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Online Discussion: Tracking new emerging diseases and the next pandemic.

Increase in human cases for 2008

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Albert View Drop Down
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    Posted: March 03 2008 at 5:07am
I noticed that we're on record pace this year for the most confirmed human cases.  Looks like we're at about 22 cases so far with a CFR of 89%.   The CFR has increased by almost 10%, which isn't good.   We could be seeing the first signs of Tamiflu resistance. 
 
Could be an interesting year ahead. 
 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 4=laro Quote  Post ReplyReply Direct Link To This Post Posted: March 03 2008 at 5:44am
As a young boy back in the 50's (in a large family and a very low family income) I remember how my father handled the influenza problem.  He put onions in all the windows, and everyone wore garlic necklaces.  Sounds crazy, but one thing - none of us got sick.  Anyone else have any home remedies?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote coyote Quote  Post ReplyReply Direct Link To This Post Posted: March 03 2008 at 6:11am
Ya Albert. I agree. Glad you posted that.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote waterboy Quote  Post ReplyReply Direct Link To This Post Posted: March 03 2008 at 6:18am
CFR?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: March 03 2008 at 6:34am
Originally posted by waterboy waterboy wrote:

CFR?
 
It's the "Case Fatality Rate".  Also known as the Death Rate or Mortality Rate.  So far this year, 89% of the human cases have been fatal. 
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waterboy View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote waterboy Quote  Post ReplyReply Direct Link To This Post Posted: March 03 2008 at 6:56am
Thanks,and "WOW" thats alot of deaths.Very sad.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote jacksdad Quote  Post ReplyReply Direct Link To This Post Posted: March 05 2008 at 1:28pm
That's especially scary when you consider that the CFR of 89% is in spite of the best we've got in terms of medical intervention. I believe H5N1 was running at about a 50% CFR when it first appeared in 1997. Eleven years later, with a better understanding of the virus and most likely the use of respirators and Tamiflu in the majority of cases, we're doing worse. Kind of makes you wonder how we'd cope in a pandemic with only an overwhelmed healthcare system to turn to, even if an H2H strain did indeed turn out to be less lethal.
    
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: March 05 2008 at 3:10pm
When H1N1 made the jump in 1918, it did not recombine with another human flu, and the virus "evolved" through natural human adaptive pressure.  What makes H5N1 unique like H1N1 is that it can naturally evolve and it does not need to recombine with a human flu.   The mild pandemics of '57 and '68 did recombine, but h1 did not, nor does h5n1 need to. 
 
H1n1 also became more lethal to humans "after" it mutated.   H5N1 will most likely become more lethal as well if it makes the jump.   Some suggested that it could become less lethal, but all indications say otherwise. 
 
Here is an old article from 2005:
 
 
1918 Flu's Genetic Code May Help Fight Bird Flu

Washington
05 October 2005

Scientists have decoded the genetic structure of the influenza virus that killed tens of millions of people soon after World War I.  The research fulfills more than a mere historical curiosity.  With fears about an impending pandemic from avian flu, the work provides insight into the structure of killer flu viruses that might lead to better medicines against them.

Emergency hospital during 1918 influenza epidemic, Camp Funston, Kansas <br />(National Museum of Health & Medicine photo)<br /><br />
Emergency hospital during 1918 influenza epidemic, Camp Funston, Kansas
(National Museum of Health & Medicine photo)
It was the 20th century's greatest plague.  Estimates of the 1918-1919 flu death toll range from 20 million to 50 million, more than died in the war that had just preceded it.

The head of the U.S. government's disease tracking agency, Julie Gerberding of the Centers for Disease Control, says hardest hit were the young and productive between 20 and 40 years old.

"The 1918 influenza virus that caused such global global disease spread very rapidly, particularly among healthy people, was very, very virulent, and certainly circled the globe in record time," she said.

U.S. government and private scientists have finished a 10-year project to determine the virus' genetic makeup.  They recreated a live virus in a high-security laboratory at the Centers for Disease Control (CDC) by combining fragments from the organism's eight genes.

Researcher Jeffrey Taubenberger of the Armed Forces Pathology Institute says the genetic scraps were gathered from well preserved lung tissue samples taken from victims during autopsies 87 years ago or, in one case, from a victim exhumed from Alaskan permafrost.

"Because influenza viruses were not known to exist in 1918, there were no isolates made of this strain of the virus, and so there was actually no way for medical scientists to directly study this influenza virus," he explained.

The scientists tested the virus by inserting it into mice, chicken embryos, and human lung cells.  They found that by substituting genes from other flu viruses, they could make it less lethal.

The research, published in the weekly journals Science and Nature, shows that the 1918 flu virus is more closely related to bird flus than human flus.  It has several of the same genetic mutations found in the bird flu strain now spreading in Asia, mutations believed to help the virus replicate more efficiently.

Chickens sit in cages at a Changji farm, in China's western Xinjiang region
Mr. Taubenberger says this reveals that bird flu viruses can cause serious human infection without first combining with a strain already adapted to people.  Some experts have said that effective human transmission might require combination with a human flu.

"We now think that the 1918 virus was an entirely avian-like virus that adapted to humans," said Mr. Taubenberger.  This is a different situation than the last two pandemics we had, the Asian flu in 1957 and the Hong Kong flu in 1968, which are mixtures in which a human-adapted influenza virus acquired two or three new genes from an avian influenza source.  So it suggests that pandemics can form in more than one way, and this is a very important point."

He says it also suggests that the current Asian bird flu, known by its scientific designation H5N1, could evolve into a human killer with just a few more mutations that allow it to jump more efficiently among people.

"It suggests to us the possibility that these H5 viruses are actually being exposed to some human adaptive pressures and that they might be acquiring some of these same changes," he added.  "In a sense, they might be going down a similar path that ultimately led to 1918."

Mr. Taubenberger says if researchers can identify virus components that are important in the process of adapting to humans, they could make a list of molecules to look for in emerging bird flus that threaten people.

Julie Gerberding
Julie Gerberding          (file photo)
Dr. Gerberding of the Centers for Disease Control says the work will allow new medical therapies to target those molecules.

"It is revealing to us some of the secrets that will help us predict and prepare for the next pandemic," she said.

Dr. Gerberding says it is comforting to know that the 1918 virus, now that it has been reconstructed, is susceptible to a new vaccine U.S. researchers have developed against bird flu.  This means it should work against the bird flu, too, if production can be expanded should a pandemic occur.

http://www.voanews.com/english/archive/2005-10/2005-10-05-voa30.cfm?CFID=24360684&CFTOKEN=54982953

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: March 06 2008 at 9:31am
Lets look at it from a different perspective. If Avian does goes pandemic and takes out 89% of the population that that will be an end to man made global warming. Avian flu can be an environmentalist blessing.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote roni3470 Quote  Post ReplyReply Direct Link To This Post Posted: March 06 2008 at 10:57am
Albert,
Can you tell me how far ahead with overal cases (not fatalities) we are this year compared to last year?  YOu had once said that if it didn't mutate into an easily human trasmissable disease last year that you thought it would not ever, do you still hold that view?  Just wondering.
 
Thanks, Roni
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: March 06 2008 at 12:30pm
Originally posted by roni3470 roni3470 wrote:

Albert,
Can you tell me how far ahead with overal cases (not fatalities) we are this year compared to last year? 
 
 
Hi Roni, we are only up 2 or 3 cases as compared to 2005, so that could obviously change.  The CFR is up, but that could also change.   However, to get the CFR number down, it would probably take a sizeable outbreak in the near future similar to what we saw in Turkey and Pakistan.  So either the virus has become more lethal, or we will see a localized outbreak of around 10 - 15 people sometime this year. 
 
 
 
 
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Albert View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: March 06 2008 at 1:08pm
Originally posted by roni3470 roni3470 wrote:

Albert, 
YOu had once said that if it didn't mutate into an easily human trasmissable disease last year that you thought it would not ever, do you still hold that view? 
 

I'm not sure Roni.  Given the history of flu pandemics and how often they occur (one no later than every 40 years), we should have probably had "a pandemic" of some sort by now.  Not necessarily an h5n1 panflu, but any pandemic.   Since we have not had any panflu whatsoever, we have to ask ourselves, what has changed, or what has possibly effected the timeline?  The only thing that has changed over the last 130 years is the mass culling that has taken place over the last few years.   So because of the "timeline", and where we're at now with no other type of Panflu, my guess is that h5n1 was in fact meant to be the next panflu.   This is just my opinion, but the mass culling has probably been effective in slowing down the evolution of h5n1 and without the culling, it would have already made the jump by now. 

 

The question is, how long can we delay nature from evolving? Are we fighting a battle that we can't win, but can only delay?  The bottom line appears to be, if we ever let up on the mass culling at any point, that's all it would probably take.

 

Anyway, have said all of that, the culling will probably delay it by 3-5 years as of 2005. 

 

 

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Post Options Post Options   Thanks (0) Thanks(0)   Quote ShaRenKa Quote  Post ReplyReply Direct Link To This Post Posted: March 09 2008 at 6:45pm
Originally posted by BoJingles BoJingles wrote:

Lets look at it from a different perspective. If Avian does goes pandemic and takes out 89% of the population that that will be an end to man made global warming. Avian flu can be an environmentalist blessing.

    I again agree with you Bo..something has to break somewhere! Between all these diseases,Global warming, Global market not looking good, food shortages, oil shortages ect...it's a forsure thing something has to give. And it will be us, the people of this great planet. Those who are blessed enough to survive it all will have to pick up the pieces, and hopefuly will have learned from the mistakes made and not repeat them. But I doubt it .....
Sha Ren Ka
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Post Options Post Options   Thanks (0) Thanks(0)   Quote PandemicsHappen Quote  Post ReplyReply Direct Link To This Post Posted: March 09 2008 at 7:26pm
Here is a graph of the Cumulative Number
of Confirmed Human Cases of Avian
Influenza A/(H5N1) Reported to W.H.O.
per Country as of February 15th, 2008:

Calculated that we are 25% through the
year 2008, we are below last years
numbers for cases and fatalities:
Source:
http://www.who.int/csr/disease/avian_influenza/country/cases_table_2008_02_15/en/index.html

    
    
    
    
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