Friday, September 29, 2006

If You’re Looking for Some Good News . . .

#182


The Pandemic hasn’t started. That we know of. Yet.


Beyond that, the news this week hasn’t been particularly comforting. Things are still going awry in Indonesia, with reports of up to 3 possible family clusters of the illness. Health Care workers, and school children being tested. So far, no huge outbreak, but officials are nervous.


From Thailand we learned that a man died on August 10th, but it was only last week that they determined he had H5N1 . . . and it required repeating the tests 9 TIMES before they got a positive ID on what killed him. His doctor was apparently far more persistent in determining the truth than most doctors have been; the majority of whom assume 1 negative test proves a patient died of ABBF (Anything But Bird Flu).


But the big news comes from the WHO and the CDC, in unrelated statements. Both agencies have been reluctant to express bad news in regards to Avian Flu, some would even suggest they have soft peddled the threat. Apparently that is beginning to change.


The WHO (World Health Organization) released a statement regarding the continuing mutation and evolution of the virus worldwide. This comes from the Associated Press:

WHO: Deadly bird flu virus mutating

Associated Press GENEVA - The deadly H5N1 strain of bird flu which has killed at least 148 people is showing signs of being able to mutate and develop resistance to the most effective anti-viral drugs and any possible vaccines yet to be produced, a WHO scientist said Thursday.

The H5N1 virus is splitting into genetically different groups, said Mike Perdue, a team leader with WHO's influenza program who took part in a two-day bird flu conference earlier this week sponsored by the U.N. health body. No vaccine for the H5N1 virus has been produced yet, but scientists are confident they will develop one in future.

However, the virus has now been shown to mutate like seasonal flu viruses that require new vaccines every year. "We are going to have to come to the realization that these viruses are genetically variable," Perdue said. "The vaccines that we have predicted to be protective today may not be protective a year from now."

The two most effective anti-viral drugs currently in use are also in danger of losing their potency, according to influenza experts. "We know from surveillance studies and from hospital clinical studies that resistance to the two primary anti-viral drugs, the Tamiflu and Amantadine drugs, have already occurred," Perdue said.


Sobering news. The virus continues to evolve, and is steadily undermining our meager medical defenses against it. Those who are banking on a vaccine anytime soon had better reconsider. As I’ve stated here many times, vaccines are `happy talk’, designed to mollify the masses. This virus is evolving too rapidly right now to make the creation, manufacture, and distribution of an effective vaccine much more than a long shot.


And this little tidbit we get from the CDC’s Journal of Emerging Infectious Diseases. You can read the whole study at http://www.cdc.gov/ncidod/EID/vol12no11/06-0426.htm, but I will attempt to summarize.

Up until now, the mantra has been that `no evidence exists to support the idea that influenza viruses routinely spread via aerosol transmission, and that large droplet transmission (from sneezing and coughing) constitute the greatest threat.


Large droplets don’t stay airborne very long, and the conventional wisdom was that staying 3 feet away from an infected person (I’ve always suggested 10 feet), was a reasonable safety precaution, and that surgical masks were `good enough’ for health care workers.


Now this study calls all of that into question.


They cite strong evidence that aerosol transmission plays a much greater part in flu transmission than previously believed. That the virus may remain airborne for 30 minutes or longer, and may be carried some distance (more than 3 feet, certainly) on air currents. They go on to say the use of surgical masks, while they may play a role in reducing the spread of the virus, is woefully inadequate for Health Care workers in close contact with infected patients.


This is very bad because the United States and Canada have both incorporated the use of the inferior (read: cheaper) surgical mask in their pandemic planning. And the laughable policy of instituting a 3-foot spacing between employees now comes into serious question.


Is this study the final word on the subject? No, of course not. But it’s the latest word, and that’s all we have to go on right now.


It is amazing that, in 2006, with all of the medical advances we’ve made and scientific knowledge we’ve accumulated, how damn little we really know about the world around us. How much of our `knowledge’ is really guesswork. And just how many facts we parrot as if they are the gospel are really seriously in error.

As depressing as that realization is, take heart. The pandemic hasn’t started. Not yet, anyway.


But then, it’s 3:00am as I write this, so it’s early in the day.