From Flu Wiki 2

Forum: Henry Niman II

05 February 2006

DemFromCTat 11:18

Whereas the original Dr. Henry Niman post has gotten lengthy, yet we are told that some sequencing predictions will soon become public, I will close off the old thread and continue the discussion here.

niman – at 11:57

On tehn prediction front, in October I predicted that H5N1 woudl acquire HA S227N in the Middle East via recombination with endemic H9N2 and the new H5N1 would have increased efficiency at infecting humans.

http://www.recombinomics.com/News/10220501/H5N1_H9N2_Recombination.html

The approach identified the location, time of year, source, and specific change.

I will soon announce a similar prediction based on H5N1 recombination. The impact could be significant, so the “need to know” groups will be notified first so they can make adjustments as they see fit.

I posted the first prediction because I assumed that most would not believe it until it happened. Therefore, the view of the next prediction might be taken more seriously, since the presence of S227N has been verfied in the index case in Turkey.

http://www.recombinomics.com/News/01190601/H5N1_Turkey_S227N_E627K.html

flewbie – at 16:15

This sounds ominous. Do I need to finish my prep this weekend?

Carolina Girl – at 16:28

Flewie I agree this sounds ominous and the news we’ve been seeing looks ominous. I know I am going to put it in high gear and get as much done as I can this next week.

new guy – at 16:49

High gear should involve a calculation of your minimum daily caloric intake…approx 1700 calories, and the relative caloric value of various foods such as rice beans etc which happen to be ballpark 1500 calories per pound.

Further consideration should be given to adequate water (consider a ceramic filter ala the back packing sort) and fuel supplies. Some camp style stoves will burn all fuels.

If you do the basic calculations it quickly reveals a daunting problem.

PS hi Dr. Niman, mad scientist or not…thanks!

new guy – at 16:49

High gear should involve a calculation of your minimum daily caloric intake…approx 1700 calories, and the relative caloric value of various foods such as rice beans etc which happen to be ballpark 1500 calories per pound.

Further consideration should be given to adequate water (consider a ceramic filter ala the back packing sort) and fuel supplies. Some camp style stoves will burn all fuels.

If you do the basic calculations it quickly reveals a daunting problem.

PS hi Dr. Niman, mad scientist or not…thanks!

flewbie – at 16:58

I apologize to the admin for opening this thread to off-topic conversation. My fault.

DemFromCTat 17:49

It’s as off- or on-topic asd any other thread. ;-)

anonymous – at 18:31

I wanted to respond to the various comments about why the WHO is being so evasive at this point. About 4 months ago, when I first became aware of the Avian Flu threat, I read that the WHO had a very big scare in Vietnam some time ago. I wish I had all the facts and data for you…sorry but I don’t. Anyway, more importantly, they said that at the time of this scare, a very important question was whether or not to alert the public. The WHO felt they had a definitive and sustained human-to-human transmission, yet they had to decide NOT to alert the public until they had 100% proof which would have come in the form of an absolute pandemic.

Their reasons for not disclosing to the public was the threat and fear of a panic. They went on to say that the economic and social panic, if unfounded, would ruin their credibility forever, so they needed to be absolutely, 100% sure. I hate to admit it, but I can understand this. Can you imagine if they cried “wolf” and they were able to snuff it out - even temporarily - which is exactly what happened. Then no one would believe them again. Just imagine the social and economic impact from a “false alarm”.

I truly believe this is what is happening today. Yes, the WHO is running scared as we all should be. But they will not push that “panic” button until they are sure that there is no turning back. In the meantime, they continue to give very strong warnings. Our governors are giving very strong warnings. They desperately want all of us to read between the lines. It is just that most continue not to listen.

I believe when the WHO does make the final announcement, we will have about 2 weeks to prepare, but of course, the panic will be full-blown. I think we should all consider ourselves “duly and fully warned” at this point. Now we just have to wait for the start. Again, it is just so sad that most are just too thick-headed to read between the lines.

anonymous – at 18:35

Couldnt agree more Anon. There are enough folk already saying “it’ll never happen” imagine if there was a so-called false alarm? I think we just have to read between the lines as you say, and act accordingly. You have to have some sympathy with the WHO folks in this regard. Its just such a huge burden they’re carrying

Sandi – at 18:35

oops..the above was me. Sorry

Melanie – at 18:37

anon,

That is, of course, your personal opinion.

anonymous – at 18:43

Melanie. Yes, it is my personal opinion. However, it is based on how they handled the situation some months back (wish I could get my hands on the article - again, apologies). I am assuming that the WHO is reacting to the potential crisis situation that we now see in Turkey and Indonesia (to name a few). I am assuming that they still will not hit the panic button until they are 100% sure (no ifs, ands or buts at all).

So, again, it is a personal opinion but one based on history.

Melanie – at 18:52

anon,

Believe me, the fine professionals at the WHO are every bit as concerned as you and me. I know some of them. But WHO, like every other organization of the kind, answers to two masters: the data and the needs of the member states. The data aren’t in yet (the seroprevelance data for Turkey won’t be available until the end of the month, and I’m much more worried about Indonesian, from whom we hear little lately) and the fact that with the declaration of Stage 4 pandemic, economic and political consequences start to kick in for the member states, so there are political pressures not to “jump the gun.” Understand the pressures the organization is working under (including the fact that it is short-staffed and short of resources) before you start looking for an organizational agenda.

anonymous – at 18:56

Melanie. I think we are saying the same thing! I am not attacking the WHO. If you reread what I have said, I think they are hell bent on making sure they have it right before they hit the button! Again, I think if you read it, we are saying exactly the same thing.

Melanie – at 18:58

No argument. I just wanted to fill it out a little. The WHO takes a beating in these threads some days and I can be as critical as the next, but I wanted to paint a more complete picture while I have the time.

informatic – at 19:01

Never attribute to malice that which can be adequately explained by stupidity. Hanlon’s Razor

De jure – at 19:33

Melanie: I, too am worried about Indonesia. I have an uneasy feeling that the next time we hear from Dr. Niman it will involve Indonesia in some way. Some of my suspicions are based on the recent deaths and human illnesses in that neck of the woods. I wouldn’t be surprised if we saw a major outbreak in Indonesia in the coming weeks. I also agree with the recent remarks regarding the WHO. It is probably the only redeemable part of the U.N. A really good book I read last year involved the WHO’s efforts in eradicating smallpox (I believe it was called The Demon in the Freezer). I think they are doing the best they can.

Melanie – at 19:38

De jure, when I was with Dem at the flu conference we attended last November, we had a one evening panel with some of the docs who are the now aging and graying MDs who stamped out smallpox in India in the 1960′s. These people are heroes to me and my eyes got wet to have the priviledge to be in the same room with them.

A little word of wisdom on human systems: all of them are going to be imperfect. Humans aren’t perfect and we won’t build perfect institutions or processes. When you get ready to pour out your wrath on any of them, ask your self first how much better you could do. Then, have at it. But maybe you’ll do it with a little humility.

De jure – at 19:48

Melanie: I almost always use humility when answering the judge (self-preservation), but hardly ever with opposing counsel (same reason) :)

anon_22 – at 20:26

Melanie, was Henderson there. What does he think of all this?

lbaum – at 21:01

“The impact could be significant, so the “need to know” groups will be notified first so they can make adjustments as they see fit.” Dr. Niman— above at 11:57

Geez, the hairs on the back of my neck are standing up after reading this thread. Would someone care to venture an ID of these “need to know” groups?

os – at 21:15

This is a bit frightening but I’m glad to see that he is issuing a prediction and not a proclamation.

Monotreme – at 21:35

lbaum: “Would someone care to venture an ID of these “need to know” groups?”

My guess: WHO, CDC, HHS, DHS, NIH

Hopefully Dr. Niman won’t keep us on pins and needles too long.

Sandi – at 21:38

The suspense is killing me. Just went out to get some lunch and the woman next to me was coughing and hacking away. I thought to myself “how long will it be before someone doing that gets arrested!”

gs – at 21:38

what’s Niman’s motivation ? There are some long threads at curevent, which I haven’t all read. He has a method which he thinks quite well predicts future H5N1-mutations/recombinations and which can be used to produce vaccine in advance and then vaccine-producers shall buy his predictions ? The “need to know” groups are the vaccine-producers ? Niman uses his previous predictions to demonstrate the quality of his predictions ? Are there other companies which do the same ? Was he the only one who predicted S227N in October ?

new guy – at 21:39

Do we actually know if it is the real Dr. Niman? Is there authentication on this…

If not, would the good docter ID on recombinomics to authenticate the post here.

gs – at 22:30

“the impact could be significant”, well everything _could_ be significant. So that doesn’t tell us anything yet.No need to panic.

Japanseminole – at 22:40

right the impact could be on the positive side

rockyman – at 22:45

Dr. Niman posted a similar “need to know” thread on Curevents—and Curevents requires login…so I think it’s pretty safe to say this is the real Dr. Niman—I’m watching a Monk-a-thon on USA Network…to learn some of the tricks of a germaphobe :)

os – at 22:53

Dem—will Dr. Niman contact the admins first before posting? If so, could you create Dr. Henry Niman III so that his post is the first one on the thread? ty

Monotreme – at 23:06

gs: “Was he the only one who predicted S227N in October ? “

Uh, Yes.

Melanie – at 23:28

Dr. Niman’s surmises sometimes get ahead of the science. Let’s not panic just yet. Henry is just a regular poster here and he doesn’t talk to me, Dem or the reveres before he does what he does. He is just like you in that regard and his information should be taken the same way. It’s another data point and you should read it in the spirit and with the agenda in which it is offered.

06 February 2006

gs – at 00:11

he doesn’t give probability estimates.

dubina – at 00:22

Melanie,

I want to take exception to something you’ve said.

“Understand the pressures the organization is working under (including the fact that it is short-staffed and short of resources) before you start looking for an organizational agenda.”

“Humans aren’t perfect and we won’t build perfect institutions or processes. When you get ready to pour out your wrath on any of them, ask your self first how much better you could do. Then, have at it.”

I say No on both counts.

If WHO as an organization is competent, fit to purpose, and by their own proclamations, eminently responsible, then it’s their responsibility to have whatever procedures and resources their purpose requires. In that regard, they’ve openly admitted so far as rapid containment is concerned, that they don’t have what it takes, and won’t have for six months or more. Call it what you will; I see that as a dramatic shortcoming, and military command authorities judged so deficient in their mission readiness tend to be replaced with more proactive leadership. More to that, whereas they were notably candid in assessing their rapid containment capabilities, they haven’t exactly taken criticisms in other areas like ducks to water.

To your second point, I’m not responsible for worldwide coordination and control of avian influenza. The fact that I’m not responsible and might not do as well in their global mission as the WHO executive shouldn’t temper my observation or lessen my judgement. I’d admit it must be easier to spot flaws and be critical of them than it is to plan and manage pandemic influenza, but if the BF situation now is truly critical, we all should care passionately how our one and only collective shot pans out.

I don’t disrespect the WHO. I’m mindful of what they’ve done to douse epidemics and eradicate diseases like smallpox and polio. My hat’s off to them for what I suppose must have been exemplary service. Here, though, when more might be at stake than ever before, I’m very skeptical for what I see and read.

I recently watched a New Orleans assembly of some kind where angry residents gave Mayor Ray Nagin pieces of their minds. They were angry because the city had threatened to condemn their flood-damaged properties if so few residents returned to their neighboorhoods that reconstruction might be impractical. I remember they were spitting mad while Mayor Nagin, who stood to hear their outrage, was outwardly impassive. What could he do? Can’t raise up the cane that’s in the field.

No, well, our cane isn’t in the field yet, and there still may be time to press these people at WHO and elewhere to do what they may or may not be willing and able to do. Let pressure be brought to bear as events show it should be brought to bear. That pressure may be more constructive than you suppose; it may strenghten the hand of elements more fit to this important purpose.

niman – at 06:08

No one else predicted S227N. In fact no one else would even hazard a guess because they think the acquisition of polymorphisms is via RANDOM mutations. This is one of the two pillars of influenza genetics (the other is on the importance of reassortment in genetic shifts).

Recombination is the name of the game (for drifts and shifts) and H5N1 is quite predictable (with a travel itinerary in full view).

niman – at 06:21

Pillars crumbling

http://www.recombinomics.com/News/05180508/H5N1_Destroys_Tenents.html

docdoc – at 07:04

at what point would cessation of air travel be prudent?

De jure – at 07:49

Dr. Niman, after reading your recent link above (6:21), I am struck with the suspicion that it would be very difficult to come up with a vaccine that would be effective due to the large number of recombinations that H5N1 will make, unless you could somehow predict which way the virus was heading. Am I getting warm?

DemFromCTat 07:49

gs – at 00:11

he doesn’t give probability estimates.

Neither does anyone else. ;-)

docdoc – at 07:04

at what point would cessation of air travel be prudent?

Tough question. When SARS hit Toronto and air travel was disrecommended by WHO, Canada went into recession. WHO (actually, member countries of the UN) would prefer to not have a ‘just in case’ recession or two anywhere else. Balance that with need to contain, and you can see why dubina’s pov and melanie’s pov clash. This isn’t the comic books or the movies. These are tough balancing acts by real people.

DemFromCTat 08:05

niman at 6:21 linked to an explnatory piece at recombinomics. Please read it for background.

It is safe to say that recombination is not universally accepted as the predominent method of influenza evolution. I’m not judging that (I’m not qualified to do so); I’m reporting my interaction with other experts besides niman. See Q and A, third question, e.g. (BTW, since that Q&A, I see the CDC has corrected that part of their FAQ and no longer lists reassortment as the only path to pandemic).

I’m not trying to start a fight. I’m trying to explain to readers that this is a strongly held pov by niman that should be understood to still be controversial. Even if one were to accept recombination as one of three mechanisms (reassortment or shift, mutation or drift, and recombination), niman says recombination is THE most important, the other experts do not. That doesn’t make niman wrong, but it is the state of affairs.

DemFromCTat 08:07

PS I have written Dr. Niman and he has verified he is ‘niman’. I have also asked him to start a new thread when he’s ready to post anything new as he as outlined above.

niman – at 08:29

The genetic diversity of H5N1 is growing increasingly large, so at this point several vaccines would be required and those targeting future sequences would be most effective in the near term.

gs – at 08:47

dem, you know that some have given estimates. Monotreme did, I did, 18 of the 20 experts in your Tufts’ link did. The experts in the global risk report did, Butcher and Siegal did (making it less than -say- 1e6)

gs – at 08:51

so, what he states as facts in that article is just only his hypothesis ? And it wasn’t stated as such by some allowed but uncommon usage of language ?

Or does he claim that he has enough proof of it to be stated as fact and it would generally be accepted as fact, if only he would release the details of that proof, which he keeps secret ? (this then could be “hazardous to the world’s health” too)

DemFromCTat 08:55

gs, Dr. Henry Niman’s pretty up front about what he thinks, and has said he’s delaying (and not hiding) his predictions. His expertise is sequencing.

maryrose – at 09:12

What to make of the following quote? If Newcastle disease is multiplying “rapidly through Kurdistan,” could it combine with H5N1 there? Causing a lethal strain?

“There are also unconfirmed reports that another avian virus, identified as Newcastle disease, is rapidly spreading through Kurdistan. Al-Sulaymaniyah daily “Kurdistani Nuwe” reported on 1 February that thousands of birds have died in Kurdistan in recent days from Newcastle disease, a bird virus unrelated to the H5N1 strain of bird flu. “

Iraq: Officials Scramble To Prepare For Bird Flu

niman – at 09:19

Newcastle disease has a history of being used as an explanation in areas where there are H5N1 outbreaks.

Racter – at 09:29
“If Newcastle disease is multiplying “rapidly through Kurdistan,” could it combine with H5N1 there?”

No. The Paramyxoviridae family of viruses are not segmented like influenza viruses.

Michael Donnelly – at 09:33

maryrose:

Different bugs. They don’t interbreed.

De jure – at 10:19

Dr. Niman, again, thank you for your explanations of how this virus works. What I still don’t understand is why H5N1 seems to be so active in its recombinations. Is this unprecedented? Why aren’t the others, such as H7N? recombining like this one? Is it something in the H5N1 sequencing which allows it to diversify so rapidly?

dubina – at 10:43

niman,

“The genetic diversity of H5N1 is growing increasingly large, so at this point several vaccines would be required and those targeting future sequences would be most effective in the near term.”

What are you saying exactly? Design one or more vaccines to intercept future strains based on their predictable recombinations?

dubina – at 10:45

By the way, do you hold any hope for an all-strain vaccine?

007 in the USA – at 12:21

dubina - Sounds like trying to catch smoke with your hands to me. Fun to try.. flailing and waving your hands through the smoke.. but never very successful. In the end all you have done is disperse the smoke better/quicker. See?

With slot machines, if you pull the arm enough, eventually you will hit. Well, our ‘virus’ numbers are about to roll up on the slot maching of life. Hey, it’s taken us about 37 years to get here. That’s a lot of pulls on the one-armed-bandit!

Cheerio! 007

007 in the USA – at 19:56

“…I will soon announce a similar prediction based on H5N1 recombination. The impact could be significant, so the “need to know” groups will be notified first so they can make adjustments as they see fit.

I posted the first prediction because I assumed that most would not believe it until it happened. Therefore, the view of the next prediction might be taken more seriously, since the presence of S227N has been verfied in the index case in Turkey….”

‘soon’ = ???

The suspense is going to crack my already weakened psyche. Oh buggah, I need a drink. Shaken, not stirred please.

Cheerio! 007

Anastasia – at 20:17

Forgive the ignorance of this question, but I did read somewhere that people who get the bird flu and survive will not develop immunity to getting it again because of all the various transformations of it. Is this correct?

niman – at 21:01

H5N1 is quite diverse, which leads to more rapid change via reecombination. An upcoming paper in PNAS by Webster et all provides more sequnece data and concludes that several vaccines will be required because H5N1 is diverse and many versions can cause human disease (which was said some time ago in recombinomics commentaries)

http://www.recombinomics.com/News/05180507/H5N1_Recombine_Vaccine.html

http://www.recombinomics.com/News/12240501/H5N1_Evolution_Europe_Asia.html

http://www.recombinomics.com/News/01050604/H5N1_Kurgan_Recombinant.html

007 having a drink – at 21:22

Dr Niman, you brilliant, brilliant, man. It seems that one of your esteemed comrads, Dr. Webster, agress. Article below my rantings…

Wow, this world is starting to feel like we are living in the middle of a sci-fi-horror novel with Government cover-ups/conspiratorial plans, death and dying, clever mad scientists (no offense, Henry) and plot twists around every corner. What next?… dare I ask. At the rate of recombination and evolution, there will be no stopping the many H5N1 variants. There aren’t enough scientists in the world to work on dozens and dozens of vaccines that will eventually be needed. Sorry to sound overly-dramatic, but it’s like Mother Nature ensuring destruction of this zero sum game. Lovely.

Now I really need another drink…

007


Researchers Uncover 4 Different Genetic Bird-Flu Strains

By Steven Reinberg HealthDay Reporter Mon Feb 6, 5:03 PM ET

MONDAY, Feb. 6 (HealthDay News) — Researchers have identified several different genetic strains of the avian flu virus, H5N1, in different bird populations in Southeast Asia — any one of which could trigger a pandemic. ADVERTISEMENT

The finding has implications for preparations against a possible pandemic and the vaccines that may be needed to ward off human infection, experts say.

One key recommendation: Better surveillance of bird populations to make sure one of the H5N1 variants doesn’t begin to spread more easily between people.

“There are multiple different lineages of H5N1 emerging in the world,” said lead researcher Robert Webster, a professor of virology at St. Jude Children’s Research Hospital, in Memphis, Tenn., and a member of the Department of Microbiology at the University of Hong Kong. “There are about four different families of viruses out there now.”

His team’s report appears in this week’s edition of the Proceedings of the National Academy of Sciences.

The threat of a mutant strain of deadly H5N1 that could pass easily from person-to-person has raised fears of a worldwide pandemic. Since January 2004, at least 152 laboratory-confirmed cases of bird-to-human infection have been reported to the World Health Organization, and 85 people have died from the disease.

So far, however, the virus appears to lack the ability to jump easily from human to human, experts say.

In the study, Webster’s team found that the H5N1 virus exists frequently in domesticated poultry populations and also in wild birds before they migrate. Using genetic analysis, the researchers found four distinct sub-lineages of the virus existing in birds from different geographical areas.

While H5N1 can be transmitted over long distances in migratory birds, in Southeast Asia infected poultry appears to be the main way H5N1 is spread, Webster’s team noted.

“These viruses can be out there in apparently healthy birds all the time,” Webster said. “These viruses are not killing all the chickens [that carry them], so they are out there,” he added.

The spread of myriad genetic types of H5N1 highlights the need for a variety of vaccines, Webster said.

“Multiple, different vaccines are going to have to be prepared and held ready in case one of these goes human-to-human,” he said. “It will be necessary to have vaccines to each one of them.” Based on evidence from the bird-to-human cases recorded so far, “there is human infection in all the types,” he added.

Webster believes that more genetic types of the virus will develop. “Whether one of these will become pandemic, God only knows,” he said. “It looks as if it could be. So it behooves us to get our ducks in a row and be prepared. It’s scary.”

One expert thinks the variety of virus types is a good argument for overhauling America’s vaccine production system.

“There is a lot of genetic variability in H5N1,” noted Dr. Marc Siegel, a clinical associate professor of medicine at New York University School of Medicine, and author of Bird Flu: Everything You Need to Know About the Next Pandemic. “This is not surprising.”

Siegel believes the ability of the virus to change should be a major concern for vaccine developers. “It’s another wake-up call that we need a vaccine system where we can turn it around quickly,” he said. “We don’t need nine-month lead times. We have the technology to make vaccines quickly.”

H5N1 may still not become pandemic, Siegel stressed. “That’s a speculation whether it’s going to be H5N1 or something else,” he said. “Eventually, there is going to be another pandemic.”

The key point about H5N1 is that it is a deadly virus to which people have no immunity, Siegel said. “That’s a good reason to be concerned and keep tracking it,” he said. “The knowledge that there are more subtypes out there is a very good reason to update how we make vaccines.”

He added that the first priority should be to control the virus in birds.

“There should be more vaccination of birds,” he said. “We need a rational approach to this. A rational approach means a greater attempt to control it in birds — put the fire out rather than build the firewall.”

Researchers Uncover 4 Different Genetic Bird-Flu Strains - Yahoo! News

Anastasia – at 21:23

Thank you Dr. Niman.

What a Pandora’s Box it is…

Anastasia – at 21:26

I cannot comprehend the hell of living through the nightmare of bird flu, only to possibly have to do it again.

007 taking a deep sigh – at 21:34

Just when some of us thought that the future couldn’t look much uglier… “Ugly” and his 3 brothers show up. How long before they turn into 8, 16, 32, 64, 128… adinfinitum. Likely, somewhere, they already have… we just are having trouble keeping up. And now we see the beauty and horror that Virologists know and live. Wow. I was really naive.

Naive007

De jure – at 21:38

Dr. Niman, is there a way to target the SN1 protein with a universal vaccine against H5N1? Do you believe there is any way to neutralize the avian part of the virus?

WildBillat 21:50

Seigal believes the first priority is to control the virus in birds… I have had a thought…. What if trying to control it in birds creates the right enviromental stressor to cause a mamalian mutation to become dominate???

lbaum – at 21:50

“There should be more vaccination of birds,” he said. “We need a rational approach to this. A rational approach means a greater attempt to control it in birds — put the fire out rather than build the firewall.” (from the Health Day posting above)

Well, that would work with domesticated birds/poultry…but what about the wild species? You can’t kill them w/out other consequences. Am I missing something?

Racter – at 22:04

Anastasia:

“I did read somewhere that people who get the bird flu and survive will not develop immunity to getting it again because of all the various transformations of it.”

I keep seeing that too, but the logic still doesn’t track for me. If the whole deal with H5N1 is that it is a new subtype, then once you’ve recovered from it, you’re past that; no subsequent infection with an H5 strain will be entirely new to your immune system. Just as is the case with seasonal flu, you could still get infected later with another strain within the same subtype — but, just as with seasonal flu, your chances of dying from it would be reduced significantly. It also seems logical to me to regard a person who had beaten the bug once as being a good bet for beating another strain within the subtype, all other things being equal — that is, while everyone may be expected to have approximately the same degree of aquired immunity (approximately none), not everyone may be equally succeptible (or at least not equally succeptible to cytokine storm, or whatever it is that produces most of the fatalities).

Granted, during a pandemic, more people are infected at any given time, which means more replication, and more antigenic heterogeneity — so the time frame is compressed, and the liklihood of encountering a strain against which you had less cross-immunity is increased — but I still don’t see how it could be as bad as encountering the subtype for the first time.

niman – at 22:13

No you are not missing anything. Wild birds have been moving influenza genes around forever. H5N1 has been picking up some pieces (primarily H9N2), but the classical virologists can’t figure this out because they think the recombinations are random mutations so they don’t realize that exchanges are most often with neighbors. Now that a lethal H5N1 is in migtaory birds and moving into new areas, it is easier to see the movement, but the major moves are in the air (migratory birds) not on the ground (domestic poultry).

The classical view just watches the train wreck because everything is “random”, and all actions are reactions, so they are always chasing the H5N1 instead of getting in front of it.

I will soon tell them the next big event, which they won’t believe until it happens, but H5N1 is quite predicatble and its itinerary is known.

jack walt – at 22:20
Petergunn – at 22:21

niman: I will soon tell them the next big event

C’mon Niman spit it out - Im need to know if I should buy the generator or get my wife the ipod for Valentines!

crfullmoon – at 22:23

Will they ever be able to get in front of it?

I hate watching train wrecks. Good luck, even though that sounds too random; I mean well.

jack walt – at 22:26

Dr. Niman, I am looking forward to your new information. You were the only source by which i found out about the recombination with h9n2. So i must admit to a bit of fear concerning your new annoucement. But welcome it all the same. Thank you, and keep up this important work.

dude – at 22:27

Do you mind at least sharing a date by which those of us with “no need to know” will be informed of this next big event?

lbaum – at 22:30

Dr N…you mentioned “itinerary” before…is it where N5N1 is going that will be the real problem?

mother of five – at 22:30

Dr. Niman, the question that is being chased around in my head is “What are you waiting for?” Please do not be offended. To go further into my question, is it because you are waiting for something else to show up before making your prediction, or you need more proof to back up your next prediction? I think everyone here is curious as to why you need to wait? I am sure you have good reasons, actually, but I am definitely curious! Thank you

Medical Maven – at 22:42

Dr. Niman: Just give us this clue. Have you recently accelerated your prepping efforts?

Or is it like this with you? “How I learned to stop worrying and love THE Virus”.

Kidding aside, Thanks so much for sharing with us.

lbaum – at 22:50

Dr N…it’s past my bedtime but my Mom said I could stay up to see if you’ll answer my question…please do….and thank you for sharing with us, too.

new guy – at 22:56

“It is going to rain.” Noah

CK – at 23:05

What’s with the suspens?

gs – at 23:11

I cannot believe that <<classical virologists cannot figure this out>> «they do not realize». They must be aware about your views still they have probably some other indicators too, which you don’t mention. Shouldn’t you and those classical virologists give up on this rivalry and cooperate instead in a situation, when else -as you say- it could be hazardous to the world’s health ? I’d like to hear, what Dem has to say about the classical virologist and their relationship with Niman…

Japanseminole – at 23:21

It silly to play games with peoples lifes, this Dr. Niman should just tell us when he will announce it or provide some reasoning as to why the delay or just stop teasing everyone, while I don’t take his views 100% I think some here do based on some of the responses about buying generator etc.. so stop playing games by teasing people and provide a date or the information,

Japanseminole – at 23:27

Sorry forgot to say “Please”

Medical Maven – at 23:36

Japanseminole: The way I look at it, Dr. Niman did us a favor by giving us a heads-up. He did not have to do that. He knows our intense interest in this matter, and he probably thinks we are intelligent enough to read between the lines. In other words guys, Full Speed Ahead with your preps. That is my take.

And it is totally his right to release this information in a controlled way to best suit his interests and the interests of the people and/or organizations that he is working with. My hat is off to the guy. I began with Dr. Niman’s site many months ago, and his information spurred me and my family to get a head start on meds such as Tamiflu. For all I know, he saved my life and the life of my family.

And this ain’t “sucking up”. This is the truth.

NW – at 23:41

Dr. Niman I’m quite sure is not “teasing”, Japanseminole. It is indeed a heads-up. And also a “stay-tuned” in case anyone might be thinking of changing the channel. Be patient.

Japanseminole – at 23:42

Maven: maybe your are right, I am not sure if I can say he has done us a favor as this has not played out yet, but either way if his intention is to ensure people prepare no matter what happens I have no problem with that. Only problem is the posts with no commitment, anyway that is just my opinion. The guy does do interesting work.

Japanseminole – at 23:44

NW, ok I am relative new so I will wait and see, good luck to everyone.. I am not sure how many of you are in Asia but being in Japan close to the “possible” hotspot is scary, I am sourcing some Tamiflu for my kids already.

anon_22 – at 23:45

Dr Niman has his motives. He has his own idiosyncrasies. He scares me. He is infuriating sometimes, like now.

BUT he does good work, and most of the time he turns out to be right given a certain time interval. He makes invaluable contributions, he is willing to stick his neck out to warn the world.

I figure that until I can be as clever as he is (which is never ever) the least I can do is sit tight and wait.

I am willing to trade patience for insight.

giraffe – at 23:47

Well said…..

Japanseminole – at 23:56

I trade insight for my families well being

07 February 2006

Many Cats – at 00:13

Dr. Niman needs to hold off and give the heads up to the “need to know” folks because A. He needs to keep them reassured that he will be putting world interests first and B. By showing that his predictions could prove right again, it will be likely that they will actually LISTEN to him and not be so dismissive of his theory. If he is right and we can “get ahead” of H5N1 because of its set behavior, don’t we want the people with the means and resources to make a difference to begin to finally trust in his info.? Sadly, the wiki will have to wait, but for good reason.

mother of five – at 00:16

Medical Maven, Ditto! I just don’t think I’ll be sleeping well tonight….

gs – at 00:34

but why do “classical virologists” not accept his arguments, as Dem said ? Why doesn’t Niman publish in journals etc. ? I’d really like to see other experts commenting on his views.And him commenting on the comments etc. I don’t want to follow some Guru only because there are some mystical signs and some of his predictions happened to came true.

dubina – at 00:56

Racter – at 22:04

“If the whole deal with H5N1 is that it is a new subtype, then once you’ve recovered from it, you’re past that; no subsequent infection with an H5 strain will be entirely new to your immune system. Just as is the case with seasonal flu, you could still get infected later with another strain within the same subtype — but, just as with seasonal flu, your chances of dying from it would be reduced significantly.”

De jure – at 21:38

“Dr. Niman, is there a way to target the SN1 protein with a universal vaccine against H5N1?”

I’m reaching a little bit, here…OK, reaching a lot, but here’s a theory emerging from conversations with Suresh Mittal (not my conversation, and possibly somewhat garbled in my understanding of it, but here it is).

Could it be that the experimental “human adenoviral-vector-based, haemagglutinin subtype 5 influenza vaccine (HAd-H5HA)” developed at Purdue University and / or the experimental vaccine developed at the U Pitt Medical Center confers all-strain immumity within haemagglutinin subtype 5? (I think I detect that being claimed, as I will presently show.)

Furthermore, if that is being claimed, and if that claim proves true, would it not then be possible in theory to design a human adenoviral-vector-based, haemagglutinin subtype 7 influenza vaccine (HAd-H7HA) … and, by extension, any other all-strain Hx vaccine?

Peej – at 00:58

Sorry to barge in here but I’d like to get my $0.02 cents in about the way Dr. Niman is handling things. The public health agencies and research institutes are way too conservative to work with Dr. Niman. The world needs more scientists like him — he’s willing to put his reputation on the line to save lives by pushing the limits of traditional science. He’s probably too busy with his own stuff to publish in journals, if that’s the case. Also, if they think his methods are radical they won’t publish them.

dubina – at 01:40

The paper can be found under Premium Content (paid viewing) at www.thelancet.com. It was published online February 2, 2006. I received my copy courtesy of Mom_11 who recently volunteered for human trials.

DOI:10.1016/S0140–6736(06)68076–8

Introduction

Highly pathogenic avian influenza viruses of subtype H5N1 are now endemic in domestic poultry in southeast Asia. Since early 2004, human infections with H5N1 viruses have been frequently reported in the region with increasing frequency and high fatality rates.

H5N1 viruses were first recognised to cause respiratory disease in people in 1997, when 18 documented cases, including six deaths, occurred after outbreaks of highly pathogenic avian influenza in poultry farms and markets in Hong Kong.1,2

Two additional human H5N1 infections were identified in a family in Hong Kong in 2003.3

Since then, H5N1 viruses have spread to nine Asian countries, and recently have reached several countries in eastern Europe. More than 120 laboratory confirmed cases of human infection with a fatality rate of greater than 50% have been reported to WHO since January, 2004.4

So far, most human H5N1 infections have been due to direct transmission of the virus from infected poultry, although possible cases of human-to-human transmission have been reported.5

Genetic reassortment between a human and avian influenza virus or mutations in the avian H5N1 virus genome could result in the generation of a novel influenza virus of the haemagglutinin subtype 5 (H5) that could initiate a pandemic if it acquired the ability to undergo sustained transmission in an immunologically naive human population. Therefore, effective vaccines against highly pathogenic avian influenza H5N1 viruses are an urgent and global public-health priority.6–8

Vaccines developed and investigated in response to the 1997 human outbreak of H5N1 influenza were only modestly immunogenic in people, and needed multiple and higher doses of antigen or adjuvant (or both) to elicit detectable seroconversions.9,10

The H5N1 viruses isolated from human beings in 2004 were genetically and antigenically distinct from those in 1997 and 2003,11 necessitating the development of new vaccines currently undergoing clinical investigation.12

Current H5N1 vaccines depend on a supply of embryonated eggs to produce inactivated sub-virion vaccines. 13–16

To produce enough egg-derived pandemic vaccine for 1·2 billion people worldwide at high risk would need 4 billion embryonated eggs. However, this type of vaccine will not be effective against the genetic drift variants, and therefore precludes the stockpiling option. Moreover, in the event of a pandemic, maintenance of the availability of embryonated eggs would be a potential problem since H5N1 viruses are highly virulent in poultry. Hence, alternative vaccinemanufacturing strategies are needed.

We have developed an Ad-vector-based strategy for pandemic influenza vaccine using the haemagglutinin from an H5N1 human isolate and assessed its immunogenicity and efficacy to confer protection in BALB/c

Published Online February 2, 2006 DOI:10.1016/S0140–6736(06) 68076–8 Influenza Branch, Division of Rickettsial and Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333,

USA (M A Hoelscher BS, S Garg PhD, J A Belser BS, X Lu MD, I Stephenson MD, R A Bright PhD, J M Katz PhD, S Sambhara PhD); and Department of Veterinary Pathobiology, Purdue University, West Lafayette, IN, USA (D S Bangari PhD, Prof S K Mittal PhD)

Correspondence to: Dr Suryaprakash Sambhara ssambhara@cdc.gov

www.thelancet.com Published online February 2, 2006 DOI:10.1016/S0140–6736(06)68076–8 1

Development of adenoviral-vector-based pandemic influenza vaccine against antigenically distinct human H5N1 strains in mice

Mary A Hoelscher, Sanjay Garg, Dinesh S Bangari, Jessica A Belser, Xiuhua Lu, Iain Stephenson, Rick A Bright, Jacqueline M Katz, Suresh K Mittal, Suryaprakash Sambhara

Summary

Introduction

Avian H5N1 influenza viruses currently circulating in southeast Asia could potentially cause the next pandemic. However, currently licensed human vaccines are subtype-specific and do not protect against these H5N1 viruses. We aimed to develop an influenza vaccine and assessed its immunogenicity and efficacy to confer protection in BALB/c mice.

Methods

We developed an egg-independent strategy to combat the avian influenza virus, because the virus is highly lethal to chickens and the maintenance of a constant supply of embryonated eggs would be difficult in a pandemic.

We used a replication-incompetent, human adenoviral-vector-based, haemagglutinin subtype 5 influenza vaccine (HAd-H5HA), which induces both humoral and cell-mediated immune responses against avian H5N1 influenza viruses isolated from people.

Findings

Immunisation of mice with HAd-H5HA provided effective protection from H5N1 disease, death, and primary viral replication (p0·0001) against antigenically distinct strains of H5N1 influenza viruses. Unlike the recombinant H5HA vaccine, which is based on a traditional subunit vaccine approach, HAd-H5HA vaccine induced a three to eight-fold increase in HA-518-epitope-specific interferon-g-secreting CD8 T cells (p-0·001). Interpretation Our findings highlight the potential of an Ad-vector-based delivery system, which is both egg-independent and adjuvant-independent and offers stockpiling options for the development of a pandemic influenza vaccine.

And so on. I think the Lancelet pdf has Method, Results, data and discussion that would gladden the hearts of discerning virologists. For example:

Discussion

Our results show that BALB/c mice immunised with HAd-H5HA vaccine were effectively protected from H5N1 disease, death, and primary viral replication against antigenically distinct strains of H5N1 influenza viruses. Our data highlight the potential of an Ad-vectorbased delivery system for the development of a pandemic influenza vaccine. This strategy has the advantage of inducing strong humoral and cellular immunity and conferring cross-protection against continuously evolving H5N1 viruses without the need of an adjuvant.

“…has the advantage of inducing strong humoral and cellular immunity and conferring cross-protection against…continuously evolving H5N1 viruses…without the need of an adjuvant”

To further enhance the cross-reactive immunity and effectiveness induced by Ad-vector-based vaccines, genes of highly conserved proteins such as the nucleoprotein or matrix proteins could be included in the vaccine formulation, since CD8 T cells against influenza viral antigens have been shown to provide protection in animal models as well as in people.24,27–31

Furthermore, inclusion of haemagglutinin from the genetic drift variants of H5N1 viruses and other potential pandemic strains such as H7N7 and H9N2 could be considered for the development of Ad-vector-based vaccines that could cover a wide range of pandemic influenza viruses. Replication-incompetent adenoviral (Ad) vectors are a viable egg-independent approach to pandemic influenza vaccines because they can be grown to very high titres in available qualified cell lines; they can overcome glycosylation issues that might contribute to poor immunogenicity; they can be effectively delivered by either a parenteral or mucosal route; and they replicate episomally and do not insert their genome into that of the host cell, thereby ensuring less disruption of vital cellular genes. These vectors are highly immunogenic because of preferential targeting of antigen-presenting cells, and several National Institute of Health (NIH)-sponsored or independent human clinical trials for several infectious diseases and cancer targets are ongoing, ensuring that Ad vector delivery and expression of therapeutic antigens is safe in people.32,33

Studies with animals have shown that pre-existing immunity to human adenoviruses could be a potential problem in the generation of immune response against a foreign gene of interest.34,35

However, the results from a phase I study, albeit in a small number of recruits, indicated little correlation between the titres against adenoviruses and the immune response to the vaccine antigen.36

In our mouse inoculation studies, we always recorded enhanced immune response after the second immunisation, indicating that immune response generated against the Ad vector during the primary immunisation was not critically interfering with the porcine Ad type 3, bovine Ad type 3, canine Ad type 2, bovine Ad, and chimpanzee Ad, could also serve as alternative or supplemental vectors to overcome human Ad-specific immunity, if it becomes a serious problem.32,37

In recent years, avian H5N1 viruses have undergone rapid genetic evolution and have expanded their host range and level of virulence in mammalian species.38

Viruses from two genetic clades have caused human infections and death in Asia in 2005.1,8 In this study, the HAd-H5HA vaccine induced H5 cross-reactive humoral and cellular immunity and conferred cross-protection against lethal challenge of viruses with less than 96% aminoacid identity in the haemagglutinin subunit. This approach is a feasible vaccine strategy against existing and newly emerging viruses of highly pathogenic avian influenza to prepare against a potential pandemic. This approach also provides a viable option for potential vaccine stockpiling for the influenza pandemic.

Contributors

M A Hoelscher and S Garg contributed equally to this paper. M A Hoelscher participated in the planning, execution, and assessment of immune responses and protection. S Garg participated in the execution and assessment of immune responses and protection. J A Belser participated in the assessment of protective immune responses against H5N1 challenges. X Lu participated in the serological assessment of immune responses and protection. R A Bright provided the necessary plasmids and serological reagents for the generation of adenoviral vectors to undertake the experiments. J M Katz provided guidance as well as editorial assistance. S Sambhara participated in the planning, supervision, and execution of the experiments that led to the present manuscript. S K Mittal participated in the planning and supervision of the study. S K Mittal and D S Bangari participated in the generation, characterisation, purification, and titration of adenoviral vectors used in the study. All the authors saw and approved the final version of the manuscript.

Conflict of interest statement

I Stephenson has received travel grants to attend scientific meetings from several pharmaceutical companies including Roche, Chiron, Solvay, GSK, and Sanofi. He has grant awards from Roche Hoffman to conduct scientific-investigator-led studies. All the other authors declare that they have no conflict of interest. Acknowledgments

We thank Kristy Szretter, Catherine Smith, Randy Albrecht, and Nancy Cox for their advice and critical reading of this manuscript; and Po-Yng Cheng, and Soyoun Park for advice on statistical analyses of the data. Work at Purdue University was supported by public-health service grant AI059374 from the National Institute of Allergy and work at the Centers for Disease Control and Prevention was funded by the Infectious Diseases and National Vaccine Program Office. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the funding agency.

References

1 de Jong JC, Claas EC, Osterhaus AD, Webster RG, Lim WL. A pandemic warning? Nature 1997; 389: 554. 2 Subbarao K, Klimov A, Katz J, et al. Characterization of an avian influenza A (H5N1) virus isolated from a child with a fatal respiratory illness. Science 1998; 279: 393–96. 6

tixit – at 05:41

Who is Henry Niman???

Interesting: Henry Niman: prophet of doom for the Internet

And again: http://www.freerepublic.com/focus/f-news/823470/posts?page=351#351

http://www.curevents.com/vb/showpost.php?p=98855&postcount=25

http://www.siliconinvestor.com/readmsg.aspx?msgid=21713563

I don’t want to say everything Niman say is wrong (instead a lot of them seem very interesting to me) but his words are not The Bible as someone on this forum beleves. And he has something to explain us, about his life and his studies yet!

niman – at 06:51

Consider your sources.

Japanseminole – at 07:05

is funny the section about ligand.. looks like is doing pretty good the past few months..

007 in the USA – at 08:40

Question the source. I agree. Interesting that it’s ‘Birders’ who are throwing the stones. Remember that Birders have been very angry ever since birds were suggested to be the global vector (or at least one of the vectors) for the spread of HPAI H5N1. I have read several rather preposterous articles by Birders that it’s ABB’s (anything but birds) that are spreading H5N1. I found their conspiracy theories even a bit kooky for my black helicopter tastes.

I have gone up against people in my life who have gone after me for personal BS reasons and until you have had this happen to you in a public forum, don’t even think about throwing a single stone in judgement as you don’t know what it’s like. I know what it’s like to be hated for coming up with novel ideas that challenging the status quo. Anytime anyone in this world tries to move from their ‘place in line’ there will always be someone standing there demanding that they get back into their ‘Matrix’ position. I don’t see much of anyone other than Dr. Niman offering FREE information that might save your life, your family’s life and anyone else life whom you share the information with. The Birders aren’t offering anything relevant. The WHO isn’t offering anything relevant. The CDC isn’t offering anything relevant. The HHS isn’t offering anything relevant. Do you see a trend. So be d@mn yelling someone down who is willing to offer information relevant to saving your life.

Dr. Niman, I will always welcome and look forward to your comments.

Regards. Dan

DemFromCTat 08:52

interestingly, as is often in life, Dr. Niman and the birders might both be right. See the New Scientist link on the Main page:

The existence of distinct clusters also means the main carriers cannot be wide-ranging birds – instead, most transmission is via local poultry movements. Co-author Malik Peiris, of the University of Hong Kong, told New Scientist: “If there had been repeated waves of virus introduced into, for example, Yunnan, one would expect multiple sub-lineages of the virus. But in each place there is only one.”

Long distance transmission

But wild birds are involved. The team found H5N1 in six apparently-healthy migratory ducks at Poyang Lake in Jiangxi province, which borders Guangdong and Hunan, in January and March 2005, before the northward migration. The isolates had all the genes, and certain specific mutations, later found in geese at Qinghai Lake, 1700 kilometres northwest. And this virus, notes Peiris, is very like H5N1 in Turkey.
The team also tested whether the Poyang viruses would make ducks too sick to fly by infecting young mallards. “Most got a bit sick then recovered,” says Webster, and all shed virus for up to a week. “The evidence is now overwhelming that migrating birds can move H5N1 over long distances,” says Peiris. “But they are not the scapegoats for maintaining H5N1 within poultry. There the cause and solution lies within the poultry industry.”

It ain’t simple, it ain’t black and white. The birders have always said both commerce and smuggling (i.e. ground spread) is a big part of this and they’re absolutely right. But sick birds do fly.

anon_22 – at 09:16

Dem, “The existence of distinct clusters also means the main carriers cannot be wide-ranging birds – instead, most transmission is via local poultry movements.”

There is also the issue of non-migratory wild birds in local areas transmitting the disease. Part of the concern currently in Hong Kong raised by the discovery of several hundred dead birds in the city is that some of these are local wild species, suggesting the disease is now endemic in the area. The problem raised by this, of course, is that while you can cull farmed birds, there is nothing you can do if native wild birds are infected.

It is very disturbing to see pictures of dead birds on the streets in some of the busiest and most glamorous shopping areas of the cities. Particularly if you think of the poop that drops from trees every day. How long would it be before it is no longer safe for kids to go to parks?

What would Londoners do if the pigeons of Tralfalgar square start dropping H5N1-laced poop all over them? Carry an umbrella all day? Disinfect umbrella, coat, everything you wear everyday? Go to the car wash every evening before you go home?

Alas, Chicken Little would have the last laugh….

Medical Maven – at 09:59

Dr. Niman: Keep following your bliss. And don’t change your style, (as if you could). I predict that you will continue to have more hits than misses, just like you have in the past. We don’t expect certainties. We just want some good ideas about the possible direction and evolution of this beast. And you have proven out on those scores. Kudos to you.

But if it isn’t proprietary information, we would like a little more information on how you arrive at these conclusions that more often than not, prove out.

JoeWat 10:08

ditto, ditto, ditto — is that redundant?

JoeWat 10:44

From Middle East Online re Iraq “Hamma Sur Abdullah, 40, who died of flu-like symptoms a little over a week after his niece, was confirmed by a lab in Cairo as having died of the same cause.” Sounds like another h2h per Niman’s supposition.

niman – at 10:59

H5N1 is in wild birds, both migratory and non-migratory. However long range migratory birds have been carry flu sequences forever and recombination between these sequences and those in H5N1 has led to genetic change.

Prior to Qinghai Lake, there was NO H5N1 reported outside of soth and eastern Asia. It is now in Russia, Mongolia, Kazakhstan, Romania, Croatia, Turkey, Iraq and throughout the Middle East and Africa because of migratory birds, which are the main mover of H5N1 at this time (and they will take H5N1 worldwide in the next 12 months).

Luke – at 11:06

Niman,

Mr. Martin (you know how “Mr.” ruffles a guy like that) sounds like he is on a real mission to discredit you. I am always suspect of those who dispute and are simply critical of others work, instead of producing their own theories to give us something else to think about. When I got to is rant about how migratory fowl are not spreading the virus, I stopped reading. The Canadians just published work showing again what you have been saying.

New study examines bird flu’s genesis in China
(started a thread on it)

I check “What’s New” every day, and the basic message I get (aside from the learning how these little bugs work) is that “this is all ‘cause for concern’. Which it is.

Martin seems very “Fellowsesque”. Fellows, right? The doctor from “And The Band Played On”. More concerned with his ego than checking the spread of a killer virus?

Everyone on the board has seen the movie right? It covers the discovery, subsequent lack of action by the US Government, and bickering over intellectual credit with the Pastuer Institut in France on the discovery and spread of AIDS.

007 in the USA – at 11:46

Luke, Simply look at Mr. Martin’s web page theme. That’s the only ‘motive’ I needed to see. He’s a Birder and Dr. Niman called his baby ugly. Nuff said.

007

JoeWat 12:12

How does Niman do it?

Seems to me that any journeyman level scientist knows not to get too far from the data. If something new is discovered the scientist will first do his own negative testing (couldn’t it be something else, type of thinking). When this is discounted he puts his findings out there for others to criticize. Niman appears (I am not qualified in his area) to do his homework.

However there is also a subtle point in Niman’s work that was identified by Katzenmyer in his theories in Neurophysiology several years ago. I can not put my hands on the book right now or I would give the reference. It seems that one very fruitful way of thinking in the sciences, contrary to the ways in which most people proceed / believe, is to use teleological reasoning. That is, “what purpose could this serve?” is one of the more fruitful ways to construct hypotheses. Niman does not state this directly (to my knowledge) but I see him using this highly useful type of reasoning. For instance, “bird flu knows what it is doing.” Good minds do not necessarily think like others, nor do they stick to the rules. However he is doing it, we all win and lets hope he gets better at tracking this down.

Petergunn – at 13:30

I went for the ipod :-)

Question to Niman or other knowledgeable readers - where/how does recombination occur? As a completely unknowledgable lay persion I can think of several possibilities:

I read an article that shows the ‘Anatomy of a Virus’ ( http://tinyurl.com/a5rn6 ). I always just thought viri were just blobs of sub-DNA like goo. The article suggests they have much more structure. Is this true of Flu viri as well? Could recombination occur outside of cells or during the process of infection?

Name – at 14:00

I don’t see Dr Niman as either a prophet or a fraud, as he seems commonly portrayed. Clearly, he’s a maverick in the world of science — he doesn’t do things by the book. Great discoveries and insights can come from individuals who refuse to think and play inside the box. However, those who operate outside the normal systems of checks and balances also operate with far more risk, and tend to crash and burn pretty often.

I for one, wish Niman success. We need good news and we need bright minds at work on this. But with respect, I also won’t bet the farm on his predictions alone.

niman – at 14:09

Recombination happens when twp virii in the same cell. Polymerase starts copying gene from one and then hops over to other, so new gene is a hybrid (chimera) and polymerase can hop back and forth more than once (or can happen over several replication cycles).

De jure – at 14:17

Dr. Niman, if recombination happens more frequently than what is currently held to be believed, then why haven’t we seen more variants in the H7N7 virus? Why hasn’t it recombined with H9N2? What makes H5N1 so special?

anonymous – at 15:11

Dr.Niman, I’m sure that many people are waiting for your latest predictions and intend to take actions based upon them. Is it possible for you to give some idea as to when you might be able to share your new information?

dubina – at 15:56

niman – at 10:59

“Prior to Qinghai Lake, there was NO H5N1 reported outside of South and Eastern Asia.”

“It is now in Russia, Mongolia, Kazakhstan, Romania, Croatia, Turkey, Iraq and throughout the Middle East and Africa because of migratory birds, which are the main mover of H5N1 at this time (and they will take H5N1 worldwide in the next 12 months).”

Hmmm, do I detect a hint of schedule / itenary?

Kristy – at 16:10

do you expect that the flu will arrive in the US via migratory birds first, or via H2H first? I don’t know much about the migration of birds overseas. Perhaps there is no such thing.

chillindame – at 16:18

http://www.npwrc.usgs.gov/resource/othrdata/migratio/routes.htm

Kristy, this is a good reference for NA migration routes, but certainly not the only one.

chillindame – at 16:36

http://www.answers.com/topic/bird-migration This is a bit long, but also a very good reference on migration patterns.

chillindame – at 17:00

I will put this in its own topic later, but if anyone has any questions about bird migration patterns, the ones to ask are at the Patuxent Wildlife Center in Maryland, http://www.mbr-pwrc.usgs.gov/. They even track migrations by radar and could answer any questions I think. Personally, I think it will get here in NA by H2H. There are some birds that have migration patterns that are circular around the North Atlantic, but most birds in North America fly north-south and most of the ones in Europe/Middle East fly east-west but don’t cross the ocean. Notice I said “most,” I am leaving open the possibility that there is an exception or two.

Tom DVM – at 18:45

It is inappropriate and unprofessional to sensationalise the issue particularly at this point in time. This outlier…freak…frankenstein virus doesn’t need the hype. Sir, enjoy the limelight. I can only assume by your actions that your ‘15 minutes’ is almost up.

anon_22 – at 19:04

For North America, the most important migratory bird issue at the moment would be Alaska’s overlap with the Eurasian land mass.

lbaum – at 19:10

Re: itinerary…Dr. N mentions Africa with some authority.

Are there any reports of BF in wild birds in Africa yet?

Africa is the real “hot zone” according to the Maplecroft risk maps which have been referenced on several FWiki threads.

dubina – at 19:31

“For North America, the most important migratory bird issue at the moment would be Alaska’s overlap with the Eurasian land mass.”

I can’t say that I know the Asian flyways downpat, but I think the waves incoming to Alaska aren’t due here for two or three months, and any intermingled outbounds to Canada, the Lower 48 and beyond won’t happen until September, October.

De jure – at 19:34

Tom DVM, how right you are. This situation doesn’t need a Vegas-like touch…it is already surreal enough as it as. Good luck on your research, Dr. Niman.

dubina – at 19:34

Some personal observations of niman’s work and method:

What was it: “The Godfather”? Anyway, somebody had a way of speaking very softly in order that anyone listening should pay very close attention.

Niman has been going on about wild birds for months. He’s tracked HPAI cases month by month throughout Asia, the Middle East and Eastern Europe.

http://www.recombinomics.com/H5N1_Map_2005_QinghaiL.html

He predicted the S227N polymorphism in Turkey because it was already present in H9N2 in bird populations in Israel.

H9N2 has become endemic in Israel and millions of migratory birds will be passing through the area in the upcoming days. Thus, the potential for dual infections by H9N2 and H5N1 is high. The 10 nucleotides of identity offer an opportunity for homologous recombination that would create the S227N polymorphism and increase the efficiency of H5N1 human transmission.”

He made that prediction first on his web site and then [here] on FW.

http://www.fluwikie.com/index.php?n=Forum.HAS227NMutation

His HAS227N prediction inspired some Flu Wiki questions and comment, though in retrospect, most of our questions and comments seem to have missed the point. We weren’t paying that requisite close attention. Some have scoffed aloud, so to speak. I think that’s changing now.

Tom DVM – at 19:43

There are only three requirements to be a scientist. You must be inquisitive, observe and identify previously unexamined or unexplained patterns in nature and most of all you must, at all times, keep an open mind. Therefore, to my esteemed colleagues, those of you with degrees and those without, I ask that you keep one thing in mind as we together examine each conflicting opinion and filter an increasing amount of background noise (information). On a true and false exam, monkeys are right 50% of the time.

lbaum – at 19:51

http://tinyurl.com/9f6er

News from Africa reported today.

clark – at 20:02

Henry Niman uses his real name on the forum- most of the rest of us are anonymous. I think he really tries to be aloof and scientific with his statements- but now and then he stumbles- is unscientific in style and expresses his emotions. That is what happens when you are posting on line- spontaneity- not always flatering. He mostly handles attacks like a diplomat (consider your sources!).

I largely feel like a spectator in this. I have done most of the prep things that seem valuable. Have you ever watched a lightening storm or a hurricane. You do what you can to get out of the way- and be secure- but there is a point where all you can do is watch. I don’t care when Henry makes his next prediction. I am very interested in what it is. But, what is totally facinating/frightening is this unfolding story- It is about a mutant swarm that is behaving with the same sensitivity towards other species as we humans have recently shown.

De jure – at 20:03

Tom: I don’t think it should have anything to do with being right or wrong. As far as I’m concerned, Dr. Niman could be wrong on his next prediction, and based on what he has shared so far, I would still consider him a premiere authority on this virus, in the same league with Dr. Webster, in fact. What I object to is the anxiety that his remark is having on others in this forum. Folks are asking him whether they should continue air travel or not, for example. Dubina: I agree with you in that there are those who haven’t paid close attention to Dr. Niman; however, there are better ways to get people’s attention. I think in light of his recent successes, he doesn’t have to go to any great lengths to get anyone’s attention now anyway.

clark – at 20:10

Tom DVM- I have found your posts extremely interesting and helpful. Could you email me at clarky90 AT yahoo.co.nz? I have a couple of Pdf files that reacon you might find interesting- (plague in Iceland in 1402). cheers

clark – at 20:13

Tom DVM- could you contact me at clarky90 at yahoo.co.nz? I have a paper (Plague without rats- Iceland in 15th century) that i’d like to send you -Or anyone else that is interested.

dubina – at 20:20

De jure,

“…there are better ways to get people’s attention.”

I think he couldn’t afford a Superbowl ad, and predicting the S227N polymorphism now showing up almost five months later in Iraq sounds quite sufficient to me.

Scaredy Cat – at 20:24

I have not followed the Niman storm very closely. But in checking the links tixit provided, I did notice that none of the attacks on Henry Niman were based on facts or sound reasoning. The writers took suspicions, accusations, gossip and innuendo and used them as the bases for ad hominem attacks.

I am all for looking at all sides of an argument. I think it is healthy to keep an open mind, even to the point of considering that someone you highly admire might not be what you think. Too few people ever do that these days - certainly in the political world - and I’m not just talking about those I disagree with. Be skeptical, be a critical thinker. If you can make a case with facts and reasoning, I think we should hear it. But if your argument amounts to nothing more than a personal attack, then you are adding nothing to the knowledge base, and possibly steering people away from the truth.

De jure – at 20:44

Dubina: Re-read what I said. He is telling us he knows something. OK, fine. Tell us what it is, or decline to do so. Telling us he will make a grand announcement at some uncertain time in the future is creating unnecessary anxiety in most people, who are almost over the edge as it is. You of all people ought to know (from your comments concerning the WHO) how important it is for full disclosure, right? ;-)

Anastasia – at 20:54

I wish Dr. Niman had not made the announcement of the announcement and just made the announcement when he was ready. What’s the point of all this high drama? Such things are usually reserved for those who crave attention. I held him in high regard. Now I’m questioning his motives.

But, that’s just my humble opinion.

JoeWat 20:55

Tom, DVM: Your comments are startling given some of your prior posts and your credentials.

Medical Maven – at 21:04

I won’t care if Dr. Niman puts on a clown suit and speaks in Pidgin English so long as he keeps giving us and the world his take on what is going on. The time for convention is long past. If other “experts” out there have kept similarly correct predictions to themselves out of caution, sanction, fear of scaring the unwashed masses, well then, they only have themselves to blame.

And we aren’t dead yet. If you can’t laugh in the face of death, you haven’t met the future.

Tom DVM – at 21:05

Joe. Thanks for the comment. It’s not about the information. It’s about the process. If you have read my prior posts, you know that I think we are in a mess of trouble at the moment. There are no winners and losers in this scientific argument. If the train continues on its present track, we are all losers….but like I said before, Dr. Butcher could be right and I could be completely wrong. As a scientist, you must never take anything at face value.

De jure – at 21:12

If I remember correctly, Albert Einstein thought the greatest error he ever made had to do with the cosmological constant in his equation explaining whether the universe was contracting or expanding. Turns out he might have been wrong about being wrong (I guess in that case 2 wrongs would make a right?)

anon_22 – at 21:14

Maybe he is trying to tell us something is up but he is not at liberty possibly due to contractual obligations to disclose, at least not yet.

Tom DVM – at 21:16

Annon. Then he should have kept his mouth shut. That’s what a professional does…all the time.

JoeWat 21:19

In the present circumstances, science and its methods are but one contributor to this potential catastrophe that will undoubtedly have a serious impact on all of humanity. I think that we in the sciences sometimes overvalue our contribution. Indeed, we need to look at all sides and perhaps the politics, philosophies and indeed the showmanship all contribute. All of these things help us get to a well reasoned position. Who knows the “wrong” thinking may be just what we need to bring the problem to a place where we can all deal with the problem. Of course, all of this requires strong personalities ready to stand up and contribute. In all of this chaos, perhaps the truth will come out. God, I hope so.

De jure – at 21:20

Anon_22: Perhaps you are right. Dr. Niman is not some governmental entity. I assume his company is also driven by the profit motive, if it is a typical company (not to cast any disparagements on that…we for the most part still live in a capitalist society here in the U.S. of A.) Maybe he is waiting for his patent attorney to give him the green light? Those d—n attorneys! We’ll find somewhere to lay the blame!

anon_22 – at 21:26

Tom, I think a lot of us would say that he is not a typical professional. Again I am just wildly guessing but if someone were ever in a situation where there is a conflict between a commercial interest and the public good, sometimes they do try weird ways of communicating.

I have also known certain types particularly scientists of the geeky type who when they discover something new they get so excited they can’t wait to tell the world. Some of them are like little kids who find it hard to keep the lid on secrets and stuff.

Anyway, this is just idle chit-chat.

De jure – at 21:32

No, Anon_22, I’ve seen his picture on the web…he doesn’t look the geeky type to me. He’s too serious-looking. Now Michael Leavitt, well now your talking! (does anyone else think he resembles Steve Forbes, or is it just me?)

anon_22 – at 21:33

De jure, you could be right about the patent issue. What is the law on patents about intellectual property that is in the public domain?

But I was thinking more of consulting contracts because he talked about people who ‘need to know’ who have to be informed first. Suppose he was asked to do some research with proprietary data that he is not at liberty to disclose without prior approval. Because this whole issue also has a public interest angle, I could conceive of terms built into contracts that specify a time frame where the client(s) get a heads-up before he is then able to disclose to the rest of the world.

[OK, this is a far less depressing thread now…]

Medical Maven – at 21:33

Tom DVM: I have marveled at the depth of your knowledge and your grasp of the current situation. I really zero-in when I see that you have posted. You are a tremendous asset to this site. I saw that immediately from your first post. That being said, Dr. Niman is an eccentric and a maverick, and he is on a roll. We are going to have to accept him as he is, flaws and all.

You may not like how he says it or when he says it, but we all will pay attention to the content.

Tom DVM – at 21:35

Annon. I won’t go on about this but raising hysteria is unethical. In my humble opinion, its all about ‘I know something that you don’t know and I will tell you the secret maybe when I feel like it’….and that it unprofessional.

anon_22 – at 21:39

Dr Niman can say whatever he says…or not.

We can decide to be hysterical… or not.

But you are right about not going on. It was just a little diversion on my part :-)

De jure – at 21:46

Anon_22: Patent law is pretty tricky…so tricky in fact that you need a special license in addition to the one you get to practice general law (at least in my state). You are probably aware of the fact that scientists are patenting genes in addition to procedures, so an attorney would have to be very much up on his microbiology. I wouldn’t practice it even if I did meet the special requirements. But all kidding aside, I really wouldn’t be surprised if something like that was holding this whole thing up.

Japanseminole – at 22:28
Japanseminole – at 22:29

just a timeline is what we would like, when he will have some information.

Tom DVM – at 22:43

Dejure. My brother the patent agent and I have four or five (I lost track) patents at the US patent office on medical devices. This is not a patent issue.

NW – at 22:44

Don’t worry about timing. Just prepare. Just like the girl on the Tai beach (“it doesn’t take a weatherman…etc”) saw the water retreating before the tsunami and sounded a warning to everyone- it doesn’t matter whether it is 10 minutes or 1/2 hour or an hour. Just get to high ground and warn a few people on the way. Don’t stand around at water’s edge and ask people’s opinion about “When to you think the wave will arrive?”. “What percentage go you give the wave arriving in 10 minutes or less??? “. Doesn’t really matter if there is a tsunami expert there to converse with just get your a** to high ground!!

anon_22 – at 22:47

NW, “Don’t stand around at water’s edge and ask people’s opinion about “When to you think the wave will arrive?”. “What percentage go you give the wave arriving in 10 minutes or less??? “. Doesn’t really matter if there is a tsunami expert there to converse with just get your a** to high ground!! “

Great post! Couldn’t agree more!

Japanseminole – at 22:58

you assume that I will only use his opinion, I will base my decision to take “extra” precautions based on other reading and research I will do. We already have started or preparations, just waiting to see if we need to take a step further, since we are expats in Japan we would likely not remain Japan but take my family back home either to the US or a remote cottage in Canada. this is why I am interested.. is not as easy as just prepare.. maybe for some it is.

anon_22 – at 23:06

Japanseminole, I guess you are like me then. Our family of 4 is over 3 different continents so I know what you mean. Good luck then.

BillyJat 23:09

Here’s my take on Dr. Niman’s comment—just read between the lines:

“I will soon…” (I want to be sure my facts are straight) “…announce a similar prediction based on H5N1 recombination…”(announce the estimated time/location of sustained H2H H5N1 infection “…The impact could be significant” (The world is going to panic) “…so the ?need to know? groups” (WHO, world governments) “…will be notified first so they can make adjustments as they see fit. (start handing out Tamiflu stockpiles)

Monotreme – at 23:16

No-one, not even Henry Niman, can tell you when the pandemic is *about* to start. We will only know the date the pandemic started, retrospectively. Storm clouds are brewing, we can all see that. If you don’t think you can leave Japan after a pandemic starts, and you really don’t want to be there when it happens, then leave now.

I may be wrong, but I suspect Dr. Niman will predict another recombination event(s) that will be ominous. He will not tell us a particular date the pandemic is likely to start. He’s a scientist, not a prophet. The sign for pandemic onset that I am looking for is a hosptital that closes because too many of the doctors and nurses are ill.

The drama is just part of the Niman style.

Medical Maven – at 23:25

Japanseminole: You have a tough situation. It is sort of like the people who did not know whether to leave Europe or not prior to the outbreak of World War II, and some got caught there for the duration. I hope you make the right decision. Good luck to you and your family.

One last thought, Iran is a major supplier of oil to Japan and the rest of Asia. Iran could very well be closed-off as a supplier of oil by summer. Or it could be worse, Iran could close the Strait of Hormuz in the Persian Gulf, and supplies could be curtailed even further. Japan is very vulnerable in this regard. Lots of storms are gathering. I don’t think you need a lot more information. That is my two cents.

Japanseminole – at 23:25

Monotreme - as many have mentioned in other threads not everyone takes this seriously, so it is impossible for me to tell my work that I am leaving Japan b/c of the bird flu, I will be laughed out of the office, so while my Family come first, if I am out of job this will also not be good for my family of 5, thus I need to carefully research, monitor and ask the right people, I feel Dr Niman is one of those that I need to monitor. Thus I must wait until the time is right. the way I see and based on information and hints things will get ugly over the next few months, maybe it will start in Africa, the spread out from there, or maybe Idonesia and spread out from there.. who knows..and I don’t mean WHO knows!

Japanseminole – at 23:29

Medical Maven- thanks for your comments, interesting information about Iran and Japan, I will also do a bit of research on that end, luckily I have some very smart co-workers here that I can check with… just not really worried about bird-flu.. when I mention it they don’t even know why I am talking about it. but one thing about people here is they are very aware of flu colds, when people are sick they wear maskes and do the proper coughing etc.. maybe it is safer here as there is a already a culture established.

Japanseminole – at 23:33

Niman has been busy posting at curevents.com..

Japanseminole – at 23:34

Niman has made a couple of posts at curevents.com..

Monotreme – at 23:34

Japanseminole: I appreciate your situation. I just would not count anyone or any WHO to provide reliable information about when the pandemic will start. The odds that you will decide to leave Japan right before it starts are very small, IMO. My point is, if you feel uncomfortable there, why wait? Even if the pandemic doesn’t start for 2 years, you will suffer the stress of wondering with each piece of news whether the pandemic is about to start and whether you should go. Better to live (and work) in a place where you feel safe.

BillysBlueat 23:35

“The genetic diversity of H5N1 is growing increasingly large, so at this point several vaccines would be required and those targeting future sequences would be most effective in the near term.” (Niman from above)

http://tinyurl.com/9ooew

The above news link from CNN dated February 8 reinforces what Dr. Niman has stated above.

Japanseminole – at 23:43

Monotreme, thank you, I agree but I am still not sure this will ever happen. Luckily my contract is not 4-ever so probably in late 2007 I will return to Boston, then my name will go back to Bostonseminole.

Monotreme – at 23:53

Japanseminole: I’m not 100% sure it will happen either, only 99.956% sure (for gs).

I hope we have until 2007. In any case, I’m not sure Japan would be such a bad place to weather a pandemic storm. Standards of hygiene are high, society is very orderly, crime is low, excellent health care system…

Hey, maybe I should move to Japan ;-)

08 February 2006

clark – at 00:02

Japanseminole- I suspect that you and your family could be safer in Japan than mainland USA. I believe that Japan did very well in 1918 in terms of mortality. There are so many factors to think of- stability of the society, food supply, access to medical care. Would the Japanese include or exclude you in an emergency. Societies act in surprising ways (good and bad) during a crisis.

Rather than listen to what people say for a clue as when the time to move- watch what they do. Watch the world’s financial markets. TPTB may be making soothing noises, but you can be sure that they will be looking out for their back pocket. Watch all the charts. everyday

Medical Maven – at 00:05

Wasn’t Japan one of the least hit countries during the 1918 Pandemic? I think I read that here some months back. And wasn’t the speculation that it was something in their genetic makeup that maybe partially protected them? Or maybe it was the above as described by Monotreme. I think you might have an idea. And I will say again that I fear the social disorder far more than I do the flu. But, on the other hand, I believe Japan is woefully dependent on food imports, too.

Japanseminole – at 00:13

Clark and MD Maven, you have very good points for me to ponder. I have already planned and contacted the US Embassy here just in case things got to crazy, one thing you gotta love about the US govt is they take care of their people anywhere in the world. I was reading about the food imports, I might be eating lots of rice!! hopefully we will here more soon!

Good point about the markets, I am also watching the Euro and $ closely for any sudden move

gs – at 03:45

monotreme said:

 >I’m not 100% sure it will happen either, only 99.956% sure (for gs). 

what will happen ? A human pandemic at any time in the future on earth ? Let’s define a pandemic as >10% infected on each of the 4 big continents. I guess, it’s 80%. (without thinking a lot)

probability that H5N1 will ever go pandemic : ~40% that it will go pandemic this year, ~10% Hmm. Actually I’m a bit more optimitic with my estimates than last week… The numbers 10%,40% don’t compare so well, I might have to think again.

gs – at 03:54

so Niman is delaying info for patent issue ? Info of same quality which he accuses WHO to withhold, because it cauld be “hazardous for world’s health” ? Why doesn’t Niman clarify about the patent issues then ?

Can’t we find a way to protect his patent concerns and yet let him release the info for everyone’s benefit ?

I mean, if it’s true what he claims, then we’re not just talking about some money which his company might loose. It would be important for world’s health (his own words).

So, can’t we just “change” this patent-issue or circumvent it to ensure that he has no disadvantage from telling things earlier as he would do else ?

This is a special situation, isn’t it ?

It doesn’t make sense that he refers to patent-issues himself but on the other hand accuses WHO of withholding data and risking world’s health. He should at least try to resolve the patent-issue somehow (I think it could be done), if he just wants more money. We should be more flexible in patent-negotiations when the threat are 1e8 deaths, shouldn’t we ?

Also his questionable past, I can’t make sense of the situation. Nobody knows, what he really wants. What is recombinatorics selling ?

The recombinatorics webpage is a bit strange too. It says nothing about the actual buisiness. What people are involved ? What legal-form of company ? How much money ? What are the partners ? Does recombinatorics earn from fees which vaccine producers pay for using their patents ? Or does R. sell the patents to vaccine producers ? Or does it hope to do this in the future ? It also says nothing about Niman’s past activities. What else is he hiding ? He wants us to believe him just only because of his previous (successful ?) predictions ? But he doesn’t keep a statistics of these. Nor does he publish papers. Not even on his webpage. So, how can I know whether it’s significant or coincidence ?

dubina – at 04:54

So far as niman’s decision to withhold specifics of his forthcoming prediction, I’m pretty sure none of us know why he hasn’t made it yet. That said, what I take to be his broad hint isn’t ambiguous at all: “migratory birds…will take H5N1 worldwide in the next 12 months”.

That implies larger domains for mutation, reassortment and / or recombination. Superficially, H5N1 gone worldwide doesn’t necessitate sustainable h2h, but tendencies seem headed in that direction. Just thinking about niman’s prediction of the S227N polymorphism and his tracking charts, I’d think of mapping forthcoming bird migrations over existing geographical distributions of HPAI. He might comprehend the meaning of those intersections where we do not. I suspect those eventualities might take time to simulate and more time to devise a succinct report.

Since he’s been so categorical in saying the course of H5N1 is predictable, he’d want his prediction(s) to be specific enough to be taken seriously and sufficiently precise in method and results to map a credible, verifiable timeline to pandemic. He’d want to be ready to respond to skeptics. While it seems to me that there might be high risk he’ll miss his forecasts, he might already have four aces in the hole.

Or he might still be working to fine tune his projections and shore up his arguments.

Anyway, if niman’s general timeline for H5N1 is that it might go worldwide in the next 12 months, it seems to me there’s room to think we might wait a few days or even weeks for his predictions to be made public.

gs – at 05:22

why is there noone who copies him ? Doesn’t look so hard to predict, what he predicts, given his assumptions…

Japanseminole – at 07:39

he just posted this.. maybe a hint..

http://www.curevents.com/vb/showthread.php?t=38205

“It will be worlwide in 10 months, not 10 years.”

Anon_06 – at 08:33

To use Niman’s favorite sentence, I would say “Dr Niman raises concerns!!!!”

007 in the USA – at 12:43

Curve Fitting… As an Mechanical Engineer, I spent many months at college developing iterative equations to ‘fit’ certain types of linear (predictable) situations/curves. The more data that we were given, the better we were able to fine-tune the equations until we had eventually modeled situations very closely. Most situations/conditions can be modeled reasonably well. After several model iterations, they eventually become decent predictors for future conditions (with small ± errors).

H5N1 ‘range’ expansion, clinical rates, deaths and the overall number of H5N1 variants could be easily modeled. This is likely something that Dr. Niman is developing. And I have no doubt that the WHO has also modeled this too. Many scientists know within a month when H5N1 will arrive in most places in the world. Taking the cursory look at the ‘public’ data, I give North America 6 months max.

007

food storage nut – at 13:09

007 in the USA I have a master’s degree in mathematics and am very interested to know who is working on a mathatical model of the pandemic. I know from past newspaper reports that Furguson at Imperial College, London has been working on it but I don’t know any more than that. I have tried to find more information on the internet but so far no luck. If you come across any more information on it please start a new thread perhaps entitled mathematically modelling the pandemic. Are there any other math types out there? If you have any information I am interested.

niman – at 13:15

Nigerian strain like Qingahi strain. H5N1 itinerary is well marked

http://www.recombinomics.com/News/02080604/H5N1_Nigeria_Qinghai.html

dubina – at 13:50

Channeling niman:

“More sequence information of the Nigerian isolates would be useful as would more transparency in reporting H5N1 along the migratory path.”

How strange: news of H5N1 dieoffs in Nigerian birds attains public notice only after H5N1 is confirmed by lab tests in Padua, Italy.

Medical Maven – at 13:55

h2h by the fall of 2007, if that long.

dubina – at 14:14

gs,

I think Dr. Niman might agree with you.

[gs]

“…why is there noone who copies him ? Doesn’t look so hard to predict, what he predicts, given his assumptions…”

[niman]

“Although this problem is obvious to the most casual observer….”

Recombinomics Commentary September 29, 2005

As a result of intensified surveillance and heightened public concern, growing numbers of people with respiratory symptoms or possible exposure to the virus are being admitted to hospital for observation and, when appropriate, treatment. Until a conclusive diagnosis is made, these patients are classified by the Ministry of Health as suspect cases. While many do not have symptoms compatible with a diagnosis of H5N1 infection, screening of patient samples is being undertaken in national laboratories as part of efforts to ensure that no new cases are missed.

Laboratory testing to confirm human infection with H5N1 avian influenza is technically difficult; some tests produce inconclusive or unreliable results. To ensure a reliable assessment of the situation in Indonesia, authorities are, after initial screening, continuing to send samples from people considered likely to have H5N1 infection to WHO reference laboratories for diagnostic confirmation.

The above comments by WHO announcing the fourth confirmed H5N1 case in Indonesia fails to address the false negatives in Indonesia due to improper sample collection. Although this problem is obvious to the most casual observer, the WHO continues to battle H5N1 via press release. Sample collection and testing remain scandalously poor. The samples are clearly improperly collected, but the WHO comments on the unreliability of the testing and fails to address the issue.

The problem can be easily identified in the first few cases, which clearly show human-to-human transmission and false negatives.

The initial familial cluster involved three fatalities. All three fatalities were clearly due to H5N1 infection, but only one tested positive for H5N1 by PCR. The failure to detect H5N1 in the other two fatalities was simply due to the improper collection of samples.

The index case, an 8 year-old girl, was hospitalized for almost 3 weeks before she died, but never tested positive for H5N1. This is because no early samples were collected. The same was true for her 1 year old sister. However, her father was admitted after his two daughters were clearly dying, so a sample was collected from him shortly after admission, and he was PCR positive for H5N1. Eventually serum was collected from the index case and both samples were also strongly H5N1 positive by testing in Hong Kong and Atlanta leaving little doubt that all three fatalities were due to H5N1. However, because the serum samples were collected just 3 days apart, and the initial sample was strongly positive, the second sample was not four fold higher than the first, so the index case was excluded from confirmed cases.

Thus, although there was strong evidence for human-to-human transmission, only one of the three fatalities was included in the WHO list of confirmed cases in Indonesia. The one positive was a 38 year old government auditor, with no history of contact with infected birds. The birdcage across the street was H5N1 positive, raising the possibility of infection of the 8 year old by a pet bird leading to three fatalities in the suburban Tangerang family.

The second confirmed case was another office worker who worked for immigration at the airport. She was PCR positive, as was her nephew, who was the third confirmed case in Indonesia. The time between symptoms of the index case and the family member again points to human-to-human transmission. Because of the screening of relatives of the index case, a sample was collected early and he tested positive for H5N1. However, in contrast to the fatal outcome in the first four cases, he had a relatively mild case and has been discharged. His outcome indicates that H5N1 can be transmitted human-to-human and such transmissions can produce mild disease, raising the real possibility of silent spread of H5N1 in humans.

The casual spread of H5N1 was highlighted by analysis of workers and visitors at the Ragunan Zoo. They had bird flu symptoms and tested positive for H5N1 antibody. However most of the visitors initially went to primary hospitals, where no samples were collected. When the patients did not improve, they were transferred to the infectious disease hospital. Sample collection at this time produced negative PCR tests because by this time the patient was transferred to the infectious disease hospital, the H5N1 was no longer in the nose or throat, so swabs of those sites were negative.

The testing of zoo visitors with symptoms has been far from ideal. When 115 arrived at the infectious disease hospital, they were turned away because their symptoms were too mild. However, as seen by the nephew of the second index case, H5N1 infections can produce mild disease, and it is at the time of initial symptoms that H5N1 is most easily collected from swabs of the nose or throat.

The screening of patients also reduces the likelihood of detecting human to human transmissions. Patients not recovering were transferred if they had been to the zoo. More recent transfers have been linked to dying poultry. Thus, the screening would screen out those that were H5N1 infected by other people or casual contact not involving dying poultry or zoo visits.

The ability to test and treat these patients is limited. There are only four beds set aside for patients requiring ventilators, but one ventilator is not functioning and a monitor is broken, so there are only two ventilators available at the infectious disease hospital.

There is also an effort to quickly discharge patients to make room for more patients. One was scheduled to be discharged today, but when her 14 month-old baby was admitted, she was not released.

The resource shortage also applies to individual families. In Demak two children died without being admitted because the family could not afford the medical expenses. Now a third sibling has symptoms, suggesting more human-to-human transmission and more missed patients and samples.

The larger clusters and clusters of clusters (see map) indicates that the pandemic in Indonesia has moved to phase 5, yet WHO maintains a phase 3 level.

The number of false negatives in Indonesia is a cause for concern and WHO’s efforts of battling H5N1 by press release become more remarkable by the hour.

The time for collection and testing of samples at primary sites is long overdue.

WHO’s failure to address this obvious problem remains scandalous.

http://www.fluwikie.com/index.php?n=Forum.SixHospitalizedSuspectedH5N1CasesInTurkey

Medical Maven – at 14:44

I know many people like to rap Dr. Niman for his dramatic flair, but his comment at the end of the Quinghai Lake announcement many months ago was this I believe, “the time for hopes and dreams is past”. That was from memory, so forgive me if I was wrong. Also, I will never forget my first look at those photos from Quinghai Lake. I had a very bad feeling at that moment.

Well that was my dramatic flair. I will keep such things to a minimum.

niman – at 15:32

Commentary on additional spread in Nigeria

http://www.recombinomics.com/News/02080605/H5N1_Nigeria_Spread_More.html

dubina – at 16:45

Niman channeling himself…and a gratuitous comment.

“More sequence information of the Nigerian isolates would be useful as would more transparency in reporting H5N1 along the migratory path.”

How strange: news of H5N1 dieoffs in Nigerian birds attains public notice only after H5N1 is confirmed by lab tests in Padua, Italy.

“The above comments indicate that H5N1 in Nigeria has already spread significantly into three regions. Earlier media reports describe sick or dying birds in Ungowan Doka, Maduna, Kawa, and Kano in addition to the Jaji outbreak described in the OIE report.”

“The Jaji outbreak began on January 10, so significant spread in the area has been possible in the past month. However, the similarity between the sequences of the Nigerian isolates and those in Siberia and Mongolia indicate that the H5N1 has migrated into the area and H5N1 is likely spread across Africa along the migratory flight path.”

“Thus, the location of H5N1 is somewhat established, but the countries along the flight path in Africa and the Middle East have failed to report the outbreaks.”

It may also be appropriate to say for purposes of accountability that foreign people who attended the bird dieoffs in Ungowan Doka, Maduna, Kawa, Kano and /or Jaji haven’t had much to say in public either. If these events have been described in news stories prior to * February, then I’m wrong, but I’m wrong for that reason, how could major media have missed the stories or kept them quiet.

We’re being managed, folks. What other explanations obtain?

Medical Maven – at 16:49

H5N1 has found our “soft spot” in the uncontrolled, never-to-be-controlled, HIV-saturated shanytowns of Africa where the bushmeat trade is a way of living.

dubina – at 16:51

Sorry, meant to say…

“If these events have been described in news stories prior to 8 February, then I’m wrong, but if I’m wrong for that reason, how could major media have missed the stories or kept them quiet.”

Let’s see, simultaneous outbreaks in January in Turkey and Nigeria. Very worrying. It’ll be interesting to see when the WHO or whoever first got wind of this and appeared on the scene.

Melanie – at 17:28

WHO arrived in Turkey earlier this week. I’m in touch with one of the team and I’ll let you know what I hear.

lbaum – at 18:29

There is a report from 28 Nov 05 on BF in Cameroon…check the thread: Africa

anon_22 – at 18:38

Melanie, I thought WHO had already been in Turkey for a while? Am I mistaken or is this something new?

007 in the USA – at 20:10

food storage nut… I’ll do some asking around and post back anything I find about us math geeks. But it may now be as simple as talking with some folks with thorough knowledge of migratory patters out of Africa. From what I’ve read, in the next 3 or so months, many birds will fly north from Africa into Europe. From there into Norway then across to Iceland and eastern Canada and then down the east coast of the US toward the Mississippi valley. And if a sick bi-ped flying over on a 747 doesn’t beat the birds to the punch, the will fly H5N1 right into the heartland. What a horrible scenario. Six months before North American touchdown max.

Cheerio! 007

Melanie – at 20:13

Anon, the WHO infectious disease investigation team went into Turkey on Sunday or Monday.

09 February 2006

dubina – at 04:03

Melanie,

You may know Padua is the OIE Reference Laboratory for Avian Influenza.

From a conference in late January of 2005….

10.10. OIE/FAO Avian Influenza Network

The Commission participated by teleconference with Dr I. Capua from the OIE Reference Laboratory for Avian Influenza in Padua, Italy, to discuss the formation and terms of reference for a proposed OIE/FAO Avian Influenza Network. The structure and membership in the network were reviewed. A Steering Committee will be chaired by the President of the Commission. The main activities will beled by a Scientific Committee of experts chaired by Dr Capua, supported by a wider team of scientific collaborators. The Commission commented that this network is an important part of the global response to threats of avian influenza, and emphasised the importance of co-ordinating with WHO, as already decided.

So it seems OIE or WHO may have got to Kaduna, Nigeria sometime in the latter part of January of this year. Can you ask your collegue when that might have been and why news of the HPAI problem wasn’t made public?

I apologize if the Padua OIE-WHO connection has already been posted to this forum. If so, I haven’t seen it yet.

Melanie – at 05:18

dubina,

I only know what I hear and OIE aren’t among my informants. If they sent a team into Nigeria last month, I didn’t know about it and they were prescient. It makes sense: Nigeria is both the largest(by population) and most crammed (by density of population) country in Africa and I’d want to be doing some heavy monitoring there.

Remember that HPIA data from ANY agency won’t be made public until they have test results and the tests being run right now are on serum titers which take weeks to run. This isn’t something you can run in the wild in 15 minutes and get a result. We won’t get the serum data back from Turkey for another couple of weeks.

Another point to consider: WHO is a lean agency (most departments are budget starved by design) but it isn’t small. Don’t expect that the right and left hands have coffee with each other.

dubina – at 10:59

Melanie,

The mind boggles.

pogge – at 11:49

Getting long and loading slowly. Discussion can continue on Niman III. Closing this.

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