18 April 2006

Am I being Chicken Little?

This week, U.S.News & World Report is convening its first-ever Health Summit in Washington, D.C., to examine the state of the nation's emergency preparedness. On the agenda: keynote addresses by Homeland Security Secretary Michael Chertoff and Health and Human Services Secretary Michael Leavitt.

At 2PM this afternoon the below panel convened. The discussion can be viewed on CSPAM at various times.

Bernadine Healy, M.D., health editor, U.S. News & World Report (moderator);
William K. Atkinson II, president and CEO, WakeMed (Raleigh, N.C.);
Georges Benjamin, M.D., F.A.C.P., executive director, American Public Health Association;
Arthur Kellermann, M.D., M.P.H., chairman, Dept. of Emergency Medicine, Emory University Hospital;
Thomas V. Inglesby, M.D., chief operating officer and deputy director, Center for Biosecurity, University of Pittsburgh Medical Center
click the link above view a bunch of interactive stuff

Let's Talk Turkey
By Bernadine Healy
The greatest worry about the latest bird flu news is not that the H5N1 virus has taken root beyond eastern Asia into multiple provinces of Turkey. No, the real issue is that the deadly H5N1 virus seems to be changing its stripes. What's evident from the Turkish outbreak is that the virus is being more rapidly and efficiently transmitted from birds to humans than has been seen in the past. We don't know why. But preliminary studies of the genetic makeup of samples of the deadly virus last week confirm that the virus is mutating in a way that could make it an even more serious threat to human health...

A Dose of Reality
An eagerly awaited bird flu vaccine comes up short
By Josh Fischman
There is a protective shot against bird flu, researchers reported last week. An occasion for joy and relief? Not quite. The vaccine works only half the time, and it has to be given in such large amounts that there would not be enough to go around. Vaccine makers may be able to produce shots for only 75 million people, but "we'd want to protect close to 200 million" in the United States alone, says Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. "We're not going to be ready." At least not with this vaccine version.
The shots were given to 451 healthy adults in the United States, doctors reported in last week's New England Journal of Medicine. They tried several different dose levels. The best results: If people were given two shots at a hefty 90 micrograms each, about half of them developed a strong immune response. By comparison, seasonal flu shots take just one injection at 15 micrograms. "It took 12 times the usual dose to protect half of the people who got it," says infectious disease specialist Gregory Poland, who runs the vaccine research group at the Mayo Clinic. "Clearly this isn't the answer."
But it may be a starting point, he adds, for there are ways to get a bigger bang with a smaller dose. Tests on this vaccine are now underway with adjuvants, added chemicals that can boost the immune response so vaccine makers can shrink the dose size and thus stretch the supply. "We should have answers in about six to 12 months," Poland says. "This is really a race against time."

Spreading Its Wings
It's only a matter of time before Bird flu reaches the United States. Can we stop the killer virus?
By Nancy Shute
Nebraska is on the famed Central Flyway, a route that millions of birds follow each year as they migrate from southern wintering grounds north to Alaska and the Arctic to breed. While there, the birds often mingle with birds from Asia, where H5N1 avian flu, widely regarded as the bug most likely to mutate and spark a human pandemic, is rampant. When the sandhills return in the fall, Hinrichs wonders, "what will they bring back?"

...But in the past year, avian influenza has started to kill wild birds, which had long been able to harbor the disease without getting sick. In April 2005, more than 6,000 bar-headed geese died at Qinghai Lake in central China, a congregating point for migratory fowl. That was a wake-up call to wildlife biologists; the last time avian influenza afflicted large numbers of wildfowl was in 1961. "That's the really surprising part of it, that wild birds are now being killed by this virus as well," says Leslie Dierauf, director of the USGS National Wildlife Health Center in Madison, Wis. "It's changed somehow, and we're not sure how."

...In the past three months, the H5N1 virus has gone ballistic, infecting birds in 21 countries in Africa, Europe, and the Middle East. It's unclear if the outbreaks are the result of bird migrations, poultry shipments, or other human activities. In some countries, like Nigeria, only poultry has been infected. In others, like Germany, only wild birds are dying. The uncertainty has set off a fierce battle between some wildlife conservationists, who feel that wild birds are being unfairly maligned, and agricultural interests.

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