Monday, August 01, 2005

That Flu Thing...

Mr.Atos

The Flu season is coming. Take two cold-eze a day and drink plenty of liquid right? Well, in 1918, that
'Flu thing' killed between 50 and 100 million people worldwide. From Sunday's Rocky Mountain News,

For several years now, infectious-disease experts have been warning the public about the next global pandemic. Well worth reading, in our view, is a series of articles in the current issue of Foreign Affairs, which its editors have generously offered the international health community as a "call to action."

The series' focus is H5N1, the lethal avian influenza virus, which has so far killed 59 people who came into contact with infected birds. The dilemma is that scientists cannot predict with certainty whether the virus could evolve and become capable of human-to-human transmission. If it does, writes Laurie Garrett, senior fellow for global health at the Council on Foreign Relations, "humanity could well face a pandemic unlike any ever witnessed."
Unfortunately, the subject creates a glaze over the attention span where typically there is thoughtful consideration. It's not Ebola, Small Pox, or Anthrax. It is the Flu, so it cannot be that serious, right? And yet, one of author Stephen King's most popular books ever, described a fictional 'superflu' epidemic that claimed 99% of the world's population and instigated the rapture. Might I have your attention, now?

I received a call from a friend on Sunday morning. He lives halfway across the country from me, and we do not talk nearly as much as we should considering the Man is my best friend. He wanted to talk about bird flu and something to do with pigs. Being that I had become familiar with Freeper
DogGone while blogging on Angola's Marburg outbreak, I was mildly familiar with both subjects. From his Avian Flu Surveillance Project on Free Republic,

A UK doctor writing in the British Medical Journal has warned that governments around the world must stop burying their heads in the sand over the growing threat of a global epidemic of avian flu. Dr. Nigel Higson writes that disasters like the Asian Tsunami will "pale into insignificance" when compared to the human cost of an influenza pandemic which has the potential to wipe out "hundreds of millions" of lives.

Higson says the catalyst for government action should have been the discovery
earlier in the year that avian flu (known as strain H5N1) is now spreading via human to human transmission. "Development of vaccines against H5N1 needs government pump priming, as will the stockpiling of euraminidase inhibitors, which should be effective against avian flu," writes Higson. "It is many years since a pandemic struck, and people have become complacent in that time. For governments to bury their heads in the sand may have some benefits in many political areas but it will be disastrous in terms of pandemic planning."

Now that human to transmission has been confirmed, Higson believes that doctors should prepare themselves for the practicalities of treating epidemic or pandemic influenza as well as encouraging increased pharmaceutical company capacity.
Judith Anne is another Freeper of note who has done yeomen's work in contributing to and extending this information thread with the latest information on the spread of this mysterious killer. I would encourage you to review what you can of the information developing there. This morning she posts an update from a site she has been monitoring,

Prior to May 21, China did not report any H5N1 outbreaks in 2005. Moreover, they have still not reported any infections outside of Qingahi and Xinjiang provinces. They have not given permission to WHO to visit Xinjiang and have not provided samples or sequences of isolates from live birds at Qinghai Lake. The suspect bird flu case in Kazakhstan, just across the border from the confirmed outbreaks near Chany Lake in Novosibirsk, casts additional doubt on China's claims of now human cases in H5N1. Boxun reports suggest there is a raging pandemic in China, which is being covered up. Most countries have little incentive to report H5N1 cases. India claims to have never had H5N1 in poultry of people, although, poultry workers in India have H5N1 antibodies. Thailand claims to have had no H5N1 cases in 2005 although the H5N1 isolated from birds closely matches the H5N1 in northern Vietnam isolated from patients. Indonesia claim their H5N1 infections in 2003 were due to New Castle Disease and the H5N1 in a Jakarta suburban family was a fatal bacterial infection. China has denied any human cases of H5N1, including the large number of cases reported by Boxun in Qinghai and the pneumonia isolation wards in Tacheng, Xinjiang. The sequences of isolates from Qinghai Lake are public and the H5N1 infected birds are beginning to migrate to Europe, India, Bangladesh, Tibet, eastern China, and southeast Asia. The exported H5N1 will be reported as dead birds and people begin to accumulate, and the sequences from the fatal infections will point to China and its massive cover-up.
This would seem to be the information that has the experts on edge. Perhaps we all should be on edge, just like my friend; an ER trauma surgeon working frontline in a major American City. And he is worried. The crux of his concern came from information being posted at the same site referenced by Judith Anne: a site called Recombinomics. I warn you that the information there is nearly raw information being presented for the benefit professional experts. Do not let it spread glaze, because there are distinct references to events that make one sit up and take notice. Here there is more clarification of the information that Judith Anne conveys.

A 20-year-old man showing bird flu symptoms has been hospitalized in Kazakhstan's Pavlodar region, where 600 domestic geese died between July 20 and July 30 as a result of an outbreak of the disease in the area.

The patient, a poultry farm worker from the village of Golubovka, was later diagnosed with double pneumonia and taken to the intensive care unit of Pavlodar's regional infectious diseases hospital in a critical condition, sources in the region's emergency medicine center told Interfax."

All birds that might have contracted the disease from the infected geese have already been slaughtered and the poultry farm has been disinfected. Virus samples have been sent to Kazakhstan's National Veterinary Center in Astana to establish a final diagnosis," Emergency Situations Ministry sources told Interfax...
...The possibility of a raging pandemic in China appears to be more likely than ever and the failure of China to release samples and information should be addressed by more than just WHO, who have not been given permission to visit Tacheng, which is five miles from the Kazakhstan border.
Then there's this inquiry from Asia One out of Singapore, Is it Ebola-like bird flu?...
CHINA's official Xinhua news agency confirmed this week earlier wire reports about the mysterious deaths of 27 farmers in several villages around the cities of Ziyang and Neijiang in Sichuan province.

Another 41 people in Sichuan have also fallen seriously ill. All victims had
been exposed to swine and developed high fever, fatigue, nausea, vomiting, and
'became comatose later with bruises under the skin', according to Xinhua. The
provincial health authorities insist that 'the disease is absolutely not Sars,
anthrax or bird flu'.

Instead, they ascribed the outbreak to a common swine bug called streptococcus suis. Based on information from the Chinese, the World Health Organisation (WHO) agrees that the symptoms 'seem consistent with' the diagnosis.

Could the WHO be wrong? Are the provincial authorities prevaricating?
Okay, so we have the fuzzy picture, right. Now try to compliment what you have already gathered, with the content of this discussion from Recombinomics,

D: "It's alright. We ran tests on those samples and isolated the SZ77++A3231 virus."

I: "What is this SZ77++A3231 virus?"

D: "This is a strain of the Ebola virus."

I: "Would you like to comment about it?"

D: "It's rather impossible to totally explain it."

I: "I can understand so, but why is the term "less-infectious" always
affixed to our version of the Ebola virus?"

D: "There are 2 reasons for doing so. First, to reduce panic among the
people should it ever leak. And second, the Ebola virus has evolved in China.
Re-combination has been detected. Most prominently at the portion which
determines its effect on humans (very technical description, I can't describe
it. sorry.). Also, abrupt breaks in the sequencing were detected, leading to
changes in the incubation period. (Or possibly "changes in the incubation period
were detected")

I: "How were these viruses classified then? / Could you elaborate more
about the various strains?"

D: "Previously, strains of Ebola in China always had the EBO prefix.
Subsequently following information leaks, the classification method was changed.
We stopped using the EBO prefix. Instead, coupled with the discovery that the
virus had become more virulent and lethal, we re-named the strains according to
the placed where they were first discovered. For example, the strain in June
became the SZ77++A3231. Sometimes, we don't even use their place of discovery,
instead directly naming it the ++A3231."

I: "In that way, the Ebola virus wouldn't even be brought into the
picture."

D: "Precisely, viruses such as the Ebola are national secrets."

Now take the content of that discussion and apply it to the following analysis from the same update.

The above comments by a physician involved in testing samples from patients in the mysterious swine outbreak in Sichuan indicate that one of the agents isolated is a recombinant Ebola virus originally isolated from Shenzen. Prior reports had listed the names and characteristics of various Ebola isolates and EB-SZ-277 was capable of infecting birds. SZ277++A3231 is a recombinant version of SZ-277 isolated from a patient. The discussion indicates China has an active Ebola project and the virus is rapidly evolving via recombination. It was not clear from earlier reports if the agent was isolated and sequenced, but this interview leaves little doubt that both isolation and sequencing of Ebola is quite active. It is unclear if the recombination is related to the region of identity between Ebola and H5N1. Ebola is considered a state secret, so there are no reports of the virus or availability of virus or sequences.
That 'Flu Thing,' would seem to be an 'Ebola' thing. Ebola orginated in Monkeys and spread to humans with horrifying killing potential. Avian Flu appears to be a similar agent, originating in pigs, spread to birds, then to humans (See Correction Below). And although it is slightly less deadly than its African cousin (so not quite as deadly to the individual), it is far more deadly to humanity as a whole. Ebola is a quick and efficient contagion that kills and infects, burning itself out quickly by eliminating its carriers. This particular strain infects and infects, then kills; magnifying its epidemic potential to a horrifying degree.

The Chinese are
officially denying Ebola rumors.

I do not pretend to be an expert on this subject. But, it has grasped my attention with both hands. I suggest that it at least tickle yours as well. Meantime, I welcome any informed or expert commentary on this subject. And when you hear the discussion about the 'Flu' thing in the coming months, recall that the term is being loosely applied to a mysterious virus originating from an extremely secretive place. Little more is known about the agent that may be coming through an airport near you this fall. It might very well sit down behind you on the bus... and spread more death than a lunatic fanatic with bomb.


Update...
Slight correction, courtesy of my friend, Dr. Knowho,

"Avian flu is flu. They don't know what is going on in that one specific area of China. It may be one of at least 5 possible scenerios. The truth may be one or none of the following.The quarantine may be related to the avian flu from the Quinha aviary outbreak and migrating birds, or could be a Streptococcus suis (pig) bacteria as the Chinese allege or could be a weapons lab accident with ebola or a weaponized avian flu, or some recombined avian flu ebola virus. A virus that spreads like flu but kills like ebola! Or a recombined bird and pig flu virus. If an animal or person is infected with two different viruses, it is possible for genetic jumps form one virus to another to form a sort of new "hybrid" virus that can be very lethal.The descriptions of the dead and dying do seem similar to a U.S. physician's description of the dying in 1918 flu pandemic with the skin changes, etc. but it is hard to say with the news clampdown." (emphasis mine)
I must admit again, that this area is not my specialty, so I welcome your comments and corrections.

Update:
A correction provided by Judith Anne, regarding the history and process of transmission of this contagion:
Avian flu originated in birds, in Hong Kong chickens, first seen in 1997. At that time, 18 people were infected, six died. Every chicken in Hong Kong was killed, in an attempt to wipe out the virus. But it survived. Now it is in pigs, and pigs are usually the last step a flu virus takes before being readily transmitted from human to human. This is due to remarkable pig-human similarities. (After all, porcine grafts are used to repair mitral valve prolapses within the human heart.)
Thank you, JA.

1 comment:

Anonymous said...

Thanks for an excellent summary, I really appreciate the work you went to, to make it.

I have one tiny correction, relating to this comment:

Avian Flu appears to be a similar agent, originating in pigs, spread to birds, then to humans.

Avian flu originated in birds, in Hong Kong chickens, first seen in 1997. At that time, 18 people were infected, six died. Every chicken in Hong Kong was killed, in an attempt to wipe out the virus. But it survived. Now it is in pigs, and pigs are usually the last step a flu virus takes before being readily transmitted from human to human. This is due to remarkable pig-human similarities. (After all, porcine grafts are used to repair mitral valve prolapses within the human heart.)

Thank you again for your kind comments. You are doing a wonderful service for your readers...