived threads. They should answer all of your questions with respect to medications.
anonymous. There are two kinds of bacteria gram positive and gram negative. Some antibiotics like penicillin only work on gram positive bacteria. Broad spectrum antibiotics work on both types. The archived threads will tell you the best ones to pick…if not, when you see JV post on flu wiki..ask you question to him/her.
Janet. A vaccine against pneumonia is probably a good idea…however, it appears there too many localized and systemic reactions to pneumovax for my liking…this should not be happening and should be investigated. Without an appropriate investigation, I am not sure that I would be suggesting that anyone get it at this point in time.
Annonx2. I do not believe that the over prescription of antibiotics have caused the super-bugs we are seeing now.
I believe it is mistakes made in hospitals with antibioitic use and disenfectants…plus prescriptions that are not being taken properly and most importantly not finished (stopped after a few days) that have caused the resistance problem.
Antivirals can result in resistance in one week that took twenty-forty years with antibiotics…therefore I am not sure how much use they will be in a pandemic and it does not appear they will be avaliable to many people anyway…I have made the decision not to take them and have not ordered them even though I could.
When you suspect that you have pandemic influenza, I would start a broadspectrum antibiotic and continue taking it for seven to ten days…what this will in effect do…is to stop the secondary pneumonia before it starts.
The reason antibiotic treatments must stop, at that point, is because the natural bacterial flora in your gut etc. will be affected if you continue beyond this point.
Hope that helps. If it doesn’t maybe start a new thread, incorporate these posts and we can have a full discussion of the treatment issues.
Thanks
So back to the shrimp, what I understand that article to say is that this company, analyzes the shrimp for a virus trend (DNA) whatever and if it increases in the shrimp then it could be a precursor for a pandemic?
…”Using FluForecast® proprietary technology, Replikins, Ltd. researchers have identified a new group of virus peptides of specific structure, called “replikins”…
(Something about press-release-y things that get my “skeptical hackles” up…Are they looking for funding to make Replikins vaccines, ect? I guess I’d have to see what the reveres or Tom DVM thought that article was saying.)
Tom, maybe you could share your insight into the shrimp article. I’m afraid I don’t understand how the shrimp fit into the big picture of panflu.
Thanks.
Just had a few coconut shrimp and butternut squash for lunch. At least the butternut squash and broccali is still safe.
Hi everyone. I tried to read this article but couldn’t hang with it long enough to finish.
The bottom line here is that we know nothing about influenza. We know more then they did in 1918…like that in fact an influenza virus caused the pandemic..but we honestly don’t know any of the really important stuff…
…That doesn’t stop scientists from dancing on the head of a pin trying to impress everyone.
My colleagues at flu wiki have refined the science of influenza to a sharp edge. We pretty much know all the science there is to know…which like I said isn’t a lot.
This report is bunkum…snake oil…are Governments supposed to spend billions on shrimp research?
Oh well…the truth is that many diseases have been teased into submission without knowing very much about the genetics or physiology. We may not have all the direct answers but we are darn good at following the little terrorist (H5N1) through the briars, and the thickets and the meadows…and I think we have a hold of its tail right now.
TomDVM
I agree completely. It made no sense to me. sounded like something that was thrown out there for the sake of reporting something.
Recently, I read an on-line article stating that scientists could not replicate the H5N1 virus in a petre dish, so therefore it wasn’t as bad as people are saying. I believe this was a Japanese scientist that made that statement. (I must start keeping tract of what I read.) If someone has heard of this article, please post it.
cottontop. I wrote something a couple of years ago…the pandemic would not come until every scientist, regulatory and Government was convinced that it was not going to happen…sounds like we are about there.
In my opinion, and it is only my opinion, there are four factors to consider…
1) we are presently at the top end of the longest inter-pandemic period in history.
2) After a century, a ‘kissing cousin’ of H5N1 has emerged. It hung around long enough to explode out from Q. Lake and reach…CRITICAL MASS…and it has managed to increase its virulence during the same time period.
3) I have never heard of a virus, in the history of the world, that can infect as many animal species as this virus…and most importantly, it is hitting species that have not been infected before, ever…like cats.
4) There are viruses and bacteria of all types mutating to increase virulence and transissibility (West Nile, Dengue Fever) all over the world. The level of this is unprecedented.
Everyone else can make up their minds for themselves…but I am waiting because I believe that H5N1 is going to put all the needed mutations (two according to Dr’s Osterhaus and Webster) together at once and just explode…I have seen it before and I am absolutely convinced that I am about to see history repeated again…
…I just don’t know when.
TomDVM-
How do you supose the H5N1 strain came about? And how would it find it’s way to it’s first victim, poultry? If this strain is a “kissing cousin” to the 1918 strain, where do you suppose it mutated? Wait-I don’t think I’m making myself clear.
The 1918 pandemic is over. There survives a portion, one strain, however you would like to call it, it goes dormant, in what, and where? Could it have stayed dormant all these years? Then something happens, triggers it to mutate, and surface now. where would it find it’s first host? were ever it was dormant? could it have been dormant in soil? Poultry is the first host that it has shown up in, to my knowledge. I hope you can somewhat understand this.
Vietnam’s success against avian flu may offer blueprint for others
Maryn McKenna Contributing Writer
Editor’s note: This is the first of a two-part Special Report on bird flu in Vietnam. Part two, “When avian flu control meets cultural resistance,” will be published Oct 26.
Oct 25, 2006 (CIDRAP News) – HANOI, Vietnam – Among countries affected by avian influenza H5N1, Vietnam stands out twice over.
It was one of the first hit by the virus in the current outbreak: It discovered its first human infections in December 2003 and its first widespread poultry outbreaks in January 2004. And it was one of the hardest hit, with 66 million birds culled to prevent spread of the virus, and more human infections than any other country to date.
But it has also controlled the virus more successfully than any other country where the disease became endemic, with no new human cases since last November and only a handful of infected birds this year—12 farm chickens and ducks, and a small flock of tame storks in an amusement park.
The shift is so striking that international health authorities are asking whether Vietnam’s success can be replicated elsewhere. But reproducing its efforts faces an unusual hurdle: sorting out which of its aggressive interventions actually made a difference.
“The absence of human cases is a direct reflection of the lack of cases on the animal side,” said Dr. Richard Brown, a World Health Organization epidemiologist based in Hanoi. “But it is actually difficult to know exactly what that is due to, because there were a number of different interventions applied in the latter half of 2005 on the animal health side.”
[snip]
Cotttontop-
I don’t think it’s that H5N1 has been here I believe the 1918 flu was H1N1. After the 1918 flu the virus stayed around and has mutated slightly over the years, most strains that we still come in contact with are decendants so to say of that viral strain be we all hae some immumity to it now.
This says it better than I can.
It’s a link to CDC page on influenza viruses.
The day after tomorrow-
Very informative. I now know why I keep getting what appears to be the same “crud”. thanks.
Tom DVM, As a physician, I feel I must disagree with your advice of “When you suspect that you have pandemic influenza, I would start a broadspectrum antibiotic and continue taking it for seven to ten days…what this will in effect do…is to stop the secondary pneumonia before it starts.” Among my reasons: Allergic reactions are common with antibiotics and can be severe; Side effects are common - everything from rashes and stomach upset to liver and kidney damage; Other unwanted effects like yeast infections; Interfering with other medications you are taking; and the big one, infection with a bacteria that is now resistent to broadspectrum antibiotics, will be difficult to treat and will require very expensive antibiotics (likely, more than one)that you have no way of getting your hands on. Your odds have having a probolem with the antibiotic are far greater than the chance of preventing a secondary pneumonia. As an aside, they have been seeing primary viral pneumonias, not secondary pneumonia in H5N1 patients.
I realize that people are trying to prepare to deal with a pandemic without availability of medical care, but without tryng to sound self-important, there are good reasons for some medications being prescription and not over-the-counter.
BTW, anyone who is at higher risk for secondary pneumonia should have gotten the pneumovax.
I apologize now for disagreeing with a well-loved wiki guru!
Back to lurking…..
I am not an MD type nor do I play one on TV but:
instead of starting antibotics later and risking problems during a time when the health system is stressed think about getting your Pneumococcal (PPV) Vaccine. After all there are a lot of pneumonia bugs that are resistant to most antibotics anyway.
Canada
Pandemic to be ‘disaster in slow motion’
Canadians should brace for a pandemic within three months of an outbreak elsewhere in the world that could result in dire consequences for the country’s economy, business leaders heard Wednesday.
Companies could expect up to a third of their employees to be absent if a pandemic were to hit, Dr. Karen Grimsrud told a health emergency planning conference
[snip]
The cost to the country’s health-care system alone could reach $1.4 billion, she said, while a modest forecast for lost productivity could reach as high as $38 billion.
Janet, Annonx2, anonymous -
I went through a lot of discussion re antibiotics over a couple of threads starting with “Tom DVM Pet Med Question”: http://tinyurl.com/yycx5d
You would get more out of the discussion back and forth if you read those threads. I could post everything again, but it is really all there, but I do post over three continuous threads. I think if you read through those threads, you will have more information than you want!
DennisC – at 20:45
That’s good advice, IMO. [I’m not an MD either].
LR, would you agree?
Don’t be afraid to post, we won’t bite. We need input from everyone.
Arkansas, USA
Washington County emergency personnel plan for flu pandemic
Local emergency planners met Tuesday to discuss how Washington County will prepare for – and respond to – an influenza pandemic.
At a meeting of the Local Emergency Planning Committee, Rick Johnson of the County Health Department presented the county’s draft flu plan.
[snip]
The best thing for people to do if they haven’t already been exposed, will be to stay at home, Johnson said. One thing that people can do to prepare is stock their homes with supplies. The CDC recommends keeping two months’ worth of food and supplies in the home because that is how long a pandemic is expected to last.
Whoa. The CDC is telling people in Arkansas to stockpile for 2 months? Then how come New Yorkers are being told 3 days is enough? I need to get back to the Triage thread. Arkansas is going on the saveable list.
Indiana, USA
Agencies form plan for possible flu pandemic
If a flu pandemic strikes, sparsely populated Warren County might have few victims, but it more likely would be overrun by people fleeing urban areas.
“We have designated areas that we could activate — schools, churches, camps,” says Greg Robison, environmental health specialist with the Fountain-Warren Health Department. “If there’s a problem in Illinois, it will bleed over to our state.”
[snip]
State officials estimate nearly 6,000 Hoosiers could die if a new flu strain hit 35 percent of Indiana’s population. Nationally, 1.8 million Americans could die.
Whoa again. Some quick math shows that 2% of infected Americans would die of pandemic but only .3% of infected Hoosiers would die. A ten-fold reduction! That’s it, I’m moving to Indiana.
Indiana, USA
Officials discuss ways to combat flu pandemic
Officials from across Indiana on Tuesday participated in a tabletop exercise that simulated a statewide pandemic influenza outbreak.
“The purpose of a tabletop exercise is to evaluate plans and identify any issues that need to be addressed,” Indiana Department of Homeland Security Executive Director Eric Dietz said in a prepared statement. “The open discussion can also play a valuable role in developing and enhancing working relationships among agencies and individuals that will need to work together as a team during an actual response.”
The exercise was conducted at 11 Indiana National Guard facilities. Video-teleconferencing technology allowed officials from across the state to participate. The technology could prove valuable during a real pandemic because the outbreak likely would prompt limitations on large gatherings to stop the flu from spreading.
LR – at 20:29 wrote:
“Tom DVM, As a physician, I feel I must disagree with your advice of… “When you suspect that you have pandemic influenza, I would start a broad spectrum antibiotic and continue taking it for seven to ten days…what this will in effect do…is to stop the secondary pneumonia before it starts.” Among my reasons: Allergic reactions are common with antibiotics and can be severe; Side effects are common - everything from rashes and stomach upset to liver and kidney damage; Other unwanted effects like yeast infections;….”
I have no disagreement in principle with prophylactic measures against secondary infections. There will be differences as to how this is approached. There are safe options. I have no problems with Cipro.
“Allergic reactions”, are not as common as suspected - in my humble opinion. I did a retrospective analysis on this 10-years ago. Maybe something new has come up since, that I’m unaware of.
All bets are off for when discussing - C.Difficile, biofilms, MRSA, along with H5N1.
Cheers.
I’m so frustrated with New York’s prepardness plan. Just left their website, and honestly, they sounded as if they were preparing for, well, nothing. It all sounded cinderalla to me. Their confident their 11 hospitals will hold up to the onslught of millions of New Yorkers. How many are in new York city? It really scares me, not only for them, but for us (upstate), as well.
So, if you are allergic not only to Cipro, but have been told to never take anything in that family of ATB, what would you suggest? Stevens Johnson syndrome is no fun.
Tom DVM, and LR -
The time to start an antibiotic for pneumonia is when you have SYMPTOMS of pneumonia. If someone can’t get to a hospital for a diagnosis of viral versus bacterial pneiumonia, or what the heck is going on, the best symptom of bacterial pneumonia is coughing up sputum (pus), and almost always a temperature. Some people who are elderly or debilitated may not even cough up sputum or have a temperature (they can’t mount a response).
From what I have read, guidelines have been written so that if someone has suspected H5N1 influenza, AND has symptoms of a respiratory syndrome of influenza-like illiness (ILI) or community acquired pneumonia (CAP), empirical treatment is given for CAP (which is bacterial) according to standard regimens. Please look at the flow chart in the following frequently referenced article:http://tinyurl.com/h3fud, page 195 (page 7 on Internet).
I do not treat these patients with H5N1, obviously, but from what I have read, this is the standard. Please, if there is a doctor who is treating patients with H5N1 and feels that the situation had now changed, and they do not frequently get bacterial pneumonia, please post here with the review articles so we can all be better informed.
LR – at 20:29 You are correct that Tom DVM is well respected and loved here, However he would be the first to say to you.
LR keep posting and as a physician we could sure use your experience and assistance in developing a sound plan for the members to use, because we know that medical help will be all but non existent during a pandemic and we are trying to save as many lives as we can.
In quantum physics they refer to the certain open-minded hypothetical extrapolations/explorations as “thought experiments”.
Viral Tsunamis, might require some thinking-out-of-the-box, when the situation goes F.U.B.A.R.
When I lose focus, I go to the following page to sift the wheat from the chaff.
October 2006
Zimbabwe ostriches hit by suspected avian bird flu
southern africa? We need a thread for this somebody.
cactus -
The family of antibiotics that cipro is in is fluoroquinolones. A list of them (?complete) is: Cinoxacin Ciprofloxacin Enoxacin Gatifloxacin Grepafloxacin Levofloxacin Lomefloxacin Moxifloxacin Nalidixic Acid Norfloxacin Ofloxacin Sparfloxacin Trovafloxacin
So, as long as that is all you are allergic to, you could take amoxicillin, augmentin, doxycycline, erythromycin.
A great place to look up things about antibiotics in general is the “Johns Hopkins Antibiotic Guiide:” http://tinyurl.com/vxkdx
Also, pharmacists usually are very happy to answer questions re medicines. If ever in doubt, just pick up the phone and ask a pharmacist!
cactus -
Add azithromycin to the ones you could take.
Thanks. Much appreciated
Hi LR and JV and everyone.
LR. You’ve been outed now. Like JV, when you come out there is no going back…it’s a one way mirror!! /:0)
You just fell down the rabbit hole. We need your help and your opinion and you perspective…in the same way we need everyone’s.
This is a wonderful collaborative community…but you already know that.
Anon 451 has already said it for me. Flu wiki would not be interesting at all, if we all agreed on things…I’m glad you disagree with me. You’re wrong, but I’m glad you disagree with me anyway. /:0)
cottontop - There are 8 million people resident in New York City (not counting the commuters) or 40% of the population of New York State. That’s 26,000 people per square mile.
Pixie- bless your little heart. Thank you. 11 hospitals for 8 million people. Just don’t see it going as well as they think it will. Out of those 8 million, how many do you see leaving the city and heading instate, and spreading out? I think it’s safe to say, we will see an increase in people.
cottontop - I think that there are around 75 hospitals in NYC, not that it will make much of a difference, cos the math kind of works out the same - it just doesn’t.
“All bets are off for when discussing - C.Difficile, biofilms, MRSA, along with H5N1.”
Klatu. What are biofilms?
Pixie-@ 22:53 Do you feel your state is even moderately prepared?
New Zealand
NZ Puts $2M Towards Pandemic Planning In Pacific
New Zealand is putting $2 million towards a project for influenza preparedness for the Pacific region.
The Prime Minister, Helen Clark, made the announcement in Fiji, where she is attending the Pacific Islands Forum.
[snip]
Miss Clark says other than Fiji no Pacific Island country has completed and tested a national influenza plan.
She says Samoa and Tahiti had mortality rates as high as 25 percent in the 1918 flu pandemic.
cottontop and Pixie,
New Yorkers are being actively told *not* to prepare. The Health Commissioner for New York City has said that a flu pandemic is unlikely. You can watch him say it here. Other Fluwikians have pointed out that the Health Department is telling other agencies not to bother planning for a flu pandemic, it’s not going to happen.
I honestly think it would have been possible to prepare New York City for a severe pandemic. But it would’ve taken alot of planning and alot of money. I guess TPTB figured that New Yorkers aren’t worth the expense.
cottontop - Is my state prepared for a pandemic? Well, I guess that depends on how one looks at things. We are counting on a Tamiflu stockpile that does not yet exist and a pandemic vaccine that does not yet exist. Evidently, some here find that reassuring somehow. Beyond that - no.
Oregon, USA
Health officials: Pandemic planning a priority
Many scientists and health officials believe a pandemic flu will sweep the globe in the next five years.
[snip]
The Health Department suggested administrators prepare to close schools early-on to prevent a widespread infection - but Klewitz said he feels closures should be done on a case-by-case basis.
“Typically, if a student has a fever the parents are called and the student goes home,” he said. “If we have to close school it’ll be because of an attendance issue or a staffing issue.”
Monotreme - I have a sneaking suspicion that the Health Commissioner of NYC may see this event as his long-awaited opportunity to buy prime Manhattan real estate at a deep discount. It will also be easier to get theatre tickets (and cheaper too - a show can now cost the equivalent of a flight to London). What the other possible motivations for this attitude are, I cannot even begin to imagine.
Pixie,
Yes, when he returns from his ranch in Wyoming or Colorado or Idaho, real estate in NYC should be real cheap.
Study warns U.S. of avian influenza perils
Many Americans would have no one to care for them if they became ill during a bird flu pandemic, and a substantial number would suffer serious financial hardship, a Harvard University poll showed on Thursday….
According to Harvard’s poll, 24 percent of 1,697 Americans surveyed nationwide from Sept. 28 to Oct. 5 said no one could take care of them if they became sick’ and had to remain at home for seven to 10 days during a bird flu pandemic.
About 45 percent of those living alone said no one would be available to care for them, and 34 percent of black adults said they would have no one to take care of them if they became ill with pandemic flu…..
I have just arrived home so I will get started on the News Summary shortly - just need to get essentials organised - like cats fed and coffee made ..
Once I have finished I will start a new thread, so give me about 30–40 minutes (lots of news to sort through)
Cheers and thanks