Showing posts with label Review. Show all posts
Showing posts with label Review. Show all posts

H5N1 in 2012: The Year in Review

 

 


# 6815

 

For several years now, Laidback Al (Editor–Senior Moderator–& Newshound) on FluTrackers – has published  a terrific overview of the previous year’s global H5N1 activity in early January.

 

You’ll find his 2010, and 2011 summaries here, and here.

 

Today Al has posted another detailed and highly informative analysis of the past year’s H5N1 human cases (complete with his signature charts & graphs).

 

This fine piece of work is a `keeper’, and I’ve already saved it to my desktop as a PDF file. I’m sure I’ll refer to it often over the next year or so, as I have with his earlier efforts. 

 

A few excerpts follow, but use the link and download this entire review.

 

H5N1 in 2012: The Year in Review

Laidback Al, Senior Moderator, www.FluTrackers.com
January 1, 2013


Abstract – In 2012, 32 human cases of H5N1 were reported from around the world, the lowest number of reported human cases since the World Health Organization (WHO) began reporting H5N1 cases in 2003. In 2012, six countries reported cases, Bangladesh, Cambodia, China, Egypt, Indonesia, and Viet Nam. More than 60% of the reported cases died, a slight increase in the fatality rate over 2011. Although there were only 32 cases reported in 2012, five are associated with two clusters. The source of infection for all of the cases has been reported as exposure to sick and dying poultry.

 

Also, in 2012, controversy over H5N1 laboratory experimentation erupted, several genetic studies were published, and seroprevalence results were evaluated. Although fewer cases were reported in 2012 than preceding years, an H5N1 pandemic is still a potential worldwide public health threat.

Background

Influenza A(H5N1) (often referred to “bird flu” or avian influenza or HPAI) is a novel influenza virus. It was first detected in humans in Hong Kong in 1997. Since 2003, the World Health Organization (WHO) has been monitoring human outbreaks of H5N1, because of its potential to become a pandemic virus. The current WHO report on Human infection with avian influenza A(H5N1) viruses and associated animal health events was updated on December 17, 2012. Through December 31, 2012, WHO has officially reported a total of 610 confirmed human cases of H5N1. The most recent WHO time line of significant events associated with the H5N1 virus was last updated on June 15, 2012 (link).

 

The following summary of human cases from 2012 is generally organized according to the outlined presented last year in “A Summary of Human H5N1 Cases in 2011”(FT link). Additional discussions of H5N1 topics from 2012 are also presented in this review.

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Highly recommended.

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Why You Should Catch `Contagion’

 

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# 5830

 

 

Like a lot of infectious disease geeks, I hurried to the theatre last night (with a good flu buddy, of course) for my first look at Steven Soderbergh’s pandemic thriller `Contagion’

 

For those hoping for a typical summer blockbuster – with over-the-top CGI special effects, juvenile plot lines, incessant pyrotechnics, and gratuitous gore – Contagion may fail to impress.

 

 

But for the rest of us . . .  Contagion provides a thought provoking and realistic look the nightmare scenario presented by a severe pandemic. Understated and scientifically plausible, this film is designed to make you `think’ as well as feel. 

 

And 12 hours post-exposure (that’s how one feels after watching), the images and themes of this movie continue to haunt.

 

The movie incorporates plot points reminiscent of China’s SARS outbreak of 2002-2003, the Nipah virus outbreak in Malaysia in 1998, and the less well known Melaka Virus family cluster in Malaysia in 2006. 

 

Like SARS, the movie’s fictional MEV-1 virus is initially passed on to the public via unsanitary restaurant practices, and like Nipah, the virus enters the food chain when, as the movie states, `the wrong bat met up with the wrong pig’.

 

The Maleka virus – which was initially reported in a 2007 PNAS article called A previously unknown reovirus of bat origin is associated with an acute respiratory disease in humans, infected a 39 year old man when a bat flew into their Malaysian home.

 

More than a week after he was placed in isolation, two other members of his family came down with the same illness, suggesting H-2-H transmission. 

 

The authors of this report write:

 

Bats, probably the most abundant, diverse, and geographically dispersed vertebrates on earth, have recently been shown to be the reservoir hosts of a variety of zoonotic viruses responsible for severe human disease outbreaks, some with very high mortality (9).

 

In the period from 1994 to 1999, four new viruses in the family Paramyxoviridae were discovered, and all appeared to have bats as a reservoir host.

You can read more about this case in First Bird Flu, Now Bat Flu. 

 

For more background on the Nipah Virus – which this movie’s MEV-1 virus is patterned after – you may wish to revisit:

 

The Scientific Plausibility of `Contagion’
Bangladesh: Updating The Nipah Outbreak
Bangladesh: Mystery Fever Identified As Nipah
The Nipah Virus: An Emerging Infectious Threat

 

 

While movie’s utilizes a fictional MEV-1 virus (created painstakingly by Professor Ian Lipkin) – to borrow once more from the movie:

 

They really didn’t have to design a new virus, the bats are already doing that.

 

In all likelihood the next pandemic will be sparked by a far less-lethal (but still potentially devastating) influenza virus, but the truth is a high CFR (case fatality ratio) novel pathogen can’t be discounted.

 

But I digress  . . .

 

Soderbergh’s Contagion manages to avoid most of the clichés of the genre. Instead of focusing on gratuitous death and destruction, the more horrific events are seen as part of the passing parade, while scientists and doctors race to find a vaccine.

 

While I come away greatly impressed with this movie, and the respect it gives the science of virology and epidemiology, I do have a few  - mostly minor – quibbles.

 

The number of people infected four months into the pandemic seemed low given the R0 number (basic reproductive number) of the mutated MEV-1 virus was stated to be 6.

 

And the societal disruptions seemed oddly mixed – with grocery stores looted and empty – but with apparently gas for cars and people still going to the airport.

 

Having the CDC send a single EIS officer (Kate Winslet) to conduct a major epidemiological investigation stretches credulity, but adds to the dramatic plot line.

 

The biggest quibble for me, however, was the speed with which a vaccine is developed, manufactured, and starts to be delivered.

 

We’d need to get very lucky indeed, to have a vaccine for a novel non-influenza pathogen in fewer than 6 months.

 

I’ll pass on taking umbrage over the depiction of Internet bloggers as conspiracy nut jobs, only because that dangerous and vocal contingent does exist.

 

It would have been nice if they could have showed the positive side of Flublogia, but I accept it was only an 106 minute movie.

 

Quite commendably, all of the performances were restrained and believable. No one was tempted to `chew the scenery’, even during the most intense moments of the film.

 

Laurance Fishburne was solid and authoritative as always – yet humanly flawed, Matt Damon handled a difficult scene where he is told of his wife’s death with great aplomb, and Jennfier Ehle literally shone as courageous Dr. Ally Hextall, who risks taking an unproven vaccine she is working on and then exposes herself to the virus. 

 

Despite the high powered Hollywood ensemble cast, the real `star’ of this movie was never seen.

 

Soderbergh wisely focused his lens on the mundane surfaces we touch mindlessly hundreds of times every day – door knobs, credit cards, menus, telephones . . . and our faces  – and resists the urge to show us CGI representations of swarming virus particles.

 

The fact that we never see the virus only builds the paranoia. Suddenly, nothing is benign. Nothing is safe. Everything you touch could be contaminated.

 


While those expecting a post-apocalyptic zombie-virus movie may be disappointed, Contagion proves that it is possible to create an intelligent and effective thriller based on solid science and where the government isn’t always the bad guy.

 

The bottom line: Go see it.

 

Who knows?  

 

If Contagion wins at the box office this summer, perhaps the idea of intelligent movie making will go on to infect other studios.

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UK Releases Independent Pandemic Review

 

 

# 4691

 

UK Review

 

At 182 pages and released within the past few hours, I haven’t even begun to read it.  There is a lot here to absorb. The report, The 2009 Influenza Pandemic, is a 1 Mb PDF File and is now available to download.

 

The executive summary lists 28 recommendations  which you can find summarized on the GemaTEch Website.

 

28 Recommendations From Government’s Official Pandemic Review

At 11am today the government published an Independent Review of the UK response to the 2009 influenza (swine flu) pandemic.

(Continue . . .)

 

 

SKY News has a report on their website on the costs of the pandemic as listed in this report.  

 

While costly, the authors are calling it a `proportionate response’.

 

Follow the link to read it in its entirety.

 

 

£1.2bn Cost Of Swine Flu Pandemic Revealed

1:55pm UK, Thursday July 01, 2010

Ruth Barnett, Sky News Online

Britain spent more than £1.2bn tackling the swine flu pandemic but the response was proportionate, an independent review has concluded.

The report by Dame Deirdre Hine, a former chief medical officer for Wales, concluded that the UK's response to the outbreak was "effective".

 

However, she said Britain had been left with vaccines against the H1N1 virus which it did not need, due to the lack of flexibility in the contracts the Government signed.

 

 

 

  • I think we have got to set these figures, which seem enormous, against the potential for saving lives.  -  Report author Dame Deirdre Hine

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Two Experts Exit WHO Review Panel

 

 


# 4668

 

 

In January of this year the WHO (World Health Organization) announced it would conduct a review of how they handled their pandemic response 

 

While an after-action review is normal and expected, this announcement came amid criticisms launched by the COE (Council of Europe), and recently echoed in the the BMJ, calling the pandemic declaration inappropriate and possibly driven by outside interests.

 

To fend off these attacks the WHO set up an expert panel in April to examine their actions.

 

Robert Roos, News Editor of CIDRAP has details of two members of the review panel who have decided to step down, citing concerns over their being an appearance of having conflicts of interest.

 

 

 

Two who helped WHO's pandemic response quit review panel

Robert Roos * News Editor

Jun 22, 2010 (CIDRAP News) – Two experts have resigned from the committee reviewing the World Health Organization's (WHO's) pandemic response because their involvement in the response itself may appear to compromise the independence of the review, the WHO said yesterday.

 

The two experts are Dr. John MacKenzie, an Australian virologist who chairs the WHO Emergency Committee, which has been advising the agency on its pandemic response, and Dr. Anthony Evans, chief of the aviation medicine section at the International Civil Aviation Association, based in Montreal.

 

"Two members have withdrawn from the committee due to their concerns that their close association with the work of WHO during the H1N1 pandemic could be perceived as inconsistent with the Committee's role in providing an independent evaluation of this work," the WHO said in an update on the pandemic review committee's work.

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WHO Begins External Review

 

 

4489

 

 

Today an panel of 29 experts from around the world, convened by the World Health Organization, will begin a lengthy review of what went right . . . and what went wrong, with the world’s response to the H1N1 pandemic. 

 

This pandemic post-mortem comes in the wake of much criticism of the WHO, along with big pharmaceutical companies, by a number of entities, particularly coming out of Europe.

 

Helen Branswell, ace medical reporter for the Canadian Press, brings us the details.  Follow the link to read her coverage in its entirety.

 

Panel of external experts starts review of WHO, international response to H1N1

Provided by: Canadian Press
Written by: Helen Branswell, Medical Reporter, THE CANADIAN PRESS
Apr. 11, 2010


TORONTO - A panel of external experts begins the task Monday of critiquing how the World Health Organization and the international community responded to the H1N1 pandemic.

 

The WHO, which was drawing members of the review committee from a list of experts nominated by countries, has insisted on keeping the roster secret until the work begins.

 

Among the 29 committee members is Dr. Arlene King, Ontario's chief medical officer of health. King, who took over the Ontario job last spring, was for years Canada's point person for pandemic planning at the Public Health Agency of Canada.

 

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