thoughts on avian flu - revisited

DeeGee

DeeGee

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Earlier thread on avian flu, a number, rather a large number, of peeps were pooh-pooh'ing the whole thing, as if it were scaremongering.

Here are some statistics:

Spanish Flu - 1918-1920 : about 20 million dead, about 1 billion sick
Asian Flu - 1957 : 70000+ dead in USA, I dont have figures for whole world, it hit US hardest, I believe.
Hong Kong Flu - 1968 : 18000+ dead in France, again, dont have figs for whole world.

I believe scientists fears are based on the fact that this strain of avian flu is widespread in wildfowl, not apparently the case previously. I am not an expert, but I reckon going sailing for October to January is a great idea.... /forums/images/graemlins/tongue.gif /forums/images/graemlins/tongue.gif /forums/images/graemlins/tongue.gif

EDITED: just found a nice link to World Health Organisation World Health Organisation
 
DeeGee, at the risk of stating the blindingly obvious, the figure for the 1918 outbreak reflects the fact the majority who died had just returned from the Front and weren't in the best of condition to start off with.

Listening to R4 yesterday they were saynig that a pandemic might kill 20,000 in the UK over the course of a winter against the 10,000 who die every year as a result of flu. The most likely ones to cop it being the infirm, the old and the young. Not wishing to play this down merely putting the whole thing into perspective.
 
I think as yachties before this thing hits we should all meet up in the middle of the Atlantic or somewhere else that is out of sight of land and the range of most of the problem birds and sit it out until the flu epidemic dies down (and therefore survive ).

Besides, as the labels start to fall off the tinned food we can all swap cans for 'tinned surprise' for dinner !!!!
 
Chris, not actually true, just one of those myths that persist. The virus spread world wide, including South America, and other areas not involved in the fronts, and killed many young healthy people

eg in US 675,000 people died, of which just over 40,000 were G.I.s, and many of these died before being shipped out to Europe.

There is a huge amount of evidence to contradict what you state and one of the huge unknowns which may be now unravelled with the recent resurrection of the 1918 virus and research on it with modern techniques, is why, after mainly killing young, old and infirm, the virus suddenly in middle of 1918 started killing 20-40 year old in huge numbers, and these were not soldiers, just normal people
 
I'm not going to argue about the past but would add that in 1918 average life expectancy was less than 60 for the good reason that people literally wore out from hard physical work and the general state of health and nutrition were somewaht lower than they are now and the figures for a pandemic now came from a model run recently.

Personally, I'll worry about a pandemic when a. there is a demonstrable link between birds and us and b. peeps start dying in hordes otherwise remains the past ioutbreaks are an interesting piece of history and no more.
 
The effect of the flu pandemic in 1918 was to lower life expectancy in US by 10 years. Health had very little effect, it was a new virus, with no immmune resistance. Historical facts are actually of great assistance in providing scientists of today understand the mechanisms of infection, and what can happen in a pandemic


I can explain all this in great detail, it was one of my favourite hobbies when I did PhD in molecular biology many years ago, but suspect it will fall on deaf ears, as few seem capable of following the logic and level of understanding of viral infection, mutation statistics etc involved in deep understanding. It takes years to teach biology students to a level they can understand the why's and whynot's of the underlying principles, where they can grasp the actual implications.
 
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I can explain all this in great detail...... It takes years to teach biology students to a level they can understand the why's and whynot's of the underlying principles, where they can grasp the actual implications.

[/ QUOTE ]

You may well be right, but I would hope not. The basic core principles are actually very simple if you accept lots of 'black-boxes', which we all do at some level. I often feel that we spend 3 or 5 years confusing students by opening too many boxes! I certainly feel that was often what happened to them at school. The misconceptions we find in some students with 4 grade A A-levels are astounding.

At the same time, very simple concepts are absent. I saw a survey in which most people appeared to believe that only GM food contained DNA!

So I would suggest that we identify core principles and not pile on too much detail; although I confess that is not apparently very successful either.

(in case its relevant here, I have updated my proflie to give more detail of my background. I will change it back soon!)
 
I bow to your superior biological knowledge. I'm a bit of a statistician and was merely extrapolating the decreasing numbers killed in successive outbreaks set against a world population that has gone up from 2 billion in 1920 to nearly 6 billion now.

Still who knows, the weekend is nearly upon us and my greatest concern at present is whether I'll survive a boozy weekend with some friends /forums/images/graemlins/smile.gif
 
I'll be a simple soul and put a simplistic position.

13 deaths in Thailand, apparently from avian flu.

How many cases of infection?

If 13, we are all going to die.

If 26, start to panic now.

If 10,000, its all going to be very runny indeed. But as you probably know fewer than 10000/13 people then you might not actually know anybody who dies. People can be that callous at times. This is a lower death rate than quoted for the Spanish flu by DeeGee above.

If 10 million, relax, light a big cigar, eat a rare steak and ride the odds.

As I said, simplistic, but potentially quite illuminating.

BrendanS, any indications that there would have been significantly differing Spanish flu death rates with modern medical services?
 
Avoiding the detail and giving the bare facts only really works with a trusting audience. I know very little about virology but I listen to people like yourself who do. The problem appears to be when people have already made their mind up about a subject. Whatever an expert says, if it is not trusted, and the audience is committed to a diametrically opposite view from the outset, no end of explaining will change their view. There are none so blind as they who will not see......
This all started by me asking a question about bird poo.... And then the arguments about a deep political conspiracy took over which I still find annoying.
However, on the basis that there are people out there who think out of the box, I wil try again.

I think what I have learned is as follows....

1. While any form of poo might contain bacterial infection it's unlikely to contain viral infection as viruses don't live long away from a host.

2. The only real defence we have against viral disease is a specific antibody produced by the immune system to counter each mutation of the virus. We don't have that at present because the virus has not mutated so our immune system cant react to it yet . For the same reason we cant develop an inoculation against it yet. It's therefore not realistic to compare with previous forms of Flu that we have antibodies to deal with. It's potentially much more dangerous to all of us not just the young or infirm.

3. Until a specific form of the virus can be transmitted from human to human we can only catch it from birds so the risk is low at the moment.

4. If the virus becomes transmissible between humans and it hits us before we have been inoculated against it we are in deep doo-doos. Tamiflu is an antiviral agent but will only lessen its effect.

5. It may never mutate to a strain that could cause a pandemic but there is a high statistical chance that it will.

Bearing in mind that I am an engineer with a totally unrelated and irrelevant degree in thermodynamics and have been building ships all my life, how am I doing?

I would seriously like to know if I am understanding this thing properly and in particular what Tamiflu is if its not an antibody........ /forums/images/graemlins/confused.gif
 
From my understanding you seem to have it right. I think some people don't like to accept that there is a risk as effectively there is nothing they can personally do about it. I suspect even G Bush falls in this catagory as politically he cannot harm the US economy so he pretends that global warming is not occurring!

There is has always been health risks but with more international travel the speed that a epedemic could spread is much greater.

I have already lost one close colleague through an antibiotic resistant infection.

As I cannot personally do anything about these risk and tomorrow there may be a Flu, Ebola virus, anti biotic resistant bacteria epedemic I will continue to ride my motorcycle, go skiing, diving and this weekend go out sailing in the full knowledge that I am going to die of something but I don't know what or when so I had better get as much fun out of my remaining life as possible. If I can get extended summer vacations sailing in the next few years great.

Now if I am missing something or I can contribute to lowering the risks to mankind please let me know otherwise I will stick with trying to copy Peter Cook who (I think) said something like "I am sure there are many worthwhile things to do in life but frankly I have been too busy enjoying life to persue them".

I am not ignoring the risks and would like to understand them as much as possible so would welcome reading Brendans offer of a fuller explaination.
 
I don't advocate giving the bare facts only; but an explanation rarely needs to be very technical - as long as it does not gloss-over areas of uncertainty.

You give pretty fair account of the situation.

1. Most viruses are very fragile and quickly zapped by UV light. So bird poo in a dark environment is much more likely to contain a nasty for a longer period. But the biggest risk of transmission to humans seems to come from very enclosed, dry, dusty environments with close human/bird contact.

2. Yes, except that lots of flu is actually 'new' in terms of the antigens it expresses and therefore in the ability of the immune system to respond. The questions are, how ‘new’? ie how far will partial protection from cross-reacting responses help and how pathogenic?

3. Exactly

4. I don’t know exactly how confident the virologists are about how likely a new mutant derived from bird flu is to be highly pathogenic. But the track-record is worrying.

5. See 2.

Tamiflu is a drug that inhibits viral growth, hopefully allowing time for your immune system to wake up. (There are mutants not affected by it, but lets not go there)

That reminds me, its always amusing that all cheap American films seem to describe any magical new drug developed by the hero as a 'serum', maybe that's adding to the confusion ? There are some treatments based on use of serum containing antibodies to something, but very very few.



PS I am NOT a virologist!
 
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I would seriously like to know if I am understanding this thing properly and in particular what Tamiflu is if its not an antibody

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Tamiflu ( that's its brand name - chemical name is oseltamivir phosphate ) is a Neuraminidase inhibitor , which means that it interferes with the virus's ability to replicate thus allowing your own body to catch up and produce enough antibodies.

Although HMG have ordered 14.5 million doses what they haven't owned up to is the fact that they only did this quite recently and we are quite far back in the queue.

Their bland assurances that they will produce 120 million vaccine doses once the pandemic starts is similar pie-in-the-sky thinking. There simply won't be time. Normal vaccines are obtained from viruses bred in eggs. Can't do that with Bird Flu because it kills the egg.

Worried now ? I am ! /forums/images/graemlins/frown.gif
 
I am impressed by the responses this time round, both from scientists who have some closer idea of things, and engineers who apply common sense to their reading and listening. Bravo Boatmike.

Just a couple of questions:

first, could the numbers affected be influenced by the advancement of our knowledge of the mechanisms involved - ie. we know what to do, and are geared up to doing it (must be true when Roche are allowing manufacture under licence!). In this way, we would expect that successive pandemics would be numerically decreasing.

second: although it is a very un-English thing to do, far-East Asians seem to have no hangups about wearing diddy face-masks. Will the human transmission be by aerosol (sneezing)? If so, those facemasks seem a good idea. France has sorted 50million and is currently putting them into strategic position.

third, same as second really: is flu contageous?
 
I was convinced before.

SWMBO been to Tesco buying tins and tins and tins

And an inedlible pen.

Do Fray Bentos do vegitarian meant pies?
 
>>BrendanS, any indications that there would have been significantly differing Spanish flu death rates with modern medical services? <<

In theory yes. In 1918, they didn't even know what they were dealing with, but did stop people gathering in large numbers, and even introduced some bans on travel in some countries.

These days we have antivirals, are already running up to testing vaccines for generic bird flu (this concurrently in several countries) which may have some effect against a mutated strain, and will also possibly allow quicker development and manufacture of a specific vaccine against the mutated strain. We also have much better medical techniques to treat people who are seriously ill.

The big issue though, is that is fine if treating small numbers. If a fast spreading killer strain were to emerge, there is a likelihood that resources would fast be inundated. All non emergency treatments in hospitals would be cancelled, as they would be taking on possibly huge numbers of people, and medical staff might also be stricken and unavailable.

So yes, survival would significantly better these days than in 1918, but only if medical services are not swamped.
 
The reported known cases of H1N5 bird flu are 100, and there have been 60 deaths. However, I suspect many more cases have gone unreported, as this is an extremely high death rate.
 
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