# 4755
DemFromCt, who is both a physician and one of the founding editors of The Flu Wiki , also finds time to write a column on the Daily Kos as well.
Yesterday he posted a terrific piece on Pandemics, Pertussis and Vaccine on the Flu Wiki, and also on Daily Kos.
Given the reduced traffic this site sees on Sundays, I decided to wait till this morning to plug this piece to try to give it a little more exposure.
Highly Recommended.
# 4754
My thanks to Crof at Crofsblog for picking up this item overnight translated and posted by Ida at the Bird Flu Information Corner (BFIC).
This report comes on the heels of a confirmation a week ago (see Forgotten, But Not Gone ) of a teenage girl who died from the H5N1 virus last month.
Reports out of Indonesia have declined in the past couple of years - in part - because Indonesia decided to stop talking about their bird flu problems in 2008 (see Indonesia To Stop Announcing Bird Flu Deaths).
In recent months we’ve seen some small signs of more openness.
Today’s report is of suspected H5N1 fatality. Based, apparently on a clinical diagnosis and not laboratory testing. There are, however, a number of other infectious diseases that can mimic the signs and symptoms of bird flu.
We’ll have to await lab results to know for sure.
This from BFIC.
Pontianak, West Kalimantan ::: A girl possibly dies of bird flu
Posted by Ida on July 26, 2010
Pontianak – A 5-year-old girl from Toho, Kabupaten Pontianak, died after being treated for few hours in Soedarso regional hospital, Pontianak, West Kalimantan. The girl is suspected of having bird flu H5N1 infection.
Wingky’s mother, Ratna, said her daughter died on Saturday evening (24/7) in Soedarso hospital. Wingky had been having high fever for a week before and then admitted to a public health center in Toho. Because illness continued, Wingky was then transferred to Rubini regional hospital in Mempawah, Kabupaten Pontianak. Later the hospital referred the girl to Santo Antonius hospital in Pontianak.
“After a day treated in Santo Antonius hospital, my daughter was then referred to Soedarso hospital and isolated as bird flu suspect patient,” Ratna added.
Ratna mentioned her daughter showed symptoms such as fever, coughing, breathing difficulty, and sore throat. Soedarso hospital had collected patient’s blood sample to be tested for H5N1.
Within last two months, six children have been treated as bird flu suspect patient in Soedarso hospital. All of them were tested negative.
It is unclear whether Wingky had any contact with birds, because the family doesn’t rear any birds. However, patient’s parents said many chicken deaths were found in their neighborhood.
BFIC is a joint effort between Kobe University in Japan and the Institute of Tropical Disease, Airlangga University, Indonesia
Additionally, bgw in MT – one of the hard-working newshounds at the Flu Wiki – has several other translated articles from the Borneo Tribune and ANTARA on this story in their Indonesia thread.
The above article notes that several children recently suspected of having H5N1 in this province tested negative (see Follow Up On Kalimantan Province Report) for the virus.
Several of them did, however, test positive for H1N1.
# 4753
It’s a quiet Sunday morning, with very little flu-related news out there, so I thought it would be a good day to post some disaster and hurricane preparedness videos.
Even if you don’t live in hurricane country, many of the preparedness tips in the storm videos still apply for floods, tornadoes, earthquakes and other disasters.
To start, a brief statement by FEMA director Craig Fugate. (You can Follow FEMA and its director on TWITTER by following @FEMA and @CraigatFEMA).
From Sun-Sentinel.com, a major south Florida newspaper, we get this one-minute reminder of things to do before the storm strikes.
Although geared for the mid-Atlantic states, this 5-minute video from Nassau and Suffolk Counties Red Cross, in cooperation with the Long Island Power Authority, reminds people they may need to cope with utilities being out for days or even weeks after a major storm.
From the USGS Great Southern California Shakeout website, we’ve this 4 and 1/2 minute video called Preparedness Now (Streaming | Video) that “depicts the realistic outcome of a hypothetical, but plausible, magnitude 7.8 earthquake on the San Andreas fault in Southern California.”
Visit the Shakeout site (above) for more information on how you can participate in this yearly exercise.
While California-centric, the preparedness advice in this video could apply to any of the seismically active areas of the country.
And to round out today’s offerings, UCTV (University of California) has 4 1-hour Disaster videos available at http://www.uctv.tv/disaster/
Disaster Preparedness: Disaster Volunteerism
First Air Date: 10/26/2009
Disaster Preparedness: Pandemic Influenza and Emerging Infections
First Air Date: 10/15/2009
Disaster Preparedness: Chemical and Biological Agents
# 4752
Egypt hasn’t reported a human infection with the H5N1 virus since last April (see Egypt Reports 109th Bird Flu Case), but today KUNA – the Kuwait News Agency - is reporting on a 20-year old woman in critical condition from bird flu in Cairo.
Egypt announces 110th discovered bird flu case
Health 7/24/2010 9:49:00 PM
CAIRO, July 24 (KUNA) -- Egypt on Saturday announced the 110th discovered bird flu case in the country, saying the patient's condition is "critical".
"The 20-year-old female was transferred to Sadr al-Abbasiya Hospital in Cairo, as she was suffering from high temperature and breathing difficulties," Health Ministry Spokesman Dr. Abdulrahman Shahin told reporters.
The patient has been medicated with Tamiflu and is still under supervision, he noted.
Egypt had taken preventive measures to contain the pandemic since its outbreak in 2006, including restraints on mobilizing live birds between provinces, as well as banning the slaughtering of birds outside allocated locations among other precautions. (end)
Sporadic human infections with the virus continue to occur in regions where the virus is endemic. Human-to-human transmission remains rare, however, as the virus has not adapted well to humans.
On Thursday of this week, the Eurosurveillance Journal gave us an overview of the spread of H5N1 in humans (see Eurosurveillance: 500 H5N1 Cases After 6 1/2 Years).
The author’s conclusion was that while the number of cases reported has dropped, the overall situation has not improved appreciably since the virus re-emerged in 2003.
The threat of the virus someday adapting to humans remains.
# 4751
Once upon a time, not so very long ago, Whooping Cough infected more than a 160,000 Americans each year, and killed about 5,000 of them.
All that began to change in the 1940s when the first whole-cell pertussis vaccine combined with diphtheria and tetanus toxoids (DTP) was introduced.
In what was a remarkable success story, by 1976 the number of reported cases reached a record-low of 1,010 cases, a decrease of 99%.
But since then, the number of cases has increased ten-fold, and on average 8 to 40 deaths now occur each year.
That resurgence is due in part to the reluctance of some parents to get their kids vaccinated, but is also due to a lack of adults getting their recommended booster shots.
Exactly a month ago I blogged on the growing California Pertussis outbreak (see California: Pertussis Epidemic). Since then, at least 500 more cases have been detected, putting California on track for having the worst year for Pertussis in half a century.
Pertussis, or `Whooping Cough’ is a highly contagious bacterial infection that can cause serious illness and even death. It is sometimes called the `hundred days cough’, because it can take months to get over.
Although it is thought of as a `childhood’ disease, anyone of any age can catch it.
Whooping cough outbreaks are cyclical, with outbreaks occurring every 3 to 5 years. California saw its last big outbreak in 2005, with more than 3,000 cases reported.
Prevention is through vaccination, but since the vaccine offered is `inactivated’ (contains no live bacteria), it requires repeated doses during childhood and a booster shot as adults.
The CDC has a simple, 2-page pamphlet on the DTaP vaccine.
This latest appeal comes from the California Department of Public Health.
CDPH BROADENS RECOMMENDATIONS FOR VACCINATING AGAINST PERTUSSIS: IMMUNIZATION KEY TO CONTROLLING WHOOPING COUGH
Date: 7/19/2010
Number: 10-048U
Contact: Al Lundeen, (916) 4407259)
SACRAMENTO
To protect Californians against the current epidemic levels of pertussis (whooping cough) health experts at the California Department of Public Health (CDPH) today broadened recommendations for immunizing against pertussis and reiterated the importance of getting vaccinated.
“We are facing what could be the worst year for pertussis that this state has seen in more than 50 years,” said CDPH Chief of the Center for Infectious Disease Dr. Gilberto Chávez, who also is the state’s epidemiologist. “We are urging health providers to broaden their use of the pertussis vaccine and we are urging Californians to take the simple step of getting vaccinated to prevent pertussis.”
- In addition to the typical series of childhood pertussis immunizations, CDPH now recommends an adolescent-adult pertussis booster vaccine (Tdap) for:
- anyone 7 years and older who is not fully immunized, including those who are more than 64 years old,
- women of childbearing age, before, during, or immediately after pregnancy, and
- other people who have contact with pregnant women or infants.
“Considering that immunity from pertussis vaccine or disease wears off and that most adults are susceptible to pertussis, now is the time for Californians to get immunized to protect themselves and their families,” said Chávez. “In particular, all family members and caregivers of infants should get the booster vaccine.”
<SNIP>
Pertussis has reached an epidemic level in California. For the first six months of this year, 1,496 cases of pertussis were reported, a five-fold increase from the same period last year when 258 cases were reported. In addition, approximately 700 possible cases of pertussis are under investigation.
Since this alert was released, a 6th child has died from Pertussis in California. Five out of the six fatalities have been in infants under the age of 3 months – too young to receive the vaccine.
Which is why health officials urge that the general community get vaccinated, in order to protect those that cannot be immunized.
And that means adults and children.
In recent years more parents are filing “personal belief exemptions” to avoid vaccinating their children.
Although California, like all states, requires that all students be vaccinated against Whooping Cough before entering school, parents can ask for their children to be exempted from the program if vaccines run contrary to their religious or personal beliefs.
The following information comes from the Johns Hopkins Bloomberg School of Public Health.
VACCINE EXEMPTIONS
It is law in all US states that children be properly immunized before attending school. However, in addition to medical exemptions offered in each state, 48 states allow for religious exemptions and 21a states allow personal belief exemptions for daycare and school.
(Click to view)
Other states, including Idaho, Arkansas, and Texas are reporting outbreaks of Pertussis this year as well.
Again from Johns Hopkins:
October 10, 2006
High Rates of Pertussis Found in States with Easy Immunization Exemptions
Saad B. Omer
States that easily permit parents to opt out of vaccinating their children for nonmedical reasons are at increased risk of pertussis (whooping cough), according to a new study from researchers with the Johns Hopkins Bloomberg School of Public Health, the University of Florida and the Centers for Disease Control and Prevention (CDC).
States that easily grant exemptions or offer personal belief exemptions have higher nonmedical exemption rates than states that offered only religious exemptions. The study is published in the October 11, 2006, issue of the Journal of the American Medical Association.
While (mostly mild to moderate) adverse effects have sometimes been associated with the Pertussis vaccine, their incidence has dropped since the adoption of the acellular or DTaP formulation in 1991.
The vaccine is widely regarded as being both safe and effective. This from the From the Immunization Action Coalition
What side effects have been reported with this vaccine?
About 20%-40% of children have some local reaction such as pain, redness, or swelling after the first three doses of DTaP. Such local reactions seem to be more frequent after the fourth and/or fifth doses. A temperature of 101° F or higher is reported in 3%-5% of DTaP recipients. Less common reactions (e.g., persistent crying, higher fever, febrile seizure) are rare and generally occur in fewer than 1 in 10,000 doses.
If a child has a medical reason not to receive the pertussis vaccine, they can and should still be vaccinated against diphtheria and tetanus with DT (pediatric) vaccine.
The most frequently reported side effects following vaccination with Tdap are headache, generalized body aches, and tiredness.
Whether due to activism or apathy, a declining rate of vaccination for preventable diseases like Whooping Cough will almost certainly lead to more cases – and more deaths – in our communities down the road.
# 4750
During a major influenza pandemic, millions of people could fall desperately ill during the first few months. Pharmaceutical interventions – like vaccines – take months to produce and distribute, and antivirals are in short supply as well.
What the world really needs is a cheap (preferably generic) medication that will help treat severe influenza cases.
Ideally it would be a shelf stable pill, one that is easy to dispense, has a low incidence of side effects, and can reduce influenza morbidity and mortality.
A tall order. But perhaps not impossible to fill.
At least, that’s the hope of a number of scientists who are looking into whether statins, or corticosteroids (or a combination of the two), might prove effective in reducing some of the most serious flu symptoms.
Dr. David Fedson has long championed the idea that we should be investigating statins and other cheaper drugs that may help modulate the immune response.
Fedson is a former Professor of Medicine at the University of Virginia School of Medicine and was formerly Director of Medical Affairs, Aventis Pasteur MSD.
A couple of his papers on the subject include:
Pandemic Influenza: A Potential Role for Statins in Treatment and Prophylaxis
David S. Fedsona
New Approaches to Confronting an Imminent Influenza Pandemic
Dr. Fedson and Peter Dunnill, DSc,FREng
In 2007 we saw a study that seemed to support the idea, one that indicated that statins lowered the mortality rate of people with pneumonia.
Statin drugs lower respiratory death risk: study
Tue Apr 10, 2007 12:40pm EDT
By Maggie Fox, Health and Science Editor
WASHINGTON (Reuters) - People who use statin drugs are less likely to die of influenza and chronic bronchitis, according to a study that shows yet another unexpected benefit of the cholesterol-lowering medications.
And in 2008 this encouraging report made the headlines:
Statins may cut pneumonia death, blood clot risks
27 Oct 2008 20:00:13 GMT
Source: Reuters
By Will Dunham
WASHINGTON, Oct 27 (Reuters) - Cholesterol-fighting drugs known as statins reduced the risk of dying from pneumonia or developing dangerous blood clots in the legs, adding to a growing list of benefits from the popular drugs, two research groups said on Monday.
Of course, not all of the studies have been positive.
Last July there was a report that found no evidence of benefit among pneumonia patients (see Another Take On Statins And Pneumonia) taking statins.
But another study, presented in October of last year at the annual meeting of the IDSA, the Infectious Diseases Society of America, in Philadelphia suggested the opposite - that statins cut the mortality rate for seasonal flu by 50%.
Maryn McKenna writing for CIDRAP brought us the details.
Statins may help patients with severe seasonal flu
Maryn McKenna
Contributing Writer
Oct 29, 2009 (CIDRAP News) – Commonly available drugs that are sold in lower-cost generic versions improve the survival of patients hospitalized for seasonal influenza, researchers reported today, raising the possibility of a widely available treatment that could be used in a severe flu pandemic if other drugs are in short supply.
So while not all of these studies are in alignment, many of them do support the idea that statins may be of considerable value during a pandemic.
Which brings us to a guest editorial posted today on the Center For Biosecurity’s Clinicians’ Biosecurity Network website.
I’ve just reproduced the opening paragraph. By all means, you’ll want to follow the link to read it in its entirety.
An Alternative Approach to Pandemic Influenza That Clinicians Everywhere Could Use
By David S. Fedson, MD, July 23, 2010
The initial waves of the first influenza pandemic of the 21st Century have passed. Despite the best efforts of influenza scientists, health officials, and companies, more than 90% of the world’s people did not have timely access to affordable supplies of vaccines and antiviral agents. Instead, they had to rely on 19th Century public health “technologies.” They should have (and probably could have) had something better.1-5
