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Online Discussion: Tracking new emerging diseases and the next pandemic

Mechanics of BF Infection, Why H2H Rare

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bruss01 View Drop Down
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    Posted: March 22 2006 at 2:33pm
Interesting article.
 

In an interview, Dr. Kawaoka said the finding also explains why most of the human cases of infection with the highly pathogenic avian flu H5N1 have been among people living or working in close contact with infected birds.

To get the virus deep into the lungs, where it can infect its preferred cells, requires extensive exposure, Dr Kawaoka said. That's unlike the typical human influenza virus, which infects cells found high in the airway and can be easily spread by coughing and sneezing.

"Deep in the respiratory system, receptors for avian viruses, including avian hemagglutinin type 5 (H5) neuraminidase type 1 (N1) viruses, are present," he said. "But these receptors are rare in the upper portion of the respiratory system."

"For the viruses to be transmitted efficiently, they have to multiply in the upper portion of the respiratory system so that they can be transmitted by coughing and sneezing."

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Post Options Post Options   Thanks (0) Thanks(0)   Quote maddie-n-emmy Quote  Post ReplyReply Direct Link To This Post Posted: March 22 2006 at 3:48pm
Ok maybe I'm way off base here but doesn't this mean that in order to gain efficient h2h, this virus would need to mutate to gain the ability to attach to cells in the UPPER repiratory tract.....which, it seems to me, would greatly decrease the mortality rate...due to the attaching in the deep lung tissue is what makes this so deadly?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote RicheeRich Quote  Post ReplyReply Direct Link To This Post Posted: March 23 2006 at 5:20am
I think that H5N1 changing it's "jumping off point" to a higher area of the lungs would be very bad news. It would then be easily transmitted H2H, and would still likely invoke the strong response in healthy humans (lungs full of crap), still cause viral pneumonia, with bacterial pneumonia following shortly behind.
 
As long as the new (hypothetical) strain of H5N1 still had the ability to shut down our immune systems, we would continue to be in deep poop.
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UPDATED: 09:16, March 24, 2006 (excerpt)

Now, two deadly strains of virus
       

The fight against avian flu is like an "endless hurdle race," once you cross one, there is another.

That is the challenge facing the world, Julie Hall, co-ordinator of communicable disease surveillance and response in the Beijing office of the World Health Organization (WHO), said yesterday.

During the Consultation on Social Determinants of Health in the Western Pacific Region, WHO officials told their audience that the disease is still dangerous, the virus is mutating quickly, and the prospects for man-to-man transmission, though not detected till now, remain highly likely.

"Change is the only constant. Only time will tell whether the virus evolves or mutates in such a way that it can be transmitted from human to human efficiently,?said Garten.

"We do not know which of these clades, or either of these clades, will cause a pandemic. But it is certainly important we have a library or factual vaccine developed, based on clade 1 and clade 2,"Julie Hall noted.

So, it is also important for scientists to continue to collect samples of viruses, testing them and developing vaccines based on them, she said.

In terms of developing pandemic vaccines, she said that scientists can not currently develop a vaccine that will definitely fight against the virus that might cause a pandemic.

Scientists are producing vaccines based on clade 1 and 2 now. This is an ongoing process, she said.

"So every time we see new different strains of viruses in particular areas, we have to develop something that can be added to that base vaccine,?she noted.


http://english.peopledaily.com.cn/200603/24/eng20060324_253138.html


    
    
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Post Options Post Options   Thanks (0) Thanks(0)   Quote wannago Quote  Post ReplyReply Direct Link To This Post Posted: March 23 2006 at 10:00pm
On the ABC radio yesterday a doctor was advising  Australians (of all ages) to get this year's  flu shots  not because it prevents BF but because all flu types initially show the same symptoms. 

I'm understanding this as:  get the flu shot so that if you come down with flu, leg it to the hospital cos it's  probably bird flu  Dead 
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Friday, March 24, 2006; Page A02 - WASHINGTON POST

"If we take everything we know about influenza virology now, take everything I know about influenza virology now, and formulate a model of the next pandemic, it would look like this," Taubenberger said as he displayed a large question mark on the screen.

In fact, Taubenberger had evidence that the bird flu might have some difficulty mutating to a human form. But that did not entirely satisfy David Nabarro, the U.N. coordinator for influenza. "It's a very virulent and horrible virus," he said. "It has also moved into 20 countries during the last six weeks and I just checked the reports this morning: Overnight we have reports of it moving into the Gaza Strip and also moving into settlements in the West Bank."

Nabarro spoke of "mounting concern" across the world. "We are very vulnerable," he warned. "Most of us, I think, feel that it's best to be preparing to hunker down."



http://www.washingtonpost.com/wp-dyn/content/article/2006/03/23/AR2006032301783.html


    
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"We are very vulnerable," he warned. "Most of us, I think, feel that it's best to be preparing to hunker down."
 
 
 
 
Now there is a very interesting idea...hummmm...best I prepareWink
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Post Options Post Options   Thanks (0) Thanks(0)   Quote seesthelight Quote  Post ReplyReply Direct Link To This Post Posted: March 24 2006 at 6:01am
Originally posted by bruss01 bruss01 wrote:

Interesting article.
 

In an interview, Dr. Kawaoka said the finding also explains why most of the human cases of infection with the highly pathogenic avian flu H5N1 have been among people living or working in close contact with infected birds.

To get the virus deep into the lungs, where it can infect its preferred cells, requires extensive exposure, Dr Kawaoka said. That's unlike the typical human influenza virus, which infects cells found high in the airway and can be easily spread by coughing and sneezing.

"Deep in the respiratory system, receptors for avian viruses, including avian hemagglutinin type 5 (H5) neuraminidase type 1 (N1) viruses, are present," he said. "But these receptors are rare in the upper portion of the respiratory system."

"For the viruses to be transmitted efficiently, they have to multiply in the upper portion of the respiratory system so that they can be transmitted by coughing and sneezing."

 
Here are my reasons why none of the above means anything ...
 
Osterholm:  The 1918 virus jumped right from birds to people. There was no combining with other viruses. One of the problems we've had is, if you look at the 1918 virus and this one, they're in essence kissing cousins. Genetically, these things look very similar. Frank Obenauer and colleagues just published a paper the last week of January in Science, and they actually have gone back and looked at the full genetic codes for 169 avian virus genomes, dating way back. They looked at 2,169 distinct avian virus genes. There were two viruses that showed a protein tag at the end of one of the nonstructural genes that actually looks to help cause the cytokine storm that makes this a unique illness.* And guess which two viruses they were: 1918 H1N1, and the current H5N1.

Then, when you look at the Turkey virusóthat thing mutated. This is the case of the young girl in Turkey who died from her infection, and so did her uncle. We definitely have clusters where it's not just bird contact [spreading the virus]. The uncle's only exposure to this virus was riding in the ambulance with her from hospital one to hospital two. He became ill three days later and died. Her virus has now been fully sequenced, and there were three mutations that occurred in that virus, between the bird version and hers. One was the substitution of a glutamic acid with lysine at the 223-hemagglutinin position. That is what changes it from a bird-receptor virus to a human-receptor virus. The second thing was two other substitutions that served to make it look more and more like a human virus.
So this thing just continues to march. Changes are occurring in it all the time. [Human-to-human transmission] could happen tonight. Or it may never happen. But I don't know what will keep it from happening, because when you have this kind of worldwide bird population as we do nowóChina's a good example. In 1969, during the last pandemic, China only had about 12 million chickens. Now it's got over 15 billion.

http://citypages.com/databank/27/1320/article14219.asp


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"They say that an infinite amount of monkeys typing at an infinite amount of typewriters will produce literature greater than Shakespeare." Or lycris for Modona tune.

I wonder if the same line of thinking is applicable with H5N1. The only thing I know for certain is, the virus has been around for a long time, its not going away and is constantly evolving, just like Modonna.

    
    
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Post Options Post Options   Thanks (0) Thanks(0)   Quote RicheeRich Quote  Post ReplyReply Direct Link To This Post Posted: March 25 2006 at 5:52am
I'm not planning on getting the flu shot until it's custom-designed for H5N1 prevention. For now, I am sticking with the pneumonia shot. It makes more sense to me.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote seesthelight Quote  Post ReplyReply Direct Link To This Post Posted: March 25 2006 at 6:10am

Don't want to burst your bubble BUT...The bacterial pneumonia shot may not be a bad idea but remember it is not the bacterial type pneumonia that is the problem with H5N1 -it is viral  pneumonia and the cytokine storm , high temperature- mulitple organ failure which ultimately kills-so the bacterial pneumonia shot is no panacea.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote oknut Quote  Post ReplyReply Direct Link To This Post Posted: March 25 2006 at 6:35am
Not sure what happened, but I have been sick since getting the annual flu shot in October. Our city health department gave out free shots for 2 days. We've been getting the flu shots for probably 10 years now and have never become ill from them. Husband and I both got sick after getting the shot. He was well in a few days and I have been sick for 5 months now.
We both had the pneumonia shot less than 5 years ago.

I finally went to the doctor yesterday and although my doc didn't take any swabs or blood, he gave me a chest xray and told me I have pnuemonia. He gave me a 7 day supply of antibiotics and told me to come back next Friday. If I'm not over this, I will insist on some tests.

Just my personal opinion, but I feel there was something very wrong with the flu vaccine I received in October and I will NOT trust any other vaccine in the near future.
Hubby thinks I'm crazy, but I suspect the "free" flu shots were not so free afterall. Of course, he hasn't been sick for the past 5 months.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Kirby Quote  Post ReplyReply Direct Link To This Post Posted: March 25 2006 at 7:16am
 We are seeing many cases of rapid flu tests that are positive for Influenza A in patients who got this season's flu vaccine and still got the flu. 
 
 The vaccine is prepared based upon info from other countries and what is being seen there, months in advance of the flu season in the US.  It is based on what they think will be the predominate strains for the season. 
 
 When giving the vaccine, I always advise folks that the vaccine takes at least 2 weeks to become effective so they may get sick with the flu during the period before it is really protecting them if they are exposed to the virus, and that there are strains of the flu out there that the vaccine may not cover, as is happening this year. 
 
 My son got the flu vaccine in November and is currently sick as a dog with the flu.  I found and collected a dead sparrow and crow last week; however he wasn't home at the time.  Now, if I was not well informed and was an alarmist, I would be freaking out but folks do get the flu at times in spite of receiving the vaccine.
 
It IS aggrevating to have taken the vaccine to be proactive then get sick, anyway, though! 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote oknut Quote  Post ReplyReply Direct Link To This Post Posted: March 25 2006 at 7:41am
Perhaps I am being paranoid. That would be the best scenario. I'll try to stop speculating why so many people I know have been so ill and developed pneumonia this year, despite having both the flu shot and the pneumonia shot.

I apologize for posting my paranoid thoughts on the issue. Still not likely to get another flu shot in the future, but that's a personal decision.

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It's both interesting and aggravating to see these in the press: already convinced, I find it interesting.  But, also this week, I've heard several people that I've been trying to nudge toward prepping cite these type articles that came out this week back at me.  Cry  Angry  (Im not sure which)
 
 
I think we are seeing media management with these types of articles in the wide press.  This and the ones that say "No H5 subtype has ever infected humans", etc.  The conclusion does not follow the argument.  The fallacy of the excluded middle.
 
The actual message means nothing: the implied message is "don't worry".
 
Of course it's poorly suited: that's why it hasn't done it.  Yes, no H5 has every infected people, that's why they are worried.
 
It speaks twisty, my precious and bends it's words to tricks us.
 
There should have been a big disclaimer at the end:
 
"Avian Flu is a highly  dangerous and pathological organism which could result in the death of you, your family, your loved ones or your neighbors.   People investigating Avian Flu should consider all aspects of Avian Flu and choose their actions carefully.  Past performance of Avian Flu is no guarantee of future returns or performance.    This offer of re-assurance from your local media outlet is not a guarantee  nor are any given, offered or implied by this article."
 
 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote cisne Quote  Post ReplyReply Direct Link To This Post Posted: March 25 2006 at 12:18pm

I was not happy with the way the press touted this article.  It was if the media was trying to say"see, it's alright, you don't have to worry."  The lethality of this virus and its transmissability are two very different things.  This virus has the ability to keep our immune response from stopping its replication -- that's why the body keeps pushing out cytokines, because our body doesn't sense a reduction in viral load.

Changing the site where the virus attaches in our systems doesn't have anything to do with this nasty little ability to sabotage our immune response.  Chaning the site of infection just makes it easier to spread.
There was another article (I'm trying to locate it) that spoke about this ability of H5N1.  If I can relocate it, I will post the url.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote cisne Quote  Post ReplyReply Direct Link To This Post Posted: March 25 2006 at 12:24pm
Here's the link to the article published in Nature Medicine.
 
http://tinyurl.com/kk4f9
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Post Options Post Options   Thanks (0) Thanks(0)   Quote seesthelight Quote  Post ReplyReply Direct Link To This Post Posted: March 27 2006 at 7:46am
Originally posted by cisne cisne wrote:

I was not happy with the way the press touted this article.  It was if the media was trying to say"see, it's alright, you don't have to worry."  The lethality of this virus and its transmissability are two very different things.  This virus has the ability to keep our immune response from stopping its replication -- that's why the body keeps pushing out cytokines, because our body doesn't sense a reduction in viral load.

Changing the site where the virus attaches in our systems doesn't have anything to do with this nasty little ability to sabotage our immune response.  Chaning the site of infection just makes it easier to spread.
There was another article (I'm trying to locate it) that spoke about this ability of H5N1.  If I can relocate it, I will post the url.
 
________
 
I agree with you Cisne,,,what was disturbing is that the articles that they keep pumping out really do try and twist the real issues and are also trying to sway people's minds into thinking we do not have to be concerned ....this is not the truth and it bothers me that they can print that.
 
The pathogenic lethality is the issue and it is not the transmission since we know the virus is continuing to evolve and before it lessens its highly pathogenic strain it will continue to kill and clusters may turn into a sustained transmission of the virus which is what has been the greatest concern from the beginning of this.
 
Articles like those are doing people a disservice.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote bruss01 Quote  Post ReplyReply Direct Link To This Post Posted: March 27 2006 at 8:44am
Guess I should have been more explicit when posting this about my own views on the subject.
 
Some of the nay-sayers say you only get Avian Flu from close exposure to birds.  I thought this article did a good job of explaining why this has been the case in MOST CASES - SO FAR.  I also thought the article mentioned that with sufficient mutation, the virus was capable of becomming H2H transmissible.
 
Apologies if some took this as a "Don't worry, you won't get it..." type of posting.  Probably should have also cut and pasted this part as well:
 
"On the other hand, Dr. Kawaoka said, only "a couple of mutations" would be required for the virus to change its preference. He added that surveillance for such changes is relatively easy.

"Identification of H5N1 viruses with the ability to recognize human receptors would bring us one step closer to a pandemic strain," he said. "

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Post Options Post Options   Thanks (0) Thanks(0)   Quote seesthelight Quote  Post ReplyReply Direct Link To This Post Posted: March 27 2006 at 10:00am

Wild and domestic animals are getting the virus, they will continue to spread it   ...Effective means of control of its spread and effective treatment is the only thing that will help us ,short of the virus becoming less pathogenic/ or less deadly with time.

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