Avian Flu - How bad could it get?

[donaldbuzz&minnie]

Any mouse-loving epidemiologists or infectious disease specialists out there who can answer a question for me? I don't want to blow the avian flu out of proportion, but I am taking it seriously. I know that it could be as deadly as the Spanish Flu of 1918, which killed 2.5% of its victims, but the avian flu in its present form seems to killing 50% of the people who get it. I know it would be likely to become less virulent if it mutates into a human to human strain. Is there any chance it could stay almost as lethal as it is now, or does the science say it would almost certainly drop into the single digits?

Thanks for any help you guys can give me!

 

[Christine]

I can't really answer your questions but, if you a really interested in knowing all about the flu, what could possibly happen, and exactly *why* the Spanish flu (which really didn't start in Spain) was so bad, then you should go out and buy the book "The Great Influenza" by John Barry.

There is a lot of extraneous stuff in the book that probably didn't need to be in it and it is tough to get through, but it actually put my mind at ease a bit in regards to a pandemic. Now, I'm not saying that he "poo-poohs" a pandemic--he doesn't at all, but when you see how thoroughly atrocious the U.S. handled the 1918 pandemic, well, I think we've learned a lot since then.

If you just continue to sift through your daily newspaper reports and watch the nightly news, you're going to get really scared.

 

[donaldbuzz&minnie]

*bump*

 

[DawnCt1]

*bump*

I just PM'd you.

 

[DawnCt1]

I attended a symposium for physicians on the Avian Flu Friday night that was very enlightening. (I went because I knew the food would be good) We will definately have a "panzootic" because it is already spreading around the world in the avian population. This will have a major impact on agriculture. Ultimately it will become a human health concern. DH talked about hospital/private practice preparedness and the impact on the community. The point that he wanted to highlight is that in this day and age, hospitals operate on the "business model" and do not stockpile a lot of supplies. There is a danger that there will be a supply shortfall just when serious demand peaks. In a serious pandemic, 40% of the population will not be at work. That impacts law enforcement, truckers, warehouse personnell, food handlers, grocers, etc. That type of social disruption is not something that I frankly thought about. Also, healthcare workers. When a vaccine is developed, and there are great possibilities. One company in particular can develop a recombinant vaccine 6 weeks from gene identification to vaccine and then 8 weeks from gene ID to human injection. It isn't licensed yet but the FDA has them on track for perhaps 2007/08. When a pandemic hits (If isn't really operative here), health care workers will be the first vaccinated for obvious reasons. DH pointed out that private physicians, hospitals, etc need to start preparing their workers now as to what there responsibilities will be in terms of showing up for work. He said the "fear factor" and family illness may keep a lot away just when hospital demand peaks. In anticipation of isolation gowns, his hospital will order a million and a half gowns and 125 (I think) disposible ventilators to have on hand.

 

[N.Bailey]

I just PM'd you.

If you PM'd information on the flu, could you PM it my way too, Dawn? If it was a personal PM though, I apologize.

EDIT: Never mind about the PM. I see you've posted your thoughts and concerns about the possibilities.

 

[mafibisha]

When a vaccine is developed, and there are great possibilities. One company in particular can develop a recombinant vaccine 6 weeks from gene identification to vaccine and then 8 weeks from gene ID to human injection. It isn't licensed yet but the FDA has them on track for perhaps 2007/08. .

EXCELLENT information Dawn, thank you.


The above is also a great reason NOT to buy GENERIC drugs!

The generic companies will NEVER, EVER create a life-saving or extending drug such as this vaccine! (they don't create, they copy!)

Only the BRAND NAME major companies will. The public MUST understand this if we expect new MIRACLE DRUGS!





(getting off my soap box now, putting on my flame-retardant suit... )

 

[phamton]

I just still have visions of the swine flu scare in 1976. Almost everyone was panicked by this and a nationwide innoculation was set up. At that time, we were warned that it would be as bad as the 1918 flu epidemic and millions would die. It turned out to be a fiasco.

If you aren't familiar with this, just type in "swine flu" into Google and search.

 

[DawnCt1]

I just still have visions of the swine flu scare in 1976. Almost everyone was panicked by this and a nationwide innoculation was set up. At that time, we were warned that it would be as bad as the 1918 flu epidemic and millions would die. It turned out to be a fiasco.

If you aren't familiar with this, just type in "swine flu" into Google and search.

Well, it will be a lucky break if its a repeat of 1976, won't it? We do know that pandemics occur every 10 to 40 years.

 

[DawnCt1]

EXCELLENT information Dawn, thank you.


The above is also a great reason NOT to buy GENERIC drugs!

The generic companies will NEVER, EVER create a life-saving or extending drug such as this vaccine! (they don't create, they copy!)

Only the BRAND NAME major companies will. The public MUST understand this if we expect new MIRACLE DRUGS!



(getting off my soap box now, putting on my flame-retardant suit... )

There has been some rejoicing in the media as of late, about the decrease in profits for the "evil" drug companies. The impact of this is less money for research and development. That is NOT a good thing.

 

[phamton]

We do know that pandemics occur every 10 to 40 years.

Is that a fact? I suspect with the advancement in medicine in the last hundred years that the facts of years ago might not be the fact of today. It was a fact in my childhood that many would die of polio, TB, and smallpox. My grandmother died of pneumonia where now, in most cases, it can be treated. You can't determine the epidemics of the past to determine what we will face now. Believe me, I know about epidemics. My father worked for the state health department from 1945-1985. I remember the quarantine signs that he had to put up on people's doors.

 

[DawnCt1]

Is that a fact? I suspect with the advancement in medicine in the last hundred years that the facts of years ago might not be the fact of today. It was a fact in my childhood that many would die of polio, TB, and smallpox. My grandmother died of pneumonia where now, in most cases, it can be treated. You can't determine the epidemics of the past to determine what we will face now. Believe me, I know about epidemics. My father worked for the state health department from 1945-1985. I remember the quarantine signs that he had to put up on people's doors.

It is a fact and people still contract polio and certainly TB is on the rise. People still die of pneumonia. Influenza pandemics occur two to three times per century and we have very good serologic records going back to the early 1800's. There is no reason to believe therefore that anything has changed. I am glad you know about epidemics. Epidemics, as you know, occur in an area or a population. Pandemics are world wide. DH is an Infectious Disease Specialist, and Director of Infectious Diseases and Geographic Medicine of a large teaching hospital as well as a Professor of Medicine. He feels confident that we are facing a serious threat at some point in the future and he feels it is prudent to prepare now. Edited to add, We have a much smaller world now with air travel available to more people than ever before. Increase trade between nations and continents. In addition, no one in the world has immunity to H5N1 which makes it even more of a devastating threat. Its a virus that has a short incubation period, and while its primarily a respiratory illness it has a gastrointestinal component and can cause encephalitis.

 

[phamton]

It is a fact and people still contract polio and certainly TB is on the rise.

Neither TB or polio are at the high records of the past.

People still die of pneumonia.

Never said they did. In fact my posts said "in most cases". With antibiotics, more people are surviving. (Once again I didn't say "all" are surviving.

Influenza pandemics occur two to three times per century and we have very good serologic records going back to the early 1800's. There is no reason to believe therefore that anything has changed.

I never said that we wouldn't have a flu epidemic. My point is that with modern medicine we have a greater chance of survival.

I am glad you know about epidemics. Epidemics, as you know, occur in an area or a population. Pandemics are world wide.

Thanks for the vocabulary lesson. I done been to college and got my degree, too.

DH is an Infectious Disease Specialist, and Director of Infectious Diseases and Geographic Medicine of a large teaching hospital as well as a Professor of Medicine.

Then you are aware that all cases of flu are reported directly to the health department. They are the ones who handle the information and recommend what needs to be done, and report to the general public.

He feels confident that we are facing a serious threat at some point in the future and he feels it is prudent to prepare now.

And the Infectious Diseases specialists and the CDC were confident that swine flu would be a major problem in the US in 1976. No problem in preparing. I just participated in a research project on smallpox. I was vaccinated again and blood drawn to determine immunity. I was told during this project that since it had been 50 years since my last smallpox vaccination that I would not be immune and would develop a scab. I had no reaction whatsoever. I don't expect a smallpox epidemic but have no problem with the government preparing. My blood tests also revealed that I was still immune after all that time. But yet, from all the reports we are told that smallpox vaccinations only last a few years and that if smallpox hits again, all of us who were vaccinated as children would have no immunity.

Personally, I would rather efforts be focused on HIV, cancer, etc. I just hate to see the Chicken Little syndrome. If I am wrong and it does indeed turn out to be the killer flu, feel free to say I told you so. Until then, I am not going to worry.

Just a couple of years ago, people mentioned being afraid to go to WDW because of SARS. People are already becoming to panic over bird flu and I blame the sensationalism of the media. That doesn't mean I have my head in the sand though. I will follow the information on Bird Flu carefully.

 

[DawnCt1]

1.Neither TB or polio are at the high records of the past.





2. I never said that we wouldn't have a flu epidemic. My point is that with modern medicine we have a greater chance of survival.


.



3. Then you are aware that all cases of flu are reported directly to the health department. They are the ones who handle the information and recommend what needs to be done, and report to the general public.



4. And the Infectious Diseases specialists and the CDC were confident that swine flu would be a major problem in the US in 1976. No problem in preparing. I just participated in a research project on smallpox. I was vaccinated again and blood drawn to determine immunity. I was told during this project that since it had been 50 years since my last smallpox vaccination that I would not be immune and would develop a scab. I had no reaction whatsoever. I don't expect a smallpox epidemic but have no problem with the government preparing. My blood tests also revealed that I was still immune after all that time. But yet, from all the reports we are told that smallpox vaccinations only last a few years and that if smallpox hits again, all of us who were vaccinated as children would have no i2 mmunity.

5. Personally, I would rather efforts be focused on HIV, cancer, etc. I just hate to see the Chicken Little syndrome. If I am wrong and it does indeed turn out to be the killer flu, feel free to say I told you so. Until then, I am not going to worry.

Just a couple of years ago, people mentioned being afraid to go to WDW because of SARS. People are already becoming to panic over bird flu and I blame the sensationalism of the media. That doesn't mean I have my head in the sand though. I will follow the information on Bird Flu carefully.

1. The problem is, there are more cases of drug resistant TB than there was a few years ago.

2. You can have all the modern medicine and technology you want, but the people now in Asia that are hospitalized in tertiary care centers are still dying at rate of 50% mortality. That includes healthy 10 year olds. In the U.S we can anticipate that our care would be a better but we don't know how much impact that "better" would have. Again, we are talking of an "epidemic" but a world wide threat of a pandemic.

3. And that implies what?

4. If you didn't form a scab then you had a "non take". Either your immune system didn't respond to the vaccine or the vaccine was improperly delivered. You should have had the vaccination repeated. The last person in the world to have small pox was a health care worker in Somalia who had a "non take". He contracted smallpox from the penultimate case and nearly died.

 

[Disneycrazymom]

Is there something that I should do now, or in the near future, for my family concerning the flu that you are discussing?

 

[phamton]

4. If you didn't form a scab then you had a "non take". Either your immune system didn't respond to the vaccine or the vaccine was improperly delivered. You should have had the vaccination repeated.

Sorry, but you are wrong about that. I donated plasma two times a week for 6 weeks. According to the numerous blood test, it was determined that the vaccine had increased my immunity to vaccinia. I was able to then donate plasma twice a week for 6 weeks. My plasma was used to produce vaccinia immune globulin (VIG). I was able to continue until my level dropped at around 6 weeks. So yes, the vaccine did kick my immune system into action but just not enough to get a scab. If it hadn't "taken", I wouldn't have been able to continue in the study. Twice a week I had a plasmapheresis visit where my blood was tested for titer levels. Once it dropped below an acceptable level, I wasn't able to donate anymore. My levels were up for 6 weeks which was the average level for previously vaccinated participants who did develop a scabs even though I never developed a scab.

If you are interested the study title was: Vaccinia Vaccine (Dryvax) for the production of Vaccinia Immune Globulin
Sponsor: Cangene Corporation
Mid-Florida Biologicals, Inc.
All information was also sent to the CDC.

 

[DisneyPhD]

Ok, 1st I have to go on record of saying that I am not a supporter of end of the world doom and gloom. SARS, west nile, and many more are blown out of proportion. I don't aprove of freaking the puplic out when it isn't helpful.

I also think that while diseases may have things in common I do have faith in our research drug companys, WHO, CDC and other places. Also we don't live the same way we did 1918, we have more info on spread of disease. We know more about germs and how not to spread disease.

My brother is a professor of Epidemiology at Wanye State Univeristy and does a lot of contract work with both CDC and WHO. He mostly works in AIDS research but does know about most areas. I wonder if he and you DH know each other (or of each other) DawnCt1.

I also have to thank you for your informational post. While I agree with level headedness and not stressing out over things we can't control I do think that informations is our best tool.

phamton, your posts seem very imformed and interesing too. I have read some posts about this topic that were way off based and most of their info came from media scares.

I must say that I think a lot of credit has to be given to our wonderful professionals and Doctors who has dedicated their lives works for controling and reducing things like this. (around the world!)

 

[DawnCt1]

Sorry, but you are wrong about that. I donated plasma two times a week for 6 weeks. According to the numerous blood test, it was determined that the vaccine had increased my immunity to vaccinia. I was able to then donate plasma twice a week for 6 weeks. My plasma was used to produce vaccinia immune globulin (VIG). I was able to continue until my level dropped at around 6 weeks. So yes, the vaccine did kick my immune system into action but just not enough to get a scab. If it hadn't "taken", I wouldn't have been able to continue in the study. Twice a week I had a plasmapheresis visit where my blood was tested for titer levels. Once it dropped below an acceptable level, I wasn't able to donate anymore. My levels were up for 6 weeks which was the average level for previously vaccinated participants who did develop a scabs even though I never developed a scab.

If you are interested the study title was: Vaccinia Vaccine (Dryvax) for the production of Vaccinia Immune Globulin
Sponsor: Cangene Corporation
Mid-Florida Biologicals, Inc.
All information was also sent to the CDC.

Again, most people who do not form a scab are not immune and do not have the opportunity to follow through with repeated blood work to verify that. You were in a minority group who did form immunity and had the opportunity to verify that with blood work. If large groups of people were being vaccinated, it would be impractical to test the apparent "non takes" since the lack of scab formation is usually due to "non takes".

 

[DawnCt1]

Is there something that I should do now, or in the near future, for my family concerning the flu that you are discussing?

I suppose that it would be prudent to have canned food, etc on hand to minimize trips to the store if supply lines are disrupted. Flu usually impacts an area for 8 week stretches. Unfortunately, we don't know when the pandemic will occur. Hopefully it will be far enough in the future so that vaccine development is streamlined and we have the community resources in place to deal with the situation. There are ways that communities and states can respond to minimize spread; closing schools and non essential businesses. In fact, that was originally the purpose of February vacations. To close schools during the cold and flu season to minimize spread.

 

[rockin_rep]

There has been some rejoicing in the media as of late, about the decrease in profits for the "evil" drug companies. The impact of this is less money for research and development. That is NOT a good thing.

I totally agree with you, Dawn!

While drug companies obviously make a healthy profit, people don't consider how much of those profits go right back into research and development. We're talking millions and millions for EACH and every new RX drug.

Between 93-95% of the NEW DRUG therapies come from the PRIVATE SECTOR (i.e. Drug Companies) and NOT the NIH, CDC or WHO.

In other words, if our drug companies don't do well, then WE as patients needing medicine won't do well. That's why generics can be a VIABLE threat to our healthcare in america.

When a life is spared or a life is extended or the quality of life is made better, in addition to thanking the doctor, maybe we should also thank the drug companies!

"Today's medicines fund tomorrows miracles."