New ladder to a pandemic alert

[Giuseppe]

Re: New ladder to a pandemic alert

do the phases count for H5N1 only ?

will they establish phases for -say- H7 also, when the human cases
increase a lot -more than with H5N1 ?

what phase would they have been in in 1976 ?
in 1977 ?

Yes. The Canadian H7 case

''Avian influenza A(H7) human infections in Canada​

5 April 2004​

The first human case of avian influenza A(H7) in British Columbia occurred in a person who was involved in culling of infected birds on 13-14 March. On 13 March, he may have been accidentally exposed in the eye. On 16 March, the individual reported conjunctivitis and nasal discharge. Treatment with oseltamavir, an antiviral drug active against influenza A viruses, began on 18 March. On 30 March, Health Canada concluded that this case was caused by avian influenza A(H7). Health Canada informed WHO of this case on 31 March. The patient's symptoms have fully resolved.​

On 2 April, WHO was informed by Health Canada of a second poultry worker in British Columbia identified with avian influenza A(H7). This worker developed conjunctivitis in March 25 after close contact with infected birds. He was treated with oseltamivir on 25 March and his symptoms resolved.​

Based on this epidemiological information provided by Health Canada, the World Health Organization today raised the global pandemic preparedness level from 0.1 to 0.2 for the Canadian outbreak.​

Global pandemic preparedness levels are dictated by the epidemiological situation for each local event. Level 0.2 means that more than one human case caused by a new subtype of influenza virus has been identified in the local event.​

In Asia, another avian influenza virus, A(H5N1), has been responsible for 34 reported human illnesses and 23 deaths. The existing global preparedness level of 0.2 for the avian influenza in Asia remains unchanged.​

Preparedness levels have been organized into a matrix established by WHO in 1999(WHO Influenza Pandemic Preparedness plan). When a preparedness level is raised to 0.2, affected countries are advised to step up their surveillance in persons exposed to affected poultry, to organize special investigations to better understand the new virus, to advise persons at risk to wear protected clothing, and to consider the use of antivirals and normal human influenza vaccine.​

WHO has been informed that Canada has taken all required actions in response to the current avian influenza A(H7) outbreak in British Columbia.​

The new pandemic preparedness level for avian influenza A(H7) also means that WHO will begin a series of activities to obtain the virus, characterize it, and assess the needs for diagnostics and vaccine development.​

-​

http://www.who.int/csr/don/2004_04_05/en/index.html​

------​

(OLD WHO Pandemic Phase Level, http://www.who.int/entity/csr/resources/publications/influenza/whocdscsredc991.pdf)​

-------''​

 

[gsgs]

Re: New ladder to a pandemic alert

wow, they even had fractional levels in 2004 and for 2 strains
separately !

I once proposed 60 fractional levels 0.0,...,5.9 but everyone
ridiculed or said I were posting nonsense or such

reducing the number of levels=phases is not good, IMO.
The more the better, the more informative.

 

[Oracle]

Re: H7 human cases in BC.

Re: H7 human cases in BC.

If HPAI H7 was going to make a 'bid for pandemic power', it could have done it, neatly, in Abbottsford. It started out innocuously as LPAI in late February.

Four prisons. Thriving Asian immigrant population. First Nations reservation. Major continental flyway intersection with major river valley with areas of local wetlands. Large, densely-packed poultry operations.

If it had been an Asian H5N1 strain, it would have worse than nominal conjunctivitis in humans.

Who Pandemic Alert Phases and Levels are IRRELEVANT for H5N1. This is an AVIAN disease. Humans and assorted mammalian and avian scavenger species reported to date are accidental victims.

If this strain wished to mutate to move into humans as a specialty virus of our species, it would have done so by now.

 

[rymich13]

Re: New ladder to a pandemic alert

So as I see it we have had limited h2h transmission all along. But the question is, has it become more easily transmitted as time goes on? Also it seems that this virus may take some to become pandemic because it seems to be adapting to humans, but at a slow and steady rate which leads me to beleive that we may still be a few years away from a pandemic. But anything can happen it may happen next week, next month, next year, 10 years from now, etc. We just do not know.

 

[Sally Furniss]

Re: New ladder to a pandemic alert

<table border="0" cellpadding="6" cellspacing="0" width="100%"> <tbody><tr> <td style="border: 1px inset ;" class="alt2"> Originally Posted by rymich13
When was the earliest known h2h transmission?
</td> </tr> </tbody></table>
From a epidemiological and serosurveys point of view, the first instance of unsustained human-to-human transmission of H5N1 avian influenza virus was in Hong Kong, 1997.

The most clear, and accepted, instance of h2h transmission was the so-called Karo Cluster, Sumatra Island, Indonesia, May 2006 (http://www.who.int/csr/don/2006_05_23/en/index.html)

FT thread on the Karo cluster Indonesia - Family in Karo suspected of having bf

FT threads on Pakistan Cluster
http://www.flutrackers.com/forum/showthread.php?t=62591
http://www.flutrackers.com/forum/showthread.php?t=46327
http://www.flutrackers.com/forum/showthread.php?t=45631

<!-- / message --><!-- sig -->

 

[rymich13]

Re: New ladder to a pandemic alert

I read that the new system would be completed by years end but when do they plan on implementing it fully?

 

[Commonground]

Re: New ladder to a pandemic alert

So as I see it we have had limited h2h transmission all along. But the question is, has it become more easily transmitted as time goes on? Also it seems that this virus may take some to become pandemic because it seems to be adapting to humans, but at a slow and steady rate which leads me to beleive that we may still be a few years away from a pandemic. But anything can happen it may happen next week, next month, next year, 10 years from now, etc. We just do not know.

In my opinion, we can not judge the rate of the spread, because it is stifled by Tamiflu. Although I do agree it is not efficient transmission, I do wonder exactly how efficient it is? As Dr. Niman has noted many times in the past week, our latest outbreaks this year have included 3 clusters, albeit with different diagnoses, but circumstances point to H5N1.

 

[Sally Furniss]

Re: New ladder to a pandemic alert

So as I see it we have had limited h2h transmission all along. But the question is, has it become more easily transmitted as time goes on? Also it seems that this virus may take some to become pandemic because it seems to be adapting to humans, but at a slow and steady rate which leads me to beleive that we may still be a few years away from a pandemic. But anything can happen it may happen next week, next month, next year, 10 years from now, etc. We just do not know.

Length of transmission chain is a significant measure of transmissibility. Tamiflu is rightly given to contacts of a case. Use of the Tamiflu blanket can mask transmission events.

 

[Commonground]

Re: H7 human cases in BC.

Re: H7 human cases in BC.

If HPAI H7 was going to make a 'bid for pandemic power', it could have done it, neatly, in Abbottsford. It started out innocuously as LPAI in late February.

Four prisons. Thriving Asian immigrant population. First Nations reservation. Major continental flyway intersection with major river valley with areas of local wetlands. Large, densely-packed poultry operations.

If it had been an Asian H5N1 strain, it would have worse than nominal conjunctivitis in humans.

Who Pandemic Alert Phases and Levels are IRRELEVANT for H5N1. This is an AVIAN disease. Humans and assorted mammalian and avian scavenger species reported to date are accidental victims.

If this strain wished to mutate to move into humans as a specialty virus of our species, it would have done so by now.

I thought this was interesting

WHO: on pandemic influenza you need to know 10 things
2008-01-07 China CDC website read 262 times

1. Pandemic influenza and avian flu different.

Avian influenza refers to a group mainly affected birds of different influenza virus. Is extremely difficult these bird viruses transmitted to other species, including pigs and humans. The vast majority of the avian flu virus will not spread to people. When a spread in humans has never been a new subtype of virus can occur when the influenza pandemic.

Therefore, H5N1 avian influenza virus is a potential for a pandemic strain, because it eventually could mutate into a human transmission of the virus. Once the mutations, it will no longer be a bird virus, which will become a human influenza virus. Influenza pandemic is a human disease can make a new influenza virus triggered.
-snip-
10. When the threat of a pandemic, the World Health Organization to increase global warning.

World Health Organization and the ministries of health and various public health organizations in close cooperation to support countries in monitoring the spread of influenza virus strains. One able to identify influenza virus strain of influenza monitoring system for rapid detection of a pandemic virus is essential.

In order to promote pandemic preparedness plans, provides for six different stages and to determine the government, industry and the World Health Organization duties. The current situation as the third stage: a new virus to humans is causing infections, but does not spread easily in the world.
-snip-
http://64.233.179.104/translate_c?h...jshealth.com/jscdcnew/ShowZtNews.aspx?Id=2779

 

[Oracle]

Re: New ladder to a pandemic alert

H5N1 lacks more than half of the sequence markers for pandemic human disease, according to articles posted here recently.

The real danger in H5N1 lies in the continued spread, reinfection of migrating waterbirds and episodic infection of passerines, and viral transmission to highly susceptible domestic poultry.

The danger to the global food source posed by H5N1 was also noted in a commentary article posted today (and previously noted in other threads).

In the last 20 years, global industrial-scale poultry production has increased by thousands of percent, particularly in Asia and more recently in Africa - it's the new, cheap protein source to feed a hungry, overpopulated planet.

The match between migration patterns, Niman's molecular travel logs, and recent adoption of large-scale poultry operations in specific countries and outbreaks:

Priceless.

I concur with Henry: the so-called pandemic experts simply don't 'get it'. The necessary molecular markers for pandemic aren't acquired by ressortment, nor by 'random mutation'.

But at least we understand why Webster was 'far less concerned' about H5N1 than he had been several years ago.

 

[Giuseppe]

Re: New ladder to a pandemic alert

Length of transmission chain is a significant measure of transmissibility. Tamiflu is rightly given to contacts of a case. Use of the Tamiflu blanket can mask transmission events.

Another feature of a readily transmissible virus is its spread among general population with casual contacts.

To date no such event happened.

A large cluster of cases involving both index cases, HCWs, transportation personnell will signal efficient, sustained human-to-human transmission.

A casual contacts - not traceable directly to index cases - may be a person who lives in a apartments building as happened at Hong Kong Amoy Garden residential building, when several people were quarantined after a man fell ill with SARS and some residents developed clinical symptoms without proven close contact with the patient.

 

[Giuseppe]

Re: New ladder to a pandemic alert

H5N1 lacks more than half of the sequence markers for pandemic human disease, according to articles posted here recently.

The real danger in H5N1 lies in the continued spread, reinfection of migrating waterbirds and episodic infection of passerines, and viral transmission to highly susceptible domestic poultry.

The danger to the global food source posed by H5N1 was also noted in a commentary article posted today (and previously noted in other threads).

In the last 20 years, global industrial-scale poultry production has increased by thousands of percent, particularly in Asia and more recently in Africa - it's the new, cheap protein source to feed a hungry, overpopulated planet.

The match between migration patterns, Niman's molecular travel logs, and recent adoption of large-scale poultry operations in specific countries and outbreaks:

Priceless.

I concur with Henry: the so-called pandemic experts simply don't 'get it'. The necessary molecular markers for pandemic aren't acquired by ressortment, nor by 'random mutation'.

But at least we understand why Webster was 'far less concerned' about H5N1 than he had been several years ago.

At the end, even Robert Webster and his monumental work on influenzaviruses is on the way of trashbin?

Perhaps, one may investigate a bit prior to draw similar conclusion.

I hope in a honest, valuable debate, not only in a partisan acceptance of a single point of view.

When Webster told to world about catastrophic pandemic he was good, now that (perhaps) he has modified the position is bad.

Too simple to accept without skepticism.