Experts probe high bird flu mortality rate in Indonesia
BANGKOK (Reuters) - Medical experts are worried about how death rates for H5N1 bird flu have shot up in places like Indonesia, and studies are being carried out to see if victims require higher dosages of drugs.
Although the H5N1 has only infected 352 people since 2003, it has killed 219 of them, with mortality rates rising to more than 80 percent in places like Indonesia in the past two years.
“It could be they are treated later, or the virus is different, more virulent. There are many maybes, including differences in susceptibility of the virus,” Menno de Jong, a doctor who has treated bird flu victims in Vietnam, told Reuters on the sidelines of a bird flu conference in Bangkok.
He said a major concern was the H5N1 variant in Indonesia appeared to be less susceptible to oseltamivir, the antiviral used to combat the disease.
“It’s not a (drug) resistant virus, it’s just that a bit more drug (may be) needed to inhibit these (H5N1) clade 2 viruses,” he said, referring to the sub-category that Indonesia’s H5N1 virus has been classified under.
Studies are being conducted in Thailand, Vietnam and Indonesia to see if H5N1 patients need to be given higher dosages of oseltamivir.
Bird flu story source: Reuters
Posted by on 01/24 at 10:05 AM
The Indonesian human kill rate seems to be averaging about 1 per week for the last few months. This suggests that the virulent virus strain is considerably endemic in the wild bird population there and moreso that a growing percentage of surviving birds wild AND domesticated have now become more or less immune and might act as virus vectors to humans. Possibly even some fowl vendors also having developed immunity.
One big question is why is “HP” H5N1 not appearing in North America?(though there is a LP clade) The migrational evolution of the disese is simple to follow. First the disease appears in China and kills many BUT NOT ALL infected birds. The virus then spreads, again killing many BUT NOT ALL infected birds. The immune birds then act as vectors to ever spreading regions. As the virus enters each region it kills many BUT NOT ALL infected birds.
The last two years have been the years of infiltration of the virus into the Eurasian and European theatres. There are two links of natural migration possible into North America. The eastern route via Scandinavia to Iceland to Greenland to Newfoundland and the western route from Northern China/Mongolia through Siberia across the Bering Straight to Alaska and Canada.
A first look is that we will eventually see the development of a naturally selected immunization of flocks on both of those fronts. As time progresses these vectors may make their way across the land bridges. However this may not be the case at all as “birds of a feather flock together” and have well established ancestral breeding grounds which do not seem to be mixed with North American breeding grounds. i.e we do not see Gray Geese in North America, nor Canadian Geese in Eurasia and Scandinavia. Since the land bridges to North America are only available in the extreme northern latitudes, the number of migratory species as potential vectors are by their historical domains self limited.
Whats the upshot? The Americas (Canada, North, Central and South America) appear to be a natural geographical refuge from the spread of the avian influenza endemic manifesting elsewhere AND BEING VECTORED BY BIRDS. Whilst the enedmic in birds causes a greater naturally selected immunized pool of birds, more and more opportunities for mutations capable of Mammalian and/or Human transmission becomes progressively more likely within these pools. Given the number of virus replications and likely mutations, a flock of approximately 6000 infected birds would present a high likelihood if not certainty that at least one in that flock carries a mutation that would allow mammal to mammal or human to human transmission. It is neither ethical nor practical to eliminate all avian species to safeguard our own.
It is likely that as we hear of acceleration of the disease amongst humans as is observable in Indonesia in particular, that this may represent an increase in the number of “Typhoid Mary” birds in circulation in areas other than the Americas, despite whether human to human transmission has become common.
It may behoove any readers and qualified researchers to examine the plausibility of the theory given here and for those that are of sufficient authority to advise our nations leaders to consider the advocacy of a closed border policy to travellers, to maintain our natural refuge paradigm whilst we still have the time to easily implement same. Draconian, maybe yes. Necessary, you betcha! As the vector of HP H5N1 is not likely to easily come from the natural migration of birds into the Americas due to geographic difficulties, the enemy will actually be our own species, as imported mammals are typically already subject to mandatory quarantine. We can high level of assurance of our protection AS LONG AS WE ARE WILLING enforce a quaratine of international ingressing travellers or returning citizens for a term of the incubation period to insure that as the pathogen becomes common amongst humans that they are caught at the borders, so to speak. Internet and other technologies make it where commerce would only need some small adjustments
to continue business as normal. Once the virus has mutated to human to human transmissivity a ban on imports would also become necessary or a sterilization program at Customs ports so as to stop viral infiltration upon goods.
Our national leaders of all countries of the Americas and it’s nearby island nations should be made aware of this and consider the adoption of policies that serve such a beneficial end. The inevitable counter argument will be one of deleterious economic impacts. However such should be tempered by consideration of the economic impacts that manifest should the virus be allowed to enter into the Americas. It may be that we are forced to consider what is more important. A policy that serves money or a policy that revolves serves humanity. Without the latter you will not have the former. Some food for thought . . .
Posted by on 01/28 at 12:21 PM
