Are you ready for the next Flu Pandemic

welsh

welsh

Junkmaster
Ok, so it's the flu-

For most people the flu means that for a couple of weeks you feel like shit. Maybe you sneeze, headaches, fever, body aches and you might even throw up or have a bad case of shits.

Yet one should not discount the flu. Near the end of World War I an influenza outbreak (as the flu is often caused) killed nearly 50 million people- more than World War 1 itself.

And now they say we are in for another round of Flu. A little Avian Bird Flu got you down?

Does your country have enough vaccine?

Flu vaccine

Preparing for a pandemic

Sep 22nd 2005
From The Economist print edition

More vaccine is needed to prepare the world for an influenza pandemic

IT IS hard to imagine that the aches and pains that most people know as flu could mutate into a superflu that might kill tens of millions of people within two years. And yet, if superflu strikes—as it has done three times in the past century—that is what may well happen. In the global influenza pandemic of 1918, 25m-50m people died. Many scientists now believe that another influenza pandemic is inevitable some time soon.

These concerns might be little more than another background worry if it were not for the fact that there is currently a strain of bird flu in widespread circulation to which humans have no natural immunity. This strain has killed more than 60 people so far, about half the number infected. Small pockets of human-to-human transmission have already been seen, and health officials are worried that the widespread geographical extent of bird flu means that it is not a question of if a strain emerges that can be transmitted easily between humans, but when.
Click to expand...

So 1/2 of the people that are infected end up dead. Hmmm....

If only we could kill all the birds? Unlikely if you paid attention to the beginning of Hitchcock's The Birds.

Worried scientists have finally managed to catch the attention of politicians. Last week at the United Nations General Assembly, George Bush announced a new international partnership to address avian and pandemic influenza. World health ministers will meet in Canada next month to discuss how to pool resources, boost surveillance and improve the capacity to contain and respond to an outbreak. The World Health Organisation (WHO) wants more governments to draw up preparedness plans (only 40 have these so far) and agree on how they will co-ordinate their responses.
Click to expand...

This is W- the fellow who was on vacation when Katrina hit New Orleans, who forgot to plan for the post-war in Iraq before the invasion. So if he's doing something about this now it means either-(a) Shit this is really fucking bad, or
(b) We're already in deep shit and don't know it yet.

One leading concern is the scarcity of flu vaccine. Although the WHO's new global stockpile of anti-viral drugs is a good first line of defence, the only sure way of protecting billions of people against superflu is to vaccinate them. Few people would have natural immunity.

It could also take six months from the appearance of the first superflu strain to produce a vaccine. In that time, large numbers of people would be likely to die. Anti-viral drugs rushed to the location of any outbreak might delay its spread by a month. But, even with such a delay, the world is woefully unprepared for a pandemic. Its entire capacity for flu-vaccine production is only 300m shots a year (each containing 15 micrograms of the active ingredient known as antigen). Yet in the case of superflu, several billion people would need vaccination—and they may need two shots at higher doses.

While most people only need one shot of vaccine against chicken pox or measles to have life-long immunity, flu is different. The vaccine must be produced each year from scratch because, each year, the influenza virus changes.

Vaccines are complicated to produce and prone to hit production problems. To make a flu vaccine, the virus must be grown on fertilised chicken eggs without allowing the growth of any other organisms that might contaminate the product. The eggs must be specially produced to assure the health of the hens and the sanitation of supply.
Click to expand...

So wait a minute. Our pharmaceuticals can spend millions investing in viagra but not on flu vaccines?

Reliance on eggs is the rate-limiting step in flu-vaccine production. The eggs take weeks to grow. Then the virus is extracted from the cells it has attacked, and inactivated. When the virus is injected into a subject, it stimulates an immune reaction in the form of antibodies, which would protect that person against the real live version of the virus.

Most of the world's flu vaccine is produced in nine countries: Australia, Britain, Canada, France, Germany, Italy, Japan, the Netherlands and the United States. Europe produces 70% of the vaccines. And Europe's vaccine producers are worried. Without international agreements now, they say there is a high risk of inadequate, inequitable and delayed supplies of vaccines. Among public-health officials and vaccine manufacturers, there is a widespread assumption that, during an outbreak, countries with production facilities would declare a national emergency and limit or ban the export of vaccine to other countries. That might be good for people living in the nine countries on the list, but it would leave the rest of the world without any vaccine at all.
Click to expand...

Whichmeans that if you live in the developing world, you're kind of fucked.
Again.

Luc Hessel is the director of public affairs at Sanofi Pasteur, a vaccine manufacturer in France. He is also in charge of pandemic influenza at European Vaccine Manufacturers, the vaccine-industry's trade association. He says that the race to prepare for the next strain of superflu is “both a sprint and a marathon”.

The spread of bird flu has recently forced a bit of strategic sprinting. America's National Institutes of Health has paid Sanofi Pasteur and Chiron, a manufacturer based in Emeryville, California, to make prototype vaccines against H5N1, the strain of bird flu that is currently circulating. Should superflu emerge from this bird flu, the hope is that these vaccines would confer enough resistance against the new strain of superflu to save lives. And having a prototype or a pre-approved vaccine would speed the drug-approval process. In Europe, there is no obvious way of funding such short-term development work. Dr Hessel says that the vaccine industry's association is in “close contact” with the European Commission about plugging this obvious gap.

The American work has already produced some important findings. A vaccine has been developed, and the authorities have ordered small amounts to protect some health workers. The most important finding, though, is that large quantities of antigen—the active ingredient—are needed to confer resistance. For protection, two shots of 90 micrograms are needed. At this concentration, America could protect only 5% of its population.

A novel solution to this problem is emerging from European laboratories. Rino Rappuoli, the chief scientific officer at Chiron, is one of those working on a way to make vaccines protective at low doses by delivering the injection along with something called an adjuvant. This makes the vaccine linger at the site where it has been injected, and causes an enhanced immune response. Dr Rappuoli says that if an adjuvant is used, half the normal flu dose would work. This technique could thus be used to double the world's capacity to produce a superflu vaccine.

Adjuvants also appear to stimulate longer-lasting immunity. In work published earlier this year in the Journal of Infectious Diseases, Dr Rappuoli's group studied samples from people involved in a vaccine study after the 1997 outbreak of bird flu in Hong Kong. They found that people who had received adjuvanted vaccine years ago are still significantly immune to the strain of bird flu currently circulating.

The next step is to test a vaccine against H5N1, the current strain of bird flu, with an adjuvant. John Treanor, professor of medicine at the University of Rochester, says that there are three candidate adjuvants. Two are proprietary products (owned by Chiron and GlaxoSmithKline) and so less attractive. The other is alum, a salt containing aluminium. It has been used widely in vaccines, although not in flu vaccines, so development work is needed.

Despite all the promise of adjuvants, some obstacles remain. They can cause mild localised reactions, and they are only licensed for use in flu vaccines in 20 countries, including Italy—where Dr Rappuoli is based and where Chiron has treated 18m people with adjuvanted vaccine. Nevertheless, given their substantial advantages, adjuvants are certainly worth pursuing as a matter of urgency.

Other ideas under scrutiny include ways to use less vaccine at the injection stage, and injecting at different sites to stimulate a greater reaction—such as into the skin itself. But Klaus Stohr, who runs the WHO's global influenza programme, is adamant that the only sure way to answer the unknowns about pandemic influenza is for governments to provide a better environment for flu-vaccine development, and to increase the uptake of seasonal vaccines where this fits in with national health priorities. By this, he means that governments need to buy all of the seasonal vaccine that national health agencies have said would be worthwhile.

It would also help for governments to give the manufacturers more long-term certainty over the amount of vaccine they plan to buy each year. Canada, for example, recently signed a ten-year agreement with a manufacturer for its seasonal vaccine supply, and the country also pays an annual “pandemic readiness fee” which stipulates the company has the capacity to produce 8m doses of vaccine per month for four months.

In the longer term, there will be more options. Flu vaccines could be grown in a vat of cells rather than laboriously in eggs, which would make them easier to produce in volume. And the novel approaches that are today on the drawing board may mean that, one day, neither flu nor superflu would be a problem. Some people are working on a universal vaccine, a shot that is given once and which works for ever against all flu. Others are trying to devise an inhaled drug that coats the cells of the lungs and prevents the virus from gaining access. But this is the work of the superflu marathon runners. Before they reach the finishing line, the sprinters may be called upon.
Click to expand...

Or maybe the best defense is to get yourself on a small farm, start growing your own food, and stockpile the shotguns and canned food?
 
Wow i guess those vaccinesellers are realing trying new things now that copper is gone.
 
Nice post, and yes, it is more than a little scary. While I may not harbor the hatred for W's ineptitude as you (I prefer to spread it out over the whole lot of the administration) there is more than a little cause for alarm, after all foresight isn’t there strong suit, so I can't help but think the worse is already here and just hasn’t broken out yet.

And I won’t start on pharmaceutical companies... Or even better the pharmacon/ insurance/government triangle, as it tends to remove my generally calm exterior and lead to me needing to be sedated; it’s even worse than my petrochemical/automotive industry/ government triangle tirade. Puts me in a killing mood to see capitalism and corruption outweigh humanity and compassion.
 
I don't bathe twice a day like the rest of you germaphobes, so my immune system will be kicking ass while the rest of you bite the dust.

Feel free to dance on my grave, though, should I keel over.
 
Welsh said:
Yet one should not discount the flu. Near the end of World War I an influenza outbreak (as the flu is often caused) killed nearly 50 million people- more than World War 1 itself.
Click to expand...

Yes, in a hunger-ridden continent, where basically, every country's population was poor and starving after a ravaging war. Do people in Africa die of the same causes that people in rich countries, in which basic medicine and proper alimentation is easily available? No. A lot of the diseases could be relatively cheaply cured, hence all the "Save A Child For $20" charity programs you usually get on airliner jets.

Every year, we get the same news. "OMG This time it's teh killer strain of flu!1". They could diversify a little, it's getting tedious.
 
On the other hand, if we could get something like the "Mexican Flu" it'd be a great excuse to get rid of Carlos Mencia.
 
Great post Welsh. I also enjoyed the stuff about antigens and things. Always good for a freshman yearish snicker!

VIROLOGIST MODE:

The bird flu evolved in SE because a bird (or human, whichever) was infected in the same cell with both an avian influenza bug and a human influenza bug. Under these circumstances the surface antigens of the two strains co-mingled. The resulting influenza bug had aspects of both human-specific and bird-specific virulence. This means two things:

1) the bug is now theoretically able to infect both humans and birds, exposing either to virulence factors that neither are able to combat effectively with the battery of antibodies they have developed against normal flu strains. Bird flu factors are completely foreign to humans, human factors completely foreign to birds. Hence the death rates among YOPIs

2) This same multiply infective ability is also the new bugs greatest weakness. Because it doens't carry the complete set of human or bird attachment and fusion proteins, it cannot attach to either species as well and the bird or human specific bug.

There are multiple consequences of this. First, YOPIs (Young, Old, Pregnant and Infirm) with their compromised immune systems, are much more susceptible to this new bug, because the bug doesn't have such a steep infectivity hill to climb if your immune system is so badly off.

Conversely, if your immune system is healthy your chances of acquiring avian flu is reduced (important caveat: this is acording to the people, true virologists, who I know and agree with) because it is easier to fight off the bug since it cannot attach and fuse as easily, because it lacks the complete set of human attachment factors.

The net result is that if you are already sick, the avian flu may very well be lethal to you. But if you are already healthy (or at least have a healthy immune system) you can probably shrug it off. Plus, if you can shrug it off you've just developed lifelong immuneity to this particular strain.

Important caveats continued: The bird flu evolved because of the close association of birds and people in SE Asia. The flu had many opportunities to comingle and change. This means that only in environments where there are large viral loads in the population of either humans or birds (or both) are the chances of an epidemic beginning high. You need lots of sick people releasing lots of virus for a critical mass to exist, able to spread to lower viral load areas.

This is why so many millions of birds have been culled in SE Asia where the scares have occured. It is to reduce the viral load and thus eliminate the incubation conditions needed for epidemics.

/VIROLOGIST MODE

Questions?
 
Nice post Murdoch-

So the ones at greatest risk are,as Wooz suggests, the poor, the elderly, children and people that are already malnourished?

What are the chances of it spreading across continents?
 
I'd imagine it'd be pretty good depending on the migration season, but that's something Murdoch can probably better touch on than I.
 
The virus spreading (in its current perutation) across contnents is only possible in one of two ways. First is that an epidemic in SE turns into a pandemic. Then the viral load will be of critical mass to infect healthy people, who board airliners and boats, carrying the virus to new areas. Because strains tht can survive in healthy individuals are selected to survive in healthy people (via selective pressures brought on by the critical mass in SE Asia) it can now infect everyone else.

The other option is a flood of immunocompromised refugees flooding into other parts of the continent-think China proper or India, where the virus develops in new populations and can thus now follow path a above.

Fun huh?

EDIT: Article on Brid Flu in Indonesia Notice how the victims are mostly YOPIs.
 
I got a question Murdoch. So if you are infirmed and your ability to fend off the “fusing” of this bug is weak you could get it and then die. If your system is strong and you can resist it you wont get it and thus may live. However what if a reasonably healthy person gets this bug? Is it an always fatal kind of thing so if you get it your toast and your only chance of survival is the aforementioned immune system that is strong enough to resist the “fusing” of the bug?

Oh, on a side note, ponder for a moment this super bug getting into one of our industrial chicken plants. Spreading and mutating all the while being bombarded with antibiotics making it tougher and more resilient to medication, then breaking out… Wouldn’t it be ironic if the lowly and abused chickens managed to kick our ass and bring about the downfall of humanity?
 
Um. Chickens don't get bombarded by antibiotics in industrial, cheap-producing chicken meat. The only thing they get bombarded with is minerals, hormones and nutrients in liquid form, all in liquid form over their own shit on a producing line.

A "reasonably healthy" person wouldn't have the bug fusing, as the immune system would be working enough not to be infected with any flu in the first place. The rest of the "healthy" persons to be infected with it wouldn't have their immunity systems on a sufficient level to "fend off" the flu, wouldn't they?
 
Wooz said:
Um. Chickens don't get bombarded by antibiotics in industrial, cheap-producing chicken meat. The only thing they get bombarded with is minerals, hormones and nutrients in liquid form, all in liquid form over their own shit on a producing line.
Click to expand...

Please stop spoiling my "end of the world by mutated viral death chicken story" with logic and fact. :P

Wooz said:
The rest of the "healthy" persons to be infected with it wouldn't have their immunity systems on a sufficient level to "fend off" the flu, wouldn't they?
Click to expand...

Yes, that was my question to Murdoch. I mean if its just like the yearly flu, so what, I have had it a couple times and shrugged it of. But with all the fuss about it is it just another flu like the one that goes around every year? Or is it a super mega super death ebola flu that if you do catch it your landfill...
 
Please stop spoiling my "end of the world by mutated viral death chicken story" with logic and fact.
Click to expand...

Well, by empirical knowledge, I happen to have seen a chicken meat farm. No, really. It really is a vaguely oval, closed production line in which birds are put on and fed cellullose with nutrients all day. In a certain time of the line, they pass under a nutrient bath, in which the cellullose they shit is covered with aliments.

This is not a joke.

Or is it a super mega super death ebola flu that if you do catch it your landfill...
Click to expand...

I'll let you know as soon as I've read the WHO report.
 
Here's a link to a BBC story Q and A portion. It can explain this much better than I ever could.

This in particular is what concerns me:
Q: Can avian flu be passed from person to person?

There are indications that it can, although so far not in the feared mutated form which could fuel a pandemic.
Click to expand...
Again, this is because the virus isn't very good at infecting non-immunocompromised people. Once it can though...
 
You must log in or register to reply here.
Back
Top