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If pandemic flu hits soon, 1 in 3 will be affected in U.S., study says

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If pandemic flu hits soon, 1 in 3 will be affected in U.S., study says

Seth Borenstein
Last update: April 26, 2006 – 12:18 PM

If pandemic flu hits soon, 1 in 3 will be affected in U.S., study says

WASHINGTON— If pandemic influenza hits in the next year or so, the few weapons the United States has to keep it from spreading will do little, a new computer model shows.

A pandemic flu is likely to strike one in three people if nothing is done, according to the results of computer simulation published in Thursday's journal Nature. If the government acts fast enough and has enough antiviral medicine to use as preventive dosings — which the United States does not — that could drop to about 28 percent of the population getting sick, the study found.

"Both cases we came up with were very pessimistic,'' said lead author Neil Ferguson of the Department of Infectious Disease Epidemiology at Imperial College in London. "There is no single magic bullet for stopping pandemic flu.''

So far this year, H5N1 bird flu — which is not yet pandemic flu because it doesn't move easily between people — has infected 204 people and killed 113, according to the World Health Organization. Most of the human cases and deaths have been in Asia, but birds with the disease have been found in Europe.

Ferguson's computer simulation is the second released this month and is more pessimistic than one led by Timothy Germann of Los Alamos National Laboratory, who said the flu could be less infectious and that efforts could slow it a bit.

Measures such as closing schools to halt breeding grounds and the use of the antiviral Tamiflu could reduce the disease's toll, Ferguson said. But efforts to stop flu from entering American borders — usually on planes with sick passengers — won't work, he said. At most, they can buy a couple of weeks of delay before the disease sets in, he said.

If the United States were like Britain and had enough antiviral medicine for one quarter of the population to be used before people get sick, computer models show that the number of people getting sick would drop from about 102 million to about 84 million in America, Ferguson said.

Bill Hall, spokesman for Department of Health and Human Services, said his agency has 28 million courses of the antiviral (9.3 percent of the U.S. population), but acknowledged that on hand, there's only enough medicine for 5 million people (1.7 percent). The other 23 million courses are on order and should arrive by the end of the year. The plan is to have 81 million courses (27.1 percent) by 2008, he said.

One course of treatment for people involves ten doses.

"Twenty-five percent doesn't go very far and we don't have anywhere near that,'' said study co-author Donald Burke, professor of international health and epidemiology at Johns Hopkins University's School of Public Health. "If it does occur before we have enough drug and enough vaccine, then the epidemic will have a substantial impact.''

If a country gets enough Tamiflu for half its population, it could then act aggressively in dosing families of flu-struck patients and that could cut the flu attack rate by 75 percent, Ferguson said. So instead of 102 million infected people in the U.S., it would be 33 million.

But even Germann, who conducted the more optimistic study, said no one knows which computer model is closer to reality.

"It would have to be a very weak pandemic strain for us to be able to stop it right now,'' Germann said this week. "Most likely we wouldn't be completely prepared.''

http://www.startribune.com/1244/story/394654.html
 
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U.S. efforts won't slow pandemic, model shows

U.S. efforts won't slow pandemic, model shows

U.S. efforts won't slow pandemic, model shows


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FENDING OFF BIRD FLU</td></tr><tr><td valign="top" width="5">
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</td><td class="vaLink" valign="top" width="228">Health official: 'A lot has to happen' to start pandemic | Q&A</td></tr><tr><td colspan="2">
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</td><td class="vaLink" valign="top" width="228">U.S. poultry industry to 'close down' if virus appears</td></tr><tr><td colspan="2">
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</td><td class="vaLink" valign="top" width="228">Drugmakers find new ways to battle flu</td></tr><tr><td colspan="2">
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</td><td class="vaLink" valign="top" width="228">Study: Bird flu virus infects body in wrong place to spread easily</td></tr></tbody></table></td></tr></tbody></table></td></tr><tr><td colspan="2" height="20">
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<!-- EdSysObj ID="SandboxLede" FRAGMENTID="13525954" pmichals --><script language="javascript">swapContent('firstHeader','applyHeader');</script><!--endclickprintexclude-->WASHINGTON (AP) — If pandemic influenza hits in the next year or so, the few weapons the United States has to keep it from spreading will do little, a new computer model shows.

A pandemic flu is likely to strike one in three people if nothing is done, according to the results of computer simulation published in Thursday's journal Nature. If the government acts fast enough and has enough antiviral medicine to use as preventive dosings — which the United States does not — that could drop to about 28% of the population getting sick, the study found.

"Both cases we came up with were very pessimistic," said lead author Neil Ferguson of the Department of Infectious Disease Epidemiology at Imperial College in London. "There is no single magic bullet for stopping pandemic flu."

So far this year, H5N1 bird flu — which is not yet pandemic flu because it doesn't move easily between people — has infected 204 people and killed 113, according to the World Health Organization. Most of the human cases and deaths have been in Asia, but birds with the disease have been found in Europe.

Ferguson's computer simulation is the second released this month and is more pessimistic than one led by Timothy Germann of Los Alamos National Laboratory, who said the flu could be less infectious and that efforts could slow it a bit.

Measures such as closing schools to halt breeding grounds and the use of the antiviral Tamiflu could reduce the disease's toll, Ferguson said. But efforts to stop flu from entering American borders — usually on planes with sick passengers — won't work, he said. At most, they can buy a couple of weeks of delay before the disease sets in, he said.

If the United States were like Britain and had enough antiviral medicine for one quarter of the population to be used before people get sick, computer models show that the number of people getting sick would drop from about 102 million to about 84 million in America, Ferguson said.

Bill Hall, spokesman for Department of Health and Human Services, said his agency has 28 million courses of the antiviral (9.3 percent of the U.S. population), but acknowledged that on hand, there's only enough medicine for 5 million people (1.7 percent). The other 23 million courses are on order and should arrive by the end of the year. The plan is to have 81 million courses (27.1 percent) by 2008, he said.

One course of treatment for people involves ten doses.

"Twenty-five percent doesn't go very far and we don't have anywhere near that," said study co-author Donald Burke, professor of international health and epidemiology at Johns Hopkins University's School of Public Health. "If it does occur before we have enough drug and enough vaccine, then the epidemic will have a substantial impact."

If a country gets enough Tamiflu for half its population, it could then act aggressively in dosing families of flu-struck patients and that could cut the flu attack rate by 75%, Ferguson said. So instead of 102 million infected people in the U.S., it would be 33 million.

But even Germann, who conducted the more optimistic study, said no one knows which computer model is closer to reality.

"It would have to be a very weak pandemic strain for us to be able to stop it right now," Germann said this week. "Most likely we wouldn't be completely prepared."

<!--startclickprintexclude-->Posted 4/26/2006 1:17 PM ET
 
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Re: If pandemic flu hits soon, 1 in 3 will be affected in U.S., study says

The DHHS is as usual totally ignorant of the studies that PROVE that Tamiflu must be taken in much larger "dosage".

The ridiculous, absurd, misrepresentative numbers stated here for applicability, for SUCCESS in the use of Tamiflu are 1 course representing 10 doses, or in our words, the real words, 10 capsules per carton, 1 carton representing in the peabrain minds of the DHHS 1 course.

What's real? 5 million cartons available (less probably what the US military will pull from this, but let's say 5 million cartons).

At minimum one requires 2 cartons, a double dose, and at probable (imo) best, one requires 4 cartons. The math therefore says, there are 2.5 to 1.25 million courses available for the US population of 295 million. That's, oh, let's guess, 1 course of Tamiflu for every 120 to 220 people.

Got yours yet? Or are you flipping odds here? 1 in 120? And you don't expect you or your family or your business employees to be amongst the 119? If you think that, I'd very much like to bet with you, the deed to your house versus a couple of cartons of Tamiflu.

Putting the best face on tragedy in the making is very tough.

If the flu impacts on 1/3 of the population, and the virulence remains the same, we all know that one-half to seventy percent of all those infected will DIE, forget about the collateral damage among the living medically dependent. Phew...big numbers.
 
Re: If pandemic flu hits soon, 1 in 3 will be affected in U.S., study says

A tragedy of biblical proportions.....

This is 2006 not 1918...
more people more densly packed...
faster travel time - jets not ships and trains...
50%+ deathrate not 2.5%...
Greater media coverage penetration = more panic

When this puppy hits... in DB's words "we're screwed"
 
Re: If pandemic flu hits soon, 1 in 3 will be affected in U.S., study says

So far all the flu pandemic modeling efforts have focused on the percent of population exposed to the flu and the number of individuals that might die as a direct result of infection. The studies are directed at trying to understand how to reduce the rate of infection and lower the death rate.

Have there been any demographic modeling efforts about secondary deaths not directly related to infection but from other causes, i.e. lack of meds, famine, exposure, suicide, thuggery, etc? The list goes on and on. Deaths due to direct flu infection might be the smallest percentage of all deaths once the pandemic starts. Has anyone looks at the potential numbers of deaths due to collateral effects of a pandemic?
 
Marc ("the unwise") Siegel quoted...in reply...get ready...

Marc ("the unwise") Siegel quoted...in reply...get ready...


Computers Predict Bird Flu Pandemic's Course
Quarantining the sick will be key to limiting outbreak, study shows

By Steven Reinberg
HealthDay Reporter

13520004.jpg
WEDNESDAY, April 26 (HealthDay News) -- As the fear of a potential bird flu pandemic mounts, researchers have used a computer model to figure out the best way of controlling a pandemic should it occur.

According to their model, fast treatment and isolation of infected cases and all their household contacts would be key to effective control of any flu outbreak. The model looks at a potential flu pandemic in both the United States and Great Britain.

In addition, the researchers recommend that vaccine should be stockpiled, even if the vaccine has low effectiveness. The computer simulation also shows that tight border controls and travel restrictions would only slow -- not stop -- the outbreak, even if they were firmly enforced.
All of these interventions would help put the brakes on a pandemic, however.

"This report acknowledges that even in a worse-case scenario, the preparedness being talked about will slow the spread of the disease," said Dr. Marc Siegel, a clinical associate professor of medicine at New York University School of Medicine and author of Bird Flu: Everything You Need to Know About the Next Pandemic.

He was not involved in drawing up the model, which appears in the April 26 online edition of Nature.

In their study, a team led by Neil Ferguson, a professor of mathematical biology from Imperial College London, used computer models to study the influence of anti-pandemic measures, such as treatment and prophylaxis with antiviral drugs, household quarantine, vaccination and restrictions on travel.

Some of their conclusions: "Border restrictions and/or internal travel restrictions are unlikely to delay spread by more than two to three weeks unless more than 99 percent effective. School closure during the peak of a pandemic can reduce peak attack rates by up to 40 percent, but has little impact on overall attack rates, whereas case isolation or household quarantine could have a significant impact, if feasible."

The models showed that giving antiviral drugs, both as treatment to infected cases and as prevention for family members, in addition to early closing of schools, could cut the rate of the disease spread by almost half.

But for this policy to work, there would have to be stockpiles of antivirals to treat about 50 percent of the population. That's twice the amount many countries are now planning to keep on hand, the researchers note.

However, such a stockpile, combined with the vaccination of children, might reduce illness rates by two-thirds, even if the vaccine was not completely effective. Greater drug availability would have a larger protective impact overall, the British team concludes.

These models are based on a typical strain of human influenza. However, a virus that caused more prolonged and severe disease, such as the H5N1 avian influenza virus, might be even easier to control, since the time it would take for a pandemic to develop might give health agencies more time to react, the researchers say.

Siegel said history supports the notion that isolating the sick and their families helps contain an epidemic. "It is always isolating sick people and household quarantine that is most effective in preventing the spread of disease," he said.

However, he does worry about the premature institution of quarantine and travel restrictions. "I am concerned about the timely use of public health measures," Siegel said. "I hope that people will follow isolation in an emerging epidemic, but I don't know how fear is going to factor into this -- it's unpredictable."

The expert also noted that no one can predict whether current antiviral medications will be effective against an as yet unknown mutated strain of flu. "In actual practice, using antivirals effectively is very difficult," he said.

As for vaccines, he said that getting enough vaccine to those who need it will be a tough challenge, given current vaccine production methods.
"It is going to be very hard to match the serotypes with any emerging strain when you consider that we are using an approach that requires six to nine months to make a vaccine," Siegel said.

Another public health expert warns that these strategies can only be effective if the public health community is organized and prepared. That could prove a daunting task: a team from Johns Hopkins University released a survey earlier this week that found that close to half of U.S. public health-care workers would not show up for work if a pandemic occurred.

But health-care workers will be key to beating back any outbreak, said Dr. David L. Katz, an associate professor of public health and director of the Prevention Research Center at Yale University School of Medicine. "Almost all of the potentially effective flu containment strategies require coordination among first responder agencies, clear messages, rapid and reliable communication, unambiguous chains of command, and efficient distribution of resource materials," he said.

"Absent these fundamentals of public health preparedness, no computer model will help us," Katz added.

More information

There's more on bird flu at the U.S. Centers for Disease Control and Prevention.


SOURCES: Marc Siegel, M.D., clinical associate professor, medicine, New York University School of Medicine, New York City, and author, Bird Flu: Everything You Need to Know About the Next Pandemic; David L. Katz, M.D., M.P.H., associate professor, public health, director, Prevention Research Center, Yale University School of Medicine, New Haven, Conn.; April 26, 2006, Nature online
Last Updated: April 26, 2006
Copyright ? 2006 ScoutNews LLC. All rights reserved.
 
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On Dr. Marc Siegel...

On Dr. Marc Siegel...

Marc ("the unwise") Siegel quoted...in reply...get ready...
:rolleyes:

I know you know all about Dr. Marc Siegel, GR -- but just for those people who are not familiar with him -- from Effect Measure:
Siegel is a primary care doctor who writes books about how other people are scaring us. He is a fear-monger of fear. He is also careless about his science and when it is pointed out to him he doesn't care enough to correct his errors (Example: "This bird flu appears to be better absorbed by the deep pockets of bird lungs, whereas human flu is absorbed by the cells of our upper airways." This is an intestinal disease of birds. The paper he refers to was about human lungs, not bird lungs).
More here: http://effectmeasure.blogspot.com/2006/04/flu-denier-two-fer.html
 
Computer model offers grim view of pandemic

Computer model offers grim view of pandemic

Computer model offers grim view of pandemic
http://www.theolympian.com/apps/pbcs.dll/article?AID=/20060427/NEWS/60427026/1001


Computer model offers grim view of pandemic
By SETH BORENSTEIN
The Associated Press
<!-- ARTICLE BODY TEXT--><!-- BODY TEXT -->

WASHINGTON ? A mostly unarmed United States could do little to slow pandemic flu if it hits anytime soon, according to a new computer model.
<SCRIPT language=JavaScript> OAS_AD('300x250_1'); </SCRIPT>
And Britain is only a bit better off, the same study suggests.

If the U.S. government does nothing, a deadly global flu outbreak likely will strike one in three people, according to the results of a computer simulation published today in the journal Nature. If government acts fast enough and has enough antiviral medicine to use as a preventive ? and the United States doesn?t right now ? the number could drop to about 28 percent of the population, the study found.

?Both cases we came up with were very pessimistic,? said lead author Neil Ferguson of the Department of Infectious Disease Epidemiology at Imperial College in London.

So far this year, H5N1 bird flu ? which doesn?t move easily from person-to-person ? has infected 204 people and killed 113, according to the World Health Organization. Most of the human cases and deaths have been in Asia, but birds with the disease have hit Europe.

Combining use of the antiviral Tamiflu with school closings could reduce the disease?s toll a bit, Ferguson said. But efforts to stop flu from crossing U.S. borders ? usually on planes with sick passengers ? won?t work, he said. At most, such efforts can buy a couple of weeks? delay before the disease sets in, he said.

Ferguson?s computer simulation is the second released this month and is more pessimistic than an earlier study, which said the flu could be less infectious and that efforts could slow it a bit.
 
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