DJHJD

DJHJD

Thursday, December 28, 2006

Flu Stories: Bird Flu Deaths in 2006 Exceed Prior 3 Years Combined

Cross posted from Daily Kos


If you don't write about a problem, does it go away? Whether it's global warming, Afghanistan or H5N1 the answer is no. The headline is from Bloomberg:

Bird flu killed three members of a family in Egypt, pushing the number of fatalities worldwide this year to 79, more than reported in the previous three years combined...

"In the second half of 2006, there was a steep decline in the number of case reports, although similar declines occurred in 2004 and 2005, but were then followed by resurgences," the influenza team at the European Centre for Disease Surveillance and Control in Stockholm wrote in a Dec. 21 report in Eurosurveillance Weekly

Females are over-represented among H5N1 patients aged 10-29 years, possibly because it is usually young people and women who look after domestic poultry, the influenza team said.

``Human-to-human transmission, as indicated by cluster size, is still extremely inefficient, as it was a decade ago when the first human-to-human transmission took place in Hong Kong..."

The total number of infected is 261 worldwide, with the virus killing 157 as of today (a case fatality rate of 60%. In comparison, the devastating Spanish Flu of 1918 had a 2.5% CFR). So what's the big deal about a few hundred overseas cases? As John Oxford put it while reviewing Michael Greger's book on the topic:

However, the book fails to confront the question I am asked daily: "Why are you so worried about 151 deaths from H5N1?" Well, go back to 1916, to Etaples in northern France, where a form of flu causing heliotrope cyanosis (a characteristic lavender coloration of the face) with a case fatality of 60% was beginning to spread. There were 145 cases. At some point in the next two years it mutated to become more infectious and 30 times less virulent. Then it killed 50 million people. Doesn't this ring a nasty bell?

So are we doomed? Of course not. H5N1 may never become the pandemic strain (or it may), but some other influenza A inevitably will (pandemics happens about three times every century), with varying effects - just like category 5 hurricanes). The point of keeping up with the news is to remain aware, so that policy decisions that stray into the political realm become more understandable. And policy will be made.

For example, this is a previous diary on policy decisions being considered:

Okay, so it's Science Friday, but what's that got to do with politics? Well, if your local school board has to consider the ramifications of closing the schools for 8-12 weeks, shouldn't you be involved in the process? I'd think as a parent or as an employer you'd want to be.

Expect a policy announcement in January from the Feds on the topic of NPIs and community mitigation. Stay educated so you're in a position to be part of the process at the local level, where it counts. And recognoze that this isn't just an issue for specialty sites like Flu Wiki. This is an issue for all of us.

Why would folks want to close the schools? Because St. Louis did in 1918, and Philadelphia didn't. See slide from .pdf presentation by Ben Schwartz (HHS):

In fact, school closings are at the top of the pack of non-pharmaceutical interventions to discuss. So while old and tired comments about Rumsfeld and Tamiflu are still made, the discussion has moved beyond that.

Policy is coming down the pike. it will involve you and your community. The schools may be used to teach parents and kids about potential school closures and how to do modest preps and planning to function during that time frame, which could last weeks. None of that is accidental, and none of it is in a vacuum. So, the reason to stay abreast of the news is to understand that preparation needs to be done in advance of a pandemic, and not during. Like hurricane, blizzard and other disaster prep, it is insurance for that which we hope never happens, but sometimes does.

You can always learn more here. And knowledge is power, not hype.

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